Principles of palliative care in gynaecological cancer

1. Big picture

Palliative care in gynaecological cancer is active, holistic care for women with advanced, recurrent, metastatic, incurable, or highly symptomatic disease. It is not “giving up.” It is a clinical approach that aims to relieve suffering, improve quality of life, support decision-making, and help the patient and family through the disease trajectory.

In the exam, the examiner wants to hear that palliative care is:

1. Early and integrated, not only last-days care.
2. Multidimensional: physical, psychological, social, sexual, spiritual, and family support.
3. Symptom-focused: pain, bleeding, discharge, ascites, bowel obstruction, fistula, cachexia, dyspnoea, lymphoedema.
4. Goal-directed: match treatment to patient priorities and realistic prognosis.
5. Multidisciplinary: gynaecological oncologist, palliative physician, nurses, psychologist, social worker, physiotherapist, dietitian, pain team, hospice, spiritual care.
6. Ethically grounded: autonomy, informed consent, proportional treatment, advance care planning, dignity at end of life.

WHO describes palliative care as improving quality of life for patients and families facing life-threatening illness through prevention and relief of suffering, using early identification and treatment of physical, psychosocial, and spiritual problems. ([World Health Organization][1])

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