03/20/2017

NCCN has published updates to the NCCN Guidelines® for Palliative Care

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) for Palliative Care. These NCCN Guidelines^® are currently available as Version 1.2017. 

• Recommended agents and dosage for symptom management are now included in the Palliative Care Drug Appendix (PAL-A).
• The Assessment section of PAL-7 (formerly PAL-6) has been extensively revised.
• Benefits and Burdens of Anticancer Therapy, new bullets added (PAL-9).
  • For estimated life expectancy of Months to Weeks:
    • "Consider palliative RT for spinal cord compression; brain metastases; SVC syndrome; dyspnea due to cancer related bronchial obstruction; cancer-related bleeding; painful bone metastases"
    • “Consider discontinuation of cancer treatment not directly addressing a symptom complex”
  • For estimated life expectancy of Weeks to Days:
    • “Discontinue all treatments not directly contributing to patient comfort.”
• New sub-bullets were added to Malignant Bowel Obstructions, Procedural Interventions (PAL-21)
  • "Discuss risks with patient/family, including risk of mortality, morbidity, and re-obstruction"
  • "Take into account prognosis and relative invasiveness of the intervention proposed"
  • "Risk factors for poor surgical outcome include ascites, carcinomatosis, palpable intra-abdominal masses, multiple bowel obstructions, previous abdominal radiation, very advanced disease, and poor overall clinical status"
• Preparing patients and families for end-of-life and transition to hospice care is the new title for (PAL-28).

For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Drugs & Biologics Compendium (NCCN Compendium^®), the NCCN Biomarkers Compendium^®, the NCCN Chemotherapy Order Templates (NCCN Templates^®), and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), please visit NCCN.org.