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Talking Palliative Care Part 1: Symptom management and getting the most out of your palliative care team

End of life is not an easy topic to think about let alone plan for. Understanding what palliative care is and what decisions you will face when planning for end of life is central to ensuring your needs and wants are met when you may no longer be able to make decisions for yourself.  Over the next several months we’ll be sharing information and resources to help you make these decisions and to better prepare you and your loved ones. Our Talking Palliative Care blog series will focus on topics such as pain management, grief, hospice and palliative care considerations, dying well, financial planning, funeral planning and more. Special thanks to the Canadian Virtual Hospice for providing their expert guidance on this series.

The thing to know about palliative care is that you don’t actually need to be at end of life to get the benefits of it. Palliative care is about getting the best quality of life while living with a life-limiting diagnosis. Symptom management and maintaining your emotional well-being are key aspects in palliative care treatment.

Palliative care while living with metastatic breast cancer can look different to each person. In the early stages, your primary oncology team will likely be who you see for symptom management. According to the Canadian Virtual Hospice, many palliative programs will offer consultations and advice to your oncologist.  You can also see social workers, spiritual care providers, and physiotherapists.

When the time comes to make the difficult decision to end treatment, you may be transferred to a specialized palliative care team. Most programs specializing in hospice palliative care will start seeing patients within six months of death, but this can vary by program and facility. This team will be responsible for ensuring you are comfortable straight through to the final days of life.

When it comes to symptom management for mBC, pain is often the most common concern we’re asked about. There are different ways your palliative care doctor can help you relieve pain depending on where it is and how bad it is. Medication can be used beginning with over the counter medicines like acetaminophen or nonsteroidal ani-inflammatory drugs (NSAIDS). Stronger doses can also be prescribed by your doctor. Opioids are drugs that can be prescribed if your pain becomes severe and come in a variety of strengths as well. Cannabinoids can also be used to help manage pain; currently not all physicians are comfortable prescribing cannabinoids, but your palliative care team can connect you with a physician who is.

Other forms of pain relief are available if medicine is not the only way you want to treat your pain symptoms. Medically, your doctors may use surgery or radiation to help treat your pain. Acupuncture, massage, transcutaneous electric nerve stimulation (TENS) and meditation have all been shown to help relieve pain symptoms. These complementary therapies can also help relieve other symptoms you may be experiencing. Keep following our blog to learn more about these and other complementary therapies.

The most important way for your doctor to help relieve pain symptoms or any other symptom you may be experiencing is to let them know about it early and when it changes. Keep a diary or use an app like our Health Storylines App to track your symptoms. Keep track of details like:

  • How severe is your pain?
  • Where is it?
  • What does it feel like?
  • Does it come and go?
  • What causes it?

How you treat your symptoms can largely depend on how much information you share with your doctors, whether or not they are specialized in palliative care treatments. Talking to them early on and creating a plan for when the symptoms progress or change is important to helping you feel in control of the management of your disease.

Symptoms and side effects of your cancer will progress gradually once you choose to stop your treatments. Creating an Advance Care Plan that outlines how you want your pain and other symptoms managed is also an important.

For more information on treating pain during palliative care, read this article from our partners, the Canadian Virtual Hospice, on pain and pain management.