Future strategies needed for palliative care.

Too many cancer patients have less than optimal care at the end of life, as measured by unrelieved pain, death in a setting other than home, and uncoordinated care. Solutions will require at least the following: (1) new models of care and better coordination of care; (2) new drugs or techniques; (3) better professional knowledge and dissemination of that knowledge; (4) facing the issue of death; and (5) acknowledgment of cost constraints. Cost constraints will lead to more gaps between the haves and have nots in the United States in the next 5 years.