How Late-Stage Cancer Care Impacts Patients
- Reality TV star Jonnie Irwin, 49, shares what it's been like undergoing palliative care in hospice amid his late-stage cancer battle. He spoke positively about the care he receives that’s focused on comfort by emphasizing it’s nothing like he expected.
- Irwin rose to fame by hosting several television shows including "Escape to the Country." He was diagnosed with lung cancer in 2020 and has since focused primarily on his health and family. He spends lots of time creating lasting memories with loved ones, especially his wife and three young sons.
- Palliative care is a type of care that's meant to address the symptoms and side effects that your cancer or its treatment brings. Examples of these symptoms may include psychological experiences like stress and fear to physical experiences like pain and discomfort.
- Hospice focuses solely on comforting the patient rather than a cure for the illness.
- Families faced with the tough and emotional decision surrounding hospice care are encouraged to talk to their care team early enough before pursuing hospice care to take advantage of all the comforts it provides.
Earlier this summer, Irwin revealed he would go into hospice care periodically when he's not feeling well. He adds, going into hospice to receive comfort care helps mask his diagnosis from his children. In a new interview with "BBC Morning Live," he revealed he's been going to hospice care since his diagnosis roughly 3 years ago.
"It's a delight, actually. My perception of the hospice was very much a boiling hot room full of people that looked frail and towards the end of their days. This is nothing of the sort. It's spacious, energized, and comfortable. I mean, it's even got a jacuzzi bath, and ensuite rooms, and the staff are just amazing. So I've had a really, really good experience at my hospice," Irwin explained.
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Irwin was diagnosed with lung cancer in 2020, however, he further added his cancer was terminal. Since the diagnosis, he's focused on his family and dedicated much of his time to creating lasting memories for his three young sons.
"I want to make memories and capture these moments with my family because the reality is, my boys are going to grow up not knowing their dad and that breaks my heart," Irwin previously told Hello Magazine in an interview.
In addition to focusing on family, he's also completed other projects that keep his spirits high including a home improvement project.
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"Phase 1 complete," Irwin wrote in a recent Instagram post complimenting his efforts.
Hospice and Palliative Care
Irwin's misperception about hospice and palliative care is not uncommon. While the two forms of care for patients share things in common, they're not exactly the same.
The main difference between palliative care and hospice care is during hospice care no efforts are made to cure the illness while palliative care may also provide treatment "intended to cure" the illness.
"Hospice care focuses on the care, comfort, and quality of life of a person with a serious illness who is approaching the end of life," the National Institute of Health (NIH) explains.
Irwin's decision to leave his family home in favor of hospice care when his pains intensify is an emotional thing to do. However, he believes his children should see him in a positive light and in good spirits.
Hospice focuses solely on comforting the patient rather than a cure for the illness. Families faced with the tough and emotional decision surrounding hospice care are encouraged to talk to their care team early enough before pursuing hospice care to take advantage of all the comforts it provides.
"Starting hospice early may be able to provide months of meaningful care and quality time with loved ones," the NIH says.
During palliative care, the patient is provided specialized medical care as they manage symptoms associated with their medical condition. This form of care may also provide treatment "intended to cure" the illness as opposed to hospice care which does not.
WATCH: Palliative care improves your overall treatment by focusing on comfort.
"It's not the same thing as hospice. It's really important to recognize that palliative care, whether provided by your oncologist or by a specialty palliative care team, is an important adjunct to your oncologic care," Dr. Lisa Diver, a gynecologic oncologist and Medical Director at ImmunoGen explained to SurvivorNet.
"It doesn't mean that your doctor is going to stop treatment or even wants to talk about that, but simply that he or she thinks it's important to support all aspects of your health. That could be pain control, [relief for] nausea or constipation, or mental health care. All of these other symptoms that commonly arise and are intertwined inextricably with your cancer care," Dr. Diver added.
Research has been published showing the benefits of beginning palliative care early in the course of treatmentsometimes as soon as the initial diagnosis.
In 2016, based on results from a total of nine randomized clinical trials, one quasi-experimental trial, and five secondary analyses, the American Society of Clinical Oncology (ASCO) issued a set of guidelines stating that "inpatients and outpatients with advanced cancer should receive dedicated palliative care services early in the disease course, concurrent with active treatment."
Some oncologists have adjusted how they talk about palliative care because of the common misconception about it compared to end-of-life hospice care.
Dr. Ishwaria Subbiah, a medical oncologist and palliative care physician at the MD Anderson Cancer Center, shared a fascinating experiment from 2009 (published in 2011): rather than trying to eliminate the deeply ingrained end-of-life connotations of the term "palliative care," Dr. Subbiah's colleagues at MD Anderson decided to change the name altogether, rebranding their palliative care center as the "Supportive Care Clinic."
Within a year of changing the name, MD Anderson's Supportive Care Clinic saw their referrals (that is, patients coming from their medical oncologists and tumor-directed cancer treatment to access their symptom management services) rise 41 percent. "And it has been consistently increasing in the double digits ever since," Dr. Subbiah said.
More on Late-stage Care for Patients
Questions for Your Doctor
If you or a loved one is considering palliative or hospice care, you should consider the following questions for your care team to help you make the best decision for optimal care.
- What would I expect if I received palliative care for my health condition?
- Who will provide my care?
- Will insurance cover my care and treatment?
- How does palliative care differ from the kind of care I'm receiving now?
- Is there a point where palliative care transitions to hospice care? If so, how does this come about?
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