Articles: palliative-care.
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J Pain Symptom Manage · Jul 1997
Assessment of knowledge about cancer pain management by physicians in training.
This survey assessed the knowledge of physicians in training about the pharmacology of opioid analgesics and the benefits of palliative radiation therapy in the management of cancer pain. Eighty-one trainees at the Washington University Medical Center completed a questionnaire that addressed the palliative care of a hypothetical patient with metastatic non-small cell lung cancer. The questions addressed were 1) opioid selection, 2) conversion of parenteral to oral morphine, 3) management of opioid toxicities, 4) opioid addiction, and 5) efficacy of radiation therapy. ⋯ Although 41% recognized that complete relief of pain could be achieved in 50%-60% of patients, most (70%) predicted that maximum pain relief would be seen within the first month, and 98% predicted maximum benefit by 12 weeks. Although cancer pain management has been highlighted in the lay and medical literature, physicians in training still demonstrate deficiencies in their knowledge about the pharmacology and bioequivalency of the opioid and the benefits of radiation therapy. Published guidelines for the management of cancer pain need to be disseminated to all medical personnel caring for patients with cancer.
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To describe the services available for the treatment of acute pain in surgical hospitals in New Zealand. ⋯ Most New Zealand surgical hospitals use a wide range of modern analgesic modalities and an increasing number are providing formal acute pain services with designated medical and/or nursing time.
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La Revue du praticien · Jun 1997
[Radiotherapy and symptomatic treatments of advanced colorectal cancers].
Treatments of colorectal cancers can still be curative up to fairly advanced stage. Clinical situations vary greatly depending on the primary: local recurrence is a major event in rectal cancer whereas metastases are the main problem in colon cancer. Therefore, rectal cancer benefit from locoregional combined treatments, chemotherapy, radiotherapy and surgery, to control the pelvic disease. ⋯ Radiotherapy for bone or brain metastasis is well known and frequently used; irradiation of painful liver metastasis is less regularly discussed despite its efficacy. Symptomatic treatments like analgesics narcotic or not, non steroidal anti-inflammatory, anxiolytics, etc. are useful. All these treatments must be evaluated, not only in term of anti-tumoural but also from the quality of life point of view.
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A variety of treatments can be effective palliative therapy of symptoms of airway obstruction caused by endobronchial tumour: Nd-YAG laser resection may be indicated for tumours that are relatively short in length, situated in trachea, mainstem or proximal lobe bronchi. Cryotherapy may be an alternative to laser resection. ⋯ Endobronchial stents. Randomised trials are required to determine the relative merits of these treatments and the optimal management of endobronchial complications of lung cancer.