"Why (not) me?" Why doctors do it differently......

In this study, almost 90% of surveyed physicians, presumably healthy, would forego resuscitation efforts for themselves.In our next #hpm chat, on Wednesday, April 20th, 2016, let’s unpack this head-scratching situation together--not just for doctors, but for all of us…nurses, social workers, chaplains, program folks… that have reason to think differently about the nature of modern dying and our desired intensity of medical treatment.Topic 1: What do you think about those of us in healthcare, with knowledge about the limitations of modern medicine, choosing less of it?  Topic 2: What is your belief and / or perspective on our healthcare system often inflicting harm rather than delivering value?Topic 3: What explains the disconnect between what healthcare practitioners know &what the public expects? How might we bridge that divide? Topic 4: How does your belief about the success or failures of the healthcare system influence your practice?   Michael D. Fratkin, MD @MichaelDFratkin is a Father, Husband, and Palliative Care physician pioneering from far Northern California with soulful technology enabled person centered care in the home. With an incredible team, he is building ResolutionCare and changing the rules as he goes.What: #hpm chat on TwitterWhen: Wed 4/20/2015 - 9p ET/ 6p PTHost: Michael D. Fratkin MD Follow @ResolutionCareFor more on past tweetchats, see our archive here and go to ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: #hpm death dying medical services medicine models of care modern medicine palliative care Source Type: blogs

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CONCLUSIONS: The use of RT within 2 weeks of CDK4/6 inhibitors had low acceptable toxicity and high efficacy, suggesting that it is safe for palliation of metastatic breast cancer.PMID:34653725 | DOI:10.1016/j.breast.2021.10.001
Source: Breast - Category: Cancer & Oncology Authors: Source Type: research
Palliat Med. 2021 Sep 2:2692163211042770. doi: 10.1177/02692163211042770. Online ahead of print.ABSTRACTBACKGROUND: Palliative sedation is sometimes interrupted by undesired arousals. Pupillometry has been used in anesthesiology to monitor pain and sedation but has never been used during palliative sedation.ACTUAL CASE: A 48 years-old patient, with multi-metastatic cancer, underwent palliative sedation to manage global suffering. On the second day, the patient experienced arousal which required medication adjustments to ensure pain relief and increased sedation.POSSIBLE COURSE OF ACTION: Depth of sedation is monitored with...
Source: Palliative Medicine - Category: Palliative Care Authors: Source Type: research
ConclusionsCSF diversion for LM with hydrocephalus and intracranial hypertension secondary to metastasis can achieve symptomatic relief, hospital discharge, and return to further oncologic therapy, with a complication profile unique to this pathophysiology. However, decision-making in this population must incorporate end-of-life goals of care given limited prognosis.
Source: Journal of Neuro-Oncology - Category: Cancer & Oncology Source Type: research
ConclusionOur radiation schedule showed a reasonable treatment effectiveness and tolerance. Representing an optimal salvage treatment for critical BM in patients with a very poor prognosis and clinical performance state, CK-hSRS may close the gap between surgery, stereotactic radiosurgery, conventional radiotherapy, and palliative care.
Source: Journal of Cancer Research and Clinical Oncology - Category: Cancer & Oncology Source Type: research
Palliat Support Care. 2021 Jul 23:1-3. doi: 10.1017/S1478951521000900. Online ahead of print.ABSTRACTOBJECTIVE: Cancer patients often want to spend their final days at home, and it is essential that general practitioners have knowledge of and technical skills related to cancer medicine and symptom relief. Recent clinical studies have revealed that Wernicke encephalopathy (WE) is quite common in cancer patients. However, there have been no reports to date on WE in cancer patients undergoing home medical care.METHODS: From a series of cancer patient undergoing home medical care, we reported a patient with lung cancer who dev...
Source: Palliative and Supportive Care - Category: Palliative Care Authors: Source Type: research
ConclusionIn this single-center retrospective study, brain metastases (BRMs) occur with a high frequency (6.5%) in gastroesophageal cancer (GEC), significantly more often in male patients and adenocarcinomas. Since survival of these patients considerably correlates with successful BRMs resection, our observations propose further prospective trails to validate our hypothesis and ultimately the implementation of routine screening procedures to detect asymptomatic brain metastases.
Source: Gastric Cancer - Category: Gastroenterology Source Type: research
ConclusionsThis case highlights the diagnosis and treatment of uncommon metastases of nasopharyngeal carcinoma. Clinicians should remain vigilant for metastases during the treatment and follow-up periods.
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Lung spindle cell carcinoma has a poor prognosis and is usually resistant to cytotoxic chemotherapy. Our findings suggest that immune checkpoint inhibitors (ICIs) are a novel therapeutic strategy for lung spindle cell carcinoma. AbstractA 52-year-old man underwent pneumonectomy of the left lung for previously diagnosed primary spindle cell carcinoma (pT4aN1M0, stage III B) with programmed death-ligand 1 expression (tumor proportion score ≥95%) and without epidermal growth factor receptor gene mutation and anaplastic lymphoma kinase fusion gene. However, brain metastasis and chest wall tumor relapse occurred. Considering...
Source: Thoracic Cancer - Category: Cancer & Oncology Authors: Tags: CASE REPORT Source Type: research
J Thorac Dis. 2021 May;13(5):3258-3268. doi: 10.21037/jtd-2019-rbmlc-11.ABSTRACTLung cancer is the most common cause of intracranial metastases (ICM). Metastases in the brain can result in a broad range of uncomfortable symptoms and significant morbidity secondary to neurological disability. Treatment options can range from surgical resection of solitary metastases to radiotherapy and more recently systemic targeted therapies and immunotherapy. Patient survival continues to improve with innovations made in treatments for this condition, but each of these treatments carry their own adverse effects that must be appropriately...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Authors: Source Type: research
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