TY  - JOUR
T1  - Impact of Early Integrated Palliative Care on Symptom Burden in Advanced Metastatic Renal Cell Carcinoma
A1  - Hiroshi Nakamura
A1  - Yuta Kato
JF  - Journal of Integrative Nursing and Palliative Care
JO  - J Integr Nurs Palliat Care
SN  - 3006-5550
Y1  - 2025
VL  - 6
IS  - 2
DO  - 10.51847/d0GTP2T1HG
SP  - 296
EP  - 307
N2  - Modern therapies have substantially extended survival for patients with metastatic renal cell carcinoma (mRCC). However, individuals with advanced disease frequently experience intense symptoms. Research has demonstrated that incorporating palliative care early into cancer treatment can enhance quality of life and potentially increase overall survival. As a result, guidelines suggest initiating palliative care for patients presenting with complex symptoms as soon as the disease reaches an advanced stage. To the best of our knowledge, no prior study has examined the specific impact of palliative care in the mRCC population. The present study sought to evaluate changes in symptom burden and quality of life among patients before and after receiving inpatient palliative care. This investigation was designed as a retrospective observational study. The analysis included patients diagnosed with mRCC who were hospitalized in our palliative care unit from 2011 to 2017 because of severe symptoms. Symptom burden was measured upon admission, during the course of treatment, and at the time of discharge. Assessments involved the standard palliative care baseline evaluation, together with daily recording of key symptoms. 

A total of 110 hospitalizations involving 58 RCC patients were examined. On average, admission to the palliative care unit occurred 7 years after the initial diagnosis (range 1–305 months). The median age at admission was 70.5 years; 69% of the patients were male, and 3% were female. The primary reasons for hospitalization were pain (52%) and dyspnea (26%). The most commonly reported symptoms by patients included fatigue/exhaustion (87%), weakness (83%), and the need for help with activities of daily living (83%). Following multidisciplinary palliative care intervention, there was a statistically significant decrease in the median minimal documentation system (MIDOS) symptom score (15.6–9.9, P < 0.001), in the median numeric pain rating scale (3–0, P < 0.001), and in the mean scores on the distress thermometer (5.5–3.1, P = 0.016). These findings indicate that palliative care integration provides measurable benefits across the disease trajectory in mRCC by substantially alleviating symptom burden in this patient group. Palliative care should not be viewed solely as end-of-life support; instead, it should be incorporated throughout the advanced stages of the illness, especially once a curative approach is no longer feasible.  
UR  - https://journalinpc.com/article/impact-of-early-integrated-palliative-care-on-symptom-burden-in-advanced-metastatic-renal-cell-carci-b1l50fgkrygetj9
ER  -