The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Dec 2010
Clinical TrialTreatment of cancer-related chest wall pain using spinal cord stimulation.
it has been estimated that 15% to 40% of chronic cancer pain has a neuropathic component, and this type of pain often responds poorly to opioids. In an attempt to provide increased pain relief for patients with intractable cancer pain, unconventional agents and interventional management approaches have received considerable attention. Spinal cord stimulation (SCS) has been used with increased frequency for the treatment of intractable cancer pain. ⋯ SCS provides an effective, alternative treatment option for select patients with cancer-related chest wall pain who have failed conservative treatment. SCS may provide pain relief with advantages over conservative treatments and more invasive techniques.
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Am J Hosp Palliat Care · Dec 2010
Hospice utilization and end-of-life care decision making of African Americans.
Multiple, complex factors influence end-of-life (EOL) decisions for all persons. In the African American population, these factors include history of disparities and discrimination in health care, which may affect the individual and the family, family system beliefs, values, and practices, and health care system issues. ⋯ A family systems framework can guide the clinicians in appreciating care needs and preferences at EOL. Understanding why so many African Americans choose aggressive and often burdensome care, even at the expense of suffering, is important for communication about options at the EOL and the delivery of quality care at the EOL.