Cancer control : journal of the Moffitt Cancer Center
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Patients with pain caused by cancer frequently experience visceral pain. In addition to oral pharmacologic therapy to manage pain, neurolytic blocks of the sympathetic axis are also effective in controlling visceral cancer pain. ⋯ Neurolysis of the sympathetic axis has been shown to be an effective and safe approach to treat visceral pain in cancer patients and should be incorporated in the armamentarium of the pain specialist as a useful adjunct to oral pharmacologic therapy.
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Recent basic science research has greatly added to our knowledge of pain mechanisms. Application of this knowledge to cancer pain syndromes has led to new and innovative approaches to cancer pain management. ⋯ Understanding the neurophysiology of cancer pain promotes use of the most appropriate palliative measures for pain control.
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Physicians who treat patients approaching the end of life often face moral, ethical, and legal issues involving shared decision making, futility, the right to refuse medical treatment, euthanasia, and physician-assisted suicide. ⋯ Legal and ethical issues continue to confront patients, courts, and physicians. A better understanding of these issues and an awareness of the availability of effective palliative care will help physicians, patients, and families adequately address the end-of-life issues that are an intrinsic part of medical care.
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Palliative care is received by a small number of patients with terminal illness, most of them with cancer. ⋯ Recognizing and overcoming the barriers to the provision of palliative care can bring about changes in education, health care practices, and administration to achieve the desired goals.