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Palliative Care in Cholangiocarcinoma

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Liver Fluke, Opisthorchis viverrini Related Cholangiocarcinoma

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 219))

Abstract

This chapter details all aspects of the general principles of palliative care for advanced stage cholangiocarcinoma patients. These include symptoms management, communication guide, advance care planning, and management for bereavement. Surgical and intervention techniques of palliative biliary drainage are described in detail for patients with obstructive jaundice with advanced stage CCA. Additionally, details are provided regarding the establishment of a multidisciplinary palliative care team which is critical to provide the most appropriate multimodal treatment for good quality of life and survival of patients.

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References

  1. Shirabe K, Mano Y, Taketomi A, Soejima Y, Uchiyama H, Aishima S et al (2010) Clinicopathological prognostic factors after hepatectomy for patients with mass-forming type intrahepatic cholangiocarcinoma: relevance of the lymphatic invasion index. Ann Surg Oncol 17(7):1816–1822

    Article  PubMed  Google Scholar 

  2. Nishihara Y, Aishima S, Hayashi A, Iguchi T, Fujita N, Taketomi A et al (2009) CD10+ fibroblasts are more involved in the progression of hilar/extrahepatic cholangiocarcinoma than of peripheral intrahepatic cholangiocarcinoma. Histopathology 55(4):423–431

    Article  PubMed  Google Scholar 

  3. Ferrell BR, Temel JS, Temin S, Alesi ER, Balboni TA, Basch EM et al (2017) Integration of palliative care into standard oncology care: American society of clinical oncology clinical practice guideline update. J Clin Oncol 35(1):96–112

    Article  PubMed  Google Scholar 

  4. Pairojkul S, Thongkhamcharoen R, Raksasataya A, Sorasit C, Nakawiro P, Sudsa S et al (2021) Integration of specialist palliative care into tertiary hospitals: a multicenter point prevalence survey from Thailand. Palliat Med Rep 2(1):272–279

    Article  PubMed  PubMed Central  Google Scholar 

  5. Eagan A, Mishra M, Bangerter L (2017) Salzburg global seminar, Session Report 562: rethinking care toward the end of life

    Google Scholar 

  6. Gomez-Batiste X, Murray SA, Thomas K, Blay C, Boyd K, Moine S et al (2017) Comprehensive and integrated palliative care for people with advanced chronic conditions: an update from several European initiatives and recommendations for policy. J Pain Symptom Manage 53(3):509–517

    Article  PubMed  Google Scholar 

  7. World Health Organization (2021) Assessing the development of palliative care worldwide: a set of actionable indicators

    Google Scholar 

  8. Kaasa S, Loge JH, Aapro M, Albreht T, Anderson R, Bruera E et al (2018) Integration of oncology and palliative care: a lancet oncology commission. Lancet Oncol 19(11):e588–e653

    Article  PubMed  Google Scholar 

  9. Stjernsward J, Foley KM, Ferris FD (2007) The public health strategy for palliative care. J Pain Symptom Manage 33(5):486–493

    Article  PubMed  Google Scholar 

  10. Henderson JD, Boyle A, Herx L, Alexiadis A, Barwich D, Connidis S et al (2019) Staffing a specialist palliative care service, a team-based approach: expert consensus white paper. J Palliat Med 22(11):1318–1323

    Article  PubMed  Google Scholar 

  11. Kamal AH, Bowman B, Ritchie CS (2019) Identifying palliative care champions to promote high-quality care to those with serious illness. J Am Geriatr Soc 67(S2):S461–S467

    Article  PubMed  Google Scholar 

  12. Murray S, Boyd K (2011) Using the “surprise question” can identify people with advanced heart failure and COPD who would benefit from a palliative care approach. Palliat Med 25:382

    Article  PubMed  Google Scholar 

  13. Moroni M, Zocchi D, Bolognesi D, Abernethy A, Rondelli R, Savorani G et al (2014) The “surprise” question in advanced cancer patients: a prospective study among general practitioners. Palliat Med 28(7):959–964

    Article  PubMed  Google Scholar 

  14. White N, Kupeli N, Vickerstaff V, Stone P (2017) How accurate is the ‘Surprise question’ at identifying patients at the end of life? A systematic review and meta-analysis. BMC Med 15(1):139

    Article  PubMed  PubMed Central  Google Scholar 

  15. Downar J, Goldman R, Pinto R, Englesakis M, Adhikari NK (2017) The “surprise question” for predicting death in seriously ill patients: a systematic review and meta-analysis. CMAJ 189(13):E484–E493

    Article  PubMed  PubMed Central  Google Scholar 

  16. Aishima S, Matsuura S, Terashi T, Taguchi K, Shimada M, Maehara Y et al (2004) Aberrant expression of laminin gamma 2 chain and its prognostic significance in intrahepatic cholangiocarcinoma according to growth morphology. Mod Pathol 17(8):938–945

    Article  CAS  PubMed  Google Scholar 

  17. Dunn GP (2001) Patient assessment in palliative care: how to see the “big picture” and what to do when “there is no more we can do.” J Am Coll Surg 193(5):565–573

    Article  CAS  PubMed  Google Scholar 

  18. Hui D, Bruera E (2017) The edmonton symptom assessment system 25 years later: past, present, and future developments. J Pain Symptom Manage 53(3):630–643

    Article  PubMed  Google Scholar 

  19. Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K (1991) The edmonton symptom assessment system (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care 7(2):6–9

    Article  CAS  PubMed  Google Scholar 

  20. Seniors Health—Edmonton Zone Regional Palliative Care Program (2010) Guidelines for using the revised Edmonton symptom assessment system (ESAS-r)

    Google Scholar 

  21. Watanabe SM, Nekolaichuk C, Beaumont C, Johnson L, Myers J, Strasser F (2011) A multicenter study comparing two numerical versions of the Edmonton symptom assessment system in palliative care patients. J Pain Symptom Manage 41(2):456–468

    Article  PubMed  Google Scholar 

  22. Kelley AS, Morrison RS (2015) Palliative care for the seriously Ill. N Engl J Med 373(8):747–755

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Somjaivong B, Thanasilp S, Preechawong S, Sloan R (2011) The influence of symptoms, social support, uncertainty, and coping on health-related quality of life among cholangiocarcinoma patients in northeast Thailand. Cancer Nurs 34(6):434–442

    Article  PubMed  Google Scholar 

  24. WHO Guidelines for the Pharmacological and Radiotherapeutic Management of Cancer Pain in Adults and Adolescents. Geneva: World Health Organization 2018 Available from: https://www.ncbi.nlm.nih.gov/books/NBK537492/

  25. Caraceni A, Hanks G, Kaasa S, Bennett MI, Brunelli C, Cherny N et al (2012) Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC. Lancet Oncol 13(2):e58-68

    Article  CAS  PubMed  Google Scholar 

  26. Parshall MB, Schwartzstein RM, Adams L, Banzett RB, Manning HL, Bourbeau J et al (2012) An official American thoracic society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med 185(4):435–452

    Article  PubMed  PubMed Central  Google Scholar 

  27. Pereira JL (2008) The pallium palliative pocketbook: a peer-reviewed, reference resource: pallium project

    Google Scholar 

  28. Mercadante S, Marinangeli F, Masedu F, Valenti M, Russo D, Ursini L et al (2018) Hyoscine Butylbromide for the management of death rattle: sooner rather than later. J Pain Symptom Manage 56(6):902–907

    Article  PubMed  Google Scholar 

  29. Taguchi K, Aishima S, Asayama Y, Kajiyama K, Kinukawa N, Shimada M et al (2001) The role of p27kip1 protein expression on the biological behavior of intrahepatic cholangiocarcinoma. Hepatology 33(5):1118–1123

    Article  CAS  PubMed  Google Scholar 

  30. Ratanasuwan P, Raksasataya A (2019) Update handbook for palliative care guidelines NHS, U.K. Khon Kaen, Klungnana Vitthaya Press, pp 1–200

    Google Scholar 

  31. Raksasataya A (2021) Textbook of palliative care, 1st edn. Thai palliative care society, Bangkok, pp 215–223

    Google Scholar 

  32. Abrams DI (2018) The therapeutic effects of Cannabis and cannabinoids: an update from the National Academies of sciences, engineering and medicine report. Eur J Intern Med 49:7–11

    Article  CAS  PubMed  Google Scholar 

  33. Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP (2000) SPIKES-a six-step protocol for delivering bad news: application to the patient with cancer. Oncologist 5(4):302–311

    Article  CAS  PubMed  Google Scholar 

  34. Tulsky J, Schapira L (2008) Communication: what do patients want and need? J Oncol Pract 4(5):249–253

    Article  Google Scholar 

  35. Sudore RL, Lum HD, You JJ, Hanson LC, Meier DE, Pantilat SZ, et al. (2017) Defining advance care planning for adults: a consensus definition from a multidisciplinary Delphi panel. J Pain Symptom Manage 53(5):821–32 e1

    Google Scholar 

  36. Rietjens J, Korfage I, Seymour J. Communication and palliative medicine. In: Cherny NI, Fallon MT, Kaasa S, Portenoy RK, Currow DC (eds) Oxford textbook of palliative medicine. 6th ed. New York, USA, Oxford University Press

    Google Scholar 

  37. Boyd K (2021) RED-MAP framework: the University of Edinburgh. Available from: https://www.spict.org.uk/red-map/

  38. Bereavement KD (2021) In: Cherny NI, Fallon MT, Kaasa S, Portenoy RK, Currow DC (eds) Oxford textbook of palliative medicine, 6th edn. Oxford University Press, New York, USA, pp 773–784

    Google Scholar 

  39. Zhao XQ, Dong JH, Jiang K, Huang XQ, Zhang WZ (2015) Comparison of percutaneous transhepatic biliary drainage and endoscopic biliary drainage in the management of malignant biliary tract obstruction: a meta-analysis. Digestive Endoscopy: Official J Japan Gastroenterol Endoscopy Soc 27(1):137–145

    Article  Google Scholar 

  40. Zhang GY, Li WT, Peng WJ, Li GD, He XH, Xu LC (2014) Clinical outcomes and prediction of survival following percutaneous biliary drainage for malignant obstructive jaundice. Oncol Lett 7(4):1185–1190

    Article  PubMed  PubMed Central  Google Scholar 

  41. Bai AG, Zheng CS, Zhou GF, Liang HM, Feng GS (2010) Comparison of the therapeutic effects of PTBD and PTBS in treatment of malignant obstructive jaundice. Zhonghua zhong liu za zhi [Chinese J Oncol] 32(6):456–458

    PubMed  Google Scholar 

  42. Sangchan A, Kongkasame W, Pugkhem A, Jenwitheesuk K, Mairiang P (2012) Efficacy of metal and plastic stents in unresectable complex hilar cholangiocarcinoma: a randomized controlled trial. Gastrointest Endosc 76(1):93–99

    Article  PubMed  Google Scholar 

  43. Sangchan A, Chaiyakunapruk N, Supakankunti S, Pugkhem A, Mairiang P (2014) Cost utility analysis of endoscopic biliary stent in unresectable hilar cholangiocarcinoma: decision analytic modeling approach. Hepatogastroenterology 61(133):1175–1181

    PubMed  Google Scholar 

  44. Rerknimitr R, Angsuwatcharakon P, Ratanachu-ek T, Khor CJ, Ponnudurai R, Moon JH et al (2013) Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma. J Gastroenterol Hepatol 28(4):593–607

    Article  PubMed  Google Scholar 

  45. Yarmohammadi H, Covey AM (2016) Percutaneous biliary interventions and complications in malignant bile duct obstruction. Chin Clin Oncol 5(5):68

    Article  PubMed  Google Scholar 

  46. Inal M, Aksungur E, Akgul E, Oguz M, Seydaoglu G (2003) Percutaneous placement of metallic stents in malignant biliary obstruction: one-stage or two-stage procedure? Pre-dilate or not? Cardiovasc Intervent Radiol 26(1):40–45

    Article  PubMed  Google Scholar 

  47. Sohn SH, Park JH, Kim KH, Kim TN (2017) Complications and management of forgotten long-term biliary stents. World J Gastroenterol 23(4):622–628

    Article  PubMed  PubMed Central  Google Scholar 

  48. Liberato MJ, Canena JM (2012) Endoscopic stenting for hilar cholangiocarcinoma: efficacy of unilateral and bilateral placement of plastic and metal stents in a retrospective review of 480 patients. BMC Gastroenterol 12:103

    Article  PubMed  PubMed Central  Google Scholar 

  49. Schmidt A, Riecken B, Rische S, Klinger C, Jakobs R, Bechtler M, et al. Wing-shaped plastic stents versus self-expandable metal stents for palliative drainage of malignant distal biliary obstruction: a randomized multicenter study. Endoscopy 47(5):430–6

    Google Scholar 

  50. Ridtitid W, Rerknimitr R (2012) Management of an occluded biliary metallic stent. World J Gastrointest Endosc 4(5):157–161

    Article  PubMed  PubMed Central  Google Scholar 

  51. Ridtitid W, Rerknimitr R, Janchai A, Kongkam P, Treeprasertsuk S, Kullavanijaya P (2010) Outcome of second interventions for occluded metallic stents in patients with malignant biliary obstruction. Surg Endosc 24(9):2216–2220

    Article  PubMed  Google Scholar 

  52. Kang H, Chung MJ, Cho IR, Jo JH, Lee HS, Park JY et al (2021) Efficacy and safety of palliative endobiliary radiofrequency ablation using a novel temperature-controlled catheter for malignant biliary stricture: a single-center prospective randomized phase II TRIAL. Surg Endosc 35(1):63–73

    Article  PubMed  Google Scholar 

  53. Witzigmann H, Lang H, Lauer H (2008) Guidelines for palliative surgery of cholangiocarcinoma. HPB (Oxford) 10(3):154–160

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Palliative Care Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

    Attakorn Raksasataya

  2. Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

    Anucha Ahooja & Vivian Krangbunkrong

  3. Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

    Apiwat Jareanrat, Attapol Titapun & Narong Khuntikeo

Authors
  1. Attakorn Raksasataya
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  2. Anucha Ahooja
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  3. Vivian Krangbunkrong
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  4. Apiwat Jareanrat
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  5. Attapol Titapun
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  6. Narong Khuntikeo
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Editor information

Editors and Affiliations

  1. Department of Surgery, Khon Kaen University, Khon Kaen, Thailand

    Narong Khuntikeo

  2. Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

    Ross H. Andrews

  3. Karlsruh Erbprinzenstr, State Museum of Natural History Karlsruhe, Karlsruhe, Baden-Württemberg, Germany

    Trevor N. Petney

  4. St. Mary's Hospital, Imperial College London, London, UK

    Shahid A. Khan

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Raksasataya, A., Ahooja, A., Krangbunkrong, V., Jareanrat, A., Titapun, A., Khuntikeo, N. (2023). Palliative Care in Cholangiocarcinoma. In: Khuntikeo, N., Andrews, R.H., Petney, T.N., Khan, S.A. (eds) Liver Fluke, Opisthorchis viverrini Related Cholangiocarcinoma. Recent Results in Cancer Research, vol 219. Springer, Cham. https://doi.org/10.1007/978-3-031-35166-2_9

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  • DOI: https://doi.org/10.1007/978-3-031-35166-2_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-35165-5

  • Online ISBN: 978-3-031-35166-2

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