Palliative Care - Peter MacCallum Cancer Centre
|The Pain and Palliative Care Department provides comprehensive symptom control for complex symptoms, regardless of stage of cancer illness, end of life care and care planning for all patients attending East Melbourne site. In addition, the service provides State wide outreach through liaison with community providers across Victoria, and in particular, with the Lodden Mallee palliative care consortium through monthly outreach clinic, education and telephone liaison. The department has continued to progress its initiatives on service development with an increased focus on integration of palliative care and end of life care planning, research and education, participating in further national and international collaborative activities and engaging in presentations both nationally and internationally.|
|What is palliative care? >>|
|What we do >>|
|Referral and liaison to other services|
|What is palliative care?|
|Palliative care is the relief of pain and symptom control. |
The management of the patient is directed toward control of pain and symptoms including psychological and social issues. In our experience, the best way to achieve this goal is via a multi-disciplinary team.
We recognise that symptoms, both physical and emotional, are present at any and all stages of the illness. For this reason, we advocate that palliation - the relief of symptoms - be available to our patients at all stages, including from the time of diagnosis through to recovery. With this in mind we work in close collaboration with the medical oncologists, the radiation oncologists and the surgical oncologists.
One of the greatest burdens that patients and families face is uncertainty. In recognising this we are aware of the importance of maintaining quality care throughout the illness be it at home, in the hospital or in palliative care units. The challenge in particular is to ensure that this care is provided without interruption and as seamlessly as possible.
|What we do|
|The palliative care service looks after patients either as outpatients or as inpatients. In either case we usually do so in conjunction with the other treating oncologist or radiotherapist. We prefer to review patients in our twice-a-week clinic:|
|However practical considerations, either distance from hospital, or acuteness of symptoms, or simply 'saving' a visit, means that we also see patients in other clinics in conjunction with the regular treating doctor. Contacting the team, preferably prior to the patients’ arrival, is appreciated.|
Another important follow-up is via the telephone. The initial assessment will be made in person, but thereafter, for adjustment of medication or 'fine-tuning' follow up can often be done via the telephone. It saves a visit to the clinic.
In addition there is 24 hour on-call access to a member of the palliative care team via the Peter Mac switchboard.
|Referral and liaison to other services|
|We work closely with psychiatry, psychology, social work, pastoral care, physiotherapy, occupational therapy and the dieticians. The purpose for having a 'team approach' is to have as many experts as possible available while at the same time, by coordinating under a single umbrella, retain a person-orientated care.|
Psycho-oncology is a comparatively new branch of cancer care, but one that is critically important. With this in mind Peter Mac has a 24-hour on-call service for psycho-oncology. In addition there are three outpatient clinics per week on: Monday afternoon, Thursday morning, and Tuesday morning.
As well a full-time and experienced psychiatry registrar is at the hospital for consultation of in-patients. The psychological problems that cancer patients develop include anxiety, depression, and what is called existential distress. Existential distress is a technical word for an experience common to all people, including well persons. It refers to issues such as: Why me? What is the purpose of my life? Did I achieve all that I could have? What does death mean? It's not fair? Palliative care physicians and psycho-oncologists are trained to help navigate a way through these difficulties.
Interventional pain management
We work very closely with the Acute Pain Team, which has a long-standing interest in palliative care and helps to bridge the disciplines.
Community services include general practitioners, Peter Mac @ Home, nursing services that do home visits, and hospices. Peter Mac is not a local hospital for most people. Therefore we are very aware of the importance of arranging follow-up care with medical and allied-health services close to home. Fortunately Victoria has a wonderful community-wide set of services to cover all areas. You will find on this website a full list of palliative care services for all areas in Victoria, including the country.
|Highlights for 2010/11|
|A randomised, double-blind placebo controlled study of subcutaneous ketamine in the management of cancer pain. |
Randomised, double blind control trial of megestrol acetate, dexamethasone and placebo in the management of anorexia in people with cancer.
A randomised double blind placebo controlled trial of infusional subcutaneous octreotide in the management of malignant bowel obstruction in people with advanced cancer.
Randomised control trial of oral risperidone, oral haloperidol, and oral placebo with rescue subcutaneous midazolam in the management of delirium in palliative care inpatients.
A randomised, double-blind, placebo-controlled study of fixed dose of subcutaneous methylnaltrexone in adults with advanced illness and opioid-induced constipation: efficacy, safety, and additional health outcomes.
European survey of oncology patient’s experience of breakthrough pain.
WCMICS Cancer specific End of life care pathway project.
A systematic review of palliative care clinical indicators for pain
|Dr Odette Spruyt|
Palliative Care Consultant / Head of Department
Dr Maria Pisasale
Palliative Care Physician (Sessional consultant)
Dr Natasha Michael
Palliative Care Consultant
Advanced Nurse Practitioner Candidate
Clinical Nurse Consultant
Dr Renuka Chittajallu
Dr Martina Welz
Dr Helen Farrell
Dr Jenny Weil
|Fact sheets on cancer pain from the International Association for the Study of Pain >>|
|Frequently Asked Questions >>|
|Website Link: Department of Human Services Palliative Care Search >>|
|Website Link: Palliative Care Victoria Search >>|