Program of palliative cancer care--our experience.

INTRODUCTION: Annually more than 27,000 persons die of cancer in the Czech Republic and the overall incidence of malignancies is still increasing. These data shows the need for affordable and good follow-up care especially for patients without any cancer treatment due to irreversible progression of tumor. Currently the outpatient palliative cancer care gets more into the forefront. Prerequisite for a well working outpatient palliative care is cooperation with general practitioners and home health care agencies. The purpose of the so called program of palliative cancer care is to guide a patient in palliative cancer care and to improve the cooperation among health care providers. METHODS: During the period from January 2008 to October 2010 we evaluated in patient without any oncology treatment due to irreversible progression of tumor. RESULTS: In palliative outpatient clinic we treated 446 patients, 119 of them received home care services with average length of 27.8 days. 77 patients died at home, 51 in health facilities and 41 in inpatient hospice care. CONCLUSION: We present pilot study focusing on outpatient palliative cancer care which shows the real benefit from early indication of palliative cancer care. This type of care allows patients to stay as long as possible at home among their close relatives.

Palliative care among elderly cancer patients: Own experience.

BACKGROUND: Annually, more than 27,000 persons die of cancer in the Czech Republic. It is known that in addition to the demographic aging of the Czech population, the cancer burden is increased. AIM: These data clearly demonstrate the need for affordable and good follow-up care for patients, especially for older patients and/or patients with no other cancer treatment due to irreversible progression of tumor. MATERIALS AND METHODS: We are talking about so-called palliative cancer care, which can be provided at different levels. One of the most common forms of palliative cancer care is hospice care. RESULTS: Our clinic in the years 2008-2010 received a total of 446 patients. 288 of them were women and 158 men. The average age of women was 61 years (age range 20-81 years). The average age of men was 56 years (age range 18-96 years). The performance status was in the fitness category PS-0 (8%), PS-1 (54%), PS-2 (33%) and PS-3 (5%). CONCLUSION: Currently the outpatient palliative cancer care are coming more into the forefront. This type of care allows patients to stay as long as possible at home among their close relatives. Prerequisite for a well working outpatient palliative care is cooperation with general practitioners and home health care agencies.

Quality of life and depression among metastatic breast cancer patients.

Depression is seen in many cancer patients. It is common in the general population and in adults and children with cancer and frequently coexists with anxiety and pain. The pilot study evaluated the level of the global quality of life (QoL) and the incidence and the relevance of the depression among metastatic breast cancer patients in a programme of palliative cancer care. The study is prospective and cross-sectional. Dates were obtained during year 2008 among 41 patients. The mean age of all 41 subjects was 58 years old (aged 41-80 years old). The Czech version of Zung self-rating depression scale was performed for the evaluation of the depression. The Czech version of generic European Quality of Life Questionnaire EQ-5D was performed for the evaluation of the level of global QoL. The statistical evaluation presents that mean ZSDS (Zung self-rating depression score) certifies the presence of the signs of the moderate depression among metastatic breast cancer patients (ZSDS range was 60-69). The incidence of the depression was 61% (25 of all 41 subjects). The relevance of the depression is characterized: the severe depression was proved in five of all 25 subjects, the moderate depression in 10 of all 25 subjects, and the mild depression in 10 of all 25 subjects. The global QoL among metastatic breast cancer patients is on very low level. The mean EQ-5D score (dimension of QoL) was 55%. The mean EQ-5D VAS (subjective health status) was 59.2%. The results showed that subsist association between metastatic breast cancer, depression, and the low level of the global QoL.