Surgical Oncology Clinics of North America This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Advanced Endoscopic Techniques for the Diagnosis of Pancreatic Cancer and Management of Biliary and GastricOutlet Obstruction
Following high-quality imaging studies for staging, endoscopic ultrasound examination fine needle aspiration/biopsy is the preferred modality for tissue diagnosis of pancreatic cancer. Endoscopic retrograde cholangiopancreatography with metal stent placement is used for palliation of malignant biliary obstruction. Metal stents can be placed in patients with resectable pancreatic cancer in whom surgery is going to be delayed. For palliation of gastric outlet obstruction, endoscopic enteral stenting is often selected because of its less invasiveness. Endoscopic ultrasound-guided biliary drainage for malignant biliary obstruc...
Source: Surgical Oncology Clinics of North America - July 21, 2021 Category: Surgery Authors: Yousuke Nakai, Zachary Smith, Kenneth J. Chang, Kulwinder S. Dua Source Type: research

Minimally Invasive Techniques for Pancreatic Resection
There is increasing interest in the role of minimally invasive surgery (MIS) for pancreatectomy. Prospective data indicate significant advantages for MIS when performed for left-sided pancreatic pathologies and may be deemed as the standard of care. However, there is reluctance in implementing this technique to pancreaticoduodenectomy because of the complexity of the operation and the mixed results from randomized trials. A detailed description of the technical aspects of robotic pancreaticoduodenectomy and distal pancreatectomy is presented in this article in addition to a summary of the most important prospective and coh...
Source: Surgical Oncology Clinics of North America - July 21, 2021 Category: Surgery Authors: Ibrahim Nassour, Alessandro Paniccia, A. James Moser, Amer H. Zureikat Source Type: research

Current Guidelines for Integration of Palliative Care in Oncology
Multiple cancer societies and professional medical organizations recommend integration of palliative care into routine oncology care. A growing body of literature supports the benefits of palliative care in patients with cancer. Palliative care improves pain and other symptoms, enhances quality of life, and reduces depression. The best method and timing for integration of palliative care is unclear. Multiple barriers exist that prevent optimal palliative care integration; these barriers will require additional education and research to overcome. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Bridget N. Fahy Source Type: research

Considerations in the Management of Malignant Bowel Obstruction
Malignant bowel obstruction is a challenging clinical problem encountered in patients with advanced abdominal and pelvic malignancies. Although medical therapies form the foundation of management, some patients may be suitable candidates for surgical and procedural interventions. The literature is composed primarily of retrospective single-institution experiences and the results of prospective trials are pending. Given the high symptom burden and limited life expectancy of these patients, management may be best informed by multidisciplinary teams with relevant expertise. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Caitlin T. Yeo, Shaila J. Merchant Source Type: research

A Palliative Approach to Management of Peritoneal Carcinomatosis and Malignant Ascites
In addition to severe, life-limiting complications such as malignant bowel obstruction, fistulae, and malignant ascites, peritoneal carcinomatosis frequently causes life-impacting symptoms such as pain, nausea, anorexia, cachexia, and fatigue. A variety of medical, interventional, and surgical therapies are now available for management of both complications and symptoms. Although surgery in this population is often associated with a relatively high risk of morbidity and mortality, operative intervention can offer effective palliative treatment in appropriately selected patients. Early involvement of palliative care special...
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Josh Bleicher, Laura A. Lambert Source Type: research

Artificial Nutrition in Patients with Advanced Malignancy
Cancer is a progressive disease that can lead to malnutrition and cachexia. Artificial nutrition is a medical therapy used to combat malnutrition in these patients. In this article, the authors discuss factors affecting the decision to use artificial nutrition, including the patient ’s mental and physical health, technical factors of the procedures used to deliver artificial nutrition, and the oncologic factors affecting treatment. Through this review, the authors provide guidelines on who is and is not likely to benefit from therapy, available routes of administration, and n ecessary factors to consider for appropriate ...
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Ramses Saavedra, Bridget N. Fahy Source Type: research

Selecting Patients for Palliative Procedures in Oncology
Surgical palliation in oncology can be defined as “procedures employed with non-curative intent with the primary goal of improving symptoms caused by an advanced malignancy,” and is an important aspect of the end-of-life care of patients with incurable malignancies. Palliative interventions may provide great benefit, but they also carry high ri sk for morbidity and mortality, which may be minimized with careful patient selection. This can be done by consideration of the patient and his or her indication for the given intervention via open communication, as well as prediction of benefits and risks to define the therapeu...
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Cassandra S. Parker, Thomas J. Miner Source Type: research

Palliative Radiotherapy for Advanced Cancers
Palliative radiotherapy (PRT) is well-tolerated, effective treatment for pain, bleeding, obstruction, and other symptoms/complications of advanced cancer. It is an important component of multidisciplinary management. It should be considered even for patients with poor prognosis, because it can offer rapid symptomatic relief. Furthermore, expanding indications for treatment of noncurable disease have shown that PRT can extend survival for select patients. For those with good prognosis, advanced PRT techniques may improve the therapeutic ratio, maximizing tumor control while limiting toxicity. PRT referral should be consider...
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Graeme R. Williams, Shwetha H. Manjunath, Anish A. Butala, Joshua A. Jones Source Type: research

Palliative Chemotherapy and the Surgical Oncologist
Outcomes are improving for patients with advanced cancer, in part because of increasing diversity and efficacy of systemic therapy, often described as “palliative chemotherapy.” Patients with advanced cancer receiving systemic treatment sometimes require surgical interventions, and their cancer care teams must collaborate to optimally manage medical and surgical challenges while also considering patients’ goals and values. Structured communi cation can overcome the inherent ambiguity of the term “palliative chemotherapy” and facilitate optimal quality of care and quality of life for patients with advanced cancer ...
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Elizabeth Wulff-Burchfield, Lori Spoozak, Esm é Finlay Source Type: research

Role of Palliative Medicine Training in Surgical Oncology
The importance of integrated palliative care in surgical oncology has been established by high-level evidence demonstrating improved patient-centered outcomes. There has been substantial improvement in efforts to incorporate palliative medicine training into medical and surgical education over the last decade. However, although trainees may feel confident in managing patients at the end of life, they may not have the insight or proficiency to provide optimal palliative care. Surgeons and palliative care physicians should collaborate on methods to optimize palliative care education for both trainees and practicing surgeons....
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Alexandra C. Istl, Fabian M. Johnston Source Type: research

Navigating Difficult Conversations
Surgeons who provide care for patients with cancer are sometimes tasked with challenging conversations. Approaching difficult communications using a structured approach for delivering difficult news and exploring goals of care can help surgeons provide support to patients and their families. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Elizabeth J. Lilley Source Type: research

Strategies for Optimizing Perioperative Pain Management for the Cancer Patient
Effective management of pain in patients with cancer impacts quality of life and willingness to receive disease-directed treatment. This review focuses on preoperative, intraoperative, and postoperative strategies for management of perioperative pain in the patient with cancer. Managing perioperative pain in special populations, including patients with preoperative opioid use, those with a history of substance abuse, and patients near the end of life are also addressed. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Breana L. Hill, Carolyn Lefkowits Source Type: research

Evaluation and Management of Malignant Biliary Obstruction
There is no reason to be pollyannaish when approaching patients with malignant biliary obstruction (MBO). Although technology has allowed refining diagnosis and resectability of cancers causing biliary obstruction, outcomes have not improved significantly. The previous preponderant place of surgical procedures now is replaced by endoluminal and percutaneous techniques for the management of symptoms of MBO. Because quantity of life often is the primary and sole outcome for evaluation of various interventions, the main focus of patient quality of life may be erroneously deemphasized. Lagging behind scientific advances are th...
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Nadia V. Guardado, Kaysey Llorente, Benoit Blondeau Source Type: research

Ethical Considerations in Caring for Patients with Advanced Malignancy
This article uses a case-based approach to explore the balance between prognostication and directive counsel; affective forecasting and decisional regret; hope and the therapeutic misconception; and issues of patient ownership and abandonment at the end of life. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Alyssa K. Ovaitt, Susan McCammon Source Type: research

Palliative Care in Surgical Oncology
This issue of the Surgical Oncology Clinics of North America focuses on Palliative Care in Surgical Oncology. The World Health Organization defines palliative care as “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual.”1 Palliative care improves the quality of life of patients and that of their families who are facing challenges associated with life...
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Timothy M. Pawlik Tags: Foreword Source Type: research