Literature Review

What is renal cell carcinoma?JAMA; Rebecca Voelker, MSJ; 1/25Renal cell carcinoma is a common cancer that forms in the kidneys. In 2023, an estimated 81,800 people were diagnosed with renal cell carcinoma in the US, making it the sixth most common cancer among males and the ninth among females. Renal cell carcinoma is most often diagnosed in people aged 60 to 70 years. Although the diagnosis has increased slightly in the US in recent years, deaths from renal cell carcinoma have declined. Although the survival rate of stage IV renal cell carcinoma varies among individuals, the average 5-year survival is 28%.

Palliative care program for community-dwelling individuals with dementia and caregivers: The IN-PEACE randomized clinical trialJAMA Network; by Greg A. Sachs, Nina M. Johnson, Sujuan Gao, Alexia M. Torke, Susan E. Hickman, Amy Pemberton, Andrea Vrobel, Minmin Pan, Jennifer West, Kurt Kroenke; 1/25Among community-dwelling individuals with moderate to severe dementia, does a dementia care management program with integrated palliative care reduce patients’ neuropsychiatric symptoms? In this randomized clinical trial, a dementia care management program with integrated palliative care did not significantly improve patients’ neuropsychiatric symptoms.

Well-being and choosing the best job for youJAMA Internal Medicine; Jamile A. Ashmore, PhD; J. Michael DiMaio, MD; 1/25Well-being is emerging as the catch-all term describing the field dedicated to understanding and addressing the way in which the health care system, work environment, and individual interact to influence the fulfillment and meaning that health care workers derive from their work. Clinician well-being is often led by a chief wellness officer (CWO) or other executive leader who is compensated to focus on well-being. In addition to strategic planning and oversight, the CWO’s role is to ensure that well-being is considered in administrative and operational decisions including in those related to governance, rewards systems, and culture. Health care systems’ moving from the triple to the quadruple aim are signaling that they are committed to taking care of those that care for the patients. Indeed, health care systems cannot have optimal patient care without a healthy and fulfilled workforce. 

Digital meditation to target employee stress-A randomized clinical trialJAMA Network Open; Rachel M. Radin, PhD; Julie Vacarro, MA; Elena Fromer, BA; Sarah E. Ahmadi, BA; Joanna Y. Guan, BA; Sarah M. Fisher, MS; Sarah D. Pressman, PhD; John F. Hunter, PhD; Kate Sweeny, PhD; A. Janet Tomiyama, PhD; Lauren Tiongco Hofschneider, PhD; Matthew J. Zawadzki, PhD; Larisa Gavrilova, PhD; Elissa S. Epel, PhD; Aric A. Prather, PhD; 1/25Mental health is at an historic low in the US, and work stress may be a primary contributor. Work stress is associated with poorer emotional and physical well-being, as well as high absenteeism and low presenteeism. Participants were randomized 1:1 to a digital meditation program or the waiting list control condition. Participants in the intervention group were instructed to complete 10 minutes of meditation per day for 8 weeks. The findings suggest that participating in a brief digital mindfulness-based program is an effective method for reducing general and work-related stress in employees. 

Nurses' perspectives on end-of-life care for Black/African American patientsJournal of Hospice & Palliative Nursing; Aaron, Siobhan P. PhD, RN, FNP-BC; Supiano, Katherine PhD, LCSW, FT, FGSA, APHSW-C; DeSimio, Samantha BS; 2/25In this qualitative examination of health care disparities based on race and ethnicity, the accounts of Black/African American nurses shed light on a range of critical issues within the health care system. These issues encompass stereotyping, bias, and a notable absence of cultural competence among health care providers, which often result in unequitable treatment for patients of color. Socioeconomic factors, including insurance and income disparities, further exacerbate these inequalities. Discrimination, whether implicit or explicit, continues to affect diagnosis and treatment, with a particular focus on disparities in pain management. Furthermore, the cultural perspectives and historical context surrounding treatment preferences were explored, emphasizing the profound impact of health care literacy, cultural viewpoints, and historical mistrust, especially within the Black/African American community.

Defining spine cancer pain syndromes: A systematic review and proposed terminologyGlobal Spine Journal; Markian Pahuta, MD, PhD, FRCSC; Ilya Laufer, MD; Sheng-fu Larry Lo, MD; Stefano Boriani, MD; Charles Fisher, MD, MHSC, FRCSC; Nicolas Dea, MD, MSc, FRCSC; Michael H. Weber, MD, MSc, PhD, FRCSC; Dean Chou, MD; Arjun Sahgal, MD, FRCPC; Laurence Rhines, MD; Jeremy Reynolds, MB.ChB, BSc (Hons), FRCS; Aron Lazary, MD, PhD; Alessandro Gasbarrinni, MD; Jorrit-Jan Verlaan, MD, PhD; Ziya Gokaslan, MD, FACS; Chetan Bettegowda, MD, PhD; Mohamed Sarraj, MD; Ori Barzilai, MD; AO Spine Knowledge Forum Tumor; 1/25The spine is the most common site of osseous metastasis, and over one-third of patients with carcinoma or hematological malignancy will develop spinal metastases. Vertebral metastases have a negative impact on patient function and heath related quality of life (HRQoL). We consolidate the terminology used in the literature and consolidated into clinically relevant nomenclature of biologic tumor pain, mechanical pain, radicular pain, neuropathic pain, and treatment related pain. This review helps standardize terminology for cancer-related pain which may help clinicians identify pain generators.

Outpatient palliative care and end-of-life care intensity: Linking Massachusetts Cancer Registry with all-payer claimsJNCI Cancer Spectrum; Nancy L Keating, Joel S Weissman, Alexi A Wright, Robert Wolf, Susan Gershman, Richard Knowlton, John Z Ayanian; 1/25Early palliative care is associated with better outcomes for patients with advanced-stage cancers. Using a novel data linkage, we assessed outpatient palliative care use before death and its association with end-of-life care intensity and variation across eight provider networks. End-of-life care intensity varied across provider networks. Patients with palliative care visits had lower adjusted odds of receiving intensive end-of-life care ... 

Grant renews funding for pain and aging center Cornell Chronicle; by Weill Cornell Medicine; 1/30/25 The Translational Research Institute for Pain in Later Life (TRIPLL), a New York City-based center to help older adults prevent and manage pain, has been awarded a five-year, $5 million renewal grant from the National Institute on Aging (NIA). ... The institute seeks to apply insights from psychology, sociology, economics and communications to develop and implement effective pain management techniques that are acceptable to and practical for older adults.

Stories of bereavement: Examining medical students’ reflections on loss and griefOmega-Journal of Death and Dying; Johanna Shapiro, Nicholas Freeman, Alexis Nguyen, Nancy Dang, Yasaman Lorkalantari; 12/24Medical students in this study reported similar reactions to personal and professional loss, with some expected differences, such as students who experienced professional loss more often noting compassion for others and more frequently discussing managing the feelings of others, the importance of skill acquisition, processing personal emotions and team support. Students experiencing personal loss understandably appeared more focused on their own grief and more often commented about feelings of helplessness and numbness. Students in both groups reported little about how they coped with their grief or about receiving either informal or institutional support. The similarity of the essays, while due to many factors, may suggest internalizing pressures to conform to socially desirable narratives. Medical educators and clinical supervisors should help students develop effective coping skills in response to loss, provide better institutional support, and encourage students to tell authentic stories about their experiences of loss and grief. 

The 2024 election and potential battle for the social safety netJAMA Health Forum; Sara N. Bleich, PhD; Benjamin D. Sommers, MD, PhD; Rita Hamad, MD, PhD; 1/25Federal safety net programs play a major role in providing nutrition assistance, health insurance, income support, and much more to tens of millions of people with low incomes, including children, parents, and adults with disabilities or chronic conditions. Trump’s return to office for a second term with a Republican-controlled Senate and House leaves the future of the US social safety net unclear. Clinicians and public health professionals should elevate and advance strong evidence about the positive effects of the social safety net and the likely harms that would ensue if access or benefits are reduced.

Medical professionals’ perceptions of and experiences with terminally ill Orthodox Jewish patientsAmerican Journal of Hospice and Palliative Medicine; Moshe C. Ornstein, MD, MA; David Harris, MD; 1/25Orthodox Jewish patients with terminal illnesses have unique goals and desires, often driven by halakha (Jewish law and ethics) and cultural norms. Compared to the general population, Orthodox Jewish patients with terminal illnesses are more likely to request aggressive measures at end-of-life and are less likely to have completed advanced directives and health care power of attorney documentation. They also do not always have a rabbinic authority involved in decision-making. Health care professionals highlighted strong religious and community support as positive elements of caring for this population and recommend that medical teams establish early and direct communication with rabbinic authorities for those patients for whom a rabbi’s involvement is desired.

Disproportionate use of aid in dying among people with ALS: Why ALS aid-in-dying requests are common while ALS is rareJournal of Aid-in-Dying Medicine; Carolyn Rennels, MD; Steven Z. Pantilat, MD FAAHPM, MHM; Ambereen K. Mehta, MD, MPH, FAAHPM; Allison Kestenbaum, MA, MPA, BCC-PCHAC, ACPE; Kelsey Noble, DO; Jessica Besbris, MD; Ali Mendelson, MD; Kara Bischoff, MD; 12/24People with amyotrophic lateral sclerosis (ALS) disproportionately use aid in dying. We explore aspects of the ALS experience that may help explain the higher rates of aid-in-dying requests in this disease relative to others. In particular, the desire to maintain control is prominent in the face of a relentlessly progressive disease that results in substantial disability. We also describe how the requirement for self-administration of aid-in-dying medications impacts people with ALS.

High-cost cancer drug use in Medicare Advantage and Traditional MedicareJAMA Health Forum; Cathy J. Bradley, PhD; Rifei Liang, MA; Richard C. Lindrooth, PhD; Lindsay M. Sabik, PhD; Marcelo C. Perraillon, PhD; 1/25Traditional Medicare’s (TM) fee-for-service reimbursement encourages clinicians to provide higher-cost care, including prescribing expensive drugs when similar less expensive drugs are available. Medicare Advantage (MA) plans, where beneficiaries receive managed care almost exclusively from in-network hospitals and clinicians, were designed to reduce costs by paying a risk-adjusted capitated amount per member. In this cohort study of 4,240 patients with colorectal cancer (CRC) or non–small cell lung cancer (NSCLC), those with local or regional CRC who were insured by MA were less likely to receive a cancer drug, and of those patients, were less likely to receive a high-cost cancer drug than similar patients who were insured by TM. Patients diagnosed with distant NSCLC were less likely to receive a cancer drug if insured by MA compared to TM. MA appears to reduce high-cost drug utilization to treat patients with CRC, but not to treat those with NSCLC, in which few low-cost treatments exist.