A call for reform
Isolating treatment-focused care from palliative care has been a target of increasing criticism in recent years. In June 2001, a report by the National Cancer Policy Board of the Institute of Medicine and the National Research Council called for reforms in both medical practice and Medicare policy.

“The imperative in cancer research and treatment has been, understandably, an almost single-minded focus on attempts to cure every patient at every stage of disease,” the report stated. “(But) patients should not have to choose between treatment with curative intent or comfort care. There is a need for both, in varying degrees, throughout the course of cancer.”

The report included sweeping recommendations for change, from increasing the information available to cancer patients and their families about palliative care to devising better ways to deliver and reimburse that care. The report also called for increased research aimed at improving palliative care.

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Nurse Connie Kishbaugh teaches cancer patients coping skills.