Schmerztherapie und symptomkontrolle in der palliativmedizin

Efficacious pain therapy and good symptom control are the main challenges in the management of patients with advanced cancer, especially in the terminal phase. Pain is a prevalent symptom in cancer patients, affecting up to 90% of patients with advanced disease. Although adequate relief can be achieved in the majority of tumor patients following the guidelines of the World Health Organization, pain is often treated inadequately. According to the WHO analgesic stepladder, treatment should optimally consist of oral application at regular intervals. During their final phase, cancer patients experience distressing symptoms, e.g., constipation, nausea, vomiting, panic/anxiety, or dyspnea. Effective prophylaxis and cause-based therapy of these symptoms is of great importance in improving the quality of life of patients and their family members. Besides an appropriate medical treatment of pain and distressing symptoms skilled empathic communication addressing the psychosocial and spiritual problems of the patient with a short life expectancy can make a calm and peaceful dying possible.