Ann Surg Oncol. 2012 Nov 10. [Epub ahead of print]
Koczywas M, Williams AC, Cristea M, Reckamp K, Grannis Jr FW, Tiep BL, Uman G, Ferrell B.
This study evaluated the longitudinal changes (up to 1 year) in physical function, symptom burden, psychological distress and quality of life (QOL) in 103 patients with early-stage non-small cell lung cancer (34 stage I, 20 stage II and 49 stage III). At baseline there were no differences between these groups of patients demographically, clinically and functionally, however compared with stage III patients, stage I-II patients were more likely to complete the study. All groups were very symptomatic throughout the study, although over time there was a decrease in the number of symptoms and a decrease in physical QOL, whereas physical function and family QOL fluctuated irrespective of the stage of disease. Based on these findings a multidisciplinary palliative care intervention was developed, which included patient education and a multidisciplinary team meeting from which referrals to supportive care services are made.
J Pain Symptom Manage. 2012 Nov 7. pii: S0885-3924(12)00439-3. doi: 10.1016/j.jpainsymman.2012.07.014. [Epub ahead of print]
Johnson JR, Lossignol D, Burnell-Nugent M, Fallon MT.
This open-label, multicenter follow-up study investigated the long-term safety and tolerability of Sativex [Δ9-tetrahydrocannabinol (THC)/cannabidiol (CBD)] oromucosal spray (n=39) and THC spray (n=4) in patients with cancer-related pain despite taking opioids, who had participated in a previous Sativex/THC/placebo RCT. There was a maintained improvement in insomnia, pain, fatigue and quality of life in the patients using Sativex spray, without any new safety concerns associated with its extended use. Patients who kept using Sativex spray did not increase their dose of this or other analgesics, suggesting that cannabinoids could have a role in cancer-related pain.
Palliat Med. 2012 Nov 5. [Epub ahead of print]
Dening KH, Jones L, Sampson EL.
Using a nominal group technique it was explored if carers influenced the choices and preferences around end-of-life care made by people with dementia. Quality of care, family contact, dignity and respect were important in people with dementia and their carers when assessed both individually and together. Carers wanted control at the end of life and raised assisted dying and euthanasia. As people with dementia had difficulty considering their future selves and the preferences of people with dementia and their family carers may differ, the views of people with dementia should be sought early to ensure their wishes are respected.
PLoS One. 2012;7(11):e46327. doi: 10.1371/journal.pone.0046327. Epub 2012 Nov 7.
Higginson IJ, Gao W, Saleem TZ, Chaudhuri KR, Burman R, McCrone P, Leigh PN.
This study assessed how symptoms and quality of life changed over time in 82 patients with advanced Parkinson syndromes, by assessing then four times over one year. At baseline nearly 85% reported problems using their legs with over one third being immobile. Symptoms were highly prevalent in all conditions, with over 80% reporting pain, fatigue and sleepiness at baseline. Over the year, most patients showed a worsening or fluctuation for symptoms and in the Palliative care Outcome Scale. Over half of the patients with Multiple System Atrophy and Progressive Supranuclear Palsy died within the study period. The strongest predictors of higher levels of symptoms at the end of follow-up were initial scores on Palliative care Outcome Scale and a male gender. The authors suggest an early palliative assessment might help in screening patients in need of early intervention as patients with advanced Parkinson syndromes often have unresolved motor and non-motor symptoms and many patients are deteriorating. Further work is needed to test symptomatic treatments and psychological support for this cohort of patients.