Table 2.

Summary of society palliative care guidelines

Society	Guideline publication date	Timing	Indications	Patient screening	Initial needs assessment
ASCO12	January 2017 and May 2018	Needs should be addressed at presentation to the oncologist, and early specialist involvement should occur within 8 weeks of an advanced cancer diagnosis	Metastatic or poor prognosis cancer, limited treatment options, estimated survival <12 months, frequent admissions owing to refractory symptoms, functional decline, failure to thrive or complex care requirements	All patients with cancer should be screened at presentation and reassessed at appropriate intervals or as clinically indicated. Screening tools include the NCCN Distress Thermometer, Edmonton Symptom Assessment Scale, Condensed Memorial Symptom Assessment Scale and Brief Pain Inventory	Identify palliative care needs with regard to quality of life and physical, functional, spiritual, psychological and social domains; evaluate basic pain and symptom management; determine patient understanding of illness and prognostic awareness; clarify treatment goals; assess medical literacy and decision-making; and coordinate care with other medical teams
NCCN13	February 2020	Can begin at cancer diagnosis and be delivered concurrently with life-prolonging therapies	Metastatic solid tumour, uncontrolled symptoms, distress related to diagnosis or therapy, serious comorbid conditions, patient or family request for palliative care, poor performance status (ECOG >2 or KPS <60) or cachexia	All patients with cancer should be screened at presentation and reassessed at appropriate intervals or as clinically indicated. If screening criteria are met, proceed to a comprehensive initial palliative care assessment. If no criteria are present, inform patient of palliative care services and rescreen at next visit	Discuss benefit and burdens of anticancer therapy; define patient/family goals, values, priorities and expectations; evaluate for psychosocial and spiritual distress; evaluate educational, cultural and informational needs; begin with initial symptom management if needed; and determine whether criteria for formal palliative care consultation are met
EAU72	March 2013	Applicable early in the course of illness in conjunction with life-prolonging therapies and be available throughout a patient’s care pathway	No specific criteria proposed, but early collaboration between the oncologist and palliative care team is emphasized	Assess pain (using the OPQRSTUV mnemonic — Onset, Provocative factors, Quality, Radiation, Severity, Timing, Understanding/impact on patient, and Values), patient’s readiness to accept palliative care and the role they expect it to have in their care	Establish excellent communication (good eye contact, open-ended questioning, responding to patient’s emotions, displaying empathy); assess pain; assess patient knowledge and establish goals of medical care; develop realistic expectations; and develop a treatment plan

Indications less pertinent to genitourinary malignancies in general are not included in the table. ASCO, American Society of Clinical Oncology; EAU, European Association of Urology; ECOG, Eastern Cooperative Oncology Group; KPS, Karnofsky Performance Status; NCCN, National Comprehensive Cancer Network.