Getting Palliative Care — While Chemotherapy Continues
Many families hear 'palliative care' and assume treatment is ending. It is not. Palliative care alongside chemotherapy means dedicated support for symptoms and wellbeing while your oncologist continues to treat the cancer.
Medically reviewed by Dr. N. Kiranmayee, Medical Oncologist · Last reviewed September 2026
- Both at the same time — Palliative care does not replace chemotherapy. It runs alongside it, managing symptoms and side effects.
- Not a sign of giving up — Asking for palliative care does not change your treatment plan or signal that treatment is stopping.
- Recommended from early on — ASCO and ESMO both recommend starting palliative care early in treatment, not only when all other options are exhausted.
- It focuses on how you feel — Pain, nausea, sleep, anxiety and family strain — these are what the palliative care team addresses.
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Yes — you can have both, and doing so is now recommended practice. Palliative care alongside chemotherapy means dedicated support for pain, nausea, fatigue and emotional wellbeing while your treatment continues. ASCO and ESMO both recommend starting it early, not waiting until chemotherapy has finished.
Can you have palliative care while still on chemotherapy?
Yes. Palliative care and chemotherapy can run at the same time, and current guidance from ASCO and ESMO says they should — starting early in treatment, not as a last step.
The two serve different purposes. Chemotherapy targets the cancer. Palliative care addresses what the cancer and its treatment are doing to you: pain, nausea, breathlessness, sleep, anxiety and the strain on your family.
Neither cancels the other out. They are designed to work together.
What is the difference between palliative care only and having it alongside chemotherapy?
| Palliative care only (no active cancer treatment) | Palliative care alongside chemotherapy | |
|---|---|---|
| What it means | Comfort and symptom support when active treatment has stopped or is not suitable | Symptom support and emotional care running at the same time as chemotherapy |
| Is chemotherapy continuing? | No | Yes |
| Associated with end of life? | Often, though not always | No — many people receiving it complete their full course of treatment |
| Who directs cancer treatment? | Your oncologist makes any remaining treatment decisions | Your oncologist, with the palliative team supporting how you feel alongside it |
| Goal | Quality of life and comfort | Quality of life and comfort, while chemotherapy continues to target the disease |
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What does adding palliative care actually change?
The most common changes patients describe are better control of pain and nausea, improved sleep and feeling less alone in managing side effects.
A palliative care team does not take over from your oncologist. They focus on the symptoms and worries that sit alongside the cancer — helping you eat enough to tolerate chemotherapy, managing anxiety so you can attend appointments, or addressing a family member who is struggling alongside you.
They also help you understand what is happening and give you language to ask better questions at your next oncology appointment.
Did you know?
A landmark trial published in the New England Journal of Medicine found that patients with advanced lung cancer who received palliative care alongside chemotherapy reported better quality of life and mood than those who had chemotherapy alone — and lived longer on average, despite receiving less aggressive treatment at the end of life.
ASCO now recommends that patients with advanced cancer receive dedicated palliative care alongside active treatment from an early stage, not as an end-of-life measure.
Source: Temel et al., New England Journal of Medicine, 2010; ASCO Clinical Practice Guidelines on Palliative Care
The questions families ask most about palliative care during chemotherapy
Does asking for palliative care mean we are giving up on treatment?
No, and this is the most important thing to say plainly. Asking for palliative care while on chemotherapy does not change your treatment plan, does not signal that treatment is stopping, and does not communicate anything to your oncologist about your willingness to continue. It is a separate service focused on comfort and wellbeing. The misunderstanding comes from the word 'palliative' being strongly associated with end-of-life care — but that is one use of it, not the only one. Early palliative care is recommended precisely because it helps people tolerate active treatment better.
Will the palliative care team make decisions about my chemotherapy?
No. The palliative care team does not direct your cancer treatment. Your oncologist retains full responsibility for decisions about which chemotherapy you receive, whether to continue it, and when to change it. The palliative team focuses on the separate question of how you are feeling — physically, emotionally and practically — and communicates with your oncologist about anything that affects your ability to continue treatment. The two teams work alongside each other, not against each other.
My family wants to keep fighting and fears anything that sounds like giving up. How do I explain it to them?
The name is the problem, not the care itself. You might explain it as 'a team specifically responsible for how I feel while the oncologist looks after the cancer.' Families who are most determined to continue fighting are often the ones who most benefit from this kind of support too — for themselves as much as for you. The palliative care team can meet with your family if that would help them understand what it involves and, equally important, what it does not mean.
Is this only for advanced cancer, or can anyone receiving chemotherapy ask for it?
Anyone on chemotherapy can benefit from palliative care support, not only those with advanced disease. ASCO's guidance applies to patients with serious illness — which chemotherapy, with its side effects and the anxiety that comes with a cancer diagnosis, qualifies as. If your chemotherapy is being given with curative intent, palliative care still has a role in helping you tolerate it and maintain your daily life through treatment. Being told your cancer is early-stage does not mean symptom support is unnecessary.
What does a typical palliative care appointment involve?
A palliative care consultation usually involves a longer conversation than a standard oncology visit — about which symptoms are affecting your daily life, how your sleep, appetite and mood are, what worries are weighing on your family, and what matters most to you. From that, the team builds a plan: it might involve adjusting pain medicine, referring you for psychological support, helping your family understand what to expect, or simply making someone available when a new symptom appears between chemotherapy cycles.
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Frequently asked questions
Does a referral to palliative care mean my oncologist thinks treatment is not working?
No. Many oncologists now refer patients to palliative care early in treatment as a routine part of the plan, not as a signal that options are running out. The referral reflects current guidance from ASCO and ESMO. If you are uncertain what a referral means in your specific situation, ask your oncologist directly — the answer in most cases is that it is about supporting you through treatment, not signalling its end.
Can I ask for palliative care myself, or does my oncologist have to refer me?
You can ask directly. If you are experiencing symptoms — pain, nausea, fatigue, anxiety, difficulty sleeping — that are not well controlled, raise it with your oncologist or your treating nurse and ask whether a palliative care referral is appropriate. You do not need to be at a particular stage of illness or treatment to ask. The question to raise is: 'Is there a palliative care team I can see alongside my chemotherapy?'
Will palliative care conflict with my religious or cultural practices?
Palliative care teams are accustomed to working with patients from many different backgrounds, faiths and family structures. If religious rituals, dietary practices or family involvement in decisions matter to you, tell the palliative team at the first meeting — this shapes how they support you. It is also worth telling your oncologist if you are taking any herbal or traditional medicine alongside your treatment, so the complete picture is clear to everyone looking after you.
Is palliative care support available at CION?
Symptom management and supportive care are part of the care delivered at CION centres during chemotherapy. If you have specific symptoms that are not well controlled, raise them at your next appointment so your team can address them directly or coordinate additional support. Chemotherapy at CION is given as day care across 35+ centres, and your team there can guide you on what palliative support is available in your situation.
Does adding palliative care make my treatment more expensive?
The cost depends on your centre, your insurance or scheme coverage, and what the support involves — and is worth asking about directly before your first appointment. In many settings, a palliative care consultation is included in the broader treatment package rather than billed separately. Good symptom control can also reduce the need for emergency visits and unplanned admissions, which often offsets any additional cost.
What if I decide later that I do not want to continue with palliative care?
You can stop at any point. Palliative care alongside chemotherapy is not a commitment you cannot leave. If at some stage you feel it is not adding what you expected, or you want to change the kind of support you receive, that conversation is always open with your team. The role of the palliative care team is to work with what you need, and those needs will change as your treatment progresses.
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