Management of bowel obstruction in advanced cancer patients

Bowel obstruction is a common and distressing outcome in patients with abdominal or pelvic cancer. While surgery must remain the primary treatment for malignant obstruction, it is now recognized that there is a group of patients with advanced disease or poor general condition who are unfit for surgery and require alternative management to relieve distressing symptoms. A number of treatment options are now available for the patient with advanced cancer who develops intestinal obstruction. This review examines the indications for surgery, the use of nasogastric tube and percutaneous gastrostomy, and the place of drugs for symptom control.