Development Of Cancer Services Research Articles

The Correlation between the Level of Physical Activity and the Incidence of Breast Cancer in RSUD Dr. Soetomo Surabaya

Breast cancer is one of the most common cancers worldwide. This study aims to investigate and analyze the relationship between the level of physical activity and the occurrence of breast cancer at Dr. Soetomo Hospital Surabaya. The research method employed in this study is correlation analysis. The sample population was obtained from the Cancer Service Development Center (PPLK) at Dr. Soetomo Hospital Surabaya. The results of this study indicate that the majority of the 53 research subjects suffering from breast cancer had low-intensity physical activity since childhood to adolescence, with 41.5% of the total subjects (22 patients). In contrast, only 24.5% (13 patients) and 34% (18 patients) had moderate and high-intensity physical activity, respectively. Statistical analysis using Microsoft Excel version 2019 and SPSS showed that the calculated Chi-square value was greater than the tabulated Chi-square value, thus rejecting the null hypothesis (H0). This indicates a significant relationship between the intensity of physical activity during childhood to adolescence and the occurrence of breast cancer in the research subjects. This study implicates the importance of awareness regarding the significance of physical activity in maintaining breast health, especially from a young age. The practical implication of this research is the necessity of a preventive approach to breast cancer involving the promotion of a healthy lifestyle and regular physical activity, particularly during childhood and adolescence.

Five changes needed to Scottish cancer policy to support necessary transformation of services

Whilst Scottish healthcare policy has not yet set a clear direction for service transformation needed in lieu of budgetary constraints, it is important that policy makers are cognisant of where policy can support healthcare professionals to overcome barriers to service development, and better meet demand. An analysis of Scottish cancer policy is presented, informed by learning gained from supporting development of cancer services as a practitioner, insights from undertaking health service research, and known barriers to service developments. This paper is structured as five recommendations to policy-makers: the need to develop a shared understanding of quality care between policy makers and healthcare professionals to guide service development in the same direction; revisiting of partnership working given developing health and social care landscape; empowerment of national and regional networks and working groups to develop and implement Gold Standard care in speciality services; sustainability in the development of cancer services; and development of guidance relating to how services should be using and developing patient capacities.

Advancing consumer engagement: Supporting, developing and empowering youth leadership in cancer care.

Advancing consumer engagement: Supporting, developing and empowering youth leadership in cancer care.

Addressing the burden of cancer in East Africa through cascaded training and education by local doctors.

11000Background: Development of cancer services in low and middle income countries (LMIC) is a challenge. The Medical Education, Training and Fellowship (METAF) program aims to improve early detect...

PENGARUH AUTOGENIC DAN HANDGRIP RELAXATION TERHADAP ASPEK FISIKDAN ASPEK PSIKOLOGIS, PADA PENDERITA KANKER PAYUDARA YANG MENJALANI KEMOTERAPI

Women suffering breast cancer who undergo chemotherapy experience side effects both physical and psychological. Complementary therapy urgently needed for relaxing patient before chemotherapy such as Autogenic and Handgrip Relaxation through self-suggestion technique. This research aim to analyze effect of autogenic and handgrip relaxation on physical aspect (chemotherapy induced nausea and vomiting), psychological aspect (anxiety) in patients with breast cancer who undergo chemotherapy at PPLK (Cancer Service Development Center) RSUD dr. Soetomo Surabaya. Method: True Experimental with post-test only with control design. 72 respondents were involved and divided into 3 treatment groups and 1 control group. Research conducted within 3 weeks after chemotherapy until next chemotherapy session on each patients. Data were analyze used MANOVA and LSD (Least Significant Difference). Results: Autogenic and handgrip relaxation influence physical aspect and psychological aspect level significantly with p = 0.000 (p <0.05). LSD test showed no difference between autogenic relaxation, handgrip relaxation, and autogenic relaxation. Conclusion: Autogenic and handgrip relaxation have an effect on nausea vomiting and anxiety patients are able to adapt and control the body's response to be adaptive.

Nurse-led chemotherapy clinics: issues for the prescriber

Government policy has guided the development of cancer services over the last 15 years. Most importantly for chemotherapy services is the National Chemotherapy Advisory Board report ( Department of Health, 2009 ). The focus of this report is safety, and it endorses the introduction of nurse-led chemotherapy clinics. This endorsement was welcomed, but many areas have struggled to develop services prompting the United Kingdom Oncology Nurses Society to produce a position statement to offer a framework for implementation. Within this position statement, non-medical prescribing is considered the gold standard for practice. This article discusses the evidence for nurse-led chemotherapy clinics and outlines practice and the assessments tools used.

78 Engaging and Involving Teenagers in Cancer Service Development – An Exemplary Model

78 Engaging and Involving Teenagers in Cancer Service Development – An Exemplary Model

Survival trends of cancer amongst the south Asian and non-south Asian population under 30 years of age in Yorkshire, UK

Introduction: Several studies have shown differences in survival trends between ethnic groups across adults with cancer in the UK. It is unclear whether these differences exist exclusively in the older adult population or whether they begin to emerge in children and young adults. Methods: Subjects ( n = 3534) diagnosed with cancer under 30 years of age in Yorkshire between 1990 and 2005 were analysed. Differences in survival rates for diagnostic subgroups were estimated by ethnic group (south Asian or not) using Kaplan–Meier estimation and Cox regression. Results: When compared to non-south Asians (all other ethnic groups excluding south Asians) a significant increased risk of death was seen for south Asians with leukaemia (hazard ratio (HR) = 1.75; 95% confidence interval (CI) = 1.11–2.76) and lymphoma (HR = 2.05; 95% CI = 1.09–3.87), whereas south Asians with solid tumours other than central nervous system tumours had a significantly reduced risk of death(HR = 0.50; 95% CI = 0.28–0.89). This was independent of socioeconomic deprivation. Conclusion: We found evidence of poorer survival outcomes for south Asians compared to non-south Asian children and young adults with leukaemia and lymphoma, but better outcomes for south Asian children and young adults with other solid tumours. This needs to be explained, and carefully addressed in the on-going development of cancer services.

Gretchen Krueger, Hope and suffering: children, cancer, and the paradox of experimental medicine, Baltimore, Johns Hopkins University Press, 2008, pp. x, 216, £23.50, $35.00 (hardback 978-0-8018-8831-1).

Between the 1930s and the 1980s, the expectations of families facing cancer in a child changed so remarkably that the disease changed its meaning—from a time when cancer was believed to be exceptionally rare in children, it came to be seen in the developed world as the second largest killer of children after accidents, and the likely outcome shifted from being a rapid decline and inescapable death to a complete recovery with a normal life thereafter. Over these five decades, billions of dollars were poured into research by the American government and by charities with aggressive advertising campaigns, and the treatments offered diversified and intensified into today’s multiple and cutting-edge protocols. Krueger’s account of childhood cancer during these middle years of the twentieth century shows that one cannot tell this history without simultaneously tracing stories of personal heartache and uncertainty, and of clinical stumbling blocks and breakthroughs. That childhood cancer has these twin realities should come as no surprise, but this book tells both stories deftly, and weaves them together, presenting rich evidence in a highly readable style that will see it reach wide audiences. It is a very particular story, focusing only on the United States, and thus lays down a challenge to scholars elsewhere to present their own archival treasures in ways that connect with and illuminate this history. International histories of the development of cancer services and research have shown that there are marked differences between countries in how services are prioritized, funded, allocated, and accepted—see for example, David Cantor (ed.), Death in the twentieth century (Baltimore, 2008). Hope and suffering centres around the memoir Death be not proud written by John and Frances Gunther in 1949; it recounts the battle of their son Johnny, who died from a brain tumour the same year. Krueger makes wonderful use of a large archive of letters written by other families to the Gunthers, and the Gunthers’ replies, to paint a careful picture of how parents and children responded to this level of suffering in their own families and in one another’s. Earlier chapters similarly foreground the experience of one sick child, one family, allowing Krueger to probe deeply public reactions to cancer through newspaper and court reactions, as well as private correspondence. The closing chapters move further into the clinical history, following researchers into the lab and presenting families’ accounts of how they felt about their children being experimental subjects. The conclusion explores why childhood cancer has been such a popular topic for the American media since the 1930s, and why it is seen as a disease of common interest, worth state funding and close press attention, a disease of the community and not just the private family. Throughout the book, then, Krueger sets close textual analyses of private experiences alongside accounts of the available clinical options, and shows that until the major breakthroughs of the 1960s, the ultimate responsibility for a child’s health, or death, was seen to lie firmly with the mother: the widespread belief that cancer could be treated most successfully if only it was treated hard and at its first appearance, translated to an understanding—shared by parents and clinicians—that mothers should be more watchful of their offsprings’ health. Only with the advent of curative treatments did the burden to rescue these sick children fall on scientific medicine itself. The Gunthers’ memoir was frequently set as a text in American high schools in the 1950s to encourage teenagers to broaden their powers of empathy. As Krueger shows, fictional and fictionalized accounts of death from childhood or adolescent cancer remained popular through to at least the 1970s, and a quick search through any library or bookshop in the United Kingdom will show that the topic still draws a large readership here; cancer story-lines in soap operas and films also attract a substantial viewer share. The belief that the drama of childhood cancer is somehow of interest or value to us all persists. Krueger’s book takes us back stage and shows the painful and brave complexity behind each battle. It would be of value in any medical humanities course.

Interprofessional collaboration with service users in the development of cancer services: The Cancer Partnership Project

Patient and Public Involvement (PPI) is a cornerstone of UK National Health Service (NHS) policy. The Cancer Partnership Project (CPP) is the leading national PPI initiative in cancer care. The CPP espouses a “partnership” model, with a “Partnership Group” – collaborative service improvement groups formed of NHS staff and service users – in each of 34 cancer networks in England. These groups aim to enable service users to influence local cancer service development and thereby improve the effectiveness of services. We interviewed 59 cancer service users and NHS staff in a reflective evaluation of CPP. Groups were active and visible in 30 networks, their main activities being: providing an accessible source of consumer opinion; prolific networking and representation; patient information and communication projects; and lobbying for service improvements. The groups exhibited some significant tensions. The motivations of professional staff varied markedly, and “obligatory” involvement as part of a person's job was counter-productive when not coupled with a “personal” belief in the value of PPI. Other controversial areas were the disclosure by patients' of personal health and treatment experiences, and emotional attachment to the group. It was concluded that partnership groups represent a useful PPI model, but more attention generally should be paid to the complexities of PPI and timescales required for meaningful cultural change.

News analysis

The latest National Audit Office (NAO) report makes interesting reading for those involved at all levels of cancer service development, delivery, education or research.

Divided care and the Third Way: user involvement in statutory and voluntary sector cancer services.

In health care, as in much of the public sphere, the voluntary sector is playing an increasingly large role in the funding, provision and delivery of services and nowhere is this more apparent than in cancer care. Simultaneously the growth of privatisation, marketisation and consumerism has engendered a rise in the promotion of 'user involvement' in health care. These changes in the organisation and delivery of health care, in part inspired by the 'Third Way' and the promotion of public and citizen participation, are particularly apparent in the British National Health Service. This paper presents initial findings from a three-year study of user involvement in cancer services. Using both case study and survey data, we explore the variation in the definition, aims, usefulness and mechanisms for involving users in the evaluation and development of cancer services across three Health Authorities in South West England. The findings have important implications for understanding shifts in power, autonomy and responsibility between patients, carers, clinicians and health service managers. The absence of any common definition of user involvement or its purpose underlines the limited trust between the different actors in the system and highlights the potentially negative impact of a Third Way health service.

The development of cancer services: reflections on a learning journey.

The development of cancer services: reflections on a learning journey.

Treatment of anaemia in cancer patients: implications for supportive care in the National Health Service Cancer Plan

SUMMARYThe National Health Service (NHS) Cancer Plan published in 2000 has a short-term focus on the most pressing problems of improving survival rates and replacing equipment. It also mentioned as a target 'improved quality of life for those affected by cancer'. Continuity of care for longer-term care programmes was seen predominantly in terms of palliative care. Recent National Institute for Clinical Excellence (NICE) reports may have reinforced this approach by focussing on the clinical and cost effectiveness of chemotherapy for late-stage cancer. The impact on local decision-makers has been that drug funds have been prioritised for use on survival-enhancing interventions, with few resources left for short and longer-term supportive care targeted primarily on improving quality of life. Within supportive care, resources are particularly limited for funding treatments such as erythropoietin for the management of cancer-related anaemia, a common and very debilitating side-effect of intensive therapy. The need for a re-focusing on supportive care is associated with cancer becoming, in many instances, a longer-term illness. The prevalence ofcancer is rising markedly due to increased survival rates. However, this creates a new challenge of reducing disability and improving quality of life. In surveys, patients have rated fatigue associated with anaemia as one of the most debilitating effects of their cancer and its treatment with chemotherapy. This paper reviews the evidence demonstrating the quality of life benefits of erythropoietin, and then considers the policy constraints that have limited the adoption of this treatment within the NHS. Through co-ordinated planning there are opportunities for cancer networks and primary care trusts (PCTs) working with cancer centres to develop more support in ways which are feasible and fundable. The case is argued that PCTs and cancer networks, in implementing the Cancer Plan locally, need to integrate short- and longer-term supportive care into their cancer service development plans, and recognise the importance of anaemia management as an integral part of this. Lessons can be learnt from UK renal services where anaemia management with erythropoietin is standard practice.

The NCI All Ireland Cancer Conference

The NCI All Ireland Cancer Conference