Oncologists communicating with patients about assisted dying
Purpose of review Across all jurisdictions in which assisted dying is legally permissible, cancer is the primary reported underlying diagnosis. Therefore, oncologists are likely to be asked about assisted dying and should be equipped to respond to inquiries or requests for assisted dying. Because Medical Assistance in Dying was legalized in Canada in 2016, it is a relatively new end-of-life practice and has prompted the need to revisit the academic literature to inform communication with patients about assisted dying. Recent findings We reviewed applicable literature published in the past 5 years, pertaining to assisted dying and communication. In total, 86 articles were identified, 21 were flagged as relevant to review in detail, and six were included in the review. Key themes included perceived barriers and benefits to communicating with patients on the topic, pragmatic approaches for facilitating the conversation with patients, and the issue of proactively discussing assisted dying by broaching it as an option with patients. Summary These findings indicate that there is still discomfort around having conversations about assisted dying with patients but new tools and approaches are being developed to support the practice.
Large cell neuroendocrine carcinoma (LCNEC) and small cell lung carcinoma (SCLC) are aggressive neuroendocrine tumors with poor survival rates [1 –3]. For stage IV SCLC, treatment has not advanced significantly over the last decades and consists of palliative chemotherapy. The same applies to stage IV LCNEC, were no standard treatment exists and palliative chemotherapy with SCLC and non-small cell lung cancer (NSCLC) regimens are both deeme d appropriate . Recently, targeted therapy focusing on delta like protein 3 (DLL3) has received attention to improve outcomes for SCLC and LCNEC .
CONCLUSION: Indian patients with colon cancer, at a tertiary referral center, tend to present at more advanced stages of the disease as compared to the West. However, curative treatment with surgery and chemotherapy offers similar survival outcomes when compared stage for stage.
Over the past two decades, several trials addressed the impact of the early integration of palliative care on the clinical outcomes of advanced cancer patients. The first pivotal results from a randomized clinical trial on patients with newly diagnosed stage III and IV non small-cell-lung cancer, demonstrated that patients who received concurrent palliative care with standard cancer care, had better quality of life, less depressive symptoms, also longer median survival, and less aggressive treatment at the end of life, compared to patients receiving standard oncology care alone .
This article gives an outline of the history, existing radiotherapy facilities and future trends related to radiotherapy practice in India.
Sushma BhatnagarIndian Journal of Palliative Care 2019 25(4):485-486
Conclusions: There is a significant burden of psychosocial and spiritual concerns among patients with advanced incurable illness in Bangladesh, with sadness being very frequent and of high intensity. Family and friends provide significant emotional and practical support to patients who are seriously ill, but very few patients access any professional support for these concerns.
Conclusion: There is substantial inadequacy in pain management in patients with cancer. The BPI-SF should be routinely used to evaluate pain severity, and analgesics should be prescribed equitably without discrimination with regard to gender and socioeconomic status of patients.
Conclusion: We found no significant effects on the procedural pain in any of the treatment groups compared to placebo. There were only mild side effects. The doses of ketamine might be insufficient for this painful and stressful procedure.
Conclusion: This RCT shows that perioperative pregabalin may not have a role in the prevention of chronic pain after breast surgeries.
Conclusion: Patients with advanced carcinoma GB were managed with various palliative procedures with the aim to improve the quality of life of patients because of jaundice, loss of appetite, nausea, pain, etc. Symptoms are distressing for patients.