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Goal Area: Survivorship and Palliative Care

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Goal: Improve the quality of life for cancer survivors. 

A person is considered a cancer survivor from the time of diagnosis and continues to be one for the remainder of their life. Survivorship can include living free of cancer or living with cancer. It brings a complexity to one’s life, and has “physical, mental, emotional, social, and financial consequences that start at diagnosis and continue through treatment and beyond.”lxxiv Helping survivors meet and overcome the challenges cancer brings to their lives is vital to reducing the burden of the disease and enhancing quality of life overall.lxxv 

Access to supportive resources for cancer survivors, however, can be a challenge, especially for those without access to patient navigation and for those living in rural and frontier communities. In a 2024 survey of rural and frontier Nevadans, the majority of respondents said they were unaware of community resources available for survivors. Of those who were aware of resources, many found it was not easy to access those resources, and in the case of mental health resources and transportation, childcare, or financial assistance, accessing resources was difficult.lxxvi 

Patient navigators are an integral part of enhancing a survivor’s quality of life from pre-diagnosis and diagnosis through treatment, and, if necessary, into hospice care. The term “patient navigator” encompasses different roles including oncology nurse and patient navigators, lay navigators, social workers, care coordinators, and community health workers. These navigators can not only help survivors and their care partners efficiently move through the complex healthcare system, but also identify available resources to improve outcomes. In essence, patient navigators can facilitate screening and diagnosis as well as access to oncology and palliative care services. 

All survivors, but especially those in underserved communities, can greatly benefit from the support and assistance of a patient navigator who can help to address systemic inequities by coordinating care, helping to identify and remove barriers, and identifying supportive resources. These services may be delivered by clinical- or community-based navigators, and may be effective both in-person or via tele-navigation. In short, “patient navigators are increasingly recognized as an essential component of comprehensive cancer care, serving as the lynchpin for facilitating a coordinated and seamless experience for cancer patients and their families.”lxxvii 

Another essential component to support quality of life for cancer survivors is palliative care delivered in coordination with oncologic treatment. Palliative care addresses many of the non-oncology needs of cancer survivors, focusing on “quality of life, emphasizing whole-person care by addressing physical, psychosocial, family and spiritual concerns as well as planning for future care.”lxxviii Cited as a patient-centered approach to specialized medical care by Nevada’s Advisory Council on Palliative Care and Quality of Life, palliative care provides survivors autonomy and additional health care support in addition to oncology treatments, taking into account a patient’s goals and values to tailor care to their specific needs.  

The American Society of Clinical Oncology (ASCO) notes that “one cannot overstate the trauma of receiving a cancer diagnosis” and that “patients and/or caregivers should also be able to request palliative care at any stage, with any prognosis, based on their needs.”lxxix ASCO, in 2024, issued a new guideline for palliative care recommending all oncology clinicians understand the structure and significance of palliative care, have primary palliative care knowledge and skills, and know when to refer a patient to specialty palliative care when additional expertise is required. The introduction of a specialty palliative care team should come “soon after the diagnosis of advanced cancer.” lxxx This approach has been shown to result in less aggressive end-of-life care, more timely referrals, longer median survival, reduced use of invasive interventions, and lower hospital charges along with improved pain management, fewer symptoms of depression, and better quality of life for patients.lxxxi, lxxxii, lxxxiii 

Objectives

Objective: Increase equitable access to survivorship and palliative care services for survivors and their care partners from diagnosis through end-of-life care. 
Strategies: 
  • Encourage survivor enrollment in programs that promote health, well-being, and quality of life, with a focus on rural and multimedia accessibility. 
  • Identify gaps in resource awareness and launch educational campaigns to enhance knowledge and use of supportive care services. 
  • Support care partners as essential members of the cancer journey, addressing burnout and fostering resilience. 
  • Support community and clinical navigation services to streamline access to resources and supportive care. 
  • Promote behavioral health and substance use interventions to promote long-term health of survivors. 
  • Strengthen collaboration between community resources, cancer centers, and palliative care programs to improve access. 
  • Evaluate Nevada’s network of navigators to better understand how services are delivered and to whom. 
  • Support policies for navigation reimbursement, including Principal Illness Navigation (PIN). 
Objective: Expand education on survivorship and palliative care services for patients, care partners, and healthcare professionals. 
Strategies: 
  • Educate Nevadans on the distinction between palliative and hospice care, leveraging resources from the Palliative Care Council and other national entities. 
  • Promote use of National Cancer Survivorship Standards of Care to providers throughout Nevada.  
  • Identify, document, and promote survivorship and palliative care educational opportunities, including partnerships with medical, nursing, and health sciences schools. 
  • Integrate survivorship and palliative care education, including vital talk training, into curricula and training programs for healthcare professionals, including primary care providers, oncology specialists, and community health workers. 
  • Promote education on navigation through Medicaid, disability applications, supportive care referrals, and stabilizing post-treatment. 
  • Promote simplified terminology and evidence-based tools to improve patient-provider communication and care planning. 
  • Encourage early palliative care discussions as part of a comprehensive care approach. 
  • Support development of a hospice and palliative care fellowship program to expand provider expertise. 
  • Support research opportunities to improve the availability of data on survivorship in Nevada. 

Indicators

Number of navigators in Nevada Navigation Network 
Baseline: 157 
Target: 200

Annual educational opportunities for health care professionals 
Baseline: 3 
Target: 3

Source: Nevada Cancer Coalition

References

lxxiv Centers for Disease Control and Prevention. "Cancer Patients: Diagnosis and Treatment Cancer Survivors." May 2020, https://www.cdc.gov/cancer/survivors/patients/. 

lxxv American Society of Clinical Oncology. "Post-Traumatic Stress Disorder and Cancer." Mar. 2019, https://www.cancer.net/survivorship/life-after-cancer/post-traumatic-stress-disorder-and-cancer. 

lxxvi Onega, T., et al. Community Health Assessment Survey: Rural & Frontier. University of Utah Health and Huntsman Cancer Institute, 2025. 

lxxvii Blaseg, Karyl. "Oncology Patient Navigation: Bringing this Crucial Role to the Forefront." Oncology Nurse Advisor, 20 Jan. 2015, https://www.oncologynurseadvisor.com/home/departments/navigation/oncology-patient-navigation-bringing-this-crucial-role-to-the-forefront/. 

lxxviii Dy, S., S. Isenberg, N. Abu Al Hamayel. "Palliative Care for Cancer Survivors." Medical Clinics of North America, Nov. 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6467511/. 

lxxix Sanders, Justin J., et al. "Palliative Care for Patients With Cancer: ASCO Guideline Update." Journal of Clinical Oncology, vol. 42, 2024, pp. 2336-2357, doi:10.1200/JCO.24.00542. 

lxxx Sanders, Justin J., et al. "Palliative Care for Patients With Cancer: ASCO Guideline Update." Journal of Clinical Oncology, vol. 42, 2024, pp. 2336-2357, doi:10.1200/JCO.24.00542. 

lxxxi Mah, S. J., D. M. Carter Ramirez, K. Schnarr, L. R. Eiriksson, A. Gayowsky, H. Seow. "Timing of Palliative Care, End-of-Life Quality Indicators, and Health Resource Utilization." JAMA Network Open, vol. 7, no. 10, 2024, e2440977, doi:10.1001/jamanetworkopen.2024.40977. 

lxxxii de Matos, L. V., T. Louro, T. G. Padrao, M. Debiasi, B. Sousa, H. Gouveia, F. Cardoso. "Impact of the implementation of an embedded palliative care model in the continuum of care for patients with metastatic breast cancer." Supportive Care in Cancer, vol. 33, no. 6, 2025, p. 449, doi:10.1007/s00520-025-09502-w. 

lxxxiii Fabbricatore, Roman. "Palliative Care May Improve EOL Comfort in Early-Onset Colorectal Cancer." Cancer Network, 25 Jan. 2025, https://www.cancernetwork.com/view/palliative-care-may-improve-eol-comfort-in-early-onset-colorectal-cancer.