ESMO practice guidelines 2019

[Hazelgreen]

Some of you may be interested in this topic. It seems that this group takes concern for the comfort and education of MBC patients very seriously indeed. Here are a couple of quotes:

"Following a thorough assessment and confirmation of MBC, the potential treatment goals of care should be discussed. Patients should be told that MBC is incurable but treatable, and that some patients can live with MBC for extended periods of time (many years in some circumstances). This conversation should be conducted in the accessible language, respecting patient privacy and cultural differences, and whenever possible, written information should be provided."

"Every ABC patient must have access to optimal cancer treatment and supportive care according to the highest standards of patient-centred care, as defined by: - Open communication between patients and their cancer care teams as a primary goal.

- Educating patients about treatment options and supportive care, through development and dissemination of evidence-based information in a clear, culturally appropriate form.

- Encouraging patients to be proactive in their care and to share decision making with their healthcare providers.

- Empowering patients to develop the capability of improving their own QoL within their cancer experience.

- Always taking into account patient preferences, values and needs as essential to optimal cancer care.

- Patients should have easy access to well designed clinical studies since these are crucial for further improvement in the management of ABC."

Certainly my experience with my local cancer center (although not unpleasant) did not fit within these guidelines. The guidelines contain a review of the latest treatments available for MBC so you might want to check them out further:

doi.org/10.1016/j.annonc.20...

[NPmary]

Thank you for sharing.

[TammyCross]

The list of complementary medicines/nutrition/behavioral approaches is also really useful. There is a list of things to avoid because they are not helpful or are associated with worse outcomes (one was zinc, which I took last week because I thought I was getting a cold). Some were associated with longer overall survival -- exercise! -- as well as fatigue management.

Interesting to see the guidelines for treatment depending on history, location of mets., etc.

Chris O'

[life8888]

Very interesting article. I was wondering about the recommendation against high-dose Vitamin D though. With bone mets and taking xgeva, I thought calcium + Vitamin D supplementation was a given. Especially since my oncologist recommended this.

[Pbsoup]

I too was confused about the section on complementary medicine. It seemed reductive to me.

[love2golfwell]

Very interesting article, thank you for sharing!

[Hazelgreen]

Hi All,Below the section on complementary approaches, I read the following line, "No new statements for this section were developed at ABC 5". Therefore, I assumed that ABC 4 had the same statements. Although I did not compare the the two sets of guidelines line by line, that did seem to be the case.

When I went back to ABC3, I could not find a section on complementary approaches. Perhaps, one of you may have better luck. It makes sense to me that a conference of oncologists from 150 countries might have difficulty focusing on "complementary approaches" when there are so many inequities worldwide in basic cancer treatments that need to be addressed. Here, we can always go online to check on the support for any extras we might consider taking along with our cancer drugs.

Cheers,

Cindy