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palliative care and brain cancer

Chalinee Monsereenusorn, Clement Ma, Hasan Al-Sayegh, Joanne Wolfe, Carlos Rodriguez-Galindo
: 151 Background: Early phase clinical trials are critical to enhancing therapies for children with advanced cancer. However, trial enrollment may intensify end-of-life (EOL) care. We evaluated patterns of EOL care for patients at a large cancer center. METHODS: Single-center, retrospective cohort study of pediatric oncology patients, ages 6 months-21 years, who died in 2010-2014. We queried electronic medical records to assess frequencies of medical procedures (e...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Eileen Fonseca, Bongin Yoo, Thomas Wilson, Hans-Peter Goertz, Catherine Lai
: 92 Background: Patients (pts) with HER2 positive (HER2+) metastatic breast cancer (MBC) have different patterns of disease and treatment (tx) from HER2 negative MBC. Brain metastasis (BM) frequently occurs and txs vary. METHODS: This retrospective study included adult HER2+ MBC pts from a community oncology network electronic health record (EHR) database and diagnosed between 2009-2011, with follow-up until 11/2014. Pts with other primary tumors were excluded...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Helen Senderovich, Shaira Wignarajah
End of life (EOL) care is a topic that many families have difficulty discussing. A number of families are uncomfortable with accepting the fact that death is a part of every human's reality. Ideas and thoughts of death are interpreted differently across various cultures, and lacking to discuss disease trajectory and what to expect down the road with a physician, brings forward conflict during EOL care. Let us consider the complexities of treating Mr. X who is an 80-year-old male of Italian background with a history of advanced lung cancer with metastasis to the brain...
November 30, 2016: Annals of Palliative Medicine
David Hui, Masanori Mori, Sharon M Watanabe, Augusto Caraceni, Florian Strasser, Tiina Saarto, Nathan Cherny, Paul Glare, Stein Kaasa, Eduardo Bruera
Although outpatient specialty palliative-care clinics improve outcomes, there is no consensus on who should be referred or the optimal timing for referral. In response to this issue, we did a Delphi study to develop consensus on a list of criteria for referral of patients with advanced cancer at secondary or tertiary care hospitals to outpatient palliative care. 60 international experts (26 from North America, 19 from Asia and Australia, and 11 from Europe) on palliative cancer care rated 39 needs-based criteria and 22 time-based criteria in three iterative rounds...
December 2016: Lancet Oncology
Verna L Hendricks-Ferguson, Kamnesh Pradhan, Chie-Schin Shih, Karen M Gauvain, Javier R Kane, Jingxia Liu, Joan E Haase
Providing timely palliative and end-of-life care (PC/EOL) information to parents of children with a serious illness is a national health care priority. The goals of this study were to determine feasibility, acceptability, and parent responses related to a PC/EOL communication intervention, titled "Communication Plan: Early through End of Life (COMPLETE)" to parents of children with a brain tumor. The study was a 2-site prospective, single-group pilot study targeting parents' stress and coping outcomes. The sample included 13 parents of 11 children (ie, 11 families)...
December 4, 2016: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
Hsiao-Ting Chang, Ming-Hwai Lin, Chun-Ku Chen, Pesus Chou, Tzeng-Ji Chen, Shinn-Jang Hwang
Do-Not-Resuscitate (DNR) and hospice care are not only applied to cancer patients but also to patients with noncancer progressive illness. However, the trends of DNR consent and hospice utilization are not well explored for noncancer patients. This study aimed to explore the trends of DNR consent and hospice care utilization among noncancer decedents in a tertiary hospital in Taiwan. We analyzed the Death and Hospice Palliative Care Database from the Taipei Veterans General Hospital in Taiwan. The Death and Hospice Palliative Care Database contains information including patient sex, major diagnosis, admission date, date of death, age at death, department at discharge, status of DNR consent, and status of hospice care of patients who died in the Taipei Veterans General Hospital...
November 2016: Medicine (Baltimore)
Michael Huo, Peter Gorayski, Mark B Pinkham, Margot Lehman
BACKGROUND: Non-small cell lung cancer (NSCLC) is a leading cause of cancer-related death in Australia. Radiotherapy plays an important role in the curative and palliative settings. OBJECTIVE: This article reviews recent technological advances that have expanded the radiotherapy treatment options available, and presents standard and emerging approaches to NSCLC. DISCUSSION: General practitioners play an integral role in the care and education of patients during diagnosis, treatment and
follow-up of NSCLC...
November 2016: Australian Family Physician
Jung Ae Lee, Nam Kwon Lee, Won Sup Yoon, Dae Sik Yang, Chul Yong Kim, Se Ryun Lee, Hwa Jeong Seong
AIM: Our study analyzed the frequency and causes of treatment interruption among patients undergoing radiation therapy (RT). METHODS: A total of 1637 RT courses in 1500 patients were reviewed from September 2009 to October 2013. A continuous break over 7 days or a discontinuous break over 14 days was regarded as a temporary break and RT under 80% of planned treatment was regarded as incomplete. RESULTS: Two-hundred and twenty courses (13...
August 4, 2016: Asia-Pacific Journal of Clinical Oncology
Brenda Sabo, Grace Johnston
UNLABELLED: Reports highlight the growing unmet need for palliative care as it applies to all cancers, yet the system and health care professionals (HCP) appear slow to respond. The following discussion paper highlights the current state of palliative care within the context of the primary malignant brain tumour (PMBT) population and argues for a shift in the current health care system's approach, which continues to place greater emphasis on cure over care. METHODS: An exploration of extant literature over the past 10 years...
2016: Canadian Journal of Neuroscience Nursing
Tiffany A Glazer, Andrew G Shuman
Salivary gland neoplasms are rare and diverse tumors with variable disease courses, making it difficult to concisely summarize the management of distant metastases (DM). Nonetheless, there are trends of DM in salivary gland cancer that can be contextualized and reviewed. In general, the primary tumor characteristics that predict DM include the primary tumor site, tumor stage and grade, perineural spread, cervical nodal status, and genomic signatures. The most common site of DM is the lung, followed by the bone, liver, and brain...
2016: Advances in Oto-rhino-laryngology
Jan McKendrick, Merel Gijsen, Casey Quinn, Beth Barber, Zhongyun Zhao
Objectives Studies reporting healthcare resourse use (HRU) for melanoma, one of the most costly cancers to treat, are limited. Using consistent, robust methodology, this study estimated HRU associated with the treatment of metastatic melanoma in eight countries. Methods Using published literature and clinician input, treatment phases were identified: active systemic treatment (pre-progression); disease progression; best supportive care (BSC)/palliative care; and terminal care. HRU elements were identified for each phase and estimates of the magnitude and frequency of use in clinical practice were obtained through country-specific Delphi panels, comprising healthcare professionals with experience in oncology (n = 8)...
June 2016: Journal of Medical Economics
Michaela Kuhlen, Jessica Hoell, Stefan Balzer, Arndt Borkhardt, Gisela Janssen
INTRODUCTION: Brain tumors have the highest disease-related mortality rate of all pediatric cancers. The goal of this study was to determine whether all children with incurable brain tumors cared for by a pediatric palliative care team in a home setting suffer from the same symptoms towards the end of their lives or whether there are differences between the tumor localizations with implications for palliative care. PATIENTS AND METHODS: This study was conducted as a retrospective, single center chart review including all patients treated between January 1st 2000 and December 31st 2013...
March 2016: European Journal of Paediatric Neurology: EJPN
Gülcin Şenel, Neşe Uysal, Gonca Oguz, Mensure Kaya, Nihal Kadioullari, Nesteren Koçak, Serife Karaca
INTRODUCTION: Delirium is a complex but common disorder in palliative care with a prevalence between 13% and 88% but a particular frequency at the end of life yet often remains insufficiently diagnosed and managed. The aim of our study is to determine the frequency of delirium and identify factors associated with delirium at palliative care unit. METHODS: Two hundred thirteen consecutive inpatients from October 1, 2012, to March 31, 2013, were studied prospectively...
December 31, 2015: American Journal of Hospice & Palliative Care
William J Mackillop, Weidong Kong
PURPOSE: Palliative radiation therapy (PRT) benefits many patients with incurable cancer, but the overall need for PRT is unknown. Our primary objective was to estimate the appropriate rate of use of PRT in Ontario. METHODS AND MATERIALS: The Ontario Cancer Registry identified patients who died of cancer in Ontario between 2006 and 2010. Comprehensive RT records were linked to the registry. Multivariate analysis identified social and health system-related factors affecting the use of PRT, enabling us to define a benchmark population of patients with unimpeded access to PRT...
January 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Samar M Aoun, Kathleen Deas, Denise Howting, Gabriel Lee
A substantial burden is placed on family caregivers of patients diagnosed with brain cancers. Despite this, the support needs of the caregivers are often under-recognised and not addressed adequately in current routine and patient centred clinical care. The Carer Support Needs Assessment Tool (CSNAT) is a validated instrument designed to systematically identify and address caregiver needs [corrected]. It has been trialled in an Australian palliative care community setting using a stepped wedge cluster design involving 322 family carers of terminally ill patients...
2015: PloS One
Mihaela Dana Turliuc, Anca Sava, Gabriela FlorenŢa Dumitrescu, Andrei Cucu, Anda Eşanu, Cornelia Tudorache, Irina Iuliana Costache, Claudia Florida Costea
The symptomatic choroidal metastasis is a rare manifestation of lung cancer. The aim of this study was to present a clinical case of choroidal metastasis associated with multiple intracerebral metastases from a papillary adenocarcinoma of the lung diagnosed simultaneously with its metastases. We present the case of a 40-year-old male patient, smoker, admitted to the Neurosurgery Clinic II, "Prof. Dr. Nicolae Oblu" Emergency Hospital, Iassy, Romania, for right hemiparesis, headache, right visual loss, dysphonia and swallowing disorders occurring six days earlier...
2015: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Mohammad Zafir Al-Shahri, Mahmoud Yassin Sroor, Wael Ali Ghareeb, Enas Noshy Aboulela, Wael Edesa
Neuroleptics are commonly used for treating delirium as a common problem in terminally ill cancer patients. However, prescribing patterns are believed to substantially vary among health professionals. The aim of this study is to determine the pattern of prescribing neuroleptics for treating delirium in cancer patients dying in a palliative care unit in Saudi Arabia. We reviewed the medical records of adults with advanced cancer who died in the palliative care unit over 23 months. In addition to patients' demographics, data collection included the pattern of prescribing neuroleptics for the treatment of delirium during the last week of life...
2015: Journal of Pain & Palliative Care Pharmacotherapy
Yoshihiko Sugitani, Osamu Inatomi, Rie Tanabe, Toshihiro Kanda, Ayano Sonoda, Hiroshi Hasegawa, Rie Osaki, Hirotsugu Imaeda, Hiromitsu Ban, Atsushi Nishida, Makoto Shioya, Shigeki Bamba, Mitsushige Sugimoto, Tomoyuki Tsujikawa, Akira Andoh
Metastasis to the skeletal muscle from gastric cancer is relatively rare. We report cases of 3 patients undergoing chemotherapy for gastric cancer with metastasis to the skeletal muscle. Case 1: A man in his 70s was diagnosed with advanced gastric cancer (cT4N3M1P0, stage IV), with metastasis to the lung, brain, lymph node, and iliopsoas muscle. Case 2: A man in his 60s was diagnosed with advanced gastric cancer (cT3N3M1P0, stage IV), with metastasis to the brain, lung, lymph node, and iliopsoas muscle. Case 3: A man in his 50s was diagnosed with advanced gastric cancer (cT4N3M1P0, stage IV), with metastasis to the urinary duct, lymph node, back muscle, and iliopsoas muscle...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Krista L Noonan, Cheryl Ho, Janessa Laskin, Nevin Murray
Over the past three decades, survival in advanced non-small-cell lung cancer (NSCLC) clinical trials has doubled with an increase in 1-year survival from 25% to 50 to 55%. This has been mainly attributed to improvements in systemic therapy. Although modern first-line chemotherapy regimens have more favorable toxicity profiles, a statistically significant improvement in overall survival has not been demonstrated in existing meta-analyses of second-generation versus third-generation combinations. Moreover, pivotal trials demonstrating statistically significant survival superiority of third-generation regimens are consistently not reproducible even for nonsquamous populations using pemetrexed-platinum combinations...
November 2015: Journal of Thoracic Oncology
Kenichi Harano, Kan Yonemori, Akihiro Hirakawa, Chikako Shimizu, Noriyuki Katsumata, Akihiko Gemma, Yasuhiro Fujiwara, Kenji Tamura
BACKGROUND: The social or familial factors influencing the location chosen for end-of-life (EOL) care for terminally ill breast cancer patients are unknown. METHODS: We retrospectively analyzed 195 patients with recurrent or progressive breast cancer who received anticancer treatment at the National Cancer Center Hospital between January 2008 and May 2012. Detailed data concerning the patients' demographic, familial, and clinical characteristics were collected, and multivariate and Cox logistic regression analyses were performed to evaluate the impact of these characteristics on the place of EOL care and on survival, respectively...
September 2016: Breast Cancer: the Journal of the Japanese Breast Cancer Society
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