Surgical oncology clinics of North America
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Most advanced cancer patients remain incurable. They are carrying the tumor burden and the burden of symptoms as a result of physical, emotional, and spiritual distress. ⋯ Because of this, palliative medicine has emerged as the champion of pain and symptom control in advanced cancer patients. The reasons for medical oncology not embracing palliative care are analyzed and a model for palliative medical oncology is proposed.
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Surg. Oncol. Clin. N. Am. · Jan 2001
ReviewThe surgeon and palliative care: an evolving perspective.
This article examines some of the cognitive and psychologic barriers surgeons possess when attempting to palliate advanced and incurable disease. Despite these barriers, the history of surgery demonstrates numerous eloquent exponents of palliative care philosophy. The considerable body of knowledge and experience in these matters beginning with the work of Dame Cicely Saunders and subsequent medical specialists is presented and offered as a guide for surgeons as their own perspective continues to evolve.
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In the area of end-of-life bioethical issues, patients, families, and health care providers do not understand basic principles, often leading to anguish, guilt, and anger. Providers lack communication skills, concepts, and practical bedside information. ⋯ Clinicians need to learn how to balance the benefits and burdens of medications and treatments, control symptoms, and orchestrate withdrawal of treatment. Finally, all need to learn more about the dying process to benefit society, their own families, and themselves.