... future bladder cancer research through the Patient Survey Network. Read More... Don’t Miss the 2016 BCAN ... Click here for more details Bladder Cancer Advocacy Network 4915 St. Elmo Avenue, Suite 202 Bethesda, Maryland ...
Hagan, Teresa L; Medberry, Elizabeth
A growing emphasis on patient self-advocacy has emerged in the public discourse on cancer survivorship. This discourse shapes patients' conceptualizations about self-advocacy and in turn influences their health care attitudes and behaviors. The purpose of this discourse analysis is to explore the language of self-advocacy by comparing a published self-advocacy guide with the lived experiences of women with ovarian cancer. Data sources include (1) a self-advocacy patient education guide published by the National Coalition for Cancer Survivorship and (2) transcripts of focus groups conducted with ovarian cancer survivors. Discourse analysis techniques were used to take a close look at the language used by both to uncover the meaning each group ascribed to self-advocacy. Challenges and inconsistencies were noted between the patient education guide and transcripts including viewing self-advocacy as a skill set to assert one's needs as opposed to a means by which to preserve a positive attitude and maintain a trusting relationship with health care providers, respectively. Some women saw themselves as self-advocates yet struggled to locate relevant health information and hesitated to upset their relationship with their health care providers. This analysis highlights tensions between the discourses and points to ways in which patient education materials can be adjusted to support cancer survivors in advocating for their needs according to their unique situations and preferences. PMID:25846573
Patient advocacy is based on the premise that people have the right to make their own choices about their health care. Personal advocacy is centred on the experiential expertise of the individual affected by the condition, whereas group advocacy is grounded on patient-centred strategies and actions. The first patient advocacy groups for arthritis were set up over 20 years ago in the USA and have subsequently spread to many other countries. This paper discusses the growth and impact of persona...
Maxwell, G Larry
Non-profit advocacy organizations have been important in raising public awareness, promoting education, and enhancing political activism for issues related to cancer. Grassroots efforts aimed at fund-raising have substantially augmented federal funding for community outreach and research. The objective of this review was to evaluate successful accomplishments of several major non-profit organizations that are focused on cancer. A review of news media, medical literature, and financial records (using GuideStar) was performed to access the organizational structure and productivity of several successful cancer advocacy organizations. Compared to other cancer advocacy groups, the American Cancer Society is the oldest (>100years old) and worth the most with net assets of over $1.25 billion dollars and an annual total revenue of over $900 million dollars. The ACS also has the highest overhead at 41%. Most of the gynecologic cancer advocacy groups are approximately 20years old and have collective total annual revenue of over $17M dollars. The Ovarian Cancer Research Fund has been the most successful at raising funds and building net assets to date while maintaining an overhead of higher overhead, spend less on total administration, spend more on fund-raising, have more events (rather than a limited number), and use aggressive social media strategies. PMID:26325529
There have been four key steps in the advent of breast cancer advocacy: priming the market, engaging consumers, establishing political advocacy, and taking the advocacy mainstream. Breast cancer was surrounded by secrecy until the 1980s, when brave individuals such as former First Ladies Betty Ford and Nancy Reagan, and founder of the Susan G. Komen Foundation, Nancy Brinker (Susan Komen's sister), began speaking publicly about the personal impact of the disease, which increased awareness of breast cancer and made it more acceptable to talk about it openly. At the same time, statistics about breast cancer were presented in new ways that the public could understand. Public health advocates played a key role in the second step, engaging consumers, when they established guidelines in the 1980s that encouraged women to perform breast self-examinations (BSEs) and have screening mammograms and clinical breast examinations (CBEs). Other events that helped engage consumers were increased media coverage of breast cancer issues, the founding of the Komen Race for the Cure in 1983, and the establishment of other programs that both educated the public and raised funds. Funds from these efforts enabled advocates to hold educational forums and produce educational materials in different media and tailored to different audiences and to become active in the funding of research. The third step, political action, became possible when breast cancer advocates joined together in the 1980s and 1990s to work toward legislative, regulatory, and funding changes, such as passage of the Mammography Quality Standards Act and increased funding for the National Cancer Institute. These efforts contributed to a more than quadrupling of federal funding for breast cancer research in the 1990s. Going mainstream, the final step in the advocacy process, entailed establishing a solid base of support to ensure that the message about breast cancer stays strong and fresh. This has been achieved by engaging
Odedina, Folakemi T; Asante-Shongwe, Kwanele; Kandusi, Emmanuel J; Segal, Richard; Pressey, Shannon; Reams, R Renee; Simons, Virgil H
Although there is significant evidence of a cancer epidemic in Africa, there is limited awareness about cancer in most African countries. By partnering with international organizations and institutions such as the University of Florida and the Prostate Net, the African Organisation for Research and Training in Cancer (AORTIC) is committed to improving cancer advocacy in Africa. This paper presents some of the recent efforts on cancer advocacy in Africa, including the results of a SWOT analysis conducted for the cancer advocacy workshop and the guidelines developed by cancer advocates on best practices for cancer advocacy in Africa. One of the outcomes of these efforts is the African Cancer Advocates Consortium (ACAC) founded by cancer advocates in Africa to, "Make Cancer a Top Priority in Africa". While we have started the work to strengthen cancer advocacy in Africa, we still have a long way to go. Our goal of making cancer a priority in Africa can mainly be achieved by: (1) increasing the manpower for cancer advocacy through education and training; and (2) strengthening the network of cancer advocates across the continent. PMID:23902674
Odedina, Folakemi T; Rodrigues, Belmira
In this paper, we present six case studies describing innovative cancer advocacy programs in Africa. For each case study, an example of an advocacy activity, list of factors contributing to the success of the organization, and an example of an obstacle addressed by the organization are described.
Mohadeseh Motamed-Jahromi; Abbas Abbaszadeh; Fariba Borhani; Homa Zaher
Patient advocacy is an inherent component of professional nursing ethics; in other words, nurses' enough knowledge would be essential to gain a positive attitude towards nursing advocacy. Using a descriptive-analytic design, this study aimed to assess the correlation between nurses' perception and attitudes towards patient advocacy, amongst 385 nurses in Kerman, Iran; hence, a three-part questionnaire was applied: part I, a demographic data sheet, part II, attitude measuring instrument, and p...
Motamed-Jahromi, Mohadeseh; Abbaszadeh, Abbas; Borhani, Fariba; Zaher, Homa
Patient advocacy is an inherent component of professional nursing ethics; in other words, nurses' enough knowledge would be essential to gain a positive attitude towards nursing advocacy. Using a descriptive-analytic design, this study aimed to assess the correlation between nurses' perception and attitudes towards patient advocacy, amongst 385 nurses in Kerman, Iran; hence, a three-part questionnaire was applied: part I, a demographic data sheet, part II, attitude measuring instrument, and part III, perception measuring instrument in nursing advocacy. The results implied that fairly positive attitudes and perception were found amongst the participants, and nurses' attitudes, in general, were positively correlated to their perception toward nursing advocacy. This means that with an improvement in perception, the attitude would also improve. In addition to our findings, it seems that these nurses needed more advocacy educational programs and support from responsible employers. PMID:23326680
Building a Latin American cancer patient advocacy movement: Latin American cancer NGO regional overview Desarrollando un movimiento de apoyo para pacientes de cáncer en America Latina: resumen regional - ONGs de cáncer
Full Text Available The objective of the this paper is to assess and identify the key strengths and weaknesses for cancer control NGOs in Latin America, with the goal to make recommendations about how to improve thev impact of the patient advocacy movement as it pertains to cancer. The methods included literature review, expert interviews and site visits to Latin American cancer hospitals and NGOs. The overall findings conclude that NGOs currently do not take a leadership role in cancer control in Latin America. The lack of a survivorship movement, faulty patient information services and failure of the governments to include NGOs in policy creation are identified as areas for further project work and collaboration. The stigma of cancer still remains and a burgeoning patient movement can be created to help destigmatize and debunk the myths that surround cancer.El objetivo de este artículo es el de identificar y evaluar las fortalezas y debilidades clave de las ONG dedicadas al control del cáncer en Latinoamérica, con el fin de generar recomendaciones sobre el modo de mejorar el impacto del movimiento de apoyo para pacientes de cáncer. Los métodos incluyeron una revisión de la literatura, entrevistas a expertos y visitas a hospiptales y ONG dedicados al cáncer en Latinoamérica. Los hallazgos principales permiten concluir que en este momento las ONG no tienen un rol de liderazgo para el control del cáncer en Latinoamérica. La ausencia de un movimiento de sobrevivientes, servicios de información deficientes a los pacientes y el fracaso del gobierno para incluir a las ONG en la creación de políticas se identifican como áreas de trabajo y colaboración en proyectos a futuro. El estigma del cáncer aún subsiste y es factible crear un movimiento que florezca y ayude a desvanecerlo al exponer los mitos que rodean este padecimiento.
Full Text Available With an increasing number of corporate hospitals, healthcare related issues, research trials and undue attention by media in India, there is a need to focus more on patient′s rights and protection. In India, multiple agencies like regulatory bodies, scientific review committees, ethics committees, NGOs, etc. work toward patient rights and protection. However, these agencies are inadequate to cater to the general issues related to patient′s rights. There′s a need to have a separate group of people who provide advocacy to the patient, or simply, a patient advocacy group which will work explicitly in these areas to increase transparency and credibility of healthcare system in India. This group will provide special attention to patient care and protection of rights from the planning stage rather than at the troubleshooting stage.
Reams, R Renee; Odedina, Folakemi T; Pressey, Shannon
To address the need for a significant increase in cancer advocacy programs in Africa, the University of Florida (UF), the Prostate Net, and the African Organization for Research and Training in Cancer (AORTIC) co-hosted the first biennial International Workshop on Cancer Advocacy for African Countries (CAAC) on November 29, 2011, one-day prior to AORTIC’s 8th International Cancer Conference in Cairo, Egypt. Over 70 African cancer advocates representing about 12 African countries participated ...
Collins, Charlotte W; Moore, Nuala S
Health professionals can and should be game-changing influencers of U.S. health policies. The American Thoracic Society (ATS) is enabling its members to advocate on important issues through such initiatives as the Breathing Better Alliance network and the annual ATS Hill Day. Patients are also organizing to make their voices heard by participating in the member organizations of the ATS Public Advisory Roundtable and by accompanying ATS members and staff on visits to legislators and government regulators. If we join together, we can amplify our messages and promote better health policies. Doing so will require us to embrace a partnership steeped in trust and hope. PMID:24575996
Jason, Leonard A
In this article, the various players are delineated in a story of a contested illness and patient advocacy, played out within the corridors of federal power. It is suggested that the mistreatment and negative attitudes that health care providers and others have towards those with chronic fatigue syndrome (CFS) is possibly due to the social construction of this illness as being a "Yuppie flu" disease. Institutional factors are identified that created these norms and attributions, as well as the multiple stakeholders and constituent groups invested in exerting pressure on policy makers to effect systemic change. This article also provides examples of how the field of Community Psychology, which is fundamentally committed to/based on listening to and giving voice to patients, is broadly relevant to patient activism communities. This approach focused, over time, on epidemiological studies, the name, the case definition, and ultimately the change in CFS leadership at the Centers for Disease Control and Prevention. Keys to this "small wins" approach were coalition building, use of "oppositional experts" (professionals in the scientific community who support patient advocacy goals) to challenge federal research, and taking advantage of developing events/shifts in power. Ultimately, this approach can result in significant scientific and policy gains, and changes in medical and public perception of an illness. PMID:21858612
... HUMAN SERVICES Food and Drug Administration Food and Drug Administration Rare Disease Patient Advocacy Day; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. The Food and Drug... Disease Patient Advocacy Day. This meeting is intended to enhance the awareness of the rare...
... Health Disparities and Cancer For Patient Advocates Public Policy Advocacy Cancer Awareness Dates Survivorship Blog About Us You ... Health Disparities and Cancer For Patient Advocates Public Policy Advocacy Cancer Awareness Dates Cancer.Net provides timely, comprehensive, ...
Jamila Geri Tomaschewski Barlem
Full Text Available AbstractOBJECTIVEAnalyzing beliefs and actions of nurses in exercising patient advocacy in a hospital context.METHODA quantitative cross-sectional exploratory and descriptive study, conducted with 153 nurses from two hospitals in southern Brazil, one public and one philanthropic, by applying Protective Nursing Advocacy Scale - Brazilian version. Data were analyzed using descriptive statistics and analysis of variance.RESULTSNurses believe they are advocating for patients in their workplaces, and agree that they should advocate, especially when vulnerable patients need their protection. Personal values and professional skills have been identified as major sources of support for the practice of advocacy.CONCLUSIONNurses do not disagree nor agree that advocating for patients in their working environments can bring them negative consequences. It is necessary to recognize how the characteristics of public and private institutions have helped or not helped in exercising patient advocacy by nurses.
Sulik, Gayle; Zierkiewicz, Edyta
The United States breast cancer movement helped to transform breast cancer’s social and medical landscape domestically and, in some ways, internationally. However, differences in gender identities, power relations, and the role of feminism(s) cross‐culturally also shaped breast cancer advocacy itself. After giving a brief introduction to the socio‐historical context of the U.S. and Polish breast cancer movements, this article illuminates some of the linkages and divergences bet...
Brazg, Tracy; Lindhorst, Taryn; Dudzinski, Denise; Wilfond, Benjamin
The idea of patient advocacy as a function of clinical ethics consultation (CEC) has been debated in the bioethics literature. In particular, opinion is divided as to whether patient advocacy inherently is in conflict with the other duties of the ethics consultant, especially that of impartial mediator. The debate is complicated, however, because patient advocacy is not uniformly conceptualized. This article examines two literatures that are crucial to understanding patient advocacy in the context of bioethical deliberations: the CEC literature and the literature on advocacy in the social work profession. A review of this literature identifies four distinct approaches to patient advocacy that are relevant to CEC: (1) the best interest approach, (2) the patient rights approach, (3) the representational approach, and (4) the empowerment approach. After providing a clearer understanding of the varied meanings of patient advocacy in the context of CEC, we assert that patient advocacy is not inherently inconsistent with the function of the ethics consultant and the CEC process. Finally, we provide a framework to help consultants determine if they should adopt an advocacy role. PMID:27333067
... Management Education & Events Advocacy For Patients About ACOG Cancer of the Uterus [Endometrial Cancer] Home For Patients Search FAQs Cancer of the ... Uterus [Endometrial Cancer] FAQ097, May 2011 PDF Format Cancer of the Uterus [Endometrial Cancer] Gynecologic Problems What ...
Brashers, Dale E.; Haas, Stephen M.; Klingle, Renee S.; Neidig, Judith L.
Describes parallel persuasive processes between social or political activism and personal self-advocacy in a study of AIDS activism and communication patterns between people with HIV or AIDS and health care personnel. Encourages greater patient education about the illness and treatment options. Promotes a more assertive stance toward health care,…
Ksenia P Koon
Full Text Available Breast cancer is a significant health burden worldwide. In the United States, the Breast Cancer Advocacy Movement has increased awareness, enhanced dialogue, and provided significant funding opportunities that previously did not exist. Various advocacy programs are beginning to emerge in developing countries in response to the increasing impact breast cancer is having in these regions of the world. This paper discusses the influence of the Breast Cancer Advocacy Movement in the US and proposes a format for working in conjunction with medical experts, political leaders and patient advocates to stimulate discussion and encourage sustainable outcomes in breast cancer internationally.El cáncer de mama es una carga significativa de salud en el mundo. En Estados Unidos, el Movimiento de Abogacía para el Control del Cáncer de Mama ha hecho conciencia, mejorado el diálogo y provisto de oportunidades de financiamiento antes inexistentes. En los países en desarrollo, están emergiendo programas para el combate del cáncer de mama en respuesta al impacto creciente de la enfermedad en estas regiones. Este artículo aborda la influencia del movimiento en Estados Unidos y propone un formato para trabajar en conjunto con expertos en medicina, líderes políticos y defensores de pacientes y estimular la discusión y promoción de resultados sostenibles internacionalmente en cuanto al cáncer de mama.
... Management Education & Events Advocacy For Patients About ACOG Ovarian Cancer Home For Patients Search FAQs Ovarian Cancer ... Spanish Ovarian Cancer FAQ096, April 2015 PDF Format Ovarian Cancer Gynecologic Problems What is cancer? What is ...
Full Text Available Background: Advances in science and technology and the changes in lifestyle have changed the concept of health in terms of etiology and mortality. The aim of this study was to test the psychometric properties of the original Patient Self-Advocacy Scale for use with an Iranian population. Methods: In the current study, 50 chronic patients between the ages of 25 and 75 were selected as samples. This study was conducted in May 2013 at Bou Ali Sina Hospital in Sari. The translation process and cultural adaptation of the Patient Self-Advocacy Scale were conducted. The face validity and content validity of the instrument were formally verified by analyzing the feedback of patients and health professionals. In order to evaluate questionnaire’s reliability, the intraclass correlation coefficient (ICC was calculated for each item and each domain; and the Cronbach’s alpha was calculated for the entire instruments and each domain. Results: Of the 50 patients participating in the study, 36% were male and 64% were female. The mean age of the patients was 42.5. To comply with the Iranian culture and the study target population, slight changes were applied to the process of translation and validation. In the present study, intraclass correlation coefficient for each item was 0.8-1, which demonstrates excellent reliability of the questionnaire. The Cronbach’s alpha value was 0.75 for overall scale. Conclusion: The Persian version of Patient Self-Advocacy Scale was valid and reliable. Hence, it can be used by public health researchers and health system policy makers for programming and offering patient-oriented health services based on patients’ comments, needs, and preferences.
Henson, Lily Jung; May, Eugene F.
Over the past decade, neurology advocacy has caught the attention of neurologists feeling increasingly frustrated about the health care environment in which they practice. We describe our experience in practicing advocacy at the national and local levels. Neurologists can participate in many levels of advocacy to benefit their patients and their profession.
Jonikas, Jessica A; Grey, Dennis D; Copeland, Mary Ellen; Razzano, Lisa A; Hamilton, Marie M; Floyd, Carol Bailey; Hudson, Walter B; Cook, Judith A
A fundamental aspect of successful illness self-management for people with serious mental illnesses is the ability to advocate for themselves in health and rehabilitation settings. This study reports findings from a randomized controlled trial comparing propensity for patient self-advocacy among those who received a peer-led mental illness self-management intervention called Wellness Recovery Action Planning (WRAP) and those who received usual care. Outcomes were self-reported engagement in self-advocacy with service providers, and the relationship between patient self-advocacy and other key recovery outcomes. In a multivariable analysis, at immediate post-intervention and 6-month follow-up, WRAP participants were significantly more likely than controls to report engaging in self-advocacy with their service providers. Higher self-advocacy also was associated with greater hopefulness, better environmental quality of life, and fewer psychiatric symptoms among the intervention group. These findings provide additional support for the positive impact of peer-led illness self-management on mental health recovery. PMID:22167660
In life-threatening conditions such as cancer and rare diseases, where there is no cure and no U.S. Food and Drug Administration (FDA)-approved therapy, patients sometimes seek access to an unapproved, experimental therapy through expanded access programs as their last, best hope for treatment to save their lives. Since the 1980s, the policies and the practice of expanded access have evolved, but a common challenge remains that there is no obligation, and often little incentive, for manufacturers to offer expanded access programs, especially for individual patients. In recent years, online campaigns seeking access to an experimental therapy have become more common, paralleling growth in and representing an intersection of social media, digital health, and patient advocacy.Mackey and Schoenfeld have examined the evolution of expanded access policy, practice, and trends, as well as case studies of online campaigns to access experimental therapies, to arrive at several recommendations for the future of expanded access. This commentary puts their paper in context, examines their recommendations, and suggests further reforms.Please see related article: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0568-8. PMID:26926908
Dowd, Karen J.; Curva, Fely
Most state professional associations promote and fund at some level, an advocacy program. These advocacy programs usually aim to support or plead for a program, policy, or proposal. They can range from simple communication to complex strategies, from daily interactions to annual productions, and from position papers to onsite, legislative visits.…
This paper is about the issue of advocacy. Standing at the vanguard of literacy, library media specialists have a unique role. However, it is time for media specialists to advocate their services in a proactive way. If library media specialists cannot, both individually and collectively, put advocacy at the forefront, then students will suffer the…
Advocacy is a continuous process that involves more than simply passing legislation. It is a year-round commitment that involves educating policymakers about the importance of achieving health and wellness in any state. As such, it is important for the advocacy group to have a plan, be organized, and work together toward a unified goal. Success is…
Wilhere, George F
Policy advocacy is an issue regularly debated among conservation scientists. These debates have focused on intentional policy advocacy by scientists, but advocacy can also be unintentional. I define inadvertent policy advocacy as the act of unintentionally expressing personal policy preferences or ethical judgments in a way that is nearly indistinguishable from scientific judgments. A scientist may be well intentioned and intellectually honest but still inadvertently engage in policy advocacy. There are two ways to inadvertently engage in policy advocacy. First, a scientist expresses an opinion that she or he believes is a scientific judgment but it is actually an ethical judgment or personal policy preference. Second, a scientist expresses an opinion that he or she knows is an ethical judgment or personal policy preference but inadvertently fails to effectively communicate the nature of the opinion to policy makers or the public. I illustrate inadvertent advocacy with three examples: recovery criteria in recovery plans for species listed under the U.S. Endangered Species Act, a scientific peer review of a recovery plan for the Northern Spotted Owl (Strix occidentalis caurina), and the International Union for Conservation of Nature's definition of threatened. In each example, scientists expressed ethical judgments or policy preferences, but their value judgments were not identified as such, and, hence, their value judgments were opaque to policy makers and the public. Circumstances suggest their advocacy was inadvertent. I believe conservation scientists must become acutely aware of the line between science and policy and avoid inadvertent policy advocacy because it is professional negligence, erodes trust in scientists and science, and perpetuates an ethical vacuum that undermines the rational political discourse necessary for the evolution of society's values. The principal remedy for inadvertent advocacy is education of conservation scientists in an effort to
Rakhshanda Layeequr Rahman
Full Text Available Women who are at high risk of breast cancer can be offered chemoprevention. Chemoprevention strategies have expanded over the past decade and include selective receptor modulator inhibitors and aromatase inhibitors. Physicians are expected to provide individualized risk assessments to identify high risk women who may be eligible for chemoprevention. It is prudent that physicians utilize a shared decision approach when counseling high risk women about their preventive options. Barriers and misperceptions however exist with patient and physician acceptance of chemoprevention and continue to impede uptake of chemoprevention as a strategy to reduce breast cancer risk. Programs to increase awareness and elucidate the barriers are critical for women to engage in cancer prevention and promote chemoprevention adherence.
Full Text Available It is not enough to consider treatment and care depression in the oncology that is the most common psychiatric illness in cancer patient affects of cancer treatment and the patient`s quality of life negatively, which is determined through researches in the field. With development of psycho-oncology it has been demonstrated to establish an important link between the cancer patient`s treatment as well as psycho-social support for the patient and psychiatric treatment and care for the if it is needed. With this connection between them it has been proposed to use of bio-psycho-social-model in cancer patient to improve their care. To achieve this goal, it is expected from medical personnel to realize patients psychosocial need und if he/she has a psychiatric disorders or syndromes. For the medical personnel that work in oncology services, it is inevitable to organize in order to raise the awareness of depression in the cancer patients. In the present study, it is focused on raising the awareness of depression in cancer patient for the medical personnel. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 186-198
Son, Yu Ri; Choi, Kyoung Hyo; Kim, Tae Gyun
Objective To identify risk factors for dysphagia in tongue cancer patients. Dysphagia is a common complication of surgery, radiotherapy, and chemotherapy in tongue cancer patients. Previous studies have attempted to identify risk factors for dysphagia in patients with head and neck cancer, but no studies have focused specifically on tongue cancer patients. Methods This study was conducted on 133 patients who were diagnosed with tongue cancer and who underwent a videofluoroscopy swallowing stu...
Thulasiraj D Ravilla
Full Text Available The effectiveness of eye care service delivery is often dependant on how the different stakeholders are aligned. These stakeholders range from the ministries of health who have the capacity to grant government subsidies for eye care, down to the primary healthcare workers who can be enrolled to screen for basic eye diseases. Advocacy is a tool that can help service providers draw the attention of key stakeholders to a particular area of concern. By enlisting the support, endorsement and participation of a wider circle of players, advocacy can help to improve the penetration and effectiveness of the services provided. There are several factors in the external environmental that influence the eye care services - such as the availability of trained manpower, supply of eye care consumables, government rules and regulations. There are several instances where successful advocacy has helped to create an enabling environment for eye care service delivery. Providing eye care services in developing countries requires the support - either for direct patient care or for support services such as producing trained manpower or for research and dissemination. Such support, in the form of financial or other resources, can be garnered through advocacy.
Pandey M; Thomas B
With the developments in cancer treatment, more and more patients are surviving their disease. However, very little emphasis is being placed to rehabilitate these cancer survivors. Ignorance, social structure, stigma attached in seeking psychological help, and poor communication skills of oncology staff all contribute to poor rehabilitative efforts. The priority of governmental agencies and health efforts to fight rampant communicable diseases, malnutrition, maternal health, and the frequent ...
O'Donnell, Joseph F
Insomnia affects up to 50% of patients with cancer, but has received little attention from the oncology community compared with other symptoms such as pain and fatigue. Insomnia and subsequent sleep disturbances can lead to fatigue, mood disturbances, and contribute to immunosuppression, which can have a profound impact on quality of life and perhaps affect the course of disease. Insomnia in cancer patients must be distinguished from cancer-related fatigue. Although they are 2 distinct conditions, insomnia and fatigue are interrelated. Insomnia often leads to daytime fatigue that interferes with normal functioning. Conversely, daytime fatigue can lead to behaviors such as napping, which result in insomnia. The primary goal of insomnia treatment should first be to relieve any underlying disorder (eg, cancer pain, depression, anxiety) that may be causing the sleep disturbance. Because insomnia in this patient population may be due to a variety of causes, treatment must be multimodal and include both pharmacologic and nonpharmacologic therapies. A plan that combines attention to sleep hygiene and cognitive-behavioral therapy with prescription of hypnotic medications can help relieve the symptoms of insomnia in cancer patients and improve their quality of life. PMID:15675652
Full Text Available Abstract Background Screening tests for cervical cancer are effective in reducing the disease burden. In Thailand, a Pap smear program has been implemented throughout the country for 40 years. In 2008 the Ministry of Public Health (MoPH unexpectedly decided to scale up the coverage of free cervical cancer screening services, to meet an ambitious target. This study analyzes the processes and factors that drove this policy innovation in the area of cervical cancer control in Thailand. Methods In-depth interviews with key policy actors and review of relevant documents were conducted in 2009. Data analysis was guided by a framework, developed on public policy models and existing literature on scaling-up health care interventions. Results Between 2006 and 2008 international organizations and the vaccine industry advocated the introduction of Human Papillomavirus (HPV vaccine for the primary prevention of cervical cancer. Meanwhile, a local study suggested that the vaccine was considerably less cost-effective than cervical cancer screening in the Thai context. Then, from August to December 2008, the MoPH carried out a campaign to expand the coverage of its cervical cancer screening program, targeting one million women. The study reveals that several factors were influential in focusing the attention of policymakers on strengthening the screening services. These included the high burden of cervical cancer in Thailand, the launch of the HPV vaccine onto the global and domestic markets, the country’s political instability, and the dissemination of scientific evidence regarding the appropriateness of different options for cervical cancer prevention. Influenced by the country’s political crisis, the MoPH’s campaign was devised in a very short time. In the view of the responsible health officials, the campaign was not successful and indeed, did not achieve its ambitious target. Conclusion The Thai case study suggests that the political crisis was a
Hall, P.; Holm, L E; Lundell, G.; Bjelkengren, G.; Larsson, L. G.; Lindberg, S.; Tennvall, J.; Wicklund, H.; Boice, J. D.
Cancer risks were studied in 834 thyroid cancer patients given 131I (4,551 MBq, average) and in 1,121 patients treated by other means in Sweden between 1950 and 1975. Record-linkage with the Swedish Cancer Register identified 99 new cancers more than 2 years after 131I therapy [standardised incidence ratio (SIR) = 1.43; 95% confidence interval (CI) 1.17-1.75] vs 122 (SIR = 1.19; 95% CI 0.88-1.42) in patients not receiving 131I. In females treated with 131I overall SIR was 1.45 (95% CI 1.14-1....
Dintinjana, Renata Dobrila; Redžović, Arnela; Čubranić, Aleksandar; Dintinjana, Marin; Vanis, Nenad
Cachexia is defi ned as an unintended loss of stable weight exceeding 10%. Patients with advanced cachexia express anorexia, early satiety, severe weight loss, weakness, anemia, and edema. Anorexia represents the result of a failure of the usual appetite signals whereas cachexia is the debilitating state of involuntary weight loss. This syndrome, referred to as the »cancer anorexia-cachexia syndrome« (CACS) and usually consists of a combination of anorexia, tissue wasting, malnutr...
Mehmet Fuat Eren
Full Text Available Venous thromboembolism (VTE is a major complication of cancer and represents an important cause of morbidity and mortality. The incidence of VTE is 0.6-7.8% in patients with cancer more than double the incidence of VTE in patients without cancer. The risk of VTE which includes deep venous thrombosis (DVT and pulmonary embolism (PE is increased two to seven fold in patients with cancer. VTE risk is especially high among certain groups such as hospitalized patients with cancer and those receiving active antineoplastic therapy. Also cancer patients, who undergoing major surgery, are increased risk of VTE. Trauma, long-haul travel, increased age, obesity, previous VTE and genetic component are also predisposing factors for VTE. Patients with cancer who develop VTE should be managed multidisciplinary treatment guidelines. The primary goal of thromboprophylaxis in patients with cancer is to prevent VTE. The large majority of cancer patients should be treated with therapeutic doses of unfractioned heparin (UFH or low molecular weight heparin (LMWH. Prophylaxis should include cancer patients who underwent major surgery for cancer and patients with a history of VTE.
The concept of the nurse as the patient's advocate is one that has become popular in the last fifteen years or so in both North America and the United Kingdom, having its basis in nursing theory. The UKCC first embraced the concept, stating in the Code of Professional Conduct that nurses must; 'act always in such a manner so as to promote and safeguard the interests and well being of patients and clients'. This is a laudable principle and one that nurses cannot dispute as there are many members of our society who are weak and vulnerable and may be unable to speak up for themselves. But are nurses always in a position to be an advocate for their patients? As the nature of nursing is so diverse then the nature of advocacy will be different in the multifarious settings in which nurses practise. Can theatre nurses ever be in a position to act as an advocate for a patient who is often anaesthetised? What precisely is advocacy and is the Concise Oxford Dictionary definition of 'one who pleads for another' appropriate in the nursing context? Then there is the position of nurses in the healthcare organisation in which they practise. In advocating for their patients, nurses may find they are pleading a case for a patient, or a group of patients, that could bring the nurse into conflict with their medical colleagues or with the management of the organisation by whom they are employed. Additionally, they may not posses the skills and knowledge to advocate effectively under such circumstances. Nursing is littered with the casualties of such conflicts over the years, the most publicised of whom, in the UK, was probably Graham Pink who lost his job as a charge nurse after drawing public attention to what he considered to be an unacceptable standard of care in the hospital in which he worked. PMID:8974516
The inevitable need for rationing of healthcare has apparently presented the medical profession with the dilemma of choosing the lesser of two evils. Physicians appear to be obliged to adopt either an implausible version of traditional professional ethics or an equally problematic ethics of bedside...... I shall argue that this dilemma is false, since a third intermediate alternative exists. This alternative, which I term 'administrative gatekeeping', makes it possible for physicians to be involved in rationing while at the same time being genuine advocates of their patients. According to this ideal......, physicians are required to follow fair rules of rationing adopted at higher organizational levels within healthcare systems. At the same time, however, they are prohibited from including considerations of cost in their clinical decisions....
Psychodynamic psychotherapy is effective as an approach to understanding the psychological conflicts and the psychiatric symptoms of cancer patients as well as to planning useful psychological interventions. The author recommends that the psychotherapist who treats cancer patients be familiar with the following: 1) the natural course and treatment of the illness, 2) a flexible approach in accord with the medical status of the patient, 3) a common sense approach to defenses, 4) a concern with ...
S P Sawant
Full Text Available Aims and Objectives: Pulmonary embolism (PE is rare in the Indian population and is under-reported in patients with malignancy. We studied the clinical profile and outcome of patients with PE and cancer in the Indian population. Materials and Methods: Data of cancer patients with PE, admitted in a tertiary cancer centre, was analyzed. The prevalence of PE was calculated as the number of patients with PE per 10,000 hospital admissions. The demographic data, details of cancer, co-morbidities, details of PE, and treatment given for PE and their outcomes were recorded and analyzed. Results: There were 56,425 hospital admissions in the study period. The prevalence of PE was 6.4 per 10,000 hospital admissions .Thirty-six cancer patients were diagnosed to have PE. In females, gynecological malignancies (36.84% and in males gastrointestinal, head and neck cancers, and hematological malignancies were the most common sites (17.7% each. PE was associated with DVT in 41.7%. Dyspnea was the most common presenting symptom. Five patients (13.88% were asymptomatic and were incidentally detected to have PE . The most common echocardiographic finding was right ventricular dysfunction (55.55%. Mortality among the treated patients was 22% (7 / 31 and in untreated patients it was 80% (4 / 5. The factors that had an impact on a three-month survival were, the presence of massive PE (P = 0.019 and the presence of RV dysfunction at presentation (P = 0.005. Conclusion: The prevalence of PE and mortality due to PE is high in cancer patients. Risk stratification for venous thromboembolism (VTE should be done in all cancer patients and thromboprophylaxis should be optimally used.
Daniela de Araújo Lamino
Full Text Available Cross-sectional study, carried out at the outpatient clinic of an oncology hospital. Data were collected from 88 caregivers of cancer patients using the Caregiver General Comfort Questionnaire (GCQ to assess the caregivers’ comfort. The caregivers’ GCQ score mean was 203.9; better comfort scores was associated with age, care time and current occupation; positive aspects of comfort were related to the fact that caregivers felt loved, to patients’ physical and environmental comfort and to caregivers’ spirituality. 203.9; better comfort scores were associated with age of the caregiver and current occupation; positive aspects of comfort were related to the fact that caregivers felt loved, to patients’ physical and environmental comfort and to caregivers’ spirituality. Caregivers, who didn’t have a paid job or leisure’s activities showed a worse GCQ. The GCQ scale can help to identify factors that interfere in caregivers’ comfort, as well as needs that can be modified through health professionals’ interventions.
Although weight loss is a frequent, though not invariable, component of the cancer syndrome, the associated malnutrition is a poor prognostic sign among both children and adults. This article describes the possible mechanisms of cancer cachexia; reviews the present state of nutritional support in cancer patients; identifies nutritional problems and workable approaches during the pre- and post-treatment periods; discusses the unconventional nutritional practices commonly encountered and lists ...
Coleman, R; Body, J J; Aapro, M;
There are three distinct areas of cancer management that make bone health in cancer patients of increasing clinical importance. First, bone metastases are common in many solid tumours, notably those arising from the breast, prostate and lung, as well as multiple myeloma, and may cause major...... morbidity including fractures, severe pain, nerve compression and hypercalcaemia. Through optimum multidisciplinary management of patients with bone metastases, including the use of bone-targeted treatments such as potent bisphosphonates or denosumab, it has been possible to transform the course of advanced...... cancer for many patients resulting in a major reduction in skeletal complications, reduced bone pain and improved quality of life. Secondly, many of the treatments we use to treat cancer patients have effects on reproductive hormones, which are critical for the maintenance of normal bone remodelling...
... site. Top of Page Preventing fungal infections in cancer patients Fungi are difficult to avoid because they are a natural part of the environment. Fungi live outdoors in soil, on plants, trees, and other vegetation. They are also on ...
Burney, Basil O.; Garcia, Jose M.
Prevalence of hypogonadism in men with cancer has been reported between 40% and 90%, which is significantly higher than in the general population. Hypogonadism is likely to affect the quality of life in these patients by contributing to non-specific symptoms, including decreased energy, anorexia, sarcopenia, weight loss, depression, insomnia, fatigue, weakness, and sexual dysfunction. Pathogenesis of hypogonadism in cancer patients is thought to be multi-factorial. Inflammation may play an im...
Mark, Michael L.
Provides a history of advocacy in music education discussing when formal advocacy started as well as advocacy with government agencies, the state level, and other types of advocacy. Includes a bibliography of resources related to music advocacy. (CMK)
Christensen, Jesper Frank; Jones, L W; Andersen, J L;
dysfunction is evident across all stages of the cancer trajectory. The causes of cancer-related muscle dysfunction are complex, but may involve a wide range of tumor-, therapy- and/or lifestyle-related factors, depending on the clinical setting of the individual patient. The main importance of muscle...... dysfunction in cancer patients lies in the correlation to vital clinical end points such as cancer-specific and all-cause mortality, therapy complications and quality of life (QoL). Such associations strongly emphasize the need for effective therapeutic countermeasures to be developed and implemented in...... powered to evaluate clinical outcomes associated with improvements in muscle function, or be promoted in advanced stage settings, aiming to reverse cancer-related muscle dysfunction, and thus potentially improve time-to-progression, treatment toxicity and survival....
Tutt, Kevin; Townley, Marc
Knowledge about music advocacy strategies has long been promoted as important for music educators, not only for the benefit of their individual programs but also for the specific benefit of music students and the general public. This article suggests an approach to advocacy grounded in the teacher's professional beliefs, phrased in terms…
Ross, Lone; Petersen, Morten Aagaard; Johnsen, Anna Thit;
PURPOSE: The aims of this study were to assess how communication with health care staff is perceived by Danish cancer patients and to characterise those patients who report problems in communication. METHODS: In a cross-sectional survey, a nationally representative sample of 2,202 cancer patients...... consultations, and whether doctors criticised other doctors. RESULTS: A total of 1,490 cancer patients responded to the questionnaire. Of these, 24 % reported one or more problems with the areas of communication measured. The problem most frequently reported (by 12 %) was not having sufficient time for...... who had been in contact with a hospital department during the past year was invited to respond to a questionnaire. Communication with doctors and nurses was assessed separately as were their abilities as listeners, doctors' use of an understandable language, timing of the information, duration of...
Hayden, Mary F., Ed.; Ward, Nancy, Ed.
This feature issue newsletter looks at issues the self-advocacy movement is raising and the contributions it is making to the lives of people with developmental disabilities. Articles by self-advocates and advisors to self-advocacy organizations talk about their self-advocacy experiences, barriers to self-advocacy, and ways to support it. Primary…
Shin, Takeshi; Miyata, Akane; Arai, Gaku; Okada, Hiroshi
Testicular cancer(TC)is the most common and curable cancer affecting men of reproductive age. Successful treatment approaches have resulted in longer life expectancy in TC survivors. The most frequently used treatment for TC is a combination of inguinal orchiectomy, and either radiotherapy or cisplatin-based chemotherapy. In many TC patients, sperm quality is already abnormal and there may even be a lack of viable spermatozoa at the time of diagnosis. Therefore, the effect of cancer treatment on fertility is a potentially significant issue. Fertility preservation in these men has become essential and needs to be discussed prior to the start of cancer treatment. The only currently established fertility preservation method is the cryopreservation of sperm before therapy. For most patients seeking cryopreservation, the semen sample is collected via masturbation. If the patient is unable to ejaculate for any reason, other techniques such as vibratory stimulation and electroejaculation can be performed. In azoospermic or severely oligozoospermic patients, testicular sperm extraction at the time of the inguinal orchiectomy is a useful technique for obtaining spermatozoa before cytotoxic therapy. We herein present an overview of the current topics on fertility in TC patients, including the effects of surgery, chemotherapy, and radiation therapy. We also describe the strategy for fertility preservation in these patients. PMID:25812494
Selanders, Louise C; Crane, Patrick C
Modern nursing is complex, ever changing, and multi focused. Since the time of Florence Nightingale, however, the goal of nursing has remained unchanged, namely to provide a safe and caring environment that promotes patient health and well being. Effective use of an interpersonal tool, such as advocacy, enhances the care-giving environment. Nightingale used advocacy early and often in the development of modern nursing. By reading her many letters and publications that have survived, it is possible to identify her professional goals and techniques. Specifically, Nightingale valued egalitarian human rights and developed leadership principles and practices that provide useful advocacy techniques for nurses practicing in the 21st century. In this article we will review the accomplishments of Florence Nightingale, discuss advocacy in nursing and show how Nightingale used advocacy through promoting both egalitarian human rights and leadership activities. We will conclude by exploring how Nightingale's advocacy is as relevant for the 21st century as it was for the 19th century. PMID:22320877
There is a known association between chemotherapy and radiotherapy for treatment of cancer patients and development or worsening of hypertension. The aim of this article is to review this association. A literature search was conducted for articles reporting this association on the databases PubMed, SciELO and LILACS between 1993 and 2013. There was a high coprevalence of hypertension and cancer, since both diseases share the same risk factors, such as sedentary lifestyle, obesity, smoking, unhealthy diet and alcohol abuse. The use of chemotherapy and adjuvant drugs effective in the treatment of cancer increased the survival rate of these patients and, consequently, increased the incidence of hypertension. We described the association between the use of angiogenesis inhibitors (bevacizumab, sorafenib and sunitinib), corticosteroids, erythropoietin and non-steroidal anti-inflammatory drugs with the development of hypertension. We also described the relationship between hypertension and carotid baroreceptor injury secondary to cervical radiotherapy. Morbidity and mortality increased in patients with cancer and hypertension without proper antihypertensive treatment. We concluded that there is need for early diagnosis, effective monitoring and treatment strategies for hypertension in cancer patients in order to reduce cardiovascular morbidity and mortality
Souza, Vinicius Barbosa de; Silva, Eduardo Nani; Ribeiro, Mario Luiz; Martins, Wolney de Andrade, E-mail: email@example.com [Curso de Pós-Graduação em Ciências Cardiovasculares da Universidade Federal Fluminense, Niterói, RJ (Brazil)
There is a known association between chemotherapy and radiotherapy for treatment of cancer patients and development or worsening of hypertension. The aim of this article is to review this association. A literature search was conducted for articles reporting this association on the databases PubMed, SciELO and LILACS between 1993 and 2013. There was a high coprevalence of hypertension and cancer, since both diseases share the same risk factors, such as sedentary lifestyle, obesity, smoking, unhealthy diet and alcohol abuse. The use of chemotherapy and adjuvant drugs effective in the treatment of cancer increased the survival rate of these patients and, consequently, increased the incidence of hypertension. We described the association between the use of angiogenesis inhibitors (bevacizumab, sorafenib and sunitinib), corticosteroids, erythropoietin and non-steroidal anti-inflammatory drugs with the development of hypertension. We also described the relationship between hypertension and carotid baroreceptor injury secondary to cervical radiotherapy. Morbidity and mortality increased in patients with cancer and hypertension without proper antihypertensive treatment. We concluded that there is need for early diagnosis, effective monitoring and treatment strategies for hypertension in cancer patients in order to reduce cardiovascular morbidity and mortality.
Lordick, Florian; Hacker, Ulrich
Cancer patients are regularly affected by malnutrition which often leads to a worsened quality of life and activity in daily living, more side effects and complications during anticancer treatment and shorter survival times. The early diagnosis and treatment of malnutrition are therefore relevant components of oncological treatment. The assessment of the nutritional status and determination of the body-mass-index should be done in every patient with cancer. The clinical examination delivers important findings and indications for malnutrition. Bioimpedance analysis can deliver additional objective information. The treatment of malnutrion should start early and follows a step-wise escalation reaching from nutritional counseling to enteral nutritional support to parenteral nutrition. PMID:26886037
Burney, Basil O; Garcia, Jose M
Prevalence of hypogonadism in men with cancer has been reported between 40% and 90%, which is significantly higher than in the general population. Hypogonadism is likely to affect the quality of life in these patients by contributing to non-specific symptoms, including decreased energy, anorexia, sarcopenia, weight loss, depression, insomnia, fatigue, weakness, and sexual dysfunction. Pathogenesis of hypogonadism in cancer patients is thought to be multi-factorial. Inflammation may play an important role, but leptin, opioids, ghrelin, and high-dose chemotherapy through different mechanisms have all been implicated as the cause. Hypogonadism is also associated with poor survival in cancer patients. Data looking into the treatment of hypogonadal male cancer patients with testosterone are limited. However, improvements in body weight, muscle strength, lean body mass, and quality of life have been shown in hypogonadal men with other chronic diseases on testosterone replacement therapy. Prospective and interventional trials are needed to test the efficacy and safety of testosterone treatment in improving quality of life of these patients. PMID:22528986
Mackey, Tim K; Schoenfeld, Virginia J
Social media is fundamentally altering how we access health information and make decisions about medical treatment, including for terminally ill patients. This specifically includes the growing phenomenon of patients who use online petitions and social media campaigns in an attempt to gain access to experimental drugs through expanded access pathways. Importantly, controversy surrounding expanded access and "compassionate use" involves several disparate stakeholders, including patients, manufacturers, policymakers, and regulatory agencies-all with competing interests and priorities, leading to confusion, frustration, and ultimately advocacy. In order to explore this issue in detail, this correspondence article first conducts a literature review to describe how the expanded access policy and regulatory environment in the United States has evolved over time and how it currently impacts access to experimental drugs. We then conducted structured web searches to identify patient use of online petitions and social media campaigns aimed at compelling access to experimental drugs. This was carried out in order to characterize the types of communication strategies utilized, the diseases and drugs subject to expanded access petitions, and the prevalent themes associated with this form of "digital" patient advocacy. We find that patients and their families experience mixed results, but still gravitate towards the use of online campaigns out of desperation, lack of reliable information about treatment access options, and in direct response to limitations of the current fragmented structure of expanded access regulation and policy currently in place. In response, we discuss potential policy reforms to improve expanded access processes, including advocating greater transparency for expanded access programs, exploring use of targeted economic incentives for manufacturers, and developing systems to facilitate patient information about existing treatment options. This includes
The patient perspective research advocates brings into NCI’s research enterprise helps to inform research focus and support the dissemination of results that lead to new and better cancer prevention, detection, and treatment methods.
Lothian, Judith A.
A childbirth educator asks how she can continue to use best evidence and prepare women adequately for birth within the constraints of a hospital practice that pressures educators not to “rock the boat.” This column discusses the challenge of advocating for normal birth and the dangers inherent in the advocacy role. Advocacy requires the childbirth educator to “dance” with many partners, including physicians and hospitals. Strategies for inviting colleagues and class participants onto the danc...
Kargiotis, Odysseas; Markoula, Sofia; Kyritsis, Athanasios P.
Abstract Purpose Epileptic seizures in patients with malignancies usually occur as a consequence of brain metastases from systemic cancer or the presence of a primary brain tumor. Other less-frequent causes include metabolic disorders such as electrolyte abnormalities, hypoglycemia, hypoxia and liver failure, paraneoplastic encephalitis, leptomeningeal carcinomatosis, side effects of certain chemotherapeutic agents, central nervous system infections, and ...
te Poele, EM; Kamps, WA; Tamminga, RYJ; Leew, JA; Postma, A; de Bont, ESJM
Chemotherapy-induced neutropenia is a major dose-limiting side effect of intensive chemotherapy in cancer patients. Recently, pegfilgrastim (a product with a long half-life, resulting in once-per-cycle dosage) was introduced to prevent neutropenia in adults. The authors report 32 episodes of pegfilg
... nlm.nih.gov/medlineplus/news/fullstory_158689.html Lung Cancer Surgery Worthwhile for Older Patients Study found those ... 2016 THURSDAY, May 5, 2016 (HealthDay News) -- Older lung cancer patients are surviving longer when they have lung ...
... page: https://medlineplus.gov/news/fullstory_158689.html Lung Cancer Surgery Worthwhile for Older Patients Study found ... 2016 THURSDAY, May 5, 2016 (HealthDay News) -- Older lung cancer patients are surviving longer when they have ...
Diagnostic radiology in cancer patients suffering from limb edemas serves two main purposes: to detect or to rule out lymph node metastases, recurrent cancer, or secondary malignancies, and to differentiate venous edema from lymphedema. The authors suggest an algorithmic pathway where the non-invasive imaging modalities, real-time ultrasonography and computed tomography are recommended as the initial diagnostic step. Both techniques are equally well suited to detect enlarged lymph nodes with high accuracy. In addition, computed tomography allows to a certain degree to separate venous from lymphedema. Phlebography is rarely needed in these patients. Lymphography should only be considered in patients undergoing microsurgical reconstructive operations of the lymphatics (e.g. lymphovenous anastomoses) because this invasive study carries the risk of deteriorating the edematous limb. (orig.)
Peters, P.E.; Groth, W.
Diagnostic radiology in cancer patients suffering from limb edemas serves two main purposes: to detect or to rule out lymph node metastases, recurrent cancer, or secondary malignancies, and to differentiate venous edema from lymphedema. The authors suggest an algorithmic pathway where the non-invasive imaging modalities, real-time ultrasonography and computed tomography are recommended as the initial diagnostic step. Both techniques are equally well suited to detect enlarged lymph nodes with high accuracy. In addition, computed tomography allows to a certain degree to separate venous from lymphedema. Phlebography is rarely needed in these patients. Lymphography should only be considered in patients undergoing microsurgical reconstructive operations of the lymphatics (e.g. lymphovenous anastomoses) because this invasive study carries the risk of deteriorating the edematous limb.
... and data sets for researchers Research by Cancer Type Find research about a specific cancer type Progress Annual Report ... Laws Careers Visitor Information Search Search Home Cancer Types Prostate Cancer Research Prostate Cancer Patient Prostate Cancer Treatment Prostate Cancer ...
Lopez-Baez, Sandra I.; Paylo, Matthew J.
This article discusses the community collaboration and systems advocacy domains of the ACA (American Counseling Association) Advocacy Competencies (J. A. Lewis, M. S. Arnold, R. House, & R. L. Toporek, 2002). A case illustration is presented, and the 8 Advocacy Competencies within each domain are applied to the case study.
Ionizing radiation used in treating the head and neck area produces oral side effects such as mucositis, salivary changes, trismus and radiation caries. Sequelae of cancer chemotherapy often include oral stomatitis, myelosuppression and immunosuppression. Infections of dental origin in compromised patients are potentially lethal. Specific programs to eliminate dental pathology before radiation and chemotherapy, and to maintain oral hygiene during and after therapy, will minimize these complications
Braun, Kathryn L; Kagawa-Singer, Marjorie; Holden, Alan E. C.; Burhansstipanov, Linda; Tran, Jacqueline H.; Seals, Brenda F.; Corbie-Smith, Giselle; Tsark, JoAnn U.; Harjo, Lisa; Foo, Mary Anne; Ramirez, Amelie G.
Cancer patient navigation (PN) programs have been shown to increase access to and utilization of cancer care for poor and underserved individuals. Despite mounting evidence of its value, cancer patient navigation is not universally understood or provided. We describe five PN programs and the range of tasks their navigators provide across the cancer care continuum (education and outreach, screening, diagnosis and staging, treatment, survivorship, and end-of-life). Tasks are organized by their ...
Eyigor, Sibel; Akdeniz, Sedef
Exercise and rehabilitation approaches in palliative care programs for cancer patients affect patients’ symptoms, physical functioning, muscle strength, emotional wellbeing, psychological symptoms, functional capacities, quality of life, mortality and morbidity positively. Based on scientific data, palliative cancer patients should be recommended to participate in exercise programs. There is no standard approach to recipe an exercise regimen for a palliative cancer survivor. Studies for demon...
Two case studies are used to discuss topical issues current in follow-up management of patients with early stage breast cancer. These issues include the role of screening and diagnostic bone scintigraphy and patient self-advocacy in clinical management. Breast cancer is common. Standard clinical practice in Australia for patients treated for early stage carcinoma of the breast is regular follow-up, usually lasting 5 years, and often 10 years. There are numerous benefits for patients receiving regular clinical checkups post-treatment of breast cancer. However, the three prime objectives are early detection of recurrence, assessment of treatment-related morbidity, and provision of psychological support. Not surprisingly, a variety of intercurrent clinical events can occur in a population of post-treatment breast cancer patients on long-term follow-up. In this article we describe two interesting cases, each presenting with a solitary new destructive rib lesion highly suggestive of a first clinical diagnosis of metastatic breast cancer. Subsequent biopsy revealed the lesions to be benign. Copyright (1999) Blackwell Science Pty Ltd
Cvetković, Jovana; Nenadović, Milutin
Breast cancer is the third most common illness in the world and the most frequent malignant disease with women. Cytotoxic therapy is connected to significant psychiatric adverse effects, and the appearance of depressive symptoms is the most common. The main goal is determining the degree of depression with breast cancer patients in the oncology ward of the University Clinical Hospital in Niš and its connection to their marital status, age, level of education, economic status and the number of therapy cycles. This research is a prospective study. The statistical data analysis included measures of descriptive and analytical statistics. The presence of depressive symptoms of different intensity was showed in 76.00% of the interviewees in group I, and the second included 77.4%. The frequency distributions show that 27.084% interviewees from the first group showed signs of depressive symptoms, while the second included 25%. The intensity of these symptoms categorizes them into the group of moderate to significantly expressed depressive states, so they require therapeutic treatment. Depression is significantly more often recorded with cancer patients receiving cytotoxic therapy; mild depression is the most common, followed by moderate and severe depression. PMID:27138829
S B Bansal, Sanjay Dixit, Geeta Shivram
Full Text Available Background: Mental health is the balanced development of the individual’s personality and the emotional attitude which will enable him or her to live harmoniously with his or her Fellow citizens. Mental health is not exclusively a matter of relation between persons It is also a matter of relation of individuals towards the community in which they live, towards the society of which the community is a part, and towards the social institutions which for a large part guide their life, determine their way of living, working, leisure, and the way they spends and earns the money, the way they sees happiness, stability and security. Objective: To asses and quantify the prevalence of psychological morbidity in cancer patients of government cancer hospital MGM Medical College Indore, M.P. Material and Methods: 100 cancer patients were chosen randomly all of them were interviewed through a questionnaire survey in ward and OPD of cancer hospital in November and December 2009. Data on demographics, and duration of diagnosis were collected. Results: Gender wise prevalence of psychological morbidity Grade II &III; were 94% in males and 86% in females. Chi square test was not significant. According to age the Grade II & III psychological morbidity were 41(46% in 15-45 years age group and 49 (54% in 46-75 years age group which is significantly higher than previous age group .Chi square test (x2 = 7.54 p value < 0.05 Grade II & III psychological morbidity were 52% in 0-6 months duration while it was 38% in more than 6 months duration Chi square test (x2= 8.04, P value < 0.05 statistically significant Conclusion: the prevalence of psychological morbidity was slightly higher in males and older age group, and also high psychological morbidity was seen in recently diagnosed cancer patients. A good counseling, stress relaxation and life style modification program is required to make such patients live their life in a positive and better way.
Gregurek, Rudolf; Braš, Marijana; Đorđević, Veljko; Ratković, Ana-Strahinja; Brajković, Lovorka
Psycho-oncology is a broad approac to cancer therapy with treats the emotional, social, and spiritual distress which often accompanies cancer patients. The development of psycho-oncology began in the second part of the 20th century reflecting the increased interest in the study of cancer patients' psychological reactions to their illness at all stages of its course, and the analysis of the emotional, spiritual, social, and behavioral factors which influence the risk of developing cancer and l...
Baldwin, Laura-Mae; Cai, Yong; Larson, Eric H.; Dobie, Sharon A.; Wright, George E.; Goodman, David C.; Matthews, Barbara; Hart, L. Gary
Context: Cancer care requires specialty surgical and medical resources that are less likely to be found in rural areas. Purpose: To examine the travel patterns and distances of rural and urban colorectal cancer (CRC) patients to 3 types of specialty cancer care services--surgery, medical oncology consultation, and radiation oncology consultation.…
Joana Pedro Lopes; Paula Manuela de Castro Cardoso Pereira; Ana Filipa dos Reis Baltazar Vicente; Alexandra Bernardo; María Fernanda de Mesquita
The present study intended to evaluate the nutritional status of Portuguese colorectal patients and associated it with surgery type as well as quality of life outcomes. Malnutrition can affect up to 85% of cancer patients and specifically 30-60% in colorectal cancer and can significantly influence health outcomes. A sample of 50 colorectal cancer patients was evaluated in what refers to several anthropometric measures, food intake, clinical history, complications rate before and after surgery...
Rančić Milan; Ristić Lidija; Stanković Ivana
Introduction. This study was aimed at analyzing the site, kind and type of infection which develop in patients having lung cancer at hospital treatment. Material and methods. Clinical data of the patients hospitalized for lung cancer were analyzed at the Clinic for Lung Diseases and Tuberculosis in Knez Selo in the period from January 2002 till December 2007. A great number of patients (1296-75.9%) had non-small cell lung cancer. In 1708 patients with lung cancer, 773 febrile episodes were re...
Background. The aim of this review is to present common psychosocial problems in cancer patients and their possible coping strategies. Cancer patients are occupied with many psychosocial problems, which are only partially related to their health state and medical treatments. They are faced with a high social pressure, based on prejudices and stereotypes of this illness. The review presents the process of confrontation with the cancer diagnosis and of managing the psychological consequences of cancer. The effects of specific coping styles, psychosocial interventions and a social support on initiation, progression and recurrence of cancer are also described. Conclusions. Although some recent meta-analysis could not provide scientific evidence for the association between coping strategies and the cancer initiation, the progression or the recurrence (neither have studies rejected the thesis of association), the therapeutic window for the psychosocial intervention is still wide and shows an important effect on the quality of lives of many cancer patients. (author)
In the scholarly communications world, the concept of open access publishing has proliferated at faster pace since the global open access declarations such as the Budapest Open Access Initiative (BOAI) in February 2002 and the Berlin Declaration on Open Access to Knowledge in the Sciences and Humanities in October 2003. After one decade of these two epoch-making declarations, we see growing instances of open access resources due to collective efforts put by the advocacy organizations, advocac...
Beikmoradi, Ali; NAJAFI, Fatemeh; Roshanaei, Ghodratallah; Pour Esmaeil, Zahra; Khatibian, Mahnaz; Ahmadi, Alireza
Background: Anxiety has negative effects on mental and physical performance, quality of life, duration of hospitalization, and even on the treatment of patients with cancer. Objectives: Today acupressure is widely used to treat anxiety. Thus, the present study aimed to investigate the effects of acupressure on anxiety in patients with cancer. Patients and Methods: A double-blind randomized clinical trial was conducted on 85 patients hospitalized with 3 groups including acupressure group (n = ...
Cross, Sarah E.; Jin, Yu-Sheng; Rao, Jianyu; Gimzewski, James K.
Change in cell stiffness is a new characteristic of cancer cells that affects the way they spread. Despite several studies on architectural changes in cultured cell lines, no ex vivo mechanical analyses of cancer cells obtained from patients have been reported. Using atomic force microscopy, we report the stiffness of live metastatic cancer cells taken from the body (pleural) fluids of patients with suspected lung, breast and pancreas cancer. Within the same sample, we find that the cell stiffness of metastatic cancer cells is more than 70% softer, with a standard deviation over five times narrower, than the benign cells that line the body cavity. Different cancer types were found to display a common stiffness. Our work shows that mechanical analysis can distinguish cancerous cells from normal ones even when they show similar shapes. These results show that nanomechanical analysis correlates well with immunohistochemical testing currently used for detecting cancer.
Egeberg, A; Thyssen, J P; Gislason, G H;
BACKGROUND: Psoriasis is a chronic inflammatory skin disease that is commonly treated with ultraviolet phototherapy and systemic immunosuppressant drugs, which may confer a risk of skin cancer. Previous studies on the risk of skin cancer in patients with psoriasis have shown conflicting results....... OBJECTIVES: We investigated the risk of new-onset melanoma and non-melanoma skin cancer (NMSC), respectively, in a large cohort of patients with psoriasis and psoriatic arthritis. METHODS: Data on all Danish individuals aged ≥18 years between 1 January 1997 and 31 December 2012 were linked at individual...... risk of skin cancer is only modestly increased in patients with psoriasis, clinicians should remain vigilant....
Tracy, Erin E; Bortoletto, Pietro
The dissemination of information online and resultant public discourse through social media and other online channels has influenced the practice of medicine in dramatic ways. Physicians have historically worked to develop new techniques and devices for the benefit of their patients. It is only a more recent phenomenon, however, that these tools are either removed or their use is curtailed largely driven by anecdotal reports; passionate, vocal, often media-savvy advocates; and plaintiff attorneys. The use of power morcellation, hysteroscopic tubal sterilization, and mesh in urogynecologic procedures all have been victims of these societal pressures. It is important for health care professionals to be involved in the debate to ensure that public outcry does not unduly influence what we, as clinicians, are able to safely offer our patients. By being better advocates for our field, our instruments, and our patients, we can ensure medical decision-making is driven by good science and not public fervor. PMID:26959205
This Special Listing of Current Cancer Research Projects is a publication of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute. Each Listing contains descriptions of ongoing projects in one selected cancer research area. The research areas include: Infectious disease in cancer patients; Immunological aspects of supportive care of cancer patients; Nutritional evaluation and support of cancer patients; Pain management of cancer patients
Τogas Κ.; Alexias G.
Background: Lung cancer is a very common type of cancer. The psychological reactions of these patients haven't been studied yet. Aim: The examination of the mental health of lung cancer patients. Methods: A bibliographical review of relevant articles was conducted at the electronic data bases of Pubmed, Pcych Info and Scholar Google by key-words. The quest included researches and reviews which have been published in Greek and English language between 1990- 2013. Results: Lung canc...
O'Toole, D. M.; Golden, A. M.
The Karnofsky performance scale is the most widely used method of quantifying cancer patients' ability to function. It has also been used to measure patients' function before and after treatment. Because identifying problems with function is the cornerstone of rehabilitating patients with cancer, we developed a table that relates the functional independence measure with the Karnofsky scale. This approach encourages oncologists to consider inpatient or outpatient rehabilitation services for a ...
Suhami, Norhasmilia; Muhamad, Mazanah Bt; Krauss, Steven Eric
Islamic healing is frequently referred to as the treatment of choice by many Muslim cancer patients in Malaysia. Despite its widespread use, there is limited information relating to patients' healing preferences. With rising cancer rates in the country, this issue has become a concern to public health policy makers. The purpose of this study was to understand why cancer patients seek Islamic healing. This qualitative study utilized in-depth interviews with 18 cancer patients. The findings indicate three main reasons: (1) recommendations from family, friends and doctors; (2) belief in Islamic healing and (3) the perceived ineffectiveness and dissatisfaction with conventional treatments. Islamic healing will likely continue to be popular complementary cancer treatment in Malaysia as it is grounded in strong cultural and religious beliefs. PMID:26391242
The goal of this review is to discuss the psychiatric aspects of pain in cancer patients from a biopsychosocial approach. Pain in cancer patients is considered as a complex reaction causing severe suffering and involves many psychological aspects. It has many dimensions such as personality, affect, cognition and social relations. The pain experience may also be influenced by some psychological factors such as anxiety, depression and the meaning of pain. Therefore, a successful management of cancer pain requires a multidisciplinary approach. Since cancer pain is generally treated medically, the psychological impact of pain is often underestimated. However, cancer pain is usually related to high levels of psychological distress. Culture, as an important factor affecting cancer pain, will also be discussed during this review. It is crucial to understand cultural diversity in the treatment of cancer patients with pain. Research shows that a minority patients of various ethnicities have less control of their pain because of the miscommunication problem within the medical setting. By paying attention to patients' cultural diversities, problems such as miscommunication causing inadequate control of pain can be eliminated. In order to manage pain in cancer patients, cognitive-behavioral interventions may be integrated with pharmacotherapy. The main goal of these strategies is to provide a sense of control and better coping skills to deal with cancer. Patients' maladaptive thoughts or behaviors may cause physical and emotional stress. Main behavioral strategies include biofeedback, relaxation training, and hypnosis. Cognitive strategies include guided imagery, distraction, thought monitoring and problem solving. By discussing all of these aspects of cancer pain, the multidimensional characteristic of pain and the relation between cancer pain and psychiatric factors will be clarified. PMID:20590361
Full Text Available Aims: To determine the level of oral cancer awareness and knowledge among patients referred to the Department of Oral and Maxillofacial Radiology in Central Anatolia. Settings and Design: The study was conducted with 1,125 patients who applied to the school of dentistry for routine dental examinations. The authors collect information with a 20-item written questionnaire from the participants about oral cancer risk factors, epidemiology, etiology, and signs and symptoms. Statistical Analysis: Descriptive statistics of demographic variables and other data were reported as means and percentages. Statistical analysis was performed by means of SPSS +11.0 statistical package. Results: Overall, only 48.9% of all patients showed awareness of oral cancer, with awareness especially poor among lower socioeconomic groups. Awareness of oral cancer risk factors and signs and symptoms did not vary significantly between men and women (P > 0.5; however, older participants (aged 40-64 years were more familiar with oral cancer signs than younger participants. More than half of all participants (56.8% were unaware of the common clinical presentations of oral cancer. Conclusions: The results of this survey showed knowledge regarding oral cancer to be quite low. Thus, educational programs are needed to increase public awareness about oral cancer, and dentists should request patients undergo examinations for oral cancer to ensure early detection.
Full Text Available Background: A supportive needs assessment is an essential component of any care program. There is no research evidence regarding the supportive care needs of cancer patients in Iran or other Middle Eastern countries. Aims: The aim of this study was to determine the supportive care needs of Iranian cancer patients. Materials and Methods: This descriptive study was conducted in a referral medical center in the northwest of Iran. A total of 274 cancer patients completed the Supportive Care Needs Survey (SCNS-59. Descriptive statistics were used for data analysis. Results: In 18 items of the SCNS, more than 50% of the participants reported that their needs were unmet. Most frequently, unmet needs were related to the health system, information, physical, and daily living domains, and most met needs were related to sexuality, patient care, and support domains. Conclusions: Iranian cancer patients experience many unmet needs and there is an urgent need for establishing additional supportive care services in Iran.
Full Text Available Abstract Cancer patients experience several stressors and emotional upheavals. Fear of death, interruption of life plans, changes in body image and self-esteem, changes in social role and lifestyle are all important issues to be faced. Moreover, Depressive Disorders may impact the course of the disease and compliance. The cost and prevalence, the impairment caused, and the diagnostic and therapeutic uncertainty surrounding depressive symptoms among cancer patients make these conditions a priority for research. In this article we discuss recent data, focusing on detection of Depressive Disorders, biological correlates, treatments and unmet needs of depressed cancer patients.
With open access and repositories assuming a high profile some may question whether advocacy is still necessary. Those involved in the business of setting up and populating repositories are aware that in the majority of institutions there is still a great need for advocacy. This tutorial will give participants an opportunity to discuss different advocacy methods and approaches, including the 'top down' and 'bottom up' approach, publicity methods and the opportunities offered by funding body positions on open access. Participants will have the opportunity to share experiences of what works and what doesn't. The advocacy role often encompasses responsibility for advising academics on IPR issues. This is a particularly critical area where repository staff are engaged in depositing content on behalf of academics. The tutorial will offer an opportunity to discuss the IPR issues encountered by those managing repositories. The tutorial will draw on the experience of participants who have been engaged in advocacy act...
Pain, Neuropathic; Epilepsy; Renal Pelvis Cancer; Pancreatic Cancer; Breast Cancer; Nervous System Cancer; Chronic Pancreatitis; Stomach Cancer; Renal Cell Carcinoma; Diabetes; Bladder Cancer; Bone and Joint Cancer; Penis Cancer; Anal Cancer; Cancer; Renal Cancer
Varkey, Prashanth; Tang, Wen-Ruay; Tan, Ngian Chye
Anorexia and cachexia frequently complicate the late stages of malignancy and can be a prominent feature of early disease. The resulting weight loss significantly affects the morbidity and mortality of the cancer patient. A fundamental understanding of nutrition and the pathophysiology of cancer cachexia will aid in diligent treatment decisions to achieve optimal results. The pathophysiology of cancer cachexia is discussed, together with methods of nutritional assessment, nutritional requirem...
Body, J J; Lossignol, D; Ronson, A
The scope of supportive care and cancer rehabilitation is very wide and heterogeneous. In this review we focus on nutritional aspects, sexual and gonadal function, psychological rehabilitation, treatment of cancer pain, and rehabilitation of patients with bone metastases. The anorexia-cachexia syndrome is a particularly frequent manifestation of cancer that profoundly affects body image and significantly impairs quality of life of cancer patients. However, enteral feeding through nasogastric tubes, gastrostomies, or jejunostomies is an efficient method for providing long-term enteral nutrition at home and for contributing to complete rehabilitation after cancer therapy. Recent effort has focused on nutritional pharmacology and on the optimalization of the use of appetite-stimulating drugs, such as progestational agents. The psychological components of cancer, anticancer therapy, and quality of life have now been widely recognized and studied. Effective pharmacological and psychotherapeutic interventions help patients and their family to better adjust to the chronic stress of cancer, but more specific determinants of psychological morbidity should be developed. In particular, the safe and efficient use of the most recent classes of antidepressants and anxiolytics should be urgently studied. More than 90% of cancer patients present one or more pain syndromes during their illness. The adequate use of drugs is the cornerstone of treatment. The development on new molecules and new routes of administration opens interesting perspectives for cancer pain control. Bone metastases are the source of considerable morbidity. Intravenous bisphosphonates have been successfully used for the treatment of the symptoms of metastatic bone disease, especially bone pain. Moreover, monthly pamidronate infusions in addition to chemotherapy reduce the mean skeletal morbidity rate by more than one third and contribute to the rehabilitation of cancer patients with bone metastases from breast
Full Text Available Background: Malnutrition is widely prevalent in the pediatric population in India. There is paucity of data on the prevalence of malnutrition in pediatric cancer patients and the impact of cancer treatment on nutritional status of Indian children. Aims: The study was conducted to look at the prevalence of malnutrition and assess the impact of treatment on nutritional status of pediatric cancer patients. Settings And Design: This was a retrospective study. Materials And Methods: Data on the weight of pediatric cancer patients <16 years of age treated at Cancer Institute, Chennai, from January 2013 to May 2014 were analyzed at systematic time points in therapy. Patients' weight were plotted on the Centre for Disease Control (CDC growth charts. Patients were defined to be undernourished if their weight for age was ≤3rd centile in CDC growth charts and obese if their weight for age was ≥97th centile on CDC growth charts. RESULTS: A total of 295 patient case records were analyzed. Acute lymphoblastic leukemia was the most common malignancy. At diagnosis, under-nutrition was seen in 44% patients, this increased to 46% midway during treatment (end of induction in acute leukemia and completion of 50% of planned treatment in solid tumors and decreased to 27% at the end of treatment (beginning of maintenance in acute leukemia and completion of planned treatment in solid tumors (P = 0.0005. There was no significant difference in nutritional status between patients with hematological malignancies and solid tumors (P = 0.8. Conclusion: Under-nutrition is present in close to half of the pediatric cancer patients presenting to our institute. Active nutritional intervention and education were able to significantly reduce the prevalence of under-nutrition in patients at the end of treatment.
Jevne, Ronna F.; Nekolaichuk, Cheryl L.; Williamson, F. Helen A.
Describes a model for counseling cancer patients that integrates the unique features of the cancer experience within a basic counseling framework. It combines a nine-step problem-solving approach with a biopsychosocial perspective, placing greater emphasis on the person than the problem. Utilizes innovative questioning techniques and strategies.…
Jun Ho Lee; Jae-Gahb Park; Jae-Moon Bae; Ja Seong Bae; Keun Won Ryu; Jong Seok Lee; Sook Ryun Park; Chan Gyoo Kim; Myoung Cheorl Kook; Il Ju Choi; Young Woo Kim
AIM: To identify patients with a high-risk of having a synchronous cancer among gastric cancer patients.METHODS: We retrospectively analyzed the prospective gastric cancer database at the National Cancer Center,Korea from December 2000 to December 2004. The clinicopathological characteristics of patients with synchronous cancers and those of patients without synchronous cancers were compared. Multivariate analysis was performed to identify the risk factors for the presence of a synchronous cancer in gastric cancer patients.RESULTS: 111 of 3291 gastric cancer patients (3.4%)registered in the database had a synchronous cancer.Among these 111 patients, 109 had a single synchronous cancer and 2 patients had two synchronous cancers. The most common form of synchronous cancer was colorectal cancer (42 patients, 37.2%) followed by lung cancer (21 patients, 18.6%). Multivariate analyses revealed that elderly patients with differentiated early gastric cancer have a higher probability of a synchronous cancer.CONCLUSION: Synchronous cancers in gastric cancer patients are not infrequent. The physicians should try to find synchronous cancers in gastric cancer patients,especially in the elderly with a differentiated early gastric cancer.
Full Text Available Cognitive behavioral therapy is one of the structured but flexible psychosocial interventions that could be applied to patients with cancer. In many studies the positive effects of cognitive behavioral therapy in reducing psychological morbidity and improving the quality of life of cancer patients have been shown. In this article, the contents and techniques of adapted cognitive behavioral therapy for patients with cancer and its effectiveness in commonly seen psychiatric disorders have been reviewed. The aim of this article is to contribute positively to physicians and nurses in Turkey for early detection of psychological distress and referral to the therapist that would clearly increase the quality of life of cancer patients. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(3.000: 257-270
... medlineplus.gov/news/fullstory_159903.html Cancer Patients, Doctors Often Disagree About Prognosis Those with advanced disease are likely to be more optimistic than their doctor, study shows To use the sharing features on ...
Full Text Available BACKGROUND: Second cancers have been reported to occur in 10-20% of patients with neuroendocrine tumors (NETs. However, most published studies used data from a single institution or focused only on specific sites of NETs. In addition, most of these studies included second cancers diagnosed concurrently with NETs, making it difficult to assess the temporality and determine the exact incidence of second cancers. In this nationwide population-based study, we used data recorded by the Taiwan Cancer Registry (TCR to analyze the incidence and distribution of second cancers after the diagnosis of NETs. METHODS: NET cases diagnosed from January 1, 1996 to December 31, 2006 were identified from the TCR. The data on the occurrence of second cancers were ascertained up to December 31, 2008. Standardized incidence ratios (SIRs of second cancers were calculated based on the cancer incidence rates of the general population. Cox-proportional hazards regression analysis was performed to estimate the hazard ratio (HR and 95% confidence interval (CI for the risk of second cancers associated with sex, age, and primary NET sites. RESULTS: A total of 1,350 newly diagnosed NET cases were identified according to the selection criteria. Among the 1,350 NET patients, 49 (3.63% developed a second cancer >3 months after the diagnosis of NET. The risk of second cancer following NETs was increased compared to the general population (SIR = 1.48, 95% CI: 1.09-1.96, especially among those diagnosed at age 70 or older (HR = 5.08, 95% CI = 1.69-15.22. There appeared to be no preference of second cancer type according to the primary sites of NETs. CONCLUSIONS: Our study showed that the risk of second cancer following NETs is increased, especially among those diagnosed at age 70 or older. Close monitoring for the occurrence of second cancers after the diagnosis of NETs is warranted.
Background Hyaluronan(HA)is most likely associated with tumor invasion and metastasis.Studies have shown that HA levels are often increased in serum of patients with various malignant tumors.The purpose of this study was to determine the levels of serum hyaluronan in patients with oral cancer and evaluate the value of serum HA in adjuvant diagnosis,staging and monitoring treatment response in these patients.Methods Eighty-four hospitalized patients with oral cancer,65 patients with benign tumors in the oral and maxillofacial region and 67 healthy individuals were included in this investigation.Venous blood was collected from these patients and the healthy individuals before therapy.One week after therapy,venous blood was collected once again in 43 patients with oral cancer.Serum samples were obtained and serum HA levels examined.Results The serum HA concentration was significantly higher in oral cancer patients than in patients with benign tumors and in healthy controls(P＜0.05).The serum HA level in patients with stages Ⅲ and Ⅳ disease was higher than in patients with stages Ⅰ and Ⅱ disease,but there was no significant difference in the HA level between stages Ⅰ and Ⅱ nor between stages Ⅲ and Ⅳ(P＞0.05).After a complete treatment the HA levels in patients with oral cancer became lower than before treatment,but the difference was not significant(P＞0.05).Conclusions The results of this study suggest that the determination of HA levels may provide additional information in diagnosis of oral cancer,but its usefulness as an adjunct in clinical staging and in monitoring treatment response was limited.
Handberg, C; Lomborg, K; Nielsen, C V; Oliffe, J L; Midtgaard, J
The aim was to describe male cancer survivors' barriers towards participation in cancer rehabilitation as a means to guiding future targeted men's cancer rehabilitation. Symbolic Interactionism along with the interpretive descriptive methodology guided the study of 35 male cancer survivors representing seven cancer types. Data were generated through a 5-month fieldwork study comprising participant observations, semi-structured individual interviews and informal conversations. The analyses revealed two overarching findings shedding light on male cancer survivors' barriers to rehabilitation: 'Fear of losing control' and 'Striving for normality'. While 'Fear of losing control' signified what the men believed rehabilitation would invoke: 'Reduced manliness', 'Sympathy and dependency' and 'Confrontation with death', 'Striving for normality' was based on what the men believed rehabilitation would hinder: 'Autonomy and purpose', 'Solidarity and fellowship' and 'Forget and move on'. This study of male cancer survivors' and cancer rehabilitation documents how masculine ideals may constitute barriers for participation in rehabilitation and provides insights about why men are underrepresented in rehabilitation. The findings can guide practice to develop research-based rehabilitation approaches focused on preserving control and normality. Further empirical evidence is needed to: (1) explore the conduct of health professionals' towards male cancer patients and (2) address gender inequalities in cancer rehabilitation. PMID:26223855
Chung-Hoon Kim; Gyun-Ho Jeon
With improved survival rates among cancer patients, fertility preservation is now being recognized as an issue of great importance. There are currently several methods of fertility preservation available in female cancer patients and the options and techniques via assisted reproduction and cryopreservation are increasing, but some are still experimental and continues to be evaluated. The established means of preserving fertility include embryo cryopreservation, gonadal shielding during radiat...
Objective To examine self-reported symptoms by the patients receiving cancer therapy, and find out the symptoms that should be coped with and managed during the treatment. Methods A pilot study was conducted on self-reported symptoms on 185 patients receiving chemotherapy and/or radiotherapy for different cancers. The Therapy-Related Symptoms Checklist (TRSC) was used. Results Severe symptoms on the TRSC subscales: loss of appetite, feeling sluggish, weight loss, nausea and hair loss, were reported by the p...
Fabienne Camilo da Silveira Pirajá; Rafael Bandeira Lages; Uylma Assunção Costa; João Batista Mendes Teles; Viriato Campelo
Objective: To analyze the survival after five years among patients treated of prostate cancer at Hospital São Marcos. Methods: A descriptive population-based epidemiological study performed in Teresina-PI, evaluating a hospital cohort consisting of 71 patients of Hospital São Marcos, enrolled in Hospital Cancer Registry (HCR) from 2000 to 2001, under ICD10 - C61. The variables considered in the evaluation of survival were: age group, tumor staging and skin color. The Kaplan-Meier method ...
Jay, Nicolas; Napoli, Amedeo; Kohler, François
In France, cancer care is evolving to the design of regional networks, so as to coordinate expertise, services and resources allocation. Existing information systems along with data-mining tools can provide better knowledge on the distribution of patient flows. We used one year data of the French Diagnosis Related Groups (DRGs) based system to perform our analysis. Formal Concept Analysis has been used to build Iceberg Lattices of cancer patient flows in the French region of Lorraine. This un...
Melda Misirlioglu; Rana Nalcaci; Selmi Yilmaz Yardimci; Mehmet Zahit Adisen
Aims: To determine the level of oral cancer awareness and knowledge among patients referred to the Department of Oral and Maxillofacial Radiology in Central Anatolia. Settings and Design: The study was conducted with 1,125 patients who applied to the school of dentistry for routine dental examinations. The authors collect information with a 20-item written questionnaire from the participants about oral cancer risk factors, epidemiology, etiology, and signs and symptoms. Statistical Analysis: ...
Muñoz, Elkin; González, Naira; Muñoz, Luis; Aguilar, Jesús; Velasco, Juan A García
Breast cancer is the most prevalent malignancy among women under 50. Improvements in diagnosis and treatment have yielded an important decrease in mortality in the last 20 years. In many cases, chemotherapy and radiotherapy develop side effects on the reproductive function. Therefore, before the anti-cancer treatment impairs fertility, clinicians should offer some techniques for fertility preservation for women planning motherhood in the future. In order to obtain more available oocytes for IVF, the ovary must be stimulated. New protocols which prevent exposure to increased estrogen during gonadotropin stimulation, measurements to avoid the delay in starting anti-cancer treatment or the outcome of ovarian stimulation have been addressed in this review. There is no evidence of association between ovarian stimulation and breast cancer. It seems that there are more relevant other confluent factors than ovarian stimulation. Factors that can modify the risk of breast cancer include: parity, age at full-term birth, age of menarche, and family history. There is an association between breast cancer and exogenous estrogen. Therefore, specific protocols to stimulate patients with breast cancer include anti-estrogen agents such as letrozole. By using letrozole plus recombinant follicular stimulating hormone, patients develop a multifollicular growth with only a mild increase in estradiol serum levels. Controlled ovarian stimulation (COS) takes around 10 days, and we discuss new strategies to start COS as soon as possible. Protocols starting during the luteal phase or after inducing the menses currently prevent a delay in starting ovarian stimulation. Patients with breast cancer have a poorer response to COS compared with patients without cancer who are stimulated with conventional protocols of gonadotropins. Although many centres offer fertility preservation and many patients undergo ovarian stimulation, there are not enough studies to evaluate the recurrence, breast cancer
Gillessen, S; Omlin, A; Attard, G;
The first St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) Expert Panel identified and reviewed the available evidence for the ten most important areas of controversy in advanced prostate cancer (APC) management. The successful registration of several drugs for castration......-resistant prostate cancer and the recent studies of chemo-hormonal therapy in men with castration-naïve prostate cancer have led to considerable uncertainty as to the best treatment choices, sequence of treatment options and appropriate patient selection. Management recommendations based on expert opinion, and not...
Full Text Available Introduction: Being a cancer patient is a unique and singular. The cancer disease associated with pain and suffering is a challenging process for the sufferer, for whom have around or for those caring for the sick. Pain, considered the 5 th vital sign, is often identified as the main complaint of our patients suffering from cancer. We dare to say that to explore the essence of the care provided by nurses and primary health care to cancer patients with prolonged pain at the time found in his home and family, we would be helping to build a know -how by itself, with positive externalities for patients, families, professionals and nursing itself. Methods: Ask "What does Care for Nurses and primary health care for cancer patients with prolonged pain in time for your family?" we may lead the cornerstone of our problems, by studying quantitative nature using a questionnaire and a significance level of care. Results: the average age is 59.27 years, mostly women, 51% are married and in 29.8% of studies has only completed the first cycle of education. The majority of cancer patients who participated in this study share a room with a relative. In regard to aspects of their pain, cancer patients referred to 47.1% of cases, that their pain started weeks ago and 38.5% even refers to the pain persists for months. The pain felt by these patients is not the severe type, in 68.3% of cases, and has an average intensity of 5, although we have 25% of these patients with pain greater than a 6.75. The Meaning of Caring scale applied to the group of nurses who provide care at primary health reveals an alpha of 0.8857 and 0.9025 standardized alpha. The Meaning of Caring scale applied to the group of cancer patients with prolonged pain at the time they are at home shows an alpha of 0.6672and 0.7374 standardized alpha. The Meaning of Caring scale applied to the group of cancer family patients with prolonged pain shows an alpha of 0.6712 and an alpha standardized 0
Svendsen, E; Karwinski, B
The series studied comprised 6197 patients who had died of or who had cancer at death and represents all patients with cancer from 21,530 necropsies performed at this department from 1960-84. Pulmonary embolism was significantly more common among cancer patients than in those with non-neoplastic diseases. Among those palliatively treated, patients with ovarian cancer, cancer of the extrahepatic bile duct system, and cancer of the stomach had the highest prevalence of pulmonary embolism (34.6%...
Jansson, Bruce S; Nyamathi, Adeline; Heidemann, Gretchen; Bird, Melissa; Ward, Cathy Rogers; Brown-Saltzman, Katherine; Duan, Lei; Kaplan, Charles
This study aims to describe the factors that predict health professionals' engagement in policy advocacy. The researchers used a cross-sectional research design with a sample of 97 nurses, 94 social workers, and 104 medical residents from eight hospitals in Los Angeles. Bivariate correlations explored whether seven predictor scales were associated with health professionals' policy advocacy engagement and revealed that five of the eight factors were significantly associated with it (p engagement, eagerness, skills, tangible support, and organizational receptivity. Regression analysis examined whether the seven scales, when controlling for sociodemographic variables and hospital site, predicted levels of policy advocacy engagement. Results revealed that patient advocacy engagement (p engagement. Ethical commitment did not predict policy advocacy engagement. The model explained 36% of the variance in policy advocacy engagement. Limitations of the study and its implications for future research, practice, and policy are discussed. PMID:27151835
The total number of malignant neoplasms included on this study 7,787 cases(10.4%) among 74,928 cases for 2 years. On sex, females with 57.6% were much more than males with 42.4%. The highest proportion of cancer 50-59 age group. The most frequent primary site among males was found to be stomach with 36.2%, followed by liver(12.3%), lung(12.2%), esophagus(15.5%) and larynx(4.9%). In females, the first order was uterine cervix with 47.3%, followed most common type of morphology of malignant neoplasms was adenocarcinoma(39.0%) in males an squamous cell carcinoma(56.2%) in females. Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the extent of disease was 4.6% for patient with carcinoma-in-situ, 76.3% for patients with localized involvement, 11.6% for patients with regional involvement and 7.5% for patients with distant involvement. Among,the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 19.0% for surgery, 27.7 for radiotherapy and 24.2% for chemotherapy. Among the cancer patients confirmed by medical records, 11.2% was traced more than 5 years. (Author)
Kim, Chung-Hoon; Jeon, Gyun-Ho
With improved survival rates among cancer patients, fertility preservation is now being recognized as an issue of great importance. There are currently several methods of fertility preservation available in female cancer patients and the options and techniques via assisted reproduction and cryopreservation are increasing, but some are still experimental and continues to be evaluated. The established means of preserving fertility include embryo cryopreservation, gonadal shielding during radiation therapy, ovarian transposition, conservative gynecologic surgery such as radical trachelectomy, donor embryos/oocytes, gestational surrogacy, and adoption. The experimental methods include oocyte cryopreservation, ovarian cryopreservation and transplantation, in vitro maturation, and ovarian suppression. With advances in methods for the preservation of fertility, providing information about risk of infertility and possible options of fertility preservation to all young patients with cancer, and discussing future fertility with them should be also considered as one of the important parts of consultation at the time of cancer diagnosis. PMID:22462006
Full Text Available Introduction. This study was aimed at analyzing the site, kind and type of infection which develop in patients having lung cancer at hospital treatment. Material and methods. Clinical data of the patients hospitalized for lung cancer were analyzed at the Clinic for Lung Diseases and Tuberculosis in Knez Selo in the period from January 2002 till December 2007. A great number of patients (1296-75.9% had non-small cell lung cancer. In 1708 patients with lung cancer, 773 febrile episodes were recorded, i.e. 687 states of infections. Results. Most of the infections were recorded in the tracheobronchial tree (60.9%. The infection was confirmed microbiologically in 38% of infectious states. Predominant Gram positive pathogens were Staphylococcus aureus and Streptococcus, but among Gram negative pathogens there were Escherichia coli and Haemophilus influenzae. Discussion. A significantly better therapy response to antibiotics was found in the group of patients where microbiological agents were isolated (p<0.05. The predominant site of infection in the patients with lung cancer is the tracheobronchial tree without a significant difference between frequency of Gram positive and Gram negative pathogens.
Victoria M Villaflor; Marco E Allaix; Bruce Minsky; Fernando A Herbella; Marco G Patti
Patients with esophageal cancer have a poor prognosis because they often have no symptoms until their disease is advanced.There are no screening recommendations for patients unless they have Barrett's esophagitis or a significant family history of this disease.Often,esophageal cancer is not diagnosed until patients present with dysphagia,odynophagia,anemia or weight loss.When symptoms occur,the stage is often stage Ⅲ or greater.Treatment of patients with very early stage disease is fairly straight forward using only local treatment with surgical resection or endoscopic mucosal resection.The treatment of patients who have locally advanced esophageal cancer is more complex and controversial.Despite multiple trials,treatment recommendations are still unclear due to conflicting data.Sadly,much of our data is difficult to interpret due to many of the trials done have included very heterogeneous groups of patients both histologically as well as anatomically.Additionally,studies have been underpowered or stopped early due to poor accrual.In the United States,concurrent chemoradiotherapy prior to surgical resection has been accepted by many as standard of care in the locally advanced patient.Patients who have metastatic disease are treated palliatively.The aim of this article is to describe the multidisciplinary approach used by an established team at a single high volume center for esophageal cancer,and to review the literature which guides our treatment recommendations.
Jensen, Line Flytkjær; Hvidberg, Line; Pedersen, Anette Fischer;
Størstedelen af kolorektal cancere opdages gennem patienters symptomatiske henvendelse i almen praksis. Man ved dog ikke meget om, hvordan patienter selv oplever deres symptomer. Formålet med studiet var, at undersøge om symptom attributioner er associeret med hvilket symptom man oplevede før læg...
Vissers, Kris C P; Besse, Kees; Wagemans, Michel; Zuurmond, Wouter; Giezeman, Maurice J M M; Lataster, Arno; Mekhail, Nagy; Burton, Allen W; van Kleef, Maarten; Huygen, Frank
Pain in patients with cancer can be refractory to pharmacological treatment or intolerable side effects of pharmacological treatment may seriously disturb patients' quality of life. Specific interventional pain management techniques can be an effective alternative for those patients. The appropriate application of these interventional techniques provides better pain control, allows the reduction of analgesics and hence improves quality of life. Until recently, the majority of these techniques are considered to be a fourth consecutive step following the World Health Organization's pain treatment ladder. However, in cancer patients, earlier application of interventional pain management techniques can be recommended even before considering the use of strong opioids. Epidural and intrathecal medication administration allow the reduction of the daily oral or transdermal opioid dose, while maintaining or even improving the pain relief and reducing the side effects. Cervical cordotomy may be considered for patients suffering with unilateral pain at the level below the dermatome C5. This technique should only be applied in patients with a life expectancy of less than 1 year. Plexus coeliacus block or nervus splanchnicus block are recommended for the management of upper abdominal pain due to cancer. Pelvic pain due to cancer can be managed with plexus hypogastricus block and the saddle or lower end block may be a last resort for patients suffering with perineal pain. Back pain due to vertebral compression fractures with or without pathological tumor invasion may be managed with percutaneous vertebroplasty or kyphoplasty. All these interventional techniques should be a part of multidisciplinary patient program. PMID:21679293
Brock, G.; Gurekas, V; Deom, P.
The coping mechanisms used by patients diagnosed with cancer play a role in their well-being and, therefore, influence their quality of life and possibly even their survival. We review the characteristics of one of these mechanisms, denial, and suggest an approach to dealing with denying patients.
CONCLUSION: This study shows that patients who are less depressed have higher levels of resilience and that psychological resilience may independently contribute to lower levels of depression among breast cancer patients. The level of psychological resilience may be a protective factor for depression and psychological distress.
Scharl, Anton; Salterberg, Annette; Untch, Michael; Liedtke, Cornelia; Stickeler, Elmar; Papathemelis, Thomas
Patients not older than 40 years are referred to as young patients. These women benefit from chemo-, endocrine and anti-HER2 therapy to a similar degree as older women. Surgery and radiation therapy also follow the same recommendations. This manuscript deals with the following topics that need special consideration in young women: endocrine therapy and ovarian suppression; fertility protection and family planning; and genetic counselling. There is an on-going debate on whether tamoxifen is sufficient as an endocrine treatment in young patients with endocrine-responsive tumours or whether suppression of ovarian function in combination with tamoxifen or aromatase inhibitor should be preferred. Recent data suggest a benefit from ovarian suppression plus exemestane in women of 35 years or younger with high-risk breast cancer. However, increased side effects bear the risk of lesser compliance, which eventually results in higher mortality. Child bearing is nowadays frequently postponed to the 4th decade of life, thereby increasing the number of women who have not yet finished their reproductive desires when diagnosed with breast cancer. These patients are in urgent need of counselling for fertility protection. Breast cancer diagnosis at young age is an indication for a possible mutation in breast cancer susceptibility genes. This has an impact on the cancer risk of the whole family, especially the offspring. Drugs that are specifically targeted to cancer cells with genetic alterations that impair DNA repair are already entering the arsenal of oncologists. PMID:27031253
Full Text Available As a result of advances in treatment, almost 80% of children and adolescents who receive a diagnosis of cancer become long-term survivors. The increased survival rate of children and adolescents with cancer has resulted in a major interest in the long-term effects of cancer treatment on the possibility for future fertility. Currently established methods for the preservation of fertility are available only for pubertal males and females. Pubertal male cancer patients should be encouraged to freeze numerous sperm samples even when sperm count and motility are poor. In these cases, intracytoplasmic sperm injection is a powerful technique compared with intrauterine insemination since thawed sperm samples with poor parameters can produce relatively high fertilization rates resulting in normal pregnancies and deliveries. Married pubertal women should be proposed ovulation induction, follicular aspiration, and fertilization with husband sperm. Single women could benefit from vitrification of oocytes. This requires a delay of about 3 weeks in the commencement of chemotherapy to enable follicular growth. Fertility preservation for prepubertal patients is more of a problem. Young girls could be offered cryopreservation of gametes in the gonadal tissue. Cryopreservation of testicular tissue was suggested for fertility preservation for young boys, but this method is totally experimental and not currently offered. Discussing future fertility is part of the consultation of young female and male patients facing potentially gonadotoxic cancer therapy. It is the role of reproductive specialists to create various options in their laboratory to preserve fertility potential of cancer patients.
Skeels, Meredith M.; Unruh, Kenton T.; POWELL, Christopher; Pratt, Wanda
Social support is a critical, yet underutilized resource when undergoing cancer care. Underutilization occurs in two conditions: (a) when patients fail to seek out information, material assistance, and emotional support from family and friends or (b) when family and friends fail to meet the individualized needs and preferences of patients. Social networks are most effective when kept up to date on the patient’s status, yet updating everyone takes effort that patients cannot always put in. To ...
Huijbers, E J M; Baars, J W; Schutte, P F E; Schellens, J H M; Beijnen, J H
A breast cancer patient experienced an accidental propofol extravasation in the dorsum of her hand during a Port-A-Cath replacement. She had heavy pain which was treated with analgesics. The patient's hand was cooled and kept in an upright position. Three days later the patient received her last AC (adriamycin/cyclophosphamide) course without complications. Propofol extravasation did not result in tissue necrosis in this case. AC chemotherapy could be administered safely 3 days after propofol extravasation. PMID:18753182
J. R. Gardanova; I. I. Abdullin; D. N. Chernov; Chernov, A. V.; Y. I. Kekteeva
Diagnostics of psycho-emotional disorders of patients with malignant diseases of the prostate is not doubt, because timely correction contributes to the shortening of rehabilitation period and restoration of the quality of life of patients after treatment. Detection and diagnosis of prostate cancer for many patients is stressful and causes changes in the affective sphere, and manifests itself in increased levels of anxiety and depression in men. To cope with stress is possible due to the used...
Weight loss and other nutritional problems are common in cancer patients. The problems are of importance for response to treatment and survival and the well-being of the patients. Nutritional support can be carried out in different ways. The efforts considered in this thesis are; assessment of nutritional status to find the patients who are at risk to become or already are malnourished, assessment of dietary intake, dietary advice, information and support to the families, information and educ...
Although palliative care has been developed and implemented as care for cancer pain, it is holistic care for suffering that includes physical, psychosocial and spiritual pain of life-threatening illness. It turned out that non-cancer patients in the end-stage are also suffering from various pain that should be treated as cancer patients. Trajectories of illness in non-cancer patients are with more gradual decline than those of cancer patients with steady progression and it is often difficult to make decision about end-of-life. The purpose of advance care planning was originally to help describe legal documents. This process is proved to contribute to improving QOL of patients and their families to discuss preference, hope, economic problems, spiritual question as well as medical treatment In Japan guideline of decision making process in end-of-life stage has been established. A program of communication training in end-of-life discussion has been made. Under current situation some comments on the role of anesthesiologists are also mentioned. PMID:27097506
Kjær, Andreas; Loft, Annika; Law, Ian;
Combined PET/MRI systems are now commercially available and are expected to change the medical imaging field by providing combined anato-metabolic image information. We believe this will be of particular relevance in imaging of cancer patients. At the Department of Clinical Physiology, Nuclear...... described include brain tumors, pediatric oncology as well as lung, abdominal and pelvic cancer. In general the cases show that PET/MRI performs well in all these types of cancer when compared to PET/CT. However, future large-scale clinical studies are needed to establish when to use PET/MRI. We envision...... that PET/MRI in oncology will prove to become a valuable addition to PET/CT in diagnosing, tailoring and monitoring cancer therapy in selected patient populations....
Choi, Soo Yong; Kim, Kee Hwa; Kang Sung Mok [Korea Cancer Center Hospital of Korea Atomic Energy Research Institute, Seoul (Korea, Republic of)
The total number of malignant neoplasms included in this study 53,566 cases(14.1%) among 379,582 patients from 1984 to 1993. On sex, females with 51.3% were much more than males with 48.7%. The highest proportion of cancer patients by age was 35.0% in males and 28.4% in females, respectively for 50-59 age group. The most frequent primary site among males was found to be stomach with 33.2%, followed by liver(15.1%), lung(14.9%), esophagus(5.3%) and larynx(3.3%). In females, the first order was uterine cervix with 37.8%, followed by stomach(16.5%), breast(14.8%), thyroid gland(4.3%) and lung (3.8%). The proportion of malignant neoplasms diagnosed by histology made up 67.0%, whereas 20.2% was diagnosed by clinical investigation(X-ray, CT, MRI etc). Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the extent of disease was 3.7% for patient with carcinoma-in-situ, 58.7% for patients with localized involvement, 18.4% for patients with regional involvement and 11.1% for patients with distant involvement. Among the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 27.5% for surgery, 22.5% for radiotherapy and 30.1% for chemotherapy. The proportion of cancer patients traced to death was only to 3.6%, 1,944 cases. Among them, 72.5% survived for less than 1 year. 17 figs, 7 tabs, 28 refs. (Author).
The total number of malignant neoplasms included in this study 53,566 cases(14.1%) among 379,582 patients from 1984 to 1993. On sex, females with 51.3% were much more than males with 48.7%. The highest proportion of cancer patients by age was 35.0% in males and 28.4% in females, respectively for 50-59 age group. The most frequent primary site among males was found to be stomach with 33.2%, followed by liver(15.1%), lung(14.9%), esophagus(5.3%) and larynx(3.3%). In females, the first order was uterine cervix with 37.8%, followed by stomach(16.5%), breast(14.8%), thyroid gland(4.3%) and lung (3.8%). The proportion of malignant neoplasms diagnosed by histology made up 67.0%, whereas 20.2% was diagnosed by clinical investigation(X-ray, CT, MRI etc). Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the extent of disease was 3.7% for patient with carcinoma-in-situ, 58.7% for patients with localized involvement, 18.4% for patients with regional involvement and 11.1% for patients with distant involvement. Among the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 27.5% for surgery, 22.5% for radiotherapy and 30.1% for chemotherapy. The proportion of cancer patients traced to death was only to 3.6%, 1,944 cases. Among them, 72.5% survived for less than 1 year. 17 figs, 7 tabs, 28 refs. (Author)
Mazanah Muhamad; Sharan Merriam; Norhasmilia Suhami
Traditional healing is a common practice in low and middle income countries such as Malaysia. Eighty percent of Malaysians consult traditional healers or “bomoh” at some time in their life for health-related issues. The purpose of our study was to explore why breast cancer patients visit traditional healers. This is a qualitative study utilizing in-depth interviews with 11 cancer survivors who sought both traditional and Western medicine. The findings revealed the following reasons for which ...
Pedersen, Anette Fischer; Hansen, Rikke P; Vedsted, Peter
Blødning fra endetarmen ses normalt som et alarmsymptom på kolorektalkræft. Alligevel vælger mange patienter at lade være med at opsøge lægen. Denne artikel ser nærmere på sammenhængen mellem et alarmsymptom (rektal blødning), forsinkelser i patientforløbet og tanker om kræft. Resultaterne viser,...
This paper reviews the results of a breast cancer screening program sponsored by organizations at workplace or community locations. A comprehensive mobile breast cancer screening program, including education, breast physical examination, and mammography, was provided to 89 local organizations at $50.00 per examination over an 18-month period. The examination was patient initiated, following the ACS screening guidelines. Estimates of eligible women were provided by each organization. A total of 5,030 women at 89 organizations were screened for breast cancer. Approximately 25,727 women were eligible
Allen, R R
Cancer presents itself in numerous ways, adding to the complexity of any pain syndrome with which it is associated. Neuropathic pain, unlike many other pain syndromes, is difficult to treat even in the absence of cancer. The combination results in a heterogeneous group of patients with a complex set of symptoms. This makes the assessment of pain, classification of syndromes, and clinical study a challenge. If the disease is nonprogressive, general principles of care are essentially the same as in those without cancer. In patients with progressive disease and more refractory painful conditions, spinal anesthetic and neurosurgical therapies must often be considered. Under such circumstances, caregivers are forced to carefully balance uncertain benefits and risks, often without the luxury of time. More careful observation and controlled trials in these patients help facilitate this challenging process. PMID:9767067
The total number of malignant neoplasms included in this study 15,737 cases(11.8%) among 133,251 cases for 3 years. On sex, females with 52.9% were much more than males with 47.1%. The highest proportion of cancer patients by age was 33.7% in males and 28.5% in females, respectivelty for 50-59 age group. The most frequent primary site among males was found to be stomach with 35.5%, followed by liver(14.7%), lung(13.0%), esophagus(5.4%) and colon (3.2%). In females, the first order was uterine cervix with 40.6%, followed by stomach(17.2%), breast(14.4), rectum(3.7%) and lung(3.4%). The most common type of morphology of malignant neoplasms was adenocarcinoma(47.4%) in males an squamous cell carcinoma(58.0%) in females. Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the exent of disease was 2.5% for patient with carcinoma-in-situ, 54.1% for patients with localized involvement, 13.3% for patients with regional involvement and 8.5% for patients with distant involvement. Among the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 23.6% for surgery, 25.3% for radiotherapy and 30.3% for chemotherapy. Among the cancer patients confirmed by medical records, 7.7% was traced more than 5 years. (Author)
Maura Gabriela FELEA
Full Text Available Negative emotions (distress are recognized as part of the psychological profile of patients diagnosed with advanced stage cancer. However, most patients are not accustomed to verbalize feelings towards their physician, and generally towards family and medical care personnel. The purpose of this paper is to analyze the expression of emotions by patients in advanced stages of cancer, respectively the means by which they get to express emotions. To this respect, we identified the most common types of emotions expressed, or metaphors used by patients to describe their emotions and topics that trigger emotions. Words and phrases most commonly used are in relation to: fear, anxiety, depression, guilt, negligence, concern. They are uttered in order to depict the network created between disclosed emotions and topics on health status, symptoms, adverse effects and therapeutic choice, patient privacy, and social and family issues.
J. R. Gardanova
Full Text Available Diagnostics of psycho-emotional disorders of patients with malignant diseases of the prostate is not doubt, because timely correction contributes to the shortening of rehabilitation period and restoration of the quality of life of patients after treatment. Detection and diagnosis of prostate cancer for many patients is stressful and causes changes in the affective sphere, and manifests itself in increased levels of anxiety and depression in men. To cope with stress is possible due to the used coping strategies.Purpose. Studying the coping mechanisms in prostate cancer patients.Materials and methods. 56 men treated in FGBU "LRTS" Russian Ministry of Health. The average age was 65.7 ± 6.1 years. The average duration of the disease prostate cancer is 3 ± 2 months. All men were subjected to the standard algorithm for the evaluation of hormonal status, the PSA, taking a history, inspection and physical examination, magnetic resonance imaging and scintigraphy of bones of a skeleton. All the patients underwent laparoscopic radical prostatectomy. Psychological testing with the use of the method of "Coping test" the scale of reactive and personal anxiety for the differentiated evaluation of anxiety. Results. The most common for prostate cancer revealed constructive coping strategies are "planning solve", "selfcontrol" and "search of social support". According to the scale Spielberg–Hanin a high level of situational anxiety was revealed.Conclusion. According to the results of the research, patients with prostate cancer are likely to use constructive coping strategies, that leads to stabilization of psycho-emotional state of men and promotes more effective adaptation in the terms of stress, that is caused by treatment of prostate cancer.
High energy gamma radiation (8 to 30 MeV) is gaining acceptance for radiation therapy of patients with deep cancers. This radiation is of sufficient energy to induce photonuclear activation of the elements in the human body. Our results of measurements of nitrogen and phosphorus in an anthropomorphic phantom, a cadaver, and a cancer patient with bremsstrahlung radiation from 15 MeV electrons demonstrate the feasibility of a method to monitor these two elements in the human body in vivo by measuring the radioactivity induced in these targets by photonuclear reactions. 14 refs., 3 figs., 2 tabs
Fabienne Camilo da Silveira Pirajá; Rafael Bandeira Lages; Uylma Assunção Costa; João Batista Mendes Teles; Viriato Campelo
Objective: To analyze the survival after five years among patients treated of prostate cancer at Hospital São Marcos. Methods: A descriptive population-based epidemiological study performed in Teresina-PI, evaluating a hospital cohort consisting of 71 patients of Hospital São Marcos, enrolled in Hospital Cancer Registry (HCR) from 2000 to 2001, under ICD10 -C61. The variables considered in the evaluation of survival were: age group, tumor staging and skin color. The Kaplan-Meier method was us...
Kostev, Karel; Waehlert, Lilia; Jockwig, Achim; Jockwig, Barbara; Hadji, Peyman
In recent years there have been major advances in the treatment of breast cancer. However, taking the prescribed medication for a sufficient period of time is crucial to the success of any therapy. Thus far, no database-based studies have been published in German-speaking countries empirically examining the influence of the physician on the compliance of patients. The aim of this study is to investigate, quantify, and critically discuss the effect treating physicians have on the compliance of their breast cancer patients. Patients with a confirmed breast cancer diagnosis who started therapy (tamoxifen or aromatase inhibitors) between January 2001 and December 2011 were selected from the representative IMS Disease Analyzer database and analyzed with regard to their compliance. Practices were grouped into two categories concerning the compliance of all treated patients. A regression model showed that a breast cancer patient who is treated in a practice with a trend toward poor compliance has a nearly 60% higher risk for treatment discontinuation than would be the case in a practice with good compliance. It shows how important it is to motivate physicians to strive toward good compliance rates. PMID:24454275
Frascà, Giovanni M; Sandrini, Silvio; Cosmai, Laura; Porta, Camillo; Asch, William; Santoni, Matteo; Salviani, Chiara; D'Errico, Antonia; Malvi, Deborah; Balestra, Emilio; Gallieni, Maurizio
Renal cancer occurs more frequently in renal transplanted patients than in the general population, affecting native kidneys in 90% of cases and the graft in 10 %. In addition to general risk factors, malignancy susceptibility may be influenced by immunosuppressive therapy, the use of calcineurin inhibitors (CNI) as compared with mammalian target of rapamycin inhibitors, and the length of dialysis treatment. Acquired cystic kidney disease may increase the risk for renal cancer after transplantation, while autosomal dominant polycystic kidney disease does not seem to predispose to cancer development. Annual ultrasound evaluation seems appropriate in patients with congenital or acquired cystic disease or even a single cyst in native kidneys, and every 2 years in patients older than 60 years if they were on dialysis for more than 5 years before transplantation. Immunosuppression should be lowered in patients who develop renal cancer, by reduction or withdrawal of CNI. Although more evidence is still needed, it seems reasonable to shift patients from CNI to everolimus or sirolimus if not already treated with one of these drugs, with due caution in subjects with chronic allograft nephropathy. PMID:26202137
Anandavadivelan, Poorna; Lagergren, Pernilla
Oesophageal cancer is a debilitating disease with a poor prognosis, and weight loss owing to malnutrition prevails in the majority of patients. Cachexia, a multifactorial syndrome characterized by the loss of fat and skeletal muscle mass and systemic inflammation arising from complex host-tumour interactions is a major contributor to malnutrition, which is a determinant of tolerance to treatment and survival. In patients with oesophageal cancer, cachexia is further compounded by eating difficulties owing to the stage and location of the tumour, and the effects of neoadjuvant therapy. Treatment with curative intent involves exceptionally extensive and invasive surgery, and the subsequent anatomical changes often lead to eating difficulties and severe postoperative malnutrition. Thus, screening for cachexia by means of percentage weight loss and BMI during the cancer trajectory and survivorship periods is imperative. Additionally, markers of inflammation (such as C-reactive protein), dysphagia and appetite loss should be assessed at diagnosis. Routine assessments of body composition are also necessary in patients with oesophageal cancer to enable assessment of skeletal muscle loss, which might be masked by sarcopenic obesity in these patients. A need exists for clinical trials examining the effectiveness of therapeutic and physical-activity-based interventions in mitigating muscle loss and counteracting cachexia in these patients. PMID:26573424
Purpose: To review the impact of anemia/tumor hypoxemia on the quality of life and survival in cancer patients, and to assess the problems associated with the correction of this difficulty. Methods: MEDLINE searches were performed to find relevant literature regarding anemia and/or tumor hypoxia in cancer patients. Articles were evaluated in order to assess the epidemiology, adverse patient effects, anemia correction guidelines, and mechanisms of hypoxia-induced cancer cell growth and/or therapeutic resistance. Past and current clinical studies of radiosensitization via tumor oxygenation/hypoxic cell sensitization were reviewed. All clinical studies using multi-variate analysis were analyzed to show whether or not anemia and/or tumor hypoxemia affected tumor control and patient survival. Articles dealing with the correction of anemia via transfusion and/or erythropoietin were reviewed in order to show the impact of the rectification on the quality of life and survival of cancer patients. Results: Approximately 40-64% of patients presenting for cancer therapy are anemic. The rate of anemia rises with the use of chemotherapy, radiotherapy, and hormonal therapy for prostate cancer. Anemia is associated with reductions both in quality of life and survival. Tumor hypoxemia has been hypothesized to lead to tumor growth and resistance to therapy because it leads to angiogenesis, genetic mutations, resistance to apoptosis, and a resistance to free radicals from chemotherapy and radiotherapy. Nineteen clinical studies of anemia and eight clinical studies of tumor hypoxemia were found that used multi-variate analysis to determine the effect of these conditions on the local control and/or survival of cancer patients. Despite differing definitions of anemia and hypoxemia, all studies have shown a correlation between low hemoglobin levels and/or higher amounts of tumor hypoxia with poorer prognosis. Radiosensitization through improvements in tumor oxygenation/hypoxic cell
PURPOSE: Severe neutropenia and febrile neutropenia (FN) are the major causes of morbidity, treatment interruptions and dose reductions in patients undergoing chemotherapy. The European Oncology Nursing Society (EONS) conducted an European survey to evaluate nurse perspectives on prevention of infection and FN in this setting, and how much they educate their patients about this. A separate survey explored these issues in patients receiving chemotherapy. METHODS: 217 nurse participants were identified by EONS from the membership database and 473 cancer patients who were receiving\\/had received chemotherapy were identified through patient advocacy groups. Questionnaires were completed anonymously online for both surveys. RESULTS: More than 90% of the nurses agreed that preventing infections including FN is extremely\\/very important for a successful chemotherapy outcome and said that they, or other health professionals in their practice, advised patients about these issues. Most (90%) indicated that they favoured giving treatment to protect against FN and infections in chemotherapy patients at risk, rather than treating infection after it develops, but 82% expressed concern over patient concordance with measures employed. A substantial proportion of patients reported emergency room visits, hospitalization and\\/or chemotherapy delays or changes as a result of neutropenia, infection or FN. However, only 44% said that their infection risk was discussed with them before starting chemotherapy. CONCLUSIONS: Our findings indicate that nurses recognise the importance of reducing the risk of infection and FN in patients undergoing chemotherapy, as well as the need to educate patients. However, results of the patient survey suggest a need for better patient education.
... 158167.html Chemo May Prolong Lives of Some Brain Cancer Patients: Study Those with slow-growing gliomas lived ... States, nearly 23,000 adults were diagnosed with brain cancer in 2015, according to the U.S. National Cancer ...
Full Text Available Infertility can arise as a consequence of treatment of oncological conditions. The parallel and continued improvement in both the management of oncology and fertility cases in recent times has brought to the forefront the potential for fertility preservation in patients being treated for cancer. Many survivors will maintain their reproductive potential after the successful completion of treatment for cancer. However total body irradiation, radiation to the gonads, and certain high dose chemotherapy regimens can place women at risk for acute ovarian failure or premature menopause and men at risk for temporary or permanent azoospermia. Providing information about risk of infertility and possible interventions to maintain reproductive potential are critical for the adolescent and young adult population at the time of diagnosis. There are established means of preserving fertility before cancer treatment; specifically, sperm cryopreservation for men and in vitro fertilization and embryo cryopreservation for women. Several innovative techniques are being actively investigated, including oocyte and ovarian follicle cryopreservation, ovarian tissue transplantation, and in vitro follicle maturation, which may expand the number of fertility preservation choices for young cancer patients. Fertility preservation may also require some modification of cancer therapy; thus, patients' wishes regarding future fertility and available fertility preservation alternatives should be discussed before initiation of therapy.
Full Text Available Purpose: Several studies have shown that HIV patients are at higher risk of lung cancer. Our aim is to analyse the prevalence and features of lung cancer in HIV-infected patients. Methods: The clinical charts of 4,721 HIV-infected patients seen in three hospitals of southeast Spain (study period 1992–2012 were reviewed, and all patients with a lung cancer were analysed. Results: There were 61 lung cancers, giving a prevalence of 1.2%. There was a predominance of men (82.0%, and smokers (96.6%; mean pack-years 35.2, with a median age of 48.0 (41.7–52.9 years, and their distribution according to risk group for HIV was: intravenous drug use 58.3%, homosexual 20.0%, and heterosexual 16.7%. Thirty-four (56.7% patients were Aids cases, and 29 (47.5% had prior pulmonar events: tuberculosis 16, bacterial pneumonia 9, and P. jiroveci pneumonia 4. The median nadir CD4 count was 149/mm3 (42–232, the median CD4 count at the time of diagnosis of the lung cancer was 237/mm3 (85–397, and 66.1%<350/mm3. 66.7% were on ART, and 70% of them had undetectable HIV viral load. The most common histological types of lung cancer were adenocarcinoma and epidermoid, with 24 (40.0% and 23 (38.3% cases, respectively. There were 49 (80.3% cases with advanced stages (III and IV at diagnosis. The distribution of treatments was: only palliative 23 (39.7%, chemotherapy 14 (24.1%, surgery and chemotherapy 8 (13.8%, radiotherapy 7 (12.1%, surgery 4 (6.9%, and other combined treatments 2 (3.4%. Forty-six (76.7% patients died, with a median survival time of 3 months. The Kaplan-Meier survival rate at 6 months was 42.7% (at 12 months 28.5%. Conclusions: The prevalence of lung cancer in this cohort of HIV-patients is high. People affected are mainly men, smokers, with transmission of HIV by intravenous drug use, and around half of them with prior opportunistic pulmonary events. Most patients had low nadir CD4 count, and were immunosuppressed at the time of diagnosis
Liu, J.; Chadder, J.; Fung, S.; Lockwood, G.; Rahal, R.; Halligan, M.; Mowat, D.; Bryant, H.
Evidence shows that continued smoking by cancer patients leads to adverse treatment outcomes and affects survival. Smoking diminishes treatment effectiveness, exacerbates side effects, and increases the risk of developing additional complications. Patients who continue to smoke also have a higher risk of developing a second primary cancer or experiencing a cancer recurrence, both of which ultimately contribute to poorer quality of life and poorer survival. Here, we present a snapshot of smoking behaviours of current cancer patients compared with the non-cancer patient population in Canada. Minimal differences in smoking behaviours were noted between current cancer patients and the rest of the population. Based on 2011–2014 data from the Canadian Community Health Survey, 1 in 5 current cancer patients (20.1%) reported daily or occasional smoking. That estimate is comparable to findings in the surveyed non-cancer patient population, of whom 19.3% reported smoking daily or occasionally. Slightly more male cancer patients than female cancer patients identified as current smokers. A similar distribution was observed in the non-cancer patient population. There is an urgent need across Canada to better support cancer patients in quitting smoking. As a result, the quality of patient care will improve, as will cancer treatment and survival outcomes, and quality of life for these patients.
Examines arguments for and against evaluation advocacy in terms of the American Evaluation Association's "Guiding Principles for Evaluators" and other statements on advocacy and neutrality. Suggests revision of the "Guiding Principles." (Author/SLD)
Full Text Available The hair loss in 8 cancer patients aged between 18 and 60 years on chemotherapy was studied. All had diffuce moderate alopecio within 1 month of starting treatment. Of the 8, 3 had only telogen hairs and 3 had high dystrophic hair count. Both anagen and telogen effluvium are implicated.
Paaschburg, B.; Pedersen, A.; Tuxen, M.K.;
The latest investigations have been searched in order to present new guidelines for the treatment of elderly patients with primary breast cancer. It is concluded that breast-conserving surgery should be offered as well as the sentinel node technique. Axillary lymph node dissection is not necessary...
Dahl, Sune; Bendixen, Morten; Fristrup, Claus Wilki; Mortensen, Michael Bau
Cancer of the papilla of Vater is a relatively rare disease. It is difficult to separate from other periampullary tumours at the time of diagnosis. Recent studies have shown that patients with cancer of the papilla tend survive longer than patients with pancreatic cancer and cancers of biliary and...
... nlm.nih.gov/medlineplus/news/fullstory_158339.html Only Half of Rectal Cancer Patients Get Recommended Treatment: ... therapy for rectal cancer in the United States, only slightly more than half of patients receive it, ...
... nih.gov/medlineplus/news/fullstory_158365.html Many Breast Cancer Patients May Not Need Chemo: Study Genetic test ... 2016 MONDAY, April 18, 2016 (HealthDay News) -- Many breast cancer patients receive chemotherapy they don't need, according ...
In the recent years, a lot of attention has been devoted to oncological rehabilitation, because progress in diagnostics and methods of treatment of cancer leads to increased survival time of cancer patients. The goals of oncological rehabilitation are improvement of quality of life and support to return these patients to family and social environment with the minimal possible consequences of the disease. The paper presents the goals and contents of the early rehabilitation programs at the Ins...
Royea, Amber J.; Appl, Dolores J.
Over the years parents, professionals, and politicians have come together to advocate on behalf of children's rights. Advocacy can occur individually, collectively, or a combination of both. Although some advocacy efforts are more successful than others, it is the process of the advocacy and voices behind it that matter most. In this guest…
Debra A. Strong; Todd Honeycutt; Judith Wooldridge
This toolkit is designed to help advocacy organizations, evaluators, and other groups collect and analyze data using the instruments and methods Mathematica used in its Consumer Voices for Coverage evaluation. It includes surveys of advocacy coalition members, interviews with policymakers, and measures of coalition advocacy capacity.
Kim, Kwangsoo; Lee, Ji-Hun
Background and Purpose Stroke is common among cancer patients. However, risk factors and biomarkers of stroke in cancer patients are not well established. This study aimed to investigate risk factors and biomarkers as well as etiology of ischemic stroke in cancer patients. Methods A retrospective review was conducted in cancer patients with ischemic stroke who were admitted to a general hospital in Busan, Korea, between January 2003 and December 2012. The risk factors and biomarkers for strok...
Full Text Available Competition advocacy is considered, together with enforcement, the core business of an antitrust authority. Broadly speaking there are at least three main tasks regularly performed by most, if not all, antitrust agencies that are amenable to the advocacy function: addressing laws and regulations in order to remove unnecessary impediments to competition; engaging in sector enquiries to understand markets behavior and identify critical issues; explaining the benefits of open competitive markets to the public opinion. This article examines these three main tasks and outlines the challenges for competition agencies, with references to the experience of the Italian Competition Authority (ICA and the initiatives undertaken at international level.
Pfeiffer, Per; Qvortrup, Camilla; Tabernero, Josep
Recent modalities and strategies have increased the complexity of treatment choice in patients with colorectal cancer (CRC), and therefore all cases should be assessed at a multidisciplinary conference. Adjuvant chemotherapy for 6 months increases the chance of cure by absolutely 5 % in stage II...... and 10–15 % in stage III. Targeted therapy is not recommended in the adjuvant setting. Treatment options in patients with non- resectable CRC are based on the extent of disease (resectable/potential resectable/non-resectable) and symptoms. Surgery fi rst or chemotherapy fi rst in patients with...
Warren, Jane; Klepper, Konja K.; Lambert, Serena; Nunez, Johnna; Williams, Susan
Creating and retaining empathic connections with the most disenfranchised among us can take a toll on the wellness of counselor advocates. The Advocacy-Serving Model is introduced as a creative approach to strengthening the ability of advocates to serve through enhancing awareness, focusing actions, and connecting to community. The model…
Brunelli, Cinzia; Bennett, Michael I; Kaasa, Stein;
and on the relevance of patient-reported outcome (PRO) descriptors for the screening of NP in this population. An international group of 42 experts was invited to participate in a consensus process through a modified 2-round Internet-based Delphi survey. Relevant topics investigated were...... good agreement was found on the statement "the pathophysiology of NP due to cancer can be different from non-cancer NP" (MED=9, IQR=2). Satisfactory consensus was reached for the first 3 NeuPSIG criteria (pain distribution, history, and sensory findings; MEDs⩾8, IQRs⩽3), but not for the fourth one...
Joana Pedro Lopes
Full Text Available The present study intended to evaluate the nutritional status of Portuguese colorectal patients and associated it with surgery type as well as quality of life outcomes. Malnutrition can affect up to 85% of cancer patients and specifically 30-60% in colorectal cancer and can significantly influence health outcomes. A sample of 50 colorectal cancer patients was evaluated in what refers to several anthropometric measures, food intake, clinical history, complications rate before and after surgery procedure. The sample was divided between convention and fast-track procedures. Most of the individuals were overweight or obese but had lost weight on the past six months. Despite mild, there were signs of malnutrition in this sample with high losses of fat free mass, weight and also fat mass during the hospitalization period. These results reinforce the importance of malnutrition assessment in colorectal patients as well as consider weight loss on the past months and body composition in order to complement nutritional status evaluation.
Fung, Chunkit; Dale, William; Mohile, Supriya Gupta
Treatment for prostate cancer (PCa) has evolved significantly over the last decade. PCa is the most prevalent non-skin cancer and the second leading cause of cancer death in men, and it has an increased incidence and prevalence in older men. As a result, physicians and patients are faced with the challenge of identifying optimal treatment strategies for localized, biochemical recurrent, and advanced PCa in the older population. When older patients are appropriately selected, treatment for PCa results in survival benefits and toxicity profiles similar to those experienced in younger patients. However, underlying health status and age-related changes can have an impact on tolerance of hormonal therapy and chemotherapy in men with advanced disease. Therefore, the heterogeneity of the elderly population necessitates a multidimensional assessment to maximize the benefit of medical and/or surgical options. Providing clinicians with the requisite health status data on which to base treatment decisions would help ensure that older patients with PCa receive optimal therapy if it will benefit them and/or active surveillance or best supportive care if it will not. We provide a review of the existing evidence to date on the management of PCa in the older population. PMID:25071137
This tutorial is aimed at those who are new to the area of repositories and who want to learn more about key advocacy and policy issues. The tutorial will include information and advice on putting together an institutional advocacy campaign and developing policies for your repository. There will be opportunities for participants to share experiences and to ask questions. The tutorial will include a practical exercise in developing an advocacy presentation. Participants with experience of advocacy are welcome to attend the session to share their experiences, but should bear in mind that it is aimed primarily at those looking for help and advice in advocacy matters.
Kjær, Andreas; Loft, Annika; Law, Ian;
described include brain tumors, pediatric oncology as well as lung, abdominal and pelvic cancer. In general the cases show that PET/MRI performs well in all these types of cancer when compared to PET/CT. However, future large-scale clinical studies are needed to establish when to use PET/MRI. We envision......Combined PET/MRI systems are now commercially available and are expected to change the medical imaging field by providing combined anato-metabolic image information. We believe this will be of particular relevance in imaging of cancer patients. At the Department of Clinical Physiology, Nuclear...... Medicine & PET at Rigshospitalet in Copenhagen we installed an integrated PET/MRI in December 2011. Here, we describe our first clinical PET/MR cases and discuss some of the areas within oncology where we envision promising future application of integrated PET/MR imaging in clinical routine. Cases...
The contributions of the interventional radiologist in the diagnosis and management of the cancer patient include angiography and intraarterial CT-angiography, intraarterial infusion therapy, embolization, chemoembolization, biopsy and drainage procedures, central venous catheter reposition and retrieval, and stent dilation of stenotic tubular structures in the following organ systems: (1) Kidney. Arterial embolization, therapeutic delay, enphrectomy, and medroxyprogesterone yield a response rate of 28% in patients with renal cell carcinoma and pulmonary parenchymal metastases. (2) Liver. The carcinoid syndrome secondary to hepatic metastases can be controlled by embolization in 87% of patients. Islet cell carcinoma of the pancreas with hepatic metastases is successfully managed in 75% of patients. Chemoembolization (Ivalon and cisplatin) has been effective in 60% of patients with hepatic metastases from ocular melanoma. (3) Bone. A 73% 3-year survival rate is now possible with the inraarterial infusion of cisplatin, while Adriamycin is given intravenously in patients with osteosarcoma. Limb salvage is now possible in 80% of cases. Cancers of the vulva, vagina, urethra, and penis have been successfully treated with intraarterial infusion of chemotherapy followed by radiation therapy. (5) An expansile metallic stent is available to alleviate obstructions of the vena cava, the aorta and its major branches, the tracheobronchial tree, and the common duct. These techniques are demonstrated and results discussed
Seok, Jeong-Ho; Choi, Won-Jung; Lee, Yong Sang; Park, Cheong Soo; Oh, Young-Ja; Kim, Jong-Sun; Chang, Hang-Seok
Purpose Previous studies have reported that over a third of cancer patients experience significant psychological distress with diagnosis and treatment of cancer. Mental adjustment to cancer as well as other biologic and demographic factors may be associated with their distress. We investigated the relationship between mental adjustment and distress in patients with thyroid cancer prior to thyroidectomy. Materials and Methods One hundred and fifty-two thyroid cancer patients were included in t...
Dubetz, Nancy E.; de Jong, Ester J.
As a consequence of changes in federal and state policies in education, educators who believe in the value and importance of bilingualism find themselves in a contested environment where their notions of best practices for emergent bilinguals contradict those espoused in such policies. In this context, acts of advocacy that support bilingual…
Stout, Daniel A.
Focuses on the preliminary process of corporate advocacy, which provides direction for issues management. Provides insights into: (1) the degree to which organizational spokespersons are willing to express a position on a variety of issues; (2) how such positions come to be advocated through organizational communication; and (3) how organizational…
Saraiva P.P.; Figueiredo N.B.; Padovani C.R.; Brentani M.M.; Nogueira C.R.
Estrogen involvement in breast cancer has been established; however, the association between breast cancer and thyroid diseases is controversial. Estrogen-like effects of thyroid hormone on breast cancer cell growth in culture have been reported. The objective of the present study was to determine the profile of thyroid hormones in breast cancer patients. Serum aliquots from 26 patients with breast cancer ranging in age from 30 to 85 years and age-matched normal controls (N = 22) were analyze...
Eyigor, Sibel; Kanyilmaz, Selcen
Breast cancer is the most common type of cancer in women, but fortunately has high survival rates. Many studies have been performed to investigate the effects of exercise in patients diagnosed with breast cancer. There is evidence that exercise after the diagnosis of breast cancer improves mortality, morbidity, health related quality of life, fatigue, physical functioning, muscle strength, and emotional wellbeing. Based on scientific data, breast cancer patients should be recommended to parti...
Jai N Patel Department of Cancer Pharmacology, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC, USA Abstract: Cancer pharmacogenomics is an evolving landscape and has the potential to significantly impact cancer care and precision medicine. Harnessing and understanding the genetic code of both the patient (germline) and the tumor (somatic) provides the opportunity for personalized dose and therapy selection for cancer patients. While germline DNA is useful in understandin...
Loh, Kah Poh; Janelsins, Michelle C.; Mohile, Supriya G.; Holmes, Holly M.; Hsu, Tina; Inouye, Sharon K.; Karuturi, Meghan S.; Kimmick, Gretchen G.; Lichtman, Stuart M.; Magnuson, Allison; Whitehead, Mary I.; Wong, Melisa L.; Ahles, Tim A.
Chemotherapy-related cognitive impairment (CRCI) can occur during or after chemotherapy and represents a concern for many patients with cancer. Among older patients with cancer, in whom there is little clinical trial evidence examining side effects like CRCI, many unanswered questions remain regarding risk for and resulting adverse outcomes from CRCI. Given the rising incidence of cancer with age, CRCI is of particular concern for older patients with cancer who receive treatment. Therefore, research related to CRCI in older patients with cancers is a high priority. In this manuscript, we discuss current gaps in research highlighting the lack of clinical studies of CRCI in older adults, the complex mechanisms of CRCI, and the challenges in measuring cognitive impairment in older patients with cancer. Although we focus on CRCI, we also discuss cognitive impairment related to cancer itself and other treatment modalities. We highlight several research priorities to improve the study of CRCI in older patients with cancer. PMID:27197918
In order to test the radiosensitivity of normal skin tissue, the authors cultured cancer patient's skin tissue fibroblast, surviving fraction experiment was employed to provide data for understanding of the different radiosensitivity among the cancer patients, Method: cancer patient's skin tissue fibroblast were cultured in vitro by the way of tar's attachment, cells were irradiated by graded doses of γ-ray , cell dose response experiment was used to test the radiosensitivity of cell. Result: Cancer patient's skin fibroblast could be propagated and passaged by the method of culture in vitro. Radiosensitivity are different among the various cancer patient's skin tissue fibroblasts
Tukaye, Deepali N; Brink, Heidi; Baliga, Ragavendra
Thrombosis and thromboembolic events contribute to significant morbidity in cancer patients. Venous thrombosis embolism (which includes deep vein thrombosis and pulmonary embolism) accounts for a large percentage of thromboembolic events. Appropriate identification of cancer patients at high risk for venous thromboembolism and management of thromboembolic event is crucial in improving the quality of care for cancer patients. However, thromboembolism in cancer patients is a complex problem and the management has to be tailored to each individual. The focus of this review is to understand the complex pathology, physiology and risk factors that drive the process of venous thrombosis and embolism in cancer patients and the current guidelines in management. PMID:26919091
Traditional healing is a common practice in low and middle income countries such as Malaysia. Eighty percent of Malaysians consult traditional healers or bomoh at some time in their life for health-related issues. The purpose of our study was to explore why breast cancer patients visit traditional healers. This is a qualitative study utilizing in-depth interviews with 11 cancer survivors who sought both traditional and Western medicine. The findings revealed the following reasons for which patients seek traditional healers: (1) recommendation from family and friends, (2) sanction from family, (3) perceived benefit and compatibility, (4) healer credibility, and (5) reservation with Western medicine and system delay. These factors work together and are strongly influenced by the Malaysian cultural context. The issue with the Western health system is common in a developing country with limited health facilities
Full Text Available Traditional healing is a common practice in low and middle income countries such as Malaysia. Eighty percent of Malaysians consult traditional healers or “bomoh” at some time in their life for health-related issues. The purpose of our study was to explore why breast cancer patients visit traditional healers. This is a qualitative study utilizing in-depth interviews with 11 cancer survivors who sought both traditional and Western medicine. The findings revealed the following reasons for which patients seek traditional healers: (1 recommendation from family and friends, (2 sanction from family, (3 perceived benefit and compatibility, (4 healer credibility, and (5 reservation with Western medicine and system delay. These factors work together and are strongly influenced by the Malaysian cultural context. The issue with the Western health system is common in a developing country with limited health facilities.
Radiotherapy to treat cancer was given for the first time exactly one hundred years ago. Today, radiotherapy and surgery are the two main modes of treating cancer. One in two cancer patients receives radiotherapy at some point during the course of treatment for the disease. Radiotherapy is applied most commonly in cases where surgery is not possible. Moreover, these two modes of treatment are often used together to supplement each other. About half of new cancer cases detected today can be ordered. The estimate given by the EU for cancers cured is 45 per cent, which is divided between the various treatment modes as follows: surgery 22 %, radiotherapy 12 %, surgery plus radiotherapy 6 %, and drug therapy 6 %. In addition to curative treatment, radiotherapy plays a crucial role in palliative treatment, i.e. treatment that alleviates symptoms. The sensitivity of malignant tumours to radiotherapy varies over a wide range; the same is true for healthy tissues. Radiotherapy can only be used to cure a tumour that is more sensitive to radiation than the surrounding healthy tissue. The tumour must also be sufficiently small in size and limited to a relatively small area. (orig.)
Objective: To demonstrate the profile that comes to query the patient with cancer Lung in Paraguay, as well as therapeutic limitations found in stadiums advanced. Material and Methods: A retrospective analysis of medical records of patients who consulted was held at the Institute of Cancer in 2008. Inclusion criteria: patients with histologically confirmed attending their first consultation in the period from January 2008 to December 2008. Data Collection: sex, age, origin, occupation, toxic habits, reason was analyzed consultation, ECOG, histology, stage and treatment performed. Results: Of 59 patients studied there is a predominance of males (83%) from mostly in rural areas. The average age is 61 years. Of risk factors (Snuff, environmental exposure) 100% of women do not have such and only 2.3% of men; It is more frequent association of the two factors cited. Dyspne a (44%) is The most common symptom, followed by pain (20.3%), Cough / hemoptysis (17%) and finally headache (6.7%). The histological prevalence is a non-small cell cancer (98.3%) and among the Adenocarcinoma heads the frequency (56.8%), Squamous Cell Carcinoma (24.1%) and carcinoma differentiated ((19.1%), there is only one record of a Oat Cell Carcinoma. The stadium's presentation common is the Est. IV (44%) being the most frequent sites Liver metastases (26.7%) and Brain (23%) come in relatively general condition, mostly with ECOG 2 (30.5%) .. In As for treatment: one patient was performing a partial lobectomy operable; They performed chemotherapy or radiotherapy alone 24.5% and 16.9% respectively, the combination of both 10% and made no treatment, rejected or made exclusive palliative care 46% of the sample. Of 25 patients who received chemotherapy and 92% received 1st line Paclitaxel + Carboplatin and of them only 16% showed greater than 50% response. Only 6 patients performed 2nd line with Gemzitabina + cisplatin; and only one patient performed The 3rd line (Vinorelbine + Gemzitabina) and 4
Background Cancer has been known as a class of dangerous diseases which cause tremendous physical and emotional problems to both patients and their families. In spite of medical advances, cancer is still considered to be equal with death and pain. This study aims to analyze the emotional distress and the causes in breast cancer patients. Methods This study was a quantitative study which tries to analyze the emotional distress in 82 breast cancer patients referred to the Radiotherapy and Oncol...
Dworkind, M.; Shvartzman, P; Adler, P. S.; Franco, E. D.
Members in the Department of Family Medicine of a university teaching hospital were surveyed to find out their involvement in caring for cancer patients. Respondents indicated that many cancer patients were followed, but few cancer support services in the hospital and the community were used. The desire to take on new cancer patients was lacking, yet an interest in continuing medical education existed. Feedback from the department will help guide our Education Committee to develop continuing ...
Chuang-Chi Liaw; Hung Chang; Tsai-Sheng Yang; Ming-Sheng Wen
Background. We study the clinical significance and management of pulmonary venous obstruction in cancer patients. Methods. We conducted a prospective cohort study to characterize the syndrome that we term “pulmonary vein obstruction syndrome” (PVOS) between January 2005 and March 2014. The criteria for inclusion were (1) episodes of shortness of breath; (2) chest X-ray showing abnormal pulmonary hilum shadow with or without presence of pulmonary edema and/or pleural effusion; (3) CT scan demo...
Invasive fungal infections are important causes of morbidity and mortality in cancer patients with prolonged neutropenia following chemotherapy. Recent trends indicate a change toward infections by Aspergillus species, non-albicans species of Candida, and previously uncommon fungal pathogens. These have decreased susceptibility to current antifungal agents. In the last decade there has been much effort to find solutions for these changing trends. This article reviews current approaches to prevention and treatment of opportunistic fungal infections in postchemotherapy neutropenic patients and discussion future antifungal approaches and supportive methods. (author)
Kahán, Zsuzsanna; Szántó, István; Molnár, Mária; Rohánszky, Magda; Koncz, Zsuzsa; Mailáth, Mónika; Kapitány, Zsuzsanna; Dudás, Rita
The development of a recommendation was intended for the follow-up of breast cancer patients treated with curative intent in Hungary. Follow-up includes the permanent contact with and health education of the patient, the surveillance and control of the adverse effects of oncological therapies or radiotherapy, the screening of metachron cancers, and the comprehensive (physical, psychological and social) rehabilitation of the patient. The early detection of local/regional tumor relapse is essential with careful follow-up, but there is no need for screening of distant metastases by means of imaging studies or tumor marker tests. If adjuvant endocrine therapy is needed, optimal adherence should be ensured with supportive therapy. In rare cases, special issues such as breast cancer risk/genetic mutation, pregnancy are raised, which should be thoughtfully discussed in view of recent advances in oncology. Follow-up is generally practised by the oncologist, however, in some cases the social worker, the physiotherapist, the psychooncologist, or in special cases, the lymphoedema expert is to be involved. The follow-up approach should be comprehensive and holistic. PMID:27579724
Marrazzoa, Antonio; Taormina, Pietra; David, Massimo; Riili, Ignazio; Casà, Luigi; Catalano, Filippo; Lo Gerfo, Domenico; Noto, Antonio
Life expectancy for patients with breast carcinoma has changed in Europe over the last two decades. In Italy, the overall survival rate is about 77% at 5 years. When considering the situation in Sicily, the EUROCARE 2 study examined survival data from the Ragusa Cancer Registry, showing that the curves are worse than in other regions of Italy. Starting from these considerations we decide to evaluate whether these data from the Ragusa Cancer Registry corresponded to Palermo data. So we analysed data from 575 consecutive patients with breast cancer, treated in our Breast Unit from 1990 to 2003 according to the St. Gallen Recommendations and followed for a median period of 5 years. The prognostic role of age, tumour size, nodal status, TNM, stage, grading and hormonal receptors (OR, PR) were analysed and survival curves at 5 and 10 years were produced using the actuarial survival methods. All causes of death were considered. The median follow-up was 33 months. The Log rank test and univariate cox proportional model were used to demonstrate the association between prognostic factors and outcome. When considering T and N status, the curves showed an inverse correlation between survival and increases in these parameters. Overall survival was 92.9% at 5 years and 81.4% at 10 years for T1, 78.4% at 5 years and 61.4% at 10 years for T2 and 40.8% for T3-T4 at 5 and 10 years. Overall survival for NO was 92.1% and 78.2%, respectively, at 5 and 10 years, but decreased to 72.0% and 59.9% at 5 and 10 years for N1. In N2 patients we found that only about 50% of patients were still alive at 5 and 10 years, while for N3 patients the figures were 57.2% and 40%, respectively. PMID:17663369
Hagedoorn, Mariet; Kreicbergs, Ulrika; Appel, Charlotte
Cancer affects not only patients but also their loved ones. Material and methods. This paper presents a selective, narrative review of psychosocial consequences of cancer and its treatment for relatives of patients, including parents and siblings of children with cancer, children of parents with can
Benjamin Kasenda; Annatina Bass; Dieter Koeberle; Bernhard Pestalozzi; Markus Borner; Richard Herrmann; Lorenz Jost; Andreas Lohri; Viviane Hess
Background Cancer registry data suggest that conditional survival prognosis in patients with aggressive malignancies improves over time. We investigated conditional survival in patients with advanced pancreatic cancer. Patients and Methods In this retrospective study, we included all patients with advanced pancreatic cancer treated at four Swiss hospitals between 1994 and 2004. Main outcome was 6-month conditional survival, defined as the probability of surviving an additional 6 months condit...
Rocco, Nicola; Rispoli, Corrado; Pagano, Gennaro; Rengo, Giuseppe; Compagna, Rita; Danzi, Michele; Accurso, Antonello; Amato, Bruno
Aims and background Old age is associated with comorbidity and decreased functioning which influences treatment decisions in elderly breast cancer patients. The purpose of this study was to identify risk factors for complications after breast cancer surgery in elderly patients, and to assess mortality in patients with postoperative complications. Methods We retrospectively considered all female patients aged 65 years and older with invasive and in situ breast cancer who were diagnosed and tre...
Yao Wanxia; Lin Miao; Lü Ye; Yang Biao; Yao Cong; Liu Juan; Wang Wenru
Objective To examine self-reported symptoms by the patients receiving cancer therapy, and find out the symptoms that should be coped with and managed during the treatment. Methods A pilot study was conducted on self-reported symptoms on 185 patients receiving chemotherapy and/or radiotherapy for different cancers. The Therapy-Related Symptoms Checklist (TRSC) was used. Results Severe symptoms on the TRSC subscales: loss of appetite,feeling sluggish, weight loss, nausea and hair loss, were reported by the patients. The frequently reported symptoms by those on chemotherapy were nausea, feeling sluggish, weight loss, vomiting, and taste change. The frequently reported symptoms by those on radiotherapy were feeling sluggish, weight loss, loss of appetite, difficult sleeping, and changing taste. The symptoms of loss of appetite, feeling sluggish, weight loss, hair loss, and nausea were both frequently reported by those on radiotherapy and those on chemotherapy. Conclusion Symptom monitoring may be facilitated by TRSC, based on the severity and frequency of reported symptoms, more patients and caregivers could know which symptoms should be preferential interventions.
Objective: Based on T. N. M classification, this study was conducted to evaluate the clinical presentation of carcinoma of breast in central part of rural Sindh. Design: This is a 5-year combined study i.e. 3 years retrospective and 2 years prospective. Place and Duration of Study: This study was carried out at People's Medical College Hospital (PMCH) Nawabshah from June 1995 to May, 2000 for a period of five years. Subjects and Methods: Fifty patients having carcinoma breast and admitted to surgical department ware included in study. Results: Eighty four percent of these patients presented in advanced stage of the disease. Well established predisposing factors like early menarche, age at first pregnancy, breast feeding and number of children did not contribute to the risk of developing breast cancer in our patients. Conclusion: Majority of breast cancer patients present in advance stage of the disease, hence can not be benefited from modern methods of treatment. The reasons for this delayed presentation are multi fold and are discussed here. (author)
Aline Carniato Dalle Nogario
Full Text Available OBJECTIVEUnderstanding nursing actions in the practice of inpatient advocacy in a burn unit.METHODA single and descriptive case study, carried out with nurses working in a referral burn center in southern Brazil. Data were collected through focus group technique, between February and March 2014, in three meetings. Data was analysed through discursive textual analysis.RESULTSThree emerging categories were identified, namely: (1 instructing the patient; (2 protecting the patient; and (3 ensuring the quality of care.CONCLUSIONSThis study identified that the nurses investigated exercised patient advocacy and that the recognition of their actions is an advance for the profession, contributing to the autonomy of nurses and the effectiveness of patients' rights and social justice.
Full Text Available Abstract Background Most of the studies about invasive Candida infections in cancer patients have focused on haematological patients. The aim of this study was to provide information about risk factors for candidaemia in patients with solid tumours. Methods Retrospective cohort study. During a 9-year period (1995–2003 we reviewed all cases of candidaemia that affected cancer patients in Santa Casa Complexo Hospitalar, Brazil. Results During the period of study, 210 patients had the diagnosis of candidaemia in our medical centre, and 83 of these patients had cancer (39.5%. The majority of patients with cancer had solid tumours (77.1%, mostly in the alimentary tract. Most of solid cancers were non-metastatic (71.9%. Major diagnoses in patients with haematological neoplasia were acute leukaemia (n = 13, high grade non-Hodgkin lymphoma (n = 5 and Hodgkin's disease (n = 1. Non-Candida albicans species caused 57.8% of the episodes of candidaemia in patients with cancer, mainly in patients with haematological malignancies (p = 0.034. Neutropenia and treatment with corticosteroids were more frequent in the haematological group, in comparison with patients with solid tumours. Only 22.2% of patients with solid tumours were neutropenic before candidaemia. Nonetheless, the presence of ileus and the use of anaerobicides were independent risk factors for candidaemia in patients with solid cancers. The overall mortality in cancer patients with candidaemia was 49.4%. We then compared 2 groups of adult patients with candidaemia. The first was composed of non-neutropenic patients with solid tumours, and the second group included patients without cancer. We found that central venous catheters and gastrointestinal surgery were independently associated with candidaemia in patients with solid tumour. Conclusion Cancer patients with candidaemia seem to have very different predisposing factors to acquire the infection when stratified according to baseline diseases
Full text: Objective: To perform a retrospective descriptive study on breast cancer in patients treated in our hospital to assess the biological profile and treatment heating in these patients. Material and methods: We collect information from medical records for the period 2006 to 2010 included. Basic statistical analyzes were performed with the sample obtained using the Epi data. Results: From a total of 720 patients, showed that 31% are under 50 and 69% are older than 50 years. The 95 % of the total, surgery was performed. The 94 % is to Infiltrating Ductal Carcinoma. I stages were 17%, 39% Stages II, III Stages Stages IV 29% and 15%. 79% had one or two positive hormone receptors. At 86 % Radiation was performed either in the breast or chest wall treatments regional nodal areas when directed. In the vast majority gave a dose of 50 Gy to the whole breast and nodal areas when corresponded with overprinting in the surgical bed of 16Gy. In cases of treatment of wall thoracic, was given a dose of 50 Gy. The number of relapses in irradiated territories was 5 patients. The average treatment time was 45 heating days for patients who underwent conservative surgery and 38 days for patients who underwent mastectomy. Conclusions: The parameters analyzed in this study are comparable to those work results in other centers. The local recurrence rate in patients treated with surgery and adjuvant radiotherapy is extremely low
Fabienne Camilo da Silveira Pirajá
Full Text Available Objective: To analyze the survival after five years among patients treated of prostate cancer at Hospital São Marcos. Methods: A descriptive population-based epidemiological study performed in Teresina-PI, evaluating a hospital cohort consisting of 71 patients of Hospital São Marcos, enrolled in Hospital Cancer Registry (HCR from 2000 to 2001, under ICD10 - C61. The variables considered in the evaluation of survival were: age group, tumor staging and skin color. The Kaplan-Meier method was used in the calculation of survival functions in five years and the Kruskal-Wallis test in comparison between variables. Results: The specific survival rate for prostate cancer was of 78.5% in five years. The death risk in this study increased with age and advanced stage at diagnosis (aged 80 or above = 60%; and stage IV = 63%. The Kruskal-Wallis test showed no statistically significant variation between groups. Conclusion: The age and advanced stage at diagnosis decreased patients’ survival.
Fabienne Camilo da Silveira Pirajá
Full Text Available Objective: To analyze the survival after five years among patients treated of prostate cancer at Hospital São Marcos. Methods: A descriptive population-based epidemiological study performed in Teresina-PI, evaluating a hospital cohort consisting of 71 patients of Hospital São Marcos, enrolled in Hospital Cancer Registry (HCR from 2000 to 2001, under ICD10 -C61. The variables considered in the evaluation of survival were: age group, tumor staging and skin color. The Kaplan-Meier method was used in the calculation of survival functions in five years and the Kruskal-Wallis test in comparison between variables. Results: The specific survival rate for prostate cancer was of 78.5% in five years. The death risk in this study increased with age and advanced stage at diagnosis (aged 80 or above = 60%; and stage IV = 63%. The Kruskal-Wallis test showed no statistically significant variation between groups. Conclusion: The age and advanced stage at diagnosis decreased patients’ survival.
The effect of chest irradiation on pulmonary function was studied in 16 patients with lung cancer and one with malignant thymoma. Radiation pneumonitis was detected by chest radiography in 15 cases (88%), 35 days (average) after the completion of radiation therapy. In these cases the radiation field included the lungs, and the hilar and mediastinal regions. No radiation pneumonitis occurred in the other two patients, receiving only lung field irradiation. Various pulmonary functions were measured in all patients following radiation therapy. Inspiratory reserve volume, inspiratory capacity and diffusing capacity were significantly reduced 1 month and 3 months after the completion of radiotherapy. Furthermore, reduction of vital capacity was found 3 months after treatment. It may be concluded that pulmonary function tests are not useful in predicting the onset of radiation pneumonitis, as chest radiography revealed inflammatory changes before the reduction of pulmonary function was detected. (author)
Schulman, Sam; Shrum, Jeffrey; Majeed, Ammar
There has been a concern that major bleeding events (MBE) on direct-acting oral anticoagulants (DOACs) will be more difficult to manage than on vitamin K antagonists. Patients with cancer and DOAC-associated bleeding may be even more of a challenge to manage. We therefore reviewed the literature on bleeding in patients with cancer on DOACs. In addition, we performed an analysis of individual patient data from 5 phase III trials on treatment with dabigatran with focus on those with cancer. In 6 randomized trials the risk of MBE in patients with cancer was similar on treatment with DOACs compared to vitamin K antagonists. Bleeding was in the majority of patients managed with supportive therapy alone. In the individual patient data analysis there were no significant differences in use of hemostatic products, transfusion of red cells, effectiveness of management, bleeding-related mortality or 30-day all-cause mortality between patients with cancer treated with dabigatran or with warfarin. Local hemostatic therapy, including resection of the cancer site was more common in patients with gastrointestinal bleeding with cancer than among those without cancer. We conclude that management of bleeding in patients with cancer and on a DOAC does not pose a greater challenge than management of bleeding in patients without cancer. PMID:27067968
Zaidi Adnan A; Ansari Tayyaba Z; Khan Aziz
Abstract Introduction The emotional burden associated with the diagnosis of cancer is sometimes overshadowed by financial burden sustained by patient and the family. This is especially relevant for a developing country as there is limited state support for cancer treatment. We conducted this study to estimate the cost of cancer care for two major types of cancer and to assess the perception of patients and families regarding the burden of the cost for undergoing cancer treatment at a private ...
Byung Hyun Byun
Full Text Available Objective: Resistance of metastatic lymph nodes (LNs to high dose I-131 therapy is associated with high morbidity in patients with differentiated thyroid cancer. We evaluated the role of F-18 FDG PET/CT in the prediction of resistance to high dose I-131 therapy in patients with papillary thyroid cancer. Methods: The subjects were 307 patients who underwent total or near total thyroidectomy followed by high dose (5.55-6.66 GBq I-131 therapy. We divided the patients into three subgroups by visual assessment of regional LNs: FDG-avid LNs with a malignant shape on CT (PET/CT-positive group, FDG-avid LNs with a benign shape on CT (PET/CT-intermediate group and no FDG-avid lesion (PET/CT-negative group. We measured the maximum SUV (SUVmax of FDG-avid LNs in each patient. The presence or absence of focal increased uptake of I-131 was evaluated by whole body scan (WBS, and was denoted as WBS-positive group or WBS-negative group, respectively. Resistance to therapy was defined as presence of thyroglobulin (Tg in serum (Tg ≥1.0 ng/ml 3-6 months after I-131 therapy. Univariate and multivariate analyses were performed to determine the relationship between resistance to I-131 therapy and various clinico-pathologic variables. Results: PET/CT-positive, intermediate, and negative groups included 20 (6.5%, 44 (14.3% and 243 (79.2% patients, respectively. The mean SUVmax was significantly higher in the PET/CT-positive group than that of the PET/CT-intermediate group (4.6 vs. 2.7, P
Stover, Alyson D
Occupational therapy practitioners must advocate for clients in multiple ways. The Occupational Therapy Practice Framework: Domain and Process as well as the Occupational Therapy Code of Ethics lend support to advocacy. Recognizing one's responsibility to provide advocacy for clients is different from knowing how to provide that advocacy. One aspect of health care affected by the Patient Protection and Affordable Care Act (ACA) is the definition and implementation of medical necessity. This article outlines some major concepts around medical necessity, particularly in relation to the passage of the ACA, and outlines guidance on how to advocate effectively to meet both individual and community needs. PMID:27548855
... fullstory_159214.html Useless Treatments Common in Young, Terminal Cancer Patients 3 in 4 get aggressive therapies with ... quarters of young or middle-aged Americans with terminal cancer receive aggressive treatment during the last month of ...
Serena, A; Zurkinden, C; Castellani, P; Eicher, M
The fight against cancer comprises not only survival of the disease but also survival with the highest possible quality of life. Thus, supportive care in cancer aims at reducing physical and psycho-emotional symptom burden. Furthermore, supportive care in cancer includes self-management-support for patients and their families/caregivers. Due to high symptom prevalence and poor prognosis, lung cancer patients express more unmet supportive care needs than other patient populations with cancer. Interventions to meet these needs have been developed in the last decade. They involve new models of care that incorporate the role of a lung cancer nurse in comprehensive cancer centers and eHealth-systems to support lung cancer patients and their families/caregivers. PMID:26152086
A four-drug chemotherapy regimen has produced the longest improvement in survival ever seen in a phase III clinical trial of patients with metastatic pancreatic cancer, one of the deadliest types of cancer.
Twenty-five patients, having either unilateral ovarian tumors of unknown etiology or suspected of having ovarian cancer recurrence were investigated by the method of immunoscintigraphy to rule out primary and/or metastatic tumor sites. Four-hundred micrograms of the tumor-associated monoclonal mouse antibody HMFG-2, raised against human milk fat globulin membranes and labeled with 123I, were used for each patient to display the tumor sites by external scintigraphy. The dose ranged between 0.5 and 2.2 mCi, the specific activity between 1.25 and 5.5 mCi per mg of antibody. Nineteen of the patients underwent operations a few days after immunoscintigraphy. The remaining six patients were investigated by transmission computed tomography (TCT) to establish the presence or absence of tumor of the imaging. In 22 of the 25 cases the scintigraphic results correlated with the situation found at the subsequent operation, or by TCT, respectively, as well as with the histological diagnosis of the tumor type. Overall, there were just two false-negative and one false-positive scan report, the latter due to faulty reading of the scintigrams. Sixteen out of 18 tumor sites in 25 patients could be revealed by immunoscintigraphy, the smallest one being 1.5 cm in diam. In four of the patients immunoscintigraphy was the only noninvasive investigation method that could reveal the malignant tumor sites prior to the operation
Wisconsin's Radioactive Waste Review Board is required by law to advocate for and educate the public on the high-level nuclear waste issue. The goal of its education program is to empower people by giving them information and skills. Environmental advocacy and public activism are part of the State's Progressive political tradition. The Board seeks and uses public input while developing education programs, and helps local areas organize committees to develop their own programs
Loring, David W; Hermann, Bruce P; Cohen, Morris J
Neuropsychologists are in a unique position to be active advocates for patients with epilepsy given their unique understanding of the behavioral and cognitive effects associated the disease, its progression, and its treatment. Neuropsychologists communicate the cognitive and behavioral consequences of epilepsy and its long-term implications to patients, family, school, and employers. In this article we review factors influencing the neuropsychological profile of patients with epilepsy, and discuss common behavioral comorbidities, as well as special issues associated with school placement and long-term planning. We also include a seizure action plan, which is designed to be both an educational tool for individuals with limited epilepsy knowledge, and a way to minimize stigma associated with an event should a seizure occur during school or work. PMID:19214828
Hu, Chunling; Steven N Hart; William R Bamlet; Moore, Raymond M.; Nandakumar, Kannabiran; Bruce W Eckloff; Lee, Yean K.; Petersen, Gloria M.; Robert R McWilliams; Couch, Fergus J.
The prevalence of germline pathogenic mutations in a comprehensive panel of cancer predisposition genes is not well defined for patients with pancreatic ductal adenocarcinoma (PDAC). To estimate the frequency of mutations in a panel of 22 cancer predisposition genes, 96 patients unselected for a family history of cancer who were recruited to the Mayo Clinic Pancreatic Cancer patient registry over a 12 month period were screened by next-generation sequencing. Fourteen pathogenic mutations in 1...
Sirohi, B; S Dawood; S. Rastogi; Pandey, A.; Bal, M; N Shetty; Shrikhande, S. V.
Background: The aim of this study was to look at the outcome of patients with metastatic pancreatic cancer treated at a tertiary cancer center in India. Patients And Methods: A total of 101 patients with locally advanced and metastatic pancreatic cancer diagnosed between May 2012 and July 2013 were identified from a prospectively maintained database at the tertiary cancer center. Overall survival (OS) was computed using the Kaplan–Meir product limit method and compared across groups using the...
A DIAGNOSIS OF CANCER INTERRUPTS THE LIFE OF A PATIENT AND HIS OR HER FAMILY. Cancer treatment often entails continued investigation and therapy that typically has side effects and offers the repeated warning to be vigilant. Cancer is often a life-threatening illness. The field of psycho-oncology is well established, and clinical oncologists often have a good awareness of the psychological challenges cancer poses to their patients. Despite the nature of the stressor, it is important to note t...
Javed, Saba; Javed, Syed A; Mays, Rana M; Tyring, Stephen K.
Skin cancer in darker skin is associated with considerable morbidity and mortality. We sought to assess the clinical characteristics of cutaneous malignancy amongst Hispanic skin cancer patients and compare them to age-matched non-Hispanic Caucasians. In this retrospective study, 150 Hispanic skin cancer patients were identified from electronic medical records and age-matched to 150 non-Hispanic Caucasian controls with skin cancer. The incidence of actinic keratoses (AKs) in Hispanic skin c...
Lymphedema; Stage IA Cervical Cancer; Stage IA Uterine Corpus Cancer; Stage IA Vulvar Cancer; Stage IB Cervical Cancer; Stage IB Uterine Corpus Cancer; Stage IB Vulvar Cancer; Stage II Uterine Corpus Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIIA Vulvar Cancer; Stage IIIB Vulvar Cancer; Stage IIIC Vulvar Cancer; Stage IVB Vulvar Cancer
Modell, Stephen M.; Greendale, Karen; Citrin, Toby; Kardia, Sharon L. R.
Description: Among the two leading causes of death in the United States, each responsible for one in every four deaths, heart disease costs Americans $300 billion, while cancer costs Americans $216 billion per year. They also rank among the top three causes of death in Europe and Asia. In 2012 the University of Michigan Center for Public Health and Community Genomics and Genetic Alliance, with the support of the Centers for Disease Control and Prevention Office of Public Health Genomics, hosted a conference in Atlanta, Georgia to consider related action strategies based on public health genomics. The aim of the conference was consensus building on recommendations to implement genetic screening for three major heritable contributors to these mortality and cost figures: hereditary breast and ovarian cancer (HBOC), familial hypercholesterolemia (FH), and Lynch syndrome (LS). Genetic applications for these three conditions are labeled with a “Tier 1” designation by the U.S. Centers for Disease Control and Prevention because they have been fully validated and clinical practice guidelines based on systematic review support them. Methodology: The conference followed a deliberative sequence starting with nationally recognized clinical and public health presenters for each condition, followed by a Patient and Community Perspectives Panel, working group sessions for each of the conditions, and a final plenary session. The 74 conference participants represented disease research and advocacy, public health, medicine and nursing, genetics, governmental health agencies, and industry. Participants drew on a public health framework interconnecting policy, clinical intervention, surveillance, and educational functions for their deliberations. Results: Participants emphasized the importance of collaboration between clinical, public health, and advocacy groups in implementing Tier 1 genetic screening. Advocacy groups could help with individual and institutional buy-in of Tier 1
Stephen M. Modell
Full Text Available Description: Among the two leading causes of death in the United States, each responsible for one in every four deaths, heart disease costs Americans $300 billion, while cancer costs Americans $216 billion per year. They also rank among the top three causes of death in Europe and Asia. In 2012 the University of Michigan Center for Public Health and Community Genomics and Genetic Alliance, with the support of the Centers for Disease Control and Prevention Office of Public Health Genomics, hosted a conference in Atlanta, Georgia to consider related action strategies based on public health genomics. The aim of the conference was consensus building on recommendations to implement genetic screening for three major heritable contributors to these mortality and cost figures: hereditary breast and ovarian cancer (HBOC, familial hypercholesterolemia (FH, and Lynch syndrome (LS. Genetic applications for these three conditions are labeled with a “Tier 1” designation by the U.S. Centers for Disease Control and Prevention because they have been fully validated and clinical practice guidelines based on systematic review support them. Methodology: The conference followed a deliberative sequence starting with nationally recognized clinical and public health presenters for each condition, followed by a Patient and Community Perspectives Panel, working group sessions for each of the conditions, and a final plenary session. The 74 conference participants represented disease research and advocacy, public health, medicine and nursing, genetics, governmental health agencies, and industry. Participants drew on a public health framework interconnecting policy, clinical intervention, surveillance, and educational functions for their deliberations. Results: Participants emphasized the importance of collaboration between clinical, public health, and advocacy groups in implementing Tier 1 genetic screening. Advocacy groups could help with individual and institutional
Andersen, Andreas Holst; Vinther, Anders; Poulsen, Lise-Lotte;
Patients with lung cancer are often burdened by dyspnoea, fatigue, decreased physical ability and loss of weight. Earlier studies of physical exercise of patients with COPD have shown promising results. The aim of this study was to investigate, if a well-documented COPD rehabilitation protocol can...... improve physical fitness and quality of life (QoL) in patients with lung cancer....
Ballard, Deborah; Hill, Jill
Patients with cancer are often faced with complex diagnoses that require decision making in a highly stressful environment. The role of the healthcare team is to ensure that patients have the information, tools, and resources needed to make informed decisions. However, low health literacy is a common and undervalued factor in the outcomes of patients, particularly those with cancer. PMID:27206288
Thompson, Amy; Kerr, Dianne; Dowling, Jamie; Wagner, Laurie
Involvement in advocacy is a responsibility of health educators, as identified by the National Commission on Health Education Credentialing. Of all the professional responsibilities, participation in advocacy-related activity is often neglected. This lack of participation may be due to the absence of advocacy and policy skills training in health…
... Internal Revenue Service Taxpayer Advocacy Panel Meeting Cancellation AGENCY: Internal Revenue Service (IRS... the open meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee scheduled... Advocacy Panel. BILLING CODE 4830-01-P...
... Internal Revenue Service Taxpayer Advocacy Panel; Meeting Cancellation. AGENCY: Internal Revenue Service... cancellation of the open meeting of the Taxpayer Advocacy Panel Taxpayer Communications Project Committee..., Acting Director, Taxpayer Advocacy Panel. BILLING CODE 4830-01-P...
... Internal Revenue Service Taxpayer Advocacy Panel Meeting Cancellation AGENCY: Internal Revenue Service (IRS... the open meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Improvements Project..., Taxpayer Advocacy Panel. BILLING CODE 4830-01-P...
Kruijver, I.P.M.; Kerkstra, A.; Bensing, J.M.; van de Wiel, H.B.M.
In this paper the balance of affective and intrumental communication employed by nurses during the admission interview with recently diagnosed cancer patients was investigated. Rationale: The balance of affective and instrumental communication employed by nurses appears to be important, especially during the admission interview with cancer patients. Methods: For this purpose, admission interviews between 53 ward nurses and simulated cancer patients were videotaped and analysed using the Roter...
In Sweden and elsewhere there is evidence of poorer cancer survival for patients of low socioeconomic status (SES), and in some settings differences in treatment by SES have been shown. The aim of this thesis was to explore factors which influence cancer treatment decisions, such as knowledge reaped from clinical trials, patient-related factors, and physician-related factors. In a register study of colorectal cancer, all stages, patients were stratified for SES-factors. Differences were seen ...
Dominique Farge-Bancel; Henri Bounameaux; Benjamin Brenner; Büller, Harry R.; Ajay Kakkar,; Ingrid Pabinger; Michael Streiff; Philippe Debourdeau
Venous thromboembolism is a frequent and serious complication in patients with cancer. It is an independent prognostic factor of death in cancer patients and the second leading cause of death, but physicians often underestimate its importance, as well as the need for adequate prevention and treatment. Management of venous thromboembolism in patients with cancer requires the coordinated efforts of a wide range of clinicians, highlighting the importance of a multidisciplinary approach. However,...
Z. V. Grigoryevskaya
Full Text Available Lung cancer (LC annually afflicts 63–65 thousand people in Russia and 1.04 million worldwide, which amounts to 12.8% of all notified cases of neoplasms. In LC patients, infectious complications are characterized by a severe course; destruction foci, decay cavities, and abscess may form.All give rise to difficulties in making a diagnosis and in choosing a treatment policy. Infections caused by P. aeruginosa, A. baumanii, bacteria of the family Enterobacteriacae, S. aureus, and Enterococcus spp present the greatest problem in inpatients with LC. The early diagnosis of infectiouscomplications and the use of adequate schemes of antibiotic prevention and therapy promote a reduction in mortality from infection in this categoryof patients and expand the possibilities of their specific antitumor treatment.
G. A. Nerodo
Full Text Available A parallel study of some parameters of the endocrine and immune systems was conducted in 120 patients with vulvar cancer prior to treatment.Most patients were found to have impaired immunogenesis: the reduced count and function of T and B lymphocytes, decreased natu- ral killer cells, suppressed macrophageal transformation of monocytes, higher percentage of immunocomplexes, insufficient production of immunoglobulins (IgA, IgM, IgG, which was induced by the elevated level of cortisol in its slower metabolism at the periphery, reduced function of the pituitary-thyroid system, the balance of sex steroids shifted towards testosterone, a predominance of luteiniz- ing hormone over follicle-stimulating hormone, and inhibited growth hormone production.
Full Text Available Objective: In a regional hospital, many patients are newly diagnosed with cancer. Breaking the bad news in these patients and their relatives is a tough task. Many doctors are not experienced in talking to patients about death or death-related diseases. In recent years, there have been great efforts to change the current situation. The aim of this study was to investigate the experience and education of medical personnel in breaking bad news in a secondary hospital. Materials and Methods: 59 doctors from General Hospital of Komotini, Greece were included in the study. All the doctors were in clinical specialties that treated cancer patients. A brief questionnaire was developed based on current guidelines such as Baile/SPIKES framework and the ABCDE mnemonic. Results: Residents are involved in delivering bad news less frequently than specialists. Only 21 doctors (35.59% had specific training on breaking bad news. 20 doctors (33.90% were aware of the available techniques and protocols on breaking bad news. 47 doctors (79.66% had a consistent plan for breaking bad news. 57 (96.61% delivered bad news in a quiet place, 53 (89.83% ensured no interruptions and enough time, 53 (89.83% used simple words and 54 (91.53% checked for understanding and did not rush through the news. 46 doctors (77.97% allowed relatives to determine patient′s knowledge about the disease. Conclusions: There were low rates of specific training in breaking bad news. However, the selected location, the physician′s speech and their plan were according to current guidelines.
Blank, Mikhail; Blank, Olga; Myasnikova, Ekaterina; Denisova, Daria
The goal of the present research is to investigate and analyze possible peculiarities of the psychological state of cancer patients undergoing treatment. Scores characterizing the trait and state anxiety were acquired using the Integrative Anxiety Test from four groups: adults with no appreciable disease, pregnant women, cancer patients examined during the specific antitumor treatment, and cancer patients brought into lasting clinical remission. Statistical analysis of the testing results revealed the bimodal type of the distribution of scores. The only statistically significant exception was the distribution of the state anxiety scores in cancer patients undergoing treatment that was clearly unimodal. PMID:26176239
Tatiana C.S. Bonetti
Full Text Available PURPOSE: Report the characteristics of cryopreserved semen from a cohort of male cancer patients, attitudes towards cryopreservation and outcomes of semen samples based on a 12-year cryopreservation program. MATERIAL AND METHODS: Data from 98 male cancer patients whose sperm samples were banked were evaluated. Demographic parameters, semen characteristics, destination of sperm banked samples and questionnaires answered by the patients regarding cryopreservation time were evaluated. RESULTS: The cancer diagnoses were testicle (56.1%, prostate (15.3%, Hodgkin’s lymphomas (9.2%, non-Hodgkin’s lymphomas (7.1%, leukemia (3.1% and other malignancies (9.2%. The patients with testicular cancer presented lower sperm concentration (p < 0.001; however, there were no differences with the percentage of normozoospermic patients among cancer type groups (p = 0.185. A shorter time between cancer diagnosis and sperm banking was observed for testicular and prostate cancer patients (p < 0.001. Most of the patients (89.5% favored sperm banking as a fertility preservation method. CONCLUSIONS: Although less than 20% of banked sperm samples were disposed of, the majority of patients related sperm banking with safe for fertility preservation. Our results show that all male cancer patients of reproductive age facing cancer treatment could be offered sperm banking.
Kasum, Miro; von Wolff, Michael; Franulić, Daniela; Čehić, Ermin; Klepac-Pulanić, Tajana; Orešković, Slavko; Juras, Josip
The purpose of this review is to analyse current options for fertility preservation in young women with breast cancer (BC). Considering an increasing number of BC survivors, owing to improvements in cancer treatment and delaying of childbearing, fertility preservation appears to be an important issue. Current fertility preservation options in BC survivors range from well-established standard techniques to experimental or investigational interventions. Among the standard options, random-start ovarian stimulation protocol represents a new technique, which significantly decreases the total time of the in vitro fertilisation cycle. However, in patients with oestrogen-sensitive tumours, stimulation protocols using aromatase inhibitors are currently preferred over tamoxifen regimens. Cryopreservation of embryos and oocytes are nowadays deemed the most successful techniques for fertility preservation in BC patients. GnRH agonists during chemotherapy represent an experimental method for fertility preservation due to conflicting long-term outcome results regarding its safety and efficacy. Cryopreservation of ovarian tissue, in vitro maturation of immature oocytes and other strategies are considered experimental and should only be offered within the context of a clinical trial. An early pretreatment referral to reproductive endocrinologists and oncologists should be suggested to young BC women at risk of infertility, concerning the risks and benefits of fertility preservation options. PMID:26370157
To compare the dosimetric differences among fixed field intensity-modulated radiation therapy (IMRT), single-arc volumetric-modulated arc therapy (SA-VMAT) and double-arc volumetric-modulated arc therapy (DA-VMAT) plans in rectal cancer. Fifteen patients with rectal cancer previously treated with IMRT in our institution were selected for this study. For each patient, three plans were generated with the planning CT scan: one using a fixed beam IMRT, and two plans using the VMAT technique: SA-VMAT and DA-VMAT. Dose prescription to the PTV was 50 Gy in 2 Gy per fraction. Dose volume histograms (DVH) for the target volume and the organs at risk (small bowel, bladder, femoral heads and healthy tissue) were compared for these different techniques. Monitor units (MU) and delivery treatment time were also reported. DA-VMAT achieved the highest minimum planning target volume (PTV) dose and the lowest maximal dose, resulting in the most homogeneous PTV dose distribution. DA-VMAT also yielded the best CI, although the difference was not statistically significant. Between SA-VMAT and IMRT, the target dose coverage was largely comparable; however, SA-VMAT was able to achieve a better V95 and V107. VMAT showed to be inferior to IMRT in terms of organ at risk sparing, especially for the small bowel. Compared with IMRT, DA-VMAT increased the V15 of small bowel nearly 55 cc. The MU and treatment delivery time were significantly reduced by the use of VMAT techniques. VMAT is a new radiation technique that combines the ability to achieve highly conformal dose distributions with highly efficient treatment delivery. Considering the inferior role of normal tissue sparing, especially for small bowel, VMAT need further investigation in rectal cancer treatment
Studlar, Donley T
The role of the US federal government in developing tobacco control through a cooperative, interactive program with state and local private and public organizations has been underestimated. This article investigates how the government initiated and sustained a program of "capacity building" through the scientific authority of the National Cancer Institute, beginning in the 1980s. There are several major questions to be answered: (1) How did this program manage to be adopted and sustained despite the well-documented hindrances to effective tobacco control policy at the federal level? (2) How did a tobacco control policy program become incorporated into the scientific research agenda of the National Cancer Institute? (3) How have science, social factors, and government at various levels interacted in this capacity-building program? The study emphasizes how the US federal government, blocked by a tobacco-friendly Congress from enacting effective tobacco control legislation, utilized its scientific research role and, with the cooperation of other levels of government and large, private antitobacco organizations, established an ongoing policy effort. PMID:24879831
Background and purpose: Elderly patients with head and neck cancer may not be treated aggressively with radiotherapy, due to concerns regarding tolerance of treatment and toxicity. A retrospective study was undertaken of patients aged 80 years and over, treated by definitive radiotherapy for head and neck cancer. Material and methods: 98 patients aged 80-92 received radiotherapy for carcinoma of the head and neck between 1991 and 1995. All patients received beam directed radiotherapy with radical intent using an immobilisation shell. Results: Cancer specific survival was 59% and overall local control was 70% at 5 years. Both were significantly affected by T stage and site of disease. Cancer specific survival was comparable to that of patients aged below 80 years. Seven patients died within 6 months of the treatment. Three patients developed severe late toxicity. Metastatic disease occurred in eight patients. Conclusions: Radiotherapy is a beneficial and well tolerated treatment in elderly patients with carcinoma of the head and neck
郭毅; 生秀杰; 刘阳; 花象锋
Objective: To compare the quality of life (QOL) for gynecologic cancer patients with different cancer sites and to assess the impact of patients' characteristics, disease parameters, and treatments on the subscale and overall QOL. Methods: A prospective study was conducted including 146 gynecologic cancer patients. QOL data were collected using the general Functional Assessment of Cancer Therapy (FACT- G) QOL questionnaire. Results: Advanced stage patients showed significantly poor physical well-being, emotional well-being, and functional well-being, as compared with early stage patients. QOL was reported higher in older patients (P=0.03), patients above high school education (P=0.004), and patients with help at home (P=0.009). Conclusion: Patients with later stage, multi- modality therapy, poor education, and little social support have the most significant impairments and need more support.
Deckx, Laura; van Abbema, Doris L.; van den Akker, Marjan; Van Den Broeke, Carine; van Driel, Mieke; Bulens, Paul; Tjan-Heijnen, Vivianne C. G.; Kenis, Cindy; de Jonge, Eric T.; Houben, Bert; Buntinx, Frank
Background Although older cancer survivors commonly report psychosocial problems, the impact of both cancer and ageing on the occurrence of these problems remains largely unknown. The evolution of depression, cognitive functioning, and fatigue was evaluated in a group of older cancer patients in comparison with a group of younger cancer patients and older persons without cancer. Methods Older (≥70 years) and younger cancer patients (50 – 69 years) with breast or colorectal cancer stage I - II...
Purpose: To evaluate the utility of an infrared-guided patient setup (iGPS) system to reduce the uncertainties in the setup of lung cancer patients. Methods and Materials: A total of 15 patients were setup for lung irradiation using skin tattoos and lateral leveling marks. Daily electronic portal device images and iGPS marker locations were acquired and retrospectively reviewed. The iGPS-based shifts were compared with the daily electronic portal device image shifts using both the central axis iGPS marker and all five iGPS markers. For shift calculation using the five markers, rotational misalignment was included. The level of agreement between the iGPS and portal imaging to evaluate the setup was evaluated as the frequency of the shift difference in the range of 0-5 mm, 5-10 mm, and >10 mm. Results: Data were obtained for 450 treatment sessions for 15 patients. The difference in the isocenter shifts between the weekly vs. daily images was 0-5 mm in 42%, 5-10 mm in 30%, and >10 mm in 10% of the images. The shifts seen using the iGPS data were 0-5 mm in 81%, 5-10 mm in 14%, and >10 mm in 5%. Using only the central axis iGPS marker, the difference between the iGPS and portal images was 10 mm in 7% in the left-right direction and 73%, 18%, and 9% in the superoinferior direction, respectively. When all five iGPS markers were used, the disagreements between the iGPS and portal image shifts >10 mm were reduced from 7% to 2% in the left-right direction and 9% to 3% in the superoinferior direction. Larger reductions were also seen (e.g., a reduction from 50% to 0% in 1 patient). Conclusion: The daily iGPS-based shifts correlated well with the daily electronic portal device-based shifts. When patient movement has nonlinear rotational components, a combination of surface markers and portal images might be particularly beneficial to improve the setup for lung cancer patients
Full Text Available Background. We study the clinical significance and management of pulmonary venous obstruction in cancer patients. Methods. We conducted a prospective cohort study to characterize the syndrome that we term “pulmonary vein obstruction syndrome” (PVOS between January 2005 and March 2014. The criteria for inclusion were (1 episodes of shortness of breath; (2 chest X-ray showing abnormal pulmonary hilum shadow with or without presence of pulmonary edema and/or pleural effusion; (3 CT scan demonstrating pulmonary vein thrombosis/tumor with or without tumor around the vein. Results. Two hundred and twenty-two patients developed PVOS. Shortness of breath was the main symptom, which was aggravated by chemotherapy in 28 (13%, and medical/surgical procedures in 21 (9% and showed diurnal change in intensity in 32 (14%. Chest X-rays all revealed abnormal pulmonary hilum shadows and presence of pulmonary edema in 194 (87% and pleural effusion in 192 (86%. CT scans all showed pulmonary vein thrombosis/tumor (100% and surrounding the pulmonary veins by tumor lesions in 140 patients (63%. PVOS was treated with low molecular weight heparin in combination with dexamethasone, and 66% of patients got clinical/image improvement. Conclusion. Physicians should be alert to PVOS when shortness of breath occurs and chest X-ray reveals abnormal pulmonary hilum shadows.
Objective: Knowledge, information and communication, within oncology, are a core clinical strength for the out-come of the disease and inadequate communication, can cause distress for the patient and their families. Design: A senior doctor conducted this study by filling in the performa after interviewing the subject of the study. Place and duration of study: This study was done in Oncology Department of Service Hospital, Lahore and was completed in four months. Subjects and Method: One hundred cancer patients were interviewed regarding their knowledge about their disease, its causes, prognosis, and information supplied by the health-care providers. They were also asked about their satisfaction regarding this information, deficiencies and pitfalls in this information, need for more information, which should supply the information from among the hospital team or their relative, attitude of the family and their communication regarding the disease. Results: Study revealed that the knowledge about the disease and its causes was present in 53% and 7% respectively. The patients (59%) wanted more information. Majority perceived that the information was not adequate and needed more information and 68% thought that more information would reduce their anxiety. The attitude of family was found encouraging in 87% of patients and 42% were communicating with other family members regarding their diseases. Conclusion: Knowledge about the disease and its cause should be increasingly supplied by the doctors, as it will reduce the anxiety and have a good effect on health. Communication among the family members needs to be improved. (author)
Suk Jae Kim
Full Text Available BACKGROUND: We hypothesized that hidden malignancy could be detected in patients with cryptogenic stroke without active cancer when they showed the distinctive characteristics of cancer-related stroke. METHODS AND FINDINGS: Among 2,562 consecutive patients with acute ischemic stroke, patients with cryptogenic stroke were analyzed and categorized into two groups according to the presence of active cancer: cryptogenic stroke with active cancer (cancer-related stroke, CA-stroke group and without active cancer (CR-stroke group. Patients with active lung cancer without stroke were also recruited for comparison purposes (CA-control. Clinical factors, lesion patterns on diffusion-weighted MRI (DWI, and laboratory findings were analyzed among groups. A total of 348 patients with cryptogenic stroke were enrolled in this study. Among them, 71 (20.4% patients had active cancer at the time of stroke. The D-dimer levels were significantly higher in patients with CA-stroke than those with CR-stroke or CA-control (both p<0.001. Regarding lesion patterns, patients with CA-stroke mostly had multiple lesions in multiple vascular territories, while more than 80% of patients with CR-stroke had single/multiple lesions in a single vascular territory (P<0.001. D-dimer levels (OR 1.11 per 1 µg/mL increase; 95% CI 1.06-1.15; P<0.001 and DWI lesion patterns (OR 7.13; 95% CI 3.42-14.87; P<0.001 were independently associated with CA-stroke. Workup for hidden malignancy was performed during hospitalization in 10 patients who showed elevated D-dimer levels and multiple infarcts involving multiple vascular territories but had no known cancer, and it revealed hidden malignancies in all the patients. CONCLUSION: Patients with CA-stroke have distinctive D-dimer levels and lesion patterns. These characteristics can serve as clues to occult cancer in patients with cryptogenic stroke.
Børresen, Betina; Clausen, Malene Martini; Hansen, Anders Elias; Engelholm, Svend Aage; Kjær, Andreas; Kristensen, Annemarie Thuri; Zornhagen, Kamilla Westarp
Cancer bearing dogs represent a unique clinical cancer model with a direct potential for accelerating translation into human patients. A research collaboration between the veterinary and human medical facilities at Copenhagen University and Rigshospitalet has taken offset in this. Canine cancer...
Fisher, A.; Beeken, R.J.; Heinrich, M.; Williams, K.; Wardle, J.
BACKGROUND: This study aimed to examine whether fear of cancer recurrence (FCR) was related to two important health behaviours (physical activity and smoking) in a large sample of colorectal cancer patients. METHODS: Ten thousand nine hundred sixty nine patients, diagnosed in 2010-11, and in remission in 2013, completed the 'Living with and Beyond Colorectal Cancer' survey. The survey included purpose-designed questions on fear of recurrence ('I have fear about my cancer coming back'), demogr...
Kaberi Das; Munlima Hazarika; Manigreeva Krishnatreya; Amal Chandra Kataki
Background: Paediatric cancer patients who receive radiation and chemotherapy (CT) suffer from various risks of oral complications and odontogenesis. Materials and Methods: This study was conducted at a regional cancer centre of North East India from 2010 to 2013. The impact of cancer treatment by CT and radiation on orodental health was studied on a total of 100 paediatric cancer patients. Results: The common dental abnormalities were microdontia, hypodontia, root abnormalities, abnorm...
Evaluation of quality of life (QOL) in cancer patients is an important theme. However, we do not have an established method to assess QOL in cancer patients during radiotherapy in Japan. We evaluated both the changes of QOL and the factors affecting QOL in radiotherapy patients. Three hundred fifty-five cancer patients, who filled in a questionnaire at the beginning, middle, and end of radiotherapy between 1998 and 2001, were studied. We used The QOL Questionnaire for Cancer Patients Treated with Anticancer Drugs (QOL-ACD)'' devised by Kurihara et al, the Ministry of Health and Welfare. The QOL Questionnaire had five categories: physical activity, physical condition, mental state, social interaction, and face scale. The total score, sum of the score of five categories, were established synthetically (maximum score is 110). The mean of total QOL scores were 75.8, 77.6, and 78.2 at the beginning, middle, and end of radiotherapy respectively. Patients with symptoms related to cancer had apparent improvement of QOL score. Patients receiving chemotherapy had a decreased QOL score at the end of radiotherapy. The score of physical condition was reduced improvement. It was suggested that radiotherapy could be performed without losing QOL of cancer patients, including older patients. However, patients receiving chemotherapy and those with head and neck cancer may lose their QOL, therefore, we should treat such patients carefully. (author)
NCI scientists have studied cells of patients with an extremely rare genetic disease that is characterized by drastic premature aging and discovered a new protective cellular mechanism against cancer. They found that cells from patients with Hutchinson Gi
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