Palliative Care has been defined by NICE as follows:
Palliative care is the active holistic care of patients with advanced progressive illness. Management of pain and other symptoms and provision of psychological, social and spiritual support is paramount. The goal of palliative care is achievement of the best quality of life for patients and their families. Many aspects of palliative care are also applicable earlier in the course of the illness in conjunction with other treatments.
Palliative care aims to:
Supportive Care is defined by the National Council for Palliative Care as:
Supportive care helps the patient and their family to cope with their condition and treatment of it from pre-diagnosis, through the process of diagnosis and treatment, to cure, continuing illness or death and into bereavement. It helps the patient to maximise the benefits of treatment and to live as well as possible with the effects of the disease. It is given equal priority alongside diagnosis and treatment. Supportive care should be fully integrated with diagnosis and treatment. It encompasses:
Palliative care is part of supportive care. It embraces many elements of supportive care.
Palliative and Supportive care studies can either be small phase II trials to demonstrate the therapy is effective and feasible in the affected patients, or large, randomised phase III trials which aim to provide firm evidence that a treatment is effective, compared to the current standard treatment. Therapies which are successful in phase II are evaluated further in phase III trials. A therapy which is successful in phase III can then be introduced into clinical practice, outside of a trial setting.
For trials in palliative care, we appreciate the associated difficulties with designing large scale trials to explore many research questions in this area. With the palliative care research focus often on complex interventions we, therefore, also consider trials that may adopt appropriate strategies. For example, the use of a phased approach to assess feasibility, patient experience and obtain suitable outcome measures prior to a larger study. We can also accommodate strategically used methodologies, such as the use of qualitative methodologies, patient preference trials and cluster randomisation, in this research population. Equally, we aim to demonstrate that, with an appropriate research design, large phase III trials are viable and manageable in palliative care.
The palliative care portfolio is coordinated by the palliative care clinical Scientific Lead and the Marie Curie Senior Research Fellow, who is also the qualitative lead for the unit. Current funded studies include:
The WCTU covers trials not only in cancer therapies, but also has trials in primary care (GP patients) and cancer therapies (chemotherapy, radiotherapy, or other anti-cancer agent, which is given to either cure the disease or delay disease progression). Each of these areas has an associated working group, consisting of expert cancer clinicians and researchers based within Wales. The group is chaired by Dr Anthony Byrne. It meets on a quarterly basis with the aim of developing trial ideas and providing support for up and coming Chief Investigators. Attendees are invited to present their trial ideas, which are then confidentially discussed. Ideas are either then developed by the researcher or reworked for the next meeting. Experts interested in joining the group should contact Annmarie Nelson or Anthony Byrne
Tel: 029 2068 7500
Fax: 029 2068 7501