Being an Oncologist, I have seen many patients suffering from cancer. It pains a lot looking at them fighting the battle of life, though knowing that they would lose miserably and surrender meekly as majority of the patients report to the hospital at an advanced stage of disease and only palliative care may be the option. There is an urgent need to create - Cancer Awareness in the villages and also about the end of life care in all terminally ill patients. 20 patients in the terminal phase were questioned regarding end of life care. The common questions they asked are, why has God punished me like this? Why me on earth? Should I die so early? Why should I leave my near and dear ones and go far away, from the point of no return? Do I ever see them again? With deep sorrow and sigh, they suffer till the last breath, having the feeling of insecurity as what would happen to their dear ones. In the terminal phase, the patients wishes must be respected and their needs must be fulfilled. The health care professionals should plan an appropriate care for each patient. Most of them feel that the best place to be in end of life is the home. Research has shown that Hospice care may improve the quality of life of a patient who is dying and of the patient's family. Communication about end of life care and decision making during the final moments of a person's life are very important. The patients suffering are mainly due to the physical, psychological, social and spiritual issues. Death of a terminally ill patient should never be a sudden loss. All healthcare professionals, Social workers and Non-Governmental Organisations must install the life after death of the person, who has struggled for every breath and assure that he/she shall rest in peace and shall smile seeing their near and dear ones living with dignity and pride in the society. Ultimately, the patient must have dignity in dying.
Aims:To evaluate the clinical outcome and complications with two different palliative chemotherapy regimens in recurrent cervical carcinoma. Methods and materials: Forty (40) women with recurrent cervical squamous cell carcinoma were treated with palliative chemotherapy using paclitaxel plus cisplatin or single-agent docetaxel. Clinical outcome and toxicities were analysed. The parameters in two arms were compared using Student's t-test and statistical analysis was done using R software. Results: At a median follow up of 1.35 years the clinical outcome was complete response/partial response in 50% and 60% and progressive disease in 20% and 10% of the patients with either paclitaxel/cisplatin or docetaxel, respectively, which was not statistically significant. Stable disease (SD) was 30% in both arms. Toxicity included nausea, seen in all the patients in both arms, and diarrhoea, seen in 90% and 70% of the patients in the two arms, respectively. Grade II to III neutropenia was seen in 10% of patients with paclitaxel/cisplatin and none with docetaxel. Hypersensitivity was encountered in 40% and 30% in the two arms, respectively. Conclusion: There was no significant difference in clinical outcome and morbidity in patients with either paclitaxel/cisplatin or single-agent docetaxel. Further prospective clinical trials with larger study groups and longer follow-up are required to substantiate these claims.
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