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Editor

Online Resources

How to Make Practical Sense of Pain Research.

The first in a series on interpreting pain research on the Pain Treatment Topics website and blog

101 Things a New Hospice Nurse Should Know.

A mix of serious and humorous teaching points from the Hospice of Hillsborough, Tampa, FL. From a 1995 issue of Fanfare, a newsletter of the Hospice Nurses Association. HNA is now the Hospice and Palliative Nurses Association (HPNA), celebrating its 25th Anniversary. Fanfare has been replaced by the peer-reviewed Journal of Hospice and Palliative Nursing.

Tobacco/Smoking cessation resources from the U.S. Surgeon General for individuals and clinicians.

Online Resources for Patients

New/updated sexuality resources

Cancer and Sex: How Cancer Affects Your Sex Life.

Follow the links on the page for additional very helpful articles.
Learn More >>

Exploring Self-Esteem and Intimacy.

An American Cancer Society online class.
Learn More >>

Sexual and Reproductive Health.

From the ASCO-sponsored Cancer.net site.
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Guide to safe use of pain medicine. Produced by the Food and Drug Administration for consumers.

Learn More >> (PDF)

New Book of Note

Oxford Textbook of Palliative Social Work

book

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)

Yale Bioethics Center End of Life Issues Study Group.

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.

Connecticut

October 20-21

End-of-Life Nursing Education Consortium (ELNEC): Geriatric Train the Trainer Course. Cromwell, CT. Sponsored by Connecticut Coalition to Improve End-of-Life Care and CT Department of Public Health. Stay tuned for details. (CNE)

Elsewhere

May 20

Second Biennial Survivorship Research Symposium to Create Health Equality. Washington, DC.

June 2-3

The Art & Science of Palliative Care Nursing. Boston.

June 17 - 19

Cancer Survivorship and Sexual Health Symposium. Washington, DC.

August 10 - 12

The Science of Compassion: Future Directions in Palliative and End-of-Life Care. National Institute for Nursing Research, Bethesda, MD.

October 16 -17

2nd National Conference on Cancer and Female Sexuality.

Sponsored by Memorial Sloan-Kettering Cancer Center and University of Chicago. New York City.

Online

Cancer Survivorship: A Distinct Phase of Cancer Care.

Harvard Medical School. (CME)

May 2011 Volume 5 · No 5

It's never too late. Or early.

April 16 was the 4^th Annual National Healthcare Decisions Day (NHDD). NHDD is an advocacy group, a coalition of national, state, and local organizations that promotes the use of advance directives. Each state defines its own law for advance directives, but in essence they document a person's wishes for healthcare if he/she is unable to make decisions at the time of serious illness or injury.

There are numerous barriers to completing an advance directive, including discomfort about discussing serious illness and death, assumptions that only sick or old people need to worry about these issues, or a belief that the family "knows" what an individual would want, even without explicit conversation. Indeed, the most important part of advance care planning is discussing our values, beliefs, and wishes with family and other loved ones. Even written directives sometimes need interpretation or explanation. During a life-threatening illness, for example, the question "What would your Mom (or sister or husband) want in this circumstance?" is going to be asked by the healthcare team.

Advance directives can be somewhat controversial. A recent blog discusses an article about unintended consequences of the system as it currently exists.

Most people would agree that making decisions in a crisis is much easier if there has been advance preparation. States have tried to make this easier for people by creating laws, legal forms, and standard procedures that support the decision-making process. Unfortunately, some of these are not portable, that is, they are not honored in other states. Several states have, or are in the process of adopting, the POLST Paradigm which originated in Oregon. POLST is an acronym for 'Physician Orders for Life-Sustaining Treatment,' although different terminology is used in some of the adopting states. Instead of multiple documents (as is the case in Connecticut, for example), a single multipage POLST form (printed in a bright color) contains all advance directives for an individual.

There are many resources for getting the process started.The Connecticut Coalition to Improve End-of-Life Care has developed a booklet, "Beginning the Conversation about Death, Dying and End-of-Life Care in Connecticut." The booklet, now in a second edition, is available at cost ($5.00) on their website. NHDD has an extensive list of resources, including the legal forms for each state (a written narrative is acceptable to supplement or replace the forms in many states).

In the News

For the first time in four decades, lung cancer death rates in women have fallen.

Overall, the cancer death rate continues to decline, but the number of people dying from cancer continues to increase because of the aging population.

Shingles vaccine now approved for those over the
age of 50.

The original age was 60. According to a recent blog , it may be even more effective-70% success rate-than for those over the age of 60.

New Smoking Cessation Service opens at Smilow Cancer Hospital at Yale-New Haven.

Journal Watch

Survivorship

Hahn EE, Ganz PA. Survivorship Programs and Care Plans in Practice: Variations on a Theme. Journal of Clinical Practice. 2011;7(2):70-75.

Katz A. Breast Cancer and Women's Sexuality. AJN. 2011; 111(4):63-67.

Kim C, et al. Quality of Life Among Testicular Cancer Survivors: a case-control study in the United States. Qual Life Res. 2011 Apr 17.

Vachani C, et al. Nursing Resources: Preparing Patients for Life After Cancer Treatment. AJN. 2011; 111(4):51-55.

End-of-Life Care

Downar J, et al. Why Do Patients Agree to a "Do Not Resuscitate" or "Full Code" Order? Perspectives of Medical Inpatients. J Gen Intern Med. 2011 Jan 11.

Rich BA, Paterniti DA. Conversations About Treatment at the End of Life. J Gen Intern Med. Mar 30, 2011. Learn More >>

Moorman SM. The Importance of Feeling Understood in Marital Conversations about End-of-Life Health Care. J Soc Pers Relat 2011;28(1):100-116.

Neilson SJ, et al. Caring for Children Dying from Cancer at Home: a qualitative study of the experience of primary care practitioners. Family Practice. Mar 22, 2011.

Palliative and Supportive Care

The April issue of Surgical Clinics of North America [April 2011; 91(2)] is devoted to an "Update on Surgical Palliative Care."

Campos MP, et al. Cancer-related Fatigue: a practical review. Ann Oncol. 2011 Feb 16.

Guo Y, et al. (2011). Inpatient Rehabilitation Improved Functional Status in Asthenic Patients with Solid and Hematologic Malignancies. Am J Phys Med Rehabil. 2011 Jan 7.

Medicine & Rehabilitation, 90 (4), 265-271. See also Pallimed blog on this article.

Nahman-Averbuch H, et al. Pronociceptive Pain Modulation in Patients with Painful Chemotherapy-Induced Polyneuropathy. J Pain Symptom Manage. 2011 Mar 30. Learn More >>

Rosenfeld B, et al. Assessing Hopelessness in Terminally Ill Cancer Patients: Development of the Hopelessness Assessment in Illness Questionnaire. Psychol Assess 2011.

Wanchai A, et al. Nonpharmacologic Supportive Strategies to Promote Quality of Life in Patients Experiencing Cancer-related Fatigue. Clin J Oncol Nurs. 2011 Apr 1;15(2):203-14.

Other Articles of Interest

DeSantis C, et al. Breast Cancer Incidence Rates in U.S. Women are no Longer Declining. Cancer Epidemiology, Biomarkers, & Prevention. Feb 28, 2011.

Sandblom G et al. Randomised prostate cancer screening trial: 20 year follow-up. BMJ. Mar 31, 2011. Learn More >>