Updates on Palliative Medicine

Dear Colleagues,

In modern society, palliative medicine represents an important advancement in the health care system, so much so that some countries have promulgated laws obliging the national health care systems to provide appropriate care to terminal patients and their families. Life expectancy is now increasingly longer, and chronic pathologies are more diffused, with patients requiring support even if affected by hopeless diseases. Palliative Medicine is a medical specialty dedicated to providing relief from the stress, burden, and symptoms of an illness. Its ultimate goal is to provide patients with better management, reduce their suffering, and increase their quality of life. In addition, palliative care should support patients’ families, relieving their psychological and physical burden to assist a terminal patient, with all the associated consequences that this entails.

Palliative support of terminal patients may be provided both at home and in dedicated and organized care facilities, named hospices. The organization of palliative care depends on many local aspects but is also strictly correlated with the patient's health condition, the social conditions of the family, the organization of the health care system, etc. In general, palliative support is granted by a dedicated team able to interact and implement the care already provided to patients’ other doctors. In fact, palliative medicine should be based on patients’ needs, and not on their prognoses. Moreover, palliative support should be provided along with curative therapy when possible and where necessary. In essence, palliative care teams are not focused on the disease itself but rather on the symptoms affecting the quality of life of terminal patients, and on cooperating with their relatives in order to reduce stress in their lives.

The large majority of palliative care patients are affected by cancer, but the number of chronic patients requiring palliative care is increasing, especially in the area of heart diseases, such as congestive heart failure (CHF), chronic obstructive pulmonary diseases (COPD), and chronic renal insufficiency, as well as many neurodegenerative diseases, such as amyotrophic lateral sclerosis (ALS), Alzheimer’s disease, and Parkinson’s disease. The result has been an increase in interest of clinical medicine toward this medical specialty, the main goal of which is to provide the best possible quality of life for patients and their families and to relieve their suffering.

The most frequent symptoms to care for are pain, fatigue, breathing difficulties, gastrointestinal problems (loss of appetite, nausea, vomiting, constipation), and/or psychiatric and psychological alterations (difficulty sleeping, anxiety, depression). The palliative care teams should always help terminal patients and their families to gain the strength to cope with daily life. Many studies have clearly shown that palliative care may increase the life expectancy of terminal patients and increase their quality of life.

For these reasons, a Special Issue of the Journal of Clinical Medicine dedicated to updates in palliative medicine is timely. We hope that the readers of the journal will enjoy the topic as well, and that we will receive a high number of submissions, especially focused on a modern vision for this new medical specialty. Let us work together for better medicine and a more humanistic approach to the patients’ life.

Dr. Giustino Varrassi
Guest Editor

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• cancer pain
• fatigue
• hospice and palliative care nursing
• nausea and vomiting
• palliative care
• palliative care medicine
• palliative care nursing
• terminal patient management