Grant: Doctoral: Vanier Canada Graduate Scholarships

Research has shown that early palliative care (PC) is not only associated with improved quality of life (QOL) but also with improved survival in some patients with cancer. Palliative care can provide an additional layer of support to patients and caregivers and help patients live as well as they can for as long as they can. In spite of the proven benefits of the integration of PC in oncology, it has been well established that patients with blood cancers and those undergoing bone marrow or blood stem cell transplant do not routinely receive PC and that end-of-life quality measures are typically worse in patients with blood cancers compared to those with solid tumours. Bone marrow and blood stem cell transplantation are associated with high symptom burden and the potential for serious complications, many of which may be persistent and distressing to patients and their family caregivers. There is an urgent need to proactively address suffering throughout bone marrow or blood stem cell transplant, even before treatment starts, so that patients and caregivers are not inevitably waiting for symptoms to arise before they can be addressed and to optimize QOL for patients undergoing transplant and their caregivers. The purpose of this study is to investigate the impact of early PC integration, in the outpatient setting, for patients undergoing bone marrow or blood stem cell transplantation. Patients and their caregivers will meet with a palliative care nurse practitioner prior to their transplant as well as at various time points following transplant. Validated questionnaires will be utilized to assess patients' symptoms, quality of life, distress and mood; caregivers will also be asked to complete validated questionnaires to assess quality of life, distress and mood. It is hoped that the integration of PC will help improve the experience of bone marrow or blood stem cell transplantation for patients as well as for their caregivers.