Reaching breast cancer patients with varying needs can be a challenging feat for palliative care providers. Their referral strategies often hinge on how palliative services can help improve outcomes.
Palliative care providers help address patients’ various nonmedical, emotional, caregiver and social determinants of health needs, a key point to highlight when seeking to build stronger referral relationships and expand the reach of their services, according to Dr. Arif Kamal, oncologist and palliative care physician. Kamal also serves as chief patient officer for the American Cancer Society and president-elect of the American Academy of Hospice and Palliative Medicine (AAHPM).
Managing breast cancer patients’ pain and symptoms is an instrumental area that palliative care providers have helped to evolve for the better, Kamal stated. Communicating this point to referral sources is crucial to fostering better outcomes as more health care providers seek out coordinated, person-centered care delivery approaches.
“A real shift is happening where there is a lot more emphasis on compounding symptom management,” Kamal told Palliative Care News. “With the chronic illness component it is important to recognize not only the symptoms, but the non-physical effects of financial toxicity, loneliness, social isolation, emotional resilience and the needs of caregivers. Palliative care is about the complexity of need … [Providers] need to figure out a pathway for patients who will be long-term survivors with an active disease, ongoing treatments and need various resources.”
Palliative care’s major referral hurdles, key selling points
More than 3.97 million women in the United States had some type of breast cancer in 2021, according to research from the National Cancer Institute. Annual breast cancer-related death rates reached 19.3 per 100,000 females between 2018 and 2022, the research found.
Recognition has grown around the issues that breast cancer patients face, including the global celebration of October as Breast Cancer Awareness Month, which was established in 1985 by the American Cancer Society in partnership with the British company Chemical Industries.
Research often focuses on examining the outcomes and experiences of women with breast cancer, with less data available for male or transgender patients. About 1 in 726 men face a lifetime risk of developing breast cancer, while roughly 530 men die each year from the disease, reported the American Cancer Society.
The gaps in data complicate clinicians’ ability to identify and treat breast cancer across all genders, according to Steve Cone, chief of marketing, communications and philanthropy at Capital Caring Health. Cone is a two-time breast cancer survivor.
Expanding awareness and breaking down gender biases around breast cancer is a key to improving outcomes among diverse patient groups, Cone indicated. Another significant aspect of quality is understanding what goal-concordant care looks like across different genders, an area in which palliative care providers are well-poised to support and should communicate with referral sources, he added.
“While it’s very rare, men can get breast cancer and it’s usually in men 60 and older, and sometimes in their 50s,” Cone told Palliative Care News. “Palliative care folks should be cognizant of that point. It’s not often spoken about … and goes undetected. That lack of awareness can impact the mortality rates among men, which are 10x above women’s. Men are not really told that it’s possible, and most of the time when breast cancer is discovered, it’s extremely advanced.”
When seeking to expand awareness and communicate their value propositions among referrals, palliative care providers can focus on illustrating how their services help breast cancer patients and their families to navigate a complex health care system, Kamal indicated. For instance, social workers can help connect patients and their families with financial and psychosocial resources and community support groups.
Palliative care services can also help with stress management, a significant quality component as breast cancer patients live longer with the disease among treatment and testing innovations, Kamal added. Referring providers can collaborate with palliative care professionals to address several unmet and challenging needs as patients contend with longer illness trajectories, he said.
“We have people who are truly in a sandwich generation of taking care of parents, themselves and kids at home. That journey is not easy,” Kamal said. “Having a good referral threshold understanding the juggle and complexity of a cancer diagnosis, regardless of the sage, is an extra layer of support with palliative care. The benefit of palliative care is that the oncology team can prepare for the treatment of tomorrow while the palliative team takes care of the needs of today. Regular integration of palliative care means that team is addressing things on patients’ minds and helping to manage them.”