Universität zu Köln

Bausewein, Claudia ORCID: 0000-0002-0958-3041, Simon, Steffen T., Pralong, Anne, Radbruch, Lukas, Nauck, Friedemann and Voltz, Raymond (2015). Palliative Care of Adult Patients With Cancer. Dtsch. Arztebl. Int., 112 (50). S. 863 - 878. COLOGNE: DEUTSCHER AERZTE-VERLAG GMBH. ISSN 1866-0452

Full text not available from this repository.

Abstract

Background: In Germany, the annual mortality rate from cancer in the year 2011 was 269.9 deaths per 100 000 persons; every fourth death was due to cancer. A central objective of palliative care is to maintain the best possible quality of life for cancer patients right up to the end of their lives. Methods: The PubMed, Embase, and Cochrane Library databases were systematically searched for pertinent publications, and the ones that were selected were assessed as recommended by the Scottish Intercollegiate Guidelines Network. As part of the German Guideline Program in Oncology, recommendations for the S3 Guideline on Palliative Care concerning seven different topics in the management of adult patients with incurable cancer were developed by a representative expert panel employing a consensus process. Results: Opioids are the drugs of first choice for severe and moderately severe cancer-related pain, and for breathlessness. No clinically relevant respiratory depression was observed in any study. When opioids are used, accompanying medication to prevent constipation is recommended. Drugs other than opioids are ineffective against breathlessness, but clinical experience has shown that benzodiazepines and opioids can be used in combination in advanced stages of disease, or if the patient suffers from marked anxiety. Depression should be treated even in patients with a short life expectancy; psychotherapy is indicated, and antidepressant medication is indicated as well if depression is at least moderately severe. Communication skills, an essential component of palliative care, play a major role in conversations between the physician and the patient about the diagnosis, the prognosis, and the patient's wish to hasten death. When the dying phase begins, tumor-specific treatments should be stopped. Conclusion: Palliative care should be offered to cancer patients with incurable disease. Generalist and specialist palliative care constitute a central component of patient care, with the goal of achieving the best possible quality of life for the patient.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bausewein, Claudia UNSPECIFIED orcid.org/0000-0002-0958-3041 UNSPECIFIED Simon, Steffen T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pralong, Anne UNSPECIFIED UNSPECIFIED UNSPECIFIED Radbruch, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Nauck, Friedemann UNSPECIFIED UNSPECIFIED UNSPECIFIED Voltz, Raymond UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-383774
DOI:	10.3238/arztebl.2015.0863
Journal or Publication Title:	Dtsch. Arztebl. Int.
Volume:	112
Number:	50
Page Range:	S. 863 - 878
Date:	2015
Publisher:	DEUTSCHER AERZTE-VERLAG GMBH
Place of Publication:	COLOGNE
ISSN:	1866-0452
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EVIDENCE-BASED RECOMMENDATIONS; RANDOMIZED CONTROLLED-TRIAL; ORAL MORPHINE; DOUBLE-BLIND; PHARMACOLOGICAL-TREATMENT; REFRACTORY DYSPNEA; GUIDELINES PROJECT; CROSSOVER TRIAL; PAIN; METAANALYSIS Multiple languages Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/38377