Charles von Gunten

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PURPOSE To present guidance for patients and physicians regarding the use of radiotherapy in the treatment of bone metastases according to current published evidence and complemented by expert opinion. METHODS AND MATERIALS A systematic search of the National Library of Medicine's PubMed database between 1998 and 2009 yielded 4,287 candidate original(More)
PURPOSE In 1998, the American Society of Clinical Oncology (ASCO) published a special article regarding palliative care and companion recommendations. Herein we summarize the major accomplishments of ASCO regarding palliative cancer and highlight current needs and make recommendations to realize the Society's vision of comprehensive cancer care by 2020. (More)
Methylnaltrexone, a peripherally-acting quaternary opioid antagonist, is an investigational treatment for opioid-induced constipation in patients with advanced illness. This randomized, parallel-group, repeated dose, dose-ranging trial included a double-blind phase for one week followed by an open-label phase for a maximum of three weeks. Opioid-treated(More)
Patients with cancer frequently report dyspnea, the uncomfortable awareness of breathing. Lung involvement with cancer does not predict its occurrence. Patients describe it as one of the most frightening and distressing symptoms, and patient self-report is the only reliable measure. Measurements of respiratory rate, oxygen saturation, and arterial blood(More)
PURPOSE OF REVIEW Dyspnea is a common symptom experienced by patients suffering from life-limiting illnesses. This review aims to summarize the nonpharmacological therapies that exist to treat this complex symptom. RECENT FINDINGS There is a wide array of nonpharmacological therapies to target the symptom of dyspnea by either changing physiologic factors(More)
IMPORTANCE For patients with limited prognosis, some medication risks may outweigh the benefits, particularly when benefits take years to accrue; statins are one example. Data are lacking regarding the risks and benefits of discontinuing statin therapy for patients with limited life expectancy. OBJECTIVE To evaluate the safety, clinical, and cost impact(More)
BACKGROUND Integrating end-of-life care (EOL) education into medical residency programs requires knowledge of what programs currently teach and what residents learn. OBJECTIVE Evaluate EOL teaching content and practices in internal medicine residency programs and the EOL knowledge of their faculty and residents. DESIGN An interinstitutional pilot study.(More)
Palliative and end-of-life care is changing in the United States. This dynamic field is improving care for patients with serious and life-threatening cancer through creation of national guidelines for quality care, multidisciplinary educational offerings, research endeavors, and resources made available to clinicians. Barriers to implementing quality(More)
PURPOSE The Liaison Committee for Medical Education requires accredited U.S. and Canadian medical schools to teach end-of-life care. The purpose of this study was to evaluate a new required curriculum in palliative medicine for third-year medical students. METHOD Beginning in July 2001, a required four-day (32 hour) curriculum was piloted as part of an(More)
The aim of this article is to summarize the current evidence base about interventions that improve symptoms at the end of life. Moderate to severe symptoms are highly prevalent in the weeks and months before death: 1.4 million individuals have dyspnea; and 1 million have pain. Of those with pain, 300,000 want more pain relief. 700,000 may need more relief,(More)