In men with advanced prostate cancer, what is the evidence that referral to specialist palliative care can assist with symptom control?
There was evidence that interdisciplinary palliative care can improve symptom management and enhance the wellbeing of men with metastatic prostate cancer. As far as symptom control was concerned a study involving a home nursing intervention and one involving a structured multidisciplinary intervention showed improvement in overall symptom control. Pain management was improved in two models of co-ordinated home careas was the symptom of dyspnoea in a nurse-led intervention and with involvement of a palliative medicine team . Vomiting was less frequent and more effectively treated in a study of co-ordinated care for terminally ill cancer patients. Palliative interventions were shown to improve overall quality of life of the patient as well as emotional wellbeing and functioning and spiritual wellbeing.Social functioning, mental and general health and vitality were improved in terminally ill patients. Financial wellbeing was also improved in one study.
The opinions of caregivers (family and informal carers) were sought in relation to the management of the patient’s symptoms in several studies. Increased satisfaction with the patient’s pain management was reported in one study, with improved caregiver satisfaction with services for symptom control shown in six studies. 
Although studies failed to show consistent improvement in all domains of care, this may reflect the fact that ‘usual care’ is not equivalent to ‘no care’ and ‘usual care’ already incorporates many elements of palliative care. The improvements shown in symptom control emphasises the significant benefit of involving interdisciplinary palliative care in managing men with metastatic prostate cancer, for both the patient and family carers.
Evidence summary and recommendations
|There is evidence that coordinated interdisciplinary palliative care can improve symptom management and emotional, spiritual and social wellbeing in patients with advanced cancer. This finding can be generalised to men with metastatic prostate cancer.||II||, , , , , |
|Men with metastatic prostate cancer should be referred for interdisciplinary palliative care to assist in symptom control and in providing emotional, social and spiritual support.||C|
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