Our nation’s health care system faces numerous challenges, but there is one that can be solved with near universal support: the tragic lack of emphasis on patients’ quality of life during and after treatment. Thanks to scientific discoveries, many people can now live long and full lives with serious diseases such as cancer that were once a virtual death sentence. We’ve had great success in treating patients, but less so in preventing pain and the often harmful after-effects of treatment that patients often face during and after their life-threatening struggle with cancer.
Compounding the problem is the fact that many patients falsely believe that severe pain and suffering are a necessary component of aggressive treatment. Patient comfort should not take a back seat during treatment, and it does not need to. Treating the whole patient – not only the disease but also the physical and psychological side effects of treatment – is the key to both extending life and enhancing the quality of the time gained.
The good news is that patients’ quality of life is receiving increasing emphasis in the way our health care system is evolving. According to the Center to Advance Palliative Care (CAPC) and the National Palliative Care Research Center (NPCRC), a growing number of hospitals across the country are offering the extra layer of team-based patient support that comes with palliative care, which is proven to extend life and save money. Palliative care is appropriate at any age and any stage of a serious illness and can be provided alongside curative treatment. It is delivered by a team of doctors, nurses and specialists, who work with patients to address pain, stress and other symptoms of treatment, with the goal of improving the quality of life of patients and their families. Palliative care empowers patients and their families to be actively involved in making key decisions about treatment and symptom management.
Palliative care works. And an Institute of Medicine (IOM) report released last year concluded that providing cancer patients greater access to palliative care is necessary if we are going to have a health care system that provides high-quality cancer care. A 2010 clinical study published in the New England Journal of Medicine found that lung cancer patients who received palliative care services during curative treatment survived longer and with fewer symptoms such as pain, shortness of breath and nausea. Palliative care also can lead to fewer patient days in intensive care units, shorter hospital stays and reductions in health care costs.
Despite the benefits, palliative care remains a mystery to many Americans, 70 percent of whom say they are unaware of palliative care, according to a 2011 poll by the American Cancer Society, the American Cancer Society Cancer Action Network (ACS CAN) and CAPC. Physicians and patients often mistakenly equate palliative care exclusively with hospice or end-of-life care. However, once consumers understand what palliative care is – a team-based emphasis on symptom management and patient comfort – 92 percent of Americans support making it available for a loved one with a serious disease.
Misconceptions about palliative care stem largely from a lack of training among medical professionals and a scarcity of information among patients and consumers. The lack of research in this area is also a problem; less than 1 percent of the National Institutes of Health (NIH) budget is spent on palliative care research.
Public policy can help to reverse this trend, and a bi-partisan bill in Congress would do just that. The Palliative Care and Hospice Education and Training Act (H.R. 3119), sponsored by Reps. Eliot Engel (D-NY) and Rep. Tom Reed (R-NY), would enhance the training and education of health professionals in palliative care, facilitate federal research into palliative care and establish a national palliative care education and awareness campaign. By establishing workforce training incentives and grants for palliative care research, these bills would help address the lack of palliative care expertise among medical professionals. They are also low cost and provide measurable outcomes, and they are gaining support among lawmakers of both parties.
We can make significant strides against cancer and other life-threatening conditions through patient-centered care that treats the person as well as the disease. Palliative care is a solution that Americans overwhelmingly want, saves money and improves patients’ quality of life.
Chris Hansen is president of the American Cancer Society Cancer Action Network, the advocacy affiliate of the American Cancer Society.