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End-of-Life Care in Patients with Lung Cancer

  • J. H. Von Roenn
  • J. F. Brandman

Abstract

Lung cancer is among the most frequently occurring malignancies in the world and an increasing cause of cancer death in both men and women (Centers for Disease Control and Prevention 2002). Fewer than 15% of patients who develop lung cancer survive five years (Fry et al. 1999; Quddus et al. 2001), underscoring the need to address palliative care needs and end-of-life issues with this patient population. The preceding chapter focused on symptom management during lung cancer therapy, while this chapter will address advanced care planning, withdrawal of ventilatory support, issues in palliative care, and the relief of symptoms and suffering during the terminal phase of the disease.

Keywords

Lung Cancer Palliative Care Morphine Sulfate Subcutaneous Infusion Effective Palliation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. American Thoracic Society (1999) Dyspnea: mechanisms, assessment, and management: a consensus statement. Am J Respir Crit Care Med 159:321–340CrossRefGoogle Scholar
  2. Anonymous (2002) From the Centers for Disease Control and Prevention. Recent trends in mortality rates for four major cancers, by sex and race/ethnicity — United States, 1990–1998. JAMA 287:1391–1392CrossRefGoogle Scholar
  3. Bardgett D, Howard C, Murray GR, Calvey TN, Williams NE (1984) Plasma concentration and bioavailability of a buccal preparation of morphine sulfate. Br J Clin Pharmacol 17: 198–199Google Scholar
  4. Billings JA (1998) What is palliative care? J Palliat Med 1:73–81PubMedCrossRefGoogle Scholar
  5. Billings JA (2002) Vicissitudes of the clinician-patient relationship in end-of-life care: recognizing the role for teams. J Palliat Med 5:295–299PubMedCrossRefGoogle Scholar
  6. Bottomley DM, Hanks GW (1990) Subcutaneous midazolam infusion in palliative care. J Pain Symptom Manage 5:259–261PubMedCrossRefGoogle Scholar
  7. Breitbart W, Bruera E, Chochinov H, Lynch M (1995) Neuropsychiat ricsyndro mes and psychological symptoms in patients with advanced cancer. J Pain Symptom Manage 10: 131–141PubMedCrossRefGoogle Scholar
  8. Brody H, Campbell ML, Faber-Langendoen K, Ogle KS (1997) Withdrawing intensive life-sustaining treatment — recommendations for compassionate clinical management. N Engl J Med 336:652–657PubMedCrossRefGoogle Scholar
  9. Bruera E, Stoutz N de, Velasco-Leiva A, Schoeller T, Hanson J (1993) Effects of oxygen on dyspnoea in hypoxaemic terminal-care patients. Lancet 342:13–14PubMedCrossRefGoogle Scholar
  10. Burke AL, Diamond PL, Hulbert J, Yeatman J, Farr EA (1991) Terminal restlessness — its management and the role of midazolam. Med J Aust 155:485–487PubMedGoogle Scholar
  11. Byock IR (1999) Conceptual models and the outcomes of caring. J Pain Symptom Manage 17:83–92PubMedCrossRefGoogle Scholar
  12. Callahan D (2000) Death and the research imperative. N Engl J Med 342:654–656PubMedCrossRefGoogle Scholar
  13. Cassel CK, Ludden JM, Moon GM (2000) Perceptions of barriers to high-quality palliative care in hospitals. Health Aff 19: 166–172CrossRefGoogle Scholar
  14. Cassell EJ (1982) The nature of suffering and the goals of medicine. N Engl J Med 306:639–645CrossRefGoogle Scholar
  15. Cassell EJ (1999) Diagnosing suffering: a perspective. Ann Intern Med 131:531–534PubMedGoogle Scholar
  16. Cleeland CS, Gonin R, Hatfield AK, Edmonson JH, Blum RH, Stewart JA (1994) Pain and its treatment in outpatients with metastatic cancer. N Engl J Med 330:592–596PubMedCrossRefGoogle Scholar
  17. Cleeland CS, Gonin R, Baez L, Loehrer P, Pandya KJ (1997) Pain and treatment of pain in minority patients with cancer: the Eastern Cooperative Oncology Group Minority Outpatient Pain Study. Ann Intern Med 127:813–816PubMedGoogle Scholar
  18. Cooley ME, Kaiser LR, Abrahm JL, Giarelli E (2001) The silent epidemic: tobacco and the evolution of lung cancer and its treatment. Cancer Invest 19:739–753PubMedCrossRefGoogle Scholar
  19. Davis C (1995) The role of nebulised drugs in palliating respiratory symptoms from malignant disease. Eur J Palliat Care 2: 9–15Google Scholar
  20. De Conno F, Saita L, Ripamonti C, Ventafridda V (1993) In retrospect — on the last days of life. J Palliat Care 9:47–49PubMedGoogle Scholar
  21. Dunlop RJ (1989) Is terminal restlessness sometimes drug induced? Palliat Med 3:65–66CrossRefGoogle Scholar
  22. Edmonds P, Karlsen S, Khan S. Addington-Hall J (2001) A comparison of the palliative care needs of patients dying from chronic respiratory diseases and lung cancer. Palliat Med 15: 287–295PubMedCrossRefGoogle Scholar
  23. Emanuel EJ (1996) Cost savings at the end of life: what do the data show? JAMA 275:1907–1914PubMedCrossRefGoogle Scholar
  24. Emanuel EJ, Emanuel LL (1998) The promise of a good death. Lancet 351 (Suppl 2):SII21–29PubMedCrossRefGoogle Scholar
  25. Emanuel LL, Gunten CF von, Ferris FD (1999) The Education for Physicians on End-of-Life Care (EPEC©) Curriculum. American Medical Association, ChicagoGoogle Scholar
  26. Fainsinger R, Miller MJ, Bruera E, Hanson J, Maceachern T (1991) Symptom control during the last week of life on a palliative care unit. J Palliat Care 7:5–11Google Scholar
  27. Fox E (1997) Predominance of the curative model of medical care: a residual problem. JAMA 278:761–763PubMedCrossRefGoogle Scholar
  28. Friedman BT, Harwood MK, Shields M (2002) Barriers and enablers to hospital referrals: an expert overview. J Palliat Med 5: 73–82PubMedCrossRefGoogle Scholar
  29. Fry WA, Phillips JL, Menck HR (1999) Ten-year survey of lung cancer treatment and survival in hospitals in the United States: A National Cancer Data Base Report. Cancer 86: 1867–1876PubMedCrossRefGoogle Scholar
  30. Gianakos D (1995) Terminal weaning. Chest 108:1405–1406PubMedCrossRefGoogle Scholar
  31. Gilligan T, Raffin TA (1995) Rapid withdrawal of support. Chest 108:1407–1408PubMedCrossRefGoogle Scholar
  32. Goodlin SJ (1997) What is palliative care? Hosp Prac 32:13–16Google Scholar
  33. Goudie TA, Allan MW, Lonsdale M, Burrow LM, Macrae WA, Grant IS (1985) Continuous subcutaneous infusion of morphine for post-operative pain relief. Anaesthesia 40:1086–1092PubMedCrossRefGoogle Scholar
  34. Higginson I, McCarthy M (1989) Measuring symptoms in terminal cancer: are pain and dyspnea controlled? J R Soc Med 82:264–267PubMedGoogle Scholar
  35. Hughes AC, Wilcock A, Corcoran R (1996) Management of “death rattle.” J Pain Symptom Manage 12:271–272PubMedCrossRefGoogle Scholar
  36. Introcaso D, Lynn J (2002) Systems of care: future reform. J Palliat Med 5:255–257PubMedCrossRefGoogle Scholar
  37. Kunik ME, Yudofsky SC, Silver JM, Hales RE (1994) Pharmacologic approach to management of agitation associated with dernentia. J Clin Psychiatry 55:13–17PubMedGoogle Scholar
  38. Lamont EB, Christakis NA (2001) Prognostic disclosure to patients with cancer near the end of life. Ann Intern Med 134: 1096–1105PubMedGoogle Scholar
  39. Lee KF (2002) Future end-of-life care: partnership and advocacy. J Palliat Med 5:329–334PubMedCrossRefGoogle Scholar
  40. Massocato C, Buclin T, Rapin C-H (1999) The effects of morphine on dyspnea and ventilatory function in elderly patients with advanced cancer: a randomized double-blind controlled trial. Ann Oncol 10:1511–1514CrossRefGoogle Scholar
  41. Miles S (1995) Rapid extubation protocol. University of Minnesota, Minneapolis. Available at http://wings.buffalo.edu/faculty/ research/bioethics/miles. Accessed August 2002Google Scholar
  42. Pannuti F, Rossi AP, Iafelice G, Marraro D, Camera P, Cricca A, Strocchi E (1982) Control of chronic pain in very advanced cancer patients with morphine hydrochloride administered by oral, rectal, and sublingual routes. Clinical report and preliminary results of morphine pharmacokinetics. Pharmacol Res Commun 14:369–380PubMedCrossRefGoogle Scholar
  43. Payne SK, Coyne P, Smith TJ (2002) The health economics of palliative care. Oncology 16:801–808PubMedGoogle Scholar
  44. Quddus AM, Kerr GR, Price A, Gregor A (2001) Long-term survival in patients with non-small cell lung cancer treated with palliative radiotherapy. Clin Oncol 13:95–98Google Scholar
  45. Reuben DB, Mor Y (1986) Dyspnea in terminally ill cancer patients. Chest 89:234–236PubMedCrossRefGoogle Scholar
  46. Rousseau P (2000). The losses and suffering of terminal illness. Mayo Clin Proc 75:197–198PubMedGoogle Scholar
  47. Silveira MJ, DiPiero A, Gerrity MS, Feudtner C (2000) Patients' knowledge of options at the end of life: ignorance in the face of death. JAMA 284:2483–2488PubMedCrossRefGoogle Scholar
  48. Stagno SJ, Zhukovsky DS, Walsh D (2000) Bioethics: communication and decision-making in advanced disease. Semin Oncol 27:94–100PubMedGoogle Scholar
  49. Steinhauser KE, Christakis NA, Clipp EC, McNeilly M, McIntyre L, Tulsky JA (2000). Factors considered important at the end of life by patients, family, physicians, and other care providers. JAMA 284:2476–2482PubMedCrossRefGoogle Scholar
  50. Storey P (1998) Symptom control in dying. In Berger A et al. (eds): Principles and Practice of Supportive Oncology. Lippincott Raven Publishers, Philadelphia, pp 741–748Google Scholar
  51. Storey P, Hill HH, St. Louis RH, Tarver EE (1990) Subcutaneous infusions for control of cancer symptoms. J Pain Symptom Manage 5:33–41PubMedCrossRefGoogle Scholar
  52. Taylor JW, Simon KB(1990) Possible intramuscular midazolam-associated cardiorespiratory arrest and death. DICP (Ann Pharmacother) 24:695–697Google Scholar
  53. Tropiano P, Walsh D (2000) Organization of services and nursing care: hospice and palliative medicine. Semin Oncol 27:7–13PubMedGoogle Scholar
  54. Ventafridda Y, Ripamonti C, De Conno F, Tambarini M, Cassileth BR (1990) Symptom prevaIance and control during cancer patient’s last days of life. J Palliat Care 6:7–11PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2004

Authors and Affiliations

  • J. H. Von Roenn
  • J. F. Brandman

There are no affiliations available

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