Palliative Care 2016: Attitudes of ASTRO Members Toward Palliative and Supportive Care in the United States

Key Points

  • The majority (91%) of radiation oncologists surveyed believe palliative/supportive care is an important competency for radiation oncologists.
  • Most radiation oncologists reported that they are moderately confident in their ability to assess and manage pain and gastrointestinal symptoms, but less confident in their ability to manage anorexia, anxiety, and depression.
  • Despite areas of decreased confidence, a large number (42%) of radiation oncologists do not receive any additional palliative/supportive care education beyond their residency training.

Radiation oncologists are frequently involved in providing palliative and supportive care for patients with advanced cancers through delivery of palliative radiation. Whether they are confident in their ability to assess and initiate treatments for pain, nonpain, and psychosocial distress is unknown. The American Society for Radiation Oncology (ASTRO) surveyed its practicing members in the United States on self-assessment of their primary palliative/supportive care skills and access to continuing medical education on these skills. The results of the survey were presented by Wei et al at the 2016 Palliative Care in Oncology Symposium (Abstract 105).

Study Methods

Researchers led by Randy Wei, MD, PhD, a radiation oncologist at the University of California (UC) Irvine Health, electronically surveyed 4,093 practicing radiation oncologists in the United States. The survey consisted of 17 questions in 5 sections: demographics; palliative and supportive care training; domains of palliative/supportive care; perceived barriers as a radiation oncologist to initiate advanced care planning; and discussion on prognosis.

Key Results

The majority (91%) of radiation oncologists surveyed believe palliative/supportive care is an important competency for radiation oncologists. Most radiation oncologists reported that they are moderately confident in their ability to assess and manage pain and gastrointestinal symptoms but less confident in their ability to manage anorexia, anxiety, and depression.

Despite areas of decreased confidence, a large proportion (42%) of radiation oncologists do not receive any additional palliative/supportive care education beyond their residency training. A perceived fear of upsetting referring medical oncologists and lack of clinic time are concerns for radiation oncologists who may want to initiate goals of care and/or advance care planning discussions with patients and their families.

Conclusions

Radiation oncologists are more confident in their ability to assess and manage pain than in their ability to manage depression, anxiety, anorexia, and fatigue. There is a need for increasing continuing medical educational efforts in palliative and supportive care for practicing radiation oncologists, and strengthening palliative/supportive care training in residency programs.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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