Endocrinological evaluations of brief hand massages in palliative care.

BACKGROUND AND OBJECTIVES: Some patients with advanced cancer make use of complementary therapies for the reduction of anxiety and stress. These patients can suffer distressing end-of-life symptoms, which conventional treatments might not relieve satisfactorily. Although previous studies have suggested that complementary therapies could be useful for reducing distress in patients with cancer, it has remained unclear whether these benefits are applicable at the end-of-life stage. The current study examined to validate salivary chromogranin A (CgA) as a biomarker for relieving stress by hand massage in terminally ill patients. METHODS: The study group comprised 34 inpatients in palliative care units. Each of these patients received a 5-minute massage to the upper extremity. Before and after the massage, saliva samples were collected in order to measure the CgA levels. RESULTS: The brief hand massage appears to reduce levels of stress according to the salivary CgA (p < 0.05). In addition, we found statistically significant changes in patient satisfaction with hand massage. CONCLUSIONS: Salivary CgA could potentially be used as a biomarker to measure relieving stress by hand massage in a palliative-care setting.

Attitudes toward and current practice of complementary and alternative medicine in Japanese palliative care units.

Complementary and alternative medicine (CAM) might enhance the quality of life of patients with cancer. The aim of this study was to investigate the current practice of CAM in Japanese palliative care units. A 17-item questionnaire was mailed to all 150 certified palliative care units in Japan, 80% of which responded. In total, 75 institutions (64%) provided at least one modality of CAM. Only 33% of the palliative care units surveyed had any regulations about patient usage of CAM, and 42% rejected some types of CAM because they caused difficulties for other patients (34%), required medical procedures (26%), used fire (5%), or required outside practitioners (4%). In total, 92% of surveyed palliative care units had no regulation and actually provided CAM. The obstacles to the use of CAM included the availability of certified practitioners, costs, added responsibilities for staff members, and insufficient evidence of efficacy. We concluded that Japanese palliative care units generally had a positive attitude toward CAM, and were willing to provide this type of therapy to patients.

[Palliative care complementing cancer treatment].

Palliative medicine had conventionally been initiated after all avenues of anticancer treatment were exhausted, and the treatment of other medical problems was considered inappropriate. However, it is increasingly being recognized that the palliative principles and interdisciplinary palliative care should be initiated when a patient becomes symptomatic with an incurable disease, and should never be withheld only after all modalities of anticancer treatment have failed. Palliative care should be regarded as being complementary to direct cancer treatment. It should be implemented long before the terminal phases of the disease, and integrated in a seamless manner with other aspects of support. Palliative care is no longer merely terminal care.