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Lawson McLean AC, Lawson McLean A, Ernst T, Forster MT, Freyschlag C, Gempt J, Goldbrunner R, Grau S, Jungk C, van Oorschot B, Rosahl SK, Wedding U, Senft C, Kamp MA. Benchmarking palliative care practices in neurooncology: a german perspective. J Neurooncol 2024; 168:333-343. [PMID: 38696050 PMCID: PMC11147867 DOI: 10.1007/s11060-024-04674-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/04/2024] [Indexed: 06/04/2024]
Abstract
PURPOSE To benchmark palliative care practices in neurooncology centers across Germany, evaluating the variability in palliative care integration, timing, and involvement in tumor board discussions. This study aims to identify gaps in care and contribute to the discourse on optimal palliative care strategies. METHODS A survey targeting both German Cancer Society-certified and non-certified university neurooncology centers was conducted to explore palliative care frameworks and practices for neurooncological patients. The survey included questions on palliative care department availability, involvement in tumor boards, timing of palliative care integration, and use of standardized screening tools for assessing palliative burden and psycho-oncological distress. RESULTS Of 57 centers contacted, 46 responded (81% response rate). Results indicate a dedicated palliative care department in 76.1% of centers, with palliative specialists participating in tumor board discussions at 34.8% of centers. Variability was noted in the initiation of palliative care, with early integration at the diagnosis stage in only 30.4% of centers. The survey highlighted a significant lack of standardized spiritual care assessments and minimal use of advanced care planning. Discrepancies were observed in the documentation and treatment of palliative care symptoms and social complaints, underscoring the need for comprehensive care approaches. CONCLUSION The study highlights a diverse landscape of palliative care provision within German neurooncology centers, underscoring the need for more standardized practices and early integration of palliative care. It suggests the necessity for standardized protocols and guidelines to enhance palliative care's quality and uniformity, ultimately improving patient-centered care in neurooncology.
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Affiliation(s)
- Anna Cecilia Lawson McLean
- Department of Neurosurgery, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG), Jena/Leipzig, Germany
| | - Aaron Lawson McLean
- Department of Neurosurgery, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany.
- Comprehensive Cancer Center Central Germany (CCCG), Jena/Leipzig, Germany.
| | - Thomas Ernst
- University Tumor Center (UTC), Jena University Hospital, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG), Jena/Leipzig, Germany
| | | | | | - Jens Gempt
- Department of Neurosurgery, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | | | - Stefan Grau
- Department of Neurosurgery, Klinikum Fulda, Fulda, Germany
| | - Christine Jungk
- Department of Neurosurgery, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | | | - Steffen K Rosahl
- Department of Neurosurgery, Helios Klinikum and Health Medical University Erfurt, Erfurt, Germany
| | - Ulrich Wedding
- Department of Palliative Care, Jena University Hospital, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG), Jena/Leipzig, Germany
| | - Christian Senft
- Department of Neurosurgery, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
| | - Marcel A Kamp
- Department of Palliative Care and Neuro-Palliative Care, Brandenburg Medical School Theodor Fontane, Immanuel Klinik Rüdersdorf, Neuruppin, Germany
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Pasdaran A, Grice ID, Hamedi A. A review of natural products and small-molecule therapeutics acting on central nervous system malignancies: Approaches for drug development, targeting pathways, clinical trials, and challenges. Drug Dev Res 2024; 85:e22180. [PMID: 38680103 DOI: 10.1002/ddr.22180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/09/2023] [Accepted: 03/19/2024] [Indexed: 05/01/2024]
Abstract
In 2021, the World Health Organization released the fifth edition of the central nervous system (CNS) tumor classification. This classification uses histopathology and molecular pathogenesis to group tumors into more biologically and molecularly defined entities. The prognosis of brain cancer, particularly malignant tumors, has remained poor worldwide, approximately 308,102 new cases of brain and other CNS tumors were diagnosed in the year 2020, with an estimated 251,329 deaths. The cost and time-consuming nature of studies to find new anticancer agents makes it necessary to have well-designed studies. In the present study, the pathways that can be targeted for drug development are discussed in detail. Some of the important cellular origins, signaling, and pathways involved in the efficacy of bioactive molecules against CNS tumorigenesis or progression, as well as prognosis and common approaches for treatment of different types of brain tumors, are reviewed. Moreover, different study tools, including cell lines, in vitro, in vivo, and clinical trial challenges, are discussed. In addition, in this article, natural products as one of the most important sources for finding new chemotherapeutics were reviewed and over 700 reported molecules with efficacy against CNS cancer cells are gathered and classified according to their structure. Based on the clinical trials that have been registered, very few of these natural or semi-synthetic derivatives have been studied in humans. The review can help researchers understand the involved mechanisms and design new goal-oriented studies for drug development against CNS malignancies.
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Affiliation(s)
- Ardalan Pasdaran
- Medicinal Plants Processing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmacognosy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Irwin Darren Grice
- Institute for Glycomics, Griffith University, Gold Coast Campus, Southport, Queensland, Australia
- School of Medical Science, Griffith University, Gold Coast, Southport, Queensland, Australia
| | - Azadeh Hamedi
- Medicinal Plants Processing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmacognosy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
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Besbris JM, Taylor LP. Palliative Care in Neuro-oncology. Semin Neurol 2024; 44:26-35. [PMID: 38176423 DOI: 10.1055/s-0043-1777703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Historically, the practice of neurology as an independent subspecialty from internal medicine began in Europe and the United States in the 1930s. The American Academy of Neurology (AAN) was founded 75 years ago in 1948, solidifying its emergence as a stand-alone discipline of medicine. In 1967, St. Christopher's Hospice, the first free standing hospice home, was opened in London by Dame Cicely Saunders. Dame Saunders is considered a pioneer in the development of the hospice movement, and she embodies the importance of the multi-disciplinary team in the care of the patient, as she began her career as a nurse, then became a social worker and, finally, a physician. A decade later, in 1978, Dr. Balfour Mount, a Canadian urologic cancer surgeon, coined the term "palliative care" ("to improve the quality of life") after having spent time with Dr. Saunders at St. Christopher's some years earlier. The field of palliative care continued to develop as a distinct subspecialty focused on improving quality of life for patients at any age and in any stage of serious illness. In a 1996 position statement, the AAN made clear that the practice of primary palliative care is the responsibility of all neurologists to their patients. Finally, coming full circle, the specialty of neuro-palliative care, a subspecialty not just of neurology but of palliative medicine, became established around 2018. Neuro-palliative care can be seen as a specialty focusing on the holistic approach to symptom management in patients suffering from neurologic disease with the aim of improved symptom control and attention to the psychologic and spiritual aspects of illness.
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Sharma A. Palliative Care and Care Partner Support in Neuro-oncology. Continuum (Minneap Minn) 2023; 29:1872-1895. [PMID: 38085902 DOI: 10.1212/con.0000000000001353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
ABSTRACT The journey for a patient with a brain tumor and their loved ones can be extremely challenging due to the high burden of physical symptoms and the emotional distress caused by the diagnosis. Optimizing quality of life by addressing symptoms and reducing this emotional distress can improve treatment tolerance and outcomes and alleviate care partner distress and burden. Symptoms in patients with central nervous system (CNS) tumors can vary in onset and intensity, ranging from headaches, seizures, and focal weakness to emotional distress and cognitive dysfunction. Additionally, care partners may demonstrate distress due to the high burden of care and need appropriate support structures and access to resources to alleviate this stress. Evidence-based recommendations are unfortunately limited given the lack of high-quality research in this area, but patients living with CNS tumors and their loved ones can benefit from early and routine symptom identification and management, compassionate and transparent communication, and practical guidance for the future. These principles are part of palliative care, a field of medicine focused on alleviating suffering in patients with serious, chronic illness. Clinicians involved in the care of patients with CNS tumors must be educated in these important primary palliative care principles. This article focuses on key symptom management, strategies for high-quality communication, a discussion of advance care planning, and an overview of end-of-life care.
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Burgers VWG, Reuvers MJP, Taphoorn MJB, Kok M, de Langen AJ, van den Bent MJ, Frissen SAMM, Harthoorn NCGL, Dickhout A, Husson O, van der Graaf WTA. A qualitative study on the healthcare experiences of adolescents and young adults (AYA) with an uncertain or poor cancer prognosis. Support Care Cancer 2023; 31:721. [PMID: 38008874 DOI: 10.1007/s00520-023-08149-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 10/28/2023] [Indexed: 11/28/2023]
Abstract
PURPOSE Treatment advancements have improved life expectancy for adolescents and young adults (AYAs) with an uncertain and/or poor cancer prognosis (UPCP) and change clinical practice. This improved survival requires a different approach and specific expertise to meet the needs of this group. The aim of this study is to explore the health care experiences of AYAs with a UPCP. METHODS We conducted a multicenter qualitative study using semi-structured interviews and elements of the grounded theory by Corbin and Strauss. RESULTS Interviews were conducted with 46 AYAs with a UPCP. They were on average 33.4 years old (age range 23-44), and most of them were woman (63%). Additionally, five AYAs with a UPCP participated as AYA research partners in two focus groups. They were on average 31.8 years old and four of them were woman. AYAs with a UPCP reported four pillars for a satisfied healthcare experience: (1) trust, (2) tailored communication, (3) holistic empathic open attitude, and (4) care being offered (pro-)actively. They reported both optimal and suboptimal experiences about distrust based on a delay in diagnostic trajectory, lack of tailored communication and discussion of sensitive topics, preference for a holistic approach, and struggles with finding the way to get additional healthcare support. CONCLUSION For AYAs with a UPCP, it is important that both age-specific issues and issues related to the UPCP are understood and addressed; however, this seems not yet optimally implemented in clinical practice. This emphasizes the importance of providing this patient group with tailored care incorporating both aspects. Healthcare professionals need to be supported with training and tools to understand the healthcare needs of AYAs with a UPCP. AYAs can be empowered to take more control over their own healthcare needs.
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Affiliation(s)
- Vivian W G Burgers
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Milou J P Reuvers
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Martin J B Taphoorn
- Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands
- Department of Neurology, Haaglanden Medical Center, The Hague, the Netherlands
| | - Marleen Kok
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Division of Tumor Biology & Immunology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Adrianus J de Langen
- Department of Thoracic Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | - Martin J van den Bent
- Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | | | - Annemiek Dickhout
- AYA Research Partner, Amsterdam, the Netherlands
- Internal Medicine, Division Medical Oncology, Maastricht University Medical Center, Maastricht, the Netherlands
- GROW-School of Oncology and Reproduction, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Olga Husson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Winette T A van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
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Rhee JY, Strander S, Podgurski A, Chiu D, Brizzi K, Forst DA. Palliative Care in Neuro-oncology: an Update. Curr Neurol Neurosci Rep 2023; 23:645-656. [PMID: 37751050 DOI: 10.1007/s11910-023-01301-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE OF REVIEW While the benefits of palliative care for patients with cancer are well established, palliative care in neuro-oncology is still in its early stages. However, in recent years, there has been increasing attention drawn to the need for better palliative care for patients with brain tumors. RECENT FINDINGS There is a growing body of literature demonstrating the high symptom burden and significant supportive care and information needs of these patients and their caregivers. In the area of caregiver needs, the last 3 years has seen a more rapid growth in recognizing and characterizing these needs. However, there remains a knowledge gap regarding the optimal means of addressing these needs. In this article, we outline important recent advances in the literature on palliative care for patients with brain tumors and highlight areas in need of greater attention and investigation.
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Affiliation(s)
- John Y Rhee
- Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, 55 Fruit St, Boston, MA, 02114, USA.
- Department of Neuro-Oncology, Dana Farber Cancer Institute, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
| | | | - Alyx Podgurski
- Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, 55 Fruit St, Boston, MA, 02114, USA
| | - Daniel Chiu
- Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, 55 Fruit St, Boston, MA, 02114, USA
- Department of Neuro-Oncology, Dana Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Kate Brizzi
- Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Deborah A Forst
- Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, 55 Fruit St, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
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van der Meer PB, Dirven L, Hertler C, Boele FW, Batalla A, Walbert T, Rooney AG, Koekkoek JAF. Depression and anxiety in glioma patients. Neurooncol Pract 2023; 10:335-343. [PMID: 37457222 PMCID: PMC10346395 DOI: 10.1093/nop/npad019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023] Open
Abstract
AbstractGlioma patients carry the burden of having both a progressive neurological disease and cancer, and may face a variety of symptoms, including depression and anxiety. These symptoms are highly prevalent in glioma patients (median point prevalence ranging from 16-41% for depression and 24-48% for anxiety when assessed by self-report questionnaires) and have a major impact on health-related quality of life and even overall survival time. A worse overall survival time for glioma patients with depressive symptoms might be due to tumor progression and/or its supportive treatment causing depressive symptoms, an increased risk of suicide or other (unknown) factors. Much is still unclear about the etiology of depressive and anxiety symptoms in glioma. These psychiatric symptoms often find their cause in a combination of neurophysiological and psychological factors, such as the tumor and/or its treatment. Although these patients have a particular idiosyncrasy, standard treatment guidelines for depressive and anxiety disorders apply, generally recommending psychological and pharmacological treatment. Only a few nonpharmacological trials have been conducted evaluating the efficacy of psychological treatments (eg, a reminiscence therapy-based care program) in this population, which significantly reduced depressive and anxiety symptoms. No pharmacological trials have been conducted in glioma patients specifically. More well-designed trials evaluating the efficacy of nonpharmacological treatments for depressive and anxiety disorders in glioma are urgently needed to successfully treat psychiatric symptoms in brain tumor patients and to improve (health-related) quality of life.
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Affiliation(s)
- Pim B van der Meer
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
| | - Caroline Hertler
- Competence Center for Palliative Care, Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Florien W Boele
- Department of Psychology, Leeds Institute of Medical Research at St. James’s, St. James’s University Hospital, University of Leeds, Leeds, United Kingdom
- Department of Psychology, Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Albert Batalla
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Tobias Walbert
- Department of Neurology and Neurosurgery Henry Ford Health, Department of Neurology Wayne State University and Michigan State University, Detroit, Michigan, The United States of America
| | - Alasdair G Rooney
- Department of Neurology, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Johan A F Koekkoek
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
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Paterson C, Roberts C, Li J, Chapman M, Strickland K, Johnston N, Law E, Bacon R, Turner M, Mohanty I, Pranavan G, Toohey K. What are the experiences of supportive care in people affected by brain cancer and their informal caregivers: A qualitative systematic review. J Cancer Surviv 2023:10.1007/s11764-023-01401-5. [PMID: 37256499 DOI: 10.1007/s11764-023-01401-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/05/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE To critically synthesise qualitative research to understand experiences of supportive care in people affected by brain cancer and their informal caregivers. METHODS A qualitative systematic review was conducted according to the Joanna Briggs methodology and has been reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Guidelines. Electronic databases were searched by an expert systematic review librarian for all qualitative studies irrespective of research design. All publications were double screened by two reviewers using a pre-determined exclusion and inclusion criteria. The review was managed using Covidence systematic review software. Methodological quality assessment and data extraction were performed. Qualitative findings accompanied by illustrative quotes from included studies were extracted and grouped into categories, which created the overall synthesised findings. RESULTS A total of 33 studies were included which represented a total sample of 671 participants inclusive of 303 patients and 368 informal caregivers. There was a total of 220 individual findings included in this review, which were synthesised into two findings (1) caregivers and patients perceived supports which would have been helpful and (2) caregiver and patient experiences of unmet supportive care needs. CONCLUSION This review highlighted the suffering and distress caused by brain cancer and associated treatments. Both patients and their informal caregivers experienced disconnect from themselves in renegotiating roles, and a profound sense of loneliness as the physical deterioration of the disease progressed. Both patients and informal caregivers reported similar unmet needs within the current service provision for brain cancer. However, what is apparent is that current cancer services are provided solely for patients, with little or no consideration to the support needs of both the patient and their informal caregiver. Service re-design is needed to improve care coordination with individualised informational support, implementation of holistic needs assessments for both the patients and their caregivers, better community support provision, improved opportunities for emotional care with early referral for palliative care services. IMPLICATIONS FOR CANCER SURVIVORS It is recommended that members of the multidisciplinary brain cancer team reflect on these findings to target holistic needs assessments and develop shared self-management care plans for both the patient and the informal caregiver.
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Affiliation(s)
- C Paterson
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia.
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia.
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Canberra, ACT, Australia.
- Canberra Health Services and ACT Health, Garran, Canberra, Australia.
- Robert Gordon University, Aberdeen, Scotland, UK.
| | - C Roberts
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Canberra, ACT, Australia
| | - J Li
- Canberra Health Services and ACT Health, Garran, Canberra, Australia
| | - M Chapman
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia
- Department of Palliative Care, Canberra Health Services, Garran, Canberra, Australia
- School of Medicine and Psychology, Australian National University, Canberra, Australia
| | - K Strickland
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Canberra, ACT, Australia
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, WA, Australia
- School of Clinical Sciences, Faculty of Health and Environmental Sciences, AUT, Auckland, New Zealand
| | - N Johnston
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Canberra, ACT, Australia
- Canberra Health Services and ACT Health, Garran, Canberra, Australia
| | - E Law
- Icon Cancer Centre, Canberra, Australia
| | - R Bacon
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia
| | - M Turner
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia
| | - I Mohanty
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia
| | - G Pranavan
- Canberra Health Services and ACT Health, Garran, Canberra, Australia
| | - K Toohey
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia
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Pasman H, Koekkoek J. Palliative care and neuro-oncological care: Better integration is needed. Palliat Med 2023; 37:806-807. [PMID: 37129302 DOI: 10.1177/02692163231172546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- Hrw Pasman
- Department of Public and Occupational Health, Amsterdam Public Health research Institute, Expertise Center for Palliative Care, Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - Jaf Koekkoek
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
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10
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Zhang R, Wang DM, Liu YL, Tian ML, Zhu L, Chen J, Zhang J. Symptom management in adult brain tumours: A literature review. Nurs Open 2023. [PMID: 37120840 DOI: 10.1002/nop2.1795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/11/2023] [Accepted: 04/17/2023] [Indexed: 05/02/2023] Open
Abstract
AIM To review the literature related to symptom management, clinical significance and related theoretical framework systems in adult patients with brain tumours. BACKGROUND As understanding of symptoms or symptom clusters and underlying biologic mechanisms has grown, it is apparent that symptom science is moving forward. Although some progress has been made in the symptom science of solid tumours such as breast and lung neoplasms, insufficient attention has been paid to symptom management for patients suffering from brain tumours. Further research is needed to achieve effective symptom management for these patients. DESIGN A literature review with a systematic search of symptom management in adult brain tumours. METHODS Electronic data bases were searched to obtain relevant published literature on symptom management in adults with brain tumours. This was then analysed and a synthesis of relevant findings is presented. FINDINGS Four significant general themes relating to symptom management of brain tumours in adults were identified: (1) The potential theoretical foundation related to symptom management was revealed. (2) Widely accepted validated scales or questionnaires for the assessment of single symptoms or symptom clusters were recommended. (3) Several symptom clusters and the underlying biologic mechanisms have been reported. (4) Specific symptom interventions for adults with brain tumours were collected and classified as evidence-based or insufficient evidence. CONCLUSION There are still many challenges in the effective management of symptoms in adults with brain tumours. The guiding role of theoretical frameworks or models related to symptom management should be utilized in future research. Using the concept of symptom clustering for research into symptoms found in patients with brain tumours, exploring common biological mechanisms for specific symptom clusters and making full use of modern big data resources to build a strong evidence base for an effective intervention or management program may inform the management of symptoms among these patients leading to better results. NO PATIENT OR PUBLIC CONTRIBUTION This is a literature review. IMPLICATIONS FOR SYMPTOM MANAGEMENT The ultimate goal is obviously not only improving the survival rate of patients with brain tumours, but also enhancing their quality of life. Several important findings from our review include the theoretical foundations, validated assessment tools, the assessment of symptom clusters and the underlying biologic mechanism, and the identification of the evidence base for symptom interventions. These are of relevance for managers, researchers and practitioners and may function as a reference to help the effective symptom management for adults with brain tumours.
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Affiliation(s)
- Rong Zhang
- School of Nursing, Wuhan University, Wuhan, China
- Department of Neuro-Oncology Center, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Dong-Mei Wang
- Department of Neuro-Oncology Center, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Yong-Li Liu
- Nursing Department, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Man-Li Tian
- College of Nursing, Hubei University of Medicine, Shiyan, China
| | - Ling Zhu
- Department of Neuro-Oncology Center, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Jing Chen
- Department of Neuro-Oncology Center, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Jun Zhang
- School of Nursing, Wuhan University, Wuhan, China
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11
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Diamond EL. Advances in palliative care in neuro-oncology come in many forms. Neuro Oncol 2023; 25:457-458. [PMID: 36610079 PMCID: PMC10013640 DOI: 10.1093/neuonc/noac287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Indexed: 01/09/2023] Open
Affiliation(s)
- Eli L Diamond
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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