What's in a Name? Word descriptors of cancer-related fatigue.

Many different words are used to describe fatigue. It is unclear whether these word descriptors represent the same cancer symptom or dimension. The objective of this study was to identify clinical associations of three fatigue word descriptors (FWDs): 'easy fatigue', 'weakness', and 'lack of energy' (LOE).

Scopolamine for cancer-related nausea and vomiting.

Nausea and vomiting is a common and troublesome symptom in advanced cancer. There have been different approaches described for the management of nausea and vomiting, specifically empirical and etiological. Scopolamine is listed in textbooks as a useful medication in management of nausea and vomiting in this setting, although there is no published data to support this recommendation.

The business of palliative medicine--part 6: clinical operations in a comprehensive integrated program.

The medical care of individuals with advanced disease is complex and has historically been fragmented and suboptimal. Palliative medicine attempts to address these needs. The Harry R.

Symptom clusters: myth or reality?

Clinical experience suggests that many symptoms occur together. In this paper, we examine the rationale and evidence base for symptom clusters in different medical fields, particularly the cluster phenomenon in cancer. Cancer symptom clusters are a reality.

Consistency of symptom clusters in advanced cancer.

Background: The reproducibility of symptom clusters (SCs) in different populations would support the validity of the cluster concept. Ideal approaches to cluster identification are unknown. The presence of a sentinel (most prevalent) symptom may reduce the number of symptoms in a comprehensive symptom assessment tool.

Recent development in therapeutics for breakthrough pain.

Breakthrough pain is defined as transitory flares of pain. Breakthrough pain is caused by cancer, cancer complications, treatment or comorbidities. The usual onset to maximum breakthrough pain intensity time is 3 min and duration is 30 min; therefore, the assessment for response needs to be at short intervals.

A systematic review of the treatment of nausea and/or vomiting in cancer unrelated to chemotherapy or radiation.

Context: A systematic review of antiemetics for emesis in cancer unrelated to chemotherapy and radiation is an important step in establishing treatment recommendations and guiding future research. Therefore, a systematic review based on the question "What is the evidence that supports antiemetic choices in advanced cancer?" guided this review.

Objectives: To determine the level of evidence for antiemtrics in the management of nausea and vomiting in advanced cancer unrelated to chemotherapy and radiation, and to discover gaps in the evidence, which would provide important areas for future research.

Errors in opioid prescribing: a prospective survey in cancer pain.

Context: Cancer pain is debilitating and has multidimensional consequences. It can be treated adequately in up to 90% of patients by following pain management guidelines. Nevertheless, inadequate pain control remains a global problem.

Cancer symptom clusters: old concept but new data.

Individuals with cancer have multiple symptoms, which frequently co-occur. A nonrandom distribution of symptoms suggests a common mechanism. Symptom clusters (SCs) were considered part of various syndromes in the early years of medicine.

Nausea and vomiting in advanced cancer.

Nausea and vomiting are relatively common in advanced cancer and is dreaded more than pain by patients. The history, pattern of nausea and vomiting, associated symptoms, and physical examination provides clues as to etiology and may guide therapy. Continuous severe nausea unrelieved by vomiting is usually caused by medications or metabolic abnormalities, while nausea relieved by vomiting or induced by eating is usually due to gastroparesis, gastric outlet obstruction, or small bowel obstruction.

Intermittent cancer pain: clinical importance and an updated cancer pain classification.

Aim: We report the characteristics of intermittent cancer pain. In addition, we propose a new clinically based classification.

Methods: Consecutive patients with cancer referred to our palliative medicine service were consented and underwent a comprehensive pain evaluation including available laboratory and radiological studies, at the time of initial contact.

The cancer anorexia-cachexia syndrome: myth or reality?

Background: Controversy exists as what constitutes the cancer anorexia-cachexia syndrome (CACS), and whether it truly is a distinct clinical disorder. In this study, we aimed to: (1) assess if CACS is a distinct clinical disorder, (2) identify the symptoms characteristic of CACS, (3) evaluate CACS impact on patient outcomes (symptom burden and survival time from referral).

Methods: Consecutive patients referred to palliative medicine were assessed by 38-symptom questionnaire.

The intravenous to oral relative milligram potency ratio of morphine during chronic dosing in cancer pain.

Morphine (M) is the opioid analgesic of choice for severe cancer pain. The IV to PO M equipotent switch ratio (CR) is controversial. We designed this prospective observational cohort to confirm the efficacy and safety of M IV to PO CR of 1:3.

Validation of a simplified anorexia questionnaire.

Context: Anorexia is a common symptom in cancer and is usually assessed by multiple questions and multidimensional questionnaires. A simplified questionnaire would be less burdensome to patients and abbreviate the process.

Objectives: We compared the reliability at one point in time, sensitivity to change over time, and prognostic accuracy of a two-item questionnaire with the Functional Assessment of Anorexia and Cachexia Therapy shortened 12-question version (A/CS-12).

A comparative study of 2 sustained-release morphine preparations for pain in advanced cancer.

Purpose: Several sustained-release morphine (SRM) formulations are available internationally. This study compared 2 such products available in the United States, SR1 and SR2.

Patients And Methods: In an open-label study, patients with advanced cancer pain were randomized to receive SR1 or SR2 every 12 hours around-the-clock (ATC) for 5 days, with immediate release (IR) liquid morphine for rescue dosing (RD).

Methylphenidate side effects in advanced cancer: a retrospective analysis.

Introduction: Methylphenidate (MP) is often recommended for symptom control in advanced cancer. Little is known about its side effects in frail adults.

Objectives: To evaluate MP-associated symptoms or side effects (S/E).

Opioid equianalgesic tables: are they all equally dangerous?

Pain is one of the most common symptoms in cancer patients. Opioids are widely prescribed for this and other purposes. Properly used, they are safe, but they have serious and potentially lethal side effects.

Buprenorphine for neuropathic pain--targeting hyperalgesia.

Opioids are well known to relieve severe, acute, and chronic nociceptive pain, but neuropathic pain shows a relatively poor response to opioids. Buprenorphine, a partial mu and ORL-1-receptor agonist, kappa-delta receptor antagonist, interacts with different G proteins than potent mu agonists and hence is not cross-tolerant to standard opioids. Buprenorphine blocks central sensitization (hyperalgesia) that is commonly found with neuropathic pain.

Symptom assessment in palliative medicine: complexities and challenges.

Symptoms are important patient-reported outcomes (PRO), which help to evaluate the impact of diseases and treatments and assess quality of care. Thorough symptom assessment is a challenge, as patients in palliative settings are often polysymptomatic and easily fatigued. There is no consensus about standardization of symptom assessment in palliative medicine.

Components of the anorexia-cachexia syndrome: gastrointestinal symptom correlates of cancer anorexia.

Introduction: Cancer-related anorexia is traditionally considered part of a complex but ill-defined anorexia-cachexia syndrome in which anorexia is intimately associated with other gastrointestinal (GI) symptoms and weight loss. We surveyed cancer patients with anorexia to learn more about the relationship between anorexia and these symptoms.

Materials And Methods: A 22-item GI questionnaire assessed the severity of anorexia and the prevalence of concurrent GI symptoms, including taste changes, food aversions, altered sense of smell, and diurnal food intake changes.

Bioelectrical impedance phase angle changes during hydration and prognosis in advanced cancer.

Introduction: We wished to determine bioelectrical impedance (BIA) correlates before hydration or changes during hydration and determine if these changes were prognostically important.

Methods And Materials: Fifty eligible patients underwent BIA measurements 3 consecutive days. Laboratory studies (electrolytes, creatinine, and hemoglobin) on day 1; weights and vital signs were recorded.

Visual analogue scales and assessment of quality of life in cancer.

Assessment of quality of life (QOL) in cancer clinical trials is important when comparing treatments, especially when prolonged survival is not expected. QOL scores may reflect physical or psychosocial functioning or distress. The choice of QOL instrument depends upon the definition, research hypothesis, cancer population, depth and sensitivity of information required, and frequency of measurement.

Narrative review: furosemide for hypercalcemia: an unproven yet common practice.

Although primary hyperparathyroidism is the most common cause of hypercalcemia, cancer is the most common cause requiring inpatient intervention. An estimated 10% to 20% of all patients with cancer have hypercalcemia at some point in their disease trajectory, particularly in advanced disease. Aggressive saline hydration and varying doses of furosemide continue to be the standard of care for emergency management.