Wednesday, August 29, 2007

Molecular to Clinical; Pall-pourri

The journal Cancer has an article by Loberg et al that describes the lethal phenotype of cancer (free pdf!). While the article does get into the molecular level it keeps a pretty steady course and is very approachable for the 'non-bench research' physician. The article abstract highlights the key reason this is important for most palliative care practitioners to read:

While these studies describe the cellular events of the lethal phenotype of cancer in detail, how these events result in the common clinical syndromes that kill the majority of cancer patients is not well understood. It is clear that the central step that makes most cancers incurable is metastasis. Understanding the traits that a cancer acquires to successfully grow and metastasize to distant sites gives insight into how tumors produce multiple factors that result in multiple different clinical syndromes that are lethal for the patient.
Starting from the molecular level, the authors do a good job of linking research findings with the syndromes most palliative care practitioners are familiar with: anorexia-cachexia, thrombosis, bone pain and dyspnea. The figures and tables are informative and make for good presentation slides. Like the following one:

Getting PubMed alerts by email always turns up interesting things. Like this article which highlights 'Survivin' a protein that inhibits apoptosis in cancer cells. What a great name for a protein. You don't even have to put the apostrophe on the end and drop the g, as if you were talking in a hip manner.

And it is not only the US media who confuses the semantic differences among euthanasia, physician-assisted suicide, withdrawing/withholding medical treatments, and appropriate palliative care. Even in Japan, the newspaper mixes-up the terms causing the general public to think they are committing euthanasia when life support is discontinued in accordance with the patient's wishes. Here is the headline:

"Nippon Medical School drafts euthanasia guide"

Kind of grabs your attention doesn't it?! But then the rest of the article mentions nothing about euthanasia, only withdrawal of medical technologies at the end of life. Pallimed offers its services to any media outlet wishing to double check the appropriate use of any medical terms at the end-of-life for the good of the public understanding about these complex issues.

St. Oswald's Hospice in the UK is getting on the blog train by offering blogs/forums for patients to post about their experience with the hospice. (Adult blogs here / Peds blogs here) Does anyone know of any other hospice or palliative medicine programs that do this? If you start one let us know. (via the UK News Guardian)

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