In this webinar, Dr. Popp will discuss everything you need to know about palliative care! This is an important webinar for colorectal cancer patients and their loved ones.
Palliative Care What Is Palliative MedicineIndranil Khan
What is Palliative Care Who needs Palliative Care Components of Palliative Care Doctors in Kolkata West Bengal India Pain Treatment Yoga Morphine Buprenorphine
Carle General Surgery Grand Rounds presentation on palliative care symptom management, specifically pain, nausea, constipation, and malignant bowel obstruction.
Dr. Elizabeth Paulk gives an excellent review of palliative care topics including end of life discussions, hospice, pain management, and family counseling.
Palliative Care What Is Palliative MedicineIndranil Khan
What is Palliative Care Who needs Palliative Care Components of Palliative Care Doctors in Kolkata West Bengal India Pain Treatment Yoga Morphine Buprenorphine
Carle General Surgery Grand Rounds presentation on palliative care symptom management, specifically pain, nausea, constipation, and malignant bowel obstruction.
Dr. Elizabeth Paulk gives an excellent review of palliative care topics including end of life discussions, hospice, pain management, and family counseling.
The goal of this webinar was to help hospice and healthcare professionals understand the ethics and application of artificial nutrition and hydration (ANH) for patients near the end of life.
Through palliative care, we change the role of a patient into a whole human being.
Through palliative care, we transform the stages leading to death into times filled with life
Palliative care is an approach to care which improves the quality of life of patients and their families facing the problem associated with life-threatening illness.
Out-patient Primary and Specialty Palliative CareMike Aref
Presentation on primary and specialty palliative care, covering what is palliative care, basics of primary palliative care including pain and symptom management, and referral criteria for out-patient specialty palliative care.
Effective pain management in terminally ill requires
Understanding of pain control strategies
Ongoing assessment
Diagnosis of pain
Breakthrough pain relief
Fine adjustment of medications
Opioid rotation
Unresolved psychosocial or spiritual issue can be great impact to pain management
45 minutes of suffering (or Anesthesia Grand Rounds on Palliative Care)Mike Aref
Presentation on what palliative care is, comparison with hospice, primary palliative care screening, goals-of-care, definitions of DNR, basics of acute pain management and WHO analgesic ladder.
Palliative Care Across the Continuum as presented to the The Palliative Care Summit for PeopleFirst Homecare and Hospice that was held in Snowbird Utah on September 15, 2012, following the Rocky Mountain Geriatric Conference.
The objective of Advance Care Planning (ACP) is to help
ensure that patients receive medical care that is aligned with their
values, goals and preferences.
Hospice care and palliative care: Is there a difference between the two, and if so, what?
Many people still think that palliative care means hospice care. But today, hospice is only a small part of palliative care.
The goal of palliative care is to prevent or treat the symptoms and side effects of a disease; and it should be part of the picture from the first day a serious illness is diagnosed.
Dr. Jim Meadows, Director of Hospice and Palliative Care at Tennessee Oncology, will discuss this important topic. How does a family and a health care team best work together to guide a patient through a terminal illness? How does everyone continue to support quality, patient-centered, end-of-life care?
Understanding Supportive Care: What Every Caregiver Needs to Knowbkling
Palliative (supportive) care is an incredibly important approach that improves the quality of life for patients with life-threatening illnesses. Although often confused with hospice, this approach is very different. Join Dr. Andrew Esch as he explains the differences between palliative care and hospice, and provides tips for you to support your loved one.
The goal of this webinar was to help hospice and healthcare professionals understand the ethics and application of artificial nutrition and hydration (ANH) for patients near the end of life.
Through palliative care, we change the role of a patient into a whole human being.
Through palliative care, we transform the stages leading to death into times filled with life
Palliative care is an approach to care which improves the quality of life of patients and their families facing the problem associated with life-threatening illness.
Out-patient Primary and Specialty Palliative CareMike Aref
Presentation on primary and specialty palliative care, covering what is palliative care, basics of primary palliative care including pain and symptom management, and referral criteria for out-patient specialty palliative care.
Effective pain management in terminally ill requires
Understanding of pain control strategies
Ongoing assessment
Diagnosis of pain
Breakthrough pain relief
Fine adjustment of medications
Opioid rotation
Unresolved psychosocial or spiritual issue can be great impact to pain management
45 minutes of suffering (or Anesthesia Grand Rounds on Palliative Care)Mike Aref
Presentation on what palliative care is, comparison with hospice, primary palliative care screening, goals-of-care, definitions of DNR, basics of acute pain management and WHO analgesic ladder.
Palliative Care Across the Continuum as presented to the The Palliative Care Summit for PeopleFirst Homecare and Hospice that was held in Snowbird Utah on September 15, 2012, following the Rocky Mountain Geriatric Conference.
The objective of Advance Care Planning (ACP) is to help
ensure that patients receive medical care that is aligned with their
values, goals and preferences.
Hospice care and palliative care: Is there a difference between the two, and if so, what?
Many people still think that palliative care means hospice care. But today, hospice is only a small part of palliative care.
The goal of palliative care is to prevent or treat the symptoms and side effects of a disease; and it should be part of the picture from the first day a serious illness is diagnosed.
Dr. Jim Meadows, Director of Hospice and Palliative Care at Tennessee Oncology, will discuss this important topic. How does a family and a health care team best work together to guide a patient through a terminal illness? How does everyone continue to support quality, patient-centered, end-of-life care?
Understanding Supportive Care: What Every Caregiver Needs to Knowbkling
Palliative (supportive) care is an incredibly important approach that improves the quality of life for patients with life-threatening illnesses. Although often confused with hospice, this approach is very different. Join Dr. Andrew Esch as he explains the differences between palliative care and hospice, and provides tips for you to support your loved one.
Basics of palliative care including symptom management: pain, dyspnea, nausea and constipation; family meetings, goals-of-care, end-of-life care, and artificial nutrition.
I didn't know this option of Palliative care existed prior to my mother's passing earlier this year of colorectal cancer. However, I do now know about it and want to share it with all of you
We will cover the topic of Palliative Care – specialized medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for both the patient and the family.
Presented by Dr. Jean S. Kutner, MD, MSPH a tenured Professor of Medicine in the Divisions of General Internal Medicine (GIM), Geriatric Medicine, and Health Care Policy and Research at the University of Colorado School of Medicine (UC SOM)
Presentation on palliative care given at the Caregiver's Conference for the Cystic Fibrosis Affiliate and Satellite Sites at Riley Children's Hospital.
Gayle Jameson, MSN, ACNP-BC, AOCN, Barbara A. Biedrzycki, PhD, CRNP, AOCNP, and Jessica MacIntyre, ARNP, NP-C, AOCNP, prepared useful practice aids pertaining to pancreatic cancer for this CE activity titled "The Pancreatic Cancer Journey: Oncology Nurses Paving the Path to Patient-Centric Care." For the full presentation, monograph, complete CE information, and to apply for credit, please visit us at http://bit.ly/2HpFjr8. CE credit will be available until June 14, 2019.
Tricia Strusowski, MS, RN
Director, Cancer Care Management
Helen F. Graham Cancer Center
Christiana Care Health System
Sharon Gentry, RN, MSN, AOCN, CBCN
Breast Health Navigator
Derrick L. Davis Forsyth Regional Cancer Center
Dr. Murphy presents slides discussing general screening trends in the US, including how the US compares to other countries, different screening modalities, and differences in screening by:
-Age
-Gender
-Geography
-Race/Ethnicity
Looking to kick start your physical activity? Hoping to learn about how body movement can be a huge benefit for CRC patients and survivors? Curious about Climb for a Cure? Join this interactive webinar featuring Karia Coleman, MSK, personal trainer and athletic strength coach, and Fight CRC advocates as they discuss the importance, challenges, and joys of physical activity.
From bowel frequency, pain, and more, many colorectal cancer treatments lead to digestive side effects. Join this webinar with Dr. Cathy Eng to learn all about the digestive system, the side effects that are common due to CRC treatment, and how to manage those side effects.
Maine recently passed major colorectal cancer (CRC) policy at the state level. Join us to listen to their story and learn what worked well for CRC state advocacy!
Indiana just passed major colorectal cancer (CRC) policy this year. Join us to listen to their story and learn what worked well for CRC advocacy in Indiana!
Kentucky was one of the first states in the US to pass major colorectal cancer (CRC) policy. Join us to listen to their story and learn what worked well for CRC state advocacy!
Join Fight CRC in a webinar about biomarkers. In this session, Dr. Chris Lieu will focus the discussion on the NTRK biomarker, in addition to ctDNA, and Next-Generation Sequencing.
Join us as Eden Stotsky-Himelfarb, BSN, RN from Johns Hopkins Medicine discusses how to manage after a colorectal cancer diagnosis. In this session, she will cover understanding diagnoses, shared decision making, managing mental health, talking to family and colleagues, and more.
Some colorectal cancer treatments lead to side effects of the skin. In this webinar, Dr. Nicole LeBoeuf will discuss these specific side effects. She will talk about why they occur, how to prepare for them, and how to manage them.
Hear about the latest breaking colorectal cancer research! Fight CRC will be joined by Dr. Axel Grothey who will spend the hour detailing the research presented at the 2020 Gastrointestinal (GI) Cancers Symposium hosted by the American Society of Clinical Oncology.
Anticipating the end of life and making decisions about medical care at this time can be difficult and distressing for people with cancer and their loved ones. However, it is incredibly important to plan for the transition to end-of-life care.
In this webinar, we will discuss questions to ask when considering an end to curative treatment, what to expect with hospice and end-of-life care, a new medical care team, advance directives and healthcare proxies, options for pain, the role of caregivers and loved ones, and more.
In this webinar, Dr. Angela Nicholas, Dr. Chris Heery, and Wenora Johnson discuss all things clinical trials. Dr. Nicholas, a family practitioner and caregiver to her late husband, John MacCleod will dive into her experience searching for clinical trials along with advice to those currently searching, or planning on searching in the future. Dr. Heery, Chief Medical Officer for Precision Biosciences will spend time dispelling myths around clinical trials and challenges to enrollment, and Wenora Johnson, a stage III colon cancer survivor will describe the process and her point of view curating trials in the Fight CRC trial finder.
eeling worn out and exhausted all the time? You may be experiencing cancer-related fatigue. Tune in to this webinar to learn what cancer-related fatigue is, how to spot it, and how to manage it.
In this webinar, Dr. Azad discusses colorectal cancer recurrence. She addresses things to do to help reduce the risk of recurrence, in addition to what steps should be taken if colon or rectal cancer returns.
Join Fight CRC and Dr. Scott Kopetz to learn about the latest breaking colorectal cancer research from the American Society of Clinical Oncology 2019 Annual Conference.
May 2019 – What You Need to Know About Chemotherapy Induced Neuropathy WebinarFight Colorectal Cancer
Neuropathy is a common side effect for colorectal cancer patients. It is a side effect that can be incredibly challenging to manage, and can affect daily living. Join this informative webinar to learn all about neuropathy—why it happens, how to prepare for it, and methods to try and reduce its effects. This is an important webinar for all survivors and patients! Dana will speak from both the medical professional and patient angle, as she is a colon cancer survivor herself!
A cancer diagnosis and cancer treatment can be traumatic. An experience with cancer can lead to serious psychological distress that should be addressed. In this webinar, Schuyler Cunningham, Clinical Social Worker, talks about what trauma is, how to identify it, and what steps to take next.
There are countless questions when it comes to medical cannabis and colorectal cancer: How can it help? How do you get it? Are there drug interactions with chemo? What are the side effects? Is it legal where I live?
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. TODAY’S
WEBINAR
SPEAKER(S)
Beth Popp, MD, FACP
QUESTIONS
Ask a question in the panel on the
RIGHT SIDE of your screen
WEBINAR ARCHIVE
FightCRC.org/webinar
TWEET ALONG
Follow along via Twitter – use the
hashtag #CRCWebinar
4. FIGHTCOLORECTALCANCERDISCLAIMER
The information and services provided
by Fight Colorectal Cancer are for
general informational purposes only.
The information and services are not
intended to be substitutes for
professional medical advice,
diagnoses or treatment.
If you are ill, or suspect that you are ill,
see a doctor immediately. In an
emergency, call 911 or go to the
nearest emergency room.
Fight Colorectal Cancer never
recommends or endorses any specific
physicians, products or treatments for
any condition.
5. Beth Popp, MD, FACP, is associate professor in the Brookdale
Department of Geriatrics and Palliative Medicine at the Icahn
School of Medicine at Mount Sinai in New York. She has dedicated
her career to improving care and quality of life for cancer patients.
Dr. Popp has served as a clinician educator and provided
leadership to develop hospital-based inpatient and ambulatory
palliative care services at three medical centers in the New York
area over a career that has already spanned more than two
decades. She has been on the faculties of the Medical School of
SUNY Health Science Center at Brooklyn, New York Medical
College, and Albert Einstein College of Medicine in addition to
Mount Sinai School of Medicine. She served as the senior
associate program director for the hematology/oncology training
program at Maimonides Medical Center for 15 years, from 2002 to
2017. She has also served as an adjunct faculty member at the
NYU School of Nursing.
Dr. Popp has served as the physician leader, guiding the development of several teaching hospital programs
which provide hospital consultation services and ambulatory services to a range of patients at all stages of
serious illnesses. Her clinical work has focused on management of pain and other symptoms in patients with
cancer, communication skills for clinicians, customizing treatment plans to incorporate the unique values of
patients (especially immigrants and patients from minority religious and cultures), biomedical ethics issues in
palliative care, and palliative care needs of the developmentally disabled adult.
Dr. Popp participates in public awareness activities about palliative care on behalf of the Center to Advance
Palliative Care and GetPalliativeCare.org, CAPC’s online resource for patients and families. The website
focuses solely on providing information on palliative care from the point of diagnosis.
Dr. Popp resides in Brooklyn with her husband and four sons.
Dr.BethPopp
6. An initiative of the Center to Advance Palliative Care
Managing Colorectal Cancer
Symptoms: How Palliative Care Helps
October 24, 2019
Beth Popp, MD FAAHPM
Associate Professor
Icahn School of Medicine at Mount Sinai
New York
7. An initiative of the Center to Advance Palliative Care
Today’s Agenda
➔Define and clarify what palliative care is and who
can benefit
➔Where palliative care comes in for those with
colorectal cancer – early, advanced or metastatic
➔Frequently asked questions
➔Your questions
➔GetPalliativeCare.org as a resource
7
8. An initiative of the Center to Advance Palliative Care
What is Palliative Care?
➔ Specialized medical care for people living with a serious illness
that focuses on relief from the symptoms and stress of a
serious illness
➔ The goal is to improve quality of life for both the patient and
the family
➔ Palliative care is provided by a specially-trained
interdisciplinary team who work together with a patient’s
other health care providers to provide an extra layer of
support
➔ It is appropriate at any age and at any stage in a serious illness
➔ It can be provided along with disease-focused and curative
treatment
8
9. An initiative of the Center to Advance Palliative Care
Fact:
➔ Treating the pain, symptoms, and stress of cancer
and its aftermath is as important as treating the
cancer
10. An initiative of the Center to Advance Palliative Care
While the oncologist may be most
focused on treating the cancer…
➔The person living with cancer is dealing with:
– Insomnia and fatigue
– Weight loss – or weight gain
– Nausea
– Pain, including neuropathy
– Anxiety and/or depression
– ………..
11. An initiative of the Center to Advance Palliative Care
It’s really not that
complicated…..
➔ When serious illness strikes, we want:
– To treat the disease
• Make it go away for as long as we can
• Slow it down
• Minimize it impinging on our ability to do what matters most to us
– Maintain good functioning and quality of life
– Have coordination and connection of care
– Have support to help us make informed decisions
12. An initiative of the Center to Advance Palliative Care
➔ Currently our system:
– Is a “sick care” system, more than a “health care” system
– Is technology driven
– Is disease-driven
– Undervalues the importance of quality of life
➔ Until very recently, doctors* were not trained to assess or
address pain, symptoms, and distress in serious illness
➔ We can and need to do better about these issues faced
by cancer patients and survivors
How well does the health care
system meet theses challenges?
13. An initiative of the Center to Advance Palliative Care
Where Palliative Care
Comes In
14. An initiative of the Center to Advance Palliative Care
Oncology and Palliative Care
➔ ASCO Clinical Practice Guideline Update 2017
“Patients with advanced cancer, whether inpatient or
outpatient, should receive dedicated palliative care services,
early in the disease course, concurrent with active
treatment. Referring patients to interdisciplinary palliative
care teams is optimal, and services may complement existing
programs. Providers may refer caregivers of patients with
early or advanced cancer to palliative care services.”
15. An initiative of the Center to Advance Palliative Care
Low Public Understanding of
Palliative Care
Q: Rate your overall impression of Palliative Care (0=very unfavorable,
50=neutral, 100=very favorable)
Source:
National
survey of 800
adults
age 25+,
June 2019,
commissioned
by CAPC
When asked to rate their
opinion of palliative care,
a large portion were
unable to do so.
16. An initiative of the Center to Advance Palliative Care
Once Informed About
Palliative Care
➔ >90% would be likely to consider palliative care for
themselves or their families
➔ 94% believed patients should have access to
palliative care at all hospitals
➔ 78% strongly agree that it’s important that patients,
and their families, be educated that palliative care is
available together with curative treatment
(Source: National survey of 800 adults age 25+, June 2019, commissioned by CAPC)
17. An initiative of the Center to Advance Palliative Care
Palliative Care and Early Colorectal
Cancer
➔ Often no symptoms, diagnosed by screening
colonoscopy
➔ Some patients have symptoms from treatment that
are not managed by cancer care team, and would
benefit from palliative care
➔ Treatment may range from surgery to chemo and
other approaches, and may occur at different
intervals complicating communication with care
team
18. An initiative of the Center to Advance Palliative Care
Palliative Care and Early Colorectal
Cancer
Pain and Symptom Management
➔ Pain
➔ Neuropathy
➔ Nausea
➔ Changes in bowel habits
➔ Taste changes
➔ Weight gain
➔ Fatigue from chemotherapy
and/or radiation therapy
Psychological Support
➔ Body image
➔ Anxiety
➔ Depression
➔ Sexuality
Decision-Making Support
➔ Goals of care
➔ Treatment decisions
➔ Care coordination
19. An initiative of the Center to Advance Palliative Care
Palliative Care and Metastatic Colorectal
Cancer
➔ Quality of life is greatly affected by the symptoms
patients experience
➔ Traditionally has significant symptom burden due to
the disease process and treatments
➔ New disease-directed therapies and early inclusion
of palliative care can lead to improved outcomes and
greater quality of life throughout the disease
20. An initiative of the Center to Advance Palliative Care
Palliative Care and Metastatic Colorectal
Cancer
➔Pain and Symptom
Management
➔Psychological
Support
➔Spiritual Support
➔Decision Making
➔Care Coordination
➔Treatment Decisions
➔Goals of Care
21. An initiative of the Center to Advance Palliative Care
Palliative Care and Colorectal Cancer
22. An initiative of the Center to Advance Palliative Care
Palliative Care FAQs
23. An initiative of the Center to Advance Palliative Care
When do you need palliative care?
➔Palliative care is based on need, not
prognosis
➔It is for any age and any stage of disease, and
you can have it along with disease-focused
and curative treatments
24. An initiative of the Center to Advance Palliative Care
Who is it for?
➔People in need of relief from the pain,
symptoms, and stress of a serious illness
➔The goal is to improve quality of life for both
the patient and family
➔It is appropriate at any age and at any stage
and can be provided along with disease-
focused and curative treatment
25. An initiative of the Center to Advance Palliative Care
What’s the ultimate goal of
palliative care?
To improve quality of life
26. An initiative of the Center to Advance Palliative Care
What is the impact of palliative
care?
➔ Relieves pain &
symptoms
➔ Patients may live
longer
➔ Better family
support
➔ Reduces
hospitalizations &
emergency
department visits
➔ Reduces
unnecessary tests,
procedures
27. An initiative of the Center to Advance Palliative Care
Can a patient have palliative care
and still receive cancer treatment?
➔Yes, absolutely!
28. An initiative of the Center to Advance Palliative Care
Should the patient bring it up or
wait until the doctor mentions it?
➔It can be either, however, patients shouldn’t
wait for the doctor to bring it up
➔Most people ask their doctor for the referral
to palliative care
➔Palliative care teams are specialists, so the
primary doctor must bring in the team
29. An initiative of the Center to Advance Palliative Care
Who provides palliative care?
➔Palliative care is provided by a team of
palliative care specialists, including palliative
care doctors, nurses, and others
➔It can be provided in a variety of settings
including the hospital, rehabilitation facility,
outpatient clinic, and at home
30. An initiative of the Center to Advance Palliative Care
How and when do you ask for a
referral to palliative care?
➔If you are struggling with pain, other symptoms
or stress due to the cancer or its treatment, you
should ask your doctor for a palliative care
referral
➔Explain that you could benefit from an extra layer
of support
➔The patient, family or doctor can find a local team
through the Provider Directory on
GetPalliativeCare.org
31. An initiative of the Center to Advance Palliative Care
What resources are there to learn
more about palliative care?
➔ GetPalliativeCare.org
– The most clear and comprehensive website on palliative care
– Provides:
– A definition, a 5-question self-assessment to understand if it’s
right for you, information on how to get it – with tips on how to
talk to your doctor about it
– Real stories through free podcasts, including people living with
colorectal cancer
– Webinars on managing specific symptoms, living with different
serious illnesses
– A Provider Directory searchable by state, and now with
community-based listings
– “What You Should Know” – a downloadable handout
32. An initiative of the Center to Advance Palliative Care
Key Takeaways
➔ Colorectal cancer patients are living longer than
ever before
➔ Patients* often have symptoms that need to be
addressed by specialists, when not addressed by
their oncologist or primary doctor
➔ The cancer and the symptoms can and should be
treated
➔ Palliative care improves outcomes for patients*
➔ Patients and family members can ask for palliative
care
*during treatment and some cancer survivors with long-term effects
33. An initiative of the Center to Advance Palliative Care
Your Questions
34. An initiative of the Center to Advance Palliative Care
To learn more, visit
GetPalliativeCare.org