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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...

palliative care
symptom management

Palliative Radiation Therapy for Bone Metastases: Update of an ASTRO Evidence-Based Guideline

The American Society for Radiation Oncology (ASTRO) recently published an updated clinical guideline that underscores the safety and effectiveness of palliative radiation therapy for treating painful bone metastases. Based on recent clinical trial data, the guideline recommends optimal radiotherapy ...

palliative care

Patient Coaching and End-of-Life Discussions in Advanced Cancer

As reported by Rodenbach et al in the Journal of Clinical Oncology, a patient coaching session for patients with advanced cancer prior to an oncologist visit made it more likely that patients would discuss their prognosis during the visit. However, prognosis was still infrequently discussed. Study ...

Palliative Care

Canadian Study Looks at an Integrated Palliative Care Model

Although initiation of palliative care from the time of cancer diagnosis produces optimal outcomes for patients, this strategy is often not practiced. A recent Canadian study conducted in patients with advanced cancer and their caregivers examined the opinions of patients with advanced cancer and...

palliative care

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

As reported by Betty R. Ferrell, PhD, of the City of Hope Medical Center, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline update on the integration of palliative care into standard oncology care. This update of a 2012 ASCO provisional clinical...

palliative care

Benefit of Early Integrated Palliative Care in Patients With Newly Diagnosed Incurable Cancer

In a study reported in the Journal of Clinical Oncology, Temel et al found that early integration of palliative care resulted in better quality of life and reduced depression in patients with newly diagnosed incurable lung or noncolorectal gastrointestinal cancer. Outcomes differed by cancer type. ...

Palliative Care

Weighing the Benefits and Risks of Medical Marijuana

Despite the fact that 28 states and the District of Columbia have enacted laws to permit the use of cannabis and cannabinoid-based drugs to treat medical conditions, including cancer and symptoms from its treatment, federal law prohibits physicians from prescribing marijuana to their patients,...

palliative care

ESMO Asia 2016: Study Validates Set of Six Adaptable Prognosis Prediction Models for Patients With Cancer in Palliative Care Settings

A routine blood test may predict how long patients with cancer in palliative care will survive, researchers reported at the ESMO Asia 2016 Congress in Singapore. “Cancer patients in palliative care want honest and accurate prognostic information but this information needs to be shared...

palliative care
hematologic malignancies

Effect of Inpatient Palliative Care on Quality of Life After Stem Cell Transplant

Integrating palliative care into the treatment of patients undergoing hematopoietic stem cell transplantation for cancers like leukemia and lymphoma can improve their quality of life, relieve symptoms associated with the procedure, and reduce depression and anxiety, not only during the 3- to 4-week ...

Palliative Care

Palliative Care Improves Quality of Life, Relieves Symptoms

People living with serious illness who receive palliative care have better quality of life and fewer symptoms than those who don’t receive palliative care, according to a new study by researchers at the University of Pittsburgh School of Medicine. Published by Dio Kavalieratos, PhD, Assistant...

Palliative Care

How When Breath Becomes Air Is Helping the Public—and Physicians—Confront Their Mortality

It should not come as a surprise to anyone who has read Dr. Paul Kalanithi’s brilliant—and unforgettable—memoir, When Breath Becomes Air (Random House, 2016), that nearly a year after publication, it remains on The New York Times best-seller list, its popularity only increasing with time. Written...

Palliative Care

How Video Support Tools Help Patients Make Informed Decisions About End-of-Life Care

A relatively recent study by Areej El-Jawahri, MD, and her colleagues is showing how the use of visual media can empower patients with advanced cancer, as well as other life-threatening illnesses, to make more informed decisions about their end-of-life care.1 The aim of Dr. El-Jawahri’s study was ...

Palliative Care

Research Highlights From the 2016 Palliative Care in Oncology Symposium

More than 650 attendees gathered in San Francisco on September 9 and 10 for the 2016 Palliative Care in Oncology Symposium, focusing on the theme of “Patient-Centered Care Across the Cancer Continuum.” Research presented during the Symposium demonstrated how integrating palliative care into cancer...

palliative care
issues in oncology
symptom management

Prolonged Length of Stays, Readmissions, and Discharge to Care Facilities Among Postoperative Patients With Advanced Cancer

Patients with disseminated advanced cancer who undergo surgery are far more likely to endure long hospital stays and readmissions, referrals to extended care facilities, and death, University of California (UC) Davis researchers have found. Their study, published by Bateni et al in PLOS One,...

Palliative Care

Quality Improvement Project Results in Timelier Hospice Referrals

A quality improvement project conducted within the OhioHealth system showed that oncologists can change their behavior and refer patients earlier to hospice care. After a relatively minor intervention, 18 medical oncologists in private practice doubled the mean length of stay in hospice care for...

Palliative Care

Food as Medicine: Study Sets Out to Prove Its Effectiveness

Could the quality of life of patients with advanced-stage cancer be improved by personal delivery of nutritious, medically tailored meals? Researchers at the New York University School of Medicine Perlmutter Cancer Center think so, and they have set out to prove it in a randomized clinical trial....

Hematologic Malignancies
Palliative Care

Palliative Care Still in Its Infancy in Hematologic Malignancies

Palliative care is slowly but surely being integrated into the treatment of patients with solid tumors, but its role in the hematopoietic stem cell transplant setting is still lagging, speakers said at the 2016 Palliative Care in Oncology Symposium. “There is a huge symptom burden among patients...

palliative care

ESMO 2016: Researchers Identify Factors Associated With End-of-Life Chemotherapy Use

The rates of administering chemotherapy to patients with solid cancers within a month of succumbing to their disease remain high, which calls for a paradigm shift to consider initiating palliative care at an earlier stage and formulating clear guidelines for end-of-life care, according to findings...

solid tumors
palliative care

Philippe Rochigneux, MD, on Solid Tumors: Use of Chemotherapy Near End of Life (French Language Version)

Philippe Rochigneux, MD, of the Paoli Calmettes Institute, Marseille Cancer Center, discusses in French his findings on the high rates of chemotherapy used at the end of life for metastatic solid cancer, especially in young patients treated in high-volume centers without a palliative care unit. (Abstract 1300O)

solid tumors
palliative care

Philippe Rochigneux, MD, on Solid Tumors: Use of Chemotherapy Near the End of Life

Philippe Rochigneux, MD, of the Paoli Calmettes Institute, Marseille Cancer Center, discusses his findings on the high rates of chemotherapy used at the end of life for metastatic solid cancer, especially in young patients treated in high-volume centers without a palliative care unit. (Abstract 1300O)

Issues in Oncology
Supportive Care
Palliative Care

Why Care About the Caregivers?

Caregivers of patients with cancer provide invaluable health-care services, but they are an underserved and undervalued group, with many unmet needs. Early palliative care may provide important benefits to these often tireless individuals, according to J. Nicholas Dionne-Odom, PhD, RN, ACHPN, of...

Palliative Care

Benefits of Early Palliative Care Interventions Extend Beyond the Patient

A session at the 2016 Palliative Care in Oncology Symposium focused on the special needs of cancer caregivers. In a large survey, caregivers of persons with cancer reported higher levels of stress and significantly more duties than caregivers of other patients. But, according to research from...

Palliative Care

Palliative Care: Let’s Use the Tools We Already Have

Clinicians and researchers in the field of palliative and supportive care are enjoying the recognition the field is now receiving and expecting the future to be ripe with opportunity. But one thought leader in this specialty had a suggestion for attendees at the 2016 Palliative Care in Oncology...

Symptom Management
Palliative Care

Pearls for Managing Immune-Related Toxicities

With checkpoint inhibitors in frequent use, clinicians strive daily to balance the efficacy and toxicity of these treatments. At the 2016 Palliative Care in Oncology Symposium, Lynn M. Schuchter, MD, FASCO, the C. Willard Professor of Hematology-Oncology at the University of Pennsylvania,...

Issues in Oncology
Palliative Care

Immunotherapy Brings Unique Challenges for Clinicians

The advent of immunotherapies has created a number of interesting challenges for oncology providers. At the 2016 Palliative Care in Oncology Symposium, specialists in the field tackled these issues. “There is a lot of newness to how we approach patient care with immunotherapies on board,” said...

Palliative Care

Bridging the Gap in Oncology Care

The third annual Palliative Care in Oncology Symposium, held on September 9–10, 2016, in San Francisco, California, brought together more than 650 attendees from multiple countries, including the United States, Canada, the United Kingdom, France, Italy, and China. It featured over 250 study...

palliative care

Palliative Care 2016: Rehospitalization of Patients With Advanced Cancer in the Year After Diagnosis

Among individuals with advanced cancer, frequent hospitalization is often at odds with patient preference and is increasingly viewed as a hallmark of poor quality care. Hospitalization contributes substantially to costs and regional spending variation in this population, but patterns and reasons...

palliative care

Palliative Care 2016: Attitudes of ASTRO Members Toward Palliative and Supportive Care in the United States

Radiation oncologists are frequently involved in providing palliative and supportive care for patients with advanced cancers through delivery of palliative radiation. Whether they are confident in their ability to assess and initiate treatments for pain, nonpain, and psychosocial distress is...

palliative care
issues in oncology

Palliative Care 2016: Usage of Oregon’s Death With Dignity Act

In 1997, Oregon enacted a voter initiative allowing terminally ill residents to self-administer physician-prescribed medication to end their lives called the Oregon Death With Dignity Act (ORDWDA). Statute requires prescriptions written for lethal medications be reported; the state also collects...

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