title: Palliative care.
abstract: Though many of the treatment strategies used in palliative care have never been subjected to clinical trial, it has been argued that advances in palliative care have outstripped those in many other specialties. This article is not a comprehensive review of therapeutic options, nor even of recent advances in this topic, but concentrates on the latest developments and controversies in the pharmacological treatment of four frequent and important symptoms: neuropathic pain, anorexia and cachexia, intestinal obstruction, and breathlessness. It is difficult to perform blinded, randomised trials in patients with advanced disease and poor performance status, yet it is these patients who may gain most from the adoption of new well evaluated treatment strategies.
authors.affiliation: Royal Marsden Hospital, Sutton, Surrey.
authors.forename: C L
authors.initials: CL
authors.lastname: Davis
authors.forename: J R
authors.initials: JR
authors.lastname: Hardy
mesh_terms: D000855:Anorexia / Q000188:drug therapy / Q000209:etiology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002100:Cachexia / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007415:Intestinal Obstruction / Q000628:therapy; D009022:Morphine Derivatives / Q000627:therapeutic use; D009369:Neoplasms / Q000150:complications / Q000503:physiopathology*; D010146:Pain / Q000188:drug therapy; D010166:Palliative Care / Q000379:methods*; D012120:Respiration Disorders / Q000188:drug therapy / Q000209:etiology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D009022:Morphine Derivatives; C035349:morphine-6-glucuronide