Palliative Therapy

Abstract

Palliative treatment, in one of its various forms, is appropriate in three types of clinical situation. Firstly, a patient with a potentially operable tumour may be considered too old, infirm or to have such serious intercurrent disease as to render the risks of resection unacceptably high. Secondly, the tumour may be considered unresectable, or incurable by virtue of the presence of metastatic disease or of gross involvement of contiguous structures, such as the presence of tracheo-oesophageal fistula, recurrent laryngeal nerve paresis or extensive mediastinal spread demonstrated by CT scanning. Thirdly, there is a small but finite group of patients who are considered to be fit for resection, to have a localised, resectable tumour, but who at operation are found to have either undetected metastases or an unexpected degree of tumour extension into contiguous structures which makes resection hazardous or technically impossible.