Whilst for many types of cancer there are very effective treatments that result in a complete cure or perhaps a sustained period of remission, some cancer sufferers are not as fortunate. Sadly some patients have cancers that have already spread to other parts of the body when they are first diagnosed and are deemed incurable. Other cancers may progress after periods of remission, and further treatment is not possible. Some patients are either too elderly or too frail to cope with aggressive anti-cancer treatments. For these folk the cure is more risky and distressing than living with the natural progression of the illness. At this stage it becomes essential that medical interventions are directed at helping the patient and their families live as comfortably as possible with the effects of the cancer. Inevitably for many of these patients the cancer will progress to the patient's death.
Palliative care means providing active medical care that reduces or camouflages the unpleasant effects of the cancer. It endeavours to provide relief from pain and other distressing symptoms. For some however, the only symptom is a progressive and relentless fatigue, and care is focused on providing practical, psychological, emotional and spiritual support to the patient and those nursing him/her. Patients and their families need to know how to access assistance when the patient's situation changes and additional help is required at short notice.
Palliative care recognises dying as a normal process, and intends neither to hasten death nor prolong suffering. This sort of care is multidisciplinary, and is provided by a network of medical, nursing and allied health (physiotherapists, occupational therapists, chaplains etc) professionals.
Care is ideally provided where possible in the patient's home, but sometimes admission to hospital is required to sort out and stabilize unpleasant symptoms, or administer interventions such as blood transfusions, fluids and treatments by intravenous drip. These are aimed at optimising the patient's comfort.
Sometimes the level of support that can be provided by the patient's family at this difficult time is just not enough and the need to consider residential care such as a nursing home or hostel must be considered.
Sydney Adventist Hospital is committed to providing sensible, caring and appropriate support at all times during the cancer journey. The Poon Oncology and Palliative Care Ward is located on Level 6 at the San and patients are able to be admitted for either short-term symptom management or terminal care (care during the dying phase) under the patient's usual specialist and/or a palliative care specialist.
If discharge is contemplated either to home or into residential care, an experienced case manager coordinates the process. This is usually done with the assistance of a social worker and occupational therapist. Liaison is made with the patient's general practitioner, relevant district nursing and community palliative care team to ensure the best possible care at all times for the patient. Patients can be re-admitted for acute symptom management if required.
To cure, occasionally
To relieve, often
To comfort, always
Anonymous (16th Century)
