BMJ Supportive & Palliative Care最新文献

{"title":"Voluntary-assisted dying, euthanasia and physician-assisted suicide: global perspectives-systematic review.","authors":"Graham Llewellyn Grove, Melanie R Lovell, Ian Hughes, Elise Maehler, Megan Best","doi":"10.1136/spcare-2024-005116","DOIUrl":"https://doi.org/10.1136/spcare-2024-005116","url":null,"abstract":"<p><strong>Background: </strong>Discussions about euthanasia and physician-assisted suicide (EAS) involve various stakeholders, including patients, healthcare professionals and the general public. This review examines perspectives across different population subgroups to contribute to a broader understanding of EAS attitudes.</p><p><strong>Methods: </strong>A systematic review of literature published prior to July 2023 with quantitative data about EAS views was undertaken. Details extracted from eligible papers included data year, geography, demographic features of population subgroups and levels of support for EAS under various circumstances. Proportions in support for EAS were calculated based on these factors. Meta-analyses were conducted to estimate changes in the proportion of support for euthanasia dependent on the presence or absence of pain or terminal illness in patients.</p><p><strong>Results: </strong>The search identified 521 relevant studies. There were 1863 relevant survey questions with 1 945 945 individual responses, spanning years 1936 to 2023.478 studies explored whether EAS should be allowed, 134 examined clinician willingness to practise EAS and 78 investigated which persons might seek EAS. Clinician views were surveyed in 266 studies, public opinion in 139 and patient beliefs in 54.Support for EAS across studies and subpopulations varied widely. Mean support for EAS was lower in doctors than in the general public (25% compared with 55%). Support varied depending on access criteria to EAS with 54% support for patients in pain vs 36% for those without and 53% for terminally ill patients vs 29% for those without a terminal illness. Public support for EAS was lower in religious people, females, older people and African Americans.</p><p><strong>Conclusions: </strong>Support for EAS varies widely across studies, with numerous demographic and situational factors associated with differing levels of support. This indicates a complex interplay of elements is involved in the formation of EAS beliefs. Understanding these factors is valuable for facilitating meaningful discussions among clinicians and the community and informing policy debates and decisions.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771360","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":"Handgrip strength assessment in geriatric populations: digital dynamometers comparative study.","authors":"Nina Kemala Sari, Stepvia Stepvia, Muhana Fawwazy Ilyas, Siti Setiati, Kuntjoro Harimurti, Ika Fitriana","doi":"10.1136/spcare-2024-005245","DOIUrl":"https://doi.org/10.1136/spcare-2024-005245","url":null,"abstract":"<p><strong>Background/objectives: </strong>Handgrip strength is a critical indicator of overall health, particularly in older adults, and is associated with frailty, sarcopenia and risk of adverse health outcomes. Precise and reliable measurement instruments are necessary to ensure accuracy in personalised diagnostic evaluations. This study aimed to assess the inter-instrument reliability and agreement between the Jamar Plus+ digital and Jamar hydraulic dynamometers in measuring handgrip strength.</p><p><strong>Methods: </strong>A cross-sectional study was conducted to assess the handgrip strength of older individuals in the community aged more than 60, using the Jamar Plus+ digital and Jamar hydraulic dynamometers. The inter-instrument reliability and agreement between the devices were evaluated using Intraclass Correlation Coefficients (ICCs) and Bland-Altman analysis.</p><p><strong>Results: </strong>A total of 109 participants with a mean age of 66±5.3 years were included in this study. The Jamar Plus+ digital dynamometer recorded significantly higher handgrip strength measurements (27.0±7.1 kg) compared with the Jamar hydraulic dynamometer (21.0±6.7 kg). The ICCs between the two devices ranged from 0.67 to 0.70, indicating moderate reliability. Bland-Altman analysis revealed a consistent overestimation of handgrip strength by the Jamar Plus+ digital dynamometer, with systematic biases of 4.8 kg in men and 6.26 kg in women compared with the Jamar hydraulic dynamometer.</p><p><strong>Conclusion: </strong>The Jamar Plus+ digital dynamometer consistently overestimated handgrip strength compared with the Jamar hydraulic dynamometer, but both devices demonstrated moderate reliability. The Jamar Plus+ showed greater responsiveness to variations in strength. Selecting appropriate diagnostic tools is crucial for optimising individualised health assessments in older adults.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771358","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":"Ambulatory palliative care and cancer symptom control: a systematic review and meta-analysis.","authors":"Rajvi Shah, Rachel Everitt, Dana Hince, David Kissane, Natasha Michael","doi":"10.1136/spcare-2024-005152","DOIUrl":"https://doi.org/10.1136/spcare-2024-005152","url":null,"abstract":"<p><strong>Background: </strong>Ambulatory palliative care clinics are associated with improved outcomes in cancer patients, including short-term quality of life. However, their impact on individual patient-reported symptoms is not well understood.</p><p><strong>Aim: </strong>We evaluated the impact of ambulatory palliative care on individual symptoms in adult cancer patients.</p><p><strong>Design: </strong>Following a standard protocol (PROSPERO: CRD42022321909), investigators independently identified randomised and non-randomised intervention studies that assessed patient-reported symptom scores using validated symptom assessment scales longitudinally. Data were synthesised using random-effects meta-analyses.</p><p><strong>Data sources: </strong>Database of PubMed, CINAHL, EMBASE, PsycINFO and Cochrane Central was searched from inception to September 2023 for eligible studies.</p><p><strong>Results: </strong>20 studies encompassing 4 prospective cohort studies, 1 randomised control trial and 15 retrospective studies were included. Most studies focused on cohorts with advanced cancers of mixed primary tumour type, were colocated within or linked to a tertiary cancer centre and assessed symptoms using the Edmonton Symptom Assessment Scale (ESAS). The meta-analyses confirmed evidence for improvement in pain (standardised mean difference (SMD) 0.31, 95% CI 0.18 to 0.44), anxiety (SMD 0.31, 95% CI 0.12 to 0.49), fatigue (SMD 0.31, 95% CI 0.10 to 0.51), insomnia (SMD 0.29, 95% CI 0.15 to 0.42), depression (SMD 0.25, 95% CI 0.09 to 0.40), drowsiness (SMD 0.23, 95% CI 0.11 to 0.34), well-being (SMD 0.28, 95% CI 0.12 to 0.45) and overall symptom burden (SMD 0.29, 95% CI 0.22 to 0.36). There was no evidence for improvement in nausea (SMD 0.19, 95% CI -0.02 to 0.40), dyspnoea (SMD 0.16, 95% CI 0.02 to 0.29) and appetite scores (SMD 0.14, 95% CI -0.00 to 0.29).</p><p><strong>Conclusions: </strong>Ambulatory palliative care had positive effects on multiple common symptoms. The strength of this evidence however is low, largely due to the considerable heterogeneity among included studies. Further research could determine thresholds on symptom assessment scales to guide urgency of referral, timing of follow-up and optimal multidisciplinary staff involvement.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691074","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":"Lower physical activity and functional capacity after breast cancer neoadjuvant chemotherapy.","authors":"Clarice Gomes Chagas Teodózio, Thamyres Vitória Francisco da Silva Correia Gomes, Louise Acalantis Pereira Pires Fernandes, Raphaela Nunes de Lucena, Jessica Malena Pedro da Silva, Suzana Sales de Aguiar, Luiz Claudio Santos Thuler, Anke Bergmann","doi":"10.1136/spcare-2024-005358","DOIUrl":"https://doi.org/10.1136/spcare-2024-005358","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the levels of physical activity (PA) and functional capacity of breast cancer patients before and after neoadjuvant chemotherapy.</p><p><strong>Methods: </strong>The investigation comprises a prospective cohort study including women 18 years or older who underwent neoadjuvant chemotherapy for breast cancer at a single oncology centre between 4 April 2016 and 31 October 2018. Patients were evaluated in terms of self-reported PA levels and physical capacity using the following physical tests: handgrip strength, sitting and standing up in 30 s and stationary walking for 2 min. Variables were compared before and after neoadjuvant chemotherapy using the Wilcoxon test.</p><p><strong>Results: </strong>A total of 440 women were analysed, 88.2% of whom presented at an advanced clinical stage. The mean age of the patients was 51.0 years (±11.0), 68.0% were non-white and 53.9% were not working at the time of diagnosis. Decreased PA levels and handgrip strength (p<0.002) were observed following chemotherapy, although no changes in aerobic capacity and lower limb resistance (LLR) were noted (p=0.595 and p=0.163, respectively).</p><p><strong>Conclusion: </strong>Women with breast cancer exhibit decreased PA levels and handgrip strength following neoadjuvant chemotherapy, although no alterations in aerobic capacity and LLR were observed at the end of treatment.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691075","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 care is related to less aggressive end-of-life treatment in haematology-oncology: a retrospective cohort study.","authors":"Davide Facchinelli, Corinna Greco, Manuela Rigno, Daniela Menon, Pietro Manno, Leonardo Potenza, Claudio Cartoni, Marcello Riva, Laura Dalla Verde, Anna Varalta, Alberto Tosetto","doi":"10.1136/spcare-2024-005089","DOIUrl":"https://doi.org/10.1136/spcare-2024-005089","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with haematological malignancies (HM) experience high-intensity medical care near the end of life (EOL), have low rates of hospice and palliative care (PC) use and are more likely to die in the hospital. We compared the quality indicators for EOL care in patients followed by a haematologist with or without PC.</p><p><strong>Methods: </strong>This observational, retrospective study evaluated a cohort of 196 consecutive patients with HM. We used a mean composite score for the aggressiveness of EOL. The quality indicators evaluated were chemotherapy, place of death, transfusions and hospital use in the last month of life.</p><p><strong>Results: </strong>Eighty patients were offered PC and 116 were not. The composite score for aggressive EOL care was significantly higher for patients not followed by PC (2.2 vs 0.5; p<0.0001). None of the PC group patients was intubated or admitted to intensive care; 91.2% of the patients followed by PC died at home or in hospice, while 81.9% of the other patients died in the hospital.</p><p><strong>Conclusion: </strong>Many patients who died of HM received intensive treatment near EOL. Our data support the value of integrating PC into the HM routine practice and can be the basis for new studies.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656176","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":"Long-term opioid prescribing and healthcare encounters in metastatic cancer: observational population study.","authors":"Hannah Harsanyi, Lin Yang, Jenny Lau, Winson Y Cheung, Yuan Xu, Colleen Cuthbert","doi":"10.1136/spcare-2024-005185","DOIUrl":"https://doi.org/10.1136/spcare-2024-005185","url":null,"abstract":"<p><strong>Background: </strong>Although opioids are effective for cancer pain management, long-term use may result in adverse effects which are understudied among patients with metastatic disease.</p><p><strong>Objectives: </strong>To describe long-term opioid prescribing among patients with metastatic cancer and investigate how long-term prescribing practices are associated with the incidence of opioid-related hospitalisations and emergency department visits.</p><p><strong>Methods: </strong>This retrospective cohort study included all opioid-naïve patients diagnosed with solid metastatic cancer in Alberta, Canada from 2004 to 2017 who had ≥1 year of follow-up. Patients were identified and followed using linked administrative health data. Long-term prescribing was defined as receiving a ≥90-day supply of opioids with a <30-day gap in supply within a 180-day period. The incidence rate of opioid-related healthcare encounters was compared based on characteristics of long-term prescribing (timing, dosage, duration and concurrent medications).</p><p><strong>Results: </strong>The study included 10 927 patients, 2521 (23%) of whom received long-term opioid prescribing. These practices became more common near the end of life, with 53% of cases initiated during patients' last year of life. Opioid-related healthcare encounters were experienced by 85 (3.4%) recipients of long-term prescribing. Higher dosage (p<0.001) and concurrent prescribing of anxiolytics (p=0.001), benzodiazepines (p=0.001), antidepressants (p=0.027) and neuroleptics (p<0.001) were associated with a higher incidence of opioid-related healthcare encounters.</p><p><strong>Conclusions: </strong>Long-term opioid prescribing is common, and patients receiving long-term prescriptions with high dosage or concurrent psychoactive medications may benefit from interventions aimed at reducing opioid-related adverse effects. Further research is needed to determine strategies to minimise opioid-related harms for these patients while providing appropriate pain and symptom management.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622968","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":"Physical activity and supportive care intervention preferences: a cross-sectional study of barriers in advanced cancer.","authors":"Megan Agnew, Lisa Cadmus-Bertram, Christian W Schmidt, Kristine Kwekkeboom, Amy Trentham-Dietz, Ronald Gangnon, Shaneda Warren Andersen","doi":"10.1136/spcare-2025-005367","DOIUrl":"https://doi.org/10.1136/spcare-2025-005367","url":null,"abstract":"<p><strong>Purpose: </strong>Physical activity may greatly benefit adults living with advanced cancer; however, barriers to physical activity and preferences for supportive care interventions are not well understood. This study investigates barriers to physical activity and differences in intervention preferences by demographic and clinical characteristics among adults with advanced cancer.</p><p><strong>Methods: </strong>Data came from a cross-sectional study of 247 adults with advanced cancer who visited the University of Wisconsin Carbone Cancer Centre from January 2021 to January 2023. The Godin-Shepard Leisure Score Index (insufficiently active, moderately active and active) was used to assess physical activity. Physical activity barriers were reported as mean scores (1-5: 'not at all' to 'a great deal'). Differences in intervention preferences were assessed using X² tests.</p><p><strong>Results: </strong>Adults living with advanced cancer were insufficiently active (53%), moderately active (21%) or active (26%). Respondents identified several barriers to physical activity spanning tiredness (x̄=3.2), winter weather concerns (x̄=3.2) and lack of motivation (x̄=2.7). Respondents were most interested in a supportive care intervention designed to increase energy (88%) and improve physical health (86%) with physical therapy (73%), walking (72%) and resistance exercises (72%). Differences in preferences emerged by demographic characteristics and to a lesser extent by clinical characteristics.</p><p><strong>Conclusions: </strong>Adults with advanced cancer reported several barriers to physical activity. Future interventions should emphasise increasing energy and physical health and include strategies to manage tiredness and winter weather concerns.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622971","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":"End-of-life care in a major UK trauma centre.","authors":"Sarah Edwards, Nicola Ubayasiri","doi":"10.1136/spcare-2025-005421","DOIUrl":"https://doi.org/10.1136/spcare-2025-005421","url":null,"abstract":"<p><strong>Objectives: </strong>Death occurs within the emergency department (ED) sadly not infrequently. There is limited evidence exploring the demographics of these patients and the experience they have in the ED when they die or are approaching the end of life (EOL).</p><p><strong>Methods: </strong>A retrospective review of patients aged 18 years and over who died in our major trauma centre was conducted. Data collected included demographics, frailty scores, time of arrival, time of death, time of EOL decision, cause of death in the ED and who wrote do not attempt cardiopulmonary resuscitation (DNACPR) forms.</p><p><strong>Results: </strong>From January to December 2023, 326 patients died in the ED. 76% of patients were aged 65 years or over, with 69% having a clinical frailty score of 5 or more. The average time from arrival to death was 5 hours 56 min, with the average time from EOL decision to death being 1 hour and 53 min. 60% of all patients had a DNACPR, with 75% of those being written by ED clinicians.</p><p><strong>Conclusion: </strong>EOL is becoming ever more important in the ED. Further work is needed to see if our local experience matches other EDs.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540171","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":"Divergence in DNACPR and resuscitation policies: institutional survey in England.","authors":"Emily Fitton, Karen Chumbley, Caroline Barry, Aneta Bartova, Ben Troke, Wayne Martin","doi":"10.1136/spcare-2024-005263","DOIUrl":"https://doi.org/10.1136/spcare-2024-005263","url":null,"abstract":"<p><strong>Objectives: </strong>Our objective was to analyse the policies of hospitals and care homes in England as regards the use of do not attempt cardiopulmonary resuscitation (DNACPR) recommendations. We sought to identify (i) variations among policies at different institutions, and (ii) divergence of local policies from national guidance, particularly with reference to decisions either (a) to initiate cardiopulmonary resuscitation (CPR) despite the presence of a DNACPR recommendation, or (b) not to initiate CPR in the absence of a DNACPR recommendation.</p><p><strong>Methods: </strong>We conducted a survey of 14 DNACPR and/or resuscitation policies, drawn from care homes, NHS trusts and hospices.</p><p><strong>Results: </strong>Many of the policies we surveyed diverge significantly from national guidance. Some require that CPR be administered in all cases where no DNACPR recommendation has been made. Others fail to specify that CPR may be appropriate even in the presence of a DNACPR recommendation.</p><p><strong>Conclusions: </strong>Local DNACPR policies currently place both patients and healthcare professionals at significant risk.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540170","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":"Cardiac dysfunction in solid tumours: scoping review.","authors":"Bernadette Brady, Alexandra Brown, Michelle Barrett, Vikram Maraj, Fiona Lawler, Ross Murphy, Declan Walsh","doi":"10.1136/spcare-2023-004440","DOIUrl":"10.1136/spcare-2023-004440","url":null,"abstract":"<p><p>Cardio-oncology is a dynamic field. Research has suggested that cancer itself can damage the heart, independent of cancer treatment-related cardiac dysfunction (CTRCD). The aim of this study was to establish the nature of cardiovascular abnormalities reported in cancer, excluding CTRCD. Scoping review search included cardiovascular abnormalities in adults with solid tumour malignancies, and excluded CTRCD and thrombotic events. Three databases (CINAHL, Embase, Medline) were searched, supplemented by a handsearch. All screening and data extraction was done by two researchers with consensus reached for any conflicts. Given the heterogeneous nature of the studies identified, data synthesis was narrative. The search identified 42 366 studies. Following deduplication and title/abstract screening, 195 studies were assessed for full-text eligibility. Forty-four studies are included in the final analysis. There are 19 prospective observational studies, 13 retrospective studies, 9 case reports and 3 cross-sectional studies. Types of abnormality identified include cardiomyopathy (16, including Takotsubo (9)), autonomic nervous system (ANS) dysfunction (10), biomarker disturbances (9), reduced myocardial strain (6) and others (3). Due to variable study design, the prevalence was not determined. Cardiovascular abnormalities were associated with morbidity (chest pain, dyspnoea, fatigue) and shortened prognosis. In conclusion: (1) There is evidence for cardiovascular dysfunction in patients with solid tumour malignancies, distinct from CTRCD. People with solid tumours have higher rates of cardiac disease, even when newly diagnosed and treatment naïve. (2) Abnormalities manifest mainly as cardiomyopathies, ANS dysfunction and raised biomarker levels and are associated with significant symptoms. (3) Treatment plans need to take account of these risks, and widen criteria for screening.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"168-177"},"PeriodicalIF":2.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138481914","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}