Palliative care of ovarian cancer

Introduction Palliative care is the provision of medical care that focuses on improving the quality of life of patients and families facing serious and life-threatening illness through relief of suffering across physical, psychosocial, emotional, and spiritual dimensions [1]. Palliative medicine specialists are an interdisciplinary team that includes physicians, nurse practitioners, nurses, social workers, chaplains, and nutritionists who focus on assisting patients and families with a variety of care needs including symptom control, psychosocial support, communication, addressing care goals, and transitions in care [2-4]. Palliative care is given simultaneously with other disease-modifying treatments and potentially curative treatments. Patients with ovarian cancer can have significant symptom distress either from the disease or the associated treatments (chemotherapy and/or surgery). As such, it is important to provide palliative care early in the course of illness whether the treatment goals are for cure or for maximizing quality of life. National and international organizations currently have clinical guidelines recommending palliative care be routinely integrated into comprehensive cancer care [5,6]. The role of the palliative care team is to support the gynecologic oncologist/gynecologic specialist in the care of ovarian cancer patients by providing aggressive symptom management; assisting with time-consuming and difficult communication between providers, patients, and families; and facilitating transitions in care when there is a change in goals or disease status. There is an existing clinical practice guideline for quality palliative care that identifies eight domains essential to providing exemplary clinical palliative care. These include: structures and processes of care; physical aspects of care; psychological and psychiatric aspects; social aspects; spiritual, religious, and existential aspects; cultural aspects; care of the imminently dying patient; and ethical and legal aspects of care [7]. In this chapter, we will focus on communication, symptom management, and end-of-life/terminal care.