Xiao Zhang’s mother is already in the advanced stage of the tumor. She suffers from pain all over her body every day and it is very difficult to eat. At this time, even if she has an operation, she cannot cut the tumor clean. The doctor suggested that a smaller operation can be performed to help her relieve the pain, but at the same time she should also bear the risks brought by the operation.
Is it necessary to do this kind of operation?
Can the mother’s body still withstand these treatments?
Do you want to let nature take its course or try again for the last time? … …
Countless problems and possible results flashed in Xiao Zhang’s mind. He considered them over and over again, but he did not know what choice to make after all.
Many patients and their families with advanced tumors will face the same dilemma as Xiao Zhang. This [smaller operation] is called palliative operation in medicine. Is it necessary to do it? Who can decide whether to do it or not? Today, let’s discuss one thing or two.
Palliative surgery is what?
To understand this treatment, you can remember the following 3 points:
1. When the malignant tumor develops to [cannot be cut clean], palliative surgery can be tried;
2. It can help patients improve their quality of life, reduce pain and prolong their life to a certain extent.
3. This kind of treatment cannot achieve the goal of radical cure, but only accompanies the patient through the last leg of his life in a more soothing way.
Do you want palliative surgery?
In fact, whether palliative surgery should be performed or not is not only a unilateral decision of doctors, but also requires full communication between patients and their families.
In short, it is necessary to weigh the risks and effects of surgical treatment.
1. Can surgery solve the problem?
The first thing to consider is the actual situation of the patient. What is the current situation in what? Is it that serious? Can palliative surgery solve the problems existing in patients? Is it helpful to relieve symptoms and improve the quality of life? Can we prevent related complications that may occur in a short period of time?
2. Does the surgical effect meet the expectations of patients and their families?
Successful palliative surgery should meet the treatment expectations of patients and their families with minimum risks, so it must be considered whether the expected effect of surgery meets the expectations of patients and their families.
3. What is the risk of surgery?
In general, the physical condition of patients with advanced tumors is not very good. While considering the expected effect of surgery, the risks that any treatment operation may bring should also be evaluated. For example, can the patient still tolerate the trauma caused by surgery? What is the risk of complications (hemorrhage, infection, incision healing, etc.) caused by surgery? Do you need long-term hospitalization?
4. Are patients and their families willing to bear the risks of surgery?
Patients and their families should fully communicate with doctors, try their best to understand the expected effect of the operation, the doctor’s assurance of the success of the operation, the risk of complications, expenses, etc., and then decide whether to bear the risk.
5. It must be, willing to do it > can you do it?
In fact, for patients and their families, the most important thing is to think clearly whether the desired result is what, whether they want to prolong their life time or improve their quality of life through palliative surgery.
On the basis of conforming to the medical routine, the wishes of patients and their families are the key for doctors to consider whether to perform palliative surgery.
Although palliative surgery is not technically difficult, it is difficult for doctors to make such a decision. Because the result may be that no one benefits, but the patient will bear more pain and risks. At this time, whether it can be done or not is not important, and whether it is willing or not is the most important thing for patients and their families.
6. See a doctor nearby and receive treatment at ease.
Malignant tumor is a serious illness, and family members all hope that patients can get better treatment in 3A hospitals. However, for advanced tumor patients who can only undergo palliative surgery, they are usually in poor physical condition and may not be able to withstand the ordeal back and forth.
Besides, most palliative operations are not difficult and can be carried out in local hospitals, so that patients can receive treatment at ease and spend the last time of their lives in the place closest to their relatives.
What are the types of palliative surgery?
There are many kinds of palliative surgery. Here are a few examples to help you understand.
Step 1 Remove obstruction
Pelvic or abdominal tumors will compress the intestinal canal when they grow up, thus causing the intestinal canal to be blocked (just like a big stone suddenly popped up on the road), blocking the way of poop. An artificial anus can be built through palliative surgery, and poop will go out without worry.
Larger lumps in esophageal cancer will lead to esophageal stenosis or obstruction, making it more difficult for patients to swallow. It is much easier for patients to swallow by placing stents to help the esophagus expand again.
Step 2: Excision
If the tumor is very large or has undergone distant metastasis, although there is no way to completely cut all the tumors in the body, most of the tumors can still be removed to reduce the number of tumor cells, thus reducing the [erosion] of the disease on the body.
Breast cancer and some skin malignant tumors can cause skin ulceration and hemorrhage, which can also be alleviated or delayed by resection of tumors.
Step 3 Reduce pain
If the location of the tumor is just close to the sensory nerve, the tumor will stimulate and compress the nerve that transmits pain when it grows up, bringing intolerable and persistent pain to the patient. If such nerve is cut off by surgery, the patient will not suffer so much pain.
For osteosarcoma patients with distant metastasis, the unbearable pain caused by pathological fracture can also be relieved by amputation. Although painkillers can also be used, continuous administration or partial analgesic effect is not ideal.
Step 4 Draining effusion
A large amount of pleural effusion often occurs in the late stage of pleural mesothelioma, which accumulates in the thoracic cavity [presses] against the lungs, resulting in dyspnea of patients. Palliative surgery can reduce pleural effusion and make breathing smoother.
Advanced liver cancer complicated with liver cirrhosis and portal hypertension, abdominal cavity will have a large amount of ascites, leading to abdominal distension, etc. By putting a tube to drain ascites from abdominal cavity, symptoms can be alleviated.
For the question of whether to perform palliative surgery or not, it needs to be analyzed on a case-by-case basis and cannot be absolute. Patients and their families must make their own choices after full communication and consideration.
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