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Cancer: Palliative Care and Quality of Life


WebMD Feature

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 programs.

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 disease.

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 family members.

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.

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