The supportive roles of religion and spirituality in end-of-life and palliative care of patients with cancer in a culturally diverse context: a literature review
Purpose of review: This is a literature review of the supportive roles of religion and spirituality (R/S) in end-of-life (EoL) and palliative care of patients with cancer in a culturally diverse context. This review examines 26 noteworthy articles published between August 2013 and August 2014 from five well supported databases. Recent findings: Current evidence shows that R/S evokes in patients the sources to find the necessary inner strengths, which includes perspective thinking, rituals for transcending immediate physical condition and modalities of coping with their oncological illnesses. R/S are not a monolithically ex...
Source: Current Opinion in Supportive and Palliative Care - January 29, 2015 Category: Palliative Care Tags: SUPPORTIVE CARE AND PSYCHOLOGICAL ISSUES AROUND CANCER: Edited by Elie Isenberg-Grzeda and Janet Ellis Source Type: research

Existential distress among healthcare providers caring for patients at the end of life
Purpose of review: Existential distress is well documented among patients at end of life (EOL) and increasingly recognized among informal caregivers. However, less information is known about existential concerns among healthcare providers working with patients at EOL, and the impact that such concerns may have on professionals. Recent findings: Recent literature documents five key existential themes for professionals working in EOL care: (1) opportunity for introspection; (2) death anxiety and potential to compromise patient care; (3) risk factors and negative impact of existential distress; (4) positive effects such as en...
Source: Current Opinion in Supportive and Palliative Care - January 29, 2015 Category: Palliative Care Tags: SUPPORTIVE CARE AND PSYCHOLOGICAL ISSUES AROUND CANCER: Edited by Elie Isenberg-Grzeda and Janet Ellis Source Type: research

Improving the quality of end-of-life discussions
This article provides an update on the recent research and evidence regarding quality in end-of-life (EOL) discussions with a focus on the care of a person with cancer. Recent findings: Clinicians have the challenging task of customizing the information exchange that occurs during an EOL discussion. Patients identify important stipulations that accompany a desire for frank EOL discussions. These include timing of the discussion, ensuring evaluation of readiness to engage in the EOL discussion, and being invited to participate. The timing of an EOL discussion is likely to be more important than the setting in which an EOL d...
Source: Current Opinion in Supportive and Palliative Care - January 29, 2015 Category: Palliative Care Tags: SUPPORTIVE CARE AND PSYCHOLOGICAL ISSUES AROUND CANCER: Edited by Elie Isenberg-Grzeda and Janet Ellis Source Type: research

Desire for hastened death: exploring the emotions and the ethics
Purpose of review: As we approach the end of our lives, many of us will have a desire for hastened death (DHD). Fortunately, our ability to respond to suffering at the end of life is improving. At the same time, in many jurisdictions, changes are underway to legislate physician-assisted death. This compels us as clinicians to explore DHD in a compassionate way – to reduce suffering and reduce premature death. This challenge is becoming more compelling as a large cohort of individuals, who value autonomy and control, age and experience illness. Recent findings: Studies confirm that DHD is not always a request to die. ...
Source: Current Opinion in Supportive and Palliative Care - January 29, 2015 Category: Palliative Care Tags: SUPPORTIVE CARE AND PSYCHOLOGICAL ISSUES AROUND CANCER: Edited by Elie Isenberg-Grzeda and Janet Ellis Source Type: research

Supporting youth grieving the dying or death of a sibling or parent: considerations for parents, professionals, and communities
Purpose of review: The aim of this article is to highlight considerations for parents, professionals, and communities regarding supporting children and adolescents who are grieving the dying or death of a parent or sibling. Recent findings: Current research is directly engaging the voices of youth who have experienced a parent or sibling's death. Although there continues to be much evidence about the distressing effect of such deaths on children and adolescents, there is a welcome emerging tendency to distinguish between adaptive and maladaptive grief. Although the literature strongly encourages parents to take an open and...
Source: Current Opinion in Supportive and Palliative Care - January 29, 2015 Category: Palliative Care Tags: SUPPORTIVE CARE AND PSYCHOLOGICAL ISSUES AROUND CANCER: Edited by Elie Isenberg-Grzeda and Janet Ellis Source Type: research

Parenting challenges in the setting of terminal illness: a family-focused perspective
Purpose of review: In the advanced stages of illness, families with dependent children experience disruption across all dimensions of family life. The need for family support during palliative care is well recognized, yet little is understood about how parents and their children navigate these difficult circumstances. This review summarizes the current body of research on parenting challenges in advanced cancer. Recent findings: To date, the study of parental cancer has focused predominantly on the early stages of disease and its impact on children and adolescents. Less is known about how families with minor children prepa...
Source: Current Opinion in Supportive and Palliative Care - January 29, 2015 Category: Palliative Care Tags: SUPPORTIVE CARE AND PSYCHOLOGICAL ISSUES AROUND CANCER: Edited by Elie Isenberg-Grzeda and Janet Ellis Source Type: research

The central role of meaning in adjustment to the loss of a child to cancer: implications for the development of meaning-centered grief therapy
Purpose of review: This review describes research on meaning and meaning-making in parents who have lost a child to cancer, suggesting the need for a meaning-centered therapeutic approach to improve their sense of meaning, purpose, and identity and help with management of prolonged grief symptoms. Recent findings: Several studies have demonstrated that parents bereaved by cancer experience unique meaning-related challenges associated with the caregiving and illness experience, including struggles with making sense of their loss, benefit-finding, their sense of identity and purpose, disconnection from sources of meaning, an...
Source: Current Opinion in Supportive and Palliative Care - January 29, 2015 Category: Palliative Care Tags: SUPPORTIVE CARE AND PSYCHOLOGICAL ISSUES AROUND CANCER: Edited by Elie Isenberg-Grzeda and Janet Ellis Source Type: research

Understanding death with limited experience in life: dying children's and adolescents’ understanding of their own terminal illness and death
Purpose of review: An up-to-date summary of the literature on children's and adolescents’ understanding of their own terminal illness and death. Recent findings: Clinicians still find it difficult to speak with pediatric patients about death even though guidelines for facilitating communication on the topic exist. As a result, pediatric patients are less likely to develop a clear understanding of their illness and there is a disconnect between clinicians and parents about prognosis, even when clinicians have concluded there is no longer possibility for cure. Insufficient communication and poor understanding may incre...
Source: Current Opinion in Supportive and Palliative Care - January 29, 2015 Category: Palliative Care Tags: SUPPORTIVE CARE AND PSYCHOLOGICAL ISSUES AROUND CANCER: Edited by Elie Isenberg-Grzeda and Janet Ellis Source Type: research

Editorial, supportive care and psychological issues around cancer
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - January 29, 2015 Category: Palliative Care Tags: SUPPORTIVE CARE AND PSYCHOLOGICAL ISSUES AROUND CANCER: Edited by Elie Isenberg-Grzeda and Janet Ellis Source Type: research

Heart failure and palliative care: training needs assessment to guide priority learning of multiprofessionals working across different care settings
Purpose of review: International bodies acknowledge that palliative care principles and access to palliative care services should be offered to persons living with and dying from advanced illness such as heart failure. Without an appropriately trained workforce, however, appropriate goals of care and associated reductions in hospital utilizations may not be feasible. Marie Curie Cancer Care, British Heart Foundation Scotland and NHS Greater Glasgow and Clyde are working in partnership to improve the quality and access to palliative care for patients and their caregivers living with and dying from advanced heart failure. A ...
Source: Current Opinion in Supportive and Palliative Care - January 29, 2015 Category: Palliative Care Tags: CARDIAC AND CIRCULATORY PROBLEMS: Edited by James M. Beattie Source Type: research

Burden of caring: risks and consequences imposed on caregivers of those living and dying with advanced heart failure
Purpose of review: To summarize the latest research on the risks and consequences of the burden that may be imposed on informal carers of persons living and dying with advanced heart failure. Recent findings: A systematic search in PubMed over the period 2013–2014 ultimately revealed 24 original articles included in this review. From this research update it can be concluded that the body of knowledge increased with more studies focusing on caregivers of patients with advanced heart failure. Summary: Caregivers are important partners in care and their lives are seriously affected by the condition of advanced heart fai...
Source: Current Opinion in Supportive and Palliative Care - January 29, 2015 Category: Palliative Care Tags: CARDIAC AND CIRCULATORY PROBLEMS: Edited by James M. Beattie Source Type: research

Palliative and supportive care needs of heart failure patients in Africa: a review of recent developments
Purpose of review: Despite the rising prevalence of heart failure in Africa, it remains unclear what supportive and palliative care services are required to meet patient needs. This review highlights recent contributions to knowledge of the supportive and palliative care needs of heart failure patients in Africa. Recent findings: Multiple epidemiological studies demonstrate the population-level burden of heart failure in Africa, characterized by low levels of ischaemic heart disease and a young mean patient age. However, few studies have addressed patients’ specific palliative and supportive care needs. Only one rece...
Source: Current Opinion in Supportive and Palliative Care - January 29, 2015 Category: Palliative Care Tags: CARDIAC AND CIRCULATORY PROBLEMS: Edited by James M. Beattie Source Type: research

Palliative and end-of-life care issues in chronic kidney disease
Purpose of review: Patients with progressive chronic kidney disease (CKD) have high morbidity, mortality, and symptom burden. Cardiovascular disease (CVD) and congestive heart failure (CHF) often contribute to these burdens and should be considered when providing recommendations for care. This review aims to summarize recent literature relevant to the provision of palliative and end-of-life care for patients with progressive CKD and specifically highlights issues relevant to those with CVD and CHF. Recent findings: Dialysis may not benefit older, frail patients with progressive CKD, especially those with other comorbiditie...
Source: Current Opinion in Supportive and Palliative Care - January 29, 2015 Category: Palliative Care Tags: CARDIAC AND CIRCULATORY PROBLEMS: Edited by James M. Beattie Source Type: research

Palliative care issues in heart transplant candidates
Purpose of review: Heart failure is a serious condition and equivalent to malignant disease in terms of symptoms burden and mortality. Presently, only a comparatively small number of heart failure patients receive specialized palliative care. A literature search was conducted with the terms, palliative care and heart failure, using the electronic databases of PubMed and MEDLINE. Recent findings: Nine-hundred and five articles were reviewed and of those, 78 articles discussed clinical trials in palliative care and heart failure. A complex set of management tools and strategies were used and recommended, including but not li...
Source: Current Opinion in Supportive and Palliative Care - January 29, 2015 Category: Palliative Care Tags: CARDIAC AND CIRCULATORY PROBLEMS: Edited by James M. Beattie Source Type: research

Advanced heart failure, communication and the Goldilocks principle
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - January 29, 2015 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 - January 29, 2015 Category: Palliative Care Tags: Editorial Introductions Source Type: research

Correlates between basic science and therapeutic interventions: the theory and the practice: Erratum
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - December 1, 2014 Category: Palliative Care Tags: Erratum Source Type: research

Chronobiology of chronic pain: focus on diurnal rhythmicity of neuropathic pain
Purpose of review: Although circadian rhythmicity has long been recognized in various nociceptive pain conditions such as arthritis, diurnal pain patterns in neuropathic conditions have only recently been described. The purpose of this article is to review emerging evidence and discuss future research to further understand this phenomenon. Recent findings: Secondary analyses of neuropathic pain clinical trials demonstrate that pain intensity fluctuations exhibit a distinct diurnal pattern that contrasts that of nociceptive pain conditions. Ongoing preclinical investigations support the phenomenon of circadian pain fluctuat...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2014 Category: Palliative Care Tags: Special Commentary Source Type: research

Long-term benefits versus side-effects from bone-targeted therapies for cancer patients: minimizing risk while maximizing benefits
This article explores strategies to maximize the clinical benefit of such therapy while minimizing associated risks. (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - December 1, 2014 Category: Palliative Care Tags: BONE AND HAEMATOLOGICAL PROBLEMS: Edited by Allan Lipton and James R. Berenson Source Type: research

Bisphosphonates in adjuvant setting for breast cancer: a review of the meta-analysis of bisphosphonates’ effects on breast cancer recurrence presented in December 2013 at San Antonio Breast Conference
Purpose of review: Bisphosphonate therapy has been used as standard of care for patients with metastatic bone disease. As bisphosphonate had demonstrated antitumor effects in preclinical studies, it was natural to advance to the development of large phase 3 trials that would test the activity of bisphosphonate in the adjuvant setting. Surprisingly, the results of adjuvant breast cancer trials have shown either modest or contradictory effects. One of the most consistent results across the latest reports on this issue is that bisphosphonate shows benefit in the prevention of distant relapses in breast cancer women after meno...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2014 Category: Palliative Care Tags: BONE AND HAEMATOLOGICAL PROBLEMS: Edited by Allan Lipton and James R. Berenson Source Type: research

Bone-targeted therapies for cancer patients and bone cell biology: where do we stand?
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - December 1, 2014 Category: Palliative Care Tags: BONE AND HAEMATOLOGICAL PROBLEMS: Edited by Allan Lipton and James R. Berenson Source Type: research

End-of-life care: pathways and evidence
Purpose of review: Studies in different countries and settings of care have reported the quality of care for the dying patients as suboptimal. Care pathways have been developed with the aim of ensuring that dying patients and their family members received by health professionals the most appropriate care. This review presents and discusses the evidence supporting the effectiveness of the end-of-life care pathways. Recent findings: Two Cochrane systematic reviews updated at June 2013 did not identify studies that met minimal criteria for inclusion. One randomized cluster trial aimed at assessing the effectiveness of the Liv...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2014 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone Source Type: research

Trust and autonomy in end of life: considering the interrelation between patients and their relatives
Purpose of review: Patients’ autonomy is seen as a major issue in modern medicine but requires the ability to understand and rate an issue without being influenced by others. However, near the end of life, patients often decide considering the consequences for their relatives. Recent findings: Our study results and recent literature suggest that existing relational patterns determine experiences, family dynamics, and decision-making processes at the end of life. Relatives as a resource can promote patients’ autonomy. In doubt of the patients’ judgment or prioritizing their own needs, relatives can undermi...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2014 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone Source Type: research

Caregivers of people at the end of life: emerging evidence
Purpose of review: This review aims to identify and highlight recent evidence from studies that aim to improve outcomes for caregivers of patients living with life-limiting progressive conditions. It appears that although the volume and quality of studies reporting outcomes for this population is increasing, there is still a paucity of evidence that has reliable quality and can inform policy and practice. Recent findings: One trial has been reported, which found that a one-to-one psychoeducational intervention found no change in distress at 1 week after intervention but found improvements in preparedness and competence. Fo...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2014 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone Source Type: research

Opioids prescription for symptoms relief and the impact on respiratory function: updated evidence
Purpose of review: Opioids are used for treating dyspnea and other symptoms in oncological and nononcological patients. The relief of respiratory fatigue and anxiety that these opioids offer is well known. One of the scarcely frequent, but very much feared, side-effects is respiratory depression. The purpose of this review is to determine whether or not the situation of an advanced-stage patient under palliative care and the use of opioids are risk factors for respiratory depression. Recent findings: Studies conducted on respiratory function and opioids have proliferated in the past 10 years, but there is no recent review ...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2014 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone Source Type: research

Glycaemic control in end-of-life care
Purpose of review: Diabetes mellitus is one of the most common comorbidities in palliative care. Yet, the optimal handling of diabetes mellitus in dying patients is debated. This review aims to discuss comprehensively the scientific basis as of today for diabetes mellitus management decisions in end-of-life (EOL) care. Recent findings: Glycaemic control provides prognostic information in EOL care of diabetes mellitus patients. Original data on how to manage dying patients with type 2 diabetes mellitus are scarce. Findings in elderly type 2 diabetes mellitus patients and expert opinions support that glycaemic control should...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2014 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone Source Type: research

Role of corticosteroids for fatigue in advanced incurable cancer: is it a ‘wonder drug’ or ‘deal with the devil’
Purpose of review: Although corticosteroids are frequently used to palliate cancer-related symptoms, limited published studies are available. This review summarizes recent literature on the impact of corticosteroids on fatigue, its related symptoms, and the role of ‘corticosteroid rotation’ in improving the corticosteroid-related side-effects. Recent findings: Only two placebo-controlled double-blinded randomized studies on corticosteroid for symptoms that met the inclusion criteria were published recently, despite the criteria being extended beyond 2012 and 2013. These two studies confirm the preliminary data ...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2014 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Systemic inflammation in chronic obstructive pulmonary disease and lung cancer: common driver of pulmonary cachexia?
Purpose of review: In this article, a putative role of systemic inflammation as a driver of pulmonary cachexia induced by either chronic obstructive pulmonary disease or nonsmall cell lung cancer is reviewed. Gaps in current translational research approaches are discussed and alternative strategies are proposed to provide new insights. Recent findings: Activation of the ubiquitin proteasome system has generally been considered a cause of pulmonary cachexia, but current animal models lack specificity and evidence is lacking in nonsmall cell lung cancer and conflicting in chronic obstructive pulmonary disease patients. Recen...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2014 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Role of interleukin-6 in cachexia: therapeutic implications
Purpose of review: Interleukin-6 (IL-6) has emerged as a cytokine involved in cachexia progression with some cancers. This review will present the recent breakthroughs in animal models and humans related to targeting IL-6 as a cancer cachexia therapy. Recent findings: IL-6 can target adipose, skeletal muscle, gut, and liver tissue, which can all affect cachectic patient recovery. IL-6 trans-signaling through the soluble IL-6R has the potential to amplify IL-6 signaling in the cachectic patient. In the skeletal muscle, chronic IL-6 exposure induces proteasome and autophagy protein degradation pathways that lead to wasting. ...
Source: Current Opinion in Supportive and Palliative Care - December 1, 2014 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Discovering and targeting the epigenetic pathways to treat muscle loss: working toward a paradigm shift in cancer therapeutics
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - December 1, 2014 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Correlates between basic science and therapeutic interventions: the theory and the practice: Erratum
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: Erratum Source Type: research

Chronobiology of chronic pain: focus on diurnal rhythmicity of neuropathic pain
Purpose of reviewAlthough circadian rhythmicity has long been recognized in various nociceptive pain conditions such as arthritis, diurnal pain patterns in neuropathic conditions have only recently been described. The purpose of this article is to review emerging evidence and discuss future research to further understand this phenomenon. Recent findingsSecondary analyses of neuropathic pain clinical trials demonstrate that pain intensity fluctuations exhibit a distinct diurnal pattern that contrasts that of nociceptive pain conditions. Ongoing preclinical investigations support the phenomenon of circadian pain fluctuations...
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: Special Commentary Source Type: research

Long-term benefits versus side-effects from bone-targeted therapies for cancer patients: minimizing risk while maximizing benefits
This article explores strategies to maximize the clinical benefit of such therapy while minimizing associated risks. (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: BONE AND HAEMATOLOGICAL PROBLEMS: Edited by Allan Lipton and James R. Berenson Source Type: research

Bisphosphonates in adjuvant setting for breast cancer: a review of the meta-analysis of bisphosphonates’ effects on breast cancer recurrence presented in December 2013 at San Antonio Breast Conference
Purpose of reviewBisphosphonate therapy has been used as standard of care for patients with metastatic bone disease. As bisphosphonate had demonstrated antitumor effects in preclinical studies, it was natural to advance to the development of large phase 3 trials that would test the activity of bisphosphonate in the adjuvant setting. Surprisingly, the results of adjuvant breast cancer trials have shown either modest or contradictory effects. One of the most consistent results across the latest reports on this issue is that bisphosphonate shows benefit in the prevention of distant relapses in breast cancer women after menopa...
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: BONE AND HAEMATOLOGICAL PROBLEMS: Edited by Allan Lipton and James R. Berenson Source Type: research

Role of osteocytes in multiple myeloma bone disease
Purpose of reviewDespite the increased knowledge of osteocyte biology, the contribution of this most abundant bone cell to the development and progression of multiple myeloma in bone is practically unexplored. Recent findingsMultiple myeloma bone disease is characterized by exacerbated bone resorption and the presence of osteolytic lesions that do not heal because of a concomitant reduction in bone formation. Osteocytes produce molecules that regulate both bone formation and resorption. Recent findings suggest that the life span of osteocytes is compromised in multiple myeloma patients with bone lesions. In addition, multi...
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: BONE AND HAEMATOLOGICAL PROBLEMS: Edited by Allan Lipton and James R. Berenson Source Type: research

Bone-targeted therapies for cancer patients and bone cell biology: where do we stand?
No abstract available (Source: Current Opinion in Supportive and Palliative Care)
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: BONE AND HAEMATOLOGICAL PROBLEMS: Edited by Allan Lipton and James R. Berenson Source Type: research

End-of-life care: pathways and evidence
Purpose of reviewStudies in different countries and settings of care have reported the quality of care for the dying patients as suboptimal. Care pathways have been developed with the aim of ensuring that dying patients and their family members received by health professionals the most appropriate care. This review presents and discusses the evidence supporting the effectiveness of the end-of-life care pathways. Recent findingsTwo Cochrane systematic reviews updated at June 2013 did not identify studies that met minimal criteria for inclusion. One randomized cluster trial aimed at assessing the effectiveness of the Liverpo...
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone Source Type: research

Trust and autonomy in end of life: considering the interrelation between patients and their relatives
Purpose of reviewPatients’ autonomy is seen as a major issue in modern medicine but requires the ability to understand and rate an issue without being influenced by others. However, near the end of life, patients often decide considering the consequences for their relatives. Recent findingsOur study results and recent literature suggest that existing relational patterns determine experiences, family dynamics, and decision-making processes at the end of life. Relatives as a resource can promote patients’ autonomy. In doubt of the patients’ judgment or prioritizing their own needs, relatives can undermine p...
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone Source Type: research

Caregivers of people at the end of life: emerging evidence
Purpose of reviewThis review aims to identify and highlight recent evidence from studies that aim to improve outcomes for caregivers of patients living with life-limiting progressive conditions. It appears that although the volume and quality of studies reporting outcomes for this population is increasing, there is still a paucity of evidence that has reliable quality and can inform policy and practice. Recent findingsOne trial has been reported, which found that a one-to-one psychoeducational intervention found no change in distress at 1 week after intervention but found improvements in preparedness and competence. Follow...
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone Source Type: research

Opioids prescription for symptoms relief and the impact on respiratory function: updated evidence
Purpose of reviewOpioids are used for treating dyspnea and other symptoms in oncological and nononcological patients. The relief of respiratory fatigue and anxiety that these opioids offer is well known. One of the scarcely frequent, but very much feared, side-effects is respiratory depression. The purpose of this review is to determine whether or not the situation of an advanced-stage patient under palliative care and the use of opioids are risk factors for respiratory depression. Recent findingsStudies conducted on respiratory function and opioids have proliferated in the past 10 years, but there is no recent review that...
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone Source Type: research

Glycaemic control in end-of-life care: fundamental or futile?
Purpose of reviewDiabetes mellitus is one of the most common comorbidities in palliative care. Yet, the optimal handling of diabetes mellitus in dying patients is debated. This review aims to discuss comprehensively the scientific basis as of today for diabetes mellitus management decisions in end-of-life (EOL) care. Recent findingsGlycaemic control provides prognostic information in EOL care of diabetes mellitus patients. Original data on how to manage dying patients with type 2 diabetes mellitus are scarce. Findings in elderly type 2 diabetes mellitus patients and expert opinions support that glycaemic control should be ...
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone Source Type: research

End-of-life matters in chronic renal failure
Purpose of reviewThe population considered eligible for dialysis has expanded dramatically over the past 4 decades, so that a significant proportion of patients receiving renal replacement therapy are elderly, frail and infirm. These patients have an extremely limited life expectancy and suffer from significant symptom burden, similar to patients with other end-stage organ failure or cancer. As dialysis has been offered more broadly, it is now initiated earlier than in decades past, further adding to cost and patient burden. Recent findingsThe trend toward more expansive and intensive care has not been corroborated by robu...
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone Source Type: research

End-of-life matters in chronic heart failure patients
Purpose of reviewUntil recently, concepts of care for people with heart failure had rarely included preparation for unavoidable imminent death or caring for the dying.The purpose of this review is to provide an update on current end-of-life issues specific to heart failure patients. Recent findingsMortality in the heart failure population remains high, especially shortly after the first acute heart failure hospitalization. Patients with systolic heart failure die more frequently from progressive heart failure or sudden cardiac death; patients with diastolic heart failure for noncardiovascular reasons and sudden cardiac dea...
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone Source Type: research

Indications and practice of artificial hydration for terminally ill cancer patients
Purpose of reviewTo update medical professionals on the role of artificial hydration in terminally ill cancer patients and to highlight recent research. Recent findingsFirst, we explain dehydration-related symptoms such as sensation of thirst, fatigue, and delirium. A multicenter, double-blinded, placebo-controlled randomized trial showed that artificial hydration did not improve dehydration symptoms, quality of life, or survival in terminally ill cancer patients. Then we explain overhydration-related symptoms such as bronchial secretion, pleural effusion, nausea/vomiting, ascites, and peripheral edema.The establishment of...
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Exploiting the therapeutic potential of leptin signaling in cachexia
Purpose of reviewThe anorexia-cachexia syndrome is a complication of many chronic conditions including cancer, chronic obstructive pulmonary disease, congestive heart failure, and chronic kidney disease (CKD). Leptin levels are significantly elevated in CKD patients and are associated with markers of poor nutritional status as well as mortality and morbidity. This review will focus on the mechanism and exploit the therapeutic potential of leptin signaling in CKD-associated cachexia. Recent findingsStudies in db/db mice show that the lack of leptin receptor is protective against CKD-induced cachexia. Blockade of leptin's do...
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Role of corticosteroids for fatigue in advanced incurable cancer: is it a ‘wonder drug’ or ‘deal with the devil’
Purpose of reviewAlthough corticosteroids are frequently used to palliate cancer-related symptoms, limited published studies are available. This review summarizes recent literature on the impact of corticosteroids on fatigue, its related symptoms, and the role of ‘corticosteroid rotation’ in improving the corticosteroid-related side-effects. Recent findingsOnly two placebo-controlled double-blinded randomized studies on corticosteroid for symptoms that met the inclusion criteria were published recently, despite the criteria being extended beyond 2012 and 2013. These two studies confirm the preliminary data that...
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Systemic inflammation in chronic obstructive pulmonary disease and lung cancer: common driver of pulmonary cachexia?
Purpose of reviewIn this article, a putative role of systemic inflammation as a driver of pulmonary cachexia induced by either chronic obstructive pulmonary disease or nonsmall cell lung cancer is reviewed. Gaps in current translational research approaches are discussed and alternative strategies are proposed to provide new insights. Recent findingsActivation of the ubiquitin proteasome system has generally been considered a cause of pulmonary cachexia, but current animal models lack specificity and evidence is lacking in nonsmall cell lung cancer and conflicting in chronic obstructive pulmonary disease patients. Recent st...
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Psychosocial, educational and communicative interventions for patients with cachexia and their family carers
Purpose of reviewCancer cachexia has a substantial impact on both patients and their family carers. It has been acknowledged as one of the two most frequent and devastating problems of advanced cancer. The impact of cachexia spans biopsychosocial realms. Symptom management in cachexia is fraught with difficulties and globally, there remains no agreed standard care or treatment for this client group. There is a need to address the psychosocial impact of cachexia for both patients and their family carers. Recent findingsPatients living at home and their family carers are often left to manage the distressing psychosocial impa...
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Immunomodulatory agents for the treatment of cachexia
This article covers the role of inflammatory response in cachexia, measurement of inflammatory response, mechanism and measurement of cachexia, immunomodulation in cancer, drugs targeting inflammatory cytokines, effect of exercise in cachexia, and treatment of cancer cachexia using immunomodulatory agents. SummaryUnderstanding the immune response associated with cachexia may improve future pharmacological modification of the cytokines. In addition, the multifactorial contributions to the mechanisms of cachexia indicate that a multimodal approach may be necessary to treat cachexia and its associated symptoms. (Source: Curre...
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research

Role of interleukin-6 in cachexia: therapeutic implications
Purpose of reviewInterleukin-6 (IL-6) has emerged as a cytokine involved in cachexia progression with some cancers. This review will present the recent breakthroughs in animal models and humans related to targeting IL-6 as a cancer cachexia therapy. Recent findingsIL-6 can target adipose, skeletal muscle, gut, and liver tissue, which can all affect cachectic patient recovery. IL-6 trans-signaling through the soluble IL-6R has the potential to amplify IL-6 signaling in the cachectic patient. In the skeletal muscle, chronic IL-6 exposure induces proteasome and autophagy protein degradation pathways that lead to wasting. IL-6...
Source: Current Opinion in Supportive and Palliative Care - October 30, 2014 Category: Palliative Care Tags: CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser Source Type: research