Palliative Surgery

Surgery
Surgery is the oldest form of cancer treatment. It also has a key role in diagnosing cancer and finding out how far it has spread (staging). Advances in surgical techniques have allowed surgeons to successfully operate on a growing number of patients. Today, less invasive operations often can be done to remove tumors while saving as much normal tissue and function as possible.

Palliative surgery
Sometimes cancer cannot be cured by surgery or by any method of treatment. Many uncomfortable symptoms of cancer, however, can be relieved by surgery. This is known as "palliative" treatment. To palliate means to ease or to relieve.
Some of the main symptoms that can be helped or totally relieved by this kind of surgery are:
* pain,
* the inability to move or to function as usual, or
* an obstruction (something that blocks a necessary body function) of bowel or bladder function.
Cancer causes pain to most cancer patients as does the treatment. It is estimated that 80% of cancer patients have two or more episodes of pain. More patients experience pain with advanced disease. The quality of life of those patients in great pain, resulting from either the disease or the treatment, is greatly compromised. Under such circumstances, palliative surgery may be performed. For example, the procedure may involve the removal of a painful primary or metastatic tumor mass such as a solitary spinal metastasis.

Palliative Surgery Eases End of Life

he study was presented by Betty R. Ferrell, PhD, RN, a research scientist with City of Hope Cancer Center in Los Angeles, who has led the effort to bring palliative oncology surgery to the forefront.
"One of our first messages is that people should consider surgery. We?re finding that there are very good surgical techniques now that are less invasive and can be done on an outpatient basis," says Ferrell. "So, even someone who may only live for four or six months might be able to have a short stay in the hospital and benefit from a better quality of life during their months," she says.

What is the most appropriate management of cancer pain?
Recently published guidelines for the management of cancer pain emphasize a deliberate plan of pain assessment, pain quantification, and short-term reassessment of pain after appropriate therapy has been selected and delivered.4 A comprehensive assessment of pain is important because it guides the initial therapy. Appropriate drug selection, dosing, and timing of reassessment are all directed by the initial severity of a patient's symptoms. The initial assessment of cancer pain must include a careful history of the pain—including intensity, location, quality, and associated symptoms—and an assessment of psychosocial issues that may play a role in the patient's pain condition.

Intraoperative photodynamic therapy: Intraoperative photodynamic therapy is a new type of treatment that uses special drugs and light to kill cancer cells during surgery. A drug that makes cancer cells more sensitive to light is injected into a vein several days before surgery. During surgery to remove as much of the cancer as possible, a special light is used to shine on the pleura. This treatment is being studied for early stages of mesothelioma in the chest.