A comparison of liver cancer and lung cancer patients at two Veteran Affairs Medical Centers.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21642-e21642
Author(s):  
Sejal Kothadia ◽  
Zhen Wang ◽  
Sarah Lee ◽  
Victor Tsu-Shih Chang ◽  
Yucai Wang ◽  
...  

e21642 Background: Little is known about palliative care for liver cancer. In this study, we examined palliative care for liver cancer and lung cancer patients. Methods: In an IRB approved protocol, we reviewed medical records of patients diagnosed with liver cancer who were seen by the palliative care service between 2006 and 2012 at 2 VA medical centers, and matched them to patients with lung cancer by year, KPS, and stage. Veterans were compared by symptom prevalence with the CMSAS and by palliative care interventions. Statistical analyses were performed with SAS Studio Version 3.5. Results: We analyzed a total of 138 male patients at 2 VA centers; 69 with lung cancer and 69 with liver cancer. The mean age in both groups was 65 years and 60% of patients self-identified as a minority. There was a high prevalence of symptoms in both groups. Symptom prevalence differed significantly between liver and lung cancer pts for weight loss and dyspnea at one site, and for feeling drowsy, constipation, at the other site. These differences disappeared in a pooled analysis. During palliative care evaluation, more lung cancer patients received treatment for constipation (n = 44 in lung, 29 in liver, p = 0.0107) and dyspnea treatment (n = 37 in lung, 22 in liver, p = 0.0167). More patients with lung cancer were evaluated by physical therapy (n = 41 in lung, n = 28 in liver, p = 0.0276) and psychiatry (n = 31 in lung, n = 20 in liver, p = 0.032). Conclusions: Differences between lung and liver cancer patients’ symptom prevalence and treatment by palliative care can vary by site. This reinforces the importance of local surveys of symptom prevalence . Further studies should be replicated in other sites.

2021 ◽  
pp. 003022282110598
Author(s):  
Gönül Düzgün ◽  
Ayfer Karadakovan

This study aimed to investigate the effect of music on pain, anxiety, comfort, and functional capacity of cancer patients who received care in a palliative care unit. The population of this randomized controlled trial consisted of cancer patients hospitalized in the palliative care service between July 2018 and July 2019. The study included 60 patients (30 interventions/30 controls). The patients in the intervention group were given a total of six music sessions, 10 minutes each with the Turkish classical music in maqams of their choice (Hejaz or Rast accompanied by an expert tambour (drum) player). There was a significant difference between the mean total pain scores, anxiety, comfort, and functional capacity scores of the patients in the intervention and control groups before and after music therapy. Music therapy decreased the level of pain. It is demonstrated that Turkish classical music therapy improved the pain, anxiety, comfort, and functional capacity in the palliative care unit.


2021 ◽  
Vol 37 (S1) ◽  
pp. 17-17
Author(s):  
Amanda Lovato ◽  
Nisha Almeida

IntroductionAn important reason for receiving non-beneficial treatment at end-of life is the lack of timely discussions on goals of care and end-of-life preferences. A recent randomized clinical trial demonstrated that patients primed with a questionnaire on their end-of-life preferences were more likely to initiate such conversations with their doctors. Our objective is to integrate the questionnaire into a smartphone application to facilitate early goals of care discussions. To achieve this goal, we first plan to undertake a feasibility study to understand stakeholder preferences.MethodsAs part of a quality improvement initiative at our Canadian quaternary-care hospital, we conducted focus groups with oncology and palliative care physicians and patients to understand barriers to early conversations on end-of-life preferences, and to assess feasibility of using smartphone technology in facilitating these conversations. The app would integrate a questionnaire to patients and send prompts to physicians on patient readiness and timing of conversations.ResultsWe conducted separate focus groups with lung cancer patients (n = 6) and clinicians in oncology (n = 6) and palliative care (n = 6). Clinical teams expressed enthusiasm about early conversations but raised several barriers including system (lack of electronic documentation and access to data; multiple physicians), clinician (lack of time) and patient (stigma associated with end-of-life) barriers. Clinicians agreed that an app could overcome some of these barriers such as access to patient and electronic data by making patients the repository of all their data and empowering them to initiate discussions. However, they raised concerns about universal accessibility of such technology, especially among the elderly. Patient focus groups will take place in March 2021 and inform us on feasibility in this population.ConclusionsThere is a consensus among physicians at our hospital that early end-of-life conversations have the potential to mitigate adverse events and that use of a smart phone app could facilitate such conversations.


2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 131-131
Author(s):  
Si Won Lee ◽  
Hye Jin Choi

131 Background: The importance of palliative care in cancer patients continues to be emphasized and studies are proving its importance. Several studies proved the improvement of quality of life in advanced cancer patients. The efficacy of symptom control based on outpatient palliative care service has not yet been reported in Korea. The objective of this study is to review the outcome of outpatient palliative care service at Yonsei Cancer Center, a tertiary cancer center in Korea. Methods: We retrospectively reviewed 155 cancer patients who used outpatient clinic at Yonsei Cancer Center in Korea between April 2014 and December 2014. Symptom severity was measured by modified Korean version of Edmonton Symptom Assessment System. Twelve symptoms were assessed: pain, fatigue, nausea, depression, anxiety, drowsiness, dyspnea, sleep disorder, anorexia, constipation, wellbeing, financial distress. Higher score means worse symptom. ESAS scores at baseline and follow-up assessments were analyzed. Results: The 155 patients had following characteristics: female 52.3%, median age 65 years (range 58-75), Hepatobiliary-pancreatic cancer and lung cancer patients accounted for the largest portion (n = 37, 23.9%; n = 36, 23.2% respectively). Most patients were Eastern Cooperative Oncology Group performance status 1 (n = 28, 18.1%) or 2 (n = 24, 15.5%). Ninety-two (59.4%) patients were referred to the palliative care team after anti-cancer treatments were all finished. Overall the symptoms did not change significantly from baseline to 2 consecutive follow up assessment except anorexia ( p value = 0.0195). Patients who were on active anticancer treatment had tendency of higher ESAS score than those finished with the anticancer treatment. However, all symptoms except nausea were not statistically significant. Conclusions: Most patients in this study did not have severe symptom scores that would show the differences of the symptom changes. Nevertheless, although not statistically significant, we found that patients on active anticancer treatment had higher symptom burden than those who were finished with the anticancer treatment. More meticulous symptom management is necessary to improve the symptom control.


Lung Cancer ◽  
2014 ◽  
Vol 83 ◽  
pp. S47-S48
Author(s):  
R. Knight ◽  
A.G. Sutherland ◽  
E. Shereston ◽  
A. Parr ◽  
L. Forman ◽  
...  

2021 ◽  
Author(s):  
Mitra McLarney ◽  
Frances S. Shofer ◽  
Jasmine Zheng

Abstract Purpose: Lung cancer patients experience functional deconditioning secondary to their underlying cancer and treatment yet rehabilitation service use remains low. The goal of this study is to compare post-acute care service use in lung cancer patients admitted to a metropolitan academic medical center. Methods: Adult lung cancer patients admitted from January 1, 2017 to August 31, 2018 with a diagnosis of lung cancer based on International Classification of Diseases 10, C34.0-C34.9, were included in this study. Patient characteristics including age, gender, race, marital status, functional status on admission, length of stay, and number of comorbidities were compared based on discharge setting. Results: 1,139 lung cancer patients were included in our study. The majority of patients discharged home with home care (51%) followed by home without services (35%), skilled nursing facilities (SNF) (10%) and acute inpatient rehabilitation facilities (IRF) (4%). 44% (498) of patients were primarily admitted for their lung cancer diagnosis. In unadjusted analyses, patients who discharged to SNF compared to home were more likely to be older, black, unmarried, live alone and have died during the study period. Patients who discharged to IRF had longer acute care hospitalization length of stays. In adjusted analyses, age, number of concurrent comorbidities and length of stay significantly correlated with discharge location. Conclusion: Lung cancer patients are unlikely to be discharged to a post-acute care facility after an acute hospitalization. Rehabilitation service use differs by sociodemographic factors, concurrent medical history and functional status. Future study is needed to better understand why these differences in discharge setting persists.


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