Each patient should receive an evaluation for first and second line chemotherapy. The most important parameter therefore is the health performance status.
The reevaluation of patients under treatment should include an every 2 to 3 month assessment of therapy effectiveness, always performed with the same tools for comparison reasons.
The patient assessment and decision about treatment options should be done during the multidisciplinary team meeting, in presence of the patient’s general practitioner. The role of the pain clinic in pain management has to be discussed.
The need for a psychosocial help must be evaluated and, if required, the help has to be started.
Patients with advanced colorectal cancer may benefit both from treatment of the cancer and from palliative care. These are concomittant approaches to management.
Palliative care specialists should be members of, and integrated with, colorectal cancer multi-disciplinary teams; their role includes the provision of education and advice for other health professionals and direct patient management.
A patient in good health status and progressive under standard therapy should be proposed a clinical trial protocol.