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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...
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...
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).
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).
Stephen T. Sonis, DMD, DMSc, of Dana-Farber Cancer Institute, discusses the epidemiology, pathogenesis, and scope of oral complications of radiation therapy.
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.
Scott A. Irwin, MD, PhD, of Cedars-Sinai’s Samuel Oschin Comprehensive Cancer Institute, discusses delirium—its definition, prevalence, consequences, assessment, and management.
Eric Roeland, MD, of the University of California, San Diego, discusses the key papers presented at this year’s Palliative Care in Oncology Symposium.
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.
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).
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).
Joseph A. Greer, PhD, of Massachusetts General Hospital, discusses the development of a mobile application to address treatment adherence and symptoms (Abstract 104).
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.
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.
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.
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.
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.
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).
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...
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...
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 ...
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...
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...
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,...
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...
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...
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...
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).
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...
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).
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...
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...
Joseph V. Simone, MD, of the Simone Consulting Company, gives his expert perspective on the important messages of this year’s meeting.
Toby C. Campbell, MD, of the University of Wisconsin Carbone Cancer Center, discusses palliative care, hospice care, and best supportive care practices, as well as the challenges of symptom management and end-of-life issues.
In a study reported in JAMA, Bekelman et al assessed the site of death, health-care utilization, and hospital expenditures among patients aged ≥ 65 years dying with cancer in Belgium, Canada, England, Germany, the Netherlands, Norway, and the United States. The United States had lower...
The Palliative Care in Oncology Symposium, held October 9–10, 2015, in Boston, Massachusetts, brought together more than 670 members of the cancer care community, including oncologists, radiologists, palliative care specialists, nurses, and patient advocates. Sessions delivered information on...
Kerin B. Adelson, MD, of the Yale Cancer Center, discusses the major healthcare cost drivers at the end of life—aggressive treatments, emergency room visits, and futile care—and strategies for improving value. (Abstract 3)
Non–small cell lung cancer (NSCLC) patients with common epidermal growth factor (EGFR) mutations and brain metastases showed improved progression-free survival and response from the EGFR tyrosine kinase inhibitor afatinib (Gilotrif) compared to standard platinum doublet chemotherapy....
Care for mothers with terminal cancer could be improved to help resolve their psychological distress and to help surviving family members cope, a study by University of North Carolina at Chapel Hill researchers have found. Based on the study findings published by Park et al in the journal BMJ...
Samuel M. Silver, MD, PhD, of the University of Michigan Comprehensive Cancer Center, and David S. Ettinger, MD, of The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, discuss the evolution of the NCCN Guidelines, the importance of including palliative care and survivorship recommendations, and the use of the guidelines in community practices.
Daniel A. Vorobiof, MD, of the Sandton Oncology Centre, and Bernardo Leon Rapoport, MD, of The Medical Oncology Centre of Rosebank, discuss the first study to evaluate the efficacy and safety of a single dose of intravenous fosaprepitant. The use of this NK1 inhibitor and another (rolapitant) in a second study discussed may change the management of chemotherapy-induced nausea and vomiting and improve quality of life for patients (Abstracts 9629 and 9615).
Thomas W. LeBlanc, MD, of Duke University Medical Center, and Eric Roeland, MD, FAAHPM, of the University of California, San Diego Moores Cancer Center, discuss the use of palliative and hospice care for patients with solid tumors vs hematologic cancers and clinicians’ attitudes (Abstracts e20554 and 9524).
Eric Roeland, MD, FAAHPM, of the University of California, San Diego Moores Cancer Center, and Areej El-Jawahri, MD, of Massachusetts General Hospital, discuss two important studies on early palliative care and the use of anamorelin in advanced NSCLC with cachexia.
Charles F. von Gunten, MD, PhD, of OhioHealth Kobacker House discusses the ROMANA 1 and 2 trials on cachexia in NSCLC and a study on olanzapine vs fosaprepitant for the prevention of nausea and vomiting (Abstracts 9500 and 9502).
Irene Higginson, MD, of Cicely Saunders International, discusses the goals of psychosocial palliative care for patients around the world with advanced cancer.
Wendy Lichtenthal, PhD, of Memorial Sloan Kettering Cancer Center, and David Kissane, MD, of Monash University, discuss the importance of and challenges with attending to the whole family during palliative care.
Eduardo Bruera, MD, of The University of Texas MD Anderson Cancer Center, discusses exciting developments in the assessment and management of cachexia, as well as a number of emerging pharmacologic and nonpharmacologic interventions (Abstract 67).
Lorenzo Cohen, MD, of The University of Texas MD Anderson Cancer Center, discusses nonpharmacologic approaches to symptom control. Techniques such as acupuncture for managing pain and chemotherapy-induced nausea and vomiting, or yoga and meditation to help improve quality of life, can be safely integrated into oncology care.
Judith Vick, MD Candidate, of Johns Hopkins University School of Medicine, and Rachelle E. Bernacki, MD, of Dana-Farber Cancer Institute, discuss a tool that could help clinicians identify seriously ill patients who would benefit from conversations about their goals and values (Abstract 8).
Diane Portman, MD, of Moffitt Cancer Center, discusses clinical pathways that embed palliative care along the spectrum of care for a variety of cancer disease states.