Aust Fam Physician
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Review Case Reports
Pain management in palliative care. Reviewing the issues.
Cancer pain remains significantly undertreated despite being one of the most prevalent and feared symptoms associated with cancer. Approximately 90% of patients can have their cancer pain controlled through relatively simple measures. ⋯ Each component of the pain experience is addressed using a four point approach to pain and involves pharmacological and nonpharmacological measures. The general practitioner's role is pivotal in optimal cancer pain management. This is the first of two articles by Kiran Virik and Paul Clare on pain management in palliative care. The second, outlining treatment options, will appear in the December issue of Australian Family Physician.
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Suffering threatens the integrity of the person, never more so in palliative care than when existential distress is left unaddressed. ⋯ Each existential challenge operates across a spectrum of response from successful adaptation to morbid complication. Clinical responses to such predicaments and their complications described herein, are exemplified by the demoralisation syndrome and its treatment. Boundary violations that arise from a 'burnt out' clinician can be avoided. Our goal is to ameliorate suffering and help our patients accomplish a more peaceful journey during their dying.