Palliative care and orthopedics: what is on the horizon?

Patient-centered palliative care involves effective and empathetic communication between the physician and patient, with the ultimate goal of providing improved quality of life for individuals who have terminal illnesses. Although several nonoperative and operative treatment options are available to improve the patient's quality of life, providing palliative care requires more than technical expertise and knowledge. Orthopedic surgeons need to be supportive facilitators who inform patients of the available treatments, risks, and benefits and incorporate these treatments into the wishes of patients and their families. Realistic expectations and outcomes of treatment need to be discussed with patients so that they can decide what risks they are willing to accept and what measures of success are meaningful to them. Advances in medical treatments and surgical techniques and principles are available to patients who have metastatic bone disease that were not available less than a decade ago. Although many orthopedic surgeons are involved in the care of patients who have metastatic disease, at times, expertise from an orthopedic oncologist may be required to optimize palliative care.