Addressing Breast Cancer Patients' Misconceptions on Palliative Care

Navigating a cancer diagnosis is difficult for patients and their loved ones. Patients have to learn complex information to understand their condition and treatment options – from understanding their diagnosis and potential side effects of treatment to managing the financial impact of care. Healthcare providers (HCPs) are vital in this process. A recent survey shows that patients trust their HCP most when making treatment decisions, with 81 percent of patients citing their HCP as a leading factor.^1,2
However, misconceptions and a lack of understanding about certain aspects of care can make it difficult for patients to make informed decisions. Palliative and hospice care are 2 areas where patient understanding is often unclear. Patients may not fully understand what these types of care entail and how they differ from one another.
This article is based on the findings from several Health Union surveys, conducted from 2018 to 2022. These surveys examined the experiences of cancer patients and caregivers when it comes to cancer treatment and what they know about palliative care.

Understanding the misconceptions

Patients often have a lot of uncertainty about what palliative care is, particularly how it differs from hospice care. Survey results showed that many patients defined palliative care as "end-of-life care" or "comfort care" during the end-of-life phase. This misconception can lead to a belief that palliative care is only for patients when treatment is no longer working.^1,2
The survey found that a little more than one-quarter of patients were unsure what palliative care was, and some were not familiar with the term itself. In contrast, most patients were aware of the term hospice and how it is used in cancer care. This highlights a key challenge. Patients may not be comfortable with the term "palliative care" because they associate it with giving up on treatment.¹
This misconception is not a new issue. A 2019 study looked at patient-reported treatment decisions and found that misperceptions about palliative care are common among cancer patients. The study found that many patients believe that palliative care is the same as hospice care. They also found that patients often believe that they must stop curative treatment in order to begin palliative care. Again, this is untrue.³

Explaining palliative care versus hospice care

Patients and families need to understand the difference between these 2 types of care.

Palliative care

Palliative care is specialized medical care for people with a serious illness. It focuses on providing relief from the symptoms and stress of the illness, as well as potential side effects from treatment. The goal is to improve the quality of life for both the patient and the family.⁴
A breast cancer patient may experience joint pain, fatigue, or other physical symptoms from their treatments. Palliative care can help patients address these issues.
Survey results showed that in 2018, 9 percent of patients had used palliative care. A separate 2021 survey found that just 7 percent had used palliative care.^1-3
Healthcare teams need to make it clear: Palliative care is appropriate at any age and at any stage in a serious illness, and can be provided along with curative treatment. Patients who do use palliative care often cite that it is necessary to continue with their daily lives while fighting their disease. Therefore, palliative care can be a meaningful addition to their overall treatment plan and allow them to continue doing things they find meaningful.⁴

Hospice care

Hospice care is a specific type of palliative care for patients who are nearing the end of their lives. Hospice care focuses on comfort and quality of life rather than on a cure. It is typically for patients who have a life expectancy of 6 months or less and who have decided to stop curative treatments.⁴
Hospice care helps manage pain and addresses emotional and physical needs. A key difference is that hospice care is used when no other treatment options are left or patients do not wish to continue treatment.⁴

Providing clarity and support

The data suggest that patients may avoid discussing palliative care because of their misconceptions. To address this, HCPs can use clear, simple language when discussing these topics.^1-3
When discussing palliative care with patients, it is helpful to frame it as an additional layer of support rather than a replacement for current treatment. Emphasize that palliative care can be started at any point in their treatment journey, even when they are actively seeking a cure. Patients who have received chemotherapy, for example, have also used palliative care.^1-3
Patients with cancer are already managing a lot of physical and emotional challenges. They may be experiencing anxiety and stress. They may also be dealing with treatment side effects that negatively impact their daily lives. Fatigue is one of the symptoms with the highest negative impact on patients. The 2022 survey found that only half of patients felt their HCP fully explained potential side effects to them. Patients who feel they can talk openly with their doctor about side effects are more likely to manage them. This can lead to greater satisfaction with their treatment decisions.^1-3
By helping patients understand that palliative care can help manage these symptoms, HCPs can improve a patient's quality of life. By providing clear, accurate information, HCPs can empower patients to make informed decisions and improve their quality of life throughout their cancer journey.^1-3