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Symptom control palliative

L Tagliaferri, C Casà, G Macchia, A Pesce, G Garganese, B Gui, G Perotti, S Gentileschi, F Inzani, R Autorino, S Cammelli, A G Morganti, V Valentini, M A Gambacorta
OBJECTIVE/PURPOSE: Extramammary Paget disease (EMPD) is a rare neoplasm of the skin generally affecting the anogenital area. Because of the low-frequency of the disease, no specific guidelines about the treatment strategy are available. Surgery is the recommended therapy for resectable and localized disease, but several other local treatments have been reported such as radiotherapy (RT). Most articles report small retrospective studies, referring to patients treated decades ago with large heterogeneity in terms of RT dose and technique...
March 17, 2018: International Journal of Gynecological Cancer
Yee-Hsin Kao, Yao-Ting Liu, Malcolm Koo, Jui-Kun Chiang
BACKGROUND: For patients receiving palliative home care, the need to visit the emergency department is considered to be an indicator of poor quality care. The situation can be particularly distressing when it occurs outside of normal hours of palliative home care service. The aim of this study was to investigate the factors for emergency department use during out-of-hours periods of palliative home care service among advanced cancer patients in Taiwan. METHODS: This case-control study was based on a retrospective medical chart review (January 2010 to December 2012) of advanced cancer patients who were receiving palliative home care in a community hospital in south Taiwan...
March 12, 2018: BMC Palliative Care
Marianne Goudreault, Nago Humbert, France Gauvin, Monia Marzouki, Catherine K Beaumier, Dickens St-Vil, Nelson Piché
INTRODUCTION: Pediatric surgeons are often involved in the management of severely or terminally ill patients. However, articles addressing their specific roles in the context of palliative care are almost inexistent. We sought to characterize the involvement of pediatric surgeons caring for children near end of life. METHODS: Chart review of children who had a procedure under general anesthesia within 6months of their death over a five-year period at a tertiary children's hospital (excluding traumas and neonatology cases)...
February 9, 2018: Journal of Pediatric Surgery
Marie Nordström, Peter Strang
OBJECTIVE: At the initiative of Stockholm County Council, a survey was performed by an independent investigator to evaluate satisfaction among patients and their families with the advanced palliative home care teams in the county of Stockholm. The survey was performed in 2010 and compiled in 2011. The aim was to evaluate the impressions of patients and their families of the support given by the palliative home care teams in the Stockholm area and to evaluate the management of symptom control, availability, continuity, confidence, and quality of communication...
January 1, 2018: Journal of Palliative Care
Celina F Estacio, Phyllis N Butow, Melanie R Lovell, Skye T Dong, Josephine M Clayton
CONTEXT: Understanding patients' symptom experiences is essential to providing effective clinical care. The discussion between patients and physicians of symptom meaning and its significance, however, is ill understood. OBJECTIVES: To investigate palliative care physicians' understanding of symptom meaning, and their experiences of and attitudes towards the discussion of symptom meaning with patients. METHODS: Semi-structured interviews were conducted (N = 17) across Sydney, Australia...
March 3, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Kathy Latham, Brian Nyatanga
This study explored the lived experiences of clinical nurse specialists who can prescribe independently in their role of providing support to patients with palliative care needs within the community. Part 1 of this study examined how the study was carried out; this second part explores the findings. The nurses reported that being able to prescribe enabled them to provide seamless, holistic care, which gave patients faster access to medicines, especially at weekends when their GP was unavailable. Prompt availability of medicines led to effective symptom control and consequently a better quality of life for patients...
March 2, 2018: British Journal of Community Nursing
Syahrir Zaini, N G Chong Guan, Ahmad Hatim Sulaiman, Nor Zuraida Zainal, Hasniza Zaman Huri, Siti Hadijah Shamsudin
: Cancer patients are commonly associated with various physical and psychological symptoms. In view of this matter, palliative care is usually given to relieve those symptoms, improve quality of life, and increase medication adherence. Antidepressants are generally accepted for the treatment of depression among patients with or without cancer. Some other potential benefits of these medications have been experienced in clinical practice. Therefore, this study aimed to review the use of antidepressant for physical and psychological symptoms in cancer...
February 26, 2018: Current Drug Targets
David B Bekelman, Larry A Allen, Connor F McBryde, Brack Hattler, Diane L Fairclough, Edward P Havranek, Carolyn Turvey, Paula M Meek
Importance: Many patients with chronic heart failure experience reduced health status despite receiving conventional therapy. Objective: To determine whether a symptom and psychosocial collaborative care intervention improves heart failure-specific health status, depression, and symptom burden in patients with heart failure. Design, Setting, and Participants: A single-blind, 2-arm, multisite randomized clinical trial was conducted at Veterans Affairs, academic, and safety-net health systems in Colorado among outpatients with symptomatic heart failure and reduced health status recruited between August 2012 and April 2015...
February 26, 2018: JAMA Internal Medicine
Ke-Fei Chen, You-Yin Tang, Rui Wang, Dan Fang, Jun-Hua Chen, Yong Zeng, Bo Li, Tian-Fu Wen, Wen-Tao Wang, Hong Wu, Ming-Qing Xu, Jia-Yin Yang, Yong-Gang Wei, Ji-Wei Huang, Jia-Xin Li, Han-Zhi Zhang, Xi Feng, Lü-Nan Yan, Zhe-Yu Chen
The aim of this study was to evaluate different surgical therapies for hepatic alveolar echinococcosis in different clinical stages.We analyze the clinical data of 115 patients who received surgical treatment in West China Hospital from January 2004 to June 2016. Among these patients, 77 cases underwent radical hepatic resection (group A, n = 77); 17 cases underwent palliative resection (group B, n = 17), and 21 cases underwent liver transplantation (group C, n = 21) with 12 cases of orthotopic liver transplantation and 9 cases of liver autotransplantation...
February 2018: Medicine (Baltimore)
Hongsik Kim, Kyung Sik Yi, Won-Dong Kim, Seung-Myoung Son, Yaewon Yang, Jihyun Kwon, Hye Sook Han
Dural metastasis from primary gastric adenocarcinoma has been rarely reported, and its prognosis is very poor because it frequently leads to acute subdural hematoma. Here, we describe a case with sequential spinal and cranial dural metastases from gastric adenocarcinoma without subdural hematoma. A 43-year-old woman with gastric adenocarcinoma and well-controlled peritoneal carcinomatosis presented with back pain, right radiating leg pain, left facial palsy, and hearing loss. Magnetic resonance imaging of the spine and brain revealed dural masses at the lumbosacral junction with invasion to the L5 and S1 nerve roots and at the skull base with invasion to the internal auditory canal...
February 7, 2018: World Journal of Gastroenterology: WJG
Uri Hochberg, Jordi Perez, Manuel Borod
Cancer pain is a multi-dimensional experience, varies from person to person both physically and psycho-socially, and impacts all aspects of the patients' quality of life. Majority of patients with an advanced or metastatic cancer will experience pain. It is estimated that as many as half of cancer patients are under-treated and as many as 20% experience pain refractory to the conventional WHO ladder of pain management. The McGill University Health Centre (MUHC) Cancer Pain Clinic (CPC) was created to meet the needs of those patients with a diagnosis of cancer whose pain had become a main symptom and those who failed to respond to conventional treatment...
February 10, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Eleanor Anderson Reid, Esayas Kebede Gudina, Nicola Ayers, Wondimagegnu Tigineh, Yoseph Mamo Azmera
BACKGROUND: Palliative care aims to reduce physical suffering and the emotional, spiritual, and psychosocial distress of life-limiting illness. Palliative care is a human right, yet there are vast disparities in its provision: of the 40 million people globally in need of palliative care, less than 10% receive it, largely in high-income countries. There is a particular paucity of data on palliative care needs across the spectrum of incurable disease in Ethiopia. OBJECTIVES: The aims of this research were to assess the overall burden of life-limiting illness, the costs associated with life-limiting illness, and barriers to accessing palliative care in Ethiopia...
February 9, 2018: Journal of Palliative Medicine
Kathryn Elizabeth Hudson, Steven Paul Wolf, Gregory P Samsa, Arif H Kamal, Amy Pickar Abernethy, Thomas William LeBlanc
BACKGROUND: Little is known about quality of life (QOL), depression, and end-of-life (EOL) outcomes among hospitalized patients with advanced cancer. OBJECTIVE: To assess whether the surprise question identifies inpatients with advanced cancer likely to have unmet palliative care needs. DESIGN: Prospective cohort study and long-term follow-up. SETTING/SUBJECTS: From 2008 to 2010, we enrolled 150 inpatients at Duke University with stage III/IV solid tumors or lymphoma/acute leukemia and whose physician would not be surprised if they died in less than one year...
February 8, 2018: Journal of Palliative Medicine
Kari E Hacker, R Kevin Reynolds, Shitanshu Uppal
The opioid crisis in the United States has been declared a public health emergency. Various governmental agencies, cancer care organizations and the Centers for Disease Control and Prevention have issued guidelines in hopes of managing this crisis. Curbing over-prescription of opioids by medical professionals has been a central theme in many of these guidelines. Gynecologic oncologists encounter patients with a variety of pain sources, including acute pain secondary to the underlying malignancy or surgical procedures as well as chronic pain related to the malignancy and the sequelae of treatments rendered...
February 3, 2018: Gynecologic Oncology
Grace Meijuan Yang, Irene Teo, Shirlyn Hui-Shan Neo, Daniel Tan, Yin Bun Cheung
CONTEXT: New models of care that are effective and feasible for widespread implementation need to be developed for the delivery of early palliative care to patients with advanced cancer. OBJECTIVES: The objectives were to determine the feasibility and acceptability of the Enhancing Quality of Life in Patients (EQUIP) intervention, data completion rate of patient-reported outcome measures in the context of the EQUIP trial, and the estimated effect of the EQUIP intervention on quality of life and mood...
January 1, 2018: American Journal of Hospice & Palliative Care
Martin Mücke, Megan Weier, Christopher Carter, Jan Copeland, Louisa Degenhardt, Henning Cuhls, Lukas Radbruch, Winfried Häuser, Rupert Conrad
We provide a systematic review and meta-analysis on the efficacy, tolerability, and safety of cannabinoids in palliative medicine. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsycINFO, PubMed, Scopus, and, and a selection of cancer journals were searched up until 15th of March 2017. Of the 108 screened studies, nine studies with a total of 1561 participants were included. Overall, the nine studies were at moderate risk of bias. The quality of evidence comparing cannabinoids with placebo was rated according to Grading of Recommendations Assessment, Development, and Evaluation as low or very low because of indirectness, imprecision, and potential reporting bias...
February 5, 2018: Journal of Cachexia, Sarcopenia and Muscle
Susan Dababou, Cristina Marrocchio, Roberto Scipione, Hans-Peter Erasmus, Pejman Ghanouni, Michele Anzidei, Carlo Catalano, Alessandro Napoli
Cancer-related pain affects up to 80% of patients with malignancies. Pain is an important distressing symptom that diminishes the quality of life and negatively affects the survival of patients. Opioid analgesics are generally the primary therapy for cancer-related pain, with surgery, radiation therapy, chemotherapy, and other interventions used in cases of treatment-resistant pain. These treatments, which can be associated with substantial side effects and systemic toxicity, may not be effective. High-intensity focused ultrasound is an entirely noninvasive technique that is approved for treatment of uterine fibroids, bone metastases, and essential tremors...
January 30, 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Benjamin Hudson, Victoria Hunt, Andrea Waylen, Catherine Anne McCune, Julia Verne, Karen Forbes
BACKGROUND: Liver disease represents the third commonest cause of death in adults of working age and is associated with an extensive illness burden towards the end of life. Despite this, patients rarely receive palliative care and are unlikely to be involved in advance care planning discussions. Evidence addressing how existing services meet end-of-life needs, and exploring attitudes of patients and carers towards palliative care, is lacking. AIM: To explore the needs of patients and carers with liver disease towards the end of life, evaluate how existing services meet need, and examine patient and carer attitudes towards palliative care...
January 1, 2018: Palliative Medicine
Yvonne Y R Ng, Grace H C Tan, Richard H H Quek, Mohamad B H R Farid, Khee Chee Soo, Melissa C C Teo
BACKGROUND: Primary mucosal melanomas (MM) are rare neoplasms arising from melanocytes in mucosal membranes. Delayed diagnosis and aggressive disease biology contribute to a poorer prognosis. The clinical patterns of MMs treated in a large tertiary centre, and the differences between MMs in the head and neck versus other anatomical sites are described. METHODS: A retrospective review of 43 patients diagnosed with MM in the head and neck, urogenital, esophageal and anorectal sites from 1993 to 2015 was conducted...
February 1, 2018: ANZ Journal of Surgery
Dean A Tripp, Phylicia Verreault, Steven Tong, Jason Izard, Angela Black, D Robert Siemens
INTRODUCTION: Prostate cancer is the most non-cutaneous malignancy in men, and androgen-deprivation therapy (ADT) is a cornerstone of management in advanced disease. The aim of this study was to evaluate the association of ADT with changes in depression and mental and physical quality of life (QoL) within a prospective patient cohort design. METHODS: Patients were prospectively recruited and consented at a single academic health sciences centre in Ontario, Canada...
October 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
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