Early, integrated palliative rehabilitation improves quality of life of patients with newly diagnosed advanced cancer


Each month, Professor Catherine Walshe, Editor-in-Chief of ‘Palliative Medicine’, chooses an article that readers may find particularly interesting or useful and invites the authors to draw out the key points on the EAPC blog. Focusing on research that is novel, a robust review, from a specific country or just slightly left of field, the ‘Editor’s Choice’ post aims to share experience and stimulate ideas. We hope you’ll read the longer article in ‘Palliative Medicine’, or EAPC members can download a FREE copy of the article…

Lise Nottelmann, MD PhD, Denmark, explains the background to the longer article, of which she is first author, selected as ‘Editor’s Choice’ in the July 2021 issue of ‘Palliative Medicine’.

Lise Nottelmann.

“You gave me my life back!” The words came out of his mouth, and he seemed a bit startled as if he had only just realised this and verbalised it for the first time. His wife nodded slowly and grabbed his hand.

We, a palliative care physician and a nurse, sat across from the couple as they evaluated the last 12 weeks of participating in a palliative rehabilitation programme while the husband was receiving treatment for advanced colon cancer. His goal on entering the programme was to be able to take the dog for a walk around the local lake. He had just told us how he could now easily make the trip twice a day and still find the energy to meet up with his friends at the pub at least once a week.

Four years earlier, we had laid the foundation stones of a new palliative rehabilitation outpatient clinic at our cancer centre at Vejle University Hospital, Denmark. As palliative care professionals, we were inspired by the growing body of work about early integration of palliative care into the oncology treatment of patients with advanced cancer. (1) At the same time, we saw how feelings of loss of control sometimes sent patients and families into the arms of somebody or something that ultimately led to harm or hopelessness. We asked ourselves how we might offer earlier symptom control, while providing our patients with suggestions for evidence-based interventions they could follow themselves that might improve their quality of life.

These thoughts led to the founding of a palliative rehabilitation outpatient clinic offering individual consultations, as well as a 12-week interdisciplinary group programme combining a weekly patient/caregiver training session with individually tailored physical exercise in groups. The usual members of our team comprising physicians, nurses, physiotherapists and psychologists were supplemented by an occupational therapist, a dietician, a social worker and a chaplain to form the palliative rehabilitation team. We decided to test this new initiative in a randomised, parallel-group controlled trial and we are delighted to present the results of the study in our longer article published in Palliative Medicine, and to give a preview here to readers of the EAPC blog.

We found that the quality of life of the patients in the group that received palliative rehabilitation integrated in the cancer care was significantly improved, as opposed to the group receiving standard oncology care alone. In a previous publication, we described the development of the palliative rehabilitation offer, and how it was utilised and evaluated by the patients during the study.(2)

We believe the study adds to the evidence on the effect of early, integrated palliative care and offers additional and new knowledge of a highly flexible and interdisciplinary model of delivery incorporating elements of rehabilitation.

Editor’s note: This post is among the Top Twenty most-viewed posts for 2021.


1.    American Society of Clinical Oncology Provisional Clinical Opinion: The Integration of Palliative Care into Standard Oncology Care. Journal of Clinical Oncology 30, no. 8 (March 10, 2012) 880-887. DOI: 10.1200/JCO.2011.38.5161

2.    Nottelmann, L., Jensen, L.H., Vejlgaard, T.B. et al. A new model of early, integrated palliative care: palliative rehabilitation for newly diagnosed patients with non-resectable cancer. Support Care Cancer 27, 3291–3300 (2019). https://doi.org/10.1007/s00520-018-4629-8

This post relates to the longer article, ‘Early, integrated palliative rehabilitation improves quality of life of patients with newly diagnosed advanced cancer: the Pall-Rehab randomized controlled trial’, by Lise Nottelmann, Mogens Groenvold, Tove Bahn Vejlgaard, Morten Aagaard Petersen, Lars Henrik Jensen, published in Palliative Medicine Volume 35 issue: 7, page(s): 1344-1355. Article first published online on 17 May 2021. Issue published 1 July 2021. https://journals.sagepub.com/doi/10.1177/02692163211015574


If you are currently an Individual or Associate EAPC Member you have full access to the Members Area of the EAPC website, and the chance to download a free PDF of all ‘Editor’s choice’ articles, as well as many other membership benefits. Just click here, enter your email address and membership password and choose from the list of journal articles in 2021.

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This entry was posted in Palliative Medicine: Editor's Choice and tagged , . Bookmark the permalink.

1 Response to Early, integrated palliative rehabilitation improves quality of life of patients with newly diagnosed advanced cancer

  1. HealthTimes says:

    Great read and information. Thank you for sharing this.

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