Palliative care for cancer: what you need to know
Medicine is not yet omnipotent, sometimes it is impossible to cure a person. But to support him, relieve pain and preserve the quality of life is possible thanks to palliative therapy. In Russia, 260,000 cancer patients need it annually.
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There is a way out - palliative therapy
According to the World Health Organization, 40 million people need palliative care every year. One third of them suffer from advanced cancer. In half of the cases, oncology is detected when the disease has already started.
There is an exit. Palliative therapy is a treatment designed to relieve pain and provide the patient with the highest quality of life for his case.
Palliative care: standards
The European Association for Palliative Care (EAPC) addressed the needs of the terminally ill and their families. The experts set out their recommendations in the White Paper.
Palliative care principles
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Respect for the patient's personality. He has the right to know about the diagnosis, possible outcome, treatment and care options. The person must have a choice: to receive palliative care at home or in a specialized institution.
- Life should be a joy. The patient should have as many reasons as possible to feel active, independent and happy.
- Help is needed not only by the patient, but also by his family members. Consultations of a psychologist will help them to accept the situation.
- Multidisciplinary and inter-professional approach. The patient needs help not only from a doctor, but also from a psychologist, nutritionist, clergyman, etc.
For incurable patients, issues of spirituality come to the fore. Death is not perceived as the end and it is easier for a person to accept it. Foreign experts have established that if a palliative patient communicates with a clergyman, he has better relationships with loved ones.
PEPSI COLA for patient
In the UK, they are guided by the Liverpool Care Pathway.
Recommendations for the care of palliative patients are as follows:
- Physical. Attention to health status;
- Emotional. Positive emotions are an integral part of therapy;
- Personal. Respect for the patient's personality;
- Social support. Community support;
- Information and communication. The patient should not be limited in information or communication;
- Control and autonomy. The supervision of specialists must be combined with the maximum independence of the patient;
- Out of Hours. A person with an incurable disease may seek help outside of working hours.
- Late. All actions during death are known in advance;
- Aftercare. Those close to you need support and comfort.
If you read the first letters, you get the abbreviation PEPSI COLA.
5 questions for effective help
Experts have developed 5 questions for an incurable patient and his family. The answers to them help to provide the person with maximum care.
- Where would the patient like to be for the remaining time?
- What is needed to bring this plan to life?
- What steps need to be taken to implement your plans?
- What spiritual and social support does the patient need?
- Does a person need to make a will?
Deciding how to spend the rest of your life takes some thought. It will not be superfluous to find out what kind of assistance can be provided by medical institutions in your home country and abroad.
How can hospices help?
Relatives cannot always be around the sick 24 hours a day. Hospices are called upon to solve the problem of housing, treatment and care.
Here the patient receives inpatient and outpatient palliative care. Also, most of these medical institutions have a mobile service.
The patient is referred to the hospice by an oncologist, the diagnosis must be confirmed by documents.
Weekend help
It is difficult for relatives to be with an incurable patient all the time. The solution may be weekend help. The patient spends the day in the hospital, or stays with the workers of the mobile team.
This support can be obtained from a hospice or a specialized department at a hospital.
Palliative care in Russia
In Russia, many seriously ill patients have to stay at home. According to the standards of the World Health Organization, 100 places for palliative patients are needed per 1 million population. In the country there are about half of such places. The problem is partially solved by paid hospices, but in the regions this area is poorly developed.
Also, palliative care is provided by:
- hospital departments;
- general practitioners in outpatient clinics;
- nursing home.
But there, health workers do not always have special training. This has a bad effect on the patient's well-being and the psychological mood of the relatives.
Abroad, the main specialists of palliative therapy centers are certified oncologists and anesthesiologists. They have completed the required course to work with such patients.
Palliative cancer therapy in Israel
In Israel, much attention is paid to symptomatic palliative therapy in oncology. A set of therapeutic procedures has been developed for patients with advanced forms of cancer.
- Chemotherapy. The drugs kill abnormal cells, so the tumor shrinks in size. Doctors select drugs that cause the least side effects.
- Radiation therapy. Helps the patient to preserve the organ, stops the growth of malignant cells, reduces the size of the tumor and relieves pain in metastases. Doctors also use brachytherapy - a technique of radiation therapy in which a radiator is placed inside the tumor.
- Targeted therapy. The patient receives drugs that act on cancer cell molecules. They stop receiving oxygen and die.
- Pain relievers. They do not affect the tumor, but they improve the patient's well-being.
Symptomatic treatment is necessary for patients with extensive tumors and for those for whom treatment is contraindicated.
Beilinson Clinic
20% of all cancer patients in Israel are treated at the Medical Center. Yitzhak Rabin. It includes the Golda Hasharon and Beilinson clinics. Also, the largest oncological center in the country - Davidov, functions under him.
Davidov's doctors are involved in the development of new methods of cancer treatment. They use targeted therapy drugs that block cancer cells from accessing nutrients. As a result, the tumor shrinks.
You can find out more about cancer treatment in Israel on the Beilinson clinic page.
Palliative care as a care
Economist Intelligence Unit experts estimate that palliative care makes life easier for 100 million people every year. These are both relatives and patients.
In turn, WHO experts have calculated that palliative care will be increasingly in demand. People want to stay active to the last, and skilled care and quality pain relievers can help them do that.
