Articles: palliative-care.
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Support Care Cancer · Jul 1996
Supportive care programs in cancer at the National Cancer Center in Tokyo.
Until recently, supportive care for cancer patients in Japan was not well organized. Not too many oncologists paid attention to the improvement of daily life of patients with advanced or terminal cancer. Oncological staffs such as doctors, nurses, psychologists, and pharmacists at hospitals in Japan did not really cooperate efficiently. ⋯ At the National Cancer Center in Japan an effort is being made to expand activities in PCU, the application of Chinese acupuncture for pain relief, and the development of a virtual reality technique. A system to connect cancer centers has been established and is now being expanded to facilitate a new database on up-to-date cancer information. We have already started holding multi-institutional medical teleconferences, telepathology and teleradiology on a weekly basis, covering nine cancer centers throughout Japan.
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The authors define the role of palliative pancreaticoduodenectomy in patients with pancreatic carcinoma. ⋯ Pancreaticoduodenectomy can be performed with a similar perioperative morbidity and mortality and only a minimal increase in hospital stay when compared with traditional surgical palliation. Pancreaticoduodenectomy with postoperative chemotherapy and radiation therapy is associated with improved long-term survival when compared with patients treated with surgical bypass. These data support the role of palliative pancreaticoduodenectomy in patients with pancreatic carcinoma and with local residual disease.
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This study presents a prospective evaluation of the home care programme for patients with advanced cancer at the National Cancer Institute of Milan. Demographic, psychosocial and physical variables were evaluated. The Therapy Impact Questionnaire was used for symptom and quality of life assessment. ⋯ Home care is a feasible alternative for implementing palliative care in a selected population of patients with advanced cancer. Palliation of physical symptoms is more easily achieved than the control of psychological suffering. Family and economical issues implied by home care models should be part of the discussion in implementing palliative care for advanced cancer patients.
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This paper considers whether a physician is criminally liable for administering a dose of painkillers that hastens a patient's death. The common wisdom is that a version of the doctrine of double effect legally protects the physician. That is, a physician is supposedly acting lawfully so long as the physician's primary purpose is to relieve suffering. ⋯ Physician culpability can be based on recklessness, and recklessness hinges on whether a physician has taken an unjustifiable risk of hastening death. The authors identify three conditions of justifiability. Their analysis helps to explain the distinction between euthanasia, which is legally banned, and the use of risky analgesics, which is permitted in limited circumstances.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A randomized, double-blind, double-dummy, crossover trial comparing the safety and efficacy of oral sustained-release hydromorphone with immediate-release hydromorphone in patients with cancer pain. Canadian Palliative Care Clinical Trials Group.
To evaluate the safety and efficacy of a new slow-release preparation of hydromorphone (SRH) in the treatment of cancer pain. ⋯ Our findings suggest that SRH is as safe and effective as IRH in the treatment of cancer pain.