Palliative+Care+for+the+Oncology+Patient



== Palliative Care can be a way to organize care of a chronic disease. For patients living with cancer, it offers organization of a myriad of different aspects of care from treatment options to transportation to treatment centers. It offers answers to questions regarding the disease state and questions regarding pain management. Palliative care can offer a caring environment that gives relief to the patient faced with fear of the unknown. It can relieve physical and mental suffering and increase quality of life at a time when it is most needed. ==

== Palliative care integrates the care of a multi-disciplinary team of doctors, nurses, social workers and other specialists who provide support to one another in determining the path of treatment. Palliative care is a treatment plan that can be adapted to any serious illness for a patient of any age. The goal is to improve not only the patient’s quality of life but also the families. ==



=What is the difference between palliative care and hospice care? =

**//Palliative care//** is based on an overall plan to minimize the suffering a patient must endure during a serious illness. It can be beneficial to the patient of any age and at any stage of their disease. Palliative care considers the patient holistically - physically, emotionally and spiritually and incorporates all of these factors when developing a plan to minimize suffering while improving the quality of life for the patient and their family. Families can receive information explaining their loved ones illness and the course it will lead to allowing them to prepare for long-term needs.

//**Hospice care**// is a more specialized medical care plan for the patient who has been given less than six months to live. It is a form of palliative care that is enacted when a patient is nearing the end of their life. Hospice provides more extensive support and medical care for the patient and their family.

=How will family members react to palliative care? =

As the death of a loved one grows near, each family member will react differently. It is common to experience a range of emotions, such as anger, shock, anxiety and helplessness. There is no single "right way" to deal with this situation. Family members should try to accept one another's different responses and feelings. Also, they should keep in mind that emotions don't follow a time schedule. Just because one person is ready to move on to the next stage of grieving doesn't mean everyone else is. As part of palliative care, it's important for family members to make the most of the time they have with their loved one rather than focusing on his or her death.

Robert S. Krouse [|Authors and Disclosures] Posted: 10/28/2008; Cancer Chemother Rev. 2008;3(4):152-160. © 2008 P. Permanyer
 * Palliative Care for Cancer Patients: An Interdisciplinary Approach **

Abstract
Palliative care is increasingly recognized as an important component of quality care for cancer patients. Given an estimated 1,437,180 new patients diagnosed with cancer in the USA in 2008, and approximately 565,650 cancer-related deaths, care for those patients who are near the end of life is an essential aspect of cancer care. Palliative care is an interdisciplinary team approach to care, with a focus on comfort and quality of life rather than prolongation of life or "cure" for a patient and their loved ones. Depending on the palliative care issue, many various treatments approaches may be available to manage symptoms and complications of advanced cancer. Common palliative care problems include pain, cachexia, asthenia, and wound issues. Examples of frequent concerns that necessitate an interdisciplinary team approach include pain, dyspnea, and malignant bowel obstruction. It is imperative to consider invasive or minimally invasive approaches in addition to noninvasive approaches for each of these problems. Each of these issues may mandate the expertise of specialists beyond the palliative care practitioner or medical oncologist, including surgeons, interventional radiologists, gastroenterologists, radiation oncologists, or anesthesiologists. Often there is a lack of high-quality research related to the optimal approach. The absence of an established evidence base in many areas of palliative care, at least in part due to the major challenges investigators face in designing palliative-care trials, emphasizes the need to involve other specialists in the care of these patients. In this way, the optimal approaches can be offered at this time of distress for patients and families.

**Introduction **
Approximately 565,650 people die in the USA each year related to cancer. [|[1]] Care for those patients who are near the end of life is an essential aspect of cancer care. [|[2]] The World Health Organization (WHO) defines palliative care as "the active total care of patients whose disease is not responsive to curative treatment. Control of pain, of other symptoms, and of psychological, social, and spiritual problems is paramount. The goal of palliative care is achievement of the best QOL for patients and their families." [|[3]] Quite simply, palliative care is treatment with the intent to improve the quality of life (QOL) for patients. Palliative care is an interdisciplinary team approach to care, with a focus on comfort and QOL rather than prolongation or "cure" for a patient. The goal of palliative care is to relieve suffering and to improve QOL. [|[4]] In addition to curative treatment for cancer patients, recent years have seen a dramatic increase in a focus on palliative care. Although the past 10 years have seen impressive growth in palliative care research, this rate of growth appears to be particularly rapid for interventional research, including controlled trials of pain medications, [|[5,6]] interventional procedures for pain, [|[7]] and other nonpharmacologic interventions to improve a variety of aspects of end-of-life care.



=Interdisciplinary Nature of Care for Patients Facing the End of Life =

There are multiple potential treatments for palliative care problems. These can include medical symptom management, surgical interventions, radiation therapy options, endoscopic opportunities, chemotherapy, as well as many innovative and complementary alternatives. In addition, palliative care teams must include nursing, social work, chaplain services, along with other potential specialties that could impact on a patient's QOL. There are often widely variant therapies for a specific QOL problem, enforcing the need for interdisciplinary teams to design optimal treatment approaches.

= = =Some of the people involved in palliative care of cancer patients =
 * === [|oncologists] ===
 * === [|nurses] ===
 * === [|social workers] ===
 * === [|nursing assistants] ===
 * === [|palliative care nurses] ===
 * === [|respiratory therapists] ===
 * === [|physical therapists] ===
 * === [|chaplain services] ===
 * ===[|family doctor]===

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=Where to begin when considering palliative care. . . = **//Step 1 - Speak with your doctor//** //**Step 2 - Speak with your family and caregivers **//
 * <span style="background-color: #fdfcfa; color: #555555; font-family: Arial,Helvetica,sans-serif; font-size: 17px;">If you or your loved one has been suffering from declining health that is getting progressively worse despite medical interventions, increased pain, infections, weakness, fatigue, altered mental status and frequent hospitalizations you may want to consult with your physician to determine if palliative care is right for you.
 * <span style="background-color: #fdfcfa; color: #555555; font-family: Arial,Helvetica,sans-serif; font-size: 17px;">Your physician can provide you with an order for palliative care and may even provide referrals for palliative care centers in your area.
 * <span style="background-color: #fdfcfa; color: #555555; font-family: Arial,Helvetica,sans-serif; font-size: 17px;">Palliative care focuses on treating the patient as well as their family. Make sure your family is aware of your desires and is included in the planning stages from the beginning. Palliative care will incorporate the family's needs during the illness and once their loved one has gone to rest.

//**<span style="background-color: #fdfcfa; color: #555555; font-family: Arial,Helvetica,sans-serif; font-size: 17px;">Step 3 - Contact your insurance company **//
 * <span style="background-color: #fdfcfa; color: #555555; font-family: Arial,Helvetica,sans-serif; font-size: 17px;">Most insurance companies including Medicare and Medicaid offer assistance with palliative care expenses.

<span style="color: #0000ff; font-family: Arial,Helvetica,sans-serif; font-size: 17px; line-height: 25px;">**Palliative Care in our Area** <span style="color: #555555; font-family: Arial,Helvetica,sans-serif; font-size: 17px; line-height: 25px;">[|Hospice and Palliative Care of Northeastern Illinois] <span style="background-color: #ffffff; font-family: Helvetica,Arial,sans-serif;"> 405 Lake Zurich Road <span style="background-color: #ffffff; font-family: Helvetica,Arial,sans-serif;"> Barrington, IL 60010 <span style="background-color: #ffffff; font-family: Helvetica,Arial,sans-serif;"> To request **<span style="background-color: #ffffff; font-family: Helvetica,Arial,sans-serif;">Hospice Care call 224-770-2489 **<span style="background-color: #ffffff; font-family: Helvetica,Arial,sans-serif;"> or __[|submit a request online now]__.

**[|Rainbow Hospice and Palliative Care Offices]**  1550 Bishop Court   Mount Prospect, IL 60056   (847) 685-9900 888-70-RAINBOW (888-707-2462)  <span style="color: #0066cc; font-family: arial,helvetica,verdana;">[|Click here] for directions and maps =<span style="color: #0000ff; font-family: Arial,Helvetica,sans-serif; font-size: 1.5em;">References =

<span style="color: #045d5d; font-family: Arial,Helvetica,sans-serif; font-size: 1.25em;">**Websites**

 * American Cancer Society**
 * Cancer Treatment Centers of America**
 * Center to Advance Palliative Care**
 * National Hospice and Palliative Care Organizatio**
 * National Palliative Care Research Center**

<span style="color: #045d5d; font-family: Arial,Helvetica,sans-serif; font-size: 1.25em;">**Articles**

 * Choices for Palliative Care**
 * Family Meetings in Palliative Care: Multidisciplinary Clinical Practice Guidelines**
 * Improving Patient's Quality of Life Through Palliative Care**
 * Palliative Care: Easing the Course of Serious Illness**
 * Palliative Care for Cancer Patients: An Interdisciplinary Approach**
 * Palliative Care Organizations**
 * Why Everyone Deserves Palliative Care** by Terri Ades, DNG, FNP-BC, AOCN:


 * Evidence Based Practice Related to Palliative Care**
 * Position Statement on Access to Palliative Care in Critical Care Settings**