Massage therapy for symptom reduction and improved quality of life in children with cancer in palliative care: A pilot study
child; human; palliative therapy; controlled study; female; male; article; Quality of Life; adolescent; clinical article; pain; Massage; follow up; quantitative study; pilot study; expectation; leukemia; lymphoma; sarcoma; carcinoma; pain measurement; patient worry
Background: For children with cancer in palliative care, pain and worry are common and frequently under-managed, which negatively impacts quality of life (QOL). Massage therapy (MT) can lead to reduced pain in children with chronic illnesses. Children with cancer have experienced lower anxiety after MT. No studies have examined the effects of MT in pediatric oncology patients receiving palliative care.
Genik L M; McMurtry C M; Marshall S; Rapoport A; Stinson J
Complementary Therapies in Medicine
2020
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ctim.2019.102263" target="_blank" rel="noreferrer noopener">10.1016/j.ctim.2019.102263</a>
The use of an intrathecal pump to manage intractable cancer pain in a pediatric patient: a case report
adolescent; Female; Humans; Pain; Pain Measurement; Analgesics; Prognosis; Fatal Outcome; Infusion Pumps; Injections; Spinal; Implantable; Carcinoma; Intractable; Anus Neoplasms; Condylomata Acuminata; Immunologic Deficiency Syndromes; Neutropenia; Squamous Cell; Vulvar Diseases
A 15-year-old girl with combined immune deficiency syndrome, diagnosed with metastatic squamous cell cancer of the anus, had significant pain secondary to vulvar-perianal condyloma. Conventional treatment with oral and intravenous analgesics was limited by significant side effects of mental status changes and urinary retention leading to clinical deterioration that precluded attempts at chemotherapy. An intrathecal pump was implanted in the challenging setting of neutropenia. There was a drastic improvement in her quality of life and the ability to tolerate further chemotherapy. The option of an intrathecal pump for pain control extended our patient's ability to enjoy important quality time with family by several months.
2014-04
Bengali R; Huang MS; Gulur P
Journal Of Pediatric Hematology/oncology
2014
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Journal Article
<a href="http://doi.org/10.1097/MPH.0b013e31828e5dca" target="_blank" rel="noreferrer">10.1097/MPH.0b013e31828e5dca</a>
Early palliative care for patients with metastatic non-small-cell lung cancer
Female; Humans; Male; Palliative Care; Terminal Care; Aged; Middle Aged; Affect; Time Factors; Linear Models; quality of life; Kaplan-Meiers Estimate; Carcinoma; Depression/epidemiology/prevention & control; Lung Neoplasms/mortality/psychology/therapy; Non-Small-Cell Lung/mortality/psychology/secondary/therapy
BACKGROUND: Patients with metastatic non-small-cell lung cancer have a substantial symptom burden and may receive aggressive care at the end of life. We examined the effect of introducing palliative care early after diagnosis on patient-reported outcomes and end-of-life care among ambulatory patients with newly diagnosed disease. METHODS: We randomly assigned patients with newly diagnosed metastatic non-small-cell lung cancer to receive either early palliative care integrated with standard oncologic care or standard oncologic care alone. Quality of life and mood were assessed at baseline and at 12 weeks with the use of the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale and the Hospital Anxiety and Depression Scale, respectively. The primary outcome was the change in the quality of life at 12 weeks. Data on end-of-life care were collected from electronic medical records. RESULTS: Of the 151 patients who underwent randomization, 27 died by 12 weeks and 107 (86% of the remaining patients) completed assessments. Patients assigned to early palliative care had a better quality of life than did patients assigned to standard care (mean score on the FACT-L scale [in which scores range from 0 to 136, with higher scores indicating better quality of life], 98.0 vs. 91.5; P=0.03). In addition, fewer patients in the palliative care group than in the standard care group had depressive symptoms (16% vs. 38%, P=0.01). Despite the fact that fewer patients in the early palliative care group than in the standard care group received aggressive end-of-life care (33% vs. 54%, P=0.05), median survival was longer among patients receiving early palliative care (11.6 months vs. 8.9 months, P=0.02). CONCLUSIONS: Among patients with metastatic non-small-cell lung cancer, early palliative care led to significant improvements in both quality of life and mood. As compared with patients receiving standard care, patients receiving early palliative care had less aggressive care at the end of life but longer survival. (Funded by an American Society of Clinical Oncology Career Development Award and philanthropic gifts; ClinicalTrials.gov number, NCT01038271.)
2010
Temel JS; Greer JA; Muzikansky A; Gallagher ER; Admane S; Jackson VA; Dahlin CM; Blinderman CD; Jacobsen J; Pirl WF; Billings JA; Lynch TJ
The New England Journal Of Medicine
2010
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Journal Article
<a href="http://doi.org/10.1056/NEJMoa1000678" target="_blank" rel="noreferrer">10.1056/NEJMoa1000678</a>
Development of quality indicators for diagnosis and treatment of patients with non-small cell lung cancer: a first step toward implementing a multidisciplinary, evidence-based guideline
Humans; Netherlands; Evidence-Based Medicine; Neoplasm Staging; Practice Guidelines; Health Care; Carcinoma; Lung Neoplasms/diagnosis/therapy; Non-Small-Cell Lung/diagnosis/therapy; Quality Indicators
BACKGROUND: While developing and distributing clinical practice guidelines are important in optimising clinical healthcare, insight into actual care is necessary to achieve successful implementation. Developing quality indicators may be the first step to becoming aware of actual care. The Dutch national practice guideline Non-small cell lung cancer: staging and treatment is one of the first clinical, multidisciplinary guidelines for oncology in the Netherlands for which quality indicators were developed systematically. We describe indicator development based on this guideline as a practical experience. METHODS: To develop a set of indicators for diagnosis and treatment of patients with non-small cell lung cancer, we systematically achieved consensus on the basis of a national, multidisciplinary, evidence-based guideline and the opinions of professionals and patients. After the researchers extracted the recommendations from the guideline, we carried out a so-called Rand-modified-Delphi procedure. This consisted of three rounds: a national panel of professionals and representatives of the national patient organization scored all recommendations, the professionals had a consensus meeting, and the final set of indicators was e-mailed for a last check. Subsequently, some clinimetric characteristics of this final set were assessed in a practice test. RESULTS: Thirty-two of 83 recommendations were selected in the first round. After the consensus meeting, 8 recommendations met the final criteria and were incorporated into 15 indicators, which were tested in practice. The most successful indicators for quality improvement are indicators that are measurable, have potential for improvement, have a broad range between practices and are applicable to a large part of the population. CONCLUSIONS: For successful implementation of evidence-based guidelines, each new guideline should be developed and tested with a set of indicators based on the guideline. The procedure we describe can serve as an example for other new guidelines.
2006
Hermens RP; Ouwens MM; Vonk-Okhuijsen SY; van der Wel Y; Tjan-Heijnen VC; van den Broek LD; Ho VK; Janssen-Heijnen ML; Groen HJ; Grol RP; Wollersheim HC
Lung Cancer (amsterdam, Netherlands)
2006
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Journal Article
<a href="http://doi.org/10.1016/j.lungcan.2006.07.001" target="_blank" rel="noreferrer">10.1016/j.lungcan.2006.07.001</a>
Non-invasive ventilation and palliation: experience in a district general hospital and a review
Female; Humans; Male; Terminally Ill; Aged; Middle Aged; Respiration; Time Factors; Lung Diseases; Carcinoma; Respiratory Insufficiency/therapy; Artificial/ethics/methods; Emphysema/therapy; Lung Neoplasms/complications; Motor Neuron Disease/complications; Multiple Sclerosis/complications; Myeloproliferative Disorders/complications; Obstructive/therapy; Palliative Care/ethics/methods; Small Cell/complications; Syringomyelia/complications
Non-invasive ventilation (NIV) is increasingly being used in hospitals to treat respiratory failure. The use of NIV with palliative intent in a district general hospital is described and ten illustrative cases where NIV was used in an attempt to palliate symptoms or to 'buy time' are presented. The role of NIV in relieving symptoms in various conditions is reviewed and ethical aspects are considered. It is suggested that hospital palliative care teams will increasingly see patients treated by this technique as it becomes more widely used for exacerbations of chronic obstructive airways disease, for relief of breathlessness in the terminally ill and for buying time in patient management. Domiciliary teams will see increasing numbers of people with motor neurone disease and other conditions treated with NIV.
2003
Shee CD; Green M
Palliative Medicine
2003
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Journal Article
<a href="http://doi.org/10.1191/0269216303pm659oa" target="_blank" rel="noreferrer">10.1191/0269216303pm659oa</a>
Using a treatment-tradeoff method to elicit preferences for the treatment of locally advanced non-small-cell lung cancer
Female; Humans; Male; Attitude to Health; Aged; Treatment Outcome; Choice Behavior; Decision Support Techniques; Survival Analysis; Feasibility Studies; Reproducibility of Results; Non-U.S. Gov't; Research Support; Comparative Study; Adjuvant; Chemotherapy; Carcinoma; Questionnaires/standards; Antineoplastic Agents/adverse effects/therapeutic use; Lung Neoplasms/psychology/radiotherapy; Non-Small-Cell Lung/psychology/radiotherapy; Prostatic Neoplasms/psychology/radiotherapy; Radiotherapy/adverse effects/methods
The study was designed to evaluate a treatment-tradeoff method for its potential in helping lung cancer patients make treatment decisions. A treatment-tradeoff interview was conducted to determine how patients weighed potential survival benefits against the potential toxicities of different treatment options: 1) low-dose versus high-dose radiotherapy, and 2) high-dose radiotherapy versus combination chemo-radiotherapy. Fifty-six patients who had experienced cancer and 20 clinic staff participated; twenty of these participants repeated the interview in an assessment of response consistency. The treatment-tradeoff method proved feasible: all staff and 53 of the 56 patients were able to complete the process. A wide range of threshold scores across participants was observed for both tradeoffs. Sixty percent of the patients would accept the more toxic combination therapy over high-dose radiotherapy if the former offered a 10% absolute improvement in three-year survival. The method also proved reliable: test-retest correlations were high (tau ranged from 0.7 to 0.87 and r from 0.82 to 0.94) and test-retest mean score differences were low (1.3-4.2). The most clinically useful measure of consistency was a "preference consistency" index, which revealed that most patients declared the same treatment preference at test and retest. The authors conclude that, while there is great interindividual variability in willingness to accept aggressive treatments for lung cancer, patients' values can be consistently elicited with the tradeoff method. The method has potential for clinical application in decision making and for health-care policy development.
1998
Brundage MD; Davidson JR; Mackillop WJ; Feldman-Stewart D; Groome P
Medical Decision Making
1998
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Journal Article
<a href="http://doi.org/10.1177/0272989x9801800302" target="_blank" rel="noreferrer">10.1177/0272989x9801800302</a>
Trading treatment toxicity for survival in locally advanced non-small cell lung cancer
Female; Humans; Male; Aged; Middle Aged; Patient Satisfaction; Non-U.S. Gov't; Research Support; Carcinoma; Radiotherapy/adverse effects; Antineoplastic Combined Chemotherapy Protocols/adverse effects; Combined Modality Therapy/psychology; Lung Neoplasms/mortality/pathology/psychology/therapy; Non-Small-Cell Lung/mortality/pathology/psychology/therapy; Prostatic Neoplasms/mortality/pathology/psychology/therapy; Radiotherapy Dosage
PURPOSE: To determine how patients weigh potential survival benefits against the potential toxicity of different treatment strategies for locally advanced non-small cell lung cancer (NSCLC). Specifically, we were interested in what improvement in survival probability patients would want to have before accepting more toxic therapy. PATIENTS AND METHODS: Fifty-six outpatients who had experienced lung cancer (n = 22) or prostate cancer (n = 34), and 20 clinic nurses and radiation therapy technologists participated. A treatment trade-off interview was conducted with each participant that compared low-dose versus high-dose radiotherapy and high-dose radiotherapy versus combination chemo-radiotherapy. Preferences for treatments were assessed by systematically increasing the hypothetical survival advantage of the more toxic treatment until the person reached his or her threshold for choosing the more toxic treatment. RESULTS: A wide range of thresholds was observed for both groups. The distributions of survival advantage thresholds for lung cancer and prostate cancer patients were not significantly different but were generally lower thresholds than those declared by staff. If the 3-year survival advantage was 10%, 60% of patients and 15% of staff would consider combination therapy over high-dose radiotherapy. Within patients, apparent willingness to consider more toxic treatments was not significantly related to age, sex, education, or preferred role in decision making. The treatment trade-off method had good test-retest reliability. CONCLUSION: There is great interindividual variability in willingness to accept aggressive treatments for locally advanced NSCLC. When choosing NSCLC treatment, each patient should be provided with comprehensive information about the options so that he or she may express his or her preferences should he or she wish to participate in the decision.
1997
Brundage MD; Davidson JR; Mackillop WJ
Journal Of Clinical Oncology
1997
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Journal Article
<a href="http://doi.org/10.1200/jco.1997.15.1.330" target="_blank" rel="noreferrer">10.1200/jco.1997.15.1.330</a>