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In this issue
December 2, 2014

Jonathan Tobin: Defending the Right to a Jewish State

Heather Hale: Compliment your kids without giving them big heads

Megan Shauri: 10 ways you are ruining your own happiness

Carolyn Bigda: 8 Best Dividend Stocks for 2015

Kiplinger's Personal Finance editors: 7 Things You Didn't Know About Paying Off Student Loans

Samantha Olson: The Crucial Mistake 55% Of Parents Are Making At Their Baby's Bedtime

Densie Well, Ph.D., R.D. Open your eyes to yellow vegetables

The Kosher Gourmet by Megan Gordon With its colorful cache of purples and oranges and reds, COLLARD GREEN SLAW is a marvelous mood booster --- not to mention just downright delish
April 18, 2014

Rabbi Yonason Goldson: Clarifying one of the greatest philosophical conundrums in theology

Caroline B. Glick: The disappearance of US will

Megan Wallgren: 10 things I've learned from my teenagers

Lizette Borreli: Green Tea Boosts Brain Power, May Help Treat Dementia

John Ericson: Trying hard to be 'positive' but never succeeding? Blame Your Brain

The Kosher Gourmet by Julie Rothman Almondy, flourless torta del re (Italian king's cake), has royal roots, is simple to make, . . . but devour it because it's simply delicious

April 14, 2014

Rabbi Dr Naftali Brawer: Passover frees us from the tyranny of time

Greg Crosby: Passing Over Religion

Eric Schulzke: First degree: How America really recovered from a murder epidemic

Georgia Lee: When love is not enough: Teaching your kids about the realities of adult relationships

Cameron Huddleston: Freebies for Your Lawn and Garden

Gordon Pape: How you can tell if your financial adviser is setting you up for potential ruin

Dana Dovey: Up to 500,000 people die each year from hepatitis C-related liver disease. New Treatment Has Over 90% Success Rate

Justin Caba: Eating Watermelon Can Help Control High Blood Pressure

The Kosher Gourmet by Joshua E. London and Lou Marmon Don't dare pass over these Pesach picks for Manischewitz!

April 11, 2014

Rabbi Hillel Goldberg: Silence is much more than golden

Caroline B. Glick: Forgetting freedom at Passover

Susan Swann: How to value a child for who he is, not just what he does

Cameron Huddleston: 7 Financial Tasks You Should Tackle Right Now

Sandra Block and Lisa Gerstner: How to Profit From Your Passion

Susan Scutti: A Simple Blood Test Might Soon Diagnose Cancer

Chris Weller: Have A Slow Metabolism? Let Science Speed It Up For You

The Kosher Gourmet by Diane Rossen Worthington Whitefish Terrine: A French take on gefilte fish

April 9, 2014

Jonathan Tobin: Why Did Kerry Lie About Israeli Blame?

Samuel G. Freedman: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Jessica Ivins: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Kim Giles: Asking for help is not weakness

Kathy Kristof and Barbara Hoch Marcus: 7 Great Growth Israeli Stocks

Matthew Mientka: How Beans, Peas, And Chickpeas Cleanse Bad Cholesterol and Lowers Risk of Heart Disease

Sabrina Bachai: 5 At-Home Treatments For Headaches

The Kosher Gourmet by Daniel Neman Have yourself a matzo ball: The secrets bubby never told you and recipes she could have never imagined

April 8, 2014

Lori Nawyn: At Your Wit's End and Back: Finding Peace

Susan B. Garland and Rachel L. Sheedy: Strategies Married Couples Can Use to Boost Benefits

David Muhlbaum: Smart Tax Deductions Non-Itemizers Can Claim

Jill Weisenberger, M.S., R.D.N., C.D.E : Before You Lose Your Mental Edge

Dana Dovey: Coffee Drinkers Rejoice! Your Cup Of Joe Can Prevent Death From Liver Disease

Chris Weller: Electric 'Thinking Cap' Puts Your Brain Power Into High Gear

The Kosher Gourmet by Marlene Parrish A gift of hazelnuts keeps giving --- for a variety of nutty recipes: Entree, side, soup, dessert

April 4, 2014

Rabbi David Gutterman: The Word for Nothing Means Everything

Charles Krauthammer: Kerry's folly, Chapter 3

Amy Peterson: A life of love: How to build lasting relationships with your children

John Ericson: Older Women: Save Your Heart, Prevent Stroke Don't Drink Diet

John Ericson: Why 50 million Americans will still have spring allergies after taking meds

Cameron Huddleston: Best and Worst Buys of April 2014

Stacy Rapacon: Great Mutual Funds for Young Investors

Sarah Boesveld: Teacher keeps promise to mail thousands of former students letters written by their past selves

The Kosher Gourmet by Sharon Thompson Anyone can make a salad, you say. But can they make a great salad? (SECRETS, TESTED TECHNIQUES + 4 RECIPES, INCLUDING DRESSINGS)

April 2, 2014

Paul Greenberg: Death and joy in the spring

Dan Barry: Should South Carolina Jews be forced to maintain this chimney built by Germans serving the Nazis?

Mayra Bitsko: Save me! An alien took over my child's personality

Frank Clayton: Get happy: 20 scientifically proven happiness activities

Susan Scutti: It's Genetic! Obesity and the 'Carb Breakdown' Gene

Lecia Bushak: Why Hand Sanitizer May Actually Harm Your Health

Stacy Rapacon: Great Funds You Can Own for $500 or Less

Cameron Huddleston: 7 Ways to Save on Home Decor

The Kosher Gourmet by Steve Petusevsky Exploring ingredients as edible-stuffed containers (TWO RECIPES + TIPS & TECHINQUES)

Jewish World Review

Palliative care: Underused therapy yields surprising benefits

By Harvard Health Letters


Palliative care helps patients feel and function better, striving to relieve both physical and emotional suffering




Patients can stop the clock without jeopardizing their health


JewishWorldReview.com | Hippocrates, the father of medicine, called on physicians to "cure sometimes, treat often, comfort always." With the limited tools available to the doctors of ancient Greece, it's no surprise that medical treatment succeeded in providing comfort more often than cure.

Little changed during most of the 2,400 years that have elapsed since the Greek era. But as medicine developed powerful new ways to diagnose and treat disease over the past century, cure has become the main goal of treatment. It's great progress, and the improvements are bound to accelerate in our age of modern molecular medicine.

As doctors and patients focus on cure, however, both groups risk losing sight of comfort, sometimes even assuming that cure and comfort are antithetical. In some cases, the result is needless suffering, which may be compounded by aggressive treatments that have little prospect of success.

It doesn't have to be that way -- and a recent study from a Harvard teaching hospital shows that palliative care may provide substantial benefits in addition to comfort.

WHAT IS PALLIATIVE CARE?
The word palliate is derived from the Latin word for a cloak or coverlet. Perhaps that's one reason many people, both health care professionals and their patients, assume its goal is to simply mask or cover up symptoms when a remedy or cure is unavailable. But reducing discomfort and suffering is very different from and much more important than merely hiding distress from view -- and palliative care can go hand-in-hand with curative care and life-extending therapies.


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Curative care focuses on the disease, while palliative care focuses on the patient. Modern palliative care strives to relieve physical and emotional suffering and to enhance the quality of life for patients and their families. It's a team effort. In 2006, palliative care was recognized as a distinct discipline by the American Board of Medical Specialties. In addition to palliative care physicians, a palliative care team typically includes nurses and social workers with additional support from nutritionists, physical therapists, psychiatrists, pharmacists, and chaplains.

Pain relief is an important goal of palliative care, but the team is also equipped to help with a wide range of problems, including respiratory symptoms (coughing, shortness of breath), intestinal symptoms (loss of appetite, hiccups, vomiting, constipation, diarrhea), weakness and impaired mobility, skin conditions, and mental changes (depression, anxiety, confusion, delirium). Palliative care teams can also assist patients and their families in deciding what tests and treatments are most appropriate and what goals are realistic and attainable.

In theory, everyone with a serious illness might benefit from some aspect of palliative care. In fact, palliative care is offered by more than 80 percent of the large hospitals where most Americans receive treatment for complex and advanced illnesses. But even at these referral centers, palliative care teams are typically deployed late in the course of terminal illnesses, often in conjunction with hospice care. Palliative care is appropriate and important in these circumstances -- but the recent Harvard study reminds us that it is also beneficial early in serious illnesses, even when patients are managing well at home.

RECENT RESULTS
The new study was conducted at Massachusetts General Hospital, a Harvard teaching hospital that cares for many patients with complex illnesses. The investigation focused on lung cancer, the leading cause of cancer death in the U.S.

Between 2006 and 2009, 151 patients with non-small cell lung cancer (NSCLC), the most common form of the disease, enrolled in the trial. All had been newly diagnosed with metastatic NSCLC; since their cancers had spread from the lungs to other organs, none of the patients were candidates for curative lung surgery. Although they had advanced disease, all were outpatients who volunteered for the study within eight weeks of receiving the diagnosis of metastatic NSCLC.

Half the patients were randomly assigned to receive palliative care plus standard cancer care, while the others received standard cancer care alone. Palliative care was delivered by members of a palliative care unit who followed a specific protocol. All of the cancer care was provided by oncologists who specialize in lung cancer and was based on each patient's individual clinical needs.

The researchers used detailed questionnaires to evaluate the patients' mood and health-related quality of life when they entered the study and again 12 weeks later. Members of the palliative care and standard care groups had similar results on their initial tests, but after 12 weeks, the patients who received early palliative care reported both a better quality of life and less depression than the patients who received standard cancer care.

It's not surprising that palliative care helped patients feel and function better. The study also found that members of the palliative care group were more likely to specify their wishes for end-of-life care and were less likely to receive aggressive treatment near life's end; no surprises there, either. But the study also added two important new observations.

First, early palliative care was beneficial. About a third of the patients had no cancer-related symptoms when they first received palliative care and 94 percent were fully ambulatory; in ordinary clinical practice, doctors would have offered palliative care to few, if any, of these high-functioning individuals.

The second new finding was even more impressive: Although the palliative care patients received less aggressive end-of-life care than the standard care patients, they lived an average of 2.7 months longer.

COMFORT AND CARE
The Harvard study reminds us that vigorous cancer therapy, which includes chemotherapy, radiation therapy, or both, can go hand-in-hand with palliative care. It also shows that palliative care can help patients with serious disease, even if it is initiated before symptoms develop. And the trial also found that palliative care can significantly improve survival even if it results in less aggressive end-of-life care.

More research is needed to confirm the survival benefit of early palliative care. Still, while this finding may be surprising, it is not unreasonable. Patients who feel better have an increased will to live. They have less stress and depression and are likely to eat better, be more active, and spend more time with friends and family -- and social supports, good spirits, balanced nutrition, and prudent exercise are all good medicine.

Care and cure are not mutually exclusive. It's true that palliative care can help dying patients by reducing suffering, promoting dignity and peacefulness, and contributing to appropriate and realistic choices. But it's also true that early palliative care can improve the quality of life in patients who are getting all-out therapy, and it may even improve survival in these circumstances.

Comfort or care? Many people view it as a choice, but that's a false proposition. The answer is not one or the other, but both. - Harvard Men's Health Watch

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