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Annals of Palliative Medicine

Egidio Del Fabbro
Since Cancer cachexia is defined as a "multifactorial syndrome", an effective therapeutic approach might be comprehensive multi-faceted treatment that targets different pathophysiological mechanisms simultaneously. The defining features of cancer cachexia, such as weight loss, reduced food intake, and chronic inflammation, might provide both a framework for classification of cachexia and a rationale for identifying multiple therapeutic targets. Past efforts to treat cachexia with nutritional or medical interventions may have disappointed because they were directed at a single domain of the syndrome, such as anorexia or muscle wasting, usually with a single therapeutic agent...
August 27, 2018: Annals of Palliative Medicine
Andrew Bang, Jonathan D Schoenfeld
Immune checkpoint inhibitors have emerged as a breakthrough therapy in the treatment in various metastatic cancers. In parallel, the role of radiotherapy in metastatic cancers has been expanding to include stereotactic ablative radiotherapy for oligometastases, in addition to the more conventional palliation of symptoms. Thus, many patients are appropriate candidates for both radiation and immunotherapy-highlighting the need for data to guide this treatment combination in patients with metastatic disease. Here, we review the literature to address questions regarding the safety of combined treatment (focusing on radionecrosis and pneumonitis), and the impact of dose, timing and site of radiotherapy...
August 22, 2018: Annals of Palliative Medicine
Cathryn Pinto, Katherine Bristowe, Jana Witt, Joanna M Davies, Susanne de Wolf-Linder, Marsha Dawkins, Ping Guo, Irene J Higginson, Barbara Daveson, Fliss E M Murtagh
BACKGROUND: Routine use of outcome measures in palliative care is recommended to demonstrate and improve quality of care. The use of outcome measures is relatively recent in UK specialist palliative care services and understanding their use in practice is key to successful implementation. We therefore aimed to explore how patient-centred outcome measures are used in specialist palliative care, and identify key considerations for implementation. METHODS: Multi-method qualitative study (semi-structured interviews and non-participant observation)...
October 2018: Annals of Palliative Medicine
Bárbara Antunes, Claudia Bausewein
No abstract text is available yet for this article.
October 2018: Annals of Palliative Medicine
Richard J Gralla
No abstract text is available yet for this article.
October 2018: Annals of Palliative Medicine
Francesca Rusalen, Maria Elena Cavicchiolo, Paola Lago, Sabrina Salvadori, Franca Benini
No abstract text is available yet for this article.
October 2018: Annals of Palliative Medicine
Alze Pereira Dos Santos Tavares, Carmen Tzanno-Matins, Marcio J C Arruda, Bárbara Antunes
BACKGROUND: Renal Supportive/Palliative Care is gaining gradual recognition as a patient-centered care approach that should be integrated to the traditional disease-centered model of care, mainly in elder patients with advanced chronic kidney disease (CKD). The objective of this study was to assess knowledge, perceptions, attitude, experience and interest in palliative care among renal care providers. METHODS: Online survey, administered between May 23 to June 13, 2017 to members of the Brazilian Society of Nephrology (BSN)...
October 2018: Annals of Palliative Medicine
Anna W LaVigne, Babe Gaolebale, Goitseone Maifale-Mburu, Surbhi Grover
BACKGROUND: A rising tide of cancers and other chronic diseases, alongside the ongoing HIV/AIDS epidemic, has created an increasing demand for palliative care in Africa. Yet, few African nations have established effective palliative care programs. In Botswana, the escalating HIV/AIDS crisis revealed an unmet need for holistic care, prompting efforts to expand palliative care education and policy, and target curricular and health system integration in the years that followed. Despite numerous successes, Botswana continues to face barriers to palliative care development...
October 2018: Annals of Palliative Medicine
Bárbara Antunes, Pedro Pereira Rodrigues, Irene J Higginson, Pedro Lopes Ferreira
The aim of this scoping review is to give an overview and appraisal of the development of outcome measurement throughout time and its present importance to healthcare and specifically to palliative care clinical practice. It is based on a search and search results of a published systematic review on implementing patient reported outcome measures in palliative care clinical practice. Medline, PsycInfo, Cumulative Index to Nursing and Allied Health Literature, Embase and British Nursing Index were systematically searched from 1985...
October 2018: Annals of Palliative Medicine
Ahsan Azhar, Eduardo Bruera
Patients with advanced illnesses, especially near the end of life, often experience multiple complex symptoms which may have profound impact on the quality of life of not only the patients but also their family members. Early and prompt recognition of such clinical challenges is linked with better end of life care for the dying patients, their caregivers and family members. In this narrative, which is not meant to be an in-depth systematic review, we attempt to provide an overview of some commonly used outcome measurement tools available for bedside clinical assessment of the different dimensions of suffering, especially near the time of death...
October 2018: Annals of Palliative Medicine
Anne-Sophie Bertrand, Antoine Iannessi, Sandrine Buteau, Xiong-Ying Jiang, Hubert Beaumont, Benoit Grondin, Guillaume Baudin
BACKGROUND: Interventional radiology procedures in cancer patients cause stress and anxiety. Our objective was to relate our experience in the use of sophrology techniques during interventional radiology procedures and evaluate the effects on patient's pain and anxiety. METHODS: We present a prospective observational study on 60 consecutive patients who underwent interventional radiology procedures in a context of oncologic management from September 2017 to March 2018...
October 2018: Annals of Palliative Medicine
Erin McKenzie, Matthew K Hwang, Stephanie Chan, Liying Zhang, Pearl Zaki, May Tsao, Elizabeth Barnes, Yasmeen Razvi, Leah Drost, Caitlin Yee, Edward Chow
BACKGROUND: More than 70% of patients with advanced cancer experience dyspnea. Dyspnea is predictive of shorter survival and interferes with quality of life (QOL). The present study aimed to identify predictors of the presence and severity of dyspnea in advanced cancer patients. METHODS: A prospective database collected from patients attending a palliative radiotherapy clinic was analyzed for patient demographics, Edmonton Symptom Assessment System (ESAS) scores, Patient-Reported Functional Status (PRFS), history of smoking and respiratory conditions, pulse oximetry readings, and primary cancer site...
October 2018: Annals of Palliative Medicine
Claudia Bausewein, Eva Schildmann, Johannes Rosenbruch, Birgit Haberland, Susanne Tänzler, Christina Ramsenthaler
Outcome measurement is becoming increasingly important in palliative care both in research as well as clinical care. Regular ongoing assessments in palliative care clinical practice have the potential to enable monitoring of the patient's situation, assess the effectiveness of interventions, assess symptoms accurately and focus on patients' priorities. Implementing routine outcome measurement into clinical practice remains a challenge. Therefore, the aim of this article is to describe the process of implementing routine outcome measurement into daily clinical work in a university palliative care unit...
October 2018: Annals of Palliative Medicine
Sandra Martins Pereira, Pablo Hernández-Marrero
Several outcome measures have been systematically implemented to be used in palliative care. However, routine use in clinical practice is not without ethical challenges, which are not commonly addressed. The objectives of this study are therefore (I) to identify the ethical challenges/issues of outcome measurement in palliative care and (II) to understand how these ethical challenges/issues are addressed in palliative care clinical practice. The study consisted of a systematic review of systematic reviews, which is a type of review that brings together a summary of reviews in one place...
October 2018: Annals of Palliative Medicine
Peter May, J Brian Cassel
The status of economic research in palliative care is evaluated. Significant limitations are observed in research to date. Recommendations are made for broadening the scope of economic enquiry in palliative care.
October 2018: Annals of Palliative Medicine
Caroline Nicholson, Joanna M Davies, Rob George, Blake Smith, Victor Pace, Laura Harris, Joy Ross, Jan Noble, Penny Hansford, Fliss E M Murtagh
BACKGROUND: Older people with multimorbidities are projected to be the main recipients of palliative care in the coming decades. However, because their specific palliative care needs are poorly understood and service response is underdeveloped, older people with multimorbidity are less likely to receive palliative care. Innovative specialist palliative care services are developing to address this gap, but with little underpinning evidence. Therefore the aim of this paper is to describe the clinical characteristics, symptoms and other concerns of older people with multi-morbidity referred to a new community palliative care service; and to explore possible implications for service delivery by comparing this service population with people receiving standard community-based specialist palliative care...
October 2018: Annals of Palliative Medicine
Anis A Hamid, Francis J Ha, Oindrila Das, Andrew J Weickhardt
BACKGROUND: Communication of prognosis and goals of care between oncologists, community health care providers (HCPs) and patients treated for advanced cancer facilitates optimal care planning. We aimed to review the frequency, content and timing of documented prognosis in written correspondence during the last year of life of advanced cancer patients. METHODS: All patients who died during palliative care or medical oncology admission in 2015 at a large, Australian tertiary center were identified...
October 2018: Annals of Palliative Medicine
Claude Cyr, Maria Fernanda Arboleda, Sunil Kumar Aggarwal, Lynda G Balneaves, Paul Daeninck, Andrée Néron, Erin Prosk, Antonio Vigano
Pain and symptom control challenges are common in palliative care, and the search for other therapeutic strategies is ongoing. Unfortunately, patients and their caregivers are receiving little information or support from healthcare providers regarding the increasingly popular cannabinoid-based medicines (CBM). Clinicians, meanwhile, feel understandably perplexed by the discrepancy between the available evidence and the rapid interest in which patients and their families have demonstrated for CBM. There is an urgent need to address the many challenges that are delaying the appropriate integration of CBM into clinical practice, notwithstanding the obvious need for a solid general knowledge of pharmacology, mechanism of action and available clinical evidence supporting its use...
October 2018: Annals of Palliative Medicine
Anna W LaVigne, Babe Gaolebale, Goitseone Maifale-Mburu, Eberechi Nwogu-Onyemkpa, Miriam Sebego, Sebathu P Chiyapo, Erin McMenamin, Surbhi Grover
BACKGROUND: The persistent global unmet need for palliative care continues to be felt acutely in Sub-Saharan Africa, where the volume is growing and access to palliative services remains underdeveloped. Recognizing the increasing urgency of bolstering palliative care infrastructure, several countries, such as Botswana, have established national policies and strategies to enhance care delivery. Given that education and training are essential components in pursuing this goal, we present a model for a training workshop that was successful in increasing the palliative care knowledge base and skill set in a group of nurses...
October 2018: Annals of Palliative Medicine
Caitlin Yee, Yasir Alayed, Leah Drost, Irene Karam, Danny Vesprini, Claire McCann, Hany Soliman, Liying Zhang, Edward Chow, Stephanie Chan, Justin Lee
BACKGROUND: Management of locally-advanced breast cancer is determined by multiple factors, but in patients without distant metastases often involves neoadjuvant systemic therapy, surgery and radiation. If the primary tumour remains unresectable following systemic therapy, radiotherapy may be used for tumour shrinkage prior to surgery. When metastatic disease is present, locoregional radiotherapy is generally reserved for management of tumour-related symptoms. We reviewed our experience of high-dose radiotherapy for unresected locally-advanced breast cancer...
October 2018: Annals of Palliative Medicine
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