The Oncology Department of ICOT is a complex operative unit where cancer diagnosis, treatments, follow-up, supportive and palliative care take place.
It consists of a Day Hospital (where patients receive chemotherapy and/or supportive care), consulting rooms ( where patients are examined for chemotherapy toxicity or follow-up checks) and hospital ward (where patients undergo anticancer, severe toxicity therapy are treated by supportive care and where simultaneous and palliative care take place). The Palliative Care Unit includes home care for 36 patients and residential care for 9 patients. Daily nurses go to patients’ home to administer supportive and palliative therapies and they update physicians about patients’ medical conditions, while a physician goes to the patients’ home weekly. Home care patients can benefit from a telephone service called “Pronto Hospice” available for 24 hours a day, while a hospital ward is available for patients who can’t be managed at home and need intensive medical therapies.
Supportive and Palliative Medicine
In our Centre there are two different system to integrate palliative care with usual oncologic strategies in order to ensure patients and their families a continuity of care. The first is called “SIMULTANEOUS CARE”. Many aspects of palliative care are also applicable earlier in the course of illness in conjunction with anticancer treatment and this is associated with an improvement in QOL, symptom control and satisfaction of patients and their family. Moreover this strategy reduces unnecessary admissions to medical ward and improves the management of cancer care.
Later, when there is no more space for simultaneous care, we have the second strategy ” the end-of life” program, that warrants an additional continuity of care.
Obviously in both strategies, the patient is not is not only considered from the physical point of view, because the aim of palliative and supportive care is the relief of physical, emotional, social and spiritual suffering of patient and his family.
The decision to transfer the patient management from an oncologic care (curative and active) to palliative care, the best therapeutic strategy and the kind of management (such as home care vs ward care) is made during meetings between oncologists, palliativists and psychologists. Obviously they consider the preferences of patient and their relatives and the clinical and familiar condition.
Home care service consists of a specialized nurse who goes daily to the patients’ home and a palliativist who goes weekly to the patients’ home. Home care patients can benefit from a telephone service called “Pronto Hospice” available for 24 hours a day and another telephone number for a psychological consultation. Patients and relatives who require a psychological colloquy can receive a psychologist at home.