Cancer: Palliative Care and Quality of Life
A significant improvement in cancer care is a new medical specialty called
palliative medicine -- care that alleviates the side effects of cancer
treatment and eases pain and discomfort.
Palliative care has already transformed the quality of life for many cancer
patients. A 2010 survey by researchers at The University of Texas M.D. Anderson
Cancer Center in Houston, published in the Journal of the American Medical
Association, found that most major cancer centers now offer palliative care
Unfortunately, some patients still don’t get the help they need. “Even
though we’re making progress, many people with cancer still suffer unnecessary
pain or distress,” says Eduardo Bruera, MD, chair of the department of
palliative medicine at M.D. Anderson and one of the authors of the study.
One reason palliative care doesn’t reach everyone who could benefit is the
common misconception that palliative and hospice care are the same thing. They
aren’t, experts say.
How Palliative Care Differs From Hospice
Hospice care is usually provided to people with incurable illnesses who are
at the end of life. To qualify for Hospice Medicare Benefits, patients
typically are no longer receiving treatments from an oncologist for their
Palliative care is for anyone with a serious illness that causes discomfort,
anxiety, nausea, or other physical or emotional distress – even people who are
newly diagnosed and just starting treatment.
“The diagnosis of cancer can be devastating. People starting on
chemotherapies or radiation may have side effects that palliative support can
help alleviate,” Bruera says.
Indeed, some of the same treatments used to fight cancer are used to ease
discomfort. Even when there’s little doctors can do to cure advanced cancer,
chemotherapy or radiation may be used to shrink tumors, alleviating discomfort.
Such treatments are sometimes called palliative chemotherapy or radiation.
In the absence of effective treatments, palliative care becomes even more
important as a way to make people comfortable at the end of life.
What to Expect From Palliative Care
The goal of comprehensive palliative care is to address the full range of
problems associated with a serious illness, from physical symptoms to emotional
anxiety and even spiritual concerns.
- Cancer and its treatment can cause pain, nausea, fatigue, anxiety,
shortness of breath, loss of appetite, and an array of other symptoms.
- A serious illness can also put a heavy emotional and financial burden on
To address all those challenges, a palliative care team typically includes a
doctor or nurse, a psychologist or counselor, a pain management specialist, a
social worker, a nutritionist, a chaplain, and others.
The first step is assessing a patient’s condition and quality of life.
Experts have developed standard questionnaires that help doctors quickly
identify where problems exist, such as uncontrolled pain, anxiety, fatigue,
depression, or sleep problems.