Palliative Care Improves Quality of Life for Ovarian Cancer Patients

Although misconceptions about the distinction between palliative and hospice care are common, the two treatments are not the same. Hospice care is end-of-life care that doesn't begin until the disease is no longer treatable. Palliative care can be given at any stage of cancer care.

"Palliative care does not mean giving up," says Dr. Kimberly Resnick, a gynecologic oncologist at MetroHealth in Cleveland. "It simply means switching the focus of treating the cancer to supporting the patient and their symptoms."

How Can Palliative Care Help?

Palliative care is a collection of therapies designed to provide comfort and support. Providers of this care include doctors, nurses, psychologists, social workers, and other health care professionals who have undergone specialized training in the delivery of quality-of-life care.

You can receive palliative care in a variety of settings, including a hospital, outpatient clinic, or at home. It typically encompasses a number of different interventions that address both physical and emotional symptoms, including:

• Pain control
• Relief of nausea, fatigue, swelling, and shortness of breath
• Exercise
• Dietary recommendations
• Psychological counseling for depression and anxiety

Palliative care recognizes that the person with the diagnosis isn't the only one cancer impacts. Family members and other caregivers can feel the strain of cancer, too. That's why it allows "caregivers and loved ones to have a little bit of respite, and to have a break from the caregiving," Dr. Resnick says.

When to Start Palliative Care

The decision about when to start palliative care should be highly personalized. Some experts say everyone with cancer should have access from the time they're first diagnosed. Starting early can help women manage their diagnosis and its emotional repercussions right away, so they can continue to lead relatively active and normal lives. Yet having palliative care at the beginning of treatment isn't necessarily right for everyone.

"For some patients early on in their ovarian cancer diagnosis, palliative care may not be reasonable. It may be reasonable to offer a patient two, three, four, five, even six different trials of chemotherapy," Dr. Resinick says. "But for some patients, older patients, patients who are medically unwell, or for patients where we simply can't find a chemotherapy that's going to work, it may be time to discuss palliative care."

Every recurrence puts women and their doctors at what she calls a "crossroads," where they may continue to receive chemotherapy, or have the option of switching to palliative care. Each one of these situations warrants a new conversation about how to proceed.

Discussing End of Life Care

For some women, the conversation will eventually have to turn to a difficult subject. "The hardest part of any gynecologic oncologist's job is when we have to have 'the talk' with a patient," says Dr. Resnick.

When women reach the point where their treatment is no longer effectively holding back their cancer, or it’s causing side effects they can't tolerate, palliative care aims to keep them comfortable and help ease them and their families though the rest of their journey.

"Oftentimes, when we're at the end of life with an ovarian cancer patient, they require that their loved ones become caregivers. So we need to figure out a way to offer support to both the patient and the caregivers," Dr. Resnick says.

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