Dr Toby Campbell: Palliative Care Discussions Are Difficult, but Necessary

Bringing up palliative care is inherently difficult for providers, because it means bringing up death and dying, said Toby C. Campbell, MD, MSCI, associate professor of medicine, hematology-oncology at the University of Wisconsin School of Medicine and Public Health and chief of Palliative Care and program director of the Hospice and Palliative Medicine Fellowship Training Program.

Transcript (slightly modified)

How difficult is it for healthcare providers to bring up the topic of palliative care?

Talking about palliative care means acknowledging someone’s mortality. It means, by some measure, beginning to talk about an incurable disease, beginning to talk about dying. And so I think it is inherently difficult.

I want to make clear, though, that patients are already worried about it. From the very beginning when they hear the word “cancer,” they’re already scared. They’re already worried; their minds have already gone to the question “Is this going to take my life? Am I going to die?” So this won’t be the first time that they’ve brought it up. But for many patients and families they will not bring it up without some prompting from the oncologist.

And so what we have learned in survey data and other places is that patients and families want to talk about this—in fact, they expect to talk about it. But they, generally speaking, won’t bring it up themselves. So it is important actually for the oncologist to be comfortable with bringing this up, be willing to bring it up, to talk both about palliative care but also about life expectancy, about what happens when you’re dealing with an advanced cancer.