I had the privilege of hosting a deeply insightful discussion last November on the acute challenges providers and patients with cancer are facing around palliative care. Joined by Kimberly Johnson, MD, MHS; Ramona Rhodes, MD; and Declan Walsh, MD, this esteemed panel highlighted the necessity of high-quality palliative care and continuing disparities in access to these essential services. Although specialist palliative care services are now available in most large hospitals, there are still communities where people lack access to these services. Even where palliative services exist, they sometimes are not utilized or are under-utilized, and so many patients remain underserved.

Palliative care’s reach to underserved populations, particularly minoritized racial and ethnic groups, mirrors disparities seen throughout the health care continuum. As we consider interventions to improve equitable access and delivery of palliative care, we must remember disparities occur within a broader context where some communities receive poor quality care. People of color, and Black patients specifically, are less likely to receive adequate pain and symptom management compared to White populations. These patient populations also report less satisfaction with communication and shared decision-making. Increasing access to high-quality palliative care can help address many of these disparities. Educating providers about palliative care and how to discuss this care with patients is essential. The panelists agreed that primary palliative care skills—such as pain management and communication—should be part of all providers’ training to ensure quality and equity in care.

Normalizing palliative services as a component of cancer care is an equally important step. Robust evidence shows palliative care improves communication, symptom management, and quality of life, and, in some cases, even leads to people living longer lives. Despite this evidence, palliative care remains an emerging field. There must be buy-in at both the institutional and clinician levels to make palliative care an organizational priority. Language and perception also play significant roles in how palliative care is received by patients and even providers. The term palliative is not commonly used, nor is it synonymous with the term hospice, which can be a loaded term for both patients and providers. When introducing palliative care consultations, we need to define palliative care and emphasize that it does not necessarily mean giving up other treatments. Advocating for care consistent with patients’ beliefs, preferences, and goals is crucial, especially for marginalized patient groups.

Moving forward, we need to embrace innovative approaches that can bridge gaps in palliative care delivery. Telehealth, for instance, has shown great promise in expanding access to palliative care services, especially in rural and underserved areas. By leveraging technology, we can provide timely consultations and support to patients who might otherwise be unable to access these necessary services.

Additionally, integrating palliative care into primary care settings can ensure that discussions about quality of life and symptom management begin early in the disease trajectory, thus making it a routine part of patient care. Involving patients and families in care planning ensures that their values and preferences are respected. Shared decisionmaking models can help align treatment plans with patients’ goals, leading to more personalized and satisfactory care experiences.

I extend my gratitude to Dr. Walsh, Dr. Johnson, and Dr. Rhodes for bringing their impactful insights to this panel discussion, and the more than 600 attendees who asked critical questions that brought to light the importance and need for this work. I encourage all who missed the webinar to watch the recording on our website.