Clinical Gastroenterology Vol.19 No.1(4)

Theme Palliative Medicine for Patients with Gastrointestinal Cancer
Title Gear Change for Patients with Advanced Gastrointestinal Cancer
Publish Date 2004/01
Author Shin-ya Okamoto Department of Palliative Care, Sekisinkai Sayama Hospital
[ Summary ] A "gear change" means a conversion to palliative care from medical treatment for a cure. Most patients with advanced gastrointestinal cancer are incurable. Although the main treatment is chemotherapy, physicans should discern the limits of treatment and pay attention to see that "gear changes" for patients are done smoothly. In order to achive this "gear change" the important points are (1) judgments on the adaptation of chemotherapie. judgment of the time to stop chemotherapy (2) method of making the "gear change" (diagnosis of treatment that has been used, and how to break the bad news. Decisions on the "gear change" should be made with patient leadership. Change of location for medical treatment and "gear change" are different aspects of this change piece.), (3) selection of a future place for the medical treatment after the gear change is necessary.
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