A single 20-minute session of mindful breathing significantly reduced pain intensity, pain unpleasantness, and anxiety in adult cancer inpatients with moderate to severe pain, compared with a supportive listening control group. The randomized controlled trial at the University of Malaya Medical Centre enrolled patients with a pain score of 4 or higher on a 10-point scale. The findings suggest that brief mindfulness exercises can be integrated into routine cancer care to provide rapid, holistic benefits for pain management.
A single 25 mg dose of psilocybin, combined with preparation and integration sessions, was safely administered to ten terminally ill home hospice patients. No serious adverse events occurred. Demoralization scores dropped by an average of 8.8 points three weeks after the session, despite patients' ongoing physical decline. Grief and peace themes were common during the drug sessions. Although most participants rated the treatment favorably, some found the emotional intensity challenging. The results suggest that psilocybin-assisted therapy can be feasibly and safely integrated into hospice care, but larger studies are needed to confirm its benefits.
A man with severe rectal tenesmus caused by rectal carcinoma, whose pain was difficult to manage due to adverse effects from several medications, experienced reduced pain after a seven-day continuous subcutaneous infusion of ketamine combined with midazolam and dexamethasone. His self-reported pain scores improved, and his opioid requirements decreased. This is the first reported use of ketamine for rectal tenesmus.
Psilocybin-assisted psychotherapy shows promise as a therapeutic option for palliative care, and further rigorous, interdisciplinary research is needed to ensure its implementation is grounded in anthropological and ethical considerations, extending its potential beyond oncology to other palliative settings.
Psychedelics may help address emotional and spiritual challenges in patients with life-limiting illnesses that conventional palliative care does not fully relieve. However, existing studies are limited by small sample sizes and low methodological quality, leaving their use in palliative settings poorly understood. The article outlines a research agenda calling for adequately powered randomized controlled trials with patient-centered outcome measures to inform policy and practice change.