Context The current state of palliative care in cancer centers is not known. Objective We conducted a survey to determine the availability and degree of integration of palliative care services, and to compare between National Cancer Institute (NCI) and non-NCI cancer centers in the United States. Design, Setting, and Participants Between June and October 2009, we surveyed both executives and palliative care clinical program leaders, where applicable, of 71 NCI cancer centers and a random sample of 71 non-NCI centers regarding their palliative care services. Executives were also asked about their attitudes toward palliative care. Main Outcome Measure Availability of palliative care services in the cancer center, defined as the presence of at least one palliative care physician. Results We sent 142 and 120 surveys to executives and program leaders, with response rates of 71% and 82%, respectively. NCI cancer centers were significantly more likely to have a palliative care program (50/51 (98%) vs. 39/50 (78%), P=0.002), at least one palliative care physician (46/51 (90%) vs. 28/50 (56%), P=0.04), an inpatient palliative care consultation team (47/51 (92%) vs. 28/50 (56%), P<0.001), and an outpatient palliative care clinic (30/51 (59%) vs. 11/50 (22%), P<0.001). Few centers had dedicated palliative care beds (23/101 (23%)) or an institution-operated hospice (37/101 (36%)). The median reported durations from referral to death were 7 (Q1–Q3 4–16), 7 (Q1–Q3 5–10), and 90 (Q1–Q3 30–120) days for inpatient consultation teams, inpatient units, and outpatient clinics, respectively. Research programs, palliative care fellowships, and mandatory rotations for oncology fellows were uncommon. Executives were supportive of stronger integration and increasing palliative care resources. Conclusion Most cancer centers reported a palliative care program, although the scope of services and the degree of integration varied widely. Further efforts to consolidate existing infrastructure and to integrate palliative care in cancer centers are warranted.

Testing of prostate cancer biopsy specimens from metastatic sites for p53 protein accumulation and gene mutation may provide useful prognostic information and could influence the recommended course of treatment.

The current gold standard to estimate local and global specific energy absorption rate for MRI involves numerically modeling the patient and the transmit radiofrequency coil. Recently, a patient‐individual method was presented, which estimated specific energy absorption rate from individually measured B1 maps. This method, however, was restricted to quadrature volume coils due to difficulties distinguishing phase contributions from radiofrequency transmission and reception. In this study, a method separating these two phase contributions by comparing the electric conductivity reconstructed from different transmit channels of a parallel radiofrequency transmission system is presented. This enables specific energy absorption rate estimation not only for quadrature excitation but also for the nonquadrature excitation of the single elements of the transmit array. Though the contributions of the different phases are known, unknown magnetic field components and tissue boundary artifacts limit the technique. Nevertheless, the high agreement between simulated and experimental results found in this study is promising. B1‐based specific energy absorption rate determination might become possible for arbitrary radiofrequency excitation on a patient‐individual basis. Magn Reson Med, 2012. © 2012 Wiley Periodicals, Inc.

Acupuncture is an appropriate adjunctive treatment for chemotherapy-induced nausea/vomiting, but additional studies are needed. For other symptoms, efficacy remains undetermined owing to high ROB among studies. Future research should focus on standardizing comparison groups and treatment methods, be at least single-blinded, assess biologic mechanisms, have adequate statistical power, and involve multiple acupuncturists.