Eduardo Bruera

Effect of Prophylactic Fentanyl Buccal Tablet on Episodic Exertional Dyspnea: A Pilot Double-Blind Randomized Controlled Trial - PubMed This study supports that prophylactic FBT was associated with a reduction of exertional dyspnea and was well tolerated. Our findings support the need for larger trials to confirm the therapeutic potential of rapid-onset opioids.

In opioid-tolerant patients, prophylactic fentanyl buccal tablets significantly reduced exertional dyspnea and respiratory rate during a 6-minute walk test, suggesting rapid-onset opioids may help manage exercise-induced breathlessness.​​​​​​​​​​​​​​​​

pubmed.ncbi.nlm.nih.gov/28803087/

Palliative Care Needs in an Acute Internal Medicine Ward in Mexico - PubMed The number of patients requiring palliative care in internal medicine wards may be excessive to the current palliative care structures available.

34% of internal medicine inpatients in a Mexican hospital had serious illness; 66% met advanced disease criteria, and 81% of those died within a year—highlighting a critical gap between palliative care demand and available resources.​​​​​​​​​​​​​​​​

pubmed.ncbi.nlm.nih.gov/28846483/

8th Interdisciplinary Pain and Opioid Seminar
Navigating the Opioid Use
Conundrum: Use, Underuse,
and Nonmedical Use
April 24-25, 2026 | Virtual Event

A scoping review of breakthrough cancer pain: mapping the evidence landscape - PubMed This scoping review maps heterogeneous evidence characterized by inconsistent definitions, selected populations, short-term outcomes, and geographic concentration. Key knowledge gaps include: standardized operational definitions, patient-centered functional outcomes, long-term efficacy and safety da …

Scoping review of 146 studies on breakthrough cancer pain (BTP) found major heterogeneity in definitions, assessment, and management. Most define BTP as transient severe pain despite controlled baseline pain, but criteria vary widely.

pubmed.ncbi.nlm.nih.gov/41793478/

A scoping review of breakthrough cancer pain: mapping the evidence landscape - PubMed This scoping review maps heterogeneous evidence characterized by inconsistent definitions, selected populations, short-term outcomes, and geographic concentration. Key knowledge gaps include: standardized operational definitions, patient-centered functional outcomes, long-term efficacy and safety da …

Scoping review of breakthrough cancer pain (146 studies, 13K+ patients): definitions vary widely; prevalence 33–95%; fentanyl dominates trials (82% industry-funded). Gaps: no standard definitions, limited diverse/long-term data. Consensus needed.

pubmed.ncbi.nlm.nih.gov/41793478/

Timing and outcomes of outpatient palliative care consultations in advanced cancer - PubMed Early palliative care referral was associated with improved symptoms, higher rates of ACP, and reduced aggressive end-of-life care, supporting the expansion of palliative care resources.

Early outpatient pall care referral in 177 advanced cancer patients improved symptoms (ESAS scores ), achieved 94% advance care planning, and reduced aggressive end-of-life treatment, supporting broader palliative care resource expansion.​​​​​​​​​​​​​​​​

pubmed.ncbi.nlm.nih.gov/41758445/

Outcomes of a Specialized Interdisciplinary Approach for Patients with Cancer with Aberrant Opioid-Related Behavior - PubMed There are currently no well-defined and evidence-based strategies to manage cancer patients on chronic opioid therapy who demonstrate aberrant opioid-related behavior. The findings of this study offer a promising starting point for the creation of a standardized strategy for clinicians and provides …

This program was associated with reduced aberrant behaviors and safer opioid use, supporting structured, team-based management.
pubmed.ncbi.nlm.nih.gov/29021378/

Methadone as a First-Line Opioid in Cancer Pain Management: A Systematic Review - PubMed Available data are not sufficient to draw net conclusion. However, open-label and controlled studies have shown that methadone may be effective as first-line drug in the management of cancer pain, providing analgesia and adverse effect profiles similar to those produced by other opioids. The finding …

Methadone as a First-Line Opioid in Cancer pain: Systematic review shows limited data but suggests methadone may be effective and tolerated as first-line cancer pain therapy, with similar analgesia and side effects to other opioids; further research needed.

pubmed.ncbi.nlm.nih.gov/29101087/

Determining patient-oncologist cancer treatment intent concordance using systematic screening in a supportive care center - PubMed The rate of inaccuracy in patient-reported curability perception and primary treatment goal at our SCC is high, supporting the need for systematic screening and communication interventions to improve illness understanding and provide goal-concordant care.

In 300 supportive care patients, about half had matching goals for care with the oncologist, while nearly all mismatches involved patients mistakenly believing their treatment was curative, highlighting need for better communication.

pubmed.ncbi.nlm.nih.gov/41733720/

images.squarespace-cdn.com/content/v1/5...

images.squarespace-cdn.com/content/v1/5...

Please join us for this amazing event!

Nutrition Rehabilitation Programs and Cachexia Clinics for Anorexia-Cachexia Syndrome in Patients with Cancer - PubMed The Anorexia-Cachexia Syndrome (ACS) is characterized by loss of appetite and unintentional weight loss. Important clinical outcomes are associated with ACS including increased risk of chemotherapy side-effects, decreased survival and quality of life. Because ACS is driven by complex metabolic mecha …

Anorexia-Cachexia causes appetite loss, weight/muscle loss, and worse outcomes. Addressing metabolism, nutrition impact symptoms, and inactivity needs an interdisciplinary team. Specialized nutrition rehab and cachexia clinics improve care

pubmed.ncbi.nlm.nih.gov/41693023/

Conducting clinical trials in supportive and palliative oncology: challenges and opportunities - PubMed Through interdisciplinary collaborations, we can continue to strengthen the infrastructure and refine the processes in supportive care trials. These efforts will help build a robust evidence base and ultimately improve outcomes for patients with cancer.

Conducting supportive and palliative oncology clinical trials faces barriers like limited infrastructure, funding, and patient recruitment issues. Standardizing methods and interdisciplinary collaboration can improve research quality and evidence generation.

pubmed.ncbi.nlm.nih.gov/41704002/

Nutrition Rehabilitation Programs and Cachexia Clinics for Anorexia-Cachexia Syndrome in Patients with Cancer - PubMed The Anorexia-Cachexia Syndrome (ACS) is characterized by loss of appetite and unintentional weight loss. Important clinical outcomes are associated with ACS including increased risk of chemotherapy side-effects, decreased survival and quality of life. Because ACS is driven by complex metabolic mecha …

Anorexia–cachexia in cancer involves metabolic and inflammatory drivers not fixed by nutrition alone. Interdisciplinary care, symptom management, and specialized nutrition rehabilitation and cachexia clinics may improve treatment and integration of new therapies

pubmed.ncbi.nlm.nih.gov/41693023/

Decisional control preferences among patients with advanced cancer: An international multicenter cross-sectional survey - PubMed Passive decision control preferences were less common (23%) than shared and active decision control preference even among developing countries. Significant predictors of passive decision control preferences were performance status, education, and country of origin.

Passive decision control preferences were less common (23%) than shared and active decision control preference even among developing countries. Significant predictors of passive decision control preferences were performance status, education, and country of origin.

pubmed.ncbi.nlm.nih.gov/29235415/

A Pragmatic Evaluation of Symptom Distress After Group Meditation for Cancer Patients and Caregivers: A Preliminary Report - PubMed A single meditation group class offered as part of clinical care resulted in relief of multiple self-reported symptoms in both patients and caregivers.

A single meditation group class offered as part of clinical care resulted in relief of multiple self-reported symptoms in both patients and caregivers.

pubmed.ncbi.nlm.nih.gov/29421165/

Characteristics and Outcomes of Advanced Cancer Patients Who Received Palliative Care at a Public Hospital Compared with Those at a Comprehensive Cancer Center - PubMed Advanced cancer patients at both institutions frequently had multiple distressing physical and emotional symptoms, although the frequency was higher at CCC. The median overall survival duration was higher at the PH. More research is needed.

Pall care pts at a public hospital and a comprehensive cancer center both had high distress and symptom burden. Ethnicity and insurance coverage differed widely. Follow-up timing , and overall survival were longer at the public hospital.

pubmed.ncbi.nlm.nih.gov/29451835/

Body mass index but not percentage weight loss was associated with the race/ethnicity of patients with advanced lung cancer: a cross-sectional study - PubMed In patients with advanced lung cancer, BMI and total weight loss but not percentage change in weight was significantly associated with self-identified race/ethnicity at the time of Palliative Medicine consultation. On multivariate analysis, the percentage loss in weight was significantly influenced …

patients with advanced lung cancer, BMI and total weight loss but not percentage change in weight was significantly associated with self-identified race/ethnicity at the time of Palliative Medicine consultation.

pubmed.ncbi.nlm.nih.gov/41663276/

Physicians Are Not Providers: The Ethical Significance of Names in Health Care: A Policy Paper From the American College of Physicians - PubMed More than 25 years ago, Pellegrino and Relman noted the increasing commercialization of the learned professions, anticipating what many physicians are increasingly experiencing today: an impairment of their ability to practice in accordance with standards of medical ethics and professionalism. These …

The term “provider” has not been adequately explored as a matter of ethics and professionalism. Through that lens, this paper examines the trends, significance, and implications for patients, physicians, and health care of the use of the term provider.

pubmed.ncbi.nlm.nih.gov/41662714/

Attitudes and beliefs of Italian palliative care experts regarding cachexia: A Delphi study - PubMed This study defines core PC-oriented principles for cachexia management: interprofessional collaboration, dyadic engagement, early holistic assessment, and goal-concordant interventions. Findings can inform future clinical guidelines, training, and policy development to address cachexia in advanced i …

This study defines core PC-oriented principles for cachexia management: interprofessional collaboration, dyadic engagement, early holistic assessment, and goal-concordant care

pubmed.ncbi.nlm.nih.gov/41656699/

The vast majority of our practice changing discoveries where only possible because we had a PCU: SC route, hydration, opioid rotation, oxygen and opioids for dyspnea, methadone, delirium studies.

Symptom control during the last week of life on a palliative care unit - PubMed A recent report suggested that more than 50% of terminal cancer patients have physical suffering that requires sedation in the last days of life. To evaluate this finding on our 14-bed palliative care unit, a retrospective analysis of 100 consecutive patients admitted for 6 days or more was carried …

We have known for >35 ys that the PCU can alleviate intractable pt suffering at EOL. Most American hospitals still do not have one, and absence is not a “quality metric”. Metrics are wrong !

pubmed.ncbi.nlm.nih.gov/2045996/

Acute palliative and supportive care units provide unique and tailored care: A case report - PubMed The case report demonstrates that an APSCU, with its skilled interdisciplinary team in the acute care hospital, is an ideal setting to provide patient-centered care for seriously ill patients and their families.

Every hospital with an ICU must have a PCU

pubmed.ncbi.nlm.nih.gov/41555657/

INVITACIÓN al XV Simposio Anual Collective Soul! El próximo 10 y 11 de abril tendré el placer de participar en este encuentro internacional dedicado a la espiritualidad y la salud. "Cultivar la presencia un camino cotidiano para crear entornos de sa...

www.linkedin.com/pulse/invita...

#santépublique #éthique #soinspalliatifs #hippocrate #france | Christine DEVILLET-KLEIN (Europe) Non par charité. Par justice. C’est là que se mesure une société. #SantéPublique #Éthique #SoinsPalliatifs #Hippocrate #France 🔒 Réflexion générale d’intérêt public.

www.linkedin.com/posts/christ...

Associations between Smoking, Opioid Analgesic Use, and Risk For Chemical Coping in Korean Patients with Advanced Cancer - PubMed Among Korean patients with advanced cancer, current smokers were more likely to use higher doses of opioids, have positive CAGE results, and drink more coffee. Close monitoring and appropriate management for the possibility of chemical coping or non-medical opioid use will be important in these pati …

The study of 240 Korean advanced cancer patients found current smokers used higher opioid doses, had more positive alcohol screening (CAGE),and showed greater physician-assessed risk of chemical coping, indicating need for monitoring non-medical opioid use.

pubmed.ncbi.nlm.nih.gov/41643565/

Acute palliative and supportive care units provide unique and tailored care: A case report - PubMed The case report demonstrates that an APSCU, with its skilled interdisciplinary team in the acute care hospital, is an ideal setting to provide patient-centered care for seriously ill patients and their families.

AnAcute Palliative and Supportive Care Unit (APSCU) delivered tailored, interdisciplinary care for a patient with advanced colon cancer who survived a critical event, improved with aggressive symptom management, and transitioned to hospice at home.

pubmed.ncbi.nlm.nih.gov/41555657/

Respiratory Therapists' Attitudes and Beliefs Regarding High Flow Nasal Cannula Use at End-of-Life - PubMed Only 58% of RTs agreed that goals for comfort-focused care at end-of-life affect their HFNC management. Almost half reported distress regarding HFNC use at EOL. Our findings underscore opportunities for guidance and support for RTs involved in EOL dyspnea management and the delivery of goal-concorda …

survey of respiratory therapists showed that 58% said comfort-focused goals influence HFNC management in end-of-life care. 50% feel distress about prolonging suffering or dying. Findings highlight the need for clearer guidance and support in EOL HFNC care.

pubmed.ncbi.nlm.nih.gov/41478421/

Academic and clinical leaders who invest with biomedical and /or financial benchmarks ignore the burden of disease on the person and their loved ones. Failure to consider the value of love in health care turns us into an intellectual elite