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16 papers 0 to 25 followers
By Manuel Mendez Anestesiologo, Algologo, Paliativista, Rockero
Julie Evans, Alison Chapple, Helen Salisbury, Pippa Corrie, Sue Ziebland
OBJECTIVE: This article explores how people with pancreatic cancer interpreted prediagnostic signs and symptoms, and what triggered them to seek medical help for symptoms that occurred intermittently. DESIGN: Thematic analysis of prediagnostic symptom descriptions drawn from a qualitative interview study of people with experiences of pancreatic cancer. PARTICIPANTS: 40 people affected by pancreatic cancer (32 patients and 8 relatives of people who had died)...
February 18, 2014: BMJ Open
Armin Shahrokni, Muhammad Wasif Saif
Due to pancreatic cancer's dismal prognosis, much of management is focused upon palliation and symptom management, and the decision to treat a patient with more aggressive maneuvers must always take into account the impact upon a patient's quality of life. In addition, majority of the patients with advanced pancreatic cancer are elderly. Oncologists are challenged to make tough treatment decisions. Many elderly patients cannot tolerate side effects of chemotherapy, especially the combination regimens. Despite that many patients continue to receive chemotherapy even in the last month of their lives...
July 10, 2013: JOP: Journal of the Pancreas
Cielito C Reyes-Gibby, Wenyaw Chan, James L Abbruzzese, Henry Q Xiong, Linus Ho, Douglas B Evans, Gauri Varadhachary, Samrat Bhat, Robert A Wolff, Christopher Crane
Pancreatic cancer is a lethal disease characterized by multiple disease-related symptoms. Chemoradiation therapy is a standard of treatment for locally advanced pancreatic cancer. Although shown to prolong survival, there is little information about treatment-related symptoms or the palliative benefits of chemoradiation. We assessed symptoms of patients with locally advanced pancreatic cancer receiving chemoradiation to determine the prevalence, and co-occurrence, of symptoms and to identify the extent to which symptoms interfered with function...
September 2007: Journal of Pain and Symptom Management
Sara Torgerson, Lauren A Wiebe
Despite advances in therapy, the average survival rate at 5 years for any patient diagnosed with pancreatic cancer remains only 6%. Throughout the course of cancer, most patients suffer a significant symptom burden and will need numerous interventions targeting these concerns. This paper highlights the most significant problems faced when caring for patients with advanced pancreatic cancer and provides an evidence-based approach to management. In addition, this review summarizes data on the health-related quality of life associated with current antineoplastic strategies, as well as critical issues facing patients and families along the disease trajectory...
March 2013: Oncology (Williston Park, NY)
Mariam Hameed, Haroon Hameed, Michael Erdek
A majority of pancreatic cancer patients present with pain at the time of diagnosis. Pain management can be challenging in light of the aggressive nature of this cancer. Apart from conventional pharmacotherapy, timely treatment with neurolytic celiac plexus block (NCPB) has been shown to be of benefit. NCPB has demonstrated efficacious pain control in high quality studies with analgesic effects lasting one to two months. NCPB has also shown to decrease the requirements of narcotics, and thus decrease opioid related side effects...
December 24, 2010: Cancers
Jonathan M Wyse, Marco Carone, Sarto C Paquin, Mariana Usatii, Anand V Sahai
PURPOSE: Celiac plexus neurolysis (CPN) is currently used as salvage therapy for morphine-resistant pancreatic cancer pain. Endoscopic ultrasound-guided CPN (EUS-CPN) can be performed early, at the time of EUS. We hypothesized that early EUS-CPN would reduce pain and morphine consumption, increase quality of life (QOL), and prolong survival. PATIENTS AND METHODS: Patients were eligible if referred for EUS for suspected pancreatic cancer with related pain. If EUS and EUS-guided fine-needle aspiration cytology confirmed inoperable adenocarcinoma, patients were randomly assigned to early EUS-CPN or conventional pain management...
September 10, 2011: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Lauren A Wiebe
Patients with advanced pancreatic cancer (APC) require early and frequent palliative interventions to achieve optimal quality of life for the duration of illness. Evidence-based supportive treatments exist to maximize quality of life for any patient, whether receiving chemotherapy or not. This article provides a comprehensive review of symptoms with current treatment recommendations and directions for future development. Celiac plexus neurolysis improves pain in the majority of patients with APC and should be moved earlier in the analgesic paradigm...
2012: American Society of Clinical Oncology Educational Book
Yasser M Amr, Mohamed Y Makharita
BACKGROUND: The efficacy of a celiac plexus block for the treatment of upper abdominal cancer-related pain has been documented. However, the effect of preprocedural pharmacological control of pain on its efficacy remains unknown. The researchers investigated the effect of first controlling severe pain with medications and then performing the celiac plexus block and compared the results with those obtained when the celiac block was performed first followed by pharmacotherapy for controlling severe pain; the impact on and duration of pain relief, effect on the quality of life, and analgesic requirements were analyzed...
September 2013: Clinical Journal of Pain
Andrada Seicean
Pain in pancreatic cancer is often a major problem of treatment. Administration of opioids is frequently limited by side effects or insufficient analgesia. Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) represents an alternative for the palliative treatment of visceral pain in patients with pancreatic cancer. This review focuses on the indications, technique, outcomes of EUS-CPN and predictors of pain relief. EUS-CPN should be considered as the adjunct method to standard pain management. It moderately reduces pain in pancreatic cancer, without eliminating it...
January 7, 2014: World Journal of Gastroenterology: WJG
Michael P Collins, William David Arnold, John T Kissel
Vasculitic neuropathy can occur as an isolated entity (nonsystemic vasculitic neuropathy) but more commonly evolves in the setting of primary systemic vasculitides or secondary vasculitides related to infections, drugs, or connective tissue disorders. Vasculitic neuropathies are usually but not always painful and tend to produce sensory motor or sensory symptoms. Patients with purely motor or small-fiber dysfunction are unlikely to have vasculitis. Deficits are typically multifocal or asymmetric, but distal symmetric polyneuropathy occurs uncommonly...
May 2013: Neurologic Clinics
Netta Bentur, Shirli Resnizky, Ran Balicer, Tsofia Eilat-Tsanani
This study examined the utilization and cost of all health services consumed during the last six months of life by cancer patients, and compared those with and without home-hospice care. Detailed information was extracted from the health care electronic administrative data files on 193 deceased cancer patients that their family approved the study (out of 429, 45%). About 88% had been hospitalized for 19 days on average and 53% visited the ER. One quarter received home-hospice care. Their average cost was $13,648 compared to $18,503 for patients without home-hospice care...
November 2014: American Journal of Hospice & Palliative Care
Kirsten I Marchand, Eugenia Oviedo-Joekes, Daphne Guh, Suzanne Brissette, David C Marsh, Martin T Schechter
BACKGROUND: Substitution with opioid-agonists (e.g., methadone) has shown to be an effective treatment for chronic long-term opioid dependency. Patient satisfaction with treatment has been associated with improved addiction treatment outcomes. However, there is a paucity of studies evaluating patients' satisfaction with Opioid Substitution Treatment (OST). In the present study, participants' satisfaction with OST was evaluated at 3 and 12 months. We sought to test the relationship between satisfaction and patients' characteristics, the treatment modality received and treatment outcomes...
July 26, 2011: BMC Health Services Research
Marylou Cardenas-Turanzas, Horacio Tovalin-Ahumada, Carlos Guillermo Romo, Regina Okhuysen-Cawley
BACKGROUND: Pediatric palliative care increasingly became integrated into health care institutions worldwide over the last decade. However, in Mexico and other developing countries with large populations of children, little is known regarding the need for palliative care services. We aimed to assess the need for palliative and end-of-life care for children dying in public hospitals affiliated with Secretaria de Salud in Mexico. MEASUREMENT: We conducted a retrospective review of deaths of children (1-17 years old) occurring during 2011 and determined deaths associated with underlying complex chronic conditions by reviewing the four causes of death listed in the death certificate...
February 2015: Journal of Palliative Medicine
Karen Neoh, Lucy Adkinson, Victoria Montgomery, Adam Hurlow
Nausea and vomiting are common symptoms in palliative care and can be highly distressing to patients. This review discusses the mechanisms by which nausea and vomiting are triggered, using case studies to highlight the most common scenarios and how to manage these.
July 2014: British Journal of Hospital Medicine
Joshua A Jones, Stephen T Lutz, Edward Chow, Peter A Johnstone
When delivered with palliative intent, radiotherapy can help to alleviate a multitude of symptoms related to advanced cancer. In general, time to symptom relief is measured in weeks to months after the completion of radiotherapy. Over the past several years, an increasing number of studies have explored rates of radiotherapy use in the final months of life and have found variable rates of radiotherapy use. The optimal rate is unclear, but would incorporate anticipated efficacy in patients whose survival allows it and minimize overuse among patients with expected short survival...
September 2014: CA: a Cancer Journal for Clinicians
Renee Boss, Judith Nelson, David Weissman, Margaret Campbell, Randall Curtis, Jennifer Frontera, Michelle Gabriel, Dana Lustbader, Anne Mosenthal, Colleen Mulkerin, Kathleen Puntillo, Daniel Ray, Rick Bassett, Karen Brasel, Ross Hays
OBJECTIVE: This review highlights benefits that patients, families and clinicians can expect to realize when palliative care is intentionally incorporated into the PICU. DATA SOURCES: We searched the MEDLINE database from inception to January 2014 for English-language articles using the terms "palliative care" or "end of life care" or "supportive care" and "pediatric intensive care." We also hand-searched reference lists and author files and relevant tools on the Center to Advance Palliative Care website...
October 2014: Pediatric Critical Care Medicine
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