Rethinking Palliative Care for Advanced Cancers

Palliative care is also called supportive care or comfort care. Discussing palliative care before you need to can be worrying. This is especially true if you connect palliative care with end-of-life or hospice care in your mind.^1,2

But palliative care has many benefits. And its uses are much wider than many realize. It can improve:^1,2

• Quality of life
• Coping skills
• Symptom management

By reframing the way we think and talk about palliative care, we can understand just how impactful it can be.

What is palliative care?

Palliative care is for those with serious health conditions, such as cancer. Its focus is on managing symptoms and providing support throughout a person’s health journey. Palliative care can include:^2,3

• Help with physical symptoms like pain or nausea
• Emotional, mental, and spiritual support to help you with coping
• Aid to caregivers
• Answers to questions and concerns about:
  • Finances
  • Insurance
  • Employment

Palliative care is connected to – but not the same as – hospice care. A person receiving hospice care often receives palliative care, but palliative care is not hospice. Hospice is typically used at the end of life when a person is no longer receiving treatment. On the other hand, palliative care can be used anytime during a serious illness. Active treatment and palliative care can occur at the same time.²

Because palliative care has scary associations, doctors and people with serious health conditions often put off talking about it. This can lead to delays in starting care and reduced quality of life. Spreading awareness of what palliative care is and the benefits it brings may help change the way it is used in the future.¹

Being ready for the rain

Many experts have weighed in on how we view palliative care. One interesting viewpoint comes from 2 Canadian doctors that use a metaphor to reframe our thinking. These doctors, Camilla Zimmermann and Jean Mathews compare the topic of palliative care to being prepared for rain.¹

Zimmermann and Mathews challenge people having these conversations to compare palliative care to having an umbrella on hand in case of a rainstorm. In the minds of many, palliative care is the rain. It is seen as a negative, alongside unpleasant symptoms and stress. But if we instead think of palliative care as the umbrella we carry with us just to be prepared, the story changes.¹

The doctors argue that life with advanced cancer is unpredictable, like sudden thunderstorms. New symptoms can arise out of the blue and create serious challenges at any time. Even if a person feels in control of their diagnosis 1 day, mental, physical, and emotional changes can occur the next. Not taking steps to be prepared during the good days can make the bad days even worse. But getting ready for the "rain" early on can help with navigating whatever life throws your way.¹

Carrying the umbrella

When we get stuck in the rain and do not have an umbrella, we get wet and uncomfortable. If someone offers you an umbrella after the rain has been pouring, it is not of much use. If anything, we will wish we had the umbrella sooner. When you think of palliative care as the umbrella rather than the rain, you can see how valuable it is to have on hand just in case.¹

Being prepared for the stress, symptoms, and complications in advance and having a plan in place makes it that much easier to navigate unexpected changes. Whether it is actively managing issues or simply knowing who to call when something new arises, thinking of palliative care as an umbrella makes us realize how helpful it can be to have it ready sooner rather than later.¹

Rain is not caused by carrying an umbrella

One thing Zimmermann and Mathews point out is that carrying an umbrella does not cause rain to fall. While umbrellas and rain are linked in our minds, 1 does not lead to the other. This is similar to palliative care and end of life. Although palliative care is most often used when a person is nearing death, it does not cause a person to die sooner. In many cases, it improves quality of life and sometimes may even extend survival.^1,4

By taking steps to prepare, we can best tackle whatever issues arise alongside life with advanced cancer. Just like carrying an umbrella in case of rain, using palliative care earlier rather than later can help prevent us from being caught off-guard and suffering more than we need to.