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Online Resources

 

CancerProgress.net  

A website sponsored by American Society of Clinical Oncology (ASCO) highlighting the history of cancer research and advances over 40 years.

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Resources
for Patients  

 

NIH Clinical Research Trials
and You
 

A new website for patients and families to learn about how & why to participate in a clinical trial.

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National Institute of Nursing Research's Palliative Care Brochure

Available for download in English and Spanish versions.

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Yale Cancer Center Answers

A weekly radio series heard on local WNPR stations. Addresses a wide range of questions of interest to patients, families and the public. Podcasts and online archives available.

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Young Survival Coalition: Young Women Facing Breast Cancer Together.

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NeedyMeds 

A non-profit organization that helps people who have trouble affording their prescription medications.

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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)  

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Yale Bioethics Center End of Life Issues Study Group   

77 Prospect Street, Rm A002. See website for full schedule. (CME)

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Connecticut

April 17

Connecticut Patient Navigation Conference

Jointly sponsored by Connecticut Cancer Partnership, American Cancer Society, Leukemia & Lymphoma Society, CT Dept. of Public Health. Cromwell. CE for nurses & social workers. Cromwell.

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April 20

Caring for the Elderly at End-of-Life: An Interdisciplinary Approach.

Annual educational conference of the Connecticut Coalition to Improve End-of-Life Care. Supported by the Connecticut Cancer Partnership. Cromwell. CNE & CE for social workers.

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October 19

Caring for the Elderly at End-of-Life: An Interdisciplinary Approach.

Connecticut Coalition to Improve End-of-Life Care. Supported by the Connecticut Cancer Partnership. Cromwell. CNE & CE for social workers.

 

   

Elsewhere

May 24 - 25

Art & Science of Palliative Nursing: 10th Anniversary offering.  

Boston.

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November 8 - 11

Buddhist Contemplative Care Symposium 2012: Palliative, Hospice, and Contemplative Care.  

Garrison, NY. CE for nurses, social workers, & physicians.

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Online

Persistent and Breakthrough Cancer Pain: An Expert Video Roundtable. (CME, CNE)  

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March  2012       Volume 6 No 2

 

Palliative Care for All?

 

The American Society of Clinical Oncology has published a Provisional Clinical Opinion recommending the integration of palliative with standard oncologic care beginning at the point of diagnosis (see Smith, under Palliative and Supportive Care, below). The recommendation is based on the results of seven randomized controlled trials of palliative care plus usual care vs. usual care alone. The most compelling of these, and the one that has received the most attention in both the professional and lay press, is the Temel, et al. article in the New England Journal of Medicine in 2010 that provided "strong evidence" that patients with metastatic non-small cell lung cancer should be offered concurrent palliative and standard care at diagnosis.

 

Demonstrated benefits, i.e., better patient and caregiver outcomes, of integrating palliative care with standard disease care include better symptom management, improved quality of life for the patient and caregivers, increased use of advance care planning, decreased costs, higher patient satisfaction, reduced caregiver burden, decreased use of emergency rooms and inpatient admissions, and more appropriate use of hospice. An unexpected finding of the Temel study was a possible survival benefit of palliative care integrated with standard care (e.g., chemotherapy). Most of the studies cited in the Provisional Clinical Opinion were small, different models/approaches were used, and some had other methodologic issues. However, none demonstrated harm to any patient in any domain from this approach. Clearly, more research is needed to clarify and refine the role of palliative care at all phases of disease and in multiple settings.

 

The Provisional Clinical Opinion also provides another authoritative voice to the growing chorus that emphasizes that palliative care, end-of-life-care, and hospice care are not equivalent terms, concepts, or services. End-of-life care and hospice are both subsets of palliative care, with hospice being a specialized approach to end-of-life care largely defined and limited, in this country, by the Medicare Hospice Benefit. The other end of the palliative care continuum is at the time of diagnosis of a life-threatening illness or one with a high symptom burden. At all phases of care, the goal is amelioration or prevention of suffering through symptom management, assistance with defining goals of care and care planning, and improvement in quality of life for the patient and family. Other societies and organizations have called for the integration of palliative care "early in the course of illness" (World Health Organization), "regardless of the state of the disease" (National Consensus Project), and as part of "routine cancer care" (European Society for Medical Oncology) and "comprehensive cancer care" (Society for Surgical Oncology).

 

 

 

In the News

 

Living Well with Chronic Illness is a new report from the Institute of Medicine. Cancer survivorship is one of the nine chronic conditions highlighted.

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Report Affirms Lifesaving Role of Colonoscopy  

An article in the New York Times, reporting on a study published in the New England Journal of Medicine (see Zauber article, below), reports that in a 20-year study, colonoscopy screening reduced colon cancer deaths by 53%.

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Got bicycle?  

Registration is now open for the 2nd annual Smilow Cancer Hospital Closer to Free ride on September 8.

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Journal Watch

 

Survivorship

Howard-Anderson J, et al. Quality of Life, Fertility Concerns, and Behavioral Health Outcomes in Younger Breast Cancer Survivors: A Systematic Review. J Natl Cancer Inst. 2012 Jan 23.  

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Koppelmans V, et al. Neuropsychological Performance in Survivors of Breast Cancer More Than 20 Years After Adjuvant Chemotherapy. J Clin Oncol. 2012 Feb 27.  

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Rausch SM, et al. Health behaviors among cancer survivors receiving screening mammography.  Am J Clin Oncol. 2012 Feb;35(1):22-31.

 

Yu M, et al. Employment experience of cancer survivors 2 years post-diagnosis in the Study of Cancer Survivors-I. J Cancer Surviv. 2012 Jan 5.  

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Palliative and Supportive Care

Caraceni A, et al. Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC. Lancet Oncol. 2012;13(2):e58-e68.  

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Bruera E, Yennurajalingam S. Palliative Care in Advanced Cancer Patients: How and When? Oncologist. 2012;17(2):267-273 (also available for CME )

 

Kamal AH, et al. Dyspnea review for the palliative care professional: treatment goals and therapeutic options.  J Palliat Med. 2012 Jan;15(1):106-14.  

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Sheinfeld Gorin S, et al. Meta-Analysis of Psychosocial Interventions to Reduce Pain in Patients With Cancer.  J Clin Oncol. 2012 Jan 17.  

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Smith TJ, et al. American Society of Clinical Oncology Provisional Clinical Opinion: the integration of palliative care into standard oncology care.  J Clin Oncol. 2012 Mar 10;30(8):880-7.  

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Other Articles of Interest

  



Kotton CN, Poznansky MC. Vaccination of Oncology Patients: An Effective Tool and an Opportunity Not to Be Missed.  Oncologist. 2012 Jan 12.  

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Kushi LH, et al. American Cancer Society guidelines on nutrition and physical activity for cancer prevention: Reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin. 2012 Jan;62(1):30-67.  

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Qaseem A, et al. Screening for Colorectal Cancer: A Guidance Statement From the American College of Physicians. Ann Intern Med. 2012 Mar 6;156(5):378-386.  

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Zauber AG, et al. Colonoscopic Polypectomy and Long-Term Prevention of Colorectal-Cancer Deaths. N Engl J Med 2012;366:687-696.   

Read More >>