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Palliative Treatment: What’s the Point?

In the majority of patients with advanced or metastatic cancer, chemotherapy and radiotherapy are not given with curative intent. Eradication of disease is rarely possible, and therefore treatment is palliative in nature. However the side effects of treatment may be distressing and its delivery inconvenient, and it is therefore essential that the patient understands the aims of treatment from the outset. In this way they can make an informed decision about undertaking treatment in the light of what is realistically achievable. The aims of palliative treatment are best expressed as the maximization of quality of life, while attaining the best quantity of life. The exact balance will depend on the patient, their disease, and its treatment. These issues are of cardinal importance to patients and their families, but also to funding bodies and licensing authorities given the economic implications of chemotherapy in the palliative setting.