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palliative care
issues in oncology
global cancer care

Site of Death, Health-Care Utilization, and Hospital Expenditures for Patients Dying With Cancer in Developed Countries

In a study reported in JAMA, Bekelman et al assessed the site of death, health-care utilization, and hospital expenditures among patients aged ≥ 65 years dying with cancer in Belgium, Canada, England, Germany, the Netherlands, Norway, and the United States. The United States had lower...

palliative care

2015 Palliative Care in Oncology Symposium Highlights

The Palliative Care in Oncology Symposium, held October 9–10, 2015, in Boston, Massachusetts, brought together more than 670 members of the cancer care community, including oncologists, radiologists, palliative care specialists, nurses, and patient advocates. Sessions delivered information on...

palliative care
cost of care

Kerin B. Adelson, MD, on Improving End-of-Life Planning and Reducing Futile Care

Kerin B. Adelson, MD, of the Yale Cancer Center, discusses the major healthcare cost drivers at the end of life—aggressive treatments, emergency room visits, and futile care—and strategies for improving value. (Abstract 3)

palliative care
lung cancer
issues in oncology

Afatinib Shows Clinical Benefit for Non–Small Cell Lung Cancer Patients With Brain Metastases

Non­–small cell lung cancer (NSCLC) patients with common epidermal growth factor (EGFR) mutations and brain metastases showed improved progression-free survival and response from the EGFR tyrosine kinase inhibitor afatinib (Gilotrif) compared to standard platinum doublet chemotherapy....

palliative care

Study Finds Need for Improved End-of-Life Care for Parents With Terminal Cancer

Care for mothers with terminal cancer could be improved to help resolve their psychological distress and to help surviving family members cope, a study by University of North Carolina at Chapel Hill researchers have found. Based on the study findings published by Park et al in the journal BMJ...

palliative care
survivorship

Samuel M. Silver, MD, PhD, and David S. Ettinger, MD, on the Characteristics of an Optimal Clinical Practice Guideline

Samuel M. Silver, MD, PhD, of the University of Michigan Comprehensive Cancer Center, and David S. Ettinger, MD, of The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, discuss the evolution of the NCCN Guidelines, the importance of including palliative care and survivorship recommendations, and the use of the guidelines in community practices.

supportive care
symptom management
palliative care

Daniel A. Vorobiof, MD, and Bernardo Leon Rapoport, MD, on NK-1 Inhibitors for CINV: Potentially Practice-Changing Data

Daniel A. Vorobiof, MD, of the Sandton Oncology Centre, and Bernardo Leon Rapoport, MD, of The Medical Oncology Centre of Rosebank, discuss the first study to evaluate the efficacy and safety of a single dose of intravenous fosaprepitant. The use of this NK1 inhibitor and another (rolapitant) in a second study discussed may change the management of chemotherapy-induced nausea and vomiting and improve quality of life for patients (Abstracts 9629 and 9615).

hematologic malignancies
palliative care

Thomas W. LeBlanc, MD, and Eric Roeland, MD, FAAHPM, on Palliative Care for Patients With Hematologic Malignancies

Thomas W. LeBlanc, MD, of Duke University Medical Center, and Eric Roeland, MD, FAAHPM, of the University of California, San Diego Moores Cancer Center, discuss the use of palliative and hospice care for patients with solid tumors vs hematologic cancers and clinicians’ attitudes (Abstracts e20554 and 9524).

palliative care
lung cancer
survivorship

Areej El-Jawahri, MD, and Eric Roeland, MD, FAAHPM, on Quality of Life and Satisfaction With Care

Eric Roeland, MD, FAAHPM, of the University of California, San Diego Moores Cancer Center, and Areej El-Jawahri, MD, of Massachusetts General Hospital, discuss two important studies on early palliative care and the use of anamorelin in advanced NSCLC with cachexia.

lung cancer
palliative care
symptom management

Charles F. von Gunten, MD, PhD, Discusses Anamorelin and Olanzapine for Palliative Care

Charles F. von Gunten, MD, PhD, of OhioHealth Kobacker House discusses the ROMANA 1 and 2 trials on cachexia in NSCLC and a study on olanzapine vs fosaprepitant for the prevention of nausea and vomiting (Abstracts 9500 and 9502).

palliative care
global cancer care

Irene Higginson, MD, on Palliative and End-of-Life Care: An International Perspective

Irene Higginson, MD, of Cicely Saunders International, discusses the goals of psychosocial palliative care for patients around the world with advanced cancer.

palliative care

Wendy Lichtenthal, PhD, and David Kissane, MD, on Models of Family-Centered Care During Palliative Care and Bereavement

Wendy Lichtenthal, PhD, of Memorial Sloan Kettering Cancer Center, and David Kissane, MD, of Monash University, discuss the importance of and challenges with attending to the whole family during palliative care.

palliative care
symptom management

Eduardo Bruera, MD, on Cachexia Assessment and Management State of the Art

Eduardo Bruera, MD, of The University of Texas MD Anderson Cancer Center, discusses exciting developments in the assessment and management of cachexia, as well as a number of emerging pharmacologic and nonpharmacologic interventions (Abstract 67).

pain management
palliative care
symptom management
integrative oncology

Lorenzo Cohen, MD, on Acupuncture and Other Nondrug Pain Management Techniques

Lorenzo Cohen, MD, of The University of Texas MD Anderson Cancer Center, discusses nonpharmacologic approaches to symptom control. Techniques such as acupuncture for managing pain and chemotherapy-induced nausea and vomiting, or yoga and meditation to help improve quality of life, can be safely integrated into oncology care.

palliative care

Judith Vick, MD Candidate, and Rachelle E. Bernacki, MD, on A New Clinical Tool: The “Surprise Question”

Judith Vick, MD Candidate, of Johns Hopkins University School of Medicine, and Rachelle E. Bernacki, MD, of Dana-Farber Cancer Institute, discuss a tool that could help clinicians identify seriously ill patients who would benefit from conversations about their goals and values (Abstract 8).

palliative care

Diane Portman, MD, on Integrating Palliative Care in Cancer Treatment

Diane Portman, MD, of Moffitt Cancer Center, discusses clinical pathways that embed palliative care along the spectrum of care for a variety of cancer disease states.

palliative care

Anthony L. Back, MD, on Improving Communication Between Patient and Provider

Anthony L. Back, MD, of Seattle Cancer Care Alliance, summarizes a general session on best practices and novel tools for enhancing communication between patients and oncology providers (Abstracts 8,9, 39).

palliative care

Vicki Jackson, MD, MPH, on Effective Care Integration and the Comanagement Model

Vicki Jackson, MD, MPH, of Massachusetts General Hospital, summarizes her keynote lecture (plenary talk).

symptom management
palliative care

Lawrence H. Einhorn, MD, on CINV Clinical Trial Results: The Alliance A221301 Study

Lawrence H. Einhorn, MD, of Indiana University Simon Cancer Center, discusses the encouraging study findings on olanzapine for prevention of chemotherapy-induced nausea and vomiting in patients receiving highly emetogenic chemotherapy (Abstract 176).

palliative care

Kathleen Foley, MD, on Palliative Care in Low-Resource Settings

Kathleen Foley, MD, of Memorial Sloan Kettering Cancer Center, discusses the challenges of integrating palliative care in areas without sufficient resources or health-care infrastructure.

palliative care

Kathleen Elizabeth Bickel, MD, MPhil, on Defining High-Quality Palliative Care in Oncology Practice

Kathleen Elizabeth Bickel, MD, MPhil, of the White River Junction VA Medical Center, discusses the ASCO/AAHPM Guidance Statement, which will help oncology providers enhance their delivery of palliative care (Abstract 108).

palliative care

Lawrence H. Einhorn, MD, on Palliative Radiation for Advanced Cancer and Symptomatic Bone Metastases

Lawrence H. Einhorn, MD, of Indiana University Simon Cancer Center, discusses the ways in which a dedicated palliative radiation consult service can improve the quality of palliative cancer care (Abstract 110).

palliative care

Ralph J. Hauke, MD: Toward Improved Quality of Life

Ralph J. Hauke, MD, of Nebraska Cancer Specialists, discusses the application of scientific analysis and research to palliative care issues, which will allow better prognostication, implementation of measures, and improved quality of life.

palliative care

Betty Ferrell, PhD, RN, on Depression and Cancer Care

Betty Ferrell, PhD, RN, of City of Hope, discusses two papers that look at an important issue from different perspectives: depression and anxiety among family caregivers of patients with advanced cancer, and the link between oncologists’ dispositional affect and depressive symptoms in their patients with metastatic cancer (Abstracts 224, 214).

palliative care

Jennifer S. Temel, MD's Expert Perspective: Palliative Care in 2015

As Steering Committee Chair of this year’s symposium, Jennifer S. Temel, MD, of Massachusetts General Hospital, discusses the goals and highlights of the meeting.

palliative care
symptom management
lung cancer

Amelie Harle, MD, on Aprepitant for Cough in Lung Cancer

Amelie Harle, MD, of the Christie NHS Foundation Trust, discusses a clinical trial––the first of its kind—designed to assess the efficacy of an antitussive in patients with lung cancer (Abstract 2).

palliative care

Eric Roeland, MD: Toward Better Treatment for Cachexia

Given the challenges of recruiting patients for palliative care studies, Eric Roeland, MD, of the University of California, San Diego, discusses a way to increase the participation of those with cachexia, with the hope of improving treatment (Abstract 67).

palliative care
symptom management

Charles L. Loprinzi, MD, on Olanzapine for Prevention of CINV

Charles L. Loprinzi, MD, of the Mayo Clinic, discusses olanzapine for the prevention of chemotherapy-induced nausea and vomiting in patients receiving highly emetogenic chemotherapy (Abstract 176).

palliative care

How Effective Communication Can Improve Patient Care—and Reduce Physician Burnout

Surveys conducted between 1950 and 1970 show that most physicians considered it inhumane to give patients with a poor cancer prognosis the bad news.1,2 Since then, it has been well established that open communication between physician and patient is an essential part of effective cancer care and...

multiple myeloma
palliative care

Study Confirms Benefit of Triplet vs Doublet in Newly Diagnosed Multiple Myeloma

Triplets should be the standard of care in most newly diagnosed multiple myeloma patients, according to a study that validated a practice that has become common in the United States, though not necessarily elsewhere. The use of three drugs led to significant reductions in disease progression and...

palliative care
colorectal cancer

One in Seven Colorectal Cancer Patients Diagnosed Before Recommended Screening Age

Nearly 15% of patients diagnosed with colorectal cancer were younger than 50, the age at which screening recommendations begin. The study by researchers at the University of Michigan Comprehensive Cancer Center also found that younger patients were more likely to have advanced disease. The authors ...

palliative care
pancreatic cancer

2016 GI Symposium: Irinotecan Liposome Injection in Metastatic Pancreatic Cancer: Updated Results of the Phase III NAPOLI-1 Study

Merrimack Pharmaceuticals, Inc, announced that an updated overall survival analysis of the phase III NAPOLI-1 study of irinotecan liposome injection (Onivyde) in combination with fluorouracil (5-FU) and leucovorin achieved a substantial improvement in 12-month overall survival compared to 5-FU and...

palliative care
solid tumors

2016 GI Symposium: New Regimen for Locally Advanced Rectal Cancer as Effective as, but Less Toxic Than, Chemoradiation

Findings from a Polish phase III study point to an additional treatment option for patients with advanced rectal cancer. Patients who received short-course (5-day) radiation followed by consolidation chemotherapy before surgery achieved  outcomes similar to those of patients treated with...

palliative care

New Target Identified for Reducing Metastasis

A protein that is constantly expressed by cancer cells and quiescent in healthy cells appears to be a solid target for reducing cancer's ability to spread, scientists reported. The WASF3 protein enables cancer cell invasion, and by interrupting its relationship with another protein, CYFIP1, which...

palliative care
issues in oncology
palliative care

Palliative Care Initiated in the Emergency Department Associated With Improved Quality of Life

A palliative care consultation initiated in the emergency department for patients with advanced cancer was associated with improved quality of life and did not seem to shorten survival, according to an article published by Grudzen et al in JAMA Oncology. Visits to the emergency department are...

palliative care
skin cancer
issues in oncology

Blood Test That Monitors ctDNA Better Than the Standard in Tracking Metastatic Melanoma

Physicians treating patients with metastatic melanoma may soon have a superior tool in their efforts to closely track the disease. A new study shows that a blood test that monitors blood levels of DNA fragments from dead cancer cells does a better job than the current standard test at tracking the...

Cost of Care
Palliative Care
Health-Care Policy

Palliative Care, Quality of Life, and Cost

More than half of our nation’s patients with cancer are Medicare beneficiaries, making the entitlement program ground zero in the heated debate on health-care spending. Total Medicare expenditures attributable to beneficiaries in their last year of life runs upward of 30%; this statistic serves as...

Palliative Care

A Conversation with Judith Redwing Keyssar, RN

The number of patients seeking hospice and palliative care has grown significantly since 1974, when the NCI funded the first hospice facility in Branford, Connecticut. Nevertheless, according to the National Center for Health Statistics, 85% of Americans still die in hospitals or nursing homes....

palliative care
prostate cancer

GU Symposium 2016: Even After Antiandrogen Therapy, Docetaxel Remains Useful in Prostate Cancer

A study presented at the 2016 Genitourinary Cancers Symposium showed that 40% of patients with metastatic castration-resistant prostate cancer treated with docetaxel following abiraterone (Zytiga) had at least a 50% reduction in prostate-specific antigen (PSA), demonstrating the activity of...

palliative care
supportive care
issues in oncology

Italian Study Shows Low-Dose Morphine Better Than Weak Opioids in Relieving Moderate Cancer Pain

In an Italian trial reported in the Journal of Clinical Oncology, Bandieri et al found that low-dose morphine provided better and more rapid pain relief than weak opioids in patients with moderate cancer pain. Study Details In the open-label 28-day trial, 240 adults with moderate cancer pain from ...

Palliative Care

Thomas J. Smith, MD, Appointed Director of Palliative Care, Johns Hopkins Medicine and Sidney Kimmel Comprehensive Cancer Center

Thomas J. Smith, MD, has joined Johns Hopkins as the Director of Palliative Care for Johns Hopkins Medicine and the Hopkins’ Sidney Kimmel Comprehensive Cancer Center. Before joining Johns Hopkins, Dr. Smith served as the Medical Director of the Thomas Palliative Care Program and the Co-director of ...

Palliative Care

Summary of ASCO Provisional Clinical Opinion on Palliative Care

The ASCO provisional clinical opinion on palliative care recently published1 was based largely on data from seven published randomized controlled trials, including a phase III lung cancer trial by Temel and colleagues, which was the trigger for the new recommendations.2 The trial’s principal...

Palliative Care

ASCO Releases Palliative Care Provisional Clinical Opinion

ASCO has released a provisional clinical opinion (PCO) addressing the integration of palliative care services into standard oncology care.1 The ASCO Post recently spoke with one of the PCO’s lead authors, Thomas J. Smith, MD, Director of Palliative Care for Johns Hopkins Medicine and the Johns...

Global Cancer Care
Pain Management
Palliative Care

Untreated Cancer Pain Remains a Significant Global Problem

“Physicians are afraid of morphine … Doctors [in Kenya] are so used to patients dying in pain … they think that this is how you must die. They are suspicious if you don’t die this way — [and feel] that you died prematurely.” —Human Rights Watch interview with Dr. John Weru of Nairobi Hospice,...

Palliative Care

The Semantics of Palliative Care

The interview with Thomas J. Smith, MD (The ASCO Post, April 15, 2012), the lead author of the ASCO Palliative Care Provisional Clinical Opinion, was timely. However, it left many clinical terms and issues unclear. A significant percentage of modern medicine, including cancer care, is palliative....

Pain Management
Palliative Care

Pain Remains Prevalent and Often Inadequately Treated among Cancer Outpatients

“Pain is as prevalent in ambulatory oncology patients with common solid tumors as it was more than 20 years ago, despite the fact that opioid prescribing in the United States has increased more than 10-fold since 1990,” according to results of a study among 3,023 ambulatory patients with cancer...

Breast Cancer
Issues in Oncology
Supportive Care
Palliative Care

Studies Report Findings in Patient-centered Care

New studies highlighting findings that will lead to improvements in the patient experience and identifying potential risks for development of cancers in the future were reported at a press briefing held during the 2012 ASCO Annual Meeting in Chicago. “In this era of sophisticated research advances, ...

Supportive Care
Palliative Care
Symptom Management

Antipsychotic Effectively Controls Chemotherapy-induced Breakthrough Nausea and Vomiting

Olanzapine (Zyprexa), an FDA-approved antipsychotic, effectively controlled chemotherapy-induced nausea and vomiting (CINV) in patients who failed to respond to guideline-recommended antiemetic therapy in a phase III trial presented at the ASCO Annual Meeting.1 “This is the first randomized trial...

Supportive Care
Pain Management
Palliative Care

Early Access to Palliative/Supportive Care vs Usual Care Improves Pain Management

Many cancer patients remain undertreated for pain despite availability of guidelines and educational efforts to improve pain treatment. In a recent Annals of Oncology article, Bandieri and colleagues from the Italian Epidemiologia Clinico-Assistenziale del Dolore in Ospedale (ECAD-O) group report a ...

Supportive Care
Palliative Care

Supportive Care Research Runs the Gamut from Genetic Markers of Treatment Side Effects to Neuropathic Pain Therapies

Attendees from around the world gathered for the Multinational Association for Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) International Symposium on Supportive Care in Cancer, held June 28–30 in New York. Below are highlights from the meeting, representing...

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