Palliative medicine. A new research field with specific demands

Palliative care is not merely a question of treating symptoms irrespective of cause, but is ideally based on proper analysis, treatment and evaluation. Education, quality assurance, clinical development and research are needed to improve palliative care. Education and research should be focussed on all four dimensions--the physical, the emotional, the social, and the existential. Research should be designed to address specific issues--for example, how anxiety and mood disturbances in (previously healthy) patients in palliative care differ from anxiety and depression in a psychiatric setting, in patients with a history of psychiatric problems. Efforts need to be made to link significant clinical problems and basic science. Not until we understand the underlying mechanisms (e.g., the involvement of cytokines in mediating cachexia), will it be possible to develop new treatment strategies for problematic symptoms.