- Mass General Cancer Center researchers find that shifting palliative care to the outpatient setting and offering it early in the course of cancer treatment allows palliative care clinicians to develop a longer-term relationship with patients and families
- In this way palliative care has been expanded beyond symptom management to include helping patients understand their treatment and prognosis, make more informed decisions, process grief and effectively cope with serious illness
- Coping strategies can include maintaining daily routines, working toward realistic goals, seeking help or advice from outside the family, helping others, self-distraction, looking for good in the situation, finding acceptance and using humor
Recent meta-analyses provide evidence that palliative care for patients with life-limiting illnesses, including cancer, improves quality of life and reduces symptom burden.
In fact, a clinical trial at the Massachusetts General Hospital Cancer Center determined that in patients with incurable cancer, early palliative care significantly increased the use of active coping strategies and acceptance, compared with usual care, with beneficial effects on quality of life and depression.
Writing in the Journal of Clinical Oncology, Joseph A. Greer, PhD, program director of the Center for Psychiatric Oncology and Behavioral Sciences at the Mass General Cancer Center, Vicki A. Jackson, MD, MPH, chief of the Division of Palliative Care and Geriatric Medicine, and colleagues describe the role of early palliative care in promoting effective coping.
Why Offer Palliative Care to Outpatients?
Beginning palliative care early in the course of cancer treatment allows clinicians to develop a longer-term relationship with patients and families. This expands their role beyond symptom management to include helping patients live well while acknowledging the possibility of dying.
In the outpatient setting, palliative care clinicians help patients:
- Understand their treatment and prognosis to make more informed decisions
- Process the grief associated with losses in functioning due to disease progression and treatment adverse effects
- Learn and use effective coping strategies
The review lists numerous strategies patients can use to cope with cancer and related symptoms and emotions. Examples are spiritual practices, maintaining daily routines, focusing on the present moment or day, working toward realistic goals, seeking help or advice from outside the family, helping others, self-distraction, looking for good in the situation, finding acceptance and using humor.
Involving Primary Care
Primary care clinicians can play an essential role in promoting coping strategies to help patients and families manage the burdens of cancer. There's no gold standard for evaluation, but the Brief COPE Inventory, a validated patient self-report questionnaire, assesses both functional and dysfunctional coping responses.
Learn more about palliative care at the Mass General Cancer Center
Refer a patient to the Mass General Cancer Center