Author(s): Ali Montazeri 1
cancer patients; integrated care; palliative care
The latest statistics indicate that nearly 12.7 million new cancer cases and 7.6 million cancer-related deaths occurred in 2008 worldwide  . Cancer diagnosis and its treatment have several devastating impacts on patients'â lives and their families. For instance, there is evidence that a considerable number of cancer patients in the last year of their life suffer from pain (84%), depression (38%), confusion (33%), breathlessness (47%), sleep difficulties (51%), nausea (51%), constipation (47%) and loss of appetite (71%)  . To palliate these and other problems, palliative care was proposed in order to lessen the severity and suffering of cancer patients and their primary caregivers. The WHO defines palliative care as 'âan approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual'â  . Therefore, the essence of palliative care for cancer patients might be summarized in three main areas: improvement of quality of life of patients and their families; prevention and relief of suffering by means of treatment of pain; and identification and provision of perfect care for patients'â physical, psychosocial and spiritual health.
It is argued that simple measures would result in effective palliative care, and relieving symptoms and suffering. These measures include pain relief, sensitive communication and well-coordinated care  . In addition, two other measures have been proposed for effective palliative care for cancer patients: enhancing hope and interventions for demoralization syndrome. As suggested, hope plays a very important role in the experience of advanced cancer patients and their family members. Hope is linked to coping, which might buffer the stress and thus improve physical and mental wellbeing  . Demoralization is a separate entity to depression, described as a disorder of meaning and hope. Management includes psychotherapy and narrative therapies. Narrative therapies build up a coherent...