Symptom

Basic

Clinical or Health Services

 

delirium or cognitive impairment

impairment

• Require neuropsychological assessments in cancer treatment trials to determine whether drugs are causing cognitive impairment

Dyspnea

• Standardize measurement and assessment

• Develop animal model

• Determine relationship of dyspnea to anemia in chronic illness

• Determine role of respiratory muscle metabolism and function

• Elucidate link between cachexia, tumor necrosis factor, muscle fatigue or weakness, and dyspnea

• Study prevalence, severity, and current treatment

• Conduct clinical trials of opioids by different routes of administration

• Conduct clinical trials of other agents (e.g., corticosteroids)

Fatigue

• Explore new agents (e.g., anticytokines)

• Develop animal models

• Explore common pathways for fatigue and other symptoms

Conduct clinical trials of

• Stimulant therapies

• Current anticytokines

• Selective serotonin receptor uptake inhibitors (SSRIs)

• Exercise

• Behavioral interventions

Gastrointestinal symptoms

• Study relationship of terminal nausea to other symptoms of advanced disease

• Determine mechanisms of terminal and treatment-induced nausea

• Study prevalence, severity and current treatment of terminal nausea

• Conduct clinical trials of agents for nausea of advanced disease and for bowel obstruction

Psychiatric or affective symptoms

• Develop animal model for cancer-related affective disturbances

• Study mechanisms of depression unique to cancer and its treatment

• Describe current management in advanced disease

• Conduct clinical trials of standard antidepressants, especially SSRIs; stimulant therapies (e.g., methylphenidate); and agents for terminal agitation or restlessness

• Consider trials of novel agents: “empathogens”



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