• Journal of Hospice and Palliative Care
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• v.2 no.2
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• pp.138-143
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• 1999

Accurately estimating survival times in terminal cancer patients is very difficult for palliative care clinicians. But a reasonably accurate estimate of survival would permit the medical team to : Plan the ideal therapeutic strategy between overtreatment and too early discontinuation of specific therapy. Answer any questions asked by the patient or family. Organize adequate assistance for the patient concerned. Decide on the eligibility of the patient for clinical trials and whether to begin a treatment, the effects of which will not be immediate. This case was a 79 year-old male patient with colon cancer. He complained of dry mouth, anorexia, weight loss and showed KPS $40{\sim}50$ on admission day. 40 days later he died. To improve patient/family quality of life, it is necessary to improve the ability to estimate accurately a patient's length of survival.

• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.52-56
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• 2005

Herpes zoster (HZ) is an acute infection of the unilateral sensory dermatome caused by varicella-zoster virus (VZV) and is characterized by vesicular eruption and unilateral pain along the involved dermatome. Although the pathogenesis of HZ is incompletely understood, it is thought that when cell-mediated immunity falls below a critical level, dormant VZV within cells of the sensory ganglia are allowed to replicate and infect the host with the resultant clinical presentation of HZ. It has been associated with immunosuppressed states, such as advanced age, leukemia, lymphoma, chemotherapy and/or radiation treatment. We present a case of a 62-year-old female patient with malignant lymphoma suffering herpes zoster ophthalmicus who did not respond to conventional treatment, and in whom the application of various nerve blocks and patient-controlled analgesia produced moderate pain relief. The patient died twenty days later due to cardiopulmonary failure.

• Journal of Hospice and Palliative Care
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• v.15 no.3
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• pp.141-146
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• 2012

Over the past several decades, the assessment of quality of life (QoL) has increasingly played a prominent role in both clinical practice and research regardless of the medical field. Palliative care is defined as an approach that improves the QoL of patients and their families and optimizing their QoL is the primary goal of palliative care. However, it is difficult to compare related studies due to several obstacles such as discrepancies in definitions for palliative medicine, lack of consensus on the central domains and diverse instruments. In this paper, we examined the current status of and challenges in QoL studies and discussed possible solutions. We are convinced this review will be helpful for further palliative care studies.

• Journal of Hospice and Palliative Care
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• v.12 no.1
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• pp.1-4
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• 2009

The aim of palliative radiotherapy (RT) is to control cancer-related local symptoms with minimal radiation reaction. About one third of all radiation treatments are given with palliative intent. Indications for RT in symptom palliation are as follows: Pain from bone metastasis, pressure symptom from brain and spinal cord, obstruction of bronchus, esophagus, superior vena cava and malignant cancer bleeding from bronchus, urinary tract, uterine cervix and rectum. In hospice palliative care, RT is very effective for symptom palliation and improvement of quality of life without influence on survival.

• Journal of Hospice and Palliative Care
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• v.19 no.3
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• pp.256-261
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• 2016

Radiation therapy is an effective modality to alleviate cancer-related symptoms. To deliver radiation accurately, it is essential to secure stability of the treatment position in patients during each treatment time. However, some patients could be less cooperative due to their psychoemotional issues. We present two cases of terminal-stage cancer patients who were initially unable to lie still on the treatment table before simulation. A relaxation technique was taught to them on the bed, and they could relax and undergo radiation therapy with effective symptom relief.

• Journal of Hospice and Palliative Care
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• v.21 no.3
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• pp.104-107
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• 2018

While most benign hiccups can be controlled with empirical therapy, intractable hiccups lasting longer than one month tend to have significant adverse effects with obscure etiology. Treatment strategies for intractable hiccups have not been established. Only a few sporadic cases of bilateral phrenic nerve blockage have been reported. Here, we report a case of intractable hiccups that lasted five weeks in a 56-year-old male patient with a lung cancer above the right diaphragm. We hypothesized that his intractable hiccups were caused by irritation and mass effect caused by the lung cancer. We performed an ultrasound-guided right unilateral phrenic nerve pulsed radiofrequency treatment, and the patient's intractable hiccups were successfully managed without complication.

• Journal of Hospice and Palliative Care
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• v.12 no.2
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• pp.49-55
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• 2009

Self expandable metal stent (stent) implantation of upper gastrointestinal (UGI) tract is now widely accepted for the palliation of obstructive symptoms caused by inoperable malignant UGI obstruction. With the technical progress and accumulation of clinical experiences, it became possible to perform the procedure easily, safely and effectively. However, clinicians should pay attention to the post-procedural care, because early or late complications such as ulceration, pain, bleeding, food impaction, perforation, migration or in-stent tumor growth could occur. In this review, several topics about stent placement in the UGI tract are discussed, such as major indications for stenting, kinds of stents, and post-procedural management.

• Journal of Hospice and Palliative Care
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• v.6 no.1
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• pp.58-64
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• 2003

Cancer is a life crisis which inflicts major psychological and physical trauma upon the victim. Most of the cancer patients suffer from major depression, profound frustration, and impaired social adjustment. Therefore suicidal ideation and suicidal attempt are also becoming a serious threat to cancer patients and their families. Hospice is patient-centered, and accepts the inevitability of 'death' while simultaneously being life-affirming. Even though there is no chance of physical cure, there is much scope for psychosocial and spiritual healing. Most of cancer patients who commit suicide suffer hem many mental problems. Hospice specialists must play an important role in evaluating and managing emotional or behavioral problems associated with suicidal ideatior and are also are expected to serve as informed commentators regarding suicide. It is crucial that hospice specialists define their role and develop clinical skills to intervene in suicidal event effectively. A systematic approach to suicidal cancer patients is a essential, and there is need for specific training for all hospice professionals. In this case report, the author introduced knowledge and clinical guidelines for a desirable approach to suicidal cancer patient.

• The Korean Journal of Health Service Management
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• v.13 no.4
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• pp.163-177
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• 2019

Objectives: The purpose of this study was to identify the predictors of quality of life (QOL) for terminal cancer patients admitted into the community health center, and to establish a hypothetical model to explain and verify causative relationships among the variables. Methods: Data were collected from January 2015 to June 2016. Participants were 237 registered patients in Busan Metropolitan City hospice & palliative care center. The descriptive and correlation statistics were analyzed using the SPSS/WIN 24.0, and the structural equation modeling procedure was performed using the AMOS 24.0 program. Results: The results of this study showed that the physical symptoms of terminal cancer patients were the most direct factors affecting the QOL, and satisfaction with health care services has a direct effect on the QOL. Conclusions: The study contributes to drawing up measures to improve QOL for terminally ill cancer patients who are living in the end-of-life section of the community by revealing the causal relationship to the QOL for terminal cancer patients.

• Journal of Hospice and Palliative Care
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• v.18 no.3
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• pp.179-187
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• 2015

For patients who are near the end of life, an inevitable step is discussion of a do-not-resuscitate (DNR) order, which involves patients, their family members and physicians. To discuss DNR orders, patients and family members should know the meaning of the order and cardiopulmonary resuscitation (CPR) which includes chest compression, defibrillation, medication to restart the heart, artificial ventilation, and tube insertion in the respiratory tract. And the following issues should be considered as well: patients' and their families' autonomy, futility of treatment, and the right for death with dignity. Terminal cancer patients should be informed of what futility of treatment is, such as a low survival rate of CPR, unacceptable quality of life after CPR, and an irremediable disease status. In Korea, two different law suits related to life supporting treatments had been filed, which in turn raised public interest in death with dignity. Since the 1980s, knowledge of and attitude toward DNR among physicians and the public have been improved. However, most patients are still alienated from the decision making process, and the decision is often made less than a week before death. Thus, the DNR discussion process should be improved. Early palliative care should be adopted more widely.