The last 48 hours
Principles An analytical approach to symptom control continues but usually relies on clinical findings rather than investigation. This approach spans all causes of terminal illness and applies to care at…
PAIN MEDICINE
Anorexia, cachexia, nutrition, and fatigue
What is cachexia? Cachexia, anorexia, and fatigue are an overlapping and often neglected group of symptoms that at some stage affect most patients with cancer. Similar symptoms may be seen…
Difficult pain
Opioid irrelevant pain Pain is not just a physical experience. Patients with pain that does not respond to escalating doses of opioids should be reassessed and other contributors to their…
Emergencies
Hypercalcemia Hypercalcaemia is the most common life threatening metabolic disorder encountered in patients with cancer. The incidence varies with the underlying malignancy, being most common in multiple myeloma and breast…
Breathlessness, cough, and other respiratory problems
Breathlessness Breathlessness has non-physical as well as physical aspects and, like pain, can be defined by what a patient says it is. It is the unpleasant sensation of being unable…
The principles of control of cancer pain
The WHO analgesic ladder The analgesic ladder remains the mainstay of our approach to analgesia, though this was never designed for use in isolation. Surgery, radiotherapy, and appropriate tumoricidal treatments…
Depression, anxiety, and confusion
Causes Depression and anxiety are usually reactions to the losses and threats of the medical illness. Other risk factors often contribute. Confusion usually reflects an organic mental disorder from one…
The principles of palliative care
Components of palliative care Palliative care is recognised by individualised, holistic models of care, delivered carefully, sensitively, ethically, and therapeutically by using skilled communication with attention to detail, meticulous assessment,…
Fibromyalgia and arthritis
Fibromyalgia and arthritis Introduction Fibromyalgia and arthritis are common musculoskeletal conditions causing chronic pain (7.1)1. A survey of 99 general practitioners in Italy showed that 32% of all visits were…
End-of-life care
End-of-life care Introduction End-of-life is usually defined as the final stages of a terminal illness, typically when the prognosis is considered to be ≤6 months. A more meaningful and broader…
