The Case: Mr. M’s Treatment

The Case: Mr. M’s Treatment

  1. Pain - this is a priority and needs to be evaluated and addressed promptly
  2. Nausea - a common symptom in advanced cancer, may be a result of underlying disease, pain, constipation, medication side effect, pain, or other cause; may be impacting quality of life significantly.
  3. Agitation/Anger - important to recognize and acknowledge, may be manifestation of depression, anxiety, but It is most important to evaluate and address his pain (and nausea) first since these may be major determinants of his emotional state.
  4. Stage of pancreatic cancer and treatment options - re-staging may be useful to guide goals of care and further treatment options, but not as urgent as evaluation and treatment of pain and other symptoms.
  5. Anorexia/ weight loss - may be secondary to underlying disease or to pain, nausea or mood disturbance; not an immediately pressing concern.
  6. Loose stool - may require work-up with likely differential including infection, malabsorption from pancreatic insufficiency, medication side effect, and paradoxical loose stool from constipation/obstipation.

References

  1. Fast Fact and Concept # 059 Dealing with the Angry Dying Patient
  2. Fast Fact and Concept #203 - Managing One’s Emotions as a Clinician