Palliative Care in Cancer Therapy: An Inevitable Demand of the Times
GURPREET KAUR BAMRAH
Palliative care, also known as “supportive care” or “end-of-life care”, is multidisciplinary medical caregiving practice that aims at improving the Quality of Life (QOL) of patients with serious complex illnesses. In Oncology, it is a professional discipline involved in mitigating cancer-related symptoms, managing treatment side-effects, improving physical, psychological, functional, and cognitive efficacy in patients, survivors, and family members.
Cancer rehabilitation and palliative care is the utilization of the understated medical services in oncology care to reduce symptom burden, post-traumatic disorders, and managing unbearable suffering and pain. Integrating palliative care with standard treatment as a part of the regime in the early stages is a new policy adopted by oncologists worldwide to ensure timely assessment and management of tumors or malignancies in a multisectoral manner.
NEED OF THE HOUR!
Palliative care is a multidimensional intervention that has shifted its gear to being an all-time conventional treatment for cancer patients. Improving the QOL of the patients, making them more comfortable, at ease, and recouping their intellectual abilities back to normal is the focal point of the treatment. Palliative care teams focus extensively on patient and family open-end communication to forage and determine their goals for care. Along with this, it addresses functional issues such as physical and physiological impairments that are resulting in disability or adding a negative impact to their overall welfare. Palliative care front liners operate with a pool of medical professionals including dieticians, mental-health professionals, nutritionists, pharmacists, psychologists, rehabilitation professionals, nursing-care professionals, physicians with the main oncologist.
According to few studies, palliative care in the early stages has helped reduce depression, anxiety, and burden on the family, improve social associations, enhance sexual health, and revamp the survival prognosis of patients with advanced cancer. In achieving these outcomes, hospitals and health care providers have been practicing validated models such as In-patient integrative care, out-patient consultation clinics, community-based care, regular follow-ups over call and house visits, and Hospice care to enforce the goal of ending suffering and to generate the best possible standard of life.
Patients with advanced cancer majorly experience various symptoms, the most common ones include pain, fatigue, anxiety, confusion, breathlessness, insomnia, nausea, constipation, diarrhea, and anorexia. Palliative care is determined to relieve patients from sufferings throughout the disease trajectory and is not restricted to end-of-life care. Recent research reports suggest that palliative care has decreased ICU and emergency department visits (9).
Considering that increasing life expectancy is the ultimate mission of science and technology, Palliative care offers a holistic approach based on the medical system which is not only focused on anatomic symptoms but transcends to psychological, social, and spiritual domains.
TYPES OF INTERVENTIONS
Palliative care incorporates several medical as well as drug-free practices involving the application of different generics of expertise and focuses on improving the QOL of the patients. Some of the interventions are listed below.
Percutaneous procedures- These embody minimally invasive procedures that are used to ease complications resulting from cancer or any treatment. These are performed under local anesthesia or sedation. The aforesaid includes;
- Drainage of collected fluids- reduces the risk of infection, bleeding, or injury in internal organs.
- Pain reduction- Percutaneous neurolysis, a tumor ablation procedure that is shown to ease pain and shrink the tumor.
- Decompression and release of any obstruction- These include biliary, urinary, and intestinal obstruction mostly observed in malignancies. Obstructions are decompressed and released using large wires and catheters.
Antimicrobial therapy- Therapy design includes the usage of antibiotic agents. The purpose is to improve the prognosis of patients, reduce the resistance of microorganisms, and minimize the spread of infections caused by multidrug-resistant bacteria. Fluoroquinolones and Trimethoprim-sulfamethoxazole are given to treat UTI caused by S. aureus; Oral Administration of a drug, fluconazole to metastatic malignant patients have claimed to reduce plaque and related symptoms.
Non-pharmacological Interventions- These are a wide range of non-drug-related engagement for abbreviating stress, anxiety, fatigue, depression, and intending at end-of-life care. Some of these intersections involve;
- Art therapy
- Reiki and therapeutic touch
- Massage therapy
- Music therapy
- Electromyography biofeedback-assisted relaxation
- Non-contact therapeutic touch
- Spiritual therapy
Use of opioids- Opioids are drugs that can treat serious ailments. Oncologists suggest the use of this drug to terminally ill patients. They include morphine, codeine, meperidine, and oxycodone. Their job is to block pain, relax muscles, slow down breathing and allay the suffering.
Palliative care has changed the panorama of cancer care. Integration of various model systems in the course including the Team-based model, Timely assessment care, Target approach to referral, and primary care have enhanced patient outcomes. These involve improved QOL and symptom control, decreased anxiety and depression, a better quality of end-of-life care, and fewer visits to the ICU. Considerable emphasis on increasing awareness for more widespread symptom screening must be highlighted to detect cancer in its initial stages and incorporate palliative care accordingly. In the era of personalized medicine, palliative care is a tailored provision that provides the right intervention to the right patient in the right setting and at the right time.
Author Biography: I am pursuing masters in biotechnology (research) from Shoolini University, Solan. I have completed two academic internships during my bachelor’s and two online research internships during the master’s course. My goal is to get a PhD degree and work in cancer biology department, particularly in therapeutics.