Improving palliative care for cancer patients

01 November 2012

Dr Camilla ZimmermannAccording to a new study, Canadian oncologists are referring patients too late to specialized palliative care services. While 80% of doctors refer terminally ill cancer patients to palliative care, most patients are referred in the last few months or weeks of life, and many are only referred in the last days.

“What we really need is a rebranding of palliative care,” says Dr Camilla Zimmermann, who led the study and is Head of Palliative Care at the Princess Margaret Hospital in Toronto. “Palliative care is no longer only about end-of-life care. It’s really about helping patients manage symptoms, preventing and relieving suffering and improving overall quality of life while living with cancer.”

In fact, palliative care may be appropriate for patients at all stages of disease, including those undergoing treatment for curable illnesses and those living with chronic diseases, as well as patients who are nearing the end of life.

Specialized palliative care gives patients access to a multidisciplinary team of health practitioners, including physicians, nurses, pharmacists, chaplains, social workers and psychologists, who can create a plan of care to relieve suffering in all areas of a patient’s life. The approach is a holistic one, aimed at improving the patient’s quality of life and focusing on pain management and psychosocial and spiritual care.

When patients are referred to palliative care earlier in the course of their disease, it allows palliative care teams to provide early assessment and relief of symptoms and distress for the patient and their family, to provide appropriate social services and to discuss advance care planning.

The study surveyed oncologists throughout Canada and showed that while 73% say they have access to palliative care clinics, only one third are referring patients upon diagnosis of an incurable cancer. The main barriers to referral were availability and comprehensiveness of specialized palliative care services and that not all services accept patients undergoing chemotherapy. In addition, one third of those surveyed said they would refer patients to palliative care earlier if it were renamed “supportive care.”

“There is a huge shortage of palliative care specialists and physicians,” says Dr Zimmermann. “The system needs some restructuring. We’re going to need a more integrated approach to treating cancer patients. If we can retrain doctors about the importance of palliative care and the benefits of referring earlier, we’ll be able to improve the overall care for those living with cancer.”

The findings were published on October 29 in the Journal of Clinical Oncology

Learn more about the Society’s advocacy efforts in palliative care