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Annual Report - 2007-2008

Annual Report - Winter 2009

Momentum in Symptom Management and Supportive Care

Helping Patients at All Levels of Care
Lymphedema – Education Key to Better Health
Fatigue – A Step Toward Better Definition
Metastatic Brain Tumors – Study Prompts Change in Standard Practice
Profile: Physician in Sync With Patients' Special Needs

Helping Patients at All Levels of Care

Origami Crane for Healing

Improving quality of life by preventing or treating symptoms of cancer, side effects of treatment and the psychological and social issues that result from either is the aim of MD Anderson’s Supportive Care Center. Physicians in the center offer a mobile team for inpatients, while also staffing a Palliative Care Acute Inpatient Unit. Patients referred to this unit are considering or transitioning from disease-modifying treatment to end-of-life care. A $2.5 million grant from The Brown Foundation Inc. supports an array of research projects, programs and facilities.

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Lymphedema – Education Key to Better Health

Lymphedema is an accumulation of excess fluids that causes swelling in the arm after lymph nodes are removed. Quick action by professionals can lead to a decrease in its incidence as well as better management of chronic lymphedema and improved quality of life for breast cancer patients.

“Women are living longer as breast cancer treatments get better, but at the same time, they face more devastating side effects, like lymphedema.

“This research centers on what is important to patients and their quality of life after treatment. Nurses are on the frontline and may hold the key to proactively preventing lymphedema in many patients by educating them about triggers and symptoms, providing continual and specific lymphedema assessments during each visit and pursuing research in this area,” says Mattie McDowell, clinical patient safety specialist in the Department of Performance Improvement.

Reported in May 2008 at the 33rd Annual Congress of the Oncology Nursing Society.

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Fatigue – A Step Toward Better Definition

A study at MD Anderson identified three primary themes around fatigue: loss of strength or energy (tiredness, weakness), major effects of fatigue (lack of motivation, inability to perform usual activities) and associated sensations (malaise, aching, lack of appetite) among patients treated with standard radiation therapy.

“While fatigue is a well-recognized symptom of cancer and its treatment, the measurement of fatigue has been based on many different ideas and definitions, few of which have included patient input. We’re trying to define fatigue better, based on the patient’s perceived experience. Once we determine the critical elements of fatigue, we’ll be better equipped to ask the right questions of patients. Health care professionals, including nurses, will be in a much better position to intervene with patients to manage or prevent fatigue,” says Loretta Williams, Ph.D., an instructor in the Department of Symptom Research.

Reported in May 2008 at the 33rd Annual Congress of the Oncology Nursing Society.

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Metastatic Brain Tumors – Study Prompts Change in Standard Practice

reotactic radiosurgery (SRS) and whole brain radiation therapy for the treatment of metastatic brain tumors run more than twice the risk of developing learning and memory problems than those treated with SRS alone. “This is a case where the risks of learning dysfunction outweigh the benefits of disease control and tip the scales in favor of using SRS alone. Patients are spared from the side effects of whole brain radiation and we can preserve their memory and learning ability to a higher degree. Here the study suggests patients who receive SRS as their initial treatment and then are monitored closely for any recurrence will fare better,” says Eric Chang, M.D., associate professor in the Department of Radiation Oncology.

Reported in October 2008 at the 50th annual meeting of the American Society for Therapeutic Radiology and Oncology.

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Physician in Sync With Patients' Special Needs

by Erika Hargrove

Eduardo Bruera, M.D.

Many who have cancer stay braced for bad news. As the disease progresses, so do their preparations to hear the worst. Being prepared doesn’t make it any easier, but how they hear such news can make a big difference.

The concept is simple enough, but until recently there hasn’t been any evidence to back up the belief. Thanks to Eduardo Bruera, M.D., chair of the Department of Palliative Care and Rehabilitation Medicine, more insight is available.

He and his colleagues studied patients’ perceptions and preferences around a physician’s posture when delivering bad news.

The study found that 168 patients with advanced cancer perceived physicians who sat while delivering bad news as significantly more compassionate and concerned than those who stood.

“It’s sort of common knowledge in the profession — just something physicians are taught early on — to sit when you deliver bad news,” Bruera says. “But there had never been any evidence to support the fact that this practice really made a difference to patients. This is why we decided to do the study.”

Bruera admits that space in exam rooms is often limited, and, therefore, it’s not always possible for physicians to sit. However, this study, published in the Journal of Palliative Medicine, will help physicians and other medical professionals become more aware of their postures when they are in this unfortunate situation.

Studies such as this and others have made Bruera a leader and respected mentor in palliative care.

Suresh Reddy, M.D., associate professor in the Department of Palliative Care and Rehabilitation Medicine, says the department is positioned for growth and progress due to Bruera’s visionary leadership. “Dr. Bruera walks, talks and sleeps evidence-based palliative care,” Reddy says. “He inspires a team, challenges the processes, enables others to act and gives candid feedback. He has crystal clear concepts about various principles in life.”

Faculty Honor

Thomas W. Burke, M.D., executive vice president and physician-in-chief, was elected the 40th president of the Society of Gynecologic Oncologists.

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© 2014 The University of Texas MD Anderson Cancer Center