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Diagnosis and Treatment

Dear Iris: Betrayed

Dear Iris,

Recently my cancer progressed, and my oncologist told me there aren’t many treatment options left. I’m a realist and understand what this means, but I told my oncologist that I’m not ready for hospice. This week I got a call from a “palliative care” clinic saying my oncologist sent a referral for me to see them. I feel somewhat betrayed and don’t understand why my oncologist did this. What does this mean? I’m not ready to give up.


Dear M,

I can understand how hurt you must feel. If I expressed my wishes and didn’t feel heard, I’d be disappointed too. However, what I think might have happened here is a case of misunderstanding.

When you have cancer there are many services and care options that are new to you. Palliative care and hospice are two of those. While they’re often mentioned together, they are very different support services.

Hospice is supportive care focused on supporting pain and symptom management for persons in the late phase of a life-limiting illness. One of the goals of hospice care is to maintain quality of life as much as possible in the final phases of a person's life. Some people with advanced illness may choose hospice care over active treatment. Others may choose hospice support once all treatment options have been exhausted.

Palliative medicine is specialized care for people living and coping with serious illness. The focus of palliative care is to help patients manage the symptoms and stress of illness. The goal of palliative care is to maintain or improve the quality of life for the patient. Palliative care supports patients during any phase of illness regardless of prognosis.

Knowing this distinction, you may want to consider what a palliative care team could offer you and your family. Who knows — having an extra source of comfort and support might be just what you’re looking for right now.

Missed last week? Dear Iris: Why Wasn’t I Prescribed That Medication?

Jenna Rush, RN

Oncology RN Team Lead

Iris Oncology

Jenna Rush worked as a nurse in pediatrics and cardiac/thoracic and vascular surgery before finding her home in oncology nursing in 2012. Jenna is particularly passionate about patient education, advocating for patients, and supporting holistic care models. Second to being a mother, oncology nursing is her life's highest purpose — caring for people during some of the most difficult, scary, and uncertain times of their life.

This article meets Iris standards for medical accuracy. It has been fact-checked by the Iris Clinical Editorial Board, our team of oncology experts who ensure that the content is evidence based and up to date. The Iris Clinical Editorial Board includes board-certified oncologists and pharmacists, psychologists, advanced practice providers, licensed clinical social workers, oncology-certified nurses, and dietitians.