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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,...

palliative care

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...

Palliative Care
Immunotherapy

Meeting the Challenges of Immunotherapy-Related Toxicities

In 2011, the U.S. Food and Drug Administration (FDA) approved ipilimumab (Yervoy), an anticytotoxic T-lymphocyte– associated antigen 4 (CTLA-4), the first checkpoint inhibitor for the treatment of advanced melanoma.1 Since then, several more checkpoint inhibitors directed at both the programmed...

palliative care
colorectal cancer
lung cancer
cost of care

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
issues in oncology

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...

issues in oncology
palliative care
immunotherapy

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 content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.

issues in oncology
palliative care
immunotherapy

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 Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.

Palliative Care

How Learning What’s on Your Patient’s Bucket List May Improve Care

It may sound too good to be true, but asking patients a simple question about what is on their bucket list can actually spark a dialogue about how best to make their cancer care and survivorship fit into their life plans, as well as be an effective way to identify their end-of-life care goals,...

Issues in Oncology
Palliative Care

Voluntarily Stopping Eating and Drinking Is Legal—and Ethical—for Terminally Ill Patients Looking to Hasten Death

Terminally ill patients with cancer will sometimes ask their clinicians for help with assisted or hastened death.1 Although palliative care and hospice care can usually address the concerns of most patients, some have physical or existential suffering that is refractory to comfort and supportive...

palliative care
issues in oncology

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...

palliative care
lung cancer

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...

Supportive Care
Palliative Care

Using Video Decision-Support Tools to Facilitate End-of-Life Discussions With 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. Dr. Von Roenn is ASCO’s Vice President of Education, Science, and Professional Development. Research shows that...

palliative care
lung cancer

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...

Solid Tumors
Colorectal Cancer
Supportive Care
Pain Management
Palliative Care
Survivorship
Issues in Oncology

Support, Inform Patients With ASCO Resources

Stock your practice with ASCO resources for your patients. Visit ASCO’s patient information website, Cancer.Net, for a newly updated comprehensive guide to colorectal cancer at cancer.net/colorectal and a shorter, one-page colorectal cancer fact sheet. Copies can be purchased from the ASCO...

palliative care

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 ...

Supportive Care
Palliative Care
Immunotherapy

The Challenge of Prognostication in the Era of Immunotherapy

  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. Dr. Von Roenn is ASCO’s Vice President of Education, Science, and Professional Development. Although advances in such ...

Palliative Care

Why Palliative Care Isn’t Just for Older Patients With Cancer

It is well established that adolescents and young adults (AYAs) with cancer—defined by the National Cancer Institute as those between the ages of 15 and 39 years—have not reaped a comparable survival benefit as either younger or older adult cancer survivors over the past 4 decades, despite...

Palliative Care

Working Together to Help Pediatric Patients With Cancer Live and Live Well

While many patients with cancer can benefit from palliative care to ease symptoms from the disease or its treatment, for children with cancer, especially critically ill children, palliative care can provide an additional layer of medical and emotional support for both young patients and their...

Supportive Care
Palliative Care

Helping Patients With Advanced Disease Transition From Focused to Intrinsic Hope

While hope for a cure after a cancer diagnosis is a feeling both patients and oncologists rightly cling to during treatment, when too much emphasis is placed on this type of “focused” hope, it can make it more difficult for patients to face their mortality. Moreover, such a focus can deny patients ...

Supportive Care
Palliative Care

ASCO Answers Palliative Care: A Resource for Patients

Do your patients have questions about palliative care/supportive care? Help them better understand their prognosis and goals of treatment, clarify their expectations, and maintain their quality of life with the ASCO Answers Palliative Care booklet.  This booklet shows how palliative care is used...

Supportive Care
Palliative Care

Walther Cancer Foundation Endows New ASCO Special Award and Lecture for Palliative and Supportive Care

The Walther Cancer Foundation, Inc., a private foundation based in Indianapolis, Indiana, has endowed a new ASCO award and lecture bearing its name to be presented annually at the Palliative and Supportive Care in Oncology Symposium. This grant represents a new foray for the foundation as it...

Supportive Care
Palliative Care

Caring for the Frail, Older Patient With Cancer: Four Practical Approaches

Cancer may be a disease of aging, but data suggest that older patients with cancer are undertreated, especially with respect to chemotherapy. One analysis showed that approximately 40% of patients in their 70s—and 60% of patients in their 80s—do not receive adjuvant therapy after surgery for colon...

Supportive Care
Palliative Care

‘Triple Threat’ Conditions May Predict Mortality in Patients With Cancer Presenting to Emergency Departments

Dyspnea, delirium, and poor performance—so-called “triple threat” conditions—are known to predict short survival in palliative care. According to data presented at the 2017 Palliative and Supportive Care in Oncology Symposium,1 however, the presence of at least two of these symptoms in patients...

Supportive Care
Palliative Care

Concurrent Palliative Care: Recommendations From the ASCO Clinical Practice Guideline

Updated in 2016, the ASCO clinical practice guideline on the integration of palliative care into standard oncology care provides evidence-based recommendations to oncology clinicians, patients, family and friend caregivers, and palliative care specialists about providing high-quality care for...

Supportive Care
Palliative Care
Cost of Care
Issues in Oncology

Palliative Care Intervention Reduces Total Health-Care Costs in Patients With Advanced Cancer

A matched case-controlled study among Medicare beneficiaries with metastatic lung, colorectal, breast, and prostate cancers has found that palliative care consultation significantly reduced total health-care costs following intervention. According to data presented at the 2017 Palliative and...

Supportive Care
Palliative Care

Digital Palliative Care Curriculum Improves Knowledge, Skills, and Opioid Prescribing Behavior

A new electronic curriculum delivered via e-mail with push technology may provide an efficient, cost-effective solution to the shortage of palliative care faculty serving the nation’s oncology fellowship programs. According to data presented at the 2017 Palliative and Supportive Care in Oncology...

Supportive Care
Palliative Care

Early Integrated Palliative Care Improves Patient Coping Strategies, Quality of Life, and Symptoms of Depression

A new study has shed light on how palliative care interventions may improve patient outcomes. According to data presented at the 2017 Palliative and Supportive Care in Oncology Symposium,1 patients with incurable cancer who received early integrated palliative care had an increased use of active...

Supportive Care
Palliative Care

Advancing Care Across the Cancer Continuum

Addressing the need to integrate palliative and supportive care practices into medical specialties to ensure optimal patient-centered care across the cancer continuum and the evidence-based remedies to accomplish that goal were the focus of the nearly 300 study abstracts presented at the 2017...

Supportive Care
Palliative Care

How Effective Communication Is Integral to Patient-Centered Care

Communicating effectively with patients with advanced cancer not only helps patients and their family members successfully transition to palliative and end-of-life care, it can prevent physicians from experiencing professional burnout, according to Robert M. Arnold, MD, Distinguished Service...

palliative care

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.

issues in oncology
palliative care

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.

palliative care

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 depression (Abstract 92).

palliative care

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).

palliative care
pain management

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.

palliative care

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.

palliative care

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).

palliative care
symptom management

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.

palliative care

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...

palliative care
lung cancer

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). ...

palliative care
leukemia

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....

palliative care

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...

palliative care

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...

palliative care

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...

palliative care

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...

Palliative Care

How Early Palliative Care May Benefit Patients With Incurable Cancer

Palliative care provided soon after a patient is diagnosed with incurable cancer not only helps improve the patient’s overall quality of life but also improves communication about the patient’s wishes for end-of-life care, according to a study by Jennifer S. Temel, MD, Clinical Director of Thoracic ...

Thyroid Cancer
Prostate Cancer
Lung Cancer
Survivorship
Palliative Care

News From JCO and JOP

STAYING UP-TO-DATE in the fast-paced world of oncology literature is a daunting task at best. To assist with that task, The ASCO Post has assembled an assortment of studies recently published in the Journal of Clinical Oncology (JCO) and the Journal of Oncology Practice (JOP). Future installments...

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