Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2025
Genomic Study in Opioid-Treated Cancer Patients Identifies Variants Associated With Nausea-Vomiting.
Opioids are the mainstay therapy for patients affected by cancer pain. However, about 10%-20% of patients do not benefit from the received analgesic treatment or experience side effects. Genetic variability might account for the variation in individual responses to opioids, both in terms of efficacy and toxicity. ⋯ This is the first GWAS, performed in more than two thousand individually genotyped patients treated with opioids for cancer pain, that investigated the genetic bases of opioid-induced nausea-vomiting. Although further studies are needed to confirm our findings and to characterize the functional role of the identified variants, our results emphasize the importance of performing large pharmacogenomic studies to identify germline variants associated with opioid response, with the ultimate goal of tailoring cancer pain therapies.
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J Pain Symptom Manage · Feb 2025
"Mr. Smith Has No Mealtimes": Minimal Comfort Feeding for Patients with Advanced Dementia.
While Comfort Feeding Only is appropriate for patients with advanced dementia, its emphasis on assiduous hand-feeding that may prolong life for years fails to accommodate the preferences of those who do not want to continue living with this illness. Some have proposed advance directives to completely halt the provision of oral nutrition and hydration once a person has reached an advanced stage of dementia. ⋯ Rather than offering food and liquids proactively as with Comfort Feeding Only, caregivers provide nutrition and hydration only in response to signs of hunger and thirst. While further study is required to define and negotiate challenges in operationalizing this approach, MCF provides a framework that resolves competing ethical and clinical considerations in caring for those with advanced dementia.
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J Pain Symptom Manage · Feb 2025
Review Meta AnalysisNon-pharmacological therapies for depression in women with breast cancer at different treatment phases: A systematic review and network meta-analysis.
Various non-pharmacological therapies (NPTs) have been found to be helpful for depression in women with breast cancer (BC). However, the relative efficacy of different NPTs in women with BC during different treatment phases is unclear. ⋯ Our study confirmed the efficacy of several NPTs for depression in women with BC during inter-/post-treatment phases. These results should inform future clinical decisions and guidelines for depression in women with BC.
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J Pain Symptom Manage · Feb 2025
Are muscle and fat loss predictive of clinical events in pancreatic cancer? The importance of precision metrics.
Muscle and fat loss from cancer may have prognostic significance. Skeletal muscle and fat areas measured at L3 on a CT scan correlate with body muscle and fat mass. We wished to know if reduced skeletal muscle area or fat on diagnostic CT scans or changes from initial CT scans in patients with pancreatic cancer who died in 2018 and 2019 predicted mortality. ⋯ Muscle loss in men during chemotherapy of pancreatic cancer predicts mortality.