In this webinar, Dr. Popp will discuss everything you need to know about palliative care! This is an important webinar for colorectal cancer patients and their loved ones.

2. TODAY’S
WEBINAR
 SPEAKER(S)
 Beth Popp, MD, FACP
 QUESTIONS
 Ask a question in the panel on the
RIGHT SIDE of your screen
 WEBINAR ARCHIVE
 FightCRC.org/webinar
 TWEET ALONG
 Follow along via Twitter – use the
hashtag #CRCWebinar

3. RESOURCES
TABOO-TY PODCAST MINI MAGAZINES CLINI

4. FIGHTCOLORECTALCANCERDISCLAIMER
The information and services provided
by Fight Colorectal Cancer are for
general informational purposes only.
The information and services are not
intended to be substitutes for
professional medical advice,
diagnoses or treatment.
If you are ill, or suspect that you are ill,
see a doctor immediately. In an
emergency, call 911 or go to the
nearest emergency room.
Fight Colorectal Cancer never
recommends or endorses any specific
physicians, products or treatments for
any condition.

5. Beth Popp, MD, FACP, is associate professor in the Brookdale
Department of Geriatrics and Palliative Medicine at the Icahn
School of Medicine at Mount Sinai in New York. She has dedicated
her career to improving care and quality of life for cancer patients.
Dr. Popp has served as a clinician educator and provided
leadership to develop hospital-based inpatient and ambulatory
palliative care services at three medical centers in the New York
area over a career that has already spanned more than two
decades. She has been on the faculties of the Medical School of
SUNY Health Science Center at Brooklyn, New York Medical
College, and Albert Einstein College of Medicine in addition to
Mount Sinai School of Medicine. She served as the senior
associate program director for the hematology/oncology training
program at Maimonides Medical Center for 15 years, from 2002 to
2017. She has also served as an adjunct faculty member at the
NYU School of Nursing.
Dr. Popp has served as the physician leader, guiding the development of several teaching hospital programs
which provide hospital consultation services and ambulatory services to a range of patients at all stages of
serious illnesses. Her clinical work has focused on management of pain and other symptoms in patients with
cancer, communication skills for clinicians, customizing treatment plans to incorporate the unique values of
patients (especially immigrants and patients from minority religious and cultures), biomedical ethics issues in
palliative care, and palliative care needs of the developmentally disabled adult.
Dr. Popp participates in public awareness activities about palliative care on behalf of the Center to Advance
Palliative Care and GetPalliativeCare.org, CAPC’s online resource for patients and families. The website
focuses solely on providing information on palliative care from the point of diagnosis.
Dr. Popp resides in Brooklyn with her husband and four sons.
Dr.BethPopp

6. An initiative of the Center to Advance Palliative Care
Managing Colorectal Cancer
Symptoms: How Palliative Care Helps
October 24, 2019
Beth Popp, MD FAAHPM
Associate Professor
Icahn School of Medicine at Mount Sinai
New York

7. An initiative of the Center to Advance Palliative Care
Today’s Agenda
➔Define and clarify what palliative care is and who
can benefit
➔Where palliative care comes in for those with
colorectal cancer – early, advanced or metastatic
➔Frequently asked questions
➔Your questions
➔GetPalliativeCare.org as a resource
7

8. An initiative of the Center to Advance Palliative Care
What is Palliative Care?
➔ Specialized medical care for people living with a serious illness
that focuses on relief from the symptoms and stress of a
serious illness
➔ The goal is to improve quality of life for both the patient and
the family
➔ Palliative care is provided by a specially-trained
interdisciplinary team who work together with a patient’s
other health care providers to provide an extra layer of
support
➔ It is appropriate at any age and at any stage in a serious illness
➔ It can be provided along with disease-focused and curative
treatment
8

9. An initiative of the Center to Advance Palliative Care
Fact:
➔ Treating the pain, symptoms, and stress of cancer
and its aftermath is as important as treating the
cancer

10. An initiative of the Center to Advance Palliative Care
While the oncologist may be most
focused on treating the cancer…
➔The person living with cancer is dealing with:
– Insomnia and fatigue
– Weight loss – or weight gain
– Nausea
– Pain, including neuropathy
– Anxiety and/or depression
– ………..

11. An initiative of the Center to Advance Palliative Care
It’s really not that
complicated…..
➔ When serious illness strikes, we want:
– To treat the disease
• Make it go away for as long as we can
• Slow it down
• Minimize it impinging on our ability to do what matters most to us
– Maintain good functioning and quality of life
– Have coordination and connection of care
– Have support to help us make informed decisions

12. An initiative of the Center to Advance Palliative Care
➔ Currently our system:
– Is a “sick care” system, more than a “health care” system
– Is technology driven
– Is disease-driven
– Undervalues the importance of quality of life
➔ Until very recently, doctors* were not trained to assess or
address pain, symptoms, and distress in serious illness
➔ We can and need to do better about these issues faced
by cancer patients and survivors
How well does the health care
system meet theses challenges?

13. An initiative of the Center to Advance Palliative Care
Where Palliative Care
Comes In

14. An initiative of the Center to Advance Palliative Care
Oncology and Palliative Care
➔ ASCO Clinical Practice Guideline Update 2017
“Patients with advanced cancer, whether inpatient or
outpatient, should receive dedicated palliative care services,
early in the disease course, concurrent with active
treatment. Referring patients to interdisciplinary palliative
care teams is optimal, and services may complement existing
programs. Providers may refer caregivers of patients with
early or advanced cancer to palliative care services.”

15. An initiative of the Center to Advance Palliative Care
Low Public Understanding of
Palliative Care
Q: Rate your overall impression of Palliative Care (0=very unfavorable,
50=neutral, 100=very favorable)
Source:
National
survey of 800
adults
age 25+,
June 2019,
commissioned
by CAPC
When asked to rate their
opinion of palliative care,
a large portion were
unable to do so.

16. An initiative of the Center to Advance Palliative Care
Once Informed About
Palliative Care
➔ >90% would be likely to consider palliative care for
themselves or their families
➔ 94% believed patients should have access to
palliative care at all hospitals
➔ 78% strongly agree that it’s important that patients,
and their families, be educated that palliative care is
available together with curative treatment
(Source: National survey of 800 adults age 25+, June 2019, commissioned by CAPC)

17. An initiative of the Center to Advance Palliative Care
Palliative Care and Early Colorectal
Cancer
➔ Often no symptoms, diagnosed by screening
colonoscopy
➔ Some patients have symptoms from treatment that
are not managed by cancer care team, and would
benefit from palliative care
➔ Treatment may range from surgery to chemo and
other approaches, and may occur at different
intervals complicating communication with care
team

18. An initiative of the Center to Advance Palliative Care
Palliative Care and Early Colorectal
Cancer
Pain and Symptom Management
➔ Pain
➔ Neuropathy
➔ Nausea
➔ Changes in bowel habits
➔ Taste changes
➔ Weight gain
➔ Fatigue from chemotherapy
and/or radiation therapy
Psychological Support
➔ Body image
➔ Anxiety
➔ Depression
➔ Sexuality
Decision-Making Support
➔ Goals of care
➔ Treatment decisions
➔ Care coordination

19. An initiative of the Center to Advance Palliative Care
Palliative Care and Metastatic Colorectal
Cancer
➔ Quality of life is greatly affected by the symptoms
patients experience
➔ Traditionally has significant symptom burden due to
the disease process and treatments
➔ New disease-directed therapies and early inclusion
of palliative care can lead to improved outcomes and
greater quality of life throughout the disease

20. An initiative of the Center to Advance Palliative Care
Palliative Care and Metastatic Colorectal
Cancer
➔Pain and Symptom
Management
➔Psychological
Support
➔Spiritual Support
➔Decision Making
➔Care Coordination
➔Treatment Decisions
➔Goals of Care

21. An initiative of the Center to Advance Palliative Care
Palliative Care and Colorectal Cancer

22. An initiative of the Center to Advance Palliative Care
Palliative Care FAQs

23. An initiative of the Center to Advance Palliative Care
When do you need palliative care?
➔Palliative care is based on need, not
prognosis
➔It is for any age and any stage of disease, and
you can have it along with disease-focused
and curative treatments

24. An initiative of the Center to Advance Palliative Care
Who is it for?
➔People in need of relief from the pain,
symptoms, and stress of a serious illness
➔The goal is to improve quality of life for both
the patient and family
➔It is appropriate at any age and at any stage
and can be provided along with disease-
focused and curative treatment

25. An initiative of the Center to Advance Palliative Care
What’s the ultimate goal of
palliative care?
To improve quality of life

26. An initiative of the Center to Advance Palliative Care
What is the impact of palliative
care?
➔ Relieves pain &
symptoms
➔ Patients may live
longer
➔ Better family
support
➔ Reduces
hospitalizations &
emergency
department visits
➔ Reduces
unnecessary tests,
procedures

27. An initiative of the Center to Advance Palliative Care
Can a patient have palliative care
and still receive cancer treatment?
➔Yes, absolutely!

28. An initiative of the Center to Advance Palliative Care
Should the patient bring it up or
wait until the doctor mentions it?
➔It can be either, however, patients shouldn’t
wait for the doctor to bring it up
➔Most people ask their doctor for the referral
to palliative care
➔Palliative care teams are specialists, so the
primary doctor must bring in the team

29. An initiative of the Center to Advance Palliative Care
Who provides palliative care?
➔Palliative care is provided by a team of
palliative care specialists, including palliative
care doctors, nurses, and others
➔It can be provided in a variety of settings
including the hospital, rehabilitation facility,
outpatient clinic, and at home

30. An initiative of the Center to Advance Palliative Care
How and when do you ask for a
referral to palliative care?
➔If you are struggling with pain, other symptoms
or stress due to the cancer or its treatment, you
should ask your doctor for a palliative care
referral
➔Explain that you could benefit from an extra layer
of support
➔The patient, family or doctor can find a local team
through the Provider Directory on
GetPalliativeCare.org

31. An initiative of the Center to Advance Palliative Care
What resources are there to learn
more about palliative care?
➔ GetPalliativeCare.org
– The most clear and comprehensive website on palliative care
– Provides:
– A definition, a 5-question self-assessment to understand if it’s
right for you, information on how to get it – with tips on how to
talk to your doctor about it
– Real stories through free podcasts, including people living with
colorectal cancer
– Webinars on managing specific symptoms, living with different
serious illnesses
– A Provider Directory searchable by state, and now with
community-based listings
– “What You Should Know” – a downloadable handout

32. An initiative of the Center to Advance Palliative Care
Key Takeaways
➔ Colorectal cancer patients are living longer than
ever before
➔ Patients* often have symptoms that need to be
addressed by specialists, when not addressed by
their oncologist or primary doctor
➔ The cancer and the symptoms can and should be
treated
➔ Palliative care improves outcomes for patients*
➔ Patients and family members can ask for palliative
care
*during treatment and some cancer survivors with long-term effects

33. An initiative of the Center to Advance Palliative Care
Your Questions

34. An initiative of the Center to Advance Palliative Care
To learn more, visit
GetPalliativeCare.org