A cancer diagnosis can be overwhelming — physically and emotionally. A common stressor is the unfamiliar terminology you might hear from your doctor, or read in a diagnostic report or treatment plan from your medical team. One easily misunderstood term you may be confronted with during your skin cancer journey is “palliative care.” What does this kind of health care look like, and who is it for?
Basically, palliative care is an approach to improving a patient’s quality of life, regardless of the stage of their illness. It is often confused with hospice care, which is specifically for people with late-stage illness (more on that, below).
“Palliative care is focused on providing relief from the symptoms and stress of an illness,” says Laura Gelfman, MD, associate professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai in New York City. “It is based on the needs of the patient, not on the patient’s prognosis.”
A multidisciplinary team of doctors, nurses and specialists work together to provide an extra layer of support during treatment, Dr. Gelfman explains. Recent guidelines by the National Coalition for Hospice and Palliative Care say this care should be incorporated early in a patient’s treatment plan. People who are newly diagnosed with an advanced cancer should receive a palliative care consult within eight weeks of their diagnosis. Dr. Gelfman says that patients may need to be proactive to speak up and ask their doctor for a palliative care referral to get these services.
If you are the patient, during a consultation the palliative care team will spend time with you and your family to assess your symptoms, discuss your treatment options and learn about your lifestyle and goals. You may wonder if another layer of care may mean higher costs, but Dr. Gelfman says that doesn’t have to be the case.
“Palliative care can be covered under private insurance plans, as well as Medicare and Medicaid,” says Dr. Gelfman. “Plans can cover palliative care services in the hospital, in rehabilitation and in skilled nursing or hospice facilities. Sometimes, palliative care will be called something different in your benefits, so it’s important to ask your insurance representative for clarification if you’re unsure.”
What Does Palliative Care Entail?
Dr. Gelfman says if you’re receiving palliative care, you should expect both an increased level of control over your treatment and physical relief from symptoms like pain, shortness of breath, fatigue, nausea and difficulty sleeping, among others.
“Palliative care will help you carry on with daily life,” says Dr. Gelfman. “It will improve your ability to go through treatments, and it will help you match your goals to your treatment choices.”
Some aspects of care might include nutritional advice, relaxation techniques and treatment for stress or depression. Specialists can also lend a hand with parsing the pros and cons of treatments and understanding what programs or resources might be available for different treatment challenges. They can also help you work through insurance or payment questions.
This supportive care also extends to a patient’s family and caregivers, notes Dr. Gelfman. The goal, she says, is to improve quality of life for everyone involved in the treatment process. The palliative care team will be with you for as long as you need them, which will be different for everyone. Some patients may only need one or two visits with the palliative care team; others may continue care for the duration of their treatment, both in a hospital and outpatient setting.
How Does Palliative Care Differ from Hospice Care?
One common misconception is that receiving palliative care is the same as hospice care, or that receiving this type of care means a patient’s prognosis isn’t good. Dr. Gelfman says this isn’t necessarily true, and that hospice care is a specific subtype of palliative care.
“Hospice care focuses not on a cure, but on ensuring a patient receives expert symptom control and support at the end of life,” she says. “Palliative care is offered alongside curative treatment.”
There may be many moments of doubt or confusion during cancer treatment. Patients should rest assured, however, that a palliative care plan will be in their best interest while navigating an advanced cancer diagnosis. Whether you or a loved one are dealing with uncomfortable symptoms, uncertainty regarding a treatment plan or simply stress stemming from the situation, a palliative care team can help determine how to get things back on track.