Publications by authors named "Kozue Suzuki"
Purpose: To clarify the current use of unapproved and unproven cancer treatment (UUCT) among the bereaved families of patients with cancer who died in palliative care units, the financial burden and psychological experiences of the families, and the relationship between patients in palliative care who used UUCT and communication with their physicians'.
Methods: This study was conducted as part of a cross-sectional, anonymous nationwide survey of the bereaved family members of cancer patients who died in palliative care unit in Japan.
Results: Questionnaires were sent to 1,039 bereaved family members, and responses were received from 661 (64%).
Objectives: Patients with malignant wounds suffer from physical and psychological symptom burden. Despite psychological support being required, the impact of malignant wounds on patients' psychological distress is poorly investigated. We evaluated psychological distress associated with malignant wounds for patients at their end of life.
View Article and Find Full Text PDFArticle Synopsis
- A multicenter study in Japan assessed the effectiveness of hospital-based palliative care teams (HPCTs) using patient-reported outcomes (PROs) from 318 participants, mostly cancer patients.
- Participants reported significant improvement in 12 severe symptoms within a week, with vomiting showing a 100% improvement and other symptoms like shortness of breath and pain also improving notably.
- The study highlights the effectiveness of HPCTs in symptom management, while also pointing out the ongoing challenges in providing relief for patients in palliative care.
Context: Dyspnea is among the most distressing symptoms in the last weeks to days of life (terminal dyspnea). While physicians frequently use parenteral opioids other than morphine for terminal dyspnea, little is known about their effects in cancer patients.
Objectives: To explore the effectiveness and safety of parenteral morphine, oxycodone, and hydromorphone for cancer patients with terminal dyspnea.
Dyspnea is one of the most frequent and distressing symptoms in patients with advanced cancer. As dyspnea deteriorates patients' quality of life markedly and tends to worsen as the disease progresses, comprehensive assessment and timely treatment of the underlying etiologies are essential. International guidelines recommend various non-pharmacological and pharmacological management options.
View Article and Find Full Text PDFContext: Although Systemic opioids are recommended as a pharmacological treatment for cancer-related dyspnea, their effectiveness and safety needs to be investigated in a real-world context OBJECTIVES: To evaluate the effectiveness and safety of systemic regular opioids for dyspnea in cancer patients, in the real-world palliative care practice.
Methods: This was a multicenter prospective observational study. We consecutively enrolled adult cancer patients starting regular opioids (morphine, oxycodone, hydromorphone, or fentanyl) for dyspnea from 12 palliative care services across Japan.
Background: Patients with lung cancer are more likely to have comorbidities [e.g., interstitial lung disease (ILD)], chronic obstructive pulmonary disease) and metastases that may affect dyspnea and the effectiveness and safety of opioids for dyspnea than other cancer types.
View Article and Find Full Text PDFBackground: This study aimed to investigate the effectiveness of anticholinergics (AC) for death rattle in dying patients with cancer.
Methods: This is a prospective cohort study enrolled Terminally ill adult (20 years or older) patients with cancer who developed substantial death rattle (Back score ≥2) from 23 palliative care units in Japan. AC treatment for death rattle was prescribed according to primary physician's decision.
Article Synopsis
- - This study aimed to understand how the Phase of Illness at the time of admission to palliative care units affects symptoms in patients with advanced cancer.
- - Data was collected from 1,894 patients across 23 palliative care units in Japan, revealing that symptoms were most distressing during the terminal phase, and different phases showed varying degrees of specific symptoms.
- - The findings emphasize the need for future research on patients’ medical conditions and the importance of routinely assessing both the Phase of Illness and associated symptoms in palliative care settings.
Background: How clinicians treat patients with terminal dyspnea widely varies, which could hamper quality care. We visualized comprehensive pharmacological treatment delivered by palliative care physicians.
Aim: To examine adherence to a comprehensive pharmacological treatment algorithm for patients with terminal dyspnea, and to explore its outcomes during 48 h.
Comparative study of clinicians' and family members' perceptions of patients' end-of-life experiences.
BMJ Support Palliat Care
October 2022
Objective: End-of-life experiences (ELEs), such as deathbed visions (DBVs), have been reported worldwide. However, ELEs have rarely been discussed in clinical practice, possibly because of the different perceptions of ELEs among clinicians and families. Therefore, this study aimed to investigate the differences in perception regarding ELEs, especially DBVs, between clinicians and families.
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- * One patient showed severe hypoxaemia and dyspnoea, with a worsened status classified as IPOS 3.
- * Along with standard treatments like remdesivir and dexamethasone, morphine was given and resulted in unexpected improvement in both hypoxaemia and dyspnoea.
Background: Dyspnea is a common and distressing symptom in patients with cancer. To improve its management, multicenter confirmatory studies are necessary. Research policy would be useful in conducting these studies.
View Article and Find Full Text PDFBackground: Accurately predicting impending death is essential for clinicians to clarify goals of care. We aimed to develop diagnostic models to predict death ≤3 days in cancer patients.
Methods: In this multicenter cohort study, we consecutively enrolled advanced cancer patients admitted to 23 inpatient hospices in 2017.
Article Synopsis
- The study investigates which factors predict the onset of dyspnea (difficulty breathing) in terminally ill cancer patients within a week of their admission to hospice or palliative care.
- The analysis included 1,159 patients and found that factors like primary lung cancer, a low Karnofsky Performance Status score (≤40), and the presence of ascites were significantly associated with developing dyspnea.
- The researchers suggest that these factors could help identify patients at risk for dyspnea, but they emphasize the need for more studies to confirm the results.
Dyspnea is a common and distressing symptom in patients with advanced cancer. Opioids, benzodiazepines, and corticosteroids are commonly prescribed pharmacological treatments for cancer dyspnea. The objective of this survey was to investigate physician-perceived predictive factors for the effectiveness of opioids, benzodiazepines, and corticosteroids in treating cancer dyspnea.
View Article and Find Full Text PDFContext: Conducting randomized controlled trials on palliative care is difficult owing to barriers like fragility of the patients' health status and health care providers' concerns for patients. However, quality randomized controlled trials are required for care improvement.
Objectives: To investigate the willingness of cancer patients and their relatives to participate in a clinical study on cancer dyspnea and identify feasible clinical study designs for this condition.
Context: How physicians use opioids for dyspnea in imminently dying cancer patients (terminal dyspnea) varies markedly, which could hamper quality care.
Objectives: To examine the adherence to an algorithm-based treatment for terminal dyspnea, and explore its outcomes over 24 hours.
Methods: This was a pre-planned subgroup analysis of a multicenter prospective observational study.
Optimal Paracentesis Volume for Terminally Ill Cancer Patients With Ascites.
J Pain Symptom Manage
November 2021
Context: Patients with malignant ascites often suffer from distressing symptoms, especially in their end-of-life stage. Although paracentesis is the most common treatment modality to alleviate such symptoms, the optimal volume of paracentesis is not known.
Objectives: To explore the efficacy and safety of paracentesis by the drainage volume for terminally ill cancer patients with malignant ascites.
Breathlessness is among the most common and deteriorating symptoms in patients with advanced cancer, which may worsen towards the end of life. Breathlessness in patients with estimated life expectancy of weeks to days has unique clinical features: it tends to worsen rapidly over days to hours as death approaches often despite current symptom control measures. Breathlessness in patients during the last weeks to days of life can be called 'terminal breathlessness'.
View Article and Find Full Text PDFContext: Parenteral morphine is widely used for dyspnea of imminently dying cancer patients (terminal dyspnea). However, the efficacy of other opioids such as oxycodone remains largely unknown.
Objectives: To explore the efficacy of parenteral oxycodone vs.
Death rattle occurs during the last days of life, and relatives of those afflicted frequently report that it is very distressful. However, there is no effective treatment for it. The purpose of this study was to investigate the perceptions of Japanese palliative care physicians in clinical practice in Japan.
View Article and Find Full Text PDFPurpose: For appropriate advance care planning, functional prognostication is necessary. However, there are no studies of functional prognostication in patients with cancer. The aim of this study was to develop a functional prognostic scoring system for patients with advanced cancer.
View Article and Find Full Text PDFObjectives: It is unclear whether patients with non-specific dyspnoea are suitable candidates for studies investigating the effectiveness of benzodiazepines against dyspnoea. The objective of this survey was to investigate suitable subjects for studies of benzodiazepines for cancer dyspnoea.
Methods: A nationwide questionnaire survey was conducted among 536 Japanese-certified palliative care physicians.