Advanced disease, defined as vascular invasion or invasion into adjacent organs, in pancreatic ductal adenocarcinoma still remains a major diagnostic and therapeutic challenge. In most cases, only exploratory laparotomy will ultimately ensure surgical resectibility. A physician is ill-advised to make any decision regarding palliation relying on CT-scan, MRI, ultrasonography or angiography, sinc...

Bone metastasis occurs as a result of a complex pathophysiologic process between host and tumor cells leading to cellular invasion, migration adhesion, and stimulation of osteoclastic and osteoblastic activity. The process is mediated by parathyroid hormones, cytokines, and tumor-derived factors. Several sequelae occur as a result of osseous metastases and resulting bone pain can lead to signif...

Palliative care addresses the symptoms of cancer throughout the course of the disease. Moreover, rather than just improving end-of-life care, palliative care also improves survival. It has long been established that a patient’s survival is dependent on the palliation of symptoms caused by cancer therapy, such as neutropenia and chemotherapy-induced nausea. However, the relief of other symptoms,...

Metastatic bone pain is prevalent in advanced cancer, and, despite a plethora of available therapies, effective palliation remains a clinical challenge. Bone-seeking radiopharmaceuticals are an often-overlooked but valuable analgesic option for select patients. These agents work by binding to hydroxyapatite at the tumor-bone interface of osteoblastic lesions, delivering therapeutic doses of rad...

Total pelvic exenteration is a radical abdominoperineal operation designed to treat locally extensive pelvic malignancy. In the past, the morbidity and mortality has been such that this procedure was considered justified only in the curative setting. As experience has increased and operative survival has improved, the indications for radical pelvic surgery have expanded to include palliation of...

Percutaneous radiofrequency ablation (RFA) of osteoid osteomas has replaced surgical excision as the preferred method for treatment of these benign lesions, due to high effectiveness and low morbidity. Both RFA and cryoablation are safe and effective for palliation of pain due to metastatic disease in patients who have failed conventional therapies. These image-guided treatments can be performe...

BACKGROUND Although most treatment for non-small cell lung cancer is palliative, data on the adequacy of symptom control are scanty and there has been little discussion about the appropriate indices. METHODS Two hundred and eighty nine unselected patients presenting sequentially to six specialists were studied; 242 cases were confirmed histologically and all were managed as non-small cell lun...

Designing ideal radiopharmaceuticals for use as bone pain palliatives require the use of a moderate energy β emitter with a stable carrier molecule. Cyclic polyaminophosphonate ligands are known to form complexes with higher thermodynamic stability and kinetic inertness. The present study therefore envisages the use of a few moderate energy β emitters, viz. Lu (T1/2 = 6.71 d, Eβmax= 497 keV), S...