Eduardo Bruera
@brueraeduardo.bsky.social
Chair, Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center
A study of 107 palliative patients showed that will to live (WtL) varies widely over time and correlates with all ESAS symptoms. WtL had links to total, physical, and psychological burden. Findings highlight suffering’s complexity and need for targeted care
pubmed.ncbi.nlm.nih.gov/40739928/
pubmed.ncbi.nlm.nih.gov/40739928/
Total suffering and will to live in persons with life-limiting diseases: Results from an Iberian multicenter study - PubMed
Evidence-based understanding of WtL is critical to improving care for patients who experience suffering toward end-of-life and their families. Further research is needed to inform and refine interventions targeting total suffering.
pubmed.ncbi.nlm.nih.gov
November 14, 2025 at 6:17 AM
A study of 107 palliative patients showed that will to live (WtL) varies widely over time and correlates with all ESAS symptoms. WtL had links to total, physical, and psychological burden. Findings highlight suffering’s complexity and need for targeted care
pubmed.ncbi.nlm.nih.gov/40739928/
pubmed.ncbi.nlm.nih.gov/40739928/
Non-cancer patients in Brazil’s home palliative care program were very old, highly frail, and often neurologically or circulatory impaired. Median stay was 50 days. With 1.74 clinical visits per day all died at home. Lower PPS scores required higher care intensity.
pubmed.ncbi.nlm.nih.gov/40971993/
pubmed.ncbi.nlm.nih.gov/40971993/
Home-Based Palliative Care for Patients With Non-Cancer Diagnoses: Clinical Characteristics, Symptom Burden, and Service Delivery - PubMed
IntroductionPopulation aging has contributed to the increased prevalence of chronic non-communicable and disabling diseases, increasing the demand for home-based palliative care.ObjectiveTo describe the sociodemographic, clinical, and care profile of patients with non-cancer treated by a Home Care S …
pubmed.ncbi.nlm.nih.gov
November 14, 2025 at 6:09 AM
Non-cancer patients in Brazil’s home palliative care program were very old, highly frail, and often neurologically or circulatory impaired. Median stay was 50 days. With 1.74 clinical visits per day all died at home. Lower PPS scores required higher care intensity.
pubmed.ncbi.nlm.nih.gov/40971993/
pubmed.ncbi.nlm.nih.gov/40971993/
In this pilot RCT of 100 advanced cancer patients on phase I therapies, adding weekly remote monitoring (RM) to monthly specialist palliative care (SPC) improved symptom burden and quality of life versus SPC alone, suggesting RM enhances SPC benefits.
pubmed.ncbi.nlm.nih.gov/40986798/
pubmed.ncbi.nlm.nih.gov/40986798/
Integration of Remote Monitoring Into Palliative Care for Patients With Advanced Cancer Undergoing Phase I Therapies: A Randomized Clinical Trial - PubMed
Incorporating RM into SPC may improve symptoms and HRQOL beyond SPC alone for patients with moderate-to-high symptom burden. Our findings are considered preliminary and larger confirmatory trials are needed.
pubmed.ncbi.nlm.nih.gov
November 13, 2025 at 2:22 PM
In this pilot RCT of 100 advanced cancer patients on phase I therapies, adding weekly remote monitoring (RM) to monthly specialist palliative care (SPC) improved symptom burden and quality of life versus SPC alone, suggesting RM enhances SPC benefits.
pubmed.ncbi.nlm.nih.gov/40986798/
pubmed.ncbi.nlm.nih.gov/40986798/
A letter to the editor discusses use of Olanzapine in cancer-associated cachexia, reporting possible short-term improvements in weight/appetite but raising uncertainty about long-term efficacy, risks and optimal patient selection.
pubmed.ncbi.nlm.nih.gov/41213247/
pubmed.ncbi.nlm.nih.gov/41213247/
Letter to the Editor: Olanzapine for Cachexia-Short-Term Benefit, Long-Term Questions - PubMed
Letter to the Editor: Olanzapine for Cachexia-Short-Term Benefit, Long-Term Questions
pubmed.ncbi.nlm.nih.gov
November 13, 2025 at 7:26 AM
A letter to the editor discusses use of Olanzapine in cancer-associated cachexia, reporting possible short-term improvements in weight/appetite but raising uncertainty about long-term efficacy, risks and optimal patient selection.
pubmed.ncbi.nlm.nih.gov/41213247/
pubmed.ncbi.nlm.nih.gov/41213247/
A case series of two pediatric cancer patients at end of life showed that combining nebulized tranexamic acid and recombinant factor VIIa effectively relieved hemoptysis, suggesting this approach may reduce suffering and distress in palliative care settings.
pubmed.ncbi.nlm.nih.gov/41207344/
pubmed.ncbi.nlm.nih.gov/41207344/
Use of Nebulized Tranexamic acid (TA) in combination with nebulized recombinant coagulation factor VIIa to treat hemoptysis in pediatric patients with cancer at end-of-life (EOL) - PubMed
Hemoptysis is a distressing symptom for both patients and families at end of life (EOL). In the acute care setting, this can be managed surgically or medically. However, research regarding interventions, such as nebulized tranexamic acid (TA) and nebulized factor VIIa, for palliative management of h …
pubmed.ncbi.nlm.nih.gov
November 10, 2025 at 6:38 AM
A case series of two pediatric cancer patients at end of life showed that combining nebulized tranexamic acid and recombinant factor VIIa effectively relieved hemoptysis, suggesting this approach may reduce suffering and distress in palliative care settings.
pubmed.ncbi.nlm.nih.gov/41207344/
pubmed.ncbi.nlm.nih.gov/41207344/
a man with metastatic neuroendocrine tumour who appeared agitated on bilevel non-invasive ventilation — identified as delirium — but he felt suffocated by the mask ; high-flow nasal oxygen resolved the agitation. “delirium” can mask treatable distress.
pubmed.ncbi.nlm.nih.gov/40931622/
pubmed.ncbi.nlm.nih.gov/40931622/
Not everything is delirium at the end of life: a case report - PubMed
In this report, we highlight the challenges faced by clinical teams diagnosing and managing delirium, in particular when a language barrier is present. Non-invasive bilevel ventilation is generally avoided in patients at the end of life (unless it offers comfort and it is aligned with the patient's …
pubmed.ncbi.nlm.nih.gov
November 9, 2025 at 9:49 AM
a man with metastatic neuroendocrine tumour who appeared agitated on bilevel non-invasive ventilation — identified as delirium — but he felt suffocated by the mask ; high-flow nasal oxygen resolved the agitation. “delirium” can mask treatable distress.
pubmed.ncbi.nlm.nih.gov/40931622/
pubmed.ncbi.nlm.nih.gov/40931622/
In palliative care, physicians showed consistent survival estimates when “surprised” (>50% chance) but highly variable predictions when “not surprised.” Variability increased over longer timeframes, showing differing interpretations of “surprise” in prognosis.
pubmed.ncbi.nlm.nih.gov/40711595/
pubmed.ncbi.nlm.nih.gov/40711595/
When would I be surprised? Variability in predicted probability of survival for being "surprised" and "not surprised" to the surprise question - PubMed
We found low variability for predicted probability of survival when clinicians were "surprised" but high variability when they were "not surprised."
pubmed.ncbi.nlm.nih.gov
November 9, 2025 at 9:42 AM
In palliative care, physicians showed consistent survival estimates when “surprised” (>50% chance) but highly variable predictions when “not surprised.” Variability increased over longer timeframes, showing differing interpretations of “surprise” in prognosis.
pubmed.ncbi.nlm.nih.gov/40711595/
pubmed.ncbi.nlm.nih.gov/40711595/
“timely palliative care” is systematic screening, referral criteria, automated triggers and refer oncology patients earlier to palliative care. It enhances access, resource efficiency and patient and caregiver outcomes with earlier specialist involvement.
pubmed.ncbi.nlm.nih.gov/35205793/
pubmed.ncbi.nlm.nih.gov/35205793/
Timely Palliative Care: Personalizing the Process of Referral - PubMed
Timely palliative care is a systematic process to identify patients with high supportive care needs and to refer these individuals to specialist palliative care in a timely manner based on standardized referral criteria. It requires four components: (1) routine screening of supportive care needs at …
pubmed.ncbi.nlm.nih.gov
November 9, 2025 at 9:38 AM
“timely palliative care” is systematic screening, referral criteria, automated triggers and refer oncology patients earlier to palliative care. It enhances access, resource efficiency and patient and caregiver outcomes with earlier specialist involvement.
pubmed.ncbi.nlm.nih.gov/35205793/
pubmed.ncbi.nlm.nih.gov/35205793/
The US administration has reduced resources for the National Library of Medicine and paralyzed government. Unfortunately I am unable to provide you our most recent publications. An alternative to Pubmed is needed for global medical knowledge.
November 8, 2025 at 11:16 AM
The US administration has reduced resources for the National Library of Medicine and paralyzed government. Unfortunately I am unable to provide you our most recent publications. An alternative to Pubmed is needed for global medical knowledge.
Survey of 52 palliative care fellowship graduates (84% response) found 52% burnout. Median age 38, 68% female, 77% practice PC >50%. Emotional exhaustion median 25.5. Burnout linked to female gender and administrative roles. Highlights need for prevention .
pubmed.ncbi.nlm.nih.gov/35183705/
pubmed.ncbi.nlm.nih.gov/35183705/
Frequency and Prediction of Burnout Among Physicians Who Completed Palliative Care Fellowship Training - A 10 Year Survey - PubMed
Burnout among former fellows trained in HPM between 2008 and 2018 is high. More research is needed to develop strategies to better prevent and manage burnout among HPM fellowship trained PC physicians.
pubmed.ncbi.nlm.nih.gov
November 8, 2025 at 11:11 AM
Survey of 52 palliative care fellowship graduates (84% response) found 52% burnout. Median age 38, 68% female, 77% practice PC >50%. Emotional exhaustion median 25.5. Burnout linked to female gender and administrative roles. Highlights need for prevention .
pubmed.ncbi.nlm.nih.gov/35183705/
pubmed.ncbi.nlm.nih.gov/35183705/
In 445 hospitalized cancer patients with pressure injuries, one-month overall survival was 55.3%. Lower Braden Scale scores (≤14) and advanced disease were linked to shorter survival, indicating poor prognosis in this population.
pubmed.ncbi.nlm.nih.gov/35394852/
pubmed.ncbi.nlm.nih.gov/35394852/
Overall Survival among Patients with Cancer and Pressure Injury and Its Association with Braden Scale Score - PubMed
<span><b><i>Background:</i></b> The overall survival (OS) of hospitalized cancer patients with pressure injury (PI) has not been studied in a large cohort. <b><i>Objective:</i></b> To assess risk factors associated with OS of hospitalized cancer patients with PI. <b><i>Methods:</i></b> After IRB approval,</span> …
pubmed.ncbi.nlm.nih.gov
November 7, 2025 at 9:42 AM
In 445 hospitalized cancer patients with pressure injuries, one-month overall survival was 55.3%. Lower Braden Scale scores (≤14) and advanced disease were linked to shorter survival, indicating poor prognosis in this population.
pubmed.ncbi.nlm.nih.gov/35394852/
pubmed.ncbi.nlm.nih.gov/35394852/
Over 2010–2019, 384 hematologic malignancy patients were referred to outpatient palliative care, with referrals increasing and occurring earlier. Median time from referral to death was 3.4 years, showing improved, timely access to supportive care over the decade.
pubmed.ncbi.nlm.nih.gov/35866185/
pubmed.ncbi.nlm.nih.gov/35866185/
Timing of referral to outpatient palliative care for patients with haematologic malignancies - PubMed
Outpatient palliative-care facilitates timely supportive-care access; however, there is a paucity of studies on the timing of referral in the outpatient setting for patients with haematologic malignancy. We examined the trend in timing of outpatient palliative-care referrals over a 10-year period in …
pubmed.ncbi.nlm.nih.gov
November 5, 2025 at 9:19 PM
Over 2010–2019, 384 hematologic malignancy patients were referred to outpatient palliative care, with referrals increasing and occurring earlier. Median time from referral to death was 3.4 years, showing improved, timely access to supportive care over the decade.
pubmed.ncbi.nlm.nih.gov/35866185/
pubmed.ncbi.nlm.nih.gov/35866185/
Young adults (18–39) with cancer showed more psychiatric history, higher ECOG scores, worse sleep and pain than older adults. Having children under 18 was linked to greater pain, sleep, and financial distress. Findings highlight the need for age-tailored support.
pubmed.ncbi.nlm.nih.gov/35881858/
pubmed.ncbi.nlm.nih.gov/35881858/
Physical and Psychosocial Symptoms of Young Adult Patients Referred to the Supportive Care Mobile Team - PubMed
Young adult (YA) aged cancer patients have unique psychosocial needs with studies indicating more symptoms and emotional distress compared to older patients. Our study aimed to compare clinical characteristics and symptom distress between YAs and older adults. We retrospectively studied 896 randomly …
pubmed.ncbi.nlm.nih.gov
November 5, 2025 at 9:15 PM
Young adults (18–39) with cancer showed more psychiatric history, higher ECOG scores, worse sleep and pain than older adults. Having children under 18 was linked to greater pain, sleep, and financial distress. Findings highlight the need for age-tailored support.
pubmed.ncbi.nlm.nih.gov/35881858/
pubmed.ncbi.nlm.nih.gov/35881858/
In 6310 cancer patients referred to palliative care, survival was strongly linked to performance status by both ECOG and KPS . Both showed high concordance, especially in older patients. KPS performed slightly better. Many were referred in their last month of life.
pubmed.ncbi.nlm.nih.gov/35948390/
pubmed.ncbi.nlm.nih.gov/35948390/
Performance status and survival in cancer patients undergoing palliative care: retrospective study - PubMed
PS as assessed by the most widely known tools is strongly associated with overall survival of patients with cancer attending PCS. No large differences were observed among the scales, though results slightly favour the use of KPS. Early referral to PCS and accurate survival prediction can aid in rele …
pubmed.ncbi.nlm.nih.gov
November 2, 2025 at 12:29 PM
In 6310 cancer patients referred to palliative care, survival was strongly linked to performance status by both ECOG and KPS . Both showed high concordance, especially in older patients. KPS performed slightly better. Many were referred in their last month of life.
pubmed.ncbi.nlm.nih.gov/35948390/
pubmed.ncbi.nlm.nih.gov/35948390/
A scoping review found that patients with intellectual disability face major barriers to palliative care, including under-referral, poor communication, and limited provider training. Greater education, awareness, and research are needed to improve equitable access.
pubmed.ncbi.nlm.nih.gov/35995282/
pubmed.ncbi.nlm.nih.gov/35995282/
Barriers to Palliative Care Access in Patients With Intellectual Disability: A Scoping Review - PubMed
Patients with intellectual disability do not get referred to PC frequently. Health professionals and caregivers do not recognize when it is necessary to make a referral, and they need to improve their communication abilities. Also, health care workers need more training in PC, pain management, antic …
pubmed.ncbi.nlm.nih.gov
November 2, 2025 at 12:15 PM
A scoping review found that patients with intellectual disability face major barriers to palliative care, including under-referral, poor communication, and limited provider training. Greater education, awareness, and research are needed to improve equitable access.
pubmed.ncbi.nlm.nih.gov/35995282/
pubmed.ncbi.nlm.nih.gov/35995282/
An open-labeled placebo significantly reduced cancer-related fatigue in advanced cancer patients versus waitlist control after one week, with improvements maintained for four weeks and no major side effects. Further studies are warranted.
pubmed.ncbi.nlm.nih.gov/36106759/
pubmed.ncbi.nlm.nih.gov/36106759/
Open-Label Placebo for the Treatment of Cancer-Related Fatigue in Patients with Advanced Cancer: A Randomized Controlled Trial - PubMed
Open-labeled placebo was efficacious in reducing CRF and fatigue clusters in fatigued advanced cancer patients at the end of 1 week. The improvement in fatigue was maintained for 4 weeks. Further studies are needed.
pubmed.ncbi.nlm.nih.gov
November 2, 2025 at 12:10 PM
An open-labeled placebo significantly reduced cancer-related fatigue in advanced cancer patients versus waitlist control after one week, with improvements maintained for four weeks and no major side effects. Further studies are warranted.
pubmed.ncbi.nlm.nih.gov/36106759/
pubmed.ncbi.nlm.nih.gov/36106759/
Approximately 1 in 6 patients who completed acute inpatient rehabilitation died within 2 months of discharge, had poorer baseline functional status, and were less likely to regain function than those who lived longer.
pubmed.ncbi.nlm.nih.gov/36367387/
pubmed.ncbi.nlm.nih.gov/36367387/
Palliative Rehabilitation in Acute Inpatient Rehabilitation: Prognostic Factors and Functional Outcomes in Patients with Cancer - PubMed
Approximately 1 in 6 patients who completed acute inpatient rehabilitation died within 2 months of discharge, had poorer baseline functional status, and were less likely to regain function than those who lived longer.
pubmed.ncbi.nlm.nih.gov
November 1, 2025 at 12:58 PM
Approximately 1 in 6 patients who completed acute inpatient rehabilitation died within 2 months of discharge, had poorer baseline functional status, and were less likely to regain function than those who lived longer.
pubmed.ncbi.nlm.nih.gov/36367387/
pubmed.ncbi.nlm.nih.gov/36367387/
CBT for cancer-related fatigue in newly diagnosed hematologic malignancy patients was feasible (79% adherence, 92% satisfaction) and improved fatigue, sleep, and anxiety, though not depression or hope. Results support future randomized controlled trials.
pubmed.ncbi.nlm.nih.gov/36454553/
pubmed.ncbi.nlm.nih.gov/36454553/
Medical Marijuana Legalization and Opioid- and Pain-Related Outcomes Among Patients Newly Diagnosed With Cancer Receiving Anticancer Treatment - PubMed
Findings of this cross-sectional study suggest that medical marijuana legalization implemented from 2012 to 2017 was associated with a lower rate of opioid dispensing and pain-related hospital events among some adults receiving treatment for newly diagnosed cancer. The nature of these associations a …
pubmed.ncbi.nlm.nih.gov
November 1, 2025 at 12:55 PM
CBT for cancer-related fatigue in newly diagnosed hematologic malignancy patients was feasible (79% adherence, 92% satisfaction) and improved fatigue, sleep, and anxiety, though not depression or hope. Results support future randomized controlled trials.
pubmed.ncbi.nlm.nih.gov/36454553/
pubmed.ncbi.nlm.nih.gov/36454553/
The authors argue that the second step of the World Health Organization analgesic ladder (weak opioids) may no longer be needed in modern cancer pain management—suggesting a move from non-opioid/weak opioid directly to strong opioids.
pubmed.ncbi.nlm.nih.gov/36456102/
pubmed.ncbi.nlm.nih.gov/36456102/
The end of the second step of the World Health Organization analgesic ladder? - PubMed
The end of the second step of the World Health Organization analgesic ladder?
pubmed.ncbi.nlm.nih.gov
November 1, 2025 at 12:52 PM
The authors argue that the second step of the World Health Organization analgesic ladder (weak opioids) may no longer be needed in modern cancer pain management—suggesting a move from non-opioid/weak opioid directly to strong opioids.
pubmed.ncbi.nlm.nih.gov/36456102/
pubmed.ncbi.nlm.nih.gov/36456102/
The paper reaffirms ethical norms in organ transplant, stressing physicians’ duty to donor-patients, informed consent, and equitable practices. It calls for separating donor care from recipient interests to maintain trust and protect donor-patient welfare.
pubmed.ncbi.nlm.nih.gov/41144970/
pubmed.ncbi.nlm.nih.gov/41144970/
Ethical Issues in Organ Transplantation: A Position Paper From the American College of Physicians - PubMed
Recent developments and controversies in organ transplantation necessitate the reaffirmation and application of foundational ethical norms as the laudable goal of increasing viable organs for transplantation is pursued. The physician's primary duties are to individual patients under the physician's …
pubmed.ncbi.nlm.nih.gov
October 28, 2025 at 10:17 AM
The paper reaffirms ethical norms in organ transplant, stressing physicians’ duty to donor-patients, informed consent, and equitable practices. It calls for separating donor care from recipient interests to maintain trust and protect donor-patient welfare.
pubmed.ncbi.nlm.nih.gov/41144970/
pubmed.ncbi.nlm.nih.gov/41144970/
🇺🇸 personal bankruptcies due to medical debt: 60- 66%; 🇨🇦: 15- 19%.
🇺🇸 uninsured population: 11%; Canada 0.2%
It is getting worse in 🇺🇸 every week.
Can 🇺🇸 pts and clinicians become the 11th province? Or at the very least the 4th territory ? Pretty please?
🇺🇸 uninsured population: 11%; Canada 0.2%
It is getting worse in 🇺🇸 every week.
Can 🇺🇸 pts and clinicians become the 11th province? Or at the very least the 4th territory ? Pretty please?
October 26, 2025 at 1:13 PM
🇺🇸 personal bankruptcies due to medical debt: 60- 66%; 🇨🇦: 15- 19%.
🇺🇸 uninsured population: 11%; Canada 0.2%
It is getting worse in 🇺🇸 every week.
Can 🇺🇸 pts and clinicians become the 11th province? Or at the very least the 4th territory ? Pretty please?
🇺🇸 uninsured population: 11%; Canada 0.2%
It is getting worse in 🇺🇸 every week.
Can 🇺🇸 pts and clinicians become the 11th province? Or at the very least the 4th territory ? Pretty please?
Burnout curative approach: better working conditions
Palliative approach: better self care
Always combine curative + palliative!
Palliative approach: better self care
Always combine curative + palliative!
October 26, 2025 at 1:06 PM
Burnout curative approach: better working conditions
Palliative approach: better self care
Always combine curative + palliative!
Palliative approach: better self care
Always combine curative + palliative!
In 130 cancer patients with nonmedical opioid use, the CHAT intervention reduced NMOU behaviors and pain scores at 3 and 6 months, without changing opioid doses. About 60% achieved complete response, supporting CHAT’s effectiveness in managing NMOU in cancer pain.
pubmed.ncbi.nlm.nih.gov/35997289/
pubmed.ncbi.nlm.nih.gov/35997289/
Interdisciplinary intervention for the management of nonmedical opioid use among patients with cancer pain - PubMed
Most patients who received the CHAT intervention improved in their NMOU behaviors and pain intensity scores 3 and 6 months post-intervention. These preliminary findings support the efficacy of CHAT in managing patients receiving opioids for cancer pain who demonstrate NMOU behavior.
pubmed.ncbi.nlm.nih.gov
October 26, 2025 at 12:54 PM
In 130 cancer patients with nonmedical opioid use, the CHAT intervention reduced NMOU behaviors and pain scores at 3 and 6 months, without changing opioid doses. About 60% achieved complete response, supporting CHAT’s effectiveness in managing NMOU in cancer pain.
pubmed.ncbi.nlm.nih.gov/35997289/
pubmed.ncbi.nlm.nih.gov/35997289/
In 1,440 cancer patients admitted to an APCU, symptoms, spiritual, and financial distress improved significantly. Deaths in the unit decreased, and hospice transfers rose from 32% to 62%. Most patients were successfully discharged or transitioned to hospice care.
pubmed.ncbi.nlm.nih.gov/36007209/
pubmed.ncbi.nlm.nih.gov/36007209/
Clinical Outcomes of Operating an Acute Palliative Care Unit at a Comprehensive Cancer Center - PubMed
Patients with advanced cancer admitted to the APCU may experience significant improvements in distressing symptoms. The majority of patients requiring transition to hospice were successfully transferred to certified hospice centers. The percentage discharged alive improved over time.
pubmed.ncbi.nlm.nih.gov
October 26, 2025 at 12:51 PM
In 1,440 cancer patients admitted to an APCU, symptoms, spiritual, and financial distress improved significantly. Deaths in the unit decreased, and hospice transfers rose from 32% to 62%. Most patients were successfully discharged or transitioned to hospice care.
pubmed.ncbi.nlm.nih.gov/36007209/
pubmed.ncbi.nlm.nih.gov/36007209/