4.4 Palliative care

4.4 Palliative care

Unless favourable and treatable disease is defined, CUP represents a group of patients who have a very poor prognosis. It has been demonstrated that CUP patients receive less treatment and have poorer survival compared with those with cancer of known primary sites (Riihimaki et al.2013a, Schaffer et al. 2015). Many people with CUP may benefit from palliative treatments to relieve symptoms, improve quality of life and manage the uncertainty of their prognosis more effectively.

Palliative care interventions should be considered for all patients diagnosed with CUP (NCCN 2017). It is preferable for specialist palliative care to be initiated during the diagnostic stage, and for many patients this will remain the most important intervention during their illness (Abdallah et al. 2014).

Early referral to palliative care can improve the quality of life for people with cancer including improving the capacity of patients to sit comfortably with diagnostic and prognostic uncertainty and better management of physical and psychological symptoms (Haines 2011, Temel et al. 2010, Temel et al. 2017, Zimmermann et al. 2014). This is particularly true for poor-prognosis cancers (Cancer Council Australia 2017, Philip et al. 2013, Temel et al. 2010, Temel et al. 2017). Furthermore, palliative care has been associated with improved wellbeing for carers (Higginson & Evans 2010, Hudson et al. 2014).

Ensure carers and families receive information, support and guidance regarding their role according to their needs and wishes (Palliative Care Australia 2005).

The patient and carer should be encouraged to develop an advance care plan (AHMAC 2011).

Further information

Refer patients and carers to Palliative Care Australia.