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End-of-Life Discussions Are Associated With Longer Survival and Higher Quality of Life
A review of advance care planning and end-of-life communication practices among physicians by the American College of Physicians has found that implementing early discussions about goals of care with seriously ill patients results in better quality of life, reduced use of life-sustaining treatments ...
Absence of Residual Thrombosis After 6 Months of Low–Molecular Weight Heparin Indicates Low Risk for Recurrent Cancer-Related Deep-Vein Thrombosis
In an Italian study (Cancer-DACUS) reported in the Journal of Clinical Oncology, Napolitano et al found that patients with no residual vein thrombosis after 6 months of low–molecular weight heparin for a first episode of cancer-related deep-vein thrombosis of the lower limbs had low risk for...
Survey Finds High Rates of Burnout Among Palliative Care Physicians, With Over 50% Predicted to Leave the Field in 10 Years
Physician burnout in palliative care is higher—over 62%—than the burnout rate reported in medical oncology—45%—according to a large survey of over 1,200 hospice and palliative care clinicians. The factors contributing to professional burnout severity included younger age,...
Oral Rivaroxaban Has Efficacy Similar to Enoxaparin Plus Vitamin K Antagonist in Preventing Recurrent Venous Thromboembolism
In a subgroup analysis of the pooled results of the EINSTEIN-DVT and EINSTEIN-PE trials reported in The Lancet Haematology, Prins et al found that the recurrence rate for venous thromboembolism in cancer patients receiving anticoagulant therapy with oral rivaroxaban (Xarelto) was similar to that in ...
‘Smart Technology’ System for Home Hospice Symptom Management and Care Helps Both Patients With Cancer and Family Caregivers
Early findings from a study of 319 families suggest that use of an innovative, telephone-based symptom monitoring and coaching system during home hospice care leads to significantly decreased patient symptoms in the final weeks of life. The findings will be presented at the 2014 Palliative Care in...
Partnership Between Medical Oncologists and Palliative Care Specialists Improves Outcomes at an Inpatient Oncology Unit
First evaluation of a pioneering “co-rounding” partnership between medical oncologists and palliative care specialists at Duke University Medical Center shows improvements in both health system–related and patient-related outcomes. The first year of the new partnership—set...
Having Dependent Children Motivates Parents With Advanced Cancer to Pursue More Aggressive, Life-Extending Treatments
Findings from a pilot study of 42 parents with advanced cancer indicate that parental status is an important factor in treatment decision-making. When asked how having children influences their treatment decisions, the majority of parents (64%) responded that being a parent motivates them to pursue ...
Single-Day Education Program Mitigates Psychosexual Side Effects of Risk-Reducing Salpingo-Oophorectomy
More women are undergoing salpingo-oophorectomy as a cancer prevention measure, but many are unaware of the potential sexual or psychological side effects of the procedure. A new study by researchers at Dana-Farber Cancer Institute demonstrated that a half-day educational program can help ...
Adding Aprepitant to Granisetron/Dexamethasone Reduces Chemotherapy-Induced Nausea and Vomiting After High-Dose Melphalan Conditioning in Myeloma
In a phase III trial reported in the Journal of Clinical Oncology, Schmitt et al found that adding aprepitant to granisetron and dexamethasone significantly reduced chemotherapy-induced nausea and vomiting in myeloma patients undergoing high-dose melphalan conditioning and autologous stem cell...
FDA Approves Netupitant and Palonosetron Combination Capsule for Chemotherapy-Induced Nausea and Vomiting
The U.S. Food and Drug Administration (FDA) today approved a combination of netupitant and palonosetron (Akynzeo) to treat nausea and vomiting in patients undergoing cancer chemotherapy. The new drug, also known as NEPA, is a fixed-combination capsule comprised of two agents: oral palonosetron,...
Acupuncture Provides Significant Quality-of-Life Improvements Among Breast Cancer Patients With Aromatase Inhibitor–Related Joint Pain
Use of electroacupuncture—a form of acupuncture where a small electric current is passed between pairs of acupuncture needles—produces significant improvements in fatigue, anxiety, and depression in as little as 8 weeks for early-stage breast cancer patients experiencing joint pain...
African Americans More Likely Than Whites to Receive Analgesic With Toxic Metabolite for Cancer Pain
A study reported by Meghani et al in the Journal of Clinical Oncology showed that African American patients with cancer pain are more likely than white patients to receive morphine, with its known 3- and 6-glucuronide neurotoxic metabolites, despite their higher reported risk for chronic kidney...
Corticosteroids Improve Fatigue, Appetite Loss, and Patient Satisfaction but Not Pain in Opioid-Treated Advanced Cancer Patients, Small Study Shows
In a small Norwegian study reported in the Journal of Clinical Oncology, Paulsen et al found that methylprednisolone treatment improved fatigue, appetite loss, and patient satisfaction but not pain in patients with advanced cancer receiving opioid treatment for pain. Study Details In the study,...
No Clinical Outcome Benefit With Aerobic Training Program in Cancer Patients With Heart Failure
In a retrospective analysis in the HF-ACTION trial reported in the Journal of Clinical Oncology, Jones et al found that a program of aerobic training did not reduce the rate of all-cause mortality or hospitalization in cancer patients with heart failure. Some evidence suggested that patients who...
Blocking Tumor-Derived Protein Halts Cachexia in Preclinical Study
New research raises the prospect of more effective treatments for cachexia, a profound wasting of fat and muscle occurring in about half of all cancer patients, raising their risk of death, according to scientists from Dana-Farber Cancer Institute. In a study reported in Nature, Spiegelman et al...
Long-Term Central Venous Catheter Use Associated With Three- to Sixfold Increased Risk of Infection in Older Patients With Cancer
In a retrospective SEER (Surveillance, Epidemiology, and End Results)/Medicare data analysis reported in the Journal of Clinical Oncology, Lipitz-Snyderman et al found that long-term central venous catheter use was associated with a three- to sixfold increase in risk of infection in older...
HERA Trial 8-Year Follow-up Shows Low Rate of Trastuzumab-Associated Cardiac Dysfunction
In a study reported in Journal of Clinical Oncology, Azambuja et al found low rates of trastuzumab (Herceptin)-related cardiac dysfunction over a median of 8 years of follow-up in the HERceptin Adjuvant (HERA) trial. The majority of patients with cardiac dysfunction achieved acute recovery. Study...
ASCO 2014: Starting Palliative Care Support for Family Caregivers at the Time of Cancer Diagnosis Improves Quality of Life
Introducing a palliative care support program for caregivers of patients with advanced cancer at or near the time patients are diagnosed provides greater benefits than delayed palliative care services, according to results of the ENABLE III study reported at the 2014 ASCO Annual Meeting in Chicago...
MEK Inhibitor Use Associated With Bilateral Subfoveal Neurosensory Retinal Detachment
As reported in JAMA Ophthalmology, McCannel and colleagues identified three cases of subfoveal neurosensory retinal detachment among patients receiving MEK inhibitor therapy for metastatic cancer in clinical trials requiring ophthalmologic examination at their institution. In all cases, the toxic...
Greater Risk of Pretreatment Cognitive Impairment in Older Breast Cancer Patients With More Advanced Disease and Greater Comorbidity
In a study reported in the Journal of Clinical Oncology, Mandelblatt and colleagues attempted to determine whether cognitive impairment is present in older patients with breast cancer prior to systemic therapy. They found that although there were no global differences in cognitive function between...
FDA Approves Palonosetron Hydrochloride to Prevent Chemotherapy-Induced Nausea and Vomiting in Pediatric Patients
The U.S. Food and Drug Administration (FDA) has approved palonosetron hydrochloride (Aloxi) injection for the prevention of acute nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy, including highly emetogenic cancer chemotherapy, in children aged 1...
Proactive Patient-Centered Program May Reduce the Risk of Lymphedema in Survivors of Breast Cancer
A patient-centered educational and behavioral program focusing on self-care strategies appears to be an effective way to reduce the risk of lymphedema in survivors of breast cancer, according to the results of a prospective study by Fu et al at New York University. These findings, reported in the...
Frequent but Nontargeted Use of Pharmacologic Thromboprophylaxis in Hospitalized Patients With Cancer
Retrospective studies have shown that pharmacologic thromboprophylaxis is underutilized in hospitalized patients with cancer, who are believed to be at high risk of venous thromboembolism. In a prospective cross-sectional study reported in Journal of Clinical Oncology, Zwicker et al found that...
Magnetic Resonance–Guided Focused Ultrasound Reduces Pain From Bone Metastases
Few options are available to treat pain from bone metastases in patients refractory to drug and radiation therapy. In a phase III study reported in the Journal of the National Cancer Institute, Hurwitz et al found significant pain relief using magnetic resonance–guided focused ultrasound...
Modafinil Not Better Than Placebo for Fatigue in Lung Cancer Patients
In a trial reported in the Journal of Clinical Oncology, Spathis et al found that that the central nervous system (CNS) stimulant modafinil had no effect on fatigue compared with placebo in patients with advanced non–small cell lung cancer (NSCLC). Fatigue improved in both groups during the...
Doxepin Rinse Reduces Radiotherapy-Associated Oral Mucositis Pain in Patients With Head and Neck Cancer
In a phase III double-blind crossover trial (North Central Cancer Treatment Group [NCCTG] N09C6, Alliance for Clinical Trials in Oncology cooperative group) reported in the Journal of Clinical Oncology, Leenstra et al found that oral doxepin hydrochloride rinse significantly reduced...
Addition of Tigecycline to Empiric Therapy Improves Success Rate in Febrile Neutropenic Patients With Hematologic Malignancy
Antibiotic monotherapy is considered standard in empiric therapy in febrile neutropenic cancer patients, but the approach may be insufficient given the increase in infections due to multidrug-resistant microorganisms. Tigecycline (Tygacil), the first in a new class of glycylcycline antibiotics, has ...
ASCO Releases Adapted Guideline on Screening, Assessment, and Management of Fatigue in Adult Survivors of Cancer
A majority of cancer patients experience some level of fatigue during their course of treatment, and approximately 30% contend with persistent fatigue for years after treatment. Fatigue is among the most common and distressing long-term effects of cancer treatment and significantly affects patient...
ASCO Issues Adapted Guideline on Screening, Assessment, and Care of Anxiety and Depressive Symptoms in Adults With Cancer
ASCO has adapted the Pan-Canadian Practice Guideline on Screening, Assessment, and Care of Psychosocial Distress (Depression, Anxiety) in Adults With Cancer for use in the screening, assessment, and care of anxiety and depressive symptoms in adults with cancer. The adapted guideline, reported in...
ASCO Releases Guideline on Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers
The American Society of Clinical Oncology has released a clinical practice guideline on prevention and treatment of chemotherapy-induced peripheral neuropathy in adult cancer patients, published in the Journal of Clinical Oncology. The overall incidence of chemotherapy-induced peripheral neuropathy ...
Consumptive Hypothyroidism in GIST Associated With Increased D3 Expression
In a report in The New England Journal of Medicine, Maynard et al discuss identification of consumptive hypothyroidism due to overexpression of thyroid hormone–inactivating enzyme type 3 iodothyronine deiodinase (D3) in a patient with gastrointestinal stromal tumor (GIST) and subsequent...
Experts Call for More Awareness of Sexual Dysfunction in Lung Cancer Patients
Many lung cancer patients suffer difficulties with sexual expression and intimacy, yet for too long the topic has been ignored by doctors and researchers, experts said at the 4th European Lung Cancer Conference (ELCC) in Geneva, Switzerland. Researchers have estimated that sexual dysfunction...
NCCN Cancer Survivorship Guidelines Expanded to Address Two Common Conditions
The National Comprehensive Cancer Network (NCCN) has expanded its Survivorship Guidelines to include a section on cancer-associated cognitive impairment, and to include chemotherapy-induced peripheral neuropathy as a component of the Adult Cancer Pain section. The inaugural guidelines for...
Epigenetic Imprint of Chemotherapy Linked to Inflammation in Breast Cancer Survivors
Many breast cancer survivors experience fatigue and other debilitating symptoms that persist months to years after their course of treatment has ended. Now researchers at the Winship Cancer Institute of Emory University have found clues that may explain how these symptoms can linger. Chemotherapy...
Study Finds More Hospital Deaths and Invasive Care for Terminal Cancer Patients Receiving Palliative Chemotherapy
Patients with terminal cancer who receive chemotherapy during the last months of their lives are less likely to die where they want and more likely to endure invasive medical procedures than those who do not receive chemotherapy, according to a study by Wright et al published in BMJ. The findings...
Early Palliative Care Benefits Patients With Advanced Cancer
In a study published in The Lancet, Zimmermann et al compared quality of life, symptom severity, and care satisfaction with early initiation of palliative care vs standard cancer care in patients with advanced cancer. Although early palliative care was not associated with improved quality of life...
Daily Humidification of the Mouth and Throat During Radiation for Head and Neck Cancer Reduces Mucositis
New study findings show that patients with head and neck cancer receiving daily humidification of the mouth and throat during radiation therapy had reduced symptoms of muscositis and spent nearly 50% fewer days in the hospital to manage their treatment side effects. The study by Macann et al was...
Coordination of Care Improves Patient-Reported Quality of Supportive Care Among Patients With Colorectal Cancer
In a study reported in the Journal of Clinical Oncology, van Ryn et al assessed patient-reported quality of care among patients with colorectal cancer in the Veterans Affairs health-care system. The investigators found significant gaps in patient-centered quality of supportive care, but also found...
Expressive Writing Improves Symptoms and Physical Function in Patients With Renal Cell Carcinoma
In a trial reported in the Journal of Clinical Oncology, Milbury et al compared cancer symptoms, physical and mental function, depressive symptoms, fatigue, and sleep outcomes after sessions of expressive writing about cancer vs writing about neutral topics in patients with renal cell carcinoma....
Yoga Improves Inflammation, Fatigue, and Vitality in Breast Cancer Survivors
In a study reported in the Journal of Clinical Oncology, Kiecolt-Glaser et al found that yoga reduced levels of inflammatory cytokines and fatigue and increased vitality in breast cancer survivors. Study Details In the study, 200 women with stage 0 to IIIA breast cancer who had completed...
Cognitive-Behavioral Therapy Plus Hypnosis Controls Fatigue in Breast Cancer Patients Receiving Radiotherapy
In a study reported in the Journal of Clinical Oncology, Montgomery et al found that an intervention consisting of cognitive-behavioral therapy plus hypnosis produced better control of fatigue than supportive meetings with trained interventionists for women undergoing radiotherapy for breast...
Both Mindfulness-Based Stress Reduction and, More So, Cognitive Behavioral Therapy Improve Insomnia in Cancer Patients
In a noninferiority trial reported in the Journal of Clinical Oncology, Garland et al compared the effects of mindfulness-based stress reduction vs cognitive-behavioral therapy for treatment of insomnia in patients with cancer. They found that both techniques improved insomnia, with...
Short-Term Follow-up Reveals Suboptimal Pain Relief and Marked Pain Worsening in Ambulatory Cancer Patients
In an analysis reported in the Journal of Clinical Oncology, Zhao et al assessed factors associated with pain severity changes in ambulatory patients with solid tumors in the Eastern Cooperative Oncology Group E2Z02 (Symptom Outcomes and Practice Patterns) trial. They found that approximately...
Nurse- and Gastroenterologist-Led Algorithm-Based Management Improve GI Symptoms After Pelvic Radiotherapy
In the ORBIT trial, reported in The Lancet, Andreyev et al compared outcomes with usual care, gastroenterologist-led algorithm-based management, and nurse-led algorithm-based management for patients with chronic gastrointestinal symptoms following pelvic radiotherapy for cancer. The findings...
Web-Based Self-Care Support and Communication Coaching Program Reduces Symptom Distress in Cancer Patients
In the ESRA-CII trial reported in the Journal of Clinical Oncology by Berry et al, patient use of a Web-based self-care program featuring tailored education and communication coaching resulted in significantly reduced symptom distress compared with symptom/quality-of-life tracking alone in patients ...
Most Physicians Would Enroll in Hospice If They Were Terminally Ill With Cancer, Study Finds
In a research letter published in JAMA Internal Medicine, Chinn et al surveyed physicians’ attitudes towards hospice treatment if they were terminally ill with cancer and assessed how physician preferences might affect timing of hospice discussions with their terminally ill patients. They...
Single Fractions of Radiation for Painful Bone Metastases May Be Noninferior to Multiple Fractions
Optimal dose fractionation for radiation therapy of painful bone metastases from multiple primary sites remains undefined. In a phase III noninferiority trial reported in The Lancet Oncology, Chow et al compared 8 Gy in a single fraction vs 20 Gy in multiple fractions in patients with painful bone...
No Difference for Aprepitant vs Dexamethasone for Chemotherapy-Induced Delayed Emesis in Patients With Breast Cancer
In a phase III study reported in the Journal of Clinical Oncology, Roila et al compared aprepitant vs dexamethasone in prevention of delayed emesis in breast cancer patients treated with anthracycline/cyclophosphamide who had received palonosetron/aprepitant/dexamethasone prophylaxis for acute...
No Benefit of Calcium/Magnesium in Preventing Oxaliplatin-Induced Sensory Neurotoxicity in Patients With Colon Cancer
In a phase III N08CB/Alliance trial reported in the Journal of Clinical Oncology, Loprinzi et al assessed whether calcium and magnesium treatment reduced oxaliplatin-related neurotoxicity in patients with colon cancer receiving adjuvant FOLFOX (fluorouracil, leucovorin, and oxaliplatin). They found ...
Internet-Based Intervention Improves Cancer-Related Sexual Dysfunction in Women
An Internet-based intervention may significantly improve both sexual function and satisfaction in women with sexual dysfunction years after treatment for breast or gynecologic cancer, according to a randomized trial reported in the November issue of the Journal of the National Comprehensive Cancer...
