Palliative care is a concept of care for patients living with
advanced incurable cancers.
The term 'palliative'
is derived from the Latin word 'Pallium' meaning cloak or a
mask. The aim of palliative care is to cover or mask the
distressing symptoms associated with advanced cancer and improve
the quality of life for patients and their families.
Palliative care can be given in many
settings including the hospital, a hospice, as part of a
community based hospice programme and in a nursing home.
Palliative care seeks to relieve pain and other troublesome
symptoms, provide emotional, psychological and spiritual support
to patients and their families.
It must be emphasised that even in the
serious situation of advanced stage cancer, one must not lose
Relief of pain and other symptoms as
well as supportive measures will allow patients with advanced
disease to have reasonable and comfortable quality of life.
Dame Cicely Saunders
The founder of the modern hospice, Dame Cicely Saunders was one
of the pioneers of the ethos and principles of palliative care
and the hospice movement. She founded St. Christophers Hospice
in London, which became a demonstration model to the medical and
nursing profession worldwide on care of patients with terminal
cancer. It exemplified compassionate and humane care for these
patients. Her example has been emulated the world over with the
formation of hospices and palliative care organisations in many
countries including Malaysia.
Pain management has been a central pillar in the concept of
palliative care. Effective pain management has greatly improved
the quality of life and brought comfort into the lives of
Better assessment of
pain including routine use of pain assessment scales has allowed
doctors and nurses to better identify pain in their patients.
This has allowed for more effective pain relief since
identifying pain at the earliest instance allows for prompt and
Routine use of strong painkillers such
as Morphine, an opioid analgesic, for chronic cancer pain have
translated into more effective pain control for most patients. A
better understanding of Morphine derived from studies in the
1980s has shown that it is safe and effective when used by
doctors and nurses experienced in its usage. It has also been
shown clearly in these studies that it does not cause addiction
in patients with chronic cancer pain.
By achieving pain control and comfort, people with advanced
cancer can deal with emotional and other issues arising out of
terminal disease. Palliative care allows them to explore
spiritual issues, reflect on their life achievements, their
legacy, complete any unfinished business and spend meaningful
time with their family.
Dame Cicely Saunders captured the
spirit of palliative care when she said, "You matter because you
are you, you matter to the last moment of your life and we are
here not only to help you die peacefully but also to help you
live until you die".