Revised: June 2014
When progressive incurable disease has developed, the treatment approach is individualized to optimize quality of life, through the participation of a variety of disciplines, ideally in the form of a team. The task of approaching palliative care needs may be especially challenging in the neuro-oncology patient. From the medical standpoint, in appropriate circumstances, symptoms may be palliated by surgical measures, and occasionally, by further radiation therapy or chemotherapy. Systemic steroids may be extremely useful; the dose should be titrated to maximize therapeutic effect and minimize steroid-related toxicity. Other medications, such as analgesics for headache and antiemetics for nausea and vomiting, may also be helpful. As for other disciplines, in the palliative phase, occupational therapy and physiotherapy are often just as useful as they are earlier in the disease continuum, as much as possible to preserve mobility and function. In this phase, pastoral care, counseling and other support services may be particularly important to assist patients and family cope with financial stresses, anticipatory grief, planning, and other issues.
Almost always, palliative care is most effective when given in a well co-ordinated fashion close to the home of the patient. Information on palliative care and hospice programs available throughout British Columbia may be found in the British Columbia Hospice/Palliative Care Association Resource Directory, which is available at the BCCA Library and hospitals throughout the Province, and may be ordered by contacting:
The British Columbia Hospice/Palliative Care Association
1060 West 8th Avenue
Vancouver, BC V6H 1C4
Phone (604) 734-1661
In addition, further advice on symptom control and other palliative measures may be obtained by referral to Pain and Symptom Management Clinics at the Vancouver and Vancouver Island Cancer Centres, and the Cancer Centre of the Southern Interior; a similar Clinic is planned at the Fraser Valley Cancer Centre. Such referral can be initiated with the assistance of the attending BCCA oncologist