Eva C. Winkler

When do we need to care about the caregiver? Supportive care needs, anxiety, and depression among informal caregivers of patients with cancer and cancer survivors.

Cancer not only affects patients but also their caregivers. The objective of the current study was to assess the unmet needs of cancer caregivers and to identify possible predictors of their supportive care needs.

Palliative Care for Patients Participating in Experimental or Clinical Oncology Studies

Participating in clinical studies constitutes an important aspect in oncology, even in incurable diseases, and is indispensable for improving anticancer therapy with respect to efficacy and side effects. Nevertheless, numerous medical and ethical problems can be identified in clinical situations where transition to palliative care may interfere with the enrollment in early phase clinical trials and the hopeful expectations they generate. In this chapter we introduce different moral points of view from which one can analyze the normative problems and issues related to the decision whether a patient with advanced cancer should enter an early phase clinical trial. We then address key ethical issues using paradigmatic cases that raise ethical questions: (1) prerequisites for the informed consent, (2) conflict of obligations, and (3) conflicts of interest in the context of early phase trial participations of advanced-cancer patients. We then discuss possible strategies and limitations for reconciling a clinical research-oriented and palliative care perspective with regard to patients with advanced cancer. We conclude with specific principles of how these key ethical issues can best be addressed.