PALLIATIVE MEDICINE - BEYOND ADVANCED CANCER CARE

  • Ana-Maria SÎNGEAP “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Anca TRIGAN “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • C. STANCIU Biomedical Research Center, Romanian Academy
Keywords: PALLIATIVE MEDICINE, CANCER CARE, LIVER TRANSPLANTATION

Abstract

Nowadays, medicine has the same value and meaning, and is answerable to the same formidable requirements it has always been. Medicine must soothe, heal, prevent and limit the spread of disease. A physician has the opportunity to live inspiring moments while brings the very sick patients again to life and these rare moments will uplift him in the most difficult situations. In some specialties, such moments could repeat more often as in surgery, emergency medicine and sometimes in cardiology or neurology. In the majority of time, the practicing physician has to deal with chronic diseases, some of them which aggravate and complicate itself, ultimately conducting to organ failures and a very poor quality of life. Moreover, due to the success of medicine in preventing some diseases, in treatment of infectious diseases and in effective treatment of ischemic heart disease, diabetes mellitus etc. people live much longer, and experience new problems related to advanced age (1). Death, the termination of life is seen as a disease and drained by any spiritual meaning. Twenty-one century medicine is dealing with termination of life problems, with the emerging “assisted suicide” solution for the difficulties related to advanced diseases and advanced age and with a huge pressure on health system done by chronic advanced diseases with low quality of life and disability (2). New rules, new laws, new concepts are required to respond to new approaches and needs. A different health system organization is needed.

Author Biographies

Ana-Maria SÎNGEAP, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Institute of Gastroenterology and Hepatology, “Sf. Spiridon”, Iasi

Anca TRIGAN, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Institute of Gastroenterology and Hepatology, “Sf. Spiridon”, Iasi

C. STANCIU, Biomedical Research Center, Romanian Academy

Institute of Gastroenterology and Hepatology, “Sf. Spiridon”, Iasi

References

1. Brown GC. Living too long: the current focus of medical research on increasing the quantity, rather than the quality, of life is damaging our health and harming the economy. EMBO Rep 2015; 16(2): 137-141 / doi: 10.15252/embr.201439518.
2. Dieudonné-Rahm N, Burkhardt S, Pautex S. In-hospital care prior to assisted and unassisted suicide in Swiss older people: a state-level retrospective study. BMC Geriatr 2019; 19(1): 300 / doi: 10.1186/ s12877-019-1325-6.
3. Baumgartner K, Cooper J, Smith A, St Louis J. Liver Disease: Cirrhosis. FP Essent 2021; 511: 36-43.
4. Rakoski MO, Volk ML. Palliative care and end-stage liver disease: a critical review of current knowledge. Curr Opin Gastroenterol 2019; 35(3): 155-160 / doi: 10.1097/MOG. 0000000000000530.
5. Peng Y, Qi X, Guo X. Child-Pugh versus MELD Score for the Assessment of Prognosis in Liver Cirrhosis: A Systematic Review and Meta-Analysis of Observational Studies. Medicine (Baltimore) 2016; 95(8): e2877 / doi: 10.1097/MD.0000000000002877.
6. Ruf A, Dirchwolf M, Freeman RB. From Child-Pugh to MELD score and beyond: Taking a walk down memory lane. Ann Hepatol 2022; 27(1): 100535 / doi: 10.1016/j.aohep. 2021.100535.
7. Sanchez W, Talwalkar JA. Palliative care for patients with end-stage liver disease ineligible for liver transplantation. Gastroenterol Clin North Am 2006; 35(1): 201-219 / doi: 10.1016/ j.gtc.2005.12.007.
8. Walling AM, Wenger NS. Palliative care and end-stage liver disease. Clin Gastroenterol Hepatol. 2014; 12(4): 699-700 / doi: 10.1016/j.cgh.2013.11.010.
9. Larson AM. Palliative care for patients with end-stage liver disease. Curr Gastroenterol Rep 2015; 17(5): 440 / doi: 10.1007/s11894-015-0440-6.
10. Seraj SM, Campbell EJ, Argyropoulos SK, Wegermann K, Chung RT, Richter JM. Hospital readmis-sions in decompensated cirrhotics: Factors pointing toward a prevention strategy. World J Gastroen-terol 2017; 23(37): 6868-6876 / doi: 10.3748/wjg.v23. i37.6868.
11. Trifan A, Minea H, Rotaru A, et al. Predictive Factors for the Prognosis of Alcoholic Liver Cirrhosis. Medicina (Kaunas) 2022; 58(12): 1859 / doi: 10.3390/medicina58121859.
12. Reig M, Forner A, Rimola J, et al. BCLC strategy for prognosis prediction and treatment recommen-dation: The 2022 update. J Hepatol 2022; 76(3): 681-693 / doi: 10.1016/ j.jhep. 2021.11.018.
Published
2023-06-30