Der Internist

, Volume 52, Issue 1, pp 15–19

Onkologie und Palliativmedizin



Noch immer stirbt in Deutschland rund die Hälfte der Patienten mit der Diagnose Krebs an ihrer Erkrankung. Um diesen Patienten und ihren Angehörigen mit allen ihren Nöten und Bedürfnissen gerecht zu werden, ist eine enge Zusammenarbeit von Onkologen und Palliativmedizinern sehr wertvoll. Die Umsetzung der Empfehlungen internationaler Institutionen bezüglich der Kooperation von Onkologie und Palliativmedizin soll hier am Beispiel des Centrums für Integrierte Onkologie (CIO Köln/Bonn) an der Uniklinik Köln dargestellt und kritisch diskutiert werden.


Palliative Versorgung Krebs Frühe Integration Integrative Krebsbehandlung Integrierte Onkologie 

Oncology and palliative medicine


Approximately one half of patients who receive the diagnosis of cancer still die as the result of their disease. To be able to adequately meet the patients and their families needs, it is essential that oncologists and palliative care physicians cooperate closely. How the recommendations of international institutions are concerning the cooperation between the fields of oncology and palliative care medicine can be approached is exemplified by the concepts developed in the Center for Integrated Oncology (CIO Cologne/Bonn) at the University Hospital in Cologne and discussed critically.


Palliative care Cancer Early integration Comprehensive cancer care Integrated oncology 


  1. 1.
    Alt-Epping B, Nauck F (2007) Palliativmedizin in der Onkologie – Onkologie in der Palliativmedizin. Forum 3:42–43Google Scholar
  2. 2.
    Arnold RM, Zeidel ML (2009) Dialysis in frail elders – a role for palliative care. N Engl J Med 361:1597–1598PubMedCrossRefGoogle Scholar
  3. 3.
    Bausewein C, Booth S, Gysels M, Higginson I (2008) Non-pharmacological interventions for breathlessness in advanced stages of malignant and non-malignant diseases. Cochrane Database Syst Rev 2:CD005623PubMedGoogle Scholar
  4. 4.
    Bruera E, Hui D (2010) Integrating supportive and palliative care in the trajectory of cancer: establishing goals and models of care. J Clin Oncol 28:4013–4017PubMedCrossRefGoogle Scholar
  5. 5.
    Bundesministerium für Gesundheit (2007) Gesetz zur Stärkung des Wettbewerbs in der gesetzlichen Krankenversicherung, Teil I Nr. 11. Bundesgesetzblatt, BonnGoogle Scholar
  6. 6.
    CDU, CSU, SPD (2005) Gemeinsam für Deutschland – mit Mut und Menschlichkeit. Koalitionsvertrag CDU, CSU und SPD, 11.11.2005, S 90Google Scholar
  7. 7.
    Cherny NI, Catane R (1996) Palliative medicine and the medical oncologist. Defining the purview of care. Hematol Oncol Clin North Am 10:1–20PubMedCrossRefGoogle Scholar
  8. 8.
    Ferris FD, Bruera E, Cherny N et al (2009) Palliative cancer care a decade later: accomplishments, the need, next steps – from the American Society of Clinical Oncology. J Clin Oncol 27:3052–3058PubMedCrossRefGoogle Scholar
  9. 9.
    Gaertner J, Wolf J, Scheicht D et al (2010) Implementing WHO recommendation for Palliative Care into routine lung cancer therapy – A feasibility study. J Palliat Med 13:727–732PubMedCrossRefGoogle Scholar
  10. 10.
    Hallek M, Schmidt-Wolf I, Wolf J (2009) Centrum für Integrierte Onkologie Köln-Bonn. Forum 6:21–22Google Scholar
  11. 11.
    Harrington SE, Smith TJ (2008) The role of chemotherapy at the end of life: „when is enough, enough?“. JAMA 299:2667–2678PubMedCrossRefGoogle Scholar
  12. 12.
    Levy MH, Back A, Benedetti C et al (2009) NCCN clinical practice guidelines in oncology: palliative care. J Natl Compr Canc Netw 7:436–473PubMedGoogle Scholar
  13. 13.
    Maltoni M, Amadori D (2001) Palliative medicine and medical oncology. Ann Oncol 12:443–450PubMedCrossRefGoogle Scholar
  14. 14.
    Mitchell JD, Borasio GD (2007) Amyotrophic lateral sclerosis. Lancet 369:2031–2041PubMedCrossRefGoogle Scholar
  15. 15.
    Ostgathe C, Walshe R, Wolf J et al (2008) A cost calculation model for specialist palliative care for patients with non-small cell lung cancer in a tertiary centre. Support Care Cancer 16:501–506PubMedCrossRefGoogle Scholar
  16. 16.
    Periyakoil VS, Bruera E (2008) On third base but not home yet. J Palliat Med 11:565–569CrossRefGoogle Scholar
  17. 17.
    Policy Department Economic and Scientific Policy (2008) Palliative care in the European Union. European Parliament’s Committee on the Environment, Public Health and Food Safety, Brussels, p 1–86Google Scholar
  18. 18.
    Sachs GA (2009) Dying from dementia. N Engl J Med 361:1595–1596PubMedCrossRefGoogle Scholar
  19. 19.
    Sos ML, Michel K, Zander T et al (2009) Predicting drug susceptibility of non-small cell lung cancers based on genetic lesions. J Clin Invest 119:1727–1740PubMedCrossRefGoogle Scholar
  20. 20.
    Temel JS, Greer JA, Muzikansky A et al (2010) Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 363:733–742PubMedCrossRefGoogle Scholar
  21. 21.
    Temel JS, Jackson VA, Billings JA et al (2007) Phase II study: integrated palliative care in newly diagnosed advanced non-small-cell lung cancer patients. J Clin Oncol 25:2377–2382PubMedCrossRefGoogle Scholar
  22. 22.
    Temel JS, McCannon J, Greer JA et al (2008) Aggressiveness of care in a prospective cohort of patients with advanced NSCLC. Cancer 113:826–833PubMedCrossRefGoogle Scholar
  23. 23.
    Walling A, Lorenz KA, Dy SM et al (2008) Evidence-based recommendations for information and care planning in cancer care. J Clin Oncol 26:3896–3902PubMedCrossRefGoogle Scholar
  24. 24.
    Wiffen PJ, Eccleston C (2009) The Cochrane pain, palliative and supportive care group: an update. Palliat Med 23:179–180PubMedCrossRefGoogle Scholar
  25. 25.
    Winkler EC, Reiter-Theil S, Lange-Riess D et al (2009) Patient involvement in decisions to limit treatment: the crucial role of agreement between physician and patient. J Clin Oncol 27:2225–2230PubMedCrossRefGoogle Scholar
  26. 26.
    World Health Organisation (2002) National cancer control programmes – policies and managerial guidelines, 2nd edn. WHO, GenevaGoogle Scholar
  27. 27.
    Wright AA, Katz IT (2007) Letting go of the rope – aggressive treatment, hospice care, and open access. N Engl J Med 357:324–327PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Zentrum für PalliativmedizinUniklinik KölnKölnDeutschland
  2. 2.Klinik I für Innere MedizinUniklinik KölnKölnDeutschland
  3. 3.Centrum für Integrierte Onkologie (CIO) Köln/BonnKölnDeutschland

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