The goal of this study was to identify the symptoms of patients with advanced cancer. One hundred consecutive patients referred to the Palliative Care Service at the Cleveland Clinic Foundation were studied using a standard tool that included questions on 38 specific symptoms. The most common symptoms were pain, weight loss, and anorexia. Significant findings also included that women had more frequent and severe gastrointestinal complaints than men. These do not appear to be related to specific cancer primary sites.
Oxycodone has been shown for the first time to be as versatile and flexible as oral morphine in the management of chronic pain in patients with advanced cancer.
Communication between patient/family and the professional medical team is a priority for a service working with advanced cancer. Family conferences including all those persons involved in the patient's care have been established in a busy palliative care service to facilitate open communication. We report on the questions asked by families during 50 consecutive family conferences, during which the questions were recorded verbatim and categorized. Families want detailed knowledge of the extent of the patient's illness and life expectancy. We make recommendations about how best to conduct these conferences, based on these data and our own experience.
Anorexia is a common problem in advanced cancer, part of the cancer anorexia-cachexia syndrome. Although the etiology is multifactorial, symptoms suggestive of gastroparesis are often present in patients with cancer anorexia. We have successfully used metoclopramide, a prokinetic agent, to stimulate appetite in advanced cancer and relieve other dyspeptic symptoms associated with anorexia.
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