As part of our 20 Years Later blog series, NCCS CEO Shelley Fuld Nasso discusses the difference between palliative and end-of-life care, as well as barriers to palliative care in this video.
The second principle from the Imperatives for Quality Cancer Care states, “Quality cancer care should be available in a health care system whose standards and guidelines are developed in consideration of treating the whole person with cancer. Health care plans must regard the cancer patient as an autonomous individual who has the right to be involved in decisions about his or her care.”
Treating the whole person with cancer means treating the symptoms and side effects of cancer, not just the tumor or disease. Over the last twenty years, the medical specialty of palliative medicine has emerged, with a focus on improving patients’ quality of life. Palliative care has been called an extra layer of support for patients facing serious illness.
Palliative care is not the same as end-of-life care and, in fact, should be provided to patients during any serious illness, at any stage of the illness. Even individuals with early-stage, potentially curable cancer face challenges throughout their treatment and afterward and need the support of palliative care.
A groundbreaking study released in 2010 showed that individuals with metastatic lung cancer who were offered palliative care early, along with their chemotherapy and other treatments, had better outcomes those who only received the usual oncology care. They ended chemotherapy earlier, spent more time in hospice, and experienced less suffering before they died. But the most surprisingly result was that they lived longer. This study changed the way many people viewed palliative care and provided the evidence that palliative care needs to be part of cancer care for everyone.
Physician societies have defined the elements of palliative care that should be standard for oncology care, and many oncologists are incorporating these elements into their regular practice. Efforts to reform payment for cancer care have also considered ways to improve symptom management and care coordination.
Still, not all people with cancer have access to palliative care today. There are numerous barriers, but the most unfortunate one is a cultural and perception problem. Many physicians and patients alike still equate palliative care with hospice and end-of-life care. While palliative care is an important element of end-of-life care, it is much more than that.
NCCS believes that planning and coordination of care, proper symptom management, and early incorporation of palliative care will encourage the appropriate utilization of cancer care resources while also protecting the quality of cancer care and ensuring patient satisfaction with their care.
Palliative Doctors provides information about palliative care. PalliativeDoctors.org is the patient site of the American Academy of Hospice and Palliative Medicine (AAHPM).