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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...

palliative care
hematologic malignancies
supportive care

Palliative Care 2016: Inpatient Palliative Care in Patients Hospitalized for HSCT

During hematopoietic stem cell transplantation (HSCT), patients sometimes experience physical and psychological symptoms that negatively impact their quality of life. Researchers led by Areej El-Jawahri, MD, Instructor of Medicine at Harvard Medical School, Director of the Bone Marrow Transplant...

palliative care
issues in oncology

Palliative Care 2016: Perception of Curability in Patients With Advanced Cancer Receiving Palliative Care

There are limited data on the illness understanding and perception of curability among patients with advanced cancer receiving palliative care around the world. In a study led by Sriram Yennu, MD, MS, Associate Professor in the Department of Palliative Care and Rehabilitation Medicine at The...

palliative care
supportive care
issues in oncology

Randy L. Wei, MD, PhD, on Radiation Oncologists and Palliative Care

Randy L. Wei, MD, PhD, of the University of California, Irvine, discusses findings from a survey that focused on ASTRO members who assessed their ability to deliver palliative and supportive care, and their access to continuing medical education on the topic (Abstract 105).

palliative care
issues in oncology

Sriram Yennu, MD, on Patient Perception of Curability

Sriram Yennu, MD, of The University of Texas MD Anderson Cancer Center, discusses findings from a study of an international cohort of patients with advanced cancer who received palliative care. Nearly half the patients incorrectly believed their cancer was curable (Abstract 5).

palliative care
symptom management

Stephen T. Sonis, DMD, DMSc, on Radiotherapy-Induced Oral Complications

Stephen T. Sonis, DMD, DMSc, of Dana-Farber Cancer Institute, discusses the epidemiology, pathogenesis, and scope of oral complications of radiation therapy.

palliative care
issues in oncology

Jennifer S. Temel, MD, on The Changing Conversation Around Prognostication

Jennifer S. Temel, MD, of Massachusetts General Hospital, discusses increasing prognostic uncertainty in light of targeted treatments and immunotherapies, and the difficulty predicting who will benefit.

palliative care

Scott A. Irwin, MD, PhD, on Dealing With Delirium

Scott A. Irwin, MD, PhD, of Cedars-Sinai’s Samuel Oschin Comprehensive Cancer Institute, discusses delirium—its definition, prevalence, consequences, assessment, and management.

palliative care

Eric Roeland, MD: Expert Perspective on Palliative Care in Oncology Meeting Highlights

Eric Roeland, MD, of the University of California, San Diego, discusses the key papers presented at this year’s Palliative Care in Oncology Symposium.

global cancer care
issues in oncology
palliative care

Emily Haozous, PhD, RN, on Cultural Differences in End-of-Life Care

Emily Haozous, PhD, RN, of the University of New Mexico, discusses health disparities and cultural differences in palliative and end-of-life care, with case study examples drawn from American Indian communities.

hematologic malignancies
supportive care
palliative care

Eileen Danaher Hacker, PhD, APN, AOCN: After Stem Cell Transplant: Enhancing Recovery With Strength Training

Eileen Danaher Hacker, PhD, APN, AOCN, of the University of Illinois at Chicago, discusses study findings that show improvement in physical activity, fatigue, muscle strength, and functional ability (Abstract 190).

palliative care

Charles F. von Gunten, MD, PhD, on Referrals for Hospice Care: A Quality Improvement Approach

Charles F. von Gunten, MD, PhD, of OhioHealth, discusses hospice care as a measure of quality, and findings that show medical oncologists doubled the median length of hospice service from 20 days to 40 days (Abstract 45).

palliative care
symptom management

Joseph A. Greer, PhD, on An App for Adherence to Oral Chemotherapy

Joseph A. Greer, PhD, of Massachusetts General Hospital, discusses the development of a mobile application to address treatment adherence and symptoms (Abstract 104).

palliative care
supportive care
hematologic malignancies

Areej El-Jawahri, MD, on Hematologic Malignancies: Integrating Palliative Care in Treatment

Areej El-Jawahri, MD, of Massachusetts General Hospital, discusses ways in which palliative care can reduce symptoms, improve quality of life, reduce depression and anxiety, and potentially optimize end-of-life care for patients with hematologic malignancies.

palliative care
issues in oncology

J. Nicholas Dionne-Odom, PhD, on Supporting Family Caregivers: The ENABLE Model

J. Nicholas Dionne-Odom, PhD, of the University of Alabama at Birmingham, discusses the “hidden” health-care workforce of family caregivers and what clinicians can do to help ease the burden on families.

pain management
global cancer care
palliative care

James F. Cleary, MD, on Global Access to Opioids

James F. Cleary, MD, of the University of Wisconsin Carbone Cancer Center, talks about the many reasons that 80% of the world’s population lacks access to opioids, the mainstay of cancer pain management.

palliative care
symptom management

Tracy A. Balboni, MD, MPH, on Managing Spinal Metastases With Radiation Therapy

Tracy A. Balboni, MD, MPH, of the Dana-Farber Cancer Institute, talks about how to preserve quality of life in the presence of complex spinal lesions, including novel ways to assess spinal instability and treat metastases.

palliative care
pain management
supportive care

Eduardo Bruera, MD, on Managing Opioid Use in Patients With a History of Addiction

Eduardo Bruera, MD, of The University of Texas MD Anderson Cancer Center, discusses the need for outpatient palliative care programs to monitor and support these complex patients and their family members.

palliative care
issues in oncology

Charles D. Blanke, MD, on Oregon’s Death With Dignity Act

Charles D. Blanke, MD, of the Oregon Health & Science University and Southwest Oncology Group, discusses the nearly 20 years’ experience with Oregon’s Death With Dignity (DWD) Act, a voter initiative that led to the first such law enacted in the United States (Abstract 44).

Issues in Oncology
Palliative Care

Hematologic Oncologists Surveyed on Quality Measures of End-of-Life Care

In a study reported in the Journal of Clinical Oncology, Oreofe O. Odejide, MD, MPH, of Dana-Farber Cancer Institute, and colleagues surveyed hematologic oncologists to identify acceptable end-of-life-care quality measures and barriers to such care. Respondents considered unrealistic patient...

palliative care

Palliative Care 2016: 'Mystery Shopper' Study Finds Barriers to Accessing Palliative Care Services at Major Cancer Centers

A team of researchers, using a novel approach, found that while many cancer centers offer palliative and supportive care services, patients may face challenges when trying to access them. The study showed that expanding awareness and education to patient-facing cancer center employees about such...

palliative care

Palliative Care 2016: Family Caregivers for Patients With Advanced Cancer Often Experience High Levels of Anxiety, Depression

A new multistate survey showed that nearly one-quarter to one-third of family caregivers of patients with high-mortality cancers experience high levels of depression and anxiety symptoms. The study also found that family caregivers can spend over 8 hours per day providing care and that as this time ...

palliative care

Palliative Care 2016: Early Palliative Care Improves Coping, Quality of Life for Patients With Incurable Cancers

A randomized clinical trial found that introducing palliative care shortly after a diagnosis of certain metastatic cancers greatly increases a patient’s coping abilities, as well as overall quality of life. Researchers also found that early integration of palliative care results in an...

palliative care

Palliative Care 2016: Cancer Caregivers Experience Unique Burdens Compared With Those Caring for Patients With Other Conditions

An analysis of data from more than 1,200 caregivers in the United States finds that cancer caregivers report a higher burden and spend significantly more hours per week caregiving, as opposed to individuals who care for people with other conditions. The analysis was based on survey data from the...

Palliative Care

Integrating Early Palliative Medicine Into Oncology Care to Improve Patients’ Quality of Life

At the 2015 Palliative Care in Oncology Symposium in Boston, Vicki Jackson, MD, MPH, Chief in the Division of Palliative Care and Geriatrics at Massachusetts General Hospital, Co-Director of the Harvard Center for Palliative Care, and Associate Professor of Medicine at Harvard Medical School,...

palliative care
issues in oncology

Hematologic Oncologists Surveyed on Quality Measures of End-of-Life Care and Barriers to Such Care

In a study reported in the Journal of Clinical Oncology, Odejide et al surveyed hematologic oncologists to identify acceptable end-of-life-care quality measures and asked the clinician to identify barriers to such care. Respondents considered unrealistic patient expectations the top barrier to...

palliative care

Despite Increasing Global Legalization of Physician-Assisted Suicide, Use Remains Rare

Despite increasing legalization of euthanasia and physician-assisted suicide worldwide, the practices remain relatively rare and, when carried out, are primarily motivated by psychological factors such as loss of autonomy or enjoyment of life, rather than physical pain. A new comprehensive...

Palliative Care
Issues in Oncology

Aggressive Treatment at the End of Life Continues to Be Common

Oncologists in the United States may need to improve their efforts to reduce unnecessary care for younger patients with terminal cancer over the last 30 days of life, based on the findings of a study reported at the 2016 ASCO Annual Meeting.1 Contrary to recommendations, aggressive care is still...

palliative care

Ronald C. Chen, MD, MPH, on End-of-Life Care: Impact of the Choosing Wisely Campaign

Ronald C. Chen, MD, MPH, of the University of North Carolina at Chapel Hill, discusses the substantial overuse of aggressive medical care for younger patients at the end of life, despite ASCO recommendations (Abstract  LBA10033).

palliative care
issues in oncology

ASCO 2016: Many Younger Cancer Patients Receive Aggressive End-of-Life Care Despite ASCO’s Choosing Wisely Campaign

An analysis of health claims data from 2007­–2014 on more than 28,000 patients under the age of 65 found that a large proportion of patients with advanced solid tumors received at least one form of aggressive care within the last 30 days of life. The study was presented by Chen et al at...

integrative oncology
palliative care

Eric Roeland, MD, and Jennifer S. Temel, MD, on Integrative Palliative and Oncology Care

Eric Roeland, MD, of the University of California, San Diego, and Jennifer S. Temel, MD, of Massachusetts General Hospital, discuss findings that showed the benefits of offering palliative care integrated with oncology care (Abstracts 10003 and 10131).

palliative care

ASCO 2016: Early Palliative Care Provides Benefits for Family Caregivers of Patients With Cancer

A randomized clinical trial found that introducing palliative care shortly after a cancer diagnosis results in better quality of life and fewer symptoms of depression among family caregivers. According to the authors, the study is the first to show that early palliative care alone for a...

Palliative Care

Earlier Hospice Enrollment, Avoiding ICU Admissions, and Not Dying in the Hospital Associated With Perceptions of Better End-of-Life Care

Three measures of aggressive end-of-life care “were associated with relatively large differences in family member–reported quality ratings for end-of-life care and a lower likelihood that patients with advanced-stage cancer received care congruent with their preferences,” according to a study in...

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