Current Opinion in Supportive and Palliative Care

Managing acute pain with inhaled methoxyflurane in non-cancer patients: a review of the latest evidence
Patel P, Al Aadah CF, Al Aadah LF, Wong HCY, Lee SF, Alkhaifi M, Finkelstein J and Rivlin L
Penthrox® (inhaled methoxyflurane, IMF) is an inhaled analgesic used for the treatment of moderate-to-severe acute pain. It has various advantages including the capacity for being self-administered in the presence of healthcare providers (HCPs), rapid onset and offset, and having documented evidence for minimal adverse events post-use. In a variety of non-oncological settings such as pre-hospital transport and minor outpatient procedures, amongst others, IMF has significantly reduced acute pain. As IMF has the capacity to provide appreciable pain relief but is not as widely used as other acute analgesics (i.e., opioids), this review of past and current literature hopes to explore the impact of inhaled IMF on patient outcomes, procedures where it could be used, and to inform readers about this compound.
The EORTC QLQ breast modules and the FACT-B for assessing quality of life in breast cancer patients - an updated literature review
Wang AJ, Hircock C, Sferrazza D, Goonaratne E, Cella D, Bottomley A, Lee SF, Chan A, Chow E and Wong HCY
Two commonly used quality of life questionnaires in breast cancer are EORTC QLQ-BR23, the FACT-B, and the extended FACT-B + 4. More recently, the EORTC EORTC QLQ-BR42 was developed. This systematic review compares the various versions of the EORTC QLQ and FACT tools for breast cancer in terms of their content, validity, and psychometric properties.
Bridging the care gap: radiation therapy in elderly and frail cancer patients
Hircock C, Lee SF, Raman S, Chuk E, Chan AW, Chow E and Wong HCY
This review aims to address the gap in radiation therapy (RT) care for elderly cancer patients. It will discuss the barriers to implementing effective RT in elderly and frail patients with a focus on breast cancer and metastatic settings.
Comparing the EORTC QLQ-LC13, EORTC QLQ-LC29, and the FACT-L for assessment of quality of life in patients with lung cancer - an updated systematic review
Hircock C, Wang AJ, Goonaratne E, Sferrazza D, Bottomley A, Cella D, Lee SF, Chan AW, Chow E and Wong HCY
Two commonly used quality of life (QoL) questionnaires in lung cancer patients are the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Lung Cancer 13 (QLQ-LC13) and the Functional Assessment of Cancer Therapy-Lung (FACT-L). More recently, the EORTC QLQ-LC29 was developed. This systematic review compares the EORTC QLQ-LC29, EORTC QLQ-LC13 and FACT-L in terms of the content, validity and psychometric properties in assessing the QoL of lung cancer patients.
Early palliative care and its impact on end of life care
Monnery D and Droney J
The impacts of early palliative care for patients with advanced cancer are well described. This has led to endorsement of early palliative care, alongside cancer treatment, by leading cancer organisations. The aim of this review is to consider how best to adopt and integrate the learning from studies of early palliative care into an effective, sustainable service that is offered as part of routine cancer care.
Education for people with serious chronic respiratory diseases and their informal caregivers: how to address challenges that impact learning
Muijsenberg AJL, Houben-Wilke S, Spruit MA and Janssen DJA
Shared decision making is crucial in palliative care for people with serious chronic respiratory diseases and their informal caregivers. Patient education is a critical component in this process, as it provides patients and their informal caregivers the necessary knowledge for informed decisions regarding symptom management, coping with breathlessness, and advance care planning. However, education does not automatically lead to acquiring knowledge. This review describes challenges for education for people with serious chronic respiratory diseases and their informal caregivers and describes how learner-centered education can address these.
Palliative care for people with respiratory illness: challenges, new developments, and future perspectives
Janssen DJA and Ekström M
Is there a role for capsaicin in cancer pain management?
Gordon-Williams R, Harris C and Magee DJ
Advances in oncological therapies have resulted in an increase in the number of patients living with and beyond cancer. The personal and societal impact of chronic pain in the survivor population represents an area of significant unmet need. Capsaicin (a TRPV1 agonist) may provide analgesia with limited systemic side effects. This review looks to summarise the most recent evidence regarding the use of capsaicin in the management of cancer pain.
Innovative and best models of palliative and end-of-life care - with focus on rural and remote communities
Mogan C, Davies N, Dening KH and Lloyd-Williams M
The review aims to synthesize the most recent innovative models of palliative care being delivered in rural and remote locations.
The role of digital health interventions in supporting family caregivers for people with dementia to improve quality of life
Farnood A, Johnston B and Evans C
Dementia is a chronic progressive terminal condition. Most care is provided by family caregivers (including close friends); their wellbeing is a public health priority. Caregivers manage increasingly complex needs with disease progression, and declining cognitive and physical function. This can impact the well-being of caregivers, and meaningful support is essential. This review article aims to understand what the benefits and challenges of digital health interventions are and provide considerations for future development of digital health interventions for family caregivers for people with dementia, to improve quality of life.
Symptom management for people with advanced dementia who are receiving end of life care
Drummond M and Johnston B
This review aims to synthesise contemporary research on symptom management for people with advanced dementia who are thought to be in the final year of life. It highlights the unique challenges faced by palliative care and dementia care specialists, offering insights into the clinical decision-making required to support those with advanced dementia in various care settings.
Existential aspects of breathlessness in serious disease
Baglow D, Johnston K and Williams M
Breathlessness may evoke existential threat but may also affect the person with serious illness or their caregiver/s in other important ways which can be considered 'existential'. This review explores existential aspects of breathlessness in people with serious illness and presents recent studies of assessment and management of associated distress and suffering.
How to evaluate exertional breathlessness using normative reference equations in research
Ekström M, Lewthwaite H and Jensen D
Breathlessness is a common, distressing and limiting symptom in people with advanced disease, but is challenging to assess as the symptom intensity depends on the level of exertion (symptom stimulus) during the assessment. This review outlines how to use recently developed normative reference equations to evaluate breathlessness responses, accounting for level of exertion, for valid assessment in symptom research.
The WHO guidelines: the new and the old
Thompson J
The original World Health Organisation (WHO) cancer pain guidelines were published in 1986 and used globally. Updated guidance was released in 2018. This review compares the 'old' with the 'new' with a closer look at the relevance of the WHO analgesic ladder in the current climate.
Role of caregivers being trained in assisting in end of life care - Latin American perspective
de Vries E, Calvache JA and Hernández Zambrano SM
Palliative care in Latin America is evolving, but training for informal caregivers remains underexplored. This review summarizes recent interventions to educate or train caregivers in end-of-life care.
The gut microbiome and the brain
Rykalo N, Riehl L and Kress M
The importance of the gut microbiome for human health and well-being is generally accepted, and elucidating the signaling pathways between the gut microbiome and the host offers novel mechanistic insight into the (patho)physiology and multifaceted aspects of healthy aging and human brain functions.
Advances in breathlessness support services for people with serious illness
Takemura N, Maddocks M and Brighton LJ
Breathlessness remains a common and distressing symptom among people with serious illness, particularly in advanced disease. This review synthesises recent advances in the development, characteristics, and outcomes of breathlessness support services.
Early integration of palliative care in haemato-oncology: latest developments
Papadopoulou C and Johnston B
This review aimed to explore recent progress made in the past five years towards early access to, and integration of palliative care services within the haemato-oncology context to address the unique needs of patients with Haematological malignancies (HMs).
In support of rigor and reproducibility in cancer cachexia research
Jatoi A and Laird B
Mirogabalin: a novel gabapentinoid or another false dawn?
Craig TJ and Farquhar-Smith P
Mirogabalin is a novel gabapentinoid medication for the treatment of neuropathic pain. The purpose of this review is to discuss current evidence for its use. Gabapentinoids are widely prescribed for neuropathic pain. Mirogabalin offers theoretical advantages over traditional gabapentinoids due to its specificity for the α2δ-1 subunit of voltage-gated calcium channels. It is theorised that this specificity may reduce adverse drug reactions by minimising binding to the α2δ-2 subunit which is responsible for many of the gabapentinoid side effects.
A traffic light approach for treatment and supportive care stratification in lung cancer
Phillips I, Nottelmann L and Stares M
Comprehensive supportive care interventions for patients with lung cancer are being investigated in a range of ways, including: early palliative care, prehabilitation and rehabilitation. We review recent literature on supportive care and propose a traffic light system to individualise comprehensive supportive care. Green for those very likely to receive anti-cancer treatment, red for those very unlikely to receive anti-cancer treatment and orange where the chance of accessing treatment is uncertain. Comprehensive supportive care can be individualised based on the group a particular patient is in.