Palliative care in cancer

Key takeaways

• Palliative care is not the same as giving up.
• It can be used with cancer-directed treatment.
• It can help with pain, symptoms, emotional stress, and decision-making.
• Earlier support can improve day-to-day quality of life.

The simple version

Palliative care is specialized support for people with serious illness. In cancer, it can help manage symptoms, treatment side effects, emotional stress, communication, and planning.

It can be provided at any stage of cancer and can happen alongside chemotherapy, immunotherapy, radiation, surgery, or targeted therapy.

What it can help with

• Pain, nausea, fatigue, appetite problems, shortness of breath, or sleep issues.
• Coping with uncertainty and stress.
• Clarifying treatment goals and tradeoffs.
• Support for caregivers and family communication.
• Planning for what matters most to the patient.

Who may be on the team

Palliative care can involve doctors, nurses, social workers, pharmacists, chaplains, counselors, nutrition professionals, rehabilitation specialists, or others depending on the person's needs and the services available.

The palliative-care team works with the oncology team. It does not automatically replace the clinicians treating the cancer.

Palliative care and hospice are not the same

Palliative care can begin at diagnosis or at any stage of serious illness and can be provided while a person is receiving cancer-directed treatment. Hospice is a specific form of comfort-focused care generally used when care goals have shifted away from treatment intended to control the disease and eligibility requirements are met.

Programs, insurance coverage, and terminology can vary. A care team or social worker can explain what services are available locally and how they are paid for.

When to ask for a referral

A referral may be useful when symptoms are difficult to control, treatment choices feel overwhelming, caregivers need more support, or communication about goals and tradeoffs is becoming hard. People do not need to wait for a crisis to ask what supportive services are available.

Questions to ask

• Can palliative care be added while I continue treatment?
• Which symptoms should we focus on first?
• Who is on the palliative care team?
• How does this differ from hospice in my situation?

Sources

• National Cancer Institute: Palliative Care in Cancer — NCI fact sheet on palliative care and quality of life.
• American Cancer Society: Palliative Care — Patient guide to palliative care and supportive care.