Palliative Care In Oncology
Maximal quality improvement in the setting of life-limiting illness and noxious sumptomology is worthy medical humanitarian goal. There are an estimated about 60% of all people who die would benefit from palliative care before death., according to The World Health Organization. Palliative care is not exclusively for patients at the end of life.
Palliative care is a multidisciplinary medical specialty. It focuses on the emelioration of physical, emotional, psychological, and spiritual suffering. Palliative care notbjust for palliative care specialists, but for anyone can and should be trained to provide “preliminary palliative care” such as basic care management & facilitation of clinical discussions with patients and families about disease prognosis.
The timing for the integration of specialist palliative care if cancer patients have studily risen. Research continues to show improved quality of life and improved survival in some cases. An average survival time was increased by 2.7 months (11.6 months vs 8.9 months) and the quality of life improved for patients newly diagnosed with metastatic nom-small-cell lung cancer and randomized referred to palliative care compared to control patients not so randomized. What Oncologist means by “Palliation” such as when palliative chemotherapy lines are routinely offered, might also change, showing evidence the chemotherapy might not provide palliation. It was seen in a recent cohort study of 621 patients with progressive end- stage metastatic cancer who had a life expectancy of 6 months or less who completed at least 1 chemotherapy rehmgimen. In some patients , use of “Palliative chemotherapy” was found to have a reduction in the quality of life near death for patients who had a good baseline performance status and where not associated with quality of life near death for patients with a moderate or poor baseline performance status.
Cannabinoid Integrative Medicine in Oncologic Medicine in Oncologic Palliative Care
There are many opportunities to improve and expand palliative care. As a therapeutic class, cannabinoids have an important role to play in oncologic palliative care, a role that will grow in time , as knowledge use more of these agents becomes mainstream as in the 19th and 20th century in North America and Europe.
There was a medical pioneer from the 19th century who made serious efforts to integrate cannabinoid preparations in their practice name Sir W.B. O’Shaughnessy. He treated a patient with end-syage rabies wbi was suffering from hydrophobia, a neurologic sequels of the viral syndrome. All attempts to take in liquid are met with paroxysms and convulsions. In cancer patients , refractory nausea and vomiting, especially with high emetogenic chemotherapy , can present similarily. O’Shaughnessy’s case description is likely to first modern description of using cannabis to palliative symptoms in the final days of life. The description of his patients presentation in the last days and hours of life including breathing pattern and alteration in mental status.
This starts with a clinical encounter from November 22, 1838 when a patient named Hakim Abdullah, who came in O’Shaughnessy’s chambers with a 3 week old rabid dog bite. On examination, Abdullah pulse was at 125bpm, and his skin, cols and moist. The left forearm showed a small, red painful cicatrix. He found that the patient was “unable to swallow liquid or quench a thirst. Every attempt to swallow water or tickle drops on the tounge led to severe paroxysms.”
O’Shaughnessy’s treatment was two grains (129 mg) of hemp resin in a pilluar mass every hour. In a day-to-day report, O’Shaughnessy describes how after the third dose, the patient was able to progressively begin to take in more liquids starting with swallowing the orange juice. After He slept
, he drank more juice ate moistened rice and sugarcane. This is when he sunk himself into a super and died on November 27 at 4am.
Present days, this type of care us referred to as “cannabinoid integrative medicine” (CIM). Where integrative medicine blends conventional with complementary and alternative therapies such as botanicals. COM emphasizes the integrated therapeutic use of the cannaboid-rich botanical cannabis.
Guided by cannabinoid science and Endocannabinoid physiology , CIM has been incorporated by law into health care in almost half of the U.S. and all of Canada. Even though certain cannabinoids have been approved by the U.S. Food and Drug Administration since 1985 and by the Therapeutic Products Directorate of health Canada since 1991, many patients prefer growing themselves, or getting from their caregivers, or their dealers.
Canada was one of the first to approve of cannabis use formulated 1:1 THC to CBD, which health Canada approved for use for multiple sclerosis and in cancer pain. Recently Canadian courts approved cannabis and regulated private growing of marijuana . Even though health Canada maintains that “marijuana is not an approved drug in Canada”, there are dispensaries across Canada that caters to patients needs.