The need for a multidisciplinary approach to pain management in advanced cancer: A clinical case.

Advanced cancer patients are often affected by multiple complex symptoms brought about by persistent nociceptive stimuli and intense psychosocial distress. One such complex symptom, cancer pain, has continued to pose a challenge in medical management even though the concept of total pain was described several years ago by Cicely Saunders. Oftentimes, the application of a multidisciplinary approach is delayed after numerous opioid dose escalations and invasive procedures have been performed.

Changes in medication profile among patients with advanced cancer admitted to an acute palliative care unit.

Purpose: The decision-making process for medication use in the last weeks of life is complex because of patient frailty and poor prognosis. Limited literature is available on medication use in the palliative care setting, particularly in acute palliative care units (APCUs). We examined the changes in medication profile among hospitalized patients with advanced cancer before their palliative care inpatient consultation team referral, after palliative care consultation, at the time of APCU admission, and at APCU discharge or death.

Quality of end-of-life care in patients with hematologic malignancies: a retrospective cohort study.

Background: To the authors' knowledge, only limited data are available regarding the quality of end-of-life care for patients with hematologic malignancies. In this retrospective cohort study, the quality of end-of-life care was compared between patients with hematologic malignancies and those with solid tumors.

Methods: All adult patients who died of advanced cancer between September 1, 2009 and February 28, 2010 while under the care of the study institution were included.

Concepts and definitions for "actively dying," "end of life," "terminally ill," "terminal care," and "transition of care": a systematic review.

Context: The terms "actively dying," "end of life," "terminally ill," "terminal care," and "transition of care" are commonly used but rarely and inconsistently defined.

Objectives: We conducted a systematic review to examine the concepts and definitions for these terms.

Methods: We searched MEDLINE, PsycINFO, Embase, and CINAHL for published peer-reviewed articles from 1948 to 2012 that conceptualized, defined, or examined these terms.

Effect of palliative care services on the aggressiveness of end-of-life care in the Veteran's Affairs cancer population.

Background: Cancer care near the end of life (EOL) has become more aggressive over the years. Palliative care services (PCS) may decrease this aggressive cancer care in terminally ill cancer patients. Our objective was to observe the aggressiveness of cancer care near the EOL among Veterans Affairs cancer patients before and after the institution of a PCS team.