- Advanced Cancer
- What is advanced cancer?
- What is metastatic cancer?
- Can advanced or metastatic cancer be prevented?
- How is advanced cancer found?
- How is advanced cancer treated?
- Surgery for advanced cancer
- Ablative techniques for advanced cancer
- Radiation therapy for advanced cancer
- Drug treatment for advanced cancer
- Clinical trials
- Complementary and alternative therapies for advanced cancer
- Managing symptoms of advanced cancer
- Problems grouped by where the cancer is
- What should you ask your doctor about your cancer?
- Coping with advanced cancer
- Sources of support
- Choices for palliative care
- Advance directives
- Additional resources for advanced cancer
- References: Advanced cancer
Choices for palliative care
Care aimed at relieving suffering and improving the quality of life is called palliative care. The focus of care is on the patient and family rather than the disease. Palliative care treats pain and other symptoms caused by the disease. Some health professionals also call this supportive care.
Common physical symptoms that are treated and controlled or relieved by palliative care can include:
- Breathing problems
- Appetite loss
- Weight loss
- Tiredness (fatigue)
- Depression and anxiety
- Nausea and vomiting
- Bowel blockage (obstruction)
The goal of palliative care is to prevent and relieve suffering and support the best possible quality of life for patients and their families, regardless of the state of the disease.
Palliative care can be given at home. Some cancer centers actually have special palliative care teams that can help. The team usually has professionals with extra training in cancer and hospice care. Members may include a doctor, chaplain, social worker, nurses, home health aides, physical therapists, a dietitian, pharmacist, and breathing (respiratory) therapists. The palliative care team works with the patient's doctor to:
- Develop treatment plans
- Manage pain and other symptoms
- Give emotional support
- Help deal with end-of-life issues
When the Focus Is on Care: Palliative Care and Cancer is a book by the American Cancer Society that discusses many of the questions you may have and provides a list of very helpful resources. Call us or visit our Web site for more information.
Home health care is professional health care given in your home. Home care may be right for you if you still need care but do not need to be in a hospital. A wide range of health and social services can be given at home to people with advanced cancer.
Many home health care agencies offer care and support for patients who choose to stay at home. Home care usually includes regular visits by health care professionals. But the family is still responsible for most of the care. It is important to talk with your cancer care team so that you understand what types of care will be needed and how this will affect your family. It is also important to check with your health insurance company to find out if they will pay for home care.
Sometimes, the family can't go on caring for the patient at home. There may not be enough family members to provide all the care needed or the care may be too complex to be given at home. If this happens, family members may feel guilty, especially if they had promised to keep the patient at home. Recognizing the efforts of family members can help them cope with these feelings. For more information, please see our document, Home Care Agencies.
Hospice is a program designed to give palliative or supportive care near the end of life. The right time for hospice care is when treatment aimed at a cure is no longer helping the patient and the patient is thought to have about 6 months to live. But hospice patients can live longer. Together, the patient, family, and doctor decide when hospice care should begin. Many professionals in the field feel that patients are often referred to hospice too late. A hospice program can do a lot for you and your loved ones, and most provide care for the patient in their home.
Hospice sees death as the natural, final stage of life. It seeks to manage a patient's physical and emotional symptoms. The goal of hospice is that the person's last days be spent with dignity and quality, in comfort, surrounded by loved ones. Hospice care affirms life and neither hurries nor postpones death. Its focus is on quality of life, rather than length.
Hospice programs offer family-centered care. They involve the patient and family in making decisions. Hospice care is usually given in the home. But there are some hospitals that offer hospice care and some private hospice centers. Hospice care is also available in some nursing homes.
A hospice program may give you the best chance of controlling your symptoms and keeping the quality of your life. An honest talk with your doctor can help you decide if it is the right thing for you.
In a hospice program, a team will usually care for you. The team will have a medical director who is a doctor; a nurse, a nurse's aide, a social worker, and a chaplain. In most cases, your own doctor will also play a role.
There are over 3,000 hospice programs in the United States. Most of these are designed to provide care at home. To learn more about hospice care and hospice services where you live, please see our document called Hospice Care.
It's important not to forget about money when deciding what type of palliative care you will get and where you will get it. Insurance policies differ widely. Check with your insurance company to find out which services are covered. Many insurance companies have a case coordinator who acts as your main contact. This person decides what your benefits cover in your specific case. Most health insurance plans cover hospice care. Many states mandate this.
Medicare has a special hospice benefit that not only covers care, but also pays for all medicines. For Medicare information, call the Medicare Helpline at 1-800-MEDICARE (1-800-633-4227); TTY: 1-877-486-2048. They can explain what Medicare covers and how to qualify. You can also get information on their Web site at www.cms.hhs.gov.
Serious illnesses often cause you to need a lot of money right away. In many states, you can turn death benefits from your life insurance policy into "living benefits." You can get these benefits in different ways, such as selling the policy or borrowing against it.
For more information, please see our documents, Health Insurance and Financial Assistance for the Cancer Patient and Advanced Illness: Financial Guidance for Cancer Survivors and Their Families.
Last Medical Review: 07/17/2012
Last Revised: 07/17/2012