Palliative care is care that eases pain, breathlessness, nausea, tiredness, anxiety and other problems, and supports the patient and their family so that they can live as well as possible [1, 2]. It is for anyone with a serious illness such as cancer, at any stage of the illness, from diagnosis to the end of life, and it can be given alongside treatment for the cancer itself [1]. Hospice, or "end-of-life care", is different: it is for the time when treatments are no longer controlling the disease and the only goal is the patient's comfort [3].
Key points
- Palliative care looks after all of a patient's needs: physical symptoms such as pain and sleeplessness, emotional wellbeing, spiritual needs and practical matters; and it supports family members and caregivers too [1].
- Having palliative care does not mean giving up on treatment; the patient can have chemotherapy, radiotherapy or surgery at the same time [1].
- In a study of people with lung cancer that had spread, those who had palliative care from the start felt better, were less often depressed and also lived longer [4].
- The American Society of Clinical Oncology recommends that people with advanced cancer, whether solid tumours or blood cancers, be referred to a palliative care team early in their illness [6].
- If you have been told that "nothing more can be done", it means that treatments against the cancer are no longer helping, not that there is nothing left to do: pain and other symptoms can still be treated [3].
What is palliative care for cancer patients?
To "palliate" means to ease or soothe. Palliative care is meant to improve the quality of life of people who have a serious or life-threatening illness, such as cancer [1]. It finds pain and other problems early, whether physical, emotional and social or spiritual, and treats them properly so that the patient suffers less [2]. It cares for the whole person, not just the illness [1].
Contrary to a common belief, palliative care is not only for cancer, nor only for the last weeks of life [2]: people with heart disease, lung disease, diabetes and other serious illnesses need it too [2].
A palliative care team usually includes doctors, nurses, dietitians, pharmacists, physiotherapists, occupational therapists, psychologists, social workers and chaplains [1]. This care can be given in hospital, in an outpatient clinic, in a care home or at home [1].
What does the palliative care team do?
Symptom control
The team treats pain, tiredness, nausea, breathlessness, constipation and sleeplessness [1, 5]. See the guides Cancer pain, Fatigue and Nausea and vomiting.
Emotional support
The team recognises and treats depression, anxiety and fear [1]. See the guide Anxiety and depression with cancer.
Spiritual needs
The team helps the patient find meaning and peace, based on their own beliefs [1].
Talking things through and making decisions
The team explains the illness and what may lie ahead in simple words, helps make the goals of treatment clear and helps with treatment decisions [5].
Support for the family
The team supports caregivers, helps with the family's practical needs, and stays with the family through their grief after the patient dies [1, 2]. See the guide A guide for family members and caregivers.
Coordinating care
The team works with the cancer doctor and other doctors and, when needed, refers the patient to other specialists [5].
Palliative care vs hospice: what is the difference?
| Topic | Palliative care | Hospice (end-of-life care) |
|---|---|---|
| When it starts | From diagnosis, at any stage of the illness [1] | When treatments are no longer controlling the disease [3] |
| Cancer treatment | Continues at the same time [1] | Stops, and the focus is only on easing symptoms and giving support [3] |
| Goal | A better life for the patient and family [1] | Each day as comfortable as possible; neither hastening nor postponing death [3] |
| Where | Hospital, outpatient clinic, care home or home [1] | Mostly at home; sometimes in special inpatient units, hospitals or nursing homes [3] |
| For the family | Support for caregivers [1] | Breaks for caregivers and help with grief [3] |
Hospice is a special type of care for the time when treatments are no longer holding back the disease [3]. Choosing hospice does not mean giving up hope; it means that what you hope for has changed: hoping for better days and more time with the people you love [3].
When to start hospice for cancer? In some countries, such as the United States, people can usually have hospice care when a doctor expects them to live 6 months or less; if they live longer, the care can continue [3]. Hospice can help for months, not just the last few days; many people have said they wish it had started sooner [3]. The patient can leave hospice whenever they wish and, if their condition allows, start cancer treatment again [3].
To learn about the changes of the last days and what the family can do, see the guide The last weeks and days of life with cancer.
Palliative treatment for cancer: what do palliative chemotherapy and radiotherapy mean?
Many of the methods used to treat cancer, such as medicines, chemotherapy, radiotherapy and surgery, are also used to ease pain and other symptoms [1, 3]. These are called "palliative treatment": their aim is to help the patient feel better, even if they are not meant to get rid of the cancer completely [3]. For example [3]:
- palliative chemotherapy or radiotherapy to slow the growth of a tumour that is causing pain
- palliative surgery to remove a mass that is pressing on a nerve and causing pain
Before starting any new treatment for advanced cancer, ask the doctor these questions [3]:
- Is this treatment meant to ease symptoms or to slow the spread of the cancer?
- What is the best I can hope for?
- What side effects does it have, and how likely are they?
- Are the possible benefits bigger than the drawbacks?
Read more: What is stage 4 cancer and can it be treated?, What is chemotherapy? and What is radiotherapy?
Told "nothing more can be done"? What it really means
When people are told that "nothing more can be done", it usually means the doctor has said that treatments against the cancer are no longer controlling it. At this point, people have different goals: some want to try another treatment or take part in a clinical trial, and some choose palliative care or hospice [3]. This is a very personal decision, and the patient has the right to decide how to live the rest of their life [3].
The most important point is that care does not stop: if the patient does not want more cancer treatment, they still receive supportive care to keep them as comfortable as possible [3]. Severe pain is not an unavoidable part of advanced cancer, and it can be controlled throughout the illness [3]. Tell the care team what matters most to you now; for example comfort and control of symptoms, staying at home, or being there for a family occasion [3].
When to start palliative care
The sooner, the better. Palliative care should ideally begin when the cancer is diagnosed and continue through treatment and beyond [3]. The World Health Organization also says that this care works best when it starts early [2]. The American Society of Clinical Oncology guideline recommends that people with advanced cancer, whether solid tumours or blood cancers, be referred to a specialist palliative care team early in their illness, alongside their cancer treatment, especially when symptoms are not controlled or quality of life has fallen [6]. Family members and caregivers can also be referred to this team for support [6].
These signs mean it is time to ask the doctor about palliative care [1, 6]:
- pain, breathlessness, nausea, constipation, tiredness or sleeplessness that does not get better with the usual treatments
- sadness, anxiety or fear that makes daily life hard
- difficult decisions about continuing or stopping treatment
- a lot of tiredness and strain on family members and caregivers
Does palliative care really help?
This has been looked at in many studies. In one important study, 151 people who had just learned that they had lung cancer that had spread were divided into two groups: one group saw the palliative care team every month from the start, and the other had only usual cancer care. In the palliative care group, quality of life was better and fewer than half as many people developed symptoms of depression; these patients had fewer intensive treatments in their last days, and yet they lived longer [4].
In a review of 43 studies with more than 12,000 patients, palliative care was linked with better quality of life and fewer symptoms, and it was not linked with a shorter life [7]. Another review of people with advanced cancer also showed a small improvement in quality of life and slightly fewer symptoms [8]. In another study, patients who had palliative care from the start were about twice as likely to have talked with their doctor about their wishes for the end of life [10].
When should I call the doctor?
To get palliative care, ask your cancer doctor or nurse to refer you to a palliative care team or specialist [1, 3]. If you have symptoms that are not controlled, do not wait for your next appointment: contact the care team soon [6]:
- pain that your current medicines do not ease, or that has suddenly become severe
- breathlessness that is getting worse
- nausea and vomiting that stop you eating or drinking
- sadness or anxiety that is upsetting your sleep and daily life
If you have a temperature of 38 °C or higher or chills during chemotherapy, call straight away [11]; see the guide Fever and warning signs after chemotherapy. In any emergency, such as severe breathlessness, chest pain or collapse, call your local emergency number.
Frequently asked questions
Does palliative care mean giving up on treatment and losing hope?
No. Palliative care is given alongside cancer treatment, and treatment does not stop [1]. In a study in Canada, patients and families at first linked palliative care with death and hopelessness; but those who received it early came to see it as "ongoing care" that improved their quality of life [9].
Does palliative care shorten life?
Is palliative care only for the last days, or only for cancer?
Can palliative care be given at home?
What help do family members and caregivers get?
The palliative care team supports caregivers, helps with the family's practical needs and stays with the family through their grief after the patient dies [1, 2]. Doctors can also refer caregivers to this team for extra support [6]. See also the guide A guide for family members and caregivers.
If we start hospice, can we go back to cancer treatment?
Yes. The patient can leave hospice whenever they wish; sometimes the patient's condition improves or they decide to start cancer treatment again [3].
How do I get palliative care?
Ask your cancer doctor or nurse to refer you to a palliative care specialist or team [1, 3]. Speak openly about your symptoms and worries; the care team needs to know what matters to you [3]. If you want to talk with someone you love who has cancer, the guide What to say (and not say) to someone with cancer can help.
Early palliative care: evidence and recommendations (for doctors)
For physicians
- ASCO 2017: inpatients and outpatients with advanced cancer should receive dedicated palliative care services early in the disease course, concurrent with active treatment; referral to an interdisciplinary team is optimal, and family caregivers may also be referred. For newly diagnosed patients with advanced cancer, palliative care involvement within 8 weeks of diagnosis is suggested. Core components: rapport with patient and caregiver; management of symptoms, distress and function (pain, dyspnoea, fatigue, sleep disturbance, mood, nausea, constipation); exploration of the patient's understanding of illness and prognosis; clarification of treatment goals; support for coping (e.g. dignity therapy); help with decision-making; coordination and referral [5].
- ASCO 2024 update (52 studies, 2015 to 2023): refer patients with advanced solid tumours and haematological malignancies to specialist interdisciplinary palliative care teams (outpatient and inpatient) early in the disease, alongside active treatment; dedicated specialist services for unaddressed physical, psychosocial or spiritual distress; referral of caregivers; and possible referral of patients with solid tumours on phase I trials [6].
- Temel 2010 (151 patients with newly diagnosed metastatic NSCLC): FACT-L at week 12, 98.0 vs 91.5 (P=0.03); depressive symptoms 16% vs 38% (P=0.01); aggressive end-of-life care 33% vs 54% (P=0.05); median survival 11.6 vs 8.9 months (P=0.02) [4].
- Temel 2017 (350 patients with incurable lung or non-colorectal GI cancer): improvement in quality of life at week 24 (1.59 vs −3.40; P=0.010) but not at week 12; less depression at week 24; greater effect in lung cancer; discussion of end-of-life wishes 30.2% vs 14.5% (P=0.004) [10].
- Kavalieratos 2016 meta-analysis (43 randomised trials, 12,731 patients): improvement in quality of life (SMD 0.46; 95% CI 0.08 to 0.83) and symptom burden (SMD −0.66; 95% CI −1.25 to −0.07) at 1 to 3 months; no association with survival (HR 0.90; 95% CI 0.69 to 1.17); in the 5 trials at low risk of bias, the effect on quality of life was smaller but remained significant (SMD 0.20) [7].
- Cochrane 2017 (7 trials, 1614 participants): quality of life SMD 0.27 (0.15 to 0.38; low certainty); symptom intensity SMD −0.23 (−0.35 to −0.10; low certainty); survival HR 0.85 (0.56 to 1.28; very low certainty); no significant difference in depression [8].
- Specialist lesson: Early palliative care in advanced cancer; tool: Opioid dose conversion.
References
11 referencesShow all references, 1 with a study cardClose the reference list
Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
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- 9Perceptions of palliative care among patients with advanced cancer and their caregivers
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- 11Infection and Neutropenia during Cancer Treatment
This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.
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