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Liver cancer with left lung metastasis. Guide about palliative care and nutritional support through IV.

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General & Family Physician
Practicing since : 2010
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Question
My father is suffering from liver cancer with left lung metastasis. Pse guide about palliative care and nutritional support through IV.
Posted Wed, 30 Oct 2013 in Cancer
 
 
Answered by Dr. Manjeth Kumar G 4 hours later
Brief Answer:
Multi-disciplinary approach is required for palliative care

Detailed Answer:
Hello,
Welcome to XXXXXXX

The First Step in Palliative care is to consult your treating oncologist regarding the status of your father's health and prognosis of the cancer.
Hospitals, cancer centers, and long-term care facilities provide palliative care.
Your father may also receive it at home.
Then you have to make a supporting team consisting of your treating doctor, pain management physician, psychologist, nurse, dietitian, pharmacist, and helper.
All of the members in team is essential to manage his health and sufferings.
For example. psychologist will be helpful in receiving his stress . Nurse will be useful in taking care of his daily activities and drug dosing at appropriate time.
Addressing of emotional, anxiety and depressive problems are very essential in palliative care.
Remember one thing, Palliative care is an additional care support him and improve his quality of life.
It does not replace his usual cancer treatment.

As far as nutrional support through IV is concerned, Total Parenteral Nutrition (TPN) can be used.
It supplies the essential nutrients like glucose, minerals, vitamins etc.. to the body.
Your father should be assessed i before commencing on parenteral nutrition, and a team consisting of Treating doctor, nurses, pharmacists and Dietitians ( members in palliative care team )evaluate the patient's individual data and decide what Parenteral Nutrition formula to use and at what infusion rate.

Your treating doctor may know all about this. Consult with him regarding palliative care management.

Hope this helps.
Please reply for query.
Wishing your father good health.
Above answer was peer-reviewed by
 
Follow-up: Liver cancer with left lung metastasis. Guide about palliative care and nutritional support through IV. 2 days later
Thanks for the reply. Sometimes he feels severe abdominal pain, what can be reason for this and which category of painkillers will be useful. Is meganeuron injection helpful?
 
 
Answered by Dr. Manjeth Kumar G 5 hours later
Brief Answer:
Narcotics like oxycodone.

Detailed Answer:
Hello,
Welcome,

Severe abdominal pain may be relieved by Tramadol or other narcotic injections.

Narcotics like oxycodone or tramadol are usually used in palliative care.

Meganeuron contains Mecobalamin. It is used for peripheral neuropathy and other nerve pains.

Hope this helps.
Please reply for further queries.
Wishing your father good health.
Above answer was peer-reviewed by
 
Follow-up: Liver cancer with left lung metastasis. Guide about palliative care and nutritional support through IV. 3 days later
His abdomen is swollen and tight due to ascites. Pse guide about treatment of ascites.
 
 
Answered by Dr. Manjeth Kumar G 4 hours later
Brief Answer:
Ascitic drainage, diuretics, low salt diet.

Detailed Answer:
Hello,

Thanks for your query.
In order to relieve symptoms of ascites, the treatment of ascites involves slowing the build-up of the fluid and putting a tube into the abdomen to drain it.
The procedure is known as paracentesis.

The doctor will make a very small cut in the skin of the abdomen and inserts a thin tube called a cannula, which is then attached to a drainage bag.

The ascitic fluid drains out of the abdomen and will collect inside the drainage bag.
The cannula may be held in place with a couple of stitches and covered with a dressing.

A few liters (up to 4 to 5 liters) of fluid would be removed safely by this procedure each time.
The catheter can also be used to drain fluid from the abdomen and may be left in place for several weeks. It depends upon the frequency of ascitic fluid build up.

Problems with Paracentesis:
1. Sudden release of pressure in the abdomen can cause a drop in blood pressure.
2. The ascitic drain can become blocked.
3. The drain can sometimes become infected.
The combination of spironolactone (Aldactone) and furosemide (Lasix) are also used to increase the excretion of urine. Thus reduces the fluid built up in the ascites.

Low salt diet is essential in ascites patient.

I advise you to consult for ascites fluid drainage, diuretics and low salt intake

Hope this helps.
Please reply for further queries.
Wishing your father good health.
Above answer was peer-reviewed by
 
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