Introduction and Scope of the Problem The onset of involuntary weight loss is often the first clinical sign of the presence of malignant disease. In cancers that are incurable by currently available therapies, significant weight loss can be seen in…
Introduction and Scope of the Problem Malignant bowel obstruction (MBO) is common, occurring in up to 15% of patients with cancer, and is the most common indication for palliative surgical consultation. Most frequently associated with gastric, colorectal, and ovarian malignancies,…
Introduction and Scope of the Problem Nausea, vomiting, and retching are common and distressing symptoms encountered in patients with advanced illness. Among patients with cancer, up to 70% report these symptoms. Patients with other advanced illnesses may also report these…
Introduction and Scope of the Problem Chemotherapy-induced nausea and vomiting (CINV) remains one of the most unpleasant, distressing, and feared symptoms for cancer patients. Without sufficient antiemetic prophylaxis, 30% to more than 90% of patients experience CINV with moderately emetogenic…
Introduction and Scope of the Problem Constipation resulting from opioid use, commonly referred to as opioid-related constipation, opioid-induced bowel dysfunction, or opioid-induced constipation, is one of the most distressing symptoms experienced by patients, especially those with advanced illness. The prevalence…
Introduction and Scope of the Problem Heart failure (HF) is a chronic and progressive illness that currently affects more than 6 million American adults and is projected to increase to more than 8 million individuals by 2030. Patients with advanced…
Introduction and Scope of the Problem Dyspnea is the uncomfortable awareness of breathing often associated with air hunger, rapid breathing, and breathlessness. It has a negative impact on functional status and quality of life in individuals living with chronic obstructive…
Introduction and Scope of the Problem Dyspnea is defined by a consensus panel of the American Thoracic Society (ATS) as “a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity.” Most often termed “shortness…
Introduction and Scope of the Problem Pain is a frequent and feared symptom in patients with advanced illness. It is highly prevalent in cancer and many other advanced diseases, such as human immunodeficiency virus, multiple sclerosis, congestive heart failure, and…
Introduction and Scope of the Problem Most patients can achieve satisfactory pain control and tolerable side effects with the standard WHO Three-Step Analgesic Pain Ladder, which increases medication potency and dosages until pain relief is achieved. However, systemic pain medications…