101
|
Korean version of the G-8 geriatric screening tool: Translation and linguistic validation. J Geriatr Oncol 2019; 11:470-474. [PMID: 31235435 DOI: 10.1016/j.jgo.2019.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 05/02/2019] [Accepted: 06/05/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To develop a Korean version of the G-8 questionnaire validated with Korean patients over 70 years-of-age who were scheduled to undergo cancer surgery. MATERIALS AND METHODS We conducted a translation study over a nine-month period from February to November 2017. Permission was received to use the original version of the G-8 questionnaire for forward translation into Korean and reconciliation, for backward translation of the translated Korean version into English, for cognitive debriefing, and final proofreading. These steps were performed in the order of translation and then language validation. Forward translation was performed independently by two translators who were fluent in Korean and English. The cognitive debriefing was carried out through interviews with ten Korean nurses who cared for the patients surveyed. RESULTS In the forward translation, "mobility" was replaced by "degree of activity". During the reconciliation, the difference in meaning between the terms "loss of appetite" and "severe," as determined by the two translators, was adjusted. Moreover, to achieve more natural Korean expression, some revisions were made to the questions and answers. In the backward translation, most of the forward translations were accepted without any objection. During the final proofreading, no difficulties were found in understanding the questionnaire's content, and most terms were deemed easy to understand. CONCLUSION This Korean version of the G-8 questionnaire has been validated in accordance with appropriate procedures. Therefore, the questionnaire is appropriate for use as a geriatric screening tool for older patients with cancer in Korea.
Collapse
|
102
|
Liu Z, Jiang Y, Fang Q, Yuan H, Cai N, Suo C, Ye W, Chen X, Zhang T. Future of cancer incidence in Shanghai, China: Predicting the burden upon the ageing population. Cancer Epidemiol 2019; 60:8-15. [DOI: 10.1016/j.canep.2019.03.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 02/01/2019] [Accepted: 03/04/2019] [Indexed: 01/10/2023]
|
103
|
Gregg JP, Li T, Yoneda KY. Molecular testing strategies in non-small cell lung cancer: optimizing the diagnostic journey. Transl Lung Cancer Res 2019; 8:286-301. [PMID: 31367542 PMCID: PMC6626860 DOI: 10.21037/tlcr.2019.04.14] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 04/14/2019] [Indexed: 01/21/2023]
Abstract
Molecular testing identifies patients with advanced non-small cell lung cancer (NSCLC) who may benefit from targeted therapy or immunotherapy (i.e., immune checkpoint inhibitor treatment for patients with high tumor mutational burden (TMB), microsatellite instability-high or mismatch repair-deficient tumors). Current guidelines state that molecular testing should be conducted at the time of initial diagnosis and tumor progression on targeted therapy. In real-world clinical practice in the United States (US), molecular testing is often not conducted or happens late in the diagnostic journey, resulting in delayed or inappropriate treatment. Herein, we review the rationale for molecular testing in advanced NSCLC, along with best-practice guidelines based on published recommendations and our own clinical experience, including a case study. We propose three strategies to optimize molecular testing in newly diagnosed patients with advanced NSCLC: (I) pulmonologists, interventional radiologists, or thoracic surgeons order molecular tests as soon as advanced NSCLC with an adenocarcinoma component is suspected; (II) liquid biopsies conducted early in the diagnostic pathway; and (III) pathologist-directed reflex testing, as conducted in other areas of oncology. To help facilitate these strategies, we outline our recommendations for optimal sample collection techniques and stewardship. In summary, we believe that implementation of these individual strategies will allow clinicians to effectively leverage available treatment options for advanced NSCLC, reducing the time to optimal treatment and improving patient outcomes.
Collapse
Affiliation(s)
- Jeffrey P. Gregg
- Department of Pathology and Laboratory Medicine, University of California, Davis Medical Center, CA, USA
| | - Tianhong Li
- Division of Hematology & Oncology, Department of Internal Medicine, School of Medicine, University of California, Davis Comprehensive Cancer Center, CA, USA
| | - Ken Y. Yoneda
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of California, Davis Medical Center, CA, USA
| |
Collapse
|
104
|
White MC, Holman DM, Goodman RA, Richardson LC. Cancer Risk Among Older Adults: Time for Cancer Prevention to Go Silver. THE GERONTOLOGIST 2019; 59:S1-S6. [PMID: 31511747 DOI: 10.1093/geront/gnz038] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Over two-thirds of all new cancers are diagnosed among adults aged ≥60 years. As the number of adults living to older ages continues to increase, so too will the number of new cancer cases. Can we do more as a society to reduce cancer risk and preserve health as adults enter their 60s, 70s, and beyond? Cancer development is a multi-step process involving a combination of factors. Each cancer risk factor represents a component of cancer causation, and opportunities to prevent cancer may exist at any time up to the final component, even years after the first. The characteristics of the community in which one lives often shape cancer risk-related behaviors and exposures over time, making communities an ideal setting for efforts to reduce cancer risk at a population level. A comprehensive approach to cancer prevention at older ages would lower exposures to known causes of cancer, promote healthy social and physical environments, expand the appropriate use of clinical preventive services, and engage older adults in these efforts. The collection of articles in this supplement provide innovative insights for exciting new directions in research and practice to expand cancer prevention efforts for older adults. This brief commentary sets the stage for the papers that follow.
Collapse
Affiliation(s)
- Mary C White
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dawn M Holman
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Richard A Goodman
- Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia
| | - Lisa C Richardson
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
105
|
Akushevich I, Kravchenko J, Yashkin AP, Fang F, Yashin AI. Partitioning of time trends in prevalence and mortality of lung cancer. Stat Med 2019; 38:3184-3203. [PMID: 31087384 DOI: 10.1002/sim.8170] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 03/19/2019] [Accepted: 03/25/2019] [Indexed: 01/26/2023]
Abstract
BACKGROUND Time trends of lung cancer prevalence and mortality are the result of three competing processes: changes in the incidence rate, stage-specific survival, and ascertainment at early stages. Improvements in these measures act concordantly to improve disease-related mortality, but push the prevalence rate in opposite directions making a qualitative interpretation difficult. The goal of this paper is to evaluate the relative contributions of these components to changes in lung cancer prevalence and mortality. METHODS Partitioning of prevalence and mortality trends into their components using SEER data for 1973-2013. RESULTS The prevalence of lung cancer increases for females and decreases for males. In 1998, the former was due to increased incidence (45%-50% of total trend), improved survival (40%-45%), and increased ascertainment at early stages (10%-15%). In males, a rapidly declining incidence rate overpowered the effects of survival and ascertainment resulting in an overall decrease in prevalence over time. Trends in lung cancer mortality are determined by incidence during 1993-2002 with noticeable contribution of survival after 2002. CONCLUSION Lung cancer incidence was the main driving force behind trends in prevalence and mortality. Improved survival played essential role from 2000 onwards. Trends in stage ascertainment played a small but adverse role. Our results suggest that further improvement in lung cancer mortality can be achieved through advances in early stage ascertainment, especially for males, and that in spite of success in treatment, adenocarcinoma continues to exhibit adverse trends (especially in female incidence) and its role among other histology-specific lung cancers will increase in the near future.
Collapse
Affiliation(s)
- Igor Akushevich
- Biodemography of Aging Research Unit, Center for Population Health and Aging, Duke University, Durham, North Carolina
| | - Julia Kravchenko
- Department of Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Arseniy P Yashkin
- Biodemography of Aging Research Unit, Center for Population Health and Aging, Duke University, Durham, North Carolina
| | - Fang Fang
- Center for Genomics in Public Health and Medicine, RTI International, Research Triangle Park, North Carolina
| | - Anatoliy I Yashin
- Biodemography of Aging Research Unit, Center for Population Health and Aging, Duke University, Durham, North Carolina
| |
Collapse
|
106
|
Coombs LA, Stephens C. Identifying the Contribution of Nurse Practitioners in the Care of Older Adults With Cancer. Oncol Nurs Forum 2019; 46:277-282. [PMID: 31007255 PMCID: PMC7105278 DOI: 10.1188/19.onf.277-282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To identify the best available dataset that measured the number of nurse practitioners (NPs) and the type of care they provided; patient information, including malignancy type, age, and insurance status; and volume of procedures performed by NPs. SAMPLE & SETTING All available national datasets that included patients with cancer and provider types. METHODS & VARIABLES Using prespecified consensus-driven criteria, all available administrative datasets were reviewed. The authors evaluated four that met the inclusion criteria. RESULTS The authors' analysis identified the Surveillance, Epidemiology, and End Results (SEER) Program linked with Medicare claims dataset as the most appropriate to measure the contribution of NP-provided cancer care to older adults. The Chronic Conditions Data Warehouse was excluded because of the limited number of malignancies included in the data; the SEER-Medicare dataset included all malignancies. IMPLICATIONS FOR NURSING Evidence demonstrates that NPs provide an unknown amount of cancer care to older adults. Further research using the SEER-Medicare dataset may yield a solution to the health issue of insufficient oncologists to care for the growing older adult population. Workforce research informs future training needs and influences policymakers' decisions, making secondary data analyses in nursing particularly important.
Collapse
|
107
|
Hirata K, Imamura M, Fujiwara T, Fukui T, Furukawa T, Gotoh M, Hakamada K, Ishiguro M, Kakeji Y, Konno H, Miyata H, Mori M, Okita K, Sato M, Shibata A, Takemasa I, Unno M, Yokoi K, Nishidate T, Nishiyama M. Current status of site-specific cancer registry system for the clinical researches: aiming for future contribution by the assessment of present medical care. Int J Clin Oncol 2019; 24:1161-1168. [PMID: 31011913 DOI: 10.1007/s10147-019-01434-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 03/22/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND The current status of site-specific cancer registry has not been elucidated, but sufficient system is found in some societies. The purpose of this study was to clear the present condition of site-specific cancer registries in Japan and to suggest for the improvement. METHODS The questionnaire was conducted by the study group of the Ministry of Health, Labor, and Welfare. It consisted of 38 questions, conflicts of interest, clinical research method, informed consent and funding for registry. We distributed this questionnaire to 28 academic societies, which had published the clinical practice guideline(s) assessed under Medical Information Network Distribution Service (MINDS). RESULTS The concept of the importance in assessment for medical quality by the data of the site-specific cancer registry was in good consensus. But the number of the society with the mature registry was limited. The whole-year registry with the scientific researches in the National Clinical Database (NCD) and in the Translational Research Informatics Center (TRI) might seem to be in success, because assured enhancement may be estimated. Now, academic societies have the structural factors, i.e., the financial limitation in the registry maintenance and the data analysis, and in the difficulty of employment of the researchers with skill and talent. CONCLUSIONS To manage the site-specific cancer registry effectively, the scientific registry system will be essentially important. Each academic society had much experienced highly qualified clinical researches in past. Accordingly, the scientific suggestion and co-operation should be of great importance for the improvement.
Collapse
Affiliation(s)
- Koichi Hirata
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Japan. .,JR Sapporo Hospital, North 3, East 1, Chuo-ku, Sapporo, 060-0033, Japan.
| | - Masafumi Imamura
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Toshiyoshi Fujiwara
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | | | | | | | - Kenichi Hakamada
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Megumi Ishiguro
- Department of Translational Oncology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshihiro Kakeji
- Division of Gastrointestinal Surgery, Kobe University Hospital, Kobe, Japan
| | - Hiroyuki Konno
- Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hiroaki Miyata
- The University of Tokyo, Healthcare Quality Assessment, Tokyo, Japan
| | - Masaki Mori
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kenji Okita
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Masami Sato
- Thoracic Surgery, Kagoshima University Hospital, Kagoshima, Japan
| | - Akiko Shibata
- Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Ichiro Takemasa
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Michiaki Unno
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kohei Yokoi
- Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toshihiko Nishidate
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Masahiko Nishiyama
- Department of Molecular Pharmacology and Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan
| |
Collapse
|
108
|
Zhou L, Lv F, Liu L, Wang S. In Situ-Induced Multivalent Anticancer Drug Clusters in Cancer Cells for Enhancing Drug Efficacy. CCS CHEMISTRY 2019. [DOI: 10.31635/ccschem.019.20180015] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Increasing intracellular drug concentration is an effective way for cancer chemotherapeutics to enhance efficacy and combat drug resistance. In this work, a series of anticancer drug conjugates were prepared by linking thiol-modified oligo( p-phenylene vinylene) with paclitaxel, vincristine, teniposide, tamoxifen, doxorubicin, or podophyllotoxin (OPV-S-Drugs) through a Michael addition reaction. These OPV-S-Drugs could undergo intracellular assembly and aggregation upon oxidation to yield multivalent anticancer drug clusters, which inhibited their diffusion from cancer cells. The intracellular aggregation of OPV-S-Drugs originates from π–π stacking and hydrophobic interactions between OPV backbones, followed by cross-linking via disulfide bond formation in the presence of reactive oxygen species (ROS). The drug clusters occur only in the cytoplasm of cancer cells expressing high ROS levels, but not in healthy mammalian cells, thus reducing the cytotoxicity to normal cells. Specifically, the super-toxicity of podophyllotoxin to normal cells was obviously suppressed while the drug efficacy was maintained through our new strategy. The diverse action mechanisms of OPV-S-Drugs toward cancer cells is proposed.
Collapse
Affiliation(s)
- Lingyun Zhou
- Institute of Chemistry, Chinese Academy of Sciences
| | - Fengting Lv
- Institute of Chemistry, Chinese Academy of Sciences
| | - Libing Liu
- Institute of Chemistry, Chinese Academy of Sciences
| | - Shu Wang
- Institute of Chemistry, Chinese Academy of Sciences
| |
Collapse
|
109
|
Impact of Advanced Age on Survival in Patients Undergoing Resection of Hepatocellular Carcinoma. Ann Surg 2019; 269:692-699. [DOI: 10.1097/sla.0000000000002526] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
110
|
Future projection of cancer patients with cardiovascular disease in Japan by the year 2039: a pilot study. Int J Clin Oncol 2019; 24:983-994. [PMID: 30903421 PMCID: PMC6597732 DOI: 10.1007/s10147-019-01426-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 03/01/2019] [Indexed: 11/21/2022]
Abstract
Background The number of cancer patients in Japan is estimated to rise to 3.5 million by 2025. The disease burden may be further complicated by comorbidities caused by cardiovascular disease (CVD). Predicting the number of cancer patients with CVD can help anticipate future resource needs. Methods We used statistics derived from the Niigata Cancer Center CVD Study (2015) as well as population estimates from the National Cancer Center’s Cancer Registry and Statistics survey of 2017 for convenience. We simply multiplied the projected number of cancer patients through the year 2039 by the CVD prevalence in 2015, with patients classified by sex, age, and cancer type to estimate the number of cancer patients with CVD. Results The total number of Japanese cancer patients with CVD was 253,000 in 2015 and is predicted to increase rapidly by 30,000 in 2020 and peak at 313,000 in 2030–2034. Men will dominate the CVD population at 2.5-fold the number of women. The growth rate of the population with both cancer and CVD will be greater than that of the cancer-only population (1.23 vs 1.18, P < 0.001), and will comprise notably high proportions of patients with prostatic, breast, and uterine cancers (1.80, 1.57, and 1.66, P < 0.001, respectively). Conclusion Future cancer patients will be older and more likely to have CVD. Although men will continue to dominate this population, the increase in the number of women will be pronounced. Cancer care providers should be trained to recognize CVD and provide any necessary interventions concurrently with cancer therapy. Electronic supplementary material The online version of this article (10.1007/s10147-019-01426-w) contains supplementary material, which is available to authorized users.
Collapse
|
111
|
Polat SB, Cakir B, Evranos B, Baser H, Cuhaci N, Aydin C, Ersoy R. Preoperative predictors and prognosis of bilateral multifocal papillary thyroid carcinomas. Surg Oncol 2019; 28:145-149. [DOI: 10.1016/j.suronc.2018.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 11/29/2018] [Accepted: 12/30/2018] [Indexed: 01/08/2023]
|
112
|
Reyes C, Engel-Nitz NM, DaCosta Byfield S, Ravelo A, Ogale S, Bancroft T, Anderson A, Chen M, Matasar M. Cost of Disease Progression in Patients with Metastatic Breast, Lung, and Colorectal Cancer. Oncologist 2019; 24:1209-1218. [PMID: 30796156 DOI: 10.1634/theoncologist.2018-0018] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 01/08/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION To reduce health care costs and improve care, payers and physician groups are piloting value-based and episodic or bundled-care payment models in oncology. Disease progression and associated costs may affect these models, particularly if such programs do not account for disease severity and progression risk across patient populations. This study estimated the incremental cost of disease progression in patients diagnosed with metastatic breast cancer (mBC), colorectal cancer (mCRC) and lung cancer (mLC) and compared costs among patients with and without progression. METHODS This was a retrospective study using U.S. administrative claims data from commercial and Medicare Advantage health care enrollees with evidence of mBC, mCRC, and mLC and systemic antineoplastic agent use from July 1, 2006, to August 31, 2014. Outcome measures included disease progression, 12-month health care costs, and 3-year cumulative predictive health care costs. RESULTS Of 5,709 patients with mBC, 3,707 patients with mCRC, and 5,201 patients with mLC, 56.8% of patients with mBC, 58.1% of those with mCRC, and 80.3% of those with mLC patients had evidence of disease progression over 12 months. Among patients with mBC and mCRC, adjusted and unadjusted health care costs were significantly higher among progressors versus nonprogressors. Per-patient-per-month costs, which accounted for variable follow-up time, were almost twice as high among progressors versus nonprogressors in patients with mBC, mCRC, and mLC. In each of the three cancer types, delays in progression were associated with lower health care costs. CONCLUSION Progression of mLC, mBC, and mCRC was associated with higher health care costs over a 12-month period. Delayed cancer progression was associated with substantial cost reductions in patients with each of the three cancer types. IMPLICATIONS FOR PRACTICE Data on the rates and incremental health care costs of disease progression in patients with solid tumor cancers are lacking. This study estimated the incremental costs of disease progression in patients diagnosed with lung cancer, breast cancer, and colorectal cancer and compared health care costs in patients with and without evidence of disease progression in a real-world population. The data obtained in our study quantify the economic value of delaying or preventing disease progression and may inform payers and physician groups about value-based payment programs.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - May Chen
- South Bay Oncology Hematology, San Jose, California, USA
| | - Matthew Matasar
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| |
Collapse
|
113
|
Daly MC, Paquette IM. Surveillance, Epidemiology, and End Results (SEER) and SEER-Medicare Databases: Use in Clinical Research for Improving Colorectal Cancer Outcomes. Clin Colon Rectal Surg 2019; 32:61-68. [PMID: 30647547 PMCID: PMC6327727 DOI: 10.1055/s-0038-1673355] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The Surveillance, Epidemiology, and End Results (SEER) program is a clinical database, funded by the National Cancer Institute (NCI), which was created to collect cancer incidence, prevalence, and survival data from U.S. cancer registries. By capturing approximately 30% of the U.S. population, it serves as a powerful resource for researchers focused on understanding the natural history of colorectal cancer and improvement in patient care. The linked SEER-Medicare database is a robust database allowing investigators to perform studies focusing on health disparities, quality of care, and cost of treatment in oncologic disease. Since its infancy in the early 1970s, the database has been utilized for thousands of studies resulting in novel publications that have shaped our management of colorectal cancer among other malignancies.
Collapse
Affiliation(s)
- Meghan C. Daly
- Department of Surgery, University of Cincinnati School of Medicine, Cincinnati, Ohio
- Department of Surgery, Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Cincinnati, Ohio
| | - Ian M. Paquette
- Department of Surgery, University of Cincinnati School of Medicine, Cincinnati, Ohio
- Department of Surgery, Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Cincinnati, Ohio
| |
Collapse
|
114
|
Esiaka D, Naemi P, Kuofie A, Hess R. General Well-Being in Adult Black Males With Chronic Illness. Gerontol Geriatr Med 2019; 5:2333721419855664. [PMID: 31276017 PMCID: PMC6598313 DOI: 10.1177/2333721419855664] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 01/16/2019] [Accepted: 01/30/2019] [Indexed: 11/17/2022] Open
Abstract
As individuals age, they witness a decline in physical health and functional capacities. The presence of one or more chronic illnesses challenges their quality of life and general well-being, thus, impacting their abilities to function physically, psychologically, and socially. We investigated reports of general well-being in older Black males with chronic illness(es) in a study of N = 145 participants, aged 35 to 63, and identified as Black/African American male. Participants responded to items assessing general well-being; ethnic identity; self-esteem; active coping; the presence of chronic illness(es); and additional demographic, social and ecological characteristics. Analyses of responses indicated that marital status (β = -.17, p < .05), ethnic identity (β = -.34, p = .00), self-esteem (β = .22, p = .03) are significant determinants of general well-being in Black males with chronic illness(es). Data further showed active coping (β = -.41 p = .09) to be negatively correlated with well-being. We discuss the implications of results for the understanding of health outcomes among this marginalized population.
Collapse
|
115
|
Puckett MC, Townsend JS, Gelb CA, Hager P, Conlon A, Stewart SL. Ovarian Cancer Knowledge in Women and Providers Following Education with Inside Knowledge Campaign Materials. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:1285-1293. [PMID: 28646458 PMCID: PMC5742303 DOI: 10.1007/s13187-017-1245-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Because no effective methods for preventing or screening for ovarian cancer exist, symptom recognition is integral to its early detection. The Centers for Disease Control and Prevention's Inside Knowledge: Get the Facts about Gynecologic Cancer campaign was developed to raise awareness and educate women and providers about risk factors, symptoms, recommended screening, and prevention strategies for the five main gynecologic cancers, including ovarian cancer. Inside Knowledge campaign materials were utilized by CDC's National Comprehensive Cancer Control Program grantees to educate women and providers about gynecologic cancer from 2014 to 2015. Grantees recruited participants and held educational sessions using Inside Knowledge materials. Questionnaires were given before and after the sessions to assess changes in awareness, confidence, and behavioral intentions around gynecologic cancer information and analyzed in 2016. This analysis focused on an assessment of changes related to ovarian cancer information. Participants' knowledge increased after educational sessions. Among women, there were increases in correctly identifying that the Papanicolaou (Pap) test does not screen for ovarian cancer (89.2%) and that genetic testing is available (77.9%). There was a lower increase in knowledge that HPV is not a cause of ovarian cancer (56.4%). Providers and women reported significant increases in their confidence in their ability to talk to each other about gynecologic cancer post-session. Ovarian cancer awareness, confidence, and related behaviors increased in participants exposed to Inside Knowledge materials. Using these materials to increase knowledge could lead to more empowered patients, better provider-patient communications, and improved care for gynecologic cancers, including ovarian cancer.
Collapse
Affiliation(s)
- Mary C Puckett
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop F-76, Atlanta, GA, 30341, USA.
| | - Julie S Townsend
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop F-76, Atlanta, GA, 30341, USA
| | - Cynthia A Gelb
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop F-76, Atlanta, GA, 30341, USA
| | - Polly Hager
- Michigan Department of Health and Human Services, Cancer Prevention and Control Section, Lansing, MI, 48913, USA
| | - Amy Conlon
- Wisconsin Comprehensive Cancer Control Program, Madison, WI, 53726, USA
| | - Sherri L Stewart
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop F-76, Atlanta, GA, 30341, USA
| |
Collapse
|
116
|
Dhanani M, Nassar A, Charles MS, Dinh T. Cytology of the fallopian tube: A screening model for high-grade serous carcinoma. Cytojournal 2018; 15:28. [PMID: 30534183 PMCID: PMC6243852 DOI: 10.4103/cytojournal.cytojournal_58_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 04/27/2018] [Indexed: 11/29/2022] Open
Abstract
Ovarian cancer is a heterogeneous disease having the highest gynecologic fatality in the United States with a 5-year survival rate of 46.5%. Poor overall prognosis is mostly attributed to inadequate screening tools, and the majority of diagnoses occur at late stages of the disease. Due to genetic and biological underpinnings, ovarian high-grade serous carcinomas (HGSC) have etiologic evidence in the distal fallopian tube. Fallopian tube screening modalities are aggressively investigated, but few describe cytological characteristics of benign tubal specimens to help in the comparative detection of HGSC precursor cells. Here, we describe fimbrial cytomorphological and nuclear features of tubal specimens (n = 75) from patients clinically indicated for salpingectomy, bilateral or unilateral salpingo-oophorectomy, and hysterectomies for any diagnosis other than ovarian or peritoneal cancer. Fallopian tube histology was used as the diagnostic reference. A total of 75 samples had benign diagnoses. The benign cytological characteristics of fimbrial tubal specimens included ciliated cells in clustered arrangements with mild nuclear membrane irregularity, mild anisonucleosis, round and/or oval nuclei, hyperchromatic chromatin, and mild nuclear membrane irregularity. In contrast, none of the cytology samples had spindle-shaped nuclei, significantly marked anisonucleosis (n = 1), nor had hypochromasia as a characteristic feature. These cytological characteristics could be a potential area of distinction from HGSC precursor cells. Our study establishes cytomorphological characteristics of nonmalignant tubal cells which help underscore the importance of distinguishing malignant HGSC precursors through fimbrial brush sampling in minimally invasive approach.
Collapse
Affiliation(s)
- Maya Dhanani
- Address: Department of Medical and Surgical Gynecology, Mayo Clinic, Jacksonville, FL, USA
| | - Aziza Nassar
- Department of Pathology and Laboratory Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Mélissa S Charles
- Department of Molecular Biology, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Tri Dinh
- Address: Department of Medical and Surgical Gynecology, Mayo Clinic, Jacksonville, FL, USA
| |
Collapse
|
117
|
Affiliation(s)
- Boris Böll
- German Hodgkin Study Group and Department I of Internal Medicine; University Hospital of Cologne; Cologne Germany
| | - Helen Görgen
- German Hodgkin Study Group and Department I of Internal Medicine; University Hospital of Cologne; Cologne Germany
| |
Collapse
|
118
|
Bollen L, Dijkstra SPD, Bartels RHMA, de Graeff A, Poelma DLH, Brouwer T, Algra PR, Kuijlen JMA, Minnema MC, Nijboer C, Rolf C, Sluis T, Terheggen MAMB, van der Togt-van Leeuwen ACM, van der Linden YM, Taal W. Clinical management of spinal metastases-The Dutch national guideline. Eur J Cancer 2018; 104:81-90. [PMID: 30336360 DOI: 10.1016/j.ejca.2018.08.028] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 08/22/2018] [Accepted: 08/29/2018] [Indexed: 02/06/2023]
Abstract
This article is a summary of the revised Dutch multidisciplinary evidence-based guideline 'Spinal metastases' (English translation available at: https://www.oncoline.nl/spinal-metastases) that was published at the end of 2015. This summary provides an easy-to-use overview for physicians to use in their daily practice.
Collapse
Affiliation(s)
- Laurens Bollen
- Amsterdam UMC, University of Amsterdam, Department of Radiotherapy, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Sander P D Dijkstra
- Leiden University Medical Center, Department of Orthopedics, P.O. Box 9600, 2300 RC Leiden, the Netherlands
| | - Ronald H M A Bartels
- Radboud University Medical Center, Department of Neurosurgery, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands
| | - Alexander de Graeff
- University Medical Centre Utrecht, Department of Medical Oncology, P.O. Box 85500, 3508 GA Utrecht, the Netherlands
| | - Davey L H Poelma
- Radiotherapy Institute Friesland, Borniastraat 36, 8934 AD Leeuwarden, the Netherlands
| | - Thea Brouwer
- National Federation of Cancer Patient Organizations, P.O. Box 8152, 3503 RD Utrecht, the Netherlands
| | - Paul R Algra
- Alkmaar Medical Centre, Department of Radiology, P.O. Box 501, 1800 AM Alkmaar, the Netherlands
| | - Jos M A Kuijlen
- University Medical Centre Groningen, Department of Neurosurgery, P.O. Box 30001, 9700 RB Groningen, the Netherlands
| | - Monique C Minnema
- UMC Utrecht Cancer Center, Department of Hematology, P.O. Box 85500, 3508 GA Utrecht, the Netherlands
| | - Claudia Nijboer
- VU University Medical Center, Department of Neurology, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands
| | - Christa Rolf
- Community Health Center Hardijzer en Rolf, Jel Rinckesstrjitte 2, 8851 ED Tzummarum, the Netherlands
| | - Tebbe Sluis
- Rijndam Rehabilitation Centre, SCI Unit, Westersingel 300, 3015 LJ Rotterdam, the Netherlands
| | - Michel A M B Terheggen
- Rijnstate, Department of Anesthesiology, Pain Medicine and Palliatieve Care, P.O. Box 9555, 6800 TA Arnhem, the Netherlands
| | | | - Yvette M van der Linden
- Leiden University Medical Center, Department of Radiotherapy, Centre of Expertise Palliative Care, P.O. Box 9600, 2300 RC Leiden, the Netherlands
| | - Walter Taal
- Erasmus MC Cancer Institute, Department of Neuro-Oncology/Neurology, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.
| |
Collapse
|
119
|
Min J, Im H, Allen M, McFarland PJ, Degani I, Yu H, Normandin E, Pathania D, Patel J, Castro CM, Weissleder R, Lee H. Computational Optics Enables Breast Cancer Profiling in Point-of-Care Settings. ACS NANO 2018; 12:9081-9090. [PMID: 30113824 PMCID: PMC6519708 DOI: 10.1021/acsnano.8b03029] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The global burden of cancer, severe diagnostic bottlenecks in underserved regions, and underfunded health care systems are fueling the need for inexpensive, rapid, and treatment-informative diagnostics. On the basis of advances in computational optics and deep learning, we have developed a low-cost digital system, termed AIDA (artificial intelligence diffraction analysis), for breast cancer diagnosis of fine needle aspirates. Here, we show high accuracy (>90%) in (i) recognizing cells directly from diffraction patterns and (ii) classifying breast cancer types using deep-learning-based analysis of sample aspirates. The image algorithm is fast, enabling cellular analyses at high throughput (∼3 s per 1000 cells), and the unsupervised processing allows use by lower skill health care workers. AIDA can perform quantitative molecular profiling on individual cells, revealing intratumor molecular heterogeneity, and has the potential to improve cancer diagnosis and treatment. The system could be further developed for other cancers and thus find widespread use in global health.
Collapse
Affiliation(s)
- Jouha Min
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA 02114
| | - Hyungsoon Im
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA 02114
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114
| | - Matthew Allen
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA 02114
| | | | - Ismail Degani
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA 02114
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA 02139
| | - Hojeong Yu
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA 02114
| | - Erica Normandin
- Department of Systems Biology, Harvard Medical School, Boston, MA 02115
| | - Divya Pathania
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA 02114
| | - Jaymin Patel
- BreastCare Center, Division of Hematology Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Cesar M. Castro
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA 02114
- Massachusetts General Hospital Cancer Center, Boston, MA 02114
| | - Ralph Weissleder
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA 02114
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114
- Department of Systems Biology, Harvard Medical School, Boston, MA 02115
| | - Hakho Lee
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA 02114
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114
| |
Collapse
|
120
|
Steroid Receptor Coactivator-2 Controls the Pentose Phosphate Pathway through RPIA in Human Endometrial Cancer Cells. Sci Rep 2018; 8:13134. [PMID: 30177747 PMCID: PMC6120906 DOI: 10.1038/s41598-018-31372-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 08/17/2018] [Indexed: 12/13/2022] Open
Abstract
Steroid receptor coactivator-2 (SRC-2) is a transcriptional coregulator that modulates the activity of many transcription factors. Levels of SRC-2 are elevated in endometrial biopsies from polycystic ovary syndrome patients, a population predisposed to endometrial cancer (EC). Increased expression of SRC-2 is also detected in neoplastic endometrium suggesting a causal link between elevated SRC-2 expression and the emergence of endometrial disorders that can lead to cancer. Here, we reveal that SRC-2 knockdown reduces EC cell proliferation and anchorage-independence. Additionally, SRC-2 is required to maintain cellular glycolytic capacity and oxidative phosphorylation, processes essential for EC cell proliferation. Importantly, SRC-2 is critical for the normal performance of the pentose phosphate pathway (PPP). Perturbation of the PPP due to loss of SRC-2 expression may result from the depletion of ribose-5-P isomerase (RPIA), a key enzyme of the PPP. As with SRC-2, RPIA knockdown reduces EC cell proliferation, which is accompanied by a decrease in glycolytic capacity and oxidative phosphorylation. Glucose metabolite tracking experiments confirmed that knockdown of SRC-2 and RPIA downregulates the metabolic rate of both glycolysis and the PPP, highlighting a novel regulatory cross-talk between glycolysis and the PPP modulated by SRC-2.
Collapse
|
121
|
Daly JM, Calderon R, Hoffman-Zinnel DJ, Wynohrad LA, Powers BN, Mohr TL, Levy BT. Strategies used and lessons learned by community assistants in organising regional forums for cancer education in Iowa, USA. Eur J Cancer Care (Engl) 2018; 27:e12868. [PMID: 29873862 PMCID: PMC6310140 DOI: 10.1111/ecc.12868] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 03/07/2018] [Accepted: 04/25/2018] [Indexed: 11/28/2022]
Abstract
Cancer prevention efforts at the community level are essential in the fight against cancer. Understanding community dynamics provides insights into building meaningful relationships between researchers and community organizations. In this study, community assistants were hired to organize and host forums to encourage interdisciplinary collaboration, with the goal of strengthening and transforming relationships between a university academic health center and communities. A 19-item questionnaire was developed to determine the strategies community assistants used to schedule and host community forums. Community assistants completed the questionnaire and were interviewed. Community assistants successfully scheduled and hosted 113 forums in 49 cities throughout the state of Iowa, with 2,209 persons attending. Strategies used included cold calls, using contact lists from the Iowa Cancer Consortium membership list, and contacts from business associates. Additionally, electronic and social media were used to arrange and advertise scheduled forums. The various strategies used and lessons learned by the community assistants proved successful in organizing and hosting forums throughout the state of Iowa, which reached 40 of Iowa's 99 counties. The efforts of the community assistants, the Iowa Cancer Consortium, and the Iowa Research Network, laid the foundation for continued cancer research and education collaboration between researchers and community organizations.
Collapse
Affiliation(s)
- Jeanette M. Daly
- Department of Family Medicine Carver College of Medicine, University of Iowa, Iowa City, IA. , Telephone: 319-384-8995
| | - Raul Calderon
- Faculty of Sport Science, Kasetsart University, Kamphaeng Saen, Thailand
| | | | | | | | | | - Barcey T. Levy
- Department of Family Medicine, Carver College of Medicine and the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA.
| |
Collapse
|
122
|
Liu GS, Cook A, Richardson M, Vail D, Holsinger FC, Oakley-Girvan I. Thyroid cancer risk in airline cockpit and cabin crew: a meta-analysis. CANCERS OF THE HEAD & NECK 2018; 3:7. [PMID: 31093360 PMCID: PMC6460828 DOI: 10.1186/s41199-018-0034-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/25/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Airline crew are exposed to ionizing radiation as part of their occupation and have a documented increased risk of melanoma and cataracts. However, whether their occupation predisposes them to an increased risk of thyroid cancer is not established. The purpose of this systematic review and meta-analysis was to assess the risk of thyroid cancer in airline cockpit and cabin crew compared with the general population. METHODS The MEDLINE database accessed via PubMed and Cochrane Database were searched. We included cohort studies reporting the standardized incidence ratio (SIR) or standardized mortality ratio (SMR) of thyroid cancers in any flight-based occupation. RESULTS Of the 1777 citations retrieved in PubMed, eight studies with a total of 243,088 aircrew members and over 3,334,114 person-years of follow-up were included in this meta-analysis. No relevant studies were identified on Cochrane Database. The overall summary SIR of participants in any flight-based occupation was 1.11 (95% CI, 0.79-1.57; p = 0.613; 6 records). The summary SIR for cockpit crew was 1.21 (95% CI, 0.75-1.95; p = 0.383; 4 records) and the summary SIR for cabin crew was 1.00 (95% CI, 0.60-1.66; p = 0.646; 2 records). The overall summary standardized mortality ratio for airline crew was 1.19 (95% CI, 0.59-2.39; p = 0.773; 2 records). CONCLUSION Airline crew were not found to have a significantly elevated risk of thyroid cancer incidence or mortality relative to the general population. Future research should capitalize on the growing occupational cohort dataset and employ innovative methods to quantify lifetime radiation exposure to further assess thyroid cancer risk in airline crew.
Collapse
Affiliation(s)
- George S. Liu
- Stanford University School of Medicine, Stanford University, 450 Serra Mall, Stanford, CA 94305 USA
- Department of Otolaryngology–Head and Neck Surgery, Stanford University, 801 Welch Road, Stanford, CA 94305 USA
| | - Austin Cook
- Stanford University School of Medicine, Stanford University, 450 Serra Mall, Stanford, CA 94305 USA
| | - Michael Richardson
- Stanford University School of Medicine, Stanford University, 450 Serra Mall, Stanford, CA 94305 USA
| | - Daniel Vail
- Stanford University School of Medicine, Stanford University, 450 Serra Mall, Stanford, CA 94305 USA
| | - F. Christopher Holsinger
- Department of Otolaryngology–Head and Neck Surgery, Stanford University, 801 Welch Road, Stanford, CA 94305 USA
| | - Ingrid Oakley-Girvan
- Cancer Prevention Institute of California, Fremont, CA 94538 USA
- Department of Health Research and Policy, the Canary Center at Stanford for Cancer Early Detection and the Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94305 USA
- Public Health Institute, Oakland, CA 94607 USA
| |
Collapse
|
123
|
Spaeth E, Starlard-Davenport A, Allman R. Bridging the Data Gap in Breast Cancer Risk Assessment to Enable Widespread Clinical Implementation across the Multiethnic Landscape of the US. ACTA ACUST UNITED AC 2018; 2:1-6. [PMID: 30662981 PMCID: PMC6334765 DOI: 10.29245/2578-2967/2018/4.1137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Breast cancer remains the second leading cause of cancer death among women and is the most commonly diagnosed cancer in women. Breast cancer risk assessment has been clinically available for nearly 30 years yet is under-utilized in practice for multiple reasons. Incorporation of polygenic risk as well as breast density measurements, promise to increase the accuracy of risk assessment. With that comes the hope that both prevention and screening become more personalized and thus more effective. Incidence rates have been static over the past 15 years and have even increased slightly in African American and Asian/Pacific Islander populations despite the robust data on breast cancer risk reduction measures that exist. Current challenges in reducing breast cancer incidence begin with robust data curation that allows for appropriate risk stratification across our multiethnic population and conclude with the implementation of prevention strategies within our fractured healthcare system.
Collapse
Affiliation(s)
| | - Athena Starlard-Davenport
- Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | | |
Collapse
|
124
|
Han J, Jungsuwadee P, Abraham O, Ko D. Shared Decision-Making and Women's Adherence to Breast and Cervical Cancer Screenings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071509. [PMID: 30018244 PMCID: PMC6068979 DOI: 10.3390/ijerph15071509] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 07/11/2018] [Accepted: 07/13/2018] [Indexed: 12/11/2022]
Abstract
We examined the effect of shared decision-making (SDM) on women’s adherence to breast and cervical cancer screenings and estimated the prevalence and adherence rate of screenings. The study used a descriptive cross-sectional design using the 2017 Health Information National Trends Survey (HINTS) data collected by the National Cancer Institute. Adherence was defined based on the guidelines from the American Cancer Society and the composite measure of shared decision-making was constructed using three items in the data. Multivariable logistic regression was performed to examine the association between the SDM and adherence, controlling for cancer beliefs and socio-demographic variables. The analysis included 742 responses. Weighted to represent the U.S. population, 68.1% adhered to both breast and cervical cancer screening guidelines. The composite measure of SDM was reliable (α = 0.85), and a higher SDM score was associated with women’s screening adherence (b = 0.17; p = 0.009). There were still women who did not receive cancer screenings as recommended. The results suggest that the use of the SDM approach for healthcare professionals’ communication with patients can improve screening adherence.
Collapse
Affiliation(s)
- Jayoung Han
- Department of Pharmacy Practice, School of Pharmacy and Health Sciences, Fairleigh Dickinson University, 230 Park Ave, Florham Park, NJ 07932, USA.
| | - Paiboon Jungsuwadee
- Department of Pharmaceutical Sciences, School of Pharmacy and Health Sciences, Fairleigh Dickinson University, 230 Park Ave, Florham Park, NJ 07932, USA.
| | - Olufunmilola Abraham
- Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, 777 Highland Ave, Madison, WI 53705, USA.
| | - Dongwoo Ko
- Department of Marketing, College of Business, Hankuk University of Foreign Studies, 107 Imun-ro, Imun 1-dong, Dongdaemun-gu, Seoul 02450, Korea.
| |
Collapse
|
125
|
Sumbal S, Javed A, Afroze B, Zulfiqar HF, Javed F, Noreen S, Ijaz B. Circulating tumor DNA in blood: Future genomic biomarkers for cancer detection. Exp Hematol 2018; 65:17-28. [PMID: 29940219 DOI: 10.1016/j.exphem.2018.06.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 06/06/2018] [Accepted: 06/14/2018] [Indexed: 12/12/2022]
Abstract
Cancer is characterized by Darwinian evolution and is a primary cause of mortality and morbidity around the globe. Over the preceding decade, the treatment of cancer has been markedly improved by many targeted therapies, but these treatments have given birth to new challenges and issues. Clonal evolution and tumor heterogeneity present a significant challenge in designing cancer therapies. Fortunately, these restrictions have been overcome by technological advancements allowing us to track both genetic and epigenetic aberrations. Cell-free circulating tumor DNA (ctDNA) analysis, or "liquid biopsy" from a blood sample, provides the opportunity to track the genetic landscape of cancerous lesions. This review focuses on ctDNA analysis as a noninvasive method and versatile biomarker for cancer treatment and technological advancements for ctDNA analysis. This method may able to cope with all the challenges associated with previous cancer therapies and has the potential to monitor minimal residual disease, tumor burden, and therapy response and provide rapid detection of relapse. However, there are many challenges that still need to be addressed. Future prognosis, diagnosis, and analysis of ctDNA require reproducibility and accuracy of results, which are not possible without the validation and optimization of procedures. Integrated digital error suppression has thus far shown promise in the detection of ctDNA in cancer.
Collapse
Affiliation(s)
- Sumbal Sumbal
- Centre of Excellence in Molecular Biology, University of the Punjab Lahore, Pakistan
| | - Aneeqa Javed
- Centre of Excellence in Molecular Biology, University of the Punjab Lahore, Pakistan
| | - Bakht Afroze
- Centre of Excellence in Molecular Biology, University of the Punjab Lahore, Pakistan
| | | | - Faqeeha Javed
- Centre of Excellence in Molecular Biology, University of the Punjab Lahore, Pakistan
| | - Sobia Noreen
- Department of Chemistry, University of Sargodha, Sargodha, Pakistan
| | - Bushra Ijaz
- Centre of Excellence in Molecular Biology, University of the Punjab Lahore, Pakistan.
| |
Collapse
|
126
|
Affiliation(s)
- Rob Lyerla
- College of Health and Human Services, Western Michigan University, Kalamazoo, MI, USA
| | | |
Collapse
|
127
|
Parvizpour S, Razmara J, Omidi Y. Breast cancer vaccination comes to age: impacts of bioinformatics. ACTA ACUST UNITED AC 2018; 8:223-235. [PMID: 30211082 PMCID: PMC6128970 DOI: 10.15171/bi.2018.25] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 04/02/2018] [Accepted: 04/03/2018] [Indexed: 01/01/2023]
Abstract
![]()
Introduction: Breast cancer, as one of the major causes of cancer death among women, is the central focus of this study. The recent advances in the development and application of computational tools and bioinformatics in the field of immunotherapy of malignancies such as breast cancer have emerged the new dominion of immunoinformatics, and therefore, next generation of immunomedicines .
Methods: Having reviewed the most recent works on the applications of computational tools, we provide comprehensive insights into the breast cancer incidence and its leading causes as well as immunotherapy approaches and the future trends. Furthermore, we discuss the impacts of bioinformatics on different stages of vaccine design for the breast cancer, which can be used to produce much more efficient vaccines through a rationalized time- and cost-effective in silico approaches prior to conducting costly experiments.
Results: The tools can be significantly used for designing the immune system-modulating drugs and vaccines based on in silico approaches prior to in vitro and in vivo experimental evaluations. Application of immunoinformatics in the cancer immunotherapy has shown its success in the pre-clinical models. This success returns back to the impacts of several powerful computational approaches developed during the last decade.
Conclusion: Despite the invention of a number of vaccines for the cancer immunotherapy, more computational and clinical trials are required to design much more efficient vaccines against various malignancies, including breast cancer.
Collapse
Affiliation(s)
- Sepideh Parvizpour
- Research Center for Pharmaceutical Nanotechnology, Biomedicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jafar Razmara
- Department of Computer Science, Faculty of mathematical Sciences, University of Tabriz, Tabriz, Iran
| | - Yadollah Omidi
- Research Center for Pharmaceutical Nanotechnology, Biomedicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Pharmaceutics, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
128
|
Abstract
During the prostate-specific antigen-based prostate cancer (PCa) screening era there has been a 53% decrease in the US PCa mortality rate. Concerns about overdiagnosis and overtreatment combined with misinterpretation of clinical trial data led to a recommendation against PCa screening, resulting in a subsequent reversion to more high-risk disease at diagnosis. Re-evaluation of trial data and increasing acceptance of active surveillance led to a new draft recommendation for shared decision making for men aged 55 to 69 years old. Further consideration is needed for more intensive screening in men with high-risk factors. PCa screening significantly reduces PCa morbidity and mortality.
Collapse
Affiliation(s)
- William J Catalona
- Department of Urology, Northwestern University Feinberg School of Medicine, 675 North Saint Clair Street, Suite 20-150, Chicago, IL 63110, USA.
| |
Collapse
|
129
|
Matkar PN, Singh KK, Rudenko D, Kim YJ, Kuliszewski MA, Prud'homme GJ, Hedley DW, Leong-Poi H. Novel regulatory role of neuropilin-1 in endothelial-to-mesenchymal transition and fibrosis in pancreatic ductal adenocarcinoma. Oncotarget 2018; 7:69489-69506. [PMID: 27542226 PMCID: PMC5342493 DOI: 10.18632/oncotarget.11060] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 07/18/2016] [Indexed: 12/15/2022] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is characterized by an intense fibrotic reaction termed tumor desmoplasia, which is in part responsible for its aggressiveness. Endothelial cells have been shown to display cellular plasticity in the form of endothelial-to-mesenchymal transition (EndMT) that serves as an important source of fibroblasts in pathological disorders, including cancer. Angiogenic co-receptor, neuropilin-1 (NRP-1) actively binds TGFβ1, the primary mediator of EndMT and is involved in oncogenic processes like epithelial-to-mesenchymal transition (EMT). NRP-1 and TGFβ1 signaling have been shown to be aberrantly up-regulated in PDAC. We report herein a positive correlation between NRP-1 levels, EndMT and fibrosis in human PDAC xenografts. Loss of NRP-1 in HUVECs limited TGFβ1-induced EndMT as demonstrated by gain of endothelial and loss of mesenchymal markers, while maintaining endothelial cell architecture. Knockdown of NRP-1 down-regulated TGFβ canonical signaling (pSMAD2) and associated pro-fibrotic genes. Overexpression of NRP-1 exacerbated TGFβ1-induced EndMT and up-regulated TGFβ signaling and expression of pro-fibrotic genes. In vivo, loss of NRP-1 attenuated tumor perfusion and size, accompanied by reduction in EndMT and fibrosis. This study defines a previously unrecognized role of NRP-1 in regulating TGFβ1-induced EndMT and fibrosis, and advocates NRP-1 as a therapeutic target to reduce tumor fibrosis and PDAC progression.
Collapse
Affiliation(s)
- Pratiek N Matkar
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Krishna Kumar Singh
- Division of Vascular Surgery, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Canada.,Division of Cardiac Surgery, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Dmitriy Rudenko
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Canada
| | - Yu Jin Kim
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Canada
| | - Michael A Kuliszewski
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Canada
| | - Gerald J Prud'homme
- Division of Laboratory Medicine, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Canada
| | - David W Hedley
- Division of Medical Oncology and Hematology, Ontario Cancer Institute, Campbell Family Cancer Research Institute, Princess Margaret Cancer Centre, Toronto, Canada
| | - Howard Leong-Poi
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada
| |
Collapse
|
130
|
Ballerini P, Dovizio M, Bruno A, Tacconelli S, Patrignani P. P2Y 12 Receptors in Tumorigenesis and Metastasis. Front Pharmacol 2018; 9:66. [PMID: 29456511 PMCID: PMC5801576 DOI: 10.3389/fphar.2018.00066] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 01/18/2018] [Indexed: 12/21/2022] Open
Abstract
Platelets, beyond their role in hemostasis and thrombosis, may sustain tumorigenesis and metastasis. These effects may occur via direct interaction of platelets with cancer and stromal cells and by the release of several platelet products. Platelets and tumor cells release several bioactive molecules among which a great amount of adenosine triphosphate (ATP) and adenosine diphosphate (ADP). ADP is also formed extracellularly from ATP breakdown by the ecto-nucleoside-triphosphate-diphosphohydrolases. Under ATP and ADP stimulation the purinergic P2Y1 receptor (R) initiates platelet activation followed by the ADP-P2Y12R-mediated amplification. P2Y12R stimulation amplifies also platelet response to several platelet agonists and to flow conditions, acting as a key positive feed-forward signal in intensifying platelet responses. P2Y12R represents a potential target for an anticancer therapy due to its involvement in platelet-cancer cell crosstalk. Thus, P2Y12R antagonists, including clopidogrel, ticagrelor, and prasugrel, might represent potential anti-cancer agents, in addition to their role as effective antithrombotic drugs. However, further studies, in experimental animals and patients, are required before the recommendation of the use of P2Y12R antagonists in cancer prevention and progression can be made.
Collapse
Affiliation(s)
- Patrizia Ballerini
- Department of Psychological, Health and Territorial Sciences, Università degli Studi "G. d'Annunzio" Chieti-Pescara, Chieti, Italy.,Center for Aging and Translational Medicine, Università degli Studi "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Melania Dovizio
- Center for Aging and Translational Medicine, Università degli Studi "G. d'Annunzio" Chieti-Pescara, Chieti, Italy.,Department of Neuroscience, Imaging and Clinical Science, Center for Aging and Translational Medicine, Università degli Studi "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Annalisa Bruno
- Center for Aging and Translational Medicine, Università degli Studi "G. d'Annunzio" Chieti-Pescara, Chieti, Italy.,Department of Neuroscience, Imaging and Clinical Science, Center for Aging and Translational Medicine, Università degli Studi "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Stefania Tacconelli
- Center for Aging and Translational Medicine, Università degli Studi "G. d'Annunzio" Chieti-Pescara, Chieti, Italy.,Department of Neuroscience, Imaging and Clinical Science, Center for Aging and Translational Medicine, Università degli Studi "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Paola Patrignani
- Center for Aging and Translational Medicine, Università degli Studi "G. d'Annunzio" Chieti-Pescara, Chieti, Italy.,Department of Neuroscience, Imaging and Clinical Science, Center for Aging and Translational Medicine, Università degli Studi "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| |
Collapse
|
131
|
Tovoli F, De Lorenzo S, Samolsky Dekel BG, Piscaglia F, Benevento F, Brandi G, Bolondi L. Oral oxycodone/naloxone for pain control in cirrhosis: Observational study in patients with symptomatic metastatic hepatocellular carcinoma. Liver Int 2018; 38:278-284. [PMID: 28792650 DOI: 10.1111/liv.13546] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 08/03/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND & AIMS Pain management in cirrhosis is a clinical challenge. Most analgesics are metabolized in the liver and cirrhosis may deeply alter their concentration, favouring the appearance of side effects. We aimed to assess the efficacy and safety of oral prolonged-release association of oxycodone/naloxone tablets (OXN) in the treatment of moderate/severe cancer pain in cirrhotic patients with metastatic hepatocellular carcinoma (HCC). METHODS We enrolled n = 32 HCC patients with moderate/severe cancer pain unresponsive to paracetamol alone or associated with codeine or tramadol. All patients received an initial OXN dose of 5 mg bid to be gradually increased in case of insufficient analgesia. At baseline and follow-up visits, we evaluated: pain intensity (using the Numerical Rating Scale, NRS), patients' autonomy in daily activities (Barthel Functioning Index); bowel dysfunction (Bowel Function Index, BFI), signs of hepatic encephalopathy (HE) and other opioid-induced side effects. RESULTS No clinically significant adverse effects were reported (median follow-up 122 days). No significant worsening of the BFI score was noted and no cases of HE were detected. Two patients (6.3%) discontinued treatment before T14 because of mild nausea and dizziness. The remaining n = 30 patients were assessed for efficacy. Treatment led to a significant reduction in the mean of pain scores both at T14 (-37.1 ± 16.3%, P < .001) and at T28 (-55.6 ± 21.5%, P < .001); Barthel scores showed gradual and significant increase from T0 (81.6 ± 13.0) to T14 (86.5 ± 11.4, P = .001) and to T28 (88.3 ± 13.6, P = .009). CONCLUSIONS OXN may be considered a safe and effective option in the fragile population of cirrhotic patients.
Collapse
Affiliation(s)
- Francesco Tovoli
- Unit of Internal Medicine, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Stefania De Lorenzo
- Unit of Oncology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Boaz G Samolsky Dekel
- Unit of Anesthesiology and Pain Medicine, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Fabio Piscaglia
- Unit of Internal Medicine, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Francesca Benevento
- Unit of Internal Medicine, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Giovanni Brandi
- Unit of Oncology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Luigi Bolondi
- Unit of Internal Medicine, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| |
Collapse
|
132
|
Liu J, Dang H, Wang XW. The significance of intertumor and intratumor heterogeneity in liver cancer. Exp Mol Med 2018; 50:e416. [PMID: 29303512 PMCID: PMC5992990 DOI: 10.1038/emm.2017.165] [Citation(s) in RCA: 138] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 05/11/2017] [Indexed: 02/06/2023] Open
Abstract
Genomic analyses of primary liver cancer samples reveal a complex mutational landscape with vast intertumor and intratumor heterogeneity. Different primary liver tumors and subclones within each tumor display striking molecular and biological variations. Consequently, tumor molecular heterogeneity contributes to drug resistance and tumor relapse following therapy, which poses a substantial obstruction to improving outcomes of patients with liver cancer. There is an urgent need to the compositional and functional understanding of tumor heterogeneity. In this review, we summarize genomic and non-genomic diversities, which include stemness and microenvironmental causes of the functional heterogeneity of the primary liver cancer ecosystem. We discuss the importance and intricacy of intratumor heterogeneity in the context of cancer cell evolution. We also discuss methodologies applicable to determine intratumor heterogeneity and highlight the best-fit patient-derived in vivo and in vitro models to recapture the functional heterogeneity of primary liver cancer with the aim to improve future therapeutic strategies.
Collapse
Affiliation(s)
- Jinping Liu
- Liver Carcinogenesis Section, Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Hien Dang
- Liver Carcinogenesis Section, Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Xin Wei Wang
- Liver Carcinogenesis Section, Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| |
Collapse
|
133
|
Ashamalla M, Youssef I, Yacoub M, Jayarangaiah A, Gupta N, Ray J, Iqbal S, Miller R, Singh J, McFarlane SI. Obesity, Diabetes and Gastrointestinal Malignancy: The role of Metformin and other Anti-diabetic Therapy. GLOBAL JOURNAL OF OBESITY, DIABETES AND METABOLIC SYNDROME 2018; 5:008-14. [PMID: 30533942 PMCID: PMC6282807 DOI: 10.17352/2455-8583.000032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The association between Diabetes and cancer has been known for decades with obesity and insulin resistance being postulated as the main underlying risk factors for both disorders. With rise of the epidemic of obesity in the USA and around the globe, there has been a rise in diabetes that is currently reaching epidemic proportions. Diabetes is known to be associated with increased risk of several types of malignancy including breast, cervical, pancreatic and colon cancer. In this review, we discuss the epidemic of obesity and its consequential epidemic of diabetes highlighting the pathophysiologic mechanisms of increased cancer in the diabetic population. We will then discuss the role of insulin therapy as well as, other antidiabetic medications, particularly metformin that has been to be associated with lower risk as well as better survival with GI malignancies based on several studies including a study that was recently published by our group.
Collapse
Affiliation(s)
- Michael Ashamalla
- Northwell Health care system, Department of Medicine, New Hyde Park, New York 11040, USA
| | - Irini Youssef
- Department of Radiation Oncology, Department of Medicine, Division of Endocrinology, SUNY-Downstate, Brooklyn, NY 11203, USA
| | - Mena Yacoub
- Northside Hospital, St. Petersburg, Florida, 33709, USA
| | - Apoorva Jayarangaiah
- Department of Internal Medicine, Wake Forest University, Baptist Health System, Winston-Salem, N.C, USA
| | - Nikita Gupta
- Department of Radiation Oncology, Department of Medicine, Division of Endocrinology, SUNY-Downstate, Brooklyn, NY 11203, USA
| | - Justina Ray
- Department of Radiation Oncology, Department of Medicine, Division of Endocrinology, SUNY-Downstate, Brooklyn, NY 11203, USA
| | - Sadat Iqbal
- Department of Radiation Oncology, Department of Medicine, Division of Endocrinology, SUNY-Downstate, Brooklyn, NY 11203, USA
| | - Regina Miller
- Department of Radiation Oncology, Department of Medicine, Division of Endocrinology, SUNY-Downstate, Brooklyn, NY 11203, USA
| | - Joie Singh
- Department of Radiation Oncology, Department of Medicine, Division of Endocrinology, SUNY-Downstate, Brooklyn, NY 11203, USA
| | - Samy I McFarlane
- Department of Radiation Oncology, Department of Medicine, Division of Endocrinology, SUNY-Downstate, Brooklyn, NY 11203, USA,Corresponding author: Samy I McFarlane Distinguished Teaching Professor and associate Dean, College of Medicine, Department of Medicine, Division of Endocrinology, Internal Medicine Residency Program Director, State University of New York, Downstate Medical Center, 450 Clarkson Avenue, Box 50, Brooklyn, NY 11203-2098, USA, Tel: 718-270-3711; Fax 718-270-6358;
| |
Collapse
|
134
|
Weir HK, Stewart SL, Claudia A, White MC, Thomas CC, White A, Coleman MP. Population-based cancer survival (2001 to 2009) in the United States: Findings from the CONCORD-2 study. Cancer 2017; 123 Suppl 24:4963-4968. [PMID: 29205309 PMCID: PMC6117107 DOI: 10.1002/cncr.31028] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 07/26/2017] [Accepted: 08/14/2017] [Indexed: 01/11/2023]
Abstract
The Centers for Disease Control and Prevention helps to support a nationwide network of population‐based cancer registries that collect information regarding all patients diagnosed with cancer. These data tell a compelling story about the disproportionate burden of lower cancer survival experienced by vulnerable populations, and can be used by state and national partners to inform cancer control activities.
Collapse
Affiliation(s)
- Hannah K. Weir
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sherri L. Stewart
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Allemani Claudia
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mary C. White
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cheryll C. Thomas
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Arica White
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Michel P. Coleman
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | |
Collapse
|
135
|
Richards TB, Henley SJ, Puckett MC, Weir HK, Huang B, Tucker TC, Allemani C. Lung cancer survival in the United States by race and stage (2001-2009): Findings from the CONCORD-2 study. Cancer 2017; 123 Suppl 24:5079-5099. [PMID: 29205305 DOI: 10.1002/cncr.31029] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 06/14/2017] [Accepted: 06/14/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Results from the second CONCORD study (CONCORD-2) indicated that 5-year net survival for lung cancer was low (range, 10%-20%) between 1995 and 2009 in most countries, including the United States, which was at the higher end of this range. METHODS Data from CONCORD-2 were used to analyze net survival among patients with lung cancer (aged 15-99 years) who were diagnosed in 37 states covering 80% of the US population. Survival was corrected for background mortality using state-specific and race-specific life tables and age-standardized using International Cancer Survival Standard weights. Net survival was estimated for patients diagnosed between 2001 and 2003 and between 2004 and 2009 at 1, 3, and 5 years after diagnosis by race (all races, black, and white); Surveillance, Epidemiology, and End Results Summary Stage 2000; and US state. RESULTS Five-year net survival increased from 16.4% (95% confidence interval, 16.3%-16.5%) for patients diagnosed 2001-2003 to 19.0% (18.8%-19.1%) for those diagnosed 2004-2009, with increases in most states and among both blacks and whites. Between 2004 and 2009, 5-year survival was lower among blacks (14.9%) than among whites (19.4%) and ranged by state from 14.5% to 25.2%. CONCLUSIONS Lung cancer survival improved slightly between the periods 2001-2003 and 2004-2009 but was still low, with variation between states, and persistently lower survival among blacks than whites. Efforts to control well established risk factors would be expected to have the greatest impact on reducing the burden of lung cancer, and efforts to ensure that all patients receive timely and appropriate treatment should reduce the differences in survival by race and state. Cancer 2017;123:5079-99. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
Collapse
Affiliation(s)
- Thomas B Richards
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary C Puckett
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hannah K Weir
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Bin Huang
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, Kentucky
| | - Thomas C Tucker
- Markey Cancer Center, Kentucky Cancer Registry, and College of Public Health, University of Kentucky, Lexington, Kentucky
| | - Claudia Allemani
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
136
|
Momin BR, Pinheiro PS, Carreira H, Li C, Weir HK. Liver cancer survival in the United States by race and stage (2001-2009): Findings from the CONCORD-2 study. Cancer 2017; 123 Suppl 24:5059-5078. [PMID: 29205306 DOI: 10.1002/cncr.30820] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 05/16/2017] [Accepted: 05/16/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Worldwide, liver cancer is a leading cause of death for both men and women. The number of Americans who are diagnosed with and die of liver cancer has been rising slowly each year. Using data from the CONCORD-2 study, this study examined population-based survival by state, race, and stage at diagnosis. METHODS Data from 37 statewide registries, which covered 81% of the US population, for patients diagnosed during 2001-2009 were analyzed. Survival up to 5 years was adjusted for background mortality (net survival) with state- and race-specific life tables, and it was age-standardized with the International Cancer Survival Standard weights. RESULTS Liver cancer was diagnosed overall more often at the localized stage, with blacks being more often diagnosed at distant and regional stages than whites. 5-year net survival was 12.2% in 2001-2003 and 14.8% in 2004-2009. Whites had higher survival than blacks in both calendar periods (11.7% vs 9.1% and 14.3% vs 11.4%, respectively). During 2004-2009, 5-year survival was 25.7% for localized-stage disease, 9.5% for regional-stage disease, and 3.5% for distant-stage disease. CONCLUSIONS Some progress has occurred in survival for patients with liver cancer, but 5-year survival remains low, even for those diagnosed at the localized stage. Efforts directed at controlling well-established risk factors such as hepatitis B may have the greatest impact on reducing the burden of liver cancer in the United States. Cancer 2017;123:5059-78. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
Collapse
Affiliation(s)
- Behnoosh R Momin
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Paulo S Pinheiro
- Epidemiology and Biostatistics, University of Nevada at Las Vegas, Las Vegas, Nevada
| | - Helena Carreira
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Chunyu Li
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hannah K Weir
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
137
|
White MC, Babcock F, Hayes NS, Mariotto AB, Wong FL, Kohler BA, Weir HK. The history and use of cancer registry data by public health cancer control programs in the United States. Cancer 2017; 123 Suppl 24:4969-4976. [PMID: 29205307 DOI: 10.1002/cncr.30905] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 06/16/2017] [Accepted: 07/06/2017] [Indexed: 12/18/2022]
Abstract
Because cancer registry data provide a census of cancer cases, registry data can be used to: 1) define and monitor cancer incidence at the local, state, and national levels; 2) investigate patterns of cancer treatment; and 3) evaluate the effectiveness of public health efforts to prevent cancer cases and improve cancer survival. The purpose of this article is to provide a broad overview of the history of cancer surveillance programs in the United States, and illustrate the expanding ways in which cancer surveillance data are being made available and contributing to cancer control programs. The article describes the building of the cancer registry infrastructure and the successful coordination of efforts among the 2 federal agencies that support cancer registry programs, the Centers for Disease Control and Prevention and the National Cancer Institute, and the North American Association of Central Cancer Registries. The major US cancer control programs also are described, including the National Comprehensive Cancer Control Program, the National Breast and Cervical Cancer Early Detection Program, and the Colorectal Cancer Control Program. This overview illustrates how cancer registry data can inform public health actions to reduce disparities in cancer outcomes and may be instructional for a variety of cancer control professionals in the United States and in other countries. Cancer 2017;123:4969-76. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
Collapse
Affiliation(s)
- Mary C White
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Frances Babcock
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nikki S Hayes
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Angela B Mariotto
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Faye L Wong
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Betsy A Kohler
- North American Association of Central Cancer Registries Inc., Springfield, Illinois
| | - Hannah K Weir
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
138
|
Berger AK, Haag GM, Ehmann M, Byl A, Jäger D, Springfeld C. Palliative chemotherapy for pancreatic adenocarcinoma: a retrospective cohort analysis of efficacy and toxicity of the FOLFIRINOX regimen focusing on the older patient. BMC Gastroenterol 2017; 17:143. [PMID: 29207968 PMCID: PMC5717845 DOI: 10.1186/s12876-017-0709-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 11/27/2017] [Indexed: 12/18/2022] Open
Abstract
Background Pancreatic cancer occurs more frequently in older patients, but these are underrepresented in the phase III clinical studies that established the current treatment standards. This leads to uncertainty regarding the treatment of older patients with potentially toxic but active regimens like FOLFIRINOX. Methods We conducted a retrospective analysis of patients treated according to the FOLFIRINOX protocol at our institution between 2010 and 2014 with a focus on older patients. Results Overall survival in our cohort was 10.2 months. Only 43% of patients did not need dose adaptations, but dose reductions did not lead to an inferior survival. We did not find evidence that patients aged 65 years and older deemed fit enough for palliative treatment had more toxicities or a worse outcome than younger patients. Conclusion We conclude that treatment with the FOLFIRINOX protocol in patients with pancreatic cancer should not be withhold from patients solely based on their chronological age but rather be based on the patient’s performance status and comorbidities.
Collapse
Affiliation(s)
- Anne Katrin Berger
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany.
| | - Georg Martin Haag
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - Martin Ehmann
- Pharmacy Department, Heidelberg University Hospital, Heidelberg, Germany
| | - Anne Byl
- NCT Clinical Cancer Registry, German Cancer Research Center, Heidelberg, Germany
| | - Dirk Jäger
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - Christoph Springfeld
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| |
Collapse
|
139
|
Dalwadi SM, Szeja SS, Bernicker EH, Butler EB, Teh BS, Farach AM. Practice Patterns and Outcomes in Elderly Stage I Non-Small-cell Lung Cancer: A 2004 to 2012 SEER Analysis. Clin Lung Cancer 2017; 19:e269-e276. [PMID: 29208356 DOI: 10.1016/j.cllc.2017.11.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 10/19/2017] [Accepted: 11/10/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND We reviewed the population-based treatment patterns and outcomes for elderly patients with stage I non-small-cell lung cancer (NSCLC) treated from 2004 to 2012. PATIENTS AND METHODS Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified biopsy-proven stage I NSCLC cases diagnosed from 2004 to 2012. The patients were divided into 5-year age subsets (60-64, 65-69, 70-74, 75-79, 80-84, 85-89, and ≥ 90 years). The demographic data, therapy, and survival were compared by year. Trends in overall survival (OS), cancer-specific survival (CSS), and practice patterns were analyzed. RESULTS A total of 62,213 cases were identified. The use of surgery declined sharply with age. Patients aged 60 to 64 years had a surgical rate of 81% compared with 21% for those aged ≥ 90 years (P < .0001). Radiation use increased (from 11% to 39%; P < .0001), as did the receipt of neither surgery nor radiation (from 7% to 40%; P < .0001). When analyzing the annual trends, radiation use increased, with fewer patients forgoing treatment from 2004 to 2012 (P < .0001). From 2004 to 2011, CSS at 2 years improved significantly for patients treated with radiation alone (from 48% to 72%; P < .0001) and more subtly for those receiving surgery alone (from 87% to 91%; P < .0001). The outcomes were stable for those receiving neither surgery nor radiation (38% to 45%; P = NS). Surgical outcomes declined with advancing age (P < .0001); however, the radiation outcomes did not (P = NS). CONCLUSION With advancing age, radiation replaces surgery as the most used treatment for early-stage NSCLC. OS and CSS have improved significantly for elderly stage I NSCLC patients treated with radiation alone during a timeline concurrent with the widespread adoption of stereotactic body radiation therapy. Dedicated prospective studies are indicated, because these findings are limited by the inherent biases of using the SEER database alone.
Collapse
Affiliation(s)
- Shraddha M Dalwadi
- Department of Radiation Oncology, Baylor College of Medicine, Houston, TX
| | - Sean S Szeja
- Department of Radiation Oncology, University of Texas Medical Branch, Galveston, TX
| | - Eric H Bernicker
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, TX
| | - E Brian Butler
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, TX
| | - Bin S Teh
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, TX
| | - Andrew M Farach
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, TX.
| |
Collapse
|
140
|
Kelly SP, Anderson WF, Rosenberg PS, Cook MB. Past, Current, and Future Incidence Rates and Burden of Metastatic Prostate Cancer in the United States. Eur Urol Focus 2017; 4:121-127. [PMID: 29162421 DOI: 10.1016/j.euf.2017.10.014] [Citation(s) in RCA: 156] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 10/05/2017] [Accepted: 10/24/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND Metastatic prostate cancer (PCA) remains a highly lethal malignancy in the USA. As prostate-specific antigen testing declines nationally, detailed assessment of current age- and race-specific incidence trends and quantitative forecasts are needed. OBJECTIVE To evaluate the current trends of metastatic PCA by age and race, and forecast the number of new cases (annual burden) and future trends. DESIGN, SETTING, AND PARTICIPANTS We derived incidence data for men aged ≥45 yr who were diagnosed with metastatic PCA from the population-based Surveillance, Epidemiology, and End Results registries. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS We examined the current trends of metastatic PCA from 2004 to 2014, and forecast the annual burden and incidence rates by age and race for 2015-2025, using age-period-cohort models and population projections. We also examined alternative forecasts (2012-2025) using trends prior to the revised screening guidelines issued in 2012. RESULTS AND LIMITATIONS Metastatic PCA, steadily declining from 2004 to 2007 by 1.45%/yr, began to increase by 0.58%/yr after 2008, which accelerated to 2.74%/yr following the 2012 United States Preventive Services Task Force recommendations-a pattern that was magnified among men aged ≤69 yr and white men. Forecasts project the incidence to increase by 1.03%/yr through 2025, with men aged 45-54 yr (2.29%/yr) and 55-69 yr (1.53%/yr) increasing more rapidly. Meanwhile, the annual burden is expected to increase 42% by 2025. Our forecasts estimated an additional 15 891 metastatic cases from 2015 to 2025 compared with alternative forecasts using trends prior to 2012. CONCLUSIONS The recent uptick in metastatic PCA rates has resulted in forecasts that project increasing rates through 2025, particularly among men aged ≤69 yr. Moreover, racial disparities are expected to persist and the annual burden will increase considerably. The impact of the prior and current PCA screening recommendations on metastatic PCA rates requires continued examination. PATIENT SUMMARY In this report, we assessed how the incidence of metastatic prostate cancer has changed over recent years, and forecast future incidence trends and the number of new cases expected each year. We found that the incidence of metastatic prostate cancer has been increasing more rapidly since 2012, resulting in a rise in both future incidence and the number of new cases by 2025. Future incidence rates and the number of new cases were reduced in alternative forecasts using data prior to the 2012 United States Preventive Services Task Force (USPSTF) recommendations against prostate-specific antigen (PSA) testing for prostate cancer. There is a need for additional research that examines whether national declines in PSA testing contributed to increases in rates of metastatic disease. The incidence of metastatic disease in black men is still expected to occur at considerably higher rates compared with that in white men.
Collapse
Affiliation(s)
- Scott P Kelly
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
| | - William F Anderson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Philip S Rosenberg
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Michael B Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| |
Collapse
|
141
|
Holman DM, White MC, Shoemaker ML, Massetti GM, Puckett MC, Brindis CD. Cancer Prevention During Early Adulthood: Highlights From a Meeting of Experts. Am J Prev Med 2017; 53:S5-S13. [PMID: 28818246 PMCID: PMC5890433 DOI: 10.1016/j.amepre.2017.04.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 03/22/2017] [Accepted: 04/03/2017] [Indexed: 12/16/2022]
Abstract
Using a life course approach, the Centers for Disease Control and Prevention's Division of Cancer Prevention and Control and the National Association of Chronic Disease Directors co-hosted a 2-day meeting with 15 multidisciplinary experts to consider evidence linking factors in early adulthood to subsequent cancer risk and strategies for putting that evidence into practice to reduce cancer incidence. This paper provides an overview of key themes from those meeting discussions, drawing attention to the influence that early adulthood can have on lifetime cancer risk and potential strategies for intervention during this phase of life. A number of social, behavioral, and environmental factors during early adulthood influence cancer risk, including dietary patterns, physical inactivity, medical conditions (e.g., obesity, diabetes, viral infections), circadian rhythm disruption, chronic stress, and targeted marketing of cancer-causing products (e.g., tobacco, alcohol). Suggestions for translating research into practice are framed in the context of the four strategic directions of the National Prevention Strategy: building healthy and safe community environments; expanding quality preventive services in clinical and community settings; empowering people to make healthy choices; and eliminating health disparities. Promising strategies for prevention among young adults include collaborating with a variety of community sectors as well as mobilizing young adults to serve as advocates for change. Young adults are a heterogeneous demographic group, and targeted efforts are needed to address the unique needs of population subgroups that are often underserved and under-represented in research studies.
Collapse
Affiliation(s)
- Dawn M Holman
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Mary C White
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Meredith L Shoemaker
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Greta M Massetti
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary C Puckett
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Claire D Brindis
- Philip R. Lee Institute for Health Policy Studies and Adolescent and Young Adult Health National Resource Center, University of California San Francisco, San Francisco, California
| |
Collapse
|
142
|
Mayer S, Teufel M, Schaeffeler N, Keim U, Garbe C, Eigentler TK, Zipfel S, Forschner A. The need for psycho-oncological support for melanoma patients: Central role of patients' self-evaluation. Medicine (Baltimore) 2017; 96:e7987. [PMID: 28906378 PMCID: PMC5604647 DOI: 10.1097/md.0000000000007987] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Despite an increasing number of promising treatment options, only a limited number of studies concerning melanoma patients' psycho-oncological distress have been carried out. However, multiple screening tools are in use to assess the need for psycho-oncological support. This study aimed first to identify parameters in melanoma patients that are associated with a higher risk for being psycho-oncologically distressed and second to compare patients' self-evaluation concerning the need for psycho-oncological support with the results of established screening tools.We performed a cross-sectional study including 254 melanoma patients from the Center for Dermatooncology at the University of Tuebingen. The study was performed between June 2010 and February 2013. Several screening instruments were included: the Distress Thermometer (DT), Hospital Anxiety and Depression Scale and the patients' subjective evaluation concerning psycho-oncological support. Binary logistic regression was performed to identify factors that indicate the need for psycho-oncological support.Patients' subjective evaluation concerning the need for psycho-oncological support, female gender, and psychotherapeutic or psychiatric treatment at present or in the past had the highest impact on values above threshold in the DT. The odds ratio of patients' self-evaluation (9.89) was even higher than somatic factors like female gender (1.85), duration of illness (0.99), or increasing age (0.97). Patients' self-evaluation concerning the need for psycho-oncological support indicated a moderate correlation with the results of the screening tools included.In addition to the results obtained by screening tools like the DT, we could demonstrate that patients' self-evaluation is an important instrument to identify patients who need psycho-oncological support.
Collapse
Affiliation(s)
- Simone Mayer
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tuebingen
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tuebingen
- Department of Psychosomatic Medicine and Psychotherapy, LVR-University-Hospital, University Duisburg-Essen, Essen
| | - Norbert Schaeffeler
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tuebingen
| | - Ulrike Keim
- Department of Dermatology, University Hospital, Tuebingen, Germany
| | - Claus Garbe
- Department of Dermatology, University Hospital, Tuebingen, Germany
| | | | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tuebingen
| | - Andrea Forschner
- Department of Dermatology, University Hospital, Tuebingen, Germany
| |
Collapse
|
143
|
Zhao W, Li X, Wang J, Wang C, Jia Y, Yuan S, Huang Y, Shi Y, Tong Z. Decreasing Eukaryotic Initiation Factor 3C (EIF3C) Suppresses Proliferation and Stimulates Apoptosis in Breast Cancer Cell Lines Through Mammalian Target of Rapamycin (mTOR) Pathway. Med Sci Monit 2017; 23:4182-4191. [PMID: 28854163 PMCID: PMC5590544 DOI: 10.12659/msm.906389] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Translation initiation is the rate limiting step of protein synthesis and is highly regulated. Eukaryotic initiation factor 3C (EIF3C), an oncogene overexpressed in several human cancers, plays an important role in tumorigenesis and cell proliferation. Material/Methods Immunohistochemistry was used to determine the expression of EIF3C in breast cancer tissues from 42 patients. We investigated whether EIF3C silencing decreases breast cancer cell proliferation as assessed by colony formation assay, and whether EIF3C gene knockdown induces apoptosis as assessed by flow cytometry analysis. We utilized the stress and apoptosis signaling antibody array kit, while p-ERK1/2, p-Akt, p-Smad2, p-p38 MAPK, cleaved caspase-3, and cleaved caspase-7 were explored between EIF3C-siRNA and controls. Furthermore, the effects of EIF3C gene knockdown in mTOR pathway were analyzed by western blotting for different cell lines. Results In EIF3C-positive tumors, 32 out of 42 showed significantly higher frequencies of high grade group by immunoreactivity (p=0.0016). BrdU incorporation after four days of cell plating was significantly suppressed in MDA-MB-231 cells by EIF3C knockdown compared with controls, with average changes of 7.8-fold (p<0.01). Clone number was significantly suppressed in MDA-MB-231 cells by EIF3C knockdown compared with controls (p<0.05). Cell apoptosis was significantly increased in the EIF3C-siRNA group when compared with the cells that were transfected with scrambled siRNA (3.51±0.0842 versus 13.24±0.2307, p<0.01). The mTOR signaling pathway was involved in decreasing EIF3C translational efficiency. Conclusions Unveiling the mechanisms of EIF3 action in tumorigenesis may help identify attractive targets for cancer therapy.
Collapse
Affiliation(s)
- Weipeng Zhao
- Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China (mainland)
| | - Xichuan Li
- Department of Immunology, Biochemistry and Molecular Biology, 2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, Tianjin Key Laboratory of Medical Epigenetics, Tianjin Medical University, Tianjin, China (mainland)
| | - Jun Wang
- Department of Oncology, General Hospital, Jinan Command of the People's Liberation Army, Jinan, Shandong, China (mainland)
| | - Chen Wang
- Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China (mainland)
| | - Yongsheng Jia
- Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China (mainland)
| | - Shunzong Yuan
- Department of Lymphoma, Head and Neck Cancer, The Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China (mainland)
| | - Yong Huang
- Department of Pathology, People's Liberation Army General Hospital, Beijing, China (mainland)
| | - Yehui Shi
- Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China (mainland)
| | - Zhongsheng Tong
- Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China (mainland)
| |
Collapse
|
144
|
Smith SG, Sestak I, Howell A, Forbes J, Cuzick J. Participant-Reported Symptoms and Their Effect on Long-Term Adherence in the International Breast Cancer Intervention Study I (IBIS I). J Clin Oncol 2017; 35:2666-2673. [PMID: 28661758 PMCID: PMC5549455 DOI: 10.1200/jco.2016.71.7439] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Purpose To assess the role of participant-reported symptoms on long-term adherence to preventive therapy in the United Kingdom sample of the International Breast Cancer Intervention Study (IBIS-I). IBIS-I was a randomized controlled trial that investigated the effectiveness of tamoxifen in reducing the risk of breast cancer among women at increased risk of the disease. Participants and Methods Women were randomly assigned to tamoxifen versus placebo (20 mg/day; n = 4,279). After 456 exclusions, 3,823 women were included in this analysis. Adherence (< 4.5 years or ≥ 4.5 years) was calculated using data from six monthly clinical visits. Analyses were adjusted for age, Tyrer-Cuzick risk, smoking, use of hormone replacement therapy, menopausal status, baseline menopausal symptoms, and treatment. Results Overall, 69.7% of women were adherent for at least 4.5 years (tamoxifen: 65.2% v placebo: 74.0%; P < .001). Differences in adherence between treatment arms were observed from 12 months onward (all P < .01) and were largest at 54 months. Dropout rates were highest in the first 12 to 18 months and decreased thereafter. Women reporting nausea/vomiting were less likely to be adherent in both the tamoxifen (odds ratio [OR], 0.57; 95% CI, 0.37 to 0.86; P = .007) and placebo (OR, 0.58; 95% CI, 0.37 to 0.93; P = .023) arms. Headaches were associated with adherence only in the placebo arm (OR, 0.62; 95% CI, 0.42 to 0.91; P = .016), whereas gynecologic symptoms were significant only in the tamoxifen arm (OR, 0.77; 95% CI, 0.62 to 0.97; P = .024). Effect sizes for each symptom on adherence were not significantly different between the treatment groups ( P > .05). In both treatment arms, we observed significant trends for lower adherence with increasing severity for all symptoms ( P < .01) except headaches ( P = .054). Conclusion In the IBIS-I trial, experiencing predefined symptoms in the first 6 months reduced long-term adherence. Effects were similar between treatment arms, suggesting that women were attributing age-related symptoms to preventive therapy. Interventions were required to support symptom management.
Collapse
Affiliation(s)
- Samuel George Smith
- Samuel George Smith, Leeds Institute of Health Science, University of Leeds, Leeds; Samuel George Smith, Ivana Sestak, and Jack Cuzick, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London; Anthony Howell, Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom; and John Forbes, Calvary Mater Newcastle Hospital, Newcastle, Australia
| | - Ivana Sestak
- Samuel George Smith, Leeds Institute of Health Science, University of Leeds, Leeds; Samuel George Smith, Ivana Sestak, and Jack Cuzick, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London; Anthony Howell, Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom; and John Forbes, Calvary Mater Newcastle Hospital, Newcastle, Australia
| | - Anthony Howell
- Samuel George Smith, Leeds Institute of Health Science, University of Leeds, Leeds; Samuel George Smith, Ivana Sestak, and Jack Cuzick, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London; Anthony Howell, Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom; and John Forbes, Calvary Mater Newcastle Hospital, Newcastle, Australia
| | - John Forbes
- Samuel George Smith, Leeds Institute of Health Science, University of Leeds, Leeds; Samuel George Smith, Ivana Sestak, and Jack Cuzick, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London; Anthony Howell, Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom; and John Forbes, Calvary Mater Newcastle Hospital, Newcastle, Australia
| | - Jack Cuzick
- Samuel George Smith, Leeds Institute of Health Science, University of Leeds, Leeds; Samuel George Smith, Ivana Sestak, and Jack Cuzick, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London; Anthony Howell, Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom; and John Forbes, Calvary Mater Newcastle Hospital, Newcastle, Australia
| |
Collapse
|
145
|
Mina SG, Huang P, Murray BT, Mahler GJ. The role of shear stress and altered tissue properties on endothelial to mesenchymal transformation and tumor-endothelial cell interaction. BIOMICROFLUIDICS 2017; 11:044104. [PMID: 28798857 PMCID: PMC5533495 DOI: 10.1063/1.4991738] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 06/22/2017] [Indexed: 05/03/2023]
Abstract
Tumor development is influenced by stromal cells in aspects including invasion, growth, angiogenesis, and metastasis. Activated fibroblasts are one group of stromal cells involved in cancer metastasis, and one source of activated fibroblasts is endothelial to mesenchymal transformation (EndMT). EndMT begins when the endothelial cells delaminate from the cell monolayer, lose cell-cell contacts, lose endothelial markers such as vascular endothelial-cadherin (VE-cadherin), gain mesenchymal markers like alpha-smooth muscle actin (α-SMA), and acquire mesenchymal cell-like properties. A three-dimensional (3D) culture microfluidic device was developed for investigating the role of steady low shear stress (1 dyne/cm2) and altered extracellular matrix (ECM) composition and stiffness on EndMT. Shear stresses resulting from fluid flow within tumor tissue are relevant to both cancer metastasis and treatment effectiveness. Low and oscillatory shear stress rates have been shown to enhance the invasion of metastatic cancer cells through specific changes in actin and tubulin remodeling. The 3D ECM within the device was composed of type I collagen and glycosaminoglycans (GAGs), hyaluronic acid and chondroitin sulfate. An increase in collagen and GAGs has been observed in the solid tumor microenvironment and has been correlated with poor prognosis in many different cancer types. In this study, it was found that ECM composition and low shear stress upregulated EndMT, including upregulation of mesenchymal-like markers (α-SMA and Snail) and downregulated endothelial marker protein and gene expression (VE-cadherin). Furthermore, this novel model was utilized to investigate the role of EndMT in breast cancer cell proliferation and migration. Cancer cell spheroids were embedded within the 3D ECM of the microfluidic device. The results using this device show for the first time that the breast cancer spheroid size is dependent on shear stress and that the cancer cell migration rate, distance, and proliferation are induced by EndMT-derived activated fibroblasts. This model can be used to explore new therapeutics in a tumor microenvironment.
Collapse
Affiliation(s)
- Sara G Mina
- Department of Biomedical Engineering, Binghamton University, P.O. Box 6000, Binghamton, New York 13902, USA
| | - Peter Huang
- Department of Mechanical Engineering, Binghamton University, P.O. Box 6000, Binghamton, New York 13902, USA
| | - Bruce T Murray
- Department of Mechanical Engineering, Binghamton University, P.O. Box 6000, Binghamton, New York 13902, USA
| | - Gretchen J Mahler
- Department of Biomedical Engineering, Binghamton University, P.O. Box 6000, Binghamton, New York 13902, USA
| |
Collapse
|
146
|
Cate F, Kapp ME, Arnold SA, Gellert LL, Hameed O, Clark PE, Wile G, Coogan A, Giannico GA. Core Needle Biopsy and Fine Needle Aspiration Alone or in Combination: Diagnostic Accuracy and Impact on Management of Renal Masses. J Urol 2017; 197:1396-1402. [PMID: 28093293 PMCID: PMC10863505 DOI: 10.1016/j.juro.2017.01.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2016] [Indexed: 11/16/2022]
Abstract
PURPOSE Fine needle aspiration with and without concurrent core needle biopsy is a minimally invasive method to diagnose and assist in management of renal masses. We assessed the pathological accuracy of fine needle aspiration compared to and associated with core needle biopsy and the impact on management. MATERIALS AND METHODS We performed a single institution, retrospective study of 342 cases from 2001 to 2015 with small and large renal masses (4 or less and greater than 4 cm, respectively). Diagnostic and concordance rates, and the impact on management were analyzed. RESULTS Adequacy rates for fine needle aspiration only, core needle biopsy only and fine needle aspiration plus core needle biopsy were 21%, 12% and 8% (aspiration vs aspiration plus biopsy p <0.026). In the aspiration plus biopsy group adding aspiration to biopsy and biopsy to aspiration reduced the inadequacy rate from 23% to 8% and from 27% to 8% for a total reduction rate of 15% and 19%, respectively, corresponding to 32 cases (9.3%). Rapid on-site examination contributed to a 22.5% improvement in fine needle aspiration adequacy rates. In this cohort 30% of aspiration only, 5% of biopsy only and 12% of aspiration plus biopsy could not be subtyped (aspiration vs biopsy p <0.0001, aspiration vs aspiration plus biopsy p <0.0127 and biopsy vs aspiration plus biopsy p = 0.06). The diagnostic concordance rate with surgical resection was 99%. Conversion of an inadequate specimen to an adequate one by a concurrent procedure impacted treatment in at least 29 of 32 patients. Limitations include the retrospective design and accuracy measurement based on surgical intervention. CONCLUSIONS Fine needle aspiration plus core needle biopsy vs at least fine needle aspiration alone may improve diagnostic yield when sampling renal masses but it has subtyping potential similar to that of core needle biopsy only.
Collapse
Affiliation(s)
- Frances Cate
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Meghan E Kapp
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Shanna A Arnold
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Veterans Affairs, Nashville, Tennessee
| | - Lan L Gellert
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Omar Hameed
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Peter E Clark
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Geoffrey Wile
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Alice Coogan
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Giovanna A Giannico
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee.
| |
Collapse
|
147
|
Predicted Increases in Incidence of Colorectal Cancer in Developed and Developing Regions, in Association With Ageing Populations. Clin Gastroenterol Hepatol 2017; 15:892-900.e4. [PMID: 27720911 DOI: 10.1016/j.cgh.2016.09.155] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 09/25/2016] [Accepted: 09/29/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Population growth and changes in demographic structure are linked to trends in colorectal cancer (CRC) incidence. The aim of this study is to estimate future CRC incidence in the ageing population, and compare trends across developing and developed regions. METHODS Cancer and population data were extracted from the International Agency for Research on Cancer. Annual incidence rates for the major types of cancer in 118 selected populations were extracted from 102 cancer registries in 39 countries worldwide. We selected 8 jurisdictions (from the United States, Europe, and Asia) that reported 20-year cancer incidence rates since 1988. Time series models were constructed to project cancer incidence, by sex and age, to 2030. Incidence rates for persons older than 65 years were combined and further adjusted for change of ageing population. We compared age-adjusted incidence rates among the jurisdictions. RESULTS The total population older than 65 years old was 12,917,794 in 1988, and the number increased by almost 40% to 17,950,115 in 2007. In developed countries in the West CRC incidence is predicted to decrease by 16.3% in the United States, increase by 4.8% in the United Kingdom, and increase by 4.7% in Sweden by 2030. In developing countries, such as China (Shanghai), Croatia, and Costa Rica, CRC incidence is predicted to increase in a steep curve by 2030 because of the growing population and ageing effect; in 2030, the incidence increases were 60.5% for China, 47.0% for Croatia, and 18.5% for Costa Rica. We also predict CRC incidence will increase greatly by 2030 in Japan and Hong Kong, which are developed regions. CONCLUSIONS With the exception of the United States, the incidence of CRC is expected to continue to rise in most regions in the coming decades, due to population growth and changes in demographic structure. The predicted increases are more marked in developing regions with limited health care resources.
Collapse
|
148
|
Crew KD, Albain KS, Hershman DL, Unger JM, Lo SS. How do we increase uptake of tamoxifen and other anti-estrogens for breast cancer prevention? NPJ Breast Cancer 2017. [PMID: 28649660 PMCID: PMC5460136 DOI: 10.1038/s41523-017-0021-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Several randomized controlled trials of anti-estrogens, such as tamoxifen and aromatase inhibitors, have demonstrated up to a 50–65% decrease in breast cancerincidence among high-risk women. Approximately 15% of women, age 35–79 years, in the U.S. meet criteria for breast cancer preventive therapies, but uptake of these medications remain low. Explanations for this low uptake includelack of awareness of breast cancer risk status, insufficient knowledge about breast cancer preventive therapies among patients and physicians, and toxicity concerns. Increasing acceptance of pharmacologic breast cancer prevention will require effective communication of breast cancer risk, accurate representation about the potential benefits and side effects of anti-estrogens, targeting-specific high-risk populations most likely to benefit from preventive therapy, and minimizing the side effects of current anti-estrogens with novel administration and dosing options. One strategy to improve the uptake of chemoprevention strategies is to consider lessons learned from the use of drugs to prevent other chronic conditions, such as cardiovascular disease. Enhancing uptake and adherence to anti-estrogens for primary prevention holds promise for significantly reducing breast cancer incidence, however, this will require a significant change in our current clinical practice and stronger advocacy and awareness at the national level.
Collapse
Affiliation(s)
- Katherine D Crew
- Columbia University Medical Center, Herbert Irving Comprehensive Cancer Center, New York, NY USA
| | - Kathy S Albain
- Loyola University Chicago Stritch School of Medicine, Cardinal Bernardin Cancer Center, Maywood, IL USA
| | - Dawn L Hershman
- Columbia University Medical Center, Herbert Irving Comprehensive Cancer Center, New York, NY USA
| | - Joseph M Unger
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA USA
| | - Shelly S Lo
- Loyola University Chicago Stritch School of Medicine, Cardinal Bernardin Cancer Center, Maywood, IL USA
| |
Collapse
|
149
|
Abstract
Hematological malignancies manifest as lymphoma, leukemia, and myeloma, and remain a burden on society. From initial therapy to endless relapse-related treatment, societal burden is felt not only in the context of healthcare cost, but also in the compromised quality of life of patients. Long-term therapeutic strategies have become the standard in keeping hematological malignancies at bay as these cancers develop resistance to each round of therapy with time. As a result, there is a continual need for the development of new drugs to combat resistant disease in order to prolong patient life, if not to produce a cure. This review aims to summarize advances in targeting lymphoma, leukemia, and myeloma through both cutting-edge and well established platforms. Current standard of treatment will be reviewed for these malignancies and emphasis will be made on new therapy development in the areas of antibody engineering, epigenetic small molecule inhibiting drugs, vaccine development, and chimeric antigen receptor cell engineering. In addition, platforms for the delivery of these and other drugs will be reviewed including antibody-drug conjugates, micro- and nanoparticles, and multimodal hydrogels. Lastly, we propose that tissue engineered constructs for hematological malignancies are the missing link in targeted drug discovery alongside mouse and patient-derived xenograft models.
Collapse
|
150
|
Ng AH, Gupta E, Fontillas RC, Bansal S, Williams JL, Park M, Liu D, Fu JB, Yadav RR, Bruera E. Patient-Reported Usefulness of Acute Cancer Rehabilitation. PM R 2017; 9:1135-1143. [PMID: 28461228 DOI: 10.1016/j.pmrj.2017.04.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 03/17/2017] [Accepted: 04/07/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cancer survivors often have unmet needs, and cancer rehabilitation is becoming an integral part of the continuum of care. Understanding the needs and satisfaction of patients undergoing cancer rehabilitation is important for the development of effective programs. OBJECTIVE To determine the overall perception of acute inpatient cancer rehabilitation usefulness. DESIGN Prospective study. SETTING Acute inpatient cancer rehabilitation unit at a National Cancer Institute (NCI) Comprehensive Cancer Center. PARTICIPANTS Patients admitted to the acute inpatient cancer rehabilitation unit from September 2014 to July 2015 were approached, and 200 patients enrolled with completed surveys. METHODS Patients meeting study criteria were asked to complete a survey about their perception of the rehabilitation received; their attitudes and beliefs on their condition, treatment, functional independence; and their attitudes and beliefs on obtaining health information and psychosocial issues. MAIN OUTCOME MEASURES Functional Independence Measure (FIM) scores, FIM efficiency, and results from an anonymous survey with a 22-item Likert-type scale at the end of patients' rehabilitation stay were analyzed. RESULTS Of 327 patients admitted, 239 patients (73%) were approached, and 200 patients (84%) were enrolled with completed surveys. Patients agreed or strongly agreed that rehabilitation helped with improving physical function (n = 193, 97%), regaining physical independence (n = 181, 91%), and preparing to deal with self-care tasks (n = 183, 94%). Patients agreed that rehabilitation improved hope (n = 187, 94%), mood (n = 176, 84%), anxiety (n = 180, 90%), and spirituality (n = 182, 94%). FIM score improvements (from admission to discharge) and FIM efficiency (change in FIM score / length of stay) were significant in all functional domains. Overall, respondents believed that their rehabilitation stay was extremely good (n = 128, 64%) or very good (n = 60, 30%). CONCLUSIONS Patients perceived their rehabilitation stay as beneficial in multiple respects. Significant improvements in FIM measurements were also found. LEVEL OF EVIDENCE IV.
Collapse
Affiliation(s)
- Amy H Ng
- Department of Palliative Care and Rehabilitation Medicine, Unit 1414, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030(∗).
| | - Ekta Gupta
- Department of Palliative Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX(†)
| | - Rhodora C Fontillas
- Department of Rehabilitation Services, University of Texas MD Anderson Cancer Center, Houston, TX(‡)
| | - Swati Bansal
- Department of Palliative Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX(§)
| | - Janet L Williams
- Department of Palliative Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX(‖)
| | - Minjeong Park
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX(¶)
| | - Diane Liu
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX(#)
| | - Jack B Fu
- Department of Palliative Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX(∗∗)
| | - Rajesh R Yadav
- Department of Palliative Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX(††)
| | - Eduardo Bruera
- Department of Palliative Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX(‡‡)
| |
Collapse
|