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Xuesong Han, PhD, on Medicaid Expansion and Receipt of Palliative Care Among Individuals Newly Diagnosed With Advanced-Stage Cancers
Xuesong Han, PhD, of the American Cancer Society, discusses findings showing that among newly diagnosed patients with stage IV cancers, Medicaid expansion was associated with increases in receipt of palliative care, although overall usage was low. The increase varied by cancer type. Improving...
Divya Gupta, MD, on Improving Advance Care Planning Conversations With Patients
Divya Gupta, MD, of the Stanford Cancer Center, discusses an intervention utilizing a computer model and lay care coaches to improve advance care planning conversations with patients who have metastatic cancer. The study, Dr. Gupta reports, showed a trend toward less intensive care for patients at...
Lena E. Winestone, MD, MSHP, on Health-Care Disparities in Hematologic Cancers: Real-World Data
Lena E. Winestone, MD, MSHP, of the University of California, San Francisco and Benioff Children’s Hospital, reviews different aspects of bias in treatment delivery, including patient selection for clinical trials; racial and ethnic disparities in survival for indolent non-Hodgkin diffuse large...
Robert Olson, MD, on Quality-of-Life Outcomes After Stereotactic Ablative Radiotherapy vs Standard-of-Care Palliative Treatments
Robert Olson, MD, of the BC Cancer Centre for the North, discusses a secondary analysis of the SABR-COMET trial, which showed there was a small magnitude decline in quality of life in both arms of the study but no associated detriment with stereotactic ablative radiotherapy (Abstract 148).
2019 ASCO: Differences in End-of-Life Quality Measures Across U.S. Cancer Centers
In a study presented by Wasp et al at the 2019 ASCO Annual Meeting (Abstract 6507) studying variation in end-of-life care across cancer centers in the United States, researchers found quality of care was lower at centers that served a greater concentration of minorities. However, end-of-life care...
Effect of Increased VA Hospice Care on Use of Aggressive Care and Costs for Veterans With Advanced Lung Cancer
In a study reported in JAMA Oncology, Mor et al found that veterans with advanced lung cancer treated in Veterans Affairs (VA) Medical Centers with high hospice use were more likely to receive concurrent cancer care but less likely to receive aggressive care. Moreover, veterans treated at...
Site of Care May Affect Racial and Ethnic Minorities’ Access to Palliative Treatment
For patients at the end of life, palliative care can prolong survival and improve the quality of life for patients with a life-threatening illness and for their families—but studies have found that racial and ethnic minorities are less likely to receive end-of-life palliative care than...
Impact of Survival Predictions on Aggressive End-of-Life Care Among Patients With Metastatic Cancer
In a single-institution study reported in the Journal of Oncology Practice, Sborov et al found that inaccurate prediction of life expectancy can be associated with greater likelihood of aggressive end-of-life care among patients with metastatic cancer receiving palliative radiation therapy. Study...
Factors Affecting Use of Outpatient Specialty Palliative Care Clinics Among Patients With Advanced Cancer
In a study reported in the Journal of Oncology Practice, Yu et al identified factors affecting use of outpatient specialty palliative care (OSPC) among patients with advanced cancer in the University of Pittsburgh Medical Center Hillman Cancer Center Network (UPMC-HCCN). Study Details The...
Katherine C. Lee, MD, on Emergency Surgery and End-of-Life Care
Katherine C. Lee, MD, of Massachusetts General Hospital, discusses her study findings that showed older patients with metastatic cancer who survived emergency general surgery experienced higher intensity end-of-life care than similar patients who did not undergo surgery (Abstract 56).
Mary E. Johnson on Holding Vigil With Dying Loved Ones
Mary E. Johnson, author of Stay With Me Awhile, discusses her play, a compilation of vigil stories from across cultures and religions, and the profound impact the performances have had on audience members.
Suleika Jaouad on Making the Most of a Life Interrupted: A Young Adult Perspective on Cancer
Suleika Jaouad, an Emmy Award–winning writer, advocate, and cancer survivor who was diagnosed at age 22 with myelodysplastic syndrome and acute myeloid leukemia, discusses what she has learned about coping with cancer, learning from it, and growing beyond it.
Leslie J. Blackhall, MD, on Unregulated Opioid Access: Consequences and Outcomes
Leslie J. Blackhall, MD, of the University of Virginia, discusses abuse of opioids, prescribing responsibly, and reducing cancer pain while also decreasing the risk of misusing these agents.
2018 Palliative Care: Can an AI-Based App Help Manage Cancer-Related Pain?
A study of 112 patients with metastatic solid tumors found that the use of an artificial intelligence (AI)-based smartphone app reduced both the severity of patients’ reported pain and hospital admissions. After an 8-week period, patients who used the AI-powered app to monitor and address...
ICU Admissions During Terminal Hospitalizations in Patients With Stage IV Lung Cancer
In a study reported in the Journal of Oncology Practice, Mrad et al found an increase in the proportion of patients with stage IV lung cancer admitted to the intensive care unit (ICU) during terminal hospitalization between 1998 and 2014. A large increase in palliative care contacts also occurred,...
Quality Improvement Initiative for Documenting Goals of Care for Patients With Advanced Cancer
In a study reported in the Journal of Oncology Practice, Karim et al found that a quality improvement initiative at a single cancer center improved documentation of goals-of-care discussions and referral to palliative care for patients with advanced cancer. Study Details In the study,...
Impact of Peer-Review Intervention on Radiotherapy Schedules for Palliative Treatment of Bone Metastases
In a single-center study reported in the Journal of Oncology Practice, Walker et al found that institution of a peer-review process resulted in shorter fractionation schedules for palliation of bone metastases, consistent with current guidelines. As stated by the authors, “Shorter...
Geographic Differences in End-of-Life Cancer Care
When it comes to how much end-of-life care a patient with cancer receives, geography may, indeed, be destiny, according to new research led by Harvard Medical School that found differences in this type of cancer care across different parts of the country. The findings, published by Keating et al...
Palliative Care Preferences in Male Patients With Cancer
Men with advanced cancer are 30% less likely than women to consider palliative care, according to a University of Rochester Medical Center (URMC) study. Researchers believe the findings reflect social norms about gender roles, as well as widespread messages in the media and society about...
A. Oliver Sartor, MD, on Issues in Immunotherapy
A. Oliver Sartor, MD, of Tulane University, speaks anecdotally about immunotherapy for prostate cancer and shares his experiences in speaking to patients with late-stage disease about the knowns, unknowns, risks, and toxicities of using a therapy outside the context of a clinical trial setting. The ...
Owen A. O’Connor, MD, PhD, on Issues in Immunotherapy
Owen A. O'Connor, MD, PhD, of Columbia University Medical Center, shares his perspective on immunotherapy for patients with late-stage cancer in the context of a clinical trial setting and recent Right-to-Try legislation. The content in this post has not been reviewed by the American Society of...
AMA Rejects Recommendation to Reaffirm Opposition to Medical Aid in Dying
On June 11, the American Medical Association (AMA) House of Delegates voted 56% to 44% to reject a report by its Council on Ethical and Judicial Affairs (CEJA) that recommended the AMA maintain its Code of Medical Ethics’ opposition to medical aid in dying. Instead, the House of Delegates...
Racial/Ethnic Disparities in the Quality of End-of-Life Care Among Patients With Lung Cancer
Significant disparities in the quality of end-of-life lung cancer care were found among racial/ethnic minorities, with higher odds of experiencing potentially preventable medical encounters during end of life as compared with non-Hispanic whites. These findings were published by Karanth et al in...
Updated ASTRO Guideline for Palliative Radiotherapy in Lung Cancer
The American Society for Radiation Oncology (ASTRO) has issued an update to its clinical guideline for the use of palliative-intent radiation therapy for patients with incurable non–small cell lung cancer (NSCLC). Reflecting new evidence from randomized clinical trials, the guideline now...
Association of Early Palliative Care With Patient-Reported Outcomes and End-of-Life Care
In a study reported in the Journal of Clinical Oncology, Hoerger et al found that patients with a higher proportion of early palliative care visits addressing behavioral coping strategies had improvement in depression symptoms and quality of life. In addition, those with a high proportion of visits ...
Areej El-Jawahri, MD, on A Revolutionary Plan for End-of-Life Care
Areej El-Jawahri, MD, of Massachusetts General Hospital, discusses a video tool that helps overcome communication barriers so that patients can make more informed decisions for end-of-life care and their preferences are respected.
Sandip Patel, MD, on Immunotherapy: New Developments and Toxicity Challenges
Sandip Patel, MD, of the University of California, San Diego, discusses diagnosing and managing immune-related adverse events from immune checkpoint blockade and the toxicities of these treatments.
Jamie Jacobs, PhD, on Early Integrated Palliative Care: The Positive Effects
Jamie Jacobs, PhD, of Massachusetts General Hospital Cancer Center, discusses study results that showed integrating oncology and palliative care early in the course of treatment helps people with incurable lung and gastrointestinal cancers cope better and have an improved quality of life and less...
Michael Hoerger, PhD, on Early Palliative Care: Study Results
Michael Hoerger, PhD, of Tulane University, discusses the effect on quality of life, depression, and end-of-life care when physicians focus on coping or on decision-making and advance care planning (Abstract 154).
Jacob J. Strand, MD, on Dealing With Opioid Use Disorders
Jacob J. Strand, MD, of the Mayo Clinic, discusses tips and tools that clinicians can use to develop universal precautions for prescribing opioids in oncology and palliative care practice.
Thomas J. Smith, MD, on Palliative Care and Outpatient Treatment: Expert Perspective
Thomas J. Smith, MD, of Johns Hopkins University School of Medicine, discusses successful models of integrating palliative care into outpatient oncology.
Charles F. von Gunten, MD, PhD, on Palliative Care in Oncology: A Fellows Curriculum
Charles F. von Gunten, MD, PhD, of OhioHealth, discusses an online curriculum that changed younger physicians’ use of palliative medicine in practice during the year after fellowship training (Abstract 202).
Eric Roeland, MD, on Symptom Management: Expert Perspective
Eric Roeland, MD, of the University of California, San Diego, summarizes key papers delivered at the Palliative Care Symposium on managing insomnia, fatigue, nausea, and the ways in which physical therapy and nausea can reduce the side effect burden.
Changes in Opioid Prescription for Cancer Patients Referred to Outpatient Palliative Care
In a study reported in the Journal of Oncology Practice, Haider et al found that the median morphine equivalent daily dose decreased significantly among cancer patients seen at MD Anderson Cancer Center’s outpatient palliative care clinic between 2010 and 2015. Use of hydrocodone decreased...
2017 ASCO Palliative Care: Yoga Can Be an Effective Supportive Therapy for People With Lung Cancer and Their Caregivers
In a feasibility trial of people with advanced lung cancer receiving radiation therapy and their caregivers, yoga was beneficial to both parties. These findings will be presented by Milbury et al at the upcoming 2017 Palliative and Supportive Care in Oncology Symposium in San Diego (Abstract 125). ...
2017 ASCO Palliative Care: People With Leukemia and Their Oncologists Have Vastly Different Perceptions of Prognosis
A study of 100 people with acute myeloid leukemia (AML) receiving chemotherapy found that patient and physician perceptions of treatment risk and the likelihood of a cure varied widely. Overall, patients tended to overestimate both the risk of dying due to treatment and the likelihood of a cure....
2017 ASCO Palliative Care: Resilience Intervention Improves Quality of Life for Adolescents and Young Adults With Cancer
Although a cancer diagnosis is daunting at any age, adolescents and young adults (AYAs) with the disease often face unique challenges and are at risk for poor psychosocial outcomes than older patients. A randomized study investigating whether a brief, age-appropriate, skills-based intervention...
2017 ASCO Palliative Care: Patients With Advanced Cancer Prefer Oncologists Not Use Computers in the Exam Room
Although the use of electronic health records in oncology care has led to improved care for patients, results from a new study show that oncologists need to be cautious about using computers during exam room visits, especially for patients with advanced cancer. The randomized study compared...
Integrative Therapies in Palliative Care Project
Palliative care professionals are invited to participate in a unique project sponsored by the National Cancer Institute. Collinge and Associates, Inc, is seeking interdisciplinary professionals to help develop and evaluate a new online continuing education (CE/CME) course on the use of integrative...
Inpatient Palliative Care During HCT and Psychological Distress After Transplantation
In a single-center study reported in the Journal of Clinical Oncology, El-Jawahri et al found that inpatient palliative care during hematopoietic stem cell transplantation was associated with improvement in depression and post-traumatic stress disorder (PTSD) symptoms at 6 months after...
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...
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 ...
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 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,...
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...
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...
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...
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...
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...
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....
