Palliative Care

Specialist palliative care access mediates socioeconomic gaps in end-of-life cancer care

In this Ontario cohort of 173,915 adults dying with cancer, material deprivation predicted worse end-of-life quality indicators. More deprived quintiles had lower odds of receiving systemic anticancer therapy and of dying at home, and higher odds of intensive health service use. Lack of specialised palliative care fully mediated the deprivation effect on high health service use, driven by emergency department visits. Lack of palliative care partially mediated lower systemic therapy use and fewer home deaths in deprived groups. Equitable, earlier referral to specialist palliative care may reduce emergency utilization and support preferred place of death in deprived populations. 1

AI in palliative oncology is mainly prognostic and clinician-facing, not patient-facing

This scoping review identified 199 studies deploying artificial intelligence in palliative and supportive cancer care. Most tools assisted clinicians with prediction tasks, including prognosis, symptom trajectories, and treatment-related adverse events. Machine learning on structured clinical data dominated; large language model applications were rare. Only 26 studies involved direct use by patients or caregivers, highlighting a major gap in patient-facing tools. The authors call for clinically integrated, ethically sound AI that advances person-centred palliative care rather than isolated prediction models. 2

‘Unmet palliative care needs’ is a heterogeneous construct with three main measurement approaches

This scoping review of 70 studies examined how unmet palliative care needs are defined and measured in adults with advanced illness. Only 11 studies explicitly defined ‘unmet palliative care needs’, revealing major conceptual inconsistency. Three main measurement strategies emerged: symptom/concern prevalence, access to services, and sufficiency of services in addressing problems. Choice of definition and measurement approach substantially alters estimates of unmet need and implied intervention targets. Clinicians and researchers should align their measurement strategy with the decision at hand, documenting definitions and limitations explicitly. 3

Microdose psilocybin appears feasible and safe for severe distress in advanced illness

This open-label, single-arm trial tested 3 weeks of daily oral microdose psilocybin (1–3 mg) in palliative patients with severe psychological distress. Of 20 enrolled patients with advanced, incurable illness, 17 started and 13 completed the intervention. No serious adverse events occurred; nine mild or moderate adverse events were reported. Among completers, most reported meaningful global improvement and substantial reductions in depression, anxiety, and demoralization scores. Findings suggest feasibility and potential efficacy, but lack of control group and small sample mandate cautious interpretation before routine use. 4