Palliative Care and the Management of Common Distressing Symptoms in Advanced Cancer: Pain, Breathlessness, Nausea and Vomiting, and Fatigue

Henson, Lesley A.; Maddocks, Matthew; Evans, Catherine J; Davidson, Murray; Hicks, Stephanie; Higginson, Irene J

doi:10.1200/jco.19.00470

Cited by 214 publications

(184 citation statements)

References 115 publications

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“…The goal of palliative care is improvement of quality of life. Good communication skills and flawless symptom control is associated with improved patient and family quality of life, greater treatment compliance, and may even offer survival advantages [42].…”

Section: Expected Resultsmentioning

confidence: 99%

Palliative Care in Colorectal Cancer

Caponero¹

2021

Colorectal Cancer

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Approximately 25% of patients present with liver metastases at the time of the first diagnosis and up to 50% will further develop recurrence in the liver during their disease course. Traditionally approached surgically, by resection of the primitive tumor or stoma, the management to incurable stage IV colorectal cancer patients has significantly changed over the last three decades and is nowadays multidisciplinary, with a pivotal role played by chemotherapy. Most patients with stage IV colorectal cancer have a poor prognosis, but numerous palliative modalities are available today. When a cure is no longer possible, treatment is directed toward providing symptomatic relief. Good symptom management in oncology is associated with improved patient and family quality of life, greater treatment compliance, and may even offer survival advantages.

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Section: Expected Resultsmentioning

confidence: 99%

Palliative Care in Colorectal Cancer

Caponero¹

2021

Colorectal Cancer

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“…At present, there is not specific suggestion on any other kinds of treatment for cancer patients, such as radiotherapy or ablation treatments. Overall, intensifying palliative care for cancer patients, and good management of common symptoms based on different grades, such as pain, dyspnea, nausea, vomiting, and fatigue can improve the quality of patients' life, even enhancing survival rate (31,32). Psychological counseling service for patients and their families should be provided by psychotherapists and social workers, if necessary, transferring is necessary to a psychiatrist for further intervention.…”

Section: Other Treatment Optionsmentioning

confidence: 99%

“…When surgery is performed for patients recovered from SARS-CoV-2 infection, surgery team should execute completely personal protective equipment, including N95 mask, and powered air-purifying respirator that is specially designed for operation room (37,38). For patients with thoracic tumor, the timing and type of surgery are principally determined by the severity degree of disease, for example, these conditions can be rescheduled to delay 1-2 months, including ground glass nodules with <50% solid or tumors, solid nodules or lesions <2 cm in greatest dimension, indolent behavior such as carcinoid or slow growth pattern, and asymptomatic and non-bulky thymoma (32). An alternative surgery may be an optimal choice in some cases, for example, superficial esophageal cancer (T1a/b) can be surgically removed by endoscopy.…”

Section: Surgerymentioning

confidence: 99%

Expert Consensus for Treating Cancer Patients During the Pandemic of SARS-CoV-2

Dong

Luo

et al. 2020

Front. Oncol.

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The sudden pandemic of SARS-Cov-2 (also known as novel coronavirus disease 2019, COVID-19) poses a severe threat to hundreds of millions of lives in the world. The complete cure of the virus largely relies on the immune system, which becomes particularly a challenge for the cancer subjects, whose immunity is generally compromised. However, in a constant evolving situation, the clinical data on the prevalence of SARS-Cov-2 for cancer patients is still limited. On top of a wide range of medical references and interim guidelines including CDC, NCI, ASCO, ESMO, NCCN, AACR, ESMO, and the National Health Commission of China, etc., we formed into a guideline based on our experience in our specialized cancer hospital in Wuhan, the originally endemic center of the virus. Furthermore, we formulated an expert consensus which was developed by all contributors from different disciplines after fully discussion based on our understanding and analysis of limited information of COVID-19. The consensus highlighted a multidisciplinary team diagnostic model with assessment of the balance between risks and benefits prior to treatment, individualizing satisfaction of patients' medical needs, and acceptability in ethics and patients' socioeconomic conditions.

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“…Patients receiving palliative care require medications to alleviate symptoms such as pain, breathlessness, nausea and vomiting, anxiety and terminal restlessness [ 1 , 2 ]. However, as patients start to lose the ability to swallow medication, the oral route of drug administration becomes problematic.…”

Section: Introductionmentioning

confidence: 99%

Transmucosal drug administration as an alternative route in palliative and end-of-life care during the COVID-19 pandemic

Lam

Cheung

Chow

et al. 2020

Advanced Drug Delivery Reviews

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The Coronavirus disease 2019 (COVID-19) pandemic has led to a surge in need for alternative routes of administration of drugs for end of life and palliative care, particularly in community settings. Transmucosal routes include intranasal, buccal, sublingual and rectal. They are non-invasive routes for systemic drug delivery with the possibility of self-administration, or administration by family caregivers. In addition, their ability to offer rapid onset of action with reduced first-pass metabolism make them suitable for use in palliative and end-of-life care to provide fast relief of symptoms. This is particularly important in COVID-19, as patients can deteriorate rapidly. Despite the advantages, these routes of administration face challenges including a relatively small surface area for effective drug absorption, small volume of fluid for drug dissolution and the presence of a mucus barrier, thereby limiting the number of drugs that are suitable to be delivered through the transmucosal route. In this review, the merits, challenges and limitations of each of these transmucosal routes are discussed. The goals are to provide insights into using transmucosal drug delivery to bring about the best possible symptom management for patients at the end of life, and to inspire scientists to develop new delivery systems to provide effective symptom management for this group of patients.

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Palliative Care and the Management of Common Distressing Symptoms in Advanced Cancer: Pain, Breathlessness, Nausea and Vomiting, and Fatigue

Cited by 214 publications

References 115 publications

Palliative Care in Colorectal Cancer

Palliative Care in Colorectal Cancer

Expert Consensus for Treating Cancer Patients During the Pandemic of SARS-CoV-2

Transmucosal drug administration as an alternative route in palliative and end-of-life care during the COVID-19 pandemic

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