Experience In Treatment Of Cancer Research Articles

150 Extended versus small field irradiation in high risk post esophagectomy patients receiving combined chemoradiation therapy: A decade experience in treatment of esophageal cancer

150 Extended versus small field irradiation in high risk post esophagectomy patients receiving combined chemoradiation therapy: A decade experience in treatment of esophageal cancer

Whose line is it anyway? Management of central venous catheters in children

Paediatric cancer therapy for children and young people is highly complex. It involves chemotherapy regimens, multiple blood sampling and supportive care measures, all of which require reliable, safe and acceptable venous access to manage the child through the cancer treatment experience. Among the most disturbing experiences for children receiving cancer treatment are the trauma of venepuncture and associated needle phobia (Liossi 2002). Appropriate support is required for both child and family to remove or reduce these stressful experiences and is part of improving the quality of the patient’s journey in living with cancer in the 21st century (Gibson and Evans 1999)

Choosing observers for evaluation of aesthetic results in breast cancer conservative treatment

The subjective evaluation of aesthetic results in conservative breast cancer treatment has largely been used without questioning the observer's skills. The aim of this study was to evaluate interobserver agreement of the aesthetic results of breast cancer conservative treatment in three groups of observers with different levels of experience. Photographs were taken of 55 women who had undergone conservative unilateral breast cancer treatment and 5 control women with no breast disease. The images were then distributed to 13 observers who were divided into three groups according to their experience in breast cancer treatment: experienced, medium experienced, and inexperienced. They were first asked to distinguish the patients from the controls and for the patients to identify the operated side. Subsequently, they were asked to classify the aesthetic result as excellent, good, fair, or poor. The accuracy in identifying controls, patients, and side of treatment was calculated individually for all observers. The interobserver agreement for the aesthetic result was calculated using observed agreement and multiple kappa statistic (kappa) in each of the three groups. Inexperienced observers performed significantly worse than experienced observers in identifying controls, patients, and the side of treatment. Agreement of the aesthetic result was significantly greater in the group of experienced observers (kappa = 0.59) than in the medium experienced (kappa = 0.35) and inexperienced (kappa = 0.33) observers. Previous experience in breast cancer conservative treatment should be considered a prerequisite for the evaluation of the aesthetic results.

Listening to the Voices of Lesbians Diagnosed with Cancer

This paper focuses on the operations of heterosexism and strategies to counter it in a particular service context: the context of psychosocial support services for women with cancer. The paper draws on findings from a participatory, qualitative study set in Ontario, Canada in which 26 lesbians were interviewed about their experiences of cancer diagnosis, treatment, health care and social support, and their feelings and perceptions about shifts in identity, body, sexuality and relationships. This paper focuses on findings related to the changes research participants perceived as necessary in the provision and organization of cancer support services, in order to increase access and ensure equity for lesbians with cancer and their families.

Onward in my journey: preparing nurses for a new age of cancer care.

Cancer nursing education in the United Kingdom currently is the subject of widespread debate. The imperative to improve cancer care is driven by professional and ethical obligations for clinical excellence and an aggressive political agenda seeking to demonstrate tangible improvements through centrally administered targets and benchmarks. Attempts to provide a holistic approach to care have engendered a range of alternative approaches underpinned by an appreciation of the "cancer journey." Despite the laudable intent of national policy initiatives aimed at improving the experience of cancer treatment, they have evidenced an emerging polarization in the practice arena. Nursing interventions, priorities, and goals are at risk of becoming confused by the competing paradigms of an outcome-driven strategy and a less focused humanistic philosophy of care. This dilemma presents significant problems in the planning of appropriate and effective education preparation for cancer nurses. This article aims to address the tensions produced by a dichotomy between the pragmatics of clinical practice and a professional quest for holism. It focuses on a specialist practitioner cancer nursing program, using case examples to illustrate innovations in teaching and learning. Embracing a postmodern perspective, reflection, and critical thinking, the discussion offers a challenge to diagnostic clinical language through the discursive structures of metaphor, narrative, and story.

Angiographical follow-up after radioactive “cold ends” stent implantation: a multicenter trial

This study seeks to understand the breast cancer treatment patterns and experiences of women enrolled in Georgia's Breast and Cervical Cancer Prevention and Treatment Act program, the Women's Health Medicaid Program (WHMP), and whether these experiences vary by race or location.We conducted a mixed-methods analysis of WHMP breast cancer enrollees by race and urban/rural location. Quantitative analysis used a hazard rate model approach to identify differences in the timing of diagnosis, enrollment into Medicaid, and various modalities of treatment for 810 enrollees. Qualitative analysis used a systematic retrieval and review of coded data from 34 in-depth disease life history interview transcripts to a complete, focused analysis of enrollees' cancer treatment experiences.African-American women began treatment, on average, 6 days later after diagnosis than White women, driven by delays of one month among African-American women with late-stage cancers. This time delay for African-American women was not significant on multivariate analysis of time from enrollment to treatment. Once enrolled in WHMP, women reported gaining access to equitable breast cancer treatment regardless of race or location, with the exception of breast reconstruction, for which some women in our sample reported barriers to care.The equitable access to cancer treatment and other health services provided by WHMP to low-income, uninsured women in Georgia with breast cancer makes it a critical health care safety net program in Georgia, the need for which will continue through the implementation of the Affordable Care Act.

Systolic and diastolic performance late after the Fontan procedure for a single ventricle and comparison of those undergoing operation at 12 months of age

This study seeks to understand the breast cancer treatment patterns and experiences of women enrolled in Georgia's Breast and Cervical Cancer Prevention and Treatment Act program, the Women's Health Medicaid Program (WHMP), and whether these experiences vary by race or location.We conducted a mixed-methods analysis of WHMP breast cancer enrollees by race and urban/rural location. Quantitative analysis used a hazard rate model approach to identify differences in the timing of diagnosis, enrollment into Medicaid, and various modalities of treatment for 810 enrollees. Qualitative analysis used a systematic retrieval and review of coded data from 34 in-depth disease life history interview transcripts to a complete, focused analysis of enrollees' cancer treatment experiences.African-American women began treatment, on average, 6 days later after diagnosis than White women, driven by delays of one month among African-American women with late-stage cancers. This time delay for African-American women was not significant on multivariate analysis of time from enrollment to treatment. Once enrolled in WHMP, women reported gaining access to equitable breast cancer treatment regardless of race or location, with the exception of breast reconstruction, for which some women in our sample reported barriers to care.The equitable access to cancer treatment and other health services provided by WHMP to low-income, uninsured women in Georgia with breast cancer makes it a critical health care safety net program in Georgia, the need for which will continue through the implementation of the Affordable Care Act.

10-year experience of lung cancer treatment in the Krasnodar Regional Thoracic Surgery center

10-year experience of lung cancer treatment in the Krasnodar Regional Thoracic Surgery center

Evaluating complementary and alternative therapies for cancer patients.

"Complementary and alternative" therapies are actually a vast collection of disparate, unrelated regimens and products, ranging from adjunctive modalities that effectively enhance quality of life and promising antitumor herbal remedies now under investigation, to bogus therapies that claim to cure cancer and that harm not only directly, but also indirectly by encouraging patients to avoid or postpone effective cancer care. Complementary therapies such as music and massage, herbal teas to aid digestion and relieve nausea, yoga, tai chi, meditation, and the many other well-documented techniques that relieve stress and enhance well-being should be made available to patients to augment and ease the experience of cancer treatment and recovery. Many time-tested herbal and diet-based remedies are now being studied for their abilities to induce or extend remission without toxicity. At the same time, lack of government regulatory authority leaves consumers at the mercy of those who promote unproved remedies, scores of which the grocery store and pharmacy shelves. Many of these over-the-counter products contain harmful ingredients. Herb-drug interactions, only some of which are documented, occur with frequency and are sufficiently problematic to require that patients stop taking herbal remedies prior to surgery (to prevent interactions with anesthetics and anticoagulant effects); before radiation (due to potential for increased photosensitivity); and during courses of chemotherapy (to prevent product-drug interactions). Moreover, both good information and misinformation that appear in printed materials and on the Internet appeal to better educated consumers, who are, in fact, the most likely to try complementary and alternative methods.

Health promotion interventions for adolescent cancer survivors

There is clearly a need to develop effective health promotion interventions for adolescent cancer survivors, given their increased susceptibility to adverse health risks if they practice unhealthy behaviors. Approaches typically used with healthy adolescents may not be highly effective with young cancer patients given their unique educational needs secondary to their cancer treatment experience. Interventions that capitalize on the perceptions of increased health vulnerability, characteristic of cancer survivors, may serve to enhance the impact of more traditional health education approaches. This strategy can be conceptualized from a theoretical model that focuses on the relationship between perceptions of health risk and behavior. The application of this approach as it relates to health promotion with adolescent cancer survivors will be illustrated with an intervention targeting tobacco-use prevention and cessation in this vulnerable population.

Exemestane experience in breast cancer treatment

Exemestane is a very potent, orally active, selective and long-lasting steroidal irreversible inhibitor of aromatase. It is 150 times more potent than aminoglutethimide (AG) in inhibiting human placental aromatase (Ki of 4.3 and 671 nM, respectively). The compound is presently under phase III evaluation in Europe and the U.S.A. for the treatment of postmenopausal advanced breast cancer (ABC). Clinical pharmacology studies have been carried out with single doses ranging from 0.5 to 800 mg and repeated doses of up to 600 mg a day, in 132 postmenopausal healthy volunteers and in 185 post-menopausal women with ABC. Results obtained using a very specific and sensitive analytical method (high performance liquid chromatography—radioimmunoassay; HPLC—RIA) indicated that exemestane is extremely effective in inhibiting plasma estrogens levels. Estrogen inhibition is clearly evident at 5 mg a day and maximal suppression for E2, E1 and E1S (>85%, >90% and >90%, respectively) is obtained at 10–25 mg a day. Data from non-controlled phase II studies involving more than 400 patients indicated a clear anti-tumour activity in postmenopausal ABC patients failing multiple hormonal treatments. In 62 patients progressing on AG (≥500 mg a day) exemestane treatment resulted in an objective response rate of approximately 24%; disease stabilization ≥24 weeks was observed in an additional 24% of cases. With regard to safety, although daily doses up to 600 mg were administered, the maximal tolerated dose was not achieved; reported symptoms were mainly related to the pharmacological action of the compound and were usually mild to moderate in severity, resulting in the discontinuation of therapy in less than 3% of cases. In conclusion, the available results suggest that exemestane treatment is associated with minimal toxicity, and may be of significant benefit for ABC women who have exhausted conventional therapy.

Antiandrogen effects in models of androgen responsive cancer

The ability of antiandrogens to antagonize androgen effects in androgen responsive tissues is well estabished. Antiandrogens may diminish in vivo or in vitro proliferation of some androgen responsive cancer cells without causing cessation of multiplication. These model studies are representative of clinical experience in treatment of human prostate cancer with antiandrogen therapy. Recent studies in the AXC/SSh rat prostate cancer model show that these cancer cells elaborate polypeptide growth factors which stimulate their proliferation. If growth factor production by these cells is androgen independent, this may provide an explanation for failure of androgen ablation or antiandrogen treatment to effectively halt prostate cancer cell proliferation.

Our experience in the surgical treatment of cancer and precancerous lesions of the lower lip.

We report on 279 patients with cancer and precancerous conditions of the lower lip who have been surgically treated. Cure rates and cosmetic results are evaluated in relation to the different surgical techniques employed. The types of tumors are statistically analyzed and discussed.

Some experiences in the treatment of cancer by homœopathy

Some experiences in the treatment of cancer by homœopathy

My Experiences in the Surgical Treatment of the Esophageal Cancer

My Experiences in the Surgical Treatment of the Esophageal Cancer

Influence of cervical lymph node metastases on therapy and prognosis of lingual cancer

The experience in treatment of cancer of the tongue and contiguous structures at a Veterans Hospital has been analyzed in particular reference to cervical node metastases associated with the primary lesions. A treatment policy which emphasized radical surgery, including prophylactic neck dissections and a high percentage of commando or in-continuity operations, was pursued. This made cervical nodal material available for study relatively early in the course of our treatment. Cervical lymph node metastases were found in 60 per cent of the patients when first examined or later in the still operable phases of the disease. The gross three year survival rate for lesions associated with positive cervical nodes was 25 per cent and for those associated with negative nodes was 54 per cent.

The Radiumhemmet Experience in Postoperative Radiological Treatment of Cancer of the Corpus Uteri

The Radiumhemmet Experience in Postoperative Radiological Treatment of Cancer of the Corpus Uteri

The Radiumhemmet Experience in Postoperative Radiological Treatment of Cancer of the Corpus Uteri

The Radiumhemmet Experience in Postoperative Radiological Treatment of Cancer of the Corpus Uteri

Facts and Theories in Cancer Therapy

THE etiology of cancer is still in obscurity. Its clinical appearance and cellular pathology are familiar to every student of medicine. For wellnigh fifty years, the surgical dictum that its origin is entirely local has been accepted, and early radical surgery has been, and still is, urged as the only effective cure. Recently radiation therapy has commanded the attention of many surgeons, and it has been acknowledged to be of much value in cancer, but mostly as an aid to surgery. The greater value of pre-operative over post-operative radiation, however, has not impressed the majority of surgeons. The radiologist has dealt largely with the by-products of surgery—the hopeless cases in which the surgeon has failed. Statistics are quoted by surgeons with large experience, showing about 70 to 80 per cent of so-called “cures” for the five-year period in early cases of cancer of the breast without lymphatic involvement, and around 20 per cent of five-year “cures” where there is only slight involvement of the axillary glands. In a long experience in the radiological treatment of cancer, referred mostly by surgeons, we are impressed with the idea that not 10 per cent of the average run of cases operated upon by the average surgeon, enjoy freedom from relapse for a five-year period. Vital statistics the world over show a steady increase in cancer mortality, every year up to and including 1922. If the number of cases claimed by surgery (and radiation, too) were actually true, surely this number would be reduced instead of increased. But, instead, the mortality statistics continue to increase at a rapid rate, indicating that our present conception of the etiology, pathology, and treatment of cancer is very defective. We doubt if the surgery of cancer has made any advance in ten or fifteen years. If so, it is not apparent in the statistics, nor to those of us doing radiation therapy, who see large numbers of cancer patients who have already been operated upon. Then, too, most of these patients already operated on are not well people. They are sufferers in one way or another because of disfiguring, deforming operations. Mortality records have been closely watched, but not morbidity records. The latter are quite as important as the former. The patient with the elephantiasic arm suffers perhaps more tortures than the patient with advanced carcinoma, and her case is just as hopeless. Great encouragement has been held out by surgeons if only patients will apply for treatment early, and every year of late “Cancer Week” has been observed, to educate the public on cancer, in an endeavor to have it treated early. But in spite of all this, the mortality from the disease continues to increase. With the advent of radiotherapy, without a doubt, the number of cures of superficial cancer, which if uncured, would go on to deep-seated cancer, has been enormously augmented. Every radiotherapist has his dozens and hundreds of cured cases of one to many years' standing.