6 things to know about palliative care and cancer treatment

Ever since Robin Birthisel was diagnosed with a slow-growing type of multiple myeloma 10 years ago, she’s experienced unpleasant side effects caused not only by the cancer itself, but also by the drugs used to treat it.

“I’ve had fatigue, nausea and vomiting, bone and joint pain, and numbness and pain in my hands and feet,” says Robin, 55.

Chemotherapy put the cancer into remission, but Robin’s symptoms persisted.

“Sometimes I was too uncomfortable to cook, clean, take out the trash, and do other daily chores around the house,” she says. “You don’t realize how much you value your independence until you lose it.”

Robin’s oncologist, Robert Orlowski, M.D., suggested she might benefit from palliative care – a branch of medicine that helps patients deal with the physical and emotional symptoms caused by cancer.

“A cancer diagnosis is nothing short of life-altering,” says palliative care specialist Ishwaria Subbiah, M.D. “Our goal is to deliver comprehensive care that provides not only relief from pain and symptoms, but also spiritual and psychosocial support.”

Personalized cancer symptom management

Palliative care, sometimes called “supportive care,” provides an extra layer of support that complements the care provided by oncologists.

“Think of it this way,” Subbiah suggests. “The oncologist manages the cancer. The palliative care team manages its side effects.”

At MD Anderson, outpatients receive palliative care in the Supportive Care Center, while inpatients can opt to receive palliative care in their hospital rooms.

Palliative care providers engage each new patient in an extensive dialogue to identify their needs. From that initial visit, a palliative care team is assembled to address their specific requirements.

“A patient may initially be referred to us for cancer pain. But during that first visit, we may discover that the patient will benefit from a multidisciplinary plan that addresses not only pain, but also appetite loss, anxiety, insomnia, spiritual distress, fatigue, and any other symptoms that are discussed during our conversation,” Subbiah says. “Every patient is different.”

Following her first appointment in the Supportive Care Center, Robin was referred to a nutritionist, a pain specialist, and senior counselor Thomas Hernandez Jr., who helped her establish goals for regaining some independence.

“Palliative care emphasizes the patient’s needs, not the disease,” says Hernandez. “We focus on quality of life.”

Palliative care and hospice care aren’t the same

Studies have shown that palliative care improves quality of life, reduces depression, and improves satisfaction with care. Yet some people are reluctant to consider it because they think the word “palliative” is synonymous with hospice.

“They associate palliative care with giving up. That’s a common misperception,” Subbiah says.

But while hospice care is tailored to patients whose life expectancy is generally six months or less, comprehensive symptom management with an MD Anderson palliative care team is available to patients with any stage of cancer, at any point during their illness. Even newly diagnosed patients can benefit.

Subbiah offers these six things patients, families and health care providers should know about palliative care.

1.      Early intervention means better results

Palliative care can begin as soon as you are ready and willing to accept it. You don’t have to wait for your disease to progress to a certain point; you can start receiving care the moment you feel you need it. In fact, studies have shown that patients do better and have less ICU and emergency room visits when they seek palliative care early.

2.      Palliative care is available for any stage or age

Palliative care is appropriate for all patients with serious illness regardless of age, prognosis, disease stage, or treatment choice. From infants to the elderly, from the newly diagnosed to the critically ill, palliative care can help you find relief from symptoms during treatment.

3.      Your desires come first

Palliative care specialists help you define what’s most important to you. Let’s say, for example, your passion is painting. You’ll want your pain and other symptoms managed so you can continue to paint while dealing with your illness. If your doctors know how you want to live your life, they can guide your cancer care to best support your goals.

4.       Palliative care addresses a patient’s total pain

Studies have shown that psychological pain can cause physical symptoms. Palliative care uses a holistic approach to address not only physical, but also emotional, pain and distress. You may develop anxiety and be afraid your treatment won’t work. Or you may worry about cancer’s effects on your marriage, children and finances. You may even question why God is letting you suffer. Psychologists, counselors and clergy are part of the team, and can help. Palliative care address “pain expression” a medical term that means “the sum of all that’s hurting.”

5.       Palliative care helps your family

Your family members may become stressed and overwhelmed. The palliative care team can provide them with emotional support and tools they can use to help you during treatment. Family members and anyone in your support system are welcome to participate in your appointments. You can even request to involve them in decisions about your care. To protect our cancer patients and their families from COVID-19, the Supportive Care Center is currently conducting most visits through video conferencing. This allows family members to participate from anywhere in the world.

6.       It helps your oncologist, too

The palliative care team works in partnership with your own oncologist to provide an extra layer of support. Team members relay vital information to your doctor about how you’re handling side effects of prescribed treatments. If you’re participating in a clinical trial, the palliative care team communicates with clinical trial staff to ensure your palliative care doesn’t interfere with the trial’s treatment regimen.

“The bottom line,” Subbiah says, “is we’re improving quality of life for our patients. We’re here to stand with them as they cope with their diagnosis and manage their symptoms, so they can focus on the future.”

Request an appointment at MD Anderson online or by calling 1-877-632-6789.