Published 29 July 2008, doi:10.1136/bmj.39563.581377.80
Cite this as: BMJ 2008;337:a428

Practice

Lesson of the Week

Life saving treatment for a "palliative care" patient

Jane Gibbins, specialist registrar and clinical research fellow, Gaye Senior Smith, clinical nurse specialist, Karen Forbes, consultant and macmillan professorial teaching fellow

1 Department of Palliative Medicine, Bristol Haematology and Oncology Centre, Bristol BS2 8ED

Correspondence to: J Gibbins janegibbins@hotmail.com

A "palliative care" label should not prevent life saving treatment for an illness with reversible cause

The first 150 words of the full text of this article appear below.

The word palliative is used in different ways in different contexts. Lack of clarity about its meaning can lead to confusion about the role of palliative care teams and the appropriateness of active management in a patient’s care.

A 60 year old woman was diagnosed with a rare haemangioendothelioma of the lung with liver, bone, and lung metastases in April 2004. She was referred to the outpatient clinic run by our specialist hospital palliative care team in December 2006 by her respiratory physician. Although she was extremely independent, she had severe right upper quadrant pain, which was consistent with liver capsular distension secondary to liver metastases. She had tried non-steroidal anti-inflammatory drugs and steroids with no effect. Her pain responded to opioids. Her morphine was increased, and pain was controlled by 550 mg modified release morphine twice daily, with no opioid side effects.

She remained stable with no changes in . . . [Full text of this article]


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