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palliative care

Recognizing Physical Signs Associated With Impending Death Can Assist Clinicians, Patients, and Caregivers With Complex Decisions

In a recently published study of patients with advanced cancer whose status was systematically documented twice a day, from the time of admission to a palliative care unit until death or discharge, investigators identified eight physical signs associated with death within 3 days. Taken together...

palliative care

Helping Patients Understand Palliative Care

The booklet Palliative Care: Improving Quality of Life for Patients and Families is one of the latest additions to the ASCO Answers collection of patient education materials developed by ASCO for people with cancer and their caregivers. These materials provide oncologist-approved information in a...

issues in oncology
palliative care

Why Just Having ‘Good’ Communication Skills Is Not Enough for Talking With Seriously Ill Patients

In the Institute of Medicine’s 2014 report Dying in America,1 the report’s authors found that while frequent clinician-patient conversations about end-of-life care, goals, and preferences are necessary to avoid unwanted treatment, most patients do not have those conversations with their physicians. ...

integrative oncology
palliative care

Escalation of Oncology Services at End of Life May Be Moderated by Coordinated Care

“Use of oncology-related services is increasingly scrutinized, yet precisely which services are actually rendered to patients, particularly at the end of life, is unknown,” noted an article in the Journal of Oncology Practice. To address this knowledge gap, Eijean Wu, MD, of the Los Angeles County...

Palliative Care

The Mechanisms Driving Cancer Pain

For over a decade, Patrick W. ­Mantyh, PhD, JD, has been investigating the molecular and cellular mechanisms that are involved in cancer-related pain, especially bone pain caused by advanced breast, prostate, and lung cancers. His early laboratory work using mouse models of bone cancer led to an...

Palliative Care

The Importance of Including Adolescents and Young Adults With Cancer in Their Advance Care Planning

Three years ago, a study of adolescents and young adults aged 16 to 28 with metastatic or recurrent cancer or HIV/AIDS compared the usefulness of two previously developed advance care planning guides—one prepared specifically for adolescents and young adults and one specifically for adults. The...

Issues in Oncology
Palliative Care

Using Gene Analytics to Identify Patients at Risk for Treatment Toxicity

Genomic applications are now an accepted part of oncologic science and practice. Differences in gene expression have been used to understand and predict tumor behaviors and response to treatment. And now it seems likely that genomics may also play a pivotal role in guiding treatment preferences by...

Supportive Care
Pain Management
Palliative Care
Symptom Management

Managing Cancer Pain at the End of Life

Cancer-related pain does not exist in a vacuum. To effectively treat it, clinicians should understand the contributing factors. Proper assessment and management of cancer pain at the end of life can significantly alleviate patient suffering, according to Eduardo Bruera, MD, FAAHPM, Department Chair ...

Head and Neck Cancer
Supportive Care
Palliative Care
Symptom Management

Dispelling the Myths Associated With Osteonecrosis of the Jaw

Osteonecrosis of the jaw associated with cancer treatment is frequently misunderstood, according to Cesar ­Augusto Migliorati, DDS, MS, PhD, who delivered an update on its proper recognition and management at the 2015 Multinational Association of Supportive Care in Cancer/International Society of...

Palliative Care

One Doctor’s Road to Palliative Care Services in the Inner City

St. Barnabas Hospital is located in the heart of Bronx, New York, and as such, it has a culturally diverse, largely poor, patient population. The backbone of successful palliative care services is the doctor-patient communication bonding process. However, many of the patients with late-stage cancer ...

Palliative Care

Important Research in the Palliative Care of Patients With Cancer

The emphasis at this year’s Palliative Care in Oncology Symposium, held earlier this month in Boston, was on patient-centered care throughout the cancer continuum. The meeting attracted more than 650 attendees and included six general sessions featuring best practices in communication,...

Palliative Care

End-of-Life Clinical Decisions Still Need Conversations About Improving Care

In 2014, the Institute of Medicine report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life called for more conversations about improving care for those who are dying. Improving the care of the imminently dying is an important issue in the oncology...

Prostate Cancer
Palliative Care

Aggressive End-of-Life Care More Frequent Among Black Men With End-Stage Prostate Cancer

A study to examine end-of-life care among black and white patients dying of prostate cancer found that “significant racial disparities in end-of-life care” do exist. “Although diagnostic and therapeutic interventions are less frequent in black patients with end-stage prostate cancer, the rate of...

integrative oncology
palliative care

ASCO University® Offers Resources for Palliative and Team-Based Care

ASCO University®, ASCO’s eLearning center, offers an array of courses and programs relevant to palliative care and multidisciplinary team–based cancer care. Below are descriptions of just a few of these offerings. Pain Management Released in March 2015, ASCO University’s “Pain Management Program”...

Integrative Oncology
Palliative Care

Integrating Spirituality Into Palliative Care Services

Over the past couple of decades, the oncology community has made great strides in mediating the psychosocial needs of our patients. However, a patient’s spirituality is a subjective and uncomfortable issue for many oncologists, which leaves a gap in the continuum of care. To reach a better...

Palliative Care

A Swiss Psychotherapist Gives Her Perspective on Optimal Palliative Care

Over the past few decades, the oncology community has incorporated new evidence-based therapies to address the psychosocial needs of patients with cancer, especially those with advanced disease. To bring a global perspective to this evolving discipline, The ASCO Post recently spoke with Monika...

Palliative Care

Practicing the Humanistic and Holistic Approach to End-of-Life Care

In 1990, when Bruce (B.J.) ­Miller, MD, was an undergraduate at Princeton University, the practice of medicine was far from his mind. Then a student in Chinese and Asian studies and later an art history major, Dr. Miller would come to pursue a career specializing in palliative medicine after an...

Palliative Care

Evidence-Based Practice Needed in End-of-Life Care

Evidence-based oncology practice is a systematic approach to problem solving for cancer care providers, characterized by the use of the best evidence currently available for clinical decision-making. Over the past several decades, the oncology community, led by its major organizations such as ASCO...

Lung Cancer
Palliative Care

‘Substantial Number’ of Patients Requiring Palliative Radiotherapy for Stage IV NSCLC Are Overtreated

An analysis of data from 46,803 patients with stage IV non–small cell lung cancer (NSCLC) who received palliative chest radiation therapy found that 49% received radiotherapy for longer than 15 fractions, and 28% received more than 25 fractions. This treatment pattern “is inconsistent with the...

Palliative Care

Perceptions of End-of-Life Care Differ Sharply Between African Americans and White Americans

Studies demonstrate that patients with advanced cancer who are not actively engaged in planning their end-of-life care often receive overly aggressive, physically taxing, costly and unnecessary treatment toward life’s end. Recent findings indicate that African Americans appear to be more apt to...

Palliative Care

More, Earlier, and Better Goals-of-Care Conversations at the End of Life Are Feasible

An intervention called the Serious Illness Care Program helps clinicians to conduct more, earlier, and better conversations about goals of care with their seriously ill patients, according to ­Rachelle E. Bernacki, MD, MS, who presented the preliminary results of a study using this approach at the...

Palliative Care

ASCO and AAHPM Define Primary Palliative Care in Oncology

A new guidance statement from ASCO and the American Academy of Hospice and Palliative Medicine (AAHPM) could potentially lead to more standardized primary palliative care delivery across oncology settings, according to Kathleen E. Bickel, MD, MPhil, who presented the study findings at the 2015...

symptom management
palliative care
pain management

Samuel Chao, MD, on Improving the Consistency of Radiation Oncology Processes

Samuel Chao, MD, of Cleveland Clinic, discusses the QMAP program and data-driven management, which offer ways to improve consistency and drive quality in radiation oncology departments (Abstract 39).

palliative care
pain management
symptom management

Alysa M. Fairchild, MD, on Preventing Radiation-Induced Pain Flare

Alysa M. Fairchild, MD, of the Cross Cancer Institute and the University of Alberta, discusses her study on the use of dexamethasone to reduce pain flare in patients receiving palliative radiotherapy for bone metastases (Abstract LBA6663).

palliative care

More Than One-Third of Patients With Metastatic Cancer Continue to Work

A new analysis indicated that many patients continue working after being diagnosed with metastatic cancer, but a heavy burden of symptoms may prevent them from doing so. Published by Tevaarwerk et al in Cancer, the study illustrates the need to treat difficult symptoms so that patients can maintain ...

palliative care
breast cancer
issues in oncology

SABCS 2015: Phase III BELLE-2 Trial Meets Primary Endpoint of Progression-Free Survival

Among women with locally advanced or metastatic hormone receptor–positive breast cancer that was resistant to hormone therapy, those who had mutated PIK3CA detected in their blood benefited from a combination of the investigational PI3K inhibitor buparlisib and fulvestrant (Faslodex),...

palliative care
leukemia

ASH 2015: Combination Therapy With Idelalisib Improves Progression-Free Survival vs Bendamustine/Rituximab Alone in Relapsed/Refractory CLL

In a phase III study to be presented by Zelenetz et al at the 57th American Society of Hematology Annual Meeting, idelalisib (Zydelig) plus bendamustine (Treanda) and rituximab (Rituxan), or BR, proved superior to BR alone in patients with relapsed/refractory chronic lymphocytic leukemia (CLL)...

palliative care
prostate cancer

Study Shows Abiraterone Acetate Is Useful Even in the Most Aggressive Prostate Cancers

In 1,048 prostate cancer patients previously treated with docetaxel, and 996 metastatic, castration-resistant patients, treatment with the androgen-lowering drug abiraterone acetate (Zytiga) led to longer overall disease control, even when a very high Gleason score indicated especially aggressive...

palliative care
breast cancer
issues in oncology
issues in oncology
issues in oncology
issues in oncology

Researchers Develop Mathematical Model to Forecast Metastatic Breast Cancer Survival Rates

University of Southern California (USC) researchers have developed a mathematical model to forecast metastatic breast cancer survival rates using techniques usually reserved for weather prediction, financial forecasting, and surfing the Web. For decades, medical schools have taught doctors that...

palliative care
issues in oncology
prostate cancer

Two Studies Find Protein May Inhibit Prostate Cancer Bone Metastasis

Scientists from Lawrence Livermore National Laboratory (LLNL), in collaboration with researchers from University of California Merced and Davis, have found that a secreted protein predominantly expressed in bone inhibits prostate cancer metastasis to bone. Their research was published recently by...

palliative care
lung cancer
issues in oncology

FDA Approves Osimertinib for EGFR T790M Mutation–Positive Non–Small Cell Lung Cancer After Progression on Prior EGFR-Blocking Therapy

The U.S. Food and Drug Administration (FDA) granted accelerated approval for an oral medication to treat patients with advanced non–small cell lung cancer (NSCLC). Osimertinib (Tagrisso) is now approved for patients whose tumors have a specific epidermal growth factor receptor (EGFR) mutation ...

palliative care
breast cancer
survivorship

ABC3: Experts Create New Consensus Guidelines for Advanced Breast Cancer Treatment

Although advanced breast cancer is incurable, there are some patients who have just a few small metastases who would respond well to systemic treatments such as chemotherapy and hormone therapy. In new guidelines agreed on by participants at the Advanced Breast Cancer Third International Consensus...

palliative care
supportive care

ASTRO 2015: Patients With Bone Metastases Undergoing Radiation Therapy for Symptom Control Have Lower Pain Flare Rates With Steroid Use

The steroid dexamethasone reduces radiation-induced pain flare in cancer patients with painful bone metastases, according to research presented by Chow et al (Abstract LBA1) October 18, 2015 at the American Society for Radiation Oncology’s (ASTRO’s) 57th Annual Meeting in San Antonio,...

prostate cancer
issues in oncology
palliative care

Aggressive End-of-Life Care More Frequent Among Black Than White Men With End-Stage Prostate Cancer

A study to examine racial disparities in end-of-life care among black and white patients dying of prostate cancer found that “significant racial disparities in end-of-life care" do exist. “Although diagnostic and therapeutic interventions are less frequent in black patients with...

palliative care
supportive care
palliative care

Clergy Religious Beliefs Are Associated With Greater ICU Care in Congregants’ Final Days

A survey exploring the relationship between spiritual support and end-of-life care by evaluating clergy members’ opinions and experiences related to care provided to congregants at the end of their life has found that a majority of clergy endorse religious beliefs regarding their...

palliative care
supportive care
palliative care

Palliative Care 2015: Collaboration Between Radiation Oncologists and Palliative Care Specialists Improves Care for Patients With Advanced Cancer

An innovative service model that partners radiation oncology with palliative care leads to better results for patients, according to a new analysis. The model of care, established at Mount Sinai Medical Center, is one of only a handful in the country. The study (Abstract 110) will be presented at...

supportive care
palliative care

Palliative Care 2015: Study Finds the Answer to One Question Can Help Identify Patients Nearing the End of Life

Determining the answer to a simple question, “Would you be surprised if this patient died within the next year?” can be an important tool to help predict which patients with cancer may be in their final year of life, according to the findings from a study by Vick et al. The tool, known...

palliative care

New Agent Targeting Epigenetic Modifications Shows Activity in Advanced Cancer

In a dose-escalation phase I study reported in The Lancet Oncology, Reid et al found that RRx-001, a representative of a new class of compounds called dinitroazetidines (sourced from the aerospace industry) that act on the tumor microenvironment, had activity in advanced cancers and a promising...

palliative care
skin cancer

Combining Interleukin-2 With Imiquimod and Topical Retinoid Therapy May Be Effective Against Cutaneous Metastatic Melanoma

A novel combination therapy appears to be effective in treating patients with melanoma skin metastases, according to new research from the University of California (UC) Davis. Led by Emanual Maverakis, MD, of the UC Davis Department of Dermatology, the research found that interleukin-2...

palliative care
issues in oncology
issues in oncology
palliative care

Study Shows Palliative Chemotherapy in Patients With End-Stage Cancer Did Not Improve Quality of Life and May Be Harmful

Although palliative chemotherapy is used to improve quality of life for patients with end-stage cancer, a study evaluating its use found that palliative chemotherapy did not improve quality of life near death for patients with a moderate or poor performance status and that it worsened quality of...

palliative care
issues in oncology
palliative care

Aggressive Cancer Treatment Near End of Life Persists, Despite Rise in Advance Planning Efforts

In a review of nearly 2,000 surveys with people whose loved ones died of cancer, researchers led by Johns Hopkins School of Medicine experts said they found a 40% increase over a 12-year period in the number of patients with cancer who participated in one form of advance care...

issues in oncology
palliative care

Many Teens and Young Adults With Cancer Use Aggressive End-of-Life Measures

More than two-thirds of adolescents and young adults dying of cancer utilized one or more aggressive interventions in the last month of life, according to a retrospective study from researchers at Dana-Farber/Boston Children's Cancer and Blood Disorders Center and Kaiser Permanente Southern...

palliative care
issues in oncology
multiple myeloma

Daratumumab Expanded Access Program Open to Eligible U.S. Patients With Heavily Pretreated Multiple Myeloma

Janssen Biotech, Inc, announced the opening of a daratumumab expanded access program for eligible U.S. patients. Daratumumab is an investigational human anti-CD38 monoclonal antibody being evaluated in clinical trials as a treatment for patients with multiple myeloma. The multicenter, open-label...

palliative care
issues in oncology
issues in oncology

ESMO World GI 2015: Second-Line Cetuximab Active Beyond Progression in Metastatic Colorectal Cancer

Patients with metastatic colorectal cancer that are free of mutations in the KRAS, NRAS, BRAF, and PIK3CA genes showed a significant benefit from continuing antiepidermal growth factor receptor (EGFR) therapy beyond progression following first-line chemotherapy and an anti-EGFR monoclonal antibody. ...

palliative care
issues in oncology
colorectal cancer

ESMO World GI 2015: Studies Confirm Regorafenib Benefit in Pretreated Metastatic Colorectal Cancer

The phase IIIb CONSIGN trial has confirmed the benefit of regorafenib (Stivarga) in patients with previously treated metastatic colorectal cancer, researchers announced July 3 at the European Society for Medical Oncology World Congress on Gastrointestinal Cancer in Barcelona, Spain (Abstract...

palliative care
colorectal cancer

ESMO World GI 2015: Low Body Mass Index Associated With Poorer Survival in Metastatic Colorectal Cancer

Although being overweight with a high body mass index (BMI) has long been associated with a higher risk for colorectal cancer, thinner patients might not fare as well as previously expected after treatment for advanced cancer, according to a new study from Duke Medicine. The study, which was...

palliative care
colorectal cancer
head and neck cancer

Development of New Blood Vessels Not Essential to Growth of Lymph Node Metastases

While the use of antiangiogenesis drugs that block the growth of new blood vessels can improve the treatment of some cancers, clinical trials of their ability to prevent the development of new metastases have failed. Now a study from the Massachusetts General Hospital (MGH) Cancer Center may have...

palliative care
issues in oncology
prostate cancer
issues in oncology
cost of care

Chemotherapy May Be Preferred Option for Some With Advanced Prostate Cancer

In a small clinical trial, scientists at Johns Hopkins Kimmel Cancer Center and James Buchanan Brady Urological Institute found that men with advanced prostate cancer and detection of androgen receptor splice variant-7 (AR-V7) respond to chemotherapy just as well as men who lack the variant. The...

palliative care
cns cancers
issues in oncology
issues in oncology

ASCO 2015: Gene Therapy Paired With Traditional Surgical Resection Benefits Patients With Glioblastoma

Houston Methodist Neurological Institute neurosurgeon David Baskin, MD, presented preliminary data from a phase II clinical trial that suggests gene therapy  (AdV-Tk therapy), which uses a mediated herpes simplex virus, combined with a traditional treatment—surgical resection—could ...

palliative care
issues in oncology
skin cancer
issues in oncology

Pooled Analysis Shows Similar Efficacy of Nivolumab in BRAF V600–Mutant and BRAF Wild-Type Advanced Melanoma

A pooled analysis of four clinical trials of nivolumab (Opdivo) in advanced melanoma, reported by Larkin et al in JAMA Oncology, suggested similar response rates in patients with BRAF V600–mutant and BRAF wild-type disease. Study Details The retrospective analysis included data from adult...

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