Sample records for cancer patient communication

  1. Modeling patient-centered communication: Oncologist relational communication and patient communication involvement in breast cancer adjuvant therapy decision-making

    PubMed Central

    Step, Mary M.; Rose, Julia Hannum; Albert, Jeffrey M.; Cheruvu, Vinay K.; Siminoff, Laura A

    2009-01-01

    Objective Relational communication refers to those messages communicators naturally express that carry meaning about the type and quality of relationship they share. It is expected that patients of oncologists who express positive relational communication will be more communicatively involved in their office visits, and regret their decision for adjuvant therapy following surgery less. Methods One hundred eighty (180) audio-recorded discussions between oncologists (n = 40) and early stage (I–III) breast cancer patients were coded with the Siminoff Communication Content and Affect Program (SCCAP). The data were used to test the relationships between patient demographics, oncologist relational communication, patient communication involvement and self-reported patient decision regret. Results After controlling for clinician clusters, oncologists’ verbal (i.e., confirming messages) and nonverbal (i.e., direct and inclusive speech) relational communication is indirectly associated with lower patient decision regret via the mediating effect of greater patient communication involvement. Conclusion Clinician relational communication provides an influential affective climate for decision-making that appears to have important effects on patients’ decision confidence. Practice Implications Clinicians should recognize the potential of their own relational messages to facilitate patientscommunication involvement in decision-making during cancer care. PMID:19811883

  2. Patient Perceptions of Oncologist–Patient Communication About Prognosis: Changes From Initial Diagnosis to Cancer Recurrence

    Microsoft Academic Search

    Mary M. Step; Eileen Berlin Ray

    2011-01-01

    Cancer recurrence presents oncologists with many challenges, including discussing prognosis. A thematic analysis of patient interviews was conducted to learn more about how this challenge is met by doctors and patients in their communication. Female patients being treated for a cancer recurrence at a comprehensive cancer center (N = 30) were asked to recall how they discussed their prognosis with

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

    Microsoft Academic Search

    Moshe Frenkel; Eran Ben-Arye

    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

  4. Communication between physicians and cancer patients about complementary and alternative medicine: exploring patients' perspectives.

    PubMed

    Tasaki, Katsuya; Maskarinec, Gertraud; Shumay, Dianne M; Tatsumura, Yvonne; Kakai, Hisako

    2002-01-01

    The aim of this paper is to identify barriers to communication between physicians and cancer patients regarding complementary and alternative medicine (CAM) by exploring the perspectives of patients. In face of the recent popularity of CAM use among cancer patients, the lack of communication is a serious problem. A number of CAM therapies may interfere with conventional treatments and thus impact patients' well-being and chances of survival. In addition, lack of communication is problematic in the health care context because the development of openness and trust between health care providers and clients is contingent upon effective interpersonal communication. We conducted semi-structured interviews with 143 cancer patients to explore their experiences with CAM use. Using a qualitative research method, we examined interview data from 93 CAM users who provided sufficient information about communication issues. As a result, three themes emerged describing barriers to unsuccessful communication as perceived from the patient's point of view: physicians' indifference or opposition toward CAM use, physicians' emphasis on scientific evidence, and patients' anticipation of a negative response from their physician. Increasing education about CAM and regular assessment of CAM use may help physicians to be more aware of their patients' CAM use. As a result, physicians may provide patients with information on risks and benefits of CAM use and refer patients to other services that may address unmet needs. Given a difference in epistemiologic beliefs about cancer and its treatment, the challenge is to find a common ground for an open discussion in which physicians consider that scientific evidence is not all that counts in the life of an individual facing a serious disease. PMID:12112481

  5. Patient-Centered Communication in Cancer Care: Promoting Healing and Reducing Suffering

    Cancer.gov

    Effective patient-clinician communication is central to the delivery of high-quality care. It becomes even more crucial in the cancer setting where patients have to deal with stress, uncertainty, complex information, and life-altering medical decisions.

  6. Communicating with Terminally Ill Cancer Patients and Their Families.

    ERIC Educational Resources Information Center

    Hjorleifsdottir, Elisabet; Carter, Diana E.

    2000-01-01

    Interviews with 12 fourth-year student nurses in Scotland indicated that they found communicating with terminally ill and dying patients and their families difficult. Although lectures on death and dying were helpful, support and guidance for dealing with these issues in clinical practice were needed. (SK)

  7. Breast cancer--patient choice of treatment: preliminary communication.

    PubMed Central

    Ashcroft, J J; Leinster, S J; Slade, P D

    1985-01-01

    Forty patients who have undergone treatment for breast cancer (mastectomy or lumpectomy plus radiotherapy) were assessed, both preoperatively and at intervals up to one year following surgery, using tests of anxiety, depression, body satisfaction, marital adjustment, self-esteem, sociability and life change. The women were also interviewed to assess degree of concern about the disease, appearance and treatment. Wherever appropriate, patients were given a choice of treatment. Very little adverse psychosocial reaction has been found. It would appear that this is largely because most patients could opt for treatment which resulted in minimal disfigurement. PMID:3968671

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

    Microsoft Academic Search

    Gwendolyn P. Quinn; Susan T. Vadaparampil

    2009-01-01

    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.

  9. Communication in Cancer Care (PDQ)

    MedlinePLUS

    ... fewer procedures and better quality of life. Good communication between patients, family caregivers, and the health care ... feelings and concerns. Patients with cancer have special communication needs. Patients, their families, and their health care ...

  10. Use of complimentary and alternative medicine by breast cancer patients: prevalence, patterns and communication with physicians

    Microsoft Academic Search

    Taka Ashikaga; Kwadwo Bosompra; Patricia O'Brien; Lee Nelson

    2002-01-01

    This study examined the use of complementary and alternative medicine (CAM) therapies by breast cancer patients and the communication of their CAM use to their physicians relative to lymphedema symptoms and other factors. Breast cancer patients (N=148) in the State of Vermont were interviewed 2-3 years after their primary surgery using computer-aided telephone interviewing methods. Questionnaire items included demographic information,

  11. An evidence base for patient-centered cancer care: A meta-analysis of studies of observed communication between cancer specialists and their patients

    Microsoft Academic Search

    Maria K. Venetis; Jeffrey D. Robinson; Katie LaPlant Turkiewicz; Mike Allen

    2009-01-01

    ObjectiveIn the context of patients visiting cancer specialists, the objective is to test the association between both patient-centered communication (including Affective Behavior and Participation Behavior) and Instrumental Behavior and patients’ post-visit satisfaction with a variety of visit phenomena.

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

    PubMed

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

    2014-10-01

    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

  13. Use of complimentary and alternative medicine by breast cancer patients: prevalence, patterns and communication with physicians.

    PubMed

    Ashikaga, Taka; Bosompra, Kwadwo; O'Brien, Patricia; Nelson, Lee

    2002-10-01

    This study examined the use of complementary and alternative medicine (CAM) therapies by breast cancer patients and the communication of their CAM use to their physicians relative to lymphedema symptoms and other factors. Breast cancer patients ( N = 148) in the State of Vermont were interviewed 2-3 years after their primary surgery using computer-aided telephone interviewing methods. Questionnaire items included demographic information, treatment, CAM use, lymphedema symptoms, and other measures. A large proportion (72.3%) reported using at least one CAM treatment after surgery. The most frequently used treatments were vitamins and nonfood supplements (72.3%), with herbal treatments, meditation, and traditional massage each being reported by about one-fifth of the women. Age, education, adjuvant chemotherapy, and extremity swelling were associated with use of more CAM treatments in a regression model. A large proportion (73.8%) of CAM users reported their CAM use to their physicians. Correlations between patients' income, adjuvant radiation therapy, and adjuvant tamoxifen use with communication of CAM use to their physicians were sought in a logistic regression model. CAM use is high among breast cancer patients in Vermont, and the number of CAM therapies used is related to demographic factors, adjuvant treatment, and lymphedema symptoms. Communication of CAM use to physicians appears to be multifaceted. PMID:12324809

  14. Communication training for health professionals who care for patients with cancer: a systematic review of training methods

    Microsoft Academic Search

    Marjolein Gysels; Alison Richardson; Irene J. Higginson

    2005-01-01

    Background: Effective communication is increasingly recog- nised as a core clinical skill. Many health and social care professionals, however, do not feel adequately trained in communicating and in handling interpersonal issues that arise in the care of patients with cancer. Aim: The aim of this paper was to assess the effectiveness of different training methods used in communication training courses

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

    PubMed

    Lewis, Nehama; Martinez, Lourdes S

    2014-09-01

    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

  16. Communication in Cancer Care–for health professionals (PDQ®)

    Cancer.gov

    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.

  17. Patient perspectives and preferences for communication of medical imaging risks in a cancer care setting.

    PubMed

    Thornton, Raymond H; Dauer, Lawrence T; Shuk, Elyse; Bylund, Carma L; Banerjee, Smita C; Maloney, Erin; Fox, Lindsey B; Beattie, Christopher M; Hricak, Hedvig; Hay, Jennifer

    2015-05-01

    Purpose To identify opportunities for improving patient-centered communication about diagnostic imaging tests that involve the use of radiation in a cancer care setting. Materials and Methods Institutional review board approval and informed consent were obtained for this HIPAA-compliant study. Patient knowledge, information sources, and communication preferences were assessed in six focus groups during 2012. The groups consisted of patients undergoing treatment for metastatic colorectal carcinoma, women treated within the past 6 months for early-stage breast carcinoma, men undergoing surveillance after testicular cancer treatment, parents of patients treated for stage I-III neuroblastoma, patients in a thoracic oncology survivorship program, and participants in a lung cancer screening program. A multidisciplinary research team performed thematic content analysis of focus group transcripts. High-level findings were summarized during consensus conferences. Results Although they were aware of the long-term risk of cancer from exposure to ionizing radiation, most participants reported that their health care provider did not initiate discussion about benefits and risks of radiation from imaging tests. Most patients obtained information by means of self-directed internet searches. Participants expressed gratitude for tests ("That CT saved my daughter's life," "I'd rather have the radiation dosage than being opened up"), yet they expressed concern about having to initiate discussions ("If you don't ask, nobody is going to tell you anything") and the desire to be offered information concerning the rationale for ordering specific imaging examinations, intervals for follow-up imaging, and testing alternatives. Participants believed that such information should be available routinely and that conversation with their personal physician or endorsed, readily available reference materials were ideal methods for information exchange. Understanding imaging radiation risks and active participation in decision making about imaging were especially important to cancer survivors. Conclusion A substantial gap exists between patient expectations and current practices for providing information about medical imaging tests that involve the use of radiation. (©) RSNA, 2015 Online supplemental material is available for this article. PMID:25803490

  18. Nurse-patient communication in cancer care: does responding to patient's cues predict patient satisfaction with communication

    Microsoft Academic Search

    Ruud Uitterhoeve; Jozien Bensing; Eefje Dilven; A. R. T. Donders; P. H. M. de Mulder; Theo van Achterberg

    2009-01-01

    Objective: The aim is to investigate the relationship between nurses' cue-responding behaviour and patient satisfaction. Methods: One hundred patient-nurse conversations about present concerns were videotaped and patients' expression of emotional cues and nurses' cue responses were coded using the Medical Interview Aural Rating Scale. Nurses (N=34) and patients (N=100) were recruited from seven oncology inpatient clinics from a University Medical

  19. Patient-centered Communication Research

    Cancer.gov

    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.

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

    PubMed Central

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

    2012-01-01

    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

  1. Barriers to effective communication across the primary/secondary interface: examples from the ovarian cancer patient journey (a qualitative study).

    PubMed

    Farquhar, M C; Barclay, S I G; Earl, H; Grande, G E; Emery, J; Crawford, R A F

    2005-09-01

    Effective communication across the primary/secondary interface is vital for the planning and delivery of appropriate patient care throughout the cancer patient journey. This study describes GPs' views of the communication issues across the primary/secondary interface in relation to ovarian cancer patients using qualitative interviews with purposively sampled general practitioners (GPs) and an audit of hospital medical records of 30 deceased ovarian cancer patients. Issues raised by the GPs related to the content and format of communications, but of most concern was the tardiness. The time lag between dictation and typing letters ranged from 0 to 27 days, with a delay of up to 8 days for signing before transit through various mail systems to the GP. Three stages in the patient journey were characterized by particular issues: (1) in the pre-diagnostic and diagnostic stage was a need for prompt information regarding the results of tests and diagnoses, and clearer guidance on the use of tests and fast-track referrals; (2) in the active treatment phase, when GPs could lose touch with their patients, they needed effective communication in order to provide moral support and crisis management; and (3) when oncology withdrew and the focus of care switched back to the community for the terminal phase, GPs needed information to enable them to pick up the baton of care. There is a need to develop and evaluate interventions aimed at improving the content and speed of communications between secondary and primary care. Such interventions are likely to be complex and might include the greater use of telephone or fax for more selected communications, a review of secretarial support, the use of email, the development of GP designed proformas, the feasibility of patient/carer letter delivery options, nurse-led communication, universal electronic patient records, or a revisiting of the patient-held record. PMID:16098121

  2. Information Seeking and Satisfaction With Physician–Patient Communication Among Prostate Cancer Survivors

    Microsoft Academic Search

    Donald J. Cegala; Robert R. Bahnson; Steven K. Clinton; Prabu David; Michael Chi Gong; J. Paul Monk III; Subir Nag; Kamal S. Pohar

    2008-01-01

    Relatively little is known about prostate cancer patients' information seeking after diagnosis, how they use such information in making a treatment decision, or what role information plays in adjusting to quality-of-life issues posttreatment. This research sought to explore some of these issues by examining prostate cancer patients' information seeking and its relationship to assessments of feeling informed and satisfied with

  3. Approach to Communicating with Patients About the Use of Nutritional Supplements in Cancer Care

    Microsoft Academic Search

    Moshe Frenkel; Eran Ben-Arye; Constance D. Baldwin; Victor Sierpina

    2005-01-01

    In recent years, complementary and alternative medicine has become popular among the general population in the Western world. Cancer patients have joined this global trend, often seeking supplements to conventional oncologic care, usually without their physicians' knowledge. Among the most common forms of com- plementary and alternative medicine used by cancer patients are natural products such as herbs and megavitamins.

  4. Fear of death, mortality communication, and psychological distress among secular and religiously observant family caregivers of terminal cancer patients.

    PubMed

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

    2011-02-01

    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 comunication, fear of death, and psychological distress (i.e., depressive symptomatology, emotional exhaustion) among secular and religiously observant family caregivers of terminally ill cancer patients. A total of 236 participants were recruited over 18 months within the first year of caregiver bereavement. Retrospectively reported mortality communication was statistically greater among secular caregivers; in contrast, both fear of death and depressive symptoms were greater among the religiously observant. Path analyses subsequently revealed notable differences between groups. Among secular caregivers, a significant inverse relationship between mortality communication and the two indices of caregiver distress emerged. In contrast, the association between mortality communication and psychological distress among the religious was moderated by these caregivers' fear of death. The results of this study suggest that fear of death is a significant predictor of psychological distress among religiously observant caregivers of terminal cancer patients (i.e., fear of their own death as elicited by the caregiving role). Fostering morality communication between secular caregivers and patients would appear to be one means of reducing the likelihood of clinically significant psychological distress. This may be insufficient among religiously observant caregivers, however, for whom fear of death may first need to be redressed. PMID:24501834

  5. Values and options in cancer care (VOICE): study design and rationale for a patient-centered communication and decision-making intervention for physicians, patients with advanced cancer, and their caregivers

    PubMed Central

    2013-01-01

    Background Communication about prognosis and treatment choices is essential for informed decision making in advanced cancer. This article describes an investigation designed to facilitate communication and decision making among oncologists, patients with advanced cancer, and their caregivers. Methods/design The Values and Options in Cancer Care (VOICE) Study is a National Cancer Institute sponsored randomized controlled trial conducted in the Rochester/Buffalo, NY and Sacramento, CA regions. A total of 40 oncologists, approximately 400 patients with advanced cancer, and their family/friend caregivers (one per patient, when available) are expected to enroll in the study. Drawing upon ecological theory, the intervention uses a two-pronged approach: oncologists complete a multifaceted tailored educational intervention involving standardized patient instructors (SPIs), and patients and caregivers complete a coaching intervention to facilitate prioritizing and discussing questions and concerns. Follow-up data will be collected approximately quarterly for up to three years. Discussion The intervention is hypothesized to enhance patient-centered communication, quality of care, and patient outcomes. Analyses will examine the effects of the intervention on key elements of physician-patient-caregiver communication (primary outcomes), the physician-patient relationship, shared understanding of prognosis, patient well-being, and health service utilization (secondary outcomes). Trial registration Clinical Trials Identifier: NCT01485627 PMID:23570278

  6. C2-2: Assessing Patient Perceptions of Communication throughout Cancer Care: Results of an Initial Administration of a New Item Set

    PubMed Central

    Mazor, Kathleen; Arora, Neeraj; Street, Richard; Sue, Valerie; Neergheen, Vanessa; Rabin, Borsika

    2014-01-01

    Background/Aims Patient-centered communication is vital to quality care. Strategies are needed for assessing patients’ views on communication over the entire course of cancer care. We sought to describe cancer patients’ perceptions of their communication experiences using a new set of items. Of particular interest were patients’ reports of when communication “fell short” and the aspects of communication considered most important. Methods We surveyed members of Kaiser Permanente (KP) Member Voice, a representative online panel of KP members. Questions focused on communication with the cancer care team overall and during specific phases (e.g., diagnosis, chemotherapy). Respondents indicating less than excellent communication were asked to describe how communication fell short. We asked all respondents what aspects of communication were most important during cancer care. Results A total of 375 members diagnosed with cancer completed the questionnaire. Respondents represented all KP regions; 57% (212/375) were female; 62% (233/375) had at least a college degree. Overall communication ratings varied by phase of care; the percentage of respondents rating “excellent” was lowest for Diagnosis (62%; 225/365); corresponding percentages for other phases included Decision-Making 71% (248/352); Surgery 73% (212/290); Radiation 65% (68/105); Drug Therapy 76% (82/108); Completing Treatment 70% (237/340). Only 55% (189/342) of respondents “strongly agreed” they were told their diagnosis in a sensitive, caring way. Asked where communication fell short, patients cited problems in providers’ manner, as well as the amount, timing and clarity of information. Initial analysis of what was most important revealed themes related to being treated like a person, conveying caring and optimism and providing clear, complete and timely information. Conclusions Patients are willing to provide feedback on their cancer care experiences and to identify problematic aspects of communication and when they occurred. These items can be used to assess patients’ experiences and to prioritize quality improvement efforts.

  7. Perceptions of Patient-Provider Communication in Breast and Cervical Cancer-Related Care: A Qualitative Study of Low-Income English- and Spanish-Speaking Women

    PubMed Central

    Simon, Melissa A.; Ragas, Daiva M.; Nonzee, Narissa J.; Phisuthikul, Ava M.; Luu, Thanh Ha; Dong, XinQi

    2013-01-01

    To explore patient perceptions of patient-provider communication in breast and cervical cancer-related care among low-income English- and Spanish- speaking women, we examined communication barriers and facilitators reported by patients receiving care at safety net clinics. Participants were interviewed in English or Spanish after receiving an abnormal breast or cervical cancer screening test or cancer diagnosis. Following an inductive approach, interviews were coded and analyzed by the language spoken with providers and patient-provider language concordance status. Of 78 participants, 53% (n = 41) were English-speakers and 47% (n = 37) were Spanish-speakers. All English-speakers were language-concordant with providers. Of Spanish-speakers, 27% (n = 10) were Spanish-concordant; 38% (n = 14) were Spanish-discordant, requiring an interpreter; and 35% (n = 13) were Spanish mixed-concordant, experiencing both types of communication throughout the care continuum. English-speakers focused on communication barriers, and difficulty understanding jargon arose as a theme. Spanish-speakers emphasized communication facilitators related to Spanish language use. Themes among all Spanish-speaking sub-groups included appreciation for language support resources and preference for Spanish-speaking providers. Mixed-concordant participants accounted for the majority of Spanish-speakers who reported communication barriers. Our data suggest that, although perception of patient-provider communication may depend on the language spoken throughout the care continuum, jargon is lost when health information is communicated in Spanish. Further, the respective consistency of language concordance or interpretation may play a role in patient perception of patient-provider communication. PMID:23553683

  8. Communicating with patients.

    PubMed

    Kaplowitz, G J

    1999-01-01

    Dental care providers need to be able to communicate effectively with their patients in order to build rapport and trust. Highly developed communication skills also enable the dental care provider to extract more accurate diagnostic information and to more effectively present treatment options to the patient. Neurolinguistic programming techniques can be employed to accomplish these as well as other objectives. PMID:10687469

  9. Teaching communication and stress management skills to junior physicians dealing with cancer patients: a Belgian Interuniversity Curriculum

    Microsoft Academic Search

    Isabelle Bragard; Darius Razavi; Serge Marchal; Isabelle Merckaert; Nicole Delvaux; Yves Libert; Christine Reynaert; Jacques Boniver; Jean Klastersky; Pierre Scalliet; Anne-Marie Etienne

    2006-01-01

    Background  Ineffective physicians’ communication skills have detrimental consequences for patients and their relatives, such as insufficient detection of psychological disturbances, dissatisfaction with care, poor compliance, and increased risks of litigation for malpractice. These ineffective communication skills also contribute to everyday stress, lack of job satisfaction, and burnout among physicians. Literature shows that communication skills training programs may significantly improve physicians’ key

  10. Communication and Care in an Acute Cancer Center: The Effects of Patients' Willingness to Communicate About Health, HealthCare Environment Perceptions, and Health Status on Information Seeking, Participation in Care Practices, and Satisfaction

    Microsoft Academic Search

    Kevin B. Wright; Lawrence R. Frey

    2008-01-01

    This study investigated the role of willingness to communicate about health (WTCH) among older patients in a state-of-the-art cancer center. Specifically, relationships were examined between patients' WTCH and their information seeking, perceptions of coping activities the center offered, and satisfaction with the center. The study also explored how those relationships may be mediated by patients' perceptions of the health-care environment

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

    Microsoft Academic Search

    Yaacov G. Bachner; Norm ORourke; Sara Carmel

    2011-01-01

    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 psychological distress (i.e., depressive symptomatology, emotional exhaustion) among secular and religiously observant family

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

    ERIC Educational Resources Information Center

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

    2011-01-01

    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…

  13. The cancer patient at work.

    PubMed

    Mellette, S J

    1985-01-01

    The person who has been treated for cancer may have unique problems resuming employment or starting a new job. Cancer represents a spectrum of diseases, and posttreatment impairments may vary from none, in the majority of cases, to major functional disability. Employers understandably have difficulty recognizing the variability that exists, both in terms of functional capacity and prognosis, and they are often unaware of the improved prognosis for many cancers. Today, many patients receive adjuvant chemotherapy or prolonged intermittent treatment and need to adjust their work schedule to allow for this. Some people need job training or vocational counseling; in many states, vocational rehabilitation agencies now have an increased interest in providing services to cancer patients. Discrimination against the cancer patient has been demonstrated; the major problems are in the area of hiring practices. Efforts need to be continued to educate employers and the public and to ensure that the rights of the cancer patient are recognized. We may, however, do our patients a disservice if we overemphasize potential problems to a degree that increases patient fear and insecurity in regard to employment. Instead, we as physicians may be able to help prevent problems by more effective communication with employers on behalf of our patients, as well as by direct patient counseling. The insurance problems of cancer patients, particularly those relating to health insurance, do require major attention. The potential productivity, as well as the quality of life, of the cancer patient are jeopardized when he or she feels unable to change jobs because of fear of loss of insurance coverage. The relatively high number of reported cancellations and changes in insurance benefits that have been reported by cancer patients also represents an area of concern, since some of these appear medically unjustified. The physician's opinion and input may be of importance in preventing or solving individual insurance problems. The physician can also help the cancer patient who has employment problems by providing information about available resources. The above-mentioned employment booklet (#4585-PS), available from the ACS, may be useful and contains information about legal resources. Referral to a vocational rehabilitation agency may be indicated. The best medicine of all may be a positive and optimistic attitude toward the patient's participation in the work force. PMID:3931869

  14. The Role of the Clinician in Cancer Clinical Communication

    Microsoft Academic Search

    Susan S. Eggly; Terrance L. Albrecht; Kimberly Kelly; Holly G. Prigerson; Lisa Kennedy y Sheldon; Jamie Studts

    2009-01-01

    Clinician communication is critical to positive outcomes for patients and families in most health contexts. Researchers have investigated areas such as defining and teaching effective communication and identifying specific outcomes that can be improved through more effective communication. In the area of cancer care, advances in detection and treatment require that clinicians develop new skills to adapt to the evolving

  15. Nutrition in cancer patients

    Microsoft Academic Search

    Sebastiano Mercadante

    1996-01-01

    Many factors can modify nutritional status in cancer patients, including cachexia, nausea and vomiting, decreased caloric intake or oncologic treatments capable of determining malabsorption. Cachexia is a complex disease characterized not only by a poor intake of nutrients or starvation, but also by metabolic derangement. Nausea and vomiting may limit the nutrient intake and are most often the consequences of

  16. Survivorship: tools for transitioning patients with cancer.

    PubMed

    Morgan, Mary Ann; Denlinger, Crystal S

    2014-12-01

    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

  17. PLENARY SESSION: Communications and eHealth - Office of Cancer Survivorship

    Cancer.gov

    Advances in electronic communications have made information more easily accessible to many cancer patients and survivors. Nonetheless, issues remain to be resolved regarding access to records for patients, and communication between doctors is especially important when patients finish treatment and return to a primary care setting in which health care practitioners may be unaware of their needs as cancer survivors.

  18. Standardized Geriatric Assessment or Usual Care in Improving Communication and Quality of Life in Older Patients With Advanced Solid Tumors or Lymphoma and Caregivers | Division of Cancer Prevention

    Cancer.gov

    This randomized research trial studies standardized geriatric assessment (GA) or usual care in improving communication and quality of life in older patients with advanced solid tumors or lymphoma and caregivers. A GA measures the issues important to older patients, including function, psychological status, cognitive abilities, social support, and the impact of medical problems on quality of life. A GA may improve communication between patients and their doctors in addressing patient concerns.

  19. Patient Relations and Workplace Communication.

    ERIC Educational Resources Information Center

    Career Resources Development Center, Inc., San Francisco, CA.

    The workbook contains lessons and exercises in patient relations and workplace communication in a medical services office, particularly for interactions involving one or more non-native speaker of English. Seven units address these topics: (1) greetings and basic assistance, greeting established patients, and measuring height and weight and taking…

  20. Hope in Iranian cancer patients

    PubMed Central

    Abdullah-zadeh, Farahnaz; Agahosseini, Shima; Asvadi-Kermani, Iraj; Rahmani, Azad

    2011-01-01

    BACKGROUND: Hope is an important factor in the recovery of cancer patients. Few Iranian studies investigated the level of hope in cancer patients. Therefore, the present study aimed to investigate the level of hope in Iranian cancer patients and the related factors. METHODS: In a descriptive correlational study, 150 cancer patients were selected by a consecutive sampling method. Hope in patients was measured by the Herth Hope Index. Data analysis was performed using descriptive and inferential statistics. RESULTS: Results indicated that 61.1% of the patients had high levels of hope, 35.4% had moderate levels of hope, and 3.5% had low levels of hope. Hope has a statistically significant relationship with family support, but it is not statistically associated with other patient characteristics. CONCLUSIONS: Many cancer patients had a high level of hope. However, further studies are recommended to investigate the relation between hope and patient characteristics. PMID:23450037

  1. Immunoregulation in pancreatic cancer patients

    Microsoft Academic Search

    Janet M. D. Plate; Susan Shott; Jules E. Harris

    1999-01-01

    Metastatic pancreatic cancer is one of the most aggressive cancer known in man yet specific anti-tumor immunity has been\\u000a demonstrated in lymph nodes draining the sites of pancreatic tumors. Despite this immunity, pancreatic cancer patients suffer\\u000a a quick demise. To further define tumor immunity in patients with metastatic pancreatic cancer, we sought to characterize\\u000a helper T cell subsets, serum cytokines,

  2. Risk communication strategies: state of the art and effectiveness in the context of cancer genetic services

    Microsoft Academic Search

    Claire Julian-Reynier; Myriam Welkenhuysen; Lea Hagoel; Marleen Decruyenaere; Penelope Hopwood

    2003-01-01

    The objective of this paper is first to describe the different strategies used to communicate risks to patients in the field of cancer or genetics, to review their effectiveness, and to summarise the state of the art of this practice in particular, in cancer genetics. The target audience is health care professionals involved in the communication of cancer risks, and

  3. Hyponatremia in cancer patients.

    PubMed

    Platania, Marco; Verzoni, Elena; Vitali, Milena

    2015-04-28

    Hyponatremia is the most frequent electrolyte disorder in hospitalized patients but also a well known poor prognostic factor in cancer patients. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is often misdiagnosed by oncologist because of difficulties in the interpretation of laboratory tests.Etiology is heterogeneous but the predominant cause is represented by the unbalance between excessive presence of water and serum sodium deficiency.Ectopic production of arginine vasopressin (AVP) develops more frequently in small cell lung cancer but it is not so rare in other malignancies.Neurological impairment may range from subclinical to life-threating symptoms depending by the rate of serum sodium deficiency. Appropriate diagnosis is essential to set a proper therapy. When hyponatremia is caused by SIADH, hypertonic saline infusion is indicated for acute presentation whereas fluid restriction is preferred in case of chronic asymptomatic evolution.Other options include vaptans, vasopressin receptor antagonists, targeted specifically for the correction of euvolemic hyponatremia.The aim of this brief report is to provide concise and specific informations for the management of SIADH in oncology clinical practice. PMID:25908038

  4. Social constraints and spousal communication in lung cancer.

    PubMed

    Badr, Hoda; Taylor, Cindy L Carmack

    2006-08-01

    The Social Cognitive Processing Model suggests that talking with others facilitates cognitive and emotional processing of experiences such as cancer if the social context in which these discussions take place is supportive and positive. Despite this, patients and spouses may inadvertently constrain each other's attempts to process and cope with the disease. To our knowledge, no previous studies have directly examined the effect of lung cancer on the spousal relationship. We began to examine this effect by identifying the social constraints experienced by couples coping with lung cancer through semi-structured interviews with 13 patients and 12 spouses. Using Grounded Theory methodology, our analyses showed that these couples experienced a wide variety of social constraints, including denial, avoidance, and conflict that can hinder open spousal communication. Specifically, patients and spouses reported trouble discussing continued tobacco use, cancer-related symptoms, prognosis, and the emotional effects of lung cancer on the spouse. Despite these constraints, participants who reported talking with their partners about their relationships reported fewer constraints and better communication about cancer. These findings highlight the importance of a relationship perspective in the study of lung cancer and provide information about how talking together about the spousal relationship may enable couples to minimize social constraints and enhance cognitive and emotional processing of the disease. PMID:16287210

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

    PubMed

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

    2013-09-01

    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

  6. Financial Distress in Cancer Patients

    PubMed Central

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

    2013-01-01

    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

  7. Study Protocol: A randomized controlled trial of patient navigation-activation to reduce cancer health disparities

    Microsoft Academic Search

    Samantha Hendren; Jennifer J Griggs; Ronald M Epstein; Sharon Humiston; Sally Rousseau; Pascal Jean-Pierre; Jennifer Carroll; Amanat M Yosha; Starlene Loader; Kevin Fiscella

    2010-01-01

    BACKGROUND: Cancer health disparities affecting low-income and minority patients are well documented. Root-causes are multifactorial, including diagnostic and treatment delays, social and financial barriers, and poor communication. Patient navigation and communication coaching (activation) are potential interventions to address disparities in cancer treatment. The purpose of this clinical trial is to test the effectiveness of an intervention combining patient navigation and

  8. Patient Request for Email Communications Patient Name: Date of Birth

    E-print Network

    Columbia University

    Patient Request for Email Communications Patient Name: Date of Birth: Phone Number: Email Address: Communications over the Internet and / or using the email system may not be encrypted and may not be secure. There is no assurance of confidentiality when communicating via email. To request that this provider/program communicate

  9. [COMMUNICATION WITH TERMINALLY ILL PATIENT].

    PubMed

    2014-12-01

    The communication is a essential therapeutic instrument in every process of relationship in the team patient-family, and mainly in the transmission of bad news. The communication is not just a simple transmission of information. It is a process whose goal is to enable the adaptation of the patient and family to their actual situation and where the "what", "how" and "how much do you want to know", are belonged to the own patient. Along this article, we will expose some thoughts that the team has to take into account when informing the patient. We are going to explain the SPIKES protocol, or its Spanish version EPICEE. 6-step protocol, based on those recommended by the experts to deliver bad news procedures. And finally we'll talk about the conspiracy of silence, one of the most common and difficult situations to handle in day to day due to paternalism by professionals and families, in which they prefer to hide the situation to the patient, thinking it's the best for him. PMID:26121886

  10. Patient Request for Email Communications Patient Name: _____________________________ Date of Birth: _____________________________

    E-print Network

    Qian, Ning

    Patient Request for Email Communications Patient Name: _____________________________ Date of Birth: _____________________________ Phone Number: ___________________________ Email Address:_____________________________ Communications over the Internet and / or using the email system may not be encrypted and may not be secure

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

    PubMed

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

    2009-09-01

    Sexuality is a basic need for every human being as long as he or she is alive, irrespective of age or health status. Approximately 23,500 individuals are diagnosed with cancer each year in Israel and join the 120,000 cancer patients currently living in Israel. The results of cancer treatments are traditionally assessed and based on the outcome regarding mortality versus survival. An equally important aspect to be addressed in this assessment must relate to quality of life. One of the more painful insults to the quality of life of cancer patients relates to the deleterious effects on sexuality. This article aims to present physicians with the spectrum of sexuality-related issues which are encountered by cancer patients and their partners, starting from the moment of diagnosis, throughout the various stages of treatment and to provide basic knowledge. Many individuals contracting cancer have difficulty dealing with the issue of sexuality. They are typically embarrassed and feel uneasy when asking health care providers about such a non-life threatening issue. Partners similarly feel both shame and guilt. In many cases sexuality, intimacy and emotional attachment are important aspects and may be essential for survival. Addressing these issues during treatment can provide patients with a sense of security, avoiding embarrassment and further exacerbation of such problems. Unfortunately, little has been done to develop an optimal interventional program, although standard sexual treatments have often been applied. Prospective clinical research and outcomes are missing. The physician can use the well-known PLISSIT model (1978): to provide sexuality involvement on different levels. The very new BETTER model (2004) can help emphasize that cancer treatment and the disease have an influence on intimacy and sexuality. PMID:20070056

  12. Alzheimer's disease. Physician-patient communication.

    PubMed Central

    Orange, J. B.; Molloy, D. W.; Lever, J. A.; Darzins, P.; Ganesan, C. R.

    1994-01-01

    The number of cognitively impaired elderly in Canada has increased greatly during the past two decades; nearly all have Alzheimer's disease (AD). The memory problems and changes in language and communication of these patients place tremendous strain on physicians who are searching for a differential diagnosis and are trying to communicate with them. Reviewing the salient language and communication features of AD patients leads to strategies for improving effective physician-patient communication. PMID:8019193

  13. The application of cure models in the presence of competing risks: a tool for improved risk communication in population-based cancer patient survival.

    PubMed

    Eloranta, Sandra; Lambert, Paul C; Andersson, Therese M-L; Björkholm, Magnus; Dickman, Paul W

    2014-09-01

    Quantifying cancer patient survival from the perspective of cure is clinically relevant. However, most cure models estimate cure assuming no competing causes of death. We use a relative survival framework to demonstrate how flexible parametric cure models can be used in combination with competing-risks theory to incorporate noncancer deaths. Under a model that incorporates statistical cure, we present the probabilities that cancer patients (1) have died from their cancer, (2) have died from other causes, (3) will eventually die from their cancer, or (4) will eventually die from other causes, all as a function of time since diagnosis. We further demonstrate how conditional probabilities can be used to update the prognosis among survivors (eg, at 1 or 5 years after diagnosis) by summarizing the proportion of patients who will not die from their cancer. The proposed method is applied to Swedish population-based data for persons diagnosed with melanoma, colon cancer, or acute myeloid leukemia between 1973 and 2007. PMID:25036430

  14. Prevalence of complementary and alternative medicine use in cancer patients during treatment

    Microsoft Academic Search

    Jennifer S. Yates; Karen M. Mustian; Gary R. Morrow; Leslie J. Gillies; Devi Padmanaban; James N. Atkins; Brian Issell; Jeffrey J. Kirshner; Lauren K. Colman

    2005-01-01

    Goals of work: To assess complementary and alternative medi- cine (CAM) therapies being utilized by cancer patients during treatment and communication about CAM usage between the patient and physi- cian. Patients and methods: Newly diagnosed cancer patients receiving chemotherapy or radiation therapy were recruited to complete a CAM survey within 2 weeks after the termination of treatment. Patients were queried

  15. Two augmentative communication systems for speechless disabled patients.

    PubMed

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

    1989-08-01

    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

  16. The quality of communication between parents and adolescent children in the case of parental cancer

    Microsoft Academic Search

    G. A. Huizinga; A. Visser; H. J. Hoekstra

    2005-01-01

    Background: This study was designed to investigate: (i) parent-adolescent communication in families of cancer patients; (ii) relationships between parent-adolescent communication and posttraumatic stress symptoms (PTSS) in adolescent children; and (iii) associations between parents' illness charac- teristics and parent-adolescent communication. Patients and methods: A total of 212 adolescents completed the Impact of Event Scale and Parent- Adolescent Communication Scale. Results: Adolescents

  17. Study of dyadic communication in couples managing prostate cancer: a longitudinal perspective

    PubMed Central

    Song, L; Northouse, LL; Zhang, L; Braun, TM; Cimprich, B; Ronis, DL; Mood, DW

    2013-01-01

    OBJECTIVE Cancer patients and partners often report inadequate communication about illness-related issues, although it is essential for mutual support and informal caregiving. This study examined the patterns of change in dyadic communication between patients with prostate cancer and their partners, and also determined if certain factors affected their communication over time. METHOD Using multilevel modeling, this study analyzed longitudinal data obtained from a randomized clinical trial with prostate cancer patients and their partners, to examine their communication over time. Patients and partners (N=134 pairs) from the usual-care control group independently completed baseline demographic assessment and measures of social support, uncertainty, symptom distress, and dyadic communication at baseline, and 4-, 8-, and 12-month follow-ups. RESULTS The results indicated that (1) patients and partners reported similar levels of open communication at the time of diagnosis. Communication reported by patients and partners decreased over time in a similar trend, regardless of phase of illness; (2) phase of illness affected couples’ open communication at diagnosis but not patterns of change over time; and (3) couples’ perceived communication increased as they reported more social support, less uncertainty, and fewer hormonal symptoms in patients. Couples’ demographic factors and general symptoms, and patients’ prostate cancer-specific symptoms did not affect their levels of open communication. CONCLUSIONS Perceived open communication between prostate cancer patients and partners over time is affected by certain baseline and time-varying psychosocial and cancer-related factors. The results provide empirical evidence that may guide the development of strategies to facilitate couples’ interaction and mutual support during survivorship. PMID:20967920

  18. Fatigue in cancer patients.

    PubMed

    Simon, A M; Zittoun, R

    1999-07-01

    The interest in fatigue seems to be growing. A Medline search combining the key words fatigue and cancer yielded 248 entries compared with 72 entries 10 years previously. The studies published are mainly descriptive, augmenting the knowledge about the extent of fatigue associated with cancer, as well as during and after the various treatments used to fight it. New measurement instruments integrating the multidimensional concept of fatigue are being proposed. In 1998, the first study describing fatigue in children and adolescents with cancer was published. The knowledge of the causes of fatigue related to cancer remains extremely limited. In only a few studies are interventions and treatment possibilities for fatigue discussed. Hopefully, the refined knowledge about the characteristics of fatigue and its epidemiology will provide new etiologic understanding, resulting in effective treatment. This article provides a survey on the literature published in 1998. PMID:10416875

  19. Communication with patients suffering from serious physical illness.

    PubMed

    Grassi, Luigi; Caruso, Rosangela; Costantini, Anna

    2015-01-01

    Communication is the corner stone of the relationship with the patient in all medical settings with the main aims of creating a good inter-personal relationship, exchanging information, and making treatment-related decisions. In a rapidly changing cultural and social context, the paternalistic approach of doctors knowing the best and deciding what should be done for a patient has been replaced by a shared decision-making approach, with patients being advised to educate themselves, ask questions and influence the course of the discussion with their doctors. Thus, a need for an improvement in the communication skills of physicians is extremely important for patients affected by serious physical illness (e.g. cancer, HIV infection, multiple sclerosis, amyotrophic lateral sclerosis). Certain attitudes, behaviour and skills (e.g. capacity to impart confidence, being empathetic, providing a 'human touch', relating on a personal level, being forthright, being respectful, and being thorough) are part of effective communication. However, some specific aspects influencing doctor-patient communication and relationships, such as personality variables, coping and attachment styles, as well as cultural factors, should also be taken in to account. The development of training curricula to help doctors acquire proper skills in communication is mandatory, since research has shown that training in communication may facilitate the effectiveness of a doctor-patient relationship and the patient's satisfaction with care and give a general sense of humanity, which is easily lost in a biotechnologically oriented medicine. PMID:25832510

  20. Cancer in patients receiving dialysis

    Microsoft Academic Search

    L J Kinlen; J B Eastwood; D N Kerr; J F Moorhead; D O Oliver; B H Robinson; H E de Wardener; A J Wing

    1980-01-01

    The incidence of cancer and related mortality was studied in 1651 patients from six dialysis centres in England over 10 years. The only type of cancer for which there was a significant excess was non-Hodgkin's lymphoma (four cases observed against an expected incidence of 0.15 (p < 0.001); three deaths against an expected 0.1 (p < 0.001)). This excess could

  1. Cultural Aspects of Communication in Cancer Care

    Microsoft Academic Search

    A. Surbone

    Cancer is increasing in incidence and prevalence worldwide, and the WHO has recently included cancer and its treatments as\\u000a a health priority in developed and developing countries. The cultural diversity of oncology patients is bound to increase,\\u000a and cultural sensitivity and competence are now required of all oncology professionals. A culturally competent cancer care\\u000a leads to improved therapeutic outcome and

  2. A Better Patient Experience Through Better Communication.

    PubMed

    Lang, Elvira V

    2012-12-01

    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

  3. Patients' communication with doctors: a randomized control study of a brief patient communication intervention.

    PubMed

    Talen, Mary R; Muller-Held, Christine F; Eshleman, Kate Grampp; Stephens, Lorraine

    2011-09-01

    In research on doctor-patient communication, the patient role in the communication process has received little attention. The dynamic interactions of shared decision making and partnership styles which involve active patient communication are becoming a growing area of focus in doctor-patient communication. However, patients rarely know what makes "good communication" with medical providers and even fewer have received coaching in this type of communication. In this study, 180 patients were randomly assigned to either an intervention group using a written communication tool to facilitate doctor-patient communication or to standard care. The goal of this intervention was to assist patients in becoming more effective communicators with their physicians. The physicians and patients both rated the quality of the communication after the office visit based on the patients' knowledge of their health concerns, organizational skills and questions, and attitudes of ownership and partnership. The results supported that patients in the intervention group had significantly better communication with their doctors than patients in the standard care condition. Physicians also rated patients who were in the intervention group as having better overall communication and organizational skills, and a more positive attitude during the office visit. This study supports that helping patients structure their communication using a written format can facilitate doctor-patient communication. Patients can become more adept at describing their health concerns, organizing their needs and questions, and being proactive, which can have a positive effect on the quality of the doctor-patient communication during outpatient office visits. (PsycINFO Database Record (c) 2011 APA, all rights reserved). PMID:21787080

  4. Communication and Technology in Genetic Counseling for Familial Cancer

    PubMed Central

    Lynch, Henry T.; Snyder, Carrie; Stacey, Mark; Olson, Brooke; Peterson, Susan; Buxbaum, Sarah; Shaw, Trudy; Lynch, Patrick

    2015-01-01

    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

  5. Gastric Cancer in Young Patients

    PubMed Central

    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

    2013-01-01

    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

  6. Determinants of participation in treatment decision-making by older breast cancer patients

    Microsoft Academic Search

    Rose C. Maly; Yoshiko Umezawa; Barbara Leake; Rebecca A. Silliman

    2004-01-01

    Purpose. To identify the impact of patient age and patient-physician communication on older breast cancer patients' participation in treatment decision-making.\\u000aMethods. We conducted a cross-sectional survey of breast cancer patients aged 55 years or older (n= 222) in Los Angeles County. Patients received a breast cancer diagnosis between 1998 and 2000, and were interviewed on average 7.1 months (SD =

  7. [Anal cancer in HIV patients].

    PubMed

    Quéro, Laurent; Duval, Xavier; Abramowitz, Laurent

    2014-11-01

    Despite effective highly active antiretroviral treatment, anal cancer incidence has recently strongly increased in HIV-infected population. Treatment strategy in HIV-infected patients does not differ from general population. HIV-infected patients treated by chemo-radiotherapy are exposed to high-grade toxicities and should be closely monitored to deliver the optimal treatment. Close collaboration between oncologist and infectiologist is highly recommended to adjust antiretroviral therapy if necessary. PMID:25418596

  8. Dissociative symptomatology in cancer patients

    PubMed Central

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

    2015-01-01

    Introduction: The utilization of the post-traumatic stress disorder (PTSD) diagnostic spectrum is currently being debated to categorize psychological adjustment in cancer patients. The aims of this study were to: (1) evaluate the presence of cancer-related traumatic dissociative symptomatology in a sample of cancer patients; (2) examine the correlation of cancer-related dissociation and sociodemographic and medical variables, anxiety, depression, and post-traumatic stress symptomatology; (3) investigate the predictors of cancer-related dissociation. Methods: Ninety-two mixed cancer patients (mean age: 58.94, ds = 10.13) recruited from two hospitals in northern Italy were administered a questionnaire on sociodemographic and medical characteristics, the Karnofsky Scale to measure the level of patient activity and medical care requirements, the Hospital Anxiety and Depression Scale (HADS) to evaluate the presence of anxiety and depression, the Impact of Event Scale Revised (IES-R) to assess the severity of intrusion, avoidance, and hypervigilance, and the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) to quantify the traumatic dissociative symptomatology. Results: 31.5% of participants report a PDEQ score above the cutoff. The results indicated that dissociative symptomatology was positively correlated with HADS scores (HADS-Anxiety: r = 0.476, p < 0.001; HADS-Depression: r = 0.364, p < 0.001) and with IES-R scores (IES-R-Intrusion: r = 0.698, p < 0.001; IES-R-Avoidance: r = 0.619, p < 0.001; IES-R- Hypervigilance: r = 0.681, p < 0.001). A stepwise regression analysis was performed in order to find the predictors of cancer-related traumatic dissociative symptomatology. The results converged on a three predictor model revealing that IES-R-Intrusion, IES-R-Avoidance, and IES-R-Hyperarousal accounted for 53.9% of the explained variance. Conclusion: These findings allow us to hypothesize a specific psychological reaction which may be ascribed to the traumatic spectrum within the context of cancer, emphasizing the close relationship between the origin of dissociative constituents which, according to the scientific literature, compose the traumatic experience. Our results have implications for understanding dissociative symptomatology in a cancer population and can help develop clinical programs of prevention and support for patients. PMID:25759675

  9. Communication in conversation in stroke patients

    Microsoft Academic Search

    Marc Rousseaux; Walter Daveluy; Odile Kozlowski

    2010-01-01

    In stroke patients, it has been suggested that communication disorders could result from lexical and syntactic disorders in\\u000a left hemisphere lesions and from pragmatics problems in right lesions. However, we have little information on patient behaviour\\u000a in dyadic communication, especially in conversation. Here, we analyzed the various processes participating in communication\\u000a difficulties at the rehabilitation phase (1–6 months) post-stroke, in order

  10. Monitoring care of colorectal cancer patients in

    E-print Network

    Müller, Jens-Dominik

    Monitoring care of colorectal cancer patients in Northern Ireland diagnosed 2006 (with comparisons 1996 & 2001) Colorectal1996-2006 #12;Monitoring care of colorectal cancer patients in Northern Ireland should be cited as; Fitzpatrick D and Gavin A, 2009. Monitoring care of colorectal cancer patients

  11. Cancer-specific Relationship Awareness, Relationship Communication, and Intimacy Among Couples Coping with Early Stage Breast Cancer

    PubMed Central

    Manne, Sharon L.; Siegel, Scott; Kashy, Deborah; Heckman, Carolyn J.

    2013-01-01

    If couples can maintain normalcy and quality in their relationship during the cancer experience, they may experience greater relational intimacy. Cancer-specific relationship awareness, which is an attitude defined as partners focusing on the relationship and thinking about how they might maintain normalcy and cope with cancer as a couple or “team”, is one factor that may help couples achieve this goal. The main aim of this study was to evaluate the associations between cancer-specific relationship awareness, cancer-specific communication (i.e., talking about cancer’s impact on the relationship, disclosure, and responsiveness to partner disclosure), and relationship intimacy and evaluate whether relationship communication mediated the association between relationship awareness and intimacy. Two hundred fifty four women diagnosed with early stage breast cancer and their partners completed measures of cancer-specific relationship awareness, relationship talk, self-and perceived partner disclosure, perceived partner responsiveness, and relationship intimacy. Results indicated that patients and spouses who were higher in cancer-specific relationship awareness engaged in more relationship talk, reported higher levels of self-disclosure, and perceived that their partner disclosed more. Their partners reported that they were more responsive to disclosures. Relationship talk and perceived partner responsiveness mediated the association between cancer–specific relationship awareness and intimacy. Helping couples consider ways they can maintain normalcy and quality during the cancer experience and framing coping with cancer as a “team” effort may facilitate better communication and ultimately enhance relationship intimacy. PMID:25242854

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

    PubMed

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

    2013-01-01

    Although hope is a pervasive concept in cancer treatment, we know little about how ambulatory patients with cancer define or experience hope. We explored hope through semistructured interviews with ten patients with advanced (some curable, some incurable) colon cancer at one Midwestern, university-based cancer center. We conducted a thematic analysis to identify key concepts related to patient perceptions of hope. Although we did ask specifically about hope, patients also often revealed their hopes in response to indirect questions or by telling stories about their cancer experience. We identified four major themes related to hope: 1) hope is essential, 2) a change in perspective, 3) the content of hope, and 4) communicating about hope. The third theme, the content of hope, included three subthemes: a) the desire for normalcy, b) future plans, and c) hope for a cure. We conclude that hope is an essential concept for patients undergoing treatment for cancer as it pertains to their psychological well-being and quality of life, and hope for a cure is not and should not be the only consideration. In a clinical context, the exploration of patients' hopes and aspirations in light of their cancer diagnosis is important because it provides a frame for understanding their goals for treatment. Exploration of the content of patients' hope can not only help to illuminate misunderstandings but also clarify how potential treatments may or may not contribute to achieving patients' goals. PMID:24407088

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

    PubMed Central

    Trice, Elizabeth D.; Prigerson, Holly G.

    2013-01-01

    Concerns have been raised about the quality of life and healthcare 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 of EOL care. EOL discussions with physicians are associated with an increased likelihood of: 1. acknowledgement of terminal illness, 2. preferences for comfort care over life-extension, and 3. receipt of less intensive, life-prolonging and more palliative EOL care; while this appears to hold for white patients, it is less clear for black, advanced cancer patients. These results highlight the importance of communication in determining EOL cancer care and suggest that communication disparities may contribute to black-white differences in the EOL care. We review the pertinent literature and discuss areas for future research. PMID:19449273

  14. Lung cancer patients with previous or simultaneous urologic cancers

    Microsoft Academic Search

    Kunihiko Miyazaki; Hiroaki Satoh; Katsunori Kagohashi; Koichi Kurishima; Hiroichi Ishikawa; Morio Ohtsuka; Kiyohisa Sekizawa

    2008-01-01

    Study objectives There have been few reports on clinical characteristics of lung cancer patients with previous or simultaneous urologic cancers.\\u000a Additionally, it was scarcely reported whether these patients could tolerate standard therapy. To evaluate them, we conducted\\u000a a retrospective study. Methods The records of patients with lung cancer who had previously or simultaneously urological cancers seen in our division between

  15. Risk Communication in Genetic Testing for Cancer Susceptibility

    Microsoft Academic Search

    Robert T. Croyle; Caryn Lerman

    1999-01-01

    Risk communication is an integral part of genetic counseling and testing for cancer susceptibility. This paper reviews the emerging literature on this topic. Three relevant aspects of risk communication are addressed: communication of indi- vidual risk, communication of the risks inherent in genetic testing, and family communications related to risk. These studies suggest that (a) most individuals with some family

  16. Sexual dysfunction and spousal communication in couples coping with prostate cancer

    PubMed Central

    Badr, Hoda; Taylor, Cindy L. Carmack

    2015-01-01

    Objective To characterize the sexual function of both prostate cancer patients and their partners, and to examine whether associations between sexual dysfunction and psychosocial adjustment vary depending on spousal communication patterns. Methods In this cross-sectional study, 116 prostate cancer patients and their partners completed psychosocial questionnaires. Results Patients and partners reported high rates of sexual dysfunction. Within couples, patients’ and their partners’ sexual function was moderately to highly correlated (r = 0.30–0.74). When patients had poor erectile function, their partners were more likely to report that the couple avoided open spousal discussions; this in turn was associated with partners’ marital distress (Sobel's Z = 12.47, p = 0.001). Patients and partners who reported high levels (+1SD) of mutual constructive communication also reported greater marital adjustment, regardless of their own sexual satisfaction. In contrast, greater sexual dissatisfaction was associated with poorer marital adjustment in patients and partners who reported low levels (?1SD) of mutual constructive communication (p<0.05). Conclusion Our findings underscore the need for psychosocial interventions that facilitate healthy spousal communication and address the sexual rehabilitation needs of patients and their partners after prostate cancer treatment. Although some couples may be reluctant to engage in constructive cancer-related discussions about sexual problems, such discussions may help alleviate the negative impact that sexual problems have on prostate cancer patients’ and their partners’ marital adjustment. PMID:19061199

  17. Serious game scores as health condition indicator for cancer patients.

    PubMed

    Peters, Konrad; Kayali, Fares; Reithofer, Andrea; Wölfle, Rebecca; Mateus-Berr, Ruth; Kuczwara, Jens; Lehner, Zsuzsanna; Lawitschka, Anita; Brunmaier, Barbara; Martinek, Daniel; Silbernagl, Marisa; Hlavacs, Helmut

    2015-01-01

    In this paper we present INTERACCT (Integrating Entertainment and Reaction Assessment into Child Cancer Therapy), a multidisciplinary research project aiming at creating a communication tool for pediatric patients after cancer treatment with HSCT (hematopoietic stem cell transplantation) in after care. The communication platform should foster communication between patients and clinicians, but also increase motivation for treatment compliance by using appropriate designs and gamification elements. A state of the art web interface enables the physicians to evaluate data submitted by the patients, joining data from various sources (lab data, survey data, physiotherapy performance) using HL7 and visualizing imporant changes. This contribution outlines the challenges of designing such a system and presents a solution for the medical data interface and evaluation. PMID:25991284

  18. A Better Patient Experience Through Better Communication

    PubMed Central

    Lang, Elvira V.

    2012-01-01

    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

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

    PubMed Central

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

    2014-01-01

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

  20. Oral complications in cancer patients

    SciTech Connect

    Carl, W.

    1983-02-01

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

  1. Maintaining the reproductive potential of cancer patients during cancer treatment.

    PubMed

    Harp, Djana; Chowdhury, Indrajit; Garcia-Barrio, Minerva; Welch, Crystal; Matthews, Roland; Thompson, Winston

    2014-01-01

    Cancer therapies are known to alter the reproductive potential in cancer patients. Due to improved survival rates in cancer patients of reproductive age, considerations of the long-term effects of cancer therapy have become more significant. Oncofertility is a new discipline in medicine that deals with maintaining the reproductive potential of cancer patients while they are receiving gonadotoxic cancer treatment. The purpose of this review is to explore how cancer treatment impairs reproductive functioning and present the current options for preservation of fertility in women. All patients with reproductive potential should be made aware of the possible treatment-related infertility and be offered appropriate fertility preservation options before cancer treatment is instituted. The hope is that, in the future, mechanism(s) can be developed to preserve immature germ cells in the ovary, so that they can be used for fertilization in vivo or in vitro. PMID:24389259

  2. Communication between Doctors and Patients.

    ERIC Educational Resources Information Center

    Bennett, A.E., Ed.

    The papers in this book explore the fundamental skills necessary for communication between individuals and the important benefits which improved communication could contribute to both the teaching and the practice of good clinical and administrative medicine. The papers consist of an analysis of face-to-face communicaton in terms of four systems…

  3. Sexual concerns in cancer patients: a comparison of GI and breast cancer patients

    Microsoft Academic Search

    Jennifer Barsky Reese; Rebecca A. Shelby; Francis J. Keefe; Laura S. Porter; Amy P. Abernethy

    2010-01-01

    Purpose  Although sexual concerns have been examined in breast cancer (BC), these concerns remain understudied and undertreated for\\u000a patients with gastrointestinal (GI) cancer. Objectives were to: (1) assess sexual concerns in GI cancer patients compared\\u000a with breast cancer patients; (2) examine whether sexual concerns are stable over time in GI and breast cancer patients; and\\u000a (3) evaluate whether sexual concerns in

  4. Designing a multifaceted survivorship care plan to meet the information and communication needs of breast cancer patients and their family physicians: results of a qualitative pilot study

    PubMed Central

    2013-01-01

    Background Following the completion of treatment and as they enter the follow-up phase, breast cancer patients (BCPs) often recount feeling ‘lost in transition’, and are left with many questions concerning how their ongoing care and monitoring for recurrence will be managed. Family physicians (FPs) also frequently report feeling ill-equipped to provide follow-up care to BCPs. In this three-phase qualitative pilot study we designed, implemented and evaluated a multi-faceted survivorship care plan (SCP) to address the information needs of BCPs at our facility and of their FPs. Methods In Phase 1 focus groups and individual interviews were conducted with 35 participants from three stakeholder groups (BCPs, FPs and oncology specialist health care providers (OHCPs)), to identify specific information needs. An SCP was then designed based on these findings, consisting of both web-based and paper-based tools (Phase 2). For Phase 3, both sets of tools were subsequently evaluated via focus groups and interviews with 26 participants. Interviews and focus groups were audio taped, transcribed and content analysed for emergent themes and patterns. Results In Phase 1 patients commented that web-based, paper-based and human resources components were desirable in any SCP. Patients did not focus exclusively on the post-treatment period, but instead spoke of evolving needs throughout their cancer journey. FPs indicated that any tools to support them must distill important information in a user-friendly format. In Phase 2, a pilot SCP was subsequently designed, consisting of both web-based and paper-based materials tailored specifically to the needs of BCPs as well as FPs. During Phase 3 (evaluation) BCPs indicated that the SCP was effective at addressing many of their needs, and offered suggestions for future improvements. Both patients and FPs found the pilot SCP to be an improvement from the previous standard of care. Patients perceived the quality of the BCP-FP relationship as integral to their comfort with FPs assuming follow-up responsibilities. Conclusions This pilot multi-component SCP shows promise in addressing the information needs of BCPs and the FPs who care for them. Next steps include refinement of the different SCP components, further evaluation (including usability testing), and planning for more extensive implementation. PMID:23883430

  5. Physician-Patient Communication and Patient Compliance: A Theoretical Orientation.

    ERIC Educational Resources Information Center

    Clampitt, Phillip G.; Williams, M. Lee

    This paper synthesizes much of the literature concerning physician/patient communication as it relates to patient compliance. Using the theoretical perspective that deals with belief, attitude, intention, and behavior (a perspective generated by Martin Fishbein and Icek Ajzen), a new theoretical orientation for predicting patient compliance is…

  6. More Breast Cancer Patients Opting for Lumpectomy

    MedlinePLUS

    More Breast Cancer Patients Opting for Lumpectomy: Study Experts often recommend this breast-conserving surgery, but many with early disease ... News) -- The percentage of women with early stage breast cancer who choose to have the breast-conserving surgery ...

  7. Implementing an evidence-based breast cancer support and communication tool to newly diagnosed patients as standard care in two institutions.

    PubMed

    Rahm, Alanna Kulchak; Hawkins, Robert P; Dearing, James W; Pingree, Suzanne; Lomax, Jana Bolduan; McDowell, Helen; Morse, Erica Ferro; Barela, BreAnne

    2015-06-01

    While many women turn to the Internet to obtain health information, it is unlikely that unstructured Internet use provides optimal benefit to women newly diagnosed with breast cancer, due to uneven quality, conflicting claims, redundancy, and search engine idiosyncrasies, which may make finding information and assessing its accuracy and applicability difficult. To answer the need for information and support, the Comprehensive Health Enhancement Support System (CHESS) was developed to provide access to integrated information for decision-making, behavior change, and emotional support, and has been validated in randomized trials. This observational study of real-world implementation focuses on the process of integrating CHESS into standard care in two Denver healthcare systems. Results from this study provide guidance for implementation of other web-based patient information and support programs in large healthcare organizations. PMID:26029282

  8. Professional boundaries: communication after patient discharge.

    PubMed

    Petraits, Laura R

    2013-10-01

    The blurring of professional boundaries commonly takes place when a nurse cares for a patient for an extended period of time. This article focuses on the aspects of professional boundaries in neonatal nursing, particularly in regard to communication after patient discharge. Modes of caring are investigated to understand the nature of the therapeutic relationship between nurse and patient and how this can present an ethical dilemma at the end of a patient's hospital stay. A discussion of how a patient reunion is organized is discussed at the end of this article as a possible solution to reconnecting patient-nurse ties in a professional manner. PMID:24042137

  9. Effective Communication About the Use of Complementary and Integrative Medicine in Cancer Care

    PubMed Central

    Cohen, Lorenzo

    2014-01-01

    Abstract 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

  10. Lymphedema After Surgery in Patients With Endometrial Cancer, Cervical Cancer, or Vulvar Cancer | Division of Cancer Prevention

    Cancer.gov

    This clinical trial studies lymphedema after surgery in patients with endometrial cancer, cervical cancer, or vulvar cancer. Collecting information over time about how often lymphedema occurs in patients undergoing surgery and lymphadenectomy for endometrial cancer, cervical cancer, and vulvar cancer may help doctors learn more about the disease and plan the best treatment.

  11. Doctor-patient communication: A review of the literature

    Microsoft Academic Search

    L. M. L. Ong; A. M. Hoos; F. B. Lammes

    1995-01-01

    Communication can be seen as the main ingredient in medical care. In reviewing doctor-patient communication, the following topics are addressed: (1) different purposes of medical communication; (2) analysis of doctor-patient communication; (3) specific communicative behaviors; (4) the influence of communicative behaviors on patient outcomes; and (5) concluding remarks.Three different purposes of communication are identified, namely: (a) creating a good inter-personal

  12. Epilepsy in the cancer patient

    Microsoft Academic Search

    Odysseas Kargiotis; Sofia Markoula; Athanasios P. Kyritsis

    2011-01-01

    Purpose  Epileptic seizures in patients with malignancies usually occur as a consequence of brain metastases from systemic cancer or\\u000a the presence of a primary brain tumor. Other less-frequent causes include metabolic disorders such as electrolyte abnormalities,\\u000a hypoglycemia, hypoxia and liver failure, paraneoplastic encephalitis, leptomeningeal carcinomatosis, side effects of certain\\u000a chemotherapeutic agents, central nervous system infections, and pre-existing epilepsy.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We reviewed all

  13. Access to Cancer Services for Rural Colorectal Cancer Patients

    ERIC Educational Resources Information Center

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

    2008-01-01

    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.…

  14. Communication by Mothers with Breast Cancer or Melanoma with Their Children

    PubMed Central

    Gaber, Rikki; Desai, Sapna; Smith, Maureen; Eilers, Steve; Blatt, Hanz; Guevara, Yanina; Robinson, June K.

    2013-01-01

    Communication of familial risk of breast cancer and melanoma has the potential to educate relatives about their risk, and may also motivate them to engage in prevention and early detection practices. With the Health Insurance Portability and Accountability Act (HIPAA) privacy laws, the patient often becomes the sole communicator of such risks to family members. This study surveys mothers diagnosed with either breast cancer or melanoma and their adult children about their family communication style, knowledge of increased risk, and early detection practices. In both cancer groups, most mothers alerted their children of the risk and need for early detection practices. Breast cancer mothers communicated risk and secondary prevention with early detection by breast self-examination and mammograms whereas the melanoma mothers communicated risk and primary prevention strategies like applying sunscreen and avoiding deliberate tanning. Open communication about health matters significantly increased the likelihood that children engaged in early detection and/or primary prevention behaviors. Examining the information conveyed to at-risk family members, and whether such information motivated them to engage in early detection/prevention behaviors, is key to guiding better cancer prevention communication between doctors and patients. PMID:23965923

  15. Future directions in research on consumer-provider communication and adherence to cancer prevention and treatment.

    PubMed

    DiMatteo, M Robin

    2003-05-01

    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 management. Six research questions are posed, and substantive and methodological recommendations are offered for empirical research on the measurement and achievement of patient adherence. PMID:12767580

  16. Improving the care of cancer patients: holistic needs assessment.

    PubMed

    Young, Jenny; Cund, Audrey; Renshaw, Marian; Quigley, Angela; Snowden, Austyn

    2015-02-01

    This discussion paper presents a review of holistic needs assessments (HNAs) in the care of patients with cancer. HNAs entail a structured review of patient needs as articulated by the patient. This discussion then leads to a care plan grounded in issues pertinent to that patient. Despite policy guidance advocating its use, there are barriers to overcome in order to integrate HNAs into routine care. This article discusses what role communication skills and clinician confidence may have on the use of HNAs in practice, and suggests a strategy to support HNAs becoming the norm. PMID:25723367

  17. Familial cancer among consecutive uterine cancer patients in Sweden

    PubMed Central

    2014-01-01

    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

  18. Guidelines Urge Exercise for Cancer Patients, Survivors

    Cancer.gov

    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.

  19. Cancer Genetic Counselor Information Needs for Risk Communication: A Qualitative Evaluation of Interview Transcripts

    PubMed Central

    Overby, Casey Lynnette; Chung, Wendy K.; Hripcsak, George; Kukafka, Rita

    2013-01-01

    Personalized medicine is a model of healthcare that is predictive, personalized, preventive and participatory (“P4 Medicine”). Genetic counselors are an ideal group to study when designing tools to support cancer P4 Medicine activities more broadly. The goal for this work was to gain a better understanding of the information cancer genetic counselors seek from their patients to facilitate effective information exchange for discussing risk. This was an analysis of a qualitative data set from interviews of eight cancer genetic counselors, recruited from three institutions. Genetic counselors at each site were interviewed using a semi-structured, open-ended questionnaire. A selective coding approach was used to determine major themes associated with genetic counseling information needs for communicating risk. We generated a model for understanding categories of genetic counseling information needs to support risk communication activities. Common activities for risk communication included risk assessment and tailoring communication. Categories of information needs included: (a) clinical patient characteristics, (b) social and cognitive patient characteristics and (c) patient motivation and goals for the genetic counseling session. A logical next step is for this model to inform the design of software systems for pre-visit patient planning and delivering just-in-time educational information to facilitate cancer risk communication activities. PMID:24358447

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

    SciTech Connect

    Not Available

    1981-04-01

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

  1. Breast Cancer Patients' Experiences within and outside the Safety Net

    PubMed Central

    Fayanju, Oluwadamilola M.; Jeffe, Donna B.; Elmore, Leisha; Ksiazek, Deborah N.; Margenthaler, Julie A.

    2014-01-01

    Background Following reforms to the breast-cancer referral process for our city’s health Safety Net (SN), we compared the experiences from first abnormality to definitive diagnosis of breast-cancer patients referred to Siteman Cancer Center from SN and non-Safety-Net (NSN) providers. Materials and Methods SN-referred patients with any-stage (0–IV) and NSN-referred patients with late-stage (IIB–IV) breast cancer were prospectively identified post-diagnosis during cancer-center consultations conducted between September 2008 and June 2010. Interviews were taped and transcribed verbatim; transcripts were independently coded by two raters using inductive methods to identify themes. Results Of 82 eligible patients, 57 completed interviews (33/47 SN [70%], 24/35 NSN [69%]). Eighteen (52%) SN-referred patients had late-stage disease at diagnosis, as did all NSN patients (by design). A higher proportion of late-stage SN patients (67%) than either early-stage SN (47%) or NSN (33%) patients reported feelings of fear and avoidance that deterred them from pursuing care for concerning breast findings. A higher proportion of SN late-stage patients than NSN patients reported behaviors concerning for poor health knowledge/behavior (33% vs. 8%), but reported receipt of timely, consistent communication from healthcare providers once they received care (50% vs. 17%). Half of late-stage SN patients reported improper clinical or administrative conduct by healthcare workers that delayed referral and/or diagnosis. Conclusions While SN patients reported receipt of compassionate care once connected with health services, they presented with higher-than-expected rates of late-stage disease. Psychological barriers, life stressors, and provider/clinic delays affected access to and navigation of the healthcare system and represent opportunities for intervention. PMID:24768022

  2. [Quick guide to communicate important news to terminally ill patients].

    PubMed

    Ghio, P; Dell'Orco, L

    2011-01-01

    The aim of this work is to be able to publish the information concerning communication with cancer patients as recommended in England. The observation and the study protocol during the stay abroad have been given the opportunity to stylize specific information on the methodology of communication of important information to terminally ill patients. It seems readily apparent as they characterized by both technical precision and sensivity to emotions and descriptions for the individual patient. How is shared by all chronic pain is predominantly complex emotion, a mix of additions and perceived physical and emotional pain - emotional. Because accurate information is beneficial to the patient and that really is not turned, so to speak, a "bullet" it is necessary that you have created, over time, a concrete "therapeutic alliance" between body physician, patient and possibly family. This arises, for sure, even at first accepted the patient during the clinical visit attentive to detail, is renewed in the definition of the common objective to be achieved, so analgesia and it is expressed in the certainty that the physician provides all the resources realistically available. It is then up to the sensitivity of the operator, doctor and/or nurse, described in the "take charge" find, from time to time, the words and manners, verbal and nonverbal, to respond fully to questions of the patient same. PMID:21533322

  3. Incidence of prostate cancer in male breast cancer patients: a risk factor for prostate cancer screening

    Microsoft Academic Search

    U J Lee; J S Jones

    2009-01-01

    Synchronous or metachronous occurrences of both prostate cancer and male breast cancer are rarely reported, but provide insight into their hormonal and genetic biology. We sought to determine the incidence of prostate cancer in male breast cancer patients at our institution, and to examine estrogen receptor (ER), progesterone receptor (PR) and HER-2\\/neu receptor (HR) status in these patients. A retrospective

  4. Cancer screening in patients infected with HIV.

    PubMed

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

    2011-09-01

    Non-AIDS-defining cancers are a rising health concern among HIV-infected patients. Cancer screening is now an important component of health maintenance in HIV clinical practice. The decision to screen an HIV-infected patient for cancer should include an assessment of individualized risk for the particular cancer, life expectancy, and the harms and benefits associated with the screening test and its potential outcome. HIV-infected patients are at enhanced risk of several cancers compared to the general population; anal cancer, hepatocellular carcinoma, Hodgkin's lymphoma, and lung cancer all have good evidence demonstrating an enhanced risk in HIV-infected persons. A number of cancer screening interventions have shown benefit for specific cancers in the general population, but data on the application of these tests to HIV-infected persons are limited. Here we review the epidemiology and background literature relating to cancer screening interventions in HIV-infected persons. We then use these data to inform a conceptual model for evaluating HIV-infected patients for cancer screening. PMID:21695529

  5. Cancer Screening in Patients Infected with HIV

    PubMed Central

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

    2012-01-01

    Non–AIDS-defining cancers are a rising health concern among HIV-infected patients. Cancer screening is now an important component of health maintenance in HIV clinical practice. The decision to screen an HIV-infected patient for cancer should include an assessment of individualized risk for the particular cancer, life expectancy, and the harms and benefits associated with the screening test and its potential outcome. HIV-infected patients are at enhanced risk of several cancers compared to the general population; anal cancer, hepatocellular carcinoma, Hodgkin’s lymphoma, and lung cancer all have good evidence demonstrating an enhanced risk in HIV-infected persons. A number of cancer screening interventions have shown benefit for specific cancers in the general population, but data on the application of these tests to HIV-infected persons are limited. Here we review the epidemiology and background literature relating to cancer screening interventions in HIV-infected persons. We then use these data to inform a conceptual model for evaluating HIV-infected patients for cancer screening. PMID:21695529

  6. ACOG Committee Opinion No. 587: Effective patient-physician communication.

    PubMed

    2014-02-01

    Physicians' ability to effectively and compassionately communicate information is key to a successful patient-physician relationship. The current health care environment demands increasing clinical productivity and affords less time with each patient, which can impede effective patient-physician communication. The use of patient-centered interviewing, caring communication skills, and shared decision making improves patient-physician communication. Involving advanced practice nurses or physician assistants may improve the patient's experience and understanding of her visit. Electronic communication with established patients also can enhance the patient experience in select situations. PMID:24451677

  7. Quality of life in head and neck cancers patients: predictive factors, functional and psychosocial outcome

    Microsoft Academic Search

    E. Babin; E. Sigston; M. Hitier; D. Dehesdin; J. P. Marie; O. Choussy

    2008-01-01

    The principal endpoints in head and neck cancer are survival with improvement of quality of life (QoL) in cancer patients.\\u000a Patients treated for head and neck cancer suffer from a number of symptom domains: physical symptoms linked to diet and feeding,\\u000a communication disorders, pain and their general state of health; psychological symptoms including depression, irritability,\\u000a loss of self-esteem (occasionally feelings

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

    PubMed

    Tan, Andy S L

    2015-11-01

    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

  9. Advanced nurse-patient communication system.

    PubMed

    Unluturk, Mehmet S

    2012-08-01

    Effective communication is the most important part of any healthcare organization. For many years, hospital nurse call solutions had been stand-alone systems with occasional integration to pocket paging for outputting patient call alerts to mobile staff. In the late 1990's, technology enabled in-building wireless phones to supplement or replace paging systems as a means of not only sending alerts, but also enabling voice communication between mobile staff and patients. Today's nurse call market requires integration of additional information from location and ADT (admit, discharge, transfer) systems into what have traditionally been nurse call applications. This system information is required not only at the nursing station, pagers, and phones, but also at PC's placed on each patient care floor in hallways, nurse stations, and offices, and at areas away from the patients, including administrator and clinical engineering offices. It is crucial that nurses have the latest patient information in their hand wherever they go in the hospital. In this paper, MatchMaker.NET has been developed to integrate all these technologies into the hospital's LAN to improve nurse-patient communication. PMID:21541690

  10. Optimising surgical management of elderly cancer patients

    PubMed Central

    Ramesh, Hodigere Sripathy Jois; Pope, Daniel; Gennari, Roberto; Audisio, Riccardo A

    2005-01-01

    Background Elderly population is on rise. It is an ethical dilemma how aggressive one should be when it comes to treat cancer in elderly. Presumed fear of increased postoperative morbidity and mortality has resulted in delivery of sub-optimal cancer surgery. Methods In this review article we visit physiology of the aged, tools available to assess surgical risks in oncogeriatric patients, and current practice in the management of common cancers encountered in surgical oncology, with the view of increasing awareness on optimising surgical management of senior patients with cancer. A pubmed search for cancer, surgery, elderly, was carried out. Results Cancer is on rise with increasing age predominantly affecting breast, gastrointestinal tract and lung. Increasingly more surgeons are offering surgery to elderly cancer patient but selection bias is prevalent. Available data reflect short and long-term outcome of cancer surgery in elderly is not greatly different to that of younger patient. Declining physiological reserve along with inability to respond adequately to physiological stress are salient age related changes. Comprehensive Geriatric Assessment (CGA) is not tested in surgical patient. There is need for a tool to define individualised operative risk. Preoperative assessment of cancer in elderly is designed to offer this information based on functional status of an individual utilising currently available tools of risk assessment. Conclusion All elderly cancer patients should be offered optimal treatment depending on their functional status not on chronological age. Oncogeriatric patient would benefit from dedicated multidisciplinary approach. Recruitment of elderly cancer patients to more clinical trials is needed to enhance our knowledge and to offer optimum treatment to this unique subgroup. PMID:15788092

  11. Information needs and experiences: an audit of UK cancer patients.

    PubMed

    Cox, Anna; Jenkins, Valerie; Catt, Susan; Langridge, Carolyn; Fallowfield, Lesley

    2006-09-01

    As part of a multi-centred UK study evaluating multidisciplinary team communication, the information needs, decision making preferences and information experiences of 394 cancer patients were audited. A majority of patients (342/394, 87%) wanted all possible information, both good and bad news. Assuming that all clinicians had equal skill, the majority of patients (350/394, 89%) expressed no preference for the sex of their doctor. The largest proportion of patients (153/394, 39%) wanted to share responsibility for decision making, preference was significantly influenced by age (chi2=17.42, df=4 P=0.002) with older patients more likely to prefer the doctor to make the decisions. A majority of patients reported receiving information regarding their initial tests (313/314, 100%), diagnosis (382/382, 100%), surgery (374/375, 100%) and prognosis (308/355, 87%), fewer recalled discussions concerning clinical trials (119/280, 43%), family history (90/320, 28%) or psychosocial issues, notably sexual well-being (116/314, 37%). Cancer patients want to be fully informed and share decision making responsibility, but do not report receiving sufficient information in all areas. Multidisciplinary cancer teams need to ensure that where appropriate, someone provides patients with information about clinical trials, familial risk and psychosocial issues. Regular audits highlight gaps and omissions in the information given to patients. PMID:16376146

  12. Thyroid cancer in patients with hyperthyroidism.

    PubMed

    Pazaitou-Panayiotou, K; Michalakis, K; Paschke, R

    2012-04-01

    Thyroid cancer can be associated with thyrotoxicosis caused by Graves' disease, toxic multinodular goiter, or autonomously functioning thyroid adenoma. The objective of this study was to summarize current evidence regarding the association of thyroid cancer and hyperthyroidism, particularly with respect to the type of hyperthyroidism found in some patients, and whether this affects the outcome of the patient. A PubMed search was performed up to August 2011. Articles were identified using combinations of the following keywords/phrases: thyroid cancer, papillary thyroid cancer, follicular thyroid cancer, medullary thyroid cancer, anaplastic thyroid cancer, hyperthyroidism, Graves' disease, auto-nomous adenoma, toxic thyroid nodule, and toxic multinodular goiter. Original research papers, case reports, and review articles were included. We concluded that the incidence, as well as the prognosis of thyroid cancer associated with hyperthyroidism is a matter of debate. It seems that Graves' disease is associated with larger, multifocal, and potentially more aggressive thyroid cancer than single hot nodules or multinodular toxic goiter. Patients with Graves' and thyroid nodules are at higher risk to develop thyroid cancer compared to patients with diffuse goiter. Every suspicious nodule associated with hyperthyroidism should be evaluated carefully. PMID:22334393

  13. Complications of herpes zoster in cancer patients.

    PubMed

    Tran, Trung N; Ray, G Thomas; Horberg, Michael A; Yawn, Barbara P; Castillo, Adrienne L; Saddier, Patricia; Habel, Laurel A

    2014-07-01

    Cancer patients tend to have a higher incidence of herpes zoster (HZ), but little is known about their risk of HZ complications. We conducted a retrospective study of 424 newly diagnosed hematologic (HM, n = 140) and solid tumor malignancy (STM, n = 284) patients who developed HZ between January 2001 and December 2006 to measure the frequency and identify risk factors of HZ complications. Patients were adult members of Kaiser Permanente Northern California. HZ diagnosis and complications were confirmed by medical chart review. HM patients with HZ tended to have more HZ complications than STM patients (34% vs 23%, p = 0.02), largely due to more frequent non-pain complications. On multivariate analysis, older age and being male were associated with a higher risk of HZ complications in HM patients; more advanced cancer stage was associated with HZ complications in STM patients. HZ complications are frequent and can present extra disease burden in cancer patients who develop HZ. PMID:24796470

  14. Effects of coaching patients with lung cancer to report cancer pain.

    PubMed

    Wilkie, Diana; Berry, Donna; Cain, Kevin; Huang, Hsiu-Ying; Mekwa, Julia; Lewis, Frances; Gallucci, Betty; Lin, Yu-Chuan; Chen, Angela Chia-Chen; Ko, Nai-Ying

    2010-02-01

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

  15. Study Protocol: A randomized controlled trial of patient navigation-activation to reduce cancer health disparities

    PubMed Central

    2010-01-01

    Background Cancer health disparities affecting low-income and minority patients are well documented. Root-causes are multifactorial, including diagnostic and treatment delays, social and financial barriers, and poor communication. Patient navigation and communication coaching (activation) are potential interventions to address disparities in cancer treatment. The purpose of this clinical trial is to test the effectiveness of an intervention combining patient navigation and activation to improve cancer treatment. Methods/Design The Rochester Patient Navigation Research Program (PNRP) is a National Cancer Institute-sponsored, patient-level randomized trial (RCT) of patient navigation and activation, targeting newly-diagnosed breast and colorectal cancer patients in Rochester, NY. The goal of the program is to decrease cancer health disparities by addressing barriers to receipt of cancer care and promoting patient self-efficacy. The intervention uses trained, paraprofessional patient navigators recruited from the target community, and a detailed training and supervisory program. Recruited patients are randomly assigned to receive either usual care (except for baseline and follow-up questionnaires and interviews) or intervention. The intervention patients receive tailored assistance from their patient navigators, including phone calls, in-person meetings, and behind-the-scenes coordination of care. A total of 344 patients have been recruited. Outcomes measured at three month intervals include timeliness of care, patient adherence, patient satisfaction, quality of life, self-efficacy, health literacy, and cancer knowledge. Discussion This unique intervention combining patient navigation and patient activation is designed to address the multifactorial problem of cancer health disparities. If successful, this study will affect the design and implementation of patient navigation programs. Trials Registration clinicaltrials.gov identifier NCT00496678 PMID:20939928

  16. Quality of Life in elderly patients with cancer.

    PubMed

    Di Maio, Massimo; Perrone, Francesco

    2003-01-01

    The incidence of most types of cancers is age-dependent and the progressive ageing is rapidly increasing the number of elderly people who need treatment for cancer. Elderly patients present peculiar characteristics that make the choice of the correct treatment more difficult and these patients are often undertreated. Moreover, elderly patients are largely underrepresented in cancer treatment trials, and this makes the experimental evidence on this topic even weaker. Health-related Quality of Life (QOL) has been considered as one of the hard end-points for clinical cancer research, and treatment of elderly cancer patients represents a typical situation where its assessment can be particularly useful, because the expected toxicity of treatment could be relevant in the discussion of the treatment choice. However, QOL assessment in the elderly is complicated by several unresolved methodological problems (higher frequency of illiteracy, worse compliance with the questionnaires, concomitant diseases, use of instruments not validated in the aged population). Conduct of clinical trials dedicated to elderly patients is now encouraged but there are few published studies. Advanced non-small-cell lung cancer is one of the fields with the largest amount of research on QOL in elderly patients. The ELVIS study demonstrated the efficacy of single-agent chemotherapy, both in terms of QOL and of survival. The MILES study, in which combination chemotherapy was not superior than single agents, showed that baseline QOL is a strong prognostic indicator in these patients. QOL of patients with breast cancer has been another important field in clinical research over the last decades, and interest on this topic in elderly patients is growing, from loco-regional to palliative treatment. In conclusion, some steps have been done in clinical cancer research dedicated to elderly patients, and the role of QOL assessment in this setting is important. However, many methodological problems must be resolved, in order to obtain reliable and useful results. A QOL assessment could also be useful for elderly patients in clinical practice, where it could improve patient-clinician communication: a wider application of properly selected instruments should be recommended. PMID:14525617

  17. Cultural beliefs and values in cancer patients.

    PubMed

    Daher, M

    2012-04-01

    In 2008, the International Agency for Research on Cancer (IARC) released its World Cancer Report, which indicated that cancer accounts for approximately 12% of all-cause mortality worldwide. IARC estimated that globally 7.6 million people died from cancer and that 12.4 million new cases were diagnosed in 2008. The report went on to project that, due to increases in life expectancy, improvements in clinical diagnostics, and shifting trends in health behaviors (e.g. increases in smoking and sedentary lifestyles), in the absence of significant efforts to improve global cancer control, cancer mortality could increase to 12.9 million and cancer incidence to 20 million by the year 2030. Looking deeper into the data, it becomes clear that cancer-related stigma and myths about cancer are important problems that must be addressed, although different from a country to another. Stigmas about cancer present significant challenges to cancer control: stigma can have a silencing effect, whereby efforts to increase cancer awareness are negatively affected. The social, emotional, and financial devastation that all too often accompanies a diagnosis of cancer is, in large part, due to the cultural myths and taboos surrounding the disease. Combating stigma, myths, taboos, and overcoming silence will play important roles in changing this provisional trajectory. There are several reasons that cancer is stigmatized. Many people in our area perceived cancer to be a fatal disease. Cancer symptoms or body parts affected by the disease can cultivate stigma. Fears about treatment can also fuel stigma. There was evidence of myths associated with cancer, such as the belief that cancer is contagious, or cancer may be seen as a punishment. After reviewing these different examples of cultural myths and taboos met in cancer care, we can report these lessons learned: 1. Around the world, cancer continues to carry a significant amount of stigma, myths, and taboos; however, there are opportunities to capitalize upon shifting perceptions and positive change. 2. Awareness of cancer prevention, early detection, treatment, and survival are on the rise; however, too many people still report that they feel uninformed when it comes to cancer. 3. Communication is critical to decreasing cancer-related stigma, raising cancer awareness, and disseminating cancer education. People with a personal history of cancer-especially well-known or celebrity survivors-and multiple mass media channels are key resources for dissemination. 4. The school system represents a potential venue for cancer education, and increasing cancer awareness among children may be an investment with high returns. 5. When facing cancer, people around the world want information and emotional support for themselves and their families. 6. Tobacco use and poor nutrition are widely acknowledged as cancer risks. Programs and policies that help people translate this awareness into action are needed. The global cancer community should capitalize upon positive shifts in attitudes about awareness of cancer and leverage these shifts to develop, and disseminate effective media campaigns and behavioral interventions to decrease the incidence of and morbidity and mortality associated with cancer. PMID:22628419

  18. Helping cancer patients disclose their concerns

    Microsoft Academic Search

    P. Maguire; A. Faulkner; K. Booth; C. Elliott; V. Hillier

    1996-01-01

    Health professionals are reluctant to enquire actively about cancer patients' concerns and feelings. They fear that probing will damage patients psychologically and believe they have had insufficient training in the relevant interviewing skills. In considering how their interviewing skills might be improved, the key question is which interviewing behaviours promote patient disclosure and which inhibit it. To test our predictions

  19. Patient Delay in Colorectal Cancer Patients: Associations with Rectal Bleeding and Thoughts about Cancer

    PubMed Central

    Pedersen, Anette F.; Hansen, Rikke P.; Vedsted, Peter

    2013-01-01

    Rectal bleeding is considered to be an alarm symptom of colorectal cancer. However, the symptom is seldom reported to the general practitioner and it is often assumed that patients assign the rectal bleeding to benign conditions. The aims of this questionnaire study were to examine whether rectal bleeding was associated with longer patient delays in colorectal cancer patients and whether rectal bleeding was associated with cancer worries. All incident colorectal cancer patients during a 1-year period in the County of Aarhus, Denmark, received a questionnaire. 136 colorectal cancer patients returned the questionnaire (response rate: 42%). Patient delay was assessed as the interval from first symptom to help-seeking and was reported by the patient. Patients with rectal bleeding (N?=?81) reported longer patient intervals than patients without rectal bleeding when adjusting for confounders including other symptoms such as pain and changes in bowel habits (HR?=?0.43; p?=?0.004). Thoughts about cancer were not associated with the patient interval (HR?=?1.05; p?=?0.887), but more patients with rectal bleeding reported to have been wondering if their symptom(s) could be due to cancer than patients without rectal bleeding (chi2?=?15.29; p<0.001). Conclusively, rectal bleeding was associated with long patient delays in colorectal cancer patients although more patients with rectal bleeding reported to have been wondering if their symptom(s) could be due to cancer than patients without rectal bleeding. This suggests that assignment of symptoms to benign conditions is not the only explanation of long patient delays in this patient group and that barriers for timely help-seeking should be examined. PMID:23894527

  20. Multidisciplinary care for patients with breast cancer.

    PubMed

    Hulvat, Melissa C; Hansen, Nora M; Jeruss, Jacqueline S

    2009-02-01

    The care of patients with breast cancer has become increasingly complex with advancements in diagnostic modalities, surgical approaches, and adjuvant treatments. A multidisciplinary approach to breast cancer care is essential to the successful integration of available therapies. This article addresses the key components of multidisciplinary breast cancer care, with a special emphasis on new and emerging approaches over the past 10 years in the fields of diagnostics, surgery, radiation, medical oncology, and plastic surgery. PMID:19186235

  1. Circulating procoagulant microparticles in cancer patients

    Microsoft Academic Search

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

    2011-01-01

    Accumulating evidence indicates that microparticles (MPs) are important mediators of the interaction between cancer and the\\u000a hemostatic system. We conducted a large prospective cohort study to determine whether the number of circulating procoagulant\\u000a MPs is elevated in cancer patients and whether the elevated MP levels are predictive of occurrence of venous thrombembolism\\u000a (VTE). We analyzed plasma samples of 728 cancer

  2. [Touching cancer: shiatsu as complementary treatment to support cancer patients].

    PubMed

    Argash, Oz; Caspi, Opher

    2008-01-01

    In recent years there has been an increase in the interest of cancer patients in receiving complementary medicine therapies as supportive measures to cure the disease. In response, medical units that combine conventional and complementary medicine (integrative medicine) have been established in leading cancer centers worldwide. In Israel, a special integrative medicine unit that combines mind-body, Chinese medicine, nutrition, herbs, supplements, and manual therapies (such as shiatsu) before, during and after conventional anti-cancer therapies has been established as an integral part of the Davidoff Comprehensive Cancer Center in 2006. Shiatsu represents a group of manual therapeutic techniques, including acupressure. Shiatsu offers cancer patients a non-pharmacologic method to relieve symptoms and improve quality of life throughout the course of illness. Research indicates that acupressure is relatively effective and safe for common cancer-related symptoms such as nausea, vomiting and insomnia. In our experience, shiatsu is also relatively effective and safe for other common symptoms such as fatigue, muscular pain and body image dissatisfaction. Yet, insufficient evidence exists to delineate the best means by which shiatsu and other manual therapies could or should be integrated into routine cancer care. The purpose of the present paper is to describe what is currently known about this topic in order to support decision-making that is based on facts, rather than on myths and misconceptions. We call for more research that examines the effectiveness and safety of shiatsu and other manual therapies in the care of cancer patients. PMID:18935760

  3. Cancer Patient Navigator Tasks across the Cancer Care Continuum

    PubMed Central

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

    2011-01-01

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

  4. Identifying Gender-Preferred Communication Styles within Online Cancer Communities: A Retrospective, Longitudinal Analysis

    PubMed Central

    Durant, Kathleen T.; McCray, Alexa T.; Safran, Charles

    2012-01-01

    Background The goal of this research is to determine if different gender-preferred social styles can be observed within the user interactions at an online cancer community. To achieve this goal, we identify and measure variables that pertain to each gender-specific social style. Methods and Findings We perform social network and statistical analysis on the communication flow of 8,388 members at six different cancer forums over eight years. Kruskal-Wallis tests were conducted to measure the difference between the number of intimate (and highly intimate) dyads, relationship length, and number of communications. We determine that two patients are more likely to form an intimate bond on a gender-specific cancer forum (ovarian P?=?<0.0001, breast P?=?0.0089, prostate P?=?0.0021). Two female patients are more likely to form a highly intimate bond on a female-specific cancer forum (Ovarian P<0.0001, Breast P<0.01). Typically a male patient communicates with more members than a female patient (Ovarian forum P?=?0.0406, Breast forum P?=?0.0013). A relationship between two patients is longer on the gender-specific cancer forums than a connection between two members not identified as patients (ovarian forum P?=?0.00406, breast forum P?=?0.00013, prostate forum P?=?.0.0003). Conclusion The high level of interconnectedness among the prostate patients supports the hypothesis that men prefer to socialize in large, interconnected, less-intimate groups. A female patient is more likely to form a highly intimate connection with another female patient; this finding is consistent with the hypothesis that woman prefer fewer, more intimate connections. The relationships of same-gender cancer patients last longer than other relationships; this finding demonstrates homophily within these online communities. Our findings regarding online communication preferences are in agreement with research findings from person-to-person communication preference studies. These findings should be considered when designing online communities as well as designing and evaluating psychosocial and educational interventions for cancer patients. PMID:23155460

  5. Characteristics of Cancer Patients in Internet Cancer Support Groups

    PubMed Central

    Im, Eun-Ok; Chee, Wonshik; Liu, Yi; Lim, Hyun Ju; Guevara, Enrique; Tsai, Hsiu-Min; Clark, Maresha; Bender, Melinda; Shin, Hyunjeong; Kim, Kyung Suk; Kim, Young Hee

    2008-01-01

    The purpose of this study was to describe characteristics of cancer patients who were attending Internet Cancer Support Groups (ICSGs) and to provide direction for future research. A total of 204 cancer patients were recruited through ICSGs by posting the study announcement on the websites of the ICSGs. The participants were asked to fill out Internet survey questionnaires on sociodemographic characteristics and health/disease status. The data were analyzed using descriptive and inferential statistics including t-tests, ANOVA, and chi-square tests. Findings indicate that cancer patients recruited through the ICSGs tended to be middle-aged, well-educated, female and middle class. The findings also indicate that there were significant differences in some characteristics according to gender and ethnicity. Based on the findings, some implications are suggested for future research using and developing the ICSGs. PMID:18000430

  6. [Communication during hospitalization of Japanese immigrant patients].

    PubMed

    Chubaci, Rosa Yuka Sato; Merighi, Miriam Aparecida Barbosa

    2002-01-01

    Communication--verbal or non-verbal--during hospitalization is an important tool to provide a new way of looking and acting to nursing professionals. Based on the consideration that the understanding about the disease and hospitalization can be impaired due to the difficulty in understanding the Portuguese language, the authors carried out the present study aiming at evaluating the importance of the communication during hospitalization. In order to unveil the experience of these subjects, the authors developed a qualitative investigation with a phenomenological approach. Authors interviewed 17 Japanese immigrants at a hospital in the city of São Paulo. Results showed that the difficulty in speaking Portuguese interfered in the patients' understanding about the disease, its treatment and the relationship with the health team, enhancing the feeling of insecurity and demonstrating that culture does play an important role on these patients' behavior and attitudes concerning the disease and hospitalization. PMID:12696552

  7. Incidence of cancer in patients with leprosy.

    PubMed

    Purtilo, D T; Pangi, C

    1975-04-01

    Individuals with congenital immunodeficiences and patients who are immunosuppressed for maintenance of organ allografts experience a marked increase in the occurrence of malignancy. Patients with lepromatous leprosy also have depressed cellular immunity, but or study of 195 autopsied subjects with leprosy did not reveal an increase in the occurrence of cancer. Thirty-three of the 195 subjects with leprosy or 16.9% died of cancer, which is comparable to an age-matched group of individuals. PMID:1116111

  8. Integrating palliative care with intensive care for critically ill patients with lung cancer

    PubMed Central

    2012-01-01

    With newer information indicating more favorable outcomes of intensive care therapy for lung cancer patients, intensivists increasingly are willing to initiate an aggressive trial of this therapy. Concerns remain, however, that the experience of the intensive care unit for patients with lung cancer and their families often may be distressing. Regardless of prognosis, all patients with critical illness should receive high-quality palliative care, including symptom control, communication about appropriate care goals, and support for both patient and family throughout the illness trajectory. In this article, we suggest strategies for integrating palliative care with intensive care for critically ill lung cancer patients. We address assessment and management of symptoms, knowledge and skill needed for effective communication, and interdisciplinary collaboration for patient and family support. We review the role of expert consultants in providing palliative care in the intensive care unit, while highlighting the responsibility of all critical care clinicians to address basic palliative care needs of patients and their families. PMID:22339793

  9. Integrating palliative care with intensive care for critically ill patients with lung cancer.

    PubMed

    Gay, Elizabeth B; Weiss, Stefanie P; Nelson, Judith E

    2012-01-01

    With newer information indicating more favorable outcomes of intensive care therapy for lung cancer patients, intensivists increasingly are willing to initiate an aggressive trial of this therapy. Concerns remain, however, that the experience of the intensive care unit for patients with lung cancer and their families often may be distressing. Regardless of prognosis, all patients with critical illness should receive high-quality palliative care, including symptom control, communication about appropriate care goals, and support for both patient and family throughout the illness trajectory. In this article, we suggest strategies for integrating palliative care with intensive care for critically ill lung cancer patients. We address assessment and management of symptoms, knowledge and skill needed for effective communication, and interdisciplinary collaboration for patient and family support. We review the role of expert consultants in providing palliative care in the intensive care unit, while highlighting the responsibility of all critical care clinicians to address basic palliative care needs of patients and their families. PMID:22339793

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

    PubMed

    Joseph, Galen; Guerra, Claudia

    2015-01-01

    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

  11. Older cancer patients' information and support needs surrounding treatment: An evaluation through the eyes of patients, relatives and professionals

    PubMed Central

    Posma, Elise R; van Weert, Julia CM; Jansen, Jesse; Bensing, Jozien M

    2009-01-01

    Background Providing cancer patients with adequate treatment information is important for patients' health, well-being and satisfaction. Nurses play an important role in patient education. So far, few studies focused on the specific information needs of older cancer patients surrounding chemotherapy treatment. Given the growing incidence of cancer among older individuals, insight in these needs is crucial. This article describes the views of older cancer patients, their relatives and professionals on older patients' specific communication needs regarding chemotherapy treatment. Methods A qualitative design was used. Five focus group interviews were held with older cancer patients and their partners (two groups) and professionals with a background in nursing, oncology, gerontology and/or patient-provider communication (three groups). In addition, face to face in-depth interviews were conducted with older cancer patients. A total number of 38 patients and relatives participated, with a mean age of 67.6 years. The focus groups and interviews were audio-recorded for subsequent transcription and analysis. Results Older people have more difficulties processing and remembering information than younger ones. A trustful environment appears to be a prerequisite for reflection of older patients on the information provided and individualized information is essential to enhance memory of information. However, the results show that both patients and professionals experienced insufficient exploration of the patients' personal situation and individual information needs. Patients also strengthened the importance of sensitive communication, e.g. showing empathy en emotional support, throughout the continuum of cancer care. Moreover, potential areas of improvement were identified, including engaging the patients' relatives and encouraging patients and relatives to ask questions. Conclusion Patient education should be more tailored to older cancer patients' individual information and support needs and abilities by exploring the required amount and content of information, treatment goals and expectations. Nurses can establish a trustful environment by showing empathy and emotional support. Recommendations are given to enhance recall of information in older patients; information giving should be more structured by summarizing and repeating the most important, personally relevant information. To adapt to specific information needs, communication training for nurses and the use of aids such as a question prompt sheet could be useful tools. PMID:19152675

  12. Resilience among patients across the cancer continuum: diverse perspectives.

    PubMed

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

    2014-02-01

    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

  13. Mortality communication as a predictor of psychological distress among family caregivers of home hospice and hospital inpatients with terminal cancer

    Microsoft Academic Search

    Yaacov G. Bachner; Norm ORourke; Eldad Davidov; Sara Carmel

    2009-01-01

    Terminally ill cancer patients and their caregivers experience significant difficulties discussing illness and impending death (herein defined as mortality communication). The current study compares response levels as well as patterns of association between mortality communication and psychological distress among caregivers of home hospice and hospital inpatients. For this study, 231 family caregivers were recruited within a year of bereavement from

  14. Communicating the results of randomized clinical trials: do patients understand multidimensional patient-reported outcomes?

    PubMed

    McNair, Angus G K; Brookes, Sara T; Davis, Christopher R; Argyropoulos, Miltiadis; Blazeby, Jane M

    2010-02-10

    PURPOSE Evidence suggests that patient-reported outcomes (PROs) from randomized trials in oncology may not influence clinical decision making and patient choice. Reasons for this are currently unclear and little is known about patients' interpretation of PROs. This study assessed patients' understanding of multidimensional PROs in a graphical format. PATIENTS AND METHODS Semistructured interviews in which patients interpreted a series of graphs depicting simple, then multiple different hypothetical PROs associated with two treatments with identical chances of survival were audio recorded. The interviewer and a blinded observer (listening to audio recordings) scored patients' understanding of the graphs. Logistic regression examined the associations between patient understanding of the graphs and clinical and sociodemographic details. Results One hundred thirty-two patients with esophageal and gastric cancer were interviewed and 115 understood the first two graphs depicting different PROs of two treatments (87%; 95% CI,81 to 93). Simultaneous interpretation of adverse and beneficial treatment effects was achieved by 74 (66%; 95% CI, 57 to 75). Graphs showing complex, longitudinal data were correctly interpreted by 97 (73%; 95% CI, 66 to 81) and 108 (81%; 95% CI, 75 to 88), respectively. Univariable analyses demonstrated associations between patient understanding and patient age, educational level, and cancer site (P < or = .02 for all); however, in a multivariable model each of these associations was attenuated. CONCLUSION Most patients understand graphical multidimensional PROs, although a smaller majority were able to interpret more complex, or simultaneous, presentations. Additional work is needed to define methods for communicating clinical and PRO data from trials to allow patients to make informed treatment choices. PMID:20065187

  15. New Oral Anticoagulants and the Cancer Patient

    PubMed Central

    Short, Nicholas J.

    2014-01-01

    Indications for anticoagulation are common in patients with malignancy. Cancer patients have an increased risk of developing venous thromboembolic events or may have other indications for anticoagulation, such as atrial fibrillation. New oral anticoagulants (NOACs) are now available that offer increased options for anticoagulation beyond the traditional vitamin K antagonists and low molecular weight heparins that have long been the cornerstone of treatment. This review will focus on the three NOACs that are currently approved for use in the U.S.: the direct thrombin inhibitor, dabigatran, and the factor Xa inhibitors, apixaban and rivaroxaban. Oncologists are likely to encounter an increasing number of patients taking these agents at the time of their cancer diagnosis or to have patients who develop indications for anticoagulation during the course of their disease. The basic pharmacology, current clinical indications, and approach to the use of NOACs in the cancer patient will be reviewed. PMID:24319019

  16. PALLIATIVE CARE FOR PATIENTS WITH ADVANCED CANCER

    PubMed Central

    Gray, Alan; Ezzat, Adnan

    1997-01-01

    The increasing life expectancy in Saudi Arabia will be accompanied by an alteration of the patterns of disease similar to that in Western countries. One of these will be cancer, the second leading cause of death in the west at present, where 1:3 people develop cancer during their lifetime and 1:4 die of it. Cancer deaths are rarely easy. The distress particularly the pain it can cause is legendary. Palliative care is the care and study of patients with active progressive far advanced disease, where cure is impossible, the prognosis predictably short, and the focus of care is the patient's quality of life. A Palliative Care Program has been developed at KFSH&RC, since 1991. This has broadened the spectrum of health services available to cancer patients. Palliative care needs to be more widely available in the kingdom to relieve an important cause of human suffering. PMID:23008572

  17. Older patient satisfaction with communication during an initial medical encounter

    Microsoft Academic Search

    Michele G. Greene; Ronald D. Adelman; Erika Friedmann; Rita Charon

    1994-01-01

    There has been extensive research on the factors associated with patient satisfaction with communication during medical encounters, however, little attention has been paid to satisfaction among subgroups of patients, including the elderly. It is inappropriate to assume that all patients have the same physician-patient relationship needs, and thus, they will all be satisfied with the same communication approaches during medical

  18. Improving Physician-Patient Communication through Coaching of Simulated Encounters

    ERIC Educational Resources Information Center

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

    2013-01-01

    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…

  19. Managing Body Image Difficulties of Adult Cancer Patients: Lessons from Available Research

    PubMed Central

    Fingeret, Michelle Cororve; Teo, Irene; Epner, Daniel E.

    2013-01-01

    Background Body image is a critical psychosocial issue for cancer patients as they often undergo significant changes to appearance and functioning. In this review article, our primary purpose was to identify empirically-supported approaches to treat body image difficulties of adult cancer patients that can be incorporated into high-quality comprehensive cancer care. Methods We provided an overview of theoretical models of body image relevant to cancer patients, and presented findings from published literature on body image and cancer from 2003–2013. We integrated these data with information from the patient-doctor communication literature to delineate a practical approach for assessing and treating body image concerns of adult cancer patients. Results Body image difficulties were found across patients with diverse cancer sites, and were most prevalent in the immediate postoperative and treatment period. Age, body mass index, and specific cancer treatments have been identified as potential risk factors for body image disturbance in cancer patients. Current evidence supports the use of time-limited cognitive-behavioral therapy interventions for addressing these difficulties. Other intervention strategies also show promise but require further study. We identified potential indicators of body image difficulties to alert healthcare professionals when to refer patients for psychosocial care, and proposed a framework for approaching conversations about body image that can be used by the oncologic treatment team. Conclusions Body image issues affect a wide array of cancer patients. Providers can use available evidence combined with information from the healthcare communication literature to develop practical strategies for treating body image concerns of cancer patients. PMID:24895287

  20. Denial among cancer patients. Tips and traps.

    PubMed Central

    Brock, G.; Gurekas, V.; Deom, P.

    1993-01-01

    The coping mechanisms used by patients diagnosed with cancer play a role in their well-being and, therefore, influence their quality of life and possibly even their survival. We review the characteristics of one of these mechanisms, denial, and suggest an approach to dealing with denying patients. PMID:8292934

  1. Nutritional status assessment in colorectal cancer patients.

    PubMed

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

    2013-01-01

    The present study intended to evaluate the nutritional status of Portuguese colorectal patients and associated it with surgery type as well as quality of life outcomes. Malnutrition can affect up to 85% of cancer patients and specifically 30-60% in colorectal cancer and can significantly influence health outcomes. A sample of 50 colorectal cancer patients was evaluated in what refers to several anthropometric measures, food intake, clinical history, complications rate before and after surgery procedure. The sample was divided between convention and fast-track procedures. Most of the individuals were overweight or obese but had lost weight on the past six months. Despite mild, there were signs of malnutrition in this sample with high losses of fat free mass, weight and also fat mass during the hospitalization period. These results reinforce the importance of malnutrition assessment in colorectal patients as well as consider weight loss on the past months and body composition in order to complement nutritional status evaluation. PMID:23822693

  2. The effect of complications on the patient-surgeon relationship after colorectal cancer surgery

    PubMed Central

    Regenbogen, Scott E.; Veenstra, Christine M.; Hawley, Sarah T.; Hendren, Samantha; Ward, Kevin C.; Kato, Ikuko; Morris, Arden M.

    2014-01-01

    Background Trust in physicians is an essential part of therapeutic relationships. Complications are common after colorectal cancer procedures, but little is known of their effect on patient-surgeon relationships. We hypothesized that unexpected complications impair trust and communication between patients and surgeons. Methods We performed a population-based survey of surgically diagnosed stage III colorectal cancer patients in the Surveillance Epidemiology and End Results registries for Georgia and Metropolitan Detroit between August 2011 and October 2012. Using published survey instruments, we queried subjects about trust in and communication with their surgeon. The primary predictor was the occurrence of an operative complication. We examined patient factors associated with trust and communication then compared the relationship between operative complications and patient-reported trust and communication with their surgeons. Results Among 622 preliminary respondents (54% response rate), 25% experienced postoperative complications. Those with complications were less likely to report high trust (73% vs 81%, P = .04) and high-quality communication (80% vs 95%, P < .001). Complications reduced trust among only 4% of patient-surgeon dyads with high-quality communication, whereas complications diminished patients’ trust in 50% with poorer communication (P < .001). After controlling for communication ratings, we found there was no residual effect of complications on trust (P = .96). Conclusion Most respondents described trust in and communication with their surgeons as high. Complications were common and were associated with lower trust and poorer communication. However, the relationship between complications and trust was modified by communication. Trust remained high, even in the presence of complications, among respondents who reported high levels of patient-centered communication with their surgeons. PMID:24787111

  3. Clinical Course of Pulmonary Embolism in Lung Cancer Patients

    Microsoft Academic Search

    Jung-Woo Lee; Seung-Ick Cha; Chi-Young Jung; Won-Il Choi; Kyung-Nyeo Jeon; Seung-Soo Yoo; Chang-Ho Kim; Jae-Yong Park; Tae-Hoon Jung

    2009-01-01

    Background: Although lung cancer is the most common malignancy diagnosed in patients with venous thromboembolism (VTE), data regarding pulmonary embolism (PE) in lung cancer patients are limited. Objectives: To investigate the clinicoradiological features, clinical course and survival of lung cancer patients with PE. Methods: We performed a retrospective case-control study investigating the clinical course and survival of 40 lung cancer

  4. Place of death: preferences among cancer patients and their carers

    Microsoft Academic Search

    C Thomas; S. M Morris; D Clark

    2004-01-01

    The place of death of cancer patients has become an important theme in UK cancer and palliative care policy. This paper examines the place of death preferences of 41 terminally ill cancer patients and 18 of their informal carers, living in the Morecambe Bay area of north-west England. We interviewed cancer patients referred to the research team by 13 specialist

  5. The MI-HEART Project: Information Technology (IT) for One-to-One Tailored Patient Communication

    E-print Network

    Cimino, James J.

    -tailored ones in helping individuals change behaviors such as smoking, diet, physical activity, cancer individual at varying stages of decision-making. Figure 1: MI-HEART Message Library Variable I_PR_Rate TopicThe MI-HEART Project: Information Technology (IT) for One-to-One Tailored Patient Communication

  6. [Acupuncture for cancer patients: why not?].

    PubMed

    Samuels, Noah

    2002-07-01

    Acupuncture is a complementary medical treatment whose use in cancer patients has been recommended by the American Cancer Society (ACS) for the treatment of cancer and treatment-related symptoms. Pain, nausea, breathlessness, vasomotor symptoms and limb edema have all been found to respond to this treatment modality. Accordingly to traditional Chinese medicine (TCM), acupuncture "disperses" the stagnation of energy which is thought to cause the tumor to form. As such, many acupuncturists are unwilling to treat cancer patients for fear of "dispersing" the tumor, as well as further compromising patients' immunity with this immunosuppressive treatment modality. Though it is true that care should be taken not to insert acupuncture needles in the vicinity of the tumor, there is no reason to fear "dispersal" of the tumor when using distant points, since this concept is one of TCM and not conventional medicine. In addition, the immunomodulatory effects of acupuncture, both via the release of pituitary beta-endorphin and ACTH, as well as alleviating patient stress through relief of symptoms, are anti-carcinogenic. The medical establishment in Israel should consider recommending acupuncture for cancer patients. PMID:12187559

  7. Cancer risk in patients with diabetes mellitus

    Microsoft Academic Search

    Hans-Olov Adami; Joseph McLaughlin; Anders Ekbom; Christian Berne; Debra Silverman; David Hacker; Ingemar Persson

    1991-01-01

    Cancer incidence was ascertained in a population-based cohort of 51,008 patients in Uppsala, Sweden, who were given a discharge diagnosis of diabetes mellitus during 1965–83. Complete follow-up through 1984 with exclusion of the first year of observation showed that the observed number of cancers in females (1,294) was eight percent higher than expected (relative risk [RR]=1.1, 95 percent confidence interval

  8. Supportive Care of the Older Cancer Patient

    Microsoft Academic Search

    Lodovico Balducci

    Cancer mainly affects individuals aged 65 and over, so that supportive care for cancer treatment concerns mostly elderly patients.\\u000a Age is a risk factor for increased incidence and severity of chemotherapy-related toxicity and also for the emergence of different\\u000a forms of toxicity including delirium and malnutrition; in addition age may modulate the perception of pain and the response\\u000a to analgesics,

  9. Myelography in cancer patients: modified technique.

    PubMed

    Lee, Y Y; Glass, J P; Wallace, S

    1985-10-01

    Because of the frequency of multiple sites of involvement, a thorough evaluation of the entire spinal canal is essential for detection and treatment of spinal compression in cancer patients. For the examination of the entire spinal canal in cancer patients, a modified approach is described using water-soluble contrast medium (metrizamide), oil-based material (Pantopaque), and a "squeezing" technique for a complete myelographic block. Of 240 patients who underwent myelography for possible spinal compression, the squeezing technique was applied through a lumbar puncture to demonstrate a complete block in 39 patients; six of these had more than one block. Of the other 201 patients, the quality of the myelograms was satisfactory or excellent in 189 (94%). PMID:3876000

  10. Complementary therapy use by cancer patients. Physicians' perceptions, attitudes, and ideas.

    PubMed Central

    O'Beirne, Maeve; Verhoef, Marja; Paluck, Elan; Herbert, Carol

    2004-01-01

    OBJECTIVE: To explore family physicians' perceptions of their cancer patients' use of complementary therapy. DESIGN: Qualitative pilot study. SETTING: British Columbia and Alberta. PARTICIPANTS: Rural and urban family physicians. METHOD: Five focus groups were conducted with a total of 28 participants. Content analysis of focus group transcripts. MAIN FINDINGS: Eight themes were identified: definition of complementary therapies, importance of holistic health, role of evidence, attitudes toward complementary therapies, perceptions of cancer patients' use of complementary therapies, patient-physician communication, perceptions of family physicians' role with respect to complementary therapies, and concerns about complementary therapies. Family physicians believed that many of their patients were using complementary therapies and that patients and physicians needed to communicate about this practice. CONCLUSION: The study increased understanding of physicians'perspectives on communication about complementary therapies and exposed issues that need to be addressed through education and research. PMID:15233371

  11. Coordinating care and treatment for cancer patients.

    PubMed

    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

    2012-01-01

    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

  12. Management of breast cancer in elderly patients.

    PubMed

    Reginelli, Alfonso; Calvanese, Mariagrazia; Ravo, Vincenzo; Di Franco, Rossella; Silvestro, Giustino; Gatta, Gianluca; Squillaci, Ettore; Grassi, Roberto; Cappabianca, Salvatore

    2014-01-01

    Even if there is not a general consensus, we consider elderly patients of 65 years old or more. The degree of aging is extremely variable so that we can individuate different groups of patients that are different one from the other in relation with Performance Status, the presence of other pathology, and of eventual social discomfort. Breast Cancer is the most common Tumor in elderly woman and it represent the first death cause The 45% of Breast Cancer arise in women more than 65 years old and the 33% arise in women of more than 70 years old. Despite these data elderly women are often excluded from screening schedules, moreover despite there is no evidence that breast cancer is less aggressive in elderly patient they are generally non considered in trial studies so that they are under treated if compared to young patients that's why we cannot observe a decrease of mortality such as in younger patients Relative survival between 5 and 10 years in patients more than 75 years old it's lesser than the one observed in younger patients (between 45 and 70 years old) maybe that's because of the incongruity in the access to sanitary structures and because of the social and economic discomfort. When we speak about Breast Cancer we cannot be able to leave a multidisciplinary approach out of consideration. Patient's evaluation must be done by a group of dedicated specialists that are: Radiologist, Pathologist, Surgeon, Radiotherapist and Oncologist. The team need to analyze all data to improve treatment and obtain a better cosmetic result [4]. Complex cases must be discussed collectively before surgery to obtain the best therapeutic strategy. Moreover it's strictly important patient's involvement in treatment selection. Consensus is mandatory and it can be obtained only if the patient is well informed about treatment phases, adverse effects, and results. PMID:25157989

  13. Communication About Symptoms in Primary Care: Impact on Patient Outcomes

    Microsoft Academic Search

    Jeffrey L. Jackson

    2005-01-01

    Background and purpose: Good communication is an integral part of a healing relationship. Our study's purpose was to explore the relationship between patient-doctor communication about physical symptoms and patient outcomes Methods: Five hundred (500) consecutive adults presenting with physical symptoms were surveyed. Previsit surveys assessed for patient symptom characteristics, illness worry, stress, expectations, functional status (MOS SF-6), and mental disorders

  14. Health Literacy and Urbanicity Among Cancer Patients

    PubMed Central

    Halverson, Julie; Martinez-Donate, Ana; Trentham-Dietz, Amy; Walsh, Matthew C.; Strickland, Jeanne Schaaf; Palta, Mari; Smith, Paul D.; Cleary, James

    2014-01-01

    Purpose Low health literacy is associated with inadequate health care utilization and poor health outcomes, particularly among elderly persons. There is a dearth of research exploring the relationship between health literacy and place of residence (urbanicity). This study examined the association between urbanicity and health literacy, as well as factors related to low health literacy, among cancer patients. Methods A cross-sectional survey was conducted with a population-based sample of 1,841 cancer patients in Wisconsin. Data on sociodemographics, urbanicity, clinical characteristics, insurance status, and health literacy were obtained from the state’s cancer registry and participants’ answers to a mailed questionnaire. Partially and fully adjusted multivariate logistic regression models were fitted to examine: 1) the association between urbanicity and health literacy, and 2) the role of socioeconomic status as a possible mediator of this relationship. Findings Rural cancer patients had a 33% (95% CI: 1.06–1.67) higher odds of having lower levels of health literacy than their counterparts in more urbanized areas of Wisconsin. The association between urbanicity and health literacy attenuated after controlling for socioeconomic status. Conclusions Level of urbanicity was significantly related to health literacy. Socioeconomic status fully mediated the relationship between urbanicity and health literacy. These results call for policies and interventions to assess and address health literacy barriers among cancer patients in rural areas. PMID:24088213

  15. Communication preferences in patients with fibromyalgia syndrome: descriptive results and patient characteristics as predictors

    PubMed Central

    Ullrich, Antje; Hauer, Johannes; Farin, Erik

    2014-01-01

    Background Communication with patients with fibromyalgia syndrome (FMS) is often considered difficult. The primary objective of this explorative study was to describe the communication preferences of FMS patients in comparison with other chronic diseases, and the secondary objective was to identify patient-related predictors of those communication preferences. Methods A total of 256 FMS patients were asked to fill out the KOPRA [(Kommunikationspraeferenzen), communication preferences of patients with chronic illness] questionnaire at the beginning of their rehabilitation, answering questions about their communication preferences. The KOPRA’s descriptive parameters were calculated and compared with other diagnosis groups. In order to include as many influencing factors as possible, data on patient-related sociodemographic, medical, pain impact and psychologic variables were gathered. A hierarchical regression analysis with four steps was performed to identify patient-related predictors of patientscommunication preferences. Results FMS patients consider an open and patient-centered communication style to be especially important. Emotionally supportive communication and communication about personal circumstances are important for FMS patients, but the preferences of individual patients vary widely. FMS patients reveal higher values in all the subdimensions of communication preferences compared with patients with low back pain or chronic ischemic heart disease. Only a few variables appear to predict patient communication preferences. The explained variance ranged from 3.1% to 9.7%. Psychologic variables have been identified as predictors in conjunction with all communication preferences. Conclusion Health care providers who communicate with FMS patients should employ an open and patient-centered communication style, and affective communication components should be adapted to accommodate each patient. PMID:24520192

  16. JAMA Patient Page: Testicular Cancer

    MedlinePLUS

    ... 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 ...

  17. STANFORD CANCER CENTER Patient Treatment

    E-print Network

    Ford, James

    to ask us questions or seek clarification. I In addition to your physicians and nurses, we have a team Concierge, located in the atrium on the first floor, is an excellent resource for information and assistance: PHONE: NURSE: PHONE: CLINIC: PHONE: #12;STANFORD CANCER CENTER Treatmentmedications MEDICATION: DOSAGE

  18. A survey of patient–provider e-mail communication: what do patients think?

    Microsoft Academic Search

    Dean F. Sittig; Stephen King; Brian L. Hazlehurst

    2001-01-01

    Communication between patients and providers forms the backbone of the patient–provider relationship. Often such communication is strained due to time and space limitations on the part of both patients and providers. Many healthcare organizations are developing secure e-mail communication facilities to allow patients to exchange e-mail messages with their providers. Providers are worried that opening such lines of communication will

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

    PubMed Central

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

    2014-01-01

    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

  20. Screening for Lynch Syndrome (Hereditary Nonpolyposis Colorectal Cancer) among Endometrial Cancer Patients

    Microsoft Academic Search

    Heather Hampel; Wendy Frankel; Jenny Panescu; Janet Lockman; Kaisa Sotamaa; Daniel Fix; Ilene Comeras; Jennifer La Jeunesse; Hidewaki Nakagawa; Judith A. Westman; Thomas W. Prior; Mark Clendenning; Pamela Penzone; Janet Lombardi; Patti Dunn; David E. Cohn; Larry Copeland; Lynne Eaton; Jeffrey Fowler; George Lewandowski; Luis Vaccarello; Jeffrey Bell; Gary Reid

    Endometrial cancer is the most common cancer in women with Lynch syndrome. The identification of individuals with Lynch syndrome is desirable because they can benefit from increased cancer surveillance. The purpose of this study was to determine the feasibility and desirability of mole- cular screening for Lynch syndrome in all endometrial cancer patients. Unselected endometrial cancer patients (N = 543)

  1. Physicians’ influence on breast cancer patient compliance

    PubMed Central

    Kostev, Karel; Waehlert, Lilia; Jockwig, Achim; Jockwig, Barbara; Hadji, Peyman

    2014-01-01

    In recent years there have been major advances in the treatment of breast cancer. However, taking the prescribed medication for a sufficient period of time is crucial to the success of any therapy. Thus far, no database-based studies have been published in German-speaking countries empirically examining the influence of the physician on the compliance of patients. The aim of this study is to investigate, quantify, and critically discuss the effect treating physicians have on the compliance of their breast cancer patients. Patients with a confirmed breast cancer diagnosis who started therapy (tamoxifen or aromatase inhibitors) between January 2001 and December 2011 were selected from the representative IMS Disease Analyzer database and analyzed with regard to their compliance. Practices were grouped into two categories concerning the compliance of all treated patients. A regression model showed that a breast cancer patient who is treated in a practice with a trend toward poor compliance has a nearly 60% higher risk for treatment discontinuation than would be the case in a practice with good compliance. It shows how important it is to motivate physicians to strive toward good compliance rates. PMID:24454275

  2. Physicians' influence on breast cancer patient compliance.

    PubMed

    Kostev, Karel; Waehlert, Lilia; Jockwig, Achim; Jockwig, Barbara; Hadji, Peyman

    2014-01-01

    In recent years there have been major advances in the treatment of breast cancer. However, taking the prescribed medication for a sufficient period of time is crucial to the success of any therapy. Thus far, no database-based studies have been published in German-speaking countries empirically examining the influence of the physician on the compliance of patients. The aim of this study is to investigate, quantify, and critically discuss the effect treating physicians have on the compliance of their breast cancer patients. Patients with a confirmed breast cancer diagnosis who started therapy (tamoxifen or aromatase inhibitors) between January 2001 and December 2011 were selected from the representative IMS Disease Analyzer database and analyzed with regard to their compliance. Practices were grouped into two categories concerning the compliance of all treated patients. A regression model showed that a breast cancer patient who is treated in a practice with a trend toward poor compliance has a nearly 60% higher risk for treatment discontinuation than would be the case in a practice with good compliance. It shows how important it is to motivate physicians to strive toward good compliance rates. PMID:24454275

  3. Anemia, tumor hypoxemia, and the cancer patient

    SciTech Connect

    Varlotto, John [Department of Radiation Oncology, Boston VA Medical Center, Boston, MA (United States) and Department of Radiation Oncology, Beth (Israel) and Deaconess Medical Center, Harvard Medical School, Boston, MA (United States)]. E-mail: jvarlott@bidmc.harvard.edu; Stevenson, Mary Ann [Department of Radiation Oncology, Boston VA Medical Center, Boston, MA (United States); Department of Radiation Oncology, Beth Israel/Deaconess Medical Center, Harvard Medical School, Boston, MA (United States)

    2005-09-01

    Purpose: To review the impact of anemia/tumor hypoxemia on the quality of life and survival in cancer patients, and to assess the problems associated with the correction of this difficulty. Methods: MEDLINE searches were performed to find relevant literature regarding anemia and/or tumor hypoxia in cancer patients. Articles were evaluated in order to assess the epidemiology, adverse patient effects, anemia correction guidelines, and mechanisms of hypoxia-induced cancer cell growth and/or therapeutic resistance. Past and current clinical studies of radiosensitization via tumor oxygenation/hypoxic cell sensitization were reviewed. All clinical studies using multi-variate analysis were analyzed to show whether or not anemia and/or tumor hypoxemia affected tumor control and patient survival. Articles dealing with the correction of anemia via transfusion and/or erythropoietin were reviewed in order to show the impact of the rectification on the quality of life and survival of cancer patients. Results: Approximately 40-64% of patients presenting for cancer therapy are anemic. The rate of anemia rises with the use of chemotherapy, radiotherapy, and hormonal therapy for prostate cancer. Anemia is associated with reductions both in quality of life and survival. Tumor hypoxemia has been hypothesized to lead to tumor growth and resistance to therapy because it leads to angiogenesis, genetic mutations, resistance to apoptosis, and a resistance to free radicals from chemotherapy and radiotherapy. Nineteen clinical studies of anemia and eight clinical studies of tumor hypoxemia were found that used multi-variate analysis to determine the effect of these conditions on the local control and/or survival of cancer patients. Despite differing definitions of anemia and hypoxemia, all studies have shown a correlation between low hemoglobin levels and/or higher amounts of tumor hypoxia with poorer prognosis. Radiosensitization through improvements in tumor oxygenation/hypoxic cell sensitization has met with limited success via the use of hyperbaric oxygen, electron-affinic radiosensitizers, and mitomycin. Improvements in tumor oxygenation via the use of carbogen and nicotinamide, RSR13, and tirapazamine have shown promising clinical results and are all currently being tested in Phase III trials. The National Comprehensive Cancer Network (NCCN) guidelines recommend transfusion or erythropoietin for symptomatic patients with a hemoglobin of 10-11 g/dl and state that erythropoietin should strongly be considered if hemoglobin falls to less than 10 g/dl. These recommendations were based on studies that revealed an improvement in the quality of life of cancer patients, but not patient survival with anemia correction. Phase III studies evaluating the correction of anemia via erythropoietin have shown mixed results with some studies reporting a decrease in patient survival despite an improvement in hemoglobin levels. Diverse functions of erythropoietin are reviewed, including its potential to inhibit apoptosis via the JAK2/STAT5/BCL-X pathway. Correction of anemia by the use of blood transfusions has also shown a decrement in patient survival, possibly through inflammatory and/or immunosuppressive pathways. Conclusions: Anemia is a prevalent condition associated with cancer and its therapies. Proper Phase III trials are necessary to find the best way to correct anemia for specific patients. Future studies of erythropoietin must evaluate the possible anti-apoptotic effects by directly assessing the tumor for erythropoietin receptors or the presence of the JAK2/STAT5/BCL-X pathway. Due to the ability of transfusions to cause immunosuppression, most probably through inflammatory pathways, it may be best to study the effects of transfusion with the prolonged use of anti-inflammatory medications.

  4. Assessing Stress in Cancer Patients

    PubMed Central

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

    2009-01-01

    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

  5. Skin Cancer in Elderly Patients

    Microsoft Academic Search

    Charles Dewberry

    The dermatologist that engages in health care for the elderly is far and away the physician that is expected to be the frontrunner for detection and treatment of skin cancers. It is much like the other inherent medical sub-specialty expectations. The OB-GYN performs c-sections; cavities are the responsibility of the dentist; the cardiac surgeon performs the triple bypass; and the

  6. Management of pain in the cancer patient.

    PubMed

    Ashburn, M A; Lipman, A G

    1993-02-01

    The pain experience of the cancer patient is the result of many factors, including nociceptive sources, specific pain syndromes, and behavioral contributions. Careful evaluation of the patient is necessary to identify the contributors to the patient's pain experience and to select treatment modalities which address the underlying causes. For patients who are experiencing poorly controlled pain as a result of cancer, therapy often includes multiple management strategies involving more than one discipline. Therefore, an interdisciplinary approach may be more useful for pain management. Disciplines and specialties. involved in such care commonly include anesthesiologists, oncologists, psychiatrists, psychologists, physical therapists, pharmacists, nurses, and social workers. The locus of control often influences how patients respond to their physicians' advice. Patients with a strong internal locus of control usually want to participate actively in treatment decisions. Such patients often resent having decisions made about their treatment without their participation. A lack of sense of control can exacerbate such patients' pain and limit compliance with recommended treatments. Drug therapy is the mainstay of cancer pain management. The therapy should be individualized to the patient, and medications should be selected for specific indications. The WHO three-step analgesic ladder should be used as a guide in selecting analgesics. Drugs should be administered by mouth unless it is impossible to do so, and drug costs should be considered when selecting analgesic medications. Doses should be titrated to response. Adjuvant drug therapy should be considered early and implemented when indicated. Practitioners should be familiar with the medications prescribed and be alert for the appearance of adverse side effects. Patients should be monitored and reassessed continuously. A thorough diagnostic work-up should be completed for new symptoms when indicated. For patients with specific pain syndromes, or for whom drug therapy has not been successful, local anesthetic and neurolytic block therapy and more invasive drug delivery systems (e.g., epidural catheters) should be considered. Although cure may not be attainable in many cancer patients, the obligations of health professionals to these patients are no less than to patients for whom a cure is achievable. Effective pain management has a profound impact on the quality of life, and may give the patient the opportunity to face death with dignity and reduced suffering. PMID:8424523

  7. Energy expenditure in malnourished cancer patients.

    PubMed Central

    Knox, L S; Crosby, L O; Feurer, I D; Buzby, G P; Miller, C L; Mullen, J L

    1983-01-01

    It is widely believed that the presence of a malignancy causes increased energy expenditure in the cancer patient. To test this hypothesis, resting energy expenditure (REE) was measured by bedside indirect calorimetry in 200 heterogeneous hospitalized cancer patients. Measured resting energy expenditure (REE-M) was compared with expected energy expenditure (REE-P) as defined by the Harris-Benedict formula. The study population consisted of 77 males and 123 females with a variety of tumor types: 44% with gastrointestinal malignancy, 29% with gynecologic malignancy, and 19% with a malignancy of genitourinary origin. Patients were classified as hypometabolic (REE less than 90% of predicted), normometabolic (90-110% of predicted) or hypermetabolic (greater than 110% of predicted). Fifty-nine per cent of patients exhibited aberrant energy expenditure outside the normal range. Thirty-three per cent were hypometabolic (79.2% REE-P), 41% were normometabolic (99.5% REE-P), and 26% were hypermetabolic (121.9% REE-P) (p less than 0.001). Aberrations in REE were not due to age, height, weight, sex, nutritional status (% weight loss, visceral protein status), tumor burden (no gross tumor, local, or disseminated disease), or presence of liver metastasis. Hypermetabolic patients had significantly longer duration of disease (p less than 0.04) than normometabolic patients (32.8 vs. 12.8 months), indicating that the duration of a malignancy may have a major impact upon energy metabolism. Cancer patients exhibit major aberrations in energy metabolism, but are not uniformly hypermetabolic. Energy expenditure cannot be accurately predicted in cancer patients using standard predictive formulae. Images Fig. 2. Fig. 3. PMID:6824369

  8. The Signatures of Autozygosity among Patients with Colorectal Cancer

    E-print Network

    Stengel, Robert F.

    The Signatures of Autozygosity among Patients with Colorectal Cancer Manny D. Bacolod, 1 Gunter S normal tissues of colorectal cancer (CRC) patients. The presence of these regions in the genome may. [Cancer Res 2008;68(8):2610­21] Introduction Colorectal cancer (CRC) is one of the four most prevalent

  9. Drug management of pain in cancer patients.

    PubMed Central

    Tuttle, C B

    1985-01-01

    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

  10. Colon Cancer Biomarkers To Identify Patients Suitable For Therapeutic Intervention

    Cancer.gov

    NCI investigators have identified an inflammatory gene and microRNA biomarker portfolio that can predict aggressive colon cancer, colon cancer patient survival, and patients that are candidates for adjuvant therapy.

  11. Which patients are cured of breast cancer?

    Microsoft Academic Search

    Ian S Fentiman; J L Hayward; Rosemary R Millis

    1984-01-01

    The clinical and pathological features of 51 patients who survived for more than 20 years after diagnosis of cancer of the breast were compared with those of 176 contemporaries who died within 20 years after diagnosis. Of those who survived, 18 (35%) had had pathologically affected axillary nodes compared with at least 86 (49%) of those who died. Also, 11

  12. Hepatic Acetylator Polymorphism in Breast Cancer Patients

    Microsoft Academic Search

    José M. Ladero; María J. Fernandez; Ramiro Palmeiro; Juan J. Muñoz; Carlos Jara; Carmen Lazaro; Gumersindo Perez-Manga

    1987-01-01

    Hepatic acetylator phenotype has been determined, using sulfamethazine, in 81 white Spanish women with histologically proven breast cancer and in 75 adequate female controls. No differences were detected in the distribution of acetylator phenotype between the two groups of slow acetylators, 49 patients (60.5%) and 45 controls (60%). The percentage of acetylated sulfamethazine in plasma for each phenotype was not

  13. Rehabilitation of the head and neck cancer patient: Psychosocial aspects

    SciTech Connect

    Blitzer, A.; Baredes, S.; Kutscher, A.; Seeland, I.B.; Barrett, V.W.; Mossman, K.L.

    1985-01-01

    This book contains 42 chapters divided among six sections. Some of the chapter titles are: The Challenge of Cancer; Communicaton Needs of Head and Neck Cancer Patients; Normal Tissue Effects of the Radiotherapy of Head and Neck Cancer; Chemotherapy in the Treatment of Head and Neck Cancer; and Thyroid Cancer.

  14. [How to communicate with patients suffering from dementia].

    PubMed

    Füeßl, Hermann Sebastian

    2015-04-01

    The prevalence of patients with cognitive impairment will inevitably increase in general hospitals. Communication with these patients is difficult. However, it can be improved by implementing organisational measures and behaviour changes of the hospital staff. PMID:25945913

  15. Effective Nurse Communication With Type 2 Diabetes Patients: A Review.

    PubMed

    Mulder, Bob C; Lokhorst, Anne Marike; Rutten, Guy E H M; van Woerkum, Cees M J

    2015-08-01

    Many type 2 diabetes mellitus patients have difficulties reaching optimal blood glucose control. With patients treated in primary care by nurses, nurse communication plays a pivotal role in supporting patient health. The twofold aim of the present review is to categorize common barriers to nurse-patient communication and to review potentially effective communication methods. Important communication barriers are lack of skills and self-efficacy, possibly because nurses work in a context where they have to perform biomedical examinations and then perform patient-centered counseling from a biopsychosocial approach. Training in patient-centered counseling does not seem helpful in overcoming this paradox. Rather, patient-centeredness should be regarded as a basic condition for counseling, whereby nurses and patients seek to cooperate and share responsibility based on trust. Nurses may be more successful when incorporating behavior change counseling based on psychological principles of self-regulation, for example, goal setting, incremental performance accomplishments, and action planning. PMID:24757047

  16. Surgical errors and risks - the head and neck cancer patient.

    PubMed

    Harréus, Ulrich

    2013-01-01

    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

  17. Development and Testing of Emergency Department Patient Transfer Communication Measures

    ERIC Educational Resources Information Center

    Klingner, Jill; Moscovice, Ira

    2012-01-01

    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…

  18. Communicating bad news to patients: a reflective approach.

    PubMed

    McGuigan, D

    Part of nurses' unique and challenging role in healthcare settings is engaging in difficult conversations with patients. Effective communication is essential to establish a successful nurse-patient relationship, put the patient at ease and promote better interactions. A reflective approach to care can help nurses to learn from experience and use this knowledge to communicate bad news to patients in a sensitive and timely manner. PMID:19413074

  19. Health literacy, health communication challenges, and cancer screening among rural native Hawaiian and Filipino women.

    PubMed

    Sentell, Tetine; Dela Cruz, May Rose; Heo, Hyun-Hee; Braun, Kathryn L

    2013-06-01

    Native Hawaiians and Filipinos are disproportionately impacted by cancer and are less likely to participate in cancer screening than whites. Limited information exists about health information pathways and health communication challenges as they relate to cancer screening in these groups. Six focus groups (n=77) of Native Hawaiian and Filipino women age 40+years were conducted to investigate these research gaps. Participants noted many health information challenges. Challenges were both practical and interpersonal and included both written and oral health communication. Practical challenges included "big" words, complexity of terms, and lack of plain English. Interpersonal issues included doctors rushing, doctors not assessing comprehension, and doctors treating respondents as patients not people. Women noted that they would often not ask questions even when they knew they did not understand because they did not want the provider to think negatively of them. Overarching themes to improve cancer communication gaps included: (1) the importance of family and community in health information dissemination, (2) the key role women play in interpreting health information for others, (3) the importance of personal experience and relationships to the salience of health information, and (4) the desire for local cultural relevance in health communication. Findings are discussed in light of the 2010 National Action Plan for Health Literacy. PMID:23536194

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

    PubMed

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

    2013-12-01

    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

  1. Upward communication about cancer screening: adolescent daughter to mother.

    PubMed

    Mosavel, Maghboeba; Ports, Katie A

    2015-06-01

    Substantial breast and cervical cancer disparities exist in the United States, particularly among African American women with low socioeconomic status. There is considerable potential for discussions about cancer prevention between mothers and daughters. However, upward communication, from child to parent, remains a relatively novel research area, and it remains unclear how receptive mothers would be to messages from their daughter about cancer, a topic that may be considered culturally inappropriate for daughters to initiate. In this study, the authors simulated cancer message delivery to daughters and then conducted direct observation of daughters as they recalled and shared the message with their mother or female elder. The authors found that daughters were able to successfully recall and deliver a cancer appeal to their mother and mothers were generally receptive to this message. Not only did mothers listen to their daughters' appeals, but also daughters' knowledge of cancer was considerably improved by the opportunity to educate her female elder. Moreover, daughters' nonverbal communication suggested a surprisingly relaxed demeanor. The potential of young people to have an effect on the screening behavior of their female elders is very promising in terms of reducing cancer disparities. PMID:25848895

  2. Considering the patient-partner relationship in cancer care: coping strategies for couples.

    PubMed

    Morgan, Mary Ann

    2009-02-01

    A cancer diagnosis, regardless of type or site, raises feelings of fear and loss of control in patients and their partners. Being married is associated with lower mortality from a wide range of illnesses, including cancer.However, the quality of marital interactions is a stronger predictor of health outcomes than marital status alone.When people face great life challenges, they attach importance to their intimate partner's behaviors.Trust, a key component of relationship quality, can lend stability as well as emotional and practical support during treatment.This article will examine the results of research focused on patients with cancer and their partners and discuss the effects of a cancer diagnosis on couples.Recommendations for clinical practice include couple behaviors, communication patterns, and coping strategies.In addition, partners should be included in assessment and interventions to improve the quality of care for patients with cancer. PMID:19193550

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

    ERIC Educational Resources Information Center

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

    2013-01-01

    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…

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

    PubMed Central

    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

    2014-01-01

    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

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

    Cancer.gov

    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.

  6. Enhancing Doctor-Patient Communication Using Email: A Pilot Study

    Microsoft Academic Search

    Shou Ling Leong; Dennis Gingrich; Peter R. Lewis; David T. Mauger; John H. George

    2005-01-01

    Background: The doctor-patient relationship has been eroded by many factors. Would e-mail enhance communication and address some of the barriers inherent to our medical practices? Methods: Of our study population, 4 physicians offered e-mail communication to participating pa- tients and 4 did not. Both patients and physicians completed questionnaires regarding satisfaction, per- ceived quality, convenience, and promptness of the communication.

  7. [Hospital pathway of patients with breast cancer].

    PubMed

    Boinot, L; Gautreau, G; Defossez, G; Daban, A; Bourgeois, H; Migeot, V; Ingrand, P

    2007-04-01

    Health care network should promote better quality, equity and care efficacy. On the subject of breast cancer, literature has shown inequality in care depending on geographical areas and health centres locations. This article illustrates a method of analysis of female non in situ non metastatic breast cancer patients hospital care pathway, from the 2002 and 2003 Poitou-Charentes' county Diagnosis Related Groups (DRG's) data bases. The treatments several phases are described along with their combination. The number of chemotherapy and radiotherapy sessions per patient are each analysed for comparison between Health Centres, Health Centres Status, and in view of the referentials recommendations. Several health pathways options are quantified: Mono/pluri Health Centres sites, inside/outside a geographical department, inside/outside Poitou-Charentes county. Nine hundred and nine patients hospital care pathways are described. Surgery was more often partial (66%), with Health Centres variation between 17 and 68%. Among the 308 patients who had chemotherapy, 78% received between 4 and 6 sessions, with variation per Health Centre between 65 and 90%. Radiotherapy is difficult to trace because of the Health Centres non systematic radiotherapy sessions linkage, and private Health Centres lack of information (no DRG's). 91% of identified radiotherapy benefiting patients had 25 to 35 sessions, in conformation with recommendations depending on the surgery performed with Health Centres variation ratio between 76 and 96%. Hospital care pathways options between two type of treatments were identified. 90% of the hospital care pathways took place in the same geographical department, and 30% took place in public Health Centres alone. Despite radiotherapy tractability limits, proper DRG's data collection allows the description of health pathways between Health Centres and allows health practice disparity identification. Using this tool, in accordance with the Cancer Plan, can therefore help health networks in evaluating care pathway in cancer and many other fields. PMID:17434281

  8. Increased risk of cancer among relatives of patients with lung cancer in China

    Microsoft Academic Search

    Yongtang Jin; Yingchun Xu; Ming Xu; Saoli Xue

    2005-01-01

    BACKGROUND: Genetic factors were considered as one of the risk factors for lung cancer or other cancers. The aim of this work was to determine whether a genetic predisposition accounts for such familial aggregation of cancer among relatives of lung cancer probands. METHODS: A case-control study was conducted in 800 case families identified by lung cancer patients (probands), and in

  9. Why Breast Cancer Patients Seek Traditional Healers

    PubMed Central

    Muhamad, Mazanah; Merriam, Sharan; Suhami, Norhasmilia

    2012-01-01

    Traditional healing is a common practice in low and middle income countries such as Malaysia. Eighty percent of Malaysians consult traditional healers or “bomoh” at some time in their life for health-related issues. The purpose of our study was to explore why breast cancer patients visit traditional healers. This is a qualitative study utilizing in-depth interviews with 11 cancer survivors who sought both traditional and Western medicine. The findings revealed the following reasons for which patients seek traditional healers: (1) recommendation from family and friends, (2) sanction from family, (3) perceived benefit and compatibility, (4) healer credibility, and (5) reservation with Western medicine and system delay. These factors work together and are strongly influenced by the Malaysian cultural context. The issue with the Western health system is common in a developing country with limited health facilities. PMID:22295249

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

    PubMed Central

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

    2014-01-01

    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

  11. Patient Education Video Series | accrualnet.cancer.gov

    Cancer.gov

    The free patient education website (Cancer.net) offers information about cancer and clinical trials in patient-friendly videos. The videos are produced by ASCO and posted regularly on their YouTube channel. The series includes a variety of cancer topics that patients will find helpful, including clinical trials. Information is presented by physicians and advocates and helps patients accumulate accurate information and formulate questions for their physician as they consider a clinical trial.

  12. Posterior fossa metastasis in lung cancer patients with vertigo

    Microsoft Academic Search

    Shunji Hiyashi; Po-Wen Cheng; Yi-Ho Young

    2011-01-01

    This study investigated whether vertiginous attacks indicate a high probability for posterior fossa metastasis in lung cancer\\u000a patients. Twenty-five lung cancer patients having vertiginous episodes were enrolled in this study. All patients underwent\\u000a a battery of audiovestibular function testing and MR imaging study. Ten (40%) of 25 lung cancer patients with vertigo were\\u000a proven to have posterior fossa metastasis (PM1

  13. [Communication with palliative care patients: truth and hope--a contradiction?].

    PubMed

    Kronberger, Martina

    2010-07-01

    Especially in western countries an open communication with cancer patients has gained increasing importance in the last years. Balancing between truth and hope in view of bad prognosis presents a special challenge. Oncologists have the responsibility and duty of truthful disclosure. On the other hand they have to accept the patients handling with given information and to respect that sometimes patients do not want to know the whole truth. In this paper the difficulties to prevent hope and the importance of an individualized and empathic care will be discussed on the basis of a case report. PMID:20694759

  14. Self-consciousness in non-communicative patients

    Microsoft Academic Search

    Steven Laureys; Fabien Perrin; Serge Brédart

    2007-01-01

    The clinical and para-clinical examination of residual self-consciousness in non-communicative severely brain damaged patients (i.e., coma, vegetative state and minimally conscious state) remains exceptionally challenging. Passive presentation of the patient’s own name and own face are known to be effective attention-grabbing stimuli when clinically assessing consciousness at the patient’s bedside. Event-related potential and functional neuroimaging studies using such self-referential stimuli

  15. Acupressure and Anxiety in Cancer Patients

    PubMed Central

    Beikmoradi, Ali; Najafi, Fatemeh; Roshanaei, Ghodratallah; Pour Esmaeil, Zahra; Khatibian, Mahnaz; Ahmadi, Alireza

    2015-01-01

    Background: Anxiety has negative effects on mental and physical performance, quality of life, duration of hospitalization, and even on the treatment of patients with cancer. Objectives: Today acupressure is widely used to treat anxiety. Thus, the present study aimed to investigate the effects of acupressure on anxiety in patients with cancer. Patients and Methods: A double-blind randomized clinical trial was conducted on 85 patients hospitalized with 3 groups including acupressure group (n = 27), sham group (n = 28), and control group (n = 30) in the hematologic ward of Shahid Beheshti Hospital of Hamadan, Iran, in 2013. The sampling permuted-block randomization with triple block was used. The anxiety of the patients in the experimental, sham, and control groups were measured with Spielberger’s State-Trait Anxiety Inventory (STAI). Then, real acupressure was performed in the experimental group and fake acupressure in the sham group, and only routine care was provided for the control group. Anxiety of the patients was also assessed at 5 and 10 days after the intervention. Statistical analysis of the data was performed by SPSS software using repeated measures analysis of variance (ANOVA) and post hoc least significant difference (LSD) test. Results: According to the findings, the mean level of anxiety before the intervention between groups were matched (P > 0.05). Acupressure had a significant influence on the anxiety in the experimental group at 5 (45.30 ± 7.14) and 10 days (43.48 ± 6.82) after the intervention (P < 0.05). However, it did not have a significant impact on their covert anxiety (45.48 ± 7.92 at 5th day vs 45.63 ± 8.08 at 10th day, P > 0.05). No significant differences were observed in the fake points regarding overt and covert anxiety of patients in the sham group (overt anxiety; 47.57 ± 7.85 at 5th day vs. 46.71 ± 7.32 at 10th day, P > 0.05) (covert anxiety; 47.96 ± 6.33 at 5th day vs. 46.89 ± 6.94 at 10th day, P > 0.05). Moreover, the routine care provided for the control group did not have any effect on the overt and covert anxiety of the patients (P > 0.05). Conclusions: Acupressure is recommended as a complementary therapy to reduce anxiety in patients with cancer because of its low cost, safety, and simplicity. PMID:26019908

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

    PubMed Central

    Adib Hajbaghery, Mohsen; Rezaei Shahsavarloo, Zahra

    2014-01-01

    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

  17. Communication and Information Barriers to Health Assistance for Deaf Patients

    ERIC Educational Resources Information Center

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

    2010-01-01

    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…

  18. Cancer patients' reported experiences of suffering.

    PubMed

    Kuuppelomäki, M; Lauri, S

    1998-10-01

    This study describes the nature and content of experiences of suffering by patients with incurable cancer. The main body of data was collected in interviews. A structured questionnaire was administered for additional information. Three different dimensions were identified in patient experiences of suffering: physical, psychologic, and social. Suffering has a physical foundation, which was divided into two categories: that caused by the illness itself and that caused by treatment of the illness. The primary sources of physical suffering were fatigue, pain, and the side effects of chemotherapy. The causes of psychologic suffering lie in the physiologic changes associated with the disease and in the imminence of death. Psychologic suffering was most typically manifested in depression, which most of the patients suffered during the initial stages of the disease, when the disease metastasized, and when they were in a particularly poor condition. General deterioration and fear of infections very much restrict the social life of cancer patients, causing them to withdraw into their home or the hospital. PMID:9775487

  19. The evolving concept of "patient-centeredness" in patient-physician communication research.

    PubMed

    Ishikawa, Hirono; Hashimoto, Hideki; Kiuchi, Takahiro

    2013-11-01

    Over the past few decades, the concept of "patient-centeredness" has been intensively studied in health communication research on patient-physician interaction. Despite its popularity, this concept has often been criticized for lacking a unified definition and operationalized measurement. This article reviews how health communication research on patient-physician interaction has conceptualized and operationalized patient-centered communication based on four major theoretical perspectives in sociology (i.e., functionalism, conflict theory, utilitarianism, and social constructionism), and discusses the agenda for future research in this field. Each theory addresses different aspects of the patient-physician relationship and communication from different theoretical viewpoints. Patient-centeredness is a multifaceted construct with no single theory that can sufficiently define the whole concept. Different theoretical perspectives of patient-centered communication can be selectively adopted according to the context and nature of problems in the patient-physician relationship that a particular study aims to explore. The present study may provide a useful framework: it offers an overview of the differing models of patient-centered communication and the expected roles and goals in each model; it does so toward identifying a communication model that fits the patient and the context and toward theoretically reconstructing existing measures of patient-centered communication. Furthermore, although patient-centered communication has been defined mainly from the viewpoint of physician's behaviors aimed at achieving patient-centered care, patient competence is also required for patient-centered communication. This needs to be examined in current medical practice. PMID:24034962

  20. Hypocalcemia and hypomagnesemia in cancer patients.

    PubMed

    D'Erasmo, E; Celi, F S; Acca, M; Minisola, S; Aliberti, G; Mazzuoli, G F

    1991-01-01

    The aim of this study was to evaluate the incidence of hypocalcemia and hypomagnesemia and the relationship between calcium and magnesium serum levels in 82 hospitalized cancer patients, 61 of whom were in the terminal phase of the disease. The frequency of hypocalcemia and hypomagnesemia was 13.4% and 17.1% respectively. The incidence of hypocalcemia in patients with hypomagnesemia was 28.6%, while in those with normal or high magnesium serum levels it was 10.3%. The lowest magnesium serum level was observed in hypocalcemic patients. It may thus be concluded that hypocalcemia and hypomagnesemia are a frequent complication of malignant tumors mostly in the terminal stage of the disease, and that even hypomagnesemia could contribute to the development of tumor-associated hypocalcemia. PMID:1760524

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

    PubMed

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

    2013-03-01

    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

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

    SciTech Connect

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

    1984-07-01

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

  3. Chemotherapy Regimen Extends Survival in Advanced Pancreatic Cancer Patients

    Cancer.gov

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

  4. Genetic Differences Seen in Younger Colon Cancer Patients

    MedlinePLUS

    ... fullstory_152866.html Genetic Differences Seen in Younger Colon Cancer Patients New research suggests different treatment may ... 2, 2015 TUESDAY, June 2, 2015 (HealthDay News) -- Colon cancer is genetically different in older and younger ...

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

    PubMed Central

    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

    2015-01-01

    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

  6. Communicating for the first time with delusional patients

    Microsoft Academic Search

    Zane Robinson Wolf

    2001-01-01

    Background: Aggression and threats of violence are acknowledged elements of psychiatric settings. One of the most upsetting clinical experiences for nursing students is the psychiatric–mental health practicum in which students are expected to communicate therapeutically with hospitalized, delusional patients. Objective: The purpose of this article is to describe the experiences of undergraduate baccalaureate nursing students as they communicate for the

  7. Improving Patient Safety Through Provider Communication Strategy Enhancements

    Microsoft Academic Search

    Rebecca Persing

    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

  8. Communication in Emergency Medicine: Implications for Patient Safety

    Microsoft Academic Search

    Eric M. Eisenberg; Alexandra G. Murphy; Kathleen Sutcliffe; Robert Wears; Stephen Schenkel; Shawna Perry; Mary Vanderhoef

    2005-01-01

    Emergency medicine is largely a communicative activity, and medical mishaps that occur in this context are too often the result of vulnerable communication processes. In this year-long qualitative study of two academic emergency departments, an interdisciplinary research team identified four such processes: triage, testing and evaluation, handoffs, and admitting. In each case, we found that narrative rationality (the patient's story)

  9. Atypical cancer pattern in patients with Parkinson's disease

    Microsoft Academic Search

    J H Olsen; S Friis; K Frederiksen; J K McLaughlin; L Mellemkjaer; H Møller

    2005-01-01

    Among 14 088 patients, with a primary diagnosis of Parkinson's disease during the period 1977–98 identified from the National Register of Patients, 1282 cancers were subsequently recorded in the Danish Cancer Registry, compared with 1464 expected, with a standardised incidence ratio (SIR) of 0.88 (95% confidence interval (CI), 0.8–0.9). Significantly reduced risks were found for smoking-related cancers, for example, cancers

  10. American society of clinical oncology statement: toward individualized care for patients with advanced cancer.

    PubMed

    Peppercorn, Jeffrey M; Smith, Thomas J; Helft, Paul R; Debono, David J; Berry, Scott R; Wollins, Dana S; Hayes, Daniel M; Von Roenn, Jamie H; Schnipper, Lowell E

    2011-02-20

    Patients with advanced incurable cancer face complex physical, psychological, social, and spiritual consequences of disease and its treatment. Care for these patients should include an individualized assessment of the patient's needs, goals, and preferences throughout the course of illness. Consideration of disease-directed therapy, symptom management, and attention to quality of life are important aspects of quality cancer care. However, emerging evidence suggests that, too often, realistic conversations about prognosis, the potential benefits and limitations of disease-directed therapy, and the potential role of palliative care, either in conjunction with or as an alternative to disease-directed therapy, occur late in the course of illness or not at all. This article addresses the American Society of Clinical Oncology's (ASCO's) vision for improved communication with and decision making for patients with advanced cancer. This statement advocates an individualized approach to discussing and providing disease-directed and supportive care options for patients with advanced cancer throughout the continuum of care. Building on ASCO's prior statements on end-of-life care (1998) and palliative care (2009), this article reviews the evidence for improved patient care in advanced cancer when patients' individual goals and preferences for care are discussed. It outlines the goals for individualized care, barriers that currently limit realization of this vision, and possible strategies to overcome these barriers that can improve care consistent with the goals of our patients and evidence-based medical practice. PMID:21263086

  11. Recall in Older Cancer Patients: Measuring Memory for Medical Information

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  12. Colon cancer: risk perceptions and risk communication.

    PubMed

    Weinstein, Neil D; Atwood, Kathy; Puleo, Elaine; Fletcher, Robert; Colditz, Graham; Emmons, Karen M

    2004-01-01

    Members of a health maintenance organization (N=353) interacted with a computer program that provided personalized information about their risk of developing colon cancer in the next 20 years. Prior to computer feedback, most people greatly overestimated their numerical, absolute risk (chances per 1000) and also overestimated their relative risk compared to peers (e.g., "above average"). Their relative risk estimates were correlated with several risk factors, whereas their absolute risk estimates were not, suggesting that assessing individual risk perceptions with numerical, absolute risk scales may provide misleading information about what people believe. Computer feedback improved the accuracy of mean risk estimates, but about half of participants did not accept the personalized feedback as correct. In fact, correlations between actual and perceived risk were no greater among participants who received risk scores than among those who did not. Three possible explanations for resistance to lower-than-expected risk feedback are considered. PMID:14761833

  13. Survival Analysis of Patients with Interval Cancer Undergoing Gastric Cancer Screening by Endoscopy

    PubMed Central

    Hamashima, Chisato; Shabana, Michiko; Okamoto, Mikizo; Osaki, Yoneatsu; Kishimoto, Takuji

    2015-01-01

    Aims Interval cancer is a key factor that influences the effectiveness of a cancer screening program. To evaluate the impact of interval cancer on the effectiveness of endoscopic screening, the survival rates of patients with interval cancer were analyzed. Methods We performed gastric cancer-specific and all-causes survival analyses of patients with screen-detected cancer and patients with interval cancer in the endoscopic screening group and radiographic screening group using the Kaplan-Meier method. Since the screening interval was 1 year, interval cancer was defined as gastric cancer detected within 1 year after a negative result. A Cox proportional hazards model was used to investigate the risk factors associated with gastric cancer-specific and all-causes death. Results A total of 1,493 gastric cancer patients (endoscopic screening group: n = 347; radiographic screening group: n = 166; outpatient group: n = 980) were identified from the Tottori Cancer Registry from 2001 to 2008. The gastric cancer-specific survival rates were higher in the endoscopic screening group than in the radiographic screening group and the outpatients group. In the endoscopic screening group, the gastric cancer-specific survival rate of the patients with screen-detected cancer and the patients with interval cancer were nearly equal (P = 0.869). In the radiographic screening group, the gastric cancer-specific survival rate of the patients with screen-detected cancer was higher than that of the patients with interval cancer (P = 0.009). For gastric cancer-specific death, the hazard ratio of interval cancer in the endoscopic screening group was 0.216 for gastric cancer death (95%CI: 0.054-0.868) compared with the outpatient group. Conclusion The survival rate and the risk of gastric cancer death among the patients with screen-detected cancer and patients with interval cancer were not significantly different in the annual endoscopic screening. These results suggest the potential of endoscopic screening in reducing mortality from gastric cancer. PMID:26023768

  14. Breaking Bad News in Cancer Patients

    PubMed Central

    Konstantis, Apostolos; Exiara, Triada

    2015-01-01

    Objective: In a regional hospital, many patients are newly diagnosed with cancer. Breaking the bad news in these patients and their relatives is a tough task. Many doctors are not experienced in talking to patients about death or death-related diseases. In recent years, there have been great efforts to change the current situation. The aim of this study was to investigate the experience and education of medical personnel in breaking bad news in a secondary hospital. Materials and Methods: 59 doctors from General Hospital of Komotini, Greece were included in the study. All the doctors were in clinical specialties that treated cancer patients. A brief questionnaire was developed based on current guidelines such as Baile/SPIKES framework and the ABCDE mnemonic. Results: Residents are involved in delivering bad news less frequently than specialists. Only 21 doctors (35.59%) had specific training on breaking bad news. 20 doctors (33.90%) were aware of the available techniques and protocols on breaking bad news. 47 doctors (79.66%) had a consistent plan for breaking bad news. 57 (96.61%) delivered bad news in a quiet place, 53 (89.83%) ensured no interruptions and enough time, 53 (89.83%) used simple words and 54 (91.53%) checked for understanding and did not rush through the news. 46 doctors (77.97%) allowed relatives to determine patient's knowledge about the disease. Conclusions: There were low rates of specific training in breaking bad news. However, the selected location, the physician's speech and their plan were according to current guidelines. PMID:25709183

  15. Cultural diversity in patient participation: The influence of patients’ characteristics and doctors’ communicative behaviour

    Microsoft Academic Search

    Barbara C. Schouten; Ludwien Meeuwesen; Fred Tromp; Hans A. M. Harmsen

    2007-01-01

    ObjectiveThe primary goal of this study was to examine the extent to which patient participation during medical visits is influenced by patients’ ethnic background, patients’ culture-related characteristics (e.g. acculturation, locus of control, cultural views) and features of doctors’ communicative behaviour. Furthermore, the mutual influence between patients’ participatory behaviour and doctors’ communicative behaviour was investigated. An additional goal was to identify

  16. Mortality from Cancer among US Hemodialysis Patients, 1995–2005

    Microsoft Academic Search

    Robert N. Foley; Tricia L. Roberts; Jiannong Liu; David T. Gilbertson; Thomas J. Arneson; Stephan Dunning; Allan J. Collins

    2010-01-01

    Background\\/Aims: Concern has emerged that erythropoiesis-stimulating agents (ESAs) may decrease survival for cancer patients; many patients beginning dialysis have previous cancer diagnoses. As ESA doses have more than tripled in the USA since ESAs were introduced, we aimed to compare annual trends in cancer-specific mortality rates among incident maintenance hemodialysis patients. Methods: This national, retrospective, incident cohort study included 873,493

  17. Frequent Use of Complementary Medicine by Prostate Cancer Patients

    Microsoft Academic Search

    Anton Ponholzer; Gerhard Struhal; Stephan Madersbacher

    2003-01-01

    Objectives: To assess the use of complementary and alternative medicine (CAM) by prostate cancer patients and to characterize CAM-users in this population.Methods: Prostate cancer patients who underwent routine follow-up at urological practices completed an anonymous, self-administered questionnaire on lower urinary tract function, sexuality, quality of life and use of CAM. All patients with biopsy proven cancer irrespective of age, stage

  18. Electrocardiographic findings of palonosetron in cancer patients

    Microsoft Academic Search

    Guzin Gonullu; Sabri Demircan; Mustafa Kemal Demirag; Dilek Erdem; Idris Yucel

    Purpose  Nausea and vomiting are among the major problems occurring during and after the chemotherapy treatments of cancer patients.\\u000a The recently developed 5-HT3 antagonists have proved much more effective than former agents. Several studies have shown that these agents cause certain\\u000a ECG changes. We aimed to evaluate the ECG changes caused by palonosetron, one of the new 5-HT3 antagonists.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Our study

  19. Systemic immune dysfunction in pancreatic cancer patients

    Microsoft Academic Search

    Bertram Poch; Errki Lotspeich; Marco Ramadani; Susanne Gansauge; Hans G. Beger; Frank Gansauge

    2007-01-01

    Background and aims  We investigated the immune status in 32 pancreatic cancer patients (PC) in comparison with healthy controls (HC).\\u000a \\u000a \\u000a \\u000a Materials and methods  Using flow cytometry, peripheral blood lymphocytes (PBL) were characterized by the expression of surface markers for T helper\\u000a cells (CD4), T suppressor cells (CD8), B cells (CD19) and NK cells (CD56). The blastogenic response of PBL was analyzed after

  20. Hematological Support of a Cancer Patient

    PubMed Central

    Shear, J.M.; Rock, G.

    1988-01-01

    Transfusion medicine has come to function as a pivotal support in the treatment of cancer patients in the late 1980s. The authors of this article discuss the indications for, and uses of, various blood components, including packed red blood cells, leukocyte-poor and/or washed blood cells, random donor and single donor platelets, granulocyte concentrates, fresh frozen plasma, and cryoprecipitate. They also discuss common and not-so-common risks, reactions, and diseases associated with the transfusion of the aforementioned blood components. PMID:21253128

  1. New-age patient communications through social networks.

    PubMed

    Ogburn, Kelin M; Messias, Erick; Buckley, Peter F

    2011-01-01

    Suicide prevention continues to be a significant clinical challenge in the care of psychiatric patients, particularly among youth. New patterns of interactions and communications using online social networks create opportunities for persons to indicate their mood, their opinions, and also to express ideation and plans about suicide. We report a case of a suicide attempt and how communications through online social networks initiated treatment and affected its outcome. We discuss advantages and challenges to clinicians regarding use social networks and electronic communication in patient care. PMID:21596215

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

    ClinicalTrials.gov

    2014-12-23

    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

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

    Cancer.gov

    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.

  4. Doctor-patient communication in Southeast Asia: a different culture?

    PubMed

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

    2013-03-01

    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 study based on principles of grounded theory. Twenty residents and specialists and 20 patients of a low or high educational level were interviewed in internal medicine outpatient clinics of an Indonesian teaching hospital and two affiliated hospitals. During 26 weeks we engaged in an iterative interview and coding process to identify emergent factors. Patients were generally dissatisfied with doctors' communication style. The doctors indicated that they did not deliberately use a one-way style. Communication style appeared to be associated with characteristics of Southeast Asian culture, the health care setting and medical education. Doctor-patient communication appeared to be affected by cultural characteristics which fell into two broad categories representing key features of Southeast Asian culture, "social distance" and "closeness of relationships", and to characteristics categorized as "specific clinical context". Consideration of these characteristics could be helpful in promoting the use of a partnership communication style. PMID:22314942

  5. Cancer-Associated Fibroblasts Connect Metastasis-Promoting Communication in Colorectal Cancer

    PubMed Central

    Tommelein, Joke; Verset, Laurine; Boterberg, Tom; Demetter, Pieter; Bracke, Marc; De Wever, Olivier

    2015-01-01

    Colorectal cancer (CRC) progression and eventually metastasis is directed in many aspects by a circuitous ecosystem consisting of an extracellular matrix scaffold populated by cancer-associated fibroblasts (CAFs), endothelial cells, and diverse immune cells. CAFs are recruited from local tissue-resident fibroblasts or pericryptal fibroblasts and distant fibroblast precursors. CAFs are highly abundant in CRC. In this review, we apply the metastasis-promoting communication of colorectal CAFs to 10 cancer hallmarks described by Hanahan and Weinberg. CAFs influence innate and adaptive tumor immune responses. Using datasets from previously published work, we re-explore the potential messages implicated in this process. Fibroblasts present in metastasis (metastasis-associated fibroblasts) from CRC may have other characteristics and functional roles than CAFs in the primary tumor. Since CAFs connect metastasis-promoting communication, CAF markers are potential prognostic biomarkers. CAFs and their products are possible targets for novel therapeutic strategies. PMID:25853091

  6. Patients’ assessment of professionalism and communication skills of medical graduates

    PubMed Central

    2014-01-01

    Background Professionalism and communication skills constitute important components of the integral formation of physicians which has repercussion on the quality of health care and medical education. The objective of this study was to assess medical graduates’ professionalism and communication skills from the patients’ perspective and to examine its association with patients’ socio-demographic variables. Methods This is a hospital based cross-sectional study. It involved 315 patients and 105 medical graduates selected by convenient sampling method. A modified and validated version of the American Board of Internal Medicine’s (ABIM) Patient Assessment survey questionnaire was used for data collection through a face to face interview. Data processing and analysis were performed using the Statistical Package for Social Science (SPSS) 16.0. Mean, frequency distribution, and percentage of the variables were calculated. A non-parametric Kruskal Wallis test was applied to verify whether the patients’ assessment was influenced by variables such as age, gender, education, at a level of significance, p ? 0.05. Results Female patients constituted 46% of the sample, whereas males constituted 54%. The mean age was 36?±?16. Patients’ scoring of the graduate’s skills ranged from 3.29 to 3.83 with a mean of 3.64 on a five-point Likert scale. Items assessing the “patient involvement in decision-making” were assigned the minimum mean values, while items dealing with “establishing adequate communication with patient” assigned the maximum mean values. Patients, who were older than 45 years, gave higher scores than younger ones (p?Patients with higher education reported much lower scores than those with lower education (p?=?0.003). Patients’ gender did not show any statistically significant influence on the rating level. Conclusion Generally patients rated the medical graduates’ professionalism and communication skills at a good level. Patients’ age and educational level were significantly associated with the rating level. PMID:24517316

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

    PubMed Central

    Cinar, Ayse Basak; Schou, Lone

    2014-01-01

    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. PMID:25614885

  8. Patient–Provider Communication Differs for Black Compared to White HIV-Infected Patients

    PubMed Central

    Saha, Somnath; Korthuis, P. Todd; Sharp, Victoria; Cohn, Jonathon; Wilson, Ira B.; Eggly, Susan; Cooper, Lisa A.; Roter, Debra; Sankar, Andrea; Moore, Richard

    2010-01-01

    Poor patient–provider interactions may play a role in explaining racial disparities in the quality and outcomes of HIV care in the United States. We analyzed 354 patient–provider encounters coded with the Roter Interaction Analysis System across four HIV care sites in the United States to explore possible racial differences in patient–provider communication. Providers were more verbally dominant in conversations with black as compared to white patients. This was largely due to black patients’ talking less than white patients. There was no association between race and other measures of communication. Black and white patients rated their providers’ communication similarly. Efforts to more effectively engage patients in the medical dialogue may lead to improved patient–provider relationships, self-management, and outcomes among black people living with HIV/AIDS. PMID:20066486

  9. 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

    Saunders, CL; Abel, GA; Lyratzopoulos, G

    2015-01-01

    Patient experience is a critical dimension of cancer care quality. Understanding variation in experience among patients with different cancers and characteristics is an important first step for designing targeted improvement interventions. We analysed data from the 2011/2012 English Cancer Patient Experience Survey (n = 69 086) using logistic regression to explore inequalities in care experience across 64 survey questions. We additionally calculated a summary measure of variation in patient experience by cancer, and explored inequalities between patients with cancers treated by the same specialist teams. We found that younger and very old, ethnic minority patients and women consistently reported worse experiences across questions. Patients with small intestine/rarer lower gastrointestinal, multiple myeloma and hepatobiliary cancers were most likely to report negative experiences whereas patients with breast, melanoma and testicular cancer were least likely (top-to-bottom odds ratio = 1.91, P < 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

  10. Using the internet to enhance physician-patient communication.

    PubMed

    Biermann, J Sybil; Golladay, Gregory J; Peterson, Richard N

    2006-03-01

    The rise in Internet use by patients with musculoskeletal problems has put orthopaedic surgeons under increased pressure to provide Web-based resources. Patients are researching musculoskeletal conditions online, and many want to communicate electronically with their physicians. Online medical information may be a useful adjunct to traditional physician-patient interaction because it is readily available, is wide in scope, and can provide the patient with basic knowledge on a given topic. A clinical encounter may then be efficiently spent refining information and answering specific questions. Orthopaedic surgeons should be aware of the advantages of using Internet resources as part of their practice as well as the potential legal and confidentiality pitfalls in electronic communication. Some patient concerns may be easily satisfied and communication enhanced through the use of e-mail. Physicians planning to incorporate electronic communication with their patients must be prepared to manage unsolicited e-mail, maintain patient confidentiality, and adopt practices that maximize the use of online resources to enhance patient education. PMID:16520364

  11. Variability in the Practice of Fertility Preservation for Patients with Cancer

    PubMed Central

    Reynolds, Kasey A.; Grindler, Natalia M.; Rhee, Julie S.; Cooper, Amber R.; Ratts, Valerie S.; Carson, Kenneth R.; Jungheim, Emily S.

    2015-01-01

    Fertility is important to women and men with cancer. While options for fertility preservation (FP) are available, knowledge regarding the medical application of FP is lacking. Therefore we examined FP practices for cancer patients among reproductive endocrinologists (REs). A 36 item survey was sent to board-certified REs. 98% of respondents reported counseling women with cancer about FP options. Oocyte and embryo cryopreservation were universally offered by these providers, but variability was noted in reported management of these cases—particularly for women with breast cancer. 86% of the respondents reported using letrozole during controlled ovarian stimulation (COS) in patients with estrogen receptor positive (ER+) breast cancer to minimize patient exposure to estrogen. 49% of respondents who reported using letrozole in COS for patients with ER+ breast cancer reported that they would also use letrozole in COS for women with ER negative breast cancer. Variability was also noted in the management of FP for men with cancer. 83% of participants reported counseling men about sperm banking with 22% recommending against banking for men previously exposed to chemotherapy. Overall, 79% of respondents reported knowledge of American Society for Clinical Oncology FP guidelines—knowledge that was associated with providers offering gonadal tissue cryopreservation (RR 1.82, 95% CI 1.14–2.90). These findings demonstrate that RE management of FP in cancer patients varies. Although some variability may be dictated by local resources, standardization of FP practices and communication with treating oncologists may help ensure consistent recommendations and outcomes for patients seeking FP. PMID:26010087

  12. Nurse-patient interaction and communication: A systematic literature review

    Microsoft Academic Search

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

    2009-01-01

    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,

  13. Improving Rural Cancer Patients' Outcomes: A Group-Randomized Trial

    ERIC Educational Resources Information Center

    Elliott, Thomas E.; Elliott, Barbara A.; Regal, Ronald R.; Renier, Colleen M.; Haller, Irina V.; Crouse, Byron J.; Witrak, Martha T.; Jensen, Patricia B.

    2004-01-01

    Significant barriers exist in the delivery of state-of-the-art cancer care to rural populations. Rural providers' knowledge and practices, their rural health care delivery systems, and linkages to cancer specialists are not optimal; therefore, rural cancer patient outcomes are less than achievable. Purpose: To test the effects of a strategy…

  14. Geriatric medical oncology in the care of elderly cancer patients

    Microsoft Academic Search

    Gilbert B. Zulian

    2002-01-01

    Most cancers are diagnosed after 70 years of age but standard management and treatment for elderly cancer patients remain to be established. To determine whether the availability and recognition of medical oncology may influence cancer care in this population, five successive periods were studied. The number of formal written consultations given at the geriatric hospital and at the center for

  15. Effects of Lycopene Supplementation in Patients with Localized Prostate Cancer

    Microsoft Academic Search

    OMER KUCUK; FAZLUL H. SARKAR; Z ORA DJURIC; WAEL SAKR; MICHAEL N. POLLAK; FRED KHACHIK; MOUSUMI BANERJEE; JOHN S. BERTRAM; DAVID P. WOOD

    2002-01-01

    Epidemiological studies have shown an inverse association be- tween dietary intake of lycopene and prostate cancer risk. We conducted a clinical trial to investigate the biological and clini- cal effects of lycopene supplementation in patients with local- ized prostate cancer. Twenty-six men with newly diagnosed prostate cancer were randomly assigned to receive a tomato oleoresin extract containing 30 mg of

  16. Endometrial cancer occurence five years after breast cancer in BRCA2 mutation patient

    PubMed Central

    Oh, Sang Eun; Kim, Soo Hyun; Kim, Mee Seon

    2015-01-01

    We recently experienced a case of endometrial cancer 5 years after the diagnosis of breast cancer in a patient with a mutation in the BRCA2 gene. A 55-year-old Korean woman who had a past history of breast cancer in her 50s underwent an operation for endometrial cancer. Final pathology confirmed stage Ia, and no adjuvant treatment was performed. After surgery, considering her history of sequential cancer occurrence, genetic counseling was offered. The result showed the BRCA2 variation of unknown significance mutation. This is the first case report of sequential cancers (endometrial and breast) in a patient with a BRCA2 mutation among a Korean population. PMID:25798433

  17. Preoperative Serum Levels of Mesothelin in Patients with Colon Cancer

    PubMed Central

    Bostanc?, Özgür; Kemik, Özgür; Kemik, Ahu; Battal, Muharrem; Demir, Uygar; Purisa, Sevim; Mihmanl?, Mehmet

    2014-01-01

    Background. Screening for biochemical markers is important for diagnosing colon cancer. In this study, the reliability of serum mesothelin levels as a potential diagnostic and screening instrument was evaluated concerning colon cancer. Methods. Ninety-five patients who had undergone colonoscopic examination and who were diagnosed with colon cancer were included in the study. The serum mesothelin levels were measured with the ELISA kits and were evaluated in terms of significant difference when compared between colon cancer and control group. Results. Patients with colon cancer had significantly higher mesothelin serum levels (P < 0.001) than the control groups. We found significant associations between serum levels and tumor grade, perineural invasion, and vascular invasion (resp., P < 0.001). Conclusion. Evaluating the serum levels of mesothelin has a potential to detect and screen the colon cancer in affected patients. Our data suggest that mesothelin exhibits effects towards colon cancer and serves as a biomarker for this deadly disease. PMID:25477701

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

    PubMed

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

    2014-09-01

    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

  19. Cancer physicians’ attitude towards treatment of the elderly cancer patient in a developed Asian country

    PubMed Central

    2013-01-01

    Background With an aging population and an increasing number of elderly patients with cancer, it is essential for us to understand how cancer physicians approach the management and treatment of elderly cancer patients as well as their methods of cancer diagnosis disclosure to older versus younger patients in Singapore, where routine geriatric oncology service is not available. Methods 57 cancer physicians who are currently practicing in Singapore participated in a written questionnaire survey on attitudes towards management of the elderly cancer patient, which included 2 hypothetical clinical scenarios on treatment choices for a fit elderly patient versus that for a younger patient. Results The participants comprised of 68% medical oncologists, 18% radiation oncologists, and 14% haematologists. Most physicians (53%) listed performance status (PS) as the top single factor affecting their treatment decision, followed by cancer type (23%) and patient’s decision (11%). The top 5 factors were PS (95%), co-morbidities (75%), cancer stage (75%), cancer type (75%), patient’s decision (53%), and age (51%). 72% of physicians were less likely to treat a fit but older patient aggressively; 53% and 79% opted for less intensive treatments for older patients in two clinical scenarios of lymphoma and early breast cancer, respectively. 37% of physicians acknowledged that elderly cancer patients were generally under-treated. Only 9% of physicians chose to disclose cancer diagnosis directly to the older patient compared to 61% of physicians to a younger patient, citing family preference as the main reason. Most participants (61%) have never engaged a geriatrician’s help in treatment decisions, although the majority (90%) would welcome the introduction of a geriatric oncology programme. Conclusions Advanced patient age has a significant impact on the cancer physician’s treatment decision-making process in Singapore. Many physicians still accede to family members’ request and practice non-disclosure of cancer diagnosis to geriatric patients, which may pose as a hurdle to making an informed decision regarding management for the geriatric cancer patients. Having a formal geriatric oncology programme in Singapore could potentially help to optimize the management of geriatric oncology patients. PMID:23590357

  20. [Communication between health care professionals and patients].

    PubMed

    Ohara, Yoshiko

    2010-06-01

    In recent years, a wide variety of health-related issues make the headlines almost everyday: the shortage of physicians, an increase in elderly patients, a difficulty in maintaining emergency pediatric care services (due to the declining birthrate), the capacity of the existing emergency medical services, medical malpractice, and the H1N1 influenza vaccine. In Japan, there has been an increasing demand for health care with an emphasis on quality over quantity based the viewpoint of health care recipients, instead of providers. Since 1995, when the obligation of informed consent was adopted, there has been an improvement, although still insufficient, in patient-oriented medical services, including attitudes towards patients. A clinical laboratory technician is required to conduct a clinical examination in a prompt and accurate manner, based on a physician's instructions written on the examination slip. Based on the results of the examination, the physician determines the diagnosis and informs the patient of it, which means that clinical laboratory technicians support the QOL of patients indirectly. Patients sometimes ask about the purpose, methods, and results of a clinical examination, prior to, following, or during its implementation. In hospitals with recently developed complex, advanced equipment for clinical examination, physicians and laboratory technicians place orders for examinations without providing any detailed explanation to patients. Patients feel very anxious and nervous wondering what clinical examination they are going to undergo, and demand an adequate explanation of the test from laboratory technicians. However, patients are often dissatisfied with their manner and remarks, such as "The attending physician will give you the results in detail", and make complaints in some cases. As a provider of health care services, clinical laboratory technicians have a responsibility to meet their patients' demands. It is very important for clinical laboratory technicians to provide patients with an explanation in a caring and considerate manner, making it simple and easy-to-understand as long as it does not contradict the laws and results of an examination. PMID:20662272

  1. Survivin expression is a prognostic marker in pancreatic cancer patients

    Microsoft Academic Search

    Kazuhiro Kami; Ryuichiro Doi; Masayuki Koizumi; Eiji Toyoda; Tomohiko Mori; Daisuke Ito; Koji Fujimoto; Michihiko Wada; Shin-Ichi Miyatake; Masayuki Imamura

    2004-01-01

    BackgroundIn this study, we assessed survivin expression in pancreatic cancer specimens from patients who underwent either pancreatic resection alone or pancreatic resection plus postoperative radiation therapy (PORT) to evaluate whether survivin expression is predictive of sensitivity to PORT and outcome in pancreatic cancer patients.

  2. Thrombin-Activatable Fibrinolysis Inhibitor in Breast Cancer Patients

    Microsoft Academic Search

    O. Kaftan; B. Kasapoglu; M. Koroglu; A. Kosar; S. K. Yalcin

    2011-01-01

    Objective: To evaluate the levels of thrombin-activatable fibrinolysis inhibitor (TAFI) activity and also its relationship with other homeostasis markers in breast cancer patients. Subjects and Methods: Forty-two female patients with breast cancer and 24 healthy women (controls) were enrolled in the study and fasting blood samples of all cases were drawn from a large antecubital vein for assay of TAFI

  3. Implant Reconstruction in Breast Cancer Patients Treated with Radiation Therapy

    Microsoft Academic Search

    Jeffrey A. Ascherman; Matthew M. Hanasono; Martin I. Newman; Duncan B. Hughes

    2006-01-01

    Background: Implant reconstruction in breast cancer patients treated with radiation therapy is controversial. Prior studies are limited by older prosthetic devices, reconstructive techniques, and radiation therapy protocols. Methods: A retrospective review was performed of patients who underwent tissue expansion and implant breast reconstruction performed by a single sur- geon after mastectomy for breast cancer from 1996 to 2003. Complications and

  4. Managing Anemia in the Cancer Patient: Old Problems, Future Solutions

    Microsoft Academic Search

    MICHAEL S. GORDON

    Anemia and associated symptoms commonly mani- fest in cancer patients and may have a considerable impact on outcomes. Preliminary studies suggest that overall survival and locoregional control following radi- ation therapy may be compromised by anemia, and recent preliminary data also suggest that anemia may be related to poorer outcomes following chemotherapy. Health-related quality of life of cancer patients is

  5. A survey of pain in patients with advanced cancer

    Microsoft Academic Search

    Robert Twycross; Jean Harcourt; Stephen Bergl

    1996-01-01

    One hundred eleven patients with advanced cancer and pain newly referred to a palliative care center completed the Brief Pain Inventory (BPI) weekly for up to 4 weeks. The aims were (a) to review the numbers and causes of pain, (b) to consider the usefulness of the BPI in the evaluation of pain in cancer patients, and (c) to determine

  6. Safety and Efficacy of Massage Therapy for Patients With Cancer

    Microsoft Academic Search

    Lisa Corbin

    2005-01-01

    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

  7. Patient Satisfaction: A Study in Communication.

    ERIC Educational Resources Information Center

    Young, Laura Throckmorton; And Others

    The Program in Human Sexuality (PHS), an outpatient mental health clinic in the University of Minnesota Medical School that specializes in sexuality-related dysfunctions, had received a number of patient complaints in late 1992 and early 1993 about therapeutic processes and business services. The proactive approach was to survey patients about all…

  8. Patient communication: a multidisciplinary approach using animated cartoons.

    PubMed

    Leiner, Marie; Handal, Gilbert; Williams, Darryl

    2004-10-01

    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 with patients include the use of videotapes, videotape modeling or cartoon illustrations. Do these products communicate effectively because they overcome illiteracy or because they also transmit a very clear message? Can good transmission of messages overcome illiteracy? In this study, we compared the effectiveness of a printed message about polio vaccinations with the same message converted into a production of animated cartoons using marketing and advertising techniques. The production that resulted from using this strategy showed that in the setting of this study, a well-designed animated cartoon is more effective in delivering a message than the same information provided in written instructional materials. PMID:15150139

  9. Informing cancer patient based on his type of personality:The self-sacrificing patient.

    PubMed

    Kallergis, George

    2015-01-01

    Imparting the bad news has become a hard task for the doctor, and is usually perceived as unpleasant by the patient to whom the bad news is revealed. It is vital that the physician's approach be tailored to the cancer patient's personality. Gathering by the informing process protocols already suggested the hardest step for the doctors to take is empathic understanding which, presupposes tailoring to the individual's needs. The aim of this article was to describe the self-sacrificing type of personality thoroughly, so that any physician can make a diagnosis and tailor the information strategy to their needs. As method of research was used the qualitative method through groups with doctors and nurses, while research within groups lasted for 5 years. Assessing the denial mechanism is hard for a person that regards disease as punishment and propitiation. The physician must mobilize his countertransference, the sense he gets from the discussions with the patient and their overall communication. If he finds that the patient has self-control, then the approach of imparting the news resembles that of the controlling-orderly personality. If he ascertains that the patient has a lasting embarrassment, he should be more careful and impart the news gradually, his approach resembling that of the dependent person. PMID:26011361

  10. RESEARCH ARTICLE Open Access Colorectal cancer in patients seen at the teaching

    E-print Network

    Paris-Sud XI, Université de

    RESEARCH ARTICLE Open Access Colorectal cancer in patients seen at the teaching hospitals: In Guadeloupe and Martinique, two French Overseas Departments, colorectal cancer (CRC) has become an essential the originality of our results. Keywords: Colorectal cancer, Guadeloupian patients, Martinican patients

  11. The prevalence of thyroid cancer in patients with hyperthyroidism

    PubMed Central

    Kunjumohamed, Fathimabeebi P.; Al-Busaidi, Noor B.; Al-Musalhi, Hilal N.; Al-Shereiqi, Sulaiman Z.; Al-Salmi, Issa S.

    2015-01-01

    Objectives: To determine the prevalence of thyroid cancer in patients with hyperthyroidism. Methods: This is a retrospective observational study using the data of 71 Omani patients with a diagnosis of hyperthyroidism due to Grave’s disease, toxic multinodular goiter, and solitary toxic adenoma. These patients underwent thyroidectomy at the Royal Hospital (RH), Muscat, Oman, and were followed up at the National Diabetes and Endocrine Center (NDEC) between 2007 and 2013. The details were collected from the medical records of both the RH and the NDEC. Patients who underwent thyroidectomy for other reasons like non-toxic goiter and hypothyroidism with cancer were excluded from the study. Results: Thyroid cancer was identified in 32.8% (n=23) of patients with hyperthyroidism. Half of these patients 52.1% (n=12) had papillary micro-cancer (intra-thyroidal), and 3 patients with Grave’s disease (13%) had lymph nodes metastasis (loco-regional infiltration. The cancer preponderance was higher in young (n=21, 91.3%) and female patients (n=18, 73.9%). Most patients with thyroid cancer had abnormal ultrasound neck findings and thyroid scintigraphy (99 mTc uptake). Conclusion: Many patients with hyperthyroidism in Muscat, Oman, especially those with Grave’s disease, show malignancy, and hence a proper initial evaluation of these patients is required as part of long-term management. PMID:26108596

  12. Quality of Life in Patients Undergoing Radiation Therapy for Primary Lung Cancer, Head and Neck Cancer, or Gastrointestinal Cancer

    ClinicalTrials.gov

    2015-03-31

    Anal Cancer; Colorectal Cancer; Esophageal Cancer; Extrahepatic Bile Duct Cancer; Gallbladder Cancer; Gastric Cancer; Head and Neck Cancer; Liver Cancer; Lung Cancer; Pancreatic Cancer; Small Intestine Cancer

  13. [Cancer Survivorship: the patient and medical care staff - how will society deal with cancer ?].

    PubMed

    Honda, Mayumi

    2011-07-01

    Instead of being preoccupied with treatment effectiveness, rates of survival, and asking how much longer will I live?, let us think in terms of how will I live my life the way I want to live it? In recent years, a new way of thinking called Cancer Survivorship has emerged in the United States, and has been drawing attention in Japan. Cancer Survivorship is a concept developed by a cancer patient support group in the United States in 1986, focusing on the experience of living with, through, and beyond cancer. Opposing society's narrow view of cancer patients as victims handed out a death sentence, Cancer Survivorship focuses on living life to the fullest from the time of cancer diagnosis until the moment of death,and works as a movement appealing to society to allow cancer survivors the right to live as they wish. This way of thinking has spread globally, and in Italy, a movement aimed at protecting cancer survivors' freedom to do paid work has unfolded. Even in Japan, with an increase in the number of cancer patients and an improved five-year survival rate, patient support groups have been emerging with the Cancer Survivorship mentality. However, Japanese society still has not given the movement sufficient recognition, and the question now is if cancer patients, even those in the terminal stage, can seize their lives and be someone who lives in the present. PMID:21772088

  14. Prostate Cancer Patients' Refusal of Cancer-Directed Surgery: A Statewide Analysis

    PubMed Central

    Islam, K. M.

    2015-01-01

    Introduction. Prostate cancer is the most common cancer among men in USA. The surgical outcomes of prostate cancer remain inconsistent. Barriers such as socioeconomic factors may play a role in patients' decision of refusing recommended cancer-directed surgery. Methods. The Nebraska Cancer Registry data was used to calculate the proportion of prostate cancer patients recommended the cancer-directed surgery and the surgery refusal rate. Multivariate logistic regression was applied to analyze the socioeconomic indicators that were related to the refusal of surgery. Results. From 1995 to 2012, 14,876 prostate cancer patients were recommended to undergo the cancer-directed surgery in Nebraska, and 576 of them refused the surgery. The overall refusal rate of surgery was 3.9% over the 18 years. Patients with early-stage prostate cancer were more likely to refuse the surgery. Patients who were Black, single, or covered by Medicaid/Medicare had increased odds of refusing the surgery. Conclusion. Socioeconomic factors were related to the refusal of recommended surgical treatment for prostate cancer. Such barriers should be addressed to improve the utilization of surgical treatment and patients' well-being. PMID:25973276

  15. Measurement of Physician-Patient Communication—A Systematic Review

    PubMed Central

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

    2014-01-01

    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

  16. Oxaliplatin Plus Irinotecan in Treating Patients With Metastatic Gastrointestinal Cancer

    ClinicalTrials.gov

    2013-06-24

    Anal Cancer; Colorectal Cancer; Esophageal Cancer; Extrahepatic Bile Duct Cancer; Gallbladder Cancer; Gastric Cancer; Gastrointestinal Carcinoid Tumor; Liver Cancer; Pancreatic Cancer; Small Intestine Cancer

  17. Towards patient-based cancer therapeutics* | Office of Cancer Genomics

    Cancer.gov

    Researchers from the NCI Cancer Target Discovery and Development (CTD²) network are relating the genetic features of cancers to acquired gene and pathway dependencies and identifying small-molecule therapeutics that target them.

  18. Preoperative Quality of Life in Patients with Gastric Cancer

    PubMed Central

    Suk, Hyoam; Kwon, Oh Kyung

    2015-01-01

    Purpose We evaluated the socio-personal and clinical factors that can affect preoperative quality of life to determine how to improve preoperative quality of life in patients with gastric cancer. Materials and Methods The preoperative quality of life data of 200 patients (68 females and 132 males; mean age 58.9±12.6 years) with gastric cancer were analyzed according to socio-personal and clinical factors. The Korean versions of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core (QLQ) 30 and the EORTC QLQ-STO22, a gastric cancer-specific module, were used to assess quality of life. Patients were asked to complete the questionnaire preoperatively by themselves. Results Patients with a higher academic background and stage I disease tended to have higher global health status scores. Highly educated younger men had better physical functioning scores. Highly educated and well-nourished patients with stage I cancer had higher role functioning scores. Married patients had better emotional scores. The symptom scales were affected by sex, age, education level, nutrition, and cancer stage. Conclusions Preoperative quality of life in patients with gastric cancer can be improved by nutritional support and treatment of symptoms caused by disease progression. Psychological support may be helpful for patients with a poor quality of life. PMID:26161285

  19. Inequalities in reported cancer patient experience by sociodemographic characteristic and cancer site: Evidence from respondents to the English Cancer Patient Experience Survey

    E-print Network

    Saunders, Catherine L.; Abel, Gary A.; Lyratzopoulos, Georgios

    2014-01-01

    Inequalities in reported cancer patient experience by socio-demographic characteristic and cancer site: evidence from respondents to the English Cancer Patient Experience Survey C.L. SAUNDERS, PHD, RESEARCH ASSOCIATE – STATISTICIAN, Cambridge Centre... SENIOR RESEARCH ASSOCIATE, NIHR POST-DOCTORAL FELLOW, Cambridge Centre for Health Services Research, University of Cambridge, Cambridge, UK SAUNDERS C.L., ABEL G.A. & LYRATZOPOULOS G. (2015) European Journal of Cancer Care 24, 85–98 Inequalities...

  20. Physician-Patient Communication about Dietary Supplements

    PubMed Central

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

    2013-01-01

    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

  1. Salivary MicroRNA in Pancreatic Cancer Patients

    PubMed Central

    Humeau, Marine; Vignolle-Vidoni, Alix; Sicard, Flavie; Martins, Frédéric; Bournet, Barbara; Buscail, Louis; Torrisani, Jérôme; Cordelier, Pierre

    2015-01-01

    Background Pancreatic cancer is the fourth leading cause of cancer death in Western countries, with the lowest 1-year survival rate among commonly diagnosed cancers. Reliable biomarkers for pancreatic cancer diagnosis are lacking and are urgently needed to allow for curative surgery. As microRNA (miRNA) recently emerged as candidate biomarkers for this disease, we explored in the present pilot study the differences in salivary microRNA profiles between patients with pancreatic tumors that are not eligible for surgery, precancerous lesions, inflammatory disease or cancer-free patients as a potential early diagnostic tool. Methods Whole saliva samples from patients with pancreatic cancer (n = 7), pancreatitis (n = 4), IPMN (n = 2), or healthy controls (n = 4) were obtained during endoscopic examination. After total RNA isolation, expression of 94 candidate miRNAs was screened by q(RT)PCR using Biomark Fluidgm. Human-derived pancreatic cancer cells were xenografted in athymic mice as an experimental model of pancreatic cancer. Results We identified hsa-miR-21, hsa-miR-23a, hsa-miR-23b and miR-29c as being significantly upregulated in saliva of pancreatic cancer patients compared to control, showing sensitivities of 71.4%, 85.7%, 85,7% and 57%, respectively and excellent specificity (100%). Interestingly, hsa-miR-23a and hsa-miR23b are overexpressed in the saliva of patients with pancreatic cancer precursor lesions. We found that hsa-miR-210 and let-7c are overexpressed in the saliva of patients with pancreatitis as compared to the control group, with sensitivity of 100% and 75%, and specificity of 100% and 80%, respectively. Last hsa-miR-216 was upregulated in cancer patients as compared to patients diagnosed with pancreatitis, with sensitivity of 50% and specificity of 100%. In experimental models of PDAC, salivary microRNA detection precedes systemic detection of cancer cells markers. Conclusions Our novel findings indicate that salivary miRNA are discriminatory in pancreatic cancer patients that are not eligible for surgery. In addition, we demonstrate in experimental models that salivary miRNA detection precedes systemic detection of cancer cells markers. This study stems for the use of salivary miRNA as biomarker for the early diagnosis of patients with unresectable pancreatic cancer. PMID:26121640

  2. Psychosocial Stress in Cancer Patients during and after Radiotherapy

    Microsoft Academic Search

    Susanne Sehlen; Helmuth Hollenhorst; Beatrice Schymura; Peter Herschbach; Uelker Aydemir; Martina Firsching; Eckhart Dühmke

    2003-01-01

    Background and Purpose: The aim of this study was to investigate stress in tumor patients by means of a cancer-specific questionnaire in the course of radiotherapy. Material and Methods: Disease-specific aspects of psychosocial stress (Herschbach's Questionnaire on Stress in Cancer Patients, QSC) were self-assessed by patients with different tumor types before radiotherapy (ti1), after radiotherapy (ti2), and 6 weeks after

  3. Quality of life as conveyed by pediatric patients with cancer

    Microsoft Academic Search

    P. S. Hinds; J. S. Gattuso; A. Fletcher; E. Baker; B. Coleman; T. Jackson; A. Jacobs-Levine; D. June; S. N. Rai; S. Lensing; C.-H. Pui

    2004-01-01

    Quality-of-life instruments have provided important advances in measuring the quality of life of pediatric patients receiving treatment for cancer. However, the bases of these instruments have not included first-hand reports from the patients; thus, these instruments may be conceptually incomplete. We directly solicited from pediatric patients their perspectives regarding their quality of life during treatment for cancer. We conducted two

  4. Measurement of cancer health literacy and identification of patients with limited cancer health literacy.

    PubMed

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

    2014-01-01

    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

  5. Suicide in cancer patients in California, 1997-2006.

    PubMed

    Nasseri, Kiumarss; Mills, Paul K; Mirshahidi, Hamid R; Moulton, Lawrence H

    2012-01-01

    The objective of this study was to measure suicide risk in cancer patients and compare it with the general population. Suicide rates were based on 1,168 suicides in 1,123,528 cancer patients in California from 1997-2006 and were studied by race/ethnicity, sex, site, stage, and marital status. Suicide in cancer patients is 2.3 times the general population with 81% in the non-Hispanic Whites, and half within the first 2 years post diagnosis. In men, it rapidly increases by age to a high plateau in the early forties. Metastatic cancers and those of the prostate, lung and bronchus, pancreas, stomach, esophagus, and oral cavity in men and breast in women were associated with significantly higher risk. Cancer patients are at higher risk of suicide and should be specifically targeted for preventive efforts post diagnosis. PMID:23137222

  6. Scrambler therapy for patients with cancer pain - case series -.

    PubMed

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

    2013-01-01

    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

  7. The Nature of Communication Work During Cancer: Advancing the Theory of Illness Trajectories

    Microsoft Academic Search

    Erin Donovan-Kicken; Andrew C. Tollison; Elizabeth S. Goins

    2011-01-01

    More theory development about interpersonal communication during cancer is needed so that scholarship can be advanced and practical applications of findings can be best disseminated and applied. We proposed an evidence-based extension to the theory of illness trajectories based on findings from a qualitative study of cancer survivors' (n?=?40) experiences with communication. Grounding our analysis in respondents' descriptions of the

  8. The Nature of Communication Work During Cancer: Advancing the Theory of Illness Trajectories

    Microsoft Academic Search

    Erin Donovan-Kicken; Andrew C. Tollison; Elizabeth S. Goins

    2012-01-01

    More theory development about interpersonal communication during cancer is needed so that scholarship can be advanced and practical applications of findings can be best disseminated and applied. We proposed an evidence-based extension to the theory of illness trajectories based on findings from a qualitative study of cancer survivors' (n?=?40) experiences with communication. Grounding our analysis in respondents' descriptions of the

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

    Microsoft Academic Search

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

    2011-01-01

    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

  10. Communicating about cancer through Facebook: a qualitative analysis of a breast cancer awareness page.

    PubMed

    Abramson, Karley; Keefe, Brian; Chou, Wen-Ying Sylvia

    2015-01-01

    Social media channels are increasingly being used for health communication and promotion. Social networking sites such as Facebook have become popular platforms for organizations to communicate health messages and encourage user participation around health topics. While the evaluation of social media's effectiveness in health promotion is beginning to emerge in the literature, few studies have examined actual interactions and user behaviors on Facebook Pages hosted by health organizations. The authors present a qualitative case study of a popular Facebook Page from a nonprofit organization devoted to raising awareness about breast cancer. With the goal of identifying the functions and uses of the Page, our study analyzes the content of Wall posts during Breast Cancer Awareness Month, October 2010. Common themes and characteristics are identified, including open mic communication, scarcity of health information, the commodification of breast cancer, unpredictable locations of conversation, and the use of gendered images and language. The findings have potential implications for health promotion efforts using social media platforms. PMID:25495200

  11. Factors affecting acceptability to young cancer patients of a psychoeducational video game about cancer.

    PubMed

    Kato, Pamela M; Beale, Ivan L

    2006-01-01

    This study explored whether an action video game about cancer would be acceptable to adolescent and young adult cancer patients as a tool for learning about cancer and self-care during treatment. Interviews about a proposed video game were conducted with 43 young cancer patients, who also completed questionnaires measuring personality and adaptive style. Data were analyzed to assess the overall acceptability of the proposed video game and to reveal any factors associated with measures of acceptability. Most participants expressed willingness to play the game and a moderate degree of interest in it. Cancer content in the game was not a deterrent for most participants. Game acceptability was not affected by personality variables or adaptive style. It is concluded that an action video game using cancer themes could be useful to nurses as a tool to improve understanding and self care of adolescent and young adult cancer patients. PMID:16902082

  12. Improving quality of life among cancer patients in Malaysia.

    PubMed

    Ezat, W P Sharifa; Noraziani, K; Sabrizan, O

    2012-01-01

    There are an almost infinite number of states of health, all with differing qualities that can be affected by many factors. Each aspect of health has many components which contribute to multidimensionality. Cancer and its' related issues surrounding the treatment plan contribute to the variety of changes of quality of life of cancer patients throughout their life. The objective of this article was to provide an overview of some of the issues that can affect their quality of life and initiatives towards successful care in Malaysia by reviewing relevant reports and articles. The current strategies can be further strengthened by prevention of cancer while improving quality of service to cancer patients. PMID:22631640

  13. Managing the low-socioeconomic-status prostate cancer patient.

    PubMed Central

    Rayford, Walter

    2006-01-01

    Management of patients with low socioeconomic status and/or low literacy who have prostate cancer presents a challenge to healthcare professionals. Improving treatment outcomes for these men requires specific educational programs to provide a better understanding of prostate cancer including careful posttreatment follow-up to ensure they have recovered well, that the cancer is not progressing and that complications are not proving troublesome. Practice nurses and health educators/navigators can play an important role in achieving these objectives. Education and knowledgeable advice can lead to earlier diagnosis of prostate cancer, improved patient participation in the treatment decision-making process and effective management of posttreatment complications. PMID:16623064

  14. Impact of Patient Race on Patient Experiences of Access and Communication in HIV Care

    PubMed Central

    Saha, Somnath; Fleishman, John A.; McGrath, Moriah McSharry; Josephs, Joshua S.; Moore, Richard D.; Gebo, Kelly A.; Hellinger, James; Beach, Mary Catherine

    2008-01-01

    ABSTRACT BACKGROUND Patient-centered care—including the domains of access and communication—is an important determinant of positive clinical outcomes. OBJECTIVE To explore associations between race and HIV-infected patients’ experiences of access and communication. DESIGN This was a cross-sectional survey. PARTICIPANTS Nine hundred and fifteen HIV-infected adults receiving care at 14 U.S. HIV clinics. MEASUREMENTS Dependent variables included patients’ reports of travel time to their HIV care site and waiting time to see their HIV provider (access) and ratings of their HIV providers on always listening, explaining, showing respect, and spending enough time with them (communication). We used multivariate logistic regression to estimate associations between patient race and dependent variables, and random effects models to estimate site-level contributions. RESULTS Patients traveled a median 30 minutes (range 1–180) and waited a median 20 minutes (range 0–210) to see their provider. On average, blacks and Hispanics reported longer travel and wait times compared with whites. Adjusting for HIV care site attenuated this association. HIV care sites that provide services to a greater proportion of blacks and Hispanics may be more difficult to access for all patients. The majority of patients rated provider communication favorably. Compared to whites, blacks reported more positive experiences with provider communication. CONCLUSIONS We observed racial disparities in patients’ experience of access to care but not in patient–provider communication. Disparities were explained by poor access at minority-serving clinics. Efforts to make care more patient-centered for minority HIV-infected patients should focus more on improving access to HIV care in minority communities than on improving cross-cultural patient–provider interactions. PMID:18830770

  15. Development and psychometric testing of a breast cancer patient-profiling questionnaire

    PubMed Central

    Gorini, Alessandra; Mazzocco, Ketti; Gandini, Sara; Munzone, Elisabetta; McVie, Gordon; Pravettoni, Gabriella

    2015-01-01

    Introduction The advent of “personalized medicine” has been driven by technological advances in genomics. Concentration at the subcellular level of a patient’s cancer cells has meant inevitably that the “person” has been overlooked. For this reason, we think there is an urgent need to develop a truly personalized approach focusing on each patient as an individual, assessing his/her unique mental dimensions and tailoring interventions to his/her individual needs and preferences. The aim of this study was to develop and test the psychometric properties of the ALGA-Breast Cancer (ALGA-BC), a new multidimensional questionnaire that assesses the breast cancer patient’s physical and mental characteristics in order to provide physicians, prior to the consultation, with a patient’s profile that is supposed to facilitate subsequent communication, interaction, and information delivery between the doctor and the patient. Methods The specific validation processes used were: content and face validity, construct validity using factor analysis, reliability and internal consistency using test–retest reliability, and Cronbach’s alpha correlation coefficient. The exploratory analysis included 100 primary breast cancer patients and 730 healthy subjects. Results The exploratory factor analysis revealed eight key factors: global self-rated health, perceived physical health, anxiety, self-efficacy, cognitive closure, memory, body image, and sexual life. Test–retest reliability and internal consistency were good. Comparing patients with a sample of healthy subjects, we also observed a general ability of the ALGA-BC questionnaire to discriminate between the two. Conclusion The ALGA-BC questionnaire with 29 items is a valid instrument with which to obtain a patient’s profile that is supposed to help physicians achieve meaningful personalized care which supplements biological and genetic analyses.

  16. Outcomes of pancreaticoduodenectomy in patients with metastatic cancer

    PubMed Central

    Kwak, Joo Hwa; Park, Jin Young; Choi, Dong Wook; Choi, Seong Ho; Lee, Hui Song

    2014-01-01

    Backgrounds/Aims Metastatic cancer of pancreas is rarely resectable. Pancreaticoduodenectomy carries high risks of morbidities and mortalities that it is rarely performed for metastatic cancer. In this study, the clinical features and outcomes of metastatic cancer of pancreas after pancreaticoduodenectomy were reviewed and analyzed. Methods We retrospectively reviewed patients who underwent pancreaticoduodectomy from January 2000 to December 2012 in Samsung Medical Center. A total of 1045 patients were enrolled in this study. Inclusion criteria were patients who had metachronous lesions with tumors histologically confirmed as metastatic cancer. However, patients with tumors directly invaded pancreas head, bile duct, and duodenum were excluded from this study. Finally, a total of 12 patients who underwent pancreaticoduodenectomy due to metastatic cancer were used in this study. Clinicopathologic features and perioperative data of these 12 patients were retrospectively reviewed. Results The 12 patients included 6 females and 6 males who had metastatic lesions at pancreas head, duodenum 2nd-3rd portion, and distal common bile duct. The mean age of patients was 62.7 years old at the time of pancreaticoduodenectomy. The interval between the time of the first operation for primary cancer and pancreaticoduodenectomy was 67.7 months. The mean survival time after pancreaticoduodectomy was 38.6 months (range, 12 to 119 months). There was no fatal complication after the surgery. Conclusions Pancreaticoduodenectomy is becoming a safer procedure with less complication compared to the past. Patients with recurrent metastatic cancer should be considered for metastectomy if tumors are resectable. Pancreaticoduodenectomy should be considered as one main treatment for patients with recurrent metastatic cancer to offer a chance of long-term survival in selected patients.

  17. Mortality from thyroid cancer in patients with hyperthyroidism: the Theagenion Cancer Hospital experience

    Microsoft Academic Search

    Kalliopi Pazaitou-Panayiotou; Petros Perros; Maria Boudina; George Siardos; Apostolos Drimonitis; Frideriki Patakiouta; Iraklis Vainas

    2008-01-01

    Background: Thyroid carcinoma has been reported in patients operated for different types of hyperthyroidism and the probability of a hot nodule being malignant seems to be low. The aim of the present study was to explore the relationship between thyroid cancer, hyperthyroidism and outcome in a large cohort of patients who presented to a tertiary cancer centre in Northern Greece.

  18. Psychosocial Concerns in Patients With Advanced Cancer: An Observational Study at Regional Cancer Centre, India

    Microsoft Academic Search

    Seema Mishra; Sushma Bhatnagar; Freeny Ann Philip; Vasudha Singhal; Shiv Pratap Singh Rana; Surjya Prasad Upadhyay; Govindi Chauhan

    2010-01-01

    Introduction: The diagnosis and treatment of cancer is associated with substantial physical, psychological, and social morbidity. The objective of this study was to identify the prevalence of psychosocial concerns in the patients with advanced cancer admitted to our institute. Materials and Methods: A total of 100 patients admitted to the inpatient palliative care unit of our institute were enrolled in

  19. Risk assessment and prophylaxis for VTE in cancer patients.

    PubMed

    Khorana, Alok A

    2011-07-01

    The frequency of venous thromboembolism (VTE) is rising in patients with cancer. VTE contributes to mortality and morbidity, but the risk for VTE can vary widely between individual patients. Clinical risk factors for VTE in cancer include primary site of cancer, use of systemic therapy, surgery, and hospitalization. Biomarkers predictive of VTE include platelet and leukocyte counts, hemoglobin, D-dimer, and tissue factor. A recently validated risk model incorporates 5 easily available variables and can be used clinically to identify patients at increased risk of VTE. In high-risk settings, including surgery and hospitalization, thromboprophylaxis with either unfractionated heparin or low-molecular-weight heparins has been shown to be safe and effective. Recent studies have also suggested a potential benefit for thromboprophylaxis in the ambulatory setting, although criteria for selecting patients for prophylaxis are not currently well defined. This article focuses on recent and ongoing studies of risk assessment and prophylaxis in patients with cancer. PMID:21715725

  20. The relationship between patient physiology and cancer-specific survival following curative resection of colorectal cancer

    Microsoft Academic Search

    J T Jenkins; G O'Neill; C G Morran

    2007-01-01

    The impact of patient physiology on cancer-specific survival is poorly documented. Patient physiology predicted overall, cancer-specific (Physiology Score>30; HR 8.64 (95% CI 3.00–24.92); P=0.0005) and recurrence-free survival (Physiology Score >30; HR 7.44 (95% CI 1.99–27.73); P=0.003) independent of Dukes stage following potentially curative surgery for colorectal cancer. This independent negative association with survival is a novel observation.

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

    PubMed

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

    2014-01-01

    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

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

    PubMed

    Waldman, Deane

    2013-01-01

    In this article, we make the etiologic diagnosis for a sick patient named Healthcare: the cancer of greed. When we explore the two forms of this cancer--corporate and bureaucratic--we find the latter is the greater danger to We the Patients. The "treatments" applied to patient Healthcare by the Congressional "doctors" have consistently made the patient worse, not better. At the core of healthcare's woes is the government's diversion of money from healthcare services to healthcare bureaucracy. As this is the root cause, it is what we must address in order to cure, not sedate or palliate, patient Healthcare. PMID:24236323

  3. Towards patient-based cancer therapeutics*

    Cancer.gov

    Researchers from the NCI Cancer Target Discovery and Development (CTD²) network are relating the genetic features of cancers to acquired gene and pathway dependencies and identifying small-molecule therapeutics that target them.

  4. Cancer Patient's Health Affected by Spouse's Mood

    MedlinePLUS

    ... an effective caretaker of others," said Dr. Karen Mechanic, head of psychiatry at Fox Chase Cancer Center ... of the treatment decision-making process." SOURCES: Karen Mechanic, M.D., head of psychiatry, Fox Chase Cancer ...

  5. Breast cancer subtypes and survival in patients with brain metastases

    Microsoft Academic Search

    Byung-Ho Nam; Sun Young Kim; Hye-Sook Han; Youngmee Kwon; Keun Seok Lee; Tae Hyun Kim; Jungsil Ro

    2008-01-01

    Introduction  Brain metastases (BM) occur in up to one third of patients with metastatic breast cancer (MBC), whose incidences and prognoses\\u000a by breast cancer subtypes in BM have not been well delineated.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Retrospective survival analyses were performed in 126 BM patients from 805 MBC patients treated at the National Cancer Center\\u000a between August 2001 and April 2006, according to clinical characteristics,

  6. Increased Prevalence of Precursor Lesions in Familial Pancreatic Cancer Patients

    PubMed Central

    Shi, Chanjuan; Klein, Alison P; Goggins, Michael; Maitra, Anirban; Canto, Marcia; Ali, Syed; Schulick, Richard; Palmisano, Emily; Hruban, Ralph H

    2009-01-01

    Purpose Histologic findings in 51 pancreata resected from patients with a strong family history of pancreatic cancer were compared to the findings in 40 pancreata resected from patients with sporadic pancreatic cancer. None of the patients in the familial group had a known inherited syndrome, other than familial pancreatic cancer. Experimental Design Precursor lesions, including pancreatic intraepithelial neoplasia (PanIN), intraductal papillary mucinous neoplasm (IPMN) and incipient IPMN, were quantified. Invasive cancers were classified using established histologic criteria. Results The individual precursor lesions identified in both groups were histologically similar. Precursor lesions were more common in the familial cases than in the sporadic cases. The Relative Rate of PanINs per cm2 was 2.75 fold higher (95% CI 2.05-3.70, adjusted for age) in familial compared to sporadic cases. PanIN-3 lesions were more common in familial versus sporadic pancreatic cancer patients (Relative Rate 4.20; 95%CI 2.22-7.93 adjusted for age). High-grade incipient IPMNs were only observed in the familial cases. Nine (18%) of the 51 familial pancreatic cancers and 4 (10%) of the 40 sporadic cancers arose in association with an IPMN. No significant differences were found in the types of invasive cancers. Conclusions Non-invasive precursor lesions are more common in patients with a strong family history of pancreatic cancer than in patients with sporadic disease, and precursor lesions are of a higher grade in patients with a strong family history of pancreatic cancer. These findings can form a basis for the design of screening tests for the early detection of pancreatic neoplasia. PMID:19996207

  7. Strengthening student communication through pediatric simulated patient encounters

    PubMed Central

    2014-01-01

    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

  8. Strengthening student communication through pediatric simulated patient encounters.

    PubMed

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

    2014-01-01

    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

  9. Impact of Combined Hospice Care on Terminal Cancer Patients

    PubMed Central

    Rau, Kung-Ming; Huang, Chih-Fang

    2011-01-01

    Abstract Background Many patients with advanced cancer will develop physical and psychological symptoms related to their disease. These symptoms are infrequently treated by conventional care. Palliative care programs have been developed to fill this gap in care. However, there are limited beds in hospice units. To allow more terminal cancer patients to receive care from a hospice team, a combined hospice care system was recently developed in Taiwan. This study is a report of our experiences with this system. Patients and Methods From January to December 2009, terminal cancer patients who accepted consultation from a hospice team for combined hospice care were enrolled in the study. Demographic data, clinical symptoms, referring department, type of cancer, and outcome were analyzed. Results A total of 354 terminal cancer patients in acute wards were referred to a hospice consulting team. The mean patient age was 61 years, and the proportion of males was 63.28%. After combined hospice care, there was a significant improvement in the sign rate of do-not-resuscitate (DNR) orders from 41.53% to 71.47% (p?cancer patients who were not transferred to hospice ward to receive combined care by a hospice consulting team while in acute wards, thus increasing the hospice utilization of terminal cancer patients. The major symptoms presented by the patients were pain (58%), dyspnea (52%), constipation (45%), and fatigue (23%). Conclusions Through the hospice consulting system, hospice combined care has a positive effect on the utilization of hospice care, rate of DNR signing and quality of end-of-life care for terminal cancer patients. PMID:21504306

  10. OPTIMIZING THE DELIVERY OF RADIATION THERAPY TO CANCER PATIENTS \\Lambda

    E-print Network

    Ferris, Michael C.

    OPTIMIZING THE DELIVERY OF RADIATION THERAPY TO CANCER PATIENTS \\Lambda DAVID M. SHEPARD y patients with radiation. In recent years, new treatment machines have been developed that provide a much for optimizing each patient's treatment plan. One of the challenges is to quantify optimality in radiation

  11. Supporting cancer patients' unanchored health information management with mobile technology

    E-print Network

    Anderson, Richard

    , 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

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

    PubMed Central

    Kang, Hwi-joong; Yoon, Jung-won; Park, Ji-hye; Cho, Chong-kwan; Yoo, Hwa-seung

    2014-01-01

    Objectives: The purpose of this study is to report a case series of advanced cancer patients whose cancer pain was relieved by using autonomic nerve pharmacopuncture (ANP) treatment. ANP is a subcutaneous injection therapy of mountain ginseng pharmacopuncture (MGP) along the acupoints on the spine (Hua-Tuo-Jia-Ji-Xue; 0.5 cun lateral to the lower border of the spinous processes of vertebrae) to enhance the immune system and to balance autonomic nerve function. Methods: Patients with three different types of cancer (gastric cancer, lung cancer, colon cancer with distant metastases) with cancer pain were treated with ANP. 1 mL of MGP was injected into the bilateral Hua-Tuo-Jia-Ji-Xue on the T1-L5 sites (total 12 ? 20 mL injection) of each patient’s dorsum by using the principle of symptom differentiation. During ANP treatment, the visual analogue scale (VAS) for pain was used to assess their levels of cancer pain; also, the dosage and the frequency of analgesic use were measured. Results: The cancer pain levels of all three patients improved with treatment using ANP. The VAS scores of the three patients decreased as the treatment progressed. The dosage and the frequency of analgesics also gradually decreased during the treatment period. Significantly, no related adverse events were found. Conclusion: ANP has shown benefit in controlling cancer pain for the three different types of cancer investigated in this study and in reducing the dosage and the frequency of analgesics. ANP is expected to be beneficial for reducing cancer pain and, thus, to be a promising new treatment for cancer pain. PMID:25780711

  13. The therapeutic effects of the physician-older patient relationship: Effective communication with vulnerable older patients

    PubMed Central

    Williams, Summer L; Haskard, Kelly B; DiMatteo, M Robin

    2007-01-01

    There is growing evidence that the outcomes of health care for seniors are dependent not only upon patients’ physical health status and the administration of care for their biomedical needs, but also upon care for patients’ psychosocial needs and attention to their social, economic, cultural, and psychological vulnerabilities. Even when older patients have appropriate access to medical services, they also need effective and empathic communication as an essential part of their treatment. Older patients who are socially isolated, emotionally vulnerable, and economically disadvantaged are particularly in need of the social, emotional, and practical support that sensitive provider-patient communication can provide. In this review paper, we examine the complexities of communication between physicians and their older patients, and consider some of the particular challenges that manifest in providers’ interactions with their older patients, particularly those who are socially isolated, suffering from depression, or of minority status or low income. This review offers guidelines for improved physician-older patient communication in medical practice, and examines interventions to coordinate care for older patients on multiple dimensions of a biopsychosocial model of health care. PMID:18044195

  14. Self-Reported Financial Burden and Satisfaction With Care Among Patients With Cancer

    PubMed Central

    Chino, Fumiko; Peppercorn, Jeffrey; Taylor, Donald H.; Lu, Ying; Samsa, Gregory; Abernethy, Amy P.

    2014-01-01

    Background. Health care-related costs and satisfaction are compelling targets for quality improvement in cancer care delivery; however, little is known about how financial burden affects patient satisfaction. Methods. This was an observational, cross-sectional, survey-based study assessing patient-reported financial burden (FB). Eligible patients were ?21 years with solid tumor malignancy and were receiving chemotherapy or hormonal therapy for ?1 month. The Patient Satisfaction Questionnaire Short-Form assessed patient satisfaction with health care. Subjective FB related to cancer treatment was measured on a 5-point Likert scale. Results. Of 174 participants (32% response rate), 47% reported significant/catastrophic FB. Participants reported highest satisfaction with interpersonal manner and lowest satisfaction with financial aspects of care. In adjusted analysis, high FB was negatively associated with general satisfaction (coefficient: ?.29), satisfaction with technical quality (coefficient: ?.26), and satisfaction with financial aspects of care (coefficient: ?.62). Older age was associated with higher scores in all satisfaction subscales except patient-physician communication and financial aspects. Annual household income of <$20,000 was associated with lower satisfaction scores in all subscales except time spent with doctor. High FB was not associated with patient satisfaction scores for accessibility and convenience, communication, interpersonal manner, or time spent with doctor. Conclusion. FB is a potentially modifiable correlate of poor satisfaction with cancer care including general satisfaction and satisfaction with the technical quality of care. Addressing cancer-associated FB may lead to improved satisfaction, which in turn can influence adherence, outcomes, and quality of life. PMID:24668333

  15. Nutritional/metabolic response in older cancer patients.

    PubMed

    Horstman, Astrid M; Sheffield-Moore, Melinda

    2015-04-01

    The combination of age-related muscle loss (sarcopenia) and the diagnosis of cancer (and the onset of cachexia) is likely a metabolic challenge that skeletal muscle of older cancer patients is not prepared to handle. Albeit to a smaller extent than healthy older controls, the skeletal muscle of older cancer patients is still acutely anabolic to the provision of amino acids. To provide an anabolic stimulus to skeletal muscle during a time when it is susceptible to an advanced rate of breakdown due to cancer- and tumor-related factors, enhanced intake of protein and amino acid sources might be necessary and should likely be higher than the current US recommended daily intake of 0.8 g protein/kg body weight/day. Future studies should investigate whether the acute effects of amino acids on muscle protein anabolism can be sustained over a longer period of time in the presence of cancer cachexia in older patients. PMID:25770327

  16. Clinical guide SEOM on venous thromboembolism in cancer patients.

    PubMed

    Muñoz Martín, A J; Font Puig, C; Navarro Martín, L M; Borrega García, P; Martín Jiménez, M

    2014-12-01

    Venous thromboembolism (VTE) is a common event in cancer patients and one of the major causes of cancer-associated mortality and a leading cause of morbidity. In recent years, the incidence rates of VTE have notably increased; however, VTE is still commonly underestimated by oncologists. VTE is considered an adverse prognostic factor in cancer patients in all settings. In 2011 the Spanish Society of Medical Oncology (SEOM) first published a clinical guideline of prophylaxis and treatment of VTE in cancer patients. In an effort to incorporate evidence obtained since the original publication, SEOM presents an update of the guideline for thrombosis and cancer in order to improve the prevention and management of VTE. PMID:25366189

  17. A survey of patient-provider e-mail communication: what do patients think?

    PubMed

    Sittig, D F; King, S; Hazlehurst, B L

    2001-04-01

    Communication between patients and providers forms the backbone of the patient-provider relationship. Often such communication is strained due to time and space limitations on the part of both patients and providers. Many healthcare organizations are developing secure e-mail communication facilities to allow patients to exchange e-mail messages with their providers. Providers are worried that opening such lines of communication will inundate them with vast quantities of e-mail from their patients. Patients are worried that their messages will be intercepted and read by unauthorized people. In an attempt to determine how a group of internet-active, e-mail-ready patients currently use, or potentially view, the ability to exchange e-mail messages with their health care providers, we distributed a survey via e-mail to over 9500 patients. After determining each patient's e-mail activity level (based on the number of messages sent each day), we asked questions such as: "Have you ever sent e-mail to your provider?" "What issues or concerns have prevented you from sending e-mail messages to your provider?" "If your provider were to tell you that someone in his/her office may screen, read or perhaps reply to your message before he/she sees it, to what extent would you be concerned about this?" and "How would you rate your overall satisfaction with the use of e-mail to communicate with your provider?" Results from the survey indicate that nearly 85% of the patients surveyed send at least one e-mail message per day, but that very few (i.e. 6%) of the patients have actually sent an e-mail message to their provider. Interestingly, over half of the patients indicated that they would like to send their providers e-mail, but that they do not know their provider's e-mail address. PMID:11248604

  18. The influence of cancer impact on patients' preparatory grief.

    PubMed

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

    2009-02-01

    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 measure patients' performance status. Statistically significant associations were found between PGAC, patients' performance status, and all the IES-R-Gr scales (avoidance, intrusion, hyperarousal) and IES-R-Gr total score. The multiple regression analysis revealed that preparatory grief was predicted by patients' young age, poor performance status, as well as by their high levels of intrusion and hyperarousal, in a model explaining 51.5% of the total variance. Concluding, in advanced cancer patients, preparatory grief is significantly correlated with the impact of cancer and patients' physical condition, and seems to be influenced by components of the event impact, patients' age, and physical performance. PMID:20186647

  19. Readability of Educational Materials for Patients with Cancer

    NSDL National Science Digital Library

    Cooley, Mary E.

    This article, jointly created by authors Mary E. Cooley, Helene Moriarty and Thomas H. Short, describes a dataset on the readability of American Cancer Society and National Cancer Institute pamphlets about cancer. This tests are designed to test whether the reading levels of these patients are high enough to comprehend this literature. Students should be familiar with scales of measurement, data reduction, measuring center, constructing and interpreting displays, and reaching conclusions in real problems.

  20. Management of complications from estrogen deprivation in breast cancer patients

    Microsoft Academic Search

    Dawn L. Hershman; Christina Cho; Katherine D. Crew

    2009-01-01

    In the United States today, more than 2 million women live as breast cancer survivors. As the number of cancer survivors grows,\\u000a the unique long-term side effects of cancer treatment and aging play an increasingly prominent role in the routine care of\\u000a these patients. Of special concern are the short- and longterm effects of sex hormone deprivation. This article reviews

  1. Altered Sphingolipid Metabolism in Patients with Metastatic Pancreatic Cancer

    PubMed Central

    Jiang, Yixing; DiVittore, Nicole A.; Young, Megan M; Jia, Zhiliang; Xie, Keping; Ritty, Timothy M.; Kester, Mark; Fox, Todd E.

    2013-01-01

    Although numerous genetic mutations and amplifications have been identified in pancreatic cancer, much of the molecular pathogenesis of the disease remains undefined. While proteomic and transcriptomic analyses have been utilized to probe and characterize pancreatic tumors, lipidomic analyses have not been applied to identify perturbations in pancreatic cancer patient samples. Thus, we utilized a mass spectrometry-based lipidomic approach, focused towards the sphingolipid class of lipids, to quantify changes in human pancreatic cancer tumor and plasma specimens. Subgroup analysis revealed that patients with positive lymph node metastasis have a markedly higher level of ceramide species (C16:0 and C24:1) in their tumor specimens compared to pancreatic cancer patients without nodal disease or to patients with pancreatitis. Also of interest, ceramide metabolites, including phosphorylated (sphingosine- and sphinganine-1-phosphate) and glycosylated (cerebroside) species were elevated in the plasma, but not the pancreas, of pancreatic cancer patients with nodal disease. Analysis of plasma level of cytokine and growth factors revealed that IL-6, IL-8, CCL11 (eotaxin), EGF and IP10 (interferon inducible protein 10, CXCL10) were elevated in patients with positive lymph nodes metastasis, but that only IP10 and EGF directly correlated with several sphingolipid changes. Taken together, these data indicate that sphingolipid metabolism is altered in human pancreatic cancer and associated with advanced disease. Assessing plasma and/or tissue sphingolipids could potentially risk stratify patients in the clinical setting. PMID:24970174

  2. Altered sphingolipid metabolism in patients with metastatic pancreatic cancer.

    PubMed

    Jiang, Yixing; DiVittore, Nicole A; Young, Megan M; Jia, Zhiliang; Xie, Keping; Ritty, Timothy M; Kester, Mark; Fox, Todd E

    2013-01-01

    Although numerous genetic mutations and amplifications have been identified in pancreatic cancer, much of the molecular pathogenesis of the disease remains undefined. While proteomic and transcriptomic analyses have been utilized to probe and characterize pancreatic tumors, lipidomic analyses have not been applied to identify perturbations in pancreatic cancer patient samples. Thus, we utilized a mass spectrometry-based lipidomic approach, focused towards the sphingolipid class of lipids, to quantify changes in human pancreatic cancer tumor and plasma specimens. Subgroup analysis revealed that patients with positive lymph node metastasis have a markedly higher level of ceramide species (C16:0 and C24:1) in their tumor specimens compared to pancreatic cancer patients without nodal disease or to patients with pancreatitis. Also of interest, ceramide metabolites, including phosphorylated (sphingosine- and sphinganine-1-phosphate) and glycosylated (cerebroside) species were elevated in the plasma, but not the pancreas, of pancreatic cancer patients with nodal disease. Analysis of plasma level of cytokine and growth factors revealed that IL-6, IL-8, CCL11 (eotaxin), EGF and IP10 (interferon inducible protein 10, CXCL10) were elevated in patients with positive lymph nodes metastasis, but that only IP10 and EGF directly correlated with several sphingolipid changes. Taken together, these data indicate that sphingolipid metabolism is altered in human pancreatic cancer and associated with advanced disease. Assessing plasma and/or tissue sphingolipids could potentially risk stratify patients in the clinical setting. PMID:24970174

  3. Mortality communication as a predictor of psychological distress among family caregivers of home hospice and hospital inpatients with terminal cancer.

    PubMed

    Bachner, Yaacov G; O'Rourke, Norm; Davidov, Eldad; Carmel, Sara

    2009-01-01

    Terminally ill cancer patients and their caregivers experience significant difficulties discussing illness and impending death (herein defined as mortality communication). The current study compares response levels as well as patterns of association between mortality communication and psychological distress among caregivers of home hospice and hospital inpatients. For this study, 231 family caregivers were recruited within a year of bereavement from the south and central health regions of Israel. Contrary to our initial hypothesis, retrospectively reported levels of mortality communication did not differ between groups; however, lower levels of depressive symptomatology were reported by home hospice caregivers. Separate path analytic models indicate statistically significant inverse associations between mortality communication and psychological distress (i.e. depressive symptomatology, emotional exhaustion). Invariance analyses indicate that the strength of association between variables did not differ between path models. The results of this study are discussed in terms of self-selection biases and possible confounds associated with retrospective reporting among bereaved caregivers. PMID:19197690

  4. Antibacterial essential oils in malodorous cancer patients: Clinical observations in 30 patients

    Microsoft Academic Search

    Patrick H Warnke; E. Sherry; P. A. J. Russo; Y. Açil; J. Wiltfang; S. Sivananthan; M. Sprengel; J. C. Roldàn; S. Schubert; J. P. Bredee; I. N. G. Springer

    2006-01-01

    Malodorous necrotic ulcers in cancer patients are of major concern as it leads to social isolation and poor quality of life. Current medications and topical therapies have proven inadequate in their ability to reduce foul smell to acceptable levels.We report the positive experience we have had in using antibacterial essential oils in patients with incurable head and neck cancer and

  5. Associations between gene expressions in breast cancer and patient survival

    E-print Network

    established to characterize tumors. Relatively comprehensive profiles of mRNA levels can be obtained and used to discriminate cancer cells from normal cell (Alon et al., 1999), and to provide sub-classes of tumor typesAssociations between gene expressions in breast cancer and patient survival Authors T.-K. Jenssen1

  6. The Signatures of Autozygosity among Patients with Colorectal Cancer

    Microsoft Academic Search

    Manny D. Bacolod; Gunter S. Schemmann; Shuang Wang; Sarah F. Giardina; Zhaoshi Zeng; Jinru Shia; Robert F. Stengel; Norman Gerry; Josephine Hoh; Tomas Kirchhoff; Michael F. Christman; Kenneth Offit; William L. Gerald; Daniel A. Notterman; Jurg Ott; Philip B. Paty; Francis Barany

    2008-01-01

    Previous studies have shown that among populations with a high rate of consanguinity, there is a significant increase in the prevalence of cancer. Single nucleotide polymorphism (SNP) array data (Affymetrix, 50K XbaI) analysis revealed long regions of homozygosity in genomic DNAs taken from tumor and matched normal tissues of colorectal cancer (CRC) patients. The presence of these regions in the

  7. Psychosocial rehabilitation of cancer patients after curative therapy

    Microsoft Academic Search

    Alain Ronson; Jean-Jacques Body

    2002-01-01

    The concept of rehabilitation of cancer patients is based on the relatively recent awareness of the strong interrelations existing between physical, psychological and social aspects of human life. Cancer potentially disrupts all of these primary components of quality of life. The aim of rehabilitation is to promote global physical and psychosocial adjustment by acting at all modifiable levels, namely strengthening

  8. The Psychosocial Problems of Cancer Patients: A Prospective Study.

    ERIC Educational Resources Information Center

    Gordon, Wayne; And Others

    The course of psychosocial adjustment to cancer was examined in 105 adults with cancer of the lung, breast and skin. Half of the patients received a program of systematic psychosocial rehabilitation plus evaluation, and the other half received only an evaluation, consisting of a series of psychometric instruments and a problem-oriented structured…

  9. Biobehavioral Outcomes Following Psychological Interventions for Cancer Patients

    Microsoft Academic Search

    Barbara L. Andersen

    2002-01-01

    Psychological interventions for adult cancer patients have primarily focused on reducing stress and enhancing quality of life. However, there has been expanded focus on biobehavioral outcomes—health behaviors, compliance, biologic responses, and disease outcomes— consistent with the Biobehavioral Model of cancer stress and disease course. The author reviewed this expanded focus in quasi- experimental and experimental studies of psychological interventions, provided

  10. Where a Cancer Patient Dies: The Effect of Rural Residency

    ERIC Educational Resources Information Center

    Burge, Frederick I.; Lawson, Beverley; Johnston, Grace

    2005-01-01

    Context: Surveys indicate 50% to 80% of cancer patients would choose to die at home if possible, although far fewer actually do. In Nova Scotia (NS), cancer deaths occurring out-of-hospital increased from 19.8% in 1992 to 30.2% in 1997. The impact of rural residency on this trend has not been studied. Purpose: To determine the association between…

  11. Variations in breast cancer treatment by patient and provider characteristics

    Microsoft Academic Search

    John Z. Ayanian; Edward Guadagnoli

    1996-01-01

    Summary Guidelines for the optimal treatment of breast cancer have been publicized over the past 15 years, yet clinical practices continue to vary substantially in the United States. This article reviews the literature on variations in local and systemic treatment of breast cancer by patient and provider characteristics.

  12. Upregulation of plasma C9 protein in gastric cancer patients

    PubMed Central

    Chong, Poh-Kuan; Lee, Huiyin; Loh, Marie Chiew Shia; Choong, Lee-Yee; Lin, Qingsong; So, Jimmy Bok Yan; Lim, Khong Hee; Soo, Ross Andrew; Yong, Wei Peng; Chan, Siew Pang; Smoot, Duane T.; Ashktorab, Hassan; Yeoh, Khay Guan; Lim, Yoon Pin

    2013-01-01

    Gastric cancer is one of the leading causes of cancer-related deaths worldwide. Current biomarkers used in the clinic do not have sufficient sensitivity for gastric cancer detection. To discover new and better biomarkers, protein profiling on plasma samples from 25 normal, 15 early-stage and 21 late-stage cancer was performed using an iTRAQ-LC-MS/MS approach. The level of C9 protein was found to be significantly higher in gastric cancer compared with normal subjects. Immunoblotting data revealed a congruent trend with iTRAQ results. The discriminatory power of C9 between normal and cancer states was not due to inter-patient variations and was independent from gastritis and Helicobacter pylori status of the patients. C9 overexpression could also be detected in a panel of gastric cancer cell lines and their conditioned media compared with normal cells, implying that higher C9 levels in plasma of cancer patients could be attributed to the presence of gastric tumor. A subsequent blind test study on a total of 119 plasma samples showed that the sensitivity of C9 could be as high as 90% at a specificity of 74%. Hence, C9 is a potentially useful biomarker for gastric cancer detection. PMID:20707004

  13. Radiation Plus Hormone Therapy May Help Some Prostate Cancer Patients

    MedlinePLUS

    ... nih.gov/medlineplus/news/fullstory_152526.html Radiation Plus Hormone Therapy May Help Some Prostate Cancer Patients ... radiation therapy only, 52 percent received hormone therapy plus radiation, and 10 percent received neither treatment. The ...

  14. Many Patients with Cancer Need Better Treatments for Pain

    Cancer.gov

    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.

  15. Health Insurance and Financial Assistance for the Cancer Patient

    MedlinePLUS

    ... saved articles window. My Saved Articles » My ACS » Health Insurance and Financial Assistance for the Cancer Patient Download ... help you. Here you can learn about private health insurance, government-funded insurance plans, options if you are ...

  16. 'Watchful Waiting' Becoming More Common for Prostate Cancer Patients

    MedlinePLUS

    'Watchful Waiting' Becoming More Common for Prostate Cancer Patients Study finds men with low-risk disease often getting monitoring over surgery, radiation, hormone therapy To use the sharing features ...

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

    E-print Network

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

    2007-06-03

    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...

  18. Glycosylation status of vitamin D binding protein in cancer patients

    PubMed Central

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

    2009-01-01

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

  19. Glycosylation status of vitamin D binding protein in cancer patients.

    PubMed

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

    2009-10-01

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

  20. Combining Chemotherapy with Bevacizumab Improves Outcomes for Ovarian Cancer Patients

    Cancer.gov

    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.

  1. “Practicing medicine”: Patient perceptions of physician communication and the process of prescription

    Microsoft Academic Search

    Christy J. W. Ledford; Melinda M. Villagran; Gary L. Kreps; Xiaoquan Zhao; Colleen McHorney; Melinda Weathers; Brian Keefe

    2010-01-01

    ObjectiveThis study explores patient perceptions of physician communication regarding prescription medications and develops a theory of the effects of perceived physician communication on the patient decision-making process of medication taking.

  2. The Intracellular Mechanism of Insulin Resistance in Pancreatic Cancer Patients

    Microsoft Academic Search

    JIAN LIU; JOSEPH A. KNEZETIC; LISA STROMMER; JOHAN PERMERT; JORGEN LARSSON; THOMAS E. ADRIAN

    The diabetes that frequently occurs in pancreatic cancer patients is characterized by profound peripheral insulin resistance. The in- tracellular mechanism of this insulin resistance was investigated in skeletal muscle biopsies from pancreatic cancer patients with or with- out diabetes and control subjects. Insulin receptor (IR) binding, tyrosine kinase activity, IR messen- ger RNA (mRNA), IR substrate-1 content, GLUT-4, and GLUT-4

  3. Quality of life perspectives in patients with oral cancer.

    PubMed

    Rogers, Simon N

    2010-06-01

    This article is set in the context of the oral healthcare team caring for patients following oral cancer treatment. It provides an overview of the definition of quality of life (QoL), how it is measured, the key issues for patients with respect oral cancer, and comment about the role of the dental multidisciplinary team. It provides a source of relevant literature specific to this topic. PMID:20308002

  4. Mortality and cancer incidence in patients with Parkinson's disease

    Microsoft Academic Search

    Yuko Minami; Reiko Yamamoto; Mitsuaki Nishikouri; Akira Fukao; Shigeru Hisamichi

    2000-01-01

    To investigate the risks of mortality and cancer incidence in Parkinson's disease (PD) we studied the prognosis of 246 PD\\u000a patients in a community. The cohort of PD patients was identified in 1984, and survival, mortality, relocation, and cancer\\u000a incidence during 1984–1992 were examined retrospectively in 1994. The risk was measured by a standard effect estimate, i.\\u000a e., the standardized

  5. Modeling the impact of comorbidity on breast cancer patient outcomes

    Microsoft Academic Search

    Shengfan Zhang; Julie Simmons Ivy; Fay Cobb Payton; Kathleen M. Diehl

    2010-01-01

    The objective of this paper is to model the impact of comorbidity on breast cancer patient outcomes (e.g., length of stay\\u000a and disposition). Previous studies suggest that comorbidities may significantly affect mortality risks for breast cancer patients.\\u000a The 2006 AHRQ Nationwide Inpatient Sample (NIS) is used to analyze the relationships among comorbidities (e.g., hypertension,\\u000a diabetes, obesity, and mental disorder), total

  6. Interstitial lung disease in patients with small cell lung cancer

    Microsoft Academic Search

    Kunihiko Miyazaki; Hiroaki Satoh; Koichi Kurishima; Ryota Nakamura; Hiroichi Ishikawa; Katsunori Kagohashi; Nobuyuki Hizawa

    2010-01-01

    Interstitial lung disease (ILD) and lung cancer are two of the most common respiratory diseases. The aim of this study was\\u000a to demonstrate the prognostic significance of the presence of ILD in patients with small cell lung cancer (SCLC). All the\\u000a patients with SCLC who were admitted to our hospitals over a 23-year period up to 2008 were retrospectively analyzed.

  7. Nutritional status and quality of life of the gastric cancer patients in Changle County of China

    Microsoft Academic Search

    Jun Tian; Jian-Shun Chen ELSEVIER

    2005-01-01

    Abstract Abstract Abstract Abstract AIM: To analyze the relation between nutrition and quality of life in the stomach cancer patients, evaluate the intake of daily nutrition of the patients, and study the feasibility of nutrition intervention in improving quality of life of the stomach cancer patients. METHODS: A total of 285 surgical stomach cancer patients reported in the Changle Cancer

  8. Teaching clinician-patient communication in the treatment of breast diseases.

    PubMed

    White, M K; Malik, T

    1999-01-01

    In 1998, some 179,000 women in the United States were newly diagnosed with breast cancer, and 48,500 women died from it. Early detection by mammography, physical examination, and breast self-examination improves survival rates and can decrease mortality. The clinician's level of comfort with discussing education and prevention with patients can influence patients' adherence to preventive measures. Improved clinician-patient interpersonal communication has a demonstrated positive impact on adherence and health outcomes. We developed and pilot tested a core curriculum on breast health aimed at primary care community physicians and resident house staff. The goal was to improve interpersonal communication between clinician and patient. Two groups of participants attended either a week-long or a 2-week-long training program consisting of four components: a brief demonstration of an interview and breast examination, interviews and breast examinations with a standardized patient, and two separate workshops of varying length. This pilot program had a significant impact on clinician behavior and knowledge. We recommend further investigation of this area with larger sample sizes. PMID:10094079

  9. Latino Men and Familial Risk Communication about Prostate Cancer

    PubMed Central

    Hicks, Elisabeth M.; Litwin, Mark S.; Maliski, Sally L.

    2014-01-01

    Purpose This study investigated how familial communication about prostate cancer risk and screening affects sons of men with prostate cancer. It is important to engage Latino families shared decision making toward early detection because first degree relatives of men with PCa are at heightened risk and Latino men are diagnosed at more advanced stages of disease than Non-Hispanic White men. Methods The team conducted semi-structured interviews with seventeen sons of PCa survivors. Eight participants completed a follow up interview an average of seven months later. Therefore, our sample includes twenty-five transcripts. The sons are Latinos living in Southern California. Data were analyzed with a mix of a priori topical codes and grounded theory techniques. Results Sons were under informed about both familial risk and screening options. They became sensitized to PCa, desired information, and held protective intentions. Hopeful intentions came up against cultural taboos around sex, reproductive health, and intimacy that limited discussions between fathers and sons. Fathers were a valued source of information, but play various roles, which affect sons’ screening intentions. Open communication between father and son promoted awareness of screening and familial risk. Discussion Uncertainty about familial risk and screening options, especially early detection strategies, was exacerbated by cultural taboos around PCa. Fathers could have been primary and credible advocates for shared decision making, but sons found it difficult to learn from their fathers’ experience. Nursing Implications Findings from our study can inform community based interventions with Latino families, help to culturally tailor health messaging, and sensitize clinicians to a group which needs concerted counseling about PCa risk and screening. PMID:25158656

  10. Relatives of Prostate Cancer Patients have an Increased Risk of Prostate and Stomach Cancers: A Population-Based, Cancer Registry study in Finland

    Microsoft Academic Search

    Mika P. Matikainen; Eero Pukkala; Johanna Schleutker; Teuvo L. J. Tammela; Pasi Koivisto; Risto Sankila; Olli-P. Kallioniemi

    2001-01-01

    Objective: Five to ten percent of prostate cancers may be caused by inherited genetic defects. In order to explore the nature of inherited cancer risks in the genetically homogeneous Finnish population, we investigated the incidence of prostate cancer and other cancers in first-degree relatives of prostate cancer patients by linking the population-based parish records on relatives with the Finnish Cancer

  11. The Use of Health Functional Foods in Gastrointestinal Cancer Patients

    PubMed Central

    Kang, Hwa Pyoung; Lee, Hosun; Oh, Tak Geun; Lee, Kyong Joo; Park, Soo Jung; Kim, Seung Up; Lee, Hyuk; Park, Jun Chul; Hong, Sung Pil; Park, Jun Yong; Park, Jeong Youp; Bang, Seungmin; Kim, Do Young; Cheon, Jae Hee; Ahn, Sang Hoon; Kim, Tae Il; Park, Seung Woo; Song, Si Young

    2013-01-01

    As an adjunct to cancer treatment, the use of health functional foods (HFFs) seems to be increasing. However, little is known for the use of HFFs among cancer patients in Korea. The aims of this study were to investigate the exposure rate of HFF use among gastrointestinal (GI) cancer patients and to examine the relationship of socio-demographic and disease-related characteristics with the use of HFFs. A total of 126 patients diagnosed with GI cancer participated in the study. A cross-sectional survey was conducted using a questionnaire. Over a half of all the patients surveyed (n = 67; 53.2%) used HFFs. Patients who were younger, had higher income, or longer duration of disease showed a trend to use HFFs more frequently, even though the tendency was not statistically significant. The most commonly used HFF was vitamin complex (n = 20; 16%), followed by red ginseng (n = 15; 12%), and sweet wormwood (Artemisia annua) (n = 11; 8.8%). About 26% of all responders expressed concerns for using HFFs. The primary concern was 'going against physician's recommendations' (36.8%). About 63% of respondents expressed a desire to consult with their physicians and follow their recommendations. More basic scientific data and educational materials regarding HFFs are required for both health-care professionals and cancer patients. A larger sample and size-controlled groups representing each cancer type will continue to be recruited for participation in this survey. PMID:23429665

  12. Lymphedema Outcomes in Patients with Head and Neck Cancer

    PubMed Central

    Little, Leila G.; Skoracki, Roman J.; Rosenthal, David I.; Lai, Stephen Y.; Lewin, Jan S.

    2015-01-01

    Objective We sought to describe the presentation of external head and neck lymphedema in patients treated for head and neck cancer and examine their initial response to complete decongestive therapy. Study Design Case series with chart review. Setting MD Anderson Cancer Center, Houston, TX. Subjects and Methods Patients evaluated for head and neck cancer at MD Anderson Cancer Center after treatment 01/2007-01/2013 were retrospectively reviewed. Response to complete decongestive therapy was evaluated per changes in lymphedema severity rating or surface tape measures. Predictors of therapy response were examined using regression models. Results 1,202 patients were evaluated. Most patients (62%) had soft, reversible pitting edema (MDACC Stage 1b). Treatment response was evaluated in 733 patients after receiving therapy; 439 (60%) improved after complete decongestive therapy. Treatment adherence independently predicted complete decongestive therapy response (p<0.001). Conclusions These data support the effectiveness of a head and neck cancer-specific regimen of lymphedema therapy for cancer patients with external head and neck lymphedema. Our findings suggest that head and neck lymphedema is distinct from lymphedema that affects other sites, requiring adaptations in traditional methods of management and measurement. PMID:25389318

  13. Provider Communication, Self-Reported Health, and Post-Treatment Regret among Young Breast Cancer Survivors

    E-print Network

    Fernandes-Taylor, Sara

    2010-01-01

    and Buetow (2001) advocate patients and providers sharingencounter and advocates a relative increase in patients’advocate an “enhanced autonomy” model of medical care, in which the physician communicates medical information in accessible language to the patient and

  14. Cancer Patient and Survivor Research from the Cancer Information Service Research Consortium: A Preview of Three Large Randomized Trials and Initial Lessons Learned

    PubMed Central

    MARCUS, ALFRED C.; DIEFENBACH, MICHAEL A.; STANTON, ANNETTE L.; MILLER-HALEGOUA, SUZANNE N.; FLEISHER, LINDA; RAICH, PETER C.; MORRA, MARION E.; PEROCCHIA, ROSEMARIE SLEVIN; TRAN, ZUNG VU; BRIGHT, MARY ANNE

    2014-01-01

    Three large randomized trials are described from the Cancer Information Service Research Consortium (CISRC). Three web-based multimedia programs are being tested to help newly diagnosed prostate (Project 1) and breast cancer patients (Project 2) make informed treatment decisions and breast cancer patients prepare for life after treatment (Project 3). Project 3 is also testing a telephone callback intervention delivered by a cancer information specialist. All participants receive standard print material specific to each project. Preliminary results from the two-month follow-up interviews are reported for the initial wave of enrolled participants, most of whom were recruited from the Cancer Information Service (1-800-4-CANCER) telephone information program (Project 1 = 208, Project 2 = 340, Project 3 = 792). Self-reported use of the multimedia program was 51%, 52% and 67% for Projects 1–3, respectively. Self-reported use of the print materials (read all, most or some) was 90%, 85% and 83% for Projects 1–3, respectively. The callback intervention was completed by 92% of Project 3 participants. Among those using the CISRC interventions, perceived utility and benefit was high, and more than 90% would recommend them to other cancer patients. Five initial lessons learned are presented that may help inform future cancer communications research. PMID:23448232

  15. Pyroxamide in Treating Patients With Advanced Cancer

    ClinicalTrials.gov

    2013-06-04

    Chronic Myeloproliferative Disorders; Leukemia; Lymphoma; Multiple Myeloma and Plasma Cell Neoplasm; Myelodysplastic Syndromes; Precancerous Condition; Small Intestine Cancer; Unspecified Adult Solid Tumor, Protocol Specific

  16. Oral cancer chemotherapy: the critical interplay between patient education and patient safety.

    PubMed

    Halfdanarson, Thorvardur R; Jatoi, Aminah

    2010-07-01

    Currently, 10% of cancer chemotherapy is prescribed to patients by means of an oral formulation, but, by 2013, this percentage is predicted to increase to 25%. Oral chemotherapy offers many advantages, including no need for sometimes painful intravenous access, no intravenous drug administration fees, more time at home for patients, and a greater sense of patient autonomy. However, oral cancer chemotherapy also poses challenges, many of which revolve around adherence and safety. These challenges are discussed here. There are few other circumstances in which patient education and the maintenance of institutional safety infrastructure play such an integral role in sustaining favorable cancer clinical outcomes. PMID:20437116

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

    ClinicalTrials.gov

    2012-05-24

    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

  18. Doctor-patient communication in the e-health era.

    PubMed

    Weiner, Jonathan P

    2012-01-01

    The digital revolution will have a profound impact on how physicians and health care delivery organizations interact with patients and the community at-large. Over the coming decades, face-to-face patient/doctor contacts will become less common and exchanges between consumers and providers will increasingly be mediated by electronic devices.In highly developed health care systems like those in Israel, the United States, and Europe, most aspects of the health care and consumer health experience are becoming supported by a wide array of technology such as electronic and personal health records (EHRs and PHRs), biometric & telemedicine devices, and consumer-focused wireless and wired Internet applications.In an article in this issue, Peleg and Nazarenko report on a survey they fielded within Israel's largest integrated delivery system regarding patient views on the use of electronic communication with their doctors via direct-access mobile phones and e-mail. A previous complementary paper describes the parallel perspectives of the physician staff at the same organization. These two surveys offer useful insights to clinicians, managers, researchers, and policymakers on how best to integrate e-mail and direct-to-doctor mobile phones into their practice settings. These papers, along with several other recent Israeli studies on e-health, also provide an opportunity to step back and take stock of the dramatic impact that information & communication technology (ICT) and health information technology (HIT) will have on clinician/patient communication moving forward.The main goals of this commentary are to describe the scope of this issue and to offer a framework for understanding the potential impact that e-health tools will have on provider/patient communication. It will be essential that clinicians, managers, policymakers, and researchers gain an increased understanding of this trend so that health care systems around the globe can adapt, adopt, and embrace these rapidly evolving digital technologies. PMID:22929000

  19. Barbershop Communications on Prostate Cancer Screening Using Barber Health Advisers

    PubMed Central

    Luque, John S.; Rivers, Brian M.; Gwede, Clement K.; Kambon, Maisha; Green, B. Lee; Meade, Cathy D.

    2013-01-01

    Objective The authors report the outcomes of a community-based, barber health adviser pilot intervention that aims to develop customized educational materials to promote knowledge and awareness of prostate cancer (CaP) and informed decision making about prostate cancer screening (PCS) among a predominantly African American clientele. Method First, the authors implemented a series of learner verification processes with barbershop clients (n = 15) to adapt existing CaP health promotion materials. Following intervention implementation in the barbershop, they conducted structured surveys with barbershop clients (n = 40) to evaluate the intervention. Results Findings from the posttest showed both a significant increase in barbershop clients' self-reported knowledge of CaP and in the likelihood of discussing PCS with a health care provider (p < .001). The client's cultural model of CaP risk factors revealed cultural consensus (eigenratio = 3.3) and mirrored the biomedical model. All clients surveyed reported positively on the contents of the educational materials, and more than half (53%) had discussed CaP at least twice with their barber in the last month. Conclusion Based on the pilot results, the barber-administered intervention was an appropriate and viable communication channel for promoting CaP knowledge and awareness in a priority population, African American men. PMID:20413392

  20. Developing a complex intervention for the outpatient management of incidentally diagnosed pulmonary embolism in cancer patients

    PubMed Central

    2013-01-01

    Background Most patients with pulmonary embolism (PE) spend 5–7 days in hospital even though only 4.5% will develop serious complications during this time. In particular, the group of patients with incidentally diagnosed PE (i-PE) includes many patients with low risk features potentially ideal for outpatient management; however the evidence for their optimal management is lacking hence relative practices may vary considerably. We describe the development process, components, links and function of a nurse-led service for the management of patients with i-PE, developed in accordance to the UK Medical Research Council complex intervention guidance. Methods Phase 0 (Theoretical underpinning): The Pulmonary Embolism Severity Index (PESI) was selected for patient risk assessment and the American Society of Clinical Oncology (ASCO) guideline for the management of PE in cancer patients (2007) was selected as quality measure. Historical registry and audit data from our centre regarding i-PE incidence and management for the period between 2006 and 2009 illustrating the then current practices were reviewed. Phase 1 (Modelling): Modelling of the pathway included the following: a) Identification of training needs, planning and implementation of training schemes and development of transferable competencies and training materials. b) Mapping patient pathways and flow and c) Production of key documentation and Standard Operating Procedures for the delivery of the service. Results Phase 2 (Implementation and testing of the intervention): During the initial 12 months of implementation, remedial action was taken to address identified deficiencies regarding patient referral to the pathway, compliance with treatment protocol, patient follow up, selection challenges from the use of PESI in cancer patients and challenges regarding the “first-pass” identification of i-PE. Conclusion We have developed and piloted a complex intervention to manage cancer patients with incidental PE in an outpatient setting. Adherence to evidence- based care, improvement of communication between professionals and patients, and improved quality of data is demonstrated. PMID:23806053

  1. Guiding the Optimal Translation of New Cancer Treatments From Canine to Human Cancer Patients

    PubMed Central

    Khanna, Chand; London, Cheryl; Vail, David; Mazcko, Christina; Hirschfeld, Steven

    2009-01-01

    On June 20, 2008 a meeting entitled “Translation of new cancer treatments from canine to human cancer patients”, sponsored by the National Cancer Institute in Bethesda Maryland was convened to discuss the potential value, opportunity, risks and rewards of an integrated and comparative drug development path for new cancer therapeutics that includes naturally occurring cancers in pet animals. A summary of this meeting and subsequent discussion are provided here to afford clarity on the conduct of these studies so as to optimize the opportunities provided by this novel drug development and modeling strategy. PMID:19737961

  2. When mom or dad has cancer: markers of psychological distress in cancer patients, spouses, and children.

    PubMed

    Compas, B E; Worsham, N L; Epping-Jordan, J E; Grant, K E; Mireault, G; Howell, D C; Malcarne, V L

    1994-11-01

    This study assessed anxiety/depression and stress response symptoms in adult cancer patients (n = 117), spouses (n = 76), and their children (n = 110, ages 6 to 30 years old) near the patients' diagnoses to identify family members at risk for psychological maladjustment. Patients' and family members' distress was related to appraisals of the seriousness and stressfulness of the cancer but not related to objective characteristics of the disease. Patients and spouses did not differ in anxiety/depression or in stress-response symptoms. Both stress-response and anxiety/depression symptoms differed in children as a function of age, sex of child, and sex of patient. Adolescent girls whose mothers had cancer were the most significantly distressed. Implications for understanding the impact of cancer on the family are highlighted. PMID:7889905

  3. Geriatric Assessment Intervention in Reducing Chemotherapy Toxicity in Older Patients With Advanced Cancer | Division of Cancer Prevention

    Cancer.gov

    This randomized clinical trial compares geriatric assessment intervention in reducing chemotherapy toxicity in older patients with advanced cancer. A geriatric assessment may identify risk factors for chemotherapy toxicity and may improve treatment for older patients with advanced cancer.

  4. A Patient-Centered Perspective on Cancer Survivorship

    PubMed Central

    Zebrack, Brad

    2015-01-01

    Survivorship is a complicated notion because people often confuse a process of survivorship with a mythic identity of being a cancer survivor. This confusion may be a distraction to addressing the real-life struggles and challenges experienced by all people diagnosed with cancer. A more expansive perspective of survivorship, one that attends to patients’ physical, psychological, social, spiritual, and existential challenges throughout a continuum of care, would be more in line with what is known empirically about people’s experiences with cancer. In an effort to gain a patient-centered perspective on cancer, and one that emphasizes multiple dimensions of cancer survivorship, the author reports findings from a non-scientific social media poll (via Facebook and personal emails) in which survivors and colleagues working in the field of cancer survivorship answered the question: What does cancer survivorship mean to you? The comments are enlightening and useful for guiding the development of a patient-centered, and, thus, more comprehensive, approach to caring for people affected by cancer. PMID:25884369

  5. Cancer patients on Twitter: a novel patient community on social media

    PubMed Central

    2012-01-01

    Background Patients increasingly turn to the Internet for information on medical conditions, including clinical news and treatment options. In recent years, an online patient community has arisen alongside the rapidly expanding world of social media, or “Web 2.0.” Twitter provides real-time dissemination of news, information, personal accounts and other details via a highly interactive form of social media, and has become an important online tool for patients. This medium is now considered to play an important role in the modern social community of online, “wired” cancer patients. Results Fifty-one highly influential “power accounts” belonging to cancer patients were extracted from a dataset of 731 Twitter accounts with cancer terminology in their profiles. In accordance with previously established methodology, “power accounts” were defined as those Twitter accounts with 500 or more followers. We extracted data on the cancer patient (female) with the most followers to study the specific relationships that existed between the user and her followers, and found that the majority of the examined tweets focused on greetings, treatment discussions, and other instances of psychological support. These findings went against our hypothesis that cancer patients’ tweets would be centered on the dissemination of medical information and similar “newsy” details. Conclusions At present, there exists a rapidly evolving network of cancer patients engaged in information exchange via Twitter. This network is valuable in the sharing of psychological support among the cancer community. PMID:23270426

  6. Colorectal cancer in Chinese patients: current and emerging treatment options

    PubMed Central

    Li, Leung; Ma, Brigette BY

    2014-01-01

    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

  7. Cancer Patient Attitudes Towards Analgesic Utilization and Pain Intervention

    PubMed Central

    Simone, Charles B.; Vapiwala, Neha; Hampshire, Margaret K.; Metz, James M.

    2011-01-01

    Objectives Although pain is commonly experienced among cancer patients, many receive inadequate pain management. Little data exist quantifying analgesic utilization among oncology patients. This study evaluates perceived causes of pain and investigates reasons oncology patients fail to receive optimal pain management. Methods An IRB-approved questionnaire assessing pain control and analgesic utilization was posted on OncoLink. Between 11/05-7/08, 1107 patients responded. Respondents were female (73%), Caucasian (74%), educated beyond high school (64%), and had surgery (69%), chemotherapy (64%), and radiation (47%). Most had breast (30%), gastrointestinal (12%), gynecologic (11%), and lung (8%) malignancies. Results Sixty-seven percent of respondents reported pain, with 48% reporting pain directly from their cancer and 47% reporting pain from their cancer treatment. Among patients in pain, 25% did not use analgesics. Analgesic utilization was significantly less in men (44% vs. 52%, p=0.023), minorities (42% vs. 53%, p=0.001), and patients with lower education levels (45% vs. 53%, p=0.013). Utilization varied by cancer diagnosis and was higher among patients who received chemotherapy (56% vs. 40%, p<0.001) and radiation (53% vs. 47%, p=0.058). Reasons for not taking analgesics included: healthcare provider not recommending medications (85%), fearing addiction/dependence (80%), and inability to pay (76%). Many patients reporting pain, not taking analgesics, pursued alternative therapies (94%). Discussion Most cancer patients perceive pain from their disease or treatment, regardless of therapy received. Many, however, did not use analgesics due to concerns of addiction, cost, or lack of healthcare provider endorsement. Providers should regularly discuss pain symptoms and management with cancer patients. PMID:21705874

  8. Clinical Correlates of Suicidal Thoughts in Patients with Advanced Cancer

    PubMed Central

    Spencer, Ryan J.; Ray, Alaka; Pirl, William F.; Prigerson, Holly G.

    2011-01-01

    Objective Cancer patients are at heightened risk of suicide. Clinical correlates of suicidal ideation in advanced cancer patients were examined to identify those at risk and to inform the development of interventions to reduce suicidal ideation in this vulnerable group. Methods Coping with Cancer (CwC) is an NCI- and NIMH-funded multi-institutional investigation examining psychosocial influences on the quality of life and care of advanced cancer patients. Baseline face-to-face interviews that assessed mental and physical functioning, coping, spirituality, and use of mental health services were conducted with 700 advanced cancer patients. Results Compared to patients without suicidal ideation, the 8.9% of patients who reported suicidal thoughts were more likely to be white and report no affiliation with an organized religion (p<.05). Adjusted analyses revealed that cancer patients who met criteria for current Panic Disorder [adjusted OR (95% CI) 3.24 (1.01, 10.4)] and Posttraumatic Stress Disorder [3.97 (1.13, 14.1)], who accessed mental health services [3.70 (2.07, 6.67)], particularly psychotherapy [2.62 (1.20,5.71) ], who were not feeling well physically, and who lacked a sense of self-efficacy, spirituality, and being supported were more likely than others to report thoughts of suicide (p<.05). Conclusions Advanced cancer patients who report suicidal thoughts are more likely to meet criteria for posttraumatic stress disorder and panic disorder, feel unsupported, lack a religious affiliation, spirituality, and a sense of self-efficacy, and experience more physical distress. Palliative care interventions that promote a sense of self-efficacy, spirituality, and support while minimizing physical distress may offer promise for reducing suicidal thoughts in this at-risk group. PMID:21989317

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

    PubMed

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

    2014-01-01

    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

  10. Meeting the health information needs of prostate cancer patients using personal health records

    PubMed Central

    Pai, H.H.; Lau, F.; Barnett, J.; Jones, S.

    2013-01-01

    Background There is interest in the use of health information technology in the form of personal health record (phr) systems to support patient needs for health information, care, and decision-making, particularly for patients with distressing, chronic diseases such as prostate cancer (pca). We sought feedback from pca patients who used a phr. Methods For 6 months, 22 pca patients in various phases of care at the BC Cancer Agency (bcca) were given access to a secure Web-based phr called provider, which they could use to view their medical records and use a set of support tools. Feedback was obtained using an end-of-study survey on usability, satisfaction, and concerns with provider. Site activity was recorded to assess usage patterns. Results Of the 17 patients who completed the study, 29% encountered some minor difficulties using provider. No security breaches were known to have occurred. The two most commonly accessed medical records were laboratory test results and transcribed doctor’s notes. Of survey respondents, 94% were satisfied with the access to their medical records, 65% said that provider helped to answer their questions, 77% felt that their privacy and confidentiality were preserved, 65% felt that using provider helped them to communicate better with their physicians, 83% found new and useful information that they would not have received by talking to their health care providers, and 88% said that they would continue to use provider. Conclusions Our results support the notion that phrs can provide cancer patients with timely access to their medical records and health information, and can assist in communication with health care providers, in knowledge generation, and in patient empowerment. PMID:24311957

  11. Visual communication interface for severe physically disabled patients

    NASA Astrophysics Data System (ADS)

    Savino, M. J.; Fernández, E. A.

    2007-11-01

    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.

  12. Can Quality of Life Assessments Differentiate Heterogeneous Cancer Patients?

    PubMed Central

    McCabe, Ryan M.; Grutsch, James F.; Nutakki, Swetha B.; Braun, Donald P.; Markman, Maurie

    2014-01-01

    Purpose This research conducted a face validation study of patient responses to the application of an HRQOL assessment research tool in a comprehensive community cancer program setting across a heterogeneous cohort of cancer patients throughout the natural history of diagnosed malignant disease, many of whom would not be considered candidates for clinical research trial participation. Methods Cancer registries at two regional cancer treatment centers identified 11072 cancer patients over a period of nine years. The EORTC QLQ-C30 was administered to patients at the time of their initial clinical presentation to these centers. To determine the significance of differences between patient subgroups, two analytic criteria were used. The Mann-Whitney test was used to determine statistical significance; clinical relevance defined a range of point differences that could be perceived by patients with different health states. Results Univariate analyses were conducted across stratification variables for population, disease severity and demographic characteristics. The largest differences were associated with cancer diagnosis and recurrence of disease. Large differences were also found for site of origin, mortality and stage; minimal differences were observed for gender and age. Consistently sensitive QoL scales were appetite loss, fatigue and pain symptoms, and role (work-related), social and physical functions. Conclusions 1) The EORTC QLQ-C30 collected meaningful patient health assessments in the context of non-research based clinical care, 2) patient assessment differences are manifested disparately across 15 QoL domains, and 3) in addition to indicating how a patient may feel at a point in time, QoL indicators may also reveal information about underlying biological responses to disease progression, treatments, and prospective survival. PMID:24919068

  13. Surgical management of gastric cancer: Review and consideration for total care of the gastric cancer patient

    Microsoft Academic Search

    Samielle Brancato; Thomas J. Miner

    2008-01-01

    Opinion statement  Surgical therapy remains the most effective modality in the treatment of gastric cancer. Staging laparoscopy with laparoscopic\\u000a ultrasound may increase the accuracy of staging and prevent patients with unresectable gastric cancer from undergoing unnecessary\\u000a operations. Resection of proximal and distal gastric cancer is best accomplished with an appropriate gastrectomy that ensures\\u000a adequate resection margins. A D2 lymphadenectomy can be

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

    Microsoft Academic Search

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

    2010-01-01

    Purpose  The increase of breast cancer in young women under 40 years and the increasing age of women at the time of the birth of their\\u000a first child underlines the importance to implement counselling for fertility-preserving strategies in the management of breast\\u000a cancer care. We present the fertility-preserving procedures performed after routine counselling for primary breast cancer\\u000a patients in a large certified

  15. Sperm banking: fertility preservation for male patients with cancer.

    PubMed

    Frankel Kelvin, Joanne

    2015-02-01

    Sperm banking (SB) involves collecting and freezing sperm for potential future use. It is a simple, noninvasive way for male patients with cancer to preserve their ability to have biologic children. This article provides the information needed by nurses to effectively discuss SB with their patients. PMID:25689656

  16. Electron arc therapy: chest wall irradiation of breast cancer patients

    Microsoft Academic Search

    Lee K. McNeely; Geraldine M. Jacobson; Dennis D. Leavitt; J. Robert Stewart

    1988-01-01

    From 1980 to October 1985 we treated 45 breast cancer patients with electron arc therapy. This technique was used in situations where optimal treatment with fixed photon or electron beams was technically difficult: long scars, recurrent tumor extending across midline or to the posterior thorax, or marked variation in depth of target tissue. Forty-four patients were treated following mastectomy: 35

  17. Stress Encountered by Significant Others of Cancer Patients Receiving Chemotherapy.

    ERIC Educational Resources Information Center

    Hart, Kay

    1987-01-01

    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…

  18. Staging Laparoscopy and Its Indications in Pancreatic Cancer Patients

    Microsoft Academic Search

    René Hennig; Adrien A. Tempia-Caliera; Marc Hartel; Markus W. Büchler; Helmut Friess

    2002-01-01

    Background: Laparoscopy has become a popular and widespread surgical technique. An important goal in the treatment of patients with pancreatic cancer is to avoid any unnecessary procedure. Laparoscopy has been suggested as a routine tool for staging in order to prevent unnecessary laparotomies in these patients. Methods: In this article we present our experience regarding the value of laparoscopic staging

  19. Clinical evaluation and treatment of insomnia in patients with cancer

    Microsoft Academic Search

    Edward J. Stepanski

    Insomnia is a common symptom among patients treated for cancer. Chronic insomnia has been linked to increased levels of pain, depression, and fatigue and is therefore an appropriate target for evaluation and treatment. Assessment should establish the severity of insomnia and detect common comorbidities to optimize treatment. Several trials have shown that cognitive-behavioral treatment of insomnia is effective for patients

  20. Internet Use for Prediagnosis Symptom Appraisal by Colorectal Cancer Patients

    ERIC Educational Resources Information Center

    Thomson, Maria D.; Siminoff, Laura A.; Longo, Daniel R.

    2012-01-01

    Background: This study explored the characteristics of colorectal cancer (CRC) patients who accessed Internet-based health information as part of their symptom appraisal process prior to consulting a health care provider. Method: Newly diagnosed CRC patients who experienced symptoms prior to diagnosis were interviewed. Brief COPE was used to…

  1. Cancer biomarkers: selecting the right drug for the right patient

    Microsoft Academic Search

    Gary J. Kelloff; Caroline C. Sigman

    2012-01-01

    This Perspective highlights biomarkers that are expressed as a consequence of cancer development and progression. We focus on those biomarkers that are most relevant for identifying patients who are likely to respond to a given therapy, as well as those biomarkers that are most effective for measuring patient response to therapy. These two measures are necessary for selecting the right

  2. Cancer-related Fatigue in Patients with Advanced Cancer Treated with Autonomic Nerve Pharmacopuncture.

    PubMed

    Park, Ji-Hye; Jeon, Hyung-Jun; Kang, Hwi-Joong; Jeong, In-Sook; Cho, Chong-Kwan; Yoo, Hwa-Seung

    2015-06-01

    The purpose of this study was to observe the effects of autonomic nerve pharmacopuncture (ANP) treatment on cancer-related fatigue (CRF) in patients with advanced cancer. This observational case study was conducted at the East West Cancer Center of Daejeon University's Dunsan Korean Medical Hospital. Two patients were observed. One patient was diagnosed with left thymic cancer metastatic to the left pleura. The other patient had terminal-stage cervical cancer with iliac bone and lumbar 5 metastases. We injected mountain ginseng pharmacopuncture (MGP) into acupoints alongside the spine (Hua-Tuo-Jia-Ji-Xue, EX B2). We examined the patients for CRF using the Korean version of the Revised Piper Fatigue Scale (RPFS-K), which is a self-assessment tool. The scores on the RPFS-K for both patients tended to decrease during the treatment. Laboratory findings, including hematological changes, were also checked. Liver and renal function tests showed that the treatment was safe. Although further large-population studies are necessary, this case study suggests that ANP has a favorable effect on CRF in patients with advanced cancer. PMID:26100068

  3. Predictors of supportive message expression and reception in an interactive cancer communication system.

    PubMed

    Kim, Eunkyung; Han, Jeong Yeob; Shah, Dhavan; Shaw, Bret; McTavish, Fiona; Gustafson, David H; Fan, David

    2011-11-01

    Social support in computer-mediated settings is an important variable in health communication research, yet little is known about the factors that influence the amount of social support one gives and receives in online support groups. To shed some light on this issue, the authors examined demographics, disease-related factors, psychosocial factors, and strategies for coping with breast cancer as potential determinants of which patients provide support to others and which ones consume it. Data collected from 177 participants in the Comprehensive Health Enhancement Support System "Living With Breast Cancer" program revealed that individuals who are younger, have higher levels of positive reframing, and lower levels of self-blame are more likely to provide emotional support in online settings. In contrast, individuals who are more educated, have less perceived availability of social support, and have lower levels of religious coping are more likely to receive emotional support from others. The authors discuss the theoretical and practical implications for providing effective psychosocial support for women with breast cancer. PMID:22070449

  4. Erlotinib Hydrochloride in Treating Patients With Bladder Cancer Undergoing Surgery | Division of Cancer Prevention

    Cancer.gov

    This randomized phase II trial studies how well erlotinib hydrochloride works in treating patients with bladder cancer undergoing surgery. Erlotinib hydrochloride may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

  5. The cancer "fear" in IBD patients: is it still REAL?

    PubMed

    Connelly, T M; Koltun, W A

    2014-01-01

    Increased rates of colorectal cancer (CRC) with high rates of progression from dysplasia to CRC are well documented in the inflammatory bowel disease (IBD) population. This increased risk in the presence of currently improving but still inadequate surveillance techniques confirms that the cancer "fear" in IBD patients is still real. The majority of data on the cancer risk in IBD has been gathered from ulcerative colitis (UC) patients as these patients are generally better studied. Thus surveillance and treatment protocols for Crohn's disease (CD) are frequently modeled on UC paradigms. Dysplasia in the IBD cohort frequently is a harbinger of local, distant, or metachronous neoplasia. Therefore, frequent surveillance and referral for surgical intervention when dysplasia is detected are justified in both the CD and UC patient. PMID:24002760

  6. Nonpharmacologic approach to fatigue in patients with cancer.

    PubMed

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

    2014-01-01

    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

  7. Patient-Specific Data Fusion Defines Prognostic Cancer Subtypes

    PubMed Central

    Markowetz, Florian

    2011-01-01

    Different data types can offer complementary perspectives on the same biological phenomenon. In cancer studies, for example, data on copy number alterations indicate losses and amplifications of genomic regions in tumours, while transcriptomic data point to the impact of genomic and environmental events on the internal wiring of the cell. Fusing different data provides a more comprehensive model of the cancer cell than that offered by any single type. However, biological signals in different patients exhibit diverse degrees of concordance due to cancer heterogeneity and inherent noise in the measurements. This is a particularly important issue in cancer subtype discovery, where personalised strategies to guide therapy are of vital importance. We present a nonparametric Bayesian model for discovering prognostic cancer subtypes by integrating gene expression and copy number variation data. Our model is constructed from a hierarchy of Dirichlet Processes and addresses three key challenges in data fusion: (i) To separate concordant from discordant signals, (ii) to select informative features, (iii) to estimate the number of disease subtypes. Concordance of signals is assessed individually for each patient, giving us an additional level of insight into the underlying disease structure. We exemplify the power of our model in prostate cancer and breast cancer and show that it outperforms competing methods. In the prostate cancer data, we identify an entirely new subtype with extremely poor survival outcome and show how other analyses fail to detect it. In the breast cancer data, we find subtypes with superior prognostic value by using the concordant results. These discoveries were crucially dependent on our model's ability to distinguish concordant and discordant signals within each patient sample, and would otherwise have been missed. We therefore demonstrate the importance of taking a patient-specific approach, using highly-flexible nonparametric Bayesian methods. PMID:22028636

  8. Palliative care for cancer patients in Sudan: an overview

    PubMed Central

    Gafer, Nahla; Elhaj, Ahmed

    2014-01-01

    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. PMID:25624872

  9. Communication of Pulmonary Function Test Results: A Survey of Patient’s Preferences

    PubMed Central

    Zagami, Debbie; Hockenhull, Jessica; Bodger, Alanna; Sriram, Krishna Bajee

    2015-01-01

    Introduction Physician-patient communication in patients suffering from common chronic respiratory disease should encompass discussion about pulmonary function test (PFT) results, diagnosis, disease education, smoking cessation and optimising inhaler technique. Previous studies have identified that patients with chronic respiratory disease/s often express dissatisfaction about physician communication. Currently there is a paucity of data regarding patient awareness of their PFT results (among those who have undergone PFTs previously) or patient preferences about PFT result communication. Methods We undertook a three-month prospective study on outpatients referred to two Pulmonary Function Laboratories. If subjects had undergone PFTs previously, the awareness of their previous test results was evaluated. All subjects were asked about their preferences for PFT result communication. Subjects were determined to have chronic respiratory disease based on their past medical history. Results 300 subjects (50% male) with a median age (±SD) of 65 (±14) years participated in the study. 99% of the study participants stated that they were at least moderately interested in knowing their PFT results. 72% (217/300) of the subjects had undergone at least one PFT in the past, 48% of whom stated they had not been made aware of their results. Fewer subjects with chronic respiratory disease preferred that only a doctor discuss their PFT results with them (28% vs. 41%, p = 0.021). Conclusion Our study demonstrates that while almost all subjects want to be informed of their PFT results, this does not occur in a large number of patients. Many subjects are agreeable for their PFT results to be communicated to them by clinicians other than doctors. Further research is required to develop an efficient method of conveying PFT results that will improve patient satisfaction and health outcomes. PMID:25950951

  10. Psychiatric benefits of integrative therapies in patients with cancer.

    PubMed

    Cassileth, Barrie R

    2014-02-01

    Integrative oncology uses non-pharmacological adjuncts to mainstream care to manage physical, emotional, and psychological symptoms experienced by cancer survivors. Depression, anxiety, fatigue and pain are among the common, often burdensome symptoms that can occur in clusters, deplete patient morale, interfere with treatment plans, and hamper recovery. Patients already seek various modalities on their own to address a broad range of problems. Legitimate complementary therapies offered at major cancer institutions improve quality of life, speed recovery, and optimize patient support. They also augment the benefits of psychiatric interventions, due to their ability to increase self-awareness and improve physical and psychological conditioning. Further, these integrated therapies provide lifelong tools and develop skills that patients use well after treatment to develop self-care regimens. The active referral of patients to integrative therapies achieves three important objectives: complementary care is received from therapists experienced in working with cancer patients, visits become part of the medical record, allowing treatment teams to guide individuals in maximizing benefit, and patients are diverted from useless or harmful 'alternatives.' We review the reciprocal physical and psychiatric benefits of exercise, mind-body practices, massage, acupuncture, and music therapy for cancer survivors, and suggest how their use can augment mainstream psychiatric interventions. PMID:24716505

  11. Body Image Screening for Cancer Patients Undergoing Reconstructive Surgery

    PubMed Central

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

    2014-01-01

    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

  12. Quality of life measurement in patients with oesophageal cancer.

    PubMed Central

    Blazeby, J M; Williams, M H; Brookes, S T; Alderson, D; Farndon, J R

    1995-01-01

    Quality of life (QOL) measurement may aid decision making in the treatment of patients with oesophageal cancer but must be clinically valid to be useful. This study considered if the European Organisation for Research and Treatment of Cancer QOL questionnaire, the QLQ-C30, showed differing results in two clinically distinct groups of patients with oesophageal cancer and also investigated the correlation between dysphagia grade and various scales of QOL. Patients treated by oesophagectomy reported significantly better physical, emotional, cognitive, and global health scores than those in the palliative treatment group. Patients who received palliative treatment had significantly worse pain, fatigue, appetite loss, constipation, and dysphagia. The correlations between dysphagia grade and each of the QOL scales and items in both groups of patients were poor. This questionnaire differentiates clearly between the two clinically distinct groups of patients, but to be an entirely appropriate indicator of QOL in patients with oesophageal cancer, an additional specific oesophageal module including a dysphagia scale is required. PMID:7489936

  13. Dysphagia in Head and Neck Cancer Patients Treated with Chemoradiotherapy

    Microsoft Academic Search

    Nele Platteaux; Piet Dirix; Eddy Dejaeger; Sandra Nuyts

    2010-01-01

    Dysphagia is a very common complaint of head and neck cancer patients and can exist before, during, and after chemoradiotherapy.\\u000a It leads to nutritional deficiency, weight loss, and prolonged unnatural feeding and also has a major potential risk for aspiration.\\u000a This has a significant negative impact on the patient’s entire quality of life. Because treatment of dysphagia in this setting

  14. Estimation of glomerular filtration rate in cancer patients

    Microsoft Academic Search

    J G Wright; A V Boddy; M Highley; J Fenwick; A McGill; A H Calvert

    2001-01-01

    The frequent need to obtain an estimate of renal function in cancer patients, not least for targeting carboplatin dose, has led to a number of approaches to estimate glomerular filtration rate (GFR). This study aimed to develop a simple and reliable method to estimate GFR using readily-available patient characteristics. Data from 62 patients with estimates of 51Cr-EDTA clearance were analysed

  15. A Week of Excitement and Hope: Communicating the Story of Cancer

    Cancer.gov

    As an employee of the National Cancer Institute, I take great pride in the fact that our researchers conduct science that is necessary for improving the treatment, prevention, and diagnosis of the diseases we call cancer. As the leader of NCI’s communications efforts, I am honored to have the opportunity to support my scientific colleagues by communicating the work that we do to a global audience.

  16. Early rehabilitation of cancer patients – a randomized controlled intervention study

    PubMed Central

    2013-01-01

    Background Faced with a life-threatening illness, such as cancer, many patients develop stress symptoms, i.e. avoidance behaviour, intrusive thoughts and worry. Stress management interventions have proven to be effective; however, they are mostly performed in group settings and it is commonly breast cancer patients who are studied. We hereby present the design of a randomized controlled trial (RCT) evaluating the effectiveness and cost-effectiveness of an individual stress-management intervention with a stepped-care approach in several cancer diagnoses. Method Patients (? 18 years) with a recent diagnosis of breast cancer, colorectal cancer, lymphoma, prostate cancer or testicle cancer and scheduled for adjuvant/curative oncology treatment, will consecutively be included in the study. In this prospective longitudinal intervention study with a stepped-care approach, patients will be randomized to control, treatment as usual, or an individual stress-management intervention in two steps. The first step is a low-intensity stress-management intervention, given to all patients randomized to intervention. Patients who continue to report stress symptoms after the first step will thereafter be given more intensive treatment at the second step of the programme. In the intervention patients will also be motivated to be physically active. Avoidance and intrusion are the primary outcomes. According to the power analyses, 300 patients are planned to be included in the study and will be followed for two years. Other outcomes are physical activity level, sleep duration and quality recorded objectively, and anxiety, depression, quality of life, fatigue, stress in daily living, and patient satisfaction assessed using valid and standardized psychometric tested questionnaires. Utilization of hospital services will be derived from the computerized patient administration systems used by the hospital. The cost-effectiveness of the intervention will be evaluated through a cost-utility analysis. Discussion This RCT will provide empirical evidence of whether an individually administered stress-management programme in two steps can decrease stress as well as maintain or enhance patients’ physical activity level, quality of life and psychological well-being. Further, this RCT, with a stepped-care approach, will provide knowledge regarding the cost-effectiveness of an individually administered stress-management programme whose aim is to help and support individual patients at the right level of care. Trial registration ClinicalTrials.gov Identifier: NCT 01588262. PMID:23294513

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

    PubMed

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

    2012-05-01

    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

  18. [The perception by nurses of the significance of palliative care in patients with terminal cancer].

    PubMed

    Fernandes, Maria Andréa; Evangelista, Carla Braz; Platel, Indiara Carvalho dos Santos; Agra, Glenda; Lopes, Marineide de Souza; Rodrigues, Francileide de Araújo

    2013-09-01

    This study sought to assess the perception of nurses with respect to cancer patients under palliative care. It is an exploratory study with a qualitative approach conducted with nurses from a hospital attending cancer patients under palliative care located in the city of João Pessoa, State of Paraíba. The study included nine nurses who worked in the hospital. The empirical material was collected using the technique of semi-structured interviews and analyzed using the content analysis technique. The interpretative analysis of the interviews led to the definition of three categories: Improving the quality of life through the alleviation of pain and suffering; Palliative Care: a multi-professional study of terminal patients and their families in the grieving process; Communication: a source of dignity in the terminal care process. The conclusion reached is that the study revealed that the nurses involved acknowledge the importance of the multidisciplinary team. It enables the nurses to reflect on the use of communication as an essential element of care for patient and family under palliative care. It is hoped that the data obtained may foster further research on the topic. PMID:23989565

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

    PubMed Central

    Wolf, Jacqueline H; Wolf, Kevin S

    2013-01-01

    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

  20. Cancer Patients’ Preferences for Control at the End of Life

    PubMed Central

    Volker, Deborah L.; Wu, Hung-Lan

    2011-01-01

    The achievement of a death consistent with personal preferences is an elusive outcome for most people with cancer. Maintaining a sense of control is a core component of a dignified death; however, control might be a Western bioethical notion with questionable relevance to culturally diverse groups. Thus, the purpose of our study was to explore the meaning of control and control preferences in a group of racially and ethnically diverse patients with an advanced cancer diagnosis. Using a hermeneutic, phenomenological approach, we interviewed 20 patients with advanced cancer and uncovered two themes: (a) preferences for everyday control over treatment decisions, family issues, final days of life, and arrangements after death, versus (b) awareness that cancer and death are controlled by a higher power. Although the sample included non-Hispanic Whites, African Americans, and Hispanics, participants shared common views that are characteristic of American cultural norms regarding the value of autonomy. PMID:21734224

  1. [Dental state in patients with head and neck cancers].

    PubMed

    Rouers, M; Truntzer, P; Dubourg, S; Guihard, S; Antoni, D; Noël, G

    2015-05-01

    In France, in 2005, there were approximately 16,000 new cases of head and neck cancer. These cancers have an unfavourable prognosis: the survival rates at 3 and 10 years are 50% and 10% respectively. The consumption of alcohol and tobacco is the most important risk factor; in some countries HPV infection was identified as a risk factor of head and neck tumours. Furthermore, a poor oral hygiene seems to raise this risk. We found many decay and periodontium problems in patients with an upper aerodigestive tract cancer. An evaluation of dental state is necessary before any cancer treatment. Treatments by radiotherapy engender noxious effects: hypocellular, hypovascularization, hypoxie of the irradiated tissues, which lead to immediate and chronically oral complications such as mucositis, fibrosis, xerostomia, decay, or osteoradionecrosis. An oral follow-up of these patients can prevent these complications, or reduce the severity of oral complications, and promote a good oral state. PMID:25937188

  2. Communicating science to our patients and the public.

    PubMed

    Mandel, I D

    1994-01-01

    Communicating dental science, especially on issues of health and safety, is assuming increased importance in dental practice and in the relation of the profession to the public. Effective risk communication requires knowledge, balance and sensitivity to the concerns of our patients and the public. It is a skill that takes preparation, training and practice, and schools and professional organizations should be encouraged to include it in their educational programs. Presenting dental science to the public is a more difficult challenge than for the individual patient since there is no readily available site for exchange, such as the office, and no personally established relationship, credibility or trust. A larger cadre of trained spokespersons from the practice, public health, academic and research communities is needed, and more extensive multi-lingual and multi-cultural educational material should be made available for community outreach. Oral presentations to the public require different skills of both a verbal and nonverbal nature than for office communication or professional group presentation-and guidelines are offered. PMID:7829772

  3. Cancer-related fatigue: Links with inflammation in cancer patients and survivors

    PubMed Central

    Bower, Julienne E.

    2013-01-01

    Fatigue is one of the most common and distressing side effects of cancer and its treatment and may persist long after successful treatment completion. Emerging evidence suggests that inflammatory processes may be involved in cancer-related fatigue both during and after treatment. In this review, we consider the evidence for an association between inflammation and fatigue in cancer patients and survivors. Further, we identify potential mechanisms for persistent inflammation, focusing on the HPA axis. Risk factors and treatments for cancer-related fatigue are also discussed. PMID:17543499

  4. The relationship between patient physiology and cancer-specific survival following curative resection of colorectal cancer

    PubMed Central

    Jenkins, J T; O'Neill, G; Morran, C G

    2007-01-01

    The impact of patient physiology on cancer-specific survival is poorly documented. Patient physiology predicted overall, cancer-specific (Physiology Score>30; HR 8.64 (95% CI 3.00–24.92); P=0.0005) and recurrence-free survival (Physiology Score >30; HR 7.44 (95% CI 1.99–27.73); P=0.003) independent of Dukes stage following potentially curative surgery for colorectal cancer. This independent negative association with survival is a novel observation. PMID:17242695

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

    PubMed Central

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

    2001-01-01

    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

  6. | Office of Cancer Genomics

    Cancer.gov

    Welcome to the first National Cancer Institute (NCI) Office of Cancer Genomics (OCG) electronic newsletter. We are proud to launch this new communication tool to provide updates on ongoing projects, announce new projects, and highlight how OCG's efforts further the NCI mission to improve the lives of cancer patients by advancing the understanding of cancer's mechanisms at the molecular level.

  7. Patients’ Perspective of the Design of Provider-Patients Electronic Communication Services

    PubMed Central

    Silhavy, Petr; Silhavy, Radek; Prokopova, Zdenka

    2014-01-01

    Information Delivery is one the most important tasks in healthcare practice. This article discusses patient’s tasks and perspectives, which are then used to design a new Effective Electronic Methodology. The system design methods applicable to electronic communication in the healthcare sector are also described. The architecture and the methodology for the healthcare service portal are set out in the proposed system design. PMID:24927038

  8. Alteration of the langerhans islets in pancreatic cancer patients

    Microsoft Academic Search

    Bruno M. Schmied; Alexis B. Ulrich; Hosei Matsuzaki; Chunhui Li; Helmut Friess; Markus W. Böchler; Åke Andrøn-Sandberg; Thomas E. Adrian; Parviz M. Pour

    2000-01-01

    Summary  An abnormal glucose metabolism occurs in up to 80% of pancreatic cancer patients shortly or a few months before the first\\u000a clinical admission. Reasons for this abnormality are obscure. We investigated immunohistochemically the pattern of islets\\u000a in 14 pancreatic cancer specimens and used 14 chronic pancreatitis samples and 10 normal pancreata as controls. To study the\\u000a topographical relationship of these

  9. Brain metastasis: analysis of patients without known cancer

    SciTech Connect

    Dhopesh, V.P.; Yagnik, P.M.

    1985-02-01

    A retrospective review of the charts of patients receiving radiation therapy for brain metastasis revealed that one third presented neurologic symptoms without prior diagnosis of cancer. Lung cancer was detected in two thirds of this group, and in one third, the primary site remained unknown. There was good clinical and CT correlation. CT scans with and without contrast injection were evaluated in the study. 6 references, 4 tables.

  10. Artificial Nutrition in Cancer Patients: Which Route, What Composition?

    Microsoft Academic Search

    Federico Bozzetti; Cecilia Gavazzi; Luigi Mariani; Flavio Crippa

    1999-01-01

    .   The state of art of artificial nutrition in depleted cancer patients is reviewed in brief. Because cancer cachexia cannot\\u000a be equated to simple nutrient deficiency but is due instead to complex metabolic abnormalities, the nutritional effects of\\u000a total parenteral (TPN) and enteral (EN) nutrition are more limited than in starving subjects. TPN and EN usually prevent further\\u000a deterioration of

  11. Risk of Bladder Cancer Among Diabetic Patients Treated With Pioglitazone

    PubMed Central

    Lewis, James D.; Ferrara, Assiamira; Peng, Tiffany; Hedderson, Monique; Bilker, Warren B.; Quesenberry, Charles P.; Vaughn, David J.; Nessel, Lisa; Selby, Joseph; Strom, Brian L.

    2011-01-01

    OBJECTIVE Some preclinical in vivo studies and limited human data suggest a possible increased risk of bladder cancer with pioglitazone therapy. This is an interim report of an ongoing cohort study examining the association between pioglitazone therapy and the risk of bladder cancer in patients with diabetes. RESEARCH DESIGN AND METHODS This study includes 193,099 patients in the Kaiser Permanente Northern California diabetes registry who were ?40 years of age between 1997 and 2002. Those with prior bladder cancer were excluded. Ever use of each diabetes medication (defined as two or more prescriptions within 6 months) was treated as a time-dependent variable. Cox regression–generated hazard ratios (HRs) compared pioglitazone use with nonpioglitazone use adjusted for age, sex, race/ethnicity, diabetes medications, A1C, heart failure, household income, renal function, other bladder conditions, and smoking. RESULTS The group treated with pioglitazone comprised 30,173 patients. There were 90 cases of bladder cancer among pioglitazone users and 791 cases of bladder cancer among nonpioglitazone users. Overall, ever use of pioglitazone was not associated with risk of bladder cancer (HR 1.2 [95% CI 0.9–1.5]), with similar results in men and women (test for interaction P = 0.8). However, in the a priori category of >24 months of therapy, there was an increased risk (1.4 [1.03–2.0]). Ninety-five percent of cancers diagnosed among pioglitazone users were detected at early stage. CONCLUSIONS In this cohort of patients with diabetes, short-term use of pioglitazone was not associated with an increased incidence of bladder cancer, but use for more than 2 years was weakly associated with increased risk. PMID:21447663

  12. Salmonella enterica Pneumonia in a Patient with Lung Cancer

    Microsoft Academic Search

    George Samonis; Sofia Maraki; Charalambos Kouroussis; Dimitrios Mavroudis; Vassilios Georgoulias

    2003-01-01

    CASE REPORT The patient was a 72-year-old white male with small cell lung cancer, diagnosed 10 months prior to the present admission. He was initially treated for his cancer with three cycles of chemotherapy with cisplatin and etoposide, with partial re- sponse. The therapeutic effort was continued with radiation treatment of the primary tumor followed by second-line che- motherapy with

  13. [Between threat and hope - fertility preservation in young cancer patients].

    PubMed

    Tschudin, Sibil; Urech, Corinne

    2013-09-18

    Recent advances in cancer therapy have resulted in an increased number of long-term cancer survivors. Infertility, however, might be the consequence of an efficient cancer treatment. For young patients affected by cancer accesses to the partly established and partly still experimental options to preserve fertility are crucial. As decisions on fertility preservation have to be made in the short time period after diagnosis and before onset of cancer treatment, counselling is challenging. Based on an overview on technical options to preserve fertility, the ethical dilemma will be discussed and the nowadays available study results concerning the psychological dimension and the requirements for counselling will be presented. Due to the complexity of the topic a multidisciplinary approach considering experts' recommendations is indispensable. PMID:24025174

  14. Cancer incidence risks to patients due to hysterosalpingography

    PubMed Central

    Gyekye, Prince K.; Emi-Reynolds, Geoffrey; Boadu, Mary; Darko, Emmanuel O.; Yeboah, Johnson; Inkoom, Stephen; Mensah, Cynthia K.

    2012-01-01

    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

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

    PubMed Central

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

    2013-01-01

    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

  16. Safety considerations for erythropoietin treatment in patients with cancer.

    PubMed

    Pirker, Robert

    2007-01-01

    Cancer-related anaemia, which affects many patients with cancer, can effectively be treated by erythropoietic proteins. Erythropoietic proteins increase haemoglobin levels, reduce the risk for transfusions and also improve the quality of life of patients. When used according to published practice guidelines, these proteins benefit many patients and are generally well tolerated. Important side effects are hypertension and thromboembolic events, either of which occurs in < 10% of the patients. Administration only in anaemic patients, avoidance of target haemoglobin levels > 130 g/l, proper dose adjustments and close monitoring during treatment will ensure the clinical safety of these proteins. However, the association between erythropoietic proteins and outcome of anticancer therapy, including survival, requires further study. PMID:17181453

  17. Head and neck cancer patients' quality of life.

    PubMed

    Nelke, Kamil H; Pawlak, Wojciech; Gerber, Hanna; Leszczyszyn, Jaros?aw

    2014-01-01

    Patients suffering from head and neck cancers often require a multidisciplinary approach before and after surgery. Restoration of facial esthetics, speech, mastication and others often requires a long-lasting, divided rehabilitation. Quality of life (QOL) is measurable in a patient's life before and after surgery and complete treatment. The state of QOL has different parameters depending on the patient's clinical diagnosis, type of treatment and surgeries performed. In this paper, the authors are focusing on the quality of life of patients suffering from head and neck cancers and a proper multidisciplinary approach to achieving proper functions will be described. Also, the patient's self-esteem improvement and psychological evaluation is necessary. PMID:25618131

  18. Psychological Distress among Prostate Cancer Patients: Fact Or Fiction?

    PubMed Central

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

    2008-01-01

    Although the detrimental effect upon psychological well-being of receiving a diagnosis of, or treatment for, cancer has been demonstrated across many different types of cancer, three recent reviews of the psychological health of prostate cancer patients have produced contradictory conclusions. In order to elucidate the reasons for these apparent different conclusions, each of these reviews is described, with principal methods and findings summarised. Actual data, methodology used to select/reject research studies for inclusion in reviews, plus the validity of strict methodological culling of some research studies are discussed. Several extra studies and commentaries are also described, and a resolution of the apparent contradictory review conclusions is offered. PMID:21892333

  19. [Combined therapy for patients with invasive bladder cancer].

    PubMed

    Startsev, V Iu; Karelin, M I

    2003-01-01

    Organ preservation has been investigated inmuscle-invasivebladder cancer over the past years as an alternative to standard radical cystectomy. However, the morbidity of radical cystectomy and early reports of good results of radical transuretheral resection of bladder tumors (TURBT) have stimulated interest in combined treatment for muscle-invasive bladder cancer. Organ preservation requires a trimodal schedule, including transuretheral surgery, mega voltage radical external beam radiotherapy (EBRT) and adjuvant chemotherapy (ACT). Our results point to the effectiveness of combined therapy of urinary bladder in old patients with invasive, advanced cancer (stage T2). These results demonstrate the effectness of intra-arterial ACT when used in combination with EBRT. PMID:12785212

  20. Survival rates of cervical cancer patients in Malaysia.

    PubMed

    Muhamad, Nor Asiah; Kamaluddin, Muhammad Amir; Adon, Mohd Yusoff; Noh, Mohamed Asyraf; Bakhtiar, Mohammed Faizal; Ibrahim Tamim, Nor Saleha; Mahmud, Siti Haniza; Aris, Tahir

    2015-01-01

    Cervical cancer is the most common malignant cancer of the female reproductive organs worldwide. Currently, cervical cancer can be prevented by vaccination and detected at an early stage via various screening methods. Malaysia, as a developing country faces a heavy disease burden of cervical cancer as it is the second most common cancer among Malaysian women. This population based study was carried out to fulfil the primary aim of determining the survival rates of Malaysian women with cervical cancer and associated factors. Data were obtained from two different sources namely, the Malaysian National Cancer Registry (MNCR) and National Health Informatics Centre (NHIC) from 1st January 2000 to 31st December 2005. Kaplan Meier analyses were conducted to identify the overall survival rates and median survival time. Differences in survival among different ethnic and age group were compared using the log-rank test. A total of 5,859 patients were included. The median survival time for cervical cancer in this study was 65.8 months and the 5-year survival rate was 71.1%. The overall observed survival rates at 1, 3 and 5 years were 94.1%, 79.3% and 71.1% respectively. The log-rank test finding also showed that there were significant differences in the 5-year survival rate among different ethnic groups. Malays had the lowest survival rate of 59.2% followed by Indians (69.5%) and Chinese (73.8%). The overall 5-year survival rate among patients with cervical cancer in Malaysia is relatively good. Age and ethnic groups remain as significant determining factors for cervical cancer survival rate. PMID:25854407

  1. Psychosocial correlates of appointment keeping in immigrant cancer patients.

    PubMed

    Costas-Muniz, Rosario; Leng, Jennifer; Diamond, Lisa; Aragones, Abraham; Ramirez, Julia; Gany, Francesca

    2015-01-01

    This study aims to determine the psychosocial correlates of self-reported adherence to cancer treatment appointments and treatment delays and interruptions. The sample included 622 immigrant cancer patients from New York City. Patients completed a survey that included sociodemographic and health-related questions, questions assessing missed appointments and delays/or interruptions, and quality of life and depression scales. After controlling for sociodemographic characteristics, having a positive depression screen and poor physical and emotional well-being were significant predictors of missed appointments and delays and/or interruptions of treatment. Non-adherence to treatment appointments in immigrant cancer patients is a complex outcome related to important modifiable or treatable factors. PMID:25574581

  2. Vaginal Estrogen Therapy for Patients with Breast Cancer.

    PubMed

    Moegele, M; Buchholz, S; Seitz, S; Lattrich, C; Ortmann, O

    2013-10-01

    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

  3. Small bowel diverticulosis in patient with early gastric cancer.

    PubMed

    Kim, Pyeong Su; Jung, Eun-Joo; Bang, Ho Yoon

    2014-10-01

    Jejunal and ileal diverticula are rare in adults. Duodenal diverticula are five times more prevalent than jejunoileal diverticula. Most patients are asymptomatic. However, chronic symptoms including intermittent abdominal pain, flatulence, diarrhea and constipation are seen in 10%-30% of patients. Gastric cancer is the second most common cancer in South Korea and here we report a case of early gastric cancer with multiple duodenal and jejunal diverticula. A 67-year-old woman was admitted to Konkuk University Medical Center with chronic diarrhea and weight loss of 19 kg over 2 months. Following gastroduodenoscopy, we identified adenocarcinoma of the lower body of the stomach. On abdominopelvic computed tomography, diverticula of duodenum and jejunum were found. Patient underwent distal gastrectomy and gastroduodenostomy with lymphadenectomy. She was discharged on the tenth postoperative day without complications. PMID:25317417

  4. Secure Email Communication: A Short Guide for Patients WHEN TO USE EMAIL

    E-print Network

    Oliver, Douglas L.

    Secure Email Communication: A Short Guide for Patients WHEN TO USE EMAIL Many UConn Health Center There are a number of risks that you should consider: providers welcome secure email communication with their patients. Your provider may choose to use secure email to communicate with you. This fact · Email can

  5. Breast cancer subtypes and survival in patients with brain metastases

    PubMed Central

    Nam, Byung-Ho; Kim, Sun Young; Han, Hye-Sook; Kwon, Youngmee; Lee, Keun Seok; Kim, Tae Hyun; Ro, Jungsil

    2008-01-01

    Introduction Brain metastases (BM) occur in up to one third of patients with metastatic breast cancer (MBC), whose incidences and prognoses by breast cancer subtypes in BM have not been well delineated. Methods Retrospective survival analyses were performed in 126 BM patients from 805 MBC patients treated at the National Cancer Center between August 2001 and April 2006, according to clinical characteristics, breast cancer subtypes, and receipt of trastuzumab. Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth receptor-2 (HER2) statuses were tested by immunohistochemical (IHC) staining, and HER2 FISH analysis conducted for IHC 2+. Results The proportion of HER2+/ER- (29% vs 16%) and triple-negative (37% vs 25%) tumors was higher in the 126 BM patients than those without BM. While median survival after recurrence was longer in patients with luminal A disease (median survival of luminal A vs luminal B vs HER2+/ER- vs triple-negative: p = 0.0246; 39.6 vs 27.4 vs 20.9 vs 15.5 months), survival was shorter from BM to death in luminal A and triple negatives (median survival: p = 0.0113; 4.0 vs 9.2 vs 5.0 vs 3.4 months). Receipt of trastuzumab after BM was a significant variable for survival in HER2+ patients. Multivariate analyses identified ER-negative, HER2-negative, or triple-negative, as well as older age, presence of leptomeningeal disease, and three or more extracranial disease sites, as poor prognostic factors for survival after BM. Conclusion MBC patients who developed BM had higher proportions of triple-negative and HER2+/ER- tumor status. Triple receptor status is a useful prognostic marker for predicting survival after BM in metastatic breast cancer patients. PMID:18307763

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

    E-print Network

    Paris-Sud XI, Université de

    their efficacy and minimising the likelihood of adverse side effects. Since the advent of personalised medicine1 Communication of pharmacogenetic research results to HIV-infected treated patients: standpoints of pharmacogenetic studies is to adapt therapeutic strategies to individual genetic profiles, thus maximising

  7. Patients' perspective of the design of provider-patients electronic communication services.

    PubMed

    Silhavy, Petr; Silhavy, Radek; Prokopova, Zdenka

    2014-06-01

    Information Delivery is one the most important tasks in healthcare practice. This article discusses patient's tasks and perspectives, which are then used to design a new Effective Electronic Methodology. The system design methods applicable to electronic communication in the healthcare sector are also described. The architecture and the methodology for the healthcare service portal are set out in the proposed system design. PMID:24927038

  8. Pazopanib in Treating Patients With Metastatic Urothelial Cancer

    ClinicalTrials.gov

    2014-05-22

    Distal Urethral Cancer; Proximal Urethral Cancer; Recurrent Bladder Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Stage IV Bladder Cancer; Transitional Cell Carcinoma of the Bladder; Urethral Cancer Associated With Invasive Bladder Cancer

  9. Supporting Cancer Patients in Illness Management: Usability Evaluation of a Mobile App

    PubMed Central

    Kaufman, David R; Ruland, Cornelia M

    2014-01-01

    Background Mobile phones and tablets currently represent a significant presence in people’s everyday lives. They enable access to different information and services independent of current place and time. Such widespread connectivity offers significant potential in different app areas including health care. Objective Our goal was to evaluate the usability of the Connect Mobile app. The mobile app enables mobile access to the Connect system, an online system that supports cancer patients in managing health-related issues. Along with symptom management, the system promotes better patient-provider communication, collaboration, and shared decision making. The Connect Mobile app enables access to the Connect system over both mobile phones and tablets. Methods The study consisted of usability tests of a high fidelity prototype with 7 cancer patients where the objectives were to identify existing design and functionality issues and to provide patients with a real look-and-feel of the mobile system. In addition, we conducted semistructured interviews to obtain participants’ feedback about app usefulness, identify the need for new system features and design requirements, and measure the acceptance of the mobile app and its features within everyday health management. Results The study revealed a total of 27 design issues (13 for mobile apps and 14 for tablet apps), which were mapped to source events (ie, errors, requests for help, participants' concurrent feedback, and moderator observation). We also applied usability heuristics to identify violations of usability principles. The majority of violations were related to enabling ease of input, screen readability, and glanceability (15 issues), as well as supporting an appropriate match between systems and the real world (7 issues) and consistent mapping of system functions and interactions (4 issues). Feedback from participants also showed the cancer patients’ requirements for support systems and how these needs are influenced by different context-related factors, such as type of access terminal (eg, desktop computer, tablet, mobile phone) and phases of illness. Based on the observed results, we proposed design and functionality recommendations that can be used for the development of mobile apps for cancer patients to support their health management process. Conclusions Understanding and addressing users’ requirements is one of the main prerequisites for developing useful and effective technology-based health interventions. The results of this study outline different user requirements related to the design of the mobile patient support app for cancer patients. The results will be used in the iterative development of the Connect Mobile app and can also inform other developers and researchers in development, integration, and evaluation of mobile health apps and services that support cancer patients in managing their health-related issues. PMID:25119490

  10. Universality of aging: family caregivers for elderly cancer patients

    PubMed Central

    Baider, Lea; Surbone, Antonella

    2014-01-01

    The world population is aging, with the proportion of older people (65+ years) expected to reach 21% in 2050 and to exceed the number of younger people (aged 15 or less) for the first time in history. Because cancer is particularly a chronic disease of older people, a large increase in the number of elderly patients with cancer is anticipated. The estimated number of new cancer cases worldwide among people over 65 is expected to grow from about 6 million in 2008 to more than 11 million during the coming decade. By 2030, individuals over 65 are expected to account for 70% of all cancer patients in the Western world. Along with the increase in oncology patients, the number of older people caring for their ill spouses or other relatives is also growing, with the ensuing toll on these caregivers causing major concern, especially in western countries. In different societies the characteristics of family caregiver stressors, cultural norms concerning caregiving, and the availability of support have a huge impact on those providing care. Any study of older caregivers of older cancer patients requires an integrative evaluation of aging that takes into account cultural, social, psychological, and behavioral variables. This review proposes a critical discussion of the multidimensionality of the caregiving and of the impact that age, culture, and gender have on it. PMID:25076927

  11. 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.

    PubMed

    Sharifa Ezat, Wan Puteh; Fuad, Ismail; Hayati, Yaakub; Zafar, Ahmed; Wanda Kiyah, George Albert

    2014-01-01

    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

  12. Use of the internet for information and support: disclosure among persons with breast and prostate cancer.

    PubMed

    Owen, Jason E; Klapow, Joshua C; Roth, David L; Tucker, Diane C

    2004-10-01

    The present study examined the feasibility of evaluating online communication of cancer patients using an automated content analysis program modified for application to cancer-related communication. Public messages posted to the Breast Cancer Discussion List and the Prostate Problems Mailing List were content analyzed uasing an augmented version of Linguistic Inquiry and Word Count to evaluate communication styles within these two cancer types. Breast cancer patients were more likely to submit multiple messages to the list and made greater use of words related to emotional disclosure and cognitive processing compared with prostate cancer patients. Prostate cancer patients were less likely to seek emotional support or repeated interaction with other patients, and more of their communication focused on cancer-related information. Use of cancer-specific word libraries significantly increased word identification within these samples. Content analysis of online communication appears to be a promising method for detecting communication differences among subgroups of cancer patients. PMID:15675637

  13. The lung cancer patient, the pneumologist and palliative care: a developing alliance.

    PubMed

    Blum, Torsten; Schönfeld, Nicolas

    2015-01-01

    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

  14. Routine Endoscopy for Esophageal Cancer Is Suggestive for Patients with Oral, Oropharyngeal and Hypopharyngeal Cancer

    PubMed Central

    Hung, Shih-Han; Tsai, Ming-Chieh; Liu, Tsai-Ching; Lin, Herng-Ching; Chung, Shiu-Dong

    2013-01-01

    Background This study attempted to reveal the incidence and risk of synchronous and metachronous esophageal cancer in subjects with oral, oropharyngeal and hypopharyngeal cancer based on a population-wide database in Taiwan. Methods We retrieved data for this cross-sectional study from the Taiwanese Longitudinal Health Insurance Database 2000. The study group included 2,965 subjects who had received their first-time diagnosis of oral/oropharyngeal/hypopharyngeal cancer in 2002?2009. We assigned the date of their first diagnosis of oral/oropharyngeal/hypopharyngeal cancer as the index date. We also randomly retrieved 29,650 comparison subjects matched with the study subjects in terms of gender and age group. We assigned their first medical utilization that occurred in the index year as the index date for the comparison group. We further performed a conditional logistic regression to investigate the association between esophageal cancer and oral cancer. Results Results showed that prevalences of esophageal cancer within 3 months before and after the index date were respectively 2.19% and 0.04% for the study and comparison groups. A conditional logistic regression revealed that the odds ratio (OR) of esophageal cancer for subjects with oral/oropharyngeal/hypopharyngeal cancer was 55.33 (95% confidence interval (CI): 29.86?102.52) compared to comparison subjects. Furthermore, compared to comparison subjects, ORs for esophageal cancer were respectively 18.41 (95% CI: 8.50–39.85), 40.49 (95% CI: 15.11?108.64), and 240.96 (95% CI: 125.49–462.69) for study subjects with a malignancy of the oral cavity, oropharynx, and hypopharynx. Conclusion We concluded that there were relatively high chances for synchronous and metachronous esophageal cancers being detected through panendoscopy in patients with oral, oropharyngeal, and hypopharyngeal cancers. The routine use of panendoscopy in such patients should be encouraged with a higher priority. PMID:23977217

  15. Risk of cancer among rheumatoid arthritis patients in California

    Microsoft Academic Search

    Arti Parikh-Patel; Richard H. White; Mark Allen; Rosemary Cress

    2009-01-01

    Objective  The objective of this retrospective cohort study was to evaluate cancer risk among rheumatoid arthritis (RA) patients in California.\\u000a \\u000a \\u000a \\u000a Methods  The study cohort derived from statewide patient discharge records was followed via linkage with cancer registry data over\\u000a the period 1991–2002. Age and sex adjusted standardized incidence ratios (SIRs) and 95% confidence intervals were calculated\\u000a to compare observed to expected numbers

  16. M.D. Anderson Symptom Inventory (MDASI) Validation Study in Cancer Patients | Division of Cancer Prevention

    Cancer.gov

    The purpose of this study is to try to learn more about common symptoms that may occur in patients due to cancer and its treatment. We also want to learn more about the impact of symptoms on your quality of life. Another goal is to learn how to better measure symptoms systematically when caring for patients.

  17. Clinical features of systemic cancer patients with acute cerebral infarction and its underlying pathogenesis

    PubMed Central

    Chen, Yajuan; Zeng, Jinsheng; Xie, Xingrui; Wang, Zijun; Wang, Xiaoting; Liang, Zhijian

    2015-01-01

    Background: The increased incidence of cerebral infarction in patients with systemic cancer has been reported; however, the underline mechanisms remain unclear. Investigation regarding the clinical features of cerebral infarction in cancer patients could be helpful to understand its underlying pathogenesis. Methods: A total of 537 patients were recruited and divided into three groups: 1) stroke and cancer group (SCG), defined as active cancer patients with acute cerebral infarction; 2) stroke group (SG), defined as acute cerebral infarction patients without cancer; and 3) Cancer group (CG), defined as active cancer patients without cerebral infarction. These patients were age and gender-matched among groups. Results: 179 patients, including 128 male subjects (73.68%) were enrolled in each group. Compared to SG patients, more SCG patients lacked conventional vascular risk factors (CRFs), and had elevated plasma D-dimer, cancer antigen (CA) 125 and 199 levels with multiple lesions in multiple cerebral arterial territories. In addition, SCG patients were found to have poorer prognosis. Compared to CG patients, more SCG patientscancer had metastasized. Multiple logistic regression analysis showed that the elevated plasma D-dimer, CA125 and CA199 levels may independently increase, but chemoradiotherapy decreased the risk of cerebral infarction in cancer patients. Conclusions: Our study demonstrated that the clinical features of acute cerebral infarction in most active cancer patients can be identified as multiple lesions in multiple cerebral arterial territories with elevated plasma D-dimer and the elevated levels of cancer antigens.

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

    PubMed Central

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

    2014-01-01

    Communication is a core aspect of psycho-oncology care. This article examines key psychosocial, cultural, and technological factors that affect this communication. Drawing from advances in clinical work and accumulating bodies of empirical evidence, the authors identify determining factors for high quality, efficient, and sensitive communication and support for those affected by cancer. Cancer care in India is highlighted as a salient example. Cultural factors affecting cancer communication in India include beliefs about health and illness, societal values, integration of spiritual care, family roles, and expectations concerning disclosure of cancer information, and rituals around death and dying. The rapidly emerging area of e-health significantly impacts cancer communication and support globally. In view of current globalization, understanding these multidimensional psychosocial, and cultural factors that shape communication are essential for providing comprehensive, appropriate, and sensitive cancer care. PMID:25452741

  19. Health-related quality of life in breast cancer patients: A bibliographic review of the literature from 1974 to 2007

    PubMed Central

    Montazeri, Ali

    2008-01-01

    Background Quality of life in patients with breast cancer is an important outcome. This paper presents an extensive overview on the topic ranging from descriptive findings to clinical trials. Methods This was a bibliographic review of the literature covering all full publications that appeared in English language biomedical journals between 1974 and 2007. The search strategy included a combination of key words 'quality of life' and 'breast cancer' or 'breast carcinoma' in titles. A total of 971 citations were identified and after exclusion of duplicates, the abstracts of 606 citations were reviewed. Of these, meetings abstracts, editorials, brief commentaries, letters, errata and dissertation abstracts and papers that appeared online and were indexed ahead of publication were also excluded. The remaining 477 papers were examined. The major findings are summarized and presented under several headings: instruments used, validation studies, measurement issues, surgical treatment, systemic therapies, quality of life as predictor of survival, psychological distress, supportive care, symptoms and sexual functioning. Results Instruments-Several valid instruments were used to measure quality of life in breast cancer patients. The European Organization for Research and Treatment of Cancer Core Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its breast cancer specific complementary measure (EORTC QLQ-BR23) and the Functional Assessment Chronic Illness Therapy General questionnaire (FACIT-G) and its breast cancer module (FACIT-B) were found to be the most common and well developed instruments to measure quality of life in breast cancer patients. Surgery-different surgical procedures led to relatively similar results in terms of quality of life assessments, although mastectomy patients compared to conserving surgery patients usually reported a lower body image and sexual functioning. Systemic therapies-almost all studies indicated that breast cancer patients receiving chemotherapy might experience several side-effects and symptoms that negatively affect their quality of life. Adjuvant hormonal therapies also were found to have similar negative impact on quality of life, although in general they were associated with improved survival. Quality of life as predictor of survival-similar to known medical factors, quality of life data in metastatic breast cancer patients was found to be prognostic and predictive of survival time. Psychological distress-anxiety and depression were found to be common among breast cancer patients even years after the disease diagnosis and treatment. Psychological factors also were found to predict subsequent quality of life or even overall survival in breast cancer patients. Supportive care-clinical treatments to control emesis, or interventions such as counseling, providing social support and exercise could improve quality of life. Symptoms-Pain, fatigue, arm morbidity and postmenopausal symptoms were among the most common symptoms reported by breast cancer patients. As recommended, recognition and management of these symptoms is an important issue since such symptoms impair health-related quality of life. Sexual functioning-breast cancer patients especially younger patients suffer from poor sexual functioning that negatively affect quality of life. Conclusion There was quite an extensive body of the literature on quality of life in breast cancer patients. These papers have made a considerable contribution to improving breast cancer care, although their exact benefit was hard to define. However, quality of life data provided scientific evidence for clinical decision-making and conveyed helpful information concerning breast cancer patients' experiences during the course of the disease diagnosis, treatment, disease-free survival time, and recurrences; otherwise finding patient-centered solutions for evidence-based selection of optimal treatments, psychosocial interventions, patient-physician communications, allocation of resources, and indicating research priorities were impossible. It seems that more

  20. [Intrathecal morphine treatment in advanced cancer pain patients].

    PubMed

    Hattori, Seiji; Sano, Hiromi; Tanaka, Kiyotaka; Yokota, Miyuki

    2009-11-01

    For more than 20 years morphine for spinal analgesia in patients with refractory cancer pain has been one of the cornerstones for the management of chronic, medically intractable pain. In general, most types of cancer pain are treatable following the guideline of Cancer Pain Relief well established by the WHO. However, some patient are unable to tolerate pain only following the guideline and often suffer with side-effects from high doses of opioid and from prescribed multiple adjuvant drugs. Due to the proximity to the receptor sites, the therapeutic efficacy of intrathecal opioid application lasts longer and also reduces systemic side effects. Intrathecal drug application is cost effective and can significantly improve the quality of life in selected patients with limited life expectancy. However, an intensive training of physicians, careful patient selection, awareness of specific complications, and arrangement of social back-up medical system are essential to commence intrathecal morphine application using implantable access port. This article introduces the basic idea of intrathecal morphine therapy with implantable access port (not pumps) as cost effective, alternative therapy for cancer patient suffering from intractable pain. PMID:19928505

  1. Incidence of cryptosporidiosis in immunodeficient cancer patients in Egypt.

    PubMed

    Hassan, Soad I; Sabry, Hoda; Amer, Neimat M; Shalaby, Maysa A; Mohamed, Nahed A; Gaballah, Hussien

    2002-04-01

    A coproprotozoal study was carried out on 63 patients suffering from malignancy. The majority had cancer of haemopoietic system. All patients were under chemotherapy and included: Group A (33 children) and Group B (30 adults) of whom 20 immunocompetent diarrhoeic patients of matched age and sex were considered as controls. Stool samples were examined by merthiolate iodine-formaldehyde concentration technique (MIF). Modified Zeihl-Neelsen (ZN) stain was performed for Cryptosporidium oocysts. Detection of Cryptosporidium coproantigen by enzyme-linked immunoassay test (Ridascreen test), was used. Immunoglobulins (IgG, IgM, IgE & IgA), C3, C4 and CD4:CD8 ratio, were measured. According to their levels 25 out of 63 patients had both humoral and cellular immunodeficiency. The incidence of Cryptosporidium in cancer patients was 23.8%, while it was 37.7% and 91% in children and adults immunodeficient patients, respectively. ZN stain was able in diagnosed Cryptosporidium in 13 out of 35 immunodeficient cases while ELISA detected only 11 cases. Cryptosporidium infection in immunodeficient cancer patients had significantly more frequent and prolonged duration of diarrhoea than in negative ones. PMID:12049267

  2. Blood lymphocyte subpopulations in breast cancer patients following radiotherapy.

    PubMed Central

    Petrini, B; Wasserman, J; Blomgren, H; Baral, E

    1977-01-01

    Both T and non-T lymphocytes decreased immediately following radiotherapy in breast cancer patients. The relative depletion of non-T lymphocytes, however, was more marked than that of T cells. 3 years later the number and the proportion of non-T lymphocytes was higher than immediately after radiotherapy, while T lymphocytes were still depressed. The proportion of cells with membrane-associated Ig was higher in patients 3 years following radiotherapy than in non-treated patients and healthy controls. There was no difference in the proportion of T and non-T lymphocytes between patients with and without metastases, respectively. PMID:330065

  3. For Immediate Release --Wednesday, March 20, 2013 Treating male and female cancer patients with radiation

    E-print Network

    Seldin, Jonathan P.

    ? · gender differences in cancer treatment rarely explored · consequences of radiation with radiation treatment of cancer cells and the difference between female and male and female cancer patients with radiation ­ are their brains affected differently

  4. Japanese doctor-patient discourse : an investigation into cultural and institutional influences on patient-centred communication

    E-print Network

    Holst, Mark Anthony

    2010-10-06

    This thesis investigates how Japanese doctors create and maintain patient-centred consultations through their verbal interaction with patients, and the extent to which features of Japanese interpersonal communication ...

  5. Quantification of Rare Cancer Cells in Patients With Gastrointestinal Cancer by Nanostructured Substrate1

    PubMed Central

    Cheng, Boran; Song, Haibin; Wang, Shuyi; Zhang, Chunxiao; Wu, Bibo; Chen, Yuanyuan; Chen, Fangfang; Xiong, Bin

    2014-01-01

    Detecting the cancer cells in the peripheral blood, i.e. circulating tumor cell (CTC), have been considered as the “liquid biopsy” and become a particular area of focus. A deep insight into CTC provides a potential alternative method for early diagnosis of solid tumor. Previous studies showed that CTC counts could be regarded as an indicator in tumor diagnosis, predicting clinical outcomes and monitoring treatment responses. In this report, we utilize our facile and efficient CTC detection device made of hydroxyapatite/chitosan (HA/CTS) for rare cancer cells isolation and enumeration in clinical use. A biocompatible and surface roughness controllable nanofilm was deposited onto a glass slide to achieve enhanced topographic interactions with nanoscale cellular surface components, anti-EpCAM (epithelial cell adhesion molecule, EpCAM) were then coated onto the surface of nanosubstrate for specific capture of CTCs. This device performed a considerable and stable capture yields. We evaluated the relationship performance between serial CTC changes and the changes of tumor volume/serum tumor marker in gastrointestinal cancer patients undergoing anti-cancer treatments. The present study results showed that changes in the number of CTC were associated with tumor burden and progression. Enumeration of CTCs in cancer patients may predict clinical response. Longitudinal monitoring of individual patients during the therapeutic process showed a close correlation between CTC quantity and clinical response to anti-cancer therapy. Effectively capture of this device is capable of CTCs isolation and quantification for monitoring of cancer and predicting treatment response. PMID:25500081

  6. Impact of Patient Race on Patient Experiences of Access and Communication in HIV Care

    Microsoft Academic Search

    P. Todd Korthuis; Somnath Saha; John A. Fleishman; Moriah McSharry McGrath; Joshua S. Josephs; Richard D. Moore; Kelly A. Gebo; James Hellinger; Mary Catherine Beach

    2008-01-01

    BACKGROUND  Patient-centered care—including the domains of access and communication—is an important determinant of positive clinical outcomes.\\u000a \\u000a \\u000a \\u000a OBJECTIVE  To explore associations between race and HIV-infected patients’ experiences of access and communication.\\u000a \\u000a \\u000a \\u000a DESIGN  This was a cross-sectional survey.\\u000a \\u000a \\u000a \\u000a PARTICIPANTS  Nine hundred and fifteen HIV-infected adults receiving care at 14 U.S. HIV clinics.\\u000a \\u000a \\u000a \\u000a MEASUREMENTS  Dependent variables included patients’ reports of travel time to their HIV care site and

  7. Naproxen in Preventing DNA Mismatch Repair Deficient Colorectal Cancer in Patients With Lynch Syndrome | Division of Cancer Prevention

    Cancer.gov

    This randomized phase Ib trial studies the side effects and best dose of naproxen in preventing deoxyribonucleic acid (DNA) mismatch repair deficient colorectal cancer in patients with Lynch syndrome. Chemoprevention is the use of certain drugs to keep cancer from forming. The use of naproxen may keep cancer from forming in patients with Lynch Syndrome.

  8. Mutational Screening of Breast Cancer Susceptibility Gene 1 from Early Onset, Bilateral, and Familial Breast Cancer Patients in Taiwan

    Microsoft Academic Search

    Shou-Tung Chen; Ruei-A Chen; Shou-Jen Kuo; Yi-Chih Chien

    2003-01-01

    The BRCA1 gene has been shown to be strongly associated with the occurrence of familial breast cancer. The spectrum of BRCA1 gene mutations in breast cancer patients in various populations has been investigated. In this study, patients in Central Taiwan with breast cancer were screened for BRCA1 mutations by sequencing PCR products spanning the coding region and partial intronic regions

  9. Nucleosomes in Pancreatic Cancer Patients during Radiochemotherapy

    Microsoft Academic Search

    Andreas Kremer; Ralf Wilkowski; Stefan Holdenrieder; Dorothea Nagel; Petra Stieber; Dietrich Seidel

    2005-01-01

    Nucleosomes appear spontaneously in elevated concentrations in the serum of patients with malignant diseases as well as during chemo- and radiotherapy. We analyzed whether their kinetics show typical characteristics during radiochemotherapy and enable an early estimation of therapy efficacy. We used the Cell Death Detection Elisaplus (Roche Diagnostics) and investigated the course of nucleosomes in the serum of 32 patients

  10. Treatment of patients with advanced gastric cancer: experience from an Indian tertiary cancer center.

    PubMed

    Sirohi, Bhawna; Rastogi, Sameer; Dawood, Shaheenah; Talole, S; Ramadwar, Mukta; Shetty, Nitin; Shrikhande, Shailesh V

    2014-10-01

    Majority of patients in developing countries diagnosed with gastric cancer have an advanced stage at presentation with overall poor performance status. The aim of the study was to assess outcomes of first- and second-line chemotherapy and determine prognostic factors among patients with advanced gastric cancer (AGC). Using a prospectively maintained database, we identified 144 patients with AGC treated at Tata Memorial Centre between January 2012 and September 2013. Sixteen patients received best supportive care, and 128 patients received palliative chemotherapy. Cox regression was used for multivariate analysis of survival. Of 128 patients, 42(33%) received Cape-Ox, 22(17.1%) EOX and 47(36.7%) DOX while rest received other regimens. PS was 2 in 36 (28%) patients at presentation, and 97% of patients had ?3 sites of metastasis. Forty-eight patients (37.5%) had signet ring histology. Median follow-up was 9 months. Median progression-free survival/overall survival (OS) was 6/8 months, respectively. Of 93 patients who progressed 39 (41.9%) patients received second-line chemotherapy. Multivariate analysis for OS showed that PS and use of taxane in first-line setting were significant prognostic factors. Patients who received second-line therapy had longer survival than those who did not (12 vs. 6 months; P=0.002). The overall outcome of our patients is comparable to the Western reported data despite an advanced disease at presentation. PMID:25228200

  11. Endothelial progenitor cells in breast cancer patients

    Microsoft Academic Search

    Christiane Richter-Ehrenstein; Jörn Rentzsch; Sanyukta Runkel; Achim Schneider; Gilbert Schönfelder

    2007-01-01

    Purpose  Development of new capillary blood vessels is essential for the growth of cancer. Two distinct processes, vasculogenesis and\\u000a angiogenesis implement the formation of the new vascular network. Recently, it was demonstrated that vasculogenesis creates\\u000a the primary network of vascular endothelial cells that will become major blood vessels in malignant tumors by the recruitment\\u000a of CD34+\\/vascular endothelial growth factor receptor 2

  12. Familial Caregivers of Patients with Brain Cancer

    Microsoft Academic Search

    Youngmee Kim

    \\u000a Brain cancer affects not only the quality of life of individuals with the disease but also that of their family members and\\u000a close friends. The impact on various aspects of the family caregivers’ quality of life (QOL) is significant throughout the\\u000a trajectory of the illness, such as the acute and mid- to long-term survivorship phases a well as the bereavement

  13. Challenges to physician-patient communication about medication use: a window into the skeptical patient's world.

    PubMed

    Bezreh, Tanya; Laws, M Barton; Taubin, Tatiana; Rifkin, Dena E; Wilson, Ira B

    2012-01-01

    Patients frequently do not take medicines as prescribed and often do not communicate with their physicians about their medication-taking behavior. The movement for "patient-centered" care has led to relabeling of this problem from "noncompliance" to "nonadherence" and later to a rhetoric of "concordance" and "shared decision making" in which physicians and patients are viewed as partners who ideally come to agreement about appropriate treatment. We conducted a qualitative content analysis of online comments to a New York Times article on low rates of medication adherence. The online discussion provides data about how a highly selected, educated sample of patients thinks about medication use and the doctor-patient relationship. Our analysis revealed patient empowerment and self-reliance, considerable mistrust of medications and medical practice, and frequent noncommunication about medication adherence issues. We discuss how these observations can potentially be understood with reference to Habermas's theory of communicative action, and conclude that physicians can benefit from better understanding the negative ways in which some patients perceive physicians' prescribing practices. PMID:22272065

  14. Association of clinical experiences with patient-reported outcomes among breast cancer surgery patients: breast cancer quality care study

    Microsoft Academic Search

    Dong Young Noh; Seok Jin Nam; Se Hyun Ahn; Byeong Woo Park; Eun Sook Lee; Myung Kyung Lee; Soo Hyun Kim; Yoo Min Kim; Sang Min Park; Young Ho Yun

    2008-01-01

    Background  We aimed to clarify the association of breast cancer patients’ clinical experiences with patient-reported outcomes (PRO) of\\u000a satisfaction with care, choice of the same type of surgery again, and health-related quality of life (HRQOL).\\u000a \\u000a \\u000a \\u000a Methods  There were 2,403 (25.9%) of 9,283 eligible women who had undergone primary curative surgery for breast cancer in one of five\\u000a selected hospitals between 1993 and

  15. Plasma Shh levels reduced in pancreatic cancer patients

    PubMed Central

    El-Zaatari, Mohamad; Daignault, Stephanie; Tessier, Art; Kelsey, Gail; Travnikar, Lisa A.; Cantu, Esperanza F.; Lee, Jamie; Plonka, Caitlyn M.; Simeone, Diane M.; Anderson, Michelle A.; Merchant, Juanita L.

    2012-01-01

    Objectives Normally, sonic hedgehog (Shh) is expressed in the pancreas during fetal development and transiently after tissue injury. Although pancreatic cancers express Shh, it is not known if the protein is secreted into the blood and whether its plasma levels change with pancreatic transformation. The goal of this study was to develop an ELISA to detect human Shh in blood, and determine the levels in subjects with and without pancreatic cancer. Methods A human Shh ELISA assay was developed, and plasma Shh levels were measured in blood samples from normal volunteers and subjects with pancreatitis or pancreatic cancer. The biological activity of plasma Shh was tested using NIH-3T3 cells. Results The average levels of Shh in human blood were lower in pancreatitis and pancreatic cancer patients than in normal individuals. Hematopoietic cells did not express Shh suggesting that Shh is secreted into the bloodstream. Plasma fractions enriched for Shh did not induce Gli-1 mRNA suggesting that the protein was not biologically active. Conclusions Shh is secreted from tissues and organs into the circulation but its activity is blocked by plasma proteins. Reduced plasma levels were found in pancreatic cancer patients, but alone were not sufficient to predict pancreatic cancer. PMID:22513293

  16. [Comorbid depressive and anxiety disorders in patients with cancer].

    PubMed

    Kapfhammer, H-P

    2015-03-01

    Patients with cancer face a high risk of comorbid depressive and anxiety disorders that have to be paradigmatically considered within a complex biopsychosocial context. Several conceptual challenges have to be mastered in arriving at a correct clinical diagnosis. Coexistent affective and anxiety disorders in cancer patients include a more dramatic subjective suffering, reduced psychological coping, possible negative interference with somatic treatment and rehabilitation, impaired quality of life and higher grades of psychosocial disability. They may also lead to an overall increased risk of somatic morbidity, a more rapid progression of cancer and a higher cancer-related mortality in the course of the disease. Manifold psychological, psychosocial and existential, cancer and treatment-related stressors have to be considered with respect to common neurobiological, especially neuroendocrine and neuroinflammatory mechanisms. Complex psychosomatic, somatopsychic and somato-somatic effects must always be considered. Evidence-based approaches in psychotherapy and pharmacotherapy exist for the integrative treatment of comorbid depressive and anxiety disorders in cancer. PMID:25737493

  17. Management of the patients with hypopharyngeal cancer: eight-year experience of Miyagi Cancer Center in Japan.

    PubMed

    Tateda, Masaru; Shiga, Kiyoto; Yoshida, Humiaki; Saijo, Shigeru; Yokoyama, Jyunkichi; Nishikawa, Hitoshi; Asada, Yukinori; Matsuura, Kazuto; Kobayashi, Toshimitu

    2005-01-01

    The aim of this study is to evaluate the results of treatment for hypopharyngeal cancer and indicate the future prospect of the treatment. Seventy-four patients with squamous cell carcinoma of the hypopharynx admitted to Miyagi Cancer Center from 1993 through 2000 are reviewed. Sixty-four patients received radical treatment, and 10 patients received palliative treatment or no treatment. The cancer was advanced (stages III and IV) in 82% of all the patients. The overall 5-year survival rate of all the patients was 38%. The overall 5-year survival rate of 64 patients received radical treatment was 43%. The ten patients who received palliative treatment or no treatment died of cancer within 16 months. Fifty-two out of the 74 patients underwent neck dissection for the neck lymph node involvement; forty of the 52 patients underwent ipsilateral neck dissection and 12 underwent bilateral neck dissection. Four out of the 40 patients, who underwent ipsilateral neck dissection alone, developed late contralateral regional recurrence but were successfully treated by contralateral neck dissection at the time of recurrence. Twenty-three out of 74 patients had multiple primary cancers synchronously or metachronously (31%). Cause of the death of six patients out of 74 patients was confirmed to be primary cancers other than hypopharyngeal cancer, as judged by physicians in other department or other hospitals. Most of the patients died due to distant metastasis from hypopharyngeal cancer or other primary cancers. We therefore conclude that contralateral elective neck dissection which is frequently chosen for the treatment of hypopharyngeal cancer surgery is unnecessary. Even if locoregional control is accomplished, distant metastasis or multiple primary cancers emerge and make prognosis poor. To improve the prognosis, we should develop some strategy against hypopharyngeal cancer for each patient. New strategies including chemoprevention and surgery against distant metasistasis are necessary. PMID:15635275

  18. Management of Patients with Small Cell Lung Cancer

    Microsoft Academic Search

    Ehab M. Kamel; Daniel Zwahlen; Matthias T. Wyss; Katrin D. Stumpe; Gustav K. von Schulthess; Hans C. Steinert

    The aim of this study was to evaluate the impact of whole-body 18F-FDG PET on staging and managing patients with small cell lung cancer (SCLC). Methods: The treatment records of 42 consecutive patients (27 men, 15 women; mean age, 62 y; age range, 45- 83 y) with SCLC were reviewed. Whole-body 18F- FDG PET was performed for initial staging in

  19. Nasolacrimal Duct Obstruction and Lacrimal Surgery in Cancer Patients

    Microsoft Academic Search

    Aaron Savar; Bita Esmaeli

    \\u000a Nasolacrimal duct obstruction is often seen in patients with cancer. Iatrogenic causes such as surgery, radiation therapy,\\u000a and chemotherapy are among the most common causes. Primary lacrimal drainage tumors are less common causes. The evaluation\\u000a of patients with suspected nasolacrimal duct obstruction should include a thorough history and a comprehensive ophthalmic?examination,\\u000a including probing and irrigation of the lacrimal drainage apparatus

  20. Does Improving Patient-Practitioner Communication Improve Clinical Outcomes in Patients with Cardiovascular Diseases? A Systematic Review of the Evidence

    PubMed Central

    Schoenthaler, Antoinette; Kalet, Adina; Nicholson, Joseph; Lipkin, Mack

    2014-01-01

    Objective To conduct a systematic literature review appraising the effects of interventions to improve patient-practitioner communication on cardiovascular-related clinical outcomes. Methods Databases were searched up to March 27, 2013 to identify eligible studies that included interventions to improve patient and/or practitioner communication skills and assessment of a cardiovascular-related clinical outcome in adults ? 18 years of age. Results Fifteen papers were reviewed: The primary focus in seven studies was the patient; seven included a practitioner-focused intervention and one targeted both. Two patient-focused and two practitioner-focused studies demonstrated a beneficial effect of the intervention compared to a control group. Patient-focused studies were designed to improve patients’ information-seeking and question-asking skills with their practitioner. Practitioner-focused studies were designed to either improve practitioner’s general patient-centered communication or risk communication skills. Conclusions Few interventions targeting patient-practitioner communication have assessed the impact on cardiovascular-related clinical outcomes, limiting the ability to determine effectiveness. Additional rigorous research supported by theoretical frameworks and validated measurement is needed to understand the potential of patient-practitioner communication to improve cardiovascular-related clinical outcomes. Practice Implications Investments in communication skills trainings in medical education and practice are needed in order to attain the full potential of patient-centered care on cardiovascular-related clinical outcomes. Systematic Review Protocol Registration CRD42013006302 PMID:24795073

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

    ERIC Educational Resources Information Center

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

    2011-01-01

    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…

  2. Medical information visualization conceptual model for patient-physician health communication

    Microsoft Academic Search

    Yair G. Rajwan; George R. Kim

    2010-01-01

    Communication between patients and health care providers may require sharing of data and knowledge that is complex and of high-volume. To support communication of these types of information, visualization techniques and tools can reduce cognitive burden in informed patient-centered health decisions and empower patients in their own care. Designing and implementing effective visualization depend on iterative consideration of cognitive needs

  3. Carboplatin and Eribulin Mesylate in Triple Negative Breast Cancer Patients

    ClinicalTrials.gov

    2014-06-03

    Estrogen Receptor-negative Breast Cancer; HER2-negative Breast Cancer; Male Breast Cancer; Progesterone Receptor-negative Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Triple-negative Breast Cancer

  4. Carboplatin and Eribulin Mesylate in Triple Negative Breast Cancer Patients

    ClinicalTrials.gov

    2015-06-23

    Estrogen Receptor-negative Breast Cancer; HER2-negative Breast Cancer; Male Breast Cancer; Progesterone Receptor-negative Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Triple-negative Breast Cancer

  5. Morphological Differences between Circulating Tumor Cells from Prostate Cancer Patients and Cultured

    E-print Network

    Ma, Hongshen

    Morphological Differences between Circulating Tumor Cells from Prostate Cancer Patients more variability than cultured cancer cells in nuclear-cytoplasmic ratio and shape profile. Citation Tumor Cells from Prostate Cancer Patients and Cultured Prostate Cancer Cells. PLoS ONE 9(1): e85264. doi

  6. How have patient advocates in the United States benefited cancer research?

    Microsoft Academic Search

    Deborah Collyar

    2005-01-01

    Cancer patient advocates represent those affected by cancer and have a broad view of cancer research. They are involved in many diverse cancer research committees, where they can help tackle old problems from new perspectives that often differ from government, academic, medical and scientific approaches. In this role, patient advocates have aided the development of educational dialogue between investigators and

  7. Predicting Response to Chemotherapy in Breast Cancer Patients using Machine Learning Techniques

    E-print Network

    Sleeman, Derek

    Predicting Response to Chemotherapy in Breast Cancer Patients using Machine Learning Techniques E emission tomography (PET), breast cancer monitoring, neoadjunctive chemotherapy, machine learning. Abstract to respond to (neoadjunctive) chemotherapy. This group of 96 patients from the Aberdeen Royal Infirmary had

  8. Poor Sleep, Snoring Before Diagnosis Tied to Trouble for Breast Cancer Patients

    MedlinePLUS

    ... Sleep, Snoring Before Diagnosis Tied to Trouble for Breast Cancer Patients But whether lack of sleep -- or the ... 12, 2015 FRIDAY, June 12, 2015 (HealthDay News) -- Breast cancer patients who had poor sleep and frequent snoring ...

  9. [Effective methods of organizing complex information in advanced cancer patients].

    PubMed

    Oshiro, Tatsuo; Oshiro, Hisako; Tanimizu, Masahito

    2014-12-01

    Advanced cancer patients often present with variable clinical information documenting widespread lesions and treatment histories. For health care providers, organizing and managing this information is crucial. In our ambulatory and home palliative/ hospice care practice, two visual tools are used: 1 ) a one-page line diagram which shows the Edmonton Labeled Visual Information System (ELVIS) and a schematic demarcation of dermatomes shown as distinct segments, and 2 ) a one-page summary report containing various graphs displaying the transition of clinical variables which appear to be predictive of survival. These concise visual representations of cancer information can be beneficial for summarizing or reviewing the disease and its clinical course, and in the transfer of patient information to other institutions. They may also serve as an aid to improve information recall in cancer patients, as well as to provide both the patients and their caregivers with information about cancer trajectories so that they can set appropriate goals, priorities, and expectations of care. PMID:25595074

  10. Significance of Lymph Node Micrometastasis in Pancreatic Cancer Patients

    Microsoft Academic Search

    J. Bober

    2012-01-01

    Background \\/Aims: The present study deals with the significance of lymph node micrometastasis in the survival rate for pancreatic cancer patients. Methods: Between January 2006 and December 2010 at the First Department of Surgery in Košice, a prospective trial was done in which we investigated the survival rate after radical pancreatic resection. All negative lymph nodes removed during standard radical

  11. Support requirements for caregivers of patients with palliative cancer

    Microsoft Academic Search

    Feyuna F. I. Jansma; Lidwien M. Schure; Betty Meyboom de Jong

    2005-01-01

    Health policy is shifting from professional to informal care. Studies have shown that informal caregivers provide an average of 55% of the needed care. The aim of this study was to get insight in the needs of the caregivers of patients with palliative cancer and how to address those needs with a support program. A questionnaire developed on the basis

  12. Adjuvant Chemotherapy in 780 Patients with Early Breast Cancer

    Microsoft Academic Search

    Ezzeldin M. Ibrahim; Adnan A. Ezzat; Mohammed M. Rahal; Madras M. Raja; Dahish S. Ajarim

    Background: By and large, data about adjuvant chemotherapy for breast cancer in the Middle East are lack- ing. Retrospective analysis of prospectively captured data from a main referral center in the Kingdom of Saudi Arabia (KSA) may shed some light on the clinicopathological features and survival of patients offered adju- vant chemotherapy in a similar population in that part of

  13. Biological ageing and frailty markers in breast cancer patients

    PubMed Central

    Hatse, Sigrid; Laenen, Annouschka; Kenis, Cindy; Swerts, Evalien; Neven, Patrick; Smeets, Ann; Schöffski, Patrick; Wildiers, Hans

    2015-01-01

    Older cancer patients are a highly heterogeneous population in terms of global health and physiological reserves, and it is often difficult to determine the best treatment. Moreover, clinical tools currently used to assess global health require dedicated time and lack a standardized end score. Circulating markers of biological age and/or fitness could complement or partially substitute the existing screening tools. In this study we explored the relationship of potential ageing/frailty biomarkers with age and clinical frailty. On a population of 82 young and 162 older non-metastatic breast cancer patients, we measured mean leukocyte telomere length and plasma levels of interleukin-6 (IL-6), regulated upon activation, normal T cell expressed and secreted (RANTES), monocyte chemotactic protein 1 (MCP-1), insulin-like growth factor 1 (IGF-1). We also developed a new tool to summarize clinical frailty, designated Leuven Oncogeriatric Frailty Score (LOFS), by integrating GA results in a single, semi-continuous score. LOFS' median score was 8, on a scale from 0=frail to 10=fit. IL-6 levels were associated with chronological age in both groups and with clinical frailty in older breast cancer patients, whereas telomere length, IGF-1 and MCP-1 only correlated with age. Plasma IL-6 should be further explored as frailty biomarker in cancer patients.

  14. Underreporting by cancer patients: The case of response-shift

    Microsoft Academic Search

    I. S. Breetvelt; F. S. A. M. Van Dam

    1991-01-01

    There are a lot of studies in which self-report questionnaires are used, showing that cancer patients do not have a lower quality of life than the normal healthy population. This seems to be in contrast with the results of studies in which more extensive interviews have been used and to the everyday experience of physicians, nurses and other caretakers. This

  15. Guidelines on the radical management of patients with lung cancer

    Microsoft Academic Search

    Eric Lim; David Baldwin; Michael Beckles; John Duffy; James Entwisle; Corinne Faivre-Finn; Keith Kerr; Alistair Macfie; Jim McGuigan; Simon Padley; Sanjay Popat; Nicholas Screaton; Michael Snee; David Waller; Chris Warburton; Thida Win

    2010-01-01

    A joint initiative by the British Thoracic Society and the Society for Cardiothoracic Surgery in Great Britain and Ireland was undertaken to update the 2001 guidelines for the selection and assessment of patients with lung cancer who can potentially be managed by radical treatment.

  16. Sharing a diagnosis of HPV-related head and neck cancer: the emotions, the confusion and what patients want to know

    PubMed Central

    Baxi, Shrujal S.; Shuman, Andrew G.; Corner, Geoffrey W.; Shuk, Elyse; Sherman, Eric J.; Elkin, Elena B.; Hay, Jennifer L.; Pfister, David G.

    2013-01-01

    BACKGROUND Oropharyngeal cancers are increasingly associated with human papillomavirus (HPV). Little is known about the experience of patients receiving this diagnosis. METHODS Semi-structured interviews were conducted with 10 survivors of HPV-related oropharynx cancer. The interviews were transcribed and recurring themes were identified. RESULTS Physicians were a trusted source of information regarding HPV. Framing the diagnosis in terms of prognosis resonated with patients. The uncertainty about transmission, latency, and communicability colored the dialogue about HPV. Despite some understanding of prevalence and transmission, patients worried about their partner’s risk. Patients sought information about HPV on the internet, but it was not easily navigable. Emotional reactions to the diagnosis remained mostly cancer-centric rather than HPV-centric. A patient education handout was developed in response to patient questions. CONCLUSIONS Additional educational resources explaining the facts about HPV in HNSCC in a consistent way including content of highest priority to patients may improve understanding of HPV. PMID:23169350

  17. Impact of Patient Navigation on Timely Cancer Care: The Patient Navigation Research Program

    PubMed Central

    Battaglia, Tracy A.; Calhoun, Elizabeth; Darnell, Julie S.; Dudley, Donald J.; Fiscella, Kevin; Hare, Martha L.; LaVerda, Nancy; Lee, Ji-Hyun; Levine, Paul; Murray, David M.; Patierno, Steven R.; Raich, Peter C.; Roetzheim, Richard G.; Simon, Melissa; Snyder, Frederick R.; Warren-Mears, Victoria; Whitley, Elizabeth M.; Winters, Paul; Young, Gregory S.; Paskett, Electra D.

    2014-01-01

    Background Patient navigation is a promising intervention to address cancer disparities but requires a multisite controlled trial to assess its effectiveness. Methods The Patient Navigation Research Program compared patient navigation with usual care on time to diagnosis or treatment for participants with breast, cervical, colorectal, or prostate screening abnormalities and/or cancers between 2007 and 2010. Patient navigators developed individualized strategies to address barriers to care, with the focus on preventing delays in care. To assess timeliness of diagnostic resolution, we conducted a meta-analysis of center- and cancer-specific adjusted hazard ratios (aHRs) comparing patient navigation vs usual care. To assess initiation of cancer therapy, we calculated a single aHR, pooling data across all centers and cancer types. We conducted a metaregression to evaluate variability across centers. All statistical tests were two-sided. Results The 10521 participants with abnormal screening tests and 2105 with a cancer or precancer diagnosis were predominantly from racial/ethnic minority groups (73%) and publically insured (40%) or uninsured (31%). There was no benefit during the first 90 days of care, but a benefit of navigation was seen from 91 to 365 days for both diagnostic resolution (aHR = 1.51; 95% confidence interval [CI] = 1.23 to 1.84; P < .001)) and treatment initiation (aHR = 1.43; 95% CI = 1.10 to 1.86; P < .007). Metaregression revealed that navigation had its greatest benefits within centers with the greatest delays in follow-up under usual care. Conclusions Patient navigation demonstrated a moderate benefit in improving timely cancer care. These results support adoption of patient navigation in settings that serve populations at risk of being lost to follow-up. PMID:24938303

  18. On an ensemble algorithm for clustering cancer patient data

    PubMed Central

    2013-01-01

    Background The TNM staging system is based on three anatomic prognostic factors: Tumor, Lymph Node and Metastasis. However, cancer is no longer considered an anatomic disease. Therefore, the TNM should be expanded to accommodate new prognostic factors in order to increase the accuracy of estimating cancer patient outcome. The ensemble algorithm for clustering cancer data (EACCD) by Chen et al. reflects an effort to expand the TNM without changing its basic definitions. Though results on using EACCD have been reported, there has been no study on the analysis of the algorithm. In this report, we examine various aspects of EACCD using a large breast cancer patient dataset. We compared the output of EACCD with the corresponding survival curves, investigated the effect of different settings in EACCD, and compared EACCD with alternative clustering approaches. Results Using the basic T and N definitions, EACCD generated a dendrogram that shows a graphic relationship among the survival curves of the breast cancer patients. The dendrograms from EACCD are robust for large values of m (the number of runs in the learning step). When m is large, the dendrograms depend on the linkage functions. The statistical tests, however, employed in the learning step have minimal effect on the dendrogram for large m. In addition, if omitting the step for learning dissimilarity in EACCD, the resulting approaches can have a degraded performance. Furthermore, clustering only based on prognostic factors could generate misleading dendrograms, and direct use of partitioning techniques could lead to misleading assignments to clusters. Conclusions When only the Partitioning Around Medoids (PAM) algorithm is involved in the step of learning dissimilarity, large values of m are required to obtain robust dendrograms, and for a large m EACCD can effectively cluster cancer patient data. PMID:24565417

  19. Surveillance for endometrial cancer with transvaginal ultrasonography of breast cancer patients under tamoxifen treatment

    Microsoft Academic Search

    S Ciatto; S Cecchini; G Gervasi; A Landini; M Zappa; E Crocetti

    2003-01-01

    The association of endometrial thickness with the risk of developing endometrial cancer (EC) within 2 years was investigated in a consecutive cohort of 1205 breast cancer patients under tamoxifen treatment, undergoing transvaginal ultrasonography (TVUS) for follow-up purpose (asymptomatic, 1068) or for abnormal uterine bleeding (AUB, 137). Linkage with tumour registry allowed for the follow-up of 3184.3 person-years. According to underlying

  20. Hypothyroidism After Radiotherapy for Nasopharyngeal Cancer Patients

    SciTech Connect

    Wu, Y.-H. [Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Wang, H-M. [Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Chen, Hellen Hi-Wen [Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Lin, C.-Y.; Chen, Eric Yen-Chao; Fan, K.-H. [Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Huang, S.-F.; Chen, I-How; Liao, C.-T. [Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Department of ENT, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Cheng, Ann-Joy [Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Department of Life Science and Medical Technology, Chang Gung University, Taoyuan, Taiwan (China); Chang, Joseph Tung-Chieh, E-mail: jtchang@adm.cgmh.org.t [Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Department of Medicine, Chang Gung University, Taoyuan, Taiwan (China)

    2010-03-15

    Purpose: The aim of this study was to determine the long-term incidence and possible predictive factors for posttreatment hypothyroidism in nasopharyngeal carcinoma (NPC) patients after radiotherapy. Methods and Materials: Four hundred and eight sequential NPC patients who had received regular annual thyroid hormone surveys prospectively after radiotherapy were included in this study. Median patient age was 47.3 years, and 286 patients were male. Thyroid function was prospectively evaluated by measuring thyroid-stimulating hormone (TSH) and serum free thyroxine (FT4) levels. Low FT4 levels indicated clinical hypothyroidism in this study. Results: With a median follow-up of 4.3 years (range, 0.54-19.7 years), the incidence of low FT4 level was 5.3%, 9.0%, and 19.1% at 3, 5, and 10 years after radiotherapy, respectively. Hypothyroidism was more common with early T stage (p = 0.044), female sex (p = 0.037), and three-dimensional conformal therapy with the altered fractionation technique (p = 0.005) after univariate analysis. N stage, chemotherapy, reirradiation, and neck electron boost did not affect the incidence of hypothyroidism. Younger age and conformal therapy were significant factors that determined clinical hypothyroidism after multivariate analysis. Overall, patients presented with a low FT4 level about 1 year after presenting with an elevated TSH level. Conclusion: Among our study group of NPC patients, 19.1% experienced clinical hypothyroidism by 10 years after treatment. Younger age and conformal therapy increased the risk of hypothyroidism. We suggest routine evaluation of thyroid function in NPC patients after radiotherapy. The impact of pituitary injury should be also considered.

  1. The feasibility of using Patients Concerns Inventory (PCI) in managing Malaysian oral cancer patients.

    PubMed

    Hatta, J M M; Doss, J G; Rogers, S N

    2014-02-01

    The feasibility of using the Patients Concerns Inventory (PCI) to identify oral cancer patient concerns during consultation in oral and maxillofacial specialist clinics in Malaysia was assessed. A cross-sectional study was conducted using a consecutive clinical sampling technique of all new and follow-up oral cancer patients. Surgeons and counter staff were also recruited. Two-thirds of patients were elderly, 63.9% female, 55.6% Indian, 63.9% of lower-level education, and half had the lowest level household income. Patient status was mostly post-treatment (87.5%) and most were at cancer stage III/IV (63.9%); 59.7% had surgery. Patients took an average 5.9 min (95% CI 5.1-6.7 min) to complete the PCI. Physical domain appeared highest (94.4%); social/family relationship issues (4.2%) were lowest. Significant associations included patient age-personal function (P=0.02); patient education level-emotional status (P=0.05) and social/family relationship issues (P=0.04), and patient TNM staging-personal function (P=0.03). The patients' mean feasibility score for the PCI was 5.3 (95% CI 5.1-5.5) out of 6. Patients (93.1%) and surgeons (90%) found the PCI to be feasible. Only 57.1% of counter staff agreed on the use of the PCI during patient registration. Overall, the PCI was considered feasible, thus favouring its future use in routine oral cancer patient management. PMID:24074487

  2. Multiple primaries in pancreatic cancer patients: indicator of a genetic predisposition?

    Microsoft Academic Search

    Berthold Gerdes; Andreas Ziegler; Annette Ramaswamy; Peter Langera; Detlef K Bartscha

    2000-01-01

    Background The genetic basis of several familial cancers including breast and colon cancers has been identified recently. The occurrence of multiple cancers in one individual is also suggestive of a genetic predisposition. To evaluate inherited predisposition in pancreatic cancer we compared the clinical data of pancreatic cancer patients with and without multiple primaries as well as the frequency of malignancies

  3. Detection of early bronchial cancer by autofluorescence: results in patients with H&N cancer

    NASA Astrophysics Data System (ADS)

    Gabrecht, Tanja; Radu, Alexandre; Zellweger, Matthieu; Lovisa, Blaise; Goujon, Didier; Grosjean, Pierre; van den Bergh, Hubert; Monnier, Philippe; Wagnières, Georges

    2007-07-01

    Head and neck (H&N) cancer patients have a high incidence of second primary tumours in the tracheobronchial tree. Diagnostic autofluorescence bronchoscopy (DAFE) has shown promising results in the detection of early neoplastic and pre-neoplastic changes in the bronchi. We have investigated the medical impact of DAFE in a population of H&N cancer patients. The bronchoscopies were performed using a modified commercially available DAFE system. Endoscopic imaging of the tissue autofluorescence (AF) was combined with an online image analysis procedure allowing to discriminate between true and false positive results. White light (WL) bronchoscopy was performed as a control. Twenty-one patients with high lung cancer risk factors underwent WL and AF bronchoscopy with this improved system. Forty-one biopsies were taken on macroscopicall suspicious (WL or AF positive) sites. Seven patients were found to have second primary tumours in the bronchi. The sensitivity for the detection of these early lesions with the DAFE was 1.6 times larger than the sensitivity of WL bronchoscopy only. The positive predictive value (PPV) for AF is 79% (33% for WL alone). The PPV of both methods together is 100%. DAFE proved to be efficient for the detection of second primary lesions in H&N cancer patients and can be used as a simple addition to pre-operative work-up or follow-up in this patient population.

  4. Assessment and management of chemical coping in patients with cancer.

    PubMed

    Del Fabbro, Egidio

    2014-06-01

    Chemical coping is a working definition that describes patients' intake of opioids on a scale that spans the range between normal nonaddictive opioid use for pain all the way to opioid addiction. Most patients will fall somewhere between the two extremes in using opioid analgesics to cope with their psychological or spiritual distress. The degree to which patients use their medications in a maladaptive manner will determine their susceptibility to drug toxicity and harm. When there are no obvious cancer-related causes for increased pain intensity, chemical coping and other patient-related factors such as delirium, somatization, and depression should be considered. As part of the initial evaluation of patients with cancer-related pain, a brief screening tool such as the CAGE questionnaire should be used to identify patients who may be at risk for chemical coping. Identifying patients at risk will allow clinicians to avoid unnecessary opioid toxicity, control pain, and improve quality of life. A structured approach for managing opioid use should be adopted, including standardized documentation, opioid treatment agreements, urine drug screens, frequent visits, and restricted quantities of breakthrough opioids. All patients at risk should receive brief motivational interviewing with an objective, nonjudgmental, and empathic style that includes personalized feedback, particularly about markers of risk or harm. For chemical copers approaching the addiction end of the spectrum, with evidence of compulsive use and destructive behavior, referral should be made to substance abuse specialists. PMID:24799476

  5. Music as a method of coping with cancer: A qualitative study among cancer patients in Sweden

    PubMed Central

    Ahmadi, Fereshteh

    2013-01-01

    Background: This study investigated patients’ understanding of the role of music in coping and in influencing their well-being. Methods: A qualitative study was conducted based on semi-structured interviews with 17 cancer patients. Participants were chosen from a group of patients who had listened to or played music as a means of coping with their illness. Results: The study shows the importance of considering the roles that different kinds of music play in coping with cancer. The music of nature, healing music, religious music and cheerful music each have different benefits for patients. Conclusions: A patient's situation and his or her individual characteristics determine the types of music that can act as a useful or harmful coping strategy. Therefore, it is essential to investigate the types of individual characteristics that can make listening to different kinds of music a helpful or harmful coping method. PMID:23805166

  6. Long-term survival and conditional survival of cancer patients in Japan using population-based cancer registry data.

    PubMed

    Ito, Yuri; Miyashiro, Isao; Ito, Hidemi; Hosono, Satoyo; Chihara, Dai; Nakata-Yamada, Kayo; Nakayama, Masashi; Matsuzaka, Masashi; Hattori, Masakazu; Sugiyama, Hiromi; Oze, Isao; Tanaka, Rina; Nomura, Etsuko; Nishino, Yoshikazu; Matsuda, Tomohiro; Ioka, Akiko; Tsukuma, Hideaki; Nakayama, Tomio

    2014-11-01

    Although we usually report 5-year cancer survival using population-based cancer registry data, nowadays many cancer patients survive longer and need to be followed-up for more than 5 years. Long-term cancer survival figures are scarce in Japan. Here we report 10-year cancer survival and conditional survival using an established statistical approach. We received data on 1,387,489 cancer cases from six prefectural population-based cancer registries in Japan, diagnosed between 1993 and 2009 and followed-up for at least 5 years. We estimated the 10-year relative survival of patients who were followed-up between 2002 and 2006 using period analysis. Using this 10-year survival, we also calculated the conditional 5-year survival for cancer survivors who lived for some years after diagnosis. We reported 10-year survival and conditional survival of 23 types of cancer for 15-99-year-old patients and four types of cancer for children (0-14 years old) and adolescent and young adults (15-29 years old) patients by sex. Variation in 10-year cancer survival by site was wide, from 5% for pancreatic cancer to 95% for female thyroid cancer. Approximately 70-80% of children and adolescent and young adult cancer patients survived for more than 10 years. Conditional 5-year survival for most cancer sites increased according to years, whereas those for liver cancer and multiple myeloma did not increase. We reported 10-year cancer survival and conditional survival using population-based cancer registries in Japan. It is important for patients and clinicians to report these relevant figures using population-based data. PMID:25183551

  7. Second primary cancers in patients with nasopharyngeal carcinoma: a pooled analysis of 13 cancer registries

    Microsoft Academic Search

    Ghislaine Scélo; Paolo Boffetta; Marilys Corbex; Kee-Seng Chia; Kari Hemminki; Soren Friis; Eero Pukkala; Elisabete Weiderpass; Mary L. McBride; Elizabeth Tracey; David H. Brewster; Vera Pompe-Kirn; Erich V. Kliewer; Jon M. Tonita; Carmen Martos; Jon G. Jonasson; Paul Brennan

    2007-01-01

    Objective  To study the risk of second primary cancers in nasopharyngeal carcinoma (NPC) patients and the risk of NPC as second primary\\u000a cancer.\\u000a \\u000a \\u000a \\u000a Methods  We used data from the cancer registries from Singapore and from 12 low-incidence areas, including a total of 8,947 first occurring\\u000a NPC cases, and 167 second occurring cases. We calculated standardized incidence ratios (SIRs) by comparing the second

  8. The Tennessee antigen test. An evaluation in cancer and non-cancer patients and normal subjects.

    PubMed Central

    Pentycross, C. R.

    1982-01-01

    The Tennagen test has been evaluated in "normal" subjects, patients with cancer (predominantly colorectal) and patients with non-malignant disease. The incidence of positive values was found to be higher in patients with clinically active cancer than in those with benign conditions or normal subjects. In our hands the test fell far short of the 90% reliability previously claimed. This may be partly due to an underestimate of the upper normal limit in earlier studies. A small series of follow-up studies after resection for colorectal cancer have so far failed to reveal any advantage to be gained by Tennagen tests over existing methods, but these studied will be continued. PMID:7059472

  9. Curcumin in Treating Patients With Familial Adenomatous Polyposis | Division of Cancer Prevention

    Cancer.gov

    This clinical trial studies curcumin in treating patients with familial adenomatous polyposis. Curcumin may prevent colorectal cancer in patients with a history of rectal polyps or colorectal neoplasia.

  10. Predictors for contralateral prophylactic mastectomy in breast cancer patients

    PubMed Central

    Fu, Yun; Zhuang, Zhigang; Dewing, Michelle; Apple, Sophia; Chang, Helena

    2015-01-01

    Background: In recent years, radical breast cancer surgery has been largely replaced by breast conservation treatment, due to early diagnosis and more effective adjuvant treatment. While breast conservation is mostly preferred, the trend of bilateral mastectomy has risen in the United States. The aim of this study is to determine factors influencing patients’ choice for having contralateral prophylactic mastectomy (CPM). Methods: This is a retrospective study of 373 patients diagnosed with primary invasive breast cancer who were treated by bilateral or unilateral mastectomy (BM or UM) at the Revlon/UCLA Breast Center between Jan. 2002 and Dec. 2010. In the BM group, only those with unilateral breast cancer who chose CPM were included in the analysis. Results: When compared with the UM group, the following factors were found to be associated with BM: younger age, pre-menopausal, a family history of breast/ovarian cancer, BRCA mutation, more breast biopsies, history of breast augmentation, having MRI study within 6 months before the surgery, more likely to have reconstruction and sentinel lymph node biopsy (SLNB) and fewer had neoadjuvant/adjuvant chemotherapy/radiation. When patients with bilateral breast cancer were excluded, multivariate logistic regression analysis indicated younger patients with negative nodes, SLNB as the only nodal surgery and positive family history were significant factors predicting CPM and immediate reconstruction using tissue expanders or implants. Conclusion: Younger age, lower TN stage, requiring only SLNB and high risk family history predict contralateral prophylactic mastectomy. Tissue expander/implant-based reconstructions were more frequently chosen by patients with BM.

  11. Communication avoidance, coping and psychological distress of women with breast cancer.

    PubMed

    Yu, Yisha; Sherman, Kerry A

    2015-06-01

    This study examined the relationship between communication avoidance of cancer-related topics with psychological distress, and the mediating role of coping strategies, in women with breast cancer. Women diagnosed with breast cancer (N = 338) completed an online survey including measures of self- and perceived-partner communication avoidance, psychological distress (depression, anxiety and stress), and coping strategies. Linear regression analyses indicated that women's and perceived-partner's communication avoidance was associated with anxiety, depression, and stress in the cancer-affected women. Bootstrapping analyses showed significant mediation effects of self- and perceived-partner communication avoidance on all distress outcomes through greater disengagement coping, and on anxiety through lower engagement coping. Emotionally valenced topics (i.e., disease progression and sexuality) were most avoided and practical issues were least avoided. Enhancing couple communication about cancer and women's adaptive coping skills (i.e., discourage use of disengagement coping strategies and promote use of engagement coping strategies) may be important targets for psychosocial intervention. PMID:25804374

  12. Quality of Life in Cancer Patients Receiving Palliative Care

    PubMed Central

    Singh, Divya Pal

    2010-01-01

    Background: The main focus of palliative care services is to improve the patient’s quality of life (QOL), which is defined as the subjective evaluation of life as a whole or the patient’s appraisal and satisfaction with their current level of functioning compared with what they perceive to be possible or ideal. Aims: In this prospective study we attempt to validate the Hindi version of a questionnaire designed by the functional assessment of chronic illness therapy (FACIT) measurement system; to measure the subjective QOL of cancer patients receiving home-based palliative care, determine ease of use of the questionnaire and correlate the QOL of these patients with the objective assessment of their Karnofsky’s performance status and their numerical pain score. Settings and Design: One hundred cancer patients receiving free home-based palliative care in New Delhi, India. Materials and Methods: A multidisciplinary palliative home care team using the Functional Assessment of Cancer Therapy-General (FACT-G©) questionnaire in Hindi. Statistical Analysis Used: Microsoft Excel Correlation. Results: The FACT-G© questionnaire in Hindi is a useful tool in measuring QOL and can be used to monitor the patient’s progress and symptom control during the course of the disease. It is simple to use and does not take too much time to complete. The results are tabulated in English and can be used for comparison purposes globally; the scoring process is very simple. Conclusions: Increasing QOL and KPS showed a positive correlation whereas increasing pain and better QOL show negative correlation, as do better performance status and increasing pain score. PMID:20859470

  13. Incidence of cerebral metastases in patients treated with trastuzumab for metastatic breast cancer

    Microsoft Academic Search

    A J Clayton; S Danson; S Jolly; W D J Ryder; P A Burt; A L Stewart; P M Wilkinson; R S Welch; B Magee; G Wilson; A Howell; A M Wardley

    2004-01-01

    Trastuzumab is an effective treatment for patients with metastatic breast cancer (MBC) that overexpresses HER-2. A high incidence of brain metastases (BM) has been noted in patients receiving trastuzumab. A retrospective chart review was conducted of 100 patients commencing trastuzumab for metastatic breast cancer from July 1999 to December 2002, at the Christie Hospital. Seven patients were excluded; five patients

  14. Outcome in patients with lung cancer found on lung cancer mass screening roentgenograms, but who did not subsequently consult a doctor

    Microsoft Academic Search

    Kosuke Kashiwabara; Syu-ichi Koshi; Kotaro Itonaga; Osamu Nakahara; Makoto Tanaka; Masakazu Toyonaga

    2003-01-01

    Goals of the study: To evaluate the outcome in patients with lung cancer found on lung cancer mass screening roentgenograms, but who did not subsequently consult a doctor. Patients and Methods: This study enrolled 198 asymptomatic patients with lung cancer found by lung cancer mass screening during the 9-year period. Five-year survival rates in patients who did not consult a

  15. Impact of Pelvic Radiotherapy on Gut Microbiota of Gynecological Cancer Patients Revealed by Massive

    E-print Network

    Bae, Jin-Woo

    insights into the treatment of cancer patients suffering from complications after radiation therapy in cancer patients. Given the lack of clinical or experimental data on the impact of radiation on gut microbiota in cancer patients receiving radiation were investigated by 454 pyrosequencing. Gut microbial

  16. Actual Dose Variation of Parotid Glands and Spinal Cord for Nasopharyngeal Cancer Patients During Radiotherapy

    Microsoft Academic Search

    Chunhui Han; Yi-Jen Chen; An Liu; Timothy E. Schultheiss; Jeffrey Y. C. Wong

    2008-01-01

    Purpose: For intensity-modulated radiotherapy of nasopharyngeal cancer, accurate dose delivery is crucial to the success of treatment. This study aimed to evaluate the significance of daily image-guided patient setup corrections and to quantify the parotid gland volume and dose variations for nasopharyngeal cancer patients using helical tomotherapy megavoltage computed tomography (CT). Methods and Materials: Five nasopharyngeal cancer patients who underwent

  17. Cancer patients' information needs and information seeking behaviour: in depth interview study

    Microsoft Academic Search

    Geraldine M Leydon; Mary Boulton; Clare Moynihan; Alison Jones; Jean Mossman; Markella Boudioni; Klim McPherson; Geraldine M

    2000-01-01

    Objectives To explore why cancer patients do not want or seek information about their condition beyond that volunteered by their physicians at times during their illness. Design Qualitative study based on in›depth interviews. Setting Outpatient oncology clinics at a London cancer centre. Participants 17 patients with cancer diagnosed in previous 6 months. Main outcome measures Analysis of patients' narratives to

  18. The Baseline Ratio of Neutrophils to Lymphocytes Is Associated with Patient Prognosis in Advanced Gastric Cancer

    Microsoft Academic Search

    Takeharu Yamanaka; Shigemi Matsumoto; Satoshi Teramukai; Ryota Ishiwata; Yoji Nagai; Masanori Fukushima

    2007-01-01

    Objective: In cancer patients, the balance between neutrophil (N) and lymphocyte (L) cell counts fluctuates with advancing disease. The objective of our study was to determine the prognostic implications of the N\\/L ratio in the peripheral blood of gastric cancer patients. Methods: Study participants were identified from a prospective cohort of patients with advanced gastric cancer in Japan (n =

  19. Treatable complications of cancer patients referred to an in-patient hospice

    Microsoft Academic Search

    Tatsuya Morita; You Tei; Hideki Shishido; Satoshi Inoue

    2003-01-01

    This paper illustrates the importance of accurate diagnoses and treatments of complications in terminally ill cancer patients. The paper reports on five hospice in-patients who completely recovered from life-threatening complications; three of them had been incorrectly labeled as “imminently dying” by the referring physicians.The paper concludes that it would be beneficial for patients to receive examinations and a trial of

  20. Skin cancer in patients with chronic radiation dermatitis

    SciTech Connect

    Davis, M.M.; Hanke, C.W.; Zollinger, T.W.; Montebello, J.F.; Hornback, N.B.; Norins, A.L.

    1989-04-01

    The cases of 76 patients with chronic radiation dermatitis resulting from low-dose ionizing radiation for benign disease were reviewed retrospectively for risk factors leading to the development of neoplasia. The patients were studied with respect to original hair color, eye color, sun reactive skin type, benign disease treated, area treated, age at treatment, and age at development of first skin cancer. Analysis of data showed 37% of patients had sun-reactive skin type I, 27% had type II, and 36% had type III. Types IV through VI were not represented. There appeared to be an overrepresentation of types I and II. Increased melanin pigmentation may therefore be either directly or indirectly protective against the development of skin cancers in patients who have received low-dose superficial ionizing radiation for benign disease. The sun-reactive skin type of patients with chronic radiation dermatitis may be used as a predictor of skin cancer risk when the total dose of ionizing radiation is not known.

  1. Communicating with Alexithymic and Non-Alexithymic Patients: An Experimental Study of the Effect of Psychosocial Communication and Empathy on Patient Satisfaction

    Microsoft Academic Search

    Peter Kjær Graugaard; Kjersti Holgersen; Arnstein Finset

    2004-01-01

    Background: Previous studies have shown that alexithymia is associated with a wide range of somatic and psychiatric conditions. The aim of this study was to investigate experimentally how psychosocial communication and empathic response from the physician affects satisfaction in alexithymic and non-alexithymic patients. Method: Seven physicians and 65 female patients from a fibromyalgia patient association participated in the study. The

  2. Anxiolytic Effect of Aromatherapy Massage in Patients with Breast Cancer

    PubMed Central

    Kuriyama, Hiroko; Shigemori, Ichiro; Watanabe, Satoko; Aihara, Yuka; Kita, Masakazu; Sawai, Kiyoshi; Nakajima, Hiroo; Yoshida, Noriko; Kunisawa, Masahiro; Kawase, Masanori; Fukui, Kenji

    2009-01-01

    We examined how aromatherapy massage influenced psychologic and immunologic parameters in 12 breast cancer patients in an open semi-comparative trial. We compared the results 1 month before aromatherapy massage as a waiting control period with those during aromatherapy massage treatment and 1 month after the completion of aromatherapy sessions. The patients received a 30 min aromatherapy massage twice a week for 4 weeks (eight times in total). The results showed that anxiety was reduced in one 30 min aromatherapy massage in State-Trait Anxiety Inventory (STAI) test and also reduced in eight sequential aromatherapy massage sessions in the Hospital Anxiety and Depression Scale (HADS) test. Our results further suggested that aromatherapy massage ameliorated the immunologic state. Further investigations are required to confirm the anxiolytic effect of aromatherapy in breast cancer patients. PMID:18955225

  3. Cancer Regression in Patients After Transfer of Genetically Engineered Lymphocytes

    NASA Astrophysics Data System (ADS)

    Morgan, Richard A.; Dudley, Mark E.; Wunderlich, John R.; Hughes, Marybeth S.; Yang, James C.; Sherry, Richard M.; Royal, Richard E.; Topalian, Suzanne L.; Kammula, Udai S.; Restifo, Nicholas P.; Zheng, Zhili; Nahvi, Azam; de Vries, Christiaan R.; Rogers-Freezer, Linda J.; Mavroukakis, Sharon A.; Rosenberg, Steven A.

    2006-10-01

    Through the adoptive transfer of lymphocytes after host immunodepletion, it is possible to mediate objective cancer regression in human patients with metastatic melanoma. However, the generation of tumor-specific T cells in this mode of immunotherapy is often limiting. Here we report the ability to specifically confer tumor recognition by autologous lymphocytes from peripheral blood by using a retrovirus that encodes a T cell receptor. Adoptive transfer of these transduced cells in 15 patients resulted in durable engraftment at levels exceeding 10% of peripheral blood lymphocytes for at least 2 months after the infusion. We observed high sustained levels of circulating, engineered cells at 1 year after infusion in two patients who both demonstrated objective regression of metastatic melanoma lesions. This study suggests the therapeutic potential of genetically engineered cells for the biologic therapy of cancer.

  4. Supportive care of the older cancer patient

    Microsoft Academic Search

    Lodovico Balducci; Ignazio Carreca

    2003-01-01

    Aging is associated with decreased functional reserve of multiple organ systems and with changes in the pharmacokinetics and pharmacodinamics of drugs. Older individuals express enhanced susceptibility to the complications of cytotoxic chemotherapy, especially to myleotoxicity, mucositis, cardiotoxicity and neurotoxicity. The management of older individuals with chemotherapy involves then prevention of these complications. General precautions include proper patient selection, based on

  5. Breast cancer, ovarian gonadoblastoma and cervical cancer in a patient with Peutz-Jeghers Syndrome

    Microsoft Academic Search

    Tulay Kilic-Okman; Turgut Yardim; Fatih Gücer; Semsi Altaner; M. Ali Yuce

    2008-01-01

    Background  Peutz-Jeghers Syndrome (PJS) is a rare autosomal dominant disorder characterized by gastrointestinal hamartomatous polyps\\u000a and mucocutaneous pigmentation. Patients with PJS have increased risk for gastrointestinal, breast, and female genital tract\\u000a cancers.\\u000a \\u000a \\u000a \\u000a Case  Multiple genital tract cancers in a 34-year-old woman with PJS are described. The patient, who was admitted to our department\\u000a with severe vaginal bleeding, was performed right salpingo-oophorectomy because

  6. Physician Burnout and Patient-Physician Communication During Primary Care Encounters

    PubMed Central

    Roter, Debra; Beach, Mary Catherine; Laird, Shivonne L.; Larson, Susan M.; Carson, Kathryn A.; Cooper, Lisa A.

    2008-01-01

    Background Although previous studies suggest an association between provider burnout and suboptimal self-reported communication, no studies relate physician burnout to observed patient-physician communication behaviors. Objective To investigate the relationship between physician burnout and observed patient-physician communication outcomes in patient-physician encounters. Design Longitudinal study of enrollment data from a trial of interventions to improve patient adherence to hypertension treatment. Setting Fifteen urban community-based clinics in Baltimore, MD. Participants Forty physicians and 235 of their adult hypertensive patients, with oversampling of ethnic minorities and poor persons. Fifty-three percent of physicians were women, and the average practice experience was 11.2 years. Among the 235 patients, 66% were women, 60% were African-American, and 90% were insured. Measurements Audiotape analysis of communication during outpatient encounters (one per patient) using the Roter Interaction Analysis System and patients’ ratings of satisfaction with and trust and confidence in the physician. Results The median time between the physician burnout assessment and the patient encounter was 15.1 months (range 5.6–30). Multivariate analyses revealed no significant differences in physician communication based on physician burnout. However, compared with patients of low-burnout physicians, patients of high-burnout physicians gave twice as many negative rapport-building statements (incident risk ratio 2.06, 95% CI 1.58 – 2.86, p?patient affect, patient-centeredness, verbal dominance, or length of the encounter. Physician burnout was also not significantly associated with patients’ ratings of their satisfaction, confidence, or trust. Conclusions Physician burnout was not associated with physician communication behaviors nor with most measures of patient-centered communication. However, patients engaged in more rapport-building behaviors. These findings suggest a complex relationship between physician burnout and patient-physician communication, which should be investigated and linked to patient outcomes in future research. PMID:18618195

  7. Vincristine induced neurotoxicity in cancer patients.

    PubMed

    Gomber, Sunil; Dewan, Pooja; Chhonker, Devender

    2010-01-01

    Ten out of 20 children, treated with usual doses of vincristine for various types of childhood cancers, developed neurotoxicity during treatment. Peripheral neurotoxicity (mixed motor-sensory 4/10, pure motor 3/10, pure sensory 3/10) was seen in the form of weakness of lower limbs, areflexia, neuropathic pain, or sensory loss. Autonomic neuropathy presented as constipation and urinary retention in 2 children, while 2 children developed encephalopathy in form of seizures, confusion, aphasia, and transient blindness. In children with severe neuropathy, vincristine administration was withheld/dose reduced till clinical improvement started, which took about 2-3 weeks time. Nerve conduction velocity showed motor-sensory axonal polyneuropathy. Electrophysiological abnormalities were found to persist even six months after clinical recovery in children with neurotoxicity. We found a relatively higher incidence of vincristine induced neuropathy in Indian children, which was probably due to coexistence of severe malnutrition in them. PMID:19936661

  8. Evaluating the Linguistic Appropriateness and Cultural Sensitivity of a Self-Report System for Spanish-Speaking Patients with Cancer

    PubMed Central

    Gonzalez, Laura; Negrón, Rosalyn; Berry, Donna L.

    2014-01-01

    Spanish speakers in the United States encounter numerous communication barriers during cancer treatment. Communication-focused interventions may help Spanish speakers communicate better with healthcare providers and manage symptoms and quality of life issues (SQOL). For this study, we developed a Spanish version of the electronic self-report assessment for cancer (ESRA-C), a web-based program that helps people with cancer report, track, and manage cancer-related SQOL. Four methods were used to evaluate the Spanish version. Focus groups and cognitive interviews were conducted with 51 Spanish-speaking individuals to elicit feedback. Readability was assessed using the Fry readability formula. The cultural sensitivity assessment tool was applied by three bilingual, bicultural reviewers. Revisions were made to personalize the introduction using a patient story and photos and to simplify language. Focus group participants endorsed changes to the program in a second round of focus groups. Cultural sensitivity of the program was scored unacceptable (x¯=3.0) for audiovisual material and acceptable (x¯=3.0) for written material. Fry reading levels ranged from 4th to 10th grade. Findings from this study provide several next steps to refine ESRA-C for Spanish speakers with cancer. PMID:25045535

  9. Postoperative Mortality in Cancer Patients With Preexisting Diabetes

    PubMed Central

    Barone, Bethany B.; Yeh, Hsin-Chieh; Snyder, Claire F.; Peairs, Kimberly S.; Stein, Kelly B.; Derr, Rachel L.; Wolff, Antonio C.; Brancati, Frederick L.

    2010-01-01

    OBJECTIVE Diabetes appears to increase risk for some cancers, but the association between preexisting diabetes and postoperative mortality in cancer patients is less clear. Our objective was to systematically review postoperative mortality in cancer patients with and without preexisting diabetes and summarize results using meta-analysis. RSEARCH DESIGN AND METHODS We searched the Medical Literature Analysis and Retrieval System Online (MEDLINE) and Excerpta Medica Database (EMBASE) for articles published on or before 1 July 2009, including references of qualifying articles. We included English language investigations of short-term postoperative mortality after initial cancer treatment. Titles, abstracts, and articles were reviewed by at least two independent readers. Study population and design, results, and quality components were abstracted with standard protocols by one reviewer and checked for accuracy by additional reviewers. RESULTS Of 8,828 titles identified in our original search, 20 articles met inclusion criteria for qualitative systematic review. Of these, 15 reported sufficient information to be combined in meta-analysis. Preexisting diabetes was associated with increased odds of postoperative mortality across all cancer types (OR = 1.85 [95% CI 1.40–2.45]). The risk associated with preexisting diabetes was attenuated but remained significant when we restricted the meta-analysis to models that controlled for confounders (1.51 [1.13–2.02]) or when we accounted for publication bias using the trim and fill method (1.52 [1.13–2.04]). CONCLUSIONS Compared with their nondiabetic counterparts, cancer patients with preexisting diabetes are ?50% more likely to die after surgery. Future research should investigate physiologic pathways to mortality risk and determine whether improvements in perioperative diabetes care can reduce postoperative mortality. PMID:20351229

  10. Bevacizumab treatment in the elderly patient with metastatic colorectal cancer

    PubMed Central

    Di Bartolomeo, Maria; Maggi, Claudia; Ricchini, Francesca; Pietrantonio, Filippo; Iacovelli, Roberto; de Braud, Filippo; Inno, Alessandro

    2015-01-01

    Metastatic colorectal cancer (mCRC), like many cancers, is primarily a disease of elderly people. Despite this prevalence, such patients are often excluded from randomized trials or represent a minority of enrolled patients. Moreover, the criteria for establishing benefit or side effects of treatment strategies in this population are uncertain and not well recognized. Bevacizumab improves the outcome of mCRC when used in combination with standard first-line and second-line chemotherapy and beyond the first disease progression when given with a chemotherapy backbone different from that used in the precedent line. The particular toxicity profile of this antiangiogenesis agent (in particular hypertension, thromboembolic events, hemorrhage, and renal failure) may discourage its use in elderly patients with comorbidities. Data from subgroup analyses of randomized trials and the results of recent cohort studies suggest a significant benefit from the addition of bevacizumab to standard chemotherapy for elderly patients comparable with that observed in younger patients, except for the increased risk for thromboembolic events. Age alone should not be a barrier to use of bevacizumab, and further research with a more complete geriatric assessment should investigate the role of bevacizumab in elderly patients with mCRC to avoid undertreatment of this patient population due to a historical conservative approach. PMID:25584021

  11. Bevacizumab treatment in the elderly patient with metastatic colorectal cancer.

    PubMed

    Di Bartolomeo, Maria; Maggi, Claudia; Ricchini, Francesca; Pietrantonio, Filippo; Iacovelli, Roberto; de Braud, Filippo; Inno, Alessandro

    2015-01-01

    Metastatic colorectal cancer (mCRC), like many cancers, is primarily a disease of elderly people. Despite this prevalence, such patients are often excluded from randomized trials or represent a minority of enrolled patients. Moreover, the criteria for establishing benefit or side effects of treatment strategies in this population are uncertain and not well recognized. Bevacizumab improves the outcome of mCRC when used in combination with standard first-line and second-line chemotherapy and beyond the first disease progression when given with a chemotherapy backbone different from that used in the precedent line. The particular toxicity profile of this antiangiogenesis agent (in particular hypertension, thromboembolic events, hemorrhage, and renal failure) may discourage its use in elderly patients with comorbidities. Data from subgroup analyses of randomized trials and the results of recent cohort studies suggest a significant benefit from the addition of bevacizumab to standard chemotherapy for elderly patients comparable with that observed in younger patients, except for the increased risk for thromboembolic events. Age alone should not be a barrier to use of bevacizumab, and further research with a more complete geriatric assessment should investigate the role of bevacizumab in elderly patients with mCRC to avoid undertreatment of this patient population due to a historical conservative approach. PMID:25584021

  12. Palliative care of cancer patients: audit of current hospital procedures.

    PubMed

    Sessa, C; Pampallona, S; Carobbio, M; Neuenschwander, H; Cavalli, F

    1998-05-01

    The palliative care of cancer patients admitted for tumour-related symptoms to three different departments (medical oncology, radiotherapy, internal medicine) of a general hospital was prospectively audited. The physicians directly responsible for the patients provided prospective data by reporting both the diagnostic and therapeutic interventions performed and the degree of control achieved for each symptom. A patient form for evaluation of the control achieved in the case of each symptom by means of linear analogue scales was also provided. The appropriateness of all procedures was evaluated by two external auditors. Over 6 months, 125 such admissions were recorded: 24 patients entered the study and the management of 56 symptoms, the most common of which were pain and dyspnoea, was reviewed. A total of 72 diagnostic procedures were performed, deemed necessary for only 50% of symptoms, optional for 15%, and performed as part of a logical sequence for 38%. A total of 130 therapeutic interventions were undertaken, deemed necessary for 55% of symptoms, optional for 15% and carried out as part of a logical sequence for 44%. Re-evaluations of symptoms and physician and patient evaluations of the degree of control achieved could not be assessed because of lack of information. The audit could not be repeated owing to the low accrual of patients and incompleteness of the data collection. Reasons for failure of the study and proposals for feasible methods of auditing the management of symptoms in cancer patients are discussed. PMID:9629881

  13. Sex differences in hospital readmission among colorectal cancer patients

    PubMed Central

    Gonzalez, J. R.; Fernandez, E.; Moreno, V.; Ribes, J.; Peris, M.; Navarro, M.; Cambray, M.; Borras, J. M.

    2005-01-01

    Background: While several studies have analysed sex and socioeconomic differences in cancer incidence and mortality, sex differences in oncological health care have been seldom considered. Objective: To investigate sex based inequalities in hospital readmission among patients diagnosed with colorectal cancer. Design: Prospective cohort study. Setting: Hospital Universitary in L'Hospitalet (Barcelona, Spain). Participants: Four hundred and three patients diagnosed with colorectal between January 1996 and December 1998 were actively followed up until 2002. Main outcome measurements and methods: Hospital readmission times related to colorectal cancer after surgical procedure. Cox proportional model with random effect (frailty) was used to estimate hazard rate ratios and 95% confidence intervals of readmission time for covariates analysed. Results: Crude hazard rate ratio of hospital readmission in men was 1.61 (95% CI 1.21 to 2.15). When other significant determinants of readmission were controlled for (including Dukes's stage, mortality, and Charlson's index) a significant risk of readmission was still present for men (hazard rate ratio: 1.52, 95% CI 1.17 to 1.96). Conclusions: In the case of colorectal cancer, women are less likely than men to be readmitted to the hospital, even after controlling for tumour characteristics, mortality, and comorbidity. New studies should investigate the role of other non-clinical variable such as differences in help seeking behaviours or structural or personal sex bias in the attention given to patients. PMID:15911648

  14. Family physicians' roles in cancer care. Survey of patients on a provincial cancer registry.

    PubMed Central

    Sisler, Jeffrey J.; Brown, Judith Belle; Stewart, Moira

    2004-01-01

    OBJECTIVE: To describe cancer patients' experience of the role of family physicians (FPs) in their care. DESIGN: Mail survey of a random sample of patients from the Manitoba Cancer Registry. SETTING: Manitoba. PARTICIPANTS: Two hundred two adults, 6 to 12 months after diagnosis. MAIN OUTCOME MEASURES: Proportion needing different kinds of help from FPs and their rating of FPs' response; FACT-G quality-of-life score. RESULTS: Response rate was 56.6%; two thirds of the sample were in the follow-up phase. Most (91%) had an FP involved in their care, but FP involvement decreased after diagnosis. The most frequently needed kinds of help (with general medical problems, quick referrals, taking extra time, and quick office appointments) were well provided by FPs, but family support was not. Higher quality-of-life scores were associated with more help with general medical problems, more provision of cancer-related information, and more emotional support of patients and their families. CONCLUSION: Family physicians respond well to the most common needs of cancer patients and should be proactive in offering their support to both patients and families. PMID:15233372

  15. Resources, Parent-Child Communication and Adjustment to Pediatric Cancer | Division of Cancer Prevention

    Cancer.gov

    Skip to main content Division of Cancer Prevention Search form Search Main menu Home Major Programs Research Networks Map Alliance of Glycobiologists for Detection of Cancer Barrett's Esophagus Translational Research Network (BETRNet) Cancer Prevention

  16. Palliative Cancer Care: Music Video for AYA-Parent Communication and Resilience | Division of Cancer Prevention

    Cancer.gov

    Skip to main content Division of Cancer Prevention Search form Search Main menu Home Major Programs Research Networks Map Alliance of Glycobiologists for Detection of Cancer Barrett's Esophagus Translational Research Network (BETRNet) Cancer Prevention

  17. Quality of life in rectal cancer patients after radical surgery: a survey of Chinese patients

    PubMed Central

    2014-01-01

    Background We aimed to investigate the impact of sociodemographic and clinical characteristics on health-related quality of life (HRQoL) in disease-free survivors after radical surgery for rectal cancer in a Chinese mainland population. Methods We performed a cross-sectional survey from August 2002 to February 2011 by use of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-CR38 questionnaires of 438 patients who underwent curative surgery for rectal cancer. Patients who were followed up for a minimum of 6 months, had no relevant major comorbidities and whose disease had not recurred were asked to complete both questionnaires. The impact of sociodemographic and clinical characteristics on HRQoL were compared by univariate and multivariate regression analyses. Results In total, 285 patients responded to the survey (response rate, 65.1%). Psychological-related HRQoL variables such as emotional function (P?=?0.021) and future perspectives (P?=?0.044) were poorer for younger patients than for older patients; and physiological-related HRQoL was reflected by physical function (P?=?0.039), which was poorer for older patients than for younger patients. In terms of physiologic function and symptoms concerning HRQoL, such as pain (P?=?0.002) and insomnia (P?=?0.018), females had lower values than males. Low education and unemployment were associated with a worse HRQoL. HRQoL was worse for patients with stomas compared to those without, especially in psychosocial areas such as role function (P?=?0.025), social function (P <0.001) and body image (P?=?0.004). Financial HRQoL was worse for younger patients and patients with stoma. Conclusions HRQoL aspects and degrees to which they were impaired after curative surgery for rectal cancer were different when compared by many sociodemographic and clinical factors in Chinese mainland patients. PMID:24886668

  18. The treatment of depression in cancer patients: a systematic review

    Microsoft Academic Search

    Gary Rodin; Nancy Lloyd; Mark Katz; Esther Green; Jean A. Mackay; Rebecca K. S. Wong

    2007-01-01

    Goals of the work:  To evaluate the efficacy of pharmacological and nonpharmacological treatments for depression in cancer populations.\\u000a \\u000a \\u000a \\u000a Materials and methods:  The Supportive Care Guidelines Group conducted a systematic review of the published literature through June 2005. Search sources\\u000a includes MEDLINE, EMBASE, CINAHL, PsycInfo, and the Cochrane Library. Comparative studies of treatments for depression in\\u000a cancer patients were selected for review by

  19. Identification of Patients at Risk for Hereditary Colorectal Cancer

    PubMed Central

    Mishra, Nitin; Hall, Jason

    2012-01-01

    Diagnosis of hereditary colorectal cancer syndromes requires clinical suspicion and knowledge of such syndromes. Lynch syndrome is the most common cause of hereditary colorectal cancer. Other less common causes include familial adenomatous polyposis (FAP), Peutz-Jeghers syndrome (PJS), juvenile polyposis syndrome, and others. There have been a growing number of clinical and molecular tools used to screen and test at risk individuals. Screening tools include diagnostic clinical criteria, family history, genetic prediction models, and tumor testing. Patients who are high risk based on screening should be referred for genetic testing. PMID:23730221

  20. [Sociodemographic aspects are associated with breast cancer screening behaviour of female patients: results of a cross-sectional survey].

    PubMed

    Haluza, D; Kundi, M; Vogl, S

    2014-09-01

    In Austria, opportunistic mammography screening for detection of early-stages breast cancer is offered for women older than 40 years. In spite of public discussions on the effectiveness of mammography screening, evidence-based educative information material for female patients available online and in print is lacking. The present study describes the influence of the 3 sociodemographic characteristics migration background, education, and age on the individual's breast cancer screening behaviour as well as on the usage of various information sources on breast cancer for patients. In total, 333 outpatients of the Department of Obstetrics and Gynaecology, General Hospital, Vienna, Austria, participated in a monocentric cross-sectional study. Regarding breast cancer screening, 93.4% (n=282) of the female patients had at least one previous mammogram. Furthermore, 86.3% of the participants regularly consulted their gynaecologist, while women with migration background reported less frequent (p=0.02), and well-educated as well as older patients reported more frequent (p<0.02) gynaecological consultations. Higher-educated women (p=0.04) and participants aged between 50 and 69 years (p<0.05) felt better informed on breast cancer-related topics, whereas a migration background was not associated with the perceived level of information. Medical doctors (67.9%) as well as pertinent folders (33%) were the most relevant information sources on breast cancer. Mass media (22.8%) were also a relevant information source on this issue, whereas the Internet (10.5%) was quite rarely referred to for this purpose. The results of the present study show that female patients perceived the medical doctor as the most important source of medical information on breast cancer. The public health-care system could facilitate positive health communication in the doctors/patient relationship by providing homogenous, quality assured educative information material. PMID:23913396