Surgical oncology clinics of North America
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Surg. Oncol. Clin. N. Am. · Jan 2001
ReviewPharmacologic management of nonpain symptoms in surgical patients.
Palliative care patients present with multiple symptoms other than pain and cachexia. Asthenia, delirium, dyspnea, and chronic nausea and constipation cause significant distress to patients and families and frequently coexist in the same patient. ⋯ The success rate is variable, and it is very high for symptoms such as chronic nausea or constipation and less effective for symptoms such as asthenia and delirium. More research on the mechanism and treatment of these symptoms is needed.
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Surg. Oncol. Clin. N. Am. · Jan 2001
ReviewPharmacologic management of pain: the surgeon's responsibility.
Historically, surgeons have had to witness their patients' pain probably longer than any specialty within medicine. Pain relief in palliative care forms the cornerstone of a comprehensive pattern of care that encompasses the physical, psychologic, social, and spiritual aspects of suffering. In a society that lives by mottoes, such as "no pain, no gain," and "just say no to drugs," pervasive subconscious barriers to effective pain relief exist. In being responsible for effective pain management to the patient, the surgeon must first set aside his or her own beliefs and attitudes regarding pain and its control and be open to change.
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Surg. Oncol. Clin. N. Am. · Jan 2001
ReviewThe relationship between surgery and medicine in palliative care.
Palliative care represents the beneficence of surgery and medicine. A unified approach toward symptom control in patients with advanced diseases by surgeons and physicians is essential. Proposals are put forward to develop relationships between surgery and medicine for palliative care, teaching, and research. A model for integrating surgical and medical services to deliver the best palliative care is presented in this article.
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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.