Palliative Care and Supportive Treatments, the Heart of Oncology: The ASCO 2020 Award Has Found Its Recipient

An Eventful Success Story

Betty Ferrell, who heads the nursing research center at City of Hope Cancer Center, a cancer research and treatment center, has an eventful success story. Most recently, she received the Palliative and Supportive Care in Oncology Award, one of the special awards presented by ASCO (American Society of Clinical Oncology). As is well known, ASCO is one of the 2 most important organizations shaping clinical oncology and its community worldwide.

In 1977, while working as a newly qualified nurse, Betty Ferrell went to answer a patient's call bell. The patient had multiple bone metastases from prostate cancer and had called the nurse because he was suffering from terrible pain. At that time, little could be done to treat either the cancer or the bone pain of a patient with advanced cancer. In other words, little was known about treatment.

Betty Ferrell describes that moment: “That frail man in great pain could barely speak. He was neither angry nor demanding. He simply asked in desperation, “please, is there anything that could ease my pain?”. I remember that moment as a professional turning point. I felt an overwhelming need to do something to control the pain of people suffering in this way.” The memory of this patient's painful end would fuel Betty Ferrell's determination to continue her work. In palliative care, she would eventually become an important researcher who advanced the field.

The Birth of Palliative Care

The early career of this dedicated healthcare professional took shape as the developing modern hospice approach, first established by Cicely Saunders in London, began to spread. Of course, no discussion of palliative care would be complete without mentioning Cicely Saunders. She was the person who established palliative care in its modern sense within the health sciences. Looking at her impressive career, Saunders began her healthcare profession as a nurse, setting out with a commitment to take responsibility for the burdens of illnesses that could not be fully cured. To broaden the ways she could help patients in this area, she also earned a medical degree. This forward-thinking scientist founded St. Christopher’s Hospice in London in 1967. The institution remains one of the first places that come to mind worldwide when palliative care is mentioned. It is the longest-established institution in this field with research, education and treatment units. The approach advocated by Cicely Saunders and provided for years by St. Christophers’ Hospice, a holistic medical approach encompassing physical, psychosocial and spiritual care, has become the definition of palliative care.

The expanding palliative care movement quickly made itself felt in the United States. We first see efforts by Yale University's School of Nursing to train healthcare leaders in this field. The first hospice in the United States opened in Connecticut in 1971, and by 1986 there were more than 1000 hospices.

Her Early Career

Betty Ferrell first joined the palliative care movement in 1980. She soon realized that, to do more to benefit these patients, more data and research were needed. She already held a master's degree in nursing. But simply stating her view that there were patients with cancer suffering severe pain was not enough. She believed she needed to produce data to demonstrate it. In this field, she began a doctoral program and submitted her dissertation in 1984. Her dissertation was based on the following questions: “How do relatives feel when patients die at home? Is a death at home what they would prefer, or do they regret it? Do relatives have enough knowledge and skills to provide care during this period?”

RELATED TOPICS

• End-of-Life Directives and Advance Care Planning
• Caregivers of Patients with Cancer Must Not Be Forgotten – 4 Ways to Support Companions

After earning her doctorate, Betty Ferrell first worked as a faculty member at the University of Southern California before moving to City of Hope Cancer Center, where she currently works. At this institution, she developed a nurse education program and continued her research. Palliative care educators trained through this program are now present in every state of the United States and in more than 100 countries.

Talking about Death – Climbing a Steep Hill...

Betty Ferrell describes her journey: “Changing the way people think about death and explaining to healthcare workers that palliative care must be a priority was like climbing a steep hill. We prefer to avoid the reality that people suffer severely from cancer, have a diminished quality of life and die from cancer.”

Since 2000, Betty Ferrell has chaired consensus groups developing palliative care clinical guidelines. Initially, the guidelines were prepared for palliative care staff, including doctors, nurses, social workers and spiritual care workers. Since 2018, however, guidelines containing “basic palliative care” information have also been published, based on the view that every healthcare worker, especially those in oncology, should know the general principles of the palliative care mission. Betty Ferrell argues that all oncology nurses should know the fundamentals of palliative care practice.

A member of the American Academy of Nursing, Betty Ferrell has more than 460 publications in peer-reviewed journals. She is the principal investigator of the “End-of-Life Nursing Education Consortium project,” other projects related to end-of-life care in cancer centers, and projects on “Quality-of-Life Issues in Cancer Survivors.”

Betty Ferrell also repeatedly emphasizes this point. "Palliative care is not only for patients at the end of life. It also includes those with early-stage disease or those who have survived the disease. People with early-stage, treatable disease, as well as those who have gone through this difficult illness, also have concerns about their quality of life.”

In the field she wanted to pursue, Betty Ferrell has persistently produced scientific data based on her clinical experience and observations. By leading many organizations in this field, she has created a remarkable story of success and motivation. Reading this story, it is impossible not to think that she deserves this ASCO award and much more.

In this article, while discussing Betty Ferrell's success story, we also remembered Cicely Saunders, who is regarded as a founder of the same field. In honor of these people who began their professional careers as nurses and dedicated their lives to improving themselves, society and health, WE CELEBRATE NURSES WEEK FOR ALL OUR NURSES WHO WORK FOR OUR HEALTH. 

Palliative Care in Turkey

This care can be provided in centers and hospitals that deliver cancer treatment. Cancer centers generally have a separate team working in palliative care. Unfortunately, Turkey does not have enough specialized cancer centers. The Ministry of Health has special initiatives to develop palliative care both in oncology and in chronic illnesses other than cancer. Palliative care nursing certification courses are organized. The number of hospitals with palliative care centers and the number of palliative care beds are gradually increasing. According to the Ministry of Health's 2019 data, there are 5360 palliative care beds across the country. Palliative care can also be provided at home when appropriate arrangements and resources are available. In Turkey, however, palliative care services in inpatient facilities (hospitals) have come to the fore more than home-based palliative care.