“I didn't want to be in charge and yet I was”: Bereaved caregivers' accounts of providing home care for family members with advanced cancer
ConclusionsCaregivers were often thrust into assuming control in order to compensate for deficiencies in formal palliative home care services. Policies, quality indicators and guidelines are needed to ensure the provision of comprehensive, interdisciplinary home palliative care.
Conclusion: Survival outcomes were highly variable. Given that survival after 10 fractions of 3 Gy was indistinguishable from that after two fractions of 8.5 Gy, we suggest that the latter regimen should be considered for patients with poor prognosis. Patients with favorable prognostic factors should be treated with higher radiation doses, e.g. 15 fractions of 3 Gy.
We present an actual state of knowledge regarding mechanisms of cannabinoids’ impact on cancer cells.
In my second year of residency, I was on the hematology/oncology service where we were taking care of a pleasant lady in her 80s who was admitted with pancreatic cancer. It was apparent that the disease had spread rapidly, and when we discussed her at rounds, we knew that she likely had a few months to live, at best. We also knew, however, that there were life-extending treatment options we could provide. When we walked into her room and presented these to her, she was attentive and listened respectfully, and she ultimately decided not to pursue any more treatment. What struck me was how content she was with the decision a...
In a Belgian study, integration of palliative care as part of cancer care increased the quality of life of patients with advanced malignant solid tumors.
Authors: Schuler PJ, von Witzleben A, Doescher J, Wollenberg B, Dietz A, Hoffmann TK Abstract In recent years, immunotherapy has been shown to be a promising approach for the treatment of various tumor entities. Due to further pharmacological developments and new studies, the checkpoint inhibitors have now arrived in the clinic. To date, patients with cancers in the head and neck region have benefited from these agents as part of a palliative therapy. Current clinical trials are testing other indications for the checkpoint inhibitors as monotherapy or in combination with other therapeutic approaches. The ...
It has been more than 50 years since Charles Dotter performed a catheter-based intervention to dilate a stenotic segment of the superficial femoral artery of an 82-year-old woman (Roesch, Keller,&Kaufman, 2003). In the ensuing years, the evolution of image guidance technology has resulted in the development of diagnostic, therapeutic, palliative, and curative procedures of increasing complexity for a range of conditions offered to patients, both pediatric and adult, with varying levels of acuity, across the cancer disease arch.
Conclusions: Data support theoretical understanding of the dynamism of readiness. Future research that validates adolescent conceptualization will ensure age-appropriate readiness representation. Implications for Practice: Understanding the dynamic process of readiness for engaging in end-of-life preparedness provides clinician insight for guiding discussions that facilitate shared decision making and promote quality of life for adolescents and their families.
CONCLUSION: Pretreatment cancer-associated weight loss is common, even in early-stage disease, and is independently associated with reduced survival. Minimal weight loss represents a clinically distinct entity with an associated overall survival intermediate to that of no weight loss and overt wasting. Early diagnosis and treatment of cancer-associated wasting offers a novel therapeutic avenue for reducing cancer mortality. PMID: 29466074 [PubMed - as supplied by publisher]
Guidelines from standard-setting organizations in oncology support early adoption of palliative care along with usual oncologic care1 and Telemedicine has been utilized to improve access. A recent review examined the use of Telemedicine to provide palliative care when patient travel is excessively burdensome or not possible.2 Results showed patient and caregiver satisfaction and improved comfort from symptoms. The potential for novel uses of Telemedicine beyond symptom control in oncologic supportive/palliative care was recently demonstrated via a Telemedicine approach to supportive group psychotherapy for young adults with cancer.
Haematological malignancies (leukaemias, lymphomas and myeloma) are complex cancers that are relatively common, affect all ages and have divergent outcomes. Although the symptom burden of these diseases is com...