Palliative care aims to alleviate symptoms from cancer and side effects from cancer treatment, as well as maximize the patient’s quality of life. Palliative care does not focus on curing the disease or prolonging life, which is the goal of other breast cancer treatments. However, palliative care can be used alongside other treatments and is an important part of the patient’s treatment plan.1
Also called comfort care, supportive care, or symptom management, palliative care can help with physical symptoms, psychosocial distress, and spiritual distress. A team of healthcare professionals may be involved in providing palliative care, including doctors, nurses, dieticians, pharmacists, psychologists, social workers, and chaplains.1
Palliative care can significantly improve a person’s quality of life while they are undergoing treatment for breast cancer. Palliative care is different than hospice care, which is given near the end of life. Instead, palliative care can aid patients throughout their treatment journey.1
Palliative care for symptoms of metastatic breast cancer
Management of symptoms of metastatic breast cancer depends on the individual’s symptoms and the location and extent of the metastases (areas where cancer has spread). The most common sites where breast cancer metastasizes to are the bones, brain, liver, lungs, and the skin.2
Metastasis to the bone can cause bone pain, increased risk of fractures, and spinal cord compression. Potential palliative therapies include medications (such as pain medications, steroids, or bisphosphonates), radiation therapy, and surgery.2
Metastasis to the brain can cause swelling, which can lead to headaches, seizures, or other neurological difficulties. Palliative care strategies are aimed at relieving the individual’s symptoms and may include pain relief, anti-nausea medications, or anticonvulsants for those who experience seizures. Other therapies that may be used include radiation therapy or surgery to remove a tumor in the brain.2
If breast cancer spreads to the liver, it can cause pain, jaundice (yellowing of the skin or whites of the eyes), nausea, and/or itching. Anti-nausea medications or antihistamines may be used to relieve nausea or itching, respectively.2
Metastasis to the lungs can cause shortness of breath, difficulty breathing, chest pain, cough, fluid build-up around the lungs (pleural effusion), or airway blockages. Palliative therapy options may include medications (such as pain relievers, steroids, or anti-anxiety medications), oxygen, removal of fluid build-up, and radiation therapy.2
Skin metastases and complications
If breast cancer spreads to the skin, it can lead to ulcerated wounds that may cause both physical and emotional distress. Counseling and wound care can help ease the discomfort, and medications may include pain relievers and topical creams.2
Many women with advanced or metastatic breast cancer experience pain, either as a result of their condition or as a side effect from treatment. There are many approaches to manage pain, including medications, complementary therapies, and other treatments.2 It’s important for the patient who is experiencing pain to talk to their doctor about any pain they are experiencing, including how intense and frequent it is.3
Palliative care for psychosocial distress
In addition to the physical symptoms experienced by women with advanced breast cancer, palliative care also addresses the psychological, social, spiritual and financial well-being of patients. Women with advanced breast cancer may experience fear, depression, and anxiety, or they may face challenges with family relationships, financial or insurance issues, employment concerns, or child care. Palliative care can help address these needs and may include referrals to social workers, care coordinators, financial specialists, mental health professionals, or spiritual counselors, based on the needs of the individual.1
Palliative care in cancer. National Cancer Institute. Available at https://www.cancer.gov/about-cancer/advanced-cancer/care-choices/palliative-care-fact-sheet. Accessed 10/19/18.
Palliative care for metastatic breast cancer. Fred Hutchinson Cancer Center. Available at https://www.fredhutch.org/content/dam/public/labs-projects/PHS/breast-cancer-initiative/KSPDF/KS%20Palliative%20Care%20Metastatic%20030617.pdf. Accessed 10/19/18.
Pain and metastatic breast cancer. BreastCancer.org. Available at https://www.breastcancer.org/symptoms/types/recur_metast/stop_treat/palliative/pain. Accessed 10/22/18.