Palliative Care for Cancer Survivors?

Betty R. Ferrell, PhD, RN

Disclosures

December 15, 2017

Survived Cancer But Not Yet "Normal"

Monica is a 42-year-old woman who was diagnosed with stage II lung cancer a year ago. Fortunately, her tumor was diagnosed early because she was participating in a community lung cancer screening study targeting smokers as a high-risk group for developing cancer. Monica had a lobectomy and then went through chemotherapy. She has benefited from genetic testing and targeted therapies and has responded well to treatment. Currently, Monica has no evidence of disease.

Monica's family is eager for her to return to "normal life," including her job in a local equestrian center where she gives riding lessons and cares for the horses. Today, Monica is seen in the cancer survivorship clinic, and a nurse is completing a survivorship care plan for her. As the nurse tells Monica how exciting it is that she is completing treatment, Monica becomes very quiet, then tearful, and says, "I wish I could feel as good as everyone thinks I should feel."

On further evaluation, the nurse learns that Monica has several uncontrolled symptoms including burning pain at the lobectomy surgical incision, moderate-to-severe fatigue, insomnia, and dyspnea. The nurse is considering referring Monica to the palliative care service for outpatient evaluation.

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