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Palliative Care in the Patient with Gastrointestinal Malignancies

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Textbook of Gastrointestinal Oncology

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Abstract

Over the last 20 years, considerable progress has been made in the management of malignancies of the gastrointestinal tract. Improved surgical techniques, enhanced radiation technologies, more sensitive imaging, improved interventional radiology techniques, and more efficacious chemotherapy have all improved the quality of life of patients and have improved survival times (and cure rates). However, many patients still develop metastatic disease or treatment-related toxicities. In these patients, skillful application of palliative care measures becomes very important. This chapter touches on a variety of these techniques. The first section of the chapter discusses issues of invasive, palliative interventions including the role of esophageal stenting, the role of palliative gastrectomy in advanced gastric cancer, and the optimal management of malignant bowel obstruction. The second section reviews interventions related to pain management including celiac plexus blocks, intrathecal opioid administration, and pain management in the setting of end-organ dysfunction. The third section discusses the neurotoxicity of oxaliplatin- and irinotecan-induced diarrhea. The final section discusses situations requiring skillful application of communication techniques. This chapter aims to provide some basic understanding of these topics and also provide the reader with recent references to consult to further their knowledge in these areas.

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Authors and Affiliations

  1. Oncology and Palliative Care Solutions, Anthem Inc., Bloomfield Hills, MI, USA

    David J. Debono

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  1. David J. Debono
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Correspondence to David J. Debono .

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Editors and Affiliations

  1. Department of Medical Oncology, Hacettepe University Institute of Cancer, Sihhiye, Ankara, Turkey

    Suayib Yalcin

  2. Department of Oncology, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA

    Philip A. Philip

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Debono, D.J. (2019). Palliative Care in the Patient with Gastrointestinal Malignancies. In: Yalcin, S., Philip, P. (eds) Textbook of Gastrointestinal Oncology. Springer, Cham. https://doi.org/10.1007/978-3-030-18890-0_20

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  • DOI: https://doi.org/10.1007/978-3-030-18890-0_20

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