Palliative Medicine Point of Care UltraSound in Cancer Patients in a Specialist Palliative Medicine Outpatient Department: A Retrospective Analysis of Diagnostic and Procedural Impact

专科姑息治疗门诊癌症患者姑息治疗床旁超声检查:诊断和操作影响的回顾性分析

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Abstract

OBJECTIVES: This retrospective study aimed to evaluate the utilisation and clinical impact of palliative medicine POCUS (PM-POCUS) in a specialist palliative care OPD, in a tertiary cancer centre in India. Patients with advanced cancer frequently present to palliative care outpatient departments (OPDs) with symptoms such as dyspnoea and abdominal distension, often due to pleural effusion, ascites or deep vein thrombosis. Timely diagnosis of these conditions is critical for symptom relief, yet access to imaging is frequently delayed, particularly in resource-limited settings. Point-of-care ultrasound (POCUS), performed by the treating physician, offers a rapid, bedside diagnostic tool that can guide immediate management decisions. While POCUS has demonstrated utility in inpatient and hospice environments, its application and impact in palliative OPD settings remain underexplored. MATERIALS AND METHODS: We included adult cancer patients (≥18 years) who underwent PM-POCUS between September and December 2024. All scans were performed by a single consultant to ensure consistency. The primary outcome was the proportion of cases where PMPOCUS influenced clinical management; secondary outcomes included the spectrum of indications and symptom relief. RESULTS: Ninety PM-POCUS applications were performed in 76 patients, predominantly with gastrointestinal, breast or gynaecological cancers. The most common indications were abdominal distention and dyspnoea. Ascites was diagnosed in 58 cases, pleural effusion in 16. 33% of POCUS assessments led to interventions, including paracentesis, pain blocks and pleural tapping. CONCLUSION: Routine integration of PM-POCUS in palliative OPD facilitated rapid diagnosis and intervention, significantly impacting clinical management and symptom relief for advanced cancer patients. These findings support broader adoption and further research on PM-POCUS in outpatient palliative care.

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