title: [End-of-life dilemmas].
abstract: Cancer patients need continuous care from the time of diagnosis until the final phase of life. Comfort for the patients becomes the predominant goal as the disease progresses. Cancer patients often die with serious, unrelieved, symptoms that cause a distressing death and tremendous suffering for their families. Many physicians have not been trained to care for the dying patient. The symptoms associated with the dying process are so characteristic that all physicians should be able to recognise them, be skilled in providing appropriate care, and be prepared for problems that may arise. As the disease progresses, it may become necessary in some cases for the patient and his/ her family to consider sedation as an alternative to alertness accompanied by intolerable physical and existential disease. This article reviews the common symptoms in the final phase of life and describes the methods to manage the symptoms while supporting the patient and family through this difficult period.
authors.affiliation: Servicio de Oncología Médica, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Valentín Maganto
authors.forename: Maite
authors.initials: M
authors.lastname: Murillo González
mesh_terms: D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D001293:Attitude to Death; D003657:Decision Making / Q000941:ethics; D005260:Female; D006806:Human Rights; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007258:Informed Consent; D008297:Male; D018447:Medical Futility; D009369:Neoplasms / Q000401:mortality / Q000523:psychology / Q000628:therapy*; D010148:Intractable Pain / Q000188:drug therapy; D010166:Palliative Care; D013030:Spain / Q000453:epidemiology; D013315:Stress, Psychological / Q000188:drug therapy / Q000209:etiology; D013727:Terminal Care / Q000941:ethics / Q000331:legislation & jurisprudence / Q000379:methods / Q000523:psychology / Q000592:standards; D019452:Terminally Ill / Q000523:psychology; D028761:Withholding Treatment
chemical_list: D000700:Analgesics; D006993:Hypnotics and Sedatives