Palliative care is not the end of the line; it should be part of the journey

February 23, 2012 | by City of Hope Staff



In a recent update to its guidelines, the American Society of Clinical Oncology (ASCO) released a recommendation that palliative care be part of standard care for patients with metastatic or advanced cancer.


Photo of Jay Thomas
Jay Thomas
“The heart of medicine should be palliative care,” said Jay Thomas, M.D., Ph.D., clinical associate professor of supportive care medicine at City of Hope.


Many people mistakenly think that palliative care is the same as hospice care. It isn’t. Palliative care is medical care focusing on people who are seriously ill. It’s meant to help patients get relief from their symptoms, pain and stress — whatever their diagnosis.

ASCO’s recommendations note that many people are reluctant discuss palliative care because many physicians and the general public think it’s all about dealing with the end of life. Since palliative care aims to relieve pain and suffering, these connections might make some sense, but Thomas wants to change that perception. Says Thomas:

For palliative medicine specialists, we’ve always thought that quality of life can extend quantity. We can see that in the studies ASCO uses to support its recommendations. When palliative care is part of standard care, we see reductions in the number of visits to the emergency room, reductions in the number of time patient need to be readmitted to the hospital after treatment and increases in survivorship.

Palliative care is much more than making sure a patient is not in pain towards the end. It’s also about managing side-effects from chemotherapy or radiation therapy, about making sure patients don’t feel psychologically overwhelmed by their diagnoses, about all the issues patients can face during and after treatment.

We really need to understand what quality of life can mean individually for different patients. We need to be able to move conversations about cancer treatment in a sensitive way to a place where everyone can deal with the issues that may arise, including end-of-life care.

We should be doing this for all of health care. It would give us better outcomes.

Thomas notes that City of Hope patients’ access to palliative care is “way ahead” of the ASCO recommendations.


“Every one of our patients receives palliative care,” says Thomas, describing services through the Sheri & Les Biller Patient and Family Resource Center. “Palliative care is about interdisciplinary support to meet a patient’s medical, psychological, emotional, spiritual and social needs.”

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