This is involves in many episode of seeing the patient, whether the chronic illness or during well-person visit. In this scenario, maintain rapport with that patient is required. Family physician is committed to providing care to the patient and their family over the time.
b) Comprehensiveness
It is implied that the patient is not only viewed from biological aspect but also from social and psychological one.
So that, should considers the entire factor when designing diagnostic procedure and treatment to the patient/ they are not involve in caring the patient but also required in access to the case.
c) Coordination of care
The family physician is responsible to coordinate the patient’s health service. These include outside specialist as well as other health care profession.
d) Community
Community always influenced the patient health care. The family physicians play role to help community education and health service.
e) Prevention
Preventing illness has many aspects. These include recognizing the risk factor of the disease, delaying the consequence of chronic disease and promoting healthy lifestyle.Family Physician should participate in make prevention such illness event.
f)Family
Family physician regards the patient as a family system and recognize the influences of the illness on families as well as influences family to the illness.
Cancer is amongst the leading causes in certified death in Malaysia and worldwide.The adequate management should be applied to these patients to provide better quality of life. The field of cancer research study had developed tremendously over the past decades with the latest innovation of treating this patient in chemotherapy, radiotherapy, immunotherapy, gene therapy as well as targeted therapy. These technology advances have resulted in increased of cancer patient survival rate.
As we know, the cancer treatment still involves multimodality and a multidisciplinary approach. For early stages of cancer, combination therapy is preferred and the attention is curing patient, while for the patient late stage disease, palliation and supportive care play an important role. Surgical treatment is the first indication for the cancer patient in early stage especially for solid tumor. It can be as curative treatment for cancer.However, it can provide some symptoms and side effect due to the treatment. Other treatment for cancer patient is radiotherapy. Radiotherapy can defined as a way of treating or managing cancer using radiation. It works by damaging cells in the area being treated. Radical radiotherapy is used to try to completely get rid of cancer cells. It can be either prophylactic radiotherapy or palliative Chemotherapy is an important modality of management in cancer especially in late stage due to its characteristic which is systemic treatment. Effective combination chemotherapy has load the cure, prolongation of life and relief of cancer symptom in advance disease. Nowadays, molecular targeted therapy specifically block signaling pathways and subsequently control the cancer growth with minimal side effects and maintaining a good quality of life.
All thecancer management can result in functional disabilities, such as speech ability, impairment of mobility due weakness or incoordination or severe deconditioning . Cancer patient also predisposed to cancer-related fatigue, depressed immune system, social isolation, and anxiety and depression ether it due to the cancer or the treatment. It always associated with symptomatic side effect, an influenced the quality of life.For example, by surgical oncology, the patient may lost their physical ability and depress due lost of their physical image, while by radiation will injured certain normal cell like in intestine which usually encountered following treatment of cancers of anus, rectum, cervix or uterus. Chemotherapy also leading to many side effects due to toxicity, like alopecia, bone marrow suppression and variety of end organ toxicities.
Fortunately, the focus on cancer treatment has change to molecular targeted therapy. These drugs target the biochemical pathways that are involved in cancer cell proliferation and metastasis.New agents are promising in increasing activity in controlling cancer with minimal side effect and can maintain a god quality of life.
These factors make the reasons why supportive care extremely crucial to the treatment of cancer patient and restoration of the patient as a whole. As a health care provider to be, we should take some responsibility to manage all the problems related in delivering the treatment and side effect caused by the treatment, as well as to help managing related side effect from the treatment, psychosocial and spiritual social due to the diseases. The term of supportive care are not only limited to certain department or care provider, but all of us. It should be manage starting from diagnosis; how breaking the bad news, treatment ; pain management, antiemetic drugs, and post treatment like management side effect of therapy such as, mucositis and febrile neutropenia .
In order to maximum the quality of life in cancer patient, there are resources that can be made available to support cancer patient. Service such as physiotherapy, occupational therapy, counseling, nutrition and dietetics, speech therapy, physical modalities are most available in hospital in Malaysia. Unfortunately, there is still lack of comprehensive rehabilitation in approach to cancer patient due to their divers needed beside many of patient are still discharge with minimal information, rehabilitation and counseling.
So that,a team work between patient, family and care providersuch as oncologist, palliative care, physicians , psychiatrist, psychologist, nurses and social workers should be integrated each other. Do not point our thumb to each others because it still on our shoulder and need comprehensive co-operation each others to support cancer patient in getting the better quality of life.
by: Siti Fatimah Zahra (060100812)
Summary from Seminar of Supportive care in Cancer 2009.
