Holistic Approach to Complex Cancer Pain

Cancer pain is a major cause of disability and suffering at the end of life. Cancer pain affects a significant number of patients at the end of life. This case report seeks to highlight some of the complexities associated with managing cancer pain in terminally ill patients.

Nearly 74% of patients with advanced/metastatic cancer will suffer from pain at the end of life. Alarmingly up to 42-51% of these patients will endure suboptimal control of this symptom. It is imperative that patients with difficult pain syndrome are recognised early. This case report spotlights attempts to effectively address complex cancer pain.

Mr S is a 52 year-old gentleman who had enjoyed his independence and mobility despite a long history of hypertension, dyslipidaemia, and ischaemic heart disease. He is a divorcee and stays with his sister. His siblings described him as a cheerful and optimistic person.

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Promoting Palliative Care to Cancer Patients in the Republic of Kazakhstan

In his recent book, Palliative Care: The 400-Year Quest for a Good Death , [1] Harold Vanderpool traces the emergence of medical palliation to a proclamation by Sir Francis Bacon in 1605 challenging physicians to offer and continually improve palliative medical care and treatment for dying persons.

Florence Nightingale also contributed significantly to the evolution of what we call palliative care today, although the period of 1895 to 1959 – a time of great advances in medicine – unfortunately led to less appropriate care for the dying, though it contributed to discussions about the ethics of treating the dying. The following period (1960-1981) is described as a time of momentous transition.

The influence of Elisabeth Kübler-Ross and Cicely Saunders emerged, solidifying palliative care concepts in the US and UK, and thereafter worldwide.In 2015 the WHO added palliative care to its family of factsheets for the first time.

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Challenges to Palliative Care in Pediatric Patients

The incidence of cancer is rising in pediatric population since last decade. In 2016, about 10,000 children are projected to be diagnosed of cancer in United States. Though five-year survival in most of the pediatric cancer patients is more than 80% now, cancer remains the most common cause of mortality after trauma in age group 5-14 years.

The growing population of pediatric cancer survivors warrants parallel rise in the palliative care. As per the World Health Organization (WHO) palliative care is, ‘An approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness.

Through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual’. Notably contemp orary thoughts advocate the integration of curative and palliative approaches in pediatric patients.

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