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Showing posts from January, 2020

Geriatric Assessment in Oncology Practice: Podcast with Supriya Mohile & William Dale

Should Geriatric Assessments be part of the routine ontological care for older adults with cancer?   On this weeks podcast we attempt to answer this question with national experts in Geriatric Oncology: Dr. Supriya Mohile from the University of Rochester and William Dale from City of Hope, as well as UCSF's Melissa Wong. Lucky for us, they also have a little evidence on their side thanks to a recently published JAMA Oncology article that they authored titled "Communication With Older Patients With Cancer Using Geriatric Assessment - A Cluster-Randomized Clinical Trial".  We discuss not only the trial results, but also: reasons why geriatric principles is important in oncology what a geriatric assessment includes who should do a geriatric assessment (including does it need a geriatrician?) We also talk about these resources if you want to take a deeper dive in geriatric oncology: ASCO's Geriatric Oncology page ASCO's guideline for geriatric oncology

Depression at the end of life: Podcast with Elissa Kozlov and Claire Ankuda

You’ve probably heard patients say, “Of course I’m depressed, I’m dying.  Wouldn’t you be?”  This is a fundamental question - to what extent are depressive symptoms “normal” at the end of life?  To what extent are they maladaptive, a fancy word for psychological conditions that have a negative impact on your life. In this week’s GeriPal podcast we talked with Elissa Kozlov, a psychologist-researcher at Rutgers, and Claire Ankuda, a palliative care physician-researcher at Mt. Sinai about their JAGS paper describing the epidemiology of depressive symptoms in the last year of life. This was an interesting conversation, as Drs. Kozlov and Ankuda are pushing the boundaries of how we conceptualize depressive symptoms near the end of life.  Their work suggests that depression is far more common than we suspect clinically. And they chose a great song - Hurt as arranged by Johnny Cash (not the Nine Inch Nails original). Enjoy! -@AlexSmithMD

Opioids for Breathlessness: A Podcast with David Currow

Do opioids improve breathlessness? A simple question that unfortunately doesn't seem to have a simple answer. We get into the nitty-gritty of potential answers to this question with a preeminent researcher in this field, David Currow. David is a Professor of Palliative Medicine at University of Technology Sydney. His research has challenged common practices in Hospice and Palliative Care, including randomized control trials on oxygen for breathlessness , octreotide for malignant bowel obstruction , and antipsychotics for delirium in palliative care patients . His most recent study was published in Thorax titled " Regular, sustained-release morphine for chronic breathlessness: a multicentre, double-blind, randomised, placebo-controlled trial ." It showed no differences between those that got sustained-release morphine and those that got placebo in regards to breathlessness, but the intervention arm did use less rescue immediate-release morphine. We talk to Davi