Skip to main content
SpringerLink
Log in

Prinzipien der Palliativmedizin in der Onkologie

  • Living reference work entry
  • First Online:
Kompendium Internistische Onkologie

Part of the book series: Springer Reference Medizin ((SRM))

  • 213 Accesses

Zusammenfassung

Palliativmedizin ist ein Ansatz zur Verbesserung der Lebensqualität von Patienten und ihren Familien, die mit Problemen konfrontiert sind, welche mit einer lebensbedrohlichen Erkrankung einhergehen (WHO-Definition). Wie dies bei Patienten mit einer nicht heilbaren Krebserkrankung umgesetzt werden kann, ist im Rahmen des Leitlinienprogramms Onkologie in der S3-Leitlinie Palliativmedizin konkretisiert worden. Zahlreiche Studien zeigen die Verbesserung von relevanten Endpunkten durch die frühzeitige Einbindung palliativer Betreuung in die onkologische Versorgung. Zunächst ist im Rahmen der allgemeinen Palliativversorgung der palliativmedizinische Versorgungsbedarf zu erfassen und bei Bedarf (schwere Symptome, komplexe Versorgung, instabile Erkrankungssituation, unklare Therapiezielfindung, komplexe Angehörigenkonstellation) spezialisierte Palliativversorgung einzubinden. Diese findet im stationären Setting durch palliativmedizinische Dienste oder Palliativstationen statt, im ambulanten Setting durch spezialisierte ambulante Palliativversorgung (SAPV).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

Similar content being viewed by others

Literatur

  • Abernethy AP, Currow DC, Frith P, Fazekas BS, McHugh A, Bui C (2003) Randomised, double blind, placebo controlled crossover trial of sustained release morphine for the management of refractory dyspnoea. BMJ 327(7414):523–528

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Abernethy AP, McDonald CF, Frith PA, Clark K, Herndon JE 2nd, Marcello J, Young IH, Bull J, Wilcock A, Booth S, Wheeler JL, Tulsky JA, Crockett AJ, Currow DC (2010) Effect of palliative oxygen versus room air in relief of breathlessness in patients with refractory dyspnoea: a double-blind, randomised controlled trial. Lancet 376(9743):784–793

    Article  PubMed  PubMed Central  Google Scholar 

  • Afshar K, Feichtner A, Boyd K, Murray S, Junger S, Wiese B, Schneider N, Muller-Mundt G (2018) Systematic development and adjustment of the German version of the Supportive and Palliative Care Indicators Tool (SPICT-DE). BMC Palliat Care 17(1):27

    Article  PubMed  PubMed Central  Google Scholar 

  • Ahrens M, Hornemann B, Viehrig M, Berendt J, Gog C (2018) SOP – handling and care of the deceased. Onkologe 24:86–90

    Article  Google Scholar 

  • Alt-Epping B (2016) Klug entscheiden … in der Palliativmedizin. Dt Ärztebl 113(42):A1870–A1872

    Google Scholar 

  • Alt-Epping B, Nauck F (2019) Palliativmedizin – das Skript. Universitätskverlag, Göttingen

    Book  Google Scholar 

  • Alt-Epping B, Sitte T, Nauck F, Radbruch L (2010) Sedation in palliative medicine: guidelines for the use of sedation in palliative care : European Association for Palliative Care (EAPC). Schmerz 24(4):342–354

    Article  CAS  PubMed  Google Scholar 

  • Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, Fearon K, Hutterer E, Isenring E, Kaasa S, Krznaric Z, Laird B, Larsson M, Laviano A, Muhlebach S, Muscaritoli M, Oldervoll L, Ravasco P, Solheim T, Strasser F, de van der Schueren M, Preiser JC (2017) ESPEN guidelines on nutrition in cancer patients. Clin Nutr 36(1):11–48

    Article  PubMed  Google Scholar 

  • Basch E, Deal AM, Dueck AC, Scher HI, Kris MG, Hudis C, Schrag D (2017) Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment. JAMA 318(2):197–198

    Article  PubMed  PubMed Central  Google Scholar 

  • Bausewein C, Booth S, Gysels M, Kuhnbach R, Higginson IJ (2010) Effectiveness of a hand-held fan for breathlessness: a randomised phase II trial. BMC Palliat Care 9:22

    Article  PubMed  PubMed Central  Google Scholar 

  • Borasio GD (2011) Translating the World Health Organization definition of palliative care into scientific practice. Palliat Support Care 9(1):1–2

    Article  PubMed  Google Scholar 

  • Brinkman-Stoppelenburg A, Rietjens JA, van der Heide A (2014) The effects of advance care planning on end-of-life care: a systematic review. Palliat Med 28(8):1000–1025

    Article  PubMed  Google Scholar 

  • Bundesärztekammer (2011) Grundsätze der Bundesärztekammer zur ärztlichen Sterbebegleitung. Dtsch Ärztebl 108(7):A346–A348. https://www.bundesaerztekammer.de/fileadmin/user_upload/downloads/Sterbebegleitung_17022011.pdf. Zugegriffen am 12.03.2021

  • Bundesärztekammer (2018) Hinweise und Empfehlungen zum Umgang mit Vorsorgevollmachten und Patientenverfügungen im ärztlichen Alltag. https://www.bundesaerztekammer.de/fileadmin/user_upload/downloads/pdf-Ordner/Patienten/Hinweise_Patientenverfuegung.pdf. Zugegriffen am 12.03.2021

  • Cherny N (2010) The oncologist’s role in delivering palliative care. Cancer J 16(5):411–422

    Article  PubMed  Google Scholar 

  • Cherny NI, Catane R, P European Society of Medical Oncology Taskforce on and C. Supportive (2003) Attitudes of medical oncologists toward palliative care for patients with advanced and incurable cancer: report on a survery by the European Society of Medical Oncology Taskforce on Palliative and Supportive Care. Cancer 98(11):2502–2510

    Article  PubMed  Google Scholar 

  • Cherny NI, Radbruch L, C Board of the European Association for Palliative (2009) European Association for Palliative Care (EAPC) recommended framework for the use of sedation in palliative care. Palliat Med 23(7):581–593

    Article  PubMed  Google Scholar 

  • Cuhls H, Mochamat, Mucke M, Jaspers B, Jentschke E, Hense J, Wolf C, Ostgathe C, Radbruch L (2018) SOP – fatigue. Onkologe 24:41–47

    Article  Google Scholar 

  • Enzinger AC, Zhang B, Schrag D, Prigerson HG (2015) Outcomes of prognostic disclosure: associations with prognostic understanding, distress, and relationship with physician among patients with advanced cancer. J Clin Oncol 33(32):3809–3816

    Article  PubMed  PubMed Central  Google Scholar 

  • Eschbach C, Stachura P, Villalobos M, Wolf C, Thomas M (2018) SOP – inappetence and cachexia. Onkologe 24:35–40

    Article  Google Scholar 

  • Ettrich T, Schonsteiner S, Mayer-Steinacker R, Dohner H, Gog C, Thuss-Patience P, Wolf C, Ostgathe C (2018) SOP – intestinal passage disorder in palliative medicine. Onkologe 24:22–28

    Article  Google Scholar 

  • Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, Davis M, Muscaritoli M, Ottery F, Radbruch L, Ravasco P, Walsh D, Wilcock A, Kaasa S, Baracos VE (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12(5):489–495

    Article  PubMed  Google Scholar 

  • Ferrell BR, Temel JS, Temin S, Alesi ER, Balboni TA, Basch EM, Firn JI, Paice JA, Peppercorn JM, Phillips T, Stovall EL, Zimmermann C, Smith TJ (2017) Integration of palliative care into standard oncology care: american society of clinical oncology clinical practice guideline update. J Clin Oncol 35(1):96–112

    Article  PubMed  Google Scholar 

  • Gemeinsamer Bundesausschuss (2010) Richtlinie des Gemeinsamen Bundesausschusses zur Verordnung von spezialisierter ambulanter Palliativversorgung(Spezialisierte Ambulante Palliativversorgungs-Richtlinie/SAPV-RL). https://www.g-ba.de/downloads/62-492-437/SAPV-RL_2010-04-15.pdf. Zugegriffen am 12.03.2021

  • Hagerty RG, Butow PN, Ellis PM, Lobb EA, Pendlebury SC, Leighl N, MacLeod C, Tattersall MH (2005) Communicating with realism and hope: incurable cancer patients’ views on the disclosure of prognosis. J Clin Oncol 23(6):1278–1288

    Article  PubMed  Google Scholar 

  • Haun MW, Estel S, Rucker G, Friederich HC, Villalobos M, Thomas M, Hartmann M (2017) Early palliative care for adults with advanced cancer. Cochrane Database Syst Rev 6:CD011129

    PubMed  Google Scholar 

  • Hudson KE, Wolf SP, Samsa GP, Kamal AH, Abernethy AP, LeBlanc TW (2018) The surprise question and identification of palliative care needs among hospitalized patients with advanced hematologic or solid malignancies. J Palliat Med 21(6):789–795

    Article  PubMed  PubMed Central  Google Scholar 

  • Hui D, Bruera E (2017) The edmonton symptom assessment system 25 years later: past, present, and future developments. J Pain Symptom Manage 53(3):630–643

    Article  PubMed  Google Scholar 

  • Jennings AL, Davies AN, Higgins JP, Broadley K (2001) Opioids for the palliation of breathlessness in terminal illness. Cochrane Database Syst Rev 4:CD002066

    Google Scholar 

  • Leitlinienprogramm Onkologie (2020) Deutsche Krebsgesellschaft (DKG), Deutsche Krebshilfe (DKH), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) (2020) Erweiterte S3-Leitlinie Palliativmedizin für Patienten mit einer nicht-heilbaren Krebserkrankung. Version 2.2, AWMF-Registernummer: 128/001OL. Leitlinienprogramm Onkologie. https://www.awmf.org/uploads/tx_szleitlinien/128-1088001OLl_S3_Palliativmedizin_2020-09_02.pdf. Zugegriffen am 12.03.2021

  • Maltoni M, Nanni O, Pirovano M, Scarpi E, Indelli M, Martini C, Monti M, Arnoldi E, Piva L, Ravaioli A, Cruciani G, Labianca R, Amadori D (1999) Successful validation of the palliative prognostic score in terminally ill cancer patients. Italian Multicenter Study Group on Palliative Care. J Pain Symptom Manage 17(4):240–247

    Article  CAS  PubMed  Google Scholar 

  • Montag T, Starbatty B, Thomas M, Gog C, Ostgathe C, Simon S (2018) SOP – treatment and care in the dying phase. Onkologe 24:82–85

    Article  Google Scholar 

  • Nationaler Ethikrat (2006) Selbstbestimmung und Fürsorge am Lebensende – Stellungnahme. https://www.ethikrat.org/fileadmin/Publikationen/Stellungnahmen/Archiv/Stellungnahme_Selbstbestimmung_und_Fuersorge_am_Lebensende.pdf. Zugegriffen am 12.03.2021

  • Neitzke G (2010) On the significance of guidelines for managing sedation at the end of life. Schmerz 24(4):355–357

    Article  CAS  PubMed  Google Scholar 

  • Radbruch L, Sabatowski R, Loick G, Jonen-Thielemann I, Elsner F, Hormann E (2000) MIDOS – validation of a minimal documentation system for palliative medicine. Schmerz 14(4):231–239

    Google Scholar 

  • Rosenbruch J, Eschbach C, Viehrig M, Ostgathe C, Bausewein C (2018) SOP – respiratory distress in adult palliative care patients. Onkologe 24:18–21

    Article  Google Scholar 

  • Schwartz J, Neukirchen M, De Vilder MC, Hornemann B, Wolf C, Gartner J, Thomas M (2018) SOP – depression and anxiety in palliative care. Onkologe 24:48–54

    Article  Google Scholar 

  • Stiel S, Matthes ME, Bertram L, Ostgathe C, Elsner F, Radbruch L (2010) Validation of the new version of the minimal documentation system (MIDOS) for patients in palliative care : the German version of the edmonton symptom assessment scale (ESAS). Schmerz 24(6):596–604

    Article  CAS  PubMed  Google Scholar 

  • Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, Dahlin CM, Blinderman CD, Jacobsen J, Pirl WF, Billings JA, Lynch TJ (2010) Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 363(8):733–742

    Article  CAS  PubMed  Google Scholar 

  • Thuss-Patience P, Markwordt J, Mayer-Steinacker R, Ettrich T, Wolf C, Stachura P, Neukirchen M, Thomas M (2018) SOP – nausea and vomiting in palliative patients. Onkologe 24:29–34

    Article  Google Scholar 

  • Velikova G, Booth L, Smith AB, Brown PM, Lynch P, Brown JM, Selby PJ (2004) Measuring quality of life in routine oncology practice improves communication and patient well-being: a randomized controlled trial. J Clin Oncol 22(4):714–724

    Article  PubMed  Google Scholar 

  • Viehrig M, Schlisio B, Thomas M, Gartner J, Wolf C, Hense J (2018) SOP – pain therapy in palliative patients. Onkologe 24:7–17

    Article  Google Scholar 

  • Wedding U (2014) Palliative and supportive care for cancer patients. Onkologe 20(1):66–71

    Article  Google Scholar 

  • Wedding U (2019) Provision of palliative care – a major task for oncologists. Oncol Res Treat 42(1–2):9–10

    Article  PubMed  Google Scholar 

  • White N, Kupeli N, Vickerstaff V, Stone P (2017) How accurate is the ‚Surprise Question‘ at identifying patients at the end of life? A systematic review and meta-analysis. BMC Med 15(1):139

    Article  PubMed  PubMed Central  Google Scholar 

  • WHO (2002) https://www.dgpalliativmedizin.de/images/stories/WHO_Definition_2002_Palliative_Care_englisch-deutsch.pdf. Zugegriffen am 12.03.2021

  • Whooley MA, Avins AL, Miranda J, Browner WS (1997) Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med 12(7):439–445

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Wiesing U (2017) Indikation. Kohlhammer, Stuttgart

    Google Scholar 

  • Williams AL, McCorkle R (2011) Cancer family caregivers during the palliative, hospice, and bereavement phases: a review of the descriptive psychosocial literature. Palliat Support Care 9(3):315–325

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Abteilung für Palliativmedizin, Universitätsklinikum Jena, Jena, Deutschland

    Ulrich Wedding

  2. Department of Palliative Medicine, University Hospital Heidelberg, Heidelberg, Deutschland

    Bernd Alt-Epping

Authors
  1. Ulrich Wedding
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bernd Alt-Epping
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bernd Alt-Epping .

Editor information

Editors and Affiliations

  1. Abt. Hämatologie und Onkologie, Universitätsklinikum Halle-Wittenberg Klinik und Poliklinik Innere Medizin IV, Halle, Sachsen-Anhalt, Germany

    Hans-Joachim Schmoll

Section Editor information

  1. Abteilung für Palliativmedizin, Universitätsklinikum Jena, Jena, Deutschland

    Ulrich Wedding

  2. Department of Palliative Medicine, University Medical Center Göttingen, Göttingen, Germany

    Bernd Alt-Epping

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Wedding, U., Alt-Epping, B. (2021). Prinzipien der Palliativmedizin in der Onkologie. In: Schmoll, HJ. (eds) Kompendium Internistische Onkologie . Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46764-0_58-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-46764-0_58-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-46764-0

  • Online ISBN: 978-3-662-46764-0

  • eBook Packages: Springer Referenz Medizin

Publish with us

Policies and ethics

Search

Navigation