A Guide to Palliative or Supportive Care

What is palliative care?

Palliative care is care for adults and children with serious illness that focuses on relieving suffering and improving quality of life for patients and their families, but is not intended to cure the disease itself. It provides patients of any age or disease stage with relief from symptoms, pain, and stress, and should be provided along with curative treatment.

While palliative care may be delivered by oncology doctors and nurses, they may ask for the help of a specialized team of doctors, nurses, and other specialists who work with them to provide an extra layer of support addressing the patients’ needs and helping patients and their families have a voice in realizing their treatment goals.

Palliative care is also called supportive care. It’s aimed at relieving suffering and improving quality of life. It’s designed to help people live as well as they can for as long as they can, even though they have a serious illness.

Palliative care focuses on helping people get relief from symptoms caused by serious illness – things like nausea, pain, fatigue, or shortness of breath. Palliative care looks to help with emotional and spiritual problems, too. It’s treatment of the symptoms – it’s not expected to cure any serious illness. The goal is to improve quality of life for both the patient and the family. In the past, the term palliative care was mainly used to describe the act of promoting comfort when aggressive treatment was no longer working – the care given at the end of life. (For more on care when cancer treatment is no longer working, see Hospice Care.)

No matter what it’s called, palliative or supportive care has long been recognized as an important part of cancer treatment. For decades it was simply considered to be part of cancer treatment. But more recently, it’s getting much more attention and study. It has grown into a specialized field of knowledge as well as being a standard part of care given by doctors and cancer care teams.

Palliative or supportive care is given throughout the cancer experience, whenever the person is having symptoms that need to be controlled. This can be from the time of diagnosis until the end of life. It’s appropriate at any age and at any stage in any serious illness.

Palliative or supportive care is also about giving patients options and having them take part in decisions about their care. It’s about assuring that all their care needs are addressed – their physical, emotional, spiritual, and social needs.

Benefits of palliative care

There are many studies that show the benefits of palliative care. Studies have shown that patients who had hospital-based palliative care visits spent less time in intensive care units and were less likely to be re-admitted to the hospital after they went home. Studies have also shown that people with chronic illnesses like cancer who get palliative care have less severe symptoms. They have better quality of life, less pain, less shortness of breath, less depression, and less nausea. Their medical care tends to better align with their values, goals, and preferences. Their families also feel more satisfied.

Palliative care may also increase survival. A 2010 study of lung cancer looked at patients who were given palliative care alongside cancer treatment. The patients who received palliative care along with cancer treatment lived nearly 3 months longer than the patients who received the cancer treatment without the palliative care.

Who should get palliative care and when?

Any person diagnosed with a serious illness who is having symptoms should get palliative care. People with complex medical problems, for instance, someone with heart failure, diabetes, and cancer, should get palliative care.

This supportive care should be available from the time of diagnosis until it’s no longer needed – at any stage and in any care setting.

Who delivers palliative care?

Palliative care is most often begun by the cancer care team, and referrals to or visits with palliative care specialists may happen later.

Your oncologist (cancer doctor), your oncology nurse, and other members of your cancer care team usually treat and help you manage symptoms you’re having. For instance, they may prescribe medicines to help control or prevent nausea and vomiting or to help relieve pain. Oxygen and other measures may be used to help with breathing problems. All of these treatments are palliative care.

Palliative care can also be given by a team of doctors, nurses, and other specialists who work with your oncologist to help treat your symptoms. This option may be considered for people with symptoms that are hard to manage (like severe pain), family distress, or complex medical problems. In this case, your doctor might ask a palliative care team to see you.

This “palliative care team” typically includes a palliative care doctor (who may be board-certified in Hospice and Palliative Medicine), a palliative care nurse, social worker, patient navigator, and maybe a person with a spiritual role such as a pastoral counselor or chaplain. Many hospitals and oncology clinics have these teams as part of the services they provide. They can send the team to patients in intensive care units, emergency rooms, or hospital wards to talk with the patient and family and help with palliative care.

Even though the palliative care team is often based in a hospital or clinic, it’s becoming more common in the outpatient setting. And most of the actual care happens at home. At home, you may take medicines and use other methods prescribed by the team, or you may need help from family members and loved ones. The team provides education and support to the patient as well as to the home caregivers.

You can read more about being a home caregiver in What it Takes To Be a Caregiver.

What the American Cancer Society is doing in the field of palliative care

Saving lives and preventing suffering for people facing cancer are central to the American Cancer Society’s mission. The Society collaborates with national partners to promote palliative care as part of cancer treatment for patients and their families at any age and any stage. Through its partnership with the National Palliative Care Research Center (www.npcrc.org), initiated in 2007, the Society invests millions of dollars in palliative care and symptom management research grants designed to help improve the quality of life and quality of cancer care for patients, survivors, and their families. This partnership is also building up and supporting the community of palliative care researchers and opportunities for collaborative research projects among them.

At the same time, American Cancer Society staff in communities across the country are working with hospitals, cancer centers, and other health systems to expand the reach of palliative care services so they are available to all patients and survivors in every type of care setting.

To watch a video with more information about palliative care and the Society’s activities, visit www.youtube.com/watch?v=qXh7TW3lyP4. To watch a video with more information about pediatric palliative care as an extra layer of support for children with cancer and their families, visit www.youtube.com/watch?v=9GRl9r6elJ0.

The American Cancer Society’s advocacy affiliate, the American Cancer Society Cancer Action Network (ACS CAN), is also working to improve access to palliative care services for all seriously ill adults and children. Learn more about ACS CAN’s palliative care activities at www.acscan.org/qualityoflife.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Along with the American Cancer Society, other sources of information on palliative care include:

Website: www.getpalliativecare.org

    Has information on palliative care for patients and home caregivers, including where to find palliative care programs in your state

City of Hope Pain/Palliative Care Resource Center
Website: http://prc.coh.org

    Web-based clearinghouse of information and resources to help patients and families to improve the quality of pain management and palliative care

Gomes B, Calanzani N, Curiale V, McCrone P, Higginson IJ. Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers. Cochrane Database Syst Rev. 2013 Jun 6;6:CD007760.

Greer JA, Jackson VA, Meier DE, Temel JS. Early integration of palliative care services with standard oncology care for patients with advanced cancer. CA Cancer J Clin. 2013 Jul 15.

Litrivis E, Smith CB. Palliative care: A primer. Mt Sinai J Med. 2011;78(4):627-631.

National Comprehensive Cancer Network. NCCN Guidelines Version 1.2014: Palliative Care. Accessed at www.nccn.org/professionals/physician_gls/pdf/palliative.pdf on September 18, 2014.

Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010;363(8):733-742.

Smith T, Temin S, Alesi ER, et al. American Society of Clinical Oncology Provisional Clinical Opinion: The Integration of Palliative Care into Standard Oncology Care. J Clin Oncol. 2012;30(8):880-887.

Strand JJ, Mansel JK, Swetz KM. The growth of palliative care. Minn Med. 2014;97(6):39-43.

Last Medical Review: September 23, 2014 Last Revised: September 23, 2014

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