Gan to kagaku ryoho. Cancer & chemotherapy
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Gan To Kagaku Ryoho · Dec 1994
Clinical Trial[The importance of pain control with morphine for terminally ill patient care for at home].
From April 1987 to June 1994, 81 patients of terminally ill had been care at home. In these home care, 38 patients received pain control with morphine. In 29 patients, pain control had been started before home care but in 9 patients pain control had been started under home care. ⋯ Two patients lived but 24 patients died at home and 12 patients died at hospital. We concluded that palliative care especially pain control with morphine was very important care for patients of terminally ill who wanted care at home and ultimately die at home. We had to make ourself master of method pain control with morphine.
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Gan To Kagaku Ryoho · Dec 1994
Case Reports[Bathing a patient with cancer pain treated with continuous epidural blockade--subcutaneous catheter track and Lapack method].
Continuous epidural blockade is considered to be the most useful device for the management of cancer pain. However, it has the disadvantage to compel the patients to restrict their daily activities. We report a unique "Subcutaneous catheter track & Lapack-method" that enabled a patient with epidural catheter to safely bath at home. ⋯ Since his wishing was to bath, we made a long subcutaneous catheter track with Tuohy-needle to prevent infection, and let him bath with transparent film dressings (Bioclusive) and Lapack to tightly cover and seal up the catheter. Although subcutaneous pustule occurred 7 days after the beginning of bathing, it was easily cured by local disinfection. He was able to enjoy bathing without any infection with this method at home for about 2 months after discharge, until he returned to the hospital. "Subcutaneous catheter track & Lapack-method" offers a safe and comfortable bathing to patients with epidural catheter, and contributes to the improvement of their quality of life.
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Gan To Kagaku Ryoho · Dec 1994
Clinical Trial[Eligibility from clinical science for domiciliary cancer treatment].
To establish domiciliary treatment for cancer patients, following conditions must be settled. They are eligibility from clinical science, intentions of patients and their family, social and economical aspects, compatibility with medical service laws in Japan, and so on. Eligibility from clinical science should be the first matter to be settled among them. ⋯ When the possibility was respectively judged by two nurses in our domiciliary cancer treatment committee, a difference appeared in the numbers of the candidates for domiciliary treatment. Finally the committee decided that 37 inpatients could receive medical care practices in their homes. The analysis of the reason in difference by two nurses made us recognize that the process of the selection of cancer treatment must be properly constructed for the well-qualified domiciliary treatment.
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Gan To Kagaku Ryoho · Dec 1994
Case Reports[Current status and problems of home care for patients with terminal cancer from the viewpoint of local clinics].
On the basis of investigations of 15 patients from our clinic with terminal cancer who were treated by home hospice care, and questionnaires filled out by their caretakers, we examined the current status and problems of the home hospice care system with respect to four phases, namely, the period of preparation for home care (hospitalization period), stable period, terminal period, and the period immediately before death. [Preparation period] The following problems occurred in this phase: introduction of pain management and nutrition management was insufficient; there were only a few cases in which the patient chose home care of his or her own will; and sufficient instructions were not given to caretakers on discharge from the hospital, with respect to medical treatment at home. [Stable period] In two of the four cases in which patients complained of severe pain, the pain was not alleviated because pain management was provided only at the outpatient clinics of the hospital, and collaboration between hospitals and our clinic was insufficient. [Terminal period] Two patients could not be admitted to the hospital upon sudden exacerbation of the condition, suggesting the need to establish a system in which large hospitals can cope with sudden exacerbation of their condition of patients with terminal cancer treated at home. [Period immediately before death] Of the 14 patients who died, 7 died at home and 7 died in the hospital or during transport to the hospital. Three subjects died within a few days after admission. ⋯ On the basis of the cases taken care of at our clinic, we examined the home care system according classification into three types; hospital-outpatient clinic type; hospital-home care type; and clinic-home care type. An ideal system for the treatment of patients with terminal cancer who hope to stay at home until the last possible moment seems to be the clinic-home care type in which a primary care team that is able to dispatch physicians and nurses, and an around-the-clock support system, are supported by outside organizations and specialists.
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Gan To Kagaku Ryoho · Nov 1994
Multicenter Study Clinical Trial[Early phase II clinical study of RP56976 (docetaxel) in patients with primary pulmonary cancer. Docetaxel Cooperative Study Group for Lung Cancer].
An early phase II clinical study of RP56976 (Docetaxel), a new anticancer agent of plant origin, was conducted in patients with primary pulmonary cancer as a multicentered study involving 28 Japanese institutions. Docetaxel was administered at an intravenous dose of 60 mg/m2 based on the results of a phase I clinical study, and efficacy and safety were examined. Of the 65 patients enrolled, 57 patients were evaluated to have completed the scheduled course of treatment by the Evaluation Committee. ⋯ Hematological adverse reactions included leukopenia and neutropenia of Grade III or more as specified in the Adverse Event Reporting Form proposed by the Japan Society for Cancer Therapy in 53.3% (32/60) and 78.3% (47/60) patients, respectively. Other major adverse reactions included alopecia and anorexia. Neurological symptoms developed at a low frequency and were mild in severity.