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女性癌症护理中的姑息治疗:全球挑战与进展。

Palliative care in women's cancer care: Global challenges and advances.

机构信息

Department of Obstetrics and Gynecology, University of Massachusetts, Worcester, MA, USA.

Department Obstetrics and Gynecology, University of Cape Town/Groote Schuur Hospital, Cape Town, South Africa.

出版信息

Int J Gynaecol Obstet. 2018 Oct;143 Suppl 2:153-158. doi: 10.1002/ijgo.12624.

Abstract

Women's cancer rates are increasing in low- and middle-income countries, with presentations that are often far advanced requiring intense symptom management, thus advancing the urgent need to address palliative care. Most resource settings have some options available to assist women with advanced gynecologic cancer, and a combination of leveraging these and expanding on emerging models for palliative care could lessen suffering and improve care for women with gynecologic cancers globally. Providing palliative care for women with cancer is constrained by resources (human and physical), lack of equipment, lack of access, and policy absence or barriers. There is important work to be done in advocating for appropriate infrastructure development and legislation to assure that these options are available to women and their families. Access to adequate opioid and other pain relief options for cancer-related pain is a particular concern given that availability, cost, and legislative prohibitions create barriers that cause suffering for patients and grief for their families who are unable to address their suffering. All of these require ongoing advocacy for continual advances to improve access and infrastructure for palliative care.

摘要

在中低收入国家,女性癌症发病率正在上升,其表现往往较为晚期,需要进行强化症状管理,因此迫切需要解决姑息治疗问题。大多数资源环境都有一些可供选择的方案来帮助晚期妇科癌症患者,利用这些方案并扩展姑息治疗的新兴模式,可以减轻全球妇科癌症患者的痛苦并改善其护理。为癌症女性提供姑息治疗受到资源(人力和物力)、设备缺乏、获取途径受限以及政策缺失或障碍的限制。需要做大量工作来倡导适当的基础设施发展和立法,以确保这些方案可供妇女及其家属使用。鉴于阿片类药物和其他缓解癌症相关疼痛的药物的供应、成本和立法限制会造成障碍,导致患者痛苦和其家属的悲伤,因此,需要特别关注癌症相关疼痛的充分阿片类药物和其他缓解疼痛药物的获取问题。所有这些都需要持续倡导,以不断改善姑息治疗的获取途径和基础设施。

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