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Issues in Oncology
Supportive Care
Palliative Care

Cancer-Related Suicide Has Declined in the United States Over the Past 2 Decades

Despite increases in overall suicide rates in the United States during the past 2 decades, cancer-related suicides declined by 2.8% per year in the same time period, according to a new study published by Han et al in JNCI: Journal of the National Cancer Institute. The study found that the largest...

hematologic malignancies
lymphoma
multiple myeloma
issues in oncology
palliative care

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 B-cell lymphomas; and end-of-life hospitalization of patients with multiple myeloma, as well as outcome disparities (Abstracts 207-212).

Leukemia
Palliative Care

Integrated Palliative and Oncology Care for Patients Receiving Treatment for AML

In a study reported in JAMA Oncology, Areej El-Jawahri, MD, and colleagues found that integrated palliative and oncology care was associated with better quality of life vs usual care among patients receiving treatment for acute myeloid leukemia (AML). The investigators stated, “Patients with AML...

Palliative Care
Symptom Management

Reducing the Risk of Lymphedema in Patients With Cancer

Although the exact incidence of treatment-related lymphedema among cancer survivors is unknown—most likely due to its prolonged latency period—it can be a lifelong chronic side effect that negatively impacts survivors’ quality of life. Although the condition is often linked to treatment for breast...

Breast Cancer
Palliative Care

End-of-Life Care Among Commercially Insured Women Younger Than 65 With Metastatic Breast Cancer

In a study reported in JCO Oncology Practice, Ferrario et al found a sizable increase in end-of-life intensive care unit (ICU) admissions and a small but significant increase in emergency department visits over time among commercially insured women younger than age 65 with metastatic breast cancer...

Supportive Care
Pain Management
Palliative Care

SBRT May Provide Superior Pain Relief From Spinal Metastases vs Conventional Radiotherapy

Stereotactic body radiation therapy (SBRT) was superior to conventional radiation therapy in reducing pain from spinal metastases in a phase II/III study reported by Arjun Sahgal, MD, and colleagues at the 2020 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract LBA 2). More...

Palliative Care

Behavioral Nudges Combined With Machine Learning Mortality Estimates May Improve Rate of Advanced Cancer Care Conversations

An electronic nudge to clinicians—triggered by an algorithm that used machine-learning methods to flag patients with cancer who would most benefit from a conversation around end-of-life goals—tripled the rate of those discussions, according to a new prospective, randomized study of nearly 15,000...

Pain Management
Palliative Care
Issues in Oncology

How Anxiety, Depression, and Low Social Support Impact the Intensity of Cancer Pain

Pain is one of the most common byproducts of cancer and its treatment. Tumors, surgery, intravenous chemotherapy, radiation therapy, targeted therapy, supportive care therapies (such as bisphosphonates), and diagnostic procedures can all cause pain in patients and may contribute to symptoms of...

Palliative Care

Overcoming the Challenges of Improving Psychosocial Care for Patients With Cancer

Although the United States spends billions of dollars each year on cancer research, very little of that funding is dedicated to mental health research in patients with cancer, despite the fact that cancer survivors have a six-time higher risk for psychological disability than people without...

Palliative Care

A Palliative Care Specialist Explores What It Means to Live and Die With Dignity and Purpose

Palliative care’s road to acceptance as standard-of-care practice has been a remarkably unsmooth one, given its core mission: improving the quality of life of patients and their families by relieving the pain, symptoms, and stress of a serious or life-limiting illness. A person’s relationship with...

Palliative Care

Determining the Best Place to Die for Patients With Cancer

Studies have shown a disconnect between where patients say they want to die and where they actually die. According to research from Stanford School of Medicine, although an overwhelming majority of Americans—about 80%—would prefer to die at home, just 20% do. In fact, 60% die in acute care...

Issues in Oncology
Palliative Care

Effect of Functional Impairment on Hospitalized Patients With Cancer

New research published by Lage et al in JNCCN–Journal of the National Comprehensive Cancer Network found 40.2% of hospitalized patients with advanced, incurable cancer were functionally impaired at the time of admission—meaning they needed assistance with activities of daily living like walking,...

COVID-19
Palliative Care

Prioritizing Patients With Metastatic Disease for Palliative Radiotherapy

In anticipation of how the COVID-19 pandemic might impact oncology care as the coronavirus spread across New York City, radiation oncologists with expertise in the management of metastatic disease and inpatient oncologic emergencies at Memorial Sloan Kettering Cancer Center (MSK) met in late winter ...

Gastrointestinal Cancer
Palliative Care

2020 GI Cancers Symposium: Does Receipt of Palliative Care Increase Survival in Patients With Metastatic Esophageal Cancer Declining Chemotherapy?

Patients with metastatic esophageal cancer who declined chemotherapy but received palliative care had a numerically higher, but not statistically significant, difference in overall survival. These findings will be presented by Manguso et al at the 2020 Gastrointestinal Cancers Symposium (Abstract...

Hematologic Malignancies
Palliative Care

Early Palliative Care for Patients With Hematologic Malignancies: Beneficial but Underused

The use of billed palliative care services among Medicare beneficiaries with hematologic malignancies has risen dramatically in recent years, but most encounters still occur within days of death, according to research presented at the 2019 Supportive Care in Oncology Symposium.1 The analysis of...

Health-Care Policy
Palliative Care

Palliative Care Bill Unanimously Approved by U.S. House of Representatives

On October 28, the U.S. House of Representatives unanimously approved the Palliative Care and Hospice Education and Training Act (PCHETA). The bipartisan bill would increase federal research funding for palliative care—including pain and symptom management—and would establish palliative care...

Palliative Care

Expert Point of View: Paul B. Jacobsen, PhD, FASCO

Paul B. Jacobsen, PhD, FASCO, Associate Director of the National Cancer Institute’s Division of Cancer Control and Population Science’s Healthcare Delivery Research Program, said that this study exemplifies the type of work that is needed to more broadly and rapidly translate promising research...

Palliative Care

Community Health Workers May Improve Value of End-of-Life Cancer Care

The results of simple interventions involving community health workers suggest that improvements in value-based cancer care need not come from health-care professionals. According to data presented at the 2019 ASCO Quality Care Symposium,1 reliance upon community health workers trained to assess...

Issues in Oncology
Palliative Care

Is Implicit Bias Contributing to Time Disparities in Goals-of-Care Conversations With Minority Patients?

GUEST EDITOR Addressing the evolving needs of cancer survivors at various stages of their illness and care, Palliative Care in Oncology is guest edited by Jamie H. Von Roenn, MD, FASCO. Dr. Von Roenn is ASCO’s Vice President of Education, Science, and Professional Development. It has been well...

Palliative Care
Issues in Oncology

Is Implicit Bias Contributing to Time Disparities in Goals-of-Care Conversations With Minority Patients?

GUEST EDITOR Addressing the evolving needs of cancer survivors at various stages of their illness and care, Palliative Care in Oncology is guest edited by Jamie H. Von Roenn, MD, FASCO. Dr. Von Roenn is ASCO’s Vice President of Education, Science, and Professional Development. It has been well...

issues in oncology
palliative care

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).

Supportive Care
Palliative Care
Pain Management

How an Innovative AI-Based Smartphone Application Is Addressing Patients’ Palliative Care Needs

GUEST EDITOR Addressing the evolving needs of cancer survivors at various stages of their illness and care, Palliative Care in Oncology is guest edited by Jamie H. Von Roenn, MD, FASCO. Dr. Von Roenn is ASCO’s Vice President of Education, Science, and Professional Development.   During the 2019...

Supportive Care
Palliative Care

Improve Quality of Life With This Palliative Care Education Resource for Your Patients

Do your patients know that supportive care can help them manage their symptoms and side effects, regardless of age, cancer type, or disease stage? Make sure your patients understand the benefits of palliative care and where to access services with the ASCO Answers Palliative Care booklet. Your...

palliative care
issues in oncology

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...

Palliative Care

House Calls With Her Physician Father Sparked an Interest in Palliative Care for Janet L. Abrahm, MD

Nationally regarded palliative care expert Janet L. Abrahm, MD, was born and reared in San Francisco. Her father was a solo practitioner who saw medicine as a great profession. “My father would come home from his office for dinner and when he finished, he’d do house calls, often bringing us with...

palliative care
lung cancer
cost of 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...

Palliative Care
Supportive Care

Sweet Surrender

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

Supportive Care
Palliative Care

National Consensus Project Clinical Practice Guidelines: Improving Education on the Tenets of Palliative Care

The provision of palliative care (primary or specialty) is paramount to providing excellent quality care to all patients with cancer. Palliative care is associated with improving the quality of life, mood, and survival in patients with cancer. In fact, ASCO guidelines recommend that patients with...

Supportive Care
Palliative Care

National Consensus Project Releases 4th Edition of Clinical Practice Guidelines for Quality Palliative Care

As reported by Betty R. Ferrell, PhD, MA, FAAN, FPCN, of the Division of Nursing Research and Education, City of Hope Medical Center, Duarte, California, and colleagues in the Journal of Palliative Medicine, the National Consensus Project (NCP) of the National Coalition for Hospice and Palliative ...

Supportive Care
Palliative Care

Innovative Research to Improve the Supportive Care Needs of Cancer Survivors

First launched in 2014, the Palliative Care in Oncology Symposium introduced a nascent interdisciplinary approach to the treatment of both the physical and psychological symptoms of cancer to improve disease outcome and quality of life for patients. Today, it has evolved into a leading forum for...

palliative care
issues in oncology

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...

palliative care
issues in oncology

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...

Supportive Care
Palliative Care

Improving Palliative Care in Low-Resource Settings

In 2016, ASCO published an update to its Clinical Practice Guideline, “Integration of Palliative Care Into Standard Oncology Care,” which provides evidence-based recommendations for symptom management, clarification of treatment goals, support of coping and distress management, and coordination of...

Supportive Care
Palliative Care

The Great Opioid Debate: Treating Cancer Pain Safely

As the number of opioid-related deaths continues to rise in the United States, stakeholders are struggling to make sense of the crisis. At the 2018 Palliative and Supportive Care in Oncology Symposium, two experts in the field, Charles F. von Gunten, MD, PhD, and Leslie J. Blackhall, MD,...

Supportive Care
Palliative Care

Study Finds Poor Adherence to Guidelines in Preventing Chemotherapy-Induced Nausea and Vomiting

Adherence to antiemetic guidelines for the prevention of chemotherapy-induced nausea and vomiting has been shown to improve patient outcomes. However, a new study suggests that physicians are still struggling to reach attainable adherence targets in antiemetic prophylaxis.1 According to data...

Supportive Care
Palliative Care

Artificial Intelligence–Based Smartphone App Decreases Pain and Reduces Inpatient Hospitalizations in Patients With Cancer

A smartphone application utilizing elements of artificial intelligence was associated with improved cancer pain outcomes and a significant reduction in pain-related hospital admissions, according to data presented at the 2018 Palliative and Supportive Care in Oncology Symposium.1 Results of the...

Supportive Care
Palliative Care

Palliative Care in the Pediatric Oncology Setting

Cancer is the leading cause of disease-related childhood death. To better serve the special needs of this highly vulnerable patient population, pediatric palliative care teams use a personalized, holistic, and interdisciplinary approach tailored to relieve the physical, psychosocial, and spiritual ...

Supportive Care
Palliative Care
Issues in Oncology
Global Cancer Care

Unequal Burden of Cancer-Related Suffering and Need for Palliative Care

The global burden of cancer-related suffering is tremendously unbalanced, according to Eric L. Krakauer, MD, PhD, Director of the Global Palliative Care Program at Massachusetts General Hospital and Harvard Medical School, Boston and a lead coauthor of the Report of the Lancet Commission on Global...

palliative care
issues in oncology

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...

geriatric oncology
palliative care

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).

issues in oncology
palliative care

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.

palliative care
survivorship
myelodysplastic syndromes
leukemia

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.

palliative care
pain management

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.

palliative care
issues in oncology
symptom management

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...

Palliative Care

Developing Patient-Centered Palliative Care From Diagnosis to End of Life

In December, The University of Texas at Austin Dell Medical School will launch an innovative cancer care model called the CaLM (cancer life re-imagined) Clinic as part of its new cancer center, the Livestrong Cancer Institutes. The goal of the Livestrong Cancer Institutes and the CaLM Clinic is to...

Issues in Oncology
Palliative Care

End-of-Life Dashboard Drives Transformation With Actionable Personalized Data

A NUMBER OF STUDIES from the palliative care literature have shown that nonbeneficial health-care interventions actually may harm patients’ quality of life, increase patient and caregiver distress, and drive costs. Yet, according to the National Cancer Institute, about 30% of all cancer spending...

palliative care
lung cancer
issues in oncology
cost of care

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,...

Issues in Oncology
Palliative Care

Closing the Gender Divide in Preference for Palliative Care

Eight years ago, a survey of the preferences of Dutch patients with cancer for health care found that while gender was one aspect influencing how men and women approach cancer care, it was the most important, with men, generally, regarding most care aspects as less important than women. The study...

Issues in Oncology
Palliative Care

Expanding the Use of Provider Orders for Life-Sustaining Treatment for Patients With Advanced Cancer

Patients with advanced cancer often get more aggressive treatment than they want because too few oncologists elicit their end-of-life treatment preferences.1,2 In response to this problem, leading associations, including ASCO3,4 and the Institute of Medicine,5 have called for more advance care...

palliative care

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,...

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