When a doctor walks into the room and says the word “cancer,” everything changes. The entire focus of a person’s life shifts to dealing with the new diagnosis.
But dealing with cancer isn’t just about treatment options and medical visits. Cancer patients can experience side effects from treatments, financial worries and emotional overwhelm as they try to cope.
The good news is when a senior is diagnosed with cancer, they don’t have to face all these issues alone. Palliative care is designed to help with all of them.
What is palliative care?
Palliative care grew out of hospice care, which may be why many people confuse them, said Dr. John Mulder, MD, a palliative care doctor and chief medical consultant for hospice and palliative care at Michigan-based Holland Home.
“Because we grew out of the hospice industry, it’s pretty natural for us to be seen as palliative practitioners within that realm,” he said. “Part of our focus is always going to be to try to help people understand what it is that we do and why we do it and how it’s different from hospice. They’re still certainly related.”
Hospice care is a type of palliative care, but it’s only an option when a cancer patient is no longer actively treating their cancer and they generally have less than six months to live. The focus of hospice care is on creating the highest quality of life possible for the patient’s remaining days while managing pain and other physical manifestations of the cancer.
Palliative care is also focused on quality of life, but it’s available to cancer patients in active treatment for their cancer. While an oncologist is concerned mainly with treating a patient’s cancer, the palliative care team’s focus is on the whole person.
Palliative care provides options for reducing pain and other symptoms caused by a cancer patient’s treatment as well as helping with any mental or practical issues that arise.
Palliative care provides options for reducing pain and other symptoms caused by a cancer patient’s treatment as well as helping with any mental or practical issues that arise.
“In an ideal world, palliative care starts with diagnosis,” Mulder said. “The illness brings with it physical and existential burdens that need to be managed.”
In fact, palliative care is an option from the moment a senior receives a cancer diagnosis and at any time during their treatment.
What types of palliative care are available to cancer patients?
The type of palliative care a senior cancer patient might need depends greatly on the seriousness of the diagnosis and their current living situation. Seniors who live on their own may need access to more services than someone who lives with family or in an assisted living situation.
“We have two broad domains: helping people to strategically plan for how to live with whatever is ailing them and complex symptom management so they can live as completely and functionally and meaningfully as they can,” Mulder said. “We want them to live well.”
Some areas where palliative care can help include:
Physical care
Physical palliative care focuses on mitigating the physical effects of both the cancer itself and any treatments for the disease. The palliative care team focuses on relieving pain, nausea and other physical symptoms that can impact quality of life.
Mental health care
The mental toll on both cancer patients and their caregivers can be immense. Palliative care teams often work with both caregivers and cancer patients to provide access to mental health professionals who can address issues like depression, anxiety and fear through counseling and support groups.
Practical care
Even though it seems like the world stops with a cancer diagnosis, life does go on. Cancer can create financial difficulties through loss of employment or lack of insurance. Transportation issues and legal concerns are often part of dealing with cancer. Palliative care teams can help cancer patients and their caregivers find resources and help to deal with the practical concerns of everyday living that may be affected by cancer.
Spiritual care
If spiritual concerns are on the minds of senior cancer patients or their caregivers, palliative care teams can connect you with spiritual help through chaplains or local places of worship.
What are the benefits of palliative care?
Palliative care not only helps cancer patients deal with the symptoms of their treatment, it also helps them plan for what’s ahead and to make decisions based on their own values.
“There are two main benefits,” Mulder said. “The first one is the obvious one—that’s the symptom management side. How can we help people manage the travails of the treatment?”
Sometimes that symptom management can stabilize cancer patients enough for them to continue lifesaving treatment that might not otherwise be possible.
The second benefit is less tangible but still important.
“It’s the existential part,” Mulder said. “I don’t want people to be defined by their illness. What is sacred to you? What is meaningful to you? How can we make sure the plan of care is resonant with what is important to you?”
Mulder shared a story of a man with a recurring – and incurable – brain tumor. The side effects of treatment had left him unable to do much while undergoing therapy.
When Mulder asked what was important to him, the man replied that his daughter was getting married, and he wanted to walk her down the aisle and dance at her wedding.
With the palliative care team’s counsel and help, he chose not to undergo the debilitating treatment and was able to set his walker aside long enough to walk his daughter down the aisle and dance at her wedding.
He died three days later, but with the help of the palliative care team, his care plan had been tailored to achieve what was most important to him.
“That’s how I see palliative care with cancer care,” Mulder said. “Making sure the plan of care resonates with the patient’s values.”
Does palliative care improve survival?
Studies have shown that palliative care improves quality of life for cancer patients, but the jury is still out on whether it improves survival outcomes for all cancers.
Some studies have suggested that the early introduction of palliative care can lengthen survival times, especially in patients with a certain type of lung cancer. However, those outcomes may be dependent on the type of cancer, with certain types gaining more benefit from palliative care.
Even if palliative care itself doesn’t lengthen survival time for a cancer patient, the improved quality of life makes fighting cancer just a little bit easier.
How do I find palliative care for my senior?
Ask the senior’s doctor if the health care organization has a palliative care team. Many oncology departments have palliative care professionals integrated into their cancer care teams.
You can also contact organizations including the Center to Advance Palliative Care and the National Hospice and Palliative Care Organization, which have searchable provider directories.
A Google search for palliative care in your city can also be helpful. Calling a local hospice and asking if they can give you the contact information for a palliative care provider is also an option.
A cancer diagnosis can be overwhelming, but knowing your options when it comes to getting help through palliative care can help make a difficult time a little bit easier.
