Jinyoung Shin1, Sun Hyun Kim2, Sang-Yeon Suh3, Shao-Yi Cheng4, Ping-Jen Chen5,6, Takashi Yamaguchi7, Tatsuya Morita8, Satoru Tsuneto9, Masanori Mori8. 1. Department of Family Medicine, Research Institute on Healthy Aging, Konkuk University Medical Centre, Konkuk University School of Medicine, Seoul, South Korea. 2. Department of Family Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, 25 Simgok-ro #100 Gil, Seo-gu, Incheon, 22711, South Korea. drsunhyun@gmail.com. 3. Department of Family Medicine, Palliative Care Center, Dongguk University Ilsan Hospital, Goyang, South Korea. 4. Department of Family Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan. 5. Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. 6. Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK. 7. Division of Palliative Care, Konan Medical Center, Kobe, Japan. 8. Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan. 9. Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Abstract
BACKGROUND: Well detection of the symptoms and signs of dying patients is essential for providing proper palliative care. Our goal is to evaluate the predominant symptoms and compare the changes in dying patients with digestive tract cancer in Japan, South Korea, and Taiwan. METHODS: A total of 1057 cancer patients aged 18 years or older admitted in palliative care units with locally advanced or metastatic gastroesophageal, colorectal, and pancreaticobiliary cancer were enrolled from January 2017 to March 2019. The severity of physical and psychological symptoms and signs assessed by physicians and/or nurses upon admission, 1 week after admission, and within 3 days of death, was compared according to cancer type and country of origin. RESULTS: Among the 338 gastroesophageal, 358 pancreaticobiliary, and 361 colorectal cancer patients, 894 (93.1%) died during the observation period. Fatigue was the most severe symptom in all cancer groups before dying. Dyspnea, fatigue, drowsiness, and ascites improved after hospitalization albeit they worsened prior to death. In particular, ascites was a marked symptom in patients with pancreaticobiliary cancer. Delirium and hallucination gradually worsened during the period leading to death. Differences in manifestations with respect to the country of origin were not significant. CONCLUSION: We identified the most prevalent signs and symptoms in patients from East Asia who were dying from digestive tract cancers. Proper management, based on these prevalent signs and symptoms during the dying period, plays a vital role in providing adequate palliative care.
BACKGROUND: Well detection of the symptoms and signs of dying patients is essential for providing proper palliative care. Our goal is to evaluate the predominant symptoms and compare the changes in dying patients with digestive tract cancer in Japan, South Korea, and Taiwan. METHODS: A total of 1057 cancer patients aged 18 years or older admitted in palliative care units with locally advanced or metastatic gastroesophageal, colorectal, and pancreaticobiliary cancer were enrolled from January 2017 to March 2019. The severity of physical and psychological symptoms and signs assessed by physicians and/or nurses upon admission, 1 week after admission, and within 3 days of death, was compared according to cancer type and country of origin. RESULTS: Among the 338 gastroesophageal, 358 pancreaticobiliary, and 361 colorectal cancer patients, 894 (93.1%) died during the observation period. Fatigue was the most severe symptom in all cancer groups before dying. Dyspnea, fatigue, drowsiness, and ascites improved after hospitalization albeit they worsened prior to death. In particular, ascites was a marked symptom in patients with pancreaticobiliary cancer. Delirium and hallucination gradually worsened during the period leading to death. Differences in manifestations with respect to the country of origin were not significant. CONCLUSION: We identified the most prevalent signs and symptoms in patients from East Asia who were dying from digestive tract cancers. Proper management, based on these prevalent signs and symptoms during the dying period, plays a vital role in providing adequate palliative care.
Entities:
Keywords:
Gastrointestinal tract; Neoplasms; Palliative care; Signs and symptoms
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