Caring for the Symptoms of Cancer and its Treatment

Approved by the Cancer.Net Editorial Board, 08/2015

Listen to the Cancer.Net Podcast: Caring for the Symptoms of Cancer and its Treatment, adapted from this content.

Watch the Cancer.Net Video: What is Palliative Care?, adapted from this content

Cancer and its treatment may cause many symptoms and side effects. Symptoms and side effects may be a source of stress for patients and their families. Besides treating the underlying cancer, the health care team will also manage cancer symptoms and the side effects of treatment. This approach is called palliative or supportive care.

Understanding palliative care

Palliative care is any treatment that focuses on preventing and managing the symptoms of cancer and side effects of treatment. It also provides comprehensive support to people living with cancer and their families. Any person, regardless of age or type and stage of cancer, may receive palliative care.

People should receive treatment for the cancer and treatment to ease side effects at the same time. When side effects and other challenges of treatment are well managed, people have better quality of life and report they are more satisfied with treatment.

Palliative treatments often include medication, nutritional changes, relaxation techniques, spiritual support, emotional support, and other therapies. You may also receive palliative treatments similar to those used to eliminate the cancer, such as chemotherapy, surgery, or radiation therapy. For example, when radiation therapy helps control pain, it is considered a palliative treatment. That is why it is important to understand the goals of each treatment in your care plan.

Children with cancer should also receive palliative care. Parents usually work with the health care team to manage symptoms so their children are as comfortable as possible starting from diagnosis. Family members, including siblings, may receive counseling as part of palliative care to better cope with the child’s diagnosis.

Goals of palliative care

The goals of palliative care include:

  • Treating symptoms, including pain, nausea, breathlessness, insomnia, and other physical issues caused by cancer or its treatment

  • Managing emotional and social needs, including anxiety, depression, and relationship issues

  • Addressing spiritual needs or concerns

  • Addressing practical needs, such as transportation and financial concerns

  • Providing support for family, friends, and caregivers

Difference between palliative care and hospice care

Although you may hear “palliative care” and “hospice care” used in similar ways, they are not the same. Palliative care is given at every step of the treatment process. It provides an extra layer of support for people with any stage of cancer. Hospice care is a specific type of palliative care. It is only provided to people with cancer who are expected to live six months or less.

If you have advanced cancer, your doctor may suggest treatments to improve symptoms or treatments directed at the cancer.  If you choose to stop disease-directed treatment, this does not mean you have stopped “fighting” the disease. It also does not mean your health care team has given up. Instead, the focus may be on relieving burdensome symptoms and allowing for additional support in all areas of your life.

When a person decides to begin hospice care, a member of the palliative care team helps with the transition. He or she can also help address the physical and emotional issues that come with that choice. Learn more about hospice care.

When and where palliative care is given

Ideally, palliative care should start at diagnosis. It should then continue throughout all stages of the disease.

You may receive palliative care in a doctor’s office, hospital, cancer center, long-term care facility, or your home. The location depends on the treatments that have been recommended and the available resources. Talk with your doctor, nurse, or oncology social worker about your options.

The palliative care team

A number of people may make up your palliative care team, including:

  • Oncologist. An oncologist is a doctor who specializes in treating cancer. Usually, your oncologist will serve as the leader of your health care team. He or she is in charge of designing your treatment plan and deciding on medication and dosing. Your oncologist may consult with other health care professionals, such as a palliative medicine physician or pain specialist, to create your palliative care plan.

  • Palliative medicine physician. This is a doctor who specializes in hospice and palliative care. He or she works with the health care team to relieve symptoms and side effects. A palliative medicine physician will also talk with patients to align treatment to his or her goals and values.

  • Nurses. The nurses on your team help manage pain and other symptoms. They also act as the main contact for the rest of your health care team. If you receive palliative care at home, nurses may visit you regularly to ensure you receive the care you need.

  • Social workers. A social worker provides counseling for you and your family and arranges family meetings. A social worker may also help with practical issues like transportation and can connect you with local resources. Social workers also help with discharge from the hospital and finding in-home help, or, if necessary, hospice care.

  • Pain specialist. Pain specialists, or pain medicine doctors, are experts at finding the cause of pain and treating it. They may prescribe medication, recommend a rehabilitation program, and/or perform pain-relieving procedures. An oncologist or palliative medicine physician may be able to control your pain without referring you to a pain specialist.

  • Chaplain. A chaplain is usually affiliated with a specific religion. He or she is trained to listen to patients’ and family members’ concerns, especially about death and dying. Chaplains are also available to discuss other faith-related and spiritual matters.

  • Dietitian. A dietitian can help address nutritional challenges, such as nausea or appetite loss. Dietitians may also provide advice about nutritional supplements and help create specialized eating plans

  • Physical and occupational therapists. A physical therapist helps maintain mobility and improve how well a person moves. Physical therapists also develop exercise programs to maintain or improve physical strength during and after treatment. Occupational therapists typically focus on daily tasks and functioning, especially upper body movement.

  • Child life specialists. These trained professionals specialize in helping children and their families understand a child’s serious illness. They also assist siblings through the experience.

  • Volunteers. Many palliative care programs have trained volunteers that visit with patients who want companionship and emotional support. Volunteers often perform simple tasks, such as reading out loud or writing notes, or can simply sit and talk.

  • Grief and bereavement coordinator. A grief coordinator counsels family members who are facing or have suffered the loss of a loved one. They have specialized training in social work or psychology. Learn more about grief and loss.

Paying for palliative care

Palliative care is often covered by individual health insurance plans. Medicaid and Medicare may also pay depending on the situation. A hospital social worker can help you explore payment options. Learn more about managing the cost of cancer care.

Talking about palliative care

An important part of palliative care is talking about your diagnosis, treatment, and needs. These conversations help clarify your goals and expectations. The best palliative care occurs when patients and their families work together with the health care team.

Here are some practical tips to help promote good communication with your health care team:

  • Ask the doctor to explain your diagnosis, treatment plan, and prognosis. Prognosis is the chance of recovery. These may change over time, so continue to have open, honest discussions with your doctor. Taking notes or bringing a family member or friend along may help you remember more of the information.

  • Ask your health care team to explain if you don’t understand an explanation, description, or unfamiliar medical word.

  • Tell the doctors and nurses about any pain, discomfort, or other side effects, even if you feel they are not serious. Often there are many options for relieving symptoms. However, the health care team needs to know about them to help you feel better.

  • Keep track of your symptoms and side effects. Write down what they are, how often they occur, and how severe they are. This will help the doctor identify the cause and find solutions.

  • Don’t be afraid to ask questions. You may want to write your questions down before appointments. It is important to ask about your social, emotional, functional, and spiritual needs, as well as questions about your health. Here is a basic list of questions to ask the doctor to help you get started.

  • Talk with your doctor about the palliative care services available to you. You may want to ask to be referred to a palliative care specialist. Oncologists typically welcome the support and information palliative care specialists provide.

More Information

Palliative Care

ASCO Recommends Palliative Care as a Part of Cancer Treatment

Managing Side Effects

Coping and Emotions

Additional Resources

American Academy of Hospice and Palliative Medicine

Center to Advance Palliative Care:

Hospice and Palliative Nurses Association

National Hospice and Palliative Care Organization: CaringInfo

National Institute of Nursing Research: Palliative Care’s Many Benefits