Understanding palliative care

Palliative care is an often misunderstood realm of the health industry, usually seen as synonymous with hospice. In actuality, hospice is part of palliative care, defined as focused, intense care at the end of one’s life. General palliative care is administered by a team of highly specialized and trained individuals who provide complimentary, comprehensive care to patients through spiritual, emotional, financial, and life coaching. The team usually includes physicians, nurse practitioners, social workers, and chaplains. Patients generally are those with serious illnesses and long treatment plans, such as cancer.

“Usually when people think about palliative care, they think that this means the end of someone’s life and that physical health services end,” says Dr. Apurva Desai, palliative care medical director at Advocate Sherman Hospital in Elgin, Ill. “When in fact palliative care is all about being an additional service with the current clinical team to assist during a hard time for patients and family members.”

Recently, at the 2016 Palliative Care in Oncology Symposium, the Massachusetts General Hospital’s Center for Psychiatric Oncology and Behavioral Sciences shared the results of a study, which involved a large cohort of patients with newly diagnosed advanced cancers. These patients were primarily diagnosed with incurable lung or noncolorectal gastrointestinal cancer, and had palliative care visits which focused on physical symptoms, coping with the illness, rapport building, illness understanding, treatment decision-making, and advanced care planning. Though the studies found little difference early on (after 12 weeks) between those who received palliative care and those who did not, the results at 24 weeks revealed a significant increase in quality of life and lower levels of depression for those who received palliative care. These patients were also more likely to report using active and engaged coping strategies, and were twice as likely to discuss end-of-life preferences.

“The 24-week study is affirming to the time and care needed to have impact on our patients in cancer treatments,” says Dr. Desai. “Comprehensive palliative care teams are about the long-term needs for the patient and families, which are highly relational and focus heavily on elevating the emotional, spiritual, and physical pain and suffering.”

Interestingly, the type of cancer mattered in terms of the results. While lung cancer patients saw a significant increase with palliative care, there was not much change for the GI cancer patients. This leads to further questions about tailored and custom palliative care based on types of cancers and how far along a patient is in their illness and care plan. These are questions already being addressed in various physical treatment plans, through customization and genetic counseling depending on the cancer type.

“These are the questions and answers to be asking and seeking,” says Dr. Desai. “Patients and their family members can benefit from a palliative care team, which joins the existing clinical team, providing additional services that improve their pain, understanding of treatment, and quality of life as they fight cancer.”