{"title":"Mitigating late effects in cancer survivors: harnessing personalised medicine and new models of care.","authors":"Joanne Bird, Sara Faithfull","doi":"10.1097/SPC.0000000000000693","DOIUrl":"10.1097/SPC.0000000000000693","url":null,"abstract":"","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":"18 1","pages":"27-29"},"PeriodicalIF":1.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673381","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":"Managing chronic pain after breast cancer treatments: are web-based interventions the future?","authors":"Sue Hartup, Michelle Briggs","doi":"10.1097/SPC.0000000000000691","DOIUrl":"10.1097/SPC.0000000000000691","url":null,"abstract":"<p><strong>Purpose of the review: </strong>Chronic post-treatment pain in breast cancer affects a high proportion of patients. Symptom burden and financial costs are increasingly impacting patients and healthcare systems because of improved treatments and survival rates. Supporting long-term breast cancer symptoms using novel methodology has been examined, yet few have explored the opportunity to utilise these interventions for prevention. This review aims to explore the need for, range of, and effectiveness of such interventions.</p><p><strong>Recent findings: </strong>Three papers describe risk factors for chronic pain, with six recent papers describing the use of interventions for acute pain in the surgical setting. The evidence for the effectiveness of these interventions to improve pain management in this setting is limited but tentatively positive. The results have to take into account the variation between systems and limited testing.</p><p><strong>Summary: </strong>Multiple types of intervention emerged and appear well accepted by patients. Most assessed short-term impact and did not evaluate for reduction in chronic pain. Such interventions require rigorous effectiveness testing to meet the growing needs of post-treatment pain in breast cancer. A detailed understanding of components of web-based interventions and their individual impact on acute pain and chronic pain is needed within future optimisation trials. Their effectiveness as preventative tools are yet to be decided.</p>","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"47-54"},"PeriodicalIF":1.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089131","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":"Cancer survivor late-effects, chronic health problems after cancer treatment: what's the evidence from population and registry data and where are the gaps?","authors":"Sara Faithfull, Diana Greenfield","doi":"10.1097/SPC.0000000000000692","DOIUrl":"10.1097/SPC.0000000000000692","url":null,"abstract":"<p><strong>Purpose of review: </strong>Improvements in cancer treatment have led to more people living with and beyond a cancer diagnosis but survivors may have increased health problems as they age. The purpose of this review is to critically evaluate population data exploring incidence of late effects for cancer survivors.</p><p><strong>Recent findings: </strong>18 studies were identified between 2013 and 2023 that explored the impact on survivors' physical and emotional health. Patients who had been treated at least 2 years previously for cancer had significant cardiovascular risk factors compared with age-matched controls. Women with breast cancer were more likely to have cardiovascular disease, including hypertension, arrythmias and congestive heart failure. This was associated with anthracyclines and/or trastuzumab as part of systemic anti-cancer therapy. Survivors of colorectal cancer were three times more likely to have acute kidney injury than age-matched controls. Stress and mood disorders were higher in survivors of testicular cancer and prostate cancer.</p><p><strong>Summary: </strong>Population studies are important to identify the 'real world' consequences of cancer and its treatment beyond clinical trials. Knowledge is critical for managing an ageing cancer population. Data to personalise cancer survivorship care, not only helps determine potential health risks, but can improve secondary prevention, emotional health, recovery, and long-term outcomes.</p>","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"55-64"},"PeriodicalIF":1.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089130","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":"Supportive and palliative care for older adults with cancer; facilitating person-centred, age friendly care.","authors":"Christopher B Steer, Schroder Sattar, Ines Menjak","doi":"10.1097/SPC.0000000000000689","DOIUrl":"10.1097/SPC.0000000000000689","url":null,"abstract":"","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":"18 1","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673382","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}
Oliver Hodge, Tshepo Rasekaba, Irene Blackberry, Christopher B Steer
{"title":"Age-friendly healthcare: integrating the 4Ms to enable age-friendly cancer care.","authors":"Oliver Hodge, Tshepo Rasekaba, Irene Blackberry, Christopher B Steer","doi":"10.1097/SPC.0000000000000687","DOIUrl":"10.1097/SPC.0000000000000687","url":null,"abstract":"<p><strong>Purpose of review: </strong>There is a growing movement towards person-centred, age-friendly healthcare in the care of older adults, including those with cancer. The Age-Friendly Health Systems (AFHS) initiative uses the 4Ms framework to enable this change. This review documents the utility and implications of 4Ms implementation across different settings, with a particular focus on cancer care.</p><p><strong>Recent findings: </strong>The AFHS initiative 4Ms framework uses a set of core, evidence-based guidelines (focussing on What Matters, Medication, Mentation and Mobility) to improve person-centred care. The successful implementation of the 4Ms has been documented in many different healthcare settings including orthopaedics primary care, and cancer care. Implementation of the 4Ms framework into existing workflows complements the use of geriatric assessment to improve care of older adults with cancer. Models for implementation of the 4Ms within a cancer centre are described. Active engagement and education of healthcare providers is integral to success. Solutions to implementing the What Matters component are addressed.</p><p><strong>Summary: </strong>Cancer centres can successfully implement the 4Ms framework into existing workflows through a complex change management process and development of infrastructure that engages healthcare providers, facilitating cultural change whilst employing quality improvement methodology to gradually adapt the status quo to age-friendly processes.</p>","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"9-15"},"PeriodicalIF":1.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514014","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":"Incidence, description, predictors, and consequences of persistent taxane-induced peripheral neuropathy.","authors":"Daniel L Hertz","doi":"10.1097/spc.0000000000000684","DOIUrl":"https://doi.org/10.1097/spc.0000000000000684","url":null,"abstract":"This review aims to provide insights into persistent taxane-induced peripheral neuropathy (TIPN). The primary objective is to describe the incidence, predictors, and consequences of TIPN lasting at least 1 year after the end of taxane treatment.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":"35 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138823630","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}
Schroder Sattar, Kristen R Haase, Kayoung Lee, Kristin L Campbell
{"title":"Exercise interventions for frail older adults with cancer.","authors":"Schroder Sattar, Kristen R Haase, Kayoung Lee, Kristin L Campbell","doi":"10.1097/spc.0000000000000685","DOIUrl":"https://doi.org/10.1097/spc.0000000000000685","url":null,"abstract":"Frailty is prevalent in older adults with cancer and can lead to complications during cancer treatment and poor health outcomes. Exercise has been shown to be a promising strategy to mitigate frailty and slow the accumulation of functional impairment in the general geriatric population. In this review, we present a discussion on the state of the science of exercise interventions for frail older adults with cancer. This review is timely and relevant given the aging of the population and corresponding increase in proportion of older adults living with cancer.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":"35 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138823591","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}
Daniela C Rosenberger, Daniel Segelcke, Esther M Pogatzki-Zahn
{"title":"Mechanisms inherent in acute-to-chronic pain after surgery - risk, diagnostic, predictive, and prognostic factors.","authors":"Daniela C Rosenberger, Daniel Segelcke, Esther M Pogatzki-Zahn","doi":"10.1097/SPC.0000000000000673","DOIUrl":"10.1097/SPC.0000000000000673","url":null,"abstract":"<p><strong>Purpose of review: </strong>Pain is an expected consequence of a surgery, but it is far from being well controlled. One major complication of acute pain is its risk of persistency beyond healing. This so-called chronic post-surgical pain (CPSP) is defined as new or increased pain due to surgery that lasts for at least 3 months after surgery. CPSP is frequent, underlies a complex bio-psycho-social process and constitutes an important socioeconomic challenge with significant impact on patients' quality of life. Its importance has been recognized by its inclusion in the eleventh version of the ICD (International Classification of Diseases).</p><p><strong>Recent findings: </strong>Evidence for most pharmacological and non-pharmacological interventions preventing CPSP is inconsistent. Identification of associated patient-related factors, such as psychosocial aspects, comorbidities, surgical factors, pain trajectories, or biomarkers may allow stratification and selection of treatment options based on underlying individual mechanisms. Consequently, the identification of patients at risk and implementation of individually tailored, preventive, multimodal treatment to reduce the risk of transition from acute to chronic pain is facilitated.</p><p><strong>Summary: </strong>This review will give an update on current knowledge on mechanism-based risk, prognostic and predictive factors for CPSP in adults, and preventive and therapeutic approaches, and how to use them for patient stratification in the future.</p>","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"324-337"},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10215493","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":"Should opioids be used for breathlessness and in whom? A PRO and CON debate of the evidence.","authors":"Magnus Ekström, Daisy J A Janssen","doi":"10.1097/SPC.0000000000000674","DOIUrl":"10.1097/SPC.0000000000000674","url":null,"abstract":"Purpose of review The net clinical benefit of opioids for chronic breathlessness has been challenged by recent randomized clinical trials. The purpose was to review and weigh the evidence for and against opioid treatment for chronic breathlessness in people with serious disease. Recent findings Evidence to date on the efficacy and safety of opioids for chronic breathlessness was reviewed. Findings supporting a benefit from opioids in meta-analyses of earlier, mostly smaller trials were not confirmed by recent larger trials. Evidence pertains mostly to people with chronic obstructive pulmonary disease but also to people with pulmonary fibrosis, heart failure, and advanced cancer. Taken together, there is no consistent evidence to generally recommend opioids for severe breathlessness or to identify people who are more likely to benefit. Opioid treatment may be tested in patients with intractable breathlessness and limited other treatment options, such as in end-of-life care. Knowledge gaps were identified and recommendations were made for future research. Summary Key Points Supportive findings of net benefit of opioids for chronic breathlessness in earlier trials have not been confirmed by recent larger randomized clinical trials. There is no evidence that the opioid treatment improves the person’s exercise capacity or quality of life, and it increases the risk of adverse events. Evidence to date does not support that opioids should generally be recommended for treating breathlessness. In people with intractable symptoms and short expected survival, with few or no treatment options, it may still be reasonable to try opioid treatment with the aim to alleviate severe breathlessness. Research is needed to explore the potential benefit of opioids in selected patient groups. Opioids cannot be generally recommended for treating breathlessness based on insufficient evidence for net clinical benefit.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":" ","pages":"263-269"},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10597437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10291345","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}
Nicholas G Zaorsky, Alexander V Louie, Shankar Siva
{"title":"Radiation therapy options in kidney cancer.","authors":"Nicholas G Zaorsky, Alexander V Louie, Shankar Siva","doi":"10.1097/SPC.0000000000000683","DOIUrl":"10.1097/SPC.0000000000000683","url":null,"abstract":"<p><strong>Purpose of review: </strong>In this review, the authors discuss the use of stereotactic body radiation therapy (SBRT) for the treatment of primary and metastatic renal cell carcinoma (RCC).</p><p><strong>Recent findings: </strong>For primary RCC treated with SBRT, local control is estimated at >95%, and grade 3-4 toxicity is limited at ≤5%. The difference in glomerular filtration rate pretreatment versus posttreatment was about 7.7 ml/min. For metastatic RCC treated with SBRT, the 1-year local control is ~90%. The incidence of any grade 3-4 toxicity is ~1%. Several ongoing trials are evaluating SBRT in combination or in lieu of systemic therapy. There are many unknowns remaining in the treatment of RCC, including tumor prognostication, treatment selection, and treatment delivery.</p><p><strong>Summary: </strong>Stereotactic body radiation therapy is a safe and effective treatment option for patients with primary and metastatic RCC.</p>","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":"17 4","pages":"308-314"},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159093","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}