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European Journal (european + journal)
Selected AbstractsUncertainty, lack of control and emotional functioning in women with metastatic breast cancer: a review and secondary analysis of the literature using the critical appraisal techniqueEUROPEAN JOURNAL OF CANCER CARE, Issue 5 2010M. WARREN msc, clinical nurse specialist WARREN M. (2010) European Journal of Cancer Care19, 564,574 Uncertainty, lack of control and emotional functioning in women with metastatic breast cancer: a review and secondary analysis of the literature using the critical appraisal technique A diagnosis of metastatic (or secondary) breast cancer is frequently more distressing than the diagnosis of a primary tumour since it indicates that the cancer is no longer curable. Relatively little is known, however, about women's experiences of this condition in comparison with those diagnosed with primary breast cancer. This paper therefore reports findings from a secondary analysis of the published literature on the topic using tools from the critical appraisal skills programme to identify and analyse appropriate papers, and the constant comparative method as a means of identifying any overarching or dominant themes emerging from the literature. Uncertainty, lack of control and poor emotional functioning emerged as the main themes affecting women with metastatic breast cancer. These are discussed in relation to their antecedents in the original studies and their implications for nursing care. The themes demonstrate that living with metastatic (or secondary) breast cancer is a multifaceted experience that is influenced by a large number of factors, many of which are under-researched in comparison with those affecting women diagnosed with primary disease. It is clear, however, that women affected by the condition need a great deal more support than they currently receive, and new services may be required to meet these needs. [source] Dying at home: community nurses' views on the impact of informal carers on cancer patients' place of deathEUROPEAN JOURNAL OF CANCER CARE, Issue 5 2010B. JACK phd, bsc (econ), head of research, scholarship JACK B. & O'BRIEN M. (2010) European Journal of Cancer Care19, 636,642 Dying at home: community nurses' views on the impact of informal carers on cancer patients' place of death Giving patients with cancer a choice in where they want to die including the choice to die at home if they so wish, underpin the recent UK government policies and is embedded in the End of Life Care Programme. However, this presents increasing challenges for the informal carers particularly with an increasingly aging population. Despite the policy initiatives, there remain a persistent number of patients with cancer who had chosen to die at home being admitted to hospital in the last days and hours of life. A qualitative study using two focus group interviews with community nurses (district nurses and community specialist palliative care nurses) was undertaken across two primary care trusts in the north-west of England. Data were analysed using a thematic analysis approach. The results indicated that informal carer burden was a key reason for prompting hospital admission. Recommendations for the development of a carer assessment tool with appropriate supportive interventions are made. [source] The effect of aerobic exercise on treatment-related acute toxicity in men receiving radical external beam radiotherapy for localised prostate cancerEUROPEAN JOURNAL OF CANCER CARE, Issue 5 2010G. KAPUR frcr KAPUR G., WINDSOR P.M. & Mc COWAN C. (2010) European Journal of Cancer Care19, 643,647 The effect of aerobic exercise on treatment-related acute toxicity in men receiving radical external beam radiotherapy for localised prostate cancer We retrospectively analysed acute radiation toxicity data for patients who had participated in a randomised controlled study in our centre in order to assess the impact of aerobic exercise on acute rectal and bladder morbidity during treatment. Data from 65 of 66 patients were analysed: 33 allocated into a control group (standard advice) and 33 into an exercise group (aerobic walking for 30 min at least three times per week) during 4 weeks of external beam radiotherapy; one patient in the exercise group withdrew after randomisation before starting radiotherapy. There was a trend towards less severe acute rectal toxicity in the exercise group with a statistically significant difference in mean toxicity scores over the 4 weeks of radiotherapy (P = 0.004), with no significant difference in bladder toxicity scores between the two groups (P = 0.123). The lack of an association for severity of bladder toxicity could be attributed to the confounding effect of lower urinary tract symptoms from their prostate cancer. Keeping active and being asked to adhere to a well-defined exercise schedule appears to reduce the severity of rectal toxicity during radiotherapy to the prostate. [source] Transient response of cardiac angiosarcoma to paclitaxelEUROPEAN JOURNAL OF CANCER CARE, Issue 5 2010E. CASTILLA md CASTILLA E., PASCUAL I., RONCALÉS F., AGUIRRE E. & RÍO A. DEL (2010) European Journal of Cancer Care19, 699,700 Transient response of cardiac angiosarcoma to paclitaxel Malignant tumours of the heart are a group of tumours with low incidence but very high mortality. Delays in diagnosis are common because of their multiple forms of presentation, and 80% present with metastases, further reducing the possibility for cure. We present here the case of a patient with primary cardiac angiosarcoma that highlights the misdiagnosis at clinical presentation, current diagnostic modalities and a possible new treatment using paclitaxel for cardiac angiosarcoma. [source] Metachronous testicular teratoma, testicular seminoma and papillary thyroid carcinoma occurring in a single individual: a report of two unrelated casesEUROPEAN JOURNAL OF CANCER CARE, Issue 5 2010A.A. SYED mbbs, specialist registrar in endocrinology SYED A.A., JONES N.A.G., BLISS R.D., ROBERTS J.T., MALLICK U.K., JOHNSON S.J., DOUGLAS S.F., PERROS P. & QUINTON R. (2010) European Journal of Cancer Care19, 701,702 Metachronous testicular teratoma, testicular seminoma and papillary thyroid carcinoma occurring in a single individual: a report of two unrelated cases We describe two unrelated men who both developed teratomas in one testis followed by seminomas in the contralateral testis followed by papillary thyroid carcinomas. Neither man had a family history of cancers. Although random occurrence is possible, genetic predisposition and/or environmental influence would seem a likely explanation for this previously unreported combination of tumours. [source] A model of treatment decision making when patients have advanced cancer: how do cancer treatment doctors and nurses contribute to the process?EUROPEAN JOURNAL OF CANCER CARE, Issue 4 2010L. MCCULLOUGH msc, nurse leader clinical support services MCCULLOUGH L., MCKINLAY E., BARTHOW C., MOSS C. & WISE D. (2010) European Journal of Cancer Care A model of treatment decision making when patients have advanced cancer: how do cancer treatment doctors and nurses contribute to the process? This qualitative study describes how doctors and nurses report their contribution to treatment decision-making processes when patients have advanced cancer. Thirteen nurses and eight doctors involved in cancer treatment and palliation in one geographical location in New Zealand participated in the study. Data were collected using qualitative in-depth, face-to-face interviews. Content analysis revealed a complex context of decision making influenced by doctors and nurses as well as the patient and other factors. A model of clinician and patient decision making emerged with a distinct and cyclical process as advanced cancer remits and progresses. When patients have advanced cancer, nurses and doctors describe a predictable model of decision making in which they both contribute and that cycles through short- and long-term remissions; often nowadays to the point of the patient dying. In conclusion, the findings suggest doctors and nurses have different but complementary roles in what, when and how treatment choices are negotiated with patients, nevertheless within a distinct model of decision making. [source] Mapping the information resources available to patients with colorectal cancerEUROPEAN JOURNAL OF CANCER CARE, Issue 4 2010S.J. KING phd KING S.J., LIVINGSTON P.M., TURNER L., BYRNE K., JOHN M., SIDWELL J. & SCOTT C. (2010) European Journal of Cancer Care Mapping the information resources available to patients with colorectal cancer The objectives of this study were to identify gaps in information provision along the colorectal cancer (CRC) treatment pathway as provided by health services within the North Eastern Metropolitan Integrated Cancer Service in Victoria Australia; to evaluate the information and recommend consistent, high quality health information resources; and to recommend strategies to improve delivery of patient information. A random sample of health professionals (n= 47) from various disciplines at eight health service sites participated in semi-structured interviews regarding the types of information they provided to CRC patients. Information items were mapped against a published CRC patient management framework and evaluated. A total of 193 information items were collected with 24 items specific to CRC. Gaps in information provision were evident in the community, at diagnosis, in clinics, when treatment was determined and when completed. The quality of information delivery to CRC patients across the public health sites was variable. Resources were often unavailable, out of date and inaccessible in other languages. Results indicate a need to improve health information availability and resource delivery to all CRC patients across different health services particularly at diagnosis and after treatment. Further research is required to determine patient preferences for information about CRC. [source] Early (mucosal) gastric cancer with synchronous osteosclerotic bone metastases: a case reportEUROPEAN JOURNAL OF CANCER CARE, Issue 4 2010G. ANAGNOSTOPOULOS md ANAGNOSTOPOULOS G., SAKORAFAS G.H., KOSTOPOULOS P., MARGANTINIS G., TSIAKOS S. & PAVLAKIS G. (2010) European Journal of Cancer Care Early (mucosal) gastric cancer with synchronous osteosclerotic bone metastases: a case report Early gastric cancer (EGC) is defined as an adenocarcinoma confined to the gastric mucosa or submucosa, regardless of the presence of lymph node metastases. Early gastric cancer carries an excellent prognosis, with a 5-year survival rate at least 85% in most series. However, there are rare cases where distant metastases exist. Bone metastases are rare in gastric cancer; osteoblastic bone metastases are even rarer. We report a patient with EGC (mucosal) and synchronous osteosclerotic bone metastasis. To our knowledge, this is the first reported case of submucosal EGC with synchronous bone metastases. The patient was operated and he received adjuvant chemotherapy and radiotherapy. He died 18 months after gastric surgery from generalized disease. [source] Case report of bilateral inflammatory breast cancerEUROPEAN JOURNAL OF CANCER CARE, Issue 4 2010Y.A. MASANNAT mrcsi, mrcsed, research fellow breast surgery MASANNAT Y.A., PETER M., TURTON P. & SHAABAN A.M. (2010) European Journal of Cancer Care Case report of bilateral inflammatory breast cancer Inflammatory breast cancer (IBC) is a rare entity that makes up 1,3% of breast cancers. As the diagnosis of IBC is mainly clinical, for the inexperienced the clinical appearance can mimic mastitis leading to diagnostic delay and it is often associated with a poor prognosis. Very few cases of bilateral IBC are reported in the literature, all of which have been synchronous. We report an unusual case of bilateral metachronous IBC each with complete clinico-pathological response after treatment with neoadjuvant chemotherapy and surgery on both occasions. [source] Considerations when choosing oral chemotherapy: identifying and responding to patient needEUROPEAN JOURNAL OF CANCER CARE, Issue 2010S. IRSHAD mrcp, specialist registrar in medical oncology IRSHAD S. & MAISEY N. (2010) European Journal of Cancer Care19, 5,11 Considerations when choosing oral chemotherapy: identifying and responding to patient need Oral chemotherapeutics are becoming increasingly accepted for the treatment of cancers and their future has never been brighter. They offer a more convenient and less invasive therapeutic option, moving cancer treatment from a predominantly hospital-based day unit into the ambulatory setting. Oral chemotherapy has the potential to maintain patient's quality of life and avoid the complications and costs of intravenous chemotherapy. It offers sustained drug exposure by providing prolonged therapy compared with intermittent IV exposure and lends itself more easily to the delivery of combination therapy. In this article we highlight the expansion of oral chemotherapeutic drug development in cancer treatment and the challenges posed by this change in treatment delivery. [source] Effective management of adverse effects while on oral chemotherapy: implications for nursing practiceEUROPEAN JOURNAL OF CANCER CARE, Issue 2010K. HARROLD rn, bsc ( hons ), chemotherapy, iv access clinical nurse specialist HARROLD K. (2010) European Journal of Cancer Care19, 12,20 Effective management of adverse effects while on oral chemotherapy: implications for nursing practice The publication of guidelines by the United Kingdom National Patient Safety Agency and the National Confidential Enquiry into Patient Outcome and Death which looked into deaths within 30 days of systemic anticancer therapy and the more recent position statement from the United Kingdom Oncology Nursing Society have all highlighted the need for an improvement in the care and management of patients receiving oral chemotherapy. While it is essential that patients are aware of the rationale behind dose interruption and modification if they are to effectively deal with toxicities and complications that may arise, they also require access to a clear line of communication in order to facilitate early intervention. The value of pre treatment patient education and ongoing support for these patients has already been extensively documented and while a multidisciplinary team approach in this is vital, nurses are ideally placed to take a leading role in these two aspects of treatment management. This article aims to detail and review current best management practices for the most commonly reported toxicities associated with capecitabine, an oral chemotherapeutic agent used in the management of patients with colorectal cancer. Only if both the patient and the health care professional supporting them are aware of best management practices will the impact of toxicities be minimised and treatment outcomes optimised. [source] Survivorship in cancer careEUROPEAN JOURNAL OF CANCER CARE, Issue 3 2010N. DOYLE msc, nurse consultant DOYLE N. (2010) European Journal of Cancer Care19, 284 Survivorship in cancer care An increasing number of people are living with and beyond a cancer diagnosis. Health professionals need to understand the complexity of cancer survivorship and develop skills to help support people living with cancer. [source] Effect of comorbidity on urinary neopterin in patients with breast carcinomaEUROPEAN JOURNAL OF CANCER CARE, Issue 3 2010K. MELICHAROVÁ md K. MELICHAROVÁ, H. KALÁBOVÁ, L. KR,MOVÁ, L. URBÁNEK, D. SOLICHOVÁ, B. MELICHAR (2010) European Journal of Cancer Care19, 340,345 Effect of comorbidity on urinary neopterin in patients with breast carcinoma Urinary neopterin is increased in less than 20% of patients with breast carcinoma. Moderately increased neopterin concentrations are also known to accompany comorbid conditions commonly observed in patients with breast carcinoma, for example, diabetes mellitus or complications of atherosclerosis. In the present study, we evaluated the effect of the presence of comorbid conditions on urinary neopterin. A trend for higher neopterin concentrations was observed in patients with most of the comorbid conditions, but significantly higher neopterin was observed only in patients aged 70 years or older and in a heterogeneous group of patients with comorbidity other than diabetes mellitus, thyroid disorder, hyperlipidaemia, cardiac disorder or other malignancy. Significantly higher neopterin levels were noted in patients with two or more comorbid conditions. In conclusion, present data demonstrate an association between systemic immune activation reflected in increased urinary neopterin concentrations and age or presence of comorbid diseases in patients with breast carcinoma. A cumulative effect was observed with the presence of two or more comorbid conditions resulting in significantly increased urinary neopterin. These observations should be taken into account when interpreting the changes of parameters of systemic immune and inflammatory response in patients with breast carcinoma. [source] Complementary and alternative medicine practitioner consultations among those who have or have had cancer in a Norwegian total population (Nord-Trøndelag Health Study): prevalence, socio-demographics and health perceptionsEUROPEAN JOURNAL OF CANCER CARE, Issue 3 2010A. STEINSBEKK phd, research fellow STEINSBEKK A., ADAMS J., SIBBRITT D. & JOHNSEN R. (2010) European Journal of Cancer Care19, 346,351 Complementary and alternative medicine practitioner consultations among those who have or have had cancer in a Norwegian total population (Nord-Trøndelag Health Study): prevalence, socio-demographics and health perceptions The aim of the study was to identify the use of complementary and alternative medicine (CAM) practitioners among current and previous cancer patients in a total population. A secondary analysis of data from the Nord-Trøndelag Health Study (otherwise known as the HUNT 2 Study) , a total population survey conducted in central Norway , was undertaken. Analysis focused upon the response of 1406 individuals who reported to have or have had cancer and who answered a question on visits to CAM practitioners. The study identified 16.1% of respondents had visited a CAM practitioner in the prior 12 months compared with 12.8% in the total population, and the likelihood of consulting a CAM practitioner was significantly increased among those who had a university degree, who reported a lower perceived global health and who had experienced a health complaint during the last 12 months. Complementary and alternative medicine practitioner consultations among individuals with a previous or current malignant disease were highest for those with poor self-reported health status and with a recent health complaint. From the socio-demographic variables studied only the reporting of a university degree was significantly associated with higher CAM practitioner use. [source] Gemcitabine induced digital ischaemia and necrosisEUROPEAN JOURNAL OF CANCER CARE, Issue 3 2010A. HOLSTEIN md HOLSTEIN A., BÄTGE R. & EGBERTS E.-H. (2010) European Journal of Cancer Care19, 408,409 Gemcitabine induced digital ischaemia and necrosis A 70-year-old woman presented with a 7-day history of severe pain, paresthesia, oedema, acrocyanosis and punctate haemorrhagic lesions on her fingertips. The complaints began 2 days after the second cycle of a first-line chemotherapy consisting of cisplatin or carboplatin, and gemcitabine due to advanced urothelial carcinoma. At the fingertips of both hands, haemorrhagic and partly ulcerative lesions were found; these were attributed to vascular toxicity of gemcitabine. Therapeutically sympathicolysis by bilateral blockade of the brachial plexus was performed, accompanied by intravenous administration of the prostacyclin analog iloprost, fractionated heparin subcutaneously and oral therapy with corticosteroids and aspirin. Digital amputation could be avoided. Acral ischemia is a rare but probably underreported adverse effect of gemcitabine therapy and a potential source of misdiagnosis. [source] An unusual case of extra-abdominal desmoid tumourEUROPEAN JOURNAL OF CANCER CARE, Issue 3 2010N. ZAMPIERI doctor ZAMPIERI N., CECCHETTO M., ZORZI M.G., PIETROBELLI A., OTTOLENGHI A. & CAMOGLIO F. (2010) European Journal of Cancer Care19, 410,412 An unusual case of extra-abdominal desmoid tumour Desmoid tumour is relatively rare and generally non-metastatisizing lesion of mesenchymal origin composed of fibrous tissue and fitting in the group of aggressive fibromatosis; it is a locally aggressive proliferative soft-tissue lesion with controversial nature. This tumour accounts for 0.03% of all tumours and 3% of soft-tissue tumours with annual incidence of two to four cases per million. Although desmoid tumours are more common in persons aged 10,40 years than in others, they do occur in young children and older adults; in children the sex incidence is equal. This is a rare case of extra-abdominal desmoid tumour in a 14-year-old girl affected by spastic tetraparesis. To our knowledge no similar cases are present in literature to date. [source] Development of three different neoplasias in a patient in an 18-year period of timeEUROPEAN JOURNAL OF CANCER CARE, Issue 3 2010P. HERAS md HERAS P., GEORGOPOULOU A.P., HATZOPOULOS A. & KRITIKOS K. (2010) European Journal of Cancer Care 19, 413,416 Development of three different neoplasias in a patient in an 18-year period of time This study presents a rare case of a patient who developed three different types of neoplasia in an 18-year period of time. The case presents a 31-year-old man with a history of treated Hodgkin's lymphoma in the neck region at the age of 13 years. The patient was admitted at the General Hospital of Nafplio for differential diagnosis of pain in the right subcostal region initiated 1 month before his admission and normochromic, normocytic anaemia. The laboratory examinations lead to the diagnosis of a sarcoma in the cardioesophageal junction. The patient was subjected to total gastrectomy. Nine months later he is admitted with a palpable firm lump in the nipple of the right breast, which suggested a malignant neoplasia. The patient was subjected to modified radical mastectomy. The appearance of three different types of neoplasia in three different organ systems in the same patient and the infrequency of the specific neoplasias individually and in combination present a special interest considering the patient's genetic background and the uniqueness of the case in the international literature. [source] Once-per-cycle pegfilgrastim in breast cancer patients treated with docetaxel/epidoxorubicin/cyclophosphamideEUROPEAN JOURNAL OF CANCER CARE, Issue 2 2010L. MONTELLA md MONTELLA L., ADDEO R., GUARRASI R., CENNAMO G., FAIOLA V., CAPASSO E., CARAGLIA M. & DEL PRETE S. (2010) European Journal of Cancer Care19, 200,204 Once-per-cycle pegfilgrastim in breast cancer patients treated with docetaxel/epidoxorubicin/cyclophosphamide The incidence of neutropenia following combination chemotherapy is significant in breast cancer and impairs patients' quality of life. Colony-stimulating factors significantly decrease the risk of febrile neutropenia (FN). Aim of the present study was to assess the efficacy and safety profile of once-per-cycle pegfilgrastim in reducing FN in breast cancer patients treated with docetaxel (75 mg/m2), epidoxorubicin (75 mg/m2), cyclophosphamide (500 mg/m2) administered every 3 weeks. Thirty-five breast cancer patients were enrolled. Chemotherapy was administered in adjuvant, neoadjuvant and metastatic setting respectively in 26, 4 and 5 patients. Toxicity was monitored with programmed clinical evaluation and blood sampling. All patients completed the therapeutic programme consisting of six cycles for overall 210 cycles. The FN appeared in 6 out of 35 patients (17%), requiring dose reduction in 3 patients. Hypertransaminasemia was registered in two patients. In one patient pegfilgrastim administration was stopped because of skin hypersensititivity reaction. In conclusion, pegfilgrastim was able to maintain doses and timing of docetaxel/epidoxorubicin/cyclophosphamide in almost all breast cancer patients treated in this series. The reduced need for daily administration of colony-stimulating factors, blood sampling, antibiotic therapy and hospitalization has a significant impact in terms of both quality of life and pharmaco-economic evaluations. [source] Self-efficacy beliefs and levels of anxiety in advanced cancer patientsEUROPEAN JOURNAL OF CANCER CARE, Issue 2 2010K. MYSTAKIDOU md, associate professor MYSTAKIDOU K., TSILIKA E., PARPA E., GOGOU P., THEODORAKIS P. & VLAHOS L. (2010) European Journal of Cancer Care19, 205,211 Self-efficacy beliefs and levels of anxiety in advanced cancer patients The aims of this study were to investigate the self-efficacy and anxiety in advanced cancer patients in a palliative care unit. The subject is some 99 advanced cancer patients, treated for pain relief and cancer-related symptoms. Patients completed the General Perceived Self-Efficacy Scale (GSE) and the Spielberger's State-Trait Anxiety Inventory (STAI). The Eastern Cooperative Oncology Group was used to measure patients' performance status. Statistically significant associations were found between GSE, patients' gender, performance status, opioids and all the STAI scales. The multiple regression analysis revealed that self-efficacy was predicted by patients' age, performance status, gender, as well as by their high levels on two STAI scales, in a model explaining 39.7% of the total variance. In advanced cancer patients, self-efficacy is significantly correlated with levels of anxiety, patients' physical condition and demographic characteristics. Also, it seems to be influenced by components of the STAI, patients' age, physical performance and gender. [source] The genetic causes of the sequential occurrence of multiple primary malignancies in a young woman , 5 years onEUROPEAN JOURNAL OF CANCER CARE, Issue 2 2010V.N. HARRY mbbs, mrcog HARRY V.N., CUMMING G.P., NARAYANSINGH G.V., PARKIN D.E. & HAITES N.E. (2010) European Journal of Cancer Care19, 276,278 The genetic causes of the sequential occurrence of multiple primary malignancies in a young woman , 5 years on The finding of three primary gynaecological malignancies in a young woman attending our unit was documented in 2001. We provide an update on this report as new events have prompted further discussion on the role of clinical guidelines in cancer management. The discovery of a genetic predisposition demonstrates the need for multidisciplinary input and heightened awareness in similar cases while the importance of treating each patient as an individual is emphasized. [source] The role of therapies in managing cancer-related painEUROPEAN JOURNAL OF CANCER CARE, Issue 1 2010K. ROBB phd, consultant physiotherapist, pgcap ROBB K. & EWER-SMITH C. (2010) European Journal of Cancer Care19, 5 The role of therapies in managing cancer-related pain Cancer pain is complex and multi-dimensional and requires a multi-disciplinary team approach. Therapists have an important role in the assessment and management of patients with cancer-related pain, but the challenge remains to practise in an evidence-based way. [source] Justifying the expense of the cancer Clinical Nurse SpecialistEUROPEAN JOURNAL OF CANCER CARE, Issue 1 2010C.A. POLLARD ba POLLARD C.A., GARCEA G., PATTENDEN C.J., CURRAN R., NEAL C.P., BERRY D.P. & DENNISON A.R. (2009) European Journal of Cancer Care19, 72,79 Justifying the expense of the cancer Clinical Nurse Specialist In order to maximise patient care, assessment of the adequacy of the service provision by the Clinical Nurse Specialist (CNS) must be regularly undertaken. This study attempted to determine whether CNSs were providing an adequate service via retrospective and prospective audit. The results of a comprehensive audit of the work of the CNS within a tertiary referral Hepatobiliary Unit are presented. The audit involved postal and telephone questionnaires as well as prospective collection of data. The majority of responses from patients were positive, with many finding the CNS a useful and well-utilised contact. Overall, the CNSs performed well in each of their designated tasks; however, areas were still identified which could be further improved. Audit is essential in providing feedback to the CNS and to identify areas which require improvement. The CNS has evolved to meet a clinical gap in patient care, and as a result, the role of a CNS is frequently nebulous or poorly defined. This renders evaluation of the CNS problematic and fraught with difficulties. However, a thorough assessment can still be made using carefully constructed audit looking at each task of the CNS. [source] How many cisplatin administration protocols does your department use?EUROPEAN JOURNAL OF CANCER CARE, Issue 1 2010A.P. GREYSTOKE bsc, mbchb, registrar medical oncology GREYSTOKE A.P., JODRELL D.I., CHEUNG M., RIVANS I. & MACKEAN M.J. (2009) European Journal of Cancer Care19, 80,90 How many cisplatin administration protocols does your department use? The introduction, 30 years ago, of the co-administration of appropriate hydration and ensuring a diuresis occurs during the administration of cisplatin was important in its development, allowing clinically significant doses to be given with acceptable rates of toxicity. The clinical usage of cisplatin has increased and hydration protocols have been amended to increase patient comfort and reduce resource utilization. We suspected that this had led to unnecessary variations in practice both in clinical trials and subsequently in the clinic. Therefore, we reviewed practice in the Edinburgh Cancer Centre and discovered that 25 different hydration protocols were in use, with wide variation in dilution of cisplatin, total fluid administered, use of electrolyte (potassium and magnesium) supplementation and diuretics. These differences are a reflection of adoption of variations in hydration regimes published in pivotal clinical trials. A review of the available evidence relating to cisplatin associated hydration regimens was performed and recommendations will be made for the future design of evidence-based protocols. [source] Care of the older woman with primary breast cancer: a sign of the times?EUROPEAN JOURNAL OF CANCER CARE, Issue 6 2009D. POROCK rn, professor POROCK D., CHEUNG, K.L., MORGAN D.A.L., WINTERBOTTOM L., RICHARDSON H. & ELLIS I.O. (2009) European Journal of Cancer Care18, 527,529 Care of the older woman with primary breast cancer: a sign of the times? [source] Patient-orientated web sites on laryngectomy: is their information readable?EUROPEAN JOURNAL OF CANCER CARE, Issue 6 2009L. POTHIER m, language therapist , macmillan, speech POTHIER L. & POTHIER D.D. (2009) European Journal of Cancer Care Patient-orientated web sites on laryngectomy: is their information readable? The objective of the study was to determine levels of readability of commonly accessed websites containing patient information on laryngectomy. A Cross-sectional study of Internet websites was designed. The first 20 websites obtained from a Google® search of the word "laryngectomy" that contained a patient information section were selected. Primary outcome measures were the Flesch Readability Ease Score (FRE) and Flesch-Kincaid readability grade (FKRG) score; from these data UK reading age was calculated. The secondary outcome measure was whether or not a site was accredited by an online readability organisation. The reading ages of the 20 sites ranged from 7.8 to 14.7 years with a median of 11.7 years. Half of the Flesch Reading Ease scores were in the "Difficult" or "Fairly difficult" category with 30% falling into the "Standard" or "Fairly easy" categories. Only 20% sites fell into the "Easy" or "Very Easy" categories that are the recommended level for comprehension by the general UK population. Sites not accredited by an online healthcare quality and content control organisation had worse readability scores than those that were not (FRE: p = 0.007, FKRG: p = 0.012). The poor readability of many of the encountered sites about laryngectomy on the Internet may confuse patients who turn to the Internet for information. Methods to improve patient information websites are discussed. [source] Multiple primary cancer: an increasing health problem.EUROPEAN JOURNAL OF CANCER CARE, Issue 6 2009Strategies for prevention in cancer survivors LÓPEZ M.L., LANA A., DÍAZ S., FOLGUERAS M.V., SANCHEZ L., COMENDADOR M.A., BELYAKOVA E., RODRÍGUEZ J.M. & CUETO A. (2009) European Journal of Cancer Care Multiple primary cancer: an increasing health problem. Strategies for prevention in cancer survivors This study was set to look for associations between the sites of the first and subsequent tumours in patients with multiple primary cancer (MPC) diagnosed from 1975 to 2002 in the reference hospital of a Spanish northern region, and propose prevention strategies. Patient and tumour variables were measured. Crude and standardized incidence rates per 100 000 inhabitants were obtained, and the association between MPC incidence and time was analysed by means of lineal regression. Relative risks were calculated to analyse associations between tumour sites. A total of 2737 MPC cases were registered (male/female ratio = 2). The percentage of MPC with respect to the total cancer increased from 1.78% in the 1975,1979 period to 7.08% in the 2000,2002 period (R2 = 0.92; P = 0.003). Great increase of incidence by time was found (R2 = 0.90; P = 0.004). Breast, prostate and bladder cancers increase risk of second tumour in female genital organs [RR 4.78 (3.84,5.93)], urinary system [RR 3.69 (2.89,4.69)] and male genital organs [RR 3.76 (2.84,4.69)] respectively. The MPC incidence is increasing. Interventions for MPC prevention, according to the European Code against Cancer, should be implemented early after the first cancer principally if patients suffer breast, bladder, prostate, larynx and colon cancers. [source] Efficacy of ibandronate for the treatment of skeletal events in patients with metastatic breast cancerEUROPEAN JOURNAL OF CANCER CARE, Issue 6 2009P. HERAS md HERAS P., KRITIKOS K., HATZOPOULOS A. & GEORGOPOULOU A.-P. (2009) European Journal of Cancer Care Efficacy of ibandronate for the treatment of skeletal events in patients with metastatic breast cancer Patients with breast carcinoma often develop bone metastases that carry a high risk of complications. A randomized, placebo-controlled trial was conducted to evaluate the efficacy and safety of ibandronate in patients with metastatic bone disease following breast cancer. The primary efficacy end point of the study was the proportion of patients who developed skeletal-related events (SREs, defined as pathologic fracture, spinal cord compression, radiation therapy to bone, change in anti-neoplastic therapy and surgery to bone). Secondary end points included time to first skeletal event, skeletal morbidity rate (events/year) and time to progression of bone lesions. In 150 patients (148,/2,) with breast carcinoma and bone metastases, treatment with intravenous ibandronate 6 mg over 15 min every 4 weeks for 24 months significantly reduced the proportion of patients who experienced an SRE compared with placebo (36% vs. 48%; P = 0.027). Time to first SRE was also delayed significantly (median 457 vs. 304 days; P = 0.007). Multiple event analysis showed that ibandronate reduced the risk of developing an SRE by 32% (hazard ratio = 0.69; 95% confidence interval 0.42,0.79; P = 0.003). In general, ibandronate was well tolerated with very rare grade 3 or 4 toxicity. In this study, ibandronate was shown to be significantly more effective than placebo as a treatment for metastatic bone disease from breast cancer using multiple end points. [source] A vision for the European Journal of Clinical Investigation: note from the new editorsEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 1 2010J. P. A. Ioannidis No abstract is available for this article. [source] What are regulatory B cells?EUROPEAN JOURNAL OF IMMUNOLOGY, Issue 10 2010David Gray Abstract B cells are now acknowledged to play multiple roles in the immune response, in addition to making antibodies. Their role in regulating T-cell responses during inflammation has come into focus recently. Thus, IL-10 production by B cells has been shown to be important in limiting auto-reactive and pathogen-driven immune pathology; however, the exact identity of the regulatory B cells remains elusive; do they belong to a committed subset or can all B cells regulate given the appropriate inducing stimuli? A study in this issue of the European Journal of Immunology provides insight into the IL-10-producing B cells in humans, suggesting that many B cells have the capacity to make IL-10 when optimally stimulated via the BCR and TLR9. Despite producing significant amounts of inflammatory cytokines as well, these B cells suppress T-cell proliferation. This Commentary places this study in the context of what we think we know about regulatory B cells and more importantly highlights the questions we still need to answer. [source] Revisiting the role of IL-2 in autoimmunityEUROPEAN JOURNAL OF IMMUNOLOGY, Issue 6 2010Hans Dooms Abstract IL-2 was discovered as a T-cell growth factor that promoted T-cell-dependent immune responses; however, more recent studies suggest that the essential role of IL-2 is to maintain functional Treg and thus control immune responses. These results are leading to new ideas about the potential of IL-2 as a therapeutic strategy in autoimmune diseases. In this issue of the European Journal of Immunology, a study further examines the role of IL-2 in immune regulation and shows for the first time that IL-2 complexes can ameliorate autoantibody-mediated autoimmunity. This commentary examines the current findings in relation to what we already know about IL-2 complexes. [source] | |||||||||||||