October 11th is World Hospice and Palliative Care Day. This year’s theme, Achieving the Promise: Universal Access to Palliative Care, is a reminder that every person deserves comfort, dignity, and support while facing a serious illness. Many people still have questions about what palliative care and hospice really mean and how they can help. 

To help answer your questions, we asked medical oncologists Dr. Jessica Lin and Dr. Hardeep Phull to explain the difference between hospice and palliative care, and how both can play an important role in supporting patients with cancer at different stages.

What is the difference between hospice and palliative care?

Although both approaches can help patients with cancer manage side effects and symptoms, Dr. Jessica Lin emphasizes that they’re “distinct terms and concepts.” 

“Hospice is medical care for patients where cancer can no longer be effectively controlled using treatment modalities that we have available,” Dr. Lin explains. “If all viable treatment options have been tried, but patients are too sick or weak, then we may layer on hospice support to help manage symptoms and minimize suffering. This can be provided at home as well, if that is what the patient wants.

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With palliative care, the focus is also on easing symptoms, but this kind of care can be given with or without a curative intent. Dr. Lin says, “Palliative care is aimed at improving the patient’s quality of life by ameliorating symptoms that may be related to the cancer itself or related to cancer treatment.” 

When should you start palliative care?

In some cancers, early palliative care has been shown to improve patient survival, which is why both Dr. Lin and Dr. Phull recommend palliative support care as early as possible. Dr. Phull says, “Early goal-directed palliative care can improve outcomes. The idea is not to think of this as hospice or comfort care or pulling the plug, but early goal-directed palliative care. The idea is you handle symptoms when you find them and tackle them before they become problems.” 

Dr. Lin adds, ”We have data that showed that early engagement of palliative care, even at initial diagnosis of advanced lung cancer, for example, can improve patient survival. Not only the quality of life, which is super important, but also survival. I personally recommend palliative care support as early as possible.”

Is palliative care only for patients with advanced disease?

It’s a myth that palliative care is only reserved for patients with advanced stages of cancer or severe side effects. Dr. Lin shares that palliative care can be helpful even when treatment is going well. “Palliative care involvement is even more effective if they’re following you longitudinally,” she notes. 

Dr. Phull adds that palliative care services are another layer of support, monitoring, and connection. “There are palliative care physicians who are sometimes better at symptom management and recognizing patterns early. It’s really not even just the physician. There’s a team of nurses behind the scenes who monitor patients.”

Beyond managing your physical health, palliative care teams can also facilitate difficult conversations. Dr. Phull comments, “Patients talk about not just their treatment side effects, but their fears and goals. It becomes a journey where that palliative care professional ends up knowing the patient better than nearly anyone else in terms of who they were before the cancer, who they want to be, and who they want to be after. If they don’t survive, what is their legacy?”

Dr. Phull acknowledges that these conversations take time to develop, which is why starting palliative care early can be especially beneficial. “Early goal-directed palliative care is the idea of addressing these things early and building a relationship, so that if you have to address it later, you have a game plan that’s well documented on behalf of the patient and for the patient, reflecting their desire.”

If you’re wondering whether palliative care can help you, bring it up with your care team. It’s a simple step that can make a big difference in your care and comfort.

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