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Gorostegui-Obanos M, Chantada L, Filho NPC, Gonzalez-Ramella O, Serrano B MJ, Valencia D, Sampor C, Macedo C, Ramirez O, Sardinas S, Lezcano E, Calderón P, Gamboa Y, Fu L, Gómez W, Schelotto M, Ugaz C, Lobos P, Moreno K, Palma J, Sánchez G, Moschella F, Gassant PYH, Velasquez T, Quintero K, Forteza M, Villarroel M, Moreno F, Alabi SF, Vasquez L, Lowe J, Cappellano A, Challinor J, Chantada GL. International Society of Paediatric Oncology (SIOP) Global Mapping Program: Analysis of healthcare centers in countries of the Latin American Society of Pediatric Oncology (SLAOP). Pediatr Blood Cancer 2024:e31262. [PMID: 39133030 DOI: 10.1002/pbc.31262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 07/22/2024] [Accepted: 07/28/2024] [Indexed: 08/13/2024]
Abstract
BACKGROUND The International Society of Paediatric Oncology Society Global Mapping Program aims to describe the local pediatric oncology capacities. Here, we report the data from Latin America. METHODS A 10-question survey was distributed among chairs of pediatric oncology services. Centers were classified according to patient volume into high- (HVC; 100 or more new cases per year), medium- (MVC; 31-99 cases), and low-volume centers (LVC; 30 cases or less), respectively. National referral centers (NRC) were identified. RESULTS Total 307 centers in 20 countries were identified (271 responded), and 264 responses were evaluable, accounting for 78% of the expected cases (21,359 cases per year). Seventy-seven percent of patients are treated in public centers, including additional support by civil society organizations. We found that 66% of the patients are treated in 70 centers of excellence, including 21 NRC. There was a median of one pediatric oncologist every 21 newly diagnosed patients (44 for NRC), and in 84% of the centers, nurses rotated to other services. A palliative care team was lacking in 25% of the centers. LVC with public funding have significantly lower probability of having a palliative care team or trained pediatric oncology surgeons. Psychosocial, pharmacy, and nutrition services were available in more than 93% of the centers. No radiotherapy facility was available on campus in nine of 21 NRC. CONCLUSIONS Most children with cancer in Latin America are treated in public HVC. There is a scarcity of pediatric oncologists, specialized nurses and surgeons, and palliative care teams, especially in centers with public funding.
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Affiliation(s)
| | | | - Nevicolino Pereira Carvalho Filho
- SOBOPE (Sociedade Brasileira de Oncologia Pediátrica), Santa Marcelina Saude - TUCCA (Associação de crianças e adolescentes com Câncer), São Paulo, Brazil
| | | | | | - Diana Valencia
- Hospital Universitario de Santander, Bucaramanga, Colombia
- IMAT Oncomedica AUNA, Monteria, Colombia
| | | | - Carla Macedo
- Institute of Pediatric Oncology (IOP/GRAACC), São Paulo, Brazil
| | | | - Susan Sardinas
- Hospital del Niño Dr Ovidio Aliaga Uria, La Paz, Bolivia
| | - Eva Lezcano
- Hospital Central Del Instituto de Previsión Social (IPS), Asunción, Paraguay
| | | | - Yessika Gamboa
- Oncology Unit, National Children's Hospital, San José, Costa Rica
| | - Ligia Fu
- Hospital Escuela, Tegucigalpa, Honduras
| | - Wendy Gómez
- National Cancer Institute-INCART, Santo Domingo, Dominican Republic
| | | | - Cecilia Ugaz
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú
| | | | | | - Julia Palma
- Programa Nacional de Cáncer Infantil, Ministerio de Salud, Santiago, Chile
| | | | - Filomena Moschella
- Hospital Universitario Dr Luis Razetti, Barcelona Edo Anzoategui, Venezuela
| | | | - Thelma Velasquez
- Unidad Nacional de Oncologia Pediátrica (UNOP), Guatemala City, Guatemala
| | - Karina Quintero
- Children's Hospital Dr Jose Renan Esquivel, Panama City, Panama
| | | | | | | | - Soad Fuentes Alabi
- Hospital Nacional de Niños Benjamin Bloom y Centro Medico Ayudame a Vivir, San Salvador, El Salvador
| | - Liliana Vasquez
- Unit of Noncommunicable Diseases, Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization/World Health Organization, Washington, District of Columbia, USA
| | | | | | - Julia Challinor
- University of California San Francisco, San Francisco, California, USA
| | - Guillermo L Chantada
- Pediatric Cancer Center Barcelona (PCCB), Hospital Sant Joan de Déu, Barcelona, Spain
- Hospital Pereira Rosell, Fundación Pérez-Scremini, Montevideo, Uruguay
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de Paula Gonzaga ALAC, Palmeira VA, Ribeiro TFS, Costa LB, de Sá Rodrigues KE, Simões-E-Silva AC. ACE2/Angiotensin-(1-7)/Mas Receptor Axis in Human Cancer: Potential Role for Pediatric Tumors. Curr Drug Targets 2021; 21:892-901. [PMID: 32039680 DOI: 10.2174/1389450121666200210124217] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/09/2020] [Accepted: 01/09/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Pediatric tumors remain the highest cause of death in developed countries. Research on novel therapeutic strategies with lesser side effects is of utmost importance. In this scenario, the role of Renin-Angiotensin System (RAS) axes, the classical one formed by angiotensinconverting enzyme (ACE), Angiotensin II and AT1 receptor and the alternative axis composed by ACE2, Angiotensin-(1-7) and Mas receptor, have been investigated in cancer. OBJECTIVE This review aimed to summarize the pathophysiological role of RAS in cancer, evidence for anti-tumor effects of ACE2/Angiotensin-(1-7)/Mas receptor axis and future therapeutic perspectives for pediatric cancer. METHODS Pubmed, Scopus and Scielo were searched in regard to RAS molecules in human cancer and pediatric patients. The search terms were "RAS", "ACE", "Angiotensin-(1-7)", "ACE2", "Angiotensin II", "AT1 receptor", "Mas receptor", "Pediatric", "Cancer". RESULTS Experimental studies have shown that Angiotensin-(1-7) inhibits the growth of tumor cells and reduces local inflammation and angiogenesis in several types of cancer. Clinical trials with Angiotensin-( 1-7) or TXA127, a pharmaceutical grade formulation of the naturally occurring peptide, have reported promising findings, but not enough to recommend medical use in human cancer. In regard to pediatric cancer, only three articles that marginally investigated RAS components were found and none of them evaluated molecules of the alternative RAS axis. CONCLUSION Despite the potential applicability of Angiotensin-(1-7) in pediatric tumors, the role of this molecule was never tested. Further clinical trials are necessary, also including pediatric patients, to confirm safety and efficiency and to define therapeutic targets.
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Affiliation(s)
| | - Vitória Andrade Palmeira
- Pediatric Branch, Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, UFMG, Brazil
| | | | - Larissa Braga Costa
- Pediatric Branch, Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, UFMG, Brazil
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Telles CM. A scoping review of literature: What has been studied about adolescents and young adults (AYAs) with cancer? Cancer Treat Res Commun 2021; 27:100316. [PMID: 33545568 DOI: 10.1016/j.ctarc.2021.100316] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To map, organize and analyze the articles published in the last five years about AYAs with cancer. METHODS CAPES database and Google Scholar were searched to identify relevant studies from 2015 to February 2020. Eligible articles included empirical or theoretical research, quantitative and/or qualitative studies, targeted AYAs with cancer, addressed different topics related to AYAs such as unmet needs, hospital challenges, interventions or tools based on evidence, as well as political and socioeconomic aspects. RESULTS Of the 161 articles analyzed, 74 (46%) discussed the health system, including hospital dynamics, treatment and interventions during treatment; 63 (39.1%) discussed aspects or interventions that influence the quality of life and mental health of AYAs with cancer; 14 (8.7%) discussed issues related to sexual health; and 10 (6.2%) addressed social, economic and demographic problems of AYAs with cancer. Three types of purposes have been identified in the articles: 118 (73.3%) investigated variables in areas related to AYAs with cancer, aiming to increase the understanding of the phenomenon and the needs of AYAs; 18 (11.2%) intervened on the needs of AYAs with cancer through pilot studies or evidence-based interventions; and 22 (13.7%) aimed to evaluate an intervention previously performed or to evaluate an intervention based on evidence. CONCLUSION There is still much to be researched within the last two categories. In the last three years, these categories have been growing gradually and on a small scale.
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Affiliation(s)
- Camila M Telles
- Graduating in Psychology - Senior year, Positivo University - Curitiba, Paraná, Brazil (Student); Teen Cancer America - Los Angeles, California, the United States of America (Intern Pro Cancer).
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Balmant NV, de Paula Silva N, de O Santos M, de S Reis R, de Camargo B. Delays in the health care system for children, adolescents, and young adults with bone tumors in Brazil. J Pediatr (Rio J) 2019; 95:744-751. [PMID: 30075119 DOI: 10.1016/j.jped.2018.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 06/26/2018] [Accepted: 07/03/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To identify delays in the health care system experienced by children and adolescents and young adults (AYA; aged 0-29 years) with osteosarcoma and Ewing sarcoma using information from the Brazilian hospital-based cancer registries. METHODS Patient data were extracted from 161 Brazilian hospital-based cancer registries between 2007 and 2011. Hospital, diagnosis, and treatment delays were analyzed in patients without a previous histopathological diagnosis. Referral, hospital, and health care delays were calculated for patients with a previous histopathological diagnosis. The time interval was measured in days. RESULTS There was no difference between genders in overall delays. All delays increased at older ages. Patients without a previous histopathological diagnosis had the longest hospital delay when compared to patients with a previous histopathological diagnosis before first contact with the cancer center. Patients with Ewing sarcoma had longer referral and health care delays than those with osteosarcoma who had a previous histopathological diagnosis before first contact with the cancer center. The North and Northeast regions had the longest diagnosis delay, while the Northeast and Southeast regions had the longest treatment delay. CONCLUSION Health care delay among patients with a previous diagnosis was longer, and was probably associated with the time taken for to referral to cancer centers. Patients without a previous histopathological diagnosis had longer hospital delays, which could be associated with possible difficulties regarding demand and high-cost procedures. Despite limitations, this study helps provide initial knowledge about the healthcare pathway delays for patients with bone cancer inside several Brazilian hospitals.
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Affiliation(s)
- Nathalie V Balmant
- Instituto Nacional de Câncer, Curso de Pós-Graduação, Rio de Janeiro, RJ, Brazil; Instituto Nacional de Câncer, Centro de Pesquisa, Rio de Janeiro, RJ, Brazil
| | - Neimar de Paula Silva
- Instituto Nacional de Câncer, Curso de Pós-Graduação, Rio de Janeiro, RJ, Brazil; Instituto Nacional de Câncer, Centro de Pesquisa, Rio de Janeiro, RJ, Brazil
| | - Marceli de O Santos
- Instituto Nacional do Câncer, Divisão de Vigilância e Análise de Situação Coordenação de Prevenção e Vigilância, Rio de Janeiro, RJ, Brazil
| | | | - Beatriz de Camargo
- Instituto Nacional de Câncer, Centro de Pesquisa, Rio de Janeiro, RJ, Brazil.
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de Arruda-Colli MNF, Sansom-Daly U, Dos Santos MA, Wiener L. Considerations for the cross-cultural adaptation of an advance care planning guide for youth with cancer. CLINICAL PRACTICE IN PEDIATRIC PSYCHOLOGY 2018; 6:341-354. [PMID: 30859018 PMCID: PMC6407880 DOI: 10.1037/cpp0000254] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Adolescent and young adults' (AYAs) involvement in advance care planning and end-of-life discussions may enhance the decision-making process, reduce stress and improve the patient's quality of life. Given the importance of establishing adequate communication and having culturally-appropriate tools to introduce advance care planning, our paper will describe the cross-cultural adaptation of the advance care planning guide, Voicing My CHOiCES ™ in Australia and in Brazil. METHODS In Brazil, the process involved initially translating the document to Portuguese followed by evaluation by a group of providers and patients (aged 18-39) undergoing cancer treatment. The document was revised based on the feedback received, then back-translated to English and discussed with Voicing My CHOiCES ™ ' authors to refine the final version in Portuguese. In Australia, a multi-perspective interview-based study was undertaken with AYA cancer patients/survivors (aged 15-25), siblings, parents, and a range of healthcare providers from the oncology setting, to determine the perceived acceptability of the tool within the Australian clinical context. RESULTS These interviews pointed to a variety of recommended adaptations ranging from the aesthetic and linguistic, through to the re-structuring of content within the tool. Adaptations for the Australian setting were then revised in an iterative capacity within several focus groups of AYA participants and healthcare providers. CONCLUSIONS The processes used in both countries highlight ways to engage youth living with a life-limiting illness in conversations about advance care planning and how to develop culturally-appropriate clinical tools.
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Affiliation(s)
- Marina Noronha Ferraz de Arruda-Colli
- Department of Psychology, Faculty of Philosophy, Sciences, and Letters at Ribeirao Preto, University of São Paulo (Brazil)
- Psychosocial Support and Research Program, Pediatric Oncology Branch, Center for Cancer Research, National Institutes of Health (United States)
| | - Ursula Sansom-Daly
- Behavioural Sciences Unit proudly supported by the Kids with Cancer Foundation, Kids Cancer Centre, Sydney Children's Hospital (Australia)
- Sydney Youth Cancer Service, Prince of Wales Hospital, Randwick (Australia)
| | - Manoel Antônio Dos Santos
- Department of Psychology, Faculty of Philosophy, Sciences, and Letters at Ribeirao Preto, University of São Paulo (Brazil)
| | - Lori Wiener
- Psychosocial Support and Research Program, Pediatric Oncology Branch, Center for Cancer Research, National Institutes of Health (United States)
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