From bed to bench and back: Finding evidence to support our clinical practice

NEW SERIES: Ahead of the 15th World Research Congress of the European Association for Palliative Care, we are publishing posts from our plenary speakers . . .

Today, Dagny Faksvåg Haugen, Professor of Palliative Medicine, Haukeland University Hospital and University of Bergen, Bergen, Norway, gives a glimpse of the plenary lecture she will give at the congress in Madrid on Friday 19 May 2017.

Dagny Faksvåg Haugen

Have you ever in your career as a palliative care practitioner made an observation that just didn’t make sense? This is what happened to some of my Norwegian colleagues. However hard these doctors tried by increasing opioid doses to very high levels, the patients’ pain levels hardly improved. Also, they did not show any signs of common side effects of painkillers. How come? I am not going to tell the rest of the story here (you might well have read it before) – just hint that taking observations from the bedside to the laboratory bench may lead to eye-opening discoveries that challenge our preconceptions.

At the upcoming EAPC congress, I have been given the challenging task of discussing how palliative care can be progressed by taking the ‘personalised medicine’ or ‘precision medicine’ approach. ‘Precision medicine’ means that therapeutic interventions can be tailored to each individual’s unique genetic or cellular make-up. The ‘one size fits all’ approach is changed to ‘one size fits one’.

Cancer is basically a genetic disease, in which changes accumulated in the cancer cells’ genetic material finally lead to uncontrolled growth and tumour formation. It is logical that these changes should be mapped, and targeted by specific therapies. Palliative care is different. How can we use ‘personalised medicine’ to address subjective symptoms? Is it possible that bench information may help us understand which patients are prone to develop certain conditions, help us choose the best drugs, monitor treatment, or select the right patients for specific interventions?

In my talk, I will try to show some of the prospects for palliative care in light of modern bench research.

The observation my colleagues made was taken from bed to bench – and back again, as a tool that might be used in similar clinical situations. To me, this confirms the old saying that ‘the art of medicine lies in the observation’ – we have just expanded our toolbox with new, modern ‘omics’ techniques. The encouraging message is that we can all have a role as critical observers.

And whatever the future application of ‘precision medicine’ should be, it should neither threaten nor weaken the individualized whole person approach so central to palliative care, but rather support or underpin it.

 

Join us in Madrid for the 15th World Congress of the European Association for Palliative Care
Professor Dagny Faksvåg Haugen will give her lecture, ’From bed to bench and back: finding evidence to support our clinical practice’ in the Plenary Hall, at 09h00 to 09h30 on Friday 19 May 2017. Simultaneous translation into Spanish will be available for all plenary lectures. To view the full congress programme and to register, please visit the congress website.

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