Early Referral To Palliative Care; A Randomised Trial Of Patients With Metastatic Cancers & A Survival Expec Of
Funder
National Health and Medical Research Council
Funding Amount
$81,250.00
Summary
It is not known when, in the course of incurable cancer, palliative care advice should be sought. A randomised trial will be conducted on patients consulting with a medical or radiation oncologist. Consenting patients will be randomised to either receive palliative care advice immediately or somewhat later after diagnosis. The consequences of early contact with palliative care professionals will be documented using a range of patient measures including quality of life, symptom control and assess ....It is not known when, in the course of incurable cancer, palliative care advice should be sought. A randomised trial will be conducted on patients consulting with a medical or radiation oncologist. Consenting patients will be randomised to either receive palliative care advice immediately or somewhat later after diagnosis. The consequences of early contact with palliative care professionals will be documented using a range of patient measures including quality of life, symptom control and assessment of unmet needs. The research includes a cost consequence analysis.Read moreRead less
RCT Of Risperidone Versus Haloperidol Versus Placebo With Rescue Haloperidol In Delirium In Palliative Care
Funder
National Health and Medical Research Council
Funding Amount
$50,000.00
Summary
A simple definition of delirium is an acute confusional state that occurs when someone is unwell. It can manifest with many symptoms of varying severity, including confusion, restlessness, poor concentration and disturbance of sleep pattern. Delirium is a common problem when someone is unwell. Experience suggests that medications such as haloperidol and risperidone may be useful in managing these symptoms, however these have not been studied in detail in palliative care. This study is comparing ....A simple definition of delirium is an acute confusional state that occurs when someone is unwell. It can manifest with many symptoms of varying severity, including confusion, restlessness, poor concentration and disturbance of sleep pattern. Delirium is a common problem when someone is unwell. Experience suggests that medications such as haloperidol and risperidone may be useful in managing these symptoms, however these have not been studied in detail in palliative care. This study is comparing the three approaches: use of risperidone given regularly, use of haloperidol given regularly, and use of haloperidol given as needed for symptoms of agitation, hallucinations and restlessness related to delirium in patients being cared for in palliative care settings. This study will compare how well these medications control delirium symptoms (from health professional, patient and caregiver perspectives) and also monitor their side effects over a five-day period, and follow longer term outcomes for 6 months (function and location of care).Read moreRead less
Evidence For Psychological And-or Educational Interventions For Cancer-related Fatigue: A Systematic Review
Funder
National Health and Medical Research Council
Funding Amount
$28,283.00
Summary
Potential benefits to the community: Fatigue is one of the most common and distressing symptoms experienced by people with cancer and can exacerbate the experience of other symptoms, negatively affect mood, and impact on function and quality of life. Understanding which interventions are effective in helping people cope with cancer-related fatigue is important to inform decision-making by consumers, clinicians working in palliative care and policy makers. Objectives: This study aims to systemati ....Potential benefits to the community: Fatigue is one of the most common and distressing symptoms experienced by people with cancer and can exacerbate the experience of other symptoms, negatively affect mood, and impact on function and quality of life. Understanding which interventions are effective in helping people cope with cancer-related fatigue is important to inform decision-making by consumers, clinicians working in palliative care and policy makers. Objectives: This study aims to systematically review the evidence for psychological and-or educational interventions for managing cancer-related fatigue. Methods: This study will use the Cochrane Collaboration’s methodology to search, critically appraise, and analyse randomised controlled trials of psychological and-or educational interventions. This will involve collaboration with consumers and with the Cochrane Pain, Palliative Care, and Supportive Care Collaborative Review Group. This review will inform decision-making at all levels, assist in research translation and identify further gaps in the research regarding this distressing symptom.Read moreRead less
Improving QOL At The End Of Life: A Randomised Controlled Trial Of A Doctor-nurse-patient Intervention.
Funder
National Health and Medical Research Council
Funding Amount
$687,655.00
Summary
This project aims to promote mutual understanding between patients with incurable disease, carers and clinicians about prognosis, end of life issues and treatment goals in order to improve the quality of remaining life. Currently many patients do not understand their prognosis and make poor decisions about treatment, receiving costly, futile and invasive treatments just days before death. This project will empower patients and doctors to better discuss these issues.
Genetic And Epigenetic Mechanisms Determining Responses To Therapies In Non-small Cell Lung Cancer
Funder
National Health and Medical Research Council
Funding Amount
$22,677.00
Summary
Lung cancer results in more cancer related deaths than any other cancer. The aim of this study is to identify prognostic and predictive markers for patients with non-small cell lung cancer (NSCLC) treated with chemotherapy, palliative radiotherapy and also novel targeted agents. This will help to better utilise these treatments and hopefully improve outcomes in patients with NSCLC.
Does Palliative Chemotherapy Improve Symptoms In Women With Recurrent Ovarian Cancer?
Funder
National Health and Medical Research Council
Funding Amount
$521,878.00
Summary
This is a study in women who have relapsed ovarian cancer, and who are about to start further chemotherapy. Subjects will answer questions about their quality of life in order to measure any improvement in their symptoms and well being in response to palliative treatment. The study will relate subjects own reporting of improvement with their actual clinical response. The aim of this study is to develop an optimal palliative chemotherapy regime for use in future clinical trials.
New methods to improve regional isotope therapy of liver tumours in cancer patients. The most common cause of death in cancer patients is secondary tumours in vital organs. Successful treatment of liver tumours with regional isotope therapy now offers improved survival rates. This project will research novel radiolabelled nanoparticles and advanced computer imaging algorithms to improve regional isotope therapy of liver tumours. It will provide better methods of objective assessment and manageme ....New methods to improve regional isotope therapy of liver tumours in cancer patients. The most common cause of death in cancer patients is secondary tumours in vital organs. Successful treatment of liver tumours with regional isotope therapy now offers improved survival rates. This project will research novel radiolabelled nanoparticles and advanced computer imaging algorithms to improve regional isotope therapy of liver tumours. It will provide better methods of objective assessment and management that can reduce risk and improve patient survival.Read moreRead less
Randomised Study Of Radiotherapy (RT) Or ChemoRT To Palliate Symptoms Of Advanced Oesophageal Cancer (OC)
Funder
National Health and Medical Research Council
Funding Amount
$236,375.00
Summary
Cancer of the oesophagus (gullet) causes swallowing problems (dysphagia) by narrowing the gullet and harming food movement to the stomach. >90% of patients with oesophageal cancer (OC) have dysphagia. OC is common, representing >1% of all cancer diagnoses, but is rarely curable, >80% of patients having disease beyond the oesophagus at presentation. Overall survival is thus poor with <10% of patients alive at 3 years. Most have disease obstructing the gullet and thus most patients suf ....Cancer of the oesophagus (gullet) causes swallowing problems (dysphagia) by narrowing the gullet and harming food movement to the stomach. >90% of patients with oesophageal cancer (OC) have dysphagia. OC is common, representing >1% of all cancer diagnoses, but is rarely curable, >80% of patients having disease beyond the oesophagus at presentation. Overall survival is thus poor with <10% of patients alive at 3 years. Most have disease obstructing the gullet and thus most patients suffer dysphagia as they come to terms with dying. This affects both the patient's ability to maintain nutrition and impinges on all areas of quality of life (QoL). Enjoying food is a pleasure of life and an inability to swallow food, water and saliva causes a significant loss of personal self esteem. Relief of dysphagia is the highest priority for treatment. This must be balanced against toxicity of treatment. It is surprising that patients and their doctors must consider this with very little scientific data to help their decisions. The trial uses a simple 2 arm randomisation, radiotherapy (RT) 35Gy in 15 fractions, versus the same with chemotherapy (Cisplatin and Fluorouracil). Both the RT schedule and chemotherapy are commonly used in Australia for this and other cancers. This is the first trial in the world to prospectively assess RT and the first to compare the effect of adding chemotherapy. The trial will:- 1. establish a new method of assessing dysphagia and QoL in all patients with OC using a set of specific questions(EORTC-QLQ-C30+oesophageal module). 2. quantify response and toxicity of a common RT schedule. 3. evaluate the extra benefit and toxicities of chemotherapy. 4. evaluate patient and tumour factors determining outlook, and response to treatment. 5. provide a bench mark for trials of new chemotherapy agents and different RT schedules. The trial will guide management and provide information for incurable patients even if both arms are similar in their effect.Read moreRead less