Palliative/Symptom Management
What is palliative care?
Cancer and its treatment often cause side effects. In addition to treatments intended to slow, stop, or eliminate the cancer, an important part of cancer care is relieving a person’s symptoms and side effects. This approach is called palliative or supportive care, and it includes supporting the patient with his or her physical, emotional, and social needs.
Who should have a palliative care consultation?
Palliative care is any treatment that focuses on reducing symptoms, improving quality of life, and supporting patients and their families. Any person, regardless of age or type and stage of cancer, may receive palliative care. It works best when palliative care is started as early as needed in the cancer treatment process.
What is the aim of palliative care?
People often receive treatment for the cancer while they receive treatment to ease side effects. In fact, people who receive both at the same time often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.
Isn’t palliative care just for people who are dying?
Palliative care should not be confused with hospice care, which is discussed further below.
What treatments are used in palliative care?
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional support, and other therapies. You may also receive palliative treatments like those meant to eliminate the cancer, such as chemotherapy, surgery, or radiation therapy. Talk with your doctor about the goals of each treatment in the treatment plan.
Before treatment begins, talk with your health care team about the possible side effects of the specific treatment plan and palliative care options. During and after treatment, be sure to tell your doctor or another health care team member if you are experiencing a problem so it can be addressed as quickly as possible.
Supportive care for people with pancreatic cancer includes:
Palliative chemotherapy may help relieve the symptoms of pancreatic cancer, such as lessening pain, improving a patient’s energy and appetite, and stopping or slowing weight loss. This approach is used when the cancer has spread and cannot be cured, but the symptoms of the cancer can be improved with chemotherapy. When making decisions about palliative chemotherapy, it is important that you and your doctor weigh the benefits with the possible side effects and consider how each treatment might affect your quality of life
If the tumour is blocking the common bile duct or small intestine, placing a tube called a stent can help keep the blocked area open. This procedure can be performed using nonsurgical approaches, such as ERCP, PTC, endoscopy or endoscopic ultrasound. These stents are usually metallic.
Sometimes, a patient may need surgery to create a bypass, even if the tumour itself cannot be completely removed.
A special diet, medications, and specially prescribed enzymes may help a person digest food better if their pancreas is not working well or has been partially or entirely removed.
Diabetes can result from pancreatic cancer or be caused by the treatment for pancreatic cancer. Insulin will usually be recommended if a person develops diabetes due to the loss of insulin produced by the pancreas or as a result of treatment
How is pain from pancreatic cancer treated?
Morphine-like drugs called opioid analgesics are often needed to help reduce pain. Special types of nerve blocks done by pain specialists may also be used. A type of nerve block is a celiac plexus block, which helps relieve abdominal or back pain. During a nerve block, the nerves are injected with either an anaesthetic to stop pain for a short time or a medication that destroys the nerves and can relieve pain for a longer time. A nerve block can be performed either percutaneously (through the skin) or with an endoscopic ultrasound (see above). Depending on where the tumour is located, radiation therapy can sometimes be used be used to relieve pain.
What non-physical therapies are used?
Palliative and supportive care is not limited to managing a patient’s physical symptoms. There are also emotional and psychological issues patients experience that can be managed with professional help and support, such as anxiety, depression, help with coping skills, and the overall difficulty of dealing with cancer.
Who can attend a palliative care consultation?
Cancer also affects caregivers and loved ones, and they are encouraged to develop support networks as well.