Indications and practice of artificial hydration for terminally ill cancer patients

To update medical professionals on the role of artificial hydration in terminally ill cancer patients and to highlight recent research.

First, we explain dehydration-related symptoms such as sensation of thirst, fatigue, and delirium. A multicenter, double-blinded, placebo-controlled randomized trial showed that artificial hydration did not improve dehydration symptoms, quality of life, or survival in terminally ill cancer patients. Then we explain overhydration-related symptoms such as bronchial secretion, pleural effusion, nausea/vomiting, ascites, and peripheral edema.The establishment of clinical guidelines can contribute to patient well-being by clarifying the best practice recommended from empirical evidence and expert experience available. Among them, we summarize a Japanese guideline for artificial hydration therapy for terminally ill cancer patients, which is evidence based, and address specific clinical questions.

The determinants of the quality of life, dying, and death vary among individuals, and individuality is essential to define what is important for each patient. Clinicians need to make a decision based on the perceived benefits and harms of artificial hydration therapy in individual patient circumstances. Further researches with appropriately powered studies are required to determine which subgroups would benefit from artificial hydration therapy.

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