Literature Review

Too late to help? Disparities in palliative and hospice care among veterans with pancreatic cancer—A 10-year retrospective study at a VA medical centerJournal of Clinical Oncology; by Jonathan Blackmon, Mirza Mashaal Khan, Rahul Reddy Tirumalareddy, Zohair  Siddiqui, Saurin Chokshi, Alva Bowen Weir III; 1/26Pancreatic cancer is characterized by high symptom burden, rapid progression, and poor prognosis. ASCO [American Society of Clinical Oncology] guidelines recommend palliative care consultation at diagnosis or within 8–12 weeks. Despite guideline recommendations, many patients with pancreatic cancer did not receive timely palliative or hospice care. Delays were more pronounced among rural and Black patients, highlighting persistent disparities in access. These findings support the implementation of a quality improvement initiative at the Memphis VA to standardize early palliative care referrals for high-risk populations.

Acupuncture and acupressure for cancer symptom management: An opinion statement based on preliminary evidence mappingCurrent Treatment Options in Oncology; by Nada Lukkahatai, Jingyu Zhang, Chitchanok Benjasirisan, Sutthida Phongphanngam, Aomei Shen, Phakjira Jaiman, Jennifer Kawi, Thomas J. Smith, Leorey N. Saligan; 1/26 Symptom management remains a critical priority in oncology, particularly as many survivors continue to experience fatigue, pain, sleep disturbance, neuropathy, and psychological distress despite advances in treatment. Conventional pharmacologic options often provide only partial relief and may be limited by side effects. Acupuncture and acupressure have emerged as promising non-pharmacologic approaches, but the supporting evidence is drawn from a broad and heterogeneous literature. In this opinion paper, we provide a preliminary overview of the current review-level evidence to highlight general trends and evolving areas of promise, while emphasizing the need for further sham-controlled studies to clarify effectiveness and guide integration of acupuncture and acupressure into supportive oncology.

Research study participation, 2/21/26

Assistive intelligence: A framework for AI-powered technologies across the dementia continuumJournal of Ageing & Longevity; by Bijoyaa Mohapatra, Reza Ghaiumy Anaraky; 1/26While traditional [dementia] care models often focus on symptom management in later stages, emerging artificial intelligence (AI) technologies offer new opportunities for proactive and personalized support across the dementia trajectory. This concept paper presents the Assistive Intelligence framework, which aligns AI-powered interventions with each stage of dementia: preclinical, mild, moderate, and severe. These are mapped across four core domains: cognition, mental health, physical health and independence, and caregiver support. We illustrate how AI applications, including generative AI, natural language processing, and sensor-based monitoring, can enable early detection, cognitive stimulation, emotional support, safe daily functioning, and reduced caregiver burden. The paper also addresses critical implementation considerations such as interoperability, usability, and scalability, and examines ethical challenges related to privacy, fairness, and explainability.

Sociodemographic disparities and impact of palliative care utilization during end-of-life hospitalizations in patients with gastric cancerJournal of Palliative Medicine; by James Lee, Jasmine Lee, Rahul Tripathi, David Stein, Ballakur Rao, Daniel Jamorabo, Lisa Fisher; 1/26Gastric cancer is frequently diagnosed at an advanced stage and is associated with high symptom burden. Among 13,435 weighted hospitalizations [among gastric cancer patients who died during hospitalization] ..., 57.6% received palliative care. Black patients had 32% lower odds of receiving palliative care than White patients ... Higher palliative care use was associated with greater income, large hospitals, urban teaching hospitals, and private/other insurance. In adjusted analyses, palliative care was linked to a $36,240 reduction in hospital charges ..., with no significant difference in LOS [length of stay]. Palliative care was associated with higher odds of DNR status ... and lower odds of CPR, mechanical ventilation, transfusion, and vasopressor use.

Presence experiences after loss: Prevalence and relational meaning in a diverse urban sampleOmega; Claire White, Anna Mathiassen, Ronald Fischer; 1/26Presence experiences-the sense that a significant person who has died is nearby or perceptible-are common after bereavement but remain underexamined in grief research. This study ... [revealed that] ... over two-thirds of participants reported having ever experienced a presence, with nearly half reporting at least one occurrence in the past two weeks. These experiences were most commonly reported as a general feeling of presence, rated as both significant and welcome. Participants frequently interpreted encounters as meaningful attempts at contact and preferred disclosing these experiences to close social connections rather than institutional figures. These findings highlight presence experiences as common, relationally shaped, and culturally interpreted aspects of bereavement.

Palliative external beam radiation therapy for dysphagia in a 101-year-old man with esophageal adenocarcinomaCureus; by Pericles J. Ioannides, Jester M. Odrunia, Gina N. Perez, Morgan Butow, Georg A. Weidlich; 1/26Esophageal adenocarcinoma in centenarians is rare, and treatment options in this age group are limited. We present the case of a 101-year-old male patient with symptomatic distal gastroesophageal junction (GEJ) adenocarcinoma who presented with progressive dysphagia, aspiration, and weight loss. The patient underwent palliative external beam radiation therapy (EBRT) ... targeting the obstructive esophageal mass with a margin using volumetric-modulated arc therapy (VMAT) technique. The treatment was well tolerated by the patient with no significant acute toxicity. After treatment, the patient reported clinically meaningful improvement in functional status, with improved swallowing, advancing from liquids to a soft diet, weight gain, and improved QoL. Moderate-dose palliative radiation can be a safe and effective treatment in a centenarian with obstructive GEJ adenocarcinoma, particularly when endoscopic interventions are not successful or durable.

Advance care planning for patients with hematologic malignancies: A narrative reviewAmerican Journal of Hospice & Palliative Medicine; by Olivia M. Seecof; 1/26Advance care planning (ACP) completion rates are higher in patients with serious illness compared to the general population, however, ACP is overall under-utilized and sub-optimal, especially for patients with hematologic malignancies. This patient population can experience unique and significant physical and psychological symptoms due to their illness and the treatment, resulting in high rates of aggressive end of life care. This high healthcare utilization pattern often triggers ACP conversations and documentation, often facilitated by specialty palliative care clinicians. This review article examines existing literature about ACP for patients with hematologic malignancies with the intent to inform future prospective research to improve values-based patient care.

Positive experiences of seriously ill lesbian, gay, bisexual, transgender, and queer persons and their partners with healthcare providers: Project Respect American Journal of Hospice and Palliative Medicine; by Cathy Berkman, PhD, MSW, Gary L. Stein, JD, MSW, Noelle Marie Javier, MD, Kimberly D. Acquaviva, PhD, MSW, David Godfrey, JD, Sean O’Mahony, MD, Shail Maingi, MD, Carey Candrian, PhD, Christian González-Rivera, MUP, Imani Woody, PhD, and William E. Rosa, PhD; 1/24/26 Results: There were numerous reports of respectful, affirming, and competent care, including: healthcare providers who were open about discussing a respondent’s LGBTQ+ identity and their specific health concerns; intake and assessment forms that included pre-specified choices for sexual orientations and gender identities; using correct names, pronouns, and gender; healthcare providers who identified as LGBTQ+ or signaled being an ally; and treating spouses, partners, and widows respectfully and including them in decision-making.

Medical Aid in Dying and our ethical duties—Call to actionJAMA Health Forum; by Yesne Alici, Liz Blackler, Julia Danielle Kulikowski, Amy Scharf; 1/26Medical aid in dying (MAID) is legal in 11 US states and Washington, DC, and is being actively considered in 18 additional states ... In all jurisdictions where MAID is legal, hospital systems have the option to opt out of providing MAID services but are legally obligated to share information about where patients can access resources. We maintain that all hospital systems and individual clinicians have an ethical responsibility to go beyond simply sharing information. Patients are going to ask about MAID, and institutions are ethically obligated to establish comprehensive policies that empower and encourage their clinical staffs—primarily physicians but also nurses and advanced practice clinicians—to purposefully and thoughtfully respond. Here, we describe the experience of our institution, Memorial Sloan Kettering Cancer Center (MSK), in developing policies and procedures to fulfill this responsibility and highlight lessons for other health care organizations and oncology practices seeking to accomplish similar goals.

Preparing for the inevitable: a scoping review of death and dying education in U.S. medical schoolsAcademic Medicine; by Logan Patterson, Autumn Decker, Angelique King, Anna Roman, Cory Bolkan, Raven H Weaver; 1/26There remains a sizeable gap in evidence-based medical education related to knowledge, skills, and abilities pertaining to end-of-life care. The authors offer next steps for developing, implementing, and measuring evidence-based interventions to improve end-of-life care competency. The authors advocate for continued implementation of evidence-based educational interventions, regardless of anticipated specialty area, throughout all preclinical and clinical years.