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Bull Cancer ; 105(5): 458-464, 2018 May.
Artigo em Francês | MEDLINE | ID: mdl-29567281

RESUMO

Progress leads to increase life duration at the metastatic stage but metastatic disease is most often lethal. Decision-making is necessary for an increasing period of care, beyond evidence-based medicine, dealing with complexity and uncertain benefit/risk ratio. This requires to inform the patient realistically, to discuss prognostication, to develop anticipated written preferences. These changes mean to pass from a medicine based on informed consent to medicine based on respect of the patient wishes even if it can be complex to determine. A new multidisciplinarity is needed, centered on the meaning of the care, the proportionality of the care, the anticipated patient trajectory. The ASCO has published recommendations on early palliative care. The timing and the quality of the discussion between palliative care specialists and oncologists is crucial. We propose 10 steps to organize a multidisciplinary onco-palliative meeting, as it appears the key for the organization of care in non-curable disease.


Assuntos
Conferências de Consenso como Assunto , Oncologia , Neoplasias/terapia , Cuidados Paliativos , Comunicação , Tomada de Decisões , Família , França , Humanos , Consentimento Livre e Esclarecido , Equipe de Assistência ao Paciente/organização & administração , Preferência do Paciente , Prognóstico , Medição de Risco , Assistência Terminal , Revelação da Verdade
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