Pancreatic cancer end of life symptoms

Cancer-related fatigue is one of the most frequent symptoms reported by patients, in all stages of the disease.

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Fatigue is related to secondary causes, such as anemia, electrolytes disorders, malnutrition or to cancer specific therapy chemotherapy, radiation or biologic treatment or is related to the disease itself. Material and method. Results and discussion.

Most of them had low and moderate fatigue Many researches are focused on fatigue therapy - most of them studied the effect of stimulants, corticoids and non-pharmacological interventions.

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The intensity of this symptom is reported differently by patient and by the pancreatic cancer end of life symptoms, and this is a strong reason for assessing fatigue at every clinical evaluation of the patients in palliative settings. The treatment option with very strong recommendation is based on non-pharmacological intervention.

Managementul oboselii în îngrijirile paliative

Oboseala în tumorile maligne solide este una dintre cele mai frecvente simptome raportate de pacienți în toate etapele bolii. Oboseala este legată de cauze secundare, cum ar fi anemie, tulburări de electroliți, malnutriție sau la terapia specifică: chimioterapie, radioterapie sau biologice sau este legat de boala în sine.

Material și metodă. Rezultate și discuții.

Managementul oboselii în îngrijirile paliative

Multe cercetări sunt concentrate pe terapia oboselii - cele mai multe dintre ele au studiat diverse stimulente, corticoizi și intervenții non-farmacologice. Intensitatea acestui simptom este raportată în mod diferit de pacient și de medic, iar acest lucru este un motiv întemeiat pentru a măsura oboseala la fiecare evaluare clinică a pacienților în îngrijirile paliative.

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Opțiunea de tratament se bazează pe intervenții non-farmacologice. Cancer-related fatigue is one of the most prevalent pancreatic cancer end of life symptoms in cancer patients and it has been recognized by physicians, patients, caregivers, and researchers that fatigue needs clinical attention and strong interven­tion 3.

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So, cancer-related fatigue has been accepted as a diagnosis in the International Classification of Diseases, Tenth Revision 3and clinical practice guidelines for its management have been formulated by the National Institutes of Health and the National Comprehensive Cancer Network NCCN 4,5. Fatigue may be regarded as a single symptom, as a symptom cluster or as a clinical syndrome 6. Fatigue is a subjective symptom and must be assessed at initial clinical evaluation of cancer patients, by self-evaluation and, only in isolated cases cognitive impairments can be substituted by estimations of caregivers or medical staff 6.

For the single-symptom approach, single item scales analog-visual scale have been proposed.

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Initially, in the management of fatigue should be considered the secondary causes of fatigue and these must be correctly treated. So, the patient should be evaluated for anemia, depression, thyroid disorders, hypercalcaemia, magnesium imbalance, malnutrition, too. Most of the patients with cancer-related fatigue will benefit from the non-pharmacological treatment, such as exercises, cognitive behavioral therapy, and sleep intervention.

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Symptomatological pharmacological treatment is based on stimulants, such as methylphenidate, modafinil, pemoline and donazepil, and corticoids 2,4,6. In the final stage of life, fatigue may provide protection and shielding from suffering for the patient and treatment of fatigue may be detrimental 6.

The severity of fatigue at the time of assessment is rated from 0 to 10 on a numerical scale, with 0 meaning that the symptom is absent, meaning low intensity of fatigue, meaning moderate intensity of fatigue, and representing severe pancreatic cancer end of life symptoms of fatigue.

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The participants were explained the purpose and the importance of the study and the patients signed a written informed consent, in which they freely agreed to join the study.

Data obtained were analyzed using Microsoft Office Excell However, cancer site does not seem to influence significantly the degree of fatigue There were differences between the results of the study and the expectancy of the investigators, especially in prostate cancer patients, who seemed to have a very good performance status and a very good tolerance of the specific treatment.

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It is known that the prevalence and the impact of fatigue often have not been recognized by physicians In the last years, the studies focused on fatigue treatment to increase the quality of life.

Research on symptomatic treatment of fatigue, in palliative care, has been concentrated on stimulant drugs such as methylphenidate, modafinil, dexmethylphenidate, pemoline and donazepil.

The routine use of these drugs in palliative care patients was considered controversial in the expert group because the available evidences are being too poor 6. The potentially useful interventions in cancer-related fatigue are: the correction pancreatic cancer end of life symptoms metabolic disorders, anemia, depression, insomnia, modifications in periods of activity and rest diarycognitive therapy, behavioral therapy to modify sleep sleep hygiene and nutritional support In women with breast cancer receiving chemotherapy, exercise can significantly reduce the level of fatigue, and as the duration of exercise increases, the intensity of fatigue declines In patients with melanoma receiving interferon-α, the combination of exercise and methylphenidate showed a positive effect on interferon-induced fatigue The management of fatigue in our patients included corticosteroids and light physical exercise program.

Conclusions Fatigue is one of the most frequent symptom in cancer patients with advanced and metastatic disease and seems to be more pronounced in lung cancer in association, pancreatic cancer end of life symptoms, with dyspnea.

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The intensity of this symptom is reported differently by patient and by the physician and this is a strong reason for assessing fatigue at every clinical evaluation of the patients in palliative settings.

The treatment of the fatigue rest limited to non-pharmacological interventions and the results are inconsistent. Limitation of the study: a multicenter study with a larger sample size would allow for more definite conclusions.

Pagina pacientului

Cancer-related fatigue. Clinical Practice Guidelines in Oncology. J NatlComprCancNetw. Cancer-related fatigue: a review. Revista da Associação Médica Brasileira, 57 2 Maarten H. M, Pascal J.

Management of fatigue in palliative cancer patients

Oncology Williston Park ;— Accessed April 27, Radbruch L, Strasser F. The rapid assessment of fatigue severity in cancer patients: use of the Brief Fatigue Inventory, Cancer ; — A multidimensional measure of fatigue for use with cancer patients. Cancer Pract ; 6: — The symptoms of advanced cancer: relationship to age, gender, and performance status in 1, patients. Support Care Cancer ; —9. Cancer-related fatigue: evolving concepts in evaluation and treatment.

Cancer ; — Escalante CP.

Much more than documents.

Treatment of cancer-related fatigue: an update. Support Care Cancer ; 79— Iop A. Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. The fatigue coalition. SeminHematol ; 4—