Leveraging success through concurrent care: Integrating oncology and palliative medicine earlier in the cancer journey

Veterinary oncology has made remarkable strides over the past two decades. Earlier diagnosis, expanded therapeutic options, and improved survival times mean that many pets with cancer are living longer than ever before.

Yet despite these advances, a persistent gap remains in how we support patients and families throughout the full arc of disease, particularly when quality of life begins to fluctuate.

This extensive literature review addressed the growing need for improved palliative care in veterinary medicine as a whole. They concluded that the importance of offering palliative care alongside anticancer techniques and treatments should not be underestimated and should ideally use a multidisciplinary team approach.

Historically, hospice and palliative care have been introduced late in the disease process, often when treatment options are exhausted or when families are emotionally overwhelmed and facing urgent end-of-life decisions. Increasingly, however, veterinary teams are recognizing the power of concurrent care: the intentional integration of palliative medicine alongside active oncology treatment. When used proactively, concurrent care improves patient comfort, enhances client satisfaction, strengthens team collaboration, and supports practice sustainability.

What is concurrent care?

Concurrent care is a collaborative approach in which oncology and palliative medicine work together from the time of diagnosis–or early in the disease course–to address pain, symptom burden, caregiver stress, and evolving goals of care. The result is a more complete, humane, and client-centered care experience.

In this model, oncology teams focus on disease-directed therapy (chemotherapy, radiation, surgery, immunotherapy). Palliative medicine teams focus on comfort, function, emotional wellbeing, caregiver support, and anticipatory guidance. Quality-of-life and hospice principles are introduced gradually and thoughtfully, and are not reserved solely for the final days or weeks of life.

The limitations of late referral…or no referral at all

Late referral to hospice and palliative care often occurs during crisis moments: uncontrolled pain, intractable nausea, respiratory distress, or sudden declines in mobility or appetite. At this stage, families may feel blindsided, guilty, or rushed into decisions they do not fully understand. From a practice perspective, these scenarios can strain staff, erode trust, and limit the perceived value of specialty care, even when excellent medicine has been delivered.

When no hospice referral occurs, several risks emerge:

• Unmanaged symptom burden, including pain, dyspnea, anxiety, and gastrointestinal distress.
• Increased emergency visits, often after hours, which are stressful for families and staff alike.
• Caregiver burnout, leading to premature euthanasia or treatment discontinuation.
• Moral distress among veterinary teams, particularly when aggressive treatment continues despite declining quality of life.

The case for early integration

1. Improved patient comfort and function

Palliative care teams are trained to assess pain and distress using multimodal frameworks, incorporating pharmacologic, integrative, environmental, and caregiver-implemented strategies. Importantly, patients who feel better are often better candidates for continued oncology therapy.

When these tools are applied early:

• Pain can be addressed sooner, ideally before it becomes severe or refractory.
• Side effects of chemotherapy or radiation are mitigated proactively.
• Mobility, appetite, and sleep are supported throughout treatment.

2. Better informed, more confident clients

Concurrent care provides families with space to ask difficult questions early, before emotions are heightened by crisis. Discussions about prognosis, trade-offs, and quality-of-life benchmarks become ongoing conversations rather than single, overwhelming events. This transparency builds trust and reduces regret, regardless of outcome.

Clients supported by palliative care teams consistently report:

• Greater confidence in end-of-life decision-making
• Reduced anxiety and anticipatory grief
• A stronger sense of partnership with the veterinary and interdisciplinary teams

AAHA’s Oncology Guidelines

The 2026 AAHA Oncology Guidelines for Dogs and Cats are designed to help general practice teams navigate a cancer diagnosis, treatment, referral, and all the client conversations that come along with that.

Strengthening oncology outcomes

A common concern among oncology teams is that introducing palliative care too early may discourage clients from pursuing treatment. With a concurrent care approach, rather than functioning as competing philosophies, oncology and palliative medicine become complementary disciplines working toward a shared goal: the best possible life for the patient, for as long as possible.

When families feel supported and informed:

• They are more likely to initiate and continue recommended therapies.
• Treatment goals can be adjusted thoughtfully rather than abandoned abruptly.
• Transitions, from curative intent to comfort-focused care, occur more smoothly.

Practice benefits: Why concurrent care makes business sense

Reduced crisis management

Early palliative involvement reduces after-hours emergencies and last-minute euthanasia requests. This not only benefits families but also protects staff from burnout and compassion fatigue. In oncology referral practices, collaboration with palliative care teams often enhances, not diminishes, professional reputation.

Increased client retention and referrals

Clients who feel supported are more likely to:

• Complete treatment plans.
• Refer friends and family.
• Return to the practice for future pets.

Enhanced team satisfaction

Veterinary professionals consistently report higher job satisfaction when they feel they are meeting both medical and emotional needs.

Concurrent care allows teams to practice medicine aligned with their values, reducing moral distress, especially surrounding futile care (when intervention is pursued, yet unlikely to alter the clinical course of the disease or provide significant benefit to the patient) and turnover.^2-3

How to implement concurrent care successfully

Normalize the referral

Introduce palliative care as a standard part of pet cancer care, not solely as a last resort. Phrases such as “additional layer of support” or “comfort and quality-of-life focused” help frame the referral positively.

Refer early, but flexibly

Ideal referral points include:

• At diagnosis of a life-limiting cancer
• When starting chemotherapy or radiation treatment protocols
• At the first signs of symptom burden or caregiver capacity concerns

Not every client will engage immediately, and that’s okay. Early introduction keeps the door open.

Foster collaborative communication

Regular updates between oncology and palliative teams ensure aligned messaging and unified care plans. Shared quality-of-life metrics and goal-tracking tools can streamline this process.

Reframing Success in Veterinary Oncology

Success in cancer care doesn’t need to be measured solely by survival time or tumor response. Increasingly, it can be defined by:

• The patient’s comfort and function
• The family’s understanding and peace of mind
• The team’s ability to guide care with clarity and compassion

Concurrent care allows all three to coexist.

By integrating hospice and palliative medicine earlier, alongside oncology rather than after it, veterinary practices can elevate standards of care, strengthen client relationships, and support their teams more sustainably. The future of veterinary oncology is not just longer lives, but better lives. Concurrent care helps make that future possible.

This content was made in partnership with Caring Pathways, an AAHA End of Life Care accredited practice.

Photo credit: richiesd/iStock via Getty Images Plus 

Disclaimer: Trends™ content is meant to inform, educate, and inspire by providing an array of diverse viewpoints. Any content published should not be viewed as an official stance, position, or endorsement by the American Animal Hospital Association (AAHA) or its Board of Directors.