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Clinical decisions made by palliative care professionals shape patients' experiences and those of their carers—both in hospital settings and at home. In the January PACED digest, we have collected materials exploring how palliative care blends medical options with a focus on quality of life: minimally invasive approaches in palliative surgery, additional pain management options, the role of occupational therapy in care, digital tools, and the suitability of intensive treatment at the end of life. The materials in this issue do not provide universal answers, but they help broaden a professional perspective and encourage thoughtful dialogue about the purpose of palliative care.
If you wish to continue any of the topics listed below through a discussion or webinar, please do not hesitate to contact us at info@paced.org.uk.
Clinical decisions made by palliative care professionals shape patients' experiences and those of their carers—both in hospital settings and at home. In the January PACED digest, we have collected materials exploring how palliative care blends medical options with a focus on quality of life: minimally invasive approaches in palliative surgery, additional pain management options, the role of occupational therapy in care, digital tools, and the suitability of intensive treatment at the end of life. The materials in this issue do not provide universal answers, but they help broaden a professional perspective and encourage thoughtful dialogue about the purpose of palliative care.
If you wish to continue any of the topics listed below through a discussion or webinar, please do not hesitate to contact us at info@paced.org.uk.
If you are a palliative care specialist representing one of the PACED countries and wish to join our community—please fill out this form, and we will contact you promptly.
EUS-EC with LAMS: A New Minimally Invasive Technique in Palliative Surgery for Malignant Bowel Obstruction
Endoscopic ultrasound-guided enterocolostomy (EUS-EC) with lumen-apposing metal stents (LAMS) placement shows high technical and clinical success in palliative treatment of malignant bowel obstruction in patients with advanced abdominal cancers. The procedure provides rapid symptom relief, restoration of bowel function, and resumption of oral intake—usually within three days—along with a low complication rate and a relatively brief hospital stay (about ten days). Most reported deaths are due to disease progression rather than the procedure itself. Despite limited evidence, this approach may represent a promising alternative to surgical decompression in palliative care.
Read the article:
https://journals.sagepub.com/doi/full/10.1177/26317745251400665
Endoscopic ultrasound-guided enterocolostomy (EUS-EC) with lumen-apposing metal stents (LAMS) placement shows high technical and clinical success in palliative treatment of malignant bowel obstruction in patients with advanced abdominal cancers. The procedure provides rapid symptom relief, restoration of bowel function, and resumption of oral intake—usually within three days—along with a low complication rate and a relatively brief hospital stay (about ten days). Most reported deaths are due to disease progression rather than the procedure itself. Despite limited evidence, this approach may represent a promising alternative to surgical decompression in palliative care.
Read the article:
https://journals.sagepub.com/doi/full/10.1177/26317745251400665
Cannabis as a Potential Adjunct in Palliative Care Pain Management
This article highlights a trend observed in the United States: in states where palliative care patients have legal access to medical cannabis, both the volume and duration of opioid analgesic use among people with cancer are reduced. Within palliative care, this indicates a search for additional ways to manage pain and enhance quality of life, especially in situations where opioids are unavailable or do not offer sufficient relief. It is also important to remember that these findings do not replace standard therapy and should be interpreted with caution. Still, they may expand the discussion of potential approaches to symptom management.
Read the article:
https://www.healio.com/news/hematology-oncology/20251110/cannabis-access-may-reduce-opioid-use-for-cancer-pain
This article highlights a trend observed in the United States: in states where palliative care patients have legal access to medical cannabis, both the volume and duration of opioid analgesic use among people with cancer are reduced. Within palliative care, this indicates a search for additional ways to manage pain and enhance quality of life, especially in situations where opioids are unavailable or do not offer sufficient relief. It is also important to remember that these findings do not replace standard therapy and should be interpreted with caution. Still, they may expand the discussion of potential approaches to symptom management.
Read the article:
https://www.healio.com/news/hematology-oncology/20251110/cannabis-access-may-reduce-opioid-use-for-cancer-pain
Occupational Therapy in Orthopaedic Oncology: A Scoping Review
The review highlights the role of occupational therapy in orthopaedic oncology and in palliative care, including in hospice settings. In cases of secondary bone cancer and spinal metastases, occupational therapy can play a key role in pain management, reducing the risk of falls and fractures, enhancing safety during mobility, and supporting and educating caregivers. However, despite broad recognition of the importance of occupational therapy in palliative care, there remains a lack of systematic evidence and clearly defined interventions specifically for this patient group.
Read the article:
https://spcare.bmj.com/content/early/2025/12/30/spcare-2025-005817
The review highlights the role of occupational therapy in orthopaedic oncology and in palliative care, including in hospice settings. In cases of secondary bone cancer and spinal metastases, occupational therapy can play a key role in pain management, reducing the risk of falls and fractures, enhancing safety during mobility, and supporting and educating caregivers. However, despite broad recognition of the importance of occupational therapy in palliative care, there remains a lack of systematic evidence and clearly defined interventions specifically for this patient group.
Read the article:
https://spcare.bmj.com/content/early/2025/12/30/spcare-2025-005817
Significant Dates and Treatment Decisions at the End of Life: A Retrospective Longitudinal Study
Using clinical data, this study examines treatment practices for patients with terminal lung cancer during the Christmas and New Year holiday period and the related consequences of these practices. The findings show that a significant number of patients continue to receive anticancer treatment in their final weeks, often spending holiday periods in hospital. Questions arise about how decisions to proceed with treatment align with patients’ personal priorities at the end of life. The authors emphasise the importance of honest, personalised communication about treatment goals, taking into account how individuals wish to spend their remaining time.
Read the article:
https://www.nature.com/articles/s44276-025-00169-8
Using clinical data, this study examines treatment practices for patients with terminal lung cancer during the Christmas and New Year holiday period and the related consequences of these practices. The findings show that a significant number of patients continue to receive anticancer treatment in their final weeks, often spending holiday periods in hospital. Questions arise about how decisions to proceed with treatment align with patients’ personal priorities at the end of life. The authors emphasise the importance of honest, personalised communication about treatment goals, taking into account how individuals wish to spend their remaining time.
Read the article:
https://www.nature.com/articles/s44276-025-00169-8
Looking Ahead at the Indian Model of Palliative Care
This article offers a bold outlook on the future of palliative care in India and the potential role of the Indian Association of Palliative Care (IAPC) as an emerging global leader in the field. The author emphasises that India’s size—its large population, significant disease burden, and varied medical and cultural contexts—makes every successful IAPC initiative a form of global ‘stress test’. If a model works in India, it often proves applicable to many other health systems.
A notable strength of IAPC is its focus not on vague statements but on concrete, practical actions: ensuring that every hospital with an ICU has a palliative care service, allocating about 1% of beds for long-term care, and establishing home-based services within roughly a 5-km radius of hospitals. The author connects the association’s leadership with its ability to translate research findings into everyday clinical practice—shifting from evidence-based insights to real, operational standards of care.
Read the article: https://jpalliativecare.com/looking-ahead-assured-of-a-vibrant-indian-association-of-palliative-care-to-lead-the-world-of-palliative-care/
This article offers a bold outlook on the future of palliative care in India and the potential role of the Indian Association of Palliative Care (IAPC) as an emerging global leader in the field. The author emphasises that India’s size—its large population, significant disease burden, and varied medical and cultural contexts—makes every successful IAPC initiative a form of global ‘stress test’. If a model works in India, it often proves applicable to many other health systems.
A notable strength of IAPC is its focus not on vague statements but on concrete, practical actions: ensuring that every hospital with an ICU has a palliative care service, allocating about 1% of beds for long-term care, and establishing home-based services within roughly a 5-km radius of hospitals. The author connects the association’s leadership with its ability to translate research findings into everyday clinical practice—shifting from evidence-based insights to real, operational standards of care.
Read the article: https://jpalliativecare.com/looking-ahead-assured-of-a-vibrant-indian-association-of-palliative-care-to-lead-the-world-of-palliative-care/
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