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A Cancer Doctor’s Guide to Palliative Care and Quality of Life
September 27, 2021
By Dr. Sara Dost
Medical Oncologist and Hematologist, Palliative Care Specialist
Hartford Healthcare Cancer Institute
Palliative Care is specialized medical care that plays an important role in improving quality of life (QOL) for both patients and their families who are facing problems associated with serious illness.
Serious illnesses typically include cancer, dementia, heart and lung disease such as congestive heart failure and chronic obstructive pulmonary disease, end-stage renal disease, liver disease, ALS, HIV/AIDS and others. QOL is enhanced through pain and suffering prevention/relief by way of early identification, assessment and treatment.
It is very important to understand that Hospice Care and Palliative Care are two distinct entities.
Hospice Care is recommended when treatment is no longer pursued and the focus is solely on symptom management and QOL. Usually, patients consider hospice when no further treatment options are available or when they have a limited prognosis (such as life expectancy of six months or less), resulting in patients no longer desiring treatment.
In contrast, Palliative Care is appropriate at any age and at any stage in a serious illness and can be provided together with curative treatment. A number of studies have shown that early Palliative Care is associated with better QOL, survival and overall outcomes. And given that every patient has a unique journey, Palliative Care aims to personalize a plan that best supports a patient and their family’s needs.
Palliative Care can be beneficial to patients who need help with:
- Uncontrolled pain or other physical symptoms such as fatigue, shortness of breath, loss of appetite, difficulty sleeping, drowsiness, nausea, constipation, sexual health concerns, confusion, depression and anxiety.
- Emotional or spiritual needs.
- Social support for coping with illness for both themselves and their loved ones.
- Educating themselves on their illness and treatment options that may include high risk, medical or surgical interventions.
- Making decisions about medical care with their loved ones.
- Setting goals of care and making choices about medical care, whether it is now or in the future (i.e. Advanced care planning).
- Communicating needs and goals with their medical team.
Primary Care providers and the Primary Oncology team should be able to provide basic Palliative Care. A referral may be made to a Palliative Care specialist if a person’s needs exceed the scope of what their primary team can provide.
Here at the Hartford Healthcare Cancer Institute, we are working to develop an outpatient Palliative/supportive Care clinic to help our patients when more specialized care is required. Consider Palliative Care as an extra layer of support to help patients get through the course of illness and treatment.
Our multidisciplinary team includes Physicians, Advanced Practice Registered Nurses (APRNS) and Physician Assistants (PA) specializing in Palliative Care, as well as nurses, social workers, dietitians, therapists/behavioral health counsellors, pharmacists, financial counsellors, integrative medicine providers, chaplains and administrative support staff focused solely on strengthening, relieving and comforting patients and their families.
If you have any questions about Palliative Care or feel you may benefit from these services, please discuss this with your primary oncology team at your next visit.
Some Helpful Resources
www.cancer.net: Doctor approved patient information from the American Society of Clinical Oncology (ASCO)
www.getpalliativecare.org: The Center to Advance Palliative Care
www.aahpm.org: The American Academy of Hospice and Palliative Medicine (AAHPM)
www.nhpco.org: The National Hospice and Palliative Care Organization.