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Palliation pain nausea symptom cancer end-of-life

Lisa Martinsson, Staffan Lundström, Johan Sundelöf
INTRODUCTION: Globally, dementia is one of the leading causes of death. Given the growing elderly population in the world, the yearly number of deaths by dementia is expected to increase. Patients dying from dementia are reported to suffer from a burden of symptoms similar to that of patients with cancer, but receive less medication against symptoms, have a lower probability of palliative care planning and seldom have access to specialised palliative care. Studies investigating the quality of palliative care in dementia are scarce...
2018: PloS One
Sofia Andersson, Kristofer Årestedt, Olav Lindqvist, Carl-Johan Fürst, Margareta Brännström
CONTEXT: Residential care homes (RCHs) are a common place of death. Previous studies have reported a high prevalence of symptoms such as pain and shortness of breath among residents in the last week of life. OBJECTIVES: The aim of the study was to explore the presence of symptoms and symptom relief and identify factors associated with symptom relief of pain, nausea, anxiety, and shortness of breath among RCH residents in end-of-life care. METHODS: The data consisted of all expected deaths at RCHs registered in the Swedish Register of Palliative Care (N = 22,855)...
May 2018: Journal of Pain and Symptom Management
Andreas Jülich, Thomas Spreu, Britta Buchhold, Taras Usichenko
An integrated multidisciplinary palliative care (IMPC) program is a promising tool to improve symptom control in patients at the end of life. The aim was to study the feasibility of the IMPC program in patients at the palliative care (PC) ward. A retrospective audit, using the extended Edmonton Symptom Assessment Scale (ESAS), was conducted on the PC ward of the university hospital. Consecutive patients who were admitted for the IMPC program during 1 year were considered. One hundred forty-eight cases (93% with underlying cancer) were analyzed...
July 2017: Journal of Palliative Care
Michael J Hochman, Yinxi Yu, Steven P Wolf, Greg P Samsa, Arif H Kamal, Thomas W LeBlanc
CONTEXT: Hematologic cancer patients use palliative care services less frequently than their solid tumor counterparts. Prior work suggests that these patients have a sizable symptom burden, but comparisons between hematologic and solid tumor patients near the end of life are limited. OBJECTIVES: To compare unmet symptom needs in a cohort of hematologic and solid tumor patients referred to specialty palliative care services. METHODS: Using a novel data registry of initial palliative care encounters, we performed a cross-sectional analysis of cancer patients receiving care across 17 sites within the Global Palliative Care Quality Alliance...
January 2018: Journal of Pain and Symptom Management
Daniel L Handel, Sylvain Néron
Advanced cancer often produces significant symptoms such as pain, anxiety, insomnia, nausea, and cachexia; many symptoms require medication adjustments in dose and route of administration, and most patients have significant symptom burdens near the end of life. Treatment strategies that integrate mind-body approaches, such as hypnosis, to improve symptoms are increasingly being studied and utilized. The current article addresses the role for adjunctive hypnotic approaches to relieve suffering from pain and other symptoms, while fostering hope, even in the midst of advancing illness, similar to Snyder's (2002) metaphorical painting of "a personal rainbow of the mind" (p...
July 2017: American Journal of Clinical Hypnosis
Sarah Lee, Sejal Kothadia, Yucai Wang, Victor Tsu-Shih Chang, Yeun-Hee Anna Park, Ellen Olson, David Klein, Fengming Zhong
164 Background: Palliative care interventions and their effect on EOL outcomes for liver cancer pts have not been described. We investigated the association between palliative care intervention and EOL care outcomes. METHODS: We reviewed the charts of pts with hepatocellular carcinoma and who were seen by palliative care at 2 VA medical centers from 2006 to 2012. We investigated the association between EOL outcomes (number of ER visits, ICU visits, chemotherapy, place of death, number of hospitalizations during their last 30 days), and interventions such as early referral (within 30 days of diagnosis), defined goals of care, holding a family meeting, and symptom assessment and management...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Pedro Emilio Perez-Cruz, Cecilia Carrasco Escarate, Pilar Bonati, Bogomila Batic, Laura Tupper, Marcela Gonzalez Otaiza
64 Background: Improving symptom control during end of life (EOL) is a core goal of palliative care. When patients are not able to report their symptoms, caregivers (CG) report symptom intensity as surrogates. Data show that there is good agreement between patients and CG in reporting symptom intensity. However, little is known about factores that influence CGs' accuracy. The aim of the study was to determine CG accuracy of advanced cancer patients' symptoms and to identify CG factors that could modify it. METHODS: In this prospective study, patients with advanced cancer enrolled in the National Program of Palliative Care at a public Hospital in Santiago, Chile and their CGs independently scored ten patients' symptoms using the Edmonton Symptom Assessment Scale (ESAS)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Carolyn Lefkowits, Caroline Solomon
Palliative care is specialized care for people with life-limiting illness; it focuses on symptom management and quality of life and ensures that a patient's care is concordant with her goals and values. Unlike end-of-life care, palliative care can be offered concurrently with disease-directed therapies, including when the goal is cure. Obstetrics and gynecology patients for whom palliative care is most appropriate include women with gynecologic cancer and women with a fetus or neonate with a potentially life-limiting illness...
December 2016: Obstetrics and Gynecology
Naveen Salins, Lipika Patra, M R Usha Rani, S O Lohitashva, Raghavendra Rao, Raghavendra Ramanjulu, Nandini Vallath
INTRODUCTION: Palliative care is usually delivered late in the course of illness trajectory. This precludes patients on active disease modifying treatment from receiving the benefit of palliative care intervention. A survey was conducted to know the opinion of oncologists, oncology nurses, and patients about the role of early specialist palliative care in cancer. METHODS: A nonrandomized descriptive cross-sectional study was conducted at a tertiary cancer care center in India...
July 2016: Indian Journal of Palliative Care
Kathleen E Bickel, Kristen McNiff, Mary K Buss, Arif Kamal, Dale Lupu, Amy P Abernethy, Michael S Broder, Charles L Shapiro, Anupama Kurup Acheson, Jennifer Malin, Tracey Evans, Monika K Krzyzanowska
PURPOSE: Integrated into routine oncology care, palliative care can improve symptom burden, quality of life, and patient and caregiver satisfaction. However, not all oncology practices have access to specialist palliative medicine. This project endeavored to define what constitutes high-quality primary palliative care as delivered by medical oncology practices. METHODS: An expert steering committee outlined 966 palliative care service items, in nine domains, each describing a candidate element of primary palliative care delivery for patients with advanced cancer or high symptom burden...
September 2016: Journal of Oncology Practice
Heléne Eriksson, Anna Milberg, Katarina Hjelm, Maria Friedrichsen
BACKGROUND: Although stroke is a significant public health challenge and the need for palliative care has been emphasized for these patients, there is limited data on end-of-life care for patients dying from stroke. OBJECTIVE: To study the end-of-life care during the last week of life for patients who had died of stroke in terms of registered symptom, symptom management, and communication, in comparison with patients who had died of cancer. DESIGN: This study is a retrospective, comparative registry study...
2016: PloS One
Magnus Lindskog, Björn Tavelin, Staffan Lundström
BACKGROUND: If patient age affects the quality of end-of-life care in cancer is unknown. Using data from a population-based register of palliative care in Sweden, we addressed this question. METHODS: This nation-wide study focused on the last week of life of adults dying from cancer in 2011-2012, based on data reported to a national quality register for end-of-life care (N=26,976). We specifically investigated if age-dependent differences were present with respect to thirteen indicators of palliative care quality...
July 2015: European Journal of Cancer
Olav Lindqvist, Gunilla Lundquist, Andrew Dickman, Johannes Bükki, Urska Lunder, Carina Lundh Hagelin, Birgit H Rasmussen, Sylvia Sauter, Carol Tishelman, Carl Johan Fürst
PURPOSE: The majority of dying patients do not have access to necessary drugs to alleviate their most common symptoms, despite evidence of drug efficacy. Our aim was to explore the degree of consensus about appropriate pharmacological treatment for common symptoms in the last days of life for patients with cancer, among physicians working in specialist palliative care. MATERIAL AND METHODS: Within OPCARE9, a European Union seventh framework project aiming to optimize end-of-life cancer care, we conducted a Delphi survey among 135 palliative care clinicians in nine countries...
January 2013: Journal of Palliative Medicine
Steven M Radwany, Vivian E von Gruenigen
Palliative care improves the quality of life of patients and their families through the prevention and treatment of distressing symptoms while addressing the psychological, social, and spiritual aspects of patient care. Emerging paradigms of delivery promote early involvement in the disease trajectory and specialty approaches to care. Interdisciplinary assessment and shared decision making are important components. Throughout the disease course, aggressive symptom management can improve patients' quality of life and their ability to tolerate and continue treatment...
March 2012: Clinical Obstetrics and Gynecology
Carolyn Casey, Lee-may Chen, Michael W Rabow
Patients with gynecologic cancer experience significant symptom burden throughout their disease course and treatment, which negatively impacts their quality of life. The most common symptoms in gynecologic cancer include pain, fatigue, depression and anxiety. Palliative care, including symptom management, focuses on the prevention and relief of suffering and improvement in quality of life, irrespective of prognosis. In a comprehensive cancer care model, palliative care, including symptom management, is offered concurrently with anticancer therapies throughout the disease course, not just at the end of life and not only once curative attempts have been abandoned...
July 2011: Expert Review of Anticancer Therapy
Winson Y Cheung, Camilla Zimmermann
Patients with cancer often face significant distress from their symptoms, especially near the end of life. However, prompt palliation of these symptoms can be complex since symptoms may occur in clusters, may be cancer- or treatment-related, and frequently require a multidisciplinary approach to management and a combination of therapeutic regimens. While evidence for many conventional symptom treatments is lacking, an increasing number of randomized clinical trials in palliative oncology means that new treatments will become increasingly evidence-based...
June 2011: Seminars in Oncology
Silvia Beretta, Daniela Polastri, Carlo Alfredo Clerici, Michela Casanova, Graziella Cefalo, Andrea Ferrari, Roberto Luksch, Maura Massimino, Cristina Meazza, Marta Giorgia Podda, Filippo Spreafico, Monica Terenziani, Franca Fossati Bellani
BACKGROUND: Coping with end-stage pediatric cancer patients and the related bereavement is a challenge for all the caregivers involved. PROCEDURE: Forty-seven cancer patients who died in 2006 were assessed as concerns the main place of care in the end stage of their disease, their symptoms, the palliative treatments received, and the site of death. RESULTS: The end stage was managed at the Istituto Nazionale Tumori Pediatric Oncology Department in 61% of cases, at home in 26%, and in hospices or other hospital facilities in 11%...
January 2010: Pediatric Blood & Cancer
Leanna J Standish, Leila Kozak, Sean Congdon
Acupuncture is a complementary and alternative medical modality. A considerable body of acupuncture research has accumulated since 1998. Acupuncture has been integrated into palliative care settings in the United Kingdom but is yet to be widely offered in the United States. The literature was searched to identify clinical trials involving acupuncture, palliative care, hospice, chronic obstructive pulmonary disease, bone marrow, and cancer. Twenty-seven randomized controlled clinical trials of acupuncture were found that reported on conditions common to the hospice and palliative care setting, including dyspnea, nausea and vomiting, pain, and xerostomia, and 23 reported statistically significant results favoring acupuncture use for the conditions investigated...
August 2008: American Journal of Hospice & Palliative Care
F E M Murtagh, J M Addington-Hall, P Donohoe, I J Higginson
Increasing numbers of patients with chronic kidney disease Stage 5 (GFR <15ml/minute) are being managed without dialysis, either through their own preference or because dialysis is unlikely to benefit them. This growing group of patients has extensive health care needs. Their overall symptom burden is high, and symptom prevalence matches or exceeds that in other end of life populations, both with cancer and other non-cancer diagnoses. These symptoms may often go unrecognised and under-treated. Regular symptom assessment is necessary, together with pro-active management of identified symptoms...
April 2006: EDTNA/ERCA Journal
Jean-Jacques Georges, Bregje D Onwuteaka-Philipsen, Gerrit van der Wal, Agnes van der Heide, Paul J van der Maas
Palliative care, directed at improving the quality of life of terminally ill patients, is generally not aimed at any form of postponing or hastening death. It is possible that high quality palliative care could prevent requests for euthanasia. However, empirical evidence on this issue is scarce. In a national survey of end-of-life medical decisions in The Netherlands the subject of care at the end of life has been addressed. Data on terminally ill cancer patients who died after their request was granted and euthanasia had been performed were compared with those of terminally ill cancer patients who did not request euthanasia...
December 2005: Palliative Medicine
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