Current Opinion in Supportive and Palliative Care最新文献

{"title":"Integrated models of palliative medicine and pain management for the treatment of cancer-related pain: a review.","authors":"Lucy Hetherington, Lesley Somerville, Pete Paisley","doi":"10.1097/SPC.0000000000000828","DOIUrl":"10.1097/SPC.0000000000000828","url":null,"abstract":"<p><strong>Purpose of the review: </strong>Cancer-related pain remains one of the most common and distressing symptoms experienced by people with cancer. Increasing cancer prevalence, longer survival, and greater symptom complexity have highlighted the limitations of traditional, fragmented approaches to cancer pain management. This review examines contemporary models of integrated palliative medicine and pain management services, with particular emphasis on interdisciplinary care pathways and interventional pain techniques.</p><p><strong>Recent findings: </strong>Recent literature supports the earlier integration of palliative medicine within oncology services and closer collaboration between palliative medicine and pain medicine within a multidisciplinary service. Integrated service models are associated with improved symptom control, quality of life, and patient satisfaction. Interventional procedures, including intrathecal drug delivery and cordotomy, are increasingly recommended within comprehensive cancer pain pathways for patients with refractory pain. Evidence emphasises coordinated multifrom diagnosis to end-of-life care.disciplinary assessment and timely referral rather than escalation of pharmacological therapies alone.</p><p><strong>Summary: </strong>Integrated palliative medicine and pain management services represent an increasingly important model for addressing the multidimensional nature of cancer-related pain. Future research should focus on optimal service configuration, referral criteria, outcome measurement, and equitable access to specialist interventional expertise. Development of an interventional cancer pain registry would further strengthen data collection and models of best practice.</p>","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"226-232"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Person-centred care and palliative care: a review of recent evidence.","authors":"Bridget Johnston, Chris McParland","doi":"10.1097/SPC.0000000000000830","DOIUrl":"10.1097/SPC.0000000000000830","url":null,"abstract":"<p><strong>Purpose of review: </strong>This rapid review aimed to explore literature from the past 18 months (March 2025-August 2026) to investigate how person-centred care is conceptualised and operationalised in palliative and end-of-life settings, with attention to individuals' core values, dignity, and cultural needs.</p><p><strong>Recent findings: </strong>This rapid review identified 32 papers (March 2025-August 2026) and two key themes: person-centred care for different groups, and innovative clinical practices and their impact on health care providers. The literature emphasises culturally responsive, spiritually sensitive, and inclusive palliative care that addresses diversity, identity, disability, and family involvement. Key enablers and barriers include organisational culture, leadership, workforce capability, outcome measurement, and resources. Emerging innovations include new care models, co-designed interventions, environmental approaches, and dignity-focused practices.</p><p><strong>Summary: </strong>Recent evidence demonstrates that person-centred palliative care extends beyond symptom management to encompass cultural, spiritual, social, familial, and individual needs. Health care professionals must deliver culturally responsive, inclusive care that recognises diversity, disability, identity, and family involvement. Dignity, compassion, autonomy, and meaningful relationships remain central to high-quality person-centred palliative care. Key priorities for practice include advance care planning, shared decision-making, patient-centred outcome measurement, and education to support complex communication and goals-of-care discussions. Successful implementation requires strong leadership, supportive organisational cultures, and workforce development. Future research should evaluate innovative person-centred models, implementation strategies, and approaches that reduce inequalities and improve outcomes. Future practice and policy should align evidence more closely with practice, remaining mindful of cultural, spiritual, and psychosocial issues.</p>","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"261-266"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electroacupuncture analgesia for cancer-related pain.","authors":"Alice M Fuller, Shafaq Sikandar","doi":"10.1097/SPC.0000000000000831","DOIUrl":"10.1097/SPC.0000000000000831","url":null,"abstract":"<p><strong>Purpose of review: </strong>Cancer-related pain remains a major clinical problem arising from both malignancy and its treatment. Current pharmacotherapies rely on opioids and adjuvant analgesics, which still provide unsatisfactory relief for the majority of patients. The use of complementary therapies for the management of cancer-related pain is growing, and acupuncture is increasingly incorporated into integrative cancer care. We explore the clinical and preclinical evidence base for the use of electroacupuncture in tumour-associated pain and treatment-associated pain, with an emphasis on experimental studies of cancer-induced bone pain and chemotherapy-induced pain.</p><p><strong>Recent findings: </strong>Preclinical studies provide increasing biological plausibility for electroacupuncture analgesia by regulating peripheral and central neuroimmune and neuromodulatory nociceptive axes. Still, greater mechanistic alignment between preclinical and clinical studies is needed to understand how the mechanisms of acupuncture in rodents translate to humans. Clinical literature supports an analgesic effect of acupuncture; however, the magnitude and consistency of benefit vary considerably between studies. The biological activity of sham acupuncture further complicates the interpretation of conventional placebo-controlled trials and highlights the importance of incorporating objective physiological outcomes alongside patient-reported measures.</p><p><strong>Summary: </strong>Improved standardisation and reporting, objective outcome measures, and adequately powered trials that distinguish cancer-related pain phenotypes and acupuncture modalities will be necessary to establish how acupuncture can be optimally integrated into evidence-based cancer-related pain care.</p>","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"233-240"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life in patients with cancer treatment related nausea and vomiting - a scoping review.","authors":"Rachel Leong, Emily MacMillan, Christina Yang, Japyjot Singh, Jefferson Chan, Carlo DeAngelis, Shing Fung Lee, Tarek Hijal, Terry Ng, Kristopher Dennis, Vassilios Vassiliou, Olivera Gojsevic, Sarah Bayrakdarian, Henry Wong, Ronald Chow, Jennifer Leigh","doi":"10.1097/SPC.0000000000000825","DOIUrl":"10.1097/SPC.0000000000000825","url":null,"abstract":"<p><strong>Purpose: </strong>Treatment-related nausea and vomiting (TRNV) is among the most distressing and commonly reported adverse effects of antineoplastic therapy and can significantly impair patients' quality of life (QoL). This review summarizes the evidence on how TRNV affects QoL across cancer types, treatment regimens, antiemetic strategies, and phases of TRNV.</p><p><strong>Recent findings: </strong>TRNV negatively affects all domains of QoL in patients with cancer, particularly physical and functional well-being. Studies consistently reported worsened fatigue, insomnia, appetite loss, pain, impaired activities of daily living, meal enjoyment, and role functioning. Psycho-social and cognitive effects were also observed, although findings were more variable. Despite advances in antiemetic interventions and supportive strategies, patients continued to experience a substantial symptom burden and worsened QoL following treatment. Most studies explored chemotherapy-related TRNV and did not focus on a specific cancer type. A wide range of QoL instruments were used, but no single tool comprehensively assessed all QoL domains while remaining specific to cancer-related nausea and vomiting.</p><p><strong>Summary: </strong>TRNV is associated with a significant decline in QoL among patients with cancer. Further research on QoL after TRNV within specific cancer types and treatment modalities and the development of a more comprehensive QoL tool are needed to improve cross-study comparability and to better understand patient outcomes.</p>","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"272-286"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a role for palliative care in CAR T-cell therapy?","authors":"Jennifer Vidrine, Joanne Droney","doi":"10.1097/SPC.0000000000000824","DOIUrl":"10.1097/SPC.0000000000000824","url":null,"abstract":"<p><strong>Purpose of review: </strong>Recent international guidelines emphasise the importance of providing palliative care to patients with haematological malignancies. Chimeric antigen receptor (CAR) T-cell therapy has transformed outcomes for patients with selected haematological malignancies, offering the possibility of durable remission or cure. This review examines the emerging role of palliative and supportive care for patients being considered for and receiving CAR T-cell therapy.</p><p><strong>Recent findings: </strong>Recent studies highlight the distinct and significant symptom burden, treatment-related toxicities, psychological distress, financial toxicity, and caregiver impact associated with different stages of the CAR T-cell treatment journey. These findings suggest multiple opportunities for palliative and supportive care involvement during pre-treatment assessment, throughout the treatment and monitoring period, and into long-term follow-up and survivorship. Evidence from stem cell transplantation provides a strong rationale for early integrated models of palliative care in the CAR T setting.</p><p><strong>Summary: </strong>Palliative and supportive care can support high-quality, person-centred care for patients receiving CAR T-cell therapy. Future research should focus on defining optimal integrated service models, evaluating how best to provide supportive and palliative care for patients for whom prognosis is uncertain, and establishing the optimal timing and sustainable and equitable approaches to implementation.</p>","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"241-247"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmet palliative care needs among patients with life-limiting illnesses.","authors":"Bahaa Alassoud, Bridget Johnston, Sali Alaraj","doi":"10.1097/SPC.0000000000000822","DOIUrl":"10.1097/SPC.0000000000000822","url":null,"abstract":"<p><strong>Purpose of review: </strong>Unmet palliative-care needs remain common despite the well documented and wider recognition of early and integrated palliative care. This review examines recent evidence on unmet palliative-care needs among adults with advanced, progressive or life-limiting illness, with particular attention to how these needs are conceptualised and addressed across life-limiting illnesses.</p><p><strong>Recent findings: </strong>Recent work distinguishes the presence of a concern, access to services, and the sufficiency of the response in terms of unmet palliative-care needs. Patient-level studies continue to show multidimensional needs, with psychological, informational, relational, spiritual, functional, practical, and financial concerns often less visible than physical symptoms. Evidence from non-cancer illness and underserved populations is expanding, but differences in definitions, instruments, thresholds, timing, and reports preclude uncritical comparison. Rurality, poverty, food insecurity, stigma, fragmented care, and communication barriers shape who can disclose needs and obtain support. Implementation studies increasingly link assessment to action, although most demonstrate feasibility, referral, or service contact rather than resolution of the original patient-valued need.</p><p><strong>Summary: </strong>Current evidence supports assessment that records concerns about palliative care needs, whether help is wanted, who owns the response, what action follows, and whether support was sufficient. Services should not expand screening without response capacity. Comparative and intervention research should use patient-defined outcomes and include populations currently excluded by language, cognition, geography, and digital access.</p>","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"254-260"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of digital technologies to deliver supportive care to adolescents and young adults following treatment for cancer.","authors":"Samantha C Sodergren, Nicole Collaço","doi":"10.1097/SPC.0000000000000821","DOIUrl":"10.1097/SPC.0000000000000821","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review synthesises recent evidence on digital interventions designed to support adolescents and young adults (AYAs) following cancer treatment. It evaluates their effectiveness in addressing complex psychosocial and healthcare needs and their potential to enhance access to personalised, flexible supportive care. This is timely given improving survival rates, persistent gaps in age-appropriate follow-up, and growing interest in digital and AI-enabled care.</p><p><strong>Recent findings: </strong>Digital approaches include web-based programmes, mobile health applications, telehealth models, and emerging AI-driven tools. These interventions show promise for improving psychological outcomes, self-management, and access to support. However, the evidence base is limited, with most studies focused on feasibility and acceptability rather than efficacy. Findings are constrained by small, often unrepresentative samples, short follow-up periods, and limited evaluation of long-term outcomes and engagement.</p><p><strong>Summary: </strong>Digital technologies offer significant potential to improve AYA supportive care, but robust evidence is lacking. Most interventions adopt a 'human-in-the-loop' model, emphasising the continued role of healthcare professionals. High-quality trials are needed to establish clinical benefit and feasibility. Future research should prioritise sustainability, user engagement, accessibility, and integration into existing care pathways without increasing the burden on healthcare systems.</p>","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"267-271"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13712661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of holistic needs in people with chronic kidney disease.","authors":"Cynthia Hsin-Ya Chao, Mei-Yi Wu, Ka-Wai Tam","doi":"10.1097/SPC.0000000000000823","DOIUrl":"10.1097/SPC.0000000000000823","url":null,"abstract":"<p><strong>Purpose of review: </strong>Chronic kidney disease (CKD) is a growing global health challenge with substantial physical, psychological, social, and practical consequences beyond impaired kidney function. This review examines the rationale for holistic needs assessment, summarizes available assessment tools, and explores their role in delivering patient-centered care.</p><p><strong>Recent findings: </strong>Recognition of the multidimensional needs of patients with CKD has led to the development of numerous patient-centered assessment tools. However, these instruments vary in scope, psychometric properties, and target populations. Most assess specific domains of patients' experiences, whereas few comprehensively identify unmet holistic needs and facilitate multidisciplinary interventions. Emerging evidence supports integrating holistic needs assessments into routine clinical workflows to systematically identify unmet needs and guide appropriate referrals to supportive services.</p><p><strong>Summary: </strong>Holistic needs assessment offers a structured approach to identifying the multidimensional challenges experienced by patients with CKD that may otherwise go unrecognized in routine care. Integrating validated assessment tools into nephrology practice may enhance patient-centered care, enable earlier supportive interventions, and promote more comprehensive care delivery.</p>","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"248-253"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent chemotherapy-induced alopecia: a scoping review.","authors":"Amy Ws Lo, Sheona Sn Leung, Cindy Ls Wong, Jessica Lai, Azael Freites-Martinez, Juhee Cho, Sanam Tabataba Vakili, Muna Alkhaifi, Raymond J Chan, Michael Jefford, Jennifer M Jones, Mylin Torres, Maryam Lustberg, Jennifer Y Y Kwan, Julie Ryan Wolf, Adrian W Chan, Shing Fung Lee, Corina van den Hurk, Edward Chow, Henry Cy Wong","doi":"10.1097/SPC.0000000000000832","DOIUrl":"10.1097/SPC.0000000000000832","url":null,"abstract":"<p><strong>Purpose of review: </strong>Persistent chemotherapy-induced alopecia (pCIA) is defined as incomplete hair growth ≥6 months after chemotherapy completion. This scoping review aimed to identify gaps for future research by mapping pCIA's incidence, risk factors, quality-of-life (QoL) impacts, presentation, prevention, and management.</p><p><strong>Recent findings: </strong>Thirty-nine articles were included. The most common study type was case reports (12/39, 30.8%). Only 2/39 (5.1%) were randomized controlled trials (RCTs). Most studies (27/39, 69.2%) reported pCIA in patients with breast cancer. Alkylating agents, taxanes, and anthracyclines were most frequently reported to be associated with pCIA. All six studies that evaluated QoL reported that pCIA negatively affected patients' psychological, functional, and social well-being. Scalp cooling was the only intervention shown to prevent pCIA in four studies. Twenty-one studies reported on interventions for the management of pCIA. Topical minoxidil was reported to improve pCIA in 7 out of 12 studies (58.3%). Low-dose oral minoxidil demonstrated benefit in 7 out of 7 studies (100%).</p><p><strong>Summary: </strong>pCIA's incidence and risk factors should be prospectively evaluated across cancer types and chemotherapeutic agents. Given pCIA's significant QoL impacts, RCTs should be conducted to investigate existing and emerging interventions for its prevention and management, and to consider including these interventions in the standard of care.</p>","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"287-297"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral neuron circuitry mediating pain in head and neck cancer.","authors":"Gaurav Sharma, Shivani Ruparel","doi":"10.1097/SPC.0000000000000829","DOIUrl":"10.1097/SPC.0000000000000829","url":null,"abstract":"<p><strong>Purpose of review: </strong>Pain is a major source of morbidity in head and neck cancer (HNC), yet its neural mechanisms remain incompletely defined. This review examines how malignant cells, the tumor microenvironment, and cancer treatment remodel peripheral sensory and autonomic circuits, and how neural activity reciprocally influences tumor biology, with particular attention to findings published since 2023.</p><p><strong>Recent findings: </strong>Recent studies show that HNC selectively reorganizes tumor-associated nerves rather than merely injuring a pre-existing neural scaffold. Sensory-neuron transcriptional responses differ by sex, perineural invasion redistributes mechanosensory and nociceptive activity, and cancer-induced injury establishes sympathetic-sensory crosstalk. Tumor-derived extracellular vesicles can program persistent nociceptor hypersensitivity, while adenosine-A2A, protease-PAR2, NGF-neuropilin-1, and EGFR pathways connect tumor metabolism and signaling to neuronal excitability and analgesic tolerance. Conversely, sensory and sympathetic signals promote tumor growth through direct effects on malignant cells, metabolic reprogramming, and local or systemic immune suppression. Surgery and radiotherapy add distinct patterns of denervation, sensitization, and reparative remodeling.</p><p><strong>Summary: </strong>HNC pain arises from reciprocal remodeling across tumor, immune, stromal, glial, and neural compartments. Defining how these circuits generate clinical pain phenotypes may support mechanism-based analgesia while avoiding unintended effects on antitumor immunity, tumor progression, or treatment response.</p>","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"217-225"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}