The modified Glasgow Prognostic Score (mGPS) is a good predictor of indication for palliative bypass surgery in patients with unresectable pancreatic and biliary cancers – Online First – Springer

The mGPS is useful for predicting survival after surgical decompression due to gastrointestinal obstruction in patients with unresectable pancreatic and biliary cancers. Patients with a poor mGPS may not be indicated for palliative bypass surgery.

via The modified Glasgow Prognostic Score (mGPS) is a good predictor of indication for palliative bypass surgery in patients with unresectable pancreatic and biliary cancers – Online First – Springer.

Erroneous assumptions about deep palliative sedation and euthanasia — Materstvedt — BMJ Supportive & Palliative Care

In the present journal, I recently wrote an article on several of the differences between deep and continuous palliative sedation (DCPS) and euthanasia.1 In doing so, I also criticised certain views of a paper by Niklas Juth and colleagues.2 They answer back in a just-released article, in which they state that “Materstvedt fail[s] to provide an explanation of why there is a moral difference between DCPS and euthanasia” (italics in original).3

via Erroneous assumptions about deep palliative sedation and euthanasia — Materstvedt — BMJ Supportive & Palliative Care.

How long do you continue to fight when death is certain?

Not long from now, the last cancer will be defeated, and even today most with the dread disease survive.  However, many still fall.  This leaves us with one of the toughest questions of life.  How long do you continue to fight, when death is certain?  When does striving become vain hope which drains quality and creates only suffering?  What makes struggle worth the pain; when is it time to yield?

via How long do you continue to fight when death is certain?.

Determinants of death anxiety in patients with advanced cancer — Neel et al. — BMJ Supportive & Palliative Care

The findings suggest that death anxiety in patients with advanced cancer is common and determined by the interaction of individual factors, family circumstances and physical suffering. Multidimensional interventions that take into account these and other factors may be most likely to be effective to alleviate this death-related distress.

via Determinants of death anxiety in patients with advanced cancer — Neel et al. — BMJ Supportive & Palliative Care.

Emergency management of dyspnea in dying pat… [Emerg Med Pract. 2013] – PubMed – NCBI

Opioids are the most effective and widely studied agents available for palliation of dyspnea in this population, while adjuvant therapies such as oxygen, noninvasive positive pressure ventilation, and fans may also play a role. Other medications (eg, benzodiazepines and low-dose ketamine) may also be useful in select patients. The early involvement of palliative medicine specialists and/or hospice services for dying patients can facilitate optimal symptom management and transitions of care.

via Emergency management of dyspnea in dying pat… [Emerg Med Pract. 2013] – PubMed – NCBI.

Supportive and palliative care for metastatic breast cancer: Resource allocations in low- and middle-income countries. A Breast Health Global Initiative 2013 consensus statement

As part of the 5th Breast Health Global Initiative (BHGI) Global Summit, an expert international panel identified thirteen key resource recommendations for supportive and palliative care for metastatic breast cancer. The recommendations are presented in three resource-stratified tables: health system resource allocations, resource allocations for organ-based metastatic breast cancer, and resource allocations for palliative care.

via Supportive and palliative care for metastatic breast cancer: Resource allocations in low- and middle-income countries. A Breast Health Global Initiative 2013 consensus statement.

The Understanding of Terminal Cancer and Its Relationship with Attitudes toward End-of-Life Care Issues

The understanding of terminal cancer varied among the 4 participant groups. It was associated with different preferences regarding end-of-life issues. Standardization of these terms is needed to better understand end-of-life care.

via The Understanding of Terminal Cancer and Its Relationship with Attitudes toward End-of-Life Care Issues.

Managing End Stage Lung Disease in Children

Over the course of a career most physicians will manage only a handful of children through End Stage Lung Disease. Nonetheless, the approach of the physician to this challenge will have a profound impact on the children and families they encounter. Managing the end of life well can bring personal growth and professional satisfaction. In this review we highlight aspects of the Palliative Care approach and its integration with restorative and life-prolonging care. We review the role of active treatment, respiratory support, symptom management and psychosocial aspects of the management of End Stage Lung Disease.

via Managing End Stage Lung Disease in Children.

Palliative sedation: Why we should be more concerned about the risks that patients experience an uncomfortable death

Palliative sedation: Why we should be more concerned about the risks that patients experience an uncomfortable death

via Palliative sedation: Why we should be more concerned about the risks that patients experience an uncomfortable death.

Personal Dignity in the Terminally Ill from the Perspective of Caregivers: A Survey among Trained Volunteers and Physicians | Abstract

Conclusions: It seems that SCEN physicians consider the physical aspects of suffering to be most influential and problematic in practice in preserving dignity, while volunteers think psychosocial aspects are most important in preserving dignity at the end of life. These findings suggest that the role and responsibilities of caregivers involved in care for terminally ill patients affect the factors that they think influence dignity.

via Personal Dignity in the Terminally Ill from the Perspective of Caregivers: A Survey among Trained Volunteers and Physicians | Abstract.