Palliative Care for Cancer Patients: Nurturing the Heart, Preserving Quality of Life
“When a person has cancer, the entire family is afflicted.”
The word "cancer" often evokes feelings of alarm and apprehension. It is simply another form of illness that can affect anyone. The challenge of coping with cancer varies, contingent upon the stage and type of malignancy.
This special scoop delves into the nuanced care of patients with advanced-stage malignancies, where the therapeutic paradigm expands to encompass palliative interventions. Dr. Siyamol Mingmalairak, a distinguished medical oncologist, shares valuable insights pertinent to patients and their caregivers, enhancing the quality of life during this trying phase of the cancer journey.
Palliative care: understanding and accessing accurate and reliable information
The primary action that cancer patients and their caregivers should take, regardless of the stage of malignancy, is to understand the disease, seek accurate information from medical specialists, and comprehend the context of treatment, which is particularly important in end-stage cancer, where striking a balance between therapeutic interventions and the wishes of the patients becomes paramount.
“Sometimes, patients may feel perplexed, unable to grasp, or hesitant to acknowledge their diagnosis. From their perspective, they had diligently cared for their health with nutritious diets and regular exercise, prompting them to question why cancer still emerged. Yet, the reality underscores the multifaceted nature of cancer development. The crucial first step lies in accepting and understanding their situation and then embracing the path of treatment.”
When diagnosed with advanced-stage cancer, what steps should one take?
Dr. Siyamon shares that when patients receive a stage 4 cancer diagnosis, they often experience intense distress and despair, believing their situation is hopeless. However, treatment is not necessarily impossible. Modern medicine has made significant advancements in managing many types of stage 4 cancer. Some patients respond well to treatment and can live for another 5-10 years. Doctors will carefully evaluate and determine, for each patient, the most appropriate and effective treatment plan.
“Treatment response differs widely among individuals and types of cancer. For instance, a patient may remain in stage 4 for up to 8 years, with a scenario where the spouse, without cancer, passed away from a stroke before them. In this light, having cancer offers certain advantages over sudden-onset life-threatening illnesses, allowing patients time to organize and prepare. Conversely, acute ailments may afford no such opportunity. Therefore, upon receiving a cancer diagnosis, the initial imperative is to remain composed, seek consultation, and visit an oncologist to strategize treatment and support.”
When one person has cancer, the entire family is afflicted
“Sometimes, caregivers grapple with feelings of guilt, questioning whether they played a role in their loved one illness. Did they not provide adequate care? Did neglecting regular health checkups contribute to the disease? It is essential to dispel these thoughts as caregivers must remain strong and hardy.”
Dr. Siyamol emphasizes the necessity for caregivers to be resilient physically and mentally. If they become ill, they will be unable to support the patients. To ensure they remain healthy and capable of caring for their loved ones, caregivers should consume nutritious diets and exercise regularly. In cases where a patient is in a late stage or has a severe condition, a single caregiver may not suffice. Caregiver shift rotations might be required to provide continuous assistance and mutual support."
Palliative care for stage 4 cancer patients: an oncologist's perspective
“Caring for stage 4 or terminal cancer patients in this context means that chemotherapy, targeted therapy, immunotherapy, and surgery are no longer viable options."
When no effective treatment options can manage cancer, the primary focus for doctors and caregivers should be on addressing the symptoms and the physical and mental well-being of the patients, particularly alleviating pain. This can involve exploring both medicinal and non-medicinal methods.
“Nowadays, continuous pain relief is achievable through an implanted port under the skin. This port steadily releases small doses of morphine directly into the spinal cord, significantly reducing the pain and alleviating patient suffering. This method substantially decreases the overall morphine requirement, enhancing the quality of life.”
If patients have a poor appetite and eat very little, medical nutritional supplementation may be required or meals can be divided into small, frequent portions throughout the day. Additionally, a feeding tube can ensure sufficient nutrient intake. If patients can move, engaging in light activities with family members is encouraged.
For patients who cannot pass bowel movements, doctors may fashion an abdominal bowel stoma to facilitate waste elimination. Patients and caregivers must understand, come to terms, and adjust to the situation as patients are not dead from cancer and require these supportive measures to live on.
All these approaches are integral to palliative care, customized to the patient’s symptoms and physical condition. This form of care is more complex than standard treatments as it focuses on maintaining the patient’s quality of life, ensuring they are free from pain and suffering.
“Palliative care strives to ensure that patients traverse their final stages of life with optimal comfort.” Dr. Siyamol emphasizes.
Is it possible for patients in the terminal stage to live longer than anticipated?
“It is certainly possible, especially if patients do not have complicated factors such as infections, heart irregularities, or brain metastases. Doctors must prioritize their quality of life by reducing pain and discomfort.”
For some individuals, prolonged survival does not necessarily equate to a high quality of life. Enduring pain and discomfort can erode their will to soldier on, adding to their overall suffering. Physicians have a range of methods to alleviate such discomfort, as mentioned earlier.
