Symptom Control in Advanced Cancer: Twenty Principles

Abstract

In Palliative Medicine, symptom management is a clinical priority and one of the key skill sets of the palliative specialist. Symptom control principles have been derived from clinical practice in cancer pain management. They can also be applied to other cancer symptoms, and systematic application will help improve quality of life (QOL). They require a diagnosis of the underlying etiology, individualization of symptom therapy, a systematic approach to management, and therapeutic clarity and simplicity. There are 20 principles that have been identified as helpful to guide the clinical practice of symptom control in advanced cancer.

The importance of symptom surveillance during follow-up care of leukemia, bladder, and colorectal cancer survivors

“…Effective screening, evaluation and management of symptoms, and patient-provider communication about symptoms are essential components of survivorship care quality. Our results support a conclusion that survivorship care planning for individuals with leukemia, bladder, and colorectal cancer is needed to address the symptom experience, and should include tailored, periodic symptom screening with aggressive interdisciplinary symptom management interventions offered as clinically indicated [1, 10, 37, 46]. Our study also suggests the need for directed and systematic studies of symptom experiences in post-treatment cancer survivors.…”

Subcutaneous Administration of Drugs in Palliative Care: Results of a Systematic Observational Study

“…The route of administration should be reliable and effective but preferably not burdensome for the individual patient. 1 For a variety of reasons, oral intake can be hampered. Patients approaching the end of life may be unable to tolerate oral medication because of their underlying disease and/or symptoms, such as nausea, vomiting, or difficulty swallowing (dysphagia).…”

Estudo observacional do uso da hipodermóclise em cuidados paliativos oncológicos

“…44 Além disso, grande quantidade de volume no local da punção, ao mesmo tempo pode causar incômodo ao paciente, demora na absorção, dificultando o controle de sintomas 33 . Foi mantido o cuidado, durante o acompanhamento pela pesquisadora, em permitir no máximo três medicamentos por horário, administrados em sequência, conforme preconizado na literatura 2,44 .…”

“…O controle de sintoma é parte fundamental na prática da medicina paliativa. Na fase avançada de uma doença como câncer metastático, e sem possibilidades de cura, os sintomas físicos como dor, náusea, vômito, fadiga, dispnéia, confusão e agitação são comuns e trazem muito desconforto, sendo o manejo destes amplamente baseado no tratamento medicamentoso [1][2] .…”