The  top ten things that must be known about end of life therapy in patients with advanced cancer

SummaryEnd of life is an issue that affects every human being sooner or later. Several aspects at the end of life should not be neglected to achieve good symptom control. Basic knowledge and skills on symptom control and palliative care are important to support patients in this threatening phase of their life. Palliative care should not be provided only at the end of life. The concept of early integration of palliative care is increasingly coming into focus. Nevertheless, at the end of life there are some important facts and issues that should be taken into account. This short article provides a list of ten important facts at the end of life that are important for the authors. Prognostication, early integration, benzodiazepines, death rattle, palliative sedation, standard therapy for refractory dyspnea, opioids in renal failure, psylocibin, denial and reduction of drugs at the end of life will be discussed in detail.
Source: Memo - Magazine of European Medical Oncology - Category: Cancer & Oncology Source Type: research

Related Links:

Written by Pendell MeyersA female in her 60s with COPD, DM, hypothyroidism, CAD, and severe bladder cancer presented from a nursing home with altered mental status, hypotension, hypoxia, and bradycardia.Here is her initial ECG (no prior for comparison):What do you think?Here is another ECG minutes later:There is a regular wide complex bradycardia.There are P-waves at a rate of approximately 100bpm with no clear relationship to the QRS complexes, diagnostic of complete heart block.The QRS morphology is wide (computer QRS duration 179 msec) but it does not fit any clear bundle branch block pattern (it is similar to LBBB but ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Conclusions: to the best of our knowledge, this is the largest series of consecutive PCNSL pts aged of 80y or over prospectively recorded in a national database. This study showed that the prognosis remains poor with major toxicity under conventional treatment. No clinical predictor of survival was highlighted in our series but patients initially treated with MTX-based CT in combination with rituximab had an improved outcome. The development of target and innovative therapies is needed for this category of patients representing 8% of all PCNSL in the database of the LOC network.DisclosuresHouot: Celgene: Honoraria; BMS: Co...
Source: Blood - Category: Hematology Authors: Tags: 627. Aggressive Lymphoma (Diffuse Large B-Cell and Other Aggressive B-Cell Non-Hodgkin Lymphomas)-Results from Retrospective/Observational Studies: Poster III Source Type: research
Authors: Chan KS Abstract There is a great need for palliative care in the modern era of medicine. Despite medical advances, patients with life-limiting illnesses still suffer significantly. Palliative care emerged a half century ago as an ethos based on compassion and care for patients and their families to relieve their suffering. It entails a paradigm shift from the biomedical model to the biopsychospiritual model. Palliative care is recognised by the World Health Organization as an essential part of the continuum of universal health coverage. In 2014, the World Health Assembly approved a resolution on "Str...
Source: Hong Kong Medical Journal - Category: General Medicine Tags: Hong Kong Med J Source Type: research
Conclusions Lack of cervical cancer screening, vaginal bleeding, low abdominal pain, and unmarried status were associated with advanced disease at presentation. We recommend scale-up of cervical cancer screening and its integration into routine human immunodeficiency virus care. Capacity building in gynecologic oncology and palliative care services is currently critical.
Source: International Journal of Gynecological Cancer - Category: Cancer & Oncology Tags: Cervical Cancer Source Type: research
We describe a case of pseudoprogression that pushes the limits of immune-related response criteria and challenges the boundaries and definitions set by trial protocols. A middle-aged man with conventional clear cell renal cell carcinoma (RCC) had received multiple prior systemic treatments including vascular endothelial growth factor receptor tyrosine kinase inhibitors, as well as multiple surgeries and radiotherapy treatments. He was eventually started on nivolumab —the anti-programmed death receptor-1 monoclonal antibody approved for the treatment of advanced RCC. Clinical deterioration was observed soon after a 10...
Source: Cancer Immunology, Immunotherapy - Category: Cancer & Oncology Source Type: research
This study interviewed 21 Syrian refugees in Jordan with life-limiting conditions such as cancer, diabetes, chronic disability and renal failure, and 4 caregivers caring for refugee children with similar conditions. This study found that patients in refugee camps and communities would benefit from receiving palliative care services that are often either unavailable or inaccessible. Training humanitarian teams and primary care providers to implement pain management, offer psychosocial support services and address emotional, spiritual, and psychological conditions could ameliorate many of the problems faced by this vulnerabl...
Source: Medicine, Conflict and Survival - Category: International Medicine & Public Health Tags: Med Confl Surviv Source Type: research
We modern humans are comparatively lightly affected when it comes to kidney failure as an age-related cause of death; it ranks fairly low in the list. We are primarily killed by cardiovascular issues and cancer. In some other species, such as domestic cats, kidney failure is a leading cause of mortality, and near all older individuals are significantly impacted by the consequences of declining kidney function whether or not it is the final cause of death. Still, a comparatively low toll for humans is no great comfort to the many who suffer, especially since there is little in the way of medical technology available at pres...
Source: Fight Aging! - Category: Research Authors: Tags: Daily News Source Type: blogs
For the past seven months, I’ve carried around my husband’s advance medical directive in my purse. During this time, I’ve shown this lawyer-prepared and notarized document to dozens of doctors, nurses, ambulance crews, surgeons, dialysis center teams, hospital emergency room workers and administrators, intake staff, nurse practitioners, nursing home staff, medical transportation drivers, and others. I’m an expert in summarizing its contents, and my 11-second elevator pitch goes like this: Do not resuscitate. No heroic measures. A gentle and peaceful death, pain-free and with dignity. Please. Af...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
This study aimed to explore the trends of DNR consent and hospice care utilization among noncancer decedents in a tertiary hospital in Taiwan. We analyzed the Death and Hospice Palliative Care Database from the Taipei Veterans General Hospital in Taiwan. The Death and Hospice Palliative Care Database contains information including patient sex, major diagnosis, admission date, date of death, age at death, department at discharge, status of DNR consent, and status of hospice care of patients who died in the Taipei Veterans General Hospital. Data on patients aged 20 years old or more who died of major terminal noncancer disea...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Publication date: Available online 1 September 2016 Source:Annals of Medicine and Surgery Author(s): Kyohei Kanematsu, Hironori Tsujimoto, Shinsuke Nomura, Hiroyuki Horiguchi, Nozomi Ito, Kenji Yamazaki, Shuichi Hiraki, Suefumi Aosasa, Junji Yamamoto, Kazuo Hase A 57-year-old woman was admitted to National Defense Medical College hospital for treatment of gastric cancer with pyloric stenosis. She had been diagnosed with chronic kidney disease (CKD) 10 years prior, but received no hemodialysis. Because of peritoneal dissemination, a palliative distal gastrectomy was performed. In consideration of renal dysfunction, we deci...
Source: Annals of Medicine and Surgery - Category: Journals (General) Source Type: research
More News: Cancer | Cancer & Oncology | Palliative | Palliative Care | Renal Failure