Management of cancer pain in pregnancy: can opioids be used?

Cancer in pregnancy is less common, however its frequency is increasing due to delayed onset of childbearing. Pregnant patients with cancer can experience high frequency of moderate to severe cancer pain. It can be challenging to manage cancer pain due to the complexity with assessment and treatment as many of the analgesics are avoided.

Evaluating Pain Management Practices for Cancer Patients among Health Professionals: A Global Survey.

Cancer incidence in the world is predicted to increase in the next decade. While progress has been in diagnosis and treatment, much still remains to be done to improve cancer pain therapy, mainly in underserved communities in low-income countries. To determine knowledge, beliefs, and barriers regarding pain management in both high- and low-income countries (according to the WHO classification); and to learn about ways to improve the current state of affairs.

Unusual presentation of hepatocellular carcinoma: Case report and review of literature.

Hepatocellular carcinoma (HCC) is the most common primary cancer of the liver and a major cause of mortality globally. Atypical presentation of HCC can present a diagnostic challenge. We, therefore, present a rare case of hepatocellular carcinoma fungating through the anterior abdominal wall with concomitant lung and brain metastases in a young patient with non-cirrhotic liver but positive chronic hepatitis B serology.

Assessment of Palliative Care Needs in a Kenyan Intensive Care Unit Using a Trigger-Based Model.

Context: Palliative care triggers have been used in the intensive care unit (ICU) setting, usually in high-income countries, to identify patients who may benefit from palliative care consults. The utility and benefits of palliative care triggers in the ICU have not been previously studied in sub-Saharan Africa.

Objectives: Our objectives were to determine the prevalence of ICU admissions in those who met at least one palliative care trigger and whether a palliative care consult influenced the length of ICU stay and time to change of goals order.

Randomized control trial of advanced cancer patients at a private hospital in Kenya and the impact of dignity therapy on quality of life.

Background: Palliative care is a modality of treatment that addresses physical, psychological and spiritual symptoms. Dignity therapy, a form of psychotherapy, was developed by Professor Harvey Chochinov, MD in 2005.The aim of the study was to assess the effect of one session of dignity therapy on quality of life in advanced cancer patients.

Extension for Community Healthcare Outcomes-Palliative Care in Africa Program: Improving Access to Quality Palliative Care.

Purpose: There is limited access to quality palliative care (PC) for patients with advanced cancer in sub-Saharan Africa. Our aim was to describe the development of the Project Extension for Community Healthcare Outcomes-Palliative Care in Africa (ECHO-PACA) program and describe a preliminary evaluation of attitudes and knowledge of participants regarding the ability of the program to deliver quality PC.

Methods: An interdisciplinary team at the MD Anderson Cancer Center, guided by experts in PC in sub-Saharan Africa, adapted a standardized curriculum based on PC needs in the region.

Factors that influence advance directives completion amongst terminally ill patients at a tertiary hospital in Kenya.

Background: An advance directive (AD) is a written or verbal document that legally stipulates a person's health care preference while they are competent to make decisions for themselves and is used to guide decisions on life-sustaining treatment in the event that they become incapacitated. AD can take the form of a living will, a limitation of care document, a do-not-resuscitate order, or an appointment of a surrogate by durable power of attorney. The completion rate of AD varies from region to region, and it is influenced by multiple factors.