Empowering patients: integrating palliative care in gynecologic cancer treatment

Authors

  • Sumedha Gupta Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
  • Dheer Singh Kalwaniya Department of Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20241466

Keywords:

Pain, Malignant bowel obstruction, Nausea and vomiting, Dyspnea, Bone

Abstract

Cervical cancer severely impacts women's health, especially in low- and middle-income nations. Patients experience significant symptoms at every stage of this cancer course, from diagnosis to treatment and beyond. Palliative care (PC) integration becomes crucial, even if oncological therapies have historically focused on disease-centric methods. PC is a multifaceted field that addresses end-of-life care as well as psychological, social, and spiritual issues in addition to physical illnesses. To improve patient satisfaction, treatment adherence, and overall quality of life, early PC initiation within the context of multimodality care is essential. Advanced patients require heightened PC and a smooth transfer to hospice care as they approach terminal disease. This emphasises how crucial it is for oncology and PC teams to work together to provide comprehensive cervical cancer management. Healthcare practitioners can improve results and maintain the overall health of women affected by this condition through combined efforts. This review article emphasises the importance of early PC integration and collaboration in the cervical cancer management continuum to offer comprehensive care and enhance patient outcomes.

References

Smith TJ, Temin S, Alesi ER, Abernethy AP, Balboni TA, Basch EM, et al. American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. J Clin Oncol. 2012;30(8):880-7.

Epstein R, Street Jr RL. Patient-centred Communication in Cancer Care: Promoting Healing and Reducing Suffering. Bethesda, MD: National Cancer Institute, NIH Publications. 2007.

Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP. SPIKES-a six-step protocol for delivering bad news: application to the patient with cancer. Oncologist. 2000;5(4):302-11.

Dudgeon DJ, Shadd J. Assessment and Management of Dyspnea in Palliative Care. 2013.

Bausewein C, Booth S, Gysels M, Higginson IJ. Non-pharmacological interventions for breathlessness in advanced stages of malignant and non-malignant diseases. Cochrane Database Syst Rev 2013;11:CD005623.

Davidson PM, Johnson MJ. Update on the role of palliative oxygen. Curr Opin Support Palliat Care. 2011;5(2):87-91.

Lombardi G, Zustovich F, Nicoletto MO, Donach M, Artioli G, Pastorelli D. Diagnosis and treatment of malignant pleural effusion: a systematic literature review and new approaches. Am J Clin Oncol. 2010;33(4):420-3.

Davies HE, Mishra EK, Kahan BC, Wrightson JM, Stanton AE, Guhan A, et al. Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleural effusion: the TIME2 randomized controlled trial. JAMA. 2012;307(22):2383-9.

Pereira J, Phan T. Management of bleeding in patients with advanced cancer. Oncologist. 2004;9(5):561-70.

Spanos Jr WJ, Clery M, Perez CA, Grigsby PW, Doggett RL, Poulter CA, et al. Late effect of multiple daily fraction palliation schedule for advanced pelvic malignancies (RTOG 8502). Int J Radiat Oncol Biol Phys. 1994;29(5):961-7.

Bagley D. Treatment of Hematuria. In: Smith A, editor. Philadelphia: W.B. Saunders. 1999.

Donahue LA, Frank IN. Intravesical formalin for hemorrhagic cystitis: analysis of therapy. J Urol. 1989;141(4):809-12.

Harris DG, Noble SI. Management of terminal hemorrhage in patients with advanced cancer: a systematic literature review. J Pain Symptom Manag. 2009;38(6):913-27.

Wood GJ, Shega JW, Lynch B, Von Roenn JH. Management of intractable nausea and vomiting in patients at the end of life: “I was feeling nauseous all of the time nothing was working”. JAMA. 2007;298(10):1196-207.

DeWys WD, Begg C, Lavin PT, Band PR, Bennett JM, Bertino JR, et al. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med. 1980;69(4):491-7.

Miller S, McNutt L, McCann MA, McCorry N. Use of corticosteroids for anorexia in palliative medicine: a systematic review. J Palliat Med. 2014;17(4):482-5.

Tuca A, Jimenez-Fonseca P, Gascon P. Clinical evaluation and optimal management of cancer cachexia. Crit Rev Oncol Hematol. 2013;88(3):625-36.

Mercadante S. Parenteral versus enteral nutrition in cancer patients: indications and practice. Support Care Cancer. 1998;6(2):85-93.

Tapping CR, Ling L, Razack A. PleurX drain use in the management of malignant ascites: safety, complications, long-term patency and factors predictive of success. Br J Radiol. 2012;85(1013):623-8.

Yukita A, Asano M, Okamoto T, Mizutani S, Suzuki H. Suppression of ascites formation and re-accumulation associated with human ovarian cancer by an anti-VPF monoclonal antibody in vivo. Anticancer Res. 2000;20(1A):155-60.

Hamilton CA, Maxwell GL, Chernofsky MR, Bernstein SA, Farley JH, Rose GS. Intra-peritoneal bevacizumab for the palliation of malignant ascites in refractory ovarian cancer. Gynecol Oncol. 2008;111(3):530-2.

Kolomainen DF, Barton DP. Surgical management of bowel obstruction in gynaecological malignancies. Curr Opin Support Palliat Care. 2011;5(1):55-9.

Brard L, Weitzen S, Strubel-Lagan SL, Swamy N, Gordinier ME, Moore RG, et al. The effect of total parenteral nutrition on the survival of terminally ill ovarian cancer patients. Gynecol Oncol. 2006;103(1):176-80.

Diver E, O'Connor O, Garrett L, Boruta D, Goodman A, Del CM, et al. Modest benefit of total parenteral nutrition and chemotherapy after venting gastrostomy tube placement. Gynecol Oncol. 2013;129(2):332-5.

Hope JM, Pothuri B. The role of palliative surgery in gynecologic cancer cases. Oncologist. 2013;18(1):73-9.

Naghibi M, Smith TR, Elia M. A systematic review with meta-analysis of survival, quality of life and cost-effectiveness of home parenteral nutrition in patients with inoperable malignant bowel obstruction. Clin Nutr. 2014;34(5):825-37.

Bozzetti F, Santarpia L, Pironi L, Thul P, Klek S, Gavazzi C, et al. The prognosis of incurable cachectic cancer patients on home parenteral nutrition: a multi-centre observational study with prospective follow-up of 414 patients. Ann Oncol. 2014;25(2):487-93.

Mercadante S, Porzio G. Octreotide for malignant bowel obstruction: twenty years after. Crit Rev Oncol Hematol. 2012;83(3):388-92.

World Health Organization: Cancer Pain Relief. Geneva, Switzerland: World Health Organization, Office of Publications. 1986. Available at: https://iris.who.int/handle/10665/43944. Accessed on 15th March 2024.

Reddy S, Hui D, El OB, De la Cruz M, Walker P, Palmer JL, et al. The effect of oral methadone on the QTc interval in advanced cancer patients: a prospective pilot study. J Palliat Med. 2010;13(1):33-8.

Portenoy RK, Ahmed E. Principles of opioid use in cancer pain. J Clin Oncol. 2014;32(16):1662-70.

Kutner JS, Smith MC, Corbin L, Hemphill L, Benton K, Mellis BK, et al. Massage therapy versus simple touch to improve pain and mood in patients with advanced cancer: a randomized trial. Ann Intern Med. 2008;149(6):369-79.

Khan MI, Walsh D, Brito-Dellan N. Opioid and adjuvant analgesics: compared and contrasted. Am J Hosp Palliat Care. 2011;28(5):378-83.

Mercadante SL, Berchovich M, Casuccio A, Fulfaro F, Mangione S. A prospective randomized study of corticosteroids as adjuvant drugs to opioids in advanced cancer patients. Am J Hosp Palliat Care. 2007;24(1):13-9.

Paulsen O, Aass N, Kaasa S, Dale O. Do corticosteroids provide analgesic effects in cancer patients? A systematic literature review. J Pain Symptom Manag. 2013;46(1):96-105.

Saarto T, Wiffen PJ. Antidepressants for neuropathic pain. Cochrane Database Syst Rev. 2007;4:CD005454.

Lussier D, Huskey AG, Portenoy RK. Adjuvant analgesics in cancer pain management. Oncologist. 2004;9(5):571-91.

Dworkin RH, O'Connor AB, Backonja M, Farrar JT, Finnerup NB, Jensen TS, et al. Pharmacologic management of neuropathic pain: evidence-based recommendations. Pain. 2007;132(3):237-51.

Prommer EE. Ketamine for pain: an update of uses in palliative care. J Palliat Med. 2012;15(4):474-83.

Uccella S, Morris JM, Bakkum-Gamez JN, Keeney GL, Podratz KC, Mariani A. Bone metastases in endometrial cancer: report on 19 patients and review of the medical literature. Gynecol Oncol. 2013;130(3):474-82.

Chow E, Harris K, Fan G, Tsao M, Sze WM. Palliative radiotherapy trials for bone metastases: a systematic review. J Clin Oncol. 2007;25(11):1423-36.

Kohno N, Aogi K, Minami H, Nakamura S, Asaga T, Iino Y, et al. Zoledronic acid significantly reduces skeletal complications compared with placebo in Japanese women with bone metastases from breast cancer: a randomized, placebo-controlled trial. J Clin Oncol. 2005;23(15):3314-21.

Stopeck AT, Lipton A, Body JJ, Steger GG, Tonkin K, de Boer RH, et al. Denosumab compared with zoledronic acid for the treatment of bone metastases in patients with advanced breast cancer: a randomized, double-blind study. J Clin Oncol. 2010;28(35):5132-9.

Chi JH, Gokaslan ZL. Vertebroplasty and kyphoplasty for spinal metastases. Curr Opin Support Palliat Care. 2008;2(1):9-13.

Grill V, Martin TJ. Hypercalcemia of malignancy. Rev Endocr Metab Disord. 2000;1(4):253-63.

Ratner ES, Toy E, O'Malley DM, McAlpine J, Rutherford TJ, Azodi M, et al. Brain metastases in epithelial ovarian and primary peritoneal carcinoma. Int J Gynecol Cancer. 2009;19(5):856-9.

Vick NA, Wilson CB. Total care of the patient with a brain tumor with consideration of some ethical issues. Neurol Clin. 1985;3(4):705-10.

Ryken TC, McDermott M, Robinson PD, Ammirati M, Andrews DW, Asher AL, et al. The role of steroids in the management of brain metastases: a systematic review and evidence-based clinical practice guideline. J Neurooncol. 2010;96(1):103-14.

Mikkelsen T, Paleologos NA, Robinson PD, Ammirati M, Andrews DW, Asher AL, et al. The role of prophylactic anticonvulsants in the management of brain metastases: a systematic review and evidence-based clinical practice guideline. J Neurooncol. 2010;96(1):97-102.

NCCN Practice Guidelines in Oncology: Central Nervous System Cancers Version 2. 2014.

Breitbart W, Alici Y. Evidence-based treatment of delirium in patients with cancer. J Clin Oncol. 2012;30(11):1206-14.

Irwin SA, Pirrello RD, Hirst JM, Buckholz GT, Ferris FD. Clarifying delirium management: practical, evidenced-based, expert recommendations for clinical practice. J Palliat Med. 2013;16(4):423-35.

Stagno D, Gibson C, Breitbart W. The delirium subtypes: a review of prevalence, phenomenology, pathophysiology, and treatment response. Palliat Support Care. 2004;2(2):171-9.

Wright AA, Keating NL, Balboni TA, Matulonis UA, Block SD, Prigerson HG. Place of death: correlations with quality of life of patients with cancer and predictors of bereaved caregivers' mental health. J Clin Oncol. 2010;28(29):4457-64.

Bruera E, Russell N, Sweeney C, Fisch M, Palmer JL. Place of death and its predictors for local patients registered at a comprehensive cancer center. J Clin Oncol. 2002;20(8):2127-33.

Moinpour CM, Polissar L. Factors affecting place of death of hospice and non-hospice cancer patients. Am J Public Health. 1989;79(11):1549-51.

Downloads

Published

2024-05-29

Issue

Section

Review Articles