We empathize greatly with Dr Klepper for his loss. His compelling reflection on his wife’s care for peritoneal cancer highlights the struggles many cancer patients and their families face when battling incurable cancer. Dr Klepper advances 2 themes in his thought-provoking essay; the first addresses what is high-quality cancer care and the second is how best to inform and involve patients in shared decisions while planning their care.
In 2013, the Institute of Medicine (IOM) published the seminal report, “Delivering High Quality Cancer Care.”1 It starts with the central tenet that “engaged patients are at the center of the framework” for delivery of high-quality cancer care. In advanced, incurable cancers, there is no “gold standard treatment.” Thus, for patients with advanced cancers, it is especially important for providers to focus on the individual patient’s needs, preferences, and values. The key components of delivering patient-centered high-quality cancer care (adapted and modified from the IOM report) include:
Wang S, Drye BD, Cornett PA. The Team Approach to Advanced Cancer Care—Redefining the Gold Standard. JAMA Intern Med. 2016;176(8):1062-1063. doi:10.1001/jamainternmed.2016.2949