A simple recipe for a beautiful dish- Training, Motivation and Expertise in palliative care in cancer:

By Denise Vacca1, Giampiero Porzio2, Raffaele Giusti3.

1U.O. Terapia del Dolore e Cure Palliative ASL Sulcis – Carbonia, Italy.

2Associazione Tumori Toscana, Home Care Service, Tuscany, Italy.

3Medical Oncology Unit, Sant’Andrea Hospital of Rome, Rome, Italy.

Twitter account: @oncoblogger


Giampiero Porzio M.D. while eating a perfect Italian meal: Birra & Panino!


In Italy, food is passion, life, everything… And sometimes our most beautiful dishes don’t have all that many ingredients. It is the quality that matters. “Tutto fa brodo” is an expression that means a stew needs all its key ingredients before it is finished! How to cook up a good ‘Palliative Care” broth? We know that palliative care is an approach that improves the quality of life of patients and their families who are facing problems associated with life-threatening illness. It prevents and relieves suffering through the early identification, correct assessment and treatment of pain and other problems, whether physical, psychosocial, or spiritual.

National health systems are responsible for including palliative care in the continuum of care for people with chronic and life-threatening conditions, linking it to prevention, early detection, and treatment programs.

Providing palliative care should be considered an ethical duty for health professionals.

Globally, a number of significant obstacles need to be overcome to address the unmet need for palliative care such as national health policies and systems that often do not include palliative care at all.

How to ensure good service with few resources? This is like making a good dish with poor ingredients.

The recipe is simple and easy to make. It will not be providing a healthy dish to feed the mind and body of our patients, with the skills and attention needed in every single moment of the end of life.

The goal is to provide a treatment and approach for symptoms, to welcome the patient and their significant others.

  • First Point: Motivation.

Recognizing that the helping partnership relationship with people suffering from serious illness and close to death will be rewarding. The passion for the life of others, for the entirety of the person, for the recognition of dignity on the other hand, legitimizing the diversity even in the choices that are made. Being curious about the person. Motivation in the field of palliative care allows you to cook in the kitchen of tolerance, leaving prejudices and superstructures on the roadside, recognizing value systems drawn up on the criteria of those in front of you, promoting listening before speaking.

  • Second Point: Training.

It represents the necessary tool to acquire specific skills: from the best ability to identify patients who can make use of palliative care and the moment in which it is necessary to pass from frenetic care to active, symptomatic, and responsive care. Actively attempting to reverse reversible problems but involving patient and their significant others in that conversation.

Training allows you to review personal concepts and to deal with different points of view and situations.

Humble confidence should characterize the kitchen chef in palliative care, being able to call out when someone is overcooking.

  • Third Point: Expertise and team.

Palliative medicine is characterized by specific skills that transversely embrace the fields of internal medicine in all clinical declinations, but also the branches of surgery and radiology, psychology, physiotherapy and speech therapy, arts therapies, etc. This statement does not imply “wholeness” but the ability to draw on one or the other area, turning, when necessary, to the expert who can help improve patient care and his / her reference point of care. A team worker

The skills acquired strengthen awareness, of knowing or not knowing, so as to be able to act according to criteria that should move good medicine in general.

The skills to be acquired are inherent to the knowledge of others and of oneself.

Finally, a tip:

To cook well you need to collect the best raw materials and the time to learn to compose them together, cook them and let them settle.


Declaration of interests

DV, GP and RG nothing to declare.

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