Abstract:
PURPOSE OF REVIEW:This review summarizes recent developments in the palliative management of gastrointestinal symptoms experienced by advanced cancer patients and provides a framework for detailing that encompasses education, assessment and monitoring, and treatment. RECENT FINDINGS:Although many viable treatment options exist, gastrointestinal symptoms, particularly nausea and vomiting, constipation, and diarrhea, continue to challenge both patients and clinicians. New medications, such as skin patch delivery of granisetron for nausea or methylnaltrexone for constipation, show promise of better symptom management, and are advancing alongside an increasing emphasis on prevention. The integration into care plans of complementary and alternative therapies, such as relaxation techniques and electroacupuncture, may also assist with symptom relief. Accurate assessment is essential but often problematic, especially as the patient's experience of gastrointestinal distress is often incommensurate with objective measures. New methodologies that harness technology to collect patient-reported outcomes may improve the accuracy of assessment, better capture the patient's experience of gastrointestinal symptoms, and provide a means to simultaneously monitor symptoms, educate patients, and collect longitudinal data. SUMMARY:Palliative management of gastrointestinal symptoms in advanced cancer patients requires a multipronged approach that entails effective assessment, judicious use of latest evidence-based approaches, and monitoring that incorporates both clinical measures and patient-reported outcomes. In combination with refinements in the overall clinical approach to symptom management, the deployment of standardized instruments that streamline data collection and enable data warehousing will support better symptom management.
journal_name
Curr Opin Support Palliat Carejournal_title
Current opinion in supportive and palliative careauthors
Abernethy AP,Wheeler JL,Zafar SYdoi
10.1097/SPC.0b013e32832531cesubject
Has Abstractpub_date
2009-03-01 00:00:00pages
41-9issue
1eissn
1751-4258issn
1751-4266pii
01263393-200903000-00008journal_volume
3pub_type
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journal_title:Current opinion in supportive and palliative care
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journal_title:Current opinion in supportive and palliative care
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