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J R Soc Med. 1988 June; 81(6): 341–344.
PMCID: PMC1291628

The management of symptoms in advanced cancer: experience in a hospital-based continuing care unit.

Abstract

The treatment received by 158 patients with advanced cancer admitted over one year to the Continuing Care Unit at the Royal Marsden Hospital has been reviewed. The unit is an integral part of the hospital and this is reflected in the fact that 46 patients (29%) received radiotherapy, hormone therapy, chemotherapy or surgery in addition to symptomatic treatment for palliation of troublesome symptoms. One hundred and thirty-one patients received oral morphine in doses ranging from 2.5 mg 4-hourly to 700 mg 4-hourly. Patients with renal or hepatic impairment required lower doses of morphine and there was a highly significant inverse relationship between morphine dose and age. Eighty-five patients (54%) received parenteral diamorphine at some time due to their inability to take oral morphine. One hundred and twenty-three patients (78%) received a co-analgesic drug and anti-emetics were required by 78 patients (49% overall; 56% of those receiving morphine). Transcutaneous electrical nerve stimulation, acupuncture and relaxation were employed in selected patients, and graduated compression sleeves were used to treat lymphoedema. These data highlight the wide range of therapeutic options available to control the symptoms of advanced cancer and also indicate that tumoricidal treatments used in conjunction with symptomatic treatments may have a significant part to play.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Hanks GW, Hoskin PJ. Pain control in advanced cancer: pharmacological methods. J R Coll Physicians Lond. 1986 Oct;20(4):276–281. [PubMed]
  • Twycross RG. Control of pain. J R Coll Physicians Lond. 1984 Jan;18(1):32–39. [PubMed]
  • Hanks GW, Twycross RG. Pain, the physiological antagonist of opioid analgesics. Lancet. 1984 Jun 30;1(8392):1477–1478. [PubMed]
  • Regnard CF, Twycross RG. Metabolism of narcotics. Br Med J (Clin Res Ed) 1984 Mar 17;288(6420):860–860. [PMC free article] [PubMed]
  • Kaiko RF. Age and morphine analgesia in cancer patients with postoperative pain. Clin Pharmacol Ther. 1980 Dec;28(6):823–826. [PubMed]
  • Owen JA, Sitar DS, Berger L, Brownell L, Duke PC, Mitenko PA. Age-related morphine kinetics. Clin Pharmacol Ther. 1983 Sep;34(3):364–368. [PubMed]
  • Hanks GW. Antiemetics for terminal cancer patients. Lancet. 1982 Jun 19;1(8286):1410–1410. [PubMed]
  • Walsh TD. Antiemetic drug combinations in advanced cancer. Lancet. 1982 May 1;1(8279):1018–1018. [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press