Palliative care is broadly defined as the relief of health-related suffering, be it physical, psychological, social, or spiritual. The goal of palliative care is to improve quality of life for patients and their caregivers and can be initiated at any stage of illness. Radiation therapy is an effective palliative tool for symptoms due to advanced cancer. Yet, when expected survival is short or progression of disease is rapid, palliative radiation therapy (PRT) may have limited clinical benefit for the patient, impeding end-of-life planning and potentially delaying referral to hospice. This article defines the role of PRT at the end of life, describes instances when a patient or caregiver may stop treatment, articulates the ethical issues that arise in treating patients who are eligible for both PRT and hospice care, and discusses how radiation oncologists can bridge the realms of palliative and hospice care to deliver compassionate end-of-life care.
