Palliative needs and illness trajectory associated with metastatic upper gastrointestinal cancer

Patients suffering from metastatic upper gastrointestinal cancer are burdened by physical, social, existential and psychological problems, though documentation of these problems may be insufficient. In Denmark, basic palliative care is fragmented and characterised by quality differences. This challenges cohesive palliative care interventions as patients experience transitions in the course of illness. The aim of this study was to identify and present the illness trajectory and to investigate the documentation of palliative needs for patients with metastatic upper gastrointestinal cancer.

Data on the documented palliative needs and on transitions were retrospectively collected from the electronic medical records at a surgical ward at Herlev-Gentofte Hospital during a six-month period in 2019. Descriptive statistics were used to present the palliative care needs.

Pain and nausea/vomiting were documented in 62%, constipation in 35% and fatigue in 43% of the 63 patients included. Psychological, existential and social symptoms were sparsely documented. Several patients (41%) had more than one admittance to the surgical ward, 62% were treated in the oncology department and 35% received specialised palliative care.

The frequent transitions during the disease trajectory and the need to direct attention towards all four domains of palliative care should compel health professionals to adopt a systematic approach when identifying and treating their patients' palliative needs.

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