Objectives: Palliative anticancer treatment may alleviate patients' cancerrelated symptoms and cancer-associated syndromes without a tumour-size response. Tumour size reduction does not necessarily imply a benefit to patients. Chemotherapy may cause physical and psychosocial side effects. Both disease and illness may be monitored by four pillars: 1) tumour size/markers, 2) specific chemotherapy toxicity, 3) symptoms, 4) syndromes.
Methods: 11 Patients with advanced incurable symptomatic cancer having anticancer treatment with an expected tumour-size-response rate below 20% were included. Patients completed in the waiting room an ESAS and medication logs. The oncologist completed at each visit the patient monitoring sheet (PMS) with 4 pairs of defined symptoms (pain, fatigue, anorexia, dyspnea) and syndromes (pain [analgesic consumption], function [performance status], cachexia [weight loss], pulmonary syndromes [opioids, oxygen, antitussiva]), and 2 individual pairs. The oncologists assessed compliance of assessments, usefulness in daily oncology practice, quality of communication, clarity of goals of treatment, and impact of the MOSAIC intervention on patients' quality of life.
Results: All patients completed the ESAS and medication logs. The patientphysician communication was perceived by oncologist to focus more on symptom control and achievable goals until death, rather than on tumor control and toxicity.
Conclusion: The pilot experiences are encouraging to open the pilot/feasibility project for other members of the "Prospective SIAK Projectgroup Symptom Control & Palliative Cancer Care", and include (validated) outcome instruments (quality of communication, perceived goals, quality of life). A randomized controlled trial is aimed for in daily oncology practice settings.