Journal of pain and symptom management
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J Pain Symptom Manage · Dec 2013
Review Meta AnalysisAdvising patients on the use of non-herbal nutritional supplements during cancer therapy: a need for doctor-patient communication.
Many cancer patients are using non-herbal nutritional supplements (NHNS), often without informing their oncologists. ⋯ There is a need to develop an open and nonjudgmental dialogue between oncologists and cancer patients, addressing the needs of the patient while dealing with issues related to the efficacy and safety of these products. Referral of patients to an integrative medicine consultant may help achieve these goals, providing both parties with the option of reaching an informed and respectful decision about treatment.
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J Pain Symptom Manage · Dec 2013
Review Meta AnalysisFentanyl for the relief of refractory breathlessness: a systematic review.
Fentanyl is a potent opioid that has been proven to provide effective treatment for breakthrough cancer pain. Although opioids are the only drug group with evidence for the symptomatic treatment of breathlessness, evidence about the efficacy of fentanyl for the relief of breathlessness is unknown. ⋯ Descriptive studies yielded promising results for the use of fentanyl for the relief of breathlessness; however, efficacy trials are lacking. Fully powered RCTs are warranted to determine the efficacy of fentanyl for breathlessness relief, but these require pilot studies to evaluate effective size, study procedures, and outcome measures.