Profile, Treatment, and Survival of Palliative Cancer Patients in a Middle Income Country’s Cancer Center

Abstract

Background: Data describing the characteristics, treatment, and survival of oncological patients referred to PCS remains scarce. Aim: To establish the characteristics of oncological patients referred to PCS, including their profile, treatment, and survival within a 7-year period. Design: Retrospective review of medical records. Clinical variables such as treatment and dates were included. Ji2 or Wilcoxon tests were used accordingly; Kaplan-Meier and log rank test were used to estimate survival. Setting/Participants: Consecutive oncological patients diagnosed between 2012 and 2018 sent to PCS were included. Results: We studied 5,631 patients, 58% female and 59% at advanced stage. Median age was 59 years, with 6 years or less of formal education and low monthly income ($152.4 USD). Neoplasms included breast (12%), stomach (12%), colorectal (10%) and cervical cancer (9%). Median referral time was 5.1 months; pain was the main reason for referral. Morphine was the most prescribed opioid with 47%. Median overall survival was 3.1 months. Conclusions: Morphine remains the paradigm of treatment making necessary to emphasize information on its optimal use. Additional measures such as education for cancer prevention and early referral to PCS are vital to improve survival and quality of life.

Performance status and survival in cancer patients undergoing palliative care: retrospective study

“…The importance of performance scales as predictors in patients with survivals between 3 and 24 months (median survival in our service is 3 months)17 was demonstrated in a previous systematic review 3. However, though the scales appear to accurately predict early deaths, the correlation with longer survival is less specific, and previous reports have stated that lower scores are better predictors compared with higher ones 18.…”

Implementation and Knowledge of the Clinical Practice Guide for Palliative Care in the Ecuadorian Primary Care Level

“…In the literature that was consulted, the importance of this personnel possessing adequate knowledge to improve quality of life and reduce anguish has been highlighted [ 19 ]. Few of them treat agony, dyspnea, and delirium, being necessary to know correct management of the opioids that help alleviate suffering [ 24 , 25 ]; for them, training should be addressed that removes the myths and erroneous concepts around the use of these substances, such as those related to addiction to morphine derived from its use [ 26 ]. During the 67th World Health Assembly, the WHO urged the countries to ensure funding and allocate resources that include availability of essential medications for symptom relief [ 10 ].…”

Construção de um Guia para Avaliação e Manejo Fisioterapêutico da Dor em Pacientes com Câncer

“…Sabe-se que, com o avanço da doença oncológica, sintomas como dor se destacam como os mais prevalentes, de maior intensidade e mais angustiantes, independentemente do tipo tumoral e contexto clínico 34 . Outros estudos 33,35,36 demonstraram intensidade elevada de dor em seus achados e dificuldade no controle do sintoma. Belayneh et al 33 encontraram dor moderada a intensa em 61,7% dos pacientes com câncer em cuidados paliativos.…”

“…Belayneh et al 33 encontraram dor moderada a intensa em 61,7% dos pacientes com câncer em cuidados paliativos. Allende-Perez et al 35 observaram que 65% dos pacientes apresentavam alguma intensidade de dor e que 40% possuíam dor moderada ou intensa. Lima et al 36 avaliaram pacientes com câncer avançado em tratamento oncológico específico e paliativo, e verificaram que 70,7% deles não possuíam controle álgico no momento da internação e que a dor neuropática foi a de mais difícil controle.…”