Comment: The road ahead: a message of inclusivity for palliative care
Philip Larkin
pp 213-213
In the May issue of the European Journal of Palliative Care, Sheila Payne reflected on the achievements of the European Association for Palliative Care (EAPC) over her presidency, which came to a close at the 14th EAPC World Congress in May. Like those who preceded her as President, she has guided the EAPC with vision and wisdom to make it the vibrant international leader that it has become. The European palliative care community owes thanks to Sheila and her predecessors for their custodianship of our organisation.
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Use of palliative whole-brain radiotherapy for cerebral metastases in advanced lung cancer: does it make a difference?
Neel Bhuva, Hannah Buckley, Alison Ranger, Niraj Goyal, Shiwen Koay, Julian Singer, Nishi Gupta and Girija Anand
pp 214-218
Brain metastases occur in over 30% of patients with lung cancer and are a major cause of morbidity. The mainstay of treatment for most lung cancer patients with multiple brain metastases remains palliative whole-brain radiotherapy together with corticosteroids.
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Falling between two stools: the challenges of the palliative care approach in people with systemic sclerosis
Catherine Norton and Philip Larkin
pp 219-221
Systemic sclerosis (SSc), also known as scleroderma, is a chronic, incurable disease that causes thickening and hardening of the skin, build-up of scar tissue and damage to internal organs such as the heart and blood vessels, lungs, stomach and kidneys.
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Case study masterclass 82: Issues around communicating the end-of-life preferences of a patient with brain involvement of cancer
Mark Banting
pp 222-223
In January 2007, Jenny underwent a wide local excision and axillary clearance followed by left-sided mastectomy. She also received adjuvant chemotherapy and chest radiotherapy, as well as hormonal treatment with tamoxifen. Jenny subsequently reached stable disease, both clinically and radiologically. She was taking a regular maintenance dose of capecitabine and was able to return to work part-time, limited mainly by fatigue.
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Case study masterclass 81 answers: Improving the quality of life of an elderly man with prostate cancer and radiotherapy-induced diarrhoea
Andrew M Davis
pp 224-224
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Exploring the experiences of patients with advanced lung cancer when breaking bad news
Audrey Roulston
pp 226-231
Across the UK, an estimated 1,000 people receive a cancer diagnosis every day. The patient’s illness journey usually commences with a medical consultation for investigative tests, which may confirm a primary diagnosis or secondary disease. Similarly, patients may receive bad news about treatment outcomes or prognosis. Bad news acts as a vehicle to dissolve the perceived ‘orderliness’ of the individual’s social world, which Bury characterised as ‘biographical disruption’, where the onset of disease disrupts plans and hopes for the future.
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What role can hospices play in the management of ascites?
Paul Perkins, Luke Hounsome and Sonali Kaushik
pp 232-235
Ascites – the accumulation of fluid in the abdominal cavity – is a common problem in advanced cancer, and at the end of the cancer trajectory it is often associated with a progressive deterioration in patients’ quality of life. In 2013–14, patients admitted for paracentesis – the drainage of ascites – in hospitals accounted for almost 35,000 finished consultant episodes (more than 187,000 bed-days) in England.
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Good deaths for all in Japan: the potential role of primary palliative care
Ai Oishi and Jun Hamano
pp 236-238
Japan has entered the ‘fifth stage’ of its demographic transition, in which the death rate exceeds the birth rate. We have more deaths than before and the average age at death is also increasing. Hospitals face the challenge of coping with the increasing numbers of people who die in their care. Many people wish to die at home, so palliative care in the community, which is often called ‘primary palliative care’, potentially has a significant role to play. Here, we describe the current status of primary palliative care in Japan and its potential to address this public health issue.
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Symptom burden in patients with lung cancer at a tertiary oncology centre in India
Seema Mishra, Alka Bhatnagar, Gaurav Chanana and Sushma Bhatnagar
pp 239-243
Provision of adequate palliative care is crucial in patients with lung cancer, as they have a higher symptom burden than patients with other malignancies. Lung cancer patients experience symptoms such as pain, cough, dyspnoea, haemoptysis, fever, nausea, vomiting, mouth ulcers, loss of appetite, social isolation, dependency, anxiety, anger, fear, insomnia and confusion. Their effective management allows patients to maintain, to a certain extent, roles and activities that make life meaningful. This helps them reach a sense of completion and hope, thus allowing them to confront the terminal nature of their disease.
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Symptoms at the end of life in children with cancer: a small retrospective study at Hospice Casa Sperantei in Romania
Delia M Birtar, Diana Luca and Alina Corbu
pp 244-247
In developed countries, cancer is the second leading cause of death in children, the first being accidents. In recent years, a lot of effort has gone into researching potential cures, but this has not been matched with a similar effort directed at exploring how to relieve children’s symptoms and suffering. More systematic research into what children experience at the end of life will help us address their most burdensome symptoms.
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Do spiritual beliefs influence coping mechanisms for dealing with death and dying?
Shelley Lamprell-Josephs
pp 248-251
Kübler-Ross has highlighted the immense value of an in-depth understanding of end of life and spirituality. As a student in integrative counselling at Newham College University Centre, I was keen to explore whether there may be a definable value in attempting to measure life purpose and spirituality as a means of coping with end-of-life issues. My research was carried out using the grounded theory approach, which is designed to develop important theoretical concepts from basic needs awareness. It was an attempt to peek behind the scenes of individual metaphysical and existential awareness.
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EAPC Early Researcher Award 2015 – reflections on winning
Kathleen McLoughlin, Julie Kinley, Tora Skeidsvoll Solheim and Amara Nwosu
pp 253-256
I consider myself as a relative newcomer to palliative care. In 2001, when the Irish National Advisory Committee for Palliative Care report was published, each Health Board area in Ireland was required to conduct a palliative care needs assessment. I was working as a researcher in mental health at the time, hoping to undergo clinical psychology training. I was asked to assist with the local needs assessment, and I vividly recall googling ‘palliative care’ to find out what it was. Little did I know that it would become a daily feature of my internet searches 14 years later!
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European insight: Palliative care in Slovakia has come a long way since the 1990s
Kristina Križanová and Andrea Škripeková
pp 257-259
In Slovakia, palliative care started in the 1990s, after the Velvet Revolution of 1989 in what was then Czechoslovakia and the creation of the new Slovak Republic in 1993. Among the pioneers who promoted the idea of hospice care for the terminally ill were Stanislav Fabuš, an anaesthesiologist and pain specialist from the city of Martin in the Turiec region, Leopoldína Scheidová, a physician from Bratislava (which today is Slovakia’s capital) and Alica Válkyová, a physician from Bardejov.
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