Palliative care, sometimes also called supportive care, is given to a patient who has a serious or life-threatening disease, such as lung cancer.
The goal of palliative care is to anticipate, prevent, and treat the symptoms and side effects of the disease and its treatment. It also addresses the emotional, social, practical, and spiritual issues that a patient may face. Palliative care is not intended to cure the disease. It is intended to improve the patient’s The overall enjoyment of life; an individual’s sense of well-being and ability to carry out various activities while the patient is receiving standard medical care. Palliative care can be provided starting at the time of diagnosis, throughout treatment, and at the end of life.1,2
What is the difference between palliative care and hospice care?
- Palliative care can be provided throughout a patient's treatment and at all stages of illness. It is an extra layer of support, alongside standard medical care, to make patients as comfortable as possible.
- Hospice care is a form of palliative care given to patients with a terminal illness who have a life expectancy of six months or less and who have decided to forgo curative treatment.
Who should receive palliative care?
Any patient who suffers from pain, stress, or other symptoms due to a serious illness, such as lung cancer, should receive palliative care.
The American Society of Clinical Oncology (ASCO) recommends that all patients with advanced cancer receive palliative care early on and concurrent with cancer treatment.3 The National Comprehesive Cancer Network (NCCN) recommends that cancer patients (along with their families and caregivers) should be made aware that palliative care is part of the patient's comprehensive cancer care.4
How are patients referred for palliative care?
Usually the primary care doctor or specialist managing the patient's disease will make the referral to a board-certified palliative care specialist. Patients should themselves request a referral if the doctor does not bring it up. A hospital social worker can also help patients and their families select a palliative care provider. While many private insurance plans, as well as Medicare and Medicaid, cover at least some palliative care services, patients should discuss what services are provided with their insurer in advance. Patients without health insurance should check with a social worker or their hospital's financial counselor.1
Who provides palliative care?
Palliative care can be provided in a doctor’s office, hospital, cancer center, long-term care facility, or the patient's home. Social workers and Someone who provides personal guidance to patients as they move through the health care system can help with many of the emotional and practical issues. In addition, some doctors and advanced practice nurses specialize in palliative care. Many large hospitals and cancer centers have teams of palliative care doctors, nurses, social workers, therapists, and chaplains who work together to provide care alongside the oncologist. If the hospital or outpatient facility does not have a palliative care team, a patient's primary care doctor or specialist can refer the patient to a palliative care doctor outside the facility. (Note that a palliative care doctor never replaces any other doctors on the patient's healthcare team.) 1,3
What specific issues can palliative care address?
The diagnosis of a serious disease and its treatment raises issues that affect all areas of a patient’s life (as well as most areas of the lives of their family members/caregivers). The palliative care team is able to focus on these issues. Below are lists with examples of issues and how they might be treated by the palliative care team. These lists are by no means comprehensive. Patients should feel free to bring up any issue with their palliative care team.1,3,4
Physical symptoms or side effects
- Trouble sleeping
- Shortness of breath
- Nausea, loss of appetite
Palliative care treatments may include:
- Medicine (pain relievers, Treatment with drugs that kill cancer cells to decrease the size of a An abnormal mass of tissue that results when cells divide more than they should or do not die when they should)
- Other medical treatments (The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors or surgery to decrease the size of a tumor)
- Nutrition counseling
- Physical therapy
- Complementary therapies (massage, guided imagery, acupuncture)
- Stress of the illness leading to fear, anxiety, hopelessness, anger, or depression
- Intimacy issues
- Helping caregivers balance their roles and duties and find support
Palliative care treatments may include:
- Support groups
- Family meetings
- Referrals to mental health providers
- Money or employment difficulties
- Child care worries
- Insurance questions
- Legal issues
The palliative care team may:
- Explain complex medical forms
- Help patients and families understand diagnosis and treatment choices
- Refer families to financial counseling and financial assistance resources
- Help connect patients and families to resources for transportation, housing, and other community resources
- Looking for meaning in life
- Questioning one's faith
The palliative care team may:
- Help patients and families explore their beliefs and values so they can find peace or move toward acceptance
What benefits can palliative care have?
- Better quality of life
- Reduction in intensity of symptoms and side effects
- Lower rates of depression
- Improvement in patients’ understanding of their The likely outcome or course of a disease; the chance of recovery or recurrence
- Better clarification in treatment preferences and goals of care
- Decrease in acute care services (emergency department visits and hospital admissions)
- Longer survival
Updated March 17, 2021
- Palliative Care in Cancer. National Cancer Institute website. www.cancer.gov/about-cancer/advanced-cancer/care-choices/palliative-care-fact-sheet. Reviewed October 20, 2017. Accessed March 17, 2021.
- Temel JS, Greer JA, Muzikansky A, et al. Early Palliative Care for Patients with Metastatic Non-Small Lung Cancer. N Engl J Med, 2010; 363-733-742. doi: 10.1056/NEJMoa1000678. http://www.nejm.org/doi/full/10.1056/NEJMoa1000678. Accessed March 17, 2021.
- ASCOanswers: Palliative Care. Cancer.Net website. https://www.cancer.net/sites/cancer.net/files/palliative_care.pdf. Published 2020. Accessed March 17, 2021.
- Palliative Care. Version 2.2021. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). https://www.nccn.org/store/login/login.aspx?ReturnURL=https://www.nccn.org/professionals/physician_gls/pdf/palliative.pdf. Posted February 12, 2021. Accessed March 17, 2021.
- Parikh RB, Kirch RA, Smith TJ, et al. Early Specialty Palliative Care — Translating Data in Oncology into Practice. N Engl J Med 2013; 369(24):2347-2351. doi: 10.101056/NEJMsb1305469. http://www.nejm.org/doi/full/10.1056/NEJMsb1305469. Accessed March 17, 2021.