What Is Palliative Care?

By Katherine Kam
WebMD Feature Reviewed by Laura J. Martin, MD

Since Kathleen Huggins was diagnosed with lung cancer last November, doctors have been working hard to try to cure her. Surgeons removed part of her lung and soon she'll begin chemotherapy.

But the 56-year-old New York City resident also benefits from a new type of medical specialty called palliative care. It has its own distinct mission: to relieve suffering and improve quality of life for people with serious illnesses.

For example, Huggins had a large, painful surgical incision in her torso. Her palliative care doctor made sure the pain was managed properly.

"They would constantly ask me what my pain level was and adjust my medication to what I needed to make me comfortable," Huggins tells WebMD.

In the days before surgery, she had prepared spiritually by talking to a rabbi -- a member of her palliative care team. Then right before doctors took her to the operating room, that same rabbi appeared at her bedside.

"She sat there with me the whole time and just held my hand," Huggins says.

A social worker -- also on the palliative care team -- now is helping her with practical matters: obtaining a wig before she loses her hair and arranging transportation for chemotherapy sessions.

Twice each week, she meets with a counselor. This team member helps her to deal with the intense emotions that come with having cancer.

Say "palliative care" and most people imagine cancer patients being made comfortable in an end-of-life hospice setting.

But palliative care is actually a new medical specialty that has emerged in the last decade -- and no, it's not the same as hospice. It doesn't serve only the dying. Instead, it focuses more broadly on improving life and providing comfort to people of all ages with serious, chronic, and life-threatening illnesses.

These diseases may include cancer, congestive heart failure, kidney failure, chronic obstructive pulmonary disease, AIDS, and Alzheimer's, among others. "It's the whole spectrum, really," says Joseph Chan, MD, a palliative care physician in Fort Smith, Ark.

"The vast majority of America's medical schools have palliative care programs and are teaching medical students and residents about palliative care. That didn't occur 10 years ago. There was literally no education occurring on the topic," says Diane Meier, MD, director of the Center to Advance Palliative Care at Mount Sinai School of Medicine in New York City.

Currently, there are more than 1,400 hospital palliative care programs in the U.S., according to Meier. About 80% of large U.S. hospitals with more than 300 beds have a palliative care program, she says. Among smaller hospitals with more than 50 beds, about 55% have programs.

Typically, a palliative care team includes a physician, nurse, and social worker, Meier says. But it often involves a chaplain, psychologist or psychiatrist, physical or occupational therapist, dietitian, and others, depending on the patient's needs.

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