The hidden challenges of palliative cancer care

The hidden challenges of palliative cancer care
The National Institute of Health and
Care Excellence (NICE) guideline,
Improving Supportive and Palliative
Care for Adults with Cancer, clearly sets
out that palliative care is a key point in
the patient pathway following diagnosis
which may be offered at the same time
as active treatments 31 . Marie Curie has
previously called for earlier, ongoing
and episodic involvement of palliative
care for people in need 32 .
Patient pathway map adapted
from NICE guidelines
Diagnosis of cancer
Treatments
Palliative care
End of treatment
Continuing
treatment
Long-term
monitoring and
follow-up
Relapse
Terminal care
Cure
Long-term
survival
However, it has been found that public
awareness “remains insufficient”
around the concept and availability of
palliative care 33 . This may mean that
palliative care is feared because of its
association with dying, and avoided
until there are no other treatments 34 .
With cancer care in particular, it can
also mean that people undergo more
aggressive forms of treatment – such
as palliative chemotherapy – without
understanding that it’s not intended
to cure their cancer, but should help to
relieve symptoms and perhaps increase
life expectancy.
The need for effective communication
about the likely outcomes of treatments
is critical here; yet studies have found
that between one-third and fourfifths
of patients with advanced cancer
believe that palliative chemotherapy
might cure their disease 35 .
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