Palliative or Supportive Care
What is Palliative Care
Palliative= Relieving symptoms of a disease with treatments not intended to cure the disease itself.
Palliative care, also called supportive care, is intended to relieve suffering and improve quality of life. It is designed to help people live as well as they can for as long as they can, even though they have a serious illness.
Palliative care focuses on helping patients get relief from symptoms caused by serious illness (such as nausea, pain, fatigue, and shortness of breath). It is treatment given along with cancer treatment, even though it is better known for its role in promoting comfort when aggressive treatment is no longer working. The goal is to improve quality of life for both the patient and the family.
Palliative or supportive care can be given throughout the cancer experience. This can be from the time of diagnosis until the end of life. It is appropriate at any age and at any stage in a serious illness. It can be given along with curative treatment, and it can be given alone when cancer treatment is no longer working.
Palliative or supportive care gives patients options and allows them to take part in decisions about their care. This kind of care assures that their physical, emotional, spiritual, and social needs are being addressed.
Palliative Care and Pancreatic Cancer
Pancreatic tumors can cause several types of complications, including gastrointestinal obstructions and other problems that may require additional treatments. There are a wide array of palliative solutions, including the implantation of metal stents that “prop” open vessels and ducts to alleviate obstructions.
Treatment options include pain medication administered via different methods, including:
- Intravenous (through injection into a vein)
- Oral (by mouth)
- Peridural (through injection into spinal fluid or tissue near the spinal cord)
- Transdermal (through the skin, via pain patches or creams)
Portable and implantable infusion devices are used where indicated to ensure continued quality of life with the least amount of complications due to pain.
Powerful Nerve Blocks
One particularly effective pain management technique is neurolytic celiac plexus block (NCPB). NCPB involves the injection of medication directly into the nervous system to block the pain signals sent from the pancreas to the brain. Anesthesiologists perform this procedure with the aid of specialized X-ray techniques. Alcohol neurolysis of celiac plexus is a highly effective and efficient form of treatment. In most patients, we are able to substantially reduce pain while also decreasing the amount of medicine given to the patient by 50 to 70 percent. The majority of patients are able to return to activities for a reasonable period of time–without sedation and adverse side effects.
Benefits of Palliative Care
There are many studies that show the benefits of palliative care. Studies have shown that patients who had hospital-based palliative care visits spent less time in intensive care units and were less likely to be re-admitted to the hospital after they went home. Studies have also shown that people with chronic illnesses like cancer who get palliative care have less severe symptoms. They have better quality of life, less pain, less shortness of breath, less depression, and less nausea. Their families also feel more satisfied.
Palliative care may also increase survival. A 2010 study of lung cancer looked at patients who were given palliative care alongside cancer treatment. The patients who received palliative care along with cancer treatment lived nearly 3 months longer than the patients who received the cancer treatment without the palliative care.
Who Delivers Palliative Care?
Your oncologist (cancer doctor), your oncology nurse, and other members of your cancer care team may help you with symptoms you are having. For instance, they may prescribe medicines to help control or prevent nausea and vomiting or to help relieve your pain. Oxygen and other measures may be used to help with breathing problems. These treatments are palliative care.
Palliative care can also be given by a team of doctors, nurses, and other specialists who work with your oncologist to help with treating your symptoms. In this situation, your doctor might ask a palliative care team to see you.
This “palliative care team” typically includes a palliative care doctor, a palliative care nurse, social worker, patient navigator, and maybe a person with a spiritual role such as a pastoral counselor or chaplain. Many hospitals and oncology clinics have these teams as part of the services they provide. They can send the team to patients in intensive care units, emergency rooms, or hospital wards to talk with the patient and family and begin palliative care.
Even though the palliative care team may be based in a hospital or clinic, most of the actual care happens at home. Many hospitals and clinics have a team that they can refer people to when palliative care is needed.
At home, you may take medicines and use other methods prescribed by the team, or you may need help from family members and loved ones. The team provides education and support to the patient as well as to the home caregivers.