Another way to tailor care would be based on managing the treatment side effects unique to the type of treatment used—for example, toxicities that are specific to immunotherapy and targeted therapy as opposed to cytotoxic therapy. So, I think we will see specific tailoring of treatment over time.
However, they are all hypotheses and require further study. What is clear is that we do not have enough palliative care clinicians to care for every patient with advanced cancer on a monthly basis from the time of diagnosis until the end of life. In your overall study population, patients who received early palliative care had significantly higher quality of life, fewer depressive symptoms, and better coping skills at 24 weeks but not at 12 weeks.
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What did that finding tell you? This finding is a little confusing. Patients with advanced cancer can have good initial results from treatment and a reduction in their symptoms, so over time, their quality of life improves. This also raises the question, is palliative care more useful when symptoms start to worsen? One of our challenges going forward with this research is to be mindful of the advances in cancer therapy, because as treatments become more effective and less toxic, patients will feel better longer, and their quality of life will be better for a longer time.
We need to think more creatively about when and how to use palliative care so it is most useful for patients. It may be that palliative care is more beneficial to patients when their symptom burden is higher.
Even though all the patients in your study had incurable cancer, about one-third thought they could be cured. Why do you think that is? We see this finding repeatedly in studies where patients with metastatic or incurable cancers are asked whether their cancer is curable.
About one-third of patients say yes, it is, although they were diagnosed months before, have a treatment plan in place, and have signed consent forms noting that the purpose of their treatment is palliative, not curative. Whether these patients are more likely to believe their cancer is curable due to the availability of more effective therapies is an important question, and I want to explore that further.
Also, while patients with advanced cancer may intellectually understand their prognosis, some may not be emotionally ready to accept this reality or may feel uncomfortable admitting that their cancer is incurable on a questionnaire. Your study evaluated early palliative care in the incurable disease setting. How effective are early palliative interventions for early disease, to combat physical and emotional symptoms from cancer and its treatment side effects? Early palliative care in the outpatient setting can be effective and useful regardless of whether the cancer is curable, because it targets patients with uncontrolled symptoms who could benefit from this type of care.
Since there is a shortage of palliative care clinicians, we tend to prioritize care to those with the greatest need, and that tends to be patients with advanced illness. Nonetheless, palliative care plays an important role in curable disease when symptoms are troubling for patients.
J Clin Oncol , Toggle navigation. Joseph A. Any type of cancer can become terminal cancer. Terminal cancer is different from advanced cancer. But it does respond to treatment, which may slow down its progression. As a result, treating terminal cancer focuses on making someone as comfortable as possible. Read on to learn more about terminal cancer, including its impact on life expectancy and how to cope if you or a loved one receive this diagnosis.
But studies suggest that this estimate is usually incorrect and overly optimistic.
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To help combat this, researchers and doctors have come up with several sets of guidelines to help oncologists and palliative care doctors give people a more realistic idea of their life expectancy. Examples of these guidelines include:. They can help people and their doctors make decisions, establish goals, and work toward end-of-life plans. Terminal cancer is incurable. This means no treatment will eliminate the cancer. But there are many treatments that can help make someone as comfortable as possible. This often involves minimizing the side effects of both the cancer and any medications being used.
While doctors have some input in the treatment plan for someone with terminal cancer, it often comes down to personal preference. Some with terminal cancer prefer to stop all treatments. This is often due to unwanted side effects. They can potentially help future generations. This can be a powerful way for someone to ensure their final days have a lasting impact.
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Alternative treatments can also be beneficial for those with terminal cancer. Acupuncture , massage therapy , and relaxation techniques can help alleviate pain and discomfort while also potentially decreasing stress. Many doctors also recommend people with terminal cancer meet with a psychologist or psychiatrist to help deal with anxiety and depression.
Receiving a diagnosis of terminal cancer can be extremely overwhelming. This can make it hard to know what to do next. This is totally normal. For example, you might initially feel angry or sad, only to find yourself feeling a slight sense of relief, especially if the treatment process has been particularly difficult. Others might feel guilt over leaving loved ones behind.
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Some may feel completely numb. Try to give yourself time to feel what you need to feel. They can refer you to local resources and services that can help.
Receiving a diagnosis of terminal cancer can lead to an overwhelming sense of uncertainty. Again, this is completely normal. Consider tackling this uncertainty by jotting down a list of questions, both for your doctor and yourself. This will also help you better communicate with those close to you. After receiving a terminal cancer diagnosis, your doctor might be the last person you want to talk to.
But these questions can help start a dialogue about the next steps:. How someone proceeds after receiving a terminal cancer diagnosis involves a good deal of personal preference. These decisions may be incredibly difficult, but going over these questions with yourself may help:.