4.3 Palliative care
Early referral to palliative care can improve the quality of life for people with cancer (Haines 2011; Temel at al. 2010; Zimmermann et al. 2014). This is particularly true for cancers with poor prognosis.
In general, all patients with pancreatic cancer, given the poor prognosis, should be offered referral to palliative care assessment as an integrated aspect of their overall oncology care (Gaertner et al. 2011).
In particular, referral to palliative care services is required when:
- symptoms affect quality of life
- ECOG ≥ 2
- estimated likely survival is less than a year and/or the patient/carer has increasing difficulty managing care needs
- complex psychosocial needs, including those of carers
- patient/family wishes for palliative care support, especially in the community setting
- bereavement support for carers.
Emphasise the value of palliative care in improving symptom management and quality of life to patients and their carers.
The ‘Dying to Talk’ resource may help health professionals when initiating discussions with patients about future care needs (see ‘More information’). Ensure that carers and families receive information, support and guidance about their role in palliative care (Palliative Care Australia 2018).
Patients, with support from their family or carer and treating team, should be encouraged to consider appointing a substitute decision-maker and to complete an advance care directive.
Refer to Step 6 for a more detailed description of managing patients with recurrent, residual or metastatic disease.
These online resources are useful:
