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Improving Palliative Care for Cancer
Octreotide as Palliative Therapy for Cancer-Related Bowel Obstruction that Cannot Be Removed by Surgery
Nausea or Vomiting
Lerisetron Compared with Granisetron in Preventing Nausea and Vomiting in Men Being Treated with Radiation Therapy for Stage I Seminoma
Drugs to Reduce the Side Effects of Chemotherapy
Acupressure and Acustimulation Wrist Bands for the Prevention of Nausea and Vomiting Caused by Chemotherapy
Psychiatric and Affective Symptoms (Anxiety, Depression)
Estimates of the prevalence of depression in cancer vary somewhat with the methods used to assess depression, when the assessments are done, and possibly with the type of cancer. In general, studies have found that approximately 25 percent of patients have depressed mood, and that between 10 and 15 percent of patients have a major depression sometime during their treatment (Cleeland, 2000). Although anxiety is common, it is rarely assessed regularly in cancer patients, and few patients are diagnosed or treated for it (Bottomley, 1998). The risk of patients developing psychological symptoms is increased with advanced disease, with certain cancer treatments, with uncontrolled physical symptoms (e.g., pain) or functional limitations, with inadequate social support, or with a past history of psychiatric disorder (Breitbart, 1995).
Both pharmacologic and nonpharmacologic therapies can be used to treat psychological symptoms in patients with cancer. However, some antidepressants may have serious side effects in patients with a concurrent illness such as cancer. For this reason, McCoy (1996) argues that pharmacologic agents that have many toxicities or act at multiple receptor sites (e.g., trycyclic antidepressants, monoamine oxidase inhibitors) should not be used to treat psychological symptoms in these patients. SSRIs (e.g., fluoxetine, or Prozac) and other new antidepressants may be a better choice for patients with cancer because they have fewer anticholinergic, cardiac, or cognitive adverse effects (McCoy, 1996). Psychotherapy for the treatment of depression may actually have an effect on the course of cancer. Psychotherapy may improve patients’ quality of life and help them learn to cope with their illness. In three randomized studies, psychotherapy increased survival time in patients with breast cancer, lymphoma, and malignant melanoma (Spiegel, 1996).
A report from a 1993 National Cancer Institute of Canada panel on neuropsychiatric syndromes and psychological symptoms in cancer patients