Cancer is a serious illness – at any stage – and patients often experience painful symptoms and side effects that can make treatment more difficult to tolerate, both physically and emotionally. Seeking assistance from palliative care professionals can help patients maintain quality of life throughout treatment. But what do palliative care clinicians do, and how do they fit in with the rest of the care team?
Pain and symptom management
Chemotherapy, radiation, surgery, and other cancer treatment – and tumors themselves – may cause pain and other symptoms, such as fatigue, nausea, difficulty eating or breathing, or constipation. While oncologists are trained in treating cancer and its side effects, palliative care clinicians provide an extra layer of support and expertise in symptom management.
These clinicians may prescribe medications to ease pain or reduce nausea, or suggest integrative therapies or other interventions to ease these symptoms. Since palliative care experts work alongside the medical oncology team, they may be able to treat pain and other side effects together – for example, some pain medications may also help address other issues such as shortness of breath.
In more advanced cancers, pain may be partially addressed through palliative radiation or surgery, which may be used not to cure the cancer, but to shrink the tumor and make patients more comfortable.
“By listening carefully and exploring what a symptom means to a patient, we can help the patient better understand what he or she is experiencing both on physical and psychological levels,” he says. “We try to have an inviting place where it’s okay and encouraged to talk through these issues.”
Guidance through treatment choices
Deciding what your goals and values are is important for everyone, regardless of health status, but having these conversations with loved ones or your care team can be difficult. What makes life “life” for you? It might be the ability to communicate with loved ones, or enjoying simple pleasures like reading a book to your children or grandchildren. Palliative care clinicians can help you identify these values, discuss potential interventions and how they would affect your life, ensure these preferences are communicated to the entire care team, and prompt discussion with your family and loved ones.
Help coordinating and navigating care
Palliative care clinicians can help you find resources within your cancer center and in the community, should you decide to receive care at home. Palliative care providers at Dana-Farber collaborate closely with the oncology team, as well as psychiatrists, psychologists, and social workers – in the adult and pediatric clinics – who also focus on care for the whole person, and can help address emotional concerns and improve communication with family and caregivers.
“We want to ask, with professional intent, what’s been going well for you, and what’s been tough,” Brandoff says. “If someone is having a difficult time coping with symptoms or the illness itself, we try to understand what the cause or source of that discomfort is, and how we can provide the most helpful support for the patient and his or her family.”
While many people may still see palliative care as a step toward hospice, it is not just for patients at end-of-life. In fact, incorporating palliative care from the time of diagnosis can be effective for many patients in managing symptoms throughout the course of care and making sure their voices and preferences are heard across the care team.
“To get to cure, patients often have to go through intensive therapies that can cause a lot of side effects; we can help meet these intense needs and support patients through treatment,” Brandoff explains. “Patients receiving treatment with curative intent can still benefit from palliative care support and interventions.”
Learn more about palliative care at Dana-Farber.