TY  - CHAP
M1  - Book, Section
TI  - Pain Management and Symptom Control
A1  - Shih, Kaoswi K.
A1  - Dev, Rony
A1  - Dalal, Shalini
A2  - Kantarjian, Hagop M.
A2  - Wolff, Robert A.
A2  - Rieber, Alyssa G.
PY  - 2022
T2  - The MD Anderson Manual of Medical Oncology, 4e
AB  - KEY  CONCEPTSPatients  with  cancer  experience  multiple  symptoms  that  are  often  under-reported  and  not  alleviated.  Symptoms  are  often  interrelated  and  can  be  both  physical  and/or  psychological.Pain  expression  can  be  modified  by  cognitive  and  psychological  factors  associated  with  advanced  disease  or  the  dying  process.A  thorough  psychosocial  history,  assessment  of  mental  status,  and  screening  with  risk  assessment  tools  for  nonmedical  opioid  use  is  critical  before  prescribing  opioid  analgesics.Fatigue  is  the  most  common  symptom  in  patients  with  advanced  cancer  and  its  treatment  is  challenging  in  later  stages  of  disease.  Patients  and  families  benefit  from  education  about  the  burdens  of  both  physical  and  emotional  fatigue.  It  can  be  helpful  to  modify  daily  activities  and  rest  to  accommodate  for  symptoms  of  fatigue  as  well  as  optimizing  nutrition  and  hydration.Dyspnea  is  often  an  indicator  of  poor  prognosis  in  advanced  cancer.  Initial  management  includes  treating  underlying  causes  medically  when  able.  Palliative  measures  to  reduce  the  sensation  of  air  hunger  include  low  flow  supplemental  oxygen  for  those  with  hypoxemia,  opioids,  or  corticosteroids.Anorexia  and  weight  loss  are  a  result  of  systemic  inflammation  and  inadequate  caloric  intake  because  of  cancer  and  are  often  difficult  to  reverse.  Psychosocial  support  for  cachectic  patients  and  their  family  caregivers  can  help  diminish  patient-family  distress.Advanced  care  planning  can  decrease  anxiety  and  suffering  of  patients  and  families  as  well  as  ensure  autonomy  for  patients,  especially  if  they  become  unable  to  express  informed  consent.  However,  it  is  an  ongoing  process  that  is  best  started  early,  revisited  periodically,  and  incorporates  room  for  change  owing  to  unforeseen  changes  in  the  patient's  clinical  condition.  
SN  - 
PB  - McGraw Hill Education
CY  - New York, NY
Y2  - 2024/04/24
UR  - hemonc.mhmedical.com/content.aspx?aid=1190840650
ER  -