Palliative Care for Immigrants With Cancer in the United States: A Roadmap to Equitable Care.

Abstract

Across the U.S., immigrants with cancer, especially those who are undocumented or from low-income backgrounds, encounter significant barriers to accessing quality palliative care. Despite cancer comprising over one-third of global palliative care needs, immigrant patients are often excluded from essential services due to lack of insurance, immigration status, limited English proficiency, and culturally discordant care models. These challenges contribute to delayed diagnoses, inadequate symptom management, and lower quality of end-of-life care. This narrative review identifies both patient-level and systemic barriers and offers a four-part roadmap to address them. First, care models that prioritize cultural humility and respectful curiosity should be implemented through targeted training programs and workforce diversification. Second, community-based palliative care programs should be expanded through partnerships with trusted local organizations, bringing services directly into immigrant communities. Third, successful state-level innovations can be scaled, like California's Senate Bill 1004 and Illinois' Health Benefits for Immigrant Adults and Seniors. Finally, the routine use of patient-reported symptom tracking can improve diagnosis and guide treatment decisions. Drawing on data from national surveys, state-level policy evaluations, and peer-reviewed research on palliative care disparities, this review presents actionable strategies to ensure that all patients receive high-quality palliative care, regardless of their immigration status.