WorldWideScience

Sample records for adult cancer patients

  1. Patient engagement in research with older adults with cancer.

    Science.gov (United States)

    Puts, Martine T E; Sattar, Schroder; Ghodraty-Jabloo, Vida; Hsu, Tina; Fitch, Marg; Szumacher, Ewa; Ayala, Ana Patricia; Alibhai, Shabbir M H

    2017-11-01

    Cancer is a disease that mostly affects older adults. Older adults have been under-represented in clinical cancer research. Around the world there is a push for patient engagement on study teams as it is anticipated to improve study design, recruitment and dissemination of findings. In the current overview we examined the evidence with regard to: 1) the history of patient engagement in research and frameworks developed; 2) impact of patient engagement on patient and research outcomes; 3) use of patient engagement in geriatrics and oncology, 4) recommendations for successful engagement; and 5) gaps in the literature that should be studied further. A narrative review was conducted. Articles published in English were searched in Medline with the help of a librarian. Patient engagement has been shown to improve the conduct of studies by making the study design more relevant and feasible, and improving recruitment rates and uptake of research findings by patients. However, the best way to engage patients is not clear yet. Several resources have been developed to support researchers engaging older adults with cancer in research. While patient engagement in research seems promising to improve study outcomes, little evidence is available thus far in geriatric oncology settings. Several gaps in the literature are identified that should be further studied to determine the value of, and best approaches to, patient engagement with older adults with cancer. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Treatment of prostate cancer in unfit senior adult patients.

    Science.gov (United States)

    Falci, Cristina; Morello, Elisabetta; Droz, Jean Pierre

    2009-10-01

    Prostate cancer is a disease typical of the elderly with a peak of incidence at 80 years. As most patients aged > or = 70 years show impairment of physical and/or cognitive performance, a complete geriatric assessment should be mandatory before planning any oncological treatment, in order to remove treatable conditions and to estimate the individual cancer-independent survival probability. In unfit patients with early prostate cancer watchful waiting represent the best strategy when the chance of living patients having high risk prostate cancer. Even in locally advanced prostate cancer active treatment could be deferred in asymptomatic patients, with short individual cancer-independent survival and well or moderately differentiated tumour. When hormonal deprivation therapy is administered a great attention should be paid to potential adverse events, that could precipitate the physical performance and accelerate the development of severe frailty. In the metastatic setting, the best supportive care, including bisphosphonates, should have the priority in the management of unfit patients. Chemotherapy, with Docetaxel as the standard regimen, should be reserved to patients showing diffuse symptoms, rapidly increasing PSA and/or presence of visceral metastasis, after all steps of endocrine therapy were covered. As regard the second line, a number of possibilities are available, but none have been tested in vulnerable and frail patients. At the present a number of issues about prostate cancer in unfit senior adults patients are still unsolved and should be debated in the light of results from dedicate prospective trials.

  3. Dietary intake and nutritional status in cancer patients; comparing adults and older adults.

    Science.gov (United States)

    Gómez Valiente da Silva, Henyse; Fonseca de Andrade, Camila; Bello Moreira, Annie Seixas

    2014-04-01

    Evaluate the nutrient intake and nutritional status of food in cancer patients admitted to a university hospital, with comparison of adult and older adult age category. Cross-sectional study. This study involved cancer patients admitted to a hospital in 2010. Dietary habits were collected using a Brazilian food frequency questionnaire. Participants were divided in two groups: adults or older adults and in 4-cancer category: hematologic, lung, gastrointestinal and others. Body Mass Index evaluated nutritional status. A total of 86 patients with a mean age of 56.5 years, with 55% males and 42% older adults were evaluated. The older adult category had a higher frequency of being underweight (24.4% vs 16.3%, p cancer, nor with nutritional status. The food intake, macro and micronutrients ingestion is insufficient among cancer individuals. Food intake of older adults was inferior, when compared to the adult category. There was a high prevalence of BMI excess in the adult group and a worst nutritional status in the older adult category. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  4. [Refusal of treatments by an adult cancer patient].

    Science.gov (United States)

    Dauchy, Sarah; Faivre, Jean-Christophe; Block, Véronique; Metzger, Maude; Salleron, Julia; Charles, Cécile; Adam, Virginie

    2018-02-22

    Refusal of treatment questions the treatment's adequacy as well as the quality of the care relationship. A rigorous analysis of these situations is necessary in order to respect the patient's fundamental right to decide for him/herself while preventing a potential loss of chance. This paper proposes practical guidelines for assessment and management of the refusal of treatment by adult cancer patients. The French Association for Supportive Care in Cancer and the French Society for Psycho-Oncology formed a task force that applied a consensus methodology to draft guidelines. We propose five guidelines: (1) be informed of the conditions most often associated with refusal of treatment so as to reinforce adequate support measures; (2) understand the complexity of the process of refusal and accurately identify what is precisely refused; (3) apply an approach of systematic analysis to refusal, to try and increase the possibilities of finding an agreement while reinforcing the respect of the patient's position; (4) establish a legal procedure to address refusal of treatment that safeguards the stakeholders when no accord can be found; and (5) know the indications for ethical collective decision-making. A systematic assessment procedure of treatment refusal is necessary in order to ensure that all the physical, psychological and contextual aspects of it are taken into account, and to provide patients with the best treatment possible. The setting of good care relationship, the improvement of communication skills training and of comprehensive multidisciplinary care are all crucial elements in the prevention of these situations. Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  5. Cancer survival in adult patients in Spain. Results from nine population-based cancer registries.

    Science.gov (United States)

    Chirlaque, M D; Salmerón, D; Galceran, J; Ameijide, A; Mateos, A; Torrella, A; Jiménez, R; Larrañaga, N; Marcos-Gragera, R; Ardanaz, E; Sant, M; Minicozzi, P; Navarro, C; Sánchez, M J

    2017-07-17

    With the aim of providing cancer control indicators, this work presents cancer survival in adult (≥15 years) patients in Spain diagnosed during the period 2000-2007 from Spanish cancer registries participating in the EUROCARE project. Cancer cases from nine Spanish population-based cancer registries were included and analysed as a whole. All primary malignant neoplasms diagnosed in adult patients were eligible for the analysis. Cancer patients were followed until 31 December 2008. For each type of cancer, 1-, 3- and 5-year observed and relative survival were estimated by sex, age and years from diagnosis. Furthermore, age-standardized 5-year relative survival for the period 2000-2007 has been compared with that of the period 1995-1999. Skin melanoma (84.6 95% CI 83.0-86.2), prostate (84.6% 95% CI 83.6-85.6) and thyroid (84.2% CI 95% 82.0-86.6) cancers showed the highest 5-year relative survival, whereas the worst prognosis was observed in pancreatic (6% 95% CI 5.1-7.0) and oesophageal (9.4% 95% CI 7.9-11.1) cancers. Overall, survival is higher in women (58.0%) than in men (48.9%). The absolute difference in relative survival between 2000-2007 and 1995-1999 was positive for all cancers as a whole (+4.8% in men, +1.6% in women) and for most types of tumours. Survival increased significantly for chronic myeloid leukaemia, non-Hodgkin's lymphoma and rectum cancer in both sexes, and for acute lymphoid leukaemia, prostate, liver and colon cancers in men and Hodgkin's lymphoma and breast cancer in women. Survival patterns by age were similar in Europe and Spain. A decline in survival by age was observed in all tumours, being more pronounced for ovarian, corpus uteri, prostate and urinary bladder and less for head and neck and rectum cancers. High variability and differences have been observed in survival among adults in Spain according to the type of cancer diagnosed, from above 84% to below 10%, reflecting high heterogeneity. The differences in prognosis by age, sex

  6. Disclosure of information to adult cancer patients: issues and update.

    Science.gov (United States)

    Goldberg, R J

    1984-08-01

    Clinicians are regularly faced with decisions regarding disclosure of information to cancer patients. Many of these decisions constitute a dilemma between the physician's paternalistic concern for the patient and the patient's right to know as much as possible. This paper reviews changes in the attitudes of physicians over the last several decades, elaborates on the problems that confront the clinician in the process of disclosure, and reviews the available data concerning the documented impact on the patient from receiving or not receiving information. The arguments both supporting and challenging the paternalistic view are discussed, and the necessity for viewing the disclosure of clinical information as a clinical process is offered.

  7. Social Media and the Adolescent and Young Adult (AYA) Patient with Cancer.

    Science.gov (United States)

    Perales, Miguel-Angel; Drake, Emily K; Pemmaraju, Naveen; Wood, William A

    2016-12-01

    Over 70,000 adolescent and young adults (AYA) aged 15 to 39 years are diagnosed with cancer each year in the US. The National Cancer Institute (NCI) has identified AYA cancer patients as a unique population. The most common cancers in this age group include tumors typically seen in pediatric patients such as acute lymphoblastic leukemia (ALL) and brain tumors, as well as cancers more typically seen in adult patients such as breast cancer and melanoma. In addition, some cancers have their highest incidence in AYA patients, such as Hodgkin Lymphoma, testicular cancer, and bone tumors. AYA patients face additional unique issues due to their age, not just questions about treatment choices due to lack of data but also questions about fertility, relationships, loss of autonomy, and interruptions in school/work with potentially significant financial complications. This age group also has very high rates of social media usage with up to 90 % of adults aged 18 to 29 using social networking sites. In this review, we will describe the use of social media in AYAs with cancer and highlight some of the online resources for AYAs.

  8. Yoga in adult cancer: an exploratory, qualitative analysis of the patient experience.

    Science.gov (United States)

    McCall, Marcy; Thorne, Sally; Ward, Alison; Heneghan, Carl

    2015-07-22

    Some patients receiving treatment in conventional health care systems access therapeutic yoga outside their mainstream care to improve cancer symptoms. Given the current knowledge gap around patient preferences and documented experiences of yoga in adult cancer, this study aimed to describe patient-reported benefits, barriers and characteristics of programming for yoga practice during conventional treatment. In depth semi-structured interviews (n=10) were conducted in men and women recruited from cancer care clinics in Vancouver, Canada using a purposive sampling technique. The exploratory interviews were audio-recorded, transcribed and analyzed using Interpretive Description methodology and constant comparative analysis methods. Four themes emerged from the data to address our research objectives: patient-perceived benefits of yoga, reasons and motivations for practising yoga, hurdles and barriers to practising yoga, and advice for effective yoga program delivery in adult cancer. Several patients reported yoga reduced stress and other symptoms associated with cancer treatment. Thematic analysis found the social dimension of group yoga was important, as well as yoga's ability to encourage personal empowerment and awareness of physical body and self. Barriers to yoga adherence from the patient perspective included lack of time, scheduling conflicts and worries about financial burden. This small, diverse sample of patients reported positive experiences and no adverse effects following yoga practice for management of cancer and its symptoms. Results of this qualitative study identified patient-reported preferences, barriers and characteristics of yoga intervention optimal during adult cancer treatment.

  9. The Value of Fatigue Severity to Rule Out Depression in Older Adult Patients With Cancer.

    Science.gov (United States)

    Deckx, Laura; van den Akker, Marjan; Vergeer, Denise; van Abbema, Doris; van den Berkmortel, Franchette; Linsen, Loes; de Jonge, Eric T; Houben, Bert; van Driel, Mieke; Buntinx, Frank

    2015-07-01

    To evaluate whether fatigue severity can serve as a cue to investigate the presence of depression in older adult patients with cancer. Cross-sectional observational cohort study. Seven hospitals and general practices in Belgium and the Netherlands. 205 older adult patients with cancer and 436 older adults without cancer (aged 70 years or older). The diagnostic accuracy of fatigue as a proxy for depression was evaluated using sensitivity, specificity, and predictive values. Fatigue was measured with a visual analog scale, and depression was measured with the 15-item Geriatric Depression Scale. Fifty-six percent of the population experienced fatigue, and 13% were depressed. For fatigue as a cue for depression, sensitivity was 82%, specificity was 47%, positive predictive value was 18%, and negative predictive value was 95%. The data confirm that fatigue is a valuable cue to investigate the presence of depression because 82% of depressed participants were correctly identified by fatigue. The assessment of fatigue severity is intuitive, quick, straightforward, and usually already implemented. Identification of depression is difficult in older adult patients with cancer. Instead of experiencing affective symptoms of depression, older adult patients are more likely to disclose somatic symptoms, such as fatigue, which often overlap with cancer-related symptoms. Nurses should be aware of this problem and should be alert for the possibility of depression in older adult patients presenting with fatigue.

  10. Incidence and survival of adult cancer patients in Taiwan, 2002-2012.

    Science.gov (United States)

    Chiang, Chun-Ju; Lo, Wei-Cheng; Yang, Ya-Wen; You, San-Lin; Chen, Chien-Jen; Lai, Mei-Shu

    2016-12-01

    Little is known about the annual changes in cancer incidence and survival that occurred after the establishment of the long-form cancer registry database in Taiwan. Therefore, this study aimed to investigate the updated incidence and stage-specific relative survival rates (RSRs) among adult cancer patients in Taiwan. Cancer incidence data from 2002 to 2012 were collected using the Taiwan Cancer Registry Database. Age-standardized incidence rates, average annual percent changes (AAPCs), and sex ratios were calculated for adults. Five-year stage-specific RSRs were estimated for cases diagnosed between 2004 and 2008 and were followed up to 2013 for major cancers. The overall age-standardized incidence rates per 100,000 populations increased from 348.39 in 2002 to 401.18 in 2012, and the AAPC was 1.7% (p cancer sites showed a trend of increasing incidence, with the exception of common cancers such as cervix uteri (AAPC = -6.2%, p cancers were greater than 93% for the colon and rectum, female breast, and cervix uteri, whereas RSRs for patients with Stage IV cancers ranged from 2.9% to 38.9%, with patients with liver cancer and those with oral cancer showing the lowest and highest RSRs, respectively. Our study showed increased incidence in most cancers and provided baseline estimates of stage-specific RSRs among the Taiwanese adult population. Continuous surveillance may help politicians to improve health policies and cancer care in Taiwan. Copyright © 2016. Published by Elsevier B.V.

  11. Adult Cancer Patient Recruitment and Enrollment into Cell Phone Text Message Trials.

    Science.gov (United States)

    Spoelstra, Sandra L; Sikorskii, Alla; Given, Charles W; Coursaris, Constantinos K; Majumder, Atreyee; Schueller, Monica; Given, Barbara A

    2016-10-01

    Text messaging (TMs) on cell phones is emerging as an effective means of delivering behavioral interventions. However, little is known about TM use in adult cancer patients. The present study aimed to extend knowledge on acceptability of a TM intervention in adult cancer patients; examine factors of those screened and enrolled; and compare recruitment at a large national specialty pharmacy versus community-based cancer clinics. Screening, enrollment, and baseline data collected in two randomized controlled trials examining the efficacy of TMs on medication adherence or symptom severity in adults prescribed oral anticancer agents were linked. Chi-square, Fisher's exact, t-tests, and generalized linear modeling were used to examine sociodemographics, cancer type and stage, depressive symptoms, self-efficacy, social support, and symptoms. The cancer clinics screened 293 patients, 43% were eligible, and 56% consented. The specialty pharmacy screened 169 patients, 72% were eligible, and 74% consented. Mean age was 58 years and did not differ by recruitment setting. Later stage disease (p = 0.01) and higher number of symptoms (p cancer patients were likely to participate in a TM intervention trial. Recruiting through the specialty pharmacy reached a population with higher cell phone ownership and TM usage; with greater interest in a TM intervention compared to the cancer clinics.

  12. Adult Cancers in Adolescents and Young Adults.

    Science.gov (United States)

    Laurence, Valérie; Marples, Maria; Stark, Daniel P

    2016-01-01

    The pattern of cancer seen in young people changes with increasing age, transitioning from childhood- to adult-type cancer in adolescence and the third decade. The risk factors, presentation and biology of cancer in young adults differ from those in the older adult population. Factors of particular significance in adolescents and young adults (AYAs) include genetic predisposition to adult-type cancer, diagnostic uncertainty, long-term morbidity and considerations of fertility. New systemic therapies are being introduced that can prolong life and even increase the chance of cure, but the impact on AYAs is uncertain, as these patients are often under-represented in clinical trials. Here, we discuss the management of AYAs with 3 of the most common cancers affecting adults, when they emerge in the AYA populations, and therefore are currently met by medical oncologists - breast cancer, colorectal cancer and melanoma. © 2016 S. Karger AG, Basel.

  13. Post-Traumatic Growth and Resilience in Adolescent and Young Adult Cancer Patients: An Overview

    NARCIS (Netherlands)

    Greup, Suzanne R.; Kaal, Suzanne E. J.; Jansen, Rosemarie; Manten-Horst, Eveliene; Thong, Melissa S. Y.; van der Graaf, Winette T. A.; Prins, Judith B.; Husson, Olga

    2017-01-01

    The aim of this study was to provide an overview of the literature on post-traumatic growth (PTG) and resilience among adolescent and young adult (AYA) cancer patients. A literature search in Embase, PsychInfo, PubMed, Web of Science, Cochrane Library, and Cinahl was carried out. Thirteen articles

  14. Adult Comorbidity Evaluation 27 score as a predictor of survival in endometrial cancer patients.

    Science.gov (United States)

    Binder, Pratibha S; Peipert, Jeffrey F; Kallogjeri, D; Brooks, Rebecca A; Massad, L Stewart; Mutch, David G; Powell, Matthew A; Thaker, Premal H; McCourt, Carolyn K

    2016-12-01

    The incidence of endometrial cancer increases with age and is associated with medical comorbidities such as obesity and diabetes. Although a few cohort studies of endometrial cancer, the degree of association must be better described. The Adult Comorbidity Evaluation 27 is a validated comorbidity instrument that provides a score of 0-3 based on the number of and severity of medical comorbidities. This study was performed to explore the association between medical comorbidities and survival of patients with endometrial cancer. Patients who were diagnosed with endometrial cancer from 2000-2012 were identified from the prospectively maintained Siteman Cancer Center tumor registry. Patients who underwent primary surgical treatment for endometrioid, serous, and clear cell endometrial carcinoma were included. Patients who primarily were treated with radiation, chemotherapy, or hormone therapy were excluded. Patients with uterine sarcomas or neuroendocrine tumors were excluded. Patients with missing Adult Comorbidity Evaluation 27 scores were also excluded from analysis. Information that included patient demographics, Adult Comorbidity Evaluation 27 score, tumor characteristics, adjuvant treatment, and survival data were extracted from the database. The association of Adult Comorbidity Evaluation 27 and overall and recurrence-free survival was explored in a multivariable Cox regression analysis after being controlled for variables that have been found to be associated significantly with survival in univariable analysis. A total of 2073 patients with a median age of 61 years (range, 20-94 years) at diagnosis were identified. The Adult Comorbidity Evaluation 27 score was 0, 1, 2, and 3 in 22%, 38%, 28%, and 12% of patients, respectively. Stage distribution was I (73%), II (5%), III (15%), and IV (7%), and grade distribution was 1 (52%), 2 (23%), and 3 (25%). Most patients had endometrioid histologic condition (87%) followed by serous (11%) and clear cell (3%) endometrial

  15. A Comparison Study: The Risk Factors in the Lifestyles of Thyroid Cancer Patients and Healthy Adults of South Korea.

    Science.gov (United States)

    Yoo, Yang Gyeong; Yu, Boas J; Choi, Eun-Hi

    2016-12-09

    In South Korea, there has been a rapid increase in thyroid cancer diagnoses, and the thyroid cancer incidence rate is the highest in the world. This study explored possible risk factors that may influence the development of thyroid cancer by comparing life habits of thyroid cancer patients and healthy adults. The aims of this study were to identify lifestyle and habit differences in thyroid cancer patients and healthy adults and to investigate risk factors that influence the development of thyroid cancer. The study was designed as a retrospective comparison survey study of thyroid cancer patient group and healthy adult group. One hundred two thyroid cancer patients in a university hospital and 115 healthy adults were recruited for this study. Data were analyzed using descriptive statistics, χ test/t test, and logistic regression with SPSS program. Previous smoking history, lower physical activity level, higher stress, and unhealthy eating habits (consumption of instant food products) were shown to be risk factors in the development of thyroid cancer. Based on the results of this study comparing thyroid cancer patients and healthy adults, it is recommended to encourage an increase in physical activity, minimize both direct and indirect exposure to smoking, develop healthy eating habits of consuming more vegetables, and effectively manage stress levels. Lifestyle preferences and habits may influence the development of thyroid cancer. It is imperative to identify and modify the risk factors in order to prevent thyroid cancer development.

  16. Routine radiography does not have a role in the diagnostic evaluation of ambulatory adult febrile neutropenic cancer patients

    NARCIS (Netherlands)

    Nijhuis, CSMO; Gietema, JA; Vellenga, E; Daenen, SMGJ; De Bont, ESJM; Kamps, WA; Groen, HJM; van der Jagt, EJ; van der Graaf, WTA

    2003-01-01

    Cancer patients treated with chemotherapy are susceptible to bacterial infections. When an adult patient presents with febrile neutropenia. standard diagnostic care includes physical examination, laboratory diagnostics, chest X-ray (CXR) and sinus radiography. However, the yield of routine

  17. Introduction to Adolescent and Young Adult Cancers

    Science.gov (United States)

    Cancer researchers, advocates, and a cancer survivor introduce the topic of adolescent and young adult (AYA) cancers, covering distinct aspects of cancer in these patients and research questions to answer.

  18. An analysis of falls experienced by older adult patients diagnosed with cancer.

    Science.gov (United States)

    Overcash, Janine A; Rivera, Henry R; Van Schaick, Jill

    2010-09-01

    To examine themes associated with falls specific to older adult patients diagnosed with cancer. Prospective, exploratory, qualitative study. A senior adult oncology program at a cancer and research center in the southeastern United States. Men and women aged 70 years and older with any cancer diagnosis who had experienced a fall within three months. Patients were telephoned after research consent to participate in an interview about their falls. Frequencies were conducted on the biographic data. Themes were identified and grouped according to topic. Eastern Cooperative Oncology Group performance status, cancer site, cancer treatment modality, location of fall, and fear of falls. Mean age was 76.2 years. Most falls occurred at home (75%). The themes of physical problems, general weakness, and walking were found to be the most common motivations for falls. Themes associated with self-imposed activities as a result of falls included "being more careful" and "using an assistive device." Perceptions of physical problems, general weakness, and difficulty walking should be included in an oncology nursing fall-risk assessment. Exploration of perceptions concerning activities that have potentially caused a past fall and self-imposed activities also should be included. Beyond the boundaries of a fall-risk assessment, conducting a subjective interview to identify the individualities of falls and fall risk is vital to constructing a realistic plan of care.

  19. [Standards, Options and Recommendations for home parenteral or enteral nutrition in adult cancer patients].

    Science.gov (United States)

    Schneider, S; Blanc-Vincent, M P; Nitenberg, G; Senesse, P; Bachmann, P; Colomb, V; Desport, J C; Gory-Delabaere, G; Kere, D; Raynard, B; Melchior, J C

    2001-06-01

    The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of the French Cancer Centres (FNCLCC), the 20 French Cancer Centres and specialists from French Public Universities, General Hospitals and Private Clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and outcome for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. To develop clinical practice guidelines according to the definitions of the Standards, Options and Recommendations project for home parenteral or enteral nutrition in adult cancer patients. Data were identified by searching Medline, Cancerlit, web sites and using the personal reference lists of members of the expert groups. Once the guidelines were defined, the document was submitted for review to 72 independent reviewers. The main recommendations for home parenteral or enteral nutrition in adult cancer patients are: 1) Home parenteral or enteral nutrition concerns cancer patients with malnutrition or with inadequate/impossible oral intake, during therapy of because of therapeutic after-effects (standard). Same indications apply for home and hospital artificial nutrition (standard). 2) Patients need a multidisciplinary follow-up (oncologists, nutritionists, and pain specialists), and this follow-up will make treatment adaptations according to the nutritional status possible (recommendation, expert agreement). An active participation of patients and/or their family circle is very important (standard). 3) The benefit of home parenteral or enteral nutrition on the quality of life of terminally ill patients (vs. hydration) has not been demonstrated. When life expectancy is below 3 months, and the Karnofsky index below 50, the drawbacks of home artificial nutrition are more important than its

  20. The frequency of QTc prolongation among pediatric and young adult patients receiving methadone for cancer pain.

    Science.gov (United States)

    Madden, Kevin; Park, Minjeong; Liu, Diane; Bruera, Eduardo

    2017-11-01

    A prolonged corrected QT (QTc) interval in pediatric patients is defined as ≥470 msec. Methadone can cause a prolonged QTc interval that can lead to ventricular arrhythmias. The risk of methadone-induced prolongation of the QTc interval in children and young adults is unknown. The purpose of the study was to determine the frequency of QTc prolongation among pediatric and young adult patients with cancer pain on methadone treatment. We retrospectively reviewed data for all patients on methadone during the study period. Qualifying patient data were reviewed to determine whether these patients had an electrocardiogram (ECG) while on methadone. The QTc values for analysis were manually calculated using the standard formula described by Bazett. Twenty-five patients were identified that met eligibility criteria. The median QTc decreased from baseline after initiation of methadone. QTc prolongation occurred in four of 25 (16%) patients and only one patient had a QTc greater than 500 msec. This patient had 17 normal QTc intervals on methadone prior to the prolongation. After resolution of electrolyte abnormalities, six subsequent ECGs on methadone had a normal QTc interval. Prolongation of the QTc interval is infrequent. The only observed case was transient during multiple comorbid conditions. A prospective study is justified to better understand what role methadone plays as one of many risk factors for prolongation of the QTc interval in children and young adults. © 2017 Wiley Periodicals, Inc.

  1. The effectiveness of therapeutic patient education on adherence to oral anti-cancer medicines in adult cancer patients in ambulatory care settings: a systematic review.

    Science.gov (United States)

    Arthurs, Gilly; Simpson, Janice; Brown, Andrea; Kyaw, Ohnma; Shyrier, Sharon; Concert, Catherine M

    2015-06-12

    Adherence to oral cancer medicines is a challenge for adult patients with cancer. Education specifically tailored for an individual patient with cancer may improve adherence. Therapeutic patient education when utilized effectively may maximize health outcomes and positively affect the quality of life of adult patients with cancer. Currently, there are no published systematic reviews specific to the effectiveness of therapeutic patient education on improvement of oral anti-cancer medicines adherence in patients with cancer. To synthesize the best available evidence on the effectiveness of therapeutic patient education on adherence to oral anti-cancer medicines in adult cancer patients 18 years and older in an ambulatory care setting. Types of participants: This review considered studies involving adults of any ethnicity, race or gender, aged 18 years or older who were diagnosed with any form of cancer, receiving oral anti-cancer medicines in an ambulatory care setting. Types of intervention(s): This review considered studies on the use of therapeutic patient education as the additional intervention to routine patient education for promoting oral anti-cancer medicine adherence in adult patients with cancer in an ambulatory care setting. Routine patient education was considered as a comparator. Types of outcomes: The outcome considered was adherence to prescribed oral anti-cancer medicines. Types of studies: This review considered experimental and observational studies. The literature search included published and unpublished studies in the English Language from 1953 through August 2014. A search of PubMed, CINAHL, Excerpta Medica Database, Academic Search Premier, Cochrane Library, PsycINFO, and Health Source: Nursing/Academic Edition was conducted using identified keywords and indexed terms across all included databases. A search for grey literature and electronic hand searching of relevant journals was also performed. Two reviewers independently evaluated the

  2. Adolescent and young adult oncology patients: Disparities in access to specialized cancer centers.

    Science.gov (United States)

    Alvarez, Elysia; Keegan, Theresa; Johnston, Emily E; Haile, Robert; Sanders, Lee; Saynina, Olga; Chamberlain, Lisa J

    2017-07-01

    Adolescents and young adults (AYAs) ages 15 to 39 years with cancer continue to experience disparate survival outcomes compared with their younger and older counterparts. This may be caused in part by differential access to specialized cancer centers (SCCs), because treatment at SCCs has been associated with improved overall survival. The authors examined social and clinical factors associated with AYA use of SCCs (defined as Children's Oncology Group-designated or National Cancer Institute-designated centers). A retrospective, population-based analysis was performed on all hospital admissions of AYA oncology patients in California during 1991 through 2014 (n = 127,250) using the Office of Statewide Health Planning and Development database. Multivariable logistic regression analyses examined the contribution of social and clinical factors on always receiving care from an SCC (vs sometimes or never). Results are presented as adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Over the past 20 years, the percentage of patients always receiving inpatient care at an SCC increased over time (from 27% in 1991 to 43% in 2014). In multivariable regression analyses, AYA patients were less likely to always receive care from an SCC if they had public insurance (OR, 0.64; 95% CI, 0.62-0.66), were uninsured (OR, 0.51; 95% CI, 0.46-0.56), were Hispanic (OR, 0.88; 95% CI, 0.85-0.91), lived > 5 miles from an SCC, or had a diagnosis other than leukemia and central nervous system tumors. Receiving care at an SCC was influenced by insurance, race/ethnicity, geography, and tumor type. Identifying the barriers associated with decreased SCC use is an important first step toward improving outcomes in AYA oncology patients. Cancer 2017;123:2516-23. © 2017 American Cancer Society. © 2017 American Cancer Society.

  3. Information needs of adolescent and young adult cancer patients and their parent-carers.

    Science.gov (United States)

    McCarthy, Maria C; McNeil, Robyn; Drew, Sarah; Orme, Lisa; Sawyer, Susan M

    2017-12-08

    This study aimed to explore health-related information needs of adolescent and young adults (AYAs) and their parent-carers and to examine demographic and clinical variables associated with unmet information needs, including patient activation. In a national cross-sectional study, 196 Australian AYAs diagnosed with cancer between 15 and 25 years and within 24 months of diagnosis and 204 parent-carers reported on total and unmet needs for cancer and health-related information. Fifty-one percent of AYAs were male, 81% had completed treatment and 86% were treated in adult hospitals. AYAs and parents reported high levels of total need for information. The mean number of unmet needs was 5.63 and 6.82 for AYAs and parents, respectively. AYAs reported the highest unmet needs in relation to their cancer (e.g. late effects and cancer recurrence, and having children in the future). The highest unmet parent information needs were related to medical information about their child as well as information on financial issues for their children and themselves. Unmet information need was associated with psychological distress (posttraumatic stress symptoms) for AYAs and parents. Patient activation was negatively associated with unmet information needs for AYAs. Demographic and treatment variables were not significantly associated with information needs. These findings indicate the importance of information needs for AYAs and their carers. The association between patient activation and information needs suggests that promoting young people's engagement with healthcare is a key opportunity within AYA care. Parent information needs and associated emotional distress additionally highlight the importance of family-centered care.

  4. Physician, Patient and Contextual Factors Affecting Treatment Decisions in Older Adults with Cancer: A Literature Review

    Science.gov (United States)

    Tariman, J. D.; Berry, D. L.; Cochrane, B.; Doorenbos, A.; Schepp, K.

    2010-01-01

    Purpose/Objectives To review physician, patient, and contextual factors that affect treatment decision-making in older adults diagnosed with cancer and relate these factors to theoretical models of decision-making. Data Sources PubMed (1966-April 2010), PsycINFO (1967-April 2010) and CINAHL (1982-April 2010) databases were searched to access relevant medical, psychological and nursing literature. Data Synthesis Physician factors in treatment decisions include physician personal beliefs and values, expertise, practice type, perception of lowered life expectancy, medical factors, power, and communication style. Patient factors include personal beliefs and values, ethnicity, decisional control preferences, previous health-related experience, perception of the decision-making process, and personal factors. Contextual factors include availability of caregiver, lack of insurance, poor financial status, and geographical barrier. The interplay of physician, patient, and contextual factors are not well understood. Existing models of decision-making are not sufficient to explicate TDM process in older adults diagnosed with cancer. Conclusions Clinical studies in older adult patient population using a longitudinal and prospective design are needed to examine real-time interplay of patient, physician, and contextual factors and to better understand how these divergent factors influenced actual treatment decisions. Implications for Nursing Oncology nurses can advocate for a patient’s autonomy during TDM by coaching them to seek evidence-based discussion of various treatment options, benefits and risks assessments, and truthful discussion of the probability of success for each treatment option from their physicians. Oncology nurses must promote an informed treatment decisions that are consistent with a patient’s personal preference and values within the limits of the patient’s personal contexts. PMID:22201670

  5. A review of mobile applications to help adolescent and young adult cancer patients

    Directory of Open Access Journals (Sweden)

    Wesley KM

    2015-08-01

    Full Text Available Kimberly M Wesley,1 Philip J Fizur2 1Department of Psychology, St Jude Children's Research Hospital, Memphis, TN, 2Department of Psychology, La Salle University, Philadelphia, PA, USA Objective: To review research articles utilizing mobile applications with adolescent and young adult (AYA cancer patients. Materials and methods: We identified articles via online searches and reference lists (eg, PsycInfo, PubMed. Articles were reviewed by two study team members for target population, stated purpose, technological utilization, sample size, demographic characteristics, and outcome data. Strengths and weaknesses of each study were described. Results: Of 19 identified manuscripts, six met full inclusion criteria for this review (four smartphone applications and two tablet applications. One additional article that included an application not specific to oncology but included AYA patients with cancer within the target sample was also reviewed. Uses of these applications included symptom tracking, pain management, monitoring of eating habits following bone marrow transplant, monitoring of mucositis, and improving medication management. Utility results from pilot studies are presented. Conclusion: Mobile applications are growing in number and increasingly available to AYAs with and without chronic illness. These applications may prove useful in helping to support AYAs throughout their cancer treatment and beyond. However, few applications provide empirical data supporting their utility. Numerous strengths and benefits of these applications include increased accessibility to educational resources and self-management strategies, more frequent physical and emotional symptom tracking, and increased access to peer support. Despite these strengths, numerous limitations are identified, highlighting the need for future research in this area. Keywords: adolescent, young adult, cancer, smartphone, mobile, applications

  6. Post-Traumatic Growth and Resilience in Adolescent and Young Adult Cancer Patients: An Overview.

    Science.gov (United States)

    Greup, Suzanne R; Kaal, Suzanne E J; Jansen, Rosemarie; Manten-Horst, Eveliene; Thong, Melissa S Y; van der Graaf, Winette T A; Prins, Judith B; Husson, Olga

    2018-02-01

    The aim of this study was to provide an overview of the literature on post-traumatic growth (PTG) and resilience among adolescent and young adult (AYA) cancer patients. A literature search in Embase, PsychInfo, PubMed, Web of Science, Cochrane Library, and Cinahl was carried out. Thirteen articles met the pre-defined inclusion criteria. Qualitative interview studies showed that AYA cancer patients report PTG and resilience: PTG is described by AYA cancer patients in terms of benefit finding, including changing view of life and feeling stronger and more confident, whereas resilience is described as a balance of several factors, including stress and coping, goals, optimism, finding meaning, connection, and belonging. Quantitative studies showed that sociodemographic and clinical characteristics were not associated with PTG. Enduring stress was negatively, and social support positively, associated with PTG. Symptom distress and defensive coping were negatively and adaptive cognitive coping was positively associated with resilience. Both PTG and resilience were positively associated with satisfaction with life and health-related quality of life (HRQoL). Resilience was found to be a mediator in the relationship between symptom distress and HRQoL. Two interventions aiming to promote resilience, a stress management and a therapeutic music video-intervention, were not successful in significantly increasing overall resilience. Most AYA cancer patients report at least some PTG or resilience. Correlates of PTG and resilience, including symptom distress, stress, coping, social support, and physical activity, provide further insight to improve the effectiveness of interventions aimed at promoting these positive outcomes and potentially buffer negative outcomes.

  7. Home-based palliative care for adult cancer patients in Ibadan-a three year review.

    Science.gov (United States)

    Omoyeni, Ne; Soyannwo, Oa; Aikomo, Oo; Iken, Of

    2014-01-01

    Home-based palliative care is a recognised model of health service provision globally, but is just emerging in Nigeria. The aim of this study isto review the spectrum of adult cancer patients involved in home-based palliative care, the services provided, outcome and benefits. Records of all adult cancer patients seen on home-based palliative care between March 2009 and January 2013 by the hospice and palliative care unit, University College Hospital (UCH), Ibadan were reviewed. Their biographical data, days on programme, diagnosis, stage of disease, major complaint, pain score, other symptoms, services offered, number of home visits, follow-up, and outcomes were extracted, reviewed, and analysed. The data were analysed using SPSS version 16.0. Sixty patients were enrolled during the study period: there were 20 (33.3%) males and 40 (66.7%) females out of a total of 787 patients. All of them reside within catchment area of the hospice. Breast and prostate cancer constitute 21.7% each, gastrointestinal 16.7%, liver 11.7%, and cervical cancer 10.0%. Homes were visited 1-23 times per person. Days on programme ranged from 9-1207 days (average: 286 days). Pain was reported by 52 (86.7%) with scores of 7 to10 in 26 (50.0%). Only eight (13.3%) were pain-free. Services offered included pain and other symptom control, counselling and training for carers at home, provision of funds and comfort packs, bereavement services. The cost of services was heavily subsidised by the Centre for Palliative Care, Nigeria (CPCN), a non-governmental organisation and UCH. Although all patients are now deceased, the compassionate care received at a subsidised cost was highly valued, as shown from the appreciative comments of relations and carers. Home-based palliative care provided at low cost was beneficial to patients and their families. More can be achieved through the training of more health professionals, increased funding, and increased public awareness of the services.

  8. Self-reported physical activity behaviour; exercise motivation and information among Danish adult cancer patients undergoing chemotherapy

    DEFF Research Database (Denmark)

    Midtgaard, J.; Baadsgaard, M.T.; Moller, T.

    2009-01-01

    BACKGROUND: Physical activity is considered an important and determining factor for the cancer patient's physical well-being and quality of life. However, cancer treatment may disrupt the practice of physical activity, and the prevention of sedentary lifestyles in cancer survivors is imperative....... PURPOSE: The current study aimed at investigating self-reported physical activity behaviour, exercise motivation and information in cancer patients undergoing chemotherapy. METHODS AND SAMPLE: Using a cross-sectional design, 451 patients (18-65 years) completed a questionnaire assessing pre...... undergoing chemotherapy (OR 1.69, p=0.023). CONCLUSIONS: This study suggests that Danish adult cancer patients in chemotherapy experience a significant decline in physical activity behaviour. Results indicate a general positive interest in physical activity amongst the patients, which however may be only...

  9. Recent developments in supporting adolescent and young adult siblings of cancer patients.

    Science.gov (United States)

    Patterson, Pandora; Medlow, Sharon; McDonald, Fiona E J

    2015-07-01

    The psychosocial needs of adolescent and young adult (AYA) siblings of cancer patients are easily overlooked. Accordingly, the evidence base informing short and long-term outcomes for these young people is sparse. This review provides an overview of recent research highlighting the experiences, unmet needs and psychosocial issues of AYA siblings, together with recent interventions. The reviewed studies bring focus to the range of informational and supportive care needs that typically remain unmet in AYA siblings. The limited number of interventions designed specifically for this group not only appear to have positive results but also underscore the need for effective risk stratification preintervention and tailoring of interventions to the specific needs of participants. AYA siblings of cancer patients display a range of psychosocial symptoms that can be ameliorated with age-appropriate information and targeted intervention programs. Limited research suggests that the majority of unmet needs for AYA siblings seem to occur during the acute phases of the brother or sister's initial diagnosis, treatment and relapse. Further research is required on siblings' long-term psychosocial assessment and management, bereavement, family systems, the impact of the cancer experience on siblings' personality and identity, and the development and evaluation of tailored psychosocial interventions. Policy research is also required to identify opportunities for expanding established healthcare systems to include sibling support.

  10. A review of mobile applications to help adolescent and young adult cancer patients.

    Science.gov (United States)

    Wesley, Kimberly M; Fizur, Philip J

    2015-01-01

    To review research articles utilizing mobile applications with adolescent and young adult (AYA) cancer patients. We identified articles via online searches and reference lists (eg, PsycInfo, PubMed). Articles were reviewed by two study team members for target population, stated purpose, technological utilization, sample size, demographic characteristics, and outcome data. Strengths and weaknesses of each study were described. Of 19 identified manuscripts, six met full inclusion criteria for this review (four smartphone applications and two tablet applications). One additional article that included an application not specific to oncology but included AYA patients with cancer within the target sample was also reviewed. Uses of these applications included symptom tracking, pain management, monitoring of eating habits following bone marrow transplant, monitoring of mucositis, and improving medication management. Utility results from pilot studies are presented. Mobile applications are growing in number and increasingly available to AYAs with and without chronic illness. These applications may prove useful in helping to support AYAs throughout their cancer treatment and beyond. However, few applications provide empirical data supporting their utility. Numerous strengths and benefits of these applications include increased accessibility to educational resources and self-management strategies, more frequent physical and emotional symptom tracking, and increased access to peer support. Despite these strengths, numerous limitations are identified, highlighting the need for future research in this area.

  11. Experiences of aromatherapy massage among adult female cancer patients: A qualitative study.

    Science.gov (United States)

    Ho, Simone S M; Kwong, Alice N L; Wan, Karen W S; Ho, Rosita M L; Chow, Ka Ming

    2017-12-01

    To explore the experiences towards aromatherapy massage use, and to examine the perceived benefits and adverse effects of aromatherapy massage among adult female cancer patients. A qualitative research design was used. Fifteen women with cancer were recruited for semi-structured interviews. Sample recruitment was undertaken through cancer self-help groups and referrals of a private aromatherapy clinic by convenience sampling. The interview data were analysed by thematic analysis. All participants had a positive experience towards aromatherapy massage. The perceived benefits of aromatherapy massage included physical and psychological dimensions: overall comfort, relaxation, reduced pain, muscular tension, lymphoedema and numbness, improved sleep, energy level, appetite and mood. Interestingly, a few participants reported that aromatherapy massage helped to enhance self-acceptance and coping with their altered torso. No adverse effects were reported. The findings focused on four main themes that emerged: (i) an immediate effect that brings all-round comfort and reconnection to daily life; (ii) a pleasurable moment to forget the disease with aroma as a booster; (iii) a pampering experience of being cared for with a sense of dignity preserved; and (iv) communicating with the failing body. This study contributed by providing a better understanding in aromatherapy massage from female cancer patients' perspective which adds to the existing body of knowledge. The implications for nursing practice, education and future research were suggested. Aromatherapy massage seems to have both physical and psychological benefits for women with cancer. The findings elucidated a wide range of benefits that are perceived in such complex intervention, and the contextual factors that may influence these perceived benefits. This will inform future nurse-led quantitative research in the clinical setting. The study highlights the importance of touch towards a caring relationship and the

  12. The relationship between nutritional status and handgrip strength in adult cancer patients: a cross-sectional study.

    Science.gov (United States)

    Alkan, Şenay Burçin; Artaç, Mehmet; Rakıcıoğlu, Neslişah

    2018-02-09

    Malnutrition is a common complication in head, neck and lung cancer patients, particularly in cases of gastrointestinal system (GIS) cancer. Therefore, an assessment of malnutrition is crucial for early nutritional interventions. It was conducted as a cross-sectional study to evaluate nutritional status of adult cancer patients. The nutritional status of 104 cancer patients (52 GIS and 52 non-GIS cancer cases) using a Patient-Generated Subjective Global Assessment (PG-SGA), handgrip strength, certain anthropometric measurements and food consumption in and outside of the hospital were assessed. The percentages of malnutrition were 64.6 and 64.3% in the male patients with and without GIS cancer, respectively. They were 61.9 and 45.8% in the female patients with GIS and without GIS cancer, respectively. However, no significant difference was found between these two groups according to the malnutrition classification, PG-SGA score, handgrip strength and other anthropometric measurements (p > 0.05). The daily energy and protein intakes (per body weight) of the female patients in the hospital were significantly lower than those outside (p Cancer patients could be provided with nutritional education, and arrangements could be made with hospital nutritional services in order to prevent malnutrition.

  13. Palliative care experiences of adult cancer patients from ethnocultural groups: a qualitative systematic review protocol.

    Science.gov (United States)

    Busolo, David; Woodgate, Roberta

    2015-01-01

    The objective of this review is to synthesize the best available evidence on palliative care experiences of adult cancer patients from ethnocultural groups.More specifically, this systematic review seeks to answer the following questions:1. What are the palliative care experiences of adult cancer patients from diverse ethnocultural groups?2. What meanings do adult patients with cancer from diverse ethnocultural groups assign to their experiences with palliative care? Globally, over 20.4 million people need palliative care services annually. The majority of these people (19 million) are adults, with 34% of them being patients diagnosed with cancer. With the current increase in the aging population, especially in developed countries, the number of adults requiring palliative care is expected to rise. Furthermore, how palliative care is offered and received continues to be shaped by culture and ethnicity. Likewise, culture and ethnicity influence how palliative care patients experience diseases like cancer, and seek and utilize palliative care services. Also, healthcare providers sometimes find it challenging to address the palliative care needs of patients from different ethnocultural groups. Sometimes these challenges are believed to be due to cultural incompetence of the care provider. When palliative care patients and their providers differ in their perception of care needs and how to address them, negative palliative care experiences are likely to ensue. Therefore, as the demand for palliative care increases, and ethnocultural factors continue to affect palliation, it is important to gain a better understanding of palliative care experiences of patients from different ethnocultural groups.The terms culture and ethnicity have been defined and used differently in literature which sometimes lead to confusion. Ethnicity has been defined as distinctive shared origins or social backgrounds and traditions of a group of people that are maintained between generations and

  14. What do adolescents and young adults want from cancer resources? Insights from a Delphi panel of AYA patients.

    Science.gov (United States)

    Cheung, Christabel K; Zebrack, Brad

    2017-01-01

    Cancer treatment programs and community-based support organizations are increasingly producing information and support resources geared to adolescent and young adult patients (AYAs); however, systematically-derived knowledge about user preferences for these resources is lacking. The primary purpose of this study was to generate findings from informed AYA cancer patients that resource developers can use to create products consistent with AYAs' expressed preferences for information and support. Utilizing a modified Delphi technique, AYA cancer patients identified barriers to optimal AYA cancer care, cancer resources that address their needs, and specific characteristics of cancer resources they find helpful. The Delphi panel consisted of a convenience sample of 21 patients aged 18-39 years, who were diagnosed with cancer between ages 15-39 and were no more than 8 years out from cancer treatment at the time of the study. Survey data were collected in three consecutive and iterative rounds over the course of 6 months in 2015. Findings indicated that AYA patients prefer resources that reduce feelings of loneliness, create a sense of community or belonging, and provide opportunities to meet other AYA patients. Among the top barriers to optimal cancer care, AYAs identified a lack of cancer care providers specializing in AYA care, a lack of connection to an AYA patient community, and their own lack of ability to navigate the health system. Participants also described aspects of cancer information and supportive care resources that they believe address AYAs' concerns. Information derived from this study will help developers of cancer information and support resources to better reach their intended audience. From the point of view of AYA cancer patients, optimal cancer care and utilization of information and support resources requires that cancer support programs foster meaningful connections among AYA patients. Results also suggest that patient resources should equip

  15. Personality-Related Risk and Resilience Factors in Coping with Daily Stress among Adult Cancer Patients.

    Science.gov (United States)

    Diehl, Manfred; Hay, Elizabeth L

    2013-01-01

    We employed a diary design to study personality-related risk and resilience factors in adult cancer patients coping with daily stress. We focused on individuals' self-concept incoherence (SCI) as a personality-related risk factor and on psychological well-being (PWB) at baseline and daily beliefs of control as resilience factors. Reactivity to daily stress was assessed in terms of negative daily mood. Multilevel modeling analyses yielded significant main effects of daily stress, PWB at baseline, and daily control. These main effects were qualified by significant two- and three-way interactions. The significant Stress X Control interaction indicated that individuals reported more negative mood in response to daily stress on low-control days compared to high-control days. Similarly, a significant SCI X Control interaction suggested that individuals with a more coherent self-concept benefited more from feeling in control in terms of experiencing less increase in negative mood compared to individuals with a more incoherent self-concept. Significant three-way interactions also indicated that the associations between stress, control and negative daily mood differed by level of SCI and level of PWB at the beginning of the study. Overall, the findings from this study show the complex associations between risk and resilience factors and daily emotional well-being in a sample of adults who were affected by a life-threatening illness.

  16. Pre-exercise participation cardiovascular screening in a heterogeneous cohort of adult cancer patients.

    Science.gov (United States)

    Kenjale, Aarti A; Hornsby, Whitney E; Crowgey, Theresa; Thomas, Samantha; Herndon, James E; Khouri, Michel G; Lane, Amy R; Bishop, Caroline E; Eves, Neil D; Peppercorn, Jeffrey; Douglas, Pamela S; Jones, Lee W

    2014-09-01

    The purpose of this study was to investigate the extent of pre-exercise participation ("preparticipation") health screening in a heterogeneous cohort of adult cancer patients. Patients (n = 413) with histologically confirmed solid or hematologic malignancy were categorized into preparticipation health screening risk stratification based on American College Sports Medicine (ACSM) recommendations. Risk of an exercise-related event was evaluated during a symptom-limited cardiopulmonary exercise test (CPET) with 12-lead electrocardiography (ECG). Participant risk was categorized as low risk (n = 59, 14%), moderate risk (n = 217, 53%), and high risk (n = 137, 33%). Mean peak oxygen consumption was 21.7 ± 6.7 mL/kg(-1) per minute(-1) or 19.5 ± 21.7% below age- and sex-predicted sedentary values. No major serious adverse events or fatal events were observed during CPET procedures. A total of 31 positive ECG tests were observed, for an event rate of 8%. ACSM risk stratification did not predict the risk of a positive test. Age, statin use, antiplatelet therapy use, cardiovascular disease, prior treatment with anthracycline or radiation therapy, and being sedentary were predictors of a positive test (all p exercise-induced event is low, suggesting that the use of exercise testing is not required for pre-exercise clearance in the majority of patients. ©AlphaMed Press.

  17. Aetiology of Bacteraemia as a Risk Factor for Septic Shock at the Onset of Febrile Neutropaenia in Adult Cancer Patients

    Directory of Open Access Journals (Sweden)

    Regis Goulart Rosa

    2014-01-01

    Full Text Available Septic shock (SS at the onset of febrile neutropaenia (FN is an emergency situation that is associated with high morbidity and mortality. The impact of the specific aetiology of bloodstream infections (BSIs in the development of SS at the time of FN is not well established. The aim of this study was to evaluate the association between the aetiology of BSIs and SS at the time of FN in hospitalised adult cancer patients. This prospective cohort study was performed at a single tertiary hospital from October 2009 to August 2011. All adult cancer patients admitted consecutively to the haematology ward with FN were evaluated. A stepwise logistic regression was conducted to verify the association between the microbiological characteristics of BSIs and SS at the onset of FN. In total, 307 cases of FN in adult cancer patients were evaluated. There were 115 cases with documented BSI. A multivariate analysis showed that polymicrobial bacteraemia (P=0.01 was associated with SS. The specific blood isolates independently associated with SS were viridans streptococci (P=0.02 and Escherichia coli (P=0.01. Neutropaenic cancer patients with polymicrobial bacteraemia or BSI by viridans streptococci or Escherichia coli are at increased risk for SS at the time of FN.

  18. A systematic review of instruments assessing dimensions of distress among caregivers of adult and pediatric cancer patients.

    Science.gov (United States)

    Tanco, Kimberson; Park, Ji Chan; Cerana, Agustina; Sisson, Amy; Sobti, Nikhil; Bruera, Eduardo

    2017-02-01

    Caregivers of cancer patients face intense demands throughout the course of the disease, survivorship, and bereavement. Caregiver burden, needs, satisfaction, quality of life, and other significant areas of caregiving are not monitored regularly in the clinic setting, resulting in a need to address the availability and clinical effectiveness of cancer caregiver distress tools. This review aimed to determine the availability of cancer caregiver instruments, the variation of instruments between different domains of distress, and that between adult and pediatric cancer patient populations. A literature search was conducted using various databases from 1937 to 2013. Original articles on instruments were extracted separately if not included in the original literature search. The instruments were divided into different areas of caregiver distress and into adult versus pediatric populations. Psychometric data were also evaluated. A total of 5,541 articles were reviewed, and 135 articles (2.4%) were accepted based on our inclusion criteria. Some 59 instruments were identified, which fell into the following categories: burden (n = 26, 44%); satisfaction with healthcare delivery (n = 5, 8.5%); needs (n = 14, 23.7%); quality of life (n = 9, 15.3%); and other issues (n = 5, 8.5%). The median number of items was 29 (4-125): 20/59 instruments (33.9%) had ≤20 items; 13 (22%) had ≤20 items and were psychometrically sound, with 12 of these 13 (92.3%) being self-report questionnaires. There were 44 instruments (74.6%) that measured caregiver distress for adult cancer patients and 15 (25.4%) for caregivers of pediatric patients. There is a significant number of cancer caregiver instruments that are self-reported, concise, and psychometrically sound, which makes them attractive for further research into their clinical use, outcomes, and effectiveness.

  19. Are patient-nurse relationships in breast cancer linked to adult attachment style?

    Science.gov (United States)

    Harding, Rachel; Beesley, Helen; Holcombe, Christopher; Fisher, Jean; Salmon, Peter

    2015-10-01

    The aim of this study was to ascertain if patients with breast cancer who have positive attachment models of 'self' and 'other' perceive higher levels of support from nurses than do patients with negative attachment models. Attachment models of 'self' and 'other' develop in childhood and affect relationships throughout life. People with negative attachment models tend to perceive themselves as unworthy of receiving support and to perceive others as incapable or unwilling to offer support. Attachment processes are activated when individuals feel threatened and seek support from those close to them. Breast cancer may represent such a threat and relationships between patients with breast cancer and nurses may therefore be influenced by patients' attachment models. A between-subjects cross-sectional design was used. Explanatory variables were indicators of patients' attachment models. Response variables were patient ratings of nurse support. Covariates were patient age and patient distress levels. One hundred and fifty-three patients with breast cancer, diagnosed 1-3 years previously, were recruited when attending follow-up oncology appointments over 51 weeks in 2010-2011. Participants completed questionnaires assessing attachment models, distress and perceived support, from the nurse who was available to support them through their cancer. The hypotheses were tested by logistic regression analysis. Patients with more positive models of 'self' perceived more support from nurses. Patients' perceptions of nurses when being treated for breast cancer are influenced by patients' own models of attachment. Knowledge of this would help nurses further to individualize the emotional support they give patients. © 2015 John Wiley & Sons Ltd.

  20. A trial examining an advanced practice nurse intervention to promote medication adherence and symptom management in adult cancer patients prescribed oral anti-cancer agents: study protocol.

    Science.gov (United States)

    Spoelstra, Sandra L; Burhenn, Peggy S; DeKoekkoek, Tracy; Schueller, Monica

    2016-02-01

    To report a study protocol that refines then examines feasibility, preliminary efficacy and satisfaction of ADHERE, an intervention using motivational interviewing and brief cognitive behaviorial therapy as a mechanism for goal-oriented systematic patient education to promote symptom management and adherence among cancer patients prescribed oral anti-cancer agents. Cancer treatment with oral anti-cancer agents shifts responsibility for managing treatment from clinicians in supervised cancer centres to patients and their caregivers. Thus, a need exists to standardize start-of-care to support patient self-management of care at home. A two-phase quasi-experimental sequential design with repeated measures. Sixty-five adult patients newly prescribed an oral anti-cancer agent will be recruited from three community cancer centres. Phase 1 will enrol five patients to refine the ADHERE intervention prior to testing. After completion, Phase 2 will enrol 30 patients who receive usual care. Advanced practice nurses will then be trained. Thirty patients will be then enrolled in the intervention group and provided ADHERE, a 4-week intervention using semi-structured interactions (initial face-to-face session and once a week phone sessions over 3 weeks) and a Toolkit to promote self-management of care. Outcome measures include: oral anti-cancer agents adherence rate, symptom presence and severity, feasibility and satisfaction with ADHERE. This protocol was approved January 2014. This nurse-led intervention has the potential to standardize the start-of-care training for the patients to self-manage when oral anti-cancer agents for treatment were prescribed. © 2015 John Wiley & Sons Ltd.

  1. Lifestyle advice provision to teenage and young adult cancer patients: the perspective of health professionals in the UK.

    Science.gov (United States)

    Pugh, Gemma; Hough, Rachael; Gravestock, Helen; Williams, Kate; Fisher, Abigail

    2017-12-01

    Health professionals are an important source of information for teenage and young adult (TYA) cancer patients. However, little is known about health professionals' provision of lifestyle advice to young people with cancer who are in their care. An online survey was distributed to health professionals within the UK who identified themselves as working with TYA cancer patients. Health professional awareness of lifestyle guidance, provision of lifestyle advice to young people and views on lifestyle information format and delivery were explored. Ninety-five health professionals (44% nurses; 28% allied health professionals; 17% physicians) completed the survey. The majority (72%) of respondents were aware of some lifestyle guidance for cancer patients. However, less than half of TYA health professionals (46%) were able to successfully recall the source of the guidelines and less than a third reported proving specific advice to the majority of their patients on weight management, smoking, alcohol consumption and sun safety. Many health professionals (38%) felt that they were not the right person to provide advice and cited lack of resources as a key barrier to advice provision. The majority (95%) reported being interested in a resource containing relevant lifestyle information that could be given to young people with cancer. TYA health professionals' awareness of lifestyle guidance and provision of advice regarding health behaviour is sub-optimal. Clear and comprehensive guidance written specifically for TYA health professionals could overcome the reported barriers and improve professionals' confidence in addressing and providing advice on lifestyle to young people with cancer.

  2. The impact of music interventions on anxiety for adult cancer patients: a meta-analysis and systematic review.

    Science.gov (United States)

    Nightingale, Chandylen L; Rodriguez, Carmen; Carnaby, Giselle

    2013-09-01

    Listening to music can positively benefit neurophysiological and emotional responses as well as promote relaxation, which may be especially beneficial for cancer patients undergoing painful and anxiety inducing treatments. The purpose of the present study was to conduct an evidenced-based systematic review and meta-analysis of randomized controlled trials of music interventions to reduce anxiety for adult cancer patients undergoing medical treatment. A systematic literature search was conducted and data were abstracted from all eligible studies. Studies were included if they tested a music therapy randomized controlled trial in adult cancer patients (in active treatment), assessed anxiety postintervention using a validated measure, were published in English (or were translatable), and accessible in full text. Studies were qualitatively reviewed by the first author and 2 raters independently assessed each study using the PEDro scale. Standardized mean differences between experimental and control groups were calculated for studies meeting a specified methodological rigor score with accessible means and standard deviations postintervention. Heterogeneity and publication bias were explored. Thirteen randomized controlled trials were included with 4 eligible for meta-analysis. Studies varied in intervention methodology and utilization of anxiety measures. Almost all studies reported either a significant difference in anxiety between groups postintervention or a significant decrease in anxiety over time in the music intervention group. Meta-analytic results of 4 studies (4/13) demonstrated that differences in anxiety between experimental and control groups were not significant in the main analysis or subgroup analysis. Studies demonstrated heterogeneity in anxiety results. Publication bias was not evident. The meta-analytic results failed to demonstrate a positive effect on anxiety among adult cancer patients in treatment but may in part be attributed to the small sample

  3. Self-management for adult patients with cancer: an integrative review.

    Science.gov (United States)

    Hammer, Marilyn J; Ercolano, Elizabeth A; Wright, Fay; Dickson, Victoria Vaughan; Chyun, Deborah; Melkus, Gail D'Eramo

    2015-01-01

    Individuals with cancer are surviving long term, categorizing cancer as a chronic condition, and with it, numerous healthcare challenges. Symptoms, in particular, can be burdensome and occur from prediagnosis through many years after treatment. Symptom severity is inversely associated with functional status and quality of life. Management of these millions of survivors of cancer in a stressed healthcare system necessitates effective self-care strategies. The purpose of this integrative review is to evaluate intervention studies led by nurse principal investigators for self-care management in patients with cancer. PubMed, CINAHL (Cumulative Index to Nursing and Allied health Literature), and the Cochrane Database were searched from January 2000 through August 2012. Search terms included "symptom management and cancer," "self-management and cancer," and "self-care and cancer." All articles for consideration included intervention studies with a nurse as the primary principal investigator. Forty-six articles were included yielding 3 intervention areas of educational and/or counseling sessions, exercise, and complementary and alternative therapies. Outcomes were predominately symptom focused and often included functional status and quality of life. Few studies had objective measures. Overarching themes were mitigation, but not prevention or elimination of symptoms, and improved quality of life related to functional status. No one intervention was superior to another for any given outcome. Current interventions that direct patients in self-care management of symptoms and associated challenges with cancer/survivorship are helpful, but incomplete. No one intervention can be recommended over another. Guiding patients with cancer in self-care management is important for overall functional status and quality of life. Further investigation and tailored interventions are warranted.

  4. The nutrition and hydration of older adult cancer patients in hospice

    OpenAIRE

    Ferrandino, Donna S.

    1995-01-01

    The use of artificial means of nutrition and hydration for terminally ill patients is a controversial topic, involving medical, legal, social, and ethical issues. Often, the patient who is dying in the hospital and ceases to eat and drink receives tube feeding. In contrast, hospice patients are usually not given tube feeding, and emphasis is placed on palliative treatment. The purpose of the first project was to describe the dietary intake of twelve older adult can...

  5. Position paper on management of iron deficiency in adult cancer patients.

    Science.gov (United States)

    Barni, Sandro; Gascòn, Pere; Petrelli, Fausto; García-Erce, José Antonio; Pedrazzoli, Paolo; Rosti, Giovanni; Giordano, Giulio; Mafodda, Antonio; Múñoz, Manuel

    2017-08-01

    Disorders of iron metabolism are commonly seen in onco-hematological clinical practice. Iron-deficiency anemia and cancer-associated anemia are usually treated with supportive therapies. Optimal management of these conditions are discussed in this perspective paper. Areas covered: A position paper discussing a number of hot topics on anemia in cancer patients is presented. The main areas covered by experts in the field are: definitions, prevalence and consequences of anemia and iron deficiency, incidence of anemia resulting from targeted therapies, importance of anemia diagnosis and monitoring, evaluation of iron status before and during treatment, role of transfusions and erythropoiesis-stimulating agents, management of iron deficiency with or without anemia, parenteral iron supplementation, role of new oral iron formulations, safety and cost issues regarding different iron compounds and administration routes. Expert commentary: Despite the availability of newer therapeutic options for its management, anemia still represents a major complication of treatment in cancer patients (surgery, chemotherapy, radiotherapy, targeted therapies), aggravating physical impairment, and negatively affecting general outcome. The view expressed by the panelists, attendees of the 4th Mediterranean Course on Iron Anemia, summarizes what they consider optimal clinical practice for screening, diagnosis, treatment and monitoring of iron deficiency and anemia in cancer patients.

  6. The effect of creative psychological interventions on psychological outcomes for adult cancer patients: a systematic review of randomised controlled trials.

    Science.gov (United States)

    Archer, S; Buxton, S; Sheffield, D

    2015-01-01

    This systematic review examined the effectiveness of creative psychological interventions (CPIs) for adult cancer patients. In particular, the findings of randomised controlled trials of art, drama, dance/movement and music therapies on psychological outcomes were examined. The review yielded 10 original studies analysing data from a total of 488 patients. Data extraction and quality assessment were conducted by two independent reviewers. Four of the papers focused on the use of art therapy, three studies used music therapy, one paper utilised dance therapy, one study used dance/movement therapy and the remaining paper used creative arts therapies, which was a combination of different art-based therapy approaches. Eight papers focused solely on breast cancer patients, and the remaining studies included mixed cancer sites/stages. The studies reported improvements in anxiety and depression, quality of life, coping, stress, anger and mood. However, few physical benefits of CPIs were reported; there was no significant impact of a CPI on physical aspects of quality of life, vigour-activity or fatigue-inertia or physical functioning. One study was assessed as high quality, seven studies were assessed as satisfactory and two studies were assessed to be of poorer quality. There is initial evidence that CPIs benefit adult cancer patients with respect to anxiety and depression, quality of life, coping, stress, anger and mood; there was no evidence to suggest that any one type of CPI was especially beneficial. However, more and better quality research needs to be conducted, particularly in the areas of drama and dance/movement therapies. Copyright © 2014 John Wiley & Sons, Ltd.

  7. The average body surface area of adult cancer patients in the UK: a multicentre retrospective study.

    Directory of Open Access Journals (Sweden)

    Joseph J Sacco

    2010-01-01

    Full Text Available The majority of chemotherapy drugs are dosed based on body surface area (BSA. No standard BSA values for patients being treated in the United Kingdom are available on which to base dose and cost calculations. We therefore retrospectively assessed the BSA of patients receiving chemotherapy treatment at three oncology centres in the UK between 1(st January 2005 and 31(st December 2005.A total of 3613 patients receiving chemotherapy for head and neck, ovarian, lung, upper GI/pancreas, breast or colorectal cancers were included. The overall mean BSA was 1.79 m(2 (95% CI 1.78-1.80 with a mean BSA for men of 1.91 m(2 (1.90-1.92 and 1.71 m(2 (1.70-1.72 for women. Results were consistent across the three centres. No significant differences were noted between treatment in the adjuvant or palliative setting in patients with breast or colorectal cancer. However, statistically significant, albeit small, differences were detected between some tumour groups.In view of the consistency of results between three geographically distinct UK cancer centres, we believe the results of this study may be generalised and used in future costings and budgeting for new chemotherapy agents in the UK.

  8. Adolescents and Young Adults with Cancer

    Science.gov (United States)

    ... Young Adults with Cancer Reports, Research, and Literature Adolescents and Young Adults with Cancer View this video ... and Young Adults SeventyK Stupid Cancer Teens and Adolescents CureSearch Starlight Children's Foundation Teen Cancer America 13thirty ...

  9. Spinal opioids in adult patients with cancer pain: a systematic review: a European Palliative Care Research Collaborative (EPCRC) opioid guidelines project

    DEFF Research Database (Denmark)

    Kurita, Geana Paula; Kaasa, Stein; Sjøgren, Per

    2011-01-01

    A systematic review, undertaken according to an initiative to revise European Association for Palliative Care guidelines on the use of opioids for cancer pain, which aimed to analyse analgesic efficacy and side effects of spinal opioids in adult cancer patients previously treated with systemic...... opioids....

  10. Spinal opioids in adult patients with cancer pain: a systematic review: a European Palliative Care Research Collaborative (EPCRC) opioid guidelines project

    DEFF Research Database (Denmark)

    Kurita, Geana Paula; Kaasa, Stein; Sjøgren, Per

    2011-01-01

    A systematic review, undertaken according to an initiative to revise European Association for Palliative Care guidelines on the use of opioids for cancer pain, which aimed to analyse analgesic efficacy and side effects of spinal opioids in adult cancer patients previously treated with systemic...

  11. Adolescent and Young Adult Patient Engagement and Participation in Survey-Based Research: A Report From the "Resilience in Adolescents and Young Adults With Cancer" Study.

    Science.gov (United States)

    Rosenberg, Abby R; Bona, Kira; Wharton, Claire M; Bradford, Miranda; Shaffer, Michele L; Wolfe, Joanne; Baker, Kevin Scott

    2016-04-01

    Conducting patient-reported outcomes research with adolescents and young adults (AYAs) is difficult due to low participation rates and high attrition. Forty-seven AYAs with newly diagnosed cancer at two large hospitals were prospectively surveyed at the time of diagnosis and 3-6 and 12-18 months later. A subset participated in 1:1 semistructured interviews. Attrition prompted early study closure at one site. The majority of patients preferred paper-pencil to online surveys. Interview participants were more likely to complete surveys (e.g., 93% vs. 58% completion of 3-6 month surveys, P = 0.02). Engaging patients through qualitative methodologies and using patient-preferred instruments may optimize future research success. © 2015 Wiley Periodicals, Inc.

  12. Reproductive health in the adolescent and young adult cancer patient: an innovative training program for oncology nurses.

    Science.gov (United States)

    Vadaparampil, Susan T; Hutchins, Nicole M; Quinn, Gwendolyn P

    2013-03-01

    In 2008, approximately 69,200 adolescents and young adults (AYAs) were diagnosed with cancer, second only to heart disease for males in this age group. Despite recent guidelines from professional organizations and clinical research that AYA oncology patients want information about reproductive health topics and physician support for nurses to address these issues with patients, existing research finds few oncology nurses discuss this topic with patients due to barriers such as lack of training. This article describes an innovative eLearning training program, entitled Educating Nurses about Reproductive Issues in Cancer Healthcare. The threefold purpose of this article is to: (1) highlight major reproductive health concerns relevant to cancer patients, (2) describe the current status of reproductive health and oncology communication and the target audience for the training, and (3) present a systematic approach to curriculum development, including the content analysis and design stages as well as the utilization of feedback from a panel of experts. The resulting 10-week curriculum contains a broad-based approach to reproductive health communication aimed at creating individual- and practice-level change.

  13. Adult Co-morbidity Evaluation 27 scores of head and neck cancer patients using touch-screen technology: patient satisfaction and clinical verification.

    Science.gov (United States)

    Brammer, C; Dawson, D; Joseph, M; Tipper, J; Jemmet, T; Liew, L; Spinou, C; Grew, N; Pigadas, N; Rehman, K

    2017-05-01

    This study aimed to assess head and neck cancer patient satisfaction with the use of a touch-screen computer patient-completed questionnaire for assessing Adult Co-morbidity Evaluation 27 co-morbidity scores prior to treatment, along with its clinical reliability. A total of 96 head and neck cancer patients were included in the audit. An accurate Adult Co-morbidity Evaluation 27 co-morbidity score was achieved via patient-completed questionnaire assessment for 97 per cent of participants. In all, 96 per cent of patients found the use of a touch-screen computer acceptable and would be willing to use one again, and 62 per cent would be willing to do so without help. Patients were more likely to be willing to use the computer again without help if they were aged 65 years or younger (χ2 test; p = 0.0054) or had a performance status of 0 or 1 (χ2 test; p = 0.00034). Use of a touch-screen computer is an acceptable approach for assessing Adult Co-morbidity Evaluation 27 scores at pre-treatment assessment in a multidisciplinary joint surgical-oncology clinic.

  14. Association Between SLC16A5 Genetic Variation and Cisplatin-Induced Ototoxic Effects in Adult Patients With Testicular Cancer.

    Science.gov (United States)

    Drögemöller, Britt I; Monzon, Jose G; Bhavsar, Amit P; Borrie, Adrienne E; Brooks, Beth; Wright, Galen E B; Liu, Geoffrey; Renouf, Daniel J; Kollmannsberger, Christian K; Bedard, Philippe L; Aminkeng, Folefac; Amstutz, Ursula; Hildebrand, Claudette A; Gunaretnam, Erandika P; Critchley, Carol; Chen, Zhuo; Brunham, Liam R; Hayden, Michael R; Ross, Colin J D; Gelmon, Karen A; Carleton, Bruce C

    2017-11-01

    Cisplatin-induced ototoxic effects are an important complication that affects testicular cancer survivors as a consequence of treatment. The identification of genetic variants associated with this adverse drug reaction will further our mechanistic understanding of its development and potentially lead to strategies to prevent ototoxic effects. To identify the genetic variants associated with cisplatin-induced ototoxic effects in adult testicular cancer patients. This retrospective study was performed by the Canadian Pharmacogenomics Network for Drug Safety using patients recruited from 5 adult oncology treatment centers across Canada. Male patients who were 17 years or older, diagnosed with germ cell testicular cancer, and previously treated with cisplatin-based chemotherapy were recruited from July 2009 to April 2013 using active surveillance methodology. Cisplatin-induced ototoxic effects were independently diagnosed by 2 audiologists. Patients were genotyped for 7907 variants using a custom pharmacogenomic array. Logistic regression was used to identify genetic variants that were significantly associated with ototoxic effects. The validity of these findings was confirmed through independent replication and cell-based functional assays. Cisplatin-based chemotherapy. Cisplatin-induced ototoxic effects. After exclusions, 188 patients (median [interquartile range] age, 31 [24-39] years) were enrolled in this study to form the discovery and replication cohorts. Association and fine-mapping analyses identified a protein-coding variant, rs4788863 in SLC16A5, that was associated with protection against cisplatin-induced ototoxic effects in 2 independent cohorts (combined cohort: odds ratio, 0.06; 95% CI, 0.02-0.22; P = 2.17 × 10-7). Functional validation of this transporter gene revealed that in vitro SLC16A5-silencing altered cellular responses to cisplatin treatment, supporting a role for SLC16A5 in the development of cisplatin-induced ototoxic effects. These

  15. Opioid addiction and misuse in adult and adolescent patients with cancer.

    Science.gov (United States)

    Pinkerton, Ross; Hardy, Janet R

    2017-06-01

    In the context of a therapeutic opioid epidemic, particularly in the USA, where increasingly stringent screening for 'at risk' individuals and close monitoring of opioid prescription and use is strongly recommended, the issue of misuse within the cancer population must be addressed. Most patients with advanced cancer will have pain requiring opioid therapy at some stage during their disease course. In the majority, this will provide good pain relief with no short- or longer-term adverse sequelae. A subset will present with substance misuse issues that will influence management and prescribing practice. The potential ethical issues of limiting effective analgesia on the basis of addiction risk or history must be acknowledged. Both a judgemental or 'relaxed' approach to such patients is problematic. Ignoring the situation will not be in the patient's best interest, but an undue focus on this aspect may damage therapeutic relationships with clinicians and adversely affect a holistic approach to care. Clinical practitioners must be aware of the risk factors for opioid misuse and in patients who are not under palliative care consider screening prior to commencing opioids. Clinicians must be able to manage and monitor those identified as having an opioid misuse problem. © 2017 Royal Australasian College of Physicians.

  16. Transcutaneous iodine absorption in adult patients with thyroid cancer disinfected with povidone-iodine at operation.

    Science.gov (United States)

    Tomoda, Chisato; Kitano, Hiroya; Uruno, Takashi; Takamura, Yuuki; Ito, Yasuhiro; Miya, Akihiro; Kobayashi, Kaoru; Matsuzuka, Fumio; Amino, Nobuyuki; Kuma, Kanji; Miyauchi, Akira

    2005-06-01

    Povidone-iodine is used as disinfection in patients undergoing many kinds of operations. Several cases of thyroid dysfunction induced by transcutaneous absorption of povidone-iodine have been reported in small infants. However, transcutaneous absorption was not clearly reported in adults. The aim of this study was to assess transcutaneous absorption of iodine in patients who received single topical application with povidoneiodine and serial changes of urinary iodine excretion under the condition with a simple iodine-restricted diet in Japan, an iodine-sufficient area. Sixty-eight patients with thyroid carcinoma undergoing total thyroidectomy received single skin disinfection with either povidone-iodine (group A; n = 47) or chlohexidine gluconate, a noniodine containing biguanide (group B; n = 21). In group A, urinary iodine excretion on the first day after operation increased up to 7 times that of the preoperative value. The amounts of urinary iodine correlated positively with operating time. Increased urinary iodine, however, returned to preoperative values on the third or fifth day after operation. In group B, there was no increase in urinary iodine excretion and urinary iodine excretion was ranged from 54 to 193 microg/g of creatinine on the third day of operation. In conclusion, a large amount of povidone-iodine was absorbed through healthy skin even in adults. This may possibly interfere with scintigraphy or radioactive iodine treatment, or cause thyroid disinfection in susceptible patients.

  17. The effects of the Balanced Budget Act of 1997 on home health and hospice in older adult cancer patients.

    Science.gov (United States)

    Kilgore, Meredith L; Grabowski, David C; Morrisey, Michael A; Ritchie, Christine S; Yun, Huifeng; Locher, Julie L

    2009-03-01

    Home health and hospice services can constitute important elements in the continuum of care for older adults diagnosed with cancer. The Balanced Budget Act (BBA) of 1997 included provisions affecting those services. The first objective of this study is to assess the effect of the BBA of 1997 on home health and hospice service utilization in older cancer patients. The second objective is to estimate the effect of the BBA of 1997 on costs associated specifically with home health and hospice services and on total costs of care. The final objective is to evaluate the effect of the BBA of 1997 on mortality in these patients. Longitudinal analysis using the Surveillance, Epidemiology, and End Results-Medicare Database, covering a service area that includes 26% of the US population. Community-dwelling Medicare beneficiaries 65 years of age and older. Utilization rates of home health and hospice services; costs associated with those services, and total costs of care; and mortality. Home health utilization rates dropped substantially and hospice utilization rates increased after the BBA. Medicare costs for home health services declined as did total Medicare costs but hospice costs increased. There was no discernable effect on mortality rates. The BBA was successful in containing the costs of home health services and resulted in savings in overall costs of care for older cancer patients. Reduction in utilization of home health services did not seem to negatively affect outcomes. The BBA may have contributed to the trend of increasing use of hospice care.

  18. Corticosteroids for adult patients with advanced cancer who have nausea and vomiting (not related to chemotherapy, radiotherapy, or surgery).

    Science.gov (United States)

    Vayne-Bossert, Petra; Haywood, Alison; Good, Phillip; Khan, Sohil; Rickett, Kirsty; Hardy, Janet R

    2017-07-03

    Nausea is a common symptom in advanced cancer, with a prevalence of up to 70%. While nausea and vomiting can be related to cancer treatments, such as chemotherapy, radiotherapy, or surgery, a significant number of people with advanced cancer also suffer from nausea unrelated to such therapies. Nausea and vomiting may also cause psychological distress, and have a negative impact on the quality of life of cancer patients; similarly to pain, nausea is often under-treated. The exact mechanism of action of corticosteroids on nausea is unclear, however, they are used to manage a number of cancer-specific complications, including spinal cord compression, raised intracranial pressure, and lymphangitis carcinomatosis. They are also commonly used in palliative care for a wide variety of non-specific indications, such as pain, nausea, anorexia, fatigue, and low mood. However, there is little objective evidence of their efficacy in symptom control, and corticosteroids have a wide range of adverse effects that are dose and time dependent. In view of their widespread use, it is important to seek evidence of their effects on nausea and vomiting not related to cancer treatment. To assess the effects of corticosteroids on nausea and vomiting not related to chemotherapy, radiotherapy, or surgery in adult cancer patients. We searched CENTRAL, MEDLINE Ovid, Embase Ovid, CINAHL EBSCO, Science Citation Index Web of Science, Latin America and Caribbean Health Sciences (LILACS), Conference Proceedings Citation Index - Science Web of Science, and clinical trial registries, from inception to 23rd August 2016. Any double-blind randomised or prospective controlled trial that included adults aged 18 years and over with advanced cancer with nausea and vomiting not related to chemotherapy, radiotherapy, or surgery were eligible for the review, when using corticosteroids as antiemetic treatment. All review authors independently assessed trial quality and extracted data. We used arithmetic means

  19. An Australian survey of clinical practices in management of neutropenic fever in adult cancer patients 2009.

    Science.gov (United States)

    Lingaratnam, S; Slavin, M A; Mileshkin, L; Solomon, B; Burbury, K; Seymour, J F; Sharma, R; Koczwara, B; Kirsa, S W; Davis, I D; Prince, M; Szer, J; Underhill, C; Morrissey, O; Thursky, K A

    2011-01-01

    An abundance of new evidence regarding treatment strategies for neutropenic fever is likely to contribute to variability in practice across institutions and clinicians alike. To describe current clinical practices in Australia, by surveying haematologists, oncologists and infectious diseases physicians involved in cancer care. Clinician members from Australian professional associations, accounting for the vast majority of Australian cancer specialists, were invited to participate in an electronic survey, comprising of a clinical case-based questionnaire. Clinical practice areas explored were: use of risk-assessment and empiric antibiotic strategies across various treatment settings; use of anti-bacterial prophylaxis; and use of granulocyte-colony stimulating factors for established neutropenic fever and for secondary prophylaxis. A total of 252 clinicians returned responses (approximately 30% response rate). The majority (>70%) were representative of practices in public, major city, tertiary referral hospitals. Less than half of clinicians were aware of risk-assessment tools and less than quarter currently used ambulatory care strategies. If adequate resources were made available, more than 80% were willing to use risk-assessment tools and 60% more clinicians were likely to use ambulatory care strategies. Most clinicians prescribed dual therapy parenteral antibiotics, even for clinically stable patients (53% haematologists, 56% oncologists). Granulocyte-colony stimulating factor was used frequently as secondary prophylaxis in the breast cancer case (91%), follicular lymphoma case (59%) and non-small cell lung cancer case (31%). Fluoroquinolone prophylaxis was infrequently prescribed (19% oncologists, 30% haematologists). Evidence-practice gaps were identified around the use of risk-assessment-based empiric therapy, and help to inform better clinical guidance. © 2011 The Authors. Internal Medicine Journal © 2011 Royal Australasian College of Physicians.

  20. Aetiology and resistance in bacteraemias among adult and paediatric haematology and cancer patients.

    Science.gov (United States)

    Mikulska, Małgorzata; Viscoli, Claudio; Orasch, Christina; Livermore, David M; Averbuch, Diana; Cordonnier, Catherine; Akova, Murat

    2014-04-01

    A knowledge of current epidemiology and resistance patterns is crucial to the choice of empirical treatment for bacteraemias in haematology and cancer patients. A literature review on bacteraemias in cancer patients considered papers published between January 1st 2005 and July 6th 2011. Additionally, in 2011, a questionnaire on the aetiology and resistance in bacteraemias, and empirical treatment, was sent to participants of the European Conference on Infections in Leukemia (ECIL) meetings; recipients were from 80 haematology centres. For the literature review, data from 49 manuscripts were analysed. The questionnaire obtained responses from 39 centres in 18 countries. Compared with the published data, the questionnaire reported more recent data, and showed a reduction of the Gram-positive to Gram-negative ratio (55%:45% vs. 60%:40%), increased rates of enterococci (8% vs. 5%) and Enterobacteriaceae (30% vs. 24%), a decreased rate of Pseudomonas aeruginosa (5% vs. 10%), and lower resistance rates for all bacteria. Nevertheless the median rates of ESBL-producers (15-24%), aminoglycoside-resistant Gram-negatives (5-14%) and carbapenem-resistant P. aeruginosa (5-14%) were substantial, and significantly higher in South-East vs. North-West Europe. The published epidemiological data on bacteraemias in haematology are scanty and mostly dated. Important differences in aetiology and resistance exist among centres. Updated analyses of the local epidemiology are mandatory to support appropriate empirical therapy. Copyright © 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  1. Case Report: Recurrent Mucoepidermoid Carcinoma of the Tongue in Adult Female Patient With Lung Cancer

    Directory of Open Access Journals (Sweden)

    Arielle Rubin

    2017-07-01

    Full Text Available There is a steady rise in incidence of malignant salivary gland tumors in the United States, with mucoepidermoid carcinoma (MEC the most frequent. Although 40% of MECs are found in the parotid gland, these lesions possess the capacity to develop anywhere along the aerodigestive tract. Here, we present a case of recurrent tongue MEC in a young adult female patient with history of lung malignancy and multiple brain metastases. Without a universally accepted management protocol for recurrent MECs, the current clinical practice uses tumor grade, location, and clinical progression to determine both prognosis and goals of care. The patient had transoral laser excision of the first MEC lesion in 2013. Her tongue MEC recurred 3 years later with 2 distinct lesions. One was discovered on physical examination and computed tomography and the other diagnosed intraoperatively 1 month later. These lesions were located on a previously unaffected portion of dorsal tongue base. These lesions were completely excised in the operating room. The patient currently remains on chemotherapy. This underscores the importance for developing a guideline that delineates the most efficacious surveillance and treatment plans for recurrent MECs.

  2. Applying Social Network Analysis to Identify the Social Support Needs of Adolescent and Young Adult Cancer Patients and Survivors.

    Science.gov (United States)

    Koltai, Kolina; Walsh, Casey; Jones, Barbara; Berkelaar, Brenda L

    2017-11-06

    This article examines how theoretical and clinical applications of social network analysis (SNA) can inform opportunities for innovation and advancement of social support programming for adolescent and young adult (AYA) cancer patients and survivors. SNA can help address potential barriers and challenges to initiating and sustaining AYA peer support by helping to identify the diverse psychosocial needs among individuals in the AYA age range; find strategic ways to support and connect AYAs at different phases of the cancer trajectory with resources and services; and increase awareness of psychosocial resources and referrals from healthcare providers. Network perspectives on homophily, proximity, and evolution provide a foundational basis to explore the utility of SNA in AYA clinical care and research initiatives. The uniqueness of the AYA oncology community can also provide insight into extending and developing current SNA theories. Using SNA in AYA psychosocial cancer research has the potential to create new ideas and pathways for supporting AYAs across the continuum of care, while also extending theories of SNA. SNA may also prove to be a useful tool for examining social support resources for AYAs with various chronic health conditions and other like groups.

  3. Characterizing Time to Diagnostic Resolution After an Abnormal Cancer Screening Exam in Older Adult Participants in the Ohio Patient Navigation Research Program.

    Science.gov (United States)

    DeSalvo, Jennifer M; Young, Gregory S; Krok-Schoen, Jessica L; Paskett, Electra D

    2017-06-01

    This study aims to test the effectiveness of a patient navigation (PN) intervention to reduce time to diagnostic resolution among older adults age ≥65 years versus those <65 years with abnormal breast, cervical, or colorectal cancer screening exams participating in the Ohio Patient Navigation Research Program (OPNRP). The OPNRP utilized a nested cohort group-randomized trial design to randomize 862 participants ( n = 67 for ≥65 years; n = 795 for <65 years) to PN or usual care conditions. A shared frailty Cox model tested the effect of PN on time to resolution. Older adult participants randomized to PN achieved a 6-month resolution rate that was 127% higher than those randomized to usual care ( p = .001). This effect was not significantly different from participants <65 years. PN significantly reduced time to diagnostic resolution among older adults beginning 6 months after an abnormal cancer screening exam. Health care systems should include this population in PN programs to reduce cancer disparities.

  4. Optimized granulocyte colony-stimulating factor prophylaxis in adult cancer patients: from biological principles to clinical guidelines.

    Science.gov (United States)

    Silvestris, Nicola; Del Re, Marzia; Azzariti, Amalia; Maiello, Evaristo; Lombardi, Lucia; Cinieri, Saverio; Guarini, Attilio; Brunetti, Anna Elisabetta; Delcuratolo, Sabina; De Vita, Fernando; Pisconti, Salvatore; Danesi, Romano; Colucci, Giuseppe

    2012-04-01

    Chemotherapy-induced neutropenia, the depth and length of which are correlated to the risk of febrile neutropenia (FN) and neutropenia sepsis, remains a serious problem in medical oncology. Granulocyte colony-stimulating factors (G-CSF) stimulate the proliferation and survival of neutrophils and their precursors, thereby reducing the incidence, duration and severity of neutropenic events across a broad range of malignancies and regimens, often enabling the delivery of full chemotherapy dose intensity. In this review, areas covered include the physiologic role of G-CSF in granulopoiesis, as well as a related biological model of bone marrow kinetics after chemotherapy. Information relating to the application of clinical guidelines for optimization of prophylaxis of FN in adult cancer patients was critically summarized. The literature and pharmacological data were obtained through an electronic search. There are relevant physiological and clinical evidences for the use of G-CSF to prevent FN and to ameliorate the myelotoxicities of cancer chemotherapy. In particular, biological models are in favor of the prophylactic rather than therapeutic use of G-CSF therapy. Use of a single dose of pegfilgrastim per cycle in appropriate patients provides a more convenient and potentially more effective strategy for assisting neutrophil recovery. While biosimilars may cost less, future developments in their regulation will need to address multiple issues. In the interim, physicians should remember that small differences in biochemical and biophysical characteristics might translate into differences in potency and immunogenic potential.

  5. Systematic review of caregiver responses for patient health-related quality of life in adult cancer care.

    Science.gov (United States)

    Roydhouse, Jessica K; Wilson, Ira B

    2017-08-01

    In surveys and in research, proxies such as family members may be used to assess patient health-related quality of life. The aim of this research is to help cancer researchers select a validated health-related quality of life tool if they anticipate using proxy-reported data. Systematic review and methodological appraisal of studies examining the concordance of paired adult cancer patient and proxy responses for multidimensional, validated HRQOL tools. We searched PubMed, CINAHL, PsycINFO and perused bibliographies of reviewed papers. We reviewed concordance assessment methods, results, and associated factors for each validated tool. A total of 32 papers reporting on 29 study populations were included. Most papers were cross-sectional (N = 20) and used disease-specific tools (N = 19), primarily the FACT and EORTC. Patient and proxy mean scores were similar on average for tools and scales, with most mean differences papers (N = 15) evaluated factors associated with concordance, and results and measurement approaches were inconsistent. The EORTC was the most commonly evaluated disease-specific tool (N = 5 papers). For generic tools, both concordance and associated factor information was most commonly available for the COOP/WONCA (N = 3 papers). The MQOL was the most frequently evaluated end-of-life tool (N = 3 papers). Proxy and patient scores are similar on average, but there is large, clinically important residual variability. The evidence base is strongest for the EORTC (disease-specific tools), COOP/WONCA (generic tools), and MQOL (end-of-life-specific tools).

  6. Personality Traits and Health-Related Quality of Life Among Adolescent and Young Adult Cancer Patients: The Role of Psychological Distress

    NARCIS (Netherlands)

    Husson, O.; Zebrack, B.; Block, R.; Embry, L.; Aguilar, C.; Hayes-Lattin, B.; Cole, S.

    2017-01-01

    Personality may affect the way adolescents and young adults (AYAs) with cancer report health-related quality of life (HRQoL). Patients aged 15-39 years (n = 165) completed a survey at 12-16 months postdiagnosis. The survey included questions on HRQoL (SF-36), distress Brief Symptom Inventory-18, and

  7. The Effect of Mindfulness-Based Therapy on Symptoms of Anxiety and Depression in Adult Cancer Patients and Survivors: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Piet, Jacob; Wurtzen, Hanne; Zachariae, Robert

    2012-01-01

    Objective: The use of mindfulness-based therapy (MBT) in oncology settings has become increasingly popular, and research in the field has rapidly expanded. The objective was by means of a systematic review and meta-analysis to evaluate the current evidence for the effect of MBT on symptoms of anxiety and depression in adult cancer patients and…

  8. Methotrexate encephalopathy: Two cases in adult cancer patients, who recovered with pathophysiologically based therapy

    Directory of Open Access Journals (Sweden)

    Shodeinde A Coker

    2017-05-01

    Full Text Available Background/Objectives: Neurotoxicity is a serious and sometimes fatal adverse effect that can occur following methotrexate treatment. We describe two adult patients with hematological malignancies with methotrexate encephalopathy who recovered with dextromethorphan therapy. Results: Case 1: A 24-year-old male with acute lymphoblastic leukemia developed the acute onset of bilateral facial weakness and slurred speech after his first treatment with high-dose intravenous methotrexate. The clinical scenario and a head magnetic resonance imaging supported a diagnosis of methotrexate encephalopathy. Treatment with dextromethorphan was coincident with recovery. Case 2: A 65-year-old female with recurrent diffuse large B-cell lymphoma was treated with high-dose intravenous methotrexate. Two weeks after a cycle, she developed hypoactive delirium, marked lethargy, ocular ataxia, and a right-sided facial weakness. Within 2 days of starting dextromethorphan, there was improvement with clinical recovery. Conclusions: These two cases suggest that N-methyl d-aspartate receptor activation by homocysteine may play an important role in the pathogenesis of methotrexate neurotoxicity.

  9. Implementation of evidence into practice for cancer-related fatigue management of hospitalized adult patients using the PARIHS framework.

    Directory of Open Access Journals (Sweden)

    Li Tian

    Full Text Available This study aimed to explore an evidence-based nursing practice model of CRF management in hospitalized adult patients using the PARIHS evidence-implementation framework as the theoretical structure to provide guidance for similar nursing practices. The implementation of guideline evidence into clinical practice was conducted on the oncology and radiotherapy wards of a university-affiliated hospital. The process of integrating the guideline into the symptom management system of cancer patients was described. The impact of the evidence implementation was evaluated from three aspects: organizational innovations and outcome measures associated with nurses and with patients pre- and post-evidence implementation. During the implementation of evidence into practice on the wards, a nursing process, health education, a quality control sheet and CRF training courses were established. Through this implementation, compliance with evidence related to CRF increased significantly on the two wards, with that of ward B being higher than that of ward A. Regarding nursing outcomes, nursing knowledge, attitude and behavior scores with respect to CRF nursing care increased substantially after its application on the two wards, and the ward B nurses' scoring was higher than that of the ward A nurses. Qualitative analysis concerning the nurses suggested that leadership, patient concern about CRF management, and the need for professional development were the main motivators of the application, whereas the shortage and mobility of nursing human resources and insufficient communication between doctors and nurses were the main barriers. Additionally, most nurses felt more professional and confident about their work. Regarding patient outcomes, patient knowledge, attitude and behavior scores regarding CRF self-management increased significantly. Patients' post-implementation CRF was alleviated compared with the pre-implementation treatment cycle. The PARIHS framework may

  10. Cancer Patient Experience in the Teenage Young Adult Population- Key Issues and Trends Over Time: An Analysis of the United Kingdom National Cancer Patient Experience Surveys 2010-2014.

    Science.gov (United States)

    Furness, Caroline L; Smith, Lesley; Morris, Eva; Brocklehurst, Caroline; Daly, Sasha; Hough, Rachael E

    2017-09-01

    Improving outcomes for teenagers and young adults (TYA) with cancer is a key element of the national cancer strategy in England. Recognition of the unique needs of this group has led to the development of recommendations for specific models of care and delivery of this care through the provision of dedicated clinical units in principal treatment centers (PTCs) across the United Kingdom. The aim of this study was to understand the current cancer patient experience for this patient group. We aimed to determine whether treatment experience is influenced by place of treatment and whether it has changed over time using patient-reported data from national cancer patient experience surveys. This study highlights that a prolonged pathway to diagnosis remains an issue for the TYA group and identifies areas on which quality improvement measures for TYA services should focus, including communication and involvement of the patient in treatment decisions. Positive experiences for the TYA group such as involvement in research were also highlighted. Treatment within a TYA PTC was associated with positive patient perception in a number of key areas highlighting the need for future studies to fully elucidate the impact of the full range of TYA services now available in the United Kingdom on both patient experience and outcome.

  11. Recommended patient-reported core set of symptoms to measure in adult cancer treatment trials

    NARCIS (Netherlands)

    Reeve, B.B.; Mitchell, S.A.; Dueck, A.C.; Basch, E.; Cella, D.; Miller Reilly, C.; Minasian, L.M.; Denicoff, A.M.; O'Mara, A.M.; Fisch, M.J.; Chauhan, C.; Aaronson, N.K.; Coens, C.; Watkins Bruner, D.

    2014-01-01

    Background: The National Cancer Institute’s Symptom Management and Health-Related Quality of Life Steering Committee held a clinical trials planning meeting (September 2011) to identify a core symptom set to be assessed across oncology trials for the purposes of better understanding treatment

  12. Pain management: a review of organisation models with integrated processes for the management of pain in adult cancer patients.

    NARCIS (Netherlands)

    Brink-Huis, A.; Achterberg, T. van; Schoonhoven, L.J.

    2008-01-01

    AIMS AND OBJECTIVES: This paper reports a review of the literature conducted to identify organisation models in cancer pain management that contain integrated care processes and describe their effectiveness. BACKGROUND: Pain is experienced by 30-50% of cancer patients receiving treatment and by

  13. Self-reported physical activity behaviour; exercise motivation and information among Danish adult cancer patients undergoing chemotherapy

    DEFF Research Database (Denmark)

    Midtgaard, Julie; Baadsgaard, Marie Topp; Møller, Tom

    2009-01-01

    . PURPOSE: The current study aimed at investigating self-reported physical activity behaviour, exercise motivation and information in cancer patients undergoing chemotherapy. METHODS AND SAMPLE: Using a cross-sectional design, 451 patients (18-65 years) completed a questionnaire assessing pre......BACKGROUND: Physical activity is considered an important and determining factor for the cancer patient's physical well-being and quality of life. However, cancer treatment may disrupt the practice of physical activity, and the prevention of sedentary lifestyles in cancer survivors is imperative......-illness and present physical activity; motivation and information received. RESULTS: Patients reported a significant decline in physical activity from pre-illness to the time in active treatment (pexercise to be beneficial; and 78% claimed...

  14. In a unique position or squeezed out? The professional roles of general practitioners in cancer care in general and of young adult cancer patients in particular

    DEFF Research Database (Denmark)

    Hølge-Hazelton, B.; Christensen, I.

    2009-01-01

    language, they experience that their patients disappear, they are seldom involved, and they lack knowledge. CONCLUSIONS: GPs have few experiences with YA cancer patients, but they have a potentially unique role in general primary cancer care if they develop their vocational vocabulary, relate more...

  15. Psychological and Physical Interventions for 
the Management of Cancer-Related Pain in Pediatric and Young Adult Patients: An Integrative Review.

    Science.gov (United States)

    Jibb, Lindsay A; Nathan, Paul C; Stevens, Bonnie J; Seto, Emily; Cafazzo, Joseph A; Stephens, Nisha; Yohannes, Liza; Stinson, Jennifer N

    2015-11-01

    To identify and appraise current evidence related to the effectiveness of psychological and physical (nonpharmacologic) pain management modalities for children and young adults with cancer
. Electronic searches in MEDLINE, EMBASE, CINAHL, PsycINFO, and Web of Science (from database inception to June 2013) for clinical trials. A total of 32 unique studies were identified. Substantial heterogeneity existed across identified studies, precluding meta-analysis. Therefore, a narrative review of included studies is presented. Studies featured psychological and/or physical pain interventions for children and young adults (N = 1,171) aged 1-21 years with a variety of cancer diagnoses. Interventions included aromatherapy, art therapy, distraction, hypnosis, physical activity, physical positioning, touch therapy, and multimodal cognitive-behavior therapy. Twenty-two studies (69%) reported success in preventing or reducing pain intensity. The level of evidence and methodologic quality of studies were generally low
. Current nonpharmacologic pain interventions for pediatric and young adult patients with cancer are diverse. Several modalities significantly decreased pain intensity, suggesting that these strategies may be effective methods of pain treatment, particularly in the case of painful medical procedures. Future well-designed, multicenter, randomized, controlled trials are needed to further discern treatment effects on pain and other health outcomes in this population and to compare the relative effectiveness of different modalities. Nurses play a key role in pain assessment and management in pediatric and young adult patients with cancer. The studies included in this review constitute the beginnings of an evidence base that supports the need to implement psychological and physical interventions to improve pain outcomes in pediatric and young adult patients with cancer.

  16. Incidence of primary cancers and intracranial tumour recurrences in GH-treated and untreated adult hypopituitary patients: analyses from the Hypopituitary Control and Complications Study.

    Science.gov (United States)

    Child, Christopher J; Conroy, Daniel; Zimmermann, Alan G; Woodmansee, Whitney W; Erfurth, Eva Marie; Robison, Leslie L

    2015-06-01

    Speculation remains that GH treatment is associated with increased neoplasia risk. Studies in GH-treated childhood cancer survivors suggested higher rates of second neoplasms, while cancer risk data for GH-treated and untreated hypopituitary adults have been variable. We present primary cancer risk data from the Hypopituitary Control and Complications Study (HypoCCS) with a focus on specific cancers, and assessment of recurrence rates for pituitary adenomas (PA) and craniopharyngiomas (CP). Incident neoplasms during HypoCCS were evaluated in 8418 GH-treated vs 1268 untreated patients for primary malignancies, 3668 GH-treated vs 720 untreated patients with PA history, and 956 GH-treated vs 102 untreated patients with CP history. Using population cancer rates, standardised incidence ratios (SIRs) were calculated for all primary cancers, breast, prostate, and colorectal cancers. Neoplasm rates in GH-treated vs untreated patients were analysed after propensity score adjustment of baseline treatment group imbalances. During mean follow-up of 4.8 years, 225 primary cancers were identified in GH-treated patients, with SIR of 0.82 (95% CI 0.71-0.93). SIRs (95% CI) for GH-treated patients were 0.59 (0.36-0.90) for breast, 0.80 (0.57-1.10) for prostate, and 0.62 (0.38-0.96) for colorectal cancers. Cancer risk was not statistically different between GH-treated and untreated patients (relative risk (RR)=1.00 (95% CI 0.70-1.41), P=0.98). Adjusted RR for recurrence was 0.91 (0.68-1.22), P=0.53 for PA and 1.32 (0.53-3.31), P=0.55 for CP. There was no increased risk for all-site cancers: breast, prostate or colorectal primary cancers in GH-treated patients during HypoCCS. GH treatment did not increase the risk of PA and CP recurrences. © 2015 European Society of Endocrinology.

  17. Factors affecting effective communication between registered nurses and adult cancer patients in an inpatient setting: a systematic review.

    Science.gov (United States)

    Tay, Li Hui; Hegney, Desley; Ang, Emily

    2011-06-01

    To establish the best available evidence regarding the factors affecting effective communication between registered nurses and inpatient cancer adults. Electronic databases (CINAHL, Ovid, PubMed, ScienceDirect, Scopus and Wiley InterScience) were searched using a three-step search strategy to identify the relevant quantitative and qualitative studies published in English. The grey literature was not included in the review. The identified studies were evaluated using the guidelines from the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information. A total of three studies were included in the quantitative component of the review, and the data were presented in a narrative summary. Five studies were included in the qualitative component of the review, and the findings were categorised in a meta-synthesis which generated four synthesised findings. The factors that were found to influence effective communication were identified in the characteristics of nurses, patients and the environment. The promoting factors in nurses included genuineness, competency and effective communication skills. The role of post-basic training in improving nurse-patient communication remained inconclusive. Conversely, nurses who were task-orientated, who feared death and who had low self-awareness of their own verbal behaviours inhibited communication. Nurses were also observed to communicate less effectively when delivering psychosocial aspects of care and in emotionally charged situations. On the other hand, patients who participated actively in their own care and exhibited information-seeking behaviour promoted communication with the nurses. However, patients' unwillingness to discuss their disease/feelings, their preference to seek emotional support from their family/friends and their use of implicit cues were some of the factors that were found to inhibit communication. A supportive ward environment increased facilitative behaviour in nurses

  18. Disparities in Stage at Diagnosis, Treatment, and Survival in Nonelderly Adult Patients With Cancer According to Insurance Status

    Science.gov (United States)

    Walker, Gary V.; Grant, Stephen R.; Guadagnolo, B. Ashleigh; Hoffman, Karen E.; Smith, Benjamin D.; Koshy, Matthew; Allen, Pamela K.; Mahmood, Usama

    2014-01-01

    Purpose The purpose of this study was to determine the association of insurance status with disease stage at presentation, treatment, and survival among the top 10 most deadly cancers using the SEER database. Patients and Methods A total of 473,722 patients age 18 to 64 years who were diagnosed with one of the 10 most deadly cancers in the SEER database from 2007 to 2010 were analyzed. A Cox proportional hazards model was used for multivariable analyses to assess the effect of patient and tumor characteristics on cause-specific death. Results Overall, patients with non-Medicaid insurance were less likely to present with distant disease (16.9%) than those with Medicaid coverage (29.1%) or without insurance coverage (34.7%; P poverty level, site, stage, and receipt of cancer-directed surgery and/or radiation therapy, patients were more likely to die as a result of their disease if they had Medicaid coverage (hazard ratio [HR], 1.44; 95% CI, 1.41 to 1.47; P < .001) or no insurance (HR, 1.47; 95% CI, 1.42 to 1.51; P < .001) compared with non-Medicaid insurance. Conclusion Among patients with the 10 most deadly cancers, those with Medicaid coverage or without insurance were more likely to present with advanced disease, were less likely to receive cancer-directed surgery and/or radiation therapy, and experienced worse survival. PMID:25092774

  19. Risk of subsequent cancer among pediatric, adult and elderly patients following a primary diagnosis of glioblastoma multiforme: a population-based study of the SEER database.

    Science.gov (United States)

    Li, Xuezhen; Li, Yanbin; Cao, Yang; Li, Peiliang; Liang, Bo; Sun, Jidian; Feng, Enshan

    2017-11-01

    Purpose/aim of the study: Our objective was to determine the risk of a subsequent malignancy in patients with glioblastoma multiforme (GBM). Data of patients with a primary diagnosis of GBM were extracted from the Surveillance, Epidemiology, and End Results database. Patients were divided into three age groups: pediatric, ≤19 years of age; adult, 20-59 years; elderly, ≥60 years. Outcomes were overall survival and incidence of second cancer. A total of 24 348 patients with primary GBM were identified during the period from 2004 to 2013: 349 pediatric, 9841 adults and 14 518 elderly. There were significant differences in terms of sex, race, registry site, tumor histological type, tumor size and extension among the groups. The median survival time for pediatric, adult and elderly patients was 15, 15 and 5 months, respectively. Of the study population, 1.8% developed a second malignancy and the rates of the three groups were statistically different. Secondary tumors of the cranial nerves and other nervous system were the most common occurrence in the adults and elderly. Female, registry site, giant cell glioblastoma, undergoing surgery or radiation therapy were associated with developing a second malignancy. The risk of a second malignancy in GBM patients is 1.8%, and associated with certain patient and treatment factors.

  20. Effects of nutritional counselling on anthropometric measures in adult patients with cancer undergoing treatment and their perception and satisfaction level: a comprehensive systematic review.

    Science.gov (United States)

    Sean, Lim Chai; Neo Kim, Emily Ang; Moon Fai, Dr Chan

    2011-01-01

    Patients with cancer undergoing treatment often develop malnutrition. Malnutrition can lead to multiple complications. In view of the potential complications, it is important for the patients to maintain good nutritional status. One method to maintain a good nutritional status is to provide frequent nutritional support such as nutritional counselling. The effectiveness of nutritional counselling is commonly indicated by anthropometric measures. Other than anthropometric measures, the value of patients' perception and satisfaction levels towards nutritional counselling are important as well. The objectives of this systematic review were: (1) to examine the effect of nutritional counselling based on anthropometric measures in adult patients with cancer undergoing treatment, and (2) to determine patients' perceptions and satisfaction levels towards nutritional counselling. Types of participants This review considered adult patients with cancer aged 18 years or over. Patients were at various stages of the disease. Patients were undergoing treatment.Types of intervention This review considered all types of nutritional counselling given to patients with cancer.Types of outcomes The outcome of interest were anthropometric measures, patients' subjective perceptions and patients' satisfaction level.Types of studies This review considered studies that examined the effectiveness of nutritional counselling on anthropometric measures in adult patients with cancer undergoing treatment, as well as their perception and satisfaction levels towards nutritional counselling. A comprehensive search strategy was developed using all identified MeSH headings and key words for quantitative and qualitative studies. Both quantitative and qualitative papers selected for review for methodological validity were assessed by two independent reviewers prior to inclusion in the review. The review was then carried out using the standardised critical appraisal instruments. Following the critical

  1. Evaluation of quality of life of adult cancer patients attending Tikur Anbessa specialized referral hospital, Addis Ababa Ethiopia.

    Science.gov (United States)

    Tadele, Niguse

    2015-01-01

    Little is known about the quality of life of cancer patients in the Ethiopian context. This study evaluated quality of life of cancer patients in Ethiopia. A cross-sectional study was conducted in Addis Ababa University Tikur Anbessa Specialized Referral Hospital Addis Ababa, Ethiopia (TASRH) from March to May 2013. A total of 388 cancer patients were included. Translated in to Amharic, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QOL C-30) was used to measure Quality of life (QoL). The data was analyzed with SPSS Version 17.0. Among the participants, 251(64.7%) were men and 138(35.6%) were below the age of 40 years. Large proportion of patients were diagnosed with breast cancer, 114(29.4%), and cervical cancer, 102(26.3%), and the clinical stages during the beginning of therapy were at stage II a 133(34.3%). The mean of global health status/QoL was 57.28 (SD= 25.28). Quality of life was found to be associated with some functional scales as role functioning, P≤0.001, social function, P=0.00, and symptom scales as pain, P=0.00, loss of appetite, P=0.004, and financial impact, P=0.02, but no associations were noted in relation to socio demographic characteristics. Quality of life assessments should be included in patient treatment protocols to improve their quality of life since being a cancer patient may be associated with a high level of impairment in different aspects of life.

  2. Hospitalizations in Pediatric and Adult Patients for All Cancer Type in Italy: The EPIKIT Study under the E.U. COHEIRS Project on Environment and Health

    Directory of Open Access Journals (Sweden)

    Prisco Piscitelli

    2017-05-01

    Full Text Available Background: Cancer Registries (CRs remain the gold standard for providing official epidemiological estimations. However, due to CRs’ partial population coverage, hospitalization records might represent a valuable tool to provide additional information on cancer occurrence and expenditures at national/regional level for research purposes. The Epidemiology of Cancer in Italy (EPIKIT study group has been built up, within the framework of the Civic Observers for Health and Environment: Initiative of Responsibility and Sustainability (COHEIRS project under the auspices of the Europe for Citizens Program, to assess population health indicators. Objective: To assess the burden of all cancers in Italian children and adults. Methods: We analyzed National Hospitalization Records from 2001 to 2011. Based on social security numbers (anonymously treated, we have excluded from our analyses all re-hospitalizations of the same patients (n = 1,878,109 over the entire 11-year period in order to minimize the overlap between prevalent and incident cancer cases. To be more conservative, only data concerning the last five years (2007–2011 have been taken into account for final analyses. The absolute number of hospitalizations and standardized hospitalization rates (SHR were computed for each Italian province by sex and age-groups (0–19 and 20–49. Results: The EPIKIT database included a total of 4,113,169 first hospital admissions due to main diagnoses of all tumors. The annual average number of hospital admissions due to cancer in Italy has been computed in 2362 and 43,141 hospitalizations in pediatric patients (0–19 years old and adults (20–49 years old, respectively. Women accounted for the majority of cancer cases in adults aged 20–49. As expected, the big city of Rome presented the highest average annual number of pediatric cancers (n = 392, SHR = 9.9, followed by Naples (n = 378; SHR = 9.9 and Milan (n = 212; SHR = 7.3. However, when we look at SHR

  3. Hospitalizations in Pediatric and Adult Patients for All Cancer Type in Italy: The EPIKIT Study under the E.U. COHEIRS Project on Environment and Health.

    Science.gov (United States)

    Piscitelli, Prisco; Marino, Immacolata; Falco, Andrea; Rivezzi, Matteo; Romano, Roberto; Mazzella, Restituta; Neglia, Cosimo; Della Rosa, Giulia; Pellerano, Giuseppe; Militerno, Giuseppe; Bonifacino, Adriana; Rivezzi, Gaetano; Romizi, Roberto; Miserotti, Giuseppe; Montella, Maurizio; Bianchi, Fabrizio; Marinelli, Alessandra; De Donno, Antonella; De Filippis, Giovanni; Serravezza, Giuseppe; Di Tanna, Gianluca; Black, Dennis; Gennaro, Valerio; Ascolese, Mario; Distante, Alessandro; Burgio, Ernesto; Crespi, Massimo; Colao, Annamaria

    2017-05-09

    Background: Cancer Registries (CRs) remain the gold standard for providing official epidemiological estimations. However, due to CRs' partial population coverage, hospitalization records might represent a valuable tool to provide additional information on cancer occurrence and expenditures at national/regional level for research purposes. The Epidemiology of Cancer in Italy (EPIKIT) study group has been built up, within the framework of the Civic Observers for Health and Environment: Initiative of Responsibility and Sustainability (COHEIRS) project under the auspices of the Europe for Citizens Program, to assess population health indicators. Objective: To assess the burden of all cancers in Italian children and adults. Methods: We analyzed National Hospitalization Records from 2001 to 2011. Based on social security numbers (anonymously treated), we have excluded from our analyses all re-hospitalizations of the same patients (n = 1,878,109) over the entire 11-year period in order to minimize the overlap between prevalent and incident cancer cases. To be more conservative, only data concerning the last five years (2007-2011) have been taken into account for final analyses. The absolute number of hospitalizations and standardized hospitalization rates (SHR) were computed for each Italian province by sex and age-groups (0-19 and 20-49). Results: The EPIKIT database included a total of 4,113,169 first hospital admissions due to main diagnoses of all tumors. The annual average number of hospital admissions due to cancer in Italy has been computed in 2362 and 43,141 hospitalizations in pediatric patients (0-19 years old) and adults (20-49 years old), respectively. Women accounted for the majority of cancer cases in adults aged 20-49. As expected, the big city of Rome presented the highest average annual number of pediatric cancers (n = 392, SHR = 9.9), followed by Naples (n = 378; SHR = 9.9) and Milan (n = 212; SHR = 7.3). However, when we look at SHR, minor cities (i

  4. Risk of thyroid cancer, brain cancer, and non-Hodgkin lymphoma after adult leukemia

    DEFF Research Database (Denmark)

    Nielsen, Sune F; Bojesen, Stig E; Birgens, Henrik S

    2011-01-01

    are at increased risk of developing thyroid cancer, brain cancer, and NHL. We included the entire adult Danish population (14 years of age or older), in a 28-year follow-up period from 1980 through 2007, composed of 6 542 639 persons; during this period, 18 834 developed adult leukemia, 4561 developed thyroid......Patients with childhood leukemia surviving into adulthood have elevated risk of developing thyroid cancer, brain cancer, and non-Hodgkin lymphoma (NHL); these risks cannot automatically be extrapolated to patients surviving adult leukemia. We tested whether survivors of adult leukemia...... cancer, 13 362 developed brain cancer, and 15 967 developed NHL. In nested studies using Cox regression models on individual participant data, we found that, after adult leukemia, the multivariate adjusted hazard ratios were 4.9 (95% confidence interval [CI], 2.8-8.5) for thyroid cancer, 1.9 (95% CI, 1...

  5. Risk of thyroid cancer, brain cancer, and non-Hodgkin lymphoma after adult leukemia

    DEFF Research Database (Denmark)

    Nielsen, Sune F; Bojesen, Stig E; Birgens, Henrik S

    2011-01-01

    Patients with childhood leukemia surviving into adulthood have elevated risk of developing thyroid cancer, brain cancer, and non-Hodgkin lymphoma (NHL); these risks cannot automatically be extrapolated to patients surviving adult leukemia. We tested whether survivors of adult leukemia...... are at increased risk of developing thyroid cancer, brain cancer, and NHL. We included the entire adult Danish population (14 years of age or older), in a 28-year follow-up period from 1980 through 2007, composed of 6 542 639 persons; during this period, 18 834 developed adult leukemia, 4561 developed thyroid...... cancer, 13 362 developed brain cancer, and 15 967 developed NHL. In nested studies using Cox regression models on individual participant data, we found that, after adult leukemia, the multivariate adjusted hazard ratios were 4.9 (95% confidence interval [CI], 2.8-8.5) for thyroid cancer, 1.9 (95% CI, 1...

  6. Strengths and resources used by Australian and Danish adult patients and their family caregivers during treatment for cancer

    DEFF Research Database (Denmark)

    Coyne, Elisabeth; Dieperink, K. B.; Østergaard, Birte

    2017-01-01

    Crisis Orientated Personal Evaluation Scales (F-COPES), together with demographic and health information. Results The family's appraisal of the cancer and ways the family worked together predicted the level of external resources used to manage their circumstances. Conclusion After a cancer diagnosis......Purpose Family plays an essential role in supporting the patient with cancer, however, relatively little attention has been given to understanding the strengths and resources of the family unit across different settings and countries. This study aims to investigate the strengths and resources...... of patients and family members in Australia and Denmark. Methods Using a descriptive, cross-sectional design, 232 patient and family participants from inpatient and outpatient oncology services in Australia and Denmark completed paper based surveys that included the Family Hardiness Index (FHI) and Family...

  7. The prevalence and predictors of subsyndromal anxiety and depression in adult Asian cancer patients across the first year of diagnosis.

    Science.gov (United States)

    Mahendran, Rathi; Lim, Haikel A; Tan, Joyce Ys; Kua, Ee Heok; Griva, Konstadina

    2016-12-01

    There is an increased prevalence of anxiety and depression in Asian patients diagnosed with cancers; these are known to interfere with treatment, treatment adherence and mortality. This study sought to investigate the prevalence and predictors of subsyndromal anxiety and depression in first-year Asian cancer patients. A total of 206 patients newly diagnosed with cancer in Singapore completed the Hospital Anxiety and Depression Scale (HADS) at T1 (baseline; on average 2 months post-diagnosis), T2 (3 months post-baseline) and T3 (6 months post-baseline). Subsyndromal anxiety and depression were identified using locally validated cut-offs (HADS-A ≥5 and HADS-D ≥7). Adjusted odds ratios were calculated using baseline predictors. Across the three time points, 68-69% of participants were identified as having subsyndromal anxiety and close to 27-38% participants were identified as having subsyndromal depression. Multivariate logistic regressions revealed a lack of predictors for T1 subsyndromal anxiety and depression. Participants with late/metastatic stages of cancer were almost four times as likely to suffer from subsyndromal anxiety at T2. Single participants had a 75% lowered odds, but those living in three to four room public housing were close to four times as likely to suffer from subsyndromal depression at T2. Older patients and those who had undergone surgery were found to significantly suffer from subsyndromal depression at T3. The significant levels of depression and anxiety coupled with the lack of consistent predictors across the first year following cancer diagnosis further underscore the importance of careful assessment and clinician-vigilance in recognizing and identifying Asian patients who may express these emotional sequelae following the cancer diagnosis. A better understanding of patients' pathophysiological and psychological responses and individual strengths and coping skills are thus essential. © 2016 John Wiley & Sons Australia, Ltd.

  8. Pegfilgrastim in pediatric cancer patients

    NARCIS (Netherlands)

    Poele , te Esther; Kamps, WA; Tamminga, RYJ; Leew, JA; Postma, A; de Bont, ESJM

    2005-01-01

    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

  9. How childhood cancers are different from adult cancers

    Science.gov (United States)

    ... growth in the womb increase the risk of leukemia. However, not all children with the mutation get cancer. Children born with Down syndrome are also more likely to get leukemia. Unlike adult cancers, childhood cancers do not occur ...

  10. Symptom burden among young adults with breast or colorectal cancer.

    Science.gov (United States)

    Sanford, Stacy D; Zhao, Fengmin; Salsman, John M; Chang, Victor T; Wagner, Lynne I; Fisch, Michael J

    2014-08-01

    Cancer incidence has increased among young adults (YAs) and survival rates have not improved compared with other age groups. Patient-reported outcomes may enhance our understanding of this vulnerable population. In a multisite prospective study, patients completed a cancer symptom inventory at the time of enrollment (T1) and 4 weeks to 5 weeks later (T2). YAs (those aged ≤ 39 years) with breast or colorectal cancer were compared with older adults (those aged ≥ 40 years) with breast or colorectal cancer with regard to symptom severity, symptom interference, changes over time, and medical care. Participants included 1544 patients with breast cancer (96 of whom were YAs) and 718 patients with colorectal cancer (37 of whom were YAs). Compared with older adults, YAs with breast cancer were more likely to report moderate/severe drowsiness, hair loss, and symptom interference with relationships at T1. YAs with colorectal cancer were more likely to report moderate/severe pain, fatigue, nausea, distress, drowsiness, shortness of breath, and rash plus interference in general activity, mood, work, relationships, and life enjoyment compared with older adults. Compared with older adults, shortness of breath, appetite, and sore mouth were more likely to improve in YAs with breast cancer; vomiting was less likely to improve in YAs with colorectal cancer. Referrals for supportive care were few, especially among patients with colorectal cancer. YAs with breast cancer were somewhat more likely to be referred to nutrition and psychiatry services than older patients. YAs reported symptom severity, symptom interference, and variations over time that were distinct from older patients. Distinctions were found to differ by diagnostic group. These findings enhance the understanding of symptom burden in YAs and inform the development of targeted interventions and future research. © 2014 American Cancer Society.

  11. Rotationplasty in adult cancer patients: what is the rehab strategy and what results can be expected? A case study.

    Science.gov (United States)

    Morri, Mattia; Forni, Cristiana

    2017-10-01

    Rotationplasty is an important and demanding challenge for physiotherapists. The aim of this paper is to describe the functional outcome achieved by a patient undergoing rotationplasty in adult age following osteosarcoma. Case description and Methods: The patient was followed throughout the rehabilitation course and the results achieved were recorded at 6, 9 and 12 months after surgery. Findings and outcomes: The results progressively improved in terms of function, functional performance and quality of life. The MSTS and TESS scales showed an improvement respectively of 20 and 23 percentage points, reaching levels of 80% and 87%. The quality of life perceived by the patient increased in the three assessments, the mental health score at one-year follow-up is higher than that expected for the population. Rotationplasty, even in adult age, produces good results and in the treatment of tumours in adults this operation should be taken into consideration. Clinical relevance Rotationplasty in adult age following osteosarcoma combined with a rehabilitation program enabled a patient to reach a successful outcome in terms of functional performance and quality of life.

  12. Strengths and resources used by Australian and Danish adult patients and their family caregivers during treatment for cancer.

    Science.gov (United States)

    Coyne, E; Dieperink, K B; Østergaard, B; Creedy, D K

    2017-08-01

    Family plays an essential role in supporting the patient with cancer, however, relatively little attention has been given to understanding the strengths and resources of the family unit across different settings and countries. This study aims to investigate the strengths and resources of patients and family members in Australia and Denmark. Using a descriptive, cross-sectional design, 232 patient and family participants from inpatient and outpatient oncology services in Australia and Denmark completed paper based surveys that included the Family Hardiness Index (FHI) and Family Crisis Orientated Personal Evaluation Scales (F-COPES), together with demographic and health information. The family's appraisal of the cancer and ways the family worked together predicted the level of external resources used to manage their circumstances. After a cancer diagnosis patients and family respond in different ways related to their family functioning. There is a need for nurses to work closely with the family to understand their strengths and resources, and tailor support and information for family to promote optimal patient outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Tailoring the delivery of cancer diagnosis to adolescent and young adult patients displaying strong emotions: An observational study of two cases

    Directory of Open Access Journals (Sweden)

    Live Korsvold

    2016-04-01

    Full Text Available Delivering the bad news of a cancer diagnosis to adolescent and young adult (AYA patients who display strong emotions is particularly challenging not the least because AYAs are at a vulnerable developmental stage. Due to the lack of research on how to personalize the delivery of bad news to AYA patients’ emotions we report a case study of the communicative behavior of oncologists in two such consultations to describe the complexity of the phenomena at study. We audio-recorded and transcribed consultations where oncologists delivered cancer diagnoses to nine AYAs aged 12–25 years. Two of these patients displayed particularly strong emotional behavior (anger, fear, and sadness and were chosen as cases. An interpretative analysis in three steps was applied to investigate the oncologists’ communicative behavior when delivering bad news. The focus was on how the oncologists responded to the strong but different emotional behaviors of the AYAs. We also related the oncologists’ communicative behavior to elements from a widely used protocol for delivering bad news. We found that the oncologists applied five communication strategies: elicit patient perspective, provide information, respond to patient's expression of emotion (acknowledging and containing emotions, encourage commitment to treatment, and provide hope. The findings illustrate how oncologists’ communicative behavior may be tailored to individual expressions of emotions in AYA cancer patients.

  14. Pain management: a review of organisation models with integrated processes for the management of pain in adult cancer patients.

    Science.gov (United States)

    Brink-Huis, Anita; van Achterberg, Theo; Schoonhoven, Lisette

    2008-08-01

    This paper reports a review of the literature conducted to identify organisation models in cancer pain management that contain integrated care processes and describe their effectiveness. Pain is experienced by 30-50% of cancer patients receiving treatment and by 70-90% of those with advanced disease. Efforts to improve pain management have been made through the development and dissemination of clinical guidelines. Early improvements in pain management were focussed on just one or two single processes such as pain assessment and patient education. Little is known about organisational models with multiple integrated processes throughout the course of the disease trajectory and concerning all stages of the care process. Systematic review. The review involved a systematic search of the literature, published between 1986-2006. Subject-specific keywords used to describe patients, disease, pain management interventions and integrated care processes, relevant for this review were selected using the thesaurus of the databases. Institutional models, clinical pathways and consultation services are three alternative models for the integration of care processes in cancer pain management. A clinical pathway is a comprehensive institutionalisation model, whereas a pain consultation service is a 'stand-alone' model that can be integrated in a clinical pathway. Positive patient and process outcomes have been described for all three models, although the level of evidence is generally low. Evaluation of the quality of pain management must involve standardised measurements of both patient and process outcomes. We recommend the development of policies for referrals to a pain consultation service. These policies can be integrated within a clinical pathway. To evaluate the effectiveness of pain management models standardised outcome measures are needed.

  15. Assessing the Quality, Feasibility, and Efficacy of Electronic Patient Platforms Designed to Support Adolescents and Young Adults With Cancer: A Systematic Review Protocol.

    Science.gov (United States)

    Pugh, Gemma; McCann, Lisa

    2017-01-17

    A range of innovative websites, mobile technologies, eHealth and mHealth platforms have emerged to support adolescents and young adults (AYAs) with cancer. Previous reviews have identified these various applications and solutions, but no review has summarized the quality, feasibility, and efficacy of existing patient platforms (inclusive of websites, mobile technologies, mHealth and eHealth platforms) developed specifically for young people with cancer. This paper describes the design of a protocol to conduct a review of published studies or reports which describe or report on an existing platform designed specifically for AYAs who have had a cancer diagnosis. A search string was developed using a variety of key words and Medical Subject Heading and applied to bibliographic databases. General data (sample characteristics, patient platform development, design and, if applicable, pilot testing outcomes) will be extracted from reports and studies. Drawing on a previously developed coding schematic, the identified patient platforms will be coded for mode of delivery into (1) automated functions, (2) communicative functions, and (3) use of supplementary modes. An adapted version of the Mobile App Rating Scale (MARS) will be used to assess the of quality of each identified patient platform. The methodological quality of included studies will be assessed using the Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields (QualSyst). Both authors will independently screen eligible studies for final inclusion and will both be responsible for data extraction and appraisal. Data will be synthesized narratively to provide an overview of identified patient platforms. The review began in October 2016 and is currently in progress. The review paper will be submitted for peer-review and publication in the summer of 2017. This review will be unique in its focus on assessing, where possible, the quality and efficacy of patient platforms for

  16. Life situation and psychosocial care of adolescent and young adult (AYA) cancer patients - study protocol of a 12-month prospective longitudinal study.

    Science.gov (United States)

    Leuteritz, Katja; Friedrich, Michael; Nowe, Erik; Sender, Annekathrin; Stöbel-Richter, Yve; Geue, Kristina

    2017-01-28

    In recent years, there has been an increased research focus on adolescent and young adult (AYA) cancer patients. Few longitudinal studies have taken into consideration the specifics of their life situation and the status of psychosocial care services for this population. Our ongoing study aims to determine the psychosocial life and supportive care situation of AYA cancer patients, to describe risk groups, and to develop recommendations for their psycho-oncological care and support. The AYA-Leipzig study (AYA-LE) is a German prospective, longitudinal, study examining AYAs´ life situation (e.g. psychological distress, quality of life) and psychosocial care (e.g. evaluation and preferences, support needs) using two measurement points, namely, upon acute treatment completion (baseline) and 12 months later. N = 577 AYA cancer patients aged between 18 and 39 years at diagnosis, and representing all major tumor entities fill out a standardized questionnaire (online or by post), mainly based on validated instruments. AYA-specific concerns (e.g. family planning, sexual and reproductive health, social support, health behavior) will explicitly be considered. Participants are recruited in 16 German acute care hospitals, four rehabilitation clinics, and from two German state tumor registries. In summary, our longitudinal study will create a large database encompassing all malignant tumor entities and including detailed information about the distress and quality of life, specific problems, and specific support needs of AYA cancer patients at two different points in time post-diagnosis. The information we gather about existing psychosocial care and patient preferences and desires concerning psycho-oncological care will be used to develop recommendations for psycho-oncological care providers.

  17. Screening for psychological distress in adult primary brain tumor patients and caregivers: considerations for cancer care coordination

    Directory of Open Access Journals (Sweden)

    Wafa eTrad

    2015-09-01

    Full Text Available IntroductionThis study aimed to assess psychological distress (PD as scored by the Distress Thermometer (DT in adult primary brain tumor (PBT patients and caregivers in a clinic setting, and ascertain if any high risk sub-groups for PD exist. Material and MethodsFrom May 2012 to August 2013, n=96 patients and n=32 caregivers (CG underwent DT screening at diagnosis, and a differing cohort of n=12 patients and n=14 caregivers at first recurrence. Groups were described by diagnosis (high grade, low grade and benign, and English versus non-English speaking. Those with DT score≥4 met caseness criteria for referral to psycho-oncology services. One-way ANOVA tests were conducted to test for between group differences where appropriate.ResultsAt diagnosis and first recurrence, 37.5% and 75.0% (respectively of patients had DT scores above the cut-off for distress. At diagnosis, 78.1% of caregivers met caseness criteria for distress. All caregivers at recurrence met distress criterion. Patients with high grade glioma had significantly higher scores than those with a benign tumor. For patients at diagnosis, non-English speaking participants did not report significantly higher DT scores than English speaking participants.DiscussionPsychological distress is particularly elevated in caregivers, and in patients with high grade glioma at diagnosis. Effective PD screening, triage and referral by skilled care coordinators is vital to enable timely needs assessment, psychological support and effective intervention.

  18. Physician, patient, and contextual factors affecting treatment decisions in older adults with cancer and models of decision making: a literature review.

    Science.gov (United States)

    Tariman, Joseph D; Berry, Donna L; Cochrane, Barbara; Doorenbos, Ardith; Schepp, Karen G

    2012-01-01

    To review physician, patient, and contextual factors that affect treatment decision making in older adults diagnosed with cancer, and to relate those factors to theoretical models of decision making. PubMed (1966 to April 2010), PsycINFO (1967 to April 2010) and CINAHL® (1982 to April 2010) databases were searched to access relevant medical, psychological, and nursing literature. Physician factors in treatment decisions included physician's personal beliefs and values, medical expertise, practice type, perception of lowered life expectancy, medical factors, power, and communication style. Patient factors included personal beliefs and values, ethnicity, decisional control preferences, previous health-related experience, perception of the decision-making process, and personal factors. Contextual factors included availability of caregiver, insurance, financial status, and geographical barrier. A diverse group of factors were identified, which are likely to form a unique framework to understand clinical decision making and plan future investigations in older adult patient populations. Using longitudinal and prospective designs to examine the real-time interplay of patient, physician, and contextual factors will enable a better understanding of how those divergent factors influence actual treatment decisions. Oncology nurses can advocate autonomous (patient-driven), shared, or family-controlled treatment decisions, depending on an older patient's decisional role preference. Nurses can support patient autonomy during treatment decision making by coaching patients to engage in discussion of various evidence-based treatment options and a comprehensive discussion of the probability of success for each option with specialist providers. Oncology nurses may be able to promote treatment decisions that are consistent with a patient's personal preferences and values, with strong consideration of the patient's personal contexts.

  19. Depression in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Beyhan Bag

    2014-06-01

    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

  20. Developing a clinical pathway for the identification and management of anxiety and depression in adult cancer patients: an online Delphi consensus process.

    Science.gov (United States)

    Shaw, Joanne M; Price, Melanie A; Clayton, Josephine M; Grimison, Peter; Shaw, Tim; Rankin, Nicole; Butow, Phyllis N

    2016-01-01

    People with cancer and their families experience high levels of psychological morbidity. However, many cancer services do not routinely screen patients for anxiety and depression, and there are no standardized clinical referral pathways. This study aimed to establish consensus on elements of a draft clinical pathway tailored to the Australian context. A two-round Delphi study was conducted to gain consensus among Australian oncology and psycho-oncology clinicians about the validity of 39 items that form the basis of a clinical pathway that includes screening, assessment, referral and stepped care management of anxiety and depression in the context of cancer. The expert panel comprised 87 multidisciplinary clinician members of the Australian Psycho-oncology Co-operative Research Group (PoCoG). Respondents rated their level of agreement with each statement on a 5-point Likert scale. Consensus was defined as >80% of respondents scoring within 2 points on the Likert scale. Consensus was reached for 21 of 39 items, and a further 15 items approached consensus except for specific contextual factors, after two Delphi rounds. Formal screening for anxiety and depression, a stepped care model of management and recommendations for inclusion of length of treatment and time to review were endorsed. Consensus was not reached on items related to roles and responsibilities, particularly those not applicable across cancer settings. This study identified a core set of evidence- and consensus-based principles considered essential to a stepped care model of care incorporating identification, referral and management of anxiety and depression in adult cancer patients.

  1. Sexuality in cancer patients.

    Science.gov (United States)

    Walbroehl, G S

    1985-01-01

    The sexual concerns of patients with cancer may be overlooked during the acute stage of illness. Both the general stress of hospitalization and the specific threat of surgery can affect sexuality. Breast cancer and cancer of the reproductive organs cause the most concern, although other tumors can be as devastating. "Ostomies" and limb amputations raise special questions, and radiation therapy affects sexual and reproductive function. Underlying depression has a profound effect.

  2. Community-acquired bacterial meningitis in adults with cancer or a history of cancer.

    Science.gov (United States)

    Costerus, Joost M; Brouwer, Matthijs C; van der Ende, Arie; van de Beek, Diederik

    2016-03-01

    To study the incidence, clinical presentation, causative bacteria, and outcome of community-acquired bacterial meningitis in adults with cancer. We evaluated incidence and characteristics of patients with cancer included in a nationwide prospective cohort study of adults with community-acquired meningitis performed in the Netherlands from March 1, 2006, to September 31, 2014. All patients underwent a neurologic examination at hospital discharge, and outcome was graded using the Glasgow Outcome Scale. Active cancer was identified in 68 of 1,351 episodes (5%) and a history of cancer in 87 (6%). The annual incidence of community-acquired bacterial meningitis was 2.71-fold (95% confidence interval [CI] 1.68-4.36, p bacterial meningitis in patients with cancer compared to patients without cancer was similar. Patients with active cancer presented with lower leukocyte count in blood (12.1 × 10(9) cells/L vs 17.3 × 10(9) cells/L, p bacterial meningitis (odds ratio 1.85, 95% CI 1.09-3.13). One of 8 patients with community-bacterial meningitis was identified to have a history of cancer and cancer was considered active in half of these patients. Patients with active cancer present with lower CSF leukocyte counts, are more likely to be infected with L monocytogenes, and are at high risk of unfavorable outcome. © 2016 American Academy of Neurology.

  3. Lung Cancer in the Older Patient.

    Science.gov (United States)

    Barta, Julie A; Zinner, Ralph G; Unger, Michael

    2017-11-01

    Cancers of the lung and bronchus are the leading cause of cancer deaths in men and women in the United States, and two-thirds of new lung cancer cases are diagnosed in patients over age 65. There are few dedicated clinical trials in the elderly, leading to both undertreatment and overtreatment biases. Even fit older adults experience age-related decline in physiologic reserve, and additional issues of polypharmacy, geriatric syndromes, and inadequate social support are not uncommon, leading to disparities in treatment and survival. This review discusses the challenges in balancing benefits and harms in management of lung cancer in elderly patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Effectiveness of psycho-educational interventions with telecommunication technologies on emotional distress and quality of life of adult cancer patients: a systematic review.

    Science.gov (United States)

    Bártolo, Ana; Pacheco, Emelda; Rodrigues, Fabiana; Pereira, Anabela; Monteiro, Sara; Santos, Isabel M

    2017-12-07

    To provide a comprehensive review of psycho-educational interventions using telecommunication technologies developed for adult cancer patients, assessing their effectiveness in reducing emotional distress and improving quality of life (QoL). A narrative approach was used for extraction and synthesis of the data. Relevant studies were identified through the electronic databases PubMed, Scopus, Web of Science, ProQuest, Psychology & Behavioral Sciences Collection (through EBSCOhost), and CENTRAL. Eight studies involving 1016 participants met inclusion criteria. The majority of the studies included (n = 6) used a randomized design and were published between 2007 and 2016. Interventions used a variety of delivery resources, such as telephone, e-mail and websites, but all were aiming to respond to information needs and develop stress control skills. A trend toward reducing distress and improving QoL was found, but estimated effect sizes were typically small (d < 0.5). Telephonically delivered psycho-educational interventions presented the highest between-group effects on these outcomes during survival, but were limited by sample size. The efficacy of interventions using distance approaches in the cancer setting is still not well-established. Further research should be conducted through well-designed studies with more interactive features that minimize the lack of face-to-face interaction. Implications for rehabilitation Rehabilitation professionals working in the field of oncology should invest in the development of psycho-educational interventions responding the patients' educational needs and promoting their stress control skills. Programs using telecommunications technologies may reduce disparities in service delivery within this setting, minimizing geographic and socio-economic barriers to engagement in the interventions. With the current technological development, it is possible to perform more interactive interventions that stimulate therapist-patient

  5. A randomised controlled trial to evaluate the clinical and cost-effectiveness of Hickman line insertions in adult cancer patients by nurses.

    Science.gov (United States)

    Boland, A; Haycox, A; Bagust, A; Fitzsimmons, L

    2003-01-01

    To examine the clinical and cost-effectiveness of image-guided Hickman line insertions versus blind Hickman line insertions undertaken by nurses in adult cancer patients. A cost-effectiveness analysis was carried out alongside a randomised controlled trial. A large acute cancer centre in Manchester, UK. Cancer patients due to have a Hickman line insertion who were over 18 years of age and were clinically and physically compliant with specified protocols. In order to obtain central venous access for the patient, two interventions were investigated: (i) blind insertion of a Hickman line and (ii) image-guided insertion of a Hickman line. Both interventions involved blind venipuncture of the subclavian vein. In the blind arm, the Hickman line was routinely inserted without the use of image guidance at any point in the procedure. Transfer to the interventional X-ray suite and use of image guidance were options immediately available to the operator during the procedure if required. In the image-guided arm, the position of the guidewire was checked before the Hickman line was introduced and later the Hickman line was positioned with the use of X-ray fluoroscopy. The primary clinical outcome measure was catheter-tip misplacement and this was expected to be higher in the blind arm. When comparing the skill level of the trainer and the trainees, pneumothorax was the primary clinical outcome measure. Other outcomes measures included arterial puncture, haematoma, infection, failed insertion and assistance from other healthcare professionals. No statistically significant difference was found between the mean cost per patient in the two arms of the trial. The only statistically significant difference in clinical outcomes was the frequency of catheter-tip misplacement, which was higher in the blind arm of the trial. At very low costs, the image-guided approach dominates the blind approach as fewer costs and greater benefits are incurred. It is evident that nurses previously

  6. Preventing Infections in Cancer Patients

    Science.gov (United States)

    ... Cancel Submit Search The CDC Preventing Infections in Cancer Patients Note: Javascript is disabled or is not supported ... this page: About CDC.gov . Preventing Infections in Cancer Patients Patients and Caregivers Prepare: Watch Out for Fever ...

  7. Treatment Option Overview (Adult Primary Liver Cancer)

    Science.gov (United States)

    ... Types Bladder Cancer Breast Cancer Colorectal Cancer Kidney (Renal Cell) Cancer Leukemia Liver Cancer Lung Cancer Lymphoma Pancreatic Cancer Prostate Cancer Skin Cancer Thyroid Cancer Uterine Cancer All ...

  8. Treatment Options for Adult Primary Liver Cancer

    Science.gov (United States)

    ... Types Bladder Cancer Breast Cancer Colorectal Cancer Kidney (Renal Cell) Cancer Leukemia Liver Cancer Lung Cancer Lymphoma Pancreatic Cancer Prostate Cancer Skin Cancer Thyroid Cancer Uterine Cancer All ...

  9. Integrative Review: Effects of Music on Cancer Pain in Adults.

    Science.gov (United States)

    Keenan, AnnMarie; Keithley, Joyce K

    2015-11-01

    To evaluate the literature for music's effect on adult cancer pain.
. An electronic literature search from 1986-2014 was conducted to evaluate the effects of quantitative music among adults with cancer pain in settings including homes, hospitals, and palliative care units. Databases used were PubMed (MEDLINE) and Scopus.
 The study designs, methods, measures, outcomes, and limitations were evaluated independently by the primary author and verified by the second author. The primary outcome measure of interest was the effect of music in cancer pain. Of 82 studies, 5 of them--totaling 248 participants--met eligibility criteria. Review of findings suggests a paucity of innovative approaches for using music to mitigate cancer pain among adults. Psychological outcomes, anxiety, depression, and mood were understudied. Advanced pain, multiple cancer types, and lack of racial diversity characterize the samples.
 Modern treatments for cancer have improved survival rates; however, patients often experience tumor- and treatment-related pain. Pharmacologic and nonpharmacologic methods may minimize cancer pain. The use of music as an adjunct to pain medication requires additional studies, particularly on mechanisms of its effect on pain among diverse, large samples with multiple cancer pain types. A limitation of this review is the small number of available studies to date. The evidence for music therapy in the management of pain is limited. Integrative methods using music may represent an important intervention that nurses may be able to suggest as an inexpensive, nontoxic, and readily available intervention for potentially minimizing cancer pain.

  10. [Physiotherapy of cancer patients].

    Science.gov (United States)

    Gomez, Izabella; Szekanecz, Éva; Szekanecz, Zoltán; Bender, Tamás

    2016-07-01

    Physiotherapy of cancer patients is one of the most controversial issues in our country. Malignant diseases are firstly mentioned as a contraindication of physiotherapy. Until now, physiotherapy was not suggested (or only in limited accessibility) for those patients who had malignant disease in medical history. International medical practice was less restrictive in managing this topic. The development of imaging techniques put this question in a new light. On the basis of evidence, the majority of articles have reported beneficial effects of physiotherapy in cancer patients, and only few articles mentioned it as harmful. Of course, each patient requires an individual assessment, however, if we exclude the possibility of tumor recurrence and metastasis, most of physiotherapy procedures can be used safely. One of the aims of this review is to support the physicians' decisions when to prescribe treatments, in such a way, that more patients could receive physiotherapy. Orv. Hetil., 2016, 157(31), 1224-1231.

  11. Music in Reducing Anxiety and Pain in Adult Patients Undergoing Bone Marrow Biopsy for Hematologic Cancers or Other Diseases

    Science.gov (United States)

    2017-05-25

    Chronic Myeloproliferative Disorders; Leukemia; Lymphoma; Lymphoproliferative Disorder; Multiple Myeloma and Plasma Cell Neoplasm; Myelodysplastic Syndromes; Myelodysplastic/Myeloproliferative Neoplasms; Pain; Precancerous Condition; Psychosocial Effects of Cancer and Its Treatment

  12. Emotional intelligence and locus of control of adult patients with ...

    African Journals Online (AJOL)

    Background: This article investigates emotional intelligence and locus of control in an adult breast cancer population receiving treatment. Gaining insight into these constructs will contribute to improving breast cancer patients' psychological well-being and to reducing physical vulnerability to disease before and during ...

  13. Prevalence of Cancer in Adults With Congenital Heart Disease Compared With the General Population.

    Science.gov (United States)

    Gurvitz, Michelle; Ionescu-Ittu, Raluca; Guo, Liming; Eisenberg, Mark J; Abrahamowicz, Michal; Pilote, Louise; Marelli, Ariane J

    2016-12-01

    The prevalence rate of cancer among adult patients with congenital heart disease (CHD) in North America has not been previously described. The Quebec adult CHD database was used to determine the prevalence rate of cancer among adult patients with CHD measured as the number of adults with CHD and cancer alive in 2005 per 1,000 adults with CHD. This prevalence rate was compared with the prevalence rate of cancer in the general population of adults in Canada. Types of cancer among the CHD group were described by gender and age. Adult patients with CHD had a 1.6 to 2 times higher prevalence of cancer at 2, 5, and 10 years for both men and women. Overall, men had a greater prevalence of total cancers in all-time durations than did women. Breast, colon, and prostate cancer were the most common cancers reported in adults with CHD. In conclusion, we observed an increased prevalence of cancer among the adult CHD population of Quebec compared with the general Canadian population. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Mortality of Adult Critically Ill Subjects With Cancer.

    Science.gov (United States)

    Rosa, Regis Goulart; Tonietto, Tulio Frederico; Duso, Bruno Achutti; Maccari, Juçara Gasparetto; de Oliveira, Roselaine Pinheiro; Rutzen, William; Madeira, Laura; Ascoli, Aline; Hessler, Rachel; Morandi, Paola; Cremonese, Ricardo Viegas; Neto, Felippe Leopoldo Dexheimer; Tagliari, Luciana; de Campos Balzano, Patrícia; Barth, José Hervê Diel; Teixeira, Cassiano

    2017-05-01

    Cancer patients may require intensive care support for postoperative care, complications associated with underlying malignancy, or toxicities related to cancer therapy. The higher mortality rates found in this population than in the population of ICU patients without cancer may be attributable to confounding due to a higher prevalence of multiple organic dysfunctions at ICU admission in patients with malignancy; however, data regarding this hypothesis are scarce. Accordingly, we performed the present study to compare the crude and propensity score-matched mortality rates between adult subjects with and without cancer admitted to a mixed medical-surgical ICU. We conducted a retrospective analysis of a comprehensive longitudinal ICU database in a tertiary referral hospital in Southern Brazil. All adult subjects who were admitted to the ICU from January 2008 to December 2014 were evaluated. Crude and propensity score-matched all-cause 30-d mortality rates of critically ill subjects with cancer were compared with those of critically ill subjects without cancer. A total of 4,221 subjects were evaluated. The survival analysis revealed that the crude mortality rate was higher among subjects with cancer than among subjects without cancer (18.7% vs 10.2%, P < .001). However, after matching by propensity score, the 30-d mortality rates of subjects with and without cancer were similar (18.5% vs 15.2%, P = .17). The present study failed to show an association between malignancy and all-cause 30-d mortality rate in adult subjects admitted to a mixed medical-surgical ICU. The propensity score-matched analysis showed no evidence of excessive mortality due to cancer diagnosis. Copyright © 2017 by Daedalus Enterprises.

  15. Management of total cancer pain: A case of young adult

    Directory of Open Access Journals (Sweden)

    Aanchal Satija

    2014-01-01

    Full Text Available Pain due to cancer is one of the most distressing symptoms experienced by the patients at some or the other time during the course of treatment or disease progression. The multidimensional nature of cancer pain is characterized by various dimensions including physical, social, psychological, and spiritual; which together constitute the term "total pain". Young cancer patients illustrate their unique psychological and developmental needs. This case report highlights the concept of "total cancer pain" in a young adult and demonstrates his distinctive social, spiritual, and psychological sufferings. The report emphasizes that addressing all these concerns is considerably significant in order to provide optimal pain relief to the patient. In the present scenario, it has been done by a skillful multiprofessional team communicating effectively with both the patient and the carer.

  16. An Evaluation of Hepatotoxicity in Breast Cancer Patients Receiving ...

    African Journals Online (AJOL)

    hanumantp

    liver injury may be affected by pre-existing medical problems, ... investigation was a prospective study that was conducted in cancer patients receiving ... study using the patient information format and the written ... Adult (36-50) ..... Last updated.

  17. Physical exercise training interventions for children and young adults during and after treatment for childhood cancer

    NARCIS (Netherlands)

    Braam, Katja I.; van der Torre, Patrick; Takken, Tim; Veening, Margreet A.; van Dulmen-den Broeder, Eline; Kaspers, Gertjan J L

    BACKGROUND: A decreased physical fitness has been reported in patients and survivors of childhood cancer. This is influenced by the negative effects of the disease and the treatment of childhood cancer. Exercise training for adult cancer patients has frequently been reported to improve physical

  18. Issues in adult blood cancer survivorship care.

    Science.gov (United States)

    Bugos, Kelly G

    2015-02-01

    To describe the current literature and future directions of survivorship care for the adult blood cancer population including unique features, identification of needs, practice guidelines, care models and the implications for nursing. Peer reviewed literature, government and national advocacy organization reports, professional organization guidelines. Adult blood cancer survivors are a heterogeneous population that often receives complicated treatments to live a longer life. Survivorship needs among this population are often unmet throughout the cancer care continuum. The limited research literature and guidelines point to survivorship care strategies from the day of diagnosis to enhance long-term outcomes and improve quality of life. Nurses are experts in symptom management and central to preventing, detecting, measuring, educating, and treating the effects of cancer and its treatment. Moreover, nurses are key to implementing strategies to support blood cancer survivors, families, and caregivers from the day of diagnosis to the last day of life. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Rehabilitation of cancer patients.

    Directory of Open Access Journals (Sweden)

    Pandey M

    2001-01-01

    Full Text Available 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 natural calamities, puts rehabilitation movements in the back seat. Treatment and prevention of disability and its rehabilitation requires comprehensive and multidisciplinary approach. There is an urgent need to promote physical and psychological rehabilitation.

  20. The intensity of caregiving is a more important predictor of adverse bereavement outcomes for adult-child than spousal caregivers of patients who die of cancer.

    Science.gov (United States)

    McLean, Sarah; Gomes, Barbara; Higginson, Irene J

    2017-03-01

    Increasing attention is being paid to specific difficulties experienced by bereaved family caregivers (FCs). Limited capacity within health and social care structures results in high intensity of informal caregiving. The focus of recent research is the identification of specific predictors of adverse FC outcomes, in order to identify those FCs who will benefit most from intervention and support. Research is challenged by multiple influencing and confounding variables. This study aimed to evaluate factors of care associated with higher grief intensity in bereaved adult-child (AC-FCs) and spousal FCs (S-FCs). Data from the Qualycare study, a mortality follow-back study of bereaved FCs of patients who died of cancer, was analyzed. Four hundred eighty-four patient-FC dyads were included: 246 AC-FCs and 238 S-FCs. S-FCs received more formal (SPC) (p = 0.026), and AC-FCs more informal (p < 0.001), support. AC-FCs were more likely to continue to work while caregiving (p < 0.001). Patients with AC-FCs were more likely to spend time in and die in a nursing home (p < 0.001). Higher grief intensity was associated with higher caregiving intensity (p < 0.001), as well as other factors. AC-FCs whose relative died in NH experienced significantly lower grief intensity (p < 0.001). Intensity of caregiving predicted 11.6% of variance in grief intensity for AC-FCs compared to 0.5% for S-FCs. The 'relief model' of bereavement is relevant for AC-FCs. The support needs of AC-FCs and S-FCs differ. AC-FCs should be targeted for practical supports and interventions, in order to support home-death, if desired by patient and FC, and optimize bereavement outcomes.Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Screening for thyroid cancer in survivors of childhood and young adult cancer treated with neck radiation.

    Science.gov (United States)

    Tonorezos, Emily S; Barnea, Dana; Moskowitz, Chaya S; Chou, Joanne F; Sklar, Charles A; Elkin, Elena B; Wong, Richard J; Li, Duan; Tuttle, R Michael; Korenstein, Deborah; Wolden, Suzanne L; Oeffinger, Kevin C

    2017-06-01

    The optimal method of screening for thyroid cancer in survivors of childhood and young adult cancer exposed to neck radiation remains controversial. Outcome data for a physical exam-based screening approach are lacking. We conducted a retrospective review of adult survivors of childhood and young adult cancer with a history of neck radiation followed in the Adult Long-Term Follow-Up Clinic at Memorial Sloan Kettering between November 2005 and August 2014. Eligible patients underwent a physical exam of the thyroid and were followed for at least 1 year afterwards. Ineligible patients were those with prior diagnosis of benign or malignant thyroid nodules. During a median follow-up of 3.1 years (range 0-9.4 years), 106 ultrasounds and 2277 physical exams were performed among 585 patients. Forty survivors had an abnormal thyroid physical exam median of 21 years from radiotherapy; 50% of those with an abnormal exam were survivors of Hodgkin lymphoma, 60% had radiation at ages 10-19, and 53% were female. Ultimately, 24 underwent fine needle aspiration (FNA). Surgery revealed papillary carcinoma in seven survivors; six are currently free of disease and one with active disease is undergoing watchful waiting. Among those with one or more annual visits, representing 1732 person-years of follow-up, no cases of thyroid cancer were diagnosed within a year of normal physical exam. These findings support the application of annual physical exam without routine ultrasound for thyroid cancer screening among survivors with a history of neck radiation. Survivors with a history of neck radiation may not require routine thyroid ultrasound for thyroid cancer screening. Among adult survivors of childhood and young adult cancer with a history of radiation therapy to the neck, annual physical exam is an acceptable thyroid cancer screening strategy.

  2. How should older adults with cancer be evaluated for frailty?

    Science.gov (United States)

    Huisingh-Scheetz, M; Walston, J

    2016-01-01

    Traditionally used as a descriptive term, frailty is now a recognized medical syndrome identifying individuals with decreased physiologic reserve. Frailty is characterized by diminished strength, endurance, and reduced physiologic function. Several valid frailty screening tools exist in the literature, and these measures have been used to relate frailty to outcomes important to the older patient with cancer. Frail adults are at increased risk of adverse surgical outcomes and early findings suggest that frailty predicts poor chemotherapy tolerance. While much research is needed to explore the biologic relationships between frailty and cancer, there is an urgent need to implement frailty screening and management into the care of the older patient with cancer in order to improve outcomes in this vulnerable subset. The purpose of this paper is to provide an introduction of frailty to oncologists including a review of the definition, frailty screening tools, its clinical relevance to older patients with cancer, and a brief guide to frailty management. PMID:27318797

  3. Primary care for young adult cancer survivors: an international perspective

    DEFF Research Database (Denmark)

    Hølge-Hazelton, Bibi; Blake-Gumbs, Lyla; Miedema, Baujke

    2010-01-01

    PURPOSE: Internationally, family physicians (FP) are not routinely involved in young adult cancer (YAC) care. In this short report, we would like to make a compelling argument for primary care involvement. METHODS: Comparative descriptions and literature review. RESULTS: Cancer among YAs is rare...... issues the YA cancer patient may present with. The role of the FP in follow-up care seems to be very limited. CONCLUSIONS: YACs in the western world seem to have comparable medical and psychosocial problems. However, the nature of health insurance is such that it impacts differently on the care...

  4. Occupational Therapy for Adults With Cancer: Why It Matters.

    Science.gov (United States)

    Pergolotti, Mackenzi; Williams, Grant R; Campbell, Claudine; Munoz, Lauro A; Muss, Hyman B

    2016-03-01

    Adults with cancer may be at risk for limitations in functional status and quality of life (QOL). Occupational therapy is a supportive service with the specific mission to help people functionally engage in life as safely and independently as possible with the primary goal of improving QOL. Unfortunately, for people with cancer, occupational therapy remains underused. The overall purpose of this review is to provide an understanding of what occupational therapy is and its relevance to patients with cancer, highlight the reasons to refer, and, last, provide general advice on how to access services. ©AlphaMed Press.

  5. A Comparative Pharmacokinetic Study of 2 Pemetrexed Formulations in Indian Adult Chemonaive Patients With Adenocarcinoma Stage III/IV Non-Small Cell Lung Cancer.

    Science.gov (United States)

    Kavathiya, Krunal; Gurjar, Murari; Patil, Anand; Naik, Madhura; Noronha, Vanita; Joshi, Amit; Gota, Vikram; Prabhash, Kumar

    2017-05-01

    The study aimed to compare the pharmacokinetics of 2 pemetrexed formulations (Pemgem, Dr. Reddy's Laboratories w.r.t; Alimta, Eli Lilly) in adult chemonaive subjects with adenocarcinoma stage III/IV non-small cell lung cancer. All patients received 500 mg/m2 pemetrexed (Alimta or Pemgem) as a 10-minute infusion on day 1 of a 21-day cycle. Plasma pemetrexed concentrations were determined on day 1 of cycle 1. Area under the concentration-time curve (AUC0-inf ) and the maximum plasma concentration (Cmax ) were estimated using noncompartment analysis and compared between the 2 arms. Forty-eight patients were enrolled in the study, 24 in each arm. Patient demographics were comparable in both arms. Mean AUC0-inf for the generic and innovator formulations was 218.2 ± 19.18 and 223.6 ± 34.24 μg·h/mL, respectively, and mean Cmax was 119 ± 13.44 and 113 ± 7.26 μg/mL, respectively. Volume of distribution of pemetrexed was 17.5 and 27.6 L, clearance was 4.2 versus 4.72 L/h, and half-life was 4.3 and 4.83 h in the 2 arms respectively. Both formulations showed comparable response rates (objective response of 45% versus 50% in the Pemgem and Alimta arms, respectively) and similar safety profiles. To conclude, Pemgem showed pharmacokinetic and safety profiles similar to Alimta. Substitution of Alimta with Pemgem will be cost-effective and likely to yield comparable efficacy. © 2017, The American College of Clinical Pharmacology.

  6. Regenerative Endodontics for Adult Patients.

    Science.gov (United States)

    He, Ling; Kim, Sahng G; Gong, Qimei; Zhong, Juan; Wang, Sainan; Zhou, Xuedong; Ye, Ling; Ling, Junqi; Mao, Jeremy J

    2017-09-01

    The goal of endodontics is to save teeth. Since inception, endodontic treatments are performed to obturate disinfected root canals with inert materials such as gutta-percha. Although teeth can be saved after successful endodontic treatments, they are devitalized and therefore susceptible to reinfections and fractures. The American Association of Endodontists (AAE) has made a tremendous effort to revitalize disinfected immature permanent teeth in children and adolescents with diagnoses including pulp necrosis or apical periodontitis. The American Dental Association (ADA) in 2011 issued several clinical codes for regenerative endodontic procedures or apical revascularization in necrotic immature permanent teeth in children and adolescents. These AAE and ADA initiatives have stimulated robust interest in devising a multitude of tissue engineering approaches for dental pulp and dentin regeneration. Can the concept of regenerative endodontics be extended to revitalize mature permanent teeth with diagnoses including irreversible pulpitis and/or pulp necrosis in adults? The present article was written not only to summarize emerging findings to revitalize mature permanent teeth in adult patients but also to identify challenges and strategies that focus on realizing the goal of regenerative endodontics in adults. We further present clinical cases and describe the biological basis of potential regenerative endodontic procedures in adults. This article explores the frequently asked question if regenerative endodontic therapies should be developed for dental pulp and/or dentin regeneration in adults, who consist of the great majority of endodontic patients. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  7. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer

    Science.gov (United States)

    Alexander, Erik K.; Bible, Keith C.; Doherty, Gerard M.; Mandel, Susan J.; Nikiforov, Yuri E.; Pacini, Furio; Randolph, Gregory W.; Sawka, Anna M.; Schlumberger, Martin; Schuff, Kathryn G.; Sherman, Steven I.; Sosa, Julie Ann; Steward, David L.; Tuttle, R. Michael; Wartofsky, Leonard

    2016-01-01

    Background: Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer. Methods: The specific clinical questions addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of task force members. Task force panel members were educated on knowledge synthesis methods, including electronic database searching, review and selection of relevant citations, and critical appraisal of selected studies. Published English language articles on adults were eligible for inclusion. The American College of Physicians Guideline Grading System was used for critical appraisal of evidence and grading strength of recommendations for therapeutic interventions. We developed a similarly formatted system to appraise the quality of such studies and resultant recommendations. The guideline panel had complete editorial independence from the ATA. Competing interests of guideline task force members were regularly updated, managed, and communicated to the ATA and task force members. Results: The revised guidelines for the management of thyroid nodules include recommendations regarding initial evaluation, clinical and ultrasound criteria for fine-needle aspiration biopsy, interpretation of fine-needle aspiration biopsy results, use of molecular markers, and management of benign thyroid nodules. Recommendations regarding the initial management of thyroid cancer include those relating to screening for thyroid cancer, staging and risk assessment, surgical management, radioiodine remnant ablation and therapy

  8. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.

    Science.gov (United States)

    Haugen, Bryan R; Alexander, Erik K; Bible, Keith C; Doherty, Gerard M; Mandel, Susan J; Nikiforov, Yuri E; Pacini, Furio; Randolph, Gregory W; Sawka, Anna M; Schlumberger, Martin; Schuff, Kathryn G; Sherman, Steven I; Sosa, Julie Ann; Steward, David L; Tuttle, R Michael; Wartofsky, Leonard

    2016-01-01

    Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer. The specific clinical questions addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of task force members. Task force panel members were educated on knowledge synthesis methods, including electronic database searching, review and selection of relevant citations, and critical appraisal of selected studies. Published English language articles on adults were eligible for inclusion. The American College of Physicians Guideline Grading System was used for critical appraisal of evidence and grading strength of recommendations for therapeutic interventions. We developed a similarly formatted system to appraise the quality of such studies and resultant recommendations. The guideline panel had complete editorial independence from the ATA. Competing interests of guideline task force members were regularly updated, managed, and communicated to the ATA and task force members. The revised guidelines for the management of thyroid nodules include recommendations regarding initial evaluation, clinical and ultrasound criteria for fine-needle aspiration biopsy, interpretation of fine-needle aspiration biopsy results, use of molecular markers, and management of benign thyroid nodules. Recommendations regarding the initial management of thyroid cancer include those relating to screening for thyroid cancer, staging and risk assessment, surgical management, radioiodine remnant ablation and therapy, and thyrotropin suppression

  9. Denial in cancer patients.

    Science.gov (United States)

    Kreitler, S

    1999-01-01

    Denial is a basic mechanism for coping with stressful themes, common in healthy and sick individuals. This article deals with the role and functions of denial in cancer, reviewing empirical studies about the effects of denial on cancer prevention, screening, undergoing tests for early detection, delay in seeking medical attention and getting treatment, complying with medical instructions, and coping with the disease in different stages. Special sections are devoted to the possible role of denial as a risk factor for cancer, the effects of denial on disease course and survival, and the relation of denial to immunocompetence. Major conclusions are that denial may have a positive effect when applied in the first phase of coping, after diagnosis, because it reduces anxiety. This holds also for the terminal stage. The negative effects of denial are that it may interfere with getting treatment (e.g., delay in going to the doctor, not showing up for follow-ups, noncompliance), may disrupt the process of assimilating the stressful event, may affect adversely interpersonal relations, and constitutes a cumulative stressor depressing even immunocompetence. The use of denial varies with the severity of the situation, the patient's personality, and his or her familial and cultural background. A large body of research examined the hypothesis that a tendency toward denial could be one of the risk factors for cancer. Despite evidence supporting the occurrence of denial as a correlate of cancer, a lot of research is necessary to clarify the role of denial in general and of anger specifically as a factor affecting the occurrence of cancer and the course of disease and survival.

  10. High Prevalence of Hereditary Cancer Syndromes in Adolescents and Young Adults With Colorectal Cancer.

    Science.gov (United States)

    Mork, Maureen E; You, Y Nancy; Ying, Jun; Bannon, Sarah A; Lynch, Patrick M; Rodriguez-Bigas, Miguel A; Vilar, Eduardo

    2015-11-01

    Established guidelines recommend evaluation for hereditary cancer syndromes in patients younger than 50 years diagnosed with colorectal cancer (CRC). This group has been well described in the literature; however, patients diagnosed as adolescents and young adults are not well represented in CRC studies. Here, we define the clinical profile, including the extent of hereditary cancer syndromes and family history of cancer, in patients diagnosed with CRC at age 35 or younger. We reviewed patients who underwent genetic counseling at our institution during 5 years (2009 to 2013). Data were collected regarding demographics, clinicopathologic information, tumor and genetic testing, and family history. Patients with an identified hereditary cancer syndrome were compared with those without a syndrome. Of the 193 patients with evaluable data, 35% had an identifiable hereditary cancer syndrome, including 23 with Lynch syndrome, 22 with mutation-negative Lynch syndrome, 16 with familial adenomatous polyposis, two with constitutional mismatch repair deficiency, two with biallelic MUTYH mutations, and one with Li-Fraumeni syndrome. Patients without a hereditary syndrome more frequently presented with metastatic disease, whereas patients with a syndrome were more likely to present at earlier stages and to have a family history of cancer. Nevertheless, a substantial proportion of the hereditary syndromes (19%) were diagnosed in individuals with no family history of the disease. We conclude that patients diagnosed with CRC at age 35 years or younger should receive genetic counseling regardless of their family history and phenotype. © 2015 by American Society of Clinical Oncology.

  11. Cancer patients' evaluation of communication

    DEFF Research Database (Denmark)

    Ross, Lone; Petersen, Morten Aagaard; Johnsen, Anna Thit

    2013-01-01

    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.......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....

  12. Lung cancer in younger patients

    DEFF Research Database (Denmark)

    Abbasowa, Leda; Madsen, Poul Henning

    2016-01-01

    INTRODUCTION: Lung cancer remains a leading cause of cancer-related death. The incidence increases with age and the occurrence in young patients is relatively low. The clinicopathological features of lung cancer in younger patients have not been fully explored previously. METHODS: To assess the age...... differences in the clinical characteristics of lung cancer, we conducted a retrospective analysis comparing young patients ≤ 65 years of age with an elderly group > 65 years of age. Among 1,232 patients evaluated due to suspicion of lung cancer in our fast-track setting from January-December 2013, 312 newly...... diagnosed lung cancer patients were included. RESULTS: Patients ≤ 65 years had a significantly higher representation of females (p = 0.0021), more frequent familial cancer aggregation (p = 0.028) and a lower incidence of squamous cell carcinoma (p = 0.0133). When excluding pure carcinoid tumours...

  13. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: What is new and what has changed?

    Science.gov (United States)

    Haugen, Bryan R

    2017-02-01

    Thyroid nodules are very common, and thyroid cancer is currently the fifth leading cancer diagnosis in women. The American Thyroid Association has led the development and revision of guidelines for the management of patients with thyroid nodules and differentiated thyroid cancer (DTC). The most current revision was published in the January 2016 issue of the journal Thyroid. The current guidelines have 101 recommendations, with 8 figures and 17 tables that are hopefully helpful to those treating patients with thyroid nodules and cancer. The primary goals of the American Thyroid Association Guidelines Task Force were to use the current evidence to guide recommendations and yet be as helpful and practical as possible within the scope and strength of the evidence. The current review focuses on new and significantly revised recommendations that may very well change clinical practice. The author notes 3 new basic principles that have emerged in this guidelines revision: 1) the management of thyroid nodules, including the decision to perform a fine-needle aspiration biopsy as well as follow-up decision making, will be heavily influenced by the newly developed sonographic risk pattern; 2) the long-term management of DTC along with thyroid-stimulating hormone target goals will be heavily influenced by the 4 categories of "response to therapy"; and 3) the management of patients with radioactive iodine-refractory DTC will be divided into 4 basic decision-making groups: patients who should undergo monitoring, patients who should undergo directed therapies, patients who should undergo systemic therapies, and patients who should be offered entry into clinical trials. Cancer 2017;123:372-381. © 2016 American Cancer Society. © 2016 American Cancer Society.

  14. Pain in patients with cancer

    NARCIS (Netherlands)

    Vissers, K.C.P.; Besse, K.; Wagemans, M.; Zuurmond, W.; Giezeman, M.J.; Lataster, A.; Mekhail, N.; Burton, A.W.; Kleef, M. van; Huygen, F.

    2011-01-01

    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

  15. A phase I pharmacokinetic and safety study of cabazitaxel in adult cancer patients with normal and impaired renal function.

    Science.gov (United States)

    Azaro, Analía; Rodón, Jordi; Machiels, Jean-Pascal; Rottey, Sylvie; Damian, Silvia; Baird, Richard; Garcia-Corbacho, Javier; Mathijssen, Ron H J; Clot, Pierre-François; Wack, Claudine; Shen, Liji; de Jonge, Maja J A

    2016-12-01

    Limited data are available on cabazitaxel pharmacokinetics in patients with renal impairment. This open-label, multicenter study assessed cabazitaxel in patients with advanced solid tumors and normal or impaired renal function. Cohorts A (normal renal function: creatinine clearance [CrCL] >80 mL/min/1.73 m2), B (moderate renal impairment: CrCL 30 to renal impairment: 40 and 15 mL/min/1.73 m2) versus a control (90 mL/min/1.73 m2). Overall, 25 patients received cabazitaxel (median cycles: 3 [range 1-20]; Cohort A: 5 [2-13]; Cohort B: 3 [1-15]; and Cohort C: 5 [1-20]), of which 24 were eligible for pharmacokinetic analysis (eight in each cohort). For moderate and severe renal impairment versus normal renal function, GMR estimates were: clearance normalized to body surface area (CL/BSA) 0.95 (90% CI 0.80-1.13) and 0.89 (0.61-1.32); area under the curve normalized to dose (AUC/dose) 1.06 (0.88-1.27) and 1.14 (0.76-1.71); and F U 0.99 (0.94-1.04) and 0.97 (0.87-1.09), respectively. Estimated slopes of linear regression of log parameters versus log CrCL (renal impairment) were: CL/BSA 0.06 (-0.15 to 0.28); AUC/dose -0.07 (-0.30 to 0.16); and F U 0.02 (-0.05 to 0.08). Cabazitaxel safety profile was consistent with previous reports. Renal impairment had no clinically meaningful effect on cabazitaxel pharmacokinetics.

  16. Prospective study of falls and risk factors for falls in adults with advanced cancer.

    LENUS (Irish Health Repository)

    Stone, Carol A

    2012-06-10

    Retrospective studies of inpatients with cancer suggest that a cancer diagnosis confers a high risk of falls. In adults with advanced cancer, we aimed to prospectively document the incidence of falls, identify the risk factors, and determine if falls in this population occur predominantly in older patients.

  17. CT Colonographic Screening of Patients With a Family History of Colorectal Cancer: Comparison With Adults at Average Risk and Implications for Guidelines.

    Science.gov (United States)

    Pickhardt, Perry J; Mbah, Ifeanyi; Pooler, B Dustin; Chen, Oliver T; Hinshaw, J Louis; Weiss, Jennifer M; Kim, David H

    2017-04-01

    The purposes of this study were to compare rates of lesion detection at CT colonographic (CTC) screening of adults without symptoms who had and who did not have a family history of colorectal cancer according to American Cancer Society guidelines and to consider the clinical implications. Over 134 months, consecutively registered CTC cohorts of adults without symptoms who had (n = 156; 88 [56.4%] women; 68 [43.6%] men; mean age, 56.3 years) and who did not have (n = 8857; 4757 [53.7%] women; 4100 [46.3%] men; mean age, 56.6 years) an American Cancer Society-defined family history of colorectal cancer (first-degree relative with diagnosis before age 60 years or two first-degree relatives with diagnosis at any age) were compared for relevant colorectal findings. For the family history versus no family history cohorts, the frequency of all nondiminutive polyps (≥ 6 mm) reported at CTC was 23.7% versus 15.5% (p = 0.007); small polyps (6-9 mm), 13.5% versus 9.1% (p = 0.068); and large polyps (≥ 10 mm), 10.2% versus 6.5% (p = 0.068). The rate of referral for colonoscopy was greater for the family history cohort (16.0% vs 10.5%; p = 0.035). However, the frequencies of proven advanced adenoma (4.5% vs 3.2%; p = 0.357), nonadvanced adenoma (5.1% vs 2.6%; p = 0.070), and cancer (0.0% vs 0.4%; p = 0.999) were not significantly increased. The difference in positive rates between the two cohorts (11.5% vs 4.3%; p colorectal cancer relevance, such as small hyperplastic polyps, diverticular disease, and false-positive CTC findings. Although the overall CTC-positive and colonoscopy referral rates were higher in the family history cohort, the clinically relevant frequencies of advanced neoplasia and cancer were not sufficiently increased to preclude CTC screening. These findings support the use of CTC as a front-line screening option in adults with a family history of colorectal cancer.

  18. The Clinician's Toolbox: Assessing the Sexual Impacts of Cancer on Adolescents and Young Adults with Cancer (AYAC

    Directory of Open Access Journals (Sweden)

    Sylvie Aubin, PhD

    2015-09-01

    Conclusion: Cancer can have a significant impact on numerous domains of AYAC sexuality. The assessment of and attention to the impact of sexuality on AYAC is crucial in order to provide effective and comprehensive quality patient cancer care. Aubin S and Perez S. The clinician's toolbox: assessing the sexual impacts of cancer on adolescents and young adults with cancer (AYAC. Sex Med 2015;3:198–212.

  19. PET-CT in Determining the Radioembolization Dose Delivered to Patients With Liver Metastasis, Primary Liver Cancer, or Biliary Cancer

    Science.gov (United States)

    2017-01-24

    Adult Primary Hepatocellular Carcinoma; Advanced Adult Primary Liver Cancer; Metastatic Extrahepatic Bile Duct Cancer; Recurrent Adult Primary Liver Cancer; Recurrent Extrahepatic Bile Duct Cancer; Stage D Adult Primary Liver Cancer (BCLC); Unspecified Adult Solid Tumor, Protocol Specific

  20. Psychological distress and unsatisfied need for psychosocial support in adolescent and young adult cancer patients during the first year following diagnosis.

    Science.gov (United States)

    Zebrack, Brad J; Corbett, Virginia; Embry, Leanne; Aguilar, Christine; Meeske, Kathleen A; Hayes-Lattin, Brandon; Block, Rebecca; Zeman, David T; Cole, Steven

    2014-11-01

    Identifying at-risk adolescent and young adult (AYA) cancer patients and referring them to age-appropriate psychosocial support services may be instrumental in reducing psychological distress and promoting psychosocial adaptation. The purpose of this study is to identify trajectories of clinically significant levels of distress throughout the first year following diagnosis and to distinguish factors, including supportive care service use, that predict the extent to which AYAs report distress. In this prospective multisite study, 215 AYAs aged 15-39 years were assessed for psychological distress and psychosocial support service use within the first 4 months of diagnosis and again 6 and 12 months later. On the basis of distress scores, respondents were assigned to one of four distress trajectory groups (Resilient, Recovery, Delayed, and Chronic). Multiple logistic regression analyses examined whether demographics, clinical variables, and reports of unsatisfied need for psychosocial support were associated with distress trajectories over 1 year. Twelve percent of AYAs reported clinically significant chronic distress throughout the first 12 months following diagnosis. An additional 15% reported delayed distress. Substantial proportions of AYAs reported that needs for information (57%), counseling (41%), and practical support (39%) remained unsatisfied at 12 months following diagnosis. Not getting counseling needs met, particularly with regard to professional mental health services, was observed to be significantly associated with distress over time. Substantial proportions of AYAs are not utilizing psychosocial support services. Findings suggest the importance of identifying psychologically distressed AYAs and addressing their needs for mental health counseling throughout a continuum of care. Copyright © 2014 John Wiley & Sons, Ltd.

  1. Compromised quality of life in adult patients who have received a radiation dose towards the basal part of the brain. A case-control study in long-term survivors from cancer in the head and neck region

    Directory of Open Access Journals (Sweden)

    Löfdahl Elisabet

    2012-10-01

    Full Text Available Abstract Background Adult patients with hypothalamic-pituitary disorders have compromised quality of life (QoL. Whether this is due to their endocrine consequences (hypopituitarism, their underlying hypothalamic-pituitary disorder or both is still under debate. The aim of this trial was to measure quality of life (QoL in long-term cancer survivors who have received a radiation dose to the basal part of the brain and the pituitary. Methods Consecutive patients (n=101 treated for oropharyngeal or epipharyngeal cancer with radiotherapy followed free of cancer for a period of 4 to10 years were identified. Fifteen patients (median age 56 years with no concomitant illness and no hypopituitarism after careful endocrine evaluation were included in a case-control study with matched healthy controls. Doses to the hypothalamic-pituitary region were calculated. QoL was assessed using the Symptom check list (SCL-90, Nottingham Health Profile (NHP, and Psychological Well Being (PGWB questionnaires. Level of physical activity was assessed using the Baecke questionnaire. Results The median accumulated dose was 1.9 Gy (1.5–2.2 Gy to the hypothalamus and 2.4 Gy (1.8–3.3 Gy to the pituitary gland in patients with oropharyngeal cancer and 6.0–9.3 Gy and 33.5–46.1 Gy, respectively in patients with epipharyngeal cancer (n=2. The patients showed significantly more anxiety and depressiveness, and lower vitality, than their matched controls. Conclusion In a group of long time survivors of head and neck cancer who hade received a low radiation dose to the hypothalamic-pituitary region and who had no endocrine consequences of disease or its treatment QoL was compromised as compared with well matched healthy controls.

  2. Screening strategies for colorectal cancer in asymptomatic adults.

    Science.gov (United States)

    Turgeon, D Kim; Ruffin, Mack T

    2014-06-01

    This article provides an update for the primary care community on the evidence and recommendations for colorectal cancer screening in the adult population without symptoms at average and increased risk, excluding patients with high-risk genetic syndromes. The current and possible new screening strategies are reviewed, along with clinical wisdom related to the implementation of each method. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Muscle dysfunction in cancer patients

    DEFF Research Database (Denmark)

    Christensen, Jesper Frank; Jones, L W; Andersen, J L

    2014-01-01

    implications of muscle dysfunction in cancer patients. The efficacy of exercise training to prevent and/or mitigate cancer-related muscle dysfunction is also discussed. DESIGN: We identified 194 studies examining muscular outcomes in cancer patients by searching PubMed and EMBASE databases. RESULTS: Muscle...... in oncology practice. Significant progress has been made over the last decade in the field of exercise oncology, indicating that exercise training constitutes a potent modulator of skeletal muscle function in patients with cancer. CONCLUSION: There are clear associations between muscle dysfunction...... 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...

  4. Patient function, long-term survival, and use of surgery in patients with kidney cancer.

    Science.gov (United States)

    Tan, Hung-Jui; Chamie, Karim; Daskivich, Timothy J; Litwin, Mark S; Hu, Jim C

    2016-12-15

    Beyond age and comorbidity, functionality can shape the long-term survival potential of patients with cancer. Accordingly, herein the authors compared mortality and receipt of cancer-directed surgery according to patient function among older adults with kidney cancer. Using Surveillance, Epidemiology, and End Results (SEER)-Medicare data from 2000 through 2009, the authors studied 28,326 elderly subjects with primary kidney cancer. Patient function was quantified using function-related indicators, claims indicative of dysfunction and disability. Adjusting for patient and cancer characteristics, competing risk regression was used to assess the relationship between function-related indicator count and cause-specific mortality and then generalized estimating equations were used to quantify the probability of surgery. A total of 13,619 adult patients (48.1%) with at least 1 function-related indicator were identified. A higher indicator category was associated with older age, greater comorbidity, female sex, unmarried status, lower socioeconomic status, and higher stage of disease (Pkidney cancer mortality varied minimally with patient function. Patients with ≥ 2 indicators received cancer-directed surgery less often than those without disability (odds ratio, 0.61; 95% CI, 0.56-0.66), although treatment probabilities remained high for patients with locoregional disease and low for those with metastatic cancer. Among older adults with kidney cancer, functional health stands as a significant predictor of long-term survival. However, receipt of cancer-directed surgery appears largely determined by cancer stage. Patient function should be considered more heavily when determining treatment for older adults with kidney cancer. Cancer 2016;122:3776-3784. © 2016 American Cancer Society. © 2016 American Cancer Society.

  5. Health Literacy: Cancer Prevention Strategies for Early Adults.

    Science.gov (United States)

    Simmons, Robert A; Cosgrove, Susan C; Romney, Martha C; Plumb, James D; Brawer, Rickie O; Gonzalez, Evelyn T; Fleisher, Linda G; Moore, Bradley S

    2017-09-01

    Health literacy, the degree to which individuals have the capacity to obtain, process, and understand health information and services needed to make health decisions, is an essential element for early adults (aged 18-44 years) to make informed decisions about cancer. Low health literacy is one of the social determinants of health associated with cancer-related disparities. Over the past several years, a nonprofit organization, a university, and a cancer center in a major urban environment have developed and implemented health literacy programs within healthcare systems and in the community. Health system personnel received extensive health literacy training to reduce medical jargon and improve their patient education using plain language easy-to-understand written materials and teach-back, and also designed plain language written materials including visuals to provide more culturally and linguistically appropriate health education and enhance web-based information. Several sustainable health system policy changes occurred over time. At the community level, organizational assessments and peer leader training on health literacy have occurred to reduce communication barriers between consumers and providers. Some of these programs have been cancer specific, including consumer education in such areas as cervical cancer, skin cancer, and breast cancer that are targeted to early adults across the cancer spectrum from prevention to treatment to survivorship. An example of consumer-driven health education that was tested for health literacy using a comic book-style photonovel on breast cancer with an intergenerational family approach for Chinese Americans is provided. Key lessons learned from the health literacy initiatives and overall conclusions of the health literacy initiatives are also summarized. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Current lifestyle of young adults treated for cancer in childhood.

    Science.gov (United States)

    Evans, S E; Radford, M

    1995-05-01

    The aim of this study was to look at the current lifestyle of young adult survivors of childhood cancer between the ages of 16 and 30 years to document their achievements and expose any psychosocial problems. Sixty six young adult survivors were contacted and asked if they and their siblings (16-30 years) would take part in a lifestyle study; 48 patients and 38 sibling controls were interviewed. This took the form of a structured lifestyle questionnaire, a self esteem questionnaire (Oxford Psychologists Press), and an unstructured interview. Fifty five per cent of patients achieved five or more A-C grades at 'O' level/GCSE compared with 62% of siblings and a national average of 30%. Despite that these patients were significantly less likely to go on to higher education than their siblings. The two groups were equally employable and earning similar salaries. There were three cases of known employer prejudice. A slightly higher percentage of patients than siblings had their driving licence. Seventeen patients felt their appearance had changed and eight felt that they had a residual physical mobility problem. Both groups were socially active and equally likely to partake in competitive sports. There was no overall difference in the self esteem of the two groups. In general the survivors of childhood cancer were coping well in their young adult life and achieving the same lifestyle goals as their siblings. However, significant problems have been identified.

  7. Use of general practice, diagnostic investigations and hospital services before and after cancer diagnosis - a population-based nationwide registry study of 127,000 incident adult cancer patients

    DEFF Research Database (Denmark)

    Christensen, Karina Garnier; Fenger-Grøn, Morten; Flarup, Kaare Rud

    2012-01-01

    their diagnosis, cancer patients had twice as many general practitioner (GP) consultations, ten to eleven times more diagnostic investigations and five times more hospital contacts than the reference population. The demand for GP services peaked one month before diagnosis, the demand for diagnostic investigations...... one month after diagnosis and the number of hospital contacts three months after diagnosis. The proportion of cancer patients receiving each of these three types of health services remained more than 10% above that of the reference population from two months before diagnosis until the end of the study...... period. CONCLUSIONS: Cancer patients' health service utilisation rose dramatically three months before their diagnosis. This increase applied to all services in general throughout the first year after diagnosis and to the patients' use of hospital contacts in particular. Cancer patients' heightened...

  8. ESPEN guidelines on nutrition in cancer patients.

    Science.gov (United States)

    Arends, Jann; Bachmann, Patrick; Baracos, Vickie; Barthelemy, Nicole; Bertz, Hartmut; Bozzetti, Federico; Fearon, Ken; Hütterer, Elisabeth; Isenring, Elizabeth; Kaasa, Stein; Krznaric, Zeljko; Laird, Barry; Larsson, Maria; Laviano, Alessandro; Mühlebach, Stefan; Muscaritoli, Maurizio; Oldervoll, Line; Ravasco, Paula; Solheim, Tora; Strasser, Florian; de van der Schueren, Marian; Preiser, Jean-Charles

    2017-02-01

    Cancers are among the leading causes of morbidity and mortality worldwide, and the number of new cases is expected to rise significantly over the next decades. At the same time, all types of cancer treatment, such as surgery, radiation therapy, and pharmacological therapies are improving in sophistication, precision and in the power to target specific characteristics of individual cancers. Thus, while many cancers may still not be cured they may be converted to chronic diseases. All of these treatments, however, are impeded or precluded by the frequent development of malnutrition and metabolic derangements in cancer patients, induced by the tumor or by its treatment. These evidence-based guidelines were developed to translate current best evidence and expert opinion into recommendations for multi-disciplinary teams responsible for identification, prevention, and treatment of reversible elements of malnutrition in adult cancer patients. The guidelines were commissioned and financially supported by ESPEN and by the European Partnership for Action Against Cancer (EPAAC), an EU level initiative. Members of the guideline group were selected by ESPEN to include a range of professions and fields of expertise. We searched for meta-analyses, systematic reviews and comparative studies based on clinical questions according to the PICO format. The evidence was evaluated and merged to develop clinical recommendations using the GRADE method. Due to the deficits in the available evidence, relevant still open questions were listed and should be addressed by future studies. Malnutrition and a loss of muscle mass are frequent in cancer patients and have a negative effect on clinical outcome. They may be driven by inadequate food intake, decreased physical activity and catabolic metabolic derangements. To screen for, prevent, assess in detail, monitor and treat malnutrition standard operating procedures, responsibilities and a quality control process should be established at each

  9. Falls in Older Adults With Cancer: Evaluation by Oncology Providers.

    Science.gov (United States)

    Guerard, Emily J; Deal, Allison M; Williams, Grant R; Jolly, Trevor A; Nyrop, Kirsten A; Muss, Hyman B

    2015-11-01

    Falls in older adults are common. Screening for falls is quick, simple, and important because falls increase the risk of morbidity and mortality in older patients with cancer. The aim of this study was to evaluate oncology providers' recognition of and response to falls in older patients with cancer. From a sample of older patients with cancer who completed a geriatric assessment blinded to oncology providers, we identified patients who self-reported falls within the past 6 months. Their history and physical and/or clinic notes completed by an oncology provider were reviewed for the following: documentation of falls, gait assessment, referral to geriatrics or physical and/or occupational therapy, and measurement of 25-hydroxy vitamin D level. In our sample of older patients with cancer who reported at least one recent fall (N = 125), the average age was 72 years (range, 65 to 93 years), 78% were female, and 62% had a breast cancer diagnosis. Chart reviews showed that 13 (10%) had falls documented, 25 (20%) had a gait assessment, eight (6%) were referred, and 21 (17%) had vitamin D level measured. We found that only 10% of older patients with cancer who self-reported a recent fall had appropriate medical record documentation. Oncologists are often the primary care providers for older patients and are largely unfamiliar with the frequency and impact of falls in this population. There is a need to increase awareness of falls prevalence and consequences among oncology providers in order to provide timely interventions to reduce the risks associated with falls. Copyright © 2015 by American Society of Clinical Oncology.

  10. Comprehensive geriatric assessment in the older cancer patient: coming of age in clinical cancer care

    Science.gov (United States)

    Owusu, Cynthia; Berger, Nathan A

    2015-01-01

    Cancer care at the extremes of life, in the young and the old, is characterized by unique issues associated with pediatrics and geriatric medicine, accentuated by the special vulnerabilities of these groups. In response to these needs, the field of pediatric oncology has been well honed to deal with the special problems associated with juvenile cancer patients. While most adult oncologists consider themselves well prepared to deal with older cancer patients, the current expansion of the geriatric population – their variable levels of fitness, frailty and vulnerability, the fact that cancer is primarily a disease of older adults, the significant expansion of agents and approaches to treat cancer, as well as their resultant toxicities and complications – has led to the development of specialized geriatric oncologists. Moreover, the special characteristics and needs of these patients have led to the evolution of new guidelines for evaluation, management and the conduct of research in older patients with cancer. PMID:25642321

  11. Supportive care needs of Mexican adult cancer patients: validation of the Mexican version of the Short-Form Supportive Care Needs Questionnaire (SCNS-SFM).

    Science.gov (United States)

    Doubova, Svetlana V; Aguirre-Hernandez, Rebeca; Gutiérrez-de la Barrera, Marcos; Infante-Castañeda, Claudia; Pérez-Cuevas, Ricardo

    2015-09-01

    The purpose of this study is to validate the Mexican version of the Short-Form Supportive Care Needs survey (SCNS-SFM). A cross-sectional survey was conducted from June to December 2013 at the Oncology Hospital of the Mexican Institute of Social Security in Mexico City. The study included 825 subsequent cancer patients >20 years of age with all forms of solid cancer. Patients had prior surgical removal of histologically confirmed cancer and attended outpatient consultations. Validation of SCNS-SFM included the following: (1) content validity through a group of experts; (2) construct validity through an exploratory factor analysis based on the polychoric correlation matrix; (3) internal consistency using Cronbach's alpha; (4) convergent validity between SCNS-SFM and quality of life, anxiety, and depression scales by calculating Pearson's correlation coefficient; (5) discriminative validity through analysis of MANOVAs; and (6) test-retest reliability using intraclass correlation coefficient calculations. SCNS-SFM has 33 items with five factors accounting for 59 % of total variance. Cronbach's alpha values ranged from 0.78 to 0.90 among factors. SCNS-SFM has good convergent validity compared with quality of life and depression and anxiety scales and good discriminative validity, revealing great information, psychological support, and physical daily living needs for women, patients <60 years, and high physical daily living needs for those with <1 year since cancer diagnosis, with advanced disease stages and current chemo- or radiotherapy. Intraclass correlation coefficient between SCNS-SFM measurements was 0.9. SCNS-SFM has acceptable psychometric properties and is suitable to evaluate supportive care needs of cancer patients.

  12. Cachexia among US cancer patients.

    Science.gov (United States)

    Arthur, Susan T; Van Doren, Bryce A; Roy, Debosree; Noone, Joshua M; Zacherle, Emily; Blanchette, Christopher M

    2016-09-01

    Cancer cachexia is a debilitating condition and results in poor prognosis. The purpose of this study was to assess hospitalization incidence, patient characteristics, and medical cost and burden of cancer cachexia in the US. This study used a cross-sectional analysis of the Nationwide Inpatient Sample (NIS) for 2009. Five cancers reported to have the highest cachexia incidence were assessed. The hospitalization incidence related to cachexia was estimated by cancer type, cost and length of stay were compared, and descriptive statistics were reported for each cancer type, as well as differences being compared between patients with and without cachexia. Risk of inpatient death was higher for patients with cachexia in lung cancer (OR = 1.32; CI = 1.20-1.46) and in all cancers combined (OR = 1.76; CI = 1.67-1.85). The presence of cachexia increased length of stay in lung (IRR = 1.05; CI = 1.03-1.08), Kaposi's sarcoma (IRR = 1.47; CI = 1.14-1.89) and all cancers combined (IRR = 1.09; CI = 1.08-1.10). Additionally, cachectic patients in the composite category had a longer hospitalization stay compared to non-cachectic patients (3-9 days for those with cachexia and 2-7 days for those without cachexia). The cost of inpatient stay was significantly higher in cachexic than non-cachexic lung cancer patients ($13,560 vs $13 190; p Cachexia increases hospitalization costs and length of stay in several cancer types. Identifying the medical burden associated with cancer cachexia will assist in developing an international consensus for recognition and coding by the medical community and ultimately an effective treatment plans for cancer cachexia.

  13. Documentation of Fertility Preservation Discussions for Young Adults With Cancer: Examining Compliance With Treatment Guidelines.

    Science.gov (United States)

    Salsman, John M; Yanez, Betina; Smith, Kristin N; Beaumont, Jennifer L; Snyder, Mallory A; Barnes, Khouri; Clayman, Marla L

    2016-03-01

    Professional guidelines have been developed to promote discussion between providers and newly diagnosed young adults with cancer about the possibility of cancer treatment-related infertility, but previous research suggests many young adults fail to receive this information. The aim of this study was to examine rates of and factors predictive of oncologists' compliance with national guidelines for discussing potential treatment-related infertility with newly diagnosed young adults with cancer seen at an NCI-designated comprehensive cancer center. We reviewed data from the electronic medical record for new clinic encounters between medical oncologists and young adults with cancer (ages 18-39 years) from 2010 to 2012. Data from oncologist discussions of fertility preservation were abstracted, as were patient (age, sex, race, ethnicity, cancer type) and oncologist (gender, graduation year from fellowship) characteristics. A total of 1,018 cases were reviewed, with 454 patients (mean, 31.5 years; 67.8% women) meeting inclusion criteria. Overall, 83% of patients were informed about potential treatment-related infertility, with patients with breast cancer (85% informed), Hodgkin lymphoma (95% informed), non-Hodgkin's lymphoma (94% informed), leukemia (88% informed), or testicular cancer (100% informed) more likely to be informed than those with other cancer types (60%-74% informed). There was a significant effect for patient sex (odds ratio, 3.57; CI, 1.33, 9.60; P=.012), with women being more likely to be informed than men. Reported compliance with fertility preservation guidelines was greater than published rates. Higher compliance rates in female patients and in patients with cancers more common among young adults may reflect greater awareness of fertility-related concerns among these patients and their providers. Copyright © 2016 by the National Comprehensive Cancer Network.

  14. Improving the Evidence Base for Treating Older Adults With Cancer: American Society of Clinical Oncology Statement.

    Science.gov (United States)

    Hurria, Arti; Levit, Laura A; Dale, William; Mohile, Supriya G; Muss, Hyman B; Fehrenbacher, Louis; Magnuson, Allison; Lichtman, Stuart M; Bruinooge, Suanna S; Soto-Perez-de-Celis, Enrique; Tew, William P; Postow, Michael A; Cohen, Harvey J

    2015-11-10

    The American Society of Clinical Oncology (ASCO) convened a subcommittee to develop recommendations on improving the evidence base for treating older adults with cancer in response to a critical need identified by the Institute of Medicine. Older adults experience the majority of cancer diagnoses and deaths and make up the majority of cancer survivors. Older adults are also the fastest growing segment of the US population. However, the evidence base for treating this population is sparse, because older adults are underrepresented in clinical trials, and trials designed specifically for older adults are rare. The result is that clinicians have less evidence on how to treat older adults, who represent the majority of patients with cancer. Clinicians and patients are forced to extrapolate from trials conducted in younger, healthier populations when developing treatment plans. This has created a dearth of knowledge regarding the risk of toxicity in the average older patient and about key end points of importance to older adults. ASCO makes five recommendations to improve evidence generation in this population: (1) Use clinical trials to improve the evidence base for treating older adults with cancer, (2) leverage research designs and infrastructure for generating evidence on older adults with cancer, (3) increase US Food and Drug Administration authority to incentivize and require research involving older adults with cancer, (4) increase clinicians' recruitment of older adults with cancer to clinical trials, and (5) use journal policies to improve researchers' reporting on the age distribution and health risk profiles of research participants. © 2015 by American Society of Clinical Oncology.

  15. Survival of Sami cancer patients

    Directory of Open Access Journals (Sweden)

    Leena Soininen

    2012-07-01

    Full Text Available Objectives. The incidence of cancer among the indigenous Sami people of Northern Finland is lower than among the Finnish general population. The survival of Sami cancer patients is not known, and therefore it is the object of this study. Study design. The cohort consisted of 2,091 Sami and 4,161 non-Sami who lived on 31 December 1978 in the two Sami municipalities of Inari and Utsjoki, which are located in Northern Finland and are 300–500 km away from the nearest central hospital. The survival experience of Sami and non-Sami cancer patients diagnosed in this cohort during 1979–2009 was compared with that of the Finnish patients outside the cohort. Methods. The Sami and non-Sami cancer patients were matched to other Finnish cancer patients for gender, age and year of diagnosis and for the site of cancer. An additional matching was done for the stage at diagnosis. Cancer-specific survival analyses were made using the Kaplan–Meier method and Cox regression modelling. Results. There were 204 Sami and 391 non-Sami cancer cases in the cohort, 20,181 matched controls without matching with stage, and 7,874 stage-matched controls. In the cancer-specific analysis without stage variable, the hazard ratio for Sami was 1.05 (95% confidence interval 0.85–1.30 and for non-Sami 1.02 (0.86–1.20, indicating no difference between the survival of those groups and other patients in Finland. Likewise, when the same was done by also matching the stage, there was no difference in cancer survival. Conclusion. Long distances to medical care or Sami ethnicity have no influence on the cancer patient survival in Northern Finland.

  16. Impact of Cancer on Work and Education Among Adolescent and Young Adult Cancer Survivors

    Science.gov (United States)

    Parsons, Helen M.; Harlan, Linda C.; Lynch, Charles F.; Hamilton, Ann S.; Wu, Xiao-Cheng; Kato, Ikuko; Schwartz, Stephen M.; Smith, Ashley W.; Keel, Gretchen; Keegan, Theresa H.M.

    2012-01-01

    Purpose To examine the impact of cancer on work and education in a sample of adolescent and young adult (AYA) patients with cancer. Patients and Methods By using the Adolescent and Young Adult Health Outcomes and Patient Experience Study (AYA HOPE)—a cohort of 463 recently diagnosed patients age 15 to 39 years with germ cell cancer, Hodgkin's lymphoma, non-Hodgkin's lymphoma, sarcoma, and acute lymphocytic leukemia from participating Surveillance, Epidemiology, and End Results (SEER) cancer registries—we evaluated factors associated with return to work/school after cancer diagnosis, a belief that cancer had a negative impact on plans for work/school, and reported problems with work/school after diagnosis by using descriptive statistics, χ2 tests, and multivariate logistic regression. Results More than 72% (282 of 388) of patients working or in school full-time before diagnosis had returned to full-time work or school 15 to 35 months postdiagnosis compared with 34% (14 of 41) of previously part-time workers/students, 7% (one of 14) of homemakers, and 25% (five of 20) of unemployed/disabled patients (P < .001). Among full-time workers/students before diagnosis, patients who were uninsured (odds ratio [OR], 0.21; 95% CI, 0.07 to 0.67; no insurance v employer-/school-sponsored insurance) or quit working directly after diagnosis (OR, 0.15; 95% CI, 0.06 to 0.37; quit v no change) were least likely to return. Very intensive cancer treatment and quitting work/school were associated with a belief that cancer negatively influenced plans for work/school. Finally, more than 50% of full-time workers/students reported problems with work/studies after diagnosis. Conclusion Although most AYA patients with cancer return to work after cancer, treatment intensity, not having insurance, and quitting work/school directly after diagnosis can influence work/educational outcomes. Future research should investigate underlying causes for these differences and best practices for

  17. [Sexy cancer--sexuality for cancer patients].

    Science.gov (United States)

    Peleg-Nesher, Sharon; Yachini, Brurya; Inbar, Moshe

    2009-09-01

    Sexuality is a basic need for every human being as long as he or she is alive, irrespective of age or health status. Approximately 23,500 individuals are diagnosed with cancer each year in Israel and join the 120,000 cancer patients currently living in Israel. The results of cancer treatments are traditionally assessed and based on the outcome regarding mortality versus survival. An equally important aspect to be addressed in this assessment must relate to quality of life. One of the more painful insults to the quality of life of cancer patients relates to the deleterious effects on sexuality. This article aims to present physicians with the spectrum of sexuality-related issues which are encountered by cancer patients and their partners, starting from the moment of diagnosis, throughout the various stages of treatment and to provide basic knowledge. Many individuals contracting cancer have difficulty dealing with the issue of sexuality. They are typically embarrassed and feel uneasy when asking health care providers about such a non-life threatening issue. Partners similarly feel both shame and guilt. In many cases sexuality, intimacy and emotional attachment are important aspects and may be essential for survival. Addressing these issues during treatment can provide patients with a sense of security, avoiding embarrassment and further exacerbation of such problems. Unfortunately, little has been done to develop an optimal interventional program, although standard sexual treatments have often been applied. Prospective clinical research and outcomes are missing. The physician can use the well-known PLISSIT model (1978): to provide sexuality involvement on different levels. The very new BETTER model (2004) can help emphasize that cancer treatment and the disease have an influence on intimacy and sexuality.

  18. Managing an Older Adult with Cancer: Considerations for Radiation Oncologists

    Directory of Open Access Journals (Sweden)

    Sanders Chang

    2017-01-01

    Full Text Available Older adults with cancer present a unique set of management complexities for oncologists and radiation oncologists. Prognosis and resilience to cancer treatments are notably dependent on the presence or risk of “geriatric syndromes,” in addition to cancer stage and histology. Recognition, proper evaluation, and management of these conditions in conjunction with management of the cancer itself are critical and can be accomplished by utilization of various geriatric assessment tools. Here we review principles of the geriatric assessment, common geriatric syndromes, and application of these concepts to multidisciplinary oncologic treatment. Older patients may experience toxicities related to treatments that impact treatment effectiveness, quality of life, treatment-related mortality, and treatment compliance. Treatment-related burdens from radiotherapy are increasingly important considerations and include procedural demands, travel, costs, and temporary or permanent loss of functional independence. An overall approach to delivering radiotherapy to an older cancer patient requires a comprehensive assessment of both physical and nonphysical factors that may impact treatment outcome. Patient and family-centered communication is also an important part of developing a shared understanding of illness and reasonable expectations of treatment.

  19. Nitrous oxide/oxygen mixture for analgesia in adult cancer patients with breakthrough pain: A randomized, double-blind controlled trial.

    Science.gov (United States)

    Liu, Q; Gao, L-L; Dai, Y-L; Li, Y-X; Wang, Y; Bai, C-F; Mu, G-X; Chai, X-M; Han, W-J; Zhou, L-J; Zhang, Y-J; Tang, L; Liu, J; Yu, J-Q

    2017-12-11

    The aim of this study was to assess the efficacy of a fixed nitrous oxide/oxygen mixture for the management of breakthrough cancer pain. A double-blind, placebo-controlled, randomized clinical trial was undertaken in the Medical ward of Tumor Hospital of General Hospital of Ningxia Medical University. 240 cancer patients with breakthrough pain were recruited and randomly received a standard pain treatment (morphine sulphate immediate release) plus a pre-prepared nitrous oxide/oxygen mixture, or the standard pain treatment plus oxygen. The primary endpoint measure was the numerical rating scale (NRS) score measured at baseline, 5 and 15 min after the beginning of treatment, and at 5 min post treatment. In all, analysis of pain score (NRS) at 5 min after the beginning of treatment shown a significant decrease in nitrous oxide/oxygen mixture treated patients with 2.8 ± 1.3 versus 5.5 ± 1.2 in controls (p nitrous oxide/oxygen was 2.0 ± 1.1 compared with 5.6 ± 1.3 for oxygen (p nitrous oxide/oxygen mixture was effective in reducing moderate to severe breakthrough pain among patients with cancer. The management of breakthrough cancer pain is always a challenge due to its temporal characteristics of rapid onset, moderate to severe in intensity, short duration (median 30-60 min). Our study find that self-administered nitrous oxide/oxygen mixture was effective in reducing moderate to severe breakthrough cancer pain. © 2017 European Pain Federation - EFIC®.

  20. Cardiovascular Disease in Survivors of Adolescent and Young Adult Cancer

    DEFF Research Database (Denmark)

    Rugbjerg, Kathrine; Mellemkjaer, Lene; Boice, John D

    2014-01-01

    at ages 15 to 39 years (1943-2009) and alive in 1977; from the Danish Civil Registration System, we randomly selected a comparison cohort of the same age and sex. Subjects were linked to the Danish Patient Register, and observed numbers of first hospitalizations for cardiovascular disease (International......BACKGROUND: Cardiovascular disease has emerged as a serious late effect in survivors of adolescent and young adult cancer, but risk has not been quantified comprehensively in a population-based setting. METHODS: In the Danish Cancer Registry, we identified 43153 1-year survivors of cancer diagnosed......-sided. RESULTS: During follow-up, 10591 survivors (24.5%) were discharged from the hospital with cardiovascular disease, whereas 8124 were expected (RR = 1.30; 95% confidence interval [CI)] = 1.28 to 1.33; P cardiovascular disease per 100000...

  1. Chronic diseases among older cancer patients.

    OpenAIRE

    Deckx, L.D.; Akker, M.A. van der; Metsemakers, J.M.; Knottnerus, A.K.; Schellevis, F.G.; Buntinx, F.B.

    2011-01-01

    Introduction: With the growing number of older cancer patients, the burden of chronic diseases among older cancer patients will become increasingly important. Chronic diseases often interfere with treatment decisions and prognosis for cancer patients. However, little is known about the occurrence of chronic diseases among older cancer patients. Aim: We aim to examine the frequency of pre-existing and subsequent chronic diseases among cancer patients above age 60 in comparison with non-cancer ...

  2. Bone health in cancer patients

    DEFF Research Database (Denmark)

    Coleman, R; Body, J J; Aapro, M

    2014-01-01

    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...... 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....... This endocrine disturbance results in accelerated bone loss and an increased risk of osteoporosis and fractures that can have a significant negative impact on the lives of the rapidly expanding number of long-term cancer survivors. Finally, the bone marrow micro-environment is also intimately involved...

  3. Cancer Patients Caregivers Comfort

    Directory of Open Access Journals (Sweden)

    Daniela de Araújo Lamino

    2014-04-01

    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.

  4. Swallowing dysfunction in cancer patients.

    Science.gov (United States)

    Raber-Durlacher, Judith E; Brennan, Mike T; Verdonck-de Leeuw, Irma M; Gibson, Rachel J; Eilers, June G; Waltimo, Tuomas; Bots, Casper P; Michelet, Marisol; Sollecito, Thomas P; Rouleau, Tanya S; Sewnaik, Aniel; Bensadoun, Rene-Jean; Fliedner, Monica C; Silverman, Sol; Spijkervet, Fred K L

    2012-03-01

    Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools, prevalence, complications, and impact on quality of life in patients with a variety of different cancers, particularly in those treated with curative chemoradiation for head and neck cancer. The literature search was limited to the English language and included both MEDLINE/PubMed and EMBASE. The search focused on papers reporting dysphagia as a side effect of cancer and cancer therapy. We identified relevant literature through the primary literature search and by articles identified in references. A wide range of assessment tools for dysphagia was identified. Dysphagia is related to a number of factors such as direct impact of the tumor, cancer resection, chemotherapy, and radiotherapy and to newer therapies such as epidermal growth factor receptor inhibitors. Concomitant oral complications such as xerostomia may exacerbate subjective dysphagia. Most literature focuses on head and neck cancer, but dysphagia is also common in other types of cancer. Swallowing impairment is a clinically relevant acute and long-term complication in patients with a wide variety of cancers. More prospective studies on the course of dysphagia and impact on quality of life from baseline to long-term follow-up after various treatment modalities, including targeted therapies, are needed.

  5. Emerging markers of cachexia predict survival in cancer patients

    OpenAIRE

    Mondello, Patrizia; Lacquaniti,Antonio; Mondello, Stefania; Bolignano, Davide; Pitini, Vincenzo; Aloisi, Carmela; Buemi, Michele

    2014-01-01

    Background Cachexia may occur in 40% of cancer patients, representing the major cause of death in more than 20% of them. The aim of this study was to investigate the role of leptin, ghrelin and obestatin as diagnostic and predictive markers of cachexia in oncologic patients. Their impact on patient survival was also evaluated. Methods 140 adults with different cancer diagnoses were recruited. Thirty healthy volunteers served as control. Serum ghrelin, obestatin and leptin were tested at basel...

  6. Informal education and health promoting approaches in adult cancer survivors.

    Science.gov (United States)

    Argyriou, A A; Ifanti, A A; Kalofonos, H

    2011-01-01

    This review looks at the available data relating to the informal education aspects and other health promoting approaches applied by adult cancer survivors to reduce the risk of cancer. The implications of such behavioral interventions on oncology practice are discussed. We also highlight areas of future research to pursue. Available data show that many cancer survivors remain engaged in risky health behaviors post-diagnosis, which are associated with an increased risk of disease's recurrence. However, over the last years patients seem to increasingly receive adequate risk-based medical care. The application of appropriate informal education approaches, such as diet, exercise, and cessation of former unhealthy habits, such as smoking and alcohol has facilitated behavioral changes in cancer survivors, thoroughly improving their well being and overall quality of life (QOL). Most of the research studies published to date have applied structured lifestyle interventions on intensive, individualized counseling sessions delivered by trained personnel or psychosocial-based mediations and reported that these approaches are largely effective in promoting the adoption of a healthier lifestyle in cancer survivors. These interventions have been reported to reduce the risk of cancer recurrence and thus to obtain an obvious positive impact on their well-being and overall QOL. However, there is still insufficient evidence to conclude and support with confidence the effectiveness of any of these behavioral interventions and therefore future interventions should be initiated to assess the long-term effects and validating outcomes of lifestyle and other psychosocial interventions.

  7. Fertility preservation in young patients with cancer

    Directory of Open Access Journals (Sweden)

    Virender Suhag

    2015-01-01

    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.

  8. Social Media: Support for Survivors and Young Adults With Cancer.

    Science.gov (United States)

    Walton, AnnMarie L; Albrecht, Tara A; Lux, Lauren; Judge Santacroce, Sheila

    2017-10-01

    Social media use is ubiquitous among young adults. Young adults with cancer must make important decisions about where, what, and how to share information on social media. Oncology nurses are in a unique position to start conversations about the risks and benefits of social media use. This column aims to review a variety of social media platforms that may be used by young adults with cancer and provide guidance to nurses on initiating open dialogue with young adults about social media usage. 
.

  9. Use of general practice, diagnostic investigations and hospital services before and after cancer diagnosis - a population-based nationwide registry study of 127,000 incident adult cancer patients

    Directory of Open Access Journals (Sweden)

    Christensen Karina

    2012-07-01

    Full Text Available Abstract Background Knowledge of patterns in cancer patients’ health care utilisation around the time of diagnosis may guide health care resource allocation and provide important insights into this groups’ demand for health care services. The health care need of patients with comorbid conditions far exceeds the oncology capacity and it is therefore important to elucidate the role of both primary and secondary care. The aim of this paper is to describe the use of health care services amongst incident cancer patients in Denmark one year before and one year after cancer diagnosis. Methods The present study is a national population-based case–control (1:10 registry study. All incident cancer patients (n = 127,210 diagnosed between 2001 and 2006 aged 40 years or older were identified in the Danish Cancer Registry. Data from national health registries were provided for all cancer patients and for 1,272,100 controls. Monthly consultation frequencies, monthly proportions of persons receiving health services and three-month incidence rate ratios for one year before and one year after the cancer diagnosis were calculated. Data were analysed separately for women and men. Results Three months before their diagnosis, cancer patients had twice as many general practitioner (GP consultations, ten to eleven times more diagnostic investigations and five times more hospital contacts than the reference population. The demand for GP services peaked one month before diagnosis, the demand for diagnostic investigations one month after diagnosis and the number of hospital contacts three months after diagnosis. The proportion of cancer patients receiving each of these three types of health services remained more than 10% above that of the reference population from two months before diagnosis until the end of the study period. Conclusions Cancer patients’ health service utilisation rose dramatically three months before their diagnosis. This increase applied to

  10. Cancer patients and mass media

    Directory of Open Access Journals (Sweden)

    Mirjana Rajer

    2015-06-01

    Full Text Available ABSTRACTBACKGROUNDNowadays cancer patients tend to be more involved in the medical decision process. Active participation improves health outcomes and patient satisfaction. To participate effectively patients require a huge amount of information, but time limits make it impossible to satisfy all information needs at clinics. We tried to find out which kind of media cancer patients use when searching for information and how often. Lastly, we try to find out how popular the Internet is in this regard.METODSIn this research we invited cancer patients, who had regular clinic examinations at the Oncology Institute between 21st and 25th May in 2012. We carried out a prospective research by anonymous questionnaires. We were investigating which media were used and how often. We analysed results with descriptive statistics, ANOVA, the χ²-Test and the t-test.RESULTS478 of 919 questionnaires distributed among cancer patients were returned. Mean age was 59.9 years. 61 % of responders were female, and the most common level of education was high school (33 %. Most common cancer type was breast cancer (33 %, followed by gastrointestinal and lung cancer. Patients search for information most often on television (81.4% responders, followed by specialized brochures (78%, internet (70.8% and newspapers (67.6%. Patients who do not use media for information searching are older than average (62.5 years vs. 59.9 years; p<0,000.CONCLUSIONSAccording to our results patients search for information most often on television, followed by brochures, internet and newspapers. Older patients less often search for information. This data might help doctors in everyday clinical practice.

  11. Candidaemia and cancer: patients are not all the same

    Directory of Open Access Journals (Sweden)

    Medeiros Lidia

    2006-03-01

    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

  12. Documentation of fertility preservation discussions for young adults with cancer: Examining compliance with treatment guidelines

    Science.gov (United States)

    Salsman, John M.; Yanez, Betina; Smith, Kristin N.; Beaumont, Jennifer L.; Snyder, Mallory A.; Barnes, Khouri; Clayman, Marla L.

    2017-01-01

    Background Professional guidelines have been developed to promote discussion between providers and newly diagnosed young adults with cancer about the possibility of cancer treatment-related infertility, but previous research suggests many young adults fail to receive this information. The aim of this study was to examine rates of and factors predictive of oncologists’ compliance with national guidelines for discussing potential treatment-related infertility with newly diagnosed young adults seen at an NCI-designated comprehensive cancer center. Methods We reviewed data from the electronic medical record for new clinic encounters between medical oncologists and young adults with cancer (ages 18–39) from 2010 to 2012. Data from oncologist discussions of fertility preservation were abstracted, as were patient (age, gender, race, ethnicity, cancer type) and oncologist (gender, graduation year from fellowship) characteristics. Results 1018 cases were reviewed with 454 patients (M=31.5 years old, 67.8% women) meeting inclusion criteria. Overall, 83% of patients were informed about potential treatment-related infertility with patients with breast cancer (85% informed), Hodgkin lymphoma (95% informed), Non-Hodgkin lymphoma (94% informed), leukemia (88% informed) or testicular cancer (100% informed) more likely to be informed than other cancer types (60%–74% informed). There was a significant effect for patient gender (OR=3.57, CI: 1.33, 9.60, p=0.012) with females being more likely to be informed than males. Conclusions Reported compliance with fertility preservation guidelines was greater than published rates. Higher compliance rates in female patients and in patients with cancers more common among young adults may reflect greater awareness of fertility-related concerns among these patients and their providers. PMID:26957616

  13. Pattern of chemotherapy-related adverse effects among adult cancer patients treated at Gondar University Referral Hospital, Ethiopia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Belachew SA

    2016-12-01

    Full Text Available Sewunet Admasu Belachew,1 Daniel Asfaw Erku,2 Abebe Basazn Mekuria,3 Begashaw Melaku Gebresillassie1 1Department of Clinical Pharmacy, 2Department of Pharmaceutical Sciences, 3Department of Pharmacology, School of Pharmacy, University of Gondar, Gondar, Ethiopia Background: Adverse drug reactions (ADRs are a global problem and constitute a major clinical problem in terms of human suffering. The high toxicity and narrow therapeutic index of chemotherapeutic agents makes oncology pharmacovigilance essential. The objective of the present study was to assess the pattern of ADRs occurring in cancer patients treated with chemotherapy in a tertiary care teaching hospital in Ethiopia.Methods: A cross-sectional study over a 2-year period from September 2013 to August 2015 was conducted on cancer patients undergoing chemotherapy at Gondar University Referral Hospital Oncology Center. Data were collected directly from patients and their medical case files. The reported ADRs were assessed for causality using the World Health Organization’s causality assessment scale and Naranjo’s algorithm. The severities of the reported reactions were also assessed using National Cancer Institute Common Terminology CTCAE version 4.0. The Pearson’s chi-square test was employed to examine the association between two categorical variables.Results: A total of 815 ADRs were identified per 203 patients included in the study. The most commonly occurring ADRs were nausea and vomiting (18.9%, infections (16.7%, neutropenia (14.7%, fever and/or chills (11.3%, and anemia (9.3%. Platinum compounds (31.4% were the most common group of drugs causing ADRs. Of the reported ADRs, 65.8% were grades 3–4 (severe level, 29.9% were grades 1–2 (mild level, and 4.3% were grade 5 (toxic level. Significant association was found between age, number of chemotherapeutic agents, as well as dose of chemotherapy with the occurrence of grades 3–5 toxicity.Conclusion: The high incidence of

  14. Observational study of the development and evaluation of a fertility preservation patient decision aid for teenage and adult women diagnosed with cancer: the Cancer, Fertility and Me research protocol.

    Science.gov (United States)

    Jones, G L; Hughes, J; Mahmoodi, N; Greenfield, D; Brauten-Smith, G; Skull, J; Gath, J; Yeomanson, D; Baskind, E; Snowden, J A; Jacques, R M; Velikova, G; Collins, K; Stark, D; Phillips, R; Lane, S; Bekker, H L

    2017-03-13

    Women diagnosed with cancer and facing potentially sterilising cancer treatment have to make time-pressured decisions regarding fertility preservation with specialist fertility services while undergoing treatment of their cancer with oncology services. Oncologists identify a need for resources enabling them to support women's fertility preservation decisions more effectively; women report wanting more specialist information to make these decisions. The overall aim of the 'Cancer, Fertility and Me' study is to develop and evaluate a new evidence-based patient decision aid (PtDA) for women with any cancer considering fertility preservation to address this unmet need. This is a prospective mixed-method observational study including women of reproductive age (16 years +) with a new diagnosis of any cancer across two regional cancer and fertility centres in Yorkshire, UK. The research involves three stages. In stage 1, the aim is to develop the PtDA using a systematic method of evidence synthesis and multidisciplinary expert review of current clinical practice and patient information. In stage 2, the aim is to assess the face validity of the PtDA. Feedback on its content and format will be ascertained using questionnaires and interviews with patients, user groups and key stakeholders. Finally, in stage 3 the acceptability of using this resource when integrated into usual cancer care pathways at the point of cancer diagnosis and treatment planning will be evaluated. This will involve a quantitative and qualitative evaluation of the PtDA in clinical practice. Measures chosen include using count data of the PtDAs administered in clinics and accessed online, decisional and patient-reported outcome measures and qualitative feedback. Quantitative data will be analysed using descriptive statistics, paired sample t-tests and CIs; interviews will be analysed using thematic analysis. Research Ethics Committee approval (Ref: 16/EM/0122) and Health Research Authority approval

  15. Balancing truth-telling: relatives acting as translators for older adult cancer patients of Turkish or northwest African origin in Belgium.

    Science.gov (United States)

    van Eechoud, I; Grypdonck, M; Leman, J; Van Den Noortgate, N; Deveugele, M; Verhaeghe, S

    2017-09-01

    The first generation of Turkish and Northwest African immigrants in Belgium are ageing and at risk for developing cancer. Relatives play an important role and provide both emotional and practical care, including mental support and acting as a contact person and/or a translator for improving access to healthcare, as most patients and their spouses have only a limited command of the language. Although access to professional interpreters has shown to be the best guarantee for qualitative healthcare, oncology health providers working with relatives as interpreters is much more common than professional interpreters. The aim of this study was to provide insight into the process wherein relatives balance truth-telling in translating for an older family member diagnosed with cancer. This was a qualitative research study, with elements of constructivist grounded theory. Twenty-eight loosely structured interviews were conducted. Most relatives consider it their responsibility to contribute to a positive attitude of the patient. Relatives decided to what extent they inform the patient, based on several motives and embedded in their assessment of the patient's emotional strength, understanding and need to be informed. What they decide influences the way they act as a translator and/or a contact person between the patient and health professional(s). Some considered it best to omit medical information while others considered it best to inform the patient fully. The results emphasise the importance for healthcare providers to take into account the complexity and unpredictable character of the process of balancing truth-telling when family members translate for their ill older relative. © 2016 John Wiley & Sons Ltd.

  16. Contributors and Inhibitors of Resilience Among Adolescents and Young Adults with Cancer

    OpenAIRE

    Rosenberg, Abby R.; Yi-Frazier, Joyce P.; Wharton, Claire; Gordon, Karen; Jones, Barbara

    2014-01-01

    Purpose: Self-perceived resilience may enable coping and mitigate poor psychosocial outcomes among adolescent and young adult (AYA) patients with cancer. In order to inform the development of resilience-promoting interventions, we aimed to: (1) describe AYA patient-reported resilience and (2) identify AYA patient-reported contributors and inhibitors of resilience.

  17. Childhood height, adult height, and the risk of prostate cancer

    DEFF Research Database (Denmark)

    Bjerregaard, Lise Geisler; Aarestrup, Julie; Gamborg, Michael

    2016-01-01

    through linkage to the Danish Cancer Registry. Direct and total effects of childhood height on prostate cancer risk were estimated from Cox regressions. RESULTS: From 1996 to 2012, 429 prostate cancers occurred. Child and adult heights were positively and significantly associated with prostate cancer risk.......15 [95 % confidence interval (CI) 1.01-1.32]. CONCLUSIONS: The effect of height at 13 years on the risk of prostate cancer was not entirely mediated through adult height, suggesting that child height and adult height may be associated with prostate cancer through different pathways.......PURPOSE: We previously showed that childhood height is positively associated with prostate cancer risk. It is, however, unknown whether childhood height exerts its effects independently of or through adult height. We investigated whether and to what extent childhood height has a direct effect...

  18. Social comparisons in cancer patients

    Directory of Open Access Journals (Sweden)

    Abraham P. Buunk

    2015-09-01

    Full Text Available Social comparison refers to relating one ́s own characteristics to those of other individuals. Due to the enhanced degree of physical distress, depression, and uncertainty, cancer patients tend to compare themselves often with other patients, especially when they are high in social comparison orientation, i.e. in the dispositional tendency to compare themselves with others. Downward comparison, i.e. with others who are worse- off, may contribute to the well-being of cancer patients when it is interpreted as a contrast, i.e. when it is emphased how much better-off one is oneself. Nevertheless, cancer patients tend to prefer information about other patients who are better-off, and such upward comparison may improve coping and contribute to well-being. 

  19. Hope in Patients with Cancer

    Directory of Open Access Journals (Sweden)

    Selma Turan Kavradim

    2014-06-01

    Full Text Available Cancer, which is one of the major health problems leading to despair, uncertainty, pain and suffering, is perceived as a serious and chronic disease. Cancer negatively affects individuals' quality of life due to the physical, psychological, and socio-economic problems. Today, despite inspiring advances in diagnosis and treatment of cancer and increase in survival rates of patients, appearance of physical and psycho-social disorders during cancer course disrupts the adaptation mechanisms of patients and undermines expectations for the future. Most of the time in clinical practice, clinicians focus on physical assessments and treatment planning of cancer patients primarily, ignoring social, psychological, economic and cultural factors related with the disease. This approach definitely influences patients' hope levels and their effective dealing with the disease. The aim of this article is to guide medical staff and increase awareness about the concept of hope in patients with cancer. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 154-164

  20. Heart failure following blood cancer therapy in pediatric and adult populations.

    Science.gov (United States)

    Franzon, Julie; Berry, Narelle M; Ullah, Shahid; Versace, Vincent L; McCarthy, Alexandra L; Atherton, John; Roder, David; Koczwara, Bogda; Coghlan, Douglas; Clark, Robyn A

    2017-10-12

    The link between chemotherapy treatment and cardiotoxicity is well established, particularly for adults with blood cancers. However, it is less clear for children. This analysis aimed to compare the trajectory and mortality of children and adults who received chemotherapy for blood cancers and were subsequently hospitalized for heart failure. Linked data from the Queensland Cancer Registry, Death Registry and Hospital Administration records for initial chemotherapy and later heart failure were reviewed (1996-2009). Of all identified blood cancer patients (N = 23 434), 8339 received chemotherapy, including 817 children (aged ≤18 years at time of cancer diagnosis) and 7522 adults. Time-varying Cox proportional hazards regression models were used to compare the characteristics and survival between the two groups. Of those who were subsequently hospitalized for heart failure, 70% of children and 46% of adults had the index admission within 12 months of their cancer diagnosis. Of these, 53% of the pediatric heart failure population and 71% of the adult heart failure population died within the study period. Following adjustment for age, sex and chemotherapy admissions, children with heart failure had an increased mortality risk compared to their non-heart failure counterparts, a difference which was much greater than that between the adult groups. The impact of heart failure on children previously treated for blood cancer is more severe than for adults, with earlier morbidity and greater mortality. Improved strategies are needed for the prevention and management of cardiotoxicity in this population. © 2017 John Wiley & Sons Australia, Ltd.

  1. Issues of hope and faith in the cancer patient.

    Science.gov (United States)

    Carni, E

    1988-12-01

    Akira Kurosawa's 1952 film about a man with a terminal gastric cancer introduces a discussion of hope and faith in the oncology patient. A psychodynamic relationship between hope and faith is explored, using Lawrence LeShan's research in cancer psychotherapy and Erik Erikson's lifespan developmental theory. LeShan describes a cancer personality characterized by hopeless despair, while Erikson formulates a psychogenetic framework for the development of hope and despair. Hope and faith are linked through the individual's earliest strivings toward basic trust in the world and his or her own self-efficacy. Accordingly, cancer psychotherapy may aim at restoring adult patients' faith in life and inner creative resources.

  2. Incidence of colorectal cancer in young patients

    Directory of Open Access Journals (Sweden)

    FÁBIO GUILHERME C. M. DE CAMPOS

    Full Text Available ABSTRACT Sporadic colorectal cancer (CRC is traditionally diagnosed after de sixth decade of life, although a small percentage of cases are diagnosed in patients under 40 years of age, and incidence is increasing. There exists a great volume of controversy regarding clinical outcome of young patients diagnosed with colorectal cancer (CRC when compared to elder counterparts. Our aims were to evaluate the rate of CRC in young patients, to review the pertaining literature and to discuss outcomes and clinical prognosis. A retrospective review involving patients with CRC was undertaken, focusing on age at diagnosis. The information extracted from this literature review showed a trend towards a decreased incidence in older people with an opposite effect among adolescents and young adults. Moreover, biological aggressiveness in young adults diagnosed with CRC has not been fully recognized, although it is usually diagnosed later and in association with adverse histological features. Besides that, these features don't affect outcome. These apparent increase in CRC incidence among young patients during the last decades raises the need for a greater suspicious when evaluating common symptoms in this group. Thus, educational programs should widespread information for both population and physicians to improve prevention and early diagnosis results.

  3. Occupational therapy use by older adults with cancer.

    Science.gov (United States)

    Pergolotti, Mackenzi; Cutchin, Malcolm P; Weinberger, Morris; Meyer, Anne-Marie

    2014-01-01

    Occupational therapy may significantly improve cancer survivors' ability to participate in activities, thereby improving quality of life. Little is known, however, about the use of occupational therapy services by adults with cancer. The objective of this study was to understand what shapes patterns of occupational therapy use to help improve service delivery. We examined older (age >65 yr) adults diagnosed with breast, prostate, lung, or melanoma (skin) cancer between 2004 and 2007 (N = 27,131) using North Carolina Central Cancer Registry data linked to Medicare billing claims. Survivors who used occupational therapy within 1 yr before their cancer diagnosis were more likely to use occupational therapy after diagnosis but also experienced the highest levels of comorbidities. Survivors with Stage 4 cancers or lung cancer were less likely to use occupational therapy. These findings suggest possible disparities in utilization of occupational therapy by older adults with cancer. Copyright © 2014 by the American Occupational Therapy Association, Inc.

  4. Occupational Therapy Use by Older Adults With Cancer

    Science.gov (United States)

    Pergolotti, Mackenzi; Cutchin, Malcolm P.; Weinberger, Morris; Meyer, Anne-Marie

    2014-01-01

    Occupational therapy may significantly improve cancer survivors’ ability to participate in activities, thereby improving quality of life. Little is known, however, about the use of occupational therapy services by adults with cancer. The objective of this study was to understand what shapes patterns of occupational therapy use to help improve service delivery. We examined older (age >65 yr) adults diagnosed with breast, prostate, lung, or melanoma (skin) cancer between 2004 and 2007 (N = 27,131) using North Carolina Central Cancer Registry data linked to Medicare billing claims. Survivors who used occupational therapy within 1 yr before their cancer diagnosis were more likely to use occupational therapy after diagnosis but also experienced the highest levels of comorbidities. Survivors with Stage 4 cancers or lung cancer were less likely to use occupational therapy. These findings suggest possible disparities in utilization of occupational therapy by older adults with cancer. PMID:25184473

  5. Have We Improved Pain Control in Cancer Patients? A Multicenter Study of Ambulatory and Hospitalized Cancer Patients.

    Science.gov (United States)

    Porta-Sales, Josep; Nabal-Vicuna, Maria; Vallano, Antonio; Espinosa, Jose; Planas-Domingo, Josep; Verger-Fransoy, Eugènia; Julià-Torras, Joaquim; Serna, Judith; Pascual-López, Antonio; Rodríguez, Dulce; Grimau, Isidre; Morlans, Germà; Sala-Rovira, Carme; Calsina-Berna, Agnes; Borras-Andrés, Josep Ma; Gomez-Batiste, Xavier

    2015-11-01

    Pain in cancer patients is recognized as a major health problem, yet few studies of both inpatient and outpatient populations have been carried out. The study objective was to assess the frequency, type, and characteristics of pain in adult cancer patients, including both inpatients and outpatients. This cross-sectional study involved 1064 adult cancer patients (437 outpatients and 627 inpatients) from 44 hospitals and/or long-term-care centers in Catalonia, Spain. Cancer patients suffering from pain of any etiology for ≥2 weeks and/or under analgesic treatment ≥2 weeks were enrolled. Demographic and pain data were collected. The Spanish version of the Brief Pain Inventory was used to assess pain. Pain frequency was 55.3%. Pain was less frequent in outpatients than inpatients (41.6% versus 64.7%; ppatients, and intensity was similar in both out- and inpatients; however, outpatients reported less improvement, less pain interference with daily life, and less pain related to the cancer per se. In both groups, patients with multiple myeloma (73%), breast (65%), and lung cancer (61%) were most likely to report pain. Pain in cancer patients, both ambulatory and hospitalized, remains a challenge for health care professionals, health administrators, and stakeholders. Our study reveals the high level of pain and distress that cancer patients continue to suffer, a problem that is particularly notable in outpatients due to the intensity and duration of the pain.

  6. Teenagers and young adults with cancer in Europe: from national programmes to a European integrated coordinated project

    DEFF Research Database (Denmark)

    Stark, D; Bielack, S; Brugieres, L

    2016-01-01

    Over 14 000 patients aged 15-24 are estimated to be diagnosed with cancer in the European Union (EU) each year. Teenagers and young adults (TYA) often fall down gaps between children's and adults cancer services. The specific challenges of providing optimal care to them are described, but we...... Network for Cancer Research in Children and Adolescents programme (ENCCA), a specific European Network for Teenagers and Young Adults with Cancer has held a series of scientific meetings, including professionals, patients and caregivers. This group has proposed unanswered research questions and agreed key...

  7. No excess fatigue in young adult survivors of childhood cancer

    NARCIS (Netherlands)

    Langeveld, N. E.; Grootenhuis, M. A.; Voûte, P. A.; de Haan, R. J.; van den Bos, C.

    2003-01-01

    Clinical reports suggest that many survivors of childhood cancer experience fatigue as a long-term effect of their treatment. To investigate this issue further, we assessed the level of fatigue in young adult survivors of childhood cancer. We compared the results with a group of young adults with no

  8. Patient-centered communication between adolescent and young adult cancer survivors and their healthcare providers: Identifying research gaps with a scoping review.

    Science.gov (United States)

    Gorman, Jessica R; Standridge, Daniel; Lyons, Karen S; Elliot, Diane L; Winters-Stone, Kerri; Julian, Anne K; Weprin, Jennifer; Storksdieck, Martin; Hayes-Lattin, Brandon

    2017-09-01

    To conduct a scoping literature review to identify practices or programs that promote AYA patient-centered communication. Between January and May of 2016, we applied standard scoping review methodology to systematically review articles. We considered peer-reviewed, English language articles written at any phase of intervention research. Both qualitative and quantitative studies were eligible, and no additional search restrictions were applied. We retained articles that included explicit or implicit outcomes for one of the six functions of patient-centered communication in cancer care. At least two independent reviewers assessed the articles. We screened a total of 4072 titles and abstracts, retaining 27 for full-text review. Ultimately, eight titles met the review's inclusion criteria. We categorized each publication by the action or setting used to improve patient-centered communication, resulting in five categories. Most studies were not included because they did not include a patient-centered communication outcome. This area of research is still emerging, as indicated by the small number of eligible studies and predominance of qualitative, descriptive, pilot, and feasibility studies with small sample sizes. Our results suggest a clear need to develop and evaluate interventions focused on improving patient-centered communication between AYA survivors and their healthcare providers. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Individualized Approach to Cancer Screening in Older Adults.

    Science.gov (United States)

    Lee, Kimberley T; Harris, Russell P; Schoenborn, Nancy L

    2018-02-01

    The primary goal of cancer screening is early detection of cancer to reduce cancer-specific mortality and morbidity. The benefits of screening in older adults are uncertain due to paucity of evidence. Extrapolating data from younger populations, evidence suggests that the benefit occurs years later from the time of initial screening and therefore may not be applicable in those older adults with limited life expectancy. Contrast this with the harms of screening, which are more immediate and increase with age and comorbidities. An individualized approach to cancer screening takes these factors into consideration, allowing for thoughtful decision making for older adults. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Is admittance to specialised palliative care among cancer patients related to sex, age and cancer diagnosis?

    DEFF Research Database (Denmark)

    Adsersen, Mathilde; Thygesen, Lau Caspar; Jensen, Anders Bonde

    2017-01-01

    /units. Patients with brain cancer were more often admitted to hospices, whereas patients with prostate cancer were more often admitted to hospital-based palliative care teams/units. CONCLUSION: It is unlikely that the variations in relation to sex, age and cancer diagnoses can be fully explained by differences...... to investigate whether cancer patients' admittance to SPC in Denmark varied in relation to sex, age and diagnosis, and whether the patterns differed by type of institution (hospital-based palliative care team/unit, hospice, or both). METHODS: This was a register-based study of adult patients living in Denmark...... who died from cancer in 2010-2012. Data sources were the Danish Palliative Care Database, Danish Register of Causes of Death and Danish Cancer Registry. The associations between the explanatory variables (sex, age, diagnosis) and admittance to SPC were investigated using logistic regression. RESULTS...

  11. Risk Factors for Thyroid Cancer: A Hospital-Based Case-Control Study in Korean Adults

    OpenAIRE

    Myung, Seung-Kwon; Lee, Chan Wha; Lee, Jeonghee; Kim, Jeongseon; Kim, Hyeon Suk

    2016-01-01

    Purpose Although the incidence of thyroid cancer in Korea has rapidly increased over the past decade, few studies have investigated its risk factors. This study examined the risk factors for thyroid cancer in Korean adults. Materials and Methods The study design was a hospital-based case-control study. Between August 2002 and December 2011, a total of 802 thyroid cancer cases out of 34,211 patients screened from the Cancer Screenee. Cohort of the National Cancer Center in South Korea were inc...

  12. Long-term non-cancer mortality in pediatric and young adult cancer survivors in Finland.

    Science.gov (United States)

    Prasad, Pinki K; Signorello, Lisa B; Friedman, Debra L; Boice, John D; Pukkala, Eero

    2012-03-01

    Excess late mortality has been reported among pediatric cancer survivors, but there is a need to further establish risk profiles for non-cancer death and to examine cause-specific mortality among survivors of young adult cancers. In a nationwide record linkage study in Finland, we identified 9,245 5-year cancer survivors diagnosed before age 35 and treated between 1966 and 1999, and followed them for mortality endpoints from 1971 to 2008. Standardized mortality ratios (SMRs) and 95% confidence intervals (95% CIs) were calculated to compare the observed number of deaths with those expected in the general Finnish population. Primary endpoints included death from cardiovascular and respiratory diseases; death from malignant diseases was excluded. Non-malignant disease mortality in the cohort was 90% higher (SMR=1.9, 95% CI: 1.7-2.2) than expected, with SMRs for circulatory and respiratory disease similarly elevated (SMR=1.9, 95% CI: 1.5-2.3 and SMR=2.3, 95% CI: 1.3-3.8, respectively). Important differences were noted amongst patient subgroups, with risk greatest for survivors of central nervous system (CNS) cancer, Hodgkin lymphoma (HL), and non-Hodgkin lymphoma (NHL). The SMR's for circulatory disease were 6.6 (95% CI: 4.8-8.9) for HL and 4.8 (95% CI: 2.6-8.1) for NHL for the entire population; but these risks remained elevated for survivors diagnosed between 15 and 34 years of age. Previous studies have shown that there is an elevated risk of non-cancer mortality in childhood cancer survivors; this is one of the first studies that show an increase in cardiovascular and respiratory mortality in long-term survivors of adolescent and young adult cancers. Copyright © 2011 Wiley Periodicals, Inc.

  13. Suboptimal Vitamin D levels among adult survivors of childhood cancers

    Directory of Open Access Journals (Sweden)

    Denise A. Rokitka

    2016-07-01

    Full Text Available Purpose: Vitamin D plays an important role in many bodily systems, with increasing evidence suggesting its importance for the prevention of chronic diseases and cancer. The identification of vitamin D levels in childhood cancer survivors becomes, therefore, particularly relevant, given that optimizing levels may contribute to the prevention of secondary malignancies and chronic diseases.Methods: A cross - sectional analysis of serum 25 - hydroxyvitamin D levels among adult survivors of childhood cancers living in New York State and surrounding areas (n = 139 was performed. Independent variables included gender, race/ethnicity, cancer site, year of diagnosis, past medical and surgical history, prior radiation therapy; prior chemotherapy, age at diagnosis, age at last clinic visit, year of last clinic visit, height, weight, body mass index, and vitamin D supplementation.Results: Overall, 34% of survivors were vitamin D deficient (< 20 ng/ml, 39% were classified as insufficient (20 - 29 ng/ml and 27% (≥ 30 ng/ml were classified as having sufficient levels. Despite vitamin D supplementation among 41 patients, 68.3% continued to have insufficient or deficient levels. Participants with a BMI > 25 demonstrated lower levels of vitamin D (p < 0.05. Vitamin D levels did not vary by age group, race, ethnicity, diagnosis, or years since diagnosis.Conclusion: Given the growing awareness of the role of vitamin D and the documented late effects of treatment for childhood cancers, the high prevalence of vitamin D deficiency within the childhood cancer survivor population is of concern. Vitamin D represents an important target for surveillance and intervention to help improve long - term outcomes of childhood cancer survivors.

  14. Innovative fertility preservation strategies and programs for young adults with cancer

    Directory of Open Access Journals (Sweden)

    Johnson RH

    2016-01-01

    Full Text Available Rebecca H Johnson Division of Pediatric Hematology/Oncology, Department of Pediatrics, Mary Bridge Hospital, MultiCare Health System, Tacoma, WA, USA Abstract: Preservation of fertility is a key issue for young adults newly diagnosed with cancer. Up to 90% of cancer patients under the age of 45 are at risk for fertility impairment following cancer therapy. Cancer patients who are not offered fertility preservation (FP and those who become infertile following therapy may experience long-term psychosocial distress. This review summarizes the numerous effective strategies for preserving fertility, including sperm banking, electroejaculation, and testicular sperm extraction in males and cryopreservation of embryos or oocytes in females. This paper also highlights novel methods currently in development, such as gonadal tissue cryopreservation and in vitro maturation of gametes. In women, anti-Mullerian hormone is emerging as an accurate marker of ovarian reserve, and the use of gonadotropin releasing hormone analogs to protect fertility is increasingly well validated. Although national guidelines mandate FP counseling and referral prior to the start of cancer therapy for patients with reproductive potential, only a minority of young cancer patients in the USA currently take steps to preserve fertility prior to the start of therapy. Some cancer centers across the USA are developing institutional strategies to support FP, resulting in increased utilization of fertility services by newly diagnosed cancer patients. Keywords: young adult, cancer, fertility preservation, program, oocyte, sperm

  15. General Information about Adult Primary Liver Cancer

    Science.gov (United States)

    ... This type of liver cancer is the third leading cause of cancer-related deaths worldwide. This summary ... Therapy and You: Support for People With Cancer Coping with Cancer Questions to Ask Your Doctor about ...

  16. Stages of Adult Primary Liver Cancer

    Science.gov (United States)

    ... This type of liver cancer is the third leading cause of cancer-related deaths worldwide. This summary ... Therapy and You: Support for People With Cancer Coping with Cancer Questions to Ask Your Doctor about ...

  17. Adult height and age at menarche in childhood cancer survivors

    NARCIS (Netherlands)

    Noorda, E. M.; Somers, R.; van Leeuwen, F. E.; Vulsma, T.; Behrendt, H.

    2001-01-01

    The aim of this study was to assess the long-term effects of cancer treatments on adult height and age at menarche in survivors of various types of childhood cancer. 285 childhood cancer survivors (161 men and 124 women), at least 18 years old and having been off treatment for at least 5 years, were

  18. Hypertension in Patients with Cancer

    Directory of Open Access Journals (Sweden)

    Vinicius Barbosa de Souza

    2015-03-01

    Full Text Available 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.

  19. Hypertension in Patients with Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Vinicius Barbosa de; Silva, Eduardo Nani; Ribeiro, Mario Luiz; Martins, Wolney de Andrade, E-mail: wolney@cardiol.br [Curso de Pós-Graduação em Ciências Cardiovasculares da Universidade Federal Fluminense, Niterói, RJ (Brazil)

    2015-03-15

    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.

  20. Performance of activities of daily living among hospitalized cancer patients

    DEFF Research Database (Denmark)

    Lindahl-Jacobsen, Line; Hansen, Dorte Gilså; Wæhrens, Eva Ejlersen

    2015-01-01

    and characterize ADL task performance problems among a group of adult disabled hospitalized cancer patients using interview and questionnaire data. METHODS: Cross-sectional study on prevalence of ADL task performance problems experienced by disabled hospitalized cancer patients using the Activities of Daily Living...... when using only one of the instruments. CONCLUSION: Adult hospitalized disabled cancer patients experience a high degree and variation in difficulties performing ADL, illustrating the need for a comprehensively planned assessment of problems and needs....... Questionnaire (ADL-Q) (n = 118) and the Canadian Occupational Performance Measure (COPM) (n = 55). RESULTS: All 118 patients reported problems with ADL task performance. Based on the ADL-Q patients reported more problems within instrumental (I-)ADL than personal (P-)ADL. In both I-ADL and P-ADL the results...

  1. A content analysis of emotional concerns expressed at the time of receiving a cancer diagnosis: An observational study of consultations with adolescent and young adult patients and their family members.

    Science.gov (United States)

    Korsvold, Live; Mellblom, Anneli Viktoria; Finset, Arnstein; Ruud, Ellen; Lie, Hanne Cathrine

    2017-02-01

    Little is known about the emotional concerns expressed by adolescent and young adult (AYA) patients in consultations when a diagnosis of cancer is delivered. Here, we investigated the content of such concerns and how health care providers respond to them. We audio-recorded nine consultations with AYA cancer patients (ages: 12-25 years) at the time of diagnosis. We have previously identified and coded 135 emotional concerns and the responses to these in the nine consultations using the Verona Coding Definitions of Emotional Sequences (VR-CoDES) framework. Here, we used qualitative content analysis to study these emotional concerns and categorize them according to overarching themes. We then quantitatively explored associations between the themes of the concerns and whether the responses to them varied according to their themes. We identified four themes for the content of concerns: "Side-effects/late-effects" (39%), "What happens in the near future/practical aspects" (16%), "Fear" (27%) and "Sadness" (17%) (e. g. crying, sighing or other sounds that expressed sadness). Health care providers' responses did not appear to vary according to the different themes of concerns, but typically consisted of providing medical information. The content analysis revealed that patients and family members expressed a wide range of emotional concerns. Health care providers tended to respond to the content-aspect of the concerns, but did rarely explicitly acknowledge the affective-aspect of the concerns. The effect of responses to patients' emotional concerns in the important first consultations about the cancer diagnosis and planned treatment should be investigated in future studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Personality traits in cancer patients.

    Science.gov (United States)

    Turhal, Nazim Serdar; Demirhan, Salih; Satici, Celal; Cinar, Caner; Kinar, Abdullah

    2013-01-01

    This study was planned to investigate the personality traits of cancer patients in different treatment settings, and to correlate the demographics with the personality features. A total of 237 patients referred either to Marmara University School of Medicine (MUSM) Oncology Outpatient Unit or to the private office of the faculty between March 10th and April 22nd, 2010 were enrolled in the study. The Big Five Mini Test was used to evaluate the 40 personality traits of the patients. The study group consisted of 98 males (41.35%) and 139 females (58.65%) with a mean age of 51. Out of the 237, 73.9% had an educational level beyond the junior high school, and 47.3% of all patients reported a positive family history for cancer. A significant difference in terms of reconcilability, extraversion, and responsibility was observed between patients admitting to the university outpatient clinic and the private office (pcancer, age and marital status showed no relevance to their characters. No discordance was observed between the self-analysis of the patient and the patient's relatives. Patients with cancer are typically highly reconcilable and responsible, moderately stable, open and extraverted.

  3. Patient education for adults with rheumatoid arthritis

    NARCIS (Netherlands)

    Riemsma, R.P.; Kirwan, J.R.; Taal, Erik; Rasker, Hans J.

    2009-01-01

    Patient education shows short-term benefits for adults with rheumatoid arthritis. The purpose was to examine the effectiveness of patient education interventions on health status (pain, functional disability, psychological well-being and disease activity) in patients with rheumatoid arthritis (RA).

  4. Disseminated cutaneous trichosporonosis in an adult bone marrow transplant patient

    Directory of Open Access Journals (Sweden)

    A. M. Y. Yong

    2017-01-01

    Full Text Available The Trichosporon species are yeast-like opportunistic pathogens in immunocompromised patients. Trichosporon asahii infections have been reported in pediatric bone marrow transplant (BMT patients. However, its incidence is low in the adult literature. A 52-year-old Chinese woman who was diagnosed with acute myeloid leukemia received induction chemotherapy and underwent allogenic bone marrow transplant, which was complicated by a relapse and required salvage chemotherapy. She developed persistent non-neutropenic fever secondary to presumed hepatosplenic candidiasis. Antifungal therapy with fluconazole and anidulafungin was administered. She remained febrile and tender dusky nodules appeared over all the four limbs. Histopathological examination and fungal culture identified T. asahii. Oral voriconazole was initiated with complete resolution of her lesions. The Trichosporon species is a frequently isolated yeast species from cancer patients. Voriconazole has become the first choice agent against Trichosporon. We highlight the increased awareness and clinical suspicion required for diagnosis and subsequent management in similar adult patients.

  5. Global estimates of cancer prevalence for 27 sites in the adult population in 2008.

    Science.gov (United States)

    Bray, Freddie; Ren, Jian-Song; Masuyer, Eric; Ferlay, Jacques

    2013-03-01

    Recent estimates of global cancer incidence and survival were used to update previous figures of limited duration prevalence to the year 2008. The number of patients with cancer diagnosed between 2004 and 2008 who were still alive at the end of 2008 in the adult population is described by world region, country and the human development index. The 5-year global cancer prevalence is estimated to be 28.8 million in 2008. Close to half of the prevalence burden is in areas of very high human development that comprise only one-sixth of the world's population. Breast cancer continues to be the most prevalent cancer in the vast majority of countries globally; cervix cancer is the most prevalent cancer in much of Sub-Saharan Africa and Southern Asia and prostate cancer dominates in North America, Oceania and Northern and Western Europe. Stomach cancer is the most prevalent cancer in Eastern Asia (including China); oral cancer ranks as the most prevalent cancer in Indian men and Kaposi sarcoma has the highest 5-year prevalence among men in 11 countries in Sub-Saharan Africa. The methods used to estimate point prevalence appears to give reasonable results at the global level. The figures highlight the need for long-term care targeted at managing patients with certain very frequently diagnosed cancer forms. To be of greater relevance to cancer planning, the estimation of other time-based measures of global prevalence is warranted. Copyright © 2012 UICC.

  6. Psychological referral and consultation for adolescents and young adults with cancer treated at pediatric oncology unit.

    Science.gov (United States)

    Clerici, Carlo Alfredo; Massimino, Maura; Casanova, Michela; Cefalo, Graziella; Terenziani, Monica; Vasquez, Roberto; Meazza, Cristina; Ferrari, Andrea

    2008-07-01

    Managing older adolescents and young adults with cancer is a challenge, both medically and psychosocially: it is important to assess these patients' psychological issues and the type of services they need when deciding who should treat these patients, and where. This study describes the pattern of psychological referral and consultation for older adolescents and young adults with cancer being treated at a pediatric oncology unit, as compared with the case of younger patients. Between 1999 and 2006, 318 patients /= 15 years old (30%) were referred for psychological consultation. The number of interviews per patient was 2.8 for patients under fifteen and 7.8 for older patients. Younger patients were referred by all members of staff, while most older patients were referred by doctors, mainly because they had trouble adapting to the cancer's diagnosis and treatment. An ongoing, weekly, long-term psychotherapy was needed for 1% of patients /=15 years old. Adolescents and young adults with cancer have specific psychological needs. While awaiting the full development of programs dedicated to these patients, they would seem to benefit from being treated in a multidisciplinary setting of the kind usually developed at pediatric units, fully integrating the psychological operators with the other staff members. (c) 2008 Wiley-Liss, Inc.

  7. Adult versus Pediatric Neuroblastoma: The M.D. Anderson Cancer Center Experience

    Directory of Open Access Journals (Sweden)

    Henry J. Conter

    2014-01-01

    Full Text Available Background. Staging and treatment of adult neuroblastoma has yet to be formalized. We sought to determine the utility of the pediatric classification system in adults and determine the efficacy of different treatment modalities. Methods. Medical records of 118 adults (patients >17 years old and 112 pediatric patients (ages 2–17, who were treated for neuroblastoma at M.D. Anderson Cancer Center from January 1994 to September 2012, were reviewed. International neuroblastoma risk group (INRG variables were abstracted. The primary outcome of interest was actuarial progression-free survival. Results. Median age of pediatric patients was 5 years (range 3–16 and 47 years (range 18–82 for adult patients. There were no differences in PFS or OS between stage-matched risk categories between pediatric and adult patients (L1-P=0.40, L2-P=0.54, and M-P=0.73. In the treatment of L1 disease, median PFS for adults treated with surgery and radiation was 11.1 months compared with single modality local treatment ± chemotherapy (6.4 and 5.1 months, resp.; P=0.07. Median PFS in L2 adult patients was 5.2 months with local therapy and 4 months with the addition of chemotherapy (P=0.23. Conclusions. Adult and pediatric patients with neuroblastoma achieve similar survival outcomes. INRG classification should be employed to stratify adult neuroblastoma patients and help select treatment.

  8. Palliative therapy in adults with cancer: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Angelita Visentin

    Full Text Available ABSTRACT Objective: To characterize the socioeconomic and clinical profile of adult cancer patients in palliative therapy. Method: Cross-sectional study in an oncology hospital in Paraná, with 124 adult patients who started palliative therapy in the period from Jan. 2 to June 30, 2015. Results: Of the participating population, 60.5% were women, 68.5% white, 48.4% married, 72.6% catholic and with income of one to two minimum wages. Non-smokers, 45.2%, non-alcoholics 75%, and 92% had Performance Status 1 and 2. The predominant primary diagnosis was breast cancer, with previous chemotherapy and radiotherapy. The sites of metastasis were lung/mediastinum/bronchi and lymph nodes. Conclusion: The socioeconomic and clinical context characterized the profile of adult patients in palliative therapy. The demand arising from the increase in cases of advanced cancer requires nursing care at all stages of treatment.

  9. Trends in Adult Cancer-Related Emergency Department Utilization: An Analysis of Data From the Nationwide Emergency Department Sample.

    Science.gov (United States)

    Rivera, Donna R; Gallicchio, Lisa; Brown, Jeremy; Liu, Benmei; Kyriacou, Demetrios N; Shelburne, Nonniekaye

    2017-10-12

    The emergency department (ED) is used to manage cancer-related complications among the 15.5 million people living with cancer in the United States. However, ED utilization patterns by the population of US adults with cancer have not been previously evaluated or described in published literature. To estimate the proportion of US ED visits made by adults with a cancer diagnosis, understand the clinical presentation of adult patients with cancer in the ED, and examine factors related to inpatient admission within this population. Nationally representative data comprised of 7 survey cycles (January 2006-December 2012) from the Nationwide Emergency Department Sample were analyzed. Identification of adult (age ≥18 years) cancer-related visits was based on Clinical Classifications Software diagnoses documented during the ED visit. Weighted frequencies and proportions of ED visits among adult patients with cancer by demographic, geographic, and clinical characteristics were calculated. Weighted multivariable logistic regression was used to examine the associations between inpatient admission and key demographic and clinical variables for adult cancer-related ED visits. Adult cancer-related ED utilization patterns; identification of primary reason for ED visit; patient-related factors associated with inpatient admission from the ED. Among an estimated 696 million weighted adult ED visits from January 2006 to December 2012, 29.5 million (4.2%) were made by a patient with a cancer diagnosis. The most common cancers associated with an ED visit were breast, prostate, and lung cancer, and most common primary reasons for visit were pneumonia (4.5%), nonspecific chest pain (3.7%), and urinary tract infection (3.2%). Adult cancer-related ED visits resulted in inpatient admissions more frequently (59.7%) than non-cancer-related visits (16.3%) (P cancer were the most common cancer diagnoses presenting to the ED. Pneumonia was the most common reason for adult cancer-related ED

  10. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, J.E.; Brennan, M.T.; Verdonck- de Leeuw, I.M.; Gibson, R.J.; Eilers, J.G.; Waltimo, T.; Bots, C.P.; Michelet, M.; Sollecito, T.P.; Rouleau, T.S.; Sewnaik, A.; Bensadoun, R.J.; Fliedner, M.C.; Silverman, S.; Spijkervet, F.K.L.

    2012-01-01

    Purpose Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools,

  11. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, Judith E.; Brennan, Mike T.; Leeuw, Irma M. Verdonck-de; Gibson, Rachel J.; Eilers, June G.; Waltimo, Tuomas; Bots, Casper P.; Michelet, Marisol; Sollecito, Thomas P.; Rouleau, Tanya S.; Sewnaik, Aniel; Bensadoun, Rene-Jean; Fliedner, Monica C.; Silverman, Sol; Spijkervet, Fred K. L.

    Purpose Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools,

  12. Sexual health and self-esteem in adolescents and young adults with cancer.

    Science.gov (United States)

    Evan, Elana E; Kaufman, Miriam; Cook, Andrew B; Zeltzer, Lonnie K

    2006-10-01

    A diagnosis of cancer compounds the complexities of adolescent development. Self-esteem and sexual health have a significant impact on adolescent identity formation, especially those young patients coping with a diagnosis of cancer. Knowledge of sexual health, interpersonal relationships, and body image concerns are factors that have an impact on the development of self-esteem during these transition periods into adulthood. A clinical perspective on these issues was utilized to highlight the nature of self-esteem and sexuality in adolescents and young adults with cancer. Case examples and clinical recommendations from a workshop on self-esteem and sexuality in adolescents and young adults with cancer are presented. Understanding the adolescent's and young adult's stage of identity formation, their social and developmental histories, and methods for increasing self-esteem can give insight to healthcare professionals in fostering positive self-esteem and sexual health in these young patients. Through the awareness of the specific factors affecting adolescents and young adults with cancer, oncology teams can assist in creating an atmosphere for the growth of positive self-esteem and sexual health in their adolescent patients. (c) 2006 American Cancer Society.

  13. Factors affecting quality of life of older adults with cancer in Korea.

    Science.gov (United States)

    Yoon, Hyunsook; Kim, Yojin; Lim, Yeon Ok; Lee, Hyun Joo; Choi, Kyoungwon

    2015-08-01

    The main objective of the present study was to examine the quality of life of older adults with cancer and investigate factors associated with it. Some practical problems experienced by older adults with cancer are introduced, such as changes in work situation, availability of caregivers and financial difficulties relative to medical expenditures. A total of 339 patients aged 65 years or older who were treated for five major cancer diseases--colorectal, stomach, lung, liver or kidney cancer--participated in the present study. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire was used to measure the quality of life. Performance status (physical functioning) was assigned according to the Eastern Cooperative Oncology Group classification. The Life Orientation Test-Revised was used to assess future expectations. The multiple linear regression analysis was used to identify predictors of the quality of life of older persons with cancer. The results showed that physical functioning and optimism were significant predictors of all four functions (physical, role, emotional and social function) and global quality of life of older adults with cancer. Nearly 60% experienced changes in work situation and had financial burden on medical costs. The findings suggest that efforts to assess physical functioning with more attention and enhance optimism should be emphasized in interventions for older adults with cancer. © 2014 Japan Geriatrics Society.

  14. Decline in Cognitive Function in Older Adults With Early-Stage Breast Cancer After Adjuvant Treatment

    OpenAIRE

    Lange, Marie; Heutte, Natacha; Rigal, Olivier; Noal, Sabine; Kurtz, Jean-Emmanuel; Lévy, Christelle; Allouache, Djelila; Rieux, Chantal; Lefel, Johan; Clarisse, Bénédicte; Veyret, Corinne; Barthélémy, Philippe; Longato, Nadine; Castel, Hélène; Eustache, Francis

    2016-01-01

    International audience; Background. The impact of chemotherapy on cognition among elderly patients has received little attention, although such patients are more prone to presenting with age-related cognitive deficits and/or cognitive decline during chemotherapy. The present study assessed the cognitive function in older adults treated for early-stage breast cancer (EBC). Patients and Methods. The participants were newly diagnosed EBC patients aged $65 years without previous systemic treatmen...

  15. Chronic diseases among older cancer patients.

    NARCIS (Netherlands)

    Deckx, L.D.; Akker, M.A. van der; Metsemakers, J.M.; Knottnerus, A.K.; Schellevis, F.G.; Buntinx, F.B.

    2011-01-01

    Introduction: With the growing number of older cancer patients, the burden of chronic diseases among older cancer patients will become increasingly important. Chronic diseases often interfere with treatment decisions and prognosis for cancer patients. However, little is known about the occurrence of

  16. Clinical audit on "evaluation of special issues in adolescents with cancer treated in an adult cancer setting": an Indian experience.

    Science.gov (United States)

    Salins, Naveen S; Vallath, Nandini; Varkey, Prince; Ranganath, Kavya; Nayak, Malathi G

    2012-09-01

    Adolescents with cancer form a distinct group with special care needs. These patients are often cared in an adult supportive care setting where the special needs of adolescents are not met. To identify special issues in adolescents with cancer and to determine whether special needs of adolescents are met in an adult cancer setting 10 adolescents with cancer were randomly chosen and retrospectively studied for physical, psychoscocial and emotional issues using an internally validated tool. Pain was the most common physical symptom seen in all 10 patients. 3 out of 10 patients were involved in decision making, 3 out of 10 patients had identity issues and 4 out of 10 patients had peer group isolation issues. Only 3 were aware of diagnosis and none were aware of treatment outcomes and mortality. 4 out of 10 had anxiety and depression and 3 out of 10 had body image issues. Sexuality, spiritual and existential issues were not explored in any of the patients studied. The outcomes of the study were in an adult oncology setting there was a poor recognition of key adolescent issues such as sexuality, body image, identity and peer group isolation. The psychosocial supports to these adolescents were minimal and spiritual and existential issues were not explored. The inferences drawn from this study suggested a need for multidisciplinary team approach oriented in handling adolescent care needs and preferably to have a dedicated space that will help the peer group to interact, bond and cope better with the illness.

  17. Advocacy groups for breast cancer patients.

    OpenAIRE

    Waller, M.; Batt, S

    1995-01-01

    Breast cancer patient advocacy groups emerged in the 1990s to support and empower women with breast cancer. Women with cancer and oncologists tend to have divergent perspectives on how breast cancer prevention should be defined and what the priorities for research should be. As their American counterparts have done, breast cancer patient advocates in Canada are seeking greater participation in decision making with respect to research. To date they have had more input into research policy deci...

  18. Iron deficiency in cancer patients

    Directory of Open Access Journals (Sweden)

    Flávio Augusto Naoum

    Full Text Available ABSTRACT Anemia is a frequent complication in cancer patients, both at diagnosis and during treatment, with a multifactorial etiology in most cases. Iron deficiency is among the most common causes of anemia in this setting and can develop in nearly half of patients with solid tumors and hematologic malignancies. Surprisingly, this fact is usually neglected by the attending physician in a way that proper and prompt investigation of the iron status is either not performed or postponed. In cancer patients, functional iron deficiency is the predominant mechanism, in which iron availability is reduced due to disease or the therapy-related inflammatory process. Hence, serum ferritin is not reliable in detecting iron deficiency in this setting, whereas transferrin saturation seems more appropriate for this purpose. Besides, lack of bioavailable iron can be further worsened by the use of erythropoiesis stimulating agents that increase iron utilization in the bone marrow. Iron deficiency can cause anemia or worsen pre-existing anemia, leading to a decline in performance status and adherence to treatment, with possible implications in clinical outcome. Due to its frequency and importance, treatment of this condition is already recommended in many specialty guidelines and should be performed preferably with intravenous iron. The evidences regarding the efficacy of this treatment are solid, with response gain when combined with erythropoiesis stimulating agents and significant increments in hemoglobin as monotherapy. Among intravenous iron formulations, slow release preparations present more favorable pharmacological characteristics and efficacy in cancer patients.

  19. Metacognitive Therapy for Emotional Distress in Adult Cancer Survivors: A Case Series.

    Science.gov (United States)

    Fisher, Peter L; Byrne, Angela; Salmon, Peter

    2017-01-01

    Many adult cancer survivors experience persistent emotional distress after completing cancer treatment. The aim of this study was to test the potential of a brief transdiagnostic psychological intervention-metacognitive therapy (MCT)-in reducing emotional distress in adult cancer survivors. A non-concurrent multiple baseline design with 3- and 6-months follow-up was used to evaluate the effects of MCT in four patients consecutively referred to a psycho-oncology service. Each patient received six 1-h sessions of MCT. Anxiety, depression, worry/rumination, fear of cancer recurrence and metacognitive beliefs were assessed using self-report questionnaires. MCT was associated with clinically significant reductions in anxiety, depression, fear of cancer recurrence, worry/rumination and metacognitive beliefs at the end of treatment, and gains were maintained in all patients to 3-months follow-up and in three out of four patients to 6-months follow-up. MCT is a promising brief transdiagnostic approach to psychological morbidity in adult survivors of cancer. Larger scale controlled trials are now required.

  20. Impersonal, interpersonal, and hyperpersonal social support: cancer and older adults.

    Science.gov (United States)

    Robinson, James D; Turner, Jeanine

    2003-01-01

    Although cancer occurs throughout the life span, many of the most frequently occurring types of cancer increase as we grow older. In fact, only cardiovascular disease accounts for more deaths in adults 65 years of age and older. One of the ways that cancer patients cope or adapt to their illness is through socially supportive communicative interactions and relationships. Cutrona and Russell (1990) argued that social support is multidimensional and suggested that social support is most effective when the support needs of the individual are consistent with the type of social support being offered by the support provider. From the communicative perspective, the notion of optimal matching between the types of social support desired and the type of social support offered is extended to include the type of relationship between the communicants. In addition, it is argued that computer-mediated social support can be superior to face-to-face social support. This article attempts to identify some of the conditions under which this is true.

  1. Acute kidney injury in the cancer patient.

    Science.gov (United States)

    Campbell, G Adam; Hu, Daniel; Okusa, Mark D

    2014-01-01

    Acute kidney injury (AKI) is a frequent and significant complication of cancer and cancer therapy. Cancer patients frequently encounter risk factors for AKI including older age, CKD, prerenal conditions, sepsis, exposure to nephrotoxins, and obstructive physiology. AKI can also be secondary to paraneoplastic conditions, including glomerulonephritis and microangiopathic processes. This complication can have significant consequences, including effects on patients' ability to continue to receive therapy for their malignancy. This review will serve to summarize potential etiologies of AKI that present in patients with cancer as well as to highlight specific patient populations, such as the critically ill cancer patient. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  2. Fatigue Among Older Advanced Cancer Patients

    OpenAIRE

    Su, Wen-Hao; Yeh, En-Tien; Chen, Hong-Wen; Wu, Meng-Hao; Lai, Yuen-Liang

    2011-01-01

    Background: Fatigue among older patients and cancer patients is often reported in the literatures. However, relatively few studies can conclude whether fatigue happens more frequently in older patients with advanced cancer. We designed our study to examine the prevalence and features of fatigue among older advanced cancer patients in Taiwan. Methods: Because self-reporting from patients is the most effective method to measure fatigue, the instrument of International Classification of Disea...

  3. Childhood body mass index and risk of adult pancreatic cancer

    DEFF Research Database (Denmark)

    Nogueira, Leticia; Stolzenberg-Solomon, Rachael; Gamborg, Michael

    2017-01-01

    Background: Excess weight in adulthood is one of the few modifiable risk factors for pancreatic cancer, and height has associations as well. This leads to question whether body weight and height in childhood are associated with adult pancreatic cancer. Objective: To examine if childhood body mass...

  4. Posttraumatic stress symptoms in adult survivors of childhood cancer

    NARCIS (Netherlands)

    Langeveld, N. E.; Grootenhuis, M. A.; Voûte, P. A.; de Haan, R. J.

    2004-01-01

    Background. Previous research suggests that posttraurnatic stress disorder (PTSD) is present in survivors of childhood cancer. The aim of the current study was to explore posttraurnatic stress symptoms in a sample of young adult survivors of childhood cancer. In addition, the impact of demographic,

  5. Quality of life in young adult survivors of childhood cancer

    NARCIS (Netherlands)

    Langeveld, N. E.; Stam, H.; Grootenhuis, M. A.; Last, B. F.

    2002-01-01

    In recent years the necessity of measuring quality of life in childhood cancer survivors has been stressed. This paper gives an overview of the results of studies into the quality of life (QL) of young adult survivors of childhood cancer and suggest areas for future research. The review located 30

  6. Primary care for young adult cancer survivors: an international perspective.

    NARCIS (Netherlands)

    Holge-Hazelton, B.; Blake-Gumbs, L.; Miedema, B.; Rijswijk, E. van

    2010-01-01

    PURPOSE: Internationally, family physicians (FP) are not routinely involved in young adult cancer (YAC) care. In this short report, we would like to make a compelling argument for primary care involvement. METHODS: Comparative descriptions and literature review. RESULTS: Cancer among YAs is rare and

  7. Oral complications in cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Carl, W.

    1983-02-01

    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.

  8. Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults.

    Science.gov (United States)

    Hurlow, Adam; Bennett, Michael I; Robb, Karen A; Johnson, Mark I; Simpson, Karen H; Oxberry, Stephen G

    2012-03-14

    Cancer-related pain is complex and multi-dimensional but the mainstay of cancer pain management has predominantly used a biomedical approach. There is a need for non-pharmacological and innovative approaches. Transcutaneous Electric Nerve Stimulation (TENS) may have a role in pain management but the effectiveness of TENS is currently unknown. This is an update of the original review published in Issue 3, 2008. The aim of this systematic review was to determine the effectiveness of TENS for cancer-related pain in adults. The initial review searched The Cochrane Library, MEDLINE, EMBASE, CINAHL, PsychINFO, AMED and PEDRO databases in April 2008. We performed an updated search of CENTRAL, MEDLINE, EMBASE, CINAHL and PEDRO databases in November 2011. We included only randomised controlled trials (RCTS) investigating the use of TENS for the management of cancer-related pain in adults. The search strategy identified a further two studies for possible inclusion. One of the review authors screened each abstract using a study eligibility tool. Where eligibility could not be determined, a second author assessed the full paper. One author used a standardised data extraction sheet to collect information on the studies and independently assess the quality of the studies using the validated five-point Oxford Quality Scale. The small sample sizes and differences in patient study populations of the three included studies (two from the original review and a third included in this update) prevented meta-analysis. For the original review the search strategy identified 37 possible published studies; we divided these between two pairs of review authors who decided on study selection; all four review authors discussed and agreed final scores. Only one additional RCT met the eligibility criteria (24 participants) for this updated review. Although this was a feasibility study, not designed to investigate intervention effect, it suggested that TENS may improve bone pain on movement in a

  9. Contributors and Inhibitors of Resilience Among Adolescents and Young Adults with Cancer.

    Science.gov (United States)

    Rosenberg, Abby R; Yi-Frazier, Joyce P; Wharton, Claire; Gordon, Karen; Jones, Barbara

    2014-12-01

    Purpose: Self-perceived resilience may enable coping and mitigate poor psychosocial outcomes among adolescent and young adult (AYA) patients with cancer. In order to inform the development of resilience-promoting interventions, we aimed to: (1) describe AYA patient-reported resilience and (2) identify AYA patient-reported contributors and inhibitors of resilience. Methods: The "Resilience in Adolescents and Young Adults with Cancer" study was a prospective longitudinal mixed-methods study. Consecutive Caucasian patients aged 14-25 years old enrolled 14-60 days following their diagnosis of cancer and completed one-on-one semi-structured interviews both at the time of enrollment and 3-6 months later. Constant comparative analyses identified salient themes describing modifiable contributors and inhibitors to patient-perceived resilience. Results: Seventeen patients (85% of those approached) enrolled in the study. The mean age was 17 years (SD=2.6) and 53% were female. All patient definitions of resilience inferred an ability to handle adversity. Five themes emerged as predominant contributors or inhibitors of resilience: (1) stress and coping; (2) goals, purpose, and planning; (3) optimism; (4) gratitude and meaning; and (5) connection and belonging. Merged analyses suggested that AYA resilience was a balance that may be enabled by promoting certain skills. Conclusion: AYA patients with cancer perceive resilience as a balance. Learned skills in stress management, goal-setting, and benefit-finding may empower AYAs during their cancer experience, in turn improving long-term psychosocial outcomes.

  10. Frailty and skeletal muscle in older adults with cancer.

    Science.gov (United States)

    Williams, Grant R; Deal, Allison M; Muss, Hyman B; Weinberg, Marc S; Sanoff, Hanna K; Guerard, Emily J; Nyrop, Kirsten A; Pergolotti, Mackenzi; Shachar, Shlomit Strulov

    2017-08-24

    Computerized tomography (CT) imaging is routine in oncologic care and can be used to measure muscle quantity and composition that may improve prognostic assessment of older patients. This study examines the association of single-slice CT-assessed muscle measurements with a frailty index in older adults with cancer. Using the Carolina Senior Registry, we identified patients with CT imaging within 60days ± of geriatric assessment (GA). A 36-item Carolina Frailty Index was calculated. Cross-sectional skeletal muscle area (SMA) and Skeletal Muscle Density (SMD) were analyzed from CT scan L3 lumbar segments. SMA and patient height (m(2)) were used to calculate skeletal muscle index (SMI). Skeletal Muscle Gauge (SMG) was calculated by multiplying SMI×SMD. Of the 162 patients, mean age 73, 53% were robust, 27% pre-frail, and 21% frail. Significant differences were found between robust and frail patients for SMD (29.4 vs 24.1 HU, pfrailty increased by 20% (PR=1.20 [1.09, 1.32]) while the prevalence of frailty did not differ based on SMI. Muscle mass (measured as SMI) was poorly associated with a GA-based frailty index. Muscle density, which reflects muscle lipid content, was more associated with frailty. Although frailty and loss of muscle mass are both age-related conditions that are predictive of adverse outcomes, our results suggest they are separate entities. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Cancer Risk Factor Knowledge Among Young Adults.

    Science.gov (United States)

    Merten, Julie Williams; Parker, Alexander; Williams, Adrienne; King, Jessica L; Largo-Wight, Erin; Osmani, Morsal

    2017-12-01

    Cancer is the second leading cause of death in the USA. Incidence and mortality rates for cancer have risen steadily and cost the healthcare system over $264 billion annually. Cancer risk can be reduced by restricting alcohol consumption, avoiding tobacco, eating a balanced diet, limiting sun exposure, exercising, and seeking routine cancer screenings. The purpose of this study is to examine cancer risk factor knowledge among college students. Researchers surveyed undergraduate and graduate students (n = 758) at a mid-sized public university in the Southeast about their knowledge regarding cancer risk factors including smoking, alcohol consumption, diet, obesity, hypertension, and human papillomavirus (HPV). Participants were mostly able to identify the association between cancers and health risk behaviors that have received widespread media coverage, are somewhat intuitive, or are salient to their life stage such as drinking, tanning, and smoking. Nearly all participants correctly reported exposure to ultraviolet (UV) rays, and smoking increased risk of developing skin and lung cancer, respectively. Most students correctly identified an increased risk of liver cancer associated with alcohol use but missed head/neck and breast cancer. However, knowledge of less publicized relationships was insufficient. The findings offer encouragement to public health professionals that campaigns have increased awareness of cancer risk. However, there were many relationships that revealed a lack of knowledge, and future campaigns can target lesser-known cancer risk relationships to reduce the personal tragedy and societal burden of cancer.

  12. Symptom Levels in Care-Seeking Bangladeshi and Nepalese Adults With Advanced Cancer

    OpenAIRE

    Richard Reed Love; Tahmina Ferdousy; Bishnu D. Paudel; Shamsun Nahar; Rumana Dowla; Mohammad Adibuzzaman; Golam Mushih Tanimul Ahsan; Miftah Uddin; Reza Salim; Sheikh Iqbal Ahamed

    2016-01-01

    Purpose: Three-fourths of patients with advanced cancer are reported to suffer from pain. A primary barrier to provision of adequate symptom treatment is failure to appreciate the intensity of the symptoms patients are experiencing. Because data on Bangladeshi and Nepalese patients’ perceptions of their symptomatic status are limited, we sought such information using a cell phone questionnaire. Methods: At tertiary care centers in Dhaka and Kathmandu, we recruited 640 and 383 adult patients, ...

  13. Mental Health Problems and Cancer Risk Factors Among Young Adults.

    Science.gov (United States)

    Massetti, Greta M; Thomas, Cheryll C; King, Jessica; Ragan, Kathleen; Buchanan Lunsford, Natasha

    2017-09-01

    Chronic mental health problems often emerge in young adulthood, when adults begin to develop lifelong health behaviors and access preventive health services. The associations between mental health problems and modifiable cancer risk factors in young adulthood are not well understood. In 2016, the authors analyzed 2014 Behavioral Risk Factor Surveillance System data on demographic characteristics, health service access and use, health status, and cancer risk factors (tobacco use, alcohol use, overweight or obesity, physical activity, and sleep) for 90,821 young adults aged 18-39 years with mental health problems (depressive disorder or frequent mental distress) compared to other young adults. Mental health problems were associated with white race; less than a high school education; lower income; being out of work or unable to work; being uninsured (for men only); poor health; previous diagnosis of asthma, skin cancer, or diabetes; and not having a recent checkup. After controlling for demographic characteristics, health service use, and health status, mental health problems among young adults were associated with smoking, binge drinking, inadequate sleep, having no leisure time physical activity, and being overweight or obese (among women only). Cervical cancer screening was not associated with mental health problems after controlling for demographic characteristics, health service use, and health status. Mental health problems in young adulthood were associated with potentially modifiable factors and behaviors that increase risk for cancer. Efforts to prevent cancer and promote health must attend to mental health disparities to meet the needs of young adults. Published by Elsevier Inc.

  14. Priorities in Fertility Decisions for Reproductive-Aged Cancer Patients: Fertility Attitudes and Cancer Treatment Study.

    Science.gov (United States)

    Flink, Dina M; Kondapalli, Laxmi A; Kellar-Guenther, Yvonne

    2017-09-01

    The Fertility Attitudes and Cancer Treatment Study (FACTS) aims at better understanding the reasons and priorities of young adult cancer patients making decisions for fertility preservation (FP). Identifying the factors that center around a patient's fertility decisions will support the development of educational tools for providers and improve clinical care to meet patients' reproductive needs. An exploratory qualitative study was conducted of 27 newly diagnosed male and female cancer patients who had presented for an oncofertility consultation. Interviews lasted ∼30 minutes and were transcribed verbatim. A thematic analysis was conducted to explore the factors driving decisions for future fertility. Themes were grouped to address the following topics: reasons for/against FP, patient priorities, informational needs, support, wellness, and satisfaction with information. Strength of the theme was determined by examining the frequency of a response. Patients who chose FP versus those who did not choose FP and men versus women proved to be more similar than different in their reasoning, priorities, and informational needs for FP decisions. Patients who chose FP identified a "concern for future fertility" as a top reason to do so and "parenthood" as a top priority. For those who did not choose FP, "cancer treatment" was identified as their top priority. For patients identifying financial barriers, 50% of them were able to overcome this to pursue FP. Reproductive-aged patients diagnosed with a new cancer should be referred to a reproductive specialist and provided the opportunity to come to a fertility decision on their own before initiating cancer treatment.

  15. Electronic Monitoring Device of Patient-Reported Outcomes and Function in Improving Patient-Centered Care in Patients With Gastrointestinal Cancer Undergoing Surgery

    Science.gov (United States)

    2017-06-06

    Stage I Adult Liver Cancer; Stage I Colorectal Cancer; Stage IA Gastric Cancer; Stage IA Pancreatic Cancer; Stage IB Gastric Cancer; Stage IB Pancreatic Cancer; Stage II Adult Liver Cancer; Stage IIA Colorectal Cancer; Stage IIA Gastric Cancer; Stage IIA Pancreatic Cancer; Stage IIB Colorectal Cancer; Stage IIB Gastric Cancer; Stage IIB Pancreatic Cancer; Stage IIC Colorectal Cancer; Stage III Pancreatic Cancer; Stage IIIA Adult Liver Cancer; Stage IIIA Colorectal Cancer; Stage IIIA Gastric Cancer; Stage IIIB Adult Liver Cancer; Stage IIIB Colorectal Cancer; Stage IIIB Gastric Cancer; Stage IIIC Adult Liver Cancer; Stage IIIC Colorectal Cancer; Stage IIIC Gastric Cancer; Stage IV Gastric Cancer; Stage IVA Colorectal Cancer; Stage IVA Liver Cancer; Stage IVA Pancreatic Cancer; Stage IVB Colorectal Cancer; Stage IVB Liver Cancer; Stage IVB Pancreatic Cancer

  16. Microbial dysbiosis in colorectal cancer (CRC) patients

    National Research Council Canada - National Science Library

    Sobhani, Iradj; Tap, Julien; Roudot-Thoraval, Françoise; Roperch, Jean P; Letulle, Sophie; Langella, Philippe; Corthier, Gérard; Tran Van Nhieu, Jeanne; Furet, Jean P

    2011-01-01

    The composition of the human intestinal microbiota is linked to health status. The aim was to analyze the microbiota of normal and colon cancer patients in order to establish cancer-related dysbiosis...

  17. Access to Cancer Services for Rural Colorectal Cancer Patients

    Science.gov (United States)

    Baldwin, Laura-Mae; Cai, Yong; Larson, Eric H.; Dobie, Sharon A.; Wright, George E.; Goodman, David C.; Matthews, Barbara; Hart, L. Gary

    2008-01-01

    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.…

  18. Yoga for Health-Related Quality of Life in Adult Cancer: A Randomized Controlled Feasibility Study

    Directory of Open Access Journals (Sweden)

    Marcy McCall

    2015-01-01

    Full Text Available An increase in patient-led uptake of complementary therapies in adult cancer has led to a need for more rigorous study of such interventions and their outcomes. This study therefore aimed to evaluate the feasibility and acceptability of a yoga intervention in men and women receiving conventional treatment for a cancer diagnosis. Prospective, mixed methods feasibility trial allocated participants to receive one of three yoga interventions over a four-week study period. Data collection was completed through online survey of QOL-CA/CS and customized surveys. Fifteen participants were included (11 female undergoing treatment for breast, prostate, colorectal, brain, and blood and lung cancer. Two participants dropped out and complete qualitative and quantitative data sets were collected from 12 participants and four yoga instructors. Other outcome measures included implementation costs patient-reported preferences for yoga intervention and changes in QOL-CA/CS. Three types of yoga intervention were safely administered in adult cancer. Mixed methods, cost-efficiency, QOL-CA/CS, and evidence-based design of yoga intervention have been used to establish feasibility and patient-preferences for yoga delivery in adult caner. Results suggest that, with some methodological improvements, a large-scale randomized controlled trial is warranted to test the efficacy of yoga for male and female cancer patients. This trial is registered with Clinicaltrials.gov NCT02309112.

  19. Iron deficiency in cancer patients.

    Science.gov (United States)

    Naoum, Flávio Augusto

    Anemia is a frequent complication in cancer patients, both at diagnosis and during treatment, with a multifactorial etiology in most cases. Iron deficiency is among the most common causes of anemia in this setting and can develop in nearly half of patients with solid tumors and hematologic malignancies. Surprisingly, this fact is usually neglected by the attending physician in a way that proper and prompt investigation of the iron status is either not performed or postponed. In cancer patients, functional iron deficiency is the predominant mechanism, in which iron availability is reduced due to disease or the therapy-related inflammatory process. Hence, serum ferritin is not reliable in detecting iron deficiency in this setting, whereas transferrin saturation seems more appropriate for this purpose. Besides, lack of bioavailable iron can be further worsened by the use of erythropoiesis stimulating agents that increase iron utilization in the bone marrow. Iron deficiency can cause anemia or worsen pre-existing anemia, leading to a decline in performance status and adherence to treatment, with possible implications in clinical outcome. Due to its frequency and importance, treatment of this condition is already recommended in many specialty guidelines and should be performed preferably with intravenous iron. The evidences regarding the efficacy of this treatment are solid, with response gain when combined with erythropoiesis stimulating agents and significant increments in hemoglobin as monotherapy. Among intravenous iron formulations, slow release preparations present more favorable pharmacological characteristics and efficacy in cancer patients. Copyright © 2016 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. All rights reserved.

  20. Cancer patients' experiences with nature: Normalizing dichotomous realities.

    Science.gov (United States)

    Blaschke, Sarah; O'Callaghan, Clare C; Schofield, Penelope; Salander, Pär

    2017-01-01

    To explore cancer patients' subjective experiences with nature in order to examine the relevance of nature-based care opportunities in cancer care contexts. The rationale was to describe the underlying mechanisms of this interaction and produce translatable knowledge. Qualitative research design informed by grounded theory. Sampling was initially convenience and then theoretical. Competent adults with any cancer diagnosis were eligible to participate in a semi-structured interview exploring views about the role of nature in their lives. Audio-recorded and transcribed interviews were analyzed using inductive, cyclic, and constant comparative analysis. Twenty cancer patients (9 female) reported detailed description about their experiences with nature from which a typology of five common nature interactions emerged. A theory model was generated constituting a core category and two inter-related themes explaining a normalization process in which patients negotiate their shifting realities (Core Category). Nature functioned as a support structure and nurtured patients' inner and outer capacities to respond and connect more effectively (Theme A). Once enabled and comforted, patients could engage survival and reconstructive maneuvers and explore the consequences of cancer (Theme B). A dynamic relationship was evident between moving away while, simultaneously, advancing towards the cancer reality in order to accept a shifting normality. From a place of comfort and safety, patients felt supported to deal differently and more creatively with the threat and demands of cancer diagnosis, treatment and outlook. New understanding about nature's role in cancer patients' lives calls attention to recognizing additional forms of psychosocial care that encourage patients' own coping and creative processes to deal with their strain and, in some cases, reconstruct everyday lives. Further research is required to determine how nature opportunities can be feasibly delivered in the cancer

  1. Adverse events in hospitalised cancer patients

    DEFF Research Database (Denmark)

    Haukland, Ellinor; von Plessen, Christian; Nieder, Carsten

    2017-01-01

    Background: Patients with cancer are often treated by many healthcare providers, receive complex and potentially toxic treatments that can increase the risk for iatrogenic harm. The aim of this study is to investigate whether hospitalised cancer patients are at higher risk of adverse events (AEs......) compared to a general hospital population. Material and methods: A total of 6720 patient records were retrospectively reviewed comparing AEs in hospitalised cancer patients to a general hospital population in Norway, using the IHI Global Trigger Tool method. Results: 24.2 percent of admissions for cancer...... patients had an AE compared to 17.4% of admissions of other patients (pcancer patients did not have a higher rate of AEs per 1000 patient days compared to other patients, 37.1 vs. 36.0 (p¼.65, rr 0.94, 95% CI 0.90–1.18). No particular cancer category is at higher...

  2. Psychologic predictors of cancer information avoidance among older adults: the role of cancer fear and fatalism.

    Science.gov (United States)

    Miles, Anne; Voorwinden, Sanne; Chapman, Sarah; Wardle, Jane

    2008-08-01

    Little is known about the correlates of cancer information avoidance and whether people with negative feelings and beliefs about cancer are more likely to avoid cancer information, allowing such thoughts and feelings to persist unchallenged. Using the Extended Parallel Processing Model as a theoretical guide, we tested the hypothesis that cancer fear and fatalism would predict cancer information avoidance but that part of this effect would be mediated via cancer-specific threat and efficacy beliefs. A community sample of older adults, ages 50 to 70 years (n = 1,442), completed a postal questionnaire that included the Powe Fatalism Inventory and the Champion Cancer Fear scale along with other measures of cancer-specific beliefs and demographic variables. Higher levels of cancer fear were positively associated with higher levels of cancer information avoidance, and part of this relationship was mediated via perceived cancer severity. The relationship between cancer fatalism and cancer information avoidance was partly mediated by severity and response-efficacy beliefs. This research shows that people with negative views about cancer are more likely to avoid cancer information. This means people with higher levels of cancer fear and fatalism are less likely to learn about positive developments made in the field of cancer control, allowing such negative feelings and views to continue. Research needs to focus on how to get positive messages about improvements in cancer prevention and control through to people who are fearful of and fatalistic about the disease.

  3. Screening methods of ovarian cancer in adults

    Directory of Open Access Journals (Sweden)

    Milenković Vera

    2005-01-01

    Full Text Available Ovarian cancer is associated with high mortality rate which has improved a little despite therapeutic advances. It causes more deaths than combined cervical and uterine cancer. High mortality is believed to be a direct result of already advanced stage at the time of diagnosis. Survival is excellent in case of early stage disease but poor in late stage disease, regardless of histology. The goal of screening for ovarian cancer is restricted to detection of asymptomatic early stage disease, as precursor lesions of ovarian cancer have not been identified. At present, there is no reliable method of ovarian cancer screening which has been shown to reduce mortality from ovarian cancer. Therefore, routine screening of women in general population can not be currently advised. Screening should be limited to high-risk population and subjects participating in research projects as long as the results of current studies are available.

  4. Bladder cancer in HIV-infected adults: an emerging concern?

    Directory of Open Access Journals (Sweden)

    Sylvain Chawki

    2014-11-01

    Full Text Available Introduction: As HIV-infected patients get older more non-AIDS-related malignancies are to be seen. Cancer now represents almost one third of all causes of deaths among HIV-infected patients (1. Albeit bladder cancer is one of the most common malignancy worldwide (2, only 13 cases of bladder cancer in HIV-infected patients have been reported in the literature so far (3. Materials and Methods: We conducted a monocentric study in our hospital. We selected all patients who were previously admitted (from 1998 to 2013 in our hospital with diagnoses of HIV and bladder cancer. The objective was to assess the prevalence and characteristics of bladder cancers in HIV-infected patients in our hospital. Results: Based on our administrative HIV database (6353 patients, we found 15 patients (0.2% with a bladder cancer. Patients’ characteristics are presented in Table 1. Patients were mostly men and heavy smokers. Their median nadir CD4 cell count was below 200 and most had a diagnosis of AIDS. A median time of 14 years was observed in those patients, between the diagnosis of HIV-infection and the occurrence of bladder cancer, although in patients much younger (median age 56 than those developing bladder cancer without HIV infection (71.1 years (4. Haematuria was the most frequent diagnosis circumstance in HIV-infected patients who had relatively preserved immune function on highly active antiretroviral therapy (HAART. Histopathology showed relatively advanced cancers at diagnosis with a high percentage of non transitional cell carcinoma (TCC tumor and of TCC with squamous differentiation, suggesting a potential role for human papilloma virus (HPV co-infection. Death rate was high in this population. Conclusions: Bladder cancers in HIV-infected patients remain rare but occur in relatively young HIV-infected patients with a low CD4 nadir, presenting with haematuria, most of them being smokers, and have aggressive pathological features that are associated with

  5. Exploring Positive Survivorship Experiences of Indigenous Australian Cancer Patients

    Directory of Open Access Journals (Sweden)

    Laura Tam

    2018-01-01

    Full Text Available Amongst Indigenous Australians, “cancer” has negative connotations that detrimentally impact upon access to cancer care services. Barriers to accessing cancer services amongst Indigenous Australians are widely reported. In contrast, factors that facilitate this cohort to successfully navigate cancer care services (“enablers” are scarcely reported in the literature. Through qualitative interviews, this article examines factors that assist Indigenous Australians to have positive cancer experiences. Semi-structured interviews were conducted with twelve adult Indigenous oncology patients recruited from a tertiary hospital in Queensland, Australia during 2012–2014. Data generated from the interviews were independently reviewed by two researchers via inductive thematic analytical processes. Discussions followed by consensus on the major categories allowed conclusions to be drawn on potential enablers. Two major categories of enablers were identified by the researchers: resilience and communication. Individual’s intrinsic strength, their coping strategies, and receipt of support improved participant’s resilience and consequently supported a positive experience. Communication methods and an effective patient-provider relationship facilitated positive experiences for participants. Despite potential barriers to access of care for Indigenous cancer patients, participants in the study demonstrated that it was still possible to focus on the positive aspects of their cancer experiences. Many participants explained how cancer changed their outlook on life, often for the better, with many feeling empowered as they progressed through their cancer diagnosis and treatment processes.

  6. Symptom prevalence and management of cancer patients in Lebanon.

    Science.gov (United States)

    Abu-Saad Huijer, Huda; Abboud, Sarah; Doumit, Myrna

    2012-09-01

    Cancer patients experience a great number of distressing physical and psychological symptoms. In Lebanon, there are no available data on symptom prevalence and symptom management in adults with cancer. The aim of this study was to determine the prevalence of symptoms and the effectiveness of treatment received as reported by patients. The study used a cross-sectional, descriptive survey design. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the Memorial Symptom Assessment Scale were translated to Arabic and used; data were collected from adult Lebanese cancer patients at the American University of Beirut Medical Center. A total of 200 cancer patients participated in the study; the majority were female with breast cancer and mean age was 54 years. The cognitive functioning domain of the EORTC QLQ-C30 scale was found to have the highest score and social functioning the lowest. The most prevalent symptom was lack of energy. Nausea and pain were the symptoms most treated. Males reported better quality of life (QoL), physical functioning, and role functioning than females; females reported more fatigue, pain, and appetite loss than males. Higher physical and psychological symptoms were correlated with lower health status, QoL, and functioning. Although this sample reported a fair QoL and social functioning, many symptoms were highly prevalent and inadequately treated. Symptoms were found to negatively affect QoL and functioning. Based on these results, providing adequate symptom management and social support to Lebanese cancer patients is highly recommended. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  7. Psychiatric Problems in Patients with Breast Cancer

    Directory of Open Access Journals (Sweden)

    Munevver Tunel

    2012-06-01

    Full Text Available Cancer is a physical disorder with concurrent mental and social components. During cancer, the feelings of fear, hopelessness, guilt, helplessness, abandonment perceived as a crisis leading to destruction in the suffering person. Breast cancer is the most common type of cancer among women. Prevalence of psychiatric disorders among cancer patients is approximately 50% and most of disorders are related with the occurrence of cancer and cancer treatment. Majority of patients present with major depression, adjustment disorder, anxiety disorders, sleep disorders, suicidial ideation, and delirium. Treatment of psychiatric disorders and cancer therapy should be conducted along with special consideration of drug interactions. This article reviews the adaptation process experienced by individuals during diagnosis and treatment of breast cancer, it psychological effects, resulting psychiatric comorbidites and their treatments. [Archives Medical Review Journal 2012; 21(3.000: 189-219

  8. Evidence-based nutritional support of the elderly cancer patient.

    Science.gov (United States)

    Bozzetti, Federico

    2015-04-01

    The papers included in this section represent the effort of the Task Force on Nutrition of the International Society of Geriatric Oncology to synthetize the evidence-based concepts on nutritional support of the elderly cancer patients. In the attempt of presenting a comprehensive overview of the topic, the panel included experts from different specialties: basic researchers, nutritionists, geriatricians, nurses, dieticians, gastroenterologists, oncologists. Cancer in elderly people is a growing problem. Not only in almost every country, the proportion of people aged over 60 years is growing faster than any other age group, but cancer per se is also a disease of old adult-elderly people, hence the oncologists face an increasing number of these patients both now and in the next years. The are several studies on nutrition of elderly subjects and many other on nutrition of cancer patients but relatively few specifically devoted to the nutritional support of the elderly cancer patients. However, the awareness that elderly subjects account for a high proportion of the mixed cancer patients population, in some way legitimates us to extend some conclusions of the literature also to the elderly cancer patients. Although the topics of this Experts' Consensus have been written by specialists in different areas of nutrition, the final message is addressed to the oncologists. Not only they should be more directly involved in the simplest steps of the nutritional care (recognition of the potential existence of a "nutritional risk" which can compromise the planned oncologic program, use of some oral supplements, etc.) but, as the true experts of the natural history of their cancer patient, they should also coordinate the process of the nutritional support, integrating this approach in the overall multidisciplinary cancer care. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Staphylococcal Blood Stream Infections in Cancer Patients

    African Journals Online (AJOL)

    Cancer Patients. Dear Sir,. Cancer patients are at an increased risk of the blood stream infections (BSI) due to their immune-compromised status, repeated ... Table 1: Details of the Staphylococci isolated from BSI. Staphylococcal isolates. Number. (%). Number of methicillin resistant isolates (%). Number of patients who.

  10. Adolescents and Young Adults With Cancer: Oncology Nurses Report Attitudes and Barriers to Discussing Fertility Preservation.

    Science.gov (United States)

    Nobel Murray, Alexandra; Chrisler, Joan C; Robbins, Mark L

    2016-08-01

    Fertility issues have been found to be an important topic for adolescents and young adults (AYAs) with cancer. Medical technology has made fertility preservation (FP) increasingly effective for postpubertal patients whose treatment course may inhibit their future ability to achieve biologic parenthood. Oncology providers' recommendations have been shown to vary, potentially affecting patients' decision-making processes regarding FP. This study was designed to assess oncology nurses' recommendations for patients to consider FP options and to explore what patient-related factors may influence discussion of FP with AYAs with cancer. 116 oncology nurses participated in this study and were randomized to read one of four vignettes about a patient whose proposed treatment course could affect his or her fertility. Participants' recommendations to partake in FP were analyzed to test for differences by patient age and gender. Open-ended responses to questions about their experiences as oncology nurses were analyzed descriptively. Nurses strongly recommended that all patients explore FP options before the start of treatment. Oncology nurses endorsed stronger opinions that young adult female patients should be given independent decision-making power to delay treatment for FP, compared to male and female adolescent patients and young adult male patients. Participants mentioned barriers to discussions that included concerns about exacerbating negative emotions and the decision-making capacity of young patients.

  11. Associations between education and physical functioning and pain in adult Danish cancer survivors

    DEFF Research Database (Denmark)

    Winther, Dorte; Nygaard, Tina K; Horsbøl, Trine A

    2017-01-01

    BACKGROUND: Late effects after cancer diagnosis and treatment are common, but only few studies have examined the role of social factors in developing these late effects. The aim of this study was to examine the association between educational level and physical function and pain among cancer...... survivors two years after diagnosis. MATERIAL AND METHODS: The study population consisted of adult Danish patients with a first-time cancer diagnosis who were sent a questionnaire in 2010 and followed up in 2012. In total, 4346 returned the first questionnaire shortly after diagnosis and 2568 returned...

  12. The Association of Perceived Provider-Patient Communication and Relationship Quality with Colorectal Cancer Screening

    Science.gov (United States)

    Underhill, Meghan L.; Kiviniemi, Marc T.

    2012-01-01

    Background: Two-thirds of adults aged 50 years and older are adherent to recommendations for colorectal cancer screening. Provider-patient communication and characteristics of the patient-provider relationship may relate to screening behavior. Methods: The association of provider communication quality, relationship, and colorectal cancer screening…

  13. Patients' perspectives on hospitalisation: Experiences from a cancer ward in Kenya

    NARCIS (Netherlands)

    Mulemi, B.A.

    2008-01-01

    This paper explores how adult cancer in-patients feel about and make sense of their condition and therapy. Data was collected through observation and informal conversations with patients and hospital staff, over a period of 12 months, on a cancer ward in a teaching hospital in Kenya. I held in-depth

  14. Rhabdomyosarcoma in adolescent and young adult patients: current perspectives

    Directory of Open Access Journals (Sweden)

    Egas-Bejar D

    2014-06-01

    Full Text Available Daniela Egas-Bejar, Winston W Huh Division of Pediatrics, The Children’s Cancer Hospital, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Abstract: Rhabdomyosarcoma (RMS, a malignant tumor of mesenchymal origin, is the third most common extracranial malignant solid tumor in children and adolescents. However, in adults, RMS represents <1% of all solid tumor malignancies. The embryonal and alveolar histologic variants are more commonly seen in pediatric patients, while the pleomorphic variant is rare in children and seen more often in adults. Advances in the research of the embryonal and alveolar variants have improved our understanding of certain genes and biologic pathways that are involved in RMS, but much less is known for the other variants. Multimodality therapy that includes surgery and chemotherapy with or without radiation therapy is the mainstay of treatment for RMS. Improvements in the risk stratification of the pediatric patients based on presurgical (primary tumor site, tumor size, regional lymph node involvement, presence of metastasis and postsurgical parameters (completeness of resection or presence of residual disease or metastasis has allowed for the treatment assignment of patients in different studies and therapeutic trials, leading to increases in 5-year survival from 25%–70% over the past 40 years. However, for adult patients, in great part due to rarity of the disease and the lack of consensus on optimal treatment, clinical outcome is still poor. Many factors have been implicated for the differing outcomes between pediatric RMS versus adult RMS, such as the lack of standardized treatment protocols for adult RMS patients and the increased prevalence of advanced presentations. Now that there are increased numbers of survivors, we can appreciate the sequelae from therapy in these patients, such as bone growth abnormalities, endocrinopathies, and infertility. Improvements in risk stratification have led

  15. Patterns of use of medical cannabis among Israeli cancer patients: a single institution experience

    National Research Council Canada - National Science Library

    Waissengrin, Barliz; Urban, Damien; Leshem, Yasmin; Garty, Meital; Wolf, Ido

    2015-01-01

    .... Efficacy and patterns of use of cannabis were evaluated using physician-completed application forms, medical files, and a detailed questionnaire in adult cancer patients treated at a single institution...

  16. Assessment of depression and anxiety in adult cancer outpatients: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Shahzad Mohammad A

    2010-10-01

    Full Text Available Abstract Background The prevalence of anxiety and depressive disorders in cancer patients and its associated factors in Pakistan is not known. There is a need to develop an evidence base to help introduce interventions as untreated depression and anxiety can lead to significant morbidity. We assessed the prevalence of depression and anxiety among adult outpatients with and without cancer as well as the effect of various demographic, clinical and behavioral factors on levels of depression and anxiety in cancer patients. Methods This cross-sectional study was carried out in outpatient departments of Multan Institute of Nuclear Medicine and Radiotherapy and Nishtar Medical College Hospital, Multan. Aga Khan University Anxiety and Depression Scale (AKUADS was used to define the presence of depression and anxiety in study participants. The sample consisted of 150 diagnosed cancer patients and 268 participants without cancer (control group. Results The mean age of cancer patients was 40.85 years (SD = 16.46 and median illness duration was 5.5 months, while the mean age of the control group was 39.58 years (SD = 11.74. Overall, 66.0% of the cancer patients were found to have depression and anxiety using a cutoff score of 20 on AKUADS. Among the control group, 109 subjects (40.7% had depression and anxiety. Cancer patients were significantly more likely to suffer from distress compared to the control group (OR = 2.83, 95% CI = 1.89-4.25, P = 0.0001. Performing logistic regression analysis showed that age up to 40 years significantly influenced the prevalence of depression and anxiety in cancer patients. There was no statistically significant difference between gender, marital status, locality, education, income, occupation, physical activity, smoking, cancer site, illness duration and mode of treatment, surgery related to cancer and presence of depression and anxiety. Cancers highly associated with depression and anxiety were gastrointestinal

  17. Clinical effectiveness and cost-effectiveness of first-line chemotherapy for adult patients with locally advanced or metastatic non-small cell lung cancer: a systematic review and economic evaluation.

    Science.gov (United States)

    Brown, T; Pilkington, G; Bagust, A; Boland, A; Oyee, J; Tudur-Smith, C; Blundell, M; Lai, M; Martin Saborido, C; Greenhalgh, J; Dundar, Y; Dickson, R

    2013-07-01

    The National Institute for Health and Care Excellence (NICE) has issued multiple guidance for the first-line management of patients with lung cancer and recommends different combinations of chemotherapy treatments. This review provides a synthesis of clinical effectiveness and cost-effectiveness evidence supporting current guidance. To evaluate the clinical effectiveness and cost-effectiveness of first-line chemotherapy currently licensed in Europe and recommended by NICE, for adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC). Three electronic databases (MEDLINE, EMBASE and The Cochrane Library) were searched from 2001 to August 2010. Trials that compared first-line chemotherapy currently licensed in Europe and recommended by NICE in chemotherapy-naive adult patients with locally advanced or metastatic NSCLC were included. Data on key outcomes including, but not limited to, overall survival (OS), progression-free survival (PFS) and adverse events (AEs) were extracted. For the assessment of cost-effectiveness, outcomes included incremental cost per quality-adjusted life-year (QALY) gained. Analyses were performed for three NSCLC subpopulations: patients with predominantly squamous disease, patients with predominantly non-squamous disease and patients with epidermal growth factor receptor (EGFR) mutation-positive (M+) status. Meta-analysis and mixed-treatment comparison methodology were conducted where appropriate. Twenty-three trials involving > 11,000 patients in total met the inclusion criteria. The quality of the trials was poor. In the case of patients with squamous disease, there were no statistically significant differences in OS between treatment regimes. The mixed-treatment comparison demonstrated that, in patients with non-squamous disease, pemetrexed (Alimta®, Eli Lilly and Company; PEM) + platinum (PLAT) increases OS statistically significantly compared with gemcitabine (Gemzar®, Eli Lilly and Company; GEM) + PLAT

  18. Obesity adversely affects survival in pancreatic cancer patients.

    Science.gov (United States)

    McWilliams, Robert R; Matsumoto, Martha E; Burch, Patrick A; Kim, George P; Halfdanarson, Thorvardur R; de Andrade, Mariza; Reid-Lombardo, Kaye; Bamlet, William R

    2010-11-01

    Higher body-mass index (BMI) has been implicated as a risk factor for developing pancreatic cancer, but its effect on survival has not been thoroughly investigated. The authors assessed the association of BMI with survival in a sample of pancreatic cancer patients and used epidemiologic and clinical information to understand the contribution of diabetes and hyperglycemia. A survival analysis using Cox proportional hazards by usual adult BMI was performed on 1861 unselected patients with pancreatic adenocarcinoma; analyses were adjusted for covariates that included clinical stage, age, and sex. Secondary analyses incorporated self-reported diabetes and fasting blood glucose in the survival model. BMI as a continuous variable was inversely associated with survival from pancreatic adenocarcinoma (hazard ratio [HR], 1.019 for each increased unit of BMI [kg/m2], Ppancreatic cancer. Although the mechanism of this association remains undetermined, diabetes and hyperglycemia do not appear to account for the observed association. Copyright © 2010 American Cancer Society.

  19. Analysis of Maryland cancer patient participation in National Cancer Institute-supported cancer treatment clinical trials.

    Science.gov (United States)

    Baquet, Claudia R; Ellison, Gary L; Mishra, Shiraz I

    2009-05-01

    We examined the relationship of sociodemographic factors, urban/rural residence, and county-level socioeconomic factors on accrual of Maryland patients with cancer to National Cancer Institute (NCI)-sponsored cancer treatment clinical trials. Data were analyzed for the period 1999 to 2002 for 2240 Maryland patients with cancer accrued onto NCI-sponsored treatment trials. The extent to which Maryland patients with cancer and patients residing in lower socioeconomic and/or rural areas were accrued to cancer trials and were representative of all patients with cancer in Maryland was determined. Data were obtained from several sources, including NCI's Cancer Therapy Evaluation Program for Maryland patients with cancer in Cooperative Group therapeutic trials, Maryland Cancer Registry data on cancer incidence, and United States Census and the Department of Agriculture. For Maryland patients with cancer accrued onto NCI-sponsored treatment trials between 1999 and 2002, subgroups accrued at a higher rate included pediatric and adolescent age groups, white patients, female patients (for sex-specific tumors), patients with private health insurance, and patients residing in the Maryland National Capitol region. Moreover, between 1999 and 2002, there was an estimated annual decline (8.9% per year; P Maryland patients with cancer onto NCI-sponsored treatment trials based on patient age, race/ethnicity, geography of residence, and county-level socioeconomic factors. Findings provide the basis for development of innovative tailored and targeted educational efforts to improve trial accrual, particularly for the underserved.

  20. Cancer patients' interest and preferences for music therapy.

    Science.gov (United States)

    Burns, Debra S; Sledge, Renata B; Fuller, Leigh Ann; Daggy, Joanne K; Monahan, Patrick O

    2005-01-01

    The reason for lack of routine integration of music therapy into healthcare may be that patients are not comfortable being involved in a music therapy intervention. Therefore, the goal of this study was to examine cancer patients' interest in and preferences for using 2 types of music therapy interventions, music-making and music listening. Sixty-five patients completed the Music Interest Survey in addition to standardized measures of coping, affect, anxiety, and fatigue. Results suggest adult cancer patients are interested in music therapy, especially music listening. Patient interest and preference were associated with negative affect, anxiety, age, perceived intervention-specific benefits, barriers, and self-efficacy. Findings highlight the need for a comprehensive assessment of patient needs and preferences prior to intervention.

  1. Pregnancy and abortion in breast cancer patients

    African Journals Online (AJOL)

    Breast cancer in pregnancy is by itself not an indication for abortion. We document the case histories of 2 patients with breast cancer (recurrent or advanced) who elected to carry pregnancies to term. Pregnancy concurrent with or subsequent to breast cancer is not associated with a worse prognosis than would be observed ...

  2. Early palliative care for adults with advanced cancer.

    Science.gov (United States)

    Haun, Markus W; Estel, Stephanie; Rücker, Gerta; Friederich, Hans-Christoph; Villalobos, Matthias; Thomas, Michael; Hartmann, Mechthild

    2017-06-12

    Incurable cancer, which often constitutes an enormous challenge for patients, their families, and medical professionals, profoundly affects the patient's physical and psychosocial well-being. In standard cancer care, palliative measures generally are initiated when it is evident that disease-modifying treatments have been unsuccessful, no treatments can be offered, or death is anticipated. In contrast, early palliative care is initiated much earlier in the disease trajectory and closer to the diagnosis of incurable cancer. To compare effects of early palliative care interventions versus treatment as usual/standard cancer care on health-related quality of life, depression, symptom intensity, and survival among adults with a diagnosis of advanced cancer. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, OpenGrey (a database for grey literature), and three clinical trial registers to October 2016. We checked reference lists, searched citations, and contacted study authors to identify additional studies. Randomised controlled trials (RCTs) and cluster-randomised controlled trials (cRCTs) on professional palliative care services that provided or co-ordinated comprehensive care for adults at early advanced stages of cancer. We used standard methodological procedures as expected by Cochrane. We assessed risk of bias, extracted data, and collected information on adverse events. For quantitative synthesis, we combined respective results on our primary outcomes of health-related quality of life, survival (death hazard ratio), depression, and symptom intensity across studies in meta-analyses using an inverse variance random-effects model. We expressed pooled effects as standardised mean differences (SMDs, or Hedges' adjusted g). We assessed certainty of evidence at the outcome level using GRADE (Grading of Recommendations Assessment, Development, and

  3. Is admittance to specialised palliative care among cancer patients related to sex, age and cancer diagnosis?

    DEFF Research Database (Denmark)

    Adsersen, Mathilde; Thygesen, Lau Caspar; Jensen, Anders Bonde

    2017-01-01

    BACKGROUND: Specialised palliative care (SPC) takes place in specialised services for patients with complex symptoms and problems. Little is known about what determines the admission of patients to SPC and whether there are differences in relation to institution type. The aims of the study were...... to investigate whether cancer patients' admittance to SPC in Denmark varied in relation to sex, age and diagnosis, and whether the patterns differed by type of institution (hospital-based palliative care team/unit, hospice, or both). METHODS: This was a register-based study of adult patients living in Denmark...... who died from cancer in 2010-2012. Data sources were the Danish Palliative Care Database, Danish Register of Causes of Death and Danish Cancer Registry. The associations between the explanatory variables (sex, age, diagnosis) and admittance to SPC were investigated using logistic regression. RESULTS...

  4. The feasibility of using conversational agent technology to improve problem-solving and coping skills of young adults with cancer

    Directory of Open Access Journals (Sweden)

    von Friederichs-Fitzwater M

    2011-04-01

    Full Text Available Marlene M von Friederichs-Fitzwater1, Frederick J Meyers21Division of Hematology/Oncology, Internal Medicine, 2School of Medicine, University of California Davis, Sacramento, CA, USAObjective: Young adults with cancer have unique psychosocial needs and often lack the problem-solving and coping skills for effective resolution. We conducted a study to clarify these needs and then developed and tested an educational intervention to coach young adults with cancer in problem-solving and coping skills using a new conversational agent technology that uses a multi-media format to simulate face-to-face encounters.Methods: We qualitatively assessed online focus groups and chat rooms with 45 young adults with cancer and used the results to develop and test an online 15-minute educational prototype using a new conversational agent technology with 49 young adults (18–35 years of age with cancer.Results: Young adults with cancer are most concerned about reproductive issues, emotional issues, communicating with healthcare providers, and the risks and benefits of treatments. The study participants found the I-COPE prototype to be useful, easy to use, and worth recommending to others. They wanted to have more video segments about the experiences of other young adults with cancer; more video segments of actual procedures and treatments; more Internet links to information and resources; and more opportunities to interact with the conversational agent.Conclusion: New conversational agent technology is useful in coaching problem-solving and coping skills to empower young adults with cancer.Practice implications: New conversational agent technology is a useful tool in patient education and skill development, particularly among young adults.Keywords: young adult cancer patients, conversational agent technology, problem-solving, coping, self-efficacy, survivorship

  5. Second primary malignancies in adults with gastric cancer – A US population-based study

    Directory of Open Access Journals (Sweden)

    Binay Kumar Shah

    2016-04-01

    Full Text Available Background: Multiple studies have examined the incidence of secondary primary malignancies (SPM in gastric cancer patients in Europe and Asia. This retrospective review was conducted to analyze risk of SPM in patients with gastric cancer diagnosed in the United States (US.Methods: We included adult patients diagnosed with gastric cancer from the Surveillance, Epidemiology and End Result (SEER 13 database. We calculated the risk of secondary primary malignancies in these patients using the multiple primary standardized incidence ratio (MP-SIR session of SEER*stat software and performed subset analyses of SPM with regard to age, sex, radiotherapy used, and latency period.Results: Among 33,720 patients, 1838 (5.45% developed 2019 secondary primary malignancies with an observed/expected (O/E ratio of 1.11 (95% confidence interval (CI = 1.06-1.16, p<.001 and an absolute excess risk (AER of 18.16 per 10,000 population. The median time to first SPM from the time of diagnosis of gastric cancer was 46.9 months (range 6-239 months. Significant excess risk was observed for gastrointestinal malignancies [O/E ratio 1.71 (CI = 1.59-1.84, p<.001], thyroid [O/E ratio 2.00 (CI = 1.37-2.8, p<.001] and pancreatic cancer [O/E ratio 1.60 (CI = 1.29-21.96, p<.001]. Risk of secondary melanoma, breast cancer and prostate cancer was lower than in the general population.Conclusions: The risk for secondary primary malignancies is significantly increased in adults with gastric cancer compared to the general population.

  6. Cediranib Maleate and Combination Chemotherapy in Treating Patients With Advanced Biliary Cancers

    Science.gov (United States)

    2017-02-10

    Adult Primary Cholangiocellular Carcinoma; Advanced Adult Primary Liver Cancer; Cholangiocarcinoma of the Extrahepatic Bile Duct; Cholangiocarcinoma of the Gallbladder; Localized Unresectable Adult Primary Liver Cancer; Periampullary Adenocarcinoma; Recurrent Adult Primary Liver Cancer; Recurrent Extrahepatic Bile Duct Cancer; Recurrent Gallbladder Cancer; Unresectable Extrahepatic Bile Duct Cancer; Unresectable Gallbladder Cancer

  7. Young adult cancer survivors' follow-up care expectations of oncologists and primary care physicians.

    Science.gov (United States)

    Hugh-Yeun, Kiara; Kumar, Divjot; Moghaddamjou, Ali; Ruan, Jenny Y; Cheung, Winson Y

    2017-06-01

    Young adult cancer survivors face unique challenges associated with their illness. While both oncologists and primary care physicians (PCPs) may be involved in the follow-up care of these cancer survivors, we hypothesized that there is a lack of clarity regarding each physician's roles and responsibilities. A self-administered survey was mailed to young adult cancer survivors in British Columbia, Canada, who were aged 20 to 39 years at the time of diagnosis and alive at 2 to 5 years following the diagnosis to capture their expectations of oncologists and PCPs in various important domains of cancer survivorship care. Multivariate logistic regression models that adjusted for confounders were constructed to examine for predictors of the different expectations. Of 722 young cancer survivors surveyed, 426 (59%) responded. Among them, the majority were White women with breast cancer. Oncologists were expected to follow the patient's most recent cancer and treatment-related side effects while PCPs were expected to manage ongoing and future cancer surveillance as well as general preventative care. Neither physician was perceived to be responsible for addressing the return to daily activities, reintegration to interpersonal relationships, or sexual function. Older survivors were significantly less likely to expect oncologists (p = 0.03) and PCPs (p = 0.01) to discuss family planning when compared to their younger counterparts. Those who were White were significantly more likely to expect PCPs to discuss comorbidities (p = 0.009) and preventative care (p = 0.001). Young adult cancer survivors have different expectations of oncologists and PCPs with respect to their follow-up care. Physicians need to better clarify their roles in order to further improve the survivorship phase of cancer care for young adults. Young adult cancer survivors have different expectations of their oncologists and PCPs. Clarification of the roles of each physician group during follow-up can

  8. Positive consequences of cancer: exploring relationships among posttraumatic growth, adult attachment, and quality of life.

    Science.gov (United States)

    Tanyi, Zsuzsanna; Szluha, Kornélia; Nemes, László; Kovács, Sándor; Bugán, Antal

    2015-01-01

    Cancer can be a life-threatening illness; however, it can also be a source of positive life changes, the posttraumatic growth (PTG) that comes from struggling with this serious illness. This cross-sectional study examines the sociodemographic and cancer-related predictors of PTG following a diagnosis of cancer. In addition, the relationships among adult attachment, health-related quality of life, and PTG are investigated. Measuring adult attachment is important because it can greatly influence the response to a highly distressing event, like facing cancer. Immediately before undergoing radiotherapy, 152 patients with breast or prostate cancer (mean = 59.1 years old, SD = 10.7) who had received a positive diagnosis within an average of 3.5 months prior to treatment were tested for measures of PTG, adult attachment, and health-related quality of life. Patients also completed a questionnaire regarding medical and sociodemographic characteristics. Hierarchical multiple regression analyses were conducted to reveal the significant predictors of PTG total score and PTG subscale scores. Younger age was a significant predictor of the PTG total score and New Possibilities subscale score. Subjective severity of cancer was positively associated with the PTG total score and scores on the Appreciation of Life and New Possibilities subscales. Regarding health-related quality of life, analyses indicated that greater social/family well-being significantly predicted greater PTG total score and higher scores on the New Possibilities, Spiritual Change, Appreciation of Life, and Relating to Others subscales. Finally, dismissive attachment style predicted fewer scores on the Personal Strength and Relating to Others subscales. These findings suggest that in addition to quality of life and adult attachment, sociodemographic and cancer-related variables may significantly contribute to positive growth.

  9. Copper Cu 64 Anti-CEA Monoclonal Antibody M5A PET in Diagnosing Patients With CEA Positive Cancer

    Science.gov (United States)

    2017-10-27

    Breast Cancer; Colon Cancer; Extrahepatic Bile Duct Cancer; Gallbladder Cancer; Gastrointestinal Cancer; Liver and Intrahepatic Biliary Tract Cancer; Lung Cancer; Metastatic Cancer; Pancreatic Cancer; Rectal Cancer; Thyroid Gland Medullary Carcinoma; Unspecified Adult Solid Tumor, Protocol Specific

  10. Emerging markers of cachexia predict survival in cancer patients.

    Science.gov (United States)

    Mondello, Patrizia; Lacquaniti, Antonio; Mondello, Stefania; Bolignano, Davide; Pitini, Vincenzo; Aloisi, Carmela; Buemi, Michele

    2014-11-16

    Cachexia may occur in 40% of cancer patients, representing the major cause of death in more than 20% of them. The aim of this study was to investigate the role of leptin, ghrelin and obestatin as diagnostic and predictive markers of cachexia in oncologic patients. Their impact on patient survival was also evaluated. 140 adults with different cancer diagnoses were recruited. Thirty healthy volunteers served as control. Serum ghrelin, obestatin and leptin were tested at baseline and after a follow-up period of 18 months. Ghrelin levels were significantly higher in cancer patients than in healthy subjects (573.31 ± 130 vs 320.20 ± 66.48 ng/ml, p obestatin (17.42 ± 7.12 vs 24.89 ± 5.54 ng/ml, p obestatin (AUC 0.798; sensitivity 74.5%; specificity 81.5%) and leptin (AUC 0.828; sensitivity 79%; specificity 73%) was superior to that of albumin (AUC 0.547; sensitivity 63%, specificity 69.4%) for detecting cachexia among cancer patients. On Cox multivariate analyses ghrelin (HR 1.02; 95% CI 1.01 - 1.03; p cancer patients.

  11. Cancer-related information needs and cancer's impact on control over life influence health-related quality of life among adolescents and young adults with cancer.

    Science.gov (United States)

    DeRouen, Mindy C; Smith, Ashley Wilder; Tao, Li; Bellizzi, Keith M; Lynch, Charles F; Parsons, Helen M; Kent, Erin E; Keegan, Theresa H M

    2015-09-01

    Adolescents and young adults (AYAs) diagnosed with cancer between 15 and 39 years of age often report need for greater amounts of cancer-related information and perceive that cancer has had a negative impact on control over their life. We examined whether unmet information need and perceived control over life are associated with health-related quality of life (HRQOL). We examined data from 484 AYA cancer survivors recruited from population-based cancer registries in 2007-2008. Participants completed surveys a median of 11 months after diagnosis. Multivariable linear regression analyses estimated associations of unmet cancer-related information needs and impact of cancer on control over life on HRQOL (SF-12). Two-thirds of AYAs reported an intermediate or high level of unmet information need, and half (47%) reported a negative impact of cancer on control. Greater unmet information need was associated with lower overall mental and physical HRQOL and lower levels of all HRQOL subscales except vitality. A negative impact on control over life was associated with lower overall mental HRQOL as well as lower HRQOL across all subscales except general health perceptions (all p 0.1). Adolescent and young adult patients with cancer have high levels of unmet cancer-related information needs and perceived negative impact of cancer on control over life; both were independently associated with lower HRQOL. Addressing unmet information needs among AYA cancer survivors and finding ways to increase their sense of control may help improve HRQOL in this understudied population. Copyright © 2015 John Wiley & Sons, Ltd.

  12. Exercise for Cancer Patients; Guidelines and Precautions.

    Science.gov (United States)

    Winningham, Maryl L.; And Others

    1986-01-01

    Research and clinical observation indicate that exercise is a promising restorative technique for cancer patients. Guidelines for designing an exercise program are offered, including considerations for initial screening and ongoing monitoring of patients. (Author/MT)

  13. Depression and Resilience in Breast Cancer Patients

    OpenAIRE

    Gordana Ristevska-Dimitrоvska; Petar Stefanovski; Snezhana Smichkoska; Marija Raleva; Beti Dejanova

    2015-01-01

    OBJECTIVE: A significant number of breast cancer patients, during their life with the diagnosis, experience emotional distress in the form of depression and anxiety. Psychological resilience is the ability of a person to protect his/her mental health when faced with adverse circumstances such as the cancer diagnosis. This study aims to assess the resilience in breast cancer patients and to explore whether depression affects the resilience. MATERIAL AND METHODS: Two hundred eighteen (218) ...

  14. Influenza vaccination coverage among adult survivors of pediatric cancer.

    Science.gov (United States)

    Ojha, Rohit P; Offutt-Powell, Tabatha N; Gurney, James G

    2014-06-01

    A large proportion of long-term survivors of childhood cancer have treatment-related adverse cardiac and pulmonary late-effects, with related mortality. Consequently, this population of approximately 379,000 individuals in the U.S. is at high risk of complications from influenza infections. To estimate influenza vaccination coverage overall and among subgroups of adult survivors of pediatric cancer aged 18-64 years and to compare coverage with the general adult U.S. population. Data from the 2009 Behavioral Risk Factor Surveillance System were analyzed in 2013 using binomial regression to estimate influenza vaccination coverage differences (CDs) and corresponding 95% confidence limits (CLs) between adult survivors of pediatric cancer and the general U.S. population. Analyses were stratified by demographic characteristics and adjusted for design effects, non-coverage, and non-response. Influenza vaccination coverage was 37% for adult pediatric cancer survivors overall and 31% for the general adult U.S. population (CD=6.3%, 95% CL=0.04%, 13%). Dramatically lower coverage was observed for non-Hispanic black survivors (6%) than for non-Hispanic blacks in the general U.S. population (26%; CD=-18%, 95% CL=-25%, -11%). Although influenza vaccination coverage was modestly higher among adult survivors of pediatric cancer than the general U.S. population, coverage was less than desirable for a population with a high prevalence of cardiopulmonary conditions and early mortality, and far lower than the Healthy People 2010 goal of 60% or Healthy People 2020 goal of 80% for the general population. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Haemorheological Changes in African Breast Cancer Patients

    African Journals Online (AJOL)

    elearning

    ABSTRACT. Several Studies have indicated the existence of thrombo-embolic complications in cancer patients and that this ... There were significant differences between the controls and breast cancer patients in all the parameters measured. (p<0.05). .... the previous work of Trosseau2 which suggested an evidence of ...

  16. Taste and smell changes in cancer patients

    NARCIS (Netherlands)

    IJpma, Irene

    2017-01-01

    Patients with cancer often experience changes in taste and smell perception during chemotherapy. The aim of this dissertation was to investigate taste and smell changes and short- and long-term effects of chemotherapy in a homogeneous population of testicular cancer patients treated with

  17. Patient empowerment: a systematic review of questionnaires measuring empowerment in cancer patients.

    Science.gov (United States)

    Eskildsen, Nanna Bjerg; Joergensen, Clara Ruebner; Thomsen, Thora Grothe; Ross, Lone; Dietz, Susanne Malchau; Groenvold, Mogens; Johnsen, Anna Thit

    2017-02-01

    There is an increased attention to and demand for patient empowerment in cancer treatment and follow-up programs. Patient empowerment has been defined as feeling in control of or having mastery in relation to cancer and cancer care. This calls for properly developed questionnaires assessing empowerment from the user perspective. The aim of this review was to identify questionnaires and subscales measuring empowerment and manifestations of empowerment among cancer patients. We conducted a systematic search of the PubMed, PsycINFO and CINAHL databases. Empowerment and multiple search terms associated with empowerment were included. We included peer-reviewed articles published in English, which described questionnaires measuring empowerment or manifestations of empowerment in a cancer setting. In addition, the questionnaire had to be a patient-reported outcome measure for adult cancer patients. Database searches identified 831 records. Title and abstract screening resulted in 482 records being excluded. The remaining 349 full text articles were retrieved and assessed for eligibility. This led to the inclusion of 33 individual instruments measuring empowerment and manifestations of empowerment. Of these, only four were specifically developed to measure empowerment, and two were originally developed for the cancer setting, whereas the remaining two were developed elsewhere, but adapted to the cancer setting. The other 29 questionnaires were not intended to measure the concept of empowerment, but focused on patient-centered care, patient competence, self-efficacy, etc. However, they were included because part of the instrument (at least five items) was considered to measure empowerment or manifestations of empowerment. Our study provides an overview of the available questionnaires, which can be used by researchers and practitioners who wish to measure the concept of empowerment among cancer patients. Very few questionnaires were explicitly developed to explore

  18. Music therapy as part of the alternative-complementary therapy in cancer patients in hospital

    OpenAIRE

    Efstratios Athanassakis; Savvato Karavassiliadou

    2012-01-01

    Cancer is one of the modern health problems of people living in developed countries. Furthermore, therapeutic approaches to cancer patients is constantly updated with new data. Aim: The aim of the present study was to review the international literature referred to the application of music therapy in the treatment for pediatric and adult patients with cancer. Method and materials: The method of this study included bibliography research from both the review and the research literature on MEDLI...

  19. Osteoporosis in adult patients with celiac disease.

    Science.gov (United States)

    Kemppainen, T; Kröger, H; Janatuinen, E; Arnala, I; Kosma, V M; Pikkarainen, P; Julkunen, R; Jurvelin, J; Alhava, E; Uusitupa, M

    1999-03-01

    We investigated the bone mineral density (BMD) and prevalence of osteopenia and osteoporosis in adult celiac patients with varying disease states. In this cross-sectional study the data on the severity of celiac disease and BMD were collected from 77 celiac patients (28 newly diagnosed and 49 previously diagnosed celiac patients), and BMD results were compared with those of 157 control subjects matched for age, gender, and menopausal status. The celiac patients had significantly lower BMD than the control subjects at the lumbar spine (-6%) and femoral neck (-5%). The mean BMD did not differ significantly among celiac patients classified by severity of disease. Based on Z scores, 35% of the celiac patients and 17% of the control subjects had low BMDs for age at the lumbar spine (p = 0.005), whereas 31% of celiac patients and 16% of control subjects had Z scores of celiac patients, but only 5% of control subjects, were classified as having osteoporosis (T score osteoporosis was rare at the femoral neck in both groups (3% vs. 1%, p = 1.00). Prevalence of osteopenia and osteoporosis was highest in newly diagnosed celiac patients and in patients with disease not in remission. A low 25-(OH)D vitamin concentration was a typical biochemical abnormality in our patients (64% of men and 71% of women). The main associated variables of low BMD were age (men), low serum vitamin D level, low body weight, and postmenopausal status (women). The present study suggests that celiac disease constitutes a risk factor for osteoporosis. This finding applies particularly to untreated and poorly treated patients.

  20. Ab interno trabeculectomy in the adult patient.

    Science.gov (United States)

    SooHoo, Jeffrey R; Seibold, Leonard K; Kahook, Malik Y

    2015-01-01

    Glaucoma is a potentially blinding disease that affects millions of people worldwide. The mainstay of treatment is lowering of intraocular pressure (IOP) through the use of medications, laser and/or incisional surgery. The trabecular meshwork (TM) is thought to be the site of significant resistance to aqueous outflow in open angle glaucoma. Theoretically, an incision through TM or TM removal should decrease this resistance and lead to a significant reduction in IOP. This approach, commonly referred to as goniotomy or trabeculotomy, has been validated in the pediatric population and has been associated with long-term IOP control. In adults, however, removal of TM tissue has been historically associated with more limited and short-lived success. More recent evidence, reveals that even adult patients may benefit significantly from removal of diseased TM tissue and can lead to a significant reduction in IOP that is long-lasting and safe. In this review, we discuss current evidence and techniques for ab interno trabeculectomy using various devices in the adult patient.

  1. Overweight duration in older adults and cancer risk

    DEFF Research Database (Denmark)

    Arnold, Melina; Freisling, Heinz; Stolzenberg-Solomon, Rachael

    2016-01-01

    Recent studies have shown that cancer risk related to overweight and obesity is mediated by time and might be better approximated by using life years lived with excess weight. In this study we aimed to assess the impact of overweight duration and intensity in older adults on the risk of developin...

  2. Quality of palliative care. Perspective of Lebanese patients with cancer.

    Science.gov (United States)

    Abu-Saad Huijer, Huda; Doumit, Myrna; Abboud, Sarah; Dimassi, Hani

    2012-01-01

    The number of cancer patients in Lebanon is increasing, and patients are living longer due to early detection and enhanced methods of treatment. The purpose of this study was to evaluate the quality of life, symptom management, functional ability, and the quality of palliative care in adult Lebanese cancer patients at the American University of Beirut-Medical Center. A cross sectional survey design was used. A number of internationally validated instruments were translated into Arabic. A total of 200 cancer patients participated in the study; the majority was female with breast cancer and mean age 54. The cognitive functioning domain of the Quality of Life scale was found to have the highest score and social functioning the lowest. The most prevalent symptom was lack of energy and the least prevalent was shortness of breath. Nausea and pain were the symptoms mostly treated. In conclusion, this sample reported a fair quality of life and social functioning with high prevalence of physical and psychological symptoms. Inadequate symptom management was reported especially for the psychological symptoms. Participants reported a satisfactory level with the quality of care. Based on these results, providing adequate symptom management and social support to Lebanese cancer patients is highly recommended.

  3. Cancer immunotherapy in children

    Science.gov (United States)

    More often than not, cancer immunotherapies that work in adults are used in modified ways in children. Seldom are new therapies developed just for children, primarily because of the small number of pediatric patients relative to the adult cancer patient

  4. Understanding cognition in older patients with cancer

    OpenAIRE

    Karuturi, Meghan; Wong, Melisa L.; Hsu, Tina; Kimmick, Gretchen G.; Lichtman, Stuart M.; Holmes, Holly M.; Inouye, Sharon K.; Dale, William; Loh, Kah P.; Whitehead, Mary I.; Magnuson, Allison; Hurria, Arti; Janelsins, Michelle C.; Mohile, Supriya

    2016-01-01

    Cancer and neurocognitive disorders, such as dementia and delirium, are common and serious diseases in the elderly that are accompanied by high degree of morbidity and mortality. Furthermore, evidence supports the under-diagnosis of both dementia and delirium in older adults. Complex questions exist regarding the interaction of dementia and delirium with cancer, beginning with guidelines on how best measure disease severity, the optimal screening test for either disorder, the appropriate leve...

  5. Fertility in cancer patients after cryopreservation of one ovary

    DEFF Research Database (Denmark)

    Schmidt, K T; Nyboe Andersen, A; Greve, T

    2013-01-01

    This questionnaire study describes the fertility and ovarian function in 143 adult female cancer survivors with only one ovary due to cryopreservation of the other. The women were asked about their ovarian function (as defined by the presence of a spontaneous menstrual cycle), pregnancies...... and their outcome. The mean follow-up time was 58months after cryopreservation (range 24-129months). The risk of premature ovarian failure was high in the group of patients with leukaemia (13/15; 87%) but low in the breast cancer group (5/54; 9%). Fifty-seven women had actively tried to become pregnant after end...

  6. Vitamin D supplementation for prevention of cancer in adults

    DEFF Research Database (Denmark)

    Bjelakovic, Goran; Gluud, Lise Lotte; Nikolova, Dimitrinka

    2014-01-01

    BACKGROUND: The evidence on whether vitamin D supplementation is effective in decreasing cancers is contradictory. OBJECTIVES: To assess the beneficial and harmful effects of vitamin D supplementation for prevention of cancer in adults. SEARCH METHODS: We searched the Cochrane Central Register...... included randomised trials that compared vitamin D at any dose, duration, and route of administration versus placebo or no intervention in adults who were healthy or were recruited among the general population, or diagnosed with a specific disease. Vitamin D could have been administered as supplemental...... vitamin D₃, one trial tested vitamin D₂, and three trials tested calcitriol supplementation. Cancer occurrence was observed in 1927/25,275 (7.6%) recipients of vitamin D versus 1943/25,348 (7.7%) recipients of control interventions (RR 1.00 (95% confidence interval (CI) 0.94 to 1.06); P = 0.88; I² = 0...

  7. Prevalence of complementary and alternative medicine use in cancer patients.

    Science.gov (United States)

    Bernstein, B J; Grasso, T

    2001-10-01

    Interest in complementary and alternative medicine (CAM) has grown dramatically over the past several years. Cancer patients are always looking for new hope, and many have turned to nontraditional means. This study was conducted to determine the prevalence of complementary and alternative medicine use in cancer patients and what if any agents are being used. Approximately, 100 adult cancer patients in a private nonprofit South Florida hospital completed a descriptive cross-sectional survey questionnaire. The mean age of participants was 59 years; 42 patients were male and 58, female. According to survey results, 80% of patients reported using some type of CAM; 81% took vitamins, 54% took herbal products, 30% used relaxation techniques, 20% received massages, and 10% used home remedies. Among patients who took vitamins, 65% said they took a multivitamin, 39% took vitamin C, and 31%, vitamin E. The most common herbal remedies used were green tea, echinacea, shark cartilage, grape seed extract, and milk thistle. Meditation and deep breathing were the two most common relaxation techniques practiced. A large majority of cancer patients are using CAM. In light of the growing interest in CAM, health-care professionals need to be educated about the most common therapies used.

  8. Cancer in Patients With Gabapentin (GPRD)

    Science.gov (United States)

    2017-06-06

    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

  9. The risk of being depressed is significantly higher in cancer patients than in the general population

    DEFF Research Database (Denmark)

    Hartung, T J; Brähler, E; Faller, H

    2017-01-01

    of depressive symptoms by cancer site, thereby identifying cancer patients with the highest prevalence of depression. PATIENTS AND METHODS: We included 4020 adult cancer inpatients and outpatients from five distinct regions across Germany in a proportional stratified random sample based on the nationwide cancer......BACKGROUND: Depression is a common co-morbidity of cancer that has a detrimental effect on quality of life, treatment adherence and potentially survival. We conducted an epidemiological multi-center study including a population-based random comparison sample and estimated the prevalence...

  10. Symptom Levels in Care-Seeking Bangladeshi and Nepalese Adults With Advanced Cancer

    Directory of Open Access Journals (Sweden)

    Richard Reed Love

    2017-06-01

    Full Text Available Purpose: Three-fourths of patients with advanced cancer are reported to suffer from pain. A primary barrier to provision of adequate symptom treatment is failure to appreciate the intensity of the symptoms patients are experiencing. Because data on Bangladeshi and Nepalese patients’ perceptions of their symptomatic status are limited, we sought such information using a cell phone questionnaire. Methods: At tertiary care centers in Dhaka and Kathmandu, we recruited 640 and 383 adult patients, respectively, with incurable malignancy presenting for outpatient visits and instructed them for that single visit on one-time completion of a cell phone platform 15-item survey of questions about common cancer-associated symptoms and their magnitudes using Likert scales of 0 to 10. The questions were taken from the Edmonton Symptom Assessment System and the Brief Pain Inventory instruments. Results: All but two Bangladeshi patients recruited agreed to study participation. Two-thirds of Bangladeshi patients reported usual pain levels ≥ 5, and 50% of Nepalese patients reported usual pain levels ≥ 4 (population differences significant at P < .001. Conclusion: Bangladeshi and Nepalese adults with advanced cancer are comfortable with cell phone questionnaires about their symptoms and report high levels of pain. Greater attention to the suffering of these patients is warranted.

  11. Adoption consideration and concerns among young adult female cancer survivors.

    Science.gov (United States)

    Gorman, Jessica R; Whitcomb, Brian W; Standridge, Daniel; Malcarne, Vanessa L; Romero, Sally A D; Roberts, Samantha A; Su, H Irene

    2017-02-01

    We compared adoption consideration between female young adult cancer survivors and women of the same age in the general US population, hypothesizing that cancer survivors who desired children would report greater interest in adoption than an age-adjusted general population sample who desired children. After age-standardizing the cancer survivor cohort to match the age distribution of the 2006-2010 National Survey for Family Growth (NSFG), we estimated adoption consideration among women age 18-35 years who wanted a (another) child in the two cohorts overall and within age groups. We assessed characteristics and concerns related to adoption consideration among cancer survivors. Among cancer survivors, 81.6 % (95 % CI 75.7-87.6) reported that they would consider adoption compared to 40.3 % (95 % CI 40.3-40.3) of women in the general population. While over 80 % of the cancer survivor sample reported that they would consider adoption, only 15 % of cancer survivors reported no concerns about adoption. The most common concerns were desire for a biological child (48 %), expense (45 %), adoption agency candidacy (41 %), and needing more information (39 %). We observed a twofold higher interest in adoption when comparing the cancer survivor with the general population, suggesting that adoption is a consideration for many young women who have survived cancer. Adoption is an important family-building option for those who want to have a child but are unable to or choose not to have a biological child. However, young adult survivors may need more support to understand and navigate this process.

  12. Patient navigation and the American Cancer Society.

    Science.gov (United States)

    Esparza, Angelina

    2013-05-01

    To review the evolution, implementation, and development of the American Cancer Society's Navigator program. American Cancer Society reports and published articles The American Cancer Society has a long history of supporting the growth and development of navigation, from provision of funding for Dr Freeman's pilot program, to developing a program that includes training, policy development, and research. The Society continues to play a key role in providing leadership to advance patient navigation as a means to improve patients' access to care, movement through the health care system while furthering patient centered care, patients' quality of life and eliminating health outcome disparities. With the American Cancer Society navigation model, navigators are trained to meet with patients, identify barriers to care, and work with institutional health care teams to support patients and assist staff with aspects of care that can be managed by non-medical personnel. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Why Cancer Patients Seek Islamic Healing.

    Science.gov (United States)

    Suhami, Norhasmilia; Muhamad, Mazanah Bt; Krauss, Steven Eric

    2016-10-01

    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.

  14. Psychosocial Intervention In Prostate Cancer Patients

    Directory of Open Access Journals (Sweden)

    Potočníková Jana

    2015-05-01

    Full Text Available Prostate cancer is the second most common cancer worldwide for males, and the fifth most common cancer overall. Using of autogenic training could reduce the influence of ADT and raise quality of prostate cancer patients. The aim of this study was to determine the effects of autogenic training in patients with prostate cancer. Patients were divided to experimental and control group. Experimental group participated in fourteen weeks long autogenic training program. Control group performed usual daily activities. Every subject of research performed input and output diagnostics which monitored psychical states of patients by psychological standardized tests - Differential questionnaire of depression (DDF and Questionnaire of anxiety (STAI X1. Our data showed autogenic training program significant improved depressions symptoms and anxiety in experimental research group (p ≤ 0.05, however there was no main change of depression symptoms and anxiety values for control group (p = n.s..

  15. Survival of ovarian cancer patients in Denmark

    DEFF Research Database (Denmark)

    Edwards, Hellen McKinnon; Noer, Mette Calundann; Sperling, Cecilie Dyg

    2016-01-01

    linked via the patients' personal identification number and the analyses included data on cancer stage, age, survival, surgery status and comorbidity. The computed outcome measures were age-adjusted mortality rates and age-adjusted overall and relative survival rates for one and five years. RESULTS: We......BACKGROUND: Ovarian cancer has a high mortality rate, especially in Denmark where mortality rates have been reported higher than in adjacent countries with similar demographics. This study therefore examined recent survival and mortality among Danish ovarian cancer patients over an 18-year study...... period. METHODS: This nationwide registry-based observational study used data from the Danish Gynecology Cancer Database, Danish Pathology Registry, and Danish National Patient Registry. All patients with ovarian cancer diagnosed between 1995 and 2012 were included in the study. The data sources were...

  16. Advance directives: cancer patients' preferences and family-based decision making.

    Science.gov (United States)

    Xing, Yan-Fang; Lin, Jin-Xiang; Li, Xing; Lin, Qu; Ma, Xiao-Kun; Chen, Jie; Wu, Dong-Hao; Wei, Li; Yin, Liang-Hong; Wu, Xiang-Yuan

    2017-07-11

    Advance directives are a sensitive issue among traditional Chinese people, who usually refrain from mentioning this topic until it is imperative. Medical decisions for cancer patients are made by their families, and these decisions might violate patients' personal will. This study aimed to examine the acceptance of advance directives among Chinese cancer patients and their families and patient participation in this procedure and, finally, to analyze the moral risk involved. While 246 patients and their family members refused official discussion of an advance directive, the remaining 166 patients and their families accepted the concept of an advance directive and signed a document agreeing to give up invasive treatment when the anti-cancer treatment was terminated. Of these, only 24 patients participated in the decision making. For 101 patients, anti-cancer therapy was ended prematurely with as many as 37 patients not told about their potential loss of health interests. Participants were 412 adult cancer patients from 9 leading hospitals across China. An advance directive was introduced to the main decision makers for each patient; if they wished to sign it, the advance directive would be systematically discussed. A questionnaire was given to the oncologists in charge of each patient to evaluate the interaction between families and patients, patients' awareness of their disease, and participation in an advance directive. Advance directives were not widely accepted among Chinese cancer patients unless anti-cancer therapy was terminated. Most cancer patients were excluded from the discussion of an advance directive.

  17. Supportive Care Needs and Association With Quality of Life of Mexican Adults With Solid Cancers.

    Science.gov (United States)

    Doubova, Svetlana V; Casales-Hernández, Maria Guadalupe; Perez-Cuevas, Ricardo

    2017-04-20

    Patients with cancer have supportive care needs. Studies that analyze the relationship between supportive care needs and health-related quality of life (HRQoL) are scarce. Cultural differences in supportive care needs and perceived QoL are also worth analyzing. The aim of this study was to assess the association between supportive care needs and HRQoL of Mexican adults given a diagnosis of solid cancers. We performed a secondary data analysis of a cross-sectional survey of 825 adult patients with cancer treated at the Oncology Hospital of the Mexican Institute of Social Security. The QLQ-30 from the European Organization for Research and Treatment of Cancer served to measure HRQoL, and the Supportive Care Needs Questionnaire was used to ascertain the needs. The analysis included multiple linear regression models for each HRQoL domain controlled for demographic, clinical, and social support covariates. There was an association between psychological needs with low scores in the HRQoL domains of global health, emotional functioning, and increased fatigue. Physical and daily living needs were associated with most HRQoL domains except the emotional domain. Patient care needs were related to low scores in the emotional and social functioning domains. Health systems and information needs were associated with low scores on cognitive functioning. Physical, psychological, patient care, and informational needs were associated with decreased HRQoL of Mexican patients with cancer. Healthcare providers, including nurses, are encouraged to perform routine, comprehensive evaluations of the supportive care needs and HRQoL of patients with solid cancers to respond in a timely manner to their needs.

  18. OPEN INGUINAL HERNIA REPAIR IN ADULT PATIENTS

    Directory of Open Access Journals (Sweden)

    M. S. Tomin

    2014-06-01

    Full Text Available The review presents the frequency, anatomy, classification, diagnosis, and the most effective open methods of inguinal hernia’s operative therapy in adult patients. These findings are in agreement with the recommendations of the Ukrainian association of surgeons-herniologists and the European European Hernia Society (EHS. The article does not deal with laparoendoscopic options of hernia repair (TAPP and TEP, as they require a separate section in the anatomy of the inguinal region and endoscopic techniques’ volumetric description. Besides, in Ukraine inguinal hernia repair is most frequently performed of open access that causes the topic’s timeliness.

  19. Prognostic factors in young ovarian cancer patients

    DEFF Research Database (Denmark)

    Klar, M; Hasenburg, A; Hasanov, M

    2016-01-01

    OBJECTIVES: We evaluated in a large study meta-database of prospectively randomised phase III trials the prognostic factors for progression-free survival (PFS) and overall survival (OS) in patients 40 years of age with advanced epithelial ovarian cancer. METHODS: A total of 5055 patients...... epithelial ovarian cancer, excellent performance status, who had received complete macroscopic upfront cytoreduction and ≥5 chemotherapy cycles. RESULTS: For patients

  20. [Touching cancer: shiatsu as complementary treatment to support cancer patients].

    Science.gov (United States)

    Argash, Oz; Caspi, Opher

    2008-01-01

    In recent years there has been an increase in the interest of cancer patients in receiving complementary medicine therapies as supportive measures to cure the disease. In response, medical units that combine conventional and complementary medicine (integrative medicine) have been established in leading cancer centers worldwide. In Israel, a special integrative medicine unit that combines mind-body, Chinese medicine, nutrition, herbs, supplements, and manual therapies (such as shiatsu) before, during and after conventional anti-cancer therapies has been established as an integral part of the Davidoff Comprehensive Cancer Center in 2006. Shiatsu represents a group of manual therapeutic techniques, including acupressure. Shiatsu offers cancer patients a non-pharmacologic method to relieve symptoms and improve quality of life throughout the course of illness. Research indicates that acupressure is relatively effective and safe for common cancer-related symptoms such as nausea, vomiting and insomnia. In our experience, shiatsu is also relatively effective and safe for other common symptoms such as fatigue, muscular pain and body image dissatisfaction. Yet, insufficient evidence exists to delineate the best means by which shiatsu and other manual therapies could or should be integrated into routine cancer care. The purpose of the present paper is to describe what is currently known about this topic in order to support decision-making that is based on facts, rather than on myths and misconceptions. We call for more research that examines the effectiveness and safety of shiatsu and other manual therapies in the care of cancer patients.

  1. Spirituality in Adolescents and Young Adults With Cancer: A Review of Literature.

    Science.gov (United States)

    McNeil, Sharon B

    2016-01-01

    Spirituality and religion have been found to have a positive impact on adults with cancer, but these concepts have not been well examined in adolescents and young adults (AYA) with cancer. AYA often question and struggle with their religious and spiritual beliefs, so it is not clear if spirituality and religion have the same positive impact on this age group. The purpose of this review of literature was to examine the research that has been conducted in spirituality in AYA with cancer. The review covered the years from 1980 to present. The terms cancer, adolescents, and young adults as well as the phrases spirit* and relig* were used to capture the different variations of words. Nine articles were found that explored spirituality and religiosity in AYA with cancer. This review highlighted the need for clarifying the terms used in describing the concept. This lack of continuity in terms makes it difficult to compare the studies. The methods used to measure spirituality are varied. Pediatric oncology nurses need to be sensitive to the spiritual needs of their patients. This can be accomplished by keeping an open line of communication and ensuring uninterrupted time to pray or read scriptures. Because of the variety of ways to express spirituality, the important first step is to ask what spirituality means to them. © 2015 by Association of Pediatric Hematology/Oncology Nurses.

  2. Cancer patients and characteristics of pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Hasenberg, U.; Paul, T. [Department of Radiology, University Hospital Essen (Germany); Feuersenger, A. [Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen (Germany); Goyen, M. [Department of Radiology, University Medical Center Hamburg-Eppendorf (Germany); Kroeger, K. [Department of Angiology, University Hospital Essen (Germany)], E-mail: knut.kroeger@uk-essen.de

    2009-03-15

    Objective: To check the hypothesis that cancer patients suffer from extended pulmonary embolism (PE) more frequently than patients without cancer we analysed PEs proved by computed tomography (CT)-imaging. Patients and methods: One hundred and fifty consecutive CT scans at the University Hospital of Essen from March 2002 until December 2004 which proved a definite case of pulmonary embolism were retrospectively reviewed (79 men, 71 women; mean age 57 {+-} 15 years). Underlying disease and blood parameters were included (haemoglobin, haematocrit, fibrinogen and total protein, if determined within 48 h before the CT scans). Results: Patients with malignant disease were older (59 {+-} 12 years vs. 54 {+-} 19 years, p = 0.05) and tend to have a higher rate of central PEs (52% vs. 34%, p = 0.08) than patients without malignancies. The odds of a central PE in cancer patients was about twice as high as in patients without a malignant disease (Odds ratio: 2.08, 95%-confidence interval: 1.06-4.10; age-adjusted Odds ratio 1.88, 95%-confidence interval: 0.92-3.84). Additional adjustment for the clinical information dyspnoea, inhospital patient and clinically expected PE did not deteriorate the odds. Thrombus density determined in patients with central PE only shows a trend towards a lower density in patients with malignant disease (52 {+-} 13 HE vs. 45 {+-} 15 HE, p = 0.13). There is no statistical evidence that thrombus density is related to one of the blood parameters or even blood density measured in the pulmonary artery. Conclusion: Although this is a retrospective study including a small number of patients it shows that cancer patients are at a higher risk for central PE than patients without cancer. Characteristics of the intrapulmonal thrombus in cancer and non-cancer patients seem to be different.

  3. Hypothyroidism after cancer and the ability to meet reproductive goals among a cohort of young adult female cancer survivors.

    Science.gov (United States)

    Chin, Helen B; Jacobson, Melanie H; Interrante, Julia D; Mertens, Ann C; Spencer, Jessica B; Howards, Penelope P

    2016-01-01

    To determine whether developing hypothyroidism after cancer treatment is associated with a decreased probability of women being able to meet their reproductive goals. A population-based cohort study. Not applicable. A total of 1,282 cancer survivors, of whom 904 met the inclusion criteria for the analysis. None. Three outcomes that may indicate reduced fertility, which include failure to achieve desired family size, childlessness, and not achieving pregnancy after at least 6 months of regular unprotected intercourse. We used data from the Furthering Understanding of Cancer Health and Survivorship in Adult (FUCHSIA) Women's Study to examine the association between being diagnosed with hypothyroidism after cancer and meeting reproductive goals. After adjusting for age and other potential confounders, women reporting hypothyroidism after cancer treatment were twice as likely to fail to achieve their desired family size (adjusted odds ratio [aOR] 1.91; 95% confidence interval [CI], 1.09, 3.33) and be childless (aOR 2.13; 95% CI, 1.25, 3.65). They were also more likely to report having unprotected intercourse for at least 6 months without conceiving (aOR 1.37; 95% CI, 0.66, 2.83). Although cancer treatments themselves are gonadotoxic, it is important to consider other medical conditions such as hypothyroidism that occur after cancer treatment when counseling patients on the risks for impaired fertility or a shortened reproductive window. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Cancer patients, emergencies service and provision of palliative care

    Directory of Open Access Journals (Sweden)

    Bruno Miranda

    2016-06-01

    Full Text Available SUMMARY Objective: To describe the clinical and sociodemographic profile of cancer patients admitted to the Emergency Center for High Complexity Oncologic Assistance, observing the coverage of palliative and home care. Method: Cross sectional study including adult cancer patients admitted to the emergency service (September-December/2011 with a minimum length of hospital stay of two hours. Student’s t-test and Pearson chi-square test were used to compare the means. Results: 191 patients were enrolled, 47.6% elderly, 64.4% women, 75.4% from the city of Recife and greater area. The symptom prevalent at admission was pain (46.6%. 4.2% of patients were linked to palliative care and 2.1% to home care. The most prevalent cancers: cervix (18.3%, breast (13.6% and prostate (10.5%; 70.7% were in advanced stages (IV, 47.1%; 39.4% without any cancer therapy. Conclusion: Patients sought the emergency service on account of pain, probably due to the incipient coverage of palliative and home care. These actions should be included to oncologic therapy as soon as possible to minimize the suffering of the patient/family and integrate the skills of oncologists and emergency professionals.

  5. Understanding male cancer patients' barriers to participating in cancer rehabilitation.

    Science.gov (United States)

    Handberg, C; Lomborg, K; Nielsen, C V; Oliffe, J L; Midtgaard, J

    2015-11-01

    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. © 2015 John Wiley & Sons Ltd.

  6. Supportive care needs of Iranian cancer patients

    Directory of Open Access Journals (Sweden)

    Azad Rahmani

    2014-01-01

    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.

  7. [Spiritual care model for terminal cancer patients].

    Science.gov (United States)

    Cheng, Ju-Fen; Lin, Ya-Ching; Huang, Pai-Ho; Wei, Chih-Hsin; Sun, Jia-Ling

    2014-12-01

    Providing spiritual care to patients with advanced cancer may improve the quality of life of these patients and help them experience a good death. Cancer patients are eager for additional spiritual care and for a sense of peace at the end of their life. However, spirituality is an abstract concept. The literature on spiritual care focuses primarily on elaborations of spirituality theory. Thus, first-line medical care professionals lack clear guidelines for managing the spiritual needs of terminal cancer patients. The purposes of this article were to: 1) introduce a spiritual care model based on the concept of repair and recovery of relationships that addresses the relationship between the self and God, others, id, and objects and 2) set out a four-step strategy for this model that consists of understanding, empathizing, guiding, and growing. This article provides operational guidelines for the spiritual care of terminal cancer patients.

  8. Sleep Dysfunction in Patients with Cancer

    Science.gov (United States)

    Fiorentino, Lavinia; Ancoli-Israel, Sonia

    2010-01-01

    Opinion statement Sleep complaints are common in cancer patients. Insomnia is particularly a concern in this population. Although pharmacotherapy is the most prescribed treatment for sleep disturbances, there is evidence that cognitive-behavioral therapy (CBT) is an effective treatment for insomnia in all patients, including those with cancer. CBT for insomnia is a flexible treatment, tailored to the needs of a specific patient, and focusing on behavioral and psychologic skills that foster better sleep and lower anxiety. Many cancer patients with insomnia may be hesitant to use drugs for their sleep treatment because they are already overwhelmed by the chemical and pharmacologic treatments they are prescribed for the cancer; thus, CBT may become the treatment of choice for insomnia in these patients. PMID:17716597

  9. [Metabolic emergencies in critically ill cancer patients].

    Science.gov (United States)

    Namendys-Silva, Silvio A; Hernández-Garay, Marisol; García-Guillén, Francisco J; Correa-García, Paulina; Herrera Gómez, Angel; Meneses-García, Abelardo

    2013-11-01

    Severe metabolic alterations frequently occur in critically ill cancer patients; hypercalcemia, hypocalcemia, hyponatremia, tumor lysis syndrome, metabolic complications of renal failure and lactic acidosis. Cancer patients with metabolic emergencies should be treated in a medical oncology department or an intensive care unit. Most metabolic emergencies can be treated properly when they are identified early. The clinician should consider that the prognosis of critically ill cancer patients depends on their primary disease, comorbidities and organ failure. Copyright AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  10. Emotional distress among adult survivors of childhood cancer.

    Science.gov (United States)

    Oancea, S Cristina; Brinkman, Tara M; Ness, Kirsten K; Krull, Kevin R; Smith, Webb A; Srivastava, D Kumar; Robison, Leslie L; Hudson, Melissa M; Gurney, James G

    2014-06-01

    The purposes of this study were to estimate the prevalence of emotional distress in a large cohort of adult survivors of childhood cancer and to evaluate the interrelationship of risk factors including cancer-related late effects. Adult survivors of childhood cancer (N = 1,863), median age of 32 years at follow-up, completed comprehensive medical evaluations. Clinically relevant emotional distress was assessed using the Brief Symptom Inventory 18 and was defined as T-scores ≥63. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariable logistic regression models to identify risk factors for distress. Path analysis was used to examine associations among identified risk factors. Elevated global distress was reported by 15.1% of survivors. Cancer-related pain was associated with elevated distress (OR 8.72; 95% CI, 5.32-14.31). Survivors who reported moderate learning or memory problems were more likely to have elevated distress than survivors who reported no learning or memory problems (OR 3.27; 95% CI, 2.17-4.93). Path analysis implied that cancer-related pain has a direct effect on distress symptoms and an indirect effect through socioeconomic status and learning or memory problems. Similar results were observed for learning or memory problems. Childhood cancer-related morbidities including pain and learning or memory problems appear to be directly and indirectly associated with elevated distress symptoms decades after treatment. Understanding these associations may help inform intervention targets for survivors of childhood cancer experiencing symptoms of distress. A subset of long-term childhood cancer survivors experience significant emotional distress. Physical and cognitive late effects may contribute to these symptoms.

  11. Incidence and incidence trends of the most frequent cancers in adolescent and young adult Americans, including "nonmalignant/noninvasive" tumors.

    Science.gov (United States)

    Barr, Ronald D; Ries, Lynn A G; Lewis, Denise R; Harlan, Linda C; Keegan, Theresa H M; Pollock, Bradley H; Bleyer, W Archie

    2016-04-01

    Incidence rates and trends of cancers in adolescents and young adults (AYAs) ages 15 to 39 years were reexamined a decade after the US National Cancer Institute AYA Oncology Progress Review Group was established. Data from the Surveillance, Epidemiology, and End Results program through 2011 were used to ascertain incidence trends since the year 2000 of the 40 most frequent cancers in AYAs, including tumors with nonmalignant/noninvasive behavior. Seven cancers in AYAs exhibited an overall increase in incidence; in 4, the annual percent change (APC) exceeded 3 (kidney, thyroid, uterus [corpus], and prostate cancer); whereas, in 3, the APC was between 0.7 and 1.4 (acute lymphoblastic leukemia and cancers of the colorectum and testis). Eight cancers exhibited statistically significant decreases in incidence among AYAs: Kaposi sarcoma (KS), fibromatous neoplasms, melanoma, and cancers of the anorectum, bladder, uterine cervix, esophagus, and lung, each with an APC less than -1. AYAs had a higher proportion of noninvasive tumors than either older or younger patients. An examination of cancer incidence patterns in AYAs observed over the recent decade reveal a complex pattern. Thyroid cancer by itself accounts for most of the overall increase and is likely caused by overdiagnosis. Reductions in cervix and lung cancer, melanoma, and KS can be attributed to successful national prevention programs. A higher proportion of noninvasive tumors in AYAs than in children and older adults indicates a need to revise the current system of classifying tumors in this population. © 2016 American Cancer Society.

  12. Long Term Toxicity of Cancer Treatment in Older Patients

    Science.gov (United States)

    Shahrokni, Armin; Wu, Abraham; Carter, Jeanne; Lichtman, Stuart M.

    2016-01-01

    Synopsis With earlier cancer diagnosis among older cancer patients, the possibility of curing cancer increases. However, cancer treatment may have long lasting impact on older cancer survivors. It is vital to screen, diagnose and properly manage the long term toxicities of cancer treatment, in order to maintain quality of life of older cancer survivors PMID:26614861

  13. Nutrition in Head and Neck Cancer Patients

    OpenAIRE

    Varkey, Prashanth; Tang, Wen-Ruay; Tan, Ngian Chye

    2010-01-01

    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...

  14. On-Site Fertility Preservation Services for Adolescents and Young Adults in a Comprehensive Cancer Center.

    Science.gov (United States)

    Peavey, Mary; Arian, Sara; Gibbons, William; Lu, Karen; Gershenson, David; Woodard, Terri

    2017-06-01

    Adolescents and young adults (AYAs) receiving cancer treatments that may impair fertility should receive counseling about risk of infertility and options for fertility preservation (FP) before treatment and/or during survivorship. Our objective was to define the AYA patient population referred to an on-site fertility consultation service within a comprehensive cancer center and determine factors associated with patients proceeding with FP treatment. We conducted a retrospective chart review of AYA women who completed a consultation at the MD Anderson Fertility Preservation and Family Building Service during the first year of service. Records of 154 referred AYA patients were reviewed for age, ethnicity, cancer type gravidity and parity, survivorship status, and decision to pursue FP treatment. Patients (mean age 29.7) were Caucasian (55%), Hispanic (23%), and African American (10%). The majority of women (67%) were seen for FP before cancer treatment and the remaining sought options for family building while in survivorship. The most common cancer types were hematologic (29%), breast (25%), and gynecologic (23%). Patients referred to an on-site fertility consultation service were medically and ethnically diverse. Interest in fertility counseling and treatment was apparent in both survivorship pre- and postcancer treatment. Although the referral group was ethnically diverse, Caucasian women were most likely to pursue FP treatment compared to women of other ethnicities.

  15. "Sometimes you just have to walk alone"--meanings of emotional support among Danish-born and migrant cancer patients

    DEFF Research Database (Denmark)

    Kristiansen, Maria; Tjørnhøj-Thomsen, Tine; Krasnik, Allan

    2010-01-01

    The study explores differences and similarities in needs for and experiences with emotional support among Danish-born and migrant cancer patients. Qualitative narrative interviews with 18 adult cancer patients were conducted. Analysis was inspired by phenomenological methods. Migrant patients exp...

  16. Safety of cabazitaxel in senior adults with metastatic castration-resistant prostate cancer

    DEFF Research Database (Denmark)

    Heidenreich, Axel; Bracarda, Sergio; Mason, Malcolm

    2014-01-01

    BACKGROUND: Cabazitaxel/prednisone has been shown to prolong survival versus mitoxantrone/prednisone in patients with metastatic castration-resistant prostate cancer (mCRPC) that has progressed during or after docetaxel. Subsequently, compassionate-use programmes (CUPs) and expanded-access progra......-CSF, especially at cycle 1 and in men aged > or =75 years, is important and improves tolerability in senior adults treated with cabazitaxel....

  17. Aetiology, genetics and prevention of secondary neoplasms in adult cancer survivors.

    Science.gov (United States)

    Travis, Lois B; Demark Wahnefried, Wendy; Allan, James M; Wood, Marie E; Ng, Andrea K

    2013-05-01

    Second and higher-order malignancies now comprise about 18% of all incident cancers in the USA, superseding first primary cancers of the breast, lung, and prostate. The occurrence of second malignant neoplasms (SMN) is influenced by a myriad of factors, including the late effects of cancer therapy, shared aetiological factors with the primary cancer (such as tobacco use, excessive alcohol intake, and obesity), genetic predisposition, environmental determinants, host effects, and combinations of factors, including gene-environment interactions. The influence of these factors on SMN in survivors of adult-onset cancer is reviewed here. We also discuss how modifiable behavioural and lifestyle factors may contribute to SMN, and how these factors can be managed. Cancer survivorship provides an opportune time for oncologists and other health-care providers to counsel patients with regard to health promotion, not only to reduce SMN risk, but to minimize co-morbidities. In particular, the importance of smoking cessation, weight control, physical activity, and other factors consonant with adoption of a healthy lifestyle should be consistently emphasized to cancer survivors. Clinicians can also play a critical role by endorsing genetic counselling for selected patients and making referrals to dieticians, exercise trainers, and others to assist with lifestyle change interventions.

  18. Perioperative nutrition support in cancer patients.

    Science.gov (United States)

    Huhmann, Maureen B; August, David A

    2012-10-01

    Malnutrition and weight loss negatively affect outcomes in surgical cancer patients. Decades of research have sought to identify the most appropriate use of nutrition support in these patients. National and international guidelines help to direct clinicians' use of nutrition support in surgical patients, but a number of specific issues concerning the use of nutrition support continue to evolve. This review focuses on 5 key issues related to perioperative nutrition support in cancer patients: (1) Which perioperative cancer patients should receive nutrition support? (2) How can the nutrition status and requirements of these patients be optimally assessed? (3) What is the optimal route of administration (parenteral nutrition vs enteral nutrition) and composition of nutrition support in this setting? (4) When should feedings be initiated? (5) What is the role of glycemic control in these patients?

  19. Cryptosporidiosis in HIV/AIDS Adult Patients in Jos | Banwat ...

    African Journals Online (AJOL)

    %) of the control group excreted the oocyst. Conclusion: The prevalence of Cryptosporidiosis is high in HIV/AIDS adult patients in this environment. KEY WORDS: Cryptosporiodiosis, Adults, HIV./AIDS, Jos. Highland Medical Research Journal ...

  20. Non-oncology physician visits after diagnosis of cancer in adolescents and young adults.

    Science.gov (United States)

    Heins, Marianne J; Lorenzi, Maria F; Korevaar, Joke C; McBride, Mary L

    2016-08-01

    Health care needs of adolescents and young adults (AYAs) with cancer are probably different from other age groups. Studying their non-oncology physician visits in the first years after diagnosis may provide insight into the specific health problems AYA patients experience and thereby help to improve care for these patients. Seven hundred seventy-four AYAs identified from a Canadian provincial registry diagnosed with cancer between ages 15 and 24 years in 1991/2001 were included, matched by birth year and sex to ten controls. Based on provincial health insurance plan records, we determined the number of family physician and non-cancer specialist visits in the 5 years after diagnosis (for patients) or inclusion (for controls). The percentage of patients visiting a non-cancer specialist decreased from 96 to 49 % over the 5-year period. The percentage visiting a family physician decreased from 96 to 84 %. Visits in all years were significantly higher than among controls. In the first year after diagnosis, many patients visited a non-cancer specialist or a family physician for neoplasm-related health problems (77 and 55 %, respectively). In addition, family physicians were also consulted for general age-specific problems, such as genitourinary symptoms In the first years after diagnosis of cancer in AYAs, both non-cancer specialist and family physician visits are common, although non-cancer specialist visits are less common and decline considerably faster than in younger children. The specific pattern of physician visits of this age group calls for care that is tailored to their specific needs.

  1. Survival of adolescents with cancer treated at pediatric versus adult oncology treatment centers in France.

    Science.gov (United States)

    Desandes, Emmanuel; Brugieres, Laurence; Laurence, Valérie; Berger, Claire; Kanold, Justyna; Tron, Isabelle; Clavel, Jacqueline; Lacour, Brigitte

    2017-05-01

    In France, although children aged less than 15 years with cancer are usually referred to pediatric oncology centers, adolescents may be treated at pediatric or adult oncology centers. The objective was to compare survival according to their site of treatment. Using population-based registration, 15- to 19-year-old patients diagnosed with cancer in 2006 or 2007 and living in six French regions (accounting for 41% of the French population) were included. Of the 594 patients included, 33% of the French adolescents were treated at a pediatric oncology center. Compared with those treated at a pediatric center, adolescents treated at an adult center were older, were more likely to have carcinoma and germ-cell tumor, had a longer time to diagnosis, and were less likely to be enrolled in a clinical trial. In addition, the decisions for their management were less likely to be taken in the context of multidisciplinary team meetings. In multivariate analysis, adolescent patients treated at a pediatric center did not have significantly different overall survival (OS) compared with those treated at an adult center (5-year OS: 84.1% [95% confidence interval: 78.6-90.0] versus 87.7% [95% confidence interval: 84.2-91.3]; P = 0.25). The outcomes of French adolescents with cancer have begun to improve, with 81.2% survival in 2006-2007, with no difference between the types of treatment center. However, for this unique group of diseases, survival is not the unique endpoint. In order to ensure good quality of life after cancer, management of those patients requires specific approaches, designed to reduce the late effects of cancer treatment and improve supportive care. © 2016 Wiley Periodicals, Inc.

  2. A Model for Counselling Cancer Patients.

    Science.gov (United States)

    Jevne, Ronna F.; Nekolaichuk, Cheryl L.; Williamson, F. Helen A.

    1998-01-01

    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.…

  3. Resilience among patients across the cancer continuum: diverse perspectives.

    Science.gov (United States)

    Molina, Yamile; Yi, Jean C; Martinez-Gutierrez, Javiera; Reding, Kerryn W; Yi-Frazier, Joyce P; Rosenberg, Abby R

    2014-02-01

    Each phase of the cancer experience profoundly affects patients' lives. Much of the literature has focused on negative consequences of cancer; however, the study of resilience may enable providers to promote more positive psychosocial outcomes before, during, and after the cancer experience. The current review describes the ways in which elements of resilience have been defined and studied at each phase of the cancer continuum. Extensive literature searches were conducted to find studies assessing resilience during one or more stages of the adult cancer continuum. For all phases of the cancer continuum, resilience descriptions included preexisting or baseline characteristics, such as demographics and personal attributes (e.g., optimism, social support), mechanisms of adaptation, such as coping and medical experiences (e.g., positive provider communication), as well as psychosocial outcomes, such as growth and quality of life. Promoting resilience is a critical element of patient psychosocial care. Nurses may enable resilience by recognizing and promoting certain baseline characteristics and optimizing mechanisms of adaptation.

  4. Cardiac arrhythmias in adult patients with asthma

    DEFF Research Database (Denmark)

    Warnier, Miriam J; Rutten, Frans H; Kors, Jan A

    2012-01-01

    OBJECTIVE: The pathogenesis of cardiac arrhythmias in asthma patients has not been fully elucidated. Adverse drug effects, particularly those of β2-mimetics, may play a role. The aim of this study was to determine whether asthma is associated with the risk of cardiac arrhythmias and electrocardio......OBJECTIVE: The pathogenesis of cardiac arrhythmias in asthma patients has not been fully elucidated. Adverse drug effects, particularly those of β2-mimetics, may play a role. The aim of this study was to determine whether asthma is associated with the risk of cardiac arrhythmias...... and electrocardiographic characteristics of arrhythmogenicity (ECG) and to explore the role of β2-mimetics. METHODS: A cross-sectional study was conducted among 158 adult patients with a diagnosis of asthma and 6303 participants without asthma from the cohort of the Utrecht Health Project-an ongoing, longitudinal, primary...... or flutter). Secondary outcomes were tachycardia, bradycardia, PVC, atrial fibrillation or flutter, mean heart rate, mean corrected QT (QTc) interval length, and prolonged QTc interval. RESULTS: Tachycardia and PVCs were more prevalent in patients with asthma (3% and 4%, respectively) than those without...

  5. Antioxidant status in canine cancer patients

    OpenAIRE

    Plavec Tanja; Nemec-Svete Alenka; Butinar J.; Tozon Nataša; Prezelj Marija; Kandel Bettina; Kessler M

    2008-01-01

    The present study was conducted to investigate the antioxidant status in canine cancer patients. Patients with multicentric lymphoma, oral fibrosarcoma, mast cell tumor, malignant melanoma, appendicular osteosarcoma, nasal tumors and peripheral ameloblastoma were selected. Each group consisted of 6 patients. Total antioxidant capacity (TAC) and enzyme antioxidants: glutathione peroxidase (GPX), catalase (CAT) and superoxide dismutase (SOD) were measured in serum and whole blood, respectively,...

  6. Port-a-caths in cancer patients

    African Journals Online (AJOL)

    1990-01-01

    Jan 1, 1990 ... Abstract We report on 91 patients with cancer who under- went the insertion of89 venous and 4 hepatic arte- rial, implanted vascular ports (port-a-caths) for periods of up to 33 Illonths (total 1 525 patient-. ITlOnths). There were 1 fatal, 9 serious and 8 Illinor. cOlnplications in 18 patients which are described.

  7. History of Depression in Lung Cancer Patients

    DEFF Research Database (Denmark)

    Iachina, M; Brønserud, M M; Jakobsen, E

    2017-01-01

    AIMS: To examine the influence of a history of depression in the process of diagnostic evaluation and the choice of treatment in lung cancer. MATERIALS AND METHODS: The analysis was based on all patients with non-small cell lung cancer who were registered in 2008-2014; in total, 27 234 patients....... To estimate the effect of depression on the diagnostic process and the choice of treatment in lung cancer we fitted a logistic regression model and a Cox regression model adjusting for age, gender, resection and stage. RESULTS: Depression in a patient's anamnesis had no significant effect on the delay...... that patients with a history of periodic depression need special attention when diagnosed with lung cancer....

  8. Cognitive Behavioral Therapy in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Cem Soylu

    2014-09-01

    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

  9. Most Breast Cancer Patients Have Help Choosing Treatments

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_167104.html Most Breast Cancer Patients Have Help Choosing Treatments Support system can be ... cancer don't go it alone. Many breast cancer patients depend on family and friends to help them ...

  10. Management of Malnutrition in Esophageal Cancer Patients

    OpenAIRE

    Xu, Yu-juan; Cheng, Jason Chia-Hsien; Lee, Jang-Ming; Chen, Cheryl Chia-Hui

    2014-01-01

    The prevalence of malnutrition in patients with esophageal cancer is estimated to be as high as 78.9%. Malnutrition in esophageal cancer is significantly correlated with an increased risk of treatment toxicity and postoperative complications. It is therefore important to maintain an optimal nutritional status, particularly during the course of neoadjuvant chemoradiation. This article aims to review the mechanism, evaluation, and management strategies of malnutrition for patients with esophage...

  11. Recruiting young adult cancer survivors for behavioral research.

    Science.gov (United States)

    Rabin, Carolyn; Horowitz, Santina; Marcus, Bess

    2013-03-01

    Young adults have been dramatically underrepresented in cancer survivorship research. One contributing factor is the difficulty recruiting this population. To identify effective recruitment strategies, the current study assessed the yield of strategies used to recruit young survivors for an exercise intervention including: clinic-based recruitment, recruitment at cancer-related events, mailings, telephone-based recruitment, advertising on the internet, radio, television and social networking media, distributing brochures and word-of-mouth referrals. When taking into account the strategies for which we could track the number of survivors approached, recruitment at an oncology clinic was the most productive: 38 % of those approached were screened and 8 % enrolled. When evaluating which strategy yielded the greatest percentage of the sample, however, mailings were the most productive. Given widespread use of the internet and social networking by young adults, investigators should also consider these low-cost recruitment strategies.

  12. Younger age distribution of cervical cancer incidence among survivors of pediatric and young adult cancers.

    Science.gov (United States)

    Ojha, Rohit P; Jackson, Bradford E; Tota, Joseph E; Offutt-Powell, Tabatha N; Hudson, Melissa M; Gurney, James G

    2014-08-01

    Pediatric and young adult (PAYA) cancer survivors may have an earlier onset of chronic diseases compared with the general population. We compared the age at cervical cancer diagnosis between PAYA cancer survivors and females in the general US population. We used longitudinal data from 9 population-based registries of the Surveillance, Epidemiology, and End Results program collected between 1973 and 2010. PAYA cancer survivors were females diagnosed with any cancer before age 30 years, survived at least 5 years post-diagnosis, and were subsequently diagnosed with invasive cervical cancer (n=46). The general US population comprised females who were diagnosed with invasive cervical cancer as the primary malignancy (n=26,956). We estimated the difference in median age at diagnosis (ß₅₀) and bootstrap 95% confidence limits (CL) of invasive cervical cancer after adjustment for year of diagnosis and race. The median age at diagnosis of invasive cervical cancer was 33 years for female PAYA cancer survivors and 40 years for females in the general US population (ß50=-7.0, 95% CL: -11, -3.2). Similar differences were observed across subgroups of stage and histologic subtype of invasive cervical cancer. Our results suggest that PAYA cancer survivors are diagnosed with invasive cervical cancer at a substantially younger age compared with females without a prior cancer diagnosis in the general US population. This issue warrants further study, and could have implications for determining age at initiation or frequency of cervical cancer screening if younger age at diagnosis is attributable to an underlying biological phenomenon. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Prevalence and correlates of fear of recurrence among adolescent and young adult versus older adult post-treatment cancer survivors.

    Science.gov (United States)

    Shay, L Aubree; Carpentier, Melissa Y; Vernon, Sally W

    2016-11-01

    We sought to (1) assess prevalence of fear of recurrence among cancer survivors diagnosed as adolescent and young adults (AYA; 15-39 years) versus those diagnosed at a later age (40+ years) and (2) identify factors associated with fear of recurrence in each group. We used logistic regression to determine the correlates of fear of recurrence by age group at diagnosis among survivors responding to the 2010 LIVESTRONG survey. Prevalence of fear of recurrence was significantly higher among AYA survivors (85.2 %) than those diagnosed at an older age (79.7 %). Among AYA respondents, being employed and less than 5 years off treatment were positively associated with fear of recurrence while those with thyroid cancer and those who participated in a clinical trial were less likely to experience fear of recurrence. Among older adults, receipt of surgery was associated with fear of recurrence whereas having insurance coverage through Medicare or Medicaid and positive patient-provider communication were negatively associated with fear of recurrence. For both AYA and older adult survivors, changeable factors such as having a more positive cancer care experience may impact fear of recurrence. Our findings highlight the need to identify and understand aspects of the communication process that can be targeted in future interventions with survivors and healthcare providers to ensure that fear of recurrence is being appropriately managed. Factors associated with fear of recurrence differ for AYA and older adult survivors; thus, interventions would likely benefit from tailoring based on age at diagnosis.

  14. Radiographic findings of pulmonary tuberculosis in non-AIDS immunocompromised adult patients: comparison with immunocompetent adult patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Joung; Lee, Sun Kyoung; Lim, Chae Ha; Kim, Young Sook; Kim, Eun Gyung; Kim, Young Chul; Oh, Jae Hee [College of Medicine, Chosun University, Gwangju (Korea, Republic of)

    1994-11-15

    To compare chest radiographic findings of pulmonary tuberculosis in non-AIDS immunocompromised adult patients with those in immunocompetent patients. Eighty six patients who had pulmonary tuberculosis were included in the study. Of these, 41 were non-AIDS immunocompromised adult patients and 45 were immunocompetent adult patients. Chest radiographs obtained from 86 patients were retrospectively evaluated with regard to the followings; the anatomic distribution and extent of tuberculous lesions, typical or atypical patterns of radiographic findings. We then compared the results in non-AIDS immunocompromised adult patients with those in immunocompetent adult patients. The characteristic manifestation of pulmonary tuberculosis was a tendency of pulmonary lesions to localize in the apico-posterior segments of the upper lobe and the superior segment of the lower lobe in both groups but more wide distribution such as the anterior segment and the lingular segment of the upper lobe and the basal segments of the lower lobe was frequently identified in non-AIDS immunocompromised adult patients, and also bilateral, multi segmental and multi lobular extents were common findings. In immunocompetent adult patients, more common findings were in local exudative and productive lesions and several cavities in preferential sites. Atypical plain radiographic findings were more common in non-AIDS immunocompromised adult patients, and which were multiple cavitary lesions, wide extent of bronchogenic spread and tuberculous pneumonia, and miliary disseminations and mass like lesions. Pulmonary tuberculosis in non-AIDS immunocompromised adult patients is characterized by frequent bilateral distribution, wide pulmonary extent, and atypical radiographic findings.

  15. Optimal management of venous thromboembolism in adolescent and young adult oncology patients

    Directory of Open Access Journals (Sweden)

    McKillop S

    2016-09-01

    Full Text Available Sarah McKillop,1 Cynthia Wu,2 Aisha Bruce,1 Joseph Brandwein2 1Division of Immunology, Hematology, Oncology, Palliative Care and Environmental Medicine, Department of Pediatrics, 2Division of Hematology, Department of Medicine, University of Alberta, Edmonton, AB, Canada Abstract: Venous thromboembolism (VTE is a serious complication experienced by adolescents and young adults (AYAs diagnosed with cancer. Data exist in the adult literature to guide the management of cancer-associated thrombosis. Unfortunately, little is known regarding the epidemiology of cancer-associated thrombosis in AYAs. As a result, evidence on the treatment and prevention of thrombosis in this vulnerable population is lacking, posing a great challenge to physicians caring for AYAs with cancer. It is clear that the basic principles of VTE likely apply to AYAs and that low-molecular-weight heparin is the drug of choice for the treatment of VTE regardless of age. We review the available data on the epidemiology, diagnostic methods, and management of AYAs with cancer and VTE. Recognizing the lack of accepted guidelines for the prevention or management of VTE in this population, we offer expert opinion recommendations to serve as guidance to improve management of thrombosis in AYA cancer patients. Keywords: adolescents, young adults, thrombosis, cancer, venous thromboembolism, anticoagulation

  16. Incidence of colorectal cancer in young patients.

    Science.gov (United States)

    Campos, Fábio Guilherme C M DE; Figueiredo, Marleny Novaes; Monteiro, Mariane; Nahas, Sérgio Carlos; Cecconello, Ivan

    2017-01-01

    Sporadic colorectal cancer (CRC) is traditionally diagnosed after de sixth decade of life, although a small percentage of cases are diagnosed in patients under 40 years of age, and incidence is increasing. There exists a great volume of controversy regarding clinical outcome of young patients diagnosed with colorectal cancer (CRC) when compared to elder counterparts. Our aims were to evaluate the rate of CRC in young patients, to review the pertaining literature and to discuss outcomes and clinical prognosis. A retrospective review involving patients with CRC was undertaken, focusing on age at diagnosis. The information extracted from this literature review showed a trend towards a decreased incidence in older people with an opposite effect among adolescents and young adults. Moreover, biological aggressiveness in young adults diagnosed with CRC has not been fully recognized, although it is usually diagnosed later and in association with adverse histological features. Besides that, these features don't affect outcome. These apparent increase in CRC incidence among young patients during the last decades raises the need for a greater suspicious when evaluating common symptoms in this group. Thus, educational programs should widespread information for both population and physicians to improve prevention and early diagnosis results. RESUMO O câncer colorretal (CCR) esporádico é tradicionalmente diagnosticado após a sexta década de vida, embora uma pequena porcentagem de casos seja diagnosticada em doentes abaixo dos 40 anos de idade, e a incidência está aumentando. Existe uma grande controvérsia a respeito da evolução clínica de doentes jovens portadores de CCR em comparação aos mais idosos. Os objetivos deste estudo foram avaliar a prevalência de CCR em doentes jovens, rever a literatura pertinente e discutir suas características mais importantes nesta faixa etária. Para tanto realizou-se revisão da literatura envolvendo doentes com CCR com foco na

  17. Histopathological results of nasopharyngeal masses of adult patients

    African Journals Online (AJOL)

    Background: Nasopharyngeal masses in adult patients in most cases are considered to be tumours unless proven otherwise. Aim: To determine the histopathological results of nasopharyngeal masses seen in adult patients in Port Harcourt Nigeria. It will also highlight the management outcomes of these patients. Methods: ...

  18. Quality of Cancer Care Among Foreign-Born and US-Born Patients With Lung or Colorectal Cancer

    DEFF Research Database (Denmark)

    Nielsen, Signe Smith; He, Yulei; Ayanian, John Z.

    2010-01-01

    of care (adjusted odds ratio [AOR], 0.80; 95% confidence interval [95% CI], 0.65-1.00), a difference partly explained by the language of the survey, an indicator of English proficiency. Rates of recommended therapies ranged from 64% to 85%; foreign-born patients were less likely to receive chemotherapy......  BACKGROUND: Disparities in care have been documented for foreign-born cancer patients in the United States. However, few data are available regarding patients with lung and colorectal cancer. In the current study, the authors assessed whether patient-reported quality and receipt of recommended...... care differed between US-born and foreign-born cancer patients. METHODS: The authors collected surveys and medical records for a population-based cohort including white, Hispanic, and Asian adults (2205 US-born and 890 foreign-born individuals) with lung or colorectal cancer diagnosed in California...

  19. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... Home » Patients Fertility Preservation for Children Diagnosed with Cancer Fertility Preservation for Children Diagnosed with Cancer Ask Your Doctor Information for Patients Many adult ...

  20. Management of Malnutrition in Esophageal Cancer Patients

    Directory of Open Access Journals (Sweden)

    Yu-Juan Xu

    2014-06-01

    Full Text Available The prevalence of malnutrition in patients with esophageal cancer is estimated to be as high as 78.9%. Malnutrition in esophageal cancer is significantly correlated with an increased risk of treatment toxicity and postoperative complications. It is therefore important to maintain an optimal nutritional status, particularly during the course of neoadjuvant chemoradiation. This article aims to review the mechanism, evaluation, and management strategies of malnutrition for patients with esophageal cancer. The optimal management strategy involved both non-pharmacological and pharmacological approaches. We hope that by increasing awareness among professionals, early detection and timely intervention could lead to improved care.

  1. How should we design supportive cancer care? The patient's perspective.

    Science.gov (United States)

    Casarett, David; Fishman, Jessica; O'Dwyer, Peter J; Barg, Frances K; Naylor, Mary; Asch, David A

    2008-03-10

    Hospice services are designed to meet the needs of patients near the end of life. Although so-called open-access hospice programs and bridge programs are beginning to offer these services to patients who are still receiving treatment, it is not known whether they best meet patients' needs. Three hundred adult patients receiving treatment for cancer completed interviews in which each patient's value or ability for supportive care services were calculated from the choices that they made among combinations of those services. Preferences for five traditional hospice services and six alternative supportive care services were measured, and patients were followed up for 6 months or until death. Patients' utilities for alternative services were higher than those for traditional hospice services (0.53 v 0.39; sign-rank test P 2; n = 54; 0.65 v 0.48; P < .001) and among those who were in the last 6 months of life (0.68 v 0.56; sign-rank test P = .003). Even patients who were willing to forgo cancer treatment (n = 38; 13%) preferred alternative services (3.1 v 1.8; P < .001). Patients who are receiving active treatment for cancer, and even those who are willing to stop treatment, express a clear preference for alternative supportive care services over traditional hospice services. Supportive care programs for patients with advanced cancer should reconsider the services that they offer and might seek to include novel services in addition to, or perhaps instead of, traditional hospice services.

  2. Correlates of social support in young adults with advanced cancer.

    Science.gov (United States)

    Trevino, K M; Fasciano, K; Block, S; Prigerson, H G

    2013-02-01

    This study examined the relationship between perceived social support, quality of life (QoL), and grief in young adults with advanced cancer. Seventy-one young adults (20-40 years) with advanced cancer were administered measures of social support, QoL, and grief. Regression analyses examined the relationship between social support and QoL and grief. Higher levels of total social support were associated with better psychological and existential QoL and less severe grief. Availability of someone to talk to about problems was also associated with better psychological and existential QoL and less severe grief. Tangible support was associated with better psychological and existential QoL. Availability of someone to engage in activities with was only associated with better existential QoL. These results suggest that enhancing social support may improve psychological well-being in this population. In addition, specific types of social support may be particularly relevant to the psychological well-being of young adults with advanced cancer.

  3. Positive Effect of Higher Adult Body Mass Index on Overall Survival of Digestive System Cancers Except Pancreatic Cancer: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Jie Han

    2017-01-01

    Full Text Available High body mass index (BMI has been inconsistently associated with overall survival (OS of digestive system cancers (DSCs. This meta-analysis was conducted to investigate whether high BMI was associated with DSCs prognosis. 34 studies were accepted, with a total of 23,946 DSC cases. Hazard ratios (HRs with 95% confidence intervals (95% CIs for OS in BMI categories from individual studies were extracted and pooled by random-effect model. The overall HR of DSCs except pancreatic cancer for OS of adult overweight cases was 0.76 (95% CI = 0.67–0.85. DSC individuals except pancreatic cancer with adult obesity were at decreased risk for OS (HR = 0.85, 95% CI = 0.72–0.98. Among DSC patients except pancreatic cancer, the overall HR for the highest versus the lowest BMI category was 0.82 (95% CI = 0.71–0.92. Additionally, comparing the highest and lowest BMI categories, the combined HR of pancreatic cancer was 1.22 (95% CI = 1.01–1.43. Our meta-analysis suggested an increased OS among adult overweight and obese DSC survivors except pancreatic cancer. Overweight and obesity in adulthood may be important prognostic factors that indicate an increased survival from DSC patients except pancreatic cancer.

  4. Hyperthyroidism in patients with thyroid cancer.

    Science.gov (United States)

    Sharma, Sunil Dutt; Kumar, Gaurav; Guner, Karen; Kaddour, Hesham

    2016-06-01

    We present a retrospective case series of patients with hyperthyroidism and thyroid cancer. Our goal was to look at their clinical characteristics and outcomes to determine which patients would require further investigation. We reviewed the case notes of all patients with a histopathologic diagnosis of thyroid cancer and biochemical evidence of hyperthyroidism who had been treated at a thyroid cancer center from January 2006 through October 2013. During that time, 66 patients had been diagnosed with thyroid cancer. Of these, 8 patients (12%)-all women, aged 29 to 87 years (mean: 55.6; median: 50.5)-had biochemical evidence of hyperthyroidism. Among these 8 patients, 4 had an autonomously functioning toxic nodule (AFTN), 3 were diagnosed with Graves disease, and 1 had a toxic multinodular goiter. Five patients had suspicious features on preoperative ultrasonography. All 8 patients were diagnosed with the papillary type of thyroid carcinoma. The mean size of the tumor in the 4 patients with AFTN was significantly larger than it was in those with Graves disease (42.3 ± 23.8 mm vs. 3.8 ± 1.6; p = 0.04). The 3 patients with Graves disease all had incidentally found papillary microcarcinoma. Between these two groups, the patients with AFTN had a poorer prognosis; 2 of them had extracapsular invasion and lymph node metastasis, and another died of her disease. We found that the incidence of hyperthyroidism in thyroid cancer patients was relatively high (12%). In contrast to what has previously been reported in the literature, patients with AFTN seem to have more aggressive disease and poorer outcomes than do patients with Graves disease. Any suspicious nodule associated with hyperthyroidism should be evaluated carefully.

  5. Care in the perception of cancer patients

    Directory of Open Access Journals (Sweden)

    Carolina Henriques

    2011-08-01

    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

  6. Cancer patients' coping styles and doctor-patient communication

    NARCIS (Netherlands)

    Ong, L. M.; Visser, M. R.; van Zuuren, F. J.; Rietbroek, R. C.; Lammes, F. B.; de Haes, J. C.

    1999-01-01

    Monitoring and blunting styles have become relevant concepts regarding their potential impact on patients' and doctors' behaviors. The present study aimed at investigating the relation between cancer patients' coping styles and doctor-patient communication and global affect. Coping styles were

  7. Cancer patient decision making related to clinical trial participation: an integrative review with implications for patients' relational autonomy.

    Science.gov (United States)

    Bell, Jennifer A H; Balneaves, Lynda G

    2015-04-01

    Oncology clinical trials are necessary for the improvement of patient care as they have the ability to confirm the efficacy and safety of novel cancer treatments and in so doing, contribute to a solid evidence base on which practitioners and patients can make informed treatment decisions. However, only 3-5 % of adult cancer patients enroll in clinical trials. Lack of participation compromises the success of clinical trials and squanders an opportunity for improving patient outcomes. This literature review summarizes the factors and contexts that influence cancer patient decision making related to clinical trial participation. An integrative review was undertaken within PubMed, CINAHL, and EMBASE databases for articles written between 1995 and 2012 and archived under relevant keywords. Articles selected were data-based, written in English, and limited to adult cancer patients. In the 51 articles reviewed, three main types of factors were identified that influence cancer patients' decision making about participation in clinical trials: personal, social, and system factors. Subthemes included patients' trust in their physician and the research process, undue influence within the patient-physician relationship, and systemic social inequalities. How these factors interact and influence patients' decision-making process and relational autonomy, however, is insufficiently understood. Future research is needed to further elucidate the sociopolitical barriers and facilitators of clinical trial participation and to enhance ethical practice within clinical trial enrolment. This research will inform targeted education and support interventions to foster patients' relational autonomy in the decision-making process and potentially improve clinical trial participation rates.

  8. Family Caregivers to Adults with Cancer: The Consequences of Caring.

    Science.gov (United States)

    Williams, Anna-Leila

    2018-01-01

    A person living with cancer will potentially have some degree of physical, cognitive, and/or psychological impairment, periods of unemployment, financial concerns, social isolation, and existential questions, any or all of which can impact the family and friends who surround them. In our current era of health care, patients with cancer receive invasive diagnostic studies and aggressive treatment as outpatients, and then convalesce at home. As such, cancer family caregivers are de facto partners with the healthcare team. The cancer family caregiver role is demanding and may lead to increased morbidity and mortality-in effect, the cancer family caregiver can become a second patient in need of care. This chapter discusses the consequences cancer family caregivers may accrue. The topics covered include caregiver mood disturbance and psychological impairment and some of the mutable factors that contribute to these states (i.e., sleep disturbance, decline in physical health, restriction of activities, and financial concerns), uncertainty, spiritual concerns, and caregiver witnessing. There is a discussion of the factors that influence the caregiving experience (caregiver characteristics, patient characteristics, and social supports). The chapter concludes with comments on intervention studies that have been conducted to ameliorate the burden of caregiving, and the state of caregiver research.

  9. Development of a Primary Care-Based Clinic to Support Adults With a History of Childhood Cancer: The Tactic Clinic.

    Science.gov (United States)

    Overholser, Linda S; Moss, Kerry M; Kilbourn, Kristin; Risendal, Betsy; Jones, Alison F; Greffe, Brian S; Garrington, Timothy; Leonardi-Warren, Kristin; Yamashita, Traci E; Kutner, Jean S

    2015-01-01

    Describe the development and evolution of a primary-care-based, multidisciplinary clinic to support the ongoing care of adult survivors of childhood cancer. A consultative clinic for adult survivors of childhood cancer has been developed that is located in an adult, academic internal medicine setting and is based on a long-term follow-up clinic model available at Children's Hospital Colorado. The clinic opened in July 2008. One hundred thirty-five patients have been seen as of April 2014. Referrals and clinic capacity have gradually increased over time, and a template has been developed in the electronic medical record to help facilitate completion of individualized care plan letters. A primary care-based, multidisciplinary consultative clinic for adults with a history of childhood cancer survivor is feasible and actively engages adult primary care resources to provide risk-based care for long-term pediatric cancer survivors. This model of care planning can help support adult survivors of pediatric cancer and their primary care providers in non-academic, community settings as well. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Bone health in patients with prostate cancer.

    Science.gov (United States)

    Miñana, B; Cózar, J M; Alcaraz, A; Morote, J; Gómez-Veiga, F J; Solsona, E; Rodríguez-Antolín, A; Carballido, J

    2014-12-01

    In patients with prostate cancer, bone health is compromised by advanced age at diagnosis, androgen suppression treatments and the developmentofbone metastases. In this paper the medical literature is reviewed in order to update the state of the art on their incidence, prevention and management. A literature review about bone involvement in patients with prostate cancer in different clinical settings is performed. Decreased bone mineral density is higher in patients diagnosed of prostate cancer before starting treatment than in healthy men with the same age. During the first year of treatment, a severe loss bone density is reported due to androgen suppression therapy. From then on, loss bone density seems to slow down, persisting at long-term. It is important to know the starting point and the dynamics of loss bone in order to prevent its progression. The skeletal events have an important impact on quality of life in patients with prostate cancer. Both Denosumab and Zoledronic Acid have proven effective in reducing loss bone. The prevention and management of bone involvement in patients with prostate cancer is critical to quality of life in these patients and requires an individualized approach. Before starting a prolonged androgen deprivation, baseline risk of fracture should be evaluated in order to adopt the proper protective measures. In patients with metastases, early treatments reducing the risk of bone events should be taken into account. Copyright © 2014 AEU. Published by Elsevier Espana. All rights reserved.

  11. Teenagers and young adults with cancer in Europe: from national programmes to a European integrated coordinated project.

    Science.gov (United States)

    Stark, D; Bielack, S; Brugieres, L; Dirksen, U; Duarte, X; Dunn, S; Erdelyi, D J; Grew, T; Hjorth, L; Jazbec, J; Kabickova, E; Konsoulova, A; Kowalczyk, J R; Lassaletta, A; Laurence, V; Lewis, I; Monrabal, A; Morgan, S; Mountzios, G; Olsen, P R; Renard, M; Saeter, G; van der Graaf, W T; Ferrari, A

    2016-05-01

    Over 14 000 patients aged 15-24 are estimated to be diagnosed with cancer in the European Union (EU) each year. Teenagers and young adults (TYA) often fall down gaps between children's and adults cancer services. The specific challenges of providing optimal care to them are described, but we present a summary of recent progress. Progress to overcome these challenges is happening at different rates across Europe. We summarise the European national projects in this field but more recently we have seen the beginnings of European coordination. Within the EU 7th Funding Programme (FP7) European Network for Cancer Research in Children and Adolescents programme (ENCCA), a specific European Network for Teenagers and Young Adults with Cancer has held a series of scientific meetings, including professionals, patients and caregivers. This group has proposed unanswered research questions and agreed key features of a high-quality service that can improve outcomes for TYA with cancer, including the primacy of collaboration between adult and paediatric services to eliminate the gap in the management of TYA with cancer. © 2015 John Wiley & Sons Ltd.

  12. A pilot intervention to enhance psychosexual development in adolescents and young adults with cancer.

    Science.gov (United States)

    Canada, Andrea L; Schover, Leslie R; Li, Yisheng

    2007-11-01

    Evidence suggests that cancer diagnosed during adolescence and young adulthood may present considerable challenges to what would otherwise be a relatively smooth developmental trajectory, particularly in areas related to reproductive health. We created and pilot tested a two-session, individually-delivered, counseling intervention to enhance psychosexual development in this unique population. A total of 21 patients, aged 15 to 25 years and treated for cancer within the past 5 years, completed the counseling intervention. Patients were adaptively randomized to begin the intervention immediately, or to be placed on a 3-month waitlist, after which time, they were reassessed and began the intervention. The content of the intervention included education, dialog, and support regarding cancer and such issues as sexual development and function, body image, fertility, prevention of sexually transmitted disease and unwanted pregnancy, and romantic relationships (e.g., dating, sexual communication). A 1-month follow-up booster call followed the intervention. Questionnaires were completed at baseline, post-waitlist (for half the sample), post-treatment, and at 3-month follow-up. Participation in the intervention increased cancer-specific knowledge regarding sexual issues; improved body image; lessened anxiety about sexual and romantic relationships; and decreased overall level of psychological distress. Gains were maintained through the 3-month follow-up. Addressing issues of reproductive health in the adolescent/young adult with cancer can and should be offered as a part of comprehensive pediatric cancer care. (c) 2007 Wiley-Liss, Inc.

  13. Opioid Prescribing Among Cancer and Non-cancer Patients: Time Trend Analysis in the Elderly Using Administrative Data.

    Science.gov (United States)

    Barbera, Lisa; Sutradhar, Rinku; Chu, Anna; Seow, Hsien; Howell, Doris; Earle, Craig C; O'Brien, Mary Ann; Dudgeon, Deb; Atzema, Clare; Husain, Amna; Liu, Ying; DeAngelis, Carlo

    2017-10-01

    In 2007, Cancer Care Ontario introduced a provincial symptom screening program, which included pain, for cancer patients. Over this same time, opioid prescribing has been increasingly scrutinized among non-cancer patients. The study purpose was to see if opioid prescribing changed among older adults after 2007 in the context of changing opioid regulations, and whether effects were different among patients with a cancer history. Ontario residents aged ≥65 years were identified from 2004 to 2013. Subjects were annually stratified into three groups: no cancer history, cancer diagnosis >5 years ago, and cancer diagnosis ≤5 years ago. We evaluated time trends by year for: 1) opioid prescription rate, comparing trends before and after 2007 and 2) mean daily opioid dose. Between 2004 and 2013, opioid prescribing was relatively constant for cancer patients with no observed change in trends after 2007. For non-cancer patients, there was a 2% relative annual increase during this period. Significant changes were seen for opioid sub-classes (e.g., decreasing use of long-acting oxycodone). These were similar for those with or without a history of cancer. Among all groups, changes in the mean daily dose over time were similar in all drug classes. Overall prescribing rates for cancer patients aged ≥65 years remain unchanged over time, in spite of the introduction of a provincial symptom screening program. Decreasing prescription rates in some drug sub-classes were observed. The potential impact of these changes on the quality of symptom control for cancer patients needs further investigation. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  14. Transition and transfer of childhood cancer survivors to adult care: A national survey of pediatric oncologists.

    Science.gov (United States)

    Kenney, Lisa B; Melvin, Patrice; Fishman, Laurie N; O'Sullivan-Oliveira, Joanne; Sawicki, Gregory S; Ziniel, Sonja; Diller, Lisa; Fernandes, Susan M

    2017-02-01

    Pediatric oncologists are responsible for ensuring that adolescent and young adult (AYA) childhood cancer survivors have the knowledge and skills necessary to manage their follow-up care in adult healthcare systems. To describe transition practices and barriers to transfer, we electronically surveyed U.S. Children's Oncology Group members: 507/1449 responded (35%) and 347/507 (68%) met eligibility criteria. Of 347 respondents, 50% are male, median years in practice 10 (range 5-22), 37% practice in freestanding children's hospitals. Almost all care for survivors up to age 21 years (96%), 42% care for survivors over age 25 years, and only 16% over age 30 years. While 66% of oncologists reported providing transition education to their patients, very few (8%) reported using standardized transition assessments. The most frequent barriers to transfer were perceived attachment to provider (91%), lack of adult providers with cancer survivor expertise (86%), patient's cognitive delay (81%), or unstable social situation (80%). Oncologists who continue to care for patients older than 25 years are more likely to perceive parents' attachment to provider (P = 0.037) and patients' social situation as barriers to transfer (P = 0.044).  Four themes emerged from a content analysis of 75 respondents to the open-ended question inviting comments on transition/transfer practices: desire for flexible transfer criteria; providers as barriers; provider lack of transition knowledge, skills, and resources; and desire for collaboration. Although most pediatric oncologists reported transferring AYA cancer survivors to adult care and providing some transition education, they endorse deficits in transition skills, emotional readiness, and institutional resources. © 2016 Wiley Periodicals, Inc.

  15. Protecting an adult identity: A grounded theory of supportive care for young adults recently diagnosed with cancer.

    Science.gov (United States)

    Soanes, Louise; Gibson, Faith

    2018-01-31

    For adolescents and young adults living in high-income countries cancer remains the most common disease-related death. Increasing survival rates and projected longevity are positive outcomes, although long-term consequences of cancer and/or its treatment will likely increase the global burden of cancer. In low and middle-income countries the impact and needs of young adults with cancer are largely unknown and require further attention. However, universal studies have revealed that cancer-related needs for this group are multifactorial, complex and largely unmet. In response to these findings, the body of work on supportive care for young adults with cancer is growing. Yet, there is no published research in the context of the United Kingdom, regarding the role young adults play in managing their supportive cancer care needs. To explore the experience, purpose and meaning of supportive cancer care to young adults recently diagnosed with cancer. Using constructivist grounded theory, data were collected in one to one interviews with eleven young adults (seven women and four men aged 19-24 years) being treated for cancer in two English hospitals. Data were analyzed using open and focused coding, constant comparison, theoretical coding and memoing, and this enabled construction of a subjective theory. Young adults in this study interpreted cancer as an interruption to the events, experiences and tasks forming the biographical work of their adult identity. Data analysis led to the construction of the theory, 'protecting an adult identity: self in relation to a diagnosis of cancer in young adulthood'. This theory arose from three categories: fragility of self, maintaining self in an altered reality and mobilizing external resources. Young adults faced the loss of their early adult identity. Interpreting cancer as a temporary interruption, they sought to re-establish their identity by directly and indirectly managing their supportive care needs. These findings contribute to

  16. Second Primary Malignant Neoplasms and Survival in Adolescent and Young Adult Cancer Survivors.

    Science.gov (United States)

    Keegan, Theresa H M; Bleyer, Archie; Rosenberg, Aaron S; Li, Qian; Goldfarb, Melanie

    2017-11-01

    Although the increased incidence of second primary malignant neoplasms (SPMs) is a well-known late effect after cancer, few studies have compared survival after an SPM to survival of the same cancer occurring as first primary malignant neoplasm (PM) by age. To assess the survival impact of SPMs in adolescents and young adults (AYAs) (15-39 years) compared with that of pediatric (cancer in 13 Surveillance, Epidemiology and End Results regions in the United States diagnosed from 1992 to 2008 and followed through 2013. Data analysis was performed between June 2016 and January 2017. Five-year relative survival was calculated overall and for each cancer occurring as a PM or SPM by age at diagnosis. The impact of SPM status on cancer-specific death was examined using multivariable Cox proportional hazards regression. A total of 15 954 pediatric, 125 750 AYAs, and 878 370 older adult patients diagnosed as having 14 cancers occurring as a PM or SPM were included. Overall, 5-year survival after an SPM was 33.1% lower for children, 20.2% lower for AYAs, and 8.3% lower for older adults compared with a PM at the same age. For the most common SPMs in AYAs, the absolute difference in 5-year survival was 42% lower for secondary non-Hodgkin lymphoma, 19% for secondary breast carcinoma, 15% for secondary thyroid carcinoma, and 13% for secondary soft-tissue sarcoma. Survival by SPM status was significantly worse in younger vs older patients for thyroid, Hodgkin lymphoma, non-Hodgkin lymphoma, acute myeloid leukemia, soft-tissue sarcoma, and central nervous system cancer. Adolescents and young adults with secondary Hodgkin lymphoma (hazard ratio [95% CI], 3.5 [1.7-7.1]); soft-tissue sarcoma (2.8 [2.1-3.9]); breast carcinoma (2.1 [1.8-2.4]); acute myeloid leukemia (1.9 [1.5-2.4]); and central nervous system cancer (1.8 [1.2-2.8]) experienced worse survival compared with AYAs with the same PMs. The adverse impact of SPMs on survival is substantial for AYAs and may partially

  17. Quality of life in long-term survivors of adult-onset cancers.

    Science.gov (United States)

    Gotay, C C; Muraoka, M Y

    1998-05-06

    The long-term survival of cancer patients has risen dramatically during the last few decades, yet little is known about the quality of life experienced by these survivors. This paper reviews research on the quality of life in long-term cancer survivors to identify quality-of-life concerns in this population, to provide a critical evaluation of the literature, and to suggest areas for future research. Searches of computerized literature databases were conducted to identify all studies of quality of life in cancer survivors that were published in English language journals during the period from January 1, 1980, through February 12, 1998, and that were based on responses from individuals who have survived 5 or more years after the diagnosis of adult-onset cancers. Thirty-four papers were identified. Most studies utilized self-report questionnaires to measure quality of life. Although methodologies and cancer patient populations varied greatly, most studies showed that many survivors continue to experience negative effects of cancer and/or treatment on their daily lives well beyond the completion of therapy. Sexual functioning and/or satisfaction and psychological functioning were found to be concerns for many survivors. Several reports documented positive coping strategies and enhanced quality of life in long-term cancer survivors, supporting the need to measure positive aspects of quality of life as well as problems in this population. Study designs that more accurately measure quality of life among survivors of cancer by adjusting for the effects of aging and long-term therapy and the impact of second cancers should be utilized. Additional data are needed to understand the needs of long-term survivors, especially of those in groups underrepresented in published quality-of-life studies, and to determine what kinds of support survivors want.

  18. Clinical Characteristics of Patients with Sporadic Colorectal Cancer and Primary Cancers of Other Organs

    Directory of Open Access Journals (Sweden)

    Jung-Yu Kan

    2006-11-01

    Full Text Available Most cancer patients often neglect the possibility of secondary cancer. Colorectal cancer (CRC is the third leading cause of cancer death in Taiwan. It is important to be aware of the clinical characteristics of double cancer in CRC patients for early diagnosis and treatment. We retrospectively analyzed 1,031 CRC patients who underwent surgical treatment at the Department of Surgery of Kaohsiung Medical University Hospital between January 1998 and December 2004. Among these patients, CRC was accompanied by cancer of other organs in 17 patients (1.65%, either synchronously or metachronously. Therefore, we describe our experience regarding the location of CRC, the clinical symptoms and signs of these patients, the TNM stage, histology, phase, association with other malignancies, interval between cancers and clinical outcomes. Of the 17 patients in whom CRC was accompanied by primary cancer of other organs, there were four synchronous and 13 metachronous multiple cancer patients. Our patient group comprised six men and 11 women with ages ranging from 47 to 88 years (median age, 66 years. The most common location of CRC was the sigmoid colon. Six gastric cancers (35.2% and six breast cancers (35.2% were associated with primary CRC. The remaining six second primary cancers were one lung cancer, one thyroid cancer, one cervical cancer, one ovarian cancer, one skin cancer, and one urinary bladder cancer. Of the 13 metachronous multiple cancer patients, eight patients developed subsequent CRC after primary cancers of other organs, whereas two patients developed a subsequent second primary cancer after CRC. The intervals between the development of metachronous multiple cancers ranged from 2 to 19 years. In this retrospective analysis, breast and gastric cancer patients were at increased risk of developing subsequent secondary CRC. Careful attention should always be paid to the possibility of secondary CRC in treating these cancer patients. Cancer

  19. Medication adherence decision-making among adolescents and young adults with cancer.

    Science.gov (United States)

    McGrady, Meghan E; Brown, Gabriella A; Pai, Ahna L H

    2016-02-01

    Nearly half of all adolescents and young adults (AYAs) with cancer struggle to adhere to oral chemotherapy or antibiotic prophylactic medication included in treatment protocols. The mechanisms that drive non-adherence remain unknown, leaving health care providers with few strategies to improve adherence among their patients. The purpose of this study was to use qualitative methods to investigate the mechanisms that drive the daily adherence decision-making process among AYAs with cancer. Twelve AYAs (ages 15-31) with cancer who had a current medication regimen that included oral chemotherapy or antibiotic prophylactic medication participated in this study. Adolescents and young adults completed a semi-structured interview and a card sorting task to elucidate the themes that impact adherence decision-making. Interviews were transcribed verbatim and coded twice by two independent raters to identify key themes and develop an overarching theoretical framework. Adolescents and young adults with cancer described adherence decision-making as a complex, multi-dimensional process influenced by personal goals and values, knowledge, skills, and environmental and social factors. Themes were generally consistent across medication regimens but differed with age, with older AYAs discussing long-term impacts and receiving physical support from their caregivers more than younger AYAs. The mechanisms that drive daily adherence decision-making among AYAs with cancer are consistent with those described in empirically-supported models of adherence among adults with other chronic medical conditions. These mechanisms offer several modifiable targets for health care providers striving to improve adherence among this vulnerable population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. To foster healing among adolescents and young adults with cancer: what helps? What hurts?

    Science.gov (United States)

    Zebrack, Brad; Chesler, Mark A; Kaplan, Stuart

    2010-01-01

    The physical and emotional well-being of adolescents and young adults with cancer (AYA) rests on the ability of all concerned to promote helpful forms of care and reduce hurtful forms. The purpose of this study was to identify aspects of behavior that may promote or inhibit healthy psychosocial adjustment for this age-defined population. Seventeen young adult cancer survivors participated in focus groups to discuss what people said or did that they found helpful or hurtful. Inductive and deductive techniques of coding and analysis of these qualitative data were performed. Survivors reported being the recipients of positive and negative communications and behaviors of an informational, practical, interpersonal, and/or emotional character. Most common were comments and actions in the interpersonal realm. More helpful than hurtful comments were reported, except in the informational category, where the "bad news" about cancer and the style of information-sharing created hurt. How people communicate information, tasks, and feelings to AYA patients and survivors affects how they experience their illness and think about themselves and their current and future situations. All parties-doctors, other medical providers, family members, and friends-need to attend to the manner as well as content of their communications and interactions with AYAs and to the social and emotional context within which communication and interaction occurs. Specific recommendations for the care of AYA cancer patients are offered, emphasizing the importance of attending to the cognitive capabilities and unique developmental challenges associated with adolescence and young adulthood.

  1. Hematopoietic and lymphatic cancers in relatives of patients with infectious mononucleosis

    DEFF Research Database (Denmark)

    Hjalgrim, Henrik; Rostgaard, Klaus; Askling, Johan

    2002-01-01

    BACKGROUND: Young adults with a history of Epstein-Barr virus (EBV)-related infectious mononucleosis have an increased risk for Hodgkin's lymphoma. EBV is detected in Hodgkin's lymphoma Reed-Sternberg cells from some patients, but in young adult patients, it is detected at a relatively low...... the importance of socioeconomic status on the association between these diseases, we determined the risk for hematopoietic and lymphatic cancers in first-degree relatives of patients with confirmed EBV-related infectious mononucleosis. METHODS: We identified parents, siblings, and offspring of 17,045 persons...... with serologically confirmed EBV-related infectious mononucleosis. Subjects in these cohorts were linked with the population-based Danish Cancer Register to identify those developing hematopoietic/lymphatic cancers after the index patient was diagnosed with infectious mononucleosis. The relative risk for cancer...

  2. Biomarkers of depression in cancer patients.

    Science.gov (United States)

    Jehn, Christian Friedrich; Kuehnhardt, Dagmar; Bartholomae, Andrea; Pfeiffer, Sebastian; Krebs, Michael; Regierer, Anne Constanze; Schmid, Peter; Possinger, Kurt; Flath, Bernd Christian

    2006-12-01

    Inflammation and perturbation of the hypothalamic-pituitary-adrenal (HPA) axis function appears to play a putative role in the etiology of depression. Patients with metastatic cancer demonstrate elevated prevalence rates for depression. The objective of the current study was to illustrate the efficacy of interleukin-6 (IL-6) and HPA axis function as adjuncts to support the diagnosis of depression in cancer patients. Plasma concentrations of IL-6 and cortisol were measured in 114 cancer patients with and without depression. The relative diurnal variation of cortisol (cortisol VAR), expressed as a percentage, was calculated. Receiver operating characteristics analysis was performed. Depression was associated with increased plasma concentrations of IL-6 (18.7 pg/mL vs. 2.7 pg/mL; P < .001) and higher cortisol concentrations at 8 AM and 8 PM. The relative cortisol VAR (11.7% vs. 60.6%, respectively; P < .001) was found to be decreased in cancer patients with depression, indicating a disturbed circadian function of the HPA axis. As a biomarker of depression, IL-6 yielded at a cutoff value of 10.6 pg/mL, a sensitivity of 79%, and a specificity of 87% (area under the curve [AUC] = 0.86; 95% confidence interval [95% CI], 0.78-0.94), whereas cortisol VAR demonstrated a sensitivity of 81% and a specificity of 88% (AUC = 0.85; 95% CI, 0.74-0.97) at a cutoff value of 33.5%. Depression is associated with increased plasma IL-6 concentrations in patients with cancer. These patients demonstrate a dysfunction of the HPA-axis, characterized by a decreased diurnal variation of cortisol. The high sensitivity and specificity of these parameters biomarkers of depression make IL-6 and cortisol VAR helpful tools in the diagnosis of depression in patients with cancer. (c) 2006 American Cancer Society.

  3. Trismus release in oral cancer patients.

    Science.gov (United States)

    Lee, Yao-Chou; Wong, Tung-Yiu; Shieh, Shyh-Jou; Lee, Jing-Wei

    2012-12-01

    Trismus is a common problem among oral cancer patients. This report aimed to study the inciting factors of trismus and to find out the rationale of trismus release. Between 1996 and 2008, 61 oral cancer patients with retrievable records of interincisor distance (IID) were analyzed by retrospective chart review. The IID decreased from 31.4 (12.4) to 24.9 (12.0) mm in 36 patients undergoing cancer ablation only (P = 0.001). Other variables prompting trismus include buccal cancer (P = 0.017), radiotherapy (P = 0.008), and recurrence (P = 0.001). In contrast, the IID improved from 11.7 (7.1) to 22.7 (11.9) mm in 25 patients receiving cancer ablative and trismus releasing surgeries (P = 0.000). The improvement fared better in individuals with IID less than 15 mm than the others (P = 0.037). In conclusion, involvement of buccal region, ablative surgery, radiotherapy, and recurrence are provocative factors of trismus. Patients with IID less than 15 mm will benefit from releasing surgery significantly. Others may better be handled with conservative managements firstly, and enrolled as candidates of surgical release only until the patients entertained a 28-month period of disease-free interval, by which time the risk of recurrence would be markedly reduced.

  4. Dental implications in oral cancer patients.

    Science.gov (United States)

    Escoda-Francolí, Jaume; Rodríguez-Rodríguez, Araceli; Pérez-García, Silvia; Gargallo-Albiol, Jordi; Gay-Escoda, Cosme

    2011-07-01

    A study is made of the dental implications of oral cancer, with a view to avoiding the complications that appear once oncological treatment is started. The study comprised a total of 22 patients diagnosed with oral cancer according to clinical and histological criteria in the Service of Maxillofacial Surgery (Dental Clinic of the University of Barcelona, Spain) during the period 1996-2005, and posteriorly treated in different hospital centers in Barcelona. Of the 22 patients diagnosed with oral cancer in our Service, the present study finally analyzed the 12 subjects who reported for the dental controls. As regards the remaining 10 patients, 5 had died and 5 could not be located; these subjects were thus excluded from the analysis. All of the smokers had abandoned the habit. The most common tumor location was the lateral margin of the tongue. None of the patients visited the dentist regularly before the diagnosis of oral cancer. T1N0M0 was the most common tumor stage. Surgery was carried out in 50% of the cases, while 8.4% of the patients received radiotherapy and 41.6% underwent surgery with postoperative radiotherapy. In turn, 66.6% of the patients reported treatment sequelae such as dysgeusia, xerostomia or speech difficulties, and one patient suffered osteoradionecrosis. Forty-one percent of the patients did not undergo regular dental controls after cancer treatment. As regards oral and dental health, 16.6% presented caries, and 50% had active periodontal disease. Protocols are available for preventing the complications of oral cancer treatment, and thus for improving patient quality of life. However, important shortcomings in the application of such protocols on the part of the public health authorities make it difficult to reach these objectives.

  5. Enterobacteriaceae bacteremias among cancer patients: an observational cohort study

    Science.gov (United States)

    Henao-Martínez, Andrés F.; González-Fontal, Guido R.; Castillo-Mancilla, José R.; Yang, Ivana V.

    2013-01-01

    Summary Background Enterobacteriaceae bacteremia is a common complication in patients with neoplasm. The cancer itself, chemotherapy-induced immunosuppression, and other cancer-related procedures play a role as predisposing factors for this condition. However, despite the clear association between cancer and Enterobacteriaceae bacteremia, the distinctive clinical characteristics of patients with cancer presenting with Enterobacteriaceae bacteremia have not been well established. Methods The population studied was a prospective cohort of adult hospitalized patients with Enterobacteriaceae bacteremia in a tertiary care hospital. We compared the clinical variables and microbiological features between patients with an underlying neoplasm (n = 203) and those without (n = 259). STATA software was used for statistical association analysis. Results In a bivariate analysis, older age, prior exposure to aminopenicillins, fewer days of symptoms, biliary source of bacteremia, greater severity of APACHE II score, lower white blood cell and platelet counts, and the presence of Klebsiella pneumoniae were more common in the neoplasm group. In a multivariable analysis, K. pneumoniae bacteremia (odds ratio (OR) 6.13, 95% confidence interval (CI) 1.65–22.71; p = 0.007), APACHE II score (OR 1.18, 95% CI 1.05–1.34; p = 0.007), and exposure to aminopenicillins (OR 28.84, 95% CI 1.94–429.3; p = 0.015) were associated with neoplasm. K. pneumoniae bacteremia was more commonly present in patients with lung and gastrointestinal cancers. Conclusions We have confirmed the association of K. pneumoniae bacteremia with underlying neoplastic disease, especially with gastrointestinal malignancies, which may allow stratification for initial empiric antibiotic therapy in this subset of patients. Prior exposure to aminopenicillins in the neoplasm group might contribute to this finding. PMID:23313157

  6. Cancer-related information needs and cancer’s impact on control over life influence health-related quality of life among adolescents and young adults with cancer

    Science.gov (United States)

    DeRouen, Mindy C.; Smith, Ashley Wilder; Tao, Li; Bellizzi, Keith M.; Lynch, Charles F.; Parsons, Helen M.; Kent, Erin E.; Keegan, Theresa H. M.

    2015-01-01

    Objective Adolescents and young adults (AYAs) diagnosed with cancer between 15 and 39 years of age often report need for greater amounts of cancer-related information and perceive that cancer has had a negative impact on control over their life. We examined whether unmet information need and perceived control over life are associated with health-related quality of life (HRQOL). Methods We examined data from 484 AYA cancer survivors recruited from population-based cancer registries in 2007–2008. Participants completed surveys a median of 11 months after diagnosis. Multivariable linear regression analyses estimated associations of unmet cancer-related information needs and impact of cancer on control over life on HRQOL (SF-12). Results Two-thirds of AYAs reported an intermediate or high level of unmet information need, and half (47%) reported a negative impact of cancer on control. Greater unmet information need was associated with lower overall mental and physical HRQOL and lower levels of all HRQOL subscales except vitality. A negative impact on control over life was associated with lower overall mental HRQOL as well as lower HRQOL across all subscales (all p 0.1). Conclusions AYA patients with cancer have high levels of unmet cancer-related information needs and perceived negative impact of cancer on control over life; both were independently associated with lower HRQOL. Addressing unmet information needs among AYA cancer survivors and finding ways to increase their sense of control may help improve HRQOL in this understudied population. PMID:25611943

  7. Decline in Cognitive Function in Older Adults With Early-Stage Breast Cancer After Adjuvant Treatment.

    Science.gov (United States)

    Lange, Marie; Heutte, Natacha; Rigal, Olivier; Noal, Sabine; Kurtz, Jean-Emmanuel; Lévy, Christelle; Allouache, Djelila; Rieux, Chantal; Lefel, Johan; Clarisse, Bénédicte; Veyret, Corinne; Barthélémy, Philippe; Longato, Nadine; Castel, Hélène; Eustache, Francis; Giffard, Bénédicte; Joly, Florence

    2016-07-29

    The impact of chemotherapy on cognition among elderly patients has received little attention, although such patients are more prone to presenting with age-related cognitive deficits and/or cognitive decline during chemotherapy. The present study assessed the cognitive function in older adults treated for early-stage breast cancer (EBC). The participants were newly diagnosed EBC patients aged ≥65 years without previous systemic treatment or neurological or psychiatric disease and matched healthy controls. They underwent two assessments: before starting adjuvant therapy and after the end of chemotherapy (including doxorubicin ± docetaxel [CT+ group], n = 58) or radiotherapy for patients who did not receive chemotherapy (CT- group, n = 61), and at the same interval for the healthy controls (n = 62). Neuropsychological and geriatric assessments were performed. Neuropsychological data were analyzed using the Reliable Change Index. Forty-nine percent of the patients (mean age, 70 ± 4 years) had objective cognitive decline after adjuvant treatment that mainly concerned working memory. Among these patients, 64% developed a cognitive impairment after adjuvant treatment. Comorbidity was not associated with cognitive decline. No significant difference in objective cognitive decline was found between the two groups of patients; however, the CT+ group had more subjective cognitive complaints after treatment (p = .008). The oldest patients (aged 70-81 years) tended to have more objective decline with docetaxel (p = .05). This is the largest published study assessing cognitive function in older adults with EBC that included a group of patients treated with modern chemotherapy regimens. Approximately half the patients had objective cognitive decline after adjuvant treatment. The oldest patients were more likely to have cognitive decline with chemotherapy, particularly with docetaxel. This is the largest published study assessing cognitive function in older adults with early

  8. Decline in Cognitive Function in Older Adults With Early-Stage Breast Cancer After Adjuvant Treatment

    Science.gov (United States)

    Lange, Marie; Heutte, Natacha; Rigal, Olivier; Noal, Sabine; Kurtz, Jean-Emmanuel; Lévy, Christelle; Allouache, Djelila; Rieux, Chantal; Lefel, Johan; Clarisse, Bénédicte; Veyret, Corinne; Barthélémy, Philippe; Longato, Nadine; Castel, Hélène; Eustache, Francis; Giffard, Bénédicte

    2016-01-01

    Background. The impact of chemotherapy on cognition among elderly patients has received little attention, although such patients are more prone to presenting with age-related cognitive deficits and/or cognitive decline during chemotherapy. The present study assessed the cognitive function in older adults treated for early-stage breast cancer (EBC). Patients and Methods. The participants were newly diagnosed EBC patients aged ≥65 years without previous systemic treatment or neurological or psychiatric disease and matched healthy controls. They underwent two assessments: before starting adjuvant therapy and after the end of chemotherapy (including doxorubicin ± docetaxel [CT+ group], n = 58) or radiotherapy for patients who did not receive chemotherapy (CT− group, n = 61), and at the same interval for the healthy controls (n = 62). Neuropsychological and geriatric assessments were performed. Neuropsychological data were analyzed using the Reliable Change Index. Results. Forty-nine percent of the patients (mean age, 70 ± 4 years) had objective cognitive decline after adjuvant treatment that mainly concerned working memory. Among these patients, 64% developed a cognitive impairment after adjuvant treatment. Comorbidity was not associated with cognitive decline. No significant difference in objective cognitive decline was found between the two groups of patients; however, the CT+ group had more subjective cognitive complaints after treatment (p = .008). The oldest patients (aged 70–81 years) tended to have more objective decline with docetaxel (p = .05). Conclusion. This is the largest published study assessing cognitive function in older adults with EBC that included a group of patients treated with modern chemotherapy regimens. Approximately half the patients had objective cognitive decline after adjuvant treatment. The oldest patients were more likely to have cognitive decline with chemotherapy, particularly with docetaxel. Implications for Practice: This is

  9. Kelp use in patients with thyroid cancer.

    Science.gov (United States)

    Rosen, Jennifer E; Gardiner, Paula; Saper, Robert B; Pearce, Elizabeth N; Hammer, Kallista; Gupta-Lawrence, Rebecca L; Lee, Stephanie L

    2014-05-01

    To report on the incidence and use of kelp among patients with thyroid cancer. Data were collected using a web-based online anonymous survey under Institutional Review Board approval from Boston University. This report is based on 27 responses from subjects with thyroid cancer who use kelp. Demographic factors and complementary and alternative use were included. Respondents were primarily over age 40, white, female and have at least a high school education. The top five modalities were multivitamins, special diets, herbal supplements, prayer for health reasons and herbal tea. Only one patient reported perceiving a particular modality had a negative effect on treatment. Complementary and alternative medicine (CAM) was more often perceived as being used to aid their thyroid cancer treatment than to help with symptoms. On average, respondents who use kelp also use at least 11 additional CAM modalities. Only 1/2 of respondents who use kelp reported telling their physicians about their CAM use, and nearly 1/3 of respondents reported their CAM use was neither known, prescribed nor asked about by their physicians. In comparison to both national surveys of the general US population and patients with thyroid cancer, kelp users with thyroid cancer use at least twice the number of additional CAM therapies and report their use far less often. Physicians who treat patients with thyroid cancer should be aware of these data to further assist in their assessment and care.

  10. Fertility preservation in young cancer patients

    Directory of Open Access Journals (Sweden)

    Ariel Revel

    2010-01-01

    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.

  11. [Systemic cancer treatment in geriatric patients].

    Science.gov (United States)

    Hess, J

    2015-12-01

    Functional health issues and the ability to autonomously participate in social life play a more pronounced role for geriatric patients than the mere prolongation of life. Quality-adjusted life years reflect the relation of health and life span. Comorbidities and functional or cognitive impairment represent independent predictors for the overall survival of geriatric patients. This must be kept in mind when planning systemic cancer treatment. All forms of cancer-specific therapy should evaluate whether the patient can truly benefit taking into consideration geriatric aspects. This particularly demands a great deal of palliative chemotherapy. When curation is no longer possible, a cancer-specific treatment must not lead to therapy-related symptoms. Clear communication of the aims of therapy is indispensable. In addition to routine urooncologic data, other relevant information must be inquired in advance of cancer-specific treatment in order to identify those functionally or cognitively impaired patients who may not benefit from systemic cancer treatment. A precise indication with respect of age-dependent physiological changes and a clear prioritization of symptoms outline the approach for systemic cancer-specific treatment.

  12. Myofacial trigger points in advanced cancer patients

    Directory of Open Access Journals (Sweden)

    Hideaki Hasuo

    2016-01-01

    Full Text Available Myofascial pain syndrome is started to be recognized as one of important factors of pain in cancer patients. However, no reports on features of myofascial trigger points were found in terminally-ill cancer populations. This time, we encountered 5 patients with myofascial pain syndrome and terminal cancer in whom delirium developed due to increased doses of opioid without a diagnosis of myofascial pain syndrome on initial presentation. The delirium subsided with dose reductions of opioid and treatment of myofascial pain syndrome. The common reason for a delayed diagnosis among the patients included an incomplete palpation of the painful sites, which led to unsuccessful myofascial trigger points identification. The features of myofascial trigger points included single onset in the cancer pain management site with opioid and the contralateral abdominal side muscles of the non-common sites. Withdrawal reflexes associated with cancer pain in the supine position, which are increasingly seen in the terminal cancer patients, were considered to have contributed to this siuation.We consider that careful palpation of the painful site is important, in order to obtain greater knowledge and understanding of the features of myofascial trigger points.

  13. Depression and Resilience in Breast Cancer Patients.

    Science.gov (United States)

    Ristevska-Dimitrovska, Gordana; Stefanovski, Petar; Smichkoska, Snezhana; Raleva, Marija; Dejanova, Beti

    2015-12-15

    A significant number of breast cancer patients, during their life with the diagnosis, experience emotional distress in the form of depression and anxiety. Psychological resilience is the ability of a person to protect his/her mental health when faced with adverse circumstances such as the cancer diagnosis. This study aims to assess the resilience in breast cancer patients and to explore whether depression affects the resilience. Two hundred eighteen (218) women, treated for early breast cancer responded to Connor - Davidson Resilience Scale and Hospital Depression and Anxiety Scale, in order to assess the level of psychological resilience and the level of depression. There is a significant negative correlation between depression and resilience in our sample (r = - 0.562, p resilience. There is no statistically significant correlation between the ages of the participants; time passed since diagnosis, cancer stage and resilience levels. 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.

  14. Genetic Analysis-Guided Dosing of FOLFIRABRAX in Treating Patients With Advanced Gastrointestinal Cancer

    Science.gov (United States)

    2017-07-10

    Adenocarcinoma of Unknown Primary; Adult Cholangiocarcinoma; Gallbladder Carcinoma; Gastric Adenocarcinoma; Malignant Gastrointestinal Neoplasm; Metastatic Pancreatic Adenocarcinoma; Pancreatic Adenocarcinoma; Stage III Ampulla of Vater Cancer; Stage III Pancreatic Cancer; Stage IIIA Gallbladder Cancer; Stage IIIA Gastric Cancer; Stage IIIB Gallbladder Cancer; Stage IIIB Gastric Cancer; Stage IV Ampulla of Vater Cancer; Stage IV Gallbladder Cancer; Stage IV Gastric Cancer; Stage IV Pancreatic Cancer

  15. Cancer Prevention Among Adults Aged 45–64 Years

    Science.gov (United States)

    Ory, Marcia G.; Anderson, Lynda A.; Friedman, Daniela B.; Pulczinski, Jairus C.; Eugene, Nola; Satariano, William A.

    2015-01-01

    As part of setting the stage for this supplement to the American Journal of Preventive Medicine, a life-course perspective is presented to assist in understanding the importance of cancer prevention for adults in midlife, a period roughly spanning 20 years between ages 45 and 64 years. Drawing on disciplinary perspectives from the social sciences and public health, several life-course themes are delineated in this article: how specific life transitions present unique opportunities for interventions to inform policy and practice that can improve population health outcomes; how interventions can be focused on those at particular life stages or on the entire life course; and how the onset and progression of chronic conditions such as cancer are dependent on a complex interplay of critical and sensitive periods, and trajectory and accumulation processes. A translational research framework is applied to help promote the movement of applied public health interventions for cancer prevention into practice. Also explored are differences that can affect people at midlife relative to other age cohorts. Specifically, cancer-related risks and care networks are examined, with examples of public health strategies that can be applied to cancer prevention and control. As a conclusion, select methodologic issues and next steps for advancing research and practice are identified. PMID:24512925

  16. Coping and psychological distress in young adults with advanced cancer

    Science.gov (United States)

    Trevino, K. M.; Maciejewski, P. K.; Fasciano, K.; Greer, J.; Partridge, A.; Kacel, E. L.; Block, S.; Prigerson, H.G.

    2011-01-01

    Little is known about how young adults (YAs) cope with cancer or the relationship between coping and psychological distress in YAs with advanced cancer. Structured clinical interviews with 53 YAs (20–40 years) with advanced cancer assessed coping methods, depression, anxiety, and grief. A principal components factor analysis identified underlying coping factors. Regression analyses examined the relationship between these coping factors and depression, anxiety, and grief. Six coping factors emerged and were labeled as: Proactive, Distancing, Negative Expression, Support-seeking, Respite-seeking, and Acceptance coping. Acceptance and Support-seeking coping styles were used most frequently. Coping by Negative Expression was positively associated with severity of grief after controlling for depression, anxiety, and confounding variables. Support-seeking coping was positively associated with anxiety after controlling for depression and grief. This study was limited by cross-sectional design, small sample size, and focus on YAs with advanced cancer. YAs with advanced cancer utilize a range of coping responses that are uniquely related to psychological distress. PMID:22285777

  17. Symptom attributions in patients with colorectal cancer

    DEFF Research Database (Denmark)

    Jensen, Line Flytkjær; Hvidberg, Line; Pedersen, Anette Fischer

    2015-01-01

    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...

  18. MANAGEMENT OF CANCER IN PATIENTS WITH HIV

    African Journals Online (AJOL)

    Owing to the effects of HIV on haemopoiesis and immune function, HIV infection of patients with cancer poses management difficulties for both the physician managing .... chemotherapy. In addition, the obvious susceptibility to infection is synergistic with the immune suppression of cytotoxic therapy. The HIV-positive patient ...

  19. Depression and Resilience in Breast Cancer Patients

    Directory of Open Access Journals (Sweden)

    Gordana Ristevska-Dimitrоvska

    2015-11-01

    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.

  20. The Patient Protection and Affordable Care Act dependent coverage expansion: Disparities in impact among young adult oncology patients.

    Science.gov (United States)

    Alvarez, Elysia M; Keegan, Theresa H; Johnston, Emily E; Haile, Robert; Sanders, Lee; Wise, Paul H; Saynina, Olga; Chamberlain, Lisa J

    2018-01-01

    Private health insurance is associated with improved outcomes in patients with cancer. However, to the authors' knowledge, little is known regarding the impact of the Patient Protection and Affordable Care Act Dependent Coverage Expansion (ACA-DCE), which extended private insurance to young adults (to age 26 years) beginning in 2010, on the insurance status of young adults with cancer. The current study was a retrospective, population-based analysis of hospitalized young adult oncology patients (aged 22-30 years) in California during 2006 through 2014 (11,062 patients). Multivariable regression analyses examined factors associated with having private insurance. Results were presented as adjusted odds ratios and 95% confidence intervals. A difference-in-difference analysis examined the influence of the ACA-DCE on insurance coverage by race/ethnicity and federal poverty level. Multivariable regression demonstrated that patients of black and Hispanic race/ethnicity were less likely to have private insurance before and after the ACA-DCE, compared with white patients. Younger age (22-25 years) was associated with having private insurance after implementation of the ACA-DCE (odds ratio, 1.20; 95% confidence interval, 1.06-1.35). In the difference-in-difference analysis, private insurance increased among white patients aged 22 to 25 years who were living in medium-income (2006-2009: 64.6% vs 2011-2014: 69.1%; P = .003) and high-income (80.4% vs 82%; P = .043) zip codes and among Asians aged 22 to 25 years living in high-income zip codes (73.2 vs 85.7%; P = .022). Private insurance decreased for all Hispanic patients aged 22 to 25 years between the 2 time periods. The ACA-DCE provision increased insurance coverage, but not among all patients. Private insurance increased for white and Asian patients in higher income neighborhoods, potentially widening social disparities in private insurance coverage among young adults with cancer. Cancer 2018;124:110-7. © 2017 American

  1. Preparing childhood cancer survivors for transition to adult care: The young adult perspective.

    Science.gov (United States)

    Frederick, Natasha N; Bober, Sharon L; Berwick, Lexie; Tower, Mary; Kenney, Lisa B

    2017-10-01

    Childhood cancer survivors (CCSs) remain at risk for developing treatment-associated health conditions as they age; however, many do not obtain recommended follow-up, putting them at unnecessary risk for morbidity. Educational interventions targeted at providing survivors with the knowledge and skills necessary for healthcare independence might improve adherence and outcomes as they transition care to the adult medical system. To identify informational needs, educational preferences, and support that young adult CCSs perceive as beneficial for transition from pediatric to adult medical care. Sixteen young adult CCSs (ages 22-39 years) who have transitioned to adult care participated in focus groups led by a trained moderator and analyzed using a thematic analysis approach. Four major themes emerged: (1) education preferences-pediatric oncology provider as the primary source of information and guidance, enhanced by other formats, and early and ongoing engagement in education; (2) family role in transition-desire for independence and acknowledgement of need for ongoing parental support; (3) expectations for adult providers, such as close relationships, open communication, and care coordination; and (4) knowledge deficits regarding disease/treatment history, risk for long-term complications, and navigation of the adult medical system. Transition education as described by young adult CCSs should be a developmentally appropriate process beginning in early adolescents, primarily administered by pediatric oncology providers, and delivered in multiple formats. While healthcare independence is a goal for young adult CCSs, all stakeholders must recognize that families and providers continue to have an important role supporting survivors with transition logistics and medical decision-making. © 2017 Wiley Periodicals, Inc.

  2. Incidental health information use and media complementarity: a comparison of senior and non-senior cancer patients.

    Science.gov (United States)

    Tian, Yan; Robinson, James D

    2008-06-01

    This study compares the health information and media usage patterns of older adults diagnosed with cancer with their younger adult counterparts and is based theoretically in media complementarity theory [Dutta-Bergman MJ. Complementarity in consumption of news types across traditional and new media. J Broadcast Electron 2004;48:41-60; Dutta-Bergman MJ. Interpersonal communication after 9/11 via telephone and Internet: a theory of channel complementarity. New Media Soc 2004;6:659-73] and health information seeking and scanning research [Shim M, Kelly B, Hornik R. Cancer information scanning and seeking behavior is associated with knowledge, lifestyle choices, and screening. J Health Commun 2006;11:157-72]. A secondary analysis of the Health Information National Trends Survey (HINTS) II data collected by the National Cancer Institute (NCI) is performed to investigate differences in the health information behavior of younger and older adult cancer patients. The sample size was 401, with 260 non-senior cancer patients and 141 senior cancer patients. Younger adults diagnosed with cancer were more likely to gain information about health incidentally through their use of the Internet and to seek health information for others on the Internet than senior cancer patients. Complementarity of active health information seeking and incidental health information use online was supported with senior cancer patients, while complementarity of incidental health information use between traditional media channels and the Internet was partially confirmed with younger adults. This study reveals similarities and differences in the health information and media usage behavior of younger and older adults diagnosed with cancer. It also provides partial support for media complementarity theory. The Internet is not a panacea for health information. Health professionals need to provide written instructions to older adult cancer patients because they do not rely on the Internet for information

  3. The influence of a department's psychosocial climate and treatment environment on cancer patients' anxiety during radiotherapy

    OpenAIRE

    Mullaney, Tara; Olausson, Kristina; Sharp, Lena; Zackrisson, Björn; Edvardsson, David; Nyholm, Tufve

    2016-01-01

    PURPOSE: The objective of this study is to determine whether there is a relationship between cancer patients' perceptions of the person-centeredness of their treatment experience and their anxiety levels during treatment. METHOD: A questionnaire was distributed to adult cancer patients going through external beam radiotherapy (RT) with curative intent at a university hospital in Sweden (n = 892), which included two surveys, the State Trait Anxiety Inventory-state specific questions (STAI-S), ...

  4. How Exercise Can Benefit Patients With Cancer.

    Science.gov (United States)

    Musanti, Rita

    2016-12-01

    Thirty years ago, the first article on exercise for patients with cancer appeared in the cancer research literature. The time from that first article to the present has included oncology nurses taking the lead in investigations related to exercise and cancer-related symptoms, most notably cancer-related fatigue (CRF). The Oncology Nursing Society (ONS) has been instrumental in publishing much of the research on exercise and cancer and continues in that tradition by issuing this supplement to the Clinical Journal of Oncology Nursing. In addition, ONS has facilitated the translation of research findings to practicing oncology nurses by convening meetings, participating in expert opinion consensus groups, and disseminating evidence through Putting Evidence Into Practice resources.

  5. Formalized exercise program for paediatric and young adult cancer survivors

    Directory of Open Access Journals (Sweden)

    Karen Y. Wonders

    2017-09-01

    Full Text Available Survival rates of childhood cancer patients has steadily increased through the years, making it necessary to develop strategies aimed at long term improvements to quality of life. This paper presents a formalized exercise program for paediatric cancer survivors, based on current risk-based exercise recommendations, with the primary goal of helping families return to a normal life that emphasizes overall wellness and physical activity. Background Children tend to respond better to anti-cancer treatments, including chemotherapy. Research indicates that proper nutrition and regular physical activity will help a paediatric cancer survivor continue to grow and develop properly, however, at present, there is no standard of care with regards to this subject. Aims To create a fun and supportive atmosphere that encourages movement and healthy eating for the participants while increasing participant knowledge regarding proper nutrition and exercise.

  6. PET/MRI in cancer patients

    DEFF Research Database (Denmark)

    Kjær, Andreas; Loft, Annika; Law, Ian

    2013-01-01

    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.......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...

  7. PET/MRI in cancer patients

    DEFF Research Database (Denmark)

    Kjær, Andreas; Loft, Annika; Law, Ian

    2013-01-01

    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....

  8. Helping families of patients with cancer.

    Science.gov (United States)

    Northouse, Laurel

    2005-07-01

    To discuss the impact of cancer on families of patients with cancer. National reports on caregiving and research articles related to cancer and families. Family caregivers are the bedrock of chronic care in the United States. They provide an enormous amount of unpaid care that is often invisible. Cancer can affect the emotional, social, physical, and spiritual well-being of family members. Family intervention research can have a positive effect on patient and family caregiver outcomes. More intervention research with families is needed that is theoretically based, uses randomized clinical trial designs, and uses instruments that are sensitive to intervention effects. Although family intervention research is limited, descriptive and exploratory research has identified protective factors and risk factors that need to be addressed in clinical practice.

  9. Nutritional support strategies for malnourished cancer patients.

    Science.gov (United States)

    van Bokhorst-de van der Schueren, Marian A E

    2005-01-01

    A large body of evidence exists, which demonstrates the importance of nutritional support in cancer. The nutritional needs of patients with cancer may differ from those of the healthy population due to hypermetabolism, impaired organ function, increased nutrient losses and therapy-related malnutrition. Patients with cancer often have increased requirements for both macro- and micronutrients due to long periods of undernutrition prior to diagnosis. The aim of nutritional support should be the prevention or reversal of malnutrition, and this should be initiated as early as possible to improve outcomes. Oral supplementation is a simple, non-invasive method of increasing the nutrient intake of those patients who are unable to meet nutritional requirements, despite dietary counselling. Enteral tube feeding is indicated for patients who are unable to meet their nutritional needs by oral intake alone, and has been shown to improve clinical outcomes. Novel approaches in oral supplementation include the use of eicosapentaenoic acid (EPA), a compound under investigation for its role in preventing and treating cancer-associated malnutrition. Individual studies suggest that EPA attenuates cancer-associated wasting and improves immune function. In addition, it has been shown to have anti-tumour effects and improve clinical outcomes. However, results are not consistent for all patient groups and further research is required.

  10. Management of Pain and Distress in the Adult ICU patient

    OpenAIRE

    Schoonderbeek, Fenna

    2008-01-01

    textabstractThe literature presents vast amounts of scientific evidence as to the significance of pain in the process of severe illness, yet evidence on the effectiveness of pain assessment and pain management for the adult critically ill patient is scarce. In critically ill adult patients the process of clinical decision making for pain interventions remains very complex. The Critically Ill Assessment (CIA) scale is introduced, a new pain-distress observational tool for critically ill adult ...

  11. Management of Pain and Distress in the Adult ICU patient

    NARCIS (Netherlands)

    F.J. Schoonderbeek (Fenna)

    2008-01-01

    textabstractThe literature presents vast amounts of scientific evidence as to the significance of pain in the process of severe illness, yet evidence on the effectiveness of pain assessment and pain management for the adult critically ill patient is scarce. In critically ill adult patients the

  12. Gastric cancer surgery in elderly patients.

    Science.gov (United States)

    Gretschel, Stephen; Estevez-Schwarz, Lope; Hünerbein, Michael; Schneider, Ulrike; Schlag, Peter M

    2006-08-01

    To investigate the value of individual risk-adapted therapy in geriatric patients, we performed a consecutive analysis of 363 patients undergoing potentially curative surgery for gastric cancer. All patients underwent extensive preoperative workup to assess surgical risk. The following criteria were evaluated in 3 age groups (75 years): comorbidity, tumor characteristics, type of resection, postoperative morbidity and mortality, recurrence rate, overall survival, and disease-free survival. There was an increased rate of comorbidity in the higher age groups (51% vs 76% vs 83%; PPatient selection and risk-adapted surgery in elderly patients can result in acceptable therapeutic results comparable to younger patients. Limited surgery in elderly gastric cancer patients with high comorbidity does not necessarily compromise oncological outcome.

  13. Lateral positioning for critically ill adult patients.

    Science.gov (United States)

    Hewitt, Nicky; Bucknall, Tracey; Faraone, Nardene M

    2016-05-12

    Critically ill patients require regular body position changes to minimize the adverse effects of bed rest, inactivity and immobilization. However, uncertainty surrounds the effectiveness of lateral positioning for improving pulmonary gas exchange, aiding drainage of tracheobronchial secretions and preventing morbidity. In addition, it is unclear whether the perceived risk levied by respiratory and haemodynamic instability upon turning critically ill patients outweighs the respiratory benefits of side-to-side rotation. Thus, lack of certainty may contribute to variation in positioning practice and equivocal patient outcomes. To evaluate effects of the lateral position compared with other body positions on patient outcomes (mortality, morbidity and clinical adverse events) in critically ill adult patients. (Clinical adverse events include hypoxaemia, hypotension, low oxygen delivery and global indicators of impaired tissue oxygenation.) We examined single use of the lateral position (i.e. on the right or left side) and repeat use of the lateral position (i.e. lateral positioning) within a positioning schedule. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 5), MEDLINE (1950 to 23 May 2015), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1937 to 23 May 2015), the Allied and Complementary Medicine Database (AMED) (1984 to 23 May 2015), Latin American Caribbean Health Sciences Literature (LILACS) (1901 to 23 May 2015), Web of Science (1945 to 23 May 2015), Index to Theses in Great Britain and Ireland (1950 to 23 May 2015), Trove (2009 to 23 May 2015; previously Australasian Digital Theses Program (1997 to December 2008)) and Proquest Dissertations and Theses (2009 to 23 May 2015; previously Proquest Digital Dissertations (1980 to 23 May 2015)). We handsearched the reference lists of potentially relevant reports and two nursing journals. We included randomized and quasi-randomized trials examining effects of

  14. Communicating with head and neck cancer patients.

    Science.gov (United States)

    McGrory, Arlene

    2011-01-01

    Head and neck cancer is only 3 to 5% of all the cancers in the United States. The disease causes major changes in the appearance and functional ability of patients. To explore how caregivers communicate with head and neck cancer patients who have impaired communication abilities from the disease and from treatment. A qualitative grounded theory approach was used. Thirty-nine caregivers of head and neck cancer patients were recruited from three east coast academic-affiliated hospitals with dedicated head and neck cancer units. Each person was interviewed, while being audiotaped for 1 1/2 hours. Open-ended questions were used to elicit comprehensive responses to the issues and concerns most important to care for these patients. The tapes were transcribed and inputted using Ethnograph v.5. The analysis of the interviews used grounded theory methods. Methods to ensure rigor and trustworthiness were incorporated into the design. The results of the data collection revealed the majority of participants were women age 47 (average). For most, their beginning and highest education was the baccalaureate degree. The entire sample averaged 23 years in their profession and a more than 15.1 years caring for head and neck cancer patients. The sample represented caregivers from primarily the inpatient setting, but also included clinic, administrative, research and education. The results of the data analysis revealed engaging and distancing behaviors based the caregivers' level of comfort. The central topic was communication impairment. The core category was "Reading the Patient". The strategies used to identify problems, and meet the needs of the patients were "Giving Voice", "Being There", "Giving Control", "Saving Face", "Normalizing", "Relieving Pain", and "Giving Hope". A hypothesis emerged from the analysis of the interviews. Successfully meeting the physical and psychosocial needs of head and neck cancer patients requires an intensive effort and the use of creative methods of

  15. Colorectal Cancer Treatment in Older Patients

    OpenAIRE

    Sanoff, Hanna K.; Goldberg, Richard M.

    2007-01-01

    The burden of colorectal cancer (CRC) morbidity and mortality falls largely on the elderly, who make up more than 70% of CRC patients. Recent evidence from pooled analyses suggests that both adjuvant and palliative chemotherapy are as efficacious in fit older patients as in younger patients. Although severe hematologic toxicity is increased in older age groups treated with chemotherapy, this does not appear to increase the risk of other severe adverse events. Little evidence is available to g...

  16. Burden of Geriatric Events Among Older Adults Undergoing Major Cancer Surgery

    Science.gov (United States)

    Saliba, Debra; Kwan, Lorna; Moore, Alison A.; Litwin, Mark S.

    2016-01-01

    Purpose Most malignancies are diagnosed in older adults who are potentially susceptible to aging-related health conditions; however, the manifestation of geriatric syndromes during surgical cancer treatment is not well quantified. Accordingly, we sought to assess the prevalence and ramifications of geriatric events during major surgery for cancer. Patients and Methods Using Nationwide Inpatient Sample data from 2009 to 2011, we examined hospital admissions for major cancer surgery among elderly patients (ie, age ≥ 65 years) and a referent group age 55 to 64 years. From these observations, we identified geriatric events that included delirium, dehydration, falls and fractures, failure to thrive, and pressure ulcers. We then estimated the collective prevalence of these events according to age, comorbidity, and cancer site and further explored their relationship with other hospital-based outcomes. Results Within a weighted sample of 939,150 patients, we identified at least one event in 9.2% of patients. Geriatric events were most common among patients age ≥ 75 years, with a Charlson comorbidity score ≥ 2, and who were undergoing surgery for cancer of the bladder, ovary, colon and/or rectum, pancreas, or stomach (P geriatric event had a greater likelihood of concurrent complications (odds ratio [OR], 3.73; 95% CI, 3.55 to 3.92), prolonged hospitalization (OR, 5.47; 95% CI, 5.16 to 5.80), incurring high cost (OR, 4.97; 95% CI, 4.58 to 5.39), inpatient mortality (OR, 3.22; 95% CI, 2.94 to 3.53), and a discharge disposition other than home (OR, 3.64; 95% CI, 3.46 to 3.84). Conclusion Many older patients who receive cancer-directed surgery experience a geriatric event, particularly those who undergo major abdominal surgery. These events are linked to operative morbidity, prolonged hospitalization, and more expensive health care. As our population ages, efforts focused on addressing conditions and complications that are more common in older adults will be essential to

  17. The cost of cancer: a retrospective analysis of the financial impact of cancer on young adults.

    Science.gov (United States)

    Landwehr, Michelle S; Watson, Samantha E; Macpherson, Catherine F; Novak, Katherine A; Johnson, Rebecca H

    2016-05-01

    Young adult cancer survivors (YAs) are confronted with immense financial challenges in the wake of their treatment. Medical bills and loss of savings may cause YAs to forgo recommended medications or follow-up appointments. Young survivors with financial concerns also report depression, stress and anxiety. The Samfund is a national nonprofit organization that provides financial support to YAs post-treatment. To quantify the financial burden of cancer in YAs, a retrospective analysis was performed of data collected from Samfund grant applications of 334 YA cancer survivors. Grants were awarded between 2007 and 2013 and grant recipients were consented electronically in 2014 for retrospective data analysis. Recipients ranged from 19 to 39 years of age at the time of their grant applications. Descriptive statistics were calculated and compared to the Medical Expenditure Panel Survey (MEPS) and U.S. census data on age-matched peers. Financial indicators of YA cancer survivors are worse in many domains than those of age-matched controls. Furthermore, YA survivors in their 30s report more perilous prefunding financial situations than younger grant recipients. Cancer has a devastating and age-specific impact on the finances of YAs. Philanthropic grants from the cancer support community, in conjunction with healthcare policy reforms, have the potential to break the cycle of financial need and help YAs move forward with their lives after cancer treatment. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  18. Survival analysis of patients with interval cancer undergoing gastric cancer screening by endoscopy.

    Science.gov (United States)

    Hamashima, Chisato; Shabana, Michiko; Okamoto, Mikizo; Osaki, Yoneatsu; Kishimoto, Takuji

    2015-01-01

    Interval cancer is a key factor that influences the effectiveness of a cancer screening program. To evaluate the impact of interval cancer on the effectiveness of endoscopic screening, the survival rates of patients with interval cancer were analyzed. We performed gastric cancer-specific and all-causes survival analyses of patients with screen-detected cancer and patients with interval cancer in the endoscopic screening group and radiographic screening group using the Kaplan-Meier method. Since the screening interval was 1 year, interval cancer was defined as gastric cancer detected within 1 year after a negative result. A Cox proportional hazards model was used to investigate the risk factors associated with gastric cancer-specific and all-causes death. A total of 1,493 gastric cancer patients (endoscopic screening group: n = 347; radiographic screening group: n = 166; outpatient group: n = 980) were identified from the Tottori Cancer Registry from 2001 to 2008. The gastric cancer-specific survival rates were higher in the endoscopic screening group than in the radiographic screening group and the outpatients group. In the endoscopic screening group, the gastric cancer-specific survival rate of the patients with screen-detected cancer and the patients with interval cancer were nearly equal (P = 0.869). In the radiographic screening group, the gastric cancer-specific survival rate of the patients with screen-detected cancer was higher than that of the patients with interval cancer (P = 0.009). For gastric cancer-specific death, the hazard ratio of interval cancer in the endoscopic screening group was 0.216 for gastric cancer death (95%CI: 0.054-0.868) compared with the outpatient group. The survival rate and the risk of gastric cancer death among the patients with screen-detected cancer and patients with interval cancer were not significantly different in the annual endoscopic screening. These results suggest the potential of endoscopic screening in reducing

  19. Patients' preference to hear cancer diagnosis.

    Directory of Open Access Journals (Sweden)

    Mohammad Arbabi

    2014-03-01

    Full Text Available Bad news disclosure is one of the complex communication tasks of the physicians. Bad news is defined as:" any news that adversely and seriously affects an individual's view of his or her future". Recent studies indicate that the patients' and physicians' attitudes toward disclosure of bad news have been changed since few years ago. The evidence of breaking bad news is also different across different cultures. In the present study, we aimed to evaluate the patients' prospect about breaking bad news and to provide a clinical guidance for Iranian patients and those patients in countries with a similar cultural background.A cross sectional descriptive study was conducted on a sample of 200 cancer patients at a cancer institute in Tehran. The patients' demographic characteristics and their attitudes toward the manner of disclosing the diagnosis were registered in a research based questionnaire.In this study, 165 patients (82.5% claimed to be aware of the diagnosis; however, only 121 patients (73% were aware of the actual diagnosis of their disease. Most patients tended to know the diagnosis (n = 186, 93% and accepted patient as the first person to be informed (n = 151, 75.5% by their physician (n = 174, 87%. The preference of being alone or with a family member when exposed to bad news was almost the same. Most patients (n = 169, 84.5% believed that physicians should consult the patients to make treatment decisions. Treatment options (n = 140, 70% and life expectancy (n = 121, 60.5% were the most desirable topics to be discussed. Most patients (n = 144, 72% agreed upon allowing them to express their emotional feelings.According to the patients' preferences about being fully informed about the diagnosis, it is suggested that the disclosure of cancer diagnosis be done by a physician and in the presence of a family member. It is also recommended that physicians consult the patients about treatment options.

  20. Characteristics and outcome of spontaneous bacterial meningitis in patients with cancer compared to patients without cancer.

    Science.gov (United States)

    Pomar, Virginia; Benito, Natividad; López-Contreras, Joaquin; Coll, Pere; Gurguí, Mercedes; Domingo, Pere

    2017-05-01

    In cancer patients, who are frequently immunocompromised, bacterial meningitis (BM) can be a severe complication, with a different presentation, etiology, and course, compared to patients without cancer. Our objective is to compare the characteristics and outcomes of BM in patients with and without cancer. A single-center, prospective observational cohort study, conducted between 1982 and 2012, in a tertiary university hospital in Barcelona (Spain). The main outcome measure is in-hospital mortality. We evaluated 659 episodes of BM; 97 (15%) had active cancer. Patients with malignancies were older (median 63 (interquartile range [IQR] 24) vs 52 [IQR 42] years, P meningitis triad (35% vs 50%, P = .05), fever (91% vs 96%, P = .03), neck stiffness (58% vs 78%, P meningitis was the commonest cause of BM (29%) and was more frequent in cancer than noncancer (8%, P meningitis was much less frequent (4% vs 36%, P meningitis and cancer are older and have more subtle clinical manifestations than patients without cancer. Listeria monocytogenes is the predominant pathogen and mortality is higher in cancer patients.

  1. Adult prostatic sarcoma: A contemporary multicenter Rare Cancer Network study

    NARCIS (Netherlands)

    Bari, B. De; Stish, B.; Ball, M.W.; Habboush, Y.; Sargos, P.; Krengli, M.; Bossi, A.; Stabile, A.; Pesutic, C. Sole; Lestrade, L.; Smeenk, R.J.; Jereczek-Fossa, B.A.; Zilli, T.; Crehange, G.; Alongi, F.; Zaorsky, N.; Ozsahin, M.

    2017-01-01

    INTRODUCTION: Adult prostatic sarcoma (PS) is a rare disease. While surgery is considered the standard approach, the role of other therapies is not completely established. We report results of the largest multicentric contemporary cohort of PS patients. MATERIALS AND METHODS: This study included 61

  2. Meaning in life of patients with cancer.

    Science.gov (United States)

    Erci, Behice

    2015-02-01

    The aim of this study was to evaluate meaning in life and its predictors in Turkish patients with cancer. A convenience sample of 182 patients with cancer at a Turkish university hospital completed a structured questionnaire including demographic characteristics, disease/treatment characteristics, symptom level, and the meaning in life scale for patients with cancer in 2007. The researcher visited the oncology clinic five work days in every week and conducted interviews with the patients. In analysis of the data, correlation, t-tests, Kruskal-Wallis variance and regression analysis were used. In this study, the mean score of the total meaning in life showed that the patients tended to be undecided concerning meaning in life. Education level, age, and diagnosis duration of the independent variables were effective predictors of meaning in life. Together the independent variables explained 24.3% of the variance of the purpose subscale, 26.2% of the variance of the coherence subscale, 14% of the variance of the choice/responsibleness subscale, and 44.1% of the total variance of the goal seeking subscale. Overall the independent variables explained 19.8% of the total variance of the total meaning in life. The results in this study should increase the awareness of cancer care professionals about a range of the meaning in life and may help them to target particular patient groups for detail support interventions.

  3. [Cancer treatment for patients with dementia].

    Science.gov (United States)

    Ogawa, Asao

    2014-09-01

    Cancer is a disease associated with aging. In Japan, the rate of aging is estimated to be over 25%. Further, the prevalence of dementia also increases with age, and cancer patients with dementia are becoming more common. Dementia is a progressive condition characterized by impairment in memory and at least one other cognitive domain(language, praxis, gnosis, or executive function), as well as a compromised ability to perform daily functions. Impairment of short-term memory and executive function in particular are associated with an increased risk for functional decline and mortality. Assessment of cognitive function is necessary to ensure that cancer patients can provide informed consent and understand the risks, benefits, and alternatives of therapeutic treatment. The health care team needs to ascertain whether patients have the mental capacity for cancer treatment, will comply with the treatment schedule, and will understand when to seek help. Elderly cancer patients undergoing treatment need to be assessed for vulnerability with the comprehensive geriatric assessment (CGA).

  4. Usefulness of mirtazapine in cancer patients

    Directory of Open Access Journals (Sweden)

    Massimo Pasquini

    2010-09-01

    Full Text Available The rate of depression in the general population is estimated as high as 15% and is at least two to three times more common in patients with cancer. Due to the complexity and constraints of cancer care, depression is often under-recognised and under-treated. Antidepressants are the most commonly used medications, however among cancer patients there are few randomised trials comparing antidepressants to placebo. Mirtazapine is an effective antidepressant with unique and special mechanism of action characterised by high response and remission rates, relatively early onset of action and favourable side-effect profile. Several studies reported that mirtazapine has a receptor-binding profile that may be suitable for use in controlling appetite loss and nausea of cancer patients. We conducted a review of the literature on the use of mirtazapine in cancer patients. We evaluated the effectiveness of mirtazapine for the management of depressive and anxiety symptoms and for several distressing symptoms such as pain, nausea, appetite loss, and sleep disturbances.

  5. Platelet transfusion for patients with cancer.

    Science.gov (United States)

    Fletcher, Craig H; DomBourian, Melkon G; Millward, Peter A

    2015-01-01

    Platelet transfusion is a critical and often necessary aspect of managing cancer. Low platelet counts frequently lead to bleeding complications; however, the drugs used to combat malignancy commonly lead to decreased production and destruction of the very cell whose function is essential to stop bleeding. The transfusion of allogeneic platelet products helps to promote hemostasis, but alloimmunization may make it difficult to manage other complications associated with cancer. The literature relating to platelet transfusion in patients with cancer was reviewed. Platelet storage, dosing, transfusion indications, and transfusion response are essential topics for health care professionals to understand because many patients with cancer will require platelet transfusions during the course of treatment. The workup and differentiation of non-immune-mediated compared with immune-mediated platelet refractoriness are vital because platelet management is different between types of refractoriness. A combination of appropriate utilization of platelet inventory and laboratory testing coupled with communication between those caring for patients with cancer and those providing blood products is essential for effective patient care.

  6. Evaluation of the Quality of Life in Adult Cancer Survivors (QLACS scale for long-term cancer survivors in a sample of breast cancer survivors

    Directory of Open Access Journals (Sweden)

    Foley Kristie

    2006-12-01

    Full Text Available Abstract Background This paper evaluates psychometric properties of a recently developed measure focusing on the health-related quality of life (HRQL of long-term cancer survivors, the Quality of Life in Adult Survivors scale (QLACS, in a sample of breast cancer survivors. This represents an important area of study, given the large number of breast cancer patients surviving many years post diagnosis. Methods Analyses are based on an 8-year follow-up of a sample of breast cancer survivors who participated in an earlier study conducted in 1995. Participants were re-contacted in 2003 and those who were reachable and agreed to participate (n = 94 were surveyed using a variety of measures including the QLACS. Additional follow-up surveys were conducted 2 weeks and one year later. Psychometric tests of the QLACS included test-retest reliability, concurrent and retrospective validity, and responsiveness. Results The QLACS domain and summary scores showed good test-retest reliability (all test-retest correlations were above .7 and high internal consistency. The Generic Summary Score showed convergent validity with other measures designed to assess generic HRQL. The Cancer-Specific Summary score exhibited divergent validity with generic HRQL measures, but not a cancer-related specific measure. The QLACS Cancer-Specific Summary Score demonstrated satisfactory predictive validity for factors that were previously shown to be correlated with HRQL. The QLACS generally demonstrated a high level of responsiveness to life changes. Conclusion The QLACS may serve as a useful measure for assessing HRQL among long-term breast cancer survivors that are not otherwise captured by generic measures or those specifically designed for newly diagnosed patients.

  7. Psychosocial issues in the cancer patient.

    Science.gov (United States)

    Csaszar, N; Ganju, Aruna; Mirnics, Z S; Varga, P P

    2009-10-15

    Systematic review of the literature. To identify psychosocial issues affecting patients with a diagnosis of a spinal column or cord tumor. Using the keywords "cancer communication," "psychosocial care," "cancer patient," and "spine cancer patient," a review of the English literature was performed on Medline, EMBASE, and PsycInfo, a database of the psychology and psychiatry literature in the United States. The relevant articles were reviewed; in addition, relevant references from selected articles were searched. The Spine Oncology Study Group, an international panel of spine oncology surgeons, medical and radiation oncologists, identified 2 key questions to be addressed in the course of the systematic review of the literature. Pertinent manuscripts were rated as being of high, moderate, low, or very low quality. Using the Grading of Recommendations, Assessment, Development, and Evaluation evidence-based review system, the 2 key questions were answered using literature review and expert opinion. 1. Who are the allied health care professionals necessary for the comprehensive care of the spine tumor patient? 2. Does compassionate communication (in giving life altering information) affect outcome? What tools can be used in communication with the spine tumor patient? Systematic review of the 3 databases yielded 228 articles pertaining to the psychosocial care of spine tumor patients; systematic review yielded 326 articles addressing communication in cancer patients. Systematic search of the Medline, EMBASE, and PsycInfo databases failed to identify any articles that specifically addressed the 2 questions of interest in the spine tumor patient population. The literature search identified low and very low quality evidence; 2 randomized controlled studies were identified. Although neither specifically pertained to the spine tumor patient population, these articles were reviewed and graded as low-quality evidence. A multidisciplinary group of allied health care professionals

  8. Patients with genetic cancer undergoing surveillance at a specialized clinic rate the quality of their care better than patients at non-specialized clinics

    NARCIS (Netherlands)

    Fritzell, Kaisa; Eriksson, Lars E.; Björk, Jan; Sprangers, Mirjam; Wettergren, Lena

    2012-01-01

    Objectives. To compare ratings of quality of care between patients with genetic cancer who receive specialized care with patients who receive non-specialized care while controlling for socio-demographic and clinical variables; Material and methods. All patients in a national cohort of adult patients

  9. Determinants of patient satisfaction with cancer care delivered by the Danish healthcare system

    DEFF Research Database (Denmark)

    Heerdegen, Anne Christine Stender; Petersen, Gitte Stentebjerg; Jervelund, Signe Smith

    2017-01-01

    BACKGROUND: Patient-reported quality of care, which is often measured by patients' overall rating of care, is gaining more attention within the field of oncology. The aim of this study was to examine factors that determine adult cancer patients' overall rating of prediagnosis care (PDC) and care...... provided during treatment (CDT). METHODS: Data were collected from 2 recurrent nationwide surveys among adult cancer patients in Denmark in 2010 and 2012. Analyses regarding PDC were based on the 2010 study population (n = 3681), and CDT analyses were based on the 2012 follow-up population (n = 2315......). Multivariable logistic regression models were applied. RESULTS: Overall, 55.1% of patients reported excellent PDC and 61.9% reported excellent CDT. The odds of rating PDC and CDT as excellent differed significantly according to sex, age, and cancer diagnosis. Furthermore, the extent of supportive relatives...

  10. COPING STRATEGIES IN PATIENTS WITH PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    J. R. Gardanova

    2015-01-01

    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.

  11. Financial distress in patients with advanced cancer.

    Directory of Open Access Journals (Sweden)

    Cécile Barbaret

    Full Text Available We examined the frequency and severity of financial distress (FD and its association with quality of life (QOL and symptoms among patients with advanced cancer in France.In this cross-sectional study, 143 patients with advanced cancer were enrolled. QOL was assessed using the Functional Assessment of Cancer General (FACT-G and symptoms assessed using Edmonton Assessment System (ESAS and Hospital Anxiety and Depression Scale (HADS. FD was assessed using a self-rated numeric scale from 0 to 10.Seventy-three (51% patients reported having FD. Patients reported having FD were most likely to be younger (53.8 (16,7SD versus 62 (10.5SD, p<0.001, single (33 (62% versus 40(44%, p = 0.03 and had a breast cancer (26 (36%, p = 0.024. Patients with FD had a lower FACT-G score (59 versus 70, p = 0.005. FD decreased physical (14 versus 18, p = 0.008, emotional (14 versus 16, p = 0.008, social wellbeing (17 versus 19, p = 0.04. Patients with FD had higher HADS-D (8 versus 6 p = 0.007 and HADS-A (9 versus 7, p = 0.009 scores. FD was linked to increased ESAS score (59 (18SD versus 67 (18SD, p = 0.005 and spiritual suffering (22(29SD versus 13(23SD, p = 0.045.The high rate of patient-reported FD was unexpected in our studied population, as the French National Health Insurance covers specific cancer treatments. The FD was associated with a poorer quality of life. Having a systematic assessment, with a simple tool, should lead to future research on interventions that will increase patients' QOL.

  12. Cancer family history characterization in an unselected cohort of 121 patients with uveal melanoma.

    Science.gov (United States)

    Abdel-Rahman, M H; Pilarski, R; Ezzat, S; Sexton, J; Davidorf, F H

    2010-09-01

    Uveal melanoma (UM) is the most common primary intraocular malignancy in adults. The extent of the contribution of familial/hereditary predisposition to the development of uveal melanoma is largely unknown. Thus we sought to ascertain the frequency of cancers in patients with UM and their family members to identify the prevalence of hereditary/familial predisposition to cancer in these patients. An unselected series of 121 patients with UM seen in a university-based tertiary referral program were consented to the study. Cancer histories (site and age of diagnosis) were obtained for all first- and second-degree relatives. Patients/families were classified as being potentially at high risk for hereditary predisposition if they met any of the following criteria: (1) Diagnosis of UM at age 30 or under, (2) Two or more cases of UM in the family, (3) UM plus at least one other primary cancer in the same patient (excluding non-melanoma skin and cervix cancers due to their strong environmental etiological link). (4) Family history meeting high risk criteria for a known hereditary cancer predisposition syndrome as defined by Hampel et al. (J Med Genet 41(2): 81-91, 2004). One patient had a family history of UM (0.8%). Ten patients (8.3%) had a personal and/or family history consistent with predisposition to a known hereditary cancer syndrome including six with possible hereditary breast, two with hereditary colon and two with hereditary melanomas. Twenty three patients (19%) had a personal history of a second cancer after exclusion of non-melanoma skin and cervical cancers. The frequency of cutaneous melanomas was significantly higher in UM patients than the general population (RR: 2.97, 95% CI: 1.00-6.94). Patients with a family history suggestive of a high risk predisposition to a known cancer syndrome had a significantly higher risk for having a second cancer than the remaining UM patients (P = 0.02). Our results indicate that the frequency of UM patients with high risk

  13. Enteral feeding in head and neck cancer patients at a UK cancer centre.

    Science.gov (United States)

    Sheth, C H; Sharp, S; Walters, E R

    2013-10-01

    Patients undergoing radiotherapy or chemoradiotherapy treatment for head and neck cancer have an increased risk of malnutrition, and may require enteral feeding via nasogastric or gastrostomy tube. The aim of this audit was to examine current enteral feeding practice, mortality, morbidity and 6-month outcome data of head and neck cancer patients receiving radical (chemo)radiotherapy at a regional cancer centre and to compare the results with a regional head and neck cancer gastrostomy audit. A 2-year audit was conducted (2006-2008). Inclusion criteria were all adult patients diagnosed with squamous cell carcinoma of the head and neck, receiving radical radiotherapy or chemoradiotherapy treatment. The first-year data were collected retrospectively, and the second-year data were collected prospectively. Data were collected on all patients requiring enteral feeding with 6-month outcome data relating to route of nutrition. Approximately 14% (n = 32/223) of patients were admitted for nasogastric feeding as a result of inadequate oral alimentation. On admission, 94% were at risk of refeeding syndrome, taking a mean (SD) of 11 (4.9) days to reach full nutritional requirements. Mean (SD) length of hospital stay was 13 (5.1) days. No major complications from nasogastric tube insertion were found. The mean (SD) length of nasogastric feeding was 72 (20.1) days with 89.6% managing full nutritional requirements orally at 6 months. Patients requiring enteral feeding during treatment were fed via a nasogastric tube, rather than via a prophylactic gastrostomy tube. Compared with the regional gastrostomy audit results, our patients had a lower clinical risk/complication rate, with a greater proportion tolerating full oral intake at 6 months. Therefore, nasogastric feeding, rather than prophylactic gastrostomy tube feeding, could be a more appropriate method of enteral feeding in this patient group. © 2013 University Hospital Southampton Journal of Human Nutrition and Dietetics

  14. Rehabilitation for cancer patients at Black Lion hospital, Addis Ababa, Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Worku, Teshager; Mengistu, Zuriash; Semahegn, Agumasie; Tesfaye, Gezahegn

    2017-11-16

    In Ethiopia, there were greater than 2000 adult and 200 pediatric cancer patients annually in 2010, but the estimated number of cancer patients were increasing. Oncologic rehabilitation treatment may result in improved physical and mental impairment. There is a paucity of information about rehabilitation service utilization among cancer patients in Ethiopia. Hence, the purpose of this study was to assess the rehabilitation service for cancer patient and associated factors at Black Lion hospital, Addis Ababa, Ethiopia. A hospital-based cross-sectional quantitative study was conducted from March to April 2014. Convenient sampling method was employed to recruit the study participants. Interviewer administered questionnaire was used to collect data. Data were entered into EPI data version 3.1 and exported to SPSS (16.0) software for analysis. Descriptive analysis, binary and multiple logistic regression were carried out. Significance association was interpreted using adjusted odds ratio at 95% confidence interval and p-value less than 0.05. A sample of 423 patients aged 18 years and older were involved in the study. Breast cancer (25%), colorectal cancer (20.6%), cervical cancer (14.7%), lymphoma (7.7%), lung (7.2%), leukemia (5.4%), kidney (3.6%) and prostate cancer (2.6%) were the common forms of cancer diagnosed at cancer unit of the Black Lion Hospital. Twenty six percent of cancer patients received rehabilitation service at least once. The main rehabilitation services given were nutritional and psychological support. Unavailability of supplies, lack of professionals and cost of service were among the barriers to receiving rehabilitation services. Only a few cancer patients received cancer rehabilitation services. Increasing the knowledge of the professionals, stocking cancer units with necessary supplies, and other comprehensive programs are needed.

  15. Clinical issues: music therapy in an adult cancer inpatient treatment setting.

    Science.gov (United States)

    O'Callaghan, Clare

    2006-01-01

    The adult oncology inpatient music therapy program at Peter MacCallum Cancer Center, which is Australia's only hospital solely dedicated to cancer treatment, research and care, is described. Patients' treatment requirements and often changing conditions compel music therapist to be flexible in their approach, offering both pre-planned treatment sessions and spontaneous sessions in open ward contexts. Patients and families who wish to engage im music therapy choose from various music therapy methods, including live song choice, music imagery and relaxation, therapeutic music lessons, and improvisation. Complex variables inevitable in such human relationship therapies necessitate that, alongside randomized controlled trials, research methods are grounded in the social sciences to meaningfully substantiate, and further advance, oncologic music therapy.

  16. Evaluation of an online course on the care of teenagers and young adults with cancer.

    Science.gov (United States)

    Cable, Maria; Parr, Margaret

    2009-05-01

    Teenagers and young adults with cancer face significant challenges throughout their cancer journey. Psychosocial issues are considered to be among the most challenging faced by patients, families and healthcare professionals. Staff from Coventry University met with a group of international experts in Bangkok in 2006 to discuss the specific educational needs of various members of the healthcare team who care for this group of patients. Key concepts discussed there became a reality when this online, interprofessional course was accredited and commenced in February 2007. Evaluation from student, educational, technical and organisational perspectives indicates that the course is meeting the needs of students and has established a model for online provision that can be used in other subject domains.

  17. EXPRESSING DISTRESS IN PATIENTS WITH ADVANCED CANCER

    Directory of Open Access Journals (Sweden)

    Maura Gabriela FELEA

    2014-11-01

    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.

  18. Total parenteral nutrition in cancer patients.

    Science.gov (United States)

    Bozzetti, Federico

    2007-12-01

    To report on how the parenteral nutrition of patients with advanced cancer has evolved and on the current status of research and clinical practice in this field. Clinical research has shown that parenteral nutrition may play a role in incurable cancer if patients are expected to die earlier from starvation than from tumour progression. A benefit was recently observed in hypophagic patients requiring supplemental on-demand home parenteral nutrition. There is some doubt that parenteral nutrition plays a palliative role, and data on quality of life are limited. The regimen of parenteral nutrition should be tailored to the needs of the patient, and recent data indicate a reduction in total energy expenditure and water requirements. There is interest in new lipid emulsions enriched with N-3 polyunsaturated fatty acids, which are well utilized by tumour-bearing individuals and may reduce the catabolic drive of cachectic patients. Future research is addressed at identifying parameters to help in the selection of aphagic/obstructed patients who may benefit from home parenteral nutrition, the early use of supplemental parenteral nutrition in hypophagic patients and developing a better nutritional formulation of lipid emulsions more appropriate for use in advanced cancer patients.

  19. Clinical Management of Diabetes Mellitus in the Older Adult Patient.

    Science.gov (United States)

    Adu-Sarkodie, Nana Yaw

    2017-01-01

    In 2009, approximately 40 million people were 65 years or older. The majority of people over the age of 65 have at least one chronic medical condition. In 2002-2003, the following medical conditions were common among older adults: hypertension (51%), arthritis (48%), heart disease (31%), cancer of any type (21%), and diabetes (16%). The cost of diabetes care, both direct and indirect, was $245 billion in 2012. Fifty-nine percent of the direct medical cost was for the population aged 65 and over. A literature review was conducted with a review of mostly peer-reviewed publications from 1987 - 2016 in the preparation of this manuscript. Management goals include control and minimization of hypo- and hyperglycemia and their symptoms, evaluation and treatment of associated risks for atherosclerotic and micro-vascular disease; evaluation and treatment of related complications; support for diabetes self-management and education; maintenance or improvement of the patient's general health status. Providers, patients, caregivers and family members should be vigilant to recognize and manage, micro - and macro-vascular diseases quickly, to prevent increased incidence in morbidity and mortality, as well as medical costs of diabetes care attributed to this age group. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  20. An integrated psychological strategy for advanced colorectal cancer patients

    Directory of Open Access Journals (Sweden)

    Giannarelli Diana

    2006-02-01

    Full Text Available Abstract Background There is evidence regarding the usefulness of psychosocial intervention to improve health related quality of life (HRQOL in adult cancer patients. The aim of this report is to describe an integrated approach and to evaluate its feasibility in routine clinical practice in 98 advanced colorectal cancer (ACC patients during chronomodulated chemotherapy. Methods A prospective non-randomised design was developed and applied in a cancer out-patient setting. The intervention consisted of an integrated approach, whereby the psycho-oncologist had an active role in the health care team with the physician and routinely included psychological understanding in the medical treatment program. The psychological evaluation assessed: a adaptation, awareness, psychopathological disorders through a psychodynamic interview; b anxiety and depression using the HAD scale; c subjective perception of care quality through a structured interview and d HRQOL evaluation assessment with the EORTC QLQ C30. Outcomes data were collected before and after 18 weeks of chemotherapy. Results After 18 weeks of chemotherapy a significant improvement of adaptation and awareness was observed. The HADs results showed a significant decrease in anxiety when compared to pre-treatment. The structured interview showed a significant increase of patients who positively experienced the impact of medical treatment on HRQOL, anxiety, depression, interpersonal relationships, free-time and who positively experienced the care quality. Indeed, a majority of patients positively experienced the team relationship modality during the whole treatment. All scales on the EORTC questionnaire remained unchanged during the entire treatment. Conclusion Our results suggest that it is feasible to carry out an integrated approach during chemotherapy. These results seem to support the integrated approach as a tool in aiding advanced colorectal cancer patients' ability to cope with their diagnosis

  1. History of Comorbidities and Survival of Ovarian Cancer Patients, Results from the Ovarian Cancer Association Consortium

    NARCIS (Netherlands)

    Minlikeeva, A.N.; Freudenheim, J.L.; Eng, K.H.; Cannioto, R.A.; Friel, G.; Szender, J.B.; Segal, B.; Odunsi, K.; Mayor, P.; Diergaarde, B.; Zsiros, E.; Kelemen, L.E.; Kobel, M.; Steed, H.; Defazio, A.; Jordan, S.J.; Fasching, P.A.; Beckmann, M.W.; Risch, H.A.; Rossing, M.A.; Doherty, J.A.; Chang-Claude, J.; Goodman, M.T.; Dork, T.; Edwards, R.; Modugno, F.; Ness, R.B.; Matsuo, K.; Mizuno, M.; Karlan, B.Y.; Goode, E.L.; Kjaer, S.K.; Hogdall, E.; Schildkraut, J.M.; Terry, K.L.; Cramer, D.W; Bandera, E.V.; Paddock, L.E.; Kiemeney, L.A.L.M.; Massuger, L.F.A.G.; Sutphen, R.; Anton-Culver, H.; Ziogas, A.; Menon, U.; Gayther, S.A.; Ramus, S.J.; Gentry-Maharaj, A.; Pearce, C.L.; Wu, A.H.; Kupryjanczyk, J.; Jensen, A.; Webb, P.M.; Moysich, K.B.

    2017-01-01

    Background: Comorbidities can affect survival of ovarian cancer patients by influencing treatment efficacy. However, little evidence exists on the association between individual concurrent comorbidities and prognosis in ovarian cancer patients.Methods: Among patients diagnosed with invasive ovarian

  2. "Making My Own Decisions Sometimes": A Pilot Study of Young Adult Cancer Survivors' Perspectives on Medical Decision-Making.

    Science.gov (United States)

    Shay, L Aubree; Schmidt, Susanne; Cornell, Stephanie D; Parsons, Helen M

    2017-07-27

    This study aimed to provide a better understanding of the medical decision-making preferences and experiences of young adult survivors of pediatric, adolescent, and young adult cancers. We conducted key informant interviews and a cross-sectional mailed survey with young adult survivors (currently aged 18-39 years) of pediatric, adolescent, and young adult cancers in South Texas. Of the responding survivors, almost all wanted to be actively involved in medical decision-making, but preferences regarding family and doctor involvement varied. In open-ended responses, the most commonly reported concerns related to medical decision-making were feelings of uncertainty and fear of receiving bad news. Survivors reported that they desired more information in order to feel better about medical decision-making. Due to the variety of preferences regarding decision-making and who to include in the process, physicians should be prepared to ask and accommodate patients regarding their decision-making preferences.

  3. Kundalini yoga as a support therapy for cancer patients

    OpenAIRE

    Kröneck, Mia

    2016-01-01

    This study was designed to describe cancer patient’s experience of kundalini yoga and its effect on their internal coping resources. The intention of this study is to put forward kundalini yoga as a support therapy for cancer patients for improving their wellbeing during active cancer treatment. This is a descriptive study. An academic literature review was conducted for cancer, cancer treatment, internal coping resources and yoga as therapy topics. Four voluntary female cancer patients (...

  4. The psychological impact of vitiligo in adult Sudanese patients

    African Journals Online (AJOL)

    Results: Psychological disturbances as a consequence of vitiligo were found in 36 (31 %) adult patients. Patients with mild psychological disturbances were found in 20 of these patients and severe disturbances in 16. Conclusion: Psychological consequences are common in patients with vitiligo. Key words: Vitiligo; Stress; ...

  5. What do cancer patients' spouses know about the patients?

    Science.gov (United States)

    Chaitchik, S; Kreitler, S; Rapoport, Y; Algor, R

    1992-10-01

    A large body of research shows that social support in general and of family members in particular plays an important role in determining cancer patients' quality of life. We assumed that the spouse's information about how the patient experiences the situation determines the spouse's ability to help. The present study was designed to examine how much the spouse knows about the attitudes and experiences of their husband or wife who is a cancer patient, and whether this knowledge depends on the questions' structure, disease duration, its severity, or level of patient's information about the disease and prognosis. A questionnaire with multiple-choice and open-ended questions assessing 13 domains (e.g., fears and worries concerning health, functioning in the family, and anxiety) was administered to patients and their partners. Subjects were 55 head-and-neck cancer patients, 40 men and 15 women, with disease stages I to IV, grade of tumors G1 to G3-4, and disease duration of 0.5 to 21 years. The results showed that correspondence between the patients' and their spouses' responses was very low, and was not affected by the structure of the questions or the disease's duration and severity. Correspondence was high only in patients informed about their disease. In the discussion, it was pointed out that when the patient is informed, communication channels in the family are opened and this brings about an increase in the spouses's information about the patient and hence in the spouse's ability to provide the patient the needed social support as a psychotherapeutic agent and a friend. The cancer nurse may play a crucial role in instituting the patient-spouse dialogue.

  6. Racial disparities and colorectal cancer survival in older adults with and without diabetes mellitus.

    Science.gov (United States)

    Waheed, Salman; Azad, Nilofer; Waheed, Sehrish; Yeh, Hsin-Chieh

    2014-12-01

    To investigate whether pre-existing diabetes modifies racial disparities in colorectal cancer (CRC) survival. We analyzed prospective data from 16 977 patients (age ≥ 67 years) with CRC from the Surveillance Epidemiology and End Results (SEER)-Medicare database. SEER registries included data on demographics, tumor characteristics, and treatment. Medicare claims were used to define pre-existing diabetes and comorbid conditions. Mortality was confirmed in both sources. At baseline, 1332 (8%) were African Americans and 26% had diabetes (39% in blacks; 25% in whites). From 2000 to 2005, more than half of the participants died (n = 8782, 52%). This included 820 (62%) deaths (23.8 per 100 person-years) among blacks, and 7962 (51%) deaths (16.6 per 100 person-years) among whites. Among older adults with diabetes, blacks had significantly higher risk of all-cause and CRC mortality after adjustments for demographic characteristics (hazard ratio [HR], 95% confidence interval [CI]: 1.21 [1.08-1.37] and 1.21 [1.03-1.42]), respectively, but these associations attenuated to null after additional adjustments for cancer stage and grade. Among adults without diabetes, the risk of all-cause mortality (HR [95% CI]: 1.14 [1.04-1.25]) and CRC mortality (HR [95% CI]: 1.21 [1.08-1.36]) remained higher in blacks than whites in fully adjusted models that included demographic variables, cancer stage, grade, treatments, and comorbidities. Among older adults with CRC, diabetes is an effect modifier on the relationship between race and mortality. Racial disparities in survival were explained by demographics, cancer stage, and grade in patients with diabetes. © 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  7. Physicians' influence on breast cancer patient compliance.

    Science.gov (United States)

    Kostev, Karel; Waehlert, Lilia; Jockwig, Achim; Jockwig, Barbara; Hadji, Peyman

    2014-01-01

    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.

  8. Physicians’ influence on breast cancer patient compliance

    Science.gov (United States)

    Kostev, Karel; Waehlert, Lilia; Jockwig, Achim; Jockwig, Barbara; Hadji, Peyman

    2014-01-01

    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

  9. Renal cancer in kidney transplanted patients.

    Science.gov (United States)

    Frascà, Giovanni M; Sandrini, Silvio; Cosmai, Laura; Porta, Camillo; Asch, William; Santoni, Matteo; Salviani, Chiara; D'Errico, Antonia; Malvi, Deborah; Balestra, Emilio; Gallieni, Maurizio

    2015-12-01

    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.

  10. Cachexia in patients with oesophageal cancer.

    Science.gov (United States)

    Anandavadivelan, Poorna; Lagergren, Pernilla

    2016-03-01

    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.

  11. Adult patients in the pediatric emergency department: presentation and disposition.

    Science.gov (United States)

    Little, Wendalyn K; Hirsh, Daniel A

    2014-11-01

    Pediatric emergency departments (PEDs) are intended to care for acutely ill and injured children. Adult patients sometimes present to these facilities as well. Some of these are young adults still under the care of pediatric specialists, but older adults and those not under the care of specialists may seek care and may challenge pediatric care providers. Understanding the spectrum of adult illness encountered in the PED may help ensure optimum care for this patient population. This study aimed to describe the presentations of adult patients in 2 high-volume PEDs of a pediatric health care system. This is a retrospective review of electronic medical record to identify all visits for patients 21 years or older between 2008 and 2010. Patient demographics, reason for visit, diagnosis, and treatment details were identified. The combined PEDs recorded 417,799 total visits with 1097 patients 21 years or older; 188 of these were still followed by pediatric specialists. For the 907 remaining, the mean age was 36.5.years (range, 21-88 years); 73% were female. Fifty-one percent of the patients were triaged into the highest acuity levels. Fifty-seven percent of the patients were transferred to adult facilities for definitive care. There were no deaths among these patients at either PED, but 2 patients did require intubation and 1 received a period of chest compressions. Reason for presenting to the PED included on-site visitor (45%), mistakenly presented to children's hospital (34%), and hospital employee (21%). The most common presenting complaints were neurologic conditions, trauma/acute injuries, and chest pain. Adult patients in PEDs are rare but have relatively high acuity and often require transfer. Pediatric emergency department clinicians should have adequate, ongoing training to capably assess and stabilize adult patients across a spectrum of illness presentation.

  12. Lung cancer patients frequently visit the emergency room for cancer-related and -unrelated issues

    OpenAIRE

    KOTAJIMA, FUTOSHI; KOBAYASHI, KUNIHIKO; SAKAGUCHI, HIROZO; NEMOTO, MANABU

    2014-01-01

    Lung cancer patients visit the emergency room (ER) for cancer-related and -unrelated reasons more often compared to patients with other types of cancer. This results in increased admissions and deaths in the ER. In this study, we retrospectively reviewed the characteristics of lung cancer patients visiting the ER in order to optimize the utilization of emergency medical services and improve the patients’ quality of life. Lung cancer patients visiting the ER of a single institution over a 2-ye...

  13. Anxiety in Terminally Ill Cancer Patients

    Science.gov (United States)

    Kolva, Elissa; Rosenfeld, Barry; Pessin, Hayley; Breitbart, William; Brescia, Robert

    2011-01-01

    Context Anxiety in terminal cancer is linked to diminished quality of life, yet overall it is poorly understood with regard to prevalence and relationship to other aspects of psychological distress. Objectives This study examines anxiety in terminally ill cancer patients, including the prevalence of anxiety symptoms, the relationship between anxiety and depression, differences in anxiety between participants receiving inpatient palliative care and those receiving outpatient care, and characteristics that distinguish highly anxious from less anxious patients. Methods Participants were 194 patients with terminal cancer. Approximately half (n = 103) were receiving inpatient care in a palliative care facility and half (n = 91) were receiving outpatient care in a tertiary care cancer center. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression, and was administered along with measures of hopelessness, desire for hastened death, and social support. Results Moderately elevated anxiety symptoms were found in 18.6% of participants (n = 36) and 12.4% (n = 24) had clinically significant anxiety symptoms. Level of anxiety did not differ between the two treatment settings. However, participants receiving palliative care reported significantly higher levels of depression and desire for hastened death. A multivariate prediction model indicated that belief in an afterlife, social support, and anxiolytic and antidepressant use were unique, significant predictors of anxiety. Conclusion Severity of anxiety symptoms did not differ between the study sites, suggesting that anxiety may differ from depression and desire for hastened death in the course that it takes over the duration of terminal cancer. PMID:21565460

  14. Patient Beliefs About Colon Cancer Screening.

    Science.gov (United States)

    Ely, John W; Levy, Barcey T; Daly, Jeanette; Xu, Yinghui

    2016-03-01

    Only about half of eligible individuals undergo colon cancer screening. We have limited knowledge about the patient beliefs that adversely affect screening decisions and about which beliefs might be amenable to change through education. As part of a clinical trial, 641 rural Iowans, aged 52 to 79 years, reported their beliefs about colon cancer screening in response to a mailed questionnaire. Consenting subjects were randomized into four groups, which were distinguished by four levels of increasingly intensive efforts to promote screening. Two of the groups received mailed educational materials and completed a follow-up questionnaire, which allowed us to determine whether their beliefs about screening changed following the education. We also completed a factor analysis to identify underlying (latent) factors that might explain the responses to 33 questions about readiness, attitudes, and perceived barriers related to colon cancer screening. The strongest predictors of a patient's stated readiness to be screened were a physician's recommendation to be screened (1 point difference on 10-point Likert scale, 95 % confidence interval [CI], 0.5 to 1.6 point difference), a family history of colon cancer (0.85-point Likert scale difference, 95 % CI, 0.1 to 1.6), and a belief that health-care decisions should be mostly left to physicians rather than patients (Spearman correlation coefficient 0.21, P colon cancer screening.

  15. Exercise barriers in Korean colorectal cancer patients.

    Science.gov (United States)

    Kang, Dong-Woo; Chung, Jae Youn; Lee, Mi Kyung; Lee, Junga; Park, Ji-Hye; Kim, Dong-Il; Jones, Lee W; Ahn, Joong Bae; Kim, Nam Kyu; Jeon, Justin Y

    2014-01-01

    To identify barriers to exercise in Korean colorectal cancer patients and survivors, and to analyze differences in exercise barriers by age, gender, treatment status, and physical activity level. A total of 427 colorectal cancer patients and survivors from different stages and medical status completed a self-administered questionnaire that surveyed their barriers to exercise and exercise participation. The greatest perceived exercise barriers for the sampled population as a whole were fatigue, low level of physical fitness, and poor health. Those under 60-years old reported lack of time (p=0.008), whereas those over 60 reported low level of physical fitness (p=0.014) as greater exercise barriers than their counterparts. Women reported fatigue as a greater barrier than men (pACSM guidelines, cancer-related exercise barriers were additionally reported (p<0.001), compared to those who were. Our study suggests that fatigue, low level of physical fitness, and poor health are most reported exercise barriers for Korean colorectal cancer survivors and there are differences in exercise barriers by age, sex, treatment status, and physical activity level. Therefore, support for cancer patients should be provided considering these variables to increase exercise participation.

  16. New resilience instrument for patients with cancer.

    Science.gov (United States)

    Ye, Zeng Jie; Liang, Mu Zi; Li, Peng Fei; Sun, Zhe; Chen, Peng; Hu, Guang Yun; Yu, Yuan Liang; Wang, Shu Ni; Qiu, Hong Zhong

    2017-11-08

    Resilience is an important concept in the cancer literature and is a salient indicator of cancer survivorship. The aim of this study is to develop and validate a new resilience instrument that is specific to patients with cancer diagnosis (RS-SC) in Mainland China. First, a resilience framework was constructed for patients with cancer diagnosis. Second, items were formulated based on the framework to reflect different aspects of resilience. Third, two rounds of expert panel discussion were performed to select important and relevant items. Finally, two cross-sectional studies were conducted to evaluate the psychometric properties of this instrument. Fifty-one items were generated based on the resilience framework and the final 25-item RS-SC resulted in a five-factor solution including Generic Elements, Benefit Finding, Support and Coping, Hope for the Future and Meaning for Existence, accounting for 64.72% of the variance. The Cronbach's α of the RS-SC was 0.825 and the test-retest reliability was 0.874. The RS-SC is a brief and specific self-report resilience instrument for Chinese patients with cancer and shows sound psychometric properties in this study. The RS-SC has potential applications in both clinical practice and research with strength-based resiliency interventions.

  17. Patient Delay in Colorectal Cancer Patients

    DEFF Research Database (Denmark)

    Pedersen, Anette Fischer; Hansen, Rikke P; Vedsted, Peter

    2013-01-01

    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,...

  18. Distress and adjustment among adolescents and young adults with cancer: an empirical and conceptual review

    Science.gov (United States)

    Wakefield, Claire E.

    2013-01-01

    Adolescents and young adults (AYAs) with cancer must simultaneously navigate the challenges associated with their cancer experience, whilst striving to achieve a number of important developmental milestones at the cusp of adulthood. The disruption caused by their cancer experience at this critical life-stage is assumed to be responsible for significant distress among AYAs living with cancer. The quality and severity of psychological outcomes among AYAs remain poorly documented, however. This review examined the existing literature on psychological outcomes among AYAs living with cancer. All psychological outcomes (both distress and positive adjustment) were included, and AYAs were included across the cancer trajectory, ranging from newly-diagnosed patients, to long-term cancer survivors. Four key research questions were addressed. Section 1 answered the question, “What is the nature and prevalence of distress (and other psychological outcomes) among AYAs living with cancer?” and documented rates of clinical distress, as well as evidence for the trajectory of this distress over time. Section 2 examined the individual, cancer/treatment-related and socio-demographic factors that have been identified as predictors of these outcomes in this existing literature. Section 3 examined current theoretical models relevant to explaining psychological outcomes among AYAs, including developmental models, socio-cognitive and family-systems models, stress-coping frameworks, and cognitive appraisal models (including trauma and meaning making models). The mechanisms implicated in each model were discussed, as was the existing evidence for each model. Converging evidence implicating the potential role of autobiographical memory and future thinking systems in how AYAs process and integrate their cancer experience into their current sense of self and future goals are highlighted. Finally, Section 4 addressed the future of psycho-oncology in understanding and conceptualizing

  19. Exercise effects on mood in breast cancer patients

    African Journals Online (AJOL)

    Breast cancer is one of the most common cancers worldwide, and statistics reveal that the number of women diagnosed with breast cancer in South Africa is increasing. As such, medical practitioners will treat an increasing number of breast cancer patients. Although increasingly effective treatments improve patient survival ...

  20. Lung cancer in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    R Palacios

    2012-11-01

    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

  1. Exercise rehabilitation in patients with cancer

    Science.gov (United States)

    Lakoski, Susan G.; Eves, Neil D.; Douglas, Pamela S.; Jones, Lee W.

    2013-01-01

    Emerging evidence indicates that patients with cancer have considerable impairments in cardiorespiratory fitness, which is likely to be a result of the direct toxic effects of anticancer therapy as well as the indirect consequences secondary to therapy (for example, deconditioning). This reduced cardiorespiratory fitness is associated with heightened symptoms, functional dependence, and possibly with an increased risk of cardiovascular morbidity and mortality. Current understanding of the complex interaction between the effects of the tumour and cancer-associated therapies on the organ components that govern cardiorespiratory fitness, and the effects of exercise training on these parameters is limited; further research will be critical for further progress of exercise-based rehabilitation in the oncology setting. We assess the current evidence regarding the level, mechanisms, and clinical importance of diminished cardiorespiratory fitness in patients with cancer. The efficacy and adaptations to exercise training to prevent and/or mitigate dysfunction in conjunction with exercise prescription considerations for clinical use are also discussed. PMID:22392097

  2. Thrombosis and bleeding in cancer patients

    Directory of Open Access Journals (Sweden)

    Brian Vicuna

    2011-12-01

    Full Text Available It is well recognized that thrombosis and bleeding are two major complications seen in cancer patients. Recent advances in both basic and clinical observations have enhanced our understanding of the pathogenesis of both phenomena. In this article, the significance of thrombotic complications is reviewed first. This is followed by a detailed discussion of the present day concept of thrombogenesis in cancer based on Virchow’s original triad of aberrant blood flow, loss of vascular integrity and altered blood components. While most cancer patients experience bleeding at some time during the course of their illness, there are special situations that increase bleeding diathesis. These include thrombocytopenia, endothelial injury, acquired hemophilia and adverse effects of drugs. Recognition of these factors will assit in the adoption of appropriate preventive and therapeutic measures.

  3. Engagement and experience with cancer-related follow-up care among young adult survivors of childhood cancer after transfer to adult care.

    Science.gov (United States)

    Szalda, Dava; Pierce, Lisa; Hobbie, Wendy; Ginsberg, Jill P; Brumley, Lauren; Wasik, Monika; Li, Yimei; Schwartz, Lisa A

    2016-04-01

    Young adult survivors (YAS) of childhood cancer require annual adult-focused, cancer-related follow-up given their risk for late effects of treatment. This study describes perception of and engagement with adult-focused, cancer-related follow-up care and general health care among YAS formally transferred to adult care from pediatric survivorship care. YAS transferred from pediatric survivorship care in the prior 1-5 years completed measures indicating engagement with cancer-related follow-up care, other health care utilization, content of communication by providers, quality of cancer-related care, and satisfaction with health care in the prior year. Eighty YAS (M age = 27.7 years, M time since diagnosis = 10.4 years) participated. Just over half of YAS surveyed (n = 44, 55%) endorsed continuing cancer-related follow-up care since transfer. Those with cancer-related follow-up endorsed seeing subspecialty survivorship providers (n = 16, 44%) and primary care providers (n = 22, 50%) or utilizing a shared care model (n = 6, 14%). About a third of YAS endorsed seeing subspecialists (n = 29, 36%) or using other support services (n = 22, 27%). YAS-perceived content of communication varied significantly depending on care model with less cancer-related content being discussed by primary care providers, though perceived quality of cancer-related care and satisfaction with health care was generally favorable. YAS report less than optimal engagement in cancer-related follow-up care and communication in their health care encounters. Young adult survivors should receive anticipatory guidance about expectations for delivery and content of adult-focused cancer-related follow-up care.

  4. Characterization of Cancer Patients in Inpatient Rehabilitation Facilities: A Retrospective Cohort Study.

    Science.gov (United States)

    Mix, Jacqueline M; Granger, Carl V; LaMonte, Michael J; Niewczyk, Paulette; DiVita, Margaret A; Goldstein, Richard; Yates, Jerome W; Freudenheim, Jo L

    2017-05-01

    To identify the types of cancer patients admitted to inpatient medical rehabilitation and to describe their rehabilitation outcomes. Retrospective cohort study. U.S. inpatient rehabilitation facilities (IRFs). Adult patients (N=27,952) with a malignant cancer diagnosis admitted to an IRF with a cancer-related impairment between October 2010 and September 2012 were identified from the Uniform Data System for Medical Rehabilitation database. Not applicable. Demographic, medical, and rehabilitation characteristics for patients with various cancer tumor types were summarized using data collected from the Inpatient Rehabilitation Facility-Patient Assessment Instrument. Rehabilitation outcomes included the percentage of patients discharged to the community and acute care settings, and functional change from admission to discharge. Functional status was measured using the FIM instrument. Cancer patients constituted about 2.4% of the total IRF patient population. Cancer types included brain and nervous system (52.9%), digestive (12.0%), bone and joint (8.7%), blood and lymphatic (7.6%), respiratory (7.1%), and other (11.7%). Overall, 72% were discharged to a community setting, and 16.5% were discharged back to acute care. Patients with blood and lymphatic cancers had the highest frequency of discharge back to acute care (28%). On average, all cancer patient groups made significant functional gains during their IRF stay (mean FIM total change ± SD, 23.5±16.2). In a database representing approximately 70% of all U.S. patients in IRFs, we found that patients with a variety of cancer types are admitted to inpatient rehabilitation. Most cancer patients admitted to IRFs were discharged to a community setting and, on average, improved their function. Future research is warranted to understand the referral patterns of admission to postacute care rehabilitation and to identify factors that are associated with rehabilitation benefit in order to inform the establishment of

  5. Palliative care for the cancer patient.

    Science.gov (United States)

    Reville, Barbara; Axelrod, David; Maury, Rebecca

    2009-12-01

    Palliation of symptoms to optimize QOL is the foundation of cancer care regardless of stage of disease or level of anticancer treatment. Patients commonly experience pain, constipation, nausea, vomiting, dyspnea, fatigue, and delirium. Many valid clinical tools are available to the primary care clinician to screen for symptoms, assess severity, measure treatment response, and elicit the patient's subjective symptom experience. Although there is limited evidence regarding the relative efficacy of symptom interventions from randomized controlled trials, clinical practice guidelines are available.

  6. Parenteral nutrition in the elderly cancer patient.

    Science.gov (United States)

    Orrevall, Ylva

    2015-04-01

    Parenteral nutrition may be considered when oral intake and/or enteral nutrition are not sufficient to maintain nutritional status and the patient is likely to die sooner from starvation than from the cancer. A detailed assessment should be made prior to the decision about whether parenteral nutrition should be started. A follow up plan should be documented with objective and patient centred treatment goals as well as specific time points for evaluation. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Hot flushes in breast cancer patients

    NARCIS (Netherlands)

    Mom, CH; Buijs, C; Willemse, PHB; Mourits, MJE; de Vries, EGE

    Objective : A literature search was conducted to gather information concerning the pathophysiologic mechanisms leading to hot flushes, their prevelence and severity in breast cancer patients, their influence on quality of life, and the best therapeutic option. Methods: Relevant studies in English

  8. [Treatment of elderly patients with breast cancer

    DEFF Research Database (Denmark)

    Paaschburg, B.; Pedersen, A.; Tuxen, M.K.

    2008-01-01

    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...

  9. The behavior of Turkish cancer patients in fasting during the holy month of Ramadan.

    Science.gov (United States)

    Tas, Faruk; Karabulut, Senem; Ciftci, Rumeysa; Yildiz, Ibrahim; Keskin, Serkan; Kilic, Leyla; Disci, Rian

    2014-08-01

    Fasting during the holy month of Ramadan is one of the major obligations for all adult Muslims. We performed a survey of Turkish Muslim cancer patients to examine the extent of their fasting status and to compare various clinical characteristics of fasting and non-fasting cancer patients during the month of Ramadan. This study was conducted on 701 adult cancer patients who attended ambulatory patient care units answered the questionnaires. The population comprised 445 women (63.5%), and the median age was 54 years. Before diagnosis of cancer, 93.1% of the patients used fast consists of completely (78.3%) and partial (14.8%). However, 15% of cases were fasting on the day of interview, either partially (7.4%) or completely (7.6%) with equal distributions. Patients who were females, those with good performance status, those without any comorbid disease, who had non-metastatic disease, those with history of surgery, those treated with radiotherapy and those being treated with oral chemotherapeutic agents were more likely to be fasting than others. The fasting ones had more prevalent among patients with lymphoma, urogenital cancer and breast cancer; conversely, the rate of fasting status among patients with lung and gastrointestinal cancer was quite low. Only 20.8% of all patients asked their physician whether it was alright for them to fast and physicians generally had a negative attitude towards fasting (83.2%). Majority of cancer patients are not fasting during the month of Ramadan, and a small part of patients consult this situation to their physician. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Cancer Patients and Fungal Infections

    Science.gov (United States)

    ... Patients Medications that Weaken Your Immune System Outbreaks Rhizopus Investigation CDC at Work Global Fungal Diseases Cryptococcal ... January 25, 2017 Content source: Centers for Disease Control and Prevention National Center for Emerging and Zoonotic ...

  11. Emotional intelligence and locus of control of adult patients with ...

    African Journals Online (AJOL)

    Conclusion: Having an understanding of the psychosocial variables that impact on individuals diagnosed with a chronic illness, in this case breast cancer, can assist interventionists working in the field of positive psychology. While the stressors and challenges that breast cancer patients face are well documented, this article ...

  12. Patient education interventions for colorectal cancer patients with stoma: A systematic review.

    Science.gov (United States)

    Faury, Stéphane; Koleck, Michèle; Foucaud, Jérôme; M'Bailara, Katia; Quintard, Bruno

    2017-10-01

    To describe the various types of patient education interventions for colorectal cancer patients with stoma and to examine their effects on quality of life, psychosocial skills and self-management skills. A systematic review was performed. Six electronic databases were searched. Inclusion criteria were: studies about patient education applying quantitative methods including digestive stoma adults with colorectal cancer. The primary outcome was quality of life. Secondary outcomes were psychosocial and self-management skills. Thirteen studies were identified and included. Five studies examined quality of life and three reported improvements. Patient education improved some psychosocial and self-management skills. Contrasting findings were reported for specific-disease quality of life, emotional distress, length of hospital stay, stoma complications and readmission rate. Patient education has a positive impact on some psychosocial and self-management skills, indicating that this area should be developed. Contrasting findings were reported for quality of life. Methodologies are heterogeneous making it difficult to produce evidence-based guidelines. This article proposes tools to carry out further studies on this subject and to improve understanding. Further education intervention for stoma patients with colorectal cancer should be standardized in terms of intervention, duration and outcome measures to compare intervention and determine best practice. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Multidimensional fatigue and its correlates in hospitalised advanced cancer patients.

    NARCIS (Netherlands)

    Echteld, M.A.; Passchier, J.; Teunissen, S.; Claessen, S.; Wit, R. de; Rijt, C.C.D. van der

    2007-01-01

    Although fatigue is a multidimensional concept, multidimensional fatigue is rarely investigated in hospitalised cancer patients. We determined the levels and correlates of multidimensional fatigue in 100 advanced cancer patients admitted for symptom control. Fatigue dimensions were general fatigue

  14. Primary Patient-Derived Cancer Cells and Their Potential for Personalized Cancer Patient Care

    Directory of Open Access Journals (Sweden)

    David P. Kodack

    2017-12-01

    Full Text Available Personalized cancer therapy is based on a patient’s tumor lineage, histopathology, expression analyses, and/or tumor DNA or RNA analysis. Here, we aim to develop an in vitro functional assay of a patient’s living cancer cells that could complement these approaches. We present methods for developing cell cultures from tumor biopsies and identify the types of samples and culture conditions associated with higher efficiency of model establishment. Toward the application of patient-derived cell cultures for personalized care, we established an immunofluorescence-based functional assay that quantifies cancer cell responses to targeted therapy in mixed cell cultures. Assaying patient-derived lung cancer cultures with this method showed promise in modeling patient response for diagnostic use. This platform should allow for the development of co-clinical trial studies to prospectively test the value of drug profiling on tumor-biopsy-derived cultures to direct patient care.

  15. Older adults' preferences for colorectal cancer-screening test attributes and test choice.

    Science.gov (United States)

    Kistler, Christine E; Hess, Thomas M; Howard, Kirsten; Pignone, Michael P; Crutchfield, Trisha M; Hawley, Sarah T; Brenner, Alison T; Ward, Kimberly T; Lewis, Carmen L

    2015-01-01

    Understanding which attributes of colorectal cancer (CRC) screening tests drive older adults' test preferences and choices may help improve decision making surrounding CRC screening in older adults. To explore older adults' preferences for CRC-screening test attributes and screening tests, we conducted a survey with a discrete choice experiment (DCE), a directly selected preferred attribute question, and an unlabeled screening test-choice question in 116 cognitively intact adults aged 70-90 years, without a history of CRC or inflammatory bowel disease. Each participant answered ten discrete choice questions presenting two hypothetical tests comprised of four attributes: testing procedure, mortality reduction, test frequency, and complications. DCE responses were used to estimate each participant's most important attribute and to simulate their preferred test among three existing CRC-screening tests. For each individual, we compared the DCE-derived attributes to directly selected attributes, and the DCE-derived preferred