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Cancer Population (cancer + population)
Selected AbstractsProstate cancer in London: is the triadic clinical encounter the standard?INTERNATIONAL JOURNAL OF UROLOGICAL NURSING, Issue 2 2008Amanda Euesden Hughes Abstract It has been reported that men with prostate cancer in London were less satisfied with the service they received than patients with other cancers. Studies from the USA have looked at the experience of the prostate cancer couple. It has been established that the cancer couple have information needs and that when a clinical encounter is triadic in nature, these needs are more likely to be met and information is more likely to be retained. The aim of this study was to examine the clinic attendance patterns of men in London with prostate cancer (n = 200). A comparison group of women in London with breast cancer was identified (n = 200). Direct observation of the groups was performed, accompanied/unaccompanied (triadic/dyadic) attendance was recorded and demographic data were extracted from the clinical notes. Forty-one percent (81) of the women experienced their clinical encounter as a triad compared with 24% (48) of the prostate group who experienced their clinical encounter as a dyad between themselves and their health care provider (p < 0.05). In the first year of diagnosis, men with prostate cancer were more likely to experience a triadic encounter, but this was more evenly distributed throughout the cancer journey for women with breast cancer. There did not appear to be a correlation with marriage and triadic encounters for either group. Men with prostate cancer in this tertiary referral centre in London are less likely to experience a triadic clinical encounter than women with breast cancer. Further work is needed to establish a relationship between unmet informational needs of the prostate cancer couple and the high level of dissatisfaction in the prostate cancer population in London, but the nature of the dyadic encounter may play a part in this. [source] Psychosocial interventions and quality of life in gynaecological cancer patients: a systematic reviewPSYCHO-ONCOLOGY, Issue 8 2009Jolyn Hersch Abstract Objective: Women with gynaecological cancer are at risk of poor quality of life outcomes. Although various psychosocial interventions have been developed to address these concerns, such interventions have not yet been systematically evaluated in this population. The current review provides an up-to-date and comprehensive summary of the evidence regarding the effectiveness of psychosocial interventions in women with gynaecological cancers. Methods: Relevant studies were identified via Medline, CINAHL, and PsycINFO databases (1980 to June 2008), reference lists of articles and reviews, grey literature databases, and consultations with physicians and other experts in the field. Only controlled trials comparing a psychosocial intervention with a control group in a gynaecological cancer population, with at least one quality of life variable as a main outcome, were included in the review. Two authors independently assessed trial quality and extracted data. Results: Twenty-two studies involving 1926 participants were included. There was substantial variability in study quality and results. Evidence was mixed regarding intervention effects on social and sexual functioning, distress, depression, anxiety, attitude to medical care, self-esteem and body image. Interventions generally did not improve physical or vocational outcomes. Conclusions: There was limited evidence in support of healing touch, whereas information-based interventions seemed largely unable to provide meaningful benefits. Cognitive-behavioural interventions had some positive effects. Counselling appeared to be the most promising intervention strategy for addressing quality of life concerns for women with gynaecological cancers. Copyright © 2008 John Wiley & Sons, Ltd. [source] Mental health and other clinical correlates of euthanasia attitudes in an Australian outpatient cancer populationPSYCHO-ONCOLOGY, Issue 4 2007G. L. Carter Abstract A majority of patients with cancer have been reported to endorse euthanasia and physician assisted suicide (PAS) in general and a substantial proportion endorse these for themselves. However, the potential influence of mental health and other clinical variables on these decisions is not well understood. This study of 228 outpatients attending an oncology clinic in Newcastle, Australia used a cross-sectional design and logistic regression modelling to examine the relationship of demographic, disease status, mental health and quality of life variables to attitudes toward euthanasia and PAS. The majority reported support for euthanasia (79%, n=179), for PAS (69%, n=158) and personal support for euthanasia/PAS (68%, n=156). However, few reported having asked their doctor for euthanasia (2%, n=5) or PAS (2%, n=5). Three outcomes were modelled: support for euthanasia was associated with active religious belief (adjusted odds ratio (AOR) 0.21, 95% CI: 0.10,0.46); support for PAS was associated with active religious belief (AOR 0.35, 95% CI: 18,0.70) and recent pain (AOR 0.87, 95% CI: 0.0.76,0.99); and personal support for euthanasia/PAS was associated with active religious belief (AOR 0.26, 95% CI: 0.14,0.48). Depression, anxiety, recent suicidal ideation, and lifetime suicide attempt were not independently associated with any of the three outcomes modelled. Copyright © 2006 John Wiley & Sons, Ltd. [source] Second Malignant Neoplasms in Patients Under 40 Years of Age With Laryngeal Cancer,THE LARYNGOSCOPE, Issue 4 2001James T. Albright MD Abstract Objectives/Hypothesis To determine the incidence of second malignant neoplasms (SMN) in patients under 40 years of age with invasive squamous cell carcinoma (SCC) of the larynx. Study Design Retrospective. Methods Using a National Cancer Institute tumor registry database encompassing 1973,1996, the incidence of SMN in patients under 40 years of age with laryngeal cancer was determined and compared with that of the registry's older, more traditional laryngeal cancer population. Median follow-up was 136 months. Results Among the 364 patients under the age of 40 years with laryngeal cancer, 30 (8.2%) had developed a secondary malignancy to date. In comparison, 4876 (21.4%) of 22,786 patients 40 years or older with laryngeal cancer were affected by an SMN. Kaplan-Meier analysis of the younger cohort projected 3.0%, 6.8%, and 10.7% relative risk of developing a SMN at any site over 5-, 10-, and 15-year periods, respectively, after index tumor diagnosis. Similar results for the older cohort were 14.2%, 28.1%, and 39.4% at 5, 10, and 15 years, respectively. Further Kaplan-Meier analysis demonstrated at least a fourfold increased risk for the development of secondary upper aerodigestive tract malignancies among older compared with younger patients. Conclusion Patients under 40 years of age with invasive SCC of the larynx are significantly less likely to develop a second malignancy than their older counterparts. [source] Clinical and socio-demographic profile of an Australian multi-institutional prostate cancer cohortASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 4 2009Kerri BECKMANN Abstract Aims: To describe the clinical and socio-demographic data from a South Australian prostate cancer cohort (PCCOD). Methods: Clinical data for 2329 prostate cancer patients treated at three South Australian teaching hospitals between 1998 and 2007 were analyzed by place of residence, time of diagnosis and socioeconomic status (SES). ,2 tests were used to investigate differences in stage, grade and prostate-specific antigen (PSA) at diagnosis, among subgroups and over time. Logistic regression was used to examine predictors of treatment modalities. Five-year survival was assessed using Kaplan,Meier methods. Results: The distributions of age, SES and place of residence of PCCOD patients closely reflected those of the state-based prostate cancer population, with rural patients slightly underrepresented. Lower SES or rural residence was not associated with higher stage, grade, PSA level or disease-specific survival. Treatment modalities varied with SES (for radical prostatectomy), rural residence (radical prostatectomy, radiotherapy and androgen ablation), age and clinical characteristics. There was a trend over time towards a younger age at diagnosis and more favorable clinical profiles, consistent with earlier diagnosis. However, the current risk profile for this cohort is similar to that reported approximately a decade earlier in a US series. Conclusion: PCCOD patients have a broadly similar socio-demographic profile to prostate cancer patients statewide. Socioeconomic status is not associated with clinical characteristics at diagnosis, but does predict treatment type. The clinical characteristics of the cohort are consistent with a much later stage presentation than reported in current US case series. [source] Breast cancer subtypes and response to systemic treatment after whole-brain radiotherapy in patients with brain metastasesCANCER, Issue 18 2010Anna Niwi, ska MD Abstract BACKGROUND: The aim of this study was to assess the role of systemic treatment after whole-brain radiotherapy (WBRT) in immunohistochemically defined biological subsets of breast cancer patients with brain metastases. METHODS: The group of 420 consecutive breast cancer patients with brain metastases treated at the same institution between the years of 2003 to 2009 was analyzed. Patients were divided into 4 immunohistochemically biological subsets, based on the levels of estrogen, progesterone, and human epidermal growth factor receptor 2 (HER2) receptors, and labeled as luminal A, luminal B, HER2, and triple-negative. Survival from brain metastases with and without systemic treatment after WBRT was calculated in 4 subsets. RESULTS: In the entire group, the median survival from brain metastases in patients without and with systemic treatment after WBRT was 3 and 10 months, respectively (P < .0001). In the triple-negative subset, the median survival from brain metastases with and without systemic treatment was 4 and 3 months (P = .16), and in the luminal A subset, it was 12 and 3 months, respectively (P = .003). In the luminal B subset, the median survival without further treatment, after chemotherapy and/or hormonal therapy, and after chemotherapy and/or hormonal therapy with targeted therapy was 2 months, 9 months, and 15 months, respectively (P < .0001). In the HER2 subset, the median survival was 4 months, 6 months, and 13 months, respectively (P < .0001). No significant response to systemic treatment was noted in the triple-negative breast cancer population. CONCLUSIONS: Systemic therapy, ordered after WBRT, appears to improve survival in patients with the luminal A, luminal B, and HER2 breast cancer subtypes. Targeted therapy was found to have an additional positive impact on survival. In patients with triple-negative breast cancer, the role of systemic treatment after WBRT appears to be less clear, and therefore this issue requires further investigation. Cancer 2010. © 2010 American Cancer Society. [source] Clinical trial enrollment, patient characteristics, and survival differences in prospectively registered metastatic colorectal cancer patientsCANCER, Issue 20 2009Halfdan Sorbye MD Abstract BACKGROUND: Trial accrual patterns were examined to determine whether metastatic colorectal cancer (mCRC) patients enrolled in trials are representative of a general cancer population concerning patient characteristics and survival. METHODS: A total of 760 mCRC patients referred for their first oncological consideration at 3 hospitals in Scandinavia covering defined populations were registered consecutively during 2003 to 2006. Clinical trial enrollment, patient characteristics, and treatment were recorded prospectively, and the follow-up was complete. RESULTS: Palliative chemotherapy was initiated in 61% of the patients. Approximately one,third (36%) of patients receiving chemotherapy were included in a trial. The main reason for nonparticipation was failed eligibility criteria (69%). The median survival after chemotherapy was 15.8 months for all patients, and 18 months after combination chemotherapy. Trial patients had better prognostic characteristics and significantly longer survival than nontrial patients: 21.3 months versus 15.2 months when receiving combination chemotherapy. Poor performance status was the main reason for giving best supportive care only, and the median survival was then only 2.1 months. The median survival for all 760 nonresectable mCRC patients was 10.7 months. CONCLUSIONS: mCRC patients enrolled into clinical trials differ in characteristics from patients receiving chemotherapy outside protocol and have better survival, even when given the same treatment. Although trial patients have a median survival close to 2 years, survival is lower for all patients receiving chemotherapy and much lower for all patients diagnosed with mCRC. Studies that better accept the heterogeneity of the population with mCRC are needed. Cancer 2009. © 2009 American Cancer Society. [source] An evidence-based review of yoga as a complementary intervention for patients with cancerPSYCHO-ONCOLOGY, Issue 5 2009Kelly B. Smith Abstract Objective: To conduct an evidence-based review of yoga as an intervention for patients with cancer. Specifically, this paper reviewed the impact of yoga on psychological adjustment among cancer patients. Methods: A systematic literature search was conducted between May 2007 and April 2008. Data from each identified study were extracted by two independent raters; studies were included if they assessed psychological functioning and focused on yoga as a main intervention. Using a quality rating scale (range,=,9,45), the raters assessed the methodological quality of the studies, and CONSORT guidelines were used to assess randomized controlled trials (RCTs). Effect sizes were calculated when possible. In addition, each study was narratively reviewed with attention to outcome variables, the type of yoga intervention employed, and methodological strengths and limitations. Results: Ten studies were included, including six RCTs. Across studies, the majority of participants were women, and breast cancer was the most common diagnosis. Methodological quality ranged greatly across studies (range,=,15.5,42), with the average rating (M,=,33.55) indicating adequate quality. Studies also varied in terms of cancer populations and yoga interventions sampled. Conclusions: This study provided a systematic evaluation of the yoga and cancer literature. Although some positive results were noted, variability across studies and methodological drawbacks limit the extent to which yoga can be deemed effective for managing cancer-related symptoms. However, further research in this area is certainly warranted. Future research should examine what components of yoga are most beneficial, and what types of patients receive the greatest benefit from yoga interventions. Copyright © 2008 John Wiley & Sons, Ltd. [source] A pilot study on disseminating physical activity promotion among cancer survivors: a brief reportPSYCHO-ONCOLOGY, Issue 5 2008Bernardine M. Pinto Abstract There is growing evidence that physical activity (PA) can improve quality of life (QOL) and reduce fatigue in cancer survivors. Research staff or healthcare providers have delivered PA interventions to cancer populations. As a first step to dissemination of a previously tested PA intervention, seven American Cancer Society Reach to Recovery volunteers (mean age,=,57.4 years) were trained to deliver the telephone-based intervention to 25 breast cancer survivors (mean age,=,52.9 years, 56% Stage 2 cancer, mean of 3.3 years since diagnosis). A single group design was used. The theory-based intervention consisted of 12 weekly calls to encourage participants to adopt moderate-intensity PA. Participants' PA, QOL, mood, and fatigue were assessed at baseline, 12, and 24 weeks. Data on intervention feasibility and preliminary effects were collected. The intervention was feasible (mean of 10.7 out of 12 calls were delivered) and acceptable to the volunteers. At 12 weeks, there were significant increases in participants' PA and improvements in fatigue, QOL, and vigor. Effects were maintained at 24 weeks. This pilot study demonstrated that it was feasible for trained volunteers to deliver a telephone-based PA intervention to breast cancer survivors, and there were positive effects on survivors' PA behavior and psychological outcomes. Copyright © 2007 John Wiley & Sons, Ltd. [source] Recruiting and retaining breast cancer survivors into a randomized controlled exercise trial,CANCER, Issue S11 2008Survivorship Study, The Yale Exercise Abstract BACKGROUND. Given observational findings that physical activity reduces breast cancer risk, improves survival, and improves quality of life in breast cancer survivors, a need has been identified for randomized controlled trials that testthe efficacy of exercise on biological mechanisms associated with breast cancer survival. The primary aims of the Yale Exercise and Survivorship Study were to 1) determine the feasibility of recruiting breast cancer survivors into a randomized controlled trial of the effects of exercise on biological markers and/or mechanisms associated with survival, 2) compare the effectiveness of various recruitment strategies on accrual rates and baseline characteristics, and 3) report adherence to the exercise trial. METHODS. Seventy-five postmenopausal breast cancer survivors self-referred into the trial or were recruited through the Connecticut Tumor Registry and randomly assigned to an exercise (n = 37) or usual-care (n = 38) group. The exercise group participated in 150 min/wk of supervised gym-based and home-based aerobic exercise for 6 months. The usual-care group was instructed to maintain current physical activity level. RESULTS. A total of 75 women (an accrual rate of 9.5%) were randomized to the trial. Rates of accrual were higher for women who self-referred into the study (19.8%) compared with women recruited via the cancer registry (7.6%); however, demographic, physiologic, and prognostic characteristics did not differ between the 2 recruitment strategies. On average, exercisers increased moderate- intensity to vigorous-intensity aerobic exercise by 129 minutes per week compared with 44 minutes per week among usual-care participants (P < .001). Women in the exercise-intervention group increased their average pedometer steps by 1621 steps per day compared with a decrease of 60 steps per day among women in the usual-care group (P < .01). CONCLUSIONS. Findings from this study will provide useful information for investigators who are conducting exercise trials in cancer populations, clinicians who are treating women diagnosed with breast cancer, and exercise professionals who are developing community-based exercise programs for cancer survivors. 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