Journal of pain and symptom management
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J Pain Symptom Manage · Dec 2014
Chemotherapy-associated oral sequelae in patients with cancers outside the head and neck region.
Chemotherapy induces a wide array of acute and late oral adverse effects that makes symptom alleviation and information important parts of patient care. ⋯ Oral sequelae were frequently reported, and health care providers should be attentive to the presence and severity of these problems. Less than one-third of the patients remembered having received information about oral sequelae associated with chemotherapy. A continuous focus on how to diagnose, manage, and inform about oral cancer-related complications is advisable.
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J Pain Symptom Manage · Dec 2014
Ethical conduct of palliative care research: enhancing communication between investigators and institutional review boards.
Palliative care has faced moral and ethical challenges when conducting research involving human subjects. There are currently no resources to guide institutional review boards (IRBs) in applying standard ethical principles and terms-in a specific way-to palliative care research. Using as a case study a recently completed multisite palliative care clinical trial, this article provides guidance and recommendations for both IRBs and palliative care investigators to facilitate communication and attain the goal of conducting ethical palliative care research and protecting study participants while advancing the science. Beyond identifying current challenges faced by palliative care researchers and IRBs reviewing palliative care research, this article suggests steps that the palliative care research community can take to establish a scientifically sound, stable, productive, and well-functioning relationship between palliative care investigators and the ethical bodies that oversee their work.
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Most patients will lose decision-making capacity at the end of life. Little is known about the quality of care received by patients who have family involved in their care. ⋯ Family involvement at the end of life is associated with receipt of palliative care consultation and a chaplain visit and a higher likelihood of a DNR order. Clinicians should support early advance care planning for vulnerable patients who may lack family or friends.
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J Pain Symptom Manage · Dec 2014
Is race/ethnicity related to the presence or severity of pain in colorectal and lung cancer?
Developing interventions to address racial/ethnic cancer pain disparities requires exploration of the role of socioeconomic status, health status, and pain severity from the time of diagnosis. ⋯ Although the odds of experiencing pain differed only for multiracial patients, among those reporting pain, both blacks and multiracial individuals reported higher pain severity than whites. Sociodemographic status, health status, and depression were associated with severity but did not explain the disparity. Interventions to address these disparities will need to focus on reported severity and patient-level factors.
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J Pain Symptom Manage · Dec 2014
Differential expression of genes related to mitochondrial biogenesis and bioenergetics in fatigued prostate cancer men receiving external beam radiation therapy.
This prospective study explored relationships between expression changes of genes related to mitochondrial biogenesis/bioenergetics and fatigue in men with prostate cancer receiving external beam radiation therapy (EBRT). ⋯ Genes related to oxidative phosphorylation, energy production, and mitochondrial membrane integrity are associated with worsening fatigue during EBRT. Further investigation of the pathways involved with this association may explain mechanisms behind the development of fatigue in this population.