Caregiver anticipatory grief: phenomenology, assessment and clinical interventions
Purpose of review This review aims to synthesize recent findings on anticipatory grief in caregivers, referring to its phenomenology, assessment and clinical interventions. Recent findings Recent literature illustrates the wide scope of the current use of the term anticipatory grief, reflecting caregivers’ experiences in different end-of-life trajectories. The anticipation of death is the distinctive aspect of anticipatory grief in the predeath grief continuum, encompassing several progressive losses, past and future. Recently developed assessment instruments capture key aspects of this experience, such as separ...
Source: Current Opinion in Supportive and Palliative Care - February 2, 2018 Category: Palliative Care Tags: The Silent Struggles in Survivorship Source Type: research

Existential distress and meaning-focused interventions in cancer survivorship
Purpose of review Cancer can challenge fundamental assumptions about security, controllability and life priorities, which may lead to clinically relevant existential distress. We review recent studies on the prevalence of existential distress in cancer survivors, its distinctness from other distress concepts and interventions to address cancer-specific existential challenges. We further describe psychological mechanisms that may underlie change resulting from such interventions. Recent findings One-third to one-half of cancer survivors experienced existential fears and concerns related to reduced control, identity and...
Source: Current Opinion in Supportive and Palliative Care - February 2, 2018 Category: Palliative Care Tags: The Silent Struggles in Survivorship Source Type: research

The fear of cancer recurrence literature continues to move forward: a review article
Purpose of review The volume of literature addressing fear of cancer recurrence (FCR) is rapidly increasing. A summary of key developments in the research and treatment of FCR was published by Sharpe et al. in 2017, and the current review focuses on works published thereafter. Recent findings A comprehensive literature review was conducted to provide an up-to-date summary of peer-reviewed publications focusing on FCR. The search consisted of the most recent FCR reports published between 2016 and 2017, which can be broadly categorized as: methods of assessment; associations with FCR; FCR and caregivers; and FCR interve...
Source: Current Opinion in Supportive and Palliative Care - February 2, 2018 Category: Palliative Care Tags: The Silent Struggles in Survivorship Source Type: research

The silent struggles of survivorship in cancer
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - February 2, 2018 Category: Palliative Care Tags: PSYCHOSOCIAL AND SUPPORTIVE CARE CONSIDERATIONS IN CANCER SURVIVORSHIP: EXISTENTIAL, EMOTIONAL, PHYSICAL, AND PRACTICAL CONCERNS: Edited by Janet Ellis and Elie Isenberg-Grzeda Source Type: research

Challenges in clarifying goals of care in patients with advanced heart failure
Purpose of review Patients with advanced heart failure require communication about goals of care, yet many challenges exist, leaving it suboptimal. High mortality rates and advances in the use of life-sustaining technology further complicate communication and underscore the urgency to understand and address these challenges. This review highlights current research with a view to informing future research and practice to improve goals of care communication. Recent findings Clinicians view patient and family barriers as more impactful than clinician and system factors in impeding goals of care discussions. Knowledge gap...
Source: Current Opinion in Supportive and Palliative Care - February 2, 2018 Category: Palliative Care Tags: CARDIAC AND CIRCULATORY PROBLEMS: Edited by James M. Beattie Source Type: research

Palliative care needs assessment in chronic heart failure
Purpose of review The unmet palliative care needs of patients with chronic heart failure (CHF) are well known. Palliative care needs assessment is paramount for timely provision of palliative care. The present review provides an overview of palliative care needs assessment in patients with CHF: the role of prognostic tools, the role of the surprise question, and the role of palliative care needs assessment tools. Recent findings Multiple prognostic tools are available, but offer little guidance for individual patients. The surprise question is a simple tool to create awareness about a limited prognosis, but the reliab...
Source: Current Opinion in Supportive and Palliative Care - February 2, 2018 Category: Palliative Care Tags: CARDIAC AND CIRCULATORY PROBLEMS: Edited by James M. Beattie Source Type: research

Symptom cluster among patients with advanced heart failure: a review of its manifestations and impacts on health outcomes
Purpose of review Assessment of symptom clustering is effective in enhancing care planning for symptom palliation in life-limiting disease. This review was aimed at identifying symptom cluster manifestation among advanced heart failure patients and to investigate the prognostic impact of the identified symptom clusters. Recent findings A systematic search of the literature identified 10 relevant articles. Two approaches were undertaken based on: correlations between symptoms and shared characteristics of patients’ symptom profiles, to identify the symptom clusters. By comparing the findings for heart failure pat...
Source: Current Opinion in Supportive and Palliative Care - February 2, 2018 Category: Palliative Care Tags: CARDIAC AND CIRCULATORY PROBLEMS: Edited by James M. Beattie Source Type: research

Palliative care needs of heart failure patients in China: putting people first
Purpose of review Recognizing the rising prevalence of heart failure in China, patients with heart failure have substantial palliative needs. This review highlights recent evidence on the epidemic of heart failure, identifies needs and potential benefit of palliative care in heart failure, and sets future strategic policy and research directions in China. Recent findings Epidemiological studies demonstrate the prevalence of heart failure among women is higher than men in China and increases substantially with age. However, few studies have addressed the palliative needs of Chinese heart failure patients. The main them...
Source: Current Opinion in Supportive and Palliative Care - February 2, 2018 Category: Palliative Care Tags: CARDIAC AND CIRCULATORY PROBLEMS: Edited by James M. Beattie Source Type: research

Thirst in heart failure: what do we know so far?
Purpose of review Thirst is a common and burdensome symptom of heart failure, which impacts adversely on quality of life. To date, there is limited research on the prevalence of thirst, the factors associated with thirst and interventions to help manage thirst in heart failure. This review summarizes key empirical research developments of thirst. Recent findings Recent research shows that the heart failure syndrome, medications, self-care practice such as fluid restriction and anxiety contributes greatly to increased thirst in patients with heart failure. In addition, predictors such as being younger, male patient, wi...
Source: Current Opinion in Supportive and Palliative Care - February 2, 2018 Category: Palliative Care Tags: CARDIAC AND CIRCULATORY PROBLEMS: Edited by James M. Beattie Source Type: research

Matters of the heart: failing better
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - February 2, 2018 Category: Palliative Care Tags: CARDIAC AND CIRCULATORY PROBLEMS: Edited by James M. Beattie Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - February 2, 2018 Category: Palliative Care Tags: Editorial Introduction Source Type: research

Advances in delivery of ambulatory autologous stem cell transplantation for multiple myeloma
Purpose of review Autologous stem cell transplantation (ASCT) is generally performed in the inpatient setting in its entirety. Several centers have demonstrated the feasibility of performing ASCT for myeloma in the ambulatory setting. We review the safety, cost-effectiveness, complications and outcomes of outpatient ASCT for myeloma. Recent findings Published studies are heterogeneous but suggest that outpatient ASCT for myeloma is cost-effective and associated with a shorter or no initial hospitalization, albeit there is a high rate of readmission for complications. The transplant-related mortality rate is less than ...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2017 Category: Palliative Care Tags: BLOOD, BONE MARROW AND LYMPHATICS: Edited by Sam H. Ahmedzai, John A. Snowden, Chris Dalley, and Annie Young Source Type: research

Advances in understanding and management of lymphoedema (cancer, primary)
Purpose of review Despite being neglected both clinically and in research in the past, primary lymphoedema, and lymphoedema secondary to cancer treatment have been the subject of an increasing number of studies in recent years. This review will focus on new developments relevant to clinical practice. Recent findings The main themes covered by the review include the incidence and prevalence of lymphoedema, early detection and intervention in cancer-related lymphoedema, risk reduction for the development of cancer-related lymphoedema, surgical treatment, palliative care for lymphoedema in advanced cancer and development...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2017 Category: Palliative Care Tags: BLOOD, BONE MARROW AND LYMPHATICS: Edited by Sam H. Ahmedzai, John A. Snowden, Chris Dalley, and Annie Young Source Type: research

Advances in managing and preventing thromboembolic disease in cancer patients
Purpose of review To update on new data for low-molecular weight heparins (LMWHs) and the direct oral anticoagulants (DOACs) for the treatment and prevention of cancer-associated thrombosis (CAT), to discuss progress with the risk-adaptive management scores (RAMS) and update on increased dose primary thromboprophylaxis (IDPTP). Recent findings In a pooled meta-analysis of 1132 cancer patients who received DOACs vs. vitamin K analogues (VKAs), recurrence of venous thromboembolism (VTE) was reduced from 6.0% on VKA schedules to 3.9% on DOACs. In a randomized trial of warfarin vs. once daily sc. tinzaparin (175 IU/kg), c...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2017 Category: Palliative Care Tags: BLOOD, BONE MARROW AND LYMPHATICS: Edited by Sam H. Ahmedzai, John A. Snowden, Chris Dalley, and Annie Young Source Type: research

Advances in the understanding and management of mucositis during stem cell transplantation
Purpose of review Mucositis is a severe and common side effect of anticancer treatments, with an incidence of between 40 and 80% depending on the cytotoxic regimen used. The most profound mucositis burden is experienced during conditioning regimens for hematopoietic stem cell transplant (HSCT), where the use of highly mucotoxic agents with or without total body irradiation leads to serious damage throughout the alimentary tract. Currently, the assessment and management of both oral and gastrointestinal mucositis lack authoritative guideline, with recommendations only achieved in narrow clinical scenarios. This review pro...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2017 Category: Palliative Care Tags: BLOOD, BONE MARROW AND LYMPHATICS: Edited by Sam H. Ahmedzai, John A. Snowden, Chris Dalley, and Annie Young Source Type: research

Spiritual needs of patients with cancer in palliative care: an integrative review
Purpose of review The experience of a life crisis, such as the experience of end-of-life terminality whenever facing cancer can make the spiritual needs of patients clear. The goal of this revision was to synthesize the existing evidence regarding the spiritual needs of patients with cancer in palliative care. Recent findings An integrated revision of the literature was conducted regarding the database sources from PubMed, CINAHL, EMBASE, LILACS and Scopus, without publishing year restrictions. There were 16 primary studies included. A total of 1469 patients have been evaluated, whereas eight groups of spiritual needs...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2017 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone and Bridget Johnston Source Type: research

Identifying palliative care needs in people with dementia
Purpose of review Dementia is now recognized as a progressive life-limiting illness where many patients can benefit from access to palliative care. Recent findings The present review has focused on three areas namely, advanced care planning in supporting palliative care for dementia, hospice provision for people with dementia and provision of care within family home. In advanced care planning, there is little research on systematically developed and implemented advance care planning interventions or whether they achieve desired outcomes for end-of-life care. There is limited research on hospice-based care for patients...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2017 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone and Bridget Johnston Source Type: research

Palliative and end-of-life care for adults with advanced chronic obstructive pulmonary disease: a rapid review focusing on patient and family caregiver perspectives
Purpose of review The aim of the review was to explore patient and family caregiver perspectives on key issues for ensuring quality of end-of-life care for people with chronic obstructive pulmonary disease (COPD). The growing evidence on the value of specialist palliative care services demonstrates significant improvements in treatments and provisions; however, much of the literature is generic in nature or centred on people with a cancer diagnosis. In this review, we examine the literature to ascertain the views and needs of patients and carers affected by advanced COPD, a highly debilitating condition that can have a p...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2017 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone and Bridget Johnston Source Type: research

Population-based models of planning for palliative care in older people
Purpose of review Health service planning requires demographic, clinical, and health systems data and is unique to each health system. Planning for palliative care in older people must include patients and their carers. This review explores literature from the last 24 months. Recent findings The proportion of people living in skilled nursing facilities is increasing and many residents require quality palliative care. Simultaneously, the complexity of care for older people is also increasing. Systematic approaches to improving palliative care in these facilities have shown benefits that are cost-effective. Although ad...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2017 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone and Bridget Johnston Source Type: research

Health professionals’ quality of life in relation to end of life care
Purpose of review Palliative care professionals are frequently exposed to stressful and demanding situations in the assistance of patients and their families, therefore research related to their quality of life is a relevant topic to provide evidence on interventions oriented to professional self-care. Recent findings Research about professionals’ quality of life is having a profuse development with core concepts being under review. Summary Currently, burnout syndrome and compassion fatigue are considered relevant determinants of professionals’ quality of life. Self-awareness-based interventions could b...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2017 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone and Bridget Johnston Source Type: research

The use of methylphenidate to relieve fatigue
Purpose of review To review recent evidence on the efficacy and safety of methylphenidate as a symptomatic treatment of patients with cancer-related fatigue (CRF). Recent findings Five clinical trials published since 2011 were identified. Two of these concluded that methylphenidate is more efficacious than placebo in providing relief from CRF, but the remaining three showed no difference in favour of methylphenidate. The studies were heterogeneous as per the dosage, scales used for evaluating fatigue and the target group studied. None of the studies detected serious reactions, and only mild and infrequent side-effects...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2017 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone and Bridget Johnston Source Type: research

Impact of advance care planning on end-of-life management
Purpose of review The aim of this review is to critically appraise the recent evidence on different aspects of impact of advance care planning (ACP) in palliative care and to reflect on further implications on practice and research in the future. Recent findings Evidence about various ACP impacts is rapidly growing and most common outcome measures are still advance directive completion, change in hospital admission rate and patients’ and families’ views and experiences with ACP. Mainly descriptive studies bring new information of ACP impact for specific groups of patients, their families, settings, countri...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2017 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone and Bridget Johnston Source Type: research

The role of vitamin D in cancer cachexia
Purpose of review The possibility to use vitamin D supplementation to improve muscle wasting, with particular focus on cancer cachexia, is discussed. Recent findings Vitamin D exerts biological actions on myogenic precursor proliferation and differentiation, impinging on muscle regeneration. However, the effects of VitD supplementation in diseases associated with muscle atrophy, such as cancer cachexia, are poorly investigated. Data obtained in experimental models of cancer cachexia show that the administration of vitamin D to tumor-bearing animals is not able to prevent or delay both muscle wasting and adipose tissue...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2017 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Research priorities in cancer cachexia: The University of Rochester Cancer Center NCI Community Oncology Research Program Research Base Symposium on Cancer Cachexia and Sarcopenia
Purpose of review Cancer cachexia remains understudied and there are no standard treatments available despite the publication of an international consensus definition and the completion of several large phase III intervention trials in the past 6 years. In September 2015, The University of Rochester Cancer Center NCORP Research Base led a Symposium on Cancer Cachexia and Sarcopenia with goals of reviewing the state of the science, identifying knowledge gaps, and formulating research priorities in cancer cachexia through active discussion and consensus. Recent findings Research priorities that emerged from the discussi...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2017 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Practical approaches to managing cancer patients with weight loss
Purpose of review Poor appetite and weight loss are a source of family conflict, psychological distress, and associated with poor tolerance to chemotherapy, impaired quality of life, and decreased survival. Despite clinicians’ concern about the effect of cachexia on their patients, few oncological professional organizations provide guidelines for the treatment of cancer-related weight loss. Recent findings Recent publications indicate there is an unmet need for addressing cachexia in patients with cancer. Studies also reveal that patients are often consuming inadequate calories and protein. Inadequate oral intak...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2017 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

What is next after anamorelin?
Purpose of review In spite of its relevance, treatments for the cancer anorexia and cachexia syndrome (CACS) are not available. One of the agents that recently reached phase III clinical trials is anamorelin. Its development, along with that of other agents for this indication, will be reviewed here, with a focus on the gaps in the current knowledge and future directions. Recent findings In spite of several targets showing promising results in early development, their difficulties obtaining regulatory approval underscore the need to reconsider the current strategies in drug development and the challenges in the field ...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2017 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Implications of weight loss for cancer patients receiving radiotherapy
Purpose of review Cancer-associated weight loss is a common comorbid condition best described among patients with advanced malignancy receiving systemic therapy, but its relationship to patients undergoing radiation treatment is less well described. We review the interaction between cancer-associated weight loss and radiation treatment as well as its prognostic significance. Recent findings Multiple studies demonstrate a consistent detrimental effect of cancer-associated weight loss either existing prior to treatment or developing during radiotherapy. Emerging data suggest cancer-associated weight loss independently c...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2017 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Cancer-associated weight loss: releasing its firm grip on negative clinical outcomes
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - December 1, 2017 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - December 1, 2017 Category: Palliative Care Tags: Editorial Introductions Source Type: research

Advances in delivery of ambulatory autologous stem cell transplantation for multiple myeloma
Purpose of review: Autologous stem cell transplantation (ASCT) is generally performed in the inpatient setting in its entirety. Several centers have demonstrated the feasibility of performing ASCT for myeloma in the ambulatory setting. We review the safety, cost-effectiveness, complications and outcomes of outpatient ASCT for myeloma. Recent findings: Published studies are heterogeneous but suggest that outpatient ASCT for myeloma is cost-effective and associated with a shorter or no initial hospitalization, albeit there is a high rate of readmission for complications. The transplant-related mortality rate is less than 1%...
Source: Current Opinion in Supportive and Palliative Care - October 27, 2017 Category: Palliative Care Tags: BLOOD, BONE MARROW AND LYMPHATICS: Edited by Sam H. Ahmedzai, John A. Snowden, Chris Dalley, and Annie Young Source Type: research

Advances in understanding and management of lymphoedema (cancer, primary)
Purpose of review: Despite being neglected both clinically and in research in the past, primary lymphoedema, and lymphoedema secondary to cancer treatment have been the subject of an increasing number of studies in recent years. This review will focus on new developments relevant to clinical practice. Recent findings: The main themes covered by the review include the incidence and prevalence of lymphoedema, early detection and intervention in cancer-related lymphoedema, risk reduction for the development of cancer-related lymphoedema, surgical treatment, palliative care for lymphoedema in advanced cancer and developments ...
Source: Current Opinion in Supportive and Palliative Care - October 27, 2017 Category: Palliative Care Tags: BLOOD, BONE MARROW AND LYMPHATICS: Edited by Sam H. Ahmedzai, John A. Snowden, Chris Dalley, and Annie Young Source Type: research

Advances in managing and preventing thromboembolic disease in cancer patients
Purpose of review: To update on new data for low-molecular weight heparins (LMWHs) and the direct oral anticoagulants (DOACs) for the treatment and prevention of cancer-associated thrombosis (CAT), to discuss progress with the risk-adaptive management scores (RAMS) and update on increased dose primary thromboprophylaxis (IDPTP). Recent findings: In a pooled meta-analysis of 1132 cancer patients who received DOACs vs. vitamin K analogues (VKAs), recurrence of venous thromboembolism (VTE) was reduced from 6.0% on VKA schedules to 3.9% on DOACs. In a randomized trial of warfarin vs. once daily sc. tinzaparin (175 IU/kg), cum...
Source: Current Opinion in Supportive and Palliative Care - October 27, 2017 Category: Palliative Care Tags: BLOOD, BONE MARROW AND LYMPHATICS: Edited by Sam H. Ahmedzai, John A. Snowden, Chris Dalley, and Annie Young Source Type: research

Advances in the understanding and management of mucositis during stem cell transplantation
Purpose of review: Mucositis is a severe and common side effect of anticancer treatments, with an incidence of between 40 and 80% depending on the cytotoxic regimen used. The most profound mucositis burden is experienced during conditioning regimens for hematopoietic stem cell transplant (HSCT), where the use of highly mucotoxic agents with or without total body irradiation leads to serious damage throughout the alimentary tract. Currently, the assessment and management of both oral and gastrointestinal mucositis lack authoritative guideline, with recommendations only achieved in narrow clinical scenarios. This review prov...
Source: Current Opinion in Supportive and Palliative Care - October 27, 2017 Category: Palliative Care Tags: BLOOD, BONE MARROW AND LYMPHATICS: Edited by Sam H. Ahmedzai, John A. Snowden, Chris Dalley, and Annie Young Source Type: research

Spiritual needs of patients with cancer in palliative care: an integrative review
Purpose of review: The experience of a life crisis, such as the experience of end-of-life terminality whenever facing cancer can make the spiritual needs of patients clear. The goal of this revision was to synthesize the existing evidence regarding the spiritual needs of patients with cancer in palliative care. Recent findings: An integrated revision of the literature was conducted regarding the database sources from PubMed, CINAHL, EMBASE, LILACS and Scopus, without publishing year restrictions. There were 16 primary studies included. A total of 1469 patients have been evaluated, whereas eight groups of spiritual needs h...
Source: Current Opinion in Supportive and Palliative Care - October 27, 2017 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone and Bridget Johnston Source Type: research

Identifying palliative care needs in people with dementia
Purpose of review: Dementia is now recognized as a progressive life-limiting illness where many patients can benefit from access to palliative care. Recent findings: The present review has focused on three areas namely, advanced care planning in supporting palliative care for dementia, hospice provision for people with dementia and provision of care within family home. In advanced care planning, there is little research on systematically developed and implemented advance care planning interventions or whether they achieve desired outcomes for end-of-life care. There is limited research on hospice-based care for patients w...
Source: Current Opinion in Supportive and Palliative Care - October 27, 2017 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone and Bridget Johnston Source Type: research

Palliative and end-of-life care for adults with advanced chronic obstructive pulmonary disease: a rapid review focusing on patient and family caregiver perspectives
Purpose of review: The aim of the review was to explore patient and family caregiver perspectives on key issues for ensuring quality of end-of-life care for people with chronic obstructive pulmonary disease (COPD). The growing evidence on the value of specialist palliative care services demonstrates significant improvements in treatments and provisions; however, much of the literature is generic in nature or centred on people with a cancer diagnosis. In this review, we examine the literature to ascertain the views and needs of patients and carers affected by advanced COPD, a highly debilitating condition that can have a pr...
Source: Current Opinion in Supportive and Palliative Care - October 27, 2017 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone and Bridget Johnston Source Type: research

Population-based models of planning for palliative care in older people
Purpose of review: Health service planning requires demographic, clinical, and health systems data and is unique to each health system. Planning for palliative care in older people must include patients and their carers. This review explores literature from the last 24 months. Recent findings: The proportion of people living in skilled nursing facilities is increasing and many residents require quality palliative care. Simultaneously, the complexity of care for older people is also increasing. Systematic approaches to improving palliative care in these facilities have shown benefits that are cost-effective. Although adva...
Source: Current Opinion in Supportive and Palliative Care - October 27, 2017 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone and Bridget Johnston Source Type: research

Health professionals’ quality of life in relation to end of life care
Purpose of review: Palliative care professionals are frequently exposed to stressful and demanding situations in the assistance of patients and their families, therefore research related to their quality of life is a relevant topic to provide evidence on interventions oriented to professional self-care. Recent findings: Research about professionals’ quality of life is having a profuse development with core concepts being under review. Summary: Currently, burnout syndrome and compassion fatigue are considered relevant determinants of professionals’ quality of life. Self-awareness-based interventions could brin...
Source: Current Opinion in Supportive and Palliative Care - October 27, 2017 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone and Bridget Johnston Source Type: research

The use of methylphenidate to relieve fatigue
Purpose of review: To review recent evidence on the efficacy and safety of methylphenidate as a symptomatic treatment of patients with cancer-related fatigue (CRF). Recent findings: Five clinical trials published since 2011 were identified. Two of these concluded that methylphenidate is more efficacious than placebo in providing relief from CRF, but the remaining three showed no difference in favour of methylphenidate. The studies were heterogeneous as per the dosage, scales used for evaluating fatigue and the target group studied. None of the studies detected serious reactions, and only mild and infrequent side-effects o...
Source: Current Opinion in Supportive and Palliative Care - October 27, 2017 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone and Bridget Johnston Source Type: research

Impact of advance care planning on end-of-life management
Purpose of review: The aim of this review is to critically appraise the recent evidence on different aspects of impact of advance care planning (ACP) in palliative care and to reflect on further implications on practice and research in the future. Recent findings: Evidence about various ACP impacts is rapidly growing and most common outcome measures are still advance directive completion, change in hospital admission rate and patients’ and families’ views and experiences with ACP. Mainly descriptive studies bring new information of ACP impact for specific groups of patients, their families, settings, countries...
Source: Current Opinion in Supportive and Palliative Care - October 27, 2017 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone and Bridget Johnston Source Type: research

The role of vitamin D in cancer cachexia
Purpose of review: The possibility to use vitamin D supplementation to improve muscle wasting, with particular focus on cancer cachexia, is discussed. Recent findings: Vitamin D exerts biological actions on myogenic precursor proliferation and differentiation, impinging on muscle regeneration. However, the effects of VitD supplementation in diseases associated with muscle atrophy, such as cancer cachexia, are poorly investigated. Data obtained in experimental models of cancer cachexia show that the administration of vitamin D to tumor-bearing animals is not able to prevent or delay both muscle wasting and adipose tissue d...
Source: Current Opinion in Supportive and Palliative Care - October 27, 2017 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Research priorities in cancer cachexia: The University of Rochester Cancer Center NCI Community Oncology Research Program Research Base Symposium on Cancer Cachexia and Sarcopenia
Purpose of review: Cancer cachexia remains understudied and there are no standard treatments available despite the publication of an international consensus definition and the completion of several large phase III intervention trials in the past 6 years. In September 2015, The University of Rochester Cancer Center NCORP Research Base led a Symposium on Cancer Cachexia and Sarcopenia with goals of reviewing the state of the science, identifying knowledge gaps, and formulating research priorities in cancer cachexia through active discussion and consensus. Recent findings: Research priorities that emerged from the discussion...
Source: Current Opinion in Supportive and Palliative Care - October 27, 2017 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Practical approaches to managing cancer patients with weight loss
Purpose of review: Poor appetite and weight loss are a source of family conflict, psychological distress, and associated with poor tolerance to chemotherapy, impaired quality of life, and decreased survival. Despite clinicians’ concern about the effect of cachexia on their patients, few oncological professional organizations provide guidelines for the treatment of cancer-related weight loss. Recent findings: Recent publications indicate there is an unmet need for addressing cachexia in patients with cancer. Studies also reveal that patients are often consuming inadequate calories and protein. Inadequate oral intake ...
Source: Current Opinion in Supportive and Palliative Care - October 27, 2017 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

What is next after anamorelin?
Purpose of review: In spite of its relevance, treatments for the cancer anorexia and cachexia syndrome (CACS) are not available. One of the agents that recently reached phase III clinical trials is anamorelin. Its development, along with that of other agents for this indication, will be reviewed here, with a focus on the gaps in the current knowledge and future directions. Recent findings: In spite of several targets showing promising results in early development, their difficulties obtaining regulatory approval underscore the need to reconsider the current strategies in drug development and the challenges in the field of...
Source: Current Opinion in Supportive and Palliative Care - October 27, 2017 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Implications of weight loss for cancer patients receiving radiotherapy
Purpose of review: Cancer-associated weight loss is a common comorbid condition best described among patients with advanced malignancy receiving systemic therapy, but its relationship to patients undergoing radiation treatment is less well described. We review the interaction between cancer-associated weight loss and radiation treatment as well as its prognostic significance. Recent findings: Multiple studies demonstrate a consistent detrimental effect of cancer-associated weight loss either existing prior to treatment or developing during radiotherapy. Emerging data suggest cancer-associated weight loss independently con...
Source: Current Opinion in Supportive and Palliative Care - October 27, 2017 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Cancer-associated weight loss: releasing its firm grip on negative clinical outcomes
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - October 27, 2017 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - October 27, 2017 Category: Palliative Care Tags: Editorial Introductions Source Type: research

Exercise medicine for advanced prostate cancer
Purpose of review: Exercise is a provocative medicine, known for its preventive, complimentary and rehabilitative role in the management of cancer. Impressively, exercise is also emerging as a synergistic and targeted medicine to enhance symptom control, modulate tumour biology and delay disease progression, with the potential to increase overall survival. Given the complex clinical presentation of advanced prostate cancer patients and their omnipresent comorbidities, this review describes the current and potential role of exercise medicine in advanced prostate cancer. Recent findings: Exercise has been shown to be safe, ...
Source: Current Opinion in Supportive and Palliative Care - August 3, 2017 Category: Palliative Care Tags: RENAL AND UROLOGICAL PROBLEMS: Edited by Fred Saad Source Type: research

Novel imaging in advanced prostate cancer
Purpose of review: Prostate cancer (PCa) is the most commonly diagnosed noncutaneous cancer and second leading cause of death in men. Imaging evaluation of PCa is challenging because of the prostate's deep pelvic location, its complex zonal anatomy and its multifocal nature. Novel imaging modalities are needed to improve detection, reassessment in biochemical relapse, and disease progression in advanced metastatic stages. Recent findings: Current imaging modalities have distinct strengths. However, all lack the ability to diagnose micrometastases, differentiate high from low-grade disease and diagnose advanced disease, es...
Source: Current Opinion in Supportive and Palliative Care - August 3, 2017 Category: Palliative Care Tags: RENAL AND UROLOGICAL PROBLEMS: Edited by Fred Saad Source Type: research

Current management of metastatic renal cell carcinoma: evolving new therapies
Purpose of review: Targeted therapies have recently replaced cytokine treatments as the gold standard for management of metastatic renal cell carcinoma (mRCC). Currently approved treatments include the tyrosine kinase inhibitors sunitinib, pazopanib, axitinib, sorafenib, cabozantinib and lenvatinib; the vascular endothelial growth factor (VEGF) inhibitor bevacizumab; the mammalian target of rapamycin (mTOR) inhibitors everolimus and temsirolimus; and the immunologic nivolumab. The purpose of this review is to provide an updated analysis of the clinical data supporting the use of these agents in the first-line and second-li...
Source: Current Opinion in Supportive and Palliative Care - August 3, 2017 Category: Palliative Care Tags: RENAL AND UROLOGICAL PROBLEMS: Edited by Fred Saad Source Type: research