9.3 The role of general surgery in the palliative care of patients with cancer
While there have been dramatic advances leading to increased survival for oncology patients, many individuals with cancer will ultimately succumb to their disease. Therefore, palliation is increasingly becoming recognized as an important component of care of the cancer patient. This includes general surgeons, who have long played a critical role in curative attempts in oncology patients, but now are increasingly recognized as important contributors in the palliative care of patients with cancer. This has been aided through advances in technology, improved surgical techniques, and a greater knowledge of the disease and its effects on anatomy and physiology. Thus, surgical procedures have become accepted as an important and common component of the comprehensive palliative care of patients with advanced cancer. In fact, in one review at a cancer centre, it was noted that 12.5 per cent of cases were done with a palliative intent( 1 ). Additionally, in a survey of cancer surgeons, it was estimated that 21 per cent of all surgical procedures for cancer patients are for palliation( 2 ).
The role of the surgeon is multifactoral in the treatment of palliative issues. The diverse indications for palliative procedures include hormonal imbalance, malignant fluid re-accumulation, obstructions, tumour bleeding or other local complications, and pain( 3 ). The general surgeon may participate in the care of the advanced cancer patient to improve the quality of life (QOL) related to each of these indications, which may be due to the many various primary or metastatic cancers.
