Prostate cancer immunotherapy: the path forward
Purpose of review: To provide an overview of current strategies being investigated in the development of immunotherapy in prostate cancer. Recent findings: Development of immunotherapy in prostate cancer actually began in 2010 with FDA approval of sipuleucel-T. Given that immune checkpoint inhibitor trials have either been negative at the phase III level or underwhelming in smaller studies, it is likely that combination strategies will be required to further maximize the impact immune-based therapies on the clinical course of the disease. Emerging data suggests the presence of multiple checkpoint inhibitors in the prostat...
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

The role of bone-targeted therapies for prostate cancer in 2017
Purpose of review: Bone-targeted agents (BTAs), such as zoledronic acid and denosumab, delay the occurrence of skeletal-related events (SREs) in metastatic prostate cancer (PCa) patients. Recently, several agents, such as abiraterone acetate, enzalutamide and radium-223, were approved for the treatment of metastatic castration-resistant PCa (mCRPC). These agents resulted in improved overall survival (OS), pain control and had positive effects on bone health. Combining BTAs to the newly approved agents demonstrates additional benefits that warrant a review of available evidence looking at appropriate combination therapies a...
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

Improving cancer care in metastatic kidney and prostate cancer: steps in the right direction
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
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

Long-term and late treatment consequences: endocrine and metabolic effects
Purpose of review: Cancer therapies often result in the ‘late effect of cancer treatment’ whereby secondary health complications emerge years after radiotherapy and chemotherapy. This review focuses on endocrine and metabolic consequences in adult cancer survivors as late treatment effects. Recent findings: Endocrine and metabolic disorders are among the most common late effects. Endocrine disorders include hypopituitarism, which leads to growth hormone deficiency, hypogonadism, adrenal insufficiency and hypothyroidism and related clinical manifestations. Hypogonadism in particular is associated with a wide ra...
Source: Current Opinion in Supportive and Palliative Care - August 3, 2017 Category: Palliative Care Tags: LONG-TERM AND LATE TREATMENT CONSEQUENCES: Edited by Diana M. Greenfield Source Type: research

Late respiratory effects of cancer treatment
Purpose of review: The aim of this article is to examine significant advances in our understanding of the late respiratory effects of cancer treatment, including surgery, radiotherapy, chemotherapy, biological therapies and haematopoietic stem cell transplant, and to provide a framework for assessing such patients. Recent findings: Oncology therapies have advanced considerably over recent years but pulmonary toxicity remains a concern. Advances have been made in our understanding of the risk factors, including genetic ones that lead to toxicity from radiotherapy and chemotherapy and risk stratification models are being de...
Source: Current Opinion in Supportive and Palliative Care - August 3, 2017 Category: Palliative Care Tags: LONG-TERM AND LATE TREATMENT CONSEQUENCES: Edited by Diana M. Greenfield Source Type: research

Current directions in research and treatment of fear of cancer recurrence
Purpose of review: An expert meeting in Ottawa in 2015 galvanized efforts to answer key questions relevant to the understanding and management of fear of cancer recurrence (FCR). The aim of this review is to summarize key developments. Recent findings: A consensus on the definition of FCR has helped to further research in this area. There have been a number of theories put forward to account for the development of FCR, all of which share key components. Importantly, a number of important trials have been published that confirm both brief and more intensive interventions can successfully treat FCR. Summary: The consensus ...
Source: Current Opinion in Supportive and Palliative Care - August 3, 2017 Category: Palliative Care Tags: LONG-TERM AND LATE TREATMENT CONSEQUENCES: Edited by Diana M. Greenfield Source Type: research

Persistent pain in cancer survivors
Purpose of review: As people are living longer after a diagnosis and primary treatment for cancer, or indeed living with cancer as a chronic disease, new problems are emerging in this growing population of so-called ‘survivors’. Persistent or chronic pain is one of the commonest complaints, arising from the tissue damage caused by the original neoplasm, consequences of surgery and other therapies, and – especially in older people – multimorbidity. This review explores some of the principle causes and mechanisms of this phenomenon and reviews the evidence for their management. Recent findings: We re...
Source: Current Opinion in Supportive and Palliative Care - August 3, 2017 Category: Palliative Care Tags: LONG-TERM AND LATE TREATMENT CONSEQUENCES: Edited by Diana M. Greenfield Source Type: research

A growing epidemic: cancer treatment consequences
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - August 3, 2017 Category: Palliative Care Tags: LONG-TERM AND LATE TREATMENT CONSEQUENCES: Edited by Diana M. Greenfield Source Type: research

Respiratory problems in low-resource settings
Purpose of review: Chronic breathlessness is common in patients with advanced illness who require palliative care. Achieving good symptom control can be challenging. More people with advanced illness live in low and middle income than in high-income countries, but they are much less likely to receive palliative care. Most of the emerging evidence for the palliative management of chronic breathlessness is from high-income countries. This review explores the context of chronic breathlessness in low-income settings, how evidence for control of chronic breathlessness might relate to these settings and where further work should...
Source: Current Opinion in Supportive and Palliative Care - August 3, 2017 Category: Palliative Care Tags: RESPIRATORY PROBLEMS: Edited by David C. Currow and Miriam J. Johnson Source Type: research

Carers and breathlessness
Purpose of review: Informal carers play a key role in supporting patients living with breathlessness in advanced disease, but with considerable impacts on their own well being. The purpose was to review recent advances in our understanding of the caring role in refractory breathlessness, its impacts on carers, and interventions to support them. Recent findings: A systematic literature search resulted in 28 included articles that could be mapped to four broad areas of carer enquiry: the carer role (n = 6), role impact (n = 7), carer support (n = 11) and carer views (n = 4). Search terms focused on breathles...
Source: Current Opinion in Supportive and Palliative Care - August 3, 2017 Category: Palliative Care Tags: RESPIRATORY PROBLEMS: Edited by David C. Currow and Miriam J. Johnson Source Type: research

Palliative oxygen for chronic breathlessness: what new evidence?
Purpose of review: Supplemental oxygen improves survival in patients with chronic obstructive pulmonary disease (COPD) and severe hypoxaemia, but the effect of oxygen therapy in mild or moderate hypoxaemia to reduce symptomatic chronic breathlessness remains unclear. This review provides an overview of recent evidence about the role of oxygen therapy for the relief of chronic breathlessness in advanced illness. Recent findings: In COPD, a recent Cochrane review strengthens earlier findings regarding the positive effect of supplemental oxygen compared with air during exercise test in the training setting. The novel analysi...
Source: Current Opinion in Supportive and Palliative Care - August 3, 2017 Category: Palliative Care Tags: RESPIRATORY PROBLEMS: Edited by David C. Currow and Miriam J. Johnson Source Type: research

Breathlessness in the primary care setting
We present systems that support decisions made by primary healthcare professionals and an increasingly strong case that a solution is required in primary care for an ageing and frail population where breathlessness will be common. Summary: Primary care practitioners and leaders must start to realize the importance of recognizing and acting early in the life course of the person with breathlessness because its impact is enormous. They will need to work closely with public health colleagues and learn from specialists who have been doing this work usually with people near to the end of life translating the skills and knowled...
Source: Current Opinion in Supportive and Palliative Care - August 3, 2017 Category: Palliative Care Tags: RESPIRATORY PROBLEMS: Edited by David C. Currow and Miriam J. Johnson Source Type: research

Pharmacology of cough in palliative care
Purpose of review: Cough is a common and distressing symptom. It has a marked decrement on quality-of-life particularly in the arena of palliative care where coexisting symptoms such as pain may be exacerbated. Whilst local definitive treatment may alleviate coughing it usually requires general measures. The purpose of the review is to assess the current evidence relating to the pharmacological management of cough. Recent findings: Key to understanding cough is the realization that most cough is because of a hypersensitivity of the afferent vagus nerve. Cough suppression with opioids and first-generation antihistamines ma...
Source: Current Opinion in Supportive and Palliative Care - August 3, 2017 Category: Palliative Care Tags: RESPIRATORY PROBLEMS: Edited by David C. Currow and Miriam J. Johnson Source Type: research

Palliative care and interstitial lung disease
Purpose of review: The palliative care needs of people with interstitial lung disease (ILD) have recently been highlighted by the National Institute for Health and Care Excellence. All people with progressive ILD should receive best supportive care to improve symptom control and quality of life and where possible this should be evidence based. Recent findings: Deaths from ILD are increasing and deaths in hospital are more common compared to home. People with ILD experience a wide range of symptoms including breathlessness and cough. People living with ILD often suffer unmet physical and psychological needs throughout the ...
Source: Current Opinion in Supportive and Palliative Care - August 3, 2017 Category: Palliative Care Tags: RESPIRATORY PROBLEMS: Edited by David C. Currow and Miriam J. Johnson Source Type: research

Unmasking chronic breathlessness
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - August 3, 2017 Category: Palliative Care Tags: RESPIRATORY PROBLEMS: Edited by David C. Currow and Miriam J. Johnson Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - August 3, 2017 Category: Palliative Care Tags: Editorial Introductions Source Type: research

Proteasome inhibitor-induced gastrointestinal toxicity
Purpose of review: Gastrointestinal toxicities are commonly reported following treatment with proteasome inhibitors. The first-generation proteasome inhibitor, bortezomib, induces significant gastrointestinal side effects including nausea, vomiting, diarrhoea, and constipation, occurring in up to 84% of patients. Despite the development of safer proteasome inhibitors, such as carfilzomib, gastrointestinal toxicities remain some of the most common side effects. This review aims to summarize the previous literature on proteasome inhibitor-induced gastrointestinal toxicities, report on recent updates in the field, and investi...
Source: Current Opinion in Supportive and Palliative Care - May 3, 2017 Category: Palliative Care Tags: GASTROINTESTINAL SYMPTOMS: Edited by Joanne M. Bowen Source Type: research

Determining risk of severe gastrointestinal toxicity based on pretreatment gut microbial community in patients receiving cancer treatment: a new predictive strategy in the quest for personalized cancer medicine
Purpose of review: Currently, our ability to accurately predict a patient's risk of developing severe gastrointestinal toxicity from their cancer treatment is limited. Risk stratification continues to rely on traditional patient-related and treatment-related factors including age, ethnicity, sex, comorbidities, genetics, agent, dose and schedule. Although informative, these crude measures continue to underestimate toxicity risk, and hence alternative methods of risk prediction must be investigated. Given the increasing focus on the gut microbiome in driving disease, this review will provide an overview of the current liter...
Source: Current Opinion in Supportive and Palliative Care - May 3, 2017 Category: Palliative Care Tags: GASTROINTESTINAL SYMPTOMS: Edited by Joanne M. Bowen Source Type: research

Prevention of gastrointestinal side-effects in paediatric oncology: what are the guidelines?
Purpose of review: Gastrointestinal side-effects, particularly with regard to alimentary tract mucositis and chemotherapy-induced nausea and vomiting (CINV), continue to be frequent and debilitating symptomatic conditions among children and adolescents receiving cytotoxic cancer therapy. Further avenues of progress for mucositis and CINV prevention in paediatric oncology setting are warranted. Recent findings: The current article reviews the major guidelines and literature published in 2016 pertaining to the prevention of mucositis and CINV. Considerable professional organizational efforts have been made to develop consen...
Source: Current Opinion in Supportive and Palliative Care - May 3, 2017 Category: Palliative Care Tags: GASTROINTESTINAL SYMPTOMS: Edited by Joanne M. Bowen Source Type: research

Cancer treatment-related gastrointestinal symptoms
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - May 3, 2017 Category: Palliative Care Tags: GASTROINTESTINAL SYMPTOMS: Edited by Joanne M. Bowen Source Type: research

Improving the treatment of infant pain
Purpose of review: Pain management presents a major challenge in neonatal care. Newborn infants who require medical treatment can undergo frequent invasive procedures during a critical period of neurodevelopment. However, adequate analgesic provision is infrequently and inconsistently provided for acute noxious procedures because of limited and conflicting evidence regarding analgesic efficacy and safety of most commonly used pharmacological agents. Here, we review recent advances in the measurement of infant pain and discuss clinical trials that assess the efficacy of pharmacological analgesia in infants. Recent findings...
Source: Current Opinion in Supportive and Palliative Care - May 3, 2017 Category: Palliative Care Tags: PAIN: NON-MALIGNANT DISEASE: Edited by Anthony H. Dickenson and Kirsty Bannister Source Type: research

Clinical application of perioperative multimodal analgesia
Purpose of review: The experience of intense postoperative pain remains a significant problem in perioperative medicine. The mainstay of postoperative analgetic therapy is the combination of nonopioid agents (e.g. paracetamol and NSAIDs) with strong opioids (e.g. morphine) according to the WHO analgesic ladder. But as the incidence and intensity of postoperative pain remains high, the search for and evaluation of additional concepts is ongoing. This review highlights the current trends of perioperative multimodal analgesia concepts. Recent findings: Gabapentinoids, ketamine, dexamethasone and magnesium are effective parts...
Source: Current Opinion in Supportive and Palliative Care - May 3, 2017 Category: Palliative Care Tags: PAIN: NON-MALIGNANT DISEASE: Edited by Anthony H. Dickenson and Kirsty Bannister Source Type: research

Editorial
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - May 3, 2017 Category: Palliative Care Tags: PAIN: NON-MALIGNANT DISEASE: Edited by Anthony H. Dickenson and Kirsty Bannister Source Type: research

Pain prevalence in cancer patients: status quo or opportunities for improvement?
Purpose of review: Cancer incidence increases worldwide and thus more patients will suffer from cancer pain. As cancer pain severely affects quality of life, the decrease of pain should be of high priority for every clinician. In the last decade, attention for cancer pain and for its treatment has increased, and new pharmacological based treatment options became available. This gave reason to hypothesize a decrease in pain prevalence in cancer patients over the last decade. Recent findings: Despite increased attention to cancer pain, pain prevalence in cancer patients has not significantly changed over the last decade as ...
Source: Current Opinion in Supportive and Palliative Care - May 3, 2017 Category: Palliative Care Tags: PAIN: CANCER: Edited by Anthony H. Dickenson and Paul Farquhar-Smith Source Type: research

The role of topiceuticals in cancer pain
Purpose of review: Pain is one of the most common and feared symptoms associated with a new diagnosis of cancer and its subsequent treatment. Unfortunately, it remains undertreated in around one third of patients. It has been recently postulated that one mechanism for this could be failure to recognize neuropathic pain. One attractive option in both the case of neuropathic pain and pain associated with intolerable side effects of prescribed opioids is the use of ‘topiceuticals’, as a means of targeted pain relief with potentially fewer side effects. The present review summarizes the evidence base for the variou...
Source: Current Opinion in Supportive and Palliative Care - May 3, 2017 Category: Palliative Care Tags: PAIN: CANCER: Edited by Anthony H. Dickenson and Paul Farquhar-Smith Source Type: research

Ketamine for cancer pain: what is the evidence?
Purpose of review: In this review, we assess the benefit of ketamine in the treatment of terminal cancer pain that is refractory to opioid treatment and/or complicated by neuropathy. Recent findings: While randomized controlled trials consistently show lack of clinical efficacy of ketamine in treating cancer pain, a large number of open-label studies and case series show benefit. Summary: Ketamine is an N-methyl-D-aspartate receptor antagonist that at low-dose has effective analgesic properties. In cancer pain, ketamine is usually prescribed as adjuvant to opioid therapy when pain becomes opioid resistant or when neuropa...
Source: Current Opinion in Supportive and Palliative Care - May 3, 2017 Category: Palliative Care Tags: PAIN: CANCER: Edited by Anthony H. Dickenson and Paul Farquhar-Smith Source Type: research

Use of corticosteroids for pain control in cancer patients with bone metastases: a comprehensive literature review
Purpose of review: Despite a limited understanding of the exact mechanism, corticosteroids are commonly employed for pain control in patients with bone metastases. The aim of this review was to evaluate the efficacy of corticosteroid-mediated pain control in patients with bone metastases associated with solid cancers. Recent findings: A literature search was conducted using OVID MEDLINE and Embase databases (from 1946 up to July 19, 2016). Studies involving patients with bone metastases receiving corticosteroids as the primary means of pain control were included. Screening and data extraction were conducted by paired revi...
Source: Current Opinion in Supportive and Palliative Care - May 3, 2017 Category: Palliative Care Tags: PAIN: CANCER: Edited by Anthony H. Dickenson and Paul Farquhar-Smith Source Type: research

Editorial
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - May 3, 2017 Category: Palliative Care Tags: PAIN: CANCER: Edited by Anthony H. Dickenson and Paul Farquhar-Smith Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - May 3, 2017 Category: Palliative Care Tags: Editorial Introductions Source Type: research

Cancer-related cognitive impairment in children
Purpose of review: To review recent research on cancer-related cognitive impairment (CRCI) in children, including correlational studies and interventions in which outcomes have included cognitive test performance, neuroimaging or academic performance. Recent findings: Impairments in processing speed, working memory, executive function and attention continue to be demonstrated in survivors of childhood cancers. Children receiving radiation treatment for their cancer demonstrate greater impairment than those who undergo surgery and/or chemotherapy without radiation. However, CRCI still occurs in the absence of radiation tre...
Source: Current Opinion in Supportive and Palliative Care - February 1, 2017 Category: Palliative Care Tags: CANCER-RELATED COGNITIVE IMPAIRMENT: Special considerations: CRCI among older adults and children: Edited by Janet Ellis and Elie Isenberg-Grzeda Source Type: research

Cancer-related cognitive impairment in older adults
Purpose of review: Cancer, aging, and cognition form a complicated interface that can challenge patients, caretakers, and healthcare professionals. Although the typical aging process allows for compensatory mechanisms to help maintain daily functioning, cancer and cancer treatments can remove the fail-safes and exacerbate cognitive decline. As a result, older cancer patients can experience increased morbidity and mortality. The goal of this article is to provide additional assessment strategies, diagnostic considerations, and treatment options for providers taking care of this growing population. Recent findings: In this ...
Source: Current Opinion in Supportive and Palliative Care - February 1, 2017 Category: Palliative Care Tags: CANCER-RELATED COGNITIVE IMPAIRMENT: Special considerations: CRCI among older adults and children: Edited by Janet Ellis and Elie Isenberg-Grzeda Source Type: research

Effects of exercise interventions and physical activity behavior on cancer-related cognitive impairments: an update
Purpose of review: The purpose of this review is to give an update on studies investigating the influence of physical activity behavior and exercise interventions on cancer-related cognitive impairments. Recent findings: Cross-sectional and observational studies underline previous findings, revealing an association of cancer patients’ fitness and their cognitive functions. Results from interventional studies are sparse. Only one study investigated self-perceived cognitive function in breast cancer patients as a secondary outcome, indicating no effects. Summary: Recent research on physical activity and exercise inte...
Source: Current Opinion in Supportive and Palliative Care - February 1, 2017 Category: Palliative Care Tags: CANCER-RELATED COGNITIVE IMPAIRMENT: Management of CRCI: Edited by Janet Ellis and Elie Isenberg-Grzeda Source Type: research

Cognitive behavioral therapy for cancer-related cognitive dysfunction
Purpose of review: To provide the reader with an overview of the cognitive-behavioral conceptualization of cancer-related cognitive dysfunction (CRCD) and how cognitive behavioral therapy (CBT) can play an important role in treatment. Recent findings: Recent findings show that Memory and Attention Adaptation Training (MAAT), a CBT developed to help cancer survivors develop adaptive skills to improve daily cognitive performance and emotional coping, may be an efficacious treatment of CRCD and can be delivered through videoconference technology to improve survivor access to care. Summary: The etiology of CRCD remains large...
Source: Current Opinion in Supportive and Palliative Care - February 1, 2017 Category: Palliative Care Tags: CANCER-RELATED COGNITIVE IMPAIRMENT: Management of CRCI: Edited by Janet Ellis and Elie Isenberg-Grzeda Source Type: research

Cognitive impairment following hormone therapy: current opinion of research in breast and prostate cancer patients
Purpose of review: Hormone therapy is a common cancer treatment that may be associated with numerous side and late effects, and in recent years, has been linked to changes in cognition. Here, we present the most important recent findings from empirical studies and reviews that have focused on the effects of hormone therapy on cognitive functioning in breast and prostate cancer populations, underline some general shortcomings, and propose directions for future research. Recent findings: Recent research indicates that cognitive impairment may occur in breast and prostate cancer patients following onset of hormone therapy. H...
Source: Current Opinion in Supportive and Palliative Care - February 1, 2017 Category: Palliative Care Tags: CANCER-RELATED COGNITIVE IMPAIRMENT: Beyond 'Chemofog': CRCI due to radiation and hormone therapies: Edited by Janet Ellis and Elie Isenberg-Grzeda Source Type: research

Neurocognitive impact of cranial radiation in adults with cancer: an update of recent findings
Purpose of review: Radiation to the brain is associated with adverse effects on cognition in cancer patients. Advances in technology have improved treatment efficacy, while new or adjuvant approaches continue to be developed. The long-term impact of both established and newer treatments on cognition is an active area of research. Recent findings: The article reviews the 15 studies published between January 2015 and October 2016 that include data on neurocognitive functions following radiation to the brain in adults with brain metastases, primary brain tumors, or other cancers. These studies examine neurocognitive outcomes...
Source: Current Opinion in Supportive and Palliative Care - February 1, 2017 Category: Palliative Care Tags: CANCER-RELATED COGNITIVE IMPAIRMENT: Beyond 'Chemofog': CRCI due to radiation and hormone therapies: Edited by Janet Ellis and Elie Isenberg-Grzeda Source Type: research

A review of cognitive screening tools in cancer
Purpose of review: Cancer-related cognitive impairment (CRCI) is highly prevalent, and assessment of cognition is crucial in providing optimal cancer care. Neuropsychological assessment (NPA) can be lengthy and expensive. Cognitive screening tools are plenty but validity has not been thoroughly studied for use in cancer patients. Recent findings: Our search of the recent literature revealed that the Montreal Cognitive Assessment, Mini–Mental State Examination, and Clock Draw Test were the most frequently studied objective screening tools. The Functional Assessment of Cancer Therapy-Cognitive Function and the Cogniti...
Source: Current Opinion in Supportive and Palliative Care - February 1, 2017 Category: Palliative Care Tags: CANCER-RELATED COGNITIVE IMPAIRMENT: Impact and identification of cancer-related cognitive impairment: Edited by Janet Ellis and Elie Isenberg-Grzeda Source Type: research

Cancer-related cognitive impairment and patients’ ability to work: a current perspective
Purpose of review: About half of all cancer survivors are 65 years of age or younger and potentially part of the labor force. Increasing numbers of these survivors are able to return to work (RTW) or even continue working during treatment. Many factors are known to inhibit occupational reintegration of cancer survivors, and further affect job performance after RTW. However, the impact of cancer-related cognitive impairment on work-related outcomes in cancer survivors is not well understood. Recent findings: Previous studies exploring cancer, cognition and the ability to work reported mixed results, because of inconsistenc...
Source: Current Opinion in Supportive and Palliative Care - February 1, 2017 Category: Palliative Care Tags: CANCER-RELATED COGNITIVE IMPAIRMENT: Impact and identification of cancer-related cognitive impairment: Edited by Janet Ellis and Elie Isenberg-Grzeda Source Type: research

Cancer-related cognitive impairment
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - February 1, 2017 Category: Palliative Care Tags: CANCER-RELATED COGNITIVE IMPAIRMENT: Edited by Janet Ellis and Elie Isenberg-Grzeda Source Type: research

Measuring quality of life in advanced heart failure
Purpose of review: Patients with Stage D heart failure can benefit from palliative care consultation to help them manage unpleasant symptoms and improve quality of life. Although guidelines describe how to manage symptoms, very little direction is provided on how to evaluate the effectiveness of those interventions. Recent findings: Numerous studies have used the measurement of symptoms, emotional distress, functional capacity and quality of life to evaluate the effectiveness of interventions in heart failure. There is limited evidence on the use of these instruments in heart failure palliative care. Four studies were ide...
Source: Current Opinion in Supportive and Palliative Care - February 1, 2017 Category: Palliative Care Tags: CARDIAC AND CIRCULATORY PROBLEMS: Edited by James M. Beattie Source Type: research

Palliative care in pulmonary arterial hypertension
Purpose of review: Developments in the management of pulmonary arterial hypertension have significantly improved prognosis changing this from an acute to a chronic disease. Despite optimal treatment many patients still have a high-symptom burden both because of the disease and the side-effects of therapy, consequently there is an increasing need for a palliative care approach to improve the quality of life for this patient group. This review article will outline the need for palliative care support for patients with pulmonary arterial hypertension, discuss the barriers that currently exist and suggest how this may be impro...
Source: Current Opinion in Supportive and Palliative Care - February 1, 2017 Category: Palliative Care Tags: CARDIAC AND CIRCULATORY PROBLEMS: Edited by James M. Beattie Source Type: research

Improving the support of the suddenly bereaved
Purpose of review: It is recognized that death is inevitable but rarely are we prepared for the death of significant persons in our lives. Sudden death is by its nature unexpected and thus shocking for family members and friends of the decedent. Sudden deaths have customarily been divided into four categories based on the cause of death, including natural, accidental, suicidal, or homicidal (NASH) deaths. Supporting the suddenly bereaved can be stressful, for both novice and experienced professionals; this review provides information important to healthcare professionals (HCP) who are often in a position to support family ...
Source: Current Opinion in Supportive and Palliative Care - February 1, 2017 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 1, 2017 Category: Palliative Care Tags: Editorial Introductions Source Type: research

Targeting the host immune system: PD-1 and PD-L1 antibodies and breast cancer
This article describes the role of the PD-1 axis and reviews current data and future directions inhibiting PD-1 and PD-L1 in breast cancer. Recent findings: Four phase I monotherapy expansion trials in patients with metastatic breast cancer have demonstrated low but durable single agent responses to PD-1 and PD-L1 inhibitors, ranging from 4.8 to 19%. Higher response rates are seen in triple negative breast cancer, compared with hormone receptor positive disease. Variability in requirements for tumor PD-L1 expression, and variations in testing complicate cross trial comparisons. A fifth phase Ib trial reported a 38% respon...
Source: Current Opinion in Supportive and Palliative Care - October 28, 2016 Category: Palliative Care Tags: BONE AND HAEMATOLOGICAL PROBLEMS: Edited by Allan Lipton and James Berenson Source Type: research

Caregivers burden in palliative care patients: a problem to tackle
Purpose of review: To revise the family caregiver's burden concept and to understand the implications for the patient, family and healthcare system. We analyzed recent literature in three main areas: the role of family caregiver at the end of life, the family caregiver's burden and the involvement of social care networks. Recent findings: The family caregiver often accepts the caring as a natural action, presumably imposed by the society. A recent review described seven main roles of care which, according to family system and society, consist of different tasks and activities. To assume this role is not stress free. It is...
Source: Current Opinion in Supportive and Palliative Care - October 28, 2016 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone Source Type: research

Promoting patient-centred palliative care: a scoping review of the patient dignity question
Purpose of review: In recent years, there has been a growing interest in promoting dignity in care, and specific interventions have been developed to include it at the end of life. The patient dignity question (PDQ) is a recent, novel and simple intervention that healthcare professionals can implement; however, little information is known about its impact. This scoping review aims to examine and map out the PDQ literature. Recent findings: Studies suggest that patients, families and professionals have a positive view of the PDQ in that it helps to get to know patients and provide them with the best care possible. The PDQ ...
Source: Current Opinion in Supportive and Palliative Care - October 28, 2016 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone Source Type: research

Neuroleptics in the management of delirium in patients with advanced cancer
Purpose of review: Delirium is the most common and distressing neuropsychiatric syndrome in cancer patients. Few evidence-based treatment options are available due to the paucity of high quality of studies. In this review, we shall examine the literature on the use of neuroleptics to treat delirium in patients with advanced cancer. Specifically, we will discuss the randomized controlled trials that examined neuroleptics in the front line setting, and studies that explore second-line options for patients with persistent agitation. Recent findings: Contemporary management of delirium includes identification and management o...
Source: Current Opinion in Supportive and Palliative Care - October 28, 2016 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone Source Type: research

The impact of early palliative care on the quality of care during the last days of life: what does the evidence say?
Purpose of review: The aim of this review is to critically appraise the existing evidence on ‘early palliative care’ (EPC), discuss its relationship with advance care planning, and to reflect on the impact of EPC on the quality of care provided during the last days of life. Recent findings: There are indicators that EPC may help to avoid aggressive treatment, shorten hospital stay, improve overall quality of life, and to see more frequently dying and death at the preferred place of care. Summary: The evidence from randomized controlled trials supports the integration of palliative care early in the disease tr...
Source: Current Opinion in Supportive and Palliative Care - October 28, 2016 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone Source Type: research

Does physical exercise improve quality of life of advanced cancer patients?
Purpose of review: We discuss the principal issues about physical activity in advanced cancer patients through the analyses of the last articles and our experience in this field. Recent findings: The efficacy of exercise training intervention could improve quality of life (QOL), fatigue and well being in advanced cancer patients. Several published studies have included, nevertheless, patients with early stage of disease and more recently, populations of patients with local advanced tumors of the breast, rectum and lung, who are undergoing neoadjuvant therapy. Despite the insufficient sample of patients in these studies, p...
Source: Current Opinion in Supportive and Palliative Care - October 28, 2016 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo de Simone Source Type: research

Practical multimodal care for cancer cachexia
Purpose of review: Cancer cachexia is common and reduces function, treatment tolerability and quality of life. Given its multifaceted pathophysiology a multimodal approach to cachexia management is advocated for, but can be difficult to realise in practice. We use a case-based approach to highlight practical approaches to the multimodal management of cachexia for patients across the cancer trajectory. Recent findings: Four cases with lung cancer spanning surgical resection, radical chemoradiotherapy, palliative chemotherapy and no anticancer treatment are presented. We propose multimodal care approaches that incorporate n...
Source: Current Opinion in Supportive and Palliative Care - October 28, 2016 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Cachexia in children with chronic kidney disease: challenges in diagnosis and treatment
Purpose of review: Although cachexia is highly prevalent in adult patients with chronic kidney disease (CKD), it is understudied and less well characterized in children. Recent evidence suggests that cachexia is also prevalent in children with CKD but presents challenges in diagnosis and treatment. Recent findings: A study from the CKD in children cohort showed that CKD cachexia or protein-energy wasting, using modified pediatric diagnostic criteria, such as lack of expected weight gain instead of weight loss and BMI for height age, had a prevalence of 7–20%. When growth indices such as height SD score (SDS)/height ...
Source: Current Opinion in Supportive and Palliative Care - October 28, 2016 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research