hematologists generally accepted most EOL quality measures but face unrealistic patient expectations and discomfort with GOC/ACP discussions. Many feel unprepared for these conversations. They support earlier palliative care and better home-care access. pubmed.ncbi.nlm.nih.gov/41068303/

In a pediatric palliative pts nebulised Tranexamic acid (TA) and nebulised Recombinant factor VIIa was used to manage haemoptysis near end-of-life. There was relief of bleeding and reduced distress, suggesting this combination may offer a palliative option. pubmed.ncbi.nlm.nih.gov/41207344/

Caregivers and nurses differed in preferred sedation goals for agitated delirium. Caregivers favored lighter sedation, nurses deeper. Patients were often undersedated. Vignettes showed deeper sedation preferred when communication impossible or prognosis short. pubmed.ncbi.nlm.nih.gov/34432293/

Depression (60%) and anxiety (51%) were common in 1,221 new psychiatric oncology outpatients. Age and gender correlated with anxiety. ESAS cutoffs ≥3 (depression) and ≥5 (anxiety) showed good sensitivity for detecting symptoms using PHQ-9 and GAD-7. pubmed.ncbi.nlm.nih.gov/34546618/

The Edmonton Injector for scheduled and PRN dosing. PRN wait times dropped from 18 to 3 minutes. The EI is safe, effective, inexpensive, great for resource-limited settings. After 35 years there is still no device to replace it, since ironically it is too cheap! pubmed.ncbi.nlm.nih.gov/2052383/

Three cancer patients with opioid use disorder (OUD) on buprenorphine were hospitalized for cancer pain. Primary clinicians managed complex needs, illustrating challenges and approaches to inpatient care for OUD in cancer. pubmed.ncbi.nlm.nih.gov/39383025/

In this letter, the authors report on a small case-series using Levetiracetam for refractory confusional syndromes in palliative patients. They suggest it may offer a safe alternative when standard therapies fail, calling for further study. pubmed.ncbi.nlm.nih.gov/39441578/

A patient with metastatic melanoma admitted to ICU and later to palliative care unexpectedly improved despite multiple death-predicting signs. The authors highlight that clinicians often misestimate survival, and call for better prognostic tools. pubmed.ncbi.nlm.nih.gov/39478369/

A study of 107 palliative patients showed that will to live (WtL) varies widely over time and correlates with all ESAS symptoms. WtL had links to total, physical, and psychological burden. Findings highlight suffering’s complexity and need for targeted care pubmed.ncbi.nlm.nih.gov/40739928/

Non-cancer patients in Brazil’s home palliative care program were very old, highly frail, and often neurologically or circulatory impaired. Median stay was 50 days. With 1.74 clinical visits per day all died at home. Lower PPS scores required higher care intensity. pubmed.ncbi.nlm.nih.gov/40971993/

In this pilot RCT of 100 advanced cancer patients on phase I therapies, adding weekly remote monitoring (RM) to monthly specialist palliative care (SPC) improved symptom burden and quality of life versus SPC alone, suggesting RM enhances SPC benefits. pubmed.ncbi.nlm.nih.gov/40986798/

A letter to the editor discusses use of Olanzapine in cancer-associated cachexia, reporting possible short-term improvements in weight/appetite but raising uncertainty about long-term efficacy, risks and optimal patient selection. pubmed.ncbi.nlm.nih.gov/41213247/

A case series of two pediatric cancer patients at end of life showed that combining nebulized tranexamic acid and recombinant factor VIIa effectively relieved hemoptysis, suggesting this approach may reduce suffering and distress in palliative care settings. pubmed.ncbi.nlm.nih.gov/41207344/

a man with metastatic neuroendocrine tumour who appeared agitated on bilevel non-invasive ventilation — identified as delirium — but he felt suffocated by the mask ; high-flow nasal oxygen resolved the agitation. “delirium” can mask treatable distress. pubmed.ncbi.nlm.nih.gov/40931622/

In palliative care, physicians showed consistent survival estimates when “surprised” (>50% chance) but highly variable predictions when “not surprised.” Variability increased over longer timeframes, showing differing interpretations of “surprise” in prognosis. pubmed.ncbi.nlm.nih.gov/40711595/

“timely palliative care” is systematic screening, referral criteria, automated triggers and refer oncology patients earlier to palliative care. It enhances access, resource efficiency and patient and caregiver outcomes with earlier specialist involvement. pubmed.ncbi.nlm.nih.gov/35205793/

The US administration has reduced resources for the National Library of Medicine and paralyzed government. Unfortunately I am unable to provide you our most recent publications. An alternative to Pubmed is needed for global medical knowledge.

Survey of 52 palliative care fellowship graduates (84% response) found 52% burnout. Median age 38, 68% female, 77% practice PC >50%. Emotional exhaustion median 25.5. Burnout linked to female gender and administrative roles. Highlights need for prevention . pubmed.ncbi.nlm.nih.gov/35183705/

In 445 hospitalized cancer patients with pressure injuries, one-month overall survival was 55.3%. Lower Braden Scale scores (≤14) and advanced disease were linked to shorter survival, indicating poor prognosis in this population. pubmed.ncbi.nlm.nih.gov/35394852/

Over 2010–2019, 384 hematologic malignancy patients were referred to outpatient palliative care, with referrals increasing and occurring earlier. Median time from referral to death was 3.4 years, showing improved, timely access to supportive care over the decade. pubmed.ncbi.nlm.nih.gov/35866185/

Young adults (18–39) with cancer showed more psychiatric history, higher ECOG scores, worse sleep and pain than older adults. Having children under 18 was linked to greater pain, sleep, and financial distress. Findings highlight the need for age-tailored support. pubmed.ncbi.nlm.nih.gov/35881858/

In 6310 cancer patients referred to palliative care, survival was strongly linked to performance status by both ECOG and KPS . Both showed high concordance, especially in older patients. KPS performed slightly better. Many were referred in their last month of life. pubmed.ncbi.nlm.nih.gov/35948390/

A scoping review found that patients with intellectual disability face major barriers to palliative care, including under-referral, poor communication, and limited provider training. Greater education, awareness, and research are needed to improve equitable access. pubmed.ncbi.nlm.nih.gov/35995282/

An open-labeled placebo significantly reduced cancer-related fatigue in advanced cancer patients versus waitlist control after one week, with improvements maintained for four weeks and no major side effects. Further studies are warranted. pubmed.ncbi.nlm.nih.gov/36106759/

Approximately 1 in 6 patients who completed acute inpatient rehabilitation died within 2 months of discharge, had poorer baseline functional status, and were less likely to regain function than those who lived longer. pubmed.ncbi.nlm.nih.gov/36367387/

CBT for cancer-related fatigue in newly diagnosed hematologic malignancy patients was feasible (79% adherence, 92% satisfaction) and improved fatigue, sleep, and anxiety, though not depression or hope. Results support future randomized controlled trials. pubmed.ncbi.nlm.nih.gov/36454553/

The authors argue that the second step of the World Health Organization analgesic ladder (weak opioids) may no longer be needed in modern cancer pain management—suggesting a move from non-opioid/weak opioid directly to strong opioids. pubmed.ncbi.nlm.nih.gov/36456102/

The paper reaffirms ethical norms in organ transplant, stressing physicians’ duty to donor-patients, informed consent, and equitable practices. It calls for separating donor care from recipient interests to maintain trust and protect donor-patient welfare. pubmed.ncbi.nlm.nih.gov/41144970/

🇺🇸 personal bankruptcies due to medical debt: 60- 66%; 🇨🇦: 15- 19%. 🇺🇸 uninsured population: 11%; Canada 0.2% It is getting worse in 🇺🇸 every week. Can 🇺🇸 pts and clinicians become the 11th province? Or at the very least the 4th territory ? Pretty please?

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

In 130 cancer patients with nonmedical opioid use, the CHAT intervention reduced NMOU behaviors and pain scores at 3 and 6 months, without changing opioid doses. About 60% achieved complete response, supporting CHAT’s effectiveness in managing NMOU in cancer pain. pubmed.ncbi.nlm.nih.gov/35997289/

In 1,440 cancer patients admitted to an APCU, symptoms, spiritual, and financial distress improved significantly. Deaths in the unit decreased, and hospice transfers rose from 32% to 62%. Most patients were successfully discharged or transitioned to hospice care. pubmed.ncbi.nlm.nih.gov/36007209/

A nine-item Self-Care Handbook improved well-being among palliative care staff. Most found it useful, especially “offer help,” “ask for help,” and “hydration.” During COVID-19, perceived usefulness and adherence increased, supporting its value in stressful times. pubmed.ncbi.nlm.nih.gov/36318801/

Patients with advanced cancer and caregivers receiving early palliative care (EPC) are more open to discussing death and use more positive language about it than those in standard care. EPC may promote acceptance of death through supportive communication pubmed.ncbi.nlm.nih.gov/36320128/

Clinicians reported that nonmedical opioid use in cancer pain is underdiagnosed and challenging to manage. Most found our opioid stewardship program helpful and supported its integration into routine supportive oncology care . pubmed.ncbi.nlm.nih.gov/36476019/

A GOC Rapid Response Team at a cancer center proved feasible during COVID-19, completing 85% of requested consults. Core team participation was 64%, and care limitation occurred in 74% of cases, showing effectiveness in promoting goal-concordant care. pubmed.ncbi.nlm.nih.gov/36496112/

Survey of clinicians from four specialties found few preferred medical marijuana (9%) or CBD (13%) over opioids for cancer pain; some supported combining them with opioids. MM and CBD were not favored over standard treatments for pain or other symptoms. pubmed.ncbi.nlm.nih.gov/36576904/

Meta-analysis of 32 RCTs (4896 patients) found that pharmacological, phytopharmaceutical treatments significantly reduced cancer-related fatigue (pooled effect −0.29). Only corticosteroids showed significant benefit (effect −0.94); other agents were not effective. pubmed.ncbi.nlm.nih.gov/36612088/

A very nice synthetic opioid agonist. Unfortunately American Pharma and Insurance cartels make access impossible for American patients with cancer pain. pubmed.ncbi.nlm.nih.gov/36720398/

Oncology trainees value function and believe CRM improves treatment tolerance and survival, yet most rarely refer patients to CRM. Prior PM&R exposure increases referrals. Most trainees support adding CRM education to oncology training. pubmed.ncbi.nlm.nih.gov/36762725/

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Head and neck cancer patients often experience severe anxiety from radiation masks. Two claustrophobic patients received early supportive desensitization, enabling successful treatment completion. Early psychological support may improve adherence and outcomes. pubmed.ncbi.nlm.nih.gov/36730789/

Malignant GIO carries a poor prognosis. In this study, palliative care consultation improved advance care planning, DNR orders, hospice transitions, and interdisciplinary involvement, suggesting malignant GIO should automatically trigger palliative care referral. pubmed.ncbi.nlm.nih.gov/36745760/

In a survey of 200 Jordanian advanced cancer patients, 40.5% preferred passive decision-making, while 35% preferred shared and 24.5% active control. Male, educated, and Christian patients favored active roles. Most were satisfied with decisions. pubmed.ncbi.nlm.nih.gov/37107832/

In this randomized trial among advanced cancer patients, a disease-specific Question Prompt Sheet (QPS) was rated as equally helpful as a general information sheet but was preferred overall. QPS encouraged more questions without increasing anxiety or time. pubmed.ncbi.nlm.nih.gov/37129892/

CAGE-AID may not reliably identify nonmedical opioid use in cancer patients. One patient with a positive score had no misuse, while another with a negative score showed misuse behaviors. Clinical judgment must complement screening to assess opioid risk accurately. pubmed.ncbi.nlm.nih.gov/37691336/

Among 220 cancer patients in Brazil, 25% preferred cremation and 71% burial. Cremation was linked to discussing death, weaker religious beliefs, and higher education. Understanding these factors can help improve end-of-life care and respect wishes. pubmed.ncbi.nlm.nih.gov/37194763/

Some things I learned from the Dr R Neil MacDonald: “administrative arrangements are important”, “you are the boss (to the patient)”, “common things are common”, “ Better someone inside the tent p- ing out than outside the tent p- ing in”, hockey, fried zucchini with soy sauce, love of medicine.