Palliative medicine is a vital but often misunderstood component of comprehensive cancer care, said Dr. Jennifer Temel, an associate professor of medicine at Harvard Medical School. Temel sought to debunk myths and criticism surrounding palliative care as part of the University of Chicago Pritzker School of Medicine’s Grand Rounds series.

Temel offered her definition of palliative medicine: symptom management, psycho-social support, assistance with treatment decision-making, emphasizing well-being of patients and care of patients’ families. Palliative care helps treat the side-effects of disease and aggressive cancer treatments, like chemotherapy and radiation. Temel said palliative care also helps comfort oncologists suffering from the psychological effects of treating aggressive cancer by providing carefully managed pain medications to their patients.

“Oncology has become more complex and improvements in cancer care increase ‘prognostic uncertainty’ amongst oncologists,” she said. “Unfortunately, there are not enough palliative care physicians to see all patients with metastatic cancer.” Temel outlined three common myths about this medical speciality:

Myth 1: Cancer patients will receive less care and die sooner

There have been a number of studies raising questions of whether patients who get better palliative supportive care live longer than patients who don’t. In one study of lung cancer patients who were on hospice and patients who were not on hospice, the patients who received hospice care appeared to have a longer survival.

Patients getting early palliative care get the same cancer care, and early palliative care is not withholding care from them and will not impact their life in a negative fashion. In fact, maybe by improving their quality of life and making their moods better, they are living longer with illness.

Myth 2: Palliative care physicians will be negative and scare patients

Palliative care physicians really focus on first getting to know patients and their families. They focus on the illness, and if they understand the decisions they are making. Palliative care focuses on the entire family unit, and physicians have end of life conversations only when it is appropriate.

Myth 3: Palliative care is unnecessary because oncologists provide adequate care

Palliative care and oncology care are complementary– they both focus on symptom management- but they also focus on different things. It is a team approach to taking care of patients.

It does not result in excess costs, and early palliative care can save hundreds of dollars per day.

Promising Research

Recent data suggest that terminally ill adults referred to early palliative care experience “higher quality” and less aggressive end of life care than similar patients receiving inpatient care.

Dr. David Hui, an assistant professor of palliative care and rehabilitation medicine at The University of Texas MD Anderson Cancer Center, studied data from 366 Houston-area patients who died of advanced cancer between 2009 and 2010.

According to the 2014 study published in the journal Cancer, patients who received early palliative care experienced fewer emergency department visits (39 percent vs. 68 percent), hospitalizations (48 percent vs. 81 percent) and hospital deaths (17 percent vs. 31 percent) in the last 30 days of life compared to patients with later referrals.

“The best way to prevent pain and unnecessary medical treatments is to use medicine properly,” Hui told Life Matters Media. “If patients are seen very, very late in their illness, they may not be able to discuss treatment options with their doctors. Most patients seeking palliative medicine only see their physicians two times.”

A 2010 study published in the New England Journal of Medicine found that among 151 patients diagnosed with non-small-cell lung cancer, those who received palliative care lived almost two months longer than those who received standard care.

“Among patients with metastatic non–small-cell lung cancer, early palliative care led to significant improvements in both quality of life and mood,” researchers wrote. “As compared with patients receiving standard care, patients receiving early palliative care had less aggressive care at the end of life but longer survival.”