The PDQ supportive and palliative care information summaries provide descriptions of the pathophysiology and treatment of common physical and psychosocial complications of cancer and its treatment, including complications such as pain, anxiety, depression, fatigue, and nausea and vomiting. Each PDQ health professional summary generally includes an overview; information about etiology, assessment, and management; and citations to published literature.
The supportive and palliative care of cancer patients and their families and caregivers can involve the identification and mitigation of physiological, psychological, and spiritual needs.
The Gonzalez regimen, developed by Dr. Nicholas Gonzalez, involves taking pancreatic enzymes thought to have anticancer activity. The regimen also includes prescribed diets, nutritional supplements, and coffee enemas (see Question 1).
The Gonzalez regimen is based on the theory that pancreatic enzymes help the body get rid of toxins (harmful substances) that lead to cancer (see Question 3).
A few studies have examined the effect of pancreatic enzymes in animals with implanted cancers, but...
Psychological or behavioral complications currently addressed in the PDQ supportive and palliative care summaries include the following:
Post-traumatic stress disorder.
Tobacco dependence/smoking cessation.
Spiritual and religious concerns currently addressed in the PDQ supportive and palliative care summaries include the following:
Approaches to addressing these issues.
References cited in the PDQ supportive and palliative care information summaries are drawn primarily from the peer-reviewed biomedical literature. The quality and reliability of such published reports can vary considerably. To help readers assess the strength of findings from clinical research studies, levels-of-evidence rankings are often employed. These rankings generally take into account the strength of a study's design and the strength of the clinical outcome(s) measured. Clinical research in supportive and palliative care is feasible in some settings but difficult to conduct in others, such as at the end of life. Furthermore, as in other areas of medicine, supportive and palliative care decisions must be made in the context of existing evidence, which may be weaker than ideal.
In general, the quality of evidence depends on:
The appropriateness of the study to the question being asked.
How well the study was designed, implemented, analyzed, and interpreted.
For evaluating outcomes of both medical and psychosocial interventions, the strongest evidence is obtained from well-designed, well-conducted randomized clinical trials. For evaluating other questions, particularly those related to symptom management, well-designed descriptive studies may provide the strongest evidence practicable. Particular elements of study design, such as the nature of the population being studied or the duration of observation, may be crucial to assessing the quality of a study. Reviews of studies will indicate the level of evidence and any confounding design issues.