For many women with ovarian cancer, the term “palliative care” can induce panic. Women tend to equate the term to giving up on treating the cancer and resigning oneself to giving in to the disease. This may lead women to avoid discussions of palliative care– when such care could aid in their recovery.
Indeed, shying away from palliative care could keep women from maintaining a positive quality of life during the course of treatment.Read More
The truth is, while palliative care itself does not have the direct aim of killing a cancer tumor, it often goes hand in hand with other treatments that do. A patient with ovarian cancer may receive palliative care alongside chemotherapy, surgery, or targeted therapy, and these treatments do not have to fail or end for a palliative care regimen to begin.
Palliative care, at its most basic definition, means treating the symptoms and side effects of serious illness—though for every patient, this care will look different. Palliative care regimens are personalized to address the severity of a women’s side effects and the types of stresses and symptoms her cancer is causing.
“What palliative care offers is a focus not just on killing the tumor, but also maintaining a high quality of life at the same time,” Dr. Kumar says. “Quality of life has to be defined by the patient.”
For some women, for instance, that care could mean treating side effects associated with chemotherapy, such as nausea, fatigue, and neuropathy— a tingling or loss of feeling, usually in the fingers or toes. Treating the physical pain that ovarian cancer can cause is a main focus of palliative care, as well.
For other women, the most difficult symptoms of cancer may not be physical. Depression, stress, anxiety, and the financial burdens (“financial toxicity”) often come with a cancer diagnosis. Palliative care teams can help women determine the best ways to ameliorate all of the above.
The Stages of Palliative Care
Dr. Kumar breaks palliative care into stages. At the onset, there’s primary palliative care, which helps to treat side effects and stress in every patient.
“This is what we all do in our oncology clinics,” Dr. Kumar says. Every oncologist is trained in this care; it’s a fundamental part of their medical education. And then there’s also secondary and tertiary palliative care, which usually comes from specialized palliative care specialists—doctors that have devoted their professions to helping patients who are having a difficult time coping with their cancer.
“Just like I did extra training in order to treat cancers, and to do surgery to treat cancers, there’s a group of people who did extra training in order to treat the symptoms and side effects of serious illness,” Dr. Kumar says, explaining that as a gynecologic oncologist trained specifically in treating cancer, there sometimes comes a point in her patients’ treatment cycle where she needs to turn to a specialized palliative care team to help maintain quality of life.
The Benefits of Discussing Palliative Care Early On
Unfortunately—and in part due to the misconceptions surrounding the term—many women and their oncologists don’t have discussions about palliative care upfront. These conversations need to begin at the point of diagnosis, when a woman begins treatment—regardless of the stage of her cancer.
“If we don’t talk about palliative care upfront, then when we really need to talk about goals of care, we’ve missed this long opportunity to get to know our patients and get them and their families to talk about ‘what are the things I’m willing to undergo to treat this cancer?’” Dr. Kumar says.
From the start, doctors should be encouraging their patients to consider how they can use their personal values to guide decisions about their cancer treatment.
If these critical topics don’t come up right away, don’t be afraid to ask—and don’t fall into the trap of viewing palliative care as quitting (it’s not). In fact, studies have shown that receiving the right palliative care early on not only ensures quality of life throughout the course of treatment, but may also improve treatment outcomes.