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NCCN Flash Updates™: NCCN Guidelines® Updated

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Palliative Care. These NCCN Guidelines® are currently available as Version 1.2017.

  • Recommended agents and dosage for symptom management are now included in the Palliative Care Drug Appendix (PAL-A).
  • The Assessment section of PAL-7 (formerly PAL-6) has been extensively revised.
  • Benefits and Burdens of Anticancer Therapy, new bullets added (PAL-9).
    • For estimated life expectancy of Months to Weeks:
      • "Consider palliative RT for spinal cord compression; brain metastases; SVC syndrome; dyspnea due to cancer related bronchial obstruction; cancer-related bleeding; painful bone metastases"
      • “Consider discontinuation of cancer treatment not directly addressing a symptom complex”
    • For estimated life expectancy of Weeks to Days:
      • “Discontinue all treatments not directly contributing to patient comfort.”
  • New sub-bullets were added to Malignant Bowel Obstructions, Procedural Interventions (PAL-21)
    • "Discuss risks with patient/family, including risk of mortality, morbidity, and re-obstruction"
    • "Take into account prognosis and relative invasiveness of the intervention proposed"
    • "Risk factors for poor surgical outcome include ascites, carcinomatosis, palpable intra-abdominal masses, multiple bowel obstructions, previous abdominal radiation, very advanced disease, and poor overall clinical status"
  • Preparing patients and families for end-of-life and transition to hospice care is the new title for (PAL-28).


For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Drugs & Biologics Compendium (NCCN Compendium®), the NCCN Biomarkers Compendium®, the NCCN Chemotherapy Order Templates (NCCN Templates®), and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), please visit

To view the NCCN Guidelines for Patients®, please visit

Free NCCN Guidelines apps for iPhone, iPad, and Android tablets are now available! Visit

About NCCN Flash Updates™ 
NCCN Flash Updates™ is a subscription service from NCCN that provides timely notification of updated and new information appearing in the NCCN Guidelines, the NCCN Compendium®, and other NCCN Content. 

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