Palliative Cancer Care versus Hospice Cancer Care
You may be familiar with hospice, which supports people with life-limiting illnesses. However, you may not be as familiar with palliative care, a related concept that is invaluable to people with cancer or other serious illnesses.
What is Palliative Care?
The goal of palliative care, sometimes called comfort care, is to make patients comfortable by treating the symptoms, side effects, and psychosocial aspects of dealing with serious illnesses, such as cancer.
What's the Difference between Hospice and Palliative Care?
Palliative care begins at diagnosis (or any point in the patient's illness) and may continue through treatment. Hospice provides pain and symptom management and end-of-life emotional and spiritual support to patients and their families. Hospice patients' measure their life expectancy in months and have generally exhausted all available medical treatments. Palliative care may overlap with hospice for some patients.
What are the Benefits of Palliative Care?
Palliative care helps patients manage symptoms and side effects of cancer and cancer treatment, such as pain, fatigue, loss of appetite, nausea, vomiting, shortness of breath, and insomnia. Palliative care also helps patients and families cope with the psychosocial challenges that accompany a serious illness.
Cancer provokes stress, fear, and anxiety, for patients and their families. Left unmanaged, these emotions can negatively affect patients' health and lessen the effectiveness of their treatment. Palliative care offers emotional support, practical help with legal and financial issues, and spiritual guidance (if requested) to help patients explore their beliefs and values as they deal with, and learn to accept, their illness.
A recent study found that patients with metastatic (not curable) non small-cell lung cancer who received palliative care earlier in their disease had better quality of life, less depression, fewer symptoms, and even lived longer than patients who didn't.
Although palliative care is tremendously helpful to cancer patients and their families, few patients know to ask about it and most physicians do not make referrals for palliative care, or if they do, it's very late in the patient's illness.
In an interview, Gabriela Kaplan, RN, MSN, AOCN, an oncology clinical nurse specialist who specializes in end-of-life care, explains why so few physicians think about palliative care. She says, "We function according to a medical model, which focuses on curing people. In emphasizing cure, we have forgotten that there's care."
The earlier patients begin palliative care, the sooner they can reap the benefits. If you, or a loved one, have cancer, ask your physician for a referral. Most hospitals and cancer centers offer palliative care.
National Cancer Institute. "Palliative Care in Cancer." Web. 16 March 2010. http://www.cancer.gov/cancertopics/coping
Miller, Kathy D. M.D. "Palliative Care Integrated with Chemotherapy Improves Survival in NSCLC." Medscape Hematology-Oncology. Web. August 2010. http://www.medscape.com/viewarticle/727474
"ONS The Difference Between Palliative and Hospice Care: An Expert Interview With Gabriela Kaplan, RN, MSN, AOCN." Medscape Medical News. Web.7 June 2010.
Melvin, Christina S. MS, PHCNS, BC, and Oldham, Lynn PhD, BN (Hons), RN. "When to Refer Patients to Palliative Care: Triggers, Traps, and Timely Referrals ." Journal of Hospice and Palliative Nursing 11(5) (2009): 291-301. Medscape Medical News. Web. 12 March 2010. http://www.medscape.com/viewarticle/715632_6
Mazanec, Polly, PhD, ACNP-BC, AOCN, Daly, Barbara J., PhD, RN, FAAN, Pitorak, Elizabeth F., MSN, FPCN, Kane, Donna, MSN, Wile, Sally, MDiv, and Wolen, Judith, MSW, LISW-S. "A New Model of Palliative Care for Oncology Patients with Advanced Disease." Journal of Hospice and Palliative Nursing 11(6) (2009): 324-331. Medscape Medical News. Web. 30 November 2009. http://www.medscape.com/viewarticle/712742
Krouse, Robert S. "Palliative Care for Cancer Patients: An Interdisciplinary Approach." Cancer Chemotherapy Review 3(4) (2008): 152-160. Medscape Medical News. Web. 28 October 2008.
National Hospice and Palliative Care Organization. "How Can Palliative Care Help?" Web. http://www.caringinfo.org/LivingWithAnIllness/PalliativeCare.htm
Institute of Medicine. "Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs."
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