Few advanced cancer patients (21%) discussed post-mortem social media management. Lower income predicted such talks. The survey spurred most to consider account planning (67%) and explore management (71%). Social media was key for coping; more research needed . pubmed.ncbi.nlm.nih.gov/39352567/

This study of 34,911 cancer patients (2016–2022) found medical marijuana laws with dispensaries reduced strong opioid prescribing but increased hospital events, while laws without dispensaries raised weak opioid use. Effects on cancer pain management need study. pubmed.ncbi.nlm.nih.gov/41031641/

A survey of 70 palliative care clinicians found 59% joined a five-minute group meditation during rounds, reporting stress reduction and control. Over half also practiced weekly outside work. Participants viewed it as useful, supporting further study. pubmed.ncbi.nlm.nih.gov/40285484/

In 432 patients with advanced cancer, only one-third accurately understood their curability, with little change over time. Misperception was linked to Asian race, better well-being, and fewer symptoms. Systematic screening is needed pubmed.ncbi.nlm.nih.gov/40992638/

La Dra Mariela Bertolino murió hoy. Mariela creo el equipo de que educó a la mayoría de los líderes de CP en Argentina y Latinoamérica. Su integridad ayudó a miles . “When sorrows come….” Godspeed Mariela. I am sure you will have great discussions with Bal about pall care,

Dr Balfour Mount died yesterday. Our clinical and spiritual leader, he was the first to use the term “palliative care” and opened the Royal Vic PCU. He inspired all of us to work with energy and integrity . We are all a bit more lonely today. Godspeed, Bal Mount

In the 1980s oncologists and internists were using a higher opioid dose before pall care, pall care teams were using a higher dose and more parental, and pain control was better! We’re back to the 70s in cancer pain pubmed.ncbi.nlm.nih.gov/1691252/

In 58 advanced cancer patients, hypodermoclysis provided safe, effective hydration for up to 14 days, with minimal local toxicity and frequent co-administration of opioids and potassium. And 30 ys later still not done in American hospices and hospitals pubmed.ncbi.nlm.nih.gov/2384700/

Opioid rotation in palliative care improved toxicity symptoms in 73% of patients and enhanced pain control with lower doses than predicted, showing benefit for long-term management. After this paper it took many years before rotation became accepted practice! pubmed.ncbi.nlm.nih.gov/7673770/

In a pilot RCT of 100 advanced cancer patients on phase I therapies, adding weekly remote monitoring to monthly palliative care visits improved symptoms and quality of life versus SPC alone. Benefits were seen at 2 weeks and sustained at 12 weeks pubmed.ncbi.nlm.nih.gov/40986798/

In 432 patients with advanced cancer, only one-third accurately understood their curability, with little change over time. Misperception was linked to Asian race, better well-being, and fewer symptoms. Systematic screening may help identify needs and support . pubmed.ncbi.nlm.nih.gov/40992638/

Among 375 cancer patients (2016–2021), opioid doses prescribed by oncologists fell five-fold (37.5→7.5 mg/day). ER opioids declined, while no-opioid cases rose. Higher pain and CAGE-AID received more and non-English speakers received less. pubmed.ncbi.nlm.nih.gov/40138614/

We compared ChatGPT, Bard, and Bing on palliative care terms found ChatGPT most accurate (9/10) and comprehensive (8.5/10). Credibility was low (3/10) across all. Readability was poor (FRE 41.7; grade 14.1). Clinician oversight is needed to avoid misinformation. pubmed.ncbi.nlm.nih.gov/40138176/

In 128 advanced cancer patients with end-of-life delirium, breakthrough restlessness peaked between 3–11 PM, with higher rescue med use and RASS ≥+1 episodes. This “sundowning” pattern may guide monitoring, timing, and caregiver education in palliative care. pubmed.ncbi.nlm.nih.gov/40239874/

In a tertiary hospital palliative clinic, 28% of 47 advanced cancer patients were high-risk for NMOU. Risk linked to younger age, higher opioid doses, substance use, and employment. SOAPP-SF showed good agreement with SOAPP-R, retaining most predictive accuracy pubmed.ncbi.nlm.nih.gov/40252199/.

In a study of 444 cancer patients in an acute palliative care unit, 38% required palliative sedation (PS), mainly for delirium. PS patients were younger, had longer stays, and advance directives. 28% needed multiple drugs, linked to longer PS and hydration. pubmed.ncbi.nlm.nih.gov/40442717/

A Brazilian study of 248 non-cancer patients in home palliative care (mean age 80.8) found neurological/circulatory diseases most common. Median stay was 50 days, with high functional decline and frequent visits. All died at home, showing intensive PC works . pubmed.ncbi.nlm.nih.gov/40971993/

A five-minute group meditation during palliative care rounds was well received, with most clinicians participating and reporting stress reduction, satisfaction, and continued practice outside rounds. pubmed.ncbi.nlm.nih.gov/40285484/

Our next MASCC Short Talk features @brueraeduardo.bsky.social discussing how we can best partner with patients in managing chronic toxicities of cancer and its treatment Watch now: vimeo.com/1119840739 #MASCC25 #SuppOnc

Burnout curative approach: better working conditions Palliative approach: better self care Always combine curative + palliative!

Burnout diagnosed in >50% pall care clinicians , and attrition extremely high. The problem are NOT the patients, but the working conditions imposed by bosses and executives

In advanced cancer, palliative physicians showed consistent survival estimates when “surprised” (>50% survival, low variability), but wide variation when “not surprised” (2–100%, high variability). Variability rose with longer timeframes. pubmed.ncbi.nlm.nih.gov/40711595/

In advanced cancer, the first unscheduled hospitalization predicts poor survival (median OS 108–164 days). Older age, male sex, poor performance, long or tumor-related admissions worsened outcomes. First admission is a good trigger for palliative care referral. pubmed.ncbi.nlm.nih.gov/40715739/

In 40 cancer patients with G-tubes, rotation to oxymorphone IR every 8h was successful in 62.5%, achieving pain reduction and continued use. Median opioid rotation ratio (MEDD:oxymorphone) was 3.5. No predictors of success were identified across subgroups. pubmed.ncbi.nlm.nih.gov/33549000/

A 2018 survey of US cancer centers found PC education and research stronger at NCI-designated sites, with more fellowships, provider training, and funding. Progress since 2009 was modest; gains included more PC fellowships and mandatory oncology fellow rotations. pubmed.ncbi.nlm.nih.gov/33662148/

Among 211 Italian cancer patients, 60% had financial toxicity (COST <26). Higher symptom burden correlated with greater out-of-pocket (OOP) medication use, mainly analgesics and laxatives, which were linked to worse financial toxicity. Routine assessment is needed. pubmed.ncbi.nlm.nih.gov/40569026/

This study compared placebo response in advanced cancer patients with fatigue under blinded vs. open-label designs. No difference was found (6.6 vs. 7.9). Placebo response was linked to baseline fatigue, GI cancers, pain, anxiety, and symptom distress, warranting further research.

A nationwide French study (2021–2023) found oncology residents lack palliative care (PC) training. While least trained residents showed low interest, 95% supported improved education, and national curriculum integration and PC unit rotations to foster integration. pubmed.ncbi.nlm.nih.gov/40685495/

A palliative care team replaced email handoffs with EMR-integrated I-PASS. Within six months, utilization exceeded 99%, with clinicians reporting higher accuracy, shorter length, and less time required. I-PASS was strongly endorsed as an effective handoff tool. pubmed.ncbi.nlm.nih.gov/40940972/

In a study of health care workers during COVID-19, 100 interested staff enrolled in a 4-week virtual yoga breathwork program. Of 69 who gave feedback, 77% found it useful. The intervention proved feasible and acceptable, supporting its role in HCW well-being. pubmed.ncbi.nlm.nih.gov/33835830/

Among 325 advanced cancer patients in Chile, Guatemala, and the U.S., most valued spirituality/religiosity, which aided coping and QOL but was unsupported by clinicians. Over half reported spiritual pain, strongly linked to distress: more spiritual care is needed pubmed.ncbi.nlm.nih.gov/33844951/

In a retrospective analysis of 257 cancer patients discharged after inpatient rehab, 21% were readmitted within 30 days, mainly for infection or cancer-related issues. Lower locomotion scores, more medications, and lower hemoglobin predicted readmission. pubmed.ncbi.nlm.nih.gov/34313031/

Delirium near end of life can be hard to assess, especially with language barriers. A patient on bilevel ventilation appeared delirious and agitated, but symptoms resolved after switching to high-flow oxygen, showing the mask itself caused distress, not delirium. pubmed.ncbi.nlm.nih.gov/40931622/

Caregivers in the palliative care unit (PCU) reported higher emotional stress and worse mental health than those in the outpatient center Stress was linked to caregiver burden, mental health, education, caregiving duration, and patients’ anxiety and treatment. pubmed.ncbi.nlm.nih.gov/33926226/

A double-blind RCT with 120 cancer patients found that the PRIME-EHR model improved perceptions of physician compassion, communication, and professionalism compared to standard EHR use. 77% preferred PRIME-EHR, highlighting its potential to enhance cancer care. pubmed.ncbi.nlm.nih.gov/34264520/

In 333 metastatic cancer patients at MD Anderson, higherESAS Global Score (GDS) was linked to worse performance status and shorter overall survival (13.1 vs 7.9 vs 3.7 months; P<.001). The effect held in middle-aged and older adults but not young adults. pubmed.ncbi.nlm.nih.gov/34269810/

In a review of 1221 cancer patients at a psychiatric oncology clinic, 60% reported depression and 51% anxiety (PHQ-9/GAD-7 ≥10). Severe symptoms occurred in ~30%. ESAS cutoffs (≥3 depression, ≥5 anxiety) showed good sensitivity, supporting their use for screening. pubmed.ncbi.nlm.nih.gov/34546618/

A pilot RCT tested Zoom-based mindfulness vs psychoeducation groups for women with lung cancer (N=54, mean age 66). Feasibility was high with strong attendance and positive ratings, though some had tech discomfort. Remote group delivery was generally preferred. pubmed.ncbi.nlm.nih.gov/34663123/

Implementation of I-PASS for inpatient palliative care handoffs replaced email with a structured EMR tool, achieving >99% use within 6 months. Surveys showed improved accuracy, shorter and faster handoffs, and higher satisfaction, with strong clinician endorsement. doi.org/10.3390/canc...

At MD Anderson’s palliative care clinic, telehealth has become routine since COVID-19, offering benefits but also unexpected etiquette challenges. We present three cases highlighting these issues and propose guidelines to foster effective, compassionate visits. pubmed.ncbi.nlm.nih.gov/35670297/

In a survey of ~200 palliative care patients, 67% preferred video visits during COVID-19 and 61% after. Video was favored for cost, convenience, and wait time. Preference higher with tech comfort, while Hispanic and dyspnea predicted lower preference. pubmed.ncbi.nlm.nih.gov/38467349/

Pall care team members (94% response) reported positive experiences (87%) and emotions (79%) toward remote work during COVID-19, though clinicians reported more stress and lower productivity. Overall, 69% favored permanent remote work pubmed.ncbi.nlm.nih.gov/34847735/

A survey of Hospice and Palliative Medicine fellowship graduates (2008–2018) found a high burnout rate (52%). Burnout was linked to female gender and administrative duties, but not workload factors. Findings highlight the need for strategies to prevent and manage burnout in PC physicians.

Timely palliative care uses systematic screening, referral criteria, and EHR integration to identify patients with high needs early. It optimizes limited resources, improves patient and caregiver outcomes, and requires oncology leadership and outpatient capacity. pubmed.ncbi.nlm.nih.gov/35205793/

In a randomized trial of 151 pancreatic cancer patients, a home-based exercise program during neoadjuvant therapy improved 6-minute walk distance in both groups, with greater strength training in the exercise arm. Physical activity improved function and outcomes. pubmed.ncbi.nlm.nih.gov/37026453/

In a randomized trial of 130 advanced cancer patients, a disease-specific question prompt sheet (QPS) was as helpful as a general info sheet but was preferred, viewed more positively, and prompted more new questions—without raising anxiety or lengthening visits. pubmed.ncbi.nlm.nih.gov/37129892/

In a study of 445 hospitalized cancer patients with pressure injuries, 1-month OS was 55.3%. Survival was significantly worse in those with advanced disease and Braden Scale ≤14. Findings highlight limited prognosis and need for targeted care in this population. pubmed.ncbi.nlm.nih.gov/35394852/