If you have metastatic, or advanced, breast cancer, you may consider palliative care. This form of medical care treats someone’s symptoms and aims to cure their illness. But the main goal of palliative care focuses on the well-being and quality of life for you and your family.
This type of care is available for anyone with serious breast cancer, no matter their age, disease stage, prognosis, or choice of treatment. You can receive palliative care alongside your curative treatments -- ones that aim to cure your breast cancer -- and with your life-prolonging treatments.
What Are the Benefits of Palliative Care?
Palliative care is best to receive soon after your breast cancer diagnosis. It can be helpful for many reasons:
It can improve your comfort. Your care team will help address your needs, allowing you to be stronger during your breast cancer treatment. They’ll help you stay comfortable physically, socially, and spiritually.
Helps to manage the stress. Many people with serious illnesses don’t get the treatment they’d prefer. Palliative care intends to not only meet your physical health requirements, but your mental needs as well.
Improves your loved ones’ quality of life. Palliative care can help ease the anxiety or stress your family members and caretakers may have. It’s important that their needs are met as well, since your loved ones are a part of your care journey. Palliative care will help keep your family comfortable, which, in turn, will put you more at ease.
It can help you live longer. One study found that people who received palliative care lived longer than those who only had standard care. Your doctor may provide antineoplastic treatment (therapies and drugs for cancer) through hormonal therapy, chemotherapy, and biological therapies to ease breast cancer pain. These care options can also prolong your life.
What Are the Types of Palliative Care?
There are different types of palliative care to help keep you more comfortable with metastatic breast cancer. They include:
Oncologist-based palliativecare. Your oncologist (cancer doctor) takes the lead role in this model. They’ll provide you with your cancer treatment as well as your palliative care. The relationship between you and your oncologist is strong in this type of care plan.
Successful oncologist-based palliative care models involve cancer doctors who are skilled in both palliative care and breast cancer treatment.
Concurrent model. In these plans, you’ll receive care from both your oncologist and a palliative medicine specialist. These experts will work together as a care team. Their roles will be based on your specific needs and potential issues you may confront during treatment.
Effective concurrent models require your oncologist and palliative medicine specialist to openly communicate and work closely together.
How Do Doctors Perform Palliative Care?
In addition to your oncologist and palliative care specialist, different experts may play a role in your care program. Your team may include:
- Doctors (such as your primary care doctor or cancer specialists)
- Social workers
- Nurses
- Religious leaders
Your specific plan will look different, based on your needs and symptoms. Your palliative care team will work with your cancer doctors to ease side effects from treatment, pain caused by breast cancer, and any anxiety or stress you have from a metastatic breast cancer diagnosis. Before you begin palliative care, your team will do an evaluation. It’s crucial that they complete a:
Patient assessment. Your care team will begin to earn you and your family’s trust and create an open line of communication. They’ll learn more about your:
- Disease status
- Symptoms
- Expected disease progression
- Level of function (your mobility, communication level, ability to do daily activities, bowel and bladder function, and level of alertness)
- Current therapies
- Potential future problems
Experts on your team will make sure you and your family understand the nature and scope of your illness as well as your expected treatment and long-term outcome.
Family assessment. In order for your family to help with your care, your team needs to evaluate their ability to do so. They’ll assess:
- Your family’s ability and willingness to give you care at home
- Any potential medical issues your family members have (since this could interfere with your care)
- Any social or psychological barriers your family may have while they provide you care
You’ll want to set up a plan to have family meetings. These can include any relevant loved ones as well as any members of your health care team. At these meetings, you can routinely chat about your goals, concerns, and the needs of all people on your team.
You, your care team, and your family will talk about information you’d like to share with each other and things you’d like to keep private. This can help prevent information overload and allow you to protect your family from an unfavorable medical outlook (if one should come up).
Health care professional assessment. It’s important that your care team understands any limits that each expert has. Your team should evaluate each professional’s experience level, knowledge, and ability to provide home care. This will allow you all to plan for your ongoing care.
Your team can use this information to create a report that defines:
- Your medical condition and your care goals
- An overview of your involved loved ones and health care experts
- Any mental, psychological, social, communication, or understanding issues you or your family might have
- Staffing, resource, emotional, coping, or training issues your care team may have
- The overall coping abilities of you, your family, and your health care team
- Future planning
As time goes on, your palliative care may shift. If you have early metastatic breast cancer, your goal will most likely be to prolong survival. Often, in the beginning stages, this will take priority over comfort. But as your cancer progresses, you may put more attention on comfort and your ability to function. When changes happen, you and your care team should repeat an assessment.
It’s important to discuss your palliative care goals with your team and family. Everyone involved in your treatment should be aware of the priorities so they can help make well-informed decisions.
How Are Palliative Care and Hospice Different?
Hospice and palliative care may have similar intentions for those with breast cancer. But the two services are separate.
Palliative care focuses on curative treatments and lengthening your life.
You may choose to switch to hospice care near the end of life. People usually begin to consider hospice when they have a high risk of passing away within 6 months and won’t benefit from (or have chosen to stop) treatment. In hospice care, you’ll move from cancer treatment to comfort care.
Where Can You Find Palliative Care?
You can receive care in different ways. Some people choose to receive palliative care from health systems, private companies, home health agencies, nursing homes, or outpatient palliative care clinics.
If you or a loved one wants to begin palliative care, first ask your primary care doctor for recommendations. They may be able to offer you suggestions that fit your specific wishes. If they can’t help, you can ask another health care provider for a referral.
