By Robert Dunlop (auth.)
Cancer: Palliative Care examines the character of the care and help that may be supplied to these wanting palliative care and their households. This covers not just the actual therapy, comparable to ache administration, but additionally the mental health of sufferers. medical examiners, clinicians, expert nurses and scientific scholars will discover a balanced and considerate evaluation of the topic in an effort to be of worth in dealing with sufferers and aiding them to come back to phrases with their condition.
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Additional resources for Cancer: Palliative Care
Nerve pain is frequently not recognised. Even when the diagnosis is made, appropriate treatments are often not used. Patients may have experienced escalating pain for many months before effective treatment is offered. Nerve pain is variously described by patients as burning, stabbing, shooting, like 'electric shocks' or 'pins and needles'. It is often the cause of pain which radiates into a limb or around the trunk. Examination will reveal evidence of nerve damage in the area of the pain. Sensation will be reduced or heightened.
Some centres give a single dose which is repeated if the pain returns. This is particularly helpful for patients who already have advanced disease and for whom travelling for treatment will further deplete dwindling reserves of energy. If bone fracture or collapse has produced mechanical instability, radiotherapy may produce minimal analgesia. For pharmacological treatment, patients should be started on paracetamol and then an NSAID, as described for superficial pain. If the pain is not controlled, the next step is to use a weak opioid in combination with the simple analgesics.
The patches provide a relatively constant level of fentanyl over a 2-3 day period. This reduces the number of tablets taken by the patient, although some form of 'rescue' analgesia, such as oral morphine, is needed for breakthrough pain. The patches are very expensive and should only be considered when the oral route is unavailable. Pethidine and pentazocine must not be used as alternatives to morphine. They have no place in the management of cancer pain. Whenever a strong opioid is prescribed, time should be spent with the patient and family eliciting their fears and reassuring them.
Cancer: Palliative Care by Robert Dunlop (auth.)