Introducing concept of palliative care in chronic cancer pain management

Global Cancer Conference & Medicare Summit

September 15-17, 2014 Hyderabad International Convention Centre, India

Sushma Bhatnagar

Accepted Abstracts: J Cancer Sci Ther

Abstract :

Chronic cancer pain is a distinct pathology which causes changes in whole of the body and it becomes worse as time passes. Chronic cancer pain has four essential components physical, psychological, social and spiritual. Thus it is mandatory to treat patient as a whole, this means to treat ?Total Pain?. To treat total pain we need multimodal, multi dispensary approach to achieve maximum benefit to patient and to improve quality of life. As per the definition by International Association for the Study of Pain, Pain is defined as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Pain physicians are following this IASP pain definition for the last many years but all of them have not understood this definition well. The major dilemma is, on one side chronic cancer pain management has done major advances in medical science, on other side we all fail to teach our young physician how to manage total pain addressing the psychological state of the patient. Palliative care is recognized by individualized, holistic models of care, delivered carefully, sensitively, ethically and therapeutically by using skilled communication with attention to detail, meticulous assessment, and advancing knowledge. It basically implies a personalized form of health care. It takes pain physician to wider horizon of biopsychosocial model of pain management. Patients? body, mind and spirit are inseparable and interdependent. If we want to take care of patient pain thorough assessment of each complaint should be considered in patient?s total suffering. According to WHO palliative care is the approach that improves the quality of life of patients and their families facing the problems associated with life threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual. Essential components of palliative care: ? Control of symptoms ? Effective communication ? Rehabilitation ? Continuity of care ? Terminal care ? Support in bereavement ? Education and research The major prerequisites of palliative care in domain of pain are: A. Empathy at the time of assessment B. Communication C. Improve functional status D. Learning judicious role of opioids in treating malignant and non malignant pain E. Improving psychological pain F. Multidisciplinary team approach Conclusions: Palliative care is an important part of pain medicine, especially in the management of cancer pain. It is also important in other chronic painful conditions like osteoarthritis of knee, chronic back pain, neuropathic pain and pain due to advanced heart, renal and respiratory disease, AIDS, etc. Inclusion of Palliative care principles in pain practice will enhance interpersonal relationships and psychological well-being by addressing all four components of pain and thus improved quality of life.