Progress on palliative care education and adoption in cancer centers has been slow, but an expert from The University of Texas MD Anderson Cancer Center says studies show that it can improve cancer outcomes.
The National Comprehensive Cancer Network states that palliative care can — and should — begin at the point of diagnosis for patients with cancer. Often confused with hospice, or end-of-life-care, palliative care focuses on managing distressing symptoms, from psychosocial issues to side effects, and can be used regardless of a patient’s cancer stage or prognosis.
Despite the well-documented advantages of palliative care, it is still underutilized in cancer centers around the United States (U.S.), according to recent study results published in Cancer.
“Patients are living longer with better therapeutics, so there are a lot of people who are doing pretty well, but they have a lot of distress and side effects from treatment,” said study author Dr. David Hui, an associate professor in the department of palliative care and rehabilitation at The University of Texas MD Anderson Cancer Center, in an interview with CURE®.
Hui and his colleagues analyzed palliative care educational programs for health care providers at 52 National Cancer Institute (NCI)-designated cancer centers and 27 non-designated cancer centers across the U.S. The team also looked at changes in palliative care education and research between 2009 and 2018.
Ultimately, they found that NCI-designated cancer centers were far more likely to have palliative care fellowships, training programs and research for palliative care. Across the board, changes and improvements in palliative care programs were slow at best.
“The take home message, I think is that the glass is half full and half empty,” Hui said. “There has been some progress, but in my mind, I feel that it’s still inadequate, and much more needs to be done.”
Hui mentioned that much funding is spent on the development of new cancer therapies. However, palliative care may be able to boost the effectiveness of these new treatments, ultimately leading to better outcomes.
“Fundraising is still very much focused on cure more so than care, perhaps. I recognize that both of them are important,” Hui said. “In fact, I will argue that palliative care can hopefully help to improve the chances of patients getting through their cancer treatments (and) tolerate them better. So they are truly hand-in-hand.”
Hui said that it is important for researchers and palliative care advocates to educate patients, clinicians, hospital leaders and policymakers about the importance of palliative care. In doing so, he hopes to see an eventual increase in palliative care training for health care providers, and an uptake in its usage by patients.
One major stigma to overcome is the confusion between palliative care and hospice — the former can be used alongside treatment, regardless of disease stage or prognosis, while the latter is specifically for end-of-life care.
At MD Anderson, Hui said that the outpatient palliative care center had its name changed to supportive care.
“We found that actually helped to reduce the stigma from the perspective of the referral clinicians,” Hui said. “They feel much more comfortable talking about this term and getting patients involved, even though the program is the same.”
Hui explained that this type of care can be seen as preventative care in many ways. It provides symptom education early on, teaches patients how to use their medicine and avoid pain crisis and emergency room visits.
“Rather than preventing a fire, we are putting out a fire to begin with,” Hui said.
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