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The value of the ethnographic approach to research issues in palliative care
Purpose of review Qualitative research in the field of palliative care allows for a crucial study of the final stage of life from a social point of view and cultural perspective. This review evaluates the advantages and challenges of applying an ethnographic approach to palliative care research. Recent findings Thirteen ethnographic articles on organization or quality of care, decision-making, delirium, death, and the process of dying, were reviewed. Most studies use interviews, participant observation, and field notes as their primary data collection techniques. In ethnographic research, cultural issues, relationship...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone and Bridget Johnston Source Type: research

What information and resources do carers require pre and post bereavement in the acute hospital setting? A rapid review
Purpose of review: This mixed-method, rapid review of published research from 2014 to 2019 aims to explore the experiences of pre and postbereaved carers, and the information that they receive in the acute hospital setting. The quality of articles was evaluated using a standardized quality matrix. The techniques of conceptual analysis and idea mapping were used to create a structured synthesis of the findings. Recent findings: From the initial search of 432 articles, ten studies met the inclusion criteria for this review. These studies generated data from 42 patients, 1968 family/carers and 139 healthcare staff. Theme...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone and Bridget Johnston Source Type: research

Meaningful measures in cancer cachexia: implications for practice and research
Purpose of review Cancer cachexia is a complex inflammatory syndrome, which presents with a variety of discrete symptoms and signs. This creates a challenge for both clinicians and researchers in recognizing and assessing the syndrome. This review explores the evidence for various measures used in the assessment of cachexia. Recent findings Objectively, cachexia may be assessed using CT-derived measures of skeletal muscle [skeletal muscle index (SMI) and skeletal muscle density (SMD)]. Evidence suggests that SMD may be of equal or greater value than SMI in assessing cachexia. Inflammatory markers are also used, and in...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Barry J.A. Laird Source Type: research

Cancer cachexia in thoracic malignancy: a narrative review
Purpose of review Thoracic malignancies are amongst the most lethal of all cancers. Cancer cachexia lacks unanimously accepted diagnostic criteria, and therefore is referenced to as a conceptual framework whereby cancer cachexia is ‘an ongoing loss of skeletal muscle mass (termed sarcopenia), with or without loss of fat mass that cannot be reversed by conventional nutritional support and leads to progressive functional impairment’. This review summarises the current evidence base in this field, including imaging techniques currently used to define sarcopenia, inflammatory and metabolic changes associated with the syn...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Barry J.A. Laird Source Type: research

Dietetic assessment and intervention in lung cancer
Purpose of review Systemic therapy for lung cancer is increasing in intensity and duration. European nutrition guidelines suggest screening for weight loss and malnutrition, however acknowledges there is a lack of evidence. We discuss current data round this issue and identify opportunities for further research. Recent findings International guidelines now exist to aid the definition of weight loss in cancer, including cachexia, sarcopenia and malnutrition. These allow consistent definition of overlapping, but distinct clinical syndromes. Nutritional status can be assessed in a range of ways including questionnaires, ...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Barry J.A. Laird Source Type: research

From cachexia to obesity: the role of host metabolism in cancer immunotherapy
Purpose of review Currently, several clinical trials in cancer therapy have demonstrated the success of immunomodulatory therapies. However, only a variable fraction of patients actually benefit from these treatments. The understanding of key mechanisms behind this response heterogeneity is one of the major unmet need and intense research field in immuno-oncology. This review will discuss the host metabolic dysfunctions derived from cachexia or obesity that can affect the response to cancer immunotherapy. Recent findings Preclinical studies demonstrated that chronic inflammation, nutritional intake impairment and endo...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Barry J.A. Laird Source Type: research

Cardiac cachexia: the mandate to increase clinician awareness
Purpose of review Heart failure is a frequent problem in an ageing population, associated with high rates of morbidity and mortality. Today, it is important to not only treat heart failure itself but also the related comorbidities. Among them, cardiac cachexia is one of the major challenges. It is a complex multifactorial disease with a negative impact on quality of life and prognosis. Therefore, prevention, early recognition and treatment of cardiac cachexia is essential. Recent findings Cardiac cachexia frequently presents with skeletal as well as heart muscle depletion. Imaging-based diagnostic techniques can help ...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Barry J.A. Laird Source Type: research

Cancer cachexia and treatment toxicity
Purpose of review Cancer cachexia is a metabolic disturbance resulting in a loss of skeletal muscle mass that is generally not reversed through traditional nutritional interventions. We review on both the impact of nutritional status on cancer treatment side effects, as well as cancer- specific outcomes. Recent findings Cancer-specific cachexia and sarcopenia are associated with increased treatment-associated toxicity, and overall worse cancer-specific outcomes across all cancer types in surgical, chemotherapeutic, and radiotherapeutic populations. Despite the fact that cancer cachexia is generally thought to be irrev...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Barry J.A. Laird Source Type: research

Endocrinopathies and cancer cachexia
Purpose of review Cancer cachexia cannot be easily reversed by standard nutritional support and interventions directed at underlying metabolic derangements may be needed to prevent or reverse cachexia and maintain healthy body composition. The following review will highlight the contribution and potential therapeutic interventions for insulin resistance, alterations in ghrelin signaling, and hypogonadism in cancer patients. Recent findings In addition to decreased caloric intake, chronic inflammation, and altered metabolism of glucose, proteins and lipids, endocrine abnormalities can propagate weight loss or changes i...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Barry J.A. Laird Source Type: research

Sarcopenia: looking to muscle mass to better manage pancreatic cancer patients
Purpose of review Overall survival of patients with pancreatic cancer is strongly conditioned by tumor biology and the incidence of malnutrition and metabolic disorders. In this landscape, the assessment of body composition is crucial to properly manage the clinical implications of muscle wasting. The pathogenesis of this condition is the result of a complex interplay between cancer and the host. In particular, sarcopenia is induced by an inadequate nutritional intake, hormonal abnormalities, inflammation and imbalance between anabolic and catabolic pathways. Recent findings Recent evidences have highlighted the role ...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Barry J.A. Laird Source Type: research

Editorial: Merging therapeutics and supportive care: synergy and yield
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Barry J.A. Laird Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: EDITORIAL INTRODUCTIONS Source Type: research

Myofascial pain syndrome and trigger points: evaluation and treatment in patients with musculoskeletal pain
Purpose of review Myofascial pain syndrome is a chronic pain condition characterized by the presence of myofascial trigger point, a hyperirritable painful spot involving a limited number of muscle fibers. The literature suggest that myofascial trigger points should be considered peripheral pain generators and this critical review will summarize recent findings concerning the clinical evaluation and the treatment of myofascial trigger points. Recent findings The clinical features of myofascial trigger points and their contribution to the patient pain and disability have been detailed in several recent studies, which su...
Source: Current Opinion in Supportive and Palliative Care - August 2, 2019 Category: Palliative Care Tags: MUSCULOSKELETAL PROBLEMS: Edited by Roberto Casale and Piercarlo Sarzi Source Type: research

Interventions for myofascial pain syndrome in cancer pain: recent advances: why, when, where and how
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 cancer. Rec...
Source: Current Opinion in Supportive and Palliative Care - August 2, 2019 Category: Palliative Care Tags: MUSCULOSKELETAL PROBLEMS: Edited by Roberto Casale and Piercarlo Sarzi Source Type: research

Cytoreductive nephrectomy in metastatic kidney cancer: what do we do now?
Purpose of review Metastatic renal cell carcinoma (mRCC) has traditionally been treated with a combination of targeted systemic therapy and cytoreductive nephrectomy. This approach has recently become a topic of debate, because of new randomized data suggesting a lack of survival benefit for cytoreductive nephrectomy. We review the literature relevant to cytoreductive nephrectomy in the modern era of targeted and immune systemic therapy, and discuss the ongoing role of surgery for treatment of patients with mRCC. Recent findings Randomized trials in the cytokine era of systemic therapy for mRCC demonstrated a survival...
Source: Current Opinion in Supportive and Palliative Care - August 2, 2019 Category: Palliative Care Tags: RENAL AND UROLOGICAL PROBLEMS: Edited by Fred Saad Source Type: research