Two cases of rare late onset life-threatening pseudoprogression with immune check point inhibitors in advanced cancer patients – a case report

9146 Background: Research on posttraumatic stress in cancer patients has focused on patient reactions to their cancer diagnosis. Few studies have examined the impact of lifetime traumatic events prior to diagnosis on how advanced cancer patients understand the life-threatening nature of their illness and how likely they are to discuss their end-of-life (EOL) wishes with their oncology providers. Methods: The Coping with Cancer (CwC) is an NCI-funded prospective, multi-institutional cohort study of advanced cancer patients and their caregivers. Participants were recruited from September 2002 to February 2008 from six comprehensive cancer centers across the United States. Lifetime traumas were captured by the number of events reported in response to the Structured Clinical Interview for the DSM-IV (SCID) Lifetime Posttraumatic Stress Disorder question that probed for “extremely upsetting” life events. Associations between patient characteristics and number of lifetime traumas were estimated as odds ratios using ordinal logistic regression. Associations between number of lifetime traumatic exposures, controlling for confounding patient characteristics, and patient Terminal Illness Acknowledgement (TIA) and reports of EOL discussions were estimated as odds ratios using multiple logistic regression. Results: After adjusting for race, education, and recruitment site, the number of lifetime traumas patients reported remained significantly associated with TIA (OR = 1.25, p = .034) and discussion of EOL wishes (OR = 1.29, p = .013). Conclusions: The greater the number of traumatic experiences reported by cancer patients the more likely they are to acknowledge that they are terminally ill and discuss their end-of-life wishes with their oncology providers. The impact of witnessing or experiencing serious or life-threatening events in the past appears to improve advanced cancer patients’ abilities to understand the seriousness of their condition and increases the likelihood that they will discuss their preferences for care at the end of life with their doctors.

Download Full-text

Hope in Advanced Cancer Patients in the Terminal Phase of Neoplastic Disease and Stability of Basic Mood

Journal of Clinical Medicine ◽

10.3390/jcm9113550 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3550

Author(s):

Bożena Baczewska ◽

Bogusław Block ◽

Beata Kropornicka ◽

Maria Malm ◽

Dagmara Musiał ◽

...

Keyword(s):

Cancer Patients ◽

Advanced Cancer ◽

Diagnostic Tools ◽

Terminal Phase ◽

Neoplastic Disease ◽

Advanced Cancer Patients ◽

Temporal Dimension ◽

Spiritual Dimension ◽

Life Threatening ◽

The Stability

The aim of this research is to compare the hope experienced by advanced cancer patients in the terminal phase of neoplastic disease in relation to the stability of their basic mood. The study group consisted of 246 patients, average age 59.5. The youngest respondent was 18 and the oldest was 90. The diagnostic tools used in the work comprised the Personal Card designed by T. Witkowski (PC) and an NCN-36 test (Block’s Hope test), designed by B.L. Block to measure the strength of hope in people struggling with serious life-threatening diseases. The test consists of 4 subscales distinguished by factor analysis. Each subscale consists of 8 items. The test allows an evaluation of hope in the following dimensions: situational dimension (health, thelic-temporal dimension), goals to be achieved in the future, spiritual dimension (spirituality), religious beliefs, and emotional-motivational (affective) dimension (motivations). In cheerful patients who are in the terminal phase of cancer, mood stability does not constitute a major differentiating factor for experiencing hope. In sad people, on the other hand, mood stability affects the intensity of hope—those with an unstable mood are more likely to have a stronger emotional-motivational dimension of hope than sad people with a balanced mood.

Download Full-text

High-dose continuous infusion of tranexamic acid for controlling life-threatening bleed in advanced cancer patients

Indian Journal of Palliative Care ◽

10.4103/ijpc.ijpc_48_20 ◽

2021 ◽

Vol 27 (1) ◽

pp. 172

Author(s):

Shrikant Atreya

Keyword(s):

Tranexamic Acid ◽

Continuous Infusion ◽

Cancer Patients ◽

Advanced Cancer ◽

High Dose ◽

Advanced Cancer Patients ◽

Life Threatening

Download Full-text

Psychotherapy and Behavioral Interventions in Palliative Care

Psychosocial Palliative Care ◽

10.1093/med/9780199917402.003.0009 ◽

2014 ◽

pp. 91-102

Author(s):

William S. Breitbart

Keyword(s):

Palliative Care ◽

Depressive Symptoms ◽

Cancer Patients ◽

Advanced Cancer ◽

Behavioral Interventions ◽

Psychosocial Interventions ◽

Advanced Cancer Patients ◽

Behavioural Interventions ◽

Life Threatening Illness ◽

Life Threatening

A range of psychotherapeutic and behavioural interventions have been demonstrated to be effective and useful for patients struggling with advanced life-threatening illness. Despite lack of evidence for prolonged survival, psychosocial interventions have been shown to be effective in decreasing depressive symptoms and suffering in advanced cancer patients. This chapter provides an overview of the commonly used, effective individual, group, and family psychotherapy modalities among advanced cancer patients and their families.

Download Full-text