The National Cancer Institute's Physical Sciences - Oncology Network

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Espey, Michael Graham

In 2009, the NCI launched the Physical Sciences - Oncology Centers (PS-OC) initiative with 12 Centers (U54) funded through 2014. The current phase of the Program includes U54 funded Centers with the added feature of soliciting new Physical Science - Oncology Projects (PS-OP) U01 grant applications through 2017; see NCI PAR-15-021. The PS-OPs, individually and along with other PS-OPs and the Physical Sciences-Oncology Centers (PS-OCs), comprise the Physical Sciences-Oncology Network (PS-ON). The foundation of the Physical Sciences-Oncology initiative is a high-risk, high-reward program that promotes a `physical sciences perspective' of cancer and fosters the convergence of physical science and cancer research by forming transdisciplinary teams of physical scientists (e.g., physicists, mathematicians, chemists, engineers, computer scientists) and cancer researchers (e.g., cancer biologists, oncologists, pathologists) who work closely together to advance our understanding of cancer. The collaborative PS-ON structure catalyzes transformative science through increased exchange of people, ideas, and approaches. PS-ON resources are leveraged to fund Trans-Network pilot projects to enable synergy and cross-testing of experimental and/or theoretical concepts. This session will include a brief PS-ON overview followed by a strategic discussion with the APS community to exchange perspectives on the progression of trans-disciplinary physical sciences in cancer research.

Efficacy of bowel cancer appeals for promoting physical activity.

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Jalleh, Geoffrey; Donovan, Robert J; Slevin, Terry; Dixon, Helen

2005-08-01

To investigate the potential efficacy of bowel cancer prevention messages in increasing intentions to be more physically active. A convenience sample of 281 physically inactive persons aged 30-60 years was recruited in the Perth city centre and randomly assigned to a bowel cancer and physical activity message or a heart disease and physical activity message. After reading a booklet containing information about physical activity and its link either to bowel cancer (n = 141) or cardiovascular disease (n = 140), respondents filled in a self-completion questionnaire. The main response measures were impact on intentions to be more physically active, and perceived believability and relevance of the message. Perceived believability of the message was high in both conditions. Perceived personal relevance of the message was substantially lower in the bowel cancer than the cardiovascular disease condition. Overall, the cardiovascular disease condition achieved somewhat higher behavioural intentions than the bowel cancer condition. The finding that two in three respondents in the bowel cancer condition had increased intention to increase their level of physical activity provides support for the potential efficacy of promoting physical activity in reducing the risk of bowel cancer.

Effects of cancer rehabilitation on problem-solving, anxiety and depression : a RCT comparing physical and cognitive-behavioural training versus physical training

NARCIS (Netherlands)

Korstjens, Irene; Mesters, Ilse; May, Anne M; van Weert, Ellen; van den Hout, Johanna H C; Ros, Wynand; Hoekstra-Weebers, Josette E H M; van der Schans, Cees; van den Borne, Bart

2011-01-01

We tested the effects on problem-solving, anxiety and depression of 12-week group-based self-management cancer rehabilitation, combining comprehensive physical training (PT) and cognitive-behavioural problem-solving training (CBT), compared with PT. We expected that PT + CBT would outperform PT in

Effects of cancer rehabilitation on problem-solving, anxiety and depression : A RCT comparing physical and cognitive-behavioural training versus physical training

NARCIS (Netherlands)

Korstjens, Irene; Mesters, Ilse; May, Anne M.; van Weert, Ellen; van den Hout, Johanna H. C.; Ros, Wynand; Hoekstra-Weebers, Josette E. H. M.; van der Schans, Cees P.; van den Borne, Bart

2011-01-01

We tested the effects on problem-solving, anxiety and depression of 12-week group-based self-management cancer rehabilitation, combining comprehensive physical training (PT) and cognitive-behavioural problem-solving training (CBT), compared with PT. We expected that PT + CBT would outperform PT in

Information, Physics, and Cancer

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Adami, Chris

Many researchers have doubts that a ''theory of cancer'' can exist, given the fact that there are so many different cancer phenotypes. However, such a situation-many significantly different manifestations of an underlying law-is not at all uncommon in physics. I argue that a unified cause for all forms of cancer is possible, but that such a theory must be cast in terms of information and communication theory. I briefly revisit key concepts of that theory, then discuss possible applications to communication in game theory that could lead us to view cancer as a disease that, at its root, is a cellular failure to properly communicate.

Cancer pain management-current status

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Deepak Thapa

2011-01-01

Full Text Available Cancer pain is still one of the most feared entities in cancer and about 75% of these patients require treatment with opioids for severe pain. The cancer pain relief is difficult to manage in patients with episodic or incidental pain, neuropathic pain, substance abuse and with impaired cognitive or communication skills. This non-systematic review article aims to discuss reasons for under treatment, tools of pain assessment, cancer pain and anxiety and possibly carve new approaches for cancer pain management in future. The current status of World Health Organization analgesic ladder has also been reviewed. A thorough literature search was carried out from 1998 to 2010 for current status in cancer pain management in MEDLINE, WHO guidelines and published literature and relevant articles have been included.

Management of colorectal cancer and diabetes

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Yao, Caroline; Nash, Guy F; Hickish, Tamas

2014-01-01

Colorectal cancer is associated with diabetes mellitus and both of these common conditions are often managed together by a surgeon. The surgical focus is usually upon cancer treatment rather than diabetes management. The relationship between colorectal cancer and diabetes is a complex one and can raise problems in both diagnosis and the management of patients with both conditions. This literature review explores the relationship between diabetes, diabetic treatment and colorectal cancer and a...

A qualitative exploration of barriers and motivators to physical activity participation in women treated for breast cancer.

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Brunet, Jennifer; Taran, Samantha; Burke, Shaunna; Sabiston, Catherine M

2013-01-01

The adoption and maintenance of a physically active lifestyle among women after breast cancer is an important priority for public health and rehabilitation science. The purpose of this qualitative study was to explore breast cancer survivors' perceptions of the factors influencing their ability to maintain a self-directed physical activity program. Nine women participated in semi-structured, in-depth interviews. Data were coded into perceived barriers and motivators to maintenance of physical activity using thematic analysis. Women identified a range of physical (e.g. cancer-related physical symptoms), environmental/organizational (e.g. bad weather, lack of equipment/facilities, lack of knowledge, time constraints) and psychosocial (e.g. lack of motivation, low social support, low confidence/skill) barriers. They also identified perceived physical (e.g. weight management, health improvement or maintenance, increase energy) and psychosocial (e.g. improve body image, experience enjoyment, social support, positive emotions) motivators. These findings are consistent with research on barriers and motivators to physical activity initiation, and can be used to develop self-directed physical activity programs that target active breast cancer survivors to sustain regular engagement. Furthermore, the barriers and motivators identified represent key variables for further investigation. The present study identifies a number of perceived physical, psychosocial and organizational/environmental barriers to naturally occurring physical activity participation among active breast cancer survivors that should be addressed to ensure they maintain a physically active lifestyle This study also provides evidence that comprehensive approaches that address physical and psychosocial motivators to physical activity should be developed to assist women with a history of breast cancer maintain their physical activity levels.

Controversial Issues in Thyroid Cancer Management.

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Tuttle, R Michael

2018-04-13

The lack of prospective randomized clinical trials for most management topics in differentiated thyroid cancer force us to make management recommendations based on retrospective observational data which is often incomplete, subject to selection bias, and conflicting. Therefore, it is not surprising that many aspects of thyroid cancer management remain controversial and not well defined. This review will examine the controversies surrounding three important topics in thyroid cancer management: (1) the option of thyroid lobectomy as initial therapy for thyroid cancer, (2) the proper use of preoperative neck imaging to optimize the completeness of the initial surgical procedure, and (3) the selective use RAI therapy as remnant ablation, adjuvant treatment or treatment of known persistent/recurrent disease. As thyroid cancer management moves toward a much more risk adapted approach to personalized management recommendations, clinicians and patients must balance the risks and benefits of the potential management options to arrive at a management plan that is optimized based on both patient preferences/values and the philosophy/experience of the local disease management team. Copyright © 2018 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Effect of Breast Cancer on Physical Activity in Women

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Kalinowski Paweł

2017-12-01

Full Text Available Introduction. Breast cancer is the most commonly found type of cancer in women. One cancer risk factor related to lifestyle that seems to be particularly worth examining is physical activity. The aims of the study were to analyse the physical activity of women who had been diagnosed with breast cancer for the first time and had undergone surgical treatment as well as to determine how their physical activity patterns changed with respect to the patterns from before the diagnosis.

Management of colorectal cancer and diabetes.

Science.gov (United States)

Yao, Caroline; Nash, Guy F; Hickish, Tamas

2014-03-01

Colorectal cancer is associated with diabetes mellitus and both of these common conditions are often managed together by a surgeon. The surgical focus is usually upon cancer treatment rather than diabetes management. The relationship between colorectal cancer and diabetes is a complex one and can raise problems in both diagnosis and the management of patients with both conditions. This literature review explores the relationship between diabetes, diabetic treatment and colorectal cancer and addresses the issues that arise in diagnosing and treating this patient group. By highlighting these difficulties, this review aims to improve understanding and to provide clearer insight into both surgical and non-surgical management.

Physical Activity in Puerto Rican Breast Cancer Survivors.

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Tirado-Gómez, Maribel; Hughes, Daniel C; González-Mercado, Velda; Treviño-Whitaker, Rose A; Basen-Engquist, Karen

2016-06-01

Breast cancer survivors do not engage in appropriate levels of physical activity, despite the known benefits of such activity. This study aims to describe physical-activity levels and the barriers to it in a group of Puerto Rican breast cancer survivors, as well as detailing their preferences for an intervention. Participants who finished their chemotherapy and/or radiotherapy for breast cancer at least 4 months prior to the study were included. Demographic, anthropometric, and clinical data were obtained. The Godin Leisure-Time Exercise Questionnaire (GLTEQ) and questionnaires on exercise self-efficacy, barriers to self-efficacy, modeling, and social support were filled out by study participants. Data on access to exercise equipment and preferences regarding a physical-activity intervention were collected. Descriptive statistics and correlation analyses were performed. Fifty breast cancer survivors were recruited. Almost all the participants reported that they did not engage in any kind of strenuous physical activity (94%), with more than three fourths (76%) reporting that they did not even participate in any kind of moderate physical activity. The GLTEQ score was associated with barriers to selfefficacy, while the association with exercise self-efficacy approached significance (p = 0.055). Nearly half of the patients (44%) had access to exercise equipment. Preferred methods for the delivery of physical-activity interventions were participating in group settings (72%) and receiving material in the postal mail (44%). The study described herein reports on the low levels of physical activity being practiced by a group of Puerto Rican breast cancer survivors, despite the fact that many of them had access to exercise equipment and facilities. Further studies aimed at understanding breast cancer survivors' barriers to physical activity and at developing culturally competent interventions to increase the levels of such activity are warranted.

Exercise for the Management of Side Effects and Quality of Life among Cancer Survivors

OpenAIRE

Mustian, Karen M.; Sprod, Lisa K.; Palesh, Oxana G.; Peppone, Luke J.; Janelsins, Michelle C.; Mohile, Supriya G.; Carroll, Jennifer

2009-01-01

Physical activity may play an important role in the rehabilitation of cancer survivors during and following treatment. Current research suggests numerous beneficial outcomes are experienced in cancer survivors undergoing exercise interventions during or following cancer treatment. Exercise not only plays a role in managing side effects but also improves functional capacity and quality of life. The purpose of this article is to provide an overview of the oncology literature supporting the use ...

Physical activity and sedentary behavior of cancer survivors and non-cancer individuals: results from a national survey.

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Kim, Roy B; Phillips, Allison; Herrick, Kirsten; Helou, Marieka; Rafie, Carlin; Anscher, Mitchell S; Mikkelsen, Ross B; Ning, Yi

2013-01-01

Increasing physical activity and decreasing sedentary behavior are associated with a higher quality of life and lower mortality rates for cancer survivors, a growing population group. Studies detailing the behavior of cancer survivors are limited. Therefore, we investigated physical activity and sedentary behavior of cancer survivors using data from the National Health and Nutrition Examination Survey (NHANES) 2007-2010. Participants were those who provided physical activity and sedentary behavior data. Those who were pregnant, physical activity, compared to non-cancer participants. These patterns are similar for breast and prostate cancer survivors, with prostate cancer survivors more likely to engage in physical activity for more than one hour per day (OR = 1.98, 95% CI (1.05, 3.71)). Our findings suggest that cancer survivors tend to have more physical activity, but they are also more likely to engage in sedentary behavior.

Cancer-Related Fatigue in Cancer Survivorship.

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Ebede, Chidinma C; Jang, Yongchang; Escalante, Carmen P

2017-11-01

Cancer-related fatigue (CRF) significantly interferes with usual functioning because of the distressing sense of physical, emotional, and cognitive exhaustion. Assessment of CRF is important and should be performed during the initial cancer diagnosis, throughout cancer treatment, and after treatment using a fatigue scoring scale (mild-severe). The general approach to CRF management applies to cancer survivors at all fatigue levels and includes education, counseling, and other strategies. Nonpharmacologic interventions include psychosocial interventions, exercise, yoga, physically based therapy, dietary management, and sleep therapy. Pharmacologic interventions include psychostimulants. Antidepressants may also benefit when CRF is accompanied by depression. Copyright © 2017 Elsevier Inc. All rights reserved.

Randomized Trial of a Lifestyle Physical Activity Intervention for Breast Cancer Survivors: Effects on Transtheoretical Model Variables.

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Scruggs, Stacie; Mama, Scherezade K; Carmack, Cindy L; Douglas, Tommy; Diamond, Pamela; Basen-Engquist, Karen

2018-01-01

This study examined whether a physical activity intervention affects transtheoretical model (TTM) variables that facilitate exercise adoption in breast cancer survivors. Sixty sedentary breast cancer survivors were randomized to a 6-month lifestyle physical activity intervention or standard care. TTM variables that have been shown to facilitate exercise adoption and progress through the stages of change, including self-efficacy, decisional balance, and processes of change, were measured at baseline, 3 months, and 6 months. Differences in TTM variables between groups were tested using repeated measures analysis of variance. The intervention group had significantly higher self-efficacy ( F = 9.55, p = .003) and perceived significantly fewer cons of exercise ( F = 5.416, p = .025) at 3 and 6 months compared with the standard care group. Self-liberation, counterconditioning, and reinforcement management processes of change increased significantly from baseline to 6 months in the intervention group, and self-efficacy and reinforcement management were significantly associated with improvement in stage of change. The stage-based physical activity intervention increased use of select processes of change, improved self-efficacy, decreased perceptions of the cons of exercise, and helped participants advance in stage of change. These results point to the importance of using a theory-based approach in interventions to increase physical activity in cancer survivors.

Parents' perceptions of skin cancer threat and children's physical activity.

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Tran, Alexander D; Aalborg, Jenny; Asdigian, Nancy L; Morelli, Joseph G; Mokrohisky, Stefan T; Dellavalle, Robert P; Berwick, Marianne; Box, Neil F; Crane, Lori A

2012-01-01

Sun exposure is a major risk factor for skin cancer, but without physical activity, children are at risk of childhood obesity. The objective of this study was to explore relationships between parental perceptions of skin cancer threat, sun protection behaviors, physical activity, and body mass index (BMI) in children. This is a cross-sectional analysis nested within the Colorado Kids Sun Care Program sun safety intervention trial. In summer 2007, parent telephone interviews provided data on demographics, perceptions of skin cancer threat, sun protection behaviors, and physical activity. Physical examinations provided data on phenotype, freckling, and BMI. Data from 999 Colorado children born in 1998 were included in analysis. We used analysis of variance, Spearman's rho (ρ) correlation, and multivariable linear regression analysis to evaluate relationships with total amount of outdoor physical activity. After controlling for sex, race/ethnicity, skin color, and sun protection, regression analysis showed that each unit increase in perceived severity of nonmelanoma skin cancer was associated with a 30% increase in hours of outdoor physical activity (P = .005). Hours of outdoor physical activity were not related to perceived severity of melanoma or perceived susceptibility to skin cancer. BMI-for-age was not significantly correlated with perceptions of skin cancer threat, use of sun protection, or level of physical activity. The promotion of sun safety is not likely to inhibit physical activity. Skin cancer prevention programs should continue to promote midday sun avoidance and sun protection during outdoor activities.

Community-Based Recreational Football: A Novel Approach to Promote Physical Activity and Quality of Life in Prostate Cancer Survivors

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Bruun, Ditte Marie; Bjerre, Eik; Krustrup, Peter; Brasso, Klaus; Johansen, Christoffer; Rørth, Mikael; Midtgaard, Julie

2014-01-01

As the number of cancer survivors continues to increase, there is an increasing focus on management of the long-term consequences of cancer including health promotion and prevention of co-morbidity. Prostate cancer is the most frequent type of cancer type in men and causes increased risk of heart disease, diabetes and osteoporosis. Epidemiological evidence points to a positive effect of regular physical activity on all-cause and prostate cancer mortality and current clinical evidence supports the use of exercise in cancer rehabilitation. However, the external validity of existing exercise studies is limited and the majority of prostate cancer survivors remain sedentary. Hence, novel approaches to evaluate and promote physical activity are warranted. This paper presents the rationale behind the delivery and evaluation of community-based recreational football offered in existing football clubs under the Danish Football Association to promote quality of life and physical activity adherence in prostate cancer survivors. The RE-AIM framework will be applied to evaluate the impact of the intervention including outcomes both at the individual and organizational level. By introducing community-based sport environments, the study offers a novel approach in the strive towards sustained physical activity adherence and accessibility in prostate cancer survivors. PMID:24865394

Community-Based Recreational Football: A Novel Approach to Promote Physical Activity and Quality of Life in Prostate Cancer Survivors

Directory of Open Access Journals (Sweden)

Ditte Marie Bruun

2014-05-01

Full Text Available As the number of cancer survivors continues to increase, there is an increasing focus on management of the long-term consequences of cancer including health promotion and prevention of co-morbidity. Prostate cancer is the most frequent type of cancer type in men and causes increased risk of heart disease, diabetes and osteoporosis. Epidemiological evidence points to a positive effect of regular physical activity on all-cause and prostate cancer mortality and current clinical evidence supports the use of exercise in cancer rehabilitation. However, the external validity of existing exercise studies is limited and the majority of prostate cancer survivors remain sedentary. Hence, novel approaches to evaluate and promote physical activity are warranted. This paper presents the rationale behind the delivery and evaluation of community-based recreational football offered in existing football clubs under the Danish Football Association to promote quality of life and physical activity adherence in prostate cancer survivors. The RE-AIM framework will be applied to evaluate the impact of the intervention including outcomes both at the individual and organizational level. By introducing community-based sport environments, the study offers a novel approach in the strive towards sustained physical activity adherence and accessibility in prostate cancer survivors.

LIFETIME PHYSICAL INACTIVITY IS ASSOCIATED WITH LUNG CANCER RISK AND MORTALITY.

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Cannioto, Rikki; Etter, John Lewis; LaMonte, Michael J; Ray, Andrew D; Joseph, Janine M; Al Qassim, Emad; Eng, Kevin H; Moysich, Kirsten B

2018-01-01

Investigations of the independent associations of physical inactivity with cancer endpoints have been mounting in the epidemiological literature, in part due to the high prevalence of physical inactivity among cancer patients and to evidence that inactivity associates with carcinogenesis via pathways independent of obesity. Yet, physical inactivity is not currently recognized as a well-established risk or prognostic factor for lung cancer. As such, we examined the associations of lifetime physical inactivity with lung cancer risk and mortality in a hospital-based, case-control study. Materials and Methods: The analyses included data from 660 lung cancer patients and 1335 matched cancer-free controls. Multivariable logistic regression analyses were utilized to assess the association between lifetime physical inactivity and lung cancer risk, and Cox proportional hazards models were utilized to estimate the association between lifetime physical inactivity and mortality among lung cancer cases. Results: We observed a significant positive association between lifetime physical inactivity and lung cancer risk: [Odds ratio (OR)=2.23, 95% confidence interval (CI): 1.77-2.81]; the association remained significant among never smokers (OR=3.00, 95% CI:1.33-6.78) and non-smokers (OR=2.33, 95% CI: 1.79-3.02). We also observed a significant positive association between lifetime physical inactivity and lung cancer mortality [Hazard ratio (HR)=1.40, 95% CI: 1.14-1.71]; the association remained significant in non-smokers (HR=1.51, 95% CI: 1.16-1.95). These data add to the body of evidence suggesting that physical inactivity is an independent risk and prognostic factor for cancer. Additional research utilizing prospectively collected data is needed to substantiate the current findings.

Correlates and geographic patterns of knowledge that physical activity decreases cancer risk.

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Ramírez, A Susana; Finney Rutten, Lila J; Vanderpool, Robin C; Moser, Richard P; Hesse, Bradford W

2013-04-01

While many lifestyle-related cancer risk factors including tobacco use, poor diet, and sun exposure are well recognized by the general public, the role of physical activity in decreasing cancer risk is less recognized. Studies have demonstrated gender-, race/ethnicity-, and age-based disparities in cancer risk factor knowledge; however, beliefs and geographic factors that may be related to knowledge are under-examined. In this study, we analyzed data from the 2008 Health Information National Trends Survey to determine correlates of knowledge of the relationship between physical activity and reduced cancer risk in the adult US population. We generated geographic information system maps to examine the geographic distribution of this knowledge. Results revealed that there is confusion among US adults about the relationship between physical activity and cancer risk: Respondents who believed that cancer is not preventable had significantly lower odds of knowing that physical activity reduces cancer risk (p physical activity reduces cancer risk (p physical activity guidelines were also significantly more likely to know that physical activity reduces cancer risk (p physical inactivity. Correlates of cancer risk factor knowledge point to opportunities for targeted interventions.

Management of male breast cancer

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Nikolay V. Dimitro v

2011-12-01

Full Text Available The management of male breast cancer is still under discussion due to lack of information from prospective, randomized clinical trials and low incidence of this disease. Current management is based largely on extrapolation from data related to treatment of female breast cancer. Over the last two decades, several review articles have discussed mainly retrospective and anecdotal data related to hormonal and chemotherapy treatment modalities. In this review, we present the most recent information and future considerations related to the management of male breast cancer. In addition to the conventional treatment options we will discuss the possible role of targeted therapy. Establishing a national or global registry for male breast cancer will provide more precise information about the natural history of the disease and will facilitate the design and execution of prospective, randomized multicenter clinical trials.

Motivations associated with physical activity in young breast cancer survivors.

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Voege, Patricia; Bower, Julienne E; Stanton, Annette L; Ganz, Patricia A

2015-01-01

Physical activity is associated with positive health outcomes in breast cancer survivors. However, factors that promote or discourage physical activity in this population are not fully understood. This cross-sectional study was designed to examine approach and avoidance motivations, barriers for exercise, and their association with physical activity in breast cancer survivors younger than 50 years old at time of diagnosis. Current physical activity levels, approach and avoidance motivations, and barriers to exercise were assessed through self-report questionnaires in young breast cancer survivors (N = 156). Results indicated that barriers to exercise were negatively associated with physical activity (p physical activity (p barriers (p physical activity (p = .91).

Usefulness of 18FDG PET in the management of cervical cancer

International Nuclear Information System (INIS)

Belhocine, T.; Rigo, P.

2002-01-01

Cervical carcinoma is the second most common gynaecological cancer worldwide. Despite substantial advances in screening the pre-invasive forms, the management of women suffering from invasive cervical carcinomas remains problematic. In pre-treatment staging, the evaluation of the loco-regional and distant extent of the disease, according to the international federation of gynecology and obstetrics, has shown to be sub-optimal. After treatment, the routine surveillance protocol, based on a physical examination at the control visits and clinically oriented conventional imaging procedures, most often fails to accurately detect a recurrent disease. Its sensitivity is particularly low for asymptomatic women. On the other hand, the clinical value of positron emission tomography using 18 F-fluorodeoxyglucose in the field of oncology is nowadays firmly established. In many tumour types, including the gynaecological cancers such as breast cancer and ovarian cancer, the metabolic imaging has proved to play a determinant role in both the pre-treatment and post-treatment evaluation. In the present review-article, we analyse in the light of the literature data and our experience, the potential contribution of positron emission tomography using 18 F-fluorodeoxyglucose in the management of cervical cancer. (authors)

POSITIVE study: physical exercise program in non-operable lung cancer patients undergoing palliative treatment.

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Wiskemann, Joachim; Hummler, Simone; Diepold, Christina; Keil, Melanie; Abel, Ulrich; Steindorf, Karen; Beckhove, Philipp; Ulrich, Cornelia M; Steins, Martin; Thomas, Michael

2016-07-19

Patients with advanced stage non-small cell lung cancer (NSCLC) or small cell lung cancer (SCLC) often experience multidimensional impairments, affecting quality of life during their course of disease. In lung cancer patients with operable disease, several studies have shown that exercise has a positive impact on quality of life and physical functioning. There is limited evidence regarding efficacy for advanced lung cancer patients undergoing palliative treatment. Therefore, the POSITIVE study aims to evaluate the benefit of a 24-week exercise intervention during palliative treatment in a randomized controlled setting. The POSITIVE study is a randomized, controlled trial investigating the effects of a 24-week exercise intervention during palliative treatment on quality of life, physical performance and immune function in advanced, non-operable lung cancer patients. 250 patients will be recruited in the Clinic for Thoracic Diseases in Heidelberg, enrolment begun in November 2013. Main inclusion criterion is histologically confirmed NSCLC (stage IIIa, IIIb, IV) or SCLC (Limited Disease-SCLC, Extensive Disease-SCLC) not amenable to surgery. Patients are randomized into two groups. Both groups receive weekly care management phone calls (CMPCs) with the goal to assess symptoms and side effects. Additionally, one group receives a combined resistance and endurance training (3x/week). Primary endpoints are quality of life assessed by the Functional Assessment of Cancer Therapy for patients with lung cancer (FACT-L, subcategory Physical Well-Being) and General Fatigue measured by the Multidimensional Fatigue Inventory (MFI-20). Secondary endpoints are physical performance (maximal voluntary isometric contraction, 6-min walk distance), psychosocial (depression and anxiety) and immunological parameters and overall survival. The aim of the POSITIVE trial is the evaluation of effects of a 24-week structured and guided exercise intervention during palliative treatment stages

Management of side effects during and post-treatment in breast cancer survivors.

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Palesh, Oxana; Scheiber, Caroline; Kesler, Shelli; Mustian, Karen; Koopman, Cheryl; Schapira, Lidia

2018-03-01

Cancer-related fatigue, insomnia, and cancer-related cognitive impairment are commonly experienced symptoms that share psychological and physical manifestations. One or more of these symptoms will affect nearly all patients at some point during their course of treatment or survivorship. These side effects are burdensome and reduce patients' quality of life well beyond their cancer diagnosis and associated care treatments. Cancer-related fatigue, insomnia, and cancer-related cognitive impairment are likely to have multiple etiologies that make it difficult to identify the most effective method to manage them. In this review, we summarized the information on cancer-related fatigue, insomnia, and cancer-related cognitive impairment incidence and prevalence among breast cancer patients and survivors as well as recent research findings on pharmaceutical, psychological, and exercise interventions that have shown effectiveness in the treatment of these side effects. Our review revealed that most current pharmaceutical interventions tend to ameliorate symptoms only temporarily without addressing the underlying causes. Exercise and behavioral interventions are consistently more effective at managing chronic symptoms and possibly address an underlying etiology. Future research is needed to investigate effective interventions that can be delivered directly in clinic to a large portion of patients and survivors. © 2017 Wiley Periodicals, Inc.

Role of physical activity and diet after colorectal cancer diagnosis.

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Van Blarigan, Erin L; Meyerhardt, Jeffrey A

2015-06-01

This review summarizes the evidence regarding physical activity and diet after colorectal cancer diagnosis in relation to quality of life, disease recurrence, and survival. There have been extensive reports on adiposity, inactivity, and certain diets, particularly those high in red and processed meats, and increased risk of colorectal cancer. Only in the past decade have data emerged on how such lifestyle factors are associated with outcomes in colorectal cancer survivors. Prospective observational studies have consistently reported that physical activity after colorectal cancer diagnosis reduces mortality. A meta-analysis estimated that each 15 metabolic equivalent task-hour per week increase in physical activity after colorectal cancer diagnosis was associated with a 38% lower risk of mortality. No randomized controlled trials have been completed to confirm that physical activity lowers risk of mortality among colorectal cancer survivors; however, trials have shown that physical activity, including structured exercise, is safe for colorectal cancer survivors (localized to metastatic stage, during and after treatment) and improves cardiorespiratory fitness and physical function. In addition, prospective observational studies have suggested that a Western dietary pattern, high carbohydrate intake, and consuming sugar-sweetened beverages after diagnosis may increase risk of colorectal cancer recurrence and mortality, but these data are limited to single analyses from one of two US cohorts. Additional data from prospective studies and randomized controlled trials are needed. Nonetheless, on the basis of the available evidence, it is reasonable to counsel colorectal cancer survivors to engage in regular physical activity and limit consumption of refined carbohydrates, red and processed meats, and sugar-sweetened beverages. © 2015 by American Society of Clinical Oncology.

Nanoscale theranostics for physical stimulus-responsive cancer therapies.

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Chen, Qian; Ke, Hengte; Dai, Zhifei; Liu, Zhuang

2015-12-01

Physical stimulus-responsive therapies often employing multifunctional theranostic agents responsive to external physical stimuli such as light, magnetic field, ultra-sound, radiofrequency, X-ray, etc., have been widely explored as novel cancer therapy strategies, showing encouraging results in many pre-clinical animal experiments. Unlike conventional cancer chemotherapy which often accompanies with severe toxic side effects, physical stimulus-responsive agents usually are non-toxic by themselves and would destruct cancer cells only under specific external stimuli, and thus could offer greatly reduced toxicity and enhanced treatment specificity. In addition, physical stimulus-responsive therapies can also be combined with other traditional therapeutics to achieve synergistic anti-tumor effects via a variety of mechanisms. In this review, we will summarize the latest progress in the development of physical stimulus-responsive therapies, and discuss the important roles of nanoscale theranostic agents involved in those non-conventional therapeutic strategies. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pain management in cancer cervix

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Palat Gayatri

2005-01-01

Full Text Available Cancer of the cervix uteri is a common cause of pain among women. On the physical realm, the cancer may cause somatic [soft tissue and bone], visceral and neuropathic pain [lumbosacral plexopathy]. Radiotherapy and chemotherapy may cause neuropathy too. Psychological, social and cultural factors modify the pain. Evaluation of the individual type of pain and a patient-centred approach are fundamental requirements for rational management. Disease modifying treatment like radiotherapy and chemotherapy must be considered when applicable. Pain control is usually achieved by the use of WHO three-step ladder, remembering that possible association of renal dysfunction would necessitate caution in the use of NSAIDs and opioids. Side effects must be anticipated, prevented when possible, and aggressively treated; nausea and vomiting may already be present, and constipation can worsen pain when there is a pelvic mass. Pain emergencies can be treated by quick titration with intravenous morphine bolus doses. Neuropathic pain may warrant the use of usual adjuvants, with particular reference to cortico-steroids and the NMDA antagonist, ketamine. In intractable pain, many neurolytic procedures are tried, but a solid evidence base to justify their use is lacking. Continuous epidural analgesia with local anaesthetic and opioid may be needed when drug therapy fails, and desperate situations may warrant interventions such as neurolysis. Such physical measures for pain relief must be combined with psychosocial support and adequate explanations to the patient and the family.

Health-related quality of life and satisfaction with case management in cancer survivors.

Science.gov (United States)

Hsu, Ya-Hui; Chai, Hsiu-Ying; Lin, Yu-Fen; Wang, Chao-Hui; Chen, Shu-Ching

2017-12-01

To (i) investigate the characteristics of health-related quality of life and satisfaction with case management and (ii) to identify factors associated with health-related quality of life in cancer survivors. The level of health-related quality of life can reflect treatment efficacy and satisfaction with cancer care. A cross-sectional study design was adopted. Subjects from the outpatient setting of a cancer centre in northern Taiwan were recruited by consecutive sampling. A set of questionnaires were employed, including a background information form, case management service satisfaction survey (CMSS) and The European Quality of Life Scale (EQ-5D). Descriptive statistics were used to examine levels of health-related quality of life and satisfaction with case management. Pearson's correlation was used to identify relationships between treatment characteristics, satisfaction with case management and health-related quality of life. Multiple stepwise regression was used to identify factors associated with health-related quality of life. A total of 252 cancer patients were recruited. The three lowest scores for items of health-related quality of life were mobility, self-care and usual activities. Cancer survivors with higher mobility, less pain and discomfort, and lower anxiety and depression were more likely to have better health-related quality of life. Mobility, pain and discomfort, and anxiety and depression are important predictive factors of high health-related quality of life in cancer survivors. In clinical care, patients' physical mobility, pain and discomfort, and anxiety and depression are important indicators of health-related quality of life. Case managers should include self-care and symptom management into survivorship care plans to improve health-related quality of life during survival after treatment concludes. © 2017 John Wiley & Sons Ltd.

Physical activity influences the immune system of breast cancer patients

Directory of Open Access Journals (Sweden)

Thorsten Schmidt

2017-01-01

Full Text Available It has been suggested that physical activity in breast cancer patients can not only improve quality of life. Influences on physical and psychological levels have been evaluated, but effects on the immune system of breast cancer patients are hardly known. A PubMed search identified relevant trials and meta-analyses from 1970 to 2013. This review summarizes the results of international studies and the current discussion of effects of physical activity on the immune system of breast cancer patients. Highlighted are effects of physical activity on the immune system. Seven original articles and 14 reviews included in this review. Two original and the review articles includes other tumor entities besides breast cancer.Evaluated methods such as dose-response relationships for exercise in oncology, hardly exist. Increased immunological anti-cancer activity due to physical activity is probably mediated via an increase in number and cytotoxicity of monocytes and natural killer cells and cytokines.

Women with family cancer history are at risk for poorer physical quality of life and lower self-efficacy: a longitudinal study among men and women with non-small cell lung cancer.

Science.gov (United States)

Banik, Anna; Schwarzer, Ralf; Pawlowska, Izabela; Boberska, Monika; Cieslak, Roman; Luszczynska, Aleksandra

2017-04-04

We investigated the determinants of trajectories of physical symptoms related to lung cancer (a quality of life [QOL] aspect) and self-efficacy among patients with non-small cell lung cancer (NSCLC). It was hypothesized that gender and family cancer history in first-degree relatives would have synergistic effects on QOL-lung cancer specific symptoms and self-efficacy. Women with family cancer history were expected to be at risk of poorer adjustment. Quantitative, longitudinal design was applied. Participants provided their responses at 3-4 days after surgery, 1-month follow-up, and 4-month follow-up. We recruited 102 in-patients (men: 51%) with NSCLC who underwent surgery aimed at removing a lung tumor. Self-report data were collected with QLQ-LC13 and a scale for self-efficacy for managing illness. Mixed-models analysis indicated that trajectories of physical quality of life (symptoms of lung cancer) as well as self-efficacy were unfavorable among women with family cancer history. Among NSCLC patients, gender and family cancer history may be considered basic screening criteria for identifying groups of patients at risk for poorer physical QOL (higher level of physical symptoms related to lung cancer) and lower incline of self-efficacy after cancer surgery.

Cancer molecular markers: A guide to cancer detection and management.

Science.gov (United States)

Nair, Meera; Sandhu, Sardul Singh; Sharma, Anil Kumar

2018-02-08

Cancer is generally caused by the molecular alterations which lead to specific mutations. Advances in molecular biology have provided an impetus to the study of cancers with valuable prognostic and predictive significance. Over the hindsight various attempts have been undertaken by scientists worldwide, in the management of cancer; where, we have witnessed a number of molecular markers which allow the early detection of cancers and lead to a decrease in its mortality rate. Recent advances in oncology have led to the discovery of cancer markers that has allowed early detection and targeted therapy of tumors. In this context, current review provides a detail outlook on various molecular markers for diagnosis, prognosis and management of therapeutic response in cancer patients. Copyright © 2018 Elsevier Ltd. All rights reserved.

Do patients with lung cancer benefit from physical exercise?

DEFF Research Database (Denmark)

Andersen, Andreas Holst; Vinther, Anders; Poulsen, Lise-Lotte

2011-01-01

Patients with lung cancer are often burdened by dyspnoea, fatigue, decreased physical ability and loss of weight. Earlier studies of physical exercise of patients with COPD have shown promising results. The aim of this study was to investigate, if a well-documented COPD rehabilitation protocol can...... improve physical fitness and quality of life (QoL) in patients with lung cancer....

Population-attributable causes of cancer in Korea: obesity and physical inactivity.

Science.gov (United States)

Park, Sohee; Kim, Yeonju; Shin, Hai-Rim; Lee, Boram; Shin, Aesun; Jung, Kyu-Won; Jee, Sun Ha; Kim, Dong Hyun; Yun, Young Ho; Park, Sue Kyung; Boniol, Mathieu; Boffetta, Paolo

2014-01-01

Changes in lifestyle including obesity epidemic and reduced physical activity influenced greatly to increase the cancer burden in Korea. The purpose of the current study was to perform a systematic assessment of cancers attributable to obesity and physical inactivity in Korea. Gender- and cancer site-specific population-attributable fractions (PAF) were estimated using the prevalence of overweight and obesity in 1992-1995 from a large-scale prospective cohort study, the prevalence of low physical activity in 1989 from a Korean National Health Examination Survey, and pooled relative risk estimates from Korean epidemiological studies. The overall PAF was then estimated using 2009 national cancer incidence data from the Korea Central Cancer Registry. Excess body weight was responsible for 1,444 (1.5%) and 2,004 (2.2%) cancer cases among men and women, respectively, in 2009 in Korea. Among men, 6.8% of colorectal, 2.9% of pancreatic, and 16.0% of kidney cancer was attributable to excess body weight. In women, 6.6% of colorectal, 3.9% of pancreatic, 18.7% of kidney, 8.2% of postmenopausal breast, and 32.7% of endometrial cancer was attributable to excess body weight. Low leisure-time physical activity accounted for 8.8% of breast cancer, whereas the PAF for overall cancer was low (0.1% in men, 1.4% in women). Projections suggest that cancers attributable to obesity will increase by 40% in men and 16% in women by 2020. With a significantly increasing overweight and physically inactive population, and increasing incidence of breast and colorectal cancers, Korea faces a large cancer burden attributable to these risk factors. Had the obese population of Korea remained stable, a large portion of obesity-related cancers could have been avoided. Efficient cancer prevention programs that aim to reduce obesity- and physical inactivity-related health problems are essential in Korea.

Local search in physical distribution management

NARCIS (Netherlands)

G.A.P. Kindervater (Gerard); M.W.P. Savelsbergh (Martin)

1992-01-01

textabstractPhysical distribution management presents a variety of decision making problems at three levels of strategic, tactical and operational planning. The importance of effective and efficient distribution management is evident from its associated costs. Physical distribution management at the

Physical activity in advanced cancer patients: a systematic review protocol.

Science.gov (United States)

Lowe, Sonya S; Tan, Maria; Faily, Joan; Watanabe, Sharon M; Courneya, Kerry S

2016-03-11

Progressive, incurable cancer is associated with increased fatigue, increased muscle weakness, and reduced physical functioning, all of which negatively impact quality of life. Physical activity has demonstrated benefits on cancer-related fatigue and physical functioning in early-stage cancer patients; however, its impact on these outcomes in end-stage cancer has not been established. The aim of this systematic review is to determine the potential benefits, harms, and effects of physical activity interventions on quality of life outcomes in advanced cancer patients. A systematic review of peer-reviewed literature on physical activity in advanced cancer patients will be undertaken. Empirical quantitative studies will be considered for inclusion if they present interventional or observational data on physical activity in advanced cancer patients. Searches will be conducted in the following electronic databases: CINAHL; CIRRIE Database of International Rehabilitation Research; Cochrane Database of Systematic Reviews (CDSR); Database of Abstracts of Reviews of Effects (DARE); Cochrane Central Register of Controlled Trials (CENTRAL); EMBASE; MEDLINE; PEDro: the Physiotherapy Evidence Database; PQDT; PsycInfo; PubMed; REHABDATA; Scopus; SPORTDiscus; and Web of Science, to identify relevant studies of interest. Additional strategies to identify relevant studies will include citation searches and evaluation of reference lists of included articles. Titles, abstracts, and keywords of identified studies from the search strategies will be screened for inclusion criteria. Two independent reviewers will conduct quality appraisal using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies (EPHPP) and the Cochrane risk of bias tool. A descriptive summary of included studies will describe the study designs, participant and activity characteristics, and objective and patient-reported outcomes. This systematic review will summarize the current

Bladder cancer: overview and disease management. Part 1: non-muscle-invasive bladder cancer.

Science.gov (United States)

Anderson, Beverley

2018-05-10

Part 1 of this two-part article provides an overview of bladder cancer and discusses its management. Since publication of a previous article entitled 'Understanding the role of smoking in the aetiology of bladder cancer' ( Anderson, 2009 ), the author has received many requests for an update. This article provides an overview of bladder cancer and its current management practices, underlining the continued role of smoking as the predominant risk factor in the disease's development. The management of bladder cancer is governed by specific guidelines. Management of non-muscle-invasive cancers, including surgical intervention with transurethral resection, and intravesical therapy using chemotherapy and immunotherapy agents, is discussed. Cystectomy (removal of the bladder), is sometimes necessary. Treatments are effective in reducing tumour recurrence, but the effects of the risks and side-effects on the individual's quality of life can be significant. The prevalence of bladder cancer, and the nature of its management make this cancer one of the most expensive for the NHS to treat. The effectiveness of health promotional strategies in increasing peoples' awareness of their risk of developing the disease, and in enabling them to change long-term health behaviours is discussed. The role of the multidisciplinary team is explored, along with that of the uro-oncology cancer nurse specialist. Part 2 will consider the management of muscle-invasive and metastatic bladder cancer.

Recommendations for physical and occupational therapy practice from the perspective of clients undergoing therapy for breast cancer-related impairments.

Science.gov (United States)

Lattanzi, Jill B; Giuliano, Susan; Meehan, Caitlin; Sander, Beth; Wootten, Rachel; Zimmerman, Amanda

2010-01-01

Evidence points to the efficacy of physical and occupational therapy intervention for the management of impairments and functional limitations related to the treatment of breast cancer. However, few studies give voice to the women participating in the physical rehabilitation programs intended to ameliorate their deficits. The purpose of this qualitative investigation was to explore the experience of physical rehabilitation as well as to identify recommendations for physical and occupational therapy practice from the perspective of the client undergoing therapy for breast cancer-related impairments. A phenomenological design was chosen and included a purposive sample of women (n = 10) undergoing physical rehabilitation for impairments related to breast cancer treatment. Data included semistructured interviews and artifact examination. Ten semistructured interviews were conducted at a setting of the participants' choice. Data collection continued until saturation was reached. Data analysis was cyclical and ongoing and involved all six researchers in analyzing and triangulating all pieces of data. Member checks and a peer review were conducted to confirm relevance and validity. Five themes emerged: 1) challenges with obtaining referrals, 2) challenges with patient education, 3) improvements in functional impairments, 4) emotional support, and 5) benefits of a specialized clinic environment. Consideration of the five themes led to four recommendations for physical and occupational therapist practice from the perspective of the client: 1) advocate for presurgical therapy consultations, 2) be competent in the management of all impairments and functional limitations associated with breast cancer treatment, 3) be aware of the emotional support the therapist has the capacity to provide or not provide, and 4) as much as possible, create an inviting, nonclinical environment.

Pain, movement, and mind: does physical activity mediate the relationship between pain and mental health among survivors of breast cancer?

Science.gov (United States)

Sabiston, Catherine M; Brunet, Jennifer; Burke, Shaunna

2012-07-01

This study examined the relationship between pain and mental health outcomes of depression and affect among survivors of breast cancer. The mediating role of physical activity was also tested. Survivors of breast cancer (N=145) completed self-report measures of pain symptoms at baseline, wore an accelerometer for 7 days, and reported levels of depression symptoms and negative and positive affect 3 months later. Hierarchical linear regression analyses, controlling for personal and cancer-related demographics, were used to test the association between pain symptoms and each mental health outcome, as well as the mediation effect of physical activity. Pain positively predicted depression symptoms [F(6,139)=4.31, Paffect [F(5,140)=4.17, Ppositive affect [F(6,139)=2.12, P=0.03, R=0.08]. Physical activity was a significant (Ppositive affect. Participation in physical activity is one pathway through which pain influences mental health. Efforts are needed to help survivors of breast cancer manage pain symptoms and increase their level of physical activity to help improve mental health.

Physical Activity, Biomarkers, and Disease Outcomes in Cancer Survivors: A Systematic Review

Science.gov (United States)

Friedenreich, Christine M.; Courneya, Kerry S.; Siddiqi, Sameer M.; McTiernan, Anne; Alfano, Catherine M.

2012-01-01

Background Cancer survivors often seek information about how lifestyle factors, such as physical activity, may influence their prognosis. We systematically reviewed studies that examined relationships between physical activity and mortality (cancer-specific and all-cause) and/or cancer biomarkers. Methods We identified 45 articles published from January 1950 to August 2011 through MEDLINE database searches that were related to physical activity, cancer survival, and biomarkers potentially relevant to cancer survival. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement to guide this review. Study characteristics, mortality outcomes, and biomarker-relevant and subgroup results were abstracted for each article that met the inclusion criteria (ie, research articles that included participants with a cancer diagnosis, mortality outcomes, and an assessment of physical activity). Results There was consistent evidence from 27 observational studies that physical activity is associated with reduced all-cause, breast cancer–specific, and colon cancer–specific mortality. There is currently insufficient evidence regarding the association between physical activity and mortality for survivors of other cancers. Randomized controlled trials of exercise that included biomarker endpoints suggest that exercise may result in beneficial changes in the circulating level of insulin, insulin-related pathways, inflammation, and, possibly, immunity; however, the evidence is still preliminary. Conclusions Future research directions identified include the need for more observational studies on additional types of cancer with larger sample sizes; the need to examine whether the association between physical activity and mortality varies by tumor, clinical, or risk factor characteristics; and the need for research on the biological mechanisms involved in the association between physical activity and survival after a cancer diagnosis. Future randomized

Physical activity and cancer prevention: awareness and meeting the recommendations among adult Saudis.

Science.gov (United States)

Amin, Tarek Tawfik; Al-Hammam, Abudllah Mohammed; AlMulhim, Nasser Abdullah; Al-Hayan, Mohammed Ibrahim; Al-Mulhim, Mona Mohammed; Al-Mosabeh, Modhahir Jawad; Al-Subaie, Mohammed Ali; Al-Hmmad, Qassem Ahmed; Al-Omran, Ahmed Adi

2014-01-01

There is a scarcity of information about the proportion of the adult Saudi population that meet the recommended guidelines of physical activity (PA) to reduce cancer risk. Moreover, their awareness about the role of PA in cancer prevention is unclear. This cross-sectional study aimed at estimating the proportion of adult Saudis meeting the PA guidelines, specifically those recommended by American Cancer Society (ACS) for cancer prevention, and to assess the public awareness about the role of PA in cancer prevention. Using a multistage sampling method, 2,127 adult Saudis of both genders were recruited from 6 urban and 4 rural primary health care centers in Al Hassa, Saudi Arabia. Participants were personally interviewed to gather information about their sociodemographic characteristics, searching activity about PA and cancer, and the time spent in leisure time PA (moderate and vigorous)/week using the Global Physical Activity Questionnaire with show cards. Finally, items about the role of PA in cancer risk reduction were inquired. Of the included participants, 11.6% met the recommendations for cancer prevention (≥ 45 minutes of moderate-vigorous PA activity/≥ 5 days/week or 225 minutes/week). Multivariate regression showed that being male (AOR=1.49, CI=1.09-2.06), cancer prevention. Only 11.4% of the sample indicated correctly the frequency and duration of PA required for an average adult to be physically active and while >70% of them indicated the role of PA in prevention of hypertension, coronary heart disease and lowering elevated blood cholesterol, only 18.6% and 21.7% correctly mentioned the role of PA in reducing colon and breast cancer risk, respectively. Poor knowledge was found among those with less than college education and aged ≥ 50 years. The level of knowledge was significantly positively correlated with total leisure time PA of the participants. A minority of adult Saudis in Al Hassa was aware about the role of PA in cancer prevention and

Clinical Trials Management | Division of Cancer Prevention

Science.gov (United States)

Information for researchers about developing, reporting, and managing NCI-funded cancer prevention clinical trials. Protocol Information Office The central clearinghouse for clinical trials management within the Division of Cancer Prevention.Read more about the Protocol Information Office. | Information for researchers about developing, reporting, and managing NCI-funded

Physical activity and the risk of colorectal cancer in Lynch syndrome.

Science.gov (United States)

Dashti, S Ghazaleh; Win, Aung Ko; Hardikar, Sheetal S; Glombicki, Stephen E; Mallenahalli, Sheila; Thirumurthi, Selvi; Peterson, Susan K; You, Y Nancy; Buchanan, Daniel D; Figueiredo, Jane C; Campbell, Peter T; Gallinger, Steven; Newcomb, Polly A; Potter, John D; Lindor, Noralane M; Le Marchand, Loic; Haile, Robert W; Hopper, John L; Jenkins, Mark A; Basen-Engquist, Karen M; Lynch, Patrick M; Pande, Mala

2018-06-14

Greater physical activity is associated with a decrease in risk of colorectal cancer for the general population; however, little is known about its relationship with colorectal cancer risk for people with Lynch syndrome, carriers of inherited pathogenic mutations in genes affecting DNA mismatch repair (MMR). We studied a cohort of 2,042 MMR gene mutations carriers (n=807, diagnosed with colorectal cancer), from the Colon Cancer Family Registry. Self-reported physical activity in three age-periods (20-29, 30-49, and ≥50 years) was summarized as average metabolic equivalent of task hours per week (MET-h/week) during the age-period of cancer diagnosis or censoring (near-term exposure), and across all age-periods preceding cancer diagnosis or censoring (long-term exposure). Weighted Cox regression was used to estimate the hazard ratio (HR) and 95% confidence intervals (CI) for the association between physical activity and colorectal cancer risk. Near-term physical activity was associated with a small reduction in the risk of colorectal cancer (HR ≥35 vs. Lynch syndrome, however, further confirmation is warranted. The potential modifying effect of physical activity on colorectal cancer risk for people with Lynch syndrome could be useful for risk prediction and support counseling advice for lifestyle modification to reduce cancer risk. This article is protected by copyright. All rights reserved. © 2018 UICC.

The importance of food, nutrition and physical activity in cancer prevention: an interview with Dr Kate Allen.

Science.gov (United States)

Allen, Kate

2018-05-02

Kate Allen speaks to Roshaine Wijayatunga, Managing Commissioning Editor. Dr Kate Allen works as an Executive Director in Science and Public Affairs at World Cancer Research Fund International ( http://wcrf.org ), an NGO and leading authority in the field of cancer prevention through diet, weight and physical activity. Kate is responsible for the organization's scientific, policy and conference programs in the areas of food, nutrition, physical activity and weight management. An important aspect of her role is helping to create collaborative relationships and activities across the WCRF national charities (in Europe, America and Asia) in these areas, as well as maintaining and creating external partnerships. Previously, Kate worked at the Institute of Cancer Research, where she set up an award-winning Interactive Education Unit to develop learning materials for scientists, healthcare professionals, students, patients and the general public. Before that she worked at Medi Cine International, a medical education agency, where she developed educational materials across all media, mainly for specialist physician audiences. Kate has a PhD in neuroscience, carried out at the Institute of Neurology and the National Hospital for Neurology and Neurosurgery at Queen Square, London and the Royal College of Surgeons of England. The Third Expert Report that Kate mentions in the interview, featuring the updated World Cancer Research Fund Cancer Prevention Recommendations is launched 24 May 2018. For more information see http://wcrf.org .

Physical activity can lower risk of 13 types of cancer

Science.gov (United States)

A new study of the relationship between physical activity and cancer has shown that greater levels of leisure-time physical activity were associated with a lower risk of developing 13 different types of cancer; the risk of developing seven cancer types was 20 percent lower among the most active participants as compared with the least active participants.

Cervical cancer management in Zaria, Nigeria SUMMARY ...

African Journals Online (AJOL)

kemrilib

24 patients who needed blood transfusion were adequately transfused and only 21.74% of all patients had complete treatment). ... cancer management in this centre with a view to finding ways to improve its management. Methods. All case notes for patients managed for cervical cancer in Ahmadu Bello University Teaching ...

Nutrition in peri-operative esophageal cancer management.

Science.gov (United States)

Steenhagen, Elles; van Vulpen, Jonna K; van Hillegersberg, Richard; May, Anne M; Siersema, Peter D

2017-07-01

Nutritional status and dietary intake are increasingly recognized as essential areas in esophageal cancer management. Nutritional management of esophageal cancer is a continuously evolving field and comprises an interesting area for scientific research. Areas covered: This review encompasses the current literature on nutrition in the pre-operative, peri-operative, and post-operative phases of esophageal cancer. Both established interventions and potential novel targets for nutritional management are discussed. Expert commentary: To ensure an optimal pre-operative status and to reduce peri-operative complications, it is key to assess nutritional status in all pre-operative esophageal cancer patients and to apply nutritional interventions accordingly. Since esophagectomy results in a permanent anatomical change, a special focus on nutritional strategies is needed in the post-operative phase, including early initiation of enteral feeding, nutritional interventions for post-operative complications, and attention to long-term nutritional intake and status. Nutritional aspects of pre-optimization and peri-operative management should be incorporated in novel Enhanced Recovery After Surgery programs for esophageal cancer.

The physics of cancer: The role of epigenetics and chromosome conformation in cancer progression

Energy Technology Data Exchange (ETDEWEB)

Naimark, Oleg B.; Nikitiuk, Aleksandr S. [Institute of Continuous Media Mechanics UrB RAS, Perm, 614013 (Russian Federation); Baudement, Marie-Odile; Forné, Thierry [Institut de Génétique Moléculaire de Montpellier UMR 5535, CNRS, Université de Montpellier, 1919 route de Mende, Montpellier cedex 5, 34293 France (France); Lesne, Annick, E-mail: annick.lesne@igmm.cnrs.fr [Institut de Génétique Moléculaire de Montpellier UMR 5535, CNRS, Université de Montpellier, 1919 route de Mende, Montpellier cedex 5, 34293 France (France); Laboratoire de Physique Théorique de la Matière Condensée UMR 7600, CNRS, UPMC, Sorbonne Universités, 4 place Jussieu, Paris cedex 5, 75252 France (France)

2016-08-02

Cancer progression is generally described in terms of accumulated genetic alterations and ensuing changes in cell properties. However, intermediary modifications are involved in the establishment of cancer cell phenotypes, at different levels of nuclear organization: DNA damages and their structural consequences, epigenetic modifications and their impact on chromatin architecture, changes in chromosome 3D organization. We review some of these alterations with a focus on their physical aspects. The challenge is to understand the multiscale interplay between generic physical mechanisms and specific biological factors in cancer cells. We argue that such an interdisciplinary perspective offers a novel viewpoint on cancer progression, early diagnosis and possibly therapeutic targets.

Rationale for promoting physical activity among cancer survivors: literature review and epidemiologic examination.

Science.gov (United States)

Loprinzi, Paul D; Lee, Hyo

2014-03-01

To review the extant literature on the link between physical activity and health outcomes among cancer survivors; identify evidence-based strategies to promote physical activity among this population; and conduct an epidemiologic study based on gaps from the literature review, examining the association between physical activity and various biologic markers. The authors used PubMed and Google Scholar up to July 2013, as well as data from the 2003-2006 National Health and Nutrition Examination Survey for the empirical study. Studies were examined through a systematic review process. In the epidemiologic study, 227 adult cancer survivors wore an accelerometer for four days or longer, with biologic markers (e.g., cholesterol) assessed from a blood sample. The review study demonstrated that cancer survivors are relatively inactive, but physical activity may help to reduce the risk of cancer recurrence and cancer-related mortality, increase cancer treatment rates, reduce pain and other side effects associated with cancer treatment, and improve physical and mental health. The epidemiologic study showed that physical activity was associated with several understudied biomarkers (e.g., neutrophils, white blood cells) that are linked with cancer recurrence, cancer-related mortality, and other chronic diseases. Nurses are encouraged to promote physical activity in cancer survivors.

Contemporary Management of Primary Distal Urethral Cancer.

Science.gov (United States)

Traboulsi, Samer L; Witjes, Johannes Alfred; Kassouf, Wassim

2016-11-01

Primary urethral cancer is one of the rare urologic tumors. Distal urethral tumors are usually less advanced at diagnosis compared with proximal tumors and have a good prognosis if treated appropriately. Low-stage distal tumors can be managed successfully with a surgical approach in men or radiation therapy in women. There are no clear-cut indications for the choice of the most appropriate treatment modality. Organ-preserving modalities have shown effective and should be used whenever they do not compromise the oncological safety to decrease the physical and psychological trauma of dismemberment or loss of sexual/urinary function. Copyright © 2016 Elsevier Inc. All rights reserved.

Nutrition habits, physical activity, and lung cancer: an authoritative review.

Science.gov (United States)

Koutsokera, Alexandra; Kiagia, Maria; Saif, Muhammad W; Souliotis, Kyriakos; Syrigos, Kostas N

2013-07-01

Lung cancer is the leading cause of cancer death worldwide. Because of high incidence rates and low survival rates, it is important to study the risk factors that may help prevent the disease from developing. It has been well established that cigarette smoking is the most important risk factor for lung cancer. Nonetheless it is likely that there are other modifiable risk factors that would assist in the prevention of lung cancer. Research on factors such as nutrition and physical activity and their influence on lung cancer has been carried out for nearly 3 decades. A systematic review in the MEDLINE database of published studies was conducted, focusing on systematic reviews, meta-analyses, and large prospective studies. The association between physical activity and lung cancer has been conflicting. Among the researched studies, 10 showed an inverse association, whereas 11 reported no association. A meta-analysis that was conducted from 1996 to October 2003 showed that leisure physical activity (LPA) prevents lung cancer. Data from 11 cohort and case-control studies showed an inverse relationship between fruit and vegetable consumption and lung cancer. Evidence from case-control studies suggests a positive association between meat intake and risk of lung cancer, although several more recent studies have presented doubts about these findings. The possible association of physical activity, nutrition, and the risk of lung cancer development remains controversial. Further prospective studies should be conducted to determine the potential influence of these 2 risk factors. Copyright © 2013 Elsevier Inc. All rights reserved.

Pain management in lung cancer.

Science.gov (United States)

Nurwidya, Fariz; Syahruddin, Elisna; Yunus, Faisal

2016-01-01

Lung cancer is the leading cause of cancer-related mortality worldwide. Not only burdened by the limited overall survival, lung cancer patient also suffer from various symptoms, such as pain, that implicated in the quality of life. Cancer pain is a complicated and transiently dynamic symptom that results from multiple mechanisms. This review will describe the pathophysiology of cancer pain and general approach in managing a patient with lung cancer pain. The use of opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and adjuvant analgesia, as part of the pharmacology therapy along with interventional strategy, will also be discussed.

Cancer-related fatigue and physical activity among premenopausal cervical and endometrial cancer survivors in Japan.

Science.gov (United States)

Obama, Kyoko; Maru, Mitsue; Maeda, Rumi; Kubota, Toshiro

2015-09-30

To examine the relationship between cancer-related fatigue (CRF) and physical activity in daily living in premenopausal disease-free cervical and endometrial cancer survivors. A physical activity monitor was used to collect objective data on daily physical activity. CRF and related variables were measured using self-report scales in a cross-sectional manner. The average age was 44.9 years among 64 women. The higher CRF group comprised 22 women (34%), 10% of whom had severe fatigue. The participants had higher physical activity levels compared with the findings in previous studies, and reported an average of 40 min/day of moderate to vigorous activity. Moderate to vigorous levels of physical activity were derived from essential social activities rather than leisure time exercise. There were no significant differences in physical activity levels between the lower and higher CRF groups. Our study results suggested that the higher level of physical activity in daily living itself had no relationship with decreasing CRF among premenopausal cervical and endometrial cancer survivors. It would be better to focus on cognitive and psychological factors before introducing physical activity programs and be careful of the characteristics of the participants' physical activity among this population in daily basis.

Neighborhood influences on recreational physical activity and survival after breast cancer.

Science.gov (United States)

Keegan, Theresa H M; Shariff-Marco, Salma; Sangaramoorthy, Meera; Koo, Jocelyn; Hertz, Andrew; Schupp, Clayton W; Yang, Juan; John, Esther M; Gomez, Scarlett L

2014-10-01

Higher levels of physical activity have been associated with improved survival after breast cancer diagnosis. However, no previous studies have considered the influence of the social and built environment on physical activity and survival among breast cancer patients. Our study included 4,345 women diagnosed with breast cancer (1995-2008) from two population-based studies conducted in the San Francisco Bay Area. We examined questionnaire-based moderate/strenuous recreational physical activity during the 3 years before diagnosis. Neighborhood characteristics were based on data from the 2000 US Census, business listings, parks, farmers' markets, and Department of Transportation. Survival was evaluated using multivariable Cox proportional hazards models, with follow-up through 2009. Women residing in neighborhoods with no fast-food restaurants (vs. fewer fast-food restaurants) to other restaurants, high traffic density, and a high percentage of foreign-born residents were less likely to meet physical activity recommendations set by the American Cancer Society. Women who were not recreationally physically active had a 22% higher risk of death from any cause than women that were the most active. Poorer overall survival was associated with lower neighborhood socioeconomic status (SES) (p(trend) = 0.02), whereas better breast cancer-specific survival was associated with a lack of parks, especially among women in high-SES neighborhoods. Certain aspects of the neighborhood have independent associations with recreational physical activity among breast cancer patients and their survival. Considering neighborhood factors may aide in the design of more effective, tailored physical activity programs for breast cancer survivors.

How do I best manage insomnia and other sleep disorders in older adults with cancer?

Science.gov (United States)

Loh, Kah Poh; Burhenn, Peggy; Hurria, Arti; Zachariah, Finly; Mohile, Supriya Gupta

2016-11-01

Insomnia is common in older adults with cancer, with a reported prevalence of 19-60% in prior studies. Cancer treatments are associated with increased risk of insomnia or aggravation of pre-existing insomnia symptoms, and patients who are receiving active cancer treatments are more likely to report insomnia. Insomnia can lead to significant physical and psychological consequences with increased mortality. We discuss physiological sleep changes in older adults, and illustrated the various sleep disorders. We present a literature review on the prevalence and the effects of insomnia on the quality of life in older adults with cancer. We discuss the risk factors and presented a theoretical framework of insomnia in older adults with cancer. We present a case study to illustrate the assessment and management of insomnia in older adults with cancer, comparing and contrasting a number of tools for sleep assessment. There are currently no guidelines on the treatment of sleep disorders in older adults with cancer. We present an algorithm developed at the City of Hope Comprehensive Cancer Center by a multidisciplinary team for managing insomnia, using evidence-based pharmacologic and non-pharmacologic interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

Thyroid cancer: Natural history, management strategies and outcomes

International Nuclear Information System (INIS)

Shaha, Ashok R.

1997-01-01

Objectives: To understand the natural history of thyroid cancer and high risk groups; To define the biological behavior of thyroid cancer and relate it to various prognostic factors and risk groups; To divide the management strategies into conservation, radical surgery and radioactive iodine treatment; To define the role of external radiation therapy and the management of complex and advanced thyroid cancer; To analyze the results of management of anaplastic thyroid cancer and make a plea for combined modality treatment; To define the current role of genetic studies in medullary thyroid cancer. At the end of this refresher course, the attendees will be able to understand the natural history, the prognostic factors and risk groups and surgical and combined modality treatment in thyroid cancer

Management of patients with advanced prostate cancer

DEFF Research Database (Denmark)

Gillessen, S; Omlin, A; Attard, G

2015-01-01

The first St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) Expert Panel identified and reviewed the available evidence for the ten most important areas of controversy in advanced prostate cancer (APC) management. The successful registration of several drugs for castration......-resistant prostate cancer and the recent studies of chemo-hormonal therapy in men with castration-naïve prostate cancer have led to considerable uncertainty as to the best treatment choices, sequence of treatment options and appropriate patient selection. Management recommendations based on expert opinion...

Chronic and episodic stress predict physical symptom bother following breast cancer diagnosis.

Science.gov (United States)

Harris, Lauren N; Bauer, Margaret R; Wiley, Joshua F; Hammen, Constance; Krull, Jennifer L; Crespi, Catherine M; Weihs, Karen L; Stanton, Annette L

2017-12-01

Breast cancer patients often experience adverse physical side effects of medical treatments. According to the biobehavioral model of cancer stress and disease, life stress during diagnosis and treatment may negatively influence the trajectory of women's physical health-related adjustment to breast cancer. This longitudinal study examined chronic and episodic stress as predictors of bothersome physical symptoms during the year after breast cancer diagnosis. Women diagnosed with breast cancer in the previous 4 months (N = 460) completed a life stress interview for contextual assessment of chronic and episodic stress severity at study entry and 9 months later. Physical symptom bother (e.g., pain, fatigue) was measured at study entry, every 6 weeks through 6 months, and at nine and 12 months. In multilevel structural equation modeling (MSEM) analyses, both chronic stress and episodic stress occurring shortly after diagnosis predicted greater physical symptom bother over the study period. Episodic stress reported to have occurred prior to diagnosis did not predict symptom bother in MSEM analyses, and the interaction between chronic and episodic stress on symptom bother was not significant. Results suggest that ongoing chronic stress and episodic stress occurring shortly after breast cancer diagnosis are important predictors of bothersome symptoms during and after cancer treatment. Screening for chronic stress and recent stressful life events in the months following diagnosis may help to identify breast cancer patients at risk for persistent and bothersome physical symptoms. Interventions to prevent or ameliorate treatment-related physical symptoms may confer added benefit by addressing ongoing non-cancer-related stress in women's lives.

A chronic care ostomy self-management program for cancer survivors.

Science.gov (United States)

Krouse, Robert S; Grant, Marcia; McCorkle, Ruth; Wendel, Christopher S; Cobb, Martha D; Tallman, Nancy J; Ercolano, Elizabeth; Sun, Virginia; Hibbard, Judith H; Hornbrook, Mark C

2016-05-01

Individuals with ostomies experience extensive changes in health-related quality of life (HRQOL) and daily routine. Patients and families are typically forced to use trial and error to improve self-management. This is a longitudinal one-group design pilot study of a five-session ostomy self-care curriculum based on the Chronic Care Model to improve HRQOL and self-management for cancer survivors with ostomies. Participants were surveyed to evaluate each session. Multiple instruments were administered to examine outcomes at baseline, post-intervention, and at 6-month follow-up (Patient Activation Measure, self-efficacy, Hospital Anxiety and Depression Scale, Ways of Coping, Group Health Association of America Satisfaction with ostomy care survey, and the City of Hope Quality of Life Ostomy). Changes from pre-intervention to post-intervention and pre-intervention to follow-up were evaluated with paired t-tests. Text responses were coded and evaluated for important themes and recommendations. Thirty-eight subjects participated in the study. Most had a history of rectal cancer (60.5%) or bladder cancer (28.9%). Participants rated the overall program high (4.4-4.8 on 5-point scale). Text feedback indicated that participants enjoyed the group forums, wanted more participants, and more hands-on training. Scores on multiple surveys were shown to be improved and sustained, including patient activation (p = 0.0004), self-efficacy (p = 0.006), total HRQOL (p = 0.01), physical well-being (p = 0.005), and social well-being (p = 0.002). Survivor anxiety was significantly reduced by follow-up (p = 0.047). This self-management ostomy program can help cancer survivors with ostomies adapt to their stoma. Initiating this program in the community setting would be beneficial to many cancer survivors. Copyright © 2016 John Wiley & Sons, Ltd.

Contemporary management of patients with penile cancer and lymph node metastasis.

Science.gov (United States)

Leone, Andrew; Diorio, Gregory J; Pettaway, Curtis; Master, Viraj; Spiess, Philippe E

2017-06-01

Penile cancer is a rare disease that causes considerable physical and psychological patient morbidity, especially at advanced stages. Patients with low-stage nodal metastasis can achieve durable survival with surgery alone, but those with extensive locoregional metastasis have overall low survival. Contemporary management strategies for lymph node involvement in penile cancer aim to minimize the morbidity associated with traditional radical inguinal lymphadenectomy through appropriate risk stratification while optimizing oncological outcomes. Modified (or superficial) inguinal lymph node dissection and dynamic sentinel lymph node biopsy are diagnostic modalities that have been recommended in patients with high-risk primary penile tumours and nonpalpable inguinal lymph nodes. In addition, advances in minimally invasive and robot-assisted lymphadenectomy techniques are being investigated in patients with penile cancer and might further decrease lymphadenectomy-related adverse effects. The management of patients with advanced disease has evolved to include multimodal treatment with systemic chemotherapy before surgical intervention and can include adjuvant chemotherapy after pelvic lymphadenectomy. The role of radiotherapy in the neoadjuvant or adjuvant setting remains largely unclear, owing to a lack of high-level evidence of possible benefits. New targeted therapies have shown efficacy in squamous cell carcinomas of other sites and might also prove effective in patients with penile cancer.

Physical break-down of the classical view on cancer cell invasion and metastasis.

Science.gov (United States)

Mierke, Claudia T

2013-03-01

Eight classical hallmarks of cancer have been proposed and are well-defined by using biochemical or molecular genetic methods, but are not yet precisely defined by cellular biophysical processes. To define the malignant transformation of neoplasms and finally reveal the functional pathway, which enables cancer cells to promote cancer progression, these classical hallmarks of cancer require the inclusion of specific biomechanical properties of cancer cells and their microenvironment such as the extracellular matrix and embedded cells such as fibroblasts, macrophages or endothelial cells. Nonetheless a main novel ninth hallmark of cancer is still elusive in classical tumor biological reviews, which is the aspect of physics in cancer disease by the natural selection of an aggressive (highly invasive) subtype of cancer cells. The physical aspects can be analyzed by using state-of-the-art biophysical methods. Thus, this review will present current cancer research in a different light and will focus on novel physical methods to investigate the aggressiveness of cancer cells from a biophysicist's point of view. This may lead to novel insights into cancer disease and will overcome classical views on cancer. In addition, this review will discuss how physics of cancer can help to reveal whether cancer cells will invade connective tissue and metastasize. In particular, this review will point out how physics can improve, break-down or support classical approaches to examine tumor growth even across primary tumor boundaries, the invasion of single or collective cancer cells, transendothelial migration of cancer cells and metastasis in targeted organs. Finally, this review will show how physical measurements can be integrated into classical tumor biological analysis approaches. The insights into physical interactions between cancer cells, the primary tumor and the microenvironment may help to solve some "old" questions in cancer disease progression and may finally lead to novel

Coping with pediatric cancer: strategies employed by children and their parents to manage cancer-related stressors during treatment.

Science.gov (United States)

Hildenbrand, Aimee K; Clawson, Kathleen J; Alderfer, Melissa A; Marsac, Meghan L

2011-01-01

Pediatric cancer patients and their families face significant physical, emotional, and psychosocial challenges. Few studies have investigated how children manage these challenges and how parents may help in the process. This qualitative study aimed to explore common cancer-related stressors for children and to examine child coping and parental assistance in coping with these stressors during treatment. Fifteen children undergoing cancer treatment and their parents participated in semistructured interviews. Four themes emerged capturing cancer-related stressors: cancer treatment/side effects, distressing emotions, disruption in daily routines, and social challenges. Six themes emerged regarding child coping strategies that were classified within an approach/avoidance coping framework. Approach coping strategies included the following: cognitive restructuring, relaxation, practical strategies, seeking social support, and emotional expression. Distraction was the only avoidant coping strategy. Parents tended to encourage approach coping strategies (eg, cognitive restructuring, social support). Within families, few coping strategies were reported (child: M = 1.47, SD = 0.99; parent: M = 3.33, SD = 1.18), suggesting that early family-based interventions teaching coping techniques for cancer-related stressors may be beneficial.

Perioperative management of nonmuscle-invasive bladder cancer

NARCIS (Netherlands)

Falke, J.; Witjes, J.A.

2011-01-01

PURPOSE OF REVIEW: The management of nonmuscle-invasive bladder cancer is a challenge. Despite current guidelines, the treatment is suboptimal as illustrated by the high risk of recurrence and progression. Transurethral resection plays a pivotal role in the management of bladder cancer, but the

The role of radiotherapy in the management of cancer patients infected by human immunodeficiency virus (HIV)

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-06-01

Cancer and AIDS are both pandemics: they have an emotional and social impact that goes far beyond the physical disruption they cause. These are usually perceived and addressed as independent disease entities. When these coexist in one patient, however, the appropriate management of the cancer needs to be modified from the standard clinical protocols. New protocols appearing in the radiotherapy literature have been investigative rather than definitive and, with few exceptions, analyse the results of small series of patients. The IAEA has extensive projects in radiation oncology in developing countries. In Africa, there is concern that AIDS related cancers utilise an increasing amount of scarce resources, that they frequently require equipment for the management of superficial tumours, and that inadequate training is available in the management of these cancers. This report developed from the need to address these concerns. An Advisory Group Meeting (AGM) on the Relationship between Human Immunodeficiency Virus (HIV) and Cancer Management Protocols for Developing Countries was convened in October 1999. A reading of this report will show that considerable amount of further investigation is required to respond authoritatively to many of the management decisions that need be made. It is also evident that the greatest number of patients requiring optimal management protocols live in sub-Saharan Africa - a region where research resources are at a minimum. The IAEA has made available limited funding for a research project in determining the intermediate term effects of radiation therapy on the immune system in AIDS related cervical cancer.

The role of radiotherapy in the management of cancer patients infected by human immunodeficiency virus (HIV)

International Nuclear Information System (INIS)

2001-06-01

Cancer and AIDS are both pandemics: they have an emotional and social impact that goes far beyond the physical disruption they cause. These are usually perceived and addressed as independent disease entities. When these coexist in one patient, however, the appropriate management of the cancer needs to be modified from the standard clinical protocols. New protocols appearing in the radiotherapy literature have been investigative rather than definitive and, with few exceptions, analyse the results of small series of patients. The IAEA has extensive projects in radiation oncology in developing countries. In Africa, there is concern that AIDS related cancers utilise an increasing amount of scarce resources, that they frequently require equipment for the management of superficial tumours, and that inadequate training is available in the management of these cancers. This report developed from the need to address these concerns. An Advisory Group Meeting (AGM) on the Relationship between Human Immunodeficiency Virus (HIV) and Cancer Management Protocols for Developing Countries was convened in October 1999. A reading of this report will show that considerable amount of further investigation is required to respond authoritatively to many of the management decisions that need be made. It is also evident that the greatest number of patients requiring optimal management protocols live in sub-Saharan Africa - a region where research resources are at a minimum. The IAEA has made available limited funding for a research project in determining the intermediate term effects of radiation therapy on the immune system in AIDS related cervical cancer

Cancer-related fatigue and physical activity among premenopausal cervical and endometrial cancer survivors in Japan

OpenAIRE

小濵, 京子; 丸, 光惠; 前田, 留美; 久保田, 俊郎

2015-01-01

Purpose: To examine the relationship between cancer-related fatigue (CRF) and physical activity in daily living in premenopausal disease-free cervical and endometrial cancer survivors. Methods: A physical activity monitor was used to collect objective data on daily physical activity. CRF and related variables were measured using self-report scales in a cross-sectional manner. Results: The average age was 44.9 years among 64 women. The higher CRF group comprised 22 women (34%), 10% of whom had...

Coordinating cancer care: patient and practice management processes among surgeons who treat breast cancer.

Science.gov (United States)

Katz, Steven J; Hawley, Sarah T; Morrow, Monica; Griggs, Jennifer J; Jagsi, Reshma; Hamilton, Ann S; Graff, John J; Friese, Christopher R; Hofer, Timothy P

2010-01-01

The Institute of Medicine has called for more coordinated cancer care models that correspond to initiatives led by cancer providers and professional organizations. These initiatives parallel those underway to integrate the management of patients with chronic conditions. We developed 5 breast cancer patient and practice management process measures based on the Chronic Care Model. We then performed a survey to evaluate patterns and correlates of these measures among attending surgeons of a population-based sample of patients diagnosed with breast cancer between June 2005 and February 2007 in Los Angeles and Detroit (N = 312; response rate, 75.9%). Surgeon practice specialization varied markedly with about half of the surgeons devoting 15% or less of their total practice to breast cancer, whereas 16.2% of surgeons devoted 50% or more. There was also large variation in the extent of the use of patient and practice management processes with most surgeons reporting low use. Patient and practice management process measures were positively associated with greater levels of surgeon specialization and the presence of a teaching program. Cancer program status was weakly associated with patient and practice management processes. Low uptake of patient and practice management processes among surgeons who treat breast cancer patients may indicate that surgeons are not convinced that these processes matter, or that there are logistical and cost barriers to implementation. More research is needed to understand how large variations in patient and practice management processes might affect the quality of care for patients with breast cancer.

A regional programme to improve skin cancer management.

Science.gov (United States)

McGeoch, Graham R; Sycamore, Mark J; Shand, Brett I; Simcock, Jeremy W

2015-12-01

In 2008, public specialist and general practice services in Canterbury were unable to manage demand for skin cancer treatment. Local clinicians decided the solution was to develop a see-and-treat skin excision clinic staffed by plastic surgeons and general practitioners (GPs), and the introduction of subsidised excisions in general practice. This paper describes the collaboration between clinicians, managers and funders and the results and quality management measures of these initiatives. There is an increasing incidence of skin cancer. GPs in Canterbury were unable to meet increasing demand for skin cancer treatment because some lacked confidence and competence in skin cancer management. There was no public funding for primary care management of skin cancer, driving patients to fully funded secondary care services. Secondary care services were at capacity, with no coordinated programme across primary and secondary care. The programme has resulted in a greater number of skin cancers being treated by the public health system, a reduction in waiting times for treatment, and fewer minor skin lesions being referred to secondary care. Quality measures have been achieved and are improving steadily. Development of the programme has improved working relationships between primary and secondary care clinicians. The strategy was to facilitate the working relationship between primary and secondary care and increase the capacity for skin lesion excisions in both sectors. Skin cancer management can be improved by a coordinated approach between primary and secondary care.

Potential of probiotics, prebiotics and synbiotics for management of colorectal cancer

Science.gov (United States)

Raman, Maya; Ambalam, Padma; Kondepudi, Kanthi Kiran; Pithva, Sheetal; Kothari, Charmy; Patel, Arti T.; Purama, Ravi Kiran; Dave, J.M.; Vyas, B.R.M.

2013-01-01

Colorectal Cancer (CRC) is the second leading cause of cancer-related mortality and is the fourth most common malignant neoplasm in USA. Escaping apoptosis and cell mutation are the prime hallmarks of cancer. It is apparent that balancing the network between DNA damage and DNA repair is critical in preventing carcinogenesis. One-third of cancers might be prevented by nutritious healthy diet, maintaining healthy weight and physical activity. In this review, an attempt is made to abridge the role of carcinogen in colorectal cancer establishment and prognosis, where special attention has been paid to food-borne mutagens and functional role of beneficial human gut microbiome in evading cancer. Further the significance of tailor-made prebiotics, probiotics and synbiotics in cancer management by bio-antimutagenic and desmutagenic activity has been elaborated. Probiotic bacteria are live microorganisms that, when administered in adequate amounts, confer a healthy benefit on the host. Prebiotics are a selectively fermentable non-digestible oligosaccharide or ingredient that brings specific changes, both in the composition and/or activity of the gastrointestinal microflora, conferring health benefits. Synbiotics are a combination of probiotic bacteria and the growth promoting prebiotic ingredients that purport “synergism.” PMID:23511582

Chronic Recreational Physical Inactivity and Epithelial Ovarian Cancer Risk

DEFF Research Database (Denmark)

Cannioto, Rikki; LaMonte, Michael J.; Risch, Harvey A

2016-01-01

physical activity and epithelial ovarian cancer (EOC) is less clear. Despite extensive research, including several epidemiological studies and 2 systematic reviews, insufficient and inconsistent evidence is available to support an independent association between recreational physical activity and risk......It is estimated that 5% of women in the United States and 10% to 50% of women worldwide are physically inactive. Previous studies have demonstrated that recreational physical activity is associated with decreased risks of developing breast, colon, and endometrial cancers. The association between...... of EOC. This is largely due to use of common methodology in most studies that overlooks recreational physical inactivity as an independent risk factor for EOC. The aim of this study was to determine whether self-reported, chronic, recreational physical inactivity is an independent risk factor...

Can models of self-management support be adapted across cancer types? A comparison of unmet self-management needs for patients with breast or colorectal cancer.

Science.gov (United States)

Mansfield, Elise; Mackenzie, Lisa; Carey, Mariko; Peek, Kerry; Shepherd, Jan; Evans, Tiffany-Jane

2018-03-01

There is an increased focus on supporting patients with cancer to actively participate in their healthcare, an approach commonly termed 'self-management'. Comparing unmet self-management needs across cancer types may reveal opportunities to adapt effective self-management support strategies from one cancer type to another. Given that breast and colorectal cancers are prevalent, and have high survival rates, we compared these patients' recent need for help with self-management. Data on multiple aspects of self-management were collected from 717 patients with breast cancer and 336 patients with colorectal cancer attending one of 13 Australian medical oncology treatment centres. There was no significant difference between the proportion of patients with breast or colorectal cancer who reported a need for help with at least one aspect of self-management. Patients with breast cancer were significantly more likely to report needing help with exercising more, while patients with colorectal cancer were more likely to report needing help with reducing alcohol consumption. When controlling for treatment centre, patients who were younger, experiencing distress or had not received chemotherapy were more likely to report needing help with at least one aspect of self-management. A substantial minority of patients reported an unmet need for self-management support. This indicates that high-quality intervention research is needed to identify effective self-management support strategies, as well as implementation trials to identify approaches to translating these strategies into practice. Future research should continue to explore whether self-management support strategies could be adapted across cancer types.

The medical management of breast cancer

International Nuclear Information System (INIS)

Williams, C.J.; Buchanan, R.

1988-01-01

The text is brief and directed primarily to the breast cancer specialist. Topics include epidemiology, screening, prognostic factors, pre- and postoperative assessment, surgery, radiotherapy adjuvant endocrine therapy, and management of advanced disease. Brief chapters also address nonspecific symptoms of advanced disease, male breast cancer, and psychological considerations. Emphasis is on clinical management and review of many published controlled trials. Chapters conclude with short lists of recommendations and long alphabetic lists of reference material from the world literature. Since breast cancer continues to increase gradually in incidence and is most common in the United States, it commands attention

Maximum physical capacity testing in cancer patients undergoing chemotherapy

DEFF Research Database (Denmark)

Knutsen, L.; Quist, M; Midtgaard, J

2006-01-01

BACKGROUND: Over the past few years there has been a growing interest in the field of physical exercise in rehabilitation of cancer patients, leading to requirements for objective maximum physical capacity measurement (maximum oxygen uptake (VO(2max)) and one-repetition maximum (1RM)) to determin...... early in the treatment process. However, the patients were self-referred and thus highly motivated and as such are not necessarily representative of the whole population of cancer patients treated with chemotherapy....... in performing maximum physical capacity tests as these motivated them through self-perceived competitiveness and set a standard that served to encourage peak performance. CONCLUSION: The positive attitudes in this sample towards maximum physical capacity open the possibility of introducing physical testing...

Chronic recreational physical inactivity and epithelial ovarian cancer risk

DEFF Research Database (Denmark)

Cannioto, Rikki; LaMonte, Michael J.; Risch, Harvey A

2016-01-01

. We conducted a pooled analysis of nine studies from the Ovarian Cancer Association Consortium to investigate the association between chronic recreational physical inactivity and EOC risk. Methods: In accordance with the 2008 Physical Activity Guidelines for Americans, women reporting no regular......Background: Despite a large body of literature evaluating the association between recreational physical activity and epithelial ovarian cancer (EOC) risk, the extant evidence is inconclusive, and little is known about the independent association between recreational physical inactivity and EOC risk......, weekly recreational physical activity were classified as inactive. Multivariable logistic regression was utilized to estimate the ORs and 95% confidence intervals (CI) for the association between inactivity and EOC risk overall and by subgroups based upon histotype, menopausal status, race, and body mass...

Cervical cancer management in Zaria, Nigeria | Sule | African ...

African Journals Online (AJOL)

The paper\\'s objective was to identify factors influencing cervical cancer management in Zaria with a view to improving the outcome of management. Case notes of patients managed for cervical cancer in Ahmadu Bello University Teaching Hospital (ABUTH), Zaria between January 1 1999 and December 31 2003, were ...

Physical Activity and Cervical Cancer Testing among American Indian Women

Science.gov (United States)

Muus, Kyle J.; Baker-Demaray, Twyla B.; Bogart, T. Andy; Duncan, Glen E.; Jacobsen, Clemma; Buchwald, Dedra S.; Henderson, Jeffrey A.

2012-01-01

Purpose: Studies have shown that women who engage in high levels of physical activity have higher rates of cancer screening, including Papanicalaou (Pap) tests. Because American Indian (AI) women are at high risk for cervical cancer morbidity and mortality, we examined Pap screening prevalence and assessed whether physical activity was associated…

A prospective study of occupational physical activity and breast cancer risk.

Science.gov (United States)

Ekenga, Christine C; Parks, Christine G; Sandler, Dale P

2015-12-01

Physical activity has been associated with reduced breast cancer risk, but studies of occupational activity have produced inconsistent results. The purpose of this study was to evaluate the relationship between occupational physical activity and breast cancer in a prospective study of women with a family history of breast cancer. We studied breast cancer risk in 47,649 Sister Study participants with an occupational history. Information on occupational activity and breast cancer risk factors was collected during baseline interviews (2004-2009). Physical activity at each job was self-reported and categorized as mostly sitting, sitting and standing equally, mostly standing, and active. Multivariable Cox proportional hazards regression was used to evaluate associations between lifetime occupational activity and incident breast cancer, after adjusting for established risk factors and recreational activity. During follow-up, a total of 1,798 breast cancer diagnoses were reported. Compared with women who did not spend any time in active jobs, women who spent a high proportion (≥75%) of their working years in active jobs had a reduced risk of breast cancer (HR 0.72; 95% CI 0.52-0.98). Associations were strongest among overweight (HR 0.64; 95% CI 0.42-0.98) and postmenopausal (HR 0.67; 95% CI 0.45-0.98) women. Occupational activity was associated with a reduced risk of breast cancer. Occupational activity is a domain of physical activity that should be further examined in studies of postmenopausal breast cancer risk. Additional research is necessary to better understand the mechanisms underlying the relationships between occupational activity, body size, and breast cancer.

Cardiorespiratory fitness and physical function in children with cancer from diagnosis throughout treatment

DEFF Research Database (Denmark)

Thorsteinsson, Troels; Larsen, Hanne Baekgaard; Schmiegelow, Kjeld

2017-01-01

treatment as well as the feasibility of physical activity intervention in the Rehabilitation including Social and Physical activity and Education in Children and Teenagers with Cancer study. PATIENTS AND METHODS: The study included children diagnosed from January 2013 to April 2016 with paediatric cancer...... programme with no dropouts. Strenuous physical exercise and physiological testing during paediatric cancer treatment was safe and feasible, with only five minor adverse events during the intervention. Cardiorespiratory fitness was significantly lower in children with cancer than norms for healthy age...... with cancer have significantly lower physical capacity and functionality than healthy age-matched norms. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov: NCT01772862....

Physical activity reduces fatigue in patients with cancer and hematopoietic stem cell transplant recipients: A systematic review and meta-analysis of randomized trials.

Science.gov (United States)

Oberoi, Sapna; Robinson, Paula D; Cataudella, Danielle; Culos-Reed, S Nicole; Davis, Hailey; Duong, Nathan; Gibson, Faith; Götte, Miriam; Hinds, Pamela; Nijhof, Sanne L; Tomlinson, Deborah; van der Torre, Patrick; Cabral, Sandra; Dupuis, L Lee; Sung, Lillian

2018-02-01

Objective was to determine whether physical activity reduces the severity of fatigue in patients with cancer or hematopoietic stem cell transplant (HSCT) recipients. We conducted a meta-analysis of randomized trials comparing physical activity with control interventions for the management of fatigue in patients with cancer or HSCT recipients. There were 170 trials included. Physical activity reduced the severity of fatigue when compared to all control groups (standardized mean difference -0.49, 95% confidence interval -0.60 to -0.37; P fatigue although smaller effects were observed with resistance exercises (P interaction = 0.01). Other intervention and patient characteristics did not influence the effect of physical activity on the severity of fatigue. Physical activity was effective at reducing fatigue in patients with cancer and HSCT recipients across patient sub-groups. Determining the best approaches for safe implementation should be a priority. Copyright © 2017 Elsevier B.V. All rights reserved.

Physical View on the Interactions Between Cancer Cells and the Endothelial Cell Lining During Cancer Cell Transmigration and Invasion

Science.gov (United States)

Mierke, Claudia T.

There exist many reviews on the biological and biochemical interactions of cancer cells and endothelial cells during the transmigration and tissue invasion of cancer cells. For the malignant progression of cancer, the ability to metastasize is a prerequisite. In particular, this means that certain cancer cells possess the property to migrate through the endothelial lining into blood or lymph vessels, and are possibly able to transmigrate through the endothelial lining into the connective tissue and follow up their invasion path in the targeted tissue. On the molecular and biochemical level the transmigration and invasion steps are well-defined, but these signal transduction pathways are not yet clear and less understood in regards to the biophysical aspects of these processes. To functionally characterize the malignant transformation of neoplasms and subsequently reveal the underlying pathway(s) and cellular properties, which help cancer cells to facilitate cancer progression, the biomechanical properties of cancer cells and their microenvironment come into focus in the physics-of-cancer driven view on the metastasis process of cancers. Hallmarks for cancer progression have been proposed, but they still lack the inclusion of specific biomechanical properties of cancer cells and interacting surrounding endothelial cells of blood or lymph vessels. As a cancer cell is embedded in a special environment, the mechanical properties of the extracellular matrix also cannot be neglected. Therefore, in this review it is proposed that a novel hallmark of cancer that is still elusive in classical tumor biological reviews should be included, dealing with the aspect of physics in cancer disease such as the natural selection of an aggressive (highly invasive) subtype of cancer cells displaying a certain adhesion or chemokine receptor on their cell surface. Today, the physical aspects can be analyzed by using state-of-the-art biophysical methods. Thus, this review will present

Interventional Analgesic Management of Lung Cancer Pain.

Science.gov (United States)

Hochberg, Uri; Elgueta, Maria Francisca; Perez, Jordi

2017-01-01

Lung cancer is one of the four most prevalent cancers worldwide. Comprehensive patient care includes not only adherence to clinical guidelines to control and when possible cure the disease but also appropriate symptom control. Pain is one of the most prevalent symptoms in patients diagnosed with lung cancer; it can arise from local invasion of chest structures or metastatic disease invading bones, nerves, or other anatomical structures potentially painful. Pain can also be a consequence of therapeutic approaches like surgery, chemotherapy, or radiotherapy. Conventional medical management of cancer pain includes prescription of opioids and coadjuvants at doses sufficient to control the symptoms without causing severe drug effects. When an adequate pharmacological medical management fails to provide satisfactory analgesia or when it causes limiting side effects, interventional cancer pain techniques may be considered. Interventional pain management is devoted to the use of invasive techniques such as joint injections, nerve blocks and/or neurolysis, neuromodulation, and cement augmentation techniques to provide diagnosis and treatment of pain syndromes resistant to conventional medical management. Advantages of interventional approaches include better analgesic outcomes without experiencing drug-related side effects and potential for opioid reduction thus avoiding central side effects. This review will describe various pain syndromes frequently described in lung cancer patients and those interventional techniques potentially indicated for those cases.

Physical activity and risk of pancreatic cancer: a systematic review and meta-analysis.

Science.gov (United States)

Behrens, Gundula; Jochem, Carmen; Schmid, Daniela; Keimling, Marlen; Ricci, Cristian; Leitzmann, Michael F

2015-04-01

Physical activity may prevent pancreatic cancer by regulating body weight and decreasing insulin resistance, DNA damage, and chronic inflammation. Previous meta-analyses found inconsistent evidence for a protective effect of physical activity on pancreatic cancer but those studies did not investigate whether the association between physical activity and pancreatic cancer varies by smoking status, body mass index (BMI), or level of consistency of physical activity over time. To address these issues, we conducted an updated meta-analysis following the PRISMA guidelines among 30 distinct studies with a total of 10,501 pancreatic cancer cases. Random effects meta-analysis of cohort studies revealed a weak, statistically significant reduction in pancreatic cancer risk for high versus low levels of physical activity (relative risk (RR) 0.93, 95 % confidence interval (CI) 0.88-0.98). By comparison, case-control studies yielded a stronger, statistically significant risk reduction (RR 0.78, 95 % CI 0.66-0.94; p-difference by study design = 0.07). When focusing on cohort studies, physical activity summary risk estimates appeared to be more pronounced for consistent physical activity over time (RR 0.86, 95 % CI 0.76-0.97) than for recent past physical activity (RR 0.95, 95 % CI 0.90-1.01) or distant past physical activity (RR 0.95, 95 % CI 0.79-1.15, p-difference by timing in life of physical activity = 0.36). Physical activity summary risk estimates did not differ by smoking status or BMI. In conclusion, physical activity is not strongly associated with pancreatic cancer risk, and the relation is not modified by smoking status or BMI level. While overall findings were weak, we did find some suggestion of potential pancreatic cancer risk reduction with consistent physical activity over time.

Parents' Voice in Managing the Pain of Children with Cancer during Palliative Care.

Science.gov (United States)

Mariyana, Rina; Allenidekania, Allenidekania; Nurhaeni, Nani

2018-01-01

Pain experienced by children can adversely affect their growth and development. Pain is a major health problem for cancer patients and remains an unresolved problem. To know how the experiences of mothers managing their children's pain during palliative care following cancer diagnosis. Pain experienced by children can adversely affect their growth and development. Using qualitative methods within a descriptive phenomenological approach, in-depth interviews were conducted with parents (mostly mothers) of eight children diagnosed with cancer. The data were collected using the snowball sampling method. Participants experienced in managing the pain of children with cancer. Analysis of the results identified 8 themes: the dimensions of pain experienced by children undergoing palliative care; mothers' physical and psychological responses; mothers' emotional responses; barriers encountered by mothers when taking care of their child at home; mothers' interventions to reduce their child's pain; mothers' efforts to distract their child from pain; giving encouragement when the child is in pain; and mothers' efforts and prayers to make their child comfort. It can be concluded that the child's pain is the main cause of mothers' stress and pressure and also affects the daily lives of mothers and children. Along with the most effective intervention, nurses need to provide mothers and children with adequate information about cancer pain.

Cancer-Related Worry and Physical Well-Being in the Context of Perceived Stress in Young Adults with Testicular Cancer.

Science.gov (United States)

Darabos, Katie; Hoyt, Michael A

2017-06-01

Uncertainty associated with cancer can foster future-focused worry and ultimately diminish physical well-being, especially among young adult survivors. Stress perceptions might exacerbate the association of worry and physical well-being. Young adults with testicular cancer (N = 171) completed measures of physical well-being, perceived stress, and future cancer-related worry. Perceived stress and future worry were both negatively associated with physical well-being. Perceived stress moderated the relationship; more perceived stress was related to lower physical well-being in those with high worry. Interventions aimed at worry reduction might benefit from reducing global stress perceptions.

Evidences in multidisciplinary management of rectal cancer

International Nuclear Information System (INIS)

De Bari, B.; Bosset, J.F.; Gerard, J.P.; Maingon, P.; Valentini, V.

2012-01-01

In the last 10 years, a number of important European randomized published studies investigated the optimal management of rectal cancer. In order to define an evidence-based approach of the clinical practice based, an international consensus conference was organized in Italy under the endorsement of European Society of Medical Oncology (ESMO), European Society of Surgical Oncology (ESSO) and European Society of Therapeutic Radiation Oncology (ESTRO). The aim of this article is to present highlights of multidisciplinary rectal cancer management and to compare the conclusions of the international conference on 'Multidisciplinary Rectal Cancer Treatment: looking for an European Consensus' (EURECA-CC2) with the new National Comprehensive Cancer Network (NCCN) guidelines. (authors)

Management of low (favourable)-risk prostate cancer.

Science.gov (United States)

Carter, H Ballentine

2011-12-01

What's known on the subject? and What does the study add? Most men who are diagnosed with favourable-risk prostate cancer undergo some form of active intervention, despite evidence that treatment will not improve health outcomes for many. The decision to undergo treatment after diagnosis is, in part, related to the inability to precisely determine the long-term risk of harm without treatment. Nevertheless, physicians should consider patient age, overall health, and preferences for living with cancer and the potential side effects of curative treatments, before recommending a management option. This is especially important for older men, given the high level of evidence that those with low-risk disease are unlikely to accrue any benefit from curative intervention. What is known on the subject: Over treatment of favourable-risk prostate cancer is common, especially among older men. What does the study add: A review of the natural history of favourable-risk prostate cancer in the context of choices for management of the disease. • The management of favourable-risk prostate cancer is controversial, and in the absence of controlled trials to inform best practice, choices are driven by personal beliefs with resultant wide variation in practice patterns. • Men with favourable-risk prostate cancer diagnosed today often undergo treatments that will not improve overall health outcomes. • A shared-decision approach for selecting optimal management of favourable-risk disease should account for patient age, overall health, and preferences for living with cancer and the potential side effects of curative treatments. © 2011 THE AUTHOR. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

Physical activity for women with breast cancer after adjuvant therapy.

Science.gov (United States)

Lahart, Ian M; Metsios, George S; Nevill, Alan M; Carmichael, Amtul R

2018-01-29

Women with a diagnosis of breast cancer may experience short- and long-term disease and treatment-related adverse physiological and psychosocial outcomes. These outcomes can negatively impact prognosis, health-related quality of life (HRQoL), and psychosocial and physical function. Physical activity may help to improve prognosis and may alleviate the adverse effects of adjuvant therapy. To assess effects of physical activity interventions after adjuvant therapy for women with breast cancer. We searched the Cochrane Breast Cancer Group (CBCG) Specialised Registry, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Physiotherapy Evidence Database (PEDro), SPORTDiscus, PsycINFO, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform, on 18 September 2015. We also searched OpenGrey and Healthcare Management Information Consortium databases. We searched for randomised and quasi-randomised trials comparing physical activity interventions versus control (e.g. usual or standard care, no physical activity, no exercise, attention control, placebo) after adjuvant therapy (i.e. after completion of chemotherapy and/or radiation therapy, but not hormone therapy) in women with breast cancer. Two review authors independently selected studies, assessed risk of bias, and extracted data. We contacted trial authors to ask for additional information when needed. We calculated an overall effect size with 95% confidence intervals (CIs) for each outcome and used GRADE to assess the quality of evidence for the most important outcomes. We included 63 trials that randomised 5761 women to a physical activity intervention (n = 3239) or to a control (n = 2524). The duration of interventions ranged from 4 to 24 months, with most lasting 8 or 12 weeks (37 studies). Twenty-eight studies included aerobic exercise only, 21 involved aerobic

Cardiorespiratory fitness and physical function in children with cancer from diagnosis throughout treatment

DEFF Research Database (Denmark)

Thorsteinsson, Troels; Larsen, Hanne Bækgaard; Schmiegelow, Kjeld

2017-01-01

Background: Children with cancer experience severe reductions in physical fitness and functionality during and following intensive treatment. This may negatively impact their quality of life. Purpose: To describe the physical capacity and functionality of children with cancer during and after...... treatment as well as the feasibility of physical activity intervention in the Rehabilitation including Social and Physical activity and Education in Children and Teenagers with Cancer study. Patients and methods: The study included children diagnosed from January 2013 to April 2016 with paediatric cancer...... or Langerhans cell histiocytosis, all treated with chemotherapy. Seventy-five of 78 consecutively eligible children (96.2%) were included. Median age was 11 years (range 6‒18). The physical capacity and function were assessed based on testing of physical strength, balance and cardiorespiratory fitness. Children...

The impact of cancer and its treatment on physical activity levels and quality of life among young Hong Kong Chinese cancer patients.

Science.gov (United States)

Lam, Katherine K W; Li, William H C; Chiu, S Y; Chan, Godfrey C F

2016-04-01

Despite the evidence that regular physical activity can have beneficial effects on the physical and psychological well-being of cancer patients, a review of the literature reveals that a majority of young cancer patients fail to attain the same levels of physical activity that they had before contracting the disease. This study is to examine the impact of cancer and its treatment on the physical activity levels and quality of life of young Hong Kong Chinese cancer patients. A cross-sectional study was conducted, with 76 young cancer patients admitted for treatment to a pediatric oncology unit, and another similar age group of 148 healthy counterparts from the two integrated child and youth service centers were invited to join the study. The study found that the current physical activity levels of young cancer patients were markedly reduced when compared with their pre-cancer situation. Moreover, they were significantly less active in performing physical exercise, and reported lower levels of self-efficacy and quality of life than their healthy counterparts. The results of the hierarchical multiple regression analysis showed that physical activity is an important indicator of quality of life among young cancer patients. The results provide further evidence that cancer and its treatment have negative effects on physical and psychological well-being and quality of life among young cancer patients. There is an imperative need for healthcare professionals to promote the adoption of regular physical activity among such patients, even during the treatment itself. Copyright © 2016 Elsevier Ltd. All rights reserved.

Clinically Relevant Physical Benefits of Exercise Interventions in Breast Cancer Survivors.

Science.gov (United States)

Kirkham, Amy A; Bland, Kelcey A; Sayyari, Sarah; Campbell, Kristin L; Davis, Margot K

2016-02-01

Evidence is currently limited for the effect of exercise on breast cancer clinical outcomes. However, several of the reported physical benefits of exercise, including peak oxygen consumption, functional capacity, muscle strength and lean mass, cardiovascular risk factors, and bone health, have established associations with disability, cardiovascular disease risk, morbidity, and mortality. This review will summarize the clinically relevant physical benefits of exercise interventions in breast cancer survivors and discuss recommendations for achieving these benefits. It will also describe potential differences in intervention delivery that may impact outcomes and, lastly, describe current physical activity guidelines for cancer survivors.

Physical activity and risk of prostate and bladder cancer in China: The South and East China case-control study on prostate and bladder cancer.

Directory of Open Access Journals (Sweden)

Raoul C Reulen

Full Text Available Recent meta-analyses have suggested a modest protective effect of high levels of physical activity on developing both prostate and bladder cancer, but significant heterogeneity between studies included in these meta-analyses existed. To our knowledge, few Chinese studies investigated the association between physical activity and prostate cancer and none between physical activity and bladder cancer. Given the inconsistencies between previous studies and because studies on the relation between physical activity and prostate and bladder cancer in China are scarce, it remains elusive whether there is a relationship between physical activity and prostate and bladder cancer within the Chinese population.We investigated the association between physical activity and risk of developing prostate and bladder cancer within a hospital-based case-control study in the East and South of China among 260 and 438 incident prostate and bladder cancer cases, respectively, and 427 controls. A questionnaire was administered to measure physical activity as metabolic equivalents (METs. Random effects logistic regression was used to calculate odds ratios (ORs of prostate and bladder cancer for different levels of physical activity and for the specific activities of walking and cycling.Increasing overall physical activity was associated with a significant reduction in prostate cancer risk (Ptrend = 0.04 with the highest activity tertile level showing a nearly 50% reduction in prostate cancer risk (OR = 0.53, 95%CI: 0.28-0.98. Overall physical activity was not significantly associated with risk of bladder cancer (Ptrend = 0.61, neither were vigorous (Ptrend = 0.60 or moderate levels of physical activity (Ptrend = 0.21. Walking and cycling were not significantly associated with either prostate (Ptrend> = 0.62 or bladder cancer risk (Ptrend> = 0.25.The findings of this largest ever case-control study in China investigating the relationship between physical activity and

Penile Cancer: Contemporary Lymph Node Management.

Science.gov (United States)

O'Brien, Jonathan S; Perera, Marlon; Manning, Todd; Bozin, Mike; Cabarkapa, Sonja; Chen, Emily; Lawrentschuk, Nathan

2017-06-01

In penile cancer, the optimal diagnostics and management of metastatic lymph nodes are not clear. Advances in minimally invasive staging, including dynamic sentinel lymph node biopsy, have widened the diagnostic repertoire of the urologist. We aimed to provide an objective update of the recent trends in the management of penile squamous cell carcinoma, and inguinal and pelvic lymph node metastases. We systematically reviewed several medical databases, including the Web of Science® (with MEDLINE®), Embase® and Cochrane databases, according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) guidelines. The search terms used were penile cancer, lymph node, sentinel node, minimally invasive, surgery and outcomes, alone and in combination. Articles pertaining to the management of lymph nodes in penile cancer were reviewed, including original research, reviews and clinical guidelines published between 1980 and 2016. Accurate and minimally invasive lymph node staging is of the utmost importance in the surgical management of penile squamous cell carcinoma. In patients with clinically node negative disease, a growing body of evidence supports the use of sentinel lymph node biopsies. Dynamic sentinel lymph node biopsy exposes the patient to minimal risk, and results in superior sensitivity and specificity profiles compared to alternate nodal staging techniques. In the presence of locoregional disease, improvements in inguinal or pelvic lymphadenectomy have reduced morbidity and improved oncologic outcomes. A multimodal approach of chemotherapy and surgery has demonstrated a survival benefit for patients with advanced disease. Recent developments in lymph node management have occurred in penile cancer, such as minimally invasive lymph node diagnosis and intervention strategies. These advances have been met with a degree of controversy in the contemporary literature. Current data suggest that dynamic sentinel lymph node biopsy provides excellent

Association of Physical Activity by Type and Intensity With Digestive System Cancer Risk.

Science.gov (United States)

Keum, NaNa; Bao, Ying; Smith-Warner, Stephanie A; Orav, John; Wu, Kana; Fuchs, Charles S; Giovannucci, Edward L

2016-09-01

Accumulating evidence indicates that common carcinogenic pathways may underlie digestive system cancers. Physical activity may influence these pathways. Yet, to our knowledge, no previous study has evaluated the role of physical activity in overall digestive system cancer risk. To examine the association between physical activity and digestive system cancer risk, accounting for amount, type (aerobic vs resistance), and intensity of physical activity. A prospective cohort study followed 43 479 men from the Health Professionals Follow-up Study from 1986 to 2012. At enrollment, the eligible participants were 40 years or older, were free of cancer, and reported physical activity. Follow-up rates exceeded 90% in each 2-year cycle. The amount of total physical activity expressed in metabolic equivalent of task (MET)-hours/week. Incident cancer of the digestive system encompassing the digestive tract (mouth, throat, esophagus, stomach, small intestine, and colorectum) and digestive accessory organs (pancreas, gallbladder, and liver). Over 686 924 person-years, we documented 1370 incident digestive system cancers. Higher levels of physical activity were associated with lower digestive system cancer risk (hazard ratio [HR], 0.74 for ≥63.0 vs ≤8.9 MET-hours/week; 95% CI, 0.59-0.93; P value for trend = .003). The inverse association was more evident with digestive tract cancers (HR, 0.66 for ≥63.0 vs ≤8.9 MET-hours/week; 95% CI, 0.51-0.87) than with digestive accessary organ cancers. Aerobic exercise was particularly beneficial against digestive system cancers, with the optimal benefit observed at approximately 30 MET-hours/week (HR, 0.68; 95% CI, 0.56-0.83; P value for nonlinearity = .02). Moreover, as long as the same level of MET-hour score was achieved from aerobic exercise, the magnitude of risk reduction was similar regardless of intensity of aerobic exercise. Physical activity, as indicated by MET-hours/week, was inversely associated with the risk of

Background risk of breast cancer and the association between physical activity and mammographic density.

Science.gov (United States)

Trinh, Thang; Eriksson, Mikael; Darabi, Hatef; Bonn, Stephanie E; Brand, Judith S; Cuzick, Jack; Czene, Kamila; Sjölander, Arvid; Bälter, Katarina; Hall, Per

2015-04-02

High physical activity has been shown to decrease the risk of breast cancer, potentially by a mechanism that also reduces mammographic density. We tested the hypothesis that the risk of developing breast cancer in the next 10 years according to the Tyrer-Cuzick prediction model influences the association between physical activity and mammographic density. We conducted a population-based cross-sectional study of 38,913 Swedish women aged 40-74 years. Physical activity was assessed using the validated web-questionnaire Active-Q and mammographic density was measured by the fully automated volumetric Volpara method. The 10-year risk of breast cancer was estimated using the Tyrer-Cuzick (TC) prediction model. Linear regression analyses were performed to assess the association between physical activity and volumetric mammographic density and the potential interaction with the TC breast cancer risk. Overall, high physical activity was associated with lower absolute dense volume. As compared to women with the lowest total activity level (association was seen for any type of physical activity among women with association between total activity and absolute dense volume was modified by the TC breast cancer risk (P interaction = 0.05). As anticipated, high physical activity was also associated with lower non-dense volume. No consistent association was found between physical activity and percent dense volume. Our results suggest that physical activity may decrease breast cancer risk through reducing mammographic density, and that the physical activity needed to reduce mammographic density may depend on background risk of breast cancer.

The European initiative for quality management in lung cancer care

DEFF Research Database (Denmark)

Blum, Torsten G; Rich, Anna; Baldwin, David

2014-01-01

. The Task Force undertook four projects: 1) a narrative literature search on quality management of lung cancer; 2) a survey of national and local infrastructure for lung cancer care in Europe; 3) a benchmarking project on the quality of (inter)national lung cancer guidelines in Europe; and 4) a feasibility...... study of prospective data collection in a pan-European setting. There is little peer-reviewed literature on quality management in lung cancer care. The survey revealed important differences in the infrastructure of lung cancer care in Europe. The European guidelines that were assessed displayed wide...... countries. The European Initiative for Quality Management in Lung Cancer Care has provided the first comprehensive snapshot of lung cancer care in Europe....

Chronic Recreational Physical Inactivity and Epithelial Ovarian Cancer Risk: Evidence from the Ovarian Cancer Association Consortium.

Science.gov (United States)

Cannioto, Rikki; LaMonte, Michael J; Risch, Harvey A; Hong, Chi-Chen; Sucheston-Campbell, Lara E; Eng, Kevin H; Brian Szender, J; Chang-Claude, Jenny; Schmalfeldt, Barbara; Klapdor, Ruediger; Gower, Emily; Minlikeeva, Albina N; Zirpoli, Gary R; Bandera, Elisa V; Berchuck, Andrew; Cramer, Daniel; Doherty, Jennifer A; Edwards, Robert P; Fridley, Brooke L; Goode, Ellen L; Goodman, Marc T; Hogdall, Estrid; Hosono, Satoyo; Jensen, Allan; Jordan, Susan; Kjaer, Susanne K; Matsuo, Keitaro; Ness, Roberta B; Olsen, Catherine M; Olson, Sara H; Leigh Pearce, Celeste; Pike, Malcolm C; Anne Rossing, Mary; Szamreta, Elizabeth A; Thompson, Pamela J; Tseng, Chiu-Chen; Vierkant, Robert A; Webb, Penelope M; Wentzensen, Nicolas; Wicklund, Kristine G; Winham, Stacey J; Wu, Anna H; Modugno, Francesmary; Schildkraut, Joellen M; Terry, Kathryn L; Kelemen, Linda E; Moysich, Kirsten B

2016-07-01

Despite a large body of literature evaluating the association between recreational physical activity and epithelial ovarian cancer (EOC) risk, the extant evidence is inconclusive, and little is known about the independent association between recreational physical inactivity and EOC risk. We conducted a pooled analysis of nine studies from the Ovarian Cancer Association Consortium to investigate the association between chronic recreational physical inactivity and EOC risk. In accordance with the 2008 Physical Activity Guidelines for Americans, women reporting no regular, weekly recreational physical activity were classified as inactive. Multivariable logistic regression was utilized to estimate the ORs and 95% confidence intervals (CI) for the association between inactivity and EOC risk overall and by subgroups based upon histotype, menopausal status, race, and body mass index. The current analysis included data from 8,309 EOC patients and 12,612 controls. We observed a significant positive association between inactivity and EOC risk (OR = 1.34; 95% CI, 1.14-1.57), and similar associations were observed for each histotype. In this large pooled analysis examining the association between recreational physical inactivity and EOC risk, we observed consistent evidence of an association between chronic inactivity and all EOC histotypes. These data add to the growing body of evidence suggesting that inactivity is an independent risk factor for cancer. If the apparent association between inactivity and EOC risk is substantiated, additional work via targeted interventions should be pursued to characterize the dose of activity required to mitigate the risk of this highly fatal disease. Cancer Epidemiol Biomarkers Prev; 25(7); 1114-24. ©2016 AACR. ©2016 American Association for Cancer Research.

Impact of physical activity in group versus individual physical activity on fatigue in patients with breast cancer: A pilot study.

Science.gov (United States)

Desbiens, Christine; Filion, Myriam; Brien, Marie-Chantale; Hogue, Jean-Charles; Laflamme, Christian; Lemieux, Julie

2017-10-01

Physical activity improves the quality of life of cancer survivors, but whether there is a difference between individual vs. group physical activity is unknown. To compare fatigue at 12 weeks in breast cancer survivors after participation in a program of group vs. individual video-assisted physical activity. This was a randomized phase II pilot study carried out in breast cancer survivors at a tertiary breast cancer center. Eligible patients were randomized to individual or group 12-week physical activity program. The primary outcome was fatigue (FACT-F). Aerobic capacity (6-min walk test), muscular strength, and quality-of-life (FACT-G and FACT-B) were assessed. Because of poor accrual, 200 consecutive breast cancer patients were surveyed about their physical activity habits to assess reasons for low recruitment. For all participants (n = 26; n = 12 for group vs. n = 14 for individual), there were some improvement in FACT-F, FACT-G, FACT-B, physical activity level, aerobic capacity, and shoulder strength. Among the 200 patients surveyed, 58% were interested to increase their physical activity level, 15% declared that they were already exercising enough, 9% declared being unable to, 3% declared having no time, and 2% declared having no interest, and other reasons (13%). Among the 200 patients surveyed, 25% preferred in group, 57% preferred alone, and 18% had no preference. Low recruitment precluded conclusions about the efficacy of physical activity practiced in group vs. individually, but both groups derived a benefit. Low willingness to change exercising habits could be the biggest barrier to physical activity in breast cancer survivors. Copyright © 2017 Elsevier Ltd. All rights reserved.

Surgical management of non-small-cell lung cancer

Directory of Open Access Journals (Sweden)

Bamousa Ahmed

2008-10-01

Full Text Available Surgery plays a major role in the management of patients with lung cancer. Surgery is not only the main curative treatment modality in patients with early-stage lung cancer but it also has a significant role in the initial workup for the diagnosis and staging of lung cancer. This article describes the surgical management of patients with lung cancer. Surgical resection for lung cancer is still regarded as the most effective method for controlling the primary tumor, provided it is resectable for cure and the risks of the procedure are low. The 5-year survival rare following complete resection (R0 of a lung cancer is stage dependent [Table 1]. [1-3] Incomplete resection (R1, R2 rarely, if ever, cures the patient.

Relationship between Resilience, Psychological Distress and Physical Activity in Cancer Patients: A Cross-Sectional Observation Study.

Directory of Open Access Journals (Sweden)

Martin Matzka

Full Text Available Psychological distress remains a major challenge in cancer care. The complexity of psychological symptoms in cancer patients requires multifaceted symptom management tailored to individual patient characteristics and active patient involvement. We assessed the relationship between resilience, psychological distress and physical activity in cancer patients to elucidate potential moderators of the identified relationships.A cross-sectional observational study to assess the prevalence of symptoms and supportive care needs of oncology patients undergoing chemotherapy, radiotherapy or chemo-radiation therapy in a tertiary oncology service. Resilience was assessed using the 10-item Connor-Davidson Resilience Scale (CD-RISC 10, social support was evaluated using the 12-item Multidimensional Scale of Perceived Social Support (MSPSS and both psychological distress and activity level were measured using corresponding subscales of the Rotterdam Symptom Checklist (RSCL. Socio-demographic and medical data were extracted from patient medical records. Correlation analyses were performed and structural equation modeling was employed to assess the associations between resilience, psychological distress and activity level as well as selected socio-demographic variables.Data from 343 patients were included in the analysis. Our revised model demonstrated an acceptable fit to the data (χ2(163 = 313.76, p = .000, comparative fit index (CFI = .942, Tucker-Lewis index (TLI = .923, root mean square error of approximation (RMSEA = .053, 90% CI [.044.062]. Resilience was negatively associated with psychological distress (β = -.59, and positively associated with activity level (β = .20. The relationship between resilience and psychological distress was moderated by age (β = -0.33 but not social support (β = .10, p = .12.Cancer patients with higher resilience, particularly older patients, experience lower psychological distress. Patients with higher resilience are

Exploratory study of impact of cancer-related posttraumatic stress symptoms on diabetes self-management among cancer survivors.

Science.gov (United States)

James, Janey; Harris, Yael T; Kronish, Ian M; Wisnivesky, Juan P; Lin, Jenny J

2018-02-01

Posttraumatic stress symptoms (PTSS) can be triggered by a diagnosis of a potentially life-threatening illness such as cancer. Little is known about the impact of cancer-related PTSS symptoms on self-management behaviors for comorbid chronic medical conditions such as diabetes mellitus (DM). We recruited patients with DM and a recent diagnosis of early-stage cancer from 2 medical centers in New York City. Cancer-related PTSS were assessed using the Impact of Events Scale (score ≥ 26). DM self-management behaviors (medication adherence, exercise, healthy diet, and glucose testing) were measured 3 months later. Logistic regression was used to assess the association between cancer-related PTSS symptoms and DM self-management behaviors, adjusting for gender, marital status, and anxiety symptoms. Of 56 participants recruited, 33% reported cancer-related PTSS symptoms. Elevated cancer-related PTSS symptoms were associated with lack of healthy diet (odds ratio: 0.08, 95% confidence interval: 0.01-0.62). Early-stage cancer survivors with cancer-related PTSS symptoms were less likely to adhere to some DM self-management behaviors. Providers should recognize the impact of cancer-related PTSS symptoms to better support comorbid disease management in cancer survivors. Copyright © 2017 John Wiley & Sons, Ltd.

Current management of oral cancer. A multidisciplinary approach.

Science.gov (United States)

Ord, R A; Blanchaert, R H

2001-11-01

Recent basic science discoveries have contributed to our understanding of the etiology of oral cancer and allowed us to consider innovative approaches to therapy. The authors evaluated and summarized current approaches to the management of oral cancer, emphasizing the multidisciplinary team approach to coordinate surgery, radiation therapy and chemotherapy. Current concepts in management, including complications of therapy, are described. State-of-the-art surgical techniques can spare patients with oral cancer from much of the morbidity and complications common in the past. The refinement of treatment strategies reduces complications and improves efficacy. Many exciting new clinical trials in the areas of gene therapy and immunomodulation are showing promise. Management of oral cancer has undergone radical change in the past 10 years and continues to evolve rapidly. Discoveries in molecular biology, diagnosis, surgery, radiation therapy and medical oncology have altered many traditional concepts and practices. General dental practitioners need to understand current treatment modalities for oral and pharyngeal cancers to determine to whom they should refer patients for the most appropriate treatment, and to make recommendations regarding complications associated with these cancers.

Neighborhood disadvantage, physical activity barriers, and physical activity among African American breast cancer survivors

Directory of Open Access Journals (Sweden)

Antwan Jones

2015-01-01

Higher renter rates and individual barriers both contribute to lower levels of physical activity in African American breast cancer survivors. These data suggest that the potential for constant residential turnover (via rentership and perceived barriers may increase physical inactivity even where facilities may be available.

Management of gastric cancer in Asia: resource-stratified guidelines.

Science.gov (United States)

Shen, Lin; Shan, Yan-Shen; Hu, Huang-Ming; Price, Timothy J; Sirohi, Bhawna; Yeh, Kun-Huei; Yang, Yi-Hsin; Sano, Takeshi; Yang, Han-Kwang; Zhang, Xiaotian; Park, Sook Ryun; Fujii, Masashi; Kang, Yoon-Koo; Chen, Li-Tzong

2013-11-01

Gastric cancer is the fourth most common cancer globally, and is the second most common cause of death from cancer worldwide. About three-quarters of newly diagnosed cases in 2008 were from Asian countries. With a high mortality-to-incidence ratio, management of gastric cancer is challenging. We discuss evidence for optimum management of gastric cancer in aspects of screening and early detection, diagnosis, and staging; endoscopic and surgical intervention; and the concepts of perioperative, postoperative, and palliative chemotherapy and use of molecularly targeted therapy. Recommendations are formulated on the basis of the framework provided by the Breast Health Global Initiative, using the categories of basic, limited, enhanced, and maximum level. We aim to provide a stepwise strategy for management of gastric cancer applicable to different levels of health-care resources in Asian countries. Copyright © 2013 Elsevier Ltd. All rights reserved.

Improved physical fitness of cancer survivors : A randomised controlled trial comparing physical training with physical and cognitive-behavioural training

NARCIS (Netherlands)

May, Anne M.; Van Weert, Ellen; Korstjens, Irene; Hoekstra-Weebers, Josette E. H. M.; Van Der Schans, Cees P.; Zonderland, Maria L.; Mesters, Ilse; Van Den Borne, Bart; Ros, Wynand J. G.

2008-01-01

We compared the effect of a group-based 12-week supervised exercise programme, i.e. aerobic and resistance exercise, and group sports, with that of the same programme combined with cognitive-behavioural training on physical fitness and activity of cancer survivors. One hundred and forty seven cancer

New data libraries and physics data management tools

International Nuclear Information System (INIS)

Han, M; Kim, C H; Seo, H; Pia, M G; Saracco, P; Augelli, M; Hauf, S; Kuster, M; Moneta, L; Quintieri, L

2011-01-01

A number of physics data libraries for Monte Carlo simulation are reviewed. The development of a package for the management of physics data is described: its design, implementation and computational benchmarks. This package improves the data management tools originally developed for Geant4 electromagnetic physics models based on data libraries. The implementation exploits recent evolutions of the C++ libraries appearing in the C++0x draft, which are intended for inclusion in the next C++ ISO Standard. The new tools improve the computational performance of physics data management.

Recent BWR fuel management reactor physics advances

International Nuclear Information System (INIS)

Crowther, R.L.; Congdon, S.P.; Crawford, B.W.; Kang, C.M.; Martin, C.L.; Reese, A.P.; Savoia, P.J.; Specker, S.R.; Welchly, R.

1982-01-01

Improvements in BWR fuel management have been under development to reduce uranium and separative work (SWU) requirements and reduce fuel cycle costs, while also maintaining maximal capacity factors and high fuel reliability. Improved reactor physics methods are playing an increasingly important role in making such advances feasible. The improved design, process computer and analysis methods both increase knowledge of the thermal margins which are available to implement fuel management advance, and improve the capability to reliably and efficiently analyze and design for fuel management advances. Gamma scan measurements of the power distributions of advanced fuel assembly and advanced reactor core designs, and improved in-core instruments also are important contributors to improving 3-d predictive methods and to increasing thermal margins. This paper is an overview of the recent advances in BWR reactor physics fuel management methods, coupled with fuel management and core design advances. The reactor physics measurements which are required to confirm the predictions of performance fo fuel management advances also are summarized

Complementary therapies for symptom management in cancer patients

Directory of Open Access Journals (Sweden)

Aanchal Satija

2017-01-01

Full Text Available Cancer patients are often poly-symptomatic which distressingly affects their quality of lives (QOLs. Alhough, conventional management provides adequate symptom control, yet is coupled with some limitations. Complementary therapies (CTs have shown beneficial effects in cancer patients for symptomatic relief. The aim of this article is to provide evidence-based review of commonly used CTs for symptom management in cancer care. Hypnosis has promising evidence to be used for managing symptoms such as pain, chemotherapy-induced nausea/vomiting, distress, fatigue, and hot flashes. Guided imagery increases comfort and can be used as a psycho-supportive therapy. Meditation substantially improves psychological function, mental health, and QOL. Cognitive behavioral therapies effectively reduce pain, distress, fatigue, anxiety, and depression; and improve subjective sleep outcomes along with mood and QOL. Yoga has short term beneficial effects for anxiety, depression, fatigue, perceived stress, QOL, and well-being. T'ai Chi and qigong are beneficial adjunctive therapies for supportive cancer care, but their role in reducing cancer pain is not well proven. Acupuncture is effective for reducing treatment related side-effects, pain and fatigue. Other therapies such as massage techniques, energy therapies, and spiritual interventions have also demonstrated positive role in managing cancer-related symptoms and improve overall well-being. However, the clinical effectiveness of these therapies for symptom management in cancer patients cannot be concluded due to poor strength of evidence. Nonetheless, these are relatively free from risks and hence can be given along with conventional treatments. Only by tailoring these therapies as per patient's beliefs and preferences, optimal patient-centered holistic care can be provided.

Parents' voice in managing the pain of children with cancer during palliative care

Directory of Open Access Journals (Sweden)

Rina Mariyana

2018-01-01

Full Text Available Context: Pain experienced by children can adversely affect their growth and development. Pain is a major health problem for cancer patients and remains an unresolved problem.Aim: To know how the experiences of mothers managing their children's pain during palliative care following cancer diagnosis.Background: Pain experienced by children can adversely affect their growth and development.Subject and Methods: Using qualitative methods within a descriptive phenomenological approach, in-depth interviews were conducted with parents (mostly mothers of eight children diagnosed with cancer. The data were collected using the snowball sampling method.Results: Participants experienced in managing the pain of children with cancer. Analysis of the results identified 8 themes: the dimensions of pain experienced by children undergoing palliative care; mothers' physical and psychological responses; mothers' emotional responses; barriers encountered by mothers when taking care of their child at home; mothers' interventions to reduce their child's pain; mothers' efforts to distract their child from pain; giving encouragement when the child is in pain; and mothers' efforts and prayers to make their child comfort.Conclusion: It can be concluded that the child's pain is the main cause of mothers' stress and pressure and also affects the daily lives of mothers and children. Along with the most effective intervention, nurses need to provide mothers and children with adequate information about cancer pain.

Efficacy of Mobile Health Care Application and Wearable Device in Improvement of Physical Performance in Colorectal Cancer Patients Undergoing Chemotherapy.

Science.gov (United States)

Cheong, In Yae; An, So Yeon; Cha, Won Chul; Rha, Mi Yong; Kim, Seung Tae; Chang, Dong Kyung; Hwang, Ji Hye

2018-06-01

The use of a mobile health care application, the delivery of health care or health care-related services through the use of portable devices, to manage functional loss, treatment-related toxicities, and impaired quality of life in cancer patients during chemotherapy through supervised self-management has been increasing. The aim of the present study was to evaluate the efficacy and feasibility of comprehensive mobile health care using a tailored rehabilitation program for colorectal cancer patients undergoing active chemotherapy. A total of 102 colorectal cancer patients undergoing chemotherapy underwent 12 weeks of smartphone aftercare through provision of a mobile application and wearable device that included a rehabilitation exercise program and information on their disease and treatment. The grip strength test, 30-second chair stand test, 2-minute walk test, amount of physical activity (International Physical Activity Questionnaire short-form), quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30), and nutritional status (Patient-generated Subjective Global Assessment) were assessed and measured at baseline, at mid-intervention (6 weeks), and at completion of the intervention (12 weeks). The rehabilitation exercise intensity was adjusted by the test results at every assessment and through real-time communication between the patients and clinicians. Of the 102 patients, 75 completed all 12 weeks of the smartphone aftercare rehabilitation program. The lower extremity strength (P mobile health care application was effective in improving patients' physical capacity and treatment-related symptoms even during active chemotherapy. Copyright © 2018 Elsevier Inc. All rights reserved.

Differentiated Thyroid Cancer Multidisciplinary Management at the Colombian National Cancer Institute

International Nuclear Information System (INIS)

Garavito, Gloria; Llamas O, Augusto; Cadena, Enrique; De Los Reyes, Amelia

2009-01-01

Thyroid cancer is the most common malignant disease of the endocrine system. Two hundred and twenty-one new cases were diagnosed at the National Cancer Institute of Colombia (NCI) in 2006, roughly 4% of all new cancer cases. Weekly multidisciplinary decision-making meetings on thyroid cancer management have been held at the NCI since 1994. This article covers the body of knowledge gathered through 14 years of interdisciplinary collaboration where experience has been combined with the best available evidence.

Internet-based physical activity intervention for women with a family history of breast cancer.

Science.gov (United States)

Hartman, Sheri J; Dunsiger, Shira I; Marinac, Catherine R; Marcus, Bess H; Rosen, Rochelle K; Gans, Kim M

2015-12-01

Physical inactivity is a modifiable risk factor for breast cancer. Physical activity interventions that can be delivered through the Internet have the potential to increase participant reach. The efficacy of an Internet-based physical activity intervention was tested in a sample of women at an elevated risk for breast cancer. A total of 55 women with at least 1 first-degree relative with breast cancer (but no personal history of breast cancer) were randomized to a 3-month theoretically grounded Internet-based physical activity intervention or an active control arm. Minutes of moderate to vigorous physical activity, psychosocial mediators of physical activity adoption and maintenance, as well as worry and perceived risk of developing breast cancer were assessed at baseline, 3-month, and 5-month follow up. Participants were on average 46.2 (SD = 11.4) years old with a body mass index of 27.3 (SD = 4.8) kg/m2. The intervention arm significantly increased minutes of moderate to vigorous physical activity compared to the active control arm at 3 months (213 vs. 129 min/week) and 5 months (208 vs. 119 min/week; both ps Internet-based physical activity intervention may substantially increase physical activity in women with a family history of breast cancer. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Need for a new skin cancer management strategy

NARCIS (Netherlands)

Geer, van der S.; Reijers, H.A.; Tuijl, van H.F.J.M.; Vries, de H.; Krekels, G.A.M.

2010-01-01

The worldwide incidence of skin cancer (especially nonmelanoma skin cancer) has increased markedly during the last decades. Skin cancer should be considered a chronic disease. To manage the future costs and quality of care for patients with skin cancer, a revised health strategy is needed. These new

Physical activity and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

DEFF Research Database (Denmark)

Johnsen, Nina Føns; Tjønneland, Anne; Thomsen, Birthe L R

2009-01-01

incidence rate and occupational activity and leisure time activity in terms of participation in sports, cycling, walking and gardening; a metabolic equivalent (MET) score based on weekly time spent on the 4 activities; and a physical activity index. MET hours per week of leisure time activity, higher score......The evidence concerning the possible association between physical activity and the risk of prostate cancer is inconsistent and additional data are needed. We examined the association between risk of prostate cancer and physical activity at work and in leisure time in the European Prospective...... in the physical activity index, participation in any of the 4 leisure time activities, and the number of leisure time activities in which the participants were active were not associated with prostate cancer incidence. However, higher level of occupational physical activity was associated with lower risk...

Pain management in cancer survivorship

DEFF Research Database (Denmark)

Kurita, Geana Paula; Sjøgren, Per

2015-01-01

BACKGROUND: The number of patients surviving cancer disease has increased in last decades. Consequently, an emerging population with different needs due to long-term or late effects of cancer disease and/or treatment, e.g. chronic pain, is of major concern. EPIDEMIOLOGY: Chronic pain is one of th...... survivors. Pain management strategies are discussed according to the biopsychosocial model and with the rapidly growing number of cancer survivors the establishment of multidisciplinary clinics as a part of comprehensive cancer centers are proposed.......BACKGROUND: The number of patients surviving cancer disease has increased in last decades. Consequently, an emerging population with different needs due to long-term or late effects of cancer disease and/or treatment, e.g. chronic pain, is of major concern. EPIDEMIOLOGY: Chronic pain is one...... of the main problems in this population and prevalence varies between 16% and 50%. Most information derives from breast cancer patients assessed by surveys from national or local institutional databases. A Danish population-based survey estimated that 41.5% of all cancer survivors reported chronic pain. PAIN...

Religion, Spirituality, and Physical Health in Cancer Patients: A Meta-Analysis

Science.gov (United States)

Jim, Heather S.L.; Pustejovsky, James; Park, Crystal L.; Danhauer, Suzanne C.; Sherman, Allen C.; Fitchett, George; Merluzzi, Thomas V.; Munoz, Alexis R.; George, Login; Snyder, Mallory A.; Salsman, John M.

2015-01-01

Background Whereas religion/spirituality (R/S) is important in its own right for many cancer patients, a large body of research has examined whether R/S is also associated with better physical health outcomes. This literature has been characterized by heterogeneity in sample composition, measures of R/S, and measures of physical health. In an effort to synthesize previous findings, we conducted a meta-analysis of the relationship between R/S and patient-reported physical health in cancer patients. Methods A search of PubMed, PsycInfo, CINAHL, and Cochrane Library yielded 2,073 abstracts, which were independently evaluated by pairs of raters. Meta-analysis was conducted on 497 effect sizes from 101 unique samples encompassing over 32,000 adult cancer patients. R/S measures were categorized into affective, behavioral, cognitive, and ‘other’ dimensions. Physical health measures were categorized into physical well-being, functional well-being, and physical symptoms. Average estimated correlations (Fisher's z) were calculated using generalized estimating equations with robust variance estimation. Results Overall R/S was associated with overall physical health (z=.153, p<.001); this relationship was not moderated by sociodemographic or clinical variables. Affective R/S was associated with physical well-being (z=.167, p<.001), functional well-being (z=.343, p<.001), and physical symptoms (z=.282, p<.001). Cognitive R/S was associated with physical well-being (z=.079, p<.05) and functional well-being (z=.090, p<.01). ‘Other’ R/S was associated with functional well-being (z=.100, p<.05). Conclusions Results of the current meta-analysis suggest that greater R/S is associated with better patient-reported physical health. These results underscore the importance of attending to patients’ religious and spiritual needs as part of comprehensive cancer care. PMID:26258868

Physical Activity during Cancer Treatment (PACT Study: design of a randomised clinical trial

Directory of Open Access Journals (Sweden)

de Wit G Ardine

2010-06-01

Full Text Available Abstract Background Fatigue is a major problem of cancer patients. Thirty percent of cancer survivors report serious fatigue three years after finishing treatment. There is evidence that physical exercise during cancer treatment reduces fatigue. This may also lead to an improvement of quality of life. Such findings may result in a decrease of healthcare related expenditures and societal costs due to sick leave. However, no studies are known that investigated these hypotheses. Therefore, the primary aim of our study is to assess the effect of exercise during cancer treatment on reducing complaints of fatigue and on reducing health service utilisation and sick leave. Methods/Design The Physical Activity during Cancer Treatment study is a multicentre randomised controlled trial in 150 breast and 150 colon cancer patients undergoing cancer treatment. Participants will be randomised to an exercise or a control group. In addition to the usual care, the exercise group will participate in an 18-week supervised group exercise programme. The control group will be asked to maintain their habitual physical activity pattern. Study endpoints will be assessed after 18 weeks (short term and after 9 months (long term. Validated questionnaires will be used. Primary outcome: fatigue (Multidimensional Fatigue Inventory and Fatigue Quality List and cost-effectiveness, health service utilisation and sick leave. Secondary outcome: health related quality of life (European Organisation Research and Treatment of Cancer-Quality of Life questionnaire-C30, Short Form 36 healthy survey, impact on functioning and autonomy (Impact on functioning and autonomy questionnaire, anxiety and depression (Hospital Anxiety and Depression Scale, physical fitness (aerobic peak capacity, muscle strength, body composition and cognitive-behavioural aspects. To register health service utilisation and sick leave, participants will keep diaries including the EuroQuol-5D. Physical activity level

Contemporary management of advanced laryngeal cancer.

Science.gov (United States)

Britt, Christopher J; Gourin, Christine G

2017-10-01

The treatment of advanced laryngeal cancer has undergone a paradigm shift in recent years, with an increase in chemoradiation for organ preservation and a decrease in primary surgery. This review will summarize the contemporary management of advanced laryngeal cancer and discuss treatment-related toxicity and strategies to improve outcomes. NA.

Conservative management of anal and rectal cancer

International Nuclear Information System (INIS)

Gerard, J.P.; Romestaing, P.; Montbarbon, X.

1989-01-01

The role of irradiation in the management of anal and rectal cancer has changed during the past ten years. In small epidermoid carcinomas of the anal canal (T1 T2) irradiation is in most departments considered the primary treatment, giving a 5-year survival rate of between 60 and 80% with good sphincter preservation. Even in larger tumors, irradiation can still offer some chance of cure without colostomy. Surgery remains the basic treatment of rectal cancer but irradiation is used in association with surgery in many cases. Radiotherapy is of value in the conservative management of cancer of the rectum in three situations: In small polypoid cancers contact X-ray therapy can give local control in about 90%. In cancers of the middle rectum, preoperative external irradiation may increase the chances of restorative surgery and reduce the risk of local relapse. In inoperable patients, external radiotherapy and/or intracavitary irradiation may cure some patients with infiltrating tumors (T2 T3) without colostomy. (orig.)

Incidental gallbladder cancer: what management?

Directory of Open Access Journals (Sweden)

Sidi Mohammed Bouchentouf

2011-11-01

Full Text Available Gallbladder cancer (GBC represents 3.8% of all gastrointestinal cancers and usually known to be of a poor prognosis. In 0.2–2.9% of cases, this cancer is found in cholecystectomy specimens. A better understanding of spread mode of this tumor helps a better surgical management. The aim of the present review is to underline the management of GBC based on the comprehension of risk factors and anatomic features. A Medline, PubMed database search was performed to identify articles published from 2000 to 2011 using the keywords ‘carcinoma of gallbladder’, ‘incidental gallbladder cancer’, ‘gallbladder neoplasm’ and ‘cholecystectomy’. Some pathological situations such as chronic lithiasis and biliopancreatic junction abnormalities have been clearly identified as predisposing to GBC. Laparoscopy increases peritoneal and parietal tumor dissemination, thus, it should not be performed when GBC is suspected. Most determinant prognostic factors are nodal, perineural and venous involvement, invasion of the cystic duct and the tumor differentiation. The simple cholecystectomy is sufficient for tumors classified as T1a; for other cancers exceeding the muscularis, radical re-resection is required due to the high risk of recurrence. This aggressive surgery improved the overall survival of patients. There is still no standard adjuvant treatment; patients should be included in prospective trials.

A Grounded Theory Approach to Physical Activity and Advanced Cancer

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Sonya S. Lowe

2015-11-01

Full Text Available Background: Physical activity has demonstrated benefits in cancer-related fatigue and physical functioning in early-stage cancer patients, however the role of physical activity at the end stage of cancer has not been established. To challenge positivist–empiricist assumptions, I am seeking to develop a new theoretical framework that is grounded in the advanced cancer patient’s experience of activity. Aim: To gain an in-depth understanding of the experience of activity and quality of life in advanced cancer patients. Objectives: (1 To explore the meaning of activity for advanced cancer patients in the context of their day-to-day life, (2 to elicit advanced cancer patients’ perceptions of activity with respect to their quality of life, and (3 to elicit advanced cancer patients’ views of barriers and facilitators to activity in the context of their day-to-day life. Study Design: A two-phase, cross-sectional, qualitative study will be conducted through the postpositivist lens of subtle realism and informed by the principles of grounded theory methods. Study Methods: Advanced cancer patients will be recruited through the outpatient department of a tertiary cancer center. For Phase one, participants will wear an activPAL™ activity monitor and fill out a daily record sheet for seven days duration. For Phase two, the activity monitor output and daily record sheets will be used as qualitative probes for face-to-face, semistructured interviews. Concurrent coding, constant comparative analysis, and theoretical sampling will continue with the aim of achieving as close as possible to theoretical saturation. Ethics and Discussion: Ethical and scientific approval will be obtained by all local institutional review boards prior to study commencement. The findings will generate new mid-level theory about the experience of activity and quality of life in advanced cancer patients and aid in the development of a new theoretical framework for designing

A randomized controlled trial of physical activity, dietary habit, and distress management with the Leadership and Coaching for Health (LEACH) program for disease-free cancer survivors.

Science.gov (United States)

Yun, Young Ho; Kim, Young Ae; Lee, Myung Kyung; Sim, Jin Ah; Nam, Byung-Ho; Kim, Sohee; Lee, Eun Sook; Noh, Dong-Young; Lim, Jae-Young; Kim, Sung; Kim, Si-Young; Cho, Chi-Heum; Jung, Kyung Hae; Chun, Mison; Lee, Soon Nam; Park, Kyong Hwa; Park, Sohee

2017-05-02

We aimed to evaluate the potential benefits of the Leadership and Coaching for Health (LEACH) program on physical activity (PA), dietary habits, and distress management in cancer survivors. We randomly assigned 248 cancer survivors with an allocation ratio of two-to-one to the LEACH program (LP) group, coached by long-term survivors, or the usual care (UC) group. At baseline, 3, 6, and 12 months, we used PA scores, the intake of vegetables and fruits (VF), and the Post Traumatic Growth Inventory (PTGI) as primary outcomes and, for secondary outcomes, the Ten Rules for Highly Effective Health Behavior adhered to and quality of life (QOL), the Hospital Anxiety and Depression Scale (HADS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). For primary outcomes, the two groups did not significantly differ in PA scores or VF intake but differed marginally in PTGI. For secondary outcomes, the LP group showed a significantly greater improvement in the HADS anxiety score, the social functioning score, and the appetite loss and financial difficulties scores of the EORTC QLQ-C30 scales from baseline to 3 months. From baseline to 12 months, the LP group showed a significantly greater decrease in the EORTC QLQ-C30 fatigue score and a significantly greater increase in the number of the Ten Rules for Highly Effective Health Behavior. Our findings indicate that the LEACH program, coached by long-term survivors, can provide effective management of the QOL of cancer survivors but not of their PA or dietary habits. Clinical trial information can be found for the following: NCT01527409 (the date when the trial was registered: February 2012).

Quality of Life and Its Association with Physical Activity among Different Types of Cancer Survivors.

Directory of Open Access Journals (Sweden)

Furong Tang

Full Text Available The main goal of this study was to compare the quality of life (QOL and its association with physical activity (PA among patients diagnosed with different types of cancer. Based on the results, we tentatively present suggestions for the cancer health care model.A cross-sectional study was conducted with 2915 cancer survivors recruited from multi-community cancer rehabilitation centers, all of which were affiliated with the Shanghai Cancer Rehabilitation Club. We collected data including socio-demographic characteristics and information about PA. All the subjects included were asked to complete the European Organization for Research and Treatment Quality of Life Questionnaires (EORTC QLQ-C30 and Functional Assessment of Cancer Therapy-General Questionnaire (FACT-G. Multiple linear regression models were employed to control the potential confounding factors.Lung cancer survivors reported the worst dyspnea. Colorectal cancer survivors claimed the highest level of constipation and diarrhea. Liver cancer survivors indicated greatest loss of appetite and financial difficulties. Generally, survivors with PA tended to reported better QOL, although these associations among liver cancer survivors were not statistically significant. Moreover, survivors of all cancer types who performed PA did not report significant lower level of constipation or diarrhea. The relationship between PA frequency and QOL among cancer survivors remained unexplored.Both QOL and its association with PA vary among survivors of different cancer types. The detailed results can assist clinicians and public health practitioners with improving health care management.

Pilot randomized trial of a volitional help sheet-based tool to increase leisure time physical activity in breast cancer survivors.

Science.gov (United States)

Chapman, Janine; Fletcher, Chloe; Flight, Ingrid; Wilson, Carlene

2018-05-16

To develop and test a volitional help sheet-based tool to improve physical activity in breast cancer survivors compared to a standard self-generated implementation intention intervention. Pilot randomized trial conducted online over 3 months. Participants were randomized to an online volitional help sheet (n = 50) or implementation intention (n = 51) intervention. Measures were taken at baseline, 1 and 3 months. The main outcome measure was moderate-strenuous leisure time physical activity. Secondary outcomes were health-related quality of life and mood. Participants exposed to the volitional help sheet and implementation intention interventions showed similar effects after 1 month, with both groups reporting a significant increase in moderate-strenuous physical activity. After 3 months, the initial increase in physical activity was maintained by the volitional help sheet group, but not the implementation intention group. Improvements were also found for negative affect and emotional quality of life. While both interventions show promise in promoting physical activity in breast cancer survivors, the volitional help sheet may be more effective for facilitating lasting change and emotional well-being. Findings suggest that the volitional help sheet may have potential to offer a cost-effective contribution to consumer-led tertiary preventive health. Future research should test these initial findings in a definitive trial. Statement of contribution What is already known on this subject? Physical activity is important for optimizing health in breast cancer survivors. Despite this, physical activity in this cohort remains low. Theory-based strategies are needed to help breast cancer survivors independently manage and maintain regular physical activity over the long term. What does this study add? Online planning interventions can improve physical activity in breast cancer survivors. Volitional help sheets, but not implementation intentions, show sustained

Relationship between physical activity, disability, and physical fitness profile in sedentary Latina breast cancer survivors.

Science.gov (United States)

Ortiz, Alexis; Tirado, Maribel; Hughes, Daniel C; Gonzalez, Velda; Song, JaeJoon; Mama, Scherezade K; Basen-Engquist, Karen

2018-10-01

To report baseline data from a physical activity (PA) intervention for Latina breast cancer survivors, and assess the relationship between PA, fitness, and disability. Eighty-nine Latina breast cancer survivors from San Juan, PR and Houston, TX (age: 55.4 ± 9.9 years; BMI: 29.87 ± 5.62 kg/m 2 ; ≥ 3 months post-treatment) participated in this study. At baseline participants completed fitness testing (six-minute walk test [6MWT], 30-second sit-stand; grip strength, lower and upper extremity and low back strength, shoulder range of motion, balance testing), and assessment of physical activity (PA) and disability. PA was assessed using the International Physical Activity Questionnaire (IPAQ). A subsample (n = 27) received an accelerometer to compare objective versus self-reported PA. Participants exhibited low PA (M = 76.5 MET·minutes/week; SD = 183.4), poor fitness (6MWT M = 436.4 meters, SD = 99.1; 30s sit-stand, M = 11.6 stands, SD = 3.1), and no detectable disability. In an adjusted model lower extremity fitness was associated with PA, with a one repetition increase in sit-to-stand associated with 49 additional minutes of self-reported PA plus walking per week. The correlation between IPAQ moderate-vigorous PA and accelerometer was 0.38 (p = 0.047). Latina breast cancer survivors have low physical activity and fitness levels that increase their risk of disability, cardiometabolic comorbidities, and potential cancer recurrence.

Contemporary Management of Bladder Cancer

Science.gov (United States)

Bell, David; Fradet, Yves

1991-01-01

Bladder cancer is currently the fifth most common cancer in Western society, and its incidence appears to be increasing. Important advances have recently occurred in both diagnostic and therapeutic approaches to bladder neoplasms. Presentation is not unique, and physician awareness is important to identify patients who are at risk for bladder neoplasia and consequently require further investigation. A diagnostic approach and contemporary management are discussed. ImagesFigure 1Figure 4 PMID:21229043

Breast Cancer In Pregnancy: Management Approach

African Journals Online (AJOL)

reflecting the more advanced stage of the disease at diagnosis. An approach to the management of breast cancer in pregnancy is presented by a case illustration and a review of literature. KEY WORDS: Breast Cancer, ... function tests, haemogram and ultra— sound. She delivered a live female baby weighing 2.8 kilogram's ...

Impact of managed care on cancer trial enrollment.

Science.gov (United States)

Gross, C P; Krumholz, H M

2005-06-01

To determine the relationship between managed care market activity and cancer trial enrollment. Trial participant data were obtained from the National Cancer Institute. Participants in cooperative group trials of breast, colorectal, lung, or prostate cancer during the years 1996 through 2001 were assigned to counties based on their zip code of residence. Linear regression was used to determine the relationship between county enrollment rate and two measures of county managed care activity (penetration and index of competition [IOC]), adjusting for other county characteristics. In bivariate analysis, there was a strong inverse correlation between trial enrollment rate and IOC (r = -0.23; P penetration, proportion uninsured, and other county characteristics. Counties in the lowest quartile of managed care penetration tended to have lower enrollment rates than the remaining counties (r = -0.05; P = .048), while counties in the second, third, and fourth quartiles of penetration all had similar enrollment rates to one another. Cancer trial enrollment rates were suboptimal across all counties, and counties with higher levels of managed care competition had significantly lower enrollment rates. The relationship between managed care penetration and trial enrollment was less consistent. Future efforts to enhance trial participation should address the potential negative influence of market factors.

The Evolution of Mindfulness-Based Physical Interventions in Breast Cancer Survivors

Directory of Open Access Journals (Sweden)

Daniela L. Stan

2012-01-01

Full Text Available Survivors of breast cancer are faced with a multitude of medical and psychological impairments during and after treatment and throughout their lifespan. Physical exercise has been shown to improve survival and recurrence in this population. Mind-body interventions combine a light-moderate intensity physical exercise with mindfulness, thus having the potential to improve both physical and psychological sequelae of breast cancer treatments. We conducted a review of mindfulness-based physical exercise interventions which included yoga, tai chi chuan, Pilates, and qigong, in breast cancer survivors. Among the mindfulness-based interventions, yoga was significantly more studied in this population as compared to tai chi chuan, Pilates, and qigong. The participants and the outcomes of the majority of the studies reviewed were heterogeneous, and the population included was generally not selected for symptoms. Yoga was shown to improve fatigue in a few methodologically strong studies, providing reasonable evidence for benefit in this population. Improvements were also seen in sleep, anxiety, depression, distress, quality of life, and postchemotherapy nausea and vomiting in the yoga studies. Tai chi chuan, Pilates, and qigong were not studied sufficiently in breast cancer survivors in order to be implemented in clinical practice.

Predicting physical activity and outcome expectations in cancer survivors: an application of Self-Determination Theory.

Science.gov (United States)

Wilson, Philip M; Blanchard, Chris M; Nehl, Eric; Baker, Frank

2006-07-01

The purpose of this study was to examine the contributions of autonomous and controlled motives drawn from Self-Determination Theory (SDT; Intrinsic Motivation and Self-determination in Human Behavior. Plenum Press: New York, 1985; Handbook of Self-determination Research. University of Rochester Press: New York, 2002) towards predicting physical activity behaviours and outcome expectations in adult cancer survivors. Participants were cancer-survivors (N=220) and a non-cancer comparison cohort (N=220) who completed an adapted version of the Treatment Self-Regulation Questionnaire modified for physical activity behaviour (TSRQ-PA), an assessment of the number of minutes engaged in moderate-to-vigorous physical activity (MVPA) weekly, and the anticipated outcomes expected from regular physical activity (OE). Simultaneous multiple regression analyses indicated that autonomous motives was the dominant predictor of OEs across both cancer and non-cancer cohorts (R(2adj)=0.29-0.43), while MVPA was predicted by autonomous (beta's ranged from 0.21 to 0.34) and controlled (beta's ranged from -0.04 to -0.23) motives after controlling for demographic considerations. Cancer status (cancer versus no cancer) did not moderate the motivation-physical activity relationship. Collectively, these findings suggest that the distinction between autonomous and controlled motives is useful and compliments a growing body of evidence supporting SDT as a framework for understanding motivational processes in physical activity contexts with cancer survivors.

Care for a Patient With Cancer As a Project: Management of Complex Task Interdependence in Cancer Care Delivery.

Science.gov (United States)

Trosman, Julia R; Carlos, Ruth C; Simon, Melissa A; Madden, Debra L; Gradishar, William J; Benson, Al B; Rapkin, Bruce D; Weiss, Elisa S; Gareen, Ilana F; Wagner, Lynne I; Khan, Seema A; Bunce, Mikele M; Small, Art; Weldon, Christine B

2016-11-01

Cancer care is highly complex and suffers from fragmentation and lack of coordination across provider specialties and clinical domains. As a result, patients often find that they must coordinate care on their own. Coordinated delivery teams may address these challenges and improve quality of cancer care. Task interdependence is a core principle of rigorous teamwork and is essential to addressing the complexity of cancer care, which is highly interdependent across specialties and modalities. We examined challenges faced by a patient with early-stage breast cancer that resulted from difficulties in understanding and managing task interdependence across clinical domains involved in this patient's care. We used team science supported by the project management discipline to discuss how various task interdependence aspects can be recognized, deliberately designed, and systematically managed to prevent care breakdowns. This case highlights how effective task interdependence management facilitated by project management methods could markedly improve the course of a patient's care. This work informs efforts of cancer centers and practices to redesign cancer care delivery through innovative, practical, and patient-centered approaches to management of task interdependence in cancer care. Future patient-reported outcomes research will help to determine optimal ways to engage patients, including those who are medically underserved, in managing task interdependence in their own care.

Spontaneous Physical Activity Downregulates Pax7 in Cancer Cachexia

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Dario Coletti

2016-01-01

Full Text Available Emerging evidence suggests that the muscle microenvironment plays a prominent role in cancer cachexia. We recently showed that NF-kB-induced Pax7 overexpression impairs the myogenic potential of muscle precursors in cachectic mice, suggesting that lowering Pax7 expression may be beneficial in cancer cachexia. We evaluated the muscle regenerative potential after acute injury in C26 colon carcinoma tumor-bearing mice and healthy controls. Our analyses confirmed that the delayed muscle regeneration observed in muscles form tumor-bearing mice was associated with a persistent local inflammation and Pax7 overexpression. Physical activity is known to exert positive effects on cachectic muscles. However, the mechanism by which a moderate voluntary exercise ameliorates muscle wasting is not fully elucidated. To verify if physical activity affects Pax7 expression, we hosted control and C26-bearing mice in wheel-equipped cages and we found that voluntary wheel running downregulated Pax7 expression in muscles from tumor-bearing mice. As expected, downregulation of Pax7 expression was associated with a rescue of muscle mass and fiber size. Our findings shed light on the molecular basis of the beneficial effect exerted by a moderate physical exercise on muscle stem cells in cancer cachexia. Furthermore, we propose voluntary exercise as a physiological tool to counteract the overexpression of Pax7 observed in cancer cachexia.

Physical exercise and return to work: cancer survivors' experiences

NARCIS (Netherlands)

Groeneveld, Iris F.; de Boer, Angela G. E. M.; Frings-Dresen, Monique H. W.

2013-01-01

In this qualitative study, we aimed to explore cancer survivors' experiences with (1) return to work (RtW) and work performance, (2) a physical exercise program after treatment, and (3) the perceived link between physical exercise and work. Semi-structured individual interviews were held with ten

Physical therapy after total mastectomy surgery in breast cancer

Directory of Open Access Journals (Sweden)

Andreia Cismaş

2011-12-01

Full Text Available Breast cancer is the most common type of cancer among women in the whole world. It is caused by the development of malignant cells in the breast. In cancer patients, physical therapy has resulted in improved physical functioning, cardiovascular fitness, sleep, quality of life, psychological and social well-being, and self esteem, and significant decreases in fatigue, anxiety and depression. Aim: The aim of this study is to underline the importance of physical therapy in the rehabilitation of patients after total mastectomy surgery in breast cancer. Material and methods: We investigated 14 women aged between 45 and 75 years old, diagnosed with breast cancer (stages I–III, having a total mastectomy surgery 6 months ago. At the beginning and after 2 weeks of intervention, the subject`s evaluations consisted in: each patient was evaluated in regard to shoulder flexibility (from Test 1 to Test 8; on the other hand, we measured the upper limb circumferences on the surgery side. The physical therapy programme consisted in 10 sessions of 20 minutes lymphatic drainage and 10 minutes individualized physical therapy programmes. Results: At the end of intervention, it was observed a score improvement at Test 2 (from 1.28±0.99 to 1.85±0.53, p=0.041, Test 3 (from 0.42±0.85 to 1.57±0.85, p=0.001, Test 7 (from 0.5±0.51 to 0.85±0.36, p=0.019 and Test 8 (from 1.28±0.99 to 1.85±0.53, p=0.041. In terms of total score (Total, the improvement was also significant increased (from 13.25±9.08 to 18.13±10.12, p=0.044. Circumference values significantly improved at arm (from 30.36±4.25 to 29.79±4.41, p=0.001, forearm (from 23±2.18 to 22.04±2.26, p=0.001 and wrist level (from 17.46±1.74 to 17.11±1.67, p=0.012. Despite the intervention, elbow circumference didn`t reached the statistical significance (p<0.05. Conclusions: After 2 weeks of intervention we noticed a significant improvement at most of the parameters which means a life quality increase in

Ballroom dancing as physical activity for patients with cancer: a systematic review and report of a pilot project.

Science.gov (United States)

Rudolph, Ivonne; Schmidt, Thorsten; Wozniak, Tobias; Kubin, Thomas; Ruetters, Dana; Huebner, Jutta

2018-04-01

Physical activity has positive effects on cancer patients. Dancing addresses diverse bio-psycho-social aspects. Our aim was to assess the evidence on ballroom dancing and to develop the setting for a pilot project. We performed a systematic review, extracted the data and designed a pilot training based on standard curricula. We included cancer patients during or after therapy. Training duration was 90 min with one regular pause and individual pauses as needed. We retrieved two systematic reviews and six controlled studies. Types of dancing varied. Only one study used ballroom dancing. Dance training might improve well-being, physical fitness, fatigue and coping during and after therapy. Yet, evidence is scarce and data to derive the effect size are lacking; 27 patients and their partners took part in the pilot training. Patients and partners needed more time to learn the steps than is planned in regular ballroom classes. Participants were very satisfied with the adaptation of the training to their physical strength and estimated the training in a sheltered group. No side effects occurred. In spite of a high rate of participants reporting fatigue, 90 min of physical activity with only a few minutes of rest were manageable for all participants. Ballroom dancing may offer benefits for patients with respect to quality of life. Cancer patients prefer sheltered training setting and curricula of regular ballroom classes must be adapted for cancer patients. Strict curricula might reduce motivation and adherence and exclude patients with lower or variable fitness.

Diagnostic Management of Pancreatic Cancer

Energy Technology Data Exchange (ETDEWEB)

Dabizzi, Emanuele [Division of Gastroenterology and Hepatology, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, Florida 32224 (United States); Assef, Mauricio Saab [Faculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Motta Jr. #61 Cep: 01221-020, São Paulo (Brazil); Raimondo, Massimo, E-mail: raimondo.massimo@mayo.edu [Division of Gastroenterology and Hepatology, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, Florida 32224 (United States)

2011-01-31

Pancreatic cancer is one of the most deadly solid tumors, with an overall 5-year survival rate of less than 5%. Due to a non-specific clinical presentation, it is often diagnosed at an advanced stage and is rarely amenable for curative treatment. Therefore early diagnosis and appropriate staging are still essential to define the best care and to improve patient survival. Several imaging modalities are currently available for the evaluation of pancreatic cancer. This review focuses on different techniques and discusses the diagnostic management of patients with pancreatic cancer. This review was conducted utilizing Pubmed and was limited to papers published within the last 5 years. The search key words pancreatic cancer, pancreatic adenocarcinoma, pancreatic tumors, diagnosis, radiology, imaging, nuclear imaging, endoscopy, endoscopic ultrasound and biochemical markers were used.

Diagnostic Management of Pancreatic Cancer

International Nuclear Information System (INIS)

Dabizzi, Emanuele; Assef, Mauricio Saab; Raimondo, Massimo

2011-01-01

Pancreatic cancer is one of the most deadly solid tumors, with an overall 5-year survival rate of less than 5%. Due to a non-specific clinical presentation, it is often diagnosed at an advanced stage and is rarely amenable for curative treatment. Therefore early diagnosis and appropriate staging are still essential to define the best care and to improve patient survival. Several imaging modalities are currently available for the evaluation of pancreatic cancer. This review focuses on different techniques and discusses the diagnostic management of patients with pancreatic cancer. This review was conducted utilizing Pubmed and was limited to papers published within the last 5 years. The search key words pancreatic cancer, pancreatic adenocarcinoma, pancreatic tumors, diagnosis, radiology, imaging, nuclear imaging, endoscopy, endoscopic ultrasound and biochemical markers were used

Hypnosis: Adjunct Therapy for Cancer Pain Management

Science.gov (United States)

Kravits, Kathy

2013-01-01

Pain is a symptom associated with prolonged recovery from illness and procedures, decreased quality of life, and increased health-care costs. While there have been advances in the management of cancer pain, there is a need for therapeutic strategies that complement pharmaceutical management without significantly contributing to the side-effect profile of these agents. Hypnosis provides a safe and efficacious supplement to pharmaceutical management of cancer pain. One barrier to the regular use of hypnosis is health-care providers’ lack of current knowledge of the efficacy and safety of hypnosis. Advanced practitioners who are well-informed about hypnosis have an opportunity to increase the treatment options for patients who are suffering with cancer pain by suggesting to the health-care team that hypnosis be incorporated into the plan of care. Integration of hypnosis into the standard of care will benefit patients, caregivers, and survivors by reducing pain and the suffering associated with it. PMID:25031986

Computerized database management system for breast cancer patients.

Science.gov (United States)

Sim, Kok Swee; Chong, Sze Siang; Tso, Chih Ping; Nia, Mohsen Esmaeili; Chong, Aun Kee; Abbas, Siti Fathimah

2014-01-01

Data analysis based on breast cancer risk factors such as age, race, breastfeeding, hormone replacement therapy, family history, and obesity was conducted on breast cancer patients using a new enhanced computerized database management system. My Structural Query Language (MySQL) is selected as the application for database management system to store the patient data collected from hospitals in Malaysia. An automatic calculation tool is embedded in this system to assist the data analysis. The results are plotted automatically and a user-friendly graphical user interface is developed that can control the MySQL database. Case studies show breast cancer incidence rate is highest among Malay women, followed by Chinese and Indian. The peak age for breast cancer incidence is from 50 to 59 years old. Results suggest that the chance of developing breast cancer is increased in older women, and reduced with breastfeeding practice. The weight status might affect the breast cancer risk differently. Additional studies are needed to confirm these findings.

Prognostic features and markers for testicular cancer management

Directory of Open Access Journals (Sweden)

Eddy S Leman

2010-01-01

Full Text Available Testicular neoplasm accounts for about 1% of all cancers in men. Over the last 40 years, the incidence of testicular cancer has increased in northern European male populations for unknown reasons. When diagnosed at early stage, testicular cancer is usually curable with a high survival rate. In the past three decades, successful multidisciplinary approaches for the management of testicular cancer have significantly increased patient survival rates. Utilization of tumor markers and accurate prognostic classification has also contributed to successful therapy. In this article, we highlight the most commonly used tumor markers and several potential "novel" markers for testicular cancer as part of the ongoing effort in biomarker research and discovery. In addition, this article also identifies several key prognostic features that have been demonstrated to play a role in predicting relapse. These features include tumor size, rete testis invasion, lymphovascular invasion, and tumor histology. Together with tumor markers, these prognostic factors should be taken into account for risk-adapted management of testicular cancer.

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......-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 (p

Management of cancer-associated thrombosis in people with advanced disease.

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Noble, Simon; Johnson, Miriam J

2012-06-01

The management of venous thromboembolism in the cancer population is clearly established. Low molecular weight heparin has a greater efficacy than warfarin in the treatment of cancer-associated thrombosis and is recommended as the preferred therapy. However, the evidence informing these recommendations excluded patients with poor prognosis or performance status, thrombocytopenia, bleeding or brain metastases. Furthermore, there is limited data on the management of venous thromboembolism resistant to anticoagulation, a phenomenon frequently encountered in the advanced cancer population. This paper will review the management of cancer-associated thrombosis with a particular focus on challenging clinical situations faced by palliative care teams looking after patients with advanced disease.

The Significance of Tailored, Web-Based Information on Experiences Regarding Perceived Self-Management in Ovarian Cancer Patients in the Diagnostic Phase-An Experimental Study

DEFF Research Database (Denmark)

Thygesen, Marianne Kirstine; Holt, Kamila Adellund; Mogensen, Ole

2016-01-01

provided data for statistical analysis. Patients’ difference in change in Sense of Coherence over time was statistically significant in favor of those who had used the website (mean difference 4.42, pwebsite prevented a decrease in self-management of Danish...... of a healthcare-professional developed website, available to both patients and relatives, on patients’ experienced self-management before surgery for ovarian cancer. In an experimental study, Danish women with ovarian cancer were consecutively included if they would participate and had a relative, willing...... to offer attention to the cancer situation. The control group had standard care, the intervention group plus their relatives had additional access to a website with cancer-specific physical, psychical, and practical information. The validated questionnaires Cancer Behavior Inventory and Sense of Coherence...

Physical modalities in chronic pain management.

Science.gov (United States)

Rakel, Barbara; Barr, John O

2003-09-01

The following conclusions can be made based on review of the evidence: There is limited but positive evidence that select physical modalities are effective in managing chronic pain associated with specific conditions experienced by adults and older individuals. Overall, studies have provided the most support for the modality of therapeutic exercise. Different physical modalities have similar magnitudes of effects on chronic pain. Therefore, selection of the most appropriate physical modality may depend on the desired functional outcome for the patient, the underlying impairment, and the patient's preference or prior experience with the modality. Certain patient characteristics may decrease the effectiveness of physical modalities, as has been seen with TENS. These characteristics include depression, high trait anxiety, a powerful others locus of control, obesity, narcotic use, and neuroticism. The effect on pain by various modalities is generally strongest in the short-term period immediately after the intervention series, but effects can last as long as 1 year after treatment (e.g., with massage). Most research has tested the effect of physical modalities on chronic low back pain and knee OA. The effectiveness of physical modalities for other chronic pain conditions needs to be evaluated more completely. Older and younger adults often experience similar effects on their perception of pain from treatment with physical modalities. Therefore, use of these modalities for chronic pain in older adults is appropriate, but special precautions need to be taken. Practitioners applying physical modalities need formal training that includes the risks and precautions for these modalities. If practitioners lack formal training in the use of physical modalities, or if modality use is not within their scope of practice, it is important to consult with and refer patients to members of the team who have this specialized training. Use of a multidisciplinary approach to chronic pain

The challenge of preserving cardiorespiratory fitness in physically inactive patients with colon or breast cancer during adjuvant chemotherapy: a randomised feasibility study

DEFF Research Database (Denmark)

Møller, Tom; Lillelund, Christian; Andersen, Christina

2015-01-01

Introduction Anti-neoplastic treatment is synonymous with an inactive daily life for a substantial number of patients. It remains unclear what is the optimal setting, dosage and combination of exercise and health promoting components that best facilitate patient adherence and symptom management...... in order to support cardio-respiratory fitness and lifestyle changes in an at-risk population of pre-illness physically inactive cancer patients.Methods Patients with breast or colon cancer referred to adjuvant chemotherapy and by the oncologists pre-screening verified as physically inactive were eligible...... to enter a randomised three-armed feasibility study comparing a 12-week supervised hospital-based moderate to high intensity exercise intervention or alternate an instructive home-based12-week pedometer intervention, with usual care.Results Using a recommendation based physical activity screening...

Physical activity, hormone replacement therapy and breast cancer risk: A meta-analysis of prospective studies.

Science.gov (United States)

Pizot, Cécile; Boniol, Mathieu; Mullie, Patrick; Koechlin, Alice; Boniol, Magali; Boyle, Peter; Autier, Philippe

2016-01-01

Lower risk of breast cancer has been reported among physically active women, but the risk in women using hormone replacement therapy (HRT) appears to be higher. We quantified the association between physical activity and breast cancer, and we examined the influence that HRT use and other risk factors had on this association. After a systematic literature search, prospective studies were meta-analysed using random-effect models applied on highest versus lowest level of physical activity. Dose-response analyses were conducted with studies reporting physical activity either in hours per week or in hours of metabolic equivalent per week (MET-h/week). The literature search identified 38 independent prospective studies published between 1987 and 2014 that included 116,304 breast cancer cases. Compared to the lowest level of physical activity, the highest level was associated with a summary relative risk (SRR) of 0.88 (95% confidence interval [CI] 0.85, 0.90) for all breast cancer, 0.89 (95% CI 0.83, 0.95) for ER+/PR+ breast cancer and 0.80 (95% CI 0.69, 0.92) for ER-/PR- breast cancer. Risk reductions were not influenced by the type of physical activity (occupational or non-occupational), adiposity, and menopausal status. Risk reductions increased with increasing amounts of physical activity without threshold effect. In six studies, the SRR was 0.78 (95% CI 0.70, 0.87) in women who never used HRT and 0.97 (95% CI 0.88, 1.07) in women who ever used HRT, without heterogeneity in results. Findings indicate that a physically inactive women engaging in at least 150 min per week of vigorous physical activity would reduce their lifetime risk of breast cancer by 9%, a reduction that might be two times greater in women who never used HRT. Increasing physical activity is associated with meaningful reductions in the risk of breast cancer, but in women who ever used HRT, the preventative effect of physical activity seems to be cancelled out. Copyright © 2015 Elsevier Ltd. All

Evolution of breast cancer management in Ireland: a decade of change

Directory of Open Access Journals (Sweden)

Malone C

2009-09-01

Full Text Available Abstract Background Over the last decade there has been a paradigm shift in the management of breast cancer, subsequent to revised surgical oncology guidelines and consensus statements which were derived in light of landmark breast cancer clinical trials conducted throughout the latter part of the 20th century. However the sheer impact of this paradigm shift upon all modalities of treatment, and the current trends in management of the disease, are largely unknown. We aimed to assess the changing practices of breast cancer management over the last decade within a specialist tertiary referral Breast Cancer Centre. Methods Comparative analysis of all aspects of the management of breast cancer patients, who presented to a tertiary referral Breast Cancer Centre in 1995/1996 and 2005/2006, was undertaken and measured against The European Society for Surgical Oncology guidelines for the surgical management of mammographically detected lesions [1998]. Results 613 patients' case profiles were analysed. Over the last decade we observed a dramatic increase in incidence of breast cancer [>100%], a move to less invasive diagnostic and surgical therapeutic techniques, as well as increased use of adjuvant therapies. We also witnessed the introduction of immediate breast reconstruction as part of routine practice Conclusion We demonstrate that radical changes have occurred in the management of breast cancer in the last decade, in keeping with international guidelines. It remains incumbent upon us to continue to adapt our practice patterns in light of emerging knowledge and best evidence.

Evolution of breast cancer management in Ireland: a decade of change.

LENUS (Irish Health Repository)

Heneghan, Helen M

2009-01-01

BACKGROUND: Over the last decade there has been a paradigm shift in the management of breast cancer, subsequent to revised surgical oncology guidelines and consensus statements which were derived in light of landmark breast cancer clinical trials conducted throughout the latter part of the 20th century. However the sheer impact of this paradigm shift upon all modalities of treatment, and the current trends in management of the disease, are largely unknown. We aimed to assess the changing practices of breast cancer management over the last decade within a specialist tertiary referral Breast Cancer Centre. METHODS: Comparative analysis of all aspects of the management of breast cancer patients, who presented to a tertiary referral Breast Cancer Centre in 1995\\/1996 and 2005\\/2006, was undertaken and measured against The European Society for Surgical Oncology guidelines for the surgical management of mammographically detected lesions [1998]. RESULTS: 613 patients\\' case profiles were analysed. Over the last decade we observed a dramatic increase in incidence of breast cancer [>100%], a move to less invasive diagnostic and surgical therapeutic techniques, as well as increased use of adjuvant therapies. We also witnessed the introduction of immediate breast reconstruction as part of routine practice CONCLUSION: We demonstrate that radical changes have occurred in the management of breast cancer in the last decade, in keeping with international guidelines. It remains incumbent upon us to continue to adapt our practice patterns in light of emerging knowledge and best evidence.

Management of Patients with Advanced Prostate Cancer

DEFF Research Database (Denmark)

Gillessen, Silke; Attard, Gerhardt; Beer, Tomasz M

2018-01-01

some of these topics. OBJECTIVE: To present the report of APCCC 2017. DESIGN, SETTING, AND PARTICIPANTS: Ten important areas of controversy in APC management were identified: high-risk localised and locally advanced prostate cancer; "oligometastatic" prostate cancer; castration-naïve and castration...... literature review or meta-analysis. The outcomes of the voting had varying degrees of support, as reflected in the wording of this article, as well as in the detailed voting results recorded in Supplementary data. CONCLUSIONS: The presented expert voting results can be used for support in areas of management...

Impact of parental cancer on IQ, stress resilience, and physical fitness in young men

Directory of Open Access Journals (Sweden)

Chen R

2018-05-01

Full Text Available Ruoqing Chen,1 Katja Fall,1,2 Kamila Czene,1 Beatrice Kennedy,2 Unnur Valdimarsdóttir,1,3,4 Fang Fang1 1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; 2Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; 3Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland; 4Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA Background: A parental cancer diagnosis is a stressful life event, potentially leading to increased risks of mental and physical problems among children. This study aimed to investigate the associations of parental cancer with IQ, stress resilience, and physical fitness of the affected men during early adulthood. Materials and methods: In this Swedish population-based study, we included 465,249 men born during 1973–1983 who underwent the military conscription examination around the age of 18 years. We identified cancer diagnoses among the parents of these men from the Cancer Register. IQ, stress resilience, and physical fitness of the men were assessed at the time of conscription and categorized into three levels: low, moderate, and high (reference category. We used multinomial logistic regression to assess the studied associations. Results: Overall, parental cancer was associated with higher risks of low stress resilience (relative risk ratio [RRR]: 1.09 [95% confidence interval (CI 1.04–1.15] and low physical fitness (RRR: 1.12 [95% CI 1.05–1.19]. Stronger associations were observed for parental cancer with a poor expected prognosis (low stress resilience: RRR: 1.59 [95% CI 1.31–1.94]; low physical fitness: RRR: 1.45 [95% CI 1.14–1.85] and for parental death after cancer diagnosis (low stress resilience: RRR: 1.29 [95% CI 1.16–1.43]; low physical fitness: RRR: 1.40 [95% CI 1.23–1.59]. Although there was no overall association between parental

First German disease management program for breast cancer.

Science.gov (United States)

Rupprecht, Christoph

2005-01-01

The first disease management program contract for breast cancer in Germany was signed in 2002 between the Association of Regional of Physicians in North-Rhine and the statutory health insurance companies in Rhineland. At the heart of this unique breast cancer disease management program is a patient-centered network of health care professionals. The program's main objectives are: (1) to improve the quality of treatment and post-operative care for breast cancer patients, (2) to provide timely information and consultation empowering the patient to participate in decisionmaking, (3) to improve the interface between inpatient and outpatient care, and (4) to increase the number of breast-conserving surgeries.

The effect of pain on physical functioning after breast cancer treatment

DEFF Research Database (Denmark)

Andersen, Kenneth Geving; Christensen, Karl Bang; Kehlet, Henrik

2014-01-01

OBJECTIVES:: Persistent postsurgical pain, musculoskeletal pain, sensory disturbances and lymphedema are major clinical problems after treatment for breast cancer. However, there is little evidence on how these sequelae affects physical function. The aim was to develop and validate a procedure...... specific tool for assessing the impact of pain and other sequelae on physical function after breast cancer treatment. METHODS:: Literature review, patient and expert interviews were used to identify dimensions of physical function and sequelae. A questionnaire was developed and tested using cognitive......, lymphedema and other causes. Convergent validity was assessed using the "Quick-disability of arm, shoulder and hand" scale (Q-DASH). RESULTS:: About half of the patients reported decreased physical function. All 5 scales displayed good fit, unidimensionality, monotonicity, local independence, and lack...

Electronic Assessment of Physical Decline in Geriatric Cancer Patients.

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Fallahzadeh, Ramin; Ghasemzadeh, Hassan; Shahrokni, Armin

2018-03-08

The purpose of this review is to explore state-of-the-art remote monitoring and emerging new sensing technologies for in-home physical assessment and their application/potential in cancer care. In addition, we discuss the main functional and non-functional requirements and research challenges of employing such technologies in real-world settings. With rapid growth in aging population, effective and efficient patient care has become an important topic. Advances in remote monitoring and in its forefront in-home physical assessment technologies play a fundamental role in reducing the cost and improving the quality of care by complementing the traditional in-clinic healthcare. However, there is a gap in medical research community regarding the applicability and potential outcomes of such systems. While some studies reported positive outcomes using remote assessment technologies, such as web/smart phone-based self-reports and wearable sensors, the cancer research community is still lacking far behind. Thorough investigation of more advanced technologies in cancer care is warranted.

Evolution, Physics, and Cancer: Disrupting Traditional Approache

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Austin, Robert

Physicists who were recruited to try and assist with the stubbornly constant mortality rates of cancer world-wide over the past 100 years have basically had the invitation withdrawn by the oncology community. The oncologists became annoyed with the independence of thought and the skepticism of some physicists with continuation of the present paradigm of the cancer genome as the rosette stone as the key to cancer. To quote a recent letter in Physics Today: ``Curing cancer is a complex biological problem to be solved by biologists''. Apparently our mission as minions is is to be high-level technicians. But I think that is wrong and will lead to continuation of the string of failures and deceptions foisted on the public at large by the Medical Industrial Complex, I think we really need to re-think cancer as a phenomena which is driven by evolution and may be desired by the organism and be a product of both the aging of the proteome and the genome. Further, searching for mutations (The Cancer Genome) may be completely the wrong direction, searching for protected genes may be as important as looking for mutated genes. I'll try to present the case that physicists should not have been kicked out of the Medical Industrial Complex that keeps the cancer business humming and profitable.

Cancer rehabilitation with a focus on evidence-based outpatient physical and occupational therapy interventions.

Science.gov (United States)

Silver, Julie K; Gilchrist, Laura S

2011-05-01

Cancer rehabilitation is an important part of survivorship as a distinct phase of treatment. Although cancer rehabilitation may involve many disciplines, this article specifically covers evidence-based treatment in physical and occupational therapy. Patients may need physical and occupational therapy services for a variety of cancer-related or cancer-treatment-related problems, including pain, fatigue, deconditioning, and difficulty with gait. They may also have problems resuming their previous level of function, which can impact on activities of daily living, instrumental activities of daily living, return to previous home and community activity levels, and return to work. This review discusses the role of physical and occupational therapy in helping cancer patients improve pain and musculoskeletal issues, deconditioning and endurance effects, fatigue, balance and falls, and lymphedema and psychosocial problems.

Locally advanced rectal cancer: management challenges

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Kokelaar RF

2016-10-01

Full Text Available RF Kokelaar, MD Evans, M Davies, DA Harris, J Beynon Department of Colorectal Surgery, Singleton Hospital, Swansea, UK Abstract: Between 5% and 10% of patients with rectal cancer present with locally advanced rectal cancer (LARC, and 10% of rectal cancers recur after surgery, of which half are limited to locoregional disease only (locally recurrent rectal cancer. Exenterative surgery offers the best long-term outcomes for patients with LARC and locally recurrent rectal cancer so long as a complete (R0 resection is achieved. Accurate preoperative multimodal staging is crucial in assessing the potential operability of advanced rectal tumors, and resectability may be enhanced with neoadjuvant therapies. Unfortunately, surgical options are limited when the tumor involves the lateral pelvic sidewall or high sacrum due to the technical challenges of achieving histological clearance, and must be balanced against the high morbidity associated with resection of the bony pelvis and significant lymphovascular structures. This group of patients is usually treated palliatively and subsequently survival is poor, which has led surgeons to seek innovative new solutions, as well as revisit previously discarded radical approaches. A small number of centers are pioneering new techniques for resection of beyond-total mesorectal excision tumors, including en bloc resections of the sciatic notch and composite resections of the first two sacral vertebrae. Despite limited experience, these new techniques offer the potential for radical treatment of previously inoperable tumors. This narrative review sets out the challenges facing the management of LARCs and discusses evolving management options. Keywords: rectal cancer, exenteration, pelvic sidewall, sacrectomy

Diagnosis and Management of High Risk Group for Gastric Cancer

Science.gov (United States)

Yoon, Hyuk; Kim, Nayoung

2015-01-01

Gastric cancer is associated with high morbidity and mortality worldwide. To reduce the socioeconomic burden related to gastric cancer, it is very important to identify and manage high risk group for gastric cancer. In this review, we describe the general risk factors for gastric cancer and define high risk group for gastric cancer. We discuss strategies for the effective management of patients for the prevention and early detection of gastric cancer. Atrophic gastritis (AG) and intestinal metaplasia (IM) are the most significant risk factors for gastric cancer. Therefore, the accurate selection of individuals with AG and IM may be a key strategy for the prevention and/or early detection of gastric cancer. Although endoscopic evaluation using enhanced technologies such as narrow band imaging-magnification, the serum pepsinogen test, Helicobacter pylori serology, and trefoil factor 3 have been evaluated, a gold standard method to accurately select individuals with AG and IM has not emerged. In terms of managing patients at high risk of gastric cancer, it remains uncertain whether H. pylori eradication reverses and/or prevents the progression of AG and IM. Although endoscopic surveillance in high risk patients is expected to be beneficial, further prospective studies in large populations are needed to determine the optimal surveillance interval. PMID:25547086

Feasibility of a mobile phone application to promote physical activity in cancer survivors

Directory of Open Access Journals (Sweden)

Anna Roberts

2016-01-01

Full Text Available Background: Regular participation in physical activity is associated with improved physical and psychosocial outcomes in cancer survivors. However, physical activity levels are low during and after cancer treatment. Interventions to promote physical activity in this population are needed. Mobile technology has potential, but currently, there is no mobile phone application designed to promote physical activity in cancer survivors. Objectives: The first aim is to assess feasibility and acceptability of an existing physical activity mobile application (‘app’ designed for the general population, in a sample of breast, colorectal and prostate cancer survivors. A further aim is to understand how the application could be adapted to overcome barriers to physical activity participation in this population. Methods: A feasibility study was carried out that investigated acceptability of and participants’ opinions on the application. A total of 11 cancer survivors tested the application for 6 weeks. Physical activity (Godin Leisure Time Exercise Questionnaire, wellbeing (FACT-G, fatigue (FACIT-Fatigue scale, quality of life (EQ5D, sleep quality (Pittsburgh Sleep Quality Index, anxiety and depression (Hospital Anxiety and Depression Scale were self-reported at baseline and at 6-week follow-up. Participants completed qualitative telephone interviews about their experiences of using the app, and these were coded using thematic analysis. Results: The application was acceptable among the participants; 73% of people who responded to the study advertisement agreed to participate, and 100% of participants who started the study completed. There was a significant increase in participants’ mean strenuous physical activity of 51.91 minutes per week from baseline to 6-week follow-up (P=0.005. There was also a significant reduction in reported sleep problems from baseline (mean=9.27, SD=6.72 to 6-week follow-up (mean=6.72, SD=5.50; P=0.01. There were no other

Progress in molecular-based management of differentiated thyroid cancer

Science.gov (United States)

Xing, Mingzhao; Haugen, Bryan R; Schlumberger, Martin

2014-01-01

Substantial developments have occurred in the past 5–10 years in clinical translational research of thyroid cancer. Diagnostic molecular markers, such as RET-PTC, RAS, and BRAFV600E mutations; galectin 3; and a new gene expression classifier, are outstanding examples that have improved diagnosis of thyroid nodules. BRAF mutation is a prognostic genetic marker that has improved risk stratification and hence tailored management of patients with thyroid cancer, including those with conventionally low risks. Novel molecular-targeted treatments hold great promise for radioiodine-refractory and surgically inoperable thyroid cancers as shown in clinical trials; such treatments are likely to become a component of the standard treatment regimen for patients with thyroid cancer in the near future. These novel molecular-based management strategies for thyroid nodules and thyroid cancer are the most exciting developments in this unprecedented era of molecular thyroid-cancer medicine. PMID:23668556

Management of Physical Education and Sport

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Krotee, March; Bucher, Charles

2006-01-01

This book offers a solid foundation of management concepts, skills, and techniques that enable students to develop and test the leadership, decision-making, and problem-solving required for their role in the profession of physical education and sport. The thirteenth edition continues to focus on the management and administration of physical…

Update on Management of Cancer-Related Cachexia.

Science.gov (United States)

Anderson, Lindsey J; Albrecht, Eliette D; Garcia, Jose M

2017-01-01

Cachexia is a metabolic syndrome driven by inflammation and characterized by loss of muscle with or without loss of fat mass. In cancer cachexia, the tumor burden and host response induce increased inflammation, decreased anabolic tone, and suppressed appetite leading to the clinical presentation of reduced body weight and quality of life (QOL). There is no approved treatment for cancer cachexia, and commonly used nutritional and anti-inflammatory strategies alone have proven ineffective for management of symptoms. Several other pharmacological agents are currently in development and have shown promise as a clinical strategy in early-phase trials. Recently, it has been proposed that multimodal strategies, with an anabolic focus, initiated early in the disease/treatment progression may provide the most therapeutic potential for symptom management. Here we review the data from recent clinical trials in cancer cachexia including pharmacological, exercise, and nutritional interventions.

Comparison of self-reported physical activity in children and adolescents before and during cancer treatment.

Science.gov (United States)

Götte, Miriam; Kesting, Sabine; Winter, Corinna; Rosenbaum, Dieter; Boos, Joachim

2014-06-01

Physical activities are important for the development of children and increasing evidence suggests beneficial effects of physical activity promotion during cancer treatment as well. The present study aimed at evaluating the current need of exercise interventions in pediatric cancer patients undergoing acute treatment and identifying risk factors for inactivity. Data about self-reported physical activity before and during treatment was collected in a cross-sectional design with the physical activity questionnaire from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) in a modified cancer specific version. One hundred thirty pediatric cancer patients with various entities were questioned 3.0 ± 1.6 months since diagnosis. Patients' activity levels before diagnosis mainly matched reference values for healthy children in Germany. Reductions during treatment affected all dimensions of daily physical activities and minutes of exercise per week decreased significantly (P physical activities during treatment were identified for bone tumor patients and in-patient stays. Due to the well known importance of physical activity during childhood and the identified risk of inactivity during cancer treatment, supervised exercise interventions should be implemented into acute treatment phase to enhance activity levels and ensure a continuously support by qualified exercise professionals. © 2013 Wiley Periodicals, Inc.

Natural biology and management of nonmuscle invasive bladder cancer

DEFF Research Database (Denmark)

Scarpato, Kristen R; Tyson, Mark D; Clark, Peter E

2016-01-01

PURPOSE OF REVIEW: This article reviews the natural biology of noninvasive bladder cancer and its management strategies while summarizing the most recent advances in the field. RECENT FINDINGS: Nonmuscle invasive bladder cancer (NMIBC) has a tendency to recur and progress. Risk stratification has...... in low-risk patients. SUMMARY: NMIBC represents a variety of disease states and continues to pose management challenges. As our understanding of tumor biology improves and technology advances, achieving better outcomes through individualized care may be possible.......PURPOSE OF REVIEW: This article reviews the natural biology of noninvasive bladder cancer and its management strategies while summarizing the most recent advances in the field. RECENT FINDINGS: Nonmuscle invasive bladder cancer (NMIBC) has a tendency to recur and progress. Risk stratification has...... helped triage patients but improved tools, including biomarkers, are still needed. Enhanced endoscopy with photodynamic imaging, narrow band imaging, optical coherence tomography and confocal laser endomicroscopy show promise for diagnosis, risk stratification and disease monitoring. Attempts at better...

Chronic Recreational Physical Inactivity and Epithelial Ovarian Cancer Risk: Evidence from the Ovarian Cancer Association Consortium

Science.gov (United States)

Cannioto, Rikki; LaMonte, Michael J.; Risch, Harvey A.; Hong, Chi-Chen; Sucheston-Campbell, Lara E.; Eng, Kevin H.; Szender, J. Brian; Chang-Claude, Jenny; Schmalfeldt, Barbara; Klapdor, Ruediger; Gower, Emily; Minlikeeva, Albina N.; Zirpoli, Gary; Bandera, Elisa V.; Berchuck, Andrew; Cramer, Daniel; Doherty, Jennifer A.; Edwards, Robert P.; Fridley, Brooke L.; Goode, Ellen L.; Goodman, Marc T.; Hogdall, Estrid; Hosono, Satoyo; Jensen, Allan; Jordan, Susan; Kjaer, Susanne K.; Matsuo, Keitaro; Ness, Roberta B.; Olsen, Catherine M.; Olson, Sara H.; Pearce, Celeste Leigh; Pike, Malcolm C.; Rossing, Mary Anne; Szamreta, Elizabeth A.; Thompson, Pamela J.; Tseng, Chiu-Chen; Vierkant, Robert A.; Webb, Penelope M.; Wentzensen, Nicolas; Wicklund, Kristine G.; Winham, Stacey J.; Wu, Anna H.; Modugno, Francesmary; Schildkraut, Joellen M.; Terry, Kathryn L.; Kelemen, Linda E.; Moysich, Kirsten B.

2016-01-01

Background Despite a large body of literature evaluating the association between recreational physical activity and epithelial ovarian cancer (EOC) risk, the extant evidence is inconclusive and little is known about the independent association between recreational physical inactivity and EOC risk. We conducted a pooled analysis of nine studies from the Ovarian Cancer Association Consortium (OCAC) to investigate the association between chronic recreational physical inactivity and EOC risk. Methods In accordance with the 2008 Physical Activity Guidelines for Americans, women reporting no regular, weekly recreational physical activity were classified as inactive. Multivariable logistic regression was utilized to estimate the odds ratios (OR) and 95% confidence intervals (CI) for the association between inactivity and EOC risk overall and by subgroups based upon histotype, menopausal status, race and body mass index (BMI). Results The current analysis included data from 8,309 EOC patients and 12,612 controls. We observed a significant positive association between inactivity and EOC risk (OR=1.34, 95% CI: 1.14-1.57) and similar associations were observed for each histotype. Conclusions In this large pooled analysis examining the association between recreational physical inactivity and EOC risk, we observed consistent evidence of an association between chronic inactivity and all EOC histotypes. Impact These data add to the growing body of evidence suggesting that inactivity is an independent risk factor for cancer. If the apparent association between inactivity and EOC risk is substantiated, additional work via targeted interventions should be pursued to characterize the dose of activity required to mitigate the risk of this highly fatal disease. PMID:27197285

Principles and management of adrenal cancer

International Nuclear Information System (INIS)

Javadpour, N.

1987-01-01

Principles and Management of Adrenal Cancer is a comprehensive presentation of the medical and surgical management of neoplastic diseases of the adrenal glands. It consists of two parts. The first provides an overview of the embryology, anatomy, physiology, pathology, and advances in methods of diagnosis and imaging techniques. The second deals with specific diseases of the adrenal cortex and medulla. (orig./MG)

Physical therapy methods in the treatment and rehabilitation of cancer patients

International Nuclear Information System (INIS)

Kucherova, T. Ya.; Choinzonov, E. L.; Tuzikov, S. A.; Vusik, M. V.; Doroshenko, A. V.; Velikaya, V. V.; Gribova, O. V.; Startseva, Zh. A.

2016-01-01

The results of the effective use of magnetic laser therapy in the treatment and rehabilitation of cancer patients were presented. The effect of magnetic-laser therapy in the treatment of radiation-induced reactions in the patients with head and neck cancer and in the patients with breast cancer was analyzed. High efficiency of lymphedema and lymphorrhea treatment in the postoperative period in the patients with breast cancer was proved. The results of rehabilitation of the patients with gastric cancer after surgical treatment were presented. These data indicate a high effectiveness of different physical methods of treatment and rehabilitation of cancer patients.

An update on the management of breast cancer in Africa.

Science.gov (United States)

Vanderpuye, V; Grover, S; Hammad, N; PoojaPrabhakar; Simonds, H; Olopade, F; Stefan, D C

2017-01-01

There is limited information about the challenges of cancer management and attempts at improving outcomes in Africa. Even though South and North Africa are better resourceds to tackle the burden of breast cancer, similar poor prognostic factors are common to all countries. The five-year overall Survival rate for breast cancer patients does not exceed 60% for any low and middle-income country (LMIC) in Africa. In spite of the gains achieved over the past decade, certain characteristics remain the same such as limited availability of breast conservation therapies, inadequate access to drugs, few oncology specialists and adherence to harmful socio-cultural practices. This review on managing breast cancer in Africa is authored by African oncologists who practice or collaborate in Africa and with hands-on experience with the realities. A search was performed via electronic databases from 1999 to 2016. (PubMed/Medline, African Journals Online) for all literature in English or translated into English, covering the terms "breast cancer in Africa and developing countries". One hundred ninety were deemed appropriate. Breast tumors are diagnosed at earlier ages and later stages than in highincome countries. There is a higher prevalence of triple-negative cancers. The limitations of poor nursing care and surgery, inadequate access to radiotherapy, poor availability of basic and modern systemic therapies translate into lower survival rate. Positive strides in breast cancer management in Africa include increased adaptation of treatment guidelines, improved pathology services including immuno-histochemistry, expansion and upgrading of radiotherapy equipment across the continent in addition to more research opportunities. This review is an update of the management of breast cancer in Africa, taking a look at the epidemiology, pathology, management resources, outcomes, research and limitations in Africa from the perspective of oncologists with local experience.

Exploring the breast cancer patient journey: do breast cancer survivors need menopause management support?

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Tanna, Nuttan; Buijs, Helene; Pitkin, Joan

2011-12-01

Breast cancer survivors can be expected to suffer from menopause symptoms with estrogen deprivation due to cancer treatments, in addition to natural menopause-related estrogen loss. To gain an understanding of what support breast cancer patients have when they suffer from menopausal symptoms, and utilize findings to further inform National Health Service (NHS) care provision for breast cancer survivors. Qualitative study with focus group sessions targeting Caucasian and Asian women with breast cancer. Patient stories, with women describing their breast cancer journey and speaking about support received for any menopausal symptoms. Thematic data analysis of transcription. Breast cancer patients were not sure if they had menopausal symptoms or whether this was due to their breast cancer condition or treatment. Patients had an attitude of acceptance of menopausal symptoms and reported trying to cope with these by themselves. This research identifies a need for more information that is culturally sensitive on managing menopause symptoms, both as side-effects of breast cancer treatments as well as for affect on quality of life during the survivorship phase. Our work also gives insight into cultural remedies used for hot flushes by Asian patients, which they consider as 'cooling' foods. Breast cancer patients want to know whether side-effects of cancer treatment persist long term and how these can be managed. There is a need for improved patient support within any new NHS service models that are developed along breast cancer patient pathways, and inclusion of personalized advice for menopause symptoms.

Physical activity communication between oncology providers and patients with early-stage breast, colon, or prostate cancer.

Science.gov (United States)

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

2016-02-01

National guidelines recommend that patients with a cancer diagnosis engage in regular physical activity to reduce cancer-related fatigue, maintain quality of life and physical function, and improve overall prognosis and survival. This study investigates oncology provider communications about physical activity during routine clinic visits with patients with early-stage breast, colon, or prostate cancer. This study used a retrospective chart review for documentation of inquiries or recommendations pertaining to physical activity in clinician notes and after-visit patient summaries. In a 1-month period, 55 oncology providers had 361 encounters (clinic visits) with early-stage cancer patients. Thirty-five percent of these encounters included a provider communication about "physical activity," "exercise," or "activity." Encounters with a medical oncologist resulted in a physical activity communication 55% of the time, whereas encounters with other clinician specialties did so 20% of the time (P communication increased with patient age (P communications was significantly higher (46%, 37%, and 58%, respectively) than the rate when the visit was during radiation treatment or surgery (6% and 19%, respectively; P communications during routine clinic visits; however, the frequency of physical activity communications varies among providers. Interventions are needed to remind and encourage all oncology providers to encourage their patients with early-stage cancer to be physically active. . © 2015 American Cancer Society.

Physical Exercise and Cancer-Related Fatigue in Hospitalized Patients: Role of the Clinical Nurse Leader in Implementation of Interventions.

Science.gov (United States)

McGowan, Katrina

2016-02-01

Guidelines suggest that aerobic endurance training and moderate resistance training lessen the effects of cancer-related fatigue (CRF). However, specifics regarding frequency, intensity, and type of physical activity required to alleviate fatigue are less specific. In addition, outcomes of these interventions during the initial stages of active treatment are not well documented. The purpose of this article is to review the current evidence-based literature regarding the effects of physical exercise on CRF and the role that the clinical nurse leader (CNL) can play in implementing interventions to address CRF and promote physical exercise to improve patient outcomes. A literature review of the effect of physical exercise on CRF was conducted using the CINAHL®, PubMed, and Google Scholar databases. As leaders in health care, CNLs have the knowledge and skill to take an active role in managing CRF and to develop evidence-based interventions to address fatigue in this patient population. Interventions may include creating and evaluating individualized exercise plans for inpatients with cancer and/or developing educational programs for the inpatient setting that may be continued after discharge and during outpatient treatment.

Patient perspectives on breast cancer treatment side effects and the prospective surveillance model for physical rehabilitation for women with breast cancer.

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Binkley, Jill M; Harris, Susan R; Levangie, Pamela K; Pearl, Marcia; Guglielmino, Janine; Kraus, Valerie; Rowden, Diana

2012-04-15

Women's experience of breast cancer is complex, affecting all aspects of life during and after treatment. Patients' perspectives about common impairments and functional limitations secondary to breast cancer treatment, including upper extremity motion restriction, lymphedema, fatigue, weight gain, pain, and chemotherapy-induced peripheral neuropathy, are addressed. Women often report being uninformed regarding these side effects and surprised that they do not always disappear after treatment, but remain part of their lives. Breast cancer patients express strong, unmet needs for education, information, and intervention for these side effects. Evidence suggests that rehabilitation and exercise are effective in preventing and managing many physical side effects of breast cancer treatment. Nevertheless, few women are referred to rehabilitation during or after treatment, and fewer receive baseline assessments of impairment and function to facilitate early detection of impairment and functional limitations. The prospective surveillance model of rehabilitation will serve the needs of women with breast cancer by providing education and information about treatment side effects, reducing the incidence and burden of side effects through early identification and treatment, and enhancing access to timely rehabilitation. Integration of exercise as a component of the model benefits patients at every phase of survivorship, by addressing individual concerns about exercise during and after treatment and highlighting the important contribution of exercise to overall health and survival. The prospective surveillance model of rehabilitation can meet the evident and often expressed needs of survivors for information, guidance, and intervention--thus addressing, and potentially improving, overall quality of life for individuals diagnosed with and treated for breast cancer. Copyright © 2012 American Cancer Society.

Correlates of physical activity among colorectal cancer survivors : Results from the longitudinal population-based profiles registry

NARCIS (Netherlands)

van Putten, Margreet; Husson, O.; Mols, F.; Luyer, Misha D P; van de Poll-Franse, L.V.; Ezendam, N.P.M.

2016-01-01

PURPOSE: Physical activity can improve health of cancer survivors. To increase physical activity levels among colorectal cancer (CRC) survivors, we need to understand which factors affect physical activity. Therefore, this study examined the longitudinal relationship between symptom-related,

Correlates of physical activity among colorectal cancer survivors: results from the longitudinal population-based profiles registry

NARCIS (Netherlands)

Putten, M van; Husson, O.; Mols, F.; Luyer, M.D.; Poll-Franse, L.V. van de; Ezendam, N.P.

2016-01-01

PURPOSE: Physical activity can improve health of cancer survivors. To increase physical activity levels among colorectal cancer (CRC) survivors, we need to understand which factors affect physical activity. Therefore, this study examined the longitudinal relationship between symptom-related,

Managing work and cancer treatment: Experiences among survivors of hematological cancer.

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Thomson, Maria D; Siminoff, Laura A

2018-04-16

The current study was performed to characterize the employment status of survivors of hematological cancer who have an informal caregiver from the time of diagnosis through the first 6 months of treatment. Using a mixed methods approach, semistructured interviews with survivors of hematological cancer were conducted within 6 months of the initiation of cancer treatment. Interviews assessed cancer treatment status, barriers and facilitators to employment, financial and insurance status, and relationship with the primary caregiver. These results are part of a longitudinal study of cancer survivors and informal caregivers. A total of 171 patients were enrolled. Within 6 months of beginning cancer treatments, approximately 35% were no longer employed. Reasons to remain employed included financial need, employee benefits, and a sense of purpose and normalcy. Employer accommodations and supportive colleagues facilitated continued employment. Logistic regression analysis demonstrated that having a higher household income, a desire to work, nonphysical job tasks, and congruent survivor-caregiver communication were associated with greater odds of remaining employed. Within 6 months of initiating cancer treatment, the majority of survivors of hematological cancer had maintained employment. Because of the limitations imposed by the physical stress of cancer treatments, as well as the need to maintain employment to continue receiving employee benefits to cover such treatments, survivors of hematological cancer likely would benefit from employment accommodations that are sensitive to their unique needs. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

The association of lifetime physical inactivity with bladder and renal cancer risk: A hospital-based case-control analysis.

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Cannioto, Rikki; Etter, John Lewis; Guterman, Lauren Beryl; Joseph, Janine M; Gulati, Nicholas R; Schmitt, Kristina L; LaMonte, Michael J; Nagy, Ryan; Minlikeeva, Albina; Szender, James Brian; Moysich, Kirsten B

2017-08-01

Recreational physical inactivity has been gaining recognition as an independent epidemiological exposure of interest in relation to cancer endpoints due to evidence suggesting that it may associate with cancer independent of obesity. In the current analyses, we examined the associations of lifetime recreational physical inactivity with renal and bladder cancer risk. In this hospital-based case-control study, we identified N=160 renal cancer patients, N=208 bladder cancer patients, and N=766 age frequency-matched controls without cancer. Participants self-reporting never participating in any regular/weekly recreational physical activity throughout their lifetime were classified as physically inactive. Utilizing unconditional multivariable logistic regression analyses, we estimated odds ratios and 95% confidence intervals to represent the associations between lifetime physical inactivity and renal and bladder cancer risk. In multivariable logistic regression models, we observed significant positive associations between lifetime recreational physical inactivity and renal cancer and bladder cancer risk: odds ratio=1.77 (95% CI: 1.10-2.85) and odds ratio=1.73 (95% CI: 1.13-2.63), respectively. Similar associations also persisted among individuals who were not obese for both renal and bladder cancer: odds ratio=1.75 (95% CI: 1.03-2.98) and odds ratio=1.70 (95% CI: 1.08-2.69), respectively. In this case-control study, we observed evidence of a positive association between renal and bladder cancer with lifetime recreational physical inactivity. These data add to the growing body of evidence suggesting that physical inactivity may be an important independent risk factor for cancer. However, additional studies using a larger sample and prospectively collected data are needed to substantiate the current findings. Copyright © 2017 Elsevier Ltd. All rights reserved.

Diet and physical activity in relation to weight change among breast cancer patients.

Science.gov (United States)

Yaw, Yong Heng; Shariff, Zalilah Mohd; Kandiah, Mirnalini; Weay, Yong Heng; Saibul, Nurfaizah; Sariman, Sarina; Hashim, Zailina

2014-01-01

This study aimed to provide an overview of lifestyle changes after breast cancer diagnosis and to examine the relationship between dietary and physical activity changes with weight changes in breast cancer patients. Women with breast carcinomas (n=368) were recruited from eight hospitals and four breast cancer support groups in peninsular Malaysia. Dietary and physical activity changes were measured from a year preceding breast cancer diagnosis to study entry. Mean duration since diagnosis was 4.86±3.46 years. Dietary changes showed that majority of the respondents had decreased their intake of high fat foods (18.8-65.5%), added fat foods (28.3-48.9%), low fat foods (46.8-80.7%), red meat (39.7%), pork and poultry (20.1-39.7%) and high sugar foods (42.1-60.9%) but increased their intake of fish (42.7%), fruits and vegetables (62.8%) and whole grains (28.5%). Intake of other food groups remained unchanged. Only a small percentage of the women (22.6%) had increased their physical activity since diagnosis where most of them (16.0%) had increased recreational activities. Age at diagnosis (β= -0.20, p= 0.001), and change in whole grain (β= -0.15, p= 0.003) and fish intakes (β= 0.13, p= 0.013) were associated with weight changes after breast cancer diagnosis. In summary, the majority of the women with breast cancer had changed their diets to a healthier one. However, many did not increase their physical activity levels which could improve their health and lower risk of breast cancer recurrence.

Patient-Provider Communication: Experiences of Low-Wage-Earning Breast Cancer Survivors in Managing Cancer and Work.

Science.gov (United States)

Nichols, Helen M; Swanberg, Jennifer E; Vanderpool, Robin C

2018-02-26

In 2017, there will be more than 250,000 new diagnoses of invasive breast cancer; most cases will occur in working-age women. The goal of this qualitative study was to explore low-wage-earning breast cancer survivors' experiences communicating with their oncology team about cancer and employment issues. Twenty-four low-wage-earning breast cancer survivors in the USA were interviewed in 2012 using a structured interview protocol. Sociodemographic data, cancer history, and patient-provider communication experiences regarding the management of cancer and work were collected. Interviews were analyzed using grounded theory strategy of constant comparative analysis. Low-wage-earning breast cancer survivors' experiences communicating with their oncology team about employment and cancer focused on three dimensions of patient-provider communication: extent, quality, and content. Over 70% of respondents reported no communication or only routine communication with their providers regarding work; three quarters of women reported poor or standard communication quality, and content of work-related communication covered scheduling issues, work absences, continuing to work during treatment, and financial concerns. Communication between oncology care teams and low-wage-earning cancer patients is critical to the successful management of treatment and work responsibilities given the vulnerable employment situation of these women. There is a need for education of oncology team members about how cancer and its treatment can impact employment for all workers, but especially for low-wage workers, thereby allowing the care team to address these issues proactively and help patients successfully manage both cancer treatment and work responsibilities.

[Relation between physical activity, weight balance and breast cancer].

Science.gov (United States)

Maître, Carole

2013-05-01

Many epidemiologic studies, with a good methodology, support the evidence of the positive role of regular physical activity on primary and tertiary prevention of breast cancer on the risk of recurrence and mortality. This relation depends on the level of total energy expenditure by week, which helps balance weight on lifetime, an essential part of benefit. The beneficial effects of physical activity are linked to many interrelated additional mechanisms: in a short-term, contraction of skeletal muscles involves aerobic metabolism which utilizes glucose and amino acids like glutamine, improves insulin sensitivity and lowers plasma insulin; in a long-term, physical activity produces favorable changes in body composition, decreasing body fat and increasing lean mass. That is a key point to reduce the intake of energy substrates stimulating carcinogenesis, to improve insulin sensitivity, to change the ratio of leptin and adiponectin, to enhance cellular immunity and to block cellular pathways of cell proliferation and angiogenesis. Maintaining a healthy weight through regular physical activity well balanced with energy intake is it a goal for prevention of breast cancer. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Canadian Cancer Risk Management Model: evaluation of cancer control.

Science.gov (United States)

Evans, William K; Wolfson, Michael C; Flanagan, William M; Shin, Janey; Goffin, John; Miller, Anthony B; Asakawa, Keiko; Earle, Craig; Mittmann, Nicole; Fairclough, Lee; Oderkirk, Jillian; Finès, Philippe; Gribble, Stephen; Hoch, Jeffrey; Hicks, Chantal; Omariba, D Walter R; Ng, Edward

2013-04-01

The aim of this study was to develop a decision support tool to assess the potential benefits and costs of new healthcare interventions. The Canadian Partnership Against Cancer (CPAC) commissioned the development of a Cancer Risk Management Model (CRMM)--a computer microsimulation model that simulates individual lives one at a time, from birth to death, taking account of Canadian demographic and labor force characteristics, risk factor exposures, and health histories. Information from all the simulated lives is combined to produce aggregate measures of health outcomes for the population or for particular subpopulations. The CRMM can project the population health and economic impacts of cancer control programs in Canada and the impacts of major risk factors, cancer prevention, and screening programs and new cancer treatments on population health and costs to the healthcare system. It estimates both the direct costs of medical care, as well as lost earnings and impacts on tax revenues. The lung and colorectal modules are available through the CPAC Web site (www.cancerview.ca/cancerrriskmanagement) to registered users where structured scenarios can be explored for their projected impacts. Advanced users will be able to specify new scenarios or change existing modules by varying input parameters or by accessing open source code. Model development is now being extended to cervical and breast cancers.

Clinicians' Perspectives on Managing Symptom Clusters in Advanced Cancer: A Semistructured Interview Study.

Science.gov (United States)

Dong, Skye T; Butow, Phyllis N; Agar, Meera; Lovell, Melanie R; Boyle, Frances; Stockler, Martin; Forster, Benjamin C; Tong, Allison

2016-04-01

Managing symptom clusters or multiple concurrent symptoms in patients with advanced cancer remains a clinical challenge. The optimal processes constituting effective management of symptom clusters remain uncertain. To describe the attitudes and strategies of clinicians in managing multiple co-occurring symptoms in patients with advanced cancer. Semistructured interviews were conducted with 48 clinicians (palliative care physicians [n = 10], oncologists [n = 6], general practitioners [n = 6], nurses [n = 12], and allied health providers [n = 14]), purposively recruited from two acute hospitals, two palliative care centers, and four community general practices in Sydney, Australia. Transcripts were analyzed using thematic analysis and adapted grounded theory. Six themes were identified: uncertainty in decision making (inadequacy of scientific evidence, relying on experiential knowledge, and pressure to optimize care); attunement to patient and family (sensitivity to multiple cues, prioritizing individual preferences, addressing psychosocial and physical interactions, and opening Pandora's box); deciphering cause to guide intervention (disaggregating symptoms and interactions, flexibility in assessment, and curtailing investigative intrusiveness); balancing complexities in medical management (trading off side effects, minimizing mismatched goals, and urgency in resolving severe symptoms); fostering hope and empowerment (allaying fear of the unknown, encouraging meaning making, championing patient empowerment, and truth telling); and depending on multidisciplinary expertise (maximizing knowledge exchange, sharing management responsibility, contending with hierarchical tensions, and isolation and discontinuity of care). Management of symptom clusters, as both an art and a science, is currently fraught with uncertainty in decision making. Strengthening multidisciplinary collaboration, continuity of care, more pragmatic planning of clinical trials to address more than one

Nutrition management for head and neck cancer patients improves clinical outcome and survival.

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Müller-Richter, Urs; Betz, C; Hartmann, S; Brands, R C

2017-12-01

Up to 80% of patients with head and neck cancers are malnourished because of their lifestyle and the risk factors associated with this disease. Unfortunately, nutrition management systems are not implemented in most head and neck cancer clinics. Even worse, many head and neck surgeons as well as hospital management authorities disregard the importance of nutrition management in head and neck cancer patients. In addition, the often extensive resection and reconstruction required for tumors in the upper aerodigestive tract pose special challenges for swallowing and sufficient food intake, placing special demands on nutrition management. This article presents the basics of perioperative metabolism and nutrition management of head and neck cancer patients and makes recommendations for clinical practice. Implementing a nutrition management system in head and neck cancer clinics will improve the clinical outcome and the survival of the patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Cancer Care Ontario and integrated cancer programs: portrait of a performance management system and lessons learned.

Science.gov (United States)

Cheng, Siu Mee; Thompson, Leslee J

2006-01-01

A performance management system has been implemented by Cancer Care Ontario (CCO). This system allows for the monitoring and management of 11 integrated cancer programs (ICPs) across the Province of Ontario. The system comprises of four elements: reporting frequency, reporting requirements, review meetings and accountability and continuous improvement activities. CCO and the ICPs have recently completed quarterly performance review exercises for the last two quarters of the fiscal year 2004-2005. The purpose of this paper is to address some of the key lessons learned. The paper provides an outline of the CCO performance management system. These lessons included: data must be valid and reliable; performance management requires commitments from both parties in the performance review exercises; streamlining performance reporting is beneficial; technology infrastructure which allows for cohesive management of data is vital for a sustainable performance management system; performance indicators need to stand up to scrutiny by both parties; and providing comparative data across the province is valuable. Critical success factors which would help to ensure a successful performance management system include: corporate engagement from various parts of an organization in the review exercises; desire to focus on performance improvement and avoidance of blaming; and strong data management systems. The performance management system is a practical and sustainable system that allows for performance improvement of cancer care services. It can be a vital tool to enhance accountability within the health care system. The paper demonstrates that the performance management system supports accountability in the cancer care system for Ontario, and reflects the principles of the provincial governments commitment to continuous improvement of healthcare.

Hypothyroidism after a cancer diagnosis: etiology, diagnosis, complications, and management.

Science.gov (United States)

Carter, Yvette; Sippel, Rebecca S; Chen, Herbert

2014-01-01

Hypothyroidism is a common disease that is easily treated in the majority of cases, when readily diagnosed; however, presentation of an aggregate of its symptoms is often clinically overlooked or attributed to another disease and can potentially be lethal. Already prevalent in older women, its occurrence in younger patients is rising as a result of radiation therapy, radioactive iodine therapy, and newer antineoplastic agents used to manage various malignancies. The presence of nonspecific constitutional symptoms and neuropsychiatric complaints in cancer patients can be attributed to a myriad of other diagnoses and therapies. Thyroid dysfunction can be easily overlooked in cancer patients because of the complexity of cancer's clinical picture, particularly in the pediatric population. Underdiagnosis can have important consequences for the management of both hypothyroidism and the malignancy. At minimum, quality of life is adversely affected. Untreated hypothyroidism can lead to heart failure, psychosis, and coma and can reduce the effectiveness of potentially life-saving cancer therapies, whereas iatrogenic causes can provoke atrial fibrillation and osteoporosis. Consequently, the diagnosis and treatment of hypothyroidism in cancer patients are pertinent. We summarize the history, epidemiology, pathophysiology, clinical diagnosis, and management of hypothyroidism in cancer patients.

Self-efficacy mediates the relationship between behavioral processes of change and physical activity in older breast cancer survivors.

Science.gov (United States)

Loprinzi, Paul D; Cardinal, Bradley J

2013-01-01

The degree to which breast cancer survivors use behavioral processes of change has not been investigated. Additionally, the relationship between behavioral processes and other theory-based mediators of adult physical activity behavior has not been extensively studied among breast cancer survivors. The objectives of this study were to: (1) determine the extent to which breast cancer survivors use behavioral processes associated with physical activity behavior change, and (2) examine the inter-relationships between behavioral processes, self-efficacy, and physical activity behavior among breast cancer survivors. Sixty-nine breast cancer survivors completed surveys examining behavioral processes and exercise-specific self-efficacy. Six months later they completed a self-report physical activity questionnaire. Findings showed the majority of breast cancer survivors did not use approximately half of the behavioral processes on a regular basis, and self-efficacy completely mediated the relationship between behavioral processes and physical activity. Health care professionals may help enhance self-efficacy and ultimately increase physical activity behavior in breast cancer survivors by teaching behavior skills such as enlisting social support.

Perceived barriers and facilitators to physical activity in men with prostate cancer: possible influence of androgen deprivation therapy.

Science.gov (United States)

Keogh, J W L; Patel, A; MacLeod, R D; Masters, J

2014-03-01

While physical activity is beneficial for men with prostate cancer, too few perform sufficient activity for such benefit. This study examined perceptions of men with prostate cancer of their barriers and facilitators to physical activity, and how androgen deprivation therapy (ADT) may influence these perceptions. Two focus groups were conducted, involving six ADT and eight non-ADT patients respectively. Data were transcribed verbatim and themes developed using a general inductive thematic approach. Facilitators to physical activity common to both groups of cancer survivors included clinician and spousal involvement, with pre-existing co-morbidities and increased age cited as barriers by both groups. The ADT subgroup cited personal involvement as a facilitator to physical activity, with fatigue, reduced motivation and a relative lack of specific advice from their clinician as additional barriers. The non-ADT subgroup had no additional facilitators to physical activity but cited time constraints as a barrier. These results highlight the important role that cancer clinicians and spouses play in promoting physical activity for men with prostate cancer and how ADT may influence their other facilitators and barriers. As physical activity is beneficial for prostate cancer survivors, especially those on ADT, cancer clinicians should regularly discuss physical activity with their patients. © 2013 John Wiley & Sons Ltd.

Integrating physical and financial approaches to manage environmental financial risk

Science.gov (United States)

Characklis, Gregory; Meyer, Eliot; Foster, Benjamin

2017-04-01

Physical and/or engineered solutions have long been used to manage risks associated with adverse environmental events. Examples include reservoirs as a tool for mitigating drought-related supply risk, levees for managing flood risk and dredging of inland waterways to ensure navigability during low flow periods. These measures can reduce many types of risk (e.g., loss of life), but are often employed as a means of protecting against financial losses. When the focus is on managing environmental financial risk, physical solutions can be effective, but also costly. In many cases, non-physical tools can provide a less expensive means of managing financial risk, with these often taking the form of financial instruments such as hedging contracts, contingency funds or insurance. Some of these instruments, such as flood insurance, are widely available, but historically many environmental financial risks have been managed primarily (or solely) via physical solutions without much consideration of alternatives, thereby opening opportunities for innovation in developing financial solutions. Recent research has demonstrated that financial instruments can play a significant role in managing drought-related financial risk in sectors as diverse as water utilities, energy generation and inland navigation. Nonetheless, this work has largely considered the use of these instruments within systems in which physical solutions are already in place (but failing to achieve desired performance). The next step in the evolution of managing environmental financial risk involves developing methods for designing risk management strategies that do not assume an established physical system. Here the goal is to identify the relative role that physical solutions and financial instruments should play as they are integrated into a comprehensive risk management strategy. This is not a straightforward challenge as one approach reduces the risk of financial losses and the other redistributes those losses

Physical activity, energy restriction, and the risk of pancreatic cancer: Prospective study in the Netherlands

NARCIS (Netherlands)

Heinen, M.M.; Verhage, B.A.J.; Goldbohm, R.A.; Lumey, L.H.; Brandt, P.A. van den

2011-01-01

Background: Because of their influence on insulin concentrations, we hypothesized that both physical activity and energy restriction may reduce the risk of pancreatic cancer. Objective: We examined the associations between physical activity, proxies for energy restriction, and pancreatic cancer

An evaluation of the behaviour-change techniques used on Canadian cancer centre Web sites to support physical activity behaviour for breast cancer survivors.

Science.gov (United States)

Sylvester, B D; Zammit, K; Fong, A J; Sabiston, C M

2017-12-01

Cancer centre Web sites can be a useful tool for distributing information about the benefits of physical activity for breast cancer (bca) survivors, and they hold potential for supporting health behaviour change. However, the extent to which cancer centre Web sites use evidence-based behaviour change techniques to foster physical activity behaviour among bca survivors is currently unknown. The aim of our study was to evaluate the presentation of behaviour-change techniques on Canadian cancer centre Web sites to promote physical activity behaviour for bca survivors. All Canadian cancer centre Web sites ( n = 39) were evaluated by two raters using the Coventry, Aberdeen, and London-Refined (calo-re) taxonomy of behaviour change techniques and the eEurope 2002 Quality Criteria for Health Related Websites. Descriptive statistics were calculated. The most common behaviour change techniques used on Web sites were providing information about consequences in general (80%), suggesting goal-setting behaviour (56%), and planning social support or social change (46%). Overall, Canadian cancer centre Web sites presented an average of M = 6.31 behaviour change techniques (of 40 that were coded) to help bca survivors increase their physical activity behaviour. Evidence of quality factors ranged from 90% (sites that provided evidence of readability) to 0% (sites that provided an editorial policy). Our results provide preliminary evidence that, of 40 behaviour-change techniques that were coded, fewer than 20% were used to promote physical activity behaviour to bca survivors on cancer centre Web sites, and that the most effective techniques were inconsistently used. On cancer centre Web sites, health promotion specialists could focus on emphasizing knowledge mobilization efforts using available research into behaviour-change techniques to help bca survivors increase their physical activity.

Cancer prehabilitation: an opportunity to decrease treatment-related morbidity, increase cancer treatment options, and improve physical and psychological health outcomes.

Science.gov (United States)

Silver, Julie K; Baima, Jennifer

2013-08-01

Cancer prehabilitation, a process on the continuum of care that occurs between the time of cancer diagnosis and the beginning of acute treatment, includes physical and psychological assessments that establish a baseline functional level, identifies impairments, and provides targeted interventions that improve a patient's health to reduce the incidence and the severity of current and future impairments. There is a growing body of scientific evidence that supports preparing newly diagnosed cancer patients for and optimizing their health before starting acute treatments. This is the first review of cancer prehabilitation, and the purpose was to describe early studies in the noncancer population and then the historical focus in cancer patients on aerobic conditioning and building strength and stamina through an appropriate exercise regimen. More recent research shows that opportunities exist to use other unimodal or multimodal prehabilitation interventions to decrease morbidity, improve physical and psychological health outcomes, increase the number of potential treatment options, decrease hospital readmissions, and reduce both direct and indirect healthcare costs attributed to cancer. Future research may demonstrate increased compliance with acute cancer treatment protocols and, therefore, improved survival outcomes. New studies suggest that a multimodal approach that incorporates both physical and psychological prehabilitation interventions may be more effective than a unimodal approach that addresses just one or the other. In an impairment-driven cancer rehabilitation model, identifying current and anticipating future impairments are the critical first steps in improving healthcare outcomes and decreasing costs. More research is urgently needed to evaluate the most effective prehabilitation interventions, and combinations thereof, for survivors of all types of cancer.

Decline in physical activity level in the Childhood Cancer Survivor Study cohort.

Science.gov (United States)

Wilson, Carmen L; Stratton, Kayla; Leisenring, Wendy L; Oeffinger, Kevin C; Nathan, Paul C; Wasilewski-Masker, Karen; Hudson, Melissa M; Castellino, Sharon M; Stovall, Marilyn; Armstrong, Gregory T; Brinkman, Tara M; Krull, Kevin R; Robison, Leslie L; Ness, Kirsten K

2014-08-01

We aimed to identify demographic and health-related predictors of declining physical activity levels over a four-year period among participants in the Childhood Cancer Survivor Study. Analyses included 7,287 ≥5-year childhood cancer survivors and 2,107 siblings who completed multiple follow-up questionnaires. Participants were classified as active if they met the Centers for Disease Control and Prevention guidelines for physical activity. Generalized linear models were used to compare participants whose physical activity levels declined from active to inactive over the study to those who remained active. In addition, selected chronic conditions (CTCAE v4.03 Grade 3 and 4) were evaluated as risk factors in an analysis limited to survivors only. The median age at last follow-up among survivors and siblings was 36 (range, 21-58) and 38 (range, 21-62) years, respectively. The rate of decline did not accelerate over time among survivors when compared with siblings. Factors that predicted declining activity included body mass index ≥30 kg/m(2) [RR = 1.32; 95% confidence interval (CI), 1.19-1.46, P physical activity levels were associated with the presence of chronic musculoskeletal conditions (P = 0.034), but not with the presence of cardiac (P = 0.10), respiratory (P = 0.92), or neurologic conditions (P = 0.21). Interventions designed to maximize physical activity should target female, obese, and less educated survivors. Survivors with chronic musculoskeletal conditions should be monitored, counseled, and/or referred for physical therapy. Clinicians should be aware of low activity levels among subpopulations of childhood cancer survivors, which may heighten their risk for chronic illness. ©2014 American Association for Cancer Research.

Comparison of Conflict Management Strategies of Physical Education Office Managers Based on some Demographic Characteristics

OpenAIRE

Fatemeh Ghorbanalizadeh Ghaziani; Mohsen Moadi; Siavash Khodaparast Sareshkeh

2013-01-01

The purpose of study was comparison of conflict management strategies of physical education office managers based on their some demographic characteristics. All of managers of physical education office of Mazandaran (n = 15) and Guilan (n = 16) province and their assistant [(n = 15) and (n =16) respectively] response to Putnam and Wilson’s “organizational communication conflict instrument (OCCI)”.Analysis showed that Mazandaran’s and Guilan’s managers and their assistant hadn’t differences to...

Interventions Using Social Media for Cancer Prevention and Management: A Systematic Review.

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Han, Claire Jungyoun; Lee, Young Ji; Demiris, George

2017-07-27

Regarding cancer awareness, social media effectively promotes health and supports self-management. Given the diverse study designs, methodologies, and approaches of social media interventions in oncology, it is difficult to determine the effects of social media on cancer prevention and management. We aim to systematically review intervention studies using social media for cancer care. A systematic search, using 7 electronic databases (PubMed, Web of Science, CINAHL, Cochrane Library, Scopus, EMBASE, and PsycINFO), was conducted to identify surveys and interventions using contemporary social media tools with a focus on cancer. Of the 18 selected studies, 7 were randomized controlled trials. Most studies were conducted for all types of cancer, and some were conducted for breast cancer in the United States, with mostly white female participants. Facebook was the most frequently used platform. Most studies targeted healthy participants providing cancer prevention education. With social media platforms as part of a larger intervention, or the main component of interventions, interventions were overall feasible and showed a significant improvement in cancer prevention and management. Social media tools have the potential to be effective in delivering interventions for cancer prevention and management. However, there was a dearth of studies with rigorous study methodologies to test social media effects on various cancer-related clinical outcomes. Social media use in cancer care will facilitate improved communication and support among patients, caregivers, and clinicians and, ultimately, improved patient care. Clinicians need to carefully harness social media to enhance patient care and clinical outcomes.

Physical activity, sedentary behaviour, diet, and cancer: an update and emerging new evidence.

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Kerr, Jacqueline; Anderson, Cheryl; Lippman, Scott M

2017-08-01

The lifestyle factors of physical activity, sedentary behaviour, and diet are increasingly being studied for their associations with cancer. Physical activity is inversely associated with and sedentary behaviour is positively (and independently) associated with an increased risk of more than ten types of cancer, including colorectal cancer (and advanced adenomas), endometrial cancers, and breast cancer. The most consistent dietary risk factor for premalignant and invasive breast cancer is alcohol, whether consumed during early or late adult life, even at low levels. Epidemiological studies show that the inclusion of wholegrain, fibre, fruits, and vegetables within diets are associated with reduced cancer risk, with diet during early life (age diet-related factors have not yet shown any conclusive associations between diet and cancer incidence. Obesity is a key contributory factor associated with cancer risk and mortality, including in dose-response associations in endometrial and post-menopausal breast cancer, and in degree and duration of fatty liver disease-related hepatocellular carcinoma. Obesity produces an inflammatory state, characterised by macrophages clustered around enlarged hypertrophied, dead, and dying adipocytes, forming crown-like structures. Increased concentrations of aromatase and interleukin 6 in inflamed breast tissue and an increased number of macrophages, compared with healthy tissue, are also observed in women with normal body mass index, suggesting a metabolic obesity state. Emerging randomised controlled trials of physical activity and dietary factors and mechanistic studies of immunity, inflammation, extracellular matrix mechanics, epigenetic or transcriptional regulation, protein translation, circadian disruption, and interactions of the multibiome with lifestyle factors will be crucial to advance this field. Copyright © 2017 Elsevier Ltd. All rights reserved.

Management of pancreatic cancer in the elderly.

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Higuera, Oliver; Ghanem, Ismael; Nasimi, Rula; Prieto, Isabel; Koren, Laura; Feliu, Jaime

2016-01-14

Currently, pancreatic adenocarcinoma mainly occurs after 60 years of age, and its prognosis remains poor despite modest improvements in recent decades. The aging of the population will result in a rise in the incidence of pancreatic adenocarcinoma within the next years. Thus, the management of pancreatic cancer in the elderly population is gaining increasing relevance. Older cancer patients represent a heterogeneous group with different biological, functional and psychosocial characteristics that can modify the usual management of this disease, including pharmacokinetic and pharmacodynamic changes, polypharmacy, performance status, comorbidities and organ dysfunction. However, the biological age, not the chronological age, of the patient should be the limiting factor in determining the most appropriate treatment for these patients. Unfortunately, despite the increased incidence of this pathology in older patients, there is an underrepresentation of these patients in clinical trials, and the management of older patients is thus determined by extrapolation from the results of studies performed in younger patients. In this review, the special characteristics of the elderly, the multidisciplinary management of localized and advanced ductal adenocarcinoma of the pancreas and the most recent advances in the management of this condition will be discussed, focusing on surgery, chemotherapy, radiation and palliative care.

The Alberta moving beyond breast cancer (AMBER cohort study: a prospective study of physical activity and health-related fitness in breast cancer survivors

Directory of Open Access Journals (Sweden)

Courneya Kerry S

2012-11-01

Full Text Available Abstract Background Limited research has examined the association between physical activity, health-related fitness, and disease outcomes in breast cancer survivors. Here, we present the rationale and design of the Alberta Moving Beyond Breast Cancer (AMBER Study, a prospective cohort study designed specifically to examine the role of physical activity and health-related fitness in breast cancer survivorship from the time of diagnosis and for the balance of life. The AMBER Study will examine the role of physical activity and health-related fitness in facilitating treatment completion, alleviating treatment side effects, hastening recovery after treatments, improving long term quality of life, and reducing the risks of disease recurrence, other chronic diseases, and premature death. Methods/Design The AMBER Study will enroll 1500 newly diagnosed, incident, stage I-IIIc breast cancer survivors in Alberta, Canada over a 5 year period. Assessments will be made at baseline (within 90 days of surgery, 1 year, and 3 years consisting of objective and self-reported measurements of physical activity, health-related fitness, blood collection, lymphedema, patient-reported outcomes, and determinants of physical activity. A final assessment at 5 years will measure patient-reported data only. The cohort members will be followed for an additional 5 years for disease outcomes. Discussion The AMBER cohort will answer key questions related to physical activity and health-related fitness in breast cancer survivors including: (1 the independent and interactive associations of physical activity and health-related fitness with disease outcomes (e.g., recurrence, breast cancer-specific mortality, overall survival, treatment completion rates, symptoms and side effects (e.g., pain, lymphedema, fatigue, neuropathy, quality of life, and psychosocial functioning (e.g., anxiety, depression, self-esteem, happiness, (2 the determinants of physical activity and

Physicians' Practice, Attitudes Toward, and Knowledge of Cancer Pain Management in China.

Science.gov (United States)

Zhang, Qiongwen; Yu, Chunhua; Feng, Shijian; Yao, Wenxiu; Shi, Huashan; Zhao, Yuwei; Wang, Yongsheng

2015-11-01

To evaluate physicians' current practice, attitudes toward, and knowledge of cancer pain management in China. We conducted a face-to-face survey of physicians (oncologists, internists, hematologists) who are responsible for the care of cancer patient of 11 general hospitals in Sichuan, China between December 2011 and December 2013. Statistical analyses were performed using SPSS (SPSS, Chicago, IL) software. A 23-item questionnaire was designed and distributed to 550 physicians in 11 medical facilities in China. Five hundred (90.90%) physicians responded. About one-third (32.6%) of physicians assessed patients' pain rarely, and 85.5% never or occasionally treated patients' cancer pain together with psychologists. More than half of physicians indicated that opioid dose titration in patients with poor pain control and assessment of the cause and severity of pain were urgently needed knowledge for cancer pain management. Inadequate assessment of pain and pain management (63.0%), patients' reluctance to take opioids (62.2%), and inadequate staff knowledge of pain management (61.4%) were the three most frequently cited barriers to physicians' pain management. Physicians' positive attitudes toward cancer pain management need to be encouraged, and active professional analgesic education programs are needed to improve pain management in China. Wiley Periodicals, Inc.

Health physics information management

International Nuclear Information System (INIS)

Schauss, R.D.

1982-01-01

The records that men have kept over the centuries have made the civilizations of man possible. Recorded history shows that our progress is closely correlated to man's ability to communicate recorded facts to others, and to effectively use knowledge gained by others. During the past few decades our ability to store and use information, and to reach larger audiences has grown dramatically. The advent of computers is discussed and their evolution to the state-of-the-art is described. Data bases, batch and on-line processing, centralized and distributed processing as well as other computer jargon are generally explained and examples are given as they apply specifically to health physics programs. It is proposed that systems designed to manage information cannot be adapted to health physics problems without extensive involvement of the HP who must use the computerized program. Specific problems which arise during the development of a computerized health physics program are explained

The Interdependence of Advanced Cancer Patients' and Their Family Caregivers' Mental Health, Physical Health, and Self-Efficacy over Time.

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Kershaw, Trace; Ellis, Katrina R; Yoon, Hyojin; Schafenacker, Ann; Katapodi, Maria; Northouse, Laurel

2015-12-01

The challenges of advanced cancer have health implications for patients and their family caregivers from diagnosis through end of life. The nature of the patient/caregiver experience suggests that their mental and physical health maybe interdependent, but limited empirical evidence exists. This study used social cognitive theory as a framework to investigate individual and interpersonal influences on patients' and their family caregivers' mental health, physical health, and self-efficacy as individuals to manage the challenges of advanced disease over time. Patients and caregivers (484 patient-caregiver dyads) completed surveys at baseline, 3 and 6 months. Longitudinal dyadic analysis techniques were used to examine (i)the influence that patients and caregivers had on their own mental health, physical health, and self-efficacy (actor effects)and (ii) the influence that they had on each other's health outcomes (partner effects). We also examined the influence of self-efficacy on mental and physical health over time. Consistent with our hypotheses, each person's mental health, physical health, and self-efficacy had significant effects on their own outcomes over time (actor effects). Patients and caregivers influenced one another's mental and physical health (partner effects), but not their self-efficacy. In addition, patients and caregivers with higher self-efficacy had better mental health, and their partners had better physical health. Patients' and caregivers' mental and physical health were interdependent. Each person's cancer-related self-efficacy influenced their own mental and physical health. However, a person's self-efficacy did not influence the other person's self-efficacy.

The Interdependence of Advanced Cancer Patients’ and Their Family Caregivers’ Mental Health, Physical Health, and Self-Efficacy Over Time

Science.gov (United States)

Kershaw, Trace; Ellis, Katrina R.; Yoon, Hyojin; Schafenacker, Ann; Katapodi, Maria; Northouse, Laurel

2016-01-01

Background The challenges of advanced cancer have health implications for patients and their family caregivers from diagnosis through end-of-life. The nature of the patient/caregiver experience suggests that their mental and physical health may be interdependent, but limited empirical evidence exists. Purpose This study used Social Cognitive Theory as a framework to investigate individual and interpersonal influences on patients’ and their family caregivers’ mental health, physical health, and self-efficacy as individuals to manage the challenges of advanced disease over time. Methods Patients and caregivers (484 patient-caregiver dyads) completed surveys at baseline, 3 months and 6 months. Longitudinal dyadic analysis techniques were used to examine (i) the influence that patients and caregivers had on their own mental health, physical health, and self-efficacy (actor effects) and (ii) the influence that they had on each other’s health outcomes (partner effects). We also examined the influence of self-efficacy on mental and physical health over time. Results Consistent with our hypotheses, each person’s mental health, physical health, and self-efficacy had significant effects on their own outcomes over time (actor effects). Patients and caregivers influenced one another’s mental and physical health (partner effects), but not their self-efficacy. In addition, patients and caregivers with higher self-efficacy had better mental health, and their partners had better physical health. Conclusions Patient and caregiver mental and physical health were interdependent. Each person’s cancer-related self-efficacy influenced their own mental and physical health. However, a person’s self-efficacy did not influence the other person’s self-efficacy. PMID:26489843

[Role and management of cancer clinical database in the application of gastric cancer precision medicine].

Science.gov (United States)

Li, Yuanfang; Zhou, Zhiwei

2016-02-01

Precision medicine is a new medical concept and medical model, which is based on personalized medicine, rapid progress of genome sequencing technology and cross application of biological information and big data science. Precision medicine improves the diagnosis and treatment of gastric cancer to provide more convenience through more profound analyses of characteristics, pathogenesis and other core issues in gastric cancer. Cancer clinical database is important to promote the development of precision medicine. Therefore, it is necessary to pay close attention to the construction and management of the database. The clinical database of Sun Yat-sen University Cancer Center is composed of medical record database, blood specimen bank, tissue bank and medical imaging database. In order to ensure the good quality of the database, the design and management of the database should follow the strict standard operation procedure(SOP) model. Data sharing is an important way to improve medical research in the era of medical big data. The construction and management of clinical database must also be strengthened and innovated.

A systematic review of web-based interventions for patient empowerment and physical activity in chronic diseases: relevance for cancer survivors.

Science.gov (United States)

Kuijpers, Wilma; Groen, Wim G; Aaronson, Neil K; van Harten, Wim H

2013-02-20

Patient empowerment reflects the ability of patients to positively influence their health and health behavior such as physical activity. While interactive Web-based interventions are increasingly used in various chronic disease settings to enhance empowerment and physical activity, such interventions are still uncommon for cancer survivors. The objective of this study was to systematically review the literature regarding interactive Web-based interventions. We focused on interventions aimed at increasing patient empowerment and physical activity for various chronic conditions, and explored their possible relevance for cancer survivors. Searches were performed in PubMed, Embase, and Scopus to identify peer-reviewed papers reporting on randomized controlled trials that studied the effects of Web-based interventions. These interventions were developed for adults with diabetes, cardiovascular disease, chronic obstructive pulmonary disease, heart failure, or cancer. Intervention characteristics, effects on patient empowerment and physical activity, information on barriers to and facilitators of intervention use, users' experiences, and methodological quality were assessed. Results were summarized in a qualitative way. We used the recommendations of the Institute of Medicine (IOM) regarding cancer survivorship care to explore the relevance of the interventions for cancer survivors. We included 19 papers reporting on trials with 18 unique studies. Significant, positive effects on patient empowerment were reported by 4 studies and 2 studies reported positive effects on physical activity. The remaining studies yielded mixed results or no significant group differences in these outcomes (ie, no change or improvement for all groups). Although the content, duration, and frequency of interventions varied considerably across studies, commonly used elements included education, self-monitoring, feedback/tailored information, self-management training, personal exercise program, and

Behaviour change techniques in physical activity interventions for men with prostate cancer: A systematic review.

Science.gov (United States)

Hallward, Laura; Patel, Nisha; Duncan, Lindsay R

2018-02-01

Physical activity interventions can improve prostate cancer survivors' health. Determining the behaviour change techniques used in physical activity interventions can help elucidate the mechanisms by which an intervention successfully changes behaviour. The purpose of this systematic review was to identify and evaluate behaviour change techniques in physical activity interventions for prostate cancer survivors. A total of 7 databases were searched and 15 studies were retained. The studies included a mean 6.87 behaviour change techniques (range = 3-10), and similar behaviour change techniques were implemented in all studies. Consideration of how behaviour change techniques are implemented may help identify how behaviour change techniques enhance physical activity interventions for prostate cancer survivors.

The association of lifetime physical inactivity with head and neck cancer: a hospital-based case-control analysis.

Science.gov (United States)

Platek, Alexis J; Cannioto, Rikki A; Etter, John Lewis; Kim, Jae; Joseph, Janine M; Gulati, Nicholas R; Schmitt, Kristina L; Callahan, Emily; Khachatryan, Edgar; Nagy, Ryan; Minlikeeva, Albina; Brian Szender, J; Singh, Anurag K; Danziger, Iris; Moysich, Kirsten B

2017-10-01

Despite mounting epidemiological evidence suggesting an inverse association between recreational physical activity and cancer risk, evidence associated with head and neck cancer is scant. We conducted a case-control analysis to examine the associations of lifetime physical inactivity with the risk of head and neck squamous cell carcinoma (HNSCC). We utilized data from the Patient Epidemiology Data System at Roswell Park Cancer Institute (RPCI). Participants included 246 patients with HNSCC and 504 cancer-free controls who received medical services at RPCI between 1990 and 1998. Participants were considered physically inactive if they did not participate in any regular, weekly recreational physical activity throughout their lifetime, prior to diagnosis. Multivariate logistic regression models were utilized to estimate odds ratios (OR) and 95% confidence intervals (CI) representing the association between lifetime physical inactivity and HNSCC risk. We observed a significant positive association between recreational physical inactivity and HNSCC risk (OR = 2.73, 95% CI 1.87-3.99, p physical inactivity associates with HNSCC independent of BMI. In addition, physical inactivity may be a modifiable risk factor among never smokers. These data add to the growing body of evidence suggesting that physical inactivity may be an independent risk factor for cancer.

Physical therapy management of low back pain has changed.

Science.gov (United States)

Groenendijk, Jolanda Jozina; Swinkels, Ilse Catharina Sophia; de Bakker, Dinny; Dekker, Joost; van den Ende, Cornelia Helena Maria

2007-03-01

Since the 1990s, new insights in the physical therapy management of low back pain have been described in guidelines. Furthermore, insurance companies introduced a volume policy to control the costs for physical therapy. This study aims to establish if developments in knowledge and health policy since the 1990s have resulted in changes in the physical therapy management of patients with low back pain (LBP) in the Netherlands. Data from 3148 patients, referred because of LBP, were selected from the databases of two registration studies (1989-1992 and 2002-2003) of patients treated by physical therapists. Descriptive statistics were used to compare patient characteristics. A multi-level regression analysis was carried out to determine a change in the number of treatment sessions adjusting for patient and disease characteristics, and to control for different levels (patient and physical therapist). A small decline in the number of treatment sessions was observed. In 2002, exercise therapy was the most frequently applied intervention, while massage and physical modalities were the interventions of first choice in the early 1990s. Our results suggest that since 1990 the management of patients with LBP by physical therapists in the Netherlands has changed. Both quality management by the profession and volume policy by government and insurance companies seem to have been instrumental in bringing about a decline in the number of treatment visits and an increase in the use of evidence-based interventions.

Understanding the importance of therapeutic relationships in the development of self-management behaviours during cancer rehabilitation: a qualitative research protocol.

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Wilkinson, Wendy M; Rance, Jaynie; Fitzsimmons, Deborah

2017-01-17

Cancer is a growing health, social and economic problem. 1 in 3 people in the UK will develop cancer in their lifetime. With survival rates rising to over 50%, the long-term needs of cancer survivors are of growing importance. Cancer rehabilitation is tailored to address the physical or psychosocial decline in ability to engage in daily activities. Its use is supported by high-quality international, multicentre research. Incorporating strategies for self-management behaviour development into rehabilitation can prepare individuals for cancer survivorship. However, healthcare professionals will need to adjust their therapeutic interactions accordingly. Research is yet to clarify the impact of the therapeutic relationship on rehabilitation outcomes in cancer. This study aims to explore the impact of therapeutic relationships on self-management behaviours after cancer. This qualitative study aims to understand cancer rehabilitation participants' beliefs regarding the importance of therapeutic relationships in developing self-management behaviours. A sample representative of a local cancer rehabilitation cohort will be asked to complete a semistructured interview to identify their perspectives on the importance of therapeutic relationships in cancer rehabilitation. Data obtained from the interviews will be analysed, coded and entered into a Delphi questionnaire for circulation to a local cancer rehabilitation population to determine if the views expressed by the interviewees are supported by group consensus. This study was approved by Wales Research Ethics Committee 6 (15/WA/0331) in April 2016. Findings will be disseminated through the first author's doctoral thesis; peer-reviewed journals; local, national and international conference presentations; and public events involving research participants and the general public. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Impairments that Influence Physical Function among Survivors of Childhood Cancer

Directory of Open Access Journals (Sweden)

Carmen L. Wilson

2015-01-01

Full Text Available Children treated for cancer are at increased risk of developing chronic health conditions, some of which may manifest during or soon after treatment while others emerge many years after therapy. These health problems may limit physical performance and functional capacity, interfering with participation in work, social, and recreational activities. In this review, we discuss treatment-induced impairments in the endocrine, musculoskeletal, neurological, and cardiopulmonary systems and their influence on mobility and physical function. We found that cranial radiation at a young age was associated with a broad range of chronic conditions including obesity, short stature, low bone mineral density and neuromotor impairments. Anthracyclines and chest radiation are associated with both short and long-term cardiotoxicity. Although numerous chronic conditions are documented among individuals treated for childhood cancer, the impact of these conditions on mobility and function are not well characterized, with most studies limited to survivors of acute lymphoblastic leukemia and brain tumors. Moving forward, further research assessing the impact of chronic conditions on participation in work and social activities is required. Moreover, interventions to prevent or ameliorate the loss of physical function among children treated for cancer are likely to become an important area of survivorship research.

Behavior Management in Physical Education, Recreation, and Sport: A Bibliography.

Science.gov (United States)

Lavay, Barry

1986-01-01

This bibliography contains references specifically pertaining to physical education, recreation, or sport and to behavior management. The references are classified into areas of behavior management overview, reinforcement systems, motor performance, physical fitness, recreation, and sport. (MT)

Physical activity and lower limb lymphedema among uterine cancer survivors.

Science.gov (United States)

Brown, Justin C; John, Gabriella M; Segal, Saya; Chu, Christina S; Schmitz, Kathryn H

2013-11-01

Physical activity (PA) is known to provide physical and mental health benefits to uterine cancer survivors. However, it is unknown if PA is associated with lower limb lymphedema (LLL), an accumulation of protein-rich fluid in the lower limbs. Therefore, we sought to examine the association between PA and LLL in uterine cancer survivors, with a focus on walking. We conducted a cross-sectional study using mailed surveys among uterine cancer survivors who received care at a university-based cancer center. We asked about PA, walking, and LLL symptoms using validated self-report questionnaires. PA was calculated using MET-hours per week, and walking was calculated using blocks per day. The response rate to our survey was 43%. Among the 213 uterine cancer survivors in our survey, 36% were classified as having LLL. Compared with participants who reported trend = 0.003). Stratified analyses suggested the association between PA and LLL existed only among women with body mass index (BMI) trend = 0.007) compared with women with BMI ≥ 30 kg · m (P trend = 0.47). Compared with participants who reported trend trend = 0.007) and women with BMI ≥ 30 kg · m (P trend = 0.03). Participation in higher levels of PA or walking is associated with reduced proportions of LLL in dose-response fashion. These findings should be interpreted as preliminary and should be investigated in future studies.

Moderate Physical Activity Mediates the Association between White Matter Lesion Volume and Memory Recall in Breast Cancer Survivors.

Directory of Open Access Journals (Sweden)

Gillian E Cooke

Full Text Available Increased survival rates among breast cancer patients have drawn significant attention to consequences of both the presence of cancer, and the subsequent treatment-related impact on the brain. The incidence of breast cancer and the effects of treatment often result in alterations in the microstructure of white matter and impaired cognitive functioning. However, physical activity is proving to be a successful modifiable lifestyle factor in many studies that could prove beneficial to breast cancer survivors. This study investigates the link between white matter lesion volume, moderate physical activity, and cognition in breast cancer survivors following treatment compared to non-cancer age-matched controls. Results revealed that brain structure significantly predicted cognitive function via mediation of physical activity in breast cancer survivors. Overall, the study provided preliminary evidence suggesting moderate physical activity may help reduce the treatment related risks associated with breast cancer, including changes to WM integrity and cognitive impairment.

Surgical management of metastatic differentiated thyroid cancer

International Nuclear Information System (INIS)

Fakih, A.R.; Mistry, R.C.

1999-01-01

The differentiated management of metastatic differentiated thyroid cancer (DTC) with lymph node and/or systemic metastases is very much a treatable cancer. Interaction between the surgeon and the nuclear medicine specialist is essential to ensure quality survival in these patient. This review is confined to surgical aspects and is based on experience with 417 patients who were operated for DTC at the Tata Memorial Hospital between 1971 and 1985

Current management of gynecologic cancer in pregnancy.

Science.gov (United States)

Iavazzo, Christos; Minis, Evelyn Eleni; Gkegkes, Ioannis D

2018-04-27

Cancer during pregnancy is a particularly challenging complication. The incidence has increased in recent years due to childbering at an advanced maternal age due to career choices and/or the development of reproductive technology. Approximately two thirds of cancer cases during pregnancy are comprised of invasive cervical cancers and breast cancer. Cancer during gestation is characterized by a need for specialized treatment due to major changes in the hormonal profile (estrogen-progesterone), metabolism (enhancement of anabolism), hemodynamic changes (hyperdynamic circulation), immunologic changes (cell mediated and humoral immunity), increased angiogenesis (increased blood flow towards the uterus). Moreover, the management of such patients is based on the trimester of pregnancy, type and stage of cancer and informed consent of the mother based on her wishes. The optimal treatment of cancer during pregnancy remains elusive, as there are limited data from retrospective studies with small samples. As a result, it is crucial that data regarding survival of the women and long-term follow up of the children from different cancer centres and registries be shared. This need is dictated by the fact that the incidence of cancer during pregnancy will continue to rise as child-bearing age continues to increase.

Long-term and baseline recreational physical activity and risk of endometrial cancer: the California Teachers Study.

Science.gov (United States)

Dieli-Conwright, C M; Ma, H; Lacey, J V; Henderson, K D; Neuhausen, S; Horn-Ross, P L; Deapen, D; Sullivan-Halley, J; Bernstein, L

2013-08-06

Physical activity may be associated with decreasing endometrial cancer risk; it remains unclear whether the association is modified by body size. Among 93 888 eligible California Teachers Study participants, 976 were diagnosed with incident endometrial cancer between 1995-1996 and 2007. Cox proportional hazards regression methods were used to estimate relative risks (RRs) and 95% confidence intervals (CIs) for endometrial cancer associated with long-term (high school through age 54 years) and baseline (3 years prior to joining the cohort) strenuous and moderate recreational physical activity, overall and by body size. Increased baseline strenuous recreational physical activity was associated with decreased endometrial cancer risk (Ptrend=0.006) with approximately 25% lower risk among women exercising >3 h per week per year than among those exercising activity was associated with lower risk among overweight/obese women. Increasing physical activity, particularly strenuous activity, may be a lifestyle change that overweight and obese women can implement to reduce their endometrial cancer risk.

[Case managers experience improved trajectories for cancer patients after implementation of the case manager function].

Science.gov (United States)

Axelsen, Karina Rahbek; Nafei, Hanne; Jakobsen, Stine Finne; Gandrup, Per; Knudsen, Janne Lehmann

2015-06-08

Case managers are increasingly used to optimize trajectories for patients. This study is based on a questionnaire among case managers in cancer care, aiming at the clarification of the func­tion and its impact on especially patient safety, when handing over the responsibility. The results show a major variation in how the function is organized, the level of competence and the task to be handled. The responsibility has in general been nar­rowed to department level. Overall, the case managers believe that the function has optimized pathways for cancer patients and improved safety, but barriers persist.

Physical perfection of future specialists to the management.

Directory of Open Access Journals (Sweden)

Dolinnyj U.A.

2012-12-01

Full Text Available The process of leadthrough of practical employments is considered on physical education on an experimental model, which are directed on the increase of reserve possibilities of organism of future specialists of management. In an experiment took part 30 students of 2 and 3 courses. It is set that management specialists for high-quality implementation of work need a high mental capacity, enhanceable psychoemotional firmness, general endurance. Directions of prophylaxis of emotional and physical overstrain are recommended, increases of level of positive motivation to systematic employments by physical exercises. It is marked that an experimental model in combination with the fixed form of leadthrough of employments on a body-conditioning and employments on specialization of the chosen type of sport is one the stages of alteration organizationally of methodical aspects of physical culture.

Moderators of the effects of group-based physical exercise on cancer survivors' quality of life

NARCIS (Netherlands)

Kalter, Joeri; Buffart, Laurien M.; Korstjens, Irene; van Weert, Ellen; Brug, Johannes; Verdonck-de Leeuw, Irma M.; Mesters, Ilse; van den Borne, Bart; Hoekstra-Weebers, Josette E. H. M.; Ros, Wynand J. G.; May, Anne M.

This study explored demographic, clinical, and psychological moderators of the effect of a group-based physical exercise intervention on global quality of life (QoL) among cancer survivors who completed treatment. Cancer survivors were assigned to a 12-week physical exercise (n = 147) or a wait-list

Perception and management of cancer among the Yoruba in Ibadan, Nigeria.

Science.gov (United States)

Oyetunde, M O

2010-09-01

Prevalence and mortality rates of cancer are on the increase worldwide. Its management is blurred by misconception in Nigeria particularly. This study therefore examines the Yoruba perception and management of cancer using health belief model as the theoretical framework. The study utilised both qualitative and quantitative approaches. It was carried out in Ibadan metropolis in Nigeria. For the qualitative data a total of 19 Focus group discussions (190 people) among people aged 20 years above 45 in-depth interviews and structured observation were held. For quantitative data, a simple random sampling technique was employed in selecting 450 people at the household level while non-probability sampling was used for the 45 people living with cancer (PLWC) and 75 health care providers. The result showed that cancer is perceived as a major health problem. It is commonly called "Jejere" literally meaning a devouring disease. Cancer is associated with natural causes due to unhealthy life styles such as nutritional pattern and indiscriminate use of both orthodox and traditional drugs. Socio-economic factors of the people determine management of cancer (43.4% and 33.0% for money and occupation respectively).Result showed that (60%) preferred and use the orthodox medical care for various reasons such as precison about treatment positive outcome of care among others. Utilization of modern healthcare however was associated with high cost. Education and occupation have significant relationship with perceived cause of cancer p 0.05) of cancer. The perceived cause of cancer does not have any relationship with the choice of cancer care p > 0.05. The available health care is significant to the choice of cancer care p 0.05. The problems encountered at the health care institutions were not significant to their utilization pattern p > 0.05, in order words, the benefits derived out-weighs the problems. Perception of cancer was not tied to the usual Yoruba perception of diseases. Cancer

Managing occupations in everyday life for people with advanced cancer living at home.

Science.gov (United States)

Peoples, Hanne; Brandt, Åse; Wæhrens, Eva E; la Cour, Karen

2017-01-01

People with advanced cancer are able to live for extended periods of time. Advanced cancer can cause functional limitations influencing the ability to manage occupations. Although studies have shown that people with advanced cancer experience occupational difficulties, there is only limited research that specifically explores how these occupational difficulties are managed. To describe and explore how people with advanced cancer manage occupations when living at home. A sub-sample of 73 participants from a larger occupational therapy project took part in the study. The participants were consecutively recruited from a Danish university hospital. Qualitative interviews were performed at the homes of the participants. Content analysis was applied to the data. Managing occupations were manifested in two main categories; (1) Conditions influencing occupations in everyday life and (2) Self-developed strategies to manage occupations. The findings suggest that people with advanced cancer should be supported to a greater extent in finding ways to manage familiar as well as new and more personally meaningful occupations to enhance quality of life.

Strategy of Education, Entertainment and Physical Activity for Women who Suffer Breast Cancer

Directory of Open Access Journals (Sweden)

María Antonia Afre Socorro

2017-12-01

Full Text Available Some research works attempt to establish new and more effective methods of prevention, diagnosis and treatment of breast cancer, since it continues being one of the most harmful frequent neoplasms in Cuba and in the world. The present aim of study is to elaborate a strategy of education, amusement and physical activity tasks for women with breast cancer to the improvement of their standard of life. An explanatory cuasi-experimental research was carried out, which consists on a proposal of education, entertainment and physical activities to be put into practice in most of the patients with diagnosis of breast cancer from Pinar del Río city. The observation, documental review and the structured interview to medical, sports and community people were used. A Strategy of actions was elaborated keeping in mind certain items or components like: beneficiaries, methodology to be used, resources and evaluation. Games, trips, shops on topics of interest, culinary activities and dancing were proposed like complement of a moderate physical exercise, all them controlled by qualified professionals of health and sport. It was concluded that education, entertainment and physical activity contribute to increase the quality of life and the social interaction in women with breast cancer.

Time trends in axilla management among early breast cancer patients

DEFF Research Database (Denmark)

Gondos, Adam; Jansen, Lina; Heil, Joerg

2016-01-01

Background We examined time trends in axilla management among patients with early breast cancer in European clinical settings. Material and methods EUROCANPlatform partners, including population-based and cancer center-specific registries, provided routinely available clinical cancer registry data...... for a comparative study of axillary management trends among patients with first non-metastatic breast cancer who were not selected for neoadjuvant therapy during the last decade. We used an additional short questionnaire to compare clinical care patterns in 2014. Results Patients treated in cancer centers were...... younger than population-based registry populations. Tumor size and lymph node status distributions varied little between settings or over time. In 2003, sentinel lymph node biopsy (SLNB) use varied between 26% and 81% for pT1 tumors, and between 2% and 68% for pT2 tumors. By 2010, SLNB use increased to 79...

Review of cancer pain management in patients receiving maintenance methadone therapy.

LENUS (Irish Health Repository)

Rowley, Dominic

2011-05-01

Methadone is commonly used in the treatment of heroin addiction. Patients with a history of opioid misuse or on methadone maintenance therapy (MMT) with cancer often have difficult to manage pain. We studied 12 patients referred to the palliative care service with cancer pain who were on MMT. All had difficult to control pain, and a third required 5 or more analgesic agents. Two patients had documented \\'\\'drug-seeking\\'\\' behavior. Methadone was used subcutaneously as an analgesic agent in 1 patient. We explore why patients on MMT have difficult to manage pain, the optimal management of their pain, and the increasing role of methadone as an analgesic agent in cancer pain.

Reduced risk of breast cancer associated with recreational physical activity varies by HER2 status

International Nuclear Information System (INIS)

Ma, Huiyan; Xu, Xinxin; Ursin, Giske; Simon, Michael S; Marchbanks, Polly A; Malone, Kathleen E; Lu, Yani; McDonald, Jill A; Folger, Suzanne G; Weiss, Linda K; Sullivan-Halley, Jane; Deapen, Dennis M; Press, Michael F; Bernstein, Leslie

2015-01-01

Convincing epidemiologic evidence indicates that physical activity is inversely associated with breast cancer risk. Whether this association varies by the tumor protein expression status of the estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), or p53 is unclear. We evaluated the effects of recreational physical activity on risk of invasive breast cancer classified by the four biomarkers, fitting multivariable unconditional logistic regression models to data from 1195 case and 2012 control participants in the population-based Women’s Contraceptive and Reproductive Experiences Study. Self-reported recreational physical activity at different life periods was measured as average annual metabolic equivalents of energy expenditure [MET]-hours per week. Our biomarker-specific analyses showed that lifetime recreational physical activity was negatively associated with the risks of ER-positive (ER+) and of HER2-negative (HER2−) subtypes (both P trend ≤ 0.04), but not with other subtypes (all P trend > 0.10). Analyses using combinations of biomarkers indicated that risk of invasive breast cancer varied only by HER2 status. Risk of HER2–breast cancer decreased with increasing number of MET-hours of recreational physical activity in each specific life period examined, although some trend tests were only marginally statistically significant (all P trend ≤ 0.06). The test for homogeneity of trends (HER2– vs. HER2+) reached statistical significance only when evaluating physical activity during the first 10 years after menarche (P homogeneity = 0.03). Our data suggest that physical activity reduces risk of invasive breast cancers that lack HER2 overexpression, increasing our understanding of the biological mechanisms by which physical activity acts

Health care professionals' familiarity with non-pharmacological strategies for managing cancer pain.

Science.gov (United States)

Zaza, C; Sellick, S M; Willan, A; Reyno, L; Browman, G P

1999-01-01

Many studies have confirmed unnecessary suffering among cancer patients, due to the inadequate use of analgesic medication and other effective interventions. While pharmacological treatments are appropriately the central component of cancer pain management, the under-utilization of effective nonpharmacological strategies (NPS) may contribute to the problem of pain and suffering among cancer patients. The purpose of this study was to determine health care professionals' familiarity with, and perceptions regarding, NPS for managing cancer pain, and to assess their interest in learning more about NPS as adjuncts to pharmacological analgesics. Two-hundred and fourteen health care professionals were surveyed at two cancer treatment centres in Ontario, Canada. The self-report questionnaire included questions regarding 11 psychological strategies (e.g. imagery) and eight other NPS (e.g. acupuncture). The response rate was 67% (141/214). Subjects were found to be the least familiar with autogenic training, operant conditioning, and cognitive therapy. Other than radiation and surgery, subjects most commonly reported recommending support groups (67%), imagery (54%), music or art therapy (49%) and meditation (43%) for managing cancer pain. Participants were most interested in learning more about acupuncture, massage therapy, therapeutic touch, hypnosis, and biofeedback. Participants were somewhat familiar with most of the 19 NPS presented; however, they use or recommend few NPS for managing cancer pain. Health professionals' interest in NPS has important implications for the supportive care of cancer patients.

Epigenomics in cancer management

International Nuclear Information System (INIS)

Costa, Fabricio F

2010-01-01

The identification of all epigenetic modifications implicated in gene expression is the next step for a better understanding of human biology in both normal and pathological states. This field is referred to as epigenomics, and it is defined as epigenetic changes (ie, DNA methylation, histone modifications and regulation by noncoding RNAs such as microRNAs) on a genomic scale rather than a single gene. Epigenetics modulate the structure of the chromatin, thereby affecting the transcription of genes in the genome. Different studies have already identified changes in epigenetic modifications in a few genes in specific pathways in cancers. Based on these epigenetic changes, drugs against different types of tumors were developed, which mainly target epimutations in the genome. Examples include DNA methylation inhibitors, histone modification inhibitors, and small molecules that target chromatin-remodeling proteins. However, these drugs are not specific, and side effects are a major problem; therefore, new DNA sequencing technologies combined with epigenomic tools have the potential to identify novel biomarkers and better molecular targets to treat cancers. The purpose of this review is to discuss current and emerging epigenomic tools and to address how these new technologies may impact the future of cancer management

Hypothyroidism After a Cancer Diagnosis: Etiology, Diagnosis, Complications, and Management

Science.gov (United States)

Carter, Yvette; Sippel, Rebecca S.

2014-01-01

Hypothyroidism is a common disease that is easily treated in the majority of cases, when readily diagnosed; however, presentation of an aggregate of its symptoms is often clinically overlooked or attributed to another disease and can potentially be lethal. Already prevalent in older women, its occurrence in younger patients is rising as a result of radiation therapy, radioactive iodine therapy, and newer antineoplastic agents used to manage various malignancies. The presence of nonspecific constitutional symptoms and neuropsychiatric complaints in cancer patients can be attributed to a myriad of other diagnoses and therapies. Thyroid dysfunction can be easily overlooked in cancer patients because of the complexity of cancer’s clinical picture, particularly in the pediatric population. Underdiagnosis can have important consequences for the management of both hypothyroidism and the malignancy. At minimum, quality of life is adversely affected. Untreated hypothyroidism can lead to heart failure, psychosis, and coma and can reduce the effectiveness of potentially life-saving cancer therapies, whereas iatrogenic causes can provoke atrial fibrillation and osteoporosis. Consequently, the diagnosis and treatment of hypothyroidism in cancer patients are pertinent. We summarize the history, epidemiology, pathophysiology, clinical diagnosis, and management of hypothyroidism in cancer patients. PMID:24309982

Feasibility, physical capacity, and health benefits of a multidimensional exercise program for cancer patients undergoing chemotherapy

DEFF Research Database (Denmark)

Adamsen, Lis; Midtgaard, Julie; Rorth, Mikael

2003-01-01

Cancer patients frequently experience considerable loss of physical capacity and general wellbeing when diagnosed and treated for their disease. The aim of this study was to evaluate the feasibility, physical capacity, and health benefits of a multidimensional exercise program for cancer patients...... during advanced stages of disease who are undergoing adjuvant or high-dose chemotherapy. The supervised program included high- and low-intensity activities (physical exercise, relaxation, massage, and body-awareness training). A total of 23 patients between 18 and 65 years of age (median 40 years...... significance. It is concluded that an exercise program, which combines high- and low-intensity physical activities, may be used to prevent and/or minimize physical inactivity, fatigue, muscle wasting and energy loss in cancer patients undergoing chemotherapy....

Assessment of Adequacy of Pain Management and Analgesic Use in Patients With Advanced Cancer Using the Brief Pain Inventory and Pain Management Index Calculation

Directory of Open Access Journals (Sweden)

Harminder Singh

2017-06-01

Full Text Available Purpose: The objective of this cross-sectional, noninterventional, 6-month observational study was to assess the adequacy of pain management in patients with cancer admitted to the Oncology Department of Guru Gobind Singh Medical College in Faridkot, India. Methods and Materials: A total of 348 patients with cancer were recruited for evaluation of the prevalence of inadequate cancer pain management using the Brief Pain Inventory Pain Management Index. Results: The current study included 127 males (36.5% and 221 females (63.5%. The most prevalent cancer type was genitourinary; 268 patients (77% had inadequately managed pain. A significant correlation was observed between poorly managed pain and age groups, analgesic used, and body mass index. Conclusion: Our observation of inadequate pain management among 77% of patients indicates that pain management was insufficient in three quarters of the patients in this study. Accumulating data regarding the inadequacy of cancer pain management is crucial to improve symptom management. Better management of pain not only alleviates pain symptoms but also increases the quality of life for patients with cancer.

Cardiorespiratory fitness and physical activity in children with cancer

NARCIS (Netherlands)

Braam, Katja I.; van Dijk-Lokkart, Elisabeth M.; Kaspers, Gertjan J. L.; Takken, Tim; Huisman, Jaap; Bierings, Marc B.; Merks, Johannes H. M.; van de Heuvel-Eibrink, Marry M.; van Dulmen-den Broeder, Eline; Veening, Margreet A.

2016-01-01

This study assessed cardiorespiratory fitness (CRF), physical activity (PA), and sedentary behavior (SB), as well as factors associated with these outcomes in children during or shortly after cancer treatment. Cross-sectionally, CRF data, obtained by the cardiopulmonary exercise test, and PA and SB

What advice are oncologists and surgeons in the United Kingdom giving to breast cancer patients about physical activity?

Directory of Open Access Journals (Sweden)

Daley Amanda J

2008-09-01

Full Text Available Abstract Evidence has shown that physical activity may attenuate the negative physical, psychological and functional effects of treatment in women diagnosed with breast cancer. Physical activity levels also decline substantially during and after completion of treatment for cancer, highlighting the importance of strategies to promote participation in regular physical activity in this population. Oncologists and surgeons may serve as an influential source of motivation to be physically activity in cancer patients, by conveying the importance of a healthy lifestyle. The primary purpose of the present study was to investigate whether oncologists and surgeons routinely discuss physical activity with their breast cancer patients and to investigate the nature of any information/advice provided during consultations. A secondary aim was to examine whether physically active oncologists and surgeons were more likely to provide advice about physical activity to patients, than inactive oncologists and surgeons. A brief postal questionnaire was sent to 710 consultant breast cancer oncologists and surgeons throughout the UK and 102 responded (response rate = 14.4%. Of responders, most (55.9% did not routinely discuss physical activity with their patients. Amongst oncologists/surgeons (clinicians who did offer advice, most focussed on discussing the benefits of physical activity for physical and functional health gains and for facilitating weight control and maintenance. A number of clinicians indicated they advised patients that physical activity may decrease risk of recurrence and improve survival, despite the lack of evidence from RCTs to support this suggestion. There was no significant association between the physical activity status of oncologists/surgeons and the likelihood that they discussed physical activity with patients. Educational strategies aimed at encouraging clinicians to promote physical activity in consultations need to be targeted widely

Spect-CT and PET: CT in the management of differentiated thyroid cancer

International Nuclear Information System (INIS)

Khan, Shoukat H.

2007-01-01

Full text: With the advancement and evolution in medical technology notably imaging there has been a sea change in the overall management strategy of most of the cancers of human body. The present day functional, imaging with PET and MRI enables us to pick up a tumour at its cellular stage. Molecular imaging and nanotechnology have further added to this expanding armamentarium of cancer imaging and treatment. Thyroid cancer is one such cancer where the cutting edge biotechnology has dramatically changed the management profile of a disease. Thyroid cancer can safely be classified as one of the cancers which if optimally managed is curable. Hybrid and fusion imaging like SPECT-CT and PET-CT with their superior sensitivity and specificity have greatly improved the accuracy of disease detection and reduced drastically the false positive disease sites. Disease not detected by conventional planar imaging can now be detected and also anatomically localized using hybrid imaging modalities of SPECT-CT and PET-CT. An accurate detection and precise localization improves image interpretation and a treatment optimization in the curable cancer of thyroid

Do we need regional guidelines for breast cancer management in the MENA region? MENA Breast Cancer Guidelines project.

Science.gov (United States)

Fayed, Reham; Hamza, Dina; Abdallah, Heba; Kelany, Mohamed; Tahseen, Amira; Aref, Adel T

2017-01-01

Breast cancer is the most common cancer among females worldwide in general and in the Middle East and the North African region (MENA region) in particular. Management of breast cancer in the MENA region faces a lot of challenges, which include younger age at presentation, aggressive behaviour, lack of national breast screening programmes and lack of reliable data registries as well as socioeconomic factors. These factors make applying the international guidelines for breast cancer management very challenging. The aim of this project is to explore the need for a regional breast cancer guideline as well as to screen the clinical practice of breast cancer management in the MENA region. Three web-based designed surveys were sent to more than 600 oncologists in the MENA region from the period of August 2013 to October 2014. Full descriptive data and information regarding the application of international breast cancer guidelines were collected. The software was using the IP address to prevent duplication of collected data. Descriptive analysis and results were shown as numbers and percentages. During the period of the survey, 104 oncologists responded, representing around an 11% response rate. The majority of replies came from Egypt (59 responses (59%)), followed by Saudi Arabia (ten responses (9.6%)). Fifty-one per cent of responders had more than ten years of experience, and further 31.7% had 5-10 years of experience. Seventy-four per cent were working in governmental hospitals, which is our target sector. There was a major defect in having a genetic counsel unit (78.8% declared an absence of this service), presence of a national breast screening programme (55.8% declared an absence of this service), performing sentinel lymph node biopsy (43.3% declared an absence of this service). The need for regional guidelines for the management of breast cancer was agreed upon by 90.6% of responders. There is a clear need to improve the management of breast cancer in the MENA

Physical activity and survival in breast cancer

DEFF Research Database (Denmark)

Ammitzbøll, Gunn; Søgaard, Karen; Karlsen, Randi V

2016-01-01

PURPOSE: Knowledge about lifestyle factors possibly influencing survival after breast cancer (BC) is paramount. We examined associations between two types of postdiagnosis physical activity (PA) and overall survival after BC. PATIENTS AND METHODS: We used prospective data on 959 BC survivors from...... the Diet, Cancer, and Health cohort, all enrolled before diagnosis. Self-reported PA was measured as time per activity, and estimated metabolic equivalent task (MET)-hours per week were summed for each activity. We constructed measures for household, exercise, and total PA. The association between...... from all causes during the study period. In adjusted analyses, exercise PA above eight MET h/week compared to lower levels of activity was significantly associated with improved overall survival (HR, 0.68; confidence interval [CI]: 0.47-0.99). When comparing participation in exercise to non...

Objectively assessed physical activity levels in Spanish cancer survivors.

Science.gov (United States)

Ruiz-Casado, Ana; Verdugo, Ana Soria; Solano, María J Ortega; Aldazabal, Itziar Pagola; Fiuza-Luces, Carmen; Alejo, Lidia Brea; del Hierro, Julio R Padilla; Palomo, Isabel; Aguado-Arroyo, Oscar; Garatachea, Nuria; Cebolla, Héctor; Lucia, Alejandro

2014-01-01

To objectively assess physical activity (PA) levels in a cohort of Spanish cancer survivors. Descriptive, cross-sectional. The Hospital Universitario de Fuenlabrada and two healthcare centers in Madrid, Spain. 204 cancer survivors and 115 adults with no history of cancer. Participants wore a triaxial accelerometer for seven or more consecutive days to assess PA levels. Body mass index (BMI), indirect indicators of adiposity (waist circumference, waist-to-hip ratio), and cardiorespiratory fitness also were determined. Light, moderate, vigorous, and total PA (sum of the former). Most (94%) of the cancer survivors met international recommendations for moderate PA, but very few (3%) fulfilled those (75 minutes or more per week) for vigorous PA. Except for lower total (minute per day, p=0.048) and vigorous PA levels (p0.05). A high percentage of the survivors (33%) were obese (BMI greater than 30 kg/m2), and many also showed poor cardiorespiratory fitness (45% were below the 8 metabolic equivalent threshold). Although cancer survivors overall met international PA recommendations for a healthy lifestyle, their BMI and cardiorespiratory profiles were not within the healthy range. Cancer survivors need to be informed about healthy lifestyle habits and should be regularly monitored.

Managing post-therapy fatigue for cancer survivors using energy conservation training.

Science.gov (United States)

Yuen, Hon Keung; Mitcham, Maralynne; Morgan, Larissa

2006-01-01

This pilot study evaluated the effectiveness of energy conservation training to help post-therapy cancer survivors manage their fatigue. Twelve post-therapy cancer survivors were randomly assigned to an energy conservation training or usual care control (6 in each group). Participants in the intervention group received 1 to 2 hours of individual, face-to-face energy conservation training from an occupational therapist followed by once-a-week telephone monitoring sessions in the subsequent three weeks. Participants in the control group received standard care from their oncologist. Analysis of pre- and post-training data from the Piper Fatigue Scale (PFS) revealed significant reduction only in the sensory subscale of the PFS (Z = 2.21; p = 0.027) for the intervention group; but no significant reduction in the four subscale or total scores of the PFS for the control group. Findings demonstrate partial support for the effectiveness of energy conservation training in helping post-therapy cancer survivors manage their fatigue. Energy conservation training seems to be a viable strategy for managing cancer-related fatigue, though its efficacy is modest. Incorporating specific energy restoration strategies such as relaxation and meditation for future research may help advance the growing body of knowledge in symptom management for post-therapy cancer survivors.

Cancer pain management by radiotherapists: a survey of radiation therapy oncology group physicians

International Nuclear Information System (INIS)

Cleeland, Charles S.; Janjan, Nora A.; Scott, Charles B.; Seiferheld, Wendy F.; Curran, Walter J.

2000-01-01

Purpose: Radiation Therapy Oncology Group (RTOG) physicians were surveyed to determine their approach to and attitudes toward cancer pain management. Methods and Materials: Physicians completed a questionnaire assessing their estimates of the magnitude of pain as a specific problem for cancer patients, their perceptions of the adequacy of pain management, and their report of how they manage pain in their own practice setting. Results: Eighty-three percent believed the majority of cancer patients with pain were undermedicated. Forty percent reported that pain relief in their own practice setting was poor or fair. Assessing a case scenario, 23% would wait until the patient's prognosis was 6 months or less before starting maximal analgesia. Adjuvants and prophylactic side effect management were underutilized in the treatment plan. Barriers to pain management included poor pain assessment (77%), patient reluctance to report pain (60%), patient reluctance to take analgesics (72%), and staff reluctance to prescribe opioids (41%). Conclusions: Physicians' perceptions of barriers to cancer pain management remain quite stable over time, and physicians continue to report inadequate pain treatment education. Future educational efforts should target radiation oncologists as an important resource for the treatment of cancer pain

Exercise Preserves Physical Function in Prostate Cancer Patients with Bone Metastases.

Science.gov (United States)

Galvão, Daniel A; Taaffe, Dennis R; Spry, Nigel; Cormie, Prue; Joseph, David; Chambers, Suzanne K; Chee, Raphael; Peddle-McIntyre, Carolyn J; Hart, Nicolas H; Baumann, Freerk T; Denham, James; Baker, Michael; Newton, Robert U

2018-03-01

The presence of bone metastases has excluded participation of cancer patients in exercise interventions and is a relative contraindication to supervised exercise in the community setting because of concerns of fragility fracture. We examined the efficacy and safety of a modular multimodal exercise program in prostate cancer patients with bone metastases. Between 2012 and 2015, 57 prostate cancer patients (70.0 ± 8.4 yr; body mass index, 28.7 ± 4.0 kg·m) with bone metastases (pelvis, 75.4%; femur, 40.4%; rib/thoracic spine, 66.7%; lumbar spine, 43.9%; humerus, 24.6%; other sites, 70.2%) were randomized to multimodal supervised aerobic, resistance, and flexibility exercises undertaken thrice weekly (EX; n = 28) or usual care (CON; n = 29) for 3 months. Physical function subscale of the Medical Outcomes Study Short-Form 36 was the primary end point as an indicator of patient-rated physical functioning. Secondary end points included objective measures of physical function, lower body muscle strength, body composition, and fatigue. Safety was assessed by recording the incidence and severity of any adverse events, skeletal complications, and bone pain throughout the intervention. There was a significant difference between groups for self-reported physical functioning (3.2 points; 95% confidence interval, 0.4-6.0 points; P = 0.028) and lower body muscle strength (6.6 kg; 95% confidence interval, 0.6-12.7; P = 0.033) at 3 months favoring EX. However, there was no difference between groups for lean mass (P = 0.584), fat mass (P = 0.598), or fatigue (P = 0.964). There were no exercise-related adverse events or skeletal fractures and no differences in bone pain between EX and CON (P = 0.507). Multimodal modular exercise in prostate cancer patients with bone metastases led to self-reported improvements in physical function and objectively measured lower body muscle strength with no skeletal complications or increased bone pain. ACTRN12611001158954.

Colorectal cancer: complexities and challenges in managed care.

Science.gov (United States)

Minkoff, Neil B

2007-08-01

Managed care weighs advances and associated costs to determine whether the combination of longer life at sometimes significantly increased cost represents value. The price of treatment is only 1 factor. To review treatment decision processes for oncologic agents in managed care environments. Price can be exceptionally high for individuals. But if the population size is low, the per-member-per-month (PMPM) impact can be almost negligible, unlike treatments that have moderate costs but are used ubiquitously. Cancer therapies have, for the most part, escaped managed care's notice. For 2007, the national Cancer Institute projects that antineoplastic agents will consume almost a quarter of the overall drug spend. The Medicare population is a unique concern with regard to cancer. Traditionally, Medicare reimbursement of chemotherapeutic agents was based on average wholesale price (AWP) discounting, not the oncologist's purchasing cost. This allowed oncologists to use reimbursement for infusions to support their medical practices. The proposed plan of the Center for Medicare & Medicaid Services (CMS) to use average sales price (ASP) plus 6% to reimburse for drugs used in the office setting leads to significant problems. Pharmacy and therapeutics committees will also face challenges: fewer data are available for some agents because they have become available through the U.S. Food and drug administration's Fast Track, Priority review, or accelerated approval processes. Oncology disease management programs must reach out to patients and not necessarily deal with oncology issues directly, but address tangential issues that impact care, especially depression and pain management.

Management of neuropathic pain following treatment for breast cancer in the absence of recurrence: a challenge for the radiation oncologist

International Nuclear Information System (INIS)

Clubb, B.

2004-01-01

This report reviews various management options for treatment-induced neuropathic pain in breast cancer. First-line options include tricyclic antidepressants and anticonvulsant drugs. Opioids should be prescribed according to published guidelines. Second-line treatments include lignocaine, mexiletine and ketamine. Sympatholytic therapies are available to patients with features of chronic regional pain syndrome. Anti-inflammatory agents are used for neurogenic inflammation. Surgical interventions are considered for refractory neuropathic pain. Interdisciplinary management is appropriate when persisting pain causes physical and psychosocial disabilities. Copyright (2004) Blackwell Science Pty Ltd

Managing the risk of cancer in Cowden syndrome: a case report

Directory of Open Access Journals (Sweden)

Hammami Sonia

2012-07-01

Full Text Available Abstract Introduction Cowden syndrome is a rare cancer predisposition syndrome inherited in an autosomal-dominant fashion. The syndrome is characterized by hamartomatous polyps that affect multiple organs: skin, mucous membranes, thyroid, breast, gastrointestinal tract, endometrium and brain. It is also associated with an increased risk of developing malignancy in many tissues but especially breast, thyroid and endometrium. Case presentation We present the case of a 30-year-old Tunisian woman with mental retardation who presented to our facility with rectal hamartomatous polyps. Her medical history included fibrocystic disease of the breast over the last three years. A physical examination revealed macrocephaly, hyperkeratotic papules on the mid-facial skin, palmoplantar keratosis and oral mucosal papillomatosis. A breast examination revealed nodular breast tissue bilaterally and a diffuse thyroid goiter. Our patient was clinically euthyroid. A total thyroidectomy was performed. A histopathologic examination revealed thyroid papillary carcinoma. A gastrointestinal evaluation revealed esophageal and gastric polyps. Biopsies showed hyperplastic and adenomatous lesions associated with Helicobacter pylori. A final diagnosis of Cowden syndrome was made according to the syndrome testing criteria adapted by the US National Comprehensive Cancer Network. A prophylactic bilateral mastectomy was proposed but refused by our patient. Our patient was kept under surveillance for breast and colorectal malignancies. Conclusions Early and accurate diagnosis of Cowden syndrome is essential because it is a cancer predisposition syndrome that carries an increased risk for developing malignancy in many tissues, especially breast and thyroid. For this reason, education regarding the signs and symptoms of cancer is important. All patients must be screened for malignancies and options for prophylactic mastectomy should be discussed. Guidelines for cancer screening

Goal adjustment, physical and sedentary activity, and well-being and health among breast cancer survivors.

Science.gov (United States)

Wrosch, Carsten; Sabiston, Catherine M

2013-03-01

This longitudinal study examined whether goal adjustment capacities (i.e., goal disengagement and goal reengagement) would predict breast cancer survivors' emotional well-being and physical health by facilitating high levels of physical activity and low levels of sedentary activity. Self-reports of goal adjustment capacities were measured among 176 female breast cancer survivors at baseline. Self-reports of physical activity, sedentary activity, daily affect, and daily physical health symptoms (e.g., nausea or pain) were measured at baseline and 3-month follow-up. Goal reengagement predicted high levels of positive affect and low levels of physical symptoms at baseline and increases in positive affect over 3 months. The combination of high goal disengagement and high goal reengagement was associated with particularly large 3-month increases in positive affect. The effects of goal reengagement on baseline affect and physical health were mediated by high baseline levels of physical activity, and the interaction effect on 3-month changes in positive affect was mediated by low baseline levels of sedentary activity. Goal adjustment capacities can exert beneficial effects on breast cancer survivors' well-being and physical health by facilitating adaptive levels of physical and sedentary activity. Integrating goal adjustment processes into clinical practice may be warranted. Copyright © 2012 John Wiley & Sons, Ltd.

Recreational Physical Activity and Differentiated Thyroid Cancer Risk: A Pooled Analysis of Two Case-Control Studies

Science.gov (United States)

Xhaard, Constance; Lence-Anta, Juan J.; Ren, Yan; Borson-Chazot, Françoise; Sassolas, Geneviève; Schvartz, Claire; Colonna, Marc; Lacour, Brigitte; Danzon, Arlette; Velten, Michel; Clero, Enora; Maillard, Stéphane; Marrer, Emilie; Bailly, Laurent; Mariné Barjoan, Eugènia; Schlumberger, Martin; Orgiazzi, Jacques; Adjadj, Elisabeth; Pereda, Celia M.; Turcios, Silvia; Velasco, Milagros; Chappe, Mae; Infante, Idalmis; Bustillo, Marlene; García, Anabel; Salazar, Sirced; Rodriguez, Regla; Benadjaoud, Mohamed Amine; Ortiz, Rosa M.; Rubino, Carole; de Vathaire, Florent

2016-01-01

Purpose Physical activity has been hypothesized to influence cancer occurrence through several mechanisms. To date, its relation with thyroid cancer risk has been examined in relatively few studies. We pooled 2 case-control studies conducted in Cuba and Eastern France to assess the relationship between self-reported practice of recreational physical activity since childhood and thyroid cancer risk. Methods This pooled study included 1,008 cases of differentiated thyroid cancer (DTC) matched with 1,088 controls (age range 9-35 and 17-60 years in the French and Cuban studies, respectively). Risk factors associated with the practice of recreational physical activity were estimated using OR and 95% CI. Logistic regressions were stratified by age class, country, and gender and were adjusted for ethnic group, level of education, number of pregnancies for women, height, BMI, and smoking status. Results Overall, the risk of thyroid cancer was slightly reduced among subjects who reported recreational physical activity (OR = 0.8; 95% CI 0.5-1.0). The weekly frequency (i.e. h/week) seems to be more relevant than the duration (years). Conclusion Long-term recreational physical activity, practiced since childhood, may reduce the DTC risk. However, the mechanisms whereby the DTC risk decreases are not yet entirely clear. PMID:27493888

Home Care Nursing Improves Cancer Symptom Management

Science.gov (United States)

Home care nursing (HCN) improves the management of symptoms in breast and colorectal cancer patients who take the oral chemotherapy drug capecitabine, according to a study published online November 16 in the Journal of Clinical Oncology.

Communication Efficacy and Couples' Cancer Management: Applying a Dyadic Appraisal Model.

Science.gov (United States)

Magsamen-Conrad, Kate; Checton, Maria G; Venetis, Maria K; Greene, Kathryn

2015-06-01

The purpose of the present study was to apply Berg and Upchurch's (2007) developmental-conceptual model to understand better how couples cope with cancer. Specifically, we hypothesized a dyadic appraisal model in which proximal factors (relational quality), dyadic appraisal (prognosis uncertainty), and dyadic coping (communication efficacy) predicted adjustment (cancer management). The study was cross-sectional and included 83 dyads in which one partner had been diagnosed with and/or treated for cancer. For both patients and partners, multilevel analyses using the actor-partner interdependence model (APIM) indicated that proximal contextual factors predicted dyadic appraisal and dyadic coping. Dyadic appraisal predicted dyadic coping, which then predicted dyadic adjustment. Patients' confidence in their ability to talk about the cancer predicted their own cancer management. Partners' confidence predicted their own and the patient's ability to cope with cancer, which then predicted patients' perceptions of their general health. Implications and future research are discussed.

[Managment of head and neck cancers during pregnancy].

Science.gov (United States)

Kiciński, Krzysztof; Skorek, Andrzej; Stankiewicz, Czesław

2011-01-01

The coincidence of malignant disease during pregnancy is uncommon. The incidence of cancer in pregnancy has increased, due to the tendency to postpone childbirth to an older age. Cancer complicates approximately 0.1% of all pregnancies. Managing head and neck cancers during pregnancy requires additional pregnancy-related understanding of the aetiological effect of pregnancy on cancer, knowledge of the direct and indirect effects of cancer on pregnancy, and the effect of diagnostic and treatment modalities on pregnancy. The timing of treatment is an important determinant on foetal wellbeing. A multidisciplinary approach should be adopted to enable parents and clinicians to make the best clinical decision. Clinicians must be cognizant with the ethical dilemmas of treatment. In head and neck cancers, pregnancy has no effect on maternal prognosis when compared to non-pregnant patients matched by age, cancer stage and treatment. Copyright © 2011 Polish Otolaryngology Society. Published by Elsevier Urban & Partner (Poland). All rights reserved.

Modern management of the cancer anorexia-cachexia syndrome.

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Nelson, K A

2000-07-01

The cancer anorexia-cachexia syndrome is common, occurring in 80% of patients with advanced-stage cancer, and it is one of the most frequent causes of death in patients with cancer. It is a complex problem involving abnormalities in protein, carbohydrate, and fat metabolism. Tumors have both direct and indirect effects that result in anorexia and weight loss. The disease burden does not necessarily correlate with the degree of cachexia. In addition to the physical manifestations, the resulting abnormalities have a significant psychologic effect on patients and their families. Although there is no treatment to reverse the process, pharmacologic and nonpharmacologic measures can enhance food intake and improve quality of life.

Cancer pain management in China: current status and practice implications based on the ACHEON survey

Directory of Open Access Journals (Sweden)

Xia Z

2017-08-01

Full Text Available Zhongjun Xia Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, ChinaPurpose: Cancer pain can seriously impact the quality of life (QoL of patients, and optimal management practices are therefore of paramount importance. The ACHEON survey queried physicians and patients from 10 Asian countries/regions to assess current clinical practices in cancer pain management in Asia. This study presents the data obtained for cancer pain management in mainland China, with an emphasis on practices related to opioid drugs.Materials and methods: In several tertiary hospitals across China, 250 patients experiencing cancer pain and 100 physicians were surveyed on questions designed to assess current cancer pain management practices and cancer pain impact on QoL.Results: The patient survey showed that 88% of patients reported moderate-to-severe cancer pain, with a median duration of 6 months. The physician survey showed that medical school/residency training with regard to cancer pain management was inadequate in ~80% of physicians. A total of 80% of physicians and 67.2% of patients reported that pain scale was used during pain assessment; 84% of physicians expressed that physician-perceived pain severity was not completely consistent with actual pain the patient experienced. Of the 147 patients who recalled the medication received, 83.7% were administered opioid prescriptions. Of the 240 patients who received treatment, 43.8% perceived the inadequacy of controlling pain. The primary barriers from physicians perceived to optimal pain management included patients’ fear of side effects (58%, patients’ fear of addiction (53%, patients’ reluctance to report pain (43%, physicians’ reluctance to prescribe (29%, physicians’ inadequacy of pain assessment (27% and excessive regulation of opioid analgesics (47%.Conclusion: Knowledge of cancer pain management should be strengthened among physicians. Quantitative pain assessment and principle-based pain

Ostomy telehealth for cancer survivors: Design of the Ostomy Self-management Training (OSMT) randomized trial.

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Sun, Virginia; Ercolano, Elizabeth; McCorkle, Ruth; Grant, Marcia; Wendel, Christopher S; Tallman, Nancy J; Passero, Frank; Raza, Sabreen; Cidav, Zuleyha; Holcomb, Michael; Weinstein, Ronald S; Hornbrook, Mark C; Krouse, Robert S

2018-01-01

An ostomy adversely affects health-related quality of life (HRQOL) in a diverse population of cancer survivors and their caregivers. Hit-or-miss ostomy care, nurse counseling, and community referral have been the primary modes of self-management education and support in the peri-operative setting. Few evidence-based, systematic ostomy self-management programs are available to ensure optimal post-operative care. This paper describes the study design of a telehealth-based Ostomy Self-management Training (OSMT) program for cancer survivors and their caregivers. The study is a three-year, randomized trial that tests the effectiveness of the OSMT program on survivor activation, self-efficacy, and HRQOL. The intervention integrates goal setting and problem-solving approaches to enhance survivor activation and self-efficacy to carry out ostomy care. The curriculum is delivered via four group sessions administered by trained ostomy certified nurses (WOCNs) and peer ostomates. An additional session is offered to caregivers to address their needs in relation to ostomy care. Telehealth approaches through videoconferencing are used to enhance program delivery to participants in three different geographic areas across two time zones. Participants join sessions via real-time videoconferencing from their homes. The OSMT program has high potential to make a positive impact on the unique physical, psychological, social, and spiritual needs of cancer survivors living with a permanent ostomy. The study design, process, and telehealth approach contributes to the success of future dissemination efforts of the intervention into diverse clinical and community settings. Copyright © 2017 Elsevier Inc. All rights reserved.

A Pilot Study of Self-Reported Physical Activity and Eating Habits in Turkish Cancer Patients Under Chemotherapy.

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Gunes-Bayir, Ayse; Kiziltan, Huriye Senay; Sentürk, Nidanur; Mayadaglı, Alpaslan; Gumus, Mahmut

2015-01-01

As in all individuals, improving the quality of life, balanced nutrition and physical activity habits must be acquired in cancer patients. The purpose of this study was to determine eating habits and physical activity of cancer patients receiving chemotherapy. Sixty-six patients were completed the questionnaire included sociodemographic data, type of cancer, anthropometric measurements (size and body weight), dietary and physical activity habits. Body mass index for each patient was calculated. Data were analyzed using Statistical Package for Social Science software. Patients were ranged from underweight to obese according to their body mass index: 6.1% of patients were classified as underweight. Almost half (48.5%, n = 32) reported to be regularly physical active, and 46.9% (n = 15) thereof reported 30 min brisk walking. More vegetables consumption was the most popular answer with 62.1% (n = 41), whereas vegetables/fruit or vegetables/legume consumption was 22.7% (n = 15). Gender differences in food choice and preferring the taste of food were not seen as statistically significant. In this article, patients with different types of cancer reported their eating habits and physical activity. Disease-related and worse prognostic factors were found. An institutional program should be offered to cancer patients for consulting about nutrition and physical activity.

Physical activity and lung cancer among non-smokers: A pilot molecular epidemiologic study within EPIC

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RUNDLE, ANDREW; RICHIE, JOHN; STEINDORF, KAREN; PELUSO, MARCO; OVERVAD, KIM; RAASCHOU-NIELSEN, OLE; CLAVEL-CHAPELON, FRANCOISE; LINSEISEN, JACOB P.; BOEING, HEINER; TRICHOPOULOU, ANTONIA; PALLI, DOMENICO; KROGH, VITTORIO; TUMINO, ROSARIO; PANICO, SALVATORE; BUENO-DE-MESQUITA, HENDRIK B.; PEETERS, PETRA H.; LUND, EILIV; GONZALEZ, CARLOS A.; MARTINEZ, CARMEN; DORRONSORO, MIREN; BARRICARTE, AURELIO; TORMO, M. JOSE; QUIROS, JOSÈ R.; AGUDO, ANTONIO; BERGLUND, GORAN; JARVHOLM, BENGT; BINGHAM, SHEILA; KEY, TIMOTHY J.; GORMALLY, EMMANUELLE; SARACCI, RODOLFO; KAAKS, RUDOLF; RIBOLI, ELIO; VINEIS, PAOLO

2013-01-01

The association between physical activity, potential intermediate biomarkers and lung cancer risk was investigated in a study of 230 cases and 648 controls nested within the European Prospective Investigation of Cancer and Nutrition. Data on white blood cell aromatic-DNA adducts by 32P-postlabeling and glutathione (GSH) in red blood cells were available from a subset of cases and controls. Compared to the first quartile, the fourth quartile of recreational physical activity was associated with lower lung cancer risk [odds ratio=0.56 (0.35–0.90)], higher GSH levels [+1.87 micro mole GSH/gram haemoglobin, p=0.04] but not with the presence of high levels of adducts [odds ratio=1.05 (0.38–2.86)]. Despite being associated with recreational physical activity, in these small scale pilot analyses GSH levels were not associated with lung cancer risk, [odds ratio=0.95 (0.84 – 1.07) per unit increase in glutathione levels]. Household and occupational activity was not associated with lung cancer risk or biomarker levels. PMID:20050820

Recreational physical inactivity and mortality in women with invasive epithelial ovarian cancer

DEFF Research Database (Denmark)

Cannioto, Rikki A.; LaMonte, Michael J.; Kelemen, Linda E

2016-01-01

Background: Little is known about modifiable behaviours that may be associated with epithelial ovarian cancer (EOC) survival. We conducted a pooled analysis of 12 studies from the Ovarian Cancer Association Consortium to investigate the association between pre-diagnostic physical inactivity...... and mortality. Methods: Participants included 6806 women with a primary diagnosis of invasive EOC. In accordance with the Physical Activity Guidelines for Americans, women reporting no regular, weekly recreational physical activity were classified as inactive. We utilised Cox proportional hazard models...... to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) representing the associations of inactivity with mortality censored at 5 years. Results: In multivariate analysis, inactive women had significantly higher mortality risks, with (HR=1.34, 95% CI: 1.18-1.52) and without (HR=1.22, 95% CI: 1...

Management of cancer pain--a survey of current practice in West Africa.

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Soyannwo, A; Amanor-Boadu, S D

2001-12-01

A comprehensive management plan for cancer pain is yet to be formulated in the West African sub region despite the priority that the World Health Organisation (WHO) has devoted to the problem over the past decade. As a prerequisite to our cancer pain management curriculum development a structured questionnaire on cancer pain management practice was administered to 80 Fellows attending the Annual Scientific Conference of the West African College of Surgeons in 1996. They were asked how often they treated cancer patients, the causes of cancer pain, their methods of assessment and therapeutic measures and complications of management techniques. Forty-four fellows from Nigeria, Ghana, Liberia and Sierra Leone, all consultants and trainers, responded to the questionnaire. About 80% of them treated cancer patients all the time. Specific anti-cancer therapy such as surgery, chemotherapy and hormone therapy were available in the four countries but radiotherapy was only available in two centers in Nigeria. The respondents estimated that 70-90% of their patients had severe pain at presentation. Pain was thought by 52% of respondents to be due to cancer and its treatment while 47% thought it was due to cancer and the fear of dying. Pain assessment was mostly by the verbal rating scale, only 20% included psychological measurement in their schedules. Oral preparations of strong opioids were not available in most countries andfor severe pain, the parenteral route was employed. Only 18% knew about the 'by the clock' dosing schedule. The study revealed that the standard of practice of the respondents falls below accepted practice. There is thus an urgent need for the formal education of personnel involved in the care of these patients.

Impact of Physical Activity on Cancer-Specific and Overall Survival of Patients with Colorectal Cancer

Directory of Open Access Journals (Sweden)

Gaetan Des Guetz

2013-01-01

Full Text Available Background. Physical activity (PA reduces incidence of colorectal cancer (CRC. Its influence on cancer-specific (CSS and overall survival (OS is controversial. Methods. We performed a literature-based meta-analysis (MA of observational studies, using keywords “colorectal cancer, physical activity, and survival” in PubMed and EMBASE. No dedicated MA was found in the Cochrane Library. References were cross-checked. Pre- and postdiagnosis PA levels were assessed by MET. Usually, “high” PA was higher than 17 MET hour/week. Hazard ratios (HRs for OS and CSS were calculated, with their 95% confidence interval. We used more conservative adjusted HRs, since variables of adjustment were similar between studies. When higher PA was associated with improved survival, HRs for detrimental events were set to <1. We used EasyMA software and fixed effect model whenever possible. Results. Seven studies (8056 participants were included, representing 3762 men and 4256 women, 5210 colon and 1745 rectum cancers. Mean age was 67 years. HR CSS for postdiagnosis PA (higher PA versus lower was 0.61 (0.44–0.86. The corresponding HR OS was 0.62 (0.54–0.71. HR CSS for prediagnosis PA was 0.75 (0.62–0.91. The corresponding HR OS was 0.74 (0.62–0.89. Conclusion. Higher PA predicted a better CSS. Sustained PA should be advised for CRC. OS also improved (reduced cardiovascular risk.

Integrating pulmonary rehabilitation into the multidisciplinary management of lung cancer: a review.

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Rivas-Perez, Hiram; Nana-Sinkam, Patrick

2015-04-01

Lung cancer is the number one cause of cancer related deaths. It is increasingly recognized that a multidisciplinary approach to the diagnosis and management of patients with lung cancer represents the ideal model for health care delivery. Given the high incidence of comorbid lung disease in lung cancer patients, strategies targeted at improving or optimizing these conditions may improve outcomes. Pulmonary rehabilitation (PR) has proven to be a useful management strategy for patients with chronic lung diseases including chronic obstructive pulmonary disease, interstitial lung disease and pulmonary hypertension. PR improves both exercise capacity and dyspnea. The effects of PR have also been studied in patients with lung cancer prior to and following surgical resection. Investigators have demonstrated significant improvements in six minute walk distance and lower extremity strength. In addition, patient recovery time is shorter when inpatient pulmonary rehabilitation is integrated prior to or following surgery. There are also positive reports regarding the benefits of exercise training in lung cancer patients receiving definite chemotherapy and radiotherapy. Pilot studies have demonstrated improvement in dyspnea scores as well as exercise capacity objectively measured by six minute walk distance. PR also offers an educational component in which patients have the opportunity to be educated regarding management of their disease as well as discuss goals of care. PR can be included as the standard of care for patients with advanced lung cancer with the goal of optimizing quality of life. Here, we provide a review of the current knowledge regarding PR in the management of patients with lung cancer. Published by Elsevier Ltd.

Management of cancer during pregnancy

International Nuclear Information System (INIS)

Doll, D.C.; Ringenberg, Q.S.; Yarbro, J.W.

1988-01-01

Although cancer during pregnancy is infrequent, its management is difficult for patients, their families, and their physicians. When termination of the pregnancy is unacceptable, decisions regarding the use of irradiation and chemotherapy are complicated by the well-known high risks of abortion and fetal malformation. This risk is concentrated in the first trimester and varies with the choice of chemotherapeutic agents or combinations of agents. There is only minimal evidence of increased risk of malformation or abortion in the second or third trimester. Recent progress in cancer therapy has made cure a reasonable goal, and for some malignant neoplasms, cure is still possible even when initial therapy is modified or delayed. When cure is a reasonable goal, curative therapy should not be compromised by modification or delay. When treatment for cure or significant palliation is not possible, however, the goal should shift to protection of the fetus from damage by the injudicious use of teratogenic cancer therapy. This report will review the available data that may assist in these difficult decisions. 114 references

A Physical Mechanism and Global Quantification of Breast Cancer.

Directory of Open Access Journals (Sweden)

Chong Yu

Full Text Available Initiation and progression of cancer depend on many factors. Those on the genetic level are often considered crucial. To gain insight into the physical mechanisms of breast cancer, we construct a gene regulatory network (GRN which reflects both genetic and environmental aspects of breast cancer. The construction of the GRN is based on available experimental data. Three basins of attraction, representing the normal, premalignant and cancer states respectively, were found on the phenotypic landscape. The progression of breast cancer can be seen as switching transitions between different state basins. We quantified the stabilities and kinetic paths of the three state basins to uncover the biological process of breast cancer formation. The gene expression levels at each state were obtained, which can be tested directly in experiments. Furthermore, by performing global sensitivity analysis on the landscape topography, six key genes (HER2, MDM2, TP53, BRCA1, ATM, CDK2 and four regulations (HER2⊣TP53, CDK2⊣BRCA1, ATM→MDM2, TP53→ATM were identified as being critical for breast cancer. Interestingly, HER2 and MDM2 are the most popular targets for treating breast cancer. BRCA1 and TP53 are the most important oncogene of breast cancer and tumor suppressor gene, respectively. This further validates the feasibility of our model and the reliability of our prediction results. The regulation ATM→MDM2 has been extensive studied on DNA damage but not on breast cancer. We notice the importance of ATM→MDM2 on breast cancer. Previous studies of breast cancer have often focused on individual genes and the anti-cancer drugs are mainly used to target the individual genes. Our results show that the network-based strategy is more effective on treating breast cancer. The landscape approach serves as a new strategy for analyzing breast cancer on both the genetic and epigenetic levels and can help on designing network based medicine for breast cancer.

Symptom management strategies for men with early-stage prostate cancer: results from the Prostate Cancer Patient Education Program (PC PEP).

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Vij, Alok; Kowalkowski, Marc A; Hart, Tae; Goltz, Heather Honoré; Hoffman, David J; Knight, Sara J; Caroll, Peter R; Latini, David M

2013-12-01

While the literature on prostate cancer health-related quality of life has grown extensively, little is known about symptom management strategies used by men to manage treatment-related side effects and the effectiveness of those strategies. We collected 628 symptom management reports from 98 men treated for localized prostate cancer. Participants were recruited from email lists and a prostate cancer clinic in Northern California. Data were collected using the Critical Incident Technique. Symptom management reports were assigned to categories of urinary, sexual, bowel, mental health, systemic, or "other." We calculated descriptive statistics by symptom type and management strategy effectiveness. The most common symptoms were urinary (26 %) and sexual (23 %). Participants' symptom management strategies varied widely, from medical and surgical interventions (20 %) to behavioral strategies (11 %) to diet and lifestyle interventions (12 %). The effectiveness of symptom management strategies varied, with sexual symptoms being managed effectively only 47 % of the time to mental health symptom management strategies considered effective 89 % of the time. Doing nothing was a commonly reported (15 %) response to symptoms and was effective only 14 % of the time. Men report the least effectiveness in symptom management for sexual dysfunction after prostate cancer treatment. Including men's experience with managing treatment side effects may be an important way to improve survivorship programs and make them more acceptable to men. More work is needed to find out why men frequently do nothing in response to symptoms when effective solutions exist and how providers can successfully engage such men.

Image-guided radiotherapy and motion management in lung cancer

DEFF Research Database (Denmark)

Korreman, Stine

2015-01-01

In this review, image guidance and motion management in radiotherapy for lung cancer is discussed. Motion characteristics of lung tumours and image guidance techniques to obtain motion information are elaborated. Possibilities for management of image guidance and motion in the various steps...

Integrating Physical Actions and Financial Instruments to Manage Environmental Financial Risk

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Foster, B.

2016-12-01

Exposure to extreme weather events can be reduced through physical actions (e.g., dams/reservoirs) or mitigated financially (e.g., insurance). Often physical actions involve investments in expensive infrastructure that reduce exposure, but whose benefits are only occasionally realized. Financial risk management does not reduce the impacts of an event, but rather redistributes them temporally, albeit at a cost. Nonetheless, these costs are typically much smaller, at least in the short run, than those incurred for physical actions. Financial strategies are also more flexible than physical ones in the face of an uncertain future. Financial contracts specifically designed to manage extreme environmental risks are becoming more common and can either replace or complement infrastructural investments as part of a risk management portfolio. In order to make optimal decisions as to the relative levels of physical and financial risk mitigation to employ, it is necessary to understand the relative merits of each strategy. This research develops a method for analyzing tradeoffs between physical and financial risk management strategies. We identify the unique cost and benefit properties of each strategy and integrate them into a single model that details the tradeoffs involved in various portfolios of physical and financial strategies. These methods are then applied to evaluate decisions to pursue emergency dredging during drought on the Mississippi River, which is used to mitigate the increased costs and/or reduced revenues barge operators face when water levels are low. Currently the U.S. Army Corps of Engineers funds most emergency dredging operations during major droughts and they are considering more intensive strategies for future droughts. Barge carriers and shippers though could manage at least some portion of their financial risks through a series of existing and experimental financial contracts. This work involves the formulation of these experimental contracts and

Emotional Intelligence and Transformational Leadership in Physical Education Managers

Directory of Open Access Journals (Sweden)

Nooshin Esfahani,

2013-03-01

Full Text Available The aim of the present research was to investigate the relationship between emotional intelligence and transformational leadership in managers of physical education of Golestan province. The managers and deputies of Golestan physical education departments participated in this research and 47 subjects were selected as the statistical sample of this study. Emotional Intelligence questionnaire that assessed five micro scales of self-awareness, self-management, self-motivation, empathy and social skills, Multifactor Leadership questionnaire (MLQ by Bass and Avolio (1996 that measured five micro scales related to transformational leadership, three micro scales of transactional leadership, and laissez-faire leadership were used to collect the data. In order to analyze the data, ANOVA test, multiple regression test, and Pearson correlation coefficient were applied. The results showed a significant relationship between emotional intelligence and transformational leadership method. Also, the results of multiple regression test indicated that among transformational leadership micro scales, personal considerations was the strongest predictive variable in transformational leadership method and among emotional intelligence micro scales, empathy had a great influence on emotional intelligence of physical education managers.

Communication Efficacy and Couples’ Cancer Management: Applying a Dyadic Appraisal Model

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Magsamen-Conrad, Kate; Checton, Maria G.; Venetis, Maria K.; Greene, Kathryn

2014-01-01

The purpose of the present study was to apply Berg and Upchurch’s (2007) developmental-conceptual model to understand better how couples cope with cancer. Specifically, we hypothesized a dyadic appraisal model in which proximal factors (relational quality), dyadic appraisal (prognosis uncertainty), and dyadic coping (communication efficacy) predicted adjustment (cancer management). The study was cross-sectional and included 83 dyads in which one partner had been diagnosed with and/or treated for cancer. For both patients and partners, multilevel analyses using the actor-partner interdependence model (APIM) indicated that proximal contextual factors predicted dyadic appraisal and dyadic coping. Dyadic appraisal predicted dyadic coping, which then predicted dyadic adjustment. Patients’ confidence in their ability to talk about the cancer predicted their own cancer management. Partners’ confidence predicted their own and the patient’s ability to cope with cancer, which then predicted patients’ perceptions of their general health. Implications and future research are discussed. PMID:25983382

Neuropathic pain in people with cancer (part 2): pharmacological and non-pharmacological management.

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Taverner, Tarnia

2015-08-01

The aim of this paper is to provide an overview of the management of neuropathic pain associated with cancer and to provide helpful clinical advice for nurses working with patients who may have neuropathic pain. While cancer pain is a mixed-mechanism pain, this article will focus only on neuropathic pain management. The impact of neuropathic pain on patients' quality of life is great and while many patients recover from their cancer, a significant number continue to suffer from a neuropathic pain syndrome. Management of neuropathic pain is significantly different from management of nociceptive pain with respect to pharmacological and non-pharmacological strategies. Neuropathic pain is complex, and as such requires complex management using pharmacological as well as non-pharmacological approaches. Specific drugs for neuropathic pain may be effective for some patients, but not all; therefore, ongoing and comprehensive assessment and management are required. Furthermore, these patients may require trials of several drugs before they find one that works for them. It is important for nurses to understand neuropathic pain, its manifestation, impact on quality of life and management when nursing patients with neuropathic pain associated with cancer.

Physical education resources, class management, and student physical activity levels: a structure-process-outcome approach to evaluating physical education effectiveness.

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Bevans, Katherine B; Fitzpatrick, Leslie-Anne; Sanchez, Betty M; Riley, Anne W; Forrest, Christopher

2010-12-01

This study was conducted to empirically evaluate specific human, curricular, and material resources that maximize student opportunities for physical activity during physical education (PE) class time. A structure-process-outcome model was proposed to identify the resources that influence the frequency of PE and intensity of physical activity during PE. The proportion of class time devoted to management was evaluated as a potential mediator of the relations between resource availability and student activity levels. Data for this cross-sectional study were collected from interviews conducted with 46 physical educators and the systematic observation of 184 PE sessions in 34 schools. Regression analyses were conducted to test for the main effects of resource availability and the mediating role of class management. Students who attended schools with a low student-to-physical educator ratio had more PE time and engaged in higher levels of physical activity during class time. Access to adequate PE equipment and facilities was positively associated with student activity levels. The availability of a greater number of physical educators per student was found to impact student activity levels by reducing the amount of session time devoted to class management. The identification of structure and process predictors of student activity levels in PE will support the allocation of resources and encourage instructional practices that best support increased student activity levels in the most cost-effective way possible. Implications for PE policies and programs are discussed. © 2010, American School Health Association.

Management of severe urethral complications of prostate cancer therapy.

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Elliott, Sean P; McAninch, Jack W; Chi, Thomas; Doyle, Sean M; Master, Viraj A

2006-12-01

We present our management of urethral stenosis and rectourinary fistula resulting from prostate cancer therapy. We concentrated on cases refractory to minimally invasive treatment, such as dilation, urethrotomy, and urinary and/or fecal diversion. In our prospectively collected urethral reconstruction database we identified patients who underwent reconstruction of urethral stenosis or rectourinary fistula who also received prior treatment for prostate cancer. We documented demographics, prostate cancer pretreatment characteristics, prostate cancer therapy type, urethral reconstruction type and success. A total of 48 patients met the inclusion criteria, including 16 with rectourinary fistula and 32 with urethral stenosis. Urethral complications followed prior radical prostatectomy, brachytherapy, external beam radiotherapy, cryotherapy, thermal ablation and any combination of these procedures. Stenosis repair was successful in 23 of 32 cases (73%) and it differed little between anterior and posterior urethral stenosis. Repair was accomplished by anastomotic urethroplasty in 19 cases, flap urethroplasty in 2, perineal urethrostomy in 2 and a urethral stent in 9. Prior external beam radiotherapy was a risk factor for urethral reconstruction failure. Fistula repair was successful in 14 of 15 patients (93%), excluding 1 who died postoperatively. The complexity of fistula management was dictated by fistula size and the presence or absence of coincident urethral stenosis. Urethral stenosis or rectourethral fistula following prostate cancer therapy can be managed by urethral reconstruction, such that normal voiding via the urethra is maintained, rather than abandoning the urethral outlet and performing heterotopic diversion. This can be accomplished with an acceptable rate of failure, given the complexity of the cases.

Study protocol: Rehabilitation including Social and Physical activity and Education in Children and Teenagers with Cancer (RESPECT).

Science.gov (United States)

Thorsteinsson, Troels; Helms, Anne Sofie; Adamsen, Lis; Andersen, Lars Bo; Andersen, Karen Vitting; Christensen, Karl Bang; Hasle, Henrik; Heilmann, Carsten; Hejgaard, Nete; Johansen, Christoffer; Madsen, Marianne; Madsen, Svend Aage; Simovska, Venka; Strange, Birgit; Thing, Lone Friis; Wehner, Peder Skov; Schmiegelow, Kjeld; Larsen, Hanne Baekgaard

2013-11-14

During cancer treatment children have reduced contact with their social network of friends, and have limited participation in education, sports, and leisure activities. During and following cancer treatment, children describe school related problems, reduced physical fitness, and problems related to interaction with peers. The RESPECT study is a nationwide population-based prospective, controlled, mixed-methods intervention study looking at children aged 6-18 years newly diagnosed with cancer in eastern Denmark (n=120) and a matched control group in western Denmark (n=120). RESPECT includes Danish-speaking children diagnosed with cancer and treated at pediatric oncology units in Denmark. Primary endpoints are the level of educational achievement one year after the cessation of first-line cancer therapy, and the value of VO2max one year after the cessation of first-line cancer therapy. Secondary endpoints are quality of life measured by validated questionnaires and interviews, and physical performance. RESPECT includes a multimodal intervention program, including ambassador-facilitated educational, physical, and social interventions. The educational intervention includes an educational program aimed at the child with cancer, the child's schoolteachers and classmates, and the child's parents. Children with cancer will each have two ambassadors assigned from their class. The ambassadors visit the child with cancer at the hospital at alternating 2-week intervals and participate in the intervention program. The physical and social intervention examines the effect of early, structured, individualized, and continuous physical activity from diagnosis throughout the treatment period. The patients are tested at diagnosis, at 3 and 6 months after diagnosis, and one year after the cessation of treatment. The study is powered to quantify the impact of the combined educational, physical, and social intervention programs. RESPECT is the first population-based study to examine the

Multi-agent systems: effective approach for cancer care information management.

Science.gov (United States)

Mohammadzadeh, Niloofar; Safdari, Reza; Rahimi, Azin

2013-01-01

Physicians, in order to study the causes of cancer, detect cancer earlier, prevent or determine the effectiveness of treatment, and specify the reasons for the treatment ineffectiveness, need to access accurate, comprehensive, and timely cancer data. The cancer care environment has become more complex because of the need for coordination and communication among health care professionals with different skills in a variety of roles and the existence of large amounts of data with various formats. The goals of health care systems in such a complex environment are correct health data management, providing appropriate information needs of users to enhance the integrity and quality of health care, timely access to accurate information and reducing medical errors. These roles in new systems with use of agents efficiently perform well. Because of the potential capability of agent systems to solve complex and dynamic health problems, health care system, in order to gain full advantage of E- health, steps must be taken to make use of this technology. Multi-agent systems have effective roles in health service quality improvement especially in telemedicine, emergency situations and management of chronic diseases such as cancer. In the design and implementation of agent based systems, planning items such as information confidentiality and privacy, architecture, communication standards, ethical and legal aspects, identification opportunities and barriers should be considered. It should be noted that usage of agent systems only with a technical view is associated with many problems such as lack of user acceptance. The aim of this commentary is to survey applications, opportunities and barriers of this new artificial intelligence tool for cancer care information as an approach to improve cancer care management.

Controversies in the management of tongue base cancer.

LENUS (Irish Health Repository)

O'Neill, J P

2012-01-31

BACKGROUND: Tongue base cancer is one of the most lethal head and neck cancers. There is considerable controversy in the management of this disease with wide variation of opinion within the literature. METHODS: We discuss the presentation, diagnostic and therapeutic strategies which exist in the literature. Articles were reviewed from 1970 to 2007 within the Medline, Pubmed and Cochrane libraries. CONCLUSIONS: Smokers with a history of persistent unilateral neck pain, even in the absence of clinical signs warrant MRI neck imaging. Tongue base cancer organ preservation therapeutic strategies, radiation and concomitant platinum based chemotherapy, currently optimise oncologic and quality of life outcomes.

Health-related physical fitness assessment in a community-based cancer rehabilitation setting.

Science.gov (United States)

Kirkham, Amy A; Neil-Sztramko, Sarah E; Morgan, Joanne; Hodson, Sara; Weller, Sarah; McRae, Tasha; Campbell, Kristin L

2015-09-01

Assessment of physical fitness is important in order to set goals, appropriately prescribe exercise, and monitor change over time. This study aimed to determine the utility of a standardized physical fitness assessment for use in cancer-specific, community-based exercise programs. Tests anticipated to be feasible and suitable for a community setting and a wide range of ages and physical function were chosen to measure body composition, aerobic fitness, strength, flexibility, and balance. Cancer Exercise Trainers/Specialists at cancer-specific, community-based exercise programs assessed new clients (n = 60) at enrollment, designed individualized exercise programs, and then performed a re-assessment 3-6 months later (n = 34). Resting heart rate, blood pressure, body mass index, waist circumference, handgrip strength, chair stands, sit-and-reach, back scratch, single-leg standing, and timed up-and-go tests were considered suitable and feasible tests/measures, as they were performed in most (≥88 %) participants. The ability to capture change was also noted for resting blood pressure (-7/-5 mmHg, p = 0.02), chair stands (+4, p exercise program setting. However, a shorter treadmill protocol and more sensitive balance and upper body flexibility tests should be investigated.

Cancer pain management and the opioid crisis in America: How to preserve hard-earned gains in improving the quality of cancer pain management.

Science.gov (United States)

Paice, Judith A

2018-06-15

Cancer pain remains a feared consequence of the disease and its treatment. Although prevalent, cancer pain can usually be managed through the skillful application of pharmacologic and nonpharmacologic interventions. Unfortunately, access to these therapies has been hampered by interventions designed to contain another serious public health problem: the opioid misuse epidemic. This epidemic and the unintended consequences of efforts to control this outbreak are leading to significant barriers to the provision of cancer pain relief. Oncologists and other professionals treating those with cancer pain will require new knowledge and tools to provide safe and effective pain control while preventing additional cases of substance use disorders (SUDs), helping patients in recovery to maintain sobriety, and guiding those not yet in recovery to seek treatment. How do these 2 serious epidemics intersect and affect oncology practice? First, oncology professionals will need to adopt practices to prevent SUDs by assessing risk and providing safe pain care. Second, oncology practices are likely to see an increased number of patients with a current or past SUD, including opioid misuse. Few guidelines exist for the direct management of pain when opioids may be indicated in these individuals. Third, modified prescribing practices along with the education of patients and families are warranted to prevent the exposure of these medications to unintended persons. Finally, advocacy on behalf of those with cancer pain is imperative to avoid losing access to essential therapies, including opioids, for those who might benefit. Cancer 2018;124:2491-7. © 2018 American Cancer Society. © 2018 American Cancer Society.

Cancer-Related Fatigue in Adolescents and Young Adults After Cancer Treatment: Persistent and Poorly Managed.

Science.gov (United States)

Spathis, Anna; Hatcher, Helen; Booth, Sara; Gibson, Faith; Stone, Paddy; Abbas, Laura; Barclay, Matt; Brimicombe, James; Thiemann, Pia; McCabe, Martin G; Campsey, Rachel; Hooker, Louise; Moss, Wendy; Robson, Jane; Barclay, Stephen

2017-09-01

Cancer-related fatigue is the most prevalent and distressing symptom experienced by adolescents and young adults (AYAs). An electronic survey was undertaken to ascertain current fatigue management and perceptions of its effectiveness. Eighty-five percent of responders (68/80) experienced fatigue, and it was worse more than 1 year after cancer treatment ended, compared to fatigue management. Although advice to exercise was the most frequent intervention, the greatest impact of fatigue was on the ability to exercise and most did not find exercise advice helpful. Early intervention is warranted, supporting AYAs to persevere with increasing activity.

Rehabilitation Using High-Intensity Physical Training and Long-Term Return-to-Work in Cancer Survivors

NARCIS (Netherlands)

Thijs, Karin M.; de Boer, Angela G. E. M.; Vreugdenhil, Gerard; van de Wouw, Agnès J.; Houterman, Saskia; Schep, Goof

2012-01-01

Introduction Due to large and increasing numbers of cancer survivors, long-term cancer-related health issues have become a major focus of attention. This study examined the relation between a high-intensity physical rehabilitation program and return-to-work in cancer survivors who had received

Physical functions, health-related outcomes, nutritional status, and blood markers in community-dwelling cancer survivors aged 75 years and older.

Science.gov (United States)

Ihira, Hikaru; Mizumoto, Atsushi; Makino, Keitarou; Yasuda, Keisuke; Yoko, Yoko; Saitoh, Shigeyuki; Ohnishi, Hirofumi; Furuna, Taketo

2014-01-01

A cancer survivor is defined as anyone who has been diagnosed with cancer, from the time of diagnosis through the rest of their life. The purpose of this study was to examine whether physical functions, health-related outcomes, nutritional status and blood markers in community-dwelling cancer survivors aged 75 years and older are different from those who do not have cancer Two hundred seventy-five participants were asked by physicians, nurses, and physical therapists, questions regarding cancer history in a face-to-face interview. Data were collected for demographic information, physical functions, such as handgrip strength, knee extension power, abdominal muscle strength, static standing balance, walking speed and the timed-up-and-go test, health-related outcomes, nutritional status, and blood markers. The measured parameters of survivor diagnosed with cancer were compared with those without a history of cancer. Thirty-seven older adults were previously diagnosed with cancer. Female cancer survivors had lower knee extension power (pcancer. In men, none of the measured parameters were significantly different between cancer survivors and older men with no history of cancer. The present study shows that partial physical function of women cancer survivors aged 75 years and older differs from that in women with no history of cancer.

Psychological and behavioural predictors of pain management outcomes in patients with cancer

DEFF Research Database (Denmark)

Jacobsen, Ramune; Møldrup, Claus; Christrup, Lona Louring

2010-01-01

To better understand the phenomenon of patient-related barriers to cancer pain management and address them more effectively in interventional studies, a theoretical model related to psychological aspects of pain experience and pain-related behaviours was elaborated. The aim of the study was to an......To better understand the phenomenon of patient-related barriers to cancer pain management and address them more effectively in interventional studies, a theoretical model related to psychological aspects of pain experience and pain-related behaviours was elaborated. The aim of the study...... was to analyse the impact of patient-related barriers on cancer pain management outcomes following this model. Thirty-three patients responded to the Brief Pain Inventory Pain scale, the Danish Barriers Questionnaire II (DBQ-II), the Hospital Anxiety and Depression scale (HADS), the Danish version of Patient...... was explained by patients' emotional distress (symptoms of anxiety and depression) and that pain relief was explained by cognitive barriers. In conclusion, interventions in emotional distress and patients' concerns may supposedly result in better cancer pain management outcomes....

Future health physics prospects in high-level nuclear waste management

International Nuclear Information System (INIS)

Waite, D.A.; Mayberry, J.J.

1986-01-01

The objective of this presentation is to provide an overview of health physics activities anticipated to be required at a high-level nuclear waste repository and to project the numbers of health physics personnel expected to be required to carry out these activities. Health physics personnel receiving consideration in the projections include the health physics manager, shift supervisors, area supervisors, health physicists, and technologists. Phases of the repository addressed are construction, operation, retrieval, and decommissioning. Specific topics discussed in the process of developing the projections are: (a) the basic features of a geologic repository, (b) the staffing requirements of such a repository, (c) health physics involvement in repository operations, and (d) the anticipated schedule for operation of repositories in the United States. A quantitative assessment of future health physics prospects in high-level nuclear waste management is included

The association of physical activity and colorectal and breast cancer: The Fifth Korea National Health and Nutrition Examination Survey (2008-2011).

Science.gov (United States)

Kang, Suh-Jung

2015-06-01

Therapeutic importance of physical activity during and after cancer treatment has been supported. To examine the patterns of physical activity according to the stages of breast and colorectal cancer survivor-ship in Korean, Korean National Health and Nutrition Examination Survey data from 2008 to 2011 were used. International Physical Activity Questionnaire (IPAQ) was utilized to estimate weekly time spent in vigorous- and moderate-intensity physical activity, and walking, and to calculate MET-minute/week. Depending on the survivorship, the subjects were categorized into "never diagnosed with cancer" (group 1), "0-4 yr since cancer diagnosis" (group 2), and "5 or more years since cancer diagnosis" (group 3), separately for colorectal and breast cancer. The associations between physical activity and the cancer survivorship were studied. Following results were obtained: (1) Breast cancer (n=10,167, mean age=48.55±16.27): The mean physical activity levels expressed in MET-minutes/week were 2,064.83, 1748.82, and 1998.36 in groups 1, 2, and 3, respectively. Even though cancer survivors tended to be less active compared to people without cancer, there were no statistically significant difference among the three groups. (2) Colorectal cancer (n=17,270, mean age=48.62): MET-minutes/week was 2064.30, 1084.83, and 709.04 36 in groups 1, 2, and 3, respectively. The differences were significant between group 1 and 2 (F=5.87, P=0.016) and group 1 and 3 (F=28.99, Pphysical activity, colorectal cancer survivors were less active than people without cancer in Korea.

Pre-Radiation dental considerations and management for head and neck cancer patients.

Science.gov (United States)

Kufta, Kenneth; Forman, Michael; Swisher-McClure, Samuel; Sollecito, Thomas P; Panchal, Neeraj

2018-01-01

Treatment of head and neck cancer (HNC) is accompanied by a high rate of morbidity, and complications can have a lifelong, profound impact on both patients and caregivers. Radiation-related injury to the hard and soft tissue of the head and neck can significantly decrease patients' quality of life. The purpose of this study is to provide patent-specific guidelines for managing the oral health and related side effects of HNC patients treated with radiation therapy. Based on reviewed articles retrieved on the PubMed database, guidelines for management of the oral health of this patient population were organized into three separate categories: cancer, patient, and dentition. The location, type, and staging of the cancer, along with the radiation used to treat the cancer significantly impact dental treatment. Several unique patient characteristics such as motivation, presence of support system, socioeconomic status, nutrition, and race have all been found to affect outcomes. Dental disease and available supportive dental management was found to significantly impact treatment and quality of life in this patient population. By comprehensively assessing unique cancer, patient, and dental-related factors, this review provides individualized evidence-based guidelines on the proper management of this complex and vulnerable patient population. Copyright © 2017 Elsevier Ltd. All rights reserved.

Management of virtualized infrastructure for physics databases

International Nuclear Information System (INIS)

Topurov, Anton; Gallerani, Luigi; Chatal, Francois; Piorkowski, Mariusz

2012-01-01

Demands for information storage of physics metadata are rapidly increasing together with the requirements for its high availability. Most of the HEP laboratories are struggling to squeeze more from their computer centers, thus focus on virtualizing available resources. CERN started investigating database virtualization in early 2006, first by testing database performance and stability on native Xen. Since then we have been closely evaluating the constantly evolving functionality of virtualisation solutions for database and middle tier together with the associated management applications – Oracle's Enterprise Manager and VM Manager. This session will detail our long experience in dealing with virtualized environments, focusing on newest Oracle OVM 3.0 for x86 and Oracle Enterprise Manager functionality for efficiently managing your virtualized database infrastructure.

The association of physical activity with all-cause, cardiovascular, and cancer mortalities among older adults.

Science.gov (United States)

Wu, Chen-Yi; Hu, Hsiao-Yun; Chou, Yi-Chang; Huang, Nicole; Chou, Yiing-Jenq; Li, Chung-Pin

2015-03-01

To evaluate the association of physical activity with all-cause, cardiovascular, and cancer mortalities among older adults. A study sample consisting of 77,541 community-dwelling Taipei citizens aged ≥ 65 years was selected based on data obtained from the government-sponsored Annual Geriatric Health Examination Program between 2006 and 2010. Subjects were asked how many times they had physical activity for ≥ 30 min during the past 6 months. Mortality was determined by matching cohort identifications with national death files. Compared to subjects with no physical activity, those who had 1-2 times of physical activity per week had a decreased risk of all-cause mortality [hazard ratio (HR): 0.77; 95% confidence interval (CI): 0.71-0.85). Subjects with 3-5 times of physical activity per week had a further decreased risk of all-cause mortality (HR: 0.64; 95% CI: 0.58-0.70). An inverse dose-response relationship was observed between physical activity and all-cause, cardiovascular, and cancer mortality. According to stratified analyses, physical activity was associated with a decreased risk of mortality in most subgroups. Physical activity had an inverse association with all-cause, cardiovascular, and cancer mortality among older adults. Furthermore, most elderly people can benefit from an active lifestyle. Copyright © 2015 Elsevier Inc. All rights reserved.

Physical and mental health status and health behaviors in male breast cancer survivors: a national, population-based, case-control study.

Science.gov (United States)

Andrykowski, Michael A

2012-09-01

Identify the current physical and mental health status and health behaviors of male breast cancer survivors. Using data from the national, population-based, 2009 Behavioral Risk Factor Surveillance System (BRFSS) survey, 66 cases of male breast cancer were identified (mean age = 66.2 years, mean time since diagnosis = 12.0 years). Male breast cancer cases were matched with 198 male BRFSS respondents with no history of cancer (control group) on age, education, and minority status. The male breast cancer and control groups were compared on physical and mental health status and health behaviors, using t-test and logistic regression analyses. The male breast cancer group reported poorer physical and mental health than controls. Male breast cancer survivors were significantly (p mental health (Effect Size = 0.49), and physical health (Effect Size = 0.29) were not good. In contrast, the male breast cancer and control groups were similar with regard to current health behaviors, including tobacco and alcohol use, diet, exercise, and health care. The diagnosis and treatment of male breast cancer may be associated with clinically important and long-term deficits in physical and mental health status, deficits which may exceed those evidenced by long-term female breast cancer survivors. Copyright © 2011 John Wiley & Sons, Ltd. Copyright © 2011 John Wiley & Sons, Ltd.

Understanding narrative effects in physical activity promotion: the influence of breast cancer survivor testimony on exercise beliefs, self-efficacy, and intention in breast cancer patients.

Science.gov (United States)

Falzon, Charlène; Radel, Rémi; Cantor, Ambre; d'Arripe-Longueville, Fabienne

2015-03-01

Research in health communication has shown that narratives contribute more positively to changing health behaviors than informational messages. The main purposes of this study were to examine and to compare the effects of two messages promoting physical activity, one narrative and the other informational, on the perceptions and behavioral intentions of cancer patients. A total of 158 women with breast cancer, undergoing chemotherapy and sedentary, were assigned to read the testimony of a breast cancer survivor who had been physically active during and after treatment (TE group), a content-equivalent message composed of expert recommendations about physical activity in breast cancer patients (RE group), or no message (control group). Source trust was higher in TE group than RE group (p Exercise self-efficacy and exercise intention were higher in TE group than RE and control groups (p exercise benefits (p exercise risks (p exercise self-efficacy, and beliefs about exercise benefits and risks mediated the relationship between the message and exercise intention. The results suggest that narratives may be more effective in improving perceived physical abilities and involvement in physical activity, whereas informational messages seem to be more appropriate to convey the benefits and the absence of risks related to physical activity.

Management of synchronous rectal and prostate cancer.

LENUS (Irish Health Repository)

Kavanagh, D O

2012-11-01

Although well described, there is limited published data related to management on the coexistence of prostate and rectal cancer. The aim of this study was to describe a single institution\\'s experience with this and propose a treatment algorithm based on the best available evidence.

Current management of locally recurrent rectal cancer

DEFF Research Database (Denmark)

Nielsen, Mette Bak; Laurberg, Søren; Holm, Thorbjörn

2011-01-01

ABSTRACT Objective: A review of the literature was undertaken to provide an overview of the surgical management of locally recurrent rectal cancer (LRRC) after the introduction of total mesorectal excision (TME). Method: A systematic literature search was undertaken using PubMed, Embase, Web...

Assessment of physical performance using the 6-minute walk test in children receiving treatment for cancer.

Science.gov (United States)

Hooke, Mary C; Garwick, Ann W; Neglia, Joseph P

2013-01-01

The study of physical performance in children with cancer is emerging as an important variable in symptom research. Studies have shown that children with cancer experience deficits in physical performance during treatment that may be present years after therapy. The aim of this study was to determine if distance on the 6-minute walk test (6MWT) changed in children during the first 3 cycles of cancer treatment and to compare the distances walked with healthy norms. This is a secondary data analysis of 19 boys and 10 girls, aged 6 to 17 years, who were newly diagnosed with cancer and were part of a larger study that measured changes in fatigue and physical performance during the first 3 cycles of chemotherapy. Participants performed the 6MWT between days 15 and 29 of the first and third cycles of chemotherapy. Pediatric cancer patients did not have a significant change in the distance walked at cycle 3 of chemotherapy compared with cycle 1. When compared with 2 different normative data sets for healthy children, most children with cancer performed significantly below their peers. Children had poor strength and endurance after 3 cycles of chemotherapy even when their disease was responding to treatment. Interventions are needed to promote rehabilitation and maintenance of physical performance, as both are important to quality of life and ongoing child development. Children receiving cancer treatment who are ambulatory may appear to be functioning normally but are in fact severely deconditioned compared with their healthy peers.

Surgical management of malignant bowel obstruction in recurrent pancreatic cancer

Directory of Open Access Journals (Sweden)

Hyung Sun Kim

2017-01-01

Discussion and conclusion: Palliative surgery improves quality of life in recurrent pancreatic cancer patients and can continue patient’s palliative management. In selected patients, palliative surgery may effective management for progress of survival and quality of life.

[Consensus on clinical diagnosis, treatment and pedigree management of hereditary colorectal cancer in China].

Science.gov (United States)

2018-01-23

Hereditary colorectal cancer can be divded into two categories based on the presence or absence of polyps. The first category is characterized by the development of polyposis, which includes familial adenomatous polyposis (FAP); The second category is nonpolyposis colorectal cancer, which is represented by Lynch syndrome. "Consensus on clinical diagnosis, treatment and pedigree management of hereditary colorectal cancer in China" developed by the Genetics Group of the Committee of Colorectal Cancer, Chinese Anti-cancer Association, is composed of three sections, including hereditary nonpolyposis syndrome, polyposis syndrome as well as genetic evaluation of hereditary colorectal cancer. The consensus aims to provide recommendations on management of the respective hereditary syndromes in terms of definition, clinical and pathological features, diagnostic standards, treatment, and follow-ups. In addition to describing diagnostic and treatment strategies, prophylactic treatment as well as genetic screening and pedigree monitoring is highly recommended. Through the establishment of this expert consensus, we hope to promote better understanding of hereditary colorectal cancer for clinicians and encourage standardized treatment through multidisciplinery approaches, eventually improving clinical treatment and pedigree management of hereditary colorectal cancer in China.

Anthropometry, physical activity, and endometrial cancer risk: Results from the Netherlands Cohort Study

NARCIS (Netherlands)

Schouten, L.J.; Goldbohm, R.A.; Brandt, P.A. van den

2004-01-01

Although obesity is an established risk factor for endometrial cancer, evidence linking risk to height, weight change since age 20, and physical activity is limited. In this case-cohort study, 62 573 women from The Netherlands Cohort Study on Diet and Cancer were followed up from 1986 to 1995, and

Quality of life and physical activity in long-term (≥5 years post-diagnosis) colorectal cancer survivors - systematic review.

Science.gov (United States)

Eyl, Ruth Elisa; Xie, Kun; Koch-Gallenkamp, Lena; Brenner, Hermann; Arndt, Volker

2018-06-01

Due to the increasing number of long-term (≥5 years post diagnosis) colorectal cancer survivors, long-term quality of life of these patients is highly relevant. Several studies have reported a positive association between physical activity and quality of life in colorectal cancer survivors, however, so far no systematic review has been published which focuses on long-term colorectal cancer survivors. A systematic review was conducted using the databases PubMed, Web of Science, PsychINFO, and CINAHL. Studies which investigated associations between physical activity and quality of life in long-term colorectal cancer survivors were included. Ten articles based on seven studies were identified. Long-term colorectal cancer survivors who were physically active reported better quality of life than long-term survivors who were not physically active. Both, moderate to vigorous physical activity and lower levels like light physical activity were associated with higher quality of life. Most studies assessed the association between physical activity and quality of life cross-sectionally but one prospective study which measured physical activity and quality of life at three different points in time also found associations between physical activity and quality of life. The association between physical activity and quality of life seemed to be stronger among women than among men. The findings of this systematic review support an association between physical activity and quality of life in long-term colorectal cancer survivors. However, the evidence is limited as most studies were based on cross-sectional and observational design.

Impact of sarcopenia in the management of urological cancer patients.

Science.gov (United States)

Fukushima, Hiroshi; Koga, Fumitaka

2017-05-01

Sarcopenia, the degenerative and systemic loss of skeletal muscle mass, develops as a consequence of the progression of cancer cachexia. Recent studies suggest that sarcopenia may be used as a biomarker in the management of patients with several cancers. Areas covered: In this article, the authors review 1) the methods to simply and optimally evaluate and define sarcopenia using computed tomography images in daily clinical practice and 2) the impact of sarcopenia in the management of urological cancers, specifically focusing on the usefulness in predicting treatment-related complications and prognosis. The authors also discuss the prognostic importance of changes in skeletal muscle mass in the course of treatment and the potential roles of nutritional support and exercise to prevent progression of sarcopenia. Expert commentary: Sarcopenia is associated with treatment-related complications and unfavorable prognosis in urological cancer patients. Nutritional support and exercise might be helpful in improving sarcopenia. The impact of these interventions on clinical outcomes would be elucidated by ongoing or future clinical studies.

Physician-related barriers to cancer pain management with opioid analgesics

DEFF Research Database (Denmark)

Jacobsen, Ramune; Sjøgren, Per; Møldrup, Claus

2007-01-01

OBJECTIVE: The purpose of this review is to summarize the results of studies on physician-related barriers to cancer pain management with opioid analgesics. METHODS: A literature search was conducted in PUBMED, using a combined text word and MeSH heading search strategy. Those articles whose full...... texts were not available in PUBMED were retrieved from the electronic databases of specific journals. RESULTS: Sixty-five relevant articles, published in the period from 1986 to 2006, were identified. Physicians' barriers to cancer pain management were studied in questionnaire surveys and in the reviews...

Increasing physical activity and exercise in lung cancer: reviewing safety, benefits, and application.

Science.gov (United States)

Bade, Brett C; Thomas, D David; Scott, JoAnn B; Silvestri, Gerard A

2015-06-01

Lung cancer continues to be a difficult disease frequently diagnosed in late stages with a high mortality and symptom burden. In part because of frequent lung comorbidity, even lung cancer survivors often remain symptomatic and functionally limited. Though targeted therapy continues to increase treatment options for advanced-stage disease, symptom burden remains high with few therapeutic options. In the last several decades, exercise and physical activity have arisen as therapeutic options for obstructive lung disease and lung cancer. To date, exercise has been shown to reduce symptoms, increase exercise tolerance, improve quality of life, and potentially reduce length of stay and postoperative complications. Multiple small trials have been performed in perioperative non-small-cell lung cancer patients, although fewer studies are available for patients with advanced-stage disease. Despite the increased interest in this subject over the last few years, a validated exercise regimen has not been established for perioperative or advanced-stage disease. Clinicians underutilize exercise and pulmonary rehabilitation as a therapy, in part because of the lack of evidence-based consensus as to how and when to implement increasing physical activity. This review summarizes the existing evidence on exercise in lung cancer patients.

Management of recurrent venous thromboembolism in patients with cancer: A review.

Science.gov (United States)

Piran, Siavash; Schulman, Sam

2018-04-01

Venous thromboembolism (VTE) occurs in 10-20%% of patients with cancer and is associated with significant mortality and morbidity in these patients. The current standard of care recommended by international guidelines is to use low-molecular-weight heparin (LMWH) for 6months for the management of cancer-associated thrombosis (CAT), which is based on evidence from randomized controlled trials demonstrating that LMWH significantly reduced the risk of recurrent VTE compared with vitamin K antagonists. However, patients with CAT have a high risk of VTE recurrence of up to 20% despite receiving anticoagulation. Reasons for recurrent VTE may include non-compliance, temporary cessation of therapy due to bleeding or for procedures, inadequate dosing, cancer progression, and the presence of heparin-induced thrombocytopenia. Management of patients with CAT and recurrent VTE is not well defined. Management strategies for recurrent VTE include switching to LMWH if an oral anticoagulant is employed, dose escalation of LMWH, or as a last resort option consider insertion of a vena cava filter. In this review, we discuss the acute, long-term, and extended management of CAT, risk factors for recurrent VTE, and management of recurrent VTE. Copyright © 2018 Elsevier Ltd. All rights reserved.

Physical and Psychological Effects of a 12-Session Cancer Rehabilitation Exercise Program.

Science.gov (United States)

Smith, Tricia M; Broomhall, Christine N; Crecelius, Anne R

2016-12-01

The positive effects of regular exercise for cancer survivors are becoming increasingly apparent. However, comprehensive examination of the benefits of modest levels of physical activity is somewhat lacking. This study aimed to test the hypothesis that participating in a 12-session exercise program will improve depression, fatigue, aerobic endurance, muscular strength, and quality of life (QOL) in patients with cancer. A group of 20 older adult women with a prior cancer diagnosis were evaluated during a 6- to 10-week exercise program that occurred twice weekly. The majority of patients had breast cancer (n = 14), but treatment status varied (11 were currently undergoing treatment, and 9 were post-treatment). Each patient completed initial and exit assessments, which consisted of three physical function tests and three psychosocial questionnaires. Patient charts contained the initial and final assessment scores and personal demographics. Analyses of pre- and postprogram data using paired t tests revealed that 12 exercise sessions (each lasting about an hour) significantly improved six-minute walk test, 30-second sit-and-stand test, hand grip strength test (dominant and nondominant hand), and overall QOL scores in patients. As a result, moderate levels of exercise have a beneficial effect in this population.

[China expert consensus on the management of dyslipidemia in postmenopausal patients with early-stage breast cancer].

Science.gov (United States)

2017-01-23

Estrogen has an impact on the type of lipoproteins and the blood lipid levels, thus protecting the cardiovascular system. Postmenopausal breast cancer patients suffer a significant decrease in estrogen levels due to both physiological changes and the use of drugs, and thus have a higher risk of atherosclerotic cardiovascular diseases. Therefore, strict lipid management is required for postmenopausal breast cancer patients receiving endocrine therapy. However, no guidelines have been developed in terms of lipid management and intervention for postmenopausal breast cancer patients. The Chinese expert group of multidisciplinary management of dyslipidemia in breast cancer patients with endocrine therapy, after deep investigation into the management of dyslipidemia in postmenopausal patients with early-stage breast cancer, has developed the China Expert Consensus on Dyslipidemia Management in Postmenopausal Patients with Early-stage Breast Cancer. The Consensus clearly defines the goals and measures of interventions for dyslipidemia, hoping to effectively reduce the risk of atherosclerotic cardiovascular disease in postmenopausal breast cancer patients and further improve the long-term survival of the patients.

Contemporary Management of Primary Distal Urethral Cancer

NARCIS (Netherlands)

Traboulsi, S.L.; Witjes, J.A.; Kassouf, W.

2016-01-01

Primary urethral cancer is one of the rare urologic tumors. Distal urethral tumors are usually less advanced at diagnosis compared with proximal tumors and have a good prognosis if treated appropriately. Low-stage distal tumors can be managed successfully with a surgical approach in men or radiation

Avoidable cancers in the Nordic countries. Diet, obesity and low physical activity

DEFF Research Database (Denmark)

Winther, J F; Dreyer, L; Overvad, K

1997-01-01

through well-described modifications of dietary habits. During the last 10 years, low physical activity has been pinpointed as a risk factor for cancers at various sites, especially the colon; however, the causal mechanism is still unknown. Obesity, defined as a body mass index of 30 or more...... from case-control studies, but have not been confirmed in large population-based cohort studies. Although the research in this area indicates that diet is important in cancer prevention, current knowledge does not allow reliable estimates of the numbers and proportions of cancers that could be avoided...

Cervical cancer and pregnancy: treatment management

International Nuclear Information System (INIS)

Lazar, I.; Toth, R.

2011-01-01

Pregnancy and cervical carcinoma occurring concomitantly causes therapeutic and ethical dilemmas. The management for this situation will depend on the gestational age at the time of diagnosis, disease staging, size of the lesion and the patient’s wish to maintain pregnancy and fertility. Review of the literature suggest that pregnancy does not seem to influence the prognosis of cervical cancer. (author)

Effect of nurse case management on the treatment of older women with breast cancer.

Science.gov (United States)

Goodwin, James S; Satish, Shiva; Anderson, Elizabeth T; Nattinger, Ann B; Freeman, Jean L

2003-09-01

To evaluate the effect of nurse case management on the treatment of older women with breast cancer. Randomized prospective trial. Sixty surgeons practicing at 13 community and two public hospitals in southeast Texas. Three hundred thirty-five women (166 control and 169 intervention) aged 65 and older newly diagnosed with breast cancer. Women seeing surgeons randomized to the intervention group received the services of a nurse case manager for 12 months after the diagnosis of breast cancer. The primary outcome was the type and use of cancer-specific therapies received in the first 6 months after diagnosis. Secondary outcomes were patient satisfaction and arm function on the affected side 2 months after diagnosis. More women in the intervention group received breast-conserving surgery (28.6% vs 18.7%; P=.031) and radiation therapy (36.0% vs 19.0%; P=.003). Of women undergoing breast-conserving surgery, greater percentages in the case management group received adjuvant radiation (78.3% vs 44.8%; P=.001) and axillary dissection (71.4% vs 44.8%; P=.057). Women in the case management group were also more likely to receive more breast reconstruction surgery (9.3% vs 2.6%, P=.054), and women in the case management group with advanced cancer were more likely to receive chemotherapy (72.7% vs 30.0%, P=.057). Two months after surgery, higher percentages of women in the case manager group had normal arm function (93% vs 84%; P=.037) and were more likely to state that they had a real choice in their treatment (82.2% vs 69.9%, P=.020). Women with indicators of poor social support were more likely to benefit from nurse case management. Nurse case management results in more appropriate management of older women with breast cancer.

The intelligent clinical laboratory as a tool to increase cancer care management productivity.

Science.gov (United States)

Mohammadzadeh, Niloofar; Safdari, Reza

2014-01-01

Studies of the causes of cancer, early detection, prevention or treatment need accurate, comprehensive, and timely cancer data. The clinical laboratory provides important cancer information needed for physicians which influence clinical decisions regarding treatment, diagnosis and patient monitoring. Poor communication between health care providers and clinical laboratory personnel can lead to medical errors and wrong decisions in providing cancer care. Because of the key impact of laboratory information on cancer diagnosis and treatment the quality of the tests, lab reports, and appropriate lab management are very important. A laboratory information management system (LIMS) can have an important role in diagnosis, fast and effective access to cancer data, decrease redundancy and costs, and facilitate the integration and collection of data from different types of instruments and systems. In spite of significant advantages LIMS is limited by factors such as problems in adaption to new instruments that may change existing work processes. Applications of intelligent software simultaneously with existing information systems, in addition to remove these restrictions, have important benefits including adding additional non-laboratory-generated information to the reports, facilitating decision making, and improving quality and productivity of cancer care services. Laboratory systems must have flexibility to change and have the capability to develop and benefit from intelligent devices. Intelligent laboratory information management systems need to benefit from informatics tools and latest technologies like open sources. The aim of this commentary is to survey application, opportunities and necessity of intelligent clinical laboratory as a tool to increase cancer care management productivity.

Managing cancer risk and decision making after kidney transplantation.

Science.gov (United States)

Webster, A C; Wong, G; Craig, J C; Chapman, J R

2008-11-01

Kidney transplant recipients are at higher risk of cancer at most sites, and cancer after transplantation causes considerable morbidity and mortality. To optimize long-term patient outcomes, clinicians balance the prospect of graft failure and dialysis, with competing risks of diabetes, cardiovascular and cerebrovascular disease and the risk of malignancy. In this paper we critically examine the assumptions underpinning primary prevention, immunization, chemoprevention and screening programs, and highlight considerations when applying evidence to the kidney transplant population, and suggest a clinical research agenda that aims to define a rational approach to managing posttransplant cancer risk.

Daily physical-rest activities in relation to nutritional state, metabolism, and quality of life in cancer patients with progressive cachexia.

Science.gov (United States)

Fouladiun, Marita; Körner, Ulla; Gunnebo, Lena; Sixt-Ammilon, Petra; Bosaeus, Ingvar; Lundholm, Kent

2007-11-01

To evaluate daily physical-rest activities in cancer patients losing weight in relation to disease progression. Physical activity-rest rhythms were measured (ActiGraph, armband sensor from BodyMedia) in relation to body composition (dual-energy X-ray absorptiometry), energy metabolism, exercise capacity (walking test), and self-scored quality of life (SF-36, Hospital Anxiety and Depression Scale) in weight-losing outpatients with systemic cancer (71 +/- 2 years, n = 53). Well-nourished, age-matched, and previously hospitalized non-cancer patients served as controls (74 +/- 4 years, n = 8). Middle-aged healthy individuals were used as reference subjects (49 +/- 5 years, n = 23). Quality of life was globally reduced in patients with cancer (P sleep and bed-rest activities did not differ between patients with cancer and age-matched non-cancer patients. Spontaneous physical activity correlated weakly with maximum exercise capacity in univariate analysis (r = 0.41, P < 0.01). Multivariate analysis showed that spontaneous physical activity was related to weight loss, blood hemoglobin concentration, C-reactive protein, and to subjectively scored items of physical functioning and bodily pain (SF-36; P < 0.05-0.004). Anxiety and depression were not related to spontaneous physical activity. Patient survival was predicted only by weight loss and serum albumin levels (P < 0.01), although there was no such prediction for spontaneous physical activity. Daily physical-rest activities represent variables which probably reflect complex mental physiologic and metabolic interactions. Thus, activity-rest monitoring provides a new dimension in the evaluation of medical and drug interventions during palliative treatment of patients with cancer.

Pharmacogenetics and breast cancer management: current status and perspectives.

Science.gov (United States)

Ciccolini, Joseph; Fanciullino, Raphaelle; Serdjebi, Cindy; Milano, Gérard

2015-05-01

Breast cancer has benefited from a number of innovative therapeutics over the last decade. Cytotoxics, hormone therapy, targeted therapies and biologics can now be given to ensure optimal management of patients. As life expectancy of breast cancer patients has been significantly stretched and that several lines of treatment are now made available, determining the best drug or drug combinations to be primarily given and the best dosing and scheduling for each patient is critical for ensuring an optimal toxicity/efficacy balance. Defining patient's characteristics at the tumor level (pharmacogenomics) and the constitutional level (pharmacogenetics) is a rising trend in oncology. This review covers the latest strategies based upon the search of relevant biomarkers for efficacy, resistance and toxicity to be undertaken at the bedside to shift towards precision medicine in breast cancer patients. In the expanding era of bioguided medicine, identifying relevant and clinically validated biomarkers from the plethora of published material remains an uneasy task. Sorting the variety of genetic and molecular markers that have been investigated over the last decade on their level of evidence and addressing the issue of drug exposure should help to improve the management of breast cancer therapy.

The relationship of psychosocial factors to mammograms, physical activity, and fruit and vegetable consumption among sisters of breast cancer patients

Directory of Open Access Journals (Sweden)

Hartman SJ

2011-08-01

Full Text Available Sheri J Hartman1, Shira I Dunsiger1, Paul B Jacobsen21Centers for Behavioral and Preventive Medicine, The Miriam Hospital and W Alpert Medical School of Brown University, Providence, RI; 2Department of Health Outcomes and Behavior, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USAAbstract: This study examined the relationship of psychosocial factors to health-promoting behaviors in sisters of breast cancer patients. One hundred and twenty sisters of breast cancer patients completed questionnaires assessing response efficacy of mammography screenings, physical activity, and fruit and vegetable consumption on decreasing breast cancer risk, breast cancer worry, involvement in their sister’s cancer care, mammography screenings, physical activity, and fruit and vegetable consumption. Results indicate that greater perceived effectiveness for mammograms was associated with a 67% increase in odds of yearly mammograms. Greater involvement in the patient’s care was associated with a 7% decrease in odds of yearly mammograms. Greater perceived effectiveness for physical activity was significantly related to greater physical activity. There was a trend for greater perceived effectiveness for fruits and vegetables to be associated with consuming more fruits and vegetables. Breast cancer worry was not significantly associated with the outcomes. While perceived effectiveness for a specific health behavior in reducing breast cancer risk was consistently related to engaging in that health behavior, women reported significantly lower perceived effectiveness for physical activity and fruits and vegetables than for mammograms. Making women aware of the health benefits of these behaviors may be important in promoting changes.Keywords: breast cancer risk, mammograms, physical activity, diet, perceived effectiveness

Innovative approach for increasing physical activity among breast cancer survivors: protocol for Project MOVE, a quasi-experimental study.

Science.gov (United States)

Caperchione, Cristina M; Sabiston, Catherine M; Clark, Marianne I; Bottorff, Joan L; Toxopeus, Renee; Campbell, Kristin L; Eves, Neil D; Ellard, Susan L; Gotay, Carolyn

2016-08-16

Physical activity is a cost-effective and non-pharmaceutical strategy that can help mitigate the physical and psychological health challenges associated with breast cancer survivorship. However, up to 70% of women breast cancer survivors are not meeting minimum recommended physical activity guidelines. Project MOVE is an innovative approach to increase physical activity among breast cancer survivors through the use of Action Grants, a combination of microgrants (small amounts of money awarded to groups of individuals to support a physical activity initiative) and financial incentives. The purpose of this paper is to describe the rationale and protocol of Project MOVE. A quasi-experimental pre-post design will be used. Twelve groups of 8-12 adult women who are breast cancer survivors (N=132) were recruited for the study via face-to-face meetings with breast cancer-related stakeholders, local print and radio media, social media, and pamphlets and posters at community organisations and medical clinics. Each group submitted a microgrant application outlining their proposed physical activity initiative. Successful applicants were determined by a grant review panel and informed of a financial incentive on meeting their physical activity goals. An evaluation of feasibility will be guided by the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework and assessed through focus groups, interviews and project-related reports. Physical activity will be assessed through accelerometry and by self-report. Quality of life, motivation to exercise and social connection will also be assessed through self-report. Assessments will occur at baseline, 6 months and 1 year. Ethical approval was obtained from the University of British Columbia's Behavioural Research Ethics Board (#H14-02502) and has been funded by the Canadian Cancer Society Research Institute (project number #702913). Study findings will be disseminated widely through peer-reviewed publications

Psychological and behavioral approaches to cancer pain management.

Science.gov (United States)

Syrjala, Karen L; Jensen, Mark P; Mendoza, M Elena; Yi, Jean C; Fisher, Hannah M; Keefe, Francis J

2014-06-01

This review examines evidence for psychological factors that affect pain across the cancer continuum from diagnosis through treatment and long-term survivorship or end of life. Evidence is convincing that emotional distress, depression, anxiety, uncertainty, and hopelessness interact with pain. Unrelieved pain can increase a desire for hastened death. Patients with cancer use many strategies to manage pain, with catastrophizing associated with increased pain and self-efficacy associated with lower pain reports. A variety of psychological and cognitive behavioral treatments can reduce pain severity and interference with function, as indicated in multiple meta-analyses and high-quality randomized controlled trials. Effective methods include education (with coping skills training), hypnosis, cognitive behavioral approaches, and relaxation with imagery. Exercise has been tested extensively in patients with cancer and long-term survivors, but few exercise studies have evaluated pain outcomes. In survivors post-treatment, yoga and hypnosis as well as exercise show promise for controlling pain. Although some of these treatments effectively reduce pain for patients with advanced disease, few have been tested in patients at the end of life. Given the clear indicators that psychological factors affect cancer pain and that psychological and behavioral treatments are effective in reducing varying types of pain for patients with active disease, these methods need further testing in cancer survivors post-treatment and in patients with end-stage disease. Multidisciplinary teams are essential in oncology settings to integrate analgesic care and expertise in psychological and behavioral interventions in standard care for symptom management, including pain. © 2014 by American Society of Clinical Oncology.

Current Management Strategy for Active Surveillance in Prostate Cancer.

Science.gov (United States)

Syed, Jamil S; Javier-Desloges, Juan; Tatzel, Stephanie; Bhagat, Ansh; Nguyen, Kevin A; Hwang, Kevin; Kim, Sarah; Sprenkle, Preston C

2017-02-01

Active surveillance has been increasingly utilized as a strategy for the management of favorable-risk, localized prostate cancer. In this review, we describe contemporary management strategies of active surveillance, with a focus on traditional stratification schemes, new prognostic tools, and patient outcomes. Patient selection, follow-up strategy, and indication for delayed intervention for active surveillance remain centered around PSA, digital rectal exam, and biopsy findings. Novel tools which include imaging, biomarkers, and genetic assays have been investigated as potential prognostic adjuncts; however, their role in active surveillance remains institutionally dependent. Although 30-50% of patients on active surveillance ultimately undergo delayed treatment, the vast majority will remain free of metastasis with a low risk of dying from prostate cancer. The optimal method for patient selection into active surveillance is unknown; however, cancer-specific mortality rates remain excellent. New prognostication tools are promising, and long-term prospective, randomized data regarding their use in active surveillance will be beneficial.

Current trends in the management of bladder cancer.

Science.gov (United States)

Patel, Amit R; Campbell, Steven C

2009-01-01

This article provides a review of bladder cancer etiology, diagnosis, and management for WOC nurses. Bladder cancer incidence continues to rise yearly in the United States, and patients with bladder cancer comprise some of the most challenging cases in urologic oncology. Nurses are involved with all aspects of the processes of care for the patient with bladder cancer, from initial diagnosis and treatment to postsurgical care and follow-up. For nonmuscle invasive bladder cancer, treatment includes transurethral resection followed by intravesical chemotherapy or immunotherapy to prevent recurrence or progression. Radical cystectomy along with chemotherapy protocols provides a survival advantage for muscle invasive bladder cancer, although the timing of chemotherapy remains controversial. Numerous factors are considered when determining the type of urinary diversion used at the time of radical cystectomy, but patient, family, surgeon, and nursing input are essential for preserving an optimal health-related quality of life and reducing morbidity. Patients with metastatic bladder cancer are generally treated with a cisplatin-based chemotherapy but continue to have a poor prognosis. Newer therapies involving novel molecular-targeted agents provide hope for the future for patients with metastatic disease.

Reduction of Cancer-Specific Thought Intrusions and Anxiety Symptoms With a Stress Management Intervention Among Women Undergoing Treatment for Breast Cancer

Science.gov (United States)

Antoni, Michael H.; Wimberly, Sarah R.; Lechner, Suzanne C.; Kazi, Aisha; Sifre, Tammy; Urcuyo, Kenya R.; Phillips, Kristin; Smith, Roselyn G.; Petronis, Vida M.; Guellati, Sophie; Wells, Kurrie A.; Blomberg, Bonnie; Carver, Charles S.

2017-01-01

Objective After surgery for breast cancer, many women experience anxiety relating to the cancer that can adversely affect quality of life and emotional functioning during the year postsurgery. Symptoms such as intrusive thoughts may be ameliorated during this period with a structured, group-based cognitive behavior intervention. Method A 10-week group cognitive behavior stress management intervention that included anxiety reduction (relaxation training), cognitive restructuring, and coping skills training was tested among 199 women newly treated for stage 0-III breast cancer. They were then followed for 1 year after recruitment. Results The intervention reduced reports of thought intrusion, interviewer ratings of anxiety, and emotional distress across 1 year significantly more than was seen with the control condition. The beneficial effects were maintained well past the completion of adjuvant therapy. Conclusions Structured, group-based cognitive behavior stress management may ameliorate cancer-related anxiety during active medical treatment for breast cancer and for 1 year following treatment. Group-based cognitive behavior stress management is a clinically useful adjunct to offer to women treated for breast cancer. PMID:17012691

Managing cancer and employment: Decisions and strategies used by breast cancer survivors employed in low-wage jobs.

Science.gov (United States)

Swanberg, Jennifer E; Nichols, Helen M; Ko, Jungyai; Tracy, J Kathleen; Vanderpool, Robin C

2017-01-01

Advances in breast cancer screening and treatment have led to an overall 5-year survival rate of 90%. Many of these cancer cases are diagnosed in working women. Few studies have explicitly examined the cancer-work interface, as experienced by low-wage earning women with breast cancer. This study uses in-depth, semistructured interviews with 24 low-wage breast cancer survivors to identify employment decisions and factors that influenced or enabled these decisions, and examine the individual strategies and workplace supports used to manage the cancer-work interface among a subset of women (n = 13) who continued to work. Future research areas and clinical implications are discussed.

Cancer Cachexia: Beyond Weight Loss.

Science.gov (United States)

Bruggeman, Andrew R; Kamal, Arif H; LeBlanc, Thomas W; Ma, Joseph D; Baracos, Vickie E; Roeland, Eric J

2016-11-01

Cancer cachexia is a multifactorial syndrome characterized by skeletal muscle loss leading to progressive functional impairment. Despite the ubiquity of cachexia in clinical practice, prevention, early identification, and intervention remain challenging. The impact of cancer cachexia on quality of life, treatment-related toxicity, physical function, and mortality are well established; however, establishing a clinically meaningful definition has proven challenging because of the focus on weight loss alone. Attempts to more comprehensively define cachexia through body composition, physical functioning, and molecular biomarkers, while promising, are yet to be routinely incorporated into clinical practice. Pharmacologic agents that have not been approved by the US Food and Drug Administration but that are currently used in cancer cachexia (ie, megestrol, dronabinol) may improve weight but not outcomes of interest such as muscle mass, physical activity, or mortality. Their routine use is limited by adverse effects. For the practicing oncologist, early identification and management of cachexia is critical. Oncologists must recognize cachexia beyond weight loss alone, focusing instead on body composition and physical functioning. In fact, becoming emaciated is a late sign of cachexia that characterizes its refractory stage. Given that cachexia is a multifactorial syndrome, it requires early identification and polymodal intervention, including optimal cancer therapy, symptom management, nutrition, exercise, and psychosocial support. Consequently, oncologists have a role in ensuring that these resources are available to their patients. In addition, in light of the promising investigational agents, it remains imperative to refer patients with cachexia to clinical trials so that available options can be expanded to effectively treat this pervasive problem.

Studying the Physical and Psychological Symptoms of Patients With Cancer

Directory of Open Access Journals (Sweden)

Memnun Seven

2013-06-01

Full Text Available Objectives; Aim of the descriptive study was to evaluate the frequency and severity of physical and psychological symptoms so as to determine palliative care needs of cancer patients. Methods; Total 142 patients who were treated in oncology clinic at an university hospital were enrolled in the cross sectional research. “Descriptive Information Questionnaire” was developed by the authors and the adapted “Beck Depression Inventory (BAI” and “Beck Anxiety Inventory (BDI”, “Edmonton Symptom Assessment System (ESAS” to evaluate psychological and physical symptoms were used to collect data. Results; The mean age was 49,35±36,61 years and 54.9% of them were out-patients. %16.2 of the patients were diagnosed with colon and 13.4% breast cancer. The mean BDI score was 8.59±6.36, and 88.7% the patients have depressive symptoms. The mean BAI score was 11.39±7.53. The three most frequent problems were fatigue (87.3%, breathlessness (76.1%, and insomnia (67.6%. The mean of the highest-ranking problems were anorexia (6.02+2.77, fatigue (5.33+2.09 and insomnia (0.04+2.42. Conclusion: The study shows that some symptoms might be experienced by majority of the cancer patients as well as some symptoms might be felt more severe by fewer patients. Therefore, It should be assessed that both the frequency and severity of symptoms that patients experienced associated with cancer and its’ treatment individually and focusing on primary care. [TAF Prev Med Bull 2013; 12(3.000: 219-224

A qualitative synthesis of trials promoting physical activity behaviour change among post-treatment breast cancer survivors.

Science.gov (United States)

Short, Camille E; James, Erica L; Stacey, Fiona; Plotnikoff, Ronald C

2013-12-01

Health outcome trials have provided strong evidence that participating in regular physical activity can improve the quality of life and health of post-treatment breast cancer survivors. Focus is now needed on how to promote changes in physical activity behaviour among this group. This systematic review examines the efficacy of behavioural interventions for promoting physical activity among post-treatment breast cancer survivors. Behavioural intervention studies published up until July 2012 were identified through a systematic search of two databases: MEDLINE and CINAHL, and by searching reference lists of relevant publications and scanning citation libraries of project staff. Eight out of the ten identified studies reported positive intervention effects on aerobic physical activity behaviour, ranging from during the intervention period to 6 months post-intervention. Only two studies reported intervention effect sizes. The identification of factors related to efficacy was not possible because of the limited number and heterogeneity of studies included, as well as the lack of effect sizes reported. Nonetheless, an examination of the eight studies that did yield significant intervention effects suggests that 12-week interventions employing behaviour change techniques (e.g., self-monitoring and goal setting) derived from a variety of theories and delivered in a variety of settings (i.e., one-on-one, group or home) can be effective at changing the aerobic physical activity behaviour of breast cancer survivors in the mid- to long terms. Behavioural interventions do hold promise for effectively changing physical activity behaviour among breast cancer survivors. However, future research is needed to address the lack of studies exploring long-term intervention effects, mediators of intervention effects and interventions promoting resistance-training activity, and to address issues impacting on validity, such as the limited use of objective physical activity measures and

Cancer-Related Fatigue and Rehabilitation : A Randomized Controlled Multicenter Trial Comparing Physical Training Combined With Cognitive-Behavioral Therapy With Physical Training Only and With No Intervention

NARCIS (Netherlands)

van Weert, E.; May, A.M.; Korstjens, I.; Post, W.J.; van der Schans, C.P.; van den Borne, B.; Mesters, I.; Ros, W.J.G.; Hoekstra-Weebers, J.E.H.M.

2010-01-01

Background. Research suggests that cancer rehabilitation reduces fatigue in survivors of cancer. To date, it is unclear what type of rehabilitation is most beneficial. Objective. This randomized controlled trial compared the effect on cancer-related fatigue of physical training combined with

Management of sexuality, intimacy, and menopause symptoms in patients with ovarian cancer.

Science.gov (United States)

Whicker, Margaret; Black, Jonathan; Altwerger, Gary; Menderes, Gulden; Feinberg, Jacqueline; Ratner, Elena

2017-10-01

Issues of sexuality, intimacy, and early menopause significantly impact the quality of life of patients following the diagnosis and treatment of ovarian cancer. These are undertreated problems. Successful treatment requires the provider's awareness of the problem, ability to identify it, and willingness to treat it. Unfortunately many providers do not address these issues in the pretreatment or perioperative period. Furthermore, patients do not often alert their providers to their symptoms. While systemic hormone therapy may improve many of the issues, they are not appropriate for all patients given their action on estrogen receptors. However, other nonhormonal treatments exist including selective serotonin reuptake inhibitors, antiepileptics, natural remedies, and pelvic floor physical therapy. In addition psychological care and the involvement of the partner can be helpful in managing the sexual health concerns of these patients. At the time of diagnosis or at initial consultation, women should be informed of the potential physiologic, hormonal, and psychosocial effects of ovarian cancer on sexuality and that there is a multimodal approach to dealing with symptoms. Copyright © 2017 Elsevier Inc. All rights reserved.

Non-pharmacological interventions to manage fatigue and psychological stress in children and adolescents with cancer: an integrative review.

Science.gov (United States)

Lopes-Júnior, L C; Bomfim, E O; Nascimento, L C; Nunes, M D R; Pereira-da-Silva, G; Lima, R A G

2016-11-01

Cancer-related fatigue (CRF) is the most stressful and prevalent symptom in paediatric oncology patients. This integrative review aimed to identify, analyse and synthesise the evidence of non-pharmacological intervention studies to manage fatigue and psychological stress in a paediatric population with cancer. Eight electronic databases were used for the search: PubMed, Web of Science, CINAHL, LILACS, EMBASE, SCOPUS, PsycINFO and the Cochrane Library. Initially, 273 articles were found; after the exclusion of repeated articles, reading of the titles, abstracts and the full articles, a final sample of nine articles was obtained. The articles were grouped into five categories: physical exercise, healing touch, music therapy, therapeutic massage, nursing interventions and health education. Among the nine studies, six showed statistical significance regarding the fatigue and/or stress levels, showing that the use of the interventions led to symptoms decrease. The most frequently tested intervention was programmed physical exercises. It is suggested that these interventions are complementary to conventional treatment and that their use can indicate an improvement in CRF and psychological stress. © 2015 John Wiley & Sons Ltd.

Suicidal ideation in prostate cancer survivors: understanding the role of physical and psychological health outcomes.

Science.gov (United States)

Recklitis, Christopher J; Zhou, Eric S; Zwemer, Eric K; Hu, Jim C; Kantoff, Philip W

2014-11-01

Epidemiological studies have shown prostate cancer (PC) survivors are at an increased risk of suicide compared with the general population, but to the authors' knowledge very little is known regarding what factors are associated with this increased risk. The current study examined the prevalence of suicidal ideation (SI) and its association with cancer treatment and posttreatment physical and emotional health in a cohort of long-term PC survivors. A total of 693 PC survivors (3-8 years after diagnosis) completed a mailed survey on physical and psychological functioning, including cancer treatments, the Short Form-12 (SF-12), the Expanded Prostate Cancer Index Composite Instrument (EPIC-26), a depression rating scale, and 8 items regarding recent suicidal thoughts and behaviors. A total of 86 PC survivors (12.4%) endorsed SI, with 10 individuals (1.4%) reporting serious SI. Serious SI was more common in this sample compared with age-adjusted and sex-adjusted normative data. SI was not associated with most demographic variables, or with PC stage or treatments. However, SI was found to be significantly associated with employment status, poor physical and emotional functioning, greater symptom burden on the EPIC-26, higher frequency of significant pain, and clinically significant depression (P physical and emotional function, including disability status and pain, were found to be associated with SI (P depression. A significant percentage of PC survivors report recent SI, which is associated with both physical and psychological dysfunction, but not PC treatments. The results of the current study help to explain the increased risk of suicide previously reported in PC survivors and have important implications for identifying and treating those survivors at greatest risk of suicidality. © 2014 American Cancer Society.

[Issues involving breast cancer management in Senegal: a cross-sectional study].

Science.gov (United States)

Gueye, Serigne Modou Kane; Gueye, Mamour; Coulbary, Sophie Aminata; Diouf, Alassane; Moreau, Jean Charles

2016-01-01

At a time when innovative therapies in breast cancer multiply, poorer countries such as Senegal are still lag far behind in the overall management of this type of cancer. In Senegal, although the treatment of advanced breast cancer is now well codified, survival and morbidity outcomes are still mediocre in view of diagnostic delays and of sometimes expensive and poorly tolerated mutilating treatments become necessary. With respect to advanced cancers, the challenges will lie in building of palliative care centres and in developing multidisciplinary approaches to improve quality of life and to support patients. On the other hand, with respect to preclinical or potentially curable cancers, the challenges are immense given the importance of early detection, localisation and diagnosis (stereotactic or ultrasound guided biopsy) but also of precision surgery and of complete resection (indexing - excision ensuring a margin of healthy tissue and specimen radiograph) while minimizing complications such as those of classic dissection (sentinel lymph node biopsy). Our health structures are not always prepared to achieve these goals. This is a situational analysis of the contextual obstacles that still exist and add a burden on the overall management of breast cancer in Senegal.

Psychological and physical effects of pain on cancer patients in ...

African Journals Online (AJOL)

Psychological and physical effects of pain on cancer patients in Ibadan, Nigeria. FT Nuhu, OA Odejide, KO Adebayo, AJ Yusuf. Abstract. No Abstract. African Journal of Psychiatry Vol. 12 (1) 2009: pp. 64-70. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

Optimal management of cervical cancer in HIV-positive patients: a systematic review

International Nuclear Information System (INIS)

Ntekim, Atara; Campbell, Oladapo; Rothenbacher, Dietrich

2015-01-01

The clinical management of cervical cancer in HIV-positive patients has challenges mainly due to the concerns on immune status. At present, their mode of management is similar to HIV-seronegative patients involving the use of chemotherapy and radiotherapy concurrently as indicated. HIV infection, cancer, radiotherapy, and chemotherapy lower immunity through reduction in CD4 cell counts. At present there are no treatment guidelines for HIV-positive patients. This study was done to systematically review the literature on cervical cancer management in HIV-positive patients and treatment outcomes. A systematic literature search was done in the major databases to identify studies on the management of HIV-positive patients with cervical cancer. Identified studies were assessed for eligibility and inclusion in the review following the guidelines of The Cochrane Handbook for Systematic Reviews and CRD's (Centre for Reviews and Dissemination) guidance for undertaking reviews in health care. Eight eligible studies were identified from the literature. Three of them were prospective while five were retrospective studies. Notably, the average age at diagnosis of cervical cancer in HIV-positive patients was a decade lower than in seronegative patients. There was no difference in distribution of stages of disease at presentation between HIV-positive and negative patients. Mild acute toxicity (Grades 1 and 2) was higher in HIV-positive patients than in HIV-negative patients in hematopoietic system. In the grades 3 and 4 reactions, anemia was reported in 4% versus 2% while gastrointestinal reactions were reported in 5% versus 2% respectively. In general, patients who were started early on HAART had higher rates of treatment completion. The study supports the suggestion that HAART should be commenced early at cervical cancer diagnosis in HIV-positive patients diagnosed with cervical cancer to ensure less toxicity and better treatment compliance

Clinical review: surgical management of locally advanced and recurrent colorectal cancer.

LENUS (Irish Health Repository)

Courtney, D

2014-01-01

Recurrent and locally advanced colorectal cancers frequently require en bloc resection of involved organs to achieve negative margins. The aim of this review is to evaluate the most current literature related to the surgical management of locally advanced and recurrent colorectal cancer.

The effect of pain on physical functioning after breast cancer treatment

DEFF Research Database (Denmark)

Andersen, Kenneth Geving; Christensen, Karl Bang; Kehlet, Henrik

2015-01-01

OBJECTIVES:: Persistent postsurgical pain, musculoskeletal pain, sensory disturbances and lymphedema are major clinical problems after treatment for breast cancer. However, there is little evidence on how these sequelae affects physical function. The aim was to develop and validate a procedure...

Hereditary Kidney Cancer Syndromes and Surgical Management of the Small Renal Mass.

Science.gov (United States)

Nguyen, Kevin A; Syed, Jamil S; Shuch, Brian

2017-05-01

The management of patients with hereditary kidney cancers presents unique challenges to clinicians. In addition to an earlier age of onset compared with patients with sporadic kidney cancer, those with hereditary kidney cancer syndromes often present with bilateral and/or multifocal renal tumors and are at risk for multiple de novo lesions. This population of patients may also present with extrarenal manifestations, which adds an additional layer of complexity. Physicians who manage these patients should be familiar with the underlying clinical characteristics of each hereditary kidney cancer syndrome and the suggested surgical approaches and recommendations of genetic testing for at-risk individuals. Copyright © 2016 Elsevier Inc. All rights reserved.

Physical examination of the female cancer patient with sexual concerns: What oncologists and patients should expect from consultation with a specialist.

Science.gov (United States)

Lindau, Stacy Tessler; Abramsohn, Emily M; Baron, Shirley R; Florendo, Judith; Haefner, Hope K; Jhingran, Anuja; Kennedy, Vanessa; Krane, Mukta K; Kushner, David M; McComb, Jennifer; Merritt, Diane F; Park, Julie E; Siston, Amy; Straub, Margaret; Streicher, Lauren

2016-05-01

Answer questions and earn CME/CNE Sexual concerns are prevalent in women with cancer or cancer history and are a factor in patient decision making about cancer treatment and risk-reduction options. Physical examination of the female cancer patient with sexual concerns, regardless of the type or site of her cancer, is an essential and early component of a comprehensive evaluation and effective treatment plan. Specialized practices are emerging that focus specifically on evaluation and treatment of women with cancer and sexual function problems. As part of a specialized evaluation, oncologists and their patients should expect a thorough physical examination to identify or rule out physical causes of sexual problems or dysfunction. This review provides oncology professionals with a description of the physical examination of the female cancer patient with sexual function concerns. This description aims to inform anticipatory guidance for the patient and to assist in interpreting specialists' findings and recommendations. In centers or regions where specialized care is not yet available, this review can also be used by oncology practices to educate and support health care providers interested in expanding their practices to treat women with cancer and sexual function concerns. CA Cancer J Clin 2016;66:241-263. © 2016 American Cancer Society. © 2016 American Cancer Society, Inc.

Using Concept Mapping to Identify Action Steps for Physical Activity Promotion in Cancer Treatment

Science.gov (United States)

Fitzpatrick, Sean Joseph; Zizzi, Sam J.

2014-01-01

Background: The benefits of exercise during and after cancer treatment represent research areas that have received increased attention throughout the past 2 decades. Numerous benefits have been observed for cancer survivors who are physically active, yet oncologists have been slow to incorporate exercise counseling into practice. Purpose: The…

Active video games to promote physical activity in children with cancer: a randomized clinical trial with follow-up.

Science.gov (United States)

Kauhanen, Lotta; Järvelä, Liisa; Lähteenmäki, Päivi M; Arola, Mikko; Heinonen, Olli J; Axelin, Anna; Lilius, Johan; Vahlberg, Tero; Salanterä, Sanna

2014-04-05

Low levels of physical activity, musculoskeletal morbidity and weight gain are commonly reported problems in children with cancer. Intensive medical treatment and a decline in physical activity may also result in reduced motor performance. Therefore, simple and inexpensive ways to promote physical activity and exercise are becoming an increasingly important part of children's cancer treatment. The aim of this study is to evaluate the effect of active video games in promotion of physical activity in children with cancer. The research is conducted as a parallel randomized clinical trial with follow-up. Patients between 3 and 16 years old, diagnosed with cancer and treated with vincristine in two specialized medical centers are asked to participate. Based on statistical estimates, the target enrollment is 40 patients. The intervention includes playing elective active video games and, in addition, education and consultations for the family. The control group will receive a general recommendation for physical activity for 30 minutes per day. The main outcomes are the amount of physical activity and sedentary behavior. Other outcomes include motor performance, fatigue and metabolic risk factors. The outcomes are examined with questionnaires, diaries, physical examinations and blood tests at baseline and at 2, 6, 12 and 30 months after the baseline. Additionally, the children's perceptions of the most enjoyable activation methods are explored through an interview at 2 months. This trial will help to answer the question of whether playing active video games is beneficial for children with cancer. It will also provide further reasoning for physical activity promotion and training of motor skills during treatment. ClinicalTrials.gov identifier: NCT01748058 (October 15, 2012).

Ontology modeling in physical asset integrity management

CERN Document Server

Yacout, Soumaya

2015-01-01

This book presents cutting-edge applications of, and up-to-date research on, ontology engineering techniques in the physical asset integrity domain. Though a survey of state-of-the-art theory and methods on ontology engineering, the authors emphasize essential topics including data integration modeling, knowledge representation, and semantic interpretation. The book also reflects novel topics dealing with the advanced problems of physical asset integrity applications such as heterogeneity, data inconsistency, and interoperability existing in design and utilization. With a distinctive focus on applications relevant in heavy industry, Ontology Modeling in Physical Asset Integrity Management is ideal for practicing industrial and mechanical engineers working in the field, as well as researchers and graduate concerned with ontology engineering in physical systems life cycles. This book also: Introduces practicing engineers, research scientists, and graduate students to ontology engineering as a modeling techniqu...

Cancer Pain Management Education Rectifies Patients' Misconceptions of Cancer Pain, Reduces Pain, and Improves Quality of Life.

Science.gov (United States)

Koh, Su-Jin; Keam, Bhumsuk; Hyun, Min Kyung; Ju Seo, Jeong; Uk Park, Keon; Oh, Sung Yong; Ahn, Jinseok; Lee, Ja Youn; Kim, JinShil

2018-03-26

More than half of the patients have reported improper management of breakthrough cancer pain. Empirical evidence is lacking concerning the effectiveness of cancer pain education on breakthrough pain control. This study aimed to examine the effects of individual pain education on pain control, use of short-acting analgesics for breakthrough pain, quality of life outcomes, and rectification of patients' misconceptions regarding cancer pain. A quasi-experimental design was used. In total, 176 (102 inpatients and 74 outpatients) and 163 (93 inpatients and 70 outpatients) cancer patients completed questionnaires on pain intensity, quality of life, use of short-acting medication for breakthrough pain, and misconceptions about cancer pain and opioid use before and immediately and/or seven days after individual pain education. The mean age of the participants was 60.9 years (±11.2), and 56.3% were male. The most common cancers were lung cancer (17.0%), colon cancer (15.9%), and breast cancer (12.5%). The subjects' reasons for attrition were conditional deterioration, death, or voluntary withdrawal (N = 13, 7.4%). Following the education, there was a significant reduction in overall pain intensity over 24 hours (P < 0.001). The outpatients showed more use of short-acting analgesics for breakthrough pain. Sleep quality change was most significantly associated with intervention; other quality of life aspects (e.g., general feelings and life enjoyment) also improved. Pain education also significantly reduced misconceptions regarding cancer pain management. The present educational intervention was effective in encouraging short-acting analgesic use for breakthrough pain, improving quality of life outcomes, and rectifying patients' misconceptions about analgesic use.

Tailored approach to management of bilateral breast cancer in Indian women

Directory of Open Access Journals (Sweden)

Veda Padma Priya Selvakumar

2015-01-01

Conclusions: The management of BCC is complex and has to be tailored to the individual based on characteristics of index and second tumor, prior therapy, adjuvant treatment, and risk stratification. Moreover, the concordance of receptor expression is higher in synchronous cancers than metachronous cancers.

Management of Breast Fibroadenomas

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Greenberg, Ron; Skornick, Yehuda; Kaplan, Ofer

1998-01-01

OBJECTIVE To identify from the literature and clinical experience a rational approach to management of fibroadenomas of the breast. METHOD Recent literature on detection, diagnosis, and natural history of fibroadenomas was reviewed. Experience with over 4,000 women evaluated in the breast clinic at the Tel- Aviv Medical Center contributed to the management strategies suggested by review of the literature. RESULTS Fibroadenomas of the breast are common, accounting for 50% of all breast biopsies performed. Physical examination, sonography, and fine needle aspiration are effective in distinguishing fibroadenomas from breast cancer. Transformation from fibroadenoma to cancer is rare; regression or resolution is frequent, supporting conservative approaches to follow-up and management. CONCLUSION Age-based algorithms that allow for conservative management and that limit excision to patients whose fibroadenomas fail to regress are presented. PMID:9754521

Management of Dysgeusia related to Cancer

Directory of Open Access Journals (Sweden)

DURGESHWORI MUNANKARMI

2017-05-01

Full Text Available Introduction: Taste change due to cancer is a notorious side effect, adversely affecting appetite and weight. Even though taste change or dysgeusia is one of the major causes of poor nutritional status in cancer survivors, it is not addressed as a significant problem and is often left untreated. The main purpose of this review is to explore current knowledge of pharmacological and behavioral interventions for the treatment of cancer related taste change. Methods: This systematic review was conducted in accordance with PRISMA guidelines to identify original articles on taste change. Multiple databases including; Scopus, Medline, EMBASE, CINAHL, and all databases via Pro quest were searched for original articles or studies related to taste change caused by cancer or its treatment. Relevant articles were subjected to a full text evaluation and assessed by Critical appraisal skills program (CASP guidelines and the Effective public health practice project (EPHPP instrument. Results: The search revealed 12 eligible studies, six of which were randomized controlled trials. Most of the studies used a standardized validated tool to measure taste change. Dysgeusia is common in cancer, 14 to 100% cancer patient report it. Pharmacological management with zinc remains inconclusive as one study reports it as beneficial and two other studies reported null effect. Few studies suggested dietary modifications such as use of sugary, salty foods that are helpful to reduce the effect of dysgeusia. Conclusion: Dietary counseling and informing the patient well about self-care strategies before treatment has consistently shown positive results on taste change, with strong statistical power. Other potential treatments for dysgeusia such as zinc, amifostine, and megestrol acetate gave inconsistent results.

Lung Cancer Workshop XI: Tobacco-Induced Disease: Advances in Policy, Early Detection and Management.

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Mulshine, James L; Avila, Rick; Yankelevitz, David; Baer, Thomas M; Estépar, Raul San Jose; Ambrose, Laurie Fenton; Aldigé, Carolyn R

2015-05-01

The Prevent Cancer Foundation Lung Cancer Workshop XI: Tobacco-Induced Disease: Advances in Policy, Early Detection and Management was held in New York, NY on May 16 and 17, 2014. The two goals of the Workshop were to define strategies to drive innovation in precompetitive quantitative research on the use of imaging to assess new therapies for management of early lung cancer and to discuss a process to implement a national program to provide high quality computed tomography imaging for lung cancer and other tobacco-induced disease. With the central importance of computed tomography imaging for both early detection and volumetric lung cancer assessment, strategic issues around the development of imaging and ensuring its quality are critical to ensure continued progress against this most lethal cancer.

Nuclear medicine in thyroid cancer management: A practical approach

International Nuclear Information System (INIS)

2009-03-01

Thyroid cancers are now being diagnosed at an earlier stage and treatments together with follow-up strategies are more effective. However this is not consistent throughout the world. The practice does differ considerably from country to country and region to region. Many International Atomic Energy Agency (IAEA) Members States can benefit from the lessons learned and improve overall patient management of thyroid cancers. The IAEA has significantly enhanced the capabilities of many Member States in the field of nuclear medicine. Functional imaging using nuclear medicine procedures has become an indispensable tool for the diagnosis, treatment planning and management of patients. In terms of treatment, the use of radioiodine ( 131 I) has been central to thyroid cancer and has been successfully used for over six decades. Over the years the IAEA has also assisted many Member States to develop indigenous manufacturing of radioiodine therefore reducing the barriers for the care of patients. This publication is a culmination of efforts by more than twenty international experts in the field to produce a global perspective on the subject. Views expressed are those of individual experts involved and are intended to assist national or regional authorities in decisions regarding the frameworks for effective treatment of thyroid cancer

Managing Potentially Resectable Metastatic Colon Cancer

OpenAIRE

Marshall, John L.

2008-01-01

For patients with metastatic colon cancer, management has evolved from resecting a single liver metastasis and having only one chemotherapy medicine, to resecting multiple metastases including those outside the liver as well as using combination chemotherapy (based on recent supportive trials) to improve outcomes. This success has also raised many questions, including the role of adjuvant chemotherapy to downstage borderline resectable tumors, whether patients who receive preoperative chemoth...

Image-derived biomarkers and multimodal imaging strategies for lung cancer management

Energy Technology Data Exchange (ETDEWEB)

Sauter, Alexander W. [Eberhard Karls University Tuebingen, Diagnostic and Interventional Radiology, Department of Radiology, Tuebingen (Germany); Eberhard Karls University Tuebingen, Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Tuebingen (Germany); Schwenzer, Nina; Pfannenberg, Christina [Eberhard Karls University Tuebingen, Diagnostic and Interventional Radiology, Department of Radiology, Tuebingen (Germany); Divine, Mathew R.; Pichler, Bernd J. [Eberhard Karls University Tuebingen, Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Tuebingen (Germany)

2015-04-01

Non-small-cell lung cancer is the most common type of lung cancer and one of the leading causes of cancer-related death worldwide. For this reason, advances in diagnosis and treatment are urgently needed. With the introduction of new, highly innovative hybrid imaging technologies such as PET/CT, staging and therapy response monitoring in lung cancer patients have substantially evolved. In this review, we discuss the role of FDG PET/CT in the management of lung cancer patients and the importance of new emerging imaging technologies and radiotracer developments on the path to personalized medicine. (orig.)

Relationship between nutritional status, physical activity and quality of life among gastrointestinal cancer survivors.

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Zalina, A Z; Lee, V C; Kandiah, M

2012-08-01

The objective of this study was to determine the relationship between nutritional status, physical activity and quality of life among gastrointestinal cancer survivors. A cross-sectional study was conducted among gastrointestinal cancer survivors attending the oncology outpatient clinic in Hospital Selayang, Malaysia. A total of 70 gastrointestinal cancer survivors with a mean age of 52.54 +/- 14.59 years (95% CI: 47.48 - 57.60) were included in this study. Results showed that 40% of the patients were classified as having low physical activity. The mean Patient Generated Subjective Global Assessment (PGSGA) score was 10.27 +/- 7.36 (95% CI: 8.23-12.31) and nearly half the patients (48.6%) were identified as severely malnourished (Stage C). Mean Gastrointestinal Quality of Life Index (GQLFI) score was 103.57 +/- 23.85 (95% CI: 92.94-114.20), and about 24.3% of the patients were classified as having a low quality of life. Pearson's correlation test showed a highly significant negative relationship between nutritional status and quality of life (r = -0.661, pnutritional status (low total mean score of PGSGA), the better the quality of life of the survivors (high total mean score of GQLFI). There was a significant negative relationship between physical activity level and nutritional status score (r = -0.309, pnutritional status (low total mean score of PGSGA). This study shows a significant relationship between nutritional status, physical activity and quality of life among gastrointestinal cancer survivors. Those low in nutritional status have a low quality of life while survivors with higher nutritional status have a better quality of life.

Living with Metastatic Breast Cancer: A Qualitative Analysis of Physical, Psychological, and Social Sequelae

OpenAIRE

Mosher, Catherine E.; Johnson, Courtney; Dickler, Maura; Norton, Larry; Massie, Mary Jane; DuHamel, Katherine

2013-01-01

Women with metastatic breast cancer face a wide range of medical, practical, and emotional challenges that impact their quality of life. Research to date, however, has not focused on the quality-of-life concerns of metastatic breast cancer patients with significant distress. The present study examined a range of concerns among distressed metastatic breast cancer patients, including physical and emotional distress, social functioning, and existential issues. Forty-four distressed women with me...

Physical Activity Assessment

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Current evidence convincingly indicates that physical activity reduces the risk of colon and breast cancer. Physical activity may also reduce risk of prostate cancer. Scientists are also evaluating potential relationships between physical activity and other cancers.

Quality of life, symptom status and physical performance in patients with advanced non-small cell lung cancer undergoing chemotherapy: an exploratory analysis of secondary data.

Science.gov (United States)

Shallwani, Shirin M; Simmonds, Maureen J; Kasymjanova, Goulnar; Spahija, Jadranka

2016-09-01