Abstract
Cancer is the leading cause of death in Japan and accounts for approximately 350000 deaths per annum. Accompanied with cancer progression, aggravation of performance status (PS) cause difficulty for patients in receiving active treatments such as chemotherapy and radiotherapy. Primary purpose of palliative care therapy is considered to be removal of all kinds of pain such as spiritual, physical, and social as much as possible throughout the rest of the patient' s life. Under this situation, palliative care is expected to not only ameliorate pain but also to improve the quality of life, activities of daily living, and PS, and occasionally capable to accept the effects of anticancer therapies such as radiotherapy and chemotherapy that lead to improved prognosis. Here, we report the outcomes of three patients with highly advanced cancer, who received palliative care at our department and whose predictive prognosis indices indicated a life expectancy of less than 3-4 weeks. PS was improved after implementation of proper palliative care with medications or local treatment; this encouraged us to administer chemotherapy. As a result, the chemotherapies were safely adapted, resulting in prognostic extension. All the patients were discharged from our hospital and continued to receive chemotherapy as out-patients. Thus, our findings indicate that proper palliative treatment allows patients with highly advanced cancer with poor PS to again receive active treatments such as chemotherapy or radiotherapy by improving PS that results in improved prognosis.
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