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C
ancer
patients
,
emergencies
service
and
provision
of
palliative
care
R
ev
A
ssoc
M
ed
B
ras
2016; 62(3):207-211
207
ORIGINAL ARTICLE
Cancer patients, emergencies service and provision of palliative care
B
runo
M
iranda
¹
, S
uely
A
rruda
V
idal
²
*, M
aria
J
úlia
G
onçalves
de
M
ello
³
, J
urema
T
elles
de
O
liveira
L
ima
4
, J
udith
C
orreia
R
êgo
5
,
M
ilena
C
ândido
P
antaleão
5
, V
iviane
G
omes
C
arneiro
L
eão
5
, F
ernando
A
ntônio
R
ibeiro
de
G
usmão
F
ilho
6
, J
osé
I
ran
da
C
osta
J
únior
7
1
MSc in Palliative Care – Physician and Instructor of the Medical Oncology Residency Program at Instituto de Medicina Integral Prof. Fernando Figueira (Imip), Recife, PE, Brazil
2
PhD in Maternal and Child Health – Lecturer of the Graduate Program; Researcher of the Study Group on Management and Evaluation of Health, Imip, Recife, PE, Brazil
3
PhD in Tropical Medicine from Centro de Ciências da Saúde, Universidade Federal de Pernambuco. Operations Coordinator, Dinter Inca/Imip. Lecturer of the Undergraduate Program at Faculdade Pernambucana de Saúde,
and of the Graduate Program at Imip, Recife, PE, Brazil
4
MSc in Health Sciences from Universidade de Pernambuco. Oncology PhD Student at Dinter Inca/Imip. Vice-coordinator of the Professional Master of Palliative Care Program linked to the Medical Residency in Health,
Imip. Lecturer of the Medical Undergraduate Program, Faculdade Pernambucana de Saúde, Recife, PE, Brazil
5
Medical Student, Faculdade Pernambucana de Saúde, Recife, PE, Brazil
6
PhD in Public Health from Centro de Pesquisas Aggeu Magalhães, Pernambuco, PE. Director of Human Resource Management, Health Department of Recife, PE, and Researcher of the Study Group on Management and
Evaluation of Health, Imip, Recife, PE, Brazil
7
Oncology PhD Student at Dinter Inca/Imip. Director of Hospital de Câncer de Pernambuco, Recife, PE, Brazil
S
ummary
Study conducted at Instituto de Medicina
Integral Prof. Fernando Figueira (Imip),
Recife, PE, Brazil
Article received:
8/11/2014
Accepted for publication:
5/4/2015
*Correspondence:
Address: Rua Francisco da Cunha,
1910/102-B
Boa Viagem
Recife, PE – Brazil
Postal code: 51020-041
Phone: +55 81 2122-4122 (Imip)
suely@imip.org.br http://dx.doi.org/10.1590/1806-9282.62.03.207Objective:
To describe the clinical and sociodemographic profile of cancer pa-
tients admitted to the Emergency Center for High Complexity Oncologic Assis-
tance, observing the coverage of palliative and home care.
Method:
Cross sectional study including adult cancer patients admitted to the
emergency service (September-December/2011) with a minimum length of hos-
pital stay of two hours. Student’s t-test and Pearson chi-square test were used to
compare the means.
Results:
191 patients were enrolled, 47.6% elderly, 64.4% women, 75.4% from the
city of Recife and greater area. The symptom prevalent at admission was pain
(46.6%). 4.2% of patients were linked to palliative care and 2.1% to home care.
The most prevalent cancers: cervix (18.3%), breast (13.6%) and prostate (10.5%);
70.7% were in advanced stages (IV, 47.1%); 39.4% without any cancer therapy.
Conclusion:
Patients sought the emergency service on account of pain, proba-
bly due to the incipient coverage of palliative and home care. These actions
should be included to oncologic therapy as soon as possible to minimize the
suffering of the patient/family and integrate the skills of oncologists and emer-
gency professionals.
Keywords:
neoplasms, palliative care, home care, emergency medical services.
I
ntroduction
Cancer is currently the second cause of death in the world
1
and in Brazil,
2
causing greater impact in poor and devel-
oping countries.
3
This fact is associated with the increas-
ing aging of the world population; the adoption of un-
healthy habits such as smoking, sedentary lifestyle and
poor diet; sexually transmitted infections; and lack of ac-
cess to health services for early detection and treatment.
4
In Brazil, factors such as changes in the demographic
profile with more people aged 50 years or older and an ep-
idemiological polarization caused by growth in chronic-
degenerative diseases, increase the likelihood of cancer.
2
This change in the Brazilian profile led to the need
for restructuring the health system, especially in relation
to the care of chronic diseases such as cancer.
5
The Min-
istry of Health (MH) launched by Ordinance N
o
2,439/
GM on December 8, 2005, its National Policy for Onco-
logic Care with actions related to promotion, prevention,
diagnosis, treatment, rehabilitation and palliative care.
6
The policy was later revised, updated and extended by Or-
dinance N
o
874/GM on May 16, 2013, which established
the National Policy for Cancer Control and Prevention
in the Health Care Network of Patients with Chronic Dis-
eases under the Brazilian Unified Health System (SUS).
7
This policy calls for the implementation of a line of
care at all levels, in a hierarchical network, establishing
the obligation of integrated care, with primary and emer-
gency services. The latter should be provided by tertiary
units, called Units for High Complexity Care in Oncol-
ogy (Unacon) and Centers for High Complexity Care in