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Cancers
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Palliative Care for Patients with Cancer
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Palliative Care for Patients with Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Survivorship and Quality of Life".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 10599

Special Issue Editor

Prof. Dr. Andrew Davies

E-Mail Website
Guest Editor
Palliative Medicine, Trinity College Dublin, University College Dublin, Our Lady's Hospice, Dublin, Ireland
Interests: palliative care, end-of-life care; supportive care
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

The International Association for Hospice & Palliative Care define Palliative care as “the active holistic care of individuals across all ages with serious health-related suffering due to severe illness, and especially of those near the end of life”. It includes “prevention, early identification, comprehensive assessment and management of physical issues, including pain and other distressing symptoms, psychological distress, spiritual distress and social needs”.

This Special Issue aims to provide an evidence-based review of common palliative care problems in patients with advanced cancer, to highlight new research and new developments in the area, and to discuss the evolving role of palliative care in supportive care and oncology (in both developing and developed countries).

We are seeking original papers relating to new interventions within palliative care for patients with cancer, involving (but not exclusively) pain and symptom control, new models of care, and the use of digital health interventions.

Prof. Dr. Andrew Davies
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cancer
  • palliative care
  • terminal care
  • supportive care
  • symptom control
 

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Further information on MDPI's Special Issue polices can be found here.

Published Papers (5 papers)

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Editorial

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8 pages, 1051 KiB  
Editorial
Specialist Palliative Care for Patients with Cancer: More Than End-of-Life Care
by Craig Gouldthorpe, Jenny Power, Amy Taylor and Andrew Davies
Cancers 2023, 15(14), 3551; https://doi.org/10.3390/cancers15143551 - 9 Jul 2023
Cited by 7 | Viewed by 2542
Abstract
Palliative care has traditionally focused on end-of-life care for patients with advanced cancer. This has since expanded to include symptom management and quality-of-life improvement from the moment of cancer diagnosis. Specialist palliative care teams work across community and inpatient settings and focus on [...] Read more.
Palliative care has traditionally focused on end-of-life care for patients with advanced cancer. This has since expanded to include symptom management and quality-of-life improvement from the moment of cancer diagnosis. Specialist palliative care teams work across community and inpatient settings and focus on dealing with complex problems whilst supporting healthcare colleagues in providing generalist palliative care. This article will outline the principles of palliative care, models of palliative care delivery, the distinctions between palliative care and supportive care, and the role of specialist palliative care in cancer survivorship. Full article
(This article belongs to the Special Issue Palliative Care for Patients with Cancer)
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Research

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14 pages, 733 KiB  
Article
Association between Inappropriate End-of-Life Cancer Care and Specialist Palliative Care: A Retrospective Observational Study in Two Acute Care Hospitals
by Manon S. Boddaert, Heidi P. Fransen, Ellen J. M. de Nijs, Dagmar van Gerven, Leontine E. A. Spierings, Natasja J. H. Raijmakers and Yvette M. van der Linden
Cancers 2024, 16(4), 721; https://doi.org/10.3390/cancers16040721 - 8 Feb 2024
Viewed by 1503
Abstract
A substantial number of patients with life-threatening illnesses like cancer receive inappropriate end-of-life care. Improving their quality of end-of-life care is a priority for patients and their families and for public health. To investigate the association between provision, timing, and initial setting of [...] Read more.
A substantial number of patients with life-threatening illnesses like cancer receive inappropriate end-of-life care. Improving their quality of end-of-life care is a priority for patients and their families and for public health. To investigate the association between provision, timing, and initial setting of hospital-based specialist palliative care and potentially inappropriate end-of-life care for patients with cancer in two acute care hospitals in the Netherlands, we conducted a retrospective observational study using hospital administrative databases. All adults diagnosed with or treated for cancer in the year preceding their death in 2018 or 2019 were included. The main exposure was hospital-based specialist palliative care initiated >30 days before death. The outcome measures in the last 30 days of life were six quality indicators for inappropriate end-of-life care (≥2 ED-visits, ≥2 hospital admissions, >14 days hospitalization, ICU-admission, chemotherapy, hospital death). We identified 2603 deceased patients, of whom 14% (n = 359) received specialist palliative care >30 days before death (exposure group). Overall, 27% (n = 690) received potentially inappropriate end-of-life care: 19% in the exposure group, versus 28% in the non-exposure group (p < 0.001). The exposure group was 45% less likely to receive potentially inappropriate end-of-life care (AOR 0.55; 95% CI 0.41 to 0.73). Early (>90 days) and late (≤90 and >30 days) initiation of specialist palliative care, as well as outpatient and inpatient initiation, were all associated with less potentially inappropriate end-of-life care (AOR 0.49; 0.62; 0.32; 0.64, respectively). Thus, timely access to hospital-based specialist palliative care is associated with less potentially inappropriate end-of-life care for patients with cancer. The outpatient initiation of specialist palliative care seems to enhance this result. Full article
(This article belongs to the Special Issue Palliative Care for Patients with Cancer)
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10 pages, 609 KiB  
Article
Quality of End-of-Life Care during the COVID-19 Pandemic at a Comprehensive Cancer Center
by Yvonne Heung, Donna Zhukovsky, David Hui, Zhanni Lu, Clark Andersen and Eduardo Bruera
Cancers 2023, 15(8), 2201; https://doi.org/10.3390/cancers15082201 - 8 Apr 2023
Cited by 5 | Viewed by 2366
Abstract
To evaluate how the COVID-19 pandemic impacted the quality of end-of-life care for patients with advanced cancer, we compared a random sample of 250 inpatient deaths from 1 April 2019, to 31 July 2019, with 250 consecutive inpatient deaths from 1 April 2020, [...] Read more.
To evaluate how the COVID-19 pandemic impacted the quality of end-of-life care for patients with advanced cancer, we compared a random sample of 250 inpatient deaths from 1 April 2019, to 31 July 2019, with 250 consecutive inpatient deaths from 1 April 2020, to 31 July 2020, at a comprehensive cancer center. Sociodemographic and clinical characteristics, the timing of palliative care referral, timing of do-not-resuscitate (DNR) orders, location of death, and pre-admission out-of-hospital DNR documentation were included. During the COVID-19 pandemic, DNR orders occurred earlier (2.9 vs. 1.7 days before death, p = 0.028), and palliative care referrals also occurred earlier (3.5 vs. 2.5 days before death, p = 0.041). During the pandemic, 36% of inpatient deaths occurred in the Intensive Care Unit (ICU) and 36% in the Palliative Care Unit, compared to 48 and 29%, respectively, before the pandemic (p = 0.001). Earlier DNR orders, earlier palliative care referrals, and fewer ICU deaths suggest an improvement in the quality of end-of-life care in response to the COVID-19 pandemic. These encouraging findings may have future implications for maintaining quality end-of-life care post-pandemic. Full article
(This article belongs to the Special Issue Palliative Care for Patients with Cancer)
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Review

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14 pages, 740 KiB  
Review
Vital Signs in Palliative Care: A Scoping Review
by Jenny Power, Craig Gouldthorpe and Andrew Davies
Cancers 2023, 15(18), 4641; https://doi.org/10.3390/cancers15184641 - 20 Sep 2023
Viewed by 1936
Abstract
Vital signs are routinely measured in secondary healthcare settings and can be used to detect clinical problems, guide treatment, and monitor response to treatment. Vital signs are less frequently measured in palliative care settings. Reasons for this are unclear. This scoping review aimed [...] Read more.
Vital signs are routinely measured in secondary healthcare settings and can be used to detect clinical problems, guide treatment, and monitor response to treatment. Vital signs are less frequently measured in palliative care settings. Reasons for this are unclear. This scoping review aimed to assess the generic use of vital signs in palliative care, and its role in prognostication for adult patients with cancer receiving palliative care. Medline, Embase, and CINAHL were searched for articles involving adult patients with advanced cancer receiving palliative care who had their vital signs measured. Twenty-six articles were identified in which one or a combination of vital signs, with or without other clinical parameters, was used to prognosticate for patients. An additional three articles investigated the generic use of vital signs in patients with advanced cancer. There was significant heterogeneity between identified studies, with some indication that changes in vital signs may indicate that a patient is close to death. However, other studies suggested that patients may maintain normal vital signs until the time of death. Further studies are needed to explore whether abnormal vital signs may be used as a prognostic indicator for patients with cancer receiving palliative care. Full article
(This article belongs to the Special Issue Palliative Care for Patients with Cancer)
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Other

8 pages, 561 KiB  
Opinion
The Use of Parenteral Opioids in Cancer Pain Management
by Sebastiano Mercadante
Cancers 2023, 15(15), 3778; https://doi.org/10.3390/cancers15153778 - 25 Jul 2023
Cited by 1 | Viewed by 1668
Abstract
Opioids should be offered to patients with moderate-to-severe pain related to cancer or active cancer treatment unless contraindicated. Although oral administration of opioids is generally preferable, a parenteral route may be advisable and mandatory in some clinical circumstances. Parenteral administration of opioids may [...] Read more.
Opioids should be offered to patients with moderate-to-severe pain related to cancer or active cancer treatment unless contraindicated. Although oral administration of opioids is generally preferable, a parenteral route may be advisable and mandatory in some clinical circumstances. Parenteral administration of opioids may accelerate the achievement of analgesia. The intravenous route fits the need of rapid achievement of analgesia in patients poorly responsive to other opioids and provides a fast analgesia in patients with breakthrough pain, that has a specific temporal pattern requiring a rapid analgesic effect. When the oral route is unavailable for the presence of nausea, vomiting, or dysphagia. the parenteral route is one of the principal options. Opioids have different pharmacokinetic and pharmacodynamic characteristics and should be chosen according to the individual needs. Thus, the knowledge and experience with these routes of administration are mandatory for anesthesiologists committed to cancer pain management. Full article
(This article belongs to the Special Issue Palliative Care for Patients with Cancer)
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