The Cleveland Clinic: Improving the Patient Experience 1 Editorial - Medical Second Opinions - The Clinic by Cleveland Clinic Second opinions from Cleveland Clinic’s world-class expert physicians. J U N E 20, 20 2 3 Cleveland, Ohio. IMPORTANT UPDATES MARCO ANTONIO MEDINA ORTEGA JHAN SEBASTIAN SAAVEDRA TORRES The Cleveland Clinic: Gastrointestinal symptoms in cancer patients with advanced disease. He's the best physician that knows the worthlessness of the most medicines. 1 — Benjamin Franklin (1706-1790) American statesman and scientist. Gastrointestinal (GI) symptoms are prevalent, often persistent, and detrimental to patients’ quality of life. Resulting from medication side effects or underlying disease, gastrointestinal (GI) symptoms are among the most common and unpleasant side effects experienced by advanced cancer patients. Gastrointestinal symptoms are reportedly common in advanced cancer, but a causal link is controversial and adequate population control data are lacking (1). Nausea and vomiting are common symptoms, with a reported prevalence of 40–70%, in patients with advanced cancer (2). Gastrointestinal cancer is common, both in the United States and worldwide. Treatments are more effective when the cancer is detected at an early stage—which, unfortunately, can be a challenge (2). Gastrointestinal (GI), and lung cancer patients, the incidence of severe patient-reported nausea was highest in breast cancer patients (17%, versus 14% and 4% in GI and lung cancer cohorts); GI patients reported more moderate to severe diarrhea (31%, versus 22% and 11% for breast and GI cancer cohorts); breast cancer patients reported more severe constipation (15%) and heartburn (11%) than did GI (7%, 5%) or lung (6%, 3%) cancer patients; and GI cancer patients experienced more moderate to severe decrease in appetite (36%) than did lung (30%) or breast (28%) cancer patients (3). Moreover, nausea and vomiting are significant causes of morbidity in this group of patients. In palliative care, the cornerstone of the management of nausea and vomiting is the use of pharmacological interventions, i.e. antiemetic drugs (1,2). It should be noted that the successful management of nausea and vomiting necessitates a thorough assessment of the patient (taking a history, performing an examination and arranging appropriate investigations) (2). Physicians Marco A. Medina Ortega and Jhan S. Saavedra prepared this topic. Research Associates Medical Second Opinions - The Clinic by Cleveland Clinic provided assistance. - The Clinic by Cleveland Clinic cases are developed solely as the basis for class discussion. Cases are not intended to serve as endorsements, sources of primary data, or illustrations of effective or ineffective management. Copyright © 2023 The Cleveland Clinic Foundation. All rights reserved. The information provided is for educational purposes only. Use of this website is subject to the website terms of use and privacy policy. This publication may not be digitized, photocopied, or otherwise reproduced, posted, or transmitted, without the permission of The Cleveland Clinic Foundation. 9500 Euclid Avenue, Cleveland, Ohio 44195 | 800.223.2273.