Seminars in oncology
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Given modern techniques of pain assessment and management, it is now possible to be optimistic about cancer pain control. Assessment of cancer pain must include information about the site(s) of pain, pathophysiology, pain severity, and quantification of analgesic responses. Correct diagnosis of common pain patterns including breakthrough and incident pain are essential. ⋯ Misunderstandings about opioids are common and patient and family education paramount. Adjuvant analgesics are necessary for good pain control, but have important differences in indications, usage, and side effects compared with opioids. First-rate pain management is a basic professional and humanitarian responsibility of the skilled clinical oncologist.
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Cancer patients often die with serious unrelieved symptoms causing a distressing death for them and needless added suffering for their families. Many physicians have not been trained to care for the dying patient. This chapter reviews the common symptoms and describes the methods to control them and support the patient and family through this difficult time. These symptoms are so characteristic of the dying process that all physicians should recognize them, be skilled in providing appropriate care, and prepare for problems that may arise.