Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
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Support Care Cancer · Feb 2010
Randomized Controlled TrialEarly switching from morphine to methadone is not improved by acetaminophen in the analgesia of oncologic patients: a prospective, randomized, double-blind, placebo-controlled study.
This study aims to evaluate the efficacy of methadone as substitute for morphine and to investigate if the addition of acetaminophen could reduce the time to attain an equianalgesic dose of methadone and/or to improve the level of pain control in oncologic patients. ⋯ Early switching from morphine to methadone was a safe and efficient strategy for the reduction of side effects and improvement of analgesia, allowing for a comfortable dosing regimen. In this scenario, the association with acetaminophen did not improve pain control or reduce the time to achieve an equianalgesic dose of methadone.
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Support Care Cancer · Feb 2010
The life-sustaining treatments among cancer patients at end of life and the caregiver's experience and perspectives.
The goal of this study was to investigate the utilization of and attitudes toward life-sustaining treatments (LSTs) at the end of life. ⋯ Our findings underscore the importance of discussing LST with terminally ill patients based on adequate information.
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Controversy exists as what constitutes the cancer anorexia-cachexia syndrome (CACS), and whether it truly is a distinct clinical disorder. In this study, we aimed to: (1) assess if CACS is a distinct clinical disorder, (2) identify the symptoms characteristic of CACS, (3) evaluate CACS impact on patient outcomes (symptom burden and survival time from referral). ⋯ CACS appeared to be a distinct disorder with unique clinical characteristics in our advanced cancer population. Nine other symptoms constituted CACS. CACS independently predicted higher symptom burden. CACS absence predicted longer survival. More evidence is needed to better characterize this syndrome and generate a valid CACS consensus. A comprehensive validated CACS assessment instrument is required.