‘It’s About Living Better’” Repositioning Palliative Care in Hematologic Cancer

The role of palliative care is widely misperceived as a strategy reserved for patients with limited options in advanced stages of disease. This misperception has been standing in the way of broader application of treatments that can improve quality of life (QOL) of patients with serious disease even when the prognosis is good, according to experts at a symposium devoted to this topic during the 2015 annual meeting of the American Society of Hematology.

“Palliative care has moved further upstream in the 21st century. It’s really about supporting people through a serious illness. It is more about living better rather than about the issues that arise only at the end of life,” reported Thomas W. LeBlanc, MD, Division of Hematologic Malignancies and Cellular Therapy, Duke University School of Medicine, Durham, North Carolina.

Several subgroups of patients with hematologic cancers, including many of those scheduled for hematopoietic stem cell transplant (HSCT), are reasonable candidates for palliative care. However, Dr LeBlanc cited data indicating that palliative care is less likely to be offered to patients with hematologic cancer than those with solid tumors, even at the end of life.^[1] Palliative care, which is directed at symptom control and the stress imposed by symptoms, is already fundamental to hospice and end-of-life management, but it is a strategy that can be initiated at any stage of disease, including at the time of diagnosis. Although palliative care is not a treatment for the disease, it can be delivered alongside forms of treatment with curative intent in order to improve QOL.