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Supportive Care
Palliative Care

Dying Patients with Cancer Who Avoid Aggressive Care but Stay Connected with an Oncologist Have Better Quality of Life

Dying patients with cancer who avoided hospitalizations and life-prolonging measures, who worried less, prayed or meditated, were visited by a pastor, and maintained a therapeutic alliance with their oncologist had the highest quality of life at the end of life, according to a study recently...

palliative care

Important Messages about Palliative Care and Hospice at the Heart of New End-of-life Memoir 

The illness memoir’s appeal proves enduring in a very crowded genre, perhaps because illness is a tie that binds us all. As Susan Sontag wrote in her classic work, Illness as a Metaphor, “Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in...

colorectal cancer
lung cancer
prostate cancer
lymphoma
multiple myeloma
issues in oncology
palliative care

Study Shows Little Association of Multidisciplinary Tumor Boards with Measures of Care 

A survey of Veterans Affairs (VA) medical centers recently reported by Nancy L. Keating, MD, MPH, and colleagues at Harvard Medical School in the Journal of the National Cancer Institute showed that the presence of multidisciplinary tumor boards had little association with rates of recommended...

lung cancer
palliative care

Patients Receiving Palliative Radiation Therapy for Metastatic Non–Small Cell Lung Cancer May Be Overtreated 

Many patients receiving palliative radiation therapy to the bone or chest for metastatic non–small cell lung cancer (NSCLC) may be receiving a greater number of treatments and higher doses than are supported by current evidence, according to a Cancer Care and Outcomes Research and Surveillance...

palliative care

New Partnership Will Harness Technology to Foster Improved Palliative Care in Oncology

ASCO and the American Academy of Hospice and Palliative Care Medicine (AAHPM) have announced a joint initiative to support delivery of high-quality palliative care in medical oncology. The initiative, funded by the Agency for Health Care Research & Quality, aims to address the complex care...

issues in oncology
palliative care

New ASCO/AAHPM Project Will Harness Technology to Foster Improved Palliative Care in Oncology

ASCO and the American Academy of Hospice and Palliative Care Medicine (AAHPM) recently announced a joint initiative to support delivery of high-quality palliative care in medical oncology. The initiative is funded by ASCO’s first-ever grant from the Agency for Health Care Research Quality. The...

issues in oncology
palliative care

ASCO President's Priorities Aim to Build Bridges to Advance Cancer Care

Recognizing the need for greater interconnectivity to accelerate cancer care advances, Sandra M. Swain, MD, FACP, current ASCO President and Medical Director of Washington Cancer Institute MedStar Washington Hospital Center, selected “Building Bridges to Conquer Cancer” as her presidential theme....

supportive care
palliative care

Older Patients and Those with Comorbidities Are Less Likely to Receive Palliative Radiotherapy 

Older patients and those with comorbid conditions are less likely to receive palliative radiotherapy, according to an analysis of data from 51,610 patients with stage IV breast, prostate, lung, or colorectal cancer. The study also found that black patients with prostate cancer were 20% less likely...

issues in oncology
palliative care

Transforming Grand Rounds into Chartrounds: Technology and the Improving Cancer Care Grant Advance Patient Care

When Patricia Hardenbergh, MD, moved from her academic position as a breast radiation oncologist at Duke University to a small, rural practice in Edwards, Colorado, she realized that being a community oncologist was a very different experience. She was an expert in treating breast cancer and also...

palliative care

Diane E. Meier, MD: From Early Lessons in Critical Thinking to 'Palliative Care Everywhere' 

Although the world is full of suffering, it is full also of the overcoming of it.  —Helen Keller, Optimism, 1903 Shortly past 8:00 AM on July 1977, Diane E. Meier, MD, FACP, began the first day of her medical internship. Within minutes she would experience another first: the death of a patient...

palliative care

Advances in Medical Oncology Over the Next Decade 

The next 10 years are expected to usher in unprecedented advances in oncology, including molecularly driven diagnostic and therapeutic developments, whole genome sequencing that results in true precision-based medicine, survivorship care plans that address long-term quality of life concerns, and...

palliative care

Inequality in Delivery of Palliative Radiotherapy Among Black Patients With Cancer and Elderly With Comorbidities  

An analysis of data from more than 51,000 patients with stage IV cancer shows “significant inequality” in the delivery of palliative radiotherapy among the elderly, patients with comorbidity, and black patients with prostate and colorectal cancer, reported James D. Murphy, MD, MS, and colleagues...

palliative care

Illness Is Personal!

For clinicians and health service researchers striving to improve care for people living with life-threatening conditions, September was a sobering month. The Dartmouth Atlas group released a brief report on Trends in Cancer Care Near the End of Life1 showing that while the proportion of patients...

palliative care

New Report Examines Trends in End-of-Life Care

Although fewer Medicare patients with cancer died in the hospital in 2010 than in the years 2003–2007, aggressive treatment continues at the end of life, according to a new report from the Dartmouth Atlas Project.1 The findings also show that a significant number of patients were likely to receive...

survivorship
palliative care

Living With Cancer: The Role of Palliative Care in Long-Term Survivorship Care

According to data from the Surveillance, Epidemiology, and End Results Program (SEER) and the U.S. Census Bureau registries,1 there are currently about 13.7 million cancer survivors in the United States, and that number is projected to grow to 18 million by 2022. In addition, 64% of this population ...

palliative care

Standardized Approach Improves Palliative Care Services and Outcomes 

Standardized criteria for initiating palliative care consultations can substantially improve the care of patients with advanced solid tumors, according to research from Mount Sinai School of Medicine, New York, led by Kerin Adelson, MD, Coordinator for Ambulatory Oncology Quality for the Tisch...

palliative care
cost of care

Two Studies Highlight Communication Challenges Facing Medical Oncology

In one study presented at ASCO’s second annual Quality Care Symposium in San Diego, patients receiving chemotherapy with palliative care intent were at high risk of side-effect–related hospitalization, which defeats the clinical purpose and adds preventable costs to health care.1 “There is an...

palliative care

Assessing Patients for Palliative Care

In 2012, ASCO issued a provisional clinical opinion addressing the integration of palliative care services into standard oncology practice at the time a patient is diagnosed with metastatic or advanced cancer and for patients with uncontrolled symptoms.1 However, despite ASCO’s provisional clinical ...

palliative care

ASCO Cosponsors Inaugural Palliative Care in Oncology Symposium

In October, ASCO will cosponsor the inaugural Palliative Care in Oncology Symposium with the American Academy of Hospice and Palliative Medicine (AAHPM), the American Society for Radiation Oncology (ASTRO), and the Multinational Association of Supportive Care in Cancer (MASCC). The Symposium is...

palliative care

NIH Makes Palliative Care More Attainable for Pediatric Patients and Their Families

A campaign “Palliative Care: Conversations Matter” recently launched by the National Institute of Nursing Research (NINR) aims to increase the use of palliative care for children with serious illness. Palliative care can reduce a child’s pain, help manage other distressing symptoms, and provide...

palliative care

St. Jude Children’s Research Hospital Committee Identifies Eight Palliative Care Priorities in Pediatric Oncology

About 2½ years ago, St. Jude Children’s Research Hospital in Memphis conducted a series of focus groups to better understand the palliative care priorities of bereaved parents. Their findings were never intended to be generalized, but rather to be used to formulate a strategic plan for an...

palliative care

Overcoming Physician Bias in Recommending Palliative Care

In 2010, Jennifer S. Temel, MD, published her landmark study in The New England Journal of Medicine showing that the introduction of palliative care early after a diagnosis of metastatic non–small cell lung cancer, along with cancer therapy, not only provided patients with a better quality of life...

Palliative Care

The Role of Psychosocial Supportive Services in Palliative Care

More than 2 decades ago, Deane L. Wolcott, MD, helped develop comprehensive patient-centered psycho-oncology care in cancer centers across the country. Today, many aspects of that patient-centered care, including psychiatric, dietary, pain management, cancer rehabilitation medicine, survivorship,...

lung cancer
palliative care

Increased Hospice Use Among Minority Patients Treated in Provider-Based Research Networks

Minority patients with lung cancer who receive treatment in practices affiliated with provider-based research networks “have greater hospice enrollment than those treated in academic and community practices,” concluded Dolly C. Penn, MD, MSCR, and colleagues at the University of North Carolina...

palliative care

Bringing Palliative Care Services to Local Community Clinical Practices and Health Facilities Throughout the World

In 2007, the Billings Clinic Cancer Center in Billings, Montana, became one of 15 community-based oncology centers nationwide to receive funding from the National Cancer Institute (NCI) to expand programs for clinical trials, health-care disparities outreach, survivorship and palliative care,...

palliative care

Explore Cancer Care That Best Supports Patients and Families at the Palliative Care in Oncology Symposium

Palliative care is essential to good cancer care, but it is a topic that can raise red flags because of the common misperception that it is reserved for those in the terminal stage of the disease. In truth, palliative care is highly necessary for all patients with cancer, and when it is integrated...

Palliative Care

Discontinuing Statins Near the End of Life Is Safe, Can Reduce Symptom Burden, and Is Generally Acceptable to Patients

Discontinuing statins for patients near the end of life is safe, saves money, spares patients from swallowing yet another pill and from the symptoms associated with statins, and is generally welcomed by patients. That last bit might come as a surprise to some physicians who worry that discontinuing ...

palliative care

Using Patient-Reported Outcome Measures in Palliative Care Clinical Practice

Incorporating patient-reported outcomes into the palliative care clinical setting can improve patients’ symptom management, quality of life, and overall communication with their oncologists, according to Ethan Basch, MD. Dr. Basch is Director of the Cancer Outcomes Research Program and Associate...

Gastroesophageal Cancer
Palliative Care

No Overall Survival Improvement but Some Palliative Benefit With Gefitinib in Esophageal Cancer Progressing Postchemotherapy

In what may be the first randomized trial of systemic therapy in this setting, Susan J. Dutton, MSc, of University of Oxford, United Kingdom, and colleagues evaluated the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor gefitinib vs placebo in patients with esophageal cancer...

palliative care

The Role of Integrated Palliative Care in Radiation Oncology

Three years ago, Dana-Farber Cancer Institute and Brigham and Women’s Hospital in Boston, launched a Supportive and Palliative Radiation Oncology (SPRO) program to integrate generalist palliative oncology services, including the physical, psychosocial, and spiritual aspects of care, into radiation...

palliative care

Timing and Meaning of Do-Not-Resuscitate Orders in the Palliative Care Setting

Although a do-not-resuscitate (DNR) order does not mean “do not treat,” that is how it is often interpreted, according to a study examining the level of care oncology inpatients at a tertiary care hospital received.1 The study found that the interpretation of DNR orders among oncology nurses and...

issues in oncology
palliative care

Helping Patients Talk to Their Children About Cancer

Although the focus of an oncologist’s attention is understandably attuned to the needs of the patient, when a patient is a parent, quality oncology care should also include attention to the patient’s role as a parent and to the needs of the patient’s children, according to Paula K. Rauch, MD,...

gastroesophageal cancer
palliative care

Radiation Alone Is as Effective as and Less Toxic Than Chemoradiation for Advanced Esophageal Cancer

Radiation therapy alone was found to be as effective as chemoradiation in reducing dysphagia associated with advanced esophageal cancer in the palliative setting and was less toxic, according to results of a multinational phase III trial called the Trans-Tasman Radiation Oncology Group (TROG) 03.01 ...

lung cancer
palliative care

Novel Oral Agent Treats Cachexia in Patients With Non–Small Cell Lung Cancer

For the first time, studies show that a drug is effective in treating several domains of cancer-related cachexia. Oral anamorelin increased lean body mass, achieved weight gain, and improved quality of life in patients with cancer-related cachexia in two pivotal phase III studies presented together ...

palliative care

Dying in America: Ensuring High-Quality Care at the End of Life

In September, the Institute of Medicine (IOM) released its report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. The report argues that the U.S. health-care system subjects patients to too many—and often futile—interventions near the end of life, often ...

palliative care

Recipients of the 2014 Conquer Cancer Foundation of ASCO Merit Awards in Palliative Care Honored

The following seven recipients of the 2014 Conquer Cancer Foundation of ASCO Merit Awards in Palliative Care were honored at the 2014 Palliative Care in Oncology Symposium for their work in improving the care of people living with cancer around the world. Erin Alexi, MD, Virginia Commonwealth...

supportive care
palliative care

Experts Stress the Need for Integrating Palliative Care Into Standard Oncology Care

The overriding consensus from the 2014 Palliative Care in Oncology Symposium: Patient-Centered Care Across the Cancer Continuum held in Boston was that achieving optimal high-quality cancer care requires both state-of-the-art cancer therapy and the integration of palliative care principles...

palliative care

How the Earlier Introduction of Palliative Care Improves Quality of Life for Patients With Advanced Cancer

A 4-year study1 involving 461 patients with advanced stages of lung, gastrointestinal, genitourinary, breast, and gynecologic cancers has found that providing early outpatient palliative care vs standard oncology care alone improved quality of life and patient satisfaction. The study participants...

palliative care

Use of Hospice Care by Medicare Patients Associated With Lower Rate of Hospitalization, ICU Admission, Invasive Procedures, and Costs

Medicare patients with poor­prognosis cancers who received hospice care had significantly lower rates of hospitalization, intensive care unit (ICU) admissions and invasive procedures at the end of life, along with significantly lower health care expenditures during the last year of life, according...

palliative care

Debate Over Legalizing Physician-Assisted Death for the Terminally Ill

On November 1, 2014, 29-year-old Brittany Maynard ended her life through physician-assisted death, reigniting the controversy surrounding Death With Dignity laws, which allow physicians to prescribe life-ending drugs to terminally ill patients. Diagnosed with glioblastoma multiforme in January, Ms. ...

palliative care

Palliative Care in 2014

Palliative care expert Diane E. Meier, MD, is the Director of the Center to Advance Palliative Care (CAPC), a national organization devoted to enhancing the number and quality of palliative care programs across the nation. Under her leadership, the number of palliative care programs in the United...

palliative care

Cancer Care Incomplete Without Palliative Care Integration

ASCO recognizes that an array of efforts are needed to fully integrate palliative care into the cancer care continuum, and the Society is committed to facilitating the integration of palliative cancer care into existing health-care systems worldwide in order to realize the vision of comprehensive...

palliative care

Private Payer and Academic Center Data Capture Inappropriate Use of End-of-Life Care

Data sharing between a comprehensive cancer center and a private insurer appears to be a novel way to capture practice patterns that can point to potential quality improvements. A study that combined data from Dana-Farber Cancer Institute and Blue Cross Blue Shield of Massachusetts showed that some ...

palliative care

Better Studies Needed to Dispel Confusion Over When to Refer a Patient to Hospice

I read the article on “Private Payer and Academic Center Data Capture Inappropriate Use of End-of Life Care” (The ASCO Post, December 15, 2014, page 11). The data highlight Dr. Deborah Schrag’s notion that there is “ample evidence of overuse of intensive care at the end of life.” However, there is...

palliative care

Incorporating Physical Medicine and Rehabilitation Into Palliative Care

Although cancer rehabilitation has been a part of oncology clinical practice for several decades, it has largely gone unrecognized as an integral part of palliative medicine and survivorship care. Now, the role of physical medicine and rehabilitation in oncology care may increase as patients with...

issues in oncology
palliative care

What It Means to Be Mortal

“I learned a lot of things in medical school, but mortality wasn’t one of them,” writes Atul Gawande, MD, MPH, in his new book on the medicalization of aging and dying, Being Mortal: Medicine and What Matters in the End (Metropolitan Books, 2014). In the book, Dr. Gawande critiques the American...

palliative care

Palliative Care in the Middle East

While some seek peace in the Middle East through political means, others are looking to help patients with cancer find peace through palliative care. This endeavor is bringing oncology professionals together across the region’s national borders and cultural boundaries to implement solutions and...

palliative care

Improving the Quality of Palliative Care in Oncology

Two years ago, ASCO collaborated with the American Academy of Hospice and Palliative Medicine to develop the Virtual Learning Collaborative, a virtual quality improvement program intended to address the complex care needs of patients with advanced cancer and the care quality for all patients with...

palliative care

AAHPM Unveils List of Inspiring Hospice and Palliative Medicine Leaders Under 40

The American Academy of Hospice and Palliative Medicine (AAHPM) has released a list of Inspiring Leaders Under 40 in the field. Eligible candidates were evaluated on involvement in AAHPM, educating others about hospice and palliative medicine, participation in charitable work, mentoring of...

Palliative Care

Highlights From the 2014 Palliative Care in Oncology Symposium

The inaugural 2014 Palliative Care in Oncology Symposium was held October 24 to 25 in Boston. Over 200 abstracts were presented, covering topics such as the integration of palliative care into treatment and the financial hardships facing people living with cancer. The following abstracts were among ...

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