Abstract
The incidence of cancer will continue to rise in the United States as the population ages. Despite the many advances in cancer prevention, detection, and treatment of neoplastic diseases, the number of people succumbing to their cancers will similarly increase. As these patients encounter symptoms toward the end of life, palliative means, both surgical and nonsurgical, must be employed to alleviate pain and suffering. This article reviews the definitions of palliative care, methods for evaluating quality of life and effect of interventions, unique aspects of surgical palliation, attitudes of surgeons concerning palliative surgery, and data from palliative surgery studies.
References
American Cancer Society, Cancer Facts & Figures 2005
American Cancer Society, Cancer Facts & Figures 2002
Administration on Aging. Older populations by age: 1900 to 2050, 2000. http://www.aoa.gov/prof/Statistics/online_stat_data/AgePop2050.asp
Ferrell BR. Hospice fact sheet. Alexandria, VA: National Hospice and Palliative Care Organization, 2000
Egan KA, Labyak MJ. (2001) Hospice care: a model for quality end of life care. In: Ferrell BR, Coyle N (eds) Textbook of palliative nursing. New York: Oxford University Press
World Health Organization. National cancer programmes: policies and managerial guidelines, 2nd ed. Geneva, Switzerland: World Health Organization, 2002
Field MJ, Cassel CK. Approaching death: improving care at the end of life. Report of the Institute of Medicine Task Force. Washington, DC: National Academy Press, 1997
Wagman LD. Palliative surgical oncology. Surg Oncol Clin N Am 2004; xiii–xiv
Last Acts Task Force. Precepts of palliative care. Princeton, NJ: Robert Wood Johnson Foundation, 1992
McCahill LE, Smith DD, Borneman T, et al. A prospective evaluation of palliative outcomes for surgery of advanced malignancies. Ann Surg Onc 2003; 10:654–663
Krouse RS, Nelson RA, Ferrell BR, et al. Surgical palliation at a cancer center: incidence and outcome. Arch Surg 2001; 136:773–778
Ferrell BR, Smith SL, Carey CA, et al. Psychological well being and quality of life in ovarian cancer survivors. Cancer 2003; 98:1061–1071
Hassey Dow K, Ferrell B, Haberman M. The meaning of QOL in cancer survivors. Oncol Nurs Forum 1999; 26:519–528
McCahill LE. Methodology for scientific evaluation of palliative surgery. Surg Oncol Clin N Am 2004; 13:413–427
McCahill L, Ferrell B. Palliative surgery for cancer pain. West J Med 2002; 176:107–110
Silvestri G, Pritchard R, Welch HG. Preferences for chemotherapy in patients with advanced non-small cell lung cancer: descriptive study based on scripted interviews. BMJ 1998; 317:771–775
Ferrell BR, Chu DZ, Wagman L, et al. Online exclusive: patient and surgeon decision making regarding surgery for advanced cancer. Oncol Nurs Forum 2003; 30:E106–114
McCahill LE, Krouse R, Chu D, et al. Indications and use of palliative surgery – results of Society of Surgical Oncology Survey. Ann Surg Onc 2002; 9:104–112
Liason Committee on Medical Education. Available at: http://www.lcme.org/functions2005Oct.pdf. Accessed December 2, 2005
American Board of Surgery. Available at: http://www.absurgery.org/xfer/ABS_Bookletof Info05.pdf. Accessed December 2, 2005
Galante JM, Bowles TL, Khatri VP, et al. Experience and attitudes of surgeons toward palliation in cancer. Arch Surg 2005; 140:873–878
Cady B, Easson A, Aboulafia AJ, Ferson PF. Part 1: Surgical palliation of advanced illness – what’s new, what’s helpful. J Am Coll Surg 2005; 200:115–127
Hofmann B, Haheim LL, Soreide JA. Ethics of palliative surgery in patients with cancer. Br J Surg 2005; 92:802–809
Bruera E. Attitudes and beliefs of palliative care physicians regarding communication with terminally ill cancer patients. Pall Med 2000; 14:287–298
McCahill LE, Krouse RS, Chu DZJ, et al. Decision making in palliative surgery. J Am Coll Surg 2002; 195:411–423
Borneman T, Chu DZJ, Wagman L, et al. Concerns of family caregivers of patients with cancer facing palliative surgery for advanced malignancies. Oncol Nurs Forum 2003; 30:997–1005
Miner TJ, Jaques DP, Shriver CD. A prospective evaluation of patients undergoing surgery for palliation of an advanced malignancy. Ann Surg Oncol 2002; 9:696–703
Paz IB. Major palliative amputations. Surg Oncol Clin N Am 2004; 13:543–547
LLovet JM, Bruiz J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: chemoembolization improves survival. Hepatology 2003; 37:429–442
Ruan DT, Warren RS. Palliative techniques for hepatic cancer. Surg Oncol Clin N Am 2004; 13:505–516
Harmantas A, Rotstein LE, Langer B. Regional versus systemic therapy in the treatment of colorectal carcinoma metastatic to the liver: is there a survival difference? Meta-analysis of the published literature. Cancer 1996; 78:1639–1645
Seifert JK, Cozzi PJ, Morris DL. Cryotherapy for neuroendocrine liver metastases. Semin Surg Oncol 1998; 14:175–183
Machi J, Bueno RS, Wong LL. Long-term follow-up outcome of patients undergoing radiofrequency ablation for unresectable hepatocellular carcinoma. World J Surg 2005, September 30; Epub ahead of print
Krouse RS. Surgical management of malignant bowel obstruction. Surg Oncol Clin N Am 2004; 13:479–490
Miner TJ, Jaques DP, Paty P, et al. Symptom control of locally recurrent rectal cancer. Ann Surg Oncol 2002; 10:72–79
Law WL, Choi HK, Chu KW. Comparison of stenting with emergency surgery as palliative treatment for obstructing primary left-sided colorectal cancer. Br J Surg 2003; 90:1429–1433
Carne PWG, Frye JN, Robertson GM, Frizell FA. Stents or open operation for palliation of colorectal cancer: a retrospective, cohort study of perioperative outcome and long-term survival. Dis Colon Rectum 2004; 47:1455–1461
Cullinane CA, Borneman T, Smith DD, et al. The surgical treatment of cancer: a comparison of resource utilization following procedures performed with curative and palliative intent. Cancer 2003; 98:2266–2273
Luhrs CA, Meghani S, Homel P, et al. Pilot of a pathway to improve the care of imminently dieing oncology inpatients in a Veterans Affairs Medical Center. J Pain Symptom Manage 2005; 29:544–551
Surgical Palliation Task Force of the American College of Surgeons. Principles guiding care at the end of life. Bull Am Coll Surg 1998; 83
Surgeons Palliative Care Workgroup. Robert Wood Johnson Foundation Office of Promoting Excellence in End-of-Life Care: executive summary of the report from the field. J Am Coll Surg 2003; 196:807–815
Emanuel L, Alexander C, Arnold RM, et al. Integrating palliative care into disease management guidelines. J Pall Med 2004; 7:774–783
Chen ML, Tseng HH. Identification and verification of symptom clusters in cancer patients. J Supp Oncol 2005; 3(6 Suppl 4):28–29
Dodd MJ, Cho MH, Cooper B, et al. Advancing our knowledge of symptom clusters. J Supp Oncol 2005; 3(6 Suppl 4):30–31
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Podnos, Y.D., Wagman, L.D. The Surgeon and Palliative Care. Ann Surg Oncol 14, 1257–1263 (2007). https://doi.org/10.1245/s10434-006-9222-6
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DOI: https://doi.org/10.1245/s10434-006-9222-6