Research Topics
| Thomas J SmithSummaryAffiliation: Virginia Commonwealth University Country: USA Publications
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Publications
Cost and non-clinical outcomes of palliative careThomas J Smith
Department of Medicine, Virginia Commonwealth University, Massey Cancer Center, Richmond, Virginia, USA
J Pain Symptom Manage 38:32-44. 2009..In collecting and presenting the data to administrators and others, we have found that the simplest approach is the most effective-for example, presenting a few clinical outcomes alongside cost-saving data...- Barriers to effective palliative care for low-income patients in late stages of cancer: report of a study and strategies for defining and conquering the barriersLaurie J Lyckholm
Division of Hematology Oncology and Palliative Care, Massey Cancer Center, Virginia Commonwealth University School of Medicine, PO Box 980230, Richmond, VA 23298 0230, USA
Nurs Clin North Am 45:399-409. 2010.... 
Giving honest information to patients with advanced cancer maintains hopeThomas J Smith
Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
Oncology (Williston Park) 24:521-5. 2010..One of the primary reasons stated for witholding this information is to "not take away hope." We could find no study that tested if hope was influenced by honest clinical information...- Exploring hereditary cancer among dying cancer patients--a cross-sectional study of hereditary risk and perceived awareness of DNA testing and bankingJohn Martin Quillin
Massey Cancer Center, Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA 23298 0033, USA
J Genet Couns 19:497-525. 2010..These conditions are not being recognized upstream and families are losing valuable information... - Palliative care consultation in the process of organ donation after cardiac deathCatherine McVearry Kelso
Department of Internal Medicine, Virginia Commonwealth University, 1200 East Broad Street, Richmond, VA 23298, USA
J Palliat Med 10:118-26. 2007.... 
The role of chemotherapy at the end of life: "when is enough, enough?"Sarah Elizabeth Harrington
Department of Internal Medicine and the Thomas Palliative Care Program, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23298, USA
JAMA 299:2667-78. 2008..Approaches to communication about prognosis and treatment options and questions that patients may want to ask are discussed...- 'Futile care': what to do when your patient insists on chemotherapy that likely won't helpJames Khatcheressian
Division of Hematology Oncology, Massey Cancer Center of Virginia Commonwealth University, Richmond, Virginia, USA
Oncology (Williston Park) 22:881-8; discussion 893, 896, 898. 2008..In this review, we consider the roles of both the patient and the physician in driving the provision of "futile care" and offer practical steps the oncologist can take to avoid it... - Paradoxes in advance care planning: the complex relationship of oncology patients, their physicians, and advance medical directivesLindsay A Dow
School of Medicine and Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23298 0230, USA
J Clin Oncol 28:299-304. 2010..Ten years ago, patients with cancer said they would not like to discuss ADs with their oncologist but would be willing to discuss them with an admitting physician. We assessed whether this point of view still held... - A pilot trial of decision aids to give truthful prognostic and treatment information to chemotherapy patients with advanced cancerThomas J Smith
Massey Cancer Center of Virginia Commonwealth University, School of Education, VCU School of Medicine, Department of Social and Behavioral Health, and the Virginia Cancer Institute, Richmond, Virginia 23298 0230, USA
J Support Oncol 9:79-86. 2011..Research is needed to test the findings in a larger sample and measure the outcomes of truthful information on quality of life, quality of care, and costs... - A randomized, placebo controlled trial of oral zinc for chemotherapy-related taste and smell disordersLaurel Lyckholm
Division of Hematology Oncology and Palliative Care, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23298 0230, USA
J Pain Palliat Care Pharmacother 26:111-4. 2012..Zinc at standard doses did not provide significant benefit to taste or smell in patients receiving chemotherapy... - Hospital mortality rates: how is palliative care taken into account?J Brian Cassel
Virginia Commonwealth University, Richmond, Virginia, USA
J Pain Symptom Manage 40:914-25. 2010..To be a fair measure of hospital quality, hospital mortality measures must take patient-level factors, such as goals of care, into account... - Dexmedetomidine as an adjuvant analgesic for intractable cancer painSeth B Roberts
Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23298 0230, USA
J Palliat Med 14:371-3. 2011..We describe its use as an adjuvant analgesic in a patient with cancer pain refractory to multiple treatment modalities... - Palliative care consultation and hospital length of stayJ Brian Cassel
Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia 23298 0037, USA
J Palliat Med 13:761-7. 2010.... - Concrete options and ideas for increasing value in oncology care: the view from one trenchThomas J Smith
Massey Cancer Center, Virginia Commonwealth University Health System, Richmond, Virginia, USA
Oncologist 15:65-72. 2010..These actions will likely control costs, but in the short term will cause significant distress among patients, families, and health care practitioners... - Identifying supportive and unsupportive responses of others: perspectives of African American and Caucasian cancer patientsChristina M Grange
Department of Psychology, Virginia Commonwealth University VCU, 808 W Franklin St, Box 842018, Richmond, VA, 23284, USA
J Psychosoc Oncol 26:81-99. 2008.... - Organ donation after cardiac death from withdrawal of life support in patients with amyotrophic lateral sclerosisThomas J Smith
Palliative Care Program of Johns Hopkins Medicine, Baltimore, Maryland 21287, USA
J Palliat Med 15:16-9. 2012..We report DCD in two people with progressive amyotrophic lateral sclerosis (ALS)... - A pilot phase II trial of magnesium supplements to reduce menopausal hot flashes in breast cancer patientsHaeseong Park
Department of Internal Medicine Residency Program, Virginia Commonwealth University Health System, Richmond, VA, USA
Support Care Cancer 19:859-63. 2011..We tested if magnesium would diminish bothersome hot flashes in breast cancer patients... - Concentrating hospital-wide deaths in a palliative care unit: the effect on place of death and system-wide mortalityJ Brian Cassel
Oncology Service Line, Massey Cancer Center Virginia Commonwealth University, Virginia Commonwealth University Health System, Richmond, Virginia, USA
J Palliat Med 13:371-4. 2010..Observers were concerned that an active PCU would attract dying patients and worsen comparative mortality rates for Medicare and U.S. News & World Report comparisons... - Genetics assessment at the end of life: suggestions for implementation in clinic and future researchJohn Martin Quillin
Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia 23298 0033, USA
J Palliat Med 11:451-8. 2008..Once the patient has died, the chance to test or bank DNA for common inherited conditions such as breast cancer, colon cancer, cardiovascular disease, etc., is gone... - Improving palliative and supportive care in cancer patientsJames Khatcheressian
Division of Oncology and Palliative Care, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia 23298-0230, USA
Oncology (Williston Park) 19:1365-76; discussion 1377-8, 1381-2, 1384 passim. 2005..Finally, we suggest a practical plan for using symptom assessment scales, listing the problems, and managing them according to algorithms or other predetermined plans... - Tell it like it isThomas J Smith
Medical College of Virginia, Division of Hematology/Oncology, Department of Internal Medicine, PO Box 980230, Richmond, VA 23298-0230, USA
J Clin Oncol 21:12s-16s. 2003 - A high-volume specialist palliative care unit and team may reduce in-hospital end-of-life care costsThomas J Smith
Virginia Commonwealth University Massey Cancer Center, and Medical College of Virginia Hospitals, Richmond, Virginia 23298 0230, USA
J Palliat Med 6:699-705. 2003..Current end-of-life hospital care can be of poor quality and high cost. High volume and/or specialist care, and standardized care with clinical practice guidelines, has improved outcomes and costs in other areas of cancer care... - Pain management, including intrathecal pumpsThomas J Smith
Division of Hematology Oncology and Palliative Care, Massey Cancer Center of Virginia Commonwealth University, MCV Box 980230, Richmond, VA 23298 0230, USA
Curr Oncol Rep 6:291-6. 2004..Given multiple positive small cohort studies and a positive high-power randomized trial, IDDS should be considered as the best treatment for this population... - How to use implantable intrathecal drug delivery systems for refractory cancer painThomas J Smith
Division of Hematology/ Oncology and Palliative Care, Virginia Commonwealth University Health System, Richmond, Virginia 23298-0230, USA
J Support Oncol 1:73-6. 2003 - Use of an implantable drug delivery system for refractory chronic sickle cell painThomas J Smith
VCU Sickle Cell Anemia Program and Thomas Palliative Care Unit of Virginia Commonwealth University Medical Center, Richmond, VA, USA
Am J Hematol 78:153-4. 2005..IDDS may offer relief for sickle cell patients with refractory pain. A prospective trial with more participants is planned... - Fatal Loeffler's endocarditis due to hypereosinophilic syndromeBo H Chao
Department of Internal Medicine, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, USA
Am J Hematol 82:920-3. 2007..HES is a potentially fatal disease with less than 50% reported 10-year survival. This case presentation is unusual in its rapidly progressive course leading to sudden death... - Randomized clinical trial of an implantable drug delivery system compared with comprehensive medical management for refractory cancer pain: impact on pain, drug-related toxicity, and survivalThomas J Smith
Medical College of Virginia Campus of Virginia Commonwealth University, Richmond, VA 23298, USA
J Clin Oncol 20:4040-9. 2002..Implantable intrathecal drug delivery systems (IDDSs) have been used to manage refractory cancer pain, but there are no randomized clinical trial (RCT) data comparing them with comprehensive medical management (CMM)... - Using claims-based measures to predict performance status score in patients with lung cancerRamzi G Salloum
Center for Health Services Research, Henry Ford Health System, Detroit, Michigan, USA R01 CA 114204 03, USA
Cancer 117:1038-48. 2011..To the authors' knowledge, no attempts have been made to estimate PS using claims-based measures. The current study explored the ability to estimate PS using routinely available measures... - Epoprostenol use for pulmonary arterial hypertension in the palliative care settingColin P Wozencraft
Department of Internal Medicine, Division of General Medicine, Virginia Commonwealth University, Richmond, Virginia 23298, USA
J Palliat Med 15:619-22. 2012..We herein report our experience using epoprostenol in a dedicated palliative care unit and present our inpatient protocol for the drug's administration... - Allocating cancer-directed expenditures: tensions between prevention, early detection and treatment is unnecessaryBruce E Hillner
Department of Internal Medicine and the Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23298 0170, USA
Recent Results Cancer Res 188:1-9. 2011..Changing behaviors, incentives, expectations, and the framing of treatment effects are necessary to "bend" the current unrelenting cancer care cost curve... - Explaining marginal benefits to patients, when "marginal" means additional but not necessarily smallThomas J Smith
Division of Hematology Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
Clin Cancer Res 16:5981-6. 2010..These difficult conversations can be done if the oncologist has the right medical information, the right script, and some decision aids... - Clinical and financial impact of a palliative care program at a small rural hospitalJ Brian Cassel
Virginia Commonwealth University Massey Cancer Center, Richmond, Virginia, USA
J Palliat Med 13:1339-43. 2010..This study reports the clinical and financial impact of a new palliative care service at a 76-bed nonprofit hospital located in rural Virginia, Rappahannock General Hospital (RGH)... - Pilot trial of a patient-specific cutaneous electrostimulation device (MC5-A Calmare®) for chemotherapy-induced peripheral neuropathyThomas J Smith
Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
J Pain Symptom Manage 40:883-91. 2010..To date, there is no effective prevention or therapy. An evolving hypothesis for reducing CIPN pain involves direct nerve stimulation to reduce the pain impulse... - Implantable drug delivery systems (IDDS) after failure of comprehensive medical management (CMM) can palliate symptoms in the most refractory cancer pain patientsThomas J Smith
Thomas Palliative Care Unit, Division of Hematology Oncology and Palliative Care, Virginia Commonwealth University, MCV Box 980230, Richmond, VA 23298 0230, USA
J Palliat Med 8:736-42. 2005..The objective of this study was to evaluate whether IDDS could help the most refractory patients failed by expert CMM... - Why do patients choose chemotherapy near the end of life? A review of the perspective of those facing death from cancerRobin Matsuyama
Massey Cancer Center of Virginia Commonwealth University, Richmond, VA 23298 0230, USA
J Clin Oncol 24:3490-6. 2006..We sought to determine the available sources of knowledge, the choices, and concerns of actual patients, and how patients balanced competing issues... - Nonclinical outcomes of hospital-based palliative careKenneth R White
Graduate Program in Health Administration, Department of Health Administration, Virginia Commonwealth University, Richmond, Virginia, USA
J Healthc Manag 51:260-73; discussion 273-4. 2006..This study highlights the nonclinical outcomes of one institution's inpatient PCU and provides guidelines for healthcare executives and managers to use in making decisions about adopting such programs... - A case of inaccurate prognostication after the ARCTIC protocolChristina J Chen
Virginia Commonwealth University Massey Cancer Center, Richmond, Virginia, USA
J Pain Symptom Manage 43:1120-5. 2012.... - Cultural perceptions in cancer care among African-American and Caucasian patientsRobin K Matsuyama
Social and Behavioral Health, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23298 0149, USA
J Natl Med Assoc 99:1113-8. 2007..This exploratory study examined perceptions and beliefs of African Americans and Caucasians related to cancer care. Understanding belief systems and cultures optimizes cancer treatment and care delivery to ethnic minority individuals... - Dexmedetomidine: exploring its potential role and dosing guideline for its use in intractable pain in the palliative care settingPatrick J Coyne
Thomas Palliative Care Program, Virginia Commonwealth University Massey Cancer Center, Richmond, Virginia, USA
J Pain Palliat Care Pharmacother 24:384-6. 2010..The authors offer criteria to consider in utilizing this medication within the context of palliative care... - Intrathoracic malignant peripheral nerve sheath tumor in neurofibromatosis 1Bo H Chao
Department of Internal Medicine, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, USA
J Clin Oncol 26:2216-8. 2008 - Physicians' current practices and opportunities for DNA banking of dying patients with cancerJohn M Quillin
Department of Human and Molecular Genetics, Department of Social and Behavioral Health, and Department of Medicine, Massey Cancer Center, Commonwealth University, Richmond, VA
J Oncol Pract 7:183-7. 2011..This study explored the current practices and potential for DNA banking for cancer susceptibility among oncologists specializing in palliative care... - Difficult cases of pain and nonpain symptoms in intractable spinal infections: a case seriesMolly L Olsen
Department of Medicine, Mayo Clinic, Rochester, MN, USA
Am J Hosp Palliat Care 29:493-6. 2012..Furthermore, each case presented challenges regarding optimal medical management of somatic and neuropathic pain associated with the SI... - Historical estimation of diesel exhaust exposure in a cohort study of U.S. railroad workers and lung cancerFrancine Laden
Channing Laboratory, Department of Medicine, Brigham and Women s Hospital and Harvard Medical School, 181 Longwood Ave, Boston, MA 02115, USA
Cancer Causes Control 17:911-9. 2006..In conclusion, although precise historical estimates of exposure are not available, weighting factors helped better define the exposure-response relationship of diesel exhaust with lung cancer mortality... - American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant settingJames L Khatcheressian
Virginia Commonwealth University/Massey Cancer Center, Richmond, VA, USA
J Clin Oncol 24:5091-7. 2006..CONCLUSION: Careful history taking, physical examination, and regular mammography are recommended for appropriate detection of breast cancer recurrence... - Pain management, including intrathecal pumpsThomas J Smith
Division of Hematology Oncology and Palliative Care, Massey Cancer Center of Virginia Commonwealth University, MCV Box 980230, Richmond, VA 23298 0230, USA
Curr Pain Headache Rep 9:243-8. 2005..Given multiple positive small cohort studies and a positive high-power randomized trial, IDDS should be considered as the best treatment for this population... - Massive hydromorphone dose delivered subcutaneously instead of intrathecally: guidelines for prevention and management of opioid, local anesthetic, and clonidine overdosePatrick J Coyne
Virginia Commonwealth University Health System, School of Pharmacy, Richmond, Virginia 23298, USA
J Pain Symptom Manage 28:273-6. 2004..Counteracting an opioid with naloxone until the opioid is metabolized and excreted can be done safely. Inadvertent subcutaneous administration of other types of drugs could be more difficult to manage... - The health economics of palliative careS Kirk Payne
Palliative Care Service, Medical College of Virginia Hospitals and Massey Cancer Center, Virginia Commonwealth University, Richmond 23298-0230, USA
Oncology (Williston Park) 16:801-8; discussion 808, 811-2. 2002..One model is coordinated, expert, high-volume care that can prevent end-of-life hospitalization, with early use of advance directives. Preliminary data from our program support the hypothesis that costs may be reduced by 40% to 70%... - Nebulized fentanyl citrate improves patients' perception of breathing, respiratory rate, and oxygen saturation in dyspneaPatrick J Coyne
Palliative Care Services, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
J Pain Symptom Manage 23:157-60. 2002..This inexpensive and readily available treatment may offer substantial relief of end-of-life dyspnea. Randomized trials, dose, and length of effect trials are underway...