Palliative medicine is the holistic treatment of patients with advanced illnesses and a limited life expectancy. This means that a cure is no longer possible and the patient will die from their illness in the foreseeable future.
Palliative care accompanies the patient during this time. It has the following goals, modified according to the WHO:
- Control of pain and reduction of suffering,
- Inclusion of the patient's psychological and spiritual wishes,
- Involvement of the family environment,
- care and support at the hour of death.
After the patient's death, palliative care offers relatives help in dealing with the loss.
There are no definitive laboratory or imaging diagnostic criteria for colon carcinoma that indicate the initiation of a palliative care phase of the disease.
However, the following list summarizes some of the characteristics:
Relative signs that the tumor could not be completely eliminated by previous therapies are
- Tumor expansion,
- tumor constriction of the intestine and
- metastasis.
These signs indicate that the patient may be facing a palliative phase of the disease and death.
- Constipation(constipation),
- Nausea and vomiting,
- heartburn,
- distended abdomen, e.g. due to abdominal fluid (ascites) or air in the bowel,
- Pain, both visceral and neuropathic,
- emaciation (cachexia),
- Loneliness,
- despair.
Contemporary medicine is very technically oriented. However, especially in the palliative phase of the disease, technical treatment procedures are not the main focus. The focus here is more on comprehensive general care, even outside of palliative care units.
Treatment is based on the signs of illness on the list above. However, many patients have a strong desire to talk. The fact that this desire in particular is more difficult to fulfill than in the past is due to the reduction in staff and the high level of bureaucratization in the healthcare system.
In palliative care for colon cancer, human closeness is more important than further treatment © Photographee.eu | AdobeStock
Patients know how they are doing by observing themselves and changing the behavior of their caregivers. The hope of getting rid of the tumor is in the foreground for a long time. However, it then turns into the wish not to have to suffer in the last phase of life. They are particularly in need of spiritual support from counselors or family.
Technical treatments, such as an abdominal puncture or blood transfusion, should only be carried out with the aim of reducing suffering.
With a living will, or even better with a power of attorney, the patient can determine
- what treatment should still take place and
- what should be omitted,
if he is confused. Sick people also feel secure if they know that their death will be made easier, e.g. through terminal sedation, and that their loved ones will be cared for.