Palliative care is often misunderstood. Because hospice is a well-known form of palliative care, some patients may think the two are synonymous—and as a result, may initially feel resistant to palliative care, assuming they should seek this type of care only if their cancer has become terminal. Despite this stigma, patients at all stages of cancer treatment may benefit from palliative care.
We sat down with palliative care physician Kathleen Lee, MD, to discuss this holistic, comprehensive approach to cancer care, including the latest research developments in the field.
What is palliative care, and how can it help cancer patients?
This interdisciplinary team approach to caring for people with serious illnesses, like cancer, aims to improve quality of life and lessen the symptom burden of the disease. We also hope to provide an extra layer of support, collaborating closely with their primary oncology team. Palliative care can benefit patients with serious illness from time of diagnosis and throughout their disease trajectory, even while receiving treatments with curative intent.
We can think of palliative care as an umbrella term under which hospice care exists. Hospice care also takes a comprehensive interdisciplinary approach to improving patient’s quality of life, specifically when at the end of their lives.
People with all types of cancer may benefit from palliative care, depending on their disease course and symptom burden. For cancer patients, palliative care helps to provide relief from the symptoms that cancer or its treatment may present. Examples include treating symptoms like chemotherapy-related nausea, cancer related pain, and alleviating various forms of psychosocial or emotional distress—not only for patients, but for their families as well.
Our goal is really to meet the patient where they are at—understanding who they are, what’s important to them, and helping them align their treatment plans with their goals and needs.
What types of doctors or clinicians are involved in palliative care?
At Dana-Farber, our palliative care team includes physicians board-certified in Hospice and Palliative Medicine, nurse practitioners, physician assistants, clinical social workers, pharmacists, and chaplains. In both the Dana-Farber clinic and hospital settings, our team closely collaborates with a patient’s primary oncology team to provide expert care for patients at any stage in their cancer treatment. A patient’s palliative care needs may change over time, depending on factors like the cancer’s stage or the type of treatment the patient receives.
Are there other benefits that can be attributed to palliative care?
Palliative care clinicians help to ensure patients and their families have good understanding of their illness and that they are presented information in ways that make sense to them. We also want to ensure that the care they receive is consistent with their goals and values. With this in mind, patients who receive palliative care may feel more involved in their cancer treatment and care.
In addition, growing evidence shows that with regard to improved quality of life, palliative care can decrease depression and anxiety in cancer patients as they cope with their diagnosis and disease. In some cases, palliative care may improve outcomes, such as living longer—and some studies have even shown that palliative care has the potential to improve health care value by lowering overall healthcare costs.
Are there any other developments in palliative care research?
Since palliative care is a relatively newer field, there is certainly a need for continued research to inform how we can better care for patients. With that said, there have been some encouraging developments in recent years. In a recent study, early palliative care along with standard oncology care was shown to improve quality of life for those with metastatic non-small cell lung cancer patients or (non-colorectal) gastrointestinal cancer patients. There was also a recent study showing patients admitted for bone marrow transplant receiving palliative care had a lesser decrease in quality of life compared to those receiving standard transplant care alone.