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Palliating delirium in patients with cancer
Augusto Caraceni1, Fabio Simonetti
1Palliative Care (Pain Therapy, Rehabilitation), Fondazione IRCCS, National Cancer Institute, Milan, Italy. augusto.caraceni@istitutotumori.mi.it
The Lancet. Oncology
|February 3, 2009
Summary
Delirium, a common issue in cancer patients, involves consciousness, attention, and cognition changes. Early screening for causes and palliative care, including haloperidol, are key for managing this complication.
Area of Science:
- Oncology
- Geriatrics
- Neuroscience
Background:
- Delirium frequently complicates the course of cancer treatment.
- Understanding delirium as a disorder of consciousness, attention, and cognition provides a framework for its pathophysiology.
- Multiple etiological factors and their interactions contribute to delirium in cancer patients.
Purpose of the Study:
- To provide a framework for understanding the pathophysiology of delirium in oncology.
- To interpret the roles of various etiological factors and therapeutic interventions.
- To emphasize the importance of screening for reversible causes and palliative care.
Main Methods:
- Literature review and synthesis of existing knowledge on delirium in oncology.
- Analysis of etiological factors, risk factors, and predisposing conditions.
- Evaluation of current therapeutic strategies, including pharmacological and non-pharmacological approaches.
Main Results:
- Delirium is characterized by disturbances in consciousness, attention, and cognition.
- A multifactorial etiology involving risk and predisposing factors is common.
- Screening for reversible causes is mandatory for effective management.
- Palliative treatment includes non-pharmacological interventions and haloperidol; sedation may be required if haloperidol is ineffective.
Conclusions:
- A comprehensive approach to delirium in oncology requires identifying and addressing etiological factors.
- Palliative care strategies, including medication and environmental modifications, are crucial.
- The impact of delirium on patients and their families necessitates integrated care planning.
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