Palliative Care (End of Life)

29.02.2024

PALLIATIVE CARE IN CANCER TREATMENT

Palliative care is a healthcare approach aimed at people with serious and incurable diseases, focusing on relieving pain and other symptoms and improving the quality of life of the patient and their family. Rather than focusing on treating the disease, this care addresses the physical, psychological, social and spiritual needs of the patient and their family. It usually comes into play when cancer treatments end or the disease does not respond to treatment, and aims to ensure the patient's comfort and support in the last stages of life.

WHICH PATIENTS SHOULD IT BE APPLIED?

Palliative care is an approach that aims to improve the quality of life and relieve symptoms for individuals with serious illnesses. Palliative care is necessary for many different diseases and conditions.

Some diseases and conditions that require palliative care support:

Cancer: Cancer patients may experience symptoms such as pain, nausea, fatigue and depression during the treatment process. Palliative care helps cancer patients manage these symptoms.

Advanced Stage Heart Failure: As heart failure progresses, symptoms such as edema, shortness of breath and weakness may occur. Palliative care is important to relieve these symptoms and improve quality of life.

Advanced Stage Neurological Diseases: Progressive neurological diseases such as Alzheimer's disease, Parkinson's disease, and ALS can cause physical and mental difficulties in individuals. Palliative care can help alleviate the course of these diseases.

Advanced Stage Respiratory Failure: Diseases such as chronic respiratory failure or pulmonary fibrosis can cause symptoms such as difficulty breathing, weakness and cough. Palliative care can contribute to the management of these symptoms.

Advanced Stage Renal Failure: Patients with kidney failure may experience symptoms such as fatigue, loss of appetite and edema. Palliative care is important to reduce these symptoms and improve quality of life.

AIDS and Other Advanced Stage Infections: Late-stage HIV/AIDS and other serious infections may be associated with symptoms such as weakness, fatigue, and pain. Palliative care can help relieve symptoms and provide psychosocial support in these patients.

Advanced Stage Organ Failures: Serious organ diseases, such as liver, kidney or other organ failures, may require palliative care to manage symptoms and improve patients' quality of life.

Palliative care is an appropriate approach for these diseases as well as many other serious diseases and conditions. Each patient's needs may be different, so it is important to individually tailor palliative care. It offers an approach to improving the quality of life by meeting the physical and emotional needs of patients and their families.

Image 1: The palliative care process for cancer patients is carried out with the support of a healthcare team.

PALLIATIVE CARE IN CANCER PATIENTS

Palliative treatments for cancer patients may include a number of different methods to relieve symptoms, improve quality of life and provide psychosocial support.

Palliative treatment methods frequently used in cancer patients:

Pain Management:

Medications: Painkillers are used to relieve pain in cancer patients. While medications such as aspirin or ibuprofen can be used for mild pain, opioid painkillers (such as morphine) may be prescribed for severe pain.

Epidural Blockade: Epidural blockade can be used to manage severe pain in advanced cancer patients. With this method, medication is given to the epidural area to reduce pain.

Nausea and Vomiting Control:

Antiemetic Drugs: Antiemetic drugs can be used to control symptoms of nausea and vomiting that occur during or after cancer treatment.

Fatigue Management:

Physical Activity: Appropriate levels of physical activity are recommended for cancer patients. These activities can help reduce fatigue.

Rest and Sleep: A good sleep pattern and rest are important in relieving fatigue in cancer patients

Oral care:

Treatment of Mouth Ulcers: Mouth ulcers may occur during or after cancer treatment. Treatment of these ulcers and attention to oral hygiene can improve the patient's nutrition and quality of life.

Psychosocial Support:

Psychotherapy: Cancer patients and their families can receive emotional support through psychotherapy or counseling services.

Support Groups: For those dealing with cancer, support groups can be helpful in sharing similar experiences and providing psychosocial support.

Nutritional Support:

Dietary Counseling: By providing appropriate nutritional advice to cancer patients, a dietitian can address nutritional issues and help prevent malnutrition.

Symptom Management:

Control Constipation and Diarrhea: Medications or dietary changes may be used for digestive problems that occur during cancer treatment.

Management of Shortness of Breath: In cases such as lung cancer or metastatic cancer, oxygen therapy or breathing exercises may be recommended for symptoms of shortness of breath.

Patient and Family Education:

Cancer patients and their families should be educated about symptom management, side effects of medications, and care plans. These trainings can help patients take better care of themselves.

Palliative care in cancer patients should be tailored to individual needs and the stage of the disease. Treatment aims to improve the patient's quality of life and minimize symptoms. Therefore, it should be planned and implemented by a multidisciplinary healthcare team.

Image 2: The final phase of cancer patients may be spent at home or in a palliative care center.

PALLIATIVE CARE TREATMENT METHODS

Whether palliative care for cancer patients is provided at home or in the hospital depends on the patient's condition, needs and preferences. Palliative care at home can provide the patient with comfort and peace in a familiar environment and allows family members to take a more active role. In-hospital palliative care is necessary to manage more complex medical needs and provides ongoing medical supervision. Both options offer personalized care to improve the patient's quality of life and relieve symptoms.

Palliative Care at Home:

Advantages:

Patient Comfort: Home care allows the patient to be in their own environment and with their family, which can help the patient feel more comfortable.

More Freedom: Home palliative care can allow the patient to participate more in daily life.

Emotional Support: Family and friends can be there for the patient and offer emotional support.

Ease of Medication Administration: Medications and symptom management at home can be easier and more personalized.

Disadvantages:

Lack of Professional Care: Home care may mean that the professional healthcare team is not with the patient.

Meeting Needs: Obtaining and managing medical equipment and medications at home can be difficult.

Burden for Patient and Family: Home care can be physically and emotionally challenging for family members and caregivers.

Image 3: Patients whose general condition improves and are discharged during the palliative care treatment process can consult their follow-up oncologist to continue their cancer treatment.

Palliative Care in Hospital:

Advantages:

Professional Support: The hospital environment provides ongoing medical support and expertise.

Emergency Response: In case of an emergency, rapid medical attention can be provided.

Rapid Symptom Management: Symptoms can be assessed and managed quickly.

Disadvantages:

Patient Comfort: The hospital environment can be stressful and disturbing for some patients.

Time Split with Family: The patient and his family may spend less time in the hospital.

Inadequate Emotional Support: Emotional support may be lacking in the hospital environment.

As a result, whether palliative care should be given to cancer patients at home or in the hospital may vary depending on each patient's situation and preferences. While some patients feel comfortable at home and feel better being with their families, others may need more professional support and rapid intervention in a hospital setting. Therefore, the needs and preferences of the patient and his family should be evaluated by a multidisciplinary healthcare team and the most appropriate care environment should be determined.