Is Palliative Care Appropriate for Cancer Survivors?

Betty R. Ferrell, PhD, RN


September 01, 2015

Case Presentation

Delores is a 62-year-old elementary school teacher and a breast cancer survivor. She was diagnosed with stage IIB, estrogen-receptor (ER)-positive and progesterone-receptor (PR)-positive, HER2-negative breast cancer and was treated with mastectomy and chemotherapy. She is maintained on endocrine therapy with anastrazole. She has diabetes with mild neuropathy that began before chemotherapy but has now become worse. She is also experiencing hot flashes and muscle pain from the endocrine therapy, as well as weight gain, which she attributes to her decreased activity.

In the office today, Delores expressed her concern about these symptoms, especially the increased pain from the neuropathy. She says that she really wants to improve so that she can return to her teaching position because she must work another year to receive full retirement benefits. As during previous visits, she expresses her high anxiety about the possibility of recurrence of her disease, and her anxiety has worsened since the recent death of her sister from breast cancer.

You tell Delores that you would like to refer her to the palliative care clinic and she replies, "No way! Not yet. Not palliative care. That's only for people at the end."


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