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Patient-centered Communication in Cancer Care Symposium

On May 15-16, 2006, the Outcomes Research Branch (ORB) and the Health Communication and Informatics Research Branch (HCIRB) organized a symposium on Patient-centered Communication (PCC) in Bethesda, MD. Participants included more than 25 researchers and practitioners from federal agencies, private sector healthcare systems, cancer centers, and other academic departments. The expert panel of researchers and practitioners represented various areas of expertise, including oncology, nursing, primary care, health services research, large delivery systems, communication and behavioral sciences, and patient advocacy.


Informational Flyer for the Patient-Centered Communication in Cancer Care monograph



Considering culture in physician-- patient communication during colorectal cancer screening.  


Racial and ethnic disparities exist in both incidence and stage detection of colorectal cancer (CRC). We hypothesized that cultural practices (i.e., communication norms and expectations) influence patients' and their physicians' understanding and talk about CRC screening. We examined 44 videotaped observations of clinic visits that included a CRC screening recommendation and transcripts from semistructured interviews that doctors and patients separately completed following the visit. We found that interpersonal relationship themes such as power distance, trust, directness/ indirectness, and an ability to listen, as well as personal health beliefs, emerged as affecting patients' definitions of provider-patient effective communication. In addition, we found that in discordant physician-patient interactions (when each is from a different ethnic group), physicians did not solicit or address cultural barriers to CRC screening and patients did not volunteer culture-related concerns regarding CRC screening. PMID:19363141

Ge Gao; Burke, Nancy; Somkin, Carol P; Pasick, Rena



Outcomes, preferences for resuscitation, and physician-patient communication among patients with metastatic colorectal cancer  

Microsoft Academic Search

Purpose: To describe characteristics, outcomes, and decision making in patients with colorectal cancer metastatic to the liver, and to examine the relationship of doctor-patient communication with patient understanding of prognosis and physician understanding of patients’ treatment preferences.Patients and Methods: The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT) was a prospective cohort study conducted at

Paul Haidet; Mary Beth Hamel; Roger B Davis; Neil Wenger; Douglas Reding; Peter S Kussin; Alfred F Connors; Joanne Lynn; Russell S Phillips



[Coping among patients with advanced cancer and medical communication].  


Advanced cancer is likely to be perceived as a non-controllable source of stress for the individual. The patient distress at this stage of the illness and the strategies he uses to cope with it need to be explored so as physical symptoms, since they are correlated with quality of life at the end-of-life. But very few recent studies have considered patient coping and quality of life in the palliative stage of cancer. For patient at advanced stage of cancer, quality of life includes the quality of death, including being prepared to death, being informed about prognosis and receiving global care. For relatives, get medical information is a key point since uncertainty is often perceived as frightening. Patient coping strategies interact with those of the physician, who has to cope with different sources of stress. Taking into account these strategies among patients with advanced cancer could facilitate a medical communication respectful of the patient's mental state, under the complex context of palliative care in oncology. PMID:23917682

Fouquet, Carine; Brédart, Anne; Bouleuc, Carole



Communication in Cancer Care (PDQ®)

Expert-reviewed information summary about communicating with the cancer patient and his or her family, including unique aspects of communication with cancer patients, factors affecting communication, and training in communication skills.


Communicating with Patients about the Use of Complementary and Integrative Medicine in Cancer Care  

Microsoft Academic Search

Communication is crucial to establishing trust with patients, gathering information, addressing patient emotions, and assisting\\u000a patients in decisions about care. The quality of communication in cancer care has been shown to affect patient satisfaction,\\u000a decision making, patient distress, and even malpractice litigation. Communication is now recognized as a core clinical skill\\u000a in medicine and in cancer care. In using a

Moshe Frenkel; Eran Ben-Arye


Hope and Probability: Patient Perspectives of the Meaning of Numerical Information in Cancer Communication  

Microsoft Academic Search

Although the complexities inherent in human communication make it a difficult target for empirical investigation and systematic interpretation, it is well recognized that patient- provider communication can have either a powerfully negative or positive influence on the experience of cancer. Drawing on an extensive data set derived from interviews with 200 cancer patients, the authors examine the impact of information

Sally Thorne; T. Gregory Hislop; Margot Kuo; Elizabeth-Anne Armstrong



Nurse-patient communication in cancer care: a review of the literature  

Microsoft Academic Search

Patients with cancer seem to experience distress particularly in the first period after diagnosis, and are likely to develop an affective disorder in the first 2 to 3 months. Communicative behaviors of nurses seem to play an important role in meeting the cognitive and affective needs of patients with cancer. This review of the literature examines the communicative behaviors of

Irma P. M. Kruijver; Ada Kerkstra; Jozien M. Bensing; Harry B. M. van de Wiel



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

ERIC Educational Resources Information Center

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

Underhill, Meghan L.; Kiviniemi, Marc T.



“You Are Not at All Bothersome” – Nurses’ Online Communication with Testicular Cancer Patients  

PubMed Central

To some extent, electronic communication has supplemented nurses’ face-to-face contact with patients over the last few years. In this paper, we report findings from a study in which we examined cancer nurses’ answers to messages from testicular cancer patients in a nurse-managed online patient-provider communication service. The aim of the study was to investigate how nurses manage to meet patients’ different questions and concerns, and what aspects of expert nursing care are demonstrated when they communicate with patients online. The content of the messages formed a continuum from practical to existential issues. In their answers, the nurses demonstrated an ability to make reflected choices between both support modalities and means of communication. The professional knowledge and care of expert cancer nurses were clearly exposed in the nurses’ answers, although they were good at adapting their professional language so that it would be understandable to the patients. PMID:24199140

Wibe, Torunn; Ekstedt, Mirjam; Hellesø, Ragnhild; Varsi, Cecilie; Ruland, Cornelia



December 2009 Special Issue on Patient-Centered Cancer Communication Research

A December 2009 special issue of Patient Education and Counseling highlighted empirical studies from across the world that inform researchers, clinicians, and policy makers about the salience of patient-clinician communication at different phases of the cancer control continuum, from prevention to end-of-life care. The papers highlight the multidisciplinary nature of cancer communication research. A variety of study designs and analytical strategies are employed. Neeraj K.


An examination of the psychosocial factors influencing colorectal cancer patients' communication of colorectal cancer patient risk with their siblings.  


This study examined psychosocial factors influencing colorectal cancer (CRC) patients' communication with their first-degree relatives regarding their CRC risk. Among a sample of CRC patients who were members of a colon registry in New York (n = 127), 60% reported discussing CRC risk with their siblings. These discussions were related to the CRC patients' age of diagnosis, such that those diagnosed before age 45 years were more likely to communicate with their siblings about CRC risk. Despite advances made in CRC prevention, compliance with screening recommendations among individuals who may be at familial risk for the disease is low. Perhaps this underrepresentation reflects how CRC patients communicate with their first-degree relatives about their potential risk for the disease. This study examined the psychosocial factors influencing whether CRC patients communicate with their siblings about CRC risk. The sample included CRC patients with siblings who enrolled in a colon disease registry at a NYC metropolitan hospital. Participants completed questionnaires regarding their current psychosocial functioning, perceived risk of sibling's development of CRC, and communication of CRC risk with their siblings. Patients were predominantly Caucasian, with a mean age of 60.4 years. Of the 127 patients, 60% engaged in discussions with their siblings regarding their CRC risk. Patients diagnosed with CRC before the age of 45 years were more likely to discuss the risk of CRC with their siblings (P < 0.01). These data suggest that CRC patients may serve as an effective vehicle to promote CRC screening and support the need for health care providers to not only educate patients of the familial risk of CRC, but to also encourage these patients to communicate this information with their siblings. PMID:19900939

Lawsin, Catalina; Duhamel, Katherine; Itzkowitz, Steven; Brown, Karen; Lim, Helen; Jandorf, Lina



Fertility Preservation and Adolescent\\/Young Adult Cancer Patients: Physician Communication Challenges  

Microsoft Academic Search

PurposeThe doctor–parent–adolescent triad is a unique communication challenge, particularly in the area of fertility preservation for adolescents with cancer. This paper provides a preliminary exploration into the barriers experienced by physicians in discussing cancer related fertility issues with patients aged 12–18.

Gwendolyn P. Quinn; Susan T. Vadaparampil



Factors Influencing Communication Between the Patients with Cancer and their Nurses in Oncology Wards  

PubMed Central

Aims: The purpose of this study was to demonstrate the factors influencing nurse-patient communication in cancer care in Iran. Materials and Methods: This study was conducted with a qualitative conventional content analysis approach in oncology wards of hospitals in Tabriz. Data was collected through purposive sampling by semi-structured deep interviews with nine patients, three family members and five nurses and analyzed simultaneously. Robustness of data analysis was evaluated by the participants and external control. Results: The main theme of the research emerged as “three-factor effects” that demonstrates all the factors related to the patient, nurse, and the organization and includes three categories of “Patient as the center of communication”, “Nurse as a human factor”, and “Organizational structures”. The first category consists of two sub-categories of “Imposed changes by the disease” and the “patient's particular characteristics”. The second category includes sub-categories of “sense of vulnerability” and “perception of professional self: Pre-requisite of patient-centered communication”. The third category consists of the sub-categories of “workload and time imbalance”, “lack of supervision”, and “impose duties in context of neglecting nurse and patient needs”. Characteristics of the patients, nurses, and care environment seemed to be the influential factors on the communication. Conclusions: In order to communicate with cancer patients effectively, changes in philosophy and culture of the care environment are essential. Nurses must receive proper trainings which meet their needs and which focus on holistic and patient-centered approach. PMID:24600177

Zamanzadeh, Vahid; Rassouli, Maryam; Abbaszadeh, Abbas; Nikanfar, Alireza; Alavi-Majd, Hamid; Ghahramanian, Akram



Evaluation of a Pilot Communication Skills Training Intervention for Minority Cancer Patients  

PubMed Central

The aim of this study was to pilot test in a minority cancer patient population a communication workshop to improve doctor-patient communication skills. Thirty-two patients participated. Eighteen evaluated a face-to-face workshop, while 14 completed surveys only. Participants in the workshop group completed the Patient Report of Communication Behavior (PRCB) before and after the workshop and a course evaluation. Participants did not differ on baseline PRCB scores. Post-test scores were significantly higher than pre-test scores (p<.01). All participants agreed or strongly agreed that they would use the communication skills; 93% agreed or strongly agreed that the skills would improve their healthcare. PMID:21966720

Bylund, Carma L.; Goytia, Elliott J.; D'Agostino, Thomas A.; Bulone, Linda; Horner, Jennifer; Li, Yuelin; Kemeny, Margaret; Ostroff, Jamie S.



Hospice Nurse Communication with Patients with Cancer and their Family Caregivers  

PubMed Central

Abstract Background Effective communication by hospice nurses enhances symptom management for the patient, reduces family caregiver burden and distress, and potentially improves bereavement adjustment. However, research has not kept pace with the rising use of hospice by patients with cancer and thus we know little about how hospice nurses communicate. Methods The overriding objective of this pilot study was to provide insight into these in-home visits. Hospice nurses audiorecorded their interactions over time with family caregivers and patients with cancer. The communication within these tapes was coded using Roter Interaction Analysis System (RIAS) and analyzed. Results We found that tape recording home hospice nurse visits was feasible. RIAS was suited to capture the general content and process of the home hospice encounter and the coded interactions show the range of topics and emotions that are evident in the dialogue. Implications and future directions for research are discussed. PMID:22339285

Reblin, Maija; Clayton, Margaret F.; Berry, Patricia; Mooney, Kathleen



Communicating bodily changes: Physicians' ways of enabling patient understanding in gastrointestinal cancer consultations.  


Objective: To explore how physicians communicatively enable patients' understanding of bodily changes in gastrointestinal cancer care consultations. Method: Two datasets were used. The first consisted of transcribed video-recorded palliative care consultations with three oncologists and six patients diagnosed with advanced gastrointestinal cancer, in the context of outpatient palliative care. The second dataset was audio-recorded transcriptions from diagnostic consultations with six surgeons and seven patients diagnosed with colorectal cancer, in the context of cancer surgery. An inductively driven and iterative analysis of interaction was performed, guided by Wetherell et al. (2001). Results: Two overarching communicative strategies were identified: (1) "visualizing strategies," with the dimensions: visible strategies (visualizing with what you actually or potentially can see), sensory strategies (visualizing with what is possible to feel), and imaginative strategies; and (2) "contrasting strategies," with the dimensions: contrasting subjective experiences and contrasting between the patient and other people. Significance of results: The visualizing and contrasting communicative strategies form parts of physicians' tacit and experience-based knowledge. The strategies employed by physicians reveal clear potentials to enable patients' understanding and sense making of bodily changes. However, these strategies need to be explicated and problematized as parts of both consultation practice and basic medical education. By means of increased awareness, physicians can more easily identify turning points in patients' levels of understanding, thereby enriching ordinary medical consultations with reflected pedagogical strategies and skills in how to dialogue in a person-centered manner. PMID:24784141

Friberg, Febe; Lidén, Eva; Håkanson, Cecilia; Ohlén, Joakim



Shame, guilt, and communication in lung cancer patients and their partners  

PubMed Central

Lung cancer patients report the highest distress levels of all cancer groups. In addition to poor prognosis, the self-blame and stigma associated with smoking might partially account for that distress and prevent patients from requesting help and communicating with their partners. The present study used innovative methods to investigate potential links of shame and guilt in lung cancer recovery with distress and marital adjustment. A specific emphasis was an examination of the impact of shame on partner communication. Lung cancer patients (n = 8) and their partners (n = 8) completed questionnaires and interviews that were videotaped. We report descriptive statistics and Spearman correlations between shame and guilt, relationship talk, marital satisfaction, distress, and smoking status. We coded the interviews for nonverbal expressions of shame. Greater self-reported shame was associated with decreased relationship-talk frequency and marital satisfaction, and with increased depression and smoking behaviour. Nonverbal shame behaviour also correlated with higher depression and increased smoking behaviour. Guilt results were more mixed. More recent smoking behaviour also correlated with higher depression. At a time when lung cancer patients often do not request help for distress, possibly because of shame, our preliminary study suggests that shame can also disrupt important partner relationships and might prevent patients from disclosing to physicians their need for psychosocial intervention and might increase their social isolation. Even if patients cannot verbally disclose their distress, nonverbal cues could potentially give clinicians an opportunity to intervene. PMID:25302043

Dirkse, D.; Lamont, L.; Li, Y.; Simoni?, A.; Bebb, G.; Giese–Davis, J.



Shame, guilt, and communication in lung cancer patients and their partners.  


Lung cancer patients report the highest distress levels of all cancer groups. In addition to poor prognosis, the self-blame and stigma associated with smoking might partially account for that distress and prevent patients from requesting help and communicating with their partners. The present study used innovative methods to investigate potential links of shame and guilt in lung cancer recovery with distress and marital adjustment. A specific emphasis was an examination of the impact of shame on partner communication. Lung cancer patients (n = 8) and their partners (n = 8) completed questionnaires and interviews that were videotaped. We report descriptive statistics and Spearman correlations between shame and guilt, relationship talk, marital satisfaction, distress, and smoking status. We coded the interviews for nonverbal expressions of shame. Greater self-reported shame was associated with decreased relationship-talk frequency and marital satisfaction, and with increased depression and smoking behaviour. Nonverbal shame behaviour also correlated with higher depression and increased smoking behaviour. Guilt results were more mixed. More recent smoking behaviour also correlated with higher depression. At a time when lung cancer patients often do not request help for distress, possibly because of shame, our preliminary study suggests that shame can also disrupt important partner relationships and might prevent patients from disclosing to physicians their need for psychosocial intervention and might increase their social isolation. Even if patients cannot verbally disclose their distress, nonverbal cues could potentially give clinicians an opportunity to intervene. PMID:25302043

Dirkse, D; Lamont, L; Li, Y; Simoni?, A; Bebb, G; Giese-Davis, J



Effects of an intervention aimed at improving nurse-patient communication in an oncology outpatient clinic. |

This study evaluated a 2-day communication skills training program in nursing care through surveys with nurses and patients before and after the training. The training had no effect on patient perception of nurse empathy and attentiveness, patients’ moods, or cancer-related self-efficacy. The training also did not significantly affect nurses on measures related to communication and work-related stress.


Advancing Research Methodology for Measuring & Monitoring Patient-centered Communication in Cancer Care

A critical step in facilitating the delivery of patient-centered communication (PCC) as part of routine cancer care delivery is creating a measurement and monitoring system that will allow for the ongoing assessment, tracking, and improvement of these six functions of patient-centered communication. To build the foundation of such a system and to advance research methodology in this area, the ORB has collaborated with the Agency for Healthcare Research and Quality (AHRQ) on a research project conducted within AHRQ's DEcIDE network.


Nurses' attitudes toward truthful communication with patients with cancer. A Greek study.  


The purpose of this study was to examine Greek nurses' attitudes toward truth-telling practices when working with cancer patients and their psychological status regarding the difficulties they face in their day-to-day communication with these patients. A self-administered questionnaire composed of 19 questions, including both multi-item scales and single-item measures, was designed for the study. For this study, 200 nurses were asked to participate, of whom 148 (74%) completed and returned the questionnaire. The questionnaire is self-administered, formulated after a thorough review of the relevant literature. The pretesting was carried out using the alpha model of reliability and the Cochran Chi Square test (Q-test), which was 545.46 (P < .0001) and showed a Cronbach alpha coefficient of 0.7148. A large percentage of the respondents (75.7%) believe that only some patients with cancer should be told the truth of their diagnosis and prognosis, although a larger percentage (89.1%) believe that the truth should be told to the relatives. Most of the respondents (66.2%) reported that is difficult to engage in open communication with the patients, because their academic education did not sufficiently train them in communication skills. Although 83.78% of the nurse respondents do not reveal that the disease is incurable, 86 (58.1%) believe that only the patient's physician should reveal the truth. These results indicate that although many Greek nurses believe that the patients should be informed and know their condition, lack of training in communication skills is a major obstacle to achieving this. Finally, this self-assessment questionnaire may provide acceptable and valid assessment of Greek nurses' perceptions and attitudes on truth telling. PMID:12464835

Georgaki, Stavroula; Kalaidopoulou, Ourania; Liarmakopoulos, Ioannis; Mystakidou, Kyriaki



Communicating cancer treatment information using the Web: utilizing the patient¿s perspective in website development.  


BackgroundOnline cancer information can support patients in making treatment decisions. However, such information may not be adequately tailored to the patient¿s perspective, particularly if healthcare professionals do not sufficiently engage patient groups when developing online information. We applied qualitative user testing during the development of a patient information website on stereotactic ablative radiotherapy (SABR), a new guideline-recommended curative treatment for early-stage lung cancer.MethodsWe recruited 27 participants who included patients referred for SABR and their relatives. A qualitative user test of the website was performed in 18 subjects, followed by an additional evaluation by users after website redesign (N¿=¿9). We primarily used the `thinking aloud¿ approach and semi-structured interviewing. Qualitative data analysis was performed to assess the main findings reported by the participants.ResultsStudy participants preferred receiving different information that had been provided initially. Problems identified with the online information related to comprehending medical terminology, understanding the scientific evidence regarding SABR, and appreciating the side-effects associated with SABR. Following redesign of the website, participants reported fewer problems with understanding content, and some additional recommendations for better online information were identified.ConclusionsOur findings indicate that input from patients and their relatives allows for a more comprehensive and usable website for providing treatment information. Such a website can facilitate improved patient participation in treatment decision-making for cancer. PMID:25481306

Hopmans, Wendy; Damman, Olga C; Timmermans, Danielle; Haasbeek, Cornelis; Slotman, Ben J; Senan, Suresh



Does the number of cancer patients' close social ties affect cancer-related information seeking through communication efficacy? Testing a mediation model.  


This study addresses whether having a broad social network of close friends equips cancer patients with increased efficacy to engage in communication about their cancer, which then leads to an increased likelihood of patients actively seeking cancer-related information. Guided by the theory of motivated information management, the study also tests whether the effect of the number of close social ties on information seeking is mediated, in part, by communication efficacy. Results are based on data collected from a randomly drawn sample from the Pennsylvania Cancer Registry of 2,013 cancer patients who completed mail surveys in the Fall of 2006. Results are consistent with a cross-sectional mediation effect in which the number of close social ties in one's social network is positively associated with communication efficacy (b = .17, p = .001), which, in turn, is positively associated with cancer-related information seeking (b = .13, p < .001). PMID:24673194

Lewis, Nehama; Martinez, Lourdes S



Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers  

PubMed Central

Background Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians’ perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers’ (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs’ views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). Methods A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006 - September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. Results CSPs’ lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients’ limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient–provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people’s distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff, providing appropriate cultural training for CSPs, cancer education for Aboriginal stakeholders, continuity of care, avoiding use of medical jargon, accommodating patients’ psychosocial and logistical needs, and in-service coordination. Conclusion Individual CSPs identified challenges in cross-cultural communication and their willingness to accommodate culture-specific needs within the wider health care system including better communication with Aboriginal patients. However, participants’ comments indicated a lack of concerted effort at the system level to address Aboriginal disadvantage in cancer outcomes. PMID:24188503



Patient-centered Communication Research

Several recent reports, including NCI's Strategic Plan for Leading the Nation and the NCI-designated cancer center directors' report Accelerating Successes Against Cancer, have recognized the salience of patient-clinician communication in optimizing cancer patients' and survivors' health outcomes.


Consultations Between Patients With Breast Cancer and Surgeons: A Pathway From Patient-Centered Communication to Reduced Hopelessness  

PubMed Central

Purpose Patient-centered communication (PCC) affects psychosocial health outcomes of patients. However, these effects are rarely direct, and our understanding of such effects are largely based on self-report (v observational) data. More information is needed on the pathways by which concrete PCC behaviors affect specific psychosocial outcomes in cancer care. We hypothesized that PCC behaviors increase the satisfaction of patients with surgeons, which, in turn, reduces the postconsultation hopelessness of patients. Patients and Methods In Portland, OR, we videotaped consultations between 147 women newly diagnosed with breast cancer and nine surgeons and administered surveys to participants immediately preconsultation and postconsultation. Consultations were coded for PCC behaviors. Multivariate regression models analyzed the association between PCC and the satisfaction of patients and between satisfaction and hopelessness. Results Levels of hopelessness of patients significantly decreased from preconsultation to postconsultation (P < .001). Two PCC behaviors (ie, patient asserting treatment preference [odds ratio {OR}, 1.50/log unit; 95% CI, 1.01 to 2.23/log unit; P = .042] and surgeon providing good/hopeful news [OR, 1.62/log unit; 95% CI, 1.01 to 2.60/log unit; P = .047]) were independently significantly associated with the satisfaction of patients with surgeons, which, in turn, independently predicted reduced levels of postconsultation hopelessness (linear change, ?0.78; 95% CI, 1.44 to ?0.12; P = .02). Conclusion Although additional research is needed with larger and more-diverse data sets, these findings suggest the possibility that concrete and trainable PCC behaviors can lower the hopelessness of patients with breast cancer indirectly through their effects on patient satisfaction with care. PMID:23233706

Robinson, Jeffrey D.; Hoover, Donald R.; Venetis, Maria K.; Kearney, Thomas J.; Street, Richard L.



Communication about symptoms and quality of life issues in patients with cancer: provider perceptions.  


This study used qualitative data collection and analysis methods to describe provider perceptions of addressing patient-initiated communication about common or sensitive symptom and quality of life issues (SQIs) in oncology. Eligible participants were health care providers who had participated in a larger trial testing a patient-centered technology to assess cancer SQIs and support self-care. Audio-recorded vignettes were simulated based on recorded clinic visits from the larger trial and presented during semi-structured cognitive interviews with each participant. Transcripts of the interviews were content analyzed. Twelve providers participated. Participants' responses included four themes: the institutional and clinical context, the complexity of addressing SQIs, strategies used to understand SQIs, and creating a plan to address SQIs. Participants felt that approaching SQIs inside and outside of the clinic required ongoing communication within a multidisciplinary team both to gather information and manage the SQI. Forming a relationship with the patient was one strategy to facilitate assessing SQIs. Most participants expressed a need for guidance about effective SQI communication. Providers perceived approaching SQIs as a routine part of interdisciplinary clinical care. The specific symptom and the complexity of its management influenced the process of assessing and managing SQIs. Findings have implications for institutional processes, training, evaluation, and program development. PMID:24748096

Underhill, Meghan L; Sheldon, Lisa Kennedy; Halpenny, Barbara; Berry, Donna L



Cancer patients’ experiences of using an Interactive Health Communication Application (IHCA)  

PubMed Central

Interactive Health Communication Applications (IHCAs) are increasingly used in health care. Studies document that IHCAs provide patients with knowledge and social support, enhance self- efficacy and can improve behavioural and clinical outcomes. However, research exploring patients’ experiences of using IHCAs has been scarce. The aim of this study was to explore cancer patients’ perspectives and experiences related to the use of an IHCA called WebChoice in their homes. Qualitative interviews were conducted with infrequent, medium and frequent IHCA users—six women and four men with breast and prostate cancer. The interviews were transcribed and analyzed inspired by interactionistic perspectives. We found that some patients’ perceived WebChoice as a “friend,” others as a “stranger.” Access to WebChoice stimulated particularly high frequency users to position themselves as “information seeking agents,” assuming an active patient role. However, to position oneself as an “active patient” was ambiguous and emotional. Feelings of “calmness”, “normalization of symptoms”, feelings of “being part of a community”, feeling “upset” and “vulnerable”, as well as “feeling supported” were identified. Interaction with WebChoice implied for some users an increased focus on illness. Our findings indicate that the interaction between patients and an IHCA such as WebChoice occurs in a variety of ways, some of which are ambivalent or conflicting. Particularly for frequent and medium frequency users, it offers support, but may at the same time reinforce an element of uncertainty in their life. Such insights should be taken into consideration in the future development of IHCAs in healthcare in general and in particular for implementation into patients’ private sphere. PMID:22582085

Grimsbø, Gro H.; Engelsrud, Gunn H.; Ruland, Cornelia M.



"What am I Going to Say Here?" The Experiences of Doctors and Nurses Communicating with Patients in a Cancer Unit.  


This paper describes a study investigating the provider-patient communication perceptions, experiences, needs, and strategies of doctors and nurses working together in a UK cancer setting. This was a qualitative study using individual interviews and focus group discussions. Interpretative phenomenological analysis was used to underpin data collection and analysis. Twenty-six staff participated in the project (18 nurses and 8 doctors). Both professional groups identified an inherent emotional strain in their daily interactions with patients. The strategies they adopted to reduce this strain fell into two main categories: (1) Handling or managing the patient to keep negative emotion at bay; and (2) Managing self to keep negative emotion at bay. These strategies allowed staff to maintain a sense of control in an emotionally stressful environment. Most believed that their communication skills were sufficient. In conclusion, communicating with and caring for cancer patients causes considerable psychosocial burden for doctors and nurses. Managing this burden influences their communication with patients. Without recognition of the need for staff to protect their own emotional well-being, communication skills training programs, emphasized in current UK cancer care guidelines, may have little impact on practice. PMID:22144970

McLean, Margaret; Cleland, Jennifer A; Worrell, Marcia; Vögele, Claus



Communication training for health professionals who care for patients with cancer: a systematic review of effectiveness  

Microsoft Academic Search

BackgroundEffective communication is increasingly recognised as a core clinical skill. However, there is evidence that health and social care professionals still lack basic communication skills.PurposeTo assess the effectiveness of different communication skills training courses for health professionals in cancer care.MethodsWe searched six computerised databases and augmented this with a follow-up of references and grey (unpublished) literature. We included all studies

Marjolein Gysels; Alison Richardson; Irene J. Higginson



A Short Communication Course for Physicians Improves the Quality of Patient Information in a Clinical Trial |

This article addresses the question of how to improve the informed consent process. The investigators tested a one-day communications course for physicians and research nurses that included lecture and role-play approaches for its ability to improve the quality of informed consent and the satisfaction of patients who enrolled in a randomized clinical trial of adjuvant treatment for breast cancer.


Are racial differences in patient-physician cancer communication and information explained by background, predisposing, and enabling factors?  


Research shows that African Americans tend to have poorer and less informative patient-physician communication than Whites. We analyzed survey data from 248 African American and 244 White cancer patients to examine whether this disadvantage could be explained by race variability on several other variables commonly reported to affect communication. These variables were organized into background, enabling, and predisposing factors, based on the Precede-Proceed Model. Multivariate regressions were used to test whether race differences in communication and information variables persisted after successively controlling for background, enabling, and predisposing factors. African American patients had higher interpersonal communication barriers than Whites, but this difference did not persist after controlling for background factors. African Americans also had higher unmet information needs and were less likely to receive the name of a cancer expert. These differences persisted after controlling for all other factors. Future research should focus on the informational disadvantages of African American patients and how such disadvantages may affect cancer treatment decisions. PMID:20432108

Manfredi, Clara; Kaiser, Karen; Matthews, Alicia K; Johnson, Timothy P



Considering racial and ethnic preferences in communication and interactions among the patient, family member, and physician following diagnosis of localized prostate cancer: study of a US population  

PubMed Central

Prostate cancer is the most commonly diagnosed cancer among American men. The multiple treatment options for localized prostate cancer and potential side effects can complicate the decision-making process. We describe the level of engagement and communication among the patient, family member, and physician (the decision-making “triad”) in the decision process prior to treatment. Using the Family and Cancer Therapy Selection (FACTS) study baseline survey data, we note racial/ethnic variations in communication among the triad. Sensitivity to and awareness of decision-making styles of both the patient and their family member (or caregiver) may enable clinicians to positively influence communication exchanges about important clinical decisions. PMID:21760749

Rim, Sun Hee; Hall, Ingrid J; Fairweather, Megan E; Fedorenko, Catherine R; Ekwueme, Donatus U; Smith, Judith Lee; Thompson, Ian M; Keane, Thomas E; Penson, David F; Moinpour, Carol M; Zeliadt, Steven B; Ramsey, Scott D



Considering racial and ethnic preferences in communication and interactions among the patient, family member, and physician following diagnosis of localized prostate cancer: study of a US population.  


Prostate cancer is the most commonly diagnosed cancer among American men. The multiple treatment options for localized prostate cancer and potential side effects can complicate the decision-making process. We describe the level of engagement and communication among the patient, family member, and physician (the decision-making "triad") in the decision process prior to treatment. Using the Family and Cancer Therapy Selection (FACTS) study baseline survey data, we note racial/ethnic variations in communication among the triad. Sensitivity to and awareness of decision-making styles of both the patient and their family member (or caregiver) may enable clinicians to positively influence communication exchanges about important clinical decisions. PMID:21760749

Rim, Sun Hee; Hall, Ingrid J; Fairweather, Megan E; Fedorenko, Catherine R; Ekwueme, Donatus U; Smith, Judith Lee; Thompson, Ian M; Keane, Thomas E; Penson, David F; Moinpour, Carol M; Zeliadt, Steven B; Ramsey, Scott D



Patient-physician communication concerning participation in cancer chemotherapy trials. |

Physicians seem to underestimate patients’ desire for information and their ability to understand it. Patients perceived obtaining as much information as possible about the trial as an asset rather than a burden. Providing detailed and comprehensive treatment information helps patients make decisions about participating in clinical trials.


Communication to Pediatric Cancer Patients and their Families: A Cultural Perspective  

PubMed Central

Background: Communication is a key component of palliative care. The area of pediatric palliative care is emotionally distressing for families and healthcare providers. Inadequate communication can increase the stress and lead to mistrust or miscommunication. Materials and Methods: Reviewing the literature on communication between physicians and patients, we identified several barriers to communication such as paternalism in medicine, inadequate training in communication skills, knowledge of the grieving process, special issues related to care of children and cultural barriers. In order to fill the void in area of cultural communication, a study questionnaire was administered to consecutive families of children receiving chemotherapy at a large, north Indian referral hospital to elicit parental views on communication. Results: Most parents had a protective attitude and favored collusion, however, appreciated truthfulness in prognostication and counseling by physicians; though parents expressed dissatisfaction on timing and lack of prior information by counseling team. Conclusion: Training programs in communication skills should teach doctors how to elicit patients’ preferences for information. Systematic training programs with feedback can decrease physicians stress and burnout. More research for understanding a culturally appropriate communication framework is needed. PMID:20859468

Seth, Tulika



Communicating about Cancer Pain

Patients with cancer may be reluctant to discuss their pain with their doctors for a variety of reasons. NCI sponsors research that examines the barriers that prevent patients from talking about pain.


[Communication with patients].  


A survey on patients' opinions about and needs for communication is reported. Most patients consider communication as an important part of nursing and recovery. Not only information is demanded, but also a discussion of problems and distress. Nurses are well requested to play a part herein. While most patients indicate that their communication demands are well cared for, there are also deficits. A considerable minority of patients has notable problems with solitude and lack of communication, they want personal help to cope with disease and help for better social integration. Special demands for more communication are indicated by younger patients and by women. Patients who feel severely ill and patients who suffer from pain, depression or fright say they need more communication about their feelings and fears. Frequent, long-term or immobile patients are less convinced that doctors and nurses know what is good for them. Patients with reduced mobility tend to express less interest in communication. A field for improvement may also be found within clinics: Quality of relationships between nurses and patients differ between clinics with a clear impact on quality of nursing and wellbeing of the patients. PMID:9456780

Kolleck, B; Huber, A; Breitmann, A; Barth, I; Kirchgässner, R



Educational Counseling in Improving Communication and Quality of Life in Spouses and Breast Cancer Patients

Anxiety Disorder; Depression; Ductal Breast Carcinoma in Situ; Lobular Breast Carcinoma in Situ; Psychosocial Effects of Cancer and Its Treatment; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer



Patient-physician communication.  


Extensive research has shown that no matter how knowledgeable the physician might be, if he/she is not able to open good communication channels with the patient, he/she may be of no help to the latter Despite this known fact and the fact that a patient-physician consultation is the most widely performed 'procedure' in a physician's professional lifetime, effective communication with the patient has been found to be sadly lacking. This review article seeks to discuss 'the what', 'the why' and 'the how' of doctor-patient communication. PMID:20099777

Asnani, M R



National Cancer Institute Funds Four Centers of Excellence in Cancer Communications Research

The National Cancer Institute (NCI) today announced plans to fund four Centers of Excellence in Cancer Communications Research (CECCR). The CECCR initiative is the centerpiece of NCI's Extraordinary Opportunity in Cancer Communications (EOCC), a broad initiative that supports research and outreach aimed at increasing the knowledge about, tools for, access to, and use of cancer communications by the public, patients, survivors, and health professionals.


Development Of An Educational Video To Improve Patient Knowledge And Communication With Their Healthcare Providers About Colorectal Cancer Screening.  


BACKGROUND: Low rates of colorectal cancer (CRC) screening persist due to individual, provider and system level barriers. PURPOSE: To develop and obtain initial feedback about a CRC screening educational video from community members and medical professionals. METHODS: Focus groups of patients were conducted prior to the development of an educational video and focus groups of patients provided initial feedback about the developed CRC screening educational video. Medical personnel reviewed the video and made recommendations prior to final editing of the video. RESULTS: Patients identified CRC screening barriers and made suggestions about the information to include in the educational video. Their suggestions included using a healthcare provider to state the importance of completing CRC screening, demonstrate how to complete the fecal occult blood test, and that men and women from diverse ethnic groups and races could be included in the same video. Participants reviewed the developed video and mentioned that their suggestions were portrayed correctly, the video was culturally appropriate, and the information presented in the video was easy to understand. Medical personnel made suggestions on ways to improve the content and the delivery of the medical information prior to final editing of the video. DISCUSSION: Participants provided valuable information in the development of an educational video to improve patient knowledge and patient-provider communication about CRC screening. The educational video developed was based on the Protection Motivation Theory and addressed the colon cancer screening barriers identified in this mostly minority and low-income patient population. Future research will determine if CRC screening increases among patients who watch the educational video. TRANSLATION TO HEALTH EDUCATION PRACTICE: Educational videos can provide important information about CRC and CRC screening to average-risk adults. PMID:20209024

Katz, Mira L; Heaner, Sarah; Reiter, Paul; van Putten, Julie; Murray, Lee; McDougle, Leon; Cegala, Donald J; Post, Douglas; David, Prabu; Slater, Michael; Paskett, Electra D



Promoting Chinese-speaking primary care physicians' communication with immigrant patients about colorectal cancer screening: a cluster randomized trial design.  


Chinese Americans underutilize colorectal cancer screening. This study evaluated a physician-based intervention guided by social cognitive theory (SCT) to inform future research involving minority physicians and patients. Twenty-five Chinese-speaking primary care physicians were randomized into intervention or usual care arms. The intervention included two 45-minute in-office training sessions paired with a dual-language communication guide detailing strategies in addressing Chinese patients' screening barriers. Physicians' feedback on the intervention, their performance data during training, and pre-post intervention survey data were collected and analyzed. Most physicians (~85%) liked the intervention materials but ~84% spent less than 20 minutes reading the guide and only 46% found the length of time for in-office training acceptable. Despite this, the intervention increased physicians' perceived communication self-efficacy with patients (p<.01). This study demonstrated the feasibility of enrolling and intervening with minority physicians. Time constraints in primary care practice should be considered in the design and implementation of interventions. PMID:25130226

Wang, Judy Huei-yu; Liang, Wenchi; Ma, Grace X; Gehan, Edmund; Wang, Haoying Echo; Ji, Cheng-Shuang; Tu, Shin-Ping; Vernon, Sally W; Mandelblatt, Jeanne S



Patient-centered Communication  

PubMed Central

OBJECTIVE To investigate patient preferences for a patient-centered or a biomedical communication style. DESIGN Randomized study. SETTING Urgent care and ambulatory medicine clinics in an academic medical center. PARTICIPANTS We recruited 250 English-speaking adult patients, excluding patients whose medical illnesses prevented evaluation of the study intervention. INTERVENTION Participants watched one of three videotaped scenarios of simulated patient-physician discussions of complementary and alternative medicine (CAM). Each participant watched two versions of the scenario (biomedical vs. patient-centered communication style) and completed written and oral questionnaires to assess outcome measurements. MEASUREMENTS AND MAIN RESULTS Main outcome measures were 1) preferences for a patient-centered versus a biomedical communication style; and 2) predictors of communication style preference. Participants who preferred the patient-centered style (69%; 95% confidence interval [CI], 63 to 75) tended to be younger (82%[51/62] for age < 30; 68%[100/148] for ages 30–59; 55%[21/38] for age > 59; P < .03), more educated (76%[54/71] for postcollege education; 73%[94/128] for some college; 49%[23/47] for high school only; P = .003), use CAM (75%[140/188] vs. 55%[33/60] for nonusers; P = .006), and have a patient-centered physician (88%[74/84] vs. 30%[16/54] for those with a biomedical physician; P < .0001). On multivariate analysis, factors independently associated with preferring the patient-centered style included younger age, use of herbal CAM, having a patient-centered physician, and rating a “doctor's interest in you as a person” as “very important.” CONCLUSIONS Given that a significant proportion of patients prefer a biomedical communication style, practicing physicians and medical educators should strive for flexible approaches to physician-patient communication. PMID:15566435

Swenson, Sara L; Buell, Stephanie; Zettler, Patti; White, Martha; Ruston, Delaney C; Lo, Bernard



Testing a Mediational Model of Communication Among Medical Staff and Families of Cancer Patients  

ERIC Educational Resources Information Center

Three structural equation models of communication between family members and medical staff were examined to understand relations among staff accessibility, inhibitory family attitudes, getting communication needs met, perceived stress, and satisfaction with communication. Compared to full and direct models, a mediational model fit best in which…

Gionta, Dana A.; Harlow, Lisa L.; Loitman, Jane E.; Leeman, Joanne M.



Cancer Patients Versus Cancer Survivors  

PubMed Central

Two studies examined the social and emotional implications of different linguistic classifications of individuals with cancer. Undergraduates were randomly assigned to rate their reactions to either cancer patients or cancer survivors. Across studies, participants held more favorable perceptions of the character of cancer survivors relative to cancer patients and displayed more positive attitudes toward the former group. In addition, participants in Study 1 reported greater willingness to interact with cancer survivors compared with cancer patients. Positive perceptions of prognosis did not appear to account for favorable attitudes toward cancer survivors; most participants in Study 2 did not assume that cancer survivors were beyond the treatment phase of their illness or cured of their disease. Findings point to a potentially powerful effect of word choice on reactions to individuals with cancer. PMID:24371366

Mosher, Catherine E.; Danoff-Burg, Sharon



Fear of Death, Mortality Communication, and Psychological Distress among Secular and Religiously Observant Family Caregivers of Terminal Cancer Patients  

ERIC Educational Resources Information Center

Previous research suggests that caregivers and terminally ill patients face substantial difficulties discussing illness and death. Existing research, however, has focused primarily on the experience of patients. The current study compared responses as well as the relative strength of association between mortality communication, fear of death, and…

Bachner, Yaacov G.; O'Rourke, Norm; Carmel, Sara



NCI Community Cancer Centers Program - Pilot Subcommittees - Communications

Community awareness of the goals and benefits of the NCCCP pilot is critical to its success. The Communications Subcommittee works with public affairs and communications representatives from the 16 participating hospitals to educate pilot communities about the local availability of the latest evidence-based cancer care and the importance of patient participation in cancer research.


Cancer Communication: Status and Future Directions  

Microsoft Academic Search

On November 7, 2005, the directors of the National Cancer Institute's (NCI's) Comprehensive Cancer Centers met to identify ways of accelerating success against cancer using current knowledge. Not surprisingly, cancer communication was identified as a focal point of research that needed to be conducted to extend the benefits of cancer knowledge throughout the population. There were three foci of communication

Bradford W. Hesse



Development of an Educational Video to Improve Patient Knowledge and Communication with Their Healthcare Providers about Colorectal Cancer Screening  

ERIC Educational Resources Information Center

Background: Low rates of colorectal cancer (CRC) screening persist due to individual, provider, and system level barriers. Purpose: To develop and obtain initial feedback about a CRC screening educational video from community members and medical professionals. Methods: Focus groups of patients were conducted prior to the development of the CRC…

Katz, Mira L.; Heaner, Sarah; Reiter, Paul; van Putten, Julie; Murray, Lee; McDougle, Leon; Cegala, Donald J.; Post, Douglas; David, Prabu; Slater, Michael; Paskett, Electra D.



Clinician-patient communication: a systematic review  

Microsoft Academic Search

Goal of Work  The goal of this work was to identify methods of clinician–patient cancer-related communication that may impact patient outcomes\\u000a associated with distress at critical points in the course of cancer care.\\u000a \\u000a \\u000a \\u000a Materials and methods  A systematic review of practice guidelines, systematic reviews, or randomized trials on this topic was conducted. Guidelines\\u000a for quality was evaluated using the Appraisal of Guidelines

Gary Rodin; Jean A. Mackay; Camilla Zimmermann; Carole Mayer; Doris Howell; Mark Katz; Jonathan Sussman; Melissa Brouwers



Communicating with patients  


... Ask your patients about their outlooks, attitudes, and motivations. Learn the patient's perspective. Talk to the patient ... beliefs. This will help you understand the patient's motivation and let you plan the best ways to ...


Anti-Smoking Communication to Preadolescents With and Without a Cancer Diagnosis: Parents and Health Care Providers as Important Communicators  

Microsoft Academic Search

A cancer diagnosis does not prevent smoking among pediatric oncology patients, and anti-smoking communications among parents and health care providers have been proposed as influencing smoking outcomes in this group. Anti-smoking communications were compared among 93 preadolescents with cancer and 402 controls. After adjusting for demographics and covariates, preadolescents with cancer were less likely than control participants to report receipt

Leslee Throckmorton-Belzer; Vida L. Tyc; Leslie A. Robinson; James L. Klosky; Shelly Lensing; Andrea K. Booth



Survivorship: tools for transitioning patients with cancer.  


The number of cancer survivors will be increasing over the next decade. Caring for this burgeoning population will place demands on oncologists and primary care providers to meet the needs of the expected large numbers of new patients as the baby-boom generation ages. Many will live beyond 5 years and possibly for decades after diagnosis. Patients experience many transitions depending on the type and stage of cancer, its treatment, and the long-term or late effects they have from the disease and its treatment. The Institute of Medicine's report, "From Cancer Patient to Cancer Survivor: Lost in Transition," recommends that patients be provided with a summary of their cancer treatment and follow-up care plan (ie, survivorship care plan [SCP]), including recommendations on healthy lifestyle behaviors and resources to promote self-care. This plan should be shared with the patient's other health care providers, including the primary care provider. This will facilitate communication among providers and with the patient, which is a key component to quality care. The American College of Surgeons Commission on Cancer has also made providing SCPs to patients at completion of treatment a quality standard. Barriers to providing SCPs have been identified and include lack of time, reimbursement, and knowledge of late treatment effects and current guidelines. Survivorship guidelines are being developed by professional organizations that may be useful for providers. This article provides some practical tools that address these recommendations to help providers and patients with transitions along the cancer trajectory. PMID:25505209

Morgan, Mary Ann; Denlinger, Crystal S



A disparity of words: racial differences in oncologist-patient communication about clinical trials. |

Skip to content The National Cancer Institute The National Institutes of Health AccrualNetTM STRATEGIES, TOOLS AND RESOURCES TO SUPPORT ACCRUAL TO CLINICAL TRIALS User menu Register Sign In Search form Search Main menu Protocol Accrual


Physician-patient communication in managed care.  

PubMed Central

The quality of physician-patient communication affects important health care outcomes. Managed care presents a number of challenges to physician-patient communication, including shorter visits, decreased continuity, and lower levels of trust. Good communication skills can help physicians create and maintain healthy relationships with patients in the face of these challenges. We describe 5 communication dilemmas that are common in managed care and review possible solutions suggested by recent literature on physician-patient communication. We also describe ways that managed care plans can promote more effective communication between physicians and patients. PMID:8553634

Gordon, G H; Baker, L; Levinson, W



Physician-patient communication in managed care.  


The quality of physician-patient communication affects important health care outcomes. Managed care presents a number of challenges to physician-patient communication, including shorter visits, decreased continuity, and lower levels of trust. Good communication skills can help physicians create and maintain healthy relationships with patients in the face of these challenges. We describe 5 communication dilemmas that are common in managed care and review possible solutions suggested by recent literature on physician-patient communication. We also describe ways that managed care plans can promote more effective communication between physicians and patients. PMID:8553634

Gordon, G H; Baker, L; Levinson, W



NCI: SBIR & STTR - Find Funding - Contracts - 262 Health Information Technology to Facilitate Patient-centered Communication in Cancer-related Care

The 2001 Institute of Medicine (IOM) report titled “Crossing the Quality Chasm” cited a need to make care “patient-centered”. To achieve that end physicians and organizations who are delivering care must begin to see medical care from the patient perspective. As outlined in a recent NCI report on Patient-Centered Communication (2007), “patient-centeredness” is a multi-dimensional concept that goes beyond the notion of satisfaction.


Verbal analysis of doctor-patient communication  

Microsoft Academic Search

A microscopic analysis of doctor-patient communication in the general practitioner's surgery is presented. Verbatim transcripts of 85 medical interviews, audiotaped in a natural situation were analysed. The effects of type of complaint, patient gender and physician gender on the process of verbal communication were assessed. This study focused upon the relational aspects of communication, using Stiles' Verbal Response Mode coding

Ludwien Meeuwesen; Cas Schaap; Cees van der Staak



Understanding patient decisions about clinical trials and the associated communication process: a preliminary report. |

This article presents a conceptual model of factors affecting patient decisions about participating in clinical trials and describes videotaping methods for observing interactions between patients, physicians, and family members. Preliminary findings suggest that awareness of the camera during videotaped conversations does not significantly alter the behavior of participants. Further study of this model and methodology may produce results that can be incorporated into provider training.


[Oral management for cancer patients].  


Chemotherapy and radiotherapy administered to cancer patients can be harmful because of their effect on normal cells as well as cancer cells, and cause many adverse events. The oral cavity is one of the sites most vulnerable to the direct and indirect effects of cancer therapy. Severe adverse events of the oral cavity can not only reduce a patient's QOL, but also disrupt cancer treatment. We discuss the concept of oral management by maintenance of the oral environment. PMID:24335358

Kishimoto, Hiromitsu; Shudo, Atsushi



Exploring resources for intrafamilial communication of cancer genetic risk: we still need to talk.  


While the importance of intrafamilial communication of hereditary cancer risk has been acknowledged, the factors that promote and act as barriers to patients disclosing their information to their families are complex and emerging. This raises the question: How are patients guided in practice to contemplate intrafamilial communication? Focusing on breast cancer, we conducted an exploratory study examining current resources supporting patients and health-care professionals, and isolated the messages surrounding intrafamilial communication of cancer risk. We find the duty for health-care professionals to counsel patients regarding intrafamilial communication is acknowledged to varying degrees by multiple actors in the cancer care delivery landscape, including health-care professional associations, health service organizations, and patient groups. A range of medical, psychosocial, and other factors underlying intrafamilial communication are acknowledged in messages to patients. Patients, however, are often referred to a single group of health-care professionals to discuss their diverse and complex needs. At the same time, messages aimed at patients appear to place the emphasis on barriers that could exist for patients contemplating intrafamilial communication, while highlighting the benefits families derive from such communication. Taken together, this points to a lack of coherence within materials directed to patients and suggests the need to do coordinated research among stakeholders to address two related issues: (1) determining who are the actors best positioned to send messages surrounding intrafamilial communication to patients and (2) addressing the content of messages conveyed in patient materials. PMID:23340514

McClellan, Kelly A; Kleiderman, Erika; Black, Lee; Bouchard, Karine; Dorval, Michel; Simard, Jacques; Knoppers, Bartha M; Avard, Denise



Two augmentative communication systems for speechless disabled patients.  


Patients may be rendered speechless because of many conditions, including cancer surgery, stroke, cerebral palsy, cervical cord and head trauma, neuromuscular paralysis, and intubation for respiratory failure. These same conditions may also be associated with decreased use of the hands, so that writing and other nonverbal forms of communication are also impaired. Lack of communication can frustrate the patient, the family, and health care personnel; increase the patient's isolation; and lead to poor patient cooperation, thus impeding progress in therapy and producing secondary psychiatric disturbances. Two communication programs that use a Commodore 64 computer are described in this paper. One communication program uses the alphabet and the other is based on the international Morse code. These programs are easy to use and inexpensive to establish, and they accommodate any switching device. PMID:2528298

Newman, G C; Sparrow, A R; Hospod, F E



Cancer Screening Among Patients With Advanced Cancer  

PubMed Central

Context Cancer screening has been integrated into routine primary care but does not benefit patients with limited life expectancy. Objective To evaluate the extent to which patients with advanced cancer continue to be screened for new cancers. Design, Setting, and Participants Utilization of cancer screening procedures (mammography, Papanicolaou test, prostate-specific antigen [PSA], and lower gastrointestinal [GI] endoscopy) was assessed in 87 736 fee-for-service Medicare enrollees aged 65 years or older diagnosed with advanced lung, colorectal, pancreatic, gastroesophageal, or breast cancer between 1998 and 2005, and reported to one of the Surveillance, Epidemiology, and End Results (SEER) tumor registries. Participants were followed up until death or December 31, 2007, whichever came first. A group of 87 307 Medicare enrollees without cancer were individually matched by age, sex, race, and SEER registry to patients with cancer and observed over the same period to evaluate screening rates in context. Demographic and clinical characteristics associated with screening were also investigated. Main Outcome Measure For each cancer screening test, utilization rates were defined as the percentage of patients who were screened following the diagnosis of an incurable cancer. Results Among women following advanced cancer diagnosis compared with controls, at least 1 screening mammogram was received by 8.9% (95% confidence interval [CI], 8.6%-9.1%) vs 22.0% (95% CI, 21.7%-22.5%); Papanicolaou test screening was received by 5.8% (95% CI, 5.6%-6.1%) vs 12.5% (95% CI, 12.2%-12.8%). Among men following advanced cancer diagnosis compared with controls, PSA test was received by 15.0% (95% CI, 14.7%-15.3%) vs 27.2% (95% CI, 26.8%-27.6%). For all patients following advanced diagnosis compared with controls, lower GI endoscopy was received by 1.7% (95% CI, 1.6%-1.8%) vs 4.7% (95% CI, 4.6%-4.9%). Screening was more frequent among patients with a recent history of screening (16.2% [95% CI, 15.4%-16.9%] of these patients had mammography, 14.7% [95% CI, 13.7%-15.6%] had a Papanicolaou test, 23.3% [95% CI, 22.6%-24.0%] had a PSA test, and 6.1% [95% CI, 5.2%-7.0%] had lower GI endoscopy). Conclusion A sizeable proportion of patients with advanced cancer continue to undergo cancer screening tests that do not have a meaningful likelihood of providing benefit. PMID:20940384

Sima, Camelia S.; Panageas, Katherine S.; Schrag, Deborah



[Marital communication and depressive symptoms in couples in which the woman has cancer of the breast].  


If doctor-patient communication is a frequent subject of research, couples communication where one partner has cancer is quite recent. Some studies deal with couples communication, but from an anecdotic perspective, without any operational measure. The aim of this paper is to study couples' communication frequency and link it to depressive symptomatology. Marital communication was assessed with three scales: frequency of general communication, frequency of communication about cancer and satisfaction with communication. About one month following surgery, 120 breast cancer patients were interviewed; only 11 partners (9%) refused to be interviewed. Results show less communication is associated with higher depressive level. Patients and partners with a passable level of communication, particularly about cancer, are clinically at risk for depression. Communicating frequently about cancer in the couple seems thus associated with a positive effect, i.e. a depressive level found in the general population. Direction of causality between frequency of marital communication and depressive symptomatology cannot be established from this study. PMID:15047460

Normand, Julie; Lasry, Jean-Claude; Margolese, Richard G; Perry, J Christopher; Fleiszer, David



Nutritional Considerations for Cancer Patients  

PubMed Central

Although weight loss is a frequent, though not invariable, component of the cancer syndrome, the associated malnutrition is a poor prognostic sign among both children and adults. This article describes the possible mechanisms of cancer cachexia; reviews the present state of nutritional support in cancer patients; identifies nutritional problems and workable approaches during the pre- and post-treatment periods; discusses the unconventional nutritional practices commonly encountered and lists resource materials for patients and families. PMID:21274086

Chen, Angela



Elderly patients with pancreatic cancer.  


Pancreatic cancer marked significant increase of incidence during the last decades in the elderly population. Despite the certain increase of incidence there are no international guidelines for elderly patients who are suffering from pancreatic cancer. During the ASCO Annual Meeting 2014, two abstracts focusing on elderly patients suffering from different histological types of pancreatic cancer were presented. The first retrospective study (Abstract #4119) showed the benefit of the systemic treatment on overall survival for elderly patients with stage IV pancreatic adenocarcinoma. The second retrospective study (Abstract #4112) demonstrates the positive effect of somatostatin analogue (octreotide-LAR) treatment on overall survival for elderly patients with neuroendocrine pancreatic carcinoma. PMID:25076333

Kougioumtzopoulou, Andromachi S; Syrigos, Kostas N; Saif, Muhammad Wasif



Cancer and Communication in the Health Care Setting: Experiences of Older Vietnamese Immigrants, A Qualitative Study  

PubMed Central

Background As patients grow older, accurate communication with health care providers about cancer becomes increasingly important. However, little is known about the cancer communication experiences of older Asian immigrants. Objective To learn about the cancer-related communication experiences of older Vietnamese immigrants from the insider perspective. Design Qualitative study (grounded theory, constant comparative method) using individual interviews with older Vietnamese immigrants with the purpose of discussing how they learn about cancer. Interviews were conducted in Vietnamese. Participants Vietnamese immigrants aged 50–70 years, recruited through community-based organizations. Most had low education and limited English proficiency. The sample size of 20 was sufficient to achieve theoretical saturation. Results We identified 3 categories of themes concerning informants’ experiences with cancer communication in the health care setting: (1) attitudes about addressing screening with providers, (2) issues/problems communicating with physicians about cancer, and (3) language/translation difficulties. There was substantial overlap between informants who mentioned each theme category, and 40% of the participants mentioned all 3 categories. Conclusion Clinicians should be aware of and act upon specific cancer communication needs/challenges of their older immigrant patients. Moreover, health care systems need to be prepared to address the needs of an increasingly multiethnic and linguistically diverse patient population. Finally, community-level interventions should address baseline knowledge deficits while encouraging immigrant patients to engage their doctors in discussions about cancer screening. PMID:18030538

Barg, Frances K.; Armstrong, Katrina; Holmes, John H.; Hornik, Robert C.



Financial Distress in Cancer Patients  

PubMed Central

Novel diagnostic and therapeutic options offer hope to cancer patients with both localized and advanced disease. However, many of these treatments are often costly and even well-insured patients can face high out-of-pocket costs. Families may also be at risk of financial distress due to lost wages and other treatment-related expenses. Research is needed to measure and characterize financial distress in cancer patients and understand how it affects their quality of life. In addition, health care providers need to be trained to counsel patients and their families so they can make patient-centered treatment decisions that reflect their preferences and values. PMID:24349677

de Souza, Jonas A.; Wong, Yu-Ning



Communication and technology in genetic counseling for familial cancer.  


When a cancer predisposing germline mutation is detected in an index case, the presence of the underlying syndrome is confirmed and the potential for predictive testing of at-risk relatives is established. However, the reporting of a positive family history does not routinely lead to communication of information about risk to close, much less distant relatives. This review summarizes information technology utilized to address penetration or 'reach' of knowledge of risk within extended families, including the use of telephone and video counseling to reach distant patients, and anticipate novel internet-based processes for communication between investigators and relatives. PMID:24355094

Lynch, H T; Snyder, C; Stacey, M; Olson, B; Peterson, S K; Buxbaum, S; Shaw, T; Lynch, P M



Communication in End-Stage Cancer: Review of the Literature and Future Research  

Microsoft Academic Search

Concerns have been raised about the quality of life and health care received by cancer patients at the end of life (EOL). Many patients die with pain and other distressing symptoms inadequately controlled, receiving burdensome, aggressive care that worsens quality of life and limits patient exposure to palliative care, such as hospice. Patient–physician communication is likely a very important determinate

Elizabeth D. Trice; Holly G. Prigerson



Future directions in research on consumer–provider communication and adherence to cancer prevention and treatment  

Microsoft Academic Search

The goal of this paper is to examine emerging issues in consumer–provider communication and patient adherence to cancer prevention, screening, diagnosis, treatment, and coping with survivorship. Many factors that have been shown to affect adherence can be supported or hindered by provider–patient communication, including the provider–patient relationship, patients’ beliefs, social and cultural norms, family and social support, mood, and behavioral

M. Robin DiMatteo



Home Care for Cancer Patients  


... be given by authorized agencies. Contact the insurance company to see which services are covered. Many national organizations, such as the American Cancer Society (ACS), offer services to cancer patients and their families. Services vary among ACS chapters; however, many of ...


A Better Patient Experience Through Better Communication  

PubMed Central

The transformation of healthcare from a seller’s market to a consumer’s market has pushed the element of patient satisfaction into the forefront of various medical facility evaluation tools, including those used by Medicare when weighing reimbursement to hospitals for patient care. Research has identified good communication skills to be a key factor in ensuring better patient outcomes, and nurturing patient satisfaction. Because of the growing amount of money at stake for patients’ satisfaction with a facility, the communication skills of individual healthcare providers are bound to impact their employees' reimbursement, bonuses, and promotion options. Although the dangers of “poor communication,” are evident: “poor communication” is a primary reason for filing a law suit in >80% of cases (Avery, 1985). Identifying the characteristics of “good communication” has been difficult. One factor that adds to the confusion is that research has found some long accepted codes of professional communication protocol to actually be counterproductive. Another factor that adds to the uncertainty is that accurate interpretations of some communication events are counterintuitive. Fortunately it has been possible to extract observable, proven, and teachable “good communication” behaviors from large-scale trials in the radiology department. The resultant Comfort Talk™ approach to communication includes rapid rapport techniques, patient-centered talking styles, and use of hypnotic language. This article overviews some of the Comfort Talk™ approaches to patients interaction and provides operational summaries of a sampling of specific Comfort Talk™ communication techniques, which nurses, technologists, and other healthcare workers can implement in their own practices. PMID:23471099

Lang, Elvira V.



An Electronic Patient Risk Communication Board  

PubMed Central

Communication failures have been identified as the root cause of the majority of medical malpractice claims and patient safety violations. We believe it is essential to share key patient risk information with healthcare team members at the patient’s bedside. In this study, we developed an electronic Patient Risk Communication Board (ePRCB) to assist in bridging the communication gap between all health care team members. The goal of the ePRCB is to effectively communicate the patient’s key risk factors, such as a fall risk or risk of aspiration, to the healthcare team and to reduce adverse events caused by communication failures. The ePRCB will transmit patient risk information and tailored interventions with easy-to-understand icons on an LCD screen at the point of care. A set of patient risk reminder icons was developed and validated by focus groups. We used the results of the evaluation to refine the icons for the ePRCB. PMID:24199109

Ohashi, Kumiko; Caligtan, Christine A.; Benoit, Angela N.; Breydo, Eugene M.; Carroll, Diane L.; Keohane, Carol A.; Bates, David W.; Dykes, John S.; Dykes, Patricia C.



Metabolism in cancer patients.  


Today still only 50% of newly diagnosed cancers can be cured. While molecular mechanisms of cell proliferation are being studied intensively, comparably little research energy, however, has been spent on unravelling metabolic interactions of cancer and host tissues. Evidence is accumulating that systemic as well as local metabolic patterns have considerable impact on tumour growth, as well as on body composition and organ functions. This may lead to new treatments in oncology. Cancer development - and recurrence - may be inhibited by physical activity, as well as by avoiding obesity, the metabolic syndrome and insulin resistance. Antineoplastic treatments induce reductions in nutritional intake and require individually tailored nutritional support. New concepts are being considered to metabolically starve or reprogram cancer cells. During palliative treatment of progressive tumours, it should be good clinical practice to avoid or treat malnutrition and chronic inflammatory states. At late stages, the primary goal should be symptomatic relief and attention to subjective individual needs. PMID:20592393

Arends, Jann



Clinical trial awareness, attitudes, and participation among patients with cancer and oncologists. |

This study reinforces the need for better communication between oncologists and cancer patients regarding clinical trials. In general, oncologists believe that patients are more fearful of trial participation than patients really are. In addition, although 84 percent of oncologists believe they discuss clinical trials with eligible patients, 81 percent of patients indicated that they were unaware of available and appropriate trials when they were exploring treatment options.


Patient-centered Care & Communication

Patient-centeredness is increasingly being recognized as a critical indicator of high-quality health care delivery. Although several definitions of patient-centeredness have been proposed in the literature, two attributes are considered central to the delivery of patient-centered care. These attributes are being responsive to patient needs and incorporating the patient's perspective and experiences in care planning and decision-making.


Childhood cancer patients at school.  


The aim of this study was to assess the school-related problems of childhood cancer patients. A cross-sectional questionnaire study for school-aged children with extracranial malignancies, in the area of Turku University Hospital serving around 1000000 people. Siblings, healthy pupils and teachers were studied as controls. 43 patients responded. None of the patients or controls was placed in special educational programmes. However, 30.8% of the patients, 15.7% of the controls and 3.7% of the siblings had required extra tutoring. The patients' results differed statistically from both the siblings' (P=0.022) and the controls' (P=0.041) results. The school marks in mathematics (P=0.05) and in foreign languages (P=0.06) tended to be worse for the patients than for the healthy controls. Bullying was reported by 31.7% of the patients, 10.9% of controls (P=0.0012) and 8.3% of the siblings (P=0.056). The biggest problem faced by the cancer patients was bullying-the patients reported approximately 3 times as much bullying as the healthy children did. It seems that there are still several aspects which need to be reconsidered when these children return to school or start their school-life as survivors of childhood cancer. Some proposals are presented. PMID:12044510

Lähteenmäki, P M; Huostila, J; Hinkka, S; Salmi, T T



Immunoregulation in pancreatic cancer patients.  


Metastatic pancreatic cancer is one of the most aggressive cancer known in man yet specific antitumor immunity has been demonstrated in lymph nodes draining the sites of pancreatic tumors. Despite this immunity, pancreatic cancer patients suffer a quick demise. To further define tumor immunity in patients with metastatic pancreatic cancer, we sought to characterize helper T cell subsets, serum cytokines, cellular cytotoxicity that is both T-cell and non-T cell mediated, as well as known tumor-derived immunosuppressive products that may be present in their peripheral blood. Significantly heightened levels of interleukin 2 (IL-2), a Th1 cytokine, were found in patients before treatment with chemotherapy while serum IL-10, a Th2 cytokine, were at significantly lower levels than observed in normal donors tested between their fifth and seventh decades of life. IL-10 levels increased progressively with age as a serum-bound protein in normal, healthy donors tested between the ages of 24 through 61. An age associated progression of increased IL-10 levels was not observed in pancreatic cancer patients. Few patients had detectable serum levels of soluble fas ligand but approximately half had elevated levels of a tumor marker, detected with the CA-15.3 assay, known as soluble MUCIN 1 (MUC1). Cell mediated cytotoxicity including T-cell mediated killing of pancreatic tumor cell lines was detected in many patients. These data suggest that pancreatic cancer patients have activated type 1 helper T cells that can support development of cell-mediated immunity, and that their sera contain lowered levels of the "anti-inflammatory" type 2 cytokine, IL-10. PMID:10478644

Plate, J M; Shott, S; Harris, J E



Strategic health communication across the continuum of breast cancer care in limited-resource countries.  


Strategic health communication is a critical component of healthcare that should be implemented across the continuum of care. Recognizing the importance of communication strategies and incorporating such strategies into healthcare policies, programs, and interventions is essential to the effective delivery of breast cancer care. The authors reviewed relevant literature and suggested practical evidence-based strategies for effective communication interventions across the continuum of care for breast cancer patients, including early detection, diagnosis, treatment, survivorship, palliative care, and end-of-life care. Examples were provided from limited-resource nations to support health communication recommendations. PMID:18837025

Kreps, Gary L; Sivaram, Rama



Discordance between Perceived and Actual Cancer Stage among Cancer Patients in Korea: A Nationwide Survey  

PubMed Central

Purpose We assessed the accuracy of communication between doctors and patients by evaluating the consistency between patient perception of cancer stage and the medical records, and analyzed the most influential factors of incongruence among cancer patients at 10 cancer centers across Korea. Methods Information was gathered from cancer patients at the National Cancer Center and nine regional cancer centers located in every province of Korea between 1 July 2008 and 31 August 2008. Data were analyzed using Pearson's ?2 test and multivariate logistic regression analysis. Results The stages of cancer reported by the 1,854 patients showed a low degree of congruence with the stages given in medical records (k?=?0.35, P<0.001). Only 57.1% of the patients had accurate knowledge of their cancer stage. In total, 18.5% underestimated their stage of disease, and the more advanced the cancer stage, the more likely they were to underestimate it, in order of local (14.2%), regional (23.7%), and distant (51.6%). Logistic regression analysis showed that congruence was lower in patients with cervical cancer (odds ratio [OR]?=?0.51, 95% confidence interval [CI]?=?0.30–0.87), recurrence (OR?=?0.64, 95% CI?=?0.50–0.83), and treatment at the National Cancer Center (OR?=?0.53, 95% CI?=?0.39–0.72). Conclusion There are knowledge gaps between patients' perceived and actual stage of cancer. Patients with cervical cancer, recurrence, and who received treatment at a regional cancer center showed less understanding of their cancer stage. PMID:24817193

Shim, Hye-Young; Park, Jong-Hyock; Kim, So-Young; Shin, Dong Wook; Shin, Ji-Yeon; Park, Bo Young; Huh, Jung-Sik; Shin, Hee-Young; Won, Young Joo; Seo, Hong Gwan



Clinical communication and patient safety.  


JCAHO says communication problems were the leading root cause of sentinel events in 2005. The reasons are manifold: a harried environment, a hierarchical staffing system and illegible handwriting, to name a few. This gatefold examines the scope of the problem, including data and risk factors, and offers some strategies for improvement. PMID:16964898

Scalise, Dagmara



Outcomes Research Branch | Stimulating Research on the Patient-Centeredness of Cancer Care

Effective patient-clinician communication is central to the delivery of high-quality care and is crucial in the cancer setting where patients face stress, uncertainty, complex information, and life-altering medical decisions.


The Effectiveness of a Patient Communication Course.  

ERIC Educational Resources Information Center

Reports data from three consecutive classes of first- year optometry students at the Southern California College of Optometry, who were tested preceding and following completion of a patient communication course. Findings indicated that students improved their ability to respond to patients and were better able to discriminate among various levels…

Marsden, Harue J.



Family Support and the Cancer Patient.  

ERIC Educational Resources Information Center

Research has shown that social support is psychologically beneficial to cancer patients, with support from families being especially important. A survey of the social support needs of 407 cancer patients and an in-depth interview study of 55 of those patients were conducted to examine issues concerning family support and cancer patients. Results…

Dakof, Gayle A.; And Others


Communication and Cancer: The Role of Health Communication Specialists in Achieving National Health Goals.  

ERIC Educational Resources Information Center

Proceeding from the implicit message promoted by the National Cancer Institute to the communication profession--expertise in health communication is central to the effort to alleviate the costs of the national burden placed on the economy because of cancer--this paper proposes the development of health communication as a career. Specifically, the…

Cline, Rebecca J.


Gastric Cancer in Young Patients  

PubMed Central

Aim. The aim of this study was to see the clinical, pathological, and demographic profile of young patients with stomach carcinoma besides association with p53. Patients and Methods. Prospective study of young patients with stomach carcinoma from January 2005 to December 2009. A total of 50 patients with age less than 40 years were studied. Results. Male female ratio was 1?:?1.08 in young patients and 2.5?:?1 in older patients. A positive family history of stomach cancer in the first degree relatives was present in 10% of young patients. Resection was possible only in 50% young patients. 26% young patients underwent only palliative gastrojejunostomy. The most common operation was lower partial gastrectomy in 68%. Amongst the intraoperative findings peritoneal metastasis was seen in 17.4% in young patients. 50% young patients presented in stage IV as per AJCC classification (P value .004; sig.). None of the patients presented as stage 1 disease in young group. Conclusion. Early detection of stomach carcinoma is very important in all patients but in young patients it is of paramount importance. PMID:24381753

Dhobi, Manzoor A.; Wani, Khursheed Alam; Parray, Fazl Qadir; Wani, Rouf A.; Peer, G. Q.; Abdullah, Safiya; Wani, Imtiyaz A.; Wani, Muneer A.; Shah, Mubashir A.; Thakur, Natasha



Effective communication about the use of complementary and integrative medicine in cancer care.  


Complementary and integrative medicine (CIM) is becoming an increasingly popular and visible component of oncology care. Many patients affected by cancer and their family members are looking for informed advice and desire communication with their physicians about CIM use. Patients affected by cancer come to discuss CIM use with intense emotions and are experiencing an existential crisis that cannot be ignored. Effective communication is crucial in establishing trust with these patients and their families. Communication is now recognized as a core clinical skill in medicine, including cancer care, and is important to the delivery of high-quality care. The quality of communication affects patient satisfaction, decision-making, patient distress and well-being, compliance, and even malpractice litigation. The communication process about CIM use requires a very sensitive approach that depends on effective communication skills, such as experience in listening, encouraging hope, and ability to convey empathy and compassion. This process can be divided into two parts: the "how" and the "what". The "how" relates to the change in clinician attitude, the process of gathering information, addressing patients' unmet needs and emotions, and dealing with uncertainty. The "what" relates to the process of information exchange while assisting patients in decisions about CIM use by using reliable information sources, leading to informed decision-making. PMID:23863085

Frenkel, Moshe; Cohen, Lorenzo



Immune imbalance in cancer patients.  


The immune status of the tumor-bearing patient remains poorly defined. In various solid-tumor-bearing patients, we demonstrated the absence of ADCC modifications in the patient in relapse or in evolution. These same patients presented a significant increase in immune complexes when compared with patients in remission. Furthermore, we noted a decreased NK activity, a decreased number of ARFC, corresponding to a helper T cell subpopulation, and a corollary increase in T-dependent suppressor activity. These results, on the whole, suggest an immune imbalance and that the helper cell-suppressor cell ratio should be investigated in greater depth within the context of the immune response in the cancer patient. PMID:6453412

Serrou, B; Gauci, L; Caraux, J; Cupissol, D; Thierry, C; Esteve, C



Do Cancer Patients Tweet? Examining the Twitter Use of Cancer Patients in Japan  

PubMed Central

Background Twitter is an interactive, real-time media that could prove useful in health care. Tweets from cancer patients could offer insight into the needs of cancer patients. Objective The objective of this study was to understand cancer patients’ social media usage and gain insight into patient needs. Methods A search was conducted of every publicly available user profile on Twitter in Japan for references to the following: breast cancer, leukemia, colon cancer, rectal cancer, colorectal cancer, uterine cancer, cervical cancer, stomach cancer, lung cancer, and ovarian cancer. We then used an application programming interface and a data mining method to conduct a detailed analysis of the tweets from cancer patients. Results Twitter user profiles included references to breast cancer (n=313), leukemia (n=158), uterine or cervical cancer (n=134), lung cancer (n=87), colon cancer (n=64), and stomach cancer (n=44). A co-occurrence network is seen for all of these cancers, and each cancer has a unique network conformation. Keywords included words about diagnosis, symptoms, and treatments for almost all cancers. Words related to social activities were extracted for breast cancer. Words related to vaccination and support from public insurance were extracted for uterine or cervical cancer. Conclusions This study demonstrates that cancer patients share information about their underlying disease, including diagnosis, symptoms, and treatments, via Twitter. This information could prove useful to health care providers. PMID:24867458

Tsuya, Atsushi; Sugawara, Yuya; Tanaka, Atsushi



Medical Interpreting: Improving Communication with Your Patients.  

ERIC Educational Resources Information Center

The guide is designed for physicians and other medical practitioners who need to work with medical interpreters to improve communication with patients. Special attention is given to the Australian context. An introductory section discusses the need for medical interpreters and explains the guide's organization. Subsequent sections address these…

Tebble, Helen


Couples' Support-Related Communication, Psychological Distress, and Relationship Satisfaction among Women with Early Stage Breast Cancer  

ERIC Educational Resources Information Center

This study examined associations between couple communication about cancer and psychological distress and relationship satisfaction of women diagnosed with early stage breast cancer. One hundred forty-eight couples completed a videotaped discussion of a cancer-related issue and a general issue. Patients completed measures of psychological distress…

Manne, Sharon; Sherman, Marne; Ross, Stephanie; Ostroff, Jamie; Heyman, Richard E.; Fox, Kevin



To know or not to know? Not the only question in familial breast cancer risk communication  

PubMed Central

Background Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in females, 5–10% of these breast cancers occur in women because of an inherited mutation. The term ‘risk’ in relation to familial cancer can have multiple meanings for both clinicians and patients. Failing to identify and address this may impair effective communication and informed decision making and adversely affect the quality of patient care. The aim of this research for the Eurocancercoms project was to explore patients' experience of risk communication in breast cancer and to investigate a mechanism for sharing these experiences using a filmed round-table discussion (RTD). Methods A filmed RTD with six women who had experience of, or some connection with familial breast cancer was conducted. Criteria for inclusion included a willingness and ability to participate in the discussion in English and to be prepared for the discussion to be hosted online with opportunities for others to view and comment. Results The main findings are presented as key themes and issues arising from the RTD. There was consistency in the group on the need for improvements to the risk communication process as a whole and in particular around onward diffusion of information i.e. ‘Telling the family’. There were differences regarding ‘wanting to know’ their genetic status. Conclusions The perception of cancer risk in the narratives stems not only from the way risks are stated, but from family history, personal experiences, cultural norms and beliefs and therefore a multifaceted approach to risk communication addressing these issues is necessary to ensure the patient fully understands the potential risks. There is a balance when attending to patient's information needs, as to what level and amount of information is required by the individual at a particular time and communicators need to be able to tailor information accordingly. PMID:22276070

Maddock, C; Schrijvers, D; Turco, MRD; Marotti, L; Sullivan, R



Thromboembolic disease in cancer patients.  


Thromboembolic events are common among patients with cancer as a consequence of cancer- and treatment-related factors. As these events are the second most frequent cause of death in this population, their prevention and treatment are important. Venous ultrasonography is the technique of choice for diagnosis, with sensitivity and specificity above 95 % in symptomatic thrombosis. Routine prophylaxis is not recommended for ambulatory patients, although it could be useful in selected cases. On the other hand, all inpatients should receive prophylactic therapy unless contraindicated. Therapy of thromboembolic disease is based on anticoagulants. Clinical trials demonstrate that the use of low-weight heparins is associated with a lower incidence of bleeding and recurrent thrombosis as compared with non-fractionated heparin or warfarin. Options for recurrent thrombosis include change to another anticoagulant agent, increasing doses of the same agent and cava filters. PMID:23430009

Hindi, Nadia; Cordero, Nazaret; Espinosa, Enrique



Oral complications in cancer patients  

SciTech Connect

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

Carl, W.



Second primary malignancies in thyroid cancer patients  

Microsoft Academic Search

The late health effects associated with radioiodine (131I) given as treatment for thyroid cancer are difficult to assess since the number of thyroid cancer patients treated at each centre is limited. The risk of second primary malignancies (SPMs) was evaluated in a European cohort of thyroid cancer patients. A common database was obtained by pooling the 2-year survivors of the

C Rubino; F de Vathaire; M E Dottorini; P Hall; C Schvartz; J E Couette; M G Dondon; M T Abbas; C Langlois; M Schlumberger



Yoga for cancer patients and survivors  

Microsoft Academic Search

BACKGROUND: Yoga has been practiced for thousands of years to improve physical and emotional well-being. Empirical research on yoga has been ongoing for several decades, including several recent studies conducted with cancer patients and survivors. METHODS: This review provides a general introduction to yoga and a detailed review of yoga research in cancer. RESULTS: Nine studies conducted with cancer patients

J. E. Bower; A. Woolery; B. Sternlieb; D. Garet



Characteristics of older newly diagnosed cancer patients refusing cancer treatments  

Microsoft Academic Search

Purpose  With the aging of the population, there will be an increase in the number of older adults diagnosed with cancer. Little is\\u000a known about the characteristics of older newly diagnosed cancer patients who refuse cancer treatment and how often they refuse.\\u000a The aim of this paper was to describe the health and functional status characteristics of patients who refused cancer

Martine T. E. Puts; Johanne Monette; Veronique Girre; Christina Wolfson; Michèle Monette; Gerald Batist; Howard Bergman



[Enteral nutrition in cancer patients].  


The significance of nutritional management in patients with malignant tumors is under-recognized due to the lack of clear evidence of a direct link with survival rate. However, for cancer patients, with markedly reduced food intake continuing for?7 days or intake of under 60% of estimated energy expenditure for?10 days, as referred to in the European Society for Clinical Nutrition and Metabolism, rapid implementation of nutritional support constitutes a clinically appropriate intervention. With regard to route of administration, as with other conditions, enteral nutritional management is recommended if the gastrointestinal tract is available. The utility of enteral immunonutrition formulae containing eicosapentaenoic acid and other forms of nutritional management has also recently been reported and further studies are anticipated. However, the principles of nutritional management for cancer patients comprise not simply weight increase or improvement in nutritional markers but the maintenance of patient QOL in ways that include alleviation of symptoms and antitumor therapy side-effects, and decreased risk of infection. Administration routes such as percutaneous endoscopic gastrostomy should therefore also be discussed from this perspective. PMID:25335700

Suzuki, Yutaka



Original Article Communication boards in critical care: patients' views B  

Microsoft Academic Search

Background: Some patients receiving mechanical ventilation experience an intensified need to communicate while their ability to do so is compromised as the endotracheal tube prevents speech. Although the use of a communication board to enhance communication with such patients has been suggested, few descriptive or empirical studies have addressed the content and format of these devices or of patients' perspectives

Lance Patak; Anna Gawlinski; Ng Irene Fung; Lynn Doering; Jill Berg; Elizabeth A. Henneman


DCCPS: HCIRB: CECCR: Centers of Excellence in Cancer Communication Research at The Cancer Research Network Cancer Communication Research Center

Along with administrative core funding, four research projects were awarded as part of the center’s establishment. In addition, a Discovery Core was funded with the goal of identifying, documenting, and assessing clinical innovations in cancer communication. This Discovery Core was then paired with a Dissemination Core to accelerate the spread of effective practices, programs, and organizational policies into health care systems.


NCI Cancer Patient Educators Listserv Unsubscribe Form

NCI Cancer Patient Educators Listserv Unsubscribe Form Name: * Email: Reason for leaving listserv: (please select one option below or describe your reason in the comments field if none of the options are appropriate) No longer involved in cancer


Could patients' coughing have communicative significance?  


Medical discourse positions patients with coughs and colds negatively, so consulting health services with 'minor' respiratory illness is therefore more accountable than for other medical problems. Patients face dilemmas since they must persuade doctors of the doctorability of their illness without being seen as hypochondriacal, and they risk losing face if doctors decide that there is nothing much wrong. It is known that the placement of non-lexical features of talk such as laughing or crying can have interactional meaning. Using a data set of video-recorded doctor-patient cough and cold consultations, this study explores whether patients' coughing could have communicative significance. The study is a qualitative analysis of 33 consultations drawing on a constructionist, sociolinguistic analytic approach. Coughing is co-ordinated with talk rather than occurring randomly. Coughing helps patients to demonstrate the doctorability of their symptoms and to legitimize their claims for medical attention. Coughing is also associated with resistance to 'no problem' diagnoses, resulting in changes in the trajectory of talk (for example, soliciting more explanation from doctors and/or re-negotiation of doctors' investigation or treatment plans). Coughing is undoubtedly a manifestation of respiratory illness, but also has communicative significance in consultations for coughs and colds. PMID:19736650

Bailey, Julia V



Access to Cancer Services for Rural Colorectal Cancer Patients  

ERIC Educational Resources Information Center

Context: Cancer care requires specialty surgical and medical resources that are less likely to be found in rural areas. Purpose: To examine the travel patterns and distances of rural and urban colorectal cancer (CRC) patients to 3 types of specialty cancer care services--surgery, medical oncology consultation, and radiation oncology consultation.…

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



The construct of breast cancer risk perception: need for a better risk communication?  

PubMed Central

Breast cancer risk assessment and communication are much neglected aspects of women’s health care. Breast cancer is the most prevalent cancer-related disease that touches the deepest of a women’s feelings and the subject thus attracts much of the attention of the media. Disease prevalence and media coverage are the roots of inappropriate breast cancer risk perception. Many women overestimate their personal breast cancer risk. Inappropriate risk perception precedes inappropriate health behaviour and it is pivotal to understand the underlying mechanisms in order to plan intervention. Whether interventions such as patient education through counselling and objective risk assessment are effective in restoring inappropriate breast cancer risk perception remains a question unanswered, but the tools to measure breast cancer risk are available and were validated. PMID:25478077

de Jonge, E. T. M.; Vlasselaer, J.; Van de Putte, G.; Schobbens, J.-C.



Using a family systems approach to investigate cancer risk communication within melanoma families  

PubMed Central

OBJECTIVE The family provides an important communication nexus for information and support exchange about family cancer history, and adoption of family-wide cancer risk reduction strategies. The goals of this study were to: 1) use the family systems theory to identify characteristics of this sample of families at increased risk of developing melanoma and 2) to relate familial characteristics to the frequency and style of familial risk communication. METHODS Participants were first-degree relatives (n=313) of melanoma patients, recruited into a family web-based intervention study. We used multivariable logistic regression models to analyze the association between family functioning and family communication. RESULTS Most participants were female (60%), with an average age of 51 years. Fifty percent of participants reported that they spoke to their relatives about melanoma risk and people were more likely to speak to their female family members. Familial adaptation, cohesion, coping, and health beliefs were strongly associated with an open style of risk communication within families. None were associated with a blocked style of risk communication. Only cohesion and adaptation were associated with the amount of risk communication that occurred within families. CONCLUSIONS Overall, individuals who came from families that were more highly cohesive, adaptable, and shared strong beliefs about melanoma risk were more likely to communicate openly about melanoma. The fact that this association was not consistent across blocked communication and communication frequency highlights the multifaceted nature of this process. Future research should focus on the interplay between different facets of communication. PMID:20119933

Harris, Julie N.; Hay, Jennifer; Kuniyuki, Alan; Asgari, Maryam M; Press, Nancy; Bowen, Deborah J.



Improving Physician-Patient Communication through Coaching of Simulated Encounters  

ERIC Educational Resources Information Center

Objective: Effective communication between physicians and their patients is important in optimizing patient care. This project tested a brief, intensive, interactive medical education intervention using coaching and standardized psychiatric patients to teach physician-patient communication to family medicine trainees. Methods: Twenty-six family…

Ravitz, Paula; Lancee, William J.; Lawson, Andrea; Maunder, Robert; Hunter, Jonathan J.; Leszcz, Molyn; McNaughton, Nancy; Pain, Clare



Familial cancer among consecutive uterine cancer patients in Sweden  

PubMed Central

Background Uterine cancer (UC) represents 5.1% of all female malignancies in Sweden. Accumulation of UC in families occurs in around 5% of cases. We wanted to identify any familial association between UC and other selected cancers and to study the frequency of Lynch,Cowden and cancer syndromes among consecutive UC patients in Sweden. Methods 481 UC patients were included. Information on the cancer diagnoses of their relatives (first- (FDRs) and second-degree (SDRs) relatives and first cousins) was obtained. The relative frequencies of different cancers among relatives were compared to those in the Swedish general cancer population in 1970 and 2010. Families that fulfilled the criteria for hereditary cancer syndromes were tested for mutations in the causative genes. Families with at least one case of UC in addition to the index patient were compared to families with no additional cases to investigate possible characteristics of putative hereditary cancer syndromes. Results There was an increased prevalence of UC in our study population compared to the Swedish general cancer population in 1970 and 2010 (6% vs. 4% and 3%, respectively). Seven families had Lynch Syndrome according to the Amsterdam II criteria. No families fulfilled the criteria for Cowden syndrome. In total 13% of index patients had at least one relative with UC and these families tended to have more cases of early onset cancer among family members. In addition, 16% of index patients were diagnosed with at least one other cancer. No families fulfilled the criteria for Cowden syndrome. Conclusion We showed a familial clustering of UC among relatives of our index patients. Of the seven families with mutation-verified Lynch Syndrome, only one had been previously diagnosed, highlighting the need to increase gynecologists’ awareness of the importance of taking family history. Our data on multiple cancers and young age of onset in families with uterine cancer is compatible with the existence of additional hereditary uterine cancer syndromes. PMID:24851142



Grantee Research Highlight: Taking Account of the Patient's Perspective when Examining the Quality of Cancer Care

Optimizing patient experiences with care is especially important in cancer because cancer care is often complex and involves communication with and coordination across providers of multiple specialties and across multiple institutional settings. Unsatisfactory interactions with the health care system pose an additional burden on patients when they are already ill and vulnerable. More importantly, less-than-optimal patient experiences can have a significant negative impact on patients’ health-related quality of life.


“Best Practice” for Patient-Centered Communication: A Narrative Review  

PubMed Central

Background Communicating with patients has long been identified as an important physician competency. More recently, there is a growing consensus regarding the components that define physician-patient communication. There continues to be emphasis on both the need to teach and to assess the communication skills of physicians. Objective This narrative review aims to summarize the work that has been conducted in physician-patient communication that supports the efficacy of good communications skills. This work may also help to define the physician-patient communication skills that need to be taught and assessed. Results A review of the literature shows it contains impressive evidence supporting positive associations between physician communication behaviors and positive patient outcomes, such as patient recall, patient understanding, and patient adherence to therapy. There is a consensus about what constitutes “best practice” for physician communication in medical encounters: (1) fostering the relationship, (2) gathering information, (3) providing information, (4) making decisions, (5) responding to emotions, and (6) enabling disease- and treatment-related behavior. Conclusions Evidence supports the importance of communication skills as a dimension of physician competence. Effort to enhance teaching of communication skills to medical trainees likely will require significant changes in instruction at undergraduate and graduate levels, as well as changes in assessing the developing communication skills of physicians. An added critical dimension is faculty understanding of the importance of communication skills, and their commitment to helping trainees develop those skills. PMID:24404300

King, Ann; Hoppe, Ruth B.



An information system to support the care for head and neck cancer patients.  


The potential of Information and communication technology (ICT) as a method to improve care is widely acknowledged. However, before ICT can be used in a specific patient population, the needs of that population must first be made explicit. In this paper we aim to explore the feasibility and functionality of an electronic information system to support head and neck (H&N) cancer care. We describe communication and information bottlenecks in supportive care for H&N cancer patients. These bottlenecks were used to determine the functionality of an electronic health information support system. We discern three perspectives of problems in H&N cancer care: lacking communication among professionals, lacking information about the disease and its treatment, and lacking supportive measures to reduce uncertainty and fear in patients. To support care, an information support system can facilitate (1). communication among all professionals involved and between professionals and patients, (2). professionals' and patients' access to information, (3). contact with fellow sufferers, and (4). early detection of patient problems by means of monitoring. Based on these analyses we subsequently built such a system and established a setting for evaluation. Information and communication technology can be tailored to address the communication and information bottlenecks in supportive H&N cancer care. As we aim to investigate whether care for H&N cancer patients may benefit from ICT, we are currently performing a clinical evaluation study. PMID:12707835

van den Brink, Jaap L; Moorman, Peter W; de Boer, Maarten F; van Bemmel, Jan H; Pruyn, Jean F A; Verwoerd, Carel D A




PubMed Central

Despite evidence that nurses may play a crucial part in the wellbeing and recovery of cancer patients by facilitating their expression of feelings, research is lacking into the emotional content of nurse–patient talk and patients' use of language in emotion disclosure. In this study, 23 participating nurses in a variety of cancer care settings were asked to tape-record their conversations with patients during daily care. A data set of 60 nurse–patient conversations was collected. Individual expression of emotion by patients was identified through interpretive literary analysis within a framework of psychodynamic theory. Overall the picture of emotion disclosure was intense. In particular, patients' use of metaphor and figurative language to express their distress was powerful and pervasive. Participating nurses demonstrated responsive skills but their responses to figurative expression were often problematic. The study provides evidence of unconscious processes in nurses' work and advocates career-long psychoanalytically informed supervision for nurses to better support them in challenging dialogue with cancer patients. Research is needed to evaluate the impact of supervision on communications with cancer patients to ensure patients have access to appropriate emotional supportive and care. PMID:24748706

Lanceley, Anne; Clark, Jill Macleod



Is exercise ignored in palliative cancer patients?  

PubMed Central

Exercise and rehabilitation approaches in palliative care programs for cancer patients affect patients’ symptoms, physical functioning, muscle strength, emotional wellbeing, psychological symptoms, functional capacities, quality of life, mortality and morbidity positively. Based on scientific data, palliative cancer patients should be recommended to participate in exercise programs. There is no standard approach to recipe an exercise regimen for a palliative cancer survivor. Studies for demonstrating the positive effects of exercising in palliative care patients are increasing in number day by day. At this point, increasing awareness about exercising in the entire team monitoring the patient and our efforts in this matter seems to be very important. PMID:25114869

Eyigor, Sibel; Akdeniz, Sedef



Guidelines Urge Exercise for Cancer Patients, Survivors

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


To worry or not to worry: breast cancer genetic counseling communication with low-income Latina immigrants.  


The purpose of this pilot study was to describe communication practices during hereditary breast cancer genetic counseling (GC) with low-income immigrant Latina patients in a public hospital setting. We utilized qualitative ethnographic methods, including direct observation of GC appointments with Latina patients at a public hospital offering free GC and BRCA testing and in-depth qualitative interviews with patients after they had received their BRCA genetic test results. Twenty-five patients participated; 20 were observed during genetic counseling appointments, and ten participated in interviews after BRCA testing with six participating in both observations and an interview. Analyses of qualitative data from observation field notes and interviews identified both strengths and limitations of current communication practices within the following themes: (1) family health history communication, (2) education regarding genes and genetics and patient information needs, (3) the purpose of the genetic test, (4) genetic test results and cancer risk, (5) building rapport and providing support, and (6) medical interpretation for monolingual Spanish speakers. As access to cancer GC expands in the public safety net settings and for the diverse populations they serve, it is critical to ensure effective communication in order for patients, whether or not they have a BRCA mutation, to understand the nature of their cancer risk and recommended methods of screening and prevention. Intervention strategies that address both structural constraints and patient-provider communication are needed to improve GC communication with immigrant Latinas, especially monolingual Spanish speakers. PMID:25148879

Joseph, Galen; Guerra, Claudia



Communication about Cancer Clinical Trials in Internet Cancer-Related Forums |

A qualitative analysis revealed that Internet-based cancer groups engage in discussion regarding clinical trials. The communication related to diverse aspects of participation and reflected the complex nature of decision making about trial participation. This abstract may be of interest for those designing interventions and recruitment procedures to promote trial participation.


Communicate with patients using common office equipment.  


Computer telephony is the technology associated with the electronic transmission of voice, fax, or other information using a computer via the telephone. Medical practices are increasingly under pressure to raise the level of customer service they offer while controlling or cutting expenses. Properly used, interactive voice technology will help a practice expand customer contact, reduce operating expenses, and increase staff efficiency. This article provides an overview of one of the most effective uses of telephony for a medical practice-patient communication systems. It looks at the benefits of such a system, lists the reasons for and advantages of using appointment reminders, and provides tips and criteria for buying a system, judging sound quality, justifying the cost, and keeping patients satisfied. PMID:10662265

Baker, L P



A Study of the Frequency and Social Determinants of Exposure to Cancer-Related Direct-to-Consumer Advertising Among Breast, Prostate, and Colorectal Cancer Patients.  


Cancer-related direct-to-consumer advertising (DTCA) is controversial because cancer treatment is complex and entails more risks and costs than typical treatments that are advertised for other conditions. Drawing from the Structural Influence Model of Communication, this study explores communication inequalities in DTCA exposure across social determinants among a population-based sample of 2013 patients diagnosed with breast, prostate, or colorectal cancers. Three survey items assessed patients' frequency of encountering ads concerning treatment alternatives for cancer, dealing with side effects of treatment, and doctors or hospitals offering services for cancer following their diagnosis. The analysis showed that overall exposure to DTCA in this study population was modest (median was once per week). Breast cancer patients reported significantly higher exposure to all three ad categories and overall DTCA exposure than prostate and colorectal cancer patients. Older patients consistently reported lower overall exposure to DTCA across the three cancer types. Other significant correlates included ethnicity (higher exposures among African American prostate cancer patients vs. White; lower exposures in Hispanic colorectal cancer patients vs. White) and cancer stage (higher exposures in Stage IV prostate cancer patients vs. Stages 0-II). Education level did not predict patients' DTCA exposure. The implications of these observed inequalities in DTCA exposure on cancer outcomes are discussed. PMID:25357119

Tan, Andy S L



Breaking bad news to patients with cancer.  


For the patient with cancer, bad news can occur several times between diagnosis and death. Patients expect honesty from professionals. Patients may choose to face up to bad news or actively deny what is happening. Nurses need to be able to deal with the patient's emotional response to bad news. PMID:8718375

Morton, R



Family consent, communication, and advance directives for cancer disclosure: a Japanese case and discussion.  

PubMed Central

The dilemma of whether and how to disclose a diagnosis of cancer or of any other terminal illness continues to be a subject of worldwide interest. We present the case of a 62-year-old Japanese woman afflicted with advanced gall bladder cancer who had previously expressed a preference not to be told a diagnosis of cancer. The treating physician revealed the diagnosis to the family first, and then told the patient: "You don't have any cancer yet, but if we don't treat you, it will progress to a cancer". In our analysis, we examine the role of family consent, communication patterns (including ambiguous disclosure), and advance directives for cancer disclosure in Japan. Finally, we explore the implications for Edmund Pellegrino's proposal of "something close to autonomy" as a universal good. PMID:10461591

Akabayashi, A; Fetters, M D; Elwyn, T S



Practice improvement, part II: update on patient communication technologies.  


Patient portals (ie, secure web-based services for patient health record access) and secure messaging to health care professionals are gaining popularity slowly. Advantages of web portals include timely communication and instruction, access to appointments and other services, and high patient satisfaction. Limitations include inappropriate use, security considerations, organizational costs, and exclusion of patients who are uncomfortable with or unable to use computers. Attention to the organization's strategic plan and office policies, patient and staff expectations, workflow and communication integration, training, marketing, and enrollment can facilitate optimal use of this technology. Other communication technologies that can enhance patient care include automated voice or text reminders and brief electronic communications. Social media provide another method of patient outreach, but privacy and access are concerns. Incorporating telehealthcare (health care provided via telephone or Internet), providing health coaching, and using interactive health communication applications can improve patient knowledge and clinical outcomes and provide social support. PMID:24261435

Roett, Michelle A; Coleman, Mary Thoesen



The Relationship of Perceived Physician Communicator Style to Patient Satisfaction.  

ERIC Educational Resources Information Center

Examines how patients' perceptions of their physicians' communicator styles were related to patient satisfaction. Identifies eight communicator styles and six dimensions of patient satisfaction. Concludes that most significant relationships were nonlinear and that different styles were related to different types of satisfaction. Discusses…

Cardello, Laura L.; And Others



Effects of Coaching Patients with Lung Cancer to Report Cancer Pain  

PubMed Central

We examined effects of sensory self-monitoring and reporting Coaching on pain-related variables in patients with lung cancer. Randomly assigned to Coached or Not-Coached groups, 215 patients had their interactions with their providers audiotaped and completed study measures pre and post intervention. Of the 151 patients who completed the 4-week study, those Coached were more likely than those Not-Coached to give their providers unsolicited sensory pain information and to mention it before their providers asked for it. The mean number of pain parameters discussed during the audiotaped clinic visit was statistically larger at study-end for the Coached group. Scores for analgesic adequacy, all pain indices except one, anxiety, depression, and catastrophizing coping were not significantly different. Although Coaching increased the amount of pain data communicated to providers by patients with lung cancer, the magnitude was small and did not lead to improved adequacy of analgesics prescribed for each patient's pain level. PMID:20164474

Wilkie, Diana J.; Werley, Harriet H.; Berry, Donna L.; Cain, Kevin C.; Huang, Hsiu-Ying; Mekwa, Julia; Lewis, Frances Marcus; Gallucci, Betty; Lin, Yu-Chuan; Chen, Angela Chia-Chen; Ko, Nai-Ying



Researching the experience of kidney cancer patients.  


The author's personal experience as a kidney cancer patient, researcher and founder of a kidney cancer support group forms the basis for consideration of the challenges involved in researching patients' experiences. The researcher needs to understand the variability of those experiences in both clinical and psychological-emotional terms, and in relation to the personal, familial and social contexts of the patient. It is also essential to define the purpose of the research and to show how an understanding of personal experiences of cancer can be used to enhance the quality of care for cancer patients. The research encounter with a patient is also in some respects a therapeutic encounter requiring a considerable degree of sensitivity on the part of the researcher. The person-centred approach of Carl Rogers is of value in supporting such an encounter. PMID:12296838

Taylor, K



Breast Cancer Drug Helps Patients with Gastric Cancer

Patients with advanced gastric cancer who received standard chemotherapy plus trastuzumab (Herceptin®) survived several months longer than those who received chemotherapy alone, according to findings presented at the 2009 ASCO meeting in Orlando.


Evaluation of New Multimedia Formats for Cancer Communications  

PubMed Central

Background Providing quality, current cancer information to cancer patients and their families is a key function of the National Cancer Institute (NCI) Web site. This information is now provided in predominantly-text format, but could be provided in formats using multimedia, including animation and sound. Since users have many choices about where to get their information, it is important to provide the information in a format that is helpful and that they prefer. Objective To pilot and evaluate multimedia strategies for future cancer-information program formats for lay users, the National Cancer Institute created new multimedia versions of existing text programs. We sought to evaluate user performance and preference on these 3 new formats and on the 2 existing text formats. Methods The National Cancer Institute's "What You Need to Know About Lung Cancer" program was the test vehicle. There were 5 testing sessions, 1 dedicated to each format. Each session lasted about 1 hour, with 9 participants per session and 45 users overall. Users were exposed to the assigned cancer program from beginning to end in 1 of 5 formats: text paperback booklet, paperback booklet formatted in HTML on the Web, spoken audio alone, spoken audio synchronized with a text Web page, and Flash multimedia (animation, spoken audio, and text). Immediately thereafter, the features and design of the 4 alternative formats were demonstrated in detail. A multiple-choice pre-test and post-test quiz on the cancer content was used to assess user learning (performance) before and after experiencing the assigned program. The quiz was administered using an Authorware software interface writing to an Access database. Users were asked to rank from 1 to 5 their preference for the 5 program formats, and provide structured and open-ended comments about usability of the 5 formats. Results Significant improvement in scores from pre-test to post-test was seen for the total study population. Average scores for users in each of the 5 format groups improved significantly. Increments in improvement, however, were not statistically different between any of the format groups. Significant improvements in quiz scores were seen irrespective of age group or education level. Of the users, 71.1% ranked the Flash program first among the 5 formats, and 84.4% rated Flash as their first or second choice. Audio was the least-preferred format, ranking fifth among 46.7% of users and first among none. Flash was ranked first among users regardless of education level, age group, or format group to which the user was assigned. Conclusions Under the pilot study conditions, users overwhelmingly preferred the Flash format to the other 4 formats. Learning occurred equally in all formats. Use of multimedia should be considered as communication strategies are developed for updating cancer content and attracting new users. PMID:14517107

Strickman-Stein, Nancy



Patient Communication: A Multidisciplinary Approach Using Animated Cartoons  

ERIC Educational Resources Information Center

Communication is a major problem in the management of patients. Miscommunication occurs frequently in populations with low reading skills, illiteracy does not completely account for the observed low rates of recall of communicated information. Transmission of the message also plays an important role. Successful strategies to improve communication

Leiner, Marie; Handal, Gilbert; Williams, Darryl



Development and Testing of Emergency Department Patient Transfer Communication Measures  

ERIC Educational Resources Information Center

Purpose: Communication problems are a major contributing factor to adverse events in hospitals. The contextual environment in small rural hospitals increases the importance of emergency department (ED) patient transfer communication quality. This study addresses the communication problems through the development and testing of ED quality…

Klingner, Jill; Moscovice, Ira



Counseling cancer patients about herbal medicine  

Microsoft Academic Search

More than half of all cancer patients now use some form of complementary\\/alternative medicine, yet the majority of these patients do not disclose this use to their physicians. Health care practitioners need to educate themselves about the complementary\\/alternative medicine products their patients are using. Eight herbal products (astragalus, essiac, Asian ginseng, Siberian ginseng, green tea, garlic, Hoxsey formula and iscador)

Michael Smith; Heather S. Boon



Nurses' experiences of communicating with hospitalized, suddenly speechless patients.  


We used a qualitative focus group design to explore the experiences and challenges of nurses who work with hospitalized patients experiencing the sudden inability to verbalize their needs, also known as sudden speechlessness. In response to open-ended questions in facilitated focus groups, 18 nurses discussed issues around the care and communication needs of suddenly speechless (SS) patients. Nurses identified multiple, commonly occurring communication challenges when caring for SS patients. They believed these challenges led to poorer recognition of patient needs, with the potential for compromised patient care. Nurses described how the lack of reliable strategies to facilitate communication sometimes resulted in negative patient outcomes, including unmet psychosocial needs and the potential that informed consent and educational issues were being inadequately addressed for the SS patients. Even experienced nurses indicated ongoing problems in communicating with SS patients, despite using a multitude of strategies, leaving many to deal with issues of frustration and role conflict. PMID:25225048

Rodriguez, Carmen S; Spring, Heather J; Rowe, Meredeth



Cancer in Patients With Gabapentin (GPRD)

Pain, Neuropathic; Epilepsy; Renal Pelvis Cancer; Pancreatic Cancer; Breast Cancer; Nervous System Cancer; Chronic Pancreatitis; Stomach Cancer; Renal Cell Carcinoma; Diabetes; Bladder Cancer; Bone and Joint Cancer; Penis Cancer; Anal Cancer; Cancer; Renal Cancer



Survival Curve for Cancer Patients Following Treatment  

Microsoft Academic Search

On the basis of experience with calculated survivorships of patients following treatment for cancer, a simple function, in terms of two physically meaningful parameters, has been evolved, which fits such survivorship data very well. These two parameters can be used to compare succinctly the mortality of two groups, different in respect of treatment, type of cancer, or other characteristics.The parameters

Joseph Berkson; Robert P. Gage



Prostate Cancer Patients Who Smoke Fare Worse  


... sharing features on this page, please enable JavaScript. Prostate Cancer Patients Who Smoke Fare Worse, Study Finds They ... 2015) Tuesday, January 27, 2015 Related MedlinePlus Pages Prostate Cancer Smoking TUESDAY, Jan. 27, 2015 (HealthDay News) -- Smoking ...


Resilience Among Patients Across the Cancer Continuum: Diverse Perspectives  

PubMed Central

Each phase of the cancer experience profoundly affects patients’ lives. Much of the literature has focused on negative consequences of cancer; however, the study of resilience may enable providers to promote more positive psychosocial outcomes before, during, and after the cancer experience. The current review describes the ways in which elements of resilience have been defined and studied at each phase of the cancer continuum. Extensive literature searches were conducted to find studies assessing resilience during one or more stages of the adult cancer continuum. For all phases of the cancer continuum, resilience descriptions included preexisting or baseline characteristics, such as demographics and personal attributes (e.g., optimism, social support), mechanisms of adaptation, such as coping and medical experiences (e.g., positive provider communication), as well as psychosocial outcomes, such as growth and quality of life. Promoting resilience is a critical element of patient psychosocial care. Nurses may enable resilience by recognizing and promoting certain baseline characteristics and optimizing mechanisms of adaptation. PMID:24476731

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



Doctor-Patient Communication in Southeast Asia: A Different Culture?  

ERIC Educational Resources Information Center

Studies of doctor-patient communication generally advocate a partnership communication style. However, in Southeast Asian settings, we often see a more one-way style with little input from the patient. We investigated factors underlying the use of a one-way consultation style by doctors in a Southeast Asian setting. We conducted a qualitative…

Claramita, Mora; Nugraheni, Mubarika D. F.; van Dalen, Jan; van der Vleuten, Cees



Incidence of Microsporidia in Cancer Patients  

Microsoft Academic Search

Introduction Microsporidia are considered opportunistic pathogens as evidenced by the significant detection in immunocompromised HIV\\/AIDS population. Cancer patients receiving chemotherapy are considered to be immunosuppressed. Materials and Methods Stool samples were collected from 311 cancer patients in the Klang Valley. Each sample underwent water–ether concentration and staining with modified trichrome stain. Results and Discussion Sixty-eight samples were positive by oil

Angela R. Lono; Suresh Kumar; Tan T. Chye



Enhancing Oncology Health Care Provider’s Sensitivity to Cultural Communication to Reduce Cancer Disparities: A Pilot Study  

PubMed Central

Under the auspices of a partnership grant to reduce cancer health disparities, Moffitt Cancer Center (MCC) partnered with the Ponce School of Medicine to identify the perceived cultural communication needs of MCC healthcare providers regarding Hispanic patients with limited or no English skills. Oncologists (N=72) at MCC were surveyed to identify the specific areas of cultural communication techniques for which they desired to receive additional training. The majority of participants (66%) endorsed an interest in obtaining training to communicate difficult issues (terminal illness, controversial diagnosis) in a manner respectful to Hispanic culture. A workshop was conducted with providers (N=55) to improve cultural communication between Hispanic patients and families focusing on culture, terminal illness, and communication strategies. Findings from a pre–post test indicate an overall positive response to the workshop. Results from this study can help inform future efforts to enhance cultural competency among health providers. PMID:21479572

Jimenez, Julio; Meade, Cathy; Muñoz-Antonia, Teresita; Gwede, Clement; Castro, Eida; Vadaparampil, Susan; Simmons, Vani; McIntyre, Jessica; Crocker, Theresa; Brandon, Thomas



Barriers to cancer care, perceived social support, and patient navigation services for korean breast cancer patients.  


The present study aimed to examine the relationships among barriers to cancer care, perceived social support, and patient navigation services (PNS) for Korean breast cancer patients. For Korean breast cancer patients, PNS are comprised of five services, including emotional, financial, information, transportation, and disease management. The study findings demonstrated that transportation and disease management barriers were directly associated with PNS, whereas emotional and financial barriers were indirectly associated with PNS through perceived social support. The current study provides a preliminary Korean patient navigation model to identify how barriers to cancer care can be reduced through social support and PNS. PMID:25588096

Lim, Jung-Won



Assessing the Older Cancer Patient  

Microsoft Academic Search

By 2030, one in every five individuals will be over the age of 65. Because the incidence of cancer increases with age, over\\u000a 60% of all new cancer cases and 80% of deaths from cancer occur in people over 65 years of age in the United States and Europe\\u000a [1–3]. Despite recent advances in geriatric care, elders still remain at

Melissa Cohen; David Reuben; Arash Naeim


Communication about Sexuality and Intimacy in Couples Affected by Lung Cancer and their Clinical Care Providers  

PubMed Central

OBJECTIVE Little is known about the effects of lung cancer on intimate and sexual relationships. This study explores health care provider, patient, and partner perspectives on: 1) the effects of lung cancer on physical and emotional intimacy, 2) the ways in which intimacy affects the experience of living with lung cancer, and 3) communication about intimacy and sexuality in the context of lung cancer. METHODS Qualitative, in-depth interviews with 8 cancer care providers and 13 married couples (ages 43–79) affected by lung cancer were conducted and audiotaped in the clinical setting. Interviews were transcribed, iteratively analyzed, and coded according to the above domains. Coding was performed independently by members of an interdisciplinary team; inter-rater reliability was assessed using the kappa statistic; and analyses were summarized by domain. RESULTS Most cancer care providers and couples affected by lung cancer believed intimacy and sexuality issues were salient, yet few reported discussing these. Couples described negative and positive effects of cancer on intimacy. Negative effects were driven by cancer or its treatment, including physical and psychological effects. Positive effects included an increase in non-coital physical closeness and appreciation of the spouse. Age was perceived as an important factor influencing the relationship between lung cancer and intimacy. CONCLUSIONS Emotional intimacy and sexuality are important concerns for couples affected by lung cancer. The findings suggest previously unrecognized positive effects of lung cancer on emotional and physical intimacy. Couples affected by lung cancer and providers believe these issues are relevant for lung cancer care. PMID:20540168

Lindau, Stacy Tessler; Surawska, Hanna; Paice, Judith; Baron, Shirley R.



The incidence of communication disorders in dysphagic patients.  


A retrospective study investigated the incidence and types of communication problems in 115 patients referred for swallowing difficulties. Each patient had a bedside swallowing evaluation completed as well as a screening of communication abilities. A formal speech-language evaluation was done when warranted and possible. Of the 115 patients, 93 had suspected swallowing problems based on the bedside evaluation done by the speech-language pathologist. Videofluoroscopy was performed on 85 of these patients. A significant positive correlation was found between communication impairments and both suspected and videofluoroscopically confirmed dysphagia. Cognitive problems were the most frequent communication impairment with dysarthria being second. Neurological diseases were the most common medical diagnoses in patients with swallowing difficulties. The case is presented for the speech-language pathologist to be the primary diagnostician and manager of both communication and oral-pharyngeal swallowing disorders whether they co-occur or not. PMID:2299837

Martin, B J; Corlew, M M



DCCPS: HCIRB: CECCR: Penn’s Center of Excellence in Cancer Communication Research, University of Pennsylvania

Skip Navigation Twitter Multimedia Home About Key Initiatives Funding Resources Tools Cancer Control & Population Sciences Home Behavioral Research Program Home Health Communication and Informatics Research Home Center of Excellence in Cancer Communication


Patient-Physician Communication About Complementary and Alternative Medicine in a Radiation Oncology Setting  

SciTech Connect

Purpose: Despite the extensive use of complementary and alternative medicine (CAM) among cancer patients, patient-physician communication regarding CAM therapies remains limited. This study quantified the extent of patient-physician communication about CAM and identified factors associated with its discussion in radiation therapy (RT) settings. Methods and Materials: We conducted a cross-sectional survey of 305 RT patients at an urban academic cancer center. Patients with different cancer types were recruited in their last week of RT. Participants self-reported their demographic characteristics, health status, CAM use, patient-physician communication regarding CAM, and rationale for/against discussing CAM therapies with physicians. Multivariate logistic regression was used to identify relationships between demographic/clinical variables and patients' discussion of CAM with radiation oncologists. Results: Among the 305 participants, 133 (43.6%) reported using CAM, and only 37 (12.1%) reported discussing CAM therapies with their radiation oncologists. In multivariate analyses, female patients (adjusted odds ratio [AOR] 0.45, 95% confidence interval [CI] 0.21-0.98) and patients with full-time employment (AOR 0.32, 95% CI 0.12-0.81) were less likely to discuss CAM with their radiation oncologists. CAM users (AOR 4.28, 95% CI 1.93-9.53) were more likely to discuss CAM with their radiation oncologists than were non-CAM users. Conclusions: Despite the common use of CAM among oncology patients, discussions regarding these treatments occur rarely in the RT setting, particularly among female and full-time employed patients. Clinicians and patients should incorporate discussions of CAM to guide its appropriate use and to maximize possible benefit while minimizing potential harm.

Ge Jin [Perelman School of Medicine at University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States)] [Perelman School of Medicine at University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Fishman, Jessica [Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States) [Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Annenberg School for Communication at University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Vapiwala, Neha [Abramson Comprehensive Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States) [Abramson Comprehensive Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Department of Radiation Oncology, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Li, Susan Q.; Desai, Krupali [Department of Family Medicine and Community Health, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States)] [Department of Family Medicine and Community Health, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Xie, Sharon X. [Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States)] [Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Mao, Jun J., E-mail: [Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Abramson Comprehensive Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Department of Family Medicine and Community Health, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States)



A metasynthesis of patient-provider communication in hospital for patients with severe communication disabilities: informing new translational research.  


Poor patient-provider communication in hospital continues to be cited as a possible causal factor in preventable adverse events for patients with severe communication disabilities. Yet to date there are no reports of empirical interventions that investigate or demonstrate an improvement in communication in hospital for these patients. The aim of this review was to synthesize the findings of research into communication in hospital for people with severe communication disabilities arising from lifelong and acquired stable conditions including cerebral palsy, autism, intellectual disability, aphasia following stroke, but excluding progressive conditions and those solely related to sensory impairments of hearing or vision. Results revealed six core strategies suggested to improve communication in hospital: (a) develop services, systems, and policies that support improved communication, (b) devote enough time to communication, (c) ensure adequate access to communication tools (nurse call systems and communication aids), (d) access personally held written health information, (e) collaborate effectively with carers, spouses, and parents, and (f) increase the communicative competence of hospital staff. Currently there are no reports that trial or validate any of these strategies specifically in hospital settings. Observational and evaluative research is needed to investigate the ecological validity of strategies proposed to improve communication. PMID:25229213

Hemsley, Bronwyn; Balandin, Susan



A Metasynthesis of Patient-Provider Communication in Hospital for Patients with Severe Communication Disabilities: Informing New Translational Research  

PubMed Central

Poor patient–provider communication in hospital continues to be cited as a possible causal factor in preventable adverse events for patients with severe communication disabilities. Yet to date there are no reports of empirical interventions that investigate or demonstrate an improvement in communication in hospital for these patients. The aim of this review was to synthesize the findings of research into communication in hospital for people with severe communication disabilities arising from lifelong and acquired stable conditions including cerebral palsy, autism, intellectual disability, aphasia following stroke, but excluding progressive conditions and those solely related to sensory impairments of hearing or vision. Results revealed six core strategies suggested to improve communication in hospital: (a) develop services, systems, and policies that support improved communication, (b) devote enough time to communication, (c) ensure adequate access to communication tools (nurse call systems and communication aids), (d) access personally held written health information, (e) collaborate effectively with carers, spouses, and parents, and (f) increase the communicative competence of hospital staff. Currently there are no reports that trial or validate any of these strategies specifically in hospital settings. Observational and evaluative research is needed to investigate the ecological validity of strategies proposed to improve communication. PMID:25229213

Balandin, Susan



Partnering against cancer today: a blueprint for coordinating efforts through communication science.  


One of the hallmarks of the communication revolution over the past decade has been its support for participation, whether that be in the active engagement of patients searching the Web for answers to vital health questions, or in the collective energies of self-organizing communities through social media. At the same time, some of the major obstacles to achieving a full and equitable reach of evidence-based cancer control knowledge have been traced back to discontinuities in communication either within clinical care or the broader public awareness system. Communication scientists from the National Cancer Institute, the Centers for Disease Control and Prevention, and the American Cancer Society joined forces in 2010 to investigate ways in which communication science can be used to improve coordination and enhance participation in cancer control for the nation. From 2010 to 2013, the three organizations worked together in 1) convening two meetings designed to assess the status of funded research in communication science, 2) completing a systematic review of literature published over the previous 10 years, and 3) authoring a blueprint for coordinated efforts using the implications of communication science. The blueprint consists of three major goals: first, to identify high-yield targets of opportunity using the health impact pyramid articulated by Centers for Disease Control and Prevention Director, Thomas Frieden; second, to leverage opportunities within the new communication environment, including the opportunities catalyzed by national efforts to create an infrastructure for evidence implementation through health information technology; and third, to assist in coordinating efforts across collaborative entities through participative media. PMID:24395998

Hesse, Bradford W; Cole, Galen E; Powe, Barbara D



Partnering Against Cancer Today: A Blueprint for Coordinating Efforts Through Communication Science  

PubMed Central

One of the hallmarks of the communication revolution over the past decade has been its support for participation, whether that be in the active engagement of patients searching the Web for answers to vital health questions, or in the collective energies of self-organizing communities through social media. At the same time, some of the major obstacles to achieving a full and equitable reach of evidence-based cancer control knowledge have been traced back to discontinuities in communication either within clinical care or the broader public awareness system. Communication scientists from the National Cancer Institute, the Centers for Disease Control and Prevention, and the American Cancer Society joined forces in 2010 to investigate ways in which communication science can be used to improve coordination and enhance participation in cancer control for the nation. From 2010 to 2013, the three organizations worked together in 1) convening two meetings designed to assess the status of funded research in communication science, 2) completing a systematic review of literature published over the previous 10 years, and 3) authoring a blueprint for coordinated efforts using the implications of communication science. The blueprint consists of three major goals: first, to identify high-yield targets of opportunity using the health impact pyramid articulated by Centers for Disease Control and Prevention Director, Thomas Frieden; second, to leverage opportunities within the new communication environment, including the opportunities catalyzed by national efforts to create an infrastructure for evidence implementation through health information technology; and third, to assist in coordinating efforts across collaborative entities through participative media. PMID:24395998



Microbial Dysbiosis in Colorectal Cancer (CRC) Patients  

PubMed Central

The composition of the human intestinal microbiota is linked to health status. The aim was to analyze the microbiota of normal and colon cancer patients in order to establish cancer-related dysbiosis. Patients and Methods Stool bacterial DNA was extracted prior to colonoscopy from 179 patients: 60 with colorectal cancer, and 119 with normal colonoscopy. Bacterial genes obtained by pyrosequencing of 12 stool samples (6 Normal and 6 Cancer) were subjected to a validated Principal Component Analysis (PCA) test. The dominant and subdominant bacterial population (C. leptum, C. coccoides, Bacteroides/Prevotella, Lactobacillus/Leuconostoc/Pediococcus groups, Bifidobacterium genus, and E. coli, and Faecalibacterium prausnitzii species) were quantified in all individuals using qPCR and specific IL17 producer cells in the intestinal mucosa were characterized using immunohistochemistry. Findings Pyrosequencing (Minimal sequence 200 nucleotide reads) revealed 80% of all sequences could be assigned to a total of 819 taxa based on default parameter of Classifier software. The phylogenetic core in Cancer individuals was different from that in Normal individuals according to the PCA analysis, with trends towards differences in the dominant and subdominant families of bacteria. Consequently, All-bacteria [log10 (bacteria/g of stool)] in Normal, and Cancer individuals were similar [11.88±0.35, and 11.80±0.56, respectively, (P?=?0.16)], according to qPCR values whereas among all dominant and subdominant species only those of Bacteroides/Prevotella were higher (All bacteria-specific bacterium; P?=?0.009) in Cancer (-1.04±0.55) than in Normal (-1.40±0.83) individuals. IL17 immunoreactive cells were significantly expressed more in the normal mucosa of cancer patients than in those with normal colonoscopy. Conclusion This is the first large series to demonstrate a composition change in the microbiota of colon cancer patients with possible impact on mucosal immune response. These data open new filed for mass screening and pathophysiology investigations. PMID:21297998

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



Non-verbal behaviour in nurse-elderly patient communication  

Microsoft Academic Search

This study explores the occurence of non-verbal communication in nurse-elderly patient interaction in two different care settings: home nursing and a home for the elderly. In a sample of 181 nursing encounters involving 47 nurses a study was made of videotaped nurse-patient communication. Six non-verbal behaviours were observed: patient-directed eyegaze, affirmative head nodding smiling, forward leaning, affective touch and instrumental

Wilma M. C. M. Caris-Verhallen; Ada Kerkstra; Jozien M. Bensing



Enhancing breast cancer communications: A cultural models approach  

Microsoft Academic Search

The present research demonstrates the utility of cultural models theory as a novel approach for understanding disparities in prevention behaviors in response to health communications. We explore the cultural model of breast cancer among low-income African American women in an in-depth qualitative study. Findings reveal a cultural model based on perceptions of ‘difference’ in the way they perceive and experience

Frances K. Barg; Sonya A. Grier



Strategic Use of Communication to Market Cancer Prevention and Control to Vulnerable Populations  

Microsoft Academic Search

There are significant challenges to communicating relevant cancer prevention and control information to health care consumers due both to the complexities of the health information to be communicated and the complexities of health communication, especially with vulnerable populations. The need for effective communication about cancer risks, early detection, prevention, care, and survivorship is particularly acute, yet also tremendously complex, for

Gary L. Kreps



Development of a Communication Protocol for Telephone Disclosure of Genetic Test Results for Cancer Predisposition  

PubMed Central

Background Dissemination of genetic testing for disease susceptibility, one application of “personalized medicine”, holds the potential to empower patients and providers through informed risk reduction and prevention recommendations. Genetic testing has become a standard practice in cancer prevention for high-risk populations. Heightened consumer awareness of “cancer genes” and genes for other diseases (eg, cardiovascular and Alzheimer’s disease), as well as the burgeoning availability of increasingly complex genomic tests (ie, multi-gene, whole-exome and -genome sequencing), has escalated interest in and demand for genetic risk assessment and the specialists who provide it. Increasing demand is expected to surpass access to genetic specialists. Thus, there is urgent need to develop effective and efficient models of delivery of genetic information that comparably balance the risks and benefits to the current standard of in-person communication. Objective The aim of this pilot study was to develop and evaluate a theoretically grounded and rigorously developed protocol for telephone communication of BRCA1/2 (breast cancer) test results that might be generalizable to genetic testing for other hereditary cancer and noncancer syndromes. Methods Stakeholder data, health communication literature, and our theoretical model grounded in Self-Regulation Theory of Health Behavior were used to develop a telephone communication protocol for the communication of BRCA1/2 genetic test results. Framework analysis of selected audiotapes of disclosure sessions and stakeholders’ feedback were utilized to evaluate the efficacy and inform refinements to this protocol. Results Stakeholder feedback (n=86) and audiotapes (38%, 33/86) of telephone disclosures revealed perceived disadvantages and challenges including environmental factors (eg, non-private environment), patient-related factors (eg, low health literacy), testing-related factors (eg, additional testing needed), and communication factors (eg, no visual cues). Resulting modifications to the communication protocol for BRCA1/2 test results included clarified patient instructions, scheduled appointments, refined visual aids, expanded disclosure checklist items, and enhanced provider training. Conclusions Analyses of stakeholders’ experiences and audiotapes of telephone disclosure of BRCA1/2 test results informed revisions to communication strategies and a protocol to enhance patient outcomes when utilizing telephone to disclose genetic test results. PMID:25355401

Egleston, Brian L; Fetzer, Dominique; Forman, Andrea; Bealin, Lisa; Rybak, Christina; Peterson, Candace; Corbman, Melanie; Albarracin, Julio; Stevens, Evelyn; Daly, Mary B; Bradbury, Angela R



JAMA Patient Page: Ovarian Cancer  


... a child. The ovaries are attached to the uterus (the womb) by the fallopian tubes. Like other ... ovarian cancer. TREATMENT Hysterectomy (surgical removal of the uterus), along with removal of both ovaries and fallopian ...


CRCHD PNP Project: Moffitt Cancer Center Patient Navigator Program

CRCHD PNP Project: Moffitt Cancer Center Patient Navigator Program  Back to CRCHD Ongoing Research PNP Project Listing Patient Navigation Research Program (PNRP) Participating Research Sites Moffitt Cancer Center Patient Navigator Program


Assessing the Nursing and Midwifery Students Competencies in Communication With Patients With Severe Communication Problems  

PubMed Central

Background: Clients with communication impairment are at risk for health disparity. Hence, health care workers should be knowledgeable and skillful in communication. However, no studies are available on Iranian nursing and midwifery students’ communication skills with patients with severe communication problems. Objectives: The present study was conducted to investigate Iranian nursing and midwifery students' competencies in communication with patients with severe communication problems. Materials and Methods: This study was performed on all senior nursing and midwifery students of Kashan University of Medical Sciences in spring 2013. Data were collected through a knowledge questionnaire and two checklists for evaluation of skills needed for communication with patients with severe communication problems. Data analysis was performed through independent samples t test, and Fisher’s exact test. Results: In total, 68.8% of the participants were female, 37.6% had a history of part-time job as a nurse or midwife. The mean score of knowledge were 4.41 ± 1.42 and 4.77 ± 1.77 for nursing and midwifery students, respectively and the difference was not significant (P = 0.312). In addition, the mean score of communication skills with deaf patients was 13.23 ± 4.68 and 11.86 ± 5.55 for nursing and midwifery students, respectively and the difference was not significant (P = 0.258). Also, the mean score of communication skills with stutter patients was 23.91 ± 4.17 and 21.25 ± 3.91 for nursing and midwifery students, respectively but the difference was not significant (P = 0.269). Conclusions: Nursing and midwifery students did not significantly differ in terms of communication with patients with severe communication problems. Most of the students had low or very low knowledge and skills in communication with patients with hearing impairment. However, they had better skills in communication with patient with speech problem. Special workshops or training programs are recommended to empower nursing and midwifery students in communication with patients with communication problems. PMID:25414902

Adib Hajbaghery, Mohsen; Rezaei Shahsavarloo, Zahra



Serum Galactosyl Transferase Levels in Patients with Advanced Cancer  

Microsoft Academic Search

Serum galactosyl transferase was significantly higher in patients with various types of cancer than in age-matched controls. The highest serum enzyme levels were observed in the breast and respiratory cancer, followed by ovarian and gastrointestinal tumours; whereas the enzyme activity in prostatic cancer patients was not significantly higher than in the control subjects. In the cancer patients the serum levels

Ifor D. Capel; Helen M. Dorrell; Donald C. Williams; Iain W. F. Hanham; Harry N. Levitt



Communication and Information Barriers to Health Assistance for Deaf Patients  

ERIC Educational Resources Information Center

In Brazil, recent regulations require changes in private and public health systems to make special services available to deaf patients. In the present article, the researchers analyze the perceptions of 25 sign language-using patients regarding this assistance. The researchers found communication difficulties between these patients and health…

Pereira, Patricia Cristina Andrade; Fortes, Paulo Antonio de Carvalho



Fertility preservation in the female cancer patient.  


Hundreds of thousands of young women are diagnosed with cancer each year, but due to advances in screening, diagnosis, and treatment, survival rates have improved dramatically. With improved survival, long-term effects of cancer treatment including infertility need to be addressed and should be discussed as soon as possible. Oncologists should be familiar with their patients' risks of infertility and available options for fertility preservation and future reproduction. J. Surg. Oncol. 2014; 110:907-911. © 2014 Wiley Periodicals, Inc. PMID:25284123

Ross, Lauren; Chung, Karine; Macdonald, Heather



Access Family Functioning and Related Factors from the Viewpoints of Male Cancer Patients  

PubMed Central

Introduction: Assessment of family functioning is essential prior to planning any family-based intervention for cancer patients. In an extensive literature review, any relevant studies related to the functions of Iranian families with cancer patient was not found. Therefore, the aims of present study were to investigate the function of Iranian families with a male cancer patient and its related factors from patients' perspectives. Methods: This was a descriptive- corelational study in which 101 men with cancer admitted to Tabriz Shahid Ghazi hospital were participated by convenience sampling method. Family assessment device was used for data collection that investigates family functioning in problem solving, communication, roles, affective involvement, affective responsiveness, behavior control, and general functioning domains. Also, demographic characteristics were collected. The higher score indicates better family functioning. Data analyzed by SPSS software version13 using descriptive and inferential statistics is including independent samples t-test, one-way ANOVA and Pearson correlation tests. Results: Male participants in this study reported inappropriate family functioning in all domains. The lower score was on communication and the higher score was on behavior control domain. There was significant statistical correlation between patients' perception of family functioning with the participants' education level and job, while, there was no significant correlation between patients' score of family functioning with age, life situation, number of children, age of senior child, marriage duration and time passed since diagnosis. Conclusion: Inappropriate family functioning reported by the male cancer patients indicates importance of providing consultation services for cancer patients and their family. PMID:25276754

Barzanjeh Atri, Shirin; Rahmani, Azad; Sheikhnejhad, Leila



ATM mutations in hereditary pancreatic cancer patients  

PubMed Central

Genome-wide sequencing identified heterozygous, constitutional, Ataxia telangiectaisa mutated (ATM) gene mutations in two kindreds with familial pancreatic cancer. Mutations segregated with disease in both kindreds and tumor analysis demonstrated LOH of the wildtype allele. Sequence analysis of an additional 166 familial pancreatic cancer probands indentified four additional patients with deleterious mutations in the ATM gene, while no deleterious mutations were identified in 190 spouse controls (p=0.046). These results indicate that ATM mutations play an important role in familial pancreatic cancer predisposition. PMID:22585167

Roberts, Nicholas J.; Jiao, Yuchen; Yu, Jun; Kopelovich, Levy; Petersen, Gloria M.; Bondy, Melissa; Gallinger, Steven; Schwartz, Ann G.; Syngal, Sapna; Cote, Michele L.; Axilbund, Jennifer; Schulick, Richard; Ali, Syed Z.; Eshleman, James R.; Velculescu, Victor; Goggins, Michael; Vogelstein, Bert; Papadopoulous, Nikolas; Hruban, Ralph H.; Kinzler, Kenneth W.; Klein, Alison P.



Improving Patient Safety Through Provider Communication Strategy Enhancements  

Microsoft Academic Search

The purpose of this study was to develop, implement, and evaluate a comprehensive provider\\/ team communication strategy, resulting in a toolkit generalizable to other settings of care. The specific aims included implementation of a structured communication tool; a standardized escalation process; daily multidisciplinary patient-centered rounds using a daily goals sheet; and team huddles. The study setting was the 477-bed medical

Rebecca Persing


Mutual patient-psychiatrist communication and the therapeutic contract  

Microsoft Academic Search

The increasing complexity and subspecialization of medicine make the patient feel lost in the anonymity and strange complexity of modern hospitals, lead to a misunderstanding of the increasing risks and impact of modern treatments, and restrict personal communication due to the prevalence of a knowledge-oriented approach, to a shortage of time, and to insufficient communication skills. All of this may

H Helmchen



Management of elderly patients with cancer.  


Whether a patient is a candidate for cancer therapy goes far beyond the person's age. To evaluate an older adult for cancer treatment, oncologists must understand the benefits and quantify the risks of the proposed treatment, determine the patient's decision-making capacity, and make the decision in collaboration with the patient's preferences and values. In her presentation at the NCCN 18th Annual Conference, Dr. Arti Hurria discussed the major components in the comprehensive geriatric assessment in the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Senior Adult Oncology, focusing on functional (rather than chronologic) age, comorbidities, nutritional status, cognitive impairment, and psychosocial support. By uncovering problems possibly left undetected on a routine history and physical examination, this assessment may lead to interventions that improve health and wellbeing in older people with cancer. PMID:23704247

Hurria, Arti



Fertility counseling of young breast cancer patients  

PubMed Central

Approximately 6% of women with breast cancer are diagnosed before the age of 40. Young age is an independent predictor of adverse outcome and most young breast cancer patients receive systemic treatment with chemotherapy, hormonal therapy or both. The loss or impairment of fertility is a potential side effect of antineoplastic treatments. Due to the rising trend to delaying pregnancy in life, an increasing proportion of young cancer patients who are yet to have a pregnancy will face the problem of iatrogenic menopause in the future. The incidence of anticancer-treatment-related ovarian failure depends on the type of chemotherapy regimen administered, the use of tamoxifen and the age of patients. It rises with increasing age, in the range of 22-61% and 61-97% in women aged <40 years and >40 years respectively. Although there is a clear trend to increasing incidence of ovarian failure with the rise in aging, there may be a small proportion of patients who became amenorrhoeic despite the very young age, thus indicating that also individual factors still unknown may affect the probability of treatment-related ovarian failure. A prompt referral of patients to reproductive counseling and a multidisciplinary team including Oncology and Reproductive Units are essential to face the management of fertility issues in cancer patients. Fertility counseling should include a detailed description of all the available techniques to preserve fertility. The main available fertility preservation techniques, standard and experimental, for young breast cancer patients include: temporary ovarian suppression during chemotherapy with gonadotropin-releasing hormone analogues, embryo cryopreservation, cryopreservation of oocytes and cryopreservation of ovarian tissue. Research efforts are still necessary to improve the efficacy and safety of the available fertility preservation strategies as well as an efficient collaboration between oncologists and gynecologists is necessary to improve patients’ access to the strategies themselves. PMID:23819030

Anserini, Paola; Levaggi, Alessia; Poggio, Francesca; Del Mastro, Lucia



Functional health literacy and the quality of physician-patient communication among diabetes patients  

Microsoft Academic Search

While patients with poor functional health literacy (FHL) have difficulties reading and comprehending written medical instructions, it is not known whether these patients also experience problems with other modes of communication, such as face-to-face encounters with primary care physicians. We enrolled 408 English- and Spanish-speaking diabetes patients to examine whether patients with inadequate FHL report worse communication than patients with

Dean Schillinger; Andrew Bindmana; Frances Wang; Anita Stewart; John Piette



Coordinating care and treatment for cancer patients.  


Survival following a diagnosis of cancer is contingent upon an interplay of factors, some non-modifiable (e.g., age, sex, genetics) and some modifiable (e.g., volitional choices) but the majority determined by circumstance (personal, social, health system context and capacity, and health policy). Accordingly, mortality and survival rates vary considerably as a function of geography, opportunity, wealth and development. Quality of life is impacted similarly, such that aspects of care related to coordination and integration of care across primary, community and specialist environments; symptom control, palliative and end-of-life care for those who will die of cancer; and survivorship challenges for those who will survive cancer, differs greatly across low, middle and high-income resource settings. Session 3 of the 4th International Cancer Control Congress (ICCC-4) focused on cancer care and treatment through three plenary presentations and five interactive workshop discussions: 1) establishing, implementing, operating and sustaining the capacity for quality cancer care; 2) the role of primary, community, and specialist care in cancer care and treatment; 3) the economics of affordable and sustainable cancer care; 4) issues around symptom control, support, and palliative/end-of-life care; and 5) issues around survivorship. A number of recommendations were proposed relating to capacity-building (standards and guidelines, protocols, new technologies and training and deployment) for safe, appropriate evidence-informed care; mapping and analysis of variations in primary, community and specialist care across countries with identification of models for effective, integrated clinical practice; the importance of considering the introduction, or expansion, of evidence-supported clinical practices from the perspectives of health economic impact, the value for health resources expended, and sustainability; capacity-building for palliative, end-of-life care and symptom control and integration of these services into national cancer control plans; the need for public education to reduce the fear and stigma associated with cancer so that patients are better able to make informed decisions regarding follow-up care and treatment; and the need to recognize the challenges and needs of survivors, their increasing number, the necessity to integrate survivorship into cancer control plans and the economic and societal value of functional survival after cancer. Discussions highlighted that coordinated care and treatment for cancer patients is both a ' systems'challenge and solution, requiring the consideration of patient and family circumstances, societal values and priorities, the functioning of the health system (access, capacity, resources, etc.) and the importance assigned to health and illness management within public policy. PMID:22631594

Yip, Cheng Har; Samiei, Massoud; Cazap, Eduardo; Rosenblatt, Eduardo; Datta, Niloy Ranjan; Camacho, Rolando; Weller, David; Pannarunothai, Supasit; Goh, Cynthia; Black, Fraser; Kaur, Ranjit; Fitch, Margaret; Sutcliffe, Catherine; Sutcliffe, Simon



JAMA Patient Page: Testicular Cancer  


... DIAGNOSIS TREATMENTS • A complete physical examination and medical history look for possible spread of testicular cancer, as well as other medical problems that may affect the treatment plan. • Complete blood count and blood chemistries including tests for serum alpha- fetoprotein, beta-human ...


Information needs of patients with cancer: results from a large study in UK cancer centres  

PubMed Central

As part of a multi-centred study evaluating a communication skills training model for clinicians, we collected information preferences using an adaptation of Cassileth's Information Needs questionnaire from a heterogeneous sample of 2331 patients. Results showed that 87% (2027) wanted all possible information, both good and bad news and 98% (2203) preferred to know whether or not their illness was cancer. Cross tabulation of responses revealed no significant differences in information preferences for tumour site or treatment aims but did show an effect of age and sex. The few 58/440 (13.2%) patients who stated that in general they preferred to leave disclosure of details up to the doctor, tended to be older patients more than 70 years of age (chi square = 26.01, df = 2, P< 0.0001), although paradoxically they still wanted to know certain specific details. In comparison to men women preferred to know the specific name of the illness (chi square = 4.9, df = 1, P< 0.02) and what were all the possible treatments (chi square = 8.26, df = 1, P< 0.004). The results from this very large sample provide conclusive evidence that the vast majority of patients with cancer want a great deal of specific information concerning their illness and treatment. Failure to disclose such information on the grounds that significant numbers of patients prefer not to know is untenable. © 2001 Cancer Research Campaign PMID:11139312

Jenkins, V; Fallowfield, L; Saul, J



Cancer Patients’ Understanding of Prognostic Information  

PubMed Central

Prognostic information is necessary for cancer patients to be fully informed about the likely course of their disease. This information is needed for practical planning and treatment decisions. This study sought to examine how cancer patients understand the prognosis information available to them. The setting is an urban safety net hospital. Six focus groups with cancer patients (N=39) were digitally recorded and transcribed verbatim then analyzed using phases of content analysis. Participants in all groups discussed the prognosis almost exclusively in terms of mortality and reported that their physicians and nurses mostly provided prognostic information in terms of months or years for survival. This finding held across all cancer types and stages. Patients tend to think of prognosis information as being only estimated limited survival and find the idea upsetting. Due to this view on prognosis, patients need further explanation regarding where the prognosis information comes from and what prognostic information can tell them in order to make use of it. PMID:24402976

Dumenci, Levent; Siminoff, Laura A.; Matsuyama, Robin K.



Assessing Stress in Cancer Patients  

PubMed Central

Using the Perceived Stress Scale (PSS), perceptions of global stress were assessed in 111 women following breast cancer surgery and at 12 and 24 months later. This is the first study to factor analyze the PSS. The PSS data were factor analyzed each time using exploratory factor analysis with oblique direct quartimin rotation. Goodness-of-fit indices (root mean square error of approximation [RMSEA]), magnitude and pattern of factor loadings, and confidence interval data revealed a two-factor solution of positive versus negative stress items. The findings, replicated across time, also indicate factor stability. Hierarchical factor analyses supported a second-order factor of “perceived stress.” This alternative factor model of the PSS is presented along with observations regarding the measure's use in cancer research. PMID:15358877

Golden-Kreutz, Deanna M.; Browne, Michael W.; Frierson, Georita M.; Andersen, Barbara L.



Antimicrobial stewardship in patients with cancer.  


Consensus guidelines recommend antimicrobial stewardship in all hospitals with the following goals in mind: appropriate and judicious use of antimicrobial agents leading to increased drug safety, reduced antimicrobial utilization, reduction in the development and selection of resistant organisms, cost containment, and improved patient outcomes. Patients with cancer, especially those with hematologic malignancies and neutropenia, develop serious infections often and receive antimicrobial therapy frequently. Consequently, there is considerable opportunity to practice antimicrobial stewardship in this population. Several antimicrobial stewardship strategies such as antimicrobial restriction, cycling, prospective audit and feedback, and de-escalation have been evaluated in patients with cancer. The primary focus has been on the prevention and treatment of bacterial infections in febrile neutropenic patients. These efforts should be expanded to include fungal, viral, and other infections. PMID:23307520

Tverdek, Frank P; Rolston, Kenneth V; Chemaly, Roy F



Central Nervous System Infections in Cancer Patients  

Microsoft Academic Search

Despite the development of effective prophylactic regimens and better antimicrobials for active infection, central nervous\\u000a system infections in cancer patients continue to be a source of significant morbidity and mortality. The combination of more\\u000a intense immunosuppression and longer survival has changed the spectrum of infections in several vulnerable populations. Patients\\u000a at highest risk for CNS infection include hematopoietic cell transplant

Amy A. Pruitt


Surgical errors and risks – the head and neck cancer patient  

PubMed Central

Head and neck surgery is one of the basic principles of head and neck cancer therapy. Surgical errors and malpractice can have fatal consequences for the treated patients. It can lead to functional impairment and has impact in future chances for disease related survival. There are many risks for head and neck surgeons that can cause errors and malpractice. To avoid surgical mistakes, thorough preoperative management of patients is mandatory. As there are ensuring operability, cautious evaluation of preoperative diagnostics and operative planning. Moreover knowledge of anatomical structures of the head and neck, of the medical studies and data as well as qualification in modern surgical techniques and the surgeons ability for critical self assessment are basic and important prerequisites for head and neck surgeons in order to make out risks and to prevent from mistakes. Additionally it is important to have profound knowledge in nutrition management of cancer patients, wound healing and to realize and to be able to deal with complications, when they occur. Despite all precaution and surgical care, errors and mistakes cannot always be avoided. For that it is important to be able to deal with mistakes and to establish an appropriate and clear communication and management for such events. The manuscript comments on recognition and prevention of risks and mistakes in the preoperative, operative and postoperative phase of head and neck cancer surgery. PMID:24403972

Harréus, Ulrich



Drug management of pain in cancer patients.  

PubMed Central

Chronic severe cancer pain is often not well controlled because both patient and physician have a poor understanding of the nature of the pain and of the actions of various potent analgesics. Physicians often fail to tailor analgesic dosages to the needs of the individual and unnecessarily limit the dosage because they have an ill founded fear that the patient will become addicted. The basis of rational management of cancer pain with drugs is an appropriate analgesic given regularly in doses adequate to suppress pain continuously. This review compares the potent analgesics and identifies and discusses those that have a role in treating chronic cancer pain. It emphasizes the value of morphine sulfate and gives information on starting and individualizing dosages and managing side effects. PMID:2856896

Tuttle, C B



NCI Community Cancer Centers Program - Related Programs - Centers of Excellence in Cancer Communications Research

The novelty and scope of this initiative reflects the enormous potential of cancer communication to improve health, and NCI's recognition that effective communications can and should be used to narrow the gap between discovery and application and to reduce health disparities among our citizens. It is expected that the Centers' interdisciplinary efforts will result in new theories, methods, and interventions, including those for diverse populations.


Palliative care in patients with lung cancer  

PubMed Central

Lung cancer accounts for 12% of all cancers and has the highest annual rate of mortality in men and women. The overall aim is cure or prolongation of life without evidence of disease. Almost 60% of patients at the moment of diagnosis are not eligible for radical treatment. Therefore soothing and supportive treatment is the only treatment of choice. Patients with lung cancer who have symptoms of dyspnea, chronic cough, severe pain, exhaustion and cachexia syndrome, fear and depression and significantly reduced physical and intellectual activities are qualified for inpatient or home palliative care. Knowledge about various methods used in palliative treatment allows one to alleviate symptoms that occur in an advanced stage of disease with an expected short survival period. Methods of oncological treatment that are often used in patients with advanced lung cancer include radiotherapy and chemotherapy. Drawing attention to the earlier implementation of palliative care is an objective of research carried out during recent years. Advances in surgical and conservative treatment of these patients have contributed to better outcomes and longer survival time. PMID:24596508

Farbicka, Paulina



Cancer Treatment Costs Weigh Heavily on Patients, Study Finds  


... sharing features on this page, please enable JavaScript. Cancer Treatment Costs Weigh Heavily on Patients, Study Finds Researchers ... Dec. 19, 2014 (HealthDay News) -- The cost of cancer treatment can cause financial stress that threatens patients' well- ...


Patients' perspectives on the role of their general practitioner after receiving an advanced cancer diagnosis.  


The aim of this study was to explore patients' perspectives on the role of their general practitioner (GP) after an advanced cancer diagnosis. A qualitative research approach was used. Semi-structured interviews were conducted and data were analysed using a constant comparative methodology. Participants were eligible if they were diagnosed with advanced cancer and referred for palliative radiotherapy. Data saturation was achieved after 21 interviews. Key themes included (1) obtaining diagnosis and referral for advanced cancer treatment; (2) preference for specialist oncology care; (3) a preference for GP to act as an advocate; and (4) obtaining ongoing routine care from their GP. GP involvement in the patients' management was dependent on: time since diagnosis, GP's involvement in diagnosis and referral, doctor/patient relationship, additional chronic conditions requiring management, frequency of seeing oncologist and specialist recommendation to involve GP. Patients want GPs to have varying levels of involvement following an advanced cancer diagnosis. Not all communication between GPs and patients was positive suggesting communication skills training may be a priority. Patients wished to maintain continunity of care for their non-cancer related issues and healthcare of their family members. Future research needs to focus on working with GPs to increase their role in the management of advanced cancer. PMID:25132066

Halkett, G K B; Jiwa, M; Lobb, E A



Prescribing new medications: A taxonomy of physician–patient communication  

PubMed Central

Physician-patient communication about new medications can influence patient medication adherence. Little is known about the detailed content of conversations about new medications, or about how physicians and patients word information when discussing new medications. Yet nuances in communication may influence patient comprehension and affect behaviour. A comprehensive coding framework delineating the intricacies of physician-patient discussions is needed to better understand the range of communication about new prescriptions. This study used analytic induction to analyse 185 audiotaped outpatient encounters, during which 243 new medications were prescribed by family physicians, internists and cardiologists in two healthcare settings. Seventy-six codes were developed to demonstrate the range of physician counselling about information concerning new prescriptions, such as medication name, purpose, directions for use, side effects, acquisition and monitoring. The conversational content represented by the codes can be used to understand the breadth of conversations regarding new medications, identify sources of potential patient misunderstandings when medication instructions are conveyed, and inform recommendations for desired communication content. The coding system also can be used to measure the quality of new medication discussions for linkage to outcomes and can inform interventions to improve communication when prescribing new drugs. PMID:19644569




Nurse-patient interaction and communication: A systematic literature review  

Microsoft Academic Search

Aim  The purpose of this review is to describe the use and definitions of the concepts of nurse-patient interaction and nurse-patient\\u000a communication in nursing literature. Furthermore, empirical findings of nurse-patient communication research will be presented,\\u000a and applied theories will be shown.\\u000a \\u000a \\u000a \\u000a Method  An integrative literature search was executed. The total number of relevant citations found was 97. The search results were\\u000a reviewed,

Steffen Fleischer; Almuth Berg; Markus Zimmermann; Kathleen Wüste; Johann Behrens



The protective role of carotenoids and polyphenols in patients with head and neck cancer.  


Head and neck cancer is a critical global health problem and approximately 650,000 patients per year are diagnosed with this type of cancer. In addition, head and neck cancer exhibits a high recurrence rate, readily causing second primary cancers in other locations, often yielding a poor prognosis. Current medical and surgical treatment options result in considerable impairment of speaking and swallowing functions, with side effects such as nausea, vomiting, bone marrow suppression, and renal damage, thereby impairing patients' quality of life. Thus, developing a prevention and therapeutic intervention strategy for head and neck cancer is vital. Phytochemicals have been shown to have a unique ability to protect cells from damage and modulation of cell repair. The chemopreventive activities of phytochemicals have also been demonstrated to be associated with their antioxidant properties and the induction and stimulation of intercellular communication via gap junctions, which play a role in the regulation of cancer cell cycle, differentiation, apoptosis, and stagnate cancer cell growth. Phytochemicals can also regulate cancer cell signaling pathways, reduce the invasion and metastasis of cancer cells, and protect normal cells during treatment, thus reducing the damage caused by chemotherapy and radiotherapy. The most studied of the chemopreventive effects of phytochemicals are the carotenoids and phenolics. In this review, we investigated the multiple mechanisms of carotenoids and polyphenols (PPs) for use in preventing head and neck cancer, reducing the side effects of chemotherapy and radiotherapy, improving patient survival rates, and reducing the occurrence rate of second primary cancers. PMID:25306067

Chang, Hui-Ping; Sheen, Lee-Yan; Lei, Yen-Ping



Effect of Systemic Hyperinsulinemia in Cancer Patients1  

Microsoft Academic Search

Data defining the isolated effect of insulin on whole body protein and glucose metabolism in cancer patients are limited. Ten normal volun teers (controls), age 55 ± 3 years (mean ± SEM); 8 cancer patients, age 61 ±3years, weight loss 2 ± 1%(CANWL); and 8 cancer patients, age 55 ±2 years, weight loss 18 ± 2% (CAWL), were studied in

Martin J. Heslin; Elliot Newman; Ronald F. Wolf; Peter W. T. Pisters; Murray F. Brennan


The influence of cancer impact on patients’ preparatory grief  

Microsoft Academic Search

The aims of this study were to investigate the preparatory grief and traumatic distress in advanced cancer patients in a palliative care unit. A total of 94 advanced cancer patients completed the Preparatory Grief in Advanced Cancer Patients (PGAC) scale and the Greek version of the Impact of Events Scale- Revised (IES-R-Gr). The Eastern Cooperative Oncology Group was used to

Eleni Tsilika; Kyriaki Mystakidou; Efi Parpa; Antonis Galanos; Pavlos Sakkas; Lambros Vlahos



Interrelation between Patient Satisfaction and Patient-Provider Communication in Diabetes Management  

PubMed Central

The present study aims to assess how patient satisfaction with medical provider-patient communication can affect oral health, diabetes, and psychobehavioural measures among type 2 diabetes (T2DM) patients. It is part of a prospective intervention study among randomly selected T2DM patients, in Turkey. The data analyzed were Community Periodontal Need Index (CPI), HbA1c, patient satisfaction with communication, and psychobehavioural variables. Data was collected initially and at the end of the intervention. The participants were allocated to either health coaching (HC) or health education (HE). At baseline, there were no statistical differences between the HC and the HE groups on any of the measures (P > 0.05). Patients in both the HC and the HE groups had low satisfaction with communication. At postintervention, the increase in patient satisfaction with communication in the HC group was significantly higher than that in the HE group (P = 0.001). Principal component analysis revealed that patient satisfaction with communication shared the same cluster with clinical measures (CPI and HbA1c) and quality of life in the HC group. In conclusion, the present study showed, to our knowledge for the first time, that overall patient satisfaction with medical care provider-patient communication, empowered by HC approach, was interrelated with well-being of T2DM patients, in terms of psychobehavioural and clinical measures.

Cinar, Ayse Basak; Schou, Lone



Metastatic breast cancer in patients with schizophrenia  

PubMed Central

Breast cancer is a major health problem worldwide. The median survival duration for patients with metastatic breast cancer is two to three years. Approximately 1% of populations worldwide have schizophrenia. The manner in which schizophrenic patients fare when diagnosed with metastatic breast carcinoma (MBC) was evaluated. We queried the National Department of Veterans Affairs (DVA) datasets using computer codes for a pre-existing diagnosis of schizophrenia and a later diagnosis of breast carcinoma. Chart-based data concerning the identified subjects were then requested. Previously determined inclusion and exclusion criteria were applied to select evaluable patients from the medical records, prior to extracting demographic details and data concerning the treatment course in each subject. Ten patients had distant metastases at initial diagnosis, while seven developed MBC following prior curative-intent treatment. Two patients refused therapy. Ten did not comply with recommended management. Five harmed or threatened physicians, other caregivers or themselves. Schizophrenic patients with MBC often fail to understand the nature of their illnesses. Often they do not accept palliative treatment, while a number of them do not comply with therapy, once initiated. They often exhibit behaviors that are detrimental to themselves or others. Formal psychiatric consultation is therefore necessary in patients. Several detrimental behaviors may be predicted reliably by history alone. PMID:24649175




Risk Factors and Biomarkers of Ischemic Stroke in Cancer Patients  

PubMed Central

Background and Purpose Stroke is common among cancer patients. However, risk factors and biomarkers of stroke in cancer patients are not well established. This study aimed to investigate risk factors and biomarkers as well as etiology of ischemic stroke in cancer patients. Methods A retrospective review was conducted in cancer patients with ischemic stroke who were admitted to a general hospital in Busan, Korea, between January 2003 and December 2012. The risk factors and biomarkers for stroke and stroke subtypes in cancer patients were compared with age- and sex-matched noncancer patients with ischemic stroke who were admitted to the same hospital during the same period. Results One hundred fifty-six cancer patients with ischemic stroke were identified. Cancer patients with ischemic stroke were found to have a significantly lower proportion of hypertension, atrial fibrillation, hyperlipidemia, and ischemic heart disease than noncancer patients with ischemic stroke. However, stroke biomarkers, such as erythrocyte sedimentation rate and high-sensitivity C-reactive protein, fibrinogen, pro-brain natriuretic peptide, and D-dimer levels, were significantly increased in cancer patients with ischemic stroke than in noncancer patients. Large-artery atherosclerosis and stroke of undetermined cause were more common in cancer patients with ischemic stroke than in noncancer patients with ischemic stroke. Conclusions Cancer patients with ischemic stroke showed different risk factors, stroke biomarkers, and stroke etiology compared with noncancer patients with ischemic stroke. PMID:24949315

Lee, Ji-Hun



Patient-centred communication intervention study to evaluate nurse-patient interactions in complex continuing care  

PubMed Central

Background Communication impairment is a frequent consequence of stroke. Patients who cannot articulate their needs respond with frustration and agitation, resulting in poor optimization of post-stroke functions. A key component of patient-centred care is the ability of staff to communicate in a way that allows them to understand the patient’s needs. We developed a patient-centred communication intervention targeting registered and unregulated nursing staff caring for complex continuing care patients with communication impairments post stroke. Research objectives include 1) examining the effects of the intervention on patients’ quality of life, depression, satisfaction with care, and agitation; and (2) examining the extent to which the intervention improves staff’s attitudes and knowledge in caring for patients with communication impairments. The intervention builds on a previous pilot study. Methods/design A quasi-experimental repeated measures non-equivalent control group design in a complex continuing care facility is being used. Patients with a communication impairment post-stroke admitted to the facility are eligible to participate. All staff nurses are eligible. Baseline data are collected from staff and patients. Follow-up will occur at 1 and 3 months post-intervention. Subject recruitment and data collection from 60 patients and 30 staff will take approximately 36 months. The Patient-Centred Communication Intervention consists of three components: (1) development of an individualized patient communication care plan; (2) a one-day workshop focused on communication and behavioural management strategies for nursing staff; and (3) a staff support system. The intervention takes comprehensive patient assessments into account to inform the development of communication and behavioural strategies specifically tailored to each patient. Discussion The Patient-Centred Communication Intervention will provide staff with strategies to facilitate interactions with patients and to minimize agitation associated with considerable stress. The improvement of these interactions will lead to a reduction of agitation, which has the additional significance of increasing patients’ well-being, quality of life, and satisfaction with care. Trial registration Identifier NCT01654029 PMID:23050517



[The Canon communicator as a means of communication for intensive care patients (author's transl)].  


A description of the electrical "Ultra-Mini-Type Writer" is presented, developed and offered by Japanese Canon Corp. Comparable to pocket-calculators in size and handling the little typewriter easily enables communication to intensive-care-patients unable to speak. The paper prints can be documented in the patient's case history. PMID:6451190

Wittenburg, J P



[Supervised administration of Alzheimer's patients using information communication technology].  


Drug adherence is central to the treatment of dementia, which might reduce compliance due to memory loss, particularly among home-based patients with dementia. In order to improve drug adherence, we suggest the efficient and effective supervised administration by use of information communication technology(ICT). ICT makes face-to-face real-time communication possible, and it also enables picture sharing. Therefore, it might be useful to apply ICT to controlling and supervising medication for patients with dementia to improve drug adherence. Accordingly, we enrolled patients who were supposed to take a newly prescribed anti-dementia patch containing the choline esterase inhibitor rivastigmine(Rivastach®)and investigated the effect of ICT-based intervention for drug adherence, emotional change, and cognitive change, utilizing Skype, a free communication software program. Scheduled Skype interventions increased drug adherence ratio, levels of subjective satisfaction, and instrumental activities of daily living(IADL). Furthermore, we can provide patients and their caregivers with a feeling of safety through regular bidirectional communication, as patients can easily consult medical staff regarding the adverse effects of newly prescribed drugs. Instead of frequent visits to their primary physicians, ICT-based communications can be used as a substitute for supervision of medication, given the availability of the telecommunication system. By directly connecting the medical institution to the home, we expect that this ICT-based system will expand into the geriatric care field, including the care of elderly individuals living alone. PMID:25595075

Noda, Yasuha; Sakata, Yoshifumi; Kubota, Masakazu; Uemura, Kengo; Kihara, Takeshi; Kimura, Toru; Ino, Masashi; Tsuji, Teruyuki; Hayashi, Michiyuki; Kinoshita, Ayae



Cancer surviving patients' rehabilitation – understanding failure through application of theoretical perspectives from Habermas  

Microsoft Academic Search

This study aims to analyze whether the rehabilitation of cancer surviving patients (CSPs) can be better organized. The data for this paper consists of focus group interviews (FGIs) with CSPs, general practitioners (GPs) and hospital physicians. The analysis draws on the theoretical framework of Jürgen Habermas, utilizing his notions of 'the system and the life world' and 'communicative and strategic

Thorbjørn H Mikkelsen; Jens Soendergaard; Anders B Jensen; Frede Olesen



Family Survivorship for Patients with Cancer: Existing Knowledge and Future Directions - Office of Cancer Survivorship

Cancer is a family issue; 66 percent of patients diagnosed with cancer will need family care. Despite this, there is little research describing caregivers' roles and duties and the impact cancer has on them.


Evaluating the Cancer Information Service: a model for health communications. Part 1.  


The Cancer Information Service (CIS) was established in 1975 by the National Cancer Institute (NCI) to meet the information needs of cancer patients, their families, health professionals, and the public. As the nation's foremost source for cancer information, the CIS applies a unique health communications model to bring the latest research findings on cancer prevention, detection, treatment, and supportive care to the nation. It does this through two main program components: a toll-free telephone service (1-800-4-CANCER) and an outreach program that focuses on providing technical assistance, specifically to partners reaching minority and underserved audiences. During its 22-year history, more than 7.5 million callers have reached the CIS telephone service. In addition, 100,000 requests are received each year from 4,500 organizations nationwide seeking cancer-related outreach expertise. This overview describes the CIS model for health communications, describes the program's impact in broad terms, and defines the critical role evaluation plays in each program component. The overview describes two customer satisfaction and impact surveys performed by an independent survey research firm in 1996 to evaluate the CIS model: (a) the telephone service user survey, a random sample of 2,489 persons representing major caller groups who were interviewed 3 to 6 weeks after their initial call to the CIS; and (b) the outreach partner survey, a random sample of 867 partner organizations, the majority of which reach minority and underserved audiences with information and programs, surveyed within a few months after a contact with the CIS outreach program. Impact data for both program areas were favorable: Approximately 8 out of 10 CIS callers reported that the information they received had a positive impact (either in eliciting a positive action [56%] or in reassurance of decisions made [22%]) and two-thirds of CIS partners said the CIS has an important impact on their programs. PMID:10977265

Thomsen, C A; Ter Maat, J



Cost Concerns of Patients With Cancer  

PubMed Central

Purpose: Health care providers are accustomed to identifying populations for whom cost-related concerns may be a significant barrier, such as the poor, but few empiric data have been collected to substantiate such assumptions, particularly among insured patients. Methods: Patients with cancer from academic and community hospitals completed a questionnaire that included closed-ended items concerning demographic variables, optimism, numeracy, and concerns about present and future medical costs. In addition, they answered open-ended questions regarding cost concerns and medical expenses. Results: Nearly all (99%) participants were insured. In response to the closed-ended questions, 30.3% of patients reported concern about paying for their cancer treatment, 22.3% reported that their family had made sacrifices to pay for their care, and 8.3% stated that their insurance adequately covered their current health care costs, and 17.3% reported concerns about coverage for their costs in the future. On open-ended questions, 35.3% reported additional expenses, and 47.5% reported concerns about health care costs. None of the assessed patient characteristics proved to be a robust predictor across all cost-related concerns. There was a strong association between the identification of concerns or expenses on the open-ended questions and concerns on closed-ended questions. Conclusion: Cost concerns are common among patients with cancer who have health insurance. Health care providers may alleviate concerns by discussing cost-related concerns with all patients, not only those of lower socioeconomic status or those without insurance. A closed-ended screening question may help to initiate these conversations. This may identify potential resources, lower distress, and enable patients to make optimal treatment decisions. PMID:23943901

Stump, Tammy K.; Eghan, Naa; Egleston, Brian L.; Hamilton, Olivia; Pirollo, Melanie; Schwartz, J. Sanford; Armstrong, Katrina; Beck, J. Robert; Meropol, Neal J.; Wong, Yu-Ning



The patient's role in the assessment of students' communication skills.  


The central focus of this study was to investigate the effects of the introduction of a new system of formative assessment on students' perceptions of their communication skills, by recruiting patients to assess the student who provided their treatment on that day. The assessment tool detailed 12 aspects of communication and the patient 'scored' the student from 0 (representing very poor skills) to 10 (representing excellence). The patients then handed the completed form at the end of the treatment session to the student. This would then form part of their clinical portfolio for reflection and consideration. A pilot scheme was implemented with the consent of staff, students and patients. Minor adjustments were made to the forms to clarify more precisely the point for assessment. The communication visual analogue scale demonstrated a perceived improvement over the ten-week period 86.4% for the experienced students and 80% for the novice students. The students who were interviewed all stated that they were comfortable with the patients assessing them and for some it made them feel more confident. Some students were surprised by the marks that the patients gave on some aspects of their communication, particularly pertaining to maintaining eye contact. PMID:18947910

Davies, Christopher S; Lunn, Katherine



Prostate cancer from the horizon of the patient.  


The democratization of civil society and the development of modern medicine changed the sacrosanct doctor-patient relationship to a doctor-partner dialogue. Values and respect were lost in the process where common courtesy and empathy in trust were replaced by patient rights. LAUNCH OF EUROPA UOMO: Europa Uomo, the European prostate cancer coalition, represents 22 national, autonomous patient support groups. Its aim includes increasing the awareness of prostate diseases, support individualized treatment as a balance between optimal medical treatment and personalized care delivered by a multiprofessional team. We expect our information/education from dedicated professional societies while in return we share care for properly informed members as well as a fast, unbiased and cheap distribution of information/innovation across the European continent. THE ROLE OF A PATIENT GROUP: Our advocacy role is focused on quality of life, tailored treatment, knowledge of risk factors, support for research and last but not least active partnerships. We believe that we can play a modest but basic role in common actions to overcome inequalities in treatment and care in Europe. Our responsibilities range from defining patient obligations to facilitating translational research and saving scarce health resources. THE HORIZON OF THE PATIENT: Our hope is to plead for a treatment policy on the man first and then on his cancer and to improve treatment outcomes by multiprofessional collaboration and the development of expert Prostate Units. FUTURE EXPECTATIONS: A transparent, open communication line between the multiprofessional team and the patient is mandatory. The existing uncertainties should be discussed with common sense but always leave a factor of hope in survival or quality of life. PMID:21604956

Denis, Louis J; Roobol, Monique; Dourcy-Belle-Rose, Brigitte



Talking with text: communication in therapist-led, live chat cancer support groups.  


CancerChatCanada is a pan-Canadian initiative with a mandate to make professionally led cancer support groups available to more people in Canada. Although online support groups are becoming increasingly popular, little is known about therapist-led, synchronous groups using live chat. The purpose of this study was to generate a rich descriptive account of communication experiences in CancerChatCanada groups and to gain an understanding of processes associated with previously-reported benefits. We used interpretive description to analyze interview segments from 102 patients, survivors and family caregivers who participated in CancerChatCanada groups between 2007 and 2011. The analysis yielded four inter-related process themes (Reaching Out From Home, Feeling Safe, Emotional Release, and Talking With Text) and one outcome theme (Resonance and Kinship). The findings extend previous research about text-only online support groups and provide novel insights into features of facilitated, live chat communication that are valued by group members. PMID:24581076

Stephen, Joanne; Collie, Kate; McLeod, Deborah; Rojubally, Adina; Fergus, Karen; Speca, Michael; Turner, Jill; Taylor-Brown, Jill; Sellick, Scott; Burrus, Kimberly; Elramly, Mai



Measurement of Physician-Patient Communication—A Systematic Review  

PubMed Central

Background Effective communication with health care providers has been found as relevant for physical and psychological health outcomes as well as the patients' adherence. However, the validity of the findings depends on the quality of the applied measures. This study aimed to provide an overview of measures of physician-patient communication and to evaluate the methodological quality of psychometric studies and the quality of psychometric properties of the identified measures. Methods A systematic review was performed to identify psychometrically tested instruments which measure physician-patient communication. The search strategy included three databases (EMBASE, PsycINFO, PubMed), reference and citation tracking and personal knowledge. Studies that report the psychometric properties of physician-patient communication measures were included. Two independent raters assessed the methodological quality of the selected studies with the COSMIN (COnsensus based Standards for the selection of health status Measurement INtruments) checklist. The quality of psychometric properties was evaluated with the quality criteria of Terwee and colleagues. Results Data of 25 studies on 20 measures of physician-patient communication were extracted, mainly from primary care samples in Europe and the USA. Included studies reported a median of 3 out of the nine COSMIN criteria. Scores for internal consistency and content validity were mainly fair or poor. Reliability and structural validity were rated mainly of fair quality. Hypothesis testing scored mostly poor. The quality of psychometric properties of measures evaluated with Terwee et al.'s criteria was rated mainly intermediate or positive. Discussion This systematic review identified a number of measures of physician-patient communication. However, further psychometric evaluation of the measures is strongly recommended. The application of quality criteria like the COSMIN checklist could improve the methodological quality of psychometric property studies as well as the comparability of the studies' results. PMID:25532118

Zill, Jördis M.; Christalle, Eva; Müller, Evamaria; Härter, Martin; Dirmaier, Jörg; Scholl, Isabelle



E-cigarettes and cancer patients.  


The increasing popularity and availability of electronic cigarettes (i.e., e-cigarettes) in many countries have promoted debate among health professionals as to what to recommend to their patients who might be struggling to stop smoking or asking about e-cigarettes. In the absence of evidence-based guidelines for using e-cigarettes for smoking cessation, some health professionals have urged caution about recommending them due to the limited evidence of their safety and efficacy, while others have argued that e-cigarettes are obviously a better alternative to continued cigarette smoking and should be encouraged. The leadership of the International Association for the Study of Lung Cancer asked the Tobacco Control and Smoking Cessation Committee to formulate a statement on the use of e-cigarettes by cancer patients to help guide clinical practice. Below is this statement, which we will update periodically as new evidence becomes available. PMID:24736063

Cummings, K Michael; Dresler, Carolyn M; Field, John K; Fox, Jesme; Gritz, Ellen R; Hanna, Nasser H; Ikeda, Norihiko; Jassem, Jacek; Mulshine, James L; Peters, Matthew J; Yamaguchi, Nise H; Warren, Graham; Zhou, Caicun



Fertility preservation in young patients' with cancer.  


Preservation of fertility is an important issue in the management of young cancer patients. Though embryo cryostorage is a well-established procedure, it can only be availed by couples. Recent studies have indicated increasing success rates with mature and immature oocyte cryopreservation. Cryostorage induces injuries on the human oocytes which can be minimized by slow freezing and vitrification. Selection of candiidates is crucial so that the most suitable technique can be offered without any delay in initiation of cancer therapy. Factors affecting suitability are age of patient, assessment of ovarian reserve, hormonal status and type and stage of neoplastic disease. Encouraging results have been obtained with oocyte in vitro maturation (IVM) followed by vitrification for cryostorage. Data on the use of vitrified eggs in routine in vitro fertilization (IVF) show that pregnancy rates can be comparable to those achieved with fresh oocytes. PMID:25540565

Dudani, Sharmila; Gupta, Apurva



Fertility preservation in young patients’ with cancer  

PubMed Central

Preservation of fertility is an important issue in the management of young cancer patients. Though embryo cryostorage is a well-established procedure, it can only be availed by couples. Recent studies have indicated increasing success rates with mature and immature oocyte cryopreservation. Cryostorage induces injuries on the human oocytes which can be minimized by slow freezing and vitrification. Selection of candiidates is crucial so that the most suitable technique can be offered without any delay in initiation of cancer therapy. Factors affecting suitability are age of patient, assessment of ovarian reserve, hormonal status and type and stage of neoplastic disease. Encouraging results have been obtained with oocyte in vitro maturation (IVM) followed by vitrification for cryostorage. Data on the use of vitrified eggs in routine in vitro fertilization (IVF) show that pregnancy rates can be comparable to those achieved with fresh oocytes. PMID:25540565

Dudani, Sharmila; Gupta, Apurva



Infections in Patients with Cancer: Overview  

Microsoft Academic Search

\\u000a Patients with neoplastic disease are often highly susceptible to severe infections. The following factors influence the types,\\u000a severity, and response to therapy of these infections: (1) Changing epidemiology of infections; (2) cancer- and\\/or treatment-associated\\u000a neutropenia; (3) acquired immune deficiency states such as cellular immune defect; (4) recent development of new-generation\\u000a diagnostic tools including widely available DNA amplification tests; (5) effective

Amar Safdar; Gerald Bodey; Donald Armstrong


The art and science of cancer education and evaluation: toward facilitating improved patient outcomes.  


Cancer education is a constantly evolving field, as science continues to advance both our understanding of cancer and its effects on patients, families, and communities. Moving discoveries to practice expeditiously is paramount to impacting cancer outcomes. The continuing education of cancer care professionals throughout their practice life is vital to facilitating the adoption of therapeutic innovations. Meanwhile, more general educational programs serve to keep cancer patients, their families, and the public informed of the latest findings in cancer research. The National Cancer Institute conducted an assessment of the current knowledge base for cancer education which involved two literature reviews, one of the general literature of the evaluation of medical and health education efforts, and the other of the preceding 5 years of the Journal of Cancer Education (JCE). These reviews explored a wide range of educational models and methodologies. In general, those that were most effective used multiple methodologies, interactive techniques, and multiple exposures over time. Less than one third of the articles in the JCE reported on a cancer education or communication product, and of these, only 70% had been evaluated for effectiveness. Recommendations to improve the evaluation of cancer education and the educational focus of the JCE are provided. PMID:20953858

Johnson, Lenora; Ousley, Anita; Swarz, Jeffrey; Bingham, Raymond J; Erickson, J Bianca; Ellis, Steven; Moody, Terra



[Colorectal cancer. Experience in 120 patients].  


The medical records of 120 patients with Colo-Rectal Cancer who were admitted between 1983 and 1990, were reviewed. The clinical, radiologic, epidemiologic, endoscopic and pathologic characteristic were analyzed in all the patients; also their follow up related to Age, CEA, Dukes and treatment. Late stage diagnosis (10.8% of the cases were diagnosed during obstructive episodes, and 48.3% of the cases were Dukes C and D) and the high mortality (34.1% of the patients died within the first year of the diagnosis), are still basic problems to be solved. The high percentage of patients less than 40 years old (25.8%) and the high incidence of rectal localization of the disease (49.1%), must prompt us to attempt to control the disease by means of colonic evaluation in young people with symptoms attributable to Hemorrhoids or Amebiasis. PMID:1305114

Itriago Pels, L J; Carvajal, L; Garrido, I; Méndez, A; Bracho, V



Media Mix for Awareness and Health Promotion in Lung Cancer Patients  

PubMed Central

Background Lung cancer is the most common cause of death due to malignancy. The media as a source of information about cancer especially lung cancer could make substantial contribution to help physicians and patients in terms of prevention, treatment and follow up. This study aimed to obtain in depth understanding of the role of media in the context of clinical knowledge and recognize its effect on behavior of patients. Materials and Methods Using lung cancer patients’ records admitted to Masih Daneshvari Hospital, we conducted a structured interview with them via telephone to collect information. The transcript of interviews was prepared. The transcript was then coded and analyzed using MaxQDA based on “theme method”. Due to the structured basis of the study, the primary frameworks were considered as conceptual categories in coding. Results The majority of lung cancer patients did not receive any information before the awareness about their disease unless having a family with a history of cancer. Following awareness of disease, they mostly received their information from physicians. In spite of the large amount of medical information available in the media, insufficient use of media by cancer patients indicated the absence of appropriate communication between the media and patients. Television was the mass media commonly used by patients and as a result of no access to Internet and medical books as well as lack of proficiency in English language they were deprived of specialized resources of information. Conclusion Mass media should focus on raising awareness about prevention and treatment of lung cancer. This study can be a preliminary step in health communication research and may be used by researchers in terms of methodology and vision. PMID:25191483

Aminian, Nasrin; Arbatani, Taher Roshandel; Khajeheian, Datis; Zangi, Mahdi



Physician-Patient Communication about Dietary Supplements  

PubMed Central

Objective Describe the content and frequency of provider-patient dietary supplement discussions during primary care office visits. Methods Inductive content analysis of 1477 transcribed audio-recorded office visits to 102 primary care providers was combined with patient and provider surveys. Encounters were collected in Los Angeles, California (2009–2010), geographically-diverse practice settings across the United States (2004–2005), and Sacramento, CA (1998–1999). Results Providers discussed 738 dietary supplements during encounters with 357 patients (24.2% of all encounters in the data). They mentioned: 1) reason for taking the supplement for 46.5% of dietary supplements; 2) how to take the supplement for 28.2%; 3) potential risks for 17.3%; 4) supplement effectiveness for 16.7%; and 5) supplement cost or affordability for 4.2%. Of these five topics, a mean of 1.13 (SD=1.2) topics were discussed for each supplement. More topics were reviewed for non-vitamin non-mineral supplements (mean 1.47 (SD=1.2)) than for vitamin/mineral supplements (mean 0.99 (SD=1.1); p<0.001). Conclusion While discussions about supplements are occurring, it is clear that more discussion might be needed to inform patient decisions about supplement use. Practice Implication Physicians could more frequently address topics that may influence patient dietary supplement use, such as the risks, effectiveness, and costs of supplements. PMID:23466249

Tarn, Derjung M.; Paterniti, Debora A.; Good, Jeffrey S.; Coulter, Ian D.; Galliher, James M.; Kravitz, Richard L.; Karlamangla, Arun; Wenger, Neil S.



Skin Cancer: A Young Person's Disease By Lauren Duffy (B.S. Communication, Journalism '14)  

E-print Network

Skin Cancer: A Young Person's Disease By Lauren Duffy (B.S. Communication, Journalism '14 is that this behavior is extremely unhealthy and risky for their bodies, specifically their skin. Skin cancer is the most common form of cancer found in young adults and second most common cancer found in adolescents

Massachusetts at Amherst, University of


Survivorship in untreated breast cancer patients.  


In any disease, the knowledge of the natural history of untreated cases provides a real background against which the real advantages of a new treatment itself are judged. Fortunately, in the present days, there are scant data on outcomes in patients with untreated breast cancer. In an attempt to provide this background against which the virtues of current curative and palliative treatments can be more accurately assessed, we have reviewed the literature regarding published untreated breast cancer series. Taking into consideration all the difficulties of analyzing reports written on the last half of the nineteenth century or on the first half of the twentieth century, in most reports, patients survived almost 3-4 years without any type of treatment. Worth mentioning, approximately 5-10 % of untreated patients lived longer than 10 years. Thus, the spectrum of clinical aggressiveness of untreated breast cancer varies between virulence and chronic disease. These facts should be taken into account when considering the value of current treatments for early-stage disease. PMID:25588926

Galmarini, Carlos M; Tredan, Olivier; Galmarini, Felipe C



Microsatellite instability in patients with gastric remnant cancer.  


BACKGROUND: About 2% of patients who undergo partial distal gastrectomy for gastroduodenal diseases develop gastric remnant cancer 10 to 30 years after the gastrectomy. It is important in clinical practice to determine a molecular marker to identify patients susceptible to gastric remnant cancer.METHODS: We investigated nine gastric remnant cancers (from nine individuals who had gastrectomies for primary gastric cancer or gastroduodenal ulcer) for microsatellite instability (MSI) at six loci, using the polymerase chain reaction (PCR). A control group of ten patients with sporadic gastric cancers in the upper third of the stomach was also similarly analyzed.RESULTS: MSI was demonstrated in eight of nine cancers from the individuals who had had primary gastric cancer or gastroduodenal ulcer (88.9%) compared with two of ten cancers from the individuals with sporadic gastric cancer in the upper third of the stomach (20%).CONCLUSION: These results suggest that one or more MSI is associated with remnant gastric cancer after gastrectomy. PMID:11957100

Nakachi, Atsushi; Miyazato, Hiroshi; Shimoji, Hideaki; Hiroyasu, Shungo; Isa, Tsutomu; Shiraishi, Masayuki; Muto, Yoshihiro



Qualitative inquiry: a method for validating patient perceptions of palliative care while enrolled on a cancer clinical trial  

PubMed Central

Background Palliative care is a vital component of patient-centered care. It has increasingly become central to the management and care of seriously ill patients by integrating physical, psychosocial, and spiritual supportive services. Through qualitative inquiry, this paper examines cancer patients’ perceptions of the process and outcomes of the pain and palliative care consultative services they received while enrolled in a clinical trial. Methods A qualitative analysis of open-ended questions was conducted from a sub-sample of patients (n?=?34) with advanced cancers enrolled in a randomized controlled trial exploring the efficacy of a palliative care consult service. Two open-ended questions focused on patient perceptions of continued participation on their primary cancer clinical trials and their perceptions of interdisciplinary communication. Results Three overarching themes emerged when asked whether receiving pain and palliative care services made them more likely to remain enrolled in their primary cancer clinical trial: patients’ past experiences with care, self-identified personal characteristics and reasons for participation, and the quality of the partnership. Four themes emerged related to interdisciplinary communication including: the importance of developing relationships, facilitating open communication, having quality communication, and uncertainty about communication between the cancer clinical trial and palliative care teams. Conclusions Our findings suggest the importance of qualitative inquiry methods to explore patient perceptions regarding the efficacy of palliative care services for cancer patients enrolled in a cancer clinical trial. Validation of patient perceptions through qualitative inquiry regarding their pain and palliative care needs can provide insight into areas for future implementation research. Trial registration NIH Office of Human Subjects Research Protection OHSRP5443 and University of Pennsylvania 813365 PMID:25276094



Elderly Breast and Colorectal Cancer Patients’ Clinical Course: Patient and Contextual Influences  

PubMed Central

Background The social and medical environments which surround people are each independently associated with their cancer course. The extent to which these characteristics may together mediate patientscancer care and outcomes is not known. Methods Using multilevel methods and data, we studied elderly breast and colorectal cancer patients (level I) within urban social (level II- ZIP code tabulation area) and health care (level III – hospital service area) contexts. We sought to determine (1) which, if any, observable social and medical contextual attributes were associated with patient cancer outcomes after controlling for observable patient attributes, and (2) the magnitude of residual variation in patient cancer outcomes at each level. Results Numerous patient attributes and social area attributes including poverty were associated with unfavorable patient cancer outcomes across the full clinical cancer continuum for both cancers. Health care area attributes were not associated with patient cancer outcomes. After controlling for observable covariates at all three levels, there was substantial residual variation in patient cancer outcomes at all levels. Conclusions After controlling for patient attributes known to confer risk of poor cancer outcomes, we find that neighborhood socioeconomic disadvantage exerts an independent and deleterious effect on residents' cancer outcomes but the area supply of the specific types of health care studied do not. Multilevel interventions targeted at cancer patients and their social areas may be useful. We also show substantial residual variation in patient outcomes across social and health care areas, a finding potentially relevant to traditional small area variation research methods. PMID:25119954

Lamont, Elizabeth B.; Zaslavsky, Alan M.; Subramanian, SV; Meilleur, Ashley E.; He, Yulei; Landrum, Mary Beth



Identifying Barriers to Patient Acceptance of Active Surveillance: Content Analysis of Online Patient Communications  

PubMed Central

Objectives Qualitative research aimed at identifying patient acceptance of active surveillance (AS) has been identified as a public health research priority. The primary objective of this study was to determine if analysis of a large-sample of anonymous internet conversations (ICs) could be utilized to identify unmet public needs regarding AS. Methods English-language ICs regarding prostate cancer (PC) treatment with AS from 2002–12 were identified using a novel internet search methodology. Web spiders were developed to mine, aggregate, and analyze content from the world-wide-web for ICs centered on AS. Collection of ICs was not restricted to any specific geographic region of origin. NLP was used to evaluate content and perform a sentiment analysis. Conversations were scored as positive, negative, or neutral. A sentiment index (SI) was subsequently calculated according to the following formula to compare temporal trends in public sentiment towards AS: [(# Positive IC/#Total IC) - (#Negative IC/#Total IC) x 100]. Results A total of 464 ICs were identified. Sentiment increased from -13 to +2 over the study period. The increase sentiment has been driven by increased patient emphasis on quality-of-life factors and endorsement of AS by national medical organizations. Unmet needs identified in these ICs include: a gap between quantitative data regarding long-term outcomes with AS vs. conventional treatments, desire for treatment information from an unbiased specialist, and absence of public role models managed with AS. Conclusions This study demonstrates the potential utility of online patient communications to provide insight into patient preferences and decision-making. Based on our findings, we recommend that multidisciplinary clinics consider including an unbiased specialist to present treatment options and that future decision tools for AS include quantitative data regarding outcomes after AS. PMID:24039699

Mishra, Mark V.; Bennett, Michele; Vincent, Armon; Lee, Olivia T.; Lallas, Costas D.; Trabulsi, Edouard J.; Gomella, Leonard G.; Dicker, Adam P.; Showalter, Timothy N.



How to Define Patients at High Risk for Pancreatic Cancer  

Microsoft Academic Search

The clinical outcome of patients with pancreatic cancer remains dismal despite recent advances in diagnostic and therapeutic modalities. Several risk factors have been reported regarding the development of pancreatic cancer. These risk factors include family history, accompanying diseases, and lifestyle\\/personal habits. Family history includes that of pancreatic cancer and hereditary pancreatic cancer syndrome. Accompanying diseases that increase the risk include

Koji Yamaguchi



Tolerance of Pain by Cancer Patients in Hyperthermia Treatment  

Microsoft Academic Search

Hyperthermia-the artificial inducement of abnormally high blood temperature-is designed to cause tumor tissue to retain heat and has additive or synergistic effects with radiation and chemotherapy. Because of the clinically administered high temperature, cancer patients often experience pain and discomfort. In the study described in this article, 30 cancer patients undergoing hyperthermia treatment as part of their overall cancer care

Ronald H. Rozensky; Laurie Feldman Honor; Steve M. Tovian; Gordon Herz; Margaret Holland



Health food store recommendations: implications for breast cancer patients  

Microsoft Academic Search

BACKGROUND: Many breast cancer patients use complementary and alternative medicine (CAM). We aimed to determine what advice health food store employees present to individuals seeking treatment options for breast cancer. METHODS: Eight data gatherers asked employees of all retail health food stores in a major Canadian city, what they recommended for a patient with breast cancer. The data gatherers inquired

Edward Mills; Edzard Ernst; Rana Singh; Cory Ross; Kumanan Wilson



Proposal for a Group Counseling Experience for Cancer Patients.  

ERIC Educational Resources Information Center

A model for using group counseling with cancer patients is proposed in this document. The literature on the psychological effects of cancer and the effects of social support are summarized. It is concluded that the literature shows cancer patients are subjected to intense psychological distress and that at the same time their social supports may…

Carter, Linda S.


Worse prognosis of metaplastic breast cancer patients than other patients with triple-negative breast cancer  

Microsoft Academic Search

The present study was designed to assess the clinical characteristics and outcomes of metaplastic breast cancer (MBC) compared\\u000a to general invasive ductal carcinoma (IDC) and the triple-negative subtype (TN-IDC). The study population included 35 MBC\\u000a and 2,839 IDC patients, including 473 TN-IDC diagnoses, from the National Cancer Center, Korea between 2001 and 2008. The\\u000a clinicopathological characteristics and clinical outcomes were

So-Youn Jung; Hyun Yul Kim; Byung-Ho Nam; Sun Young Min; Seung Ju Lee; Youngmee Kwon; Eun-A Kim; Kyoung Lan Ko; Kyung Hwan Shin; Keun Seok Lee; In Hae Park; Seeyoun Lee; Seok Won Kim; Han-Sung Kang; Jungsil Ro



Motives of cancer patients for using the Internet to seek social support.  


The purpose of the study was to describe why Finnish cancer patients choose the internet as a source of social support. The data were collected in May 2010, using an online questionnaire with open-ended questions, through four discussion forums on the websites of the non-profit Cancer Society of Finland. Seventy-four adult patients with cancer participated. The data were analysed using inductive content analysis. The mean age of the participants was 53 years and they were predominantly women. The most common cancer was breast cancer and more than three quarters of the participants had suffered from cancer for less than 5 years. The initial stimuli to use the internet as a source of social support were the ease of communication and access to information as well as the need for emotional and informational support. The actual motives that drove the use of the internet as a source of social support were the requirements for information and peer support, internet technology, a lack of support outside the internet and the negative experiences caused by the illness. The fact that there is an enormous need for information as well as for emotional support and that cancer treatment in Finland is concentrated in major hospitals, to which cancer patients may travel a considerable distance, suggests that nurses should learn to make more frequent virtual contact with their patients. PMID:23320398

Yli-Uotila, T; Rantanen, A; Suominen, T



Visfatin concentrations in patients with endometrial cancer.  


Abstract Objective: Visfatin is one of the most recent proteins shown to be highly expressed in adipose tissue. The purpose of this study was to determine visfatin levels in patients with endometrial cancer (EC). Methods: A total of 90 patients (46 EC patients and 44 healthy controls) were included in the study. Fasting venous blood samples were collected from all patients. Serum visfatin levels were measured by an enzyme-linked immunosorbent assay (ELISA). The correlation between serum visfatin levels and clinicopathologic variables were determined. Results: Serum visfatin levels were found to be higher in patients with EC (p?patients. By using classification and regression trees (C&RT) method, we found that visfatin predicted patients with EC 100% and controls 81.8%. Conclusion: Visfatin was the most important risk factor for occurrence of EC other than, age, BMI, Diabetes Mellitus and other biochemical factors like HDL, LDL, TG, TC. Clearly, there are largely unknown aspects of visfatin pathophysiology in EC and require further study. PMID:25377860

Nergiz Avcioglu, Sümeyra; Altinkaya, Sunduz Ozlem; Küçük, Mert; Yüksel, Hasan; Omürlü, Imran Kurt; Yanik, Serdar



Hispanic ethnicity, physician-patient communication, and antidepressant adherence  

Microsoft Academic Search

The purpose of the study was to examine how Hispanic ethnicity influenced physician-patient communication about antidepressants and antidepressant adherence using a data set of audiotapes and transcripts of 98 medical visits and medical and pharmacy records. The data were collected in 1995 at the University of New Mexico’s general medicine and family practice clinics. Physicians were more likely to state

Betsy Sleath; Richard H Rubin; Sally A Huston



Strengthening student communication through pediatric simulated patient encounters  

PubMed Central

As medical students enter the role of physician, clinical outcomes not only rely on their mastery of clinical knowledge, but also on the effectiveness in which they can communicate with patients and family members. While students typically have numerous opportunities to practice clinical communication with adult patients, such practice in pediatric settings is limited. This study examines if simulated patient (SP) encounters strengthen third-year medical students’ communication skills during the pediatrics clerkship. During 2011-2013, three SP encounters (comprising 3 pediatric scenarios) were incorporated into a pediatrics clerkship at one United States medical school to give students a safe venue to practice advanced communication with observation and direct feedback. Third-year medical students engaged in the scenarios and received both written and oral feedback from an evaluator observing the encounter. With IRB approval, students’ self-perceived confidence and abilities at performing the advanced communication skills were measured using an eightitem, Likert scale questionnaire administered pre and post the SP encounter. Pre- and post-questionnaires (n=215; response rate, 96%) analyzed using a Wilcoxon-matched pairs signed-rank test demonstrated statistically significant increases in students’ perception of their confidence and abilities regarding their performance (P<0.05; Bonferroni correction, P<0.006). There was an increases in student confidence and self-perceived ability in: first, communicating with children and family members of young patients; second, managing confrontational situations involving parents; third, performing a thorough psychosocial history with an adolescent; and fourth, using Evidence Based Medicine to motivate parents. PMID:25112449



Strengthening student communication through pediatric simulated patient encounters.  


As medical students enter the role of physician, clinical outcomes not only rely on their mastery of clinical knowledge, but also on the effectiveness in which they can communicate with patients and family members. While students typically have numerous opportunities to practice clinical communication with adult patients, such practice in pediatric settings is limited. This study examines if simulated patient (SP) encounters strengthen third-year medical students' communication skills during the pediatrics clerkship. During 2011-2013, three SP encounters (comprising 3 pediatric scenarios) were incorporated into a pediatrics clerkship at one United States medical school to give students a safe venue to practice advanced communication with observation and direct feedback. Third-year medical students engaged in the scenarios and received both written and oral feedback from an evaluator observing the encounter. With IRB approval, students' self-perceived confidence and abilities at performing the advanced communication skills were measured using an eightitem, Likert scale questionnaire administered pre and post the SP encounter. Pre- and post-questionnaires (n=215; response rate, 96%) analyzed using a Wilcoxon-matched pairs signed-rank test demonstrated statistically significant increases in students' perception of their confidence and abilities regarding their performance (P<0.05; Bonferroni correction, P<0.006). There was an increases in student confidence and self-perceived ability in: first, communicating with children and family members of young patients; second, managing confrontational situations involving parents; third, performing a thorough psychosocial history with an adolescent; and fourth, using Evidence Based Medicine to motivate parents. PMID:25112449

Whitt, Ryan; Toussaint, Gregory; Bruce Binder, S; Borges, Nicole J



Breaking bad news of cancer diagnosis – Perception of the cancer patients in a rural community in Malaysia  

PubMed Central

Context: Breaking of bad news is an important component in the management of cancer patients. Aims: This study aimed to assess the perceptions of breaking bad news of cancer diagnosis. Settings and Design: It was a cross-sectional study using Breaking Bad News Assessment Schedule (BAS) questionnaire on cancer patients in Serian district. Materials and Methods: Using snowballing sampling method, a total of 134 patients were interviewed face-to-face after the consent was obtained from each of the respondents. Statistical Analysis Used: Data was entered and analyzed using SPSS version 19.0. Results: Majority were comfortable with the current method of breaking bad news. The main aspects found to be the areas of concern were the importance of the usage of body language, management of time and identifying patients’ key area of concerns. There were significant difference between sex and “information giving” (P = 0.028) and “general consideration” (P = 0.016) and also between “the age and setting the scene” (P = 0.042). Significant difference was also found between the types of cancer and “the setting of scene” (P = 0.018), “breaking bad news technique” (P = 0.010), “eliciting concerns” (P = 0.003) and “information giving” (P = 0.004). Conclusion: Good and effective communication skill of breaking bad news is vital in the management of cancer patients. As the incidence of new cases of cancer increase every year, breaking of bad news has become a pertinent to the medical professionals’ role. Specific aspects of communication skills based on local characteristics should be more emphasized in the formulation of training for doctors. PMID:24818107

Bain, Mathew Gabriel; Lian, Cheah Whye; Thon, Chang Ching



Helical Tomotherapy in Cervical Cancer Patients  

Microsoft Academic Search

\\u000a Abstract\\u000a \\u000a \\u000a Purpose:\\u000a   To evaluate the acute toxicity of simultaneous integrated boost (SIB) technique for dose escalation with helical tomotherapy\\u000a (HT) in patients with locally advanced cervical cancer.\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a Patients and Methods:\\u000a   20 patients (FIGO IB1 pN1-IIIB) underwent primary chemoradiation. Prior to chemoradiation, a laparoscopic\\u000a pelvic and para-aortic lymphadenectomy was performed. A boost region was defined using titanium clips during staging for

Simone Marnitz; Carmen Stromberger; Michael Kawgan-Kagan; Waldemar Wlodarczyk; Ulrich Jahn; Achim Schneider; Uwe Ulrich; Volker Budach; Christhardt Köhler



Integrating cancer care beyond the hospital and across the cancer pathway: a patient-centred approach.  


Cancer patients constitute one of the most complex, diverse and growing patient populations in Canada. Like other high-needs patient groups, cancer patients desire a more integrated approach to care delivery that spans organizational and professional boundaries. This article provides an overview of Cancer Care Ontario's experience in fostering a more integrated cancer system, and describes the organization's emerging focus on patient-centred models of integrated care through the whole cancer pathway, from prevention to end-of-life care and survivorship. PMID:25562131

Evans, Jenna M; Matheson, Garth; Buchman, Sandy; MacKinnon, Marnie; Meertens, Elaine; Ross, Jillian; Johal, Hardeep



All-cause readmission to acute care for cancer patients.  


A recent Canadian Institute for Health Information report on all-cause readmission identified that cancer patients had higher-than-average readmission rates. This study provides further insight on the experience of cancer patients, exploring the risk factors associated with readmission at patient, hospital and community levels. An analysis showed that patient characteristics, including the reason for initial hospitalization, sex, co-morbidity levels, admission through the emergency department and the number of previous acute care admissions, were associated with readmission for cancer patients. In addition, we found that the readmission rate for these patients varied by hospital size and whether the patients lived in rural or urban locations. PMID:22986560

Ji, Hong; Abushomar, Hani; Chen, Xi-Kuan; Qian, Cheng; Gerson, Darren



Too Few Breast Cancer Patients Getting Radiation After Mastectomy  


... enable JavaScript. Too Few Breast Cancer Patients Getting Radiation After Mastectomy: Study More than a third with ' ... 17, 2015 Related MedlinePlus Pages Breast Cancer Mastectomy Radiation Therapy TUESDAY, Feb. 17, 2015 (HealthDay News) -- Many ...


Gene Mutations Linked to Colon Cancer in Black Patients  


... sharing features on this page, please enable JavaScript. Gene Mutations Linked to Colon Cancer in Black Patients ... Related MedlinePlus Pages African American Health Colorectal Cancer Genes and Gene Therapy TUESDAY, Jan. 13, 2015 (HealthDay ...


Acupuncture, Exercise May Ease Pain for Breast Cancer Patients  


... sharing features on this page, please enable JavaScript. Acupuncture, Exercise May Ease Pain for Breast Cancer Patients ... 2015) Thursday, November 13, 2014 Related MedlinePlus Pages Acupuncture Breast Cancer Exercise and Physical Fitness THURSDAY, Nov. ...


New Treatment Shows Promise in Younger Breast Cancer Patients  


... sharing features on this page, please enable JavaScript. New Treatment Shows Promise in Younger Breast Cancer Patients: ... of breast cancer recurrence in some younger women, new research suggests. This combination approach -- using estrogen-blockers ...


Speech outcome after surgical treatment for oral and oropharyngeal cancer: a longitudinal assessment of patients reconstructed by a microvascular flap  

Microsoft Academic Search

BACKGROUND: The aim of the study was to analyze speech outcome for patients with advanced oral\\/oropharyngeal cancer treated with reconstructive surgery and adjuvant radiotherapy. METHODS: Speech tests (communicative suitability, intelligibility, articulation, nasality, and consonant errors) were performed in a control group and in patients before treatment (n = 76), and 6 months (n = 51) and 12 months (n =

Pepijn A. Borggreven; Irma Verdonck-de Leeuw; Johannes A. Langendijk; Patricia Doornaert; Marike N. Koster; Remco de Bree; C. René Leemans



Changes in Bone Density after Cancer Treatment in Patients with Cervical and Endometrial Cancer  

PubMed Central

OBJECTIVE: This study aimed to evaluate the impact of cancer treatment on bone mineral density (BMD) in the lumbar spine (LS) and femur in the postmenopausal women with cervical or endometrial cancer without bone metastasis compared to normal control postmenopausal women. METHODS: We retrospectively evaluated the BMD data in the LS, femur neck (FN) and trochanter (FT) by dual-energy X-ray absorptiometry and laboratory data of bone turnover markers at baseline and after one year in 130 patients with cervical cancer, 68 patients with endometrial cancer, and 225 healthy controls. RESULTS: There were no significant differences in the T-scores of basal BMD in LS and femur between patients with endometrial cancer and controls, and only T-score of basal BMD at the fourth lumbar vertebra (L4) was significantly lower in patients with cervical cancer compared to controls. One year later, T-scores of BMD at all LS sites and FN in patients with cervical cancer and T-scores of BMD at L3, L4, FN, and FT in those with endometrial cancer after cancer treatment were significantly lower compared to controls. Lower proportions of normal BMD at all skeletal sites except L2 in patients with endometrial cancer and those at L1, L4, and FN in patients with cervical cancer were observed compared to controls after cancer treatment. CONCLUSIONS: Our results suggest that cancer treatment increase bone loss in postmenopausal women with cervical and endometrial cancer. PMID:25553092

Oh, Young Lim; Yoon, Man Soo; Suh, Dong Soo; Kim, Ari; Kim, Min Joung; Lee, Ji Young; Song, Yong Jung; Ji, Yong Il; Kim, Ki Hyung; Chun, Sungwook



Predictors of communication preferences in patients with chronic low back pain  

PubMed Central

Background The objective of this exploratory study was to identify patient-related predictors of communication preferences in patients with chronic low back pain for various dimensions of patient-physician communication (patient participation and orientation, effective and open communication, emotionally supportive communication, communication about personal circumstances). Methods Eleven rehabilitation centers from various parts of Germany participated in collection of data between 2009 and 2011. A total of 701 patients with chronic low back pain were surveyed at the start of rehabilitation. The patient questionnaire captured communication preferences, pain impact, pain intensity, and psychologic variables (fear avoidance beliefs, illness coherence, control beliefs, communication self-efficacy, and personality characteristics). The rehabilitation physicians filled out a documentation sheet containing information on diagnosis, inability to work, duration of the illness, and comorbidity at the beginning and end of rehabilitation. Hierarchical regression analyses were performed. Results On average, effective, open, and patient-centered communication was very important for patients with back pain, emotionally supportive communication was important, and communication about personal circumstances was somewhat important. The variance in communication preferences explained by the predictors studied here was 8%–19%. Older patients showed a lower preference for patient-centered and open communication, but a higher preference for communication about personal circumstances. Patients with psychologic risk factors (eg, fear avoidance beliefs), extroverted patients, and patients with high self-efficacy in patient-physician interaction generally had higher expectations of the physician’s communicative behavior. Conclusion Providers should take into consideration the fact that patients with back pain have a strong need for effective, open, and patient-centered communication. A flexible approach to communication needs appears to be especially important for communication about emotional and personal circumstances, because the patients differ most clearly in this respect. Personal characteristics provided only initial clues to possible preferences; for more precision, an individual assessment (by means of questionnaires or discussion) is needed. PMID:24187489

Farin, Erik; Gramm, Lukas; Schmidt, Erika



Serum levels of interleukin 6 in patients with lung cancer.  

PubMed Central

Serum interleukin 6 (IL-6) levels were measured in 75 patients with lung cancer and in 20 patients with benign lung diseases. IL-6 was detectable in 29 patients with lung cancer (39%), but was not detectable in any of the patients with benign lung diseases. Serum C-reactive protein levels and plasma fibrinogen levels were significantly higher and serum albumin concentration was significantly lower in lung cancer patients with detectable serum IL-6 levels than in those without detectable serum IL-6 levels and in patients with benign lung diseases. On the other hand, no significant difference was observed in blood platelet counts in these three groups. Moreover, serum IL-6 levels were not significantly different in lung cancer patients with or without clinically demonstrated distant metastasis. These results suggest that IL-6 may be a mediator of various reactions including an inflammatory response in lung cancer patients. PMID:7734307

Yanagawa, H.; Sone, S.; Takahashi, Y.; Haku, T.; Yano, S.; Shinohara, T.; Ogura, T.



Recall in Older Cancer Patients: Measuring Memory for Medical Information  

ERIC Educational Resources Information Center

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

Jansen, Jesse; van Weert, Julia; van der Meulen, Nienke; van Dulmen, Sandra; Heeren, Thea; Bensing, Jozien



Nutritional Status of Patients Undergoing Lung Cancer Operations  

Microsoft Academic Search

Background. Patients referred for lung cancer opera- tions were reported to be nutritionally depleted. This may be relevant in determining patient outcome after surgical procedures. A study was undertaken to measure a range of nutritional variables including dietary intake of patients referred to a regional cardiothoracic center for curative lung cancer operations. Methods. Anthropometric measurements, grip strength, fat-free mass (FFM),

R. Thomas Jagoe; Timothy H. J. Goodship; G. John Gibson



Improved Survival Outcomes in Cancer Patients with Hereditary Hemorrhagic Telangiectasia  

PubMed Central

Background Hereditary hemorrhagic telangiectasia (HHT) is a genetic disorder characterized by deficiency in endoglin, an angiogenic protein. The net effect of endoglin expression on cancer outcomes from animal studies has proven controversial. We evaluated whether reduced systemic endoglin levels, expected in patients diagnosed with HHT, impacted clinical outcomes for cancer. Methods A retrospective cohort analysis using SEER-Medicare was conducted to evaluate the effect of HHT on survival among patients diagnosed with breast, colorectal, lung, or prostate cancer between 2000 and 2007 (n=540,520). We generated Kaplan-Meir survival curves and Cox models to compare the effect of HHT on all cause survival for a composite of the four cancers, and separate models by cancer, adjusting for demographic variables, cancer type, cancer stage, and comorbidities. Results All cause survival analysis for a composite of the four cancers showed an adjusted hazard ratio of 0.69 (95% confidence interval (CI) of 0.51-0.91, p=0.009) for HHT, indicating significantly improved survival outcome. When stratified by cancer type, HHT diagnosis showed a significant protective effect among breast cancer patients with an adjusted hazard ratio of 0.31 (CI: 0.13-0.75, p=0.009). Conclusions There was a significant association between HHT and improved survival outcome for a composite of patients with breast, prostate, colorectal, and lung cancer, and in analysis stratified by cancer, the association was significant for HHT patients with breast cancer. PMID:24192008

Lucas, F. Lee; Fairfield, Kathleen; Miller, Heather; Brooks, Peter; Vary, Calvin P.H.



Survivorship health information counseling for patients with prostate cancer.  


Cancer survivorship has been recognized in recent years as a critical variable in the cancer care continuum. The Institute of Medicine issued a special report in 2006 addressing cancer survivorship issues. One intervention within these reports is cancer survivorship education about chronic effects following cancer treatment. This evidence-based practice (EBP) project provided a survivorship discharge health information counseling program for patients with localized prostate cancer who were treated with external beam radiation. The results of this pilot program resulted in improved patient satisfaction with survivorship discharge health information for cancel care. PMID:24592520

Colella, Joan; Gejerman, Glen



Recruiting terminally ill patients into non-therapeutic oncology studies: views of health professionals. |

Several themes emerged when interviews were conducted with clinician-researchers regarding their attitudes and concerns when recruiting terminally ill cancer patients into non-therapeutic research. The prominent themes were ethical considerations, patient-centered issues, and health professional issues. Promoting communication and autonomy and fostering familial support are important elements for overcoming patient-centered issues. Facilitating the doctor-patient relationship, using teamwork, and implementing educational programs were seen as key factors for dealing with health professional issues.


Harnessing information and communication technologies to leverage scarce resources for cancer education, research and practice in developing countries  

PubMed Central

In developing countries, low levels of awareness, cost and organizational constraints on access to specialized care contribute to inadequate patient help-seeking behavior. As much as 95% of cancer patients in developing countries are diagnosed at late to end stage disease. Consequently, treatment outcome is dismally poor and a vicious cycle sets in, with public mystification of cancer and the admonishment of cancer medicine as a futile effort, all, to the further detriment of patient help-seeking behavior and treatment engagement. The situation spirals down, when the practice of cancer medicine is not gratifying to the medical practitioner and does not appeal as a medical specialty to those in training. The future of cancer medicine in developing countries thus hinges on the demystification of cancer through positive information, coupled to an effective organization that allows for the optimal use of available resources, facilitates access to specialized care and promotes the flow of knowledge and technology amongst various stakeholders. This paper strives to make a cogent argument and highlight the capital importance of information and communication technologies in organizing and leveraging scarce resources for cancer education, research and practice in developing countries. PMID:16390555

Andela, Valentine B



The Breast Cancer Patient Navigation Kit: Development and User Feedback  

Microsoft Academic Search

Our interdisciplinary team developed a written cancer patient education tool, the Breast Cancer Navigation Kit, to respond\\u000a to the information needs of patients and family members and that meet patient literacy levels. A literature review and a focus\\u000a group provided content development for four modules: “About Breast Cancer,” “Body–Mind–Spirit,” “After Treatment Ends,” and\\u000a “Practical Information.” An evaluation by 31 women

Myriam Skrutkowski; Andréanne Saucier; Sarkis Meterissian


Anticipatory grief in patients with cancer.  


Patients and their loved ones often experience anticipatory grief when learning of a diagnosis of advanced or terminal cancer. Anticipatory grief can be a response to threats of loss of ability to function independently, loss of identity, and changes in role definition, which underlie fear of death. Dealing with multiple losses is a primary task that the dying patient must face. When an oncologist delivers bad news, the patient and family members often hear the same discussion through different filters, which can lead to conflict and dysfunction. By providing a supportive and safe environment, oncology nurses can help patients and their loved ones understand that their feelings are common and are experienced by others in similar situations and assist them with developing coping strategies and in redefining their roles within the family and in the outside world. In addition, an important goal at this time is to help the patients reframe "hope" realistically so they may have the opportunity for personal growth as well as reconciliation of primary relationships toward the end of life. PMID:20118035

Hottensen, Dory



Improving cancer pain control with NCCN guideline-based analgesic administration: a patient-centered outcome.  


Improving the control of cancer-related pain (CRP) is a clinical and ethical imperative. Clinical research has documented improved treatment tolerance and survival rates among patients with cancer who have effective pain control. Barriers to CRP control include inadequate patient and physician education. Meta-analyses of patient education studies correlate improvements in CRP control with improved communications with health care providers and the implementation of strategies that assist with adherence to medication schedules. These strategies build patient confidence, allowing better self-management of pain and reduced psychological consequences. For physicians, ample educational resources exist in CRP management. However, in both the inpatient and outpatient settings, compliance with NCCN Clinical Practice Guidelines in Oncology for Adult Cancer Pain continues to be less than 70%, and more than one-third of patients continue to receive inadequate doses of analgesics. Patient-centered outcomes have become an integral end point in health policy, and the nation's medical training, research, and delivery systems are transforming to a value-based accreditation and reimbursement system. Pain control is a significant patient-centered outcome in cancer care, because pain adversely impacts function and affects all domains of quality of life. Agreement is clear on the value of health care interventions that relieve suffering from cancer pain and restore personal dignity. PMID:25190693

Janjan, Nora



Oncology clinicians' defenses and adherence to communication skills training with simulated patients: an exploratory study.  


The aim of this exploratory study was to assess the impact of clinicians' defense mechanisms-defined as self-protective psychological mechanisms triggered by the affective load of the encounter with the patient-on adherence to a communication skills training (CST). The population consisted of oncology clinicians (N=31) who participated in a CST. An interview with simulated cancer patients was recorded prior and 6 months after CST. Defenses were measured before and after CST and correlated with a prototype of an ideally conducted interview based on the criteria of CST-teachers. Clinicians who used more adaptive defense mechanisms showed better adherence to communication skills after CST than clinicians with less adaptive defenses (F(1, 29)?=5.26, p=0.03, d=0.42). Improvement in communication skills after CST seems to depend on the initial levels of defenses of the clinician prior to CST. Implications for practice and training are discussed. Communication has been recognized as a central element of cancer care [1]. Ineffective communication may contribute to patients' confusion, uncertainty, and increased difficulty in asking questions, expressing feelings, and understanding information [2, 3], and may also contribute to clinicians' lack of job satisfaction and emotional burnout [4]. Therefore, communication skills trainings (CST) for oncology clinicians have been widely developed over the last decade. These trainings should increase the skills of clinicians to respond to the patient's needs, and enhance an adequate encounter with the patient with efficient exchange of information [5]. While CSTs show a great diversity with regard to their pedagogic approaches [6, 7], the main elements of CST consist of (1) role play between participants, (2) analysis of videotaped interviews with simulated patients, and (3) interactive case discussion provided by participants. As recently stated in a consensus paper [8], CSTs need to be taught in small groups (up to 10-12 participants) and have a minimal duration of at least 3 days in order to be effective. Several systematic reviews evaluated the impact of CST on clinicians' communication skills [9-11]. Effectiveness of CST can be assessed by two main approaches: participant-based and patient-based outcomes. Measures can be self-reported, but, according to Gysels et al. [10], behavioral assessment of patient-physician interviews [12] is the most objective and reliable method for measuring change after training. Based on 22 studies on participants' outcomes, Merckaert et al. [9] reported an increase of communication skills and participants' satisfaction with training and changes in attitudes and beliefs. The evaluation of CST remains a challenging task and variables mediating skills improvement remain unidentified. We recently thus conducted a study evaluating the impact of CST on clinicians' defenses by comparing the evolution of defenses of clinicians participating in CST with defenses of a control group without training [13]. Defenses are unconscious psychological processes which protect from anxiety or distress. Therefore, they contribute to the individual's adaptation to stress [14]. Perry refers to the term "defensive functioning" to indicate the degree of adaptation linked to the use of a range of specific defenses by an individual, ranging from low defensive functioning when he or she tends to use generally less adaptive defenses (such as projection, denial, or acting out) to high defensive functioning when he or she tends to use generally more adaptive defenses (such as altruism, intellectualization, or introspection) [15, 16]. Although several authors have addressed the emotional difficulties of oncology clinicians when facing patients and their need to preserve themselves [7, 17, 18], no research has yet been conducted on the defenses of clinicians. For example, repeated use of less adaptive defenses, such as denial, may allow the clinician to avoid or reduce distress, but it also diminishes his ability to respond to the patient's emotions, to identify and to respon

Bernard, Mathieu; de Roten, Yves; Despland, Jean-Nicolas; Stiefel, Friedrich



Nurse and patient communication profiles in a home-based telehealth intervention for heart failure management  

Microsoft Academic Search

ObjectiveThis study compared differences in nurse and patient communication profiles between two telehealth modes: telephone and videophone, and evaluated longitudinal changes in communication, nurse perceptions, and patient satisfaction.

Bonnie J. Wakefield; Carma L. Bylund; John E. Holman; Annette Ray; Melody Scherubel; Michael G. Kienzle; Gary E. Rosenthal



Giving and Receiving Emotional Support Online: Communication Competence as a Moderator of Psychosocial Benefits for Women with Breast Cancer  

PubMed Central

This study examines the moderating role of emotional communication competence in the relationship between computer-mediated social support (CMSS) group participation, specifically giving and receiving emotional support, and psychological health outcomes. Data were collected as part of randomized clinical trials for women diagnosed with breast cancer within the last 2 months. Expression and reception of emotional support was assessed by tracking and coding the 18,064 messages that 236 patients posted and read in CMSS groups. The final data used in the analysis was created by merging (a) computer-aided content analysis of discussion posts, (b) action log data analysis of system usage, and (c) baseline and six-month surveys collected to assess change. Results of this study demonstrate that emotional communication competence moderates the effects of expression and reception of emotional support on psychological quality of life and breast cancer-related concerns in both desired and undesired ways. Giving and receiving emotional support in CMSS groups has positive effects on emotional well-being for breast cancer patients with higher emotional communication, while the same exchanges have detrimental impacts on emotional well-being for those with lower emotional communication competence. The theoretical and practical implications for future research are discussed. PMID:24058261

Yoo, Woohyun; Namkoong, Kang; Choi, Mina; Shah, Dhavan V.; Tsang, Stephanie; Hong, Yangsun; Aguilar, Michael; Gustafson, David H.



Narrative communication in cancer prevention and control: A framework to guide research and application  

Microsoft Academic Search

Narrative forms of communication—including entertainment education, journalism, literature, testimonials, and storytelling—are\\u000a emerging as important tools for cancer prevention and control. To stimulate critical thinking about the role of narrative\\u000a in cancer communication and promote a more focused and systematic program of research to understand its effects, we propose\\u000a a typology of narrative application in cancer control. We assert that narrative

Matthew W. Kreuter; Melanie C. Green; Joseph N. Cappella; Michael D. Slater; Meg E. Wise; Doug Storey; Eddie M. Clark; Daniel J. O’Keefe; Deborah O. Erwin; Kathleen Holmes; Leslie J. Hinyard; Thomas Houston; Sabra Woolley



Can we deconstruct cancer, one patient at a time?  

PubMed Central

Patients with cancer face an ever-widening gap between the exponential rate at which technology improves and the linear rate at which these advances are translated into clinical practice. Closing this gap will require the establishment of learning loops that intimately link lab and clinic and enable the immediate transfer of knowledge, thereby engaging highly motivated patients with cancer as true partners in research. Here, we discuss the goal of creating a distributed network that aims to place world-class resources at the disposal of select patients with cancer and their oncologists, and then use these intensively monitored individual patient experiences to improve collective understanding of how cancer works. PMID:23102584

Blau, C. Anthony; Liakopoulou, Effie



GUCY2C molecular staging personalizes colorectal cancer patient management  

PubMed Central

While the most significant prognostic and predictive marker in the management of colorectal cancer patients is cancer cells in regional lymph nodes, approximately 30% of patients whose lymph nodes are ostensibly free of tumor cells by histopathology ultimately develop recurrent disease reflecting occult metastases. Molecular techniques utilizing highly specific markers and ultra-sensitive detection technologies have emerged as powerful staging platforms to establish prognosis and predict responsiveness to chemotherapy in colorectal cancer patients. This review describes the evolution of the tumor suppressor GUCY2C as a prognostic and predictive molecular biomarker that quantifies occult tumor burden in regional lymph nodes for staging patients with colorectal cancer. PMID:22731908

Gong, Jian P; Schulz, Stephanie; Hyslop, Terry; Waldman, Scott A



Cancer supportive care, improving the quality of life for cancer patients. A program evaluation report  

Microsoft Academic Search

Goals of workAs medical care for cancer has become more specialized in diagnosis, treatment has become more technical and fragmented. In order to help cancer patients and their families, we developed a coordinated program called the Stanford Cancer Supportive Care Program (SCSCP) at the Center for Integrative Medicine at Stanford Hospital and Clinics. The Stanford Cancer Supportive Care Program was

Ernest Rosenbaum; Holly Gautier; Pat Fobair; Eric Neri; Bernadette Festa; Margaret Hawn; Alexandra Andrews; Nama Hirshberger; Sabrina Selim; David Spiegel



Increasing participation of cancer patients in randomised controlled trials: a systematic review. |

Researchers conducted a systematic review of studies of interventions to improve cancer patient participation in randomized controlled trials. Across all studies included in this review, there was no evidence that any of the experimental interventions evaluated led to an increase in cancer patient participation. Further research is required to evaluate the effectiveness of strategies to increase participation in cancer treatment trials.


Lymphedema After Surgery in Patients With Endometrial Cancer, Cervical Cancer, or Vulvar Cancer

Lymphedema; Stage IA Cervical Cancer; Stage IA Uterine Corpus Cancer; Stage IA Vulvar Cancer; Stage IB Cervical Cancer; Stage IB Uterine Corpus Cancer; Stage IB Vulvar Cancer; Stage II Uterine Corpus Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIIA Vulvar Cancer; Stage IIIB Vulvar Cancer; Stage IIIC Vulvar Cancer; Stage IVB Vulvar Cancer



Glycosaminoglycans and activated contact system in cancer patient plasmas.  


Oncogenic mutations create cancer cells. Cancer cells require thrombin for growth, angiogenesis, and metastasis. All cancer patients display a hypercoagulable state, which includes platelet activation, blood coagulation, complement activation, vasodilatation, and inflammation. This often results in thrombosis, the second leading cause of death in cancer patients. It is established that chemically oversulfated glycosaminoglycans (GAGs) induce thrombin generation through contact system activation in human plasma. Thrombin is responsible for thrombosis. In this chapter, we show that plasmas from lung cancer patients contain activated contact systems apparent by the absence of high molecular weight kininogen and processed C1inh, by abnormal kallikrein and thrombin activities, and by increased glucosamine, galactosamine, and GAG levels. Activated contact systems were also evident in plasmas from breast, colon, and pancreatic cancer patients. These data suggest that GAGs or other molecules produced by tumors induce abnormal thrombin generation through contact system activation. Therefore, the contact system and glycans represent new targets for cancer diagnosis, prevention, and treatment. PMID:20807657

Pan, Jing; Qian, Yi; Weiser, Peter; Zhou, Xiaodong; Lu, Hong; Studelska, Daniel R; Zhang, Lijuan



Clinical Oncology Society of Australia position statement on the use of complementary and alternative medicine by cancer patients.  


Health professionals involved in the clinical management of cancer are becoming increasingly aware that their patients use complementary and alternative medicine (CAM). As cancer incidence and survival rates increase, use of CAM is also likely to increase. This paper outlines the position of the Clinical Oncology Society of Australia (COSA) on the use of CAM by cancer patients and provides guidance for health professionals involved with the treatment of cancer patients who are using or wish to use CAM. Key definitions and common communication scenarios are presented along with evidence-based recommended steps for health professionals when discussing CAM use. COSA encourages health professionals to focus on open discussion with their patients regarding CAM, to become familiar with reputable resources for CAM information, to discuss with patients the concept of evidence-based medicine, to recognize limitations to their knowledge of CAM and seek further advice when necessary, and to be respectful of the patients' right to autonomy. PMID:25244342

Braun, Lesley; Harris, Jessica; Katris, Paul; Cain, Michael; Dhillon, Haryana; Koczwara, Bogda; Olver, Ian; Robotin, Monica



Ask, understand, remember: a brief measure of patient communication self-efficacy within clinical encounters.  


Patients' ability to effectively communicate with their health care providers is an essential aspect of proper self-care, especially for those with chronic conditions. We wanted to develop and validate a brief, reliable measure of patient communication self-efficacy within clinical encounters. Consecutively recruited patients (n = 330) with diagnosed hypertension from seven primary care clinics in Chicago, Illinois, Grand Rapids, Michigan, and Shreveport, Louisiana completed an in-person interview including chronic disease self-efficacy, hypertension knowledge, health literacy assessments, and items modified from the Communication and Attitudinal Self-Efficacy (CASE) - Cancer scale. Six items from the CASE were candidates for a new scale due to their focus on the patient-provider relationship. Using principal components analysis with varimax rotation, four items strongly loaded onto one factor (Eigenvalue = 2.33; proportion of variance explained = 58%) with a Cronbach's ? coefficient of 0.75. The measure, referred to as the Ask, Understand, Remember Assessment, (AURA) was moderately correlated with the total score from an existing chronic disease management self-efficacy scale (r = 0.31) and disease knowledge (beta coefficient = 0.2, 95% Confidence Interval 0.04 - 0.3, p = .03). Patients with low health literacy had lower scores on the AURA than those with marginal or adequate health literacy (p < .05). The AURA demonstrated high internal consistency and was correlated with both hypertension knowledge and a chronic disease self-efficacy scale. The AURA is brief, valid, has low reading demands, and is an appropriate tool for use among patients with chronic illness. It may also be useful in identifying and assisting patients who are at risk for errors or non-adherence with self-care behaviors. PMID:20845194

Clayman, Marla L; Pandit, Anjali U; Bergeron, Ashley R; Cameron, Kenzie A; Ross, Emily; Wolf, Michael S



Using a population-based cancer registry for recruitment of newly diagnosed patients with ovarian cancer. |

A population-based cancer registry was successfully used to identify and enroll 60 late-stage ovarian cancer patients to a psychosocial intervention designed to improve quality of life. Cancer registries can be used to screen for some medical eligibility requirements and may be a valuable resource for clinical trials examining interventions to promote quality of life or prevent cancer recurrence.


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

PubMed Central

Patient experience is a critical dimension of cancer care quality. Understanding variation in experience among patients with different cancers and characteristics is an important first step for designing targeted improvement interventions. We analysed data from the 2011/2012 English Cancer Patient Experience Survey (n = 69 086) using logistic regression to explore inequalities in care experience across 64 survey questions. We additionally calculated a summary measure of variation in patient experience by cancer, and explored inequalities between patients with cancers treated by the same specialist teams. We found that younger and very old, ethnic minority patients and women consistently reported worse experiences across questions. Patients with small intestine/rarer lower gastrointestinal, multiple myeloma and hepatobiliary cancers were most likely to report negative experiences whereas patients with breast, melanoma and testicular cancer were least likely (top-to-bottom odds ratio = 1.91, P < 0.0001). There were also inequalities in experience among patients with cancers treated by the same specialty for five of nine services (P < 0.0001). Specifically, patients with ovarian, multiple myeloma, anal, hepatobiliary and renal cancer reported notably worse experiences than patients with other gynaecological, haematological, gastrointestinal and urological malignancies respectively. Initiatives to improve cancer patient experience across oncology services may be suitably targeted on patients at higher risk of poorer experience. PMID:25327713

Saunders, CL; Abel, GA; Lyratzopoulos, G



The dynamics of resident-patient communication: data from Canada.  


The objectives of this study were to examine patterns of resident-patient communication and the relationship between resident patterns of speech with patient satisfaction. Forty consultations, ten in each of the four gender combinations (male resident/male patient, male resident/female patient, female resident/female patient, female resident/male patient) were audiotaped and microanalyzed using the Roter Interaction Analysis System. Several findings depart significantly from previous studies with physician-only or physician-resident-mixed samples. First, the average length of the 40 consultations was 19.5 minutes, 11.3 minutes longer than consultations in a physician-only sample drawn in the same clinic previously. Second, male residents engaged in twice as much psychosocial talk as female residents and conducted longer consultations. Third, residents asked 80% of the total questions while patients asked 20% of the questions. Previous studies with physician-only or physician-resident-mixed samples reported that physicians ask 89-99% of the total questions. Finally, patients' overall satisfaction and communication satisfaction were negatively correlated with residents' positive talk, which constitutes 31% of a given resident's total utterances. In the study conducted in the same clinic with a physician-only sample, physician positive talk was 26% and physician positive talk was not correlated with patient satisfaction. Is this a signal that residents should reduce the amount of positive talk? Apparently more studies with resident-only samples are needed to answer this and other unanswered questions in the field to offer directives to resident training. PMID:17129204

Pahal, Jasrit S; Li, Han Z



Management of heart failure patients using telemedicine communication systems  

Microsoft Academic Search

Heart failure (HF) continues to place significant demands on health care resources because of the large number of hospital\\u000a admissions for HF, the growth of the elderly population with HF, and the improved survival of patients with chronic heart\\u000a disease who develop HF that requires continuous care. Because HF is best managed using a disease management approach, frequent\\u000a communication is

Abul Kashem; Robert C. Cross; William P. Santamore; Alfred A. Bove



African American Women’s Perspectives on Breast Cancer: Implications for Communicating Risk of Basal-like Breast Cancer  

PubMed Central

African American women suffer a higher burden of basal-like breast cancer, an aggressive subtype that has no targeted therapy. While epidemiologic research has identified key prevention strategies, little is known about how best to communicate risk to this population. This study explored women’s knowledge, beliefs, and attitudes about breast cancer to learn about risk perceptions. Six focus groups with 57 women (ages 18–49) women were conducted in North Carolina. Findings revealed that age, race (especially perceptions of cancer as a “White disease”), and lack of family history of breast cancer contributed to women’s perceptions of low breastcancer susceptibility. Perceptions of low risk were also attributed to conflicting risk information from family, media, and health providers. Women had little knowledge about breast cancer subtypes, but emphasized that health communications should be personally relevant, culturally appropriate, and convenient. These study findings will assist in developing health communication tools that encourage prevention. PMID:23728042

Allicock, Marlyn; Graves, Neasha; Gray, Kathleen; Troester, Melissa A.



Fewer Patients with Advanced Colon Cancer Getting Surgery, Report Finds  


... Fewer Patients With Advanced Colon Cancer Getting Surgery, Report Finds Chemotherapy is best treatment, especially for those ... surgery to have the primary tumor removed, researchers report. These patients are also living longer even as ...


Visual communication interface for severe physically disabled patients  

NASA Astrophysics Data System (ADS)

During the last years several interfaces have been developed to allow communication to those patients suffering serious physical disabilities. In this work, a computer based communication interface is presented. It was designed to allow communication to those patients that cannot use neither their hands nor their voice but they can do it through their eyes. The system monitors the eyes movements by means of a webcam. Then, by means of an Artificial Neural Network, the system allows the identification of specified position on the screen through the identification of the eyes positions. This way the user can control a virtual keyboard on a screen that allows him to write and browse the system and enables him to send e-mails, SMS, activate video/music programs and control environmental devices. A patient was simulated to evaluate the versatility of the system. Its operation was satisfactory and it allowed the evaluation of the system potential. The development of this system requires low cost elements that are easily found in the market.

Savino, M. J.; Fernández, E. A.



Quality control issues in the management of colon cancer patients  

Microsoft Academic Search

Quality assurance in colon cancer demands a multidisciplinary effort involving general practitioners, surgeons, radiologists, gastroenterologists, medical oncologists, and pathologists, among others. Maximal improvements in survival will result when colon cancer screening, diagnosis, staging, treatment and surveillance are optimized. We seek to identify those issues most relevant to the quality of care we provide our colon cancer patients.

S. R. Martinez; A. J. Bilchik



Preventing Mucositis in Head and Neck Cancer Patients

In this trial, patients undergoing combination chemotherapy and radiation therapy (chemoradiotherapy) for advanced head and neck cancer will receive intravenous palifermin or placebo before and during cancer treatment to prevent mucositis, a common but serious side effect of chemoradiotherapy for this type of cancer.


Ocular and Orbital Infections in the Immunocompromised Cancer Patient  

Microsoft Academic Search

\\u000a Significant progress has been made in the treatment of cancer patients, and the proportion of cancer patients achieving complete\\u000a remission and longer survival has increased in recent years. However, a significant proportion of patients still do not achieve\\u000a complete remission, and infection remains a frequent cause of treatment failure, particularly in patients with hematologic\\u000a malignancies. Ocular and orbital infections are

Viet H. Ho; Hao H. Ho


Impact of Previous Radiotherapy for Prostate Cancer on Clinical Outcomes of Bladder Cancer Patients  

PubMed Central

Purpose The impact of prostate cancer radiotherapy on the biological behavior of bladder cancer remains unclear. We compared outcomes of bladder cancer patients previously treated for prostate cancer with radiotherapy versus other treatment modalities. Materials and Methods We identified 144 patients diagnosed with bladder cancer between January 1992 and June 2007 with a previous prostate cancer diagnosis. Clinicopathologic data and outcomes were compared between irradiated (brachytherapy and/or external beam radiation therapy; n = 83) and nonirradiated (androgen deprivation therapy, radical prostatectomy, and/or surveillance; n = 61) patients. Results Median time between prostate and bladder cancer diagnoses was longer in irradiated versus nonirradiated patients (59 months [IQR 25–88] versus 24 months [IQR 2–87], p = 0.007). Irradiated patients presented with higher tumor grade (high: 92% versus 77%, p = 0.016) and progressed to higher stage (muscle-invasive: 70% versus 43%, p = 0.001) than nonirradiated patients. In patients undergoing cystectomy, irradiated patients had a numerically higher rate of non-organ confined disease (75% versus 56% for nonirradiated patients, p = 0.1). Among all bladder cancer patients, 5-year cancer-specific survival was 73% (95% CI 59–87) for irradiated patients versus 83% (95% CI 71–95) for nonirradiated patients (p = 0.07). Median followup was 53 months (IQR 24–75). Conclusions More time elapsed between prostate and bladder cancer diagnoses for irradiated patients, and irradiated patients presented with more advanced disease. Future studies are needed to further establish clinical differences in bladder cancer between irradiated and nonirradiated patients and whether biological differences exist. PMID:20299035

Yee, David S.; Shariat, Shahrokh F.; Lowrance, William T.; Sterbis, Joseph R.; Vora, Kinjal C.; Bochner, Bernard H.; Donat, S. Machele; Herr, Harry W.; Dalbagni, Guido; Sandhu, Jaspreet S.



The prognosis and treatment of primary thyroid cancer occurred in breast cancer patients: comparison with ordinary thyroid cancer  

PubMed Central

Purpose Due to the increased prevalence of thyroid cancer, it has been frequently detected in breast cancer patients recently. The aim of this study was to evaluate the clinicopathologic characteristics of thyroid cancer in breast cancer patients with respect to prognosis and treatment. Methods From August 1998 to September 2012, 101 breast cancer patients were diagnosed with thyroid cancer (BT group). One hundred ninety-three female patients with a thyroid malignancy that underwent thyroidectomy in 2008 were recruited as controls (oT group). The clinicopathologic results of these two groups were compared. Results Patients were older (51.40 vs. 47.16, P < 0.001), mean tumor size was smaller (0.96 cm vs. 1.43 cm, P < 0.001), and extrathyroidal extension was less common in the BT group. In both groups, papillary thyroid carcinoma was the most common type of thyroid malignancy. T and N classifications of thyroid cancer were less severe in the BT group, but group TNM stages were similar. Endoscopic thyroid surgery was performed in 12.9% of patients in the BT group and in 6.7% of patients in the oT group. Postoperative radioactive iodine ablation was performed less often in the BT group (P < 0.001). Group recurrence rates were not significantly different. Conclusion Thyroid cancer in breast cancer patients was diagnosed at earlier status than ordinary thyroid cancer. However, the prognosis of thyroid cancer in breast cancer patients was not superior to that in patients with thyroid cancer alone. Radioactive iodine ablation was performed less often and endoscopic surgery could be performed in breast cancer patients. PMID:24783175

Park, Chang Min; Lee, Young Don; Oh, Eun Mee; Kim, Kwan-Il; Park, Heung Kyu; Ko, Kwang-Pil



The Symbolic Relationship of Breast Cancer Patients to Their Cancer, Cure, Physician, and Themselves  

Microsoft Academic Search

This study examined the type of unconscious relationship patients had to their cancer and the extent to which the cancer exhibited its presence through the unconscious of the patients. Before having breast biopsies, 146 tumor patients, between the ages of 17 and 90, were given the Kahn test of symbol arrangement and the lifeline tests. Results of the study using

Suzanne R. Engelman; Ray Craddick



Breast cancer, prostaglandins and patient survival.  

PubMed Central

Prostaglandins may have both undesirable and desirable effects in malignant disease. Their possible roles in breast cancer were studied by examining the relationships between different variables and the amounts of prostaglandin-like material (PG-LM) extracted from 141 breast carcinomas. Univariate analysis indicates a direct correlation with patient age and menopausal status, with a greater yield from cancers of post- compared with pre-menopausal women. Tumours up to 2 cm diameter yielded more PG-LM than those measuring greater than 2-5 cm. Although there was also a direct correlation with bone metastasis near to the time of surgery, this was because no positive bone scans occurred in patients whose tumours yielded little total PG-LM (less than 16 ng PGE2 equivalents per g tissue). Since tumour PG-LM did not predict later spread to bone, and yields of greater than 16 ng g-1 were similar in the positive and negative bone scan groups, tumour PG-LM appears to be unimportant for skeletal metastasis. There was no obvious relationship of tumour PG-LM to the grade of malignancy, tumour type, amounts of fibrous tissue (and therefore malignant cells), invasion of blood vessels and lymphatics or presence of plasma cells. Multivariate analysis indicates that disease-free survival is longest with an intermediate production of tumour total PG-LM. Of the 82 patients now dead, the cause was attributed to metastatic disease in 69 cases. No relationship of PG-LM to the length of survival was seen with univariate or multivariate analysis. However, when just the post-menopausal patients who died within the first 3 postoperative years were analysed, there was a highly significant inverse correlation between the tumour total PG-LM and the time to death. The reason(s) for these different findings on overall survival compared with just the patients who died are not understood, but the results may indicate that one or more other variables must co-exist with a high tumour PG-LM to hasten death. PMID:2930691

Bennett, A.; Stamford, I. F.; Berstock, D. A.; Dische, F.; Singh, L.; A'Hern, R. P.



Breast cancer, prostaglandins and patient survival.  


Prostaglandins may have both undesirable and desirable effects in malignant disease. Their possible roles in breast cancer were studied by examining the relationships between different variables and the amounts of prostaglandin-like material (PG-LM) extracted from 141 breast carcinomas. Univariate analysis indicates a direct correlation with patient age and menopausal status, with a greater yield from cancers of post- compared with pre-menopausal women. Tumours up to 2 cm diameter yielded more PG-LM than those measuring greater than 2-5 cm. Although there was also a direct correlation with bone metastasis near to the time of surgery, this was because no positive bone scans occurred in patients whose tumours yielded little total PG-LM (less than 16 ng PGE2 equivalents per g tissue). Since tumour PG-LM did not predict later spread to bone, and yields of greater than 16 ng g-1 were similar in the positive and negative bone scan groups, tumour PG-LM appears to be unimportant for skeletal metastasis. There was no obvious relationship of tumour PG-LM to the grade of malignancy, tumour type, amounts of fibrous tissue (and therefore malignant cells), invasion of blood vessels and lymphatics or presence of plasma cells. Multivariate analysis indicates that disease-free survival is longest with an intermediate production of tumour total PG-LM. Of the 82 patients now dead, the cause was attributed to metastatic disease in 69 cases. No relationship of PG-LM to the length of survival was seen with univariate or multivariate analysis. However, when just the post-menopausal patients who died within the first 3 postoperative years were analysed, there was a highly significant inverse correlation between the tumour total PG-LM and the time to death. The reason(s) for these different findings on overall survival compared with just the patients who died are not understood, but the results may indicate that one or more other variables must co-exist with a high tumour PG-LM to hasten death. PMID:2930691

Bennett, A; Stamford, I F; Berstock, D A; Dische, F; Singh, L; A'Hern, R P



Ethics of clear health communication: applying the CLEAN Look approach to communicate biobanking information for cancer research.  


Cancer innovations, such as biobanking technologies, are continuously evolving to improve our understanding and knowledge about cancer prevention and treatment modalities. However, the public receives little communication about biobanking and is often unaware about this innovation until asked to donate biospecimens. It is the researchers' ethical duty to provide clear communications about biobanking and biospecimen research. Such information allows the public to understand biobanking processes and facilitates informed decision making about biospecimen donation. The aims of this paper are 1) to examine the importance of clear communication as an ethical imperative when conveying information about cancer innovations and 2) to illustrate the use of an organizing framework, the CLEAN ( C ulture, L iteracy, E ducation, A ssessment, and N etworking) Look approach for creating educational priming materials about the topic of biobanking. PMID:23124500

Koskan, Alexis; Arevalo, Mariana; Gwede, Clement K; Quinn, Gwendolyn P; Noel-Thomas, Shalewa A; Luque, John S; Wells, Kristen J; Meade, Cathy D



Ethics of Clear Health Communication: applying the CLean Look approach to Communicate Biobanking Information for Cancer research  

PubMed Central

Cancer innovations, such as biobanking technologies, are continuously evolving to improve our understanding and knowledge about cancer prevention and treatment modalities. However, the public receives little communication about biobanking and is often unaware about this innovation until asked to donate biospecimens. It is the researchers’ ethical duty to provide clear communications about biobanking and biospecimen research. Such information allows the public to understand biobanking processes and facilitates informed decision making about biospecimen donation. The aims of this paper are 1) to examine the importance of clear communication as an ethical imperative when conveying information about cancer innovations and 2) to illustrate the use of an organizing framework, the CLEAN (Culture, Literacy, Education, Assessment, and Networking) Look approach for creating educational priming materials about the topic of biobanking. PMID:23124500

Koskan, Alexis; Arevalo, Mariana; Gwede, Clement K.; Quinn, Gwendolyn P.; Noel-Thomas, Shalewa A.; Luque, John S.; Wells, Kristen J.; Meade, Cathy D.



Breast cancer patients' perspectives on and use of complementary and alternative medicine: a study by the Susan G. Komen Breast Cancer Foundation.  


The purpose of this study was to examine patterns and predictors of complementary and alternative medicine (CAM) among breast cancer patients. A review of the existing survey literature on CAM use for breast cancer was conducted with a series of eight focus groups (N = 67) to further examine the perspectives of breast cancer patients on CAM. The rates of CAM use varied from 17 to 75%, with a mean of 45%. Vitamins and minerals and herbs were the most frequently cited categories. Users tended to be younger, more educated, and more likely to have used CAM prior to their diagnosis. Focus group data indicate that breast cancer patients use a wide array of CAM for a variety of reasons, including symptom management, improving quality of life, and enhancing immune function. Although women rely on a variety of resources for information, they frequently experience frustration owing to the absence or conflicting nature of such information. Communication with conventional providers about CAM is frequently experienced as either unsupportive or not helpful by many patients. The results point to the value of developing better evidence-based informational resources related to CAM and cancer and the need for physicians to become better educated about CAM and how to communicate more effectively with their breast cancer patients about it. PMID:17022924

Astin, John A; Reilly, Colleen; Perkins, Cheryl; Child, Wendy L



Acceptance of pain: A study in patients with advanced cancer  

Microsoft Academic Search

Pain, among the most common symptoms of cancer, impacts on multiple domains of wellbeing. Significant numbers of patients continue to experience pain despite pharmacological interventions. Although there is evidence to suggest that acceptance of pain is related to better wellbeing among patients with chronic nonmalignant pain, little is known about acceptance of cancer pain. The purpose of this cross-sectional study

Lynn R. Gauthier; Gary Rodin; Camilla Zimmermann; David Warr; Malcolm Moore; Frances Shepherd; Lucia Gagliese



Transdermal Fentanyl in Opioid-Naive Cancer Pain Patients  

Microsoft Academic Search

To treat cancer pain, physicians often decide to jump directly from step 1 of the World Health Organization (WHO) analgesic ladder to step 3. The use of transdermal fentanyl in patients with cancer pain who had either used no opioid before, or only codeine, is evaluated in the present trial. Both opioid-naive (N= 14) and codeine-using (N = 14) patients

Ans P. E Vielvoye-Kerkmeer; Carlien Mattern; Martin P Uitendaal




E-print Network

AMERICAN THORACIC SOCIETY PATIENT HEALTH SERIES Lung Cancer Prevention What are the chances that I. 182, Number 10, P3. ATS Patient Health Series ©2011 American Thoracic Society What can I do to decrease my risk of developing lung cancer? The best way to lower your risk is to avoid

Kaski, Samuel


Successful treatment of chronic hiccup with baclofen in cancer patients.  


Chronic hiccup is an infrequent but distressing symptom in patients with advanced cancer. A series of drugs (chlorpromazine, haloperidol, nifedipine, metoclopramide, baclofen) have been used to treat hiccup without definitive results. Some authors have suggested a possible role of baclofen in the treatment of chronic hiccup. We report three cases of chronic hiccup in patients with cancer successfully treated with baclofen. PMID:21442315

Seker, M Metin; Aksoy, Sercan; Ozdemir, Nuriye Y?ld?r?m; Uncu, Do?an; Civelek, Burak; Ak?nc?, M Bülent; Zengin, Nurullah



Symptom management research in cancer patients: state of the art  

Microsoft Academic Search

AbstractBoth physical symptoms (eg, pain, fatigue, insomnia) and psychological symptoms (eg, depression, anxiety) are prevalent in all types and stages of cancer, from newly diagnosed patients to disease-free cancer survivors to individuals with recurrent or progressive disease. Also, patients often have multiple symptoms, so programmes that focus on single symptoms often fail to optimize treatment outcomes. Additionally, effective treatments include

K Kroenke



Safety and Efficacy of Massage Therapy for Patients With Cancer  

Microsoft Academic Search

Background: As the popularity of complementary\\/alternative medicine (CAM) grows, patients are incorporating more CAM therapies into their conventional cancer care. Massage therapy, a CAM therapy known primarily for its use in relaxation, may also benefit patients with cancer in other ways. Massage can also be associated with risks in the oncology population. Risks can be minimized and benefits maximized when

Lisa Corbin



Quality Assurance for Patients with Breast Cancer - the Impact of Clinical Cancer Registries.  


Introduction: Since 2000 all service providers in the German healthcare system are legally obliged to take part in quality assurance (QA) procedures as stipulated in Book Five of the German Social Code. Clinical cancer registries provide methodological tools to assess the quality of structures, processes and outcomes. The aim of this study was to analyze the consequences of guideline-concordant treatment using two examples of quality indicators: endocrine therapy (adjuvant hormonal therapy, AHT) to treat patients with steroid hormone receptor (SHR)-positive breast cancer and trastuzumab therapy to treat patients with HER2-positive breast cancer. Material and Methods: Data from the Tumor Center Regensburg (Bavaria, Germany) included all female patients listed in the registry with primary, non-metastatic invasive breast cancer diagnosed between 2000 and 2012. Results: A total of 6164 patients with invasive breast cancer and known HER2 status were analyzed. 1134 patients (18.4?%) had HER2-positive and 5346 patients (86.7?%) had SHR-positive breast cancer. Premenopausal patients with HER2-positive breast cancer receiving trastuzumab had a 7-year OS rate of 93.8?% compared to 86.8?% of patients who did not receive trastuzumab (p?=?0.079). Similarly, postmenopausal patients with HER2-positive breast cancer treated with trastuzumab had better 7-year OS rates (87.3?%) than patients who did not receive the antibody (76.7?%) (p?patients with SHR-positive breast cancer receiving AHT had a 7-year OS rate of 95.2?% compared to 75.9?% of patients who did not receive AHT (p?patients treated with AHT had a 7-year OS rate of 83.8?% compared to 64.1?% without AHT (p?cancer registries depend on the cooperation of the various health service providers to generate data that are essential for QA for breast cancer patients. PMID:25278629

Inwald, E C; Klinkhammer-Schalke, M; Koller, M; Ortmann, O



TNF-? levels in cancer patients relate to social variables  

PubMed Central

Tumor necrosis factor-? (TNF-?) is an important cytokine associated with tumor regression and increased survival time for cancer patients. Research evidence relates immune factors (e.g., natural killer (NK) cell counts, NK cell lysis, lymphocyte profile, and lymphocyte proliferation) to the frequency and quality of social relations among cancer patients. We hypothesized that disruptions in social relations would be associated with lower TNF-? responses, and conversely, that reports of positive changes in social relations correlate with stronger responses. A prospective design measured changes in social activity and relationship satisfaction with a partner in 44 breast cancer patients at the time of cancer diagnosis, and initial surgery and 12 months later. Results indicated that patients reporting increased social activities or satisfaction exhibited stronger stimulated TNF-? responses. This is the first study to link changes in patient social relations with a cancer-relevant immune variable. PMID:15890493

Marucha, Phillip T.; Crespin, Timothy R.; Shelby, Rebecca A.; Andersen, Barbara L.



Instrumental and socioemotional communications in doctor-patient interactions in urban and rural clinics  

PubMed Central

Background Location of practice, such as working in a rural or urban clinic, may influence how physicians communicate with their patients. This exploratory pilot study examines the communication styles used during doctor-patient interactions in urban and rural family practice settings in Western Canada. Methods We analyzed observation and interview data from four physicians practicing in these different locations. Using a grounded theory approach, communications were categorized as either instrumental or socioemotional. Instrumental communication refers to “cure-oriented interactions” and tends to be more task-oriented focusing on the patient’s health concerns and reason for the appointment. In contrast, socioemotional communication refers to more “care-oriented interactions” that may make the patient feel comfortable, relieve patient anxiety and build a trusting relationship. Results The physicians in small, rural towns appear to know their patients and their families on a more personal level and outside of their office, and engage in more socioemotional communications compared to those practicing in suburban clinics in a large urban centre. Knowing patients outside the clinic seems to change the nature of the doctor-patient interaction, and, in turn, the doctor-patient relationship itself. Interactions between urban doctors and their patients had a mixture of instrumental and socioemotional communications, while interactions between rural doctors and their patients tended to be highly interpersonal, often involving considerable socioemotional communication and relationship-building. Conclusions Despite the different ways that doctors and patients communicate with each other in the two settings, rural and urban doctors spend approximately the same amount of time with their patients. Thus, greater use of socioemotional communication by rural doctors, which may ease patient anxiety and increase patient trust, did not appear to add extra time to the patient visit. Research suggests that socioemotional communication may ultimately lead to better patient outcomes, which implies that health differences between rural and urban settings could be linked to differences in doctor-patient communication styles. PMID:23835062



Communication of ALS Patients by Detecting Event-Related Potential  

NASA Astrophysics Data System (ADS)

Amyotrophic Lateral Sclerosis(ALS) patients are unable to successfully communicate their desires, although their mental capacity is the same as non-affected persons. Therefore, the authors put emphasis on Event-Related Potential(ERP) which elicits the highest outcome for the target visual and hearing stimuli. P300 is one component of ERP. It is positive potential that is elicited when the subject focuses attention on stimuli that appears infrequently. In this paper, the authors focused on P200 and N200 components, in addition to P300, for their great improvement in the rate of correct judgment in the target word-specific experiment. Hence the authors propose the algorithm that specifies target words by detecting these three components. Ten healthy subjects and ALS patient underwent the experiment in which a target word out of five words, was specified by this algorithm. The rates of correct judgment in nine of ten healthy subjects were more than 90.0%. The highest rate was 99.7%. The highest rate of ALS patient was 100.0%. Through these results, the authors found the possibility that ALS patients could communicate with surrounding persons by detecting ERP(P200, N200 and P300) as their desire.

Kanou, Naoyuki; Sakuma, Kenji; Nakashima, Kenji


Cultural perceptions in cancer care among African-American and Caucasian patients.  

PubMed Central

PURPOSE: This exploratory study examined perceptions and beliefs of African Americans and Caucasians related to cancer care. Understanding belief systems and cultures optimizes cancer treatment and care delivery to ethnic minority individuals. PATIENTS AND METHODS: Focus groups were conducted with 39 African-American and Caucasian cancer patients. Data analysis included whole group analysis with a team of five researchers. RESULTS: Regardless of ethnicity, cancer patients share many of the same emotions and experiences, and want complete information and quality care. Differences were also apparent. African-American participants were more likely to report increased religious behaviors, believe that healthcare providers demonstrate care with simple actions and provision of practical assistance, and use church and community information sources. Caucasian participants were more likely to report spiritual but not overtly religious changes, and depend on healthcare providers for information. CONCLUSION: Understanding how culture colors perceptions, communication and information requirements is critical to providing effective care to ethnically diverse cancer patients. Findings have implications for professionals understanding ways patients seek information, the role of spirituality and religion in care, and ways healthcare providers demonstrate care. PMID:17987914

Matsuyama, Robin K.; Grange, Christina; Lyckholm, Laurie J.; Utsey, Shawn O.; Smith, Thomas J.



Fear of Cancer Recurrence and its Predictive Factors among Iranian Cancer Patients  

PubMed Central

Context: Fear of cancer recurrence (FOCR) is one of the most important psychological problems among cancer patients. In extensive review of related literature there were no articles on FOCR among Iranian cancer patients. Aim: The aim of present study was to investigation FOCR and its predictive factors among Iranian cancer patients. Materials and Methods: In this descriptive-correlational study 129 cancer patients participated. For data collection, the demographic checklist and short form of fear of progression questionnaire was used. Logistic regression was used to determine predictive factors of FOCR. Result: Mean score of FOCR among participants was 44.8 and about 50% of them had high level of FOCR. The most important worries of participants were about their family and the future of their children and their lesser worries were about the physical symptoms and fear of physical damage because of cancer treatments. Also, women, breast cancer patient, and patients with lower level of education have more FOCR. Discussion: There is immediate need for supportive care program designed for Iranian cancer patients aimed at decreasing their FOCR. Especially, breast cancer patients and the patient with low educational level need more attention. PMID:25125869

Aghdam, Alireza Mohajjel; Rahmani, Azad; Nejad, Zahra Kochaki; Ferguson, Caleb; Mohammadpoorasl, Asghar; Sanaat, Zohreh



Integrating cancer survivors' experiences into UK cancer registries: design and development of the ePOCS system (electronic Patient-reported Outcomes from Cancer Survivors)  

PubMed Central

Background: Understanding the psychosocial challenges of cancer survivorship, and identifying which patients experience ongoing difficulties, is a key priority. The ePOCS (electronic patient-reported outcomes from cancer survivors) project aims to develop and evaluate a cost-efficient, UK-scalable electronic system for collecting patient-reported outcome measures (PROMs), at regular post-diagnostic timepoints, and linking these with clinical data in cancer registries. Methods: A multidisciplinary team developed the system using agile methods. Design entailed process mapping the system's constituent parts, data flows and involved human activities, and undertaking usability testing. Informatics specialists built new technical components, including a web-based questionnaire tool and tracking database, and established component-connecting data flows. Development challenges were overcome, including patient usability and data linkage and security. Results: We have developed a system in which PROMs are completed online, using a secure questionnaire administration tool, accessed via a public-facing website, and the responses are linked and stored with clinical registry data. Patient monitoring and communications are semiautomated via a tracker database, and patient correspondence is primarily Email-based. The system is currently honed for clinician-led hospital-based patient recruitment. Conclusions: A feasibility test study is underway. Although there are possible challenges to sustaining and scaling up ePOCS, the system has potential to support UK epidemiological PROMs collection and clinical data linkage. PMID:22048035

Ashley, L; Jones, H; Thomas, J; Forman, D; Newsham, A; Morris, E; Johnson, O; Velikova, G; Wright, P



Lower extremity edema in patients with early ovarian cancer  

PubMed Central

Background The objective of this study was to investigate clinical manifestations of lower extremity edema (LEE) in early ovarian cancer. Methods Patients with early ovarian cancer who underwent staging surgery between January 2001 and December 2010. Medical records for LEE and/or responses to the Gynecologic Cancer Lymphedema Questionnaire (GCLQ) were evaluated. Results Patients had a median age of 46 years. Twenty-nine patients (40.8%) had past (13 patients, 44.8%) and/or current patient-reported LEE (16 patients, 55.2%). Symptoms reported on the GCLQ in over 20% of respondents were numbness, firmness/tightness, swelling, heaviness, limited movement of knee, and aching. GCLQ total symptoms score was significantly higher in patients with current LEE. Most of the LEE (25/29, 86.2%) developed within 12 months after surgery and LEE lasted more than 6 months in approximately two-thirds of the patients (18/29, 62.1%). Only half of the patients (52.1%) indicated knowledge of lymphedema: 86.2% of LEE patients and 28.6% of patients with no LEE. Conclusions Although a significant proportion of patients with ovarian cancer have LEE after surgery, most are not aware of lymphedema until they develop. Education and analyses for LEE and lymphedema are needed in patients with ovarian cancer. PMID:24602386



Public reaction to the death of Steve Jobs: implications for cancer communication.  


The present study aimed to examine the public reaction to the death of Steve Jobs, focusing on general and cancer-specific information seeking and interpersonal communication. Shortly after Jobs's death, employees from a large university in the Southeastern United States (N = 1,398) completed a web-based survey. Every employee had heard about Steve Jobs's death, and 97% correctly identified pancreatic cancer as the cause of his death. General (50%) and pancreatic cancer-specific (7%) information seeking, as well as general (74%) and pancreatic cancer-specific (17%) interpersonal communication, took place in response to Steve Jobs's death. In multivariate logistic regression analyses controlling for demographics and several cancer-oriented variables, both identification with Steve Jobs and cancer worry in response to Steve Jobs's death significantly (p < .05) predicted pancreatic cancer information seeking as well as interpersonal communication about pancreatic cancer. Additional analyses revealed that cancer worry partially mediated the effects of identification on these outcome variables. Implications of these results for future research as well as cancer prevention and communication efforts are discussed. PMID:24716627

Myrick, Jessica Gall; Noar, Seth M; Willoughby, Jessica Fitts; Brown, Jennifer



Utilizing Data from Cancer Patient & Survivor Studies

The number of cancer survivors in the United States continues to increase and as a result, disease recurrence and the possible late effects of cancer treatments are of increasing importance. Although numerous epidemiologic studies have investigated factors that affect cancer risk, far fewer have addressed the extent to which demographic, lifestyle, genomic, clinical, and psychosocial factors influence recurrence and other cancer outcomes.


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

PubMed Central

Background: This study quantified the risk of urinary bladder neoplasms in cancer patients taking into account the age at first diagnosis, the gender of the patients and the lead time between diagnoses. Methods: We used standardised incidence ratios (SIRs) to compare the incidence of bladder tumours in 967?767 cancer patients with the incidence rate in the general Swedish population. A total of 3324 male and 1560 female patients developed bladder tumours at least 1 year after first cancer diagnosis. Results: After bladder and renal pelvis cancers, the SIRs of bladder neoplasms were higher in female than in male patients. Men affected by lung, stomach and larynx tumours belonged to the population at high risk for bladder cancer. Treatment of breast, ovarian and cervical cancers seems to contribute to the subsequent development of bladder neoplasms. Long latencies (16–25 years) were observed after testicular, cervical and endometrial cancers. Detection bias had an important role after prostate cancer. Chemotherapy with cyclophosphamide and cisplatin, and also radiotherapy, seem to increase the risk of subsequent neoplasms in the bladder. Conclusions: These population-based results may help urologists to assess the risk of bladder neoplasms in cancer survivors. Our data should guide ongoing studies that investigate the effectiveness of bladder cancer screening in cancer patients. PMID:19755987

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



Nursing Pain Management—A Qualitative Interview Study of Patients with Pain, Hospitalized for Cancer Treatment  

Microsoft Academic Search

Pain is a significant symptom in cancer patients. Understanding of patients' experiences in relation to pain management is important in evidence-based nursing in the field of pain. The aim of this study was to explore cancer patients' experiences of nursing pain management during hospitalization for cancer treatment. Eighteen cancer patients participated in the study, all with advanced cancer, including skeleton

Tone Rustøen; Torill Gaardsrud; Marit Leegaard; Astrid K. Wahl



Microarray Profiling in Breast Cancer Patients  

Microsoft Academic Search

\\u000a Breast cancer is the most common cancer among women. It arises from a variety of genetic, epigenetic, and chromosomal alterations.\\u000a The traditional prognostic and predictive factors in breast cancer mainly focus on the clinical–pathological parameters, which\\u000a are unable to reveal the diverse molecular alterations of breast cancer and are imprecise in predicting breast cancer progression\\u000a and clinical outcomes. In recent

Yong Qian; Xianglin Shi; Vincent Castranova; Nancy L. Guo


Helping prostate cancer patients understand the causes of anxiety and depression: comparing cancer-caused vs patient response events  

Microsoft Academic Search

BackgroundProstate cancer (PCa) patients have elevated anxiety and depression, often showing impairments in decision-making and weakened relationships with their partner and family. Although treatment for these psychological side-effects of PCa is strongly recommended, relatively little is known of the causal processes underlying them. This study compared cancer-based lifestyle changes vs patient behavioural responses to cancer as predictors of anxiety and

Christopher F. Sharpley; Vicki Bitsika; David R. H. Christie



Many Breast Cancer Patients Lack Info on Their Cancer  


... News) -- Many women with breast cancer lack basic knowledge about their disease, such as their cancer stage ... according to a new study. The lack of knowledge was even more pronounced among minority women, the ...


Nurse-patient communication in the intensive care unit: a review of the literature  

Microsoft Academic Search

Patient care within an intensive care unit (ICU) can be a difficult and stressful task for even the most experienced and skilled critical care nurse. Good communication between the patient, relatives and nurse is integral to quality care of the patient and should extend to the entire health-care team. This article reviews the literature on nurse-patient communication in the ICU.

Erna Llenore; K. Robin Ogle



[Stroke in cancer patients. A paraneoplastic neurological syndrome?].  


The coincidence of stroke and cancer is frequently encountered. From recent epidemiological data, the stroke risk in cancer patients seems to be equally distributed as compared to the non-cancer population. However, there are several clinical conditions in cancer patients which increase the risk for stroke: Trousseau's syndrome, non-bacterial thrombotic endocarditis and disseminated intravascular coagulation. Also some tumour-specific conditions such as coagulopathies, changes of viscosity and cellular mechanisms such as leukocytosis or thrombocytopathies must be considered. In several types of tumour treatment, such as various anticancer drugs, an increased occurrence of stroke has been reported. Presently there is no indication that stroke and cancer are related to the immune-mediated "classic" paraneoplastic syndromes. However, there are several cancer-specific types and causes of stroke which need to be considered in each patient, as they can be of significance in the treatment. PMID:20333348

Grisold, W; Födinger, M; Oberndorfer, S



Surgical Treatment for Lung Cancer Patients with Poor Pulmonary Function  

Microsoft Academic Search

This retrospective study was aimed to review the risk factors of postoperative hospital death in lung cancer patients with poor pulmonary reserves. We performed surgery on 30 lung cancer patients (average age: 71 years) with less than 1.0L of preoperative forced expiratory volume in one second (FEV1.0<1.0L) between 1982 and 2003. The preoperative FEV1.0 of these 30 patients was 0.81±0.1L

Kiyoshi Koizumi; Shuji Haraguchi; Tomomi Hirata; Kyoji Hirai; Iwao Mikami; Daisuke Okada; Shigeki Yamagishi; Tetsuo Kawashima; Hiroyasu Kinoshita; Yutaka Enomoto; Yuki Nakajima; Kazuo Shimizu



Sleep disorders in advanced cancer patients: prevalence and factors associated  

Microsoft Academic Search

Goals of workSleep disorders have been invariably reported in cancer population. However, the prevalence of this problem in advanced cancer patients has never been assessed. The aim of this study was to evaluate the frequency of sleep disturbances in terms of quantity and quality, and possible associated factors.Patients and methodsA consecutive sample of patients admitted to a pain relief and

Sebastiano Mercadante; Davide Girelli; Alessandra Casuccio



Scrambler Therapy for Patients with Cancer Pain - Case Series -  

PubMed Central

More than 80% of cancer patients experience cancer pain. Among them, more than 50% experience moderate to severe pain. To control cancer pain, a variety of methods have been used, including medications and nerve blocks. In some patients, however, it is impossible to perform nerve blocks due to caner metastasis into the epidural space, while in other patients, opioid dose escalation is impossible due to opioid side effects; thus, cancer pain management is difficult. Scrambler therapy is a novel approach for pain control that uses EKG-like pads, which are applied above and below the site of pain. Scrambler therapy synthesizes 16 different types of nerve action potentials that provide "non-pain" information via cutaneous nerves. The advantages of this treatment are that it is non-invasive and safe and has no significant side effects. In this case series, we report the treatment results of using scrambler therapy in three cancer patients with intractable pain. PMID:23342211

Park, Hong Sik; Sin, Woo Kyung; Kim, Hye Young; Park, Soo Young; Kim, Yong Chul; Lee, Sang Chul



Measurement of Cancer Health Literacy and Identification of Patients with Limited Cancer Health Literacy  

PubMed Central

Health literacy is related to a broad range of health outcomes. This study was designed to develop a psychometrically sound instrument designed to measure cancer health literacy along a continuum (CHLT-30), to develop another instrument designed to determine whether a patient has limited cancer health literacy (CHLT-6), and to estimate the prevalence of limited cancer health literacy. The Cancer Health Literacy Study involving 1,306 Black and White cancer patients was conducted between April 2011 and April 2013 in the Virginia Commonwealth University Massey Cancer Center and surrounding oncology clinics. A continuous latent variable modeling framework was adopted to dimensionally represent cancer health literacy, whereas discrete latent variable modeling was used to estimate the prevalence rates of limited cancer health literacy. Self confidence about engaging in health decisions was used as the primary outcome in external validation of new instruments. Results from a comprehensive analysis strongly supported the construct validity and reliability of the CHLT-30 and CHLT-6. For both instruments, measurement invariance tests ruled out item/test bias to explain gender and race/ethnicity differences in test scores. The limited cancer health literacy rate was 18%, a subpopulation consisting of overrepresented Black, undereducated, and low-income cancer patients. Overall, the results supported the conclusion that the CHLT-30 accurately measures cancer health literacy along a continuum and that the CHLT-6 efficiently identifies patients with limited cancer health literacy with high accuracy. PMID:25315594

Dumenci, Levent; Matsuyama, Robin; Riddle, Daniel L.; Cartwright, Laura A.; Perera, Robert A.; Chung, Harold; Siminoff, Laura A.



The non-breast-cancer death rate among breast cancer patients  

Microsoft Academic Search

Non-breast-cancer deaths currently account for almost half of deaths among breast carcinoma patients in the 15 years following\\u000a diagnosis. Understanding the trends of non-breast-cancer death is vital for calibrating treatment and survival expectations,\\u000a and for understanding the consequences of potentially toxic therapies. To observe trends over time in non-breast-cancer relative\\u000a survival—the non-breast-cancer survival rates of breast cancer patients relative to the

Devon Bush; Barbara Smith; Jerry Younger; James S. Michaelson



A qualitative exploration of Malaysian cancer patients' perspectives on cancer and its treatment  

PubMed Central

Background Cancer patients' knowledge about cancer and experiences with its treatment play an important role in long-term adherence in their disease management. This study aimed to explore cancer patients' knowledge about cancer, their perceptions of conventional therapies and the factors that contribute to medication adherence in the Malaysian population. Methods A qualitative research approach was adopted to gain a better understanding of the current perceptions and knowledge held by cancer patients. Twenty patients were interviewed using a semi-structured interview guide. A saturation point was reached after the 18th interview, and no new information emerged with the subsequent 2 interviews. All interviews were transcribed verbatim and analysed by means of a standard content analysis framework. Results The majority of patients related the cause of their cancer to be God's will. Participants perceived conventional therapies as effective due to their scientific methods of preparations. A fear of side effects was main reasons given for delay in seeking treatment; however, perceptions were reported to change after receiving treatment when effective management to reduce the risk of side effects had been experienced. Conclusions This study provides basic information about cancer patients' perceptions towards cancer and its treatment. These findings can help in the design of educational programs to enhance awareness and acceptances of cancer screening. Priorities for future research should focus on patients who refused the conventional therapies at any stage. PMID:21718547



Functional disability high among newly diagnosed older breast cancer patients

Many older women with newly diagnosed breast cancer have difficulty accomplishing daily tasks, and African-Americans seem to be disproportionately affected. Those are the findings of a new study published early online in CANCER by researchers from the Case Western Reserve University School of Medicine and University Hospitals Case Medical Center in Cleveland (home of the Case Comprehensive Cancer Center), a peer-reviewed journal of the American Cancer Society. The study's results suggest that many breast cancer patients could benefit from receiving therapy to improve their physical function.


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

PubMed Central

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

Owusu, Cynthia; Berger, Nathan A



[Nursing care for ovarian cancer patients with intraperitoneal chemotherapy].  


Ovarian cancer, known as a "silent killer", is the leading cause of gynecologic cancer death. Standard treatments for ovarian cancer are debulking surgery combined with platinum chemotherapy drugs to prolong the survival of patients. According to clinical trials run by the American Society of Gynecologic Oncology, patients who received intraperitoneal (IP) chemotherapy survived longer on average than patients who received intravenous chemotherapy alone. Thus, intraperitoneal chemotherapy is a new potential approach for treating ovarian cancer patients. However, the toxicities and undesirable complications of IP chemotherapy are the major challenges of this treatment approach. This article helps nurses recognize the toxicities and complications of IP chemotherapy and may be used as reference for future revisions to patient care guidelines. PMID:25631188

Lu, Yu-Ying; Chou, Ju-Fen; Tsao, Lee-Ing; Liang, Shu-Yuan; Wu, Shu-Fang



Does Increased Patient Awareness Improve Accrual Into Cancer-Related Clinical Trials? |

A set of educational interventions designed for cancer patients significantly improved their satisfaction with information on clinical research, but did not improve clinical trial enrollment of these participants. The authors concluded that information relating to research may be most effectively delivered by the patients' primary cancer care providers rather than through educational materials.


Multidisciplinary Evaluation of Patients With Suspected Lung Cancer  

PubMed Central

Lung cancer diagnosis and treatment has evolved to require the input and expertise of multiple diverse medical and surgical specialties. The approach to lung cancer patients requires the adherence to a few principles that include thorough use of staging modalities to assure the proper treatment for each patient, and an understanding of the limitations and advantages of each of these modalities. Evidence is continuing to emerge that supports the notion that diagnostic workup and treatment of lung cancer patients is best done within the context of a multidisciplinary team devoted to this purpose. PMID:20161592

Bauman, Kristy; Arenberg, Douglas



Do nurses provide holistic care to cancer patients?  

PubMed Central

BACKGROUND: In order to support cancer patients, nurses need to identify different physio-psycho- social needs of patients using a holistic approach. Focusing on Quality of Life (QoL) is congruent with the philosophy of a holistic approach in nursing. The main aim of this research study thus was to identify the level of agreement between cancer patients and nurses about cancer patients’ QoL. METHODS: The study was a survey which was completed in 2008. 166 cancer patients and 95 nurses were conveniently recruited from three major hospitals in Adelaide, Australia. Each patient and nurse was invited to complete the World Health Organization Quality of Life Brief (WHOQoL-BREF) questionnaire separately. This questionnaire considers QoL across four domains or dimensions: physical health, psychological health, social relationship and environment. RESULTS: The proportion of the exact agreement between the two groups was 34.9%, 34.5%, 33.8% and 36.9% for the physical, psychological, social relationship, and environmental QoL domains, respectively. CONCLUSIONS: Results may indicate that nurses do not have a holistic understanding of cancer patients’ QoL. QoL tools like the World Health Organization Quality of Life Brief (WHOQoL-BREF) might be used as guidelines for nurses to assess cancer patients’ QoL rather than relying heavily on their perceptions and intuitions. The results provide some implications for Iran. PMID:22049289

Bahrami, Masoud



Supporting cancer patients' unanchored health information management with mobile technology  

E-print Network

, Seattle, WA Abstract Cancer patients often need to manage care-related information when they are away from that HealthWeaver Mobile can help patients to access care-related information from anywhere, to capture. The enhanced ability to manage information, in turn, helps patients to manage their care and to feel more

Anderson, Richard


Sedation for Refractory Symptoms of Terminal Cancer Patients in Taiwan  

Microsoft Academic Search

This study assessed sedation in terminal cancer patients in terms of three characteristics: frequency; relationship to intractable symptoms; and the extent to which medical staff, family, and patients found sedation to be ethically acceptable and efficacious. Two hundred seventy-six consecutive patients, who were admitted to the palliative care unit of National Taiwan University Hospital in Taiwan between August 1998 and

Tai-Yuan Chiu; Wen-Yu Hu; Bee-Horng Lue; Shao-Yi Cheng; Ching-Yu Chen



Fertility preservation in female cancer patients: an emerging challenge for physicians.  


Fertility preservation has become an issue of great importance in female cancer patients due to increasing survival rates and delayed childbearing. It is an emerging challenge for physicians, cause of several related issues (multidisciplinary approach, doctor-patient communication, ethical, religious and legal problems) and many unresolved questions. This review aims to update the latest literature data, summarizing the effects of cancer treatments on female fertility and the various options currently available to offer cancer patients the opportunity of future pregnancies. Many strategies exist for fertility preservation in young women and they should be assessed according to the patient's age, type of cancer, partner status and time available. Some techniques are well established, others are still experimental. The established methods include embryo cryopreservation, transposition of ovaries prior to radiation therapy, radiation shielding of gonads and conservative surgical approaches. The experimental methods include oocyte cryopreservation, in vitro maturation of oocytes, ovarian tissue cryopreservation and transplantation, and ovarian suppression. Improvement of these techniques as well as better characterization of their success rates and risks, await further investigation. Oocytes donation and gestational surrogacy represent the last options. Thus, the care of these patients is challenging, complex and requires a multidisciplinary approach. A close collaboration between Oncologists, Specialists in Reproductive Medicine, Gynecologic Oncologists and Endocrinologists is crucial for always offering the best possible option. PMID:24637474

Caserta, D; Ralli, E; Matteucci, E; Marci, R; Moscarini, M



National Cancer Institute Disseminates Communications Material Related to I-131 Radioactive Fallout Exposure

The National Cancer Institute (NCI) will disseminate communications materials to key partners and regional representatives to help better inform the public about potential thyroid cancer risk from Iodine-131 (I-131) radioactive fallout due to nuclear testing in the 1950s and early 1960s. Questions and Answers


Communication and Intimacy-Enhancing Interventions for Men Diagnosed with Prostate Cancer and Their Partners  

PubMed Central

Introduction The sexual dysfunction following prostate cancer treatments often leads to a reduction in intimate contact for couples. A number of psychosocial interventions have been developed to enhance intimacy in these couples. This paper reviews three of these interventions and is a summary of a presentation given as part of a symposium at the 2011 Cancer Survivorship and Sexual Health Meeting. Aim The goal of this presentation was to: (i) review three types of psychosocial interventions; and (ii) describe the methodological issues highlighted by these interventions. Main Outcome Measures Validated measures of relationship intimacy and communication. Methods To be selected, the interventions had to be: a randomized control trial, focus on a couples approach to therapy, and report at least one relationship outcome. Results The results were not consistent within or across studies, and suggest that some specific aspects of the interventions may be helpful for the patient, while other aspects of the studies may be helpful for the partner. The Northouse et al. study suggests that partners may benefit from a focus on couple work, as compared to the patient. The Canada et al. study indicates that when focusing on sexual functioning, working with a couple did not show significant benefit compared to working with a man alone. The study did show, however, that a sexual-based intervention can improve the use of erectile dysfunction treatments and suggests patients may benefit from specific focus on side effects of treatment. The Manne et al. study highlights the importance of targeting these interventions to couples who report distress, and for distressed couples, an intervention can show positive results. Conclusions Intimacy enhancing interventions can be effective for couples, while the partners may benefit more from couples work; the patients may benefit more from focus on specific side effects. PMID:23387918

Nelson, Christian J.; Kenowitz, Joslyn



A voice that wraps around the body--communication problems in the advanced stages of non-small cell lung cancer.  

PubMed Central

INTRODUCTION: Significant problems in clinician-patient communication have been described in the oncology literatures. Advanced stage non-small lung cancer a devastating disease, can cause the communication between survivors, significant others, and clinicians to falter. To date, however, no studies have used qualitative methods to examine experiential aspects of living with non-small cell lung cancer. Nor have any studies evaluated the tools survivors might use to repair some of the damage caused by living with this disease. METHODS: Exploratory, two-part qualitative design. RESULTS: Survivors of non-small cell lung cancer live with multiple fears and losses. These include a diminished sense of self, the loss of health, fears of pain in a future tainted by the threat of death, and increased feelings of alienation due to the loss of previous sources of meaning in life. These experiences significantly affect cancer survivors abilities to communicate with clinicians and significant others. CONCLUSIONS: Survivors of non-small cell lung cancer often have difficulty sharing their experiences with others not suffering a similar affliction. Through their narratives with other survivors, however, patients are better able to initiate a biopsychosocial mechanism which enables them to create a cognitive map. This cognitive map helps survivors share their experiences with others, thereby repairing some of the damage caused by this disease, including the harm done to their communication with other people. PMID:11922184

Moore, R. J.; Chamberlain, R. M.; Khuri, F. R.



Engaging communication experts in a Delphi process to identify patient behaviors that could enhance communication in medical encounters  

PubMed Central

Background The communication literature currently focuses primarily on improving physicians' verbal and non-verbal behaviors during the medical interview. The Four Habits Model is a teaching and research framework for physician communication that is based on evidence linking specific communication behaviors with processes and outcomes of care. The Model conceptualizes basic communication tasks as "Habits" and describes the sequence of physician communication behaviors during the clinical encounter associated with improved outcomes. Using the Four Habits Model as a starting point, we asked communication experts to identify the verbal communication behaviors of patients that are important in outpatient encounters. Methods We conducted a 4-round Delphi process with 17 international experts in communication research, medical education, and health care delivery. All rounds were conducted via the internet. In round 1, experts reviewed a list of proposed patient verbal communication behaviors within the Four Habits Model framework. The proposed patient verbal communication behaviors were identified based on a review of the communication literature. The experts could: approve the proposed list; add new behaviors; or modify behaviors. In rounds 2, 3, and 4, they rated each behavior for its fit (agree or disagree) with a particular habit. After each round, we calculated the percent agreement for each behavior and provided these data in the next round. Behaviors receiving more than 70% of experts' votes (either agree or disagree) were considered as achieving consensus. Results Of the 14 originally-proposed patient verbal communication behaviors, the experts modified all but 2, and they added 20 behaviors to the Model in round 1. In round 2, they were presented with 59 behaviors and 14 options to remove specific behaviors for rating. After 3 rounds of rating, the experts retained 22 behaviors. This set included behaviors such as asking questions, expressing preferences, and summarizing information. Conclusion The process identified communication tasks and verbal communication behaviors for patients similar to those outlined for physicians in the Four Habits Model. This represents an important step in building a single model that can be applied to teaching patients and physicians the communication skills associated with improved satisfaction and positive outcomes of care. PMID:20403173



Patients' Preferences for Participation in Treatment Decision-Making at the End of Life: Qualitative Interviews with Advanced Cancer Patients  

PubMed Central

Purpose Patients are often encouraged to participate in treatment decision-making. Most studies on this subject focus on choosing between different curative treatment types. In the last phase of life treatment decisions differ as they often put more emphasis on weighing quantity against quality of life, such as whether or not to start treatment aimed at life prolongation but with the possibility of side effects. This study aimed to obtain insight into cancer patients' preferences and the reasons for patients' preferred role in treatment decision-making at the end of life. Methods 28 advanced cancer patients were included at the start of their first line treatment. In-depth interviews were held prior to upcoming treatment decisions whether or not to start a life prolonging treatment. The Control Preference Scale was used to start discussing the extent and type of influence patients wanted to have concerning upcoming treatment decision-making. Interviews were audio taped and transcribed. Results All patients wanted their physician to participate in the treatment decision-making process. The extent to which patients themselves preferred to participate seemed to depend on how patients saw their own role or assessed their own capabilities for participating in treatment decision-making. Patients foresaw a shift in the preferred level of participation to a more active role depending in the later phase of illness when life prolongation would become more limited and quality of life would become more important. Conclusion Patients vary in how much involvement they would like to have in upcoming treatment decision-making. Individual patients' preferences may change in the course of the illness, with a shift to more active participation in the later phases. Communication about patients' expectations, wishes and preferences for participation in upcoming treatment decisions is of great importance. An approach in which these topics are openly discussed would be beneficial. PMID:24964036

Brom, Linda; Pasman, H. Roeline W.; Widdershoven, Guy A. M.; van der Vorst, Maurice J. D. L.; Reijneveld, Jaap C.; Postma, Tjeerd J.; Onwuteaka-Philipsen, Bregje D.



Doctor-Patient Communication in a Southeast Asian Setting: The Conflict between Ideal and Reality  

ERIC Educational Resources Information Center

Doctor-patient communication has been extensively studied in non-Western contexts and in relation to patients' cultural and education backgrounds. This study explores the perceived ideal communication style for doctor-patient consultations and the reality of actual practice in a Southeast Asian context. We conducted the study in a teaching…

Claramita, Mora; Utarini, Adi; Soebono, Hardyanto; Van Dalen, Jan; Van der Vleuten, Cees



Nurse-elderly patient communication in home care and institutional care: an explorative study  

Microsoft Academic Search

This study explores communication patterns between nurses and elderly patients in two different care settings. In a sample of 181 video-taped nursing encounters, involving 47 nurses and 109 patients, a study was made of nurse-patient communication. The video recordings were observed using an adapted version of Roter's Interaction Analysis System, which yields frequencies of 23 types of verbal behaviours. These

Wilma M. C. M. Caris-Verhallen; Ada Kerkstra; Jozien M. Bensing



NCI Awards $25 Million for Patient Navigator Research Program for Minority and Underserved Cancer Patients

The NCI today announced a total of $25 million in grants to eight research institutions to develop an innovative Patient Navigator Research Program. Navigators help patients and their families manage cancer diagnoses and overcome common barriers to obtaining timely and appropriate cancer care and treatment. Questions and Answers


Hypothesis generation for childhood cancer communication research: results of a secondary analysis.  


Secondary analysis of existing qualitative datasets offers an opportunity to efficiently use these difficult-to-collect data to generate hypotheses for future research and expand understanding of the phenomena under study. We conducted a retrospective interpretation of two qualitative datasets regarding childhood cancer treatment decision making to elaborate themes regarding parents' cancer communication (information sharing and involvement of their children in treatment decision making) that were not fully developed in the original analyses. We identified broad variability in parents' cancer communication that was not entirely dependent upon the age of their ill child. We were able to generate multiple hypotheses to help guide our future research. PMID:24159058

Kelly, Katherine Patterson; Pyke-Grimm, Kimberly; Stewart, Janet L; Hinds, Pamela S



[Diagnosis and treatment of octogenarian neoplastic patients: bladder cancers].  


Age is a risk factor for the occurrence of bladder cancer and bladder cancer is a disease of the elderly. The choice of treatment relays on the staging into non-invasive and muscle-invasive bladder cancer. Non-invasive bladder cancer is usually treated with transurethral resection of the bladder (TURB) followed by intravesical therapy with BCG or chemotherapeutic agents. The gold standard in the treatment of muscle-invasive bladder cancer is radical cystectomy. The elderly and, in particular, the octogenarian have a worse tolerance for aggressive therapies, due to the higher incidence of side effects and complications. This problem could significantly occur for intravesical BCG therapy and for radical cystectomy. When the urologist faces the treatment of an octogenarian affected by bladder cancer, he should answer many questions: 1. In case of a non-invasive bladder cancer, is it possible to use the same drugs that we use for younger patients (BCG vs chemotherapeutic agents)? Should the timing and the kind of follow-up be the same? 2. Should the octogenarian affected by muscle-invasive bladder cancer undergo radical cystectomy or a less invasive treatment? What kind of diversion should be preferred? Is it possible to propose an orthotopic neobladder to an octogenarian patient? The choice of the treatment should be made on the basis of a careful evaluation of the patient, considering not only the patient's age but also comorbidities and life expectancy. PMID:21308672

Destefanis, Paolo; Bisconti, Alessandro; Lasaponara, Fedele; Fontana, Dario



Breakthrough pain: characteristics and impact in patients with cancer pain  

Microsoft Academic Search

Few surveys have been performed to define the characteristics and impact of breakthrough pain in the cancer population. In this cross-sectional survey of inpatients with cancer, patients responded to a structured interview (the Breakthrough Pain Questionnaire) designed to characterize breakthrough pain, and also completed measures of pain and mood (Memorial Pain Assessment Card (MPAC)), pain-related interference in function (Brief Pain

Russell K Portenoy; David Payne; Paul Jacobsen



Treatment options for patients with triple-negative breast cancer  

Microsoft Academic Search

Breast cancer is a heterogeneous disease composed of different subtypes, characterized by their different clinicopathological characteristics, prognoses and responses to treatment. In the past decade, significant advances have been made in the treatment of breast cancer sensitive to hormonal treatments, as well as in patients whose malignant cells overexpress or amplify HER2. In contrast, mainly due to the lack of

Rafael Santana-Davila; Edith A Perez



Readability of patient information booklets for women with breast cancer  

Microsoft Academic Search

Providing accurate information, in both verbal and written formats, is seen as an important component of patient care. For individuals diagnosed with cancer, acquiring information may be a particularly pertinent issue in terms of coping with the disease. Numerous information booklets are available for people with cancer which aim to provide information on various aspects of care and treatment. This

Kinta Beaver; Karen Luker



Generic Drugs May Help Breast Cancer Patients Stick to Therapy  


... page, please enable JavaScript. Generic Drugs May Help Breast Cancer Patients Stick to Therapy Cost a key factor ... Preidt Friday, October 31, 2014 Related MedlinePlus Pages Breast Cancer Medicines FRIDAY, Oct. 31, 2014 (HealthDay News) -- Access ...


Nosocomial bacterial and fungal meningitis in cancer patients  

Microsoft Academic Search

Five cases of nosocomial meningitis are described that occurred within 5 years in a national cancer center in neutropenic cancer patients after cytotoxic chemotherapy: one caused by the yeast Aureobasidium mansoni and four caused by bacteria two by Enterococcus faecalis and one by Salmonella enteritis and Arcanobacterium haemolyticus. Despite the severe symptoms, all cases were cured with appropriate antimicrobial therapy.

J. Trupl; T. Minarik; J. Sufliarsky; S. Spanik; V. Kremery



Stanford study finds Hispanic lung cancer patients have higher survival than non-Hispanic white patients

Analysis of non-small cell lung cancer (NSCLC) patient records in the California Cancer Registry database during the 20-year period of 1988-2008 indicates that Hispanics/Latinos with NSCLC have a higher overall survival compared to non-Hispanic white patients, according to Stanford University research presented at the 2012 Chicago Multidisciplinary Symposium in Thoracic Oncology. Stanford University is home to the Stanford Cancer Institute.


Life events may contribute to family communication about cancer risk following BRCA1/2 testing.  


We assessed whether certain life events contributed to the communication about cancer risk within families who have undergone BRCA1/2 testing. We also explored what type of resources participants would have valued to help in supporting family communication about genetic information. Two hundred and forty-six individuals (218 women, 28 men) who received a BRCA1/2 genetic test result 3 to 10 years earlier (mean of 6.4 years) participated in a telephone interview. Participants were asked about the occurrence of a number of life events (cancer diagnosis, death, uptake of prophylactic surgery, and providing care to a family member with cancer) in their family since their BRCA1/2 test result disclosure and, for each occurrence, whether it fostered family communication about cancer risk. A total of 182 participants (74 %) reported that they or one of their relatives received a cancer diagnosis, 176 (72 %) reported that someone died in their family, and 73 (30 %) stated that they or one of their relatives undertook a prophylactic surgery. During this period, 109 participants (44 %) also provided care for a family member who had cancer. Among participants who reported these life events, family communication was fostered by these events in proportions varying from 50 % (death) to 69 % (cancer diagnosis). Our results indicate that life events may contribute to family communication about cancer risk. Further research is needed to determine whether these events provide a "window of opportunity" to reach family members, address their needs and concerns about cancer, update family cancer history, and introduce genetic counseling and risk assessment. PMID:22892900

Lapointe, Julie; Côté, Claudia; Bouchard, Karine; Godard, Béatrice; Simard, Jacques; Dorval, Michel



Many Patients with Cancer Need Better Treatments for Pain

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


Glycosylation status of vitamin D binding protein in cancer patients.  


On the basis of the results of activity studies, previous reports have suggested that vitamin D binding protein (DBP) is significantly or even completely deglycosylated in cancer patients, eliminating the molecular precursor of the immunologically important Gc macrophage activating factor (GcMAF), a glycosidase-derived product of DBP. The purpose of this investigation was to directly determine the relative degree of O-linked trisaccharide glycosylation of serum-derived DBP in human breast, colorectal, pancreatic, and prostate cancer patients. Results obtained by electrospray ionization-based mass spectrometric immunoassay showed that there was no significant depletion of DBP trisaccharide glycosylation in the 56 cancer patients examined relative to healthy controls. These results suggest that alternative hypotheses regarding the molecular and/or structural origins of GcMAF must be considered to explain the relative inability of cancer patient serum to activate macrophages. PMID:19642159

Rehder, Douglas S; Nelson, Randall W; Borges, Chad R



Glycosylation status of vitamin D binding protein in cancer patients  

PubMed Central

On the basis of the results of activity studies, previous reports have suggested that vitamin D binding protein (DBP) is significantly or even completely deglycosylated in cancer patients, eliminating the molecular precursor of the immunologically important Gc macrophage activating factor (GcMAF), a glycosidase-derived product of DBP. The purpose of this investigation was to directly determine the relative degree of O-linked trisaccharide glycosylation of serum-derived DBP in human breast, colorectal, pancreatic, and prostate cancer patients. Results obtained by electrospray ionization-based mass spectrometric immunoassay showed that there was no significant depletion of DBP trisaccharide glycosylation in the 56 cancer patients examined relative to healthy controls. These results suggest that alternative hypotheses regarding the molecular and/or structural origins of GcMAF must be considered to explain the relative inability of cancer patient serum to activate macrophages. PMID:19642159

Rehder, Douglas S; Nelson, Randall W; Borges, Chad R



Combining Chemotherapy with Bevacizumab Improves Outcomes for Ovarian Cancer Patients

Results from two phase III randomized clinical trials suggest that, at least for some patients with ovarian cancer, adding the antiangiogenesis agent bevacizumab to chemotherapy increases the time to disease progression and may improve survival.


New Drug for Patients with Advanced Thyroid Cancer

In this phase II trial, researchers are studying the effects of treatment with 17-AAG, an antitumor antibiotic drug that targets a protein called HSP90, in patients with advanced medullary or differentiated thyroid cancer.


Successful management of elderly breast cancer patients treated without radiotherapy  

E-print Network

Abstract Background Breast cancer in the elderly may follow a less aggressive course. There are data suggesting that radiotherapy (RT) following breast conserving surgery (BCS) for invasive carcinoma may not be necessary in some elderly patients...

Valassiadou, Kalliope; Morgan, David A L; Robertson, John F R; Pinder, Sarah E; Cheung, Kwok-Leung



Vanderbilt study finds more breast cancer patients opting for mastectomy

Far more breast cancer patients are choosing to undergo mastectomy, including removal of both breasts, instead of choosing breast conservation surgery even when they have early stage disease that is confined to one breast, a Vanderbilt study shows.


Medicare Launches Efforts to Improve Care for Cancer Patients

The Centers for Medicare & Medicaid Services (CMS) today issued two national coverage decisions for improving care for cancer patients by expanding coverage for diagnostic tests and chemotherapy treatments for Medicare beneficiaries.


Dietary Intervention for Patients Receiving Chemoradiotherapy for Lung Cancer

In this phase I clinical trial, patients with advanced non-small cell lung cancer who are about to undergo chemoradiation therapy will consume a very low-carbohydrate ketogenic diet for the duration of their treatment.


Building a Latin American cancer patient advocacy movement: Latin American cancer NGO regional overview.  


The objective of the this paper is to assess and identify the key strengths and weaknesses for cancer control NGOs in Latin America, with the goal to make recommendations about how to improve thev impact of the patient advocacy movement as it pertains to cancer. The methods included literature review, expert interviews and site visits to Latin American cancer hospitals and NGOs. The overall findings conclude that NGOs currently do not take a leadership role in cancer control in Latin America. The lack of a survivorship movement, faulty patient information services and failure of the governments to include NGOs in policy creation are identified as areas for further project work and collaboration. The stigma of cancer still remains and a burgeoning patient movement can be created to help destigmatize and debunk the myths that surround cancer. PMID:19967288

Durstine, Alessandra; Leitman, Elizabeth



Acute bacterial infection negatively impacts cancer specific survival of colorectal cancer patients  

PubMed Central

AIM: To assess the impact of bacterial infections on cancer-specific survival in patients with colorectal cancer. METHODS: This was a retrospective cohort study of colorectal cancer patients treated at the A.C. Camargo Cancer Center between January 2006 and April 2010. The presence of bacterial infection during cancer treatment, or up to one year after, was confirmed by laboratory tests or by the physician. Infections of the urinary, respiratory or digestive tracts, bloodstream, skin or surgical site were defined by testing within a single laboratory. Criteria for exclusion from the study were: chronically immunosuppressed patients; transplant patients (due to chronic immunosuppression); human immunodeficiency virus carriers; chronic use of corticosteroids or other immunosuppressive drugs; patients with autoimmune disease or primary immunodeficiency; known viral or parasitic infections. Patients with infections that did not require hospitalization were not included in the study because of the difficulty of collecting and tracking data related to infectious processes. In addition, patients hospitalized for pulmonary thromboembolism, stroke, acute myocardial infarction, uncontrolled diabetes, malignant hypercalcemia or other serious non-infectious complications not directly related to infection were also excluded. Survival curves were plotted using the Kaplan-Meier method, and log-rank tests (univariate analysis) and a Cox test assuming a proportional hazards model (multivariate analysis) were performed to examine associations between clinical history and characteristics of infection with cancer-specific survival. RESULTS: One-hundred and six patients with colorectal cancer were divided into two groups based on the presence or absence of bacterial infection. Patient ages ranged from 23 to 91 years, with a median of 55 years. The majority of patients were male (57/106, 53.77%) with stage III colorectal cancer (45/106, 44.11%). A total of 86 bacteriologic events were recorded. Results indicate that the presence and number of infections during or after the end of treatment were associated with poorer-cancer specific survivals (P = 0.02). Elevated neutrophil counts were also associated with poorer cancer-specific survival (P = 0.02). Analysis of patient age revealed that patients > 65 years of age had a poorer cancer-specific survival (P = 0.04). A multivariate analysis demonstrated that infection was an independent predictor of poor survival (HR = 2.62, 95%CI: 1.26-5.45; P = 0.01) along with advanced clinical staging (HR = 2.63, 95%CI: 1.08-6.39; P = 0.03). CONCLUSION: Infection and high neutrophil counts are associated with a poorer cancer-specific survival in colorectal cancer patients. PMID:25320529

Attiê, Regina; Chinen, Ludmilla Thomé Domingos; Yoshioka, Eliane Muta; Silva, Michele Cristina F; de Lima, Vladmir Cláudio Cordeiro



Cervical cancer: particularities in HIV patients.  


Cervical cancer is the second most common cancer in women worldwide. It represents one of the most challenging public health problems in developing countries. HIV-infected women have a higher risk of cervical cancer which is an AIDS defining cancer. Cervical cancer treatment in HIV-infected and non-infected women is the same. HIV naive women must be prescribed combination antiretroviral therapy at the moment of HIV cancer diagnosis. A close collaboration between oncologist and infectiologist is mandatory to optimize HIV treatment. Among HIV-infected women, PAP-smear screening for early detection and treatment of precancerous cervical lesions is recommended. HPV vaccination is also recommended with the same efficacy and safety profile as the general population. PMID:25418597

Grellier, Noémie; Quéro, Laurent



Early-Stage Breast Cancer Treatment: A Patient and Doctor Dialogue  


... A Patient and Doctor Dialogue Q: What is breast cancer, and what type do I have? A: Cancer ... think this approach is inappropriate. Q: How does breast cancer spread? A: If cancer spreads to other parts ...


Clinical significance of repeat sextant biopsies in prostate cancer patients  

Microsoft Academic Search

ObjectivesSix random systematic core biopsies (SRSCB) of the prostate is considered by many to represent the standard method of detecting prostate cancer. We sought to evaluate the sensitivity of the transrectal ultrasound (TRU)S-guided needle biopsies in 89 consecutive patients with a history of biopsy-proven prostate cancer. These patients underwent repeat biopsy prior to enrollment in an ongoing, randomized protocol. We

Nicholas Stroumbakis; Michael S. Cookson; Victor E. Reuter; William R. Fair



Raoultella ornithinolytica bacteremia in cancer patients: report of three cases.  


Raoultella ornithinolytica is a Gram-negative aerobic bacillus reclassified in the new genus from the Klebsiella species based on new genetic approaches; however, human infections caused by R. ornithinolytica are rare. We herein report three cases of R. ornithinolytica bacteremia associated with biliary tract infections in cancer patients. R. ornithinolytica can be a causative pathogen of biliary tract infection in cancer patients. PMID:23154732

Hadano, Yoshiro; Tsukahara, Mika; Ito, Kenta; Suzuki, Jun; Kawamura, Ichiro; Kurai, Hanako



Complementary and Alternative Medicine Use Among Patients with Thyroid Cancer  

PubMed Central

Background To report on the incidence and predictors of use of complementary and alternative medicine (CAM) among patients with thyroid cancer. Methods Data were collected using a web-based online anonymous survey under Institutional Review Board approval from Boston University. This report is based on 1327 responses from subjects with thyroid cancer. Patient factors were compared by univariate and multivariate analyses. Results After excluding multivitamin and prayer use, 74% (n=941) used CAM. Respondents were primarily over age 40, white, and female and held a college degree. The top five modalities were massage therapy, chiropraxy, special diets, herbal tea, and yoga. Few patients reported perceiving a particular modality had a negative effect on treatment. CAM was more often used for treatment of symptoms (73%) than as part of thyroid cancer treatment (27%). Multivariable logistic regression demonstrated that patients reporting a poor health status, higher education, cardiovascular disease, pulmonary symptoms, or persistent, recurrent, or metastatic disease were more likely to use CAM for treatment of thyroid cancer symptoms. Nearly one third of respondents reported their CAM use was not known, prescribed, or asked about by their physicians. Conclusions In comparison to national surveys of the general U.S. population, patients with thyroid cancer use CAM therapies twice as often and report their use far less often. Physicians who treat patients with thyroid cancer should be aware of these data to further assist in their assessment and care. PMID:23350883

Gardiner, Paula; Saper, Robert B.; Filippelli, Amanda C.; White, Laura F.; Pearce, Elizabeth N.; Gupta-Lawrence, Rebecca L.; Lee, Stephanie L.



Nurses' perceptions of depression in patients with cancer.  


Objective: Our study aimed at examining nurses' perceptions of depression in cancer patients and their role in its management. Method: We employed questionnaire-based semi-directed interviews. Participants were asked to classify 22 symptoms (related and specific to depression in cancer patients, related but not specific, and unrelated) as "very important," "important," "less important," or "not important" for the diagnosis of depression in cancer patients at two different timepoints (baseline and after a video education program). They were also asked to complete a questionnaire exploring their perceptions about depression and of their role in its systematic screening. We recruited nurses caring for cancer patients from four different departments (palliative care unit, hematology, medical oncology, and thoracic oncology) at an academic medical center. Results: We interviewed 18 nurses and found that they had a good general knowledge of depression in cancer patients, with the majority of them being able to distinguish specific and important symptoms from nonspecific symptoms. Some nurses considered depression as a second-line symptom, and most did not employ a screening tool in their daily practice. All considered that they had a role to play in the management of depression, even as they acknowledged lacking specific training for that task. Significance of results: Our results suggest that limited resources-especially lack of training-affects nurses' ability to correctly manage depression in their cancer patients. PMID:24968136

Rhondali, Wadih; Leprince, Tanguy; Chirac, Anne; Terra, Jean-Louis; Filbet, Marilène



Patients’ Refusal of Surgery Strongly Impairs Breast Cancer Survival  

PubMed Central

Objective: To compare patient and tumor characteristics and survival between women who refused and women who accepted surgery for breast cancer. Summary Background Data: Surgery represents the central component of curative breast cancer treatment, but some women decide not to undergo surgery. Recent studies on the prognosis of non operated breast cancer are nonexistent. Patients and Methods: This study included all 5339 patients aged < 80 years with nonmetastatic breast cancer recorded at the Geneva Cancer Registry between 1975 and 2000. We consulted the clinical files of all nonoperated women to identify those who refused surgery. Patients who refused surgery were compared with those accepting surgery using logistic regression. The effect of refusal of surgery on breast cancer mortality was evaluated by Cox proportional hazards analysis. Results: Seventy patients (1.3%) refused surgery. These women were older, more frequently single, and had larger tumors. Overall, 37 (53%) women had no treatment, 25 (36%) hormone-therapy alone, and 8 (11%) other adjuvant treatments alone or in combination. Five-year specific breast cancer survival of women who refused surgery was lower than that of those who accepted (72%, 95% confidence interval, 60%–84% versus 87%, 95% confidence interval, 86%–88%, respectively). After accounting for other prognostic factors including tumor characteristics and stage, women who refused surgery had a 2.1-fold (95% confidence interval, 1.5–3.1) increased risk to die of breast cancer compared with operated women. Conclusions: Women who refuse surgery for breast cancer have a strongly impaired survival. This information might help patients who are hesitant toward surgery make a better informed decision. PMID:16041219

Verkooijen, Helena M.; Fioretta, Gérald M.; Rapiti, Elisabetta; Bonnefoi, Hervé; Vlastos, Georges; Kurtz, John; Schaefer, Peter; Sappino, André-Pascal; Schubert, Hyma; Bouchardy, Christine



Taste thresholds in patients with small-cell lung cancer  

Microsoft Academic Search

Summary Recognition thresholds for the four basic tastes (salt, sour, sweet and bitter) were tested by the forced-choice technique in 27 patients with small-cell lung cancer, and 22 weight-matched control patients with non-malignant diseases. No significant differences in threshold concentrations could be demonstrated. When patients who were losing weight were compared with weight-stable patients, significantly lower taste thresholds for bitter

Lars Ovesen; Jens Hannibal; Merete Sørensen



Collection of Biospecimen & Clinical Information in Patients w/ Gastrointestinal Cancers

Gastrointestinal Neoplasms; Gynecologic Cancers; Gynecologic Cancers Cervical Cancer; Gastric (Stomach) Cancer; Gastro-Esophageal(GE) Junction Cancer; Gastrointenstinal Stromal Tumor (GIST); Colon/Rectal Cancer; Colon/Rectal Cancer Colon Cancer; Colon/Rectal Cancer Rectal Cancer; Colon/Rectal Cancer Anal Cancer; Anal Cancer; Hepatobiliary Cancers; Hepatobiliary Cancers Liver; Pancreatic Cancer



MR imaging in the management of patients with breast cancer.  


Magnetic resonance (MR) imaging has high sensitivity in detecting and determining the extent of breast cancer and the information provided by this modality has proven valuable in patient management. Investigations defining the strengths of MR imaging, technical advances, and greater standardization of protocols have led to its increased use in patients with breast cancer, both before and following treatment. This article reviews techniques and procedures used in the performance and interpretation of breast MR examinations. Applications of MR imaging in the management of patients with breast cancer are also summarized, including preoperative evaluation of extent of disease, postoperative assessment of residual disease, and the detection of recurrent carcinoma. The use of MR imaging to evaluate patient response to chemotherapy and to assess patients with axillary lymph node metastases with an unknown primary lesion will also be discussed. PMID:16916000

Newstead, Gillian Maclaine



A Practical Approach to Improving Pain Control in Cancer Patients  

PubMed Central

Despite a wealth of recent articles, many patients with cancer pain continue to suffer needlessly. The satisfactory treatment of cancer pain requires a variety of practical management strategies. Practicing physicians need a wider understanding of both the basic principles of analgesic therapy and the pharmacologic features of analgesics. Certain analgesics are best not used in cancer care. The use of pharmacologic adjuncts may lessen overall narcotic requirements and side effects. The appropriate use of alternative therapies can dramatically improve the quality of patients' overall survival. PMID:2884781

Brigden, Malcolm L.; Barnett, Jeffrey B.



General Care of the Older Cancer Patient  

Microsoft Academic Search

With increasing age, there are greater numbers of older people who will be diagnosed with cancer. It must be remembered that such individuals have increased frailty and have a number of geriatric syndromes and conditions particularly pertinent to older age, including incontinence, poor cognition and impaired nutrition. It is often difficult to define the effects of cancer and its treatment

M. Gosney



Physical exercise : effects in cancer patients  

Microsoft Academic Search

Physical exercise plays an important role in cancer prevention as well as in the prevention and treatment of cancer related fatigue during and after treatment. Some of these effects are presented in the thesis of M.J. Velthuis. In Part I effects of physical exercise on anthropometric measurements are examined in the Sex Hormones and Physical Exercise (SHAPE) study, a randomised

M. J. Velthuis



The Effect of Patient-Provider Communication on Medication Adherence in Hypertensive Black Patients: Does Race Concordance Matter?  

PubMed Central

Background Despite evidence of a positive effect of collaborative patient-provider communication on patient outcomes, our understanding of this relationship is unclear. Purpose To determine whether racial composition of the relationship modified the association between ratings of provider communication and medication adherence. Methods Effect modification of the communication-adherence association, by racial composition of the relationship, was evaluated using general linear mixed models while adjusting for selected covariates. Results 390 patients were in race-concordant (black patient, black provider) relationships, while 207 were in race-discordant (black patient, white provider) relationships. The communication-adherence association was significantly modified in race-discordant relationships (p=0.04). Communication rated as more collaborative in race-discordant relationships was associated with better adherence, while communication rated as less collaborative was associated with poor adherence. There was no significant association between adherence and communication in race-concordant relationships (p=0.24). Conclusions Collaborative patient-provider communication may play an influential role in black patients’ adherence behaviors when receiving care from white providers. PMID:22270266

Schoenthaler, Antoinette; Allegrante, John P.; Chaplin, William; Ogedegbe, Gbenga



The Palatability of Cereal Based Nutritional Supplements in Cancer Patients  

PubMed Central

Recently, it is reported that intervention of oral nutritional supplement improves the nutritional status of cancer patients, and the effectiveness is affected by the sensory preference of cancer patients on the oral nutritional supplement. However, the variety of oral nutritional supplement is extremely limited and the number of patient's benefits from using the products are restricted mostly due to sensory dislikes. The objective of this study was to provide sensory preference score of trial manufactured products with different accessory ingredients to maximize the use of oral nutritional supplements. Cancer patients (n = 30) and age, sex-matched healthy volunteers (n = 30) participated in the sensory assessments (taste, flavor, viscosity, color and overall preference) of three types of oral supplements (cereal base, cereal base+herb and cereal base+fruit) and a control supplement product with scorched cereal flavor, a top seller in current Korean market. Results indicate that the cancer patients' overall preference was significantly higher for the control supplement, and fruit added supplement was preferred over plain cereal and herb added products, although the difference was insignificant. However, there was no significant preference difference for the supplements among the control group for all sensory factors. These results suggest that cancer patients are more sensitive to sensory preferences compared to the control group, and the patients prefer the flavor of cooked cereal which is a staple food in Korea. PMID:24527420

Baik, Hyun Wook; Lee, Yu Sun; Song, Min-Kyung



Colorectal cancer in Chinese patients: current and emerging treatment options  

PubMed Central

Colorectal cancer is the second most common cancer in Hong Kong and its incidence is rising in economically developed Chinese cities, including Hong Kong and Shanghai. Several studies conducted in the People’s Republic of China have characterized the unique molecular epidemiology of familial colorectal cancer syndromes and molecular biomarkers such as microsatellite instability and genetic mutations (eg, KRAS, NRAS, BRAF, PIK3CA, ERCC1) in Chinese populations. Interethnic differences in anticancer drug response and toxicity have been well described in many cancers, and this review examined the literature with regard to the tolerance of Chinese patients to commonly used chemotherapeutic regimens and targeted therapies for metastatic colorectal cancer. Studies on the pharmacogenomic differences in drug metabolizing and DNA repair enzymes between Chinese, North Asians, and Caucasian patients were also reviewed. PMID:25336973

Li, Leung; Ma, Brigette BY



Cancer incidence in the first-degree relatives of ovarian cancer patients.  

PubMed Central

Cancer incidence was studied among 3072 first-degree relatives of 559 unselected ovarian cancer patients. Among cohort members there were 306 cancer cases. The overall cancer incidence was not increased: the standardised incidence ratio (SIR) in males was 0.9 (95% confidence interval 0.8-1.1) and in females 1.0 (0.8-1.1). The female relatives had a significantly increased risk for ovarian cancer (SIR 2.8, 1.8-4.2). The excess was attributable to sisters only (SIR 3.7, 2.3-5.7). The relative risk for ovarian cancer among sisters decreased both by increasing age of the sister and by increasing age at diagnosis of the index patient: the SIRs were 7.3 (1.5-21.4), 4.5 (1.6-9.8) and 3.1 (1.7-5.4) for sisters of index patients diagnosed in age < 45, 45-54 and 55-75 years respectively. The age dependency of the risk supports the role of genetic factors in familial ovarian cancer. Although the risk of ovarian cancer among sisters from families with breast cancer (SIR 9.2, 3.7-19.0) was significantly higher than among sisters from families with no breast cancer patients (SIR 2.9, 1.6-4.8, rate ratio 3.1, P < 0.05), the excess was not solely attributable to coaggregation of breast and ovarian cancer. Among the 27 families with two or more ovarian cancers, only sisters were affected in 24 families, which might implicate recessive inheritance or shared environmental factors influencing ovarian cancer risk in sisters. PMID:8688336

Auranen, A.; Pukkala, E.; Mäkinen, J.; Sankila, R.; Grénman, S.; Salmi, T.



Psychological and symptom distress in terminal cancer patients with met and unmet needs.  


This study identified the needs of terminal cancer patients, investigated the factors associated with unmet needs, and assessed psychological and symptom distress associated with unsolved needs. Ninety-four patients were randomly selected from 324 patients admitted for palliative care in 13 Italian centers. Two self-administered questionnaires (the Symptom Distress Scale and the Psychological Distress Inventory) were administered to all the patients. Patients needs were identified using a semi-structured interview, aimed at exploring five areas: physiological needs, safety needs, love and belonging needs, self-esteem needs, self-fulfillment needs. A content analysis of the answers defined 11 needs, and identified patients with unmet needs. The most frequent unmet needs were symptom control (62.8%), occupational functioning (62.1%), and emotional support (51.7%). The less frequently reported needs were those related to personal care (14.6%), financial support (14.1%), and emotional closeness (13.8%). Low functional state was significantly associated with a high proportion of patients with unmet needs of personal care, information, communication, occupational functioning, and emotional closeness. Patients with unmet needs showed significantly higher psychological and symptom distress for most needs. This study provides some suggestions about the concerns that should be carefully considered during the late stage of cancer. PMID:10388245

Morasso, G; Capelli, M; Viterbori, P; Di Leo, S; Alberisio, A; Costantini, M; Fiore, M; Saccani, D; Zeitler, G; Verzolatto, N; Tirelli, W; Lazzari, L; Partinico, M; Borzoni, G; Savian, C; Obertino, E; Zotti, P; Ivaldi, G P; Henriquet, F



Treatment-Related Mortality With Everolimus in Cancer Patients  

PubMed Central

Introduction. The overall incidence and odds of fatal adverse events (FAEs) after exposure to everolimus are not well defined. We performed a comprehensive meta-analysis of published randomized controlled trials (RCTs) to determine the role of everolimus in treatment-related mortality in patients with cancer. Methods. PubMed databases and abstracts from the proceedings of the American Society of Clinical Oncology and the San Antonio Breast Cancer Symposium were searched for RCTs of everolimus either alone or in combination with another agent compared with the control arm without everolimus and that reported deaths from an adverse event from January 1966 to July 2013. The primary objective was to determine the difference of FAEs between everolimus-treated patients and control group patients. Results. In total, 2,997 patients with multiple solid tumors from nine RCTs were included. The overall incidence of FAEs in cancer patients treated with everolimus was 0.7% (95% CI 0.3%–1.1%) compared with 0.4% (95% CI 0.0%–0.7%) in cancer patients who did not receive everolimus. The odds ratio of FAEs was greater in everolimus-treated patients (Peto odds ratio = 3.80, 95% CI 1.59–9.07, p = .003). In subgroup analyses, no significant difference was found in the incidence or odds of FAEs by everolimus administration (alone or in combination) or tumor type (breast cancer vs. nonbreast cancer; p = .63). Conclusion. In patients with cancer, everolimus is associated with a small but significant increase in the odds of a treatment-related fatal events. PMID:24794158

Wesolowski, Robert; Abdel-Rasoul, Mahmoud; Lustberg, Maryam; Paskell, Maria; Shapiro, Charles L.



Acceptance of pain: a study in patients with advanced cancer.  


Pain, among the most common symptoms of cancer, impacts on multiple domains of wellbeing. Significant numbers of patients continue to experience pain despite pharmacological interventions. Although there is evidence to suggest that acceptance of pain is related to better wellbeing among patients with chronic nonmalignant pain, little is known about acceptance of cancer pain. The purpose of this cross-sectional study was to determine the correlates of pain acceptance in 81 patients with advanced cancer and pain. Demographic, disease, and treatment-related information was collected, and patients completed measures of pain, physical, psychological, and social/relational wellbeing and pain acceptance. Multivariate regression models, using backward elimination, determined the correlates of each subscale of the Chronic Pain Acceptance Questionnaire separately. Activity Engagement was negatively associated with depressive symptoms. Pain Willingness was negatively associated with pain catastrophizing. Parents living with children had lower Pain Willingness scores than non-parents. These relationships were independent of pain severity and physical functioning. These preliminary results suggest that acceptance of cancer pain is related to better psychological wellbeing and that there may be a relational element, with parents at risk of experiencing difficulty in adapting to ongoing cancer pain. These data lay the groundwork for future research and interventions designed to enhance quality of life for patients with advanced cancer and pain. PMID:19321264

Gauthier, Lynn R; Rodin, Gary; Zimmermann, Camilla; Warr, David; Moore, Malcolm; Shepherd, Frances; Gagliese, Lucia



What Patients and Families Don't Hear: Backstage Communication in Hospice Interdisciplinary Team Meetings  

Microsoft Academic Search

Backstage communication has been shown to play a vital role in a bona fide group's teamwork. Hospice interdisciplinary teams are considered bona fide groups, and hospice interdisciplinary team meetings constitute backstage communication because they occur away from patients and families. Video recordings of interdisciplinary team meetings were systematically coded for backstage communication mess ages and the extent to which different

Elaine M. Wittenberg-Lyles; Ginnifer Cie Gee; Debra Parker Oliver; George Demiris



Factors associated with emotional and behavioural problems among school age children of breast cancer patients  

PubMed Central

To identify factors linked with emotional and behavioural problems in school age (6- to 17-year-old) children of women with breast cancer. Reports of children's emotional and behavioural problems were obtained from patient mothers, their healthy partners, the children's teacher and adolescents using the Child Behaviour Checklist and Mental Health subscale of the Child Health Questionnaire. Parents reported on their own level of depression and, for patients only, their quality of life. Family functioning was assessed using the Family Assessment Device and Cohesion subscale of the Family Environment Scale. Using a cross-sectional within groups design, assessments were obtained (N=107 families) where the patients were 3–36 months postdiagnosis. Risk of problems in children were linked with low levels of family cohesion, low affective responsiveness and parental over-involvement as reported by both child and mother. Adolescents reported family communication issues, which were associated with externalising behaviour problems. Maternal depression was related to child internalising problems, particularly in girls. Whether the mother was currently on or off chemotherapy was not associated with child problems nor was time since cancer diagnosis. These findings held across child age. Where mothers have early stage breast cancer, a substantial minority of their school-aged children have emotional and behavioural problems. Such cases are characterised by the existence of maternal depression and poor family communication, rather than by the mother's treatment status or time since diagnosis. Targeted treatments, which focus on maternal depression and family communication may benefit the children and, through improved relationships, enhance the patients' quality of life. PMID:16317432

Watson, M; St. James-Roberts, I; Ashley, S; Tilney, C; Brougham, B; Edwards, L; Baldus, C; Romer, G



Survival in Patients with Metachronous Second Primary Lung Cancer.  


Rationale Four to ten percent of patients with non-small cell lung cancer subsequently develop a metachronous second primary lung cancer (MSPLC). The decision to perform surveillance or screening imaging for patients with potentially cured lung cancer must take into account the outcomes expected when detecting MSPLCs. Methods We retrospectively reviewed patients diagnosed with lung cancer at the Cleveland Clinic (2006 - 2010). MSPLC was defined as lung cancer diagnosed after a 4-year, disease-free interval from the first lung cancer, or if there were two different histologic subtypes diagnosed at different times. Patients with first primary lung cancer (FPLC) diagnosed in the same time period were used as controls. Propensity score matching was performed using age, sex, smoking history, histologic subtype, and collaborative stage, with a 1:3 case:control ratio. Survival analyses were performed using Cox proportional hazards modeling and Kaplan-Meier estimates. Results Forty four patients met criteria for having MSPLCs. There were no statistically significant differences between cases and controls in prognostic variables. The median survival time (MST) and 2-year overall survival (OS) rate for the MSPLC group, compared to controls, were: 11.8 vs. 18.4 months (p = 0.18) and 31.0% vs. 40.9% (p = 0.28). The survival difference was largest in those with stage I MSPLC (MST 26.8 vs. 60.4 months, p = 0.09; 2-year OS 56.3% vs. 71.2%, p = 0.28). Conclusions Patients with MSPLCs, particularly stage I MSPLCs, may have worse survival than those with FPLC. This could influence the benefit-risk balance of screening the high-risk cohort with a previously treated lung cancer. PMID:25494009

Ha, Duc; Choi, Humberto; Chevalier, Cory; Zell, Katrina; Wang, Xiao-Feng; Mazzone, Peter J



Predicting survival in potentially curable lung cancer patients.  


Lung cancer is the most common cause of cancer death with unchanged mortality for 50 years. Only localized nonsmall-cell lung cancer (NSCLC) is curable. In these patients it is essential to accurately predict survival to help identify those that will benefit from treatment and those at risk of relapse. Despite needing this clinical information, prospective data are lacking. We therefore prospectively identified prognostic factors in patients with potentially curable lung cancer. Over 2 years, 110 consecutive patients with confirmed localized NSCLC (stages 1-3A) were recruited from a single tertiary center. Prognostic factors investigated included age, gender, body mass index (BMI), performance status, comorbidity, disease stage, quality of life, and respiratory physiology. Patients were followed up for 3-5 years and mortality recorded. The data were analyzed using survival analysis methods. Twenty-eight patients died within 1 year, 15 patients died within 2 years, and 11 patients died within 3 years postsurgery. Kaplan-Meier survival estimates show a survival rate of 51% at 3 years. Factors significantly (p < 0.05) associated with poor overall survival were age at assessment, diabetes, serum albumin, peak VO(2) max, shuttle walk distance, and predicted postoperative transfer factor. In multiple-variable survival models, the strongest predictors of survival overall were diabetes and shuttle walk distance. The results show that potentially curable lung cancer patients should not be discriminated against with respect to weight and smoking history. Careful attention is required when managing patients with diabetes. Respiratory physiologic measurements were of limited value in predicting long-term survival after lung cancer surgery. PMID:18264833

Win, Thida; Sharples, Linda; Groves, Ashley M; Ritchie, Andrew J; Wells, Francis C; Laroche, Clare M



Longitudinal Analysis of a Model to Predict Quality of Life in Prostate Cancer Patients and their Spouses  

Microsoft Academic Search

Background\\/Purpose  This study examined a stress-coping model to assess whether baseline antecedent variables predicted subsequent appraisal and\\u000a how that appraisal predicted coping and quality of life for prostate cancer patients and their spouses.\\u000a \\u000a \\u000a \\u000a Methods  In a sample of 121 prostate cancer patient\\/spouse dyads, we assessed baseline antecedent variables (self-efficacy, current\\u000a concerns, age, socioeconomic status, social support, communication, symptoms, phase of illness), 4-month

Trace S. Kershaw; Darlene W. Mood; Gail Newth; David L. Ronis; Martin G. Sanda; Ulka Vaishampayan; Laurel L. Northouse



Strategic physician communication and oncology clinical trials. |

Videotaped interactions during which physicians present the option of clinical trial participation to patients at a Comprehensive Cancer Center revealed that discussing the benefits of participating and potential side effects of the protocol, addressing patient concerns, and offering tangible resources to manage the concerns raised by patients were associated with patient decisions to accrue to a trial.


Fungal infections in cancer patients: An international autopsy survey  

Microsoft Academic Search

In an attempt to estimate the frequency of fungal infections among cancer patients, a survey of autopsy examinations was conducted in multiple institutions in Europe, Japan and Canada. Fungal infections were identified most often in leukemic patients and transplant recipients (25 % each). Fifty-eight percent of fungal infections were caused byCandida spp. and 30 % byAspergillus spp. There was considerable

G. Bodey; B. Bueltmann; W. Duguid; D. Gibbs; H. Hanak; M. Hotchi; G. Mall; P. Martino; F. Meunier; S. Milliken; S. Naoe; M. Okudaira; D. Scevola; J. van't Wout



Early nutritional intervention in oropharyngeal cancer patients undergoing radiotherapy  

Microsoft Academic Search

Nutritional interventions are not routine in patients undergoing oropharyngeal radiotherapy. The aim of the present study was to assess the effects of early nutritional intervention. Forty-five outpatients undergoing radiotherapy for oropharyngeal cancer were prospectively managed by nutritionists (intervention group). In this group, a percutaneous endoscopic gastrostomy (PEG) was inserted before radiotherapy in any patient in whom at least one of

Marie-Astrid Piquet; Mahmut Ozsahin; Isabelle Larpin; Abderrahim Zouhair; Pauline Coti; May Monney; Philippe Monnier; René-Olivier Mirimanoff; Michel Roulet



Diagnosis Disclosure in Cancer Patients - when the Family says \\  

Microsoft Academic Search

It is not uncommon for family members to thwart a doctor's attempt at disclosure of cancer diagnosis to the patient. This stems from concern and love as well as fear of the negative psychological impact of such revelation. Indeed, collusion of this nature was the norm in medical practice till the not too distant past. In this era of patient

A Lee; H Y Wu



Altered Pattern of Lipid Metabolism in Patients with Lung Cancer  

Microsoft Academic Search

Cholesterol distribution in tumoral tissues and lipid composition in the plasma compartment were determined in patients affected by different histologic types of lung cancer. The results showed that tumoral lung tissues contained 2-fold more total cholesterol and 3.5-fold more esterified cholesterol than normal lung tissues. In the patients the alterations in intracellular cholesterol were also associated with peculiar changes in

S. Dessi’; B. Batetta; D. Pulisci; O. Spano; R. Cherchi; G. Lanfranco; L. Tessitore; P. Costelli; F. M. Baccino; C. Anchis; P. Pani



The Determinants and Consequences of Information Seeking Among Cancer Patients  

Microsoft Academic Search

This research was designed to examine information seeking behavior among cancer patients. We present a model which identifies the determinants and consequences of information seeking and, in turn, examines the effects of prior variables on four outcome variables: whether patients discussed with their physicians information that they received from other sources, whether the information they obtained helped them make decisions




Recurrent Breast Cancer in a Patient with a Ventriculoperitoneal Shunt  

PubMed Central

We report a case of a patient with recurrent infiltrating ductal carcinoma of the breast encasing a ventriculoperitoneal shunt. We also review the current literature regarding reports of breast malignancy around a ventriculoperitoneal shunt, as well as the potential relevance of such shunts to the preoperative evaluation and management of patients with breast cancer.

Copeland-Halperin, Libby R.; Cohen, Robert A.



Stress Encountered by Significant Others of Cancer Patients Receiving Chemotherapy.  

ERIC Educational Resources Information Center

Attempts to identify and describe perceived stress and coping responses of family and nonfamily significant others of cancer patients receiving chemotherapy. Significant others were asked to identify stressful events related to treatment factors, relationship factors, and perception of the patient's condition. Coping responses were categorized in…

Hart, Kay



Dietary patterns of patients with advanced lung or colorectal cancer.  


The purpose of this study was to identify dietary patterns among patients with advanced cancer. Differences between cancer groups are described, and food groups contributing higher proportions to overall caloric intake are identified. Patients with advanced cancer (n=51) were recruited from a regional cancer centre and completed a three-day dietary record. Food items were categorized according to macronutrient content. After adjustment for body weight, substantial variation in energy intake was observed (range: 13.7 to 55.4 kcal/kg/day). For 49% of patients, protein intake was below recommendations. Overall, patients consumed the largest proportion of their calories from meat (16%), other foods (11%), dessert (9%), fruit (9%), white bread (7%), and milk (7%). Only 5% of patients consumed meal replacement supplements. The results of this descriptive study provide important insights into the dietary habits of patients with advanced cancer. These insights could be translated into the development of effective recommendations for maintaining or improving health and quality of life. PMID:23217447

Prado, Carla M M; Lieffers, Jessica R; Bergsten, Gabriella; Mourtzakis, Marina; Baracos, Vickie E; Reiman, Tony; Sawyer, Michael B; McCargar, Linda J



Second Cancers Among 40 576 Testicular Cancer Patients: Focus on Long-term Survivors  

Microsoft Academic Search

Background: Although second primary cancers are a leading cause of death among men with testicular cancer, few studies have quantifi ed risks among long-term survivors. Methods: Within 14 population-based tumor registries in Europe and North America (1943-2001), we identifi ed 40 576 1-year sur- vivors of testicular cancer and ascertained data on any new incident solid tumors among these patients.

Lois B. Travis; Sophie D. Fosså; Sara J. Schonfeld; Mary L. McMaster; Charles F. Lynch; Hans Storm; Eric Holowaty; Aage Andersen; Eero Pukkala; Michael Andersson; Magnus Kaijser; Mary Gospodarowicz; Timo Joensuu; Randi J. Cohen; John D. Boice; Graça M. Dores; Ethel S. Gilbert


Results of an intervention study to improve communication about randomised clinical trials of cancer therapy. |

The authors conducted an intervention study to improve communication during consultation about randomized trials. Questionnaires were used to collect information about patients’ information needs and their attitudes toward clinical trials. The Preferences for Information Questionnaire was helpful to doctors in understanding their patients’ interest in receiving specific details about clinical trials. The Patient Attitudes to Trials Questionnaire accurately predicted which patients would consent to enroll in the trials they were offered.


Nonpharmacologic approach to fatigue in patients with cancer.  


Cancer-related fatigue is a common yet underappreciated problem with a significant impact on functional ability and quality of life. Practice guidelines mandate that all cancer patients and survivors be screened for cancer-related fatigue (CRF) at regular intervals. Comorbidities that could contribute to fatigue should be treated, and patients with moderate to severe fatigue should undergo a comprehensive evaluation. Nonpharmacologic interventions are important tools to combat CRF and should be incorporated into routine practice. Physical activity, educational interventions, and cognitive-behavioral therapy have the most supportive data and can be recommended to patients with confidence. From a practical standpoint, general education on CRF is something that most care providers can readily offer patients as part of routine care. Other interventions that appear promising but are as yet lacking convincing evidence include mindfulness-based stress reduction, yoga, and acupuncture. Reiki, Qigong, hypnosis, and music therapy may be worthy of further investigation. PMID:25299140

Pachman, Deirdre R; Price, Katharine A; Carey, Elise C



Fears, Feelings, and Facts: Interactively Communicating Benefits and Risks of Medical Radiation With Patients  

PubMed Central

OBJECTIVE As public awareness of medical radiation exposure increases, there has been heightened awareness among patients and physicians of the importance of holistic benefit-and-risk discussions in shared medical decision making. CONCLUSION We examine the rationale for informed consent and risk communication, draw on the literature on the psychology of radiation risk communication to increase understanding, examine methods commonly used to communicate radiation risk, and suggest strategies for improving communication about medical radiation benefits and risk. PMID:21427321

Dauer, Lawrence T.; Thornton, Raymond H.; Hay, Jennifer L.; Balter, Rochelle; Williamson, Matthew J.; St. Germain, Jean



Enduring impact of communication skills training: results of a 12-month follow-up. |

Communication difficulties between oncologists and their patients impede patient accrual to clinical trials because patients are left uncertain about their diagnosis or prognosis, and confused about disease management options or the therapeutic intent of treatment. Oncologists are lacking adequate communication skills training. A three-day intensive training course involving feedback on videotaped consultations with simulated patients resulted in significant and lasting improvements in clinicians’ communication skills. Implementing communication skills training courses may lead to increased recruitment to clinical trials.


Communication Skills in Standardized-Patient Assessment of Final-Year Medical Students: A Psychometric Study  

ERIC Educational Resources Information Center

The purpose of this study is to investigate the content-specificity of communication skills. It investigates the reliability and dimensionality of standardized patient (SP) ratings of communication skills in an Objective Structured Clinical Examination(OSCE) for final year medical students. An OSCE consisting of seven standardized patient(SP)…

Guiton, Gretchen; Hodgson, Carol S.; Delandshere, Ginett; Wilkerson, Luann



Stroke Patients Communicating Their Healthcare Needs in Hospital: A Study within the ICF Framework  

ERIC Educational Resources Information Center

Background: Previous research has identified that many patients admitted into acute hospital stroke units have communication-related impairments such as hearing, vision, speech, language and/or cognitive communicative impairment. However, no research has identified how many patients in acute hospital stroke units have difficulty actually…

O'Halloran, Robyn; Worrall, Linda; Hickson, Louise



Survival analysis of endometrial cancer patients with cervical stromal involvement  

PubMed Central

Objective Stage II endometrial cancer is relatively uncommon. There is no consensus for appropriate adjuvant therapy in endometrial cancer patients with cervical stromal involvement (International Federation of Gynecology and Obstetrics [FIGO] stage II). This study investigates how adjuvant treatments and tumor characteristics influence overall survival (OS) and disease-free survival (DFS) in stage II patients in order to establish better treatment guidelines. Methods This multi-institution, Institutional Review Board approved, study is a retrospective review of 40 endometrial cancer patients with cervical stromal involvement treated from 1993 to 2009. Kaplan-Meier estimates were used to evaluate OS and DFS. Results OS was 85% at three years and 67% at five years. There were no significant differences in age, histology, depth of invasion, comorbid conditions, surgical staging or recurrence between patients who received radiation therapy (RT) and those who did not. However, patients with FIGO grade 1 cancers were less likely to receive RT (p=0.007). Patients treated with RT had a similar 5 year OS (n=33, 69%) to those treated with surgery only (n=7, 60%, p=0.746). There were no OS differences when evaluating by grade, histology, or depth of invasion between patients who did and did not receive RT. Four patients recurred: three were locoregional failures only, and one failed locally and distant. Conclusion Patients receiving RT had higher grade tumors. Despite this, OS was comparable between the RT and the no RT cohorts. Local failure was the predominant pattern of failure. Endometrial cancer patients with cervical stromal involvement likely receive better locoregional control with the addition of adjuvant RT and we continue to advocate for RT in most cases. PMID:24761213

Frandsen, Jonathan E.; Sause, William T.; Dodson, Mark K.; Soisson, Andrew P.; Belnap, Thomas W.



Operative Risk Factors in Gastric Cancer Surgery for Elderly Patients  

PubMed Central

Purpose Gastric cancer surgery is a common operation in East Asia, such as Korea and Japan, and there has been a significant increase in the need for this procedure due to the aging population. As a result, surgery for the treatment of gastric cancer for elderly patients is expected to increase. This study examined the effect of old age on gastric cancer surgery, and analyzed the operative risk factors for elderly patients. Materials and Methods From November 2008 to August 2010, 590 patients, who underwent a curative resection for gastric cancers, were enrolled. Patients who underwent palliative or emergency surgery were excluded. A retrospective analysis of the correlation between surgical outcomes and age was performed. The elderly were defined as patients who were over the age of 65 years. Results The mean age of all patients was 58.3 years, and complications occurred in 87 cases (14.7%). The most common complication was wound infection and severe complications requiring surgical, endoscopic, or radiologic intervention developed in 52 cases (8.8%). The rate of complications increased with increasing age of the patients. Univariate analysis revealed age, comorbidity, extent of resection, operation time, and combined resection to be associated with surgical complications. In particular, age over 75 years old, operation time, and comorbidity were predictive factors in multivariate analysis. In the elderly, only comorbidity was associated with surgical complications. Conclusions The patients' age is the most important factor for predicting surgical complications. Surgeons should pay an attention to the performance of gastric cancer surgery on elderly patients. In particular, it must be performed carefully for elderly patients with a comorbidity. PMID:22076212

Seo, Su Han; An, Chang Wook; Yi, Xian; Kim, June Young; Han, Sang-Uk; Cho, Yong Kwan



Palliative care for cancer patients in Sudan: an overview  

PubMed Central

Sudan is facing an increasing number of cancer patients every year, and cancer is now among the top ten killer diseases in the country. The majority of cancer patients are diagnosed with an advanced type of cancer where curative treatment has little, if any, effect. The need for palliative care (PC) is urgent. In spite of this, there is no established programme for comprehensive cancer control in the country. In this article we review the state of PC services available for cancer patients. A PC service started in 2010 as an outpatient service at the main oncology centre in Sudan. With the help of international bodies, several training activities in PC were held. Currently the service includes an outpatient clinic, a nine-bed ward, and a limited home-care service. PC has started to reach two other hospitals in the country. Unfortunately, the need is still great; the services provided are not fully supported by the hospital administration. And even now, thousands of patients outside the cities of Khartoum and Medani have no access to oral morphine.

Gafer, Nahla; Elhaj, Ahmed



Distribution of HLA Tissue Groups in Patients with Gastric Cancer  

PubMed Central

Objective: Gastric cancer is an important disease that is seen all over the world and that threats public health. At the same time, gastric cancer is a heterogeneous disorder with multifactorial etiologies. Recent studies have shown a significant association between HLA antigens and gastric adenocarcinoma. The aim of the present study was to determine the distribution of HLA class I (HLA-A, B and C) and class II (HLA-DR, DQ and DP) antigens in Turkish patients with gastric adenocarcinoma. Materials and Methods: HLA alleles or HLA haplotypes associated with gastric cancer were established in the Turkish population using PSR-SSP analysis in 71 unrelated patients with gastric cancer and in 82 unrelated healthy controls. The statistical significance of differences in allele frequencies between patients and controls was measured by the Chi-square test with Yates’s correction. Results: The study revealed that the HLA-Cw5 antigen is more prevalent in patients with gastric cancer (p=0.042) and that the HLA-DRB1*15 antigen is more prevelent in the control group (p=0.021). Conclusion: It is probable that HLA-Cw5 is a risk factor for gastric cancer whereas HLA-DRB1*15 plays a protective role for this disease. The results show that different loci on HLA may control resistance to or tendency for any disease in different societies; each society should determine its own tissue group.

Bilici, Mehmet; Okcu, Nihat; Cay?r, Kerim; Pirim, Ibrahim; Tekin, Salim B.; Gundogdu, Cemal



Cyclin D1 and Cancer Development in Laryngeal Premalignancy Patients  

PubMed Central

In a previous trial, we found that combined 13-cis retinoic acid (13-cRA), interferon-? and ?-tocopherol more effectively reversed advanced premalignant lesions of the larynx than of the oral cavity and that cyclin D1 (CD1)G/A870 single nucleotide polymorphism correlated with cancer risk. We conducted the present trial primarily to confirm the clinical activity of the combination in advanced laryngeal premalignancy and to confirm and extend our findings on CD1, both genotype and protein expression, in association with cancer risk in this setting. Twenty-seven moderate-to-severe laryngeal dysplasia patients underwent induction with combined 13-cRA daily, ?-interferon twice weekly, and ?-tocopherol daily for one year; 14 non-progressing patients then were randomized to maintenance fenretinide or placebo for two years. During induction, 2 patients had pathological complete responses, 6 had partial responses (30% overall response rate), and 5 developed laryngeal cancer. There were no significant differences between maintenance fenretinide and placebo in response or cancer rates. Ten patients developed cancer overall. Twenty-four patients were evaluated for the CD1 G/A870 genotype, and 23 for pre- and post-treatment CD1 protein expression. Consistent with our earlier report, shorter cancer-free survival was associated with the CD1 AA/AG genotype (p = 0.05). Extending our earlier work, high CD1 expression was associated with worse cancer-free survival overall (p= 0.04) and within each CD1 genotype group. These findings support CD1 genotype and protein expression as important risk markers for laryngeal cancer and suggest future trials targeting upstream regulators of CD1 transcription. PMID:19139013

Papadimitrakopoulou, Vassiliki; Izzo, Julie G.; Liu, Diane D.; Myers, Jeffrey; Ceron, Tania L.; Lewin, Jan; William, William N.; Atwell, Anthea; Lee, J. Jack; Gillenwater, Ann; El-Naggar, Adel; Wu, Xifeng; Lippman, Scott M.; Hittelman, Walter N.; Hong, Waun Ki



Online information as a decision making aid for cancer patients: recommendations from the Eurocancercoms project.  


A pan-European survey was conducted under the auspices of the FP7 Eurocancercoms project during the period September 2010-March 2011. It was designed to broaden public policy understanding of patients' specific needs when seeking online cancer information and aimed to identify gaps in the online cancer information provision across Europe. In this paper we describe the methodology and main findings of the Tenovus survey, and draw some recommendations on the use of online information as a decision making aid for cancer patients and their families, namely: (1) transparency and accountability of the sources of information presented online; (2) accreditation of information by different recognised forms of authority and expertise, i.e. both by health-care professional and by patients/public members belonging to patient advocacy groups; (3) scaling up of information: we envisage a 3-tiered system that would enable patients to access different levels of complexity and volume of information from summary to detailed; (4) embedding of custom search tools and interactive search technologies to allow users to define requirements tailored on their needs and be context-driven; (5) communication across discipline boundaries, as patients' and doctors' online communities have very little or no contact among one another. These recommendations were applied for building the online platform EcancerHub, also under the auspices of the Eurocancercoms project, which by bringing together the different cancer communities seeks to break down traditional information boundaries, and through the interactions produce a surplus knowledge that could aid patients in difficult decision making times. PMID:22033324

Maddock, Carol; Camporesi, Silvia; Lewis, Ian; Ahmad, Kafait; Sullivan, Richard



Factors affecting perceptions of clinical trials by cancer center patients. |

An eight-item questionnaire was designed to capture data on cancer patients’ perceptions about clinical trials. The instrument was used both before and after an educational video on clinical trials was displayed in cancer center waiting rooms. Viewing of the video was not compulsory. Perceptions of the study group were more positive than those of the control group, including a better understanding of randomization. It also was found that perceptions varied depending on the medical specialty the patients were visiting.


Body Image Screening for Cancer Patients Undergoing Reconstructive Surgery  

PubMed Central

Objectives Body image is a critical issue for cancer patients undergoing reconstructive surgery, as they can experience disfigurement and functional impairment. Distress related to appearance changes can lead to various psychosocial difficulties, and patients are often reluctant to discuss these issues with their healthcare team. Our goals were to design and evaluate a screening tool to aid providers in identifying patients who may benefit from referral for specialized psychosocial care to treat body image concerns. Methods We designed a brief 4-item instrument and administered it at a single time point to cancer patients who were undergoing reconstructive treatment. We used simple and multinomial regression models to evaluate whether survey responses, demographic, or clinical variables predicted interest and enrollment in counseling. Results Over 95% of the sample (n = 248) endorsed some concerns, preoccupation, or avoidance due to appearance changes. Approximately one-third of patients were interested in obtaining counseling or additional information to assist with body image distress. Each survey item significantly predicted interest and enrollment in counseling. Concern about future appearance changes was the single best predictor of counseling enrollment. Sex, age, and cancer type were not predictive of counseling interest or enrollment. Conclusions We present initial data supporting use of the Body Image Screener for Cancer Reconstruction. Our findings suggest benefits of administering this tool to patients presenting for reconstructive surgery. It is argued that screening and treatment for body image distress should be provided to this patient population at the earliest possible time point. PMID:25066586

Fingeret, Michelle Cororve; Nipomnick, Summer; Guindani, Michele; Baumann, Donald; Hanasono, Matthew; Crosby, Melissa



Controversies over spinal treatment in advanced cancer patients  

Microsoft Academic Search

About 10% of patients with cancer pain do not obtain pain relief or experience unacceptable side effects with systemic opioids.\\u000a In some cases a change of the route of administration can improve the balance of analgesia and adverse effects. In this paper\\u000a the use of spinal opioids in such patients is discussed from various aspects: patient selection, epidural vs intrathecal

Sebastiano Mercadante



Cognitive-Behavior Therapy for Depressed Cancer Patients in a Medical Care Setting  

Microsoft Academic Search

Major depression is the most common psychiatric disorder among cancer patients and is associated with decreased quality of life, significant deterioration in recreational and physical activities, relationship difficulties, sleep problems, more rapidly progressing cancer symptoms, and more metastasis and pain relative to nondepressed cancer patients. Although some research has explored the utility of psychological interventions with cancer patients, only one

Derek R. Hopko; John L. Bell; Maria Armento; Sarah Robertson; Christen Mullane; Nicole Wolf; Carl W. Lejuez



Communication of pharmacogenetic research results to HIV-infected treated patients: standpoints of professionals and patients  

PubMed Central

The aim of pharmacogenetic studies is to adapt therapeutic strategies to individual genetic profiles, thus maximising their efficacy and minimising the likelihood of adverse side effects. Since the advent of personalised medicine, the issue of communicating research results to participants has become increasingly important. We addressed this question in the context of HIV infection, as patients and associations are particularly concerned by research and therapeutic advances. We explored the standpoints of both research professionals and participants involved in a pharmacogenetics study conducted in a cohort of HIV-infected patients. The setting of the research protocol was followed over a 2 years period. Participants’ standpoints were collected through a questionnaire and interviews were conducted with research professionals. Of 125 participants, 76% wished to receive individual results and 71% wished to receive collective results; 39% did not know when results might be expected. Communication of global research results is a principle that is generally accepted by professionals. Concerning individual feedback, the professionals felt that it was necessary if it could be of direct benefit to the participant, but they expressed doubts for situations with no recognised benefit. Our results highlight the necessity to consider this issue in greater detail. We suggest the need to anticipate the debates concerning individual feedback, to differentiate between situations and the importance of further investigations on the opportunities and modalities of communication. Finally, our work emphasised the opposite pressures between the pursuit of scientific knowledge and the therapeutic orientation of clinical trials. PMID:15957002

Moutel, Grégoire; Duchange, Nathalie; Raffi, François; Sharara, Lama I.; Theodorou, Ioannis; Noël, Violaine; de Montgolfier, Sandrine; Callies, Ingrid; Bricaire, François; Hervé, Christian; Leport, Catherine



Prognostic stratification of colorectal cancer patients: current perspectives  

PubMed Central

Tumor staging according to the American Joint Committee on Cancer/Union for International Cancer Control tumor, node, metastasis (TNM) system is currently regarded as the standard for staging of patients with colorectal cancer. This system provides the strongest prognostic information for patients with early stage disease and those with advanced disease. For patients with intermediate levels of disease, it is less able to predict disease outcome. Therefore, additional prognostic markers are needed to improve the management of affected patients. Ideal markers are readily assessable on hematoxylin and eosin-stained tumor slides, and in this way are easily applicable worldwide. This review summarizes the histological features of colorectal cancer that can be used for prognostic stratification. Specifically, we refer to the different histological variants of colorectal cancer that have been identified, each of these variants carrying distinct prognostic significance. Established markers of adverse outcomes are lymphatic and venous invasion, as well as perineural invasion, but underreporting still occurs in the routine setting. Tumor budding and tumor necrosis are recent advances that may help to identify patients at high risk for recurrence. The prognostic significance of the antitumor inflammatory response has been known for quite a long time, but a lack of standardization prevented its application in routine pathology. However, scales to assess intra- and peritumoral inflammation have recently emerged, and can be expected to strengthen the prognostic significance of the pathology report. PMID:25061338

Schneider, Nora I; Langner, Cord



Effectiveness of pranayama on cancer-related fatigue in breast cancer patients undergoing radiation therapy: A randomized controlled trial  

PubMed Central

Context: Incidence of breast cancer is very high among women around the world. Breast cancer patients experience cancer-related fatigue at some points during the treatment for breast cancer. Since cancer-related fatigue is of multifactorial origin, there are no evidence-based treatment strategies for fatigue. This study tested the effectiveness of certain pranayama techniques in reducing cancer-related fatigue among breast cancer patients undergoing radiation therapy. Aims: The objective of this study was to determine the effectiveness of pranayama on cancer-related fatigue among breast cancer patients undergoing radiation therapy as measured by cancer fatigue scale. Settings and Design: Shirdi Sai Baba Cancer Hospital and Research Center, Kasturba Hospital Manipal. Materials and Methods: Study was a randomized controlled trial done among breast cancer patients receiving radiation therapy. Statistical Analysis Used: Demographic characteristics of the participants are presented as frequency and percentage. Comparison of means of cancer-related fatigue between the two groups is done by Mann-Whitney U-test and comparison of pre- and pos t-test means of cancer-related fatigue among the experimental group is done by Wilcoxon sign rank test. Results: There was a significant difference between the two groups with regard to the scores of cancer-related fatigue. The experimental group of patients who performed pranayama along with radiation therapy experienced less fatigue. Conclusions: Pranayama can be used as a supportive therapy for breast cancer patients undergoing radiation therapy. PMID:25558133

Chakrabarty, Jyothi; Vidyasagar, MS; Fernandes, Donald; Joisa, Ganapathi; Varghese, Prabha; Mayya, Sreemathi



Lung cancer symptoms and pulse oximetry in the prognostic assessment of patients with lung cancer  

PubMed Central

Background Medical oncologists continue to use performance status as a proxy for quality of life (QOL) measures, as completion of QOL instruments is perceived as time consuming, may measure aspects of QOL not affected by cancer therapy, and interpretation may be unclear. The pulse oximeter is widely used in clinical practice to predict cardiopulmonary morbidity after lung resection in cancer patients, but little is known on its role outside the surgical setting. We evaluated whether the Lung Cancer Symptom Scale and pulse oximetry may contribute to the evaluation of lung cancer patients who received standard anticancer therapy. Methods We enrolled forty-one consecutive, newly diagnosed, patients with locally advanced or metastatic lung cancer in this study. We developed a survival model with the variables gender, age, histology, clinical stage, Karnofsky performance status, wasting, LCSS symptom scores, average symptom burden index, and pulse oximetry (SpO2). Results Patient and observer-rated scores were correlated, except for the fatigue subscale. The median SpO2 was 95% (range: 86 to 98), was unrelated to symptom scores, and was weakly correlated with observer cough scores. In a multivariate survival model, SpO2 > 90% and patient scores on the LCSS appetite and fatigue subscales were independent predictors of survival. Conclusion LCSS fatigue and appetite rating, and pulse oximetry should be studied further as prognostic factors in lung cancer patients. PMID:16000170

Martins, Sandro J; Ho, Nelson; Cavamura, Sueli O; Harada, Cecilia M; Yamamoto, Crystina A; Takagaki, Teresa Y



The Lake Wobegon Effect: Are All Cancer Patients above Average?  

PubMed Central

Context When elderly patients face a terminal illness such as lung cancer, most are unaware that what we term in this article “the Lake Wobegon effect” taints the treatment advice imparted to them by their oncologists. In framing treatment plans, cancer specialists tend to intimate that elderly patients are like the children living in Garrison Keillor's mythical Lake Wobegon: above average and thus likely to exceed expectations. In this article, we use the story of our mother's death from lung cancer to investigate the consequences of elderly people's inability to reconcile the grave reality of their illness with the overly optimistic predictions of their physicians. Methods In this narrative analysis, we examine the routine treatment of elderly, terminally ill cancer patients through alternating lenses: the lens of a historian of medicine who also teaches ethics to medical students and the lens of an actuary who is able to assess physicians’ claims for the outcome of medical treatments. Findings We recognize that a desire to instill hope in patients shapes physicians’ messages. We argue, however, that the automatic optimism conveyed to elderly, dying patients by cancer specialists prompts those patients to choose treatment that is ineffective and debilitating. Rather than primarily prolong life, treatments most notably diminish patients’ quality of life, weaken the ability of patients and their families to prepare for their deaths, and contribute significantly to the unsustainable costs of the U.S. health care system. Conclusions The case described in this article suggests how physicians can better help elderly, terminally ill patients make medical decisions that are less damaging to them and less costly to the health care system. PMID:24320166

Wolf, Jacqueline H; Wolf, Kevin S



Enrollment of patients with lung and colorectal cancers onto clinical trials. |

Patient and physician survey data, as well as data gleaned from medical records, were used to examine patient and physician characteristics that might be associated with trial enrollment. Patient characteristics that were associated with enrollment included age, race, region of residence, insurance coverage, and disease stage. Relevant provider characteristics included being a medical oncologist, taking the lead in discussing trials with patients, receiving financial incentives, and working in an NCI-designated cancer center.


Why Don't Cancer Patients Enter Clinical Trials? |

This comprehensive literature review delves into the most critical factors in recruitment of patients to cancer clinical trials—patients’ attitudes, contextual barriers, and doctor-related barriers. Most studies assert that doctors play the key role in determining the success or failure of clinical trials. The main doctor-related accrual factors include patient-doctor relationship, doctors’ selection among eligible patients, reluctance to participate in clinical trials, and doctor-investigator relationships.


Prevalence and Correlates of Postdiagnosis Initiation of Complementary and Alternative Medicine Among Patients at a Comprehensive Cancer Center  

PubMed Central

Purpose: Patients with cancer increasingly use complementary and alternative medicine (CAM) in conjunction with conventional oncology treatments. Previous studies have not investigated postdiagnosis initiation of CAM therapies or independent correlates of use of individual CAM modalities. The purpose of this study was to determine the prevalence and correlates of individual CAM modalities initiated after cancer diagnosis. Methods: A cross-sectional survey was conducted of a random sample of adults with a cancer diagnosis (N = 1,228) seeking care at a National Cancer Institute–designated comprehensive cancer center within a 12-month period. Results: The majority of patients were female (64.7%), white (86.9%), and married (72.8%).Three-quarters (75.2%) used at least one CAM modality, and 57.6% of those using CAM initiated use after cancer diagnosis. For all CAM therapies combined, women were 1.7 times more likely than men to initiate any CAM therapy after cancer diagnosis. However, when CAM modalities were differentiated by type, men and women were equally likely to initiate all therapies except for psychotherapy and mind-body approaches. Postdiagnosis initiation of every CAM modality, except mind-body therapies, differed by cancer type. Conclusion: A significant proportion of patients initiated CAM use after diagnosis. However, specific type of CAM initiated varied by demographics and cancer type, suggesting there is not a “typology” of CAM user. Optimal comprehensive cancer treatment, palliation, and survivorship care will require patient and provider education regarding CAM use by modality type; improved provider-patient communication regarding potential benefits, limitations, and risks; and institutional policies to support integrated conventional and CAM treatment. PMID:23633969

Perlman, Adam; Lontok, Oliver; Huhmann, Maureen; Parrott, J. Scott; Simmons, Leigh Ann; Patrick-Miller, Linda



Recruiting Ethnically Diverse General Internal Medicine Patients for a Telephone Survey on Physician-Patient Communication  

PubMed Central

BACKGROUND Limited evidence exists on the effectiveness of recruitment methods among diverse populations. OBKECTIVE Describe response rates by recruitment stage, ethnic-language group, and type of initial contact letter (for African-American and Latino patients). DESIGN Tracking of response status by recruitment stage and ethnic-language group and a randomized trial of ethnically tailored initial letters nested within a cross-sectional telephone survey on physician-patient communication. PARTICIPANTS Adult general medicine patients with ?1 visit during the preceding year, stratified by 4 categories: African-American (N= 1,400), English-speaking Latino (N= 894), Spanish-speaking Latino (N= 965), and non-Latino white (N= 1,400). MEASUREMENTS AND RESULTS Ethnically tailored initial letters referred to shortages of African-American (or Latino) physicians and the need to learn about the experiences of African-American (or Latino) patients communicating with physicians. Of 2,482 patients contacted, eligible, and able to participate (identified eligibles), 69.9% completed the survey. Thirty-nine percent of the sampling frame was unable to be contacted, with losses higher among non-Latino whites (46.5%) and African Americans (44.2%) than among English-speaking (32.3%) and Spanish-speaking Latinos (25.1%). For identified eligibles, response rates were highest among Spanish-speaking Latinos (75.2%), lowest for non-Latino whites (66.4%), and intermediate for African Americans (69.7%) and English-speaking Latinos (68.1%). There were no differences in overall response rates between patients receiving ethnically tailored letters (72.2%) and those receiving general letters (70.0%). CONCLUSIONS Household contact and individual response rates differed by ethnic-language group, highlighting the importance of tracking losses by stage and subpopulation. Careful attention to recruitment yielded acceptable response rates among all groups. PMID:15963168

Nápoles-Springer, Anna M; Santoyo, Jasmine; Stewart, Anita L



Stigma among patients with lung cancer: A patient-reported measurement model  

PubMed Central

Objective Although stigma may have negative psychosocial and behavioral outcomes for patients with lung cancer, its measurement has been limited. A conceptual model of lung cancer stigma and a patient-reported outcome (PRO) measure is needed to mitigate these sequelae. This study identified key stigma-related themes to provide a blueprint for item development through thematic analysis of semi-structured interviews and focus groups with lung cancer patients. Methods Participants were recruited from two outpatient oncology clinics and included: a) 42 lung cancer patients who participated in individual interviews and, b) 5 focus groups (inclusive of 23 new lung cancer patients). Never smokers, long-term quitters, recent quitters, and current smokers participated. Individual interviews facilitated theme development and a conceptual model of lung cancer stigma, whereas subsequent focus groups provided feedback on the conceptual model. Qualitative data analyses included iterative coding and validation with existing theory. Results Two main thematic elements emerged from interviews with lung cancer patients: perceived (felt) stigma and internalized (self) stigma. Discussions of perceived stigma were pervasive, while internalized stigma was more commonly endorsed among current and recently quit smokers. Participants also discussed maladaptive (e.g., decreased disclosure) and adaptive (e.g., increased advocacy) stigma-related consequences. Conclusions Results indicate widespread acknowledgment of perceived stigma among lung cancer patients, but varying degrees of internalized stigma and associated consequences. Next steps for PRO measure development are item consolidation, item development, expert input, and cognitive interviews before field testing and psychometric analysis. Future work should address stigma-related consequences and interventions for reducing lung cancer stigma. PMID:24123664

Hamann, Heidi A.; Ostroff, Jamie S.; Marks, Emily G.; Gerber, David E.; Schiller, Joan H.; Craddock Lee, Simon J.



Supportive care for patients with early breast cancer  

Microsoft Academic Search

Breast cancer treatment currently requires the joint efforts of a multidisciplinary team to effectively combine chemotherapy,\\u000a hormone therapy, biological agents, surgery and radiation therapy when needed. To develop such a treatment plan, it is important\\u000a to know the benefits as well as the potential toxic effects of each therapy. Thus, many patients with early breast cancer\\u000a complain of collateral adverse

Laura García-Estévez; Ignasi Tusquets; Isabel Álvarez; César Rodríguez; Yolanda Fernández; Miguel Ángel Seguí; Jesús García-Mata; Ana Lluch



Role of Thymidylate Synthase Gene Variations in Colorectal Cancer Patients  

Microsoft Academic Search

\\u000a Colorectal cancer (CRC) is the third most common cause of cancer-related death in women and men in the United States. The\\u000a current therapeutic options for patients with metastatic CRC (mCRC) are 5-fluorouracil (5-FU) based chemotherapy regimens\\u000a with the addition of irinotecan (CPT-11) or oxaliplatin. It still remains a challenge for oncologists to evaluate the reasons\\u000a for a wide variation in

Georg Lurje; Heinz-Josef Lenz


Evaluation of Biomarker Modulation by Fenretinide in Prostate Cancer Patients  

Microsoft Academic Search

An NCI-sponsored, phase II trial of N-(4-hydroxyphenyl)- retinamide (4-HPR) in patients with organ-confined prostate cancer in the period prior to radical prostatectomy was carried out. Thirty-seven men with the histologic diagnosis of prostate cancer planning to have radical prostatectomy entered the study after informed consent and were given 4-HPR (or matching placebo) as a single daily dose (two 100-mg capsules

D. Urban; R. Myers; U. Manne; H. Weiss; J. Mohler; D. Perkins; M. Markiewicz; R. Lieberman; G. Kelloff; M. Marshall; W. Grizzle



Management of prostate cancer in HIV-positive patients  

Microsoft Academic Search

Improved medical therapy for HIV-positive patients has helped delay the progression of HIV to AIDS and reduce AIDS deaths. This dramatically prolonged survival has resulted in increased detection of non-AIDS-defining malignancies, such as prostate cancer, in people with HIV. Reported prostate cancer incidences in HIV-positive men compared with the general population vary in different studies; however, its incidence in the

Matthew S. Wosnitzer; Franklin C. Lowe



Among health care professionals effective communication is vital to achieve the best patient outcomes possible. Improving communication and other teamwork skills will result in improved  

E-print Network

outcomes possible. Improving communication and other teamwork skills will result in improved performance by the faculty should result in improved communication skills of our trainees and ultimately improved patient Among health care professionals effective communication is vital to achieve the best patient


Therapeutic Applications of Herbal Medicines for Cancer Patients  

PubMed Central

Medicinal herbs and their derivative phytocompounds are being increasingly recognized as useful complementary treatments for cancer. A large volume of clinical studies have reported the beneficial effects of herbal medicines on the survival, immune modulation, and quality of life (QOL) of cancer patients, when these herbal medicines are used in combination with conventional therapeutics. Here, we briefly review some examples of clinical studies that investigated the use of herbal medicines for various cancers and the development of randomized controlled trials (RCTs) in this emerging research area. In addition, we also report recent studies on the biochemical and cellular mechanisms of herbal medicines in specific tumor microenvironments and the potential application of specific phytochemicals in cell-based cancer vaccine systems. This review should provide useful technological support for evidence-based application of herbal medicines in cancer therapy. PMID:23956768

Yin, Shu-Yi; Wei, Wen-Chi; Jian, Feng-Yin; Yang, Ning-Sun



Observational study on patient's satisfactions and quality of life (QoL) among cancer patients receiving treatment with palliative care intent in a tertiary hospital in Malaysia.  


The main objective of palliative treatment for cancer patients has been to maintain, if not improve, the quality of life (QoL). There is a lack of local data on satisfaction and QoL among cancer patients receiving palliative treatment in Malaysia. This study covers patients with incurable, progressive cancer disease receiving palliative treatment in a teaching hospital in Kuala Lumpur, comparing the different components of QoL and correlations with patient satisfaction. A cross-sectional survey using Malay validated SF36 QoL and PSQ-18 (Short Form) tools was carried out between July 2012 -January 2013 with 120 cancer patients receiving palliative treatment, recruited into the study after informed consent using convenient sampling. Results showed that highest satisfaction were observed in Communication Aspect (50.6±9.07) and the least in General Satisfaction (26.4±5.90). The Mental Component Summary (44.9±6.84) scored higher when compared with the Physical Component Summary (42.2±7.91). In this study, we found that patient satisfaction was strongly associated with good quality of life among cancer patients from a general satisfaction aspect (r=0.232). A poor significant negative correlation was found in Physical Component (technical quality, r=-0.312). The Mental Component showed there was a poor negative correlation between time spent with doctor (r=-0.192) and accessibility, (r=-0.279). We found that feeling at peace and having a sense of meaning in life were more important to patients than being active or achieving good physical comfort. More studyis needed to investigate patients who score poorly on physical and mental component aspects to understand their needs in order to achieve better cancer care. PMID:24568481

Sharifa Ezat, Wan Puteh; Fuad, Ismail; Hayati, Yaakub; Zafar, Ahmed; Wanda Kiyah, George Albert



The lung cancer patient, the pneumologist and palliative care: a developing alliance.  


Considerable evidence is now available on the value of palliative care for lung cancer patients in all stages and at all times during the course of the disease. However, pneumologists and their institutions seem to be widely in arrears with the implementation of palliative care concepts and the development of integrated structures. This review focuses on the available evidence and experience of various frequently unmet needs of lung cancer patients, especially psychological, social, spiritual and cultural ones. A PubMed search for evidence on these aspects of palliative care as well as on barriers to the implementation, on outcome parameters and effectiveness, and on structure and process quality was performed with a special focus on lung cancer patients. As a consequence, this review particularly draws pneumologists' attention to improving their skills in communication with the patients, their relatives and among themselves, and to establish team structures with more far-reaching competences and continuity than existing multilateral cooperations and conferences can provide. Ideally, any process of structural and procedural improvement should be accompanied by scientific evaluation and measures for quality optimisation. PMID:25359341

Blum, Torsten; Schönfeld, Nicolas



The Effect of Computer-Mediated Social Support in Online Communities on Patient Empowerment and Doctor–Patient Communication  

Microsoft Academic Search

In the context of diabetes, this study tested a mechanism through which Korean diabetes patients' exchange of computer-mediated social support (CMSS) in diabetes online communities influences their sense of empowerment and intention to actively communicate with the doctor. Analysis of data from 464 Korean diabetes patients indicates significant relationships among diabetes patients' online community activities, perceived CMSS, sense of empowerment,

Hyun Jung Oh; Byoungkwan Lee



The Effect of Computer-Mediated Social Support in Online Communities on Patient Empowerment and Doctor–Patient Communication  

Microsoft Academic Search

In the context of diabetes, this study tested a mechanism through which Korean diabetes patients' exchange of computer-mediated social support (CMSS) in diabetes online communities influences their sense of empowerment and intention to actively communicate with the doctor. Analysis of data from 464 Korean diabetes patients indicates significant relationships among diabetes patients' online community activities, perceived CMSS, sense of empowerment,

Hyun Jung Oh; Byoungkwan Lee



Fertility preservation in cancer patients: the global framework.  


Cancer treatment is the most frequent cause of reduced fertility in cancer patients, with up to 80% of survivors affected. None of the established or experimental fertility preservation methods can assure parenthood, rather they may provide a future opportunity to overcome treatment induced sterility. Around 70-75% of young cancer survivors are interested in parenthood but the numbers of patients who access fertility preservation techniques prior treatment are significantly lower. Moreover, despite existing guidelines, healthcare professionals do not address fertility preservation issues adequately. Lack of time and knowledge about existing options, delay in potentially useful treatment, patient's age, partnership status, existing children, sexual orientation and socioeconomic situation are the main barriers to effective fertility preservation. Patient's fears, expectations and priorities shaped by personal values have to be addressed in the framework of medical necessities, realistic survival probabilities, socio-cultural environment and resources availability. We call for a need of patient centred fertility counselling within a framework that should include patients understanding of medical aspects of their cancer, realistic fertility preservation options, preferences based on personal values and goals. Optional support services could also include legal guidance, psychological and spiritual support and financial counselling. PMID:24953980

Linkeviciute, Alma; Boniolo, Giovanni; Chiavari, Leonora; Peccatori, Fedro A



Percutaneous cryotherapy for metastatic bladder cancer: experience with 23 patients.  


Bladder cancer is the most common malignancy of the urinary tract and in many patients is metastatic at diagnosis. Chemotherapy is the standard treatment for these patients but has serious side effects and in many patients is not tolerated. To avoid the side effects of systemic chemotherapy, patients with late stage bladder cancer have sought cryotherapy in our hospital. We reviewed data for the past 4 years to evaluate the safety and efficiency of percutaneous cryotherapy in 23 patients. Within 3 days after cryosurgery, all complications of bladder cancer (e.g. hematuria, urinary irritation, hypogastralgia, lumbago) had decreased to some degree. No new complications (e.g. bladder perforation) occurred and all complications had disappeared completely after 2 weeks. The progression-free survival (PFS) of these patients was 14 ± 8 months. There was no effect on PFS of tumor location or histopathology; however, differentiation status and tumor size influenced the therapeutic effect of percutaneous cryoablation. In conclusion, percutaneous cryotherapy may be a safe and efficacious therapeutic option in the treatment of metastatic bladder cancer. PMID:24368268

Liang, Zhou; Fei, Yao; Lizhi, Niu; Jianying, Zeng; Zhikai, Zhang; Jibing, Chen; Jialiang, Li; Kecheng, Xu



Survival Analysis of Gastric Cancer Patients with Incomplete Data  

PubMed Central

Purpose Survival analysis of gastric cancer patients requires knowledge about factors that affect survival time. This paper attempted to analyze the survival of patients with incomplete registered data by using imputation methods. Materials and Methods Three missing data imputation methods, including regression, expectation maximization algorithm, and multiple imputation (MI) using Monte Carlo Markov Chain methods, were applied to the data of cancer patients referred to the cancer institute at Imam Khomeini Hospital in Tehran in 2003 to 2008. The data included demographic variables, survival times, and censored variable of 471 patients with gastric cancer. After using imputation methods to account for missing covariate data, the data were analyzed using a Cox regression model and the results were compared. Results The mean patient survival time after diagnosis was 49.1±4.4 months. In the complete case analysis, which used information from 100 of the 471 patients, very wide and uninformative confidence intervals were obtained for the chemotherapy and surgery hazard ratios (HRs). However, after imputation, the maximum confidence interval widths for the chemotherapy and surgery HRs were 8.470 and 0.806, respectively. The minimum width corresponded with MI. Furthermore, the minimum Bayesian and Akaike information criteria values correlated with MI (-821.236 and -827.866, respectively). Conclusions Missing value imputation increased the estimate precision and accuracy. In addition, MI yielded better results when compared with the expectation maximization algorithm and regression simple imputation methods. PMID:25580358

Tapak, Lily; Roshanaei, Ghodaratolla; Mahjub, Hossein



Cancer incidence risks to patients due to hysterosalpingography  

PubMed Central

Cancer incidence estimates and dosimetry of 120 patients undergoing hysterosalpingography (HSG) without screening at five rural hospitals and with screening using image intensifier-TV at an urban hospital have been studied. Free in air kerma measurements were taken for patient dosimetry. Using PCXMC version 1.5, organ and effective doses to patients were estimated. Incidence of cancer of the ovary, colon, bladder and uterus due to radiation exposure were estimated using biological effects of ionising radiation committee VII excess relative risk models. The effective dose to patients was estimated to be 0.20 ± 0.03 mSv and 0.06 ± 0.01 mSv for procedures with and without screening, respectively. The average number of exposures for both procedures, 2.5, and screening time of 48.1 s were recorded. Screening time contributed majority of the patient doses due to HSG; therefore, it should be optimised as much as possible. Of all the cancers considered, the incidence of cancer of the bladder for patients undergoing HSG procedures is more probable. PMID:22557802

Gyekye, Prince K.; Emi-Reynolds, Geoffrey; Boadu, Mary; Darko, Emmanuel O.; Yeboah, Johnson; Inkoom, Stephen; Mensah, Cynthia K.



Circulating DNA in the blood of gastric cancer patients.  


The concentration of cell-free DNA and promoter methylation status of the MGMT, p15, and hMLH1 genes were analyzed by a fluorescence-based assay and methylation-specific PCR (MSP) in the blood of gastric cancer patients (n= 20) and healthy subjects (n= 22). Gastric cancer patients were characterized by an increased concentration of circulating DNA in the plasma; the amount of cell-surface-bound DNA was not decreased compared with controls and amounted to 80 +/- 15% of the total circulating DNA. MSP analysis of three genes in the cell-surface-bound DNA permits the detection of gastric cancer patients with a sensitivity of 75% and a specificity of 54%. Thus, the cell-surface-bound DNA is a convenient source of DNA for MSP analysis of cancer-specific markers. The data on the presence of methylated DNA in plasma combined with the analysis of other cancer-related changes in DNA can significantly contribute to cancer diagnostics. PMID:18837952

Kolesnikova, Elena V; Tamkovich, Svetlana N; Bryzgunova, Olga E; Shelestyuk, Petr I; Permyakova, Valentina I; Vlassov, Valentin V; Tuzikov, Aleksandr S; Laktionov, Pavel P; Rykova, Elena Y



Vaginal Estrogen Therapy for Patients with Breast Cancer  

PubMed Central

On account of the good prognosis for patients with breast cancer, improving or maintaining the quality of life in the aftercare period is becoming more and more important. In particular, the increasing usage of aromatase inhibitors in the past few years has led to an increased incidence of vaginal atrophy with symptoms such as vaginal dryness, petechial bleeding, dyspareunia and recurrent cystitis. And just these symptoms have a detrimental impact on the quality of life of breast cancer patients. Application of a topical estrogen therapy represents the most effective means to treat vaginal atrophy. The use of a systemic or, respectively, topical hormone therapy is, however, contraindicated for breast cancer patients. Further clinical trials are needed in order to assess the safety of vaginal estrogen therapy. PMID:24771890

Moegele, M.; Buchholz, S.; Seitz, S.; Lattrich, C.; Ortmann, O.



Factors related to survival rates for breast cancer patients  

PubMed Central

This study is to analyze the relationship between clinical parameters and prognosis and survival rates of breast cancer patients. A total of 1541 cases of breast cancer were retrospectively reviewed with respect to clinical parameters and the correlation with prognosis and survival rates. Among these patients, follow-up investigation was performed for 1381 cases. Clinical parameters including disease sites (the lesion quadrant), incidences, the number of axillary lymph node metastasis, maximum diameter of tumor, tumor regional lymph node metastasis (TNM) stages, pathological types were investigated. The estrogen receptor, progesterone receptor, Human Epidermal Growth Factor Receptor-2 levels were correlated with long term disease-free survival. Lymph node metastases, tumor diameter, TNM stage, and hormone receptor status are correlated with survival rates of breast cancer patients. PMID:25419424

Dong, Guizhi; Wang, Deguang; Liang, Xiaolin; Gao, Huiquan; Wang, Ling; Yu, Xinjiao; Liu, Jingjun



Emerging pharmacotherapy for cancer patients with cognitive dysfunction  

PubMed Central

Advances in the diagnosis and multi-modality treatment of cancer have increased survival rates for many cancer types leading to an increasing load of long-term sequelae of therapy, including that of cognitive dysfunction. The cytotoxic nature of chemotherapeutic agents may also reduce neurogenesis, a key component of the physiology of memory and cognition, with ramifications for the patient’s mood and other cognition disorders. Similarly radiotherapy employed as a therapeutic or prophylactic tool in the treatment of primary or metastatic disease may significantly affect cognition. A number of emerging pharmacotherapies are under investigation for the treatment of cognitive dysfunction experienced by cancer patients. Recent data from clinical trials is reviewed involving the stimulants modafinil and methylphenidate, mood stabiliser lithium, anti-Alzheimer’s drugs memantine and donepezil, as well as other agents which are currently being explored within dementia, animal, and cell culture models to evaluate their use in treating cognitive dysfunction. PMID:24156319