Why cancer patients who receive palliative care along with their cancer treatments live longer.
Transcription
I’m Carolyn Lefkowits; I’m an assistant professor here at the University of Colorado Gynecologic Oncology in the department of OB-GYN and I have a joint appointment in internal medicine and palliative care.
When I was a resident and thinking about going into GYN oncology, I was struck by how the care of a woman with gynecologic cancer seems to be about much more than purely treating the cancer. I felt like I wanted to know more about the other elements of caring for a woman and her family affected by gynecologic cancer: treating the symptoms that come with cancer and its treatment and making sure that quality of life is the best that it can be during treatment and beyond.
3 aspects of our palliative care
The way that I often explain it to patients is that your oncology team is going to be focusing on primarily treating the cancer. And what palliative care brings is dedicated attention to everything that comes with that. That may be:
- Side effects from the treatment
- Symptoms of the cancer itself
- The emotional weight on a woman and her family, friends and support network from having a cancer diagnosis.
Palliative care also helps with decision making at branch-points in care. We make sure that we really spend the time and energy to know a woman as an individual: what her goals and values are, what her priorities are, so that when we have decisions to make in her cancer treatment, we can match those as best as possible to who she and her family are and what’s most important to them.
Patients with OB-GYN cancers get their care here at the University and, in addition to the symptom management and support provided by the oncology team, have access to a dedicated specialty palliative care team in the outpatient center, the cancer center and in the hospital. That is an interdisciplinary team with dedicated training in palliative care that includes a physician, sometimes a nurse practitioner, nurses, social work and chaplaincy. It’s a dedicated team designed to really focus on symptom management, quality of life and emotional and spiritual support.
The similarity of hospice and palliative care is a focus on quality and comfort. But the difference is that, unlike hospice, palliative care can be delivered right alongside treatment for the cancer itself. While we are planning a big surgery, while a woman is getting chemotherapy, in the middle of radiation, palliative care can be an “and” not an “or.”
Clearing up misconceptions about palliative care
An unfortunate misconception that we run into sometimes about palliative care is the worry that, if we include palliative care, it will somehow be at the expense of the aggressiveness or the quality of the cancer treatment. Patients worry that we won’t be as aggressive with treatment of the cancer if we are worried too much about how comfortable they are or treating their symptoms.
But in fact, the research studies would suggest that, if anything, patients who are getting good attention to their symptoms and are getting regular palliative care live longer than patients who are not.
We know that the introduction of palliative care improves symptom management, improves quality of life and improves patient and family satisfaction with their care. So clinically, patients who have routine palliative care along with their cancer therapy actually do better.