Pancreatic ca

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  • Pancreatic ca

    1. 1. Taming the symptoms of pancreatic cancerSuzana Makowski, MDPain & Palliative Care
    2. 2. Goals• What are your goals for todays talk?• Pain and other physical symptoms• Psychological, spiritual, and social concerns• Where to turn?
    3. 3. Managing Pain• It is common• Barriers to treatment are many• What can you do? • Keep track of your pain and use of medicines • Work with your doctor, nurse, and pharmacist - team approach • Address your worries
    4. 4. What doctors need toknow about your Pain• Location• Intensity: how bad is it?• Quality: what does it feel like?• Timeline• What makes it better/worse • What have you tried, were there side effects...
    5. 5. Understanding PainManagement Definitions: • Adjuvant: helps the other meds work better. • Non-opioid: acetaminophen (Tylenol) ibuprofen or naprosen • Opioid: morphine, oxycodone, fentanyl, hydromorphone (Dilaudid), methadone
    6. 6. Opioids• Addiction versus dependence versus tolerance• Long-acting and short-acting (immediate release)• Pill/liquid versus IV• Side effects: • constipation - doesnt go away • Sleepiness, nausea • Less common: confusion, twitching (myoclonus)
    7. 7. Other treatments for pain
    8. 8. Pain - other treatments• Radiation therapy• ERCP• Interventional pain (anesthesia) • Nerve blocks: celiac plexus • Intraspinal medicine/pumps• Non-pharmacologic • Physical therapy, including TENS, compresses • Psychological/behavioral therapy • Complementary or alternative therapy
    9. 9. Gastrointestinal symptoms• Nausea• Vomiting• Anorexia (loss of appetite) • Megace • Dexamethasone • Small, frequent meals, plastic/wooden utensils• Constipation • Senna & colace • Yakima paste
    10. 10. Gastrointestinal symptoms• Nausea and vomiting • causes: constipation, medications, compression of intestinal tract. • treatment: “bowel regimen” for constipation, medications, procedure (stent) or surgery (bypass, or ostomy). • Sometimes a temporary tube may help relieve symptoms.
    11. 11. Weakness and fatigue• Let your doctor know• How are you sleeping?• There are many causes and treatment is targeted when possible • Anemia • Insomnia • Anxiety, depression, stress • Other...
    12. 12. Psychological symptoms• Anxiety, fear, uncertainty• Depression, sadness, grief• Concern for family and future• Dignity• Resilience and hope
    13. 13. Your team• Doctors, nurse practitioners• Nurses• Social worker• Psychologist• Family, friends, chaplains• When you need more help: palliative care
    14. 14. What is palliative care?• Treatment that focuses on alleviating suffering, improving sense of well-being• It is available at all stages of illness• It can be offered alone or during other therapies/treatment in the hospital, and sometimes at home or in a clinic• It is a team approach - lending support to patients and their family• Options in home care support: visiting nurses (bridge or choices program) and home care through hospice
    15. 15. Other resources• The Center for Mindfulness• www.cancer-pain.org• www.getpalliativecare.org• www.betterendings.org
    16. 16. Summary• Work with your team... Were here to help• Treat and identify symptoms early: • pain, fatigue, GI symptoms, psychological concerns Youre not alone We want to help We can help
    17. 17. Thank youQuestions?

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