What do you mean, palliative? I’m not dying anytime soon, am I?

When Christina, a woman in her sixties, reached out to Anticancer Fund with questions about her metastatic breast cancer, she was confused. Her doctor had told her she was a "palliative" patient.

“But I feel fit, and she said there were still plenty of treatment options. Surely I’m not going to die soon?”

There is a significant taboo surrounding the word palliative, and often a great deal of confusion regarding its meaning. For many, "palliative" is synonymous with "terminal," so it is understandable that the term causes distress. However, there is a fundamental difference between the two.

Curative versus palliative

When someone is diagnosed with cancer, the initial aim is usually to cure the disease—curare in Latin—via a curative treatment. This might involve surgery, radiotherapy, medication, or a combination of these. If the treatment succeeds, the patient is given the all-clear (declared cured), followed only by medical check-ups, scans, and blood tests.

However, sometimes curative treatment is not a viable option because the cancer is too advanced, has spread significantly (metastasis), or is incurable from the outset. Administering a curative treatment in these cases would be considered futile medical care.

In this situation, the medical team opts for palliative treatment. This comes from the Latin word palliare, which literally means "to cloak." In this context, it means to protect, cover, or alleviate. The goal is no longer to cure, but to keep the disease under control as best as possible and to limit symptoms and complications.

Important to know: Both curative and palliative treatments can be intensive and technologically advanced. The difference lies in the goal: curing the patient versus relieving symptoms and preserving quality of life.

Thanks to advances in medical science, many forms of incurable cancer can now be treated much more effectively. Cancer patients are living longer than before, often maintaining a good quality of life. Consequently, certain forms of incurable cancer are increasingly being viewed as a chronic condition.

What is palliative care?

While palliative treatment focuses on the disease, palliative care focuses on the person. It has a place both during and after treatment. It encompasses supportive care, terminal care, and bereavement care.

In the past, people would say, "There is nothing more that can be done," once cancer was deemed incurable. Nowadays, we know that palliative care can do a great deal, having a positive effect on both quality of life and life expectancy.

• Supportive care: for example, processing bad news after a scan or discussing the side effects of medication. This care often runs parallel to palliative treatment.
• Terminal care: when it becomes clear that further treatment is no longer effective, active therapy is stopped, and the focus shifts entirely to comfort. The emphasis is on pain and symptom control, as well as support as the end of life approaches.
• Bereavement care: this is care for the patient's loved ones, which can begin before death and continues into the period afterwards.

This is not the end

Palliative care is there for the patient and their loved ones. By viewing it not as "the end," but as a "protective cloak" worn throughout the illness, care can be introduced sooner and more effectively. The result is a better quality of life for the patient and stronger support for the family.

So, the answer: even if someone is not going to die for a long time, palliative care often plays a vital role.

For more information, please read: ‘Een Waardig Levenseinde’ (A Dignified End of Life) by Wim Distelmans, 18th edition, Houtekiet.