Can I have palliative care and cancer treatment at the same time?

Yes. You can receive palliative care while still having treatment aimed at your cancer.

Palliative care can be given with or without curative care. It may be provided at any point during cancer care, from diagnosis to the end of life. When a person receives palliative care, they may continue to receive cancer treatment at the same time.

The mix-up is understandable, and it costs people real comfort. Many hear "palliative" and assume treatment has stopped working. It has not. NCI defines palliative care as care meant to improve quality of life for people with a serious or life-threatening disease. Nothing in that definition says anything about stopping treatment. A person can start chemotherapy and palliative care in the same week.

What makes it a distinct service is the team. It can include doctors, nurses, and dietitians. It can also include pharmacists, physical therapists, and occupational therapists. Chaplains, psychologists, and social workers round it out. That breadth is the whole point. An oncology visit has to cover scans, blood counts, and the next cycle. It rarely has room for the eight other things making your week hard.

Those other things are exactly what palliative care takes on.

• Physical symptoms. Pain, fatigue, poor appetite, nausea, vomiting, shortness of breath, and trouble sleeping.
• Emotional strain. Depression, anxiety, and fear.
• Spiritual questions. Help exploring your beliefs and finding some peace with them.
• Practical problems. Money, legal matters, insurance, and work.
• Caregiver support, for family members who are worn down.

You can get this care in the hospital. You can also get it in an outpatient clinic, a long-term care facility, or at home. It is not one setting or one kind of visit.

This is one way palliative care differs from hospice. Palliative care can begin at any point during treatment, while hospice care begins when curative treatment is no longer the goal and the sole focus is quality of life. Put simply, all hospice care is palliative. Most palliative care is not hospice.

To start palliative care, ask your oncologist or someone on your oncology team; they may refer you to a palliative care specialist based on your needs. NCI says plainly that your oncology team is the first place to ask.

One tip makes that conversation go better. Do not open with "I want palliative care." Name the problem instead. "My pain is a 7 and I am not sleeping." "I have thrown up after every cycle." "I cannot pay the mortgage this month." Specific problems get specific referrals, and they get them faster.

Two more things are worth asking. Does your cancer center have its own palliative care clinic? And can the referral happen at a visit you already have booked? Many centers can add it to a day you are coming in anyway.