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Sept 21, 1984

Treatment for Pain in Terminal Illness

Author Affiliations

Montgomery Family Practice Center Norristown, Pa

JAMA. 1984;252(11):1410. doi:10.1001/jama.1984.03350110016016

To the Editor.—  We refer to the recent article by McGivney and Crooks1 on treatment of pain in terminal illness. However, we believe that an important modality for provision of analgesic medications has been overlooked. The following case will illustrate this.

Report of a Case.—  On Feb 5, 1982, an 87-year-old woman was admitted to the hospital with a four-month history of epigastric pain and weight loss. She was found to be anemic at the time of admission, and upper gastrointestinal tract roentgenograms revealed a mass in the stomach. Endoscopy with biopsy produced the diagnosis of adenocarcinoma of the stomach. Surgery was considered but refused by the patient and her family. The patient was without much pain initially but gradually experienced epigastric pain. This was originally controlled with antacids and oral narcotics. However, during the next 1 1/2 years, the patient had increasing difficulty swallowing and episodes of nausea.