A final CAM modality that is gaining traction is aromatherapy massage. Currently, there are just pilot studies in the literature, however while these studies have not yielded statistically significant results, the patients being treated felt they benefited from, and wanted to continue aromatherapy massage (Wilcock et al., 2004; Kyle 2006).
Chemotherapy and Radiation Palliative chemotherapy and palliative radiation provide symptom management and help patients with advance cancer maintain some semblance of normalcy in their lives (Desai et al., 2007). Bone pain is the most common source of pain in patients with metastatic prostate cancer and external beam radiation therapy has success rates of up to 90% in this patient population (Ok et al., 2005).
Invasive procedures
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CRNAs will encounter palliative care patients in the OR as more and more high-risk, terminal patients are seeking surgical treatment for their symptoms. Palliative surgery is non-curative surgery intended to improve a patient’s quality of life. The primary indications for palliative surgery are pain and uncontrolled bleeding (Desai et al., 2007). Surgical palliation should be considered a treatment option available to patients along with other palliative treatments such as pharmacology, chemotherapy, and radiation. Surgeries can include: surgical resection of gastric tumors (i.e. tumor debulking), cordotomy, dorsal rhizotomy, myelotomy, and deep brain stimulation (Desai et al., 2007).
Palliative surgery can improve quality of life through symptom control. In a year-long review of palliative surgery at City of Hope National Cancer Center 12.5% of all procedures performed that year were palliative in nature (Krouse et al., 2001). Krouse et al. (2001) report that the primary cancers operated on include: lung, colorectal, breast, and prostate and that overall surgical morbidity is 21.3% (p =