Improvement In Cancer Patients Research Articles

1033 Developing standards and indicators for quality improvement for cancer patients in Spain

1033 Developing standards and indicators for quality improvement for cancer patients in Spain

Non-Canonical Hh Signaling in Cancer-Current Understanding and Future Directions.

As a major regulatory pathway for embryonic development and tissue patterning, hedgehog signaling is not active in most adult tissues, but is reactivated in a number of human cancer types. A major milestone in hedgehog signaling in cancer is the Food and Drug Administration (FDA) approval of a smoothened inhibitor Vismodegib for treatment of basal cell carcinomas. Vismodegib can block ligand-mediated hedgehog signaling, but numerous additional clinical trials have failed to show significant improvements in cancer patients. Amounting evidence indicate that ligand-independent hedgehog signaling plays an essential role in cancer. Ligand-independent hedgehog signaling, also named non-canonical hedgehog signaling, generally is not sensitive to smoothened inhibitors. What we know about non-canonical hedgehog signaling in cancer, and how should we prevent its activation? In this review, we will summarize recent development of non-canonical hedgehog signaling in cancer, and will discuss potential ways to prevent this type of hedgehog signaling.

Clinical Improvement in Cancer Patients through Integrated Medicine, Mainly Using Low Molecular Weight Fucoidan Supplements

Clinical Improvement in Cancer Patients through Integrated Medicine, Mainly Using Low Molecular Weight Fucoidan Supplements

Integrated cell-based platform to study EGFR activation and transactivation.

The epidermal growth factor receptor (EGFR) pathway is one of the most deregulated molecular pathways in human epithelial cancers. Many approved drugs were optimized to directly target EGFR but yielded only modest clinical improvement in cancer patients due to low efficacy and drug resistance. Transactivation of EGFR by other cell surface receptors such as G-protein-coupled receptors (GPCRs) was proposed to explain this lack of efficacy. Even if direct EGFR activation and transactivation by GPCR contribute to the activation of the same signaling pathways, they are often studied as independent events resulting in partial investigation of a drug's mechanism of action. We present a novel high-throughput approach that integrates interrogation of direct activation of EGFR and its transactivation via GPCR activation. Using distinct technology platforms, three readouts were used to measure (1) direct activation of GPCR via cyclic adenosine monophosphate (cAMP) detection, (2) direct activation of EGFR through the release of intracellular Ca(2+), and (3) EGFR transactivation by GPCR using the detection of p-extracellular-signal-regulated kinases 1/2 (p-ERK1/2). In addition to being simple, quick, and homogenous, our methods were shown to be more sensitive than those in current use. These enabling tools should improve the knowledge pertaining to GPCRs and receptor tyrosine kinases trans-regulation and facilitate the design of more potent and better targeted new therapeutic strategies.

Interest in a group psychotherapy program among Philippine breast cancer patients and its associated factors

A wide variety of psychosocial interventions are available for cancer patients, among which group psychotherapy (GPT) programs have made improvements in cancer patients' quality of life, coping abilities, and emotional distress. Few research data are available describing Philippine breast cancer patients' interest in GPT. This study aimed at enumerating the factors that determine Philippine breast cancer patients' interest in a GPT program. Patients recruited from the University of Santo Tomas Hospital Benavides Cancer Institute were asked to answer a survey questionnaire about their demographic, clinical, and psychosocial status, as well as whether they would be interested in joining GPT and why. Of 135 patients approached, 123 patients completed the survey. 104 (85%) women indicated interest in GPT. Patients were mostly interested because they wanted to learn coping skills (79%) and gain knowledge or information in dealing with cancer (69%). Patients said they were 'very interested' in learning about cancer recurrence (96%) and treatments (94%). Bivariate analysis showed that compared to the uninterested group, interested patients were younger, more likely to be married, and were more likely to have used complementary therapy for breast cancer. Logistic regression showed that married women were more likely to be interested in GPT (OR 3.30, CI 1.07-10.20). There is a potentially high interest in GPT among Philippine breast cancer patients. The attributes of Philippine patients interested in GPT are similar to and yet unique, compared to other populations. Copyright © 2010 John Wiley & Sons, Ltd.

Palliative Care Team: The First Year Audit in Japan

In Japan, palliative care team (PCT) services have been covered by National Health Insurance since 2002. The primary aims of this study were to compare the characteristics of patients who received PCT services with those admitted to palliative care units (PCU), and to clarify the medical treatments and symptom improvement during the first week after consultation with the PCT. This was a prospective audit study of 111 consecutive cancer patients referred to the PCT in Seirei Mikatabara Hospital and a comparison group of 100 consecutive patients admitted to PCU. As a part of daily practice, we prospectively recorded patient symptoms on a structured data collection sheet at the initial assessment and one week later. Symptom severity was measured by the Japanese version of the Schedule for Team Assessment Scale. After PCT consultation, 25% were discharged to home, 43% died in hospital, 40% died after admission to PCU, and 14% were alive at the end of the study period. Compared with PCU patients, PCT patients were significantly younger, had better performance status, were more likely to be referred with the described aim of symptom palliation, and suffered from more serious pain, appetite loss, somnolence, insomnia, anxiety, and delirium. There were significant improvements in symptom scores of pain, nausea, vomiting, constipation, abdominal swelling, dyspnea, sputum, insomnia, and anxiety during the first week in the PCT group. However, no significant improvements were observed in symptom scores of fatigue, dry mouth, somnolence, and delirium. A median of 3 interventions was performed for each patient, and the most common interventions were administration of NSAIDs, opioids, centrally-acting antiemetics, and steroids. These data indicate that a PCT was successfully implemented in Seirei Mikatabara Hospital, and may contribute to symptom improvement in cancer patients.

Epoetin alfa offers clinically significant improvements in the quality of life of anaemic cancer patients

ABSTRACTAnaemia is a common problem for cancer patients and often causes fatigue and reduces quality of life (QoL). Although randomised trials have repeatedly shown that treatment with epoetin alfa raises haemoglobin levels, reduces fatigue and improves overall QoL, such findings may be hard to put into a clinical context and, as a result, cancer-related fatigue remains undertreated.This study gathered data using the FACTAn QoL scale from 1400 people on an internet survey panel. The 1400 were randomly selected and chosen to be representative of the total US population. Survey results were then compared with the findings from a large placebo-controlled study involving 375 anaemic cancer patients.FACT-An showed good psychometric properties in the survey population and was able to distinguish respondents with histories of anaemia and cancer from those without. Comparing the population norm values for FACT-An with the trial data showed that treatment with epoetin alfa led to clinically meaningful improvements in cancer patients' QoL.

Massage therapy for symptom control: outcome study at a major cancer center

Massage is increasingly applied to relieve symptoms in patients with cancer. This practice is supported by evidence from small randomized trials. No study has examined massage therapy outcome in a large group of patients. At Memorial Sloan-Kettering Cancer Center, patients report symptom severity pre- and post-massage therapy using 0–10 rating scales of pain, fatigue, stress/anxiety, nausea, depression and “other.” Changes in symptom scores and the modifying effects of patient status (in- or outpatient) and type of massage were analyzed. Over a three-year period, 1,290 patients were treated. Symptom scores were reduced by approximately 50%, even for patients reporting high baseline scores. Outpatients improved about 10% more than inpatients. Benefits persisted, with outpatients experiencing no return toward baseline scores throughout the duration of 48-hour follow-up. These data indicate that massage therapy is associated with substantive improvement in cancer patients' symptom scores.

Clinical Improvement In Cancer Patients Through Alternative Medicine, Mainly Fucoidan(International Conference on Mind Body Science : Physical and Physiological Approach joint with The Eighteenth Symposium on Life Information Science)

Clinical Improvement In Cancer Patients Through Alternative Medicine, Mainly Fucoidan(International Conference on Mind Body Science : Physical and Physiological Approach joint with The Eighteenth Symposium on Life Information Science)

QOL improvement in cancer patients receiving epoetin-α

QOL improvement in cancer patients receiving epoetin-α