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Palliative Care at SFGH- A case series

Explore diverse patient cases benefiting from palliative care, focusing on pain relief and improved quality of life for individuals with life-threatening illnesses. Learn about assessments, treatments, and considerations impacting care decisions.

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Palliative Care at SFGH- A case series

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  1. Palliative Care at SFGH-A case series By Dr. D. Narinesingh and team Presented by NazreenBhim

  2. Definition • Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems: physical, psychosocial and spiritual.

  3. Considerations • Age • Social/Family Support • Patient and Relatives wishes • Performance Status • Prognosis • Suitability for active intervention

  4. Case 1 • JR 63yo female • Diagnosed with Left Breast CA in 2005/2006 • Post Lt MRM & ALND • Post adjuvant Chemo-RT • Triple Negative • PS=4 • CT Scan Abd/Pelvis: • Widespread bone metastases • Ascites and pleural effusions • Bilateral hydronephrosis of indeterminate etiology • Admitted repeatedly for abdominal distension and anaemia

  5. Case 2 • 95 y.o female • Ovarian CA- Stage III diagnosed in 2010 • Had 6 cycles Carboplatin/Taxol > MaintenceFemara>Cyclophosphamide> Progression • Main Complaints: Distended Abdomen (20 ascites) • PS =2

  6. Case 3 • KS, 24yo Male • Diagnosed with Rectal CA with multiple liver metastases in October 2011 • Had Xeloda x 3cycles then, CEA↑ and ↑in size of rectal lesion, Pt counselled on starting XelOx (PS=2) • Patient presented for review and admitted non-compliance to Xeloda and agreed to start Rx. • After Xeloda x3cycles • Pt diagnosed with DVT. • Hb <6. • (PS=4)

  7. Case 4 • AB 29 yo female • Gastric CA with Bone Metastases • Diagnosed during pregnancy • Severe pancytopenia • PS=4 • Had 3cycles of weekly 5FU/LV (discontinued due to very difficult IVA and pt not stable enough for CVP line/Port insertion) and Xeloda x2cycles • Admitted to ward for severe anaemia (Hb=2.3), and UGIB

  8. Clinical scenario • 73 yo male • Pancreatic CA Stage 4 (newly diagnosed) • PS=4 • Admitted for UGIB and discharge to PCC as outpatient on Morphine SR 60mg pobd • Presented to resus room A+E 2/7 later with unresponsiveness 20 ingestion of 40 Morphine 60mg tabs

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