Palliative care for patients with esophageal cancer: a narrative review

Guyer, Dana; Almhanna, Khaldoun; McKee, Kanako Y.

doi:10.21037/atm-20-3676

Cited by 16 publications

(29 citation statements)

References 13 publications

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“…First, early clinical symptoms of EC are not obvious, and most patients are diagnosed at an advanced stage (40). Compared with other diseases, EC has a poor prognosis (41), and physiological functions are severely impaired, meaning patients face psychological problems such as anxiety, depression, fear, and the loss of meaning and spirituality in life (42). Second, most participants with lower education levels cannot properly develop an understanding of the disease (43) and seek inner peace.…”

Section: Discussionmentioning

confidence: 99%

Social Support and Spiritual Well-Being of Patients With Esophageal Cancer Aged Over 50 Years: The Mediating Role of Rumination

Xue

Pan

2022

Front. Psychiatry

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BackgroundSpiritual well-being plays an important role in helping patients cope with disease. Previous studies have investigated the association between social support and spiritual well-being, whereas few studies have explored the relationship in patients with esophageal cancer (EC), and the mechanisms behind this pathway have not been thoroughly examined.ObjectiveThis study aimed to explore the relationship between social support and spiritual well-being of Chinese patients with EC aged over 50 years and to analyze whether the relationship was mediated by rumination.MethodsA cross-sectional survey was conducted with 197 EC patients. Participants completed the general information questionnaire, the Functional Assessment of Chronic Illness Therapy–Spiritual Scale, the Chinese Event Related Rumination Inventory, and the Perceived Social Support Scale (PSSS).ResultsResults demonstrated that social support of patients with EC aged over 50 years was positively correlated with spiritual well-being and deliberate rumination and negatively correlated with intrusive rumination; spiritual well-being was positively associated with deliberate rumination and negatively correlated with intrusive rumination. The effect of social support on spiritual well-being was partially mediated by deliberate rumination and intrusive rumination.ConclusionsThe findings suggest that interventions directed toward enhancing social support and deliberate rumination and reducing the level of intrusive rumination may help patients with EC aged over 50 years improve spiritual well-being.

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Section: Discussionmentioning

confidence: 99%

Social Support and Spiritual Well-Being of Patients With Esophageal Cancer Aged Over 50 Years: The Mediating Role of Rumination

Xue

Pan

2022

Front. Psychiatry

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“…Treatment history were documented for neoadjuvant and adjuvant care (radiation/radiotherapy, chemotherapy, targeted therapy, immunotherapy), and active systemic and BSC for first‐ and second‐lines of therapy. BSC was defined as palliative measures such as pain relief, monitoring and treatment of malnutrition, and treatment of other symptoms such as anorexia, fatigue, nausea/vomiting, and consistent with those found in the literature 21 . For 2L, treatment regimens were classified as taxanes, nontaxanes, immune‐oncology, targeted and other therapy.…”

Section: Methodsmentioning

confidence: 99%

A global perspective in second‐line treatment patterns for patients with advanced esophageal squamous cell carcinoma

Jaffe¹,

Gricar

DeCongelio

et al. 2022

Thoracic Cancer

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Background: Esophageal cancer is a highly prevalent cancer associated with low survival, especially among those with advanced disease. Second-line (2L) treatment patterns and related clinical outcomes of patients with advanced esophageal squamous cell carcinoma (advESCC) treated in routine clinical care were examined globally and regionally. Methods: A retrospective, noninterventional study collected physician-provided chart data of patients aged ≥20 years receiving either 2L active systemic therapy or BSC following first-line active therapy for advESCC from 11 countries in Asian and Western regions (September-October 2018). Bivariate analyses examined treatment and outcomes by region. Results: AdvESCC patients (Asia = 192; West = 195) were examined, of which 58.1% (Asia n = 101; West n = 124) received active systemic therapy. While regional differences in tumor classification and staging at diagnosis were observed with less advanced tumors in Asia, no regional differences for these characteristics at 2L initiation were reported. Both taxane-and nontaxane-based therapies were used as 2L therapy among Asian and Western patients, although more western than Asian patients received immuno-or targeted therapies (17.0% vs. 3.0%; p = 0.001). Alopecia (10.7%), neutropenia (9.3%), and fatigue (9.3%) were the most-commonly reported adverse events (AEs) in both regions. Significantly higher 2L AE-related emergency room visits (Asia = 22.5% vs. West = 8.0%; p < 0.001) and hospitalizations (Asia = 25.9 AE 31.2 vs. West = 4.7 AE 7.0, p < 0.001) were observed in Asian than in Western patients. No regional differences were reported for response to 2L treatment or the percent of patients who received third-line treatment/died. Conclusions: While regional variations were observed throughout the course of a patient's advESCC journey, disease response and treatment outcomes were similar.

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“…At this point, curative options are often limited. Dysphagia is also often associated with negative psychosocial effects for a patient 3 4 .…”

Section: Introductionmentioning

confidence: 99%

Predictors of adverse events and early mortality after esophageal stent placement in a low resource setting: a series of 3823 patients in Kenya

et al. 2022

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Background and study aims Dysphagia from esophageal cancer may be palliated with self-expanding metallic stents (SEMS). Controversy exists about the use of dilation before SEMS deployment. Patients and methods We performed a retrospective cohort study of patients who had SEMS placement without fluoroscopy for palliation at Tenwek Hospital in Bomet, Kenya between January 1999 and April 2019. The primary outcome was any serious adverse event (AE) (chest pain, stent migration, perforation, bleeding, or all-cause mortality) within 30 days of the procedure. Various demographic and clinical characteristics, and procedural details, were examined as risk factors. Technical success, defined as correct SEMS placement, and clinical success, defined as dysphagia score improvement without 30-day mortality, were examined. Results A total of 3823 patients underwent SEMS placement, with 2844 (74.4 %) placed in the second decade of the study. Technical and clinical success were achieved in 97.2 % and 95.5 %, respectively, with mean dysphagia scores improving from 3.4 (SD 0.6) to 0.9 (SD 1.3) post-stent placement. AEs occurred in 169 patients (4.4 %). AEs, specifically perforations, were associated with dilation to greater than 36F in the first decade. Perforation rates decreased from the first (4.1 %) to the second decade (0.2 %). Only 30% had complete 30-day follow-up data. Conclusions SEMS placement is a safe, effective method of palliating malignant dysphagia, with low rates of AEs and 30-day mortality and high rates of clinical and technical success. Dilation can facilitate placement of SEMS without fluoroscopy but should not be performed above 36F due to the risk of perforation.

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Palliative care for patients with esophageal cancer: a narrative review

Cited by 16 publications

References 13 publications

Social Support and Spiritual Well-Being of Patients With Esophageal Cancer Aged Over 50 Years: The Mediating Role of Rumination

Social Support and Spiritual Well-Being of Patients With Esophageal Cancer Aged Over 50 Years: The Mediating Role of Rumination

A global perspective in second‐line treatment patterns for patients with advanced esophageal squamous cell carcinoma

Predictors of adverse events and early mortality after esophageal stent placement in a low resource setting: a series of 3823 patients in Kenya

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