A common goal for palliative care is pain management, where opioids like morphine are often on the frontline. Then, practitioners may build on medications from there, adding agents such as gabapentin and tricyclic antidepressants

To add to the message that palliative care should be individualized for each patient, researchers are investigating this even further with a drug, ketamine which is typically used to kickstart and maintain anesthesia used for the difficult-to-treat pain associated with ovarian cancer.

Palliative care should be individualized for each patient being treated, and could even use ketamine, a drug that is typically used to kickstart and maintain anesthesia use for patients with ovarian cancer whose pain is difficult to treat.

Palliative Care

Treating patients’ symptoms, just like treating peoples’ cancers, is very individualized. It’s very important to involve the oncologist, the primary care physician or a specialist in palliative care or pain so that they can assess where the symptoms are coming from.

Improving Quality Of Life

Palliative care is a multidisciplinary approach focused on improving quality of life. Lately, advocates and experts alike have been trying to knock down the stigma that palliative care is meant only for people who are dying.

Another misconception that people have is that being entered into palliative care means that their cancer treatment will stop. If someone was receiving treatment for their cancer, and we know it’s either working or we’re waiting to see if it’s working, there is no reason to stop treatment. That is unless it was directed by an oncologist in discussion with the patient,” Pietras said.

He mentioned that palliative care can help patients and their loved ones when facing difficult decisions, such as whether or not to stop chemotherapy or which chemotherapy option they should choose. It’s essential that we know what is important to them and how their symptoms affect their life, so they can receive the treatments that best match their goals.

Palliative Care Is Pain Management

A common goal for palliative care is pain management, where opioids like morphine are often on the frontline. Then, practitioners may build on medications from there, adding agents such as gabapentin and tricyclic antidepressants. 

Pain Symptoms

Although the data for ketamine does not include a large number of placebo-controlled trials, smaller studies are suggesting that ketamine may be beneficial when used appropriately for patients with very difficult-to-control pain symptoms. These patients would already be on very high doses of opioids and non-opioid adjuvant medicines, like gabapentin.

Therefore, ketamine should only be used in a select group of patients who have uncontrollable pain despite highly escalated opioids and other medications and in patients who do not have traits that would make them more likely to have side effects. 

Pain Management

Overall, pain management could look different for each patient. Although these are tough conversations, it’s important to know what patients want so that we can match treatments to their goals. They need to know if it’s better to have these conversations early or later in the disease course and what the effect on quality of life.