End of life and palliative care decisions in advanced head neck cancer

Shrikant B. Mali
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Abstract

The complexity of care for patients with advanced head and neck cancer is a significant issue, and current healthcare systems must focus on appropriate referral criteria, increased integration and coordination of care, and robust evaluation of specific care components. Linkage between research and service design delivery across teams, disciplines, and care settings is also important. Palliative care needs of patients with advanced head and neck cancer pose unique complexities due to the impact the illness has on eating, speaking, appearance, and breathing. Specialty palliative care consultation by trained experts helps primary teams facilitate goals of care discussions, symptom management, and medical resource navigation for the terminally ill patient. Early initiation of palliative care results in less invasive and more cost-effective patient-centered care. There is little literature on care practices in this population, and hospital-based care may increase towards the end of life to address potentially reversible conditions or uncertain prognosis. Early advanced care planning and end-of-life care options should be supported alongside continuation of therapy lines.

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晚期头颈部癌症患者的生命终结和姑息治疗决策
晚期头颈部癌症患者的护理工作十分复杂,这是一个重大问题,当前的医疗保健系统必须关注适当的转诊标准、加强护理的整合与协调,以及对具体护理内容进行有力的评估。跨团队、跨学科和跨护理环境的研究与服务设计之间的联系也很重要。晚期头颈部癌症患者的姑息关怀需求具有独特的复杂性,因为疾病会影响进食、说话、外观和呼吸。由训练有素的专家提供专业的姑息治疗咨询,有助于基层团队为晚期患者进行治疗目标讨论、症状管理和医疗资源导航。及早启动姑息关怀,可以减少以病人为中心的护理的侵入性,提高成本效益。有关这类人群护理实践的文献很少,在生命末期,医院护理可能会增加,以应对潜在的可逆性疾病或不确定的预后。在继续治疗的同时,应支持早期的晚期护理规划和临终护理选择。
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