Evaluation and management of treatment-related diarrhea in patients with advanced cancer: a review.
Diarrhea is a common and significant problem among patients with advanced cancer. Treatment-induced diarrhea can be severe and be associated with life-threatening dehydration and electrolyte abnormalities. The causes of diarrhea among patients with advanced cancer are diverse and some causes of diarrhea require specific therapies. Thus, careful evaluation of the underlying cause is necessary. Palliative care clinicians, particularly those dealing with patients receiving ongoing disease-modifying therapies, must be familiar with the common causes of diarrhea among cancer patients and the strategies to evaluate and manage these common and distressing symptoms. This article addresses four major issues: 1) a review of the causes of treatment-related diarrhea, focusing on diarrhea caused by chemotherapy, targeted therapies, and radiotherapy; 2) differential diagnosis and an approach to evaluation; 3) general management considerations; and 4) cause-specific issues in management.
Cherny
Nathan I
NI
Cancer Pain and Palliative Medicine Service, Department of Oncology, Shaare Zedek Medical Center, Jerusalem, Israel. chernyn@netvision.net.il
D000930:Antidiarrheals / Q000627:therapeutic use*; D003967:Diarrhea / Q000175:diagnosis / Q000209:etiology* / Q000534:rehabilitation*; D006801:Humans; D009369:Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010166:Palliative Care / Q000379:methods*; D013727:Terminal Care / Q000379:methods*; D016896:Treatment Outcome
D000930:Antidiarrheals