A Special Edition by

Palliative Medicine and Hospice Care – Open Journal (PMHCOJ)

Submissions deadline: March 30th, 2019

Release date: May 5th, 2019 (accepted papers will be publised online immediately).

Michael Silbermann, PhD

Executive Director
Middle East Cancer Consortium
P.O. Box 7495
Haifa 31074, Israel

Rejin Kebudi, MD

Istanbul University Cerrahpasa
Medical Faculty and Istanbul University
Oncology Institute
Pediatric Hematology Oncology
Istanbul, Turkey
E-mail: rejinkebudi@yahoo.com

Introduction of Special Edition







Mini Review

Cultural Challenges in Implementing Palliative Services in Lebanon

Marie Claire Mouhawej*, Nadine Maalouf-Haddad and Aline Tohmé

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Systematic Review

Cultural Aspects of Palliative Cancer Care in Iran

Sahar Fallahi, Maryam Rassouli and Leila Khanali Mojen*

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Dr. Michael Silbermann

(Guest Editor)

A Special Edition by

Palliative Medicine and Hospice Care – Open Journal (PMHCOJ)

Submissions deadline: March 30th, 2019

Release date: May 5th, 2019

Rakesh Garg, MD, DNB, PGCCHM, MNAMS, CCEPC

Fellowship in Palliative Medicine
Associate Professor of Anaesthesiology
Intensive Care, Pain and Palliative Care
Dr BRAIRCH, All India Institute of Medical Sciences, New Delhi-110029, India
E-mail: drrgarg@hotmail.com

 

Introduction of Special Edition

Cancer Pain: Holisitic Management to Improve Overall Quality of Life

Pain is common in cancer patients. Over two-third of patients would have pain at some stage of cancer. Advanced cancer patients would manifest various components of pain. Pain is explained in terms of not just physical pain but also has associated other components like psychological, social and spiritual. ‘Total Pain’ management remains the utmost priority of cancer patient management. It requires a multidimensional and multimodal management. A multidisciplinary approach would provide a better outcome of cancer patient with pain with improved quality of life (QoL). A systematic approach for assessment of the person as whole including all dimensions of pain is the key to provide a satisfactory management plan leading to patient satisfaction.

Drug management has been well described in literature and used effectively for pain management. World Health Organization (WHO) analgesic ladder remain the main guidance for selection of the drug. It has been modified further with the integration of other therapies like pain interventional procedures, other supportive therapy. These have been found to improve patient satisfaction with regards to pan relief and decreases side effects of the drugs as well. Non-drug interventions are necessitated to relive psychological or spiritual distress of advanced cancer patients. With regards to drug therapy conventional analgesics like non-steroidal anti-inflammatory drugs (NSAIDs) and opioids remains the mainstay. The adjuvants have also an important role and thus appropriate prescription needs to have combination of drugs. This requires holistic assessment of the patients to understand the need of different drugs and other non-drug interventions.

Patient and family member’s involvement in overall patient management provides a better outcome with regards to satisfaction of all. The aim of such integration is to provide an improved quality of life till the end. Advanced cancer patients may also have associated other symptoms like dyspnoea, ascites, pleural effusion, spinal cord compression in addition to pain. These symptoms needs appropriate management as they lead to poor quality of life. Hence the holistic management should comprise all symptom management. Nutritional issues also occur due to poor intake or assimilation because of underlying disease or side effects to therapy like chemotherapy or radiation therapy.

All these interventions need to be continues optimally till the end. An effective home support would be more appropriate for advanced cancer patients especially when the terminal illness occurs. The patient and family support is essential in this phase s as well. The literature has reported the role of above mentioned concepts. However, concrete evidence is yet to be generated. This special edition of the journal would invite the manuscript related to holistic cancer pain management. The journal invites original articles for this special edition.

Dr. Rakesh Garg

(Guest Editor)