Abstract
In this study we clinically reviewed the hospice in-patient records of 55 patients with terminal head and neck cancer. We focused on the dying process and strategies used for pain control, because the prediction of various events occurring during the dying process is crucial for the acceptance of death in patients and their families and relief from cancer pain is a central issue in the palliation of terminal head and neck cancer patients. The findings in this study indicated that the clinical course of 70% of patients with terminal head and neck cancer deteriorated gradually, but that death due to sudden change occurred in 30%, mainly due to hemorrhage. The mean duration of cancer pain was 14 weeks, and in the last 3 weeks patients had difficulty in ingestion. Pain management required administration of strong opioids by continuous subcutaneous infusion. Based on these findings, we suggest that it is important to pay particular attention to the high risk of sudden death and to pain management in terminal head and neck cancer patients.
