[Strategies for improving care of oncologic patients: SHARE Project results].

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Reñones Crego, María de la Concepción; Fernández Pérez, Dolores; Vena Fernández, Carmen; Zamudio Sánchez, Antonio

2016-01-01

Cancer treatment is a major burden for the patient and its family that requires an individualized management by healthcare professionals. Nurses are in charge of coordinating care and are the closest healthcare professionals to patient and family; however, in Spain, there are not standard protocols yet for the management of oncology patients. The Spanish Oncology Nursing Society developed between 2012 and 2014 the SHARE project, with the aim of establishing strategies to improve quality of life and nursing care in oncology patients. It was developed in 3 phases. First, a literature search and review was performed to identify nursing strategies, interventions and tools to improve cancer patients' care. At the second stage, these interventions were agreed within a group of oncology nursing experts; and at the third phase, a different group of experts in oncology care categorized the interventions to identify the ones with highest priority and most feasible to be implemented. As a result, 3 strategic actions were identified to improve nursing care during cancer treatment: To provide a named nurse to carry out the follow up process by attending to the clinic or telephonic consultation, develop therapeutic education with adapted protocols for each tumor type and treatment and ensure specific training for nurses on the management of the cancer patients. Strategic actions proposed in this paper aim to improve cancer patients' healthcare and quality of life through the development of advanced nursing roles based on a higher level of autonomy, situating nurses as care coordinators to assure an holistic care in oncology patients. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Pediatric psycho-oncology care: standards, guidelines, and consensus reports.

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Wiener, Lori; Viola, Adrienne; Koretski, Julia; Perper, Emily Diana; Patenaude, Andrea Farkas

2015-02-01

The aim of this study was to identify existing guidelines, standards, or consensus-based reports for psychosocial care of children with cancer and their families. Psychosocial standards of care for children with cancer can systematize the approach to care and create a replicable model that can be utilized in pediatric hospitals around the world. Determining gaps in existing standards in pediatric psycho-oncology can guide development of useful evidence-based and consensus-based standards. The MEDLINE and PubMed databases were searched by investigators at two major pediatric oncology centers for existing guidelines, consensus-based reports, or standards for psychosocial care of patients with pediatric cancer and their families published in peer-reviewed journals in English between 1980 and 2013. We located 27 articles about psychosocial care that met inclusion criteria: 5 set forth standards, 19 were guidelines, and 3 were consensus-based reports. None was sufficiently up to date, comprehensive, specific enough, or evidence- or consensus-based to serve as a current standard for psychosocial care for children with cancer and their families. Despite calls by a number of international pediatric oncology and psycho-oncology professional organizations about the urgency of addressing the psychosocial needs of the child with cancer to reduce suffering, there remains a need for development of a widely acceptable, evidence-based and consensus-based, comprehensive standard of care to guide provision of essential psychosocial services to all patients with pediatric cancer. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

The Role of the Advanced Practice Nurse in Geriatric Oncology Care.

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Morgan, Brianna; Tarbi, Elise

2016-02-01

To describe how the Advanced Practice Nurse (APN) is uniquely suited to meet the needs of older adults throughout the continuum of cancer, to explore the progress that APNs have made in gero-oncology care, and make suggestions for future directions. Google Scholar, PubMed, and CINAHL. Search terms included: "gero-oncology," "geriatric oncology," "Advanced Practice Nurse," "Nurse Practitioner," "older adult," "elderly," and "cancer." Over the last decade, APNs have made advances in caring for older adults with cancer by playing a role in prevention, screening, and diagnosis; through evidence-based gero-oncology care during cancer treatment; and in designing tailored survivorship care models. APNs must combat ageism in treatment choice for older adults, standardize comprehensive geriatric assessments, and focus on providing person-centered care, specifically during care transitions. APNs are well-positioned to help understand the complex relationship between risk factors, geriatric syndromes, and frailty and translate research into practice. Palliative care must expand beyond specialty providers and shift toward APNs with a focus on early advanced care planning. Finally, APNs should continue to establish multidisciplinary survivorship models across care settings, with a focus on primary care. Copyright © 2015 Elsevier Inc. All rights reserved.

Toward a Broader Role for Occupational Therapy in Supportive Oncology Care

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Duker, Leah I. Stein

2016-01-01

Supportive care in oncology helps people cope with cancer and its psychological, physical, and emotional side effects. However, cancer survivors report dissatisfaction with supportive care and a need for more psychosocial and self-management services. Occupational therapy practitioners represent an integral part of the supportive care team because their scope of practice emphasizes function. Through a focus on function, practitioners address the full spectrum of physical and psychosocial care. Currently, conceptualizations of occupational therapy for cancer survivors often focus solely on physical interventions and, therefore, do not represent the unique involvement of the profession in supportive oncology care. We advocate for a focused framework for occupational therapy practitioners in oncology as experts in function and providers of both physical and psychosocial treatments. Barriers to a focus on function are identified, and strategies are suggested for expanding involvement for the profession in supportive oncology care. PMID:27295001

Cancer Care and Control as a Human Right: Recognizing Global Oncology as an Academic Field.

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Eniu, Alexandru E; Martei, Yehoda M; Trimble, Edward L; Shulman, Lawrence N

2017-01-01

The global burden of cancer incidence and mortality is on the rise. There are major differences in cancer fatality rates due to profound disparities in the burden and resource allocation for cancer care and control in developed compared with developing countries. The right to cancer care and control should be a human right accessible to all patients with cancer, regardless of geographic or economic region, to avoid unnecessary deaths and suffering from cancer. National cancer planning should include an integrated approach that incorporates a continuum of education, prevention, cancer diagnostics, treatment, survivorship, and palliative care. Global oncology as an academic field should offer the knowledge and skills needed to efficiently assess situations and work on solutions, in close partnership. We need medical oncologists, surgical oncologists, pediatric oncologists, gynecologic oncologists, radiologists, and pathologists trained to think about well-tailored resource-stratified solutions to cancer care in the developing world. Moreover, the multidisciplinary fundamental team approach needed to treat most neoplastic diseases requires coordinated investment in several areas. Current innovative approaches have relied on partnerships between academic institutions in developed countries and local governments and ministries of health in developing countries to provide the expertise needed to implement effective cancer control programs. Global oncology is a viable and necessary field that needs to be emphasized because of its critical role in proposing not only solutions in developing countries, but also solutions that can be applied to similar challenges of access to cancer care and control faced by underserved populations in developed countries.

Spiritual well-being among outpatients with cancer receiving concurrent oncologic and palliative care.

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Rabow, Michael W; Knish, Sarah J

2015-04-01

Spiritual well-being is threatened by cancer, but its correlation with other illness symptoms and the efficacy of palliative care (PC) to ameliorate spiritual suffering are not well understood. We conducted a retrospective study using a convenience sample of oncology patients at a comprehensive cancer center who received concurrent oncologic and palliative care between 2008 and 2011 and completed ESAS, QUAL-E, and Steinhauser Spiritual well-being survey questions was conducted. Descriptive, correlation, and t test statistics. Eight hundred eighty-three patients surveyed had an average age of 65.6 years, with 54.1 % female, 69.3 % white, and 49.3 % married. Half (452, 51.2 %) had metastatic disease. Religious affiliation was reported as Christian by 20.3 %, Catholic by 18.7 %, and "none" by 39.0 %. Baseline spiritual well-being was not significantly correlated with age, gender, race, cancer stage, marital status, insurance provider, or having a religious affiliation. Greater spiritual well-being was correlated with greater quality of life (well-being (spiritual well-being and anxiety, depression, fatigue, and quality of life (R (2) = 0.677). Spiritual well-being improved comparing mean scores immediately prior to initial PC consultation with those at first follow-up (2.89 vs. 3.23 on a 1-5 scale, p = 0.005). Among patients with cancer receiving concurrent oncologic and palliative care, spiritual well-being was not associated with patient age, gender, or race, or disease stage. It was correlated with physical and emotional symptoms. Spiritual well-being scores improved from just prior to the initial PC consultation to just prior to the first PC follow-up visit.

Toward a Broader Role for Occupational Therapy in Supportive Oncology Care.

Science.gov (United States)

Sleight, Alix G; Duker, Leah I Stein

2016-01-01

Supportive care in oncology helps people cope with cancer and its psychological, physical, and emotional side effects. However, cancer survivors report dissatisfaction with supportive care and a need for more psychosocial and self-management services. Occupational therapy practitioners represent an integral part of the supportive care team because their scope of practice emphasizes function. Through a focus on function, practitioners address the full spectrum of physical and psychosocial care. Currently, conceptualizations of occupational therapy for cancer survivors often focus solely on physical interventions and, therefore, do not represent the unique involvement of the profession in supportive oncology care. We advocate for a focused framework for occupational therapy practitioners in oncology as experts in function and providers of both physical and psychosocial treatments. Barriers to a focus on function are identified, and strategies are suggested for expanding involvement for the profession in supportive oncology care. Copyright © 2016 by the American Occupational Therapy Association, Inc.

Breast cancer patients' presentation for oncological treatment: a single centre study.

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Akinkuolie, Akinbolaji Andrew; Etonyeaku, Amarachukwu Chiduziem; Olasehinde, Olalekan; Arowolo, Olukayode Adeolu; Babalola, Rereloluwa Nicodemus

2016-01-01

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. Prospective observational hospital based study that enrolled breast cancer patients from catchment area of an oncology service hospital in Nigeria between 2007 and 2013. Patients' demographics, breast cancer burden and health care giver presentation variables were analysed for causal factors of seeking medical help and what determines commencement of effective oncological treatment. Forty-six patients were enrolled, 19.6% of them presented primarily to oncologist while 80.4% presented secondarily for oncological treatment. There is a significant difference in presentation time for oncological treatment (t = -3.56, df = 42.90, p = 0.001) between primary (M =11.56 ± 5.21 weeks) and secondary presentation (M= 52.56 ± 10.27weeks). Tumor burden of those that presented secondarily were significantly more advanced (U = 78.5, p = 0.011) and, univariate analysis reveals that: patients' matrimonial setting, breast cancer awareness and mode of discovery of breast symptoms are patient related factors that determines their choice of health care providers and, determinant of effective oncological treatment is patient first contact health care provider. Patients' bio-characteristics that determine their choice of health care provider should be incorporated into community breast cancer sensitization drives. Additionally, there is a need for a government agency assign the task of accrediting and defining scope of enterprise of health care institutions and their health care providers in our pluralist health system.

Breast cancer patients’ presentation for oncological treatment: a single centre study

Science.gov (United States)

Akinkuolie, Akinbolaji Andrew; Etonyeaku, Amarachukwu Chiduziem; Olasehinde, Olalekan; Arowolo, Olukayode Adeolu; Babalola, Rereloluwa Nicodemus

2016-01-01

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 patients from catchment area of an oncology service hospital in Nigeria between 2007 and 2013. Patients’ demographics, breast cancer burden and health care giver presentation variables were analysed for causal factors of seeking medical help and what determines commencement of effective oncological treatment. Results Forty-six patients were enrolled, 19.6% of them presented primarily to oncologist while 80.4% presented secondarily for oncological treatment. There is a significant difference in presentation time for oncological treatment (t = -3.56, df = 42.90, p = 0.001) between primary (M =11.56 ± 5.21 weeks) and secondary presentation (M= 52.56 ± 10.27weeks). Tumor burden of those that presented secondarily were significantly more advanced (U = 78.5, p = 0.011) and, univariate analysis reveals that: patients’ matrimonial setting, breast cancer awareness and mode of discovery of breast symptoms are patient related factors that determines their choice of health care providers and, determinant of effective oncological treatment is patient first contact health care provider. Conclusion Patients’ bio-characteristics that determine their choice of health care provider should be incorporated into community breast cancer sensitization drives. Additionally, there is a need for a government agency assign the task of accrediting and defining scope of enterprise of health care institutions and their health care providers in our pluralist health system. PMID:27642404

Accessibility, Availability, and Potential Benefits of Psycho-Oncology Services: The Perspective of Community-Based Physicians Providing Cancer Survivorship Care.

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Zimmermann-Schlegel, Verena; Hartmann, Mechthild; Sklenarova, Halina; Herzog, Wolfgang; Haun, Markus W

2017-06-01

As persons of trust, community-based physicians providing survivorship care (e.g., general practitioners [GPs]) often serve as the primary contacts for cancer survivors disclosing distress. From the perspective of physicians providing survivorship care for cancer patients, this study explores (a) the accessibility, availability, and potential benefits of psycho-oncology services; (b) whether physicians themselves provide psychosocial support; and (c) predictors for impeded referrals of survivors to services. In a cross-sectional survey, all GPs and community-based specialists in a defined region were interviewed. In addition to descriptive analyses, categorical data were investigated by applying chi-square tests. Predictors for impeded referrals were explored through logistic regression. Of 683 responding physicians, the vast majority stated that survivors benefit from psycho-oncology services (96.8%), but the physicians also articulated that insufficient coverage of psycho-oncology services (90.9%) was often accompanied by impeded referrals (77.7%). A substantial proportion (14.9%) of physicians did not offer any psychosocial support. The odds of physicians in rural areas reporting impeded referrals were 1.91 times greater than the odds of physicians in large urban areas making a similar report (95% confidence interval [1.07, 3.40]). Most community-based physicians providing survivorship care regard psycho-oncology services as highly beneficial. However, a large number of physicians report tremendous difficulty referring patients. Focusing on those physicians not providing any psychosocial support, health policy approaches should specifically (a) raise awareness of the role of physicians as persons of trust for survivors, (b) highlight the effectiveness of psycho-oncology services, and (c) encourage a proactive attitude toward the assessment of unmet needs and the initiation of comprehensive care. Community-based physicians providing survivorship care for cancer

Oncology Advanced Practitioners Bring Advanced Community Oncology Care.

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Vogel, Wendy H

2016-01-01

Oncology care is becoming increasingly complex. The interprofessional team concept of care is necessary to meet projected oncology professional shortages, as well as to provide superior oncology care. The oncology advanced practitioner (AP) is a licensed health care professional who has completed advanced training in nursing or pharmacy or has completed training as a physician assistant. Oncology APs increase practice productivity and efficiency. Proven to be cost effective, APs may perform varied roles in an oncology practice. Integrating an AP into an oncology practice requires forethought given to the type of collaborative model desired, role expectations, scheduling, training, and mentoring.

Predictors of Timely Access of Oncology Services and Advanced-Stage Cancer in an HIV-Endemic Setting.

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Brown, Carolyn A; Suneja, Gita; Tapela, Neo; Mapes, Abigail; Pusoentsi, Malebogo; Mmalane, Mompati; Hodgeman, Ryan; Boyer, Matthew; Musimar, Zola; Ramogola-Masire, Doreen; Grover, Surbhi; Nsingo-Bvochora, Memory; Kayembe, Mukendi; Efstathiou, Jason; Lockman, Shahin; Dryden-Peterson, Scott

2016-06-01

Three-quarters of cancer deaths occur in resource-limited countries, and delayed presentation contributes to poor outcome. In Botswana, where more than half of cancers arise in HIV-infected individuals, we sought to explore predictors of timely oncology care and evaluate the hypothesis that engagement in longitudinal HIV care improves access. Consenting patients presenting for oncology care from October 2010 to September 2014 were interviewed and their records were reviewed. Cox and logistic models were used to examine the effect of HIV and other predictors on time to oncology care and presentation with advanced cancer (stage III or IV). Of the 1,146 patients analyzed, 584 (51%) had HIV and 615 (54%) had advanced cancer. The initial clinic visit occurred a mean of 144 days (median 29, interquartile range 0-185) after symptom onset, but subsequent mean time to oncology care was 406 days (median 160, interquartile range 59-653). HIV status was not significantly associated with time to oncology care (adjusted hazard ratio [aHR] 0.91, 95% confidence interval [CI] 0.79-1.06). However, patients who reported using traditional medicine/healers engaged in oncology care significantly faster (aHR 1.23, 95% CI 1.09-1.40) and those with advanced cancer entered care earlier (aHR 1.48, 95% CI 1.30-1.70). Factors significantly associated with advanced cancer included income oncology care was 13 months. For HIV-infected patients (51% of total), regular longitudinal contact with the health system, through quarterly doctor visits for HIV management, was not successful in providing faster linkages into oncology care. However, patients who used traditional medicine/healers engaged in cancer care faster, indicating potential for leveraging traditional healers as partners in early cancer detection. New strategies are urgently needed to facilitate diagnosis and timely treatment of cancer in low- and middle-income countries. ©AlphaMed Press.

Oncological sensitivity. Report of the training conducted for primary health care physicians in the Holycross Cancer Center

Directory of Open Access Journals (Sweden)

Ewa Błaszkiewicz

2016-04-01

Full Text Available The aim of this report is to describe the series of training sessions for primary health care (PHC physicians that concerned “oncological sensitivity” and were organized in the Holycross Cancer Center (HCC in the first quarter of 2015. The purpose of the training sessions was to present the guidelines of the oncological fast-track system and the practical information with respect to disturbing symptoms of the disease and the necessary diagnostics directed at verifying the suspicion of various types of cancer. This knowledge allows the proper implementation of the tasks entrusted to the family doctor as part of the Oncological Package. Practical training (medical was conducted by specialists working in several different clinics within the Holycross Cancer Center. The theme of the meetings covered all types of cancer, from solid tumors of various locations to tumors of the hematopoietic system.

Oncology nursing: Finding the balance in a changing health care system.

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Bakker, Debra; Fitch, Margaret I; Green, Esther; Butler, Lorna; Olson, Karin

2006-01-01

Health care restructuring has resulted in significant changes in the workload and work environment for oncology nurses. While recent studies describe the impact of these changes on the general nursing workforce in several countries, there have been no published studies that have focused on worklife issues of Canadian oncology nurses. Therefore, a qualitative study was conducted to gain insight about how oncology nursing has changed over the past decade and how Canadian oncology nurses are managing these changes. Analysis of telephone interviews with 51 practising oncology nurses employed across Canada revealed three major themes. The first theme, "health care milieu", portrayed a picture of the cancer care environment and patient and professional changes that occurred over the past decade. The second theme, "conflicting demands", reflects how the elements of change and social forces have challenged professional oncology nursing practice. The third theme, "finding the way", describes the patterns of behaviour that nurses used to manage the changing health care environment and make meaning out of nurses' work in cancer care. Overall, the findings portray a picture of Canadian oncology nurses in "survival mode". They face many workplace challenges, but are able to keep going "for now" because they find ways to balance their responsibilities on a daily basis and because they know and believe that their specialized nursing knowledge and skills make a difference in patient care.

Patient-centered care in cancer treatment programs: the future of integrative oncology through psychoeducation.

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Garchinski, Christina M; DiBiase, Ann-Marie; Wong, Raimond K; Sagar, Stephen M

2014-12-01

The reciprocal relationship between the mind and body has been a neglected process for improving the psychosocial care of cancer patients. Emotions form an important link between the mind and body. They play a fundamental role in the cognitive functions of decision-making and symptom control. Recognizing this relationship is important for integrative oncology. We define psychoeducation as the teaching of self-evaluation and self-regulation of the mind-body process. A gap exists between research evidence and implementation into clinical practice. The patients' search for self-empowerment through the pursuit of complementary therapies may be a surrogate for inadequate psychoeducation. Integrative oncology programs should implement psychoeducation that helps patients to improve both emotional and cognitive intelligence, enabling them to better negotiate cancer treatment systems.

Is emotional dissonance more prevalent in oncology care? Emotion work, burnout and coping.

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Kovács, Mariann; Kovács, Eszter; Hegedus, Katalin

2010-08-01

Emotional burden on oncology care workers is considerable. These workers develop confidential relationship with the patient through interpersonal communication, which entails managing their own emotions as well as the emotions displayed by their patients, and it involves a great deal of emotion work. The objectives in our study were to assess the prevalence of burnout and emotional dissonance and to investigate the interrelationship among burnout, emotion work and coping in oncology care. A cross-sectional survey with anonymous questionnaires was conducted among oncology health care workers (N = 48) and non-oncology health care workers (N = 151). The comparison revealed differences primarily in emotion work and coping. Emotional dissonance as stress factor was more prevalent among oncology health care workers. Caregivers dealing with cancer patients felt that they have to display negative emotions less frequently, yet at the same time they frequently have to show understanding and express sympathy to the patient. When certain coping strategies were examined, we found that humour as potential resource in coping is used less frequently among oncology health care workers. In order to devise effective interventions to oncology personnel, we need to focus on the interaction between the carer and the cancer patient and have more evidence on emotional dissonance in oncology staff. (c) 2009 John Wiley & Sons, Ltd.

Lessons learned from the science of caring: Extending the reach of psychosocial oncology: The International Psycho-Oncology Society 2016 Sutherland Award Lecture.

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Bultz, Barry D

2017-06-01

In medicine, referral to a medical oncology specialty is based on recent history, physical examination, pathology, surgery reports, imaging, blood work, and the patient's vital signs. By contrast, referral to a psychosocial specialist has typically been based on the patients expressed request for psychosocial support or the health care team's observation of the patient's limited adjustment or poor coping with the diagnosis, treatment, or end-of-life distress. These observations are usually based on clinical acumen not on metrics. In psychosocial oncology, by committing to the science of caring and relying on the use of standardized tools to screen for distress, the multidisciplinary cancer care team assess, communicate, and intervene on what is measured. That is, health care providers can begin to address the patients' identified concerns. Branding distress as the 6th vital sign and incorporating screening for distress into standard cancer practice can be an effective strategy to challenging the resistance in implementation of psychosocial oncology in cancer care institutions. Accreditation agencies are endorsing the need to assess patient distress and better manage symptoms of distress as part of routine and standardized patient care. While many international organizations and societies support the importance of screening, implementing screening for distress still has a long way to go to be operationalized in many cancer care programs. Screening for distress when implemented does, however, create an opportunity for psychosocial oncology to extend its reach into cancer care programs and institutions. Copyright © 2017 John Wiley & Sons, Ltd.

The third Symptom Management Research Trial in Oncology (SMaRT Oncology-3: a randomised trial to determine the efficacy of adding a complex intervention for major depressive disorder (Depression Care for People with Lung Cancer to usual care, compared to usual care alone in patients with lung cancer

Directory of Open Access Journals (Sweden)

Sharpe Michael

2009-09-01

Full Text Available Abstract Background Depression Care for People with Lung Cancer is a complex intervention delivered by specially trained cancer nurses, under the supervision of a psychiatrist. It is given as a supplement to the usual care for depression, which patients receive from their general practitioner and cancer service. The third Symptom Management Research Trial in Oncology (SMaRT Oncology-3 Trial will test its efficacy when compared to usual care alone. Design A two arm parallel group multi-centre randomised controlled trial. 200 patients will be recruited through established systematic Symptom Monitoring Services, which screen patients for depression. Patients will have: a diagnosis of lung cancer; an estimated life expectancy of three months or more and a diagnosis of Major Depressive Disorder. Patients will be randomised to usual care or usual care plus Depression Care for People with Lung Cancer. Randomisation will be carried out by telephoning a secure computerised central randomisation system or by using a secure web interface. The primary outcome measure is average depression severity. This will be assessed using scores on the 20-item Symptom Hopkins Checklist (SCL-20D, collected every four weeks over 32 weeks. Secondary outcomes include severity of anxiety, pain and fatigue; self-rated improvement of depression; quality of life and satisfaction with depression care. Trial Registration Current controlled trials ISRCTN75905964

Effects of a sexual health care nursing record on the attitudes and practice of oncology nurses.

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Jung, Dukyoo; Kim, Jung-Hee

2016-10-01

A nursing record focused on sexual health care for patients with cancer could encourage oncology nurses to provide sexual health care for oncology patients in a simple and effective manner. However, existing electronic information systems focus on professional use and not sexual health care, which could lead to inefficiencies in clinical practice. To examine the effects of a sexual health care nursing record on the attitudes and practice of oncology nurses. Twenty-four full-time registered nurses caring for oncology patients were randomly assigned to the intervention and control groups in Korea. The researchers developed a sexual health care record and applied it to the intervention group for one month. Data were analyzed by Mann-Whitney U test and chi-square test. Content analysis was used to analyze interviews. Oncology nurses using the sexual health care record had significantly higher levels of sexual health care practice at 4 weeks post-intervention as compared to those who provided usual care to patients with cancer. A sexual health care record may have the potential to facilitate oncology nurses' practice of sexual health care. This study highlighted the importance of using SHC records with oncology patients to improve nursing practice related to sexuality issues. A nursing record focused on SHC for patients with cancer could make it easier and more effective for oncology nurses to provide such care to their patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Don't neglect cultural diversity in oncology care.

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Muñoz-Antonia, Teresita

2014-05-01

The growing Hispanic population in the United States mandates the need for oncology providers to become more familiar with disease patterns and cultural belief systems that can impact cancer care. "Culturally competent care" should be the mandate of all providers. This comprises awareness of cultural differences, communication in a manner that the patient understands, and respect. Copyright © 2014 by the National Comprehensive Cancer Network.

Psycho-oncology: structure and profiles of European centers treating patients with gynecological cancer.

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Hasenburg, Annette; Amant, Frederic; Aerts, Leen; Pascal, Astrid; Achimas-Cadariu, Patriciu; Kesic, Vesna

2011-12-01

Psycho-oncological counseling should be an integrated part of modern cancer therapy. The aim of this study was to assess the structures and interests of psycho-oncology services within European Society of Gynecological Oncology (ESGO) centers. In 2010, a survey, which consisted of 15 questions regarding organization of psycho-oncological services and interests in training and research, was sent to all ESGO-accredited centers (n = 41). The response rate was 65.8% (27 centers). 96.3% (n = 26) of the surveys came from universities, and 3.7% (n = 1) came from nonacademic institutions. Most of the institutions (92.6%, n = 25) offer psycho-oncological care, mainly by psychologists (64%, n = 16) or psycho-oncologists (48%, n = 12). Fifty-two percent of patients are evaluated for sexual dysfunction as sequelae of their disease or treatment-related adverse effects. Fifty-two percent (n = 14) of institutions offer psychological support for cancer care providers. Eighty-five percent (n = 23) of all centers are interested in psycho-oncological training, and the preferred teaching tools are educational workshops (87%). The main issues of interest are sexual problems in patients with cancer, communication and interpersonal skills, responses of patients and their families, anxiety and adjustment disorders, and palliative care. Eighty-five percent (n = 17) of the 20 institutions look for research in the field of psycho-oncology, and 55% (n = 11) of those are already involved in some kind of research. Although psycho-oncological care is provided in most of the consulted ESGO accredited centers, almost 50% of women lack information about sexual problems. The results of the survey show the need for and interest in psycho-oncology training and research, including sexual dysfunction. Furthermore, psychological support should be offered to all cancer care providers.

Communication and integration: a qualitative analysis of perspectives among Middle Eastern oncology healthcare professionals on the integration of complementary medicine in supportive cancer care.

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Ben-Arye, Eran; Popper-Giveon, Ariela; Samuels, Noah; Mutafoglu, Kamer; Schiff, Elad; Omran, Suha; Charalambous, Haris; Dweikat, Tahani; Ghrayeb, Ibtisam; Turker, Ibrahim; Hassan, Azza; Hassan, Esmat; Nimri, Omar; Kebudi, Rejin; Silbermann, Michael

2016-05-01

The use of complementary and traditional medicine (CTM ) in Middle Eastern countries is widespread, including among patients with cancer. Perspectives of oncology healthcare professionals (HCPs) in this region regarding the integration of CTM within conventional supportive cancer care were explored. An 11-item questionnaire with an open-ended question asking respondents to comment about the integration of CTM within supportive cancer care was sent to Middle Eastern oncology HCPs, using snowball sampling methodology. The narratives provided were examined using thematic analysis. A total of 339 oncology HCPs completed and returned the study tool (80.3 % response rate ), of which 178 from 15 Middle Eastern countries responded to the open-ended question. The majority of respondents are in favor of the integration of CTM within supportive cancer care, though ideas on how this should be implemented varied. Thematic analysis identified multifactorial barriers to integration, which focused on HCPs' perspectives (e.g., a lack of knowledge and training; a skeptical approach to CTM), attitudes of patients and caregivers (e.g., unrealistic expectations regarding the outcomes of CTM treatments) and HCP-patient communication. In order to overcome these barriers, respondents suggested education and training programs for oncology HCPs which would focus on improving patients' quality-of-life-related outcomes. Middle Eastern oncology HCPs support the integration of CTM within supportive cancer care, while recognizing the need for education and training in this field. A better understanding of CTM would provide the knowledge and skills which would promote a non-judgmental, evidence-based approach, fostering better communication with patients.

Defining High-Quality Palliative Care in Oncology Practice: An American Society of Clinical Oncology/American Academy of Hospice and Palliative Medicine Guidance Statement.

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Bickel, Kathleen E; McNiff, Kristen; Buss, Mary K; Kamal, Arif; Lupu, Dale; Abernethy, Amy P; Broder, Michael S; Shapiro, Charles L; Acheson, Anupama Kurup; Malin, Jennifer; Evans, Tracey; Krzyzanowska, Monika K

2016-09-01

Integrated into routine oncology care, palliative care can improve symptom burden, quality of life, and patient and caregiver satisfaction. However, not all oncology practices have access to specialist palliative medicine. This project endeavored to define what constitutes high-quality primary palliative care as delivered by medical oncology practices. An expert steering committee outlined 966 palliative care service items, in nine domains, each describing a candidate element of primary palliative care delivery for patients with advanced cancer or high symptom burden. Using modified Delphi methodology, 31 multidisciplinary panelists rated each service item on three constructs: importance, feasibility, and scope within medical oncology practice. Panelists endorsed the highest proportion of palliative care service items in the domains of End-of-Life Care (81%); Communication and Shared Decision Making (79%); and Advance Care Planning (78%). The lowest proportions were in Spiritual and Cultural Assessment and Management (35%) and Psychosocial Assessment and Management (39%). In the largest domain, Symptom Assessment and Management, there was consensus that all symptoms should be assessed and managed at a basic level, with more comprehensive management for common symptoms such as nausea, vomiting, diarrhea, dyspnea, and pain. Within the Appropriate Palliative Care and Hospice Referral domain, there was consensus that oncology practices should be able to describe the difference between palliative care and hospice to patients and refer patients appropriately. This statement describes the elements comprising high-quality primary palliative care for patients with advanced cancer or high symptom burden, as delivered by oncology practices. Oncology providers wishing to enhance palliative care delivery may find this information useful to inform operational changes and quality improvement efforts. Copyright © 2016 by American Society of Clinical Oncology.

Nuclear oncology: From genotype to patient care

International Nuclear Information System (INIS)

1997-01-01

Nuclear medicine is the medical specialty best suited to translate the exploding body of knowledge obtained from research in genetics and molecular biology into the care of patients. This fourth annual nuclear oncology conference will address how this can be done and how positron emission tomography (PET) and single photon emission tomography (SPECT) can be used in the care of patients with cancer or with increased genetic risk of developing cancer. The course will include illustrative patient studies showing how PET and SPECT can help in diagnosis, staging and treatment planning and monitoring of patients with cancer

Addressing Burnout in Oncology: Why Cancer Care Clinicians Are At Risk, What Individuals Can Do, and How Organizations Can Respond.

Science.gov (United States)

Hlubocky, Fay J; Back, Anthony L; Shanafelt, Tait D

2016-01-01

Despite their benevolent care of others, today, more than ever, the cancer care professional who experiences overwhelming feelings of exhaustion, cynicism, and inefficacy is in grave jeopardy of developing burnout. Clinicians are repeatedly physically and emotionally exposed to exceedingly long hours in direct care with seriously ill patients/families, limited autonomy over daily responsibilities, endless electronic documentation, and a shifting medical landscape. The physical and emotional well-being of the cancer care clinician is critical to the impact on quality care, patient satisfaction, and overall success of their organizations. The prevention of burnout as well as targeting established burnout need to be proactively addressed at the individual level and organizational level. In fact, confronting burnout and promoting wellness are the shared responsibility of both oncology clinicians and their organizations. From an individual perspective, oncology clinicians must be empowered to play a crucial role in enhancing their own wellness by identification of burnout symptoms in both themselves and their colleagues, learning resilience strategies (e.g., mindful self-compassion), and cultivating positive relationships with fellow clinician colleagues. At the organizational level, leadership must recognize the importance of oncology clinician well-being; engage leaders and physicians in collaborative action planning, improve overall practice environment, and provide institutional wellness resources to physicians. These effective individual and organizational interventions are crucial for the prevention and improvement of overall clinician wellness and must be widely and systematically integrated into oncology care.

The state of survivorship care in radiation oncology: Results from a nationally distributed survey.

Science.gov (United States)

Frick, Melissa A; Rosenthal, Seth A; Vapiwala, Neha; Monzon, Brian T; Berman, Abigail T

2018-04-18

Survivorship care has become an increasingly critical component of oncologic care as well as a quality practice and reimbursement metric. To the authors' knowledge, the current climate of survivorship medicine in radiation oncology has not been investigated fully. An institutional review board-approved, Internet-based survey examining practices and preparedness in survivorship care was distributed to radiation oncology practices participating in the American College of Radiology Radiation Oncology Practice Accreditation program between November 2016 and January 2017. A total of 78 surveys were completed. Among these, 2 were nonphysicians, resulting in 76 evaluable responses. Radiation oncologists (ROs) frequently reported that they are the primary provider in the evaluation of late toxicities and the recurrence of primary cancer. Although approximately 68% of ROs frequently discuss plans for future care with survivors, few provide a written survivorship care plan to their patients (18%) or the patients' primary care providers (24%). Patient prognosis, disease site, and reimbursement factors often influence the provision of survivorship care. Although ROs report that several platforms offer training in survivorship medicine, the quality of these resources is variable and extensive instruction is rare. Fewer than one-half of ROs believe they are expertly trained in survivorship care. ROs play an active role within the multidisciplinary team in the cancer-related follow-up care of survivors. Investigation of barriers to the provision of survivorship care and optimization of service delivery should be pursued further. The development of high-quality, easily accessible educational programming is needed so that ROs can participate more effectively in the care of cancer survivors. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

Current status of medical oncology in Japan--reality gleaned from a questionnaire sent to designated cancer care hospitals.

Science.gov (United States)

Takiguchi, Yuichi; Sekine, Ikuo; Iwasawa, Shunichiro; Kurimoto, Ryota; Sakaida, Emiko; Tamura, Kenji

2014-07-01

Medical oncology in Japan has a relatively short history, with specialist certification starting in 2006, resulting in 867 certified medical oncologists as of 2014. Although the national government has appointed 397 Designated Cancer Care Hospitals, little is known about the actual situations of medical oncology services at these institutions. Questionnaires regarding the presence of a medical oncology department, the number of physicians in the department, the presence of certified medical oncologists and the degree of the medical oncologists' responsibilities for drug therapies in adults with solid cancers were sent to all 397 institutions between 21 January and 1 May 2013. The response rate was 68.0%. Among the responses, 39.4% of the institutions had medical oncology departments with a median of three physicians. Most of the medical oncology departments were primarily responsible, as evaluated according to patient number, for the treatment of limited disease categories. The medical oncologists were significantly more responsible for molecular-targeted therapy than for chemotherapy in head and neck cancer or for cytokine therapy in renal cell carcinoma. The wide variety of adverse events associated with molecular-targeted therapy might have enhanced the roles of medical oncologists. As the proportion of hospitals with a medical oncology department increased according to the number of certified medical oncologists working at the institution, cultivating medical oncologists seems to be an urgent task for advancing medical oncology in Japan. The present study provides fundamental data for the future development of medical oncology in Japan. The present study is to uncover the current situation of medical oncology in Japan. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Oncology Education in Medical Schools: Towards an Approach that Reflects Australia's Health Care Needs.

Science.gov (United States)

McRae, Robert J

2016-12-01

Cancer has recently overtaken heart disease to become the number 1 cause of mortality both globally and in Australia. As such, adequate oncology education must be an integral component of medical school if students are to achieve learning outcomes that meet the needs of the population. The aim of this review is to evaluate the current state of undergraduate oncology education and identify how Australian medical schools can improve oncology learning outcomes for students and, by derivative, improve healthcare outcomes for Australians with cancer. The review shows that oncology is generally not well represented in medical school curricula, that few medical schools offer mandatory oncology or palliative care rotations, and that junior doctors are exhibiting declining oncology knowledge and skills. To address these issues, Australian medical schools should implement the Oncology Education Committee's Ideal Oncology Curriculum, enact mandatory oncology and palliative care clinical rotations for students, and in doing so, appreciate the importance of students' differing approaches to learning.

Supportive care in radiation oncology

International Nuclear Information System (INIS)

Rotman, M.; John, M.

1987-01-01

The radiation therapist, concerned with the disease process and all the technical intricacies of treatment, has usually not been involved in managing the supportive aspects of caring for the patient. Yet, of the team of medical specialists and allied health personnel required in oncology, the radiation therapist is the one most responsible for overseeing the total care of the cancer patient. At times this might include emotional support, prevention and correction of tissue dysfunction, augmentation of nutrition, metabolic and electrolyte regulation, rehabilitation, and vocational support. This chapter is a brief overview of a considerable volume of literature that has occupied the interest of a rather small group of physicians, nutritionists, and psychologists. The discussion highlights the special management problems of the normal-tissue effects of radiation, the related nutritional aspects of cancer care, and certain emotional and pathologic considerations

Potential risks associated with traditional herbal medicine use in cancer care: A study of Middle Eastern oncology health care professionals.

Science.gov (United States)

Ben-Arye, Eran; Samuels, Noah; Goldstein, Lee Hilary; Mutafoglu, Kamer; Omran, Suha; Schiff, Elad; Charalambous, Haris; Dweikat, Tahani; Ghrayeb, Ibtisam; Bar-Sela, Gil; Turker, Ibrahim; Hassan, Azza; Hassan, Esmat; Saad, Bashar; Nimri, Omar; Kebudi, Rejin; Silbermann, Michael

2016-02-15

The authors assessed the use of herbal medicine by Middle Eastern patients with cancer, as reported by their oncology health care professionals (HCPs). Herbal products identified by the study HCPs were evaluated for potential negative effects. Oncology HCPs from 16 Middle Eastern countries received a 17-item questionnaire asking them to list 5 herbal products in use by their patients with cancer. A literature search (PubMed, Micromedex, AltMedDex, and the Natural Medicine Comprehensive Database) was conducted to identify safety-related concerns associated with the products listed. A total of 339 HCPs completed the study questionnaire (response rate of 80.3%), identifying 44 herbal and 3 nonherbal nutritional supplements. Safety-related concerns were associated with 29 products, including herb-drug interactions with altered pharmacodynamics (15 herbs), direct toxic effects (18 herbs), and increased in vitro response of cancer cells to chemotherapy (7 herbs). Herbal medicine use, which is prevalent in Middle Eastern countries, has several potentially negative effects that include direct toxic effects, negative interactions with anticancer drugs, and increased chemosensitivity of cancer cells, requiring a reduction in dose-density. Oncology HCPs working in countries in which herbal medicine use is prevalent need to better understand the implications of this practice. The presence of integrative physicians with training in complementary and traditional medicine can help patients and their HCPs reach an informed decision regarding the safety and effective use of these products. © 2015 American Cancer Society.

Social Media Use in Cancer Care.

Science.gov (United States)

Watson, Joni

2018-05-01

To describe the increasing professional use of social media within oncology health care practice. Peer-reviewed and lay publications. Social media has changed the communication landscape over the last 15 years. An integral part of worldwide culture, oncology health care professionals can utilize social media to listen, learn, engage, and co-create to advance cancer care. Nurses must be aware of the professional uses for social media, how to use the media, and where to find evidence supporting health care social media efforts within cancer care. Copyright © 2018 Elsevier Inc. All rights reserved.

Use of a Shared Mental Model by a Team Composed of Oncology, Palliative Care, and Supportive Care Clinicians to Facilitate Shared Decision Making in a Patient With Advanced Cancer.

Science.gov (United States)

D'Ambruoso, Sarah F; Coscarelli, Anne; Hurvitz, Sara; Wenger, Neil; Coniglio, David; Donaldson, Dusty; Pietras, Christopher; Walling, Anne M

2016-11-01

Our case describes the efforts of team members drawn from oncology, palliative care, supportive care, and primary care to assist a woman with advanced cancer in accepting care for her psychosocial distress, integrating prognostic information so that she could share in decisions about treatment planning, involving family in her care, and ultimately transitioning to hospice. Team members in our setting included a medical oncologist, oncology nurse practitioner, palliative care nurse practitioner, oncology social worker, and primary care physician. The core members were the patient and her sister. Our team grew organically as a result of patient need and, in doing so, operationalized an explicitly shared understanding of care priorities. We refer to this shared understanding as a shared mental model for care delivery, which enabled our team to jointly set priorities for care through a series of warm handoffs enabled by the team's close proximity within the same clinic. When care providers outside our integrated team became involved in the case, significant communication gaps exposed the difficulty in extending our shared mental model outside the integrated team framework, leading to inefficiencies in care. Integration of this shared understanding for care and close proximity of team members proved to be key components in facilitating treatment of our patient's burdensome cancer-related distress so that she could more effectively participate in treatment decision making that reflected her goals of care.

Site of childhood cancer care in the Netherlands.

Science.gov (United States)

Reedijk, A M J; van der Heiden-van der Loo, M; Visser, O; Karim-Kos, H E; Lieverst, J A; de Ridder-Sluiter, J G; Coebergh, J W W; Kremer, L C; Pieters, R

2017-12-01

Due to the complexity of diagnosis and treatment, care for children and young adolescents with cancer preferably occurs in specialised paediatric oncology centres with potentially better cure rates and minimal late effects. This study assessed where children with cancer in the Netherlands were treated since 2004. All patients aged under 18 diagnosed with cancer between 2004 and 2013 were selected from the Netherlands Cancer Registry (NCR) and linked with the Dutch Childhood Oncology Group (DCOG) database. Associations between patient and tumour characteristics and site of care were tested statistically with logistic regression analyses. This population-based study of 6021 children diagnosed with cancer showed that 82% of them were treated in a paediatric oncology centre. Ninety-four percent of the patients under 10 years of age, 85% of the patients aged 10-14 and 48% of the patients aged 15-17 were treated in a paediatric oncology centre. All International Classification of Childhood Cancers (ICCC), 3rd edition, ICCC-3 categories, except embryonal tumours, were associated with a higher risk of treatment outside a paediatric oncology centre compared to leukaemia. Multivariable analyses by ICCC-3 category revealed that specific tumour types such as chronic myelogenous leukaemia (CML), embryonal carcinomas, bone tumours other type than osteosarcoma, non-rhabdomyosarcomas, thyroid carcinomas, melanomas and skin carcinomas as well as lower-staged tumours were associated with treatment outside a paediatric oncology centre. The site of childhood cancer care in the Netherlands depends on the age of the cancer patient, type of tumour and stage at diagnosis. Collaboration between paediatric oncology centre(s), other academic units is needed to ensure most up-to-date paediatric cancer care for childhood cancer patients at the short and long term. Copyright © 2017 Elsevier Ltd. All rights reserved.

European Society of Gynaecological Oncology (ESGO) Guidelines for Ovarian Cancer Surgery

NARCIS (Netherlands)

Querleu, Denis; Planchamp, Francois; Chiva, Luis; Fotopoulou, Christina; Barton, Desmond; Cibula, David; Aletti, Giovanni; Carinelli, Silvestro; Creutzberg, Carien; Davidson, Ben; Harter, Philip; Lundvall, Lene; Marth, Christian; Morice, Philippe; Rafii, Arash; Ray-Coquard, Isabelle; Rockall, Andrea; Sessa, Christiana; van der Zee, Ate; Vergote, Ignace; duBois, Andreas

Objective The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecological cancers across Europe. Methods The European Society of Gynaecological Oncology

Oncology Nurses' Attitudes Toward the Edmonton Symptom Assessment System: Results From a Large Cancer Care Ontario Study.

Science.gov (United States)

Green, Esther; Yuen, Dora; Chasen, Martin; Amernic, Heidi; Shabestari, Omid; Brundage, Michael; Krzyzanowska, Monika K; Klinger, Christopher; Ismail, Zahra; Pereira, José

2017-01-01

To examine oncology nurses' attitudes toward and reported use of the Edmonton Symptom Assessment System (ESAS) and to determine whether the length of work experience and presence of oncology certification are associated with their attitudes and reported usage.
. Exploratory, mixed-methods study employing a questionnaire approach.
. 14 regional cancer centers (RCCs) in Ontario, Canada.
. Oncology nurses who took part in a larger province-wide study that surveyed 960 interdisciplinary providers in oncology care settings at all of Ontario's 14 RCCs.
. Oncology nurses' attitudes and use of ESAS were measured using a 21-item investigator-developed questionnaire. Descriptive statistics and Kendall's tau-b or tau-c test were used for data analyses. Qualitative responses were analyzed using content analysis.
. Attitudes toward and self-reported use of standardized symptom screening and ESAS.
. More than half of the participants agreed that ESAS improves symptom screening, most said they would encourage their patients to complete ESAS, and most felt that managing symptoms is within their scope of practice and clinical responsibilities. Qualitative comments provided additional information elucidating the quantitative responses. Statistical analyses revealed that oncology nurses who have 10 years or less of work experience were more likely to agree that the use of standardized, valid instruments to screen for and assess symptoms should be considered best practice, ESAS improves symptom screening, and ESAS enables them to better manage patients' symptoms. No statistically significant difference was found between oncology-certified RNs and noncertified RNs on attitudes or reported use of ESAS.
. Implementing a population-based symptom screening approach is a major undertaking. The current study found that oncology nurses recognize the value of standardized screening, as demonstrated by their attitudes toward ESAS.
. Oncology nurses are integral to providing high

[NEURO-ONCOLOGY A NEW FIELD IN DAVIDOFF CANCER CENTER AT RABIN MEDICAL CENTER].

Science.gov (United States)

Yust-Katz, Shlomit; Limon, Dror; Abu-Shkara, Ramez; Siegal, Tali

2017-08-01

Neuro-oncology is a subspecialty attracting physicians from medical disciplines such as neurology, neurosurgery, pediatrics, oncology, and radiotherapy. It deals with diagnosis and management of primary brain tumors, as well as metastatic and non-metastatic neurological manifestations that frequently affect cancer patients including brain metastases, paraneoplastic syndromes and neurological complications of cancer treatment. A neuro-oncology unit was established in Davidoff Cancer Center at Rabin Medical Center. It provides a multidisciplinary team approach for management of brain tumors and services, such as expert outpatient clinics and inpatient consultations for the departments of oncology, hematology, bone marrow transplantation and other departments in the Rabin Medical Center. In addition, expert consultation is frequently provided to other hospitals that treat cancer patients with neurological manifestations. The medical disciplines that closely collaborate for the daily management of neuro-oncology patients include radiotherapy, hematology, oncology, neuro-surgery, neuro-radiology and neuro-pathology. The neuro-oncology center is also involved in clinical and laboratory research conducted in collaboration with researchers in Israel and abroad. The new service contributes substantially to the improved care of cancer patients and to the advance of research topics in the field of neuro-oncology.

The second Symptom Management Research Trial in Oncology (SMaRT Oncology-2): a randomised trial to determine the effectiveness and cost-effectiveness of adding a complex intervention for major depressive disorder to usual care for cancer patients.

Science.gov (United States)

Walker, Jane; Cassidy, Jim; Sharpe, Michael

2009-03-30

Depression Care for People with Cancer is a complex intervention delivered by specially trained cancer nurses, under the supervision of a psychiatrist. It is given as a supplement to the usual care for depression, which patients receive from their general practitioner and cancer service. In a 'proof of concept' trial (Symptom Management Research Trials in Oncology-1) Depression Care for People with Cancer improved depression more than usual care alone. The second Symptom Management Research Trial in Oncology (SMaRT Oncology-2 Trial) will test its effectiveness and cost-effectiveness in a 'real world' setting. A two arm parallel group multi-centre randomised controlled trial. TRIAL PROCEDURES: 500 patients will be recruited through established systematic Symptom Monitoring Services, which screen patients for depression. Patients will have: a diagnosis of cancer (of various types); an estimated life expectancy of twelve months or more and a diagnosis of Major Depressive Disorder. Patients will be randomised to usual care or usual care plus Depression Care for People with Cancer. Randomisation will be carried out by telephoning a secure computerised central randomisation system or by using a secure web interface. The primary outcome measure is 'treatment response' measured at 24 week outcome data collection. 'Treatment response' will be defined as a reduction of 50% or more in the patient's baseline depression score, measured using the 20-item Symptom Checklist (SCL-20D). Secondary outcomes include remission of major depressive disorder, depression severity and patients' self-rated improvement of depression. Current controlled trials ISRCTN40568538 TRIAL HYPOTHESES: (1) Depression Care for People with Cancer as a supplement to usual care will be more effective than usual care alone in achieving a 50% reduction in baseline SCL-20D score at 24 weeks. (2) Depression Care for People with Cancer as a supplement to usual care will cost more than usual care alone but will be

European Society of Gynaecological Oncology Guidelines for the Management of Patients With Vulvar Cancer

DEFF Research Database (Denmark)

Oonk, Maaike H M; Planchamp, François; Baldwin, Peter

2017-01-01

OBJECTIVE: The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. METHODS: The European Society of Gynaecological...... Oncology Council nominated an international development group made of practicing clinicians who provide care to patients with vulvar cancer and have demonstrated leadership and interest in the management of patients with vulvar cancer (18 experts across Europe). To ensure that the statements are evidence...

Palliative Oncologic Care Curricula for Providers in Resource-Limited and Underserved Communities: a Systematic Review.

Science.gov (United States)

Xu, Melody J; Su, David; Deboer, Rebecca; Garcia, Michael; Tahir, Peggy; Anderson, Wendy; Kinderman, Anne; Braunstein, Steve; Sherertz, Tracy

2017-12-20

Familiarity with principles of palliative care, supportive care, and palliative oncological treatment is essential for providers caring for cancer patients, though this may be challenging in global communities where resources are limited. Herein, we describe the scope of literature on palliative oncological care curricula for providers in resource-limited settings. A systematic literature review was conducted using PubMed, Embase, Cochrane Library, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Med Ed Portal databases, and gray literature. All available prospective cohort studies, case reports, and narratives published up to July 2017 were eligible for review. Fourteen articles were identified and referenced palliative care education programs in Argentina, Uganda, Kenya, Australia, Germany, the USA, or multiple countries. The most common teaching strategy was lecture-based, followed by mentorship and experiential learning involving role play and simulation. Education topics included core principles of palliative care, pain and symptom management, and communication skills. Two programs included additional topics specific to the underserved or American Indian/Alaskan Native community. Only one program discussed supportive cancer care, and no program reported educational content on resource-stratified decision-making for palliative oncological treatment. Five programs reported positive participant satisfaction, and three programs described objective metrics of increased educational or research activity. There is scant literature on effective curricula for providers treating cancer patients in resource-limited settings. Emphasizing supportive cancer care and palliative oncologic treatments may help address gaps in education; increased outcome reporting may help define the impact of palliative care curriculum within resource-limited communities.

Pushing boundaries-culture-sensitive care in oncology and palliative care: a qualitative study.

Science.gov (United States)

Schrank, Beate; Rumpold, Tamara; Amering, Michaela; Masel, Eva Katharina; Watzke, Herbert; Schur, Sophie

2017-06-01

In increasingly globalized societies, patient-centered cancer care requires culture-sensitive approaches in order to ensure patients well-being. While migrant patients' needs are frequently reported in the literature, staff members' perception of work with migrant patients, associated challenges, or individual work approaches are largely unknown. This study addresses this research gap through qualitative exploration of experiences of multicultural health care professionals in supportive oncology and palliative care, working with patients from different cultural backgrounds. This study aims to understand staff experience of the impact of culture on cancer care. This study was conducted at the Medical University of Vienna, including staff from different settings of oncology and palliative care, in different professional positions, and with a range of individual migration backgrounds. Semistructured interviews were conducted with 21 staff members working with patients from different cultural backgrounds. Interviews explored views on the impact of culture on care were audio-taped, transcribed, and analyzed using a rigorous method of thematic analysis, enhanced with grounded theory techniques. Interviews revealed 4 key topics: culture-specific differences, assumed reasons for differences, consequences of multicultural care, and tools for culture-sensitive care. Strategies to better deal with migrant patients and their families were suggested to improve work satisfaction amongst staff. This study identifies relevant staff challenges in work with migrant patients. Concrete suggestions for improvement include measures on an organizational level, team level, and personal tools. The suggested measures are applicable to improve work satisfaction and culture-sensitive care not only in cancer care but also in other areas of medicine. Copyright © 2016 John Wiley & Sons, Ltd.

Balancing research interests and patient interests: a qualitative study into the intertwinement of care and research in paediatric oncology.

Science.gov (United States)

Dekking, Sara A S; van der Graaf, Rieke; Kars, Marijke C; Beishuizen, Auke; de Vries, Martine C; van Delden, Johannes J M

2015-05-01

Traditionally, in ethical guidelines and in research ethics literature, care and research are clearly separated based on their different objectives. In contrast, in paediatric oncology, research and care are closely combined. Currently, it is unknown how relevant actors in paediatric oncology perceive this combination of research and care. We conducted a qualitative study into the experiences of those involved in Dutch paediatric oncology with the intertwinement of research and care and the dual role of paediatric oncologists as researchers and treating physicians. A qualitative study approach, using two focus groups and 19 semi-structured, in-depth interviews with paediatric oncologists, research coordinators, parents of children with cancer, and adolescents with cancer. Four themes characterize how actors experience the intertwinement of research and care in paediatric oncology. First, research is considered of major importance, and paediatric oncology professionals convey this message to patients and their parents. Second, there is ambiguity about categorization of studies into cancer therapy as either research or treatment. Third, role conflicts appear within the work of the paediatric oncologists. Finally, the various benefits of combining treatment with research are emphasized. Research is regarded as a fundamental and indispensable characteristic of paediatric oncology practice. Paediatric oncology professionals, parents, and patients have a very positive outlook on combining research and care, but they may not be sufficiently critical with respect to potential conflicts. Increased reflection on how to optimally combine research and care could serve as an important protection of the interests of children with cancer and their parents. © 2015 Wiley Periodicals, Inc.

American Society of Clinical Oncology Policy Statement Update: Genetic and Genomic Testing for Cancer Susceptibility.

Science.gov (United States)

Robson, Mark E; Bradbury, Angela R; Arun, Banu; Domchek, Susan M; Ford, James M; Hampel, Heather L; Lipkin, Stephen M; Syngal, Sapna; Wollins, Dana S; Lindor, Noralane M

2015-11-01

The American Society of Clinical Oncology (ASCO) has long affirmed that the recognition and management of individuals with an inherited susceptibility to cancer are core elements of oncology care. ASCO released its first statement on genetic testing in 1996 and updated that statement in 2003 and 2010 in response to developments in the field. In 2014, the Cancer Prevention and Ethics Committees of ASCO commissioned another update to reflect the impact of advances in this area on oncology practice. In particular, there was an interest in addressing the opportunities and challenges arising from the application of massively parallel sequencing-also known as next-generation sequencing-to cancer susceptibility testing. This technology introduces a new level of complexity into the practice of cancer risk assessment and management, requiring renewed effort on the part of ASCO to ensure that those providing care to patients with cancer receive the necessary education to use this new technology in the most effective, beneficial manner. The purpose of this statement is to explore the challenges of new and emerging technologies in cancer genetics and provide recommendations to ensure their optimal deployment in oncology practice. Specifically, the statement makes recommendations in the following areas: germline implications of somatic mutation profiling, multigene panel testing for cancer susceptibility, quality assurance in genetic testing, education of oncology professionals, and access to cancer genetic services. © 2015 by American Society of Clinical Oncology.

78 FR 25304 - Siemens Medical Solutions, USA, Inc., Oncology Care Systems (Radiation Oncology), Including On...

Science.gov (United States)

2013-04-30

..., USA, Inc., Oncology Care Systems (Radiation Oncology), Including On-Site Leased Workers From Source... Medical Solutions, USA, Inc., Oncology Care Systems (Radiation Oncology), including on- site leased... of February 2013, Siemens Medical Solutions, USA, Inc., Oncology Care Systems (Radiation Oncology...

The current and future role of the medical oncologist in the professional care for cancer patients: a position paper by the European Society for Medical Oncology (ESMO).

Science.gov (United States)

Popescu, R A; Schäfer, R; Califano, R; Eckert, R; Coleman, R; Douillard, J-Y; Cervantes, A; Casali, P G; Sessa, C; Van Cutsem, E; de Vries, E; Pavlidis, N; Fumasoli, K; Wörmann, B; Samonigg, H; Cascinu, S; Cruz Hernández, J J; Howard, A J; Ciardiello, F; Stahel, R A; Piccart, M

2014-01-01

The number of cancer patients in Europe is rising and significant advances in basic and applied cancer research are making the provision of optimal care more challenging. The concept of cancer as a systemic, highly heterogeneous and complex disease has increased the awareness that quality cancer care should be provided by a multidisciplinary team (MDT) of highly qualified healthcare professionals. Cancer patients also have the right to benefit from medical progress by receiving optimal treatment from adequately trained and highly skilled medical professionals. Built on the highest standards of professional training and continuing medical education, medical oncology is recognised as an independent medical specialty in many European countries. Medical oncology is a core member of the MDT and offers cancer patients a comprehensive and systemic approach to treatment and care, while ensuring evidence-based, safe and cost-effective use of cancer drugs and preserving the quality of life of cancer patients through the entire 'cancer journey'. Medical oncologists are also engaged in clinical and translational research to promote innovation and new therapies and they contribute to cancer diagnosis, prevention and research, making a difference for patients in a dynamic, stimulating professional environment. Medical oncologists play an important role in shaping the future of healthcare through innovation and are also actively involved at the political level to ensure a maximum contribution of the profession to Society and to tackle future challenges. This position paper summarises the multifarious and vital contributions of medical oncology and medical oncologists to today's and tomorrow's professional cancer care.

Cancer patients and oncology nursing: Perspectives of oncology nurses in Turkey.

Science.gov (United States)

Kamisli, S; Yuce, D; Karakilic, B; Kilickap, S; Hayran, M

2017-09-01

Burnout and exhaustion is a frequent problem in oncology nursing. The aim of this study is to evaluate the aspects of oncology nurses about their profession in order to enhance the standards of oncology nursing. This survey was conducted with 70 oncology nurses working at Hacettepe University Oncology Hospital. Data were collected between January-April 2012. Each participant provided a study form comprising questions about sociodemographic information; about difficulties, positive aspects and required skills for oncology nursing; and questions evaluating level of participation and clinical perception of oncology nursing. Mean age of nurses was 29.9 ± 5.7 years. More than half of the participants were married (51.4%) and 30% had at least one child. Percent of nurses working in oncology for their entire work life was 75.8%. Most frequently expressed difficulties were exhaustion (58.6%), coping with the psychological problems of the patients (25.7%), and frequent deaths (24.3%); positive aspects were satisfaction (37.1%), changing the perceptions about life (30%), and empathy (14.3%); and required skills were patience (60%), empathy (57.1%), and experience (50%). For difficulties of oncology nursing, 28.3% of difficulties could be attributed to job-related factors, 30.3% to patient-related factors, and 77% of difficulties to individual factors. The independent predictors of participation level of the nurses were self-thoughts of skills and positive aspects of oncology nursing. According to the findings of this study, nurses declared that working with cancer patients increase burnout, they are insufficient in managing work stress and giving psychological care to patients, but their job satisfaction, clinical skills and awareness regarding priorities of life has increased.

Improving Oncology Quality Measurement in Accountable Care: Filling Gaps with Cross-Cutting Measures.

Science.gov (United States)

Valuck, Tom; Blaisdell, David; Dugan, Donna P; Westrich, Kimberly; Dubois, Robert W; Miller, Robert S; McClellan, Mark

2017-02-01

Payment for health care services, including oncology services, is shifting from volume-based fee-for-service to value-based accountable care. The objective of accountable care is to support providers with flexibility and resources to reform care delivery, accompanied by accountability for maintaining or improving outcomes while lowering costs. These changes depend on health care payers, systems, physicians, and patients having meaningful measures to assess care delivery and outcomes and to balance financial incentives for lowering costs while providing greater value. Gaps in accountable care measure sets may cause missed signals of problems in care and missed opportunities for improvement. Measures to balance financial incentives may be particularly important for oncology, where high cost and increasingly targeted diagnostics and therapeutics intersect with the highly complex and heterogeneous needs and preferences of cancer patients. Moreover, the concept of value in cancer care, defined as the measure of outcomes achieved per costs incurred, is rarely incorporated into performance measurement. This article analyzes gaps in oncology measures in accountable care, discusses challenging measurement issues, and offers strategies for improving oncology measurement. Discern Health analyzed gaps in accountable care measure sets for 10 cancer conditions that were selected based on incidence and prevalence; impact on cost and mortality; a diverse range of high-cost diagnostic procedures and treatment modalities (e.g., genomic tumor testing, molecularly targeted therapies, and stereotactic radiotherapy); and disparities or performance gaps in patient care. We identified gaps by comparing accountable care set measures with high-priority measurement opportunities derived from practice guidelines developed by the National Comprehensive Cancer Network and other oncology specialty societies. We found significant gaps in accountable care measure sets across all 10 conditions. For

[Oncological quality indicators and Colorectal Cancer Program: data from 2009-2010 of University Hospital in Ferrara, Italy].

Science.gov (United States)

Giuliani, Jacopo; Marzola, Marina; Indelli, Monica; Frassoldati, Antonio

2012-02-01

The aim of this study is to analyse the oncological quality indicators on our Colorectal Cancer Program, that are reflective of the scope of care, feasible to implement and supported by evidence. We compared two different populations during the same period: patients referring to our Clinical Oncology Unit coming from Regional Colorectal Cancer Screening Program and the other population that was not in any Colorectal Cancer Program. On the basis of our experience, we concluded for high-quality care for both population. Any critical point should be carefully analysed in order to implement quality of care.

Psychosocial standards of care for children with cancer and their families: A national survey of pediatric oncology social workers.

Science.gov (United States)

Jones, Barbara; Currin-Mcculloch, Jennifer; Pelletier, Wendy; Sardi-Brown, Vicki; Brown, Peter; Wiener, Lori

2018-04-01

In 2015, an interdisciplinary group of psychosocial experts developed The Standards of Psychosocial Care for Children with Cancer and Their Families. This paper presents data from a national survey of pediatric oncology social workers and their experiences in delivering psychosocial care to children and families. In total, 107 social workers from 81 cancer institutions participated in a 25-item online survey that mirrored the 15 Standards for Psychosocial Care. Both closed and open-ended questions were included. Social work participants reported that psychosocial support is being provided at most cancer centers surveyed, primarily by social workers and child life specialists, addressing adaptation to the cancer diagnosis, treatment, and transitions into survivorship or end-of-life care and bereavement. While social workers reported offering comprehensive services throughout the cancer trajectory, many of the 2015 Standards are not being systematically implemented. Areas for improvement include funding for psychosocial support staff and programs, incorporation of standardized assessment measures, assessment for financial burden throughout treatment and beyond, consistent access to psychology and psychiatry, integrated care for parents and siblings, and more inclusion of palliative care services from time of diagnosis.

Complementary and Alternative Medicine use in oncology: A questionnaire survey of patients and health care professionals

LENUS (Irish Health Repository)

Chang, Kah Hoong

2011-05-24

Abstract Background We aimed to investigate the prevalence and predictors of Complementary and Alternative Medicine (CAM) use among cancer patients and non-cancer volunteers, and to assess the knowledge of and attitudes toward CAM use in oncology among health care professionals. Methods This is a cross-sectional questionnaire survey conducted in a single institution in Ireland. Survey was performed in outpatient and inpatient settings involving cancer patients and non-cancer volunteers. Clinicians and allied health care professionals were asked to complete a different questionnaire. Results In 676 participants including 219 cancer patients; 301 non-cancer volunteers and 156 health care professionals, the overall prevalence of CAM use was 32.5% (29.1%, 30.9% and 39.7% respectively in the three study cohorts). Female gender (p < 0.001), younger age (p = 0.004), higher educational background (p < 0.001), higher annual household income (p = 0.001), private health insurance (p = 0.001) and non-Christian (p < 0.001) were factors associated with more likely CAM use. Multivariate analysis identified female gender (p < 0.001), non-Christian (p = 0.001) and private health insurance (p = 0.015) as independent predictors of CAM use. Most health care professionals thought they did not have adequate knowledge (58.8%) nor were up to date with the best evidence (79.2%) on CAM use in oncology. Health care professionals who used CAM were more likely to recommend it to patients (p < 0.001). Conclusions This study demonstrates a similarly high prevalence of CAM use among oncology health care professionals, cancer and non cancer patients. Patients are more likely to disclose CAM usage if they are specifically asked. Health care professionals are interested to learn more about various CAM therapies and have poor evidence-based knowledge on specific oncology treatments. There is a need for further training to meet to the escalation of CAM use among patients and to raise awareness of

The Evolution of Gero-Oncology Nursing.

Science.gov (United States)

Bond, Stewart M; Bryant, Ashley Leak; Puts, Martine

2016-02-01

This article summarizes the evolution of gero-oncology nursing and highlights key educational initiatives, clinical practice issues, and research areas to enhance care of older adults with cancer. Peer-reviewed literature, position statements, clinical practice guidelines, Web-based materials, and professional organizations' resources. Globally, the older adult cancer population is rapidly growing. The care of older adults with cancer requires an understanding of their diverse needs and the intersection of cancer and aging. Despite efforts to enhance competence in gero-oncology and to develop a body of evidence, nurses and health care systems remain under-prepared to provide high-quality care for older adults with cancer. Nurses must take a leadership role in integrating gerontological principles into oncology settings. Working closely with interdisciplinary team members, nurses should utilize available resources and continue to build evidence through gero-oncology nursing research. Copyright © 2016 Elsevier Inc. All rights reserved.

Psycho-oncology and primary prevention in cancer control plans: an absent voice?

Science.gov (United States)

Dunn, Jeff; Holland, Jimmie; Hyde, Melissa K; Watson, Maggie

2015-07-27

One third of cancer deaths are attributable to modifiable lifestyle, behaviour and psychosocial risk factors. Psycho-oncology can contribute significantly to prevention initiatives such as those described in national cancer control plans (NCCPs), to reduce or eliminate these risk factors. However, the extent to which psycho-oncology expertise has informed prevention objectives in plans is unclear. Accordingly, 35 English language NCCPs were located via existing databases and were searched using Adobe text searches ('psycho', 'social', 'behav' and 'intervention') to identify (a) representations of psycho-oncology, its dimensions (psychological, social and behavioural) and roles (e.g. psychologist); and (b) behaviour/lifestyle change interventions. A third of NCCPs included the term psycho- or psychosocial-oncology; approximately half referred to a psycho-oncology dimension regarding prevention and early detection and half included actions/objectives relating to health professionals and provision of psychosocial care. The majority of cancer plans included prevention outcomes and focussed primarily on smoking cessation and alcohol reduction. Interventions commonly proposed were education, regulation and service provision; however, many were aspirational statements of intent rather than specific interventions. Psycho-oncology was represented in NCCPs but was limited in reference to prevention with few behavioural interventions utilised. Psycho-oncology input is needed to prescribe evidence-based interventions in cancer plans that not only educate, regulate and provide resources but also motivate, empower and create a supportive normative environment for behaviour change. In this manuscript, and throughout this Special Issue on Cancer Prevention, important principles, ideas and evidence within psycho-oncology are outlined which, if properly implemented, can help reduce the global cancer burden. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley

Communication competencies of oncology nurses in Malaysia.

Science.gov (United States)

Maskor, Nor Aida; Krauss, Steven Eric; Muhamad, Mazanah; Nik Mahmood, Nik Hasnaa

2013-01-01

This paper reports on part of a large study to identify competencies of oncology nurses in Malaysia. It focuses on oncology nurses' communications-related competency. As an important cancer care team member, oncology nurses need to communicate effectively with cancer patients. Literature shows that poor communication can make patients feel anxious, uncertain and generally not satisfied with their nurses' care. This paper deliberates on the importance of effective communication by oncology nurses in the context of a public hospital. Four focus group discussions were used in this study with 17 oncology/cancer care nurses from Malaysian public hospitals. The main inclusion criterion was that the nurses had to have undergone a post-basic course in oncology, or have work experience as a cancer care nurse. The findings indicated that nurses do communicate with their patients, patients' families and doctors to provide information about the disease, cancer treatment, disease recurrence and side effects. Nurses should have good communication skills in order to build relationships as well as to provide quality services to their patients. The paper concludes by recommending how oncology nursing competencies can be improved.

Centers for medicare and medicaid services: using an episode-based payment model to improve oncology care.

Science.gov (United States)

Kline, Ronald M; Bazell, Carol; Smith, Erin; Schumacher, Heidi; Rajkumar, Rahul; Conway, Patrick H

2015-03-01

Cancer is a medically complex and expensive disease with costs projected to rise further as new treatment options increase and the United States population ages. Studies showing significant regional variation in oncology quality and costs and model tests demonstrating cost savings without adverse outcomes suggest there are opportunities to create a system of oncology care in the US that delivers higher quality care at lower cost. The Centers for Medicare and Medicaid Services (CMS) have designed an episode-based payment model centered around 6 month periods of chemotherapy treatment. Monthly per-patient care management payments will be made to practices to support practice transformation, including additional patient services and specific infrastructure enhancements. Quarterly reporting of quality metrics will drive continuous quality improvement and the adoption of best practices among participants. Practices achieving cost savings will also be eligible for performance-based payments. Savings are expected through improved care coordination and appropriately aligned payment incentives, resulting in decreased avoidable emergency department visits and hospitalizations and more efficient and evidence-based use of imaging, laboratory tests, and therapeutic agents, as well as improved end of life care. New therapies and better supportive care have significantly improved cancer survival in recent decades. This has come at a high cost, with cancer therapy consuming $124 billion in 2010. CMS has designed an episode-based model of oncology care that incorporates elements from several successful model tests. By providing care management and performance based payments in conjunction with quality metrics and a rapid learning environment, it is hoped that this model will demonstrate how oncology care in the US can transform into a high value, high quality system. Copyright © 2015 by American Society of Clinical Oncology.

Demands and Needs for Psycho-Oncological eHealth Interventions in Women With Cancer: Cross-Sectional Study.

Science.gov (United States)

Ringwald, Johanna; Marwedel, Lennart; Junne, Florian; Ziser, Katrin; Schäffeler, Norbert; Gerstner, Lena; Wallwiener, Markus; Brucker, Sara Yvonne; Hautzinger, Martin; Zipfel, Stephan; Teufel, Martin

2017-11-24

Over the last decade, a growing body of studies regarding the application of eHealth and various digital interventions has been published and are widely used in the psycho-oncological care. However, the effectiveness of eHealth applications in psycho-oncological care is still questioned due to missing considerations regarding evidence-based studies on the demands and needs in cancer-affected patients. This cross-sectional study aimed to explore the cancer-affected women's needs and wishes for psycho-oncological content topics in eHealth applications and whether women with cancer differ in their content topics and eHealth preferences regarding their experienced psychological burden. Patients were recruited via an electronic online survey through social media, special patient Internet platforms, and patient networks (both inpatients and outpatients, University Hospital Tuebingen, Germany). Participant demographics, preferences for eHealth and psycho-oncological content topics, and their experienced psychological burden of distress, quality of life, and need for psychosocial support were evaluated. Of the 1172 patients who responded, 716 were included in the study. The highest preference for psycho-oncological content topics reached anxiety, ability to cope, quality of life, depressive feelings, and adjustment toward a new life situation. eHealth applications such as Web-based applications, websites, blogs, info email, and consultation hotline were considered to be suitable to convey these content topics. Psychological burden did not influence the preference rates according to psycho-oncological content and eHealth applications. Psycho-oncological eHealth applications may be very beneficial for women with cancer, especially when they address psycho-oncological content topics like anxiety, ability to cope, depressive feelings, self-esteem, or adjustment to a new life situation. The findings of this study indicate that psycho-oncological eHealth applications are a

Compliance to exercise-oncology guidelines in prostate cancer survivors and associations with psychological distress, unmet supportive care needs, and quality of life.

Science.gov (United States)

Galvão, Daniel A; Newton, Robert U; Gardiner, Robert A; Girgis, Afaf; Lepore, Stephen J; Stiller, Anna; Occhipinti, Stefano; Chambers, Suzanne K

2015-06-18

The purpose of this study was to determine prevalence of Australian prostate cancer survivors meeting contemporary exercise-oncology guidelines and identify associations with distress, unmet supportive care needs, and quality of life. A population-based cohort of 463 prostate cancer survivors who were on 10.8 months post-curative therapy was assessed for compliance with current exercise guidelines for cancer survivors, motivational readiness for physical activity, psychological distress, unmet supportive care needs, and quality of life. Only 57 men (12.3%) reported sufficient exercise levels (150 min of moderate intensity or 75 min of strenuous exercise per week and twice weekly resistance exercise), 186 (40.2%) were insufficiently active, and 220 (47.5%) were inactive. Among inactive men, 99 (45.0%) were in the contemplation or preparation stage of motivation readiness. Inactive men had higher global distress (p = 0.01) and Brief Symptom Inventory-Anxiety (p Australian prostate cancer survivors met contemporary exercise-oncology recommendations despite increasing recognition of exercise to improve patient outcomes. Strategies are urgently required to increase prostate cancer survivors' participation in aerobic and resistance exercise training.Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Palliative nursing care for children and adolescents with cancer

Directory of Open Access Journals (Sweden)

Gilmer MJ

2012-06-01

Full Text Available Terrah L Foster,1,2 Cynthia J Bell,1 Carey F McDonald,2 Joy S Harris,3 Mary Jo Gilmer,1,21Vanderbilt University School of Nursing, Nashville, 2Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, 3Vanderbilt University, Nashville, TN, USAAbstract: Pediatric palliative care aims to enhance life and decrease suffering of children and adolescents living with life-threatening conditions and their loved ones. Oncology nurses are instrumental in providing palliative care to pediatric oncology populations. This paper describes pediatric palliative care and provides an overview of literature related to the physical, psychological, social, and spiritual domains of palliative nursing care for children and adolescents with cancer. Nurses can provide optimal palliative care by accounting for children's understanding of death, encouraging early initiation of palliative care services, and improving utilization of pediatric palliative care in cancer settings. Specific roles of registered nurses and advanced practice nurses in pediatric palliative care will be addressed. Recommendations for future research are made to further advance the science of pediatric palliative care and decrease suffering for children and teens with cancer.Keywords: pediatric palliative care, pediatric cancer, oncology, child, suffering

[Social and esthetic care in oncology, a part of the patient's journey].

Science.gov (United States)

Christ, Dominique; Reaux, Martine

2013-10-01

Socio-aesthetic care in oncology, a parenthesis in the patient's journey. Socio-aesthetics, which is an aspect of support care, is carried out within the hospital. The treatments given into the suggestion of paramedical teams or at the request of patients provide relief and well-being to women and men who are treated for cancer. Recourse to services of socio-esthetics at various stages of the cancer treatment helps avoid isolation, regain confidence in one's self image and prepare for life "after cancer".

Integrative oncology for breast cancer patients: introduction of an expert-based model

International Nuclear Information System (INIS)

Dobos, Gustav J; Voiss, Petra; Schwidde, Ilka; Choi, Kyung-Eun; Paul, Anna; Kirschbaum, Barbara; Saha, Felix J; Kuemmel, Sherko

2012-01-01

Malignant breast neoplasms are among the most frequent forms of cancer in the Western world. Conventional treatment of breast cancer may include surgery, hormonal therapy, chemotherapy, radiation and/or immunotherapy, all of which are often accompanied by severe side effects. Complementary and alternative medicine (CAM) treatments have been shown to be effective in alleviating those symptoms. Furthermore, with patient survival rates increasing, oncologists, psychologists and other therapists have to become more sensitive to the needs of cancer survivors that go beyond than the mere alleviation of symptoms. Many CAM methods are geared to treat the patient in a holistic manner and thus are also concerned with the patient’s psychological and spiritual needs. The use of certain CAM methods may become problematic when, as frequently occurs, patients use them indiscriminately and without informing their oncologists. Herbal medicines and dietary supplements, especially, may interfere with primary cancer treatments or have other detrimental effects. Thus, expertise in this highly specialized field of integrative medicine should be available to patients so that they can be advised about the benefits and negative effects of such preparations and practices. Being a beneficial combination of conventional and CAM care, integrative oncology makes possible the holistic approach to cancer care. The concept of integrative oncology for breast cancer is jointly practiced by the Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, academic teaching hospital of the University of Duisburg-Essen, and the Breast Center at Kliniken Essen-Mitte in Germany. This model is introduced here; its scope is reviewed, and its possible implications for the practice of integrative medicine are discussed. Evidence-based integrative care is crucial to the field of oncology in establishing state-of-the-art care for breast cancer patients

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.

Psycho-oncology in Korea: past, present and future.

Science.gov (United States)

Lee, Hyun Jeong; Lee, Kwang-Min; Jung, Dooyoung; Shim, Eun-Jung; Hahm, Bong-Jin; Kim, Jong-Heun

2017-01-01

Psycho-oncology in Korea was introduced among the circle of consultation-liaison psychiatrists, in the 1990s. For almost 25 years, the field has been developing at a steady pace as the psychosocial needs of patients with cancer continue to increase. In this study, we review the history of psycho-oncology in Korea, in a chronological order, within the domains of clinical practice, research activity, training, and public policy. Before the 1990s, patients with cancer with psychiatric comorbidities were usually taken care of by consultation-liaison psychiatrists in general hospitals. In 1993, psycho-oncology was first introduced by psychiatrists. Psychologists, nurses, and social workers have also been increasingly involved in providing psychosocial care for patients with cancer. Professionals from various disciplines began to communicate, and agreed to found the Korean Psycho-Oncology Study Group (KPOSG) in 2006, the first academic society in this field. In 2009, National Cancer Center published the "Recommendations for Distress Management in Patients with Cancer", which are consensus-based guidelines for Korean patients. In 2014, the KPOSG was dissolved and absorbed into a new organization, the Korean Psycho-Oncology Society (KPOS). It functions as a center of development of psycho-oncology, publishing official journals, and hosting annual conferences. There are many challenges, including, low awareness of psycho-oncology, presence of undertreated psychiatric disorders in patients with cancer, shortage of well-trained psycho-oncologists, stigma, and suicide risk. It is important to improve the cancer care system to the extent that psycho-oncology is integrated with mainstream oncology. Considering the socio-cultural characteristics of Korean cancer care, a Korean model of distress management is being prepared by the KPOS. This article provides an overview of the development, current issues, and future challenges of psycho-oncology in Korea. Through its long journey

Developing a decision-making model based on an interdisciplinary oncological care group for the management of colorectal cancer.

Science.gov (United States)

Genovesi, Domenico; Mazzilli, Lorenzo; Trignani, Marianna; DI Tommaso, Monica; Nuzzo, Antonio; Biondi, Edoardo; Tinari, Nicola; Martino, Maria Teresa; Innocenti, Paolo; DI Sebastiano, Pierluigi; Mazzola, Lorenzo; Lanci, Carmine; Neri, Matteo; Laterza, Francesco; Marino, Maria; Ferrini, Giovanni; Spadaccini, Antonio; Filippone, Antonella; DI Giandomenico, Enzo; Marulli, Antonio; Palombo, Giuseppe; Sparvieri, Antonio; Marchetti, Antonio; Pizzicannella, Giuseppe; Petrini, Flavia; DI Felice, Maria; Ottaviani, Floriana; Monteodorisio, Antonio; DI Nicola, Marta; Cefaro, Giampiero Ausili

2014-05-01

To report our experience on implementation and preliminary results of a decision-making model based on the recommendations of an Interdisciplinary Oncological Care Group developed for the management of colorectal cancer. The multidisciplinary team identified a reference guideline using appraisal of guidelines for research and evaluation (AGREE) tool based on a sequential assessment of the guideline quality. Thereafter, internal guidelines with diagnostic and therapeutic management for early, locally advanced and metastatic colonic and rectal cancer were drafted; organizational aspects, responsibility matrices, protocol actions for each area of specialty involved and indicators for performing audits were also defined. The National Institute for Health and Care Excellence (NICE) UK guideline was the reference for drafting the internal guideline document; from February to November 2013, 125 patients with colorectal cancer were discussed by and taken under the care of the Interdisciplinary Oncological Care Group. The first audit performed in December 2013 revealed optimal adherence to the internal guideline, mainly in terms of uniformity and accuracy of perioperative staging, coordination and timing of multi-modal therapies. To date, all patients under observation are within the diagnostic and therapeutic course, no patient came out from the multidisciplinary "path" and only in 14% of cases have the first recommendations proposed been changed. The selected indicators appear effective and reliable, while at the moment, it is not yet possible to assess the impact of the multidisciplinary team on clinical outcome. Although having a short observation period, our model seems capable of determining optimal uniformity of diagnostic and therapeutic management, to a high degree of patient satisfaction. A longer observation period is necessary in order to confirm these observations and for assessing the impact on clinical outcome.

European Society of Gynaecological Oncology Guidelines for the Management of Patients With Vulvar Cancer

NARCIS (Netherlands)

Oonk, Maaike H. M.; Planchamp, Francois; Baldwin, Peter; Bidzinski, Mariusz; Brannstrom, Mats; Landoni, Fabio; Mahner, Sven; Mahantshetty, Umesh; Mirza, Mansoor; Petersen, Cordula; Querleu, Denis; Regauer, Sigrid; Rob, Lukas; Rouzier, Roman; Ulrikh, Elena; van der Velden, Jacobus; Vergote, Ignace; Woelber, Linn; van der Zee, Ate G. J.

Objective The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. Methods The European Society of Gynaecological Oncology

European Society of Gynaecological Oncology Guidelines for the Management of Patients With Vulvar Cancer

NARCIS (Netherlands)

Oonk, Maaike H. M.; Planchamp, François; Baldwin, Peter; Bidzinski, Mariusz; Brännström, Mats; Landoni, Fabio; Mahner, Sven; Mahantshetty, Umesh; Mirza, Mansoor; Petersen, Cordula; Querleu, Denis; Regauer, Sigrid; Rob, Lukas; Rouzier, Roman; Ulrikh, Elena; van der Velden, Jacobus; Vergote, Ignace; Woelber, Linn; van der Zee, Ate G. J.

2017-01-01

The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. The European Society of Gynaecological Oncology Council nominated

[Professional's expectations to improve quality of care and social services utilization in geriatric oncology].

Science.gov (United States)

Antoine, Valéry; de Wazières, Benoît; Houédé, Nadine

2015-02-01

Coordination of a multidisciplinary and multi-professional intervention is a key issue in the management of elderly cancer patients to improve health status and quality of life. Optimizing the links between professionals is needed to improve care planning, health and social services utilization. Descriptive study in a French University Hospital. A 6-item structured questionnaire was addressed to professionals involved in global and supportive cares of elderly cancer patients (name, location, effective health care and services offered, needs to improve the quality of their intervention). After the analysis of answers, definition of propositions to improve cares and services utilization. The 37 respondents identified a total of 166 needs to improve quality of care in geriatric oncology. Major expectations were concerning improvement of global/supportive cares and health care services utilization, a better coordination between geriatric teams and oncologists. Ten propositions, including a model of in-hospital health care planning, were defined to answer to professional's needs with the aim of optimizing cancer treatment and global cares. Identification of effective services and needs can represent a first step in a continuous program to improve quality of cares, according to the French national cancer plan 2014-2019. It allows federating professionals for a coordination effort, a better organization of the clinical activity in geriatric oncology, to optimize clinical practice and global cares. Copyright © 2014 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Cultural aspects of communication in cancer care.

Science.gov (United States)

Surbone, Antonella

2008-03-01

Cultural competence in oncology requires the acquisition of specific knowledge, clinical skills, and attitudes that facilitate effective cross-cultural negotiation in the clinical setting, thus, leading to improved therapeutic outcomes and decreased disparities in cancer care. Cultural competence in oncology entails a basic knowledge of different cultural attitudes and practices of communication of the truth and of decision-making styles throughout the world. Cultural competence always presupposes oncology professionals' awareness of their own cultural beliefs and values. To be able to communicate with cancer patients in culturally sensitive ways, oncologists should have knowledge of the concept of culture in its complexity and of the risks of racism, classism, sexism, ageism, and stereotyping that must be avoided in clinical practice. Oncologists should develop a sense of appreciation for differences in health care values, based on the recognition that no culture can claim hegemony over others and that cultures are evolving under their reciprocal influence on each other. Medical schools and oncology training can teach communication skills and cultural competence, while fostering in all students and young doctors those attitudes of humility, empathy, curiosity, respect, sensitivity, and awareness that are needed to deliver effective and culturally sensitive cancer care.

American Society of Clinical Oncology position statement on obesity and cancer.

Science.gov (United States)

Ligibel, Jennifer A; Alfano, Catherine M; Courneya, Kerry S; Demark-Wahnefried, Wendy; Burger, Robert A; Chlebowski, Rowan T; Fabian, Carol J; Gucalp, Ayca; Hershman, Dawn L; Hudson, Melissa M; Jones, Lee W; Kakarala, Madhuri; Ness, Kirsten K; Merrill, Janette K; Wollins, Dana S; Hudis, Clifford A

2014-11-01

Rates of obesity have increased significantly over the last three decades in the United States and globally. In addition to contributing to heart disease and diabetes, obesity is a major unrecognized risk factor for cancer. Obesity is associated with worsened prognosis after cancer diagnosis and also negatively affects the delivery of systemic therapy, contributes to morbidity of cancer treatment, and may raise the risk of second malignancies and comorbidities. Research shows that the time after a cancer diagnosis can serve as a teachable moment to motivate individuals to adopt risk-reducing behaviors. For this reason, the oncology care team--the providers with whom a patient has the closest relationships in the critical period after a cancer diagnosis--is in a unique position to help patients lose weight and make other healthy lifestyle changes. The American Society of Clinical Oncology is committed to reducing the impact of obesity on cancer and has established a multipronged initiative to accomplish this goal by 1) increasing education and awareness of the evidence linking obesity and cancer; 2) providing tools and resources to help oncology providers address obesity with their patients; 3) building and fostering a robust research agenda to better understand the pathophysiology of energy balance alterations, evaluate the impact of behavior change on cancer outcomes, and determine the best methods to help cancer survivors make effective and useful changes in lifestyle behaviors; and 4) advocating for policy and systems change to address societal factors contributing to obesity and improve access to weight management services for patients with cancer. © 2014 by American Society of Clinical Oncology.

Pediatric Oncology Branch - Support Services | Center for Cancer Research

Science.gov (United States)

Support Services As part of the comprehensive care provided at the NCI Pediatric Oncology Branch, we provide a wide range of services to address the social, psychological, emotional, and practical facets of pediatric cancer and to support patients and families while they are enrolled in clinical research protocols.

Delivering care to oncology patients in the community: an innovative integrated approach.

LENUS (Irish Health Repository)

Hanan, Terry

2014-08-01

A community oncology nursing programme was developed in Ireland between the hospital and community health services for patients receiving systemic cancer therapy, in response to a service need. A robust evaluation of the pilot programme was undertaken, which found that defined clinical procedures traditionally undertaken in hospitals were safely undertaken in the patient\\'s home with no adverse effects. There was a dramatic decrease in hospital attendances for these defined clinical procedures, and hospital capacity was consequently freed up. Patients valued having aspects of their care delivered at home and reported that it improved their quality of life, including reduced hospital visits and travel time. Community nurses expanded their scope of practice and became partners with oncology day-ward nurses in caring for these patients. Community nurses developed the competence and confidence to safely deliver cancer care in the community. This initiative shows that defined elements of acute cancer care can be safely delivered in the community so long as the training and support are provided. The findings and recommendations of the evaluation resulted in university accreditation and approval for national roll-out of the programme. Integration of services between primary and secondary care is a key priority. This innovative programme is a good example of shared integrated care that benefits both patients and health-care providers.

Cancer Supportive and Survivorship Care in Singapore: Current Challenges and Future Outlook

Directory of Open Access Journals (Sweden)

Kiley Wei-Jen Loh

2018-02-01

Full Text Available Despite being a relatively young nation, Singapore has established itself as a leading multifaceted medical hub, both regionally and globally. Although Singapore continues to pursue excellence in oncology care, cancer supportive care and survivorship care remain in the infancy stage. In an effort to advance this important aspect of oncology care in Singapore, the first cancer supportive and survivorship care forum was held in December 2016, involving 74 oncology practitioners. The primary goals of this forum were to raise awareness of the importance of cancer supportive and survivorship care and to provide a platform for oncology practitioners of diverse backgrounds to converge and address the challenges associated with the delivery of cancer supportive and survivorship care in Singapore. Key challenges identified during this forum included, but were not limited to, care fragmentation in an oncologist-centric model of care, poor integration of allied health and rehabilitation services, passive engagement of community partners, lack of specialized skill sets and knowledge in supportive and survivorship care, and patient-related barriers such as poor health literacy. The survivorship care model commonly used in Singapore places an imbalanced emphasis on surveillance for cancer recurrence and second primary cancers, with little attention given to the supportive and survivorship needs of the survivors. In summary, these challenges set the stage for the development and use of a more survivor-centric model, one that focuses not only on cancer surveillance, but also on the broad and unique physical and psychosocial needs of survivors of cancer in Singapore.

Cancer Survivorship Care Plan Utilization and Impact on Clinical Decision-Making at Point-of-Care Visits with Primary Care: Results from an Engineering, Primary Care, and Oncology Collaborative for Survivorship Health.

Science.gov (United States)

Donohue, SarahMaria; Haine, James E; Li, Zhanhai; Feldstein, David A; Micek, Mark; Trowbridge, Elizabeth R; Kamnetz, Sandra A; Sosman, James M; Wilke, Lee G; Sesto, Mary E; Tevaarwerk, Amye J

2017-11-02

Every cancer survivor and his/her primary care provider should receive an individualized survivorship care plan (SCP) following curative treatment. Little is known regarding point-of-care utilization at primary care visits. We assessed SCP utilization in the clinical context of primary care visits. Primary care physicians and advanced practice providers (APPs) who had seen survivors following provision of an SCP were identified. Eligible primary care physicians and APPs were sent an online survey, evaluating SCP utilization and influence on decision-making at the point-of-care, accompanied by copies of the survivor's SCP and the clinic note. Eighty-eight primary care physicians and APPs were surveyed November 2016, with 40 (45%) responding. Most respondents (60%) reported discussing cancer or related issues during the visit. Information needed included treatment (66%) and follow-up visits, and the cancer team was responsible for (58%) vs primary care (58%). Respondents acquired this information by asking the patient (79%), checking oncology notes (75%), the SCP (17%), or online resources (8%). Barriers to SCP use included being unaware of the SCP (73%), difficulty locating it (30%), and finding needed information faster via another mechanism (15%). Despite largely not using the SCP for the visit (90%), most respondents (61%) believed one would be quite or very helpful for future visits. Most primary care visits included discussion of cancer or cancer-related issues. SCPs may provide the information necessary to deliver optimal survivor care but efforts are needed to reduce barriers and design SCPs for primary care use.

Restoring Balance for People with Cancer Through Integrative Oncology.

Science.gov (United States)

Fulop, Judy A; Grimone, Ania; Victorson, David

2017-06-01

Integrative Oncology incorporates conventional and western cancer treatment approaches with the best of ancient and traditional medicine including nutrition, supplements, Qigong, herbal medicine, mind-body practices, and more. This article offers a guiding conceptual paradigm from an integrative perspective based on the principles of balance and imbalance. An integrative approach is used to help improve quality of life, enhance lifestyle choices and mitigate symptoms and side effects from conventional treatments. By supporting the patient's mind, body and spirit throughout the cancer treatment journey, the primary care physician is in a key position to work with their patient's oncologist to provide supportive care and recommendations during cancer treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

Geriatric Assessment-Guided Care Processes for Older Adults: A Delphi Consensus of Geriatric Oncology Experts.

Science.gov (United States)

Mohile, Supriya Gupta; Velarde, Carla; Hurria, Arti; Magnuson, Allison; Lowenstein, Lisa; Pandya, Chintan; O'Donovan, Anita; Gorawara-Bhat, Rita; Dale, William

2015-09-01

Structured care processes that provide a framework for how oncologists can incorporate geriatric assessment (GA) into clinical practice could improve outcomes for vulnerable older adults with cancer, a growing population at high risk of toxicity from cancer treatment. We sought to obtain consensus from an expert panel on the use of GA in clinical practice and to develop algorithms of GA-guided care processes. The Delphi technique, a well-recognized structured and reiterative process to reach consensus, was used. Participants were geriatric oncology experts who attended NIH-funded U13 or Cancer and Aging Research Group conferences. Consensus was defined as an interquartile range of 2 or more units, or 66.7% or greater, selecting a utility/helpfulness rating of 7 or greater on a 10-point Likert scale. For nominal data, consensus was defined as agreement among 66.7% or more of the group. From 33 invited, 30 participants completed all 3 rounds. Most experts (75%) used GA in clinical care, and the remainder were involved in geriatric oncology research. The panel met consensus that "all patients aged 75 years or older and those who are younger with age-related health concerns" should undergo GA and that all domains (function, physical performance, comorbidity/polypharmacy, cognition, nutrition, psychological status, and social support) should be included. Consensus was met for how GA could guide nononcologic interventions and cancer treatment decisions. Algorithms for GA-guided care processes were developed. This Delphi investigation of geriatric oncology experts demonstrated that GA should be performed for older patients with cancer to guide care processes. Copyright © 2015 by the National Comprehensive Cancer Network.

Recommendations to support nurses and improve the delivery of oncology and palliative care in India

Directory of Open Access Journals (Sweden)

Virginia T LeBaron

2017-01-01

Full Text Available Context: Nurses in India often practice in resource-constrained settings and care for cancer patients with high symptom burden yet receive little oncology or palliative care training. Aim: The aim of this study is to explore challenges encountered by nurses in India and offer recommendations to improve the delivery of oncology and palliative care. Methods: Qualitative ethnography. Setting: The study was conducted at a government cancer hospital in urban South India. Sample: Thirty-seven oncology/palliative care nurses and 22 others (physicians, social workers, pharmacists, patients/family members who interact closely with nurses were included in the study. Data Collection: Data were collected over 9 months (September 2011– June 2012. Key data sources included over 400 hours of participant observation and 54 audio-recorded semi-structured interviews. Analysis: Systematic qualitative analysis of field notes and interview transcripts identified key themes and patterns. Results: Key concerns of nurses included safety related to chemotherapy administration, workload and clerical responsibilities, patients who died on the wards, monitoring family attendants, and lack of supplies. Many participants verbalized distress that they received no formal oncology training. Conclusions: Recommendations to support nurses in India include: prioritize safety, optimize role of the nurse and explore innovative models of care delivery, empower staff nurses, strengthen nurse leadership, offer relevant educational programs, enhance teamwork, improve cancer pain management, and engage in research and quality improvement projects. Strong institutional commitment and leadership are required to implement interventions to support nurses. Successful interventions must account for existing cultural and professional norms and first address safety needs of nurses. Positive aspects from existing models of care delivery can be adapted and integrated into general nursing

STATE OF THE ART OF CANCER CARE DELIVER Y IN MOSCOW

Directory of Open Access Journals (Sweden)

A. P. Gnatyuk

2015-01-01

Full Text Available Abstract:The globally increased concern with the situation, existing in oncology, is conditioned by a steady incidence rate of malignant neoplasms, having a tendency to its growth. Annually over 7 million people die in the world due to cancer, by 2020, according to WHO estimations, this index will increase to 10 million. By the end of the 2013 report year patient population with cancer, registered in cancer care facilities of the Russian Federation, is 3 098 855 (2 995 566 in 2012, i. e. 2,1% of the population of the country. The system of cancer care delivery to the population in the Russian Federation and in Moscow is aimed at an early diagnostics and prevention of malignant neoplasms. Municipal cancer care service establishes the patients’ routes at suspicion on oncological disease and determines the functions of all links of health care for this type of patients. Stateof-the-art delivery of oncological specialty care has been built up with account of modern demands and is functionally structured in accordance with tree-level municipal health care system.

Barriers and facilitators to implementing cancer survivorship care plans.

Science.gov (United States)

Dulko, Dorothy; Pace, Claire M; Dittus, Kim L; Sprague, Brian L; Pollack, Lori A; Hawkins, Nikki A; Geller, Berta M

2013-11-01

To evaluate the process of survivorship care plan (SCP) completion and to survey oncology staff and primary care physicians (PCPs) regarding challenges of implementing SCPs. Descriptive pilot study. Two facilities in Vermont, an urban academic medical center and a rural community academic cancer center. 17 oncology clinical staff created SCPs, 39 PCPs completed surveys, and 58 patients (breast or colorectal cancer) participated in a telephone survey. Using Journey Forward tools, SCPs were created and presented to patients. PCPs received the SCP with a survey assessing its usefulness and barriers to delivery. Oncology staff were interviewed to assess perceived challenges and benefits of SCPs. Qualitative and quantitative data were used to identify challenges to the development and implementation process as well as patient perceptions of the SCP visit. SCP, healthcare provider perception of barriers to completion and implementation, and patient perception of SCP visit. Oncology staff cited the time required to obtain information for SCPs as a challenge. Completing SCPs 3-6 months after treatment ended was optimal. All participants felt advanced practice professionals should complete and review SCPs with patients. The most common challenge for PCPs to implement SCP recommendations was insufficient knowledge of cancer survivor issues. Most patients found the care plan visit very useful, particularly within six months of diagnosis. Creation time may be a barrier to widespread SCP implementation. Cancer survivors find SCPs useful, but PCPs feel insufficient knowledge of cancer survivor issues is a barrier to providing best follow-up care. Incorporating SCPs in electronic medical records may facilitate patient identification, appropriate staff scheduling, and timely SCP creation. Oncology nurse practitioners are well positioned to create and deliver SCPs, transitioning patients from oncology care to a PCP in a shared-care model of optimal wellness. Institution support for

Do Breast Cancer Patients Tested in the Oncology Care Setting Share BRCA Mutation Results with Family Members and Health Care Providers?

International Nuclear Information System (INIS)

Vadaparampil, S. T.; Malo, T.; Cruz, C. D. L.; Christie, J.; Vadaparampil, S. T.

2012-01-01

BRCA genetic test results provide important information to manage cancer risk for patients and their families. Little is known on the communication of genetic test results by mutation status with family members and physicians in the oncology care setting. As part of a longitudinal study evaluating the impact of genetic counseling and testing among recently diagnosed breast cancer patients, we collected patients' self-reported patterns of disclosure. Descriptive statistics characterized the sample and determined the prevalence of disclosure of BRCA test results to family members and physicians. Of 100 patients who completed the baseline and the 6-month followup survey, 77 reported pursuing testing. The majority shared test results with female first-degree relatives; fewer did with males. Participants were more likely to share results with oncologists compared to surgeons, primary care physicians, or other specialty physicians. These findings suggest that while breast cancer patients may communicate results to at-risk female family members and their medical oncologist, they may need education and support to facilitate communication to other first-degree relatives and providers

Targeted drugs and Psycho-oncological intervention for breast cancer patients.

Science.gov (United States)

D'Abramo, Flavio; Goerling, Ute; Guastadisegni, Cecilia

2016-04-01

Personalized medicine is a new field based on molecular biology and genomics in which targeted tumor therapies are administered to patients. Psycho-oncology is a complementary approach that considers social and psychological aspects of patients as part of the treatments for cancer patients. The aim of this mini-review is to weigh clinical benefits for breast cancer patients of both treatments and possibly enhance benefits by modulating the use of both interventions. We have compared and evaluated on the one hand the use of anti Vascular Endothelial Growth Factor and, on the other hand, psycho-oncological interventions in metastatic and non-metastatic breast cancer patients.Both treatments did not increase survival of metastatic breast cancer patients, while in a selected study psycho-oncological interventions extended lifespan of non-metastatic breast cancer patients and ameliorate psychological and social factors of metastatic breast cancer patients. Because the two approaches address completely different aspects of cancer patients, if the comparison is limited to the extension of survival, the value of these two treatments cannot be assessed and compared.It is likely that by comparing patients reported outcomes, possibly by using standardized Quality of Life questionnaires, both patients and health care providers can weigh the benefits of the two treatments. It is therefore important to evaluate the use of cancer patients' quality of life measures as a mean to improve their experiences about life and treatment, and possibly to extend their survival.

Barriers and facilitators for oncology nurses discussing sexual issues with men diagnosed with testicular cancer.

LENUS (Irish Health Repository)

Moore, Annamarie

2013-01-02

PURPOSE: Testicular cancer occurs at a time in a man\\'s life when major social life changes are occurring and when body image, fertility, sexual desire and performance can be central issues. Oncology nurses, as members of the multidisciplinary team, are in an ideal position to address men\\'s concerns. The aim of this study was to investigate oncology nurses\\' self-perceived knowledge and comfort in relation to discussing sexuality concerns with men diagnosed with testicular cancer and to identify the barriers and facilitators to such discussions. METHODS: This study employed a self-completion, anonymous survey design with a sample of registered nurses working in five, randomly chosen, oncology centres in Ireland. RESULTS: In total, 89 questionnaires (45% response rate) were included for analysis. Findings suggest that although nurses were open to addressing concerns, few informed patients they were available to discuss sexual concerns. Nurses reported lacking knowledge of, and discomfort in, discussing the more intimate aspects of sexuality, including: ejaculatory difficulties, erectile dysfunction, impotence, prosthesis options and testicular self examination. CONCLUSIONS: Findings reinforce the need for more comprehensive education on sexuality issues and testicular cancer. Nurses need to take a more proactive approach to sexuality care, as opposed to the \\'passive waiting stance\\' that permeates the current culture of care. Education programmes need to include specific information on sexual issues associated with testicular cancer, and oncology nurses must subsume sexuality as an essential aspect of their role through changes in policies and nursing care planning.

Oncology in primary health care; La oncología en la atención primaria de salud

Energy Technology Data Exchange (ETDEWEB)

Mendoza del Pino, Mario Valentín [Hospital Provincial Docente de Oncología María Curie, Camagüey (Cuba)

2009-07-01

The book {sup O}ncology in the primary health care{sup ,} constitutes an important contribution to the prevention and treatment of cancer, from a very comprehensive assessment. It's a disease that is the second leading cause of death in our country, to much pain and suffering is for the patient and their family. The book has a very useful for basic health equipment approach, since it emphasizes that cancer can be prevented if achieved in the population changes in lifestyle. The book is valued not correct food as responsible for one third of all cancers. Currently important research being developed in relation to psiconeuroinmuno-Endocrinology, who is studying the association between psychological factors and the development of cancer valuing that kept stress and depression reduces the antitumor activity of the immune system; that made programs with encouraging results where the treatment of cancer has joined elements of psychotherapy, immunotherapy and the use of the biotherapy. The focus of the book fills an important place in the primary health care and is an indispensable guide for professionals at this level of care (author)

Precision oncology in advanced cancer patients improves overall survival with lower weekly healthcare costs

Science.gov (United States)

Haslem, Derrick S.; Chakravarty, Ingo; Fulde, Gail; Gilbert, Heather; Tudor, Brian P.; Lin, Karen; Ford, James M.; Nadauld, Lincoln D.

2018-01-01

The impact of precision oncology on guiding treatment decisions of late-stage cancer patients was previously studied in a retrospective analysis. However, the overall survival and costs were not previously evaluated. We report the overall survival and healthcare costs associated with precision oncology in these patients with advanced cancer. Building on a matched cohort study of 44 patients with metastatic cancer who received all of their care within a single institution, we evaluated the overall survival and healthcare costs for each patient. We analyzed the outcomes of 22 patients who received genomic testing and targeted therapy (precision oncology) between July 1, 2013 and January 31, 2015, and compared to 22 historically controlled patients (control) who received standard chemotherapy (N = 17) or best supportive care (N = 5). The median overall survival was 51.7 weeks for the targeted treatment group and 25.8 weeks for the control group (P = 0.008) when matching on age, gender, histological diagnosis and previous treatment lines. Average costs over the entire period were $2,720 per week for the targeted treatment group and $3,453 per week for the control group, (P = 0.036). A separate analysis of 1,814 patients with late-stage cancer diagnoses found that those who received a targeted cancer treatment (N = 93) had 6.9% lower costs in the last 3 months of life compared with those who did not. These findings suggest that precision oncology may improve overall survival for refractory cancer patients while lowering average per-week healthcare costs, resource utilization and end-of-life costs. PMID:29552312

ExCEL in Social Work: Excellence in Cancer Education & Leadership: An Oncology Social Work Response to the 2008 Institute of Medicine Report.

Science.gov (United States)

Otis-Green, Shirley; Jones, Barbara; Zebrack, Brad; Kilburn, Lisa; Altilio, Terry A; Ferrell, Betty

2015-09-01

ExCEL in Social Work: Excellence in Cancer Education & Leadership was a multi-year National Cancer Institute (NCI)-funded grant for the development and implementation of an innovative educational program for oncology social workers. The program's curriculum focused upon six core competencies of psychosocial-spiritual support necessary to meet the standard of care recommended by the 2008 Institute of Medicine (IOM) Report: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. The curriculum was delivered through a collaborative partnership between the City of Hope National Medical Center and the two leading professional organizations devoted exclusively to representing oncology social workers--the Association of Oncology Social Work and the Association of Pediatric Oncology Social Workers. Initial findings support the feasibility and acceptability of this tailored leadership skills-building program for participating oncology social workers.

Genetic consultation embedded in a gynecologic oncology clinic improves compliance with guideline-based care.

Science.gov (United States)

Senter, Leigha; O'Malley, David M; Backes, Floor J; Copeland, Larry J; Fowler, Jeffery M; Salani, Ritu; Cohn, David E

2017-10-01

Analyze the impact of embedding genetic counseling services in gynecologic oncology on clinician referral and patient uptake of cancer genetics services. Data were reviewed for a total of 737 newly diagnosed epithelial ovarian cancer patients seen in gynecologic oncology at a large academic medical center including 401 from 11/2011-7/2014 (a time when cancer genetics services were provided as an off-site consultation). These data were compared to data from 8/2014-9/2016 (n=336), when the model changed to the genetics embedded model (GEM), incorporating a cancer genetic counselor on-site in the gynecologic oncology clinic. A statistically significant difference in proportion of patients referred pre- and post-GEM was observed (21% vs. 44%, pgenetics consultation and post-GEM 82% were scheduled (pgenetics was also statistically significant (3.92months pre-GEM vs. 0.79months post-GEM, pgenetics consultation (2.52months pre-GEM vs. 1.67months post-GEM, pgenetic counselor on the same day as the referral. Providing cancer genetics services on-site in gynecologic oncology and modifying the process by which patients are referred and scheduled significantly increases referral to cancer genetics and timely completion of genetics consultation, improving compliance with guideline-based care. Practice changes are critical given the impact of genetic test results on treatment and familial cancer risks. Copyright © 2017 Elsevier Inc. All rights reserved.

Board-Certified Oncology Pharmacists: Their Potential Contribution to Reducing a Shortfall in Oncology Patient Visits.

Science.gov (United States)

Ignoffo, Robert; Knapp, Katherine; Barnett, Mitchell; Barbour, Sally Yowell; D'Amato, Steve; Iacovelli, Lew; Knudsen, Jasen; Koontz, Susannah E; Mancini, Robert; McBride, Ali; McCauley, Dayna; Medina, Patrick; O'Bryant, Cindy L; Scarpace, Sarah; Stricker, Steve; Trovato, James A

2016-04-01

With an aging US population, the number of patients who need cancer treatment will increase significantly by 2020. On the basis of a predicted shortage of oncology physicians, nonphysician health care practitioners will need to fill the shortfall in oncology patient visits, and nurse practitioners and physician assistants have already been identified for this purpose. This study proposes that appropriately trained oncology pharmacists can also contribute. The purpose of this study is to estimate the supply of Board of Pharmacy Specialties-certified oncology pharmacists (BCOPs) and their potential contribution to the care of patients with cancer through 2020. Data regarding accredited oncology pharmacy residencies, new BCOPs, and total BCOPs were used to estimate oncology residencies, new BCOPs, and total BCOPs through 2020. A Delphi panel process was used to estimate patient visits, identify patient care services that BCOPs could provide, and study limitations. By 2020, there will be an estimated 3,639 BCOPs, and approximately 62% of BCOPs will have completed accredited oncology pharmacy residencies. Delphi panelists came to consensus (at least 80% agreement) on eight patient care services that BCOPs could provide. Although the estimates given by our model indicate that BCOPs could provide 5 to 7 million 30-minute patient visits annually, sensitivity analysis, based on factors that could reduce potential visit availability resulted in 2.5 to 3.5 million visits by 2020 with the addition of BCOPs to the health care team. BCOPs can contribute to a projected shortfall in needed patient visits for cancer treatment. BCOPs, along with nurse practitioners and physician assistants could substantially reduce, but likely not eliminate, the shortfall of providers needed for oncology patient visits. Copyright © 2016 by American Society of Clinical Oncology.

Geriatric assessment in daily oncology practice for nurses and allied health care professionals: Opinion paper of the Nursing and Allied Health Interest Group of the International Society of Geriatric Oncology (SIOG).

Science.gov (United States)

Burhenn, Peggy S; McCarthy, Alexandra L; Begue, Aaron; Nightingale, Ginah; Cheng, Karis; Kenis, Cindy

2016-09-01

The management of older persons with cancer has become a major public health concern in developed countries because of the aging of the population and the steady increase in cancer incidence with advancing age. Nurses and allied health care professionals are challenged to address the needs of this growing population. The International Society of Geriatric Oncology (SIOG) Nursing and Allied Health (NAH) Interest Group described key issues that nurses and allied health care professionals face when caring for older persons with cancer. The domains of the Geriatric Assessment (GA) are used as a guiding framework. The following geriatric domains are described: demographic data and social support, functional status, cognition, mental health, nutritional status, fatigue, comorbidities, polypharmacy, and other geriatric syndromes (e.g. falls, delirium). In addition to these geriatric domains, quality of life (QoL) is described based on the overall importance in this particular population. Advice for integration of assessment of these geriatric domains into daily oncology practice is made. Research has mainly focused on the role of treating physicians but the involvement of nurses and allied health care professionals is crucial in the care of older persons with cancer through the GA process. The ability of nurses and allied health care professionals to perform this assessment requires specialized training and education beyond standard oncology knowledge. Copyright © 2016 Elsevier Inc. All rights reserved.

The importance of good death components among cancer patients, the general population, oncologists, and oncology nurses in Japan: patients prefer "fighting against cancer".

Science.gov (United States)

Miyashita, Mitsunori; Kawakami, Sachiko; Kato, Daiki; Yamashita, Hideomi; Igaki, Hiroshi; Nakano, Kimiko; Kuroda, Yujiro; Nakagawa, Keiichi

2015-01-01

The objectives of this study were to compare the importance of components of a good death among cancer patients, the general population, oncologists, and oncology nurses, and explore which patients preferred "fighting against cancer." We conducted a cross-sectional anonymous self-reported survey of cancer patients who visited a radiation oncology outpatient clinic, oncologists, and oncology nurses at the Tokyo University Hospital and a random sample of the general population in the Tokyo metropolitan area. The outcomes were 18 previously developed components of a good death in Japanese cancer care consisting of 57 attributes. Three hundred ten patients, 353 subjects from the general population, 109 oncologists, and 366 oncology nurses participated. The desire to "fight against cancer" was highly significantly different between patients and oncologists (effect size [ES] = -1.40; P = 0.001) and patients and oncology nurses (ES = -1.12; P = 0.001). "Physical and cognitive control" was, similarly, highly significantly different between patients and oncologists (ES = -1.30; P = 0.001) and patients and oncology nurses (ES = -1.06; P = 0.001). Patients who emphasized "maintaining hope and pleasure" (P = 0.0001), "unawareness of death" (P = 0.0001), and "good relationship with family" (P = 0.004) favored "fighting against cancer." The patients, however, who emphasized "physical and psychological comfort" did not significantly favor "fighting against cancer" (P = 0.004). The importance of good death components differed between groups. Medical professionals should be aware of the diversity of values surrounding death and assess the patient's values and discuss them to support his or her quality of life. In addition, the development of care and a medical/social system to maintain hope and pleasure after failure of anticancer treatment is necessary.

The Evolution of Gero-Oncology Nursing

Science.gov (United States)

Bond, Stewart M.; Bryant, Ashley Leak; Puts, Martine

2016-01-01

Objectives This article summarizes the evolution of gero-oncology nursing and highlights key educational initiatives, clinical practice issues, and research areas to enhance care of older adults with cancer. Data Sources Peer-reviewed literature, position statements, clinical practice guidelines, web-based materials, and professional organizations’ resources. Conclusion Globally, the older adult cancer population is rapidly growing. The care of older adults with cancer requires an understanding of their diverse needs and the intersection of cancer and aging. Despite efforts to enhance competence in gerooncology and to develop a body of evidence, nurses and healthcare systems remain under-prepared to provide high quality care for older adults with cancer. Implications for Nursing Practice Nurses need to take a leadership role in integrating gerontological principles into oncology settings. Working closely with interdisciplinary team members, nurses should utilize available resources and continue to build evidence through gero-oncology nursing research. PMID:26830263

Pediatric Oncology Palliative Care: Experiences of General Practitioners and Bereaved Parents.

OpenAIRE

Neilson, SJ; Gibson, F; Greenfield, SM

2015-01-01

Objective: This qualitative study set in the West Midlands region of the United Kingdom, aimed to examine the\\ud role of the general practitioner (GP) in children's oncology palliative care from the perspective of GPs who had cared for a child with cancer receiving palliative care at home and bereaved parents.\\ud Methods: One-to-one semi-structured interviews were undertaken with 18 GPs and 11 bereaved parents\\ud following the death. A grounded theory data analysis was undertaken; identifying...

Integrating Acupuncture into Cancer Care

Directory of Open Access Journals (Sweden)

Tsai-Ju Chien

2013-10-01

Full Text Available Oncology acupuncture has become a new and promising field of research because more and more cancer patients have sought non-pharmacological alternatives for symptom management. While different mechanisms have been proposed to explain its efficacy, including theories of the neural system, endocrine cytokine or immunological regulation, its eventual role has become that of alleviating the side effects induced by chemotherapy or radiotherapy. In this paper, we have reviewed the related articles focusing on acupuncture mechanisms and applications in cancer care to provide a quick sketch of acupuncture in cancer care. A detailed search was performed to identify the randomized controlled trials (RCTs and systematic reviews on acupuncture in oncology, using PUBMED and Cochrane. The search terms included: Acupuncture, acupressure, and cancer. Additional terms were used to target specific symptoms (i.e., breast cancer, hot flash, xerostomia, nausea, vomiting, cancer pain, insomnia, fatigue. Two authors independently extracted data for analysis and review. Ultimately, 25 articles underwent full-text review. Recent trials made efforts in studying (a hot flashes in breast cancer, (b xerostomia induced by radiotherapy in head and neck cancer, (c nausea and vomiting post-chemotherapy, (d cancer pain, and (e fatigue and insomnia in cancer patients. Controversial results for acupuncture application in cancer care appeared in different categories, but a trend emerged that acupuncture can palliate cancer-related symptoms. The research to date certainly offers us a valid complementary therapy in treating cancer-related symptoms. Meanwhile, practical strategies with safe measures for enhancing the efficacy are needed in further interventions, as well as continuing research with a validated methodology.

Barriers and facilitators for oncology nurses discussing sexual issues with men diagnosed with testicular cancer.

Science.gov (United States)

Moore, Annamarie; Higgins, Agnes; Sharek, Danika

2013-08-01

Testicular cancer occurs at a time in a man's life when major social life changes are occurring and when body image, fertility, sexual desire and performance can be central issues. Oncology nurses, as members of the multidisciplinary team, are in an ideal position to address men's concerns. The aim of this study was to investigate oncology nurses' self-perceived knowledge and comfort in relation to discussing sexuality concerns with men diagnosed with testicular cancer and to identify the barriers and facilitators to such discussions. This study employed a self-completion, anonymous survey design with a sample of registered nurses working in five, randomly chosen, oncology centres in Ireland. In total, 89 questionnaires (45% response rate) were included for analysis. Findings suggest that although nurses were open to addressing concerns, few informed patients they were available to discuss sexual concerns. Nurses reported lacking knowledge of, and discomfort in, discussing the more intimate aspects of sexuality, including: ejaculatory difficulties, erectile dysfunction, impotence, prosthesis options and testicular self examination. Findings reinforce the need for more comprehensive education on sexuality issues and testicular cancer. Nurses need to take a more proactive approach to sexuality care, as opposed to the 'passive waiting stance' that permeates the current culture of care. Education programmes need to include specific information on sexual issues associated with testicular cancer, and oncology nurses must subsume sexuality as an essential aspect of their role through changes in policies and nursing care planning. Copyright © 2012 Elsevier Ltd. All rights reserved.

ExCEL in Social Work: Excellence in Cancer Education & Leadership An Oncology Social Work Response to the 2008 Institute of Medicine Report

Science.gov (United States)

Otis-Green, Shirley; Jones, Barbara; Zebrack, Brad; Kilburn, Lisa; Altilio, Terry A.; Ferrell, Betty

2014-01-01

ExCEL in Social Work : Excellence in Cancer Education & Leadership was a multi-year National Cancer Institute (NCI)-funded grant for the development and implementation of an innovative educational program for oncology social workers. The program’s curriculum focused upon six core competencies of psychosocial-spiritual support necessary to meet the standard of care recommended by the 2008 Institute of Medicine (IOM) Report: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. The curriculum was delivered through a collaborative partnership between the City of Hope National Medical Center and the two leading professional organizations devoted exclusively to representing oncology social workers - the Association of Oncology Social Work and the Association of Pediatric Oncology Social Workers. Initial findings support the feasibility and acceptability of this tailored leadership skills-building program for participating oncology social workers. PMID:25146345

Psycho-Oncology: A Patient's View.

Science.gov (United States)

Garcia-Prieto, Patricia

2018-01-01

Culturally the most important, valued, and less stigmatized part of cancer care is the medical part: The surgeon cutting the tumors out and the oncologist leading the strategic decision-making of the medical treatments available. The least valued and stigmatized part of cancer remains the psychosocial care. This chapter describes-through the eyes of an academic, psychologist, stage IV melanoma patient, and patient advocate-how one patient navigated changing psycho-oncological needs from early stage-to-stage IV through a whole range of psychological interventions available. Her voice joins that of all cancer patients around the world whom are urgently calling for psycho-oncological care to be fully recognized as a central part of cancer treatment.

The Impact of Alternative Payment Models on Oncology Innovation and Patient Care.

Science.gov (United States)

Miller, Amy M; Omenn, Gilbert S; Kean, Marcia A

2016-05-15

Oncology care is in a time of major transformation. Scientific discovery is driving breakthroughs in prevention, diagnostics, and treatment, resulting in tremendous gains for patients as the number of cancer survivors continues to grow on an annual basis. At the same time, there is mounting pressure across the healthcare system to contain costs while improving the quality of cancer care. In response to this pressure, private and government payers are increasingly turning to tools such as alternative payment models (APM) and clinical pathways to improve the efficiency of care, inform coverage decisions, and support shared decision-making. As APMs, clinical pathways and other tools are utilized more broadly, it will be critical that these models support the evidence-based use of innovative biomedical advances, including personalized medicine, and deliver patient-centered, high-value care. Clin Cancer Res; 22(10); 2335-41. ©2016 AACR. ©2016 American Association for Cancer Research.

Puerto Rico NCI Community Oncology Research Program Minority/Underserved | Division of Cancer Prevention

Science.gov (United States)

The Puerto Rico NCI Community Oncology Research Program (PRNCORP) will be the principal organization in the island that promotes cancer prevention, control and screening/post-treatment surveillance clinical trials. It will conduct cancer care delivery research and will provide access to treatment and imaging clinical trials conducted under the reorganization of the National

Home care to Older adult with cancer

International Nuclear Information System (INIS)

Villagra, J; Castro, C; Meneses, S.

2004-01-01

Objective: Home care of the elderly with cancer. After the development of a program of oncology home care and over a period of five years, we believe that the evaluation allows us to have our proposal and challenges in the continuity of the program. This evidence is based in our old advanced Uruguayan population, and consequently increase this cancer population, we should define which pointed toward our objective, in order to get the best quality life. After one year with a project based on general rules, the evidence threw an evaluation, that we should review the model of care with which we were working. We continue to Auto-care model Dorothea Orem. The main objective became q uality of life : Take care as the primary Older Adult; Specific care their cancer to become symptomatic secondary complications to the evolution of tumor biology; Secondary prevention of cause therapeutic effect; Family integration, without changing the pace of life that the elderly had before being with cancer. Nursing challenge: Maintain autonomy achieved in these 5 years. Deepen the social equilibrium that we are committed daily between patient and family.Do not miss the professionalism achieved today.Proposal for nursing: Consider a wide field of nursing and for this achievement is need knowledge of 2nd level of community work, knowledge Clinical knowledge in Oncology Nursing, autonomy in decision making. For older adults with cancer: No out of its middle. Maintain priority habits and customs. Do not let it lose their self-esteem with their own values. Caution changes must take care to better manage the evolution of their illness. Conclusion: Oncology nursing is a specialty. Without this formation will be ever more away the development of these programs in our environment, or fall in applying for only economic convenience, losing professionalism. Our population is increasing

2015 President's Plenary International Psycho-oncology Society: psychosocial care as a human rights issue-challenges and opportunities.

Science.gov (United States)

Travado, Luzia; Breitbart, William; Grassi, Luigi; Fujisawa, Daisuke; Patenaude, Andrea; Baider, Lea; Connor, Stephen; Fingeret, Michelle

2017-04-01

The International Psycho-Oncology Society (IPOS) Human Rights Task Force has been working since 2008 to raise awareness and support, for the relevance of psychosocial cancer care as a human rights issue. In 2014 the "Lisbon Declaration: Psychosocial Cancer Care as a Universal Human Right" was fully endorsed by IPOS. Subsequently, the IPOS Standard on Quality Cancer Care, endorsed by 75 cancer organizations worldwide, has been updated and now includes 3 core principles: Psychosocial cancer care should be recognised as a universal human right; Quality cancer care must integrate the psychosocial domain into routine care; Distress should be measured as the 6th vital sign. The President's plenary held at the 2015 World Congress of Psycho-Oncology in Washington DC was devoted to discussing psychosocial care as a human rights issue. Many challenges and opportunities are illustrated in different continents and contexts: from Africa where resources for basic cancer treatment are scarce and children and their parents face significant difficulties with hospital detention practices; to Europe where for many countries psychosocial care is still seen as a luxury; and the Middle East where Muslim women face stigma and a culture of silence over cancer. We further discuss how to move the Lisbon Declaration forward towards its implementation into clinical practice globally, using the successful example of the World Health Assembly resolution supporting palliative care as a human right which has achieved widespread approval, and identifying the vital role the IPOS Federation of National Psychoncology Societies plays worldwide to move this agenda forward. Copyright © 2016 John Wiley & Sons, Ltd.

2015 President's Plenary International Psycho-oncology Society: psychosocial care as a human rights issue–challenges and opportunities

Science.gov (United States)

Travado, Luzia; Breitbart, William; Grassi, Luigi; Fujisawa, Daisuke; Patenaude, Andrea; Baider, Lea; Connor, Stephen; Fingeret, Michelle

2017-01-01

The International Psycho-Oncology Society (IPOS) Human Rights Task Force has been working since 2008 to raise awareness and support, for the relevance of psychosocial cancer care as a human rights issue. In 2014 the “Lisbon Declaration: Psychosocial Cancer Care as a Universal Human Right” was fully endorsed by IPOS. Subsequently, the IPOS Standard on Quality Cancer Care, endorsed by 75 cancer organizations worldwide, has been updated and now includes 3 core principles: Psychosocial cancer care should be recognised as a universal human right; Quality cancer care must integrate the psychosocial domain into routine care; Distress should be measured as the 6th vital sign. The President's plenary held at the 2015 World Congress of Psycho-Oncology in Washington DC was devoted to discussing psychosocial care as a human rights issue. Many challenges and opportunities are illustrated in different continents and contexts: from Africa where resources for basic cancer treatment are scarce and children and their parents face significant difficulties with hospital detention practices; to Europe where for many countries psychosocial care is still seen as a luxury; and the Middle East where Muslim women face stigma and a culture of silence over cancer. We further discuss how to move the Lisbon Declaration forward towards its implementation into clinical practice globally, using the successful example of the World Health Assembly resolution supporting palliative care as a human right which has achieved widespread approval, and identifying the vital role the IPOS Federation of National Psychoncology Societies plays worldwide to move this agenda forward. PMID:27530206

End-of-life care in pediatric neuro-oncology.

Science.gov (United States)

Vallero, Stefano Gabriele; Lijoi, Stefano; Bertin, Daniele; Pittana, Laura Stefania; Bellini, Simona; Rossi, Francesca; Peretta, Paola; Basso, Maria Eleonora; Fagioli, Franca

2014-11-01

The management of children with cancer during the end-of-life (EOL) period is often difficult and requires skilled medical professionals. Patients with tumors of the central nervous system (CNS) with relapse or disease progression might have additional needs because of the presence of unique issues, such as neurological impairment and altered consciousness. Very few reports specifically concerning the EOL period in pediatric neuro-oncology are available. Among all patients followed at our center during the EOL, we retrospectively analyzed data from 39 children and adolescents with brain tumors, in order to point out on their peculiar needs. Patients were followed-up for a median time of 20.1 months. Eighty-two percent were receiving only palliative therapy before death. Almost half the patients (44%) died at home, while 56% died in a hospital. Palliative sedation with midazolam was performed in 58% of cases; morphine was administered in 51.6% of cases. No patient had uncontrolled pain. The EOL in children with advanced CNS cancer is a period of active medical care. Patients may develop complex neurological symptoms and often require long hospitalization. We organized a network-based collaboration among the reference pediatric oncology center, other pediatric hospitals and domiciliary care personnel, with the aim to ameliorate the quality of care during the EOL period. In our cohort, palliative sedation was widely used while no patients died with uncontrolled pain. A precise process of data collection and a better sharing of knowledge are necessary in order to improve the management of such patients. © 2014 Wiley Periodicals, Inc.

Palliative care and pediatric surgical oncology.

Science.gov (United States)

Inserra, Alessandro; Narciso, Alessandra; Paolantonio, Guglielmo; Messina, Raffaella; Crocoli, Alessandro

2016-10-01

Survival rate for childhood cancer has increased in recent years, reaching as high as 70% in developed countries compared with 54% for all cancers diagnosed in the 1980s. In the remaining 30%, progression or metastatic disease leads to death and in this framework palliative care has an outstanding role though not well settled in all its facets. In this landscape, surgery has a supportive actor role integrated with other welfare aspects from which are not severable. The definition of surgical palliation has moved from the ancient definition of noncurative surgery to a group of practices performed not to cure but to alleviate an organ dysfunction offering the best quality of life possible in all the aspects of life (pain, dysfunctions, caregivers, psychosocial, etc.). To emphasize this aspect a more modern definition has been introduced: palliative therapy in whose context is comprised not only the care assistance but also the plans of care since the onset of illness, teaching the matter to surgeons in training and share paths. Literature is very poor regarding surgical aspects specifically dedicated and all researches (PubMed, Google Scholar, and Cochrane) with various meshing terms result in a more oncologic and psychosocial effort. Copyright © 2016 Elsevier Inc. All rights reserved.

Integration of oncology and palliative care: setting a benchmark.

Science.gov (United States)

Vayne-Bossert, P; Richard, E; Good, P; Sullivan, K; Hardy, J R

2017-10-01

Integration of oncology and palliative care (PC) should be the standard model of care for patients with advanced cancer. An expert panel developed criteria that constitute integration. This study determined whether the PC service within this Health Service, which is considered to be fully "integrated", could be benchmarked against these criteria. A survey was undertaken to determine the perceived level of integration of oncology and palliative care by all health care professionals (HCPs) within our cancer centre. An objective determination of integration was obtained from chart reviews of deceased patients. Integration was defined as >70% of all respondents answered "agree" or "strongly agree" to each indicator and >70% of patient charts supported each criteria. Thirty-four HCPs participated in the survey (response rate 69%). Over 90% were aware of the outpatient PC clinic, interdisciplinary and consultation team, PC senior leadership, and the acceptance of concurrent anticancer therapy. None of the other criteria met the 70% agreement mark but many respondents lacked the necessary knowledge to respond. The chart review included 67 patients, 92% of whom were seen by the PC team prior to death. The median time from referral to death was 103 days (range 0-1347). The level of agreement across all criteria was below our predefined definition of integration. The integration criteria relating to service delivery are medically focused and do not lend themselves to interdisciplinary review. The objective criteria can be audited and serve both as a benchmark and a basis for improvement activities.

Telehealth, Mobile Applications, and Wearable Devices are Expanding Cancer Care Beyond Walls.

Science.gov (United States)

Cannon, Carol

2018-05-01

To review telehealth solutions, mobile applications, and wearable devices that are currently impacting patients, caregivers, and providers who work in the oncology setting. A literature search was conducted using the terms (Telehealth, Mobile Health, mHealth, Wearable Devices) + (Oncology, Cancer Care). There are many current applications of telehealth and mobile health in the oncology setting. Nurses who care for patients with cancer should be aware of the pervasiveness and impact of telehealth and mobile health to this unique population. Copyright © 2018 Elsevier Inc. All rights reserved.

A Comprehensive Definition for Integrative Oncology.

Science.gov (United States)

Witt, Claudia M; Balneaves, Lynda G; Cardoso, Maria J; Cohen, Lorenzo; Greenlee, Heather; Johnstone, Peter; Kücük, Ömer; Mailman, Josh; Mao, Jun J

2017-11-01

Integrative oncology, which is generally understood to refer to the use of a combination of complementary medicine therapies in conjunction with conventional cancer treatments, has been defined in different ways, but there is no widely accepted definition. We sought to develop and establish a consensus for a comprehensive definition of the field of integrative oncology. We used a mixed-methods approach that included a literature analysis and a consensus procedure, including an interdisciplinary expert panel and surveys, to develop a comprehensive and acceptable definition for the term "integrative oncology." The themes identified in the literature and from the expert discussion were condensed into a two-sentence definition. Survey respondents had very positive views on the draft definition, and their comments helped to shape the final version. The final definition for integrative oncology is: "Integrative oncology is a patient-centered, evidence-informed field of cancer care that utilizes mind and body practices, natural products, and/or lifestyle modifications from different traditions alongside conventional cancer treatments. Integrative oncology aims to optimize health, quality of life, and clinical outcomes across the cancer care continuum and to empower people to prevent cancer and become active participants before,during, and beyond cancer treatment." This short and comprehensive definition for the term integrative oncology will facilitate a better understanding and communication of this emerging field. This definition will also drive focused and cohesive effort to advance the field of integrative oncology. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The National Cancer Institute's Physical Sciences - Oncology Network

Science.gov (United States)

Espey, Michael Graham

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

Meeting the challenge of managed care - Part I: Radiation oncology as an important part of multi-modal care

International Nuclear Information System (INIS)

Rose, Christopher M.; Botnick, Leslie E.; Hinkle, Milton; Linden, Jeffrey

1997-01-01

Radiation Oncology is an important component in multi-modality cancer care. Managed care has defined a number of different ways that radiation oncologists can interact with the other members of the cancer team. This course will review those options. The change in health care delivery is forcing radiation oncologists to examine every aspect of how they organize themselves, deliver care, evaluate that care, and how they are reimbursed for this process. This course will attempt to examine how the pressures of the new paradigms of health care delivery; managed care and outcomes research are impacting upon radiation therapy practice, and what radiation oncologists can do to maintain patient care standards. I. Introduction: A. Managed Care: What it is and where it is going 1. PPO's 2. HMO's 3. POS plans 4. Carve-outs B. Outcomes Research: What it can and cannot do 1. Patterns of care and SEER 2. Rand 3. ''Surrogate outcomes:'' patient satisfaction, quality of life indicators II. Moving from QA and CQI and Benchmarking A. Radiation Oncologists cannot take anything for granted B. Using analytical tools to evaluate all aspects of the radiation oncology practice. 1. Capital Purchases 2. Operational Aspects III Evaluating Staffing Needs A. What traditional jobs in the department should stay? B. Is the cross-training seen in the rest of the hospital appropriate in radiation oncology C. Outsourcing and multi-department organization as ways to improve efficiency D. What about physician extenders? E. What residents, newly trained radiation oncologists, and physician-practice managers must acknowledge to each other IV. Evaluating Technology A. See second and third talks in this series B. Improving efficiency: how does this help when one is not at capacity C. Increasing throughput D. Decreasing cost V. Informatics A. See second and third talks in this series B. What should one expect the computer to do for you C. Some personal observations VI. Gains from Share Services A. Should

Art Therapy with an Oncology Care Team

Science.gov (United States)

Nainis, Nancy A.

2005-01-01

Oncology nurses are particularly vulnerable to "burnout" syndrome due to the intensity of their work and the ongoing losses they experience while providing oncology care to their patients. High levels of stress in the workplace left untended lead to high job turnover, poor productivity, and diminished quality of care for patients.…

Oncology healthcare professionals' perspectives on the psychosocial support needs of cancer patients during oncology treatment.

Science.gov (United States)

Aldaz, Bruno E; Treharne, Gareth J; Knight, Robert G; Conner, Tamlin S; Perez, David

2017-09-01

This study explored oncology healthcare professionals' perspectives on the psychosocial support needs of diverse cancer patients during oncology treatment. Six themes were identified using thematic analysis. Healthcare professionals highlighted the importance of their sensitivity, respect and emotional tact during appointments in order to effectively identify and meet the needs of oncology patients. Participants also emphasised the importance of building rapport that recognises patients as people. Patients' acceptance of treatment-related distress and uncertainty was described as required for uptake of available psychosocial supportive services. We offer some practical implications that may help improve cancer patients' experiences during oncology treatment.

Acute oncological emergencies.

LENUS (Irish Health Repository)

Gabriel, J

2012-01-01

The number of people receiving systemic anti-cancer treatment and presenting at emergency departments with treatment-related problems is rising. Nurses will be the first point of contact for most patients and need to be able to recognise oncological emergencies to initiate urgent assessment of patients and referral to the acute oncology team so that the most appropriate care can be delivered promptly. This article discusses the role of acute oncology services, and provides an overview of the most common acute oncological emergencies.

Supporting cancer patients with work-related problems through an oncological occupational physician: a feasibility study.

Science.gov (United States)

Zaman, A C G N M; Bruinvels, D J; de Boer, A G E M; Frings-Dresen, M H W

2017-09-01

To evaluate the feasibility of an oncological occupational physician (OOP) who is trained in oncological work-related problems, and in providing work-related support to cancer patients within the curative setting. We assessed facilitators and barriers that affect the activities of an OOP, and the satisfaction of the OOPs and patients with this new form of health care. Interviews were held with (1) OOPs (N = 13) to assess facilitators, barriers and their satisfaction with their ability to give supportive care and (2) cancer patients (N = 8) to assess their satisfaction concerning consulting an OOP. The main facilitators were positive feedback from health care providers and patients about the received care and support that the OOP had given, and the additional knowledge of the OOPs about cancer and work-related problems. Major barriers for being active as an OOP were lack of financial support for the OOP and the unfamiliarity of patients and health care providers with the specialised occupational physician. Both OOPs and the specialised knowledge and additional training of the OOPs facilitated providing support to cancer patients and survivors with work-related problems. Familiarity with the specialised occupational physician and financial support should be improved. © 2015 John Wiley & Sons Ltd.

Effects of oncological care pathways in primary and secondary care on patient, professional, and health systems outcomes: protocol for a systematic review and meta-analysis.

Science.gov (United States)

van Hoeve, Jolanda C; Vernooij, Robin W M; Lawal, Adegboyega K; Fiander, Michelle; Nieboer, Peter; Siesling, Sabine; Rotter, Thomas

2018-03-27

The high impact of a cancer diagnosis on patients and their families and the increasing costs of cancer treatment call for optimal and efficient oncological care. To improve the quality of care and to minimize healthcare costs and its economic burden, many healthcare organizations introduce care pathways to improve efficiency across the continuum of cancer care. However, there is limited research on the effects of cancer care pathways in different settings. The aim of this systematic review and meta-analysis described in this protocol is to synthesize existing literature on the effects of oncological care pathways. We will conduct a systematic search strategy to identify all relevant literature in several biomedical databases, including Cochrane library, MEDLINE, Embase, and CINAHL. We will follow the methodology of Cochrane Effective Practice and Organisation of Care (EPOC), and we will include randomized trials, non-randomized trials, controlled before-after studies, and interrupted time series studies. In addition, we will include full economic evaluations (cost-effectiveness analyses, cost-utility analyses, and cost-benefit analyses), cost analyses, and comparative resource utilization studies, if available. Two reviewers will independently screen all studies and evaluate those included for risk of bias. From these studies, we will extract data regarding patient, professional, and health systems outcomes. Our systematic review will follow the PRISMA set of items for reporting in systematic reviews and meta-analyses. Following the protocol outlined in this article, we aim to identify, assess, and synthesize all available evidence in order to provide an evidence base on the effects of oncological care pathways as reported in the literature. PROSPERO CRD42017057592 .

Monitoring cancer stem cells: insights into clinical oncology

Directory of Open Access Journals (Sweden)

Lin SC

2016-02-01

Full Text Available ShuChen Lin,1,* YingChun Xu,2,* ZhiHua Gan,1 Kun Han,1 HaiYan Hu,3 Yang Yao,3 MingZhu Huang,4 DaLiu Min1 1Department of Oncology, Shanghai Sixth People’s Hospital East Campus, Shanghai Jiao Tong University, 2Department of Oncology, Renji Hospital, Shanghai Jiao Tong University, 3Department of Oncology, The Sixth People’s Hospital, Shanghai Jiao Tong University, 4Department of Medical Oncology, Cancer Hospital of Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Abstract: Cancer stem cells (CSCs are a small, characteristically distinctive subset of tumor cells responsible for tumor initiation and progression. Several treatment modalities, such as surgery, glycolytic inhibition, driving CSC proliferation, immunotherapy, and hypofractionated radiotherapy, may have the potential to eradicate CSCs. We propose that monitoring CSCs is important in clinical oncology as CSC populations may reflect true treatment response and assist with managing treatment strategies, such as defining optimal chemotherapy cycles, permitting pretreatment cancer surveillance, conducting a comprehensive treatment plan, modifying radiation treatment, and deploying rechallenge chemotherapy. Then, we describe methods for monitoring CSCs. Keywords: cancer stem cells, glycolytic inhibition, watchful waiting, rechallenge, immunotherapy

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.

The effects of a multimodal training program on burnout syndrome in gynecologic oncology nurses and on the multidisciplinary psychosocial care of gynecologic cancer patients: an Italian experience.

Science.gov (United States)

Lupo, F N; Arnaboldi, Paola; Santoro, L; D'Anna, E; Beltrami, C; Mazzoleni, E M; Veronesi, P; Maggioni, A; Didier, F

2013-06-01

In cancer care, the burden of psycho-emotional elements involved on the patient-healthcare provider relationship cannot be ignored. The aim of this work is to have an impact on the level of burnout experienced by European Institute of Oncology (IEO) gynecologic oncology nurses (N = 14) and on quality of multidisciplinary team work. We designed a 12 session multimodal training program consisting of a 1.5 hour theoretical lesson on a specific issue related to gynecologic cancer patient care, 20 minute projection of a short film, and 1.75 hours of role-playing exercises and experiential exchanges. The Link Burnout Questionnaire (Santinello, 2007) was administered before and after the completion of the intervention. We also monitored the number of patients referred to the Psycho-oncology Service as an indicator of the efficacy of the multidisciplinary approach. After the completion of the program, the general level of burnout significantly diminished (p = 0.02); in particular, a significant decrease was observed in the "personal inefficacy" subscale (p = 0.01). The number of patients referred to the Psycho-oncology Service increased by 50%. Nurses are in the first line of those seeing patients through the entire course of the disease. For this reason, they are at a particularly high risk of developing work-related distress. Structured training programs can be a valid answer to work-related distress, and feeling part of a multidisciplinary team helps in providing patients with better psychosocial care.

Cancer Patients and Oncology Nursing: Perspectives of Oncology ...

African Journals Online (AJOL)

2017-10-26

Oct 26, 2017 ... findings of this study, nurses declared that working with cancer patients increase burnout, they are ..... of working in oncology to entire work life was 75.8% for nurses in the study .... This professional balance is important for ...

Do critical care units play a role in the management of gynaecological oncology patients? The contribution of gynaecologic oncologist in running critical care units.

Science.gov (United States)

Davidovic-Grigoraki, Miona; Thomakos, Nikolaos; Haidopoulos, Dimitrios; Vlahos, Giorgos; Rodolakis, Alexandros

2017-03-01

Routine post-operative care in high dependency unit (HDU), surgical intensive care unit (SICU) and intensive care unit (ICU) after high-risk gynaecological oncology surgical procedures may allow for greater recognition and correct management of post-operative complications, thereby reducing long-term morbidity and mortality. On the other hand, unnecessary admissions to these units lead to increased morbidity - nosocomial infections, increased length of hospital stay and higher hospital costs. Gynaecological oncology surgeons continue to look after their patient in the HDU/SICU and have the final role in decision-making on day-to-day basis, making it important to be well versed in critical care management and ensure the best care for their patients. Post-operative monitoring and the presence of comorbid illnesses are the most common reasons for admission to the HDU/SICU. Elderly and malnutritioned patients, as well as, bowel resection, blood loss or greater fluid resuscitation during the surgery have prolonged HDU/SICU stay. Patients with ovarian cancer have a worse survival outcome than the patients with other types of gynaecological cancer. Dependency care is a part of surgical management and it should be incorporated formally into gynaecologic oncology training programme. © 2016 John Wiley & Sons Ltd.

Mucinous Histology Signifies Poor Oncologic Outcome in Young Patients With Colorectal Cancer.

Science.gov (United States)

Soliman, Basem G; Karagkounis, Georgios; Church, James M; Plesec, Thomas; Kalady, Matthew F

2018-05-01

The incidence of colorectal cancer in the young (under age 40) is increasing, and this population has worse oncologic outcomes. Mucinous histology is a potential prognostic factor in colorectal cancer, but has not been evaluated specifically in young patients. The objective of the study was to determine factors associated with poor outcome in young patients with colorectal cancer (≤40 years) and to determine relationships between mucinous histology and oncologic outcomes in this population. This is a retrospective study. Patients from a single-institution tertiary care center were studied. A total of 224 patients with colorectal cancer under 40 years of age diagnosed between 1990 and 2010 were included (mean age, 34.7 years; 51.3% female). 34 patients (15.2%) had mucinous histology. There were no interventions. Oncologic outcomes were analyzed according to the presence of mucinous histology. The mucinous and nonmucin colorectal cancer study populations were statistically similar in age, sex, tumor location, pathological stage, differentiation, and adjuvant chemotherapy use. Five-year disease-free survival was 29.1% versus 71.3% (p colorectal cancers recurred earlier at a median time of 36.4 months versus 94.2 months for nonmucin colorectal cancers (p colorectal cancer. This is associated with early and high recurrence rates, despite use of standard neoadjuvant and adjuvant regimens. Physicians need to be aware of this association and potentially explore novel treatment options. See Video Abstract at http://links.lww.com/DCR/A575.

The codesign of an interdisciplinary team-based intervention regarding initiating palliative care in pediatric oncology.

Science.gov (United States)

Hill, Douglas L; Walter, Jennifer K; Casas, Jessica A; DiDomenico, Concetta; Szymczak, Julia E; Feudtner, Chris

2018-04-07

Children with advanced cancer are often not referred to palliative or hospice care before they die or are only referred close to the child's death. The goals of the current project were to learn about pediatric oncology team members' perspectives on palliative care, to collaborate with team members to modify and tailor three separate interdisciplinary team-based interventions regarding initiating palliative care, and to assess the feasibility of this collaborative approach. We used a modified version of experience-based codesign (EBCD) involving members of the pediatric palliative care team and three interdisciplinary pediatric oncology teams (Bone Marrow Transplant, Neuro-Oncology, and Solid Tumor) to review and tailor materials for three team-based interventions. Eleven pediatric oncology team members participated in four codesign sessions to discuss their experiences with initiating palliative care and to review the proposed intervention including patient case studies, techniques for managing uncertainty and negative emotions, role ambiguity, system-level barriers, and team communication and collaboration. The codesign process showed that the participants were strong supporters of palliative care, members of different teams had preferences for different materials that would be appropriate for their teams, and that while participants reported frustration with timing of palliative care, they had difficulty suggesting how to change current practices. The current project demonstrated the feasibility of collaborating with pediatric oncology clinicians to develop interventions about introducing palliative care. The procedures and results of this project will be posted online so that other institutions can use them as a model for developing similar interventions appropriate for their needs.

Implementing and evaluating shared decision making in oncology practice.

Science.gov (United States)

Kane, Heather L; Halpern, Michael T; Squiers, Linda B; Treiman, Katherine A; McCormack, Lauren A

2014-01-01

Engaging individuals with cancer in decision making about their treatments has received increased attention; shared decision making (SDM) has become a hallmark of patient-centered care. Although physicians indicate substantial interest in SDM, implementing SDM in cancer care is often complex; high levels of uncertainty may exist, and health care providers must help patients understand the potential risks versus benefits of different treatment options. However, patients who are more engaged in their health care decision making are more likely to experience confidence in and satisfaction with treatment decisions and increased trust in their providers. To implement SDM in oncology practice, physicians and other health care providers need to understand the components of SDM and the approaches to supporting and facilitating this process as part of cancer care. This review summarizes recent information regarding patient and physician factors that influence SDM for cancer care, outcomes resulting from successful SDM, and strategies for implementing SDM in oncology practice. We present a conceptual model illustrating the components of SDM in cancer care and provide recommendations for facilitating SDM in oncology practice. © 2014 American Cancer Society, Inc.

A pilot training programme for health and social care professionals providing oncological and palliative care to lesbian, gay and bisexual patients in Ireland.

LENUS (Irish Health Repository)

Reygan, Finn C G

2012-05-09

OBJECTIVE: The international literature points to the specific cancer risks and palliative care needs of lesbian, gay and bisexual (LGB) populations. However, with the exception of a programme in the USA, there is a lack of training internationally for health and social care professionals providing oncological and palliative care to LGB patients. In Ireland, a training project funded by the Irish Cancer Society, the Irish Hospice Foundation and the Health Service Executive developed a training pilot programme for health and social care professionals providing oncological and palliative care to LGB patients. METHODS: Over 200 (N = 201) oncology and palliative care staff participated in 17 brief, 50-min trainings in pilot sites. Evaluation of the training included self-report questionnaires at the end of each training and an evaluation interview with one participant from each of the four sites. RESULTS: The majority of participants reported that they would recommend the training to their colleagues, were interested in further training in the area and found the training useful for their practice. They also reported becoming more familiar with LGB-related language and terminology, became more knowledgeable of LGB health issues and reported becoming more confident in providing care to LGB patients. CONCLUSIONS: Recommendations are that the training be made available across the health services in Ireland and included in postgraduate courses for trainee health and social care professionals. Copyright © 2012 John Wiley & Sons, Ltd.

Oncology nursing in Cuba: report of the delegation.

Science.gov (United States)

Sheldon, Lisa Kennedy; Leonard, Kathleen; Gross, Anne; Hartnett, Erin; Poage, Ellen; Squires, Jennifer; Ullemeyer, Vicki; Schueller, Mary; Stary, Susan; Miller, Mary Alice

2012-08-01

In December 2011, the first delegation of oncology nurses from the United States visited Havana, Cuba. The delegation included oncology nurses, educators, and leaders from across America and provided opportunities to learn about the healthcare system, cancer, and oncology nursing in Cuba. Delegation members attended lectures, toured facilities, and enjoyed Cuban culture. This exchange highlighted the similarities in cancer care and oncology nursing between countries and opened doors for future collaborations.

Multi-disciplinary summit on genetics services for women with gynecologic cancers: A Society of Gynecologic Oncology White Paper.

Science.gov (United States)

Randall, Leslie M; Pothuri, Bhavana; Swisher, Elizabeth M; Diaz, John P; Buchanan, Adam; Witkop, Catherine T; Bethan Powell, C; Smith, Ellen Blair; Robson, Mark E; Boyd, Jeff; Coleman, Robert L; Lu, Karen

2017-08-01

To assess current practice, advise minimum standards, and identify educational gaps relevant to genetic screening, counseling, and testing of women affected by gynecologic cancers. The Society of Gynecologic Oncology (SGO) organized a multidisciplinary summit that included representatives from the American College of Obstetricians and Gynecologists (ACOG), the American Society Clinical Oncology (ASCO), the National Society of Genetic Counselors (NSGC), and patient advocacy groups, BrightPink and Facing our Risk of Cancer Empowered (FORCE). Three subject areas were discussed: care delivery models for genetic testing, barriers to genetic testing, and educational opportunities for providers of genetic testing. The group endorsed current SGO, National Comprehensive Cancer Network (NCCN), and NSGC genetic testing guidelines for women affected with ovarian, tubal, peritoneal cancers, or DNA mismatch repair deficient endometrial cancer. Three main areas of unmet need were identified: timely and universal genetic testing for women with ovarian, fallopian tube, and peritoneal cancers; education regarding minimum standards for genetic counseling and testing; and barriers to implementation of testing of both affected individuals as well as cascade testing of family members. Consensus building among all stakeholders resulted in an action plan to address gaps in education of gynecologic oncology providers and delivery of cancer genetics care. Copyright © 2017. Published by Elsevier Inc.

Challenges Encountered by Vietnamese Nurses When Caring for Patients With Cancer.

Science.gov (United States)

Thuy Nguyen, Ly; Clemenceau Annoussamy, Lourdes; LeBaron, Virginia T

2017-03-01

Providing holistic care is acknowledged as central to providing quality care for patients with cancer, but providing competent nursing care consistent with these approaches remains a challenge for nurses in Vietnam. Obstacles for Vietnamese oncology nurses include their low status, the limited scope of nursing practice, work overload in a hierarchical system, and cultural beliefs that view death and dying as taboo. Additional research to support oncology nurses in Vietnam must acknowledge the merits of improving nursing education as an important strategy for enhancing nursing autonomy, quality of care, and outcomes for the increasing number of patients with cancer in low- and middle-income countries.

Survey of Medical Oncology Status in Korea (SOMOS-K): A National Survey of Medical Oncologists in the Korean Association for Clinical Oncology (KACO).

Science.gov (United States)

Kim, Do Yeun; Lee, Yun Gyoo; Kim, Bong-Seog

2017-07-01

This study was conducted to investigate the current role of medical oncologists in cancer care with a focus on increasing the recognition of medical oncology as an independent specialty. Questionnaires modified from the Medical Oncology Status in Europe Survey dealing with oncology structure, resources, research, and patterns of care given by medical oncologists were selected. Several modifications were made to the questionnaire after feedback from the insurance and policy committee of the Korean Association for Clinical Oncology (KACO). The online survey was then sent to KACO members. A total of 214 medical oncologists (45.8% of the total inquiries), including 71 directors of medical oncology institutions, took the survey. Most institutions had various resources, including a medical oncology department (94.1%) and a department of radiation oncology (82.4%). There was an average of four medical oncologists at each institution. Medical oncologists were involved in various treatments from diagnosis to end-of-life care. They were also chemotherapy providers from a wide range of institutions that treated many types of solid cancers. In addition, 86.2% of the institutions conducted research. This is the first national survey in Korea to show that medical oncologists are involved in a wide range of cancer treatments and care. This survey emphasizes the contributions and proper roles of medical oncologists in the evolving health care environment in Korea.

Implementation of an Integrative Oncological Concept in the Daily Care of a German Certified Breast Cancer Center.

Science.gov (United States)

Schad, Friedemann; Thronicke, Anja; Merkle, Antje; Steele, Megan L; Kröz, Matthias; Herbstreit, Cornelia; Matthes, Harald

2018-01-01

In recent decades the concept of integrative medicine has attracted growing interest in patients and professionals. At the Gemeinschaftskrankenhaus Havelhöhe (GKH), a hospital specialized in anthroposophical medicine, a breast cancer center (BCC) has been successfully certified for more than 5 years. The objective of the present study was to analyze how integrative strategies were implemented in the daily care of primary breast cancer patients. Clinical, demographic, and follow-up data as well as information on non-pharmacological interventions were analyzed. In addition, BCC quality measures were compared with data of the National Breast Cancer Benchmarking Report 2016. Between 2011 and 2016, 741 primary breast cancer patients (median age 57.4 years) were treated at the GKH BCC. 91.5% of the patients showed Union for International Cancer Control (UICC) stage 0, I, II, or III and 8.2% were in UICC stage IV. 97% of the patients underwent surgery, 53% radiation, 38% had hormone therapy, and 25% received cytostatic drugs. 96% of the patients received non-pharmacological interventions and 32% received Viscum album L. Follow-up was performed in up to 93% of the patients 2 years after first diagnosis. Compared to nationwide benchmarking BCCs, the GKH BCC met the requirements in central items. The results of the present study show that integrative therapies offered by the concept of anthroposophical medicine can be implemented in the daily care and treatment of a certified BCC. However, as national guidelines on integrative concepts in oncology are missing, further studies are needed for a systematic evaluation of integrative treatment and care concepts in this field. © 2018 The Author(s). Published by S. Karger GmbH, Freiburg.

Nonspecialty Nurse Education: Evaluation of the Oncology Intensives Initiative, an Oncology Curriculum to Improve Patient Care

Science.gov (United States)

Bagley, Kimberly A; Dunn, Sarah E; Chuang, Eliseu Y; Dorr, Victoria J; Thompson, Julie A; Smith, Sophia K

2018-04-01

A community hospital combined its medical and surgical patients with cancer on one unit, which resulted in nurses not trained in oncology caring for this patient population. The Oncology Intensives Initiative (ONCii) involved the (a) design and implementation of a daylong didactic boot camp class and a four-hour simulation session and (b) the examination of nurses' worries, attitudes, self-efficacy, and perception of interdisciplinary teamwork. A two-group, pre-/post-test design was implemented. Group 1 consisted of nurses who attended the didactic boot camp classes alone, whereas group 2 was comprised of nurses who attended the didactic boot camp classes and the simulation sessions. Results of data analysis showed a decrease in worries and an increase in positive attitudes toward chemotherapy administration in both groups, as well as an increase in self-efficacy among members of group 2.

Patterns of Care for Lung Cancer in Radiation Oncology Departments of Turkey

International Nuclear Information System (INIS)

Demiral, Ayse Nur; Alicikus, Zuemre Arican; Isil Ugur, Vahide; Karadogan, Ilker; Yoeney, Adnan; Andrieu, Meltem Nalca; Yalman, Deniz; Pak, Yuecel; Aksu, Gamze; Ozyigit, Goekhan; Ozkan, Luetfi; Kilciksiz, Sevil; Koca, Sedat; Caloglu, Murat; Yavuz, Ali Aydin; Basak Caglar, Hale; Beyzadeoglu, Murat; Igdem, Sefik

2008-01-01

Purpose: To determine the patterns of care for lung cancer in Turkish radiation oncology centers. Methods and Materials: Questionnaire forms from 21 of 24 (87.5%) centers that responded were evaluated. Results: The most frequent histology was non-small cell lung cancer (NSCLC) (81%). The most common postoperative radiotherapy (RT) indications were close/(+) surgical margins (95%) and presence of pN2 disease (91%). The most common indications for postoperative chemotherapy (CHT) were '≥ IB' disease (19%) and the presence of pN2 disease (19%). In Stage IIIA potentially resectable NSCLC, the most frequent treatment approach was neoadjuvant concomitant chemoradiotherapy (CHRT) (57%). In Stage IIIA unresectable and Stage IIIB disease, the most frequent approach was definitive concomitant CHRT (91%). In limited SCLC, the most common treatment approach was concomitant CHRT with cisplatin+etoposide for cycles 1-3, completion of CHT to cycles 4-6, and finally prophylactic cranial irradiation in patients with complete response (71%). Six cycles of cisplatin + etoposide CHT and palliative thoracic RT, when required, was the most commonly used treatment (81%) in extensive SCLC. Sixty-two percent of centers did not have endobronchial brachytherapy (EBB) facilities. Conclusion: There is great variation in diagnostic testing, treatment strategies, indications for postoperative RT and CHT, RT features, and EBB availability for LC cases. To establish standards, national guidelines should be prepared using a multidisciplinary approach

Radiolabeled antibodies in cancer. Oncology Overview

International Nuclear Information System (INIS)

1984-11-01

Oncology Overviews are a service of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute, intended to facilitate and promote the exchange of information between cancer scientists by keeping them aware of literature related to their research being published by other laboratories through the world. Each Oncology Overview represents a survey of the literature associated with a selected area of cancer research. It contains abstracts of articles which have been selected and organized by researchers associated with the field. Contents: Radiolabeled antibodies--labeling and imaging techniques; Radiolabeled antibodies--carcinoembryonic antigen; Radiolabeled antibodies--alpha-fetoprotein; Radiolabeled antibodies--human chorionic gonadotropin; Radiolabeled antibodies--ferritin; Radiolabeled antibodies--imaging of colorectal tumors; Radiolabeled antibodies--imaging of malignant melanoma; Radiolabeled antibodies--imaging of urogenital tumors; Radiolabeled antibodies--imaging of thyroid tumors; Radiolabeled antibodies--other clinical studies; Radiolabeled antibodies--selected preclinical studies; Radiolabeled antibodies--reviews

Design Challenges of an Episode-Based Payment Model in Oncology: The Centers for Medicare & Medicaid Services Oncology Care Model.

Science.gov (United States)

Kline, Ronald M; Muldoon, L Daniel; Schumacher, Heidi K; Strawbridge, Larisa M; York, Andrew W; Mortimer, Laura K; Falb, Alison F; Cox, Katherine J; Bazell, Carol; Lukens, Ellen W; Kapp, Mary C; Rajkumar, Rahul; Bassano, Amy; Conway, Patrick H

2017-07-01

The Centers for Medicare & Medicaid Services developed the Oncology Care Model as an episode-based payment model to encourage participating practitioners to provide higher-quality, better-coordinated care at a lower cost to the nearly three-quarter million fee-for-service Medicare beneficiaries with cancer who receive chemotherapy each year. Episode payment models can be complex. They combine into a single benchmark price all payments for services during an episode of illness, many of which may be delivered at different times by different providers in different locations. Policy and technical decisions include the definition of the episode, including its initiation, duration, and included services; the identification of beneficiaries included in the model; and beneficiary attribution to practitioners with overall responsibility for managing their care. In addition, the calculation and risk adjustment of benchmark episode prices for the bundle of services must reflect geographic cost variations and diverse patient populations, including varying disease subtypes, medical comorbidities, changes in standards of care over time, the adoption of expensive new drugs (especially in oncology), as well as diverse practice patterns. Other steps include timely monitoring and intervention as needed to avoid shifting the attribution of beneficiaries on the basis of their expected episode expenditures as well as to ensure the provision of necessary medical services and the development of a meaningful link to quality measurement and improvement through the episode-based payment methodology. The complex and diverse nature of oncology business relationships and the specific rules and requirements of Medicare payment systems for different types of providers intensify these issues. The Centers for Medicare & Medicaid Services believes that by sharing its approach to addressing these decisions and challenges, it may facilitate greater understanding of the model within the oncology

Guide for health professionals addressing oral care for individuals in oncological treatment based on scientific evidence.

Science.gov (United States)

Carvalho, Caroline Gomes; Medeiros-Filho, João Batista; Ferreira, Meire Coelho

2018-02-22

Oncological treatment can cause changes in the oral cavity compromising oral functions. The aim of the study was, based on a systematic review, to draft a guide directed at the team of health professionals involved in the oral care of oncological patients. A systematic search of the literature was performed for articles published between 2000 and April 2017. Searches were made of electronic databases and hand search. The inclusion criteria were systematic reviews of randomized clinical trials (RCTs) and RCTs published in English, involving pediatric and adult oncological patients and focused on the prevention and treatment of oral complications as well as studies addressing the maintenance of oral health. Among the 1237 studies identified, 129 were pre-selected and 54 were selected to form the basis for the clinical guide. The studies analyzed stress the need for oral assessments as well as preventive and curative actions prior to oncological treatment. To minimize the severity of oral problems, the studies emphasize daily oral care, the treatment of xerostomia with saliva substitute and hydration, and low-level laser therapy, nystatin, acyclovir, respectively, for the prevention and treatment of oral mucositis, oral candidiasis, and infection by herpes simplex virus. Thus, the guide produced addresses oral assessments and professional and home care before, during, and after oncological treatment. The guide drafted has the function of assisting health professionals involved in the oral care of patients with cancer, enabling the prevention or treatment of oral complications stemming from oncological treatment.

Addressing changed sexual functioning in cancer patients: A cross-sectional survey among Dutch oncology nurses.

Science.gov (United States)

Krouwel, E M; Nicolai, M P J; van Steijn-van Tol, A Q M J; Putter, H; Osanto, S; Pelger, R C M; Elzevier, H W

2015-12-01

In most types of cancer, the disease and its treatment can result in altered sexual function (SF). Oncology nurses are strategically placed to address SF since they have frequent patient interaction. Our aim was to establish their knowledge about and attitudes to SF in oncology care and identify their perceived barriers to addressing the subject. A 37-item questionnaire was administered during the 2012 Dutch Oncology Nursing Congress and mailed to 241 Dutch oncology nursing departments. The majority of 477 nurses (87.6%) agreed that discussing SF is their responsibility. Discussing SF routinely is performed by 33.4% of these nurses, consultations mainly consisted of mentioning treatment side-effects affecting SF (71.3%). There were significant differences depending on experience, knowledge, age, academic degree and department policy. Nurses ≤44 years old (p oncology experience (p = 0.001), insufficient knowledge (p oncology nurses consider counselling on sexual issues to be an important responsibility, in line with discussing other side-effects caused by the disease or its treatment. Nevertheless, cancer patients may not routinely be receiving a sexual health evaluation by oncology nurses. Results emphasize the potential benefit of providing knowledge, including practical training and a complete department protocol. Copyright © 2015 Elsevier Ltd. All rights reserved.

Patients' and Parents' Needs, Attitudes, and Perceptions About Early Palliative Care Integration in Pediatric Oncology.

Science.gov (United States)

Levine, Deena R; Mandrell, Belinda N; Sykes, April; Pritchard, Michele; Gibson, Deborah; Symons, Heather J; Wendler, David; Baker, Justin N

2017-09-01

Early palliative care integration for cancer patients is now touted as the optimal care model, yet significant barriers often prevent its implementation. A perceived barrier, especially for pediatric oncology patients, is the notion that patients and their families may not need or want palliative care involvement early in the disease trajectory. To determine the perception of symptom burden early in treatment and assess attitudes toward early integration of palliative care in pediatric oncology patient-parent pairs. Novel but pretested survey tools were administered to 129 patient-parent dyads of hospital-based pediatric oncology ambulatory clinics and inpatient units between September 2011 and January 2015. All patient participants were aged between 10 and 17 years and were diagnosed as having an oncologic condition 1 month to 1 year before enrollment. Both the patient and the parent in the dyad spoke English, and all participating parents provided written informed consent. A convenience sample was used for selection, with participants screened when otherwise presenting at a participating site. A total of 280 eligible participants were approached for study inclusion, 258 of whom were enrolled in the study (92.1% positive response-rate). Degree of perceived suffering from early symptom-related causes, attitudes toward early palliative care integration, and patient-parent concordance. Statistical analysis included descriptive statistics, calculation of concordance, McNemar test results, and Cochran-Armitage trend test results. Of the 129 patients in the dyads, 68 were boys, and 61 girls; of the 129 parents, 15 were men, and 114 women. Patients reported the following symptoms in the first month of cancer therapy: nausea (n = 109; 84.5%), loss of appetite (n = 97; 75.2%), pain (n = 96; 74.4%), anxiety (n = 77; 59.7%), constipation (n = 69; 53.5%), depression (n = 64; 49.6%), and diarrhea (n = 52; 40.3%). A large proportion of those

Cardio-Oncology - A new subspecialty with collaboration at its heart.

Science.gov (United States)

Ghosh, Arjun K; Walker, J Malcolm

Cardio-Oncology is the care of cancer patients with cardiovascular disease, overt or occult, already established or acquired during treatment. Cancer patients can present with a variety of cardiovascular problems not all of which are directly related to cancer therapy (medications or radiotherapy). The cardiovascular problems of oncology patients can range from ischaemia to arrhythmias and can also include valve problems and heart failure. As such, within cardiology, teamwork is required with members of different cardiology subspecialties. The way forward will be to adopt a multidisciplinary approach to produce optimal individual care. Close collaboration between cardiology and oncology specialists in a Cardio-Oncology setting can make this happen. Copyright © 2017. Published by Elsevier B.V.

Psycho-oncology in Australia: a descriptive review.

Science.gov (United States)

Butow, P; Dhillon, H; Shaw, J; Price, M

2017-01-01

Australia has a thriving Psycho-Oncology research and clinical community. In this article, the Australian health system in which Psycho-Oncology is embedded is described. Clinical Psycho-Oncology services are outlined, in terms of their composition, processes and reach. The development of the internationally ground-breaking Australian Psychosocial guidelines for the care of adults with cancer is described. Two large Psycho-Oncology organisations which are strongly linked to mainstream Oncology organisations are discussed: the Australian Psycho-Oncology Society (OzPos, a primarily clinician-led and focused organisation) and the Psycho-Oncology Co-operative Research Group (PoCoG, a national cancer clinical trial group). OzPos is a special interest group within the Clinical Oncology Society of Australia, while PoCoG is one of 14 cancer clinical trial groups funded by the national government. It is these strong connections with major multidisciplinary cancer organisations, and a culture of collaboration and co-operation, that have made Psycho-Oncology grow and thrive in Australia. Examples of large collaborative programs of Psycho-Oncology research are provided, as well as the mechanisms used to achieve these outcomes.

Spirituality in cancer care at the end of life.

Science.gov (United States)

Ferrell, Betty; Otis-Green, Shirley; Economou, Denice

2013-01-01

There is a compelling need to integrate spirituality into the provision of quality palliative care by oncology professionals. Patients and families report the importance of spiritual, existential, and religious concerns throughout the cancer trajectory. Leading palliative care organizations have developed guidelines that define spiritual care and offer recommendations to guide the delivery of spiritual services. There is growing recognition that all team members require the skills to provide generalist spiritual support. Attention to person-centered, family-focused oncology care requires the development of a health care environment that is prepared to support the religious, spiritual, and cultural practices preferred by patients and their families. These existential concerns become especially critical at end of life and following the death for family survivors. Oncology professionals require education to prepare them to appropriately screen, assess, refer, and/or intervene for spiritual distress.

THE NATIONAL ONCOLOGICAL PROGRAM IMPLEMENTATION – EXPERIENCE IN THE VLADIMIR REGION (TO THE 70TH ANNIVERSARY OF THE REGIONAL CLINICAL ONCOLOGICAL DISPENSARY

Directory of Open Access Journals (Sweden)

A. G. Zirin

2017-01-01

Full Text Available By 2010, on the background of the steady increase in the incidence of malignant tumors in the Vladimir area, primary oncological care level worked inefficiently.Condition of material and technical base of the Vladimir Regional Clinical Oncological Dispensary was also unsatisfactory. All these problems required solution in the form of the National Oncology Program realization in the region. The National Oncological Program has begun to work in the Vladimir region since 2011. Target indicators of the oncological program implementation by 2015 were established. They are: Increase of 5-year survival value of patients with malignant tumors after diagnosis date to 51.4%; Increase the number of malignant tumors early detection cases at the I–II stages up to 51%; Decrease the mortality rate of working age population to 99 per 100 000; Decrease of mortality within one year from the first time of cancer diagnosis to 27%. The following main objectives such as radically improved the material and technical base of oncology dispensary; modern methods of prevention, diagnosis and patients treatment improvement and introduction; the system providing population cancer care focused on the cancer early detection and the specialized combined antitumor treatment provision are realized in order to achieve these goals. The implementation of the tasks allowed to achieve positive dynamics of Vladimir region population cancer care indicators. All the main targets of the National Oncology Program for the Vladimir region were achieved successfully. Implementation of the National Oncology Program has had an extremely positive effect on the cancer services development of, as well as for the health of the entire population of the Vladimir region.

Diagnosis and treatment of pancreatic cancer. Oncology overview

International Nuclear Information System (INIS)

1982-09-01

Oncology Overviews are a service of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute, intended to facilitate and promote the exchange of information between cancer scientists by keeping them aware of literature related to their research being published by other laboratories throughout the world. Each Oncology Overview represents a survey of the literature associated with a selected area of cancer research. It contains abstracts of articles which have been selected and organized by researchers associated with the field. Contents: Radiological diagnosis of pancreatic cancer; Biopsy and cytology in the diagnosis of pancreatic cancer; Pathology and morphology of pancreatic cancer; Staging and prognosis of pancreatic cancer; Biological and immunological markers in the diagnosis of pancreatic cancer; Surgical treatment of pancreatic cancer; Drug therapy of pancreatic cancer; Radiation therapy of pancreatic cancer; Selected studies on the epidemiology of pancreatic cancer; Clinical correlates and syndromes associated with pancreatic neoplasia

Development of the Moffitt Cancer Network as a Telemedicine and Teleconferencing Educational Tool for Health Care Providers

National Research Council Canada - National Science Library

Krischer, Jeffrey

2002-01-01

The Moffitt Cancer Network's (MCN) goal is to provide up-to-date oncology related information, resources, and education to oncology health care providers and researchers for the prevention and cure of cancer...

Home Care Nursing Improves Cancer Symptom Management

Science.gov (United States)

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

Telemedicine and Palliative Care: an Increasing Role in Supportive Oncology.

Science.gov (United States)

Worster, Brooke; Swartz, Kristine

2017-06-01

With the emergence of telemedicine as a routine form of care in various venues, the opportunities to use technology to care for the most vulnerable, most ill cancer patients are extremely appealing. Increasingly, evidence supports early integration of palliative care with standard oncologic care, supported by recent NCCN guidelines to increase and improve access to palliative care. This review looks at the use of telemedicine to expand access to palliative care as well as provide better care for patients and families where travel is difficult, if not impossible. When telemedicine has been used, often in Europe, for palliative care, the results show improvements in symptom management, comfort with care as well as patient and family satisfaction. One barrier to use of telemedicine is the concerns with technology and technology-related complications in population that is often elderly, frail and not always comfortable with non-face-to-face physician care. There remain significant opportunities to explore this intersection of supportive care and telemedicine.

Patterns of symptom control and palliative care-focused original research articles in the International Journal of Radiation Oncology *Biology* Physics and the Radiotherapy and Oncology Journal, 2005-2014.

Science.gov (United States)

Shi, Diana D; DiGiovanni, Julia; Skamene, Sonia; Noveroske Philbrick, Sarah; Wang, Yanbing; Barnes, Elizabeth A; Chow, Edward; Sullivan, Adam; Balboni, Tracy A

2018-04-01

A significant portion of radiation treatment (30-40%) is delivered with palliative intent. Given the frequency of palliative care (PC) in radiation oncology, we determined the patterns of research focusing on symptom control and palliative care (SCPC) in two prominent radiation oncology journals from 2005-2014. Original research manuscripts published from 2005-2014 in the International Journal of Radiation Oncology *Biology* Physics (Red Journal) and the Radiotherapy and Oncology Journal (Green Journal) were reviewed to categorize articles as PC and/or SCPC. Articles were categorized as PC if it pertained to any aspect of treatment of metastatic cancer, and as SCPC if symptom control in the metastatic cancer setting was the goal of the research inquiry and/or any domain of palliative clinical practice guidelines was the goal of research inquiry. From 2005-2014, 4.9% (312/6,386) of original research articles published in the Red Journal and 3.5% (84/2,406) published in the Green Journal pertained to metastatic cancer, and were categorized as PC. In the Red Journal, 1.3% (84/6,386) of original research articles were categorized as SCPC; 1.3% (32/2,406) of articles in the Green Journal were categorized as SCPC. There was no trend observed in the proportion of SCPC articles published over time in the Red Journal (P=0.76), the Green Journal (P=0.48), or both journals in aggregate (P=0.38). Despite the fact that palliative radiotherapy is a critical part of radiation oncology practice, PC and SCPC-focused original research is poorly represented in the Red Journal and the Green Journal.

Geriatric Oncology Program Development and Gero-Oncology Nursing.

Science.gov (United States)

Lynch, Mary Pat; DeDonato, Dana Marcone; Kutney-Lee, Ann

2016-02-01

To provide a critical analysis of current approaches to the care of older adults with cancer, outline priority areas for geriatric oncology program development, and recommend strategies for improvement. Published articles and reports between 1999 and 2015. Providing an interdisciplinary model that incorporates a holistic geriatric assessment will ensure the delivery of patient-centered care that is responsive to the comprehensive needs of older patients. Nursing administrators and leaders have both an opportunity and responsibility to shape the future of geriatric oncology. Preparations include workforce development and the creation of programs that are designed to meet the complex needs of this population. Copyright © 2015 Elsevier Inc. All rights reserved.

The context of oncology nursing practice: an integrative review.

Science.gov (United States)

Bakker, Debra; Strickland, Judith; Macdonald, Catherine; Butler, Lorna; Fitch, Margaret; Olson, Karin; Cummings, Greta

2013-01-01

In oncology, where the number of patients is increasing, there is a need to sustain a quality oncology nursing workforce. Knowledge of the context of oncology nursing can provide information about how to create practice environments that will attract and retain specialized oncology nurses. The aims of this review were to determine the extent and quality of the literature about the context of oncology nursing, explicate how "context" has been described as the environment where oncology nursing takes place, and delineate forces that shape the oncology practice environment. The integrative review involved identifying the problem, conducting a structured literature search, appraising the quality of data, extracting and analyzing data, and synthesizing and presenting the findings. Themes identified from 29 articles reflected the surroundings or background (structural environment, world of cancer care), and the conditions and circumstances (organizational climate, nature of oncology nurses' work, and interactions and relationships) of oncology nursing practice settings. The context of oncology nursing was similar yet different from other nursing contexts. The uniqueness was attributed to the dynamic and complex world of cancer control and the personal growth that is gained from the intense therapeutic relationships established with cancer patients and their families. The context of healthcare practice has been linked with patient, professional, or system outcomes. To achieve quality cancer care, decision makers need to understand the contextual features and forces that can be modified to improve the oncology work environment for nurses, other providers, and patients.

Improving Care in Pediatric Neuro-oncology Patients: An Overview of the Unique Needs of Children With Brain Tumors.

Science.gov (United States)

Fischer, Cheryl; Petriccione, Mary; Donzelli, Maria; Pottenger, Elaine

2016-03-01

Brain tumors represent the most common solid tumors in childhood, accounting for almost 25% of all childhood cancer, second only to leukemia. Pediatric central nervous system tumors encompass a wide variety of diagnoses, from benign to malignant. Any brain tumor can be associated with significant morbidity, even when low grade, and mortality from pediatric central nervous system tumors is disproportionately high compared to other childhood malignancies. Management of children with central nervous system tumors requires knowledge of the unique aspects of care associated with this particular patient population, beyond general oncology care. Pediatric brain tumor patients have unique needs during treatment, as cancer survivors, and at end of life. A multidisciplinary team approach, including advanced practice nurses with a specialty in neuro-oncology, allows for better supportive care. Knowledge of the unique aspects of care for children with brain tumors, and the appropriate interventions required, allows for improved quality of life. © The Author(s) 2015.

Evaluation of a specialized oncology nursing supportive care intervention in newly diagnosed breast and colorectal cancer patients following surgery: a cluster randomized trial.

Science.gov (United States)

Sussman, Jonathan; Bainbridge, Daryl; Whelan, Timothy J; Brazil, Kevin; Parpia, Sameer; Wiernikowski, Jennifer; Schiff, Susan; Rodin, Gary; Sergeant, Myles; Howell, Doris

2018-05-01

Better coordination of supportive services during the early phases of cancer care has been proposed to improve the care experience of patients. We conducted a randomized trial to test a community-based nurse-led coordination of care intervention in cancer patients. Surgical practices were cluster randomized to a control group involving usual care practices or a standardized nursing intervention consisting of an in-person supportive care assessment with ongoing support to meet identified needs, including linkage to community services. Newly diagnosed breast and colorectal cancer patients within 7 days of cancer surgery were eligible. The primary outcome was the patient-reported outcome (PRO) of continuity of care (CCCQ) measured at 3 weeks. Secondary outcomes included unmet supportive care needs (SCNS), quality of life (EORTC QLQ-C30), health resource utilization, and level of uncertainty with care trajectory (MUIS) at 3 and/or 8 weeks. A total of 121 breast and 72 colorectal patients were randomized through 28 surgical practices. There was a small improvement in the informational domain of continuity of care (difference 0.29 p = 0.05) and a trend to less emergency room use (15.8 vs 7.1%) (p = 0.07). There were no significant differences between groups on unmet need, quality of life, or uncertainty. We did not find substantial gaps in the PROs measured immediately following surgery for breast and colorectal cancer patients. The results of this study support a more targeted approach based on need and inform future research focused on improving navigation during the initial phases of cancer treatment. ClinicalTrials.gov Identifier: NCT00182234. SONICS-Effectiveness of Specialist Oncology Nursing.

Postoperative adjuvant therapy of breast cancer. Oncology Overview

International Nuclear Information System (INIS)

1984-12-01

Oncology Overviews are a service of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute, intended to facilitate and promote the exchange of information between cancer scientists by keeping them aware of literature related to their research being published by other laboratories throughout the world. Each Oncology Overview represents a survey of the literature associated with a selected area of cancer research. It contains abstracts of articles which have been selected and organized by researchers associated with the field. Contents: Postoperative chemotherapy; Postoperative radiotherapy; Postoperative hormone therapy; Postoperative immunotherapy and chemoimmunotherapy; Postoperative multimodal therapy; Prognostic factors in postoperative adjuvant therapy

The Medicaid Rebate: Changes in Oncology Drug Prices After the Affordable Care Act.

Science.gov (United States)

Bonakdar Tehrani, Ali; Carroll, Norman V

2017-08-01

Prescription drug spending is a significant component of Medicaid total expenditures. The Affordable Care Act (ACA) includes a provision that increases the Medicaid rebate for both brand-name and generic drugs. This study examines the extent to which oncology drug prices changed after the increase in the Medicaid rebate in 2010. A pre-post study design was used to evaluate the correlation between the Medicaid rebate increase and oncology drug prices after 2010 using 2006-2013 State Drug Utilization Data. The results show that the average annual price of top-selling cancer drugs in 2006, adjusted for inflation and secular changes in drug prices, have increased by US$154 and US$235 for branded and competitive brand drugs, respectively, following the 2010 ACA; however, generic oncology drug prices showed no significant changes. The findings from this study indicate that oncology drug prices have increased after the 2010 ACA, and suggest that pharmaceutical companies may have increased their drug prices to offset increases in Medicaid rebates.

Cancer patients, emergencies service and provision of palliative care

Directory of Open Access Journals (Sweden)

Bruno Miranda

2016-06-01

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

How oncology fellows discuss transitions in goals of care: a snapshot of approaches used prior to training.

Science.gov (United States)

Back, Anthony L; Michaelsen, Kate; Alexander, Stewart; Hopley, Elizabeth; Edwards, Kelly; Arnold, Robert M

2010-04-01

The moment when a physician raises the possibility of discontinuing palliative chemotherapy at the end of life is a critical moment in the illness, and a difficult conversation. Expert recommendations cite the importance of giving bad news in these situations but there is limited research addressing how physicians should discuss transitions in goals of care from disease-modifying therapy to end-of-life care. While existing research includes survey data and observational studies of oncologist outpatient visits with patient who have advanced cancer, there are no studies that characterize actual physician communication behaviors when the physician tried to initiate a transitions conversation with a patient who has advanced cancer. In this study, we examined the communication approaches used by oncology fellows discussing transitions with a standardized patient using audiorecordings collected prior to an intensive communication skills workshop. In this preworkshop encounter, each oncology fellow had the task of discussing a transition in goals of care with a patient who was experiencing cancer progression despite treatment with existing evidence-based therapies. We used qualitative methodology to characterize the approaches used by oncology fellows in 20 of these pre-workshop conversations. We identified two themes in the approaches that fellows used: (1) the limitations of biomedical disease-modifying treatments and (2) the possibility of a new direction for medical care when disease-modifying treatments have been exhausted. We found that for each theme, fellows tended to emphasize a logical frame or an experiential frame. Understanding these frames could be useful in designing future communication skills training interventions.

Patients’ experience of important factors in the healthcare environment in oncology care

Directory of Open Access Journals (Sweden)

Helle Wijk

2013-08-01

Full Text Available Background and objective. The aim of this study was to describe what factors of the healthcare environment are perceived as being important to patients in oncology care. Design. A qualitative design was adopted using focus group interviews. Setting and participants. The sample was 11 patients with different cancer diagnoses in an oncology ward at a university hospital in west Sweden. Results. Analysis of the patients’ perceptions of the environment indicated a complex entity comprising several aspects. These came together in a structure consisting of three main categories: safety, partnership with the staff, and physical space. The care environment is perceived as a complex entity, made up of several physical and psychosocial aspects, where the physical factors are subordinated by the psychosocial factors. It is clearly demonstrated that the patients’ primary desire was a psychosocial environment where they were seen as a unique person; the patients wanted opportunities for good encounters with staff, fellow patients, and family members, supported by a good physical environment; and the patients valued highly a place to withdraw and rest. Conclusions. This study presents those attributes that are valued by cancer patients as crucial and important for the support of their well-being and functioning. The results show that physical aspects were subordinate to psychosocial factors, which emerged strongly as being the most important in a caring environment.

Patient/Family Education for Newly Diagnosed Pediatric Oncology Patients: Consensus Recommendations from a Children’s Oncology Group Expert Panel

Science.gov (United States)

Landier, Wendy; Ahern, JoAnn; Barakat, Lamia P.; Bhatia, Smita; Bingen, Kristin M.; Bondurant, Patricia G.; Cohn, Susan L.; Dobrozsi, Sarah K.; Haugen, Maureen; Herring, Ruth Anne; Hooke, Mary C.; Martin, Melissa; Murphy, Kathryn; Newman, Amy R.; Rodgers, Cheryl C.; Ruccione, Kathleen S.; Sullivan, Jeneane; Weiss, Marianne; Withycombe, Janice; Yasui, Lise; Hockenberry, Marilyn

2016-01-01

There is a paucity of data to support evidence-based practices in the provision of patient/family education in the context of a new childhood cancer diagnosis. Since the majority of children with cancer are treated on pediatric oncology clinical trials, lack of effective patient/family education has the potential to negatively affect both patient and clinical trial outcomes. The Children’s Oncology Group Nursing Discipline convened an interprofessional expert panel from within and beyond pediatric oncology to review available and emerging evidence and develop expert consensus recommendations regarding harmonization of patient/family education practices for newly diagnosed pediatric oncology patients across institutions. Five broad principles, with associated recommendations, were identified by the panel, including recognition that (1) in pediatric oncology, patient/family education is family-centered; (2) a diagnosis of childhood cancer is overwhelming and the family needs time to process the diagnosis and develop a plan for managing ongoing life demands before they can successfully learn to care for the child; (3) patient/family education should be an interprofessional endeavor with 3 key areas of focus: (a) diagnosis/treatment, (b) psychosocial coping, and (c) care of the child; (4) patient/family education should occur across the continuum of care; and (5) a supportive environment is necessary to optimize learning. Dissemination and implementation of these recommendations will set the stage for future studies that aim to develop evidence to inform best practices, and ultimately to establish the standard of care for effective patient/family education in pediatric oncology. PMID:27385664

Systemic therapy in men with metastatic castration-resistant prostate cancer:American Society of Clinical Oncology and Cancer Care Ontario clinical practice guideline.

Science.gov (United States)

Basch, Ethan; Loblaw, D Andrew; Oliver, Thomas K; Carducci, Michael; Chen, Ronald C; Frame, James N; Garrels, Kristina; Hotte, Sebastien; Kattan, Michael W; Raghavan, Derek; Saad, Fred; Taplin, Mary-Ellen; Walker-Dilks, Cindy; Williams, James; Winquist, Eric; Bennett, Charles L; Wootton, Ted; Rumble, R Bryan; Dusetzina, Stacie B; Virgo, Katherine S

2014-10-20

To provide treatment recommendations for men with metastatic castration-resistant prostate cancer (CRPC). The American Society of Clinical Oncology and Cancer Care Ontario convened an expert panel to develop evidence-based recommendations informed by a systematic review of the literature. When added to androgen deprivation, therapies demonstrating improved survival, improved quality of life (QOL), and favorable benefit-harm balance include abiraterone acetate/prednisone, enzalutamide, and radium-223 ((223)Ra; for men with predominantly bone metastases). Improved survival and QOL with moderate toxicity risk are associated with docetaxel/prednisone. For asymptomatic/minimally symptomatic men, improved survival with unclear QOL impact and low toxicity are associated with sipuleucel-T. For men who previously received docetaxel, improved survival, unclear QOL impact, and moderate to high toxicity risk are associated with cabazitaxel/prednisone. Modest QOL benefit (without survival benefit) and high toxicity risk are associated with mitoxantrone/prednisone after docetaxel. No benefit and excess toxicity are observed with bevacizumab, estramustine, and sunitinib. Continue androgen deprivation (pharmaceutical or surgical) indefinitely. Abiraterone acetate/prednisone, enzalutamide, or (223)Ra should be offered; docetaxel/prednisone should also be offered, accompanied by discussion of toxicity risk. Sipuleucel-T may be offered to asymptomatic/minimally symptomatic men. For men who have experienced progression with docetaxel, cabazitaxel may be offered, accompanied by discussion of toxicity risk. Mitoxantrone may be offered, accompanied by discussion of limited clinical benefit and toxicity risk. Ketoconazole or antiandrogens (eg, bicalutamide, flutamide, nilutamide) may be offered, accompanied by discussion of limited known clinical benefit. Bevacizumab, estramustine, and sunitinib should not be offered. There is insufficient evidence to evaluate optimal sequences or

Impact of the lung oncology multidisciplinary team meetings on the management of patients with cancer.

Science.gov (United States)

Ung, Kim Ann; Campbell, Belinda A; Duplan, Danny; Ball, David; David, Steven

2016-06-01

Multidisciplinary team (MDT) meetings are increasingly regarded as a component of multidisciplinary cancer care. We aimed to prospectively measure the impact of MDT meetings on clinicians' management plans for lung oncology patients, and the implementation rate of the meeting recommendations. Consecutive patient cases presented at the weekly lung oncology MDT meetings were prospectively enrolled. Investigators compared the clinicians' management plans pre-meeting with the consensus plans post-meeting. The meeting was considered to have an impact on management plans if ≥1 of the following changes were detected: tumor stage, histology, treatment intent or treatment modality, or if additional investigations were recommended. Investigators reviewed hospital patient records at 4 months to determine if the meeting recommendations were implemented. Reasons for non-implementation were also recorded. Of the 55 eligible cases, the MDT meeting changed management plans in 58% (CI 45-71%; P management plans for lung oncology patients. The majority of MDT recommendations (72%) were implemented into patient care. These findings provide further evidence to support the role of MDT meetings as an essential part of the decision-making process for the optimal multidisciplinary management of patients with cancer. © 2014 Wiley Publishing Asia Pty Ltd.

The Ontario Psychosocial Oncology Framework: a quality improvement tool.

Science.gov (United States)

Li, Madeline; Green, Esther

2013-05-01

To overview the newly developed Psychosocial Health Care for Cancer Patients and Their Families: A Framework to Guide Practice in Ontario and Guideline Recommendations in the context of Canadian psychosocial oncology care and propose strategies for guideline uptake and implementation. Recommendations from the 2008 Institute of Medicine standard Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs were adapted into the Ontario Psychosocial Oncology (PSO) Framework. Existing practice guidelines developed by the Canadian Partnership against Cancer and Cancer Care Ontario and standards developed by the Canadian Association of Psychosocial Oncology are supporting resources for adopting a quality improvement (QI) approach to the implementation of the framework in Ontario. The developed PSO Framework, including 31 specific actionable recommendations, is intended to improve the quality of comprehensive cancer care at both the provider and system levels. Important QI change management processes are described as Educate - raising awareness among medical teams of the significance of psychosocial needs of patients, Evidence - developing a research evidence base for patient care benefits from psychosocial interventions, and Electronics - using technology to collect patient reported outcomes of both physical and emotional symptoms. The Ontario PSO Framework is unique and valuable in providing actionable recommendations that can be implemented through QI processes. Overall, the result will be improved psychosocial health care for the cancer population. Copyright © 2012 John Wiley & Sons, Ltd.

Integrating Palliative Care Services in Ambulatory Oncology: An Application of the Edmonton Symptom Assessment System.

Science.gov (United States)

Rauenzahn, Sherri L; Schmidt, Susanne; Aduba, Ifeoma O; Jones, Jessica T; Ali, Nazneen; Tenner, Laura L

2017-04-01

Research in palliative care demonstrates improvements in overall survival, quality of life, symptom management, and reductions in the cost of care. Despite the American Society of Clinical Oncology recommendation for early concurrent palliative care in patients with advanced cancer and high symptom burden, integrating palliative services is challenging. Our aims were to quantitatively describe the palliative referral rates and symptom burden in a South Texas cancer center and establish a palliative referral system by implementing the Edmonton Symptom Assessment Scale (ESAS). As part of our Plan-Do-Study-Act process, all staff received an educational overview of the ESAS tool and consultation ordering process. The ESAS form was then implemented across five ambulatory oncology clinics to assess symptom burden and changes therein longitudinally. Referral rates and symptom assessment scores were tracked as metrics for quality improvement. On average, one patient per month was referred before implementation of the intervention compared with 10 patients per month after implementation across all clinics. In five sample clinics, 607 patients completed the initial assessment, and 430 follow-up forms were collected over 5 months, resulting in a total of 1,037 scores collected in REDCap. The mean ESAS score for initial patient visits was 20.0 (standard deviation, 18.1), and referred patients had an initial mean score of 39.0 (standard deviation, 19.0). This project highlights the low palliative care consultation rate, high symptom burden of oncology patients, and underuse of services by oncologists despite improvements with the introduction of a symptom assessment form and referral system.

Integrative oncology: an overview.

Science.gov (United States)

Deng, Gary; Cassileth, Barrie

2014-01-01

Integrative oncology, the diagnosis-specific field of integrative medicine, addresses symptom control with nonpharmacologic therapies. Known commonly as "complementary therapies" these are evidence-based adjuncts to mainstream care that effectively control physical and emotional symptoms, enhance physical and emotional strength, and provide patients with skills enabling them to help themselves throughout and following mainstream cancer treatment. Integrative or complementary therapies are rational and noninvasive. They have been subjected to study to determine their value, to document the problems they ameliorate, and to define the circumstances under which such therapies are beneficial. Conversely, "alternative" therapies typically are promoted literally as such; as actual antitumor treatments. They lack biologic plausibility and scientific evidence of safety and efficacy. Many are outright fraudulent. Conflating these two very different categories by use of the convenient acronym "CAM," for "complementary and alternative therapies," confuses the issue and does a substantial disservice to patients and medical professionals. Complementary and integrative modalities have demonstrated safety value and benefits. If the same were true for "alternatives," they would not be "alternatives." Rather, they would become part of mainstream cancer care. This manuscript explores the medical and sociocultural context of interest in integrative oncology as well as in "alternative" therapies, reviews commonly-asked patient questions, summarizes research results in both categories, and offers recommendations to help guide patients and family members through what is often a difficult maze. Combining complementary therapies with mainstream oncology care to address patients' physical, psychologic and spiritual needs constitutes the practice of integrative oncology. By recommending nonpharmacologic modalities that reduce symptom burden and improve quality of life, physicians also enable

Citation analysis of Canadian psycho-oncology and supportive care researchers.

Science.gov (United States)

Hack, Thomas F; Crooks, Dauna; Plohman, James; Kepron, Emma

2014-02-01

The purpose of this study was to conduct a historical review of psycho-oncology and supportive care research in Canada using citation analysis and to review the clinical impact of the research conducted by the most highly cited researchers. The lifetime journal publication records of 109 psycho-oncology and supportive care researchers in Canada were subject to citation analysis using the Scopus database, based on citations since 1996 of articles deemed relevant to psychosocial oncology and supportive care, excluding self-citations. Three primary types of analysis were performed for each individual: the number of citations for each journal publication, a summative citation count of all published articles, and the Scopus h-index. The top 20 psycho-oncology/supportive care researchers for each of five citation categories are presented: the number of citations for all publications; the number of citations for first-authored publications; the most highly cited first-authored publications; the Scopus h-index for all publications; and the Scopus h-index for first-authored publications. The three most highly cited Canadian psycho-oncology researchers are Dr. Kerry Courneya (University of Alberta), Dr. Lesley Degner, (University of Manitoba), and Dr. Harvey Chochinov (University of Manitoba). Citation analysis is useful for examining the research performance of psycho-oncology and supportive care researchers and identifying leaders among them.

CNAM: care and treatment aboard in oncology

International Nuclear Information System (INIS)

Cherif, Leila; Bayoudh, L.; Riahi, S.; Zarrad, M.

2013-01-01

The Tunisian National Health Insurance Fund (TNHIF) has 186 practitioners and advisers (physicians, dentists and pharmacists) in the service of medical supervision. These advisers are distributed on three levels (regional, district and national). In the present paper we have discussed the CNAM support in the different types of oncology (FSD (Fully Supported Disorders), Hospitalization, the scans, the radiation therapy, specific drugs and treatment abroad). We begin by presenting expenditures by year and age group for FSD and hospitalization in the private and the public sectors. We then give the conventional packages for scans, radiotherapy: either for CLAM or CRAM. Daily benefits for the sickness leave and the disability will be presented briefly. Then we will give the administrative process for the approval of the commission for specific medication. The medical advice is based on certain criteria that will be explained in the paper. In certain cases definitive medical advice needs to call for the recommendation of a national commission and oncology or different experts. The spending trend of the TNHIF from 2001 to 2012 will be discussed. TNHIF generally considered Herceptin, Nexavar Erbitaux as the main drugs for targeted therapies. We present for the treatment cost and expenditure trends for the first drug from 2008 to 2012 as well as the estimation for 2013, which increases from one year to year. For the treatment with the second and the third drug we give the evolution of expenditure between 2010 and 2012. Cancer is a serious disease that requires a costly multidisciplinary support for the patients. This support has changed the prognosis survival (see cases of healing). The financial coverage of this support can never be supported by the family (whatever the wealth level) without any TNHIF support. The real gain in survival and expenditure control are closely related to awareness and early detection of the disease. TNHIF usually intervenes in the financing of

Guide to clinical PET in oncology: Improving clinical management of cancer patients

International Nuclear Information System (INIS)

2008-10-01

information on clinical PET in oncology for nuclear medicine physicians, radiologists and clinical practitioners. Possible ideas for cost effectiveness of clinical PET in oncology are mentioned. The information is also intended to be useful in decision making to improve clinical management of cancer patients when allocating resources dedicated to the health care system. This is a critical issue that is important for the development of both clinical oncology and nuclear medicine in IAEA member states. The IAEA can be instrumental in the advancement of programmes which focus on the IAEA's coordinated research projects and technical cooperation project

Colorectal cancer: complexities and challenges in managed care.

Science.gov (United States)

Minkoff, Neil B

2007-08-01

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

Importance of nutrition in pediatric oncology

OpenAIRE

P C Rogers

2015-01-01

A nutritional perspective within pediatric oncology is usually just related to the supportive care aspect during the management of the underlying malignancy. However, nutrition has a far more fundamental importance with respect to a growing, developing child who has cancer as well as viewing cancer from a nutritional cancer control perspective. Nutrition is relevant to all components of cancer control including prevention, epidemiology, biology, treatment, supportive care, rehabilitation, and...

Who Enrolls Onto Clinical Oncology Trials? A Radiation Patterns of Care Study Analysis

International Nuclear Information System (INIS)

Movsas, Benjamin; Moughan, Jennifer; Owen, Jean; Coia, Lawrence R.; Zelefsky, Michael J.; Hanks, Gerald; Wilson, J. Frank

2007-01-01

Purpose: To identify factors significantly influencing accrual to clinical protocols by analyzing radiation Patterns of Care Study (PCS) surveys of 3,047 randomly selected radiotherapy (RT) patients. Methods and Materials: Patterns of Care Study surveys from disease sites studied for the periods 1992-1994 and 1996-1999 (breast cancer, n = 1,080; prostate cancer, n = 1,149; esophageal cancer, n = 818) were analyzed. The PCS is a National Cancer Institute-funded national survey of randomly selected RT institutions in the United States. Patients with nonmetastatic disease who received RT as definitive or adjuvant therapy were randomly selected from eligible patients at each institution. To determine national estimates, individual patient records were weighted by the relative contribution of each institution and patients within each institution. Data regarding participation in clinical trials were recorded. The factors age, gender, race, type of insurance, and practice type of treating institution (academic or not) were studied by univariate and multivariate analyses. Results: Overall, only 2.7% of all patients were accrued to clinical protocols. Of these, 57% were enrolled on institutional review board-approved institutional trials, and 43% on National Cancer Institute collaborative group studies. On multivariate analysis, patients treated at academic facilities (p = 0.0001) and white patients (vs. African Americans, p = 0.0002) were significantly more likely to participate in clinical oncology trials. Age, gender, type of cancer, and type of insurance were not predictive. Conclusions: Practice type and race significantly influence enrollment onto clinical oncology trials. This suggests that increased communication and education regarding protocols, particularly focusing on physicians in nonacademic settings and minority patients, will be essential to enhance accrual

Global curriculum in surgical oncology.

Science.gov (United States)

Are, C; Berman, R S; Wyld, L; Cummings, C; Lecoq, C; Audisio, R A

2016-06-01

The significant global variations in surgical oncology training paradigms can have a detrimental effect on tackling the rising global cancer burden. While some variations in training are essential to account for the differences in types of cancer and biology, the fundamental principles of providing care to a cancer patient remain the same. The development of a global curriculum in surgical oncology with incorporated essential standards could be very useful in building an adequately trained surgical oncology workforce, which in turn could help in tackling the rising global cancer burden. The leaders of the Society of Surgical Oncology and European Society of Surgical Oncology convened a global curriculum committee to develop a global curriculum in surgical oncology. A global curriculum in surgical oncology was developed to incorporate the required domains considered to be essential in training a surgical oncologist. The curriculum was constructed in a modular fashion to permit flexibility to suit the needs of the different regions of the world. Similarly, recognizing the various sociocultural, financial and cultural influences across the world, the proposed curriculum is aspirational and not mandatory in intent. A global curriculum was developed which may be considered as a foundational scaffolding for training surgical oncologists worldwide. It is envisioned that this initial global curriculum will provide a flexible and modular scaffolding that can be tailored by individual countries or regions to train surgical oncologists in a way that is appropriate for practice in their local environment. Copyright © 2016 Society of Surgical Oncology, European Society of Surgical Oncology. Published by Elsevier Ltd.. All rights reserved.

Extensible Open-Source Zero-Footprint Web Viewer for Oncologic Imaging Research | Informatics Technology for Cancer Research (ITCR)

Science.gov (United States)

The Tumor Imaging Metrics Core (TIMC), a CCSG Shared-Resource of the Dana-Farber/Harvard Cancer Center, has developed software for managing the workflow and image measurements for oncology clinical trials. This system currently is in use across the five Harvard hospitals to manage over 600 active clinical trials, with 800 users, and has been licensed and implemented at several other Cancer Centers, including Yale, Utah/Huntsman Cancer Institute, and UW/Seattle Cancer Care Alliance.

Significances and meanings of the musical identity of patients and relatives receiving oncological palliative care

Directory of Open Access Journals (Sweden)

Vladimir Araujo de Silva

2014-03-01

Full Text Available This phenomenological study was structured on Heidegger’s theoretical-philosophical framework, with the objective of unveiling the significances and meanings of the musical identity of patients and relatives under oncological palliative care. Individual interviews were performed with 12 clients (seven patients and five relatives staying at the support residence of the Maringa Female Network Against Cancer. A total of eight musical meetings were performed between January and February of 2011. I understood that the musical identity of the evidenced beings refers to the religious and country music styles, that their significances and meanings are connected to their spirituality and the significant events of their historicity, and that their mood and reflection intermediated by music can influence their musical choice. I gave evidence to the need to consider the music identity and empowerment in musical choices, which carries existential, social, cultural, spiritual and family aspects as qualifying elements of nursing in palliative care. Descriptors: Nursing Care; Oncology Nursing; Music; Music Therapy; Palliative Care.

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 ...

Effectiveness of a psycho-oncology training program for oncology nurses: a randomized controlled trial.

Science.gov (United States)

Kubota, Yosuke; Okuyama, Toru; Uchida, Megumi; Umezawa, Shino; Nakaguchi, Tomohiro; Sugano, Koji; Ito, Yoshinori; Katsuki, Fujika; Nakano, Yumi; Nishiyama, Takeshi; Katayama, Yoshiko; Akechi, Tatsuo

2016-06-01

Oncology nurses are expected to play an important role in psychosocial care for cancer patients. The aim of this study was to examine whether a novel training program aimed at enhancing oncology nurses' ability to assess and manage common psychological problems in cancer patients would improve participants' self-reported confidence, knowledge, and attitudes regarding care of patients with common psychological problems (trial register: UMIN000008559). Oncology nurses were assigned randomly to either the intervention group (N = 50) or the waiting list control group (N = 46). The intervention group received a 16-h program, the content of which focused on four psychological issues: normal reactions, clinically significant distress, suicidal thoughts, and delirium. Each session included a role-play exercise, group work, and didactic lecture regarding assessment and management of each problem. Primary outcomes were changes in self-reported confidence, knowledge, and attitudes toward the common psychological problems between pre-intervention and 3 months post-intervention. Secondary outcomes were job-related stress and burnout. Intervention acceptability to participants was also assessed. In the intervention group, confidence and knowledge but not attitudes were significantly improved relative to the control group. No significant intervention effects were found for job- related stress and burnout. A high percentage (98%) of participants considered the program useful in clinical practice. This psycho-oncology training program improved oncology nurses' confidence and knowledge regarding care for patients with psychological problems. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

AMCP Partnership Forum: Driving Value and Outcomes in Oncology.

Science.gov (United States)

2017-05-01

Innovation in cancer treatment has provided a wealth of recently available therapeutic agents and a healthy drug pipeline that promises to change the way we approach this disease and the lives of those affected in the years to come. However, the majority of these new agents, many of which are targeted to specific genomic features of various tumors, may challenge the health care system's ability to afford cancer care. This innovation drives the need to focus on the value of the treatments provided to patients with cancer and on methods to optimize the efficiency of the dollars we spend, in addition to the clinical value itself. The Academy of Managed Care Pharmacy (AMCP) convened a Partnership Forum to address how to improve value and outcomes in cancer care. In this multistakeholder forum, several areas were addressed: current methods for assessing the value of oncology products, the need for balancing population management with precision medicine, and the outlook for value-based contracting for oncology medications in managed care settings. Participants recommended ways in which stakeholders can work toward solutions in these areas. The forum brought together stakeholders from health plans, integrated delivery systems, pharmacy benefit managers, clinical practice, biopharmaceutical industry, and laboratory companies. Also participating were representatives from trade and professional associations. During this 1.5-day forum, participants identified current challenges, readiness, and ways to address value and improve outcomes in cancer therapy. Some of the challenges identified include choosing a viable (and practical) outcome target for value-based contracting in oncology, the development and use of value frameworks and clinical pathways, managing cancer diagnostics, utilization of alternative payment systems, moving from a large evidence base to a small clinical trial base in considering targeted treatments, and lack of best practices in value-based payment

Breast cancer prevention across the cancer care continuum.

Science.gov (United States)

Klemp, Jennifer R

2015-05-01

To review the current state of breast cancer prevention from primary prevention through survivorship, highlight cross-cutting issues, and discuss strategies for clinical integration and future research. Published articles between 1985 and 2015 and original research. Cancer risk persists across the lifespan. Interprofessional strategies to reduce morbidity and mortality from cancer include primary, secondary, and tertiary prevention (survivorship). Prevention strategies across the cancer care continuum are cross-cutting and focus on measures to: prevent the onset of disease, identify and treat asymptomatic persons who have already developed risk factors or preclinical disease, and restore function, minimize the negative effects of disease, and prevent disease-related complications. Oncology nurses and advanced practice nurses are vital in the delivery of breast cancer prevention strategies. Published by Elsevier Inc.

Knowledge and Preferences of Primary Care Providers in Delivering Head and Neck Cancer Survivorship Care.

Science.gov (United States)

Berkowitz, Callie; Allen, Deborah H; Tenhover, Jennifer; Zullig, Leah L; Ragsdale, John; Fischer, Jonathan E; Pollak, Kathryn I; Koontz, Bridget F

2017-07-14

Long-term care for head and neck cancer (HNC) survivors is complex and requires coordination among multiple providers. Clinical practice guidelines highlight the role of primary care providers (PCPs) in screening for secondary cancer/recurrence, assessment of late/long-term side effects, and referrals for appropriate specialty management of toxicity. However, these responsibilities may be difficult to meet within the scope of primary care practice. We conducted this study to explore preferences, comfort, and knowledge of PCPs in the care of HNC survivors. We piloted a 40-item web-based survey developed with oncologist and PCP input targeted for family medicine and internal medicine providers. Responses were collected within a single university health system over 2 months. PCPs (n = 28; RR = 11.3%) were interested in learning about health promotion after cancer treatment (89%) and generally agree that their current practice patterns address healthy lifestyle behaviors (82%). However, only 32% of PCPs felt confident they could manage late/long-term side effects of chemotherapy, radiation, or surgery. Only 29% felt confident they could provide appropriate cancer screening. Looking at shared care responsibilities with oncology providers, PCPs perceived being responsible for 30% of care in the first year after treatment and 81% of care after 5 years. Seventy-one percent of PCPs agreed that oncologists provided them necessary information, yet 32% of PCPs found it difficult to coordinate with cancer providers. While these PCPs perceive increased care responsibility for long-term survivors, most are uncomfortable screening for recurrence and managing late/long-term side effects. Education and mutual coordination between PCPs and oncology providers may improve survivor care.

Family-centred care: a qualitative study of Chinese and South Asian immigrant parents' experiences of care in paediatric oncology.

Science.gov (United States)

Watt, L; Dix, D; Gulati, S; Sung, L; Klaassen, R J; Shaw, N T; Klassen, A F

2013-03-01

Over the past two decades, there is increasing emphasis being placed upon providing family-centred care (FCC) in paediatric oncology settings. However, there is a lack of knowledge of FCC in paediatric oncology from the perspectives of immigrant parents. The purpose of this paper is to describe Chinese and South Asian immigrant parents' experiences of FCC in paediatric oncology settings in Canada. This study adopted a constructivist grounded theory approach. Fifty first generation Chinese and South Asian parents of children with cancer who were at least 6 months post-diagnosis were recruited from six Canadian paediatric oncology centres. Interviews were conducted in English, Cantonese, Mandarin, Urdu, Punjabi or Hindi, and transcribed into English. Analysis involved line-by-line, focused and theoretical coding, and the use of the constant comparison method. Findings indicated that overall parents were highly satisfied with the care and services they received, and their experiences were reflective of the key elements of FCC. However, there were some areas of concern identified by participants: parents not perceiving themselves as a member of the medical team; inconsistency in the quality and co-ordination of services among healthcare providers; disrespectful and mechanical manner of a few healthcare providers; and parents' discomfort with healthcare providers communicating sensitive health-related information directly with their child. In order to successfully provide family-centred services to immigrant parents of children with cancer, better communication of the elements of FCC between healthcare staff and families is needed to negotiate a clear role for the parents as partners of the healthcare team. Moreover, a better understanding of how family relationships are structured in immigrant families will assist healthcare providers to balance the best interests of the child with that of the family as a unit. © 2011 Blackwell Publishing Ltd.

Barriers and challenges in integration of anthroposophic medicine in supportive breast cancer care.

Science.gov (United States)

Ben-Arye, Eran; Schiff, Elad; Levy, Moti; Raz, Orit Gressel; Barak, Yael; Bar-Sela, Gil

2013-01-01

In the last decade, more and more oncology centers are challenged with complementary medicine (CM) integration within supportive breast cancer care. Quality of life (QOL) improvement and attenuation of oncology treatment side effects are the core objectives of integrative CM programs in cancer care. Yet, limited research is available on the use of specific CM modalities in an integrative setting and on cancer patients' compliance with CM consultation. Studies are especially warranted to view the clinical application of researched CM modalities, such as anthroposophic medicine (AM), a unique CM modality oriented to cancer supportive care. Our objective was to characterize consultation patterns provided by physicians trained in CM following oncology health-care practitioners' referral of patients receiving chemotherapy. We aimed to identify characteristics of patients who consulted with AM and to explore patients' compliance to AM treatment. Of the 341 patients consulted with integrative physicians, 138 were diagnosed with breast cancer. Following integrative physician consultation, 56 patients were advised about AM treatment and 285 about other CM modalities. Logistic multivariate regression model found that, compared with patients receiving non-anthroposophic CM, the AM group had significantly greater rates of previous CM use [EXP(B) = 3.25, 95% C.I. 1.64-6.29, p = 0.001] and higher rates of cancer recurrence at baseline (p = 0.038). Most AM users (71.4%) used a single AM modality, such as mistletoe (viscum album) injections, oral AM supplements, or music therapy. Compliance with AM modalities following physician recommendation ranged from 44% to 71% of patients. We conclude that AM treatment provided within the integrative oncology setting is feasible based on compliance assessment. Other studies are warranted to explore the effectiveness of AM in improving patients' QOL during chemotherapy.

Transforming Oncology Care: Developing a Strategy and Measuring Success.

Science.gov (United States)

Reid Ponte, Patricia; Berry, Donna; Buswell, Lori; Gross, Anne; Hayes, Carolyn; Kostka, Judy; Poyner-Reed, Mary; West, Colleen

2016-05-01

To examine accountability and performance measurement in health care and present a case study that illustrates the link between goal setting and measurement and how a strategic plan can provide a framework for metric selection. National reports, literature review and institutional experience. Nurse leaders and clinicians in oncology settings are challenged to anticipate future trends in oncology care and create a culture, infrastructure, and practice environment that supports innovation, advancement of oncology nursing practice and excellence in patient- and family-centered care. Performance metrics assessing key processes and outcomes of care are essential to meet this challenge. With an increasing number of national organizations offering their version of key quality standards and metrics, it is critical for nurses to have a formal process in place to determine and implement the measures most useful in guiding change for a particular clinical setting. Copyright © 2016 Elsevier Inc. All rights reserved.

Oncologic imaging

International Nuclear Information System (INIS)

Bragg, D.G.; Rubin, P.; Youker, J.E.

1985-01-01

This book presents papers on nuclear medicine. Topics considered include the classification of cancers, oncologic diagnosis, brain and spinal cord neoplasms, lymph node metastases, the larynx and hypopharynx, thyroid cancer, breast cancer, esophageal cancer, bladder cancer, tumors of the skeletal system, pediatric oncology, computed tomography and radiation therapy treatment planning, and the impact of future technology on oncologic diagnosis

PROGRAM OF PALLIATIVE CANCER CARE – OUR EXPERIENCE

Directory of Open Access Journals (Sweden)

Iva Slánská

2013-01-01

Full Text Available Introduction: Annually more than 27,000 persons die of cancer in the Czech Republic and the overall incidence of malignancies is still increasing. These data shows the need for affordable and good follow-up care especially for patients without any cancer treatment due to irreversible progression of tumor. Currently the outpatient palliative cancer care gets more into the forefront. Prerequisite for a well working outpatient palliative care is cooperation with general practitioners and home health care agencies. The purpose of the so called program of palliative cancer care is to guide a patient in palliative cancer care and to improve the cooperation among health care providers. Methods: During the period from January 2008 to October 2010 we evaluated in patient without any oncology treatment due to irreversible progression of tumor. Results: In palliative outpatient clinic we treated 446 patients, 119 of them received home care services with average length of 27.8 days. 77 patients died at home, 51 in health facilities and 41 in inpatient hospice care. Conclusion: We present pilot study focusing on outpatient palliative cancer care which shows the real benefit from early indication of palliative cancer care. This type of care allows patients to stay as long as possible at home among their close relatives.

[Patients' satisfaction and waiting time in oncology day care centers in Champagne-Ardenne].

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Debreuve-Theresette, A; Jovenin, N; Stona, A C; Kraïem-Leleu, M; Burde, F; Parent, D; Hettler, D; Rey, J B

2015-12-01

Quality of life of patients suffering from cancer may be influenced by the way healthcare is organized and by patient experiences. Nowadays, chemotherapy is often provided in day care centers. This study aimed to assess patient waiting time and satisfaction in oncology day care centers in Champagne-Ardenne, France. This cross-sectional survey involved all patients receiving ambulatory chemotherapy during a one-week period in day care centers of Champagne-Ardenne public and private healthcare institutions participating in the study. Sociodemographic, medical and outpatient data were collected. Patient satisfaction was measured using the Out-Patsat35 questionnaire. Eleven (out of 16) oncology day care centers and 441 patients participated in the study. Most of the patients were women (n=252, 57.1%) and the mean age was 61±12 years. The mean satisfaction score was 82±14 (out of 100) and the mean waiting time between the assigned appointment time and administration of chemotherapy was 97±60 min. This study has shown that waiting times are important. However, patients are satisfied with the healthcare organization, especially regarding nursing support. Early preparation of chemotherapy could improve these parameters. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Transition from Hospital to Community Care: The Experience of Cancer Patients

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Hanna Admi

2015-12-01

Full Text Available Purpose: This study examines care transition experiences of cancer patients and assesses barriers to effective transitions.Methods: Participants were adult Hebrew, Arabic, or Russian speaking oncology patients and health care providers from hospital and community settings. Qualitative (n=77 and quantitative (n=422 methods such as focus groups, interviews and self-administered questionnaires were used. Qualitative analysis showed that patients faced difficulties navigating a complex and fragmented healthcare system.Results: Mechanisms to overcome barriers included informal routes such as personal relationships, coordinating roles by nurse coordinators and the patients' general practitioners (GPs. The most significant variable was GPs involvement, which affected transition process quality as rated on the CTM (p<0.001. Our findings point to the important interpersonal role of oncology nurses to coordinate and facilitate the care transition process.Conclusion: Interventions targeted towards supporting the care transition process should emphasize ongoing counseling throughout a patient’s care, during and after hospitalization.-----------------------------------------Cite this article as:  Admi H, Muller E, Shadmi E. Transition from Hospital to Community Care: The Experience of Cancer Patients. Int J Cancer Ther Oncol 2015; 3(4:34011.[This abstract was presented at the BIT’s 8th Annual World Cancer Congress, which was held from May 15-17, 2015 in Beijing, China.

The missing piece: cancer prevention within psycho-oncology - a commentary.

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Rosberger, Zeev; Perez, Samara; Bloom, Joan; Shapiro, Gilla K; Fielding, Richard

2015-09-10

In this commentary, we review the place of prevention within the field of Psycho-Oncology. The thrust of Psycho-Oncology's clinical and research efforts have historically focused on behavioral and social factors implicated in the cancer patients' experience from detection and diagnosis, to treatment, survivorship and end of life along the cancer trajectory. This conceptualization has raised the standards for research, leading to a better understanding of the patient experience and the delivery of highly effective interventions to improve quality of life. Emerging data on the role of potential prevention behaviors (e.g., diet and exercise, smoking cessation, screening, etc.) suggests that Psycho-Oncology has a significant role to play in understanding and intervening on a population level to reduce cancer incidence. We present and describe an expanded model of research in Psycho-Oncology which incorporates psychosocial variables in prevention research to complement Holland et al.'s (1998, 2010) original model. The implications of this model are discussed in relation to research, clinical work and training within the discipline of Psycho-Oncology. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

2016 President's Plenary International Psycho-Oncology Society: challenges and opportunities for growing and developing psychosocial oncology programmes worldwide.

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Travado, Luzia; Bultz, Barry D; Ullrich, Andreas; Asuzu, Chioma C; Turner, Jane; Grassi, Luigi; Jacobsen, Paul

2017-09-01

Consistent with the International Psycho-Oncology Society's (IPOS) vision and goals, we are committed to improving quality cancer care and cancer policies through psychosocial care globally. As part of IPOS's mission, upon entering "Official Relations" for a second term with the World Health Organization (WHO), IPOS has dedicated much attention to reaching out to countries, which lack formalized psychosocial care programmes. One of IPOS's strategies to accomplish this goal has been to bring psycho-oncology training programmes to low- and middle-income countries and regions. To this end, the IPOS Board approved a new position on the Board of Directors for a member from a low- to middle-income country (LMIC). The IPOS 2016 President's Plenary focused on challenges and opportunities that exist in growing and developing psychosocial oncology programmes worldwide. The plenary presentations highlight how IPOS and WHO have aligned their goals to help LMICs support cancer patients as an essential element of cancer and palliative care. IPOS country representatives are strongly supported in liaising with national health authorities and with WHO Country Representatives in LMICs. The plenary speakers discussed the role IPOS Federation has taken in building a global network of psychosocial leaders and the impact this had in assisting LMICs in meeting IPOS's psychosocial care objectives. The plenary highlighted the challenges of expanding psychosocial reach into these countries. One significant question remains: Can psychosocial guidelines be adapted to LMICs and regions? Copyright © 2017 John Wiley & Sons, Ltd.

Do high-volume hospitals and surgeons provide better care in urologic oncology?

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Eastham, James A

2009-01-01

Studies focusing primarily on hospital or surgical volume as a surrogate for surgical experience have found substantial variations in outcomes. Increasing surgical experience has been shown to improve outcomes after multiple procedures, including esophagectomy, pancreatectomy, and primary surgery for colon and breast cancer. More recently, evidence has been presented that surgical volume/experience affects quality of life and cancer control outcomes after urologic oncology procedures. Although most of these data pertain to radical prostatectomy, similar conclusions have been reached for radical cystectomy, retroperitoneal lymph node dissection, and management of renal cell carcinoma. This review highlights data indicating that high-volume surgeons and hospitals provide better care for radical prostatectomy.

Oncology nurse communication barriers to patient-centered care.

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Wittenberg-Lyles, Elaine; Goldsmith, Joy; Ferrell, Betty

2013-04-01

Although quality communication has been identified as a necessary component to cancer care, communication skills training programs have yet to focus on the unique role of nurses. This study explored communication barriers as reported by seven nurse managers to better identify communication skills needed for oncology nurses to practice patient-centered care. Thematic analysis of transcripts was used to identify barriers to patient and family communication and desirable patient-centered nursing communication skills. Overall, the nurse managers reported that nurses experience patient and family communication difficulties as a result of inconsistent messages to patients and family from other healthcare staff. Physician assumptions about nursing left nurses feeling uncomfortable asking for clarification, creating a barrier to team communication processes. Patient-centered communication and care cannot be actualized for nurses unless team roles are clarified and nurses receive training in how to communicate with physicians, patients, and family. Therefore, the authors of this article created the COMFORT communication training protocol, and key concepts and resources for nurse communication training through COMFORT are detailed in this article.

Improving End-of-Life Care: Palliative Care Embedded in an Oncology Clinic Specializing in Targeted and Immune-Based Therapies.

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Einstein, David J; DeSanto-Madeya, Susan; Gregas, Matthew; Lynch, Jessica; McDermott, David F; Buss, Mary K

2017-09-01

Patients with advanced cancer benefit from early involvement of palliative care. The ideal method of palliative care integration remains to be determined, as does its effectiveness for patients treated with targeted and immune-based therapies. We studied the impact of an embedded palliative care team that saw patients in an academic oncology clinic specializing in targeted and immune-based therapies. Patients seen on a specific day accessed the embedded model, on the basis of automatic criteria; patients seen other days could be referred to a separate palliative care clinic (usual care). We abstracted data from the medical records of 114 patients who died during the 3 years after this model's implementation. Compared with usual care (n = 88), patients with access to the embedded model (n = 26) encountered palliative care as outpatients more often ( P = .003) and earlier (mean, 231 v 109 days before death; P 7 days before death-a core Quality Oncology Practice Initiative metric-was higher in the embedded model (odds ratio, 5.60; P = .034). Place of death ( P = .505) and end-of-life chemotherapy (odds ratio, 0.361; P = .204) did not differ between the two arms. A model of embedded and automatically triggered palliative care among patients treated exclusively with targeted and immune-based therapies was associated with significant improvements in use and timing of palliative care and hospice, compared with usual practice.

The role of palliative medicine in the organizational frame of oncological care in Slovakia

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Krizanova, K.

2012-01-01

In this work we would like to describe the role of palliative medicine in the organizational frame of oncological care in Slovakia. Basic statistic data are revealing that number of beds in palliative medicine and hospices is shaped rather coincidently according to the reimbursement rates and the effort to reduce a number of chronic beds. Further on we would like to point out a distinction between palliative treatments of cancer and palliative medicine, a distinction between social care and hospice care, the role and relevance of palliative medicine and we bring about some suggestions how to improve the present situation. (author)

Pediatric oncology in Slovenia.

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Jereb, B; Anzic, J

1996-01-01

Slovenia, a new country and formerly a part of Yugoslavia, has had its Childrens Hospital in Ljubljana since 1865. This became a part of the University Hospital in 1945, and in the early 1960s the Department of Pediatric Hematology-Oncology was established. The Oncological Institute of Slovenia was established in 1938 and has developed into a modern facility for comprehensive cancer care, research, and teaching. In close cooperation, established in the 1960s, a team from these two institutions takes care of the approximately 60 children per year who develop cancer in Slovenia. Consisting of pediatricians, radiation oncologists, pathologists, cytologists, surgeons, and other ad hoc specialists, the team meets at least twice weekly to plan treatment, follow the patients, discuss the results, and teach. All patients are subject to regular follow-up indefinitely. A separate team has been formed to study the late effects of cancer treatment on survivors, who by now are mostly adults.

Patient/Family Education for Newly Diagnosed Pediatric Oncology Patients.

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Landier, Wendy; Ahern, JoAnn; Barakat, Lamia P; Bhatia, Smita; Bingen, Kristin M; Bondurant, Patricia G; Cohn, Susan L; Dobrozsi, Sarah K; Haugen, Maureen; Herring, Ruth Anne; Hooke, Mary C; Martin, Melissa; Murphy, Kathryn; Newman, Amy R; Rodgers, Cheryl C; Ruccione, Kathleen S; Sullivan, Jeneane; Weiss, Marianne; Withycombe, Janice; Yasui, Lise; Hockenberry, Marilyn

There is a paucity of data to support evidence-based practices in the provision of patient/family education in the context of a new childhood cancer diagnosis. Since the majority of children with cancer are treated on pediatric oncology clinical trials, lack of effective patient/family education has the potential to negatively affect both patient and clinical trial outcomes. The Children's Oncology Group Nursing Discipline convened an interprofessional expert panel from within and beyond pediatric oncology to review available and emerging evidence and develop expert consensus recommendations regarding harmonization of patient/family education practices for newly diagnosed pediatric oncology patients across institutions. Five broad principles, with associated recommendations, were identified by the panel, including recognition that (1) in pediatric oncology, patient/family education is family-centered; (2) a diagnosis of childhood cancer is overwhelming and the family needs time to process the diagnosis and develop a plan for managing ongoing life demands before they can successfully learn to care for the child; (3) patient/family education should be an interprofessional endeavor with 3 key areas of focus: (a) diagnosis/treatment, (b) psychosocial coping, and (c) care of the child; (4) patient/family education should occur across the continuum of care; and (5) a supportive environment is necessary to optimize learning. Dissemination and implementation of these recommendations will set the stage for future studies that aim to develop evidence to inform best practices, and ultimately to establish the standard of care for effective patient/family education in pediatric oncology.

Practical multimodal care for cancer cachexia.

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Maddocks, Matthew; Hopkinson, Jane; Conibear, John; Reeves, Annie; Shaw, Clare; Fearon, Ken C H

2016-12-01

Cancer cachexia is common and reduces function, treatment tolerability and quality of life. Given its multifaceted pathophysiology a multimodal approach to cachexia management is advocated for, but can be difficult to realise in practice. We use a case-based approach to highlight practical approaches to the multimodal management of cachexia for patients across the cancer trajectory. Four cases with lung cancer spanning surgical resection, radical chemoradiotherapy, palliative chemotherapy and no anticancer treatment are presented. We propose multimodal care approaches that incorporate nutritional support, exercise, and anti-inflammatory agents, on a background of personalized oncology care and family-centred education. Collectively, the cases reveal that multimodal care is part of everyone's remit, often focuses on supported self-management, and demands buy-in from the patient and their family. Once operationalized, multimodal care approaches can be tested pragmatically, including alongside emerging pharmacological cachexia treatments. We demonstrate that multimodal care for cancer cachexia can be achieved using simple treatments and without a dedicated team of specialists. The sharing of advice between health professionals can help build collective confidence and expertise, moving towards a position in which every team member feels they can contribute towards multimodal care.

The efficacy of short-term psycho-oncological interventions for women with gynaecological cancer: a randomized study.

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Goerling, Ute; Jaeger, Carolin; Walz, Annette; Stickel, Anna; Mangler, Mandy; van der Meer, Elke

2014-01-01

We aimed to examine the efficacy of two psycho-oncological interventions in anxiety, depression, and self-perceived as well as physiological stress in inpatients with gynaecological cancer. Forty-five women were included in the trial. Thirty-five were categorized as being at high risk of anxiety and depression, and were randomized to either a single psycho-oncological therapy session or a single-session relaxation intervention. A significant decrease in anxiety [mean (t0) = 12, mean (t1) = 7.47, p = 0.001] and depression [mean (t0) = 9.71, mean (t1) = 6.35, p psycho-oncological intervention group. In the relaxation group, anxiety also significantly decreased [mean (t0) = 11.67, mean (t1) = 8.22, p = 0.003], whereas depression did not. A comparative analysis of both interventions showed a trend in favour of psycho-oncological therapy for the treatment of depression (F = 3.3, p = 0.078). However, self-reported stress (p = 0.031) and different objective stress parameters only significantly decreased in the relaxation group. Psycho-oncological interventions should represent an essential part of interdisciplinary care for gynaecological cancer patients. Both types of intervention may reduce anxiety. However, the single psycho-oncological therapy session might be slightly more effective in treating depression, whereas the single-session relaxation intervention seems to have a stronger effect on physiological stress parameters. © 2014 S. Karger AG, Basel.

Initiation of a multidisciplinary summer studentship in palliative and supportive care in oncology

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Fairchild A

2012-09-01

Full Text Available Alysa Fairchild,1 Sharon Watanabe,1 Carole Chambers,2 Janice Yurick,3 Lisa Lem,4 Patty Tachynski51Faculty of Medicine and Dentistry, University of Alberta, Edmonton, 2Department of Pharmacy, Alberta Health Services, 3Department of Rehabilitation Medicine, Cross Cancer Institute, Edmonton, 4Department of Respiratory Therapy, Cross Cancer Institute, Edmonton, 5Department of Clinical Nutrition, Cross Cancer Institute, Edmonton, Alberta, CanadaPurpose: The optimal setting for interprofessional education (IPE for prelicensure health care trainees is unclear, especially in a field as complex and emotionally challenging as oncology. In this article, the authors describe the initiation of the Cross Cancer Institute Multidisciplinary Summer Studentship in Palliative and Supportive Care in Oncology, a 6-week, multidisciplinary team-based clinical placement in supportive care, designed to incorporate features of best practice cooperative learning.Methods: A steering committee established goals, structure, eligibility criteria, application process, funding, and a consensus approach to instruction and evaluation for the IPE program. Studentship components included mandatory and flexible clinical time, an exploratory investigation, discussion groups, and a presentation. Two senior students per iteration were selected from clinical nutrition, medicine, nursing, occupational therapy, pharmacy, physiotherapy, respiratory therapy, social work, and speech–language pathology applicants. These students completed questionnaires investigating their views of their own and others' professions at baseline, at the end of the rotation, and 6 months after the studentship.Results: Eight students from medicine, clinical nutrition, occupational therapy, physiotherapy, and speech–language pathology have participated to date. At the elective's end, students have described a more positive view of multidisciplinary team practice, with each participating discipline perceived as

Clinical Pathways and the Patient Perspective in the Pursuit of Value-Based Oncology Care.

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Ersek, Jennifer L; Nadler, Eric; Freeman-Daily, Janet; Mazharuddin, Samir; Kim, Edward S

2017-01-01

The art of practicing oncology has evolved substantially in the past 5 years. As more and more diagnostic tests, biomarker-directed therapies, and immunotherapies make their way to the oncology marketplace, oncologists will find it increasingly difficult to keep up with the many therapeutic options. Additionally, the cost of cancer care seems to be increasing. Clinical pathways are a systematic way to organize and display detailed, evidence-based treatment options and assist the practitioner with best practice. When selecting which treatment regimens to include on a clinical pathway, considerations must include the efficacy and safety, as well as costs, of the therapy. Pathway treatment regimens must be continually assessed and modified to ensure that the most up-to-date, high-quality options are incorporated. Value-based models, such as the ASCO Value Framework, can assist providers in presenting economic evaluations of clinical pathway treatment options to patients, thus allowing the patient to decide the overall value of each treatment regimen. Although oncologists and pathway developers can decide which treatment regimens to include on a clinical pathway based on the efficacy of the treatment, assessment of the value of that treatment regimen ultimately lies with the patient. Patient definitions of value will be an important component to enhancing current value-based oncology care models and incorporating new, high-quality, value-based therapeutics into oncology clinical pathways.

Integration of oncology and palliative care: a systematic review.

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Hui, David; Kim, Yu Jung; Park, Ji Chan; Zhang, Yi; Strasser, Florian; Cherny, Nathan; Kaasa, Stein; Davis, Mellar P; Bruera, Eduardo

2015-01-01

Both the American Society of Clinical Oncology and the European Society for Medical Oncology strongly endorse integrating oncology and palliative care (PC); however, a global consensus on what constitutes integration is currently lacking. To better understand what integration entails, we conducted a systematic review to identify articles addressing the clinical, educational, research, and administrative indicators of integration. We searched Ovid MEDLINE and Ovid EMBase between 1948 and 2013. Two researchers independently reviewed each citation for inclusion and extracted the indicators related to integration. The inter-rater agreement was high (κ = 0.96, p oncology journals (59%) and in or after 2010 (64%, p oncology and PC. ©AlphaMed Press.

Case management in oncology rehabilitation (CAMON: The effect of case management on the quality of life in patients with cancer after one year of ambulant rehabilitation. A study protocol for a randomized controlled clinical trial in oncology rehabilitation

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Bardheci Katarina

2011-04-01

Full Text Available Abstract Background Cancer diseases and their therapies have negative effects on the quality of life. The aim of this study is to assess the effectiveness of case management in a sample of oncological outpatients with the intent of rehabilitation after cancer treatment. Case management wants to support the complex information needs of the patients in addition to the segmented structure of the health care system. Emphasis is put on support for self-management in order to enhance health - conscious behaviour, learning to deal with the burden of the illness and providing the opportunity for regular contacts with care providers. We present a study protocol to investigate the efficacy of a case management in patients following oncology rehabilitation after cancer treatment. Methods The trial is a multicentre, two-arm randomised controlled study. Patients are randomised parallel in either 'usual care' plus case management or 'usual care' alone. Patients with all types of cancer can be included in the study, if they have completed the therapy with chemo- and/or radiotherapy/surgery with curative intention and are expected to have a survival time >1 year. To determine the health-related quality of life the general questionnaire FACT G is used. The direct correlation between self-management and perceived self-efficacy is measured with the Jerusalem & Schwarzer questionnaire. Patients satisfaction with the care received is measured using the Patient Assessment of Chronic Illness Care 5 As (PACIC-5A. Data are collected at the beginning of the trial and after 3, 6 and 12 months. The power analysis revealed a sample size of 102 patients. The recruitment of the centres began in 2009. The inclusion of patients began in May 2010. Discussion Case management has proved to be effective regarding quality of life of patients with chronic diseases. When it comes to oncology, case management is mainly used in cancer treatment, but it is not yet common in the

Creation and Implementation of an Environmental Scan to Assess Cancer Genetics Services at Three Oncology Care Settings.

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Bednar, Erica M; Walsh, Michael T; Baker, Ellen; Muse, Kimberly I; Oakley, Holly D; Krukenberg, Rebekah C; Dresbold, Cara S; Jenkinson, Sandra B; Eppolito, Amanda L; Teed, Kelly B; Klein, Molly H; Morman, Nichole A; Bowdish, Elizabeth C; Russ, Pauline; Wise, Emaline E; Cooper, Julia N; Method, Michael W; Henson, John W; Grainger, Andrew V; Arun, Banu K; Lu, Karen H

2018-05-16

An environmental scan (ES) is an efficient mixed-methods approach to collect and interpret relevant data for strategic planning and project design. To date, the ES has not been used nor evaluated in the clinical cancer genetics setting. We created and implemented an ES to inform the design of a quality improvement (QI) project to increase the rates of adherence to national guidelines for cancer genetic counseling and genetic testing at three unique oncology care settings (OCS). The ES collected qualitative and quantitative data from reviews of internal processes, past QI efforts, the literature, and each OCS. The ES used a data collection form and semi-structured interviews to aid in data collection. The ES was completed within 6 months, and sufficient data were captured to identify opportunities and threats to the QI project's success, as well as potential barriers to, and facilitators of guideline-based cancer genetics services at each OCS. Previously unreported barriers were identified, including inefficient genetic counseling appointment scheduling processes and the inability to track referrals, genetics appointments, and genetic test results within electronic medical record systems. The ES was a valuable process for QI project planning at three OCS and may be used to evaluate genetics services in other settings.

Perceptions of lung cancer and potential impacts on funding and patient care: a qualitative study.

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Tran, Kim; Delicaet, Kendra; Tang, Theresa; Ashley, Leslie Beard; Morra, Dante; Abrams, Howard

2015-03-01

The objective of this study was to explore health-care professionals', health administrators', and not-for-profit cancer organization representatives' perceptions of lung cancer-related stigma and nihilism and the perceived impacts on funding and patient care. This is a qualitative descriptive study using semi-structured interviews, which was conducted in Ontario, Canada. Seventy-four individuals from medical oncology, radiation oncology, thoracic surgery, respirology, pathology, radiology, primary care, palliative care, nursing, pharmacy, social work, genetics, health administration, and not-for-profit cancer organizations participated in this study. Participants described lung cancer-related stigma and nihilism and its negative impact on patients' psychological health, lung cancer funding, and patient care. The feeling of guilt and shame experienced by lung cancer patients as a result of the stigma associated with the disease was described. In terms of lung cancer funding, stigma was described as a reason lung cancer receives significantly less research funding compared to other cancers. In terms of patient care, lung cancer-related nihilism was credited with negatively impacting physician referral patterns with the belief that lung cancer patients were less likely to receive referrals for medical treatment. Health-care professionals, health administrators, and not-for-profit cancer organization representatives described lung cancer-related stigma and nihilism with far-reaching consequences. Further work is needed to increase education and awareness about lung cancer to reduce the stigma and nihilism associated with the disease.

Open Oncology Notes: A Qualitative Study of Oncology Patients' Experiences Reading Their Cancer Care Notes.

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Kayastha, Neha; Pollak, Kathryn I; LeBlanc, Thomas W

2018-04-01

Electronic medical records increasingly allow patients access to clinician notes. Although most believe that open notes benefits patients, some suggest negative consequences. Little is known about the experiences of patients with cancer reading their medical notes; thus we aimed to describe this qualitatively. We interviewed 20 adults with metastatic or incurable cancer receiving cancer treatment. The semistructured qualitative interviews included four segments: assessing their overall experience reading notes, discussing how notes affected their cancer care experiences, reading a real note with the interviewer, and making suggestions for improvement. We used a constant comparison approach to analyze these qualitative data. We found four themes. Patients reported that notes resulted in the following: (1) increased comprehension; (2) ameliorated uncertainty, relieved anxiety, and facilitated control; (3) increased trust; and (4) for a subset of patients, increased anxiety. Patients described increased comprehension because notes refreshed their memory and clarified their understanding of visits. This helped mitigate the unfamiliarity of cancer, addressing uncertainty and relieving anxiety. Notes facilitated control, empowering patients to ask clinicians more questions. The transparency of notes also increased trust in clinicians. For a subset of patients, however, notes were emotionally difficult to read and raised concerns. Patients identified medical jargon and repetition in notes as areas for improvement. Most patients thought that reading notes improved their care experiences. A small subset of patients experienced increased distress. As reading notes becomes a routine part of the patient experience, physicians might want to elicit and address concerns that arise from notes, thereby further engaging patients in their care.

Focusing on cancer patients' intentions to use psycho-oncological support: a longitudinal, mixed-methods study.

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Tondorf, T; Grossert, A; Rothschild, S I; Koller, M T; Rochlitz, C; Kiss, A; Schaefert, R; Meinlschmidt, G; Hunziker, S; Zwahlen, D

2018-04-15

Distress screening programs aim to ensure appropriate psycho-oncological support for cancer patients, but many eligible patients do not use these services. To improve distress management, we need to better understand patients' supportive care needs. In this paper, we report the first key finding from a longitudinal study that focused on patients' intentions to use psycho-oncological support, and its association with distress and uptake of the psycho-oncology service. We conducted a prospective, observational study in an Oncology Outpatient Clinic and assessed distress, intention to use psycho-oncological support, and uptake of the psycho-oncology service using the Distress Thermometer (DT), a semi-structured interview, and hospital records. We analyzed data with a mixed-methods approach. Of 333 patients (mean age 61 years; 55% male; 54% DT≥5), 25% intended to use the psycho-oncology service (yes), 33% were ambivalent (maybe), and 42% reported no intention (no). Overall, 23% had attended the psycho-oncology service four months later. Ambivalent patients reported higher distress than patients with no intention (odds ratio (OR)=1.18, 95% confidence interval (CI)[1.06-1.32]) but showed significantly lower uptake behavior than patients with an intention (OR=14.04, 95%CI [6.74-29.24]). Qualitative analyses revealed that ambivalent patients (maybe) emphasized fears and uncertainties, while patients with clear intentions (yes/no) emphasized knowledge, attitudes, and coping concepts. We identified a vulnerable group of ambivalent patients with high distress levels and low uptake behavior. To optimize distress screening programs, we suggest addressing and discussing patients' supportive care needs in routine clinical practice. This article is protected by copyright. All rights reserved.

International Society of Geriatric Oncology Consensus on Geriatric Assessment in Older Patients With Cancer

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Wildiers, Hans; Heeren, Pieter; Puts, Martine; Topinkova, Eva; Janssen-Heijnen, Maryska L.G.; Extermann, Martine; Falandry, Claire; Artz, Andrew; Brain, Etienne; Colloca, Giuseppe; Flamaing, Johan; Karnakis, Theodora; Kenis, Cindy; Audisio, Riccardo A.; Mohile, Supriya; Repetto, Lazzaro; Van Leeuwen, Barbara; Milisen, Koen; Hurria, Arti

2014-01-01

Purpose To update the International Society of Geriatric Oncology (SIOG) 2005 recommendations on geriatric assessment (GA) in older patients with cancer. Methods SIOG composed a panel with expertise in geriatric oncology to develop consensus statements after literature review of key evidence on the following topics: rationale for performing GA; findings from a GA performed in geriatric oncology patients; ability of GA to predict oncology treatment–related complications; association between GA findings and overall survival (OS); impact of GA findings on oncology treatment decisions; composition of a GA, including domains and tools; and methods for implementing GA in clinical care. Results GA can be valuable in oncology practice for following reasons: detection of impairment not identified in routine history or physical examination, ability to predict severe treatment-related toxicity, ability to predict OS in a variety of tumors and treatment settings, and ability to influence treatment choice and intensity. The panel recommended that the following domains be evaluated in a GA: functional status, comorbidity, cognition, mental health status, fatigue, social status and support, nutrition, and presence of geriatric syndromes. Although several combinations of tools and various models are available for implementation of GA in oncology practice, the expert panel could not endorse one over another. Conclusion There is mounting data regarding the utility of GA in oncology practice; however, additional research is needed to continue to strengthen the evidence base. PMID:25071125

Widening Access; Developing an eLearning Resource for Health and Social Care Professionals Caring for Children and Young People with Cancer.

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McInally, Wendy; Pouso Lista, Maria J; McLaren, Natalia; Willis, Diane S

2017-09-29

Cancer is a key priority worldwide, and caring for children and young people with cancer requires a range of specific knowledge, skills and experience in order to deliver the complex care regimes both within the hospital or community environment. The aim of this paper is to disseminate work undertaken to design and develop pedagogical practice and innovation through an eLearning resource for health care professionals caring for children and young people with cancer across the globe. The work undertaken evaluated an existing cancer course (which has been withdrawn) that was developed and delivered through the Paediatric Oncology Nurses Forum, Royal College Nursing (Nurse Educators) and Warwick University. The evaluation consisted of 26 open and closed questions relating to the previous resource and was circulated to all health and social care professionals involved directly within specialist oncology services through the Children's Cancer and Leukaemia Group. Questionnaires were sent out to a convenience sample of 773 health care professionals and the response rate was 14%. The findings identified that the course was predominantly accessed by nurses, but other health care professionals also found it useful. Participants highlighted several areas where they believed content could be developed or was lacking. This included areas such as palliative and end of life care, nutrition, sepsis and teenagers and young people. This feedback was then used to develop a site dedicated to the care of children and young people with cancer.

Creating a Culture of Professional Development for Oncology Nursing in Asia.

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Yi, Myungsun

2016-01-01

The importance of professional development of oncology nursing in Asia is growing along with growth in the cancer burden and disparity in cancer incidence and mortality between more- and less-developed regions, the latter of which includes most Asian countries. This paper proposes ways to advance the oncology nursing in terms of education, practice, and research in Asia. It also describes major challenges expected in developing and implementing a unique professional role for oncology nurses in Asia. This study will provide insights for Asian oncology nurses in developing culturally sensitive oncology nursing practices with limited health care resources.

An overview and evaluation of the oncology family caregiver project: improving quality of life and quality of care for oncology family caregivers.

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Ferrell, Betty; Hanson, Jo; Grant, Marcia

2013-07-01

With changes in health care, oncology family caregivers (FCs) provide the vast majority of patient care. Yet, FCs assume their role with little or no training and with limited resources within the cancer setting to support them. The purpose of this project is to develop and implement a curriculum to improve the quality of life and quality of care for FCs by strengthening cancer care settings in this area. A National Cancer Institute (NCI) R25 grant funded the development of an FC curriculum for professional healthcare providers. The curriculum, based on the City of Hope Quality-of-Life Model, is presented to professionals from cancer centers in national training courses. The project brings together the most current evidence-based knowledge and multiple resources to help improve FC support. Participants develop goals related to implementation and dissemination of the course content and resources in their home institution. Goal evaluation follows at 6, 12, and 18 months. To date, three courses have been presented to 154 teams (322 individuals) representing 39 states. Course evaluations were positive, and participants have initiated institutional FC support goals. Although the goals are diverse, the broad categories include support groups, staff/FC/community education, resource development, assessment tools, and institutional change. There is a critical need to improve support for cancer FCs. This FC training course for professionals is a first step in addressing this need. Copyright © 2012 John Wiley & Sons, Ltd.

Towards culturally competent paediatric oncology care. A qualitative study from the perspective of care providers.

Science.gov (United States)

Suurmond, J; Lieveld, A; van de Wetering, M; Schouten-van Meeteren, A Y N

2017-11-01

In order to gain more insight on the influence of ethnic diversity in paediatric cancer care, the perspectives of care providers were explored. Semi-structured interviews were conducted among 12 paediatric oncologists and 13 nurses of two different paediatric oncology wards and were analysed using a framework method. We found that care providers described the contact with Turkish and Moroccan parents as more difficult. They offered two reasons for this: (1) language barriers between care provider and parents hindered the exchange of information; (2) cultural barriers between care provider and parents about sharing the diagnosis and palliative perspective hindered communication. Care providers reported different solutions to deal with these barriers, such as using an interpreter and improving their cultural knowledge about their patients. They, however, were not using interpreters sufficiently and were unaware of the importance of eliciting parents' perspectives. Communication techniques to overcome dilemmas between parents and care providers were not used and care providers were unaware of stereotypes and prejudice. Care providers should be offered insight in cultural barriers they are unaware of. Training in cultural competence might be a possibility to overcome manifest barriers. © 2017 John Wiley & Sons Ltd.

Mobile Health in Oncology: A Patient Survey About App-Assisted Cancer Care.

Science.gov (United States)

Kessel, Kerstin Anne; Vogel, Marco Me; Kessel, Carmen; Bier, Henning; Biedermann, Tilo; Friess, Helmut; Herschbach, Peter; von Eisenhart-Rothe, Rüdiger; Meyer, Bernhard; Kiechle, Marion; Keller, Ulrich; Peschel, Christian; Schmid, Roland M; Combs, Stephanie E

2017-06-14

In the last decade, the health care sector has been enriched by numerous innovations such as apps and connected devices that assist users in weight reduction and diabetes management. However, only a few native apps in the oncological context exist, which support patients during treatment and aftercare. The objective of this study was to analyze patients' acceptance regarding app use and to investigate the functions of an oncological app that are most required, and the primary reasons for patients to refuse app-assisted cancer care. We designed and conducted a survey with 23 questions, inquiring patients about their technical knowledge and equipment, as well as the possible advantages and disadvantages, data transfer, and general functionality of an app. A total of 375 patients participated; the participation rate was 60.7% (375/618). Gender distribution was about 3:4 (female:male) with a median age of 59 years (range 18-92 years). Whereas 69.6% (261/375) of patients used mobile devices, 16.3% (61/375) did not own one, and 9.1% (34/375) only used a personal computer (PC). About half of the patients rated their usability skills as very good and good (18.9% 71/375; 35.2% 132/375), 23.5% (88/375) described their skills as intermediate, and 14.4% (54/375) as bad. Of all patients, 182 (48.5%, 182/375) were willing to send data to their treating clinic via an app, that is, to a server (61.0% 111/182) or as email (33.5%, 61/182). About two-thirds (68.7%, 125/182) believed that additional and regularly sent data would be an ideal complement to the standard follow-up procedure. Additionally, 86.8% (158/182) wished to be contacted by a physician when entered data showed irregularities. Because of lack of skills (34.4%, 56/163), concerns about the use of data (35.0%, 57/163), lack of capable devices (25.8%, 42/163), and the wish for personal contact with the treating physician (47.2%, 77/163), a total of 163 (43.5%, 163/375) patients refused to use an app. Pearson correlation

Knowledge, Beliefs, and Communication Behavior of Oncology Health-care Providers (HCPs) regarding Lesbian, Gay, Bisexual, and Transgender (LGBT) Patient Health care.

Science.gov (United States)

Banerjee, Smita C; Walters, Chasity B; Staley, Jessica M; Alexander, Koshy; Parker, Patricia A

2018-01-01

Delivery of culturally competent care toward lesbian, gay, bisexual, and transgender (LGBT) patients depends on how health-care providers (HCPs) communicate with them; however, research about knowledge, attitude, and behavior of HCPs toward LGBT patients is scant. The objectives of our study were to describe oncology HCPs' knowledge and examine if beliefs about LGB and transgender patients mediate the effects of LGBT health-care knowledge on open communication behaviors with LGB and transgender patients, respectively. A total of 1253 HCPs (187 physicians, 153 advance practice professionals (APPs), 828 nurses, and 41 others) at a Comprehensive Cancer Center completed an online survey that included the following measures: LGBT health-care knowledge, beliefs, communication behaviors, willingness to treat LGBT patients, encouraging LGBT disclosure, and perceived importance of LGBT sensitivity training. Only 50 participants (5%) correctly answered all 7 knowledge items, and about half the respondents answered 3 (out of 7) items correctly. Favorable beliefs about LGBT health care mediated the effect of higher LGBT health-care knowledge on open communication behaviors with transgender patients, controlling for effects of type of profession, religious orientation, gender identity, sexual orientation, and having LGBT friends/family. The results of this study demonstrated an overall lack of medical knowledge and the need for more education about LGBT health care among oncology HCPs.

[Psycho-oncology care in rural areas : Results from a cross-sectional survey on the utilisation of community-based psychosocial support services].

Science.gov (United States)

Haun, Markus W; Sklenarova, Halina; Zimmermann-Schlegel, Verena; Herzog, Wolfgang; Hartmann, Mechthild

2018-01-01

Clinically relevant distress and unmet psychosocial needs frequently occur in the course of cancer diseases. Particularly for thinly populated rural areas in Germany rates of distressed patients and uptake of community-based psycho-oncology services are unknown. Determination of a) the proportion of cancer patients with psychosocial distress and unmet needs and b) the utilisation of community-based psycho-oncology services in thinly populated rural areas. Prospective cross-sectional study of 229 cancer patients (colon, breast, prostate cancer) living in thinly populated rural areas. Indicators for clinically relevant distress and utilisation of psychosocial services were assessed by applying screening instruments. We conducted descriptive and multivariate analyses. More than one third of all cancer patients (39.3%) in thinly populated areas exhibited clinically relevant distress. However, only 15.6% of distressed patients consulted community-based psycho-oncology services. Most frequently, medical or psychological psychotherapists were contacted. Information deficits of patients and attending physicians alongside dispositional factors emerged as the main reasons for non-utilisation. This study presents first data on psycho-oncology care in rural areas in Germany stratifying the degree of urbanisation in line with the standards of the European Commission. Concerning limitations, we only accounted for structural service coverage, leaving aside other indicators for socio-spatial deprivation.

Surgical Oncology Nursing: Looking Back, Looking Forward.

Science.gov (United States)

Crane, Patrick C; Selanders, Louise

2017-02-01

To provide a historical perspective in the development of oncology nursing and surgical oncology as critical components of today's health care system. Review of the literature and Web sites of key organizations. The evolution of surgical oncology nursing has traversed a historical journey from that of a niche subspecialty of nursing that had very little scientific underpinning, to a highly sophisticated discipline within a very short time. Nursing continues to contribute its expertise to the encyclopedic knowledge base of surgical oncology and cancer care, which have helped improve the lives of countless patients and families who have had to face the difficulties of this diagnosis. An understanding of the historical context for which a nursing specialty such as surgical oncology nursing evolves is critical to gaining an appreciation for the contributions of nursing. Copyright © 2016 Elsevier Inc. All rights reserved.

Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies

DEFF Research Database (Denmark)

Mitchell, A. J.; Chan, M.; Bhatti, H.

2011-01-01

Background Substantial uncertainty exists about prevalence of mood disorders in patients with cancer, including those in oncological, haematological, and palliative-care settings. We aimed to quantitatively summarise the prevalence of depression, anxiety, and adjustments disorders in these settin...... between palliative-care and non-palliative-care settings. Clinicians should remain vigilant for mood complications, not just depression....

Payment Reform: Unprecedented and Evolving Impact on Gynecologic Oncology.

Science.gov (United States)

Apte, Sachin M; Patel, Kavita

2016-01-01

With the signing of the Medicare Access and CHIP Reauthorization Act in April 2015, the Centers for Medicare and Medicaid Services (CMS) is now positioned to drive the development and implementation of sweeping changes to how physicians and hospitals are paid for the provision of oncology-related services. These changes will have a long-lasting impact on the sub-specialty of gynecologic oncology, regardless of practice structure, physician employment and compensation model, or local insurance market. Recently, commercial payers have piloted various models of payment reform via oncology-specific clinical pathways, oncology medical homes, episode payment arrangements, and accountable care organizations. Despite the positive results of some pilot programs, adoption remains limited. The goals are to eliminate unnecessary variation in cancer treatment, provide coordinated patient-centered care, while controlling costs. Yet, meaningful payment reform in oncology remains elusive. As the largest payer for oncology services in the United States, CMS has the leverage to make cancer services more value based. Thus far, the focus has been around pricing of physician-administered drugs with recent work in the area of the Oncology Medical Home. Gynecologic oncology is a unique sub-specialty that blends surgical and medical oncology, with treatment that often involves radiation therapy. This forward-thinking, multidisciplinary model works to keep the patient at the center of the care continuum and emphasizes care coordination. Because of the breadth and depth of gynecologic oncology, this sub-specialty has both the potential to be disrupted by payment reform as well as potentially benefit from the aspects of reform that can align incentives appropriately to improve coordination. Although the precise future payment models are unknown at this time, focused engagement of gynecologic oncologists and the full care team is imperative to assure that the practice remains patient centered

Payment Reform: Unprecedented and Evolving Impact on Gynecologic Oncology

Science.gov (United States)

Apte, Sachin M.; Patel, Kavita

2016-01-01

With the signing of the Medicare Access and CHIP Reauthorization Act in April 2015, the Centers for Medicare and Medicaid Services (CMS) is now positioned to drive the development and implementation of sweeping changes to how physicians and hospitals are paid for the provision of oncology-related services. These changes will have a long-lasting impact on the sub-specialty of gynecologic oncology, regardless of practice structure, physician employment and compensation model, or local insurance market. Recently, commercial payers have piloted various models of payment reform via oncology-specific clinical pathways, oncology medical homes, episode payment arrangements, and accountable care organizations. Despite the positive results of some pilot programs, adoption remains limited. The goals are to eliminate unnecessary variation in cancer treatment, provide coordinated patient-centered care, while controlling costs. Yet, meaningful payment reform in oncology remains elusive. As the largest payer for oncology services in the United States, CMS has the leverage to make cancer services more value based. Thus far, the focus has been around pricing of physician-administered drugs with recent work in the area of the Oncology Medical Home. Gynecologic oncology is a unique sub-specialty that blends surgical and medical oncology, with treatment that often involves radiation therapy. This forward-thinking, multidisciplinary model works to keep the patient at the center of the care continuum and emphasizes care coordination. Because of the breadth and depth of gynecologic oncology, this sub-specialty has both the potential to be disrupted by payment reform as well as potentially benefit from the aspects of reform that can align incentives appropriately to improve coordination. Although the precise future payment models are unknown at this time, focused engagement of gynecologic oncologists and the full care team is imperative to assure that the practice remains patient centered

Payment Reform: Unprecedented and Evolving Impact on Gynecologic Oncology

Directory of Open Access Journals (Sweden)

Sachin eApte

2016-04-01

Full Text Available With the signing of the Medicare Access and CHIP Reauthorization Act (MACRA in April 2015, the Centers for Medicare and Medicaid Services (CMS is now positioned to drive the development and implementation of sweeping changes to how physicians and hospitals are paid for the provision of oncology related services. These changes will have a long-lasting impact on the sub-specialty of gynecologic oncology, regardless of practice structure, physician employment and compensation model, or local insurance market. Recently, commercial payers have piloted various models of payment reform via oncology specific clinical pathways, oncology medical homes, episode payment arrangements, and accountable care organizations. Despite the positive results of some pilot programs, adoption remains limited. The goals are to eliminate unnecessary variation in cancer treatment, provide coordinated patient-centered care, while controlling costs. Yet, meaningful payment reform in oncology remains elusive. As the largest payer for oncology services in the United States, CMS has the leverage to make cancer services more value-based. Thus far, the focus has been around pricing of physician-administered drugs with recent work in the area of the Oncology Medical Home. Gynecologic oncology is a unique sub-specialty which blends surgical and medical oncology, with treatment that often involves radiation therapy. This forward-thinking, multi-disciplinary model works to keep the patient at the center of the care continuum and emphasizes care coordination. Because of the breadth and depth of gynecologic oncology, this sub-specialty has both the potential to be disrupted by payment reform as well as potentially benefit from the aspects of reform which can align incentives appropriately to improve coordination. Although the precise future payment models are unknown at this time, focused engagement of gynecologic oncologists and the full care team is imperative to assure that the

Early Integration of Palliative Care in Oncology Practice: Results of the Italian Association of Medical Oncology (AIOM) Survey.

Science.gov (United States)

Zagonel, Vittorina; Torta, Riccardo; Franciosi, Vittorio; Brunello, Antonella; Biasco, Guido; Cattaneo, Daniela; Cavanna, Luigi; Corsi, Domenico; Farina, Gabriella; Fioretto, Luisa; Gamucci, Teresa; Lanzetta, Gaetano; Magarotto, Roberto; Maltoni, Marco; Mastromauro, Cataldo; Melotti, Barbara; Meriggi, Fausto; Pavese, Ida; Piva, Erico; Sacco, Cosimo; Tonini, Giuseppe; Trentin, Leonardo; Ermacora, Paola; Varetto, Antonella; Merlin, Federica; Gori, Stefania; Cascinu, Stefano; Pinto, Carmine

2016-01-01

Early integration of palliative care in oncology practice ("simultaneous care", SC) has been shown to provide better care resulting in improved quality-of-life and also survival. We evaluated the opinions of Italian Association of Medical Oncology (AIOM) members. A 37-item questionnaire was delivered to 1119 AIOM members. Main areas covered were: social, ethical, relational aspects of disease and communication, training, research, organizational and management models in SC. Three open questions explored the definition of Quality of Life, Medical Oncologist and Palliative Care. Four hundred and forty-nine (40.1%) medical oncologists returned the questionnaires. Forty-nine percent stated they address non-curability when giving a diagnosis of metastatic tumor, and 43% give the information only to patients who clearly ask for it. Fifty-five percent say the main formative activity in palliative medicine came from attending meetings and 90% agree that specific palliative care training should be part of the core curriculum in oncology. Twenty-two percent stated they consulted guidelines for symptom management, 45% relied upon personal experience and 26% make a referral to a palliative care specialist. Seventy-four percent were in favor of more research in palliative medicine. An integration between Units of Oncology and Palliative Care Services early in the course of advanced disease was advocated by 86%. Diverse and multifaceted definitions were given for the concepts of Quality of Life, Palliative Care and Medical Oncologist. SC is felt as an important task, as well as training of medical oncologists in symptom management and research in this field.

Understanding why cancer patients accept or turn down psycho-oncological support: a prospective observational study including patients' and clinicians' perspectives on communication about distress.

Science.gov (United States)

Zwahlen, Diana; Tondorf, Theresa; Rothschild, Sacha; Koller, Michael T; Rochlitz, Christoph; Kiss, Alexander

2017-05-30

International standards prioritize introducing routine emotional distress screening in cancer care to accurately identify patients who most need psycho-oncological treatment, and ensure that patients can access appropriate supportive care. However, only a moderate proportion of distressed patients accepts referrals to or uses psycho-oncological support services. Predictors and barriers to psycho-oncological support service utilization are under-studied. We know little about how patients and oncologists perceive the discussions when oncologists assess psychosocial distress with a screening instrument. We aim to 1) assess the barriers and predictors of uptake of in-house psycho-oncological support along the distress screening pathway in cancer patients treated at a University Oncology Outpatient Clinic and, 2) determine how patients and clinicians perceive communication about psychosocial distress after screening with the Distress Thermometer. This is a quantitative prospective observational study with qualitative aspects. We will examine medical and demographic variables, cancer patient self-reports of various psychological measures, and aspects of the patient-clinician communication as variables that potentially predict uptake of psycho-oncological support service. We will also assess the patients' reasons for accepting or refusing psycho-oncological support services. We assess at three points in time, based on paper-and-pencil questionnaires and two patient interviews during the study period. We will monitor outcomes (psycho-oncology service uptake) four months after study entry. The study will improve our understanding of characteristics of patients who accept or refuse psycho-oncological support, and help us understand how patients' and oncologists perceive communication about psychosocial distress, and referral to a psycho-oncologist. We believe this is the first study to focus on factors that affect uptake or rejection of psycho-oncological support services

Enhancing collaborative leadership in palliative social work in oncology.

Science.gov (United States)

Jones, Barbara; Phillips, Farya; Head, Barbara Anderson; Hedlund, Susan; Kalisiak, Angela; Zebrack, Brad; Kilburn, Lisa; Otis-Green, Shirley

2014-01-01

The Institute of Medicine (IOM) Report-Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs-provided recommendations for meeting the palliative care needs of our growing population of older Americans. The IOM report highlights the demand for social work leadership across all aspects of the health care delivery system. Social workers are core interdisciplinary members of the health care team and it is important for them to be well prepared for collaborative leadership roles across health care settings. The ExCEL in Social Work: Excellence in Cancer Education & Leadership education project was created as a direct response to the 2008 IOM Report. This article highlights a sampling of palliative care projects initiated by outstanding oncology social work participants in the ExCEL program. These projects demonstrate the leadership of social workers in palliative care oncology.

The Dual Rounding Model: Forging Therapeutic Alliances 
in Oncology and Palliative Care.

Science.gov (United States)

Baxley, Carey E

2016-04-01

Inpatients with solid tumors at Duke University Hospital in Durham, NC, are cared for in a dynamic integrated care model that incorporates medical oncology and palliative care. This has profound implications for patients, their loved ones, medical and surgical staff, and oncology nurses. As a nurse with less than three years of experience, my participation in a setting that uses the Dual Rounding Model has accelerated my professional and personal development. During a typical shift, I am an oncology nurse, a palliative care nurse, and a hospice nurse.
.

Long-term Oncologic and Financial Implications of Lung Cancer Screening

DEFF Research Database (Denmark)

Pedersen, Jesper Johannes Holst; Sørensen, Jens Benn

2015-01-01

Benefits and risks of computed tomography lung cancer screening are discussed with specific focus on oncologic and financial issues. Earlier disease stage at diagnosis implies that more patients are treated surgically, but the changes in oncologic treatment will not be dramatic. The crucial issue...

The integration of psychology in pediatric oncology research and practice: collaboration to improve care and outcomes for children and families.

Science.gov (United States)

Kazak, Anne E; Noll, Robert B

2015-01-01

Childhood cancers are life-threatening diseases that are universally distressing and potentially traumatic for children and their families at diagnosis, during treatment, and beyond. Dramatic improvements in survival have occurred as a result of increasingly aggressive multimodal therapies delivered in the context of clinical research trials. Nonetheless, cancers remain a leading cause of death in children, and their treatments have short- and long-term impacts on health and well-being. For over 35 years, pediatric psychologists have partnered with pediatric oncology teams to make many contributions to our understanding of the impact of cancer and its treatment on children and families and have played prominent roles in providing an understanding of treatment-related late effects and in improving quality of life. After discussing the incidence of cancer in children, its causes, and the treatment approaches to it in pediatric oncology, we present seven key contributions of psychologists to collaborative and integrated care in pediatric cancer: managing procedural pain, nausea, and other symptoms; understanding and reducing neuropsychological effects; treating children in the context of their families and other systems (social ecology); applying a developmental perspective; identifying competence and vulnerability; integrating psychological knowledge into decision making and other clinical care issues; and facilitating the transition to palliative care and bereavement. We conclude with a discussion of the current status of integrating knowledge from psychological research into practice in pediatric cancer. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Nanotechnology Strategies To Advance Outcomes in Clinical Cancer Care.

Science.gov (United States)

Hartshorn, Christopher M; Bradbury, Michelle S; Lanza, Gregory M; Nel, Andre E; Rao, Jianghong; Wang, Andrew Z; Wiesner, Ulrich B; Yang, Lily; Grodzinski, Piotr

2018-01-23

Ongoing research into the application of nanotechnology for cancer treatment and diagnosis has demonstrated its advantages within contemporary oncology as well as its intrinsic limitations. The National Cancer Institute publishes the Cancer Nanotechnology Plan every 5 years since 2005. The most recent iteration helped codify the ongoing basic and translational efforts of the field and displayed its breadth with several evolving areas. From merely a technological perspective, this field has seen tremendous growth and success. However, an incomplete understanding of human cancer biology persists relative to the application of nanoscale materials within contemporary oncology. As such, this review presents several evolving areas in cancer nanotechnology in order to identify key clinical and biological challenges that need to be addressed to improve patient outcomes. From this clinical perspective, a sampling of the nano-enabled solutions attempting to overcome barriers faced by traditional therapeutics and diagnostics in the clinical setting are discussed. Finally, a strategic outlook of the future is discussed to highlight the need for next-generation cancer nanotechnology tools designed to address critical gaps in clinical cancer care.

Knowledge of Dutch GPs in caring for cancer patients using oral anticancer therapy at home

NARCIS (Netherlands)

van Roosmalen, Sanne L. C.; Pols, A. Jeannette; Willems, Dick L.

2013-01-01

The GP's role in cancer care is changing and will become increasingly important. One of the challenges for GPs in caring for cancer patients is their lack of specialized knowledge and the impossibility to keep up to date with developments in the field of oncology. We investigated GPs use of

Results of an Oncology Clinical Trial Nurse Role Delineation Study.

Science.gov (United States)

Purdom, Michelle A; Petersen, Sandra; Haas, Barbara K

2017-09-01

To evaluate the relevance of a five-dimensional model of clinical trial nursing practice in an oncology clinical trial nurse population. 
. Web-based cross-sectional survey.
. Online via Qualtrics.
. 167 oncology nurses throughout the United States, including 41 study coordinators, 35 direct care providers, and 91 dual-role nurses who provide direct patient care and trial coordination.
. Principal components analysis was used to determine the dimensions of oncology clinical trial nursing practice.
. Self-reported frequency of 59 activities.
. The results did not support the original five-dimensional model of nursing care but revealed a more multidimensional model.
. An analysis of frequency data revealed an eight-dimensional model of oncology research nursing, including care, manage study, expert, lead, prepare, data, advance science, and ethics.
. This evidence-based model expands understanding of the multidimensional roles of oncology nurses caring for patients with cancer enrolled in clinical trials.

[Therapeutic Aggressiveness and Liquid Oncology].

Science.gov (United States)

Barón Duarte, F J; Rodríguez Calvo, M S; Amor Pan, J R

2017-01-01

Aggressiveness criteria proposed in the scientific literature a decade ago provide a quality judgment and are a reference in the care of patients with advanced cancer, but their use is not generalized in the evaluation of Oncology Services. In this paper we analyze the therapeutic aggressiveness, according to standard criteria, in 1.001 patients with advanced cancer who died in our Institution between 2010 and 2013. The results seem to show that aggressiveness at the end of life is present more frequently than experts recommend. About 25% of patients fulfill at least one criterion of aggressiveness. This result could be explained by a liquid Oncology which does not prioritize the patient as a moral subject in the clinical appointment. Medical care is oriented to necessities and must be articulated in a model focused on dignity and communication. Its implementation through Advanced Care Planning, consideration of patient's values and preferences, and Limitation of therapeutic effort are ways to reduce aggressiveness and improve clinical practice at the end of life. We need to encourage synergic and proactive attitudes, adding the best of cancer research with the best clinical care for the benefit of human being, moral subject and main goal of Medicine.

Providing grief resolution as an oncology nurse retention strategy: a literature review.

Science.gov (United States)

Hildebrandt, Lori

2012-12-01

Oncology nurses play a pivotal role in optimizing care provided to patients at the end of life (EOL). Although oncology nurses commonly provide EOL care and witness deaths of patients that they have maintained long-standing relationships with, they are frequently excluded from grief resolution endeavors. With a worldwide shortage of oncology nurses, retention is paramount to ensuring that the care patients with cancer receive is not jeopardized. Various strategies were identified to resolve grief and increase nurse retention, including creating supportive work environments, debriefing with colleagues, providing EOL and grief education, and altering patient care assignments. Future research on emerging technologies and their effects on oncology nurse coping and retention strategies also was suggested.

Radiation oncology: a primer for medical students.

Science.gov (United States)

Berman, Abigail T; Plastaras, John P; Vapiwala, Neha

2013-09-01

Radiation oncology requires a complex understanding of cancer biology, radiation physics, and clinical care. This paper equips the medical student to understand the fundamentals of radiation oncology, first with an introduction to cancer treatment and the use of radiation therapy. Considerations during radiation oncology consultations are discussed extensively with an emphasis on how to formulate an assessment and plan including which treatment modality to use. The treatment planning aspects of radiation oncology are then discussed with a brief introduction to how radiation works, followed by a detailed explanation of the nuances of simulation, including different imaging modalities, immobilization, and accounting for motion. The medical student is then instructed on how to participate in contouring, plan generation and evaluation, and the delivery of radiation on the machine. Lastly, potential adverse effects of radiation are discussed with a particular focus on the on-treatment patient.

Mastering Resilience in Oncology: Learn to Thrive in the Face of Burnout.

Science.gov (United States)

Hlubocky, Fay J; Rose, Miko; Epstein, Ronald M

2017-01-01

Oncology clinician burnout has become a noteworthy issue in medical oncology directly affecting the quality of patient care, patient satisfaction, and overall organizational success. Due to the increasing demands on clinical time, productivity, and the evolving medical landscape, the oncology clinician is at significant risk for burnout. Long hours in direct care with seriously ill patients/families, limited control over daily responsibilities, and endless electronic documentation, place considerable professional and personal demands on the oncologist. As a result, the oncology clinician's wellness is adversely impacted. Physical/emotional exhaustion, cynicism, and feelings of ineffectiveness evolve as core signs of burnout. Unaddressed burnout may affect cancer clinician relationships with their patients, the quality of care delivered, and the overall physical and emotional health of the clinician. Oncology clinicians should be encouraged to build upon their strengths, thrive in the face of adversity and stress, and learn to positively adapt to the changing cancer care system. Fostering individual resilience is a key protective factor against the development of and managing burnout. Empowering clinicians at both the individual and organizational level with tailored resilience strategies is crucial to ensuring clinician wellness. Resilience interventions may include: burnout education, work-life balance, adjustment of one's relationship to work, mindful practice, and acceptance of the clinical work environment. Health care organizations must act to provide institutional solutions through the implementation of: team-based oncology care, communication skills training, and effective resiliency training programs in order to mitigate the effects of stress and prevent burnout in oncology.

Characteristics of patients in routine psycho-oncological care, and changes in outcome variables during and after their treatment.

Science.gov (United States)

Garssen, Bert; Van der Lee, Marije; Van der Poll, Amber; Ranchor, Adelita V; Sanderman, Robbert; Schroevers, Maya J

2016-10-01

The primary aim of this study was to determine the characteristics of clients and interventions in routine psycho-oncological care. The secondary aim was to determine the course of symptomatology during and after the psychological interventions. During a period of nine months, all clients who sought help in one of the seven psycho-oncological care institutes in the Netherlands were approached to participate in the present study (N = 483). Information was gathered with respect to demographic and medical characteristics, and type and duration of the interventions. In addition, depression, anxiety, well-being, quality of life, fatigue and daily function were determined before interventions and three and nine months later. Compared to the Dutch cancer population, patients in psycho-oncological care were more often young and female. Compared to the general Dutch population, they were highly educated and were more likely to have a partner. Clinical levels of depression, anxiety and/or fatigue were found among 83% of the patients. After three months, only 23% had completed their intervention; this figure was 62% after nine months. Symptoms decreased significantly for all outcome variables. An importance difference with randomised controlled trials is the low session frequency and the long intervention time of patients in clinical care.

76 FR 59167 - Siemens Medical Solutions USA, Inc., Oncology Care Systems Division, Concord, CA; Siemens Medical...

Science.gov (United States)

2011-09-23

... Medical Solutions USA, Inc., Oncology Care Systems Division, Concord, CA; Siemens Medical Solutions USA... Solutions USA, Inc. (Siemens), Oncology Care Systems Division, Concord, California (subject firm). The...., Oncology Care Systems Division, Concord, California (TA-W-73,158) and Siemens Medical Solutions USA, Inc...

Paleo-oncology: the role of ancient remains in the study of cancer.

Science.gov (United States)

Halperin, Edward C

2004-01-01

Paleo-oncology is the study of carcinomas and sarcomas in ancient human populations and their hominid precursors. These populations are informative concerning the possible influences on cancer of morphologic and functional evolution, diet, lifestyle, and other environmental factors. The prevalence of cancer in ancient populations might have differed from that in modern humans, because of substantial differences in tobacco and alcohol use, diet, life expectancy, and the availability of treatment. The available physical data concerning cancer in antiquity includes evidence of its existence in animal fossils and ancient humans and their precursors. The difficulties of paleo-oncologic research include a limited soft tissue record. In evaluating cancer in ancient remains, one must also deal with the problem of pseudopathology: whether an observed tissue change is all antemortem pathologic lesion or a postmortem artifact. Future archeological discoveries and the application of improved diagnostic techniques may enable paleo-oncology to make further contributions to our understanding of cancer.

Cardio-Oncology: An Update on Cardiotoxicity of Cancer-Related Treatment.

Science.gov (United States)

Lenneman, Carrie G; Sawyer, Douglas B

2016-03-18

Through the success of basic and disease-specific research, cancer survivors are one of the largest growing subsets of individuals accessing the healthcare system. Interestingly, cardiovascular disease is the second leading cause of morbidity and mortality in cancer survivors after recurrent malignancy. This recognition has helped stimulate a collaboration between oncology and cardiology practitioners and researchers, and the portmanteau cardio-oncology (also known as onco-cardiology) can now be found in many medical centers. This collaboration promises new insights into how cancer therapies impact cardiovascular homeostasis and long-term effects on cancer survivors. In this review, we will discuss the most recent views on the cardiotoxicity related to various classes of chemotherapy agents and radiation. We will also discuss broadly the current strategies for treating and preventing cardiovascular effects of cancer therapy. © 2016 American Heart Association, Inc.

Perceptions of Burnout, Its Prevention, and Its Effect on Patient Care as Described by Oncology Nurses in the Hospital Setting
.

Science.gov (United States)

Russell, Kimberly

2016-01-01

To identify overall perceptions of burnout within the inpatient oncology nursing population, how they perceived that burnout affected the care they provided, and how they perceived that burnout could be decreased.
. A quantitative descriptive study using questionnaires to describe perceptions of burnout.
. A university-affiliated hospital using inpatient oncology nurses from three nursing units at University of Pittsburgh Medical Center Presbyterian in Pennsylvania.
. A convenience sample of 61 nurses. 
. Two instruments were used to investigate various aspects about perceptions of burnout among inpatient oncology nurses. Nurses participated on an anonymous voluntary basis by completing these instruments. 
. Perceived burnout, perception of how burnout affects care provided to patients, and strategies to relieve burnout.
. Inpatient oncology nurses report a moderate level of perceived burnout. In addition, this nursing population perceived that this burnout had a negative impact on the care they provided. Nurses believed they experienced burnout because of increased nurse-patient ratios and skipped or shortened lunches or breaks. However, they perceived that burnout could be prevented when adequate resources, collaboration, teamwork, and the support of family and friends existed. 
. As a result of the level of care needed by inpatients with cancer, the association between burnout experienced by nurses and how it can affect care is important to recognize. One such association identified was that a relationship existed between the nurses' interactions with patients' family, friends, or visitors and increased perceptions of burnout and depersonalization. As a result, nurses can experience increased burnout and act in a manner that lacks compassion because of emotional detachment.
. With extremely ill inpatients with cancer, nurses need to be able to manage high levels of demands from patients and their family members to provide quality and

Oral and dental late effects in survivors of childhood cancer: a Children’s Oncology Group report

Science.gov (United States)

Migliorati, Cesar A.; Hudson, Melissa M.; McMullen, Kevin P.; Kaste, Sue C.; Ruble, Kathy; Guilcher, Gregory M. T.; Shah, Ami J.; Castellino, Sharon M.

2014-01-01

Purpose Multi-modality therapy has resulted in improved survival for childhood malignancies. The Children’s Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers provide practitioners with exposure- and risk-based recommendations for the surveillance and management of asymptomatic survivors who are at least 2 years from completion of therapy. This review outlines the pathophysiology and risks for oral and dental late effects in pediatric cancer survivors and the rationale for oral and dental screening recommended by the Children’s Oncology Group. Methods An English literature search for oral and dental complications of childhood cancer treatment was undertaken via MEDLINE and encompassed January 1975 to January 2013. Proposed guideline content based on the literature review was approved by a multi-disciplinary panel of survivorship experts and scored according to a modified version of the National Comprehensive Cancer Network “Categories of Consensus” system. Results The Children’s Oncology Group oral-dental pan el selected 85 relevant citations. Childhood cancer therapy may impact tooth development, salivary function, craniofacial development, and temporomandibular joint function placing some childhood cancer survivors at an increased risk for poor oral and dental health. Addition ally, head and neck radiation and hematopoietic stem cell transplantation increase the risk of subsequent ma lignant neoplasms in the oral cavity. Survivors require routine dental care to evaluate for potential side effects and initiate early treatment. Conclusions Certain childhood cancer survivors are at an increased risk for poor oral and dental health. Early identification of oral and dental morbidity and early interventions can optimize health and quality of life. PMID:24781353

Modern radiology in oncology and waiting lists for procedures: Breast cancer screening in Slovenia

Directory of Open Access Journals (Sweden)

Maksimiljan Kadivec

2007-12-01

Full Text Available Background: Good and modern radiology equipment is needed for successful treatment of the oncologic patients. New Department of Radiology of the Institute of Oncology Ljubljana is entirely digital and can compete with the similar radiologic departments all over the world. It si possible to perform all the new modern procedures that the oncologic patients need. Important diagnostic modality is PET CT that fulfill the selection of the diagnostic procedures for cancer patients. The problem of Slovenian radiology is lack of the radiologists. This problem could be solved with telemedicine and properly awarded work that was performed. Waiting lists for procedures like CT, MR, US are short for oncologic patients in comparison with the other radiologic units in Slovenia.Conclusions: At the beginning of the year 2008 we will start the Breast Cancer Screening Program in Slovenia. It is organized by Institute of Oncology Ljubljana (DORA program. Breast cancer screening program will be centralized, in accordance with of the European guidelines for quality assurance in breast cancer screening and diagnosis 2006 (fourth edition and supervision of reference breast screening center. The main goal of the breast cancer screening program in Slovenia is reduction of the breast cancer death for 25 % or more.

Patterns of Care in Elderly Head-and-Neck Cancer Radiation Oncology Patients: A Single-Center Cohort Study

International Nuclear Information System (INIS)

Huang Shaohui; O'Sullivan, Brian; Waldron, John; Lockwood, Gina; Bayley, Andrew; Kim, John; Cummings, Bernard; Dawson, Laura A.; Hope, Andrew; Cho, John; Witterick, Ian; Chen, Eric X.; Ringash, Jolie

2011-01-01

Purpose: To compare the patterns of care for elderly head-and-neck cancer patients with those of younger patients. Methods and Materials: A retrospective review was conducted of all new mucosal head-and-neck cancer referrals to radiation oncology between July 1, 2003 and December 31, 2007 at our institution. The clinical characteristics, treatment pattern, tolerance, and outcomes were compared between the elderly (aged ≥75 years) and younger (aged <75 years) cohorts. Results: A total of 2,312 patients, including 452 (20%) elderly and 1,860 (80%) younger patients, were studied. The elderly patients were more likely to be women (36% vs. 27%, p <.01) and to have other malignancies (23% vs. 13%, p <.01), Stage I or II disease (38% vs. 32%, p <.01), and N0 status (56% vs. 42%, p <.01). Treatment was less often curative in intent (79% vs. 93%, p <.01). For the 1,487 patients who received definitive radiotherapy (RT), no differences were found between the elderly (n = 238) and younger (n = 1,249) patients in treatment interruption, completion, or treatment-related death. Within the subset of 760 patients who received intensified treatment (concurrent chemoradiotherapy or hyperfractionated accelerated RT), no difference was seen between the elderly (n = 46) and younger (n = 714) patients in treatment interruption, completion, or treatment-related death. After a median follow-up of 2.5 years, the 2-year cause-specific survival rate after definitive RT was 72% (range, 65-78%) for the elderly vs. 86% (range, 84-88%) for the younger patients (p <.01). Conclusion: Elderly head-and-neck cancer patients exhibited different clinical characteristics and experienced different patterns of care from younger patients. Although age itself was an adverse predictor of cause-specific survival, its effect was modest. Elderly patients selected for definitive RT or intensified RT showed no evidence of impaired treatment tolerance.

Oncology in Cambodia.

Science.gov (United States)

Eav, S; Schraub, S; Dufour, P; Taisant, D; Ra, C; Bunda, P

2012-01-01

Cambodia, a country of 14 million inhabitants, was devastated during the Khmer Rouge period and thereafter. The resources of treatment are rare: only one radiotherapy department, renovated in 2003, with an old cobalt machine; few surgeons trained to operate on cancer patients; no hematology; no facilities to use intensive chemotherapy; no nuclear medicine department and no palliative care unit. Cervical cancer incidence is one of the highest in the world, while in men liver cancer ranks first (20% of all male cancers). Cancers are seen at stage 3 or 4 for 70% of patients. There is no prevention program - only a vaccination program against hepatitis B for newborns - and no screening program for cervical cancer or breast cancer. In 2010, oncology, recognized as a full specialty, was created to train the future oncologists on site at the University of Phnom Penh. A new National Cancer Center will be built in 2013 with modern facilities for radiotherapy, medical oncology, hematology and nuclear medicine. Cooperation with foreign countries, especially France, and international organizations has been established and is ongoing. Progress is occurring slowly due to the shortage of money for Cambodian institutions and the lay public. Copyright © 2012 S. Karger AG, Basel.

Primary Prevention of Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Guideline

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Silvina Arrossi

2017-10-01

Full Text Available Purpose: To provide resource-stratified (four tiers, evidence-based recommendations on the primary prevention of cervical cancer globally. Methods: The American Society of Clinical Oncology convened a multidisciplinary, multinational panel of oncology, obstetrics/gynecology, public health, cancer control, epidemiology/biostatistics, health economics, behavioral/implementation science, and patient advocacy experts. The Expert Panel reviewed existing guidelines and conducted a modified ADAPTE process and a formal consensus-based process with additional experts (consensus ratings group for one round of formal ratings. Results: Existing sets of guidelines from five guideline developers were identified and reviewed; adapted recommendations formed the evidence base. Five systematic reviews, along with cost-effectiveness analyses, provided evidence to inform the formal consensus process, which resulted in agreement of ≥ 75%. Recommendations: In all resource settings, two doses of human papillomavirus vaccine are recommended for girls age 9 to 14 years, with an interval of at least 6 months and possibly up to 12 to 15 months. Individuals with HIV positivity should receive three doses. Maximal and enhanced settings: if girls are age ≥ 15 years and received their first dose before age 15 years, they may complete the series; if no doses were received before age 15 years, three doses should be administered; in both scenarios, vaccination may be through age 26 years. Limited and basic settings: if sufficient resources remain after vaccinating girls age 9 to 14 years, girls who received one dose may receive additional doses between age 15 and 26 years. Maximal, enhanced, and limited settings: if ≥ 50% coverage in the priority female target population, sufficient resources, and cost effectiveness, boys may be vaccinated to prevent other noncervical human papillomavirus–related cancers and diseases. Basic settings: vaccinating boys is not recommended

Primary Prevention of Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Guideline.

Science.gov (United States)

Arrossi, Silvina; Temin, Sarah; Garland, Suzanne; Eckert, Linda O'Neal; Bhatla, Neerja; Castellsagué, Xavier; Alkaff, Sharifa Ezat; Felder, Tamika; Hammouda, Doudja; Konno, Ryo; Lopes, Gilberto; Mugisha, Emmanuel; Murillo, Rául; Scarinci, Isabel C; Stanley, Margaret; Tsu, Vivien; Wheeler, Cosette M; Adewole, Isaac Folorunso; de Sanjosé, Silvia

2017-10-01

To provide resource-stratified (four tiers), evidence-based recommendations on the primary prevention of cervical cancer globally. The American Society of Clinical Oncology convened a multidisciplinary, multinational panel of oncology, obstetrics/gynecology, public health, cancer control, epidemiology/biostatistics, health economics, behavioral/implementation science, and patient advocacy experts. The Expert Panel reviewed existing guidelines and conducted a modified ADAPTE process and a formal consensus-based process with additional experts (consensus ratings group) for one round of formal ratings. Existing sets of guidelines from five guideline developers were identified and reviewed; adapted recommendations formed the evidence base. Five systematic reviews, along with cost-effectiveness analyses, provided evidence to inform the formal consensus process, which resulted in agreement of ≥ 75%. In all resource settings, two doses of human papillomavirus vaccine are recommended for girls age 9 to 14 years, with an interval of at least 6 months and possibly up to 12 to 15 months. Individuals with HIV positivity should receive three doses. Maximal and enhanced settings: if girls are age ≥ 15 years and received their first dose before age 15 years, they may complete the series; if no doses were received before age 15 years, three doses should be administered; in both scenarios, vaccination may be through age 26 years. Limited and basic settings: if sufficient resources remain after vaccinating girls age 9 to 14 years, girls who received one dose may receive additional doses between age 15 and 26 years. Maximal, enhanced, and limited settings: if ≥ 50% coverage in the priority female target population, sufficient resources, and cost effectiveness, boys may be vaccinated to prevent other noncervical human papillomavirus-related cancers and diseases. Basic settings: vaccinating boys is not recommended. It is the view of the American Society of Clinical Oncology that

Individualized Integrative Cancer Care in Anthroposophic Medicine

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Kienle, Gunver S.; Mussler, Milena; Fuchs, Dieter; Kiene, Helmut

2016-01-01

Background. Cancer patients widely seek integrative oncology which embraces a wide variety of treatments and system approaches. Objective. To investigate the concepts, therapeutic goals, procedures, and working conditions of integrative oncology doctors in the field of anthroposophic medicine. Methods. This qualitative study was based on in-depth interviews with 35 highly experienced doctors working in hospitals and office-based practices in Germany and other countries. Structured qualitative content analysis was applied to examine the data. Results. The doctors integrated conventional and holistic cancer concepts. Their treatments aimed at both tumor and symptom control and at strengthening the patient on different levels: living with the disease, overcoming the disease, enabling emotional and cognitive development, and addressing spiritual or transcendental issues according to the patient’s wishes and initiatives. Therapeutic procedures were conventional anticancer and symptom-relieving treatments, herbal and mineral remedies, mistletoe therapy, art therapies, massages and other external applications, nutrition and lifestyle advice, psychological support, and multiple forms of empowerment. The approach emphasised good patient-doctor relationships and sufficient time for patient encounters and decision-making. Individualization appeared in several dimensions and was interwoven with standards and mindlines. The doctors often worked in teams and cooperated with other cancer care–related specialists. Conclusion. Integrative cancer care pursues an individualized and patient-centered approach, encompassing conventional and multimodal complementary interventions, and addressing, along with physical and functional needs, the emotional and spiritual needs of patients. This seems to be important for tumor and symptom control, and addresses major challenges and important goals of modern cancer care. PMID:27151589

Guidelines, minimal requirements and standard of cancer care around the Mediterranean Area: report from the Collaborative AROME (Association of Radiotherapy and Oncology of the Mediterranean Area) working parties.

Science.gov (United States)

2011-04-01

Guidelines are produced in oncology to facilitate clinical decision making and improve clinical practice. However, existing guidelines are mainly developed for countries with a certain availability of means and cultural aspects are rarely taken into account. Around the Mediterranean Area, countries share common cultural backgrounds but also great disparities with respect to availability of means; current guidelines by most societies are not applicable to all of those countries. Association of Radiotherapy and Oncology of the Mediterranean Area (AROME) is a scientific organization for the promotion and overcoming of inequalities in oncology clinical practice around the Mediterranean Area. In an effort to accomplish this goal, members of the AROME society have developed clinical recommendations for most common cancer sites in countries around the Mediterranean Area. The structure of these recommendations lies in the concept of minimal requirements vs. standard of care; they are being presented and discussed in the main text. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Predictors of outpatients' request for palliative care service at a medical oncology clinic of a German comprehensive cancer center.

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Tewes, Mitra; Rettler, Teresa; Wolf, Nathalie; Hense, Jörg; Schuler, Martin; Teufel, Martin; Beckmann, Mingo

2018-05-05

Early integration of palliative care (PC) is recommended. The determination of predictors for patients' request for PC may guide implementation in clinical practice. Toward this end, we analyzed the symptom burden and distress of cancer patients in outpatient care and examined their need and request for PC. Between October 2013 and March 2016, 705 patients receiving outpatient cancer treatment took part in the survey. We used the new MInimal DOcumentation System to detect symptom clusters. Additionally, patients' request for palliative and psychosocial support was assessed. Groups of patients with PC request were compared to patients without PC request regarding their symptom clusters. Logistic regression analysis was applied to discover significant predictors for the requested inclusion of PC. A total of 159 patients (25.5%) requested additional support by PC. Moderate and severe tiredness (40.3%), weakness (37.9%), pain (25.0%), loss of appetite (22.3%), and dyspnea (19.1%) were the most frequent symptoms. The group of patients requesting PC differed significantly in terms of pain, nausea, dyspnea, constipation, weakness, loss of appetite, tiredness, depression, and anxiety from patients without request for PC (p < .01). The perceived need for PC was identified by the significant predictors "depression," "anxiety," and "weakness" with an explained variance of 22%. Combining a standardized screening questionnaire and the assessment of patients' request for PC allows systematic monitoring for patients' need for PC in a large Medical Oncology clinic. Depression, anxiety, and weakness are predictors of requesting PC service by patients receiving outpatient cancer treatment.

Eva between anxiety and hope: integrating anthroposophic music therapy in supportive oncology care

Directory of Open Access Journals (Sweden)

Eran Ben-Arye

2015-11-01

Full Text Available Music therapy is a significant modality in the treatment of patients with cancer, who suffer emotional and spiritual distress as well as chemotherapy side effects that impair their quality of life. In this article, we present a case study of a patient challenged with recurrent ovarian cancer who received, concomitant with chemotherapy, a special form of music therapy based on anthroposophic medicine (AM aimed at alleviating anxiety and improving her general well-being. AM-centered music therapy goals are discussed in regard to two modes of treatment: receptive listening and clinical composition. Next, these two treatment modes are discussed in a broader context by reviewing conventional music therapy interventions during chemotherapy on two axes: a. standardized vs. individualized treatment; b. patient’s involvement on a passive to active continuum. In conclusion, psycho-oncology care can be enriched by adding anthroposophic medicine-oriented music therapy integrated within patients’ supportive care.

A long way from home: Access to cancer care for rural Australians

International Nuclear Information System (INIS)

Smith, Tony

2012-01-01

In 2002, the Commonwealth Radiation Oncology Inquiry reported that access to cancer care services in Australia was seriously limited. Several recommendations were made, including improving access to cancer care in rural areas by increasing the number of comprehensive oncology facilities outside the cities. Much has changed since 2002, with the establishment of a number of Regional Integrated Cancer Centres. This has been boosted again in 2011 by further Commonwealth Government funding. Cancer is primarily a disease of the elderly and, with the ageing population access to cancer care for rural and remote Australians remains a major challenge. Cancer is the second most common cause of death in Australia, exceeded only by cardiovascular disease. It has been reported that the relative risk of dying of cancer within 5 years of diagnosis is 35% higher for those living in remote locations compared with major cities. Overall cancer mortality is significantly higher in rural and remote locations (206 deaths per 100,000) compared with urbanised areas (172 per 100,000). Cancer mortality is higher again for the Aboriginal population (230 per 100,000). The reasons for the disparity in cancer outcomes for metropolitan versus non-metropolitan Australians are varied. In general, rural and remote residents have to travel long distances and stay away from home, family and work for long periods of time to access the care they need. Hence, distance is the overriding barrier to access, compounded by the financial costs and disruption to family life, not to mention the endemic lack of specialist medical and allied health workforce outside the major cities. Some rural and remote Australians choose to compromise, accessing whatever care they can locally, although this contributes to the need for cancer care services close to where people choose to live and die, to deal with the complex associated morbidities. Recent government investment in new regional cancer care infrastructure is

Summary of presentations from the 46th Annual Meeting of the American Society of Clinical Oncology: focus on non-small cell lung cancer (2010).

Science.gov (United States)

Stinchcombe, Thomas E; Baggstrom, Maria Q; Somaiah, Neeta; Simon, George R; Govindan, Ramaswamy

2011-01-01

The promising results of crizotinib in molecularly selected patients with advanced non-small cell lung cancer (NSCLC) whose tumor cells had a novel fusion protein involving anaplastic lymphoma kinase presented at the 2010 American Society of Clinical Oncology reinforce once again the importance of understanding molecular heterogeneity of lung cancer and careful patient selection. Several other important issues were the subject of presentations related to lung cancer at the recently concluded American Society of Clinical Oncology annual meeting. The articles covered a wide variety of topics including optimal staging techniques to detect mediastinal nodal involvement, the role of platinum-based doublet chemotherapy in the management of elderly patients with advanced NSCLC, use of maintenance therapy with gemcitabine, and the impact of early introduction of organized palliative care in improving the quality of life of patients with advanced NSCLC. This report provides a brief overview of the presentations related to lung cancer that are relevant to clinical practice and future research.

Provision of oncology services in remote rural areas: a Scottish perspective.

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Smith, S M; Campbell, N C

2004-05-01

There is a paucity of research into rural health care services. In particular little is known about the provision of specialist cancer services for patients who live in remote rural areas of the UK. This study set out to investigate current models of medical and clinical oncology care in Scotland. A national survey with key health professionals was conducted to identify rural oncology schemes currently in operation. Detailed quantitative data about the schemes together with qualitative data on how health professionals view current models of care were collected by a computer-assisted telephone survey. Schemes that currently provide outpatient and chemotherapy oncology services for remote rural patients fell into three categories: central clinics (5); shared care outreach clinics with chemotherapy provision (11); and shared care outreach clinics without chemotherapy provision (7). All radiotherapy was conducted at central clinics (5). Widely varying practices in delivery of cancer care were found across the country. The main issues for professionals about current models of care involved expertise, travelling and accessibility (for patients), communication and expansion of the rural service. Nation-wide consistency in cancer care has still to be achieved. Travelling for treatment was seen to take its toll on all patients but particularly for the very remote, elderly and poor. Most professionals believe that an expansion of rural services would be of benefit to these patients. It is clear, however, that the proper infrastructure needs to be in place in terms of local expertise, ensured quality of care, and good communication links with cancer centres before this could happen.

Systematic reviews of oral complications from cancer therapies, Oral Care Study Group, MASCC/ISOO : methodology and quality of the literature

NARCIS (Netherlands)

Brennan, Michael T.; Elting, Linda S.; Spijkervet, Fred K. L.

Oral complications are commonly experienced by patients undergoing cancer therapies. The Oral Care Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) has completed nine systematic reviews including Bisphosphonate

Implementing exercise in cancer care: study protocol to evaluate a community-based exercise program for people with cancer

OpenAIRE

Cormie, Prue; Lamb, Stephanie; Newton, Robert U.; Valentine, Lani; McKiernan, Sandy; Spry, Nigel; Joseph, David; Taaffe, Dennis R.; Doran, Christopher M.; Galv?o, Daniel A.

2017-01-01

Background Clinical research has established the efficacy of exercise in reducing treatment-related side-effects and increasing wellbeing in people with cancer. Major oncology organisations have identified the importance of incorporating exercise in comprehensive cancer care but information regarding effective approaches to translating evidence into practice is lacking. This paper describes the implementation of a community-based exercise program for people with cancer and the protocol for pr...

Medical oncology future plan of the Spanish Society of Medical Oncology: challenges and future needs of the Spanish oncologists.

Science.gov (United States)

Rivera, F; Andres, R; Felip, E; Garcia-Campelo, R; Lianes, P; Llombart, A; Piera, J M; Puente, J; Rodriguez, C A; Vera, R; Virizuela, J A; Martin, M; Garrido, P

2017-04-01

The SEOM Future Plan is aimed at identifying the main challenges, trends and needs of the medical oncology speciality over the next years, including potential oncologist workforce shortages, and proposing recommendations to overcome them. The estimations of the required medical oncologists workforce are based on an updated Medical Oncologist Register in Spain, Medical Oncology Departments activity data, dedication times and projected cancer incidence. Challenges, needs and future recommendations were drawn from an opinion survey and an advisory board. A shortage of 211 FTE medical oncologist specialists has been established. To maintain an optimal ratio of 158 new cases/FTE, medical oncology workforce should reach 1881 FTE by 2035. Main recommendations to face the growing demand and complexity of oncology services include a yearly growth of 2.5% of medical oncologist's workforce until 2035, and development and application of more accurate quality indicators for cancer care and health outcomes measure.

How to Develop a Cardio-Oncology Clinic.

Science.gov (United States)

Snipelisky, David; Park, Jae Yoon; Lerman, Amir; Mulvagh, Sharon; Lin, Grace; Pereira, Naveen; Rodriguez-Porcel, Martin; Villarraga, Hector R; Herrmann, Joerg

2017-04-01

Cardiovascular demands to the care of cancer patients are common and important given the implications for morbidity and mortality. As a consequence, interactions with cardiovascular disease specialists have intensified to the point of the development of a new discipline termed cardio-oncology. As an additional consequence, so-called cardio-oncology clinics have emerged, in most cases staffed by cardiologists with an interest in the field. This article addresses this gap and summarizes key points in the development of a cardio-oncology clinic. Copyright © 2017 Elsevier Inc. All rights reserved.

Prophylactic and therapeutic management of oral complications related to chemotherapy and radiotherapy: role of dental oncology in cancer patient supportive therapy

International Nuclear Information System (INIS)

Buffarah, Henry Bittar

2008-01-01

Cancer patients under treatment of head and neck tumors as well as those under chemotherapy for hematologic cancers, such as lymphoma and leukemia, and those about to receive bone marrow grafts, do require preventive oral and dental care (prior to cancer treatment), as well as oral care during and after oncological treatment. Furthermore, chemo and radiotherapy-related adverse effects are also common in patients with other types of cancer, with an estimated frequency of 10 per cent in adjuvant chemotherapy (QT), 40 per cent in primary QT, 80 per cent in bone marrow transplantation, in which myeloablative regimens are introduced, and 100 per cent in head and neck radiotherapy, in which the targeted fields are those of the oral cavity. The dentist, specialized in dental oncology, works within the multidisciplinary team at the great centers of cancer treatment, contributing to improve the quality of life of these patients. The present review of literature and of the Guidelines for Management of Oral Complications of Chemotherapy and Head and Neck Radiation (US National Cancer Institute) aims to inform the clinical oncologist, the radio therapist, and other professionals about the resources available in Oral Supportive Therapy in both the prevention and managements of such complications. (author)

Recommendations for Obesity Clinical Trials in Cancer Survivors: American Society of Clinical Oncology Statement.

Science.gov (United States)

Ligibel, Jennifer A; Alfano, Catherine M; Hershman, Dawn; Ballard, Rachel M; Bruinooge, Suanna S; Courneya, Kerry S; Daniels, Elvan C; Demark-Wahnefried, Wendy; Frank, Elizabeth S; Goodwin, Pamela J; Irwin, Melinda L; Levit, Laura A; McCaskill-Stevens, Worta; Minasian, Lori M; O'Rourke, Mark A; Pierce, John P; Stein, Kevin D; Thomson, Cynthia A; Hudis, Clifford A

2015-11-20

Observational evidence has established a relationship between obesity and cancer risk and outcomes. Interventional studies have demonstrated the feasibility and benefits of lifestyle change after cancer diagnosis, and guidelines recommend weight management and regular physical activity in cancer survivors; however, lifestyle interventions are not a routine part of cancer care. The ASCO Research Summit on Advancing Obesity Clinical Trials in Cancer Survivors sought to identify the knowledge gaps that clinical trials addressing energy balance factors in cancer survivors have not answered and to develop a roadmap for the design and implementation of studies with the potential to generate data that could lead to the evidence-based incorporation of weight management and physical activity programs into standard oncology practice. Recommendations highlight the need for large-scale trials evaluating the impact of energy balance interventions on cancer outcomes, as well as the concurrent conduct of studies focused on dissemination and implementation of interventions in diverse populations of cancer survivors, including answering critical questions about the degree of benefit in key subgroups of survivors. Other considerations include the importance of incorporating economic metrics into energy balance intervention trials, the need to establish intermediate biomarkers, and the importance of integrating traditional and nontraditional funding sources. Establishing lifestyle change after cancer diagnosis as a routine part of cancer care will require a multipronged effort to overcome barriers related to study development, funding, and stakeholder engagement. Given the prevalence of obesity and inactivity in cancer survivors in the United States and elsewhere, energy balance interventions hold the potential to reduce cancer morbidity and mortality in millions of patients, and it is essential that we move forward in determining their role in cancer care with the same care and

Two approaches to bridging the knowledge-practice gap in oncology nursing.

Science.gov (United States)

Peek, Gloanna J

2015-01-01

The field of oncology nursing is continually changing. New drugs to aid in the fight against cancer are being developed, complementary therapies to ease symptoms are gaining prominence, and survivorship care is becoming a welcome yet challenging area of subspecialty. For oncology nurses to provide quality care and to develop improved care delivery systems, they must not only have access to the most current knowledge in the field, but also be equipped with the skills necessary to integrate that knowledge into practice for the benefit of patients and families (LoBiondo-Wood et al., 2014). The importance of nursing research and its relationship to the practice of oncology nursing cannot be minimized (Moore & Badger, 2014). Oncology nurse researchers advance knowledge and, consequently, improve the quality of care for patients with cancer and their families. For example, the Oncology Nursing Society (ONS) regularly surveys its membership to identify key areas of research focus that then guide the work of nurse investigators (LoBiondo-Wood et al., 2014; ONS Research Agenda Team, 2009). Unfortunately, the shortage of nurse scientists, particularly in oncology nursing, continues to increase as senior doctoral faculty reach retirement age and doctoral education program development remains stagnant (Glasgow & Dreher, 2010; LoBiondo-Wood et al., 2014). This shortage has and will continue to lead to gaps in the generation and implementation of new knowledge, negatively affecting the quality of patient care. As a result, an urgent need exists for innovative and quality doctoral educational programs to develop nurse scientists (Moore & Badger, 2014).

Specialty Payment Model Opportunities and Assessment: Oncology Model Design Report.

Science.gov (United States)

Huckfeldt, Peter J; Chan, Chris; Hirshman, Samuel; Kofner, Aaron; Liu, Jodi L; Mulcahy, Andrew W; Popescu, Ioana; Stevens, Clare; Timbie, Justin W; Hussey, Peter S

2015-07-15

This article describes research related to the design of a payment model for specialty oncology services for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services (CMS). Cancer is a common and costly condition. Episode-based payment, which aims to create incentives for high-quality, low-cost care, has been identified as a promising alternative payment model for oncology care. Episode-based payment systems can provide flexibility to health care providers to select among the most effective and efficient treatment alternatives, including activities that are not currently reimbursed under Medicare payment policies. However, the model design also needs to ensure that high-quality care is delivered and that beneficial treatments are not withheld from patients. CMS asked MITRE and RAND to conduct analyses to inform design decisions related to an episode-based oncology model for Medicare beneficiaries undergoing chemotherapy treatment for cancer. In particular, this study focuses on analyses of Medicare claims data related to the definition of the initiation of an episode of chemotherapy, patterns of spending during and surrounding episodes of chemotherapy, and attribution of episodes of chemotherapy to physician practices. We found that the time between the primary cancer diagnosis and chemotherapy initiation varied widely across patients, ranging from one day to over seven years, with a median of 2.4 months. The average level of total monthly payments varied considerably across cancers, with the highest spending peak of $9,972 for lymphoma, and peaks of $3,109 for breast cancer and $2,135 for prostate cancer.

Ethical issues at the interface of clinical care and research practice in pediatric oncology: a narrative review of parents' and physicians' experiences.

NARCIS (Netherlands)

Vries, M.C. de; Houtlosser, M.; Wit, J.M.; Engberts, D.P.; Bresters, D.; Kaspers, G.J.L.; Leeuwen, E. van

2011-01-01

BACKGROUND: Pediatric oncology has a strong research culture. Most pediatric oncologists are investigators, involved in clinical care as well as research. As a result, a remarkable proportion of children with cancer enrolls in a trial during treatment. This paper discusses the ethical consequences

Caring for the person with cancer: Information and support needs and the role of technology.

Science.gov (United States)

Heynsbergh, Natalie; Botti, Mari; Heckel, Leila; Livingston, Patricia M

2018-06-01

Informal carers experience a variety of information and support needs when providing care to someone with cancer. It is unclear when carers seek information and what resources they access to support themselves throughout the cancer trajectory. A sample of 45 carers and 15 oncology nurses were recruited to participate in either focus groups or phone interviews. Carers in the study were more likely to be women (60%), caring for a spouse or partner (64.4%), living with the patient (86.7%), and hold a university degree (46.7%). The majority of oncology nurses were females (66.6%). Findings showed that carers had limited access to adequate information as needs arose. Supports used to address information needs included information booklets, the Internet, and communication with healthcare professionals or with other carers. Barriers in communication between nurses and carers impacted on the adequacy of information received. Participants reported that technology, such as smartphone applications, might be appropriate for improving information and support needs. Caring for someone with cancer is multifaceted. Carers need access to timely information to help them effectively manage patients' needs. Future studies should assess the role of contemporary approaches, such as digital technology, as a solution to the delivery of information and support for carers of people with cancer. © 2018 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

Pediatric Oncology Palliative Care: Experiences of General Practitioners and Bereaved Parents.

Science.gov (United States)

Neilson, Sue J; Gibson, Faith; Greenfield, Sheila M

2015-03-01

This qualitative study set in the West Midlands region of the United Kingdom, aimed to examine the role of the general practitioner (GP) in children's oncology palliative care from the perspective of GPs who had cared for a child with cancer receiving palliative care at home and bereaved parents. One-to-one semi-structured interviews were undertaken with 18 GPs and 11 bereaved parents following the death. A grounded theory data analysis was undertaken; identifying generated themes through chronological comparative data analysis. Similarity in GP and parent viewpoints was found, the GPs role seen as one of providing medication and support. Time pressures GPs faced influenced their level of engagement with the family during palliative and bereavement care and their ability to address their identified learning deficits. Lack of familiarity with the family, coupled with an acknowledgment that it was a rare and could be a frightening experience, also influenced their level of interaction. There was no consistency in GP practice nor evidence of practice being guided by local or national policies. Parents lack of clarity of their GPs role resulted in missed opportunities for support. Time pressures influence GP working practices. Enhanced communication and collaboration between the GP and regional childhood cancer centre may help address identified GP challenges, such as learning deficits, and promote more time-efficient working practices through role clarity. Parents need greater awareness of their GP's wide-ranging role; one that transcends palliative care incorporating bereavement support and on-going medical care for family members.

Cancer Patients and Oncology Nursing: Perspectives of Oncology ...

African Journals Online (AJOL)

Background and Aim: Burnout and exhaustion is a frequent problem in oncology nursing. The aim of this study is to evaluate the aspects of oncology nurses about their profession in order to enhance the standards of oncology nursing. Materials and Methods: This survey was conducted with 70 oncology nurses working at ...

Value: A Framework for Radiation Oncology

Science.gov (United States)

Teckie, Sewit; McCloskey, Susan A.; Steinberg, Michael L.

2014-01-01

In the current health care system, high costs without proportional improvements in quality or outcome have prompted widespread calls for change in how we deliver and pay for care. Value-based health care delivery models have been proposed. Multiple impediments exist to achieving value, including misaligned patient and provider incentives, information asymmetries, convoluted and opaque cost structures, and cultural attitudes toward cancer treatment. Radiation oncology as a specialty has recently become a focus of the value discussion. Escalating costs secondary to rapidly evolving technologies, safety breaches, and variable, nonstandardized structures and processes of delivering care have garnered attention. In response, we present a framework for the value discussion in radiation oncology and identify approaches for attaining value, including economic and structural models, process improvements, outcome measurement, and cost assessment. PMID:25113759

Actigraphy for measurements of sleep in relation to oncological treatment of patients with cancer

DEFF Research Database (Denmark)

Huang, Chenxi; Gögenur, Ismail; Tvilling Madsen, Michael

2015-01-01

Sleep disturbances are a prevalent and disabling problem for patients with cancer. Sleep disturbances are present throughout the cancer trajectory, especially during oncological treatment. Previously sleep disturbances have primarily been quantified with subjective rating scales. Actigraphy is an...... are prevalent, and persistent in patients with cancer. The sleep disturbances seem to be aggravated by chemotherapy treatment and accumulate as the treatment continues. Sleep disturbances need further attention among clinicians working with patients with cancer.......Sleep disturbances are a prevalent and disabling problem for patients with cancer. Sleep disturbances are present throughout the cancer trajectory, especially during oncological treatment. Previously sleep disturbances have primarily been quantified with subjective rating scales. Actigraphy...... is an easy to use, non-invasive method for objective measurement of sleep. We systematically reviewed the literature for studies using actigraphy to measure sleeping habits of patients with cancer, undergoing oncological treatment. Our study furthermore reviewed studies with interventions designed to reduce...

Cultural aspects of communication in cancer care.

Science.gov (United States)

Surbone, A

2006-01-01

Cancer is increasing in incidence and prevalence worldwide, and the WHO has recently included cancer and its treatments as a health priority in developed and developing countries. The cultural diversity of oncology patients is bound to increase, and cultural sensitivity and competence are now required of all oncology professionals. A culturally competent cancer care leads to improved therapeutic outcome and it may decrease disparities in medical care. Cultural competence in medicine is a complex multilayered accomplishment, requiring knowledge, skills and attitudes whose acquisition is needed for effective cross-cultural negotiation in the clinical setting. Effective cultural competence is based on knowledge of the notion of culture; on awareness of possible biases and prejudices related to stereotyping, racism, classism, sexism; on nurturing appreciation for differences in health care values; and on fostering the attitudes of humility, empathy, curiosity, respect, sensitivity and awareness. Cultural competence in healthcare relates to individual professionals, but also to organizations and systems. A culturally competent healthcare system must consider in their separateness and yet in there reciprocal influences social, racial and cultural factors. By providing a framework of reference to interpret the external world and relate to it, culture affects patients' perceptions of disease, disability and suffering; degrees and expressions of concern about them; their responses to treatments and their relationship to individual physicians and to the healthcare system. Culture also influences the interpretation of ethical norms and principles, and especially of individual autonomy, which can be perceived either as synonymous with freedom or with isolation depending on the cultural context. This, in turn, determines the variability of truth-telling attitudes and practices worldwide as well as the different roles of family in the information and decision-making process of

Classification of a palliative care population in a comprehensive cancer centre

DEFF Research Database (Denmark)

Benthien, K.S; Nordly, M.; Videbæk, K.

2016-01-01

PURPOSE: The purposes of the present study were to classify the palliative care population (PCP) in a comprehensive cancer centre by using information on antineoplastic treatment options and to analyse associations between socio-demographic factors, cancer diagnoses, treatment characteristics...... and receiving specialist palliative care (SPC). METHODS: This is a cross-sectional screening study of patients with cancer in the Department of Oncology, Rigshospitalet, Copenhagen University Hospital for 6 months. Patients were assessed to be included in the DOMUS study: a randomised controlled trial...... of accelerated transition to SPC at home (NCT01885637). The PCP was classified as patients with incurable cancer and limited or no antineoplastic treatment options. Patients with performance status 2-4 were further classified as the essential palliative care population (EPCP). RESULTS: During the study period...

Community oncology in an era of payment reform.

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Cox, John V; Ward, Jeffery C; Hornberger, John C; Temel, Jennifer S; McAneny, Barbara L

2014-01-01

Patients and payers (government and private) are frustrated with the fee-for-service system (FFS) of payment for outpatient health services. FFS rewards volume and highly valued services, including expensive diagnostics and therapeutics, over lesser valued cognitive services. Proposed payment schemes would incent collaboration and coordination of care among providers and reward quality. In oncology, new payment schemes must address the high costs of all services, particularly drugs, while preserving the robust distribution of sites of service available to patients in the United States. Information technology and personalized cancer care are changing the practice of oncology. Twenty-first century oncology will require increasing cognitive work and shared decision making, both of which are not well regarded in the FFS model. A high proportion of health care dollars are consumed in the final months of life. Effective delivery of palliative and end-of-life care must be addressed by practice and by new models of payment. Value-based reimbursement schemes will require oncology practices to change how they are structured. Lessons drawn from the principles of primary care's Patient Centered Medical Home (PCMH) will help oncology practice to prepare for new schemes. PCMH principles place a premium on proactively addressing toxicities of therapies, coordinating care with other providers, and engaging patients in shared decision making, supporting the ideal of value defined in the triple aim-to measurably improve patient experience and quality of care at less cost. Payment reform will be disruptive to all. Oncology must be engaged in policy discussions and guide rational shifts in priorities defined by new payment models.

Association between psychological distress and cancer type in patients referred to a psycho-oncology service

LENUS (Irish Health Repository)

Lavelle, C

2017-06-01

Psychological distress is common in patients with cancer and psychological well-being is increasingly seen as an important component of cancer care. The aim of this study was to examine the relationship between cancer type and subjective distress. The following data were collected from a database of consecutive psycho-oncology referrals to the Liaison Psychiatry service in Cork University Hospital from 2006 to 2015: demographics, cancer diagnosis, Distress Thermometer (DT) score. 2102 out of 2384 referrals were assessed. Of those assessed, the most common cancer diagnoses were breast (23%, n=486) followed by haematological (21%, n=445). There were significant difference in DT score between the different cancer types, (χ2(13)=33.685, p=0.001, Kruskal–Wallis test). When adjusted for age, gender and whether or not the cancer was recently diagnosed, there was no significant association between cancer type and psychological distress. In conclusion, cancer type is not associated with level of distress in cancer.

Development by a Large Integrated Health Care System of an Objective Methodology for Evaluation of Medical Oncology Service Sites.

Science.gov (United States)

Bjegovich-Weidman, Marija; Kahabka, Jill; Bock, Amy; Frick, Jacob; Kowalski, Helga; Mirro, Joseph

2012-03-01

Aurora Health Care (AHC) is the largest health care system in Wisconsin, with 14 acute care hospitals. In early 2010, a group of 18 medical oncologists became affiliated with AHC. This affiliation added 13 medical oncology infusion clinics to our existing 12 sites. In the era of health care reform and declining reimbursement, we need an objective method and criteria to evaluate our 25 outpatient medical oncology sites. We developed financial, clinical, and strategic tools for the evaluation and management of our cancer subservice lines and outpatient sites. The key to our success has been the direct involvement of stakeholders with a vested interest in the services in the selection of the criteria and evaluation process. We developed our objective metrics for evaluation based on strategic, financial, operational, and patient experience criteria. Strategic criteria included: population trends, full-time equivalent (FTE) medical oncologists/primary care physicians, FTE radiation oncologists, FTE oncologic surgeons, new annual cases of patients with cancer, and market share trends. Financial criteria per site included: physician work relative value units, staff FTE by type, staff salaries, and profit and loss. Operational criteria included: facility by type (clinic v hospital based), hours of operation, and facility detail (eg, No. of chairs, No. of procedure and examination rooms, square footage). Patient experience criteria included: nursing model primary/nurse navigators, multidisciplinary support at site, Press Ganey (South Bend, IN; health care performance improvement company) results, and employee engagement score. The outcome of our data analysis has resulted in the development of recommendations for AHC senior leadership and geographic market leadership to consider the consolidation of four sites (phase one, four sites; phase two, two sites) and priority strategic sites to address capacity issues that limit growth. The recommendations if implemented would

Impact of cancer support groups on childhood cancer treatment and abandonment in a private pediatric oncology centre

Directory of Open Access Journals (Sweden)

Arathi Srinivasan

2015-01-01

Full Text Available Aims: To analyze the impact of two cancer support groups in the treatment and abandonment of childhood cancer. Materials and Methods: This is a retrospective review of children with cancer funded and non-funded who were treated at Kanchi Kamakoti CHILDS Trust Hospital from 2010 to 2013. A total of 100 patients were funded, 57 by Ray of Light Foundation and 43 by Pediatric Lymphoma Project and 70 non-funded. Results: The total current survival of 80%, including those who have completed treatment and those currently undergoing treatment, is comparable in both the groups. Abandonment of treatment after initiating therapy was not seen in the financially supported group whereas abandonment of treatment after initiation was seen in one child in the non-funded group. Conclusions: Besides intensive treatment with good supportive care, financial support also has an important impact on compliance and abandonment in all socioeconomic strata of society. Financial support from private cancer support groups also has its impact beyond the patient and family, in reducing the burden on government institutions by non-governmental funding in private sector. Improvement in the delivery of pediatric oncology care in developing countries could be done by financial support from the private sector.

Palliative cancer care in Middle Eastern countries: accomplishments and challenges †

Science.gov (United States)

Silbermann, M.; Arnaout, M.; Daher, M.; Nestoros, S.; Pitsillides, B.; Charalambous, H.; Gultekin, M.; Fahmi, R.; Mostafa, K.A.H.; Khleif, A.D.; Manasrah, N.; Oberman, A.

2012-01-01

Background In larger parts of the Middle East palliative care is still misunderstood among health professionals, cancer patients and the public at large. One reason to that is because the term does not obviously communicate the intent of this clinical discipline, which is lending better quality of life while combating cancer. Further, culture, tradition and religion have contributed to this misgiving and confusion especially at the terminal stage of the disease. Methods The Middle East Cancer Consortium jointly with the American Society of Clinical Oncology, the American Oncology Nursing Society, the San Diego Hospice Center for Palliative Medicine and the Children's Hospital & Clinics of Minnesota initiated a series of training courses and workshops in the Middle East to provide updated training to physicians, nurses, social workers and psychologists from throughout the region with basic concepts of palliative care and pain managements in adults and children cancers. Results During the past 6 years hundreds of professionals took part in these educational and training activities, thereby creating the core of trained caregivers who start to make the change in their individual countries. Conclusions The outcome of consecutive training activities can overcome geopolitical instabilities, and yield a genuine change in approach of both regulators, medical administrators, medical staff and the public; as to the important contribution of palliative care services to the welfare of the patient and his/her family. PMID:22628412

EURECCA colorectal: multidisciplinary mission statement on better care for patients with colon and rectal cancer in Europe.

Science.gov (United States)

van de Velde, Cornelis J H; Aristei, Cynthia; Boelens, Petra G; Beets-Tan, Regina G H; Blomqvist, Lennart; Borras, Josep M; van den Broek, Colette B M; Brown, Gina; Coebergh, Jan-Willem; Cutsem, Eric Van; Espin, Eloy; Gore-Booth, Jola; Glimelius, Bengt; Haustermans, Karin; Henning, Geoffrey; Iversen, Lene H; Han van Krieken, J; Marijnen, Corrie A M; Mroczkowski, Pawel; Nagtegaal, Iris; Naredi, Peter; Ortiz, Hector; Påhlman, Lars; Quirke, Philip; Rödel, Claus; Roth, Arnaud; Rutten, Harm J T; Schmoll, Hans J; Smith, Jason; Tanis, Pieter J; Taylor, Claire; Wibe, Arne; Gambacorta, Maria Antonietta; Meldolesi, Elisa; Wiggers, Theo; Cervantes, Andres; Valentini, Vincenzo

2013-09-01

Care for patients with colon and rectal cancer has improved in the last twenty years however still considerable variation exists in cancer management and outcome between European countries. Therefore, EURECCA, which is the acronym of European Registration of cancer care, is aiming at defining core treatment strategies and developing a European audit structure in order to improve the quality of care for all patients with colon and rectal cancer. In December 2012 the first multidisciplinary consensus conference about colon and rectum was held looking for multidisciplinary consensus. The expert panel consisted of representatives of European scientific organisations involved in cancer care of patients with colon and rectal cancer and representatives of national colorectal registries. The expert panel had delegates of the European Society of Surgical Oncology (ESSO), European Society for Radiotherapy & Oncology (ESTRO), European Society of Pathology (ESP), European Society for Medical Oncology (ESMO), European Society of Radiology (ESR), European Society of Coloproctology (ESCP), European CanCer Organisation (ECCO), European Oncology Nursing Society (EONS) and the European Colorectal Cancer Patient Organisation (EuropaColon), as well as delegates from national registries or audits. Experts commented and voted on the two web-based online voting rounds before the meeting (between 4th and 25th October and between the 20th November and 3rd December 2012) as well as one online round after the meeting (4th-20th March 2013) and were invited to lecture on the subjects during the meeting (13th-15th December 2012). The sentences in the consensus document were available during the meeting and a televoting round during the conference by all participants was performed. All sentences that were voted on are available on the EURECCA website www.canceraudit.eu. The consensus document was divided in sections describing evidence based algorithms of diagnostics, pathology, surgery, medical

Does Cancer Literature Reflect Multidisciplinary Practice? A Systematic Review of Oncology Studies in the Medical Literature Over a 20-Year Period.

Science.gov (United States)

Holliday, Emma B; Ahmed, Awad A; Yoo, Stella K; Jagsi, Reshma; Hoffman, Karen E

2015-07-15

Quality cancer care is best delivered through a multidisciplinary approach requiring awareness of current evidence for all oncologic specialties. The highest impact journals often disseminate such information, so the distribution and characteristics of oncology studies by primary intervention (local therapies, systemic therapies, and targeted agents) were evaluated in 10 high-impact journals over a 20-year period. Articles published in 1994, 2004, and 2014 in New England Journal of Medicine, Lancet, Journal of the American Medical Association, Lancet Oncology, Journal of Clinical Oncology, Annals of Oncology, Radiotherapy and Oncology, International Journal of Radiation Oncology, Biology, Physics, Annals of Surgical Oncology, and European Journal of Surgical Oncology were identified. Included studies were prospectively conducted and evaluated a therapeutic intervention. A total of 960 studies were included: 240 (25%) investigated local therapies, 551 (57.4%) investigated systemic therapies, and 169 (17.6%) investigated targeted therapies. More local therapy trials (n=185 [77.1%]) evaluated definitive, primary treatment than systemic (n=178 [32.3%]) or targeted therapy trials (n=38 [22.5%]; Pliterature. Further research and attention are necessary to guide efforts promoting appropriate representation of all oncology studies in high-impact, broad-readership journals. Copyright © 2015. Published by Elsevier Inc.

Japanese Structure Survey of Radiation Oncology in 2005 Based on Institutional Stratification of Patterns of Care Study

International Nuclear Information System (INIS)

Teshima, Teruki; Numasaki, Hodaka; Shibuya, Hitoshi; Nishio, Masamichi; Ikeda, Hiroshi; Ito, Hisao; Sekiguchi, Kenji; Kamikonya, Norihiko; Koizumi, Masahiko; Tago, Masao; Nagata, Yasushi; Masaki, Hidekazu; Nishimura, Tetsuo; Yamada, Shogo

2008-01-01

Purpose: To evaluate the structure of radiation oncology in Japan in terms of equipment, personnel, patient load, and geographic distribution to identify and improve any deficiencies. Methods and Materials: A questionnaire-based national structure survey was conducted between March 2006 and February 2007 by the Japanese Society of Therapeutic Radiology and Oncology. These data were analyzed in terms of the institutional stratification of the Patterns of Care Study. Results: The total numbers of new cancer patients and total cancer patients (new and repeat) treated with radiotherapy in 2005 were estimated at approximately 162,000 and 198,000, respectively. In actual use were 765 linear accelerators, 11 telecobalt machines, 48 GammaKnife machines, 64 60 Co remote-controlled after-loading systems, and 119 192 Ir remote-controlled after-loading systems. The linear accelerator systems used dual-energy function in 498 systems (65%), three-dimensional conformal radiotherapy in 462 (60%), and intensity-modulated radiotherapy in 170 (22%). There were 426 Japanese Society of Therapeutic Radiology and Oncology-certified radiation oncologists, 774 full-time equivalent radiation oncologists, 117 medical physicists, and 1,635 radiation therapists. Geographically, a significant variation was found in the use of radiotherapy, from 0.9 to 2.1 patients/1,000 population. The annual patient load/FTE radiation oncologist was 247, exceeding the Blue Book guidelines level. Patterns of Care Study stratification can clearly discriminate the maturity of structures according to their academic nature and caseload. Conclusions: The Japanese structure has clearly improved during the past 15 years in terms of equipment and its use, although the shortage of manpower and variations in maturity disclosed by this Patterns of Care Study stratification remain problematic. These constitute the targets for nationwide improvement in quality assurance and quality control

Quality Oncology Practice Initiative Can Guide and Improve Oncology Providers’ Training in Brazil

Directory of Open Access Journals (Sweden)

Cristiane Decat Bergerot

2017-06-01

Full Text Available Purpose: It has become crucial to translate scientific findings and to find ways by which to mobilize local resources to improve the quality and accessibility of cancer care in developing countries. This study seeks to provide insight into challenge through examining differences in clinician documentation of patients with cancer treated at a Brazilian Public University Hospital. Methods: ASCO Quality Oncology Practice Initiative (QOPI measures were used to examine the care provided in the departments of breast, colorectal, lymphoma, gynecology, and lung cancers. For this study, data from a representative sample of patients receiving chemotherapy in the previous month were extracted and quality of cancer care indicators examined. Results: Certain elements of medical care were consistently and appropriately documented, including cancer diagnosis and stage, chemotherapy planning, administration, and summary. In general, considering the specific cancer management measures, patients received recommended care in accordance with recognized guidelines. Despite this, a number of important gaps in care were identified, including the assessment and treatment of pain, documentation of chemotherapy intention, symptom and toxicity management, patients’ psychosocial status, and provision of a treatment summary at care completion. Conclusion: These findings are encouraging in terms of adherence to core treatment guidelines in cancer care in Brazil. However, results suggest important opportunities for improving care across a number of domains, many of which represent a challenge throughout both developing and developed countries. This study may also provide preliminary guidance for enhancing educational and training programs for professionals and students alike, to implement high-quality, comprehensive cancer care.

Coordination of cancer care between family physicians and cancer specialists: Importance of communication.

Science.gov (United States)

Easley, Julie; Miedema, Baukje; Carroll, June C; Manca, Donna P; O'Brien, Mary Ann; Webster, Fiona; Grunfeld, Eva

2016-10-01

To explore health care provider (HCP) perspectives on the coordination of cancer care between FPs and cancer specialists. Qualitative study using semistructured telephone interviews. Canada. A total of 58 HCPs, comprising 21 FPs, 15 surgeons, 12 medical oncologists, 6 radiation oncologists, and 4 GPs in oncology. This qualitative study is nested within a larger mixed-methods program of research, CanIMPACT (Canadian Team to Improve Community-Based Cancer Care along the Continuum), focused on improving the coordination of cancer care between FPs and cancer specialists. Using a constructivist grounded theory approach, telephone interviews were conducted with HCPs involved in cancer care. Invitations to participate were sent to a purposive sample of HCPs based on medical specialty, sex, province or territory, and geographic location (urban or rural). A coding schema was developed by 4 team members; subsequently, 1 team member coded the remaining transcripts. The resulting themes were reviewed by the entire team and a summary of results was mailed to participants for review. Communication challenges emerged as the most prominent theme. Five key related subthemes were identified around this core concept that occurred at both system and individual levels. System-level issues included delays in medical transcription, difficulties accessing patient information, and physicians not being copied on all reports. Individual-level issues included the lack of rapport between FPs and cancer specialists, and the lack of clearly defined and broadly communicated roles. Effective and timely communication of medical information, as well as clearly defined roles for each provider, are essential to good coordination of care along the cancer care trajectory, particularly during transitions of care between cancer specialist and FP care. Despite advances in technology, substantial communication challenges still exist. This can lead to serious consequences that affect clinical decision making

Childhood cancer survivorship educational resources in North American pediatric hematology/oncology fellowship training programs: a survey study.

Science.gov (United States)

Nathan, Paul C; Schiffman, Joshua D; Huang, Sujuan; Landier, Wendy; Bhatia, Smita; Eshelman-Kent, Debra; Wright, Jennifer; Oeffinger, Kevin C; Hudson, Melissa M

2011-12-15

Childhood cancer survivors require life-long care by clinicians with an understanding of the specific risks arising from the prior cancer and its therapy. We surveyed North American pediatric hematology/oncology training programs to evaluate their resources and capacity for educating medical trainees about survivorship. An Internet survey was sent to training program directors and long-term follow-up clinic (LTFU) directors at the 56 US and Canadian centers with pediatric hematology/oncology fellowship programs. Perceptions regarding barriers to and optimal methods of delivering survivorship education were compared among training program and LTFU clinic directors. Responses were received from 45/56 institutions of which 37/45 (82%) programs require that pediatric hematology/oncology fellows complete a mandatory rotation focused on survivorship. The rotation is 4 weeks or less in 21 programs. Most (36/45; 80%) offer didactic lectures on survivorship as part of their training curriculum, and these are considered mandatory for pediatric hematology/oncology fellows at 26/36 (72.2%). Only 10 programs (22%) provide training to medical specialty trainees other than pediatric hematology/oncology fellows. Respondents identified lack of time for trainees to spend learning about late effects as the most significant barrier to providing survivorship teaching. LTFU clinic directors were more likely than training program directors to identify lack of interest in survivorship among trainees and survivorship not being a formal or expected part of the fellowship training program as barriers. The results of this survey highlight the need to establish standard training requirements to promote the achievement of basic survivorship competencies by pediatric hematology/oncology fellows. Copyright © 2011 Wiley Periodicals, Inc.

Developing a national radiation oncology registry: From acorns to oaks.

Science.gov (United States)

Palta, Jatinder R; Efstathiou, Jason A; Bekelman, Justin E; Mutic, Sasa; Bogardus, Carl R; McNutt, Todd R; Gabriel, Peter E; Lawton, Colleen A; Zietman, Anthony L; Rose, Christopher M

2012-01-01

The National Radiation Oncology Registry (NROR) is a collaborative initiative of the Radiation Oncology Institute and the American Society of Radiation Oncology, with input and guidance from other major stakeholders in oncology. The overarching mission of the NROR is to improve the care of cancer patients by capturing reliable information on treatment delivery and health outcomes. The NROR will collect patient-specific radiotherapy data electronically to allow for rapid comparison of the many competing treatment modalities and account for effectiveness, outcome, utilization, quality, safety, and cost. It will provide benchmark data and quality improvement tools for individual practitioners. The NROR steering committee has determined that prostate cancer provides an appropriate model to test the concept and the data capturing software in a limited number of sites. The NROR pilot project will begin with this disease-gathering treatment and outcomes data from a limited number of treatment sites across the range of practice; once feasibility is proven, it will scale up to more sites and diseases. When the NROR is fully implemented, all radiotherapy facilities, along with their radiation oncologists, will be solicited to participate in it. With the broader participation of the radiation oncology community, NROR has the potential to serve as a resource for determining national patterns of care, gaps in treatment quality, comparative effectiveness, and hypothesis generation to identify new linkages between therapeutic processes and outcomes. The NROR will benefit radiation oncologists and other care providers, payors, vendors, policy-makers, and, most importantly, cancer patients by capturing reliable information on population-based radiation treatment delivery. Copyright © 2012 (c) 2010 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved. Published by Elsevier Inc. All rights reserved.

Psychosocial care for cancer: a framework to guide practice, and actionable recommendations for Ontario

Science.gov (United States)

Turnbull Macdonald, G.C.; Baldassarre, F.; Brown, P.; Hatton–Bauer, J.; Li, M.; Green, E.; Lebel, S.

2012-01-01

Objectives We set out to create a psychosocial oncology care framework and a set of relevant recommendations that can be used to improve the quality of comprehensive cancer care for Ontario patients and their families.meet the psychosocial health care needs of cancer patients and their families at both the provider and system levels. Data Sources and Methods The adapte process and the practice guideline development cycle were used to adapt the 10 recommendations from the 2008 U.S. Institute of Medicine standard Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs into the psychosocial oncology care framework. In addition, the evidence contained in the original document was used, in combination with the expertise of the working group, to create a set of actionable recommendations. Refinement after formal external review was conducted. Data Extraction and Synthesis The new framework consists of 8 defining domains. Of those 8 domains, 7 were adapted from recommendations in the source document; 1 new domain, to raise awareness about the need for psychosocial support of cancer patients and their families, was added. To ensure high-quality psychosocial care and services, 31 actionable recommendations were created. The document was submitted to an external review process. More than 70% of practitioners rated the quality of the advice document as high and reported that they would recommend its use. Conclusions This advice document advocates for a multidisciplinary approach to cancer care in response to the distress experienced by cancer patients and their families. The recommendations will be useful in future to measure performance, quality of practice, and access to psychosocial services. PMID:22876147

Clinical practice guidelines of the French Association for Supportive Care in Cancer and the French Society for Psycho-oncology: refusal of treatment by adults afflicted with cancer.

Science.gov (United States)

Faivre, J C; Adam, V; Block, V; Metzger, M; Salleron, J; Dauchy, S

2017-11-01

The study's purpose was to develop practical guidelines for assessment and management of refusal of treatment by adults afflicted with cancer. The French Association for Supportive Care in Cancer and the French Society for Psycho-oncology gathered a task force that applied a consensus methodology to draft guidelines studied predisposing situations, the diagnosis, regulatory aspects, and the management of refusal of treatment by adults afflicted with cancer. We propose five guidelines: (1) be aware of the conditions/profiles of patients most often associated with refusal of treatment so as to adequately underpin the care and support measures; (2) understand the complexity of the process of refusal and knowing how to accurately identify the type and the modalities of the refused treatments; (3) apply a way to systematically analyze refusal, thereby promoting progression from a situation of disaccord toward a consensual decision; (4) devise procedures, according to the legal context, to address refusal of treatment that safeguards the stakeholders in situations of sustained disaccord; and (5) know the indications for ethical collective decision-making. The quality of the relationship between patients and health professionals, and the communication between them are essential components involved in reaching a point of consent or refusal of treatment. A process of systematic analysis of refusal is recommended as the only way to ensure that all of the physiological, psychological, and contextual elements that are potentially involved are taken into account.

Clinical and Radiation Oncology. Vol. 1

International Nuclear Information System (INIS)

Jurga, L.; Adam, Z.; Autrata, R.

2010-01-01

The work is two-volume set and has 1,658 pages. It is divided into 5 sections: I. Principles Clinical and radiation oncology. II. Hematological Malignant tumors. III. Solid tumors. IV. Treatment options metastatic Disease. V. Clinical practice in oncology. First volume contains following sections a chapters: Section I: Principles of clinical and radiation oncology, it contains following chapters: (1) The history of clinical/experimental and radiation oncology in the Czech Republic; (2) The history of clinical/experimental and radiation oncology in the Slovak Republic - development and development of oncology in Slovakia; (3) Clinical and radiation oncology as part of evidence-based medicine; (4) Molecular biology; (5) Tumor Disease; (6) Epidemiology and prevention of malignant tumors; (7) Diagnosis, staging, stratification and monitoring of patients in oncology; (8) Imaging methods in oncology; (9) Principles of surgical treatment of cancer diseases; (10) Symptomatology and signaling of malignant tumors - systemic, paraneoplastic and paraendocrine manifestations of tumor diseases; (11) Principles of radiation oncology; (12 Modeling radiobiological effects of radiotherapy; (13) Principles of anticancer chemotherapy; (14) Hormonal manipulation in the treatment of tumors; (15) Principles of biological and targeted treatment of solid tumors; (16) Method of multimodal therapy of malignant tumors; (17) Evaluation of treatment response, performance evaluation criteria (RECIST); (18) Adverse effects of cancer chemotherapy and the principles of their prevention and treatment; (19) Biological principles of hematopoietic stem cell transplantation; (20) Design, analysis and ethical aspects of clinical studies in oncology; (21) Fundamentals of biostatistics for oncologists; (22) Information infrastructure for clinical and radiological oncology based on evidence; (23) Pharmacoeconomic aspects in oncology; (24) Respecting patient preferences when deciding on the strategy and

The requirements of a specialist Prostate Cancer Unit: a discussion paper from the European School of Oncology.

Science.gov (United States)

Valdagni, Riccardo; Albers, Peter; Bangma, Chris; Drudge-Coates, Lawrence; Magnani, Tiziana; Moynihan, Clare; Parker, Chris; Redmond, Kathy; Sternberg, Cora N; Denis, Louis; Costa, Alberto

2011-01-01

The widely recognised benefits of a multidisciplinary approach to treating cancer may be particularly important in prostate cancer, where there are so many treatment options to choose from. It offers patients the best chance of receiving high-quality medical procedures administered by a team of specialists in prostate disease, which is able to tailor treatment and observational strategies to their needs, and ensure access to specialist counselling, supportive care and rehabilitation. This article proposes Prostate Cancer Units as the most suitable structures for organising specialist multidisciplinary care for patients at all stages, from newly diagnosed to advanced disease, including preventing and managing the main complications, whether physical, emotional or psychological, arising from the disease and its treatment. Following the German example with prostate cancer, the British example with urological malignancies and the European breast cancer units, this article proposes general recommendations and mandatory requirements for Prostate Cancer Units, with a view to laying the basis for a network of certified units across Europe. Such a network could help improve standards of care throughout the region, providing patients, practitioners and health authorities with a means of identifying high-quality units and providing a system of quality control and audit. The article is intended as a contribution to the debate within the European uro-oncologic community on the best way to organise prostate cancer care. Copyright © 2010 Elsevier Ltd. All rights reserved.

Bladder cancer and the use of the fast track method in the early rehabilitation of oncological patients (literature review

Directory of Open Access Journals (Sweden)

D. G. Voroshin

2018-01-01

Full Text Available In the last 20 years, a concept of using multimodal programs of early rehabilitation of patients after surgical interventions – Enhanced Recovery After Surgery (ERAS – has been developed in medicine. In oncological urology, the ERAS protocol is used only in treatment of bladder cancer. At the same time, not all available elements of this program are used despite the fact that in Russia 24.4 % of malignant tumors are urogenital tumors, and bladder cancer comprises one sixth (4.6 % of them. Frequently, reconstructive plastic surgery is an integral part of bladder cancer treatment, and it’s accompanied by various complications many of which are associated with incorrect tactics of perioperative patient care. This situation can be dramatically improved by a more widespread use of the ERAS protocol. The immediate problem  of oncological urology is development of an effective, safe, and available for wide use algorithm of postoperative rehabilitation of patients with malignant tumors of the bladder after cystectomy with cystoplasty.

The Negative Impact of Stark Law Exemptions on Graduate Medical Education and Health Care Costs: The Example of Radiation Oncology

International Nuclear Information System (INIS)

Anscher, Mitchell S.; Anscher, Barbara M.; Bradley, Cathy J.

2010-01-01

Purpose: To survey radiation oncology training programs to determine the impact of ownership of radiation oncology facilities by non-radiation oncologists on these training programs and to place these findings in a health policy context based on data from the literature. Methods and Materials: A survey was designed and e-mailed to directors of all 81 U.S. radiation oncology training programs in this country. Also, the medical and health economic literature was reviewed to determine the impact that ownership of radiation oncology facilities by non-radiation oncologists may have on patient care and health care costs. Prostate cancer treatment is used to illustrate the primary findings. Results: Seventy-three percent of the surveyed programs responded. Ownership of radiation oncology facilities by non-radiation oncologists is a widespread phenomenon. More than 50% of survey respondents reported the existence of these arrangements in their communities, with a resultant reduction in patient volumes 87% of the time. Twenty-seven percent of programs in communities with these business arrangements reported a negative impact on residency training as a result of decreased referrals to their centers. Furthermore, the literature suggests that ownership of radiation oncology facilities by non-radiation oncologists is associated with both increased utilization and increased costs but is not associated with increased access to services in traditionally underserved areas. Conclusions: Ownership of radiation oncology facilities by non-radiation oncologists appears to have a negative impact on residency training by shifting patients away from training programs and into community practices. In addition, the literature supports the conclusion that self-referral results in overutilization of expensive services without benefit to patients. As a result of these findings, recommendations are made to study further how physician ownership of radiation oncology facilities influence graduate

The Right Place at the Right Time: Medical Oncology Outpatients' Perceptions of Location of End-of-Life Care.

Science.gov (United States)

Waller, Amy; Sanson-Fisher, Rob; Zdenkowski, Nicholas; Douglas, Charles; Hall, Alix; Walsh, Justin

2018-01-01

Background: Helping people achieve their preferred location of care is an important indicator of quality end-of-life (EOL) care. Using a sample of Australian medical oncology outpatients, this study examined (1) their preferred location of EOL care; (2) their perceived benefits and worries of receiving care in that location; (3) the percentage who had discussed preferences with their doctor and/or support person; and (4) whether they wanted their doctor to ask them where they wanted to die. Methods: Adults with a confirmed diagnosis of cancer were approached between September 2015 and January 2016 in the waiting room of an Australian oncology outpatient clinic. Consenting participants completed a home-based pen-and-paper survey indicating preferred location of care, perceived benefits and worries of that location, whether they had discussed preferences with their doctors, and whether they were willing to be asked about their preferences. Results: A total of 203 patients returned the survey (47% of those eligible). Less than half preferred to be cared for at home (47%), 34% preferred a hospice/palliative care unit, and 19% preferred the hospital. Common benefits and worries associated with locations included perceived burden on others, familiarity of environment, availability of expert medical care, symptom management, and likelihood of having wishes respected. More patients had discussed preferences with their support persons (41%) than doctors (7%). Most wanted a doctor to ask them about preferred location of care (87%) and thought it was important to die in the location of their choice (93%). Conclusions: Patients were willing to have clinicians to ask them where they wanted to die, although few had discussed their preferences with doctors. Although home was the most preferred location for many patients, the overall variation suggests that clinicians should adopt a systematic approach to eliciting patient preferences. Copyright © 2018 by the National

LGBT Cultural Competence and Interventions to Help Oncology Nurses and Other Health Care Providers.

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Radix, Asa; Maingi, Shail

2018-02-01

To define and give an overview of the importance of lesbian, gay, bisexual, and transgender (LGBT) cultural competency and offer some initial steps on how to improve the quality of care provided by oncology nurses and other health care professionals. A review of the existing literature on cultural competency. LGBT patients experience cancer and several other diseases at higher rates than the rest of the population. The reasons for these health care disparities are complex and include minority stress, fear of discrimination, lower rates of insurance, and lack of access to quality, culturally competent care. Addressing the health care disparities experienced by LGBT individuals and families requires attention to the actual needs, language, and support networks used by patients in these communities. Training on how to provide quality care in a welcoming and non-judgmental way is available and can improve health equity. Health care professionals and institutions that acquire cultural competency training can improve the overall health of LGBT patients who currently experience significant health care disparities. Copyright © 2017 Elsevier Inc. All rights reserved.

Complementary Medicine and the Role of Oncology Nurses in an Acute Care Hospital: The Gap Between Attitudes and Practice.

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Admi, Hanna; Eilon-Moshe, Yael; Ben-Arye, Eran

2017-09-01

To describe hospital nurses' knowledge, attitudes, and practices regarding complementary medicine (CM); to compare the knowledge and attitudes of nurse managers to staff nurses with diverse oncology experience; and to assess attitudes toward integrating CM into the role of the hospital oncology nurse. 
. Descriptive, cross-sectional study.
. Rambam Health Care Campus in northern Israel.
. A convenience sample of 434 hospital nurses with varied oncology experience.
. Nurses completed a knowledge and attitude questionnaire developed for the current study. Data were analyzed using parametric and nonparametric statistical tests. 
. Hospital nurses' knowledge of and attitudes toward CM, and attitudes toward integrating CM into the role of the hospital oncology nurse.
. Nurses lack knowledge and are unaware of the risks associated with CM. However, they believe this approach can improve the quality of life of patients with cancer; 51% expressed an interest in receiving training. Oncology nurses were ambivalent about the feasibility of applying an integrative approach, whereas nurse managers expressed significantly more positive attitudes toward integrating CM within the scope of nursing practices.
. A large discrepancy remains between nurses' strong interest in CM and awareness of associated benefits, and their ambivalence toward its integration in their nursing practice. 
. Although improving nurses' knowledge should be mandatory, it remains insufficient; a shift in the approach to integrating CM into conventional health care is needed, from practitioners' responsibility to healthcare policymakers' responsibility. Legislations and policies are necessary, along with providing respectable infrastructures.

Improving oncology nurses' communication skills for difficult conversations.

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Baer, Linda; Weinstein, Elizabeth

2013-06-01

When oncology nurses have strong communication skills, they play a pivotal role in influencing patient satisfaction, adherence to plans of care, and overall clinical outcomes. However, research studies indicate that nurses tend to keep communication with patients and families at a superficial, nontherapeutic level. Processes for teaching goals-of-care communication skills and for implementing skills into clinical practice are not clearly defined. Nurses at a large comprehensive cancer center recognized the need for help with this skill set and sought out communication experts to assist in providing the needed education. An educational project was developed to improve therapeutic communication skills in oncology nurses during goals-of-care discussions and giving bad news. The program was tailored to nurses and social workers providing care to patients in a busy, urban, academic, outpatient oncology setting. Program topics included exploring the patient's world, eliciting hopes and concerns, and dealing with conflict about goals. Sharing and discussing specific difficult questions and scenarios were encouraged throughout the program. The program was well attended and well received by oncology nurses and social workers. Participants expressed interest in the continuation of communication programs to further enhance skills.

Pediatric Oncology Branch - training- resident electives | Center for Cancer Research

Science.gov (United States)

Resident Electives Select pediatric residents may be approved for a 4-week elective rotation at the Pediatric Oncology Branch. This rotation emphasizes the important connection between research and patient care in pediatric oncology. The resident is supervised directly by the Branch’s attending physician and clinical fellows. Residents attend daily in-patient and out-patient

Overview of pediatric oncology and hematology in Myanmar

Directory of Open Access Journals (Sweden)

Jay Halbert

2014-01-01

Full Text Available Myanmar is a country in southeast Asia in political, economic and healthcare transition. There are currently only two pediatric oncology centers serving a population of almost 19 million children. An estimated 85-92% of children with cancer are undiagnosed or not receiving treatment. Abandonment of treatment is as high as 60%. Although a number of chemotherapy agents are available, difficulties remain concerning treatment costs, quality control and the availability of supportive care. Radiotherapy services are also limited and not usually included in pediatric protocols. Healthcare professional training, improved diagnostics, strategies to tackle abandonment of treatment and the development of a parents′ support group are major priorities. Local and international partnerships including a recent partnership with world child cancer are essential in the interim to support the development of pediatric oncology and hematology in Myanmar. A unique opportunity exists to support the development of preventive, diagnostic, curative and palliative care for children′s cancer in Myanmar from the outset.

The Future of Gero-Oncology Nursing.

Science.gov (United States)

Kagan, Sarah H

2016-02-01

To project the future of gero-oncology nursing as a distinct specialty, framed between analysis of current challenges and explication of prospective solutions. Peer-reviewed literature, policy directives, web-based resources, and author expertise. Oncology nursing faces several challenges in meeting the needs of older people living with cancer. Realigning cancer nursing education, practice, and research to match demographic and epidemiological realities mandates redesign. Viewing geriatric oncology as an optional sub-specialty limits oncology nursing, where older people represent the majority of oncology patients and cancer survivors. The future of gero-oncology nursing lies in transforming oncology nursing itself. Specific goals to achieve transformation of oncology nursing into gero-oncology nursing include assuring integrated foundational aging and cancer content across entry-level nursing curricula; assuring a gero-competent oncology nursing workforce with integrated continuing education; developing gero-oncology nurse specialists in advanced practice roles; and cultivating nurse leadership in geriatric oncology program development and administration along with expanding the scope and sophistication of gero-oncology nursing science. Copyright © 2015 Elsevier Inc. All rights reserved.

Palliative care knowledge and attitudes among oncology nurses in Qatar.

Science.gov (United States)

Al-Kindi, Sadeer G; Zeinah, Ghaith F Abu; Hassan, Azza Adel

2014-08-01

Formal palliative care (PC) education is lacking in the middle eastern state of Qatar. This study was done to assess the need for PC education among oncology nurses in Qatar. In March 2012, a self-constructed questionnaire was distributed to 115 nurses at the Qatar National Center for Cancer Care and Research. A total of 115 nurses responded to the questionnaire. The majority (87.8%) were female. Although 60% had more than 10 years of work experience, only 31% had received formal training in PC, with only 6.1% having completed postgraduate training. The majority (63%) of responders attributed this issue to unavailability of PC courses rather than lack of time, interest, or financial issues. Currently, only 16.7% did not express interest in the field, with 56% showing some kind of interest. In terms of knowledge, 54% of the responders were familiar with the World Health Organization ladder for pain relief. Only 43.6% know about Palliative Performance Scale, and half of the nurses know the Edmonton Symptom Assessment System. Overall, 56% of the nurses indicated a need for training in more than 1 aspect. These aspects included training in care of the dying patients (14.6%), communication strategies (22%), caregiver support (10.6%), psychosocial care (15%), pain management (10.2%), other symptom management (13%), and other ethical/spiritual issues (14.2%). There is a clear deficiency in formal PC education among the nurses at the National Center for Cancer Care and Research, in Qatar. This is reflected by their lack of experience and exposure to PC and their mediocre knowledge in the field. This could be attributed to the fact that formal PC service was established only recently in Qatar (2008). Formal training courses in PC nursing are required. © The Author(s) 2013.

Energy Therapies in Advanced Practice Oncology: An Evidence-Informed Practice Approach

Science.gov (United States)

Potter, Pamela J.

2013-01-01

Advanced practitioners in oncology want patients to receive state-of-the-art care and support for their healing process. Evidence-informed practice (EIP), an approach to evaluating evidence for clinical practice, considers the varieties of evidence in the context of patient preference and condition as well as practitioner knowledge and experience. This article offers an EIP approach to energy therapies, namely, Therapeutic Touch (TT), Healing Touch (HT), and Reiki, as supportive interventions in cancer care; a description of the author’s professional experience with TT, HT, and Reiki in practice and research; an overview of the three energy healing modalities; a review of nine clinical studies related to oncology; and recommendations for EIP. These studies demonstrate a response to previous research design critiques. Findings indicate a positive benefit for oncology patients in the realms of pain, quality of life, fatigue, health function, and mood. Directionality of healing in immune response and cell line studies affirms the usual explanation that these therapies bring harmony and balance to the system in the direction of health. Foremost, the research literature demonstrates the safety of these therapies. In order to consider the varieties of evidence for TT, HT, and Reiki, EIP requires a qualitative examination of patient experiences with these modalities, exploration of where these modalities have been integrated into cancer care and how the practice works in the oncology setting, and discovery of the impact of implementation on provider practice and self-care. Next steps toward EIP require fleshing out the experience of these modalities by patients and health-care providers in the oncology care setting. PMID:25031994

Communication in cancer care: psycho-social, interactional, and cultural issues. A general overview and the example of India

OpenAIRE

Chaturvedi, Santosh K.; Strohschein, Fay J.; Saraf, Gayatri; Loiselle, Carmen G.

2014-01-01

Communication is a core aspect of psycho-oncology care. This article examines key psychosocial, cultural, and technological factors that affect this communication. Drawing from advances in clinical work and accumulating bodies of empirical evidence, the authors identify determining factors for high quality, efficient, and sensitive communication and support for those affected by cancer. Cancer care in India is highlighted as a salient example. Cultural factors affecting cancer communication i...

Model of care for adolescents and young adults with cancer: the Youth Project in Milan

Directory of Open Access Journals (Sweden)

Chiara Magni

2016-08-01

Full Text Available Adolescents and young adults (AYA with cancer form a particular group of patients with unique characteristics, who inhabit a so-called no man’s land between pediatric and adult services. In the last ten years, the scientific oncology community has started to pay attention to these patients, implementing dedicated programs. A standardized model of care directed towards patients in this age range has yet to be developed and neither the pediatric nor the adult oncologic systems perfectly fit these patients’ needs. The Youth Project of the Istituto Nazionale Tumori in Milan, dedicated to adolescents and young adults with pediatric-type solid tumors, can be seen as a model of care for AYA patients, with its heterogeneous multidisciplinary staff and close cooperation with adult medical oncologists and surgeons. Further progress in the care of AYA cancer patients is still needed to improve their outcomes.

Perceptions of complementary medicine integration in supportive cancer care of Arabs and Jews in Israel: a cross-cultural study.

Science.gov (United States)

Ben-Arye, Eran; Schiff, Elad; Silbermann, Michael; Agbarya, Abed; Bar-Sela, Gil

2015-05-01

There is a dearth of studies on how cultural background influences patients' attitudes and choices regarding complementary and traditional medicine (CTM) integration. To explore Arab and Jewish patients' perspectives regarding CTM use and its possible integration within conventional cancer care. This was a cross-cultural study. We developed a 27-item questionnaire that evaluates patients' perceptions regarding CTM integration in supportive cancer care. The questionnaire was administered to a convenience sample of patients receiving cancer care in community and hospital oncology centers. Of the 770 respondents (response rate 88%), 324 defined their religion as Muslim, Christian, or Druze (henceforth, regarded as Arabs) and 446 were Jews. Respondents in the two groups differed significantly in terms of age, gender, marital status, number of children, education, religiosity, and prevalence of cancer types (excluding breast cancer). Although Arab respondents reported less use of CTM for cancer-related outcomes (39.6% vs. 52.1%; P = 0.001), they expressed greater support than Jewish respondents for optional CTM consultation if provided within conventional oncology care (P < 0.0001). Respondents in both groups stated that their primary expectation from the oncologist concerning CTM was to participate in formulating a CTM treatment plan to be provided within the oncology department. Compared with Arab respondents, Jews expected CTM consultations to focus on improving daily functioning and coping, reducing chemotherapy side effects, and providing spiritual support. Although quality of life-related expectations are more pronounced among Jewish respondents, both groups share the expectation from their health care providers to be actively involved in construction of a tailored integrative CTM treatment plan. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

No Exit: Identifying Avoidable Terminal Oncology Intensive Care Unit Hospitalizations

Science.gov (United States)

Hantel, Andrew; Wroblewski, Kristen; Balachandran, Jay S.; Chow, Selina; DeBoer, Rebecca; Fleming, Gini F.; Hahn, Olwen M.; Kline, Justin; Liu, Hongtao; Patel, Bhakti K.; Verma, Anshu; Witt, Leah J.; Fukui, Mayumi; Kumar, Aditi; Howell, Michael D.; Polite, Blase N.

2016-01-01

Purpose: Terminal oncology intensive care unit (ICU) hospitalizations are associated with high costs and inferior quality of care. This study identifies and characterizes potentially avoidable terminal admissions of oncology patients to ICUs. Methods: This was a retrospective case series of patients cared for in an academic medical center’s ambulatory oncology practice who died in an ICU during July 1, 2012 to June 30, 2013. An oncologist, intensivist, and hospitalist reviewed each patient’s electronic health record from 3 months preceding terminal hospitalization until death. The primary outcome was the proportion of terminal ICU hospitalizations identified as potentially avoidable by two or more reviewers. Univariate and multivariate analysis were performed to identify characteristics associated with avoidable terminal ICU hospitalizations. Results: Seventy-two patients met inclusion criteria. The majority had solid tumor malignancies (71%), poor performance status (51%), and multiple encounters with the health care system. Despite high-intensity health care utilization, only 25% had documented advance directives. During a 4-day median ICU length of stay, 81% were intubated and 39% had cardiopulmonary resuscitation. Forty-seven percent of these hospitalizations were identified as potentially avoidable. Avoidable hospitalizations were associated with factors including: worse performance status before admission (median 2 v 1; P = .01), worse Charlson comorbidity score (median 8.5 v 7.0, P = .04), reason for hospitalization (P = .006), and number of prior hospitalizations (median 2 v 1; P = .05). Conclusion: Given the high frequency of avoidable terminal ICU hospitalizations, health care leaders should develop strategies to prospectively identify patients at high risk and formulate interventions to improve end-of-life care. PMID:27601514

Future Supply and Demand for Oncologists : Challenges to Assuring Access to Oncology Services

Science.gov (United States)

Erikson, Clese; Salsberg, Edward; Forte, Gaetano; Bruinooge, Suanna; Goldstein, Michael

2007-01-01

Purpose To conduct a comprehensive analysis of supply of and demand for oncology services through 2020. This study was commissioned by the Board of Directors of ASCO. Methods New data on physician supply gathered from surveys of practicing oncologists, oncology fellows, and fellowship program directors were analyzed, along with 2005 American Medical Association Masterfile data on practicing medical oncologists, hematologists/oncologists, and gynecologic oncologists, to determine the baseline capacity and to forecast visit capacity through 2020. Demand for visits was calculated by applying age-, sex-, and time-from-diagnosis-visit rate data from the National Cancer Institute's analysis of the 1998 to 2002 Surveillance, Epidemiology and End Results (SEER) database to the National Cancer Institute's cancer incidence and prevalence projections. The cancer incidence and prevalence projections were calculated by applying a 3-year average (2000–2002) of age- and sex-specific cancer rates from SEER to the US Census Bureau population projections released on March 2004. The baseline supply and demand forecasts assume no change in cancer care delivery and physician practice patterns. Alternate scenarios were constructed by changing assumptions in the baseline models. Results Demand for oncology services is expected to rise rapidly, driven by the aging and growth of the population and improvements in cancer survival rates, at the same time the oncology workforce is aging and retiring in increasing numbers. Demand is expected to rise 48% between 2005 and 2020. The supply of services provided by oncologists during this time is expected to grow more slowly, approximately 14%, based on the current age distribution and practice patterns of oncologists and the number of oncology fellowship positions. This translates into a shortage of 9.4 to 15.0 million visits, or 2,550 to 4,080 oncologists—roughly one-quarter to one-third of the 2005 supply. The baseline projections do not

A scoping review of the nurse practitioner workforce in oncology.

Science.gov (United States)

Coombs, Lorinda A; Hunt, Lauren; Cataldo, Janine

2016-08-01

The quality of cancer care may be compromised in the near future because of work force issues. Several factors will impact the oncology health provider work force: an aging population, an increase in the number of cancer survivors, and expansion of health care coverage for the previously uninsured. Between October 2014 and March 2015, an electronic literature search of English language articles was conducted using PubMed(®) , the Cumulative Index to Nursing and Allied Health Sciences (CINAHL(®) ), Web of Science, Journal Storage (JSTOR(®) ), Google Scholar, and SCOPUS(®) . Using the scoping review criteria, the research question was identified "How much care in oncology is provided by nurse practitioners (NPs)?" Key search terms were kept broad and included: "NP" AND "oncology" AND "workforce". The literature was searched between 2005 and 2015, using the inclusion and exclusion criteria, 29 studies were identified, further review resulted in 10 relevant studies that met all criteria. Results demonstrated that NPs are utilized in both inpatient and outpatient settings, across all malignancy types and in a variety of roles. Academic institutions were strongly represented in all relevant studies, a finding that may reflect the Accreditation Council for Graduate Medical Education (ACGME) duty work hour limitations. There was no pattern associated with state scope of practice and NP representation in this scoping review. Many of the studies reviewed relied on subjective information, or represented a very small number of NPs. There is an obvious need for an objective analysis of the amount of care provided by oncology NPs. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Determining the expected competencies for oncology nursing: A needs assessment study

Directory of Open Access Journals (Sweden)

Nikoo Yamani

2018-01-01

Full Text Available Background: A critical component of cancer care, rarely addressed in the published literature, is an expected competency in oncology nursing education. The present text describes an effort to develop cancer-nursing competencies in Iran and the process of the needs assessment. Materials and Methods: A 3-phase, mixed-method approach for needs assessment was used, incorporating modified Delphi technique, literature review, interviews, and an expert panel. Different stakeholders, consisting of nurses, faculty members in fields related to oncology nursing education, and patients and their families, participated in different phases of the study. Data were analyzed using manual content analysis. Results: In the present study, totally 123 sub-competencies were identified under holistic physical healthcare for patients, psychological and social care, spiritual care, palliative care, ability to prevent at three levels, teamwork and inter-professional competencies, management and leadership competencies, ability to conduct research and evidence-based nursing, supportive care, communication skills, professionalism, provision of education and counselling to patients and their families, and reasoning, problem solving, and critical thinking skills, respectively. Conclusions: An updated and applicable list of competencies was extracted, which can be used to design and develop educational programs, which seek to train qualified oncology nurses for an effective nursing care.

Report on the international colloquium on cardio-oncology (rome, 12-14 march 2014)

NARCIS (Netherlands)

Ewer, Michael; Gianni, Luca; Pane, Fabrizio; Sandri, Maria Teresa; Steiner, Rudolf K.; Wojnowski, Leszek; Yeh, Edward T.; Carver, Joseph R.; Lipshultz, Steven E.; Minotti, Giorgio; Armstrong, Gregory T.; Cardinale, Daniela; Colan, Steven D.; Darby, Sarah C.; Force, Thomas L.; Kremer, Leontien C. M.; Lenihan, Daniel J.; Sallan, Stephen E.; Sawyer, Douglas B.; Suter, Thomas M.; Swain, Sandra M.; van Leeuwen, Flora E.

2014-01-01

Cardio-oncology is a relatively new discipline that focuses on the cardiovascular sequelae of anti-tumour drugs. As any other young adolescent discipline, cardio-oncology struggles to define its scientific boundaries and to identify best standards of care for cancer patients or survivors at risk of

Yoga into cancer care: A review of the evidence-based research

Directory of Open Access Journals (Sweden)

Ram P Agarwal

2018-01-01

Full Text Available To cope with cancer and its treatment-related side effects and toxicities, people are increasingly using complementary and alternative medicine (CAM. Consequently, integrative oncology, which combines conventional therapies and evidence-based CAM practices, is an emerging discipline in cancer care. The use of yoga as a CAM is proving to be beneficial and increasingly gaining popularity. An electronic database search (PubMed, through December 15, 2016, revealed 138 relevant clinical trials (single-armed, nonrandomized, and randomized controlled trials on the use of yoga in cancer patients. A total of 10,660 cancer patients from 20 countries were recruited in these studies. Regardless of some methodological deficiencies, most of the studies reported that yoga improved the physical and psychological symptoms, quality of life, and markers of immunity of the patients, providing a strong support for yoga's integration into conventional cancer care. This review article presents the published clinical research on the prevalence of yoga's use in cancer patients so that oncologists, researchers, and the patients are aware of the evidence supporting the use of this relatively safe modality in cancer care.

Society of Gynecologic Oncology Future of Physician Payment Reform Task Force report: The Endometrial Cancer Alternative Payment Model (ECAP).

Science.gov (United States)

Ko, Emily M; Havrilesky, Laura J; Alvarez, Ronald D; Zivanovic, Oliver; Boyd, Leslie R; Jewell, Elizabeth L; Timmins, Patrick F; Gibb, Randall S; Jhingran, Anuja; Cohn, David E; Dowdy, Sean C; Powell, Matthew A; Chalas, Eva; Huang, Yongmei; Rathbun, Jill; Wright, Jason D

2018-05-01

Health care in the United States is in the midst of a significant transformation from a "fee for service" to a "fee for value" based model. The Medicare Access and CHIP Reauthorization Act of 2015 has only accelerated this transition. Anticipating these reforms, the Society of Gynecologic Oncology developed the Future of Physician Payment Reform Task Force (PPRTF) in 2015 to develop strategies to ensure fair value based reimbursement policies for gynecologic cancer care. The PPRTF elected as a first task to develop an Alternative Payment Model for thesurgical management of low risk endometrial cancer. The history, rationale, and conceptual framework for the development of an Endometrial Cancer Alternative Payment Model are described in this white paper, as well as directions forfuture efforts. Copyright © 2018 Elsevier Inc. All rights reserved.

American Society of Clinical Oncology Policy Statement: The Role of the Oncologist in Cancer Prevention and Risk Assessment

Science.gov (United States)

Zon, Robin T.; Goss, Elizabeth; Vogel, Victor G.; Chlebowski, Rowan T.; Jatoi, Ismail; Robson, Mark E.; Wollins, Dana S.; Garber, Judy E.; Brown, Powel; Kramer, Barnett S.

2009-01-01

Oncologists have a critical opportunity to utilize risk assessment and cancer prevention strategies to interrupt the initiation or progression of cancer in cancer survivors and individuals at high risk of developing cancer. Expanding knowledge about the natural history and prognosis of cancers positions oncologists to advise patients regarding the risk of second malignancies and treatment-related cancers. In addition, as recognized experts in the full spectrum of cancer care, oncologists are afforded opportunities for involvement in community-based cancer prevention activities. Although oncologists are currently providing many cancer prevention and risk assessment services to their patients, economic barriers exist, including inadequate or lack of insurance, that may compromise uniform patient access to these services. Additionally, insufficient reimbursement for existing and developing interventions may discourage patient access to these services. The American Society of Clinical Oncology (ASCO), the medical society representing cancer specialists involved in patient care and clinical research, is committed to supporting oncologists in their wide-ranging involvement in cancer prevention. This statement on risk assessment and prevention counseling, although not intended to be a comprehensive overview of cancer prevention describes the current role of oncologists in risk assessment and prevention; provides examples of risk assessment and prevention activities that should be offered by oncologists; identifies potential opportunities for coordination between oncologists and primary care physicians in prevention education and coordination of care for cancer survivors; describes ASCO's involvement in education and training of oncologists regarding prevention; and proposes improvement in the payment environment to encourage patient access to these services. PMID:19075281

Oncology care provider perspectives on exercise promotion in people with cancer: an examination of knowledge, practices, barriers, and facilitators.

Science.gov (United States)

Nadler, Michelle; Bainbridge, Daryl; Tomasone, Jennifer; Cheifetz, Oren; Juergens, Rosalyn A; Sussman, Jonathan

2017-07-01

Despite the reported benefits of physical activity in alleviating the impact of cancer and its treatments, oncology care providers (OCPs) are not routinely discussing exercise with their patients, suggesting a knowledge to action gap. We sought to determine OCP's knowledge, beliefs, barriers, and facilitators to exercise discussion. A survey was administered to OCPs at the cancer center in Hamilton, Ontario. Questions comprised of demographics, knowledge and beliefs regarding exercise guidelines, and barriers and facilitators to exercise discussion. Analysis of survey responses was descriptive. Pearson's chi-squared test was used to examine select associations. There were 120 respondents (61% response rate) representing a diversity of professions. Approximately, 80% of OCPs were not aware of any exercise guidelines in cancer and self-reported poor knowledge on when, how, and which patients to refer to exercise programs. OCPs who reported meeting Canada's Physical Activity guidelines were significantly more likely to identify correct guidelines (p = 0.023) and to report good knowledge on how to provide exercise counseling (p = 0.014). Across OCP groups, barriers to exercise discussion included poor knowledge, lack of time, and safety concerns. Most felt that educational sessions and having an exercise specialist on the clinical team would be beneficial. OCPs have low knowledge regarding exercise counseling, but believe that discussing exercise is a multidisciplinary task and expressed a desire for further training. Interventions will require a multi-pronged approach including education for OCPs and guidance on assessment for exercise safety.

Oncology in primary health care

International Nuclear Information System (INIS)

Mendoza del Pino, Mario Valentín

2009-01-01

The book O ncology in the primary health care , constitutes an important contribution to the prevention and treatment of cancer, from a very comprehensive assessment. It's a disease that is the second leading cause of death in our country, to much pain and suffering is for the patient and their family. The book has a very useful for basic health equipment approach, since it emphasizes that cancer can be prevented if achieved in the population changes in lifestyle. The book is valued not correct food as responsible for one third of all cancers. Currently important research being developed in relation to psiconeuroinmuno-Endocrinology, who is studying the association between psychological factors and the development of cancer valuing that kept stress and depression reduces the antitumor activity of the immune system; that made programs with encouraging results where the treatment of cancer has joined elements of psychotherapy, immunotherapy and the use of the biotherapy. The focus of the book fills an important place in the primary health care and is an indispensable guide for professionals at this level of care (author)

American Society of Clinical Oncology Strategic Plan for Increasing Racial and Ethnic Diversity in the Oncology Workforce.

Science.gov (United States)

Winkfield, Karen M; Flowers, Christopher R; Patel, Jyoti D; Rodriguez, Gladys; Robinson, Patricia; Agarwal, Amit; Pierce, Lori; Brawley, Otis W; Mitchell, Edith P; Head-Smith, Kimberly T; Wollins, Dana S; Hayes, Daniel F

2017-08-01

In December 2016, the American Society of Clinical Oncology (ASCO) Board of Directors approved the ASCO Strategic Plan to Increase Racial and Ethnic Diversity in the Oncology Workforce. Developed through a multistakeholder effort led by the ASCO Health Disparities Committee, the purpose of the plan is to guide the formal efforts of ASCO in this area over the next three years (2017 to 2020). There are three primary goals: (1) to establish a longitudinal pathway for increasing workforce diversity, (2) to enhance ASCO leadership diversity, and (3) to integrate a focus on diversity across ASCO programs and policies. Improving quality cancer care in the United States requires the recruitment of oncology professionals from diverse backgrounds. The ASCO Strategic Plan to Increase Racial and Ethnic Diversity in the Oncology Workforce is designed to enhance existing programs and create new opportunities that will move us closer to the vision of achieving an oncology workforce that reflects the demographics of the US population it serves.

Immediate reconstruction with implants in women with invasive breast cancer does not affect oncological safety in a matched cohort study.

Science.gov (United States)

Eriksen, C; Frisell, J; Wickman, M; Lidbrink, E; Krawiec, K; Sandelin, K

2011-06-01

Physicians are still concerned about the oncological safety regarding immediate breast reconstruction (IBR) in breast cancer patients. This study aimed to evaluate possible differences between local, regional, and distant recurrences between women having implant-based reconstruction versus women operated with mastectomy alone. Secondary aims were to evaluate time to oncological treatment as well as disease-free and breast-cancer-specific survival. In a retrospective cohort designed study, 300 reconstructed patients with invasive breast cancer were matched with 300 patients from the population-based Regional Breast Cancer Register of the Stockholm-Gotland health-care region operated with mastectomy alone. They were matched for age, tumor size, nodal stage, and year of operation. Also included were patients treated with neoadjuvant chemotherapy and postoperative radiotherapy. The median follow-up for both the groups was 11.5 years (range 2-20). There were no significant differences in the local recurrence rate, 8.2% in the IBR group and 9.0% in the control group or in the regional recurrence rate, 8.2% versus 9.7%. Distant metastases occurred more frequently in the control group (27.1%) when compared to the IBR group (20.3%). There were no significant differences in time to treatment or in complications rate. Breast cancer mortality was 17% for the IBR group and 23% in the control group during follow-up. This long-term follow-up survey with a well-matched control group demonstrates that IBR with implants is safe to offer patients with invasive breast cancer without any negative effect on the oncological safety.

Technology for Innovation in Radiation Oncology

Energy Technology Data Exchange (ETDEWEB)

Chetty, Indrin J. [Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan (United States); Martel, Mary K., E-mail: mmartel@mdanderson.org [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Jaffray, David A. [Departments of Radiation Oncology and Medical Biophysics, Princess Margaret Hospital, Toronto, Ontario (Canada); Benedict, Stanley H. [Department of Radiation Oncology, University of California – Davis Cancer Center, Sacramento, California (United States); Hahn, Stephen M. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Berbeco, Ross [Department of Radiation Oncology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Deye, James [Radiation Research Programs, National Cancer Institute, Bethesda, Maryland (United States); Jeraj, Robert [Department of Medical Physics, University of Wisconsin, Madison, Wisconsin (United States); Kavanagh, Brian [Department of Radiation Oncology, University of Colorado, Aurora, Colorado (United States); Krishnan, Sunil [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Lee, Nancy [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Low, Daniel A. [Department of Radiation Oncology, University of California – Los Angeles, Los Angeles, California (United States); Mankoff, David [Department of Radiology, University of Washington Medical School, Seattle, Washington (United States); Marks, Lawrence B. [Department of Radiation Oncology, University of North Carolina Hospitals, Chapel Hill, North Carolina (United States); Ollendorf, Daniel [Institute for Clinical and Economic Review, Boston, Massachusetts (United States); and others

2015-11-01

Radiation therapy is an effective, personalized cancer treatment that has benefited from technological advances associated with the growing ability to identify and target tumors with accuracy and precision. Given that these advances have played a central role in the success of radiation therapy as a major component of comprehensive cancer care, the American Society for Radiation Oncology (ASTRO), the American Association of Physicists in Medicine (AAPM), and the National Cancer Institute (NCI) sponsored a workshop entitled “Technology for Innovation in Radiation Oncology,” which took place at the National Institutes of Health (NIH) in Bethesda, Maryland, on June 13 and 14, 2013. The purpose of this workshop was to discuss emerging technology for the field and to recognize areas for greater research investment. Expert clinicians and scientists discussed innovative technology in radiation oncology, in particular as to how these technologies are being developed and translated to clinical practice in the face of current and future challenges and opportunities. Technologies encompassed topics in functional imaging, treatment devices, nanotechnology, and information technology. The technical, quality, and safety performance of these technologies were also considered. A major theme of the workshop was the growing importance of innovation in the domain of process automation and oncology informatics. The technologically advanced nature of radiation therapy treatments predisposes radiation oncology research teams to take on informatics research initiatives. In addition, the discussion on technology development was balanced with a parallel conversation regarding the need for evidence of efficacy and effectiveness. The linkage between the need for evidence and the efforts in informatics research was clearly identified as synergistic.

Technology for Innovation in Radiation Oncology

International Nuclear Information System (INIS)

Chetty, Indrin J.; Martel, Mary K.; Jaffray, David A.; Benedict, Stanley H.; Hahn, Stephen M.; Berbeco, Ross; Deye, James; Jeraj, Robert; Kavanagh, Brian; Krishnan, Sunil; Lee, Nancy; Low, Daniel A.; Mankoff, David; Marks, Lawrence B.; Ollendorf, Daniel

2015-01-01

Radiation therapy is an effective, personalized cancer treatment that has benefited from technological advances associated with the growing ability to identify and target tumors with accuracy and precision. Given that these advances have played a central role in the success of radiation therapy as a major component of comprehensive cancer care, the American Society for Radiation Oncology (ASTRO), the American Association of Physicists in Medicine (AAPM), and the National Cancer Institute (NCI) sponsored a workshop entitled “Technology for Innovation in Radiation Oncology,” which took place at the National Institutes of Health (NIH) in Bethesda, Maryland, on June 13 and 14, 2013. The purpose of this workshop was to discuss emerging technology for the field and to recognize areas for greater research investment. Expert clinicians and scientists discussed innovative technology in radiation oncology, in particular as to how these technologies are being developed and translated to clinical practice in the face of current and future challenges and opportunities. Technologies encompassed topics in functional imaging, treatment devices, nanotechnology, and information technology. The technical, quality, and safety performance of these technologies were also considered. A major theme of the workshop was the growing importance of innovation in the domain of process automation and oncology informatics. The technologically advanced nature of radiation therapy treatments predisposes radiation oncology research teams to take on informatics research initiatives. In addition, the discussion on technology development was balanced with a parallel conversation regarding the need for evidence of efficacy and effectiveness. The linkage between the need for evidence and the efforts in informatics research was clearly identified as synergistic.

Use of the distress thermometer to evaluate symptoms, outcome and satisfaction in a specialist psycho-oncology service.

Science.gov (United States)

Blenkiron, Paul; Brooks, Alexander; Dearden, Richard; McVey, Joanne

2014-01-01

The National Institute for Health and Care Excellence recommends the use of structured tools to improve holistic care for patients with cancer. The Distress Thermometer and Problem Checklist (DT) is commonly used for screening in physical health settings. However, it has not been integrated into the clinical pathway within specialist psycho-oncology services. We used the DT to examine the broad clinical effectiveness of psycho-oncology intervention and to ascertain factors from the DT linked to an improved outcome. We also evaluated patients' satisfaction with their care. We asked 111 adult outpatients referred to York Psycho-Oncology Service to complete the DT at their first appointment. Individuals offered a period of psycho-oncology care re-rated their emotional distress, problems and service satisfaction on the DT at discharge. Median distress scores decreased significantly (from 6 to 4, Wilcoxon's z = -4.83, P psycho-oncology care. It may also provide evidence to support the effectiveness of specialist psycho-oncology interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

Establishment of the Asia Oncology Nursing Society (AONS

Directory of Open Access Journals (Sweden)

Kazuko Onishi

2014-01-01

Full Text Available Over the past several years, whenever an informal group of Asian oncology nurses gathered, they talked about their mutual desire to create an organization closer to their homes that would be similar to the European Oncology Nursing Society (EONS. They saw this as a means for more of their colleagues to learn about the latest in cancer nursing and to have a time and place to network among themselves. This message continued to gain strength whenever these nurses met at other international meetings such as the International Conference on Cancer Nursing (ICCN, the Multinational Association of Supportive Care in Cancer (MASCC and the Oncology Nursing Society in US. A definite and planned step toward forming an Asian organization as the first meeting was taken on June 24 2011 when several Asian nurses were attending a MASCC meeting in Greece. The second meeting was held in Prague, Czech Republic, in conjunction with the 17 th ICCN meeting on September 10 2012, where the participants of the meeting included 21 oncology nurses from Asian countries. Finally, the first official meeting of the board directors from nine countries was held on November 21 2013 in Bangkok, Thailand. Now, and in the future, sharing and collaborating in the practice, education and research for oncology nursing in Asia is needed.

Delivering breast cancer care in urban India: Heterotopia, hospital ethnography and voluntarism.

Science.gov (United States)

Macdonald, Alison

2016-05-01

Despite substantial strides to improve cancer control in India, challenges to deliver oncology services persist. One major challenge is the provision and accessibility of adequate infrastructure. This paper offers ethnographic insight on the conceptual and material conditions that are currently shaping the delivery of oncology in Mumbai, focusing specifically on the way India's socio-economic context necessitates non-biomedical acts of voluntarism or 'seva' (selfless service). Developing the premise that hospitals are not identical clones of a biomedical model, detailed attention is paid to the way 'care' emerges through 'praxis of place' (Casey, 2003) within the cancer hospital as a multi-scalar 'heterotopic' (Street and Coleman, 2012) site. Such a perspective enables global/local tensions to come into view, together with the heterogeneous confluence of juxtaposing materialities, imaginations, social practices and values that both propels and constrains the everyday delivery of care. The paper reflects on the theoretical implications of hospital seva in Mumbai in light of social science studies of hospital ethnography and health activism and contributes important ethnographic insight into the current global health debates regarding effective implementation of cancer services in India. Copyright © 2016 Elsevier Ltd. All rights reserved.

Institutional capacity to provide psychosocial oncology support services: A report from the Association of Oncology Social Work.

Science.gov (United States)

Zebrack, Brad; Kayser, Karen; Padgett, Lynne; Sundstrom, Laura; Jobin, Chad; Nelson, Krista; Fineberg, Iris C

2016-06-15

This study reports cancer-treating institutions' capacity to deliver comprehensive psychosocial support services. Oncology care providers at 60 cancer-treating institutions completed surveys assessing the capacity of their institutions to provide psychosocial care. Capacity was assessed with the Cancer Psychosocial Care Matrix (CPCM) from the National Cancer Institute (NCI). Scores represented individuals' perceptions of their cancer program's performance with respect to 10 fundamental elements of psychosocial care. Among 2134 respondents, 62% reported a mid-level capacity for ≥5 of 10 CPCM items. In comparison with other types of cancer programs (eg, NCI-designated, academic, or comprehensive centers), providers at community cancer programs reported a significantly greater capacity with respect to patient-provider communication, psychosocial needs assessment, and continuity in the delivery of psychosocial care over time. Nurses and primary medical providers reported a significantly lower capacity for linking patients and families with needed psychosocial services within their respective cancer programs. They also reported a significantly higher capacity for conducting follow-up, re-evaluations, and adjustments of psychosocial treatment plans. Cancer programs are performing moderately well in terms of communicating to patients the importance of psychosocial care, identifying patient psychosocial needs, and referring patients and families to psychosocial services. They are doing less well with respect to the provision of that care over time. Findings suggest that gaps in psychosocial service capacity are a function of patient, provider, and system characteristics. These results may be useful in formulating strategies to enhance psychosocial care delivery. Cancer 2016;122:1937-45. © 2016 American Cancer Society. © 2016 American Cancer Society.

[Quality assurance in head and neck medical oncology].

Science.gov (United States)

Digue, Laurence; Pedeboscq, Stéphane

2014-05-01

In medical oncology, how can we be sure that the right drug is being administered to the right patient at the right time? The implementation of quality assurance criteria is important in medical oncology, in order to ensure that the patient receives the best treatment safely. There is very little literature about quality assurance in medical oncology, as opposed to radiotherapy or cancer surgery. Quality assurance must cover the entire patient care process, from the diagnosis, to the therapeutic decision and drug distribution, including its selection, its preparation and its delivery to the patient (administration and dosage), and finally the potential side effects and their management. The dose-intensity respect is crucial, and its reduction can negatively affect overall survival rates, as shown in breast and testis cancers for example. In head and neck medical oncology, it is essential to respect the few well-standardized recommendations and the dose-intensity, in a population with numerous comorbidities. We will first review quality assurance criteria for the general medical oncology organization and then focus on head and neck medical oncology. We will then describe administration specificities of head and neck treatments (chemoradiation, radiation plus cetuximab, postoperative chemoradiation, induction and palliative chemotherapy) as well as their follow-up. Lastly, we will offer some recommendations to improve quality assurance in head and neck medical oncology.

Laparoscopic resection for low rectal cancer: evaluation of oncological efficacy.

LENUS (Irish Health Repository)

Moran, Diarmaid C

2011-09-01

Laparoscopic resection of low rectal cancer poses significant technical difficulties for the surgeon. There is a lack of published follow-up data in relation to the surgical, oncological and survival outcomes in these patients.

Brief Distress Screening in Clinical Practice: Does it Help to Effectively Allocate Psycho-Oncological Support to Female Cancer Inpatients?

Science.gov (United States)

Hermelink, Kerstin; Höhn, Henrik; Hasmüller, Stephan; Gallwas, Julia; Härtl, Kristin; Würstlein, Rachel; Köhm, Janna

2014-05-01

The usefulness of distress screening in cancer inpatient settings has rarely been investigated. This study evaluated a brief distress screening of inpatients in a breast cancer centre and a gynaecological cancer centre. Hospitalised patients with breast or gynaecological cancers were screened with the Distress Thermometer. Patients who scored above the cut-off, were referred by the medical staff, or self-referred were offered bedside psycho-oncological counselling. Of 125 patients, 68 (54.4%) received an offer of counselling, and 62 patients (49.6%) accepted. Most of the counselling was induced by distress screening. Only 4 (3.2%) patients self-referred to the counselling service. Of the counselled patients, 65.8% stated that they had substantially benefited from psycho-oncological support; only 5.6% of the non-counselled patients indicated that they might have benefited from psycho-oncological support. Almost all patients who will accept and benefit from psycho-oncological counselling can be identified if distress screening is used in conjunction with referrals by physicians and nurses. Distress screening is a worthwhile component in a framework of psycho-oncological support in a cancer inpatient setting. It paves the way to counselling for cancer inpatients who need it and are willing to accept it but hesitate to self-refer to psycho-oncological services.

Challenges in Measuring Cost and Value in Oncology: Making It Personal.

Science.gov (United States)

Yu, Peter P

2016-01-01

Oncology patients often find themselves facing an incurable disease with limited treatment options and increasing patient fragility. The importance of patient preferences and values increases in shared decision making especially when the cost of cancer care is continuing its steep rise. As our understanding of cancer systems biology increases, we are justifiably optimistic about therapeutic improvements but recognize that this has complicated the traditional Food and Drug Administration approval of drug indications based on organ-specific cancer for a particular drug. Dynamic and agile clinical guidelines that reflect a rapidly changing knowledge base for decision-making support are needed. The American Society of Clinical Oncology (ASCO) has been working on three initiatives to tackle these complex issues. The first initiative is ASCO's collaboration with other international organizations to create a framework to assess drugs for the World Health Organization's Essential Medicines List, including nongenerics. The second initiative aims to define clinically meaningful outcomes as precision medicine expands the definition of cancers, leading to increased demand for the use of targeted drugs as single agents or in combination. The third initiative is ASCO's value framework, published in 2015, focusing on patient-physician shared decision making. The framework incorporates three parameters: 1) the meaningfulness of the clinical benefit, 2) the toxicity of the treatment, and 3) the patient's financial out-of-pocket cost. ASCO is concerned about the rising cost of cancer care when the clinical complexity and the pace of change in oncology are accelerating, and it is committed to help improve patient outcomes and value in cancer care as well as to engage the broader health care community in a process of collaborative improvement. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Radiation oncology: An Irish hospitals approach to supporting patients

Energy Technology Data Exchange (ETDEWEB)

Miller, Caragh [Cork University Hospital (Ireland)], E-mail: caragh.miller@tcd.ie

2009-02-15

Despite advances in medical technology, cancer is still one of the leading causes of death globally, leaving many patients to deal with the emotional and psychological aspects associated with cancer and its treatment [Department of Health and Children. A strategy for cancer control in Ireland. National Cancer Forum. Dublin; 2006]. The recognition and management of psychological conditions are an integral part of comprehensive cancer care. As a result, the Health Services Executive as part of the continuing expansion of Cork Radiation Oncology Department created the role of Information and Support Radiation Therapist. This post was specially created during June 2005 to facilitate the smooth entry into the treatment for patients and family members experiencing radiotherapy for the first time. Working alongside the oncology nurses and other health professionals the Information and Support Radiation Therapist aims to provide vital education/information and support to patients and their families. The provision of this new service for patients enables departments to adopt a holistic approach to treatment. This research identifies the cancer services and psychological support services in Ireland. Up-to-date audits of the new patient services established in the Cork Radiation Oncology Department and their psychological contribution towards cancer development and treatment are also discussed.

Radiation oncology: An Irish hospitals approach to supporting patients

International Nuclear Information System (INIS)

Miller, Caragh

2009-01-01

Despite advances in medical technology, cancer is still one of the leading causes of death globally, leaving many patients to deal with the emotional and psychological aspects associated with cancer and its treatment [Department of Health and Children. A strategy for cancer control in Ireland. National Cancer Forum. Dublin; 2006]. The recognition and management of psychological conditions are an integral part of comprehensive cancer care. As a result, the Health Services Executive as part of the continuing expansion of Cork Radiation Oncology Department created the role of Information and Support Radiation Therapist. This post was specially created during June 2005 to facilitate the smooth entry into the treatment for patients and family members experiencing radiotherapy for the first time. Working alongside the oncology nurses and other health professionals the Information and Support Radiation Therapist aims to provide vital education/information and support to patients and their families. The provision of this new service for patients enables departments to adopt a holistic approach to treatment. This research identifies the cancer services and psychological support services in Ireland. Up-to-date audits of the new patient services established in the Cork Radiation Oncology Department and their psychological contribution towards cancer development and treatment are also discussed

Cancer Control in Central and Eastern Europe: Current Situation and Recommendations for Improvement.

Science.gov (United States)

Vrdoljak, Eduard; Bodoky, Gyorgy; Jassem, Jacek; Popescu, Razvan A; Mardiak, Jozef; Pirker, Robert; Čufer, Tanja; Bešlija, Semir; Eniu, Alexandru; Todorović, Vladimir; Kubáčková, Kateřina; Kurteva, Galia; Tomašević, Zorica; Sallaku, Agim; Smichkoska, Snezhana; Bajić, Žarko; Šikić, Branimir I

2016-10-01

: The incidence of many cancers is higher in Western European (WE) countries, but mortality is frequently higher in Central and Eastern European (CEE) countries. A panel of oncology leaders from CEE countries participating in the South Eastern European Research Oncology Group (SEEROG) was formed in 2015, aiming to analyze the current status and trends of oncology care in CEE and to propose recommendations leading to improved care and outcomes. The SEEROG panel, meeting during the 11th Central European Oncology Congress, proposed the following: (a) national cancer control plans (NCCPs) required in all CEE countries, defining priorities in cancer care, including finance allocation considering limited health care budgets; (b) national cancer registries, describing in detail epidemiological trends; (c) efforts to strengthen comprehensive cancer centers; (d) that multidisciplinary care should be mandated by the NCCPs; (e) that smaller hospitals should be connected to multidisciplinary tumor boards via the Internet, providing access to specialized expertise; (f) nationwide primary prevention programs targeting smoking, obesity, and alcohol consumption and centrally evaluated secondary prevention programs for cervical, colorectal, and breast cancers; (g) prioritize education for all involved in cancer care, including oncology nurses, general practitioners, and palliative care providers; (h) establish outpatient care in day hospitals to reduce costs associated with the current inpatient model of care in CEE countries and to improve patients' quality of life; (i) long-term pharmacoeconomic evaluations of new therapies in CEE countries; (j) increase national oncology budgets in view of the higher mortality rates in CEE compared with WE countries; and (k) CEE countries urgently need help from the European Union to increase and monitor overall investment in cancer care. Significant differences in cancer incidence and mortality have been observed between European countries

Impact of Oncologists’ Attitudes Toward End-of-Life Care on Patients’ Access to Palliative Care

Science.gov (United States)

Cerana, Maria Agustina; Park, Minjeong; Hess, Kenneth; Bruera, Eduardo

2016-01-01

Background. It is unclear how oncologists’ attitudes toward end-of-life (EOL) care affect the delivery of care. The present study examined the association between oncologists’ EOL care attitudes and (a) timely specialist palliative care referral, (b) provision of supportive care, and (c) EOL cancer treatment decisions. Methods. We randomly surveyed 240 oncology specialists at our tertiary care cancer center to assess their attitudes toward EOL care using a score derived from the Jackson et al. qualitative conceptual framework (0 = uncomfortable and 8 = highly comfortable with EOL care). We determined the association between this score and clinicians’ report of specialist palliative care referral, provision of supportive care, and EOL cancer treatment decisions. Results. Of the 182 respondents (response rate of 76%), the median composite EOL care score was 6 (interquartile range, 5–7). A higher EOL score was significantly associated with solid tumor oncology (median 7 vs. 6 for hematologic oncology; p = .003), a greater willingness to refer patients with newly diagnosed cancer to specialist palliative care (median, 7 vs. 6; p = .01), greater comfort with symptom management (median, 6 vs. 5; p = .01), and provision of counseling (median, 7 vs. 4; p EOL care was associated with higher rates of specialist palliative care referral and self-reported primary palliative care delivery. More support and education are needed for oncologists who are less comfortable with EOL care. Implications for Practice: In the present survey of oncology specialists, most reported that they were comfortable with end-of-life (EOL) care, which was in turn, associated with greater provision of primary palliative care and higher rates of referral to specialist palliative care. The results of the present study highlight the need for more support and education for oncologists less comfortable with EOL care because their patients might receive lower levels of both primary and secondary