What does palliative care for MDS look like?

What does palliative care for MDS look like? So palliative care is a super interesting topic because if you give the term palliative care, it means different things to different people. So there's one type of palliative care which I like better, which is supportive things you do during a treatment for cancer or just if you have cancer. So those would be things like making sure you have good pain control. That's palliative care. Making sure that you have good nutrition. That's palliative care. That you're psychologically fit. That's palliative care. So all those things happen no matter whether you're diagnosed or whether you've gone through many, many, many treatments. Palliative care is important the whole way through and it might change what you need during that time. There's other forms of palliative care which people think about which are there are no more treatments that are available, right? And they think about it more like hospice care, right? So hospice care is something where you go into, there are no active treatments that are available. So really it's all focused on your symptoms. Pain, shortens breath, all of these other things. And so that form of palliative care is like a sort of a different offshoot of it. So what I would say is that the first type where we're just dealing with your symptoms, right, that is I think should be done all the time. I think that when you flip over to this sort of hospice-like palliative care, I think that's when you've exhausted all therapies or the therapies that are there are just way too dangerous. And so I think that those are two different things. And so you have to be careful about when you talk about palliative care to like a physician, the physician, you need to be on the same page. Like you can't just say, I want palliative care. They may send you to hospice, but you're not talking about that. So I think that it's important to remember that it is an unclear phrase. So I would just ask for more definition from the person who's offering it to you, the person you're talking to. I have to do that if I talk to patients about palliative care, what I mean by that phrase. Palliative care and MDS is a little bit tricky. Unfortunately, palliative care doesn't cover blood transfusions or platelet transfusions most of the time. And our patients with MDS who are in need of palliative care usually have a frequent need for red blood cell and platelet transfusions. However, we do like to work with our palliative care physicians at the end of life for our MDS patients to try and make the transition to hospice and the end of life as smooth and comfortable as possible.