Palliative Care for Cancer
Though the two are often confused, palliative care is not the same as hospice care. While both provide care for people with serious illnesses, there are important differences between the two. Both are focused on maximizing comfort and quality of life.
Hospice care is time-limited, dedicated to patients with an incurable illness whose life expectancy is very limited (days, weeks or months) and who are no longer seeking life-extending treatment. Palliative care, on the other hand, can be appropriate for anyone with a chronic medical condition, such as cancer, renal failure, or congestive heart failure. The goal of this specialized type of medical care is to maximize quality of life and manage challenging symptoms for these patients while they continue to receive treatment for their chronic disease.
Palliative care is appropriate for patients with serious illness, at any age and at any stage. At Yale Cancer Center and Smilow Cancer Hospital's Palliative Care Program, support is provided by a team of Yale Medicine doctors and nurses who specialize in palliative medicine. This team works alongside a social worker, psychologist, art therapist, and chaplain. Each of these highly trained professionals provides patients with an extra layer of support (including pain management) throughout the course of their illness.
“We feel a deep sense of gratitude when we can make a meaningful impact in the lives of our patients and their loved ones,” says Dmitry Kozhevnikov, DO, director of outpatient palliative care at the Smilow Care Centers. “Our role is to support the oncologist, patient, and family, while helping to make each day the best it can be.”
What do palliative care doctors do for patients?
A serious disease can cause suffering in multiple ways. Palliative care specialists are experts in evaluating and treating the physical, emotional, and spiritual distress that patients may experience at any point of their illness, Dr. Kozhevnikov says.
As part of the evaluation, a palliative care expert will learn about the patients’ goals and deliver the care they need in order to reach them, explains Dr. Kozhevnikov. An example he gives is helping a father manage his cancer pain and nausea so he is able to return to work and his favorite hobbies.
Here are some ways palliative medicine doctors may help patients along the treatment journey:
- Prescribe medications to relieve pain
- Help patients cope with the stress and worry associated with their disease
- Facilitate difficult conversations about prognosis between the oncologist and patient and his or her family
- Provide patients access to psycho-social support, which may include art therapy, psychological help or support groups
- Help patients access services to alleviate financial worries
- Assist patients who want spiritual support
- Make physical therapy and exercise recommendations
- Help patients make a transition to hospice, if and when needed
When does palliative care start?
Palliative care can begin as soon as a patient is diagnosed with a serious illness. The goal is to help the patient and family along the treatment journey to decrease pain, depression, stress and worry. Research has shown that having this support from the time of diagnosis can help people live longer and better.
What’s the difference between palliative care and hospice?
Both provide physical, emotional, and psychological comfort to patients and families to improve quality of life. The main difference is that palliative care can start any time after diagnosis and will continue throughout treatment. In contrast, hospice care is focused on end-of-life care when people are no longer receiving curative treatment.
What other benefits are there to receiving palliative care?
Palliative medicine can help families who are struggling with a loved one’s disease. A palliative medicine doctor can provide referrals to services such as support groups (like Smilow’s Parenting at a Challenging Time, PACT). The palliative medicine doctor keeps the patients’ goals in mind and helps them make treatment and care decisions in line with those personal goals.
How do you receive palliative care services?
A medical oncologist will make a referral based on a patient’s physical and emotional needs. These services are generally covered by private insurance companies, Medicare, and Medicaid.
Where do palliative care services take place?
These services are available at Smilow Cancer Hospital and at Smilow Cancer Hospital Care Centers. People may also receive palliative care services at home or at a long-term care facility.
What is Smilow Cancer Hospital’s approach to palliative care?
Our palliative medicine doctors are part of a multidisciplinary care team that includes nurses, psychologists, physical therapists, an art therapist, and a chaplain. We care for the whole patient, not just the disease. We provide support every step of the way throughout a patient’s illness, keeping the individual’s goals top of mind.