TY - JOUR
T1 - The last days of life
T2 - Symptom burden and impact on nutrition and hydration in cancer patients
AU - Hui, David
AU - Dev, Rony
AU - Bruera, Eduardo
N1 - Publisher Copyright:
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Purpose of review To examine the symptom burden in cancer patients during the last days of life, its impact on nutrition and hydration, and the role of artificial nutrition and hydration in the final days. Recent findings During the last days of life, cancer patients often experience progressive functional decline and worsening symptom burden. Many symptoms such as anorexia-cachexia, dysphagia, and delirium could impair oral intake. These, coupled with refractory cachexia, contribute to persistent weight loss and decreased quality of life. Furthermore, the inability to eat/drink and body image changes can result in emotional distress for patients and caregivers. Clinicians caring for these individuals need to ensure longitudinal communication about goals of care, education about the natural process of dying, optimization of symptom management, and provide appropriate emotional support for patients and caregivers. There is a lack of evidence to support that artificial nutrition and hydration can improve outcomes during the last days of life. Artificial nutrition is not recommended because of its invasive nature, whereas artificial hydration may be considered on a case-by-case basis. Summary This review highlights the need to conduct further research on symptom burden, nutrition, and hydration during the last days of life.
AB - Purpose of review To examine the symptom burden in cancer patients during the last days of life, its impact on nutrition and hydration, and the role of artificial nutrition and hydration in the final days. Recent findings During the last days of life, cancer patients often experience progressive functional decline and worsening symptom burden. Many symptoms such as anorexia-cachexia, dysphagia, and delirium could impair oral intake. These, coupled with refractory cachexia, contribute to persistent weight loss and decreased quality of life. Furthermore, the inability to eat/drink and body image changes can result in emotional distress for patients and caregivers. Clinicians caring for these individuals need to ensure longitudinal communication about goals of care, education about the natural process of dying, optimization of symptom management, and provide appropriate emotional support for patients and caregivers. There is a lack of evidence to support that artificial nutrition and hydration can improve outcomes during the last days of life. Artificial nutrition is not recommended because of its invasive nature, whereas artificial hydration may be considered on a case-by-case basis. Summary This review highlights the need to conduct further research on symptom burden, nutrition, and hydration during the last days of life.
KW - death
KW - fluid therapy
KW - neoplasms
KW - nutritional support
KW - palliative care
KW - symptom assessment
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U2 - 10.1097/SPC.0000000000000171
DO - 10.1097/SPC.0000000000000171
M3 - Review article
C2 - 26509860
AN - SCOPUS:84960080230
SN - 1751-4258
VL - 9
SP - 346
EP - 354
JO - Current opinion in supportive and palliative care
JF - Current opinion in supportive and palliative care
IS - 4
ER -