• The Korean Journal of Pain
• /
• v.12 no.1
• /
• pp.95-100
• /
• 1999

Background: About 75% of terminal cancer patients have severe pain. For the treatment of these patients, physicians usually use potent opioid analgesics. But many of the cancer patients were not controlled by IV or IM injection of opioids. In spite of the untreatable nature of the patient's illness, they should be hospitalized only for pain control. In that case, epidural opioid injection is one of the most effective methods in pain management. Methods: We retrospectively analyzed 126 terminal cancer patients who were treated with epidural morphine for pain management from 1993-97. In the routine procedure, an epidural catheter was inserted into the epidural space and tunnelled subcutaneously, exiting out from the anterior chest or abdomen. Morphine was used as the main analgesic and Multiday Infusor$^{(R)}$ (Baxter, 0.5 ml/h) as a continuous infusion system. Results: 1. Mean treatment time was 55 days (range; 3~373). 2. Mean daily epidural start mg dose of morphine was 8 mg (range; 2~20). 3. Mean daily dose at termination was 19 mg (range; 4~60) 4. 94 patients were controlled with continuous infusion but 32 patients needed additional bolus doses of morphine. 5. heter-associated subcutaneous infection occurred in 2 patients (1.6%). Conclusion: Terminal cancer pain management administered by a tunnelled epidural catheter is a simple, inexpensive method with a very small rate of infection.

• Biomolecules & Therapeutics
• /
• v.29 no.5
• /
• pp.506-518
• /
• 2021

The imprinted tumour suppressor NOEY2 is downregulated in various cancer types, including ovarian cancers. Recent data suggest that NOEY2 plays an essential role in regulating the cell cycle, angiogenesis and autophagy in tumorigenesis. However, its detailed molecular function and mechanisms in ovarian tumours remain unclear. In this report, we initially demonstrated the inhibitory effect of NOEY2 on tumour growth by utilising a xenograft tumour model. NOEY2 attenuated the cell growth approximately fourfold and significantly reduced tumour vascularity. NOEY2 inhibited the phosphorylation of the signalling components downstream of phosphatidylinositol-3'-kinase (PI3K), including phosphoinositide-dependent protein kinase 1 (PDK-1), tuberous sclerosis complex 2 (TSC-2) and p70 ribosomal protein S6 kinase (p70S6K), during ovarian tumour progression via direct binding to vascular endothelial growth factor receptor-2 (VEGFR-2). Particularly, the N-terminal domain of NOEY2 (NOEY2-N) had a potent anti-angiogenic activity and dramatically downregulated VEGF and hypoxia-inducible factor-1α (HIF-1α), key regulators of angiogenesis. Since no X-ray or nuclear magnetic resonance structures is available for NOEY2, we constructed the three-dimensional structure of this protein via molecular modelling methods, such as homology modelling and molecular dynamic simulations. Thereby, Lys15 and Arg16 appeared as key residues in the N-terminal domain. We also found that NOEY2-N acts as a potent inhibitor of tumorigenesis and angiogenesis. These findings provide convincing evidence that NOEY2-N regulates endothelial cell function and angiogenesis by interrupting the VEGFR-2/PDK-1/GSK-3β signal transduction and thus strongly suggest that NOEY2-N might serve as a novel anti-tumour and anti-angiogenic agent against many diseases, including ovarian cancer.

• Journal of Hospice and Palliative Care
• /
• v.3 no.1
• /
• pp.60-73
• /
• 2000

Purpose : The purpose of this study was to describe a total pain model in patients with terminal cancer and to identify factors relating to total pain using the Twycross Pain Management Model, which included physical, psycho-social and spiritual pain. Method : The study was a retrospective descriptive study. The first stage included 87 patients who received hospice service at Y hospital in 1997. The second stage included five model patients who suffer severe pain as selected by the four hospice nurses. Data collection was from 1) chart analysis and 2) in-depth interviews with the hospice nurses about their selected patients. Data analysis was performed using SPSS-WIN and content analysis. Result : 1) The main problems of 3 patient with terminal cancer were pain(77%), constipation (25.3%), family coping(35.6%), psycho-spiritual distress(17.2%)and other symptoms. 2. The Twycross model was a useful model. However, new items were added; loneliness, depression, and no improvement in condition as depression factors. In anger, new items were anger due to family neglect, at God and in relationships. The case studies identified the followsing; 1) Patient suffer from physical pain as well as multiple other symptoms when cancer is advanced. 2) Body concept, role change, threat to self concept, fear of pain, fear of death, anxiety, family conflict, financial burden, spiritual distress, hope for a cure, are all affected. Conclusion : 1) It is believed that the Twycross model is useful but further tests and revisions are necessary for deciding priorities in the care plan. 2) Pain management must improve culturally appropriate and family support, psychological, spiritual care are imperative for patient with terminal cancer. 3) Further study is recommended to test correlations of depression, anxiety, spiritual distress and family coping using valid instruments. A qualitative study on the spiritual journey of the patient with terminal cancer is also recommended.

• Journal of Hospice and Palliative Care
• /
• v.11 no.3
• /
• pp.131-135
• /
• 2008

The management of malignant ascites can be problematic for physicians and patients. The mass effect of ascites can cause symptoms of painful abdominal distention, nausea, vomiting, and bowel obstruction. Also patients often complain of shortness of breath and lower extremity edema. These symptoms not only are distressing, but also adversely affect quality of life in terminal cancer patients. We will introduce you how to treat ascites based on our cases.

• Asian Oncology Nursing
• /
• v.5 no.1
• /
• pp.40-51
• /
• 2005

The purpose of this study was to explore the relationship between burden and burnout of the family care-givers for caring of terminal patients with cancer. A total of 99 convenience sample was recruited form hospitals. The data were collected by a direct interview with Questionnaire about family burden and burnout. The mean score of burnout of main care-givers was 2.98, and the mean score of burden was 3.03. The care-givers' burnout was significantly different by age, sex, job, duration of treatment, level of acceptance on the stage of death, and ability of daily living activities. The family care-givers' burden was significantly different by the jobs, complication of patients, level of acceptance on the stage of death, and ability of daily living activities. In conclusions, the burnout of family care-givers was highly and positively correlated with the burden.

• The Journal of Internal Korean Medicine
• /
• v.29 no.3
• /
• pp.567-573
• /
• 2008

Cancer is now the leading fatal disease in every developed country. Due to very low efficiency of conventional cancer therapeutics and important aspect of quality of life (QOL), complementary/alternative medicine (CAM) has been accepted worldwide, especially by late-staged cancer patients. Oriental medicine traditionally has stressed not only the tumor itself but the body having cancer, improving cancer-related immunity and extending survival period. Herein, we report one case of a terminal staged rectal cancer patient having spread-metastasis but showing a meaningful clinical course of around four years with Oriental medicine therapies. This study aimed to report the clinical capacity of Oriental medicine for patients with cancerous disease, to help development of Oriental medicine-derived anticancer treatments.

• Health Policy and Management
• /
• v.15 no.2
• /
• pp.1-15
• /
• 2005

The aim of this study was to compare medical cost of hospice care and that of conventional care during the last year of life, and identify factors that influenced the cost. From January to August 2003 592 terminal cancer patients receiving care from 5 hospice care units and 2 hospice care teams in general hospitals were enrolled to case group. Two hundreds and seventy two terminal cancer patients receiving conventional care from 7 general hospitals were enrolled to hospital-based control group, and 1,636 terminal cancer patients from 122 general hospitals located in same regions with the 7 hospitals were enrolled to community-based control. We used characteristics and medical cost from data of National Health Insurance Cooperation. Total medical cost per beneficiary in cases was about 10 millions won, 14.5 millions in hospital-based controls and 11.1 millions in community-based controls. The hospice care saved $45\%$ over the last year of life compared with hospital-based controls (p<0.0001). Saving of inpatient cost account for approximately $80\%$ of saving per beneficiary. Hospice care saved $29\%$ of medical cost per hospitalization day compared with hospital­based controls and $17\%$ compared with community-based controls (p<0.0001). Multiple regression analyses showed that hospice care significantly saved the medical cost. This study suggest that hospice care save medical cost compared with hospital-based control and community-based control. Most of saving of inpatient cost account for approximately $80\%$ of saving of medical cost.

• Journal of Korean Academy of Rural Health Nursing
• /
• v.15 no.1
• /
• pp.30-40
• /
• 2020

Purpose: This study was done to describe a community health practitioner's nursing case management for a terminal cancer patient registered in the public health post. Methods: For this purpose, data were collected through the patient and family through home visits, health clinic offices, and phone calls. The nursing process was carried out from August to November 2019. Results: The patient suffered the most from anorexia and lack of energy. Also he expressed psychologically uncertainty about disease and death anxiety caused by long-term treatment. In order to reduce the death anxiety, Community Health Practitioner (CHP) asked him to express his life stories and listened to him. CHP provided information of appropriate medications and alternative foods for symptoms such as gastrointestinal disorders and anorexia to the patient and family. Observing the situation of the patient and family, CHP guided the patient and family to prepare for death and has confirmed to them that the process was not with the patient alone. Conclusion: CHP's this experience has shown the possibility for CHP to help the terminal cancer patient and family to prepare peaceful death in their communities.

• Asian Oncology Nursing
• /
• v.2 no.1
• /
• pp.36-49
• /
• 2002

The purpose of this study was to evaluate the effects of the pain management education on pain of the terminal cancer patients at home. For evaluating the effectiveness of the intervention modified Patient Outcome Questionnaire (APS, 1995) including patients concerns with cancer pain management, pain intensity, and interference of daily activities related to pain were measured before and after the education in control group and experimental group and the differences were compared with each other. Satisfaction with pain management was measured after the intervention. Pain management education was delivered to 16 experimental group patients by home care nurses, who were provided with 3-hour education on cancer pain management by one of the researchers. Pain management education included common misconceptions about cancer pain control and pharmacological and non-pharmacological interventions and emphasis was put on the importance of pain reports and patients' active participation in pain management. The results of the study were as follows. Patients concerns with pain management were decreased more greatly in the experimental group than those of the control group. The worst, average, and present pain intensities during the last 24 hours were decreased more greatly in the experimental group, and total score and each subcategory of the interference of daily living, except walking, were decreased more greatly in the experimental group. And satisfaction score with total pain management and nurses response to the pain reports were higher in the experimental group. The results of this study suggest that pain management education given to the patients by home care nurses is a very useful intervention to improve pain of the cancer patients at home. This positive result is thought to derive from patients' active pain report and participation in pain control and the use of powder form sustained release morphine for breakthrough pain control in part. Further studies with increased sample size from more institutions are recommended and early introduction of short acting morphine is strongly suggested for effective cancer pain control.

• Journal of Hospice and Palliative Care
• /
• v.15 no.4
• /
• pp.183-187
• /
• 2012

The importance of palliative care for terminal cancer patients has been emphasized globally. Korea has formulated and implemented its policy for cancer control as it drew up a 10-year plan for cancer patient care. We examined Korea's National Cancer Act and the second 10-year plan for cancer patient care, which are legal grounds for palliative care projects for terminal cancer patients, to check the current status of Korea's efforts to establish a hospice and palliative care system. Institutionalization of hospice and palliative care has been developed within a framework of the national cancer project. Efforts such as expansion of hospice units, experts training and quality improvement should continue after the reimbursement of hospice and palliative care begins in 2013.