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Online Resources

State of the Science: Professional Partners Supporting Family Caregiving
Proceedings of a multidisciplinary, multiagency symposium, with additional resource links.
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More Than Pamphlets Needed to Avert Lymphedema "Aftershock."
News Brief from CancerNetwork.com
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Words Matter: How "EOL" Rhetoric Undermines Good Palliative Care
Hastings Institute/Bioethics Forum blog
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AICR Cancer Awareness Quiz
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Food for the Fight
(DVD for purchase).  Information on nutrition during and after treatment
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Online Resources for Patients

NCCN Guidelines for Patients
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New Books of Note

Kissane D, et al (Eds).  (2011) Depression and Cancer.  Wiley.
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Continuing Education

Schwartz Rounds 

Second Thursday of the month 12:00 PM  

Lunch is provided.  Smilow Cancer Hospital at Yale-New Haven in the Park St. Auditorium (CME)

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Yale Bioethics Center End of Life Issues Study Group

5:30 PM - 7:00 PM  

Theme for 2010-2011:  "Ethical Aspects of the Advances in Modern Medicine." (CME) Audio and video of this year's presentations are available on the Center's website.

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March 8 

Panel Discussion  


April 12 

Substituted Interests and Best Judgments.  Daniel Sulmasy, MD, PhD


Nutrition and Cancer Survivorship:  Separating the (Whole) Wheat from the Chaff    

5th Annual Yale Survivorship Symposium   

May 5 at Yale's West Campus  Keynote Speaker:  Suzanne Dixon.  Continuing Education credits for physicians, nurses, registered dieticians, and social workers.  





March 15, 6:30 - 8:00 PM

Skin Failure & SCALE.  Charter Oak Chapter of Hospice and Palliative Nurses Association.  Middlesex Hospital, 28 Crescent Street, Middletown.  (CNE)






June 17 - 19

Cancer Survivorship and Sexual Health Symposium.  Washington, DC.

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Novel and Future Directions in Cancer Pain Management 

CME, CNE, CPE (Medscape)

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Easing the Pain:  Solving the Problem of Uncontrolled Cancer Pain

CNE (CME Corner)

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February 2011          Volume 5 · No 2


Dietary Guidelines Released


The U.S. Department of Agriculture (USDA) has just released Dietary Guidelines for Americans, 2010.  The full-text of the document can be downloaded for free.  Hard copies will not be available until the end of April.  This is a policy document, intended more for public health, nutrition, and health care professionals than for the general public.  We can expect much of this information to be translated into patient- and consumer-directed publications, media spots, and nutrition programs over the next several months.


Cancer as an outcome risk for poor dietary choices is repeatedly cited for overweight, obesity, generally poor nutrition, and certain classes of foods.  For example:


 "Poor diet and physical inactivity are associ­ated with major causes of morbidity and mortality. These include cardiovascular disease, hypertension, type 2 diabetes, osteoporosis, and some types of cancer."


"Excessive drinking increases the risk of cirrhosis of the liver, hypertension, stroke, type 2 diabetes, cancer of the upper gastrointestinal tract and colon . . ."


". . . evidence suggests an association between the increased intake of processed meats (e.g., franks, sausage, and bacon) and increased risk of colorectal cancer and cardiovascular disease."


In addition, many of the statistics and citations on food choices cite data from the National Cancer Institute.


A large percentage of the report is devoted to the epidemic of overweight and obesity:  "72 percent of men and 64 percent of women are overweight or obese, with about one-third of adults being obese."  A national "obesogenic environment" is described that fosters and perpetuates obesity.  Calorie balance (number of calories in = number of calories expended) is listed as one important goal of personal health practices.  Only one third of Americans are regularly physically active during leisure time and one third are never physically active. 


It is truly sobering that in a table listing the top 25 sources of calorie intake in Americans, the top five included desserts, breads, sodas, and alcoholic beverages.  In a table comparing actual average dietary intake to nutritional guidelines, no food class was meeting the guidelines.  Important targets for change: 


  • Decrease solid fats and added sugars-Americans eat a whopping 280% of the recommended amounts
  • Decrease refined grains-200% of the recommended amount
  • Increase whole grains-only 15% of recommended amounts
  • Increase fruit (42%) and vegetable (59%) intake


YaleCares will highlight more on nutrition in upcoming issues.  Remember that the 5th Annual Yale Survivorship Symposium on May 5 will be devoted to Nutrition and Cancer Survivorship.

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In the News

Another reason to stop smoking:  it may increase pain in people with a diagnosis of cancer (see Ditre article and Bastian editorial in Journal Watch, below).

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Journal Watch


Grzankowski KS.  Quality of life in Ovarian Cancer.  Cancer Control.  2011;18(1):52-58. (Free full text)

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McCorkle R, et al.  Self-management: Enabling and empowering patients living with cancer as a chronic illness.   

CA Cancer J Clin. 2011;61(1):50-62. (Free full text)

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Mehnert, A.  Employment and Work-related Issues in Cancer Survivors.  

Crit Rev Oncol Hematol.  2011;77(2): 109-130.

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von Gruenigen VE, et al.  Lifestyle Challenges in Endometrial Cancer Survivorship.   

Obstet Gynecol. 2011 Jan;117(1):93-100.

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End-of-Life Care

Angelo M, et al.  An Approach to Diabetes Mellitus in Hospice and Palliative Medicine.   

J Pall Med. 2011;14(1):83-87.  

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Enguidanos S, et al.  Use of Role Model Stories to Overcome Barriers to Hospice among African Americans.  J Pall Med.  2011;14(2).  

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Peppercorn JM, et al.  American Society of Clinical Oncology Statement: Toward Individualized Care for Patients With Advanced Cancer. 
J Clin Onco
l. 2011, Jan 24.  

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Palliative and Supportive Care

Review of cancer-related breakthrough pain and two peer commentaries (Free full text for all three papers): 

  • Rhiner MI, Von Gunten C.  Cancer Breakthrough Pain in the Presence of Cancer-Related Chronic Pain: Fact versus Perceptions of Health-Care Providers and Patients. 
    J Support Oncol.
    Read More >>  
  • Karver SB, Berger JH.  The Challenges of Treating Patients with Cancer Pain. 
    J Support Oncol.
    Read More >>  
  • Ledesma W, Campbell TC.  A Conceptual Solution to Improve the Management of Cancer-Related Breakthrough Pain. 
    J Support Oncol.
    Read More >> 



Baldwin C.  Nutritional support for malnourished patients with cancer.   

Curr Opin Support Palliat Care.  2011;5(1):29-36.

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Macauley R.  Patients Who Make ''Wrong'' Choices.   

J Pall Med.  2011;14(1):13-16.  

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Matsuyama RK, et al.  Will Patients Want Hospice or Palliative Care if They Do Not Know What it Is?   

J Hosp Palliat Nurs.  2011;13(1):41-46.  

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Other articles of interest

Ditre JW, et al.  Associations Between Pain and Current Smoking Status Among Cancer Patients.  

Pain. 2011 Jan;152(1):60-5.  

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Bastian LA. Pain and Smoking among Cancer Patients: the Relationship is Complex but the Clinical Implication is Clear.   

Pain. 2011 Jan;152(1):10-1.
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Jones LW, et al.  Effect of Exercise Training on Peak Oxygen Consumption in Patients with Cancer: A Meta-Analysis.   

Oncologist. 2011;16(1):112-120.

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Vadaparampil ST, et al.  Satisfaction with Physician Recommendation for and Information About Genetic Counseling Among Breast Cancer Patients.   

Breast.  2011;17(1):79-82.  

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West HF, Baile WF.  "Tell Me What You Understand": The Importance of Checking for Patient Understanding. 

J Support Oncol. 2010 Sep-Oct;8(5):216-8.