What is Palliative Care
Palliative care is a fundamental part of integrated, patient-focused healthcare services. Nothing is more patient-centered than relieving their suffering, be it physical, psychological, social, or spiritual.
Therefore, regardless of the cause of suffering – whether it is cancer, organ failure, severe burns, terminal chronic illness, prematurity, or age-related frailty – palliative care, or supportive care as it can also be called, may be necessary and should be integrated into treatment.
Quality of Life through Palliative Care
This approach improves the quality of life of the patient and those close to them, who face the issues associated with the illness together; it prevents and alleviates suffering through early identification, correct assessment, and treatment of pain and other problems.
The investigations necessary for a better understanding and choice of approaches to care for complications and stressful symptoms related to treatment and disease progression should be part of palliative care.
A curiosity: the term “palliative” derives from the Latin pallium, which means “protective cloak,” and palliare means “to protect, to welcome, to support.” Protecting someone is a form of care. In patients with advanced cancer, where some types of treatments are fundamental for symptom control, palliative care is very important.
Principles of Palliative Care
It is necessary to demystify the idea that palliative care in oncology is only adopted when there is no longer any possibility of treatment and the individual is in the terminal phase. Its main objective, in reality, is to promote the quality of life of patients and the people in their support network through prevention and relief of suffering at any stage of the disease.
Its principles are:
- Promote relief from pain and other distressing symptoms, such as asthenia, anorexia, dyspnea, and other oncological emergencies;
- Affirm life and recognize death as a natural process;
- Neither hasten nor postpone death;
- Integrate psychological and spiritual aspects as part of patient care;
- Offer a support system to help the patient live as actively as possible until death;
- Offer a support system to help family and friends cope with the patient’s illness in their own environment; and
- Use an interdisciplinary approach to address the clinical and psychosocial needs of patients and their support network, including counseling and bereavement support.
When should palliative care be initiated in cancer patients
Palliative care in oncology should be initiated as early as possible in cancer patients. It can be associated with treatment aimed at curing the disease, playing an important role in helping manage symptoms that are difficult to control and improving the patient’s clinical condition.
It is crucial to understand that patients with a disease like cancer do not have to choose between the medical team treating their disease (such as oncologists and hematologists) and the palliative care team. Patients with advanced oncological diseases or those undergoing cancer treatment with difficult-to-control symptoms benefit from receiving this joint care.
Care is provided in an integrated manner, with the entire medical and multidisciplinary team playing extremely important roles. Palliative care physicians, nurses, social workers, pharmacists, physiotherapists, occupational therapists, psychologists, nutritionists, speech therapists, and spiritual care providers work together to achieve the best conditions for the patient and their support network.
As the disease progresses, even when treatment with curative intent is ongoing, the palliative approach should be expanded to include psychological, social, and spiritual aspects. In the terminal phase, when the patient has little time left, palliative treatment continues and is done to ensure the patient’s quality of life, comfort, and dignity.
Which oncology patients should be referred to palliative care
In the oncology setting, the American Society of Clinical Oncology (ASCO) established in 2017 which patients should be under the care of palliative care. They are:
Oncology patients in advanced stage (with metastases); and
People undergoing cancer treatment with difficult-to-control symptoms at any stage of the disease.
Patients with advanced or refractory hematologic neoplasms and those with a high symptom burden and/or biopsychosocial needs also benefit from this approach.
What are the benefits of palliative care in oncology
The follow-up by the palliative care team brings various benefits, such as:
- Improved symptom control;
- Comprehensive care for the patient and their family;
- Valuing the patient’s autonomy, always respecting their values and priorities;
- Individualized care planning, according to the physical, social, familial, emotional, and spiritual needs and context of each patient;
- Humanized approach and prevention of stress for those involved in patient care; and
- Support from a transdisciplinary team during the illness and treatment period.
At Grupo Oncoclínicas, the palliative care program is called the Continuous Care team. Please inquire whether this service is offered at your unit.
