Literature Review

[The Netherlands] The focus on life-prolonging anticancer treatment hampers shared decision-making in people with advanced cancer: A qualitative embedded multiple-case studyPalliative Medicine; Daisy Jm Ermers, Maartje J van Geel, Yvonne Engels, Demi Kellenaers, Anouk Sj Schuurmans, Floortje K Ploos van Amstel, Carla Ml van Herpen, Yvonne Schoon, Henk J Schers, Kris Cp Vissers, Evelien Jm Kuip, Marieke Perry; 9/24Implementing shared decision-making in oncology practice is often limited, particularly integrating the patient's context into decision-making. Four themes were identified [in this study]: shared decision-making is a dynamic and continuous process (1), in which the medical oncologist's treatment recommendation is central (2), fuelled by the patients' experience of not having a choice (3), and integrating the patient's context into shared decision-making was considered important but hampered (4), for example, by the association with the terminal phase. The prevailing tendency among medical oncologists and persons with advanced cancer to prioritize life-prolonging anticancer treatments restricts the potential for shared decision-making.

City of Hope’s horizon: City of Hope gets $20M for pancreatic disease breakthroughs The Clinical Trial Vanguard; by Ferry Darma; 9/26/24 City of Hope, a leading cancer research and treatment institution, has received a $20 million donation from philanthropists Norman and Melinda Payson. This significant gift will establish a dedicated pancreas center to accelerate groundbreaking research and treatments for pancreatic cancer and diabetes. Inspired by the personal impact of pancreatic cancer on his mother, Norman Payson, a noted healthcare executive and City of Hope board director, expressed confidence in the organization’s capabilities. “City of Hope possesses the unique expertise to drive innovative cures for pancreatic cancer and diabetes,” he stated. “We are committed to advancing this research and bringing hope to countless individuals.”  ... The Paysons’ gift follows a historic $150 million donation from A. Emmet Stephenson Jr. and Tessa Stephenson Brand to fund pancreatic cancer research.

Palliative care in kidney cancer more than just relieving symptoms Cure; by Ashley Chan; 9/26/24 Patients with kidney cancer who want more support during treatment can consider palliative care, whether it’s for symptoms or discussing goals and values. ... For patients with kidney cancer, understanding how palliative care can help is essential throughout the treatment process. Palliative care, according to the Mayo Clinic, is medical care that specializes in relieving pain and symptoms associated with an illness. This type of care can also help patients cope with treatment-related side effects. However, there’s more to palliative care than just relieving symptoms. It also “aims to help patients and families in one of three major categories,” Dr. Pallavi Kumar explained during an interview with CURE®. Kumar is the director of Oncology Palliative Care and assistant professor of Clinical Medicine in the hematology-oncology division at the University of Pennsylvania. She noted that the three categories of palliative care include:

Hispanic Americans and Alzheimer'sAlzheimer's Association; Resources; ongoing webpage, retrieved from the internet 9/25/24 Approximately 13% of Hispanics who are 65 or older have Alzheimer's or another dementia. Learn what the Alzheimer's Association is doing to address health disparities and provide support for Hispanic community members living with Alzheimer's or another dementia. Quick Facts: ...

The evolving landscape of Amyotrophic Lateral Sclerosis: A fatal disease!  Delveinsight; 9/24/24 Amyotrophic Lateral Sclerosis (ALS) is a devastating neurodegenerative disease characterized by the progressive degeneration of motor neurons, leading to muscle weakness, paralysis, and ultimately, death. ... Despite ALS being relatively rare, affecting 2-5 per 100,000 people worldwide, the question Is ALS on the rise? is gaining attention. While global prevalence has not significantly increased, improved diagnostic techniques, earlier detection, and greater awareness have led to a more accurate identification of ALS cases. Many researchers believe that enhanced surveillance and better tools for genetic testing are uncovering more cases than previously recognized, rather than a true rise in the disease’s incidence. However, with an aging global population, the burden of ALS may grow, as age is a major risk factor. Editor's note: Do you provide disease-specific training for your staff? ALS patients' and families' needs are unique. A significant disease comparison is between ALZ (Alzheimer's) and ALS. With ALZ (Alzheimer's), the brain decreases its abilities to function while the body can remain strong; the person is mobile with cognitive limitations. In contrast, with ALS, the body decreases its abilities to function while the brain/mind/emotions can remain strong. The person is immobile with cognitive awareness, but extreme physical limitations in communicating one's thoughts, emotions, and needs. ALS-specific communication tools provide crucial help for all. For more information in your location, visit The ALS Association's USA map.

How can we make dementia care more human? Practical insights for providers. CHAP - Community Health Accreditation Partner; by Jennifer Kennedy, PhD; 9/20/24 This year’s World Alzheimer’s Day brings a renewed focus on advancing dementia care, especially with the recent launch of the CMS GUIDE Model. This groundbreaking approach emphasizes comprehensive, coordinated care, not only improving the lives of patients but also significantly easing the burden on caregivers. As healthcare providers, there’s a critical opportunity to adopt strategies that go beyond clinical treatment, focusing on the human experience and addressing the emotional, physical, and financial challenges that dementia brings. ... As we reflect on the progress made in dementia care, there are several actionable strategies healthcare providers can implement to enhance their programs:

[Canada] Cognitive symptoms across diverse cancersJAMA Network Open; Samantha J. Mayo, RN, PhD; Kim Edelstein, PhD; Eshetu G. Atenafu, MSc, PStat; Rand Ajaj, HBSc; Madeline Li, MD, PhD; Lori J. Bernstein, PhD; 8/24In this cross-sectional study of 5078 survey respondents with cancer seeking psychosocial support, over half of these patients reported having cognitive symptoms of any severity. A third of these patients reported moderate to severe cognitive symptoms, which were associated with disease, treatment, and other symptoms. Findings of this study suggest that higher severity of cognitive symptoms was consistently associated with higher symptom burden; these findings could be used to inform decision-making regarding access to cognitive screening, assessment, and supportive care in outpatient oncology clinics.

When should you refer patients with COPD to palliative care? Physician's Weekly; by Jennifer Philip; 9/17/24 Researchers identified 17 major and 30 minor criteria to guide physicians in referring their patients with COPD to specialty palliative care. ...

Current understanding of cardiovascular autonomic dysfunction in multiple sclerosisHeliyon; Insha Zahoor, Guodong Pan, Mirela Cerghet, Tamer Elbayoumi, Yang Mao-Draayer, Shailendra Giri, Suresh Selvaraj Palaniyandi; 8/24Autoimmune diseases, including multiple sclerosis (MS), are proven to increase the likelihood of developing cardiovascular disease (CVD) due to a robust systemic immune response and inflammation. CVD in MS patients can affect an already damaged brain, thus worsening the disease course by causing brain atrophy and white matter disease. Treating vascular risk factors is recommended to improve the management of this disease. Additionally, clinicians should monitor for cardiovascular complications while prescribing medications to MS patients, as some MS drugs cause severe CVD.

Too Much, Too Little, Just Right: Optimizing cancer care for older adults The ASCO Post, American Society of Clinical Oncology; by Ramy Sedhom, MD; Bobby Green, MD; and Julia  Frydman, MD, MS; 9/10/24 Imagine walking into a fancy restaurant only to find a menu consisting mostly of kids’ dishes. It would make no sense. Just 25% of restaurant diners are younger than age 12, and they rarely write Yelp reviews. But when it comes to cancer treatment, this is not very far from what we do. The median age for a new cancer diagnosis is 67, and among those who die of cancer each year, 73% are older adults. Yet just one in four clinical trial participants is aged 70 or older. Consequently, guidelines for most new cancer therapies are based on a median age that is significantly younger than the patient population who actually receives these therapies. That’s quite a conundrum. More than half of patients older than age 65 experience toxicity of grade 3 or worse while undergoing standard chemotherapy. ... Palliative Care—For a 40-year-old mother of two young children, the goal of cancer treatment is usually clear: complete remission and long-term survival. But when you ask older patients with cancer about their priorities, a majority regard symptom control, emotional coping, and other quality-of-life measures at least as much as longevity and sometimes more.

American Heart Association affirms importance of palliative care in treating cardiac conditions Hospice News; by Jim Parker; 9/4/24 Multidisciplinary palliative care offers clear benefits to patients with cardiovascular disease, particularly when it comes to medication management and goals-of-care conversations. Palliative care with effective medication management, shared decision making and symptom management can help improve quality of life for heart disease patients, according to a scientific statement from the American Heart Association (AHA) — “Palliative Pharmacotherapy for Cardiovascular Disease.” The statement offers guidance for health care providers to integrate palliative methods as part of holistic medication management at all stages of a patient’s illness, the AHA indicated. This underscores the importance of collaboration between palliative care professionals and other clinical specialties, according to Dr. Andrew Esch, director of palliative care program development at the Center to Advance Palliative Care (CAPC). 

Patient-Reported outcome measures help patients with cancerMichael J. Hassett, MD, MPH; Christine Cronin, BS; 8/24Outside of cancer medicine, there is ample evidence that care management interventions improve patient-related, therapy-related, and health care utilization outcomes, especially when PROMs [patient recorded outcome measures] are incorporated. Altogether, these findings led to the hypothesis that symptom-focused care management programs that rely on PROMs could have a substantial positive impact for patients with cancer. Over the past 2 decades, dozens of clinical trials have explored this question. The analysis by Balitsky and colleagues adds further support to the argument that PROMs should be used routinely in oncology practice.

Hospice student volunteers gain insight into dementia Ahwatukee Foothills News; by Lin Sue Flood; 8/23/24 Once a week, graduate nursing student Merle Tamondong pauses her busy college life to visit Micheline Schulte. They color together, play Micheline’s favorite songs and chat in French, her native language. “When I come here, the only time I’m on my phone is when I’m playing some music, which Micheline likes when we are coloring,” Merle said. “I feel very lucky.” Merle is part of Hospice of the Valley’s College Partners Program, an innovative collaboration with Maricopa Community Colleges, Arizona State University and other schools to provide socialization to people living with dementia and a much-needed break to family caregivers. Hospice of the Valley’s dementia and volunteer departments spearheaded this intergenerational program to help inspire careers in dementia care. ... To date, 106 students have been trained and paired with 123 patients since College Partners launched in 2021 with a grant from Community Care Corps.