Tuesday, December 25, 2012

Supportive Therapy


Parallel to the treatment of the cancer itself, a comprehensive care of the patient and his problems is now grown in specialized institutions in the management of patients with cancer . These supportive care are designed to improve the quality of life of patients throughout their care pathway. They gather several specialties.


Supportive therapy

The supportive treatments correspond to "all care and support necessary for sick people throughout the disease in conjunction with cancer treatments. " (INCA). These care complementary "are an integral part of the care of the sick" and also go to their loved ones, if necessary. In practice all the skills deemed necessary to coordinate around support cancer specific meetings of multidisciplinary collaboration. These treatments affect the overall physical, psychological or social concern specialties varied: pain , fatigue, nutritional problems, digestive disorders, respiratory, genitourinary disorders, disability, dental problems, social difficulties, psychological distress, disruption body image, support end of life .

The treatment of cancer pain

Some cancerous pathologies generate pain may increase with disease progression. In addition, the treatment itself and certain actions may lead to a more or less intense pain. They are of two types: nociceptive pain, that is to say related to a decrease in the pain threshold and which are mechanical, inflammatory ... and neuropathic pain associated with injury or nerve compression. Today, nociceptive pain, the most common, is the subject of a systematic care, regardless of its duration or intensity. In general, the relief of the patient is possible thanks to the administration phased analgesics (painkillers) depending on the intensity of pain experienced by the patient:

For mild or moderate pain, analgesics such as common aspirin, paracetamol or ibuprofen are sufficient.
Prove inadequate when they are combined together, or substituted molecules associated with more powerful as codeine, dextropropoxyphene and tramadol.

When the subject is not relieved, the opioid analgesics are considered. They are very effective in the treatment of pain intensity. By adapting graduated doses, with a regular rotation of molecules used, there is no risk of addiction or effects on the psyche. The side effects are the most frequent drowsiness and constipation, sometimes nausea and vomiting. These side effects are usually temporary, except constipation that requires diet and regular laxatives.

Neuropathic pain are, they are more difficult to treat: they are treated by treatments commonly used in depression and epilepsy (amitrytilline, clomipramine, gabapentin).

Management of malnutrition

Some cancers are sometimes responsible for malnutrition. It results in weight loss during the treatment . Malnutrition proved to be supported because it is responsible for an alteration of the general condition (generalized weakness). At first, an adaptation of the nutritional quality of inputs is recommended. Sometimes the use of nutritional supplements oral is necessary: ​​they can provide the essential nutrients, trace elements and vitamins in a small amount of sweet and savory foods. In a second step, or when oral feeding is not possible, enteral nutrition by nasogastric tube is preferred. It provides the necessary nutritional components without the patient having to feed orally, while allowing the digestive system to continue to function normally. Finally, when the two previous options are impossible, an intravenous feeding is started. It involves infusing a solution containing minerals, sugars (glucose), trace elements, vitamins, proteins and lipids split.

The psychological care

For through the trials of illness, patients need their entourage as listening and support. Psychologists involved in oncology and palliative care. Some are specially trained in the practice of psychology in the context of cancer: what are the psycho-oncologists. All are designed to help patients accept their illness, treatment and support them throughout their care pathway . Indeed, a good adherence is critical to its future success. According institutions, psycho-oncology consultations are always available or referred to in certain situations. The patient or the environment, if you feel the need, do not hesitate to ask for access to service consultations that supports it.

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