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Online Resources

 

Loss, Grief, and Bereavement in the Setting of Cancer. 
Medscape.  Adaptation of EPEC content.
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Fast Facts and Concepts provides concise, practical, peer-reviewed, and evidence-based summaries on key topics important to clinicians and trainees caring for patients facing life-limiting illnesses.
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Fast Article Critical Summaries for Clinicians in Palliative Care (PC-FACS) provides palliative care clinicians with concise summaries of the most important findings from more than 50 medical and scientific journals each month. PC-FACS is free to AAHPM members and members can earn up to 3 CME credits quarterly.
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Online Resources for Patients

Prostate Cancer Resources
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Getting back on a bike. 
Advice for fitness with one of the best exercise tools. From American Institute for Cancer Research.
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Articles from painACTION (free registration required) 
Continuing Education
  
Yale
 
 

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). Schwartz Rounds resumes September 8.

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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)

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Elsewhere

June 17 - 19

Cancer Survivorship and Sexual Health Symposium.  Washington, DC.

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August 10 - 12

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

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September 16 - 18

Practical Aspects of Palliative Care:  Integrating Palliative Care into Clinical Practice.  Cambridge, MA.

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September 21

Massachusetts Pain Initiative Annual Conference.  Judith Paice, PhD, Keynote Speaker.  Marlborough, MA.   

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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.   

 

October 27 - 29

Seventh Annual Chicago Supportive Oncology Conference.  Chicago, IL.

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Online

American Psychological Association Continuing Education End-of-Life series

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June 2011          Volume 5 · No 6

 

Smoking Cessation

Cigarette smoking continues to be the leading cause of preventable morbidity and mortality in the United States, causing approximately 443,000 premature deaths annually. Recent estimates show that about 20.6% of U.S. adults (46.6 million people) are current smokers. Smoking accounts for at least 30% of all cancer deaths and 87% of lung cancer deaths. Yet each day in the United States, approximately 3,450 young people between 12 and 17 years of age smoke their first cigarette, and an estimated 850 youth become daily cigarette smokers. This is unfortunate given that smoking is linked to a broad array of cancers including nasopharynx, nasal cavity and paranasal, sinuses, lip, oral cavity, pharynx, larynx, lung, esophagus, pancreas, uterine cervix, kidney, bladder, stomach, and acute myeloid leukemia. In addition, an estimated 8.6 million people suffer from smoking-related cerebrovascular disease, stroke, chronic bronchitis, emphysema, and gastric ulcers. On average, smokers die 13 to 14 years earlier than nonsmokers.

 

The benefits of quitting smoking are tremendous:

  • Within 20 minutes - your heart rate calms down
  • Within 8 hours - there is more oxygen in your blood and mucous begins to clear out of your lungs, which makes breathing easier
  • Within 48 hours - things smell and taste better
  • Within 3 months - your blood circulation improves and your body is better able to fight infection
  • Within 9 months - less sinus congestion, wheezing, and shortness of breath
  • Within 1 year - your risk of dying from a heart attack is cut in half
  • After 5 years - you have much less of a chance of having a stroke
  • After ten years - your risk of developing lung cancer is cut in half

Moreover, the mathematics of quitting are clear:

 

365 days/year x $5.00/pack = $1825.00 for a pack per day smoker for a year

 

365 days/year x $10.00/pack = $3650.00 for a two pack per day smoker for a year

 

10 years = $18,250.00 for a pack per day smoker or $36,500.00 for a 2 pack per day smoker

 

It is especially important that cancer patients and survivors quit smoking. A recent meta-analysis showed that 14-58% of cancer patients who were smoking at the time of diagnosis continued smoking after treatment. This is alarming because quitting smoking after initial diagnosis can:

 

  • Positively impact response to treatments (therapeutic radiology, chemotherapy, and surgery)
  • Decrease the likelihood that patients will develop second malignancies
  • Increase rates of survival

 

Importantly, there are several effective smoking cessation treatments. First line drug therapies include: nicotine replacement therapy (patch, gum, lozenge, nasal spray, and inhaler), bupropion SR (Wellbutrin XL, Zyban), and varenicline (Chantix). Of note, there is recent convincing research that dual nicotine replacement therapy (e.g., patch + lozenge) is a very safe and effective treatment regimen. It is essential that drug therapies be combined with counseling. There is a dose response curve for the amount of counseling time and the number of counseling sessions, such that a higher amount of contact time and a higher number of sessions are related to higher rates of abstinence from smoking.

 

There is a new Smoking Cessation Service at Smilow Cancer Hospital at Yale-New Haven. This service provides individual counseling combined with a first line medication treatment. All care is highly personalized and tailored to the needs of the patient. After a thorough assessment, patients are typically followed for 4 to 9 individual sessions with multiple follow-up phone calls. Every effort is made to schedule smoking cessation treatment sessions so that they coincide with pre-existing cancer treatment appointments.

 

Please feel free to contact the Smoking Cessation Service with patient referrals or any questions at (203) 688-1378. 

 

 

 

In the News

 

Breast Cancer Screening Recs More Confusing than Helpful, Study Finds  

(News article at CancerNetwork.com-free registration required.  See citation by Squiers LB, below.)

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World No Tobacco Day 2011

A World Health Organization annual observance of the health harms of tobacco and a framework to control it.

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Journal Watch

Survivorship

Irwin M, et al.  Oncology Nurses' Perspectives on the State of Cancer Survivorship Care: Current Practice and Barriers to Implementation.  Oncol Nurs Forum. 2011 Jan 1;38(1):E11-9.  

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Klemp JR, et al.  Improving Cancer Survivorship Care: Oncology Nurses' Educational Needs and Preferred Methods of Learning.  J Cancer Educ. 2011 Mar 13. Learn More >> 

 

Park SB, et al.  Long-Term Neuropathy After Oxaliplatin Treatment: Challenging the Dictum of Reversibility.  Oncologist.  2011 Apr 8.

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Puhse G, et al.  Chronic Pain Has a Negative Impact on Sexuality in Testis Cancer Survivors.  J Andrology.  2011 Apr 7.  

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Vaz AF, et al.  Quality of Life and Adverse Events after Radiotherapy in Gynecologic Cancer Survivors: A Cohort Study.  Arch Gynecol Obstet. 2011 Mar 26.  

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Villaseņor A, et al.   Dietary Fiber is Associated with Circulating Concentrations of C-reactive Protein in Breast Cancer Survivors: the HEAL study.  Breast Cancer Res Treat. 2011 Apr 1.  

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Wingard JR, et al.  Long-Term Survival and Late Deaths After Allogeneic Hematopoietic Cell Transplantation.  J Clin Oncol.  2011 Apr 4.  

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Palliative and Supportive Care

Cheng KK, Lee DT.  Effects of Pain, Fatigue, Insomnia, and Mood Disturbance on Functional Status and Quality of Life of Elderly Patients with Cancer.  Crit Rev Oncol Hematol.  2011;78(2): 127-137.  

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Cruz FM, et al.  Gabapentin for the Prevention of Chemotherapy-induced Nausea and Vomiting: A Pilot Study.  Support Care Cancer.  5 Apr 2011.   

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Durand JP, et al. Efficacy of Venlafaxine for the Prevention and Relief of Oxaliplatin-Induced Acute Neurotoxicity: Results of EFFOX, a Randomized, Double-Blind, Placebo-Controlled Phase III Trial.  Ann Oncol. 22 Mar 2011 .  

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Hui D, et al.  Quantity, Design, and Scope of the Palliative Oncology Literature.  Oncologist.  2011 Apr 6.  

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Jubelirer SJ.  The Benefit of the Neutropenic Diet: Fact or Fiction? Oncologist.  2011 Apr 6.  

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Morrison RS, et al.  Palliative Care Consultation Teams Cut Hospital Costs for Medicaid Beneficiaries.  Health Affairs.  2011;30(4):454-463.  

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Mustian KM.  Polarity Therapy for Cancer-Related Fatigue in Patients With Breast Cancer Receiving Radiation Therapy: A Randomized Controlled Pilot Study.  Integrative Cancer Therapies.  7 Mar 2011.  

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Schulman-Green D, et al.  Self-Management and Transitions in Women with Advanced Breast Cancer.  J Pain Symptom Manage. 2011 Mar 26.   

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Other Articles of Interest

Squiers LB, et al.  The Public's Response to the U.S. Preventive Services Task Force's 2009 Recommendations on Mammography Screening.  Am J Prev Med.  2011;40(5):497-504.  

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Youngwerth J, Twaddle M.  Cultures of Interdisciplinary Teams: How to Foster Good Dynamics.  J Palliat Med. 2011 Apr 8.

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