2018 Graduation Projects: Palliative Care in the Oncology Department

Palliative care is a rapidly expanding specialty that aims at symptom control and improvement of the quality of life for patients with progressive diseases. Although there has been enormous expansion of hospital palliative care programs, only a few hospitals have palliative care teams. In addition, workforce shortages combined with tenuous funding may limit the spread and sustainability of existing programs.

In their graduation project, a group of Pharmacy senior students describe symptom burden and functional dependencies in oncology patients using M.D. Anderson Symptom Inventory (MDASI) Core Items and EORTC palliative care questionnaire. Their cross-sectional observational study aims at evaluating the presence of metastases and assess symptoms burden of cancer patients at Ain Shams University hospitals.

We found that palliative care programs are not common in Egypt, especially for cancer patients. This is mainly due to lack of awareness and limited budgets.

says Kareem Mamdouh, one of the project team members.

The study shows that the major symptom that reveals is toxicity of chemotherapy course because of their severity and interference with the cancer patients’ quality of life. These toxicities include fatigue, appetite loss, pain, nausea and vomiting, insomnia, dyspnea and constipation.

Pain is the most incident symptom reported by cancer patients with frequency 205 patients (80.7 %), fatigue is reported by 148 patients (58.2%), and insomnia is reported by about 144 patients (57.08%). Additionally, more than half of the patients reported constipation and appetite loss by frequency 170 patients (66.9%) and 133 patients (52.3%) respectively.

All cancer patients need palliative care with different levels to control chemotherapy toxicities. Pain, insomnia, and fatigue are the most prevalent symptoms regardless of patient’s sex, age, or socioeconomic level.

The project team consists of Kareem Mamdouh, Mahmoud Sayed, Aya Hamdy, Samer Sameh, and Abdelfattah Mohamed under supervision of Dr. Manal Hamed, Professor of Clinical Pharmacy and Head of the Department of Clinical Pharmacy and Pharmacy Practice.