Cancer care during the last phase of life.

EXECUTIVE SUMMARY: The American Society of Clinical Oncology (ASCO) believes that it is the oncologists' responsibility to care for their patients in a continuum that extends from the moment of diagnosis throughout the course of the illness. In addition to appropriate anticancer treatment, this includes symptom control and psychosocial support during all phases of care, including those during the last phase of life. In an effort to assure that all patients and their families have access to optimal care at the end of life, ASCO firmly believes it is essential to emphasize a humane system of cancer care based on the following principles: Cancer care is centered around the longstanding and continuous relationship between the primary oncologist or other physician with training and interest in end-of-life care and the patient; Cancer care is responsive to the patient's wishes and to the parents' wishes if the patient is a child; Cancer care is based on truthful, sensitive, empathic communication with the patient, and in the case of pediatric patients, that care is both family centered as well as child focused; and Cancer care optimizes quality of life throughout the course of an illness through meticulous attention to the myriad physical, spiritual, and psychosocial needs of the patient and family. To reach these goals, ASCO has identified numerous obstacles that hinder delivery of high-quality end-of-life care and offers recommendations for improvements. ASCO is committed to informing its membership and the public about the significant barriers to optimal care at the end of life, and advocating legislative and regulatory changes that will eliminate these barriers.