Do you know how palliative medicine helps patients? The misconception is that palliative care is designed to provide comfort and pain control to people at the end of their lives.
“Very commonly, we get patients and families who are a little bit intimidated by us as palliative physicians because they mistakenly confuse us as being the same as hospice,” said Stefanie N. Mooney, M.D., an assistant clinical professor in the Department of Supportive Care Medicine, Division of Clinical Supportive Care at City of Hope.
In fact, palliative care can help patients at any stage of cancer treatment, regardless of their diagnosis or prognosis, Mooney said. “We can help guide patients throughout their process from diagnosis through their treatment and hopefully through recovery and survivorship as well.”
If you or a loved one is being treated for cancer, here’s what you should know about palliative care.
The goal of palliative care is to help patients manage symptoms such as pain, shortness of breath, nausea and the emotional impacts of a serious illness.
Palliative care is really designed for any patient at any stage of their illness that is suffering from symptoms,” Mooney said.
Palliative care specialists begin by doing a thorough assessment of symptoms that a patient is dealing with. Pain is common in people being treated for cancer, either as a result of the disease itself or as a side effect of treatments. But other symptoms can also affect quality of life, including nausea, constipation and loss of appetite.
Specialists such as Mooney can suggest methods to alleviate those symptoms, including medications, exercises or diet changes. Managing those symptoms can help people complete their treatments successfully.
Emotional support and values
Palliative care specialists can help with the emotional fallout of cancer treatment, too. “Often we find that a symptom on the physical side doesn’t exist without a symptom on the emotional side as well,” Mooney said.
For example, someone who is dealing with depression might have more trouble managing physical symptoms. Palliative care specialists work closely with psychiatrists, psychologists and social workers to help address those emotional issues as well.
Specialists in supportive care make a point to understand what’s important to patients, and often involve family members in that process, Mooney said. “In palliative care, we’re trained to really try to seek out the values that a patient and their family has. Oftentimes, we get caught up in just what’s the next step in a patient’s care, but we tend to take a step back and really look at the big picture, what matters in a person’s life and how can we best recommend a path in their care that is most aligned with their values.”
Making it happen
City of Hope’s palliative care specialists see patients in the hospital and in the outpatient clinic. Unfortunately, services are not always fully covered by insurance – but that shouldn’t stop anyone who is struggling with cancer care from reaching out to see whether palliative care might be an option, Mooney said.
“In spite of the fact that it is somewhat challenging to get fully reimbursed for our time and our services, we believe that it’s something that is so important that we find a way to make it happen,” she added. “If [you] have a serious illness and have symptoms that need managing, we can be there.”
Many of the dying don’t fear death as much as they fear how they will die. “It’s the in-between part people fear the most. If you can give them insight on what to expect, that can ease a lot of their concerns,” says City of Hope palliative care physician Heather Bitar, D.O.
Diagnosed with an aggressive form of leukemia, Jessica Appel knew that her time was running out. Still, her story has a bittersweet ending, thanks to the many City of Hope employees on her care team who did everything they could to allow her to pass away on her own terms.