Literature Review

Is extending life by weeks worth the toll some cancer drugs take? Doctors push for 'common-sense oncology' CBC News, by Amina Zafar and Christine Birak; 3/11/24 People may celebrate a 2-week improvement in survival without acknowledging costs. When a treatment buys a few weeks or months but comes with with a lot of side-effects, then the perspectives of people with cancer may differ, says Dr. Christopher Booth. ... The goal of what they call "common-sense oncology" is to prioritize treatments that meaningfully improve survival and quality of life. They aim to address what they see as problems in the field, such as a lack of critical thinking in oncology training, falling standards for drug approvals and avoidance of end-of-life discussions.

Facing dementia: clarifying end-of-life choices, supporting better lives EurekAlert!, by The Hastings Center; 3/11/24A new Hastings Center special report considers how America’s aging society responds to the needs and concerns of people facing dementia. ... Three essays reconsider familiar ways of thinking and talking about decision-making and care concerning people nearing the end of life to better reflect the needs and concerns of people facing dementia. For example, “Too Soon or Too Late: Rethinking the Significance of Six Months When Dementia Is a Primary Diagnosis” takes a critical look at the “six-month rule.”

When health care is woven in our family fabric, we find support in unexpected places Oncology Nursing Society (ONS) Voice, by Suzanne M. Mahon, DNS, RN, AOCN®, AGN-BC, FAAN; 3/7/24... We have a built-in support system in our family. We understand all of those feelings and stressors in each other. We just get it. ... Where is your dinner table of support? Who is your go-to person who just gets it and listens? My husband and daughters support me, and I also have friends from nursing school, the workplace, and ONS who support me. They make all the difference in the world. Today, take time to thank your own support team.

Palliative care: A compassionate approach for mesothelioma patientsSurviving Mesothelioma, by Holly Zink; 3/10/24Mesothelioma is a rare and aggressive cancer linked to asbestos exposure. It poses significant challenges to those diagnosed and their loved ones. The disease affects the lining of the lungs (pleura). But it can also occur in the lining of the abdomen (peritoneum) and other organs. Mesothelioma has an average survival rate ranging from 8 to 14 months post-diagnosis. Managing the physical, emotional, and practical aspects of this condition is important.

Programmatic palliative care consultations in pediatric heart transplant evaluations Pediatr Cardiol, by Erika J Mejia, Rui Xiao, Jennifer K Walter, Chris Feudtner, Kimberly Y Lin, Aaron G DeWitt, Meeta Prasad Kerlin; 3/8/24 Guidelines advocate for integrating palliative care into the management of heart failure (HF) and of children with life-limiting disease. The potential impact of palliative care integration into pediatric HF on patient-centered outcomes is poorly understood. The present study sought to assess the association of programmatic implementation of palliative care into the heart transplant evaluation process with hospital-free days (HFD) and end of life (EOL) treatment choices. 

Compassionate extubation and beyond: Is there a need for more guidance in managing end-of-life in the intensive care unit? Chest Physician, by Angela L. Birdwell, DO, MA; Nehan Sher, MD  Approximately 20% of deaths in the United States occur during or shortly after a stay in the ICU and approximately 40% of ICU deaths involve withdrawal of artificial life support (WOALS) or compassionate extubation. ... How the team approaches WOALS can make a difference to both patients and decision-makers. Unfortunately, there is striking variation in practice and lack of guidance in navigating issues that arise at end-of-life in the ICU. 

Palliative care across the spectrum of heart failure JACC Heart Fail;  y Laura P Gelfman, Moritz Blum, Modele O Ogunniyi, Colleen K McIlvennan, Dio Kavalieratos , Larry A Allen; online ahead of print 2/27/24; print 3/8/24 Persons with heart failure (HF) often suffer from poor symptom control, decreased quality of life, and poor communication with their health care providers. ... New models are required that are better informed by high-quality data, engage a range of health care providers in primary palliative care principles, and have clear triggers for specialty palliative care engagement, with specific palliative interventions tailored to patient's illness trajectory and changing needs.

Healthcare access dimensions and racial disparities in end-of-life care quality among ovarian cancer patients Cancer Research Communications; by Shama Karanth, Oyomoare L. Osazuwa-Peters; Lauren E. Wilson, Rebecca A. Previs, Fariha Rahman, Bin Huang, Maria Pisu, Margaret Liang, Kevin C. Ward, Maria J. Schymura, Andrew Berchuck, and Tomi F. Akinyemiju; 3/5/24 This study investigated the association between healthcare access (HCA) dimensions and racial disparities in end-of-life (EOL) care quality among Non-Hispanic Black (NHB), Non-Hispanic White (NHW), and Hispanic patients with ovarian cancer (OC).

Johns Hopkins study reveals medical marijuana lowers pain, hospital visits BNN, by Wojciech Zylm; 3/5/24Recent research highlights significant improvements in well-being for cannabis users, offering hope for those with chronic illnesses. The study showcases a potential shift in the perception and utilization of medical cannabis in healthcare.

Understanding the role algorithms play in our lives and navigating palliative careListen - Life Matters, by Hilary Harper, presenter podcast; 3/4/24Every day, we interact with dozens of algorithms as we go about our lives, but many of us don't understand how they work. How do we get the the best out of these tools while keeping the potential dangers in check?Editor's Note: From palliative care experts Australia; information about algorithms and Artificial Intelligence (AI) transfers to our USA palliative care (of course, without applications to CMS systems).

Creating comfort through communication: Strategies for supporting mental wellbeing in palliative careWorldHealth.net; 3/4/24... To provide comprehensive and compassionate care, this article explores the various strategies for communicating and supporting mental well-being in palliative care. 

Obstacles and opportunities for palliative care in the ICU Palliative Care News, by Rachel Edwards; 3/1/24A growing body of research touts the benefits of palliative care for patients, families, and even providers. However, when evaluated through randomized clinical trials, the results tend to lean toward mediocre. Palliative Care News spoke with experts in the field to unpack the reasons behind those results and identify the obstacles that are getting in the way of a more effective approach.

Many older adults don't receive palliative care before deathMedScape, by Marilynn Larkin; 2/28/24 "One of the challenges and a barrier to accessing palliative home care is the difficulty of predicting survival," Amy Hsu, PhD, an investigator at the Bruyère Research Institute in Ottawa, Ontario, Canada, told Medscape Medical News. "Clinicians are good at prognosticating when a patient might be entering their last 3-6 weeks of life, but they have a harder time predicting if someone will survive 6 months or longer."  The team developed the Risk Evaluation for Support: Predictions for Elder-life in their Communities Tool (RESPECT) to see whether access to predicted survival data could inform conversations about a patient's status and palliative care needs. The study was published online on February 26 in the Canadian Medical Association Journal.