November is National Hospice and Palliative Care Month, an important opportunity to recognize the power of this personalized care in helping improve quality of life for patients facing serious illnesses. Palliative care specialist Quan Dang, M.D., at Texas Oncology–Austin North and Texas Oncology–Round Rock, discusses the role of palliative care, hospice care, and advance care planning in easing suffering, offering support, and providing peace of mind for both patients and their families.
What types of patients do you typically treat with hospice and palliative care?
Typically, palliative care (or palliative medicine) patients have been diagnosed with a life-threatening illness, such as cancer or heart failure. Hospice is a separate program, either for patients with advanced, late-stage disease that is unresponsive to treatment, or for patients who decide the burden of treatment is overwhelming their quality of life and is no longer consistent with their personal goals.
With hospice and palliative care, our focus at Texas Oncology is enhancing the quality of life for all cancer patients by eliminating or controlling troubling symptoms such as pain, shortness of breath, anxiety, nausea, or depression to allow patients to focus on healing during and after their illness.
Why is palliative care individualized for each patient?
Every patient with cancer is unique. Two patients with identical cancer, even at the same stage, may be affected differently by the disease and/or its treatment. That's why every treatment plan is customized to the individual based upon their unique situation, needs, and response to treatment. Thankfully, we have many tools and approaches to help meet those variable, individual needs.
How does advance care planning relate to hospice and palliative care?
As adults, we should all be involved in advance care planning, which is simply a set of plans, documents, and discussions that outline your wishes for yourself in the event you face serious illness. That may include wills, living wills, assignment of medical power of attorney, documents indicating preferences about items such as artificial life support, artificial nutrition and feeding tubes, cardiopulmonary resuscitation, and even funeral arrangements.
While these decisions might seem distant or difficult to comprehend, the sooner you have a plan, the better. Making these decisions under pressure of a medical emergency, or worse, having loved ones make these difficult decisions for you during a very stressful time, can be extremely undesirable. These documents are easy to amend and can be adapted to fulfill your intentions at any time. They’re also widely available online, through healthcare systems, and many physician offices.
Palliative care is for any patient, at any stage of a serious illness – often the earlier, the better."
What do you consider to be the greatest misconception about palliative care?
Similar to hospice, some patients and clinicians believe palliative care is only for the late stages of a patient's journey with a serious illness, essentially at the end of life. Rather, palliative care is for any patient, at any stage of a serious illness – often the earlier, the better. In fact, major studies show that many patients under palliative care live longer and with better quality of life than those without it.
What do you think is most important for families or patients to know when considering hospice or palliative care?
Early involvement with palliative care as soon as possible after the diagnosis of a serious illness, such as cancer, can lead to a better journey and potentially one with less suffering. Getting involved as early as possible is strongly recommended for patients and their loved ones.