General symptom overview: Importance of side effect management, CINV, anorexia, and cachexia
Along with understanding patients’ goals, values, and preferences, symptom assessment and management is a cornerstone of palliative care (PC) practice. Using a clinical case, this chapter focuses on systematic assessment of PC needs including physical, psychosocial, and spiritual needs. Particular attention is paid to assessment of nausea generally and the A VOMIT mnemonic, which offers a differential diagnosis for nausea, is described and explained in detail. The importance of prevention and treatment of chemotherapy-induced nausea and vomiting is outlined and current National Comprehensive Cancer Network guidelines are described. Lastly, difficult-to-treat symptoms including cachexia and anorexia are studied and strategies to approach these conditions are described. The chapter finishes by outlining three commonly used approaches to symptom management - patient prioritization, outsourcing, and symptom clustering - and symptom clustering is demonstrated to treat the patient described in the chapter’s clinical case.
