42 cuidados paliativos em onco

  • 475 views
Uploaded on

 

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
    Be the first to like this
No Downloads

Views

Total Views
475
On Slideshare
0
From Embeds
0
Number of Embeds
1

Actions

Shares
Downloads
20
Comments
0
Likes
0

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide
  • The next four slides look at the lifetime probability of developing cancer and relative survival rates of cancer.   Presently, the risk of an American man developing cancer over his lifetime is one in two. The leading cancer sites are prostate, lung, and colon and rectum.
  • Approximately one in three women in the United States will develop cancer over her lifetime. The leading sites are breast, lung, and colon and rectum.
  • Cancer accounts for nearly one-quarter of deaths in the United States, exceeded only by heart diseases. In 2006, there were 559,888 cancer deaths in the US.
  • Compared to the peak rate of 215.1 per 100,000 in 1991, the cancer death rate decreased 16% to 180.7 in 2006. Rates for other major chronic diseases decreased substantially during this period.
  • Não há consenso, mas alguns autores dizem que o tempo minimo de CP para ter uma boa eficácia é de pelo menos 2 meses
  • 10 mil pacientes em vários hospitais nos EUA

Transcript

  • 1. Distribuição das taxas de incidência de todas as Neoplasias (C00-C96 exceto pele),ajustadas por idade*, segundo o RCBP e período de referência dos dados.
  • 2. Lifetime Probability of Developing Cancer, Men, 2003-2005* Site Risk All sites† 1 in 2 Prostate 1 in 6 Lung and bronchus 1 in 13 Colon and rectum 1 in 18 Urinary bladder‡ 1 in 27 Melanoma§ 1 in 39 Non-Hodgkin lymphoma 1 in 45 Kidney 1 in 57 Leukemia 1 in 67 Oral Cavity 1 in 72 Stomach 1 in 90* For those free of cancer at beginning of age interval.† All Sites exclude basal and squamous cell skin cancers and in situ cancers except urinary bladder.‡ Includes invasive and in situ cancer cases§ Statistic for white men.Source: DevCan: Probability of Developing or Dying of Cancer Software, Version 6.3.0 Statistical Research andApplications Branch, NCI, 2008. http://srab.cancer.gov/devcan
  • 3. Lifetime Probability of Developing Cancer, Women, US, 2003-2005* Site Risk All sites† 1 in 3 Breast 1 in 8 Lung & bronchus 1 in 16 Colon & rectum 1 in 20 Uterine corpus 1 in 40 Non-Hodgkin lymphoma 1 in 53 Urinary bladder‡ 1 in 84 Melanoma§ 1 in 58 Ovary 1 in 72 Pancreas 1 in 75 Uterine cervix 1 in 145* For those free of cancer at beginning of age interval.† All Sites exclude basal and squamous cell skin cancers and in situ cancers except urinary bladder.‡ Includes invasive and in situ cancer cases§ Statistic for white women.Source: DevCan: Probability of Developing or Dying of Cancer Software, Version 6.3.0 Statistical Research andApplications Branch, NCI, 2008. http://srab.cancer.gov/devcan
  • 4. US Mortality, 2006 No. of % of all Rank Cause of Death deaths deaths • 1. Heart Diseases 631,636 26.0 • • 2. Cancer 559,888 23.1 • 3. Cerebrovascular diseases 137,119 5.7 • • 4. Chronic lower respiratory diseases 124,583 5.1 • • 5. Accidents (unintentional injuries) 121,599 5.0 • • 6. Diabetes mellitus 72,449 3.0 • • 7. Alzheimer disease 72,432 3.0 • • 8. Influenza & pneumonia 56,326 2.3 • 9. Nephritis* 45,344 1.9 • 10. Septicemia 34,234 1.4*Includes nephrotic syndrome and nephrosis.Source: US Mortality Data 2006, National Center for Health Statistics, Centers for Disease Control and Prevention,2009.
  • 5. Change in US Death Rates* from 1991 to 2006 Rate Per 100,000400 1991 313,0300 2006 215,1 200,2200 180,7100 63,3 43,6 34,8 17,8 0 Heart diseases Cerebrovascular Influenza & Cancer diseases pneumonia* Age-adjusted to 2000 US standard population.Sources: US Mortality Data, National Center for Health Statistics, Centers for Disease Control andPrevention, 2009.
  • 6. • Assistente Social• Enfermagem durante a II guerra• Medicina aos 33• O conceito da dor total "We have to concern ourselves with the quality of life as well as its length,"
  • 7. COMPORTAMENTO DOLOROSOSOFRIMENTO DOR NOCICEPÇÃO
  • 8. • Pacientes com alto risco de morte• Objetivo: – Melhorar a capacidade de decisão em casos terminais e reduzir a freqüência: - suporte mecânico, - dor, - prolongamento do processo do morrer (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment) JAMA 274, 1995
  • 9. • Os médicos não estão atentos aos desejos de seus pacientes de não-ressuscitar em 53% dos casos.• Metade dos pacientes passam uma ou mais semanas no CTI em coma ou com respirador.• 50% dos pacientes sofrem de dores moderadas a severas durante os seus 3 últimos dias.• 31% das famílias perdem toda ou a maior parte de suas economias durante essa fase.
  • 10. • O sistema não sabe quando ou como parar.• Prognóstico – nós, geralmente, não sabemos até que seja muito tarde: – Quando uma doença é fatal, – Quando alguém está morrendo,• É muito freqüente morrermos sós, com dor e ligados a máquinas.
  • 11. Novo Conceito de Cuidado Paliativo: Adaptação de Lynn and Adamson, 2003 Modelo Antigo Modelo Atual
  • 12. “No doente oncológico em fase final mais vale dar vida aos dias que dias à vida” Raul Marchezani – 1953 Araras - SP