14 - Palliative care

Summary

Introduction

Approximately 40% of the 17 000 women diagnosed with gynaecological cancer in the UK each year will eventually die from their disease. The principles of palliative care form an important part of disease management and are encouraged as part of good practice for all health professionals caring for these women. Where problems are more complex, persistent or difficult to manage, referral to specialist palliative care is recommended.

The World Health Organization defines palliative care as improving the quality of life of patients and families who face life-threatening illness by providing pain and symptom relief and spiritual and psychological support, from diagnosis through to the end of life and into bereavement. Palliative care:

• provides relief from pain and other distressing symptoms

• affirms life but regards dying as a normal process

• intends neither to hasten nor postpone death

• integrates the psychological and spiritual aspects of patient care

• offers a support system to help people to live as actively as possible until death

• offers a support system to help family cope during the patient's illness and in bereavement

• uses a team approach

• aims to enhance quality of life and may also positively influence the course of the illness

• may be valuable early in the course of the illness in conjunction with other therapies that are intended to prolong life (these include chemotherapy or radiotherapy and those investigations needed to better understand and manage distressing clinical complications)

• puts an emphasis on open and honest communication

• respects autonomy and choice.