Journal of pain and symptom management
September 1, 2023
Benjamin R Lewis, Eric L Garland, Kevin Byrne et al.
60 citations
Psilocybin-assisted group therapy appears safe and feasible for treating depression in cancer patients. In an open-label pilot trial, twelve participants with a depressive disorder received one high-dose (25 mg) psilocybin session within a three-week group program. Depression scores on the HAM-D scale decreased substantially from an average of 21.5 at baseline to 10.09 at two weeks and 14.83 at six months. Six of twelve participants met remission criteria (HAM-D below 7) at two weeks, and no serious adverse events occurred. The group format may reduce therapist time while maintaining possible efficacy, warranting further study.
Journal of pain and symptom management
March 1, 2026
William B Alexander, Eric D Hansen, Brian T Anderson et al.
1 citation
Loss of meaning is a hallmark of demoralization syndrome, a prevalent condition in palliative care linked to diminished quality of life, increased symptom burden, and higher suicide risk. Existential psychological interventions improve psychosocial outcomes, but evidence for their effect on demoralization is limited. Psychedelic therapies, which enhance meaning-making and integrate existential approaches, show promise for existential distress and demoralization in early clinical trials. Novel combined pharmacological and psychological interventions like psychedelic therapy warrant further investigation.
Journal of pain and symptom management
January 3, 2026
Karolina L Bryl, Adam W Hanley, Raymond E Baser et al.
1 citation
Chronic pain is common among cancer survivors but often goes untreated. Existing treatments carry risks or offer limited relief, and non-drug options have shown only modest benefits. Mindfulness-Oriented Recovery Enhancement (MORE), an intervention that targets the neurocognitive mechanisms of chronic pain, has helped people without cancer but had not been tested in cancer survivors. This pilot trial enrolled 60 cancer survivors with moderate-to-severe pain (average age 60; 75% female) and randomly assigned them to one of three MORE formats (16, 8, or 2 hours) or a waitlist. MORE proved feasible, with high enrollment (71%) and assessment completion (91%), and acceptable, with high adherence and satisfaction.
Journal of pain and symptom management
August 1, 2026
Paul Noufi, Joshua B Borris, Danielle Chammas et al.
Ketamine and esketamine offer rapid antidepressant effects, with intravenous ketamine producing moderate-to-large improvements within 1–24 hours that last one to two weeks, and a number needed to treat of three in the first week. Esketamine nasal spray shows similar early efficacy and is FDA-approved for treatment-resistant depression and major depression with suicidal ideation. Evidence specific to people with serious illnesses is limited to perioperative cancer trials and small open-label studies, showing short-term reductions in depressive symptoms and suicidal ideation but not addressing long-term management. Safety is generally favorable, with transient dissociation, hypertension, and somnolence as common adverse effects. Rigorous psychiatric trials in serious illness are lacking.
Journal of pain and symptom management
August 1, 2026
Stefan Aguiar, Mary Makarious, Orly Lipsitz et al.
In adults with advanced cancer receiving palliative care, intranasal ketamine was associated with clinically meaningful improvements in existential distress, anxiety, symptom burden, and quality of life. Fifteen participants who completed three doses of ketamine showed improvements exceeding established minimal clinically important differences on measures of anxiety, death and dying distress, overall symptoms, and quality of life. Improvements in existential well-being were larger than those in physical symptoms. Changes in depression did not significantly correlate with changes in existential distress outcomes, suggesting ketamine may have independent effects on multiple dimensions of distress in this population.
Journal of pain and symptom management
September 1, 2019
Buddy Marterre
A composer and cognitive musicologist named Bruno, who integrated Taoism, Tibetan Buddhism, Zen, Christian mysticism, mathematics, and music into his life, experienced an exceptionally graceful dying process and death. His spirituality interconnected diverse faith traditions and philosophies, and his art forms of light and music moved and challenged many people. The author presents his story to encourage other healers in hospice and palliative care, noting that while some aspects of Bruno's transformation from being to nonbeing were obvious, others were inscrutable.