Svendsen, Molly K.

Survivors of human trafficking experience profound trauma with long-lasting psychological, physical, and social consequences that can complicate medical care, particularly in the context of serious illness. This case highlights the palliative care approach to a 38-year-old woman with metastatic cervical cancer and a history of trafficking-related trauma. The clinical team encountered nuanced challenges, including disrupted trust, limited social support, high symptom burden, and distress related to bodily autonomy. A trauma-informed, multidisciplinary team—comprised of palliative care, gynecological oncology, psychiatry, and social work—prioritized safety, choice, and trust-building to align care with the patient’s values and goals. Despite significant health inequities and psychosocial vulnerabilities, individualized care planning and intentional communication supported dignity, symptom control, and emotional safety during a prolonged hospitalization. This case illustrates the ethical and relational dimensions of caring for survivors of trafficking and underscores the importance of trauma-informed care principles, cultural humility, and interdisciplinary collaboration in palliative settings.

In this letter, the authors evaluate the potential of suzetrigine, a newly U.S. Food and Drug Administration-approved selective NaV1.8 sodium channel inhibitor, as a novel nonopioid alternative for managing moderate-to-severe pain. By targeting peripheral sensory neurons and avoiding the central nervous system, suzetrigine offers a favorable safety profile that bypasses typical opioid-related risks such as respiratory depression, sedation, and tolerance. While clinical trials demonstrate its noninferiority to hydrocodone/acetaminophen in acute postsurgical settings, the authors highlight significant barriers to its use in palliative and hospice care. These limitations include a lack of evidence in patients with serious illness, a current safety restriction of 14 days of use, and a high cost of approximately $15.50 per tablet. Consequently, while suzetrigine represents a significant pharmacological advancement, its current utility is likely limited to short-term acute pain crises until further data support its long-term application in serious illness management.