“Palliative” means accommodating, indulgent, and unrestricted for a good cause. The main purpose of palliative care is to improve the quality of life of patients and their families, to maintain the dignity of patients, and to extend their lives as much as possible with limited medical resources, mainly for symptoms, mental, psychological and social problems.
What does palliative care for tumors include?
Palliative care for tumors includes systemic therapy, clinical trials, and supportive care. Systemic therapy here includes palliative surgery, palliative chemotherapy, palliative radiation therapy, and local infusion chemotherapy. When no treatment is available, patients may choose to participate in clinical trials to try some of the latest research treatments. Systemic optimal supportive care is particularly important in relieving pain and in treating bleeding, obstruction, and nausea and vomiting.
For some patients with advanced gastric cancer who have lost the chance of cure, aggressive surgery, radiotherapy, chemotherapy, etc. no longer benefit them, but lead to many adverse reactions and psychological problems that worsen their physical condition, when it is advisable to try palliative care of living with tumor for a long time.
What is the purpose of palliative care?
The goals of palliative care are to improve the quality of life for patients and families, to maintain patient dignity, and to prolong life as long as possible with the judicious application of limited medical resources, targeting primarily symptomatic, psychiatric, psychological, and social problems, with slightly different goals for patients at different stages.
- For patients with progressive disease that may be transformed into curable disease, systemic therapy should be the main focus, supplemented by supportive therapy to alleviate the adverse effects caused by cancer and anticancer treatment, and to provide symptomatic supportive therapy to improve patients’ tolerance to anticancer treatment and to guarantee quality of life during treatment. In layman’s terms, for those patients who cannot be cured by surgery temporarily, they can be transformed into curable by systematic anti-cancer treatment. However, while anti-cancer treatment, many adverse reactions will occur, such as bone marrow suppression, hematopoietic function decline, easy infection and bleeding; liver and kidney function damage, liver and kidney insufficiency, etc., which are even life-threatening if not intervened. At this time, supportive therapy is symptomatic treatment, what is lacking is supplemented, what is bad is protected, as a way to reduce adverse reactions and improve the conversion cure rate.
- For patients with advanced disease that has no chance of translating into a curable cure, supportive therapy should be the mainstay, supplemented by systemic therapy to relieve symptoms, reduce pain, improve quality of life, and prolong life as much as possible. Some patients have no chance of conversion to curable, such as metastatic lesions are more numerous and extensive and cannot be completely resected, then the aim shifts to improving quality of life and prolonging life, for example, relieving cancer pain with painkillers, relieving obstruction to enable patients to eat with palliative surgery, relieving tumor compression on surrounding organs with palliative radiotherapy, etc.
- For patients in the terminal stage of advanced tumors, end-of-life humanistic care treatment and hospice services, that is, spiritual and psychological satisfaction treatment, should be provided. In the terminal stage of advanced tumor patients, it is important to make patients go to the end of life without pain as much as possible. At this point, anti-cancer treatment is no longer beneficial at all.
Palliative care in the broad sense applies to all cancer patients
Palliative care for cancer in the traditional sense refers to palliative care for incurable patients and applies mainly to: incurable patients whose cancer has progressed, recurred, or metastasized, especially those with a combination of bleeding, obstruction, pain, nausea, and vomiting. However, some scholars now propose a broader sense of palliative care, arguing that palliative care is used throughout tumor treatment, and in this sense, palliative care is applicable to all cancer patients.