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Suffering and Experiencing Pain

Paul Edwards

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"Many men tell me that they fear the process of dying—suffering and experiencing pain—more than they fear death itself.  While I am no fan of pain, as a medical oncologist I have been responsible for the treatment of hundreds of patients with terminal cancer.  I have learned that with good communication and proper medical management, pain can almost always be effectively controlled".


Click on this link to read an excellent article by leading US medical oncologist, Dr Mark Scholz.

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Care of the advanced cancer patient should begin at the moment the doctor and the patient are aware of the fact that the condition is incurable. That is when good palliative care ought commence with psychological support as there will be a sense of doom, perhaps as when a person was advised that the lab. report indicated cancer in an earlier situation.
Relief of symptoms is the basis of good palliative care and it requires a close relationship of the patient with the doctor or oncologist (of whatever ilk) associated with the case.
A multidisciplinary approach is the ideal, when problems arise.
Adequate pain management is an essential, and strong drugs like morphine, when given for severe pain is not addictive, though tolerance may mean an increased dose is needed in time. Opioid drugs tend to constipate a person, so that has to be managed.
It is certain that, though it is years since I was caring for folk with advanced cancer and some dying patients, the basic care has not really changed.

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As Jim Marshall mentioned last year:


"If you, or your doctor, believe that 'palliative care' and 'end of life' are the same thing, you could be in for some unnecessary misery.


Before one of our members insisted on a referral to palliative care, he had endured years of unresolved pain.  With palliative care added to his treatment, he was able to take up an active life again".


The Cancer Council booklet "Understanding Palliative Care" has recently been updated. Click on this link to read the booklet.

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The following has been submitted to the Cancer Council per the CEO of CCQ.


Perhaps, when next revised, consideration might be given to an improvement or two.

On p.42 is:  
 “palliative care

The holistic care of people who have
a life-limiting illness, their families and carers. It aims to improve quality of
life by addressing physical, emotional, spiritual and practical needs. It is not just for people who are about to die, although it does include end-of-life care.”

This differs from Wilipedia:

Palliative care
 is a 
 to specialised 
 for people with serious 
. It focuses on providing patients with relief from the 
, and 
 of a serious illness—whatever the 

Reference (1)
National Cancer Institute
. Retrieved 
15 July

On p. 4 is:
"Advanced cancer is a term used to describe cancer that is unlikely to be cured.
That is acceptable as within the NCI definition.
On p.9 is:
“Palliative care does not try to end life sooner, but nor does it try to prolong life.”
Perhaps the words “incurable but perhaps still treatable” as below reference p. 10, could be represented here as hormonal or chemotherapy may well relieve symptoms as well as prolong life.
On p. 10 is:
“Once you know your cancer is advanced, it is a good idea to start exploring the options provided by palliative care.”
Perhaps the words “incurable but perhaps still treatable”, or some such, could be used here, as it is submitted that when the doctor concerned conveys that message to the patient, there will be at least one symptom requiring management, namely, apprehension, quite apart from any other that might be present at that time.
Any treatment of a symptom related to the cancer in such a patient is really classed as “palliative”.
Also is:
“You can still have treatment that aims to cure advanced cancer while receiving palliative care.”
 This is badly worded as if the advanced cancer, e.g. lymphoma, be curable, is it really “palliative care”?
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