The British Medical Journal (BMJ), one of the most renowned medical publications in the world, published in September an article on the benefits of palliative care in the case of a patient with gastroesophageal junction cancer , that subsequently developed a rare neurological complication (leptomeningeal carcinomatosis), which was followed in the Unit of Palliative Care from Hospital da Luz Lisboa , under several specialties (Oncology, Neurosurgery and Radio-oncology). The authors of the article are physicians Renato Cunha and Mariana Inácio (of the Oncology Department of Hospital do Espírito Santo), João Godinho (internist of HBA Department of Oncology) and Isabel Galriça Neto (director of the Unit of Continuing and Palliative Care from Hospital da Luz Lisboa, where Renato Cunha and João Godinho where doing an internship). In the analysed case , one and a half year after being operated abroad, the patient started experiencing loss of strength in the legs, loss of balance and dysphalgia, being referred, after revision in oncology, to symptom control and stabilization in palliative care. After new exams, where extensive and irreparable neurological lesions were detected, the multidisciplinary medical team considered that further targeted chemo and radiotherapy treatments would not have beneficial effects in terms of survival or quality of life, on the contrary, due to the high level of toxicity. Given the variability of manifestations of the disease and the bad prognosis and priority of comfort objectives, it was decided that the best option would be to proceed with palliative care and offer the patient the higher stability and comfort possible. The patient was discharged from the Unit of Palliative Care after two weeks, remained other two weeks at home and ended by being readmitted to hospital five days before passing away. Author’s conclusions: In the article – entitled “Palliative approach to leptomeningeal carcinomatosis in gastroesophageal junction cancer” –, the current possibilities of medical treatment are re-evaluated, with special focus on the beneficial potentialities of palliative care for patients diagnosed with rare carcinomas, preferably not in late stages. “Although leptomeningeal carcinomatosis is rare, this case is important to understand the differences between the available strategies and support the palliative care interdisciplinary approach, with benefits for patients and family, both at physical and psychosocial level.”
