Palliative Care’s Role in Helping Patients With Breast Cancer, Their Families

Palliative care can be of great help to patients at any stage of the cancer journey, as one expert explained.

“Palliative care is specialized medical care for people living with a serious illness. And really, our focus is to help relieve symptoms and the stress of the illness. We're also called supportive care at a lot of places … and I think that's a better name for what we do. But really, our goal is to improve quality of life for both patients and families,” explained Dr. Sara S. Evans, a palliative care specialist at UC San Diego Health.

Evans appeared as part of the CURE® Educated Patient® Metastatic Breast Cancer Summit to discuss the role of palliative care in the cancer journeys of patients with breast cancer.

Common symptoms experienced by patients with breast cancer that palliative care teams work to address, Evans explained, can include pain, fatigue, nausea, vomiting, swelling known as lymphedema, cognitive difficulties, emotional distress, poor sleep and menopausal symptoms.

“We recognize that the experience of illnesses is different for everyone emotionally, spiritually, and physically as well,” Evans said. “And so with our team, we really believe in a team approach and we provide care with doctors, nurses, specialists like chaplains and social workers. And we're really just here to provide an extra layer of support for folks. Importantly, we’re appropriate for any stage of illness, and we work in conjunction with curative treatment. So often patients that see us are really worried that we're here to provide hospice care or something like that, or that we have some sort of agenda. And that's definitely not true. We're here to support your period of treatment.”

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Evans explained what patients can expect during a visit with a palliative care team and explained that during a first appointment, it is common for patients to see a form known as the Edmonton Symptom Assessment System, which rates the severity of symptoms on a scale of 0 to 10.

“We spend a lot of time at our first appointment just to getting to know patients as a whole person, and seeing what's important to them,” she said. “So we maybe ask them questions like, ‘What's important to you? What was life like before you got diagnosed with cancer? How can we help you get back to those things that are so important to you? What worries do you have about treatment? What things are you hoping for?’

“We may ask about financial situations and if there's any religious or spiritual practice that people follow, and we spend a lot of time talking about the symptoms that are from the cancer and sometimes from the cancer treatments — so things like pain, constipation, diarrhea, how the breathing of the patient is doing, if there's any shortness of breath, [and we spend] a lot of time talking about emotional health. Anxiety and depression are really common in cancer patients, and then [we are also] helping out with any nausea and nutritional needs as well.”

Importantly, Evans explained that supportive care and palliative care are not synonymous with end-of-life care or hospice care.

“We're very distinct from hospice care, although it can be a subset of what we do. We give care alongside active treatment. And really, our goal is just to provide successful treatment and to improve your quality of life,” she said.

Editor's note: This program was made possible with support from Daiichi Sankyo Inc.

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