Journal of oncology practice
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Curative chemotherapy for breast cancer is associated with significant toxicities including emergency room (ER) visits and hospital admissions (HAs), events that are underreported in clinical trials. This study examined the reasons for, and factors associated with, ER visits and HA after curative chemotherapy for breast cancer in a tertiary Ontario hospital. ⋯ Future research should focus on identifying the patient, provider, and health system factors associated with ER visits and HAs after chemotherapy for breast cancer, to minimize them and lessen the burden on the health care system.
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In December 2013, the US Preventive Services Task Force issued a final B-level recommendation indicating that individuals between the ages of 55 and 80 years who have a 30-pack-year smoking history and have smoked within the past 15 years should receive annual low-dose computed tomography (CT) lung cancer screening. We convened a multidisciplinary panel of experts to create practical guidance for efficiently implementing effective CT lung cancer screening programs. ⋯ Implementation of effective and efficient population-based CT lung cancer screening will require involvement and coordination of stakeholders across the health care system to address the data and infrastructural needs that were identified.
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The National Comprehensive Cancer Network (NCCN) palliative care (PC) guideline recommends PC screening for all patients and provides criteria for identifying those in need of referral to a PC specialist. This two-step process has not yet been validated as accurately identifying patients in need. The aim of this study was to validate a simplified method for screening and referral based on the existing guideline criteria. ⋯ The tool seems to be a valid method for identifying patients with cancer with complex PC needs who would benefit from a PC consult. Reliability testing, external validation, and demonstration of the utility of the tool as a decision aid all await confirmation.
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Hematologic cancers are associated with aggressive cancer-directed care near death and underuse of hospice and palliative care services. We sought to explore hematologic oncologists' perspectives and decision-making processes regarding end-of-life (EOL) care. ⋯ Our analysis suggests that hematologic oncologists need better clinical markers for when to initiate EOL care. In addition, current quality measures may be inappropriate for identifying overly aggressive care for patients with blood cancers. Further research is needed to develop effective interventions to improve EOL care for this patient population.