Annals of palliative medicine最新文献

{"title":"Palliative care in oncology at a time of extreme global health inequalities and over-stretched resources: contextualizing the ASCO Palliative Care for Patients with Cancer Guideline Update.","authors":"Maria Vassiliou, Agata Rembielak, Shing Fung Lee, Charles B Simone Ii, Henry Wong, Muna Al-Khaifi, Yvette Van de Linden, Primus Ochieng, Jeffrey Smith, Warren Bacorro, Adrian Chan, Seamus Coyle, Ann Griffiths, Edward Chow, Eva Oldenburger","doi":"10.21037/apm-24-165","DOIUrl":"https://doi.org/10.21037/apm-24-165","url":null,"abstract":"","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109339","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":"Exploratory study of the association between Healing Scale and symptoms among terminally ill cancer patients.","authors":"Tomofumi Miura, Takashi Kawaguchi, Takashi Igarashi, Koshin Katsu, Sakiho Noda, Mariko Harada, Yuya Ashitomi, Yukako Hattori, Mitsue Takeuchi, Emi Kubo, Seiya Enomoto, Hidehiko Taniyama, Tetsuo Iwata, Takuhiro Yamaguchi","doi":"10.21037/apm-25-12","DOIUrl":"https://doi.org/10.21037/apm-25-12","url":null,"abstract":"<p><p>The Healing Scale was developed to measure subjects' sense of healing. This study aimed to investigate the association between the Healing Scale scores and symptom improvement in terminally ill cancer patients. A sub-analysis of a previous sound-based intervention study was performed. Data from 18 terminally ill cancer patients were analyzed. The Healing Scale and symptoms were measured before and 30 minutes after the intervention. Correlations between the Healing Scale score and symptoms before intervention, and improvement of the Healing Scale and symptoms were analyzed using Pearson's rho. The mean age of subjects was 69.4 years and 33.3% were female. At baseline, higher Healing Scale Scores were significantly correlated with greater symptom burden, particularly well-being (ρ=-0.57), shortness of breath (ρ=-0.55), and lack of appetite (ρ=-0.50). At post-intervention, improvements in the Healing Scale scores showed moderate to strong correlations with reductions in shortness of breath (ρ=-0.68), tiredness (ρ=-0.58), and well-being (ρ=-0.56). These findings suggest that the Healing Scale may be a valuable outcome measure in palliative care research and clinical practice and may help to evaluate subjective aspects of patient healing and well-being that are often overlooked by traditional symptom scales. Further studies with larger sample sizes are required to validate the present findings in palliative care settings.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":"14 3","pages":"239-246"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282221","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":"Integrative medicine in breast cancer survivorship care.","authors":"Jill Shainhouse, Pauline Sok Yin Hwang, Mark Fontes, Ting Bao","doi":"10.21037/apm-24-176","DOIUrl":"https://doi.org/10.21037/apm-24-176","url":null,"abstract":"<p><p>Integrative medicine use is prevalent among breast cancer survivors to improve lifestyle and manage symptoms associated with cancer or its treatment. This review provides an overview of integrative therapies used for lifestyle improvement and symptom management in breast cancer patients, including diet and exercise recommendations, mind-body approaches including mindfulness-based intervention, acupuncture, yoga, massage, and dietary supplements. A balanced diet with an emphasis on plant-based foods and limited consumption of red meat, processed meats, alcohol, and refined sugar is recommended for cancer patients and survivors. Physical activity is also important, with recommendations of 30 minutes of moderate exercise daily, aiming for 150 minutes per week. Mind-body approaches such as meditation, yoga have been shown to improve emotional self-regulation, anxiety, depression, and other symptoms. Acupuncture has demonstrated potential benefits for aromatase inhibitor-induced musculoskeletal symptoms, hot flashes, peripheral neuropathy, and fatigue. Massage may help address pain, anxiety, stress, and improve quality of life (QoL). Supplement use should be approached with caution, especially during active treatment, due to potential interactions with cancer therapies. The review highlights the role of specialized integrative medicine practitioners, such as naturopathic doctors and acupuncturists, in safely incorporating these therapies into standard cancer care. This collaborative approach supports survivors' diverse needs and empowers them to actively participate in their recovery, ultimately improving health outcomes and QoL. Integrative therapy programs within cancer care institutions can provide structure, guidance, and support for patients to safely incorporate these modalities into their treatment and recovery plans.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":"14 3","pages":"283-294"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282222","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":"The role of emergency departments in identifying, managing and referring patients with palliative care needs.","authors":"Brian H Rowe, Scott W Kirkland","doi":"10.21037/apm-25-23","DOIUrl":"https://doi.org/10.21037/apm-25-23","url":null,"abstract":"","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":"14 3","pages":"312-316"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282229","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":"Palliative radiation oncology programs: improving value through high-quality and cost-effective care.","authors":"Andrew R Bruggeman, Jared R Robbins, Eric M Chang, Kavita Dharmarajan","doi":"10.21037/apm-24-171","DOIUrl":"https://doi.org/10.21037/apm-24-171","url":null,"abstract":"<p><p>An estimated 40% of all radiation treatments are delivered with non-curative intent, and there is strong evidence that this cohort of patients benefits from the early integration of palliative care services. Palliative radiation oncology programs (PROPs) are teams, processes, or systems that were developed to meet these needs. PROPs address specific issues related to the delivery of palliative radiation therapy (PRT) and try to enhance and improve the quality, cost, timeliness, and value of patient care. While PROPs can be tailored to specifically meet any institutional needs, establishing a sustainable PROP requires commitment from the institution, the systemic integration of standardized care pathways, workflows, and best practice guidelines, collaboration within the oncology team, and dedicated infrastructure resources. PROPs have been shown to improve timely access to care, increase patient and provider satisfaction, advance guideline-concordant care, standardize assessment of palliative care needs, improve palliative care education among radiation oncology residents, and reduce hospital stays and health care costs. While not yet widely adopted, the benefits they provide confirm their value and importance for patients with advanced cancer and for the health care system in general. This article outlines the reasons PROPs were developed, discusses elements related to developing sustainable PROPs, and highlights the value that they provide while reducing costs.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":"14 3","pages":"247-254"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282224","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":"Asymptomatic bone metastases: 2024 American Society for Radiation Oncology (ASTRO) education panel.","authors":"Shing Fung Lee, Peter J Hoskin","doi":"10.21037/apm-25-5","DOIUrl":"https://doi.org/10.21037/apm-25-5","url":null,"abstract":"","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":"14 3","pages":"309-311"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282209","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":"Palliative radiotherapy for hepatic cancer pain.","authors":"Eva Oldenburger, Shing Fung Lee, Charles B Simone, Henry C Y Wong, Hans T Chung","doi":"10.21037/apm-25-3","DOIUrl":"https://doi.org/10.21037/apm-25-3","url":null,"abstract":"","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":"14 3","pages":"295-299"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282225","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":"Digital clubbing predicts the efficacy of antifibrotic drugs in patients with idiopathic pulmonary fibrosis.","authors":"Hiroyoshi Yamauchi, Masashi Bando, Akiko Okuyama, Toshikazu Takasaki, Shu Hisata, Masayuki Nakayama, Naoko Mato, Makoto Maemondo","doi":"10.21037/apm-24-177","DOIUrl":"https://doi.org/10.21037/apm-24-177","url":null,"abstract":"<p><strong>Background: </strong>The introduction of antifibrotic drugs elicited a significant paradigm shift in the treatment of fibrosing interstitial lung diseases such as idiopathic pulmonary fibrosis (IPF). However, it remains unclear which clinical characteristics of IPF patients predicts therapeutic efficacy, and there has been limited investigation of the relationship between physical findings. The aim of this study was to investigate whether various clinical factors, including physical findings at the initiation of antifibrotic therapy, had an impact on the clinical response to treatment.</p><p><strong>Methods: </strong>We retrospectively examined baseline clinical characteristics of IPF patients to identify features associated with better responses to antifibrotic drugs. We identified 257 consecutive patients with progressive pulmonary fibrosis who received antifibrotic therapy between March 2009 and May 2021, including 153 patients treated with pirfenidone and 104 patients treated with nintedanib. Of these, 66 patients with IPF had comprehensive baseline data recorded at the time of therapy initiation, including gender, age, smoking history, symptoms, physical findings including digital clubbing, biomarkers, and pulmonary function. Based on pulmonary function at 6 months after initiation of treatment, these patients were classified into a non-deterioration group and a deterioration group. Baseline data at the initiation of antifibrotic therapy were compared between these two groups.</p><p><strong>Results: </strong>Twenty-two patients were classified into the deterioration group and 44 into the non-deterioration group. The annualized change in forced vital capacity (FVC) was -385.8±363.3 mL in the deterioration group and 94.1±207.0 mL in the non-deterioration group. The only significant difference in baseline characteristics between the groups was the presence of digital clubbing, observed in 5 of 22 patients (22.7%) in the deterioration group and in 22 of 44 patients (50.0%) in the non-deterioration group (P=0.04). Our findings indicate that IPF patients with digital clubbing experienced a smaller annual decline in FVC following antifibrotic therapy compared to those without digital clubbing.</p><p><strong>Conclusions: </strong>These findings suggest that the presence or absence of digital clubbing in IPF patients may predict the annual rate of FVC decline following antifibrotic therapy. Antifibrotic drugs may be more effective in IPF patients who present with digital clubbing.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":"14 3","pages":"231-238"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282211","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":"Sarcopenia in cirrhosis: a clinical practice review.","authors":"Ussama Ghumman, Brian Lee, Dakota Bigham, Eugenia Tsai","doi":"10.21037/apm-24-173","DOIUrl":"https://doi.org/10.21037/apm-24-173","url":null,"abstract":"<p><p>Cirrhosis, a leading cause of death in the United States, is a result of chronic liver injury leading to progressive liver fibrosis. Initially asymptomatic, cirrhosis progresses to decompensated forms characterized by jaundice, ascites, gastroesophageal variceal bleeding, and hepatic encephalopathy (HE). Malnutrition, frailty, and sarcopenia are prevalent comorbidities in cirrhosis patients and are often used interchangeably in the clinical setting. Malnutrition is a condition marked by imbalanced nutrient intake and is closely related to the development of frailty and sarcopenia. Frailty is characterized by the decline in physiological reserve and function, while sarcopenia is the generalized loss of skeletal mass. Both are insidious complications of cirrhosis and also significantly influence morbidity, mortality, and transplant outcomes. Major contributing factors include decreased oral intake, poor nutrient uptake and deranged metabolism. Accurate assessment of frailty and sarcopenia in patients with cirrhosis is essential for predicting clinical outcomes. Interventions targeting frailty and sarcopenia could significantly improve patient prognosis. Nutritional interventions and physical activity promote muscle protein synthesis, increase muscle mass and mitigate sarcopenia. A cirrhosis-specific treatment includes ammonia-lowering agents to improve cognitive function and ultimately oral intake, and increase muscle mass. Emerging therapies, such as including L-ornithine L-aspartate, leucine-enriched branch-chained amino acids, hold promise in modulating skeletal muscle. This review explores the definitions, clinical manifestations, and consequences of malnutrition, frailty, and sarcopenia in cirrhosis, emphasizing the importance of early assessment and intervention.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":"14 3","pages":"255-268"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282226","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":"The optimal radiation therapy modality for spinal metastases: stereotactic body radiation therapy versus conventional external beam radiation therapy.","authors":"Charles B Simone","doi":"10.21037/apm-25-49","DOIUrl":"https://doi.org/10.21037/apm-25-49","url":null,"abstract":"","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":"14 3","pages":"317-319"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282228","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}