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Palliative care is a defined medical specialty, and it's focused on helping patients and families
who are facing serious illness achieve the best possible quality of life.
When someone is diagnosed with cancer, the medical oncology focuses on the medicinal
approach, the systemic approach to managing the cancer.
Radiation targets a specific area.
Surgery targets a local area, but palliative care is it really looks at the patient holistically,
and not just the patient but her family.
It helps give he or she things that they can do to alleviate the symptoms of the disease
or side effects of treatment, whether it's, you know, as simple as a mouthwash for mouth
sores, you know, some sort of counseling for the grief and loss that comes with a cancer
diagnosis.
So many things.
I mean even something as simple as yoga and teaching them how to relieve stress and some
of the anxiety that comes with the uncertainty of having cancer.
Palliative care is a team sport, and the palliative care team involves physicians and nurses,
social workers, and sometimes others such as nutritionists or a physical therapist,
chaplains, all focused on helping people prevent and reduce suffering associated with their
illness.
It can sometimes be provided by specialty palliative care clinicians who do an extra
year of training on symptom management such as symptoms like pain or shortness of breath.
And they also undergo special training to help patients and their families cope with
their illness such as distress or worry.
Palliative care should also be part of the care that all physicians, nurses, social workers
provide patients who have serious illnesses like cancer.
And so really, it can be provided both by specialty clinicians and by all oncologists
taking care of patients with cancer.
Palliative care is not the same as hospice care.
Again, palliative care is comprehensive and interdisciplinary care for patients and families
who are facing serious illness where the goal is to prevent and reduce suffering.
Now, here's the difference with hospice care.
Hospice is a defined medical benefit, and hospice refers to the part of palliative care
where patients are expected to have a short lifespan, a poor prognosis.
I was diagnosed with stage 3 disease.
So, the minute somebody talked about palliative care, it was very frightening and very, you
know, it freaked me out frankly.
But once I understood that there was completely different experiences with palliative care
and hospice and just all a completely different way of practicing, that these are not one
in the same.
I think that we have to do a better job at teaching patients right from the beginning
and to use the appropriate terminology and define it and be reassuring in how we talk
to patients and clients about these managements because when I was dealing with this unrelenting
nausea, I didn't want to complain.
I felt like I get to live, you know.
I can tolerate this even though it felt intolerable.
All patients with cancer can receive palliative care.
I would say the focus has generally been on patients with advanced cancer because those
patients tend to have the greatest symptom burden.
But for example, I'm a thoracic oncologist.
If I had a patient who had early stage lung cancer and underwent surgery and had an excellent
chance of cure but they were having significant challenges with pain or shortness of breath,
I would absolutely refer that patient to palliative care if I was feeling that I just didn't have
the expertise to help maximize the management of those symptoms.
I think doctor-patient communication is almost the most important part of any cancer treatment.
If a patient doesn't feel that he or she can say whatever they need or want to say to their
oncologist, then it increases the fear, it increases the anxiety, and it's probably detrimental
to their outcome.
Doctors need to be able to communicate with their patients,
Patients need to know basically three basic things: what's happening to me, what's going
to happen to me, and what can be done to help me, and in palliative care helping patients
really understand these things in negotiating the goals of care, in tailoring the care to
fit the patient and family is something that is a core of the palliative care services
that are delivered.
I think it's important to understand that it begins at the time of diagnosis.
And the way to bring it up is to say do you have a palliative care team because I would
like an extra layer of support as I begin to go through this journey.
We have to look after the whole person and that the whole patient, the whole person actually
comes with a family and a job and a life situation.
However long people live, whether they're cured and going to have a normal lifespan
or whether their life is in any limited, I think everybody wants to have their optimal
quality of life.
A lot of people ask me where do I find out more about palliative care?
And I think it's easy to remember.
I think Cancer.Net.
Cancer.Net is the website of the American Society of Clinical Oncology directed for
patients and families.
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