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Cancer Management (cancer + management)
Selected AbstractsHead and neck cancer in the UK: what is expected of cytopathology?CYTOPATHOLOGY, Issue 2 2009G. Kocjan Objective:, This review highlights the role of cytopathology in cancer management within UK Head and Neck Cancer Networks and informs on the issues raised by recent UK Department of Health documents and other UK professional guidance. UK guidance requires the formal involvement of cytopathologists within multidisciplinary cancer teams, with medical and non-medical cytopathology staff setting up and running rapid access lump clinics, and support for image-guided fine needle aspiration cytology (FNAC) services. UK guidance also makes recommendations for training, resources and quality control. This review also highlights the resource gap between best practice evidence-based guidance for head and neck (HN) cancer services and existing UK provision for cytopathology, as evidenced by lack of availability of experienced staff and adequacy of training and quality control (QC). Finally, it stresses the importance in the UK of the Royal College of Pathologists' guidance, which defines the need for training, the experience needed for new consultants, the requirements for audit and QC. The implications for the additional resources required for HN cancer cytopathology services are discussed. Recent professional guidance specifying the provision of HN cancer services in the UK includes a cytopathology service for cancer networks, such as rapid access FNAC clinics. Although these clinics already operate in some institutions, there are many institutions where they do not and where the provision of cytopathology services would have to be restructured. This would need the support of local cancer networks and their acceptance of the detailed requirements for cytopathology, including resources, training and QC. The standards are not defined locally, as Strategic Health Authorities and Primary Care Trusts have been instructed by the Department of Health to support, invest and implement them. [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] Marginal mandibular nerve injury during neck dissection and its impact on patient perception of appearanceHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 5 2009FRACDS(OMS), FRCS(OMFS), Martin D. Batstone MPhil(Surg) Abstract Background. Neck dissection to remove cervical lymph nodes is common practice in head and neck cancer management. The marginal mandibular nerve may be injured during neck dissection, particularly of level 1. The rate of injury to this nerve is underreported in the literature and its impact on patients is not well defined. Methods. An observational study was undertaken on patients who had undergone neck dissection over a 5-year period. The patients were examined for weakness and given a questionnaire related their perception of their appearance and their function. Results. Sixty-six patients were identified who had undergone 85 neck dissections. The rate of House Brackmann injury was 18% when analyzed by patient and 23% by neck. There were moderate correlations between observed injury and subjective responses to questions relating to ability to smile and weakness of the lower lip. Discussion. The rate of smile asymmetry following neck dissection is relatively high; however, severe injuries to the marginal mandibular nerve are uncommon. © 2009 Wiley Periodicals, Inc. Head Neck, 2009 [source] Impact of tumour genotyping on cancer managementJOURNAL OF CELLULAR AND MOLECULAR MEDICINE, Issue 10 2009Gianni Bussolati No abstract is available for this article. [source] All in the family: Evaluation of the process and content of sisters' communication about BRCA1 and BRCA2 genetic test results,AMERICAN JOURNAL OF MEDICAL GENETICS, Issue 2 2002Chanita Hughes Abstract Despite the potential importance of family communication, little is known about the process and content of communicating BRCA1/2 test results to relatives. The objectives of this observational study were to describe the process and content of communicating BRCA1/2 test results to sisters, and to evaluate whether the proband's carrier status influenced communication outcomes. Participants were 43 women who were the first family member to have genetic testing (probands). Probands reported on communication outcomes for 81 sisters. Process and content variables were evaluated 1-month after receipt of BRCA1/2 test results using the Family Communication Questionnaire (FCQ). Overall, BRCA1/2 test results were communicated to 85% of sisters, and carriers communicated their results to significantly more sisters compared to uninformative (96% vs. 76%, FET,=,0.02). The most important reason for communicating results was to provide genetic risk information; however, compared to uninformatives, carriers communicated their results to significantly more sisters to obtain emotional support (74%) and to get advice about medical decisions (42%) (FET,=,0.001). Carriers also discussed the possibility of discrimination and recommendations for cancer management with significantly more sisters. Among sisters to whom BRCA1/2 test results were not communicated, the most important reason for not sharing test results was because of emotionally distant relationships. The results of this study suggest that probands are likely to quickly communicate their BRCA1/2 test results to relatives and that although needs for social support may motivate family communication, emotionally distant relationships may be a barrier to communication with relatives. © 2001 Wiley-Liss, Inc. [source] Socio-economic status and patterns of care in lung cancerAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2005Andrew C. Hui Objective: This retrospective study aims to explore the associations between socio-economic factors and lung cancer management and outcomes in the Australian setting. Methods: The study population consisted of patients who were living in the Northern Sydney Area Health Service (NSAHS) or South Western Sydney Area Health Service (SWSAHS) at the time of their lung cancer diagnosis in 1996. Data on patient demographics, tumour characteristics, management details, recurrence and survival were collected and compared between the two areas. Socio-economic status indicators of the two Area Health Services were obtained from the Australian Bureau of Statistics. Results: There were 270 and 256 new cases of lung cancer identified in NSAHS and SWSAHS respectively. Patients in NSAHS were slightly older and there were more women. Based on the 1996 Census data, the population of NSAHS is more affluent, better educated and more likely to be employed compared with SWSAHS. The stage distributions and performance status of the two areas were similar. The utilisation rates of different treatment modalities in the two areas were similar except for chemotherapy. The five-year overall survival rate was 10.5% in NSAHS and 7.2% in SWSAHS (p=0.08). Comparison based on the SEIFA Index of Relative Socio-economic Disadvantage did not reveal significant differences. Conclusion: Patients with lung cancer had similar patterns of care and survival despite differences in socio-economic profiles between the two Area Health Services. Implication: There seems to be equity of access to lung cancer services between the two Area Health Services. [source] How to implement the multidisciplinary approach in prostate cancer management: the Belgian modelBJU INTERNATIONAL, Issue 2008Simon Van Belle The Belgian oncology care system has been the subject of a major reorganization in recent years. The basis of this reorganization is the obligatory implementation of standardized care programmes in every hospital and the recognition of dedicated oncology specialists. Furthermore, health authorities created the multidisciplinary oncology consultation (MOC), as it was recognized that there was a need to organize and to reimburse the existing multidisciplinary approach. At MOC, a patient's case is discussed and a strategic plan is developed for diagnosis, treatment and follow-up. The conditions that have to be met for reimbursement of this MOC are strictly defined by law and include yearly follow-up meetings. The success of this multidisciplinary approach is partially attributable to legal requirements and reimbursement, but also to the willingness of the medical community to accept the concept that a multidisciplinary approach is the best investment to improve patient outcomes in cancer care. [source] Colon cancer management and outcome in relation to individual hospitals in a defined populationBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 4 2007A. Sjövall Background: The Stockholm and Gotland region in Sweden has a common management protocol for the treatment of colon cancer. The aim of this study was to assess the management and treatment of colon cancer in the region and to try to identify ways to improve the outcome further. Methods: Clinical data on all patients diagnosed with colon cancer in the region's nine hospitals between January 1996 and December 2000 were prospectively collected. Patients were followed until December 2004, and their management and outcome analysed. Results: Colon cancer was diagnosed in 2775 patients. An elective operation was performed in 2116 (76·3 per cent) patients and an emergency procedure in 590 (21·3 per cent). Emergency surgery was an independent risk factor for death. The crude overall cumulative 5-year survival was 46·2 per cent. A multivariable analysis of risk of dying and risk of local recurrence showed significant differences between hospitals. The number of lymph nodes examined in the specimens also differed between hospitals. Conclusion: Differences in the management and outcome of colon cancer in the nine hospitals, despite a common management protocol, indicate a need for improving collaboration between hospitals and multidisciplinary management. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Germ cell-specific heat shock protein 70-2 is expressed in cervical carcinoma and is involved in the growth, migration, and invasion of cervical cellsCANCER, Issue 16 2010Manoj Garg PhD Abstract BACKGROUND: Cervical cancer is a major cause of death among women worldwide, and the most cases are reported in the least developed countries. Recently, a study on DNA microarray gene expression analysis demonstrated the overexpression of heat shock protein 70-2 (HSP70-2) in cervical carcinoma cells (HeLa). The objective of the current study was to evaluate the association between HSP70-2 expression in cervical carcinogenesis and its potential role in various malignant properties that result in disease progression. METHODS: HSP70-2 expression was examined in various cervical cancer cell lines with different origins and in clinical cervical cancer specimens by reverse transcriptase-polymerase chain reaction (RT-PCR), flow cytometry, and immunohistochemistry (IHC) analyses. A plasmid-based, short-hairpin RNA approach was used specifically to knock down the expression of HSP70-2 in cervical tumor cells in vitro and in vivo to examine the role of HSP70-2 on various malignant properties. RESULTS: RT-PCR and IHC analyses revealed HSP70-2 expression in 86% of cervical cancer specimens. Furthermore, knockdown of HSP70-2 expression significantly reduced cellular growth, colony formation, migration, and invasion in vitro and reduced tumor growth in vivo. A significant association of HSP70-2 gene and protein expression was observed among the various tumor stages (P = .046) and different grades (P = .006), suggesting that HSP70-2 expression may be an indicator of disease progression. CONCLUSIONS: The current findings suggested that HSP70-2 may play an important role in disease progression in cervical carcinogenesis. Patients who had early stage disease and low-grade tumors had HSP70-2 expression, supporting its potential role in early detection and aggressive treatment modalities for cervical cancer management. Cancer 2010. © 2010 American Cancer Society. [source] Determinants of quality of life in patients with cancerCANCER, Issue 5 2005A South American study Abstract BACKGROUND Because health-related quality of life (QOL) is an important outcome in cancer management, the authors sought to better understand its determinants. To address this subject, they analyzed QOL, as measured with the Functional Assessment of Cancer Therapy-General questionnaire (FACT-G), Spanish Version 4, and depicted the complex relations among physical, psychological, social, and cultural factors, including spirituality. METHODS A cross-sectional study design was used with a sample of 309 patients with cancer. The influence of several possible determinants was first studied by univariate regression analysis. Variables showing an association were included in a forward stepwise multivariate regression model. RESULTS Five regression models were studied, for the FACT-G total score and its four subscales. Five variables explained 32.1% of the variance of the FACT-G total score: tumor stage, spiritual well-being, income, mood disorders, and mode of questionnaire administration. The type and relevance of the explanatory variables differed among the various dimensions of QOL. CONCLUSIONS The authors underlined the entwining of biologic, psychosocial, and spiritual factors as determinants of the QOL of patients with cancer, thus supporting the multidimensional definition and modeling of the construct. Cancer 2005. © 2005 American Cancer Society. [source] | ||||||||||