WorldWideScience

Sample records for cancer managing physical

  1. The development of an evidence-based physical self-management rehabilitation programme for cancer survivors

    NARCIS (Netherlands)

    van Weert, Ellen; Hoekstra-Weebers, Josette E. H. M.; May, Anne M.; Korstjens, Irene; Ros, Wynand J. G.; van der Schans, Cees P.

    2008-01-01

    Objective: This paper describes the development of a physical training programme for cancer patients. Four related but conceptually and empirically distinct physical problems are described: decreased aerobic capacity, decreased muscle strength, fatigue and impaired role physical functioning. The stu

  2. Cancer pain: A critical review of mechanism-based classification and physical therapy management in palliative care

    Directory of Open Access Journals (Sweden)

    Senthil P Kumar

    2011-01-01

    Full Text Available Mechanism-based classification and physical therapy management of pain is essential to effectively manage painful symptoms in patients attending palliative care. The objective of this review is to provide a detailed review of mechanism-based classification and physical therapy management of patients with cancer pain. Cancer pain can be classified based upon pain symptoms, pain mechanisms and pain syndromes. Classification based upon mechanisms not only addresses the underlying pathophysiology but also provides us with an understanding behind patient′s symptoms and treatment responses. Existing evidence suggests that the five mechanisms - central sensitization, peripheral sensitization, sympathetically maintained pain, nociceptive and cognitive-affective - operate in patients with cancer pain. Summary of studies showing evidence for physical therapy treatment methods for cancer pain follows with suggested therapeutic implications. Effective palliative physical therapy care using a mechanism-based classification model should be tailored to suit each patient′s findings, using a biopsychosocial model of pain.

  3. Quality of life after self-management cancer rehabilitation: A randomized controlled trial comparing physical and cognitive-behavioral training versus physical training

    OpenAIRE

    Korstjens, Irene; May, Anne; van Weert, Ellen; Mesters, Ilse; Tan, Frans; Ros, Wynand; Hoekstra-Weebers, Josette; van der Schans, Cees; Borne, Bart

    2008-01-01

    textabstractObjective: To conduct a randomized controlled trial and compare the effects on cancer survivors' quality of life in a 12-week group-based multidisciplinary self-management rehabilitation program, combining physical training (twice weekly) and cognitivebehavioral training (once weekly) with those of a 12-week group-based physical training (twice weekly). In addition, both interventions were compared with no intervention. Methods: Participants (all cancer types, medical treatment co...

  4. A Pilot Study of Self-Management-based Nutrition and Physical Activity Intervention in Cancer Survivors.

    Science.gov (United States)

    Miller, Michelle; Zrim, Stephanie; Lawn, Sharon; Woodman, Richard; Leggett, Stephanie; Jones, Lynnette; Karapetis, Christos; Kichenadasse, Ganessan; Sukumaran, Shawgi; Roy, Amitesh C; Koczwara, Bogda

    2016-07-01

    Exercise and a healthy diet are beneficial after cancer, but are not uniformly adopted by cancer survivors. This study reports on the feasibility, acceptability, and effectiveness of a self-management-based nutrition and exercise intervention for Australian cancer survivors. Adult survivors (n  =  25) during curative chemotherapy (stratum 1[S1]; n  =  11) or post-treatment (stratum 2 [S2]; n  =  14) were recruited prospectively from a single center. The Flinders Living Well Self-Management Program™ (FLW Program) was utilized to establish patient-led nutrition and exercise goals and develop a tailored 12-wk intervention plan. Fortnightly reviews occurred with assessments at baseline, 6 and 12 wk. A recruitment and retention rate of 38% and 84% were observed. Both strata maintained total skeletal muscle mass. Small reductions in body mass index, hip circumference, and percentage body fat, and small increases in hand grip strength and exercise capacity among subjects in both strata were observed. No significant differences were observed between strata; however, significant increases in exercise capacity and global health status for S2 were observed from baseline to 12 wk. FLW Program is a feasible mode of delivering nutrition and exercise intervention to cancer survivors and it appears that there are no barriers to implementing this program early during chemotherapy. Hence, the additive effect of gains achieved over a longer duration is promising and this should be explored in randomized controlled trials adequately powered to observe clinically and statistically significant improvements in relevant outcomes. PMID:27176450

  5. Mechanism-based classification and physical therapy management of persons with cancer pain: A prospective case series

    Directory of Open Access Journals (Sweden)

    Senthil P Kumar

    2013-01-01

    Full Text Available Context: Mechanism-based classification (MBC was established with current evidence and physical therapy (PT management methods for both cancer and for noncancer pain. Aims: This study aims to describe the efficacy of MBC-based PT in persons with primary complaints of cancer pain. Settings and Design: A prospective case series of patients who attended the physiotherapy department of a multispecialty university-affiliated teaching hospital. Material and Methods: A total of 24 adults (18 female, 6 male aged 47.5 ± 10.6 years, with primary diagnosis of heterogeneous group of cancer, chief complaints of chronic disabling pain were included in the study on their consent for participation The patients were evaluated and classified on the basis of five predominant mechanisms for pain. Physical therapy interventions were recommended based on mechanisms identified and home program was prescribed with a patient log to ensure compliance. Treatments were given in five consecutive weekly sessions for five weeks each of 30 min duration. Statistical Analysis Used: Pre-post comparisons for pain severity (PS and pain interference (PI subscales of Brief pain inventory-Cancer pain (BPI-CP and, European organization for research and treatment in cancer-quality of life questionnaire (EORTC-QLQ-C30 were done using Wilcoxon signed-rank test at 95% confidence interval using SPSS for Windows version 16.0 (SPSS Inc, Chicago, IL. Results: There were statistically significant ( P < 0.05 reduction in pain severity, pain interference and total BPI-CP scores, and the EORTC-QLQ-C30. Conclusion: MBC-PT was effective for improving BPI-CP and EORTC-QLQ-C30 scores in people with cancer pain.

  6. Physical Activity and Cancer

    Science.gov (United States)

    ... of insulin and insulin-like growth factor I (IGF-I), improving the immune response ; and assisting with ... studies have started examining the factors related to long-term behavior change and increases in physical activity. ...

  7. Epigenomics in cancer management

    Directory of Open Access Journals (Sweden)

    Fabricio F Costa

    2010-10-01

    Full Text Available Fabricio F CostaCancer Biology and Epigenomics Program, Children’s Memorial Research Center and Northwestern University’s Feinberg School of Medicine, 2430 N. Halsted St, Box 220, Chicago, IL, USAAbstract: 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.Keywords: genomics, epigenomics, epigenetics, DNA methylation, histone modifications, new technologies, cancer management

  8. Physical treatment of lung cancer

    International Nuclear Information System (INIS)

    Trend of physical treatment and its outcome of lung cancer are described together with authors' experience. In locally advanced non-small cell lung cancer (NSCC) at stages IIIA and B, radiotherapy, chemotherapy (CT) and their combined therapy (RCT) have been major mainly in US since 1980s. After phase I/II trials of RCT by Okayama Lung Cancer Study Group where 5-year survival with nondisease is shown to be 31% (2003), phase III trial has been performed with results to be reported in 2008. A similar study by West Japan Oncology Group is now in summary. The secondary carcinogenesis not by radiation post RCT has become a problem: 10 years after, reportedly 61% incidence. Concerning the choice and regimen of CT medicals, there are many discussions. In recurrent/advanced NSCC, inhibitors of epidermal growth factor receptor tyrosine kinase (RTK) (gefitinib and recently, erlotinib) will be further useful, and molecular target medicals like an anti-vascular endothelial growth factor antibody (bevacizumab) and other novel RTK inhibitors will be also promising. In small cell lung cancer (SCC), efficacy 50% of amrubicin has been reported in a phase II trial recently. Prophylactic cranial irradiation in the extensive cases has been recognized effective also recently. CT studies with a large dose of anti-cancer drugs of SCC are still under progress. Along with the introduction of many molecular target drugs, physical treatment of lung cancer is to be bright in future. (R.T.)

  9. Physical activity and breast cancer survival

    OpenAIRE

    Ogunleye, Adeyemi A; Holmes, Michelle D.

    2009-01-01

    Physical activity improves quality of life after a breast cancer diagnosis, and a beneficial effect on survival would be particularly welcome. Four observational studies have now reported decreased total mortality among physically active women with breast cancer; the two largest have also reported decreased breast cancer specific mortality. The estrogen pathway and the insulin pathway are two potential mechanisms by which physical activity could affect breast cancer survival. Randomized trial...

  10. Epigenomics in cancer management

    International Nuclear Information System (INIS)

    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

  11. Classroom management in physical education

    Directory of Open Access Journals (Sweden)

    Hüseyin Ünlü

    2008-05-01

    Full Text Available In schools, classrooms are the first and the most important places in where the interaction of student-teacher is experienced intensively and education-teaching activities are carried out. Classroom is also considered as places where the physical education lessons are taught. In physical education lessons, it is possible to have success in teaching activities and demanded behavior changes with the classrooms where the students can feel themselves comfort and untroubled, meet their needs easily and have minimum discipline problems. From this point of view in this study effective classroom management in physical education lessons, discipline problems and the design of physical environment are going to be examined.

  12. Pain management in cancer cervix

    Directory of Open Access Journals (Sweden)

    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.

  13. Adulthood lifetime physical activity and breast cancer.

    OpenAIRE

    Peplonska, Beata; Lissowska, Jolanta; Hartman, Terryl J.; Szeszenia-Dabrowska, Neonila; Blair, Aaron; Zatonski, Witold; Sherman, Mark E.; Garcia-Closas, Montserrat; Brinton, Louise A.

    2008-01-01

    BACKGROUND: Epidemiologic studies have shown that breast cancer risk is reduced 30% to 40% in highly physically active compared with inactive women. However, the effects of moderate activities, timing of activities, and intervening effects of other risk factors remain less clear. METHODS: We analyzed data on physical activity patterns in 2176 incident breast cancer cases and 2326 controls in a population-based breast cancer case-control study in Poland conducted in 2000-2003. Using unconditio...

  14. Management of vulvar cancers

    NARCIS (Netherlands)

    de Hullu, J. A.; van der Avoort, I. A. M.; Oonk, M. H. M.; van der Zee, A. G. J.

    2006-01-01

    Aim The radical surgical approach in the treatment of vulvar cancer patients has led to a favorable prognosis for the majority of the patients with early stage squamous cell cancer. However, the morbidity is impressive, leading to more individualized treatment. The aim of this review is to give an o

  15. Management of vulvar cancers.

    NARCIS (Netherlands)

    Hullu, J.A. de; Avoort, I.A.M. van der; Oonk, M.H.; Zee, A.G. van der

    2006-01-01

    AIM: The radical surgical approach in the treatment of vulvar cancer patients has led to a favorable prognosis for the majority of the patients with early stage squamous cell cancer. However, the morbidity is impressive, leading to more individualized treatment. The aim of this review is to give an

  16. 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

  17. [Management of laryngeal cancers].

    Science.gov (United States)

    Brunin, F; Rodriguez, J; Cougniot-Lescure, S; Point, D; Jaulerry, C; Brugère, J

    1995-04-01

    With 5,000 cases yearly, laryngeal carcinomas account in France for the third of squamous cell cancers of the upper digestive and respiratory tract. The crude survival rate is 50% at 5 years. Carcinomas of vocal cords are often diagnosed as early stages if dysphonia leads the patients to the ENT specialist within 2 weeks. Cure of the primary is achieved in 90% of the early stages by radiotherapy with narrow fields or partial surgery, with a 80% 5 years survival rate. Advanced tumors are often treated by total laryngectomy and postoperative radiotherapy. Supra-glottic cancers (epiglottis) are more serious. Unilateral dysphagia or upper cervical neck node often delay early diagnosis. A total laryngectomy is the commonest treatment. The 5 years survival rate of 40% is due to local and/or regional failures and metachronous cancers in head and neck, and radiotherapy remains the two major treatments. Primary prevention is based upon suppression of tobacco and reduction of alcoholic consumption, secondary prevention on resection of leucoplakia and close follow-up of patients with chronic laryngitis. PMID:7761753

  18. Therapeutic Management of Colon Cancer

    Directory of Open Access Journals (Sweden)

    Ana-Maria Todosi

    2014-09-01

    Full Text Available Colorectal cancer is a major public health problem worldwide, and a major cause of mortality and morbidity. Correct pretherapeutic staging has the role of guiding the management of colon cancer patients. The diagnosis is guided by the clinical symptoms. Chemotherapy is an important part of colon cancer treatment. Chemotherapy regimens are adapted to tumor stage and patient status and have various side effects and variable survival outcomes. International guidelines recommend different treatments depending on the presence or absence of metastases. The primary goal of treatment in nonmetastatic colon cancer is surgical removal of the tumor which could be the first step of the complex therapy or preceded by neoadjuvant therapy, depending on pretherapeutic staging. In resectable nonmetastatic tumors the preferred surgical procedure is colectomy with en bloc removal of regional lymph nodes. The extent of colectomy should be based on tumor location. The management of metastatic colon cancer also targets the therapeutic approach of the metastatic disease. Therapy is standardized and applied according to tumor stage. Surveillance has a major role in therapeutic success, reason why a time schedule and a protocol adapted to the primary lesion are essential. The goal of implementing the recommendations of international guidelines for the treatment of colon cancer is to provide a uniform treatment for this disease in view of improving overall survival of patients.

  19. Pain Management in Pancreatic Cancer

    Directory of Open Access Journals (Sweden)

    Michael Erdek

    2010-12-01

    Full Text Available A majority of pancreatic cancer patients present with pain at the time of diagnosis. Pain management can be challenging in light of the aggressive nature of this cancer. Apart from conventional pharmacotherapy, timely treatment with neurolytic celiac plexus block (NCPB has been shown to be of benefit. NCPB has demonstrated efficacious pain control in high quality studies with analgesic effects lasting one to two months. NCPB has also shown to decrease the requirements of narcotics, and thus decrease opioid related side effects. Another option for the control of moderate to severe pain is intrathecal therapy (IT. Delivery of analgesic medications intrathecally allows for lower dosages of medications and thus reduced toxicity. Both of the above mentioned interventional procedures have been shown to have low complication rates, and be safe and effective. Ultimately, comprehensive pancreatic cancer pain management necessitates understanding of pain mechanisms and delivery of sequential validated therapeutic interventions within a multidisciplinary patient care model.

  20. Current management of oral cancer

    Institute of Scientific and Technical Information of China (English)

    Robert Ord

    2008-01-01

    @@ This presentation will summarize some of the current areas of interest in the management of oral cancer. The presentation will be divided into a brief review of epidemiology and diagnosis, with a more extensive discussion regarding the controversial areas in surgery and a review of the adjuvant roles of radiation and chemotherapy.

  1. 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 cancer prevention clinical trials.

  2. Focus on the Physics of Cancer

    CERN Document Server

    Risler, Thomas

    2015-01-01

    Despite the spectacular achievements of molecular biology in the second half of the twentieth century and the crucial advances it permitted in cancer research, the fight against cancer has brought some disillusions. It is nowadays more and more apparent that getting a global picture of the very diverse and interlinked aspects of cancer development necessitates, in synergy with these achievements, other perspectives and investigating tools. In this undertaking, multidisciplinary approaches that include quantitative sciences in general and physics in particular play a crucial role. This `focus on' collection contains 19 articles representative of the diversity and state-of-the-art of the contributions that physics can bring to the field of cancer research.

  3. Management of oromandibular cancers

    International Nuclear Information System (INIS)

    Objective: To emphasize the role and importance of multidisciplinary approach in the management of oral cavity can- involving the mandible. Subjects and Methods: A total of 63 patients who had biopsy-proven oromandibular tumors, after thorough assessment/ staging in Joint Head and Neck Oncology Clinic, underwent resection and reconstruction for malignant oral cavity tumors involving the mandible were included in the study. All the resected tumor specimen were sent for histopathology. All the post-resection defects were properly classified and reconstructed by the plastic surgery team. Post-operatively, all the patients underwent adjuvant full dose radiotherapy at the Department of Radiation Oncology. Complications were recorded and managed accordingly. At one year follow-up all the available patients were assessed for functional and aesthetic restoration and recurrences. Results: Out of 63 patients there were 40 males and 23 females (ratio 1.7 : 1) with an average age of 50 years. Tumor-free resection margins could be achieved in 56 patients. In 88% cases tumor was a Squamous cell carcinoma Radical neck dissections were carried on in 27 patients. Radial forearm free flap was used in 27 patients, pectorals major myocutaneous flap in 19, free fibula osteocutaneous flap in 10, rectus-abdominis myocutaneous free flap Implant was used in 3 patients to reconstruct the post-resection defects. There was only one total flap loss and 3 partial flap losses. Implant exposure was encountered in 4 instances with 3 major and 5 minor fistulae. At one year follow-up 56 patients were available. Thirty-seven patients had intelligible speech, 15 patients were taking normal diet in 33 patients there was a satisfactory mandibular contour restoration. Seven patients had recurrences, 2 were raceable and 5 patients had died by that time. Conclusion: A multidisciplinary collaboration is the key to effectively manage this group of extremely debilitating malignancies. (author)

  4. Health Management of Breast Cancer Survivors

    Institute of Scientific and Technical Information of China (English)

    Min Li; Juan Chen; Zhendong Chen

    2009-01-01

    Breast cancer is defined as a chronic disease.Increasing amounts of attention have been paid to the health management of breast cancer survivors. An important issue is how to find the most appropriate method of follow-up in order to detect long-term complications of treatment, local recurrence and distant metastasis and to administer appropriate treatment to the survivors with recurrence in a timely fashion. Different oncology organizations have published guidelines for following up breast cancer survivors. However, there are few articles on this issue in China. Using the published follow-up guidelines,we analyzed their main limitations and discussed the content,follow-up interval and economic benefits of following up breast cancer survivors in an effort to provide suggestions to physicians.Based on a large number of clinical trials, we discussed the role of physical examination, mammography, liver echograph, chest radiography, bone scan and so on. We evaluated the effects of the above factors on detection of distant disease, survival time,improvement in quality of life and time to diagnosis of recurrence.The results of follow-up carried out by oncologists and primary health care physicians were compared. We also analyzed the correlation factors for the cost of such follow-up. It appears that follow-up for breast cancer survivors can be carried out effectively by trained primary health care physicians. If anything unusual arises, the patients should be transferred to specialists.

  5. Why is Physics Important to Cancer Research?

    Science.gov (United States)

    Barker, Anna D.

    Cancer is increasingly described as a ''disease of the genes'', and while the genome (in fact all of the ``omes'') are important information molecules that drive aspects of the initiation and progression of cancer, they are far from the whole story. Cancer is an extraordinarily complex system (in fact a complex of systems) that occurs in three-dimensional space, across multiple scales - and often over extended periods of time. The most challenging issues that plague the cancer field such as metastasis, cellular heterogeneity and resistance to therapy are in large part more rationally explained in the context of the physics of these systems vs. genomics. For example, the biology of metastasis has been studied extensively for decades with little progress. Metastatic disease depends on cells acquiring (or expressing innate information) new properties that enable and sustain their ability to migrate to distant sites. Developing a fundamental understanding of key cancer processes ranging from metastasis to immunotherapeutic responses requires that physicists (and mathematicians and engineers) be integrated into a new generation of cancer research - period! The presentation will focus on those areas where physics is essential - and the how's and whose of achieving the integration required.

  6. Promoting physical exercise in breast cancer care

    OpenAIRE

    Kirshbaum, M.

    2004-01-01

    This article is intended to promote awareness of physical exercise as a safe, advantageous and feasible intervention for the individual who has or has had breast cancer. It will specify the numerous and varied benefits of exercise and focus on the implications for nursing practice in light of current research evidence.

  7. Classroom management in physical education

    OpenAIRE

    Hüseyin Ünlü

    2008-01-01

    In schools, classrooms are the first and the most important places in where the interaction of student-teacher is experienced intensively and education-teaching activities are carried out. Classroom is also considered as places where the physical education lessons are taught. In physical education lessons, it is possible to have success in teaching activities and demanded behavior changes with the classrooms where the students can feel themselves comfort and untroubled, meet their needs easil...

  8. Management of cancer during pregnancy

    International Nuclear Information System (INIS)

    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

  9. Cancer pain management: Basic information for the young pain physicians

    Directory of Open Access Journals (Sweden)

    SPS Rana

    2011-01-01

    Full Text Available Cancer pain is multifactorial and complex. The impact of cancer pain is devastating, with increased morbidity and poor quality of life, if not treated adequately. Cancer pain management is a challenging task both due to disease process as well as a consequence of treatment-related side-effects. Optimization of analgesia with oral opioids, adjuvant analgesics, and advanced pain management techniques is the key to success for cancer pain. Early access of oral opioid and interventional pain management techniques can overcome the barriers of cancer pain, with improved quality of life. With timely and proper anticancer therapy, opioids, nerve blocks, and other non-invasive techniques like psychosocial care, satisfactory pain relief can be achieved in most of the patients. Although the WHO Analgesic Ladder is effective for more than 80% cancer pain, addition of appropriate adjuvant drugs along with early intervention is needed for improved Quality of Life. Effective cancer pain treatment requires a holistic approach with timely assessment, measurement of pain, pathophysiology involved in causing particular type of pain, and understanding of drugs to relieve pain with timely inclusion of intervention. Careful evaluation of psychosocial and mental components with good communication is necessary. Barriers to cancer pain management should be overcome with an interdisciplinary approach aiming to provide adequate analgesia with minimal side-effects. Management of cancer pain should comprise not only a physical component but also psychosocial and mental components and social need of the patient. With risk-benefit analysis, interventional techniques should be included in an early stage of pain treatment. This article summarizes the need for early and effective pain management strategies, awareness regarding pain control, and barriers of cancer pain.

  10. Hypnosis: Adjunct Therapy for Cancer Pain Management

    OpenAIRE

    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 us...

  11. 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...

  12. 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, and not...

  13. Evidences in multidisciplinary management of rectal cancer

    International Nuclear Information System (INIS)

    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)

  14. 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....

  15. Coping with cancer - managing fatigue

    Science.gov (United States)

    Fatigue is a feeling of tiredness, weakness, or exhaustion. It is different from drowsiness, which can be ... have trouble taking in nutrients during cancer treatment. Emotional stress. Having cancer can make you feel anxious, ...

  16. 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.

  17. Management of virtualized infrastructure for physics databases

    International Nuclear Information System (INIS)

    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.

  18. Management of virtualized infrastructure for physics databases

    Science.gov (United States)

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

    2012-12-01

    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.

  19. Management of virtualized infrastructure for physics databases.

    CERN Document Server

    Topurov, A; Chatal, F; Piorkowski, M

    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.

  20. 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 the...... ETIOLOGY: Neuropathic pain seems to be the major pain etiology in cancer survivors and therefore adjuvant analgesics should be the first choice of analgesic treatment. CONTEXT: This article addresses the central aspects of pain epidemiology, mechanisms and the frequent pain syndromes met in cancer...... 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...

  1. 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...

  2. The management decisions in government management structure of physical training

    Directory of Open Access Journals (Sweden)

    Lu Chzyshuan

    2015-04-01

    Full Text Available Purpose: is to improve the technology of management decision as for the function of making decision in the problem of choosing the variant. Material and Methods: analysis of scientific sources, analysis of the documents, organizational analysis. Results: different forms of management decisions are done, the structure of the decisions in the forms of orders are offered, the orders that are created due to the regional management structure are analysed, the quantity of fulfilled orders are shown, the reasons of unfulfilled orders are observed, the typical decisions of the orders and their corrections are done. Conclusions: the necessity of making the decisions are explained by conscious and aimed character of human’s activity. The improvement of making the management decisions are done according to the use of scientific approach, different models and methods of making decisions in the management structure of physical training and sport.

  3. Management of invasive bladder cancer

    International Nuclear Information System (INIS)

    Muscle invasive disease accounts for a quarter of all cases of bladder cancer. A bewildering variety of treatment options are available for patients with this disease, with combinations of surgery and/or radiotherapy, with or without chemotherapy. This review discusses these treatment options and their relative merits for patients with muscle invasive bladder cancer. 22 refs., 3 figs., 7 tabs

  4. Management of Advanced Laryngeal Cancer

    Directory of Open Access Journals (Sweden)

    Patrick Sheahan

    2014-04-01

    Full Text Available Squamous cell carcinoma of the larynx continues to be the commonest head and neck cancer in many Western countries. The larynx plays a key role for many essential functions, including breathing, voice production, airway protection, and swallowing. The goals of laryngeal cancer treatment are thus to provide best possible oncologic control, while optimizing functional outcomes. In recent decades, the treatment paradigm for advanced laryngeal cancer has shifted from one of primary surgery (total laryngectomy as gold standard, toward non-surgical organ-preserving treatment using radiotherapy or chemoradiotherapy. However, concerns have emerged regarding functional outcomes after chemoradiotherapy, as well as possible decreased overall survival in patients with laryngeal cancer. The purpose of the present review is to review surgical and non-surgical options for treatment of advanced laryngeal cancer, as well as the evidence supporting each of these.

  5. Principles and management of adrenal cancer

    International Nuclear Information System (INIS)

    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)

  6. Physical activity in patients with advanced-stage cancer: a systematic review of the literature.

    Science.gov (United States)

    Albrecht, Tara A; Taylor, Ann Gill

    2012-06-01

    The importance of physical activity for chronic disease prevention and management has become generally well accepted. The number of research interventions and publications examining the benefits of physical activity for patients with cancer has been rising steadily. However, much of that research has focused on the impact of physical activity either prior to or early in the cancer diagnosis, treatment, and survivorship process. Research focusing on the effects of physical activity, specifically for patients with advanced-stage cancer and poorer prognostic outcomes, has been addressed only recently. The purpose of this article is to examine the state of the science for physical activity in the advanced-stage disease subset of the cancer population. Exercise in a variety of intensities and forms, including yoga, walking, biking, and swimming, has many health benefits for people, including those diagnosed with cancer. Research has shown that, for people with cancer (including advanced-stage cancer), exercise can decrease anxiety, stress, and depression while improving levels of pain, fatigue, shortness of breath, constipation, and insomnia. People diagnosed with cancer should discuss with their oncologist safe, easy ways they can incorporate exercise into their daily lives. PMID:22641322

  7. Physical Activity in Patients With Advanced-Stage Cancer: A Systematic Review of the Literature

    Science.gov (United States)

    Albrecht, Tara A.; Taylor, Ann Gill

    2014-01-01

    The importance of physical activity for chronic disease prevention and management has become generally well accepted. The number of research interventions and publications examining the benefits of physical activity for patients with cancer has been rising steadily. However, much of that research has focused on the impact of physical activity either prior to or early in the cancer diagnosis, treatment, and survivorship process. Research focusing on the effects of physical activity, specifically for patients with advanced-stage cancer and poorer prognostic outcomes, has been addressed only recently. The purpose of this article is to examine the state of the science for physical activity in the advanced-stage disease subset of the cancer population. Exercise in a variety of intensities and forms, including yoga, walking, biking, and swimming, has many health benefits for people, including those diagnosed with cancer. Research has shown that, for people with cancer (including advanced-stage cancer), exercise can decrease anxiety, stress, and depression while improving levels of pain, fatigue, shortness of breath, constipation, and insomnia. People diagnosed with cancer should discuss with their oncologist safe, easy ways they can incorporate exercise into their daily lives. PMID:22641322

  8. Contemporary Management of Prostate Cancer.

    Science.gov (United States)

    Cotter, Katherine; Konety, Badrinath; Ordonez, Maria A

    2016-01-01

    Prostate cancer represents a spectrum ranging from low-grade, localized tumors to devastating metastatic disease. We discuss the general options for treatment and recent developments in the field. PMID:26949522

  9. Evolving management of colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    Jochem van der Voort van Zijp; Harald J Hoekstra; Marc D Basson

    2008-01-01

    This article reviews recent advances in surgical techniques and adjuvant therapies for colorectal cancer, including total mesorectal excision, the resection of liver and lung metastasis and advances in chemoradiation and foreshadows some interventions that may lie just beyond the frontier. In particular, little is known about the intracellular and extracellular cascades that may influence colorectal cancer cell adhesion and metastasis. Although the phosphorylation of focal adhesion kinases and focal adhesion associated proteins in response to integrin-mediated cell matrix binding ("outside in integrin signaling") is well described, the stimulation of cell adhesion by intracellular signals activated by pressure prior to adhesion represents a different signal paradigm. However, several studies have suggested that increased pressure and shear stress activate cancer cell adhesion. Further studies of the pathways that regulate integrin-driven cancer cell adhesion may identify/ways to disrupt these signals or block integrin-mediated adhesion so that adhesion and eventual metastasis can be prevented in the future.

  10. A quality management system for radiotherapy physics

    International Nuclear Information System (INIS)

    The importance of quality in Radiotherapy Physics cannot be overemphasized and the need for having controlled, written procedures for all tasks is increasing in importance. There are a number of quality standards currently in use such as ISO 9000. In the UK, the Quality Assurance in Radiotherapy (QART) Standard has been produced based on ISO9000 and recommended for implementation in all Radiotherapy Departments. A Quality Management System has been implemented in the Radiotherapy Physics Section at the Norfolk and Norwich Hospital, England, to fulfil the QART and ISO9000 recommendations. This Poster will illustrate the system used at the Norfolk and Norwich Hospital. The system offers a standardised document format and allows the issue and re-issue of all written procedures and proforma. It has enhanced the quality and consistency of tasks, when the task is performed by varying members of staff and thereby improving the quality of the service offered from the safety and organisational perspectives. It is believed that the Quality Management System used in the Radiotherapy Physics Section at the Norfolk and Norwich Hospital would be simple to implement in the majority of Radiotherapy Physics Departments

  11. [Surgical management of pancreatic cancer].

    Science.gov (United States)

    Kim, Song Cheol

    2008-02-01

    Pancreatic cancer is a major problematic concern among all forms of gastrointestinal malignancies because of its poor prognosis. Although significant progress has been made in the surgical treatment in terms of increased resection rate and decreased treatment-related morbidity and mortality, the true survival rate still remains below 5% today. Surgical options for pancreatic cancer are based on the its unique anatomy and physiology, catastrophic tumor biology, experience of surgeon, and status of patients. Four main options exist for the surgical treatment of pancreatic cancer. These include standard "Whipple" pancreaticoduodenectomy (PD), pylorus preserving PD (PPPD), distal pancreatectomy (left-side pancreatectomy), and total pancreatectomy according to the location of tumor. Portal vein involvement by tumor is regarded as an anatomical extension of disease, and en bloc resection of portal vein with tumor is recommended if technically feasible, which is stated in 2002 AJCC tumor staging for pancreatic cancer. In comparison of the survival rates between standard and extended resection of pancreatic head cancer, no significant survival benefit was demonstrated from the prospective reports. PPPD may be superior to standard PD in respect to nutrition and quality of life without any deleterious effect upon long term survival or tumor recurrence. New surgical treatment modalities including modified extended pancreatectomy, neoadjuvant chemotherapy, and radical antegrade modular distal pancreatectomy have been tried to improve the patients' survival. However, early diagnosis and treatment remain as key factors for the cure of pancreatic cancer irrespective of various surgical trials. PMID:18349571

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

    OpenAIRE

    Antwan Jones; Paxton, Raheem J.

    2015-01-01

    In view of evidence that African American cancer survivors experience the greatest challenges in maintaining adequate levels of physical activity, this cross-sectional study was designed to determine whether individual and residential environment characteristics are associated with physical activity in this population. A total of 275 breast cancer survivors completed self-report items measuring sociodemographic variables, physical activity, and select barriers to physical activity in Spring o...

  13. Physical activity and breast cancer risk in Chinese women

    OpenAIRE

    Pronk, A.; Ji, B. T.; X.O. Shu; Chow, W H; Xue, S.; G. Yang; Li, H. L.; Rothman, N.; Gao, Y.T. (Yu-Tang); Zheng, W.; Matthews, C.E.

    2011-01-01

    Background: The influence of different types and intensities of physical activity on risk for breast cancer is unclear. Methods: In a prospective cohort of 73 049 Chinese women (40–70 years), who had worked outside the home, we studied breast cancer risk in relation to specific types of self-reported and work history-related physical activity, including adolescent and adult exercise and household activity and walking and cycling for transportation. Occupational sitting time and physical activ...

  14. Surgical management of metastatic differentiated thyroid cancer

    International Nuclear Information System (INIS)

    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

  15. Management of pancreatic cancer in the elderly

    OpenAIRE

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

    2016-01-01

    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 ...

  16. Hypnosis: adjunct therapy for cancer pain management.

    Science.gov (United States)

    Kravits, Kathy

    2013-03-01

    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

  17. The National Cancer Institute's Physical Sciences - Oncology Network

    Science.gov (United States)

    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.

  18. Management of borderline resectable pancreatic cancer

    Institute of Scientific and Technical Information of China (English)

    Amit; Mahipal; Jessica; Frakes; Sarah; Hoffe; Richard; Kim

    2015-01-01

    Pancreatic cancer is the fourth most common cause of cancer death in the United States. Surgery remains the only curative option; however only 20% of the patients have resectable disease at the time of initialpresentation. The definition of borderline resectable pancreatic cancer is not uniform but generally denotes to regional vessel involvement that makes it unlikely to have negative surgical margins. The accurate staging of pancreatic cancer requires triple phase computed tomography or magnetic resonance imaging of the pancreas. Management of patients with borderline resectable pancreatic cancer remains unclear. The data for treatment of these patients is primarily derived from retrospective single institution experience. The prospective trials have been plagued by small numbers and poor accrual. Neoadjuvant therapy is recommended and typically consists of chemotherapy and radiation therapy. The chemotherapeutic regimens continue to evolve along with type and dose of radiation therapy. Gemcitabine or 5-fluorouracil based chemotherapeutic combinations are administered. The type and dose of radiation vary among different institutions. With neoadjuvant treatment, approximately 50% of the patients are able to undergo surgical resections with negative margins obtained in greater than 80% of the patients. Newer trials are attempting to standardize the definition of borderline resectable pancreatic cancer and treatment regimens. In this review, we outline the definition, imaging requirements and management of patients with borderline resectable pancreatic cancer.

  19. Cancer patient supportive care and pain management. Special listing

    International Nuclear Information System (INIS)

    This Special Listing of Current Cancer Research Projects is a publication of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute. Each Listing contains descriptions of ongoing projects in one selected cancer research area. The research areas include: Infectious disease in cancer patients; Immunological aspects of supportive care of cancer patients; Nutritional evaluation and support of cancer patients; Pain management of cancer patients

  20. CONTEMPORARY MANAGEMENT OF SINONASAL CANCER

    NARCIS (Netherlands)

    Robbins, K. Thomas; Ferlito, Alfio; Silver, Carl E.; Takes, Robert P.; Strojan, Primoz; Snyderman, Carl H.; de Bree, Remco; Haigentz, Missak; Langendijk, Johannes A.; Rinaldo, Alessandra; Shaha, Ashok R.; Hanna, Ehab Y.; Werner, Jochen A.; Suarez, Carlos

    2011-01-01

    Background. Sinonasal cancer is a relatively uncommon entity encountered by head and neck oncologists, rhinologists, and skull base surgeons. Recent innovations in surgical and nonsurgical therapeutic modalities raise the question of whether there has been any measurable improvement for treatment ou

  1. Contemporary management of sinonasal cancer

    NARCIS (Netherlands)

    Robbins, K.T.; Ferlito, A.; Silver, C.E.; Takes, R.P.; Strojan, P.; Snyderman, C.H.; Bree, R. de; Haigentz Jr., M.; Langendijk, J.A.; Rinaldo, A.; Shaha, A.R.; Hanna, E.Y.; Werner, J.A.; Suarez, C.

    2011-01-01

    BACKGROUND: Sinonasal cancer is a relatively uncommon entity encountered by head and neck oncologists, rhinologists, and skull base surgeons. Recent innovations in surgical and nonsurgical therapeutic modalities raise the question of whether there has been any measurable improvement for treatment ou

  2. Adherence to Diet and Physical Activity Cancer Prevention Guidelines and Cancer Outcomes: A Systematic Review.

    Science.gov (United States)

    Kohler, Lindsay N; Garcia, David O; Harris, Robin B; Oren, Eyal; Roe, Denise J; Jacobs, Elizabeth T

    2016-07-01

    Many studies have reported that adherence to health promotion guidelines for diet, physical activity, and maintenance of healthy body weight may decrease cancer incidence and mortality. A systematic review was performed to examine associations between adherence to established cancer prevention guidelines for diet and physical activity and overall cancer incidence and mortality. PubMed, Google Scholar, and Cochrane Reviews databases were searched following the current recommendations of Preferred Reporting Items for Systematic Reviews and Meta-analysis Approach (PRISMA). Twelve studies met inclusion criteria for this review. High versus low adherence to established nutrition and physical activity cancer prevention guidelines was consistently and significantly associated with decreases of 10% to 61% in overall cancer incidence and mortality. Consistent significant reductions were also shown for breast cancer incidence (19%-60%), endometrial cancer incidence (23%-60%), and colorectal cancer incidence in both men and women (27%-52%). Findings for lung cancer incidence were equivocal, and no significant relationships were found between adherence and ovarian or prostate cancers. Adhering to cancer prevention guidelines for diet and physical activity is consistently associated with lower risks of overall cancer incidence and mortality, including for some site-specific cancers. Cancer Epidemiol Biomarkers Prev; 25(7); 1018-28. ©2016 AACR. PMID:27340121

  3. Integrating social and physical sciences in water management

    Science.gov (United States)

    Lund, Jay R.

    2015-08-01

    Water management has always required more than physical science. This paper reviews the accomplishments of integrating social with physical sciences for water management in the last 50 years. Particular successes are highlighted to illustrate how fundamentals from both physical science and social science have been brought together to improve the performance of water management systems. Some forward-looking lessons for managing practical and academic interdisciplinary research for water management are also provided.

  4. Outage management and health physics issue, 2006

    International Nuclear Information System (INIS)

    The focus of the May-June issue is on outage management and health physics. Major articles/reports in this issue include: A design with experience for the U.S., by Michael J. Wallace, Constellation Generation Group; Hope to be among the first, by Randy Hutchinson, Entergy Nuclear; Plans to file COLs in 2008, by Garry Miller, Progress Energy; Evolution of ICRP's recommendations, by Lars-Erik Holm, ICRP; European network on education and training in radiological protection, by Michele Coeck, SCK-CEN, Belgium; Outage managment: an important tool for improving nuclear power plant performance, by Thomas Mazour and Jiri Mandula, IAEA, Austria; and Plant profile: Exploring new paths to excellence, by Anne Thomas, Exelon Nuclear

  5. mTOR inhibition in management of advanced breast cancer

    Directory of Open Access Journals (Sweden)

    Shona Nag

    2012-01-01

    Full Text Available The mTOR pathway is becoming increasingly important in several cancers including breast cancer. This review will focus on the role of its inhibition in the management of advanced breast cancer.

  6. Contemporary Clinical Management of Endometrial Cancer

    OpenAIRE

    Dinkelspiel, Helen E.; Wright, Jason D.; Lewin, Sharyn N.; Herzog, Thomas J.

    2013-01-01

    Although the contemporary management of endometrial cancer is straightforward in many ways, novel data has emerged over the past decade that has altered the clinical standards of care while generating new controversies that will require further investigation. Fortunately most cases are diagnosed at early stages, but high-risk histologies and poorly differentiated tumors have high metastatic potential with a significantly worse prognosis. Initial management typically requires surgery, but the ...

  7. Efficacy and Safety of Acupuncture in the Management of Cancer

    Institute of Scientific and Technical Information of China (English)

    Henry Liming LIANG

    2005-01-01

    @@ Acupuncture, as a complementary therapy, has been used to manage the cancer associated symptoms of cancer patients. To identify the efficacy and safety of acupuncture in the management of cancer, this review critically analyses the relevant publications including both experimental and clinical studies. The majority of studies suggest that acupuncture effectively relieves some cancer related symptoms such as cancer pain, and some adverse effects caused by the cancer conventional treatments such as nausea, vomiting, neutropenia and xerostomia.

  8. Diagnosis and Management of Ovarian Cancer.

    Science.gov (United States)

    Doubeni, Chyke A; Doubeni, Anna R; Myers, Allison E

    2016-06-01

    Ovarian cancer is the most lethal gynecologic cancer. Less than one-half of patients survive for more than five years after diagnosis. Ovarian cancer affects women of all ages but is most commonly diagnosed after menopause. More than 75% of affected women are diagnosed at an advanced stage because early-stage disease is usually asymptomatic and symptoms of late-stage disease are nonspecific. The strongest risk factors are advancing age and family history of ovarian and breast cancer. Women who have symptoms concerning for ovarian cancer should undergo a physical examination, transvaginal ultrasonography, and measurement of biomarkers such as cancer antigen 125. If results are suspicious for ovarian cancer, the patient should be referred to a gynecologic oncologist. Despite the low rate of early diagnosis, guidelines recommend against routine screening for ovarian cancer in average-risk women because screening, including routine pelvic examinations, is ineffective and associated with harm. However, a recent trial found a potential benefit of annual screening using an algorithm based on serial cancer antigen 125 measurements followed by transvaginal ultrasonography for women at increased risk, as determined by the algorithm. Women with an increased-risk family history should be referred for genetic counseling and, if genetic mutations (e.g., BRCA mutations) are identified, bilateral salpingo-oophorectomy can be considered for risk reduction. In both average- and high-risk women, long-term hormonal contraceptive use reduces risk by about 50%. The treatment of ovarian cancer usually involves surgery, with or without intraperitoneal and intravenous chemotherapy. Primary care physicians have important roles in posttreatment surveillance and end-of-life care. PMID:27281838

  9. The physics of cancer: the role of physical interactions and mechanical forces in metastasis

    OpenAIRE

    Wirtz, Denis; Konstantopoulos, Konstantinos; Searson, Peter C.

    2011-01-01

    Metastasis is a complex, multistep process responsible for >90% of cancer-related deaths. In addition to genetic and external environmental factors, the physical interactions of cancer cells with their microenvironment, as well as their modulation by mechanical forces, are key determinants of the metastatic process. We reconstruct the metastatic process and describe the importance of key physical and mechanical processes at each step of the cascade. The emerging insight into these physical in...

  10. 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 of...

  11. 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.

  12. Managing cancer-related fatigue in men with prostate cancer: a systematic review of non-pharmacological interventions.

    Science.gov (United States)

    Larkin, David; Lopez, Violeta; Aromataris, Edoardo

    2014-10-01

    The aim of this systematic review was to synthesize the best available evidence informing the effectiveness of non-pharmacological interventions for managing cancer-related fatigue in men treated for prostate cancer. This review considered experimental studies that included men with prostate cancer (regardless of staging, previous treatment or comorbidities), aged 18 years and over who were undergoing any treatment, or had completed any treatment for prostate cancer within the previous 12 months. Three interventions were identified for the management of cancer-related fatigue in men with prostate cancer. Evidence from five studies including 447 participants demonstrates the effectiveness of physical activity, both aerobic and resistance exercise, and from three studies including 153 participants suggesting the benefits of psychosocial interventions including education and cognitive behavioural therapy. Health professionals require knowledge of a range of effective interventions aimed at reducing cancer-related fatigue in men with prostate cancer and should incorporate those interventions into their patient management. Although physical activity appears to show the greatest benefit, other non-pharmacological interventions such as education and cognitive behavioural therapy have demonstrated benefit and should also be considered as a strategy in treating this debilitating side effect of cancer and its treatment. PMID:24237792

  13. Diagnosis And Management Of Vulvar Cancer

    International Nuclear Information System (INIS)

    Aim: The aim of this article is to give an overview of the management of vulvar cancer. Methods: Review the literature from database Medline using key words vulvar cancer, surgical therapy, radiotherapy, sentinel node with the emphasis on diagnostics and primary therapy. Results: Surgery is the cornerstone of treatment for early stage squamous cell vulvar cancer (with wide local excision and uni- or bilateral inguinofemoral lymphadenectomy via separate incisions as standard treatment). Primary radiotherapy may be an alternative for the inguinofemoral lymphadenectomy. The sentinel lymph node procedure with the combined technique (preoperative lymphoscintigraphy with 99m technetium-labeled nanocolloid and Patent Blue) is a promising staging technique for patients with vulvar cancer. The clinical implementation of the sentinel lymph node procedure and the role of additional histopathological techniques of the sentinel lymph nodes have to be investigated. In the cases of advanced vulvar cancer chemo radiation eventually followed by surgery is the treatment of first choice for these patients. Conclusions: The radical surgical approach in the treatment of vulvar cancer patients has led to a favorable prognosis for the majority of the patients with early stage cancer. However, the morbidity is impressive, leading to more individualized treatment. The sentinel lymph node procedure and primary radiotherapy are promising methods to reduce morbidity of treatment, but their safety needs to be studied in clinical trials. (author)

  14. Breast cancer management: Past, present and evolving

    Directory of Open Access Journals (Sweden)

    M Akram

    2012-01-01

    Full Text Available Breast cancer is known from ancient time,and the treatment strategy evolved as our understanding of the disease changed with time. In 460 BC Hippocrates described breast cancer as a humoral disease and presently after a lot of studies breast cancer is considered as a local disease with systemic roots. For most of the twentieth century Halsted radical mastectomy was the "established and standardized operation for cancer of the breast in all stages, early or late". New information about tumor biology and its behavior suggested that less radical surgery might be just as effective as the more extensive one. Eventually, with the use of adjuvant therapy likeradiation and systemic therapy, the extent of surgical resection in the breast and axilla got reduced further and led to an era of breast conservation. The radiation treatment of breast cancer has evolved from 2D to 3D Conformal and to accelarated partial breast irradiation, aiming to reduce normal tissue toxicity and overall treatment time. Systemic therapy in the form of hormone therapy, chemotherapy and biological agents is now a well-established modality in treatment of breast cancer. The current perspective of breast cancer management is based on the rapidly evolving and increasingly integrated study on the genetic, molecular , biochemical and cellular basis of disease. The challenge for the future is to take advantage of this knowledge for the prediction of therapeutic outcome and develop therapies and rapidly apply more novel biologic therapeutics.

  15. Physical activity and breast cancer risk in Chinese women

    NARCIS (Netherlands)

    Pronk, A.; Ji, B.T.; Shu, X.O.; Chow, W.H.; Xue, S.; Yang, G; Li, H.L.; Rothman, N.; Gao, Y.T.; Zheng, W.; Matthews, C.E.

    2011-01-01

    Background: The influence of different types and intensities of physical activity on risk for breast cancer is unclear. Methods: In a prospective cohort of 73 049 Chinese women (40-70 years), who had worked outside the home, we studied breast cancer risk in relation to specific types of self-reporte

  16. A physical mechanism of cancer heterogeneity

    Science.gov (United States)

    Chen, Cong; Wang, Jin

    2016-02-01

    We studied a core cancer gene regulatory network motif to uncover possible source of cancer heterogeneity from epigenetic sources. When the time scale of the protein regulation to the gene is faster compared to the protein synthesis and degradation (adiabatic regime), normal state, cancer state and an intermediate premalignant state emerge. Due to the epigenetics such as DNA methylation and histone remodification, the time scale of the protein regulation to the gene can be slower or comparable to the protein synthesis and degradation (non-adiabatic regime). In this case, many more states emerge as possible phenotype alternations. This gives the origin of the heterogeneity. The cancer heterogeneity is reflected from the emergence of more phenotypic states, larger protein concentration fluctuations, wider kinetic distributions and multiplicity of kinetic paths from normal to cancer state, higher energy cost per gene switching, and weaker stability.

  17. Conservative management of anal and rectal cancer

    International Nuclear Information System (INIS)

    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.)

  18. Management of locally advanced prostate cancer

    Institute of Scientific and Technical Information of China (English)

    Heather Payne

    2009-01-01

    The management of all stages of prostate cancer is an increasingly complex process and involves a variety of available treatments and many disciplines.Despite prostate-specific antigen (PSA) testing,the presentation of prostate cancer at a locally advanced stage is common in the UK,accounting for one-third of all new cases.There is no universally accepted definition of locally advanced prostate cancer;the term is loosely used to encompass a spectrum of disease profiles that show high-risk features.Men with high-risk prostate cancer generally have a significant risk of disease progression and cancer-related death if left untreated.High-risk patients,including those with locally advanced disease,present two specific challenges.There is a need for local control as well as a need to treat any microscopic metastases likely to be present but undetectable until disease progression.The optimal treatment approach will therefore often necessitate multiple modalities.The exact combinations,timing and intensity of treatment continue to be strongly debated.Management decisions should be made after all treatments have been discussed by a multidisciplinary team (including urologists,oncologists,radiologists,pathologists and nurse specialists) and after the balance of benefits and side effects of each therapy modality has been considered by the patient with regard to his own individual circumstances.This article reviews the current therapy options.

  19. 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 ...

  20. A Physical Mechanism and Global Quantification of Breast Cancer

    Science.gov (United States)

    Yu, Chong; Wang, Jin

    2016-01-01

    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. PMID:27410227

  1. Outage management and health physics issue, 2009

    International Nuclear Information System (INIS)

    The focus of the May-June issue is on outage management and health physics. Major articles include the following: Planning and scheduling to minimize refueling outage, by Pat McKenna, AmerenUE; Prioritizing safety, quality and schedule, by Tom Sharkey, Dominion; Benchmarking to high standards, by Margie Jepson, Energy Nuclear; Benchmarking against U.S. standards, by Magnox North, United Kingdom; Enabling suppliers for new build activity, by Marcus Harrington, GE Hitachi Nuclear Energy; Identifying, cultivating and qualifying suppliers, by Thomas E. Silva, AREVA NP; Creating new U.S. jobs, by Francois Martineau, Areva NP. Industry innovation articles include: MSL Acoustic source load reduction, by Amir Shahkarami, Exelon Nuclear; Dual Methodology NDE of CRDM nozzles, by Michael Stark, Dominion Nuclear; and Electronic circuit board testing, by James Amundsen, FirstEnergy Nuclear Operating Company. The plant profile article is titled The future is now, by Julia Milstead, Progress Energy Service Company, LLC

  2. Outage management and health physics issue, 2007

    International Nuclear Information System (INIS)

    The focus of the May-June issue is on outage management and health physics. Major articles/reports in this issue include: India: a potential commercial opportunity, a U.S. Department of Commerce Report, by Joe Neuhoff and Justin Rathke; The changing climate for nuclear energy, by Skip Bowman, Nuclear Energy Insitute; Selecting protective clothing, by J. Mark Price, Southern California Edison; and Succssful refurbishment outage, by Sudesh K. Gambhir, Omaha Public Power District. Industry innovation articles in this issue are: Containment radiation monitoring spiking, by Michael W. Lantz and Robert Routolo, Arizona Public Service Company; Improved outage performance, by Michael Powell and Troy Wilfong, Arizona Public Service Company, Palo Verde Nuclear Generating Station; Stop repacking valves and achieve leak-free performance, by Kenneth Hart, PPL Susquehanna LLC; and Head assembly upgrade package, by Timothy Petit, Dominion Nuclear

  3. Physical activity and pancreatic cancer risk: a systematic review

    Science.gov (United States)

    Bao, Ying; Michaud, Dominique S.

    2016-01-01

    Background Physical activity has been associated with a lower risk of pancreatic cancer in several studies, but the overall epidemiologic evidence is not consistent. We therefore performed a systematic review to evaluate the association between physical activity and pancreatic cancer risk. Methods We searched MEDLINE and EMBASE through April 2008 and examined the reference lists of the retrieved articles. We excluded studies that relied on job titles as surrogate measures for physical activity. We used a random-effects model to pool study-specific risk estimates comparing the highest versus the lowest category of physical activity. Results Total physical activity (occupational and leisure-time) was not significantly associated with risk of pancreatic cancer (4 prospective studies; summary relative risk (RR) = 0.76, 95% confidence interval (CI) = 0.53-1.09). A decreased risk of pancreatic cancer was observed for occupational physical activity (3 prospective studies; RR = 0.75, 95% CI = 0.58-0.96) but not for leisure-time physical activity (14 prospective studies; RR = 0.94, 95% CI = 0.83-1.05). No association was found with light physical activity (2 prospective studies; RR = 1.01, 95% CI = 0.77-1.34), moderate physical activity (6 prospective studies; RR = 0.83, 95% CI = 0.58-1.18) or vigorous physical activity (7 prospective studies; RR = 0.94, 95% CI = 0.80-1.12). Conclusions This systematic review does not provide strong evidence for an association between physical activity and risk of pancreatic cancer. PMID:18843009

  4. Breakthrough Propulsion Physics Project: Project Management Methods

    Science.gov (United States)

    Millis, Marc G.

    2004-01-01

    To leap past the limitations of existing propulsion, the NASA Breakthrough Propulsion Physics (BPP) Project seeks further advancements in physics from which new propulsion methods can eventually be derived. Three visionary breakthroughs are sought: (1) propulsion that requires no propellant, (2) propulsion that circumvents existing speed limits, and (3) breakthrough methods of energy production to power such devices. Because these propulsion goals are presumably far from fruition, a special emphasis is to identify credible research that will make measurable progress toward these goals in the near-term. The management techniques to address this challenge are presented, with a special emphasis on the process used to review, prioritize, and select research tasks. This selection process includes these key features: (a) research tasks are constrained to only address the immediate unknowns, curious effects or critical issues, (b) reliability of assertions is more important than the implications of the assertions, which includes the practice where the reviewers judge credibility rather than feasibility, and (c) total scores are obtained by multiplying the criteria scores rather than by adding. Lessons learned and revisions planned are discussed.

  5. Management of Hormone Deprivation Symptoms After Cancer.

    Science.gov (United States)

    Faubion, Stephanie S; Loprinzi, Charles L; Ruddy, Kathryn J

    2016-08-01

    Cancer survivors often experience symptoms related to hormone deprivation, including vasomotor symptoms, genitourinary symptoms, and sexual health concerns. These symptoms can occur due to natural menopause in midlife women, or they can be brought on by oncologic therapies in younger women or men. We searched PubMed for English-language studies from January 1990 through January 2016 to identify relevant articles on the management of hormone deprivation symptoms, including vasomotor, genitourinary, and sexual symptoms in patients with cancer. The search terms used included hormone deprivation, vasomotor symptoms, hot flash, vaginal dryness, sexual dysfunction, and breast cancer. This manuscript provides a comprehensive description of data supporting the treatment of symptoms associated with hormone deprivation. PMID:27492917

  6. Management of advanced medullary thyroid cancer.

    Science.gov (United States)

    Hadoux, Julien; Pacini, Furio; Tuttle, R Michael; Schlumberger, Martin

    2016-01-01

    Medullary thyroid cancer arises from calcitonin-producing C-cells and accounts for 3-5% of all thyroid cancers. The discovery of a locally advanced medullary thyroid cancer that is not amenable to surgery or of distant metastases needs careful work-up, including measurement of serum calcitonin and carcinoembryonic antigen (and their doubling times), in addition to comprehensive imaging to determine the extent of the disease, its aggressiveness, and the need for any treatment. In the past, cytotoxic chemotherapy was used for treatment but produced little benefit. For the past 10 years, tyrosine kinase inhibitors targeting vascular endothelial growth factor receptors and RET (rearranged during transfection) have been used when a systemic therapy is indicated for large tumour burden and documented disease progression. Vandetanib and cabozantinib have shown benefits on progression-free survival compared with placebo in this setting, but their toxic effect profiles need thorough clinical management in specialised centres. This Review describes the management and treatment of patients with advanced medullary thyroid cancer with emphasis on current targeted therapies and perspectives to improve patient care. Most treatment responses are transient, emphasising that mechanisms of resistance need to be better understood and that the efficacy of treatment approaches should be improved with combination therapies or other drugs that might be more potent or target other pathways, including immunotherapy. PMID:26608066

  7. Management of pancreatic cancer in the elderly.

    Science.gov (United States)

    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. PMID:26811623

  8. 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

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

    Science.gov (United States)

    Naimark, Oleg B.; Nikitiuk, Aleksandr S.; Baudement, Marie-Odile; Forné, Thierry; Lesne, Annick

    2016-08-01

    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.

  10. Rehabilitation in cancer: Training and talking? Effects of physical training versus physical training combined with cognitive-behavioural therapy

    OpenAIRE

    May-de Groot, A.M.

    2008-01-01

    Objective. As a result of recent advances in diagnosis and treatment, the number of people surviving cancer is increasing. A subgroup of cancer survivors report long-lasting physical and psychological complaints including decreased cardiorespiratory capacity, decreased physical functioning, and decreased quality of life (QoL). Physical and psychological rehabilitation had beneficial effects on cancer survivors' physical fitness and QoL. Physical training appeared to have a primarily positive ...

  11. Towards an integrated management of health physics and medical physics

    Energy Technology Data Exchange (ETDEWEB)

    Mommaert, Chantal; Rogge, Frank; Cortenbosch, Geert; Schmitz, Frederic [Association Vincotte Nuclear (AVN), Brussels (Belgium)

    2007-07-01

    AVN is a licensed body that performs health physics control in different types of installations, from large nuclear facilities to small dentist cabinets. AVN can also provide medical physics services for the quality control of, for instance, medical devices used in a radiology or nuclear medicine department. Radiation protection for personnel and environment (health physics) and radiation protection for the patient (medical physics) are usually treated separately, using different referential documents, such as the European Directives 96/29/Euratom for health physics and 97/43/Euratom for medical physics. This difference is also clearly reflected in the Belgium legislation (two types of accreditation/licence for inspectors, different chapters in the law,..) From a practical point of view it is sometimes rather difficult to split the task 'on site' during an inspection. An RX system not complying with radiation protection criteria can definitively affect the patient as well as the workers. On the other hand, the hospitals, cannot easily differentiate these two tasks because they are not fully aware of the legislation and they are mixing both. Taking into account the health physics guidelines as well as medical physics guidelines, we have decided to move to an integrated approach of these two concepts. (orig.)

  12. Diabetes, physical activity and endometrial cancer

    OpenAIRE

    Friberg, Emilie

    2006-01-01

    Accumulating evidence suggests that hyperinsulinemia, in the context of insulin resistance, is associated with carcinogenesis. Physical activity is involved in the regulation of metabolic and hormonal pathways and is an important factor affecting hyperinsulinemia, insulin resistance and body weight. The major modifiable determinants of insulin resistance, hyperinsulinemia, and diabetes such as obesity, and physical activity, have also been shown to be risk factors for endome...

  13. 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.

  14. Diabetes management before and after cancer diagnosis: missed opportunity

    Science.gov (United States)

    Camacho, Fabian T.; Chukmaitov, Askar S.; Fleming, Steven T.; Anderson, Roger T.

    2015-01-01

    Background Few studies have examined the management of comorbidities in cancer patients. This study used population-based data to estimate the guideline concordance rates for diabetes management before and after cancer diagnosis and examined if diabetes management services among cancer patients was associated with characteristics of the hospital where the patient was treated. Methods We linked 2005-2009 Medicare claims data to information on 2,707 breast and colorectal cancers patients in state cancer registry files. Multivariate logistic regression models examined hospital characteristics associated with receipt of diabetes management care after cancer diagnosis. Results The rates of HbAlc testing, LDL-C testing, and retinal eye exam decreased from 72.7%, 79.6%, and 57.9% before cancer diagnosis to 58.3%, 69.5%, and 55.8% after diagnosis. The pre- and post-diagnosis diabetes management care was not significantly different by hospital characteristics in the bivariate analysis except for that the distance between residence and hospital was negatively related to retinal eye exam after diagnosis (P<0.05). The multivariate analysis did not identify any significant differences in diabetes management care after cancer diagnosis by hospital characteristics. Conclusions Cancer patients received fewer diabetes management care after diagnosis than prior to diagnosis, even for those who were treated in large comprehensive centers. This may reflect a missed opportunity to connect diabetic cancer patients to diabetes care. This study provides benchmarks to measure improvements in comorbidity management among cancer patients. PMID:25992371

  15. Complementary and alternative medicine in cancer pain management: A systematic review

    Directory of Open Access Journals (Sweden)

    Priyanka Singh

    2015-01-01

    Full Text Available Quality of life (QoL encompasses the physical, psychosocial, social and spiritual dimensions of life lived by a person. Cancer pain is one of the physical component has tremendous impact on the QoL of the patient. Cancer pain is multifaceted and complex to understand and managing cancer pain involves a tool box full of pharmacological and non pharmacological interventions but still there are 50-70% of cancer patients who suffer from uncontrolled pain and they fear pain more than death. Aggressive surgeries, radiotherapy and chemotherapy focus more on prolonging the survival of the patient failing to realize that the QoL lived also matters equally. This paper reviews complementary and alternative therapy approaches for cancer pain and its impact in improving the QoL of cancer patients.

  16. Update in the management of penile cancer

    Directory of Open Access Journals (Sweden)

    Jorge R. Caso

    2009-08-01

    Full Text Available Purpose: The management of penile cancer has evolved as less invasive techniques are applied in the treatment of the primary tumor and inguinal lymph nodes. Materials and Methods: Herein we review the literature focusing on advances in the preservation of the phallus as well as less morbid procedures to evaluate and treat the groins. Results: Promising imaging modalities for staging are discussed. New techniques are described and tables provided for penile preservation. We also review the contemporary morbidity of modified surgical forms for evaluation of the inguinal nodes. Conclusions: Advances in surgical technique have made phallic preservation possible in a greater number of primary penile cancers. The groins can be evaluated for metastasis with greater accuracy through new radiologic means as well as with less morbid modified surgical techniques.

  17. Organizing a breast cancer database: data management.

    Science.gov (United States)

    Yi, Min; Hunt, Kelly K

    2016-06-01

    Developing and organizing a breast cancer database can provide data and serve as valuable research tools for those interested in the etiology, diagnosis, and treatment of cancer. Depending on the research setting, the quality of the data can be a major issue. Assuring that the data collection process does not contribute inaccuracies can help to assure the overall quality of subsequent analyses. Data management is work that involves the planning, development, implementation, and administration of systems for the acquisition, storage, and retrieval of data while protecting it by implementing high security levels. A properly designed database provides you with access to up-to-date, accurate information. Database design is an important component of application design. If you take the time to design your databases properly, you'll be rewarded with a solid application foundation on which you can build the rest of your application. PMID:27197511

  18. Venous thromboembolism in cancer patients: risk assessment, prevention and management.

    Science.gov (United States)

    Tukaye, Deepali N; Brink, Heidi; Baliga, Ragavendra

    2016-03-01

    Thrombosis and thromboembolic events contribute to significant morbidity in cancer patients. Venous thrombosis embolism (which includes deep vein thrombosis and pulmonary embolism) accounts for a large percentage of thromboembolic events. Appropriate identification of cancer patients at high risk for venous thromboembolism and management of thromboembolic event is crucial in improving the quality of care for cancer patients. However, thromboembolism in cancer patients is a complex problem and the management has to be tailored to each individual. The focus of this review is to understand the complex pathology, physiology and risk factors that drive the process of venous thrombosis and embolism in cancer patients and the current guidelines in management. PMID:26919091

  19. New data libraries and physics data management tools

    International Nuclear Information System (INIS)

    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.

  20. Complexities of Adherence and Post-Cancer Lymphedema Management

    OpenAIRE

    Ostby, Pamela L.; Jane M Armer

    2015-01-01

    Breast cancer survivors are at increased risk for breast cancer-related lymphedema (BCRL), a chronic, debilitating, condition that is progressive and requires lifelong self-management. Up to 40% of 3 million breast cancer survivors in the US will develop BCRL, which has no cure, is irreversible, and requires self-management with regimens that may include multiple components. The complexities of treatment can negatively affect adherence to BCRL self-management which is critical to preventing ...

  1. Effects of the BEAT Cancer physical activity behavior change intervention on physical activity, aerobic fitness, and quality of life in breast cancer survivors: a multicenter randomized controlled trial

    OpenAIRE

    Rogers, Laura Q.; Courneya, Kerry S.; Anton, Philip M.; Hopkins-Price, Patricia; Verhulst, Steven; Vicari, Sandra K.; Robbs, Randall S.; Mocharnuk, Robert; McAuley, Edward

    2014-01-01

    Most breast cancer survivors (BCS) are not meeting recommended physical activity guidelines. Here, we report the effects of the Better Exercise Adherence after Treatment for Cancer (BEAT Cancer) behavior change intervention on physical activity, aerobic fitness, and quality of life (QoL). We randomized 222 post-primary treatment BCS to the 3-month intervention (BEAT Cancer) or usual care (UC). BEAT Cancer combined supervised exercise, face-to-face counseling, and group discussions with taperi...

  2. Therapeutic management of locally unresectable pancreatic cancer

    International Nuclear Information System (INIS)

    Pancreatic cancer still have bad prognosis. At the time of diagnosis, less than 10 % of patients can undergo surgery with an overall 5-year survival rate of less than 2 %. For patients with localized pancreatic adenocarcinoma, the combination of radiation therapy and chemotherapy has been shown to control symptoms and to enhance patient survival. This treatment should be proposed to all the patients with good performance status and without icterus. Pain management should be optimized and often need morphinic and co-antalgic (anticonvulsants, steroids) consumption. The celiac plexus block with alcohol gives an excellent pain relief and should be more frequently used. (author)

  3. Physical Activity Behavioral Intervention in Obese Endometrial Cancer Survivors

    Science.gov (United States)

    2015-10-14

    Stage IA Uterine Corpus Cancer; Stage IB Uterine Corpus Cancer; Stage II Uterine Corpus Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer

  4. Emotional Intelligence and Transformational Leadership in Physical Education Managers

    OpenAIRE

    Nooshin Esfahani,; Hamid Gheze Soflu

    2013-01-01

    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...

  5. Management of breast cancer following Hodgkin's disease

    International Nuclear Information System (INIS)

    Purpose: To evaluate the incidence, histology, risk factors, treatment, and prognosis of breast cancer occurring after Hodgkin's disease. Materials and Methods: Sixty-five cases of breast cancer in 61 survivors of Hodgkin's lymphoma were analyzed. The median age at treatment for Hodgkin's disease was 24.1 [range (R): 13.3 - 71.8] years. Fifty-one percent had received radiotherapy alone, 47% radiation and chemotherapy, and 2% chemotherapy only. Relative and absolute risks were calculated based on 47 invasive breast cancers in 1049 women treated for Hodgkin's disease at Stanford. Results: The median age at diagnosis of breast cancer was 41.9 (R: 23.0 - 79.1) years; 76% of women were premenopausal. The median interval between Hodgkin's disease and breast cancer was 17.6 (R: 1.5 - 32.7) years with an increasing incidence beginning eight years after radiotherapy. The current relative risk of invasive breast cancer following Hodgkin's disease is 4.7 [95% confidence interval (CI): 3.4 - 6.1] with an absolute risk of 29.5 (CI: 18.8 - 40.2) excess cases per 10,000 person-years. Eighty-seven percent of breast cancers occurred in or at the margin of a prior radiotherapy field where a mean dose of 43.5 (R: 24.0 - 51.0) Gy was delivered. There was a family history of breast cancer in 31% of women. Cancers were detected by self examination (66%), screening mammography (27%), and physician examination (7%). Many tumors (60%) were located in the upper outer quadrants, corresponding to the axillary portion of a mantle field. There were seven cases of carcinoma in situ: six DCIS and one LCIS. The histologic distribution of invasive tumors paralleled that reported in the general population: 4% pure lobular, 35% high grade ductal, 45% intermediate grade ductal, 7% low-grade ductal, 4% tubular, 2% medullary, and 2% mucinous. Estrogen receptors were positive in 59% of evaluable cases. While 90% of invasive tumors were smaller than four centimeters, 96% were managed with mastectomy

  6. The European initiative for quality management in lung cancer care

    DEFF Research Database (Denmark)

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

    2014-01-01

    Lung cancer is the commonest cause of cancer-related death worldwide and poses a significant respiratory disease burden. Little is known about the provision of lung cancer care across Europe. The overall aim of the Task Force was to investigate current practice in lung cancer care across Europe....... 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...

  7. Effects of physical exercise during adjuvant breast cancer treatment on physical and psychosocial dimensions of cancer-related fatigue : A meta-analysis

    NARCIS (Netherlands)

    Van Vulpen, Jonna K.; Peeters, Petra H M; Velthuis, Miranda J.; van der Wall, Elsken; May, Anne M.

    2016-01-01

    Cancer-related fatigue has a multidimensional nature and complaints typically increase during adjuvant treatment for breast cancer. Physical exercise might prevent or reduce cancer-related fatigue. So far, no meta-analysis has investigated the effects of physical exercise on different dimensions of

  8. Multidisciplinary management for esophageal and gastric cancer

    Directory of Open Access Journals (Sweden)

    Boniface MM

    2016-04-01

    Full Text Available Megan M Boniface,1 Sachin B Wani,2 Tracey E Schefter,3 Phillip J Koo,4 Cheryl Meguid,1 Stephen Leong,5 Jeffrey B Kaplan,6 Lisa J Wingrove,7 Martin D McCarter1 1Section of Surgical Oncology, Division of GI, Tumor and Endocrine Surgery, Department of Surgery, 2Division of Gastroenterology and Hepatology, Department of Therapeutic and Interventional Endoscopy, 3Department of Radiation Oncology, 4Division of Radiology-Nuclear Medicine, Department of Radiology, 5Division of Medical Oncology, 6Department of Pathology, University of Colorado Denver, 7Department of Food and Nutrition Services, University of Colorado Hospital Cancer Center, Aurora, CO, USA Abstract: The management of esophageal and gastric cancer is complex and involves multiple specialists in an effort to optimize patient outcomes. Utilizing a multidisciplinary team approach starting from the initial staging evaluation ensures that all members are in agreement with the plan of care. Treatment selection for esophageal and gastric cancer often involves a combination of chemotherapy, radiation, surgery, and palliative interventions (endoscopic and surgical, and direct communication between specialists in these fields is needed to ensure appropriate clinical decision making. At the University of Colorado, the Esophageal and Gastric Multidisciplinary Clinic was created to bring together all experts involved in treating these diseases at a weekly conference in order to provide patients with coordinated, individualized, and patient-centered care. This review details the essential elements and benefits of building a multidisciplinary program focused on treating esophageal and gastric cancer patients. Keywords: tumor board, upper gastrointestinal malignancies, patient centered

  9. Management of bleeding complications in patients with cancer on DOACs.

    Science.gov (United States)

    Schulman, Sam; Shrum, Jeffrey; Majeed, Ammar

    2016-04-01

    There has been a concern that major bleeding events (MBE) on direct-acting oral anticoagulants (DOACs) will be more difficult to manage than on vitamin K antagonists. Patients with cancer and DOAC-associated bleeding may be even more of a challenge to manage. We therefore reviewed the literature on bleeding in patients with cancer on DOACs. In addition, we performed an analysis of individual patient data from 5 phase III trials on treatment with dabigatran with focus on those with cancer. In 6 randomized trials the risk of MBE in patients with cancer was similar on treatment with DOACs compared to vitamin K antagonists. Bleeding was in the majority of patients managed with supportive therapy alone. In the individual patient data analysis there were no significant differences in use of hemostatic products, transfusion of red cells, effectiveness of management, bleeding-related mortality or 30-day all-cause mortality between patients with cancer treated with dabigatran or with warfarin. Local hemostatic therapy, including resection of the cancer site was more common in patients with gastrointestinal bleeding with cancer than among those without cancer. We conclude that management of bleeding in patients with cancer and on a DOAC does not pose a greater challenge than management of bleeding in patients without cancer. PMID:27067968

  10. Management of solitary and multiple brain metastases from breast cancer

    OpenAIRE

    Addison Willett; J Ben Wilkinson; Chirag Shah; Mehta, Minesh P.

    2015-01-01

    As local and systemic control of breast cancer improves, metastasis to the brain remains a common event requiring a specialized management approach. Women diagnosed with breast cancer who develop brain metastases have superior overall survival compared to patients with other forms of metastatic carcinoma. This article summarizes some of the unique aspects of care for patients with breast cancer metastases to the brain.

  11. Spontaneous Physical Activity Downregulates Pax7 in Cancer Cachexia

    Directory of Open Access Journals (Sweden)

    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.

  12. Spontaneous Physical Activity Downregulates Pax7 in Cancer Cachexia.

    Science.gov (United States)

    Coletti, Dario; Aulino, Paola; Pigna, Eva; Barteri, Fabio; Moresi, Viviana; Annibali, Daniela; Adamo, Sergio; Berardi, Emanuele

    2016-01-01

    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. PMID:27034684

  13. Increased Physical Activity Associated With Lower Risk of 13 Types of Cancer

    Science.gov (United States)

    ... Releases News Release Monday, May 16, 2016 Increased physical activity associated with lower risk of 13 types of cancer A new study of the relationship between physical activity and cancer has shown that greater levels of ...

  14. Contemporary management of cancer of the oral cavity

    Science.gov (United States)

    Genden, Eric M.; Silver, Carl E.; Takes, Robert P.; Suárez, Carlos; Owen, Randall P.; Haigentz, Missak; Stoeckli, Sandro J.; Shaha, Ashok R.; Rapidis, Alexander D.; Rodrigo, Juan Pablo; Rinaldo, Alessandra

    2010-01-01

    Oral cancer represents a common entity comprising a third of all head and neck malignant tumors. The options for curative treatment of oral cavity cancer have not changed significantly in the last three decades; however, the work up, the approach to surveillance, and the options for reconstruction have evolved significantly. Because of the profound functional and cosmetic importance of the oral cavity, management of oral cavity cancers requires a thorough understanding of disease progression, approaches to management and options for reconstruction. The purpose of this review is to discuss the most current management options for oral cavity cancers. PMID:20155361

  15. Race, Age, and Obesity Disparities in Adult Physical Activity Levels in Breast Cancer Patients And Controls

    OpenAIRE

    Thompson, Cheryl L.; Owusu, Cynthia; Nock, Nora L.; Li LI; Berger, Nathan A.

    2014-01-01

    Physical activity has been shown to be inversely associated with breast cancer recurrence and survival. Although physical activity is known to decline with age, rates of change in physical activity have not been well characterized in breast cancer patients and subgroups with known disparities in breast cancer survival, especially in minorities, the elderly, and the obese. We evaluated moderate and strenuous physical activity from high school through diagnosis in 1,220 breast cancer patients, ...

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

    International Nuclear Information System (INIS)

    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

  17. Radiotherapy in the management of early breast cancer

    OpenAIRE

    Wang, Wei

    2013-01-01

    Radiotherapy is an indispensible part of the management of all stages of breast cancer. In this article, the common indications for radiotherapy in the management of early breast cancer (stages 0, I, and II) are reviewed, including whole-breast radiotherapy as part of breast-conserving treatment for early invasive breast cancer and pre-invasive disease of ductal carcinoma in situ, post-mastectomy radiotherapy, locoregional radiotherapy, and partial breast irradiation. Key clinical studies tha...

  18. The Evaluation of Physical Variables Which Effects Classroom Management

    OpenAIRE

    Ayşe KARAÇALI

    2006-01-01

    Classroom managament has great importance on increasing productivity of education activities.So that,it is necessary to be careful while arranging classroom environment.The teacher has an important role on arranging classroom environment.The teachers should arrange the classroom by taking care classroom physical variables and effects of classroom management.It increases productivity of education.This research explains the importance of classroom management and classroom’s physical variables o...

  19. Does pain acceptance predict physical and psychological outcomes in cancer outpatients with pain?

    Directory of Open Access Journals (Sweden)

    Evangelia Protopapa

    2013-09-01

    Full Text Available Background: Pain and psychological distress frequently co-exist in cancer patients. Pain acceptance has been associated with improved physical and psychosocial well-being in chronic non-malignant pain patients, however its effects are unclear in cancer outpatients with pain. Methods: The sample consisted of 116 outpatients recruited from a tertiary oncology centre, with various types of cancer and pain levels. To assess patients, we used the Brief Pain Inventory, the Hospital Anxiety and Depression Scale and the Chronic Pain Acceptance Questionnaire comprising of: Activity engagement and Pain willingness. The extent to which acceptance predicts physical and psychological outcomes was investigated using multiple regression analyses. Results: Adjusting for patient characteristics and outcomes, activity engagement and pain willingness significantly predicted pain interference with function (p=.033 and p=.041 respectively. However, only the activity engagement predicted anxiety (p=.001 and depression (p<.001. Conclusion: Components of pain acceptance predicted patient functional outcomes. Activity engagement in particular, shows promise in predicting psychological well-being. Further studies could confirm its role in reducing anxiety and depression in cancer patients with pain, and whether it should be included in cancer pain management interventions.

  20. The possible influence of risk management, forecasting, and personnel training in physical asset management

    OpenAIRE

    Schoeman, Jacobus Smit; Vlok, Pieter-Jan

    2014-01-01

    The work presented in this paper highlights the possible effects of risk management, forecasting, and personnel training in the physical asset management environment. Each section is taken separately, and an argument is formed as to why it is important and what portion of the physical asset management five-year budget each should receive. This paper considers the long-term and short-term benefits in its conclusion that risk management should receive 60 per cent of the budget, personnel traini...

  1. 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...

  2. Current Research and Management of Ovarian Cancer in China

    Institute of Scientific and Technical Information of China (English)

    GUMeijiao; SHIWei

    2002-01-01

    Ovarian cancer is ne of the most lethal malignant tumors in China,represents the third most common cancer after cervical cancer and endometrial cancer,and the first leading cause of death from hynaecological cancers.Due to the lack of effective screening strategies and the absence of symptoms in early-stage of disease,over 70% of patients present at an advanced stage.Despite the advances in surgical techniques and conventional chemotheraphy,the prognosis of ovarian cancer has not been improved significantly,and indeed the long-term survival for patients with advanced disease does not exceed 20%.The aetiology of ovarian cancer temains poorly understood.In China,the major focus of research is to clarify the mechanism underlying ovarian cancer,develop more effective life-saving diagnostic and therapeutic measures,and undertake more population-based studies.This article summarizes current research,diagnosis and management of ovarian cancer in China.

  3. The Resource Manager in Physical Rehabilitation.

    Science.gov (United States)

    Evans, Ron L.

    1984-01-01

    The role of resource manager, which combines the roles of therapists and health broker, is described relative to functions in agencies serving the chronically disabled. A model based on a collaborative role is proposed as a complementary addition to a multidisciplinary team of professionals. (MC)

  4. Treatment of cancer of the pancreas by intraoperative electron beam therapy: physical and biological aspects

    Energy Technology Data Exchange (ETDEWEB)

    Bagne, F.R.; Dobelbower, R.R. Jr.; Milligan, A.J.; Bronn, D.G.

    1989-01-01

    Radiation therapy has had a significant and an expanded role in the management of cancer of the pancreas during the last decade. In particular, for locally advanced disease, radiation therapy has improved the median survival of patients to 1 year. Intraoperative electron beam therapy has been applied to unresectable and resectable pancreatic cancer in an attempt to enhance local control of disease and to improve patient survival. This paper presents a survey of the role of radiation therapy in treatment of cancer of the pancreas, provides information on the radiobiological aspects of this treatment modality and details the physical and dosimetric characteristics of intraoperative radiation therapy with electrons. Presented are the design specifics of an applicator system, central axis beam data, applicator parameters, dose distribution data, shielding, treatment planning and means of verification. Emphasis is placed on the collaboration and cooperation necessary for all members of the intraoperative radiation therapy team including surgeons, radiation therapists, medical physicists, anesthesiologists, technologists, and nurses.29 references.

  5. Oxycodone controlled release in cancer pain management.

    Science.gov (United States)

    Biancofiore, Giuseppe

    2006-09-01

    illustrations of a lower incidence of side-effects in the central nervous system. It is therefore possible to conclude that oxycodone represents a valid alternative to morphine in the management of moderate to severe cancer pain, also as first-line treatment. PMID:18360598

  6. Thyroid cancer: Natural history, management strategies and outcomes

    International Nuclear Information System (INIS)

    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

  7. Analysis of Risk Management in Adapted Physical Education Textbooks

    Science.gov (United States)

    Murphy, Kelle L.; Donovan, Jacqueline B.; Berg, Dominck A.

    2016-01-01

    Physical education teacher education (PETE) programs vary on how the topics of safe teaching and risk management are addressed. Common practices to cover such issues include requiring textbooks, lesson planning, peer teaching, videotaping, reflecting, and reading case law analyses. We used a mixed methods design to examine how risk management is…

  8. A PERFORMANCE MANAGEMENT MODEL FOR PHYSICAL ASSET MANAGEMENT

    Directory of Open Access Journals (Sweden)

    J.L. Jooste

    2012-01-01

    Full Text Available

    ENGLISH ABSTRACT: There has been an emphasis shift from maintenance management towards asset management, where the focus is on reliable and operational equipment and on effective assets at optimum life-cycle costs. A challenge in the manufacturing industry is to develop an asset performance management model that is integrated with business processes and strategies. The authors developed the APM2 model to satisfy that requirement. The model has a generic reference structure and is supported by operational protocols to assist in operations management. It facilitates performance measurement, business integration and continuous improvement, whilst exposing industry to the latest developments in asset performance management.

    AFRIKAANSE OPSOMMING: Daar is ‘n klemverskuiwing vanaf onderhoudsbestuur na batebestuur, waar daar gefokus word op betroubare en operasionele toerusting, asook effektiewe bates teen optimum lewensikluskoste. ‘n Uitdaging in die vervaardigingsindustrie is die ontwikkeling van ‘n prestasiemodel vir bates, wat geïntegreer is met besigheidsprosesse en –strategieë. Die outeurs het die APM2 model ontwikkel om in hierdie behoefte te voorsien. Die model het ‘n generiese verwysingsstruktuur, wat ondersteun word deur operasionele instruksies wat operasionele bestuur bevorder. Dit fasiliteer prestasiebestuur, besigheidsintegrasie en voortdurende verbetering, terwyl dit die industrie ook blootstel aan die nuutste ontwikkelinge in prestasiebestuur van bates.

  9. Physical activity interests and preferences of cancer patients with brain metastases: a cross-sectional survey

    OpenAIRE

    Lowe, Sonya S; Danielson, Brita; Beaumont, Crystal; Watanabe, Sharon M.; Courneya, Kerry S.

    2016-01-01

    Background Physical activity has been shown to positively impact cancer-related fatigue, physical functioning and quality of life outcomes in early stage cancer patients, however its role at the end stage of cancer has yet to be determined. Brain metastases are amongst the most common neurological complications of advanced cancer, with significant deterioration in fatigue and quality of life. The purpose of the present study was to examine the physical activity interests and preferences of ca...

  10. Rehabilitation in cancer: Training and talking? Effects of physical training versus physical training combined with cognitive-behavioural therapy

    NARCIS (Netherlands)

    May-de Groot, A.M.

    2008-01-01

    Objective. As a result of recent advances in diagnosis and treatment, the number of people surviving cancer is increasing. A subgroup of cancer survivors report long-lasting physical and psychological complaints including decreased cardiorespiratory capacity, decreased physical functioning, and decr

  11. 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

  12. The role of medical physics in prostate cancer radiation therapy.

    Science.gov (United States)

    Fiorino, Claudio; Seuntjens, Jan

    2016-03-01

    Medical physics, both as a scientific discipline and clinical service, hugely contributed and still contributes to the advances in the radiotherapy of prostate cancer. The traditional translational role in developing and safely implementing new technology and methods for better optimizing, delivering and monitoring the treatment is rapidly expanding to include new fields such as quantitative morphological and functional imaging and the possibility of individually predicting outcome and toxicity. The pivotal position of medical physicists in treatment personalization probably represents the main challenge of current and next years and needs a gradual change of vision and training, without losing the traditional and fundamental role of physicists to guarantee a high quality of the treatment. The current focus issue is intended to cover traditional and new fields of investigation in prostate cancer radiation therapy with the aim to provide up-to-date reference material to medical physicists daily working to cure prostate cancer patients. The papers presented in this focus issue touch upon present and upcoming challenges that need to be met in order to further advance prostate cancer radiation therapy. We suggest that there is a smart future for medical physicists willing to perform research and innovate, while they continue to provide high-quality clinical service. However, physicists are increasingly expected to actively integrate their implicitly translational, flexible and high-level skills within multi-disciplinary teams including many clinical figures (first of all radiation oncologists) as well as scientists from other disciplines. PMID:27095755

  13. Cancer risk management decision making for BRCA+ women.

    Science.gov (United States)

    Leonarczyk, Terri Jabaley; Mawn, Barbara E

    2015-01-01

    Women with pathogenic BRCA genetic mutations face high risks for cancer development. Estimates vary among mutation carriers, with lifetime risks ranging from 41% to 90% for breast cancer and 8% to 62% for ovarian cancer. Cancer risk management options for BRCA mutation positive (BRCA+) women have life-altering implications. This qualitative, phenomenological study explored the experience of cancer risk management decision making for women who are unaffected carriers of a BRCA mutation (previvors). Fifteen previvors recruited from Facing Our Risk of Cancer Empowered (FORCE), an online informational and support group, were interviewed. Findings consisted of four major themes: the early previvor experience, intense emotional upheaval; the decisional journey, navigating a personal plan for survival; lack of knowledge and experience among health care providers; and support is essential. Findings highlight the different decisional perspectives of previvors based on age and individual factors and the need for increased competence among health care providers. PMID:24470135

  14. 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.

  15. Patients with cancer and family caregivers: management of symptoms caused by cancer or cancer therapy at home

    OpenAIRE

    Hazelwood, Daniela Maria; Koeck, Sabine; Wallner, Martin; Anderson, Kathryn Hoehn; Mayer, Hanna

    2012-01-01

    People are diagnosed with cancer sooner nowadays thanks to increased awareness and improvements in cancer screenings. Patients are able to live longer due to cancer treatment regimens; however, they suffer the consequences of living with cancer and therapy-related symptoms. Symptom management is challenging for both patients and family caregivers. Therefore, family members must be integrated in the patient’s care plan. For this review, a literature search was conducted to determine what types...

  16. Management of solitary and multiple brain metastases from breast cancer

    Directory of Open Access Journals (Sweden)

    Addison Willett

    2015-01-01

    Full Text Available As local and systemic control of breast cancer improves, metastasis to the brain remains a common event requiring a specialized management approach. Women diagnosed with breast cancer who develop brain metastases have superior overall survival compared to patients with other forms of metastatic carcinoma. This article summarizes some of the unique aspects of care for patients with breast cancer metastases to the brain.

  17. Contemporary management of cancer of the oral cavity

    OpenAIRE

    Genden, Eric M.; Ferlito, Alfio; Silver, Carl E.; Takes, Robert P.; Suárez, Carlos; Owen, Randall P.; Haigentz, Missak; Stoeckli, Sandro J.; Shaha, Ashok R.; Rapidis, Alexander D.; Rodrigo, Juan Pablo; Rinaldo, Alessandra

    2010-01-01

    Oral cancer represents a common entity comprising a third of all head and neck malignant tumors. The options for curative treatment of oral cavity cancer have not changed significantly in the last three decades; however, the work up, the approach to surveillance, and the options for reconstruction have evolved significantly. Because of the profound functional and cosmetic importance of the oral cavity, management of oral cavity cancers requires a thorough understanding of disease progression,...

  18. Imaging of lung cancer: Implications on staging and management

    OpenAIRE

    Purandare, Nilendu C; Venkatesh Rangarajan

    2015-01-01

    Lung cancer is one of the leading causes of cancer-related deaths. Accurate assessment of disease extent is important in deciding the optimal treatment approach. To play an important role in the multidisciplinary management of lung cancer patients, it is necessary that the radiologist understands the principles of staging and the implications of radiological findings on the various staging descriptors and eventual treatment decisions.

  19. Imaging of lung cancer: Implications on staging and management

    Directory of Open Access Journals (Sweden)

    Nilendu C Purandare

    2015-01-01

    Full Text Available Lung cancer is one of the leading causes of cancer-related deaths. Accurate assessment of disease extent is important in deciding the optimal treatment approach. To play an important role in the multidisciplinary management of lung cancer patients, it is necessary that the radiologist understands the principles of staging and the implications of radiological findings on the various staging descriptors and eventual treatment decisions.

  20. Metastatic Bladder Cancer: A Review of Current Management

    OpenAIRE

    Andrew Fletcher; Ananya Choudhury; Nooreen Alam

    2011-01-01

    Bladder cancer continues to result in substantial morbidity and mortality for affected individuals. Advances in the management of metastatic bladder cancer have been limited. Chemotherapy with platinum-based regimes remains the mainstay of first-line treatment. Studies investigating alternative regimes have offered no survival advantage. Targeted therapies may offer benefit either as single agent or in combination with chemotherapy. Symptoms due to metastatic bladder cancer impact patients' q...

  1. Management of the axilla in patients with breast cancer

    OpenAIRE

    Goyal, Amit

    2009-01-01

    This article reviews the changes in management of the axilla in patients with breast cancer in the last decade. It discusses the recent advances, existing controversies and provides evidence-based guidelines for use in clinical practice.

  2. 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

  3. Relationships Between Cardiorespiratory Fitness, Physical Activity, and Psychosocial Variables in Overweight and Obese Breast Cancer Survivors

    OpenAIRE

    Taylor, Deborah L.; Nichols, Jeanne F.; Pakiz, Bilgé; Bardwell, Wayne A.; Flatt, Shirley W.; Rock, Cheryl L.

    2010-01-01

    Background Breast cancer survivors not only experience distressing physical symptoms associated with treatments, but also are faced with psychosocial challenges. Despite growing scientific evidence that physical activity (PA) may mitigate psychosocial distress experienced by women treated for breast cancer, the literature is equivocal. Purpose This study investigated the relationships between cardiorespiratory fitness (CRF), PA, and psychosocial factors in breast cancer survivors. Method Data...

  4. Encouraging Health Information Management Graduates to Pursue Cancer Registry Careers.

    Science.gov (United States)

    Peterson, Jennifer

    2016-01-01

    The cancer registry profession has grown dramatically since its inception in 1926. Certified tumor registrars (CTRs) have become an integral part of the cancer care team by providing quality cancer data for research, statistical purposes, public health, and cancer control. In addition, CTRs have been found to be valuable in other cancer and health-related fields. Based on the need for high-quality, accurate data, the National Cancer Registrars Association (NCRA), the certification body for CTRs, has increased the educational requirement for eligibility for the CTR certification exam. This has resulted in fewer individuals who are able to meet the requirements for CTR certification. In addition, the existing cancer registry workforce is, on average, older than other allied health professions, and therefore will face an increasing number of retirements in the next few years. The high demand for CTRs, the decreased pool of CTR-eligible applicants, and the aging cancer registry workforce has resulted in an existing shortage that will only get worse as the population ages and the incidence of cancer increases. Health information management (HIM) students are well suited to pursuing further training in the cancer registry field and gaining the CTR credential. HIM students or new graduates have the needed skill set and education to pursue a cancer registry career. There are many avenues HIM educational programs can take to encourage students to pursue CTR certification and a cancer registry career. Including cancer registry functions in courses throughout the HIM curriculum, bringing in cancer registry speakers, encouraging networking, and promoting the cancer registry field and profession in general are just a few of the methods that HIM programs can use to raise awareness of and promote a cancer registry career to their students. Illinois State University has used these methods and has found them to be successful in encouraging a percentage of their graduates to pursue

  5. Management of locally advanced breast cancer: Evolution and current practice

    OpenAIRE

    Rustogi Ashish; Budrukkar Ashwini; Dinshaw Ketayun; Jalali Rakesh

    2005-01-01

    Locally advanced breast cancer (LABC) accounts for a sizeable number (30-60%) of breast cancer cases and is a common clinical scenario in developing countries. The treatment of LABC has evolved from single modality treatment, consisting of radical mutilating surgery or higher doses of radiotherapy in inoperable disease to multimodality management, which along with the above two included systemic therapy. Neoadjuvant chemotherapy (NACT) has made a tremendous impact on the management of ...

  6. Computerized database management system for breast cancer patients

    OpenAIRE

    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 r...

  7. 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.

  8. The Evaluation of Physical Variables Which Effects Classroom Management

    Directory of Open Access Journals (Sweden)

    Ayşe KARAÇALI

    2006-06-01

    Full Text Available Classroom managament has great importance on increasing productivity of education activities.So that,it is necessary to be careful while arranging classroom environment.The teacher has an important role on arranging classroom environment.The teachers should arrange the classroom by taking care classroom physical variables and effects of classroom management.It increases productivity of education.This research explains the importance of classroom management and classroom’s physical variables on positive learning environment and reaching the students’learning aims.

  9. Diagnosis and Management of Endometrial Cancer.

    Science.gov (United States)

    Braun, Michael M; Overbeek-Wager, Erika A; Grumbo, Robert J

    2016-03-15

    Endometrial cancer is the most common gynecologic malignancy. It is the fourth most common cancer in women in the United States after breast, lung, and colorectal cancers. Risk factors are related to excessive unopposed exposure of the endometrium to estrogen, including unopposed estrogen therapy, early menarche, late menopause, tamoxifen therapy, nulliparity, infertility or failure to ovulate, and polycystic ovary syndrome. Additional risk factors are increasing age, obesity, hypertension, diabetes mellitus, and hereditary nonpolyposis colorectal cancer. The most common presentation for endometrial cancer is postmenopausal bleeding. The American Cancer Society recommends that all women older than 65 years be informed of the risks and symptoms of endometrial cancer and advised to seek evaluation if symptoms occur. There is no evidence to support endometrial cancer screening in asymptomatic women. Evaluation of a patient with suspected disease should include a pregnancy test in women of childbearing age, complete blood count, and prothrombin time and partial thromboplastin time if bleeding is heavy. Most guidelines recommend either transvaginal ultrasonography or endometrial biopsy as the initial study. The mainstay of treatment for endometrial cancer is total hysterectomy with bilateral salpingo-oophorectomy. Radiation and chemotherapy can also play a role in treatment. Low- to medium-risk endometrial hyperplasia can be treated with nonsurgical options. Survival is generally defined by the stage of the disease and histology, with most patients at stage I and II having a favorable prognosis. Controlling risk factors such as obesity, diabetes, and hypertension could play a role in the prevention of endometrial cancer. PMID:26977831

  10. Gastric cancer in Africa: current management and outcomes.

    Science.gov (United States)

    Asombang, Akwi W; Rahman, Rubayat; Ibdah, Jamal A

    2014-04-14

    Gastric cancer is the fourth most common cancer and second most common cause of cancer death worldwide. Globally, gastric cancer poses a significant public health burden - both economically and socially. In 2008, the economic burden from premature cancer deaths and disability was $895 billion and gastric cancer was the second highest cancer responsible for healthy life lost. With the expected increase in cancer deaths and non-communicable diseases, these costs are expected to rise and impact patient care. World Health Organization, estimates a 15% increase in non-communicable disease worldwide, with more than 20% increase occurring in Africa between 2010 and 2020. Mali, West Africa, is ranked 15(th) highest incidence of gastric cancer worldwide at a rate of 20.3/100000, yet very scarce published data evaluating etiology, prevention or management exist. It is understood that risk factors of gastric cancer are multifactorial and include infectious agents (Helicobacter pylori, Epstein-Barr virus), genetic, dietary, and environmental factors (alcohol, smoking). Interestingly, African patients with gastric cancer are younger, in their 3(rd)-4(th) decade, and present at a late stage of the disease. There is sparse data regarding gastric cancer in Africa due to lack of data collection and under-reporting, which impacts incidence and mortality rates. Currently, GLOBOCAN, an International Agency for Research on Cancer resource, is the most comprehensive available resource allowing comparison between nations. In resource limited settings, with already restricted healthcare funding, data is needed to establish programs in Africa that increase gastric cancer awareness, curtail the economic burden, and improve patient management and survival outcomes. PMID:24833842

  11. Psychological and physical distress of cancer patients during radiotherapy

    CERN Document Server

    König, A

    2001-01-01

    Purpose: patients undergoing radiotherapy have physical and psychological symptoms related to the underlying disease and the treatment. In order to give the best possible support to the patients, more knowledge about the amount and the changing of distress in the course of radiotherapy is of essentially importance. Methods: The distress was measured in a consecutive sample of cancer patients (n=82) undergoing radiotherapy. Each patient was given the EORTC-QLQ-C30, the HADS and a special questionnaire which ascertain radiotherapy-specific items before starting the radiotherapy, at the onset of radiotherapy, in the third week of radiotherapy and 3 weeks after the end of radiotherapy. Results: within the first week of treatment the psychological distress of the patients is increasing; 98.8 % of the patients are 'moderate distressed', 46 % 'severe distressed'. General physical symptoms seem not to be affected by the radiotherapy, there is no changing. The distress caused by the organization of the radiotherapy is...

  12. Cancer Carepartners: Improving patients' symptom management by engaging informal caregivers

    Directory of Open Access Journals (Sweden)

    Silveira Maria J

    2011-11-01

    Full Text Available Abstract Background Previous studies have found that cancer patients undergoing chemotherapy can effectively manage their own symptoms when given tailored advice. This approach, however, may challenge patients with poor performance status and/or emotional distress. Our goal is to test an automated intervention that engages a friend or family member to support a patient through chemotherapy. Methods/Design We describe the design and rationale of a randomized, controlled trial to assess the efficacy of 10 weeks of web-based caregiver alerts and tailored advice for helping a patient manage symptoms related to chemotherapy. The study aims to test the primary hypothesis that patients whose caregivers receive alerts and tailored advice will report less frequent and less severe symptoms at 10 and 14 weeks when compared to patients in the control arm; similarly, they will report better physical function, fewer outpatient visits and hospitalizations related to symptoms, and greater adherence to chemotherapy. 300 patients with solid tumors undergoing chemotherapy at two Veteran Administration oncology clinics reporting any symptom at a severity of ≥4 and a willing informal caregiver will be assigned to either 10 weeks of automated telephonic symptom assessment (ATSA alone, or 10 weeks of ATSA plus web-based notification of symptom severity and problem solving advice to their chosen caregiver. Patients and caregivers will be surveyed at intake, 10 weeks and 14 weeks. Both groups will receive standard oncology, hospice, and palliative care. Discussion Patients undergoing chemotherapy experience many symptoms that they may be able to manage with the support of an activated caregiver. This intervention uses readily available technology to improve patient caregiver communication about symptoms and caregiver knowledge of symptom management. If successful, it could substantially improve the quality of life of veterans and their families during the stresses of

  13. Radiotherapy in the management of early breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Wei [Westmead Breast Cancer Institute, Westmead Hospital, Westmead, New South Wales (Australia); Department of Radiation Oncology, Westmead Hospital, New South Wales (Australia)

    2013-03-15

    Radiotherapy is an indispensible part of the management of all stages of breast cancer. In this article, the common indications for radiotherapy in the management of early breast cancer (stages 0, I, and II) are reviewed, including whole-breast radiotherapy as part of breast-conserving treatment for early invasive breast cancer and pre-invasive disease of ductal carcinoma in situ, post-mastectomy radiotherapy, locoregional radiotherapy, and partial breast irradiation. Key clinical studies that underpin our current practice are discussed briefly.

  14. Cancer and Disease Management: Indications for Action

    OpenAIRE

    Marybeth Regan

    1999-01-01

    In the US, 1 in 3 women and 1 in 2 men will be diagnosed with cancer at some point in their lives. More than 1.2 million individuals are diagnosed with cancer each year while it is estimated that 8.2 million Americans, alive today, have a history of cancer. Cancer diagnosis and treatment accounts for approximately 20% of all healthcare expenditures; this is estimated to be as high as 25% in the year 2010. Rising costs are a result of an aging population, environmental factors, and medical adv...

  15. Road map for pain management in pancreatic cancer: A review.

    Science.gov (United States)

    Lahoud, Marie José; Kourie, Hampig Raphael; Antoun, Joelle; El Osta, Lana; Ghosn, Marwan

    2016-08-15

    Beside its poor prognosis and its late diagnosis, pancreatic cancer remains one of the most painful malignancies. Optimal management of pain in this cancer represents a real challenge for the oncologist whose objective is to ensure a better quality of life to his patients. We aimed in this paper to review all the treatment modalities incriminated in the management of pain in pancreatic cancer going from painkillers, chemotherapy, radiation therapy and interventional techniques to agents under investigation and alternative medicine. Although specific guidelines and recommendations for pain management in pancreatic cancer are still absent, we present all the possible pain treatments, with a progression from medical multimodal treatment to radiotherapy and chemotherapy then interventional techniques in case of resistance. In addition, alternative methods such as acupuncture and hypnosis can be added at any stage and seems to contribute to pain relief. PMID:27574552

  16. 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 of the...

  17. The Effects of Physical Activity on Breast Cancer Survivors after Diagnosis

    OpenAIRE

    Kim, Jeongseon; Choi, Wook Jin; Jeong, Seung Hwa

    2013-01-01

    Adverse health outcomes are often seen in breast cancer survivors due to prolonged treatment with side effects such as loss of energy and lack of physical strength. Physical activity (PA) has been proposed as an adequate intervention for women with breast cancer. Therefore, this review summarizes the effects of physical activity on breast cancer survivors after diagnosis. We searched electronic databases including PubMed, Medline, Embase, and Google Scholar for articles published between Janu...

  18. Application of biomarkers in cancer risk management: evaluation from stochastic clonal evolutionary and dynamic system optimization points of view.

    Directory of Open Access Journals (Sweden)

    Xiaohong Li

    2011-02-01

    Full Text Available Aside from primary prevention, early detection remains the most effective way to decrease mortality associated with the majority of solid cancers. Previous cancer screening models are largely based on classification of at-risk populations into three conceptually defined groups (normal, cancer without symptoms, and cancer with symptoms. Unfortunately, this approach has achieved limited successes in reducing cancer mortality. With advances in molecular biology and genomic technologies, many candidate somatic genetic and epigenetic "biomarkers" have been identified as potential predictors of cancer risk. However, none have yet been validated as robust predictors of progression to cancer or shown to reduce cancer mortality. In this Perspective, we first define the necessary and sufficient conditions for precise prediction of future cancer development and early cancer detection within a simple physical model framework. We then evaluate cancer risk prediction and early detection from a dynamic clonal evolution point of view, examining the implications of dynamic clonal evolution of biomarkers and the application of clonal evolution for cancer risk management in clinical practice. Finally, we propose a framework to guide future collaborative research between mathematical modelers and biomarker researchers to design studies to investigate and model dynamic clonal evolution. This approach will allow optimization of available resources for cancer control and intervention timing based on molecular biomarkers in predicting cancer among various risk subsets that dynamically evolve over time.

  19. Radionuclides in the management of thyroid cancer

    OpenAIRE

    Buscombe, J R

    2007-01-01

    Abstract Nuclear medicine imaging was born over 60 years ago with imaging of thyroid conditions. Most of our present imaging devices were developed for imaging of the thyroid and thyroid cancer. Millions of patients in over 100 countries have been diagnosed and treated for thyroid cancer using nuclear medicine techniques. It remains, however, one of the most dynamic areas of development in nuclear medicine with new roles for positron emission tomography and receptor based imaging. In addition...

  20. Cancer cachexia—pathophysiology and management

    OpenAIRE

    Suzuki, Hajime; Asakawa, Akihiro; Amitani, Haruka; NAKAMURA, NORIFUMI; Inui, Akio

    2013-01-01

    About half of all cancer patients show a syndrome of cachexia, characterized by anorexia and loss of adipose tissue and skeletal muscle mass. Cachexia can have a profound impact on quality of life, symptom burden, and a patient’s sense of dignity. It is a very serious complication, as weight loss during cancer treatment is associated with more chemotherapy-related side effects, fewer completed cycles of chemotherapy, and decreased survival rates. Numerous cytokines have been postulated to pla...

  1. Medical Management of Metastatic Medullary Thyroid Cancer

    OpenAIRE

    Maxwell, Jessica E; Sherman, Scott K.; O’Dorisio, Thomas M.; Howe, James R.

    2014-01-01

    Medullary thyroid cancer (MTC) is an aggressive form of thyroid cancer, which occurs in both heritable and sporadic forms. Discovery that mutations in the RET protooncogene predispose to familial cases of this disease has allowed for presymptomatic identification of gene carriers and prophylactic surgery to improve the prognosis of these patients. A significant number of patients with the sporadic type of MTC and even with familial disease, still present with nodal or distant metastases, maki...

  2. Capecitabine in the management of colorectal cancer

    Directory of Open Access Journals (Sweden)

    Hirsch BR

    2011-03-01

    Full Text Available Bradford R Hirsch, S Yousuf ZafarDivision of Medical Oncology, Duke University Medical Center, Durham, NC, USAAbstract: 5-Fluorouracil has been a mainstay in the treatment of colorectal cancer for nearly five decades; however, the use of oral formulations of the medication has been gaining increasing traction since capecitabine was approved for use in adjuvant settings by the US Food and Drug Administration in 2005. The use of capecitabine has since spread to a number of off-label indications, including the treatment of advanced or metastatic colorectal cancer and the neoadjuvant treatment of rectal cancer. In light of increasing utilization, it is critical that clinicians have a firm understanding of the literature supporting capecitabine across various settings as well as the attributes of the drug, such as its dosing recommendations, side-effect profile, and use in the elderly. The purpose of this review is to synthesize the literature in a fashion that can be used to help guide decisions. In a setting of increasing focus on cost, the pharmacoeconomic literature is also briefly reviewed.Keywords: colon cancer, colorectal cancer, rectal cancer, capecitabine, Xeloda

  3. 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.

  4. Challenges in the Management of Older Patients with Colon Cancer

    OpenAIRE

    Dotan, Efrat; Browner, Ilene; Hurria, Arti; Denlinger, Crystal

    2012-01-01

    The majority of patients with colon cancer are over the age of 65. Their treatment poses multiple challenges to the oncologist, as these patients may have age-related comorbidities, polypharmacy, and physical or physiologic changes associated with older age. These challenges include limited data on the ability to predict tolerance to anti-cancer therapy and the appropriate use of treatment modalities in the setting of comorbidity and concurrent frailty. The low number of older patients enroll...

  5. Effects of physical exercise during adjuvant breast cancer treatment on physical and psychosocial dimensions of cancer-related fatigue: A meta-analysis.

    Science.gov (United States)

    van Vulpen, Jonna K; Peeters, Petra H M; Velthuis, Miranda J; van der Wall, Elsken; May, Anne M

    2016-03-01

    Cancer-related fatigue has a multidimensional nature and complaints typically increase during adjuvant treatment for breast cancer. Physical exercise might prevent or reduce cancer-related fatigue. So far, no meta-analysis has investigated the effects of physical exercise on different dimensions of fatigue. The aim of the present meta-analysis was to investigate the effects of physical exercise during adjuvant breast cancer treatment on physical and psychosocial dimensions of fatigue. We performed a systematic literature search in PubMed, Embase and the Cochrane Library in June 2015. Randomised controlled trials reporting the effects of physical exercise during adjuvant breast cancer treatment on different dimensions of fatigue were included. Pooled effects of 6 exercise programmes (including 784 patients) showed significant beneficial exercise effects on general fatigue (ES: -0.22, 95% CI -0.38; -0.05) and physical fatigue (ES: -0.35, 95% CI -0.49; -0.21). Effects on fatigue subscales 'reduced activity' (ES: -0.22, 95% CI -0.38; -0.05) and 'reduced motivation' (ES: -0.18, 95% CI -0.35; -0.01) were also in favour of physical exercise. No effects were found on cognitive and affective fatigue. Including only the supervised exercise programmes (n=4 studies), slightly larger pooled effect estimates were found on general fatigue (ES: -0.25, 95% CI -0.47; -0.04) and physical fatigue (-0.39, 95% CI -0.56; -0.23). In conclusion, physical exercise during adjuvant breast cancer treatment has beneficial effects on general fatigue, physical fatigue, 'reduced activity' and 'reduced motivation', but did not show effects on cognitive and affective fatigue. Largest effect sizes are found for physical fatigue, suggesting that this is the fatigue dimension most sensitive to physical exercise. PMID:26857888

  6. A physical palette for ion-beam cancer therapy

    Energy Technology Data Exchange (ETDEWEB)

    Surdutovich, E.; Solov' yov, A.V. [Frankfurt Institute for Advanced Studies, Frankfurt am Main (Germany); Surdutovich, E. [Oakland Univ., Rochester, MI (United States)

    2009-07-01

    Ion-beam cancer therapy and proton-beam therapy have been used successfully. Despite apparent experimental and clinical successes, a comprehensive theoretical description of a physical scenario is missing. One reason is that the phenomena initiated by an energetic ion incident on tissue happen on many scales in time, distance and energy. DNA is disrupted as a result of energy deposition by incident ions, mainly due to the ionization of the medium. The secondary electrons formed in this process are considered to be mostly responsible for DNA damage through either direct breaking of DNA strands, or reacting with water molecules producing more active secondaries, or through the heating of the medium. Our calculations show that the seemingly insurmountable complexity of the geometry of DNA in different states may be overcome, because the geometrical differences are found to be insignificant. (A.C.)

  7. Fit & Strong! Promotes Physical Activity and Well-Being in Older Cancer Survivors

    OpenAIRE

    Reynolds, Jana; Thibodeaux, Lorie; Jiang, Luohua; Francis, Kevin; Hochhalter, Angie

    2015-01-01

    Introduction Physical activity reduces fatigue and depression while improving quality of life in cancer survivors. Exercise is generally considered safe and is recommended to survivors of all ages. Despite the high prevalence of cancer in the elderly, few studies address physical activity interventions targeting this older population. Fit & Strong! is an evidence-based physical activity program shown to improve level of physical activity, exercise-self-efficacy, and mood in older adults wi...

  8. Psychological and physical distress of cancer patients during radiotherapy

    International Nuclear Information System (INIS)

    Purpose: patients undergoing radiotherapy have physical and psychological symptoms related to the underlying disease and the treatment. In order to give the best possible support to the patients, more knowledge about the amount and the changing of distress in the course of radiotherapy is of essentially importance. Methods: The distress was measured in a consecutive sample of cancer patients (n=82) undergoing radiotherapy. Each patient was given the EORTC-QLQ-C30, the HADS and a special questionnaire which ascertain radiotherapy-specific items before starting the radiotherapy, at the onset of radiotherapy, in the third week of radiotherapy and 3 weeks after the end of radiotherapy. Results: within the first week of treatment the psychological distress of the patients is increasing; 98.8 % of the patients are 'moderate distressed', 46 % 'severe distressed'. General physical symptoms seem not to be affected by the radiotherapy, there is no changing. The distress caused by the organization of the radiotherapy is decreasing, while therapy-related symptoms are increasing in the course of radiotherapy. Even after the end of the therapy these symptoms keep on causing distress, sometimes in a higher amount than before. A correlation between sex, sort of cancer and curative or palliative treatment and the amount of distress was found. Conclusion: the results stress the importance of adequate emotional support for patients undergoing radiotherapy especially in the first week of treatment and after the treatment. There is a need for the development of a valid radiotherapy - questionnaire in order to be able to measure the distress of these patients. (author)

  9. Psychological and Behavioral Approaches to Cancer Pain Management

    OpenAIRE

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

    2014-01-01

    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 ...

  10. Benefits of multidisciplinary teamwork in the management of breast cancer

    OpenAIRE

    Taylor C; Shewbridge A; Harris J; Green JS

    2013-01-01

    Cath Taylor,1 Amanda Shewbridge,2 Jenny Harris,1 James S Green3,4 1Florence Nightingale School of Nursing and Midwifery, King’s College London, London UK; 2Breast Cancer Services, Guy’s and St Thomas’ NHS Foundation Trust, London, UK; 3Department of Urology, Barts Health NHS Trust, London, UK; 4Department of Health and Social Care, London South Bank University, London, UK Abstract: The widespread introduction of multidisciplinary team (MDT)-work for breast cancer management ...

  11. Familial breast cancer: management of ‘lower risk' referrals

    OpenAIRE

    Young, D; McLeish, L; Sullivan, F.; Pitkethly, M; M. Reis; Goudie, D; Vysny, H; Ozakinci, G; Steel, M

    2006-01-01

    Up to 40% of referrals from primary care to ‘breast cancer family clinics' prove to be of women whose assessed risk falls below the guidelines' threshold for management in secondary or tertiary care, despite recommendations that they should be screened out at primary care level. A randomised trial, involving 87 such women referred to the Tayside Familial Breast Cancer Service compared two ways of communicating risk information, letter or personal interview. Both were found to be acceptable to...

  12. Perspectives on the clinical management of localized prostate cancer

    OpenAIRE

    Nelson, Joel B.

    2014-01-01

    If cure is necessary, is it possible and if cure is possible, is it necessary?’ -Willet F. Whitmore Defined broadly, prostate cancer has two states: An indolent histological manifestation of a locally proliferative and invasive process or a clinically relevant, potentially lethal disease. Likewise, the management of clinically localized prostate cancer must address two questions: what sort of disease is this and what needs to be done.

  13. ACOG Recommendations and Guidelines for Cervical Cancer Screening and Management

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about ACOG's recommendations for cervical cancer screening and management.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  14. Pancreatic Cancer Epidemiology, Detection, and Management

    Directory of Open Access Journals (Sweden)

    Qiubo Zhang

    2016-01-01

    Full Text Available PC (pancreatic cancer is the fourth most common cause of death due to cancer worldwide. The incidence and mortality rates have been increasing year by year worldwide, and this review has analyzed the most recent incidence and mortality data for pancreatic cancer occurrence in China. Several possible risk factors have been discussed here, involving known established risk factors and novel possible risk factors. The development of this cancer is a stepwise progression through intraepithelial neoplasia to carcinoma. Though early and accurate diagnosis is promising based on a combination of recent techniques including tumor markers and imaging modalities, lacking early clinical symptoms makes the diagnosis late. Correct staging is critical because treatment is generally based on this parameter. Treatment options have improved throughout the last decades. However, surgical excision remains the primary therapy and efficacy of conventional chemoradiotherapy for PC is limited. Recently, some novel new therapies have been developed and will be applied in clinics soon. This review will provide an overview of pancreatic cancer, including an understanding of the developments and controversies.

  15. AB008. Management of fertility post cancer

    Science.gov (United States)

    Smith, James

    2016-01-01

    The successful treatment of males with cancer has led to increasing numbers of men and boys interested in life after cancer. One of the top priorities for many of these males is the opportunity to have a family. Most cancer treatments used for common malignancies in men and boys are associated with impaired fertility; for patients receiving alkylating agents or total body irradiation, severe fertility impairment occurs in most patients. While sperm banking for males, even those as young as 12, facing sterilizing cancer treatment can be effective, this approach requires subsequent use of reproductive procedures such as in vitro fertilization (IVF) or intrauterine insemination to achieve a pregnancy. Most males would prefer to restore their natural ability to father children and avoid these expensive and invasive approaches. No proven method for human male fertility restoration has yet been demonstrated; however, work in many mammalian species and recently in primates has demonstrated that autologous testicular cell transplant (TCT) can restore spermatogenesis after cancer treatment. Promising work in non-primate species has demonstrated the feasibility of in vitro development of mature sperm from neonatal testicular tissue. The safety and efficacy of either approach has not been established in humans. The objective of this lecture is to explore current and future fertility preservation and restoration techniques for males at risk of sterility from medical and surgical treatment.

  16. The created environment for physical assessment by case managers.

    Science.gov (United States)

    Skillen, D L; Anderson, M C; Knight, C L

    2001-02-01

    Goals of gerontological nursing include maximizing health and confronting functional impairments. The health of older adults is often fragile because of age-related change, complicated by chronic illnesses. Identification of changes in health status permits responsive care and consultation but requires proficiency in physical assessment. In 1995, research was conducted in Alberta, Canada, on registered nurse case managers' reported use of assessment skills. Nineteen continuing-care facilities in 1 of 17 provincial health regions participated (N = 189). After expert review and pilot testing, questionnaires were distributed to two independent groups: nurse administrators/staff development coordinators and case managers (response rate = 73%). Qualitative data were subjected to descriptive, interpretive, and pattern coding. Reported are factors constraining or facilitating physical assessment in continuing care. Neuman's concept of the created environment provided a factor-organizing framework. A holistic view of environment and data source triangulation increased confidence in the comprehensiveness and credibility of results. PMID:11216026

  17. Key concepts in management of vulvar cancer.

    Science.gov (United States)

    Zweizig, Susan; Korets, Sharmilee; Cain, Joanna M

    2014-10-01

    Vulvar carcinoma is an uncommon tumor that is seen most often in older women. Subtle symptoms such as pruritus should prompt examination and targeted biopsy in all women as this disease can be successfully treated even in elderly, frail individuals. Vulvar cancer has a bimodal age distribution and is seen in both young and older women with risk factors including human papillomavirus (HPV) infection, smoking, and vulvar skin diseases (i.e., lichen sclerosus). This cancer is staged surgically, with an update in 2009 incorporating prognostic factors. The treatment of vulvar carcinoma has evolved to include more conservative surgical techniques that provide improved cure rates with emphasis on minimizing morbidity. Advanced and metastatic lesions are now treated with chemoradiation which produces substantial cure rates with decreased morbidity. Promising areas of research in vulvar cancer include refinement of sentinel lymph node biopsy, prevention of lymphedema, and preservation of sexual function following treatment. PMID:25151473

  18. A brief assessment of physical functioning for prostate cancer patients

    Directory of Open Access Journals (Sweden)

    Jin-Shei Lai

    2010-06-01

    Full Text Available Jin-Shei Lai1, Rita Bode2, Hwee-Lin Wee3, David Eton4, David Cella11Department of Medical Social Sciences, 2Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, IL USA; 3Department of Pharmacy, National University of Singapore, Singapore; 4Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USAAbstract: We aimed to validate a more rapid, yet reliable means of assessing physical function (PF for patients with prostate cancer. The sample included 128 prostate cancer patients recruited from urology and general oncology clinics at two Chicago-area hospitals. The main outcome measures were: A 36-item PF item bank that included a 5-item short form (BriefPF and the 10-item PF subscale (PF-10 from the Medical Outcomes Study SF-36. Validity, information function, and relative precision (calculated using Rasch analysis and raw scores of the BriefPF were compared to the PF-10 and the full PF item bank. We found that the BriefPF and PF-10 were strongly correlated (r = 0.85 with the PF bank, and all three scales differentiated patients according to performance status (FPF bank(2,124 = 32.51 P < 0.001, FPF-10(2,121 = 27.35 P < 0.001, FBriefPF (2,123 = 38.40 P < 0.001. BriefPF has excellent precision relative to the PF-10 in measuring patients with different performance status levels. The Rasch-based information function indicated that the BriefPF was more informative than PF-10 in measuring moderate to higher functioning patients. Hence, the BriefPF offers a parsimonious and precise measure of PF for use among men with prostate cancer, and may aid in the timely inclusion of patient-reported outcomes in treatment decision-making.Keywords: quality-of-life, item bank, short-form, Medical Outcomes Study

  19. Employer-Based Disease Management Programs in Cancer: Experience to Date

    OpenAIRE

    Frederick C. Lee

    2004-01-01

    The cancer disease management field took root in the early 1990s. Health plans in the US seeking to aggressively manage cancer reached out to entrepreneurial start-ups that had infused the general principles of managed care into cancer programs. More than two dozen health plans had adopted some form of cancer disease management by the end of the century. However, employers, witnessing the managed care backlash and experiencing difficulty recruiting an adequate pool of skilled labor during flu...

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    Fatemeh Ghorbanalizadeh Ghaziani

    2013-03-01

    Full Text Available 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 together in conflict management strategies, and using cooperation strategy significantly as first preference, and using compromise, dominance, accommodation, and avoidance strategies as second preference in conflicts resolution; and demographic variables (age, work duration, interaction of age and work duration, study proof, study branch, interaction of study proof and study branch hadn’t effect on conflict management strategies preferences. In conclusion, however there were no significant difference between conflict management strategies preference of Mazandaran’s and Guilan’s managers and their assistant; but, it is important that the preference of both Mazandaran’s and Guilan’s managers is cooperation suggesting that the managers use good decision making and appropriate styles for resolution of employees’ problems in offices.

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

    NARCIS (Netherlands)

    Velthuis, Miranda J.; May, Anne M.; Koppejan-Rensenbrink, Ria A. G.; Gijsen, Brigitte C. M.; van Breda, Eric; de Wit, Ardine; Schroder, Carin D.; Monninkhof, Evelyn M.; Lindeman, Eline; van der Wall, Elsken; Peeters, Petra H. M.

    2010-01-01

    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

  3. Individualized management of advanced bladder cancer: Where do we stand?

    Science.gov (United States)

    Burgess, Earle F

    2015-04-01

    Despite recent progress in the development of novel targeted therapies in various malignancies, the management of advanced urothelial cancer has changed little over the past 2 decades. Comorbidities inherent to patients with bladder cancer often preclude the use of standard cisplatin-based chemotherapy and underscore the need for individualized treatment recommendations and the development of more effective therapies. This review discusses current issues relevant to the management of patients with locally advanced and metastatic urothelial carcinoma of the bladder and highlights recent advances in defining molecular aberrations that may ultimately lead to personalized therapeutic decision making. PMID:24332641

  4. 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.

    2015-01-01

    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

  5. Canadian recommendations for the management of breakthrough cancer pain

    Science.gov (United States)

    Daeninck, P.; Gagnon, B.; Gallagher, R.; Henderson, J.D.; Shir, Y.; Zimmermann, C.; Lapointe, B.

    2016-01-01

    Breakthrough cancer pain (btcp) represents an important element in the spectrum of cancer pain management. Because most btcp episodes peak in intensity within a few minutes, speed of medication onset is crucial for proper control. In Canada, several current provincial guidelines for the management of cancer pain include a brief discussion about the treatment of btcp; however, there are no uniform national recommendations for the management of btcp. That lack, accompanied by unequal access to pain medication across the country, contributes to both regional and provincial variability in the management of btcp. Currently, immediate-release oral opioids are the treatment of choice for btcp. This approach might not always offer optimal speed for onset of action and duration to match the rapid nature of an episode of btcp. Novel transmucosal fentanyl formulations might be more appropriate for some types of btcp, but limited access to such drugs hinders their use. In addition, the recognition of btcp and its proper assessment, which are crucial steps toward appropriate treatment selection, remain challenging for many health care professionals. To facilitate appropriate management of btcp, a group of prominent Canadian specialists in palliative care, oncology, and anesthesiology convened to develop a set of recommendations and suggestions to assist Canadian health care providers in the treatment of btcp and the alleviation of the suffering and discomfort experienced by adult cancer patients. PMID:27122974

  6. 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

  7. Colorectal Cancer Screening and Physical Activity Promotion Among Obese Women: An Online Evaluation of Targeted Messages

    OpenAIRE

    LEONE, LUCIA A.; Campbell, Marci K.; Allicock, Marlyn; Pignone, Michael

    2012-01-01

    Obese women are at higher risk for several cancers, but are less likely than normal weight women to engage in cancer prevention behaviors such as screening and physical activity. Targeted health messages may help increase healthy behaviors among vulnerable groups such as obese women. Using findings from focus groups with obese women, the authors created targeted messages to promote colorectal cancer screening and physical activity among obese women. The messages addressed psychosocial constru...

  8. Impact of self-reported physical activity and health promotion behaviors on lung cancer survivorship

    OpenAIRE

    Sloan, Jeff A.; Cheville, Andrea L.; Liu, Heshan; Novotny, Paul J; Wampfler, Jason A.; Garces, Yolanda I; Clark, Matthew M.; Yang, Ping

    2016-01-01

    Background There is some initial evidence that an enhanced physical activity level can improve fquality of life, and possibly survival among patients with lung cancer. The primary aim of this project was to evaluate the impact of physical activity on the quality and quantity of life of lung cancer survivors. Methods Between January 1, 1997, and December 31, 2009, a total of 1466 lung cancer survivors completed a questionnaire with patient-reported outcomes for quality of life (QOL), demograph...

  9. The role of physical activity in the prevention of breast and endometrial cancer

    OpenAIRE

    Moradi, Tahereh

    2000-01-01

    The aim of this thesis was to explore through epidemiologic studies the role of physical activity in preventing breast and endometrial cancer in women. First, we assessed risk for endometrial (Paper I) and breast (Paper II) cancer in relation to occupational physical activity in a large nationwide cohort generated through linkage between census data in 1960 and 1970 and the Cancer Register 1971-1989. We focused on women with the same level of estimated occupational physi...

  10. Newly diagnosed lung cancer patients' preferences for and beliefs about physical activity prior to chemotherapy.

    Science.gov (United States)

    Karvinen, Kristina H; Vallance, Jeff; Walker, Paul R

    2016-07-01

    Physical activity has been found to have a number of benefits for lung cancer patients yet very little information is available concerning physical activity beliefs and preferences for this population. The purpose of the study was to explore physical activity programming and counseling preferences and beliefs about physical activity in newly diagnosed lung cancer patients scheduled to receive chemotherapy. A total of 43 new diagnosed lung cancer patients completed a researcher-administered survey prior to commencing chemotherapy. Results indicated that only 7 participants (17%) reported meeting public health recommendations for physical activity yet the majority of participants (n = 28) indicated interest or possible interest in physical activity counseling. Many participants also indicated interest or possible interest in an exercise program (n = 29) for lung cancer survivors, preferring it to start during chemotherapy (n = 20), for it to be home based (n = 21), and moderate in intensity (n = 22). The most common behavioral belief (advantage) of physical activity was to build/maintain strength (n = 26) and the most common control belief (barrier) was fatigue (n = 11). These data suggest that physical activity counseling and programming may be well received by newly diagnosed lung cancer patients. Information about physical activity and programming preferences and beliefs from this study may be useful for the design of optimal physical activity interventions for lung cancer patients. PMID:26813963

  11. Physical therapy methods in the treatment and rehabilitation of cancer patients

    Science.gov (United States)

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

    2016-08-01

    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.

  12. Propolis in dentistry and oral cancer management

    Directory of Open Access Journals (Sweden)

    Vagish Kumar L S

    2014-01-01

    Full Text Available Propolis, known as bee glue, is a wax-cum-resin substance, which is created out of a mix of buds from some trees with the substance secreted from the bee′s glands. Its diverse chemical content is responsible for many valuable properties. Multiple applications of propolis have been studied and described in detail for centuries. However, currently available information on propolis is scarce. A literature search in the PubMed database was performed for English language articles, using the search terms propolis, oral health, dentistry, and oral cancer; no restrictions were used for publication dates. The aim of the article was to review propolis and its applications in dentistry including oral cancer.

  13. Adaptive Management of Liver Cancer Radiotherapy

    OpenAIRE

    Brock, Kristy K.; Dawson, Laura A.

    2010-01-01

    Adaptive radiation therapy for liver cancer has the potential to reduce normal tissue complications and enable dose escalation, allowing the potential for tumor control in this challenging site. Using adaptive techniques to tailor treatment margins to reflect patient specific breathing motions and image-guidance techniques can reduce the high dose delivered to surrounding normal tissues while ensuring the prescription dose is delivered to the tumor. Several treatment planning and delivery tec...

  14. Laparoscopic Fertility Sparing Management of Cervical Cancer

    OpenAIRE

    Chiara Facchini; Giuseppina Rapacchia; Giulia Montanari; Paolo Casadio; Gianluigi Pilu; Renato Seracchioli

    2014-01-01

    Fertility can be preserved after conservative cervical surgery. We report on a 29-year-old woman who was obese, para 0, and diagnosed with cervical insufficiency at the first trimester of current pregnancy due to a previous trachelectomy. She underwent laparoscopic transabdominal cervical cerclage (LTCC) for cervical cancer. The surgery was successful and she was discharged two days later. The patient underwent a caesarean section at 38 weeks of gestation. Laparoscopic surgery ...

  15. Diagnosis and Management of Hereditary Thyroid Cancer.

    Science.gov (United States)

    Bano, Gul; Hodgson, Shirley

    2016-01-01

    Thyroid cancers are largely divided into medullary (MTC) and non-medullary (NMTC) cancers , depending on the cell type of origin. Familial non-medullary thyroid cancer (FNMTC) comprises about 5-15% of NMTC and is a heterogeneous group of diseases, including both non-syndromic and syndromic forms. Non-syndromic FNMTC tends to manifest papillary thyroid carcinoma , usually multifocal and bilateral . Several high-penetrance genes for FNMTC have been identified, but they are often confined to a few or single families, and other susceptibility loci appear to play a small part, conferring only small increments in risk. Familial susceptibility is likely to be due to a combination of genetic and environmental influences. The current focus of research in FNMTC is to characterise the susceptibility genes and their role in carcinogenesis. FNMTC can also occur as a part of multitumour genetic syndromes such as familial adenomatous polyposis , Cowden's disease , Werner's syndrome and Carney complex . These tend to present at an early age and are multicentric and bilateral with distinct pathology. The clinical evaluation of these patients is similar to that for most patients with a thyroid nodule. Medullary thyroid cancer (MTC) arises from the parafollicular cells of the thyroid which release calcitonin. The familial form of MTC accounts for 20-25% of cases and presents as a part of the multiple endocrine neoplasia type 2 (MEN 2) syndromes or as a pure familial MTC (FMTC). They are caused by germline point mutations in the RET oncogene on chromosome 10q11.2. There is a clear genotype-phenotype correlation, and the aggressiveness of FMTC depends on the specific genetic mutation, which should determine the timing of surgery. PMID:27075347

  16. Capecitabine in the management of colorectal cancer

    OpenAIRE

    Hirsch BR; Zafar SY

    2011-01-01

    Bradford R Hirsch, S Yousuf ZafarDivision of Medical Oncology, Duke University Medical Center, Durham, NC, USAAbstract: 5-Fluorouracil has been a mainstay in the treatment of colorectal cancer for nearly five decades; however, the use of oral formulations of the medication has been gaining increasing traction since capecitabine was approved for use in adjuvant settings by the US Food and Drug Administration in 2005. The use of capecitabine has since spread to a number of off-label indications...

  17. Management perceptions of the Health Physics Technician job

    International Nuclear Information System (INIS)

    In 1984, an industry-wide job analysis of nuclear power reactor Health Physics Technicians (HPTs) was completed. These results provided the basis for job descriptions, industry-wide task listings and recommendations for task selections for further analysis and formal training. A total of 389 tasks were identified and reviewed by 850 HPTs representing 39 plants and 6 vendor companies. Constructive criticism of the HPT job analysis focused on the fact that HPT supervisors and managers were not included in the survey. Concerns were addressed that these supervisors/managers might have a divergent perception of the HPT job that could lead to different conclusions than those that were originally drawn. The only way to confirm (or deny) this hypothesis was to verify the results of the job analysis of HPTs by also surveying radiation protection management personnel. A total of 19 HPT supervisors/managers completed the same survey that had been used for HPT job incumbents. They were asked to rate each task on the basis of their job incumbents' performance of the task. Of the 1161 ratings (389 tasks each with a rating for frequency, difficulty, and importance), only 37 of the ratings differed between the HPTs and the HPT supervisors/managers (at the 99% confidence level)

  18. Application of Text Mining in Cancer Symptom Management.

    Science.gov (United States)

    Lee, Young Ji; Donovan, Heidi

    2016-01-01

    Fatigue continues to be one of the main symptoms that afflict ovarian cancer patients and negatively affects their functional status and quality of life. To manage fatigue effectively, the symptom must be understood from the perspective of patients. We utilized text mining to understand the symptom experiences and strategies that were associated with fatigue among ovarian cancer patients. Through text analysis, we determined that descriptors such as energetic, challenging, frustrating, struggling, unmanageable, and agony were associated with fatigue. Descriptors such as decadron, encourager, grocery, massage, relaxing, shower, sleep, zoloft, and church were associated with strategies to ameliorate fatigue. This study demonstrates the potential of applying text mining in cancer research to understand patients' perspective on symptom management. Future study will consider various factors to refine the results. PMID:27332415

  19. High-Risk Prostate Cancer : From Definition to Contemporary Management

    NARCIS (Netherlands)

    Bastian, Patrick J.; Boorjian, Stephen A.; Bossi, Alberto; Briganti, Alberto; Heidenreich, Axel; Freedland, Stephen J.; Montorsi, Francesco; Roach, Mack; Schroder, Fritz; van Poppel, Hein; Stief, Christian G.; Stephenson, Andrew J.; Zelefsky, Michael J.

    2012-01-01

    Context: High-risk prostate cancer (PCa) is a potentially lethal disease. It is clinically important to identify patients with high-risk PCa early on because they stand to benefit the most from curative therapy. Because of recent advances in PCa management, a multimodal approach may be advantageous.

  20. Perceptions of managers and Physical Education teachers on Key Competencies

    Directory of Open Access Journals (Sweden)

    David HORTIGÜELA ALCALÁ

    2015-05-01

    Full Text Available Results on the perception of the management teams and teachers of Physical Education (PE on Key Competencies (KC are presented in this paper. The sample used was 30 secondary schools, administering two categorically structured questionnaires and validated by an expert group. One was completed by the management teams and another for teachers of Physical Education (PE. The working methodology has been mixed, making a quantitative and qualitative study. In the first case we have carried out a descriptive analysis that includes frequencies and percentages of each of the variables in the questionnaires are structured. Regarding the inferential analyzes were used contingency tables and ?2. In connection with the qualitative methodology, has conducted a single case study in a school, using as instruments of data collection: interviews with teachers, daily scheduled class observation and discussion groups with students after the course. Most management teams of schools considered necessary to work the KC but show some reluctance due to: a lack of different proposals for implementation, b low awareness of teachers about their need and, c the widespread belief excessive time required. PE teachers claim that the work of the KC in the classroom can generate greater student learning and consistency in the assessment process, but it is clear the lack of organization and planning in the area to achieve this end.

  1. Usefulness of 18FDG PET in the management of cervical cancer

    International Nuclear Information System (INIS)

    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 18F-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 18F-fluorodeoxyglucose in the management of cervical cancer. (authors)

  2. Novel agents in the management of lung cancer.

    LENUS (Irish Health Repository)

    Kennedy, B

    2012-01-31

    Lung cancer is the leading cause of cancer death worldwide. Survival remains poor as approximately 80% of cases present with advanced stage disease. However, new treatments are emerging which offer hope to patients with advanced disease. Insights into cell biology have identified numerous intracellular and extracellular peptides that are pivotal in cancer cell signalling. Disrupting the function of these peptides inhibits intracellular signal transduction and diminishes uncontrolled proliferation, resistance to apoptosis and tumour angiogenesis. The most widely studied signalling pathway is the Epidermal Growth Factor (EGF) pathway. EGF signalling can be disrupted at numerous points. Blockade of the cell surface receptor is achieved by the monoclonal antibody cetuximab; intracellular tyrosine kinase activity is inhibited by erlotinib. Vascular Endothelial Growth Factor (VEGF) regulates another pathway important for tumour growth. Inhibition of VEGF impairs angiogenesis and disrupts metastatic spread. Bevacizumab is a monoclonal antibody that binds to VEGF and blocks interaction with its cell surface receptor. Clinical trials have demonstrated that disruption of these signalling pathways can improve survival in advanced lung cancer. New compounds including folate antimetabolites such as pemetrexed, proteasome inhibitors such as bortezomib, modified glutathione analogues such as TLK286, and other agents such as epothilones and other small molecules are currently being evaluated in patients with lung cancer. As more and more signalling peptides are targeted for manipulation, it is hoped that a new era is dawning in the treatment of advanced stage lung cancer. This review will focus on emerging new therapies in the management of lung cancer.

  3. Ovarian Cancer Management: The role of imaging and diagnostic challenges

    Energy Technology Data Exchange (ETDEWEB)

    Bharwani, Nishat, E-mail: nishat.bharwani@nhs.net [Barts and the London NHS Trust, London (United Kingdom); Reznek, Rodney H.; Rockall, Andrea G. [Barts and the London NHS Trust, London (United Kingdom)

    2011-04-15

    Worldwide, ovarian cancer accounts for 4% of all female cancers with over 190,000 new cases diagnosed each year. The incidence rates vary considerably across the globe with the highest rates seen in Europe and the USA and low rates in Africa and Asia. Ovarian cancer has been termed a 'silent' killer with the majority of patients presenting with advanced disease due to the vague, non-specific nature of the presenting symptoms such as abdominal discomfort and bloating in 50%. The most important determinant of survival for ovarian cancer patients is the disease stage at diagnosis. Therefore there is a thrust for early detection and two large screening trials are currently underway in the UK and USA. Ovarian cancer is most commonly staged using the International Federation of Gynecology and Obstetrics (FIGO) surgical-pathological staging system. Imaging findings are not a formal component of the staging system but in clinical practice they play a significant role in the diagnosis and management of suspected ovarian cancer. Adnexal masses which are shown to have benign features on imaging can undergo simple excision at a local unit by a non-oncological gynaecologist. If a mass has malignant characteristics on imaging, then a radical surgical approach is indicated and this should be performed by a gynaecological oncological surgeon at a specialist cancer centre, as optimal cytoreductive surgery has been reported to improve outcome. This review article discusses the role of various imaging modalities in the initial assessment of an adnexal mass, the contribution to management planning and to the follow-up of patients with ovarian cancer.

  4. Ovarian Cancer Management: The role of imaging and diagnostic challenges

    International Nuclear Information System (INIS)

    Worldwide, ovarian cancer accounts for 4% of all female cancers with over 190,000 new cases diagnosed each year. The incidence rates vary considerably across the globe with the highest rates seen in Europe and the USA and low rates in Africa and Asia. Ovarian cancer has been termed a 'silent' killer with the majority of patients presenting with advanced disease due to the vague, non-specific nature of the presenting symptoms such as abdominal discomfort and bloating in 50%. The most important determinant of survival for ovarian cancer patients is the disease stage at diagnosis. Therefore there is a thrust for early detection and two large screening trials are currently underway in the UK and USA. Ovarian cancer is most commonly staged using the International Federation of Gynecology and Obstetrics (FIGO) surgical-pathological staging system. Imaging findings are not a formal component of the staging system but in clinical practice they play a significant role in the diagnosis and management of suspected ovarian cancer. Adnexal masses which are shown to have benign features on imaging can undergo simple excision at a local unit by a non-oncological gynaecologist. If a mass has malignant characteristics on imaging, then a radical surgical approach is indicated and this should be performed by a gynaecological oncological surgeon at a specialist cancer centre, as optimal cytoreductive surgery has been reported to improve outcome. This review article discusses the role of various imaging modalities in the initial assessment of an adnexal mass, the contribution to management planning and to the follow-up of patients with ovarian cancer.

  5. Laparoscopic Fertility Sparing Management of Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Chiara Facchini

    2014-03-01

    Full Text Available Fertility can be preserved after conservative cervical surgery. We report on a 29-year-old woman who was obese, para 0, and diagnosed with cervical insufficiency at the first trimester of current pregnancy due to a previous trachelectomy. She underwent laparoscopic transabdominal cervical cerclage (LTCC for cervical cancer. The surgery was successful and she was discharged two days later. The patient underwent a caesarean section at 38 weeks of gestation. Laparoscopic surgery is a minimally invasive approach associated with less pain and faster recovery, feasible even in obese women.

  6. Laparoscopic fertility sparing management of cervical cancer.

    Science.gov (United States)

    Facchini, Chiara; Rapacchia, Giuseppina; Montanari, Giulia; Casadio, Paolo; Pilu, Gianluigi; Seracchioli, Renato

    2014-04-01

    Fertility can be preserved after conservative cervical surgery. We report on a 29-year-old woman who was obese, para 0, and diagnosed with cervical insufficiency at the first trimester of current pregnancy due to a previous trachelectomy. She underwent laparoscopic transabdominal cervical cerclage (LTCC) for cervical cancer. The surgery was successful and she was discharged two days later. The patient underwent a caesarean section at 38 weeks of gestation. Laparoscopic surgery is a minimally invasive approach associated with less pain and faster recovery, feasible even in obese women. PMID:24696772

  7. Surgery or physical activity in the management of sciatica

    DEFF Research Database (Denmark)

    Fernandez, Matthew; Ferreira, Manuela L; Refshauge, Kathryn M;

    2016-01-01

    PURPOSE: Previous reviews have compared surgical to non-surgical management of sciatica, but have overlooked the specific comparison between surgery and physical activity-based interventions. METHODS: Systematic review using MEDLINE, CINAHL, Embase and PEDro databases was conducted. Randomised...... controlled trials comparing surgery to physical activity, where patients were experiencing the three most common causes of sciatica-disc herniation, spondylolisthesis and spinal stenosis. Two independent reviewers extracted pain and disability data (converted to a common 0-100 scale) and assessed...... methodological quality using the PEDro scale. The size of the effects was estimated for each outcome at three different time points, with a random effects model adopted and the GRADE approach used in summary conclusions. RESULTS: Twelve trials were included. In the short term, surgery provided better outcomes...

  8. Advanced medullary thyroid cancer: pathophysiology and management

    International Nuclear Information System (INIS)

    Medullary thyroid carcinoma (MTC) is a rare malignant tumor originating from thyroid parafollicular C cells. This tumor accounts for 3%–4% of thyroid gland neoplasias. MTC may occur sporadically or be inherited. Hereditary MTC appears as part of the multiple endocrine neoplasia syndrome type 2A or 2B, or familial medullary thyroid cancer. Germ-line mutations of the RET proto-oncogene cause hereditary forms of cancer, whereas somatic mutations can be present in sporadic forms of the disease. The RET gene encodes a receptor tyrosine kinase involved in the activation of intracellular signaling pathways leading to proliferation, growth, differentiation, migration, and survival. Nowadays, early diagnosis of MTC followed by total thyroidectomy offers the only possibility of cure. Based on the knowledge of the pathogenic mechanisms of MTC, new drugs have been developed in an attempt to control metastatic disease. Of these, small-molecule tyrosine kinase inhibitors represent one of the most promising agents for MTC treatment, and clinical trials have shown encouraging results. Hopefully, the cumulative knowledge about the targets of action of these drugs and about the tyrosine kinase inhibitor-associated side effects will help in choosing the best therapeutic approach to enhance their benefits

  9. The use of database management systems in particle physics

    CERN Document Server

    Stevens, P H; Read, B J; Rittenberg, Alan

    1979-01-01

    Examines data-handling needs and problems in particle physics and looks at three very different efforts by the Particle Data Group (PDG) , the CERN-HERA Group in Geneva, and groups cooperating with ZAED in Germany at resolving these problems. The ZAED effort does not use a database management system (DBMS), the CERN-HERA Group uses an existing, limited capability DBMS, and PDG uses the Berkely Database Management (BDMS), which PDG itself designed and implemented with scientific data-handling needs in mind. The range of problems each group tried to resolve was influenced by whether or not a DBMS was available and by what capabilities it had. Only PDG has been able to systematically address all the problems. The authors discuss the BDMS- centered system PDG is now building in some detail. (12 refs).

  10. Sympathetic blocks for visceral cancer pain management

    DEFF Research Database (Denmark)

    Mercadante, Sebastiano; Klepstad, Pal; Kurita, Geana Paula; Sjogren, Per; Giarratano, Antonino

    2015-01-01

    The neurolytic blocks of sympathetic pathways, including celiac plexus block (CPB) and superior hypogastric plexus block (SHPB) , have been used for years. The aim of this review was to assess the evidence to support the performance of sympathetic blocks in cancer patients with abdominal visceral...... effects in comparison with a conventional analgesic treatment. In one study patients treated with superior hypogastric plexus block (SHPB) had a decrease in pain intensity and a less morphine consumption, while no statistical differences in adverse effects were found. The quality of these studies was...... generally poor due to several limitations, including sample size calculation, allocation concealment, no intention to treat analysis. However, at least two CPB studies were of good quality. Data regarding the comparison of techniques or other issues were sparse and of poor quality, and evidence could not be...

  11. Diagnosis and Management of Peritoneal Metastases from Ovarian Cancer

    Directory of Open Access Journals (Sweden)

    Evgenia Halkia

    2012-01-01

    Full Text Available The management and the outcome of peritoneal metastases or recurrence from epithelial ovarian cancer are presented. The biology and the diagnostic tools of EOC peritoneal metastasis with a comprehensive approach and the most recent literatures data are discussed. The definition and the role of surgery and chemotherapy are presented in order to focuse on the controversial points. Finally, the paper discusses the new data about the introduction of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC in the treatment of advanced epithelial ovarian cancer.

  12. Diagnosis and management of peritoneal metastases from ovarian cancer.

    Science.gov (United States)

    Halkia, Evgenia; Spiliotis, John; Sugarbaker, Paul

    2012-01-01

    The management and the outcome of peritoneal metastases or recurrence from epithelial ovarian cancer are presented. The biology and the diagnostic tools of EOC peritoneal metastasis with a comprehensive approach and the most recent literatures data are discussed. The definition and the role of surgery and chemotherapy are presented in order to focuse on the controversial points. Finally, the paper discusses the new data about the introduction of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of advanced epithelial ovarian cancer. PMID:22888339

  13. Thyroid Cancer: Burden of Illness and Management of Disease

    Directory of Open Access Journals (Sweden)

    Rebecca L. Brown, Jonas A. de Souza, Ezra EW Cohen

    2011-01-01

    Full Text Available Objective: The incidence of thyroid cancer, the most common endocrine malignancy, has increased dramatically in the last fifty years. This article will review the standard approach to thyroid cancer treatment as well as novel therapies under investigation. We will also address potential cost considerations in the management of thyroid cancer.Study Design: A comprehensive literature search was performed.Methods: Review article.Results: The high prevalence of thyroid cancer and the availability of novel therapies for patients with metastatic disease have potential economic implications that have not been well-studied. Because many patients likely have very low morbidity from their cancers, better tools to identify the lowest risk patients are needed in order to prevent overtreatment. Improved risk stratification should include recognizing patients who are unlikely to benefit from radioactive iodine therapy after initial surgery and identifying those with indolent and asymptomatic metastatic disease that are unlikely to benefit from novel therapies. In patients with advanced incurable disease, randomized-controlled studies to assess the efficacy of novel agents are needed to determine if the costs associated with new agents are warranted.Conclusions: Health care costs associated with the increased diagnosis of thyroid cancer remain unknown but are worthy of further research.

  14. Complexities of Adherence and Post-Cancer Lymphedema Management

    Directory of Open Access Journals (Sweden)

    Pamela L. Ostby

    2015-11-01

    Full Text Available Breast cancer survivors are at increased risk for breast cancer-related lymphedema (BCRL, a chronic, debilitating, condition that is progressive and requires lifelong self-management. Up to 40% of 3 million breast cancer survivors in the US will develop BCRL, which has no cure, is irreversible, and requires self-management with regimens that may include multiple components. The complexities of treatment can negatively affect adherence to BCRL self-management which is critical to preventing progressive swelling and infection. The aim of this review of contemporary literature published from 2005–2015 is to examine the complexities of BCRL self-management, to identify adherence-focused studies relevant to BCRL, and to summarize barriers to self-management of BCRL. Six electronic indices were searched from which 120 articles were retrieved; 17 were BCRL-focused; and eight met inclusion criteria. Seventeen of 120 articles identified barriers to self-management of BCRL such as complexities of treatment regimens, symptom burden, balance of time for treatment and life demands, and lack of education and support; however, only eight studies included outcome measures of adherence to BCRL treatment regimens with a subsequent improvement in reduced limb volumes and/or perceptions of self-efficacy and self-regulation. A major limitation is the few number of rigorously developed outcome measures of BCRL adherence. In addition, randomized studies are needed with larger sample sizes to establish adequate levels of evidence for establishing best practice standards for improving adherence to BCRL self-management treatment regimens.

  15. Complexities of Adherence and Post-Cancer Lymphedema Management.

    Science.gov (United States)

    Ostby, Pamela L; Armer, Jane M

    2015-01-01

    Breast cancer survivors are at increased risk for breast cancer-related lymphedema (BCRL), a chronic, debilitating, condition that is progressive and requires lifelong self-management. Up to 40% of 3 million breast cancer survivors in the US will develop BCRL, which has no cure, is irreversible, and requires self-management with regimens that may include multiple components. The complexities of treatment can negatively affect adherence to BCRL self-management which is critical to preventing progressive swelling and infection. The aim of this review of contemporary literature published from 2005-2015 is to examine the complexities of BCRL self-management, to identify adherence-focused studies relevant to BCRL, and to summarize barriers to self-management of BCRL. Six electronic indices were searched from which 120 articles were retrieved; 17 were BCRL-focused; and eight met inclusion criteria. Seventeen of 120 articles identified barriers to self-management of BCRL such as complexities of treatment regimens, symptom burden, balance of time for treatment and life demands, and lack of education and support; however, only eight studies included outcome measures of adherence to BCRL treatment regimens with a subsequent improvement in reduced limb volumes and/or perceptions of self-efficacy and self-regulation. A major limitation is the few number of rigorously developed outcome measures of BCRL adherence. In addition, randomized studies are needed with larger sample sizes to establish adequate levels of evidence for establishing best practice standards for improving adherence to BCRL self-management treatment regimens. PMID:26580657

  16. Soil physics and the water management of spatially variable soils

    International Nuclear Information System (INIS)

    The physics of macroscopic soil-water behaviour in inert porous materials has been developed by considering water flow to take place in a continuum. This requires the flow region to consist of an assembly of representative elementary volumes, repeated throughout space and small compared with the scale of observations. Soil-water behaviour in swelling soils may also be considered as a continuum phenomenon so long as the soil is saturated and swells and shrinks in the normal range. Macroscale heterogeneity superimposed on the inherent microscale heterogeneity can take many forms and may pose difficulties in the definition and measurement of soil physical properties and also in the development and use of predictive theories of soil-water behaviour. Thus, measurement techniques appropriate for uniform soils are often inappropriate, and criteria for soil-water management, obtained from theoretical considerations of behaviour in equivalent uniform soils, are not applicable without modification when there is soil heterogeneity. The spatial variability of soil-water properties is shown in results from field experiments concerned with water flow measurements; these illustrate both stochastic and deterministic heterogeneity in soil-water properties. Problems of water management of spatially variable soils when there is stochastic heterogeneity appear to present an insuperable problem in the application of theory. However, for soils showing deterministic heterogeneity, soil-water theory has been used in the solution of soil-water management problems. Thus, scaling using similar media theory has been applied to the infiltration of water into soils that vary over a catchment area. Also, the drain spacing to control the water-table height in soils in which the hydraulic conductivity varies with depth has been calculated using groundwater seepage theory. (author)

  17. Knowledge management: High energy physics as model case

    International Nuclear Information System (INIS)

    Full text: The world-wide High Energy Physics (HEP) community has emerged as one of the major forces in developing new tools and concepts to enhance the overall quality of knowledge management and to support technological innovation in this field. Though joint research and academic activities in HEP represent a more than 50-years old tradition, collaboration in this field has changed over the decades. In coming years, bigger and more distributed than ever before collaborations, with several thousand physicists and engineers, will concentrate on fewer major HEP experiments. They will face unprecedented challenges to accomplish their work at the leading laboratories where large accelerators are being constructed. These challenges arise primarily from the rapidly increasing size and complexity of datasets to be collected and the enormous computational, storage and networking resources to be deployed by global collaborations in order to process, distribute and analyze information. During the last two decades, the Web was HEP community response to the new wave of scientific collaborations. Almost all data networking in the HEP community is today based on the Internet which has since grown into a global information highway. Currently, HEP community needs to attempt to progress beyond structure information towards automated knowledge management of scientific data which requires extremely capable computing infrastructures supporting several key areas. Together with computer scientists, HEP community recognised as a driving force, is extremely well positioned to continue this successful strategy with respect to the initiative to build 'the next generation internet'. Facing knowledge sharing, acquisition and organisation growing requirement, HEP scientists invented the preprint concept in order to facilitate and speed up access to the ongoing research development and results. Preprint archive has since become a global repository for research particularly in physics

  18. Knowledge management: High energy physics as model case

    International Nuclear Information System (INIS)

    Full text: The worldwide High Energy Physics (HEP) community has emerged as one of the major forces in developing new tools and concepts to enhance the overall quality of knowledge management and to support technological innovation in this field. Though joint research and academic activities in HEP represent a more than 50-years old tradition, collaboration in this field has changed over the decades. In coming years, bigger and more distributed than ever before collaborations, with several thousand physicists and engineers, will concentrate on fewer major HEP experiments. They will face unprecedented challenges to accomplish their work at the leading laboratories where large accelerators are being constructed. These challenges arise primarily from the rapidly increasing size and complexity of datasets to be collected and the enormous computational, storage and networking resources to be deployed by global collaborations in order to process, distribute and analyze information. During the last two decades, the Web was HEP community response to the new wave of scientific collaborations. Almost all data networking in the HEP community is today based on the Internet, which has since grown into a global information highway. Currently, HEP community needs to attempt to progress beyond structure information towards automated knowledge management of scientific data which requires extremely capable computing infrastructures supporting several key areas. Together with computer scientists, HEP community recognized as a driving force, is extremely well positioned to continue this successful strategy with respect to the initiative to build 'the next generation internet'. Facing knowledge sharing, acquisition and organization growing requirement, HEP scientists invented the preprint concept in order to facilitate and speed up access to the ongoing research development and results. Preprint archive has since become a global repository for research particularly in physics

  19. Nutrition and Physical Activity in Aging, Obesity, and Cancer

    OpenAIRE

    Hursting, Stephen D.; Dunlap, Sarah M.

    2012-01-01

    Obesity is an established risk and progression factor for many cancers. In the United States more than one-third of adults, and nearly one in five children, are currently obese. Thus, a better understanding of the mechanistic links between obesity and cancer is urgently needed to identify intervention targets and strategies to offset the procancer effects of obesity. This review synthesizes the evidence on key biological mechanisms underlying the obesity–cancer association, with particular em...

  20. Introduction to managing patients with recurrent ovarian cancer.

    Science.gov (United States)

    Gabra, Hani

    2014-12-01

    Ovarian cancer is the 5th most common cancer found in women in the UK. It is the leading cause of death from gynaecological cancer, and is the 4th most common cause of cancer death among UK women. Similar to the majority of other cancers, relative survival rates for ovarian cancer are improving, although 5-year mortality rates remain stubbornly low. The stage of the disease at diagnosis is the single most important determinant of ovarian cancer survival, as many patients first present with advanced disease. Treatment of ovarian cancer involves a combination of 'upfront' primary surgery followed by chemotherapy. Platinum/taxane-based chemotherapy is the recommended standard-of-care first-line chemotherapy, but the majority of patients will relapse with drug-resistant disease within 3-5 years. However, not all patients can continue with platinum combination therapies due to loss of activity or toxicity-related issues, including hypersensitivity, neurotoxicity, alopecia and ototoxicity. Therefore the choice of second-line chemotherapy must take into account factors such as platinum-free treatment interval (PFI); patient's performance status; current symptoms; history of and likely future toxicities while on chemotherapy; dosing schedule requirement; and cost of treatment. A consensus in 2010 established 4 distinct subgroups within the ROC patient population based on the PFI: (platinum sensitive <12 months, partially platinum sensitive 6-12 months, platinum resistant <6 months, and refractory disease ≤4 weeks). Within patients with platinum sensitive disease, those with partially platinum sensitive disease remain the most clinically challenging to manage effectively. Non-platinum based combination therapies, in particular trabectedin with pegylated liposomal doxorubicin (PLD), offers new options together with a significant survival advantage relative to PLD alone for these patients. PMID:26759525

  1. Introduction to managing patients with recurrent ovarian cancer

    Directory of Open Access Journals (Sweden)

    Hani Gabra

    2014-12-01

    Full Text Available Ovarian cancer is the 5th most common cancer found in women in the UK. It is the leading cause of death from gynaecological cancer, and is the 4th most common cause of cancer death among UK women. Similar to the majority of other cancers, relative survival rates for ovarian cancer are improving, although 5-year mortality rates remain stubbornly low. The stage of the disease at diagnosis is the single most important determinant of ovarian cancer survival, as many patients first present with advanced disease. Treatment of ovarian cancer involves a combination of ‘upfront’ primary surgery followed by chemotherapy. Platinum/taxane-based chemotherapy is the recommended standard-of-care first-line chemotherapy, but the majority of patients will relapse with drug-resistant disease within 3-5 years. However, not all patients can continue with platinum combination therapies due to loss of activity or toxicity-related issues, including hypersensitivity, neurotoxicity, alopecia and ototoxicity. Therefore the choice of second-line chemotherapy must take into account factors such as platinum-free treatment interval (PFI; patient's performance status; current symptoms; history of and likely future toxicities while on chemotherapy; dosing schedule requirement; and cost of treatment. A consensus in 2010 established 4 distinct subgroups within the ROC patient population based on the PFI: (platinum sensitive <12 months, partially platinum sensitive 6-12 months, platinum resistant <6 months, and refractory disease ≤4 weeks. Within patients with platinum sensitive disease, those with partially platinum sensitive disease remain the most clinically challenging to manage effectively. Non-platinum based combination therapies, in particular trabectedin with pegylated liposomal doxorubicin (PLD, offers new options together with a significant survival advantage relative to PLD alone for these patients.

  2. 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. PMID:21765263

  3. Serum thyroglobulin in management of thyroid cancer

    International Nuclear Information System (INIS)

    Serum thyroglobulin (Tg) levels were evaluated before surgery in 36 patients having primary carcinoma of the thyroid and in 603 follow-up patients having differentiated thyroid carcinoma. Serum Tg was elevated in 88.85% of the patients before operation. Amongst the 603 patients analysed, 67 had residual thyroid tissue in the neck region, 259 showed the presence of disease and 277 were free of disease. The false positive rate obtained by serum Tg determination in the disease free group was 14.1% while the false negative rate in the group with disease was 11.7%, making the sensitivity and specificity of serum Tg determination 88.3% and 85.9%, respectively. The median serum Tg levels in patients with metastatic spread in nodes, lungs and bones were 127,581 and 1721 ng/mL, respectively. A comparative analysis of serum Tg determination and whole body radioiodine scanning in 244 patients showed the sensitivity to be 88.5% and 80.7%, respectively. The detection rate was increased to 95.1% by combining both modalities. Serum Tg determination appeared to be more sensitive than whole body scanning. The evaluation of serum Tg determination while patients were on thyroid hormone therapy and in a hypothyroid state indicated that though the sensitivity of detection of cancer increased in the hypothyroid state, this advantage appeared to be marginal in comparison with the morbidity and with the cost effectiveness of whole body radioiodine scanning. (author)

  4. An Implementation Study to Improve Cancer Pain Management in Jordan Using a Case Study

    OpenAIRE

    Al Qadire, Mohammad

    2011-01-01

    An Implementation Study to Improve Cancer Pain Management in Jordan using a Case StudyManaging the symptoms of cancer effectively is one of the most important challenges facing health care providers. Many symptoms are reported by cancer patients, including, pain, depression, distress and change in life style. Pain continues to be the most frequently reported symptom, however, cancer pain is treated inadequately and cancer patients continue to suffer pain. The use of pain assessment tools is e...

  5. Integrative therapies in cancer: modulating a broad spectrum of targets for cancer management.

    Science.gov (United States)

    Block, Keith I; Block, Penny B; Gyllenhaal, Charlotte

    2015-03-01

    Integrative medicine is an approach to health and healing that "makes use of all appropriate therapeutic approaches, health care professionals, and disciplines to achieve optimal health and healing." A comprehensive integrative medicine intervention for cancer patients typically includes nutritional counseling, biobehavioral strategies, and promotion of physical activity, as well as dietary supplements including herbs, nutraceuticals, and phytochemicals. A broad-spectrum intervention of this type may contribute uniquely to improvement in cancer outcomes through its impact on a wide variety of relevant molecular targets, including effects on multiple cancer hallmarks. Hallmarks that may be particularly affected include genetic instability, tumor-promoting inflammation, deregulated metabolism, and immune system evasion. Because of their susceptibility to manipulation by diet, exercise, and supplementation, these may be characterized as metabolic hallmarks. Research on the use of comprehensive integrative approaches can contribute to the development of systems of multitargeted treatment regimens and would help clarify the combined effect of these approaches on cancer outcomes. PMID:25601968

  6. Esophageal cancer management controversies: Radiation oncology point of view

    Institute of Scientific and Technical Information of China (English)

    Patricia; Tai; Edward; Yu

    2014-01-01

    Esophageal cancer treatment has evolved from single modality to trimodality therapy.There are some controversies of the role,target volumes and dose of radiotherapy(RT)in the literature over decades.The present review focuses primarily on RT as part of the treatment modalities,and highlight on the RT volume and its dose in the management of esophageal cancer.The randomized adjuvant chemoradiation(CRT)trial,intergroup trial(INT 0116)enrolled 559 patients with resected adenocarcinoma of the stomach or gastroesophageal junction.They were randomly assigned to surgery plus postoperative CRT or surgery alone.Analyses show robust treatment benefit of adjuvant CRT in most subsets for postoperative CRT.The Chemoradiotherapy for Oesophageal Cancer Followed by Surgery Study(CROSS)used a lower RT dose of41.4 Gray in 23 fractions with newer chemotherapeutic agents carboplatin and paclitaxel to achieve an excellent result.Target volume of external beam radiation therapy and its coverage have been in debate for years among radiation oncologists.Pre-operative and postoperative target volumes are designed to optimize for disease control.Esophageal brachytherapy is effective in the palliation of dysphagia,but should not be given concomitantly with chemotherapy or external beam RT.The role of brachytherapy in multimodality management requires further investigation.On-going studies of multidisciplinary treatment in locally advanced cancer include:ZTOG1201 trial(a phaseⅡtrial of neoadjuvant and adjuvant CRT)and QUINTETT(a phaseⅢtrial of neoadjuvant vs adjuvant therapy with quality of life analysis).These trials hopefully will shed more light on the future management of esophageal cancer.

  7. Principles and management of adrenal cancer

    International Nuclear Information System (INIS)

    This book provides information on adrenal diseases of latest developments and guides the clinicians in the care of their patients. The book is divided into two parts. The first section gives an overview of the embryology, anatomy, physiology, markers, pathology, imaging and the current progress in the field. The second edition covers specific diseases of the adrenal cortex and medulla. The increasingly significant roles played by steroids, catecholamines, blockers, computed tomography and magnetic resonance are elucidated and discussed. The contents include: Overview of progress; current problems, and perspectives - embryology anatomy, physiology, and biologic markers; pathology; advances in diagnosis; imaging techniques; adrenal disorders in childhood; primary aldosteronism; Cushing's syndrome; carcinoma; pheochromocytoma; neuroblastoma; metastatic disease; surgical management; and subject index

  8. Surveillance recommendations in reducing risk of and optimally managing breast cancer-related lymphedema.

    Science.gov (United States)

    Ostby, Pamela L; Armer, Jane M; Dale, Paul S; Van Loo, Margaret J; Wilbanks, Cassie L; Stewart, Bob R

    2014-01-01

    Breast cancer survivors are at increased risk for the development of breast cancer-related lymphedema (BCRL), a chronic, debilitating, and disfiguring condition that is progressive and requires lifelong self-management of symptoms. It has been reported that over 40% of the 2.5 million breast cancer survivors in the United States may meet the criteria for BCRL during their lifetimes. Ongoing surveillance, beginning with pre-operative assessment, has been effective in identifying subclinical lymphedema (LE). A prospective model for surveillance is necessary in order to detect BCRL at an early stage when there is the best chance to reduce risk or slow progression. Physical methods for monitoring and assessment, such as circumferential arm measures, perometry, bioimpedance; exercise programs; prophylactic and early-intervention compression garments; and referral for complete decongestive therapy are all interventions to consider in the development of a BCRL surveillance program. In addition, supportive-educative programs and interactive engagement for symptom self-management should also be implemented. The importance of interdisciplinary collaboration is integral to the success of an effective personalized medicine program in breast cancer-related lymphedema surveillance. PMID:25563360

  9. Surveillance Recommendations in Reducing Risk of and Optimally Managing Breast Cancer-Related Lymphedema

    Directory of Open Access Journals (Sweden)

    Pamela L. Ostby

    2014-08-01

    Full Text Available Breast cancer survivors are at increased risk for the development of breast cancer-related lymphedema (BCRL, a chronic, debilitating, and disfiguring condition that is progressive and requires lifelong self-management of symptoms. It has been reported that over 40% of the 2.5 million breast cancer survivors in the United States may meet the criteria for BCRL during their lifetimes. Ongoing surveillance, beginning with pre-operative assessment, has been effective in identifying subclinical lymphedema (LE. A prospective model for surveillance is necessary in order to detect BCRL at an early stage when there is the best chance to reduce risk or slow progression. Physical methods for monitoring and assessment, such as circumferential arm measures, perometry, bioimpedance; exercise programs; prophylactic and early-intervention compression garments; and referral for complete decongestive therapy are all interventions to consider in the development of a BCRL surveillance program. In addition, supportive-educative programs and interactive engagement for symptom self-management should also be implemented. The importance of interdisciplinary collaboration is integral to the success of an effective personalized medicine program in breast cancer-related lymphedema surveillance.

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

    OpenAIRE

    de Wit G Ardine; van Breda Eric; Gijsen Brigitte CM; Koppejan-Rensenbrink Ria AG; May Anne M; Velthuis Miranda J; Schröder Carin D; Monninkhof Evelyn M; Lindeman Eline; van der Wall Elsken; Peeters Petra HM

    2010-01-01

    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 p...

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

    OpenAIRE

    Velthuis, Miranda J.; May, Anne M.; Koppejan-Rensenbrink, Ria AG; Gijsen, Brigitte CM; van Breda, Eric; de Wit, G. Ardine; Schröder, Carin D; Monninkhof, Evelyn M.; Lindeman, Eline; van der Wall, Elsken; Peeters, Petra HM

    2010-01-01

    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 ai...

  12. Physical Activity and Gastrointestinal Cancers: Primary and Tertiary Preventive Effects and Possible Biological Mechanisms

    OpenAIRE

    Karen Steindorf; Dorothea Clauss; Joachim Wiskemann; Schmidt, Martina E

    2015-01-01

    Gastrointestinal cancers account for 37% of all cancer deaths worldwide, underlining the need to further investigate modifiable factors for gastrointestinal cancer risk and prognosis. This review summarizes the corresponding evidence for physical activity (PA), including, briefly, possible biological mechanisms. Despite high public health relevance, there is still a scarcity of studies, especially for tertiary prevention. Besides the convincing evidence of beneficial effects of PA on colon ca...

  13. An update in breast cancer screening and management.

    Science.gov (United States)

    Warrier, Sanjay; Tapia, Grace; Goltsman, David; Beith, Jane

    2016-03-01

    This article provides an overview of the main controversies in a number of key areas of breast cancer management. Relevant studies that have contributed to guide the treatment of this heterogeneous disease in the field of breast screening, surgery, chemotherapy and radiotherapy are highlighted. Mammography and ultrasound are the main methods of breast screening. MRI and tomosynthesis are emerging as new screening tools for a selected group of breast cancer patients. From a surgical perspective, oncoplastic techniques and neoadjuvant chemotherapy are improving cosmetic results in breast-conserving surgery. For high-risk patients, controversies still remain regarding prophylactic mastectomies. Finally, the appropriate management of the axilla continues evolving with the increasing role of radiotherapy as an alternative treatment to axillary dissection. PMID:26689336

  14. Research Strategies for Nutritional and Physical Activity Epidemiology and Cancer Prevention

    Science.gov (United States)

    In response to a series of controversial articles about nutritional epidemiology and cancer published in 2014, staff from the Environmental Epidemiology Branch initiated a series of meetings to refine programmatic priorities for human nutrition/physical activity and cancer etiology research in the near term.

  15. Development and Evaluation of a Theory-Based Physical Activity Guidebook for Breast Cancer Survivors

    Science.gov (United States)

    Vallance, Jeffrey K.; Courneya, Kerry S.; Taylor, Lorian M.; Plotnikoff, Ronald C.; Mackey, John R.

    2008-01-01

    This study's objective was to develop and evaluate the suitability and appropriateness of a theory-based physical activity (PA) guidebook for breast cancer survivors. Guidebook content was constructed based on the theory of planned behavior (TPB) using salient exercise beliefs identified by breast cancer survivors in previous research. Expert…

  16. Physical activity and risk of ovarian cancer: Results from the Netherlands Cohort Study (The Netherlands)

    NARCIS (Netherlands)

    Biesma, R.G.; Schouten, L.J.; Dirx, M.J.M.; Goldbohm, R.A.; Brandt, P.A. van den

    2006-01-01

    Objective: To investigate the association between nonoccupational physical activity and the risk of ovarian cancer among post-menopausal women. Methods: The Netherlands Cohort Study on Diet and Cancer consists of 62,573 women aged 55-69 years at baseline. Information regarding baseline nonoccupation

  17. Nuclear medicine in thyroid cancer management: A practical approach

    International Nuclear Information System (INIS)

    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 (131I) 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

  18. Parents’ Perceptions of Skin Cancer Threat and Children’s Physical Activity

    OpenAIRE

    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

    Introduction 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. Methods This is a cross-sectional analysis nested within the Colorado Kids Sun Care Program sun safety intervention trial. In summer 2007, parent telephone intervie...

  19. Impact of healthy eating practices and physical activity on quality of life among breast cancer survivors.

    Science.gov (United States)

    Mohammadi, Shooka; Sulaiman, Suhaina; Koon, Poh Bee; Amani, Reza; Hosseini, Seyed Mohammad

    2013-01-01

    Following breast cancer diagnosis, women often attempt to modify their lifestyles to improve their health and prevent recurrence. These behavioral changes typically involve diet and physical activity modification. The aim of this study was to determine association between healthy eating habits and physical activity with quality of life among Iranian breast cancer survivors. A total of 100 Iranian women, aged between 32 to 61 years were recruited to participate in this cross-sectional study. Eating practices were evaluated by a validated questionnaire modified from the Women's Healthy Eating and Living (WHEL) study. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). A standardized questionnaire by the European Organization of Research and Treatment of Cancer Quality of Life and its breast cancer module (EORTC QLQ-C30/+BR-23) were applied to determine quality of life. Approximately 29% of the cancer survivors were categorized as having healthy eating practices, 34% had moderate eating practices and 37% had poor eating practices based on nutrition guidelines. The study found positive changes in the decreased intake of fast foods (90%), red meat (70%) and increased intake of fruits (85%) and vegetables (78%). Generally, breast cancer survivors with healthy eating practices had better global quality of life, social, emotional, cognitive and role functions. Result showed that only 12 women (12%) met the criteria for regular vigorous exercise, 22% had regular moderate-intensity exercise while the majority (65%) had low-intensity physical activity. Breast cancer survivors with higher level of physical activity had better emotional and cognitive functions. Healthy eating practices and physical activity can improve quality of life of cancer survivors. Health care professionals should promote good dietary habits and physical activity to improve survivors' health and quality of life. PMID:23534778

  20. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective

    OpenAIRE

    Marmot, M; Atinmo, T.; Byers, T; Chen, J; Hirohata, T.; A. Jackson; James, W; Kolonel, L.; Kumanyika, S.; Leitzmann, C.; Mann, J.; Powers, H.; Reddy, K.; Riboli, E.; Rivera, J. A.

    2007-01-01

    This Report has a number of inter-related general purposes. One is to explore the extent to which food, nutrition, physical activity, and body composition modify the risk of cancer, and to specify which factors are most important. To the extent that environmental factors such as food, nutrition, and physical activity influence the risk of cancer, it is a preventable disease. The Report specifies recommendations based on solid evidence which, when followed, will be expected to reduce the incid...

  1. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a global perspective

    OpenAIRE

    Veer, van 't, M.B.; Kampman, E.

    2007-01-01

    This Report has a number of inter-related general purposes. One is to explore the extent to which food, nutrition, physical activity, and body composition modify the risk of cancer, and to specify which factors are most important. To the extent that environmental factors such as food, nutrition, and physical activity influence the risk of cancer, it is a preventable disease. The Report specifies recommendations based on solid evidence which, when followed, will be expected to reduce the incid...

  2. Optimal management of bone metastases in breast cancer patients

    Directory of Open Access Journals (Sweden)

    Wong MH

    2011-05-01

    Full Text Available MH Wong, N PavlakisDepartment of Medical Oncology, Royal North Shore Hospital, Sydney, NSW, AustraliaAbstract: Bone metastasis in breast cancer is a significant clinical problem. It not only indicates incurable disease with a guarded prognosis, but is also associated with skeletal-related morbidities including bone pain, pathological fractures, spinal cord compression, and hypercalcemia. In recent years, the mechanism of bone metastasis has been further elucidated. Bone metastasis involves a vicious cycle of close interaction between the tumor and the bone microenvironment. In patients with bone metastases, the goal of management is to prevent further skeletal-related events, manage complications, reduce bone pain, and improve quality of life. Bisphosphonates are a proven therapy for the above indications. Recently, a drug of a different class, the RANK ligand antibody, denosumab, has been shown to reduce skeletal-related events more than the bisphosphonate, zoledronic acid. Other strategies of clinical value may include surgery, radiotherapy, radiopharmaceuticals, and, of course, effective systemic therapy. In early breast cancer, bisphosphonates may have an antitumor effect and prevent both bone and non-bone metastases. Whilst two important Phase III trials with conflicting results have led to controversy in this topic, final results from these and other key Phase III trials must still be awaited before a firm conclusion can be drawn about the use of bisphosphonates in this setting. Advances in bone markers, predictive biomarkers, multi-imaging modalities, and the introduction of novel agents have ushered in a new era of proactive management for bone metastases in breast cancer.Keywords: breast cancer, bone metastases, bisphosphonates, denosumab, biomarkers, optimal management

  3. Diagnosis and Management of Peritoneal Metastases from Ovarian Cancer

    OpenAIRE

    Evgenia Halkia; John Spiliotis; Paul Sugarbaker

    2012-01-01

    The management and the outcome of peritoneal metastases or recurrence from epithelial ovarian cancer are presented. The biology and the diagnostic tools of EOC peritoneal metastasis with a comprehensive approach and the most recent literatures data are discussed. The definition and the role of surgery and chemotherapy are presented in order to focuse on the controversial points. Finally, the paper discusses the new data about the introduction of cytoreductive surgery and hyperthermic intraper...

  4. The team approach in the management of oral cancer.

    OpenAIRE

    Rapidis, A. D.; Angelopoulos, A. P.; Langdon, J. D.

    1980-01-01

    The management of cancer of the head and neck is so complex that it demands the participation of two teams, one major or curative and the other minor or supportive, and also of the patient. The make-up of these teams and the functions of their members are discussed. The principles of treatment planning along these lines are outlined and the importance of close interdisciplinary collaboration is emphasised.

  5. Integrating new imaging modalities in breast cancer management

    OpenAIRE

    Pouw, B.

    2016-01-01

    This thesis aimed to integrate new imaging modalities in breast cancer management. In Part 1 the focus was to assess the current status of radioactive seed localisation (RSL) in clinical practice. Both patients as well as physicians or surgeons rated the technique superior compared to the conventional techniques. It is our expectation that when legislation is simplified and standard protocols for this procedure are available the adaptation rate of this procedure will further increase since le...

  6. [Prevention and management of appetite loss during cancer chemotherapy].

    Science.gov (United States)

    Tsujimura, Hideki; Yamada, Mitsugi; Asako, Eri; Kodama, Yukako; Sato, Tsuneo; Nabeya, Yoshihiro

    2014-10-01

    Appetite loss during cancer chemotherapy may lead to malnutrition and a decreased quality of life. To overcome this problem, evidence-based guidelines have been established for chemotherapy-induced emesis and mucositis. However, unsolved issues such as taste alimentation remain. Since the clinical picture of appetite loss is complex, individual management strategies depending on the type of the disease and treatment are required. PMID:25335699

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

    Directory of Open Access Journals (Sweden)

    Sohee Park

    Full Text Available BACKGROUND: 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. METHODOLOGY/PRINCIPAL FINDINGS: 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. CONCLUSIONS/SIGNIFICANCE: 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.

  8. The management of localized and locally advanced prostate cancer - 1995

    International Nuclear Information System (INIS)

    Purpose/Objectives: The intent of this course is to review the issues involved in the management of non-metastatic adenocarcinoma of the prostate. - The value of pre-treatment prognostic factors including stage, grade and PSA value will be presented, and their value in determining therapeutic strategies will be discussed. - Controversies involving the simulation process and treatment design will be presented. The value of CT scanning, Beams-Eye View, 3-D planning, intravesicle, intraurethral and rectal contrast will be presented. The significance of prostate and patient movement and strategies for dealing with them will be presented. - The management of low stage, low to intermediate grade prostate cancer will be discussed. The dose, volume and timing of irradiation will be discussed as will the role of neo-adjuvant hormonal therapy, neutron irradiation and brachy therapy. The current status of radical prostatectomy and cryotherapy will be summarized. - Treatment of locally advanced, poorly differentiated prostate cancer will be presented including a discussion of neo-adjuvant and adjuvant hormones, dose-escalation and neutron irradiation. - Strategies for post-radiation failures will be presented including data on cryotherapy, salvage prostatectomy and hormonal therapy (immediate, delayed and/or intermittent). New areas for investigation will be reviewed. - The management of patients post prostatectomy will be reviewed. Data on adjuvant radiation and therapeutic radiation for biochemical or clinically relapsed patients will be presented. This course hopes to present a realistic and pragmatic overview for treating patients with non-metastatic prostatic cancer

  9. Management of menopause in women with breast cancer.

    Science.gov (United States)

    Vincent, A J

    2015-10-01

    Increasing breast cancer incidence and decreasing mortality have highlighted the importance of survivorship issues related to breast cancer. A consideration of the issues related to menopause is therefore of great importance to both women and clinicians. Menopause/menopausal symptoms, with significant negative effects on quality of life and potential long-term health impacts, may in women with breast cancer be associated with: (1) natural menopause occurring concurrently with a breast cancer diagnosis; (2) recurrence of menopausal symptoms following cessation of hormone replacement therapy; (3) treatment-induced menopause (chemotherapy, ovarian ablation/suppression) and adjuvant endocrine therapy. A variety of non-hormonal pharmacological and non-pharmacological therapies have been investigated as therapeutic options for menopausal symptoms with mixed results, and ongoing research is required. This review presents a summary of the causes, common problematic symptoms of menopause (vasomotor, genitourinary and sexual dysfunction), and longer-term consequences (cardiovascular disease and osteoporosis) related to menopause. It proposes an evidenced-based multidisciplinary approach to the management of menopause/menopausal symptoms in women with breast cancer. PMID:25536007

  10. Evaluation of degarelix in the management of prostate cancer

    Directory of Open Access Journals (Sweden)

    Hendrik Van Poppel

    2010-01-01

    Full Text Available Hendrik Van PoppelDepartment of Urology, University Hospitals Leuven, Campus Gasthuisberg, Leuven, BelgiumAbstract: Medical castration using gonadotropin-releasing hormone (GnRH receptor agonists currently provides the mainstay of androgen deprivation therapy for prostate cancer. Although effective, these agents only reduce testosterone levels after a delay of 14 to 21 days; they also cause an initial surge in testosterone that can stimulate the cancer and lead to exacerbation of symptoms (“clinical flare” in patients with advanced disease. Phase III trial data for the recently approved GnRH receptor blocker, degarelix, demonstrated that it is as effective and well tolerated as GnRH agonists. However, it has a pharmacological profile more closely matching orchiectomy, with an immediate onset of action and faster testosterone and PSA suppression, without a testosterone surge or microsurges following repeated injections. As a consequence, with this GnRH blocker, there is no risk of clinical flare and no need for concomitant antiandrogen flare protection. Degarelix therefore provides a useful addition to the hormonal armamentarium for prostate cancer and offers a valuable new treatment option for patients with hormone-sensitive advanced disease. Here, we review key preclinical and clinical data for degarelix, and look at patient-focused perspectives in the management of prostate cancer.Keywords: degarelix, GnRH receptor antagonist, GnRH receptor blocker, prostate cancer

  11. Role of radiation therapy in lung cancer management - a review.

    Science.gov (United States)

    Shi, J-G; Shao, H-J; Jiang, F-E; Huang, Y-D

    2016-07-01

    Lung cancer is the leading cause of cancer death worldwide. Furthermore, more than 50% of lung cancer patients are found affected by distant metastases at the time of diagnosis. On the other hand, 20% of these patients are without regional spread and are good candidates for surgical operation. The remaining 30% represent an intermediate group whose tumors have metastasized up to regional lymph nodes. These remain 30% are the most appropriate candidates for radiation therapy. These patients are also called as "locally advanced lung cancer" or stage III lung cancer patients. In these patients strategy of combination therapy viz. radiation therapy in combination with chemotherapy is also tried by various groups in the recent past for this better management. However, long-term survival is still poor with a 5-year survival in 5-25% of patients. During the last decades, there has been a development in radiation strategies. The present review article focuses on different approaches to optimize radiotherapy for these patients. PMID:27466995

  12. The possibility of clinical sequencing in the management of cancer.

    Science.gov (United States)

    Kou, Tadayuki; Kanai, Masashi; Matsumoto, Shigemi; Okuno, Yasushi; Muto, Manabu

    2016-05-01

    Comprehensive genomic profiling using next-generation sequencing technologies provides insights into understanding the genomic architecture of human cancer. This new understanding of the cancer genome allows us to identify many more genomic alterations occurring within tumors than before, some of which could be potential therapeutic targets through molecular targeted agents. Currently, a large number of molecular targeted agents are being developed, and consequently, cancer treatment is rapidly shifting from empiric therapy employing cytotoxic anticancer drugs to genotype-directed therapy using molecular targeted agents. In current daily clinical practice, hotspot-based single-gene assays that detect RAS mutations in colorectal cancer or EGFR mutations in non-small cell lung cancer are widely used to identify variants. However, it is becoming evident that more comprehensive genomic analysis is crucial in identifying the patient population that may benefit from molecular targeted therapy and the accelerated development of novel drugs for early clinical trials. For these purposes, an increasing number of gene panel-based targeted sequencing is commercially available in clinical practice from sequencing companies. Despite several challenges in implementing this approach, comprehensive genomic profiling and identification of actionable mutations is likely to become one of the standard options in the management of cancer in the near future. The use of clinical sequencing has the potential to usher a new era in precision medicine for cancer diagnosis and treatment. In this review, we discuss the application of comprehensive genomic profiling using next-generation sequencing technologies in clinical oncology and address the current challenges for its implementation. PMID:26917600

  13. A prospective study of physical activity and the risk of pancreatic cancer among women (United States

    Directory of Open Access Journals (Sweden)

    Schairer Catherine

    2008-02-01

    Full Text Available Abstract Background Several epidemiologic studies have examined the association between physical activity and pancreatic cancer risk; however, the results of these studies are not consistent. Methods This study examined the associations of total, moderate, and vigorous physical activity to pancreatic cancer in a cohort of 33,530 U.S. women enrolled in the Breast Cancer Detection Demonstration Project (BCDDP. At baseline (1987–1989, information on physical activity over the past year was obtained using a self-administered questionnaire. Cox proportional hazards regression was used to estimate relative risks (RR and 95% confidence intervals of pancreatic cancer risk. Results 70 incident cases of pancreatic cancer were ascertained during 284,639 person years of follow-up between 1987–1989 and 1995–1998. After adjustment for age, body mass index, smoking status, history of diabetes, and height, increased physical activity was related to a suggestively decreased risk of pancreatic cancer. The RRs for increasing quartiles of total physical activity were 1.0, 0.80, 0.66, 0.52 (95% CI = 0.26, 1.05; ptrend = 0.05. This association was consistent across subgroups defined by body mass index and smoking status. We also observed statistically non-significant reductions in pancreatic cancer risk for women in the highest quartile of moderate (RR = 0.57; 95% CI = 0.26, 1.26 and highest quartile of vigorous physical activity (RR = 0.63; 95% CI = 0.31, 1.28 compared to their least active counterparts. Conclusion Our study provides evidence for a role of physical activity in protecting against pancreatic cancer.

  14. A mechanism for the management of physics software on the grid

    International Nuclear Information System (INIS)

    Due to the distributed and Heterogeneous characteristic of grid, it is difficult for the grid sites to manage physics software. The paper presents a physics software management mechanism which makes the installing, removing, upgrading and publishing physics software on the grid much easier by the way of grid job submission. (authors)

  15. Prioritising maintenance improvement opportunities in physical asset management

    Directory of Open Access Journals (Sweden)

    Von Petersdorff, Hagen

    2014-11-01

    Full Text Available Physical Asset Management (PAM initiatives suffer many barriers in implementation that can hinder their influence and sustainability. One of these barriers is the lack of buy-in from all levels in the organisation, due to a lack of understanding of the perceived benefits of PAM. Organisational alignment in a PAM project is achieved by aligning employees’ views on the deficient areas in the organisation, and managing their expectations of the perceived benefits of a good application of PAM. Barriers in implementation are created, however, by the lack of a transparent method for conveying the significance of critical areas in the system and by an unclear way of communicating these problems. Typically these initiatives are constrained by available resources. In order for PAM initiatives to be successful, there first needs to be an alignment in the execution through a clear understanding of which assets are critical, so that resources can be allocated effectively. In this study, this problem is thoroughly examined, and a method is sought that seeks to isolate the effects of the maintenance function in an operation and to uncover critical areas. A study is performed on the methods that are typically used to create such understanding. This study highlights the shortcomings of these methods, which limit their applicability. A new methodology is therefore created in order to overcome these problems. The methodology is validated through a case study, where it shown to be highly beneficial in uncovering critical areas and achieving organisational alignment through the communication of results.

  16. 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

  17. Asilomar conference on managing complexity in high energy physics: A summary and renaming of the conference

    International Nuclear Information System (INIS)

    The complex aspects of high energy physics work are briefly described, and approaches to managing them are discussed. Management of software and data are covered. For managing complexity in experimental physics, the choice of building or buying processor systems is addressed and the issues of compatibility and standardization are discussed

  18. Asilomar conference on managing complexity in high energy physics: A summary and renaming of the conference

    Energy Technology Data Exchange (ETDEWEB)

    Nash, T.

    1987-02-01

    The complex aspects of high energy physics work are briefly described, and approaches to managing them are discussed. Management of software and data are covered. For managing complexity in experimental physics, the choice of building or buying processor systems is addressed and the issues of compatibility and standardization are discussed. (LEW)

  19. 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. PMID:24799497

  20. Spontaneous Physical Activity Downregulates Pax7 in Cancer Cachexia

    OpenAIRE

    Dario Coletti; Paola Aulino; Eva Pigna; Fabio Barteri; Viviana Moresi; Daniela Annibali; Sergio Adamo; Emanuele Berardi

    2015-01-01

    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 regenerat...

  1. Use of capecitabine in management of early colon cancer

    Directory of Open Access Journals (Sweden)

    Cassidy J

    2011-08-01

    Full Text Available H Hameed, J CassidyBeatson West of Scotland Cancer Centre, Glasgow, Scotland, UKAbstract: Capecitabine (Xeloda®, Roche, Basel, Switzerland is a pro-drug of 5-fluorouracil (5-FU, and it is converted to 5-FU in the cancer cell by enzymatic degradation. The role of capecitabine in colorectal cancer has evolved in the last 15 years. In early trials in the metastatic setting, capecitabine has shown superior response rates compared with those achieved with 5-FU (Mayo Clinic regimen (26% vs 17%, with equivalent progression-free survival and overall survival. In the adjuvant setting, the Xeloda in Adjuvant Colon Cancer Therapy (X-ACT trial demonstrated that capecitabine as a single agent led to improvement in relapse-free survival (hazard ratio: 0.86, 95% confidence interval: 0.74–0.99, P = 0.04 and was associated with significantly fewer adverse events than 5-FU plus leucovorin (LV, folinic acid. On the basis of the X-ACT trial, capecitabine was approved by the United States Food and Drug Administration, the National Institute for Clinical Excellence, and the Scottish Medicines Consortium as monotherapy for the adjuvant treatment of stage III colon cancer. The next step was to incorporate capecitabine into combination therapy. The XELOXA trial studied the combination of capecitabine and oxaliplatin (XELOX vs 5-FU/LV and demonstrated 5-year disease-free survival of 66% for XELOX, compared with 60% for 5-FU/LV. The toxicity profile was also quite comparable in the two arms. So both the single agent use of capecitabine as well as in combination with oxaliplatin can be considered as part of the standard of care in management of early colon cancer in appropriately selected patient groups.Keywords: 5-fluorouracil, 5-FU, leucovorin, folinic acid, LV, XELOX, oxaliplatin, FOLFOX

  2. Living with metastatic breast cancer: a qualitative analysis of physical, psychological, and social sequelae.

    Science.gov (United States)

    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 metastatic breast cancer wrote their deepest thoughts and feelings regarding their illness. These essays were thematically analyzed for effects of the illness on quality of life. Three themes were identified in patients' essays. First, metastatic breast cancer and its treatment may result in a number of quality-of-life concerns, including physical symptom burden, emotional distress, body image disturbance, and disrupted daily activities. Second, social constraints on disclosure of cancer-related concerns may exacerbate patients' distress. Third, many women experience a heightened awareness of life's brevity and search for meaning in their cancer experience. Results highlight a range of quality-of-life concerns following a metastatic breast cancer diagnosis and suggest that addressing social constraints on cancer-related disclosure and the search for meaning may improve patients' psychological adjustment. PMID:23528206

  3. Management of Oropharyngeal Dysphagia in Laryngeal and Hypopharyngeal Cancer

    Directory of Open Access Journals (Sweden)

    Jose Granell

    2012-01-01

    Full Text Available On considering a function-preserving treatment for laryngeal and hypopharyngeal cancer, swallowing is a capital issue. For most of the patients, achieving an effective and safe deglutition will mark the difference between a functional and a dysfunctional outcome. We present an overview of the management of dysphagia in head and neck cancer patients. A brief review on the normal physiology of swallowing is mandatory to analyze next the impact of head and neck cancer and its treatment on the anatomic and functional foundations of deglutition. The approach proposed underlines two leading principles: a transversal one, that is, the multidisciplinary approach, as clinical aspects to be managed in the oncologic patient with oropharyngeal dysphagia are diverse, and a longitudinal one; that is, the concern for preserving a functional swallow permeates the whole process of the diagnosis and treatment, with interventions required at multiple levels. We further discuss the clinical reports of two patients who underwent a supracricoid laryngectomy, a function-preserving surgical technique that particularly disturbs the laryngeal mechanics, and in which swallowing rehabilitation dramatically conditions the functional results.

  4. Pegylated liposomal doxorubicin in the management of ovarian cancer

    Directory of Open Access Journals (Sweden)

    Gabriella Ferrandina

    2010-09-01

    Full Text Available Gabriella Ferrandina1,2, Giacomo Corrado1, Angelo Licameli1, Domenica Lorusso2, Gilda Fuoco1, Salvatore Pisconti3, Giovanni Scambia2 1Gynecologic Oncology Unit, Department of Oncology, Catholic University of Campobasso, Campobasso, Italy; 2Gynecologic Oncology Unit, Catholic University of Rome, Rome, Italy; 3Salvatore Pisconti, Oncology Unit, Taranto Hospital, Taranto, Italy Abstract: Among the pharmaceutical options available for treatment of ovarian cancer, much attention has been progressively focused on pegylated liposomal doxorubicin (PLD, whose unique formulation, which entraps conventional doxorubicin in a bilayer lipidic sphere ­surrounded by a polyethylene glycol layer, prolongs the persistence of the drug in the ­circulation and potentiates intratumor drug accumulation. These properties enable this drug to sustain its very favorable toxicity profile and to be used safely in combination with other drugs. PLD has been already approved for treatment of advanced ovarian cancer patients failing first-line platinum-based treatment. Moreover, phase III trials have been already completed, and results are eagerly awaited, which hopefully will expand the range of PLD clinical application in this neoplasia both in front-line treatment, and in the salvage setting in combination with other drugs. Moreover, attempts are continuing to enable this drug to be combined with novel cytotoxic drugs and target-based agents. This review aims at summarizing the available evidence and the new perspectives for the clinical role of PLD in the management of patients with epithelial ovarian cancer.Keywords: pegylated liposomal doxorubicin, ovarian cancer, clinical trials

  5. Physics Data Management Tools for Monte Carlo Transport: Computational Evolutions and Benchmarks

    CERN Document Server

    Han, Mincheol; Seo, Hee; Moneta, Lorenzo; Kim, Chan Hyeong

    2010-01-01

    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 physics models based on the EADL, EEDL and EPDL97 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.

  6. 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 cogniti

  7. Medical physics aspects of cancer care in the Asia Pacific region

    OpenAIRE

    2008-01-01

    Medical physics plays an essential role in modern medicine. This is particularly evident in cancer care where medical physicists are involved in radiotherapy treatment planning and quality assurance as well as in imaging and radiation protection. Due to the large variety of tasks and interests, medical physics is often subdivided into specialties such as radiology, nuclear medicine and radiation oncology medical physics. However, even within their specialty, the role of radiation oncology med...

  8. Physical Activity in Individuals with Severe Mental Illness: Client versus Case Manager Ratings

    Science.gov (United States)

    Bezyak, Jill L.; Chan, Fong; Lee, Eun-Jeong; Catalano, Denise; Chiu, Chung-Yi

    2012-01-01

    The "Physical Activity Scale for Individuals With Physical Disabilities" was examined as a physical activity measure for people with severe mental illness. Case manager ratings were more closely related to body mass index than clients' ratings, challenging the accuracy of self-report physical activity measures for individuals with severe mental…

  9. Network Physics - the only company to provide physics-based network management - secures additional funding and new executives

    CERN Multimedia

    2003-01-01

    "Network Physics, the only provider of physics-based network management products, today announced an additional venture round of $6 million in funding, as well as the addition of David Jones as president and CEO and Tom Dunn as vice president of sales and business development" (1 page).

  10. Managing the physics of the economics of integrated health care.

    Science.gov (United States)

    Zismer, Daniel K; Werner, Mark J

    2012-01-01

    The physics metaphor, as applied to the economics (and financial performance) of the integrated health system, seems appropriate when considered together with the nine principles of management framework provided. The nature of the integrated design enhances leaders' management potential as they consider organizational operations and strategy in the markets ahead. One question begged by this argument for the integrated design is the durability, efficiency and ultimate long-term survivability of the more "traditional" community health care delivery models, which, by design, are fragmented, internally competitive and less capital efficient. They also cannot exploit the leverage of teams, optimal access management or the pursuit of revenues made available in many forms. For those who wish to move from the traditional to the more integrated community health system designs (especially those who have not yet started the journey), the path requires: * Sufficient balance sheet capacity to fund the integration process-especially as the model requires physician practice acquisitions and electronic health record implementations * A well-prepared board13, 14 * A functional, durable and sustainable physician services enterprise design * A redesigned organizational and governance structure * Favorable internal financial incentives alignment design * Effective accountable physician leadership * Awareness that the system is not solely a funding strategy for acquired physicians, rather a fully -.. committed clinical and business model, one in which patient-centered integrated care is the core service (and not acute care hospital-based services) A willingness to create and exploit the implied and inherent potential of an integrated design and unified brand Last, it's important to remember that an integrated health system is a tool that creates a "new potential" (a physics metaphor reference, one last time). The design doesn't operate itself. Application of the management principles

  11. The Effect of Managers Genders on Workers Mental and Physical Health: An Application in Banking Sector

    Directory of Open Access Journals (Sweden)

    Mahmut Özdevecioğlu

    2013-09-01

    Full Text Available In this research it is evaluated the workers physical and mental health differences in which their managers gender is man or woman. To find out the differences a research is handled in banking sector. According to the results of the research, workers in which working with the male manager; there are difference between male and female workers according to physical health and there are not difference between male and female workers according to mental health. There are differences between male and female workers in which working with woman manager according to physical and mental health. The physical and mental health of woman workers, working with woman managers, looks like worse.

  12. Management of locally advanced breast cancer: Evolution and current practice

    Directory of Open Access Journals (Sweden)

    Rustogi Ashish

    2005-01-01

    Full Text Available Locally advanced breast cancer (LABC accounts for a sizeable number (30-60% of breast cancer cases and is a common clinical scenario in developing countries. The treatment of LABC has evolved from single modality treatment, consisting of radical mutilating surgery or higher doses of radiotherapy in inoperable disease to multimodality management, which along with the above two included systemic therapy. Neoadjuvant chemotherapy (NACT has made a tremendous impact on the management of LABC. NACT was initiated to institute systemic therapy upfront at the earliest in this group of patients with a high risk of micrometastasis burden. While NACT did not yield a survival advantage, it has however made breast conservation possible in selected group of cases. Large number of studies and many randomised trials have been done in women with LABC in order to improve the therapeutic decisions and also the local control and survival. With this background we have reviewed various treatment options in patients with LABC which should possibly help in guiding the clinicians for optimal management of LABC.

  13. 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

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

    Science.gov (United States)

    Cooke, Gillian E; Wetter, Nathan C; Banducci, Sarah E; Mackenzie, Michael J; Zuniga, Krystle E; Awick, Elizabeth A; Roberts, Sarah A; Sutton, Brad P; McAuley, Edward; Kramer, Arthur F

    2016-01-01

    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. PMID:26915025

  15. LAPAROSCOPIC SURGERY IN THE MANAGEMENT OF EARLY GASTRIC CANCER

    Directory of Open Access Journals (Sweden)

    Abhijit

    2016-02-01

    Full Text Available INTRODUCTION This study was performed to check Laparoscopic Surgery in the management of early Gastric Cancer. For that we choose laparoscopic and laparoscopic Assisted Gastrectomies for 119 cases. It was performed during the period from June 1996 to February 2002 in Kameda Medical Center, Kamogawa, Japan. Male and female ratio was 2.78:1. The age range was 48-88 years (65.5. MATERIALS AND METHODS 1. Laparoscopic Intragastric Mucosal Resection (LIMR. 2. Local Resection by Lesion Lifting Method (LLM. 3. Laparoscopy-Assisted Distal Gastrectomy (LADG. 4. Intragastric Mucosal Resection through laparotomy. RESULTS OF THIS STUDY AFTER USING SURGICAL TECHNIQUES ARE AS FOLLOWS- 1. The tear was successfully closed by intragastric hand suturing technique. 2. All the planned laparoscopic procedures were completed in all the cases and the operation was finished after the confirmation of tumor free margins on frozen section biopsy specimen. 3. All resected specimen underwent detailed histopathologic examination. Subsequent diagnosis includes stomach cancer in 106 cases, duodenal cancer in 1 case and stomach adenoma in 5 cases. 8cases of stromal tumors were resected laparoscopically. 4. We have not lost even a single patient in follow up or due to mortality. Five year follow up is present in the first year group. 5. 06 patients who were diagnosed with EGC have been successfully treated with 4 laparoscopic techniques at our institute from June 1996 to February 2002. CONCLUSION We, in our study had no mortality or local recurrence to date but our follow up is obviously too short to draw any conclusions. If patients are selected properly, we on the basis of our study propose that laparoscopic procedures are curative.1,2 When performed by a skilled surgeon, laparoscopic resection is a safe and useful technique in the management of Early Gastric Cancer.

  16. 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

    OpenAIRE

    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

    textabstractBackground. 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 cancerrelated fatigue of physical training combined with cognitive behavioral therapy with physical training alone and with no intervention. Design. In this multicenter randomized controlled trial, 147 survivors of cancer were randomly assigned to a ...

  17. Cancer survivors’ self-efficacy to self-manage in the year following primary treatment

    OpenAIRE

    Foster, Claire; Breckons, Matthew; Cotterell, P.; D. Barbosa; Calman, Lynn; Corner, Jessica; Fenlon, Deborah; Foster, R.; Grimmett, Chloe; Richardson, Alison; Smith, P.W.

    2014-01-01

    PURPOSE: Cancer survivors are increasingly expected to manage the consequences of cancer and its treatment for themselves. There is evidence that self-efficacy is important for successful self-management and that this can be enhanced with support. The purpose of this study was to assess self-efficacy to manage problems in the year following primary treatment. METHODS: This cross-sectional online survey included cancer survivors who had completed their treatment within the past 1...

  18. Comprehensive Management Strategies for Physical Inactivity in Youth

    OpenAIRE

    Myer, Gregory D.; Faigenbaum, Avery D.; STRACCIOLINI, ANDREA; Hewett, Timothy E.; Micheli, Lyle J.; Best, Thomas M.

    2013-01-01

    Despite the widely recognized benefits of daily play, recreation, sports, and physical education on the physical and psychosocial well-being of children and adolescents, many contemporary children and adolescents worldwide do not meet the recommendations for daily physical activity. The decline in physical activity seems to start early in life which leads to conditions characterized by reduced levels of physical activity in the pediatric population that are inconsistent with current public he...

  19. Management of breakthrough pain in children with cancer

    Directory of Open Access Journals (Sweden)

    Friedrichsdorf SJ

    2014-03-01

    Full Text Available Stefan J Friedrichsdorf,1,2 Andrea Postier1 1Department of Pain Medicine, Palliative Care and Integrative Medicine, Children's Hospitals and Clinics of Minnesota, 2University of Minnesota Medical School, Minneapolis, MN, USA Abstract: Breakthrough pain in children with cancer is an exacerbation of severe pain that occurs over a background of otherwise controlled pain. There are no randomized controlled trials in the management of breakthrough pain in children with cancer, and limited data and considerable experience indicate that breakthrough pain in this pediatric patient group is common, underassessed, and undertreated. An ideal therapeutic agent would be rapid in onset, have a relatively short duration, and would be easy to administer. A less effective pharmacologic strategy would be increasing a patient's dose of scheduled opioids, because this may increase the risk of oversedation. The most common and effective strategy seems to be multimodal analgesia that includes an immediate-release opioid (eg, morphine, fentanyl, hydromorphone, or diamorphine administered intravenously by a patient-controlled analgesia pump, ensuring an onset of analgesic action within minutes. Intranasal fentanyl (or hydromorphone may be an alternative, but no pediatric data have been published yet for commercially available fentanyl transmucosal application systems (ie, sublingual tablets/spray, buccal lozenge/tablet/film, and nasal spray, and these products cannot yet be recommended for use with children with cancer and breakthrough pain. The aim of this paper was to emphasize the dearth of available information on treatment of breakthrough pain in pediatric cancer patients, to describe the treatment protocols we currently recommend based on clinical experience, and to suggest future research on this very important and under-researched topic. Keywords: pediatric, cancer, breakthrough pain, opioid, adjuvant analgesia, integrative medicine

  20. Emerging technologies and techniques in the management of cancer

    International Nuclear Information System (INIS)

    Full text: The term cancer is used to describe a multitude of diseases all of which are linked by loss of control of normal growth and replication of cells. It is a major cause of death worldwide. If diagnosed early many cancers, particularly tumour such as skin cancers, can be cured by local treatment such as surgery or radiotherapy. Due to local invasion or dissemination of tumors via the lymphatics or blood, majority of solid malignant tumors are not curable by local measures alone. The successful treatment of a patient with cancer involves close co-operation between surgical oncologist, radiation oncologist, medical oncologist, general practitioner, nurses and support care workers, including clinical psychologists. The role of the surgeon is central to this; obtaining tissue for adequate histological analysis and identification of patients who can be cured by resection is a major component of management. Apart from curative resection of primary tumors, excision of secondary deposits can also offer long term disease control. Pancreatic ductal adenocarcinoma is a common malignancy of the gastrointestinal tract and is the tenth most common cancer for both genders. In the year 2006, in U.S, almost 34 thousand patients developed this disease and in the same year about 32 thousand succumbed to this disease. These figures demonstrate dismal prognosis of the disease and the reasons for the low survival rates are mainly due to aggressive biology, early development of peri-neural infiltration, angio-invasion and wide spread dissemination of the tumour. Despite recent advances in the field of medical and radiation oncology and the introduction of neo-adjuvant regimens surgery remains the single most important modality for the treatment of pancreatic ductal adenocarcinoma. This presentation will focus on the current status of surgical treatment of pancreatic ductal adenocarcinoma and highlight the new developments in this field

  1. How PET is changing the management of cancer with radiotherapy

    International Nuclear Information System (INIS)

    Information from PET scanning is transforming the management of many malignancies and the impact of PET is likely to increase further as new indications are recognised. PET is of particular value in patients treated with radiotherapy (RT) with curative intent. These patients rarely undergo invasive surgical staging and therefore imaging is crucial in determining the extent of disease before treatment. More accurate staging with PET means that futile aggressive RT or chcmoRT can be avoided in patients with incurable extensive disease. FDG-PET is of proven value in the staging of common metabolically-active malignancies treated with radiotherapy. These include lung cancer, head and neck cancer, lymphomas and oesophageal carcinoma. It has been shown that PET can improve the selection of patients for radical surgery or radiotherapy in lung cancer and that PET-based staging more accurately predicts survival than conventional staging. For those patients that remain eligible for definitive RT after PET. treatment can be more accurately targeted at the tumour and involved regional nodes. The value of PET for treatment planning is enhanced significantly when PET and CT scans are acquired on a combined PET/CT scanner. Fused PET-CT images can be imported into the radiotherapy planning computer and used to accurately target tumour with the best beam arrangement. After treatment, response may be hard to assess with structural imaging. PET-rcsponse to chemotherapy or radiotherapy in non-small cell lung cancer (NSCLC) predicts survival in NSCLC more accurately than CT response. However, PET has much more potential than imaging with FDG alone can realise. Markers such as FLT can be used to image proliferation in tumours, misonidazole or FAZA can be used to image hypoxia and labeled metabolites of anti-cancer drugs such as 5-FU can be used to study pharmacokinetics. New combinations of radiation and drugs may emerge that can be selected based on biological characteristics of

  2. Surgical treatment of lung cancer. On the clinical guideline for the management of lung cancer

    International Nuclear Information System (INIS)

    Surgical treatments of lung cancer are discussed mainly on the evidence-based medicine (EBM)-based Clinical Guideline for the Management of Lung Cancer (revised 2005). Described items are application of surgical treatment, techniques, evidence bases for certain techniques, lymph node excision, video-assisted thoracoscopic surgery (VATS), postoperative therapy of non-small cell lung cancer (NSCC), preoperative adjuvant therapy of NSCC, and present state and future of surgical treatment. Comments are mentioned in this order as follows. The operation can be only applicable on physiological and oncological (clinical stage) considerations. For respectable cancer, lobectomy is essentially recommendable. Recommended techniques like bronchoplasty are orderly described with their evidence. Evidence is said to be insufficient to excise lymph nodes and to perform VATS. Postoperative radiotherapy (RT) of early stage NSCC is not a standard, but chemotherapy (CMT) is recommended because evidences have been accumulated until the revision of the guideline. Evidence is said not yet enough to recommend preoperative RT, CMT or RT+CMT as a standard. Studies of diagnosis and treatment of lung cancer are now under remarkable progress as exemplified by 3D therapeutic plan by CT-simulation, heavy ion therapy, stereotactic RT and intra-cavitary RT, and surgery will be still one of multiple modalities. (R.T.)

  3. Management of cancers of the oral cavity and oropharynx

    International Nuclear Information System (INIS)

    Objective: To review the general principles and the specific techniques employed in the management of cancers of the oral cavity and oropharynx, for the judicious utilization of external radiotherapy, brachytherapy, surgery and chemotherapy, in order to maximize both the cure rates and the quality of life. The oral cavity consists of lips, buccal mucosae, lower and upper alveolar ridges, floor of the mouth, hard palate and anterior two-thirds of the tongue. The oropharynx consists of the base of tongue, tonsillar regions, soft palate and posterior pharyngeal wall. This anatomical complexity means that the choice of treatment can be significantly influenced by just a few millimeters difference in the site of the origin or spread of the cancer. The choice can be critical not only for the cure but also the patients' subsequent quality of life. It can have a tremendous impact on the appearance, the ability to eat and the ability to talk. The great majority of cancers in the oral cavity and oropharynx are squamous cell carcinomas, but cancers arising from minor salivary glands are not infrequently seen. The staging system, though useful in treatment planning, has shortcomings which will be discussed. For purposes of discussion it is useful to divide the cancers broadly into Early (T1, T2, N0 N1), Advanced Resectable, and Advanced Unresectable. Early cancers can be cured, in a large proportion of the patients, by either surgery or irradiation; the latter is particularly successful when brachytherapy can be employed to administer a significant part of the dose. Brachytherapy is usually not feasible when the cancer involves bone or is in close proximity to it, due to a high risk of osteoradionecrosis. Poor oral hygiene, in general, and poor dentition, in particular, also increases the risk of osteoradionecrosis. It is, therefore, important to be proactive with regard to dental prophylaxis for any patient contemplating irradiation for oral or pharyngeal cancer. Another

  4. Management of cancers of the oral cavity and oropharynx

    International Nuclear Information System (INIS)

    Objective: To review the general principles and the specific techniques employed in the management of cancers of the oral cavity and oropharynx, for the judicious utilization of external radiotherapy, brachytherapy, surgery and chemotherapy, in order to maximize both the cure rates and the quality of life. The oral cavity consists of lips, buccal mucosae, lower and upper alveolar ridges, floor of the mouth, hard palate and anterior two-thirds of the tongue. The oropharynx consists of the base of tongue, tonsillar regions, soft palate and posterior pharyngeal wall. This anatomical complexity means that the choice of treatment can be significantly influenced by just a few millimeters difference in the site of the origin or spread of the cancer. The choice can be critical not only for the cure but also the patients' subsequent quality of life. It can have a tremendous impact on the appearance, the ability to eat and the ability to talk. The great majority of cancers in the oral cavity and oropharynx are squamous cell carcinomas, but cancers arising from minor salivary glands are not infrequently seen. The staging system, though useful in treatment planning, has shortcomings which will be discussed. For purposes of discussion it is useful to divide the cancers broadly into Early (T1, T2, N0 N1), Advanced Resectable, and Advanced Unresectable. Early cancers can be cured, in a large proportion of the patients, by either surgery or irradiation; the latter is particularly successful when brachytherapy can be employed to administer a significant part of the dose. Brachytherapy is usually not feasible when the cancer involves bone or is in close proximity to it, due to a high risk of osteoradionecrosis. Poor oral hygiene, in general, and poor dentition, in particular, also increases the risk of osteoradionecrosis. It is, therefore, important to be proactive with regard to dental prophylaxis for any patient contemplating irradiation for oral or pharyngeal cancer. Another

  5. Management of cancers of the oral cavity and oropharynx

    International Nuclear Information System (INIS)

    Objective: To review the general principles and the specific techniques employed in the management of cancers of the oral cavity and oropharynx, for the judicious utilization of external radiotherapy, brachytherapy, surgery and chemotherapy, in order to maximize both the cure rates and the quality of life. The oral cavity consists of lips, buccal mucosae, lower and upper alveolar ridges, floor of the mouth, hard palate and anterior two-thirds of the tongue. The oropharynx consists of the base of tongue, tonsillar regions, soft palate and posterior pharyngeal wall. This anatomical complexity means that the choice of treatment can be significantly influenced by just a few millimeters difference in the site of the origin or spread of the cancer. The choice can be critical not only for the cure but also the patients' subsequent quality of life. It can have a tremendous impact on the appearance, the ability to eat and the ability to talk. The great majority of cancers in the oral cavity and oropharynx are squamous cell carcinomas, but cancers arising from minor salivary glands are not infrequently seen. The staging system, though useful in treatment planning, has shortcomings which will be discussed. For purposes of discussion it is useful to divide the cancers broadly into Early (T1, T2, N0 N1), Advanced Resectable, and Advanced Unresectable. Early cancers can be cured, in a large proportion of the patients, by either surgery or irradiation; the latter is particularly successful when brachytherapy can be employed to administer a significant part of the dose. Brachytherapy is usually not feasible when the cancer involves bone or is in close proximity to it, due to a high risk of osteoradionecrosis. Poor oral hygiene, in general, and poor dentition, in particular, also increases the risk of osteoradionecrosis. It is, therefore, important to be proactive with regard to dental prophylaxis for any patient contemplating irradiation for oral or pharyngeal cancer. Another

  6. Targeted Alpha Therapy Approach to the Management of Pancreatic Cancer

    International Nuclear Information System (INIS)

    -metastatic pancreatic cancer with over-expression of MUC1 and uPA receptors in post-surgical patients with minimal residual disease. The observation of tumor regression in a Phase I clinical trial of targeted alpha therapy for metastatic melanoma indicates that alpha therapy can regress tumors by a process called tumor anti-vascular alpha therapy (TAVAT). As a consequence, this therapy could be indicated for the management of non-surgical pancreatic cancer tumors

  7. Effect of physical therapy on breast cancer related lymphedema

    DEFF Research Database (Denmark)

    Tambour, Mette; Tange, Berit; Christensen, Robin Daniel Kjersgaard;

    2014-01-01

    BACKGROUND: Physical therapy treatment of patients with lymphedema includes treatment based on the principles of 'Complete Decongestive Therapy' (CDT). CDT consists of the following components; skin care, manual lymphatic drainage, bandaging and exercises. The scientific evidence regarding what...

  8. Gastric cancer in Africa: Current management and outcomes

    OpenAIRE

    Asombang, Akwi W; Rahman, Rubayat; Ibdah, Jamal A.

    2014-01-01

    Gastric cancer is the fourth most common cancer and second most common cause of cancer death worldwide. Globally, gastric cancer poses a significant public health burden - both economically and socially. In 2008, the economic burden from premature cancer deaths and disability was $895 billion and gastric cancer was the second highest cancer responsible for healthy life lost. With the expected increase in cancer deaths and non-communicable diseases, these costs are expected to rise and impact ...

  9. Optimal management of cancer anorexia–cachexia syndrome

    Directory of Open Access Journals (Sweden)

    Josep M Argilés

    2010-01-01

    Full Text Available Josep M Argilés, Mireia Olivan, Sílvia Busquets, Francisco Javier López-SorianoDepartament de Bioquímica i Biologia Molecular, Universitat de Barcelona, Barcelona, SpainAbstract: According to a recent consensus, cachexia is a complex metabolic syndrome associated with underlying illness and characterized by loss of muscle with or without loss of fat mass. The prominent clinical feature of cachexia is weight loss. Cachexia occurs in the majority of cancer patients before death and it is responsible for the deaths of 22% of cancer patients. Although bodyweight is the most important endpoint of any cachexia treatment, body composition, physical performance and quality of life should be monitored. From the results presented here, one can speculate that a single therapy may not be completely successful in the treatment of cachexia. From this point of view, treatments involving different combinations are more likely to be successful. The objectives of any therapeutic combination are two-fold: an anticatabolic aim directed towards both fat and muscle catabolism and an anabolic objective leading to the synthesis of macromolecules such as contractile proteins.Keywords: wasting, cancer, anorexia, nutraceuticals, drugs

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

    International Nuclear Information System (INIS)

    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 Ptrend ≤ 0.04), but not with other subtypes (all Ptrend > 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 Ptrend ≤ 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 (Phomogeneity = 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

  11. Physical activity from menarche to first pregnancy and risk of breast cancer.

    Science.gov (United States)

    Liu, Ying; Tobias, Deirdre K; Sturgeon, Kathleen M; Rosner, Bernard; Malik, Vasanti; Cespedes, Elizabeth; Joshi, Amit D; Eliassen, A Heather; Colditz, Graham A

    2016-09-15

    Breast tissue is particularly susceptible to exposures between menarche and first pregnancy, and a longer interval between these reproductive events is associated with elevated breast cancer risk. Physical activity during this time period may offset breast cancer risk, particularly for those at highest risk with longer menarche-to-first-pregnancy intervals. We used data from 65,576 parous women in the Nurses' Health Study II free of cancer in 1989 (baseline) and recalled their leisure-time physical activity at ages 12-34 in 1997. Current activity was collected at baseline and over follow-up. Relative risks (RRs) were estimated using multivariable Cox proportional hazards regression models. Between 1989 and 2011, 2,069 invasive breast cancer cases were identified. Total recreational activity between menarche and first pregnancy was not significantly associated with the risk of breast cancer. However, physical activity between menarche and first pregnancy was associated with significantly lower breast cancer risk among women in the highest category of a menarche-to first-pregnancy interval (≥20 years; RR for the highest versus the lowest quartile = 0.73, 95% confidence interval = 0.55-0.97; Ptrend  = 0.045; Pinteraction  = 0.048). This was not observed in women with a shorter interval. Physical activity between menarche and first pregnancy was associated with a lower risk of breast cancer among women with at least 20 years between these reproductive events. This may provide a modifiable factor that women can intervene on to mitigate their breast cancer risk associated with a longer interval. PMID:27130486

  12. Internet-Based Physical Activity Intervention Targeting Young Adult Cancer Survivors

    OpenAIRE

    Rabin, Carolyn; Dunsiger, Shira; Ness, Kirsten K.; Marcus, Bess H

    2011-01-01

    Purpose: Young adults who have been treated for cancer face several health and psychosocial risks. To minimize these risks, is it imperative that they address any modifiable risk factors, such as sedentary lifestyle. Unfortunately, more than half of young adult cancer survivors remain sedentary. To facilitate the adoption of physical activity (PA) in this population—potentially reducing health and psychosocial risks—we developed and pilot tested an internet-based PA intervention for young sur...

  13. Physics of cancer propagation: A game theory perspective

    Science.gov (United States)

    Cleveland, Chris; Liao, David; Austin, Robert

    2012-03-01

    This is a theoretical paper which examines at a game theoretical perspective the dynamics of cooperators and cheater cells under metabolic stress conditions and high spatial heterogeneity. Although the ultimate aim of this work is to understand the dynamics of cancer tumor evolution under stress, we use a simple bacterial model to gain fundamental insights into the progression of resistance to drugs under high competition and stress conditions.

  14. 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

  15. Environmental carcinogenic agents and cancer prevention. Risk assessment and management

    International Nuclear Information System (INIS)

    Many agents in our environment have been established as being carcinogenic, and in most cases, the carcinogenic properties of these agents were identified because of high-dose occupational or accidental exposure. Risk characterization, taking into account the dose-response relationship, and exposure assessment are essential for risk assessment and subsequent cancer prevention. Based on scientific risk assessment, risk management should be conducted practically by considering the economic, social, political, and other technical issues and by balancing the risks and benefits. Asbestos and environmental tobacco smoke are typical examples of established carcinogenic agents in the general environment, contributing to low-dose exposure. Further epidemiological studies are required to investigate the carcinogenicity of low-dose exposure to known carcinogenic agents such as arsenic and cadmium through dietary intake, radiation via medical and natural exposure, and air pollution due to diesel exhaust. In contrast, occupational chemical exposure to 1,2-dichloropropane and/or dichloromethane, whose carcinogenicity had not been established, was suggested to cause cholangiocarcinoma among workers involved in offset color proof-printing only after a rare situation of high-dose exposure was unveiled. Continuous monitoring of unusual cancer occurrences in target populations such as workers in occupational and regional settings as well as exposure reduction to suspected carcinogenic agents to levels as low as reasonably achievable is essential for reducing the risk of cancer due to environmental carcinogens. (author)

  16. Metabolic therapy: a new paradigm for managing malignant brain cancer.

    Science.gov (United States)

    Seyfried, Thomas N; Flores, Roberto; Poff, Angela M; D'Agostino, Dominic P; Mukherjee, Purna

    2015-01-28

    Little progress has been made in the long-term management of glioblastoma multiforme (GBM), considered among the most lethal of brain cancers. Cytotoxic chemotherapy, steroids, and high-dose radiation are generally used as the standard of care for GBM. These procedures can create a tumor microenvironment rich in glucose and glutamine. Glucose and glutamine are suggested to facilitate tumor progression. Recent evidence suggests that many GBMs are infected with cytomegalovirus, which could further enhance glucose and glutamine metabolism in the tumor cells. Emerging evidence also suggests that neoplastic macrophages/microglia, arising through possible fusion hybridization, can comprise an invasive cell subpopulation within GBM. Glucose and glutamine are major fuels for myeloid cells, as well as for the more rapidly proliferating cancer stem cells. Therapies that increase inflammation and energy metabolites in the GBM microenvironment can enhance tumor progression. In contrast to current GBM therapies, metabolic therapy is designed to target the metabolic malady common to all tumor cells (aerobic fermentation), while enhancing the health and vitality of normal brain cells and the entire body. The calorie restricted ketogenic diet (KD-R) is an anti-angiogenic, anti-inflammatory and pro-apoptotic metabolic therapy that also reduces fermentable fuels in the tumor microenvironment. Metabolic therapy, as an alternative to the standard of care, has the potential to improve outcome for patients with GBM and other malignant brain cancers. PMID:25069036

  17. Benefits of multidisciplinary teamwork in the management of breast cancer

    Directory of Open Access Journals (Sweden)

    Taylor C

    2013-08-01

    Full Text Available Cath Taylor,1 Amanda Shewbridge,2 Jenny Harris,1 James S Green3,4 1Florence Nightingale School of Nursing and Midwifery, King’s College London, London UK; 2Breast Cancer Services, Guy’s and St Thomas’ NHS Foundation Trust, London, UK; 3Department of Urology, Barts Health NHS Trust, London, UK; 4Department of Health and Social Care, London South Bank University, London, UK Abstract: The widespread introduction of multidisciplinary team (MDT-work for breast cancer management has in part evolved due to the increasing complexity of diagnostic and treatment decision-making. An MDT approach aims to bring together the range of specialists required to discuss and agree treatment recommendations and ongoing management for individual patients. MDTs are resource-intensive yet we lack strong (randomized controlled trial evidence of their effectiveness. Clinical consensus is generally favorable on the benefits of effective specialist MDT-work. Many studies have shown the benefits of receiving treatment from a specialist center, and evidence continues to accrue from comparative studies of clinical benefits of an MDT approach, including improved survival. Patients’ views of the MDT model of decision-making (and in particular its impact on involvement in decisions about their care have been under-researched. Barriers to effective teamwork and poor decision-making include excessive caseload, low attendance at meetings, lack of leadership, poor communication, role ambiguity, and failure to consider patients’ holistic needs. Breast cancer nurses have a key role in relation to assessing holistic needs, and their specialist contribution has also been associated with improved patient experience and quality of life. This paper examines the evidence for the benefits of MDT-work, in particular for breast cancer. Evidence is considered within a context of growing cancer incidence at a time of increased financial restraint, and it may now be important to

  18. Fun Learning Management for Physical Education, Sport and Health

    OpenAIRE

    Ramdan Pelana

    2014-01-01

    Physical education is essentially an integral part of a hollistic education system aims to develop aspects of health, physical fitness, critical thinking skills, emotional stability, social skills, reasoning and moral action through physical activity and sport. In the Physical Education learning process, teachers are expected to teach a variety of basic sports movement skills, techniques and strategies of games and sports, internalization of values (sportsmanship, honesty, cooperation, etc.) ...

  19. The interaction between early-life body size and physical activity on risk of breast cancer.

    Science.gov (United States)

    Oh, Hannah; Boeke, Caroline E; Tamimi, Rulla M; Smith-Warner, Stephanie A; Wang, Molin; Willett, Walter C; Eliassen, A Heather

    2015-08-01

    While early-life body leanness is associated with increased breast cancer risk, early-life physical activity may protect against breast cancer. We examined whether the excess risk among lean girls is modified by their levels of prior, concurrent, or future physical activity. We conducted an analysis among 74,723 women in the Nurses' Health Study II (follow-up 1997-2011). Participants recalled their body size at ages 5, 10 and 20 years in 1989 using a 9-level pictogram (Level 1 most lean). In 1997, they reported adolescent levels of physical activity (ages 12-13 and 14-17 years). Cox proportional hazards models estimated the overall association of body size with breast cancer risk and assessed interactions of adolescent physical activity with body size at three different age periods (5-10, 10-20 and 20 years), adjusting for early-life and adult risk factors for breast cancer. Regardless of levels of adolescent physical activity, early-life body leanness (level 1-2 vs. 4.5+) was significantly associated with higher breast cancer risk. The association was slightly attenuated among those who were active (60+ MET-hr/wk) during adolescence compared to those who were inactive (confidence interval = 1.04-1.81 vs. 1.66, 1.29-2.12), but the interaction was not significant (p = 0.72). The results were similar for body size at three different age periods. Being lean during early life is a risk factor for breast cancer among both inactive and active girls. Adolescent physical activity did not significantly modify the association, although some interaction cannot be excluded. PMID:25335465

  20. Serum thyroglobulin in the management of patients with thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Barsano, C.P.; Skosey, C.; DeGroot, L.J.; Refetoff, S.

    1982-04-01

    We have reviewed our experience with the management of patients with thyroid cancer to assess the potential benefits of employing the serum thyroglobulin assay in patient management programs and to determine the optimal conditions for this application. Serum thyroglobulin levels were found to be more reliable when obtained from hypothyroid patients. Levels of thyroglobulin greater than 10 ng/mL appeared to be abnormally elevated in both thyroidectomized patients prior to radioactive iodine therapy (group 1) and in thyroidectomized patients after radioactive iodine therapy (group 2). Elevated thyroglobulin levels were found to be useful indicators of the presence of metastatic disease, whereas normal thyroglobulin levels were reliable indicators of the absence of metastases. In group 1 patients, elevated thyroglobulin levels reliably predicted the presence of important total body scan uptake. In group 2 patients, normal thyroglobulin levels reliably predicted the absence of total body scan uptake. The serum thyroglobulin assay can substantially reduce the need for repetitive total body scanning in the follow-up of group 2 patients with thyroid cancer.

  1. Serum thyroglobulin in the management of patients with thyroid cancer

    International Nuclear Information System (INIS)

    We have reviewed our experience with the management of patients with thyroid cancer to assess the potential benefits of employing the serum thyroglobulin assay in patient management programs and to determine the optimal conditions for this application. Serum thyroglobulin levels were found to be more reliable when obtained from hypothyroid patients. Levels of thyroglobulin greater than 10 ng/mL appeared to be abnormally elevated in both thyroidectomized patients prior to radioactive iodine therapy (group 1) and in thyroidectomized patients after radioactive iodine therapy (group 2). Elevated thyroglobulin levels were found to be useful indicators of the presence of metastatic disease, whereas normal thyroglobulin levels were reliable indicators of the absence of metastases. In group 1 patients, elevated thyroglobulin levels reliably predicted the presence of important total body scan uptake. In group 2 patients, normal thyroglobulin levels reliably predicted the absence of total body scan uptake. The serum thyroglobulin assay can substantially reduce the need for repetitive total body scanning in the follow-up of group 2 patients with thyroid cancer

  2. Physics Based Investigations of DNA Supercoiling and of Plasmonic Nanoparticles for Photothermal Cancer Therapy

    DEFF Research Database (Denmark)

    Nørregaard, Kamilla

    Hyperthermia has great potential as a cancer therapy as it weakens or causes irreversible damage to cancer cells. However, available heat sources are poor in discriminating between healthy and cancerous tissue. In this thesis work, the application of plasmonic nanoparticles as photo-induced strong...... into subcutaneous tumor xenografts in mice. To better understand the photo-physical properties, the plasmonic heating of the resonant and non-resonant nanoparticles was also compared using an in vitro temperature sensitive assay. This assay enabled measurements of the heat generation of single NIR...

  3. Management of physical child abuse in South Africa:Literature review and children's hospital data analysis

    NARCIS (Netherlands)

    Janssen, T.L. (T. L.); M. van Dijk (Monique); Al Malki, I. (I.); A.B. van As (Àrjan Bastiaan)

    2013-01-01

    textabstractBackground: The reason for this review is the lack of data on the management of physical abused children in Africa. The primary goal of the first part is to outline the management of physical child abuse in (South) Africa and provide suggestions for other governments in Africa on which t

  4. Advancements in the Management of Pancreatic Cancer: 2013

    Directory of Open Access Journals (Sweden)

    Muhammad Wasif Saif

    2013-03-01

    Full Text Available Pancreatic cancer still remains a significant, unresolved therapeutic challenge and is the most lethal type of gastrointestinal cancer with a 5-year survival rate of 5%. Adjuvant chemotherapy remains to be gemcitabine alone, though fluorouracil offers the same survival and role of radiation remains controversial. Nevertheless, only a few patients survive for at least 5 years after R0 resection and adjuvant therapy. Borderline resectable pancreatic cancer remains an area that requires multi-disciplinary approach. Neoadjuvant therapy very likely plays a role to downstage to a resectable state in these subgroup patients. There are different treatment approaches to locally advanced pancreatic cancer management, including single or multi-agent chemotherapy, chemotherapy followed by chemoradiation, or immediate concurrent chemoradiation. Most patients need palliative treatment. Once pancreatic cancer becomes metastatic, it is uniformly fatal with an overall survival of generally 6 months from time of diagnosis. Gemcitabine has been the standard since 1997. FOLFIRINOX (5-fluorouracil, oxaliplatin, irinotecan, leucovorin has already shown superiority over gemcitabine in both progression-free survival and overall survival, but this regimen is suitable only for selected patients in ECOG performance status 0-1. FOLFIRINOX has already trickled down to the clinic in various modifications and in different patient groups, both locally advanced and metastatic. Many targeted agents, including bevacizumab, cetuximab showed negative results, except mild benefit with addition of erlotinib with gemcitabine, which was not considered clinically significant. There is no consensus regarding treatment in the second-line setting. It will be true to say that there was a real medical breakthrough with regards to improving the prognosis of pancreatic cancer as of 2013 with the results of MPACT study. In this study, patients whoreceived nab-paclitaxel plus gemcitabine lived a

  5. 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...... 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 of...

  6. 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 of...

  7. Oral Mucositis Prevention and Management by Therapeutic Laser in Head and Neck Cancers

    OpenAIRE

    Fekrazad, Reza; Chiniforush, Nasim

    2014-01-01

    Introduction: Oral mucositis is considered a severe complication in cancer patients receiving radiotherapy or chemotherapy for head and neck cancer. The aim of this review study was to assess the effect of low level laser therapy for prevention and management of oral mucositis in cancer patients.

  8. Effects of Physical Activity on Diabetes Management and Lowering Risk for Type 2 Diabetes

    Science.gov (United States)

    Tompkins, Connie L.; Soros, Arlette; Sothern, Melinda S.; Vargas, Alfonso

    2009-01-01

    Physical activity is a proven form of diabetes management and is considered a cornerstone in the prevention of diabetes. In children with diabetes, physical activity may improve insulin sensitivity and glucose uptake in skeletal muscle. Aerobic-based physical activity lasting 40-60 minutes daily for a minimum of four months is shown to enhance…

  9. 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)

    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

  10. Use of the project management methodology to establish physical protection system at nuclear facility

    International Nuclear Information System (INIS)

    The paper considers the possibility of using the project management methodology developed by the Project Management Institute (USA) in nuclear security in terms of modernization or development of physical protection system at nuclear facility. It was demonstrated that this methodology allows competent and flexible management of the projects on physical protection, ensuring effective control of their timely implementation in compliance with the planned budget and quality

  11. AWARENESS OF PHYSICAL THERAPY REHABILITATION FOR BREAST CANCER RELATED LYMPHEDEMA AMONG MEDICAL ONCOLOGY TEAM - A SURVEY

    OpenAIRE

    Mullai; Dhinakaran; Chanchal Gautam; Clarence Samuel

    2013-01-01

    Objective:To analyses the awareness of physical therapy rehabilitation for breast cancer related lymphedemaamong medical oncology team member.Method and materials:The data was contents of 12 custom made questionnaires which distributed and collectedfrom 34 medical oncology team members who are working in CMC & H, DMC & H, Chandigarh PGI,Results:Nearly 100 % of clinical oncologist and Radiation oncologist were aware about physical therapyrehabilitation and nearly 80% of Surgeon and Physician w...

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

    DEFF Research Database (Denmark)

    Winther, J F; Dreyer, L; Overvad, K; Tjønneland, A; Gerhardsson de Verdier, M

    1997-01-01

    -bladder and bile-duct cancers among women) can be predicted in the Nordic countries around the year 2000 to be caused by obesity. This implies that about 1% of all cancers in Nordic women and less than 1% of those in Nordic men could be avoided around the year 2000 if a healthy body weight could be maintained...... 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, is...... consistently associated with endometrial and gall-bladder cancers in women and renal-cell cancer in both men and women. As the prevalence of obesity was between 5 and almost 20% in the Nordic populations in 1995, 625 cancer cases (310 endometrial cancers, 270 renal-cell cancers in men and women and 45 gall...

  13. Effects of yoga on symptom management in breast cancer patients: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Hosakote Vadiraja

    2009-01-01

    Full Text Available Objectives: This study compares the effects of an integrated yoga program with brief supportive therapy on distressful symptoms in breast cancer outpatients undergoing adjuvant radiotherapy. Materials and Methods: Eighty-eight stage II and III breast cancer outpatients were randomly assigned to receive yoga (n = 44 or brief supportive therapy (n = 44 prior to their radiotherapy treatment. Intervention consisted of yoga sessions lasting 60 min daily while the control group was imparted supportive therapy once in 10 days during the course of their adjuvant radiotherapy. Assessments included Rotterdam Symptom Check List and European Organization for Research in the Treatment of Cancer-Quality of Life (EORTC QoL C30 symptom scale. Assessments were done at baseline and after 6 weeks of radiotherapy treatment. Results: A GLM repeated-measures ANOVA showed a significant decrease in psychological distress (P = 0.01, fatigue (P = 0.007, insomnia (P = 0.001, and appetite loss (P = 0.002 over time in the yoga group as compared to controls. There was significant improvement in the activity level (P = 0.02 in the yoga group as compared to controls. There was a significant positive correlation between physical and psychological distress and fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, and constipation. There was a significant negative correlation between the activity level and fatigue, nausea and vomiting, pain, dyspnea, insomnia, and appetite loss. Conclusion: The results suggest beneficial effects with yoga intervention in managing cancer- and treatment-related symptoms in breast cancer patients.

  14. Model of future officers' availability to the management physical training

    Directory of Open Access Journals (Sweden)

    Olkhovy O.M.

    2012-03-01

    Full Text Available A purpose of work is creation of model of readiness of graduating student to implementation of official questions of guidance, organization and leadthrough of physical preparation in the process of military-professional activity. An analysis is conducted more than 40 sources and questionnaire questioning of a 21 expert. For introduction of model to the system of physical preparation of students the list of its basic constituents is certain: theoretical methodical readiness; functionally-physical readiness; organizationally-administrative readiness. It is certain that readiness of future officers to military-professional activity foresees determination of level of forming of motive capabilities, development of general physical qualities.

  15. The need for hospital care of patients with clinically localized prostate cancer managed by noncurative intent

    DEFF Research Database (Denmark)

    Brasso, K; Friis, S; Juel, K;

    2000-01-01

    We studied the need for hospital care of patients 74 years old or younger with clinically localized prostate cancer managed by deferred endocrine therapy.......We studied the need for hospital care of patients 74 years old or younger with clinically localized prostate cancer managed by deferred endocrine therapy....

  16. Radiation Physics and Chemistry in Heavy-ion Cancer Therapy

    Directory of Open Access Journals (Sweden)

    Kimura, M.

    2007-12-01

    Full Text Available Heavy ions, such as carbon and oxygen ions, are classified as high-LET radiations, and produce a characteristic dose-depth distribution different from that of low-LET radiations such as γ-rays, xrays and electrons. Heavy ions lose less energy at the entrance to an irradiated biological system up to some depth than the low-LET radiations, while they deposit a large amount of dose within a very narrow range at a certain depth, producing the characteristic sharp peak called the Bragg peak. Therefore, by controlling the Bragg peak, it becomes possible to irradiate only the tumor region in a pin-point manner, while avoiding irradiation of the normal tissue, thus making heavyion therapy ideal for deep-seated tumor treatment. Clinical results on more than 2400 patients are very encouraging. However, very little is known about what is going on in terms of physics and chemistry inside the Bragg peak. In this paper the current status of our understanding of heavy-ion interactions and remaining problems of physics and chemistry for the heavy-ion treatment are explored, particularly in the Bragg peak region. Specially, the survey of the basic physical quantity, the mean energy required to form an ion pair (Wvalue for heavy ions of interest for radiotherapy is presented. Finally, the current clinical status of heavy-ion therapy is presented.

  17. Individualized dosimetry in the management of metastatic differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Aim. This paper analyzes the available data on the dosimetric approach and describes the use of dosimetry in the Division of Nuclear Medicine of the National Cancer Institute in Milan. Dosimetry is rarely performed when planning radio-iodine activity, although most of the available guidelines do mention this possibility, without giving any well defined indication. Aim of the present research was to validate the usefulness of dosimetry in the management of metastatic thyroid cancer. Benua (1962) set the limit of blood absorbed dose at 2 Gy to avoid hematological toxicity. Maxon (1983) determined at 80 Gy the dose to achieve complete destruction of a metastatic lesion. Dorn (2003) combined red marrow and lesion dosimetry showing that high activity administrations with less that 3 Gy to the red marrow are a safe and more effective with respect to fixed activities administrations. Lee (2008) reported 50% responses with high activity administrations based on blood dosimetry, in 47 patients which were unsuccessfully previously treated with fixed activities. Sgouros (2005) and Song (2006) introduced key parameters as Biological Effective Dose and Uniform Equivalent Dose in order to describe the effects of continuos low dose rate irradiation and non uniform activity uptake, typical of nuclear medicine treatments. Methods: Red marrow and lesion dosimetry (planar view) were performed during the treatment, without changing the fixed activity schema. Results: This experience demonstrate first of all, that dosimetry is feasible in the clinical routine, and that it can provide the clinician with important information, no matter its often quoted limited numerical accuracy. A total of 17/20 lesion doses below 80 Gy have been detected. Three/17 (doses between 40 and 80 Gy) disappeared in the follow-up scintigram. Two/17 were undetectable at computed tomography or nuclear magnetic resonance. These data suggest that repetition of treatment on a lesion drastically reduces its uptake

  18. Use of Ultrasound in the Management of Thyroid Cancer

    OpenAIRE

    Lew, John I.; Solorzano, Carmen C

    2010-01-01

    The article examines the utility of ultrasound in evaluating thyroid nodules, staging thyroid cancer, determining the extent of surgery needed in thyroid cancer patients, and the surveillance of patients treated for thyroid cancer.

  19. 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.

  20. Knowledge, Attitudes and Practices of Clinicians in Promoting Physical Activity to Prostate Cancer Survivors

    Science.gov (United States)

    Spellman, Claire; Craike, Melinda; Livingston, Patricia M.

    2014-01-01

    Objectives: This study examined the knowledge, attitudes and practices of clinicians in promoting physical activity to prostate cancer survivors. Design: A purposeful sample was used and cross-sectional data were collected using an anonymous, self-reported online questionnaire or an identical paper-based questionnaire. Settings: Health services…

  1. 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...

  2. Cancer Statistics

    Science.gov (United States)

    ... What Is Cancer? Cancer Statistics Cancer Disparities Cancer Statistics Cancer has a major impact on society in ... success of efforts to control and manage cancer. Statistics at a Glance: The Burden of Cancer in ...

  3. ENDOCRINE DILEMMA: Managing menopausal symptoms after breast cancer.

    Science.gov (United States)

    Eden, John

    2016-03-01

    Managing the symptoms of menopause after a diagnosis of breast cancer offers some unique clinical challenges. For some women, vasomotor symptoms can be severe and debilitating, and hormone therapy is at least relatively contraindicated. Non-oestrogen therapies for hot flushes include SSRIs, clonidine, gabapentin and perhaps black cohosh extracts. Vulvovaginal atrophy can usually be alleviated by simple moisturizers, although some may need specialized physiotherapy such as vaginal dilators. In a small number, topical oestrogens may be the only treatment that works. The CO2 laser may be a novel, non-oestrogen therapy to alleviate this unpleasant symptom. Bone loss can be accelerated in some patients on AIs or those who had early menopause induced by chemotherapy. PMID:26466611

  4. Update on the Management of Pancreatic Cancer in Older Adults.

    Science.gov (United States)

    Lee, Shin Yin; Sissoko, Moussa; Hartshorn, Kevan L

    2016-10-01

    Pancreatic cancer is more common in older adults, who are underrepresented in clinical trials and frequently under treated. Chronological age alone should not deter clinicians from offering treatment to geriatric patients, as they are a heterogeneous population. Geriatric assessment, frailty assessment tools, and toxicity risk scores help clinicians select appropriate patients for therapy. For resectable disease, surgery can be safe but should be done at a high-volume center. Adjuvant therapy is important; though there remains controversy on the role of radiation, chemotherapy is well studied and efficacious. In locally advanced unresectable disease, chemoradiation or chemotherapy alone is an option. Neoadjuvant therapy improves the chances of resectability in borderline resectable disease. Chemotherapy extends survival in metastatic disease, but treatment goals and risk-benefit ratios have to be clarified. Adequate symptom management and supportive care are important. There are now many new treatment strategies and novel therapies for this disease. PMID:27492426

  5. Anti-angiogenesis therapies: their potential in cancer management

    Directory of Open Access Journals (Sweden)

    Andrew Eichholz

    2010-05-01

    Full Text Available Andrew Eichholz, Shairoz Merchant, Andrew M GayaDepartment of Clinical Oncology, Guy’s and St. Thomas’ NHS Foundation Trust, London, United KingdomAbstract: Angiogenesis plays an important role in normal animal growth and development. This process is also vital for the growth of tumors. Angiogenesis inhibitors have a different mechanism of action to traditional chemotherapy agents and radiation therapy. The angiogenesis inhibitors can act synergistically with conventional treatments and tend to have non-overlapping toxicities. There are four drugs which have a proven role in treating cancer patients. Bevacizumab is a humanized monoclonal antibody that binds to and neutralizes vascular endothelial growth factor (VEGF. Sunitinib and sorafenib inhibit multiple tyrosine kinase receptors that are important for angiogenesis. Thalidomide inhibits the activity of basic fibroblast growth factor-2 (bFGF. The licensed indications and the supporting evidence are discussed. Other drugs are currently being tested in clinical trials and the most promising of these drugs are discussed. Aflibercept, also known as VEGF-trap, is a recombinant fusion protein that binds to circulating VEGF. The vascular disrupting agents act by targeting established blood vessels. These exciting new treatments have the potential to transform the management of cancer.Keywords: angiogenesis, bevacizumab, tyrosine kinase inhibitors, thalidomide, aflibercept, vascular disrupting agents

  6. Multidisciplinary neoadjuvant management for potentially curable pancreatic cancer

    International Nuclear Information System (INIS)

    Pancreatic adenocarcinoma remains the fourth leading cause of cancer mortality in the U.S. Despite advances in surgical technique, radiotherapy technologies, and chemotherapeutics, the 5-year survival rate remains approximately 20% for the 15% of patients who are eligible for surgical resection. The majority of this group suffers metastatic recurrence. However, despite advances in therapies for patients with advanced pancreatic cancer, only surgery has consistently proven to improve long-term survival. Various combinations of chemotherapy, biologic-targeted therapy, and radiotherapy have been evaluated in different settings to improve outcomes. In this context, a neoadjuvant (preoperative) treatment strategy offers numerous potential benefits: (1) ensuring delivery of early, systemic therapy, (2) improving selection of patients for surgical therapy with truly localized disease, (3) potential downstaging of the neoplasm facilitating a negative margin resection in patients with locally advanced disease, and (4) providing a superior clinical trial mechanism capable of rapid assessment of the efficacy of novel therapeutics. This article reviews the recent trends in the management of pancreatic adenocarcinoma, with a particular emphasis on a multidisciplinary neoadjuvant approach to treatment

  7. Multisciplinary management of patients with liver metastasis from colorectal cancer.

    Science.gov (United States)

    De Greef, Kathleen; Rolfo, Christian; Russo, Antonio; Chapelle, Thiery; Bronte, Giuseppe; Passiglia, Francesco; Coelho, Andreia; Papadimitriou, Konstantinos; Peeters, Marc

    2016-08-28

    Colorectal cancer (CRC) is one of the leading causes of cancer-related death. Surgery, radiotherapy and chemotherapy have been till now the main therapeutic strategies for disease control and improvement of the overall survival. Twenty-five per cent (25%) of CRC patients have clinically detectable liver metastases at the initial diagnosis and approximately 50% develop liver metastases during their disease course. Twenty-thirty per cent (20%-30%) are CRC patients with metastases confined to the liver. Some years ago various studies showed a curative potential for liver metastases resection. For this reason some authors proposed the conversion of unresectable liver metastases to resectable to achieve cure. Since those results were published, a lot of regimens have been studied for resectability potential. Better results could be obtained by the combination of chemotherapy with targeted drugs, such as anti-VEGF and anti-EGFR monoclonal antibodies. However an accurate selection for patients to treat with these regimens and to operate for liver metastases is mandatory to reduce the risk of complications. A multidisciplinary team approach represents the best way for a proper patient management. The team needs to include surgeons, oncologists, diagnostic and interventional radiologists with expertise in hepatobiliary disease, molecular pathologists, and clinical nurse specialists. This review summarizes the most important findings on surgery and systemic treatment of CRC-related liver metastases. PMID:27621569

  8. The role of social influences and cognitive self-regulation in supporting cancer patients to engage in physical activity

    OpenAIRE

    Ungar, Nadine

    2015-01-01

    Cancer patients are recommended to engage in regular physical activity, as research has identified various beneficial effects of exercise both during and after medical treatment (Schmitz et al., 2010; Speck, Courneya, Mâsse, Duval, & Schmitz, 2010). Most cancer patients are motivated to adopt a healthy lifestyle including regular physical activity (Demark-Wahnefried, Aziz, Rowland, & Pinto, 2005). However, it has been shown that only a minority of cancer patients meet the exercise guidelines ...

  9. Physical activity and risk for breast cancer a prospective cohort study among Swedish twins.

    Science.gov (United States)

    Moradi, Tahereh; Adami, Hans-Olov; Ekbom, Anders; Wedrén, Sara; Terry, Paul; Floderus, Birgitta; Lichtenstein, Paul

    2002-07-01

    The epidemiologic association between physical activity and breast cancer has been corroborated in many studies. Some inconsistencies remain, possibly due to variation in life periods for exposure assessment, confounding and undetected effect modification. In our cohort study, we address some of these questions by taking into account physical activity in different periods of life and by investigating effect modification by birth cohort and body mass index (BMI). Altogether 9,539 same-sex twin women aged 42-70 years who answered a questionnaire about their work and leisure-time physical exercise from ages 25 to 50 during 1967 and 1970 were included in our cohort. During follow-up, 506 breast cancer cases occurred through 1997. We used multivariate Cox models to estimate relative risk (RR) with 95% confidence interval (CI). We found no associations between physical activity and breast cancer overall. Women born between 1901 and 1917 (aged 51-70 at baseline) who reported regular leisure-time activity had a borderline significant 40% lower risk compared with those who reported no activity (RR 0.6; 95% CI 0.4-1.0; test for trend, p = 0.07). This association appeared to be confined to women with a low BMI after the age of 50 and to women with a high BMI during the premenopausal period. We found no evidence that work activity reduces risk for breast cancer. The importance of physical activity for breast cancer risk seems to depend on birth cohort. The association may be limited to normal-weight postmenopausal women and overweight premenopausal women. PMID:12115590

  10. Importance of balanced diet and physical activity during and after cancer treatment in adolescent patients

    Directory of Open Access Journals (Sweden)

    Barnes MJ

    2014-06-01

    Full Text Available Margaux J Barnes,1 Wendy Demark-Wahnefried21Department of Psychology, University of Alabama at Birmingham, 2University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama, USAAbstract: Adolescents diagnosed with cancer are at increased risk for current and future health problems and premature death. As such, it is important to foster the development of health-promoting behaviors that may ameliorate some of this risk. Specific attention has been given to diet and physical activity, as these are behaviors that can be directly controlled and modified by the survivor. Despite the importance of adequate nutrition and physical activity, a large proportion of adolescents with a history of cancer do not meet recommended guidelines for these health behaviors. The current review summarizes the beneficial effects of diet and physical activity in adolescent cancer patients both during and after treatment, evaluates interventions that have been developed to address these behaviors, and provides recommendations for future strategies on how to improve these behaviors in this population. A structured literature review identified ten empirical articles examining diet and/or physical activity interventions in adolescents with a history of cancer. While several interventions aimed at increasing diet and physical activity in this population have been successful, more research is needed to evaluate long-term maintenance of health behaviors, as well as the impact these behavioral changes have on adolescents as they continue into adulthood. Future interventions should incorporate key elements of adolescent development including individualized and specific intervention components and the incorporation of both peer and family support to increase saliency and long-term commitment.Keywords: oncology, adolescence, health-promoting behaviors

  11. Nuclear physics applications in diagnostics and cancer therapy

    CERN Document Server

    Amaldi, Ugo

    2005-01-01

    Only 1% of the 18,000 world accelerators are devoted to the production of radioisotopes for medical diagnostics. In fact at present about 85% of all the medical examinations use /sup 99m/Tc produced in nuclear reactors. But the development of Positron Emission Tomography and of its combination with Computer Tomography will boost the hospital use of cyclotrons. Much more general is the use of electron linacs in cancer therapy about 40% of the world accelerators are used for this so called "conventional" radiotherapy. In the developed countries every 10 million inhabitants about 20,000 oncological patients are irradiated every year with high-energy photons (called X-rays by radiotherapists) produced by electron linacs. Much less used is "hadrontherapy", the radiotherapy technique that employs protons, neutrons or carbon ions. Protons and ions are 'heavy' charged particles: they assure a more 'conformal' treatment than X-rays and thus spare better the surrounding healthy tissues allowing a larger dose and thus a...

  12. Regulation of breast cancer cell behaviours by the physical microenvironment constructed via projection microstereolithography.

    Science.gov (United States)

    Yang, Wenguang; Yu, Haibo; Li, Gongxin; Wang, Bo; Wang, Yuechao; Liu, Lianqing

    2016-05-26

    A considerable number of studies have examined how intrinsic factors regulate breast cancer cell behaviours; however, physical microenvironmental cues may also modulate cellular morphology, proliferation, and migration and mechanical properties. In the present study, the surrounding microenvironment of breast cancer cells was constructed using projection microstereolithography, enabling the investigation of the external environment's effects on breast cancer cell behaviours. A poly(ethylene) glycol diacrylate (PEGDA) solution was polymerized by programmable ultraviolet exposure to create arbitrary shapes with high biocompatibility, efficiency, flexibility and repeatability, and the resistance to cell attachment enabled the PEGDA coated film to hinder cell adhesion, allowing cells to grow in specific patterns. Furthermore, breast cancer cell morphology and mechanical properties were modified by altering the microenvironment. Proliferation was higher in breast cancer as compared to normal cells, consistent with the primary characteristic of malignant tumors. Moreover, breast cancer cells migrated more rapidly when grown in a narrow channel as compared to a wider channel. These findings enhance our understanding of the role of the microenvironment in breast cancer cell behaviours and can provide a basis for developing effective anticancer therapies. PMID:27072847

  13. Improving the training of managers in the sphere of physical culture and sports in Ukraine

    Directory of Open Access Journals (Sweden)

    Stadnik S.O.

    2013-09-01

    Full Text Available Analyzed contemporary research on the training of managers in the sphere of physical culture and sports in Ukraine and abroad. Analyzed 50 references, which dealt with various aspects of the preparation of sports managers. It was found that in higher education of Great Britain, Germany, France, Switzerland, Russia is working to prepare managers for the sphere of physical culture and sports. It was found that training of managers in Ukraine is carried out only on the basis of two universities. Found that the content of the training of sports managers in our country needs to be improved, taking into account international experience and current market conditions of the functioning of sports organizations. Identified the main ways of improving the training of managers in the sphere of physical culture and sports in Ukraine.

  14. 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)

    E. van Weert (Ellen); A.M. May (Anne); I. Korstjens (Irene); W.J. Post (Wendy); C.P. van der Schans (Cees); B. van den Borne (Bart); I. Mesters (Ilse); W.J.G. Ros (Wynand); J.E.H.M. Hoekstra-Weebers (Josette)

    2010-01-01

    textabstractBackground. 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 cancerrelated fatigue of physical training combined w

  15. INTERSPHINCTERIC TOTAL PROCTECTOMY IN THE MANAGEMENT OF LOW RECTAL CANCER

    Directory of Open Access Journals (Sweden)

    A. Montori

    2007-01-01

    Full Text Available The management of lower rectal cancer is still controversial. A multidisciplinary approach is recommended. There are a lot of surgical techniques for lower rectal cancer (abdomino-perineal rectal resection, nerve sparing technique, total mesorectal excision, intersphincteric total proctectomy, trans-anal anastomosis etc.. In this paper it is presented the intersphincteric total proctectomy. The key points for sphincter preservation surgery are: a good knowledge of anal function pathophysiology, 2 cm distal adequate margin (or 1 cm for neo-adjuvant treated patients, total mesorectal excision, colo-anal anastomosis, nerve sparing proctectomy. The colo-anal anastomosis is the last step of the intersphincteric total proctectomy. Neo-adjuvant therapy is also indicated. The selection criteria and the technique of intersphincteric total proctectomy is presented. Between 1987-2002 this procedure was made at 120 patients with lower rectal cancer. The postoperative specific complications were: pelvic peritonitis (n=1 and anal stenosis (n=4. No anastomotic leak was encountered. 9 patients were classified in stage 0, 48 in stage I, 26 in stage II and 37 in stage III (UICC clasification. The 5 years survival rate was 97.4% for stages 0 and I, 71.3% for stages II and III. The functional results revealed a good continence in 77.5%, incontinence of liquid stools in 12.5%, incontinence for flatus in 7.5%, local recurrence in 2.5% and sexual or urological disfunction in 5%. Conclusions: Preoperative radiotherapy and sphincter preservation surgery (intersphincteric proctectomy provide good control of distal rectal cancer. Combined radiotherapy and chemotherapy seems to improve oncologic results with minimal additional morbidity. Our 6-8 week post-radiotherapy interval maximizes tumor shrinkage reducing the risks of radiation-induced complications. Intersphincteric proctectomy according to our experience reduces post-operative complications and risk of local

  16. Physical activity in prevention and management of obesity and type-2 diabetes.

    Science.gov (United States)

    Hill, James O; Stuht, Jennifer; Wyatt, Holly R; Regensteiner, Judith G

    2006-01-01

    Obesity and type-2 diabetes can be considered diseases of physical inactivity. Physically activity protects against type-2 diabetes through its positive effects on weight management and on the metabolic pathways involved in glycemic control that are not weight-dependent. Increasing physical activity is one of the most effective strategies both for preventing type-2 diabetes and for managing it once it is present. However, we still face an enormous challenge in getting people to achieve sustainable increases in physical activity. A promising strategy is to get people walking more, starting small and increasing gradually over time. PMID:16820740

  17. Management of biochemical recurrence after primary treatment of prostate cancer: A systematic review of the literature

    OpenAIRE

    Punnen, S; Cooperberg, MR; D'Amico, AV; Karakiewicz, PI; Moul, JW; Scher, HI; Schlomm, T; Freedland, SJ

    2013-01-01

    Context Despite excellent cancer control with the treatment of localized prostate cancer (PCa), some men will experience a recurrence of disease. The optimal management of recurrent disease remains uncertain. Objective To systematically review recent literature regarding management of biochemical recurrence after primary treatment for localized PCa. Evidence acquisition A comprehensive systematic review of the literature was performed from 2000 to 2012 to identify articles pertaining to manag...

  18. 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. PMID:25831230

  19. Physical exercise, use of Plantago ovata and aspirin, and reduced risk of colon cancer.

    Science.gov (United States)

    Juarranz, M; Calle-Purón, M-E; González-Navarro, A; Regidor-Poyatos, E; Soriano, T; Martínez-Hernandez, D; Rojas, V-D; Guinee, V F

    2002-10-01

    To evaluate certain risk and protective factors for colon cancer in our population, we conducted a paired case-control study where cases were all people diagnosed with colon cancer who were registered at the Cancer Data Exchange Systems of the Community of Madrid between January 1995 and December 1996, and controls were randomly taken from electoral lists. The study population consisted of 424 persons. Using SPSS for Windows, variables were adjusted by multiple logistic regression. The results indicate that lack of physical exercise is associated with an increased risk of colon cancer, with an odds ratio (OR) of 2.8 (95% confidence interval (CI) 1.28-6.21) as compared with moderate activity 1-2 days a week. The risk decreases linearly with increasing physical exercise, and this association remains after stratifying the analysis for the existence of constipation. The consumption of is associated with a reduced risk of colon cancer in constipated patients, with an OR of 0.094 (0.014-0.639), as is aspirin use, with an OR of 0.980 (0.898-0.999). These results were obtained after adjusting all the ORs for diet, smoking, alcohol consumption, family history and socio-demographic factors such as marital status and educational level. PMID:12394244

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

    DEFF Research Database (Denmark)

    Peoples, Hanne; Brandt, Åse; Wæhrens, Eva Elisabet Ejlersen;

    Background: People with advanced cancer are increasingly able to live for extended periods of time. Advanced cancer influences the ability to manage occupations in the everyday life. Although studies have showed that people with advanced cancer experience occupational difficulties, there are...... limited research that more specifically explore how these are managed. The objective was to describe and explore how people with advanced cancer manage occupations at home. Material and methods: A qualitative descriptive design was applied. 73 participants were consecutively recruited from a Danish...... “Everyday life under change” and two sub-categories 1) Appling strategies to manage occupations in everyday life and 2) Preserving a meaningful everyday life. Significance: The findings suggest that people with advanced cancer, to a greater extent, should be supported in exploring familiar as well as new...

  1. 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.

  2. Exercise and nutrition routine improving cancer health (ENRICH: The protocol for a randomized efficacy trial of a nutrition and physical activity program for adult cancer survivors and carers

    Directory of Open Access Journals (Sweden)

    Boyes Allison

    2011-04-01

    Full Text Available Abstract Background The Exercise and Nutrition Routine Improving Cancer Health (ENRICH study is investigating a novel lifestyle intervention aimed at improving the health behaviors of adult cancer survivors and their carers. The main purpose of the study is to determine the efficacy of lifestyle education and skill development delivered via group-based sessions on the physical activity and dietary behaviors of participants. This article describes the intervention development, study design, and participant recruitment. Methods/Design ENRICH is a randomized controlled trial, conducted in Australia, with two arms: an intervention group participating in six, two-hour face-to-face sessions held over eight weeks, and a wait-list control group. Intervention sessions are co-facilitated by an exercise physiologist and dietician. Content includes healthy eating education, and a home-based walking (utilizing a pedometer and resistance training program (utilizing elastic tubing resistance devices. The program was developed with reference to social cognitive theory and chronic disease self-management models. The study population consists of cancer survivors (post active-treatment and their carers recruited through community-based advertising and referral from health professionals. The primary outcome is seven-days of sealed pedometry. Secondary outcomes include: self-reported physical activity levels, dietary intake, sedentary behavior, waist circumference, body mass index, quality of life, and perceived social support. The outcomes will be measured at baseline (one week prior to attending the program, eight-weeks (at completion of intervention sessions, and 20-weeks. The intervention group will also be invited to complete 12-month follow-up data collection. Process evaluation data will be obtained from participants by questionnaire and attendance records. Discussion No trials are yet available that have evaluated the efficacy of group-based lifestyle

  3. Sociocultural factors and breast cancer in sub-Saharan Africa: implications for diagnosis and management.

    Science.gov (United States)

    Tetteh, Dinah A; Faulkner, Sandra L

    2016-01-01

    The incidence of breast cancer is on the rise in sub-Saharan Africa (SSA) and efforts at early diagnosis have not been very successful because the public has scant knowledge about the disease, a large percentage of breast cancer cases are diagnosed late and mainly rural SSA women's practice of breast self-examination is poor. In this paper, we argue that an examination of the social and cultural contexts of SSA that influence breast cancer diagnosis and management in the region is needed. We discuss the implications of sociocultural factors, such as gender roles and spirituality, on breast cancer diagnosis and management in SSA. PMID:26757491

  4. The Effect of Managers Genders on Workers Mental and Physical Health: An Application in Banking Sector

    OpenAIRE

    Mahmut Özdevecioğlu; Cemile Çelik; Mahmut Akın; Fatma İncebalcı

    2013-01-01

    In this research it is evaluated the workers physical and mental health differences in which their managers gender is man or woman. To find out the differences a research is handled in banking sector. According to the results of the research, workers in which working with the male manager; there are difference between male and female workers according to physical health and there are not difference between male and female workers according to mental health. There are differences between ma...

  5. Management of human resources in the physical activity and sport: concepts and perspectives

    OpenAIRE

    Campos Izquierdo, Antonio

    2010-01-01

    The management proper of human resources in organizations of physical activity and sport is essential to ensure the quality, efficiency and professionalism of service offered and even, if not done the right way can produce the benefits become a nuisance and risks to health, safety and education of citizens and for society as such. The perspective of management and organization of human resources in the states of physical activity and sport should be comprehensive, integrated and cross, which ...

  6. Knowledge of physical education teachers about emergency management of tooth avulsion

    OpenAIRE

    Claudia Londero Pagliarin; Clacir Londero Zenkner; Fernando Branco Barletta

    2011-01-01

    A great number of traumatic dental injuries occur at school, during sports-related activities. However, physical education teachers are often not prepared to provide emergency management of dental trauma in general and of tooth avulsion in particular. The aim of this study was to assess the knowledge of emergency management of tooth avulsion among physical education teachers at public and private schools of a city in southern Brazil. A questionnaire covering personal and professional informat...

  7. The lived experience of physically active older prostate cancer survivors on androgen deprivation therapy.

    Science.gov (United States)

    Wright-St Clair, Valerie A; Malcolm, Wanda; Keogh, Justin W L

    2014-03-01

    This study sought to explore the lived experiences of physically active prostate cancer survivors on androgen deprivation therapy (ADT), who exercise individually. Three older men (74-88 years old) with prostate cancer, using ADT continuously for at least 12 months and regularly exercising for at least 6 months, participated in this qualitative pilot study, informed by interpretive phenomenology. Data were gathered using individual semi-structured interviews, audio recorded and transcribed verbatim. Coherent stories were drawn from each transcript and analyzed using iterative and interpretive methods. van Manen's lifeworld existentials provided a framework for interpreting across the research text. Three notions emerged: Getting started, Having a routine and Being with music. Together they reveal what drew the participants to exercising regularly despite the challenges associated with their cancer and treatments. This study provides insights into the benefits of, and what it means for, older men with prostate cancer to regularly exercise individually. These findings may assist cancer clinicians and other allied health professionals to be more attuned to prostate cancer survivors' lived experiences when undergoing ADT, allowing clinicians to better promote regular exercise to their patients as a foundational component of living well. PMID:23862577

  8. Centralization and Decentralization of Schools' Physical Facilities Management in Nigeria

    Science.gov (United States)

    Ikoya, Peter O.

    2008-01-01

    Purpose: This research aims to examine the difference in the availability, adequacy and functionality of physical facilities in centralized and decentralized schools districts, with a view to making appropriate recommendations to stakeholders on the reform programmes in the Nigerian education sector. Design/methodology/approach: Principals,…

  9. Pegylated liposomal doxorubicin in the management of ovarian cancer

    Science.gov (United States)

    Staropoli, Nicoletta; Ciliberto, Domenico; Botta, Cirino; Fiorillo, Lucia; Grimaldi, Anna; Lama, Stefania; Caraglia, Michele; Salvino, Angela; Tassone, Pierfrancesco; Tagliaferri, Pierosandro

    2014-01-01

    Ovarian cancer is the leading cause of death among gynecological tumors. Carboplatin/paclitaxel represents the cornerstone of front-line treatment. Instead, there is no consensus for management of recurrent/progressive disease, in which pegylated liposomal doxorubicin (PLD) ± carboplatin is widely used. We performed a systematic review and metaanalysis to evaluate impact of PLD-based compared with no-PLD-based regimens in the ovarian cancer treatment. Data were extracted from randomized trials comparing PLD-based treatment to any other regimens in the January 2000–January 2013 time-frame. Study end-points were overall survival (OS), progression free survival (PFS), response rate (RR), CA125 response, and toxicity. Hazard ratios (HRs) of OS and PFS, with 95% CI, odds ratios (ORs) of RR and risk ratios of CA125 response and grade 3–4 toxicity, were extracted. Data were pooled using fixed and random effect models for selected endpoints. Fourteen randomized trials for a total of 5760 patients were selected and included for the final analysis, which showed no OS differences for PLD-based compared with other regimens (pooled HR: 0.94; 95% CI: 0.88–1.02; P = 0.132) and a significant PFS benefit of PLD-based schedule (HR: 0.91; 95% CI: 0.86–0.96; P = 0.001), particularly in second-line (HR: 0.85; 95% CI: 0.75–0.91) and in platinum-sensitive (HR: 0.83; 95% CI: 0.74–0.94) subgroups. This work confirmed the peculiar tolerability profile of this drug, moreover no difference was observed for common hematological toxicities and for RR, CA125 response. PLD-containing regimens do not improve OS when compared with any other schedule in all phases of disease. A marginal PFS advantage is observed only in platinum-sensitive setting and second-line treatment. PMID:24658024

  10. 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.

  11. 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.)

  12. The Current and Evolving Role of PET in Personalized Management of Lung Cancer.

    Science.gov (United States)

    Mena, Esther; Yanamadala, Anusha; Cheng, Gang; Subramaniam, Rathan M

    2016-07-01

    Using tumor genomic profiling information has revolutionized the landscape of personalized treatment of lung cancer. The management of lung cancer and non-small cell lung cancer particularly is influenced by discoveries of activating mutations in epidermal growth factor receptor and targeted therapies with tyrosine kinase inhibitors, fusion genes involving anaplastic lymphoma kinase, and targeted therapies for Kristen-Rat-Sarcoma and MET protooncogenes. PET imaging plays an important role in assessing the biologic behavior of lung cancer and defining response to therapy. This review summarizes genomic discoveries in lung cancer and their implications for functional PET imaging. PMID:27321029

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

    International Nuclear Information System (INIS)

    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.)

  14. CUSTOMER RELATIONSHIP MANAGEMENT (CRM) IN PHYSICAL FITNESS CLUBS

    OpenAIRE

    Mahmoud Goodarzi

    2011-01-01

    Although customer relationship management has been identified as an important businessapproach in enterprise institutes; there is no universally accepted definition of CRM. Swiftdefined it as an enterprise approach to understanding and influencing customer behavior throughmeaningful communications in order to improve customer knowledge recovery; customeracquisition; customer retention; customer loyalty; and finally customer profitability (2).Thompson (2002) knows CRM as a business strategy to...

  15. Reengineering and health physics within the project Hanford management contract

    International Nuclear Information System (INIS)

    The impending transition of the Hartford Site management and operations (M ampersand O) contract to a management and integrating (M ampersand I) contract format, together with weak radiological performance assessments by external organizations and reduced financial budgets prompted the 're-engineering' of the previous Hanford prime contractor Radiological Control (Rad Con) organization. This paper presents the methodology, identified areas of improvements, and results of the re-engineering process. The conversion from the M ampersand O to the M ampersand I contract concept resulted in multiple independent Rad Con organizations reporting to separate major contractors who are managed by an integrating contractor. This brought significant challenges when establishing minimum site standards for sitewide consistency, developing roles and responsibilities, and maintaining site Rad Con goals. Championed by the previous contractor's Rad Con Director, Denny Newland, a five month planning effort was executed to address the challenges of the M ampersand I and to address identified weaknesses. Fluor Daniel Hanford assumed the responsibility as integrator of the Project Hanford Management Contract on October 1, 1996. The Fluor Daniel Hanford Radiation Protection Director Jeff Foster presents the results of the re-engineering effort, including the significant cost savings, process improvements, field support improvements, and clarification of roles and responsibilities that have been achieved

  16. Impacts of different management systems on the physical quality of an Amazonian Oxisol

    OpenAIRE

    Elaine Maria Silva Guedes; Antonio Rodrigues Fernandes; Herdjania Veras de Lima; Ademar Pereira Serra; José Ribamar Costa; Rafael da Silva Guedes

    2012-01-01

    The physical quality of Amazonian soils is relatively unexplored, due to the unique characteristics of these soils. The index of soil physical quality is a widely accepted measure of the structural quality of soils and has been used to specify the structural quality of some tropical soils, as for example of the Cerrado ecoregion of Brazil. The research objective was to evaluate the physical quality index of an Amazonian dystrophic Oxisol under different management systems. Soils under five ma...

  17. Asilomar conference on managing complexity in high energy physics: A summary and renaming of the conference

    International Nuclear Information System (INIS)

    Even if it was not either conscious or deliberate, physicists at the Asilomar Conference on Computing in High Energy Physics, probably for the first time, focussed a conference on the multitude of problems associated with the new scale of complexity in high energy physics experiments. This summary of the conference emphasizes issues of managing this complexity with new computer techniques. It also points to the emerging relevance of Artificial Intelligence subjects to particle physics. (orig.)

  18. Race, Poverty May Affect Early Stage Breast Cancer Management

    Science.gov (United States)

    ... Services, or federal policy. More Health News on: Breast Cancer Health Disparities Women's Health Recent Health News Related MedlinePlus Health Topics Breast Cancer Health Disparities Women's Health About MedlinePlus Site Map FAQs Contact ...

  19. 2014 Korean Liver Cancer Study Group-National Cancer Center Korea Practice Guideline for the Management of Hepatocellular Carcinoma

    OpenAIRE

    ,

    2015-01-01

    The guideline for the management of hepatocellular carcinoma (HCC) was first developed in 2003 and revised in 2009 by the Korean Liver Cancer Study Group and the National Cancer Center, Korea. Since then, many studies on HCC have been carried out in Korea and other countries. In particular, a substantial body of knowledge has been accumulated on diagnosis, staging, and treatment specific to Asian characteristics, especially Koreans, prompting the proposal of new strategies. Accordingly, the n...

  20. Managing and capturing the physics of robotic systems

    Science.gov (United States)

    Werfel, Justin

    Algorithmic and other theoretical analyses of robotic systems often use a discretized or otherwise idealized framework, while the real world is continuous-valued and noisy. This disconnect can make theoretical work sometimes problematic to apply successfully to real-world systems. One approach to bridging the separation can be to design hardware to take advantage of simple physical effects mechanically, in order to guide elements into a desired set of discrete attracting states. As a result, the system behavior can effectively approximate a discretized formalism, so that proofs based on an idealization remain directly relevant, while control can be made simpler. It is important to note, conversely, that such an approach does not make a physical instantiation unnecessary nor a purely theoretical treatment sufficient. Experiments with hardware in practice always reveal physical effects not originally accounted for in simulation or analytic modeling, which lead to unanticipated results and require nontrivial modifications to control algorithms in order to achieve desired outcomes. I will discuss these points in the context of swarm robotic systems recently developed at the Self-Organizing Systems Research Group at Harvard.

  1. CURRENT CONCEPTS IN MANAGEMENT OF ORAL CANCER – SURGERY

    OpenAIRE

    Jatin P. Shah; Gil, Ziv

    2008-01-01

    Oral cancer is the sixth most common cancer worldwide, with a high prevalence in South Asia. Tobacco and alcohol consumption remain the most dominant etiologic factors, however HPV has been recently implicated in oral cancer. Surgery is the most well established mode of initial definitive treatment for a majority of oral cancers. The factors that affect choice of treatment are related to the tumor and the patient. Primary site, location, size, proximity to bone, and depth of infiltration are ...

  2. High-intensity resistance and cardiovascular training improve physical capacity in cancer patients undergoing chemotherapy

    DEFF Research Database (Denmark)

    Quist, Morten; Rørth, Mikael Rahbek; Zacho, Morten;

    2006-01-01

    65 years of age (mean age 42.8) participated in a 9-h weekly training program over 6 weeks. The intervention involved physical exercise, relaxation, massage, and body-awareness training. Physical capacity (one-repetition maximum tests (1RM), VO2max) and body composition (weight, skin-fold) were......-term study support the theory that exercise is a beneficial intervention strategy for increasing muscle strength and aerobic fitness during antineoplastic chemotherapy. This type of exercise program can be an important component of complementary treatment for cancer patients undergoing chemotherapy....

  3. Bupivacaine administered intrathecally versus rectally in the management of intractable rectal cancer pain in palliative care

    Directory of Open Access Journals (Sweden)

    Zaporowska-Stachowiak I

    2014-10-01

    Full Text Available Iwona Zaporowska-Stachowiak,1,2 Grzegorz Kowalski,3 Jacek Łuczak,2 Katarzyna Kosicka,4 Aleksandra Kotlinska-Lemieszek,3 Maciej Sopata,3 Franciszek Główka4 1Chair and Department of Pharmacology, Poznan University of Medical Sciences, Poznan, Poland; 2Palliative Medicine In-patient Unit, University Hospital of Lord's Transfiguration, Poznan University of Medical Sciences, Poznan, Poland; 3Palliative Medicine Chair and Department, Poznan University of Medical Sciences, Poznan, Poland; 4Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Poznan, Poland Background: Unacceptable adverse effects, contraindications to and/or ineffectiveness of World Health Organization step III "pain ladder" drugs causes needless suffering among a population of cancer patients. Successful management of severe cancer pain may require invasive treatment. However, a patient's refusal of an invasive procedure necessitates that clinicians consider alternative options. Objective: Intrathecal bupivacaine delivery as a viable treatment of intractable pain is well documented. There are no data on rectal bupivacaine use in cancer patients or in the treatment of cancer tenesmoid pain. This study aims to demonstrate that bupivacaine administered rectally could be a step in between the current treatment options for intractable cancer pain (conventional/conservative analgesia or invasive procedures, and to evaluate the effect of the mode of administration (intrathecal versus rectal on the bupivacaine plasma concentration.Cases: We present two Caucasian, elderly inpatients admitted to hospice due to intractable rectal/tenesmoid pain. The first case is a female with vulvar cancer, and malignant infiltration of the rectum/vagina. Bupivacaine was used intrathecally (0.25–0.5%, 1–2 mL every 6 hours. The second case is a female with ovarian cancer and malignant rectal infiltration. Bupivacaine was adminstered rectally (0.05–0.1%, 100 m

  4. Contemporary management of low-risk bladder cancer

    NARCIS (Netherlands)

    Falke, J.; Witjes, J.A.

    2011-01-01

    Bladder cancer comprises a heterogeneous group of tumors, the majority of which are non-muscle-invasive bladder cancer (NMIBC) at initial presentation. Low-risk bladder cancer--defined as pTa low-grade papillary tumors--is the type of NMIBC with the most favorable oncologic outcome. Although the ris

  5. Effects of Exercise Interventions and Physical Activity Behavior on Cancer Related Cognitive Impairments: A Systematic Review

    OpenAIRE

    Zimmer, Philipp; Baumann, Freerk T.; Oberste, Max; Wright, Peter; Garthe, Alexander; Schenk, Alexander; Elter, Thomas; Daniel A. Galvao; Bloch, Wilhelm; Hübner, Sven T.; Wolf, Florian(Max-Planck-Institut für Physik (Werner-Heisenberg-Institut), Föhringer Ring 6, München, 80805, Germany)

    2016-01-01

    This systematic review analyzes current data on effects of exercise interventions and physical activity behavior on objective and subjective cancer related cognitive impairments (CRCI). Out of the 19 studies which met all inclusion criteria, five RCTs investigated rodents, whereas the other 14 trials explored humans and these included six RCTs, one controlled trial, two prospective noncontrolled trials, one case series, one observational study, and three cross-sectional studies. The results f...

  6. Prescription of Physical Activity for Patients with Rectal Cancer during Neoadjuvant Therapy

    OpenAIRE

    A. Ruiz; Fiuza Luces, María del Carmen; Pagola Aldazabal, Itziar; Soria, Ana; Ludena, Blanca; Huerga, Daniel

    2010-01-01

    Physical activity (PA) is an important health behaviour in any population and also in patients with cancer. In spite of evident benefits, prescription of exercise has not been added to general recommendations. Lack of prospective data about survival, rejection by oncologists to prescribe PA and discordant information from different physicians could explain it. Prescription of exercise through a set of recommendations, supervised training, as well as, reinforcement of these recommendations by ...

  7. Polymorphisms in DNA Repair Genes, Recreational Physical Activity and Breast Cancer Risk

    OpenAIRE

    McCullough, Lauren E.; Santella, Regina M.; Cleveland, Rebecca J.; Millikan, Robert C.; Olshan, Andrew F.; North, Kari E; Bradshaw, Patrick T.; Eng, Sybil M.; Terry, Mary Beth; Shen, Jing; Crew, Katherine D.; Rossner, Pavel; Teitelbaum, Susan L.; Neugut, Alfred I.; Gammon, Marilie D.

    2013-01-01

    The mechanisms driving the inverse association between recreational physical activity (RPA) and breast cancer risk are complex. While exercise is associated with increased reactive oxygen species production it may also improve damage repair systems, particularly those that operate on single-strand breaks including base excision repair (BER), nucleotide excision repair (NER) and mismatch repair (MMR). Of these repair pathways, the role of MMR in breast carcinogenesis is least investigated. Pol...

  8. Management of Cancer Survivors in Clinical and Public Health Perspectives: Current Status and Future Challenges in Korea

    OpenAIRE

    Shin, Dong Wook; Cho, BeLong; Kim, So Young; Jung, Je Hyuck; Park, Jong Hyock

    2013-01-01

    The number of cancer survivors is increasing dramatically. Many cancer survivors face lifetime risks associated with their cancer therapy, with a significant proportion at risk for serious morbidity and premature mortality. Concerns regarding the long-term physical, psychosocial, and economic effects of cancer treatment on cancer survivors and their families are increasingly being recognized and addressed by public and private sector. This article summarizes economic burden of cancer survivor...

  9. Bridging Gaps in Multidisciplinary Head and Neck Cancer Care: Nursing Coordination and Case Management

    International Nuclear Information System (INIS)

    Patients with advanced head and neck cancer face not only a life-threatening malignancy, but also a remarkably complex treatment regimen that can affect their cosmetic appearance and ability to speak, breathe, and swallow. These patients benefit from the coordinated interaction of a multidisciplinary team of specialists and a comprehensive plan of care to address their physical and psychosocial concerns, manage treatment-related toxicities, and prevent or limit long-term morbidities affecting health-related quality of life. Although little has been published on patient-provider communication with a multidisciplinary team, evidence has suggested that gaps often occur in communication between patients and providers, as well as between specialists. These communication gaps can hinder the multidisciplinary group from working toward common patient-centered goals in a coordinated 'interdisciplinary' manner. We discuss the role of a head-and-neck oncology nurse coordinator at a single institution in bridging gaps across the continuum of care, promoting an interdisciplinary team approach, and enhancing the overall quality of patient-centered head-and-neck cancer care

  10. Oral complications of cancer therapies. Management of mucositis during therapy

    International Nuclear Information System (INIS)

    This paper reviews the purposes of an oral care protocol, the major components of an oral care regimen, and oral care protocols and studies done to date. Many questions remain in the area of optimal oral care for the patient experiencing mucositis as a sequela of cancer treatment. Research is needed on types and use of mouth rinses, effective, harmless, and pleasant lip lubricants, appropriate analgesic and anti-inflammatory combinations, and the effectiveness of a variety of devices for oral cleansing, to name a few areas. As outpatient oncology services grow, oral care protocols must be developed to meet the needs of ambulatory patient populations. Oral care regimens must be safe, easy to use, and economical as well as effective to ensure patient and staff compliance. Research on the management of mucositis must be conducted in both inpatient and outpatient settings. Finally, in order to obtain sufficient sample sizes and optimize data collection, these studies will need to be conducted by multidisciplinary teams (including dentists, oncologists, radiation therapists, and nurses) across multiple sites. Not until large-scale clinical trials are done on the treatment of mucositis will we be able to optimize the therapeutic regimen for the patient. 43 references

  11. Beyond the visible: Managing heart disease and cancer with nuclear science

    International Nuclear Information System (INIS)

    Heart disease and cancer are the world's number one and two killers. According to the World Health Organization (WHO), heart disease kills 17 million people a year - almost one third of all deaths worldwide - and cancer causes 7 million deaths every year. Early and accurate diagnosis is vital for effective treatment of both heart disease and cancer. Nuclear medicine techniques are helping to provide the vital information that doctors need to make decisions about treatment and disease management for patients

  12. Skin care management in cancer patients: an evaluation of quality of life and tolerability

    OpenAIRE

    Haley, Ann Cameron; Calahan, Cara; Gandhi, Mona; West, Dennis P.; Rademaker, Alfred; Lacouture, Mario E.

    2010-01-01

    Purpose The objective of this study is to evaluate quality of life (QoL) and tolerability of three articles specifically developed for cancer skin care management (skin moisturizer, face moisturizer, and face wash). Methods Participants were cancer patients (n = 99) receiving systemic anticancer therapies and/or radiotherapy at Northwestern University. Subjects were assessed at the initial visit for adverse skin reactions based on the National Cancer Institute’s Common Terminology Criteria fo...

  13. Morphine mouthwash for the management of oral mucositis in patients with head and neck cancer

    OpenAIRE

    Mostafa Sarvizadeh; Simin Hemati; Mohsen Meidani; Moghtada Ashouri; Mahnaz Roayaei; Armindokht Shahsanai

    2015-01-01

    Background: Oral mucositis is a debilitating side effect of cancer treatment for which there is not much successful treatments at yet. We evaluated the effectiveness of topical morphine compared with a routine mouthwash in managing cancer treatment-induced mucositis. Materials and Methods: Thirty head and neck cancer patients with severe mucositis (World Health Organization Grade III or IV) were randomized into the morphine and magic mouthwash groups. Patients received morphine sulfate 2%...

  14. Surveillance Recommendations in Reducing Risk of and Optimally Managing Breast Cancer-Related Lymphedema

    OpenAIRE

    Ostby, Pamela L.; Jane M Armer; Dale, Paul S.; Margaret J. Van Loo; Cassie L. Wilbanks; Stewart, Bob R.

    2014-01-01

    Breast cancer survivors are at increased risk for the development of breast cancer-related lymphedema (BCRL), a chronic, debilitating, and disfiguring condition that is progressive and requires lifelong self-management of symptoms. It has been reported that over 40% of the 2.5 million breast cancer survivors in the United States may meet the criteria for BCRL during their lifetimes. Ongoing surveillance, beginning with pre-operative assessment, has been effective in identifying subclinical ly...

  15. Circulating Cell-Free Tumour DNA in the Management of Cancer

    OpenAIRE

    Glenn Francis; Sandra Stein

    2015-01-01

    With the development of new sensitive molecular techniques, circulating cell-free tumour DNA containing mutations can be identified in the plasma of cancer patients. The applications of this technology may result in significant changes to the care and management of cancer patients. Whilst, currently, these “liquid biopsies” are used to supplement the histological diagnosis of cancer and metastatic disease, in the future these assays may replace the need for invasive procedures. Applications ...

  16. Venous Thromboembolism in Cancer Patients Undergoing Major Abdominal Surgery: Prevention and Management

    OpenAIRE

    Bhavana Bhagya Rao; Kalayarasan, R.; Vikram Kate; Ananthakrishnan, N

    2012-01-01

    Cancer is an important risk factor for venous thrombosis. Venous thromboembolism is one of the most common complications of cancer and the second leading cause of death in these patients. Recent research has given insight into mechanism and various risk factors in cancer patients which predispose to thromboembolism. The purpose of this review is to summarize the current knowledge on the prophylaxis, diagnosis, and management of venous thromboembolism in these patients.

  17. Exercise Improves Physical Function and Mental Health of Brain Cancer Survivors: Two Exploratory Case Studies.

    Science.gov (United States)

    Levin, Gregory T; Greenwood, Kenneth M; Singh, Favil; Tsoi, Daphne; Newton, Robert U

    2016-06-01

    Background Malignant brain tumors are unpredictable and incurable, with 5-year survival rates less than 30%. The poor prognosis combined with intensive treatment necessitates the inclusion of complementary and supportive therapies that optimize quality of life and reduce treatment-related declines in health. Exercise therapy has been shown to be beneficial in other cancer populations, but no evidence is available for brain cancer survivors. Therefore, we report results from 2 preliminary cases. Methods Two female patients diagnosed with glioblastoma multiforme and oligodendroglioma participated in a structured and supervised 12-week exercise program. The program consisted of two 1-hour resistance and aerobic exercise sessions per week and additional self-managed aerobic sessions. Outcome measures of strength, cardiovascular fitness, and several psychological indicators (depression, anxiety, and quality of life) were recorded at baseline, after 6 weeks and at the conclusion of the intervention. Results Exercise was well tolerated; both participants completed all 24 sessions and the home-based component with no adverse effects. Objective outcome measures displayed positive responses relating to reduced morbidity. Similar positive responses were found for psychological outcomes. Scores on the Hospital Anxiety and Depression Scale showed clinically meaningful improvements in depression and total distress. Conclusion These findings provide initial evidence that, despite the difficulties associated with brain cancer treatment and survivorship, exercise may be safe and beneficial and should be considered in the overall management of patients with brain cancer. PMID:26276806

  18. Has PET-imaging changed the scenario in cancer management in India

    International Nuclear Information System (INIS)

    PET imaging changed the scenario of cancer management in India. With the help of institutes like Bhabha Atomic Research Centre and Radiation Medical Centre it would have been impossible to extend services to the needy at economical price

  19. A comprehensive review of head and neck cancer rehabilitation: Physical therapy perspectives

    Directory of Open Access Journals (Sweden)

    Karthikeyan Guru

    2012-01-01

    Full Text Available Rehabilitation in relation to cancer can be preventative, restorative, supportive, and palliative. It is recognized that patients may have rehabilitation needs throughout their care pathway. The role of physiotherapy in the cancer rehabilitation is less understood and particularly in the head and neck cancer (HNC patients. This results in various residual deformities and dysfunctions for the patients with HNC. The objective of this review is to provide detailed information regarding the problems faced after the cancer treatments and rehabilitation of patients who suffered with HNC. The fact that cancer patients are facing several months of chemotherapy and/or radiotherapy and usually major surgery, as well as the direct effect of immobility due to pain, means that muscle wasting, joint stiffness, as well as de-conditioning and fatigue are inevitable. The absence of physiotherapy intervention would be detrimental to patient care and the ability of the patient/family to cope with the effects of the disease or its treatment on their functional capacity and quality of life. Following any treatment for HNC, physical therapy may play an essential role in preventing various complications and helping patients to mitigate impairments, and restoring function of the shoulder joint, neck, and face.

  20. 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.

  1. Current Usage of Traditional Chinese Medicine in the Management of Breast Cancer: A Practitioner's Perspective.

    Science.gov (United States)

    McPherson, Luke; Cochrane, Suzanne; Zhu, Xiaoshu

    2016-09-01

    Introduction This qualitative study seeks to explore the role within the context of Australian breast cancer oncology treatments that traditional Chinese medicine (TCM) practitioners play in the treatment of breast cancer. Methods Semistructured interviews were used on 2 groups: the first group was TCM practitioners who were recognized experts in breast cancer, and the second group consisted of TCM practitioners who treated breast cancer as part of their practice but were not recognized experts. Data analysis was achieved through grounded theory with open coding. Results The main themes reported on here are the following: the role of TCM in the biomedical management of breast cancer, TCM strategies for the management of breast cancer, and the perceived holistic approach of the TCM practitioner and the importance of a TCM diagnosis in the role of breast cancer care. Discussion The role of TCM in biomedical breast cancer management is a supportive one; however, this role is difficult as there is a lack of understanding of TCM by biomedical practitioners. The viewpoints of practitioners differed on key strategies of TCM: diagnosis, and treatment protocols. Patients sought the holistic approach of TCM practitioners as they felt it addressed all aspects of their health and not just the symptoms relating to breast cancer. Conclusion The lack of an integrated medicine approach in relation to TCM makes it difficult to demonstrate the value of the contribution TCM can make to biomedicine in the field of breast care oncology. Effectiveness studies are needed that can accurately represent TCM in this field. PMID:26420777

  2. Clinical endpoints for developing pharmaceuticals to manage patients with sporadic or genetic risk of colorectal cancer

    OpenAIRE

    Rial, Nathaniel S; Zell, Jason A.; Cohen, Alfred M.; Gerner, Eugene W.

    2012-01-01

    To reduce the morbidity and mortality from colorectal cancer, current clinical practice focuses on screening for early detection and polypectomy as a form of secondary prevention, complemented with surgical interventions when appropriate. No pharmaceutical agent is currently approved for use in clinical practice for the management of patients with risk of colorectal cancer. This article will review earlier attempts to develop pharmaceuticals for use in managing patients with sporadic or genet...

  3. Patient and caregiver perspectives on managing pain in advanced cancer: A qualitative longitudinal study

    OpenAIRE

    Hackett, J; Godfrey, M.; Bennett, MI

    2015-01-01

    Background: Despite advances in treatment of pain in advanced cancer, it remains a major source of suffering with adverse effects on patients’ life quality. There is increasing understanding of its multi-dimensional nature and the variable responsiveness of medication to complex pain. Less clear is how patients and their caregivers respond to, and manage pain complexity. Aim: To explore patients’ and carers’ experiences of advanced cancer pain and the processes that they engage in to manage p...

  4. A Survey of Cancer Pain Management Knowledge and Attitudes of British Columbian Physicians

    OpenAIRE

    Gallagher, R; Hawley, P.; Yeomans, W

    2004-01-01

    INTRODUCTION: There are many potential barriers to adequate cancer pain management, including lack of physician education and prescription monitoring programs. The authors surveyed physicians about their specific knowledge of pain management and the effects of the regulation of opioids on their prescribing practices.METHODS: A questionnaire was mailed out to British Columbia physicians who were likely to encounter cancer patients. The survey asked for physicians' opinions about College of Phy...

  5. Diabetes Management and Self-Care Education for Hospitalized Patients With Cancer

    OpenAIRE

    Leak, Ashley; Davis, Ellen D.; Houchin, Laura B.; Mabrey, Melanie

    2009-01-01

    Managing diabetes can be a daunting task for patients with cancer. Empowerment-based diabetes education and motivational interviewing are complementary approaches. Oncology nurses may feel unprepared to teach patients and their families about self-care for diabetes, but they provide individualized information on symptom management of cancer throughout hospitalization and at discharge. The essential self-care issues include food, exercise, medication, blood glucose monitoring, prevention, reco...

  6. Randomized controlled trial of a collaborative care intervention to manage cancer-related symptoms: lessons learned

    Science.gov (United States)

    Steel, Jennifer; Geller, David A; Tsung, Allan; Marsh, J Wallis; Dew, Mary Amanda; Spring, Michael; Grady, Jonathan; Likumahuwa, Sonja; Dunlavy, Andrea; Youssef, Michael; Antoni, Michael; Butterfield, Lisa H; Schulz, Richard; Day, Richard; Helgeson, Vicki; Kim, Kevin H; Gamblin, T Clark

    2012-01-01

    Background Collaborative care interventions to treat depression have begun to be tested in settings outside of primary care. However, few studies have expanded the collaborative care model to other settings and targeted comorbid physical symptoms of depression. Purpose The aims of this report were to: (1) describe the design and methods of a trial testing the efficacy of a stepped collaborative care intervention designed to manage cancer-related symptoms and improve overall quality of life in patients diagnosed with hepatobiliary carcinoma; and (2) share the lessons learned during the design, implementation, and evaluation of the trial. Methods The trial was a phase III randomized controlled trial testing the efficacy of a stepped collaborative care intervention to reduce depression, pain, and fatigue in patients diagnosed with advanced cancer. The intervention was compared to an enhanced usual care arm. The primary outcomes included the Center for Epidemiological Studies-Depression scale, Brief Pain Inventory, and Functional Assessment of Cancer Therapy (FACT)-Fatigue, and the FACT-Hepatobiliary. Sociodemographic and disease-specific characteristics were recorded from the medical record; Natural Killer cells and cytokines that are associated with these symptoms and with disease progression were assayed from serum. Results and Discussion The issues addressed include: (1) development of collaborative care in the context of oncology (e.g., timing of the intervention, tailoring of the intervention, ethical issues regarding randomization of patients, and changes in medical treatment over the course of the study); (2) use of a website by chronically ill populations (e.g., design and access to the website, development of the website and intervention, ethical issues associated with website development, website usage, and unanticipated costs associated with website development); (3) evaluation of the efficacy of intervention (e.g., patient preferences, proxy raters

  7. Successful management of elderly breast cancer patients treated without radiotherapy

    Directory of Open Access Journals (Sweden)

    Robertson John FR

    2007-06-01

    Full Text Available Abstract Background Breast cancer in the elderly may follow a less aggressive course. There are data suggesting that radiotherapy (RT following breast conserving surgery (BCS for invasive carcinoma may not be necessary in some elderly patients. The addition of RT to surgery might constitute an imposition to such patients due to age-related factors. The aim of this study was to assess the efficacy of BCS without adjuvant RT in this group of patients. Patients and methods A retrospective review of 92 elderly (median age 75 years; range: 70 – 87 years patients (analysed as 93 'patients' due to one patient having bilateral cancers managed in a dedicated breast clinic and who underwent BCS for invasive carcinoma was carried out. Eighty-three patients did not receive postoperative RT to the breast (no-RT group whereas the remaining 10 had RT (RT-group. Results The median age in this group was 75 (range 70 – 87 years. The mean tumour size was 18 mm with a median follow-up of 37 (range 6 – 142 months. In the no RT group, adjuvant endocrine therapy with tamoxifen was given to 40/53 patients. No patients in the oestrogen receptor (ER negative group received tamoxifen. The local recurrence (LR rate in this group was 8.4% (2.4% per year, n = 7/83, with median time to LR of 17 months. In this no-RT group LR was correlated to ER status (2/53 ER+, 5/26ER-, p = 0.024 and margins of excision (n = 1/54 >5 mm, 2/17 1–5 mm, 4/12 Conclusion It would appear that omission of RT following successful BCS in elderly patients with ER positive tumours receiving adjuvant tamoxifen may be acceptable. The LR rate as shown in this retrospective study is highly comparable to that of younger patients treated by conventional therapy. This concept is now being evaluated prospectively following a change in treatment practice.

  8. Positron Emission Tomography in the Management of Lung Cancer (NSCLC)

    International Nuclear Information System (INIS)

    Lung cancer is the leading cause of cancer deaths in men and the second most common cancer in women. Globally it remains the most commonly diagnosed cancer at 1.35 million, representing 12.4% of all new cancers. Almost half (49.9%) of the lung cancer cases occur in the developing countries of the world, which is a big change since 1980, when it was estimated that 69% were in developed countries. Although lung cancer is the most deadly of all the cancers, it is the only major cancer that does not have a widely accepted screening test. Lung cancer often presents as a solitary pulmonary nodule on chest radiographs, which are usually performed on patients as a preoperative screening test, or as a part of routine health screening, often in the absence of symptoms. Incidental detection can occur in up to 12% of cases in asymptomatic cases. It is clear that there is a need for the accurate diagnosis of these lesions. In recent years Positron early and Emission Tomography (PET) holds early and promise as a noninvasive investigative tool for the evaluation of lung cancer. 18F-FDG PET is currently indicated for the characterization of lung lesions, staging of non-small cell lung carcinoma (NSCLC), detection of distant metastases, and diagnosis of recurrent disease. PET/CT studies are also being increasingly employed in radiotherapy treatment also planning. Furthermore PET also plays an important role in monitoring of treatment response. On the face of it a PET-CT study may appear expensive. But in the overall context, PET/CT is cost-effective in the treatment of Lung cancer. The modality is the best discriminator of disease load if used in the correct clinical setting. It can do away with the need for multiple, many times needless investigations. It can reduce the number of futile operations, unwarranted interventions, as well as over and under treatments of lung cancer. (author)

  9. Papers on reactor physics for operators and unit managers

    International Nuclear Information System (INIS)

    The monograph contains papers submitted to the Dukovany nuclear power plant personnel with the aim of improving professional knowledge of reactor operators and unit managers and helping them in their preparation for state examinations. It presents an easy to understand explanation of phenomena unit control room personnel actually encounter. The following topics are covered: radioactivity, nuclear reactions, nuclear fission and the fate of neutrons in the reactor; delayed neutrons; reactor period, reactivity; subcriticality and transition to criticality; heat generation in the reactor; reactivity coefficients; reactivity effects during the fuel cycle; reactivity compensation during power changes; reactor response to reactivity changes; xenon poisoning, samarium poisoning; residual power; unit start-up after refuelling; unit power rise to the minimal controllable level following emergency shutdown; shutdown concentrations; reactor control and safety system; scram rod drop; neutron sensors in the reactor; monitoring system inside the reactor; 3rd unit computer; ''operator's ten commandments''. (P.A.). 36 figs., 2 tabs., 6 refs

  10. Efficacy of multimodal exercise-based rehabilitation on physical activity, cardiorespiratory fitness, and patient-reported outcomes in cancer survivors

    DEFF Research Database (Denmark)

    Midtgaard, J; Christensen, Jesper Frank; Tolver, Anders;

    2013-01-01

    Sedentary behavior and impaired cardiovascular reserve capacity are common late effects of cancer therapy emphasizing the need for effective strategies to increase physical activity (PA) in cancer survivors. We examined the efficacy of a 12-month exercise-based rehabilitation program on self...

  11. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... about Advanced Cancer Research Managing Cancer Care Finding Health Care Services Advance Directives Using Trusted Resources Understanding Cancer ... Cancer Advanced Cancer & Caregivers Managing Cancer Care Finding Health Care Services Advance Directives Using Trusted Resources Cancer Types ...

  12. Cooperation project: medical physics in cancer diagnosis and therapy in Bangladesh

    International Nuclear Information System (INIS)

    Bangladesh requires 200 radiotherapy facilities, 4 are in use; 400 medical physicists are needed, 3 are employed. On a private basis, a DGMP working group started in 1996, annual workshops on medical physics in cancer diagnosis and treatment, joined by many working physicists interested to become medical physicists. Basic topics were the principles, applications, acceptance, dosimetry and planning of 60Co radiotherapy. In 1998, the Bangladesh association of physicists in medicine (BMPA) was founded, a young scientific society requiring international co-operation. The long experience in Medical Physics in India, its neighbouring country, could be very helpful in providing excellent medical physics courses. To absorb new technology and science, it is necessary to change the education policy; creativity and innovativeness must be valued more than the old knowledge, being replaced quickly by new knowledge and new technologies. (author)

  13. Novel Management of Oral Cancer: A Paradigm of Predictive Oncology

    OpenAIRE

    Sudbø, Jon

    2004-01-01

    The rationale for molecular-targeted prevention of oral cancer is strong. Oral cancer is a major global threat to public health with 300,000 new cases diagnosed worldwide on an annual basis. Notably, the great morbidity and mortality rates of this devastating disease have not improved in decades. Oral cancer development is a tobacco-related multistep and multifocal process involving field carcinogenesis and intraepithelial clonal spread. Biomarkers of genomic instability, such as aneuploidy a...

  14. Incidence and Management of Colorectal Cancer in Liver Transplant Recipients

    OpenAIRE

    Nishihori, Taiga; Strazzabosco, Mario; Saif, Muhammad Wasif

    2008-01-01

    Liver transplant recipients are at an increased risk of developing de novo malignancies because of the prolonged immunosuppression necessary to avoid acute and chronic rejections. Skin cancers and lymphoproliferative diseases are the most common malignancies, but the overall incidence of colon cancer in this patient population does differ from that of the general population. Therefore, colorectal cancer (CRC) is a major health concern in liver transplant recipients. Furthermore, there are uni...

  15. Oral Complications and Management Strategies for Patients Undergoing Cancer Therapy

    OpenAIRE

    2014-01-01

    With cancer survival rate climbing up over the past three decades, quality of life for cancer patients has become an issue of major concern. Oral health plays an important part in one’s overall quality of life. However, oral health status can be severely hampered by side effects of cancer therapies including surgery, chemotherapy, radiotherapy, and hematopoietic stem cell transplantation. Moreover, prevention and treatment of these complications are often overlooked in clinical practice. The ...

  16. Use of capecitabine in management of early colon cancer

    OpenAIRE

    Cassidy J; Hameed H

    2011-01-01

    H Hameed, J CassidyBeatson West of Scotland Cancer Centre, Glasgow, Scotland, UKAbstract: Capecitabine (Xeloda®, Roche, Basel, Switzerland) is a pro-drug of 5-fluorouracil (5-FU), and it is converted to 5-FU in the cancer cell by enzymatic degradation. The role of capecitabine in colorectal cancer has evolved in the last 15 years. In early trials in the metastatic setting, capecitabine has shown superior response rates compared with those achieved with 5-FU (Mayo Clinic regimen) (26% ...

  17. Familial Renal Cancer: Molecular Genetics and Surgical Management

    OpenAIRE

    Barrisford, Glen W.; Singer, Eric A; Rosner, Inger L.; Marston Linehan, W.; Gennady Bratslavsky

    2011-01-01

    Familial renal cancer (FRC) is a heterogeneous disorder comprised of a variety of subtypes. Each subtype is known to have unique histologic features, genetic alterations, and response to therapy. Through the study of families affected by hereditary forms of kidney cancer, insights into the genetic basis of this disease have been identified. This has resulted in the elucidation of a number of kidney cancer gene pathways. Study of these pathways has led to the development of novel targeted mole...

  18. Effects of Yoga on Psychological Health, Quality of Life, and Physical Health of Patients with Cancer: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Kuan-Yin Lin

    2011-01-01

    Full Text Available Yoga is one of the most widely used complementary and alternative medicine therapies to manage illness. This meta-analysis aimed to determine the effects of yoga on psychological health, quality of life, and physical health of patients with cancer. Studies were identified through a systematic search of seven electronic databases and were selected if they used a randomized controlled trial design to examine the effects of yoga in patients with cancer. The quality of each article was rated by two of the authors using the PEDro Scale. Ten articles were selected; their PEDro scores ranged from 4 to 7. The yoga groups compared to waitlist control groups or supportive therapy groups showed significantly greater improvements in psychological health: anxiety (=.009, depression (=.002, distress (=.003, and stress (=.006. However, due to the mixed and low to fair quality and small number of studies conducted, the findings are preliminary and limited and should be confirmed through higher-quality, randomized controlled trials.

  19. Real-Time Motion Management of Prostate Cancer Radiotherapy

    DEFF Research Database (Denmark)

    Pommer, Tobias

    The aim of radiation therapy is to deliver a radiation dose to the tumour that is high enough for all cancer cells to be killed, while sparing healthy organs to such an extent that the side effects are as low as possible. Prostate cancer is the most common type of cancer among men in Denmark......, and for prostate cancer treatments, the proximity of the bladder and rectum makes radiotherapy treatment of this site a challenging task. Furthermore, the prostate may move during the radiation delivery and treatment margins are necessary to ensure that it is still receiving the intended dose. The main aim...

  20. Physical Activity and Fatigue in Breast Cancer and Multiple Sclerosis: Psychosocial Mechanisms

    Science.gov (United States)

    McAuley, Edward; White, Siobhan M.; Rogers, Laura Q.; Motl, Robert W.; Courneya, Kerry S.

    2010-01-01

    Objective To examine the role of self-efficacy and depression as potential pathways from physical activity to fatigue in two study samples: breast cancer survivors (BCS; N=192) and individuals with multiple sclerosis (MS; N=292). Methods We hypothesized that physical activity would be indirectly associated with fatigue through its influence on self-efficacy and depressive symptomatology. A cross-sectional path analysis (BCS) and a longitudinal panel model (MS) were conducted within a covariance modeling framework. Results Physical activity had a direct effect on self-efficacy, and in turn, self-efficacy had both a direct effect on fatigue and an indirect effect through depressive symptomatology in both samples. In the MS sample, physical activity also had a direct effect on fatigue. All model fit indices were excellent. These associations remained significant when controlling for demographics and health status indicators. Conclusions Our findings suggest support for at least one set of psychosocial pathways from physical activity to fatigue, an important concern in chronic disease. Subsequent work might replicate such associations in other diseased populations and attempt to determine whether model relations change with physical activity interventions, and the extent to which other known correlates of fatigue such as impaired sleep and inflammation can be incorporated into this model. PMID:19949160

  1. An integrated, population-based framework for knowledge management for cancer control.

    Science.gov (United States)

    Hagen, Neil A; Craighead, Peter; Esmail, Rosmin

    2010-01-01

    Cancer control organizations commonly refer to the critical role of clinical practice guidelines to support the best possible cancer care. But how can a cancer care program ensure the systematic implementation of those guidelines? The goals of this article are to describe the process of developing a cancer control system driven by knowledge management, to highlight the key elements of this system and to foster discussion on the implementation of such frameworks. In order to promote best cancer practices within an expanded radiation service model for the province of Alberta, we developed an integrated conceptual framework for knowledge management. We identified six key elements of a knowledge management framework for the cancer program: evidence-based provincial guidelines, funding decisions, harmonized care pathways, targeted knowledge transfer projects, performance measurement and feedback to the system. We are establishing a process to characterize the explicit linkages and accountabilities between each of these elements as part of a broader cancer care quality agenda. We will implement the framework to support the start-up of the first of three new radiation treatment services in the province. The basic elements of a guidelines-supported cancer care system are not in doubt; how to unambiguously engage them within an integrated care system remains an area of intense interest. PMID:20523153

  2. The physical principles of near infrared breast diaphanography and early diagnosis of breast cancer

    International Nuclear Information System (INIS)

    The early-screening and diagnosis of breast cancer is very important for improving the life quality of women as well decreasing the death rate. As a main diagnostic technique, mammography might cause radiation damage to the human body. Near infrared (NIR) computer diaphanography imaging diagnosis (CDI) is a new technique for breast cancer diagnosis which can be performed multiple times with no harm. However, its high incidence of false positivity has raised doubts and questions. We introduce the physical principles of CDI, and discuss the mechanism of how a malignant growth surrounds itself with a dense network of tiny blood-filled capillaries to feed oxygen and nutrients to active tumors, thus forming unique NIR transmittance markers that reveal the presence of cancer. The advantages and difficulties of CDI are evaluated, with the conclusion that CDI satisfies all the 'three-conditions' of imaging diagnosis. The influence of competition with mammography in the development of CDI is reviewed. The opportunities of physics interacting with the life sciences are outlined. (authors)

  3. Predictors of physical activity among rural and small town breast cancer survivors: an application of the theory of planned behaviour.

    Science.gov (United States)

    Vallance, Jeff K; Lavallee, Celeste; Culos-Reed, Nicole S; Trudeau, Marc G

    2012-01-01

    The primary objective of this study was to investigate the utility of the two-component theory of planned behaviour (TPB) in understanding physical activity intentions and behaviour in rural and small town breast cancer survivors. The secondary objective was to elicit the most common behavioural, normative and control beliefs of rural and small town survivors regarding physical activity. Using a cross-sectional survey design, 524 rural and small town breast cancer survivors completed a mailed survey that assessed physical activity and TPB variables. Physical activity intention explained 12% of the variance in physical activity behaviour (p < 0.01) while the TPB constructs together explained 43% of the variance in physical activity intention (p < 0.01). Unique behavioural, normative and control beliefs were elicited from the sample. The two-component TPB framework appears to be a suitable model to initiate an understanding of physical activity determinants among rural and small town breast cancer survivors. These data can be used in the development and establishment of physical activity behaviour interventions and health promotion materials designed to facilitate physical activity behaviour among rural and small town breast cancer survivors. PMID:22409699

  4. 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

  5. End-of-life management in pediatric cancer.

    Science.gov (United States)

    Epelman, Claudia L

    2012-04-01

    Pediatric palliative care at the end-of-life is focused on ensuring the best possible quality of life for patients with life-threatening illness and their families. To achieve this goal, important needs include: engaging with patients and families; improving communication and relationships; relieving pain and other symptoms, whether physical, psychosocial, or spiritual; establishing continuity and consistency of care across different settings; considering patients and families in the decision-making process about services and treatment choices to the fullest possible and desired degree; being sensitive to culturally diverse beliefs and values about death and dying; and responding to suffering, bereavement, and providing staff support. Any effort to improve quality of palliative and end-of-life care in pediatric oncology must be accompanied by an educational strategy to enhance the level of competence among health care professionals with regard to palliative care and end-of-life management skills as well as understanding of individualized care planning and coordination processes. PMID:22350329

  6. Managing Health Care After Cancer Treatment: A Wellness Plan

    OpenAIRE

    Moye, Jennifer; Langdon, Maura; Jones, Janice M.; Haggstrom, David; Naik, Aanand D.

    2014-01-01

    Many patients and health care providers lack awareness of both the existence of, and treatments for, lingering distress and disability after treatment. A cancer survivorship wellness plan can help ensure that any referral needs for psychosocial and other restorative care after cancer treatment are identified.

  7. Epidemiology and management of depression in cancer patients

    NARCIS (Netherlands)

    Ng, C.G.

    2012-01-01

    Depression is the most frequent psychiatric comorbidity in cancer patients especially those in terminal stage. Despite the large amount of studies on depression in cancer patients, there are a lot of unanswered questions with respect to diagnosis, prevalence and treatment. Diagnosing depression in c

  8. Contemporary management of cancer of the oral cavity.

    NARCIS (Netherlands)

    Genden, E.M.; Ferlito, A.; Silver, C.E.; Takes, R.P.; Suarez, C.; Owen, R.P.; Haigentz Jr, M.; Stoeckli, S.J.; Shaha, A.R.; Rapidis, A.D.; Rodrigo, J.P.; Rinaldo, A.

    2010-01-01

    Oral cancer represents a common entity comprising a third of all head and neck malignant tumors. The options for curative treatment of oral cavity cancer have not changed significantly in the last three decades; however, the work up, the approach to surveillance, and the options for reconstruction h

  9. Co-Managing Patients with Type 1 Diabetes and Cancer.

    Science.gov (United States)

    Best, Conor J; Thosani, Sonali; Ortiz, Marjorie; Levesque, Celia; Varghese, Sigi S; Lavis, Victor R

    2016-08-01

    The life expectancy of people with type 1 diabetes is improving and now approaches that of those without diabetes. As this population ages, a growing number will be diagnosed with and treated for cancer. Cancer treatments can drastically affect insulin requirement and glycemic control through multiple mechanisms including high doses of glucocorticoids and targeted therapies that directly interfere with cellular pathways involved in the action of insulin. Patients with cancer frequently also have alterations in gastrointestinal motility or appetite and require supplemental enteral or parenteral nutrition. Few studies have evaluated these patients directly, but data on patients with and without diabetes suggest that glycemic control may play a larger role in cancer outcomes than is often recognized. Collaboration between the treating oncologist and diabetologist allows people with diabetes to receive the most effective therapies for their cancers without undue risk of hypoglycemia or adverse outcomes due to hyperglycemia. PMID:27319323

  10. Study on College Physical Education Management Information System Based on Support Vector Regression

    Directory of Open Access Journals (Sweden)

    Haibo Yan

    2013-12-01

    Full Text Available In order to effectively alleviate the great pressure of sports function development and social service needs, changing the structure of a single, working form the old educational pattern, this study is based on the current situation of college sports management, introduced the support vector construction of information of college sports management system, learning theory and the information model of college sports management value through the analysis of fuzzy evaluation method, satisfactory results have been obtained. College sports management model based on support vector regression conforms to the trend of information management, to promote the standardization of sports teaching management, to promote the college physical education teaching and research has practical significance.

  11. AWARENESS OF PHYSICAL THERAPY REHABILITATION FOR BREAST CANCER RELATED LYMPHEDEMA AMONG MEDICAL ONCOLOGY TEAM - A SURVEY

    Directory of Open Access Journals (Sweden)

    Mullai

    2013-10-01

    Full Text Available Objective:To analyses the awareness of physical therapy rehabilitation for breast cancer related lymphedemaamong medical oncology team member.Method and materials:The data was contents of 12 custom made questionnaires which distributed and collectedfrom 34 medical oncology team members who are working in CMC & H, DMC & H, Chandigarh PGI,Results:Nearly 100 % of clinical oncologist and Radiation oncologist were aware about physical therapyrehabilitation and nearly 80% of Surgeon and Physician were aware about it (p<0.05. Relatively fewteam members(53% sent their patients to out patient department of physiotherapy and mostly (47% not sent (p< 0.03.Conclusion:Medical oncology team was aware of role of physiotherapist for breast cancer related lymphedema.But they were concentrating only shoulder activity not in decongestive exercises So, it is importantthat awarenessabout physical therapy techniques and its effects to the medical professionals is necessary and alsoinclusion ofphysical therapist in the rehabilitation team make lot of difference in the quality of life of Lymphedema patients

  12. Efficacy of recreational football on bone health, body composition, and physical functioning in men with prostate cancer undergoing androgen deprivation therapy

    DEFF Research Database (Denmark)

    Uth, Jacob; Hornstrup, Therese; Christensen, Jesper F;

    2016-01-01

    Androgen deprivation therapy (ADT) for prostate cancer (PCa) impairs musculoskeletal health. We evaluated the efficacy of 32-week football training on bone mineral density (BMD) and physical functioning in men undergoing ADT for PCa. Football training improved the femoral shaft and total hip BMD...... and physical functioning parameters compared to control. INTRODUCTION: ADT is a mainstay in PCa management. Side effects include decreased bone and muscle strength and increased fracture rates. The purpose of the present study was to evaluate the effects of 32 weeks of football training on BMD, bone...... turnover markers (BTMs), body composition, and physical functioning in men with PCa undergoing ADT. METHODS: Men receiving ADT >6 months (n = 57) were randomly allocated to a football training group (FTG) (n = 29) practising 2-3 times per week for 45-60 min or to a standard care control group (CON) (n = 28...

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

    International Nuclear Information System (INIS)

    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

  14. Geriatric assessment with management in cancer care: Current evidence and potential mechanisms for future research.

    Science.gov (United States)

    Magnuson, Allison; Allore, Heather; Cohen, Harvey Jay; Mohile, Supriya G; Williams, Grant R; Chapman, Andrew; Extermann, Martine; Olin, Rebecca L; Targia, Valerie; Mackenzie, Amy; Holmes, Holly M; Hurria, Arti

    2016-07-01

    Older adults with cancer represent a complex patient population. Geriatric assessment (GA) is recommended to evaluate the medical and supportive care needs of this group. "GA with management" is a term encompassing the resultant medical decisions and interventions implemented in response to vulnerabilities identified on GA. In older, non-cancer patients, GA with management has been shown to improve a variety of outcomes, such as reducing functional decline and health care utilization. However, the role of GA with management in the older adult with cancer is less well established. Rigorous clinical trials of GA with management are necessary to develop an evidence base and support its use in the routine oncology care of older adults. At the recent U-13 conference, "Design and Implementation of Intervention Studies to Improve or Maintain Quality of Survivorship in Older and/or Frail Adults with Cancer," a session was dedicated to developing research priorities in GA with management. Here we summarize identified knowledge gaps in GA with management studies for older patients with cancer and propose areas for future research. PMID:27197915

  15. Knowledge, Practices, and Perceived Barriers Regarding Cancer Pain Management Among Physicians and Nurses In Korea: A Nationwide Multicenter Survey

    OpenAIRE

    Hyun Jung Jho; Yeol Kim; Kyung Ae Kong; Dae Hyun Kim; Eun Jeong Nam; Jin Young Choi; Sujin Koh; Kwan Ok Hwang; Sun Kyung Baek; Eun Jung Park

    2014-01-01

    Purpose Medical professionals’ practices and knowledge regarding cancer pain management have often been cited as inadequate. This study aimed to evaluate knowledge, practices and perceived barriers regarding cancer pain management among physicians and nurses in Korea. Methods A nationwide questionnaire survey was administered to physicians and nurses involved in the care of cancer patients. Questionnaire items covered pain assessment and documentation practices, knowledge regarding cancer pai...

  16. Physical exercise in cancer patients during and after medical treatment: a systematic review of randomized and controlled clinical trials.

    NARCIS (Netherlands)

    Knols, R.H.; Aaronson, N.K.; Uebelhart, D.; Fransen, J.; Aufdemkampe, G.

    2005-01-01

    PURPOSE: To systematically review the methodologic quality of, and summarize the evidence from trials examining the effectiveness of physical exercise in improving the level of physical functioning and psychological well-being of cancer patients during and after medical treatment. METHODS: Thirty-fo

  17. Cancer treatment-related cardiac toxicity: prevention, assessment and management.

    Science.gov (United States)

    Fanous, Ibrahim; Dillon, Patrick

    2016-08-01

    Cancer therapies, especially anthracyclines and monoclonal antibodies, have been linked with increased rates of cardiotoxicity. The development of some cardiac side effects happens over several months, and changes in ejection fraction can be detected long before permanent damage or disability occurs. Advanced heart failure could be averted with better and earlier detection. Methodologies for early detection of cardiac changes include stress echocardiograms, cardiac velocity measurements, radionuclide imaging, cardiac MRI and several potential biomarkers. Many agents have been described for prophylaxis of cardiac events precipitated by cancer therapy. Prophylactic use of beta-blockers and ACE inhibitors may be considered for use with trastuzumab in breast cancer as tolerated. Recovery of cardiac function is possible early after the injury from a cancer therapy. Late complications for coronary artery disease, hypertension and arrhythmia are underappreciated. Treatments for severe cancer therapy-related cardiac complications follow the existing paradigms for congestive heart failure and coronary artery disease, although outcomes for cancer patients differ from outcomes for non-cancer patients. PMID:27372782

  18. Management and Outcomes of Male Breast Cancer in Zaria, Nigeria

    Directory of Open Access Journals (Sweden)

    Adamu Ahmed

    2012-01-01

    Full Text Available Male breast cancer is an uncommon disease accounting for only 1% of all breast cancers. We present the evaluation, treatment and outcome of male patients seen with breast cancer in our institution. Male patients that had histological diagnosis of breast cancer from 2001 to 2010 were retrospectively evaluated. After evaluation patients were treated with modified radical mastectomy. Combination chemotherapy was given to patients with positive axillary lymph nodes. Radiotherapy and hormonal therapy were also employed. There were 57 male patients with breast cancer which accounted for 9% of all breast cancers seen during the study period. Their mean age was 59 ± 2.3 years. The mean tumor diameter was 13 ± 2.5 cm. Fifty three (93% patients presented with advanced disease including 15 with distant metastasis. Four patients with stage II disease were treated with modified radical mastectomy, chemotherapy and tamoxifen. Of the 30 patients with sage III disease that had modified radical mastectomy, complete axillary clearance and tumor free margins were achieved in 25. Overall 21 (36.8% patients were tumor free at one year. Overall 5-year survival was 22.8%. In conclusion, male patients with breast cancer present with advanced disease which is associated with poor outcome of treatment.

  19. Physical and cellular radiobiological properties of heavy ions in relation to cancer therapy applications

    International Nuclear Information System (INIS)

    A variety of experiments have been carried out in vitro on several mammalian cell lines with carbon, neon, silicon and argon beams at 14 and 24 cm depth penetration. The results of these experiments substantiate the conceptual basis for physical and radiobiological advantages of accelerated heavy-ion beams in cancer therapy. The best biologically effective depth dose ratio for situations corresponding to therapy needs can be obtained with accelerated carbon beams. The depression of the oxygen effect with silicon or argon ion beams is greater than that achievable with neutrons or pions, or with heavy ions of lower atomic number

  20. A multi-scale approach to the physics of ion beam cancer therapy

    CERN Document Server

    Solov'yov, A V; Scifoni, E; Mishustin, I; Greiner, W

    2008-01-01

    We propose a multi-scale approach to understanding physics related to the ion/proton-beam cancer therapy and calculation of the probability of the DNA damage as a result of irradiation of patients with energetic (up to 430 MeV/u) ions. This approach is inclusive with respect to different scales starting from the long scale defined by the ion stopping followed by a smaller scale defined by secondary electrons and radicals ending with the shortest scale defined by interactions of secondaries with the DNA. We present calculations of the probabilities of single and double strand breaks of the DNA and suggest a way of further elaboration of such calculations.

  1. Management of Hormone-Sensitive and Hormone-Refractory Metastatic Prostate Cancer.

    Science.gov (United States)

    Rago

    1998-11-01

    BACKGROUND: Prostate cancer is a significant health problem in the United States and is the focus of increasing attention in our society. With the aging of the US population, it is likely that prostate cancer will continue to grow in importance. The options for systemic therapy of metastatic prostate cancer should be familiar to physicians, including nonspecialists, whose patients seek their advice and counsel. METHODS: Past and recent literature was surveyed to provide an understanding of the systemic treatment of advanced prostate cancer. The author presents a review of the systemic treatment of metastatic prostate cancer in different clinical circumstances and addresses the current status of chemotherapy in the management of advanced prostate cancer. RESULTS: Early androgen deprivation used over prolonged periods appears to be modestly superior to delayed androgen deprivation with a small potential survival advantage and an advantage in delaying disease progression in advanced prostate cancer. Patients with hormone-refractory prostate cancer may benefit from secondary hormonal therapy (eg, adrenal enzyme inhibitors, antiandrogens, glucocorticoids) and chemotherapy. CONCLUSIONS: The choices of therapy for metastatic prostate cancer depend on individual patient preference. Patients and physicians should be aware of the possible side effects associated with the therapeutics options for treatment of metastatic prostate cancer. PMID:10761100

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

    International Nuclear Information System (INIS)

    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

  3. A comparative study of pre- and post-menopausal breast cancer: Risk factors, presentation, characteristics and management

    OpenAIRE

    Surakasula, Aruna; Nagarjunapu, Govardhana Chary; Raghavaiah, K. V.

    2014-01-01

    Objective: Breast cancer is the most common female cancer worldwide and is the second most commonly diagnosed cancer in Indian women. This study evaluates the differences between pre- and post-menopausal breast cancer women regarding risk factors, nature of disease presentation, tumor characteristics, and management. Methods: This is a prospective observational study, conducted in the Oncology Department of St. Ann's Cancer Hospital, for a period of 6 months from January to August 2012. Data ...

  4. Active Surveillance for the Management of Localized Prostate Cancer (Cancer Care Ontario Guideline): American Society of Clinical Oncology Clinical Practice Guideline Endorsement

    OpenAIRE

    Chen, RC; Rumble, RB; Loblaw, DA; Finelli, A.; Ehdaie, B; Cooperberg, MR; Morgan, SC; Tyldesley, S; Haluschak, JJ; Tan, W.; Justman, S; Jain, S

    2016-01-01

    To endorse Cancer Care Ontario's guideline on Active Surveillance for the Management of Localized Prostate Cancer. The American Society of Clinical Oncology (ASCO) has a policy and set of procedures for endorsing clinical practice guidelines developed by other professional organizations.The Active Surveillance for the Management of Localized Prostate Cancer guideline was reviewed for developmental rigor by methodologists. The ASCO Endorsement Panel then reviewed the content and the recommenda...

  5. A pedometer based physical activity self-management program for children and adolescents with physical disability – design and methods of the StepUp study

    OpenAIRE

    Maher, Carol; Crettenden, Angela; Evans, Kerry; Thiessen, Myra; Toohey, Monica; Dollman, Jim

    2014-01-01

    Background Physical activity affords a wide range of physiological and psychological benefits for children and adolescents, yet many children with physical disabilities are insufficiently active to achieve these benefits. The StepUp program is a newly developed 6-week pedometer-based self-management program for children and adolescents with physical disability. Participants use a pedometer to undertake a 6-week physical activity challenge, with personalised daily step count goals set in consu...

  6. Radical lymphadenectomy in the management of early gastric cancer.

    Science.gov (United States)

    Hayes, N; Karat, D; Scott, D J; Raimes, S A; Griffin, S M

    1996-10-01

    Lymph node metastasis in patients with early gastric cancer was evaluated prospectively to determine whether radical (D2) lymphadenectomy is appropriate in such cases. Twenty-eight (18 per cent) of 156 patients having surgery for gastric cancer had early disease. Lymph node metastasis was found in 12 of the 28 patients. Metastasis was more likely in submucosal than mucosal early gastric cancer (nine of 14 versus three of 14; P = 0.024, Fisher's exact test). In two of three patients with metastasis at the N2 level, the N1 nodes were entirely clear. This study shows a higher incidence of lymph node metastasis than has been reported previously in both the UK and Japan. The high incidence of lymph node metastasis in early gastric cancer supports the continuing use of radical lymphadenectomy in patients who are fit for such major surgery. PMID:8944462

  7. Understanding and Managing Erectile Dysfunction in Patients Treated for Cancer.

    Science.gov (United States)

    Annam, Kiran; Voznesensky, Maria; Kreder, Karl J

    2016-04-01

    Cancer can cause sexual adverse effects by direct and indirect pathways. It can involve sexual organs, indirectly affect body image, or cause fatigue or depression with subsequent effects on libido. Erectile dysfunction (ED), the inability to obtain or maintain an erection firm enough for sexual intercourse, can also result from adverse effects of cancer treatment, such as fatigue, pain, or anxiety about therapy. In addition, depressed feelings about having cancer can affect sexuality, causing a range of signs and symptoms that can lead to ED. Chemotherapy, hormone therapy, surgery, and radiation can all cause sexual adverse effects. Additional factors that play a role include patient age and degree of ED before starting cancer treatment. In this article, we discuss how chemotherapy, hormone therapy, surgery, and radiation affect erectile function as well as possible treatment options for ED. PMID:27072383

  8. Contemporary Management of Prostate Cancer [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Katherine Cotter

    2016-02-01

    Full Text Available Prostate cancer represents a spectrum ranging from low-grade, localized tumors to devastating metastatic disease. We discuss the general options for treatment and recent developments in the field.

  9. Non-surgical management of stage I lung cancer

    OpenAIRE

    Gore, Elizabeth M.

    2010-01-01

    Stage I lung cancer has a high cure rate with surgery, although many patients are not surgical candidates due to comorbid conditions. Historically, non-operative treatment has been disappointing. New and promising ablative therapies offer a curative option.

  10. Multidisciplinary Teams in the Management of Rectal Cancer

    OpenAIRE

    Obias, Vincent J.; Reynolds, Harry L.

    2007-01-01

    A myriad of advances in the treatment of rectal cancer have been achieved over the last few decades. The introduction of total mesorectal excision (TME) has resulted in significant improvements in local recurrence. Surgical education on the technique has made it the standard of care. Radiation and chemotherapy combined with TME have improved results even further with stage II and III cancers. Sphincter-sparing techniques, reservoir procedures, local treatment advances, minimally invasive tech...

  11. Management of Metastatic Colorectal Cancer: Defining the Role of Capecitabine

    OpenAIRE

    Lynda R. Wiseman; Katherine A. Lyseng-Williamson

    2005-01-01

    Colorectal cancer (CRC), one of the most common cancers, is associated with significant morbidity, mortality, and medical costs. Treatment options in metastatic CRC are largely palliative, and aim to provide symptom relief, improve health-related quality of life, and prolong survival. Chemotherapy is the mainstay of treatment for metastatic disease. Fluorouracil/leucovorin with or without oxaliplatin or irinotecan is the most widely used regimen. These agents are administered intravenously (b...

  12. Evidence-Informed Physical Therapy Management of Performance-Related Musculoskeletal Disorders in Musicians

    Directory of Open Access Journals (Sweden)

    ClifftonChan

    2014-07-01

    Full Text Available Playing a musical instrument at an elite level is a highly complex motor skill. The regular daily training loads resulting from practice, rehearsals and performances place great demands on the neuromusculoskeletal systems of the body. As a consequence, performance-related musculoskeletal disorders (PRMDs are globally recognized as common phenomena amongst professional orchestral musicians. These disorders create a significant financial burden to individuals and orchestras as well as lead to serious consequences to the musicians’ performance and ultimately their career. Physical therapists are experts in treating musculoskeletal injuries and are ideally placed to apply their skills to manage PRMDs in this hyper functioning population, but there is little available evidence to guide specific injury management approaches. An Australia-wide survey of professional orchestral musicians revealed that the musicians attributed excessively high or sudden increase in playing-load as major contributors to their PRMDs. Therefore, facilitating musicians to better manage these loads should be a cornerstone of physical therapy management. The Sound Practice orchestral musicians work health and safety project used formative and process evaluation approaches to develop evidence-informed and clinically applicable physical therapy interventions, ultimately resulting in favourable outcomes. After these methodologies were employed, the intervention studies were conducted with a national cohort of professional musicians including: health education, onsite injury management, cross-training exercise regimes, performance postural analysis, and music performance biomechanics feedback. The outcomes of all these interventions will be discussed alongside a focussed review on the existing literature of these management strategies. Finally, a framework for best-practice physical therapy management of PRMDs in musicians will be provided.

  13. Does management intensity in inter rows effect soil physical properties in Austrian and Romanian vineyards?

    Science.gov (United States)

    Bauer, Thomas; Strauss, Peter; Stiper, Katrin; Klipa, Vladimir; Popescu, Daniela; Winter, Silvia; Zaller, Johann G.

    2016-04-01

    Successful viticulture is mainly influenced by soil and climate. The availability of water during the growing season highly influences wine quality and quantity. To protect soil from being eroded most of the winegrowers keep the inter row zones of the vineyards green. Greening also helps to provide water-stress to the grapes for harvesting high quality wines. However, these greening strategies concerning the intensity of inter row management differ from farm to farm and are mainly based on personal experience of the winegrowers. However to what extent different inter row management practices affect soil physical properties are not clearly understood yet. To measure possible effects of inter row management in vineyards on soil physical parameters we selected paired vineyards with different inter row management in Austria and Romania. In total more than 7000 soil analysis were conducted for saturated and unsaturated hydraulic conductivity, soil water retention, water stable aggregates, total organic carbon, cation exchange capacity, potassium, phosphorous, soil texture, bulk density and water infiltration. The comparison between high intensity management with at least one soil disturbance per year, medium intensity with one soil disturbance every second inter row per year and low intensity management with no soil disturbance since at least 5 years indicates that investigated soil physical properties did not improve for the upper soil layer (3-8cm). This is in contrast to general perceptions of improved soil physical properties due to low intensity of inter row management, i.e. permanent vegetated inter rows. This may be attributed to long term and high frequency mechanical stress by agricultural machinery in inter rows.

  14. Cannabinoids for Symptom Management and Cancer Therapy: The Evidence.

    Science.gov (United States)

    Davis, Mellar P

    2016-07-01

    Cannabinoids bind not only to classical receptors (CB1 and CB2) but also to certain orphan receptors (GPR55 and GPR119), ion channels (transient receptor potential vanilloid), and peroxisome proliferator-activated receptors. Cannabinoids are known to modulate a multitude of monoamine receptors. Structurally, there are 3 groups of cannabinoids. Multiple studies, most of which are of moderate to low quality, demonstrate that tetrahydrocannabinol (THC) and oromucosal cannabinoid combinations of THC and cannabidiol (CBD) modestly reduce cancer pain. Dronabinol and nabilone are better antiemetics for chemotherapy-induced nausea and vomiting (CINV) than certain neuroleptics, but are not better than serotonin receptor antagonists in reducing delayed emesis, and cannabinoids have largely been superseded by neurokinin-1 receptor antagonists and olanzapine; both cannabinoids have been recommended for breakthrough nausea and vomiting among other antiemetics. Dronabinol is ineffective in ameliorating cancer anorexia but does improve associated cancer-related dysgeusia. Multiple cancers express cannabinoid receptors directly related to the degree of anaplasia and grade of tumor. Preclinical in vitro and in vivo studies suggest that cannabinoids may have anticancer activity. Paradoxically, cannabinoid receptor antagonists also have antitumor activity. There are few randomized smoked or vaporized cannabis trials in cancer on which to judge the benefits of these forms of cannabinoids on symptoms and the clinical course of cancer. Smoked cannabis has been found to contain Aspergillosis. Immunosuppressed patients should be advised of the risks of using "medical marijuana" in this regard. PMID:27407130

  15. Physics-Based Identification, Modeling and Risk Management for Aeroelastic Flutter and Limit-Cycle Oscillations (LCO) Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The proposed research program will develop a physics-based identification, modeling and risk management infrastructure for aeroelastic transonic flutter and...

  16. Geriatric assessment with management in cancer care: Current evidence and potential mechanisms for future research

    Science.gov (United States)

    Magnuson, Allison; Allore, Heather; Cohen, Harvey Jay; Mohile, Supriya G.; Williams, Grant R.; Chapman, Andrew; Extermann, Martine; Olin, Rebecca L.; Targia, Valerie; Mackenzie, Amy; Holmes, Holly M.; Hurria, Arti

    2016-01-01

    Older adults with cancer represent a complex patient population. Geriatric assessment (GA) is recommended to evaluate the medical and supportive care needs of this group. “GA with management” is a term encompassing the resultant medical decisions and interventions implemented in response to vulnerabilities identified on GA. In older, non-cancer patients, GA with management has been shown to improve a variety of outcomes, such as reducing functional decline and health care utilization. However, the role of GA with management in the older adult with cancer is less well established. Rigorous clinical trials of GA with management are necessary to develop an evidence base and support its use in the routine oncology care of older adults. At the recent U-13 conference, “Design and Implementation of Intervention Studies to Improve or Maintain Quality of Survivorship in Older and/or Frail Adults with Cancer,” a session was dedicated to developing research priorities in GA with management. Here we summarize identified knowledge gaps in GA with management studies for older patients with cancer and propose areas for future research. PMID:27197915

  17. Exploring Mediators of Physical Activity in Young Adult Cancer Survivors: Evidence from a Randomized Trial of a Facebook-Based Physical Activity Intervention

    OpenAIRE

    Valle, Carmina G.; Tate, Deborah F.; Mayer, Deborah K.; Allicock, Marlyn; Cai, Jianwen

    2015-01-01

    Purpose: This study examined the effects of a physical activity (PA) intervention for young adult cancer survivors on changes in self-efficacy, social support, and self-monitoring and determined whether changes in these social cognitive theory constructs mediated the relationship between the intervention and changes in PA.

  18. Management of cancer survivors in clinical and public health perspectives: current status and future challenges in Korea.

    Science.gov (United States)

    Shin, Dong Wook; Cho, BeLong; Kim, So Young; Jung, Je Hyuck; Park, Jong Hyock

    2013-05-01

    The number of cancer survivors is increasing dramatically. Many cancer survivors face lifetime risks associated with their cancer therapy, with a significant proportion at risk for serious morbidity and premature mortality. Concerns regarding the long-term physical, psychosocial, and economic effects of cancer treatment on cancer survivors and their families are increasingly being recognized and addressed by public and private sector. This article summarizes economic burden of cancer survivors, main post-treatment health problems including secondary primary cancer and comorbidities, health behaviors such as smoking, exercise and physical activity, nutrition, and psychosocial problems. Faced with various health and psychosocial problems specific to this population, several healthcare and policy models are being suggested to address these issues, including 'shared care model' and 'integrative supportive care service delivery system for cancer survivors'. More effort is needed to make the cancer survivorship agenda a reality, attended by a wide variety of stakeholders including researchers, patients, providers, and policy makers. PMID:23678254

  19. The Effect of Information Literacy on Physical Education Students' Perception of a Course Management System

    Science.gov (United States)

    Vernadakis, Nikolaos; Antoniou, Panagiotis; Giannousi, Maria; Zetou, Eleni; Kioumourtzoglou, Efthimis

    2011-01-01

    The purpose of this study was to determine the effect of information literacy on students' perception toward the educational services offered by an asynchronous course management system (e-Class) for the support of the traditional instruction method in tertiary physical education (PE) institutions. Participants were 211 PE students between the…

  20. Guidelines for Automatic Data Processing Physical Security and Risk Management. Federal Information Processing Standards Publication 31.

    Science.gov (United States)

    National Bureau of Standards (DOC), Washington, DC.

    These guidelines provide a handbook for use by federal organizations in structuring physical security and risk management programs for their automatic data processing facilities. This publication discusses security analysis, natural disasters, supporting utilities, system reliability, procedural measures and controls, off-site facilities,…

  1. Implementation Planning and Progress on Physical Activity Goals: The Mediating Role of Life-Management Strategies

    Science.gov (United States)

    Dugas, Michelle; Gaudreau, Patrick; Carraro, Natasha

    2012-01-01

    This 4-week prospective study examined whether the use of life-management strategies mediates the relationship between implementation planning and short-term progress on physical activity goals. In particular, the strategies of elective selection, compensation, and loss-based selection were disentangled to assess their specific mediating effects.…

  2. Knowledge of physical education teachers about emergency management of tooth avulsion

    Directory of Open Access Journals (Sweden)

    Claudia Londero Pagliarin

    2011-01-01

    Full Text Available A great number of traumatic dental injuries occur at school, during sports-related activities. However, physical education teachers are often not prepared to provide emergency management of dental trauma in general and of tooth avulsion in particular. The aim of this study was to assess the knowledge of emergency management of tooth avulsion among physical education teachers at public and private schools of a city in southern Brazil. A questionnaire covering personal and professional information and eight multiple-choice questions to assess knowledge of emergency management of tooth avulsion was sent to 217 physical education teachers. Of a total of 217 questionnaires distributed, 102 returned. Only 23.5% of the teachers had received prior information on dental trauma. When asked about the fi rst action to be taken if faced with an avulsed tooth, only 12.7% informed they would attempt to replant the tooth. Fifty two teachers (51% were not aware of the optimum extraoral time. Signifi cant differences were found between teachers who had and who had not received prior information with regard to adequate transport medium and adequate time for replantation (chi-square, p = 0.03 and p = 0.02, respectively. There is a general lack of knowledge of emergency management of avulsed teeth among physical education teachers, pointing to an urgent need to implement regular, continuing education so as to increase the level of knowledge and improve prognosis of this important traumatic dental injury.

  3. 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

  4. Challenges associated with the management of gynecological cancers in a tertiary hospital in South East Nigeria

    Directory of Open Access Journals (Sweden)

    Iyoke CA

    2014-01-01

    Full Text Available Chukwuemeka Anthony Iyoke,1 George Onyemaechi Ugwu,1 Euzebus Chinonye Ezugwu,1 Frank Okechukwu Ezugwu,2 Osaheni Lucky Lawani,3 Azubuike Kanayo Onyebuchi3 1Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, 2Department of Obstetrics and Gynaecology, Enugu State University Teaching Hospital, Park Lane, Enugu, 3Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria Background: There are reports of increasing incidence of gynecological cancers in developing countries and this trend increases the need for more attention to gynecological cancer care in these countries. Objective: The purpose of this study was to describe the presentation and treatment of gynecological cancers and identify barriers to successful gynecological cancer treatment in a tertiary hospital in South East Nigeria. Methods: This study was a retrospective longitudinal analysis of the presentation and treatment of histologically diagnosed primary gynecological cancers from 2000 to 2010. Analysis was by descriptive and inferential statistics at the 95% level of confidence using Statistical Package for the Social Sciences version 17 software. Results: Records of 200 gynecological cancers managed during the study period were analyzed. Over 94% of cervical cancers presented in advanced stages of the disease and received palliative/symptomatic treatment. Only 1.9% of cervical cancer patients had radical surgical intervention, and postoperative mortality from these radical surgeries was 100%. Approximately 76% of patients with ovarian cancer had debulking surgery as the mainstay of treatment followed by adjuvant chemotherapy. Postoperative mortality from ovarian cancer surgery was 63%. Cutting edge cytotoxic drugs were not used as chemotherapy for ovarian and chorionic cancers. Compliance with chemotherapy was poor, with over 70% of ovarian cancer patients failing to complete the

  5. Head and neck cancer treatment in the elderly. Evaluation and management of complications

    Energy Technology Data Exchange (ETDEWEB)

    Monden, Nobuya; Nishikawa, Kunio; Morishita, Tokiwa; Nagata, Motoki; Tominaga, Susumu [National Shikoku Cancer Center, Matsuyama, Ehime (Japan)

    2003-01-01

    With the population over age 70 growing, treatment for head and neck cancer in the elderly has increased. We retrospectively evaluated their management and outcome. Subjects numbered 121, 83 men and 38 women from 70 to 94 years old, initially treated at our hospital. We classified them into 2 groups by age, the aged at 70-79 years (55 men and 26 women) and the very old at 80 years and older (28 men and 12 women). We also evaluated a younger control group aged 50-59 years (37 men and 19 women). Primary tumor sites were the oral cavity (28.1%), larynx (28.1%), paranasal sinus (15.8%), and hypopharynx (9.9%). Preoperative geriatric disease was seen in 54% of controls, 74% of the aged, and 93% of the very old. Cardiovascular and respiratory diseases were most common. Surgical treatment and irradiation were essential for cancer treatment. Postoperative complications, including pneumonia, delirium, renal and cardiovascular hypofunction occurred in 56.5% of controls, 48.2% of the aged, and 47.8% of the very old. The frequency of postoperative complications correlated significantly with the American Society of Anesthesiologist classification of physical status (ASA) and preoperative performance status (PS). The complications of irradiation including pneumonia, dehydration, and feeding disturbance occurred in 53% of the very old. Cures were achieved in 83.9% of controls, 81.5% of the aged, and 65.0% of the very old. Cause specific 5-year survival in those cured was 85.2% of controls, 84.5% of the aged, and 80.0% of the very old. Median survival in those not cured was 4 months in controls, 9.6 months in the aged, and 5 months in the very old. We concluded that curative treatment is important in the elderly, and the success of curative treatment and the prevention of complications depend on careful assessment of systemic disease, PS, ASA, and mental activity. (author)

  6. Head and neck cancer treatment in the elderly. Evaluation and management of complications

    International Nuclear Information System (INIS)

    With the population over age 70 growing, treatment for head and neck cancer in the elderly has increased. We retrospectively evaluated their management and outcome. Subjects numbered 121, 83 men and 38 women from 70 to 94 years old, initially treated at our hospital. We classified them into 2 groups by age, the aged at 70-79 years (55 men and 26 women) and the very old at 80 years and older (28 men and 12 women). We also evaluated a younger control group aged 50-59 years (37 men and 19 women). Primary tumor sites were the oral cavity (28.1%), larynx (28.1%), paranasal sinus (15.8%), and hypopharynx (9.9%). Preoperative geriatric disease was seen in 54% of controls, 74% of the aged, and 93% of the very old. Cardiovascular and respiratory diseases were most common. Surgical treatment and irradiation were essential for cancer treatment. Postoperative complications, including pneumonia, delirium, renal and cardiovascular hypofunction occurred in 56.5% of controls, 48.2% of the aged, and 47.8% of the very old. The frequency of postoperative complications correlated significantly with the American Society of Anesthesiologist classification of physical status (ASA) and preoperative performance status (PS). The complications of irradiation including pneumonia, dehydration, and feeding disturbance occurred in 53% of the very old. Cures were achieved in 83.9% of controls, 81.5% of the aged, and 65.0% of the very old. Cause specific 5-year survival in those cured was 85.2% of controls, 84.5% of the aged, and 80.0% of the very old. Median survival in those not cured was 4 months in controls, 9.6 months in the aged, and 5 months in the very old. We concluded that curative treatment is important in the elderly, and the success of curative treatment and the prevention of complications depend on careful assessment of systemic disease, PS, ASA, and mental activity. (author)

  7. [Operational Management of Multidisciplinary Organ-Based Tumor Units in Our Cancer Center].

    Science.gov (United States)

    Kato, Hiroaki; Tsujie, Masanori; Ichimura, Noriko; Yukawa, Masao; Inoue, Masatoshi

    2016-05-01

    Owing to the advances in diagnosis and treatment, it is imperative to develop a multidisciplinary approach for the management of cancer patients. In our cancer center, multidisciplinary organ-based tumor units have been organized for team medical care. These units consist of cancer specialists from multiple departments including medical oncology, surgery, radiology, histopathology, and nursing. Members of each unit regularly conduct meetings to discuss diagnostic and therapeutic aspects, as well as to report the progress of cancer patients. Co-operation with the counseling and support center, utilization of the computerized medical record system, and using brochures for advertisement, all play important roles in adequate management of multidisciplinary organ-based tumor units. PMID:27210090

  8. Optimal management of asymptomatic workers at high risk of bladder cancer.

    Science.gov (United States)

    Schulte, P A; Ringen, K; Hemstreet, G P

    1986-01-01

    Many cohorts of industrial workers at increased risk of occupationally induced bladder cancer are still in the preclinical disease stage. A large proportion of workers in these populations have been exposed to aromatic amines, but have not yet experienced the average latent period for bladder cancer. A need exists for definition of what constitutes optimal management for asymptomatic workers in these cohorts. Promising advances in the epidemiology, pathology, detection, and treatment of bladder cancer pressure for a reassessment of current practices and the application of the most current scientific knowledge. Some of these apparent advances, however, have not yet been rigorously evaluated. The time has come to evaluate these advances so that their application can occur while high risk cohorts are still amenable to and likely to benefit from intervention. This commentary calls for such an evaluation leading to a comprehensive approach to managing cohorts at high risk of bladder cancer. PMID:3950777

  9. The endoscopist's role in the diagnosis and management of pancreatic cancer.

    Science.gov (United States)

    Lee, Jeffrey H; Cassani, Lisa S; Bhosale, Priya; Ross, William A

    2016-09-01

    Pancreatic cancer remains one of the most lethal malignancies with little improvement in survival over the past several decades in spite of advances in imaging, risk factor identification, surgical technique and chemotherapy. This disappointing outcome is mainly due to failures to make an early diagnosis. In fact, the majority of the patients present with inoperable advanced stages of the disease. Though some of the new tumor markers are promising, we are still in search of the one that has a high sensitivity and accuracy, yet is inexpensive and easy to obtain. The paradigm of management has shifted from up-front surgery followed by adjuvant chemotherapy to neoadjuvant chemoradiation followed by surgery, especially for borderline resectable cancers and even for some resectable cancers. In this article, we will critically assess the limitations of tumor markers and review the advancements in endoscopic techniques in the management of pancreatic cancer. PMID:27087265

  10. NCI Funding Trends and Priorities in Physical Activity and Energy Balance Research Among Cancer Survivors.

    Science.gov (United States)

    Alfano, Catherine M; Bluethmann, Shirley M; Tesauro, Gina; Perna, Frank; Agurs-Collins, Tanya; Elena, Joanne W; Ross, Sharon A; O'Connell, Mary; Bowles, Heather R; Greenberg, Deborah; Nebeling, Linda

    2016-01-01

    There is considerable evidence that a healthy lifestyle consisting of physical activity, healthy diet, and weight control is associated with reduced risk of morbidity and mortality after cancer. However, these behavioral interventions are not widely adopted in practice or community settings. Integrating heath behavior change interventions into standard survivorship care for the growing number of cancer survivors requires an understanding of the current state of the science and a coordinated scientific agenda for the future with focused attention in several priority areas. To facilitate this goal, this paper presents trends over the past decade of the National Cancer Institute (NCI) research portfolio, fiscal year 2004 to 2014, by funding mechanism, research focus, research design and methodology, primary study exposures and outcomes, and study team expertise and composition. These data inform a prioritized research agenda for the next decade focused on demonstrating value and feasibility and creating desire for health behavior change interventions at multiple levels including the survivor, clinician, and healthcare payer to facilitate the development and implementation of appropriately targeted, adaptive, effective, and sustainable programs for all survivors. PMID:26547926

  11. Improving cancer therapies by targeting the physical and chemical hallmarks of the tumor microenvironment.

    Science.gov (United States)

    Ivey, Jill W; Bonakdar, Mohammad; Kanitkar, Akanksha; Davalos, Rafael V; Verbridge, Scott S

    2016-09-28

    Tumors are highly heterogeneous at the patient, tissue, cellular, and molecular levels. This multi-scale heterogeneity poses significant challenges for effective therapies, which ideally must not only distinguish between tumorous and healthy tissue, but also fully address the wide variety of tumorous sub-clones. Commonly used therapies either leverage a biological phenotype of cancer cells (e.g. high rate of proliferation) or indiscriminately kill all the cells present in a targeted volume. Tumor microenvironment (TME) targeting represents a promising therapeutic direction, because a number of TME hallmarks are conserved across different tumor types, despite the underlying genetic heterogeneity. Historically, TME targeting has largely focused on the cells that support tumor growth (e.g. vascular endothelial cells). However, by viewing the intrinsic physical and chemical alterations in the TME as additional therapeutic opportunities rather than barriers, a new class of TME-inspired treatments has great promise to complement or replace existing therapeutic strategies. In this review we summarize the physical and chemical hallmarks of the TME, and discuss how these tumor characteristics either currently are, or may ultimately be targeted to improve cancer therapies. PMID:26724680

  12. Survey of HNPCC Management Analysis of Responses from 18 International Cancer Centres

    Directory of Open Access Journals (Sweden)

    Chow Elizabeth

    2005-10-01

    Full Text Available Abstract Eighteen international cancer centres responded to a questionnaire designed to determine clinic practices regarding the management of Hereditary Non-Polyposis Colorectal Cancer (HNPCC. Areas covered include definition, clinical intakes, pre-genetic testing for microsatellite instability (MSI or expression of mismatch repair (MMR genes by immunohistochemistry (IHC, mutational analysis, consent practices, counselling, surveillance planning, and surgical decision making. In the absence of a firm evidence base, some management practices were variable, with local access to funding and other resources being influential. More consistent responses were evident for management practices with a stronger evidence base from previous clinical research. This document provides important information to guide the management of HNPCC patients, allow comparisons to be made between the approaches of various clinics to HNPCC families, and define management issues that need to be addressed in clinical research.

  13. Emerging targets in cancer management: role of the CXCL12/CXCR4 axis

    Directory of Open Access Journals (Sweden)

    Cojoc M

    2013-09-01

    Full Text Available Monica Cojoc,1 Claudia Peitzsch,1 Franziska Trautmann,1 Leo Polishchuk,2 Gennady D Telegeev,2 Anna Dubrovska11OncoRay National Center for Radiation Research in Oncology, Medical Faculty Carl Gustav Carus, Dresden University of Technology, Dresden, Germany; 2Institute of Molecular Biology and Genetics, National Academy of Sciences of Ukraine, Kyiv, UkraineAbstract: The chemokine CXCL12 (SDF-1 and its cell surface receptor CXCR4 were first identified as regulators of lymphocyte trafficking to the bone marrow. Soon after, the CXCL12/CXCR4 axis was proposed to regulate the trafficking of breast cancer cells to sites of metastasis. More recently, it was established that CXCR4 plays a central role in cancer cell proliferation, invasion, and dissemination in the majority of malignant diseases. The stem cell concept of cancer has revolutionized the understanding of tumorigenesis and cancer treatment. A growing body of evidence indicates that a subset of cancer cells, referred to as cancer stem cells (CSCs, plays a critical role in tumor initiation, metastatic colonization, and resistance to therapy. Although the signals generated by the metastatic niche that regulate CSCs are not yet fully understood, accumulating evidence suggests a key role of the CXCL12/CXCR4 axis. In this review we focus on physiological functions of the CXCL12/CXCR4 signaling pathway and its role in cancer and CSCs, and we discuss the potential for targeting this pathway in cancer management.Keywords: epithelial-to-mesenchymal transition, cancer stem cells, metastasis

  14. Women’s Views on Handling and Managing Their Breast Cancer in Pakistan: A Qualitative Study

    OpenAIRE

    Najma Naz; Sabiha Khanum; Grace Teresinha Marcon Dal Sasso; Maria de Lourdes de Souza

    2016-01-01

    In this study, we examine and analyze the experiences of women and their perceptions on handling and managing their breast cancer. Seven women from Peshawar, Pakistan who had breast cancer and have been cured, were interviewed. Qualitative content analysis of their life stories was performed using a computerized software Atlas.ti. In the coding process, 128 codes were initially developed. These codes were then grouped into 12 categories, which were then further refined into 8 theoretically gr...

  15. Role of intranasal fentanyl in breakthrough pain management in cancer patients

    OpenAIRE

    Leppert, Wojciech

    2010-01-01

    Wojciech LeppertDepartment of Palliative Medicine, Poznan University of Medical Sciences, Poznan, PolandAbstract: Fentanyl is a strong opioid analgesic, which is commonly used in the form of a transdermal patch for the treatment of chronic cancer pain. An intranasal route of fentanyl administration is a novel treatment for breakthrough cancer pain (BTCP). The prevalence, assessment, and management of BTCP is outlined in this paper, and basic pharmacodynamic and pharmacokinetic properties, dos...

  16. 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...... review revealed mostly general and common physician-related barriers to cancer pain management: concerns about side effects to opioids, prescription of not efficient doses of opioids, and very poor prescription for the treatment of side effects from opioids. In the future, the evaluation of the influence...

  17. Targeted therapies with companion diagnostics in the management of breast cancer: current perspectives.

    Science.gov (United States)

    Myers, Meagan B

    2016-01-01

    Breast cancer is a multifaceted disease exhibiting both intertumoral and intratumoral heterogeneity as well as variable disease course. Over 2 decades of research has advanced the understanding of the molecular substructure of breast cancer, directing the development of new therapeutic strategies against these actionable targets. In vitro diagnostics, and specifically companion diagnostics, have been integral in the successful development and implementation of these targeted therapies, such as those directed against the human epidermal growth factor receptor 2. Lately, there has been a surge in the development, commercialization, and marketing of diagnostic assays to assist in breast cancer patient care. More recently, multigene signature assays, such as Oncotype DX, MammaPrint, and Prosigna, have been integrated in the clinical setting in order to tailor decisions on adjuvant endocrine and chemotherapy treatment. This review provides an overview of the current state of breast cancer management and the use of companion diagnostics to direct personalized approaches in the treatment of breast cancer. PMID:26858530

  18. Successful management of a difficult cancer pain patient by appropriate adjuvant and morphine titration

    Directory of Open Access Journals (Sweden)

    Shiv PS Rana

    2011-01-01

    Full Text Available Morphine has been used for many years to relieve cancer pain. Oral morphine (in either immediate release or modified release form remains the analgesic of choice for moderate or severe cancer pain. The dose of oral morphine is titrated up to achieve adequate relief from pain with minimal side effects. Antidepressant and anticonvulsant drugs, when used in addition to conventional analgesics, give excellent relief from cancer pain. Most cancer pain responds to pharmacological measures with oral morphine but some pain like neuropathic and bony pain, pain in children and elderly age group, and advanced malignancy pain are very difficult to treat. Here, we report the management of a similar patient of severe cancer pain and the difficulty that we came across during dose titration of oral morphine and adjuvant analgesic.

  19. Current Operative Management of Breast Cancer: An Age of Smaller Resections and Bigger Cures

    International Nuclear Information System (INIS)

    Surgical resection was the first effective treatment for breast cancer and remains the most important treatment modality for curative intent. Refinements in operative techniques along with the use of adjuvant radiotherapy and advanced chemotherapeutic agents have facilitated increasingly focused breast cancer operations. Surgical management of breast cancer has shifted from extensive and highly morbid procedures, to the modern concept obtaining the best possible cosmetic result in tandem with the appropriate oncological resection. An ever-growing comprehension of breast cancer biology has led to substantial advances in molecular diagnosis and targeted therapies. An emerging frontier involves the breast cancer microenvironment, as a thorough understanding, while currently lacking, represents a critical opportunity for diagnosis and treatment. Collectively, these improvements will continue to push all therapeutic interventions, including operative, toward the goal of becoming more focused, targeted, and less morbid

  20. Social Networks and Physical Activity Behaviors Among Cancer Survivors: Data From the 2005 Health Information National Trends Survey

    Science.gov (United States)

    KIM, BANG HYUN; WALLINGTON, SHERRIE F.; MAKAMBI, KEPHER H.; ADAMS-CAMPBELL, LUCILE L.

    2015-01-01

    The study examined the relation between social networks and physical activity behaviors among cancer survivors. The authors examined 873 cancer survivors (596 women, 277 men) 50 years of age or older who participated in the 2005 Health Information National Trends Survey. Multivariate logistic regression analysis showed that survivors who talked about health with friends/family were more likely to pay attention to new physical activity recommendations (OR = 2.89, CI [1.01, 8.33]). Female survivors were more likely to pay attention to new physical activity recommendations (OR = 2.65, CI [1.55, 4.53]) and more likely to have seen, heard, or read physical activity/exercise and cancer information within the past 12 months (OR = 2.09, CI [1.13, 3.85]) compared with their male counterparts. For male survivors, those who were a member of at least one community organization were more likely to pay attention to new physical activity/exercise recommendations (OR = 5.31, CI [1.32, 21.22]) than the men who were not members. Overall, cancer survivors with a social network (i.e., talking to family/friends about health) were more likely to pay attention to new exercise recommendations compared with those who did not have a social network. Significant differences were also observed by gender with physical activity levels, knowledge, and attitudes. Social networking is an important component in cancer survivorship and further research is needed to encourage social networking strategies that might facilitate in increasing physical activity behaviors among cancer survivors. PMID:25978562

  1. Challenges of drug resistance in the management of pancreatic cancer.

    LENUS (Irish Health Repository)

    Sheikh, Rizwan

    2012-02-01

    The current treatment of choice for metastatic pancreatic cancer involves single-agent gemcitabine or a combination of gemcitabine with capecitabine or erlotinib (a tyrosine kinase inhibitor). Only 25–30% of patients respond to this treatment and patients who do respond initially ultimately exhibit disease progression. Median survival for pancreatic cancer patients has reached a plateau due to inherent and acquired resistance to these agents. Key molecular factors implicated in this resistance include: deficiencies in drug uptake, alteration of drug targets, activation of DNA repair pathways, resistance to apoptosis and the contribution of the tumor microenvironment. Moreover, for newer agents including tyrosine kinase inhibitors, overexpression of signaling proteins, mutations in kinase domains, activation of alternative pathways, mutations of genes downstream of the target and\\/or amplification of the target represent key challenges for treatment efficacy. Here we will review the contribution of known mechanisms and markers of resistance to key pancreatic cancer drug treatments.

  2. [Management of secondary lymphedema in patients with cancer].

    Science.gov (United States)

    Wenczl, Enikő

    2016-03-27

    Due to the increased number of cancer patients and the progress in cancer treatment, there are more cases with cancer-related lymphedema. Lymphedema treatment became part of oncological patients' care. Basic therapy for lymphedema is the complex decongestive therapy, which should be embedded into the patient's comprehensive medical care and should always be determined individually. Results of therapy are influenced by the experience of the doctor and the physiotherapist in lymphedema care, patient's complience, tumor behavior and the accompanying diseases. Lymphedema is a chronic disease, requires lifelong follow-up and treatment. For prevention and better care, it would be important to inform patients about lymphedema risk and appropriate life-style (e.g. weight control) preoperatively and during oncological follow-up. Early diagnosis is important. Lymphedema treatment should be integrated into palliative programmes. If therapy is started in time, complications may be avoided, healthcare costs may be reduced and better quality of life may be achieved. PMID:26996895

  3. Utility evaluations for Markov states of lung cancer for PET-based disease management

    International Nuclear Information System (INIS)

    Utilities for the health outcomes states (Markov states) of non-small cell lung carcinoma (NSCLCL) should be measured to evaluate management options for patients because patients are key participants in the process of care, and their assessment of diagnostic and therapeutic value in the options presented to them ultimately impacts their net health outcomes. This investigation sought to measure utilities for stage-dependent outcomes states of NSCLC. Persons (n=23) with suspected NSCLC based on physical findings and computed tomography completed a short utilities survey. Utility valuations were obtained according to severity of morbidity and varied considerably. Respondents rated these health states according to accuracy measures for 18flurodeoxyglucose (18FDG) positron emission tomography (PET) imaging and mediastinoscopy. The results demonstrate that stage-dependent morbidity is an important consideration for patients with NSCLC and should be included in any decision analysis regarding the evaluation or treatment of NSCLC. Respondents valued the quality of information obtained from non-invasive mediastinoscopy comparably. The utilities obtained from this investigation are useful in clinical decision-making based on Markov processes because they provide an initial estimation of utility assessment for 18FDG-based diagnostic evaluation of lung cancer. Consequently, these utilities will be useful in future decision analyses that require patient preference in the assignment of the evaluation of decision options (branches)

  4. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy

    DEFF Research Database (Denmark)

    Lalla, Rajesh V; Bowen, Joanne; Barasch, Andrei;

    2014-01-01

    BACKGROUND: Mucositis is a highly significant, and sometimes dose-limiting, toxicity of cancer therapy. The goal of this systematic review was to update the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines...... clinicians provide evidence-based management of mucositis secondary to cancer therapy....... criteria. The body of evidence for each intervention, in each treatment setting, was assigned a level of evidence, based on previously published criteria. Guidelines were developed based on the level of evidence, with 3 possible guideline determinations: recommendation, suggestion, or no guideline possible...

  5. Current practice of radioiodine treatment in the management of differentiated thyroid cancer in Germany

    International Nuclear Information System (INIS)

    This prospective, observational study of a cohort of thyroid cancer patients in Germany focusses on the ''real-world'' practice in the management of thyroid cancer patients. This report includes data from 2376 patients with primary differentiated thyroid carcinoma first diagnosed in the year 1996. The study reveals considerable differences in actual practice concerning surgery and radioiodine treatment. The results indicate that consensus is lacking with respect to the multimodality treatment approach for differentiated thyroid carcinoma. Our analysis represents the most current and comprehensive national assessment of presenting patient characteristics, diagnostic tests, treatment and complications for thyroid cancer. (orig.)

  6. Charting a course through the CEAs: diagnosis and management of medullary thyroid cancer.

    Science.gov (United States)

    Rowe, Christopher W; Bendinelli, Cino; McGrath, Shaun

    2016-09-01

    Medullary thyroid cancer (MTC) is an uncommon thyroid cancer that requires a high index of suspicion to facilitate diagnosis of early-stage disease amenable to surgical cure. The challenges of diagnosis, as well as management in the setting of persistent disease, are explored in the context of a case presenting with the incidental finding of elevated carcinoembryonic antigen (CEA) and an (18) F-fluorodeoxyglucose positron emission tomography ((18) F-FDG-PET)-positive thyroid incidentaloma detected following treatment of colorectal cancer. Strategies to individualize prognosis, and emerging PET-based imaging modalities, particularly the potential role of (18) F-DOPA-PET in staging, are reviewed. PMID:27230389

  7. Circulating Cell-Free Tumour DNA in the Management of Cancer

    Science.gov (United States)

    Francis, Glenn; Stein, Sandra

    2015-01-01

    With the development of new sensitive molecular techniques, circulating cell-free tumour DNA containing mutations can be identified in the plasma of cancer patients. The applications of this technology may result in significant changes to the care and management of cancer patients. Whilst, currently, these “liquid biopsies” are used to supplement the histological diagnosis of cancer and metastatic disease, in the future these assays may replace the need for invasive procedures. Applications include the monitoring of tumour burden, the monitoring of minimal residual disease, monitoring of tumour heterogeneity, monitoring of molecular resistance and early diagnosis of tumours and metastatic disease. PMID:26101870

  8. Circulating Cell-Free Tumour DNA in the Management of Cancer

    Directory of Open Access Journals (Sweden)

    Glenn Francis

    2015-06-01

    Full Text Available With the development of new sensitive molecular techniques, circulating cell-free tumour DNA containing mutations can be identified in the plasma of cancer patients. The applications of this technology may result in significant changes to the care and management of cancer patients. Whilst, currently, these “liquid biopsies” are used to supplement the histological diagnosis of cancer and metastatic disease, in the future these assays may replace the need for invasive procedures. Applications include the monitoring of tumour burden, the monitoring of minimal residual disease, monitoring of tumour heterogeneity, monitoring of molecular resistance and early diagnosis of tumours and metastatic disease.

  9. Social cognitive theory mediators of physical activity in a lifestyle program for cancer survivors and carers: findings from the ENRICH randomized controlled trial

    OpenAIRE

    Stacey, F. G.; James, E. L.; K. CHAPMAN; Lubans, D. R.

    2016-01-01

    Background Despite increasing numbers of cancer survivors and evidence that diet and physical activity improves the health of cancer survivors, most do not meet guidelines. Some social cognitive theory (SCT)-based interventions have increased physical activity behavior, however few have used objective physical activity measures. The Exercise and Nutrition Routine Improving Cancer Health (ENRICH) randomized controlled trial reported a significant intervention effect for the primary outcome of ...

  10. Strategies for managing breast cancer risk after the menopause.

    Science.gov (United States)

    Warren, Ruth; Harvie, Michelle; Howell, Anthony

    2004-01-01

    Postmenopausal women in Western societies are conscious of breast cancer as a potential cause of death and ill health, which they wish to avoid with the advice of their doctors. Yet many factors that predispose women to the development of cancer will have been laid down before the menopause, in their genetic makeup or during their adolescent years. Even in middle age it is important to take account of the intrinsic level of risk, and to give women advice tailored to their own individual risk level. This results from their family history, previous diseases such as benign breast disease, and previous treatment for breast cancer or Hodgkin's disease. For those at the highest level of risk, strategies will include regular screening, prophylactic mastectomy, and the use of chemoprevention agents, such as tamoxifen. These women should avoid hormone replacement therapy (HRT) and control their menopausal symptoms and osteoporosis through the use of other agents now available - venlafaxine for menopausal symptoms and bisphosphonates for osteoporosis. Raloxifene is an agent under trial that may be valuable for breast cancer control as well as for osteoporosis. Women at standard population risk will require less robust preventive strategies, which will include screening and lifestyle modification. Their decisions regarding HRT should now be modified by recent evidence of associated risks. Recent studies show that tibolone causes less mammographic density and has a lower relative risk of breast cancer than combined estrogen/progestogen preparations. There is limited evidence that controlling obesity, participating in exercise and adopting a diet low in fats and high in fruit and vegetables will alter risk at this age. These precautions will, however, reduce the risk of other diseases common in this age group, such as hypertension, heart disease, stroke, and type 2 diabetes mellitus. Alcohol, even in small amounts, is a risk factor for breast cancer. Given the cardioprotective

  11. Risk Management and Medico-Legal Issues in Breast Cancer.

    Science.gov (United States)

    Ward, Charles J; Green, Victoria L

    2016-06-01

    Breast cancer is a leading source of malpractice claims for radiologists and gynecologists. Delay in or failure to diagnosis was the second most common cause for allegations of malpractice and failure to diagnosis breast cancer accounted for the majority of these claims. The amount paid in indemnity for such claims was only second to claims paid for neurologically impaired newborns. Issues involved in documentation and communication are reviewed with a focus on specific medical legal cases. Obstetrician gynecologists must remain cognizant of the potential for liability. PMID:27101242

  12. Molecular nuclear medicine in the management of thyroid cancer

    International Nuclear Information System (INIS)

    Full text: Background: SERUM thyroglobulin (Tg) is an established tumor marker used in the management of patients with a diagnosis of differentiated thyroid carcinoma (DTC). However, a number of technical problems impair the clinical utility of this test. These problems include a lack of method standardization, inadequate sensitivity, lack of interassay reproducibility, ''hook'' effects when measuring high concentrations, and Tg autoantibody (TgAb) interference. Recently, progress has been made in overcoming some of these limitations. For example, a collaborative effort has now produced an international Tg standard (CRM 457, BCR Brussels). RIAs are being replaced by more sensitive immunometric assay (IMA) methods with faster turn-around times, and recommendations for improving interassay precision and detecting hook effects have recently been published. The present study was carried out to evaluate the accuracy of recombinant human TSH (rhTSH) /thyroglobulin (Tg) test among differentiated thyroid cancer (DTC) patients with persistent disease and low thyroglobulin levels. Methods and materials: Concentration of TSH and Tg was investigated using RIA. A series of 13 DTC patients was selected because they had proven persistent disease associated with low Tg levels ( 5.0 micro g/I at the last THST withdrawal. We measured serum Tg and TSH levels on days 0.5, 1, 1.5, 2, 4, 7, 10 and 15 after the first of a 2-day course of intramuscular rhTSH injections. Serum Tg values were variable in terms of both peak and time-course. Results: Detectable serum Tg levels were recorded on day 4 in all patients. However, among these 13 patients, the peak Tg value was reached earlier than day 4 in three patients and later in two others. In one patient, Tg level at day 2 was higher (3.0 micro g/l) than at day 4 (1.8 micro g/1). In six of the 13 patients studied we compared Tg values after rhTSH to those subsequently obtained after THST withdrawal: in five of them Tg values were two to three

  13. The influence of family history on prostate cancer risk: implications for clinical management.

    Science.gov (United States)

    Madersbacher, Stephan; Alcaraz, Antonio; Emberton, Mark; Hammerer, Peter; Ponholzer, Anton; Schröder, Fritz H; Tubaro, Andrea

    2011-03-01

    • The most recent evidence for the link between a family history of prostate cancer and individual risk for future disease was examined, with the aim of understanding what the existence and nature of a family history of prostate cancer does to a man's risk of developing the disease. • Our findings highlighted the clear association between a family history of prostate cancer and increased risk of developing the disease; with a greater proximity of relatedness, greater number of family members affected and/or earlier age at diagnosis of the family member elevating risk further. • These findings have important clinical implications for the identification and subsequent management of men deemed to be at increased risk of developing prostate cancer. The evidence for prostate cancer risk reduction with the mono 5α-reductase inhibitor (5ARI) finasteride in a low-risk population and, more recently, with the dual 5ARI dutasteride in a population at increased risk of developing the disease, has potential to expand management options for men at risk of developing prostate cancer beyond more frequent and/or earlier surveillance. • Given that family history can be easily assessed in routine clinical practice, it should be regarded as an important parameter to consider alongside PSA level for prostate cancer risk assessment. PMID:21166744

  14. Management of the lymph nodes in penile cancer.

    Science.gov (United States)

    Heyns, Chris F; Fleshner, Neil; Sangar, Vijay; Schlenker, Boris; Yuvaraja, Thyavihally B; van Poppel, Hendrik

    2010-08-01

    A comprehensive literature study was conducted to evaluate the levels of evidence (LEs) in publications on the diagnosis and staging of penile cancer. Recommendations from the available evidence were formulated and discussed by the full panel of the International Consultation on Penile Cancer in November 2008. The final grades of recommendation (GRs) were assigned according to the LE of the relevant publications. The following consensus recommendations were accepted. Fine needle aspiration cytology should be performed in all patients (with ultrasound guidance in those with nonpalpable nodes). If the findings are positive, therapeutic, rather than diagnostic, inguinal lymph node dissection (ILND) can be performed (GR B). Antibiotic treatment for 3-6 weeks before ILND in patients with palpable inguinal nodes is not recommended (GR B). Abdominopelvic computed tomography (CT) and magnetic resonance imaging (MRI) are not useful in patients with nonpalpable nodes. However, they can be used in those with large, palpable inguinal nodes (GR B). The statistical probability of inguinal micrometastases can be estimated using risk group stratification or a risk calculation nomogram (GR B). Surveillance is recommended if the nomogram probability of positive nodes is .5 [50%] or primary tumor grade 2-3 or T2-T4 or cN1-N2, or with lymphovascular invasion), bilateral ILND should be performed (GR B). ILND can be performed at the same time as penectomy, instead of 2-6 weeks later (GR C). SNB based on the anatomic position can be performed, provided the patient is willing to accept the potential false-negative rate of /=2 nodes on one side, contralateral limited ILND with frozen section analysis can be performed, with complete ILND if the frozen section analysis findings are positive (GR B). If clinically suspicious inguinal metastases develop during surveillance, complete ILND should be performed on that side only (GR B), and SNB or limited ILND with frozen section analysis on the

  15. What next? Managing lymph nodes in men with penile cancer

    OpenAIRE

    Leveridge, Michael; Siemens, D. Robert; Morash, Christopher

    2008-01-01

    The management of patients with squamous cell carcinoma of the penis is often daunting given its rarity and subsequent lack of high-level evidence to support our decision-making. This culminates in the complex surgical issues involving the management of the regional lymph nodes, which is of critical importance to both quantity and quality of life for these patients. This review aims to highlight the decisive issues surrounding the management of the pelvic and inguinal lymph nodes in the setti...

  16. Canadian Cardiovascular Society Guidelines for Evaluation and Management of Cardiovascular Complications of Cancer Therapy.

    Science.gov (United States)

    Virani, Sean A; Dent, Susan; Brezden-Masley, Christine; Clarke, Brian; Davis, Margot K; Jassal, Davinder S; Johnson, Christopher; Lemieux, Julie; Paterson, Ian; Sebag, Igal A; Simmons, Christine; Sulpher, Jeffrey; Thain, Kishore; Thavendiranathan, Paaldinesh; Wentzell, Jason R; Wurtele, Nola; Côté, Marc André; Fine, Nowell M; Haddad, Haissam; Hayley, Bradley D; Hopkins, Sean; Joy, Anil A; Rayson, Daniel; Stadnick, Ellamae; Straatman, Lynn

    2016-07-01

    Modern treatment strategies have led to improvements in cancer survival, however, these gains might be offset by the potential negative effect of cancer therapy on cardiovascular health. Cardiotoxicity is now recognized as a leading cause of long-term morbidity and mortality among cancer survivors. This guideline, authored by a pan-Canadian expert group of health care providers and commissioned by the Canadian Cardiovascular Society, is intended to guide the care of cancer patients with established cardiovascular disease or those at risk of experiencing toxicities related to cancer treatment. It includes recommendations and important management considerations with a focus on 4 main areas: identification of the high-risk population for cardiotoxicity, detection and prevention of cardiotoxicity, treatment of cardiotoxicity, and a multidisciplinary approach to cardio-oncology. All recommendations align with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Key recommendations for which the panel provides a strong level of evidence include: (1) that routine evaluation of traditional cardiovascular risk factors and optimal treatment of preexisting cardiovascular disease be performed in all patients before, during, and after receiving cancer therapy; (2) that initiation, maintenance, and/or augmentation of antihypertensive therapy be instituted per the Canadian Hypertension Educational Program guidelines for patients with preexisting hypertension or for those who experience hypertension related to cancer therapy; and (3) that investigation and management follow current Canadian Cardiovascular Society heart failure guidelines for cancer patients who develop clinical heart failure or an asymptomatic decline in left ventricular ejection fraction during or after cancer treatment. This guideline provides guidance to clinicians on contemporary best practices for the cardiovascular care of cancer patients. PMID:27343741

  17. Supporting self-management of pain by patients with advanced cancer::Views of palliative care professionals

    OpenAIRE

    Hughes, Nicholas D.; Closs, S. José; Flemming, Katherine Ann; Bennett, Michael I.

    2016-01-01

    Purpose: To ascertain the views of specialist palliative care professionals on patient self-management of cancer pain in order to inform the development of a new educational intervention to support self-management. Methods: Qualitative research using focus group interviews. Results: Participants viewed self-management of cancer pain as desirable and achievable but also as something that could be problematic. Challenges to self-management were perceived in: patient attitudes and behaviours, pr...

  18. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... about Advanced Cancer Research Managing Cancer Care Finding Health Care Services Advance Directives Using Trusted Resources Financial Toxicity ... Cancer Advanced Cancer & Caregivers Managing Cancer Care Finding Health Care Services Advance Directives Using Trusted Resources Cancer Types ...

  19. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Cancer Research Managing Cancer Care Finding Health Care Services Advance Directives Using Trusted Resources Understanding Cancer What ... Cancer & Caregivers Managing Cancer Care Finding Health Care Services Advance Directives Using Trusted Resources Cancer Types Adolescents ...

  20. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... about Advanced Cancer Research Managing Cancer Care Finding Health Care Services Advance Directives Using Trusted Resources What Is ... Cancer Advanced Cancer & Caregivers Managing Cancer Care Finding Health Care Services Advance Directives Using Trusted Resources Cancer Types ...

  1. Managing population health to prevent and detect cancer and non-communicable diseases.

    Science.gov (United States)

    Bryant, Heather; Shin, Hai Rim; Forman, David; Stevanovic, Vladimir; Park, Sohee; Burton, Robert; Varghese, Cherian; Ullrich, Andreas; Sutcliffe, Catherine; Sutcliffe, Simon

    2012-01-01

    The goals of cancer control strategies are generally uniform across all constituencies and are to reduce cancer incidence, reduce cancer mortality, and improve quality of life for those affected by cancer. A well-constructed strategy will ensure that all of its elements can ultimately be connected to one of these goals. When a cancer control strategy is being implemented, it is essential to map progress towards these goals; without mapping progress, it is impossible to assess which components of the strategy require more attention or resources and which are not having the desired effect and need to be re-evaluated. In order to monitor and evaluate these strategies, systems need to be put in place to collect data and the appropriate indicators of performance need to be identified. Session 2 of the 4th International Cancer Control Congress (ICCC-4) focused on how to manage population health to prevent and detect cancers and non-communicable diseases through two plenary presentations and four interactive workshop discussions: 1) registries, measurement, and management in cancer control; 2) use of information for planning and evaluating screening and early detection programs; 3) alternative models for promoting community health, integrated care and illness management; and 4) control of non-communicable diseases. Workshop discussions highlighted that population based cancer registries are fundamental to understanding the cancer burden within a country. However, many countries in Africa, Asia, and South/ Central America do not have them in place. A new global initiative is underway, which brings together several international agencies, and aims to establish six IARC regional registration resource centres over the next five years. These will provide training, support, infrastructure and advocacy to local networks of cancer registries, and, it is hoped, improve the host countries' ability to assess and act on cancer issues within their jurisdictions. Multiple methods of

  2. Pain in long-term breast cancer survivors: The role of body mass index, physical activity, and sedentary behavior

    OpenAIRE

    Forsythe, Laura P; Alfano, Catherine M.; George, Stephanie M.; McTiernan, Anne; Baumgartner, Kathy B.; Bernstein, Leslie; Ballard-Barbash, Rachel

    2012-01-01

    Although pain is common among post-treatment breast cancer survivors, studies that are longitudinal, identify a case definition of clinically meaningful pain, or examine factors contributing to pain in survivors are limited. This study describes longitudinal patterns of pain in long-term breast cancer survivors, evaluating associations of body mass index [BMI], physical activity, sedentary behavior with mean pain severity and above-average pain. Women newly diagnosed with stages 0–IIIA breast...

  3. Study protocol:Rehabilitation including social and physical activity and education in children and teenagers with cancer (RESPECT)

    OpenAIRE

    Thorsteinsson, Troels; Helms, Anne Sofie; Adamsen, Lis; Andersen, Lars Bo; Andersen, Karen Vitting; Christensen, Karl Bang; Halse, Henrik; Heilmann, Carsten; Hejgaard, Nete; Johansen, Christoffer; Madsen, Marianne; Madsen, Svend Aage; Simovska, Venka; Strange, Birgit; Thing, Lone Friis

    2013-01-01

    Background 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. Methods/design The RESPECT study is a nationwide population-based prospective, controlled, mixed-methods intervention study looking at children aged 6-18 years n...

  4. Update on epidemiology classification, and management of thyroid cancer

    Directory of Open Access Journals (Sweden)

    Heitham Gheriani

    2006-06-01

    Full Text Available Thyroid cancer represents approximately 0.5–1% of all human malignancy1. In the UK the incidence of thyroid cancer is 2-3 per 100,000 populations 2. In geographical areas of low iodine intake and in areas exposed to nuclear disasters the incidence of thyroid cancer is higher. Benign thyroid conditions are much more common. In the UK approximately 8 % of the population have nodular thyroid disease2. Nodular thyroid disease increases with age and is also more common in females and in geographical areas of low iodine intake. Primary thyroid malignancy can be broadly divided into 2 groups. The first group, which generally have much better prognosis, are the well-differentiated thyroid carcinoma, which includes papillary carcinoma, follicular carcinoma and Hürthle cell tumours. The second group includes the poorly differentiated thyroid carcinoma like medullary thyroid carcinoma and the anaplastic thyroid carcinoma. Other rare tumours such as sarcomas, lymphomas and the extremely rare primary squamous cell carcinoma of the thyroid should be included in the second group. Secondary or metastatic thyroid cancer can be from breast, lung, colon and kidney malignancies.

  5. Novel agents in the management of castration resistant prostate cancer

    Directory of Open Access Journals (Sweden)

    Shruti Chaturvedi

    2014-01-01

    Full Text Available Prostate cancer (PCa is a leading cause of cancer mortality in men and despite high cure rates with surgery and/or radiation, 30-40% of patients will eventually develop advanced disease. Androgen deprivation is the first line therapy for standard of care for men with advanced disease. Eventually however all men will progress to castration-resistant prostate cancer (CRPC. Insight into the molecular mechanisms of androgen resistance has led to the development of alternative novel hormonal agents. Newer hormonal agents such as abiraterone, enzalutamide and TOK-001; and the first cancer vaccine, Sipuleucel T have been approved for use in men with CRPC. The recognition of the importance of bone health and morbidity associated with skeletal related events has led to the introduction of the receptor activator of nuclear factor kappa-B-ligand inhibitor denosumab. Other molecularly targeted therapies have shown promise in pre-clinical studies, but this has not consistently translated into clinical efficacy. It is increasingly evident that CRPC is a heterogeneous disease and an individualized approach directed at identifying primary involvement of specific pathways could maximize the benefit from targeted therapies. This review focuses on targeted therapy for PCa with special emphasis on therapies that have been Food and Drug Administration approved for use in men with CRPC.

  6. Management of Differentiated Thyroid Cancer in Children: Focus on the American Thyroid Association Pediatric Guidelines.

    Science.gov (United States)

    Parisi, Marguerite T; Eslamy, Hedieh; Mankoff, David

    2016-03-01

    First introduced in 1946, radioactive iodine (I-131) produces short-range beta radiation with a half-life of 8 days. The physical properties of I-131 combined with the high degree of uptake in the differentiated thyroid cancers (DTCs) led to the use of I-131 as a therapeutic agent for DTC in adults. There are two indications for the potential use of I-131 therapy in pediatric thyroid disorders: nonsurgical treatment of hyperthyroidism owing to Graves' disease and the treatment of children with intermediate- and high-risk DTC. However, children are not just miniature adults. Not only are children and the pediatric thyroid gland more sensitive to radiation than adults but also the biologic behavior of DTC differs between children and adults as well. As opposed to adults, children with DTC typically present with advanced disease at diagnosis; yet, they respond rapidly to therapy and have an excellent prognosis that is significantly better than that in adult counterparts with advanced disease. Unfortunately, there are also higher rates of local and distant disease recurrence in children with DTC compared with adults, mandating lifelong surveillance. Further, children have a longer life expectancy during which the adverse effects of I-131 therapy may become manifest. Recognizing the differences between adults and children with DTC, the American Thyroid Association commissioned a task force of experts who developed and recently published a guideline to address the unique issues related to the management of thyroid nodules and DTC in children. This article reviews the epidemiology, diagnosis, staging, treatment, therapy-related effects, and suggestions for surveillance in children with DTC, focusing not only on the differences between adults and children with this disease but also on the latest recommendations from the inaugural pediatric management guidelines of the American Thyroid Association. PMID:26897719

  7. INTENSITY AND TIMING IN LIFE OF RECREATIONAL PHYSICAL ACTIVITY IN RELATION TO BREAST CANCER RISK AMONG PRE- AND POSTMENOPAUSAL WOMEN

    Directory of Open Access Journals (Sweden)

    Joanna Kruk

    2010-06-01

    Full Text Available Regular recreational physical activity has been found to be associated with a decrease in breast cancer risk in women in the majority of epidemiologic studies, but research findings are inconsistent regarding the intensity of activity and timing in life. To address these issues the relations of moderate and vigorous intensity recreational physical activity during ages 14-20, 21-34, 35-50, and over age 50 years to pre- and postmenopausal breast cancer risk were examined. A case-control study of 858 women, with histological confirmation of invasive breast cancer, and 1085 controls, free of any cancer diagnosis, all subjects aged 28-79 years was conducted in the Region of Western Pomerania (Poland. Physical activity was assessed using a self-administered questionnaire with questions on type of activity, duration, frequency, and intensity for each type of activity. Odds ratios (OR and 95% confidence intervals (CI of breast cancer associated with physical activity were calculated using unconditional logistic regression. Vigorous physical activity at ages 14-20 and 21-34 years lowered breast cancer risk by at least 35% in premenopausal women and by at least 51% in postmenopausal women for the highest versus lowest quartiles of the activity. The risk was also reduced in postmenopausal women who reported on average more than 1.74 hours per week of vigorous intensity recreational activity in ages >50 years (OR = 0.58; 95%CI = 0.27-0.97; P for trend = 0.013. For moderate activity the relationships remained statistically significant only in postmenopausal women active during ages 14- 20 years. The results indicate also a plausible risk reduction among premeno-pausal women. These results support the hypothesis that recrea-tional activity, particularly done early in life, is associated with a decrease in the invasive breast cancer risk in postmenopausal women. Among premenopausal women, only vigorous forms of activity may significantly decrease the risk

  8. The effects of age, education, and treatment on physical, sexual and body concern symptoms among multimorbid, colorectal cancer survivors

    Science.gov (United States)

    Naik, Aanand D.; Uy, Natalie; Anaya, Daniel A.; Moye, Jennifer

    2016-01-01

    Objective Less is known about longitudinal changes in quality of life between treatment completion and early survivorship among multimorbid cancer survivors. The current study describes longitudinal changes in quality of life among a multimorbid cohort of US Veterans diagnosed and treated for colorectal cancer. Materials and methods A sample of 68 multimorbid adults with colon and/or rectal cancer who received one or more treatment options (surgery, chemo or radiation therapy) was recruited. Participants were not excluded by cancer stage unless they reported being in hospice or similar status. Comprehensive assessments of quality of life and treatment side-effects were conducted 6, 12, and 18 months after diagnosis. Descriptive statistics characterized treatment side-effects and changes in quality-of-life domains longitudinally. Multivariate Analysis of Variance identified sociodemographic and clinical variables associated with quality of life changes. Results Many physical symptoms improved from 6 to 18 months following diagnosis, while some remained stable. Sexual symptoms worsened, attributable to increasing rates of dysfunction in older patients. Low education attainment was predictive of worse physical symptoms (F = 5.59, p = .023) and associated with body concerns (F = 5.7; p = .005) over time. Advanced cancer stage (F = 4.94; p < .04) and receipt of chemotherapy (F = 4.21; p < .05) independently predicted body concerns in multivariate analyses. Conclusion Endorsement of physical and sexual symptoms and body concerns occurs in different patterns over time among multimorbid colorectal cancer survivors. Low education attainment is consistently associated with physical symptoms and body concerns. Cancer stage and chemotherapy are predictive of body concerns, but not physical or sexual symptoms. PMID:25920578

  9. The use of production management techniques in the construction of large scale physics detectors

    CERN Document Server

    Bazan, A; Estrella, F; Kovács, Z; Le Flour, T; Le Goff, J M; Lieunard, S; McClatchey, R; Murray, S; Varga, L Z; Vialle, J P; Zsenei, M

    1999-01-01

    The construction process of detectors for the Large Hadron Collider (LHC) experiments is large scale, heavily constrained by resource availability and evolves with time. As a consequence, changes in detector component design need to be tracked and quickly reflected in the construction process. With similar problems in industry engineers employ so-called Product Data Management (PDM) systems to control access to documented versions of designs and managers employ so- called Workflow Management software (WfMS) to coordinate production work processes. However, PDM and WfMS software are not generally integrated in industry. The scale of LHC experiments, like CMS, demands that industrial production techniques be applied in detector construction. This paper outlines the major functions and applications of the CRISTAL system (Cooperating Repositories and an information System for Tracking Assembly Lifecycles) in use in CMS which successfully integrates PDM and WfMS techniques in managing large scale physics detector ...

  10. Systematic Review of the Use of Phytochemicals for Management of Pain in Cancer Therapy

    Directory of Open Access Journals (Sweden)

    Andrew M. Harrison

    2015-01-01

    Full Text Available Pain in cancer therapy is a common condition and there is a need for new options in therapeutic management. While phytochemicals have been proposed as one pain management solution, knowledge of their utility is limited. The objective of this study was to perform a systematic review of the biomedical literature for the use of phytochemicals for management of cancer therapy pain in human subjects. Of an initial database search of 1,603 abstracts, 32 full-text articles were eligible for further assessment. Only 7 of these articles met all inclusion criteria for this systematic review. The average relative risk of phytochemical versus control was 1.03 [95% CI 0.59 to 2.06]. In other words (although not statistically significant, patients treated with phytochemicals were slightly more likely than patients treated with control to obtain successful management of pain in cancer therapy. We identified a lack of quality research literature on this subject and thus were unable to demonstrate a clear therapeutic benefit for either general or specific use of phytochemicals in the management of cancer pain. This lack of data is especially apparent for psychotropic phytochemicals, such as the Cannabis plant (marijuana. Additional implications of our findings are also explored.

  11. Screening for prostate cancer: How to manage in 2006

    Directory of Open Access Journals (Sweden)

    Lobel B.

    2005-01-01

    Full Text Available National Societies usually recommend screening for Prostate Cancer (PC with Serum Prostate Specific Antigen (PSA and digital rectal examination annually beginning at age 50. In high risk population including men with a family history of PC or African population screening should start at age of 45 years. PSA has been widely used to detect PC despite the fact that PSA is not specific for PC. Over the years serum PSA level of greater than 4,0ng/ml was considered the threshold to perform prostate biopsy, searching for PC. In 2005 the Prostate Cancer Prevention Trial (PCPT demonstrated that the cut-off of 4,0ng/ml for PSA is not anymore adapted1 due to the fact that this survey found in 15% of men with PSA < or = 4,0ng/ml a prostate cancer on sextant biopsies. Today the value of PSA and the cut-off for Prostate biopsy is questioned suggesting that PSA level higher than 2,6ng/ml must be the case to propose Prostate Biopsy. Catalona confirms that approximately 25% to 30% of men with PSA 2,6 to 4,0ng/ml have prostate cancer2. Schröder and Gosselaar3 assert that screening for PC at low PSA levels (<4,0ng/ml risks to detect clinically insignificant cancers which are no threat to man. So far in the year 2006 screening for PC demonstrates accumulating evidences of efficacy but persistent uncertainty4. The major question for an urologist at work when facing a young men searching early diagnosis of PC is: at which level of PSA do we have to perform rectal biopsy ?.

  12. The characteristics of physical activity and gait in patients receiving radiotherapy in cancer induced bone pain

    International Nuclear Information System (INIS)

    Background and purpose: An objective measure of pain relief may add important information to patients’ self assessment, particularly after a treatment. The study aims were to determine whether measures of physical activity and/or gait can be used in characterizing cancer-induced bone pain (CIBP) and whether these biomarkers are sensitive to treatment response, in patients receiving radiotherapy (XRT) for CIBP. Materials and methods: Patients were assessed before (baseline) and 6–8 weeks after XRT (follow up). The following assessments were done: Brief Pain Inventory (BPI), activPAL™ activity meter, and GAITRite® electronic walkway (measure of gait). Wilcoxon, Mann–Whitney and Pearson statistical analyses were done. Results: Sixty patients were assessed at baseline; median worst pain was 7 and walking interference was 5. At follow up 42 patients were assessed. BPI worst pain, average pain, walking interference and total functional interference all improved (p < 0.001). An improvement in functional interference correlated with aspects of physical activity (daily hours standing r = 0.469, p = 0.002) and gait (cadence r = 0.341, p = 0.03). The activPAL and GAITRite parameters did not change following XRT (p > 0.05). In responder analyses there were no differences in activPAL and GAITRite parameters (p > 0.05). Conclusion: Assessment of physical activity and gait allow a characterization of the functional aspects of CIBP, but not in the evaluation of XRT

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

    International Nuclear Information System (INIS)

    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

  14. The Influence of Instructional Climates on Time Spent in Management Tasks and Physical Activity of 2nd-Grade Students during Physical Education

    Science.gov (United States)

    Logan, Samuel W.; Robinson, Leah E.; Webster, E. Kipling; Rudisill, Mary E.

    2015-01-01

    The purpose of this study is to determine the effect of two physical education (PE) instructional climates (mastery, performance) on the percentage of time students spent in a) moderate-to-vigorous physical activity (MVPA) and b) management tasks during PE in 2nd-grade students. Forty-eight 2nd graders (mastery, n = 23; performance, n = 25)…

  15. Soil physical properties and grape yield influenced by cover crops and management systems

    OpenAIRE

    Jaqueline Dalla Rosa; Alvaro Luiz Mafra; João Carlos Medeiros; Jackson Adriano Albuquerque; Davi José Miquelluti; Marcos André Nohatto; Evandro Zacca Ferreira; Odoni Loris Pereira de Oliveira

    2013-01-01

    The use of cover crops in vineyards is a conservation practice with the purpose of reducing soil erosion and improving the soil physical quality. The objective of this study was to evaluate cover crop species and management systems on soil physical properties and grape yield. The experiment was carried out in Bento Gonçalves, RS, Southern Brazil, on a Haplic Cambisol, in a vineyard established in 1989, using White and Rose Niagara grape (Vitis labrusca L.) in a horizontal, overhead trellis sy...

  16. One in Four Questioned Children Faces Problems Regarding Reintegration Into Physical Education at School After Treatment for Pediatric Cancer.

    Science.gov (United States)

    Kesting, Sabine V; Götte, Miriam; Seidel, Corinna C; Rosenbaum, Dieter; Boos, Joachim

    2016-04-01

    Resumption of physical activity and reintegration into social surroundings after treatment for pediatric cancer is of high importance to recover from the burden of disease and treatment and to positively influence long-term health outcomes. Eighty-three children who had completed intensive treatment for pediatric cancer were surveyed regarding their participation in physical education at school (PES). The results show a concerning low rate of participation, particularly in children treated for pediatric bone tumors, and associated barriers. Reported reasons for quitting PES seem to be conquerable by individual and entity-related support to enable participation according to the children's desire. PMID:26681662

  17. The relationship between perfectionism of managers and Empowerment staff of physical education offices in Tehran

    Directory of Open Access Journals (Sweden)

    Akram G H A D I R I

    2014-09-01

    Full Text Available The aim of the present study is relationship between perfectionism of managers and empowerment staff of physical education offices in Tehran. This research is a descriptive – correlation, from Perspective of Nature, Applicable. The po pulation of this research consisted of managers and administrative staff in physical education offices of Tehran are the number of 351 persons. The sample estimate of the population and with using Morgan’s table And Karjsi and 185 patients were selected us ing stratified random number, of which 50 were managers and 135 employees. Independent variables were instrumented perfectionism of managers, 59 item questionnaires of Hill and Associates (2004 and tools to measure the dependent variable of empowerment pe rsonnel was 16 - item questionnaire Aspretizr (2002 . Statistical methods was included descriptive statistics and inferential statistics (Pearson and Friedman and the results in general showed a there is significant relationship between perfectionism of man agers and capabilities of personnel. And so dimensions of perfectionism of Managers had a meaningful significant negative relationship with empowerment personnel. However, discipline and stress had the strongest associations with empowerment personnel.

  18. Technological sequence of creating components of the training system of the future officers to the management of physical training

    Directory of Open Access Journals (Sweden)

    Olkhovy O.M.

    2012-09-01

    Full Text Available The goal is to determine constructive ways of sequence of constructing components of the training system of the future officers to carry out official questions of managing the physical training in the process of the further military career. The structural logic circuit of the interconnections stages of optimum cycle management and technological sequence of constructing the components of the training system of the future officers to the management of physical training, which provides: definition of requirements to the typical problems of professional activities on the issues of the leadership, organization and conducting of physical training, the creation of the phased system model cadets training, training of the curriculum discipline ″Physical education, special physical training and sport″; model creation and definition of criteria of the integral evaluation of the readiness of the future officers to the management of physical training was determined through the analysis more than thirty documentary and scientific literature.

  19. An ODMG-compatible testbed architecture for scalable management and analysis of physics data

    International Nuclear Information System (INIS)

    This paper describes a testbed architecture for the investigation and development of scalable approaches to the management and analysis of massive amounts of high energy physics data. The architecture has two components: an interface layer that is compliant with a substantial subset of the ODMG-93 Version 1.2 specification, and a lightweight object persistence manager that provides flexible storage and retrieval services on a variety of single- and multi-level storage architectures, and on a range of parallel and distributed computing platforms

  20. Application of integrative information system improves the quality and effectiveness of cancer case management

    OpenAIRE

    Lee PY; Chang TR

    2015-01-01

    Pei-Yi Lee,1,2 Tsue-Rung Chang11Department of Nursing, MacKay Memorial Hospital, Taipei, Taiwan; 2Department of Nursing, MacKay Medical College, Taipei, TaiwanAbstract: Cancer case management provides consecutive care during the entire process through diagnosis to treatment and follow-up. We established an integrative information system with integration of the health information system. This integrative information system shortened the time spent on case screening, follow-up data management, ...