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Sample records for feeding cancer patients

  1. Age most significant predictor of requiring enteral feeding in head-and-neck cancer patients

    International Nuclear Information System (INIS)

    Sachdev, Sean; Refaat, Tamer; Bacchus, Ian D; Sathiaseelan, Vythialinga; Mittal, Bharat B

    2015-01-01

    A significant number of patients treated for head and neck squamous cell cancer (HNSCC) undergo enteral tube feeding. Data suggest that avoiding enteral feeding can prevent long-term tube dependence and disuse of the swallowing mechanism which has been linked to complications such as prolonged dysphagia and esophageal constriction. We examined detailed dosimetric and clinical parameters to better identify those at risk of requiring enteral feeding. One hundred patients with advanced stage HNSCC were retrospectively analyzed after intensity-modulated radiation therapy (IMRT) to a median dose of 70 Gy (range: 60-75 Gy) with concurrent chemotherapy in nearly all cases (97%). Patients with significant weight loss (>10%) in the setting of severely reduced oral intake were referred for placement of a percutaneous endoscopic gastrostomy (PEG) tube. Detailed DVH parameters were collected for several structures. Univariate and multivariate analyses using logistic regression were used to determine clinical and dosimetric factors associated with needing enteral feeding. Dichotomous outcomes were tested using Fisher’s exact test and continuous variables between groups using the Wilcoxon rank-sum test. Thirty-three percent of patients required placement of an enteral feeding tube. The median time to tube placement was 25 days from start of treatment, after a median dose of 38 Gy. On univariate analysis, age (p = 0.0008), the DFH (Docetaxel/5-FU/Hydroxyurea) chemotherapy regimen (p = .042) and b.i.d treatment (P = 0.040) (used in limited cases on protocol) predicted need for enteral feeding. On multivariate analysis, age remained the single statistically significant factor (p = 0.003) regardless of other clinical features (e.g. BMI) and all radiation planning parameters. For patients 60 or older compared to younger adults, the odds ratio for needing enteral feeding was 4.188 (p = 0.0019). Older age was found to be the most significant risk factor for needing enteral feeding in

  2. Evaluating Factors for Prophylactic Feeding Tube Placement in Gastroesophageal Cancer Patients Undergoing Chemoradiotherapy

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    Vivek Verma

    2017-09-01

    Full Text Available PurposeThough better studied in head/neck cancers, there are currently no studies on timing of feeding tube (FT placement in patients with gastroesophageal cancer. This study sought to discern characteristics of patients who used versus did not use a prophylactic FT (pFT, and also analyzed factors associated with placement of FTs during chemoradiotherapy (CRT.Methods/materialsFrom 1998 to 2013, 1,329 patients underwent neoadjuvant CRT, of which 323 received an FT. Patients for whom FTs were placed prior to treatment due to tumor occlusion or substantial weight loss (n = 130, and those with FTs placed following treatment (n = 43 were excluded. One hundred patients had pFTs placed, and 50 underwent placement during CRT. The following was collected for each patient: demographic/patient information, oncologic/treatment characteristics, and CRT tolerance.ResultsNo significant differences were found in any parameter between cohorts that used (n = 66 versus did not use a pFT (n = 34; on univariate and multivariate analyses, no pretreatment characteristic associated with using a pFT. When compared with patients who used a pFT (n = 66, those who required an FT during CRT (n = 50 had lower body mass index (p = 0.045, underwent higher-dose radiotherapy (p = 0.003, and received induction chemotherapy (p = 0.031. On multivariate analysis, receipt of induction chemotherapy and greater weight loss and esophagitis during treatment were associated with placement of FTs during CRT (p < 0.05.ConclusionOf our cohort who received pFTs, there were no clinical factors that predicted for their use. Patients must be closely monitored for weight loss and esophagitis when receiving CRT in order to intervene prior to further worsening of toxicities.

  3. Patient and Family Caregivers’ Experiences of Living With a Jejunostomy Feeding Tube After Surgery for Esophagogastric Cancer

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    Halliday, V.; Baker, M.; Thomas, A.L.; Bowrey, D.

    2017-01-01

    BACKGROUND: Jejunostomy feeding tubes (JFTs) can be used to provide nutrition support to patients who have had surgery for esophagogastric cancer. Although previous research reports how patients cope with a gastrostomy tube, little is known about the impact of having a JFT. The aim of this qualitative study was to explore how patients and their informal caregivers experience living with a JFT in the first months following surgery. METHODS: Participants were purposively sampled from a cohort o...

  4. Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for patients with head and neck cancer. A systematic review

    International Nuclear Information System (INIS)

    Wang Jinfeng; Liu Minjie; Ye Yun; Liu Chao; Huang Guanhong

    2014-01-01

    There are two main enteral feeding strategies—namely nasogastric (NG) tube feeding and percutaneous gastrostomy—used to improve the nutritional status of patients with head and neck cancer (HNC). But up till now there has been no consistent evidence about which method of enteral feeding is the optimal method for this patient group. To compare the effectiveness of percutaneous gastrostomy and NGT feeding in patients with HNC, relevant literature was identified through Medline, Embase, Pubmed, Cochrane, Wiley and manual searches. We included randomized controlled trials (RCTs) and non-experimental studies comparing percutaneous gastrostomy—including percutaneous endoscopic gastrostomy (PEG) and percutaneous fluoroscopic gastrostomy (PFG)—with NG for HNC patients. Data extraction recorded characteristics of intervention, type of study and factors that contributed to the methodological quality of the individual studies. Data were then compared with respect to nutritional status, duration of feeding, complications, radiotherapy delays, disease-free survival and overall survival. Methodological quality of RCTs and non-experimental studies were assessed with separate standard grading scales. It became apparent from our studies that both feeding strategies have advantages and disadvantages. (author)

  5. Comparison between gastrostomy feeding and self-expandable metal stent insertion for patients with esophageal cancer and dysphagia.

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    Min, Yang Won; Jang, Eun Young; Jung, Ji Hey; Lee, Hyuk; Min, Byung-Hoon; Lee, Jun Haeng; Rhee, Poong-Lyul; Kim, Jae J

    2017-01-01

    Self-expandable metal stent (SEMS) insertion and percutaneous gastrostomy (PG) feeding are commonly used for patients with esophageal cancer and dysphagia. This study aimed to compare outcomes between SEMS insertion and PG feeding for them. We retrospectively analyzed 308 patients with esophageal cancer who underwent fully covered SEMS insertion (stent group) or PG (gastrostomy group) for dysphagia due to tumor. Patients with other causes of dysphagia, such as radiation-induced or postoperative stricture, were excluded from the study. Clinical outcomes were compared between the two groups, including overall survival and need for additional intervention and postprocedural nutritional status. At baseline, the stent group (n = 169) had more stage IV patients, less cervical cancers, and received radiotherapy and esophagectomy less often than the gastrostomy group (n = 64). The Kaplan-Meier curves showed higher overall survival in the gastrostomy group than in the stent group. Multivariate analysis revealed that PG was associated with better survival compared with SEMS insertion (hazard ratio 0.541, 95% confidence interval 0.346-0.848, p = 0.007). In addition, the gastrostomy group needed additional intervention less often (3.1% vs. 21.9%, p esophageal cancer and dysphagia. Stabilized nutritional status by PG may play a role in improving patient survival.

  6. Percutaneous endoscopic gastrostomy feeding of locally advanced oro-pharygo-laryngeal cancer patients: Blenderized or commercial food?

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    Papakostas, Pyrros; Tsaousi, Georgia; Stavrou, George; Rachovitsas, Dimitrios; Tsiropoulos, Gavriil; Rova, Constantina; Konstantinidis, Ioannis; Michalopoulos, Antonios; Grosomanidis, Vasilios; Kotzampassi, Katerina

    2017-11-01

    Head and neck cancer patients commonly suffer from severe malnutrition at the time of tentative diagnosis. Percutaneous Endoscopic Gastrostomy [PEG] feeding is now considered as an efficient tool to reduce nutritional deterioration alongside concurrent treatment. We undertook the challenge to retrospectively evaluate the impact of a commercial, disease-specific, feeding formula [Supportan, Fresenius Kabi, Hellas] versus blenderized family food on nutritional outcome. This is a retrospective analysis of prospectively collected nutritional and anthropometric data at the time of PEG placement, at the 8th week [after treatment termination] and at 8 months [6mo of recovery from treatment]. All patients were prescribed a commercial feeding formula. The final dataset included 212 patients: 112 received the commercial formula, 69 voluntarily decided to switch into blenderized-tube-feeding, and 31 were prescribed to receive a home-made formula of standard ingredients. The commercial formula seemed to help patients to fight the catabolism of concurrent treatment, since, at the 8mo assessment, both Body Mass index and Fat Free Mass had almost recovered to the values at the time of first diagnosis. Neither group on blenderized or home-made formulas exhibited nutritional improvement, but experienced a significant deterioration throughout the study period, with the home-made formula group being the worst. These findings clearly indicate that home-made and blenderized foods do not adequately support the nutritional requirements of patients with HNC scheduled to receive concurrent CRT treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Comparison between gastrostomy feeding and self-expandable metal stent insertion for patients with esophageal cancer and dysphagia.

    Directory of Open Access Journals (Sweden)

    Yang Won Min

    Full Text Available Self-expandable metal stent (SEMS insertion and percutaneous gastrostomy (PG feeding are commonly used for patients with esophageal cancer and dysphagia. This study aimed to compare outcomes between SEMS insertion and PG feeding for them.We retrospectively analyzed 308 patients with esophageal cancer who underwent fully covered SEMS insertion (stent group or PG (gastrostomy group for dysphagia due to tumor. Patients with other causes of dysphagia, such as radiation-induced or postoperative stricture, were excluded from the study. Clinical outcomes were compared between the two groups, including overall survival and need for additional intervention and postprocedural nutritional status.At baseline, the stent group (n = 169 had more stage IV patients, less cervical cancers, and received radiotherapy and esophagectomy less often than the gastrostomy group (n = 64. The Kaplan-Meier curves showed higher overall survival in the gastrostomy group than in the stent group. Multivariate analysis revealed that PG was associated with better survival compared with SEMS insertion (hazard ratio 0.541, 95% confidence interval 0.346-0.848, p = 0.007. In addition, the gastrostomy group needed additional intervention less often (3.1% vs. 21.9%, p < 0.001 and experienced less decrease in serum albumin levels (-0.15 ± 0.56 g/dL vs. -0.39 ± 0.58 g/dL, p = 0.011 than the stent group after procedure.Our data suggested that, compared with SEMS insertion, PG is associated with better overall survival in patients with esophageal cancer and dysphagia. Stabilized nutritional status by PG may play a role in improving patient survival.

  8. Principles of feeding cancer patients via enteral or parenteral nutrition during radiotherapy

    International Nuclear Information System (INIS)

    Fietkau, R.

    1998-01-01

    Background: The nutritional status of cancer patients is frequently impaired already before any therapy starts and may deteriorate even more by radio(chemo)therapy. Methods: This review describes the possibilities and risks of enteral and parenteral nutrition during radiotherapy. The indications of enteral nutrition will be derived from own results. Results: Enteral nutrition is the most preferable way of artificial long-term nutrition. In a prospective non-randomized trial we demonstrated that enteral nutrition via percutaneous endoscopic gastrostomy (PEG) not only improves the anthropometric and biochemical parameters during radio(chemo)therapy but also the quality of life of patients with advanced cancers of the head and neck. Moreover supportive use of megestrolacetate can improve the nutritional status. Parenteral nutrition is only recommended if enteral nutrition is not possible e.g. during radio(chemo)therapy of tumors of the upper gastrointestinal tract. Conclusions: Today adequate nutritional support is feasible during intensive radio(chemo)therapy. (orig.) [de

  9. Gastrostomy versus nasogastric tube feeding for chemoradiation patients with head and neck cancer: the TUBE pilot RCT.

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    Paleri, Vinidh; Patterson, Joanne; Rousseau, Nikki; Moloney, Eoin; Craig, Dawn; Tzelis, Dimitrios; Wilkinson, Nina; Franks, Jeremy; Hynes, Ann Marie; Heaven, Ben; Hamilton, David; Guerrero-Urbano, Teresa; Donnelly, Rachael; Barclay, Stewart; Rapley, Tim; Stocken, Deborah

    2018-04-01

    Approximately 9000 new cases of head and neck squamous cell cancers (HNSCCs) are treated by the NHS each year. Chemoradiation therapy (CRT) is a commonly used treatment for advanced HNSCC. Approximately 90% of patients undergoing CRT require nutritional support via gastrostomy or nasogastric tube feeding. Long-term dysphagia following CRT is a primary concern for patients. The effect of enteral feeding routes on swallowing function is not well understood, and the two feeding methods have, to date (at the time of writing), not been compared. The aim of this pilot randomised controlled trial (RCT) was to compare these two options. This was a mixed-methods multicentre study to establish the feasibility of a RCT comparing oral feeding plus pre-treatment gastrostomy with oral feeding plus as-required nasogastric tube feeding in patients with HNSCC. Patients were recruited from four tertiary centres treating cancer and randomised to the two arms of the study (using a 1 : 1 ratio). The eligibility criteria were patients with advanced-staged HNSCC who were suitable for primary CRT with curative intent and who presented with no swallowing problems. The primary outcome was the willingness to be randomised. A qualitative process evaluation was conducted alongside an economic modelling exercise. The criteria for progression to a Phase III trial were based on a hypothesised recruitment rate of at least 50%, collection of outcome measures in at least 80% of those recruited and an economic value-of-information analysis for cost-effectiveness. Of the 75 patients approached about the trial, only 17 consented to be randomised [0.23, 95% confidence interval (CI) 0.13 to 0.32]. Among those who were randomised, the compliance rate was high (0.94, 95% CI 0.83 to 1.05). Retention rates were high at completion of treatment (0.94, 95% CI 0.83 to 1.05), at the 3-month follow-up (0.88, 95% CI 0.73 to 1.04) and at the 6-month follow-up (0.88, 95% CI 0.73 to 1.04). No serious adverse

  10. Enteral Feeding Tubes in Patients Undergoing Definitive Chemoradiation Therapy for Head-and-Neck Cancer: A Critical Review

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    Koyfman, Shlomo A., E-mail: koyfmas@ccf.org [Departments of Radiation and Solid Tumor Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Adelstein, David J. [Departments of Radiation and Solid Tumor Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States)

    2012-11-01

    Definitive chemoradiation therapy has evolved as the preferred organ preservation strategy in the treatment of locally advanced head-and-neck cancer (LA-HNC). Dry mouth and dysphagia are among the most common and most debilitating treatment-related toxicities that frequently necessitate the placement of enteral feeding tubes (FT) in these patients to help them meet their nutritional requirements. The use of either a percutaneous endoscopic gastrostomy tube or a nasogastric tube, the choice of using a prophylactic vs a reactive approach, and the effects of FTs on weight loss, hospitalization, quality of life, and long-term functional outcomes are areas of continued controversy. Considerable variations in practice patterns exist in the United States and abroad. This critical review synthesizes the current data for the use of enteral FTs in this patient population and clarifies the relative advantages of different types of FTs and the timing of their use. Recent developments in the biologic understanding and treatment approaches for LA-HNC appear to be favorably impacting the frequency and severity of treatment-related dysphagia and may reduce the need for enteral tube feeding in the future.

  11. Principles of feeding cancer patients via enteral or parenteral nutrition during radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Fietkau, R. [Strahlentherapeutische Klinik und Poliklinik, Rostock Univ. (Germany)]|[Strahlentherapeutische Klinik und Poliklinik, Erlangen Univ. (Germany)

    1998-11-01

    Background: The nutritional status of cancer patients is frequently impaired already before any therapy starts and may deteriorate even more by radio(chemo)therapy. Methods: This review describes the possibilities and risks of enteral and parenteral nutrition during radiotherapy. The indications of enteral nutrition will be derived from own results. Results: Enteral nutrition is the most preferable way of artificial long-term nutrition. In a prospective non-randomized trial we demonstrated that enteral nutrition via percutaneous endoscopic gastrostomy (PEG) not only improves the anthropometric and biochemical parameters during radio(chemo)therapy but also the quality of life of patients with advanced cancers of the head and neck. Moreover supportive use of megestrolacetate can improve the nutritional status. Parenteral nutrition is only recommended if enteral nutrition is not possible e.g. during radio(chemo)therapy of tumors of the upper gastrointestinal tract. Conclusions: Today adequate nutritional support is feasible during intensive radio(chemo)therapy. (orig.) [Deutsch] Hintergrund: Der Ernaehrungsstatus von Tumorpatienten ist haeufig bereits vor jeder antitumoroesen Therapie reduziert und kann sich durch die notwendige Radio(chemo)therapie weiter verschlechtern. Methode: Im Rahmen dieses Uebersichtsartikels werden die Moeglichkeiten und Risiken der enteralen und parenteralen Ernaehrung waehrend einer Radiotherapie besprochen. Die Indikationen der enteralen Ernaehrung werden anhand von eigenen Ergebnissen begruendet. Ergebnisse: Die Langzeiternaehrung wird am besten ueber einen enteralen Zugang durchgefuehrt. In einer prospektiven, nichtrandomisierten Studie konnten wir zeigen, dass eine enterale Ernaehrung mittels perkutaner endoskopisch kontrollierter Gastrostomie (PEG) nicht nur die anthropometrischen und biochemischen Parameter waehrend einer Radio(chemo)therapie verbessert, sondern auch die Lebensqualitaet. Eine weitere Moeglichkeit besteht in der

  12. Third-Generation Fatty Emulsions as Part of Parenteral Feeding in Operated Cancer Patients

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    S. V. Lomidze

    2010-01-01

    Full Text Available Objective: to study the efficacy of third- versus secondary-generation fatty emulsions as part of parenteral nutrition in patients operated on for gastric cancer. Subjects and methods. Envelope randomization was used to make up two groups, each comprising 10 patients, operated on for gastric cancer in the scope of gastrectomy. A control group received parenteral nutrition having the following components: Lipofundin MST/LST 20%, (500 ml daily + Nutriflex 48/150 (B. Braun (1000 ml daily, 1744 kcal/day. The study group patients were given Lipoplus 20% (500 ml daily + Nutriflex 48/150 (1000 ml daily, 1745 kcal/day. Parenteral nutrition was used on postoperative days 1 to 5. Results. Nutritional status evaluation revealed a significant increase in the concentration of total protein and albumin in the control and study group patients on postoperative day 6. The use of both second- and third-generation fatty emulsions caused a significant increase in the concentration of triglycerides on day 6 after surgery; no differences were found between the groups. On day 6 following surgery, there was a significant decrease in IL-4 in both groups (p<0.05. At the same time the Lipofundin MST/LST group showed a significantly lower concentration of IL-4 than did the study group (p<0.05. After termination of a parenteral nutrition course, the study and control groups showed a significant decrease in one of the major pro-inflammatory cytokines — IL-6. Conclusion. In the study group, the serum anti-inflammatory activity of IL-4 was more evident than that in the control group and the proinflammatory activity (IL-6 concentration decreased, which can support that as compared with the second-generation fatty emulsions, third-generation ones with a balanced omega 3 to omega-6 fatty acid ratio (1:2.7 had a normalizing effect on systemic inflammatory processes and cytokine balance with increased anti-inflammatory and reduced proinflammatory activities. Key words: third

  13. Association of a Proactive Swallowing Rehabilitation Program With Feeding Tube Placement in Patients Treated for Pharyngeal Cancer.

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    Ajmani, Gaurav S; Nocon, Cheryl C; Brockstein, Bruce E; Campbell, Nicholas P; Kelly, Amy B; Allison, Jamie; Bhayani, Mihir K

    2018-04-19

    A proactive speech and language pathology (SLP) program is an important component of the multidisciplinary care of patients with head and neck squamous cell carcinoma (HNSCC). Swallowing rehabilitation can reduce the rate of feeding tube placement, thereby significantly improving quality of life. To evaluate the initiation of a proactive SLP rehabilitation program at a single institution and its association with rates of feeding tube placement and dietary intake in patients with HNSCC. Cohort study at a tertiary care and referral center for patients with HNSCC serving the northern Chicago region. Patients were treated for squamous cell carcinomas of the hypopharynx, oropharynx, and nasopharynx from 2004 to 2015 with radiation or chemoradiation therapy in the definitive or adjuvant setting. Patients who received less than 5000 cGy radiation or underwent reirradiation were excluded. A proactive SLP program for patients with HNSCC was initiated in 2011. Study cohorts were divided into 2 groups: 2004 through 2010 and 2011 through 2015. Primary outcome variables were SLP referral placement and timing of the referral. Secondary outcomes were feeding tube placement and ability to tolerate any oral intake. A total of 254 patients met inclusion criteria (135 before and 119 after implementation of SLP program; median age, 60 years [range, 14-94 years]; 77% male). With the initiation of a proactive SLP program, pretreatment evaluations increased from 29 (21.5%) to 70 (58.8%; risk ratio [RR], 2.74; 95% CI, 1.92-3.91), and rate of referral overall at any time increased from 60.0% to 79.8% (RR, 1.33; 95% CI, 1.13-1.57). Feeding tube placement rates decreased from 45.9% (n = 62) to 29.4% (n = 35; RR, 0.64; 95% CI, 0.46-0.89). Among patients receiving a swallow evaluation, feeding tube requirements were less frequent for those receiving a pretreatment evaluation (31 of 99 [31%]) than for those referred during (11 of 18 [61%]) or after (38 of 59 [64%]) treatment. The rate

  14. Early enteral feeding in postsurgical cancer patients. Fish oil structured lipid-based polymeric formula versus a standard polymeric formula.

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    Kenler, A S; Swails, W S; Driscoll, D F; DeMichele, S J; Daley, B; Babineau, T J; Peterson, M B; Bistrian, B R

    1996-01-01

    OBJECTIVES: The authors compared the safety, gastrointestinal tolerance, and clinical efficacy of feeding an enteral diet containing a fish oil/medium-chain triglyceride structured lipid (FOSL-HN) versus an isonitrogenous, isocaloric formula (O-HN) in patients undergoing major abdominal surgery for upper gastrointestinal malignancies. SUMMARY BACKGROUND DATA: Previous studies suggest that feeding with n-3 fatty acids from fish oil can alter eicosanoid and cytokine production, yielding an improved immunocompetence and a reduced inflammatory response to injury. The use of n-3 fatty acids as a structured lipid can improve long-chain fatty acid absorption. METHODS: This prospective, blinded, randomized trial was conducted in 50 adult patients who were jejunally fed either FOSL-HN or O-HN for 7 days. Serum chemistries, hematology, urinalysis, gastrointestinal complications, liver and renal function, plasma and erythrocyte fatty acid analysis, urinary prostaglandins, and outcome parameters were measured at baseline and on day 7. Comparisons were made in 18 and 17 evaluable patients based a priori on the ability to reach a tube feeding rate of 40 mL/hour. RESULTS: Patients receiving FOSL-HN experienced no untoward side effects, significant incorporation of eicosapentaenoic acid into plasma and erythrocyte phospholipids, and a 50% decline in the total number of gastrointestinal complications and infections compared with patients given O-HN. The data strongly suggest improved liver and renal function during the postoperative period in the FOSL-HN group. CONCLUSION: Early enteral feeding with FOSL-HN was safe and well tolerated. Results suggest that the use of such a formula during the postoperative period may reduce the number of infections and gastrointestinal complications per patient, as well as improve renal and liver function through modulation of urinary prostaglandin levels. Additional clinical trials to fully quantify clinical benefits and optimize nutritional

  15. Glucose and urea kinetics in patients with early and advanced gastrointestinal cancer: the response to glucose infusion, parenteral feeding, and surgical resection

    International Nuclear Information System (INIS)

    Shaw, J.H.; Wolfe, R.R.

    1987-01-01

    We isotopically determined rates of glucose turnover, urea turnover, and glucose oxidation in normal volunteers (n = 16), patients with early gastrointestinal (EGI) cancer (n = 6), and patients with advanced gastrointestinal (AGI) cancer (n = 10). Studies were performed in the basal state, during glucose infusion (4 mg/kg/min), and during total parenteral feeding (patients with AGI cancer only). Patients with early stages of the disease were also studied 2 to 3 months after resection of the cancer. Basal rates of glucose turnover were similar in volunteers and in patients with EGI cancer (13.9 +/- 0.3 mumol/kg/min and 13.3 +/- 0.2 mumol/kg/min, respectively) but were significantly higher in patients with AGI cancer (17.6 +/- 1.4 mumol/kg/min). Glucose infusion resulted in significantly less suppression of endogenous production in both patient groups than that seen in the volunteers (76% +/- 6% for EGI group, 69% +/- 7% for AGI group, and 94% +/- 4% for volunteers). The rate of glucose oxidation increased progressively in proportion to the tumor bulk. In the volunteers the percent of VCO2 from glucose oxidation was 23.9% +/- 0.7%, and in EGI and AGI groups the values were 32.8% +/- 2.0% and 43.0% +/- 3.0%, respectively. After curative resection of the cancer, glucose utilization decreased significantly (p less than 0.05). The rate of urea turnover was significantly higher in the AGI group (8.4 +/- 1.0 mumol/kg/min) in comparison with the volunteer group value of 5.9 +/- 0.6 mumol/kg/min (p less than 0.03). Glucose infusion resulted in a significant suppression of urea turnover in the volunteers (p less than 0.02), but in the AGI group glucose infusion did not induce a statistically significant decrease

  16. Nutritional status and feeding-tube placement in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy-based larynx preservation program.

    Science.gov (United States)

    Bozec, Alexandre; Benezery, Karen; Chamorey, Emmanuel; Ettaiche, Marc; Vandersteen, Clair; Dassonville, Olivier; Poissonnet, Gilles; Riss, Jean-Christophe; Hannoun-Lévi, Jean-Michel; Chand, Marie-Eve; Leysalle, Axel; Saada, Esma; Sudaka, Anne; Haudebourg, Juliette; Hebert, Christophe; Falewee, Marie-Noelle; Demard, François; Santini, José; Peyrade, Frédéric

    2016-09-01

    The objective of the study is to evaluate the nutritional status and determine its impact on clinical outcomes in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy (ICT)-based larynx preservation program without prophylactic feeding-tube placement. All patients with locally advanced (T3/4, N0-3, M0) hypopharyngeal squamous cell carcinoma, technically suitable for total pharyngolaryngectomy, treated by docetaxel, cisplatin and 5-fluorouracil (TPF)-ICT for larynx preservation at our institution between 2004 and 2013, were included in this retrospective study. Patients' nutritional status was closely monitored. Enteral nutrition was used if and when a patient was unable to sustain per-oral nutrition and hydration. The impact of nutritional status on clinical outcomes was investigated in univariate and multivariate analysis. A total of 53 patients (42 men and 11 women, mean age = 58.6 ± 8.2 years) were included in this study. Six (11.3 %) patients had lost more than 10 % of their usual body weight before therapy. Compared with patients' usual weight, the mean maximum patient weight loss during therapeutic management was 8.7 ± 4.5 kg. Enteral nutrition was required in 17 patients (32 %). We found no influence of the tested nutritional status-related factors on response to ICT, toxicity of ICT, overall, cause-specific and recurrence-free survival, and on post-therapeutic swallowing outcome. Maximum weight loss was significantly associated with a higher risk of enteral tube feeding during therapy (p = 0.03) and of complications (grade ≥3, p = 0.006) during RT. Without prophylactic feeding-tube placement, approximately one-third of the patients required enteral nutrition. There was no significant impact of nutritional status on oncologic or functional outcomes.

  17. Comparative effects of different enteral feeding methods in head and neck cancer patients receiving radiotherapy or chemoradiotherapy: a network meta-analysis

    Directory of Open Access Journals (Sweden)

    Zhang ZH

    2016-05-01

    Full Text Available Zhihong Zhang,1,2 Yu Zhu,1 Yun Ling,3 Lijuan Zhang,1 Hongwei Wan1 1Department of Nursing, Shanghai Proton and Heavy Ion Center, 2Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, 3Department of Human Resource, Shanghai Proton and Heavy Ion Center, Shanghai, People’s Republic of China Abstract: Nasogastric tube (NGT and percutaneous endoscopic gastrostomy were frequently used in the head and neck cancer patients when malnutrition was present. Nevertheless, the evidence was inclusive in terms of the choice and the time of tube placement. The aim of this network meta-analysis was to evaluate the comparative effects of prophylactic percutaneous endoscopic gastrostomy (pPEG, reactive percutaneous endoscopic gastrostomy (rPEG, and NGT in the head and neck cancer patients receiving radiotherapy or chemoradiotherapy. Databases of PubMed, Web of Science, and Elsevier were searched from inception to October 2015. Thirteen studies enrolling 1,631 participants were included in this network meta-analysis. The results indicated that both pPEG and NGT were superior to rPEG in the management of weight loss. pPEG was associated with the least rate of treatment interruption and nutrition-related hospital admission among pPEG, rPEG, and NGT. Meanwhile, there was no difference in tube-related complications. Our study suggested that pPEG might be a better choice in malnutrition management in the head and neck cancer patients undergoing radiotherapy or chemoradiotherapy. However, its effects need to be further investigated in more randomized controlled trials. Keywords: malnutrition, tube feeding, weight loss, treatment interruption, readmission, complication

  18. A retrospective matched cohort study evaluating the effects of percutaneous endoscopic gastrostomy feeding tubes on nutritional status and survival in patients with advanced gastroesophageal malignancies undergoing systemic anti-cancer therapy.

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    Mitchell, Scott; Williams, John P; Bhatti, Harsimrandeep; Kachaamy, Toufic; Weber, Jeffrey; Weiss, Glen J

    2017-01-01

    Many patients with cancer or other systemic illnesses can experience malnutrition. One way to mitigate malnutrition is by insertion of a percutaneous endoscopic gastrostomy feeding tube (PEG tube). The goal of this retrospective matched cohort study is to evaluate if PEG tube placement improved nutritional status and overall survival (OS) in advanced gastroesophageal (GE) cancer patients who are undergoing anti-neoplastic therapy. GE cancer patients who were treated and evaluated by a nutritionist and had at least 2 nutritionist follow-up visits were identified. Patients with PEG tube were matched to patients that did not undergo PEG placement (non-PEG). Clinical characteristics, GE symptoms reported at nutrition follow-up visits, and OS were recorded. 20 PEG and 18 non-PEG cases met criteria for further analyses. After correction for multiple testing, there were no OS differences between PEG and non-PEG, treatment naive and previously treated. However, PEG esophageal carcinoma has statistically significant inferior OS compared with non-PEG esophageal carcinoma. PEG placement did not significantly reduce the proportion of patients with weight loss between the initial nutrition assessment and 12-week follow-up. In this small study, PEG placement had inferior OS outcome for GE esophageal carcinoma, no improvement in OS for other evaluated groups, and did not reduce weight loss between baseline and 12-week follow-up. Unless there is prospective randomized trial that can show superiority of PEG placement in this population, PEG placement in this group cannot be endorsed.

  19. Randomized study of percutaneous endoscopic gastrostomy versus nasogastric tubes for enteral feeding in head and neck cancer patients treated with (chemo)radiation

    International Nuclear Information System (INIS)

    Corry, J.; Poon, W.; McPhee, N.; Milner, A. D.; Cruickshank, D.; Rischin, D.; Peters, L. J.

    2008-01-01

    Full text: Percutaneous endoscopic gastrostomy (PEG) tubes have largely replaced nasogastric tubes (NGT) for nutritional support of patients with head and neck cancer undergoing curative (chemo)radiotherapy without any good scientific basis. A randomized trial was conducted to compare PEG tubes and NGT in terms of nutritional outcomes, complications, patient satisfaction and cost. The study was closed early because of poor accrual, predominantly due to patients' reluctance to be randomized. There were 33 patients eligible for analysis. Nutritional support with both tubes was good. There were no significant differences in overall complication rates, chest infection rates or in patients' assessment of their overall quality of life. The cost of a PEG tube was 10 times that of an NGT. The duration of use of PEG tubes was significantly longer, a median 139 days compared with a median 66 days for NGT. We found no evidence to support the routine use of PEG tubes over NGT in this patient group

  20. Survival period after tube feeding in bedridden older patients.

    Science.gov (United States)

    Kosaka, Yoichi; Nakagawa-Satoh, Takuma; Ohrui, Takashi; Fujii, Masahiko; Arai, Hiroyuki; Sasaki, Hidetada

    2012-04-01

    We prospectively studied survival periods after tube feeding. Participants were 163 bedridden older patients suffering from dysphagia. A wide range of survival periods after tube feeding were observed within half a year without tube feeding after being bedridden. After this initial period, survival periods after tube feeding were limited to approximately half a year. Survival periods after tube feeding were positively proportional to the length of time patients were free from pneumonia after tube feeding. After tube feeding, patients died from pneumonia within half a year, and the frequency of pneumonia was 3.1 ± 2.7 times (mean ± SD) before death. Survival periods after tube feeding for less than 1 year were primarily determined by being bedridden for more than half a year without tube feeding and once pneumonia occurred; patients who were tube fed did not survive for more than half a year. © 2012 Japan Geriatrics Society.

  1. The Feasibility and Outcome of Oro-esophageal Tube Feeding in Patients with Various Etiologies.

    Science.gov (United States)

    Kim, Juyong; Seo, Han Gil; Lee, Goo Joo; Han, Tai Ryoon; Oh, Byung-Mo

    2015-12-01

    The oro-esophageal tube (OE tube) is widely used in dysphagia patients although its success rate for transition to oral feeding is reported only in stroke patients. The aim of this study was to evaluate the feasibility and outcome of OE tube feeding for patients with dysphagia resulting from various etiologies. The authors reviewed the medical records of 1995 dysphagic patients that had undergone videofluoroscopic swallowing study (VFSS) in a tertiary hospital from April 2002 through December 2009. Of these, 97 patients were recommended to use OE tube feeding based on the VFSS findings. Follow-up VFSS were performed on 54 patients. The mean duration of tube use at the time of follow-up VFSS was 274 days. We evaluated clinical information including age, sex, diet, etiology of dysphagia, location of lesions, duration of intervention, and complications of OE tube feeding. Initially, all 54 patients were fed using the OE tube. After their last follow-up evaluation, 19 patients (35.2 %) resumed full oral feeding without the OE tube, 12 patients (22.2 %) used partial OE tube feeding, and 23 patients (42.6 %) continued OE tube feeding only. Full oral feeding was achieved again most often in brain tumor, stroke, and head and neck cancer patients (54.5, 27.3, and 20.0 %, respectively). Mild adverse events, such as blood-tinged sputum, nausea, dyspepsia, and regurgitation of food, were reported in 4 patients. OE tube feeding is a feasible feeding method also in conditions other than stroke such as brain tumors, and head and neck cancers.

  2. Population-based comparison of two feeding tube approaches for head and neck cancer patients receiving concurrent systemic-radiation therapy: is a prophylactic feeding tube approach harmful or helpful?

    Science.gov (United States)

    Olson, Robert; Karam, Irene; Wilson, Gavin; Bowman, Angela; Lee, Christopher; Wong, Frances

    2013-12-01

    The purpose of this study is to compare patient outcomes between a therapeutic versus a prophylactic gastrostomy tube (GT) placement approach in patients treated with concurrent systemic and radiation (SRT) therapy for head and neck cancer (HNC). Outcomes were compared between all HNC patients treated with concurrent SRT from January 2001 to June 2009 from a center that only places GTs therapeutically when clinically necessary (center A) versus a center that generally places them prophylactically (center B). A total of 445 patients with HNC were identified, with 63 % from center A. As anticipated, GTs were placed less commonly in center A compared to B (31 versus 88 %; p approach results in exposing higher number of patients to GT complications. The higher rate of hospitalizations using a therapeutic approach suggests that patients are sicker when GTs are required. Given the similar weight loss and survival, a therapeutic approach at an earlier stage of need may be a preferable approach, when access to prompt GT placement is available.

  3. Early Post Operative Enteral Versus Parenteral Feeding after Esophageal Cancer Surgery

    Directory of Open Access Journals (Sweden)

    Mohammadtaghi Rajabi Mashhadi

    2015-09-01

    Full Text Available Introduction: The incidence of malnutrition in hospitalized patients is reported to be high. In particular, patients with esophageal cancer are prone to malnutrition, due to preoperative digestive system dysfunctions and short-term non-oral feeding postoperatively. Selection of an appropriate method for feeding in the postoperative period is important in these patients.   Materials and Methods: In this randomized clinical trial, 40 patients with esophageal cancer who had undergone esophagectomy between September 2008 and October 2009 were randomly assigned into either enteral feeding or parenteral feeding groups, with the same calorie intake in each group. The level of serum total protein, albumin, prealbumin, transferrin, C3, C4 and hs-C-reactive protein          (hs-CRP, as well as the rate of surgical complications, restoration of bowel movements and cost was assessed in each group.   Results: Our results showed that there was no significant difference between the groups in terms of serum albumin, prealbumin or transferrin. However, C3 and C4 levels were significantly higher in the enteral feeding group compared with the parenteral group, while hs-CRP level was significantly lower in the enteral feeding group. Bowel movements were restored sooner and costs of treatment were lower in the enteral group. Postoperative complications did not differ significantly between the groups. There was one death in the parenteral group 10 days after surgery due to myocardial infarction.   Conclusion:  The results of our study showed that enteral feeding can be used effectively in the first days after surgery, with few early complications and similar nutritional outcomes compared with the parenteral method. Enteral feeding was associated with reduced inflammation and was associated with an improvement in immunological responses, quicker return of bowel movements, and reduced costs in comparison with parenteral feeding.

  4. Feeding Arteries of Primary Tongue Cancers on Intra-arterial Infusion Chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kamitani, Takeshi, E-mail: kamitani@radiol.med.kyushu-u.ac.jp [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences (Japan); Kawanami, Satoshi, E-mail: kawanami-01@mac.com [Kyushu University, Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences (Japan); Asayama, Yoshiki, E-mail: asayama@radiol.med.kyushu-u.ac.jp; Matsuo, Yoshio, E-mail: yymatsuo@radiol.med.kyushu-u.ac.jp; Yonezawa, Masato, E-mail: ymasato@radiol.med.kyushu-u.ac.jp; Yamasaki, Yuzo, E-mail: yyama@radiol.med.kyushu-u.ac.jp [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences (Japan); Nagao, Michinobu, E-mail: minagao@radiol.med.kyushu-u.ac.jp [Kyushu University, Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences (Japan); Yamanouchi, Torahiko, E-mail: tora0228@radiol.med.kyushu-u.ac.jp [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences (Japan); Yabuuchi, Hidetake, E-mail: h-yabu@med.kyushu-u.ac.jp [Kyushu University, Department of Health Sciences, Graduate School of Medical Sciences (Japan); Nakamura, Katsumasa, E-mail: nakam@radiol.med.kyushu-u.ac.jp [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences (Japan); Nakashima, Torahiko, E-mail: nakatora@qent.med.kyushu-u.ac.jp [Kyushu University, Department of Otorhinolaryngology, Graduate School of Medical Sciences (Japan); Honda, Hiroshi, E-mail: honda@radiol.med.kyushu-u.ac.jp [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences (Japan)

    2016-02-15

    PurposeTo evaluate the frequency and the predictive factor of each feeding artery on intra-arterial infusion chemotherapy (IAIC) in primary tongue cancer.Materials and MethodsWe retrospectively evaluated 20 patients who received IAIC for primary tongue cancer. The main and accompanying feeding arteries were identified on super-selective angiography of the branches of the external carotid artery. Tumor diameter, and extension to the contralateral side, tongue extrinsic muscles (TEMs), and lateral mesopharyngeal wall were determined based on magnetic resonance imaging or computed tomography findings.ResultsThe main feeding artery was the ipsilateral lingual artery (LA) in 15 of the 20 examined tumors and the contralateral LA in the other 5. Ten cancers had only one feeding artery, and multiple feeding arteries were detected in the remaining 10. Tumors >4 cm (n = 9), those with extension to the contralateral side (n = 13), and those with extension to TEMs (n = 15) were supplied by significantly larger numbers of feeding arteries compared to tumors without these features (P = 0.01, 0.049, and 0.02, respectively). The frequency of feeding from the contralateral LA was 64 % (9/14) and 17 % (1/6) in tumors with and without extension to the contralateral side, respectively. Feeding from a facial artery (FA) was not detected in tumors ≤4 cm, while 5 of the 9 (56 %) tumors >4 cm were supplied by a FA (P = 0.01).ConclusionA careful search for feeding arteries is required, especially in large tumors with extension to the contralateral side or to TEMs.

  5. Feeding Arteries of Primary Tongue Cancers on Intra-arterial Infusion Chemotherapy.

    Science.gov (United States)

    Kamitani, Takeshi; Kawanami, Satoshi; Asayama, Yoshiki; Matsuo, Yoshio; Yonezawa, Masato; Yamasaki, Yuzo; Nagao, Michinobu; Yamanouchi, Torahiko; Yabuuchi, Hidetake; Nakamura, Katsumasa; Nakashima, Torahiko; Honda, Hiroshi

    2016-02-01

    To evaluate the frequency and the predictive factor of each feeding artery on intra-arterial infusion chemotherapy (IAIC) in primary tongue cancer. We retrospectively evaluated 20 patients who received IAIC for primary tongue cancer. The main and accompanying feeding arteries were identified on super-selective angiography of the branches of the external carotid artery. Tumor diameter, and extension to the contralateral side, tongue extrinsic muscles (TEMs), and lateral mesopharyngeal wall were determined based on magnetic resonance imaging or computed tomography findings. The main feeding artery was the ipsilateral lingual artery (LA) in 15 of the 20 examined tumors and the contralateral LA in the other 5. Ten cancers had only one feeding artery, and multiple feeding arteries were detected in the remaining 10. Tumors >4 cm (n = 9), those with extension to the contralateral side (n = 13), and those with extension to TEMs (n = 15) were supplied by significantly larger numbers of feeding arteries compared to tumors without these features (P = 0.01, 0.049, and 0.02, respectively). The frequency of feeding from the contralateral LA was 64 % (9/14) and 17 % (1/6) in tumors with and without extension to the contralateral side, respectively. Feeding from a facial artery (FA) was not detected in tumors ≤4 cm, while 5 of the 9 (56 %) tumors >4 cm were supplied by a FA (P = 0.01). A careful search for feeding arteries is required, especially in large tumors with extension to the contralateral side or to TEMs.

  6. Depression in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Beyhan Bag

    2014-06-01

    Full Text Available It is not enough to consider treatment and care depression in the oncology that is the most common psychiatric illness in cancer patient affects of cancer treatment and the patient`s quality of life negatively, which is determined through researches in the field. With development of psycho-oncology it has been demonstrated to establish an important link between the cancer patient`s treatment as well as psycho-social support for the patient and psychiatric treatment and care for the if it is needed. With this connection between them it has been proposed to use of bio-psycho-social-model in cancer patient to improve their care. To achieve this goal, it is expected from medical personnel to realize patients psychosocial need und if he/she has a psychiatric disorders or syndromes. For the medical personnel that work in oncology services, it is inevitable to organize in order to raise the awareness of depression in the cancer patients. In the present study, it is focused on raising the awareness of depression in cancer patient for the medical personnel. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 186-198

  7. Enteral feeding pumps: efficacy, safety, and patient acceptability

    Directory of Open Access Journals (Sweden)

    White H

    2014-08-01

    Full Text Available Helen White, Linsey King Nutrition and Dietetic Group, School of Health and Wellbeing, Faculty Health and Social Science, Leeds Metropolitan University, Leeds, United Kingdom Abstract: Enteral feeding is a long established practice across pediatric and adult populations, to enhance nutritional intake and prevent malnutrition. Despite recognition of the importance of nutrition within the modern health agenda, evaluation of the efficacy of how such feeds are delivered is more limited. The accuracy, safety, and consistency with which enteral feed pump systems dispense nutritional formulae are important determinants of their use and acceptability. Enteral feed pump safety has received increased interest in recent years as enteral pumps are used across hospital and home settings. Four areas of enteral feed pump safety have emerged: the consistent and accurate delivery of formula; the minimization of errors associated with tube misconnection; the impact of continuous feed delivery itself (via an enteral feed pump; and the chemical composition of the casing used in enteral feed pump manufacture. The daily use of pumps in delivery of enteral feeds in a home setting predominantly falls to the hands of parents and caregivers. Their understanding of the use and function of their pump is necessary to ensure appropriate, safe, and accurate delivery of enteral nutrition; their experience with this is important in informing clinicians and manufacturers of the emerging needs and requirements of this diverse patient population. The review highlights current practice and areas of concern and establishes our current knowledge in this field. Keywords: nutrition, perceptions, experience

  8. Parenteral and Early Enteral Feeding in Patients with Colonic Tumor

    Directory of Open Access Journals (Sweden)

    O. A. Malkov

    2008-01-01

    Full Text Available Objective: to provide evidence whether it is expedient to use an early enteral feeding protocol in patients with colonic malignancies in the postoperative period to prevent and to correct hemodynamic disorders, oxygen imbalance, and malnutrition. Subjects and methods. A hundred patients (61 males and 39 females aged 66.2±5.0 years, who had Stages 2—3 colonic malignancies, were examined. Two algorithms of postoperative management were analyzed using the traditional diet and early enteral feeding. Results. The early enteral feeding protocol improves central hemodynamics and oxygen and nutritional status, prevents moderate protein-energy deficiency in the early postoperative period and reduces the number of complications and fatal outcomes in patients with colonic malignancies. Key words: malignancies, malnutrition, hemo-dynamics, oxygen status, enteral feeding.

  9. [Physiotherapy of cancer patients].

    Science.gov (United States)

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

    2016-07-01

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

  10. Enteral Nutrition for Feeding Severely Underfed Patients with Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    Maria Gabriella Gentile

    2012-09-01

    Full Text Available Severe undernutrition nearly always leads to marked changes in body spaces (e.g., alterations of intra-extracellular water and in body masses and composition (e.g., overall and compartmental stores of phosphate, potassium, and magnesium. In patients with severe undernutrition it is almost always necessary to use oral nutrition support and/or artificial nutrition, besides ordinary food; enteral nutrition should be a preferred route of feeding if there is a functional accessible gastrointestinal tract. Refeeding of severely malnourished patients represents two very complex and conflicting tasks: (1 to avoid “refeeding syndrome” caused by a too fast correction of malnutrition; (2 to avoid “underfeeding” caused by a too cautious rate of refeeding. The aim of this paper is to discuss the modality of refeeding severely underfed patients and to present our experience with the use of enteral tube feeding for gradual correction of very severe undernutrition whilst avoiding refeeding syndrome, in 10 patients aged 22 ± 11.4 years and with mean initial body mass index (BMI of 11.2 ± 0.7 kg/m2. The mean BMI increased from 11.2 ± 0.7 kg/m2 to 17.3 ± 1.6 kg/m2 and the mean body weight from 27.9 ± 3.3 to 43.0 ± 5.7 kg after 90 days of intensive in-patient treatment (p < 0.0001. Caloric intake levels were established after measuring resting energy expenditure by indirect calorimetry, and nutritional support was performed with enteral feeding. Vitamins, phosphate, and potassium supplements were administered during refeeding. All patients achieved a significant modification of BMI; none developed refeeding syndrome. In conclusion, our findings show that, even in cases of extreme undernutrition, enteral feeding may be a well-tolerated way of feeding.

  11. Psychotherapy for cancer patients.

    Science.gov (United States)

    Chong Guan, Ng; Mohamed, Salina; Kian Tiah, Lai; Kar Mun, Teoh; Sulaiman, Ahmad Hatim; Zainal, Nor Zuraida

    2016-07-01

    Objective Psychotherapy is a common non-pharmacological approach to help cancer patients in their psychological distress. The benefit of psychotherapies was documented, but the types of psychotherapies proposed are varied. Given that the previous literature review was a decade ago and no quantitative analysis was done on this topic, we again critically and systematically reviewed all published trials on psychotherapy in cancer patients. Method We identified 17 clinical trials on six types of psychotherapy for cancer patients by searching PubMed and EMBASE. Result There were four trials involved adjunct psychological therapy which were included in quantitative analysis. Each trial demonstrated that psychotherapy improved the quality of life and coping in cancer patients. There was also a reduction in distress, anxiety, and depression after a psychological intervention. However, the number and quality of clinical trials for each type of psychotherapy were poor. The meta-analysis of the four trials involved adjunct psychological therapy showed no significant change in depression, with only significant short-term improvement in anxiety but not up to a year-the standardized mean differences were -0.37 (95% confidence interval (CI) = -0.57, -0.16) at 2 months, -0.21 (95% CI = -0.42, -0.01) at 4 months, and 0.03 (95 % CI = -0.19, 0.24) at 12 months. Conclusion The evidence on the efficacy of psychotherapy in cancer patients is unsatisfactory. There is a need for more rigorous and well-designed clinical trials on this topic.

  12. Dilemmas for guardians of advanced dementia patients regarding tube feeding.

    Science.gov (United States)

    Gil, Efrat; Agmon, Maayan; Hirsch, Ayal; Ziv, Miriam; Zisberg, Anna

    2018-01-01

    advanced dementia is an incurable illness, its last stage marked by inability to eat. Tube feeding was deemed a helpful solution at this stage, but in recent years its inefficiency has been proved, and it is no longer practiced in many countries around the world. In Israel, however, the procedure is still accepted. In the gastroenterology department at the Bnai Zion Medical Center, a serious interaction is ongoing with patients' legal guardians, where detailed information is given about the inefficiency of the tube procedure. Nevertheless, the great majority of guardians choose to have it performed. to probe the considerations underlying the decision for gastrostomy, despite the data and the recommendations. qualitative research, including participant observation at the clinic and in-depth interviews with guardians. the families of most patients did not discuss end-of-life issues with them. The overwhelming preference for using the technology was interpreted as life-saving, in contrast to comfort feeding, which was deemed euthanasia. The reasons given for the decision to tube feed were drawn from a range of outlooks: religion, the patient's earlier survival capacity, and pragmatic considerations involving relations with nursing home staff. study of the decision-making process of advanced dementia patients' guardians sheds light on the layers of meaning of the Israeli discourse regarding end-of-life issues. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

  13. Cancer patients' evaluation of communication

    DEFF Research Database (Denmark)

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

    2013-01-01

    The aims of this study were to assess how communication with health care staff is perceived by Danish cancer patients and to characterise those patients who report problems in communication.......The aims of this study were to assess how communication with health care staff is perceived by Danish cancer patients and to characterise those patients who report problems in communication....

  14. Lung cancer in younger patients

    DEFF Research Database (Denmark)

    Abbasowa, Leda; Madsen, Poul Henning

    2016-01-01

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

  15. Preventing Infections in Cancer Patients

    Science.gov (United States)

    ... Protect: Know the Signs and Symptoms of Infection Neutropenia and Risk for Infection Health Care Providers Educational Materials Cancer and Flu How to Prevent Flu from Spreading Flu Symptoms Information for Families and Caregivers Flu Treatment for Cancer Patients and ...

  16. Muscle dysfunction in cancer patients

    DEFF Research Database (Denmark)

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

    2014-01-01

    dysfunction in cancer patients lies in the correlation to vital clinical end points such as cancer-specific and all-cause mortality, therapy complications and quality of life (QoL). Such associations strongly emphasize the need for effective therapeutic countermeasures to be developed and implemented...... implications of muscle dysfunction in cancer patients. The efficacy of exercise training to prevent and/or mitigate cancer-related muscle dysfunction is also discussed. DESIGN: We identified 194 studies examining muscular outcomes in cancer patients by searching PubMed and EMBASE databases. RESULTS: Muscle...... dysfunction is evident across all stages of the cancer trajectory. The causes of cancer-related muscle dysfunction are complex, but may involve a wide range of tumor-, therapy- and/or lifestyle-related factors, depending on the clinical setting of the individual patient. The main importance of muscle...

  17. Development and validation of a prediction model for tube feeding dependence after curative (chemo- radiation in head and neck cancer.

    Directory of Open Access Journals (Sweden)

    Kim Wopken

    Full Text Available BACKGROUND: Curative radiotherapy or chemoradiation for head and neck cancer (HNC may result in severe acute and late side effects, including tube feeding dependence. The purpose of this prospective cohort study was to develop a prediction model for tube feeding dependence 6 months (TUBEM6 after curative (chemo- radiotherapy in HNC patients. PATIENTS AND METHODS: Tube feeding dependence was scored prospectively. To develop the multivariable model, a group LASSO analysis was carried out, with TUBEM6 as the primary endpoint (n = 427. The model was then validated in a test cohort (n = 183. The training cohort was divided into three groups based on the risk of TUBEM6 to test whether the model could be extrapolated to later time points (12, 18 and 24 months. RESULTS: Most important predictors for TUBEM6 were weight loss prior to treatment, advanced T-stage, positive N-stage, bilateral neck irradiation, accelerated radiotherapy and chemoradiation. Model performance was good, with an Area under the Curve of 0.86 in the training cohort and 0.82 in the test cohort. The TUBEM6-based risk groups were significantly associated with tube feeding dependence at later time points (p<0.001. CONCLUSION: We established an externally validated predictive model for tube feeding dependence after curative radiotherapy or chemoradiation, which can be used to predict TUBEM6.

  18. Cachexia among US cancer patients.

    Science.gov (United States)

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

    2016-09-01

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

  19. Survival of Sami cancer patients

    Directory of Open Access Journals (Sweden)

    Leena Soininen

    2012-07-01

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

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

    Science.gov (United States)

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

    2009-09-01

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

  1. Comparative Study of Esophageal Self-expandable Metallic Stent Insertion and Gastrostomy Feeding for Dysphagia Caused by Lung Cancer.

    Science.gov (United States)

    Kim, Jihye; Min, Yang Won; Lee, Hyuk; Min, Byung Hoon; Lee, Joon Haeng; Rhee, Poong Lyul; Kim, Jae J

    2018-03-25

    Dysphagia is encountered in a large proportion of patients with lung cancer and is associated with malnutrition and a poor quality of life. This study compared the clinical outcomes of self-expandable metallic stent (SEMS) insertion and percutaneous gastrostomy (PG) feeding for patients with lung cancer and dysphagia. A total of 261 patients with lung cancer, who underwent either SEMS insertion (stent group) or PG (gastrostomy group) as an initial treatment procedure for dysphagia between July 1997 and July 2015 at the Samsung Medical Center, were reviewed retrospectively, and 84 patients with esophageal obstruction were identified. The clinical outcomes, including the overall survival, additional intervention, complications, and post-procedural nutritional status in the two groups, were compared. Among the 84 patients finally analyzed, 68 patients received SEMS insertion and 16 had PG. The stent group had less cervical obstruction and more mid-esophageal obstruction than the gastrostomy group. The Kaplan-Meier curves revealed similar overall survival in the two groups. Multivariate analysis showed that the two modalities had similar survival rates (PG compared with SEMS insertion, hazard ratio 0.682, p=0.219). Fifteen patients (22.1%) in the stent group received additional intervention, whereas there was no case in the gastrostomy group (p=0.063). The decrease in the serum albumin level after the procedure was lower in the gastrostomy group than in the stent group (-0.20±0.54 g/dL vs. -0.65±0.57 g/dL, p=0.013). SEMS insertion and PG feeding for relieving dysphagia by lung cancer had a comparable survival outcome. On the other hand, PG was associated with a better nutritional status.

  2. Bone health in cancer patients

    DEFF Research Database (Denmark)

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

    2014-01-01

    There are three distinct areas of cancer management that make bone health in cancer patients of increasing clinical importance. First, bone metastases are common in many solid tumours, notably those arising from the breast, prostate and lung, as well as multiple myeloma, and may cause major...... morbidity including fractures, severe pain, nerve compression and hypercalcaemia. Through optimum multidisciplinary management of patients with bone metastases, including the use of bone-targeted treatments such as potent bisphosphonates or denosumab, it has been possible to transform the course of advanced...... cancer for many patients resulting in a major reduction in skeletal complications, reduced bone pain and improved quality of life. Secondly, many of the treatments we use to treat cancer patients have effects on reproductive hormones, which are critical for the maintenance of normal bone remodelling...

  3. Enteral Feeding During Chemoradiotherapy for Advanced Head-and-Neck Cancer: A Single-Institution Experience Using a Reactive Approach

    International Nuclear Information System (INIS)

    Clavel, Sebastien; Fortin, Bernard; Despres, Philippe; Donath, David; Soulieres, Denis; Khaouam, Nader; Charpentier, Danielle; Belair, Manon; Guertin, Louis; Nguyen-Tan, Phuc Felix

    2011-01-01

    Purpose: The optimal method for providing enteral nutrition to patients with head-and-neck cancer is unclear. The purpose of the present study was to evaluate the safety and efficacy of our reactive policy, which consists of the installation of a nasogastric (NG) feeding tube only when required by the patient's nutritional status. Methods and Materials: The records of all patients with Stage III and IV head-and-neck cancer treated with concomitant chemotherapy and radiotherapy between January 2003 and December 2006 were reviewed. The overall and disease-free survival rates were estimated using the Kaplan-Meier method and compared with the log-rank test. Results: The present study included 253 patients, and the median follow-up was 33 months. At 3 years, the estimated overall survival and disease-free survival rate was 82.8% and 77.8%, respectively, for the whole population. No survival difference was observed when the patients were compared according to the presence and absence of a NG tube or stratified by weight loss quartile. The mean weight loss during treatment for all patients was 10.4%. The proportion of patients requiring a NG tube was 49.8%, and the NG tube remained in place for a median duration of 40 days. No major complications were associated with NG tube installation. Only 3% of the patients were still dependent on enteral feeding at 6 months. Conclusion: These results suggest that the use of a reactive NG tube with an interdisciplinary team approach is a safe and effective method to manage malnutrition in patients treated with concomitant chemotherapy and radiotherapy for head-and-neck cancer.

  4. Cancer patients and mass media

    Directory of Open Access Journals (Sweden)

    Mirjana Rajer

    2015-06-01

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

  5. Informal Caregiving for Cancer Patients

    Science.gov (United States)

    Romito, Francesca; Goldzweig, Gil; Cormio, Claudia; Hagedoorn, Mariët; Andersen, Barbara L.

    2013-01-01

    According to the recent worldwide estimation by the GLOBOCAN project, in total, 12.7 million new cancer cases and 7.6 million cancer deaths occurred in 2008. The worldwide number of cancer survivors within 5 years of diagnosis has been estimated at be almost 28.8 million. Informal caregivers, such as family members and close friends, provide essential support to cancer patients. The authors of this report provide an overview of issues in the study of informal caregivers for cancer patients and long-term survivors in the United States and Europe, characterizing the caregivers commonly studied; the resources currently available to them; and their unmet needs, their psychosocial outcomes, and the psychosocial interventions tailored to their special circumstances. A broad overview of the state of research and knowledge, both in Europe and the United States, and observations on the directions for future research are provided. PMID:23695928

  6. The experiences of cancer patients.

    Science.gov (United States)

    Alifrangis, C; Koizia, L; Rozario, A; Rodney, S; Harrington, M; Somerville, C; Peplow, T; Waxman, J

    2011-12-01

    To assess the needs of cancer patients for information about their condition and to understand the psychological impact of their illness. The discussion of prognosis and treatment options in the palliative setting is an important and difficult part of oncology practice. To evaluate this, we examined the experiences of cancer patients of the physical and psychological impact of their disease on their life, and their opinions on the communication of end-of-life decisions and treatment options. A patient questionnaire was designed that encompassed communication regarding treatment and prognosis, quality-of-life attitudes subsequent to cancer diagnosis, end-of-life care and cancer drug funding. One hundred and twenty-five patients with a diagnosis of cancer were asked to participate and 96 questionnaires were completed and available for analysis. The questionnaire consisted of 63 questions and was completed in both an inpatient and outpatient setting. This survey brought to light a number of controversial issues in cancer service provision, highlighting the emotional and psychological changes brought about by a cancer diagnosis. Major concerns of our patients include fear of death and pain, changes in interpersonal relationships and financial constraints. Only 66% of the patients wanted to be given a prognosis by their clinicians and just 70% of the patients recalled being given a detailed prognosis. 11% of the patients were not prepared to undergo palliative treatment. In all, 7% were not prepared to accept treatment for 1 year and 2% for 5 years of life in exchange for the potential side effects of cytotoxic chemotherapy. 12% of the patients would not want to be in possession of the information that they were in the terminal phase of the illness with a short time to live and 16% would not want this discussed with their next of kin. This study informs medical professionals about the importance of tailoring information to the needs of the individual patient, and we

  7. Psychological aspects of cancer patients

    Directory of Open Access Journals (Sweden)

    Graça Cardoso

    2014-06-01

    Full Text Available Cancer is accompanied by important psychological distress experienced by both patient and family. From the moment of the diagnosis on, the patient has to develop a great number of mechanisms and tasks of adjustment to the illness and its circumstances. The high prevalence of anxiety and depressive disorders during the course of cancer increases in the end stage disea‐ se. Therefore, a global plan of intervention integrating somatic and psychological/ psychiatric care throughout all the phases of the illness is crucial in the treatment of these patients. Health professionals working on this field can also experience emotional reactions to their patients’ suffering. They should be aware of the emotional aspects involved and develop training to help them intervene adequately with the patient and the family. The articulation between oncologists, palliative care professionals, and mental health care teams can be of great help in providing good quality of care to cancer patients.

  8. Hope in Patients with Cancer

    Directory of Open Access Journals (Sweden)

    Selma Turan Kavradim

    2014-06-01

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

  9. Feeding Problems and Their Underlying Mechanisms in the Esophageal Atresia–Tracheoesophageal Fistula Patient

    Science.gov (United States)

    Mahoney, Lisa; Rosen, Rachel

    2017-01-01

    Feeding difficulties such as dysphagia, coughing, choking, or vomiting during meals, slow eating, oral aversion, food refusal, and stressful mealtimes are common in children with repaired esophageal atresia (EA) and the reasons for this are often multifactorial. The aim of this review is to describe the possible underlying mechanisms contributing to feeding difficulties in patients with EA and approaches to management. Underlying mechanisms for these feeding difficulties include esophageal dysphagia, oropharyngeal dysphagia and aspiration, and aversions related to prolonged gastrostomy tube feeding. The initial diagnostic evaluation for feeding difficulties in a patient with EA may involve an esophagram, videofluoroscopic imaging or fiberoptic endoscopic evaluation during swallowing, upper endoscopy with biopsies, pH-impedance testing, and/or esophageal motility studies. The main goal of management is to reduce the factors contributing to feeding difficulties and may include reducing esophageal stasis, maximizing reflux therapies, treating underlying lung disease, dilating strictures, and altering feeding methods, routes, or schedules. PMID:28620597

  10. Dissociative symptomatology in cancer patients

    Science.gov (United States)

    Civilotti, Cristina; Castelli, Lorys; Binaschi, Luca; Cussino, Martina; Tesio, Valentina; Di Fini, Giulia; Veglia, Fabio; Torta, Riccardo

    2015-01-01

    Introduction: The utilization of the post-traumatic stress disorder (PTSD) diagnostic spectrum is currently being debated to categorize psychological adjustment in cancer patients. The aims of this study were to: (1) evaluate the presence of cancer-related traumatic dissociative symptomatology in a sample of cancer patients; (2) examine the correlation of cancer-related dissociation and sociodemographic and medical variables, anxiety, depression, and post-traumatic stress symptomatology; (3) investigate the predictors of cancer-related dissociation. Methods: Ninety-two mixed cancer patients (mean age: 58.94, ds = 10.13) recruited from two hospitals in northern Italy were administered a questionnaire on sociodemographic and medical characteristics, the Karnofsky Scale to measure the level of patient activity and medical care requirements, the Hospital Anxiety and Depression Scale (HADS) to evaluate the presence of anxiety and depression, the Impact of Event Scale Revised (IES-R) to assess the severity of intrusion, avoidance, and hypervigilance, and the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) to quantify the traumatic dissociative symptomatology. Results: 31.5% of participants report a PDEQ score above the cutoff. The results indicated that dissociative symptomatology was positively correlated with HADS scores (HADS-Anxiety: r = 0.476, p dissociative symptomatology. The results converged on a three predictor model revealing that IES-R-Intrusion, IES-R-Avoidance, and IES-R-Hyperarousal accounted for 53.9% of the explained variance. Conclusion: These findings allow us to hypothesize a specific psychological reaction which may be ascribed to the traumatic spectrum within the context of cancer, emphasizing the close relationship between the origin of dissociative constituents which, according to the scientific literature, compose the traumatic experience. Our results have implications for understanding dissociative symptomatology in a cancer

  11. Skin cancers in elderly patients.

    Science.gov (United States)

    Malaguarnera, Giulia; Giordano, Maria; Cappellani, Alessandro; Berretta, Massimiliano; Malaguarnera, Michele; Perrotta, Rosario Emanuele

    2013-11-01

    Cancer in older people is a common problem worldwide. Among various types of cancer, skin cancers represent an important percentage. The principal risk factors are sun exposure, family history of skin cancer, fair skin color, but also the age plays an important role in the genesis of skin cancers. In older people there are a more prolonged exposure to carcinogenesis and a decreased functionality of reparation mechanisms of the cells so they acquire a selective advantage of growing and proliferating. At the same time age causes alteration in immune system by increasing NK-cells absolute number and decreasing both the endogenous and the lymphokine-induced lytic activities. The anti-tumor immune response is also mediated by the cytotoxic T- lymphocytes and in the elderly a strong reduction of T-cell function has been demonstrated. In elderly patients the diagnosis and the treatment of skin cancers can be different from younger counterpart. For example in older patients with melanoma is important to evaluate Breslow depth while higher mitotic rate has major value in younger patients. Moreover, the treatment should consider the performance status of patients and their compliance.

  12. Socioemotional selectivity in cancer patients.

    Science.gov (United States)

    Pinquart, Martin; Silbereisen, Rainer K

    2006-06-01

    This study analyzed the contact preferences of newly diagnosed cancer patients and healthy control group participants. In line with the theory of socioemotional selectivity, patients were more likely than control participants to prefer contact with familiar social partners, but this difference was stronger in younger and middle-aged patients than in older patients. Across a 6-month interval, patients' contact preferences changed according to the perceived success of therapy. For example, if therapy was perceived to be successful, patients showed an increasing interest in contacts with unfamiliar social partners. Results indicate that contact preferences are adapted to the perception of limited versus extended future lifetime. Copyright (c) 2006 APA, all rights reserved.

  13. Survival times with and without tube feeding in patients with dementia or psychiatric diseases in Japan.

    Science.gov (United States)

    Takayama, Keiko; Hirayama, Keisuke; Hirao, Akihiko; Kondo, Keiko; Hayashi, Hideki; Kadota, Koichi; Asaba, Hiroyuki; Ishizu, Hideki; Nakata, Kenji; Kurisu, Kairi; Oshima, Etsuko; Yokota, Osamu; Yamada, Norihito; Terada, Seishi

    2017-11-01

    It is widely supposed that there has been no evidence of increased survival in patients with advanced dementia receiving enteral tube feeding. However, more than a few studies have reported no harmful outcome from tube feeding in dementia patients compared to in patients without dementia. This was a retrospective study. Nine psychiatric hospitals in Okayama Prefecture participated in this survey. All inpatients fulfilling the entry criteria were evaluated. All subjects suffered from difficulty with oral intake. Attending physicians thought that the patients could not live without long-term artificial nutrition. The physicians decided whether to make use of long-term artificial nutrition between January 2012 and December 2014. We evaluated 185 patients. Their mean age was 76.6 ± 11.4 years. Of all subjects, patients with probable Alzheimer's disease (n = 78) formed the biggest group, schizophrenia patients (n = 44) the second, and those with vascular dementia (n = 30) the third. The median survival times were 711 days for patients with tube feeding and 61 days for patients without tube feeding. In a comparison different types of tube feeding, median survival times were 611 days for patients with a nasogastric tube and more than 1000 days for those with a percutaneous endoscopic gastrostomy tube. Patients with tube feeding survived longer than those without tube feeding, even among dementia patients. This study suggests that enteral nutrition for patients with dementia prolongs survival. Additionally, percutaneous endoscopic gastrostomy tube feeding may be safer than nasogastric tube feeding among patients in psychiatric hospitals. © 2017 Japanese Psychogeriatric Society.

  14. Cancer disclosure: experiences of Iranian cancer patients.

    Science.gov (United States)

    Valizadeh, Leila; Zamanzadeh, Vahid; Rahmani, Azad; Howard, Fuchsia; Nikanfar, Ali-Reza; Ferguson, Caleb

    2012-06-01

    This study explored Iranian patients' experiences of cancer disclosure, paying particular attention to the ways of disclosure. Twenty cancer patients were invited to participate in this qualitative inquiry by research staff in the clinical setting. In-depth, semistructured interview data were analyzed through content analysis. The rigor of the study was established by principles of credibility, transferability, dependability, and confirmability. Four themes emerged: the atmosphere of non-disclosure, eventual disclosure, distress in knowing, and the desire for information. Non-disclosure was the norm for participants, and all individuals involved made efforts to maintain an atmosphere of non-disclosure. While a select few were informed of their diagnosis by a physician or another patient, the majority eventually became aware of their diagnosis indirectly by different ways. All participants experienced distress after disclosure. The participants wanted basic information about their prognosis and treatments from their treating physicians, but did not receive this information, and encountered difficulty accessing information elsewhere. These challenges highlight the need for changes in current medical practice in Iran, as well as patient and healthcare provider education. © 2012 Blackwell Publishing Asia Pty Ltd.

  15. Hypertension in Patients with Cancer

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-03-15

    There is a known association between chemotherapy and radiotherapy for treatment of cancer patients and development or worsening of hypertension. The aim of this article is to review this association. A literature search was conducted for articles reporting this association on the databases PubMed, SciELO and LILACS between 1993 and 2013. There was a high coprevalence of hypertension and cancer, since both diseases share the same risk factors, such as sedentary lifestyle, obesity, smoking, unhealthy diet and alcohol abuse. The use of chemotherapy and adjuvant drugs effective in the treatment of cancer increased the survival rate of these patients and, consequently, increased the incidence of hypertension. We described the association between the use of angiogenesis inhibitors (bevacizumab, sorafenib and sunitinib), corticosteroids, erythropoietin and non-steroidal anti-inflammatory drugs with the development of hypertension. We also described the relationship between hypertension and carotid baroreceptor injury secondary to cervical radiotherapy. Morbidity and mortality increased in patients with cancer and hypertension without proper antihypertensive treatment. We concluded that there is need for early diagnosis, effective monitoring and treatment strategies for hypertension in cancer patients in order to reduce cardiovascular morbidity and mortality.

  16. Hypertension in Patients with Cancer

    International Nuclear Information System (INIS)

    Souza, Vinicius Barbosa de; Silva, Eduardo Nani; Ribeiro, Mario Luiz; Martins, Wolney de Andrade

    2015-01-01

    There is a known association between chemotherapy and radiotherapy for treatment of cancer patients and development or worsening of hypertension. The aim of this article is to review this association. A literature search was conducted for articles reporting this association on the databases PubMed, SciELO and LILACS between 1993 and 2013. There was a high coprevalence of hypertension and cancer, since both diseases share the same risk factors, such as sedentary lifestyle, obesity, smoking, unhealthy diet and alcohol abuse. The use of chemotherapy and adjuvant drugs effective in the treatment of cancer increased the survival rate of these patients and, consequently, increased the incidence of hypertension. We described the association between the use of angiogenesis inhibitors (bevacizumab, sorafenib and sunitinib), corticosteroids, erythropoietin and non-steroidal anti-inflammatory drugs with the development of hypertension. We also described the relationship between hypertension and carotid baroreceptor injury secondary to cervical radiotherapy. Morbidity and mortality increased in patients with cancer and hypertension without proper antihypertensive treatment. We concluded that there is need for early diagnosis, effective monitoring and treatment strategies for hypertension in cancer patients in order to reduce cardiovascular morbidity and mortality

  17. Needs and preferences of patients with cancer

    NARCIS (Netherlands)

    Wessels-Wynia, H.

    2010-01-01

    What do patients prefer in cancer care and does gender matter? Introduction: To provide patient-centred care for cancer patients it is important to have insight into the patients' specific preferences for health care. To gain such insight we have developed a questionnaire based on cancer patients’

  18. Comparison of Intermittent and Bolus Enteral Feeding Methods on Enteral Feeding Intolerance of Patients with Sepsis: A Triple-blind Controlled Trial in Intensive Care Units.

    Science.gov (United States)

    Nasiri, Morteza; Farsi, Zahra; Ahangari, Mojtaba; Dadgari, Fahimeh

    2017-10-01

    BACKGROUND Recent trials have shown controversial results on which enteral feeding methods has a lower risk of enteral feeding intolerance. Therefore, we aimed to compare two methods of bolus and intermittent feeding on enteral feeding intolerance of patients with sepsis. METHODS This triple-blind randomized controlled trial was conducted on 60 patients with sepsis, who were fed through tubes for at least 3 days. The patients were randomly assigned into bolus feeding, intermittent feeding, and control groups. Enteral feeding intolerance of all patients was recorded in 3 consecutive days by a researcher-made checklist including the data on gastric residual volume, vomiting, diarrhea, constipation, and abdominal distension. RESULTS There were no significant differences between the three studied groups in none of the intervention days pertaining to constipation, diarrhea, vomiting, abdominal distention, and gastric residual volume ( p > 0.05). Also, no statistically significant difference was found between all variables in the three studied groups during the 3 days ( p > 0.05). CONCLUSION As enteral feeding intolerance of patients with sepsis was similar in both bolus and intermittent feeding methods, it can be concluded that bolus method can still be used as a standard method to decrease the risk of enteral feeding intolerance if it is used properly.

  19. [Nutrition therapy of cancer patients].

    Science.gov (United States)

    Lövey, József

    2017-09-20

    The majority of cancer patients becomes malnourished during the course of their disease. Malnutrition deteriorates the efficiency of all kinds of oncologic interventions. As a consequence of it, treatment-related toxicity increases, hospital stay is lengthened, chances of cure and survival as well as the quality of life of the patients worsen. Nutritional status therefore influences all aspects of outcome of oncology care. In spite of this the use of nutritional therapy varies across health care providers but its application is far from being sufficient during active oncology interventions as well as rehabilitation and supportive care. It threatens not only the outcome and quality of life of cancer patients but also the success of oncologic treatments which often demand high input of human and financial resources. Meanwhile application of nutritional therapy is legally regulated in Hungary and a very recent update of the European guideline on cancer patient nutrition published in 2017 is available. Moreover, cost effectiveness of nutritional therapy has been proven in a number of studies. In this review we present the basics of nutritional therapy including nutritional screening and evaluation, nutritional plan, the role of nutrition support teams, oral, enteral and parenteral nutrition, the use of different drugs and special nutrients and the follow-up of the patients.

  20. Endoscopic gastrostomy, nasojejunal and oral feeding comparison in aspiration pneumonia patients

    Directory of Open Access Journals (Sweden)

    Ozge E Onur

    2013-01-01

    Full Text Available Background: Aspiration pneumonia is a potentially preventable illness requiring attention to small details of patient care. The type, management, and care of feeding should be carried out properly. Materials andMethods: This is a prospective clinical study of enteral feeding on patients admitted to hospital with aspiration pneumonia. The known enteral nutritional methods, advantages, and disadvantages were told to the patient or proxy. If they didn′t accept Percutaneous endoscopic gastrostomy (PEG, nasojejunal tube (NJT was advised. If they denied all of the procedures, oral feeding education was given. A total of 94 patients were enrolled to the study, 29 of them accepted PEG, 42 preferred NJT, and 23 preferred oral route. Results: A total of 94 patients with a mean age of 77.84, standard deviation 10.784; 95% confidence interval (CI 75.63-80.03 were enrolled to the study of which 27 (28.7% patients had a history of aspiration pneumonia. Oral feeding was prominently preferred for patients nursed by a relative (15; 65.2% of Oral feeding group and 16% of total or a caregiver (7; 30.4% of Oral feeding group and 7.4% of total while only 1 (4.3% of Oral feeding group and 1.1% of total with a health-care worker (P = 0.001. Overall re-aspiration rates at the 6 th month were 58%, 78%, 91% in EG, NJT, oral groups, respectively. Sixth months′ survival rates of the different feeding groups were not significantly divergent from each other. History of aspiration was also found to be a significant contributor of mortality. Conclusion: In aspiration pneumonia patients′ long-term survival rates of the different feeding groups were not significantly divergent from each other.

  1. Acute kidney injury in the cancer patient.

    Science.gov (United States)

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

    2014-01-01

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

  2. Oral complications in cancer patients

    International Nuclear Information System (INIS)

    Carl, W.

    1983-01-01

    Ionizing radiation used in treating the head and neck area produces oral side effects such as mucositis, salivary changes, trismus and radiation caries. Sequelae of cancer chemotherapy often include oral stomatitis, myelosuppression and immunosuppression. Infections of dental origin in compromised patients are potentially lethal. Specific programs to eliminate dental pathology before radiation and chemotherapy, and to maintain oral hygiene during and after therapy, will minimize these complications

  3. Bacterial contamination of ready-to-use 1-L feeding bottles and administration sets in severely compromised intensive care patients

    NARCIS (Netherlands)

    Mathus-Vliegen, L. M.; Binnekade, J. M.; de Haan, R. J.

    2000-01-01

    OBJECTIVE: In intensive care patients, enteral feeding requires sterile feedings because of infectious complications and adequate supplements to meet nutritional needs. Heretofore, prepacked, large-volume formula containers were developed, but bacterial contamination occurred in 4% to 15%. Our

  4. Estimation of Cachexia among Cancer Patients Based on Four Definitions

    Directory of Open Access Journals (Sweden)

    Kathleen M. Fox

    2009-01-01

    Full Text Available Objectives. Estimate and compare the proportion of cancer patients with cachexia using different definitions from available clinical data. Methods. Electronic medical records were examined to estimate the proportion of cancer patients with cachexia using 4 definitions: (1 ICD-9 diagnostic code of 799.4 (cachexia, (2 ICD-9 diagnosis of cachexia, anorexia, abnormal weight loss, or feeding difficulties, (3 prescription for megestrol acetate, oxandrolone, somatropin, or dronabinol, and (4 ≥5% weight loss. Patients with cancer of the stomach, pancreas, lung, colon/rectum, head/neck, esophagus, prostate, breast, or liver diagnosed between 1999 and 2004 were followed for cachexia. Results. Of 8541 cancer patients (60% men and 55% Caucasian, cachexia was observed in 2.4% of patients using the cachexia diagnostic code, 5.5% expanded diagnoses, 6.4% prescription medication definition, and 14.7% with ≥5% weight loss. Conclusions. The proportion of patients with cachexia varied considerably depending upon the definition employed, indicating that a standard operational definition is needed.

  5. Psychiatric Problems in Patients with Breast Cancer

    Directory of Open Access Journals (Sweden)

    Munevver Tunel

    2012-06-01

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

  6. Nutritional status assessment in colorectal cancer patients

    OpenAIRE

    Joana Pedro Lopes; Paula Manuela de Castro Cardoso Pereira; Ana Filipa dos Reis Baltazar Vicente; Alexandra Bernardo; María Fernanda de Mesquita

    2013-01-01

    The present study intended to evaluate the nutritional status of Portuguese colorectal patients and associated it with surgery type as well as quality of life outcomes. Malnutrition can affect up to 85% of cancer patients and specifically 30-60% in colorectal cancer and can significantly influence health outcomes. A sample of 50 colorectal cancer patients was evaluated in what refers to several anthropometric measures, food intake, clinical history, complications rate before and after surgery...

  7. Guidelines Urge Exercise for Cancer Patients, Survivors

    Science.gov (United States)

    The benefits of exercise are well documented in a number of cancers. A panel of experts in cancer, fitness, obesity, and exercise training convened by the American College of Sports Medicine is spreading what they believe to be one of the most important messages for cancer patients and survivors: Avoid inactivity.

  8. Increased cancer risk in patients with periodontitis.

    Science.gov (United States)

    Dizdar, Omer; Hayran, Mutlu; Guven, Deniz Can; Yılmaz, Tolga Birtan; Taheri, Sahand; Akman, Abdullah C; Bilgin, Emre; Hüseyin, Beril; Berker, Ezel

    2017-12-01

    Previous studies have noted a possible association between periodontal diseases and the risk of various cancers. We assessed cancer risk in a cohort of patients with moderate to severe periodontitis. Patients diagnosed with moderate to severe periodontitis by a periodontist between 2001 and 2010 were identified from the hospital registry. Patients younger than 35 years of age or with a prior cancer diagnosis were excluded. The age- and gender-standardized incidence rates (SIR) were calculated by dividing the number of observed cases by the number of expected cases from Turkish National Cancer Registry 2013 data. A total of 280 patients were included (median age 49.6, 54% female). Median follow-up was 12 years. Twenty-five new cancer cases were observed. Patients with periodontitis had 77% increased risk of cancer (SIR 1.77, 95% CI 1.17-2.58, p = .004). Women with periodontitis had significantly higher risk of breast cancer (SIR 2.40, 95% CI 0.88-5.33) and men with periodontitis had significantly higher risk of prostate cancer (SIR 3.75, 95% CI 0.95-10.21) and hematological cancers (SIR 6.97, 95% CI 1.77-18.98). Although showing a causal association necessitates further investigation, our results support the idea that periodontitis might be associated with increased cancer risk, particularly with hematological, breast and prostate cancers.

  9. Psychosocial coping strategies in cancer patients

    International Nuclear Information System (INIS)

    Sprah, L.; Sostaric, M.

    2004-01-01

    Background. The aim of this review is to present common psychosocial problems in cancer patients and their possible coping strategies. Cancer patients are occupied with many psychosocial problems, which are only partially related to their health state and medical treatments. They are faced with a high social pressure, based on prejudices and stereotypes of this illness. The review presents the process of confrontation with the cancer diagnosis and of managing the psychological consequences of cancer. The effects of specific coping styles, psychosocial interventions and a social support on initiation, progression and recurrence of cancer are also described. Conclusions. Although some recent meta-analysis could not provide scientific evidence for the association between coping strategies and the cancer initiation, the progression or the recurrence (neither have studies rejected the thesis of association), the therapeutic window for the psychosocial intervention is still wide and shows an important effect on the quality of lives of many cancer patients. (author)

  10. How to Feed a Patient with Anorexia Nervosa?

    Directory of Open Access Journals (Sweden)

    D.O. Ptushkina

    2015-11-01

    Full Text Available The article presents the problems of nutritional rehabilitation of patients with anorexia nervosa, methods for evaluation of nutritional status, eating behavior, weight restoration and weight gain rates, stages of treatment, enteral nutrition.

  11. Cancer screening in patients infected with HIV.

    Science.gov (United States)

    Sigel, Keith; Dubrow, Robert; Silverberg, Michael; Crothers, Kristina; Braithwaite, Scott; Justice, Amy

    2011-09-01

    Non-AIDS-defining cancers are a rising health concern among HIV-infected patients. Cancer screening is now an important component of health maintenance in HIV clinical practice. The decision to screen an HIV-infected patient for cancer should include an assessment of individualized risk for the particular cancer, life expectancy, and the harms and benefits associated with the screening test and its potential outcome. HIV-infected patients are at enhanced risk of several cancers compared to the general population; anal cancer, hepatocellular carcinoma, Hodgkin's lymphoma, and lung cancer all have good evidence demonstrating an enhanced risk in HIV-infected persons. A number of cancer screening interventions have shown benefit for specific cancers in the general population, but data on the application of these tests to HIV-infected persons are limited. Here we review the epidemiology and background literature relating to cancer screening interventions in HIV-infected persons. We then use these data to inform a conceptual model for evaluating HIV-infected patients for cancer screening.

  12. Identification of risk factors for enteral feeding intolerance screening in critically ill patients

    Science.gov (United States)

    Xu, Lei; Wang, Ting; Chen, Ting; Yang, Wen-Qun; Liang, Ze-Ping; Zhu, Jing-Ci

    2017-01-01

    Objectives: To identify risk factors for enteral feeding intolerance screening in critically ill patients, thereby, provide some reference for healthcare staff to assess the risk of feeding intolerance, and lay the foundation for future scale development. Methods: This study used a mixed methodology, including a literature review, semi-structured interviews, the Delphi technique, and the analytic hierarchy process. We used the literature review and semi-structured interviews (n=22) to draft a preliminarily item pool for feeding intolerance, Delphi technique (n=30) to screen and determine the items, and the analytic hierarchy process to calculate the weight of each item. The study was conducted between June 2014 and September 2015 in Daping Hospital, Third Military Medical University, Chongqing, China. Results: Twenty-three risk factors were selected for the scale, including 5 dimensions. We assigned a weight to each item according to their impact on the feeding intolerance, with a higher score indicating a greater impact. The weight of each dimension was decreasing as follows: patient conditions, weight score equals 42; general conditions, weight score equals 23; gastrointestinal functions, weight score equals 15; biochemical indexes, weight score equals 14; and treatment measures, weight score equals 6. Conclusion: Developed list of risk factors based on literature review, survey among health care professionals and expert consensus should provide a basis for future studies assessing the risk of feeding intolerance in critically ill patients. PMID:28762434

  13. Circulating procoagulant microparticles in cancer patients

    OpenAIRE

    Thaler, Johannes; Ay, Cihan; Weinstabl, Harald; Dunkler, Daniela; Simanek, Ralph; Vormittag, Rainer; Freyssinet, Jean-Marie; Zielinski, Christoph; Pabinger, Ingrid

    2010-01-01

    Abstract Accumulating evidence indicates that microparticles (MPs) are important mediators of the interaction between cancer and the hemostatic system. We conducted a large prospective cohort study to determine whether the number of circulating procoagulant MPs is elevated in cancer patients and whether the elevated MP levels are predictive of occurrence of venous thrombembolism (VTE). We analyzed plasma samples of 728 cancer patients from the ongoing prospective observational Vien...

  14. Predictors of Pain among Head and Neck Cancer Patients

    Science.gov (United States)

    Shuman, Andrew G.; Terrell, Jeffrey E.; Light, Emily; Wolf, Gregory T.; Bradford, Carol R.; Chepeha, Douglas; Jiang, Yunyun; McLean, Scott; Ghanem, Tamer A.; Duffy, Sonia A.

    2014-01-01

    Objective Pain is a strong contributor to cancer patients’ quality of life. The objective of this study was to determine predictors of pain 1 year after the diagnosis of head and neck cancer. Design Prospective, multi-site cohort study. Setting Three academically-affiliated medical centers. Patients Previously untreated patients with carcinoma of the upper aerodigestive tract (n=374). Main Outcome Measures Participants were surveyed pre-treatment and 1 year thereafter. Multivariate analyses were conducted to determine predictors of the SF-36 bodily pain score 1 year after diagnosis. Results The mean SF-36 bodily pain score at 1 year was 65, compared to 61 at diagnosis (p=.004), compared to 75 among population norms (lower scores indicate worse pain). Variables independently associated with pain included pre-treatment pain score (p<0.001), less education (p=0.02), neck dissection (p=0.001), feeding tube (p=0.05), xerostomia (p<0.001), depressive symptoms (p<0.001), taking more pain medication (p<0.001), less physical activity (p=.02), and poor sleep quality (p=0.006). Current smoking and problem drinking were marginally significant (p=0.07 and 0.08, respectively). Conclusions Aggressive pain management may be indicated for head and neck cancer patients who undergo neck dissections, complain of xerostomia, require feeding tubes, and have medical comorbidities. Treatment of modifiable risk factors such as depression, poor sleep quality, tobacco and alcohol abuse may also reduce pain and improve quality of life among head and neck cancer patients. PMID:23165353

  15. Fostering hope in the patient with cancer.

    Science.gov (United States)

    Lichwala, Rebecca

    2014-06-01

    When a patient is diagnosed with cancer, feelings such as fear, anxiety, and hopelessness can negatively affect a person's frame of mind. Hope can help a patient decrease anxiety and increase quality of life. Nurses should assess hope, provide interventions, be empathetic, listen, and treat patients with dignity to help improve hope and quality of life. This article features how hope can have a positive impact and provides specific information about how nurses can promote and foster hope in patients with cancer.

  16. Taste and smell changes in cancer patients

    NARCIS (Netherlands)

    IJpma, Irene

    2017-01-01

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

  17. Haemorheological Changes in African Breast Cancer Patients

    African Journals Online (AJOL)

    elearning

    complications, African patients with breast cancer may well be predisposed to thrombotic complications during illness. ... having breast cancer were studied. The patients were diagnosed by one of the authors from histological biopsy from the lump removed from the breast. None of ... statistics (Student's t-test for paired data.

  18. Nutritional Interventions in Head and Neck Cancer Patients Undergoing Chemoradiotherapy: A Narrative Review

    Directory of Open Access Journals (Sweden)

    Maurizio Bossola

    2015-01-01

    Full Text Available The present review aimed to define the role of nutritional interventions in the prevention and treatment of malnutrition in HNC patients undergoing CRT as well as their impact on CRT-related toxicity and survival. Head and neck cancer patients are frequently malnourished at the time of diagnosis and prior to the beginning of treatment. In addition, chemo-radiotherapy (CRT causes or exacerbates symptoms, such as alteration or loss of taste, mucositis, xerostomia, fatigue, nausea and vomiting, with consequent worsening of malnutrition. Nutritional counseling (NC and oral nutritional supplements (ONS should be used to increase dietary intake and to prevent therapy-associated weight loss and interruption of radiation therapy. If obstructing cancer and/or mucositis interfere with swallowing, enteral nutrition should be delivered by tube. However, it seems that there is not sufficient evidence to determine the optimal method of enteral feeding. Prophylactic feeding through nasogastric tube or percutaneous gastrostomy to prevent weight loss, reduce dehydration and hospitalizations, and avoid treatment breaks has become relatively common. Compared to reactive feeding (patients are supported with oral nutritional supplements and when it is impossible to maintain nutritional requirements enteral feeding via a NGT or PEG is started, prophylactic feeding does not offer advantages in terms of nutritional outcomes, interruptions of radiotherapy and survival. Overall, it seems that further adequate prospective, randomized studies are needed to define the better nutritional intervention in head and neck cancer patients undergoing chemoradiotherapy.

  19. Causes of death among cancer patients.

    Science.gov (United States)

    Zaorsky, N G; Churilla, T M; Egleston, B L; Fisher, S G; Ridge, J A; Horwitz, E M; Meyer, J E

    2017-02-01

    The purpose of our study was to characterize the causes of death among cancer patients as a function of objectives: (i) calendar year, (ii) patient age, and (iii) time after diagnosis. US death certificate data in Surveillance, Epidemiology, and End Results Stat 8.2.1 were used to categorize cancer patient death as being due to index-cancer, nonindex-cancer, and noncancer cause from 1973 to 2012. In addition, data were characterized with standardized mortality ratios (SMRs), which provide the relative risk of death compared with all persons. The greatest relative decrease in index-cancer death (generally from > 60% to deaths were stable (typically >40%) among patients with cancers of the liver, pancreas, esophagus, and lung, and brain. Noncancer causes of death were highest in patients with cancers of the colorectum, bladder, kidney, endometrium, breast, prostate, testis; >40% of deaths from heart disease. The highest SMRs were from nonbacterial infections, particularly among 1,000 for lymphomas, P death from index- and nonindex-cancers varies widely among primary sites. Risk of noncancer deaths now surpasses that of cancer deaths, particularly for young patients in the year after diagnosis. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. Thyroid cancer outcomes in Filipino patients.

    Science.gov (United States)

    Kus, Lukas H; Shah, Manish; Eski, Spiro; Walfish, Paul G; Freeman, Jeremy L

    2010-02-01

    To compare the outcomes of patients having thyroid cancer among Filipinos vs non-Filipinos. Retrospective medical record review. High-volume tertiary referral center in Toronto, Ontario, Canada. A total of 499 patients with thyroid cancer (36 Filipino and 463 non-Filipino) treated at Mount Sinai Hospital from January 1, 1984, to August 31, 2003, with a minimum 5-year follow-up period and a minimum 1.0-cm tumor size. Patients were identified from a thyroid cancer database. Data on patient, tumor, and treatment factors were collected along with outcomes. The presence of thyroid cancer recurrence, the rate of death from disease, and the time to recurrence. The 2 groups were similar for sex, age, history of head and neck radiation exposure, family history of thyroid cancer, follow-up time, tumor size, tumor pathologic findings, presence of tumor multifocality, stage of primary disease, type of thyroid surgery, use of postoperative radioactive iodine therapy, and use of external beam radiation therapy. Filipino patients experienced a thyroid cancer recurrence rate of 25% compared with 9.5% for non-Filipino patients (odds ratio, 3.20; 95% confidence interval, 1.23-7.49; P = .004). On multivariate analysis, the increased risk of thyroid cancer recurrence persisted for Filipino patients (odds ratio, 6.99; 95% confidence interval, 2.31-21.07; P Filipino patients and non-Filipino patients regarding the rate of death from disease (5.6% vs 1.9%) and the time to recurrence (52.6 vs 53.1 months). Filipino patients have a significantly higher risk of thyroid cancer recurrence compared with non-Filipino patients. However, no significant difference was noted in the time to recurrence or the rate of death from disease. These findings justify a more aggressive initial management and follow-up regimen for Filipino patients with thyroid cancer.

  1. Cardiopulmonary resuscitation in palliative care cancer patients.

    Science.gov (United States)

    Kjørstad, Odd Jarle; Haugen, Dagny Faksvåg

    2013-02-19

    The criteria for refraining from cardiopulmonary resuscitation in palliative care cancer patients are based on patients' right to refuse treatment and the duty of the treating personnel not to exacerbate their suffering and not to administer futile treatment. When is cardiopulmonary resuscitation futile in these patients? Systematic literature searches were conducted in PubMed for the period 1989-2010 on the results of in-hospital cardiopulmonary resuscitation in advanced cancer patients and on factors that affected the results of CPR when special mention was made of cancer. The searches yielded 333 hits and 18 included articles: four meta-analyses, eight retrospective clinical studies, and six review articles. Cancer patients had a poorer post-CPR survival than non-cancer patients. Survival declined with increasing extent of the cancer disease. Widespread and therapy-resistant cancer disease coupled with a performance status lower than WHO 2 or a PAM score (Pre-Arrest Morbidity Index) of above 8 was regarded as inconsistent with survival after cardiopulmonary resuscitation. Cardiopulmonary resuscitation is futile for in-hospital cancer patients with widespread incurable disease and poor performance status.

  2. Development of a multivariable normal tissue complication probability (NTCP) model for tube feeding dependence after curative radiotherapy/chemo-radiotherapy in head and neck cancer

    International Nuclear Information System (INIS)

    Wopken, Kim; Bijl, Hendrik P.; Schaaf, Arjen van der; Laan, Hans Paul van der; Chouvalova, Olga; Steenbakkers, Roel J.H.M.; Doornaert, Patricia; Slotman, Ben J.; Oosting, Sjoukje F.; Christianen, Miranda E.M.C.; Laan, Bernard F.A.M. van der; Roodenburg, Jan L.N.; René Leemans, C.; Verdonck-de Leeuw, Irma M.; Langendijk, Johannes A.

    2014-01-01

    Background and purpose: Curative radiotherapy/chemo-radiotherapy for head and neck cancer (HNC) may result in severe acute and late side effects, including tube feeding dependence. The purpose of this prospective cohort study was to develop a multivariable normal tissue complication probability (NTCP) model for tube feeding dependence 6 months (TUBE M6 ) after definitive radiotherapy, radiotherapy plus cetuximab or concurrent chemoradiation based on pre-treatment and treatment characteristics. Materials and methods: The study included 355 patients with HNC. TUBE M6 was scored prospectively in a standard follow-up program. To design the prediction model, the penalized learning method LASSO was used, with TUBE M6 as the endpoint. Results: The prevalence of TUBE M6 was 10.7%. The multivariable model with the best performance consisted of the variables: advanced T-stage, moderate to severe weight loss at baseline, accelerated radiotherapy, chemoradiation, radiotherapy plus cetuximab, the mean dose to the superior and inferior pharyngeal constrictor muscle, to the contralateral parotid gland and to the cricopharyngeal muscle. Conclusions: We developed a multivariable NTCP model for TUBE M6 to identify patients at risk for tube feeding dependence. The dosimetric variables can be used to optimize radiotherapy treatment planning aiming at prevention of tube feeding dependence and to estimate the benefit of new radiation technologies

  3. Feeding practice in acute stroke patients in a tertiary care hospital.

    Science.gov (United States)

    Miah, Md Titu; Al-Amin, Mohammad; Khan, Mohammad Ashik Imran; Ayaz, K F M; Zakaria, M H; Ahmed, Srijoni; Ahasan, H A M Nazmul

    2010-12-01

    Feeding is a basic component of care and it is the most common and difficult management issue for stroke patients. Objective of this study was to know the practice of feeding (oral & nasogastric tube feeding), different types of food used and their caloric value in stroke patients. This direct observational study was done from June 2010 to November 2010, in different medicine wards of Dhaka Medical College Hospital, and included 100 acute stroke patients confirmed by CT scan or MRI of brain and duration of hospital stay for at least 24 hours. Out of 100 cases, 22% took their feeding orally and 78% cases through nasogastric tube. Artificial milk powder 66% cases (NG tube vs. Orally, 58% vs. 8%), juice 18% (NG tube 13% vs. orally 5%), horlicks & juice & soup 10% (NG tube vs. Orally, 7% vs. 3%), khichury 2% orally, bread & egg & shuji 4% cases orally. In 100 cases studied, none of them fulfilled the calorie requirement up to the standard level according to the guideline of Nutrition & Food Science Institute, of Dhaka University, Bangladesh. Though this study was small scale but the magnitude of under nutrition among stroke patients revealed is alarming and needs urgent attention.

  4. Feeding tube-related complications and problems in patients receiving long-term home enteral nutrition

    Directory of Open Access Journals (Sweden)

    Vasileios Alivizatos

    2015-04-01

    Full Text Available Aim: The aim of this study was to evaluate the long-term complications and problems related to gastrostomy and jejunostomy feeding tubes used for home enteral nutrition support and the effect these have on health care use. Materials and Methods: The medical records of 31 patients having gastrostomy (27 patients and jejunostomy (4 feeding tubes inserted in our Department were retrospectively studied. All were discharged on long-term (>3 months enteral nutrition and followed up at regular intervals by a dedicated nurse. Any problem or complication associated with tube feeding as well as the intervention, if any, that occurred, was recorded. Data were collected and analyzed. Results: All the patients were followed up for a mean of 17.5 months (4-78. The most frequent tube-related complications included inadvertent removal of the tube (broken tube, plugged tube; 45.1%, tube leakage (6.4%, dermatitis of the stoma (6.4%, and diarrhea (6.4%. There were 92 unscheduled health care contacts, with an average rate of such 2.9 contacts over the mean follow-up time of 17.5 months. Conclusion: In patients receiving long-term home enteral nutrition, feeding tube-related complications and problems are frequent and result in significant health care use. Further studies are needed to address their optimal prevention modalities and management.

  5. Psychosocial Intervention In Prostate Cancer Patients

    Directory of Open Access Journals (Sweden)

    Potočníková Jana

    2015-05-01

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

  6. Combined enteral feeding and total parenteral nutritional support improves outcome in surgical intensive care unit patients.

    Science.gov (United States)

    Hsu, Min-Hui; Yu, Ying E; Tsai, Yueh-Miao; Lee, Hui-Chen; Huang, Ying-Che; Hsu, Han-Shui

    2012-09-01

    For intensive care unit (ICU) patients with gastrointestinal dysfunction and in need of total parenteral nutrition (TPN) support, the benefit of additional enteral feeding is not clear. This study aimed to investigate whether combined TPN with enteral feeding is associated with better outcomes in surgical intensive care unit (SICU) patients. Clinical data of 88 patients in SICU were retrospectively collected. Variables used for analysis included route and percentage of nutritional support, total caloric intake, age, gender, body weight, body mass index, admission diagnosis, surgical procedure, Acute Physiology and Chronic Health Evaluation (APACHE) II score, comorbidities, length of hospital stay, postoperative complications, blood glucose values and hospital mortality. Wound dehiscence and central catheter infection were observed more frequently in the group of patients receiving TPN calories less than 90% of total calorie intake (p = 0.004 and 0.043, respectively). APACHE II scores were higher in nonsurvivors than in survivors (p = 0.001). More nonsurvivors received TPN calories exceeding 90% of total calorie intake and were in need of dialysis during ICU admission (p = 0.005 and 0.013, respectively). Multivariate analysis revealed that the percentage of TPN calories over total calories and APACHE II scores were independent predictors of ICU mortality in patients receiving supplementary TPN after surgery. In SICU patients receiving TPN, patients who could be fed enterally more than 10% of total calories had better clinical outcomes than patients receiving less than 10% of total calorie intake from enteral feeding. Enteral feeding should be given whenever possible in severely ill patients. 2012 Published by Elsevier B.V

  7. An analysis of BMD changes with preopertive and postoperative premenopausal breast cancer patient

    International Nuclear Information System (INIS)

    KIm, Su Jin; Son, Soon Yong; Choi, Kwan Woo; Lee, Joo Ah; Min, Jung Whan; Kim, Hyun Soo; Ma, Sang Chull; Lee, Jong Seok; Yoo, Beong Gyu

    2014-01-01

    The purpose of this study is to provide basic data of comparing BMD (bone mineral density) value of preoperative breast cancer patient and postoperative breast cancer patient due to bone loss with radiation/chemical therapy. The participants consisted of 254 breast cancer patients with BMD after having surgery and treatment from March 2007 to September 2013. Except for 84 patients with menopause or hysterectomy and we have analysed 171 patients. The BMD value (lumbar spine and femur) of before and after treatment from PACS by dure-energy X-ray absorptiometry was analyzed. First, we found variation of entire BMD and BMD according to treatment type, and analyzed detailed correlation by using marital status, number of children, presence of feeding, age of menarche, breast cancer therapy types as variable. Data was analyzed by using SPSS for Windows Program (version 18.0). BMD was decreased 7.1% in lumbar spine, 3.1% in femur respectively (p<.01). Also there is relatively high decrement (0.067 g/cm 2 ) in group who had just chemotherapy in femur (p<.05). There is decrement depend on marital status, number of children, presence of feeding, age of menarche, breast cancer therapy types but there was no statistical significance. The results show that BMD was decreased after treatment in premenopausal breast cancer patient, patient who had relatively high decrement need to be included high-risk group. As a result, aggressive prevention policy would be necessary

  8. An analysis of BMD changes with preopertive and postoperative premenopausal breast cancer patient

    Energy Technology Data Exchange (ETDEWEB)

    KIm, Su Jin; Son, Soon Yong; Choi, Kwan Woo [Dept. of Radiology, Asan Medical Center, Seoul (Korea, Republic of); Lee, Joo Ah [Dept. of Radiation Oncology, Catholic University, Incheon St.Mary' s Hospital, Incheon (Korea, Republic of); Min, Jung Whan; Kim, Hyun Soo [Dept. of Radiology, Shingu University, Sungnam (Korea, Republic of); Ma, Sang Chull [Dept. of Radiologic Science, Shin han University, Uijeongbu (Korea, Republic of); Lee, Jong Seok; Yoo, Beong Gyu [Dept. of Radiotechnology, Wonkwang Health Science University, Iksan (Korea, Republic of)

    2014-12-15

    The purpose of this study is to provide basic data of comparing BMD (bone mineral density) value of preoperative breast cancer patient and postoperative breast cancer patient due to bone loss with radiation/chemical therapy. The participants consisted of 254 breast cancer patients with BMD after having surgery and treatment from March 2007 to September 2013. Except for 84 patients with menopause or hysterectomy and we have analysed 171 patients. The BMD value (lumbar spine and femur) of before and after treatment from PACS by dure-energy X-ray absorptiometry was analyzed. First, we found variation of entire BMD and BMD according to treatment type, and analyzed detailed correlation by using marital status, number of children, presence of feeding, age of menarche, breast cancer therapy types as variable. Data was analyzed by using SPSS for Windows Program (version 18.0). BMD was decreased 7.1% in lumbar spine, 3.1% in femur respectively (p<.01). Also there is relatively high decrement (0.067 g/cm{sup 2}) in group who had just chemotherapy in femur (p<.05). There is decrement depend on marital status, number of children, presence of feeding, age of menarche, breast cancer therapy types but there was no statistical significance. The results show that BMD was decreased after treatment in premenopausal breast cancer patient, patient who had relatively high decrement need to be included high-risk group. As a result, aggressive prevention policy would be necessary.

  9. Overview on Patient Centricity in Cancer Care

    Directory of Open Access Journals (Sweden)

    Šarunas Narbutas

    2017-10-01

    Full Text Available Successful implementation of treatment in cancer care partially depends on how patients' perspectives are taken into account, as preferences of health care professionals and patients may differ. Objectives of this exploratory research were (I to identify patient preferences and values (PPVs in cancer care as indicated by patient organizations (POs, (II to determine how these PPVs are captured in cancer care guidelines and (III to review how guidelines take into account these PPVs. Based on a survey developed and completed by 19 POs, a literature review was conducted to analyse how patient perspectives are incorporated in oncology treatment guidelines. Based on survey results traditional health technology assessment value propositions of oncology care, such as extended life, treatment-free remission and pain reduction, were also highly rated by POs. However, the heterogeneity of cancer PPVs were clearly reflected in the survey results. PPVs in cancer care guidelines were mostly limited to those micro-level aspects that are strictly related to health care provision, such as side-effects and comorbidities. Patient experience, emotional support and convenience of care were relatively neglected fields in the reviewed guidelines. Patient engagement was rarely presented in the guideline development phase. POs believe that patients should be encouraged to take an active role in their own care due to the heterogeneity of cancer patients and PPVs. Even if patient-centricity is a leading paradigm in cancer policy, based on our research it is not yet standard practice to include patients or POs at all appropriate levels of decision-making processes that are related to their health and well-being. Patient engagement should be an integral part of cancer care decision-making. This complexity must be reflected throughout policy making, avoiding a population level “one-size-fits-all” solution.

  10. Cancer Patient Navigator Tasks across the Cancer Care Continuum

    Science.gov (United States)

    Braun, Kathryn L.; Kagawa-Singer, Marjorie; Holden, Alan E. C.; Burhansstipanov, Linda; Tran, Jacqueline H.; Seals, Brenda F.; Corbie-Smith, Giselle; Tsark, JoAnn U.; Harjo, Lisa; Foo, Mary Anne; Ramirez, Amelie G.

    2011-01-01

    Cancer patient navigation (PN) programs have been shown to increase access to and utilization of cancer care for poor and underserved individuals. Despite mounting evidence of its value, cancer patient navigation is not universally understood or provided. We describe five PN programs and the range of tasks their navigators provide across the cancer care continuum (education and outreach, screening, diagnosis and staging, treatment, survivorship, and end-of-life). Tasks are organized by their potential to make cancer services understandable, available, accessible, affordable, appropriate, and accountable. Although navigators perform similar tasks across the five programs, their specific approaches reflect differences in community culture, context, program setting, and funding. Task lists can inform the development of programs, job descriptions, training, and evaluation. They also may be useful in the move to certify navigators and establish mechanisms for reimbursement for navigation services. PMID:22423178

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

    Science.gov (United States)

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

    2015-11-01

    The aim was to describe male cancer survivors' barriers towards participation in cancer rehabilitation as a means to guiding future targeted men's cancer rehabilitation. Symbolic Interactionism along with the interpretive descriptive methodology guided the study of 35 male cancer survivors representing seven cancer types. Data were generated through a 5-month fieldwork study comprising participant observations, semi-structured individual interviews and informal conversations. The analyses revealed two overarching findings shedding light on male cancer survivors' barriers to rehabilitation: 'Fear of losing control' and 'Striving for normality'. While 'Fear of losing control' signified what the men believed rehabilitation would invoke: 'Reduced manliness', 'Sympathy and dependency' and 'Confrontation with death', 'Striving for normality' was based on what the men believed rehabilitation would hinder: 'Autonomy and purpose', 'Solidarity and fellowship' and 'Forget and move on'. This study of male cancer survivors' and cancer rehabilitation documents how masculine ideals may constitute barriers for participation in rehabilitation and provides insights about why men are underrepresented in rehabilitation. The findings can guide practice to develop research-based rehabilitation approaches focused on preserving control and normality. Further empirical evidence is needed to: (1) explore the conduct of health professionals' towards male cancer patients and (2) address gender inequalities in cancer rehabilitation. © 2015 John Wiley & Sons Ltd.

  12. Fertility in patients treated for testicular cancer.

    Science.gov (United States)

    Matos, Erika; Skrbinc, Breda; Zakotnik, Branko

    2010-09-01

    Testicular cancer affects men mostly in their reproductive age with a cure rate over 90% and fertility is one of the main concerns of survivors. To further elucidate the question of fertility after treatment for testicular cancer, we performed a survey in patients treated in our institution. We sent a questionnaire to patients treated for testicular cancer at our institute from 1976 to 2002 (n = 490) of whom 297 (60.6%) responded. We considered the patients to have conserved fertility if they had children after treatment without assisted reproductive technologies. Before treatment 119/297 (40.1%) of patients and after treatment 150/297 (50.5%) of patients tried to have children (p = 0.019). Of 119 patients who tried to have children before treatment for testicular cancer 98 (82.4%) succeeded and 74/150 (49.3%) were successful after treatment (p years. The post-treatment fatherhood in patients treated with surgery only (orchidectomy +/- retroperitoneal lymphnode dissection-RPLND) was 59%, in those with additional radiotherapy 68%, and chemotherapy 50% (p = 0.233). Fertility rate in patients where a non nerve sparing RPLND was performed was only 37%, 62% in patients with nerve sapring RPLND, and 77% in patients where RPLND was not performed (p Fertility rate after treatment for testicular cancer is reduced. From our data, the most important treatment modality that influences fertility is non nerve sparing RPLND that should be avoided whenever possible in order improve the quality of life our patients.

  13. Researching the experience of kidney cancer patients.

    Science.gov (United States)

    Taylor, K

    2002-09-01

    The author's personal experience as a kidney cancer patient, researcher and founder of a kidney cancer support group forms the basis for consideration of the challenges involved in researching patients' experiences. The researcher needs to understand the variability of those experiences in both clinical and psychological-emotional terms, and in relation to the personal, familial and social contexts of the patient. It is also essential to define the purpose of the research and to show how an understanding of personal experiences of cancer can be used to enhance the quality of care for cancer patients. The research encounter with a patient is also in some respects a therapeutic encounter requiring a considerable degree of sensitivity on the part of the researcher. The person-centred approach of Carl Rogers is of value in supporting such an encounter.

  14. Supportive care needs of Iranian cancer patients

    Directory of Open Access Journals (Sweden)

    Azad Rahmani

    2014-01-01

    Full Text Available Background: A supportive needs assessment is an essential component of any care program. There is no research evidence regarding the supportive care needs of cancer patients in Iran or other Middle Eastern countries. Aims: The aim of this study was to determine the supportive care needs of Iranian cancer patients. Materials and Methods: This descriptive study was conducted in a referral medical center in the northwest of Iran. A total of 274 cancer patients completed the Supportive Care Needs Survey (SCNS-59. Descriptive statistics were used for data analysis. Results: In 18 items of the SCNS, more than 50% of the participants reported that their needs were unmet. Most frequently, unmet needs were related to the health system, information, physical, and daily living domains, and most met needs were related to sexuality, patient care, and support domains. Conclusions: Iranian cancer patients experience many unmet needs and there is an urgent need for establishing additional supportive care services in Iran.

  15. 131I therapy of thyroid cancer patients

    International Nuclear Information System (INIS)

    Reiners, C.; Farahati, J.

    1999-01-01

    Thyroid cancer is a rare malignancy with wide inter ethnic and geographic variations. In Germany thyroid carcinoma is the 13. most frequent malignancy (2.7 new cases yearly per 100,000 inhabitants). The overall temporal incidence is increasing slightly in recent years. The most common types of cancer are papillary (60-80%) and follicular cancers (10-20%). The relevant prognostic indicators are tumor stage and distant metastases. The mean survival rates in papillary thyroid cancer usually exceed 90%, whereas in follicular thyroid cancer they amount to approximately 80%. The standard treatment procedure in differentiated papillary and follicular thyroid cancer consists of total thyroidectomy followed by adjuvant ablative therapy with radioiodine. Only in papillary thyroid cancer stage pT 1 N 0 M 0 lobectomy alone is considered to be appropriate. In patients with locally invasive differentiated thyroid cancers stage pT 4 adjuvant percutaneous radiation therapy is a treatment option. Radioiodine therapy has to be performed under the stimulative influence of TSH. Usually TSH suppressive medication with Levothyroxine has to be withdrawn approximately 4 weeks prior to radioiodine therapy. In the future, exogenous stimulation by recombinant TSH may be used instead of thyroid hormone withdrawal. It has been proved by different studies that ablative radioiodine therapy reduces the frequency of recurrences and tumor spread in patients with thyroid cancer significantly. In patients with distant metastases, up to 50% of complete responses may be achieved with radioiodine treatment

  16. Cancer Patients' Informational Needs: Qualitative Content Analysis.

    Science.gov (United States)

    Heidari, Haydeh; Mardani-Hamooleh, Marjan

    2016-12-01

    Understanding the informational needs of cancer patients is a requirement to plan any educative care program for them. The aim of this study was to identify Iranian cancer patients' perceptions of informational needs. The study took a qualitative approach. Semi-structured interviews were held with 25 cancer patients in two teaching hospitals in Iran. Transcripts of the interviews underwent conventional content analysis, and categories were extracted. The results came under two main categories: disease-related informational needs and information needs related to daily life. Disease-related informational needs had two subcategories: obtaining information about the nature of disease and obtaining information about disease prognosis. Information needs related to daily life also had two subcategories: obtaining information about healthy lifestyle and obtaining information about regular activities of daily life. The findings provide deep understanding of cancer patients' informational needs in Iran.

  17. Cognitive Behavioral Therapy in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Cem Soylu

    2014-09-01

    Full Text Available Cognitive behavioral therapy is one of the structured but flexible psychosocial interventions that could be applied to patients with cancer. In many studies the positive effects of cognitive behavioral therapy in reducing psychological morbidity and improving the quality of life of cancer patients have been shown. In this article, the contents and techniques of adapted cognitive behavioral therapy for patients with cancer and its effectiveness in commonly seen psychiatric disorders have been reviewed. The aim of this article is to contribute positively to physicians and nurses in Turkey for early detection of psychological distress and referral to the therapist that would clearly increase the quality of life of cancer patients. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(3.000: 257-270

  18. 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...

  19. Posttraumatic growth in Iranian cancer patients

    OpenAIRE

    A Rahmani; R Mohammadian; C Ferguson; L Golizadeh; M Zirak; H Chavoshi

    2012-01-01

    Objectives: To investigate the level and determinants of posttraumatic growth in Iranian cancer patients. Materials and Methods: This descriptive-correlational design study was conducted within a university-affiliated oncology hospital in Iran. A convenience sample of 450 patients with a definitive diagnosis of cancer of any type completed a demographic questionnaire and a posttraumatic growth inventory. Some disease-related information was obtained from patients′ medical records. Results: Th...

  20. ESPEN guidelines on nutrition in cancer patients.

    Science.gov (United States)

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

    2017-02-01

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

  1. Statistical study on cancer patients of cancer research hospital

    International Nuclear Information System (INIS)

    Shim, Yoon Sang; Choi, Soo Yong; Won, Hyuk; Kim, Kee Hwa

    1991-01-01

    The total number of malignant neoplasms included on this study 7,787 cases(10.4%) among 74,928 cases for 2 years. On sex, females with 57.6% were much more than males with 42.4%. The highest proportion of cancer 50-59 age group. The most frequent primary site among males was found to be stomach with 36.2%, followed by liver(12.3%), lung(12.2%), esophagus(15.5%) and larynx(4.9%). In females, the first order was uterine cervix with 47.3%, followed most common type of morphology of malignant neoplasms was adenocarcinoma(39.0%) in males an squamous cell carcinoma(56.2%) in females. Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the extent of disease was 4.6% for patient with carcinoma-in-situ, 76.3% for patients with localized involvement, 11.6% for patients with regional involvement and 7.5% for patients with distant involvement. Among,the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 19.0% for surgery, 27.7 for radiotherapy and 24.2% for chemotherapy. Among the cancer patients confirmed by medical records, 11.2% was traced more than 5 years. (Author)

  2. Association between illness severity and timing of initial enteral feeding in critically ill patients: a retrospective observational study

    Directory of Open Access Journals (Sweden)

    Huang Hsiu-Hua

    2012-05-01

    Full Text Available Abstract Background Early enteral nutrition is recommended in cases of critical illness. It is unclear whether this recommendation is of most benefit to extremely ill patients. We aim to determine the association between illness severity and commencement of enteral feeding. Methods One hundred and eight critically ill patients were grouped as “less severe” and “more severe” for this cross-sectional, retrospective observational study. The cut off value was based on Acute Physiology and Chronic Health Evaluation II score 20. Patients who received enteral feeding within 48 h of medical intensive care unit (ICU admission were considered early feeding cases otherwise they were assessed as late feeding cases. Feeding complications (gastric retention/vomiting/diarrhea/gastrointestinal bleeding, length of ICU stay, length of hospital stay, ventilator-associated pneumonia, hospital mortality, nutritional intake, serum albumin, serum prealbumin, nitrogen balance (NB, and 24-h urinary urea nitrogen data were collected over 21 days. Results There were no differences in measured outcomes between early and late feedings for less severely ill patients. Among more severely ill patients, however, the early feeding group showed improved serum albumin (p = 0.036 and prealbumin (p = 0.014 but worsened NB (p = 0.01, more feeding complications (p = 0.005, and prolonged ICU stays (p = 0.005 compared to their late feeding counterparts. Conclusions There is a significant association between severity of illness and timing of enteral feeding initiation. In more severe illness, early feeding was associated with improved nutritional outcomes, while late feeding was associated with reduced feeding complications and length of ICU stay. However, the feeding complications of more severely ill early feeders can be handled without significantly affecting nutritional intake and there is no eventual difference in length of hospital stay or mortality

  3. Support needs of Chinese immigrant cancer patients.

    Science.gov (United States)

    Leng, Jennifer; Lee, Trevor; Li, Yanjun; Stern, Charles; Chen, Mei Hsuan; Winkel, Gary; Gany, Francesca

    2014-01-01

    To enable better psychosocial, informational, and practical support of Chinese patients with cancer, this study was conducted to identify the specific support needs of Chinese immigrant cancer patients. The Cancer Portal Project at Memorial Sloan-Kettering Cancer Center's Center for Immigrant Health and Cancer Disparities is a patient navigation program that assists underserved and minority cancer patients in obtaining social and economic assistance at ten New York City cancer clinics. This need assessment was conducted as part of the Portal Project. Sixty-four questions were added to the existing Portal Intake Form about the needs and preferences for Chinese-language support and survivorship services. Descriptive analysis was performed, as well as an exploratory principal component's factor analysis to determine if there were any patterns in the services and programs in which patients were interested. Ninety-six patients were approached for participation; 59 agreed to participate. Eighty-eight percent of participants were born in China. Ninety-seven percent preferred to speak Mandarin, Cantonese, or Fujianese in the healthcare setting. When asked about general interest in support programs, 53 % of the participants were "very interested," 27 % were "maybe interested," and 17 % were "not interested." Programs in which more participants were "very interested" included those that would provide information about obtaining financial assistance (79 %) and social assistance (74 %), information on treatment options (67 %), help in coping with the burden of illness on the family (65 %), and information about general healthcare (63 %). The factor analysis resulted in the identification of five factors: social/financial/treatment and care issues, nutrition and exercise/networking/general health care, coping with fear and stress, herbs and dietary supplements, and acupuncture and acupressure. In this study, 80 % of the participants expressed interest in programs tailored for

  4. Hyperthyroidism in patients with thyroid cancer.

    Science.gov (United States)

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

    2016-06-01

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

  5. Radiation therapy in aged lung cancer patients

    International Nuclear Information System (INIS)

    Ohtake, Eiji; Tobari, Chitose; Matsui, Kengo; Iio, Masahiro.

    1982-01-01

    The results and problems of radiotherapy were analyzed in 57 lung cancer patients more than 65 years of age (average age: 74.8 years). Of these, 45 (79%) were irradiated with a total dose exceeding 40 Gy. In these patients, the median survival was 13 months for Stages I and II, 6.5 months for Stage III, and 5 months for Stage IV. The results of combined radiotherapy and chemotherapy were better than those of radiotherapy alone. Also, slightly better results were obtained in patients treated with split-course than continuous-course irradiation. In aged lung cancer patients the prognosis was highly influenced by their respiratory function. Double cancers were present in 9 (16%) of the 57 patients. (author)

  6. Skin cancer in patients with psoriasis

    DEFF Research Database (Denmark)

    Egeberg, A; Thyssen, Jacob Pontoppidan; Gislason, G. H.

    2016-01-01

    Background: Psoriasis is a chronic inflammatory skin disease that is commonly treated with ultraviolet phototherapy and systemic immunosuppressant drugs, which may confer a risk of skin cancer. Previous studies on the risk of skin cancer in patients with psoriasis have shown conflicting results....... Objectives: We investigated the risk of new-onset melanoma and non-melanoma skin cancer (NMSC), respectively, in a large cohort of patients with psoriasis and psoriatic arthritis. Methods: Data on all Danish individuals aged ≥18 years between 1 January 1997 and 31 December 2012 were linked at individual...... of skin cancer is only modestly increased in patients with psoriasis, clinicians should remain vigilant. © 2016 European Academy of Dermatology and Venereology...

  7. Melanosis coli in patients with colon cancer

    Directory of Open Access Journals (Sweden)

    Dorota Biernacka-Wawrzonek

    2016-12-01

    Full Text Available Intoduction: Melanosis coli is a benign lesion affecting the mucosa of the large intestine. There is a relationship between the presence of melanosis and anthraquinone laxative use. Melanosis coli is also observed in patients with colon cancer, but there is doubt whether these two conditions are related. Aim : To analyze the correlation between melanosis and colon cancer. Material and methods: We analyzed retrospectively 436 patients undergoing colon cancer surgery. There were 246 women and 190 men. Patients were divided into three age groups: under 50 years, between 51 and 65 years, and over 66 years. We analyzed sections of the cancer and intestinal mucosa from the tumor’s proximal (2–5 cm and distal (8–10 cm zone. Results : Melanosis coli was present in 52 patients, which represents 11.9% of patients with colon cancer. More often it was present in women. The most common location of melanosis and colon cancer was the terminal part of the large intestine. In patients below 50 years of age in both sexes melanosis coli did not occur. In men, melanosis was more common in the age group over 66 years. Intensity of pigmentation was higher in the tumor’s distal zone. Conclusions : The incidence of melanosis coli increases with age, similar to that of colon cancer. Melanosis was not present inside tumors, in almost half of the cases it was not present in the proximal zone, and the degree of pigmentation increased in distal zone. The cause-effect relationship between melanosis coli and colon cancer remains uncertain.

  8. Clinical Characteristics of Patients with Sporadic Colorectal Cancer and Primary Cancers of Other Organs

    Directory of Open Access Journals (Sweden)

    Jung-Yu Kan

    2006-11-01

    Full Text Available Most cancer patients often neglect the possibility of secondary cancer. Colorectal cancer (CRC is the third leading cause of cancer death in Taiwan. It is important to be aware of the clinical characteristics of double cancer in CRC patients for early diagnosis and treatment. We retrospectively analyzed 1,031 CRC patients who underwent surgical treatment at the Department of Surgery of Kaohsiung Medical University Hospital between January 1998 and December 2004. Among these patients, CRC was accompanied by cancer of other organs in 17 patients (1.65%, either synchronously or metachronously. Therefore, we describe our experience regarding the location of CRC, the clinical symptoms and signs of these patients, the TNM stage, histology, phase, association with other malignancies, interval between cancers and clinical outcomes. Of the 17 patients in whom CRC was accompanied by primary cancer of other organs, there were four synchronous and 13 metachronous multiple cancer patients. Our patient group comprised six men and 11 women with ages ranging from 47 to 88 years (median age, 66 years. The most common location of CRC was the sigmoid colon. Six gastric cancers (35.2% and six breast cancers (35.2% were associated with primary CRC. The remaining six second primary cancers were one lung cancer, one thyroid cancer, one cervical cancer, one ovarian cancer, one skin cancer, and one urinary bladder cancer. Of the 13 metachronous multiple cancer patients, eight patients developed subsequent CRC after primary cancers of other organs, whereas two patients developed a subsequent second primary cancer after CRC. The intervals between the development of metachronous multiple cancers ranged from 2 to 19 years. In this retrospective analysis, breast and gastric cancer patients were at increased risk of developing subsequent secondary CRC. Careful attention should always be paid to the possibility of secondary CRC in treating these cancer patients. Cancer

  9. Haemorheological changes in cancer patients on chemotherapy

    International Nuclear Information System (INIS)

    Omoti, C.E.; Osime, E.

    2007-01-01

    To assess the rheological changes in haematological and non-haematological cancer patients pre and post chemotherapy. It is a prospective study of 50 patients comprising 16(32%) haematological and 34(68%) non-haematological cancers of various types from March to December 2005 at University of Benin Teaching Hospital, Nigeria. Rheologic parameters estimated by the various specific diagnostic methods were determined in cancer patient's pre and post chemotherapy. The rheological tests estimated were relative plasma viscosity (RPV) measured by means of a capillary viscometer, whole blood viscosity (WBV), erythrocyte sedimentation rate (ESR) and plasma fibrinogen concentration (PFC) estimated by the Ingram's Clot weight method. The RPV in pre chemotherapy (p=0.006) and WBV in post chemotherapy (p=0.0231) patients measured revealed a significant difference when compared to controls. The fibrinogen concentration (P<0.0001) and ESR values (P<0.0001) were significantly increased in cancer patients when compared to controls. We conclude that total reduction of hyperviscosity and hyperfibrinogenaemia may contribute to effective treatment strategies in cancer patients. (author)

  10. Posttraumatic growth in Iranian cancer patients.

    Science.gov (United States)

    Rahmani, A; Mohammadian, R; Ferguson, C; Golizadeh, L; Zirak, M; Chavoshi, H

    2012-01-01

    To investigate the level and determinants of posttraumatic growth in Iranian cancer patients. This descriptive-correlational design study was conducted within a university-affiliated oncology hospital in Iran. A convenience sample of 450 patients with a definitive diagnosis of cancer of any type completed a demographic questionnaire and a posttraumatic growth inventory. Some disease-related information was obtained from patients' medical records. The mean of posttraumatic growth reported by participants was 76.1. There was a statistically significant association between experience of posttraumatic growth and age (r = - 0.21, P=0.001), education at university level (F = 8.9, P=0.001) and history of treatment by radiotherapy (t = 2.1, P=0.03). The findings of this study suggest that Iranian cancer patients experience a moderate to high level of posttraumatic growth and confirm the hypothesis that the level of posttraumatic growth in non-Western cancer patients is more than that of Western cancer patients. Although, assessing the reasons for this difference needs more investigations.

  11. Fertility preservation in young cancer patients

    Directory of Open Access Journals (Sweden)

    Ariel Revel

    2010-01-01

    Full Text Available As a result of advances in treatment, almost 80% of children and adolescents who receive a diagnosis of cancer become long-term survivors. The increased survival rate of children and adolescents with cancer has resulted in a major interest in the long-term effects of cancer treatment on the possibility for future fertility. Currently established methods for the preservation of fertility are available only for pubertal males and females. Pubertal male cancer patients should be encouraged to freeze numerous sperm samples even when sperm count and motility are poor. In these cases, intracytoplasmic sperm injection is a powerful technique compared with intrauterine insemination since thawed sperm samples with poor parameters can produce relatively high fertilization rates resulting in normal pregnancies and deliveries. Married pubertal women should be proposed ovulation induction, follicular aspiration, and fertilization with husband sperm. Single women could benefit from vitrification of oocytes. This requires a delay of about 3 weeks in the commencement of chemotherapy to enable follicular growth. Fertility preservation for prepubertal patients is more of a problem. Young girls could be offered cryopreservation of gametes in the gonadal tissue. Cryopreservation of testicular tissue was suggested for fertility preservation for young boys, but this method is totally experimental and not currently offered. Discussing future fertility is part of the consultation of young female and male patients facing potentially gonadotoxic cancer therapy. It is the role of reproductive specialists to create various options in their laboratory to preserve fertility potential of cancer patients.

  12. Symptom attributions in patients with colorectal cancer

    DEFF Research Database (Denmark)

    Jensen, Line Flytkjær; Hvidberg, Line; Pedersen, Anette Fischer

    2015-01-01

    Størstedelen af kolorektal cancere opdages gennem patienters symptomatiske henvendelse i almen praksis. Man ved dog ikke meget om, hvordan patienter selv oplever deres symptomer. Formålet med studiet var, at undersøge om symptom attributioner er associeret med hvilket symptom man oplevede før...

  13. Multidisciplinary approach for patients with esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Victoria M Villaflor; Marco E Allaix; Bruce Minsky; Fernando A Herbella; Marco G Patti

    2012-01-01

    Patients with esophageal cancer have a poor prognosis because they often have no symptoms until their disease is advanced.There are no screening recommendations for patients unless they have Barrett's esophagitis or a significant family history of this disease.Often,esophageal cancer is not diagnosed until patients present with dysphagia,odynophagia,anemia or weight loss.When symptoms occur,the stage is often stage Ⅲ or greater.Treatment of patients with very early stage disease is fairly straight forward using only local treatment with surgical resection or endoscopic mucosal resection.The treatment of patients who have locally advanced esophageal cancer is more complex and controversial.Despite multiple trials,treatment recommendations are still unclear due to conflicting data.Sadly,much of our data is difficult to interpret due to many of the trials done have included very heterogeneous groups of patients both histologically as well as anatomically.Additionally,studies have been underpowered or stopped early due to poor accrual.In the United States,concurrent chemoradiotherapy prior to surgical resection has been accepted by many as standard of care in the locally advanced patient.Patients who have metastatic disease are treated palliatively.The aim of this article is to describe the multidisciplinary approach used by an established team at a single high volume center for esophageal cancer,and to review the literature which guides our treatment recommendations.

  14. Depression and Resilience in Breast Cancer Patients

    Directory of Open Access Journals (Sweden)

    Gordana Ristevska-Dimitrоvska

    2015-11-01

    CONCLUSION: This study shows that patients who are less depressed have higher levels of resilience and that psychological resilience may independently contribute to lower levels of depression among breast cancer patients. The level of psychological resilience may be a protective factor for depression and psychological distress.

  15. Active listening to cancer patients' stories.

    Science.gov (United States)

    ten Kroode, H F

    1998-08-01

    Approximately two thirds of all Dutch cancer patients have severe emotional problems; shortly after their change from the treatment regime into the regime of medical controls. Half of them even need professional support. It is, therefore, important that a professional listens with empathy to the patient's version of the illness story. Story telling helps to overcome the existential crisis of being a cancer patient; it is an essential step in the revalidation process. Themes and open questions which structure the communication are suggested in this article.

  16. Intersectionality and the LGBT Cancer Patient.

    Science.gov (United States)

    Damaskos, Penny; Amaya, Beau; Gordon, RuthAnn; Walters, Chasity Burrows

    2018-02-01

    To present the ways in which race, ethnicity, class, gender, and sexual orientation interact in the context of cancer risk, access to care, and treatment by health care providers. Cancer risk factors, access to care, and treatment for lesbian, gay, bisexual, and transgender (LGBT) patients are discussed within the context of intersectionality and cultural humility. Peer reviewed articles, cancer organizations, and clinical practice. LGBT patients have multiple identities that intersect to create unique experiences. These experiences shape their interactions with the health care system with the potential for positive or negative consequences. More data is needed to describe the outcomes of those experiences and inform clinical practice. Oncology nurses have an obligation to acknowledge patients' multiple identities and use the practice of cultural humility to provide individualized, patient-centered care. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Understanding taste dysfunction in patients with cancer.

    Science.gov (United States)

    McLaughlin, Laura; Mahon, Suzanne M

    2012-04-01

    Taste dysfunction is a significant but underestimated issue for patients with cancer. Impaired taste results in changes in diet and appetite, early satiety, and impaired social interactions. Nurses can play a key role in educating patients and families on the pathophysiology of taste dysfunction by suggesting interventions to treat the consequences of taste dysfunction, when available, and offering psychosocial support as patients cope with this often devastating consequence of treatment. Taste recognition helps humans identify the nutritional quality of food and signals the digestive tract to begin secreting enzymes. Spoiled or tainted foods typically are recognized by their bad taste. Along with the other sensory systems, taste is crucial for helping patients treated for cancer feel normal. This article will review the anatomy and physiology of taste; define the different types of taste dysfunction, including the underlying pathophysiologic basis related to cancer treatment; and discuss potential nursing interventions to manage the consequences of taste dysfunction.

  18. Statistical study on cancer patients of Korea cancer centre hospital

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Soo Yong; Kim, Kee Hwa; Mok, Kang Sung [Korea Cancer Center Hospital of Korea Atomic Energy Research Institute, Seoul (Korea, Republic of)

    1994-12-01

    The total number of malignant neoplasms included in this study 53,566 cases(14.1%) among 379,582 patients from 1984 to 1993. On sex, females with 51.3% were much more than males with 48.7%. The highest proportion of cancer patients by age was 35.0% in males and 28.4% in females, respectively for 50-59 age group. The most frequent primary site among males was found to be stomach with 33.2%, followed by liver(15.1%), lung(14.9%), esophagus(5.3%) and larynx(3.3%). In females, the first order was uterine cervix with 37.8%, followed by stomach(16.5%), breast(14.8%), thyroid gland(4.3%) and lung (3.8%). The proportion of malignant neoplasms diagnosed by histology made up 67.0%, whereas 20.2% was diagnosed by clinical investigation(X-ray, CT, MRI etc). Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the extent of disease was 3.7% for patient with carcinoma-in-situ, 58.7% for patients with localized involvement, 18.4% for patients with regional involvement and 11.1% for patients with distant involvement. Among the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 27.5% for surgery, 22.5% for radiotherapy and 30.1% for chemotherapy. The proportion of cancer patients traced to death was only to 3.6%, 1,944 cases. Among them, 72.5% survived for less than 1 year. 17 figs, 7 tabs, 28 refs. (Author).

  19. Statistical study on cancer patients of Korea cancer centre hospital

    International Nuclear Information System (INIS)

    Choi, Soo Yong; Kim, Kee Hwa; Kang Sung Mok

    1994-12-01

    The total number of malignant neoplasms included in this study 53,566 cases(14.1%) among 379,582 patients from 1984 to 1993. On sex, females with 51.3% were much more than males with 48.7%. The highest proportion of cancer patients by age was 35.0% in males and 28.4% in females, respectively for 50-59 age group. The most frequent primary site among males was found to be stomach with 33.2%, followed by liver(15.1%), lung(14.9%), esophagus(5.3%) and larynx(3.3%). In females, the first order was uterine cervix with 37.8%, followed by stomach(16.5%), breast(14.8%), thyroid gland(4.3%) and lung (3.8%). The proportion of malignant neoplasms diagnosed by histology made up 67.0%, whereas 20.2% was diagnosed by clinical investigation(X-ray, CT, MRI etc). Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the extent of disease was 3.7% for patient with carcinoma-in-situ, 58.7% for patients with localized involvement, 18.4% for patients with regional involvement and 11.1% for patients with distant involvement. Among the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 27.5% for surgery, 22.5% for radiotherapy and 30.1% for chemotherapy. The proportion of cancer patients traced to death was only to 3.6%, 1,944 cases. Among them, 72.5% survived for less than 1 year. 17 figs, 7 tabs, 28 refs. (Author)

  20. PET/MRI in cancer patients

    DEFF Research Database (Denmark)

    Kjær, Andreas; Loft, Annika; Law, Ian

    2013-01-01

    Combined PET/MRI systems are now commercially available and are expected to change the medical imaging field by providing combined anato-metabolic image information. We believe this will be of particular relevance in imaging of cancer patients. At the Department of Clinical Physiology, Nuclear...... described include brain tumors, pediatric oncology as well as lung, abdominal and pelvic cancer. In general the cases show that PET/MRI performs well in all these types of cancer when compared to PET/CT. However, future large-scale clinical studies are needed to establish when to use PET/MRI. We envision...... that PET/MRI in oncology will prove to become a valuable addition to PET/CT in diagnosing, tailoring and monitoring cancer therapy in selected patient populations....

  1. Eating difficulties and parental feeding strategies during and after childhood cancer treatment: The experiences of parents. : A systematic literature review.

    OpenAIRE

    Philippe, Kaat

    2017-01-01

    Childhood cancer is a life-threatening disease with a profound impact on the family. Treatment side-effects and accompanied dietary difficulties are for example severe stressors, as appropriate nutrition is important for the treatment success and quality of life. In addition, (unhealthy) dietary patterns established in childhood tend to maintain in survivors. Parents are key players in feeding and establishing these pat-terns, though, systematic research on how parents experience these dietar...

  2. Volume of hydration in terminal cancer patients.

    Science.gov (United States)

    Bruera, E; Belzile, M; Watanabe, S; Fainsinger, R L

    1996-03-01

    In this retrospective study we reviewed the volume and modality of hydration of consecutive series of terminal cancer patients in two different settings. In a palliative care unit 203/290 admitted patients received subcutaneous hydration for 12 +/- 8 days at a daily volume of 1015 +/- 135 ml/day. At the cancer center, 30 consecutive similar patients received intravenous hydration for 11.5 +/- 5 days (P > 0.2) but at a daily volume of 2080 +/- 720 ml/day (P palliative care unit patients required discontinuation of hydration because of complications. Hypodermoclysis was administered mainly as a continuous infusion, an overnight infusion, or in one to three 1-h boluses in 62 (31%), 98 (48%) and 43 (21%) patients, respectively. Our findings suggest that, in some settings, patients may be receiving excessive volumes of hydration by less comfortable routes such as the intravenous route. Increased education and research in this area are badly needed.

  3. Patient-initiated breast cancer screening

    International Nuclear Information System (INIS)

    Chilcote, W.

    1990-01-01

    This paper reviews the results of a breast cancer screening program sponsored by organizations at workplace or community locations. A comprehensive mobile breast cancer screening program, including education, breast physical examination, and mammography, was provided to 89 local organizations at $50.00 per examination over an 18-month period. The examination was patient initiated, following the ACS screening guidelines. Estimates of eligible women were provided by each organization. A total of 5,030 women at 89 organizations were screened for breast cancer. Approximately 25,727 women were eligible

  4. Statistical study on cancer patients of cancer research hospital

    International Nuclear Information System (INIS)

    Shim, Yun Sang; Choi, Soo Yong; Kim, Ki Wha; Kang, Sung Mok

    1993-01-01

    The total number of malignant neoplasms included in this study 15,737 cases(11.8%) among 133,251 cases for 3 years. On sex, females with 52.9% were much more than males with 47.1%. The highest proportion of cancer patients by age was 33.7% in males and 28.5% in females, respectivelty for 50-59 age group. The most frequent primary site among males was found to be stomach with 35.5%, followed by liver(14.7%), lung(13.0%), esophagus(5.4%) and colon (3.2%). In females, the first order was uterine cervix with 40.6%, followed by stomach(17.2%), breast(14.4), rectum(3.7%) and lung(3.4%). The most common type of morphology of malignant neoplasms was adenocarcinoma(47.4%) in males an squamous cell carcinoma(58.0%) in females. Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the exent of disease was 2.5% for patient with carcinoma-in-situ, 54.1% for patients with localized involvement, 13.3% for patients with regional involvement and 8.5% for patients with distant involvement. Among the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 23.6% for surgery, 25.3% for radiotherapy and 30.3% for chemotherapy. Among the cancer patients confirmed by medical records, 7.7% was traced more than 5 years. (Author)

  5. Prophylaxis against radiation injury. The use of elemental diet prior to and during radiotherapy for invasive bladder cancer and in early postoperative feeding following radical cystectomy and ileal conduit

    International Nuclear Information System (INIS)

    McArdle, A.H.; Reid, E.C.; Laplante, M.P.; Freeman, C.R.

    1986-01-01

    Previous studies done in animals have shown that significant prophylaxis against radiation injury could be afforded by feeding an elemental diet (ED) for three days before and during radiation. In the present study 20 patients were fed an ED for three days before and for the four days during radiotherapy (five fractions of 400 rad [4 Gy] each) prior to radical cystectomy and ileal conduit for invasive bladder cancer; ED feeding was recommenced 24 hours postoperatively via a feeding jejunostomy. The ED-fed patients exhibited positive nitrogen balance preoperatively and had an early return to positive nitrogen balance postoperatively (3.60 +/- 0.32 days). There was also prompt return of bowel sounds (3.00 +/- 0.32 days). Histologically and ultrastructurally, biopsy specimens of the ileal mucosa showed normal morphologic findings, with maintenance of normal levels of enzyme activity in the brush border. Severe or bloody diarrhea was absent in these patients. These data suggest that ED feeding provides prophylaxis against the acute phase of radiation injury in patients undergoing high-dose, short-course radiotherapy for invasive bladder cancer and that it is a safe and feasible means of postoperative nutritional support, even in the presence of a fresh bowel anastomosis

  6. Clinical implications of malnutrition in childhood cancer patients--infections and mortality.

    Science.gov (United States)

    Loeffen, E A H; Brinksma, A; Miedema, K G E; de Bock, G H; Tissing, W J E

    2015-01-01

    In childhood cancer patients, malnutrition has been proposed to increase infection rates and reduce survival. We investigated whether malnutrition at diagnosis and during treatment and weight loss during treatment are prognostic factors for infection rates and survival, within a heterogeneous childhood cancer population. From two previous studies, all children ≤18 years of age diagnosed with cancer between October 2004 and October 2011 were included in this study. Data regarding BMI, infections, and survival were retrieved. Patients with a BMI z-score lower than -2.0 were classified as malnourished. Weight loss more than 5% was considered relevant. Two hundred sixty-nine childhood cancer patients were included in this study. At diagnosis, 5.2% of all patients were malnourished. These patients showed worse survival than those who were well nourished (hazard ratio (HR) = 3.63, 95% confidence interval (CI) = 1.52-8.70, p = 0.004). Malnourishment at 3 months after diagnosis (3.3% of all patients) also showed worse survival (HR = 6.34, 95% CI = 2.42-16.65, p childhood cancer patients. In addition, we found for the first time that weight loss during treatment is associated with increased presence of febrile neutropenic episodes with bacteremia. This underlines the importance of optimal feeding designs in childhood cancer patients.

  7. [Psychosocial problems and needs among cancer patients].

    Science.gov (United States)

    Mehlsen, Mimi Yung; Jensen, Anders Bonde; Zachariae, Bobby

    2007-04-30

    Cancer can have a serious impact on patient well-being and quality of life. The international literature reports a higher prevalence of psychosocial problems among cancer patients; primarily problems associated with difficulties in the family, duties in the household, work and leisure, sexuality and finances. The prevalence of these problems among Danish cancer patients is still unknown. A questionnaire assessing psychosocial problems and needs was mailed out to all patients who had been at the Department of Oncology, Aarhus Hospital in week 35, 2004. A total of 71%, i.e. 515 patients (34% men and 66% women) in active treatment and control returned the questionnaire. High levels of emotional distress were reported by 39% of the patients. High levels of distress were primarily related to problems with worries about their spouses, household duties, financial problems and experiences of insufficient collaboration between health care and social services. Between 19% and 25% of the patients required further help to handle emotional problems, legal and financial problems and practical problems in the home. A considerable proportion of oncology patients experience significant levels of distress. This group of distressed patients also report unmet needs for psychosocial support.

  8. Scoring irradiation mucositis in head and neck cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Spijkervet, F.K.L.; Panders, A.K. (Departments of Oral and Maxillofacial Surgery, University Hospital Groningen (Netherlands)); Saene, H.K.F. van (Medical Microbiology, University of Liverpool (UK)); Vermey, A. (Department of Surgery Oncology Division, University Hospital Groningen (Netherlands)); Mehta, D.M. (Department of Radiotherapy, University Hospital Groningen (Netherlands))

    1989-01-01

    Irradiation mucositis is defined as an inflammatory-like process of the oropharyngeal mucosa following therapeutic irradiation of patients who have head and neck cancer. Clinically, it is a serious side effect because severe mucositis can cause generalized problems (weight loss, nasogastic tube feedings) and interferes with the well-being of the patient seriously. Grading mucositis is important for the evaluation of preventive and therapeutic measures. The object of this study was to develop a scoring method based on local mucositis signs only. Four clinical local signs of mucositis were used in this score: white discoloration, erythema, pseudomembranes and ulceration. Mucositis of the oral cavity was calcualted during conventional irradiation protocol for 8 distinguishable areas using the 4 signs and their extent. A prospective evaluation of this method in 15 irradiated head and neck cancer patients displayed an S-curve reflecting a symptomless first irradiation week, followed by a rapid and steady increase of white discoloration, erythema and pseudomembranes during the second and third week. Oral candidiasis, generalized symptoms such as weight loss and the highest mucositis scores were seen after 3 weeks irradiation. The novel mucositis scoring method may be of value in studying the effect of hygiene programs, topical application of disinfectans or antibiotics on oral mucositis. (author).

  9. Scoring irradiation mucositis in head and neck cancer patients

    International Nuclear Information System (INIS)

    Spijkervet, F.K.L.; Panders, A.K.; Saene, H.K.F. van; Vermey, A.; Mehta, D.M.

    1989-01-01

    Irradiation mucositis is defined as an inflammatory-like process of the oropharyngeal mucosa following therapeutic irradiation of patients who have head and neck cancer. Clinically, it is a serious side effect because severe mucositis can cause generalized problems (weight loss, nasogastic tube feedings) and interferes with the well-being of the patient seriously. Grading mucositis is important for the evaluation of preventive and therapeutic measures. The object of this study was to develop a scoring method based on local mucositis signs only. Four clinical local signs of mucositis were used in this score: white discoloration, erythema, pseudomembranes and ulceration. Mucositis of the oral cavity was calcualted during conventional irradiation protocol for 8 distinguishable areas using the 4 signs and their extent. A prospective evaluation of this method in 15 irradiated head and neck cancer patients displayed an S-curve reflecting a symptomless first irradiation week, followed by a rapid and steady increase of white discoloration, erythema and pseudomembranes during the second and third week. Oral candidiasis, generalized symptoms such as weight loss and the highest mucositis scores were seen after 3 weeks irradiation. The novel mucositis scoring method may be of value in studying the effect of hygiene programs, topical application of disinfectans or antibiotics on oral mucositis. (author)

  10. Thyroid cancer in patients with hyperthyroidism

    International Nuclear Information System (INIS)

    Kabir, M.F.; Nahar, N.; Haque, F.S.; Alam, F.; Hasan, M.

    2007-01-01

    Full text: The coexistence of hyperthyroidism and thyroid cancer is a rare event. The aim of this study was to evaluate the relevance of the association of hyperthyroidism and thyroid cancer. Method: From 1st January 2006 to 31st December 2006, a total of 388 new hyperthyroid patients attended the Institute of Nuclear Medicine and Ultrasound for radioiodine therapy. Eighty-two of them were selected before radioiodine therapy, on the basis of findings on palpation and ultrasound (USG) examination, to undergo fine needle aspiration cytology (FNAC) for cytological diagnosis. USG examination was performed to localize and mark the position of nodule/nodules for FNAC and, in cases of nonpalpable nodules, USG guided FNAC was done. In the case of non-nodular patients, guided FNAC was done in sonographically suspicious areas. Results: FNAC report was positive for thyroid cancer in 4 patients. Histopathology examination revealed the presence of papillary carcinoma. Among the four positive cases, one had multi-nodular goitre, two had uni-nodular goiters and one had no nodule. Another patient had a negative FNAC report but due to a huge goiter, the patient underwent surgery and histopathology revealed the presence of papillary carcinoma. Conclusion: Although the occurrence of thyroid cancer in hyperthyroid patients is rare, the presence of a nodule should be carefully evaluated to exclude the presence of concurrent malignancy. FNAC (USG guided in case of non-palpable nodules) is found helpful before radioiodine therapy or surgery. (author)

  11. Nutritional support for malnourished patients with cancer.

    Science.gov (United States)

    Baldwin, Christine

    2011-03-01

    Cancer and its treatments frequently have a negative impact on the weight and nutritional status of patients. Weight loss is associated with reduced survival and poorer outcomes of treatment but is not well characterized and frequently confused with cachexia, which may complicate the interpretation of studies of nutritional support. The aims of this review were to examine the impact of cancer on nutritional status and to review the role of simple oral nutritional interventions and novel agents. The terms weight loss, malnutrition and cachexia refer to different entities and new definitions have recently been proposed that take account of the role of the underlying inflammatory processes. Oral nutritional interventions are widely recommended for malnourished cancer patients, but the evidence for their benefits to clinical, nutritional and patient-centred outcomes is limited. Meta-analysis has highlighted the variability in response to simple nutritional interventions of different cohorts of cancer patients and suggested that improvements in nutritional endpoints and aspects of quality of life may be achieved in some patients. Recent research has largely focused on treatments aiming to modulate the inflammatory processes associated with cachexia, but to date has not identified a single treatment with clear efficacy. Studies characterizing the potential for nutritional support in combination with anti-inflammatory agents in defined patient groups are defined to advance the evidence base in this area.

  12. Comparison of intraoperative versus delayed enteral feeding tube placement in patients undergoing a Whipple procedure.

    Science.gov (United States)

    Scaife, Courtney L; Hewitt, Kelly C; Mone, Mary C; Hansen, Heidi J; Nelson, Edward T; Mulvihill, Sean J

    2014-01-01

    The intraoperative placement of an enteral feeding tube (FT) during pancreaticoduodenectomy (PD) is based on the surgeon's perception of need for postoperative nutrition. Published preoperative risk factors predicting postoperative morbidity may be used to predict FT need and associated intraoperative placement. A retrospective review of patients who underwent PD during 2005-2011 was performed by querying the National Surgical Quality Improvement Program (NSQIP) database with specific procedure codes. Patients were categorized based on how many of 10 possible preoperative risk factors they demonstrated. Groups of patients with scores of ≤ 1 (low) and ≥ 2 (high), respectively, were compared for FT need, length of stay (LoS) and organ space surgical site infections (SSIs). Of 138 PD patients, 82 did not have an FT placed intraoperatively, and, of those, 16 (19.5%) required delayed FT placement. High-risk patients were more likely to require a delayed FT (29.3%) compared with low-risk patients (9.8%) (P = 0.026). The 16 patients who required a delayed FT had a median LoS of 15.5 days, whereas the 66 patients who did not require an FT had a median LoS of 8 days (P < 0.001). In this analysis, subjects considered as high-risk patients were more likely to require an FT than low-risk patients. Assessment of preoperative risk factors may improve decision making for selective intraoperative FT placement. © 2013 International Hepato-Pancreato-Biliary Association.

  13. COPING STRATEGIES IN PATIENTS WITH PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    J. R. Gardanova

    2015-01-01

    Full Text Available Diagnostics of psycho-emotional disorders of patients with malignant diseases of the prostate is not doubt, because timely correction contributes to the shortening of rehabilitation period and restoration of the quality of life of patients after treatment. Detection and diagnosis of prostate cancer for many patients is stressful and causes changes in the affective sphere, and manifests itself in increased levels of anxiety and depression in men. To cope with stress is possible due to the used coping strategies.Purpose. Studying the coping mechanisms in prostate cancer patients.Materials and methods. 56 men treated in FGBU "LRTS" Russian Ministry of Health. The average age was 65.7 ± 6.1 years. The average duration of the disease prostate cancer is 3 ± 2 months. All men were subjected to the standard algorithm for the evaluation of hormonal status, the PSA, taking a history, inspection and physical examination, magnetic resonance imaging and scintigraphy of bones of a skeleton. All the patients underwent laparoscopic radical prostatectomy. Psychological testing with the use of the method of "Coping test" the scale of reactive and personal anxiety for the differentiated evaluation of anxiety. Results. The most common for prostate cancer revealed constructive coping strategies are "planning solve", "selfcontrol" and "search of social support". According to the scale Spielberg–Hanin a high level of situational anxiety was revealed.Conclusion. According to the results of the research, patients with prostate cancer are likely to use constructive coping strategies, that leads to stabilization of psycho-emotional state of men and promotes more effective adaptation in the terms of stress, that is caused by treatment of prostate cancer.

  14. Variations of blood glucose in cancer patients during chemotherapy

    African Journals Online (AJOL)

    2016-05-23

    May 23, 2016 ... Purpose: The aim of this study was to analyze the blood glucose (BG) variations in cancer patients .... cancer, brain tumor, cervical cancer, and leukemia were the ... excess glucose supply for these glucose‑hungry cells and it.

  15. Depression Screening and Patient Outcomes in Cancer : A Systematic Review

    NARCIS (Netherlands)

    Meijer, Anna; Roseman, Michelle; Milette, Katherine; Coyne, James C.; Stefanek, Michael E.; Ziegelstein, Roy C.; Arthurs, Erin; Leavens, Allison; Palmer, Steven C.; Stewart, Donna E.; de Jonge, Peter; Thombs, Brett D.

    2011-01-01

    Background: Several practice guidelines recommend screening for depression in cancer care, but no systematic reviews have examined whether there is evidence that depression screening benefits cancer patients. The objective was to evaluate the potential benefits of depression screening in cancer

  16. EXPRESSING DISTRESS IN PATIENTS WITH ADVANCED CANCER

    Directory of Open Access Journals (Sweden)

    Maura Gabriela FELEA

    2014-11-01

    Full Text Available Negative emotions (distress are recognized as part of the psychological profile of patients diagnosed with advanced stage cancer. However, most patients are not accustomed to verbalize feelings towards their physician, and generally towards family and medical care personnel. The purpose of this paper is to analyze the expression of emotions by patients in advanced stages of cancer, respectively the means by which they get to express emotions. To this respect, we identified the most common types of emotions expressed, or metaphors used by patients to describe their emotions and topics that trigger emotions. Words and phrases most commonly used are in relation to: fear, anxiety, depression, guilt, negligence, concern. They are uttered in order to depict the network created between disclosed emotions and topics on health status, symptoms, adverse effects and therapeutic choice, patient privacy, and social and family issues.

  17. Nutritional Care of Gastric Cancer Patients with Clinical Outcomes and Complications: A Review.

    Science.gov (United States)

    Choi, Wook Jin; Kim, Jeongseon

    2016-04-01

    The incidence and mortality of gastric cancer have been steadily decreased over the past few decades. However, gastric cancer is still one of the leading causes of cancer deaths across many regions of the world, particularly in Asian countries. In previous studies, nutrition has been considered one of significant risk factors in gastric cancer patients. Especially, malnourished patients are at greater risk of adverse clinical outcomes (e.g., longer hospital stay) and higher incidence of complications (e.g., wound/infectious complications) compared to well-nourished patients. Malnutrition is commonly found in advanced gastric cancer patients due to poor absorption of essential nutrients after surgery. Therefore, nutritional support protocols, such as early oral and enternal feeding, have been proposed in many studies, to improve unfavorable clinical outcomes and to reduce complications due to delayed application of oral nutritional support or parental feeding. Also, the supplied with enternal immune-enriched diet had more benefits in improving clinical outcomes and fewer complications compared to a group supplied with control formula. Using nutritional screening tools, such as nutritional risk index (NRI) and nutritional risk screening (NRS 2002), malnourished patients showed higher incidence of complications and lower survival rates than non-malnourished patients. However, a long-term nutritional intervention, such as nutritional counseling, was not effective in the patients. Therefore, early assessment of nutritional status in patients using a proper nutritional screening tool is suggested to prevent malnutrition and adverse health outcomes. Further studies with numerous ethnic groups may provide stronger scientific evidences in association between nutritional care and recovery from surgery in patients with gastric cancer.

  18. Patient representatives? views on patient information in clinical cancer trials

    OpenAIRE

    Dellson, Pia; Nilbert, Mef; Carlsson, Christina

    2016-01-01

    Background Patient enrolment into clinical trials is based on oral information and informed consent, which includes an information sheet and a consent certificate. The written information should be complete, but at the same time risks being so complex that it may be questioned if a fully informed consent is possible to provide. We explored patient representatives? views and perceptions on the written trial information used in clinical cancer trials. Methods Written patient information leaflet...

  19. Medication Errors in Patients with Enteral Feeding Tubes in the Intensive Care Unit.

    Science.gov (United States)

    Sohrevardi, Seyed Mojtaba; Jarahzadeh, Mohammad Hossein; Mirzaei, Ehsan; Mirjalili, Mahtabalsadat; Tafti, Arefeh Dehghani; Heydari, Behrooz

    2017-01-01

    Most patients admitted to Intensive Care Units (ICU) have problems in using oral medication or ingesting solid forms of drugs. Selecting the most suitable dosage form in such patients is a challenge. The current study was conducted to assess the frequency and types of errors of oral medication administration in patients with enteral feeding tubes or suffering swallowing problems. A cross-sectional study was performed in the ICU of Shahid Sadoughi Hospital, Yazd, Iran. Patients were assessed for the incidence and types of medication errors occurring in the process of preparation and administration of oral medicines. Ninety-four patients were involved in this study and 10,250 administrations were observed. Totally, 4753 errors occurred among the studied patients. The most commonly used drugs were pantoprazole tablet, piracetam syrup, and losartan tablet. A total of 128 different types of drugs and nine different oral pharmaceutical preparations were prescribed for the patients. Forty-one (35.34%) out of 116 different solid drugs (except effervescent tablets and powders) could be substituted by liquid or injectable forms. The most common error was the wrong time of administration. Errors of wrong dose preparation and administration accounted for 24.04% and 25.31% of all errors, respectively. In this study, at least three-fourth of the patients experienced medication errors. The occurrence of these errors can greatly impair the quality of the patients' pharmacotherapy, and more attention should be paid to this issue.

  20. Kundalini yoga as a support therapy for cancer patients

    OpenAIRE

    Kröneck, Mia

    2016-01-01

    This study was designed to describe cancer patient’s experience of kundalini yoga and its effect on their internal coping resources. The intention of this study is to put forward kundalini yoga as a support therapy for cancer patients for improving their wellbeing during active cancer treatment. This is a descriptive study. An academic literature review was conducted for cancer, cancer treatment, internal coping resources and yoga as therapy topics. Four voluntary female cancer patients (...

  1. Cachexia in patients with oesophageal cancer.

    Science.gov (United States)

    Anandavadivelan, Poorna; Lagergren, Pernilla

    2016-03-01

    Oesophageal cancer is a debilitating disease with a poor prognosis, and weight loss owing to malnutrition prevails in the majority of patients. Cachexia, a multifactorial syndrome characterized by the loss of fat and skeletal muscle mass and systemic inflammation arising from complex host-tumour interactions is a major contributor to malnutrition, which is a determinant of tolerance to treatment and survival. In patients with oesophageal cancer, cachexia is further compounded by eating difficulties owing to the stage and location of the tumour, and the effects of neoadjuvant therapy. Treatment with curative intent involves exceptionally extensive and invasive surgery, and the subsequent anatomical changes often lead to eating difficulties and severe postoperative malnutrition. Thus, screening for cachexia by means of percentage weight loss and BMI during the cancer trajectory and survivorship periods is imperative. Additionally, markers of inflammation (such as C-reactive protein), dysphagia and appetite loss should be assessed at diagnosis. Routine assessments of body composition are also necessary in patients with oesophageal cancer to enable assessment of skeletal muscle loss, which might be masked by sarcopenic obesity in these patients. A need exists for clinical trials examining the effectiveness of therapeutic and physical-activity-based interventions in mitigating muscle loss and counteracting cachexia in these patients.

  2. Renal cancer in kidney transplanted patients.

    Science.gov (United States)

    Frascà, Giovanni M; Sandrini, Silvio; Cosmai, Laura; Porta, Camillo; Asch, William; Santoni, Matteo; Salviani, Chiara; D'Errico, Antonia; Malvi, Deborah; Balestra, Emilio; Gallieni, Maurizio

    2015-12-01

    Renal cancer occurs more frequently in renal transplanted patients than in the general population, affecting native kidneys in 90% of cases and the graft in 10 %. In addition to general risk factors, malignancy susceptibility may be influenced by immunosuppressive therapy, the use of calcineurin inhibitors (CNI) as compared with mammalian target of rapamycin inhibitors, and the length of dialysis treatment. Acquired cystic kidney disease may increase the risk for renal cancer after transplantation, while autosomal dominant polycystic kidney disease does not seem to predispose to cancer development. Annual ultrasound evaluation seems appropriate in patients with congenital or acquired cystic disease or even a single cyst in native kidneys, and every 2 years in patients older than 60 years if they were on dialysis for more than 5 years before transplantation. Immunosuppression should be lowered in patients who develop renal cancer, by reduction or withdrawal of CNI. Although more evidence is still needed, it seems reasonable to shift patients from CNI to everolimus or sirolimus if not already treated with one of these drugs, with due caution in subjects with chronic allograft nephropathy.

  3. Patient Delay in Colorectal Cancer Patients

    DEFF Research Database (Denmark)

    Pedersen, Anette Fischer; Hansen, Rikke P; Vedsted, Peter

    2013-01-01

    Blødning fra endetarmen ses normalt som et alarmsymptom på kolorektalkræft. Alligevel vælger mange patienter at lade være med at opsøge lægen. Denne artikel ser nærmere på sammenhængen mellem et alarmsymptom (rektal blødning), forsinkelser i patientforløbet og tanker om kræft. Resultaterne viser,...

  4. Anemia, tumor hypoxemia, and the cancer patient

    International Nuclear Information System (INIS)

    Varlotto, John; Stevenson, Mary Ann

    2005-01-01

    Purpose: To review the impact of anemia/tumor hypoxemia on the quality of life and survival in cancer patients, and to assess the problems associated with the correction of this difficulty. Methods: MEDLINE searches were performed to find relevant literature regarding anemia and/or tumor hypoxia in cancer patients. Articles were evaluated in order to assess the epidemiology, adverse patient effects, anemia correction guidelines, and mechanisms of hypoxia-induced cancer cell growth and/or therapeutic resistance. Past and current clinical studies of radiosensitization via tumor oxygenation/hypoxic cell sensitization were reviewed. All clinical studies using multi-variate analysis were analyzed to show whether or not anemia and/or tumor hypoxemia affected tumor control and patient survival. Articles dealing with the correction of anemia via transfusion and/or erythropoietin were reviewed in order to show the impact of the rectification on the quality of life and survival of cancer patients. Results: Approximately 40-64% of patients presenting for cancer therapy are anemic. The rate of anemia rises with the use of chemotherapy, radiotherapy, and hormonal therapy for prostate cancer. Anemia is associated with reductions both in quality of life and survival. Tumor hypoxemia has been hypothesized to lead to tumor growth and resistance to therapy because it leads to angiogenesis, genetic mutations, resistance to apoptosis, and a resistance to free radicals from chemotherapy and radiotherapy. Nineteen clinical studies of anemia and eight clinical studies of tumor hypoxemia were found that used multi-variate analysis to determine the effect of these conditions on the local control and/or survival of cancer patients. Despite differing definitions of anemia and hypoxemia, all studies have shown a correlation between low hemoglobin levels and/or higher amounts of tumor hypoxia with poorer prognosis. Radiosensitization through improvements in tumor oxygenation/hypoxic cell

  5. Fertility preservation in young patients with cancer

    Directory of Open Access Journals (Sweden)

    Virender Suhag

    2015-01-01

    Full Text Available Infertility can arise as a consequence of treatment of oncological conditions. The parallel and continued improvement in both the management of oncology and fertility cases in recent times has brought to the forefront the potential for fertility preservation in patients being treated for cancer. Many survivors will maintain their reproductive potential after the successful completion of treatment for cancer. However total body irradiation, radiation to the gonads, and certain high dose chemotherapy regimens can place women at risk for acute ovarian failure or premature menopause and men at risk for temporary or permanent azoospermia. Providing information about risk of infertility and possible interventions to maintain reproductive potential are critical for the adolescent and young adult population at the time of diagnosis. There are established means of preserving fertility before cancer treatment; specifically, sperm cryopreservation for men and in vitro fertilization and embryo cryopreservation for women. Several innovative techniques are being actively investigated, including oocyte and ovarian follicle cryopreservation, ovarian tissue transplantation, and in vitro follicle maturation, which may expand the number of fertility preservation choices for young cancer patients. Fertility preservation may also require some modification of cancer therapy; thus, patients' wishes regarding future fertility and available fertility preservation alternatives should be discussed before initiation of therapy.

  6. Interest in screening examinations among cancer patients

    Directory of Open Access Journals (Sweden)

    Humeniuk Ewa

    2017-09-01

    Full Text Available Aim. To determine the influence of socio-demographic variables on attendance rate at screening examinations in cancer patients. Material and methods. The research group comprised of 100 cancer patients. The method applied in the research was a diagnostic survey. The research instrument was the authors‘ own questionnaire specially compiled to measure cancer patients‘ interest in screening examinations. The research material was analysed with the statistical packet STATISTICA 12 and Microsoft Office Excel software. Significance level was assumed at p<0.05 to determine statistically significant differences and dependencies. A Chi2 test was used in the research. Results. The surveyed patients mostly did not participate in screening examinations aimed at diagnosing cancer (66%. Their Age (p=0.05, gender (p=0.003 and place of residence (p=0.04 determined their participation rate in screening tests. The patients‘ marital status (p=0.47, education (p=0.85 and economic status (p=0.13 did not affect their willingness to attend screening examinations. Conclusions. The process of cancer incidence and death rate limitation requires greater participation of the population in prevention programmes.

  7. [Nutritional risk screening and nutrition assessment for gastrointestinal cancer patients].

    Science.gov (United States)

    Du, Yan-ping; Li, Ling-ling; He, Qing; Li, Yun; Song, Hu; Lin, Yi-jia; Peng, Jun-sheng

    2012-05-01

    To investigate the nutritional status, and provide evidence for nutritional treatment option. A total of 452 patients with gastrointestinal cancer were selected, including 156 gastric cancer,117 colon cancer, and 180 rectal cancer. The nutritional risk screening 2002(NRS2002) was applied to grade the nutritional risk. A multi-frequency bioelectrical impedance analysis was used to measure the patients' body composition. Albumin (Alb), prealbumin(PA), transferring(Tf), retinol binding protein(RBP), red blood cell(RBC), hemoglobin (Hb), haematocrit(Hct) were measured after fasting. The rate of patients with NRS2002 score more than 3 was 70.5%(110/156) for gastric cancer, 53.8%(63/117) for colon cancer, and 46.7%(86/180) for rectal cancer. The score for impaired nutritional status more than 1 for gastric cancer was higher than that for colorectal cancer(Pgastric cancer(Pgastric cancer patients as compared to colorectal cancer patients(Pgastric cancer patients(Pgastric cancer and colon cancer(Pgastric cancer are prone to fat loss and therefore have a higher nutritional risk and malnutrition than those with colorectal cancer. Combination of body composition analysis and laboratory examination may achieve comprehensive evaluation of the nutritional status of patients, and provide the evidence of nutritional therapy by being combined with NRS2002 score.

  8. Patient representatives' views on patient information in clinical cancer trials

    DEFF Research Database (Denmark)

    Dellson, Pia; Nilbert, Mef; Carlsson, Christina

    2016-01-01

    of future simplified and more attractive informed consent forms. CONCLUSIONS: The emotional and cognitive responses to written patient information reported by patient representatives provides a basis for revised formats in future trials and add to the body of information that support use of plain language......BACKGROUND: Patient enrolment into clinical trials is based on oral information and informed consent, which includes an information sheet and a consent certificate. The written information should be complete, but at the same time risks being so complex that it may be questioned if a fully informed...... consent is possible to provide. We explored patient representatives' views and perceptions on the written trial information used in clinical cancer trials. METHODS: Written patient information leaflets used in four clinical trials for colorectal cancer were used for the study. The trials included phase I...

  9. Exercise effects on HRV in cancer patients.

    Science.gov (United States)

    Niederer, D; Vogt, L; Thiel, C; Schmidt, K; Bernhörster, M; Lungwitz, A; Jäger, E; Banzer, W

    2013-01-01

    The present study evaluated the effects of physical exercise on heart rate variability (HRV) in cancer patients. 3 matched groups of each 15 tumour patients (60.4±8.9 years, 27 male, 18 female) were recruited: Physical exercise group 1 (acute treatment), Physical exercise group 2 (post treatment) and non-intervention group (acute treatment, no exercise). Exercise group patients received counselling for exercise and participated in a Nordic-Walking program. Short-term HRV-recordings, assessments of fatigue and quality of life (QoL) were performed prior to and 16 weeks after the exercise program initiation. MANCOVA revealed group × time differences in total power frequency domain of HRV and QoL (pHRV-parameters and prolonged survival in cancer patients, improvement in autonomic control may be an important goal of exercise. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Parenteral nutrition in the elderly cancer patient.

    Science.gov (United States)

    Orrevall, Ylva

    2015-04-01

    Parenteral nutrition may be considered when oral intake and/or enteral nutrition are not sufficient to maintain nutritional status and the patient is likely to die sooner from starvation than from the cancer. A detailed assessment should be made prior to the decision about whether parenteral nutrition should be started. A follow up plan should be documented with objective and patient centred treatment goals as well as specific time points for evaluation. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Systemic therapy for patients with colorectal cancer

    DEFF Research Database (Denmark)

    Pfeiffer, Per; Qvortrup, Camilla; Tabernero, Josep

    2015-01-01

    Recent modalities and strategies have increased the complexity of treatment choice in patients with colorectal cancer (CRC), and therefore all cases should be assessed at a multidisciplinary conference. Adjuvant chemotherapy for 6 months increases the chance of cure by absolutely 5 % in stage II...

  12. PET/MRI in cancer patients

    DEFF Research Database (Denmark)

    Kjær, Andreas; Loft, Annika; Law, Ian

    2013-01-01

    Combined PET/MRI systems are now commercially available and are expected to change the medical imaging field by providing combined anato-metabolic image information. We believe this will be of particular relevance in imaging of cancer patients. At the Department of Clinical Physiology, Nuclear Me...

  13. Haemorheological Changes in African Breast Cancer Patients ...

    African Journals Online (AJOL)

    Several Studies have indicated the existence of thrombo-embolic complications in cancer patients and that this could be associated with changes in heamorheological parameters. Packed cell volume (PCV), heamoglobin (Hb), relative plasma viscosity (RPV) and plasma Fibrinogen concentration (PFC) were measured in ...

  14. [Treatment of elderly patients with breast cancer

    DEFF Research Database (Denmark)

    Paaschburg, B.; Pedersen, A.; Tuxen, M.K.

    2008-01-01

    The latest investigations have been searched in order to present new guidelines for the treatment of elderly patients with primary breast cancer. It is concluded that breast-conserving surgery should be offered as well as the sentinel node technique. Axillary lymph node dissection is not necessary...

  15. MANAGEMENT OF CANCER IN PATIENTS WITH HIV

    African Journals Online (AJOL)

    populations of patients with HIV infection that a causal relationship is difficult to exclude. These cancers are associated with declining immune function and are considered to be ... the chemotherapy or radiotherapy is strongly associated with response rates. ... organ dysfunction such as hepatitis, renal failure and respiratory ...

  16. History of Depression in Lung Cancer Patients

    DEFF Research Database (Denmark)

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

    2017-01-01

    . To estimate the effect of depression on the diagnostic process and the choice of treatment in lung cancer we fitted a logistic regression model and a Cox regression model adjusting for age, gender, resection and stage. RESULTS: Depression in a patient's anamnesis had no significant effect on the delay...

  17. A very feasible alternative in patients with feeding difficulties from gastrostomy: Jejunal tube advanced through the gastrostomy

    Directory of Open Access Journals (Sweden)

    Ramazan Karabulut

    2015-01-01

    Full Text Available Background: Our aim is to share our experiences regarding patients who cannot be fed effectively through the gastrostomy tube, but were inserted feeding jejunostomy through the gastrostomy orifice using scopic fluoroscopic techniques utilised by the interventional radiology. Patients and Methods: Between January 2010 and May 2013 the patients that were inserted jejunostomy tube through the gastrostomy orifice using fluoroscopic techniques were retrospectively analysed. Data including primary indication for gastrostomy, sex, concomitant disease and the requirement for gastroesophageal reflux disease (GERD were all recorded. Results: There were five patients with these criteria. They all received either medical or surgical GERD therapy; nevertheless enteral feeding failed to reach an effective level, they all had vomiting and did not gain any weight. Following conversion, all the patients gained minimum 2 kg in 2-5 months; all the patients tolerated enteral feeding and were discharged in the early period. There were neither procedure related complications such as perforation, bleeding nor sedation related complications. Procedure took no more than 30 min as a whole. There was no need for surgical intervention. However in one patient re-intervention was required due to accidental removal of the catheter. Conclusions: In case of feeding difficulties following the gastrostomy; instead of an invasive surgical intervention; physicians should consider jejunal feeding that is advanced through the gastrostomy, which does not require any anaesthesia.

  18. Multidimensional fatigue and its correlates in hospitalised advanced cancer patients.

    NARCIS (Netherlands)

    Echteld, M.A.; Passchier, J.; Teunissen, S.; Claessen, S.; Wit, R. de; Rijt, C.C.D. van der

    2007-01-01

    Although fatigue is a multidimensional concept, multidimensional fatigue is rarely investigated in hospitalised cancer patients. We determined the levels and correlates of multidimensional fatigue in 100 advanced cancer patients admitted for symptom control. Fatigue dimensions were general fatigue

  19. Primary Patient-Derived Cancer Cells and Their Potential for Personalized Cancer Patient Care

    Directory of Open Access Journals (Sweden)

    David P. Kodack

    2017-12-01

    Full Text Available Personalized cancer therapy is based on a patient’s tumor lineage, histopathology, expression analyses, and/or tumor DNA or RNA analysis. Here, we aim to develop an in vitro functional assay of a patient’s living cancer cells that could complement these approaches. We present methods for developing cell cultures from tumor biopsies and identify the types of samples and culture conditions associated with higher efficiency of model establishment. Toward the application of patient-derived cell cultures for personalized care, we established an immunofluorescence-based functional assay that quantifies cancer cell responses to targeted therapy in mixed cell cultures. Assaying patient-derived lung cancer cultures with this method showed promise in modeling patient response for diagnostic use. This platform should allow for the development of co-clinical trial studies to prospectively test the value of drug profiling on tumor-biopsy-derived cultures to direct patient care.

  20. Hope in newly diagnosed cancer patients.

    Science.gov (United States)

    Duggleby, Wendy; Ghosh, Sunita; Cooper, Dan; Dwernychuk, Lynne

    2013-11-01

    Hope is important to cancer patients as it helps them deal with their diagnosis. Little is known about hope in newly diagnosed cancer patients. Based on the Transcending Possibilities conceptual model of hope, the purpose of this study was to examine the relationship of hope with pain, energy, and psychological and demographic characteristics in newly diagnosed adult oncology outpatients. Data from 310 New Patient Assessment Forms from cancer outpatients' health records were collected. Health records from the first six months of 2009 were reviewed and data were collected on hope, energy, pain, depression, anxiety, feeling overwhelmed, and demographic variables. A generalized linear modeling approach was used to study the relationship of hope scores with these variables. Hypothesized variables and variables that were significant at the P = 0.01 level from the univariate analysis were entered into the multivariate model, with hope scores as the dependent variable. Hope scores were significantly negatively related to age (P = 0.02). More specifically, oncology patients who were 65 years of age or older had significantly less hope than those under the age of 65 years (P = 0.01). Gender (P = 0.009) also was a significant factor, with men having higher hope scores than women. No other variables were significant. Older adults comprise the majority of persons in Canada with cancer. The lower hope scores found in this age group compared with their younger counterparts underscore the importance of further research. This study provides a foundation for future research in this important area for oncology patients. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  1. Inadequate Nutritional Status of Hospitalized Cancer Patients

    Directory of Open Access Journals (Sweden)

    Ali Alkan

    2017-03-01

    Full Text Available Objective: In oncology practice, nutrition and also metabolic activity are essential to support the nutritional status and prevent malignant cachexia. It is important to evaluate the patients and plan the maneuvers at the start of the therapy. The primary objective of the study is to define the nutritional status of hospitalized patients and the factors affecting it in order to define the most susceptible patients and maneuvers for better nutritional support. Methods: Patients hospitalized in oncology clinic for therapy were evaluated for food intake and nutritional status through structured interviews. The clinical properties, medical therapies, elements of nutritional support were noted and predictors of inadequate nutritional status (INS were analyzed. Results: Four hundred twenty three patients, between 16-82 years old (median: 52 were evaluated. Nearly half of the patients (185, 43% reported a better appetite at home than in hospital and declared that hospitalization is an important cause of loss of appetite (140/185, 75.6%. Presence of nausea/vomiting (N/V, depression, age less than 65 and use of non-steroidal anti-inflammatory drugs (NSAIDs were associated with increased risk of INS in hospitalized cancer patients. On the contrary, steroid medication showed a positive impact on nutritional status of cancer patients. Conclusion: N/V, younger age, presence of depression and NSAIDs medication were associated with INS in hospitalized cancer patients. Clinicians should pay more attention to this group of patients. In addition, unnecessary hospitalizations and medications that may disturb oral intake must be avoided. Corticosteroids are important tools for managing anorexia and INS.

  2. Classification of neuropathic pain in cancer patients

    DEFF Research Database (Denmark)

    Brunelli, Cinzia; Bennett, Michael I; Kaasa, Stein

    2014-01-01

    and on the relevance of patient-reported outcome (PRO) descriptors for the screening of NP in this population. An international group of 42 experts was invited to participate in a consensus process through a modified 2-round Internet-based Delphi survey. Relevant topics investigated were: peculiarities of NP...... in patients with cancer, IASP NeuPSIG diagnostic criteria adaptation and assessment, and standardized PRO assessment for NP screening. Median consensus scores (MED) and interquartile ranges (IQR) were calculated to measure expert consensus after both rounds. Twenty-nine experts answered, and good agreement...... was proposed. Clinical research on PRO in the screening phase and on the application of the algorithm will be needed to examine their effectiveness in classifying NP in cancer patients....

  3. Outcome of severe infections in afebrile neutropenic cancer patients

    Directory of Open Access Journals (Sweden)

    Strojnik Ksenija

    2016-12-01

    Full Text Available In some neutropenic cancer patients fever may be absent despite microbiologically and/or clinically confirmed infection. We hypothesized that afebrile neutropenic cancer patients with severe infections have worse outcome as compared to cancer patients with febrile neutropenia.

  4. Radiation therapy for cancer patients

    International Nuclear Information System (INIS)

    Mileikowsky, C.

    1987-01-01

    This patent describes an apparatus for irradiating a patient comprising: a source of a radiation beam directed along a radiation axis; means mounting the source for pivotal movement about a first horizontal axis which intersects the source, is stationary with respect to the apparatus, and extends in a direction substantially normal to the radiation axis, whereby the beam is capable of an angular scan in a vertical plane; table means adapted to support a patient to be irradiated; and suspension means mounted the table means for arcuate movement to any positions angularly spaced about the first horizontal axis and for pivoting movement about a second horizontal axis displacement from and substantially parallel to the first horizontal axis. The suspension means maintain the second horizontal axis in substantially intersecting relation to the radiation axis in each of the positions while maintaining a fixed angular position of the table means with respect to the environment

  5. Perceived Role Of Dietary Factors In Cancer Causation And ...

    African Journals Online (AJOL)

    Perceived Role Of Dietary Factors In Cancer Causation And Prevention Among ... The impact of cancer on patients, care givers and family could be ... as well as social support programmes including subsidized cancer-limiting feeding of ...

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

    DEFF Research Database (Denmark)

    Handberg, Charlotte; Lomborg, Kirsten; Nielsen, Claus Vinther

    2015-01-01

    The aim was to describe male cancer survivors' barriers towards participation in cancer rehabilitation as a means to guiding future targeted men's cancer rehabilitation. Symbolic Interactionism along with the interpretive descriptive methodology guided the study of 35 male cancer survivors...

  7. Ability of High-Resolution Manometry to Determine Feeding Method and to Predict Aspiration Pneumonia in Patients With Dysphagia.

    Science.gov (United States)

    Park, Chul-Hyun; Lee, Yong-Taek; Yi, Youbin; Lee, Jung-Sang; Park, Jung Ho; Yoon, Kyung Jae

    2017-07-01

    The introduction of high-resolution manometry (HRM) offered an improved method to objectively analyze the status of pharynx and esophagus. At present, HRM for patients with oropharyngeal dysphagia has been poorly studied. We aimed to determine feeding method and predict the development of aspiration pneumonia in patients with oropharyngeal dysphagia using HRM. We recruited 120 patients with dysphagia who underwent both HRM and videofluoroscopic swallow study. HRM was used to estimate pressure events from velopharynx (VP) to upper esophageal sphincter (UES). Feeding methods were determined to non-oral or oral feeding according to dysphagia severity. We prospectively followed patients to assess the development of aspiration pneumonia. VP maximal pressure and UES relaxation duration were independently associated with non-oral feeding. Non-oral feeding was determined based on optimal cutoff value of 105.0 mm Hg for VP maximal pressure (95.0% sensitivity and 70.0% specificity) and 0.45 s for UES relaxation duration (76.3% sensitivity and 57.5% specificity), respectively. During a mean follow-up of 18.8 months, 15.8% of patients developed aspiration pneumonia. On multivariate Cox regression analysis, VP maximal pressure (Pdysphagia.

  8. Nutritional status assessment in colorectal cancer patients.

    Science.gov (United States)

    Lopes, Joana Pedro; de Castro Cardoso Pereira, Paula Manuela; dos Reis Baltazar Vicente, Ana Filipa; Bernardo, Alexandra; de Mesquita, María Fernanda

    2013-01-01

    The present study intended to evaluate the nutritional status of Portuguese colorectal patients and associated it with surgery type as well as quality of life outcomes. Malnutrition can affect up to 85% of cancer patients and specifically 30-60% in colorectal cancer and can significantly influence health outcomes. A sample of 50 colorectal cancer patients was evaluated in what refers to several anthropometric measures, food intake, clinical history, complications rate before and after surgery procedure. The sample was divided between convention and fast-track procedures. Most of the individuals were overweight or obese but had lost weight on the past six months. Despite mild, there were signs of malnutrition in this sample with high losses of fat free mass, weight and also fat mass during the hospitalization period. These results reinforce the importance of malnutrition assessment in colorectal patients as well as consider weight loss on the past months and body composition in order to complement nutritional status evaluation. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  9. Palliative Care Use Among Patients With Solid Cancer Tumors: A National Cancer Data Base Study.

    Science.gov (United States)

    Osagiede, Osayande; Colibaseanu, Dorin T; Spaulding, Aaron C; Frank, Ryan D; Merchea, Amit; Kelley, Scott R; Uitti, Ryan J; Ailawadhi, Sikander

    2018-01-01

    Palliative care has been increasingly recognized as an important part of cancer care but remains underutilized in patients with solid cancers. There is a current gap in knowledge regarding why palliative care is underutilized nationwide. To identify the factors associated with palliative care use among deceased patients with solid cancer tumors. Using the 2016 National Cancer Data Base, we identified deceased patients (2004-2013) with breast, colon, lung, melanoma, and prostate cancer. Data were described as percentages. Associations between palliative care use and patient, facility, and geographic characteristics were evaluated through multivariate logistic regression. A total of 1 840 111 patients were analyzed; 9.6% received palliative care. Palliative care use was higher in the following patient groups: survival >24 months (17% vs 2%), male (54% vs 46%), higher Charlson-Deyo comorbidity score (16% vs 8%), treatment at designated cancer programs (74% vs 71%), lung cancer (76% vs 28%), higher grade cancer (53% vs 24%), and stage IV cancer (59% vs 13%). Patients who lived in communities with a greater percentage of high school degrees had higher odds of receiving palliative care; Central and Pacific regions of the United States had lower odds of palliative care use than the East Coast. Patients with colon, melanoma, or prostate cancer had lower odds of palliative care than patients with breast cancer, whereas those with lung cancer had higher odds. Palliative care use in solid cancer tumors is variable, with a preference for patients with lung cancer, younger age, known insurance status, and higher educational level.

  10. Outcomes of colon resection in patients with metastatic colon cancer.

    Science.gov (United States)

    Moghadamyeghaneh, Zhobin; Hanna, Mark H; Hwang, Grace; Mills, Steven; Pigazzi, Alessio; Stamos, Michael J; Carmichael, Joseph C

    2016-08-01

    Patients with advanced colorectal cancer have a high incidence of postoperative complications. We sought to identify outcomes of patients who underwent resection for colon cancer by cancer stage. The National Surgical Quality Improvement Program database was used to evaluate all patients who underwent colon resection with a diagnosis of colon cancer from 2012 to 2014. Multivariate logistic regression analysis was performed to investigate patient outcomes by cancer stage. A total of 7,786 colon cancer patients who underwent colon resection were identified. Of these, 10.8% had metastasis at the time of operation. Patients with metastatic disease had significantly increased risks of perioperative morbidity (adjusted odds ratio [AOR]: 1.44, P = .01) and mortality (AOR: 3.72, P = .01). Patients with metastatic disease were significantly younger (AOR: .99, P colon cancer have metastatic disease. Postoperative morbidity and mortality are significantly higher than in patients with localized disease. Published by Elsevier Inc.

  11. Pre-radiotherapy feeding tube identifies a poor prognostic subset of postoperative p16 positive oropharyngeal carcinoma patients.

    Science.gov (United States)

    Verma, Vivek; Liu, Jingxia; Eschen, Laura; Danieley, Jonathan; Spencer, Christopher; Lewis, James S; Diaz, Jason; Piccirillo, Jay F; Adkins, Douglas R; Nussenbaum, Brian; Thorstad, Wade L; Gay, Hiram A

    2015-01-09

    This study explores variables associated with poor prognosis in postoperative p16 positive oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing adjuvant radiotherapy or chemoradiotherapy. Specifically, analysis was done related to timing of feeding tube insertion relative to radiotherapy. From 1997-2009, of 376 consecutive patients with OPSCC, 220 received adjuvant IMRT, and 97 were p16 positive and eligible. Of these, 23 had feeding tube placement before IMRT (B-FT), 32 during/after IMRT (DA-FT), and 42 had no feeding tube (NO-FT). Feeding tubes were not placed prophylactically. These three groups were analyzed for differential tumor, patient, treatment, and feeding tube characteristics, as well as differences in overall survival (OS), disease free survival (DFS), and distant metastasis free survival (DMFS). Pre-RT FT insertion was associated with higher tumor size and depth, T (but not N) and overall stage, comorbidities, presence of chemotherapy, and less use of transoral laser microsurgery/transoral bovie. Additionally, time from surgery to IMRT completion was also statistically longer in the B-FT group. The feeding tube was permanent in 52% of patients in the B-FT group versus 16% in the DA-FT group (p = 0.0075). The 5-year OS for the NO-FT, DA-FT, and B-FT groups was 90%, 86%, and 50%, respectively. The 5-year DFS for the NO-FT, DA-FT, and B-FT groups was 87.6%, 83.6%, and 42.7%, respectively. Multivariate analysis showed that for OS and DFS, feeding tube placement timing and smoking history were statistically significant. Due to the poor prognosis of early FT insertion, the presence of FTs at time of radiotherapy consultation can be used as an alternate marker to identify a subset of p16 positive OPSCC patients that have a poor prognosis.

  12. Pre-radiotherapy feeding tube identifies a poor prognostic subset of postoperative p16 positive oropharyngeal carcinoma patients

    International Nuclear Information System (INIS)

    Verma, Vivek; Liu, Jingxia; Eschen, Laura; Danieley, Jonathan; Spencer, Christopher; Lewis, James S Jr; Diaz, Jason; Piccirillo, Jay F; Adkins, Douglas R; Nussenbaum, Brian; Thorstad, Wade L; Gay, Hiram A

    2015-01-01

    This study explores variables associated with poor prognosis in postoperative p16 positive oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing adjuvant radiotherapy or chemoradiotherapy. Specifically, analysis was done related to timing of feeding tube insertion relative to radiotherapy. From 1997–2009, of 376 consecutive patients with OPSCC, 220 received adjuvant IMRT, and 97 were p16 positive and eligible. Of these, 23 had feeding tube placement before IMRT (B-FT), 32 during/after IMRT (DA-FT), and 42 had no feeding tube (NO-FT). Feeding tubes were not placed prophylactically. These three groups were analyzed for differential tumor, patient, treatment, and feeding tube characteristics, as well as differences in overall survival (OS), disease free survival (DFS), and distant metastasis free survival (DMFS). Pre-RT FT insertion was associated with higher tumor size and depth, T (but not N) and overall stage, comorbidities, presence of chemotherapy, and less use of transoral laser microsurgery/transoral bovie. Additionally, time from surgery to IMRT completion was also statistically longer in the B-FT group. The feeding tube was permanent in 52% of patients in the B-FT group versus 16% in the DA-FT group (p = 0.0075). The 5-year OS for the NO-FT, DA-FT, and B-FT groups was 90%, 86%, and 50%, respectively. The 5-year DFS for the NO-FT, DA-FT, and B-FT groups was 87.6%, 83.6%, and 42.7%, respectively. Multivariate analysis showed that for OS and DFS, feeding tube placement timing and smoking history were statistically significant. Due to the poor prognosis of early FT insertion, the presence of FTs at time of radiotherapy consultation can be used as an alternate marker to identify a subset of p16 positive OPSCC patients that have a poor prognosis

  13. Every second cancer patient receives radiotherapy

    International Nuclear Information System (INIS)

    Ojala, A.

    1996-01-01

    Radiotherapy to treat cancer was given for the first time exactly one hundred years ago. Today, radiotherapy and surgery are the two main modes of treating cancer. One in two cancer patients receives radiotherapy at some point during the course of treatment for the disease. Radiotherapy is applied most commonly in cases where surgery is not possible. Moreover, these two modes of treatment are often used together to supplement each other. About half of new cancer cases detected today can be ordered. The estimate given by the EU for cancers cured is 45 per cent, which is divided between the various treatment modes as follows: surgery 22 %, radiotherapy 12 %, surgery plus radiotherapy 6 %, and drug therapy 6 %. In addition to curative treatment, radiotherapy plays a crucial role in palliative treatment, i.e. treatment that alleviates symptoms. The sensitivity of malignant tumours to radiotherapy varies over a wide range; the same is true for healthy tissues. Radiotherapy can only be used to cure a tumour that is more sensitive to radiation than the surrounding healthy tissue. The tumour must also be sufficiently small in size and limited to a relatively small area. (orig.)

  14. High incidence of thyroid cancer among patients with acromegaly.

    Science.gov (United States)

    Kaldrymidis, Dimitrios; Papadakis, Georgios; Tsakonas, Georgios; Kaldrymidis, Philippos; Flaskas, Theofanis; Seretis, Andreas; Pantazi, Eleni; Kostoglou-Athanassiou, Ifigenia; Peppa, Melpomeni; Roussou, Paraskevi; Diamanti-Kandarakis, Evanthia

    2016-01-01

    Several studies have suggested that patients with acromegaly have an increased risk of thyroid, colorectal, breast and prostate cancers. In this study we determined the prevalence of malignant neoplasms in patients with acromegaly. Cancer risk was evaluated in a cohort of 110 patients (M/F 48/62, age 58.63±13.8 years, range 30-86) with acromegaly. Mean age at diagnosis of acromegaly was 46.37±13.11 years. Mean period of time since diagnosis of acromegaly was 12.26+9.6 years. From 110 patients, cancer was diagnosed in 26 (23.6%) patients. Thyroid cancer was the most common cancer and was diagnosed in 13 patients (11.8%); other cancers encountered were gastric cancer (N=2), endometrial cancer (N-2), and breast cancer, colon cancer, prostate cancer (N-2), myelodysplastic syndrome, renal cell carcinoma, lung cancer and pancreatic carcinoma, one case each. Age, gender, age at the time of diagnosis of acromegaly, tumor size of pituitary adenoma and duration of disease were not associated with cancer development. This study suggests that patients with acromegaly have an increased risk of thyroid cancer and therefore they should undergo regular screening with hormonal and ultrasound evaluation of the thyroid and FNAB when required.

  15. Interventional radiology in the cancer patient

    International Nuclear Information System (INIS)

    Wallace, S.; Charnsangavej, C.

    1987-01-01

    The contributions of the interventional radiologist in the diagnosis and management of the cancer patient include angiography and intraarterial CT-angiography, intraarterial infusion therapy, embolization, chemoembolization, biopsy and drainage procedures, central venous catheter reposition and retrieval, and stent dilation of stenotic tubular structures in the following organ systems: (1) Kidney. Arterial embolization, therapeutic delay, enphrectomy, and medroxyprogesterone yield a response rate of 28% in patients with renal cell carcinoma and pulmonary parenchymal metastases. (2) Liver. The carcinoid syndrome secondary to hepatic metastases can be controlled by embolization in 87% of patients. Islet cell carcinoma of the pancreas with hepatic metastases is successfully managed in 75% of patients. Chemoembolization (Ivalon and cisplatin) has been effective in 60% of patients with hepatic metastases from ocular melanoma. (3) Bone. A 73% 3-year survival rate is now possible with the inraarterial infusion of cisplatin, while Adriamycin is given intravenously in patients with osteosarcoma. Limb salvage is now possible in 80% of cases. Cancers of the vulva, vagina, urethra, and penis have been successfully treated with intraarterial infusion of chemotherapy followed by radiation therapy. (5) An expansile metallic stent is available to alleviate obstructions of the vena cava, the aorta and its major branches, the tracheobronchial tree, and the common duct. These techniques are demonstrated and results discussed

  16. The effect of anxiety on breast cancer patients

    OpenAIRE

    Shadiya Mohamed Saleh Baqutayan

    2012-01-01

    Cancer is a disease wherein abnormal cells divide without control and are able to attack other tissues. Most of the patients and their families face some degree of depression, anxiety, and fear when cancer becomes a part of their lives. They feel helpless and eager to find ways on how to get rid of it. The study focuses on anxiety among breast cancer patients. It aims at investigating cancer, its symptoms, and effects the disease has on the anxiety level of patients.

  17. Why Breast Cancer Patients Seek Traditional Healers

    Directory of Open Access Journals (Sweden)

    Mazanah Muhamad

    2012-01-01

    Full Text Available Traditional healing is a common practice in low and middle income countries such as Malaysia. Eighty percent of Malaysians consult traditional healers or “bomoh” at some time in their life for health-related issues. The purpose of our study was to explore why breast cancer patients visit traditional healers. This is a qualitative study utilizing in-depth interviews with 11 cancer survivors who sought both traditional and Western medicine. The findings revealed the following reasons for which patients seek traditional healers: (1 recommendation from family and friends, (2 sanction from family, (3 perceived benefit and compatibility, (4 healer credibility, and (5 reservation with Western medicine and system delay. These factors work together and are strongly influenced by the Malaysian cultural context. The issue with the Western health system is common in a developing country with limited health facilities.

  18. Why Breast Cancer Patients Seek Traditional Healers

    International Nuclear Information System (INIS)

    Muhamad, M.; Merriam, Sh.; Merriam, Sh.; Suhami, N.

    2012-01-01

    Traditional healing is a common practice in low and middle income countries such as Malaysia. Eighty percent of Malaysians consult traditional healers or bomoh at some time in their life for health-related issues. The purpose of our study was to explore why breast cancer patients visit traditional healers. This is a qualitative study utilizing in-depth interviews with 11 cancer survivors who sought both traditional and Western medicine. The findings revealed the following reasons for which patients seek traditional healers: (1) recommendation from family and friends, (2) sanction from family, (3) perceived benefit and compatibility, (4) healer credibility, and (5) reservation with Western medicine and system delay. These factors work together and are strongly influenced by the Malaysian cultural context. The issue with the Western health system is common in a developing country with limited health facilities

  19. Cancer patients and delay in radiotherapy

    International Nuclear Information System (INIS)

    Klausen, O.G.; Olofsson, J.; Rosengren, B.

    1989-01-01

    Radiotherapeutical resources in Norway are inadequate, which was further verified in this retrospective study of 73 patients with cancer of head and neck. The average duration of symptoms before the first ear-nose-throat examination was 153 days, and it took about 10 days after the examination to get the diagnosis. An unacceptably long time (mean 30 days) elapsed between the decision on therapy until the radiotherapy was initiated. There is no doubt that radiotherapy departments in Norway need better resources

  20. Patient representatives' views on patient information in clinical cancer trials.

    Science.gov (United States)

    Dellson, Pia; Nilbert, Mef; Carlsson, Christina

    2016-02-01

    Patient enrolment into clinical trials is based on oral information and informed consent, which includes an information sheet and a consent certificate. The written information should be complete, but at the same time risks being so complex that it may be questioned if a fully informed consent is possible to provide. We explored patient representatives' views and perceptions on the written trial information used in clinical cancer trials. Written patient information leaflets used in four clinical trials for colorectal cancer were used for the study. The trials included phase I-III trials, randomized and non-randomized trials that evaluated chemotherapy/targeted therapy in the neoadjuvant, adjuvant and palliative settings. Data were collected through focus groups and were analysed using inductive content analysis. Two major themes emerged: emotional responses and cognitive responses. Subthemes related to the former included individual preferences and perceptions of effect, while subthemes related to the latter were comprehensibility and layout. Based on these observations the patient representatives provided suggestions for improvement, which largely included development of future simplified and more attractive informed consent forms. The emotional and cognitive responses to written patient information reported by patient representatives provides a basis for revised formats in future trials and add to the body of information that support use of plain language, structured text and illustrations to improve the informed consent process and thereby patient enrolment into clinical trials.

  1. Short bowel syndrome presenting with re-feeding syndrome in a Han Chinese patient: a case report

    Directory of Open Access Journals (Sweden)

    Xie Ying

    2012-05-01

    Full Text Available Abstract Introduction Re-feeding syndrome is common in patients with long-term starvation. To the best of our knowledge this case is the first to report a patient with short bowel syndrome developing re-feeding syndrome 12 years after the bowel resection. Case presentation A 33-year-old Chinese Han man underwent small bowel resection leaving only 40 cm of bowel, without an ileocecal valve, 12 years previously. At that time he was weaned from total parenteral nutrition and had a normal diet. He later developed features of severe malnutrition, and when parenteral nutrition was given, he developed re-feeding syndrome. Conclusion Although re-feeding syndrome is a common complication in patients with any kind of nutritional support, and known to us for many years, high risk patients still need more attention and monitoring. Re-feeding syndrome in this case was not only a macronutrients deficiency but also a micronutrient deficient, and prompt supplement therapy and organ function support proved to be successful.

  2. Significance of endoscopic screening and endoscopic resection for esophageal cancer in patients with hypopharyngeal cancer

    International Nuclear Information System (INIS)

    Morimoto, Masahiro; Nishiyama, Kinji; Nakamura, Satoaki

    2010-01-01

    The efficacy of endoscopic screening for esophageal cancer in patients with hypopharyngeal cancer remains controversial and its impact on prognosis has not been adequately discussed. We studied the use of endoscopic screening to detect esophageal cancer in hypopharyngeal cancer patients by analyzing the incidence, stage and prognosis. We included 64 patients with hypopharyngeal cancer who received radical radiotherapy at our institute. Chromoendoscopic esophageal examinations with Lugol dye solution were routinely performed at and after treatment for hypopharyngeal cancer. Twenty-eight esophageal cancers were detected in 28 (41%) patients (18 synchronous and 10 metachronous cancers). Of the 28 cancers, 23 were stage 0 or I cancer and 15 of these were treated with endoscopic resection. Local control was achieved in all of these 23 stage 0 or I cancers. The 5-year overall survival rates with esophageal cancer were 83% in stage 0, 47% in stage I and 0% in stage IIA-IVB. This study showed a strikingly high incidence of esophageal cancer in hypopharyngeal cancer patients. We suppose that the combination of early detection by chromoendoscopic examination and endoscopic resection for associated esophageal cancer in hypopharyngeal cancer patients improve prognosis and maintain quality of life. (author)

  3. Breast Cancer Patients' Depression Prediction by Machine Learning Approach.

    Science.gov (United States)

    Cvetković, Jovana

    2017-09-14

    One of the most common cancer in females is breasts cancer. This cancer can has high impact on the women including health and social dimensions. One of the most common social dimension is depression caused by breast cancer. Depression can impairs life quality. Depression is one of the symptom among the breast cancer patients. One of the solution is to eliminate the depression in breast cancer patients is by treatments but these treatments can has different unpredictable impacts on the patients. Therefore it is suitable to develop algorithm in order to predict the depression range.

  4. Prediction of critical weight loss during radiation treatment in head and neck cancer patients is dependent on BMI

    DEFF Research Database (Denmark)

    Lønbro, Simon; Petersen, Gry Bjerg; Andersen, Jens Rikardt

    2016-01-01

    PURPOSE: The aims of the present study were to explore pre-treatment predictors of weight loss during radiation treatment only in head and neck cancer (HNSCC) patients and investigate the weight loss in patients with or without a feeding tube. METHODS: Retrospectively, weight change during curative...... patients without (73.8 vs 78.3 kg) and feeding tube reduced, but did not prevent, weight loss which averaged 6.7 ± 4.7 kg (7.4 ± 4.7 %) compared with 4.7 ± 5.9 kg (5.5 ± 6.0 %) in patients without a feeding tube (P 

  5. Fungal infections in neutropenic cancer patients

    International Nuclear Information System (INIS)

    Parvez, T.

    2003-01-01

    Invasive fungal infections are important causes of morbidity and mortality in cancer patients with prolonged neutropenia following chemotherapy. Recent trends indicate a change toward infections by Aspergillus species, non-albicans species of Candida, and previously uncommon fungal pathogens. These have decreased susceptibility to current antifungal agents. In the last decade there has been much effort to find solutions for these changing trends. This article reviews current approaches to prevention and treatment of opportunistic fungal infections in postchemotherapy neutropenic patients and discussion future antifungal approaches and supportive methods. (author)

  6. Lung cancer: patient profile in Paraguay

    International Nuclear Information System (INIS)

    Aguero, M.; Gauna, C.; Pereira, R.

    2010-01-01

    Objective: To demonstrate the profile that comes to query the patient with cancer Lung in Paraguay, as well as therapeutic limitations found in stadiums advanced. Material and Methods: A retrospective analysis of medical records of patients who consulted was held at the Institute of Cancer in 2008. Inclusion criteria: patients with histologically confirmed attending their first consultation in the period from January 2008 to December 2008. Data Collection: sex, age, origin, occupation, toxic habits, reason was analyzed consultation, ECOG, histology, stage and treatment performed. Results: Of 59 patients studied there is a predominance of males (83%) from mostly in rural areas. The average age is 61 years. Of risk factors (Snuff, environmental exposure) 100% of women do not have such and only 2.3% of men; It is more frequent association of the two factors cited. Dyspne a (44%) is The most common symptom, followed by pain (20.3%), Cough / hemoptysis (17%) and finally headache (6.7%). The histological prevalence is a non-small cell cancer (98.3%) and among the Adenocarcinoma heads the frequency (56.8%), Squamous Cell Carcinoma (24.1%) and carcinoma differentiated ((19.1%), there is only one record of a Oat Cell Carcinoma. The stadium's presentation common is the Est. IV (44%) being the most frequent sites Liver metastases (26.7%) and Brain (23%) come in relatively general condition, mostly with ECOG 2 (30.5%) .. In As for treatment: one patient was performing a partial lobectomy operable; They performed chemotherapy or radiotherapy alone 24.5% and 16.9% respectively, the combination of both 10% and made no treatment, rejected or made exclusive palliative care 46% of the sample. Of 25 patients who received chemotherapy and 92% received 1st line Paclitaxel + Carboplatin and of them only 16% showed greater than 50% response. Only 6 patients performed 2nd line with Gemzitabina + cisplatin; and only one patient performed The 3rd line (Vinorelbine + Gemzitabina) and 4

  7. Virtual patients: development in cancer nursing education.

    Science.gov (United States)

    Moule, Pam; Pollard, Katherine; Armoogum, Julie; Messer, Simon

    2015-07-01

    The number of men diagnosed with prostate cancer is increasing and internationally there are high incidence rates. It is important that nurses and healthcare professionals are enabled to provide appropriate care to those men affected by prostate cancer and their families. Despite this need, there is recognition that many professionals feel ill prepared and lack knowledge in a number of areas. This paper presents the development of a Virtual Patient (VP) online resource to support practitioner learning. To develop five online VP simulation scenarios to meet the learning needs of nurses and health-care professionals caring for men with prostate cancer. Topic areas for the VPs were taken from previous work exploring the needs of health care professionals working with men with prostate cancer. An initial scoping exercise involving nursing practitioners, students and a prostate cancer charity confirmed the focus of the case study scenarios. Service users and specialist practitioners reviewed an outline of each case study to ensure fidelity of the simulations scenarios. Cases were entered into UChoose, a web based interactive VP player and authoring tool. The final case studies were reviewed by a sample of both registered and non-registered nurses and nursing students. The majority of respondents reported an increase in knowledge and suggested that they would recommend the resource to others. A number of positive aspects of the resource were highlighted. Respondents also commented about areas of weakness, a number of which have been addressed subsequently. The VP case studies provided an opportunity to develop knowledge and confidence in caring for men with prostate cancer. The mode of delivery and the content was acceptable for less experienced and knowledgeable staff. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Current status of patient-controlled analgesia in cancer patients.

    Science.gov (United States)

    Ripamonti, C; Bruera, E

    1997-03-01

    Patient-controlled analgesia (PCA) is a relatively new technique in which patients are able to self-administer small doses of opioid analgesics when needed. Many different devices are available for opioid infusion, including a syringe pump, disposable plastic cylinder, and battery-operated computer-driven pump. These devices allow patients to choose an intermittent (demand) bolus, continuous infusion, or both modes of administration. Parameters, such as route, drug concentration dose, frequency, and maximum daily or hourly dose, are programmed by the physician. The patient decides whether or not to take a dose. Devices can be used to deliver the drug into a running intravenous infusion, the epidural space, or subcutaneously. Controlled trials indicate that PCA is probably superior to regular opioid administration in postoperative pain. Reported advantages include greater patient satisfaction, decreased sedation and anxiety, and reduced nursing time and hospitalization. Preliminary experience suggests that PCA is also useful and safe for cancer pain, but further research is greatly needed.

  9. Gastric varicella: two cases in cancer patients

    Directory of Open Access Journals (Sweden)

    Violeta María Sastre-Lozano

    Full Text Available Gastric involvement with the varicella-zoster virus is an uncommon clinical condition where early suspicion and diagnosis are important to prevent the consequences deriving from its high morbidity and mortality, which in immunocompromised patients oscillate between 9% and 41% according to the various series. Two cases of gastric involvement with the varicella-zoster virus (VZV in two patients with blood cancer are reported below. Gastric lesions are usually preceded by typical papulovesicular skin lesions. When gastric involvement is the first symptom of the disease its diagnosis and management may be delayed, which may entail severe consequences for immunocompromised patients. It is therefore that we suggest its inclusion in the algorithm for immunocompromised patients with abdominal pain and ulcer-like endoscopic lesions.

  10. Factors affecting smoking cessation in patients with cancer

    Directory of Open Access Journals (Sweden)

    Eleni Kokkotou

    2017-05-01

    Smoking cessation in patients with cancer is accompanied by significant success, although this outcome is poorer compared with non-cancer smokers. Cancer patients must follow well-organized smoking cessation programs as soon as diagnosis is made, in order to have a successful and prolong smoking cessation.

  11. Bleeding complications during anticoagulant treatment in patients with cancer

    NARCIS (Netherlands)

    Kamphuisen, Pieter W.; Beyer-Westendorf, Jan

    Patients with cancer have an increased risk of bleeding complications, of which some are fatal. This risk is influenced by chemotherapy, cancer type and stage, thrombocytopenia, renal function, and previous bleeding. Since many cancer patients receive anticoagulant treatment for prophylaxis or

  12. Factors affecting quality of life in cancer patients undergoing ...

    African Journals Online (AJOL)

    Factors affecting quality of life in cancer patients undergoing chemotherapy. ... Objective: The aim of this study was to evaluate the QoL in cancer patients with solid tumors and at the different chemotherapy cycles (CT). ... Results: A significant relationship between the cancer type, pain intensity, and fatigue was found.

  13. Exercise effects on mood in breast cancer patients

    African Journals Online (AJOL)

    Each symptom can contribute to ... and emotional side-effects experienced by cancer patients include stress, fear of ... the role of psychological factors in cancer survival and emphasises ... Current treatments for anxiety and depression in cancer patients ... evidence that physical activity and exercise have positive effects on.

  14. Factors associated with management of cervical cancer patients at ...

    African Journals Online (AJOL)

    Forty-seven percent of the cervical cancer patients were referred to Ocean Road Cancer Institute for radiotherapy and or chemotherapy. Patients discharged home for palliative care were 30% and 17% patients died at the hospital. Known HIV positive patients were significantly associated with death and terminal care seen ...

  15. Preferences for active and aggressive intervention among patients with advanced cancer

    Directory of Open Access Journals (Sweden)

    Ennis Marguerite

    2010-10-01

    Full Text Available Abstract Background Intrinsic to "Patient-Centered Care" is being respectful and responsive to individual patient preferences, expressed needs, and personal values. Establishing a patient's preferences for active and aggressive intervention is imperative and foundational to the development of advance care planning. With the increasing awareness and acceptance of palliative philosophies of care, patients with advanced cancer are increasingly transitioning from active and aggressive medical management (AAMM to conservative palliative management (CPM. Methods A cross-sectional study based on a prospective and sequential case series of patients referred to a regional palliative medicine consultative program was assembled between May 1, 2005 and June 30, 2006. Patients and/or their substitute decision makers (SDM completed a questionnaire, at baseline, that assessed their preferences for AAMM en route to their eventual deaths. Seven common interventions constituting AAMM were surveyed: cardiopulmonary resuscitation (CPR & mechanical ventilation (MV, chemotherapy, antibiotics, anticoagulants, blood transfusions, feeding tubes, and artificial hydration. Multivariable analyses were conducted on the seven interventions individually as well as on the composite score that summed preferences for the seven interventions. Results 380 patients with advanced cancer agreed to participate in the study. A trend to desire a mostly conservative palliative approach was noted as 42% of patients desired one or fewer interventions. At baseline, most patients and their SDM's were relatively secure about decisions pertaining to the seven interventions as the rates of being "undecided" ranged from a high of 23.4% for chemotherapy to a low of 3.9% for feeding tubes. Multivariable modeling showed that more AAMM was preferred by younger patients (P Conclusions Although the majority of patients with advanced cancer in this study expressed preferences for CPM, younger age

  16. Successful enteral nutrition in the treatment of esophagojejunal fistula after total gastrectomy in gastric cancer patients

    Directory of Open Access Journals (Sweden)

    Portanova Michel

    2010-08-01

    Full Text Available Abstract Background Esophagojejunal fistula is a serious complication after total gastrectomy in gastric cancer patients. This study describes the successful conservative management in 3 gastric cancer patients with esophagojejunal fistula after total gastrectomy using total enteral nutrition. Methods Between January 2004 to December 2008, 588 consecutive patients with a proven diagnosis of gastric cancer were taken to the operation room to try a curative treatment. Of these, 173 underwent total gastrectomy, 9 of them had esophagojejunal fistula (5.2%. In three selected patients a trans-anastomotic naso-enteral feeding tube was placed under fluoroscopic vision when the fistula was clinically detected and a complete polymeric enteral formula was used. Results The complete closing of the esophagojejunal fistula was obtained in day 8, 14 and 25 respectively. Conclusion In some selected cases it is possible to make a successful enteral nutrition using a feeding tube distal to the leak area inserted with the help of fluoroscopic vision. The specialized management of a gastric surgery unit and nutritional therapy unit are highlighted.

  17. Researchers studying alternative to bladder removal for bladder cancer patients | Center for Cancer Research

    Science.gov (United States)

    A new phase I clinical trial conducted by researchers at the Center for Cancer Research (CCR) is evaluating the safety and tolerability, or the degree to which any side effects can be tolerated by patients, of a two-drug combination as a potential alternative to bladder removal for bladder cancer patients. The trial targets patients with non-muscle invasive bladder cancer (NMIBC) whose cancers have stopped responding to traditional therapies. Read more...

  18. Symptom monitoring in treatment of cancer patients

    Institute of Scientific and Technical Information of China (English)

    Yao Wanxia; Lin Miao; Lü Ye; Yang Biao; Yao Cong; Liu Juan; Wang Wenru

    2008-01-01

    Objective To examine self-reported symptoms by the patients receiving cancer therapy, and find out the symptoms that should be coped with and managed during the treatment. Methods A pilot study was conducted on self-reported symptoms on 185 patients receiving chemotherapy and/or radiotherapy for different cancers. The Therapy-Related Symptoms Checklist (TRSC) was used. Results Severe symptoms on the TRSC subscales: loss of appetite,feeling sluggish, weight loss, nausea and hair loss, were reported by the patients. The frequently reported symptoms by those on chemotherapy were nausea, feeling sluggish, weight loss, vomiting, and taste change. The frequently reported symptoms by those on radiotherapy were feeling sluggish, weight loss, loss of appetite, difficult sleeping, and changing taste. The symptoms of loss of appetite, feeling sluggish, weight loss, hair loss, and nausea were both frequently reported by those on radiotherapy and those on chemotherapy. Conclusion Symptom monitoring may be facilitated by TRSC, based on the severity and frequency of reported symptoms, more patients and caregivers could know which symptoms should be preferential interventions.

  19. Original Research Risk factors for common cancers among patients ...

    African Journals Online (AJOL)

    Conclusions. Age, smoking, and HIV are important risk factors for the 3 commonest cancer types (oesophageal, KS, and cervical) at this teaching .... cancer (95%) patients had no history of smoking or alcohol ..... Africa: a current perspective.

  20. Hypercalcaemia in patients with breast cancer: Patterns and ...

    African Journals Online (AJOL)

    hypercalcaemia at cancer diagnosis or during cancer treatment. About 25 % of the hypercalcaemic ... The main mechanism of hypercalcaemia in these patients involves pathological bone resorption through secretion of cytokines such as ...

  1. Multiple primary malignant neoplasms in breast cancer patients in Israel

    International Nuclear Information System (INIS)

    Schenker, J.G.; Levinsky, R.; Ohel, G.

    1984-01-01

    The data of an epidemiologic study of multiple primary malignant neoplasms in breast cancer patients in Israel are presented. During the 18-year period of the study 12,302 cases of breast carcinoma were diagnosed, and, of these, 984 patients (8%) had multiple primary malignant tumors. Forty-seven of these patients developed two multiple primary cancers. A significantly higher than expected incidence of second primary cancers occurred at the following five sites: the opposite breast, salivary glands, uterine corpus, ovary, and thyroid. Cancers of the stomach and gallbladder were fewer than expected. Treatment of the breast cancer by irradiation was associated with an increased risk of subsequent cancers of lung and hematopoietic system. The prognosis was mainly influenced by the site and malignancy of the second primary cancer. The incidence of multiple primary malignancies justifies a high level of alertness to this possibility in the follow-up of breast cancer patients

  2. Chemotherapy Regimen Extends Survival in Advanced Pancreatic Cancer Patients

    Science.gov (United States)

    A four-drug chemotherapy regimen has produced the longest improvement in survival ever seen in a phase III clinical trial of patients with metastatic pancreatic cancer, one of the deadliest types of cancer.

  3. Chromosomal radiosensitivity of prostate cancer patients

    International Nuclear Information System (INIS)

    McRobbie, M.L.; Riches, A.; Baxby, K.

    2003-01-01

    Full text: Radiosensitivity of peripheral blood lymphocytes from prostate cancer patients is being investigated using the G2 assay and the Cytokinesis Block Micronucleus(CBMN)assay. The G2 assay evaluates chromosomal damage caused by irradiating cells in the G2 phase of the cell cycle. The CBMN assay quantifies the post mitotic micronuclei, which are the expression of damage incurred during G0. An association between hypersensitivity to the chromosome damaging effects of ionising radiation and cancer predispostion has been demonstrated in a number of heritable conditions by using the aforementioned techniques. Recently, increased chromosomal radiosensitivity has been demonstrated in a significant proportion of patients with no obvious family history of malignancy. The aim of this study is to establish whether a group of prostatic carcinoma patients exists and if so whether there are any correlations between their G2 and G0 sensitivities. The study has shown there is no correlation between G2 and G0 sensitivity, confirming the general trend that individuals exhibiting chromosomal radiosensitivity are defective in only one mechanism and G2 and G0 sensitivity are largely independent. Current data indicates that there is an identifiable group of men within the prostate cancer population with increased chromosomal radiosensitivity. Using the G2 assay and the 90th percentile of the controls as a cut off point for sensitivity, no significant difference between the controls and the patient population has been found. However, using the CBMN assay and again the 90th percentile, approximately 11% of the control group are sensitive compared with approximately 40% of the carcinoma cases. The implications of this increased radiosensitivity are as yet unclear, but it is indicative of increased chromosomal fragility and therefore, possibly associated with malignant transformation. Hence, it may prove a useful tool in identifying individuals at increased risk of developing

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

    Directory of Open Access Journals (Sweden)

    Medeiros Lidia

    2006-03-01

    Full Text Available Abstract Background Most of the studies about invasive Candida infections in cancer patients have focused on haematological patients. The aim of this study was to provide information about risk factors for candidaemia in patients with solid tumours. Methods Retrospective cohort study. During a 9-year period (1995–2003 we reviewed all cases of candidaemia that affected cancer patients in Santa Casa Complexo Hospitalar, Brazil. Results During the period of study, 210 patients had the diagnosis of candidaemia in our medical centre, and 83 of these patients had cancer (39.5%. The majority of patients with cancer had solid tumours (77.1%, mostly in the alimentary tract. Most of solid cancers were non-metastatic (71.9%. Major diagnoses in patients with haematological neoplasia were acute leukaemia (n = 13, high grade non-Hodgkin lymphoma (n = 5 and Hodgkin's disease (n = 1. Non-Candida albicans species caused 57.8% of the episodes of candidaemia in patients with cancer, mainly in patients with haematological malignancies (p = 0.034. Neutropenia and treatment with corticosteroids were more frequent in the haematological group, in comparison with patients with solid tumours. Only 22.2% of patients with solid tumours were neutropenic before candidaemia. Nonetheless, the presence of ileus and the use of anaerobicides were independent risk factors for candidaemia in patients with solid cancers. The overall mortality in cancer patients with candidaemia was 49.4%. We then compared 2 groups of adult patients with candidaemia. The first was composed of non-neutropenic patients with solid tumours, and the second group included patients without cancer. We found that central venous catheters and gastrointestinal surgery were independently associated with candidaemia in patients with solid tumour. Conclusion Cancer patients with candidaemia seem to have very different predisposing factors to acquire the infection when stratified according to baseline diseases

  5. Outcome of severe infections in afebrile neutropenic cancer patients

    Science.gov (United States)

    Mahkovic-Hergouth, Ksenija; Novakovic, Barbara Jezersek; Seruga, Bostjan

    2016-01-01

    Abstract Background In some neutropenic cancer patients fever may be absent despite microbiologically and/or clinically confirmed infection. We hypothesized that afebrile neutropenic cancer patients with severe infections have worse outcome as compared to cancer patients with febrile neutropenia. Patients and methods We retrospectively analyzed all adult cancer patients with chemotherapy-induced neutropenia and severe infection, who were admitted to the Intensive Care Unit at our cancer center between 2000 and 2011. The outcome of interest was 30-day in-hospital mortality rate. Association between the febrile status and in-hospital mortality rate was evaluated by the Fisher’s exact test. Results We identified 69 episodes of severe neutropenic infections in 65 cancer patients. Among these, 9 (13%) episodes were afebrile. Patients with afebrile neutropenic infection presented with hypotension, severe fatigue with inappetence, shaking chills, altered mental state or cough and all of them eventually deteriorated to severe sepsis or septic shock. Overall 30-day in-hospital mortality rate was 55.1%. Patients with afebrile neutropenic infection had a trend for a higher 30-day in-hospital mortality rate as compared to patients with febrile neutropenic infection (78% vs. 52%, p = 0.17). Conclusions Afebrile cancer patients with chemotherapy-induced neutropenia and severe infections might have worse outcome as compared to cancer patients with febrile neutropenia. Patients should be informed that severe neutropenic infection without fever can occasionally occur during cancer treatment with chemotherapy. PMID:27904453

  6. Gastrectomy with limited surgery for elderly patients with gastric cancer

    Directory of Open Access Journals (Sweden)

    Koji Mikami

    2018-01-01

    Conclusion: Gastrectomy according to the gastric treatment guidelines for elderly patients with gastric cancer is recommended. Elderly male patients with poor nutrition have poor prognosis; prognostic nutrition index <40. Limited surgery is a treatment option for such patients.

  7. Cancer immunotherapy in patients with preexisting autoimmune disorders

    DEFF Research Database (Denmark)

    Donia, Marco; Pedersen, Magnus; Svane, Inge Marie

    2017-01-01

    Patients with preexisting active autoimmune disorders were excluded from clinical trials of immune checkpoint inhibitors. However, patients with autoimmune disorders are diagnosed with cancer at least as frequently as the global population, and clinicians treating patients outside clinical trials...

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

    Science.gov (United States)

    Tanna, Nuttan; Buijs, Helene; Pitkin, Joan

    2011-12-01

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

  9. Adaptation of Individual Meaning-Centered Psychotherapy for Chinese Immigrant Cancer Patients | Division of Cancer Prevention

    Science.gov (United States)

    The purpose of the study is to modify a type of counseling called "Individual Meaning Centered Psychotherapy" to meet the needs of Chinese cancer patients. Many cancer patients use counseling or other resources to help cope with the emotional burden of their illnesses. Counseling often helps them cope with cancer by giving them a place to express their feelings.

  10. Therapeutic effects of mosapride citrate and lansoprazole for prevention of aspiration pneumonia in patients receiving gastrostomy feeding.

    Science.gov (United States)

    Takatori, Kento; Yoshida, Rihito; Horai, Aya; Satake, Shinya; Ose, Takayuki; Kitajima, Naoto; Yoneda, Shushi; Adachi, Kyoichi; Amano, Yuji; Kinoshita, Yoshikazu

    2013-10-01

    Aspiration pneumonia is an emerging problem in patients receiving gastrostomy feeding. This study is designed to clarify the therapeutic effects of mosapride citrate and lansoprazole for prevention of aspiration pneumonia in patients receiving gastrostomy feeding. The study subjects were 119 patients with dysphasia who required gastrostomy feeding. They were randomly assigned to the control (without medication), lansoprazole (15 mg, 1/day), and mosapride (5 mg, 3/day) groups. The number of days with fever (≥37.8 °C), vomiting, and antibiotics administration, as well as the occurrence of pneumonia were investigated during the 6-month observation period. The incidence of pneumonia during the observation period was significantly lower in the mosapride group as compared to the control (7/38 vs. 16/40, p = 0.038) and lansoprazole (vs. 20/41, p = 0.005) groups. The mosapride group also showed a significant decrease in days with fever and antibiotics administration as compared to the other groups. Multivariate analysis revealed that the presence of hiatal hernia was a significant risk factor and administration of mosapride was a significant preventive factor for pneumonia. Mosapride has a preventive effect on occurrence of pneumonia in patients receiving gastrostomy feeding.

  11. Radiation-induced cancer in laryngectomized patients

    International Nuclear Information System (INIS)

    Miyahara, Hiroshi; Tsuruta, Yoshihiro; Sato, Takeo; Yoshino, Kunitoshi; Umatani, Katunori

    1991-01-01

    Three patients developed hypopharyngo-cervical esophageal carcinoma, 6.5, 13, and 12 years after total laryngectomy. The first patient had received irradiation (60 Gy) for hypopharyngeal carcinoma. The recurrent tumor was removed with total pharyngolaryngoesophagectomy and reconstruction was performed with a local skin flap. After 6 years and 6 months, she developed progressive dysphagia. A new cervical esophageal skin cancer was diagnosed by pharyngoesophagography and treated. The second patient had had total laryngectomy for laryngeal carcinoma and received irradiation (100 Gy) post-operatively. After 13 years, he developed progressive dysphagia. Pharyngoesophagography revealed cervical esophageal carcinoma. The third patient had received irradiation for laryngeal carcinoma (60 Gy) and underwent total laryngectomy because of recurrence. After 12 years she developed dysphagia, and was treated for hypopharyngeal carcinoma. These three patients seemed to have radiation-induced carcinoma. Patients treated with total laryngectomy and irradiation who later complain of progressive dysphagia should be examined carefully to differentiate between postoperative stenosis due to scarring and a new carcinoma. (author)

  12. Sludge and stone formation in the gallbladder in bedridden elderly patients with cerebrovascular disease: influence of feeding method.

    Science.gov (United States)

    Onizuka, Y; Mizuta, Y; Isomoto, H; Takeshima, F; Murase, K; Miyazaki, M; Ogata, H; Otsuka, K; Murata, I; Kohno, S

    2001-05-01

    The incidence of gallbladder sludge or gallstone formation in bedridden patients with cerebrovascular disease (CVD) remains obscure. The aim of this study was to determine the incidence, relationship to feeding method, and mechanisms of gallbladder sludge and gallstone formation in elderly patients with CVD. Using ultrasonography, we determined the development of gallbladder sludge and gallstone over a 12-month period, the area of the gallbladder, the gallbladder contractile response to cerulein, and fasting levels of plasma cholecystokinin (CCK) in 40 bedridden elderly patients with CVD. The patients were divided into three groups based on the feeding method: oral ingestion (OI), nasogastric feeding (NF), and total parenteral nutrition (TPN). Gallbladder sludge and gallstone were not observed in any of the 14 OI patients, but occurred in 6 and 1 of the 11 NF patients, and in 14 and 3 of the 15 TPN patients, respectively. Fasting gallbladder areas were significantly larger in the TPN group than in the other two groups. The TPN group showed a marked decrease in cerulein-induced gallbladder contractility. Fasting plasma CCK levels were lower in the TPN group than in the OI group. Our results indicate that elderly patients with CVD confined to bed over long periods are not necessarily at risk of gallbladder sludge or gallstone formation, and the development of these features may be associated with the feeding method. The predisposition of CVD patients on TPN to gallbladder disease is probably caused by failure of gallbladder contraction, resulting from insufficient secretion of CCK and impaired sensitivity of the gallbladder to CCK.

  13. The effect of a natural food based tube feeding in minimizing diarrhea in critically ill neurological patients.

    Science.gov (United States)

    Schmidt, Simone B; Kulig, Willibald; Winter, Ralph; Vasold, Antje S; Knoll, Anette E; Rollnik, Jens D

    2018-01-09

    Diarrhea has negative consequences for patients, health care staff and health care costs when neurological patients are fed enterally over long periods. We examined the effect of tube feeding with natural foods in reducing the number of fluid stool evacuations and diarrhea in critically ill neurological patients. A multicenter, prospective, open-label and randomized controlled trial (RCT) was conducted at facilities in Germany specializing in early rehabilitation after neurological damage. Patients of the INTERVENTION group were fed by tube using a commercially available product based on real foods such as milk, meat, carrots, whereas CONTROL patients received a standard tube-feed made of powdered raw materials. All received enteral nutrition over a maximum of 30 days. The number of defecations and the consistency of each stool according to the Bristol Stool Chart (BSC) were monitored. In addition, daily calories, liquids and antibiotic-use were recorded. 118 Patients who had suffered ischemic stroke, intracerebral hemorrhage, traumatic brain injury or hypoxic brain damage and requiring enteral nutrition were enrolled; 59 were randomized to receive the intervention and 59 control feed. There were no significant differences in clinical screening data, age, sex, observation period or days under enteral nutrition between the groups. Patients in both groups received equivalent amount of calories and fluids. In both groups antibiotics were frequently prescribed (69.5% in the INTERVENTION group and 75.7% in the CONTROL group) for 10-11 days on average. In comparison to the CONTROL group, patients in the INTERVENTION group had a significant reduction of the number of watery stool evacuations (type 7 BSC) (minus 61%, IRR = 0.39, p natural based food was effective in reducing the number of watery defecations and diarrhea in long term tube-fed critically ill neurological patients, compared to those fed with standard tube feeding. Copyright © 2018 The Authors. Published

  14. Prevalence of deleterious ATM germline mutations in gastric cancer patients.

    Science.gov (United States)

    Huang, Dong-Sheng; Tao, Hou-Quan; He, Xu-Jun; Long, Ming; Yu, Sheng; Xia, Ying-Jie; Wei, Zhang; Xiong, Zikai; Jones, Sian; He, Yiping; Yan, Hai; Wang, Xiaoyue

    2015-12-01

    Besides CDH1, few hereditary gastric cancer predisposition genes have been previously reported. In this study, we discovered two germline ATM mutations (p.Y1203fs and p.N1223S) in a Chinese family with a history of gastric cancer by screening 83 cancer susceptibility genes. Using a published exome sequencing dataset, we found deleterious germline mutations of ATM in 2.7% of 335 gastric cancer patients of different ethnic origins. The frequency of deleterious ATM mutations in gastric cancer patients is significantly higher than that in general population (p=0.0000435), suggesting an association of ATM mutations with gastric cancer predisposition. We also observed biallelic inactivation of ATM in tumors of two gastric cancer patients. Further evaluation of ATM mutations in hereditary gastric cancer will facilitate genetic testing and risk assessment.

  15. Predictive factors of thyroid cancer in patients with Graves' disease.

    Science.gov (United States)

    Ren, Meng; Wu, Mu Chao; Shang, Chang Zhen; Wang, Xiao Yi; Zhang, Jing Lu; Cheng, Hua; Xu, Ming Tong; Yan, Li

    2014-01-01

    The best preoperative examination in Graves' disease with thyroid cancer still remains uncertain. The objectives of the present study were to investigate the prevalence of thyroid cancer in Graves' disease patients, and to identify the predictive factors and ultrasonographic features of thyroid cancer that may aid the preoperative diagnosis in Graves' disease. This retrospective study included 423 patients with Graves' disease who underwent surgical treatment from 2002 to 2012 at our institution. The clinical features and ultrasonographic findings of thyroid nodules were recorded. The diagnosis of thyroid cancer was determined according to the pathological results. Thyroid cancer was discovered in 58 of the 423 (13.7 %) surgically treated Graves' disease patients; 46 of those 58 patients had thyroid nodules, and the other 12 patients were diagnosed with incidentally discovered thyroid carcinomas without thyroid nodules. Among the 58 patients with thyroid cancer, papillary microcarcinomas were discovered in 50 patients, and multifocality and lymph node involvement were detected in the other 8 patients. Multivariate regression analysis showed younger age was the only significant factor predictive of metastatic thyroid cancer. Ultrasonographic findings of calcification and intranodular blood flow in thyroid nodules indicate that they are more likely to harbor thyroid cancers. Because the influencing factor of metastatic thyroid cancers in Graves' disease is young age, every suspicious nodule in Graves' disease patients should be evaluated and treated carefully, especially in younger patients because of the potential for metastasis.

  16. Breaking bad news in cancer patients.

    Science.gov (United States)

    Konstantis, Apostolos; Exiara, Triada

    2015-01-01

    In a regional hospital, many patients are newly diagnosed with cancer. Breaking the bad news in these patients and their relatives is a tough task. Many doctors are not experienced in talking to patients about death or death-related diseases. In recent years, there have been great efforts to change the current situation. The aim of this study was to investigate the experience and education of medical personnel in breaking bad news in a secondary hospital. 59 doctors from General Hospital of Komotini, Greece were included in the study. All the doctors were in clinical specialties that treated cancer patients. A brief questionnaire was developed based on current guidelines such as Baile/SPIKES framework and the ABCDE mnemonic. Residents are involved in delivering bad news less frequently than specialists. Only 21 doctors (35.59%) had specific training on breaking bad news. 20 doctors (33.90%) were aware of the available techniques and protocols on breaking bad news. 47 doctors (79.66%) had a consistent plan for breaking bad news. 57 (96.61%) delivered bad news in a quiet place, 53 (89.83%) ensured no interruptions and enough time, 53 (89.83%) used simple words and 54 (91.53%) checked for understanding and did not rush through the news. 46 doctors (77.97%) allowed relatives to determine patient's knowledge about the disease. There were low rates of specific training in breaking bad news. However, the selected location, the physician's speech and their plan were according to current guidelines.

  17. 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....

  18. Young breast cancer patients in the developing world: incidence ...

    African Journals Online (AJOL)

    African patients are more likely to be premenopausal at diagnosis and the ... of whether a patient had a mastectomy or breast conserving therapy. Breast conserving treat- ment is an option for treatment of breast cancer in a young patient given the ... family and society as a whole. ... breast cancer, from the perspective of.

  19. Recall in older cancer patients: measuring memory for medical information.

    NARCIS (Netherlands)

    Jansen, J.; Weert, J. van; Meulen, N. van der; Dulmen, S. van; Heeren, T.; Bensing, J.

    2008-01-01

    PURPOSE: Remembering medical treatment information may be particularly taxing for older cancer patients, but to our knowledge this ability has never been assessed in this specific age group only. Our purpose in this study was to investigate older cancer patients' recall of information after patient

  20. Recall in older cancer patients: Measuring memory for medical information

    NARCIS (Netherlands)

    Jansen, J.; van Weert, J.; van der Meulen, N.; van Dulmen, S.; Heeren, T.; Bensing, J.

    2008-01-01

    Purpose: Remembering medical treatment information may be particularly taxing for older cancer patients, but to our knowledge this ability has never been assessed in this specific age group only. Our purpose in this study was to investigate older cancer patients' recall of information after patient

  1. Hypercalcaemia in patients with breast cancer: Patterns and ...

    African Journals Online (AJOL)

    Purpose: To assess the patterns of use of bisphosphonate therapies for hypercalcaemia in breast cancer patients, and their outcomes. Methods: A retrospective chart review study of breast cancer patients hospitalised between 2009 and 2014 at Penang Hospital, a public tertiary hospital in Malaysia was conducted. Patients ...

  2. Inequalities in reported cancer patient experience by socio-demographic characteristic and cancer site: evidence from respondents to the English Cancer Patient Experience Survey.

    Science.gov (United States)

    Saunders, C L; Abel, G A; Lyratzopoulos, G

    2015-01-01

    Patient experience is a critical dimension of cancer care quality. Understanding variation in experience among patients with different cancers and characteristics is an important first step for designing targeted improvement interventions. We analysed data from the 2011/2012 English Cancer Patient Experience Survey (n = 69,086) using logistic regression to explore inequalities in care experience across 64 survey questions. We additionally calculated a summary measure of variation in patient experience by cancer, and explored inequalities between patients with cancers treated by the same specialist teams. We found that younger and very old, ethnic minority patients and women consistently reported worse experiences across questions. Patients with small intestine/rarer lower gastrointestinal, multiple myeloma and hepatobiliary cancers were most likely to report negative experiences whereas patients with breast, melanoma and testicular cancer were least likely (top-to-bottom odds ratio = 1.91, P patients with cancers treated by the same specialty for five of nine services (P patients with ovarian, multiple myeloma, anal, hepatobiliary and renal cancer reported notably worse experiences than patients with other gynaecological, haematological, gastrointestinal and urological malignancies respectively. Initiatives to improve cancer patient experience across oncology services may be suitably targeted on patients at higher risk of poorer experience. © 2014 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.

  3. Bladder cancer in cancer patients: population-based estimates from a large Swedish study

    OpenAIRE

    Bermejo, J Lorenzo; Sundquist, J; Hemminki, K

    2009-01-01

    Background: This study quantified the risk of urinary bladder neoplasms in cancer patients taking into account the age at first diagnosis, the gender of the patients and the lead time between diagnoses. Methods: We used standardised incidence ratios (SIRs) to compare the incidence of bladder tumours in 967?767 cancer patients with the incidence rate in the general Swedish population. A total of 3324 male and 1560 female patients developed bladder tumours at least 1 year after first cancer dia...

  4. Cardiovascular complications following thoracic radiotherapy in patients with cancer

    DEFF Research Database (Denmark)

    Nielsen, Kirsten Melgaard; Borchsenius, Julie I Helene; Offersen, Birgitte Vrou

    2016-01-01

    Cardiovascular complications following thoracic radiotherapy in patients with cancer are well described. Advancements in surgery, radiotherapy and systemic treatments have led to an increasing number of cancer survivors and thus an increasing number of patients with long-term side effects...... of their cancer treatments. This article describes the short- and long-term cardiovascular morbidity and mortality following thoracic radiotherapy and further, optimal cardiovascular assessments and diagnostic tools in asymptomatic and symptomatic patients....

  5. Perioperative nutritional status changes in gastrointestinal cancer patients.

    Science.gov (United States)

    Shim, Hongjin; Cheong, Jae Ho; Lee, Kang Young; Lee, Hosun; Lee, Jae Gil; Noh, Sung Hoon

    2013-11-01

    The presence of gastrointestinal (GI) cancer and its treatment might aggravate patient nutritional status. Malnutrition is one of the major factors affecting the postoperative course. We evaluated changes in perioperative nutritional status and risk factors of postoperative severe malnutrition in the GI cancer patients. Nutritional status was prospectively evaluated using patient-generated subjective global assessment (PG-SGA) perioperatively between May and September 2011. A total of 435 patients were enrolled. Among them, 279 patients had been diagnosed with gastric cancer and 156 with colorectal cancer. Minimal invasive surgery was performed in 225 patients. PG-SGA score increased from 4.5 preoperatively to 10.6 postoperatively (pgastric cancer patients, postoperative severe malnourishment increased significantly (p60, pgastric cancer (pgastric cancer, and open surgery remained significant as risk factors of severe malnutrition. The prevalence of severe malnutrition among GI cancer patients in this study increased from 2.3% preoperatively to 26.3% after an operation. Old age, preoperative weight loss, gastric cancer, and open surgery were shown to be risk factors of postoperative severe malnutrition. In patients at high risk of postoperative severe malnutrition, adequate nutritional support should be considered.

  6. The Needs of Family Members of Cancer Patients

    Science.gov (United States)

    1988-01-01

    suffering in addition to feelings of powerlessness, guilt , anger, ambivalence, and fear for the patient and themselves. Another task for the family is...patients had breast cancer, five patients had lung cancer, five more had cancer of the gastrointestinal tract, three had cancer of the liver or pancreas ...the patient 3.03 1.07 E 14. To talk about feelings such as anger or guilt 3.03 1.07 E 15. To have comfortable furniture in the waiting room 2.82 0.90 P

  7. INFECTIOUS COMPLICATIONS IN PATIENTS WITH LUNG CANCER

    Directory of Open Access Journals (Sweden)

    Z. V. Grigoryevskaya

    2014-07-01

    Full Text Available Lung cancer (LC annually afflicts 63–65 thousand people in Russia and 1.04 million worldwide, which amounts to 12.8% of all notified cases of neoplasms. In LC patients, infectious complications are characterized by a severe course; destruction foci, decay cavities, and abscess may form.All give rise to difficulties in making a diagnosis and in choosing a treatment policy. Infections caused by P. aeruginosa, A. baumanii, bacteria of the family Enterobacteriacae, S. aureus, and Enterococcus spp present the greatest problem in inpatients with LC. The early diagnosis of infectiouscomplications and the use of adequate schemes of antibiotic prevention and therapy promote a reduction in mortality from infection in this categoryof patients and expand the possibilities of their specific antitumor treatment.

  8. INFECTIOUS COMPLICATIONS IN PATIENTS WITH LUNG CANCER

    Directory of Open Access Journals (Sweden)

    Z. V. Grigoryevskaya

    2011-01-01

    Full Text Available Lung cancer (LC annually afflicts 63–65 thousand people in Russia and 1.04 million worldwide, which amounts to 12.8% of all notified cases of neoplasms. In LC patients, infectious complications are characterized by a severe course; destruction foci, decay cavities, and abscess may form.All give rise to difficulties in making a diagnosis and in choosing a treatment policy. Infections caused by P. aeruginosa, A. baumanii, bacteria of the family Enterobacteriacae, S. aureus, and Enterococcus spp present the greatest problem in inpatients with LC. The early diagnosis of infectiouscomplications and the use of adequate schemes of antibiotic prevention and therapy promote a reduction in mortality from infection in this categoryof patients and expand the possibilities of their specific antitumor treatment.

  9. [Thyroid cancer in patients with Grave's Disease].

    Science.gov (United States)

    Mssrouri, R; Benamr, S; Essadel, A; Mdaghri, J; Mohammadine, El H; Lahlou, M-K; Taghy, A; Belmahi, A; Chad, B

    2008-01-01

    To evaluate the incidence of thyroid carcinoma in patients operated on for Graves' disease, to identify criteria which may predict malignancy, and to develop a practical approach to determine the extensiveness of thyroidectomy. Retrospective study of all patients who underwent thyroidectomy for Graves' disease between 1995 and 2005. 547 patients underwent subtotal thyroidectomy for Graves' disease during this period. Post-operative pathology examination revealed six cases of thyroid cancer (1.1%). All six cases had differentiated thyroid carcinoma (papillary carcinoma in 3 cases, follicular carcinoma in 2 cases and papillo-follicular carcinoma in 1 case). The indication for initial thyroidectomy was a palpable thyroid nodule in 3 cases (50%), failure of medical treatment for Grave's disease in 2 cases (33%), and signs of goiter compression in 1 case (17%). Five patients underwent re-operative total thyroidectomy. This study shows that while malignancy in Grave's disease is uncommon, the presence of thyroid nodule(s) in patients with Grave's disease may be considered as an indication for radical surgery. The most adequate radical surgery in this situation is to perform a total thyroidectomy.

  10. Work functioning trajectories in cancer patients: Results from the longitudinal Work Life after Cancer (WOLICA) study.

    Science.gov (United States)

    Dorland, Heleen F; Abma, Femke I; Roelen, Corné A M; Stewart, Roy E; Amick, Benjamin C; Ranchor, Adelita V; Bültmann, Ute

    2017-11-01

    More than 60% of cancer patients are able to work after cancer diagnosis. However, little is known about their functioning at work. Therefore, the aims of this study were to (1) identify work functioning trajectories in the year following return to work (RTW) in cancer patients and (2) examine baseline sociodemographic, health-related and work-related variables associated with work functioning trajectories. This longitudinal cohort study included 384 cancer patients who have returned to work after cancer diagnosis. Work functioning was measured at baseline, 3, 6, 9 and 12 months follow-up. Latent class growth modeling (LCGM) was used to identify work functioning trajectories. Associations of baseline variables with work functioning trajectories were examined using univariate and multivariate analyses. LCGM analyses with cancer patients who completed on at least three time points the Work Role Functioning Questionnaire (n = 324) identified three work functioning trajectories: "persistently high" (16% of the sample), "moderate to high" (54%) and "persistently low" work functioning (32%). Cancer patients with persistently high work functioning had less time between diagnosis and RTW and had less often a changed meaning of work, while cancer patients with persistently low work functioning reported more baseline cognitive symptoms compared to cancer patients in the other trajectories. This knowledge has implications for cancer care and guidance of cancer patients at work. © 2017 UICC.

  11. Spatial analyses identify the geographic source of patients at a National Cancer Institute Comprehensive Cancer Center.

    Science.gov (United States)

    Su, Shu-Chih; Kanarek, Norma; Fox, Michael G; Guseynova, Alla; Crow, Shirley; Piantadosi, Steven

    2010-02-01

    We examined the geographic distribution of patients to better understand the service area of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, a designated National Cancer Institute (NCI) comprehensive cancer center located in an urban center. Like most NCI cancer centers, the Sidney Kimmel Comprehensive Cancer Center serves a population beyond city limits. Urban cancer centers are expected to serve their immediate neighborhoods and to address disparities in access to specialty care. Our purpose was to learn the extent and nature of the cancer center service area. Statistical clustering of patient residence in the continental United States was assessed for all patients and by gender, cancer site, and race using SaTScan. Primary clusters detected for all cases and demographically and tumor-defined subpopulations were centered at Baltimore City and consisted of adjacent counties in Delaware, Pennsylvania, Virginia, West Virginia, New Jersey and New York, and the District of Columbia. Primary clusters varied in size by race, gender, and cancer site. Spatial analysis can provide insights into the populations served by urban cancer centers, assess centers' performance relative to their communities, and aid in developing a cancer center business plan that recognizes strengths, regional utility, and referral patterns. Today, 62 NCI cancer centers serve a quarter of the U.S. population in their immediate communities. From the Baltimore experience, we might project that the population served by these centers is actually more extensive and varies by patient characteristics, cancer site, and probably cancer center services offered.

  12. Breaking bad news in cancer patients

    Directory of Open Access Journals (Sweden)

    Apostolos Konstantis

    2015-01-01

    Full Text Available Objective: In a regional hospital, many patients are newly diagnosed with cancer. Breaking the bad news in these patients and their relatives is a tough task. Many doctors are not experienced in talking to patients about death or death-related diseases. In recent years, there have been great efforts to change the current situation. The aim of this study was to investigate the experience and education of medical personnel in breaking bad news in a secondary hospital. Materials and Methods: 59 doctors from General Hospital of Komotini, Greece were included in the study. All the doctors were in clinical specialties that treated cancer patients. A brief questionnaire was developed based on current guidelines such as Baile/SPIKES framework and the ABCDE mnemonic. Results: Residents are involved in delivering bad news less frequently than specialists. Only 21 doctors (35.59% had specific training on breaking bad news. 20 doctors (33.90% were aware of the available techniques and protocols on breaking bad news. 47 doctors (79.66% had a consistent plan for breaking bad news. 57 (96.61% delivered bad news in a quiet place, 53 (89.83% ensured no interruptions and enough time, 53 (89.83% used simple words and 54 (91.53% checked for understanding and did not rush through the news. 46 doctors (77.97% allowed relatives to determine patient′s knowledge about the disease. Conclusions: There were low rates of specific training in breaking bad news. However, the selected location, the physician′s speech and their plan were according to current guidelines.

  13. Layers in sorting practices: Sorting out patients with potential cancer

    DEFF Research Database (Denmark)

    Møller, Naja Holten; Bjørn, Pernille

    2011-01-01

    for a particular patient. Due to the limited resources within the Danish healthcare system, initiating cancer pathways for all patients with a remote suspicion of cancer would crash the system, as it would be impossible for healthcare professionals to commit to the prescribed schedules and times defined...... they show that sorting patients before initiating a standardized cancer pathway is not a simple process of deciding on a predefined category that will stipulate particular dates and times. Instead, these informal sorting mechanisms show that the process of sorting patients prior to diagnosis......In the last couple of years, widespread use of standardized cancer pathways has been seen across a range of countries, including Denmark, to improve prognosis of cancer patients. In Denmark, standardized cancer pathways take the form of guidelines prescribing well-defined sequences where steps...

  14. Priority Settings in patients with Chronic Diseases and Cancer

    DEFF Research Database (Denmark)

    Arreskov, Anne Beiter; Graungaard, Anette Hauskov; Søndergaard, Jens

    Priority setting in patients with cancer and comorbidities Background and aim As both the cancer incidence and the number of patients diagnosed with chronic diseases are increasing, a growing population of cancer survivors will also deal with comorbid chronic diseases. The period after completed...... to comorbidities. Some studies show that participation in regular follow-up consultations concerning comorbid chronic diseases and lifestyle are lower among cancer survivors than non-cancer patients. This could be explained by changes in the patient’s priority setting or in the doctor’s priority and attempt...... to spare the patient for further treatment burden, perhaps resulting in comorbidities falling down the agenda. The overall purpose is to explore patients’ and doctors’ priority settings of comorbidities in patients who have been diagnosed with non-metastatic cancer. Method: The study will consist of three...

  15. Breast cancer patients' presentation for oncological treatment: a ...

    African Journals Online (AJOL)

    Introduction: Breast cancer patients are presenting at advanced stages for oncological treatment in Nigeria and World Health Organization predicted developing countries' breast cancer incidence and mortality to increase by year 2020. Methods: Prospective observational hospital based study that enrolled breast cancer ...

  16. Hypokalemia during the early phase of refeeding in patients with cancer

    Science.gov (United States)

    Grasso, Simona; Ferro, Yvelise; Migliaccio, Valeria; Mazza, Elisa; Rotundo, Stefania; Pujia, Arturo; Montalcini, Tiziana

    2013-01-01

    OBJECTIVE: Refeeding syndrome occurs in patients with severe malnutrition when refeeding begins after a long period of starvation. This syndrome increases the risk of clinical complications and mortality. Hypophosphatemia is considered the primary characteristic of the syndrome. The aim of our study was to investigate the presence of other electrolyte alterations in patients with cancer during the early stage of refeeding. METHODS: In this observational study, we enrolled 34 patients with cancer of the upper aerodigestive tract receiving upfront radiotherapy who were also enrolled in a nutrition program. A caloric intake assessment, anthropometric measurements and biochemical laboratory tests were performed. RESULTS: Significant weight loss (∼20%) was found in these patients. In the patients receiving artificial nutrition, we found lower levels of potassium and total protein compared with those who were fed orally (p = 0.03 for potassium and 0.02 for protein, respectively). Patients on enteral tube feeding had a higher caloric intake compared with those who were fed orally (25±5 kcal/kg/day vs. 10±2 kcal/kg/day). CONCLUSION: Hypokalemia, like hypophosphatemia, could be a complication associated with refeeding in patients with cancer. Hypokalemia was present in the early stages of high-calorie refeeding. PMID:24270952

  17. Hypokalemia during the early phase of refeeding in patients with cancer

    Directory of Open Access Journals (Sweden)

    Simona Grasso

    2013-11-01

    Full Text Available OBJECTIVE: Refeeding syndrome occurs in patients with severe malnutrition when refeeding begins after a long period of starvation. This syndrome increases the risk of clinical complications and mortality. Hypophosphatemia is considered the primary characteristic of the syndrome. The aim of our study was to investigate the presence of other electrolyte alterations in patients with cancer during the early stage of refeeding. METHODS: In this observational study, we enrolled 34 patients with cancer of the upper aerodigestive tract receiving upfront radiotherapy who were also enrolled in a nutrition program. A caloric intake assessment, anthropometric measurements and biochemical laboratory tests were performed. RESULTS: Significant weight loss (∼20% was found in these patients. In the patients receiving artificial nutrition, we found lower levels of potassium and total protein compared with those who were fed orally (p = 0.03 for potassium and 0.02 for protein, respectively. Patients on enteral tube feeding had a higher caloric intake compared with those who were fed orally (25±5 kcal/kg/day vs. 10±2 kcal/kg/day. CONCLUSION: Hypokalemia, like hypophosphatemia, could be a complication associated with refeeding in patients with cancer. Hypokalemia was present in the early stages of high-calorie refeeding.

  18. Measuring cancer patients' reasons for their information preference: construction of the Considerations Concerning Cancer Information (CCCI) questionnaire

    NARCIS (Netherlands)

    ter Hoeven, Claartje L.; Zandbelt, Linda C.; Fransen, Sanne; de Haes, Hanneke; Oort, Frans; Geijsen, Debby; Koning, Caro; Smets, Ellen

    2011-01-01

    Objectives: This paper describes the further development and psychometric properties of an instrument to measure cancer patients' reasons to want complete or limited information: the Considerations Concerning Cancer Information questionnaire (CCCI). Understanding cancer patients' reasons to want

  19. Prognostic significance of cancer family history for patients with gastric cancer: a single center experience from China.

    Science.gov (United States)

    Liu, Xiaowen; Cai, Hong; Yu, Lin; Huang, Hua; Long, Ziwen; Wang, Yanong

    2016-06-14

    Family history of cancer is a risk factor for gastric cancer. In this study, we investigated the prognoses of gastric cancer patients with family history of cancer. A total of 1805 gastric cancer patients who underwent curative gastrectomy from 2000 to 2008 were evaluated. The clinicopathologic parameters and prognoses of gastric cancer patients with a positive family history (PFH) of cancer were compared with those with a negative family history (NFH). Of 1805 patients, 382 (21.2%) patients had a positive family history of cancer. Positive family history of cancer correlated with younger age, more frequent alcohol and tobacco use, worse differentiation, smaller tumor size, and more frequent tumor location in the lower 1/3 of the stomach. The prognoses of patients with a positive family history of cancer were better than that of patients with a negative family history. Family history of cancer independently correlated with better prognosis after curative gastrectomy in gastric cancer patients.

  20. Promoting Value, Affordability, and Innovation in Cancer Drug Treatment - The Rising Cost of Cancer Drugs: Impact on Patients and Society

    Science.gov (United States)

    Innovative new drugs have improved outcomes for many cancer patients. But spending on cancer drugs has increased dramatically in recent years, placing a burden on cancer patients and a strain on health system and societal resources.

  1. Patient Care Coordinator | Center for Cancer Research

    Science.gov (United States)

    blood diseases and conditions; parasitic infections; rheumatic and inflammatory diseases; and rare and neglected diseases. CMRP’s collaborative approach to clinical research and the expertise and dedication of staff to the continuation and success of the program’s mission has contributed to improving the overall standards of public health on a global scale. The Clinical Monitoring Research Program (CMRP) provides comprehensive, dedicated clinical research, study coordination, and administrative support to the National Cancer Institute’s (NCI’s), Center for Cancer Research (CCR), Urologic Oncology Branch (UOB) located at the National Institutes of Health (NIH) in Bethesda, Maryland. KEY ROLES/RESPONSIBILITIES - THIS POSITION IS CONTINGENT UPON FUNDING APPROVAL The Patient Care Coordinator III (PCC III) provides administrative services, as well as patient care coordination. Responsibilities will include: Communicates with various clinical administrative support offices/clinics/diagnostic centers concerning scheduling of patient appointments, new and existing work scopes and clinical protocols (Surgery, X-ray, etc.). Consults with the patient, chooses the appropriate appointment, and enters ID and demographic data supplied by patient to secure an appointment in order to update clinic and physician schedules. Composes correspondence on various administrative issues including patient letters and notices to the patient’s home and physicians. Provides patients with information about their appointments, including medical materials the patient will need to bring, dates and times, clinic information, hospital maps and appropriate travel and hotel information. Arranges Admission Travel Voucher (ATV) travel, including lodging, meals and direct bill requests and enters data in the ATV system daily. Obtains up-to-date patient records and other pertinent information prior to patient appointments or admission. Maintains a roster of all patients and tracks their appointments

  2. Cancer Patients and the Internet: a Survey Among German Cancer Patients.

    Science.gov (United States)

    Ebel, Marie-Desiree; Stellamanns, Jan; Keinki, Christian; Rudolph, Ivonne; Huebner, Jutta

    2017-09-01

    An increasing number of patients and relatives use the Internet to get additional or initial information about their disease. The aim of the study was to reevaluate the Internet usage among German cancer patients. Using a standardized questionnaire, we did an anonymous survey on patients attending a series of lectures on complementary medicine in 2014. We received 255 questionnaires. Nearly 80 % of the participants stated that they used the Internet to read up information about health or medicine issues. There was no significant difference regarding gender, age, or status (patient, current treatment/former treatment; relatives). Most users use the Internet in order to get additional information after a consultation with a physician (82.2 %). Important qualities from the view of the patient are a trustable source (65.3 %), information from experts (59.6 %), and actual information (52.8 %). There is an increasing number of patients in Germany looking for information in the Internet mostly in the intention of getting additional information. Yet, as the quality of information is heterogeneous, false information may lead to distrust in the doctor or wrong decision-making. Accordingly, organizations working on improving quality of cancer care should engage in conveying comprehensive and actual information adapted to the needs of patients. Physicians should know trustful websites for referral of patients.

  3. Differences in dietary intake during chemotherapy in breast cancer patients compared to women without cancer.

    Science.gov (United States)

    de Vries, Y C; van den Berg, M M G A; de Vries, J H M; Boesveldt, S; de Kruif, J Th C M; Buist, N; Haringhuizen, A; Los, M; Sommeijer, D W; Timmer-Bonte, J H N; van Laarhoven, H W M; Visser, M; Kampman, E; Winkels, R M

    2017-08-01

    Breast cancer patients receiving chemotherapy often experience symptoms such as nausea, vomiting and loss of appetite that potentially affect dietary habits. This study assessed the intake of energy, macronutrients and food groups before and during chemotherapy in breast cancer patients compared with women without cancer, and determined the association between symptoms and energy and macronutrient intake. This study included 117 newly diagnosed breast cancer patients scheduled for chemotherapy and 88 women without cancer. Habitual intake before chemotherapy was assessed with a food frequency questionnaire. Two 24-h dietary recalls were completed on random days for each participant during the whole chemotherapy treatment for patients and within 6 months after recruitment for women without cancer. Shortly, after the dietary recall, participants filled out questionnaires on symptoms. Before chemotherapy, habitual energy and macronutrient intake was similar for breast cancer patients and women without cancer. During chemotherapy, breast cancer patients reported a significantly lower total energy, fat, protein and alcohol intake than women without cancer, as shown by a lower intake of pastry and biscuits, cheese, legumes and meat products. A decline in subjective taste perception, appetite and hunger and experiencing a dry mouth, difficulty chewing, lack of energy and nausea were associated with a lower energy intake. Symptoms induced by chemotherapy are associated with lower dietary intake and manifested by a lower intake of specific food groups. To ensure an optimal dietary intake during chemotherapy, it is important to monitor nutritional status and symptom burden during chemotherapy in breast cancer patients.

  4. Caring for cancer patients in the general dental office

    International Nuclear Information System (INIS)

    McDermott, I.

    1989-01-01

    Modern therapeutic modalities and emphasis on early detection have made oral cancer a treatable, and in many cases, a curable disease. The role of the dentist in cancer patient management is two-fold. Early detection of oral lesions during routine dental examination has been shown to be a significant factor in cancer diagnosis. The dentist's other role comes after cancer treatment, specifically therapeutic radiation. Ionizing radiation can have permanent effects on both hard and soft tissues. Prescription and use of fluoride gel in topical applicators can aid in assuring oral health for post-cancer patients

  5. Cancer risk of patients discharged with acute myocardial infarct

    DEFF Research Database (Denmark)

    Dreyer, L; Olsen, J H

    1998-01-01

    We studied whether common shared environmental or behavioral risk factors, other than tobacco smoking, underlie both atherosclerotic diseases and cancer. We identified a group of 96,891 one-year survivors of acute myocardial infarct through the Danish Hospital Discharge Register between 1977...... and 1989. We calculated the incidence of cancer in this group by linking it to the Danish Cancer Registry for the period 1978-1993. There was no consistent excess over the expected figures for any of the categories of cancer not related to tobacco smoking. Specifically, the rates of colorectal cancer...... in acute myocardial infarct patients were similar to those of the general population, as were the rates for hormone-related cancers, including endometrial and postmenopausal breast cancers. We found a moderate increase in the risk for tobacco-related cancers, which was strongest for patients with early...

  6. Energy intake and sources of nutritional support in patients with head and neck cancer--a randomised longitudinal study.

    Science.gov (United States)

    Silander, E; Jacobsson, I; Bertéus-Forslund, H; Hammerlid, E

    2013-01-01

    Malnutrition decreases the cancer patient's ability to manage treatment, affects quality of life and survival, and is common among head and neck (HN) cancer patients due to the tumour location and the treatment received. In this study, advanced HN cancer patients were included and followed during 2 years in order to measure their energy intake, choice of energy sources and to assess problems with dysphagia. The main purpose was to explore when and for how long the patients had dysphagia and lost weight due to insufficient intake and if having a PEG (percutaneous endoscopic gastrostomy) in place for enteral nutrition made a difference. One hundred thirty-four patients were included and randomised to either a prophylactic PEG for early enteral feeding or nutritional care according to clinical praxis. At seven time points weight, dysphagia and energy intake (assessed as oral, nutritional supplements, enteral and parenteral) were measured. Both groups lost weight the first six months due to insufficient energy intake and used enteral nutrition as their main intake source; no significant differences between groups were found. Problems with dysphagia were vast during the 6 months. At the 6-, 12- and 24-month follow-ups both groups reached estimated energy requirements and weight loss ceased. Oral intake was the major energy source after 1 year. HN cancer patients need nutritional support and enteral feeding for a long time period during and after treatment due to insufficient energy intake. A prophylactic PEG did not significantly improve the enteral intake probably due to treatment side effects.

  7. Pulmonary Venous Obstruction in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Chuang-Chi Liaw

    2015-01-01

    Full Text Available Background. We study the clinical significance and management of pulmonary venous obstruction in cancer patients. Methods. We conducted a prospective cohort study to characterize the syndrome that we term “pulmonary vein obstruction syndrome” (PVOS between January 2005 and March 2014. The criteria for inclusion were (1 episodes of shortness of breath; (2 chest X-ray showing abnormal pulmonary hilum shadow with or without presence of pulmonary edema and/or pleural effusion; (3 CT scan demonstrating pulmonary vein thrombosis/tumor with or without tumor around the vein. Results. Two hundred and twenty-two patients developed PVOS. Shortness of breath was the main symptom, which was aggravated by chemotherapy in 28 (13%, and medical/surgical procedures in 21 (9% and showed diurnal change in intensity in 32 (14%. Chest X-rays all revealed abnormal pulmonary hilum shadows and presence of pulmonary edema in 194 (87% and pleural effusion in 192 (86%. CT scans all showed pulmonary vein thrombosis/tumor (100% and surrounding the pulmonary veins by tumor lesions in 140 patients (63%. PVOS was treated with low molecular weight heparin in combination with dexamethasone, and 66% of patients got clinical/image improvement. Conclusion. Physicians should be alert to PVOS when shortness of breath occurs and chest X-ray reveals abnormal pulmonary hilum shadows.

  8. Knowledge, information and communication among cancer patients

    International Nuclear Information System (INIS)

    Parvez, T.; Saeed, N.; Pervaiz, K.

    2001-01-01

    Objective: Knowledge, information and communication, within oncology, are a core clinical strength for the out-come of the disease and inadequate communication, can cause distress for the patient and their families. Design: A senior doctor conducted this study by filling in the performa after interviewing the subject of the study. Place and duration of study: This study was done in Oncology Department of Service Hospital, Lahore and was completed in four months. Subjects and Method: One hundred cancer patients were interviewed regarding their knowledge about their disease, its causes, prognosis, and information supplied by the health-care providers. They were also asked about their satisfaction regarding this information, deficiencies and pitfalls in this information, need for more information, which should supply the information from among the hospital team or their relative, attitude of the family and their communication regarding the disease. Results: Study revealed that the knowledge about the disease and its causes was present in 53% and 7% respectively. The patients (59%) wanted more information. Majority perceived that the information was not adequate and needed more information and 68% thought that more information would reduce their anxiety. The attitude of family was found encouraging in 87% of patients and 42% were communicating with other family members regarding their diseases. Conclusion: Knowledge about the disease and its cause should be increasingly supplied by the doctors, as it will reduce the anxiety and have a good effect on health. Communication among the family members needs to be improved. (author)

  9. Evaluation of the effect of nasogastric intubation on gastrointestinal function after gastrectomy in gastric cancer patients

    Directory of Open Access Journals (Sweden)

    Chamanzari Hamid

    2016-08-01

    Full Text Available Background and Objective: The optimal treatment strategy for patients with gastric cancer is gastrectomy. Typically, nasogastric intubation is used after this type of surgery to feed patients; however, there seems to be no unanimity of opinion on this topic. Therefore, this study aimed to evaluate the effect of nasogastric intubation on gastrointestinal function after gastrectomy in gastric cancer patients. Materials and Method: This clinical trial was conducted on gastric cancer patients, admitted to the general ward of Imam Reza Hospital in Mashhad, Iran in 2015. In total, 68 patients were selected through randomized convenience sampling and divided into two intervention and control groups of 34 individuals. Nasogastric tube insertion was applied for the intervention group after the surgery. Patients of the study groups were fasted for three days after the surgery, which was followed by the removal of nasogastric tubes and initiation of oral feeding. Gastrointestinal function of all the participants was evaluated six hours after transferring to the ward up to seven days after the surgery on a daily basis using nausea and vomiting assessment tools and researcher-made questionnaire of gastrointestinal function. Data analysis was performed in SPSS version 16 using Fisher’s exact test, Chi-square, Mann-Whitney U, repeated measures ANOVA and paired t-test. Results: In this study, the severity of nausea and vomiting, the first time of passing gas and severity of flatulence Intensity were less observed in the control group, compared to the intervention group. Moreover, postoperative food tolerance was higher in the patients of the control group, compared to the other study group (P<0.05. Conclusion: According to the results of this study, nasogastric intubation can delay normal gastrointestinal function after gastrectomy. Therefore, it is not recommended to use this method after gastrectomy.

  10. Clues to occult cancer in patients with ischemic stroke.

    Directory of Open Access Journals (Sweden)

    Suk Jae Kim

    Full Text Available BACKGROUND: We hypothesized that hidden malignancy could be detected in patients with cryptogenic stroke without active cancer when they showed the distinctive characteristics of cancer-related stroke. METHODS AND FINDINGS: Among 2,562 consecutive patients with acute ischemic stroke, patients with cryptogenic stroke were analyzed and categorized into two groups according to the presence of active cancer: cryptogenic stroke with active cancer (cancer-related stroke, CA-stroke group and without active cancer (CR-stroke group. Patients with active lung cancer without stroke were also recruited for comparison purposes (CA-control. Clinical factors, lesion patterns on diffusion-weighted MRI (DWI, and laboratory findings were analyzed among groups. A total of 348 patients with cryptogenic stroke were enrolled in this study. Among them, 71 (20.4% patients had active cancer at the time of stroke. The D-dimer levels were significantly higher in patients with CA-stroke than those with CR-stroke or CA-control (both p<0.001. Regarding lesion patterns, patients with CA-stroke mostly had multiple lesions in multiple vascular territories, while more than 80% of patients with CR-stroke had single/multiple lesions in a single vascular territory (P<0.001. D-dimer levels (OR 1.11 per 1 µg/mL increase; 95% CI 1.06-1.15; P<0.001 and DWI lesion patterns (OR 7.13; 95% CI 3.42-14.87; P<0.001 were independently associated with CA-stroke. Workup for hidden malignancy was performed during hospitalization in 10 patients who showed elevated D-dimer levels and multiple infarcts involving multiple vascular territories but had no known cancer, and it revealed hidden malignancies in all the patients. CONCLUSION: Patients with CA-stroke have distinctive D-dimer levels and lesion patterns. These characteristics can serve as clues to occult cancer in patients with cryptogenic stroke.

  11. Prognosis was not deteriorated by multiple primary cancers in esophageal cancer patients treated by radiotherapy

    International Nuclear Information System (INIS)

    Shirai, Katsuyuki; Tamaki, Yoshio; Kitamoto, Yoshizumi

    2013-01-01

    Esophageal cancer patients are often associated with multiple primary cancers (MPC). The aim of this study is to evaluate the effect of MPC on prognosis in esophageal cancer patients treated by radiotherapy. Between 2001 and 2008, esophageal cancer patients treated by definitive radiotherapy at Gunma Cancer Center were retrospectively reviewed. Exclusion criteria were preoperative or postoperative radiotherapy, palliative radiotherapy, follow-up of <6 months, radiation dose of <50 Gy and no information on MPC. We analyzed 167 esophageal cancer patients and 56 (33.5%) were associated with MPC. Gastric cancer was the most frequent tumor (38.2%), followed by head and neck cancer (26.5%). Median follow-up time was 31.5 months (range 6.1-87.3 months). Patients with MPC included more stage I/II esophageal cancer than those without MPC (66.1% vs. 36.9%, P<0.01). The 5-year overall survival rate for esophageal cancer with MPC was relatively better than those without MPC (46.1% vs. 26.7%), although the difference did not reach statistical significance in univariate analysis (P=0.09). Stage I/II esophageal cancer patients had a significantly better overall survival than stage III/IV patients (P<0.01). Among esophageal cancer patients with MPC, there was no difference in overall survival between antecedent and synchronous cancer (P=0.59). Our study indicated that the prognosis of esophageal cancer patients treated by radiotherapy was primarily determined by the clinical stage itself, but not the presence of MPC. (author)

  12. Evaluation of a cancer exercise program: patient and physician beliefs.

    Science.gov (United States)

    Peeters, C; Stewart, A; Segal, R; Wouterloot, E; Scott, C G; Aubry, T

    2009-08-01

    Participation in an exercise intervention during cancer treatment diminishes the side effects associated with cancer therapies, although such benefits vary according to the disease and the patient characteristics. A structured exercise program providing an individualized fitness program tailored to the patients' illness, treatment, and fitness level would address this variability. However, the need, desired components, and anticipated barriers of such a program have not been systematically explored from either the point of view of cancer patients or treating oncologists. Sixty-six cancer patients and 18 medical and radiation oncologists were surveyed on the above variables. Cancer patients and oncologists alike perceived a need for a structured exercise program during and after medical treatment for cancer. Among cancer patients, the most commonly preferred feature was access to consultation with an exercise specialist who could take into account the patient's previous exercise and medical history. Over a third of patients reported interest in a hospital-based fitness program. Oncologists were in favor of appropriate supervision of patients during exercise, and noted insufficient time to discuss exercise in their practice. Respondents noted time and parking as barriers to participation. Overall, results support the need for a supervised exercise program during active treatment for cancer and highlight the desired features of such a program.

  13. Evaluation of QOL in cancer patients treated with radiation therapy

    International Nuclear Information System (INIS)

    Takahashi, Takeo; Machida, Kikuo; Honda, Norinari; Hosono, Makoto; Murata, Osamu; Osada, Hisato; Omichi, Masahide

    2002-01-01

    Evaluation of quality of life (QOL) in cancer patients is an important theme. However, we do not have an established method to assess QOL in cancer patients during radiotherapy in Japan. We evaluated both the changes of QOL and the factors affecting QOL in radiotherapy patients. Three hundred fifty-five cancer patients, who filled in a questionnaire at the beginning, middle, and end of radiotherapy between 1998 and 2001, were studied. We used The QOL Questionnaire for Cancer Patients Treated with Anticancer Drugs (QOL-ACD)'' devised by Kurihara et al, the Ministry of Health and Welfare. The QOL Questionnaire had five categories: physical activity, physical condition, mental state, social interaction, and face scale. The total score, sum of the score of five categories, were established synthetically (maximum score is 110). The mean of total QOL scores were 75.8, 77.6, and 78.2 at the beginning, middle, and end of radiotherapy respectively. Patients with symptoms related to cancer had apparent improvement of QOL score. Patients receiving chemotherapy had a decreased QOL score at the end of radiotherapy. The score of physical condition was reduced improvement. It was suggested that radiotherapy could be performed without losing QOL of cancer patients, including older patients. However, patients receiving chemotherapy and those with head and neck cancer may lose their QOL, therefore, we should treat such patients carefully. (author)

  14. Proportion of gynecologic cancer patients using complementary and alternative medicine.

    Science.gov (United States)

    Supoken, Amornrat; Chaisrisawatsuk, Thitima; Chumworathayi, Bandit

    2009-01-01

    Complementary and alternative medicine (CAM) for treatment of cancer and for supportive care of cancer patients must be clearly separated. There is encouraging evidence for CAM in the latter area, such as acupuncture and progressive muscle relaxation for chemotherapy-related nausea and vomiting, and aromatherapy for decreasing anxiety and increasing quality of life. However, there are limited data about CAM used by gynecologic cancer patients, especially in Thai women. Therefore, the authors aimed to investigate the proportion and types of CAM using in our gynecologic cancer patients. This cross-sectional survey was conducted between October to December, 2008. Totals of 50 admitted and 50 walk-in gynecologic cancer patients 1 month after diagnosis, aged more than 20 years and able to give informed consent, were selected for one-by-one interview by random walking survey. Among the 100 interviewed patients, aged 21-69 (mean=50.12), there were 46 cases of cervical cancers, 35 of ovarian cancers, 18 of endometrial cancers (two of these also had ovarian cancers), 2 of malignant gestational trophoblastic diseases, 1 of vulvar cancer, and 1 liver cancer (in a patient with ovarian cancer). Some 67% (95% CI, 57.8-76.2%) of them used CAM. As diet modifications, 11 used Chinese vegetarian, 8 common vegetarian, 5 Cheewajit, and 1 macrobiotics. Five of them used dietary supplements while colonic detoxification was emplyed in three. As herbal medicines, 27 used Thai herbs, 4 Chinese herbs, and 1 a herbal sauna. Twelve were receiving Thai massage. As exercises, 23 used aerobics and 5 stretching. Interestingly, 62 of them used Buddhist praying while only 3 employed native magic. The three most common forms of CAM used by our gynecologic cancer patients were Buddhist praying (62/67, 92.5%), followed by herbal medicines (27/67, 40.3%) and exercises (25/67, 37.3%).

  15. Psychological aspects of the cancer patients' education: thoughts, feelings, behavior and body reactions of patients faced with diagnosis of cancer.

    Science.gov (United States)

    Klikovac, T; Djurdjevic, A

    2010-01-01

    In order to assess the impact of cancer diagnosis on several psychological dimensions, this study was undertaken with the aim to understand, identify and document the psychological responses of cancer patients - their common thoughts, feelings, body sensations and behavior when they faced the cancer diagnosis. The sample consisted of 80 patients who attended psychological lectures during the implementation of the European Educational Programme (EEP) "Learning to live with cancer". At the beginning of the lectures, the patients were asked to fulfill the self-describing questionnaire with 4 open questions: "Describe your common thoughts, feelings, behavior, and body reactions in the first 6 weeks when you learned that you were affected by cancer". A significant proportion of patients reported disease denial (65%) and reexamination in relation to past life experiences, stressful events and bad habits (60%). Depressive feelings and disappointment were reported by 90% of the patients, while 85% of them reported fear, hopelessness and emptiness. They also reported sadness (70%), anger and anxiety (65%), nervousness and irritability (90%). Positive thoughts and attitude in the sense of optimism concerning a successful treatment outcome were reported by 20% and 15% of patients, respectively. The diagnosis of cancer and cancer treatment can cause distress, emotional turmoil and different psychosocial disorders. Taking into consideration different psychological reactions of cancer patients can be helpful for organizing adequate psycho-educational and psychosocial support, and psychotherapy for cancer patients and their families.

  16. The Personal Experience of LGBT Patients with Cancer.

    Science.gov (United States)

    Carr, Ellen

    2018-02-01

    To capture the perspectives from lesbian, gay, bisexual and transgender (LGBT) individuals diagnosed treated for cancer. Four LGBT individuals diagnosed and treated for cancer. Care for the LGBT patient is based on sensitivity and awareness to LGBT issues and concerns. Nurses caring for the LGBT cancer patient provide that care in a context of awareness and sensitivity. The nurse's approach to LGBT patient and family care is based on open communication, establishing trusting relationships and honoring the patient's preferences. Excellent oncology nursing care for LGBT patients is excellent oncology nursing care. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    African Journals Online (AJOL)

    hanumantp

    investigation was a prospective study that was conducted in cancer patients receiving Inj. Doxorubicin .... patients. Pre-Chem o. I - Cycle. II - Cycle III - Cycle. IV - Cycle. 0. 1. 2. 3. 4 .... vitamin E, vitamin C, vitamin A, antioxidant components.

  18. Protective mechanism against cancer found in progeria patient cells

    Science.gov (United States)

    NCI scientists have studied cells of patients with an extremely rare genetic disease that is characterized by drastic premature aging and discovered a new protective cellular mechanism against cancer. They found that cells from patients with Hutchinson Gi

  19. Prognostic significance of symptoms of hospitalised advanced cancer patients

    NARCIS (Netherlands)

    Teunissen, Saskia C.; de Graeff, Alexander; de Haes, Hanneke C.; Voest, Emile E.

    2006-01-01

    To assess the prognostic value of symptoms in hospitalised advanced cancer patients. A prospective analysis was performed of 181 hospitalised patients referred to a Palliative Care Team. Comprehensive symptom questionnaire, functional status, estimated life expectancy and survival were assessed.

  20. Staging with computed tomography of patients with colon cancer

    DEFF Research Database (Denmark)

    Malmstrom, M. L.; Brisling, S.; Klausen, T. W.

    2018-01-01

    Purpose Accurate staging of colonic cancer is important for patient stratification. We aimed to correlate the diagnostic accuracy of preoperative computed tomography (CT) with final histopathology as reference standard. Methods Data was collected retrospectively on 615 consecutive patients operated...

  1. Spontaneous Hepatic Infarction in a Patient with Gallbladder Cancer

    Directory of Open Access Journals (Sweden)

    Kang Min Lee

    2016-06-01

    Full Text Available Hepatic infarction is known as a rare disease entity in nontransplant patients. Although a few cases of hepatic infarction have been reported to be linked with invasive procedures, trauma, and hypercoagulability, a case of spontaneous hepatic infarction in a nontransplanted patient has hardly ever been reported. However, many clinical situations of patients with cancer, in particular biliary cancer, can predispose nontransplant patients to hepatic infarction. Besides, the clinical outcome of hepatic infarction in patients with cancer can be worse than in patients with other etiologies. As for treatment, anticoagulation treatment is usually recommended. However, because of its multifactorial etiology and combined complications, treatment of hepatic infarction is difficult and not simple. Herein, we report a case of fatal hepatic infarction that occurred spontaneously during the course of treatment in a patient with gallbladder cancer. Hepatic infarction should be considered as a possible fatal complication in patients during treatment of biliary malignancies.

  2. Bevacizumab improves survival for patients with advanced cervical cancer

    Science.gov (United States)

    Patients with advanced, recurrent, or persistent cervical cancer that was not curable with standard treatment who received the drug bevacizumab (Avastin) lived 3.7 months longer than patients who did not receive the drug, according to an interim analysis

  3. Infrared-Guided Patient Setup for Lung Cancer Patients

    International Nuclear Information System (INIS)

    Lyatskaya, Yulia; James, Steven; Killoran, Joseph H.; Soto, Ricardo; Mamon, Harvey J.; Chin, Lee; Allen, Aaron M.

    2008-01-01

    Purpose: To evaluate the utility of an infrared-guided patient setup (iGPS) system to reduce the uncertainties in the setup of lung cancer patients. Methods and Materials: A total of 15 patients were setup for lung irradiation using skin tattoos and lateral leveling marks. Daily electronic portal device images and iGPS marker locations were acquired and retrospectively reviewed. The iGPS-based shifts were compared with the daily electronic portal device image shifts using both the central axis iGPS marker and all five iGPS markers. For shift calculation using the five markers, rotational misalignment was included. The level of agreement between the iGPS and portal imaging to evaluate the setup was evaluated as the frequency of the shift difference in the range of 0-5 mm, 5-10 mm, and >10 mm. Results: Data were obtained for 450 treatment sessions for 15 patients. The difference in the isocenter shifts between the weekly vs. daily images was 0-5 mm in 42%, 5-10 mm in 30%, and >10 mm in 10% of the images. The shifts seen using the iGPS data were 0-5 mm in 81%, 5-10 mm in 14%, and >10 mm in 5%. Using only the central axis iGPS marker, the difference between the iGPS and portal images was 10 mm in 7% in the left-right direction and 73%, 18%, and 9% in the superoinferior direction, respectively. When all five iGPS markers were used, the disagreements between the iGPS and portal image shifts >10 mm were reduced from 7% to 2% in the left-right direction and 9% to 3% in the superoinferior direction. Larger reductions were also seen (e.g., a reduction from 50% to 0% in 1 patient). Conclusion: The daily iGPS-based shifts correlated well with the daily electronic portal device-based shifts. When patient movement has nonlinear rotational components, a combination of surface markers and portal images might be particularly beneficial to improve the setup for lung cancer patients

  4. Fear of cancer recurrence and its predictive factors among Iranian cancer patients

    Directory of Open Access Journals (Sweden)

    Alireza Mohajjel Aghdam

    2014-01-01

    Full Text Available Context: Fear of cancer recurrence (FOCR is one of the most important psychological problems among cancer patients. In extensive review of related literature there were no articles on FOCR among Iranian cancer patients. Aim: The aim of present study was to investigation FOCR and its predictive factors among Iranian cancer patients. Materials and Methods: In this descriptive-correlational study 129 cancer patients participated. For data collection, the demographic checklist and short form of fear of progression questionnaire was used. Logistic regression was used to determine predictive factors of FOCR. Result: Mean score of FOCR among participants was 44.8 and about 50% of them had high level of FOCR. The most important worries of participants were about their family and the future of their children and their lesser worries were about the physical symptoms and fear of physical damage because of cancer treatments. Also, women, breast cancer patient, and patients with lower level of education have more FOCR. Discussion: There is immediate need for supportive care program designed for Iranian cancer patients aimed at decreasing their FOCR. Especially, breast cancer patients and the patient with low educational level need more attention.

  5. Assessment of Fundamental Movement Skills in Childhood Cancer Patients.

    Science.gov (United States)

    Naumann, Fiona L; Hunt, Mitchell; Hunt, Mitchel; Ali, Dulfikar; Wakefield, Claire E; Moultrie, Kevin; Cohn, Richard J

    2015-12-01

    The improved treatment protocols and subsequent improved survival rates among childhood cancer patients have shifted the focus toward the long-term consequences arising from cancer treatment. Children who have completed cancer treatment are at a greater risk of delayed development, diminished functioning, disability, compromised fundamental movement skill (FMS) attainment, and long-term chronic health conditions. The aim of the study was to compare FMS of childhood cancer patients with an aged matched healthy reference group. Pediatric cancer patients aged 5-8 years (n = 26; median age 6.91 years), who completed cancer treatment (<5 years) at the Sydney Children's Hospital, were assessed performing seven key FMS: sprint, side gallop, vertical jump, catch, over-arm throw, kick, and leap. Results were compared to the reference group (n = 430; 6.56 years). Childhood cancer patients scored significantly lower on three out of seven FMS tests when compared to the reference group. These results equated to a significantly lower overall score for FMS. This study highlighted the significant deficits in FMS within pediatric patients having completed cancer treatment. In order to reduce the occurrence of significant FMS deficits in this population, FMS interventions may be warranted to assist in recovery from childhood cancer, prevent late effects, and improve the quality of life in survivors of childhood cancer. © 2015 Wiley Periodicals, Inc.

  6. Preoperative Quality of Life in Patients with Gastric Cancer

    OpenAIRE

    Suk, Hyoam; Kwon, Oh Kyung; Yu, Wansik

    2015-01-01

    Purpose We evaluated the socio-personal and clinical factors that can affect preoperative quality of life to determine how to improve preoperative quality of life in patients with gastric cancer. Materials and Methods The preoperative quality of life data of 200 patients (68 females and 132 males; mean age 58.9?12.6 years) with gastric cancer were analyzed according to socio-personal and clinical factors. The Korean versions of the European Organization for Research and Treatment of Cancer (E...

  7. Quality of life of lung cancer patients receiving outpatient chemotherapy

    OpenAIRE

    MATSUDA, AYAKO; KOBAYASHI, MIKA; SAKAKIBARA, YUMI; TAMAOKA, MEIYO; FURUIYE, MASASHI; INASE, NAOHIKO; MATSUSHIMA, EISUKE

    2011-01-01

    An increasing number of cancer patients receive outpatient chemotherapy as an alternative to inpatient chemotherapy. The aim of this study was to investigate whether quality of life (QOL) during outpatient chemotherapy was better than QOL prior to hospital discharge, and to explore possible related factors prior to hospital discharge that affected the QOL of lung cancer patients who received outpatient chemotherapy. Lung cancer inpatients who were scheduled for outpatient chemotherapy were as...

  8. [Cancer related fatigue in patients with breast cancer after chemotherapy and coping style].

    Science.gov (United States)

    Jiang, Pinglan; Wang, Shuhong; Jiang, Dongmei; Yu, Lingli

    2011-04-01

    To study the relevance between cancer related fatigue and coping styles in breast cancer patients after chemotherapy. A survey was conducted in 396 patients with breast cancer after chemotherapy on cancer related fatigue scale and Jalowiec coping scale, and the relation was analyzed. The rate of overall fatigue in breast cancer patients was 96.97%, mostly moderate fatigue. The rate of fatigue dimensions from high to low was physical fatigue, feeling fatigue and cognitive fatigue, respectively. The score of coping styles in patients with breast cancer after chemotherapy from high to low was optimistic coping, facing bravely, support seeking, self-reliance, emotional catharsis, avoidance, fatalism, and conservation. The most widely used coping style was optimistic coping style, and the least was emotional catharisis. There was a positive correlation between coping style of emotional catharsis and cancer related fatigue of all dimensions (Pself-reliance, or conservation (P<0.05). There was also a negative correlation between physical fatigue and optimistic or support seeking (P<0.05), but there was a positive correlation between avoidance or fatalism and the dimensions of general fatigue, physical fatigue, and cognitive fatigue (P<0.05). There is prevalent cancer related fatigue in patients with breast cancer after chemotherapy. We should guide the patients to more active coping styles, to enhance the ability of psychological adaption in patients, reduce cancer related fatigue, and improve the quality of life.

  9. Continuous Palliative Sedation for Cancer and Noncancer Patients

    NARCIS (Netherlands)

    Swart, S.J.; Rietjens, J.A.C.; van Zuylen, L.; Zuurmond, W.W.A.; Perez, R.S.G.M.; van der Maas, P.J.; van Delden, J.J.M.; van der Heide, A.

    2012-01-01

    Context: Palliative care is often focused on cancer patients. Palliative sedation at the end of life is an intervention to address severe suffering in the last stage of life. Objectives: To study the practice of continuous palliative sedation for both cancer and noncancer patients. Methods: In 2008,

  10. Interventions to enhance return-to-work for cancer patients

    NARCIS (Netherlands)

    de Boer, Angela G. E. M.; Taskila, Tyna K.; Tamminga, Sietske J.; Feuerstein, Michael; Frings-Dresen, Monique H. W.; Verbeek, Jos H.

    2015-01-01

    Cancer patients are 1.4 times more likely to be unemployed than healthy people. Therefore it is important to provide cancer patients with programmes to support the return-to-work (RTW) process. This is an update of a Cochrane review first published in 2011. To evaluate the effectiveness of

  11. 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

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

    African Journals Online (AJOL)

    Background: Hepatic dysfunction in the cancer unit has a significant impact on patient outcomes. The therapeutic application of anthracycline antibiotics are limited by side‑effects mainly myelosuppression, chronic cardiotoxicity, and hepatotoxicity. Aim: To assess the risk of Hepatotoxicity in breast cancer patients receiving ...

  13. The place of death of patients with cancer in Kuwait.

    Science.gov (United States)

    Alshemmari, Salem H; Elbasmi, Amani A; Alsirafy, Samy A

    2015-12-01

    The place of death (PoD) has a significant effect on end-of-life care for patients dying of cancer. Little is known about the place of cancer deaths in our region. To identify the PoD of patients with cancer in Kuwait, we reviewed the death certificates submitted to the Kuwait Cancer Registry in 2009. Of 611 cancer deaths, 603 (98.7%) died in hospitals and only 6 (1%) patients died at home. More than half (57.3%) of inhospital deaths were in the Kuwait Cancer Control Center. Among those for whom the exact PoD within the hospital was identified (484 patients), 116 (24%) patients died in intensive care units and 12 (2.5%) patients died in emergency rooms. This almost exclusive inhospital death of patients with cancer in Kuwait is the highest ever reported. Research is needed to identify the reasons behind this pattern of PoD and to explore interventions promoting out-of-hospital death among terminally ill cancer patients in Kuwait. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  14. Variations of blood glucose in cancer patients during chemotherapy ...

    African Journals Online (AJOL)

    Purpose: The aim of this study was to analyze the blood glucose (BG) variations in cancer patients during chemotherapy according to tumor types and chemotherapeutic regimens. Materials and Methods: Patients were examined from the Department of Medical Oncology of Cancer Hospital and Institute, Chinese Academy ...

  15. Cardiotoxicity in cancer patients treated with 5-fluorouracil or capecitabine

    DEFF Research Database (Denmark)

    Polk, Anne; Vaage-Nilsen, Merete Bech; Vistisen, Kirsten

    2013-01-01

    To systematically review the incidence, manifestations and predisposing factors for cardiovascular toxicity in cancer patients treated with systemic 5-fluorouracil or capecitabine.......To systematically review the incidence, manifestations and predisposing factors for cardiovascular toxicity in cancer patients treated with systemic 5-fluorouracil or capecitabine....

  16. Palliative Sedation in Patients With Cancer.

    Science.gov (United States)

    Maltoni, Marco; Setola, Elisabetta

    2015-10-01

    Palliative sedation involves the use of sedative medication to relieve refractory symptoms in patients by reducing their level of consciousness. Although it is considered an acceptable clinical practice from most ethical points of view, palliative sedation is still a widely debated procedure and merits better understanding. The relevant medical literature pertaining to palliative sedation was analyzed and reviewed from various technical, relational, and bioethical perspectives. Proportionate palliative sedation is considered to be the most clinically appropriate modality for performing palliative sedation. However, guidelines must be followed to ensure that it is performed correctly. Benzodiazepines represent the first therapeutic option and careful monitoring of dosages is essential to avoid oversedation or undersedation. Proportionate palliative sedation is used to manage and relieve refractory symptoms in patients with cancer during their last days or hours of life. Evidence suggests that its use has no detrimental effect on survival. A different decision-making process is used to manage the withdrawal of hydration than the process used to determine whether proportionate palliative sedation is appropriate. Communication between patients, their relatives, and the health care staff is important during this medical intervention.

  17. Conformity index for brain cancer patients

    International Nuclear Information System (INIS)

    Petkovska, Sonja; Tolevska, Cveta; Kraleva, Slavica; Petreska, Elena

    2010-01-01

    The purpose of this study is to present the level of conformity achieved by using 3D conformal radiotherapy for brain cancer patients. Conformity index is a helpful quantitative tool for assessing (evaluating) the quality of a treatment plan. Treatment plans made for ninety patients with brain tumor are worked on this paper. The patients are in supine position and immobilized with thermoplastic masks for the head. Computed tomography data sets with 5 mm scan thickness are used to create a 3D image. All structures of interest are contoured. In order to obtain an optimal dose distribution, treatment fields are fit around target volume with set-up margins of 7mm in each direction. The conformity index values are between 1.21 and 2.04. Value of 1.8 is exceeded in eighteen cases; nine of them are bigger than 1.9 and only three of them are above 2. The target volume for each of these extreme CI values is ideal covered (between 95% and 105% of the prescribed dose). The most acceptable conformity index value in this paper belongs to the plan with the lowest minimal dose (84.7%). It can be concluded that conformity index is necessary but not sufficient factor for assessing radiation treatment plan conformity. To be able to estimate the acceptability of some treatment plan in daily practice, additional information as minimal, maximal and mean dose into target volume, as well as health tissues coverage must be taken into account.(Author)

  18. Paraneoplastic erythroderma in a prostate cancer patient

    Energy Technology Data Exchange (ETDEWEB)

    Momm, F.; Lutterbach, J. [Dept. of Radiation Therapy, Univ. Clinic Freiburg (Germany); Pflieger, D. [Dept. of Dermatology, Univ. Clinic Freiburg (Germany)

    2002-07-01

    Background: Erythroderma is an inflammation of the skin, which can be triggered by various diseases as psoriasis, allergies, side effects of medication, infections or malignant tumors. Caused by these various etiologic possibilities patients require extensive diagnostic effort. Patient: We report a case of a 71-year-old man presenting with an erythroderma of unknown etiology. Therapy with corticosteroids was not successful. A complete remission was reached by therapy with cyclosporine A, 350 mg/day. Finally, an increased prostate specific antigene (PSA) value was found and a prostate cancer was diagnosed in the patient. Results: After definitive radiotherapy of the carcinoma (total dose 74 Gy, 5 x 2 Gy/week), the cyclosporine A was displaced without recurrence of erythroderma. Conclusion: In this case, we consider the erythroderma to have been a paraneoplastic effect of the prostate carcinoma. In male patients with erythroderma an early PSA test should be performed. (orig.) [German] Hintergrund: Die Erythrodermie ist eine entzuendliche Reaktion der Haut, die durch verschiedene Grunderkrankungen wie Psoriasis, Allergien, Infektionen, Nebenwirkungen von Medikamenten oder paraneoplastisch in Erscheinung treten kann. Wegen dieser vielfachen aetiologischen Moeglichkeiten erfordern Erythrodermiepatienten eine aufwaendige Diagnostik. Patient: Wir berichten ueber einen 71-jaehrigen Patienten mit einer Erythrodermie zunaechst unbekannter Aetiologie. Durch die Gabe von Cyclosporin A in einer Dosis von 350 mg/Tag konnte eine Remission erreicht werden. Schliesslich wurde bei dem Patienten ein erhoehter Wert des prostataspezifischen Antigens (PSA) im Blut gefunden und daraufhin ein Prostatakarzinom diagnostiziert. Ergebnisse: Nach primaerer perkutaner Strahlentherapie des Prostatakarzinoms (Gesamtdosis 74 Gy, 5 x 2 Gy/Woche) konnte das Cyclosporin A abgesetzt werden, ohne dass ein weiterer Schub der Erythrodermie auftrat. Schlussfolgerung: Wir halten die Erythrodermie bei

  19. Sonographic appearance of thyroid cancer in patients with Hashimoto thyroiditis.

    Science.gov (United States)

    Durfee, Sara M; Benson, Carol B; Arthaud, Dylan M; Alexander, Erik K; Frates, Mary C

    2015-04-01

    To determine whether the sonographic appearance of thyroid cancer differs in patients with and without Hashimoto thyroiditis. Patients with histologically proven thyroid cancer who had thyroid peroxidase (TPO) antibodies measured and sonography performed preoperatively were included. We evaluated each nodule for size, echogenicity, composition, margins, halo, and vascularity and evaluated the background heterogeneity of the gland. There were 162 thyroid cancers in 145 patients. Forty-two patients (29.0%) had Hashimoto thyroiditis with positive TPO antibodies, and 103 patients (71.0%) had negative TPO antibodies. The background echogenicity was more often heterogeneous in TPO antibody-positive patients compared to those who had negative TPO antibodies (57.1% versus 26.2%; P= .0005). Comparing cancers in TPO antibody-positive to TPO antibody-negative patients, there was no significant difference in the size, echogenicity, composition, margins, halo presence, calcification presence and type, or vascularity of the cancerous nodule (P > .05). Among TPO antibody-positive patients, comparing thyroid cancerous nodules in patients with heterogeneous glands to those with homogeneous glands, there was no significant difference in any sonographic characteristic except the margin of the nodule, which was more often irregular or poorly defined in heterogeneous glands and more often smooth in homogeneous glands (Pthyroid cancer are similar in patients with and without Hashimoto thyroiditis. Among patients with Hashimoto thyroiditis and thyroid cancer, the sonographic appearance of the cancerous nodule is similar, except that cancerous nodule margins are more likely to be irregular or poorly defined when the gland is heterogeneous. © 2015 by the American Institute of Ultrasound in Medicine.

  20. Predictive model for survival in patients with gastric cancer.

    Science.gov (United States)

    Goshayeshi, Ladan; Hoseini, Benyamin; Yousefli, Zahra; Khooie, Alireza; Etminani, Kobra; Esmaeilzadeh, Abbas; Golabpour, Amin

    2017-12-01

    Gastric cancer is one of the most prevalent cancers in the world. Characterized by poor prognosis, it is a frequent cause of cancer in Iran. The aim of the study was to design a predictive model of survival time for patients suffering from gastric cancer. This was a historical cohort conducted between 2011 and 2016. Study population were 277 patients suffering from gastric cancer. Data were gathered from the Iranian Cancer Registry and the laboratory of Emam Reza Hospital in Mashhad, Iran. Patients or their relatives underwent interviews where it was needed. Missing values were imputed by data mining techniques. Fifteen factors were analyzed. Survival was addressed as a dependent variable. Then, the predictive model was designed by combining both genetic algorithm and logistic regression. Matlab 2014 software was used to combine them. Of the 277 patients, only survival of 80 patients was available whose data were used for designing the predictive model. Mean ?SD of missing values for each patient was 4.43?.41 combined predictive model achieved 72.57% accuracy. Sex, birth year, age at diagnosis time, age at diagnosis time of patients' family, family history of gastric cancer, and family history of other gastrointestinal cancers were six parameters associated with patient survival. The study revealed that imputing missing values by data mining techniques have a good accuracy. And it also revealed six parameters extracted by genetic algorithm effect on the survival of patients with gastric cancer. Our combined predictive model, with a good accuracy, is appropriate to forecast the survival of patients suffering from Gastric cancer. So, we suggest policy makers and specialists to apply it for prediction of patients' survival.

  1. Mortality causes in cancer patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Liu, Xiangdong; Ji, Jianguang; Sundquist, Kristina; Sundquist, Jan; Hemminki, Kari

    2012-05-01

    Cancer patients diagnosed with type 2 diabetes mellitus (T2DM) are at an increased risk of death due to cancer. However, whether T2DM comorbidity increases other causes of death in cancer patients is the novel theme of this study. Patients with T2DM were identified from the nationwide Swedish Hospital Discharge Register and linked with patients with cancer recorded from the Swedish Cancer Registry. Hazard ratios (HRs) were calculated for death due to all causes among cancer patients with and without T2DM; both underlying and multiple causes of death were examined using the Cox regression model. A total of 13 325 cancer patients were identified with comorbidity of T2DM. The total number of deaths of cancer patients was 276 021. Of these, 5900 occurred after T2DM diagnosis. For underlying causes of death, except for T2DM, the highest cause-specific HRs were found for complications of bacterial disease (HR, 3.93; 95% CI, 3.04-5.09), urinary system disease (HR, 3.39; 95% CI, 2.78-4.12), and myocardial infarction (HR, 2.93; 95% CI, 2.75-3.12). When risk of death was examined for both underlying and multiple causes of death, the highest HRs were found for hypertensive disease (HR, 3.42; 95% CI, 3.15-3.72), urinary system disease (HR, 3.39; 95% CI, 3.17-3.63), and arterial disease (HR, 3.26; 95% CI, 3.08-3.46). The diagnosis of T2DM in cancer patients is associated with an increased risk of death due to various causes, including myocardial infarction, other bacterial disease, urinary system disease, hypertensive disease, arterial disease, and so on, which may be related to both cancer and treatment. Clinicians that treat cancer patients with T2DM should pay more attention to comorbidities.

  2. Second primary cancers in subsites of colon and rectum in patients with previous colorectal cancer

    NARCIS (Netherlands)

    Liu, L.; Lemmens, V.E.; de Hingh, I.H.J.T.; de Vries, E.; Roukema, J.A.; van Leerdam, M.E.; Coebergh, J.W.; Soerjomataram, I.

    Background: Compared with the general population, patients with a previous colorectal cancer are at higher risk for a second colorectal cancer, but detailed risk analysis by subsite is scarce. Objective: Our goal was to investigate the risk of a second cancer in relation to subsite as a basis for

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

    Science.gov (United States)

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

    2010-01-01

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

  4. Acute limb ischemia in cancer patients: should we surgically intervene?

    LENUS (Irish Health Repository)

    Tsang, Julian S

    2012-02-01

    BACKGROUND: Cancer patients have an increased risk of venous thromboembolic events. Certain chemotherapeutic agents have also been associated with the development of thrombosis. Reported cases of acute arterial ischemic episodes in cancer patients are rare. METHODS: Patients who underwent surgery for acute limb ischemia associated with malignancy in a university teaching hospital over a 10-year period were identified. Patient demographics, cancer type, chemotherapy use, site of thromboembolism, treatment and outcome were recorded. RESULTS: Four hundred nineteen patients underwent surgical intervention for acute arterial ischemia, 16 of these patients (3.8%) had associated cancer. Commonest cancer sites were the urogenital tract (n = 5) and the lungs (n = 5). Eight patients (50%) had been recently diagnosed with cancer, and four (25%) of these cancers were incidental findings after presentation with acute limb ischemia. Four patients (25%) developed acute ischemia during chemotherapy. The superficial femoral artery was the most frequent site of occlusion (50%), followed by the brachial (18%) and popliteal (12%) arteries. All patients underwent thromboembolectomy, but two (12%) patients subsequently required a bypass procedure. Six patients (37%) had limb loss, and in-patient mortality was 12%. Histology revealed that all occlusions were due to thromboembolism, with no tumor cells identified. At follow-up, 44% of patients were found to be alive after 1 year. CONCLUSION: Cancer and chemotherapy can predispose patients to acute arterial ischemia. Unlike other reports that view this finding as a preterminal event most appropriately treated by palliative measures, in this series, early diagnosis and surgical intervention enabled limb salvage and patient survival.

  5. Impact of diabetes on oncologic outcome of colorectal cancer patients: colon vs. rectal cancer.

    Directory of Open Access Journals (Sweden)

    Justin Y Jeon

    Full Text Available BACKGROUND: To evaluate the impact of diabetes on outcomes in colorectal cancer patients and to examine whether this association varies by the location of tumor (colon vs. rectum. PATIENTS AND METHODS: This study includes 4,131 stage I-III colorectal cancer patients, treated between 1995 and 2007 (12.5% diabetic, 53% colon, 47% rectal in South Korea. Cox proportional hazards modeling was used to determine the prognostic influence of DM on survival endpoints. RESULTS: Colorectal cancer patients with DM had significantly worse disease-free survival (DFS [hazard ratio (HR 1.17, 95% confidence interval (CI: 1.00-1.37] compared with patients without DM. When considering colon and rectal cancer independently, DM was significantly associated with worse overall survival (OS (HR: 1.46, 95% CI: 1.11-1.92, DFS (HR: 1.45, 95% CI: 1.15-1.84 and recurrence-free survival (RFS (HR: 1.32, 95% CI: 0.98-1.76 in colon cancer patients. No association for OS, DFS or RFS was observed in rectal cancer patients. There was significant interaction of location of tumor (colon vs. rectal cancer with DM on OS (P = 0.009 and DFS (P = 0.007. CONCLUSIONS: This study suggests that DM negatively impacts survival outcomes of patients with colon cancer but not rectal cancer.

  6. Outcome of genetic evaluation of patients with kidney cancer referred for suspected hereditary cancer syndromes.

    Science.gov (United States)

    Stratton, Kelly L; Alanee, Shaheen; Glogowski, Emily A; Schrader, Kasmintan A; Rau-Murthy, Rohini; Klein, Robert; Russo, Paul; Coleman, Jonathan; Offit, Kenneth

    2016-05-01

    To analyze patients with kidney cancer referred for evaluation at a high-volume genetics service at a comprehensive cancer center and identify factors associated with positive tests for hereditary cancer syndromes. A retrospective review of patients referred to the Clinical Genetics Service at Memorial Sloan-Kettering Cancer Center was performed, and patients with a personal history of kidney cancer were identified. Patient and disease characteristics were reviewed. In all, 4 variables including age at diagnosis of kidney tumor, presence of syndromic manifestations, family history of kidney cancer, and number of primary malignancies were evaluated for association with positive test results in 2 groups: patients tested for renal cell carcinoma syndromes and Lynch syndrome. Guidance for genetic testing strategy in patients with kidney cancer is provided. Between 1999 and 2012, 120 patients with a history of kidney cancer were evaluated by the Clinical Genetics Service. The mean age at kidney cancer diagnosis was 52 years (interquartile range: 42-63), with 57% being women. A family history of kidney cancer was reported by 39 patients (33%). Time between diagnosis of first cancer and genetic consultation was 5 years in the remaining 23%. Overall, 95 patients were tested for genetic abnormalities with 27 (28%) testing positive. Testing for renal cell carcinoma (RCC)-related syndromes was performed on 43 patients, with 13 testing positive (30%). Lynch syndrome testing was positive in 9 patients (32%) after 28 were tested. In RCC-associated syndromes, young age of diagnosis was associated with positive test results. Conversely, syndromic manifestations and increasing number of primary malignancies were associated with positive Lynch testing. The discovery of inherited kidney cancer syndromes has provided a unique opportunity to identify patients at increased risk for cancer. Factors associated with positive genetic testing are unique to different syndromes. These data

  7. Salivary mineral composition in patients with oral cancer.

    Science.gov (United States)

    Dziewulska, Anna; Janiszewska-Olszowska, Joanna; Bachanek, Teresa; Grocholewicz, Katarzyna

    2013-01-01

    To analyse the mineral content of saliva in patients with oral cancer in order to identify possible markers that might aid the diagnosis of oral cancer. The study group consisted of 34 patients, aged 35-72 years with a diagnosis of oral cancer, including seven women and 27 men, before the start of treatment. Samples of unstimulated saliva were collected in plastic containers. The concentrations of sodium and potassium were assessed using ion selective electrodes, and the concentrations of calcium, magnesium, iron and phosphorus were assessed using colorimetric methods. Statistically significant differences between the study and control groups were found only for the concentration of sodium--higher concentrations were found in the study group. When comparing different cancer localisations, the highest levels of salivary sodium were found in cases of cancer of the floor of the oral cavity, and the lowest levels in tongue or parotid gland cancer. The highest calcium levels were found in cancer of the floor of the oral cavity, and the lowest levels in tongue cancer. The highest levels of magnesium were found in cancer of the floor of the oral cavity, and the lowest in tongue cancer. As regards the different histological types, higher sodium and calcium levels were found in squamous cell carcinomas than in other types. Salivary mineral content in patients with oral squamous cell carcinoma is indicative of oral dehydration; however, we found no evidence of any salivary mineral markers that would be useful for the diagnosis of oral cancer.

  8. [Home parenteral nutrition for terminal stage of cancer patient].

    Science.gov (United States)

    Takamura, S; Sakuyama, T; Nakamura, Y; Takahashi, N; Hattori, M

    1997-12-01

    In the last 6 years, we have experienced 20 cancer patients who received home parenteral nutrition for terminal stage. The patients had 13 gastric cancers, 3 esophageal cancers and 5 others. The prognosis of upper G-I cancer is known to be poorer than that of colon cancer. The home care of our cases, the gastric cancer lasted 25 days on average, which was shorter than others. So the home care for patients in the terminal stage of gastric cancer is very short. Therefore we decide the home care for the terminal stage of gastric cancer as soon as possible. We conducted a questionnaire survey of our cases and family. We finally found that the most important thing is the safety of patient for the maintenance of home care. Our home care system is made up of a 3-way relationship among the patient, support system and doctor. The doctor is on call for the problems of the patient for 24 hours. Therefore, we believe that this system is comfortable for both the patient and family.

  9. Cultural beliefs and values in cancer patients.

    Science.gov (United States)

    Daher, M

    2012-04-01

    In 2008, the International Agency for Research on Cancer (IARC) released its World Cancer Report, which indicated that cancer accounts for approximately 12% of all-cause mortality worldwide. IARC estimated that globally 7.6 million people died from cancer and that 12.4 million new cases were diagnosed in 2008. The report went on to project that, due to increases in life expectancy, improvements in clinical diagnostics, and shifting trends in health behaviors (e.g. increases in smoking and sedentary lifestyles), in the absence of significant efforts to improve global cancer control, cancer mortality could increase to 12.9 million and cancer incidence to 20 million by the year 2030. Looking deeper into the data, it becomes clear that cancer-related stigma and myths about cancer are important problems that must be addressed, although different from a country to another. Stigmas about cancer present significant challenges to cancer control: stigma can have a silencing effect, whereby efforts to increase cancer awareness are negatively affected. The social, emotional, and financial devastation that all too often accompanies a diagnosis of cancer is, in large part, due to the cultural myths and taboos surrounding the disease. Combating stigma, myths, taboos, and overcoming silence will play important roles in changing this provisional trajectory. There are several reasons that cancer is stigmatized. Many people in our area perceived cancer to be a fatal disease. Cancer symptoms or body parts affected by the disease can cultivate stigma. Fears about treatment can also fuel stigma. There was evidence of myths associated with cancer, such as the belief that cancer is contagious, or cancer may be seen as a punishment. After reviewing these different examples of cultural myths and taboos met in cancer care, we can report these lessons learned: 1. Around the world, cancer continues to carry a significant amount of stigma, myths, and taboos; however, there are opportunities to

  10. Survey of Enteric Pathogens Causing Bacteremia in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Enayatollah Kalantar

    2014-05-01

    Full Text Available Background: Symptomatic bacteraemia, is a frequent condition among cancer patients with a significant morbidity and mortality all over the world. Objectives: The aim of this study was to determine the burden of enteric pathogens causing bacteremia among cancer patients. Patients and Methods: Ten ml blood samples were withdrawn from the cancer patients under aseptic conditions. The blood specimens were added to the blood culture bottles and incubated at 37°C. The bacterial isolates from these samples were identified by routine biochemical reactions. Results: During the study period, 68 blood samples from cancer patients were analyzed for bacteremia. Of these patients, six were female (08/82% and 62 were male (91.18%; with age ranging from under 40 years to 85 years old (mean, 63 years. Gastro-intestinal cancer and cancers of head and neck were the most frequent cancer types in the studied group, accounting for 51 (75% and 15 (22.1% cases, respectively. The mean weight of patients was 69.18 Kg (range: 49-100 Kg. Similarly, the mean length of hospital stay was 8 days (range: 4-12 days. Positive blood cultures were detected in only 12 (17.65% and 11 (91.7% blood specimens from the Cancer Institute, Tehran, compared with one (08.33% from Shahid Kamali hospital, Karaj. From these patients, 15 bacteria were isolated; E. coli alone outnumbered other species and accounted for 33.33% of the episodes of bacteremia. Conclusions: In conclusion, our investigation revealed that cancers of GI tract are the most common cancer types causing bacteremia and also we identified that most common bacteria causing bacteremia in Cancer Institute, Tehran and Shahid Kamali Hospital, Karaj, are E. coli and S. aureus

  11. Radiotherapy for laryngeal cancer in patients under 50 years old

    International Nuclear Information System (INIS)

    Shimizu, Wakako; Ogino, Takashi; Ebihara, Satoshi; Ikeda, Hiroshi.

    1995-01-01

    Fifty-nine cases of laryngeal cancer treated by radiotherapy at the National Cancer Center Hospital between 1962 and 1990 were analyzed retrospectively. All the patients were less than 50 years old. The median total dose of the radiation delivered to the primary tumor site was 70 Gy. The overall 5-yr survival rate and 5-yr local control rate were 88% and 72%, respectively. Five (8.5%) of the 59 patients developed late recurrence more than five yr after initial treatment, but subsequent salvage operations were successful for disease control; three patients had T1 glottic cancer, one had T2-3 glottic cancer and one had T3N1 supraglottic cancer. Since the local control rate and the 5-yr survival rate after radiotherapy are satisfactory, radiotherapy, which allows both functional and esthetic conservation, has an important role in the treatment of laryngeal cancer in adults under 50 yr of age. (author)

  12. A protocol of early aggressive acceleration of tube feeding increases ileus without perceptible benefit in severely burned patients.

    Science.gov (United States)

    Kesey, Jennifer; Dissanaike, Sharmila

    2013-01-01

    Optimal nutrition is essential to the recovery of burned patients. The authors evaluated the efficacy of an aggressive nutrition delivery protocol. The following protocol was implemented: initiation of tube feeds within 4 hours, acceleration to goal rate within 8 hours, and tolerance of gastric residual volumes of 400 ml. Patients on the protocol formed the study group whereas patients admitted immediately before implementation served as controls for a study period of 7 days after admission. Outcome variables included ileus, prokinetic medication use, intensive care unit and overall length of stay, ventilator days and mortality. Variables were compared using bivariate analysis. The 42 study subjects and 34 controls were similar at baseline. Time to initiation was similar (6.8 vs 9.4 hours; P = .226), however, goal rate was achieved much sooner in the study group (11.2 vs 20.9 hours; P protocol was successfully implemented and resulted in early achievement of goal tube feed rates. However, this resulted in tube feed intolerance as manifested by more cases of clinical ileus.

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

    Science.gov (United States)

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

    2016-12-15

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

  14. Communicating with cancer patients in Saudi Arabia.

    Science.gov (United States)

    Younge, D; Moreau, P; Ezzat, A; Gray, A

    1997-02-20

    The following factors are relevant to the communication problems that exist in this country: 1. The impression is that patients here cope better with terminal illness at home than do patients elsewhere. The extended family, with its strong ties, and the strong Islamic faith that encourages its members to provide for parents and children in case of need mean that any input by health professionals is magnified by the family in the care of the patient. At first, it was uncertain if foreign health professionals would be accepted into Saudi homes (which are intensely private and protected for the family) for the purpose of caring for patients. This has proved unfounded. Hospitality is a very important part of Saudi society; nurses and doctors are welcomed and respected. Much of this success is due to the use of Saudi men as drivers and translators. These people provide 24-hour service, act as social workers assessing the needs of the family, and are the link between the patient and family, the nurse, and the doctor. 2. "CURE" OR "PALLIATION": The emphasis for cancer patients in Saudi Arabia is still on "curative treatment," even after any realistic hope of a cure is gone. The problem this causes is compounded by many patients being excluded from the decision-making process. Decisions made by the family may not always reflect the patient's wishes. Greater communication is needed to guide treatment decisions. 3. TRUTH-TELLING: Denying information of the patient's illness is probably more a historical than a cultural phenomenon. Similar attitudes prevailed until very recently in practically all other countries. In this very conservative country, people are committed to preserving Islamic culture in the face of Western technology. As medicine continues to demonstrate its effectiveness as well as its limitations, people will come to realize that the right of patients to know and understand their illness allows them to cope much better, and is compatible with the

  15. Management of fertility preservation in young breast cancer patients in a large breast cancer centre.

    Science.gov (United States)

    Lawrenz, B; Neunhoeffer, E; Henes, M; Lessmann-Bechle, S; Krämer, B; Fehm, Tanja

    2010-11-01

    The increase of breast cancer in young women under 40 years and the increasing age of women at the time of the birth of their first child underlines the importance to implement counselling for fertility-preserving strategies in the management of breast cancer care. We present the fertility-preserving procedures performed after routine counselling for primary breast cancer patients in a large certified breast cancer centre. Since November 2006, patients aged below 40 years with histologically confirmed breast cancer are routinely counselled on fertility-preserving possibilities before breast surgery and chemotherapy in the fertility centre of the University Women's Hospital in Tuebingen. The recommendations are based on the treatment recommendations of the network FertiPROTEKT. During the last 40 months, 56 primary breast cancer patients were counselled. Forty-one of these patients were hormone receptor positive. Thirty-four patients (63%) underwent fertility-preserving strategies. The majority of the patients (n = 22) decided on ovarian tissue cryopreservation. GnRH protection was performed in 14 patients. In 12 patients an ovarian stimulation protocol was initiated to cryopreserve fertilized or unfertilized oocytes. A combination of different fertility-preserving methods was performed in 12 patients. The preservation of ovarian function and fertility are of great importance to young breast cancer patients. Counselling on fertility-preserving strategies is therefore critical in these patients and should be routinely performed.

  16. Early Versus Delayed Postoperative Feeding After Major Gynaecological Surgery and its Effects on Clinical Outcomes, Patient Satisfaction, and Length of Stay: A Randomized Controlled Trial.

    Science.gov (United States)

    Balayla, Jacques; Bujold, Emmanuel; Lapensée, Louise; Mayrand, Marie-Hélène; Sansregret, Andrée

    2015-12-01

    To compare early versus delayed postoperative feeding in women undergoing major gynaecological surgery with regard to clinical outcomes, duration of postoperative stay, and patient satisfaction. We conducted a parallel-randomized controlled trial at a tertiary care centre in Montreal, Quebec, between June 2000 and July 2001. Patients undergoing major gynaecological surgery were randomized following a 1:1 allocation ratio to receive either early postoperative feeding in which oral clear fluids were begun up to six hours after surgery followed by solid foods as tolerated, or delayed postoperative feeding, in which clear fluids were begun on the first postoperative day and solid foods on the second or third day as tolerated. The primary outcomes analyzed were duration of postoperative stay and patient satisfaction. Secondary outcomes included mean time to appetite, passage of flatus, and bowel movement, as well as the presence of symptoms of paralytic ileus. A total of 119 patients were randomized; 61 patients were assigned to the early feeding group and 58 to the delayed feeding group. Demographic characteristics, including age, weight, smoking status, and prior surgical history were comparable between both groups. There was no difference in length of postoperative stay between the two groups (86.4 ± 21.0 hours in the early feeding group vs. 85.6 ± 26.2 hours in the delayed feeding group; P > 0.05). No significant difference was noted in patient satisfaction (P > 0.05). No difference was found in the frequency of postoperative ileus, mean time to appetite, passage of flatus, or first bowel movement. The introduction of early postoperative feeding appears to be safe and well tolerated by patients undergoing major gynaecological surgery. The duration of postoperative stay, patient satisfaction, and gastrointestinal symptoms are comparable between patients undergoing early or delayed postoperative feeding.

  17. Alternative and complementary medicine in cancer patient

    International Nuclear Information System (INIS)

    Reckova, M.

    2009-01-01

    The use of alternative and complementary medicine (CAM) in cancer patients is widespread and it is not surprising as the results gained by conventional treatments are not sufficient. However, the results from the studies with CAM are not always sufficient according to their testing in appropriate clinical studies. Another problem that is present in the use of CAM is the possibility of drug-drug interactions between conventional therapies and CAM. Thus, it is of utmost importance that the oncologist possess a good knowledge of available CAM and provide a sufficient time for discussion with the patient and his/her family about possible alternative treatments and any downside risks. The cornerstone for pertinent discussion is sufficient knowledge on the part of the oncologist about those alternative treatments that are usually presented in the media with incomplete information about their relevant clinical tests and side effects. The following article presents a review of the current alternative treatment methods with a focus on the alternative drugs that have already been clinically tested, and secondarily on the alternative drugs that have been used even without sufficient testing in clinical trials. (author)

  18. The content of hope in ambulatory patients with colon cancer.

    Science.gov (United States)

    Beckman, Emily S; Helft, Paul R; Torke, Alexia M

    2013-01-01

    Although hope is a pervasive concept in cancer treatment, we know little about how ambulatory patients with cancer define or experience hope. We explored hope through semistructured interviews with ten patients with advanced (some curable, some incurable) colon cancer at one Midwestern, university-based cancer center. We conducted a thematic analysis to identify key concepts related to patient perceptions of hope. Although we did ask specifically about hope, patients also often revealed their hopes in response to indirect questions or by telling stories about their cancer experience. We identified four major themes related to hope: 1) hope is essential, 2) a change in perspective, 3) the content of hope, and 4) communicating about hope. The third theme, the content of hope, included three subthemes: a) the desire for normalcy, b) future plans, and c) hope for a cure. We conclude that hope is an essential concept for patients undergoing treatment for cancer as it pertains to their psychological well-being and quality of life, and hope for a cure is not and should not be the only consideration. In a clinical context, the exploration of patients' hopes and aspirations in light of their cancer diagnosis is important because it provides a frame for understanding their goals for treatment. Exploration of the content of patients' hope can not only help to illuminate misunderstandings but also clarify how potential treatments may or may not contribute to achieving patients' goals.

  19. Biological Therapy in Treating Patients With Metastatic Cancer

    Science.gov (United States)

    2013-02-21

    Breast Cancer; Colorectal Cancer; Extrahepatic Bile Duct Cancer; Gallbladder Cancer; Gastric Cancer; Head and Neck Cancer; Liver Cancer; Lung Cancer; Metastatic Cancer; Ovarian Cancer; Pancreatic Cancer; Testicular Germ Cell Tumor

  20. Rates of cannabis use in patients with cancer

    Science.gov (United States)

    Martell, K.; Fairchild, A.; LeGerrier, B.; Sinha, R.; Baker, S.; Liu, H.; Ghose, A.; Olivotto, I.A.; Kerba, M.

    2018-01-01

    Background A comprehensive assessment of cannabis use by patients with cancer has not previously been reported. In this study, we aimed to characterize patient perspectives about cannabis and its use. Methods An anonymous survey about cannabis use was offered to patients 18 years of age and older attending 2 comprehensive and 2 community cancer centres, comprising an entire provincial health care jurisdiction in Canada (ethics id: hreba-17011). Results Of 3138 surveys distributed, 2040 surveys were returned (65%), with 1987 being sufficiently complete for analysis (response rate: 63%). Of the respondents, 812 (41%) were less than 60 years of age; 45% identified as male, and 55% as female; and 44% had completed college or higher education. Of respondents overall, 43% reported any lifetime cannabis use. That finding was independent of age, sex, education level, and cancer histology. Cannabis was acquired through friends (80%), regulated medical dispensaries (10%), and other means (6%). Of patients with any use, 81% had used dried leaves. Of the 356 patients who reported cannabis use within the 6 months preceding the survey (18% of respondents with sufficiently complete surveys), 36% were new users. Their reasons for use included cancer-related pain (46%), nausea (34%), other cancer symptoms (31%), and non-cancer-related reasons (56%). Conclusions The survey demonstrated that prior cannabis use was widespread among patients with cancer (43%). One in eight respondents identified at least 1 cancer-related symptom for which they were using cannabis.

  1. Identifying Malnutrition: Nutritional Status in Newly Diagnosed Patients With Cancer.

    Science.gov (United States)

    Krishnasamy, Karthikayini; Li Yoong, Tang; Mei Chan, Chong; Peng Choong, Lau; Chinna, Karuthan

    2017-02-01

    Malnutrition is common among patients with cancer, but little attention is given to its risks and consequences. The aim of this study is to assess the nutritional status and identify the factors associated with malnutrition among newly diagnosed patients with cancer. Patients admitted with newly diagnosed cancer at a teaching hospital in Malaysia were recruited from January to April 2015. Nutritional status was assessed before treatment initiation, and patients were classified into three categories. A total of 132 pretreatment patients were recruited into the study. About half were severely malnourished. Patients with stage III cancer had the highest prevalence of severe malnourishment. Clinical parameters and disease characteristics were significantly associated with nutritional status. Demographic variables were also statistically significantly associated with severe nutritional status.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    and characterize ADL task performance problems among a group of adult disabled hospitalized cancer patients using interview and questionnaire data. METHODS: Cross-sectional study on prevalence of ADL task performance problems experienced by disabled hospitalized cancer patients using the Activities of Daily Living...... Questionnaire (ADL-Q) (n = 118) and the Canadian Occupational Performance Measure (COPM) (n = 55). RESULTS: All 118 patients reported problems with ADL task performance. Based on the ADL-Q patients reported more problems within instrumental (I-)ADL than personal (P-)ADL. In both I-ADL and P-ADL the results......BACKGROUND: Many cancer patients report unmet rehabilitation needs. Rehabilitation may include activities of daily living (ADL) tasks, but little is known about how cancer patients perform these tasks and how they prioritize their daily activities. Hence, this study aims to identify...

  3. Hyponatraemia in cancer patients on an inpatient rehabilitation unit.

    Science.gov (United States)

    Nelson, M; Palmer, J L; Fu, J; Williams, J L; Yadav, R; Guo, Y

    2014-05-01

    This study identifies the incidence of hyponatraemia in cancer patients on an inpatient rehabilitation unit and examines the association between admission hyponatraemia and rehabilitation length of stay (LOS), functional outcome, and survival. After institutional review committee's approval, we retrospectively reviewed medical records of 295 consecutive patients who were admitted to this inpatient cancer rehabilitation unit between 27 January 2009 through 31 July 2010 in a tertiary cancer centre. The incidence of hyponatraemia in cancer patients admitted to our inpatient rehabilitation unit was 41.4%. Median rehabilitation LOS for patients with mild (Na 130-134 mEq/L) and moderate-severe (Na rehabilitation stay was not significantly different between three different patient groups. We concluded that large portion of patients who require acute inpatient rehabilitation presented with hyponatraemia, which is associated with prolonged rehabilitation LOS. Whether aggressive management of hyponatraemia will shorten rehabilitation stay needs further study. © 2013 John Wiley & Sons Ltd.

  4. Guidelines for primary radiotherapy of patients with prostate cancer

    International Nuclear Information System (INIS)

    Boehmer, Dirk; Maingon, Philippe; Poortmans, Philip; Baron, Marie-Helene; Miralbell, Raymond; Remouchamps, Vincent; Scrase, Christopher; Bossi, Alberto; Bolla, Michel

    2006-01-01

    Background and purposes: The appropriate application of 3-D conformal radiotherapy, intensity modulated radiotherapy or image guided radiotherapy for patients undergoing radiotherapy for prostate cancer requires a standardisation of target delineation as well as clinical quality assurance procedures. Patients and methods: Pathological and imaging studies provide valuable information on tumour extension. In addition, clinical investigations on patient positioning and immobilisation as well as treatment verification data offer an abundance of information. Results: Target volume definitions for different risk groups of prostate cancer patients based on pathological and imaging studies are provided. Available imaging modalities, patient positioning and treatment preparation studies as well as verification procedures are collected from literature studies. These studies are summarised and recommendations are given where appropriate. Conclusions: On behalf of the European Organisation for Research and Treatment of Cancer (EORTC) Radiation Oncology Group this article presents a common set of recommendations for external beam radiotherapy of patients with prostate cancer

  5. Assessing the risk for suicide in patients with cancer.

    Science.gov (United States)

    Aiello-Laws, Lisa B

    2010-12-01

    The Joint Commission publishes its annual National Patient Safety Goals to guide accredited organizations in addressing high-risk, low-volume concerns related to patient safety. The 2010 list includes a goal to identify patients at risk for suicide, but do oncology nurses need to be concerned about the risk of suicide in patients with cancer?

  6. Communicating with older cancer patients: impact on information recall

    NARCIS (Netherlands)

    Jansen, J.

    2009-01-01

    The central aim of this thesis was to unravel the relationship between patient characteristics, communication between patient and clinician, and subsequent patient information recall in the context of medical consultations with older cancer patients. Chapter 2 reviewed the literature to explore age

  7. Online Social Networks - Opportunities for Empowering Cancer Patients.

    Science.gov (United States)

    Mohammadzadeh, Zeinab; Davoodi, Somayeh; Ghazisaeidi, Marjan

    2016-01-01

    Online social network technologies have become important to health and apply in most health care areas. Particularly in cancer care, because it is a disease which involves many social aspects, online social networks can be very useful. Use of online social networks provides a suitable platform for cancer patients and families to present and share information about their medical conditions, address their educational needs, support decision making, and help to coping with their disease and improve their own outcomes. Like any other new technologies, online social networks, along with many benefits, have some negative effects such as violation of privacy and publication of incorrect information. However, if these effects are managed properly, they can empower patients to manage cancer through changing behavioral patterns and enhancing the quality of cancer patients lives This paper explains some application of online social networks in the cancer patient care process. It also covers advantages and disadvantages of related technologies.

  8. An innovative art therapy program for cancer patients.

    Science.gov (United States)

    Deane, K; Fitch, M; Carman, M

    2000-01-01

    Art therapy is a healing art intended to integrate physical, emotional, and spiritual care by facilitating creative ways for patients to respond to their cancer experience. A new art therapy program was designed to provide cancer patients with opportunities to learn about the McMichael Canadian Art Collection and to explore personal feelings about their cancer experience through combined gallery and studio components. The role of the facilitator was to assist in the interpretation of a participant's drawing in order to reveal meaning in the art. This paper presents patients' perspectives about the new art therapy program. Content analysis of participant feedback provided information about the structure, process, and outcomes of the program. Evaluation of the art therapy/museum education program demonstrated many benefits for cancer patients including support, psychological strength, and new insights about their cancer experience.

  9. Differences between right- and left-sided colon cancer in patient characteristics, cancer morphology and histology.

    Science.gov (United States)

    Nawa, Toru; Kato, Jun; Kawamoto, Hirofumi; Okada, Hiroyuki; Yamamoto, Hiroshi; Kohno, Hiroyuki; Endo, Hisayuki; Shiratori, Yasushi

    2008-03-01

    Recently, the clinical and biological differences between right- and left-sided colon cancers have been widely debated. However, close analyses of these clinical differences, based on large-scale studies, have been scarcely reported. A total of 3552 consecutive Japanese colorectal cancer cases were examined and the clinical differences between right- and left-sided colon cancer cases were investigated. The proportion of right-sided colon cancer was relatively high in patients aged less than 40 years (33%) and more than 80 years (43%). The proportion of right-sided colon cancer in patients aged 40-59 years was relatively low (male 22% and female 29%). In male patients the proportion increased in the 70-79 years age group (30%), while in female patients the proportion increased in the 60-69 years age group (39%). Right-sided colon cancer was more likely to be detected at an advanced stage (T1 stage; left 22%, right 15%) (P cancer was dominant in the left colon (left 59%; right 40%) (P cancer in the right colon was significantly higher than that in the left colon (left 25%; right 44%) (P colon cancer was observed and the difference between male and female patients was highlighted. Other clinical features also differed between right- and left-sided colon cancer, suggesting that different mechanisms may be at work during right and left colon carcinogenesis.

  10. Incidental pulmonary embolism in cancer patients: clinical characteristics and outcome – a comprehensive cancer center experience

    Directory of Open Access Journals (Sweden)

    Abdel-Razeq H

    2011-03-01

    Full Text Available Hikmat N Abdel-Razeq1, Asem H Mansour2, Yousef M Ismael11Department of Internal Medicine, 2Department of Radiology, King Hussein Cancer Center, Amman, JordanBackground and objectives: Cancer patients undergo routine imaging studies much more than others. The widespread use of the recently introduced multi-detector CT scanners has resulted in an increasing number of incidentally diagnosed pulmonary embolism (PE in asymptomatic cancer patients. The significance and clinical outcome of such incidental PE is described.Methods: Both radiology department and hospital databases were searched for all cancer patients with a diagnosis of incidental PE. CT scans were performed using a 64-slice scanner with a 5.0 mm slice thickness.Results: During the study period, 34 patients with incidental PE were identified. The mean age (±SD was 57.7 (±12.4 years. All patients had active cancer, gastric, lung, colorectal, and lymphomas being the most frequent. Most patients had advanced-stage disease at the time of PE diagnosis; 26 (77% patients had stage IV, whereas only 3 patients had stages I or II disease. Twenty-seven (79% patients had their PE while undergoing active treatment with chemotherapy (68% or radiotherapy (12%; none, however, were on hormonal therapy. Most (74% patients had their PE diagnosed without history of recent hospital admission. Except for 5 (15%, all other patients were anticoagulated. With follow-up, 2 patients developed recurrent PE, 2 others had clinical and echocardiographic evidence of pulmonary hypertension, and 9 (26% died suddenly within 30 days of the diagnosis of incidental PE; 2 of these where among the 5 patients who were not anticoagulated.Conclusion: Incidental PE in cancer patients is increasingly encountered. Similar to symptomatic PE, many were diagnosed in patients with advanced stage disease and while undergoing active anti-cancer therapy. A significant percentage of patients had recurrent emboli, pulmonary hypertension

  11. Differences in dietary intake during chemotherapy in breast cancer patients compared to women without cancer

    NARCIS (Netherlands)

    Vries, Y.C. de; Berg, M.M.; Vries, J.H.M. de; Boesveldt, S.; Kruif, J.; Buist, N.; Haringhuizen, A.; Los, M.; Sommeijer, D.W.; Timmer-Bonte, J.H.N.; Laarhoven, H.W. van; Visser, M.; Kampman, E.; Winkels, R.M.

    2017-01-01

    PURPOSE: Breast cancer patients receiving chemotherapy often experience symptoms such as nausea, vomiting and loss of appetite that potentially affect dietary habits. This study assessed the intake of energy, macronutrients and food groups before and during chemotherapy in breast cancer patients

  12. Differences in dietary intake during chemotherapy in breast cancer patients compared to women without cancer

    NARCIS (Netherlands)

    Vries, de Y.C.; Berg, van den M.M.G.A.; Vries, de J.H.M.; Boesveldt, S.; Kruif, de J.Th.C.M.; Buist, N.; Haringhuizen, A.; Los, M.; Sommeijer, D.W.; Timmer-Bonte, J.H.N.; Laarhoven, van H.W.M.; Visser, M.; Kampman, E.; Winkels, R.M.

    2017-01-01

    Purpose: Breast cancer patients receiving chemotherapy often experience symptoms such as nausea, vomiting and loss of appetite that potentially affect dietary habits. This study assessed the intake of energy, macronutrients and food groups before and during chemotherapy in breast cancer patients

  13. Differences in dietary intake during chemotherapy in breast cancer patients compared to women without cancer

    NARCIS (Netherlands)

    de Vries, Y. C.; van den Berg, M. M. G. A.; de Vries, J. H. M.; Boesveldt, S.; de Kruif, J. Th C. M.; Buist, N.; Haringhuizen, A.; Los, M.; Sommeijer, D. W.; Timmer-Bonte, J. H. N.; van Laarhoven, H. W. M.; Visser, M.; Kampman, E.; Winkels, R. M.

    2017-01-01

    Breast cancer patients receiving chemotherapy often experience symptoms such as nausea, vomiting and loss of appetite that potentially affect dietary habits. This study assessed the intake of energy, macronutrients and food groups before and during chemotherapy in breast cancer patients compared

  14. Differences in dietary intake during chemotherapy in breast cancer patients compared to women without cancer

    NARCIS (Netherlands)

    de Vries, Y. C.; van den Berg, M. M.G.A.; de Vries, J. H.M.; Boesveldt, S.; de Kruif, J. Th C.M.; Buist, N.; Haringhuizen, A.; Los, M.; Sommeijer, D. W.; Timmer-Bonte, J. H.N.; van Laarhoven, H. W.M.; Visser, M.; Kampman, E.; Winkels, R. M.

    PURPOSE: Breast cancer patients receiving chemotherapy often experience symptoms such as nausea, vomiting and loss of appetite that potentially affect dietary habits. This study assessed the intake of energy, macronutrients and food groups before and during chemotherapy in breast cancer patients

  15. The denial of cancer interview: development and first assessment of psychometric properties in lung cancer patients

    NARCIS (Netherlands)

    Vos, Martina S.; Putter, Hein; Leurs, Amber; Rooijmans, Harry G. M.; de Haes, Hanneke C. J. M.; van Houwelingen, Hans C.

    2007-01-01

    Based on Weissman and Hackett's comprehensive definition of denial, a semi-structured interview was developed to measure denial in cancer patients. The denial in cancer interview (DCI) covers both the patients' recount of their illness experience and the expert's impression of the level of denial in

  16. Rehabilitation of patients with laryngeal and lung cancer after radiotherapy

    International Nuclear Information System (INIS)

    Strashinin, A.I.; Gerasimyak, V.G.; Vladimirova, V.A.; Ivanova, L.V.

    1980-01-01

    The ways of medical and social-occupational rehabilitation after a course of radiotherapy in patients with respiratory system cancer have been determined. Medical rehabilitation in patients with lung cancer comprises expedient planning of radiotherapy by means of systematic medicamental treatment. It is shown that it is necessary to place the patients in special rehabilitation departments after radiotherapy of carry out the treatment of pneumonities

  17. Nursing workload for cancer patients under palliative care

    OpenAIRE

    Fuly, Patrícia dos Santos Claro; Pires, Livia Márcia Vidal; Souza, Claudia Quinto Santos de; Oliveira, Beatriz Guitton Renaud Baptista de; Padilha, Katia Grillo

    2016-01-01

    Abstract OBJECTIVE To verify the nursing workload required by cancer patients undergoing palliative care and possible associations between the demographic and clinical characteristics of the patients and the nursing workload. METHOD This is a quantitative, cross-sectional, prospective study developed in the Connective Bone Tissue (TOC) clinics of Unit II of the Brazilian National Cancer Institute José Alencar Gomes da Silva with patients undergoing palliative care. RESULTS Analysis of 197 ...

  18. Quality of life in urinary bladder and prostate cancer patients

    OpenAIRE

    Schmidt, Stefanie, 1979-

    2014-01-01

    The overall objective of this thesis was to describe the evolution of Health-Related Quality of Life in Spanish patients with urologic tumours; and to the examine clinical and treatment-related factors associated with changes in Health-Related Quality of Life during the first year of treatment. The EMPARO project is an observational, multicenter, prospective study on patients diagnosed with bladder cancer (n=326) and prostate cancer (n=472). Consecutive patients were enrolled in 7 Spanish hos...

  19. Factors affecting 30-month survival in lung cancer patients.

    Science.gov (United States)

    Mahesh, P A; Archana, S; Jayaraj, B S; Patil, Shekar; Chaya, S K; Shashidhar, H P; Sunitha, B S; Prabhakar, A K

    2012-10-01

    Age adjusted incidence rate of lung cancer in India ranges from 7.4 to 13.1 per 100,000 among males and 3.9 to 5.8 per 100,000 among females. The factors affecting survival in lung cancer patients in India are not fully understood. The current study was undertaken to evaluate the factors affecting survival in patients diagnosed with lung cancer attending a tertiary care cancer institute in Bangalore, Karnataka, India. Consecutive patients with primary lung cancer attending Bangalore Institute of Oncology, a tertiary care centre at Bangalore, between 2006 and 2009 were included. Demographic, clinical, radiological data were collected retrospectively from the medical records. A total of 170 consecutive subjects (128 males, 42 females) diagnosed to have lung cancer; 151 non-small cell lung cancer (NSCLC) and 19 small cell lung cancer (SCLC) were included. A higher proportion of never-smokers (54.1%) were observed, mostly presenting below the age of 60 yr. Most subjects were in stage IV and III at the time of diagnosis. More than 50 per cent of patients presented with late stage lung cancer even though the duration of symptoms is less than 2 months. The 30-month overall survival rates for smokers and never-smokers were 32 and 49 per cent, respectively. No significant differences were observed in 30 month survival based on age at presentation, gender and type of lung cancer. Cox proportional hazards model identified never-smokers and duration of symptoms less than 1 month as factors adversely affecting survival. Our results showed that lung cancer in Indians involved younger subjects and associated with poorer survival as compared to other ethnic population. Studies on large sample need to be done to evaluate risk factors in lung cancer patients.

  20. The early enteral feeding and rehabilitation of severely burned patients%严重烧伤患者的早期肠道营养与康复

    Institute of Scientific and Technical Information of China (English)

    邢德荣

    2002-01-01

    Objective To explore the effect of rehabilitation through analysis the early enteral feeding on the prevention of enteral infection in severely burned patients .Method A total of 22 patients with severe burns were randomly divided into an early enteral feeding group (EF) and a delayed enteral feeding group (DF). The levels of serum endotoxin were detected in the members of both groups in 1, 3, and 5 days .Result The levels of serum endotoxin in severely burned patients were significantly higher than in normal subjects (P< 0.01) . The levels of serum endotoxin in the EF group were significantly lower than in the DF group (P< 0.01). Conclusion Early enteral feeding may decrease enterogenic infection and it helps the nutrition support, improve the patient resistance, facilitate the repair of damaged tissue , so it contributes to the rehabilitation of burned patients.

  1. Trastuzumab and survival of patients with metastatic breast cancer.

    Science.gov (United States)

    Kast, Karin; Schoffer, Olaf; Link, Theresa; Forberger, Almuth; Petzold, Andrea; Niedostatek, Antje; Werner, Carmen; Klug, Stefanie J; Werner, Andreas; Gatzweiler, Axel; Richter, Barbara; Baretton, Gustavo; Wimberger, Pauline

    2017-08-01

    Prognosis of Her2-positive breast cancer has changed since the introduction of trastuzumab for treatment in metastatic and early breast cancer. It was described to be even better compared to prognosis of Her2-negative metastatic breast cancer. The purpose of this study was to evaluate the effect of trastuzumab in our cohort. Besides the effect of adjuvant pretreatment with trastuzumab on survival of patients with metastatic Her2-positive breast cancer was analyzed. All patients with primary breast cancer of the Regional Breast Cancer Center Dresden diagnosed during the years 2001-2013 were analyzed for treatment with or without trastuzumab in the adjuvant and in the metastatic treatment setting using Kaplan-Meier survival estimation and Cox regression. Age and tumor stage at time of first diagnosis of breast cancer as well as hormone receptor status, grading, time, and site of metastasis at first diagnosis of distant metastatic disease were analyzed. Of 4.481 female patients with primary breast cancer, 643 presented with metastatic disease. Her2-positive status was documented in 465 patients, including 116 patients with primary or secondary metastases. Median survival of patients with Her2-positive primary metastatic disease was 3.0 years (95% CI 2.3-4.0). After adjustment for other factors, survival was better in patients with Her2-positive breast cancer with trastuzumab therapy compared to Her2-negative metastatic disease (HR 2.10; 95% CI 1.58-2.79). Analysis of influence of adjuvant therapy with and without trastuzumab by Kaplan-Meier showed a trend for better survival in not pretreated patients. Median survival was highest in hormone receptor-positive Her2-positive (triple-positive) primary metastatic breast cancer patients with 3.3 years (95% CI 2.3-4.6). Prognosis of patients with Her2-positive metastatic breast cancer after trastuzumab treatment is more favorable than for Her2-negative breast cancer. The role of adjuvant chemotherapy with or without

  2. Factors related to treatment refusal in Taiwanese cancer patients.

    Science.gov (United States)

    Chiang, Ting-Yu; Wang, Chao-Hui; Lin, Yu-Fen; Chou, Shu-Lan; Wang, Ching-Ting; Juang, Hsiao-Ting; Lin, Yung-Chang; Lin, Mei-Hsiang

    2015-01-01

    Incidence and mortality rates for cancer have increased dramatically in the recent 30 years in Taiwan. However, not all patients receive treatment. Treatment refusal might impair patient survival and life quality. In order to improve this situation, we proposed this study to evaluate factors that are related to refusal of treatment in cancer patients via a cancer case manager system. This study analysed data from a case management system during the period from 2010 to 2012 at a medical center in Northern Taiwan. We enrolled a total of 14,974 patients who were diagnosed with cancer. Using the PRECEDE Model as a framework, we conducted logistic regression analysis to identify independent variables that are significantly associated with refusal of therapy in cancer patients. A multivariate logistic regression model was also applied to estimate adjusted the odds ratios (ORs) with 95% confidence intervals (95%CI). A total of 253 patients (1.69%) refused treatment. The multivariate logistic regression result showed that the high risk factors for refusal of treatment in cancer patient included: concerns about adverse effects (prefuse treatment have poor survival. The present study provides evidence of factors that are related to refusal of therapy and might be helpful for further application and improvement of cancer care.

  3. Incidence of colorectal cancer in young patients.

    Science.gov (United States)

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

    2017-01-01

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

  4. Radiation induced chromosomal instability in lymphocytes of cancer patients

    International Nuclear Information System (INIS)

    Sudo, H.; Sagara, M.; Ban, S.; Noda, S.; Iwakawa, M.; Harada, Y.; Imai, T.; Cologne, J.B.

    2003-01-01

    Full text: Cytokinesis-blocked micronucleus (CBMN) assay has been extensively used to evaluate the radiation sensitivity of human individuals. Using the CBMN assay, Scott et al (1998, 1999) demonstrated that a fraction of radiosensitive individuals in breast cancer case population was larger than in normal individual population. However, Vral et al were very skeptical about the Scott et al's findings (2002). Under the approval from the ethical committee of NIRS, peripheral blood was obtained from 46 normal healthy females, 131 breast cancer patients, 32 cervical cancer patients and 7 female head and neck cancer patients. Radiosensitivity of T-lymphocytes was assessed by using a CBMN assay. The frequencies of MN per binucleated cell in healthy donors were 0.031(±0.010) and 0.151(±0.066) for cells treated before and after X-ray-irradiation (2Gy), respectively. Spontaneous MN frequencies in cancer patients were significantly higher than healthy donors (p < 0.001). Radiation sensitivities of breast- and head and neck-cancer patients were significantly higher than normal individuals (p < 0.001). Cervical cancer patients were more resistant to irradiation than healthy donors, though the number of cases for statistical analysis was small. (p < 0.001). We are considering that the HPV infection affected the radiosensitivity of cervical cancer cases. Because it is widely believed that one key mechanism which leads to spontaneous micronucleus formation involves an imbalance of chromosomal segregation and a chromosomal instability in patients' lymphocytes might be greater than that in normal individuals' lymphocytes. Recently, Kuschel et al (2002) demonstrated that ratios in two SNPs on XRCC3 were significantly different between cancer patients and healthy females. Then, we can suppose that the radiation-related genes with low penetrance may be involved in tumorigenesis of mammary- and head and neck-cells, and also, in patients' radiation susceptibility

  5. A survey of Internet utilization among patients with cancer.

    Science.gov (United States)

    Castleton, Kimra; Fong, Thomas; Wang-Gillam, Andrea; Waqar, Muhammad A; Jeffe, Donna B; Kehlenbrink, Lisa; Gao, Feng; Govindan, Ramaswamy

    2011-08-01

    Recently published articles have established that a substantial number of cancer patients utilize the Internet to gather information about their respective diagnoses. The challenges for medical providers include understanding the prevalence and characteristics of patients using the Internet, reasons for Internet use, and the effectiveness of currently available websites in providing useful health-related information to patients. Adults with cancer were asked to complete a self-administered, anonymous, 21-item questionnaire upon registration at the Alvin J. Siteman Cancer Center at the Washington University School of Medicine. There were 500 respondents (mean age 58 years (range 18-90), 83% Caucasian and 15% African-American). Three hundred ninety-eight participants (80%) reported access to the Internet, and 315 (63%) reported searching for information about cancer on the Internet. Patients accessing the Internet for cancer information were younger than those who did not (median age 56 vs. 63 years; p Internet usage for cancer information also differed by race (p Internet for cancer information, 13.3% of patients had their decisions towards treatments affected or changed, and 11.4% of patients had their choice in physicians affected or changed because of Internet use; 23.5% of patients sought information on clinical trials, and 9.5% of patients were influenced or changed their decision regarding clinical trial enrollment due to Internet information. Approximately two thirds of patients with cancer used the Internet to obtain information about their disease. Factors affecting Internet use for cancer information included age, race, and education. Clinical decisions can be affected by Internet use.

  6. Supplementary feeding in the care of the wasted HIV infected patient

    African Journals Online (AJOL)

    from anorexia or food insecurity associated with poverty, a catabolic state induced by ... common in sub-Saharan Africa,3,4,5 and an adequate diet is believed to be ... supplementary feeding of malnourished children with and without HIV14,15.

  7. Quality of life outcomes in patients with breast cancer

    Directory of Open Access Journals (Sweden)

    Theofilou Paraskevi

    2012-01-01

    Full Text Available Health-related quality of life is now considered an important endpoint in cancer clinical trials. It has been shown that assessing quality of life in cancer patients could contribute to improved treatment and could even serve as a prognostic factor along with medical parameters. This paper presents a review of quality of life outcomes in patients with breast cancer according to previous descriptive findings. This is a bibliographic review of the literature covering publications that appeared in English language biomedical journals between 1987 and 2008. The search strategy included a combination of the key words quality of life and breast cancer in the titles of published articles. The major findings are summarized and presented under different headings: evaluation of health-related quality of life i at the time of diagnosis, ii during treatment, and iii after the completion of treatment. Breast cancer patients receiving chemotherapy might experience several side-effects and symptoms that have a negative effect on their quality of life. Also adjuvant hormonal therapies were found to have a similar negative impact on quality of life. Psychological distress-anxiety and depression were found to be common among breast cancer patients. Symptoms-pain, fatigue, and insomnia were among the most common symptoms reported. There was quite an extensive body of literature on quality of life in breast cancer patients. These papers have made a considerable contribution to improving breast cancer care.

  8. Demoralization Syndrome Among Elderly Patients with Cancer Disease

    Directory of Open Access Journals (Sweden)

    Kai-Ting Ko

    2018-03-01

    Full Text Available Summary: Background: Demoralization is distinctive psychological distress that involves hopelessness, helplessness, loss of purpose and meaning, and existential distress. Cancer patients' demoralization has been well documented, but little is known regarding older cancer patients and the related factors. Therefore, this study evaluated demoralization syndrome in older cancer patients. Methods: Cancer patients over 61 years old (n = 113, female 59.3%, mean age 65.7 years, range 61–80 diagnosed with heterogeneous types of cancer were recruited. They completed questionnaires in a hospital's inpatient and outpatient units. Their demoralization was measured using the Demoralization Scale-Mandarin Version (DS-MV. The Patient Health Questionnaire-9 (PHQ-9, Distress Thermometer (DT, Beck Scale for Suicide Ideation (BSS, and Posttraumatic Growth Inventory (PTGI were used to measure other psychological statuses and the association with demoralization. Results: The mean DS-MV score was 28.1 (SD = 16.3. In this sample, 57.7% had moderate to high demoralization (18.6% had moderate demoralization, and 38.1% had high demoralization. Twenty-three percent reported a DT score of five and above, 5.5% reported a PHQ-9 score of 10 and above, and 23.9% reported a BSS score greater than zero. Demoralization was associated with suicide ideation, depression, distress, lower education, and the cancer site. Demoralization was not associated with posttraumatic growth, gender, work status, or religion. Conclusion: More than half of older cancer patients have moderate to high demoralization and it is associated with depression, suicide ideation, and distress. Screening and interventions that are better tailored to older cancer patients could improve the quality of care in cancer treatment. Keywords: aged, cancer, depression, hospice care/psychology, morale

  9. Pretreatment depression as a prognostic indicator of survival and nutritional status in patients with head and neck cancer.

    Science.gov (United States)

    Kim, Shin-Ae; Roh, Jong-Lyel; Lee, Sang-Ah; Lee, Sang-Wook; Kim, Sung-Bae; Choi, Seung-Ho; Nam, Soon Yuhl; Kim, Sang Yoon

    2016-01-01

    The emotional status of cancer patients is associated with disease course and treatment outcomes. In this study, the authors evaluated associations between the presence of pretreatment depression and pretreatment quality of life (QOL), nutritional status, and survival outcomes in patients with head and neck squamous cell carcinoma (HNSCC). For this prospective study, 241 patients with previously untreated HNSCC who underwent curative treatments were enrolled. Patients completed the Beck Depression Inventory (BDI)-II, the European Organization for Research and Treatment of Cancer (EORTC) 30-item Core QOL Questionnaire (QLQ-C30), and the EORTC QLQ Head and Neck Cancer module (QLQ-H&N35). EORTC QLQ scores were compared between depressive and nondepressive patients, as determined according to pretreatment BDI-II scores ≥ 14 and nutritional status and laboratory data. Pretreatment depression was present in 60 patients (24.9%). In depressive and nondepressive patients, the 3-year overall survival rates were 70.8% and 82.7%, respectively (P = .045), and the 3-year DFS rates were 63.5% and 79.1%, respectively (P = .015). After controlling for clinical factors, the presence of depression was predictive of 3-year DFS (P = .032). EORTC QLQ-C30 and QLQ-HN35 scores on all items except feeding tube, nutritional supplement, and problem with mouth opening differed between depressive and nondepressive patients (P nutritional status, and survival outcomes in patients with HNSCC. © 2015 American Cancer Society.

  10. Anxiety and depression in patients with gastrointestinal cancer: does knowledge of cancer diagnosis matter?

    Directory of Open Access Journals (Sweden)

    Roshan Rasool

    2007-07-01

    Full Text Available Abstract Background Gastrointestinal cancer is the first leading cause of cancer related deaths in men and the second among women in Iran. An investigation was carried out to examine anxiety and depression in this group of patients and to investigate whether the knowledge of cancer diagnosis affect their psychological distress. Methods This was a cross sectional study of anxiety and depression in patients with gastrointestinal cancer attending to the Tehran Cancer Institute. Anxiety and depression was measured using the Hospital Anxiety and Depression Scale (HADS. This is a widely used valid questionnaire to measure psychological distress in cancer patients. Demographic and clinical data also were collected to examine anxiety and depression in sub-group of patients especially in those who knew their cancer diagnosis and those who did not. Results In all 142 patients were studied. The mean age of patients was 54.1 (SD = 14.8, 56% were male, 52% did not know their cancer diagnosis, and their diagnosis was related to esophagus (29%, stomach (30%, small intestine (3%, colon (22% and rectum (16%. The mean anxiety score was 7.6 (SD = 4.5 and for the depression this was 8.4 (SD = 3.8. Overall 47.2% and 57% of patients scored high on both anxiety and depression. There were no significant differences between gender, educational level, marital status, cancer site and anxiety and depression scores whereas those who knew their diagnosis showed a significant higher degree of psychological distress [mean (SD anxiety score: knew diagnosis 9.1 (4.2 vs. 6.3 (4.4 did not know diagnosis, P Conclusion Psychological distress was higher in those who knew their cancer diagnosis. It seems that the cultural issues and the way we provide information for cancer patients play important role in their improved or decreased psychological well-being.

  11. The incidence of other primary cancers in patients with an oral cancer treated with radiation therapy

    International Nuclear Information System (INIS)

    Shimizutani, Kiminari; Koseki, Yonoshin; Ikeda, Hiroshi

    1992-01-01

    From January 1980 through April 1990, a total of 317 patients with an oral cancer were treated with radiation therapy at Department of Radiology, Osaka University Hospital. Twenty-seven (8.5%) of these 317 patients had other primary cancers. For statistical purposes, the expected number of other primary cancers was estimated by multiplying the age-sex specific incidence rates among Osaka residents with the Person-year at risk figures, based on the Osaka Prefectural Cancer Registry. The observed/expected [0/E] ratios were 16.00 (p<0.01) for the esophagus and 28.42 (p<0.01) for the oropharynx. The present study suggested the necessity of following up oral cancer patients, especially those who have had carcinoma of the mouth floor, in order to enable the early diagnosis of upper digestive tract cancer. (author)

  12. Risk of skin cancer in HIV-infected patients

    DEFF Research Database (Denmark)

    Omland, Silje Haukali; Ahlström, Magnus Glinvad; Gerstoft, Jan

    2018-01-01

    BACKGROUND: The risk of skin cancer in HIV-infected patients has not been extensively studied. OBJECTIVE: To determine the risk of skin cancer in HIV-infected patients and compare it with the risk in the background population. METHODS: In a matched, nationwide population-based cohort study we...... compared the risk of skin cancer in 4280 HIV-infected patients from the Danish HIV cohort study with a background population cohort, according to the level of immunosuppression and route of transmission. Primary outcomes were time to first basal cell carcinoma (BCC), squamous cell carcinoma (SCC...

  13. Risk of cancer in relatives of patients with myotonic dystrophy

    DEFF Research Database (Denmark)

    Lund, M; Diaz, L J; Gørtz, S

    2014-01-01

    BACKGROUND AND PURPOSE: Myotonic dystrophies (DM) are autosomal dominantly inherited neuromuscular disorders caused by unstable nucleotide repeat expansions. DM and cancer have been associated, but the pathogenesis behind the association remains unclear. It could relate to derived effects of the DM...... genotype in which case non-DM relatives of DM patients would not be expected to be at increased risk of cancer. To elucidate this, a population-based cohort study investigating risk of cancer in relatives of DM patients was conducted. METHODS: DM was identified using the National Danish Patient Registry...

  14. Adapting Cognitive-Behavior Therapy for Insomnia in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Eric S. Zhou

    2017-12-01

    Full Text Available Insomnia disorder is common in patients undergoing cancer treatment. There is compelling evidence demonstrating that cognitive-behavioral therapy for insomnia (CBT-I should be the initial treatment, but there has been insufficient research has been conducted among cancer patients. This population presents with unique physical and psychosocial health issues that may interfere with standard CBT-I and addressing these issues can play a role in improving treatment adherence and efficacy. We explore potential adaptations that can be made to standard CBT-I for cancer patients. Further research for this growing population is essential.

  15. Patients' and family members' views on patient-centered communication during cancer care.

    Science.gov (United States)

    Mazor, Kathleen M; Beard, Reneé L; Alexander, Gwen L; Arora, Neeraj K; Firneno, Cassandra; Gaglio, Bridget; Greene, Sarah M; Lemay, Celeste A; Robinson, Brandi E; Roblin, Douglas W; Walsh, Kathleen; Street, Richard L; Gallagher, Thomas H

    2013-11-01

    To explore patients' and family members' views on communication during cancer care and to identify those aspects of clinician-patient communication which were most important to patients and family members. We conducted a secondary data analysis of qualitative data from 137 patients with cancer and family members of patients with cancer. We used a modified version of the constant comparative method and coding paradigm of grounded theory. Patients want sensitive, caring clinicians who provide information that they need, when they need it, in a way that they can understand; who listen and respond to questions and concerns, and who attempt to understand the patient's experience. Effective information exchange and a positive interpersonal relationship with the clinician were of fundamental importance to patients and family members. These were interrelated; for instance, failure to provide information a patient needed could damage the relationship, whereas excellent listening could foster the relationship. Information exchange and relationship were also integral to decision-making, managing uncertainty, responding to emotions, and self-management. Clinicians who were responsive to patients' needs beyond the immediate medical encounter were valued. The complexity of cancer care today suggests that efforts to improve communication must be multilevel, acknowledging and addressing patient, clinician, organizational and policy barriers, and facilitators. Measurement tools are needed to assess cancer patients' and family members' experiences with communication over the course of cancer care to provide meaningful, actionable feedback to those seeking to optimize their effectiveness in communicating with patients with cancer. Copyright © 2013 John Wiley & Sons, Ltd.

  16. Positive Impact of Social Media Use on Depression in Cancer Patients

    OpenAIRE

    Farpour, Hamid Reza; Habibi, Leila; Owji, Seyed Hossein

    2017-01-01

    Objective: The focus of attention was the prevalence of depression among cancer patients using social networks. An attempt was made to determine if social media could help cancer patients overcome their stress and depression, causes of serious emotional and mental problems for them and their families. Methods: To ascertain the prevalence of depression among cancer patients with reference to use of social networks, 316 cancer patients in the Association of Cancer Patients and cancer-related ce...

  17. Survival of Patients With Cervical Cancer in Rural India

    OpenAIRE

    Vinoda Thulaseedharan, Jissa; Malila, Nea; Swaminathan, Rajaraman; Esmy Pulikottil, Okuru; Hakama, Matti; Muwonge, Richard; Sankaranarayanan, Rengaswamy

    2015-01-01

    Background: Patients’ survival after diagnosis of cervical cancer is indirectly influenced by socio-economic factors. We evaluated this survival and its socio-economic determinants in a rural population in south India. Methods: We assessed 165 women diagnosed with cervical cancer from the routine care control arm of a randomized screening trial conducted in rural south India. Kaplan-Meier curves were plotted to illustrate the observed survival of cancer patients. The effect of socio-econom...

  18. Statin use and mortality among ovarian cancer patients

    DEFF Research Database (Denmark)

    Verdoodt, Freija; Hansen, Merete Kjaer; Kjaer, Susanne K.

    2017-01-01

    -cause or ovarian cancer-specific mortality. Among 4,419 patients with epithelial ovarian cancer, post-diagnostic statin use was not statistically significantly associated with all-cause (HR: 0.90, 95% CI: 0.78–1.04) or ovarian cancer-specific mortality (HR: 0.90, 95% CI: 0.76–1.08). There was little evidence...

  19. An investigation into fatigue in cancer patients during radiotherapy

    OpenAIRE

    2012-01-01

    M.Tech. In spite of the improvement in the delivery of anti-cancer treatments over the past decade, side effects from these treatments remain inevitable. A common, distressing side effect that all cancer patients experience is fatigue. However, cancer related fatigue (CRF) remains one that is under-reported and under-treated. CRF is a topic that has received very limited attention in the South African context. Regardless of the amount of literature available on CRF, many questions continue...

  20. Caring for cancer patients on non-specialist wards.

    LENUS (Irish Health Repository)

    Gill, Finola

    2012-02-01

    As cancer is the leading cause of death worldwide, every nurse will be required to care for patients with the condition at some point in his\\/her career. However, non-specialized oncology nurses are often ill-prepared to nurse patients suffering from cancer. This literature review aims to provide an overview of current trends and developments in cancer care nursing in an attempt to identify the range of previous research pertaining to caring for patients with cancer on non-specialist wards. The review finds that non-specialized cancer nurses report a lack of education and training with regard to cancer care and cancer treatments, which acts as a barrier to providing quality nursing care. Emotional and communication issues with patients and their families can also cause non-specialist nurses significant distress. International research has shown that specialist oncology nurses make a considerable difference to physical and psychosocial patient care. It is therefore paramount that non-speciality nurses\\' educational needs are met to develop clinical competence and to provide supportive holistic care for both patients and their families.

  1. Physical activity influences the immune system of breast cancer patients

    Directory of Open Access Journals (Sweden)

    Thorsten Schmidt

    2017-01-01

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

  2. Time trends in axilla management among early breast cancer patients

    DEFF Research Database (Denmark)

    Gondos, Adam; Jansen, Lina; Heil, Joerg

    2016-01-01

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

  3. Use of proton pump inhibitors is associated with increased mortality due to nosocomial pneumonia in bedridden patients receiving tube feeding.

    Science.gov (United States)

    Hamai, Kosuke; Iwamoto, Hiroshi; Ohshimo, Shinichiro; Wakabayashi, Yu; Ihara, Daisuke; Fujitaka, Kazunori; Hamada, Hironobu; Ono, Koichi; Hattori, Noboru

    2018-05-22

    To investigate the association between the use of proton pump inhibitors (PPI) and nosocomial pneumonia and gastrointestinal bleeding in bedridden patients receiving tube feeding. A total of 116 bedridden hospitalized patients receiving tube feeding, of which 80 were supported by percutaneous endoscopic gastrostomy and 36 by nasogastric tube, were included in the present study. The patients were divided into two groups: 62 patients treated with PPI (PPI group) and 54 patients without PPI (non-PPI group). Mortality due to nosocomial pneumonia was evaluated using the Kaplan-Meier approach and the log-rank test. A total of 36 patients (31%) died of nosocomial pneumonia during the observation period; the mortality rate due to nosocomial pneumonia was significantly higher in the PPI group than in the non-PPI group (P = 0.0395). Cox proportional hazard analysis showed that the use of PPI and lower levels of serum albumin were independent predictors of 2-year mortality due to nosocomial pneumonia. Gastrointestinal bleeding was observed in four patients in the non-PPI group (7.7%) and in one patient in the PPI group (1.6%); there was no significant difference between the two groups. The use of PPI in bedridden tube-fed patients was independently associated with mortality due to nosocomial pneumonia, and the PPI group had a non-significant lower incidence of gastrointestinal bleeding than the non-PPI group. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 The Authors Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

  4. Conditional survival of cancer patients: an Australian perspective

    Directory of Open Access Journals (Sweden)

    Yu Xue

    2012-10-01

    Full Text Available Abstract Background Estimated conditional survival for cancer patients diagnosed at different ages and disease stage provides important information for cancer patients and clinicians in planning follow-up, surveillance and ongoing management. Methods Using population-based cancer registry data for New South Wales Australia, we estimated conditional 5-year relative survival for 11 major cancers diagnosed 1972–2006 by time since diagnosis and age and stage at diagnosis. Results 193,182 cases were included, with the most common cancers being prostate (39,851, female breast (36,585 and colorectal (35,455. Five-year relative survival tended to increase with increasing years already survived and improvement was greatest for cancers with poor prognosis at diagnosis (lung or pancreas and for those with advanced stage or older age at diagnosis. After surviving 10 years, conditional 5-year survival was over 95% for 6 localised, 6 regional, 3 distant and 3 unknown stage cancers. For the remaining patient groups, conditional 5-year survival ranged from 74% (for distant stage bladder cancer to 94% (for 4 cancers at different stages, indicating that they continue to have excess mortality 10–15 years after diagnosis. Conclusion These data provide important information for cancer patients, based on age and stage at diagnosis, as they continue on their cancer journey. This information may also be used by clinicians as a tool to make more evidence-based decisions regarding follow-up, surveillance, or ongoing management according to patients' changing survival expectations over time.

  5. Variation in ‘fast-track’ referrals for suspected cancer by patient characteristic and cancer diagnosis: evidence from 670 000 patients with cancers of 35 different sites

    Science.gov (United States)

    Zhou, Y; Mendonca, S C; Abel, G A; Hamilton, W; Walter, F M; Johnson, S; Shelton, J; Elliss-Brookes, L; McPhail, S; Lyratzopoulos, G

    2018-01-01

    Background: In England, ‘fast-track’ (also known as ‘two-week wait’) general practitioner referrals for suspected cancer in symptomatic patients are used to shorten diagnostic intervals and are supported by clinical guidelines. However, the use of the fast-track pathway may vary for different patient groups. Methods: We examined data from 669 220 patients with 35 cancers diagnosed in 2006–2010 following either fast-track or ‘routine’ primary-to-secondary care referrals using ‘Routes to Diagnosis’ data. We estimated the proportion of fast-track referrals by sociodemographic characteristic and cancer site and used logistic regression to estimate respective crude and adjusted odds ratios. We additionally explored whether sociodemographic associations varied by cancer. Results: There were large variations in the odds of fast-track referral by cancer (P<0.001). Patients with testicular and breast cancer were most likely to have been diagnosed after a fast-track referral (adjusted odds ratios 2.73 and 2.35, respectively, using rectal cancer as reference); whereas patients with brain cancer and leukaemias least likely (adjusted odds ratios 0.05 and 0.09, respectively, for brain cancer and acute myeloid leukaemia). There were sex, age and deprivation differences in the odds of fast-track referral (P<0.013) that varied in their size and direction for patients with different cancers (P<0.001). For example, fast-track referrals were least likely in younger women with endometrial cancer and in older men with testicular cancer. Conclusions: Fast-track referrals are less likely for cancers characterised by nonspecific presenting symptoms and patients belonging to low cancer incidence demographic groups. Interventions beyond clinical guidelines for ‘alarm’ symptoms are needed to improve diagnostic timeliness. PMID:29182609

  6. Variation in 'fast-track' referrals for suspected cancer by patient characteristic and cancer diagnosis: evidence from 670 000 patients with cancers of 35 different sites.

    Science.gov (United States)

    Zhou, Y; Mendonca, S C; Abel, G A; Hamilton, W; Walter, F M; Johnson, S; Shelton, J; Elliss-Brookes, L; McPhail, S; Lyratzopoulos, G

    2018-01-01

    In England, 'fast-track' (also known as 'two-week wait') general practitioner referrals for suspected cancer in symptomatic patients are used to shorten diagnostic intervals and are supported by clinical guidelines. However, the use of the fast-track pathway may vary for different patient groups. We examined data from 669 220 patients with 35 cancers diagnosed in 2006-2010 following either fast-track or 'routine' primary-to-secondary care referrals using 'Routes to Diagnosis' data. We estimated the proportion of fast-track referrals by sociodemographic characteristic and cancer site and used logistic regression to estimate respective crude and adjusted odds ratios. We additionally explored whether sociodemographic associations varied by cancer. There were large variations in the odds of fast-track referral by cancer (P<0.001). Patients with testicular and breast cancer were most likely to have been diagnosed after a fast-track referral (adjusted odds ratios 2.73 and 2.35, respectively, using rectal cancer as reference); whereas patients with brain cancer and leukaemias least likely (adjusted odds ratios 0.05 and 0.09, respectively, for brain cancer and acute myeloid leukaemia). There were sex, age and deprivation differences in the odds of fast-track referral (P<0.013) that varied in their size and direction for patients with different cancers (P<0.001). For example, fast-track referrals were least likely in younger women with endometrial cancer and in older men with testicular cancer. Fast-track referrals are less likely for cancers characterised by nonspecific presenting symptoms and patients belonging to low cancer incidence demographic groups. Interventions beyond clinical guidelines for 'alarm' symptoms are needed to improve diagnostic timeliness.

  7. Attitude about cancer disclosure and quality of life of patients with cancer

    Directory of Open Access Journals (Sweden)

    Fatemeh Mollarahimi-Malek

    2016-07-01

    Full Text Available Detection of cancer is often equal to facing with a crisis by the patients. Traditionally it is believed that cancer diagnosis should not be told to the patients. The aim of this study was to compare the attitudes towards the disclosure of cancer diagnosis in patients with cancer and control group included healthy people. This crosssectional study was carried out in 2015 with a total of 531 people. We used three questionnaires to collect data. The first one was EORTC QLQ-C30 to assess quality of life of patients with cancer. The second one included items to assess the patients' willingness for detection of the cancer diagnosis. Finally, the third one was the DUREL to evaluate religiosity. Five hundred and thirty one subjects including 216 patients with cancer and 315 healthy people were studied. Mean age of participants was 44 ± 15.7, 50.5% were female. Overall, 63% of patien ts with cancer were informed of their disease status and 37% uninformed. A significant association was seen between the awareness of cancer with physical and social functioning of quality of life. There was a positive significant association between the tendency for being informed of the diagnosis and non-organizational religious activity in participants without cancer. Global health status and all dimensions of religious were correlated in patients significantly. We found the majority of subjects tend to be aware of the disclosure of diagnosis. The physical and social functioning of quality of life were better in uninformed patients than informed patients.

  8. Symptom clusters in cancer patients and their relation to EGFR ligand modulation of the circadian axis.

    Science.gov (United States)

    Rich, Tyvin A

    2007-04-01

    Recent studies in chronobiology and the neurosciences have led to rapid growth in our understanding of the molecular biology of the human timekeeping apparatus and the neuroanatomic sites involved in signaling between the "master clock" in the hypothalamus and other parts of the brain. The circadian axis comprises a central clock mechanism and a downstream network of hypothalamic relay stations that modulate arousal, feeding, and sleeping behavior. Communication between the clock and these hypothalamic signaling centers is mediated, in part, by diffusible substances that include ligands of the epidermal growth factor receptor (EGFR). Preclinical studies reveal that EGFR ligands such as transforming growth factor-alpha (TGF-alpha) inhibit hypothalamic signaling of rhythmic behavior; clinical observations show that elevated levels of TGF-alpha are associated with fatigue, flattened circadian rhythms, and loss of appetite in patients with metastatic colorectal cancer. These data support the hypothesis that a symptom cluster of fatigue, appetite loss, and sleep disruption commonly seen in cancer patients may be related to EGFR ligands, released either by the cancer itself or by the host in response to the stress of cancer, and suggest that further examination of their role in the production of symptom clustering is warranted.

  9. Cardiac autonomic modulation impairments in advanced breast cancer patients.

    Science.gov (United States)

    Arab, Claudia; Vanderlei, Luiz Carlos Marques; da Silva Paiva, Laércio; Fulghum, Kyle Levi; Fristachi, Carlos Elias; Nazario, Afonso Celso Pinto; Elias, Simone; Gebrim, Luiz Henrique; Ferreira Filho, Celso; Gidron, Yori; Ferreira, Celso

    2018-05-02

    To compare cardiac autonomic modulation in early- versus advanced-stage breast cancer patients before any type of cancer treatment and investigate associated factors. This cross-sectional study included women (30-69 years old) with primary diagnosis of breast cancer and women with benign breast tumors. We evaluated cardiac modulation by heart rate variability and assessed factors of anxiety, depression, physical activity, and other relevant medical variables. Patients were divided into three groups based on TNM staging of cancer severity: early-stage cancer (n = 42), advanced-stage cancer (n = 37), or benign breast tumors to serve as a control (n = 37). We analyzed heart rate variability in time and frequency domains. The advanced-stage cancer group had lower vagal modulation than early-stage and benign groups; also, the advance-stage group had lower overall heart rate variability when compared to benign conditions. Heart rate variability was influenced by age, menopausal status, and BMI. Heart rate variability seems to be a promising, non-invasive tool for early diagnosis of autonomic dysfunction in breast cancer and detection of cardiovascular impairments at cancer diagnosis. Cardiac autonomic modulation is inversely associated with breast cancer staging.

  10. The effect of almonds on inflammation and oxidative stress in Chinese patients with type 2 diabetes mellitus: a randomized crossover controlled feeding trial

    Science.gov (United States)

    Almond consumption is associated with ameliorations in obesity, hyperlipidemia, hypertension, and hyperglycemia. The hypothesis of this 12-wk randomized, crossover, controlled feeding trial was that almond consumption would ameliorate inflammation and oxidative stress in Chinese patients with type 2...

  11. The health of healthcare, Part II: patient healthcare has cancer.

    Science.gov (United States)

    Waldman, Deane

    2013-01-01

    In this article, we make the etiologic diagnosis for a sick patient named Healthcare: the cancer of greed. When we explore the two forms of this cancer--corporate and bureaucratic--we find the latter is the greater danger to We the Patients. The "treatments" applied to patient Healthcare by the Congressional "doctors" have consistently made the patient worse, not better. At the core of healthcare's woes is the government's diversion of money from healthcare services to healthcare bureaucracy. As this is the root cause, it is what we must address in order to cure, not sedate or palliate, patient Healthcare.

  12. Cytokines and depression in cancer patients and caregivers

    Directory of Open Access Journals (Sweden)

    Li M

    2017-11-01

    Full Text Available Madeline Li,1,2 Ekaterina Kouzmina,3 Megan McCusker,1 Danielle Rodin,4 Paul C Boutros,3,5,6 Christopher J Paige,6–8 Gary Rodin1,2 1Princess Margaret Cancer Centre, Department of Supportive Care, University Health Network, Toronto, Ontario, Canada; 2Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; 3Informatics & Biocomputing Program, Ontario Institute for Cancer Research, Toronto, Ontario, Canada; 4Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada; 5Department of Pharmacology & Toxicology, Toronto, Ontario, Canada; 6Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; 7Department of Immunology, University of Toronto, Toronto, Ontario, Canada; 8Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada Objective: A better understanding of the biobehavioral mechanisms underlying depression in cancer is required to translate biomarker findings into clinical interventions. We tested for associations between cytokines and the somatic and psychological symptoms of depression in cancer patients and their healthy caregivers.Patients and methods: The GRID Hamilton Rating Scale for Depression (Ham-D was administered to 61 cancer patients of mixed type and stage, 26 primary caregivers and 38 healthy controls. Concurrently, blood was drawn for multiplexed plasma assays of 15 cytokines. Multiple linear regression, adjusted for biobehavioral variables, identified cytokine associations with the psychological (Ham-Dep and somatic (Ham-Som subfactors of the Ham-D.Results: The Ham-Dep scores of cancer patients were similar to their caregivers, but their Ham-Som scores were significantly higher (twofold, p=0.016. Ham-Som was positively associated with IL-1ra (coefficient: 1.27, p≤0.001 in cancer patients, and negatively associated with IL-2 (coefficient: -0.68, p=0.018 in caregivers. Ham-Dep was negatively associated with IL-4 (coefficient: -0.67, p

  13. Posttraumatic Stress Disorder Among Bereaved Relatives of Cancer Patients

    DEFF Research Database (Denmark)

    Elklit, Ask; Reinholt, N.; Nielsen, Louise Hjort

    2010-01-01

    The aim of this study was to assess post-traumatic stress disorder (PTSD) and predictors of PTSD in individuals who experienced the loss of a close relative to cancer. A total of 251 bereaved relatives ages 14 to 76 (M = 41.3, SD = 16.8) were recruited at a counseling service for cancer patients...

  14. Recall in older cancer patients: measuring memory for medical information

    NARCIS (Netherlands)

    Jansen, J.; Weert, J. van; Meulen, N. van der; Dulmen, S. van; Heeren, Th.; Bensing, J.

    2008-01-01

    Purpose: Remembering medical treatment information may be particularly taxing for older cancer patients, but to our knowledge this ability has never been assessed in this specific age group only. Our purpose in this study was to investigate older cancer patients’ recall of information after

  15. Long-term prognosis of young breast cancer patients (

    NARCIS (Netherlands)

    G.M.H.E. Dackus (Gwen); N.D. ter Hoeve (Natalie); M. Opdam (Mark); W. Vreuls (Willem); Z. Varga (Zsuzsanna); E. Koop (Esther); S.M. Willems (Stefan Martin); C.H.M. van Deurzen (Carolien); E.J. Groen (Emilie); A. Cordoba (Alicia); J. Bart (Jos); A.L. Mooyaart (Antien); J.G. van den Tweel (Jan); V. Zolota (Vicky); J. Wesseling (Jelle); A. Sapino (Anna); E. Chmielik (Ewa); A. Ryska (Ales); F. Amant (Frédéric); A. Broeks (Annegien); R.M. Kerkhoven (Ron); N. Stathonikos (Nikolas); M. Veta (Mitko); A.C. Voogd (Adri); K. Jóźwiak (Katarzyna); M. Hauptmann (Michael); M. Hoogstraat (Marlous); M.K. Schmidt (Marjanka); G.S. Sonke (Gabe); E. van der Wall (Elsken); S. Siesling (Sabine); P.J. van Diest (Paul); S.C. Linn (Sabine)

    2017-01-01

    markdownabstract__Introduction__ Currently used tools for breast cancer prognostication and prediction may not adequately reflect a young patient’s prognosis or likely treatment benefit because they were not adequately validated in young patients. Since breast cancers diagnosed at a young age are

  16. Serum protein fingerprint of patients with gastric cancer by SELDI ...

    African Journals Online (AJOL)

    To study the serum protein fingerprint of patients with gastric cancer and to screen for protein molecules closely related to gastric cancer during the onset and progression of the disease using surface-enhanced laser desorption and ionization time-of-flight mass spectrometry (SELDI-TOF-MS). Serum samples from 80 gastric ...

  17. Risk factors for common cancers among patients at Kamuzu Central ...

    African Journals Online (AJOL)

    Background: Little is known about risk factors for different cancers in Malawi. This study aimed to assess risk factors for and epidemiologic patterns of common cancers among patients treated at Kamuzu Central Hospital (KCH) in Lilongwe, and to determine the prevalence of Human Immunodeficiency Virus (HIV) infection in ...

  18. Plasma transforming growth factor beta levels in breast cancer patients

    NARCIS (Netherlands)

    Sminia, P; Barten, AD; Van Waarde, MAWH; Vujaskovic, Z; Van Tienhoven, G

    1998-01-01

    We investigated whether the concentration of circulating transforming growth factor beta (TGF beta) yields diagnostic value in breast cancer. Blood was collected from twenty stage I and II breast cancer patients both prior to treatment and after surgical excision of the tumour. Both latent and

  19. Plasma transforming growth factor beta levels in breast cancer patients

    NARCIS (Netherlands)

    Sminia, P.; Barten, A. D.; van Waarde, M. A.; Vujaskovic, Z.; van Tienhoven, G.

    1998-01-01

    We investigated whether the concentration of circulating transforming growth factor beta (TGFbeta) yields diagnostic value in breast cancer. Blood was collected from twenty stage I and II breast cancer patients both prior to treatment and after surgical excision of the tumour. Both latent and active

  20. Clinical significance of adiponectin expression in colon cancer patients

    Directory of Open Access Journals (Sweden)

    Mustafa Canhoroz

    2014-01-01

    Conclusion: Adiponectin, which is secreted by adipose tissue, may have a role in the development and progression of cancer via its pro-apoptotic and/or anti-proliferative effects. Adiponectin expression in tumor tissues is likely to have a negative effect on disease - free survival in patients with stage II/III colon cancer; however, no statistically significant effect was demonstrated.

  1. Evaluation of patients' adherence to chemotherapy for breast cancer ...

    African Journals Online (AJOL)

    kemrilib

    study demonstrated poor economic status of the patients as one of the major reasons for non-adherence to cancer chemotherapy in Nigeria. ... countries has been shown to be poorer [14-17]. ... 13(5.8%) 70years and above. ... Table 1: Age and Stage at Presentation of Women with Breast Cancer in Ile-Ife, ... Percentage.

  2. Metallic taste in cancer patients treated with chemotherapy.

    Science.gov (United States)

    IJpma, I; Renken, R J; Ter Horst, G J; Reyners, A K L

    2015-02-01

    Metallic taste is a taste alteration frequently reported by cancer patients treated with chemotherapy. Attention to this side effect of chemotherapy is limited. This review addresses the definition, assessment methods, prevalence, duration, etiology, and management strategies of metallic taste in chemotherapy treated cancer patients. Literature search for metallic taste and chemotherapy was performed in PubMed up to September 2014, resulting in 184 articles of which 13 articles fulfilled the inclusion criteria: English publications addressing metallic taste in cancer patients treated with FDA-approved chemotherapy. An additional search in Google Scholar, in related articles of both search engines, and subsequent in the reference lists, resulted in 13 additional articles included in this review. Cancer patient forums were visited to explore management strategies. Prevalence of metallic taste ranged from 9.7% to 78% among patients with various cancers, chemotherapy treatments, and treatment phases. No studies have been performed to investigate the influence of metallic taste on dietary intake, body weight, and quality of life. Several management strategies can be recommended for cancer patients: using plastic utensils, eating cold or frozen foods, adding strong herbs, spices, sweetener or acid to foods, eating sweet and sour foods, using 'miracle fruit' supplements, and rinsing with chelating agents. Although metallic taste is a frequent side effect of chemotherapy and a much discussed topic on cancer patient forums, literature regarding metallic taste among chemotherapy treated cancer patients is scarce. More awareness for this side effect can improve the support for these patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Cardiorespiratory fitness and muscle strength in pancreatic cancer patients.

    Science.gov (United States)

    Clauss, Dorothea; Tjaden, Christine; Hackert, Thilo; Schneider, Lutz; Ulrich, Cornelia M; Wiskemann, Joachim; Steindorf, Karen

    2017-09-01

    Cancer patients frequently experience reduced physical fitness due to the disease itself as well as treatment-related side effects. However, studies on physical fitness in pancreatic cancer patients are missing. Therefore, we assessed cardiorespiratory fitness and muscle strength of pancreatic cancer patients. We included 65 pancreatic cancer patients, mostly after surgical resection. Cardiorespiratory fitness was assessed using cardiopulmonary exercise testing (CPET) and 6-min walk test (6MWT). Hand-held dynamometry was used to evaluate isometric muscle strength. Physical fitness values were compared to reference values of a healthy population. Associations between sociodemographic and clinical variables with patients' physical fitness were analyzed using multiple regression models. Cardiorespiratory fitness (VO 2 peak, 20.5 ± 6.9 ml/min/kg) was significantly lower (-24%) compared to healthy reference values. In the 6MWT pancreatic cancer patients nearly reached predicted values (555 vs. 562 m). Maximal voluntary isometric contraction (MVIC) of the upper (-4.3%) and lower extremities (-13.8%) were significantly lower compared to reference values. Overall differences were larger in men than those in women. Participating in regular exercise in the year before diagnosis was associated with greater VO 2 peak (p fitness with regard to both cardiorespiratory function and isometric muscle strength, already in the early treatment phase (median 95 days after surgical resection). Our findings underline the need to investigate exercise training in pancreatic cancer patients to counteract the loss of physical fitness.

  4. Cancer patient preferences for quality and length of life.

    Science.gov (United States)

    Meropol, Neal J; Egleston, Brian L; Buzaglo, Joanne S; Benson, Al B; Cegala, Donald J; Diefenbach, Michael A; Fleisher, Linda; Miller, Suzanne M; Sulmasy, Daniel P; Weinfurt, Kevin P

    2008-12-15

    Optimal patient decision making requires integration of patient values, goals, and preferences with information received from the physician. In the case of a life-threatening illness such as cancer, the weights placed on quality of life (QOL) and length of life (LOL) represent critical values. The objective of the current study was to describe cancer patient values regarding QOL and LOL and explore associations with communication preferences. Patients with advanced cancer completed a computer-based survey before the initial consultation with a medical oncologist. Assessments included sociodemographics, physical and mental health state, values regarding quality and length of life, communication preferences, and cancer-related distress. Among 459 patients with advanced cancer, 55% placed equal valued on QOL and LOL, 27% preferred QOL, and 18% preferred LOL. Patients with a QOL preference had lower levels of cancer-related distress (P LOL over QOL desired a more supportive and less pessimistic communication style from their oncologists. These data indicate that a values preference for LOL versus QOL may be simply measured, and is associated with wishes regarding the nature of oncologist communication. Awareness of these values during the clinical encounter could improve decision making by influencing the style and content of the communication between oncologists and their patients.

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

    Science.gov (United States)

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

    2016-03-11

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

  6. Complementary and alternative medicine in breast cancer patients.

    Science.gov (United States)

    Nahleh, Zeina; Tabbara, Imad A

    2003-09-01

    Complementary and Alternative Medicine (CAM) is becoming increasingly popular among cancer patients, in particular those with breast cancer. It represents one of the fastest growing treatment modalities in the United States. Therefore, knowledge of CAM therapies is becoming necessary for physicians and other health care providers. CAM encompasses a wide range of modalities including special diet and nutrition, mind-body approaches, and traditional Chinese medicine. We reviewed the biomedical literature on CAM use in breast cancer patients, using Medline search from 1975 until 2002. In addition, consensus reports and books on CAM and breast cancer were included in the review. We evaluated the prevalence of CAM use in breast cancer patients, the reasons cited for its use, the different available modalities, and the reported outcomes. Use of CAM in breast cancer patients ranges between 48% and 70% in the United States. The most commonly used CAM modalities include dietary supplements, mind-body approaches, and acupuncture. The reasons cited for using CAM were to boost the immune system, improve the quality of life, prevent recurrence of cancer, provide control over life, and treat breast cancer and the side effects of treatment. Several studies reported favorable results including improved survival, better pain control, reduced anxiety, improvement in coping strategies and significant efficacy in treating nausea and vomiting. Other less well-organized trials have reported either no benefit or negative effect of CAM and potential toxicity of some commercial products. CAM is a growing field in health care and particularly among breast cancer patients. Knowledge of CAM by physicians, especially oncologists, is necessary. Oncologists should be willing to discuss the role of CAM with their patients and encourage patients to participate in well-organized research about CAM.

  7. Cancer Pain Control for Advanced Cancer Patients by Using Autonomic Nerve Pharmacopuncture

    Directory of Open Access Journals (Sweden)

    Hwi-joong Kang

    2014-09-01

    Full Text Available Objectives: The purpose of this study is to report a case series of advanced cancer patients whose cancer pain was relieved by using autonomic nerve pharmacopuncture (ANP treatment. ANP is a subcutaneous injection therapy of mountain ginseng pharmacopuncture (MGP along the acupoints on the spine (Hua-Tuo-Jia-Ji-Xue; 0.5 cun lateral to the lower border of the spinous processes of vertebrae to enhance the immune system and to balance autonomic nerve function. Methods: Patients with three different types of cancer (gastric cancer, lung cancer, colon cancer with distant metastases with cancer pain were treated with ANP. 1 mL of MGP was injected into the bilateral Hua-Tuo-Jia-Ji-Xue on the T1-L5 sites (total 12 ─ 20 mL injection of each patient’s dorsum by using the principle of symptom differentiation. During ANP treatment, the visual analogue scale (VAS for pain was used to assess their levels of cancer pain; also, the dosage and the frequency of analgesic use were measured. Results: The cancer pain levels of all three patients improved with treatment using ANP. The VAS scores of the three patients decreased as the treatment progressed. The dosage and the frequency of analgesics also gradually decreased during the treatment period. Significantly, no related adverse events were found. Conclusion: ANP has shown benefit in controlling cancer pain for the three different types of cancer investigated in this study and in reducing the dosage and the frequency of analgesics. ANP is expected to be beneficial for reducing cancer pain and, thus, to be a promising new treatment for cancer pain.

  8. Cancer Impact, Complementary/Alternative Medicine Beliefs, and Quality of Life in Cancer Patients.

    Science.gov (United States)

    Kuo, Ya-Hui; Tsay, Shiow-Luan; Chang, Chun-Chi; Liao, Yen-Chi; Tung, Heng-Hsin

    2018-03-01

    The purpose of this study was to explore the relationships among cancer impact, belief in complementary and alternative medicine (CAM), CAM use, and quality of life (QOL). The study used a cross-sectional, descriptive correlational design with convenience sampling. A total of 122 cancer patients participated. Data were collected at a medical center in Chunghua, Taiwan. The questionnaires included the Chinese version of the Cancer Problem in Living Scale (CPILS), Complementary and Alternative Medicine Belief Inventory (CAMBI), Complementary and Alternative Medicine scale, and Chinese versions of QOL scales, including the Functional Assessment of Cancer Therapy-General (FACT-G). The mean age was 56.5 years, and most participants were male (n = 69, 56.6%), had completed high school or above (n = 56, 45.9%), and were married (n = 109, 89.3%). The most common type of cancer was oral (n = 17, 13.9%), followed by esophageal (n = 15, 12.3%) and colorectal (n = 13, 10.7%). Cancer patients, on average, use one or two types of CAM. The impact of cancer is significantly related to age (F = 7.12, p cancer was highly negatively associated with QOL (r = -0.71, p = 0.001). The predictors of QOL were the impact of cancer and use of CAM, and the impact of cancer accounted for 51% of the variance in QOL. This study supports research on the impact of cancer, belief in CAM, and use of CAM as related to QOL in cancer patients. These results can be used to provide options to clinicians and cancer patients.

  9. Postoperative information needs and communication barriers of esophageal cancer patients

    NARCIS (Netherlands)

    Henselmans, Inge; Jacobs, Marc; van Berge Henegouwen, Mark I.; de Haes, Hanneke C. J. M.; Sprangers, Mirjam A. G.; Smets, Ellen M. A.

    2012-01-01

    Objective: Given the poor prognosis of esophageal cancer and the impact of surgery on health-related quality of life (HRQL), addressing patients' postoperative information needs is important. This study aimed to examine (1) the content and type of patients' information needs and (2) patient

  10. Smoking status predicts cancer patients' quality of life over time

    Directory of Open Access Journals (Sweden)

    Ursula Martinez

    2018-03-01

    These results extend previous findings showing that QOL improves in cancer patients who quit smoking. Specifically, patients who quit smoking experience a greater reduction in depression and pain levels at all time points, and the reduction increases over time. In the case of fatigue, the results suggest that patients experience the greatest improvement with longer (≥ 4 months abstinence.

  11. Oestrogen receptors in tumors of breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Levin, J; Kay, G; Da Fonseca, M [University of the Witwatersrand, Johannesburg (South Africa). Department of Nuclear Medicine; Lange, M [University of the Witwatersrand, Johannesburg (South Africa). Dept. of Surgery; De Moor, N G [University of the Witwatersrand, Johannesburg (South Africa). Department of Radiation Therapy; Savage, N [University of the Witwatersrand, Johannesburg (South Africa). Department of Physiological Chemistry

    1978-04-15

    Oestrogen receptors were measured in the cytoplasmic fraction of tumors from patients with breast cancer. Receptors were detected in 48% of patients, and 52% showed no receptors. A follow-up study of a small group of patients on hormone therapy is reported.

  12. [Causes of death among prostate cancer patients of different ages].

    Science.gov (United States)

    Dariy, E V

    2016-02-01

    To date, there is no unified approach to evaluating and treating patients with suspected prostate cancer taking into account their age and comorbidities. That was the rationale for conducting this study. To assess the clinical course of prostate cancer in men of all ages with comorbidities. The study included 408 patients aged 50 to 92 years (mean age 74.3 years) with histologically verified prostate cancer. 30 (7.4%) patients had stage T1 disease, 273 (66.9%) - T2, 91 (22.3%) - T3 and 14 (3.4%) - T4. The maximum follow-up was 22 years, the minimum one - 6 months (on average 15.4 years). During the follow-up 159 patients died (39%), 51 of them (32%) of prostate cancer, 108 (68%) - from other diseases. Among the latter the causes of death were cancer (20.4%), cardiovascular and bronchopulmonary diseases (79.6%). Cancer-specific survival rate was 41.4 +/-12,4%, the survival rate for other diseases 23.4 +/-10,6% (pcancer, especially of old age, including the option for active surveillance of patients with clinically insignificant prostate cancer.

  13. Survival of Patients with Oral Cavity Cancer in Germany

    Science.gov (United States)

    Listl, Stefan; Jansen, Lina; Stenzinger, Albrecht; Freier, Kolja; Emrich, Katharina; Holleczek, Bernd; Katalinic, Alexander; Gondos, Adam; Brenner, Hermann

    2013-01-01

    The purpose of the present study was to describe the survival of patients diagnosed with oral cavity cancer in Germany. The analyses relied on data from eleven population-based cancer registries in Germany covering a population of 33 million inhabitants. Patients with a diagnosis of oral cavity cancer (ICD-10: C00-06) between 1997 and 2006 are included. Period analysis for 2002–2006 was applied to estimate five-year age-standardized relative survival, taking into account patients' sex as well as grade and tumor stage. Overall five-year relative survival for oral cavity cancer patients was 54.6%. According to tumor localization, five-year survival was 86.5% for lip cancer, 48.1% for tongue cancer and 51.7% for other regions of the oral cavity. Differences in survival were identified with respect to age, sex, tumor grade and stage. The present study is the first to provide a comprehensive overview on survival of oral cavity cancer patients in Germany. PMID:23349710

  14. Investigating the Mental Experience of Patients Suffering From Cancer

    Directory of Open Access Journals (Sweden)

    Reza Abdollahzadeh

    2017-07-01

    Full Text Available Background Despite the remarkable development of medical sciences, cancer has yet remained one of the most important diseases of the current century and the second cause of death following cardiovascular diseases. Although we witnessed considerable development in treating cancer and increased number of survivors, cancer is a unique disease that makes the patients deeply feel helplessness and fear. Methods A qualitative content analysis research was done. The present study investigated patients’ experience and behaviors after hearing about their cancer. Purposeful sampling was carried out and continued until data saturation. We used qualitative validation methods to verify the results. Results Study participants consisted of 14 patients. 10 main components emerged from the data including: 1 getting shocked, 2 fear, 3 anxiety and stress, 4 guilt, 5 hopelessness, 6 depression, 7 isolation, 8 lack of affection and dependency on family members, 9 getting prepared to die and, 10 reviving spiritual relationship with God. Conclusions There is a necessity to understand the mental feelings of cancer patients, and program suitable clinical interventions based on patients’ mental needs. As the number of cancer patients is increasing, the results of the present study can be useful for patients’ families and clinical personnel especially physicians and nurses in dealing with cancer patients.

  15. Dietary changes among breast cancer patients in Malaysia.

    Science.gov (United States)

    Shaharudin, Soraya Hanie; Sulaiman, Suhaina; Shahril, Mohd Razif; Emran, Nor Aina; Akmal, Sharifah Noor

    2013-01-01

    Breast cancer patients often show an interest in making dietary changes after diagnosis of breast cancer to improve their health condition and prevent cancer recurrence. The objective of the study was to determine changes in dietary intake 2 years after diagnosis among breast cancer patients. One hundred sixteen subjects were asked to complete a semiquantitative food frequency questionnaire, diet recalls, and dietary changes questionnaire to assess dietary intake before and after diagnosis. The information on sociodemographic background, cancer treatment history, and anthropometric indices was also collected. Seventy-two subjects considered diet as a contributing factor to breast cancer, and 67 subjects changed their dietary habits after breast cancer diagnosis. The reasons for changes in diet were physician and dietitian advice and desire to cure cancer. The sources of information were derived from their physician, mass media, and family members. Total energy, protein, total fat, fatty acids, and vitamin E intake were significantly decreased after diagnosis. Meanwhile, the intake of β-carotene and vitamin C increased significantly after diagnosis. The changes included reduction in red meat, seafood, noodles, and poultry intake. An increased consumption of fruits, vegetables, fish, low-fat milk, and soy products was observed. The subjects tended to lower high-fat foods intake and started to eat more fruits and vegetables. Breast cancer patients had changed to a healthier diet after breast cancer diagnosis, although the changes made were small. This will be helpful to dietitians in providing a better understanding of good eating habits that will maintain patients' health after breast cancer diagnosis.

  16. Self-assessment in cancer patients referred to palliative care

    DEFF Research Database (Denmark)

    Strömgren, Annette S; Goldschmidt, Dorthe; Groenvold, Mogens

    2002-01-01

    the symptomatology of participating patients and examines differences in symptomatology between patients in three palliative care functions: inpatient, outpatient, and palliative home care. RESULTS: Of 267 eligible patients who were referred to a department of palliative medicine, initial self......-based study of symptomatology in consecutive cancer patients in palliative care, achieving rather complete data from the participants. The symptomatology in these patients was very pronounced. The questionnaires were able to detect clinically important differences between places of service....

  17. Treatment Related Cardiac Toxicity in Patients Treated for Breast Cancer

    National Research Council Canada - National Science Library

    Marks, Lawrence B

    2006-01-01

    Purpose: To determine the incidence dose/time-dependence and functional significance of regional cardiac perfusion abnormalities in patients with left-sided breast cancer treated with radiation therapy (RT...

  18. Perioperative Rehabilitation in Operable Lung Cancer Patients (PROLUCA)

    DEFF Research Database (Denmark)

    Sommer, Maja S; Trier, Karen; Vibe-Petersen, Jette

    2016-01-01

    Introduction: Surgical resection in patients with non-small cell lung cancer (NSCLC) may be associated with significant morbidity, functional limitations, and decreased quality of life. Objectives: The safety and feasibility of a preoperative and early postoperative rehabilitation program...

  19. Many Patients with Cancer Need Better Treatments for Pain

    Science.gov (United States)

    Inadequate pain treatment in patients with cancer remains a significant problem and appears to be more frequent among minorities, according to a new study published online April 16, 2012, in the Journal of Clinical Oncology.

  20. Communication skills of nurses during interactions with simulated cancer patients

    NARCIS (Netherlands)

    Kruijver, IPM; Kerkstra, A; Bensing, JM; van de Wiel, H.B.M.

    Aim. In this paper the balance of affective and instrumental communication employed by nurses during the admission interview with recently diagnosed cancer patients was investigated. Rationale. The balance of affective and instrumental communication employed by nurses appears to be important,

  1. Communication skills of nurses during interactions with simulated cancer patients.

    NARCIS (Netherlands)

    Kruijver, I.P.M.; Kerkstra, A.; Bensing, J.M.; Wiel, H.B.M. van der

    2001-01-01

    In this paper the balance of affective and intrumental communication employed by nurses during the admission interview with recently diagnosed cancer patients was investigated. Rationale: The balance of affective and instrumental communication employed by nurses appears to be important, especially

  2. An Application for Measuring Frailty of Myeloma Cancer Patients

    DEFF Research Database (Denmark)

    Corradini, Andrea; Bøgelund Hansen, Martin; Savic, Toma

    2016-01-01

    In this paper, we report on a responsive web-based application that we have been developing for the cancer hospital in the city of Vejle, Denmark. The application administers and handles systematic frailty scoring of patients with multiple myeloma (bone marrow cancer) and thereby helps the doctor...... make a more efficient and more effective treatment choice. The application is currently being tested with a small number of patients and is to replace the frailty measurement system used until now, which is usually done by the doctor on a per patient basis.......In this paper, we report on a responsive web-based application that we have been developing for the cancer hospital in the city of Vejle, Denmark. The application administers and handles systematic frailty scoring of patients with multiple myeloma (bone marrow cancer) and thereby helps the doctor...

  3. Hot Flashes and Quality of Life among Breast Cancer Patients

    National Research Council Canada - National Science Library

    Jacobs, Linda A

    2005-01-01

    This ongoing longitudinal study examines hot flashes and Quality of Life (QoL) in breast cancer (BC) patients undergoing initial treatment, and develops a taxonomy of the medical and Complementary and Alternative Medicine...

  4. Trajectories of personal control in cancer patients receiving psychological care

    NARCIS (Netherlands)

    Zhu, Lei; Schroevers, Maya J.; van der Lee, Marije; Garssen, Bert; Stewart, Roy E.; Sanderman, Robbert; Ranchor, Adelita V.

    Objective: This study aimed to (1) identify subgroups of cancer patients with distinct personal control trajectories during psychological care, (2) examine whether socio-demographic, clinical, and psychological care characteristics could distinguish trajectories, and (3) examine differential

  5. Acute respiratory viral infections in pediatric cancer patients undergoing chemotherapy

    Directory of Open Access Journals (Sweden)

    Eliana C.A. Benites

    2014-07-01

    Conclusions: the prevalence of respiratory viruses was relevant in the infectious episode, with no increase in morbidity and mortality. Viral co‐detection was frequent in patients with cancer and ARIs.

  6. Validated questionnaires on intimacy in patients who have had cancer.

    Science.gov (United States)

    Hoole, J; Kanatas, A; Calvert, A; Rogers, S N; Smith, A B; Mitchell, D A

    2015-09-01

    Problems with intimacy in patients with cancer of the head and neck may not be recognised. Our aim was to review published papers on patient-reported outcomes that record concerns about intimacy, sex, and function, to help develop a tool for use in head and neck cancer. We specifically looked for instruments with evidence of validation in patients with cancer, which could be used to identify problems with intimacy and sexuality. After evaluating 2563 papers, we identified 20 that satisfied our inclusion criteria, and these have been presented in a tabulated form. This review has shown the need to develop a questionnaire on intimacy that is specific to patients with cancer of the head and neck. It is an important issue that must be addressed by clinical and research teams, and will be done most effectively if it is linked to specific interventions. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Trajectories of personal control in cancer patients receiving psychological care

    NARCIS (Netherlands)

    Zhu, Lei; Schroevers, Maya J.; van der Lee, Marije; Garssen, Bert; Stewart, Roy E.; Sanderman, Robbert; Ranchor, A.V.

    2015-01-01

    Objective This study aimed to (1) identify subgroups of cancer patients with distinct personal control trajectories during psychological care, (2) examine whether socio-demographic, clinical, and psychological care characteristics could distinguish trajectories, and (3) examine differential patterns

  8. Glycosylation status of vitamin D binding protein in cancer patients.

    Science.gov (United States)

    Rehder, Douglas S; Nelson, Randall W; Borges, Chad R

    2009-10-01

    On the basis of the results of activity studies, previous reports have suggested that vitamin D binding protein (DBP) is significantly or even completely deglycosylated in cancer patients, eliminating the molecular precursor of the immunologically important Gc macrophage activating factor (GcMAF), a glycosidase-derived product of DBP. The purpose of this investigation was to directly determine the relative degree of O-linked trisaccharide glycosylation of serum-derived DBP in human breast, colorectal, pancreatic, and prostate cancer patients. Results obtained by electrospray ionization-based mass spectrometric immunoassay showed that there was no significant depletion of DBP trisaccharide glycosylation in the 56 cancer patients examined relative to healthy controls. These results suggest that alternative hypotheses regarding the molecular and/or structural origins of GcMAF must be considered to explain the relative inability of cancer patient serum to activate macrophages.

  9. Nutritional support in patients with colorectal cancer during chemotherapy: does it work?

    Science.gov (United States)

    Dobrila-Dintinjana, Renata; Trivanovic, Dragan; Zelić, Marko; Radić, Mladen; Dintinjana, Marijan; Petranović, Duška; Toni, Valković; Vukelic, Jelena; Matijasic, Nusa

    2013-05-01

    Early intervention with nutritional supplementation has been shown to halt malnutrition and may improve outcome in some patients with colorectal cancer. The aim of this study was to investigate whether dietary counseling, oral nutrition and megestrol acetate during chemotherapy affected nutritional status and survival in patients with advanced disease. Six hundred and twenty-eight patients with colorectal advanced disease were included in the study from January 2000 through December 2009 and divided into one of two groups. Group I consisted of 315 patients who were monitored prospectively and were given nutritional support. Group II included 313 patients without nutritional counseling and support. After the completion of chemotherapy all patients were evaluated (BMI, NST, Appetite Loss Scale and ECOG). After the completion of chemotherapy, there were lower proportions of patients in Group I with a BMI=5, loss of appetite and decreased weight gain. Nutritional counseling and supplemental feeding temporarily halted weight loss and improved appetite. This improvement may have implications for patient survival. Patients with early nutritional support lived 19.1 months while patients in the control group had a survival of 12.4 months (p=0.022). This study demonstrated that concurrent individualized dietary counseling and nutritional support are effective in improving nutritional status thereby lessening chemotherapy-induced morbidity.

  10. Physical exercise : effects in cancer patients

    NARCIS (Netherlands)

    Velthuis, M.J.

    2010-01-01

    Physical exercise plays an important role in cancer prevention as well as in the prevention and treatment of cancer related fatigue during and after treatment. Some of these effects are presented in the thesis of M.J. Velthuis. In Part I effects of physical exercise on anthropometric measurements

  11. Impact of Complete Parenteral Nutrition on Metabolic Processes in Cancer Patients in the Early Postoperative Period

    Directory of Open Access Journals (Sweden)

    O. A. Obukhova

    2011-01-01

    Full Text Available Objective: to estimate blood glucose levels during complete parenteral nutrition (CPN, by using the three-in-one system with a high glucose level. Subjects and methods. Thirty adult patients without diabetes mellitus (including 18 men were examined. Twelve and 18 patients were operated on for colonic and gastric cancers, respectively. CPN (Oliclinomel No. 7 — 1000, 1500 ml; glucose, 240 g in 1500 ml, Baxter, Belgium was carried out at the Surgery Department in the early postoperative period (3-5 postoperative days with stable hemodynamics and no organ dysfunction (acute respiratory, renal, hepatic failure. The preparation was administered at a rate of about 83 ml/h over 18 hours. Insulin was not used. Serum glucose concentrations were measured before the study and then for 24 hours at an interval of 6 hours. Results. Glucose concentrations were not found to exceed the allowable values in the majority of patients during CPN at the given rate. In 5 (16.7% patients, short-term glucose increases up to 13.3 mmol/l were corrected, by decreasing the infusion rate. There was no hypoglycemia or other complications during CPN. Conclusion. Our findings suggest that three-in-one parenteral feeding is safe and causes no metabolic disturbances if simple principles are followed, the basic ones of which are to observe the intake of an adequate total dose and the rate of administration of nutrients. Key words: parenteral feeding, hyperglycemia, metabolic disturbances.

  12. Development of a Professional Certification in Cancer Patient Education.

    Science.gov (United States)

    Papadakos, Janet; D'souza, Anna; Masse, Adeline; Boyko, Susan; Clarke, Susan; Giuliani, Meredith; MacKinnon, Keira; McBain, Sarah; McCallum, Meg; MacVinnie, Jan; Papadakos, Tina

    2018-04-19

    Patient educators come into the field from diverse professional backgrounds and often lack training in how to teach and develop patient education resources since no formal patient education professional certification program exists. A professional certification program for patient educators would further define the professional scope of practice and reduce variability in performance. The purpose of this study was to (1) determine the level of interest among Canadian cancer patient educators in a patient education professional certification program and (2) determine the competencies to be included in the professional certification program. A 12-item survey was designed by executive members of the Canadian Chapter of the Cancer Patient Education Network. The survey included a list of competencies associated with patient education, and a 4-point Likert scale ranging from "slightly important" to "very important" was used to determine the rank of each competency. The survey was sent to 53 patient educators across Canada. Ninety-two percent of the patient educators are interested in a professional certification program. Patient educators indicated that competencies related to developing patient resources, collaboration, plain language expertise, and health literacy were of most importance. Patient educators support the development of a patient education professional certification program and endorsed the competencies proposed. This information provides the foundation for the creation of a professional certification program for cancer patient educators.

  13. Satisfaction with information provided to Danish cancer patients

    DEFF Research Database (Denmark)

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

    2013-01-01

    To validate five items (CPWQ-inf) regarding satisfaction with information provided to cancer patients from health care staff, assess the prevalence of dissatisfaction with this information, and identify factors predicting dissatisfaction.......To validate five items (CPWQ-inf) regarding satisfaction with information provided to cancer patients from health care staff, assess the prevalence of dissatisfaction with this information, and identify factors predicting dissatisfaction....

  14. Simplified Prosthetic Rehabilitation of a Patient after Oral Cancer Removal

    OpenAIRE

    Nikola Džakula; Josip Kranjčić; Denis Vojvodić

    2016-01-01

    The treatment of patients with oral cancer is complex: a multidisciplinary approach needs to be taken and maxillofacial and oral surgeons, an oncologist, a prosthodontist should be included, and a psychologist is often needed. This case report describes the prosthetic rehabilitation of a patient after surgical removal of oral cancer with obturator prosthesis. Resection cavity was located in central part of the hard palate and the condition belonged to Aramany class 3 maxillary defects. The tw...

  15. Efficacy of radiotherapy in esophageal cancer patients with dysphagia

    International Nuclear Information System (INIS)

    Shimizu, Yuri; Niibe, Yuzuru; Terahara, Atsuro; Shimada, Hideaki; Yajima, Satoshi; Kikuchi, Yoshinori

    2016-01-01

    To retrospectively assess the efficacy of radiotherapy in esophageal cancer patients with dysphagia due to the primary lesion at our institute, by evaluating change of Mellow-Pinkas-dysphagia score and subjective symptom. We confarmed radiotherapy for esophageal cancer help improve dysphagia. Change of Mel-low-Pinkas-dysphagia score throughout radiotherapy did not match with change of subjective dysphagia, which have relevancy to patients' quality of life. New evaluation criterion is required. (author)

  16. Adverse glycaemic effects of cancer therapy: indications for a rational approach to cancer patients with diabetes.

    Science.gov (United States)

    Gallo, Marco; Muscogiuri, Giovanna; Felicetti, Francesco; Faggiano, Antongiulio; Trimarchi, Francesco; Arvat, Emanuela; Vigneri, Riccardo; Colao, Annamaria

    2018-01-01

    Diabetes and cancer are common, chronic, and potentially fatal diseases that frequently co-exist. Observational studies have reported an increased risk of cancer in patients with diabetes. Furthermore, many patients with cancer already have diabetes, or develop hyperglycaemia as a consequence of the tumor or of cancer therapies, and coexisting diabetes confers a greater risk of mortality for many malignancies. Managing oncologic patients with diabetes is often complicated, since the co-existence of diabetes and cancer poses several complex clinical questions: what level of glycaemic control to achieve, which therapy to use, how to deal with glucocorticoid therapies and artificial nutrition, how diabetes complications can affect cancer management, which drug-drug interactions should be taken into account, or even how to manage diabetes at the end of life. In the clinical setting, both at hospital and at home, there are little agreed, evidence-based guidelines on the best management and criteria upon which clinical decisions should be based. A practical solution lies in the implementation of care networks based on communication and ongoing collaboration between Oncologists, Endocrinologists, and the nursing staff, with the patient at the centre of the care process. This manuscript aims to review the current evidence on the effect of cancer therapies on glucose metabolism and to address some of the more common challenges of diabetes treatment in patients with cancer. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. STUDY ON ADHERENCE TO CAPECITABINE AMONG PATIENTS WITH COLORECTAL CANCER AND METASTATIC BREAST CANCER

    Directory of Open Access Journals (Sweden)

    Adiel Goes de FIGUEIREDO JUNIOR

    2014-09-01

    Full Text Available Context Capecitabine, an oral drug, is as effective as traditional chemotherapy drugs. Objectives To investigate the adhesion to treatment with oral capecitabine in breast and colorectal cancer, and to determine any correlation with changes in patient’s quality of life. Methods Patients with colorectal cancer or breast cancer using capecitabine were included. The patients were asked to bring any medication left at the time of scheduled visits. The QLQ-C30 questionnaire was applied at the first visit and 8-12 weeks after treatment. Results Thirty patients were evaluated. Adherence was 88.3% for metastatic colon cancer, 90.4% for non-metastatic colon cancer, 94.3% for rectal cancer and 96.2% for metastatic breast cancer. No strong correlation between adherence and European Organisation for Research and Treatment of Cancer QLQ-C30 functional or symptom scale rates had been found. There was no statistically significant correlation between compliance and the functional and symptom scales of the questionnaire before and after chemotherapy, with the exception of dyspnea. Conclusions Although no absolute adherence to oral capecitabine treatment had been observed, the level of adherence was good. Health professionals therefore need a greater focus in the monitoring the involvement of patients with oral treatment regimens. Patients with lesser degrees of dyspnea had greater compliance.

  18. Preparing patients with cancer who work and treatment responsiveness.

    Science.gov (United States)

    Kamau, Caroline

    2017-03-01

    Many patients with life-limiting illnesses continue to work because of financial reasons and because work provides good psychosocial support. A lack of appropriate advice/support through patient education could, however, make having a job detrimental to well-being (eg, symptom worsening). This study investigated the frequency with which patients received information that empowers their understanding of their condition, treatment, side effects of treatment and the likely impact on occupational functioning. A cross-sectional study. An analysis of survey data from 3457 patients with cancer in employment. Logistic regression showed that patients who received information about the impact of cancer on work life or education are 1.72 times more likely to have a positive treatment outcome. Patients who receive written information about the type of cancer are 1.99 times more likely to have a positive treatment outcome. Also, patients who receive written information before a cancer-related operation are 1.90 times more likely to have a positive treatment outcome. Information about the side effects of cancer treatment produces worse odds of a positive treatment outcome (0.65-1). A stepwise logistic regression analysing the effects irrespective of current employment status in 6710 patients showed that preparing them produces nearly twice better odds of cancer treatment responsiveness. Palliative care teams should consider ways of actively advising patients who work. Whereas the results showed evidence of good practice in cancer care, there is a need to ensure that all working patients with potentially life-limiting illnesses receive similar support. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. Patient participation during oncological encounters: barriers and facilitators experienced by elderly cancer patients.

    NARCIS (Netherlands)

    Noordman, J.; Driesenaar, J.A.; Henselmans, I.; Heijmans, M.; Verboom, J.; Dulmen, S. van

    2017-01-01

    Objective: To enhance patient participation during (oncological) encounters, this study aims to gain insight into communication barriers and supportive interventions experienced by elderly patients with cancer. Method: A mixed method design, including both quantitative (secondary survey data

  20. Applying a coping with stress questionnaire for cancer patients to patients with non-cancer chronic illnesses.

    Science.gov (United States)

    Orive, Miren; Quintana, Jose M; Vrotsou, Kalliopi; Las Hayas, Carlota; Bilbao, Amaia; Barrio, Irantzu; Matellanes, Begoña; Padierna, Jesús A

    2013-06-01

    One of the few instruments to evaluate coping skills among patients with chronic illnesses is the Cuestionario de Afrontamiento al Estrés para Pacientes Oncológicos (CAEPO), created initially for cancer patients. We evaluate how well CAEPO applies to patients with non-cancer chronic illnesses. A total of 344 patients (115 with chronic hepatitis C, 120 with inflammatory bowel disease and 109 with recurrent vertigo) completed the CAEPO. Exploratory factor analysis and Cronbach's alpha provide only partial support for the seven factors suggested by the original CAEPO. A streamlined version with fewer dimensions and items may be a better solution for identifying coping strategies among these patients.

  1. Principle-based ethics and nurses' attitudes towards artificial feeding.

    Science.gov (United States)

    Day, L; Drought, T; Davis, A J

    1995-02-01

    Nurses often institute artificial feeding for patients who would otherwise starve. Recently, the courts in the United States have favoured withholding or withdrawing feedings from patients who currently refuse or previously gave some indication they would refuse artificial nutrition and hydration. This paper investigates under what circumstances nurses feel justified in withholding artificial nutrition and hydration. Structured interviews were conducted with 40 cancer care nurses from two sites, and 40 dementia care nurses from two sites. The interviews were based on two vignettes, one involving an alert patient with terminal cancer, the other a patient suffering end-stage Alzheimer's dementia, and were analysed for themes coinciding with principles of deontological ethics. Investigators found that autonomy, beneficence and non-maleficence most often guided nurses' decisions to withhold or implement artificial feeding.

  2. Multiple neoplasms among cervical cancer patients in the material of the lower Silesian cancer registry.

    Science.gov (United States)

    Izmajłowicz, Barbara; Kornafel, Jan; Błaszczyk, Jerzy

    2014-01-01

    According to the definition by the International Agency for Research on Cancer (IARC), primary multiple neoplasms are two or more neoplasms of different histopathological build in one organ, or two or more tumors occurring in one patient, regardless of the time of their occurrence (synchronic - up to 6 months, metachronous - after 6 months), coming from an organ or a tissue and not being an infiltration from another neoplasm, a relapse or a metastasis. It was the aim of the study to analyze the frequency of the occurrence of multiple neoplasms among patients suffering from uterine cervix cancer, with a special interest in coexistent neoplasms, the time of their occurrence and total 5-year survivals. The data from the Lower Silesian Cancer Registry concerning the years 1984-2009 formed the material of the present study. 5.3% of all cervix neoplasms occurred as multiple cancers. Cervix neoplasms were 13.4% of multiple neoplasms. On average, cervical cancer occurred as a subsequent cancer in 6 patients yearly (60.7% of the occurrences of cervical cancer were in the period of 5 years following treatment for the first neoplasm). 5-year survival in patients suffering from primarily multiple cervix neoplasms constituted 57% and was convergent with the results for all patients suffering from cervical cancer. Cervical cancer as the first neoplasm occurred in 287 patients, on average in 11 patients annually. In the period of the first 5 years after the treatment of cervical cancer, there were 42.8% occurrences of other cancers. Cervical neoplasms most frequently coexisted with cancers of the breast, lung and large intestine. The frequency of the occurrence of multiple neoplasm among cervical cancer patients is increasing. Most frequently they coexist with other tobacco-related neoplasms, those related to HPV infections and with secondary post-radiation neoplasms. These facts should be taken into consideration during post-treatment observation and when directing diagnostic

  3. Hormonal treatment of obstructed kidneys in patients with prostatic cancer

    DEFF Research Database (Denmark)

    Honnens de Lichtenberg, M; Miskowiak, J; Rolff, H

    1993-01-01

    A review of 1288 patients with previously untreated prostatic cancer revealed 209 patients (16%) with ureteric obstruction; the obstruction was bilateral in 36%. The effect of hormonal treatment was assessed in 88 patients with 120 obstructed kidneys: 77 patients had androgen deprivation...... or hormonal medication alone and 11 patients needed percutaneous nephrostomy or ureteric catheters in addition. Drainage improved in 58% of the kidneys. The diverting catheter was withdrawn in 9 of the 11 patients after a median of 4 weeks. In all, 95% of patients were discharged. The patients with hormonal...

  4. Continuous palliative sedation for cancer and noncancer patients.

    Science.gov (United States)

    Swart, Siebe J; Rietjens, Judith A C; van Zuylen, Lia; Zuurmond, Wouter W A; Perez, Roberto S G M; van der Maas, Paul J; van Delden, Johannes J M; van der Heide, Agnes

    2012-02-01

    Palliative care is often focused on cancer patients. Palliative sedation at the end of life is an intervention to address severe suffering in the last stage of life. To study the practice of continuous palliative sedation for both cancer and noncancer patients. In 2008, a structured questionnaire was sent to 1580 physicians regarding their last patient receiving continuous sedation until death. A total of 606 physicians (38%) filled out the questionnaire, of whom 370 (61%) reported on their last case of continuous sedation (cancer patients: n=282 [76%] and noncancer patients: n=88 [24%]). More often, noncancer patients were older, female, and not fully competent. Dyspnea (odds ratio [OR]=2.13; 95% confidence interval [CI]: 1.22, 3.72) and psychological exhaustion (OR=2.64; 95% CI: 1.26, 5.55) were more often a decisive indication for continuous sedation for these patients. A palliative care team was consulted less often for noncancer patients (OR=0.45; 95% CI: 0.21, 0.96). Also, preceding sedation, euthanasia was discussed less often with noncancer patients (OR=0.42; 95% CI: 0.24, 0.73), whereas their relatives more often initiated discussion about euthanasia than relatives of cancer patients (OR=3.75; 95% CI: 1.26, 11.20). The practice of continuous palliative sedation in patients dying of cancer differs from patients dying of other diseases. These differences seem to be related to the less predictable course of noncancer diseases, which may reduce physicians' awareness of the imminence of death. Increased attention to noncancer diseases in palliative care practice and research is, therefore, crucial as is more attention to the potential benefits of palliative care consultation. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  5. Cardiovascular risk during hormonal treatment in patients with prostate cancer

    International Nuclear Information System (INIS)

    Van Poppel, Hein; Tombal, Bertrand

    2011-01-01

    The objective of this review is to provide information on cardiovascular risk following androgen-deprivation therapy (ADT) in prostate cancer patients and to suggest potential prevention and management strategies. Androgen deprivation therapy can cause peripheral insulin resistance, increase fat mass and low-density lipoprotein cholesterol, and induce type 2 diabetes. While recent studies have reported an association in patients with prostate cancer between ADT and increased risk of cardiovascular events, other studies have not detected the association. However, at this time, it is plausible that ADT could increase cardiovascular risk because of the adverse effect of ADT on risk factors for cardiovascular disease. It is advisable that prostate cancer patients in whom ADT is initiated be referred to their physician, who will carefully monitor them for potential metabolic effects. Therefore, physicians should be informed about these potential side effects. This especially applies to men aged >65 years and those with pre-existing cardiovascular comorbidities. Adopting a healthy lifestyle including a balanced diet and regular physical activity is recommended. Patients with cardiovascular disease should receive appropriate preventive therapies, including lipid-lowering, antihypertensive, glucose-lowering, and antiplatelet therapy. ADT should preferably not be unnecessarily administered to prostate cancer patients with pre-existing cardiovascular disease, certainly not to those in whom the risk of prostate cancer-specific mortality is low. The physician should carefully weigh the potential benefits of ADT against the possible risks in individual patients with prostate cancer

  6. Oral Cancer: Awareness and Knowledge Among Dental Patients in Riyadh.

    Science.gov (United States)

    Al-Maweri, Sadeq Ali; Al-Soneidar, Walid Ahmed; Dhaifullah, Esam; Halboub, Esam Saleh; Tarakji, Bassel

    2017-06-01

    More than 50 % of oral cancer cases are diagnosed at advanced stages. Public knowledge about oral cancer can help in prevention and early detection of the disease. The aim of the present study was to assess the levels of awareness and knowledge about signs and risk factors of oral cancer among dental patients in Saudi Arabia. A self-administered questionnaire was used to collect information from 1410 randomly selected patients attending dental departments within public hospitals in Riyadh, Saudi Arabia. The collected data were analyzed using SPSS software. The significance level was set at P oral cancer. Some 68.2 and 56.5 %, respectively, were able to correctly identify tobacco and alcohol as risk factors. More than two thirds of subjects had no knowledge about any signs of oral cancer. Participants with lower than university education were significantly less aware, and had much less knowledge, of the signs and risk factors of oral cancer. The knowledge regarding oral cancer among Saudi dental patients is alarmingly low. Interventions to improve public knowledge about oral cancer and attitudes towards early diagnosis and treatment are urgently indicated.

  7. Combined therapy for 129 patients with second primary lung cancer

    International Nuclear Information System (INIS)

    Liang Jun; Feng Qinfu; Wang Luhua; Zhang Yaohong; Zhao Hongfa; Weng Xinran

    2004-01-01

    Objective: To analyze the clinical characteristics and prognosis of the second primary lung cancer. Methods: The interval between the second primary lung cancer and the previous primary cancer ranged from 10 days to 317 months (median 49 months). Of the 129 patients treated from 1971 to 1997 by surgery only, radiotherapy only and chemotherapy only or combined therapy, 11 (8.5%) patients had stage I, 29 (22.5%) stage II, 75 (58.1%) stage III and 14 (10.9%) stage IV; 30 patients received surgery alone, 54 radiotherapy alone, 8 chemotherapy alone, 12 surgery plus radiotherapy, 20 radiotherapy plus chemotherapy, 4 surgery plus chemotherapy and 1 surgery plus radiotherapy plus chemotherapy. Results: The overall 2-, 3- and 5-year survival rates were 40.2%, 27.2% and 15.3%. The stage I, II, III and IV 2-year survival rates were 71.6%, 60.7%, 32.9% and 0%, respectively (P 49 and ≤49 months of the interval between the second primary lung cancer and the previous primary cancer (P>0.05). Conclusions: Second primary lung cancer are similar to the first primary lung cancer in clinical characteristics and prognosis. The main cause of failure is lung cancer perse. Stage and being able to operation are prognostic factors

  8. Exploring Positive Survivorship Experiences of Indigenous Australian Cancer Patients

    Science.gov (United States)

    Tam, Laura; Garvey, Gail; Meiklejohn, Judith; Martin, Jennifer; Adams, Jon; Walpole, Euan; Fay, Michael; Valery, Patricia

    2018-01-01

    Amongst Indigenous Australians, “cancer” has negative connotations that detrimentally impact upon access to cancer care services. Barriers to accessing cancer services amongst Indigenous Australians are widely reported. In contrast, factors that facilitate this cohort to successfully navigate cancer care services (“enablers”) are scarcely reported in the literature. Through qualitative interviews, this article examines factors that assist Indigenous Australians to have positive cancer experiences. Semi-structured interviews were conducted with twelve adult Indigenous oncology patients recruited from a tertiary hospital in Queensland, Australia during 2012–2014. Data generated from the interviews were independently reviewed by two researchers via inductive thematic analytical processes. Discussions followed by consensus on the major categories allowed conclusions to be drawn on potential enablers. Two major categories of enablers were identified by the researchers: resilience and communication. Individual’s intrinsic strength, their coping strategies, and receipt of support improved participant’s resilience and consequently supported a positive experience. Communication methods and an effective patient-provider relationship facilitated positive experiences for participants. Despite potential barriers to access of care for Indigenous cancer patients, participants in the study demonstrated that it was still possible to focus on the positive aspects of their cancer experiences. Many participants explained how cancer changed their outlook on life, often for the better, with many feeling empowered as they progressed through their cancer diagnosis and treatment processes. PMID:29342934

  9. A patient-centered perspective on cancer survivorship.

    Science.gov (United States)

    Zebrack, Brad

    2015-04-15

    Survivorship is a complicated notion because people often confuse a process of survivorship with a mythic identity of being a cancer survivor. This confusion may be a distraction to addressing the real-life struggles and challenges experienced by all people diagnosed with cancer. A more expansive perspective of survivorship, one that attends to patients' physical, psychological, social, spiritual, and existential challenges throughout a continuum of care, would be more in line with what is known empirically about people's experiences with cancer. In an effort to gain a patient-centered perspective on cancer, and one that emphasizes multiple dimensions of cancer survivorship, the author reports findings from a non-scientific social media poll (via Facebook and personal emails) in which survivors and colleagues working in the field of cancer survivorship answered the question: What does cancer survivorship mean to you? The comments are enlightening and useful for guiding the development of a patient-centered, and, thus, more comprehensive, approach to caring for people affected by cancer.

  10. ATM variants and cancer risk in breast cancer patients from Southern Finland

    Directory of Open Access Journals (Sweden)

    Aittomäki Kristiina

    2006-08-01

    Full Text Available Abstract Background Individuals heterozygous for germline ATM mutations have been reported to have an increased risk for breast cancer but the role for ATM genetic variants for breast cancer risk has remained unclear. Recently, a common ATM variant, ATMivs38 -8T>C in cis with the ATMex39 5557G>A (D1853N variant, was suggested to associate with bilateral breast cancer among familial breast cancer patients from Northern Finland. We have here evaluated the 5557G>A and ivs38-8T>C variants in an extensive case-control association analysis. We also aimed to investigate whether there are other ATM mutations or variants contributing to breast cancer risk in our population. Methods Two common ATM variants, 5557G>A and ivs38-8T>C, previously suggested to associate with bilateral breast cancer, were genotyped in an extensive set of 786 familial and 884 unselected breast cancer cases as well as 708 healthy controls. We also screened the entire coding region and exon-intron boundaries of the ATM gene in 47 familial breast cancer patients and constructed haplotypes of the patients. The identified variants were also evaluated for increased breast cancer risk among additional breast cancer cases and controls. Results Neither of the two common variants, 5557G>A and ivs38-8T>C, nor any haplotype containing them, was significantly associated with breast cancer risk, bilateral breast cancer or multiple primary cancers in any of the patient groups or subgoups. Three rare missense alterations and one intronic change were each found in only one patient of over 250 familial patients studied and not among controls. The fourth missense alteration studied further was found with closely similar frequencies in over 600 familial cases and controls. Conclusion Altogether, our results suggest very minor effect, if any, of ATM genetic variants on familial breast cancer in Southern Finland. Our results do not support association of the 5557G>A or ivs38-8T>C variant with

  11. All eyes on the patient: the influence of oncologists? nonverbal communication on breast cancer patients? trust

    OpenAIRE

    Hillen, Marij A.; de Haes, Hanneke C. J. M.; van Tienhoven, Geertjan; Bijker, Nina; van Laarhoven, Hanneke W. M.; Vermeulen, Dani?lle M.; Smets, Ellen M. A.

    2015-01-01

    Trust in the oncologist is crucial for breast cancer patients. It reduces worry, enhances decision making, and stimulates adherence. Optimal nonverbal communication by the oncologist, particularly eye contact, body posture, and smiling, presumably benefits patients? trust. We were the first to experimentally examine (1) how the oncologist?s nonverbal behavior influences trust, and (2) individual differences in breast cancer patients? trust. Analogue patients (APs) viewed one out of eight vers...

  12. Clinical trial enrollment, patient characteristics, and survival differences in prospectively registered metastatic colorectal cancer patients

    DEFF Research Database (Denmark)

    Sorbye, Halfdan; Pfeiffer, Per; Cavalli-Björkman, Nina

    2009-01-01

    BACKGROUND: Trial accrual patterns were examined to determine whether metastatic colorectal cancer (mCRC) patients enrolled in trials are representative of a general cancer population concerning patient characteristics and survival. METHODS: A total of 760 mCRC patients referred for their first...... oncological consideration at 3 hospitals in Scandinavia covering defined populations were registered consecutively during 2003 to 2006. Clinical trial enrollment, patient characteristics, and treatment were recorded prospectively, and the follow-up was complete. RESULTS: Palliative chemotherapy was initiated...

  13. Non medical factors associated with psychological disorders in cancer patients

    International Nuclear Information System (INIS)

    Iqbal, A.; Intikhab, K.; Saeed, K.

    2002-01-01

    Objective: To find out major non-medial factors associated with psychological disorders in cancer patients. Design: An observational study conducted on adult cancer patients. Place and Duration of Study: The study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore Pakistan from January 1999. Patients and Methods: Two hundred and twenty-four newly-diagnosed adult cancer patients were interviewed by the clinical psychologist and data was collected regarding non-medical causal factors, patients age, gender family support system, general home atmosphere and marital status. Collected data was analyzed by utilizing. SPSS for windows version 10.0. Results: Of the 224 patients 142 (63.4%) reported non-medical factors causing psychological distress and 82 (36.6%) reported that medical sources are the most distressing. Ten most common non-medical sources of developing psychological disorders were identified. It was observed that family support system and general home atmosphere were significantly associated with the development of psychological disorders whereas the other variables such as age, gender and marital status had no significant relationship with the non Medical factors. Conclusion: It was concluded that non-medical factors causing psychological problems are significant in cancer patients. The results suggest that we should identify these factors and target psychosocial intervention for those patients most at risk. (author)

  14. Islamic Religiosity, Depression and Anxiety among Muslim Cancer Patients

    Directory of Open Access Journals (Sweden)

    Nadzirah Ahmad Basri

    2015-12-01

    Full Text Available Active religious practice is central to Muslim livelihood. Among Muslims, this religious engagement is rarely studied with regards to its association in coping with critical illnesses. This study investigated the association between Islamic religiosity with depression and anxiety in Muslim cancer patients. Fifty-nine cancer patients recruited from a Malaysian public hospital and a cancer support group completed the Muslim Religiosity and Personality Inventory, Beck Depression Inventory and Beck Anxiety Inventory in July and August 2010. Islamic religiosity score, obtained from the sum of subscale scores of Islamic worldview and religious personality represents a greater understanding and practice of Islam in a comprehensive manner. Results yielded a significant negative correlation between Islamic religiosity score with both depression and anxiety. Depression was also found to be negatively associated with religious personality subscale. Older patients scored significantly higher on both Islamic worldview and religious personality whereas patients with higher education scored higher on Islamic worldview. Married patients scored significantly higher scores on religious personality than the single patients. Results provided an insight into the significant role of religious intervention which has huge potentials to improve the psychological health of cancer patients particularly Muslims in Malaysia. Research implication includes the call for professionals to meet the spiritual needs of Muslim cancer patients and incorporating religious components in their treatment, especially in palliative care.

  15. Patient mental adjustment to selected types of cancer.

    Science.gov (United States)

    Religioni, Urszula; Czerw, Aleksandra; Deptała, Andrzej

    2018-02-28

    Physical symptoms related to cancer are associated with various mental conditions. An adopted attitude towards pain and disease affects the quality of life of patients and may even decide about the final outcome of therapy. The objective of the study was to assess the degree of mental adjustment of patients diagnosed with breast, lung, colorectal and prostate cancer. The analysis also covered the effect of socioeconomic factors on mental adjustment in patients in the above groups. The study included 902 patients treated on an outpatient basis at the Center of Oncology, the Maria Skłodowska-Curie Institute in Warsaw, in the year 2013. The study participants were patients diagnosed with breast, lung, colorectal and prostate carcinoma. The Paper and Pencil Interview (PAPI) technique was applied. The questionnaire interview included demographic-type questions (socioeconomic variables) and the Mini-Mental Adjustment to Cancer (mini-MAC) scale, which measures the degree of mental adjustment to disease. The highest scores in the anxious preoccupation and helplessness-hopelessness subclasses were those of the lung, colorectal, breast and prostate cancer patients. In breast and lung cancer study participants, differences between individual categories distinguished due to socioeconomic features proved statistically insignificant. However, significant dependencies were observed between mental adjustment to disease and chemotherapy in the past year; though, the results differ with respect to the primary site. The primary site affects patient adjustment to disease. Socioeconomic factors in the area of mental adaptation differentiate colorectal carcinoma patients.

  16. Assessment of nutritional status using abridged scored patient-generated subjective global assessment in cancer patient

    Directory of Open Access Journals (Sweden)

    Simin Shahvazi

    2017-01-01

    Conclusion: According to the high prevalence of cancers and increasing growth of them in recent years with regard to outpatient treatment development for cancer patients, using the abPG-SGA standard questionnaire by nutritionist or nurses can be effective to detect malnourished patients and reduce complications caused by disease.

  17. A study about trace element distribution in cancer tissue and serum of cancer patients

    International Nuclear Information System (INIS)

    Lee, Jong In; Lee, Eun Joo; Jung, Young Joo

    1993-01-01

    Authers analyzed the trace element distribution of cancer tissue and its corresponding normal tissue and serum of preoperative and postoperative stage in gastric, colon, breast cancer patients. Zinc and rubidium were higher in concentration in breast cancer tissue than in normal tissue. As for the distribution of trace element in serum, bromine became about 10 times higher after gastric resection. This result can be applied to experimental carcinogenesis and to relationship with other prognostic factors. (Author)

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

    Science.gov (United States)

    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 present paper aims at drawing health care professionals' attention to oral complications associated with cancer therapy by giving a comprehensive review. Brief comments on contemporary cancer therapies will be given first, followed by detailed description of oral complications associated with cancer therapy. Finally, a summary of preventive strategies and treatment options for common oral complications including oral mucositis, oral infections, xerostomia, and dysgeusia will be given. PMID:24511293

  19. Maxillofacial prosthetic rehalibilation of the oral cancer patient

    International Nuclear Information System (INIS)

    Wolfaardt, J.F.; Monteith, B.D.

    1982-01-01

    The victim of orofacial cancer is frequently subjected to severe morphological and functional disturbance: a condition which the maxillofacial prosthetist can do much to alleviate through the use of various prosthetic devices. The successful rehabilitation of these patients, however, is often compromised by the presence of psychosocial and other problems, the solution of which extends beyond the limits of a single clinical discipline. The modern approach to orofacial cancer, therefore, is organised within the context of interdisciplinary co-operation: each phase of patient management being planed and executed according to the co-ordinated efforts of the various members of a head and neck cancer team

  20. Postoperative information needs and communication barriers of esophageal cancer patients.

    Science.gov (United States)

    Henselmans, Inge; Jacobs, Marc; van Berge Henegouwen, Mark I; de Haes, Hanneke C J M; Sprangers, Mirjam A G; Smets, Ellen M A

    2012-07-01

    Given the poor prognosis of esophageal cancer and the impact of surgery on health-related quality of life (HRQL), addressing patients' postoperative information needs is important. This study aimed to examine (1) the content and type of patients' information needs and (2) patient perceived facilitators and barriers to patient participation. Interviews were conducted with 20 purposefully selected esophageal cancer patients. Open and structured questions were alternated. The transcribed interviews were analysed inductively and deductively, using MAXqda. Patients' post-operative information needs concerned HRQL, medical care and prognosis, covering several sub-domains. Different types of needs were identified, e.g., requests for information about cause, course and self-management. Barriers to patient participation mostly reflected beliefs and skills, and could be categorized into agenda and communication barriers. Facilitators of patient participation reflected physician, patient and interaction characteristics, companion support and pre-visit preparation. Many patients saw merit in pre-visit preparation interventions; few endorsed skill-building interventions. This study listed the postoperative information needs of esophageal cancer patients. Moreover, it gained insight into patient-perceived barriers and facilitators of patient participation. The findings demonstrate what information physicians should have available and informs interventions to support patients in meeting their information needs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  1. Paradoxical modulation of thyrotrope responsiveness to TRH during the treatment of thyrotoxic patients: apparent absence of feed-back regulation

    International Nuclear Information System (INIS)

    Golstein, J.; Vanhaelst, L.; Camus, M.; Glinger, D.

    1976-01-01

    Eight patients with active thyrotoxicosis have been followed up to one year after the onset of antithyroid treatment. At different time intervals during the investigation period, TRH tests were performed and total T 4 and T 3 basal levels were measured. The TRH-induced TSH release was delayed in all patients in spite of a normalization of the circulating levels of thyroid hormones. The delay varied according to the patients and lasted, in some cases, for as long as 24 weeks after the normalization of the thyroid hormone levels. Administration of thyroid hormones, together with methimazole, did not seem to prevent the pituitary thyrotropes responsiveness; moreover, it did not provoke an inhibition of the TRH-induced TSH release once the thyrotropes reactivity was fully restored. The feed-back mechanism does not seem to be the main modulator of the pituitary responsiveness to TRH in these circumstances. (orig.) [de

  2. Genomic Alterations in Liquid Biopsies from Patients with Bladder Cancer

    DEFF Research Database (Denmark)

    Birkenkamp-Demtröder, Karin; Nordentoft, Iver Kristiansen; Christensen, Emil

    2016-01-01

    Background: At least half of the patients diagnosed with non–muscle-invasive bladder cancer (NMIBC) experience recurrence and approximately 15% will develop progression to muscle invasive or metastatic disease. Biomarkers for disease surveillance are urgently needed. Objective: Development......-invasive or metastatic bladder cancer; t test for ddPCR data. Results and limitations: We developed from one to six personalised assays per patient. Patients with progressive disease showed significantly higher levels of tumour DNA in plasma and urine before disease progression, compared with patients with recurrent...

  3. Communication of the cancer diagnosis to an elderly patient

    Directory of Open Access Journals (Sweden)

    Lucélia Terra Jonas

    2015-05-01

    Full Text Available Objective: to collect evidence on matters which involve cancer diagnosis disclosure to an elderly patient. Methods: integrative revision made in five important data bases in the area of health with seven selected articles. Results: it was noticeable that there are conflicts between family members and health professionals concerning cancer diagnosis disclosure to an elderly patient and that the preferences of those people on the disclosure of the diagnosis are similar to other patients. Conclusion: health professionals, especially the nurses, need training in order to have a secure and clarifying communication, matching the information to the specific needs of each patient, considering their reality and type of confrontation..

  4. Interest in internet lung cancer support among rural cardiothoracic patients.

    Science.gov (United States)

    Quin, Jacquelyn; Stams, Victor; Phelps, Beth; Boley, Theresa; Hazelrigg, Stephen

    2010-05-01

    The Internet may provide an alternative option for rural lung cancer patients who lack access to on-site cancer support; however, Internet access and use among rural patients is unknown. An anonymous waiting-room survey was administered to all outpatient cardiothoracic surgery patients over 3 mo. Survey questions included age, gender, and diagnosis, possession of a home computer and Internet service, estimated Internet use, and use of the Internet for health information. Patients with known or suspected lung cancer were asked to indicate their interest in on-site and Internet cancer support. There were 597 returned surveys (response rate 96%). The mean age was 64.6 y (SE 0.55), and 58% were men. Diagnoses included known or possible lung cancer (15.4%), lung disease (9.5%), heart disease (30.4%), other diagnoses (13.9%), and undetermined (30.6%). There were 343 patients (57.4%) with a home computer and 299 (50.1%) with home Internet service. Average Internet use was 8.5 h per wk (n = 298), and 225 patients used the Internet for health information. Of the 92 patients with lung cancer, 10 indicated interest in on-site support services while 37 expressed interest in Internet-based support. Based on survey results, a slight majority of rural patients have a home computer and Internet access. Internet use for health information appears relatively common. Overall interest for support services among lung cancer patients appears modest with a greater interest in Internet-based services compared with on-site support. Copyright 2010 Elsevier Inc. All rights reserved.

  5. Profile of thyroid hormones in breast cancer patients

    Directory of Open Access Journals (Sweden)

    P.P. Saraiva

    2005-05-01

    Full Text Available Estrogen involvement in breast cancer has been established; however, the association between breast cancer and thyroid diseases is controversial. Estrogen-like effects of thyroid hormone on breast cancer cell growth in culture have been reported. The objective of the present study was to determine the profile of thyroid hormones in breast cancer patients. Serum aliquots from 26 patients with breast cancer ranging in age from 30 to 85 years and age-matched normal controls (N = 22 were analyzed for free triiodothyronine (T3F, free thyroxine (T4F, thyroid-stimulating hormone (TSH, antiperoxidase antibody (TPO, and estradiol (E2. Estrogen receptor ß (ERß was determined in tumor tissues by immunohistochemistry. Thyroid disease incidence was higher in patients than in controls (58 vs 18%, P < 0.05. Subclinical hyperthyroidism was the most frequent disorder in patients (31%; hypothyroidism (8% and positive anti-TPO antibodies (19% were also found. Subclinical hypothyroidism was the only dysfunction (18% found in controls. Hyperthyroidism was associated with postmenopausal patients, as shown by significantly higher mean T3 and T4 values and lower TSH levels in this group of breast cancer patients than in controls. The majority of positive ERß tumors were clustered in the postmenopausal patients and all cases presenting subclinical hyperthyroidism in this subgroup concomitantly exhibited Erß-positive tumors. Subclinical hyperthyroidism was present in only one of 6 premenopausal patients. We show here that postmenopausal breast cancer patients have a significantly increased thyroid hormone/E2 ratio (P < 0.05, suggesting a possible tumor growth-promoting effect caused by this misbalance.

  6. Radiotherapy for superficial esophageal cancer of poor risk patients

    International Nuclear Information System (INIS)

    Kagami, Yoshikazu; Ikeda, Hiroshi; Murayama, Shigeyuki; Yamaguchi, Hajime; Tachimori, Yuji; Kato, Hoichi; Watanabe, Hiroshi; Tokuue, Kouichi; Sumi, Minako; Kawashima, Mitsuhiko; Imai, Atsushi; Nakayama, Shuji

    1997-01-01

    Purpose/Objective: The reported incidence of superficial esophageal cancer (SEC) has steadily increased in Japan as result of endoscopic examination has been become common. In Japan, treatment of SEC is endoscopical mucosal resection (EMR) for mucosal cancer or esophagectomy with 3 fields lymph nodes resection for submucosal cancer. Radiotherapy is little place for the management of SEC. Because of some reasons, we treated patients with SEC by radiotherapy alternative to surgery. Purpose of this report is to evaluate efficacy of radiotherapy for SEC. Methods and Materials: Between 1989 to 1996, eighteen patients with SEC were treated with radiotherapy at our hospital. Reasons of radiotherapy that was chosen as the primary methods of treatment were refusal of surgery in one patient, poor medical condition in 4 patients and double primary cancer in 13 patients (head and neck: 11, simultaneously: 11). No patients had indication of EMR. Diagnosis was made by endoscopy and radiography. Some patients were examined with endoscopic ultrasound. Two patients (11.1%) had tumor limited to the mucosa and 16 patients (88.9%) had tumor invaded the submucosa. Seven of these tumors (38.9%) were multicentric. All patients had squamous cell carcinoma. There were 17 male patients and one female patient. The age range was 49 years to 87 years with a median of 62 years. Stage of all patients was T1N0M0 according to UICC staging system. Ten patients underwent external radiotherapy (Ex) (50 Gy - 66 Gy) alone and 8 patients did both Ex and intracavitary radiotherapy (IC) (30-60 Gy of Ex with 5-15 Gy of IC). No patients received chemotherapy. Duration of follow-up was 6 months to 96 months with a median of 30 months. Results: The overall survival rate was 55.9% in 3-year and 14% in 5-year, and the cause-specific 5-year survival rate was 100%. Causes of death were malignant tumor other than esophageal cancer in 4 patients, intercurrent disease other than malignant tumor in 3 patients and no

  7. Assessing Patient-Centered Communication in Cancer Care: Stakeholder Perspectives

    Science.gov (United States)

    Mazor, Kathleen M.; Gaglio, Bridget; Nekhlyudov, Larissa; Alexander, Gwen L.; Stark, Azadeh; Hornbrook, Mark C.; Walsh, Kathleen; Boggs, Jennifer; Lemay, Celeste A.; Firneno, Cassandra; Biggins, Colleen; Blosky, Mary Ann; Arora, Neeraj K.

    2013-01-01

    Purpose: Patient-centered communication is critical to quality cancer care. Effective communication can help patients and family members cope with cancer, make informed decisions, and effectively manage their care; suboptimal communication can contribute to care breakdowns and undermine clinician-patient relationships. The study purpose was to explore stakeholders' views on the feasibility and acceptability of collecting self-reported patient and family perceptions of communication experiences while receiving cancer care. The results were intended to inform the design, development, and implementation of a structured and generalizable patient-level reporting system. Methods: This was a formative, qualitative study that used semistructured interviews with cancer patients, family members, clinicians, and leaders of health care organizations. The constant comparative method was used to identify major themes in the interview transcripts. Results: A total of 106 stakeholders were interviewed. Thematic saturation was achieved. All stakeholders recognized the importance of communication and endorsed efforts to improve communication during cancer care. Patients, clinicians, and leaders expressed concerns about the potential consequences of reports of suboptimal communication experiences, such as damage to the clinician-patient relationship, and the need for effective improvement strategies. Patients and family members would report good communication experiences in order to encourage such practices. Practical and logistic issues were identified. Conclusion: Patient reports of their communication experiences during cancer care could increase understanding of the communication process, stimulate improvements, inform interventions, and provide a basis for evaluating changes in communication practices. This qualitative study provides a foundation for the design and pilot testing of such a patient reporting system. PMID:23943884

  8. Improving Goals of Care Discussion in Advanced Cancer Patients

    Science.gov (United States)

    2017-08-23

    Primary Stage IV Hepatobiliary; Esophageal; Colorectal Cancer; Glioblastoma; Cancer of Stomach; Cancer of Pancreas; Melanoma; Head or Neck Cancer; Stage III; Stage IV; Lung Cancers; Pancreatic Cancers

  9. Illustrations enhance older colorectal cancer patients' website satisfaction and recall of online cancer information

    NARCIS (Netherlands)

    Bol, N.; Smets, E. M A; Eddes, E. H.; de Haes, J. C J M; Loos, E. F.; van Weert, J. C M

    2015-01-01

    This study aims to investigate the effects of illustrations in online cancer information on older cancer patients' website satisfaction (i.e. satisfaction with the attractiveness, comprehensibility and emotional support from the website) and recall of information. In an online experiment, 174

  10. Quality-of-life assessment in colorectal cancer patients: evaluation of cancer therapies

    NARCIS (Netherlands)

    Sprangers, M. A.

    1999-01-01

    There is increasing recognition of the need to assess the impact of colorectal cancer and its treatment on patients' quality of life (QL). An overview is provided of generic and (colorectal) cancer-specific QL questionnaires that yield adequate levels of reliability and validity. These measures have

  11. BRCA Testing in Young Cancer Patients

    Science.gov (United States)

    Testing for genetic mutations strongly associated with an increased breast cancer risk has risen dramatically among women younger than age 40 who are diagnosed with the disease, according to a new study.

  12. [Medicinal plants in cancer patients: current practices and evaluation data].

    Science.gov (United States)

    Huet, Matthieu

    2013-05-01

    Many complementary and alternatives medicines are offered to patients with cancer. Among them, herbal medicines have a substantial place. These plants are mainly used to reduce adverse effects of anticancer treatments and for specific anticancer properties. Our review shows that only few clinical data support medicinal plants effectiveness in cancer patients. Arguments rely mainly on usual indications and pharmacological data for minimization of treatments toxicity while for the anticancer properties, on epidemiological and preclinical data. To inform and counsel patients and people around, healthcare professionals need to evaluate benefit-risk balance on evidence-based information. Because the medical decision should be shared with the patient, his beliefs and preferences have to be considered. When no adverse effect or drug interaction is associated with herbal medicine, we state that their use is acceptable. This paper discuss of potential risk and benefit of the most used medicinal plants by cancer patients.

  13. Practical review of immunizations in adult patients with cancer.

    Science.gov (United States)

    Ariza-Heredia, Ella J; Chemaly, Roy F

    2015-01-01

    Compared with the general population, patients with cancer in general are more susceptible to vaccine-preventable infections, either by an increased risk due to the malignancy itself or immunosuppressive treatment. The goal of immunizations in these patients is therefore to provide protection against these infections, and to decrease the number of vulnerable patients who can disseminate these organisms. The proper timing of immunization with cancer treatment is key to achieving better vaccine protection. As the oncology field continues to advance, leading to better quality of life and longer survival, immunization and other aspects of preventive medicine ought to move to the frontline in the care of these patients. Herein, we review the vaccines most clinically relevant to patients with cancer, as well as special cases including vaccines after splenectomy, travel immunization and recommendations for family members.

  14. Exercise and relaxation intervention for patients with advanced lung cancer

    DEFF Research Database (Denmark)

    Adamsen, Lis; Stage, M; Laursen, J

    2012-01-01

    Lung cancer patients experience loss of physical capacity, dyspnea, pain, reduced energy and psychological distress. The aim of this study was to explore feasibility, health benefits and barriers of exercise in former sedentary patients with advanced stage lung cancer, non-small cell lung cancer...... (NSCLC) (III-IV) and small cell lung cancer (SCLC) (ED), undergoing chemotherapy. The intervention consisted of a hospital-based, supervised, group exercise and relaxation program comprising resistance-, cardiovascular- and relaxation training 4 h weekly, 6 weeks, and a concurrent unsupervised home......-based exercise program. An explorative study using individual semi-structured interviews (n=15) and one focus group interview (n=8) was conducted among the participants. Throughout the intervention the patients experienced increased muscle strength, improvement in wellbeing, breathlessness and energy. The group...

  15. The Palatability of Cereal Based Nutritional Supplements in Cancer Patients

    Science.gov (United States)

    Baik, Hyun Wook; Lee, Yu Sun; Song, Min-Kyung

    2014-01-01

    Recently, it is reported that intervention of oral nutritional supplement improves the nutritional status of cancer patients, and the effectiveness is affected by the sensory preference of cancer patients on the oral nutritional supplement. However, the variety of oral nutritional supplement is extremely limited and the number of patient's benefits from using the products are restricted mostly due to sensory dislikes. The objective of this study was to provide sensory preference score of trial manufactured products with different accessory ingredients to maximize the use of oral nutritional supplements. Cancer patients (n = 30) and age, sex-matched healthy volunteers (n = 30) participated in the sensory assessments (taste, flavor, viscosity, color and overall preference) of three types of oral supplements (cereal base, cereal base+herb and cereal base+fruit) and a control supplement product with scorched cereal flavor, a top seller in current Korean market. Results indicate that the cancer patients' overall preference was significantly higher for the control supplement, and fruit added supplement was preferred over plain cereal and herb added products, although the difference was insignificant. However, there was no significant preference difference for the supplements among the control group for all sensory factors. These results suggest that cancer patients are more sensitive to sensory preferences compared to the control group, and the patients prefer the flavor of cooked cereal which is a staple food in Korea. PMID:24527420

  16. Recall in older cancer patients: measuring memory for medical information.

    Science.gov (United States)

    Jansen, Jesse; van Weert, Julia; van der Meulen, Nienke; van Dulmen, Sandra; Heeren, Thea; Bensing, Jozien

    2008-04-01

    Remembering medical treatment information may be particularly taxing for older cancer patients, but to our knowledge this ability has never been assessed in this specific age group only. Our purpose in this study was to investigate older cancer patients' recall of information after patient education preceding chemotherapy. We constructed a recall questionnaire consisting of multiple-choice questions, completion items, and open-ended questions related to information about treatment and recommendations on how to handle side effects. Immediately after a nursing consultation preceding chemotherapy treatment, 69 older patients (M = 71.8 years, SD = 4.1) completed the questionnaire. We checked recall against the actual communication in video recordings of the consultations. On average, 82.2 items were discussed during the consultations. The mean percentage of information recalled correctly was 23.2% for open-ended questions, 68.0% for completion items, and 80.2% for multiple-choice questions. Older cancer patients are confronted with a lot of information. Recall of information strongly depended on question format; especially active reproduction appeared to be poor. To improve treatment outcomes, it is important that cancer patients are able to actively retrieve knowledge about how to prevent and recognize adverse side effects and that this is checked by the health professional. We make suggestions on how to make information more memorable for older cancer patients.

  17. Hospital variation in sphincter preservation for elderly rectal cancer patients.

    Science.gov (United States)

    Dodgion, Christopher M; Neville, Bridget A; Lipsitz, Stuart R; Schrag, Deborah; Breen, Elizabeth; Zinner, Michael J; Greenberg, Caprice C

    2014-09-01

    The primary goal of an operation for rectal cancer is to cure cancer and, where possible, preserve continence. A wide range of sphincter preservation rates have been reported. This study evaluated hospital variation in the use of low anterior resection (LAR), local excision (LE), and abdominoperineal resection (APR) in the treatment of elderly rectal cancer patients. Using Surveillance, Epidemiology, and End Results-Medicare linked data, we identified 4959 patients older than 65 y with stage I-III rectal cancer diagnosed from 2000-2005 who underwent operative intervention at one of 370 hospitals. We evaluated the distribution of hospital-specific procedure rates and used generalized mixed models with random hospital effects to examine the influence of patient characteristics and hospital on operation type, using APR as a reference. The median hospital performed APR on 33% of elderly patients with rectal cancer. Hospital was a stronger predictor of LAR receipt than any patient characteristic, explaining 32% of procedure choice, but not a strong predictor of LE, explaining only 3.8%. Receipt of LE was primarily related to tumor size and tumor stage, which combined explained 31% of procedure variation. Receipt of LE is primarily determined by patient characteristics. In contrast, the hospital where surgery is performed significantly influences whether a patient undergoes an LAR or APR. Understanding the factors that cause this institutional variation is crucial to ensuring equitable availability of sphincter preservation. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Radiotherapy for prostatic cancer in patients aged 75 or older

    International Nuclear Information System (INIS)

    Hisada, Tomohiro; Kataoka, Masaaki; Mogami, Hiroshi; Inoue, Takeshi; Uemura, Masahiko; Sumiyoshi, Yoshiteru; Nagao, Shuji

    2000-01-01

    Thirty-eight patients with prostatic cancer treated with radiotherapy giving a mean dose of 60.7 Gy between 1992 and 1997 at Shikoku Cancer Center Hospital were reviewed and the treatment outcomes were investigated retrospectively. About two-third of the patients were treated with radiation by linear accelerator with 40 to 46 Gy to the whole pelvis and with 20 to 26 Gy boost to the prostate area and the other one-third were treated only to the prostate area. For almost patients, external beam radiotherapy in combination with endocrine therapy was used. The median duration of follow-up was 36 months. Overall 5-year survival and 5-year relapse-free survival rate were 65.8%, and 88.9%, respectively. Severe rectal late morbidity (over grade 3) according to RTOG grading system were seen in one (2.6%). Although the number of cases was rather small and the follow-up duration was rather short, conventional external beam radiotherapy in combination with endocrine therapy may contribute to the survival benefit of patients with prostatic cancer in aged 75 or older. Radiotherapy for elderly prostatic cancer patients should be treated with an effort to decrease the late morbidity and not to deteriorate the QOL of the patients, because many patients were died of other causes than cancer. (author)

  19. Breast Cancer Profile among Patients with a History of Chemoprevention

    Directory of Open Access Journals (Sweden)

    Freya R. Schnabel

    2016-01-01

    Full Text Available Purpose. This study identifies women with breast cancer who utilized chemoprevention agents prior to diagnosis and describes their patterns of disease. Methods. Our database was queried retrospectively for patients with breast cancer who reported prior use of chemoprevention. Patients were divided into primary (no history of breast cancer and secondary (previous history of breast cancer groups and compared to patients who never took chemoprevention. Results. 135 (6% of 2430 women used chemoprevention. In the primary chemoprevention group (n = 18, 1%, 39% had completed >5 years of treatment, and fully 50% were on treatment at time of diagnosis. These patients were overwhelmingly diagnosed with ER/PR positive cancers (88%/65% and were diagnosed with equal percentages (44% of IDC and DCIS. 117 (87% used secondary chemoprevention. Patients in this group were diagnosed with earlier stage disease and had lower rates of ER/PR-positivity (73%/65% than the nonchemoprevention group (84%/72%. In the secondary group, 24% were on chemoprevention at time of diagnosis; 73% had completed >5 years of treatment. Conclusions. The majority of patients who used primary chemoprevention had not completed treatment prior to diagnosis, suggesting that the timing of initiation and compliance to prevention strategies are important in defining the pattern of disease in these patients.

  20. Chronic fatigue in cancer patients treated with radiotherapy

    International Nuclear Information System (INIS)

    Rucinska, M.; Wojtukiewicz, M.Z.; Tokajuk, P.

    2004-01-01

    Fatigue is one of the most prevalent and profound symptoms related to both malignancy and anti-neoplastic treatment. It is being reported in 60% to 80% of cancer patients. We review the correlation between the cancer-related fatigue syndrome and radiotherapy. In patients undergoing radiotherapy, fatigue is often cumulative and may reach its peak during the last weeks of treatment. The presence of fatigue prior to therapy initiation is the most important predictive factor of the occurrence of radiotherapy-related cancer fatigue syndrome. Occasionally, fatigue persists for a prolonged period of months and even years beyond radiotherapy. Anemia may be one of major causative factors responsible for the development of the cancer-related fatigue syndrome. Fatigue has an enormous physical, mental, emotional, and economic impact on cancer patients, their families and care-providers. The treatment of radiation-related fatigue remains unknown. The initial approach should cover efforts aimed at the correction of potential etiologies, especially anemia. Education concerning fatigue greatly benefits some patients. It seems that exercise may be beneficial in relieving fatigue, bearing in mind that the exercise program for cancer patients should be initiated gradually and significantly individualized. (author)

  1. Frequency of human papillomavirus infection in patients with gastrointestinal cancer.

    Science.gov (United States)

    Roesch-Dietlen, F; Cano-Contreras, A D; Sánchez-Maza, Y J; Espinosa-González, J M; Vázquez-Prieto, M Á; Valdés-de la O, E J; Díaz-Roesch, F; Carrasco-Arroniz, M Á; Cruz-Palacios, A; Grube-Pagola, P; Sumoza-Toledo, A; Vivanco-Cid, H; Mellado-Sánchez, G; Meixueiro-Daza, A; Silva-Cañetas, C S; Carrillo-Toledo, M G; Lagunes-Torres, R; Amieva-Balmori, M; Gómez-Castaño, P C; Reyes-Huerta, J U; Remes-Troche, J M

    2018-02-15

    Cancer is the result of the interaction of genetic and environmental factors. It has recently been related to viral infections, one of which is human papillomavirus. The aim of the present study was to describe the frequency of human papillomavirus infection in patients with digestive system cancers. A prospective, multicenter, observational study was conducted on patients with gastrointestinal cancer at 2public healthcare institutes in Veracruz. Two tumor samples were taken, one for histologic study and the other for DNA determination of human papillomavirus and its genotypes. Anthropometric variables, risk factors, sexual habits, tumor location, and histologic type of the cancer were analyzed. Absolute and relative frequencies were determined using the SPSS version 24.0 program. Fifty-three patients were studied. They had gastrointestinal cancer located in: the colon (62.26%), stomach (18.87%), esophagus (7.55%), rectum (7.55%), and small bowel (3.77%). Human papillomavirus was identified in 11.32% of the patients, 66.7% of which corresponded to squamous cell carcinoma and 33.3% to adenocarcinoma. Only genotype 18 was identified. Mean patient age was 61.8±15.2 years, 56.60% of the patients were men, and 43.40% were women. A total of 15.8% of the patients had a family history of cancer and 31.6% had a personal history of the disease, 38.6% were tobacco smokers, and 61.4% consumed alcohol. Regarding sex, 5.3% of the patients said they were homosexual, 3.5% were bisexual, 29.8% engaged in oral sex, and 24.6% in anal sex. Our study showed that human papillomavirus infection was a risk factor for the development of gastrointestinal cancer, especially of squamous cell origin. Copyright © 2018 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  2. Will patients benefit from regionalization of gynecologic cancer care?

    Directory of Open Access Journals (Sweden)

    Kathleen F Brookfield

    Full Text Available OBJECTIVE: Patient chances for cure and palliation for a variety of malignancies may be greatly affected by the care provided by a treating hospital. We sought to determine the effect of volume and teaching status on patient outcomes for five gynecologic malignancies: endometrial, cervical, ovarian and vulvar carcinoma and uterine sarcoma. METHODS: The Florida Cancer Data System dataset was queried for all patients undergoing treatment for gynecologic cancers from 1990-2000. RESULTS: Overall, 48,981 patients with gynecologic malignancies were identified. Endometrial tumors were the most common, representing 43.2% of the entire cohort, followed by ovarian cancer (30.9%, cervical cancer (20.8%, vulvar cancer (4.6%, and uterine sarcoma (0.5%. By univariate analysis, although patients treated at high volume centers (HVC were significantly younger, they benefited from an improved short-term (30-day and/or 90-day survival for cervical, ovarian and endometrial cancers. Multivariate analysis (MVA, however, failed to demonstrate significant survival benefit for gynecologic cancer patients treated at teaching facilities (TF or HVC. Significant prognostic factors at presentation by MVA were age over 65 (HR = 2.6, p<0.01, African-American race (HR = 1.36, p<0.01, and advanced stage (regional HR = 2.08, p<0.01; advanced HR = 3.82, p<0.01, respectively. Surgery and use of chemotherapy were each significantly associated with improved survival. CONCLUSION: No difference in patient survival was observed for any gynecologic malignancy based upon treating hospital teaching or volume status. Although instances of improved outcomes may occur, overall further regionalization would not appear to significantly improve patient survival.

  3. The evaluation of older patients with cervical cancer

    Directory of Open Access Journals (Sweden)

    Gao Y

    2013-06-01

    Full Text Available Ying Gao,1 Jin-lu Ma,1,* Fei Gao,2,* Li-ping Song11Department of Radiotherapy Oncology, First Affiliated Hospital of Xi'an Jiaotong University, 2Department of Neurology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China *These authors contributed equally to this workObjective: The number of elderly patients being diagnosed with cervical cancer is increasing, and the outcome of cervical cancer related to age is controversial. We conducted a retrospective analysis in patients treated for advanced cervical cancer in order to investigate patient characteristics and prognosis of older patients.Methods: Medical records were collected of 159 patients with cervical cancer who had been treated with radiotherapy or combined radiotherapy and chemotherapy from January 2007 to January 2009. The patients were divided into two age groups: (1 patients ≥65 years old, and (2 patients <65 years old. There were 52 women in group 1, 107 in group 2. Prognosis, patient characteristics, treatment, and toxicities were evaluated.Results: With a median follow-up of 36.5 months, local control for groups 1 and 2 was 88.5% and 79.4%, respectively. Disease-free survival for the two groups was 71.2% and 67.3%; overall survival was 73.1% and 72.9%. As shown by univariate analyses, there was no statistically significant difference between the two groups (P > 0.05. Seventy-six patients had human papillomavirus (HPV at diagnosis (twelve women ≥65 years, 64 women ≤65 years; P = 0.000. Forty-two women tested positive for HPV 16, while 32 women tested positive for HPV 18 respectively. Pelvic and/or paraaortic lymph-node metastasis was found in 25 patients (eight in group 1, 17 in group 2; P = 0.960 on computed tomography scan. Of the 159 patients analyzed, sixteen patients (16/52 in group 1 received concurrent chemotherapy, while 96 (96/107 in group 2 completed that treatment.Conclusions: Cervical cancer has the same prognosis in old and

  4. The financial burden of cancer: Estimates from patients undergoing cancer care in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Zaidi Adnan A

    2012-10-01

    Full Text Available Abstract Introduction The emotional burden associated with the diagnosis of cancer is sometimes overshadowed by financial burden sustained by patient and the family. This is especially relevant for a developing country as there is limited state support for cancer treatment. We conducted this study to estimate the cost of cancer care for two major types of cancer and to assess the perception of patients and families regarding the burden of the cost for undergoing cancer treatment at a private tertiary care hospital. Methods This cross-sectional study was conducted at day care and radiotherapy unit of Aga Khan University, Hospital (AKUH Karachi, Pakistan. All adult patients with breast and head & neck cancers diagnosed for 3 months or more were included. Data was collected using a structured questionnaire and analysed using SPSS. Results Sixty seven patients were interviewed during the study period. The mean and median monthly income of these patients was 996.4 USD and 562.5 USD respectively. Comparatively the mean and median monthly cost of cancer care was 1093.13 USD and 946.42 USD respectively. The cost of the treatment either fully or partially was borne by the family in most cases (94%. The financial burden of cancer was perceived as significant by 28 (42% patients and unmanageable by 18 (27% patients. This perceived level of burden was associated significantly with average monthly income (p = Conclusion Our study indicates that the financial burden of cancer care is substantial and can be overwhelming. There is a desperate need for treatment support programs either by the government or other welfare organisations to support individuals and families who are already facing a difficult and challenging situation.

  5. Quality of Life in Elderly Cancer Patients Undergoing Chemotherapy.

    Science.gov (United States)

    Lavdaniti, Maria; Zyga, Sofia; Vlachou, Eugenia; Sapountzi-Krepia, Despina

    2017-01-01

    As life expectancy increases, it is expected that 60% of all cases of cancer will be detected in elderly patients in the next two decades. Cancer treatment for older persons is complicated by a number of factors, thus negatively affecting patients' quality of life. The purpose of this study is to investigate quality of life in elderly cancer patients undergoing chemotherapy. This study was descriptive and non-experimental. It was conducted in one large hospital in a major city of Northern Greece. The sample was convenience comprising 53 elderly cancer patients undergoing cycle 3 chemotherapy. The data was collected using the Functional Assessment of Cancer Therapy scale and included questions related to demographic and clinical characteristics. The majority of participants were men (n = 27, 50.9%) who were married (n = 32, 79.5%). Their mean age was 70.07 ± 3.60. Almost half of the sample (n = 30, 56.6%) had colon cancer. There was a statistical significant difference between men and women pertaining to physical wellbeing (p = 0.004) and overall quality of life (p family wellbeing (p = 0.029), functional wellbeing (p = 0.09) and overall quality of life (p family wellbeing (p = 0.029). These findings call attention to quality of life and its related factors in elderly cancer patients. It is highly recommended to envisage measures for improving quality of life in this group of cancer patients.

  6. BRCA2 Mutations in 154 Finnish Male Breast Cancer Patients

    Directory of Open Access Journals (Sweden)

    Kirsi Syrjäkoski

    2004-09-01

    Full Text Available The etiology and pathogenesis of male breast cancer (MBC are poorly known. This is due to the fact that the disease is rare, and large-scale genetic epidemiologic studies have been difficult to carry out. Here, we studied the frequency of eight recurrent Finnish BRCA2 founder mutations in a large cohort of 154 MBC patients (65% diagnosed in Finland from 1967 to 1996. Founder mutations were detected in 10 patients (6.5%, eight of whom carried the 9346(-2 A>G mutation. Two novel mutations (4075 delGT and 5808 del5 were discovered in a screening of the entire BRCA2 coding region in 34 samples. However, these mutations were not found in the rest of the 120 patients studied. Patients with positive family history of breast and/or ovarian cancer were often BRCA2 mutation carriers (44%, whereas those with no family history showed a low frequency of involvement (3.6%; P < .0001. Finally, we found only one Finnish MBC patient with 999 dell, the most common founder mutation in Finnish female breast cancer (FBC patients, and one that explains most of the hereditary FBC and MBC cases in Iceland. The variation in BRCA2 mutation spectrum between Finnish MBC patients and FBC patients in Finland and breast cancer patients in Iceland suggests that modifying genetic and environmental factors may significantly influence the penetrance of MBC and FBC in individuals carrying germline BRCA2 mutations in some populations.

  7. Return to work of cancer patients after a multidisciplinary intervention including occupational counselling and physical exercise in cancer patients: a prospective study in the Netherlands

    NARCIS (Netherlands)

    Leensen, Monique C. J.; Groeneveld, Iris F.; van der Heide, Iris; Rejda, Tomas; van Veldhoven, Peter L. J.; van Berkel, Sietske; Snoek, Aernout; van Harten, Wim; Frings-Dresen, Monique H. W.; de Boer, Angela G. E. M.

    2017-01-01

    Objectives To support return to work (RTW) among cancer patients, a multidisciplinary rehabilitation programme was developed which combined occupational counselling with a supervised physical exercise programme during chemotherapy. The aim was to investigate RTW rates of cancer patients and to

  8. Return to work of cancer patients after a multidisciplinary intervention including occupational counselling and physical exercise in cancer patients : A prospective study in the Netherlands

    NARCIS (Netherlands)

    Leensen, Monique C.J.; Groeneveld, Iris F.; Heide, Iris Van Der; Rejda, Tomas; Van Veldhoven, Peter L.J.; Berkel, Sietske Van; Snoek, Aernout; van Harten, Willem H.; Frings-Dresen, Monique H.W.; Boer, Angela G.E.M.

    2017-01-01

    Objectives To support return to work (RTW) among cancer patients, a multidisciplinary rehabilitation programme was developed which combined occupational counselling with a supervised physical exercise programme during chemotherapy. The aim was to investigate RTW rates of cancer patients and to

  9. Radiation dose and second cancer risk in patients treated for cancer of the cervix

    International Nuclear Information System (INIS)

    Boice, J.D. Jr.; Engholm, G.; Kleinerman, R.A.

    1988-01-01

    The risk of cancer associated with a broad range of organ doses was estimated in an international study of women with cervical cancer. Among 150,000 patients reported to one of 19 population-based cancer registries or treated in any of 20 oncology clinics, 4188 women with second cancers and 6880 matched controls were selected for detailed study. Radiation doses for selected organs were reconstructed for each patient on the basis of her original radiotherapy records. Very high doses, on the order of several hundred gray, were found to increase the risk of cancers of the bladder [relative risk (RR) = 4.0], rectum (RR = 1.8), vagina (RR = 2.7), and possibly bone (RR = 1.3), uterine corpus (RR = 1.3), cecum (RR = 1.5), and non-Hodgkin's lymphoma (RR = 2.5). For all female genital cancers taken together, a sharp dose-response gradient was observed, reaching fivefold for doses more than 150 Gy. Several gray increased the risk of stomach cancer (RR = 2.1) and leukemia (RR = 2.0). Although cancer of the pancreas was elevated, there was no evidence of a dose-dependent risk. Cancer of the kidney was significantly increased among 15-year survivors. A nonsignificant twofold risk of radiogenic thyroid cancer was observed following an average dose of only 0.11 Gy. Breast cancer was not increased overall, despite an average dose of 0.31 Gy and 953 cases available for evaluation (RR = 0.9); there was, however, a weak suggestion of a dose response among women whose ovaries had been surgically removed. Doses greater than 6 Gy to the ovaries reduced breast cancer risk by 44%. A significant deficit of ovarian cancer was observed within 5 years of radiotherapy; in contrast, a dose response was suggested among 10-year survivors

  10. A Patient-Centered Perspective on Cancer Survivorship

    Directory of Open Access Journals (Sweden)

    Brad Zebrack

    2015-04-01

    Full Text Available Survivorship is a complicated notion because people often confuse a process of survivorship with a mythic identity of being a cancer survivor. This confusion may be a distraction to addressing the real-life struggles and challenges experienced by all people diagnosed with cancer. A more expansive perspective of survivorship, one that attends to patients’ physical, psychological, social, spiritual, and existential challenges throughout a continuum of care, would be more in line with what is known empirically about people’s experiences with cancer. In an effort to gain a patient-centered perspective on cancer, and one that emphasizes multiple dimensions of cancer survivorship, the author reports findings from a non-scientific social media poll (via Facebook and personal emails in which survivors and colleagues working in the field of cancer survivorship answered the question: What does cancer survivorship mean to you? The comments are enlightening and useful for guiding the development of a patient-centered, and, thus, more comprehensive, approach to caring for people affected by cancer.

  11. Entacapone and prostate cancer risk in patients with Parkinson's disease.

    Science.gov (United States)

    Korhonen, Pasi; Kuoppamäki, Mikko; Prami, Tuire; Hoti, Fabian; Christopher, Solomon; Ellmén, Juha; Aho, Valtteri; Vahteristo, Mikko; Pukkala, Eero; Haukka, Jari

    2015-04-15

    The association between Parkinson's disease (PD) and prostate cancer, both common in elderly men, is disputable. In the STRIDE-PD study, prostate cancer developed in 9 patients (3.7%) receiving levodopa/carbidopa with entacapone, a catechol-O-methyltransferase inhibitor, versus 2 cases (0.9%) without entacapone. The current pharmacoepidemiological study aimed to determine whether entacapone increases prostate cancer incidence or mortality in PD patients and whether cumulative exposure affects these rates. We performed a retrospective cohort study using population-wide health care registers with patient-level linkage. Prostate cancer incidence and mortality were modeled by Cox's proportional hazards models. Use of entacapone with l-dopa/dopa decarboxylase inhibitor caused no increased risk of prostate cancer incidence (hazard ratio [HR]: 1.05; 95% confidence interval: 0.76-1.44) or mortality (0.93; 0.43-1.98). The HR for cumulative entacapone use of >360 days versus never-use was 0.82 (0.56-1.18) for prostate cancer incidence and 1.27 (0.60-2.72) for prostate cancer mortality. © 2015 International Parkinson and Movement Disorder Society.

  12. Effectiveness of prophylactic percutaneous endoscopic gastrostomy for oropharyngeal cancer patients undergoing concurrent chemoradiotherapy

    International Nuclear Information System (INIS)

    Teshima, Masanori; Tanimoto, Hitoshi; Saito, Miki; Otsuki, Naoki; Sasaki, Ryohei; Kiyota, Naomi; Okuno, Shinya; Nibu, Ken-ichi

    2009-01-01

    Patients with head and neck carcinoma are often provided concurrent chemoradiotherapy (CCRT), but they experience severe mucositis and dysphagia. These side effects can lead to decreased oral intake, resulting in interruption of treatment. In our hospital, from September 2007, all patients with oropharyngeal cancer who were to receive CCRT, were principally offered percutaneous endoscopic gastrostomy (PEG) before the start of treatment, and tube feeding was started when swallowing became impaired, to accomplish the treatment as planned. To evaluate the effect of prophylactic PEG, outcome measures in this study included the frequency of unplanned break from CCRT, nutritional deterioration and required analgesic during CCRT, complication of PEG, and patient satisfaction between 15 patients with PEG and 11 patients without PEG as a control group. Although no significant weight loss occurred in either group, there were fewer patients with a Body Mass Index <18.5 in the PEG group after CCRT than in the control group. Regarding the treatment, most patients were satisfied with their PEG and considered that prophylactic PEG was necessary and helpful in completing the CCRT. This study suggests that prophylactic PEG helps patients to complete CCRT both mentally and nutritionally. (author)

  13. Patient-centered prioritization of bladder cancer research.

    Science.gov (United States)

    Smith, Angela B; Chisolm, Stephanie; Deal, Allison; Spangler, Alejandra; Quale, Diane Z; Bangs, Rick; Jones, J Michael; Gore, John L

    2018-05-04

    Patient-centered research requires the meaningful involvement of patients and caregivers throughout the research process. The objective of this study was to create a process for sustainable engagement for research prioritization within oncology. From December 2014 to 2016, a network of engaged patients for research prioritization was created in partnership with the Bladder Cancer Advocacy Network (BCAN): the BCAN Patient Survey Network (PSN). The PSN leveraged an online bladder cancer community with additional recruitment through print advertisements and social media campaigns. Prioritized research questions were developed through a modified Delphi process and were iterated through multidisciplinary working groups and a repeat survey. In year 1 of the PSN, 354 patients and caregivers responded to the research prioritization survey; the number of responses increased to 1034 in year 2. The majority of respondents had non-muscle-invasive bladder cancer (NMIBC), and the mean time since diagnosis was 5 years. Stakeholder-identified questions for noninvasive, invasive, and metastatic disease were prioritized by the PSN. Free-text questions were sorted with thematic mapping. Several questions submitted by respondents were among the prioritized research questions. A final prioritized list of research questions was disseminated to various funding agencies, and a highly ranked NMIBC research question was included as a priority area in the 2017 Patient-Centered Outcomes Research Institute announcement of pragmatic trial funding. Patient engagement is needed to identify high-priority research questions in oncology. The BCAN PSN provides a successful example of an engagement infrastructure for annual research prioritization in bladder cancer. The creation of an engagement network sets the groundwork for additional phases of engagement, including design, conduct, and dissemination. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

  14. 'Tablet burden' in patients with metastatic breast cancer.

    Science.gov (United States)

    Milic, Marina; Foster, Anna; Rihawi, Karim; Anthoney, Alan; Twelves, Chris

    2016-03-01

    The implications for patients with cancer, of the 'tablet burden' resulting from increasing use of oral anticancer drugs and medication for co-morbidities have not previously been well explored. We sought to (i) quantify tablet burden in women with metastatic breast cancer (MBC), (ii) establish which groups of drug contribute most to this burden and (iii) gain insight into patients' attitudes towards oral anti-cancer treatment. One hundred patients with MBC anonymously completed a questionnaire describing their medication histories and attitudes towards their tablets. The patients (mean age 60, range 31-95) were all female and taking a median of six tablets (range 0-31) daily; 37 patients were taking >10 tablets. Oral anticancer treatment constituted the category of treatment taken by the highest proportion of patients, followed by symptomatic cancer treatments, proton pump inhibitors and cardiovascular medication. Numerically, however, symptomatic drugs accounted for 44% of all tablets and specific anti-cancer treatment for 15%; medication not directly related to the cancer accounted for the remaining 40% of tablets. A quarter of patients reported inconvenience in taking their tablets, the main reason being tablet size and one third reported forgetting their tablets at least once a week. Nearly two thirds of patients expressing a preference favoured oral anticancer treatment, the commonest reason being greater convenience. Tablet burden is considerable for many patients with MBC and can be problematic. A significant proportion of tablets represent treatment for co-morbidities, the significance of which may be questionable in women with MBC. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Where Do Patients With Cancer in Iowa Receive Radiation Therapy?

    Science.gov (United States)

    Ward, Marcia M.; Ullrich, Fred; Matthews, Kevin; Rushton, Gerard; Tracy, Roger; Goldstein, Michael A.; Bajorin, Dean F.; Kosty, Michael P.; Bruinooge, Suanna S.; Hanley, Amy; Jacobson, Geraldine M.; Lynch, Charles F.

    2014-01-01

    Purpose: Multiple studies have shown survival benefits in patients with cancer treated with radiation therapy, but access to treatment facilities has been found to limit its use. This study was undertaken to examine access issues in Iowa and determine a methodology for conducting a similar national analysis. Patients and Methods: All Iowa residents who received radiation therapy regardless of where they were diagnosed or treated were identified through the Iowa Cancer Registry (ICR). Radiation oncologists were identified through the Iowa Physician Information System (IPIS). Radiation facilities were identified through IPIS and classified using the Commission on Cancer accreditation standard. Results: Between 2004 and 2010, 113,885 invasive cancers in 106,603 patients, 28.5% of whom received radiation treatment, were entered in ICR. Mean and median travel times were 25.8 and 20.1 minutes, respectively, to the nearest facility but 42.4 and 29.1 minutes, respectively, to the patient's chosen treatment facility. Multivariable analysis predicting travel time showed significant relationships for disease site, age, residence location, and facility category. Residents of small and isolated rural towns traveled nearly 3× longer than urban residents to receive radiation therapy, as did patients using certain categories of facilities. Conclusion: Half of Iowa patients could reach their nearest facility in 20 minutes, but instead, they traveled 30 minutes on average to receive treatment. The findings identified certain groups of patients with cancer who chose more distant facilities. However, other groups of patients with cancer, namely those residing in rural areas, had less choice, and some had to travel considerably farther to radiation facilities than urban patients. PMID:24443730

  16. Enteral versus parenteral nutrition in cancer patients: evidences and controversies.

    Science.gov (United States)

    Cotogni, Paolo

    2016-01-01

    The debate over the use of enteral nutrition (EN) and parenteral nutrition (PN) is an old but evergreen and hot topic. Since many years, studies comparing EN and PN have been a pivotal 'leitmotif' in the published literature on artificial nutrition (AN). Actually, there is a background misunderstanding in this debate; specifically, that EN and PN are competitors in the choice of the route for delivering nutrition support in cancer patients. Conversely, EN and PN have specific indications and contraindications. This review has the purpose to discuss the indications and complications as well as pros and cons of EN and PN in cancer patients, the crucial role of nutrition support in oncology patients during anticancer treatments and throughout the course of disease, and, finally, the role of AN in advanced cancer patients. In summary, we have no evidence-based data able to definitively indicate the optimal method for delivering AN in cancer patients. EN and PN have to be considered equally effective in maintaining or improving nutritional status in cancer patients. Besides, this review strongly supports the recommendation that a baseline nutritional assessment should be carried out by a healthcare professional expert in AN for all cancer patients at the time of diagnosis or anticancer treatment plan, taking the nutritional status, estimated duration of AN, AN-related potential benefits and possible complications into consideration on an individual basis. Moreover, the patient symptoms, performance status, estimated life expectancy, and mainly, will or preferences have to be evaluated and incorporated into the nutrition support plan before the definitive choice of the route for delivering nutrients is decided. Finally, applying a decision-making process tailored to patient needs-regardless of whether receiving or not anticancer treatment-allows to choose reasonably the optimal nutritional support strategy.

  17. Can quality of life assessments differentiate heterogeneous cancer patients?

    Directory of Open Access Journals (Sweden)

    Ryan M McCabe

    Full Text Available PURPOSE: This research conducted a face validation study of patient responses to the application of an HRQOL assessment research tool in a comprehensive community cancer program setting across a heterogeneous cohort of cancer patients throughout the natural history of diagnosed malignant disease, many of whom would not be considered candidates for clinical research trial participation. METHODS: Cancer registries at two regional cancer treatment centers identified 11072 cancer patients over a period of nine years. The EORTC QLQ-C30 was administered to patients at the time of their initial clinical presentation to these centers. To determine the significance of differences between patient subgroups, two analytic criteria were used. The Mann-Whitney test was used to determine statistical significance; clinical relevance defined a range of point differences that could be perceived by patients with different health states. RESULTS: Univariate analyses were conducted across stratification variables for population, disease severity and demographic characteristics. The largest differences were associated with cancer diagnosis and recurrence of disease. Large differences were also found for site of origin, mortality and stage; minimal differences were observed for gender and age. Consistently sensitive QoL scales were appetite loss, fatigue and pain symptoms, and role (work-related, social and physical functions. CONCLUSIONS: 1 The EORTC QLQ-C30 collected meaningful patient health assessments in the context of non-research based clinical care, 2 patient assessment differences are manifested disparately across 15 QoL domains, and 3 in addition to indicating how a patient may feel at a point in time, QoL indicators may also reveal information about underlying biological responses to disease progression, treatments, and prospective survival.

  18. Patients with Acromegaly Presenting with Colon Cancer: A Case Series

    Directory of Open Access Journals (Sweden)

    Murray B. Gordon

    2016-01-01

    Full Text Available Introduction. Frequent colonoscopy screenings are critical for early diagnosis of colon cancer in patients with acromegaly. Case Presentations. We performed a retrospective analysis of the incidental diagnoses of colon cancer from the ACCESS trial (ClinicalTrials.gov identifier: NCT01995734. Colon cancer was identified in 2 patients (4.5%. Case  1 patient was a 36-year-old male with acromegaly who underwent transsphenoidal surgery to remove the pituitary adenoma. After surgery, the patient underwent routine colonoscopy screening, which revealed a 40 mm tubular adenoma in the descending colon. A T1N1a carcinoma was surgically removed, and 1 of 22 lymph nodes was positive for metastatic disease, leading to a diagnosis of stage 3 colon cancer. Case  2 patient was a 50-year-old male with acromegaly who underwent transsphenoidal surgery to remove a 2 cm pituitary adenoma. The patient reported severe cramping and lower abdominal pain, and an invasive 8.1 cm3 grade 2 adenocarcinoma with signet rings was identified in the ascending colon and removed. Of the 37 lymph nodes, 34 were positive for the presence of tumor cells, and stage 3c colon cancer was confirmed. Conclusion. Current guidelines for colonoscopy screening at the time of diagnosis of acromegaly and at appropriate follow-up intervals should be followed.

  19. Excess mortality after curative surgery for colorectal cancer changes over time and differs for patients with colon versus rectal cancer.

    Science.gov (United States)

    Nedrebø, Bjørn Steinar; Søreide, Kjetil; Eriksen, Morten Tandberg; Kvaløy, Jan Terje; Søreide, Jon Arne; Kørner, Hartwig

    2013-06-01

    Improved management of colorectal cancer patients has resulted in better five-year survival for rectal cancer compared with colon cancer. We compared excess mortality rates in various time intervals after surgery in patients with colon and rectal cancer. We analysed all patients with curative resection of colorectal cancers reported in the Cancer Registry of Norway before (1994-1996) and after (2001-2003) national treatment guidelines were introduced. Excess mortality was analysed in different postoperative time intervals within the five-year follow-up periods for patients treated in 1994-1996 vs. 2001-2003. A total of 11 437 patients that underwent curative resection were included. For patients treated from 1994 to 1996, excess mortality was similar in colon and rectal cancer patients in all time intervals. For those treated from 2001 to 2003, excess mortality was significantly lower in rectal cancer patients than in colon cancer patients perioperatively (in the first 60 days: excess mortality ratio = 0.46, p = 0.007) and during the first two postoperative years (2-12 months: excess mortality ratio = 0.54, p = 0.010; 1-2 years: excess mortality ratio = 0.60, p = 0.009). Excess mortality in rectal cancer patients was significantly greater than in colon cancer patients 4-5 years postoperatively (excess mortality ratio = 2.18, p = 0.003). Excess mortality for colon and rectal cancer changed substantially after the introduction of national treatment guidelines. Short-term excess mortality rates was higher in colon cancer compared to rectal cancer for patients treated in 2001-2003, while excess mortality rates for rectal cancer patients was significantly higher later in the follow-up period. This suggests that future research should focus on these differences of excess mortality in patients curatively treated for cancer of the colon and rectum.

  20. Evaluation of the Quality of Online Information for Patients with Rare Cancers: Thyroid Cancer.

    Science.gov (United States)

    Kuenzel, Ulrike; Monga Sindeu, Tabea; Schroth, Sarah; Huebner, Jutta; Herth, Natalie

    2017-01-24

    The Internet offers an easy and quick access to a vast amount of patient information. However, several studies point to the poor quality of many websites and the resulting hazards of false information. The aim of this study was to assess quality of information on thyroid cancer. A patients' search for information about thyroid cancer on German websites was simulated using the search engine Google and the patient portal "Patienten-Information.de". The websites were assessed using a standardized instrument with formal and content aspects from the German Cancer Society. Supporting the results of prior studies that analysed patient information on the Internet, the data showed that the quality of patient information on thyroid cancer is highly heterogeneous depending on the website providers. The majority of website providers are represented by media and health providers other than health insurances, practices and professionals offering patient information of relatively poor quality. Moreover, most websites offer patient information of low-quality content. Only a few trustworthy, high-quality websites exist. Especially Google, a common search engine, focuses more on the dissemination of information than on quality aspects. In order to improve the patient information from the Internet, the visibility of high-quality websites must be improved. For that, education programs to improve patients' eHealth literacy are needed. A quick and easy evaluation tool for online information suited for patients should be implemented, and patients should be taught to integrate such a tool into their research process.

  1. Doctor-patient communication and cancer patients' quality of life and satisfaction

    NARCIS (Netherlands)

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

    2000-01-01

    In this study, the relationship between (a) doctor's and patients' communication and (b) doctors' patient-centredness during the oncological consultation and patients' quality of life and satisfaction was examined. Consultations of 96 consecutive cancer patients were recorded and content analysed by

  2. Virtual simulation. First clinical results in patients with prostate cancer

    International Nuclear Information System (INIS)

    Buchali, A.; Dinges, S.; Koswig, S.; Rosenthal, P.; Salk, S.; Harder, C.; Schlenger, L.; Budach, V.

    1998-01-01

    Investigation of options of virtual simulation in patients with localized prostate cancer. Twenty-four patients suffering from prostate cancer were virtual simulated. The clinical target volume was contoured and the planning target volume was defined after CT scan. The isocenter of the planning target volume was determined and marked at patient's skin. The precision of patients marking was controlled with conventional simulation after physical radiation treatment planning. Mean differences of the patient's mark revealed between the 2 simulations in all room axes around 1 mm. The organs at risk were visualized in the digital reconstructed radiographs. The precise patient's mark of the isocentre by virtual simulation allows to skip the conventional simulation. The visualisation of organs at risk leeds to an unnecessarity of an application of contrast medium and to a further relieve of the patient. The personal requirement is not higher in virtual simulation than in conventional CT based radiation treatment planning. (orig./MG) [de

  3. Lung cancer symptoms and pulse oximetry in the prognostic assessment of patients with lung cancer

    Directory of Open Access Journals (Sweden)

    Harada Cecilia M

    2005-07-01

    Full Text Available Abstract Background Medical oncologists continue to use performance status as a proxy for quality of life (QOL measures, as completion of QOL instruments is perceived as time consuming, may measure aspects of QOL not affected by cancer therapy, and interpretation may be unclear. The pulse oximeter is widely used in clinical practice to predict cardiopulmonary morbidity after lung resection in cancer patients, but little is known on its role outside the surgical setting. We evaluated whether the Lung Cancer Symptom Scale and pulse oximetry may contribute to the evaluation of lung cancer patients who received standard anticancer therapy. Methods We enrolled forty-one consecutive, newly diagnosed, patients with locally advanced or metastatic lung cancer in this study. We developed a survival model with the variables gender, age, histology, clinical stage, Karnofsky performance status, wasting, LCSS symptom scores, average symptom burden index, and pulse oximetry (SpO2. Results Patient and observer-rated scores were correlated, except for the fatigue subscale. The median SpO2 was 95% (range: 86 to 98, was unrelated to symptom scores, and was weakly correlated with observer cough scores. In a multivariate survival model, SpO2 > 90% and patient scores on the LCSS appetite and fatigue subscales were independent predictors of survival. Conclusion LCSS fatigue and appetite rating, and pulse oximetry should be studied further as prognostic factors in lung cancer patients.

  4. Levels of estrogen, carcinoembryonic antigen and cancer antigen of breast in breast cancer patients

    International Nuclear Information System (INIS)

    Abdelhadi, H. A.

    2005-09-01

    This study was conducted during the period from february 2004 to July 2004; with the objective of measuring the levels of estrogen (E2), carcinoembryonic antigen (CEA) and cancer antigen of breast (CA-15.3) so as to facilitate the early diagnosis of breast cancer and determine the involvement of these parameters as risk factors for breast cancer. Ninety blood samples were collected from Sudanese females, divided into two groups; control group and patient groups. The patients group was sixty Sudanese females visiting the Radio Isotope Center, Khartoum (RICK) and they were confirmed as breast cancer patient by histopathology. The levels of the above mentioned parameters were determined by using radioimmunoassay technique. The results showed that, no significant (p=0.05) difference between the levels of the estrogen in patients compared to the control, on the other hand there was non significant (p>0.05) elevation in CEA levels in the patients with breast cancer compared to the control. The level of CA15.3 was significantly (p<0.0001) higher in the breast cancer patients compared to the control.(Author)

  5. [Nutritional assessment and perioperative nutritional support in gastric cancer patients].

    Science.gov (United States)

    Seo, Kyung Won; Yoon, Ki Young

    2013-04-01

    Weight loss and malnutrition are common in cancer patients. Although weight loss is predominantly due to loss of fat mass, the morbidity risk is given by the decrease in muscle mass. The assessment of nutritional status is essential for a diagnosis of nutritional compromise and required for the multidisciplinary approach. Subjective global assessment (SGA) is made by the patients nutritional symptoms and weight loss. The objective assessment, a significant weight loss (>10%) for 6 months is considered an indicator of nutritional deficiency. The mean body index, body fat mass and body protein mass are decreased as cancer stage increases. The biochemical data of albumin, cholesterol, triglyceride, Zn, transferrin, total lymphocyte count are decreased in advanced cancer stage. Daily energy intake, cabohyderate and Vit B1 intake is decreased according to cancer stage. The patients are divided into three groups according to SGA. The three groups showed a significant difference in body weight, 1 month weight loss%, 6 month weight loss%, body mass index, mid arm circumference, albumin, energy intake, as well as carbohyderate intake protein and energy malnutrition. Nutritional assessment is of great importance because undernutrition has been shown to be associated with increase in stomach cancer associated morbidity and mortality. The authors concluded that nutritional assessment should be done in cancer patients preoperatively, and with adequate nutritional support, the morbidity and mortality would be decreased.

  6. Patients' Awareness Of The Prevention And Treatment Of Colorectal Cancer.

    Science.gov (United States)

    Dziki, Łukasz; Puła, Anna; Stawiski, Konrad; Mudza, Barbara; Włodarczyk, Marcin; Dziki, Adam

    2015-09-01

    The aim of the study was to assess patients' awareness of the prevention and treatment of colorectal cancer. Patients diagnosed with colorectal cancer, hospitalised at the Department of General and Colorectal Surgery of the Medical University in Łódź during the period from January 2015 to April 2015, were asked to complete a questionnaire concerning their families' medical case record, factors predisposing them to the development of colorectal cancer, the tests applied in diagnostics, and the treatment process. The questionnaire comprised 42 closed-ended questions with one correct answer. A statistical analysis of all answers was carried out. The study group consisted of 30 men and 20 women aged 27-94 years old. A strong, statistically significant negative correlation between a patient's age and his/her awareness of the prevention and treatment of colorectal cancer was noted (pcancer (p=0.008), and the awareness of the prevention programme. The women's group was characterised by statistically significantly greater awareness of colonoscopy as a screening examination (p=0.004). Patients need more information on colorectal cancer, its risk factors, prevention, the treatment process, and postoperative care. Lack of awareness of the colorectal cancer issue can be one of the major factors contributing to the high incidence of this disease.

  7. Cancer risk in patients with spondyloarthritis treated with TNF inhibitors

    DEFF Research Database (Denmark)

    Hellgren, Karin; Dreyer, Lene; Arkema, Elizabeth V.

    2017-01-01

    ) patients with SpA initiating a first TNFi 2001-2011. From the Swedish National Patient and Population Registers we assembled a TNFi-naïve SpA cohort (n=28,164) and a Swedish age-matched and sex-matched general population comparator cohort (n=131 687). We identified incident cancers by linkage...... with the nationwide Swedish and Danish Cancer Registers 2001-2011, and calculated age-standardised and sex-standardised incidence ratios as measures of relative risk (RR). Results Based on 1188 cancers among the TNFi-naïve patients with SpA, RR of cancer overall was 1.1 (95% CI 1.0 to 1.2). Based on 147 cancers among......Background Safety data on cancer risks following tumour necrosis factor a inhibitors (TNFi) in patients with spondyloarthritis (SpA) (here defined as ankylosing spondylitis (AS), undifferentiated spondarthropaties (SpA UNS), psoriatic arthritis (PsA)) are scarce. Our objective was to assess risks...

  8. Internet Use for Prediagnosis Symptom Appraisal by Colorectal Cancer Patients

    Science.gov (United States)

    Thomson, Maria D.; Siminoff, Laura A.; Longo, Daniel R.

    2012-01-01

    Background: This study explored the characteristics of colorectal cancer (CRC) patients who accessed Internet-based health information as part of their symptom appraisal process prior to consulting a health care provider. Method: Newly diagnosed CRC patients who experienced symptoms prior to diagnosis were interviewed. Brief COPE was used to…

  9. a survey on drug related problems in cervical cancer patients

    African Journals Online (AJOL)

    userpc

    Cisplatin/5FU/paclitaxel. 6. 9.23. 6. Seizure. Cisplatin. 2. 3.08. 7. Loss of hair. Cisplatin/5FU/Paclitaxel. 3. 4.62. 8. Nephrotoxicity. Cisplatin. 3. 4.62. 9. Hypotension. Paclitaxel. 3. 4.62. TOTAL. 65. 100. Table 3: Relationship between cervical cancer patients' factors and DRPs. Patients Factor. Drug Related Problems (DRPs).

  10. Patients' reports of barriers to expressing concerns during cancer consultations.

    Science.gov (United States)

    Brandes, Kim; Linn, Annemiek J; Smit, Edith G; van Weert, Julia C M

    2015-03-01

    To identify cancer patients' most influential barriers to expressing concerns during cancer consultations in a new manner by examining patients' reports of perceived barriers and perceived occurrence of barriers in consultations. Two online focus groups (N=16) and an online survey (N=236) were conducted among cancer patients and cancer survivors. The online focus groups and survey were used to examine two elements of patients' barriers, i.e., patients' reports of perceived barriers and perceived occurrence of barriers in consultations. Composite scores of these two elements were calculated to determine influential barriers. Results showed that the most influential barriers were related to providers' behavior (e.g., providers do not explicitly invite patients to express concerns) and the environment where the consultation takes place (e.g., perceived lack of time). The results of this study indicate that influential barriers to expressing concerns are barriers that patients cannot overcome themselves (i.e., they are related to providers' behavior or the environment of the consultation). A collaborative approach between researchers, providers and policy makers is needed to overcome these barriers. The results of this study can be used to develop strategies to overcome barriers to patients expressing concerns. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Glomerular filtration rate profiles in paediatric patients on cancer ...

    African Journals Online (AJOL)

    Subjects: Paediatric patients who had an established diagnosis of cancer and had been on chemotherapy for at least six months. Results: Out of the 115 children enrolled in the study 43 had abnormal kidney function. This gave a prevalence of 37% (95%CI 28-46).The other 72 children had normal kidney function. Patients ...

  12. Exercise effects on mood in breast cancer patients

    African Journals Online (AJOL)

    of exercise been recognised as beneficial to psychological well-being. Cancer patients ... to augment patients' quality of life, both physically and psychologically. One precaution .... include pharmacotherapy and psychotherapeutic interventions. For many .... feelings of satisfaction and led to appraisals of less depression and.

  13. Guidance for laboratories performing molecular pathology for cancer patients

    NARCIS (Netherlands)

    Cree, Ian A.; Deans, Zandra; Ligtenberg, Marjolijn J. L.; Normanno, Nicola; Edsjo, Anders; Rouleau, Etienne; Sole, Francesc; Thunnissen, Erik; Timens, Wim; Schuuring, Ed; Dequeker, Elisabeth; Murray, Samuel; Dietel, Manfred; Groenen, Patricia; Van Krieken, J. Han

    2014-01-01

    Molecular testing is becoming an important part of the diagnosis of any patient with cancer. The challenge to laboratories is to meet this need, using reliable methods and processes to ensure that patients receive a timely and accurate report on which their treatment will be based. The aim of this

  14. Prognosis and Survival in patients with Colorectal Cancer

    NARCIS (Netherlands)

    van Schaik, P.M.

    2012-01-01

    The aim of this thesis was to investigate the outcome after colorectal surgery and to try to find possible ways to improve staging and treatment, especially in patients with stage I and II colonic cancer. The first part of this thesis describes the outcome and quality of life in patients with

  15. Guidance for laboratories performing molecular pathology for cancer patients

    NARCIS (Netherlands)

    Cree, Ian A.; Deans, Zandra; Ligtenberg, Marjolijn J. L.; Normanno, Nicola; Edsjo, Anders; Rouleau, Etienne; Sole, Francesc; Thunnissen, Erik; Timens, Wim; Schuuring, Ed; Dequeker, Elisabeth; Murray, Samuel; Dietel, Manfred; Groenen, Patricia; Van Krieken, J. Han

    Molecular testing is becoming an important part of the diagnosis of any patient with cancer. The challenge to laboratories is to meet this need, using reliable methods and processes to ensure that patients receive a timely and accurate report on which their treatment will be based. The aim of this

  16. Prevalence of delirium among patients at a cancer ward

    DEFF Research Database (Denmark)

    Grandahl, Mia Gall; Nielsen, Svend Erik; Kørner, Ejnar Alex

    2016-01-01

    Drawing Test, and the Digit Span Test can be used as screening tools for delirium among inpatients with cancer, but even in synergy, they lack specificity. Combining cognitive testing and attention to nurses' records might improve detection, yet further studies are needed to create a more detailed patient...... Method (CAM) were used for diagnostic categorization. Clinical information was gathered from medical records and all patients were tested with Mini Cognitive Test, The Clock Drawing Test, and the Digit Span Test. Results 81 cancer patients were assessed and 33% were diagnosed with delirium. All delirious...

  17. [Risk and protection of fertility in male cancer patients].

    Science.gov (United States)

    Dong, Gan; Xiu, Zi-Chao; Wang, Pei-Tao; Wang, Xin-Sheng

    2017-03-01

    Gonad damage is one of the major complications of chemotherapy, radiotherapy or surgery in male cancer patients. For those who wish for childbearing after treatment, it is of great significance how to protect the reproductive function of the cancer patients. The main strategy for fertility protection is to optimize the treatment protocol, hormone therapy, antioxidant therapy, and the preservation of sperm and testicular tissue. This article presents an overview on the pathogenesis of gonadal damage induced by different treatments and protection of the reproductive function of the patient.

  18. Quality of care in cancer: An exploration of patient perspectives

    Directory of Open Access Journals (Sweden)

    Sandeep Mahapatra

    2016-01-01

    Full Text Available Introduction: Patient satisfaction is as important as is the care itself. When the patient has a disease like cancer it becomes even more important. A cancer patient not only suffers from the disease but also undergoes substantial mental trauma, agony, stress, uncertainty, and apprehension. There are limited studies in India eliciting patient's views on the quality of care being received by cancer patients. Methodology: A cross-sectional triangulation data transformation model mixed method design (Quant + Qual was used to conduct the study between March and May 2015 among patients attending specialty hospitals providing oncology services in Odisha, India. The quantitative data were collected using, Patient Satisfaction Questionnaire-18 to assess satisfaction. The qualitative data were obtained through in-depth interviews using open-ended questionnaire. Results: The results showed that general satisfaction among the patients was 60%. The maximum score was obtained for the communication of doctors. The qualitative findings revealed that travel for distant places for minor illness, waiting period, and lack of services at the primary care facilities were reasons for patient's dissatisfaction. Conclusion: The study found that the patients were generally satisfied with the quality of services. However, more studies should be conducted including perceptions of the patients as well as the caregiver.

  19. Anxiety and depression in patients with gastrointestinal cancer: does knowledge of cancer diagnosis matter?

    Science.gov (United States)

    Tavoli, Azadeh; Mohagheghi, Mohammad Ali; Montazeri, Ali; Roshan, Rasool; Tavoli, Zahra; Omidvari, Sepideh

    2007-07-14

    Gastrointestinal cancer is the first leading cause of cancer related deaths in men and the second among women in Iran. An investigation was carried out to examine anxiety and depression in this group of patients and to investigate whether the knowledge of cancer diagnosis affect their psychological distress. This was a cross sectional study of anxiety and depression in patients with gastrointestinal cancer attending to the Tehran Cancer Institute. Anxiety and depression was measured using the Hospital Anxiety and Depression Scale (HADS). This is a widely used valid questionnaire to measure psychological distress in cancer patients. Demographic and clinical data also were collected to examine anxiety and depression in sub-group of patients especially in those who knew their cancer diagnosis and those who did not. In all 142 patients were studied. The mean age of patients was 54.1 (SD = 14.8), 56% were male, 52% did not know their cancer diagnosis, and their diagnosis was related to esophagus (29%), stomach (30%), small intestine (3%), colon (22%) and rectum (16%). The mean anxiety score was 7.6 (SD = 4.5) and for the depression this was 8.4 (SD = 3.8). Overall 47.2% and 57% of patients scored high on both anxiety and depression. There were no significant differences between gender, educational level, marital status, cancer site and anxiety and depression scores whereas those who knew their diagnosis showed a significant higher degree of psychological distress [mean (SD) anxiety score: knew diagnosis 9.1 (4.2) vs. 6.3 (4.4) did not know diagnosis, P < 0.001; mean (SD) depression score: knew diagnosis 9.1 (4.1) vs. 7.9 (3.6) did not know diagnosis, P = 0.05]. Performing logistic regression analysis while controlling for demographic and clinical variables studied the results indicated that those who knew their cancer diagnosis showed a significant higher risk of anxiety [OR: 2.7, 95% CI: 1.1-6.8] and depression [OR: 2.8, 95% CI: 1.1-7.2]. Psychological distress was

  20. Nutrition support and dietary interventions for patients with lung cancer: current insights

    OpenAIRE

    Kiss, Nicole

    2016-01-01

    Nicole Kiss1,2 1Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia; 2Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia Abstract: Malnutrition and weight loss are prevalent in patients with lung cancer. The impact of malnutrition on patients with cancer, and specifically in patients with lung cancer, has been demonstrated in a large number of studies. Malnutrition has been shown to neg...