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Supportive Care and Palliative Medicine


Introductory video transcript:
English | Español

Course Overview

90 Million Americans are living with a serious or life-threatening illness, such as cancer. The number is expected to double in coming years. Research suggests millions could benefit from palliative medicine and supportive care. Studies show that patients who receive early palliative care experience less depression, have improved quality of life and live longer.

In this professional oncology education series, participants will learn what palliative care is, the best practices for assessing, treating, and managing pain for both adults and children, how to incorporate supportive care to assure good symptom control, provide prognostication, and skillfully communicate prognosis to patients and family. Please check back frequently. Additional lectures will be added as soon as available.
     Course Overview: Español

Lectures

Eduardo Bruera, M.D.
Pain Assessment and Principles   Top of Page
 
Presenter: Eduardo Bruera, M.D.
Chair and Professor
Department of Palliative Care and Rehabilitation Medicine
 
Summary: “Pain due to cancer is unacceptable,” says Eduardo Bruera, MD, Chair of the Department of Palliative Care and Rehabilitation Medicine. In his lecture, “Pain Assessment and Principles,” Dr. Bruera explains why pain is a multidimensional construct and why it should be assessed with other symptoms. He outlines simple tools that can be used, like ESAS, to help evaluate pain level. Dr. Bruera also advises on which prognostic factors to consider when managing pain.
     Summary and Learning Objectives: Español

 

Donna S. Zhukovsky, M.D.
Caring for Life: Pediatric Palliative Care   Top of Page
 
Presenter: Donna S. Zhukovsky, M.D.
Professor
Department of Palliative Care and Rehabilitation Medicine
 

Summary: Per Sir William Osler (1848-1919), “A good physician treats the disease; a great physician treats the patient who has the disease.”

“Pediatric palliative care is a family centered approach to care for children and their families who are living with life-threatening illnesses,” says Dr. Donna Zhukovsky, professor in the Department of Palliative Care and Rehabilitation Medicine at The University of Texas MD Anderson Cancer Center. In her lecture “Caring for Life: Pediatric Palliative Care," Dr. Zhukovsky discusses how palliative care for children differs from that of adults. She also identifies common causes of death in children, describes types of age-appropriated symptoms assessment tools, using pain as a model, and examines the impact of developmental stage on death understanding in children.
     Summary and Learning Objectives: Español

 

Holly M. Holmes, M.D.
Common Pharmacologic Interactions in Palliative Care   Top of Page
 
Presenter: Holly M. Holmes, M.D.
Associate P
rofessor
Department of General Internal Medicine
 

Summary: In a palliative care setting, drug-drug interactions are very common. In this lecture, “Common Pharmacologic Interactions in Palliative Care,” Holly H. Holmes, MD, Associate Professor in the Department of General Internal Medicine, discusses the cytochrome P450 system. She explains how substrates, inhibitors, and inducers work. Dr. Holmes’ lecture highlights clinically relevant drug interactions involving medications commonly used in palliative care.
     Summary and Learning Objectives: Español

 

Suresh K. Reddy, M.D.
Opioid Switching   Top of Page
 
Presenter: Suresh K. Reddy, M.D.
Professor
Department of Palliative Care and Rehabilitation Medicine
 

Summary: Learning when and how to rotate opioids is a valuable clinical practice for pain management in cancer and non-cancer situations. However, doing so without considering all variables can be confusing and lead to adverse effects for patients. In this lecture, “Opioid Switching,” Suresh K. Reddy, MD, FFARCS, Professor in the Department of Palliative Care and Rehabilitation Medicine, advises how to best substitute one strong opioid for another to achieve better balance between pain relief and side effects. Dr. Reddy explains the principle of and indications for opioid switching; the concept of equianalgesia and use of equianalgesic tables; and how to identify and overcome common pitfalls of opioid switching.
     Summary and Learning Objectives: Español

 

David Hui, M.D., M.Sc.
Prognostication in Advanced Diseases   Top of Page
 
Presenter: David Hui, M.D., M.Sc.
Assistant Professor
Department of Palliative Care and Rehabilitation Medicine
 

Summary: “A lot of patients actually want to know how long they get to live,” says Dr. David Hui, assistant professor in the Department of Palliative Care and Rehabilitation Medicine at The University of Texas MD Anderson Cancer Center.

In Part 1 of this lecture series on Prognostication in Advanced Diseases, Dr. Hui explains the principles of prognostication in patients with advanced cancer. He reviews recent studies that show why clinicians are not doing a very good job of estimating survival, “…the numbers show that about 20%, only one-fifth of the time, clinicians are accurate.” Dr. Hui also discusses the importance of comorbid conditions, relevant laboratory variables, along with emotional, spiritual, and other factors that must be considered when giving prognostication.

In Part 2, Dr. Hui examines the principles of prognostication in patients who do not have cancer, but have other advanced diseases. He also provides valuable resources to help clinicians predict prognosis and survival, and reviews hospice admission criteria for pulmonary diseases, multisystem organ failure, heart failure, kidney disease, chronic liver disease, HIV, and neurological disorders, stroke, and coma.

In Part 3 of this educational program, Dr. Hui advises physicians how to best communicate prognosis with patients and their families. And why it’s important he says to “…utilize this information to help them focus on hope.” Diagnostic criteria for brain death and terminal extubation are also discussed.
     Summary and Learning Objectives: Español

 

 

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© 2014 The University of Texas MD Anderson Cancer Center