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Supportive Care
Palliative Care

Helping Patients With Advanced Disease Transition From Focused to Intrinsic Hope

While hope for a cure after a cancer diagnosis is a feeling both patients and oncologists rightly cling to during treatment, when too much emphasis is placed on this type of “focused” hope, it can make it more difficult for patients to face their mortality. Moreover, such a focus can deny patients ...

Supportive Care
Palliative Care

ASCO Answers Palliative Care: A Resource for Patients

Do your patients have questions about palliative care/supportive care? Help them better understand their prognosis and goals of treatment, clarify their expectations, and maintain their quality of life with the ASCO Answers Palliative Care booklet.  This booklet shows how palliative care is used...

Supportive Care
Palliative Care

Walther Cancer Foundation Endows New ASCO Special Award and Lecture for Palliative and Supportive Care

The Walther Cancer Foundation, Inc., a private foundation based in Indianapolis, Indiana, has endowed a new ASCO award and lecture bearing its name to be presented annually at the Palliative and Supportive Care in Oncology Symposium. This grant represents a new foray for the foundation as it...

Supportive Care
Palliative Care

Caring for the Frail, Older Patient With Cancer: Four Practical Approaches

Cancer may be a disease of aging, but data suggest that older patients with cancer are undertreated, especially with respect to chemotherapy. One analysis showed that approximately 40% of patients in their 70s—and 60% of patients in their 80s—do not receive adjuvant therapy after surgery for colon...

Supportive Care
Palliative Care

‘Triple Threat’ Conditions May Predict Mortality in Patients With Cancer Presenting to Emergency Departments

Dyspnea, delirium, and poor performance—so-called “triple threat” conditions—are known to predict short survival in palliative care. According to data presented at the 2017 Palliative and Supportive Care in Oncology Symposium,1 however, the presence of at least two of these symptoms in patients...

Supportive Care
Palliative Care

Concurrent Palliative Care: Recommendations From the ASCO Clinical Practice Guideline

Updated in 2016, the ASCO clinical practice guideline on the integration of palliative care into standard oncology care provides evidence-based recommendations to oncology clinicians, patients, family and friend caregivers, and palliative care specialists about providing high-quality care for...

Supportive Care
Palliative Care
Cost of Care
Issues in Oncology

Palliative Care Intervention Reduces Total Health-Care Costs in Patients With Advanced Cancer

A matched case-controlled study among Medicare beneficiaries with metastatic lung, colorectal, breast, and prostate cancers has found that palliative care consultation significantly reduced total health-care costs following intervention. According to data presented at the 2017 Palliative and...

Supportive Care
Palliative Care

Digital Palliative Care Curriculum Improves Knowledge, Skills, and Opioid Prescribing Behavior

A new electronic curriculum delivered via e-mail with push technology may provide an efficient, cost-effective solution to the shortage of palliative care faculty serving the nation’s oncology fellowship programs. According to data presented at the 2017 Palliative and Supportive Care in Oncology...

Supportive Care
Palliative Care

Early Integrated Palliative Care Improves Patient Coping Strategies, Quality of Life, and Symptoms of Depression

A new study has shed light on how palliative care interventions may improve patient outcomes. According to data presented at the 2017 Palliative and Supportive Care in Oncology Symposium,1 patients with incurable cancer who received early integrated palliative care had an increased use of active...

Supportive Care
Palliative Care

Advancing Care Across the Cancer Continuum

Addressing the need to integrate palliative and supportive care practices into medical specialties to ensure optimal patient-centered care across the cancer continuum and the evidence-based remedies to accomplish that goal were the focus of the nearly 300 study abstracts presented at the 2017...

Supportive Care
Palliative Care

How Effective Communication Is Integral to Patient-Centered Care

Communicating effectively with patients with advanced cancer not only helps patients and their family members successfully transition to palliative and end-of-life care, it can prevent physicians from experiencing professional burnout, according to Robert M. Arnold, MD, Distinguished Service...

palliative care

Areej El-Jawahri, MD, on A Revolutionary Plan for End-of-Life Care

Areej El-Jawahri, MD, of Massachusetts General Hospital, discusses a video tool that helps overcome communication barriers so that patients can make more informed decisions for end-of-life care and their preferences are respected.

issues in oncology
palliative care

Sandip Patel, MD, on Immunotherapy: New Developments and Toxicity Challenges

Sandip Patel, MD, of the University of California, San Diego, discusses diagnosing and managing immune-related adverse events from immune checkpoint blockade and the toxicities of these treatments.

palliative care

Jamie Jacobs, PhD, on Early Integrated Palliative Care: The Positive Effects

Jamie Jacobs, PhD, of Massachusetts General Hospital Cancer Center, discusses study results that showed integrating oncology and palliative care early in the course of treatment helps people with incurable lung and gastrointestinal cancers cope better and have an improved quality of life and less depression (Abstract 92).

palliative care

Michael Hoerger, PhD, on Early Palliative Care: Study Results

Michael Hoerger, PhD, of Tulane University, discusses the effect on quality of life, depression, and end-of-life care when physicians focus on coping or on decision-making and advance care planning (Abstract 154).

palliative care
pain management

Jacob J. Strand, MD, on Dealing With Opioid Use Disorders

Jacob J. Strand, MD, of the Mayo Clinic, discusses tips and tools that clinicians can use to develop universal precautions for prescribing opioids in oncology and palliative care practice.

palliative care

Thomas J. Smith, MD, on Palliative Care and Outpatient Treatment: Expert Perspective

Thomas J. Smith, MD, of Johns Hopkins University School of Medicine, discusses successful models of integrating palliative care into outpatient oncology.

palliative care

Charles F. von Gunten, MD, PhD, on Palliative Care in Oncology: A Fellows Curriculum

Charles F. von Gunten, MD, PhD, of OhioHealth, discusses an online curriculum that changed younger physicians’ use of palliative medicine in practice during the year after fellowship training (Abstract 202).

palliative care
symptom management

Eric Roeland, MD, on Symptom Management: Expert Perspective

Eric Roeland, MD, of the University of California, San Diego, summarizes key papers delivered at the Palliative Care Symposium on managing insomnia, fatigue, nausea, and the ways in which physical therapy and nausea can reduce the side effect burden.

palliative care

Changes in Opioid Prescription for Cancer Patients Referred to Outpatient Palliative Care

In a study reported in the Journal of Oncology Practice, Haider et al found that the median morphine equivalent daily dose decreased significantly among cancer patients seen at MD Anderson Cancer Center’s outpatient palliative care clinic between 2010 and 2015. Use of hydrocodone decreased...

palliative care
lung cancer

2017 ASCO Palliative Care: Yoga Can Be an Effective Supportive Therapy for People With Lung Cancer and Their Caregivers

In a feasibility trial of people with advanced lung cancer receiving radiation therapy and their caregivers, yoga was beneficial to both parties. These findings will be presented by Milbury et al at the upcoming 2017 Palliative and Supportive Care in Oncology Symposium in San Diego (Abstract 125). ...

palliative care
leukemia

2017 ASCO Palliative Care: People With Leukemia and Their Oncologists Have Vastly Different Perceptions of Prognosis

A study of 100 people with acute myeloid leukemia (AML) receiving chemotherapy found that patient and physician perceptions of treatment risk and the likelihood of a cure varied widely. Overall, patients tended to overestimate both the risk of dying due to treatment and the likelihood of a cure....

palliative care

2017 ASCO Palliative Care: Resilience Intervention Improves Quality of Life for Adolescents and Young Adults With Cancer

Although a cancer diagnosis is daunting at any age, adolescents and young adults (AYAs) with the disease often face unique challenges and are at risk for poor psychosocial outcomes than older patients. A randomized study investigating whether a brief, age-appropriate, skills-based intervention...

palliative care

2017 ASCO Palliative Care: Patients With Advanced Cancer Prefer Oncologists Not Use Computers in the Exam Room

Although the use of electronic health records in oncology care has led to improved care for patients, results from a new study show that oncologists need to be cautious about using computers during exam room visits, especially for patients with advanced cancer. The randomized study compared...

palliative care

Integrative Therapies in Palliative Care Project

Palliative care professionals are invited to participate in a unique project sponsored by the National Cancer Institute. Collinge and Associates, Inc, is seeking interdisciplinary professionals to help develop and evaluate a new online continuing education (CE/CME) course on the use of integrative...

palliative care

Inpatient Palliative Care During HCT and Psychological Distress After Transplantation

In a single-center study reported in the Journal of Clinical Oncology, El-Jawahri et al found that inpatient palliative care during hematopoietic stem cell transplantation was associated with improvement in depression and post-traumatic stress disorder (PTSD) symptoms at 6 months after...

Palliative Care

How Early Palliative Care May Benefit Patients With Incurable Cancer

Palliative care provided soon after a patient is diagnosed with incurable cancer not only helps improve the patient’s overall quality of life but also improves communication about the patient’s wishes for end-of-life care, according to a study by Jennifer S. Temel, MD, Clinical Director of Thoracic ...

Thyroid Cancer
Prostate Cancer
Lung Cancer
Survivorship
Palliative Care

News From JCO and JOP

STAYING UP-TO-DATE in the fast-paced world of oncology literature is a daunting task at best. To assist with that task, The ASCO Post has assembled an assortment of studies recently published in the Journal of Clinical Oncology (JCO) and the Journal of Oncology Practice (JOP). Future installments...

palliative care
lung cancer

ESMO 2017: 'Triggers': A New Tool to Assess Patients’ Palliative Needs

A new tool to identify patients who would benefit from early palliative care was presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract LBA54_PR). The so-called “Triggers” tool, developed by the London Cancer Alliance to help clinicians in the...

palliative care

Assessment of Embedding Palliative Care Nurse Practitioners in Oncology Clinics

In a study reported by Walling et al in the Journal of Oncology Practice, the embedding of a palliative care nurse practitioner in an oncology clinic resulted in improved hospice referral, advance care planning documentation, and referral for psychosocial support. Study Details The study compared ...

palliative care

Integration of Oncology and Palliative Care in a Solid Tumor Inpatient Service

In a retrospective study reported in the Journal of Oncology Practice, Riedel et al found that integration of oncology and palliative care in a solid tumor inpatient service resulted in improvements in quality-of-care metrics during the first year of implementation. Study Details The study...

palliative care

Palliative Care May Substantially Decrease Health-Care Utilization in Patients With Advanced Cancer

A new population-based study shows that palliative care substantially decreased health-care utilization among Medicare beneficiaries with advanced cancer, resulting in less intensive care being delivered at the end of life. This included lower rates of hospitalization, fewer invasive procedures,...

palliative care

Physician Orders for Life-Sustaining Treatment Form Use and End-of-Life Quality-of-Care Metrics in Cancer Patients

In a study reported in the Journal of Oncology Practice, Pedraza et al found that patients with advanced cancer who had Physician Orders for Life-Sustaining Treatment (POLST) forms in place were more likely to have hospice admission and death out of the hospital than those with only advance...

Palliative Care

An Expert on End-of-Life Care Shares Her Stories

“In the sufferer let me see only the human being.” So said Maimonides, the medieval Jewish philosopher and physician who espoused treating the patient rather than the illness, a philosophy that modern oncology had to relearn. This brief quote greets readers of a new book called Extreme Measures:...

Palliative Care

An Educational Program for Safe Handling of Opioids

Improper storage, use, and disposal of prescribed opioids can lead to diversion or accidental overdose. Given that opioids are the mainstay of cancer pain treatment, this issue is particularly germane in the oncology community. The ASCO Post recently spoke with Akhila Reddy, MD, and Maxine de la...

Supportive Care
Palliative Care

Ensuring Advance Directives Are Followed and Lawsuits Are Avoided

Thaddeus Mason Pope, JD, PhD, has focused his legal career on improving medical care decision-making and protecting patients’ rights at the end of life. His specific areas of legal expertise include patients’ rights, informed consent, and end-of-life medicine. Dr. Pope is the coauthor of The Right ...

Supportive Care
Palliative Care

Advance Care Planning: Ensuring Patients’ End-of-Life Wishes Are Honored

When Amy Berman, BSN, LHD (aged 58), stood in front of the mirror to perform a routine breast self-exam and saw redness and dimpling on her right breast, she feared they were the telltale signs of inflammatory breast cancer. “I have never self-diagnosed myself before, but I had recently read an...

Palliative Care
Supportive Care

Understanding the Cultural Differences Among Ethnic Minorities in Palliative and End-of-Life Care

GUEST EDITOR Addressing the evolving needs of cancer survivors at various stages of their illness and care, Palliative Care in Oncology is guest edited by Jamie H. Von Roenn, MD. Dr. Von Roenn is ASCO’s Vice President of Education, Science, and Professional Development.   Because cultural origins...

palliative care

Impact of Palliative Care on End-of-Life Services for Patients Dying in a Hospital

In a single-center retrospective analysis reported in the Journal of Oncology Practice, Wiesenthal et al found that among patients dying in a hospital, those with palliative care in place at final admission received less diagnostic testing and other services not associated with promoting patient...

palliative care

Effect of Embedding Palliative Care in an Oncology Clinic

A retrospective analysis reported in the Journal of Oncology Practice by Einstein et al showed the benefits of embedding palliative care in a clinic specializing in targeted and immune-based treatments in patients with melanoma or renal cancer. Study Details The study included data from 114...

Hematologic Malignancies
Palliative Care

Lack of Access to Transfusions Limits Hospice Use by Patients With Hematologic Malignancies

A new survey finds that doctors would refer more patients with incurable blood cancers to hospice for end-of-life care if they could receive transfusions, which are generally not available because of hospice reimbursement policies. The findings, published by Oreofe Odejide, MD, MPH, and colleagues ...

palliative care
hematologic malignancies

Lack of Access to Transfusions Limits Hospice Use by Patients With Blood Cancer

A new survey finds that doctors would refer more patients with incurable blood cancers to hospice for end-of-life care if they could receive transfusions, which are generally not available because of hospice reimbursement policies. The findings, published by Odejide et al in Cancer, help explain...

Palliative Care

Pediatric Oncology Patient and Parent Attitudes on Early Palliative Care Integration

Few pediatric oncology patients or their parents expressed negative attitudes toward early integration of palliative care during cancer treatment, in a study by Deena R. Levine, MD, of the Division of Quality of Life and Palliative Care, St Jude Children’s Research Hospital, and colleagues reported ...

palliative care

Racial/Ethnic Disparities in End-of-Life Care for Patients With Ovarian Cancer

A study using linked Texas Cancer Registry–Medicare data has identified racial/ethnic disparities in end-of-life care in women with ovarian cancer. The study was reported by Taylor et al in the Journal of Clinical Oncology. Study Details The study included 3,666 patients dying in 2000 to...

Palliative Care

Practice-Changing Research: Making Palliative Care a Routine Part of Cancer Care in the United States and Abroad

With its recently issued clinical practice guideline update, reviewed in this issue of The ASCO Post, ASCO has spoken: Interdisciplinary palliative care teams improve the outcomes of cancer care; patients live longer and feel better.1 There is no doubt. Multiple well-designed studies show the...

Palliative Care

ASCO Clinical Practice Guideline Update: Integration of Palliative Care Into Standard Oncology Care

As reported in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline update on integration of palliative care into standard oncology care.1 This update of a 2012 ASCO provisional clinical opinion2 is based on an Expert Panel’s systematic review of data reported between...

palliative care

Use of ‘Triggers’ for Palliative Care Consultation on Solid Tumor Oncology Service

In a study reported in the Journal of Oncology Practice, Adelson et al found that using standardized criteria for palliative care consultation on a solid tumor oncology service resulted in increased hospice referral and reduced rates of hospital readmission and chemotherapy use after discharge....

palliative care

Pediatric Oncology Patient and Parent Attitudes on Early Palliative Care Integration

Few pediatric oncology patients or their parents expressed negative attitudes toward early integration of palliative care during cancer treatment, according to a study by Levine et al reported in JAMA Oncology. Study Details The study involved completion of surveys by 129 patient-parent dyads...

palliative care
issues in oncology

Palliative Care Consultations for Patients With Advanced Cancers May Reduce Hospitalization and Improve Quality of Care

Patients admitted to the hospital with advanced cancers who were referred early to palliative care had decreased health-care utilization and increased use of support services following discharge, according to a new study led by researchers at the Icahn School of Medicine at Mount Sinai. Published...

Supportive Care
Palliative Care

Examining the Impact of ‘Death With Dignity’ Legislation

Despite the controversy surrounding “Death With Dignity” laws, which allow physicians to prescribe life-ending drugs to terminally ill patients, they have a long history of majority support from Americans. According to a Gallup poll taken in 2015, nearly 7 in 10 Americans (68%) agreed that...

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