Palliative Care in Oncology

Balancing Opioid Use to Relieve Cancer-Related Pain and Protecting Patients From Addiction and Death

Jo Cavallo  / December 25, 2017

According to the Centers for Disease Control and Prevention (CDC), from 1999 to 2015, more than 183,000 people have died in the United States from overdoses related to prescription opioids, including methadone, oxycodone, and hydrocodone.1 To stem the epidemic in prescription opioid–related use and ...

Supportive Care
Palliative Care

Helping Patients With Advanced Disease Transition From Focused to Intrinsic Hope

Jo Cavallo  / December 10, 2017

While hope for a cure after a cancer diagnosis is a feeling both patients and oncologists rightly cling to during treatment, when too much emphasis is placed on this type of “focused” hope, it can make it more difficult for patients to face their mortality. Moreover, such a focus can deny patie...

Supportive Care
Palliative Care

How Effective Communication Is Integral to Patient-Centered Care

Jo Cavallo  / November 10, 2017

Communicating effectively with patients with advanced cancer not only helps patients and their family members successfully transition to palliative and end-of-life care, it can prevent physicians from experiencing professional burnout, according to Robert M. Arnold, MD, Distinguished Service Pr...

Palliative Care

How Early Palliative Care May Benefit Patients With Incurable Cancer

Jo Cavallo  / September 25, 2017

Palliative care provided soon after a patient is diagnosed with incurable cancer not only helps improve the patient’s overall quality of life but also improves communication about the patient’s wishes for end-of-life care, according to a study by Jennifer S. Temel, MD, Clinical Director of Thoracic ...

Supportive Care
Palliative Care

Advance Care Planning: Ensuring Patients’ End-of-Life Wishes Are Honored

Jo Cavallo  / July 25, 2017

When Amy Berman, BSN, LHD (aged 58), stood in front of the mirror to perform a routine breast self-exam and saw redness and dimpling on her right breast, she feared they were the telltale signs of inflammatory breast cancer. “I have never self-diagnosed myself before, but I had recently read an ar...

Palliative Care
Supportive Care

Understanding the Cultural Differences Among Ethnic Minorities in Palliative and End-of-Life Care

Jo Cavallo  / July 10, 2017

GUEST EDITOR Addressing the evolving needs of cancer survivors at various stages of their illness and care, Palliative Care in Oncology is guest edited by Jamie H. Von Roenn, MD. Dr. Von Roenn is ASCO’s Vice President of Education, Science, and Professional Development.   Because cultural or...

Supportive Care
Palliative Care

Examining the Impact of ‘Death With Dignity’ Legislation

Jo Cavallo  / March 25, 2017

Despite the controversy surrounding “Death With Dignity” laws, which allow physicians to prescribe life-ending drugs to terminally ill patients, they have a long history of majority support from Americans. According to a Gallup poll taken in 2015, nearly 7 in 10 Americans (68%) agreed that phys...

Palliative Care

Weighing the Benefits and Risks of Medical Marijuana

Jo Cavallo  / December 25, 2016

Despite the fact that 28 states and the District of Columbia have enacted laws to permit the use of cannabis and cannabinoid-based drugs to treat medical conditions, including cancer and symptoms from its treatment, federal law prohibits physicians from prescribing marijuana to their patients, ...

Palliative Care

How Video Support Tools Help Patients Make Informed Decisions About End-of-Life Care

Jo Cavallo  / November 25, 2016

A relatively recent study by Areej El-Jawahri, MD, and her colleagues is showing how the use of visual media can empower patients with advanced cancer, as well as other life-threatening illnesses, to make more informed decisions about their end-of-life care.1 The aim of Dr. El-Jawahri’s study...


Using Pharmacogenetics to Predict Cancer Prognosis, Response to Treatment, and Toxicity

Jo Cavallo  / October 25, 2016

Although clinical trials are helpful in determining the effectiveness of a specific drug across a patient population, they are not as reliable at pinpointing how well a particular patient will respond to the drug or dosing regimen or how the drug may impact the patient’s quality of life from ...

Palliative Care

Integrating Early Palliative Medicine Into Oncology Care to Improve Patients’ Quality of Life

Jo Cavallo  / August 10, 2016

At the 2015 Palliative Care in Oncology Symposium in Boston, Vicki Jackson, MD, MPH, Chief in the Division of Palliative Care and Geriatrics at Massachusetts General Hospital, Co-Director of the Harvard Center for Palliative Care, and Associate Professor of Medicine at Harvard Medical...

Symptom Management

Tackling the Symptoms of Long-Term Fatigue and Insomnia in Cancer Survivors

Jo Cavallo  / June 25, 2016

Fatigue and sleep disruption are common occurrences for most patients diagnosed with cancer. Simply having a serious physical illness like cancer along with its associated pain, hospitalization, and treatment, as well as the attendant psychological impact, all contribute to the onset of fatigue...

Guidelines to Assess and Manage the Symptoms of Fatigue and Insomnia

Jo Cavallo  / June 25, 2016

In 2014, ASCO developed a clinical practice guideline to provide a mechanism for physicians to screen, assess, and manage the persistent symptoms of fatigue in adult cancer survivors.1 As summarized below, the guideline calls for regular screening, assessment, laboratory evaluation, and patient educ...

Symptom Management

How Cancer and Its Treatments Affect Cognitive Function

Jo Cavallo  / February 10, 2016

Although chemotherapy is often cited as the main culprit for diminishing cognitive function in patients with cancer, ushering the term “chemobrain” into the vernacular, research by Tim A. Ahles, PhD, and his colleagues is showing that multiple factors may contribute to the condition.1 Using breast c...

Palliative Care

How Effective Communication Can Improve Patient Care—and Reduce Physician Burnout

Jo Cavallo  / January 25, 2016

Surveys conducted between 1950 and 1970 show that most physicians considered it inhumane to give patients with a poor cancer prognosis the bad news.1,2 Since then, it has been well established that open communication between physician and patient is an essential part of effective cancer care and can...

Palliative Care

Practicing the Humanistic and Holistic Approach to End-of-Life Care

Jo Cavallo  / December 10, 2015

In 1990, when Bruce (B.J.) ­Miller, MD, was an undergraduate at Princeton University, the practice of medicine was far from his mind. Then a student in Chinese and Asian studies and later an art history major, Dr. Miller would come to pursue a career specializing in palliative medicine after an acci...

Palliative Care

Important Research in the Palliative Care of Patients With Cancer

Jo Cavallo  / October 25, 2015  / Umbraco.Web.PublishedCache.XmlPublishedCache.XmlPublishedContent

The emphasis at this year’s Palliative Care in Oncology Symposium, held earlier this month in Boston, was on patient-centered care throughout the cancer continuum. The meeting attracted more than 650 attendees and included six general sessions featuring best practices in communication, nonpharmacolo...

Pain Management

The Need for a Multidisciplinary Approach to Combating Cancer-Related Pain

Jo Cavallo  / October 10, 2015

The statistics are staggering. Despite the development of novel analgesics and the increasing awareness of the importance of adequately controlling pain from cancer or its treatment, up to 50% of patients undergoing treatment and between 70% and 90% of patients with advanced disease experience some ...

Pain Management

Improving Management of Cancer-Related Pain

Jamie H. Von Roenn, MD  / October 10, 2015

Despite multiple guidelines from national and international organizations,1,2 the quality of current cancer pain management remains inadequate. The World Health Organization’s three-step analgesic dosing ladder forms the foundation of these guidelines.3 Yet, as noted by William S. Rosenberg, MD, FAA...

Palliative Care

One Doctor’s Road to Palliative Care Services in the Inner City

Ronald Piana  / September 25, 2015

St. Barnabas Hospital is located in the heart of Bronx, New York, and as such, it has a culturally diverse, largely poor, patient population. The backbone of successful palliative care services is the doctor-patient communication bonding process. However, many of the patients with late-stage cancer ...

Issues in Oncology
Palliative Care

Using Gene Analytics to Identify Patients at Risk for Treatment Toxicity

Jo Cavallo  / August 10, 2015

Genomic applications are now an accepted part of oncologic science and practice. Differences in gene expression have been used to understand and predict tumor behaviors and response to treatment. And now it seems likely that genomics may also play a pivotal role in guiding treatment preferences by i...

Caring for the Whole Patient Both during Active Treatment and at End of Life

Jo Cavallo  / June 10, 2013

Despite studies showing that a majority of patients prefer to die at home rather than in an institutional setting,1 in many parts of the country, over 30% die in nursing homes and over 50% die in hospitals, according to Ira Byock, MD, Director of Palliative Medicine, Dartmouth-Hitchcock Medical Cent...

One Cancer Center's Approach to Death with Dignity

Frederick R. Appelbaum, MD  / June 10, 2013

In November 2008, the Washington State legislature passed the Washington Death with Dignity Act allowing patients with a terminal diagnosis and less than 6 months to live to request and self-administer lethal medication. After considerable internal debate, our cancer center elected to develop a Deat...

Death with Dignity Program at Seattle Cancer Care Alliance 

Matthew Stenger  / June 10, 2013

After passage of the Washington Death with Dignity Act in November 2008, the Seattle Cancer Care Alliance—the site of outpatient care for patients with cancer from Fred Hutchinson–University of Washington Cancer Consortium—developed a Death with Dignity program. The program is adapted from existing ...