Meeting the Associate Editor of APM: Prof. Jan Gaertner

Posted On 2024-12-12 17:34:47


Jan Gaertner1, Jin Ye Yeo2

1Palliative Care Center, Basel, Switzerland; 2APM Editorial Office, AME Publishing Company

Correspondence to: Jin Ye Yeo. APM Editorial Office, AME Publishing Company. Email: apm@amepc.org.

This interview can be cited as: Gaertner J, Yeo JY. Meeting the Associate Editor of APM: Prof. Jan Gaertner. Ann Palliat Med. 2024. Available from: https://apm.amegroups.org/post/view/meeting-the-associate-editor-of-apm-prof-jan-gaertner.


Expert introduction

Prof. Jan Gaertner (Figure 1) graduated from Medical School in Aachen, Germany. He is an anesthetist and specialist in Pain Management and Palliative Care. Clinically, his main interest was the establishment of sustainable interdisciplinary and multi-professional models for the provision of early concurrent specialist palliative care in comprehensive cancer care and other medical fields. He is also an experienced researcher in this field and has contributed numerous journal articles on early palliative care, symptom management, and other aspects of palliative care, such as breathlessness management in non-cancer patients.

Figure 1 Prof. Jan Gaertner


Interview

APM: What initially motivated you to pursue a career in palliative care?

Prof. Gaertner: As an emergency and intensive care physician, I noticed early in my career the high degree of unnecessary suffering in patients with advanced disease and a shortcoming in “thinking ahead” and meaningful, careful end-of-life discussions. Here, and in my work in the pain clinic, I noticed the big potential to care better for the patients and their families if palliative care principles are applied.

APM: Could you share a pivotal moment in your career that shaped your approach to pain management and palliative care?

Prof. Gaertner: When I was working in the pain clinic on a rotation after three years of working as a normal anaesthesiologist in the operating room, I came to work and a cancer pain patient in a wheelchair was already waving at me when I entered the front door, shouting: “Doctor! My pain has gone!”. I realized how much more this meant to me rather than just securing patients’ airways, blood management, and cardiorespiratory physiology throughout a surgical intervention.

APM: In the evolving field of cancer pain management, could you highlight some key developments in symptom management?

Prof. Gaertner: For me, it is of utmost importance that despite all my enthusiasm for early palliative care, we do not oversee the potential long-term survivors who are at risk for substance abuse if we are too uncritical with prescribing opioids years before the anticipated death (1). Moreover, I feel that we have to be more critical in using opioids for the relief of breathlessness in non-cancer patients (2).

APM: In your opinion, what are the key components of a sustainable interdisciplinary model for early concurrent specialist palliative care? How have you seen them evolve over time?

Prof. Gaertner: Definitely, there has been a wonderful evolution and acceptance toward an early integration of specialist palliative care, especially in an oncology setting since the landmark study of Temel et al. (3). Yet, I believe we should be aware that general palliative care, as delivered by oncology, cardiology, and other teams has its merits and is often delivered with huge engagement and efforts by the non-palliative care colleagues. Moreover, we should be more critical of the evidence and not solely rely on stating the study mentioned above. Rather, we should acknowledge the evidence from thoroughly performed meta-analyses despite the less encouraging findings at first sight (4).

APM: How do you ensure that patient needs and preferences are central to your care models?

Prof. Gaertner: Despite acknowledging all the potential for detailed screening tools, I believe in the wonders that happen while you are listening or staying with a patient and her or his family in silence. They will tell us. Also, multi-professional teamwork is a major key. We as physicians should listen closely to what our colleagues (i.e., nurses, psychologists, etc) perceive after they visit a patient and his or her family.

APM: What challenges have you encountered in integrating palliative care into comprehensive cancer care? Are there any strategies that you found particularly effective in overcoming these challenges?

Prof. Gaertner: The answer is traditional, and I believe everyone working in this field has the same experiences: First, we must still overcome a fear that palliative care takes away so-called “hope” in the patients. Instead, we must refer to the literature that clearly shows, that the opportunity to talk about end-of-life issues will give patients a chance to suffer less from anxiety and despair as the disease progresses. Yet, we palliative care specialists must be less offensive and confrontational toward other disciplines if we have different opinions when the potential of further anti-cancer therapies such as chemo- or immunotherapy are discussed.

APM: What areas of palliative care research do you believe require more attention and exploration?

Prof. Gaertner: One short answer, very simple: We definitely fall short of clinical trials evaluating what we choose from traditional textbook knowledge for symptom control. Many of our choices have the potential to harm, whilst the benefit for the patients is unproven in terms of solid evidence.

APM: How has your experience been as an Editorial Board Member of APM?

Prof. Gaertner: Through the years, I have seen the journal achieve significant achievements from being rather a “start-up” to a well-established institution. APM was much earlier in realizing the open-access policy, which is something I really appreciated. The same is the openness towards publications from colleagues throughout non-western parts of the world, especially Asia.

APM: As the Associate Editor, what are your expectations for APM?

Prof. Gaertner: Keep up the efforts for a thorough peer review system. In other journals and publishing companies, I believe that the strive towards publication fees is sometimes higher than the obligatory academic conscientiousness.


Reference

  1. Gaertner J, Boehlke C, Simone CB 2nd, Hui D. Early palliative care and the opioid crisis: ten pragmatic steps towards a more rational use of opioids. Ann Palliat Med 2019;8(4):490-497.
  2. Gaertner J, Fusi-Schmidhauser T, Stock S, Siemens W, Vennedey V. Effect of opioids for breathlessness in heart failure: a systematic review and meta-analysis. Heart 2023;109(14):1064-1071.
  3. Temel JS, Jackson VA, Billings JA, et al. Phase II study: integrated palliative care in newly diagnosed advanced non-small-cell lung cancer patients. J Clin Oncol 2007;25(17):2377-2382.
  4. Gaertner J, Siemens W, Meerpohl JJ, et al. Effect of specialist palliative care services on quality of life in adults with advanced incurable illness in hospital, hospice, or community settings: systematic review and meta-analysis. BMJ 2017;357:j2925.