help button home button The Oncologist
HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 Click here to read this article as a CME course

First Published Online October 6, 2009
The Oncologist, Vol. 14, No. 10, 1039-1049, October 2009; doi:10.1634/theoncologist.2009-0122
© 2009 AlphaMed Press

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
theoncologist.2009-0122v1
14/10/1039    most recent
Right arrow eLetters: Submit a response to this article
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article link to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Reprints/Permissions
Google Scholar
Right arrow Articles by Bush, S. H.
Right arrow Articles by Bruera, E.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bush, S. H.
Right arrow Articles by Bruera, E.

Symptom Management and Supportive Care

The Assessment and Management of Delirium in Cancer Patients

Shirley H. Busha,b,c,d, Eduardo Brueraa

aDepartment of Palliative Care & Rehabilitation Medicine, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA; bMcCulloch House, Southern Health Care Network, Melbourne, Victoria, Australia; cFaculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia; dDivision of Palliative Care, University of Ottawa, Ottawa, Ontario, Canada

Key Words. Delirium • Neoplasms • Palliative care • Diagnostic techniques and procedures • Antipsychotic agents

Correspondence: Shirley Bush, M.B.B.S., M.R.C.G.P., Division of Palliative Care, Bruyère Continuing Care, 43 Bruyère Street, Ottawa, Ontario, K1N 5C8, Canada. Telephone: 613-562-6262; Fax: 613-562-6371; e-mail: sbush{at}bruyere.org

Received June 18, 2009; accepted for publication September 14, 2009; first published online in THE ONCOLOGIST Express on October 6, 2009.

Disclosures

Shirley H. Bush: None; Eduardo Bruera: None.

Section editor Russell Portenoy has disclosed no financial relationships relevant to the content of this article.

The paper discusses s.c. administration of the parenteral preparation of olanzapine.

The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias.

Delirium remains the most common and distressing neuropsychiatric complication in patients with advanced cancer. Delirium causes significant distress to patients and their families, and continues to be underdiagnosed and undertreated. The most frequent, consistent, and, at the same time, reversible etiology is drug-induced delirium resulting from opioids and other psychoactive medications. The objective of this narrative review is to outline the causes of delirium in advanced cancer, especially drug-induced delirium, and the diagnosis and management of opioid-induced neurotoxicity. The early symptoms and signs of delirium and the use of delirium-specific assessment tools for routine delirium screening and monitoring in clinical practice are summarized. Finally, management options are reviewed, including pharmacological symptomatic management and also the provision of counseling support to both patients and their families to minimize distress.






HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
THE ONCOLOGIST STEM CELLS CME ALPHAMED PRESS JOURNALS


Copyright © 2009 by AlphaMed Press.