Unfortunately, some cancer patients have advanced cancer that does not respond to treatment and has spread to many organs. For a patient in this situation, treatment and support should be continued diligently, consciously and skillfully, as if the patient has the possibility of responding to treatment and recovering completely.
The most important issue for patients with advanced cancer is that the people around them do not act in pessimism and hopelessness. What is meant here is not to believe that the patient will recover even after the treatment has failed, but to have the skills and understanding to keep the patient in good spirits and reduce pain and tension, regardless of the severity of the situation.
Relatives and doctor of a patient with advanced cancer, They cannot know and determine the duration of the patient's remaining life and the value it represents for that patient. Moreover, it is not possible to predict when the spontaneous regressions (spontaneous remission) that cancer disease exhibits from time to time will occur. In fact, the majority of cancer-related deaths are not due to cancer affecting vital organs; It is caused by side causes such as infection, abnormal decreases in blood cell count, malnutrition, and bedsores. For this reason, relatives and doctors of patients with advanced cancer should continue their medical and moral support until the last moment, even if cancer treatments have failed and treatment for the disease cannot be provided.
One of the problems that cancer patients and their relatives fear the most is pain. Although pain is sometimes not directly related to cancer, it occurs when the tumor causes blockage, starts an infection, or involves the nerves. The biggest harm of constant pain is that it does not give the patient the opportunity to enjoy simple daily pleasures, which are possible even in the most advanced cases. Worse, it causes personality changes, alienating family members and friends from the patient when they are needed most. Therefore, the issue that should be taken most seriously in such a patient is pain. In patients with advanced cancer, pain is tried to be relieved in three ways.
- The first is the direct methods that can be applied, which are surgery, radiation therapy or chemotherapy aimed at eliminating or controlling the tumor itself. magic of cases In most cases, treatment of the pain mechanism, whether caused by tumor spread, infection or mechanical obstruction, is aimed at providing relief to the patient.
- Another method for pain control is the use of medication. Painkillers (analgesics) provide more comfort when given just before the patient's regular pain periods, than when given every 4 hours or when the patient complains. If mild medications are given before severe pain and the resulting panic begin, they will be more effective than strong painkillers given later. Aspirin and codeine given together at the onset of discomfort are usually effective. Initially, it is advisable to give these medications orally, saving other routes for later. It was once thought that drug addiction (addiction) was inevitable as the patient's pain increased. Research shows that, despite the initiating mechanism, many people never become drug addicted, and careful patient care can overcome this difficult situation. Some pain can be relieved by care from the caregiver and these should be done before using a narcotic medication. Gas distress, urinary retention, back pain, itching, dry mouth, high fever and uncomfortable position are sources of distress that can be immediately relieved by a caring caregiver; the attitude of the caregiver is also important. The caregiver is most effective when he listens to the complaints carefully, describes the patient's pain accurately to the doctor, tries to minimize it, and approaches the patient and the problems such as loneliness and fear that cause the patient to feel pain more, with an understanding and not belittling attitude.
- A third method to control persistent pain is to interrupt the pain transmission pathways (peripheral nerves or spinal cord) at some point. Because the results are short-term, nerve block procedures are generally used in patients with very advanced cancer. Cutting the sensory nerves is useful in the head and neck region, but it is generally not used for pain in other areas.
A visit from a relative or neighbor, a few nice and uplifting words, a new and interesting book, a movie watched in a comfortable position. TV p Although music that does not disturb the patient and suits the person's liking does not eliminate the pain and other symptoms, it greatly affects the patient's perception of the symptoms as it will strengthen the patient's psychology. It reduces the feeling of fear and anxiety, especially at night. For this reason, it is necessary to treat such patients as understandingly and compassionately as possible, but also in a way that makes them feel that you know their complaints and the seriousness of their situation.
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