• Journal of Hospice and Palliative Care
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• v.16 no.4
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• pp.205-215
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• 2013

Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1972.03a
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• pp.2.3-2
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• 1972

The vestibular function test reveals the objective findings of the impairment of the vestibular labyrinth. It's purpose is based on the analysis of the findings and detect the location and etiology of the labyrinthine impairment. In the vestibular function test, the vestibulo-spinal reflex has the clinical significance upon the tonus of the striated muscles by the labyrithine stimulation and contribute to regulating the posture and the position, at rest as well as in motion. The vestibulo-spinal reflex must performe as one of the routine vestivular function test because it can be evoked in man by such weak stimuli to the labyrinth as cannot induce vestibulo-ocular reflex. Authors performed the vestibular function test such as one leg test, gait test, stepping test and vertical writing test to one hundred of healthy and young male adult and received the following results. Results 1. One leg test: In 30 seconds, the frequency of dropping the leg on the ground was between 0 to 3 times in Rt., and 0 to 5 times in Lt. The mean frequency was 0.48 times in Rt., and 0.68 times in Lt. 2. Gait test: In forward gait; the range of the deviation was distributed 0 to 100 cm and mean range was 22.5cm to the Rt., 26.1cm to the Lt. In backward gait; the range deviation was distributed 0 to 140cm and mean range was 35.4cm to the Rt., 33.0cm to the Lt. 3. Stepping test: In normal head position; forward movement war 93% and backward 5%. The angle of displacement deviated to the Rt. side in 36%, and Lt. in 50%. The angle of rotation deviated to the Rt. side in 53 %, and Lt. in 36%. The mean values: angle of displacement was 22.05 degrees, angle of rotation was 24.40 degrees, distance of displacement was 48.95cm. In backward head position; Forward movement was 94% and backward was 3%. The angle of displacement deviated in 34%, and Rt. in 55%, to the Rt. side The angle of rotation deviated to the Rt. side in 50%, and Lt. in 42%. The mean values; angle of displacement was 29.72 degrees, angle of rotation was 39.53 degrees, distance of displacement was 44.17cm. 44.17cm. 4. Vertical writing test: The angle of deviation was between 0 to 16 degrees in all cases, and was between 0 to 12 degrees in the cases of normal head position. The mean angle of deviation was between 4.15 to 5.76 degrees on each side. The direction of deviation to the Rt. side was 54~69%, Lt. was 25~40% and 3~7% was vertical without deviation.