• Cancer

Comfort for Advanced Cancer Patients: Palliative Care and Hospice

A diagnosis of advanced cancer – with little chance for a cure – can place a severe strain on you and your family. However, even when a cure is not likely, you have several care options to help you address physical, emotional, spiritual and practical needs of everyday living. 

A type of care that focuses on making you more comfortable, at all stages of treatment, is called palliative care. Palliative care focuses on managing pain and other symptoms – rather than providing a cure – so you can enjoy life more fully. 

Hospice care is a type of palliative care generally reserved for the last months of life. Hospice is used when curative treatments are not working and you are expected to live about six months or less.

The options of palliative care and hospice care become more important as prolonging life becomes less of a focus and living the highest quality of life each day becomes your priority.

Benefits of Palliative Care

Palliative care, often called comfort care, focuses on the symptoms and effects of both cancer and cancer treatment. There are doctors who specialize in palliative care, and your primary care and cancer doctors may also have ideas about what you can do for your physical, emotional and spiritual well-being. 

You can receive this type of care throughout your cancer treatment and even when you stop receiving treatment. With palliative care, you can expect to receive help and support with the following issues:

• Managing physical symptoms, such as pain, nausea, vomiting, fatigue, shortness of breath and insomnia

• Dealing with emotions of fear, depression and anxiety
• Helping family members cope with caregiving responsibilities and keeping their own lives balanced
• Providing support and resources for financial, legal, insurance and end-of-life concerns

Private insurance, Medicare and Medicaid all provide some coverage for palliative care services. Check your plan to learn what is covered.

Palliative care focuses on managing pain and other symptoms – rather than providing a cure – so you can enjoy life more fully.

When to Contact Hospice

Hospice care generally is reserved for the last six months of life – to improve the quality of your time with family and friends once curative treatment stops. 

You may find it difficult to end disease-focused treatment, even if you have received multiple types of treatment that have not stopped the growth or spread of your cancer. To help you decide if it is time to start hospice, ask your doctor to clearly explain the chance that treatment will help you feel better or live longer.

Choosing hospice doesn’t mean that you or your family is giving up hope. Instead, hospice care focuses on you as a whole person, helping you take steps to live as comfortably and as fully as possible.

And be aware that you can leave hospice at any time to return to active cancer treatment.

Hospice care typically provides care administered by a team of doctors, nurses, aides, social workers, chaplains, therapists and family. Hospice care includes:

• Symptom control for pain, nausea and other side effects of cancer and its treatment. This includes medicines that balance making you feel better with keeping you alert to life around you.
• Medical equipment, such as a hospital bed or wheelchair, to make you more comfortable
• Home care, surrounded by family and friends. If your caregivers are unable to keep you at home, hospice care also can be provided in a hospital, a long-term care facility or an inpatient hospice center
• Spiritual care, giving you the opportunity to discuss death and religious beliefs, as well as plan or discuss a ritual or ceremony
• Care coordination of all members of your care team, seven days a week, 24 hours a day

If your family needs a break from caregiving, hospice provides respite care in an inpatient facility or inpatient hospice center. Caregivers can receive a much-needed break or take time out for an important event or trip. 

The hospice team often provides bereavement care after a hospice patient dies, helping family through the grieving process, often for up to a year.

Most insurance plans, including Medicare, cover hospice care if your doctor determines your life expectancy to be six months or less. You or your health care power of attorney must agree for you to receive hospice care. 

Source: American Cancer Society; National Cancer Institute; Choosing Wisely; American Society of Clinical Oncology