Problems of Terminal Care on Lung Cancer(Care of the Dying)

Abstract

The improvement of "Clinical Thanatology" requires comprehension of its existing problems and consideration about them.From the above standpoints, the condition of patients with terminal stage lung cancer was investigated.<Method> Ninety patients with lung cancer, who were admitted to our hospital since 1975 and died were examined, especially concerning the data within three months of their death.<Results> (1) Period of hospitalization The average period of terminal hospitalization was 70.3 days. The shortest was three days (of re-entrance) and the longest 433 days.(2) Informing the name of disease In almost all cases, the patient was given a name of diseases other than cancer. The most common name was pulmonary tuberculosis, followed by pulmonary suppuratino and tuberculous pleurisy. There were cases where these names caused some troubles in the doctor-patient relationship. On the other hand, there existed some difficulties when the real diagnosis of disease was told to the patients.(3)Symptoms At the terminal perild, loss of appetite was apparent in alomost all the cases. Other complants such as dyspnea 76%, cough and sputum 75%, back pain of chest 63%, and fever 51% were noticed. There was almost no response for the treatment of the above complaints.(4) Treatment During the last three months, 73 cases, 81.1%, received mainly chemotherapy, some of which are conservative. The cases which received anticancer therapy of any kind during the last week were about 50% of the total. Among these cases, the unexpected sudden death, contrary to the attending doctor's expectation, seemed to occur.<Conclusion> It is necessary to investigate the actual condition of patients hospitalized with terminal lung cancer and to consider the existing problems.