Articles: palliative-care.
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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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Support Care Cancer · Jan 2001
Comparative StudyPalliative cancer care in two health centres and one hospice in Finland.
This study evaluates palliative treatment of inpatient cancer patients in two health centres and in one hospice in Finland. Apart from outpatient clinics, health centres in Finland also have inpatient wards where patients are treated by GPs. The hospice provides a home-like environment for terminal patients, who are cared for by a specialist in internal medicine. ⋯ Hospice patients (20/35) were significantly (P < 0.001) more concerned about the wellbeing of their relatives than patients in the health centres (2/35). In the hospice 18 patients (50%) showed significantly (P < 0.001) more spiritual needs than health centre patients (4/34). We conclude that more education is needed to improve the awareness of the multidimensional needs of terminally ill cancer patients in primary health care.
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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.