Listen to the Cancer.Net Podcast: Explaining Palliative Care, adapted from this content.

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

Palliative care is any form of treatment that concentrates on reducing a patient’s symptoms, improving quality of life, and supporting patients and their families. People with cancer often receive curative therapy (treatment to eliminate the disease) and treatment to ease symptoms at the same time.

Palliative care is given as early as possible in the cancer treatment process and continues through all stages of illness, regardless of whether a cure is the expected outcome. If you decide to stop disease-directed treatment, palliative care focuses on managing the symptoms caused by cancer.

Palliative care is given in a doctor’s office, hospital, cancer center, long-term care facility, or your home. Your doctor or a hospital social worker will help you find palliative care.

Purpose of palliative care

The goals of palliative care include:

• Treating distressing symptoms including pain, nausea, breathlessness, insomnia, and other physical symptoms caused by cancer or its treatment
  
  
• Treating a patient’s emotional and social needs, including symptoms such as anxiety or helping with difficult family relationships
  
  
• Addressing a patient's spiritual needs or concerns
  
  
• Addressing a patient's practical needs, such as transportation and financial concerns
  
  
• Providing support for the patient's family, friends, and caregivers

Children with cancer also receive palliative care. In these situations, parents usually work with the health care team to help their children manage symptoms so they are as comfortable as possible. Members of the family, including other children, may also receive counseling as part of the palliative care plan, to help cope with the situation.

Comparing palliative care and hospice care

Although you may hear these terms used in similar ways, they are slightly different. Palliative care is given at every step of the treatment process and at all stages, whereas hospice care is a form of palliative care given to people with cancer who are expected to live six months or less, regardless of their age or type of cancer. If a person needs to make the transition to hospice care, palliative care specialists will help with the transition to hospice care and address the physical and emotional issues that come with that choice. Learn more about hospice care.

Paying for palliative care

Palliative care is often covered by health insurance. Medicaid and Medicare may also pay depending on the situation. A hospital social worker can help you explore payment options.

The palliative care team

Several health care professionals may participate in your palliative care team, including:

Doctor. The doctor serves as the health care team leader, designs treatment plans and decides on medication and dosing. He or she will also consult with other doctors, such as a pain specialist or a radiation oncologist.

Nurse. The nurse gives direct care to the patient and helps manage pain and other symptoms. The nurse also acts as a liaison (main contact) with the rest of the health care team. For people in home hospice programs, nurses visit them at home several times a week and sometimes more than once a day. Learn more about the role of an oncology nurse.

Social worker. A social worker provides counseling, helps with financial issues, arranges family meetings, and helps with the discharge from the hospital to the person’s home or, if necessary, hospice care. Read more about how an oncology social worker can help.

Chaplain. A chaplain is a person often affiliated with a specific religion who is trained to listen to the patient and family members who have concerns or interests in discussing faith-related and spiritual matters, especially in the context of a serious illness.

Dietitian. A dietitian helps the patient and family members address any nutritional concerns, such as planning healthy meals, providing practical tips for nutritional supplements, and recommending specialized eating plans.

Physical and occupational therapists. A physical therapist helps the patient maintain movement and improve the ease of movement. A physical therapist can also address safety concerns in the home. Occupational therapists typically help with upper body mobility and daily tasks/functioning, while physical therapists specialize in overall mobility.

Grief and bereavement coordinator. This is a professional with social work or psychological training who counsels family members after a death occurs.

Learn more about members of the oncology team.

The role of communication

Communication is an important part of palliative care because it helps to clarify needs and expectations. It is important for patients and caregivers to understand the diagnosis and prognosis (chance of recovery) and to be a part of the medical decision-making process. Here are some practical tips to help promote good communication with the health care team:

• Don’t be afraid to ask questions of your doctors and nurses. The best palliative care is when patients and their families work together with the health care team. Find a list of questions to ask the doctor.
  
  
• Ask the doctor to explain the diagnosis, treatment plan, and prognosis. These may change over the course of your illness, so continue to have discussions with your doctor. Taking notes or bringing a family member or friend along may help you remember all of the information.
  
  
• Tell the doctors and nurses about any pain, discomfort, or other side effects, such as mouth sores, nausea, vomiting, and constipation you experience. Often there are many options for relieving these symptoms, but the doctors and nurses need to know you are in pain or discomfort in order to help you feel better. Learn more about managing side effects.

End-of-life considerations

For people diagnosed with advanced cancer (cancer that is not curable), the time will come when the treatment changes focus from disease-directed treatment to primarily palliative care. This is because curative treatment can no longer slow or stop the growth of cancer. Often, people with cancer and those who care about them find it painful to think about the possibility that the treatments won't cure the cancer. When making decisions about end-of-life treatment, it is important to know that this is a highly personal choice. Some people want to continue disease-directed treatment as long as possible, regardless of the difficult of treatment, while others want to focus on being comfortable and free from pain, even if that means stopping treatment. Because these decisions differ with each person, it is crucial for patients to think about what is most important to them and talk about it openly with the health care team and family members. Learn more about advanced cancer care planning.

These conversations may also let family members reaffirm love and promote a special closeness, which may help ease the pain of separation. A social worker or chaplain often helps the family talk about these issues. In addition, some palliative care services offer grief counseling to help friends and family members cope with loss. Learn more about end-of-life care and preparation at the end of life.

More Information

Advanced Cancer Care Planning booklet

Advance Directives

Coping

Additional Resources

Hospice Foundation of America

National Hospice and Palliative Care Organization

Center to Advance Palliative Care: GetPalliativeCare.org

MedlinePlus: Palliative Care