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What Most People Don’t Know About Cancer Care and Palliative Medicine


Palliative medicine gets a bad rap, its name likely to elicit thoughts of fear, death, and hopelessness upon briefest mention. In reality, palliative care exists to add light to what may be perceived as a dark situation, and much of the negative connotation that surrounds the service stems from a misunderstanding of its purpose and function.

“Palliative care has a generally negative reception because people may gather from the media that it is synonymous with end-of-life,” says Milagros Silva, M.D., an attending physician within Weill Cornell Medicine and NewYork-Presbyterian Hospital’s Division of Geriatrics and Palliative Medicine. “In fact, palliative medicine is a discipline that can improve quality of life in many different ways.”

We sat down with Dr. Silva to clear up three of the most common misconceptions about palliative care.

You might think:
“’Palliative care’ is just another term for ‘hospice.’”

You should know:
Hospice care is provided to people who are so sick with an incurable disease that they are nearing the end of their life. Its primary goal is to help people cope with the mental and physical impact of the disease, rather than to treat the disease itself. Palliative care, on the other hand, begins at the time of diagnosis and continues throughout treatment of a person’s disease to help improve quality of life during therapy. It is only if a person reaches a terminal diagnosis that he or she may become eligible for a transition from palliative to end-of-life care.

You might think:
“My oncologist has given up on me.”

You should know:
Palliative care complements – not substitutes – the work of oncologists and other members of the cancer care team. The palliative care team (which can be comprised of physicians, nurse practitioners, and social workers) collaborates closely with one another and with the patient’s oncologist to provide optimal support and care while the patient continues to receive treatment.

In addition to regular meetings with their oncologist, people with acute conditions, or aggressive conditions with a sudden onset, may meet with a palliative care specialist every 1-2 weeks, whereas those with non-acute conditions may meet every 1-2 months. Palliative care specialists take the time to get to know each patient and their disease, beginning every new patient relationship with a symptom assessment to discuss psychosocial history as well as address any issues of pain or discomfort. Once they have a better understanding of the individual’s circumstances, the specialists can then make medical recommendations to help relieve treatment symptoms, as well as provide psychological, emotional, and spiritual support as patients deal with their disease. Providers also work to keep both patients and their families educated about the disease state and subsequent treatment options so that they can make informed decisions regarding goals of care.

You might think:
“Placement in palliative care means that I will die soon.”

You should know:
While cancer is often a life-threatening disease, placement in palliative care is not indicative of a specific prognosis. Palliative care providers are experts trained in symptom management whose goal is to enable patients to live comfortably as they navigate the not-so-comfortable side effects that accompany cancer and its treatment. Symptom management can take the form of helping patients cope with pain, nausea, depression or emotional distress so that they can tolerate and continue with the treatment regimen necessary to improving their health.

Anxiety is another common product of the cancer experience – one that affects more than just the person diagnosed. The palliative care team is available to address any emotional needs that the patient and his or her family members may have so that they can all handle the diagnosis one step at a time.