Cancer: Palliative Care and Quality of Life
How to Find Good Palliative Care
The best way to ensure good palliative care is to find a cancer center that offers a comprehensive program of support. That’s not always easy. Although many centers have such programs, Bruera says, “most are inpatient programs, so they’re only available to patients who are admitted to the hospital. That typically means patients who are already quite ill.”
But thanks to earlier diagnosis and better treatments, “cancer is now largely an out-patient disease,” Bruera says. Acknowledging that fact, M.D. Anderson Cancer Center and other cancer centers have created pilot outpatient palliative care programs. Early evidence suggests that such centers help improve quality of life for patients at all stages.
How to Build Your Own Palliative Care Team
If your medical center doesn’t offer a palliative care program, talk to your oncologist about putting together an informal team of people that offer help. The list should include an expert in pain management and a social worker or counselor, along with your oncologist. Seek spiritual support from any religious group with which you are affiliated.
Even when good palliative care is available, it’s important to be assertive. If you are in pain, for example, speak up. “Many cancer patients are still reluctant to say they’re in pain for fear of appearing weak,” says David Casarett, MD, associate professor of geriatrics at the University of Pennsylvania, who specializes in palliative medicine. “Pain can be managed effectively, but only when we know a patient is in pain.”
Be alert to other aspects of your physical and emotional health. If you become depressed, alert your doctor. Talking to a counselor can help, or your doctor may prescribe antidepressants or anti-anxiety medications.
Above all, insist on getting answers to your questions. “People suffering serious illnesses want information,” says Casarett. Indeed, when researchers from the Hertzberg Palliative Care Institute at Mount Sinai School of Medicine in New York polled patients and family members about what was most important to them, “timely, clear, and compassionate communications” from doctors topped the list.
“Palliative care can’t take away all the distress that comes along with a diagnosis of cancer,” says Bruera. “But we can do a tremendous amount to alleviate unnecessary suffering.”