Christopher J. Pietras, MD
There are not many randomized placebo-controlled trials investigating the use of ketamine as a palliative agent in ovarian cancer, but Christopher J. Pietras, MD, said that it can be considered in certain patients with difficult-to-treat pain symptoms. This adds to the overall message that palliative care agents should be tailored depending on patients’ symptoms.
State of the Science Summit™ on Ovarian Cancer, Pietras, who is the director, Palliative Care and assistant clinical professor, University of California, Los Angeles School of Medicine, discussed the elements of palliative care for patients with ovarian cancer.
OncLive: What did you discuss in your presentation on palliative care in ovarian cancer?
: I covered end-of-life discussions and their associations with the quality of medical care, as well as their effects on caregivers and family members. Secondly, I focused on difficult-to-control symptoms and the use of ketamine for those symptoms in patients with advanced cancer. Thirdly, I spoke about the importance of treating constipation, which is a common symptom. I also discussed the use of docusate sodium for patients near the end of their lives.
What are the elements of palliative care?
Palliative care is specialized interdisciplinary care that is focused on improving the quality of life (QOL) of patients and their families. Palliative care also provides support and direction in the setting of complex medical decision making.
What medications are used to manage difficult-to-control symptoms?
For severe pain, first-line agents include opioid medications, such as morphine. If those are ineffective, other types of medications are added. Different possibilities include gabapentin and tricyclic antidepressants such as nortriptyline or amitriptyline. [These agents can be used] for neuropathic-like pain that may result from a cancer that may be touching a nerve.
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