Cancer and Palliative Care: More Than a Physical Diagnosis

**This post was contributed by Johns Hopkins Kimmel Cancer Center development staff member Allison M. Rich.

Cancer is more than just a physical diagnosis. Here at Hopkins, we know that preserving the dignity of our patients means providing them with the tools they need to confront the impacts that cancer has on all aspects of their lives. While palliative care programs can do just that, myths about the efficacy and necessity of palliative care abound – myths which are perpetuated by uninformed associations with terminology such as “death panels.” This misinformation makes it absolutely vital that we emphasize in both the clinic and the classroom that palliative care does not comprise “death panels” at all, but is instead an integral part of quality cancer care. Interestingly, it is philanthropy that provides the perfect vehicle for this much needed shift in how we view cancer treatment.

The palliative care approach to cancer treatment can be summarized as the recognition that cancer does not exist within a vacuum, but within a person. Rather than focusing primarily on the tumor, palliative care focuses on the whole person and the relief of physical, psychological, and social symptomatology. While conventional thinking might dictate simply writing a prescription to manage a given symptom, the palliative care approach utilizes psychosocial techniques as diverse as pain management, supportive counseling, meditation, and spirituality, to get to the root of patients’ experiences of cancer.

In 2007, philanthropic giving allowed Hopkins to establish the Harry J. Duffey Family Pain and Palliative Care Program to provide the most holistic, supportive care for our patients and families. From fostering facts-based dialogue about a range of palliative care topics to advancing our understanding of palliative care through clinical trials, the Program allows Hopkins physicians to illustrate to the entire medical community that palliative care has a positive, quantifiable impact on cancer treatment outcomes. In fact, palliative care allows our patients to not just live better, but to live longer as well.

Dr. Tom Smith, the Harry J. Duffey Family Professor of Palliative Medicine and the Director of Palliative Medicine here at the Kimmel Cancer Center, describes these positive outcomes in contexts where palliative care is normalized as part of a patient’s treatment plan. Palliative care is more than just a one-time conversation, and in cases where the cancer has advanced or there is a heavy burden of symptom management implementing palliative care and disease treatment concurrently has undeniable benefits. Dr. Smith often cites a 2010 study reported in the New England Journal of Medicine which found that patients with advanced non-small cell lung cancer who received palliative care concurrently with their cancer treatment not only had a better quality of life, but longer average survival outcomes than those who did not receive palliative care.

While the Harry J. Duffey Family Pain and Palliative Care Program allows Dr. Smith and the rest of our oncology team to demonstrate the efficacy of palliative care here at the Kimmel Cancer Center, the reality is that the approach will not become universal until it is a key component of medical curricula. Restructuring cancer treatment to include palliative care across the treatment continuum necessitates a new approach to training doctors. Placing emphasis on relevant, interdisciplinary skills during medical training—such as communication, guiding patients through the decision-making process, helping patients navigate the healthcare system more broadly, and providing emotional and spiritual resources to patients and families—is absolutely vital to better integrating palliative care into standard oncologic practice.

Newly philanthropically funded programs like the MacMillan Family Fellowship Program in Oncology allow Hopkins to equip tomorrow’s oncologists with the skills necessary to navigate the delivery of cutting edge cancer care while never losing sight of the person in each patient. Increasing the depth and breadth of palliative care is dependent not only upon research findings, but on a concerted effort to educate doctors and patients alike about its capacity to improve cancer care outcomes. Philanthropy provides the tools our clinicians and scientists need to help bridge the gap between status quo and our promise towards progress. Without the generous, targeted giving of our donors, palliative care would not be nearly so integral a part of the treatment that the Kimmel Cancer Center provides.

**More resources:
On the Fine Print of Cancer video series, our social workers discuss palliative care.
Drs. Thomas Smith and Ronan Kelly discuss health care costs and palliative care.