Referral Pattern to a Tertiary Care Cancer Pain Clinic in India.
Referral Pattern to a Tertiary Care Cancer Pain Clinic in India. J Pain Palliat Care Pharmacother. 2019 Jul 01;:1-9 Authors: Chatterjee A, Nimje G, Jain PN Abstract The study aimed to identify patterns of patient referral from oncology services, including pain severity, prior analgesics, impact of patient's literacy on referral, and adequacy of pain relief offered by the pain clinic. A retrospective analysis of pain clinic data from August 2014 to February 2015 at the Tata Memorial Hospital was carried out, wherein adult cancer patients referred for the first time to the pain clinic were included. Two thousand patients were included: 38.1% of the referred were at pretreatment stage, 28.8% advanced. Most referrals were from head and neck (27.3%), gastrointestinal (26.2%), and thoracic (18.3%) disease management groups (DMGs); 88% had moderate to severe pain, only a third were prescribed analgesics. The earliest referrals were from gastrointestinal and thoracic DMGs; 75%-80% had advanced disease. The majority referred from bone and soft tissue DMG had early disease. There were few referrals from hemato-oncology and medical oncology. Among the patients, 88% had moderate to severe pain, a third were on analgesics, and less than a fifth were on opioids. Suboptimal opioid use was similar to prior studies from Asia and Europe. Pain scores were lower in the literate group, and this group were referred significantly earlier than the illiterate. Our findings demons...
As physicians, we are often asked for advice when loved ones become ill. Sometimes, the request advice is explicit; often, it is more supportive in nature and this may blur the boundary between being a friend and being a physician. Through various excerpts from social medial exchange, this narrative discusses the experience with a friend who was diagnosed with head and neck cancer during my Palliative Medicine Fellowship.
CONCLUSION: Collaboration of otorhinolaryngologists and palliative care specialists has the potential to further increase quality of life and survival of patients with oncological head and neck diseases. PMID: 32140757 [PubMed - as supplied by publisher]
Conclusion: The most commonly used drugs in the treatment of CRNP were pregabalin and amitriptyline. Most physician partially or did not adhere to the NeuPSIG guideline in the management of CRNP.
Over the past several years, a wave of new cancer immunotherapy agents referred to as immune checkpoint inhibitors (ICIs) have transformed the standard of care for patients with cancer. ICIs are most commonly used in advanced cancers with palliative intent and recently as frontline therapy for some cancers. These new agents have been shown to extend overall survival (OS) and progression free survival (PFS) in patients with lung cancer, melanoma, Hodgkin lymphoma, renal cell carcinoma, urothelial carcinoma, Merkel cell carcinoma, head and neck cancer, and more.
ConclusionsOur initial experience with the embedded OPC clinic mostly included patients with advanced disease, multiple severe symptoms and high risk of mortality. Management of these patients within the oncology clinic may address palliative care needs of these patients, provide timely therapeutic interventions, reduce unnecessary diagnostic tests and diminish emergency department applications by these patients.Legal entity responsible for the studyThe authors.FundingHas not received any funding.DisclosureAll authors have declared no conflicts of interest.
We like to thank Obi et al for their response to our manuscript entitled “The Use of Continuous Positive Airway Pressure Ventilation in the Palliative Management of Stridor in a Head and Neck Cancer Patient”. We are delighted that she has taken interest in the letter and we appreciate the time and effort she has put into formulating key principles to aid in the usage of non-invasive ventilation, especially so in this vulnerable group of palliative care patients.
We like to thank Obi et al.1 for their response to our article “The use of continuous positive airway pressure ventilation in the palliative management of stridor in a head and neck cancer patient.”2 We are delighted that she has taken interest in the letter, and we appreciate the time and effort she has put into for mulating key principles to aid in the usage of noninvasive ventilation, especially in this vulnerable group of palliative care patients.
Purpose of review Pain is one of the most feared and most common symptoms of cancer, experienced by 38–85% of patients. Pain in terminally ill cancer patients is a multidimensional experience caused by a diverse array of factors – cancer itself, its treatment or other causes. Studies have shown a high incidence of myofascial pain syndrome (MPS) in patients with cancer and the knowledge of myofascial trigger points (MTrPs) is important to address and manage existing pain, and to prevent the recurrence of pain. This review aims to summarize recent advances in interventions for managing MPS in patients with canc...
We read with interest the paper by Lee et al reporting the use of continuous positive airway pressure (CPAP) as a means of non-invasive ventilation in the palliative management of stridor at the end of life in a patient with head and neck cancer.1
Upper airway obstruction and stridor are common symptoms faced by Head and Neck Cancer patients. Progression of cancers of the head and neck region often result in an audible stridor when the primary tumor occupies an already anatomically restricted space in the upper airway. Management of upper airway obstruction includes non-pharmacological maneuvers such as head tilt, chin lift and jaw thrust 1. Pharmacological measures are usually limited to the relief of symptoms associated with the airway obstruction such as breathlessness and stridor.