Week 10: Cancer and palliative care

In this, the final newsletter in this series, we look at palliative and hospice care, and the comfort it can give to people with cancer.

The idea of being sick and unable to care for yourself, or becoming a burden to friends and family, is a source of great concern to many people with cancer.

The good news is that palliative and hospice care are available across South Africa. And, yes, you and your loved ones can benefit too.

What is palliative care?
According to the World Health Organisation (WHO), palliative care is a treatment approach that improves the quality of life of patients and families facing problems associated with life-threatening illness. It focuses on the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, whether physical, psychosocial or spiritual.

According to Dr Teresa Swart, a South African expert on palliative medicine, the approach differs from normal medicine in that it takes into consideration the psychosocial problems of the sick person, as well as the family.

“The patient has a bigger say in palliative care,” she says. “You’ll find that normal medicine is more paternalistic, where the doctor tells you what to do. In palliative care, we find out what the patient’s needs and wishes are. For instance, if the patient would like to die at home, we’ll work to achieve that.”

Palliative care is, in essence, a philosophy of care, and involves an interdisciplinary team, which typically consists of social workers, occupational therapists, doctors, professional nurses and other experts.

This type of care can be provided at any stage of the illness, even at the start. Palliative care may include treatment options for curing the condition (curative) as well as managing symptoms and side effects (palliative).

Hospice care, in turn, is aimed at people who may be in their final months or weeks of life and always includes palliative care. Hospice care is centred on caring for terminally ill patients who may no longer be seeking curative treatment options.

The WHO definition of Palliative Care (2009) states that palliative care:

• Provides relief from pain and other distressing symptoms.
• Affirms life and regards dying as a normal process.
• Intends neither to hasten nor to postpone death.
• Integrates the psychological and spiritual aspects of patient care.
• Offers a support system to help patients live as actively as possible until death.
• Offers a support system to help the family cope during the patient’s illness and in their own bereavement.
• Uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated.
• Will enhance quality of life, and may also positively influence the course of illness if applied early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy.

How to get access to palliative or hospice care
Do you or someone you love have cancer? Are you considering palliative or hospice care?
Here’s how to get help:

• Talk to your doctor.
• Find out which palliative-care services are available in your area.
• Find out which hospices are accredited and belong to the Hospice Palliative Care Association (HPCA) of South Africa so you know that they’re following the protocols and guidelines set by the HPCA (contact details below).
• Understand your illness and the implications of your symptoms or pain worsening.
• Think about and discuss the quality of life you would like to have, including spending time with loved ones, and minimising pain and other debilitating symptoms.
• Remember to include your personal, cultural and spiritual needs when considering treatment options.
• Decide on the type of facility (e.g. hospital, hospice, nursing home) you would like to be in or whether you prefer to stay at home.
• Meet and get to know your palliative-care team.

For more information, contact the Hospice Palliative Care Association of South Africa (HPCA):
Tel: +27 (0)21 531 0277
Fax: +27 (0)21 531 1706
e-mail: info@hpca.co.za
www.hpca.co.za
Monday - Friday (08:00 - 16:00)

These newsletters have, we hope, given you some of the tools you need to prevent and manage cancer. Remember to stay in close consultation with your medical team.

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