The main purpose of this study is to evaluate the acceptance by patients with metastatic pancreas cancer of integrating palliative care with usual cancer treatment. Palliative care intervention will involve use of pancreas cancer-specific decision aides (iPC3)about prognosis, treatment choices, and advance care planning for patients facing a treatment decision as well as symptom assessments. We hypothesize that palliative care consultations with iPC3 will be accepted, symptoms can be diminished, information can be received in a way that improves choices, and that the quality of care can be improved.
* Each patient undergoing treatment at Johns Hopkins for metastatic pancreas cancer will receive palliative care support during their course to include: palliative care consultation early in their treatment course; patient decision aids that give survival, treatment benefits and risks; suggestions to complete such tasks as advance directives, durable power of medical attorney, wills, family and spiritual reviews as recommend by the American Society of Clinical Oncology; and when indicated, transition to hospice. * Patient will have an iPad for their visit, and a corresponding website to print information. * Each patient will assess their distress with the Distress thermometer; symptoms with the Condensed Memorial Symptom Assessment Scale and a depression screen. This information will be given to the health care practitioner before the patient visit. * Patients facing a treatment decision will receive a Patient Information Program link (or paper for those unable to work on the iPad) to review the diagnosis, prognosis, specific benefits and risks with the proposed chemotherapy. This will then give transition "prompts" to encourage thinking about advance directives, durable power of medical attorney, use of hospice, and doing a life review. * We will also offer a hospice information visit when patient has - in the projection of the team or treating physician - 3 to 6 months to live. * The palliative care team will meet at least monthly with each of the enrolled patients. * Participants will be followed for as long as he or she is alive before receiving hospice care.
Study Type
OBSERVATIONAL
Participant is followed by the palliative care team, and at each visit, patient will assess their distress and symptoms. Patients facing a treatment decision will receive a Patient Information Program link to review the diagnosis, prognosis, specific benefits and risks with the proposed chemotherapy.
Sidney Kimmel Comprehensive Cancer Center
Baltimore, Maryland, United States
Feasibility of the patients with metastatic pancreas cancer to meet with the palliative care team and to complete symptom assessments.
Time frame: participants will be followed monthly until referred to hospice or until death, an expected average of 1 year
Changes in symptoms listed in the Memorial Symptom Assessment Scale (condensed version)
The condensed Memorial Symptom Assessment Scale evaluates 14 symptoms: lack of energy, lack of appetite, pain, dry mouth, weight loss, feeling drowsy, shortness of breath, constipation, difficulty sleeping, difficulty concentrating, nausea, worrying, feeling sad, and feeling nervous.
Time frame: participants will be followed monthly until referred to hospice or until death, an expected average of 1 year
Changes in the use of wills, living wills, advanced medical directives, durable power of medical attorney and preferred place of death.
Time frame: 1 year
Changes in hospice referral, use, acceptance, and length of stay, compared to similar patients in the prior 12 months (from retrospective review)
Time frame: 1 year
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.