ABSTRACT
In the previous chapter I suggested some ways that may help you in explaining to a patient that their disease has relapsed, and issues to do with subsequent active treatment where that is appropriate. Let us now consider your role in helping people come to terms with the situation where further active anti-cancer treatment is inappropriate – where progression is going to lead to terminal care and death. When you have gained the confidence to talk openly with patients about these issues, you will find it rather less difficult than some earlier conversations that you have held, and profoundly rewarding. The major reason why these conversations are more straightforward is that there is now much less doubt, less confusion, less choice for the doctor and fewer decisions for the patient to make. As a constant theme throughout this book, I have emphasised that one of the greatest challenges that patients with cancer have to face is the uncertainty of what lies ahead. At this stage of the disease many of those uncertainties have passed. It is now your role to focus on the relief of physical symptoms and to offer appropriate emotional and psychological support to the patient and their family. Your aim is to help all of those involved to reach a peaceful state as they prepare for the patient’s death. Let us first consider your role in treating physical symptoms at the time of progression.
Managing physical symptoms of advanced cancer
