The journal of supportive oncology
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Review Case Reports
Domestic violence against women with cancer: examples and review of the literature.
Over a recent 3-month period in our oncology practice, we became aware of multiple patients reporting domestic abuse. We present three selected cases, review the literature on domestic violence, and explore issues of diagnosis and management in a cancer population. Domestic violence against cancer patients may be more common than initially appreciated, and further awareness and research are indicated.
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Comparative Study
Measuring the maintenance of daily life activities using the functional living index-emesis (FLIE) in patients receiving moderately emetogenic chemotherapy.
Healthcare providers believe they have a positive impact on controlling chemotherapy-induced nausea and vomiting (CINV), yet patients still consider CINV to be one of the most distressing side effects of chemotherapy. The effect of CINV on daily activities has been measured using the Functional Living Index-Emesis (FLIE) scale, a validated, nausea- and vomiting-specific, patient-reported outcome instrument comprising nine items in each of two domains. ⋯ Significantly more patients given palonosetron had FLIE scores that reflected lessened impact of nausea on daily life during the acute period (0-24 hours) and of nausea/vomiting during both the acute and delayed periods (days 2-4). These findings strongly suggest that better antiemetic prevention allows patients to maintain their functional status for up to 5 days after chemotherapy.
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A substantial number of patients with cancer suffer considerable pain at some point during their disease, and approximately 25% of cancer patients die in pain. Providing effective pain management for patients with severe pain that impacts quality of life can present the oncologist or palliative care specialist with complex clinical challenges that often require multifaceted therapeutic measures. This paper presents multidisciplinary consensus-based recommendations for the treatment of intractable cancer pain using intrathecal drug delivery systems, which offer rapid and effective pain relief with less toxicity relative to oral or parenteral administration. ⋯ The use of implantable or external systems is discussed, as well as implantation procedures, drug titration recommendations, and management of potential side effects. The authors offer a newly developed algorithm for delivering intraspinal analgesia in patients with cancer. The intent is that increased understanding of available options for truly effective pain management in the oncology and palliative care arena and the benefits of multidisciplinary cooperation will translate into genuine improvements in patient quality of life and a measurable decrease in the number of patients who suffer needlessly in their final days.