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Palliative Care in Gynaecologic Oncology

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Abstract

Gynaecologic cancers are increasingly being managed at many centers. Though the intent remains curative but it may not be feasible to all patients because of various reasons including late presentation, aggressive tumor biology and locally advanced or metastatic disease. The suffering during the management of cancer can be variable and various domains including physical, psychological, social, and spiritual aspects differ at variable times in journey of life of cancer patient. Palliative care should be incorporated in the treatment trajectory of cancer patients, from the initial treatment till the end of life, and bereavement support should be provided for the family of the deceased patient. A holistic early integration on the background of a multidisciplinary approach appears to be the most beneficial in improving the quality of life of cancer patients and their immediate caregivers. Provision of palliative care services to a patient of gynaecological cancer is not a single physician endeavor and needs to be actively embraced by all providers including gynaecological oncologists, radiation oncologists, medical oncologists, and palliative care specialists along with other supportive care. It should be integrated into all areas of medical care. Early integration for palliative care among cancer patients at the time of diagnosis remains the norm for a better quality of life. Gynaecological cancer patients may present with various symptoms at various stages of cancer. Each of these symptoms can be variedly manifested and hence needs thorough assessment with a high index of suspicion in case the patient presents with the new-onset symptom(s) and their timely management.

Keywords

  • Gynaecological
  • Malignancies
  • Palliative care
  • Symptom
  • Pain
  • Bleeding
  • Supportive care
  • End-of-life
  • Pain

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References

  1. WHO definition of palliative care. World Health Organization website. www.who.int/cancer/palliative/definition/en

  2. https://www.who.int/news-room/fact-sheets/detail/palliative-care

  3. Taylor JS, Brown AJ, Prescott LS, Sun CC, Ramondetta LM, Bodurka DC. Dying well: how equal is end of life care among gynecologic oncology patients? Gynecol Oncol. 2016;140(2):295–300.

    CrossRef  Google Scholar 

  4. Buckley de Meritens A, Margolis B, Blinderman C, Prigerson HG, Maciejewski PK, Shen MJ, et al. Practice patterns, attitudes, and barriers to palliative care consultation by gynecologic oncologists. J Oncol Pract. 2017;13(9):e703–11.

    CrossRef  Google Scholar 

  5. Ferrell BR, Temel JS, Temin S, et al. Integration of palliative care into standard oncology care: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2016;35(1):96–112.

    CrossRef  Google Scholar 

  6. Jang TK, Kim SW, Park JY, Suh DS, Kim JH, Kim YM, et al. Trends in treatment during last stages of life in end-stage gynecologic cancer patients who received active palliative chemotherapy: a comparative analysis of 10-year data I a single institution. BMC Palliat Care. 2018;17:99.

    CrossRef  Google Scholar 

  7. Mullen MM, Cripe JC, Thaker PH. Palliative care in gynecologic oncology. Obstet Gynecol Clin North Am. 2019;46:179–97.

    CrossRef  Google Scholar 

  8. Cartoni C, Niscola P, Breccia M, Brunetti G, D’Elia GM, Giovannini M, et al. Hemorrhagic complications in patients with advanced hematological malignancies followed at home: an Italian experience. Leuk Lymphoma. 2009;50(3):387–91.

    CrossRef  Google Scholar 

  9. HES statistics. HES online. Hospital episode statistics:Main procedures and interventions: 4 character. NHS. The information centre for health and social care; 2007-08. http://www.hesonline.nhs.uk/Ease/servlet/ContentServer?siteID=1937&categoryID=215

  10. Pockros PJ, Esrason KT, Nguyen C, Duque J, Woods S. Mobilization of malignant ascites with diuretics is dependent on ascitic fluid characteristics. Gastroenterology. 1992;103(4):1302–6.

    CAS  CrossRef  Google Scholar 

  11. Sebastian M. Review of catumaxomab in the treatment of malignant ascites. CMAR. 2010;2:283–6.

    CAS  CrossRef  Google Scholar 

  12. Ferriss JS, Java JJ, Bookman MA, Fleming GF, Monk BJ, Walker JL, et al. Ascites predicts treatment benefit of bevacizumab in front-line therapy of advanced epithelial ovarian, fallopian tube and peritoneal cancers: an NRG Oncology/GOG study. Gynecol Oncol. 2015;139(1):17–22.

    CAS  CrossRef  Google Scholar 

  13. Sjoquist KM, Espinoza D, Mileshkin L, Ananda S, Shannon C, Yip S, et al. REZOLVE (ANZGOG-1101): a phase 2 trial of intraperitoneal bevacizumab to treat symptomatic ascites in patients with chemotherapy-resistant, epithelial ovarian cancer. Gynecol Oncol. 2021;161(2):374–81.

    CAS  CrossRef  Google Scholar 

  14. Parshall MB, Schwartzstein RM, Adams L, Banzett RB, Manning HL, Bourbeau J, et al. An official American thoracic society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med. 2012;185(4):435–52.

    CrossRef  Google Scholar 

  15. Paul Olson TJ, Pinkerton C, Brasel KJ, Schwarze ML. Palliative surgery for malignant bowel obstruction from carcinomatosis: a systematic review. JAMA Surg. 2014;149(4):383.

    CrossRef  Google Scholar 

  16. Hoppenot C, Peters P, Cowan M, Moore ED, Hurteau J, Lee NK, et al. Malignant bowel obstruction due to uterine or ovarian cancer: are there differences in outcome? Gynecol Oncol. 2019;154(1):177–82.

    CrossRef  Google Scholar 

  17. Rezk Y, Timmins PF, Smith HS. Palliative care in gynecologic oncology. Am J Hosp Palliat Med. 2011;28:356–74.

    CrossRef  Google Scholar 

  18. Landrum LM, Blank S, Chen MLM, Duska L, Bae-jump V, Lee PS, et al. Comprehensive care in gynecology oncology: the importance of palliative care. Gynecol Oncol. 2015;137:193–202.

    CrossRef  Google Scholar 

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Singhal, S., Arolker, M., Garg, R. (2022). Palliative Care in Gynaecologic Oncology. In: Singh, K., Gupta, B. (eds) Gynecological Oncology. Springer, Cham. https://doi.org/10.1007/978-3-030-94110-9_14

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  • DOI: https://doi.org/10.1007/978-3-030-94110-9_14

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  • Publisher Name: Springer, Cham

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