Advanced cancer patients worldwide are offered chemotherapy and radiotherapy under the guise and pretense that it is “palliative”. The majority of patients have virtually no idea what they are getting themselves into. The term “palliative” remains one of the most misused and confounding words in the English language. Most of the time it is used in a euphemistic manner in order to avoid using the unmitigated/unequivocal and more honest statement-“You are incurable and thus terminally ill”.
Where is the evidence that Palliative Chemotherapy actually improves pain and symptom management. Only optimal palliative pain and symptom management (opioids, adjuvants, etc) has been shown to lessen the multitude of symptoms from advanced cancer. More often than not, systemic chemotherapies create more distress through CINV, painful neuropathies, skin disorders, hematologic complications, etc. The only example in the medical literature of truly “palliative chemotherapy” is electrochemotherapy used on malignant wounds. A couple of systematic reviews show that this technique actually reduces pain, exudates, and odours resulting from such wounds.
In summary, let’s avoid using the arcane and oxymoronic expression “Palliative Chemotherapy” and replace it with “Non-curative/potentially life-prolonging chemotherapy”.