1
|
Hayes BD, Young HG, Atrchian S, Vis-Dunbar M, Stork MJ, Pandher S, Samper S, McCorquodale S, Loader A, Voss C. Primary care provider-led cancer survivorship care in the first 5 years following initial cancer treatment: a scoping review of the barriers and solutions to implementation. J Cancer Surviv 2024; 18:352-365. [PMID: 36376712 DOI: 10.1007/s11764-022-01268-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/04/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE To synthesize the barriers to primary care provider (PCP)-led cancer survivorship care (≤ 5 years after initial cancer treatment) experienced by healthcare systems around the world, and to explore potential solutions that would succeed within a developed country. METHODS A scoping review of peer-reviewed articles and grey literature was conducted. Four electronic databases (Medline, Embase, Web of Science Core Collection, and Google Scholar) were searched for articles prior to April 2021. RESULTS Ninety-seven articles published across the globe (USA, Canada, Australia, European Union, and UK) met the review inclusion/exclusion criteria. The four most frequently discussed barriers to PCP-led survivorship care in healthcare systems were as follows: (1) insufficient communication between PCPs and cancer specialists, (2) limited PCP knowledge, (3) time restrictions for PCPs to provide comprehensive survivorship care, and (4) a lack of resources (e.g., survivorship care guidelines). Potential solutions to combat these barriers were as follows: (1) improving interdisciplinary communication, (2) bolstering PCP education, and (3) providing survivorship resources. CONCLUSIONS This scoping review identified and summarized key barriers and solutions to the provision of PCP-led cancer survivorship care. Importantly, the findings from this review provide insight and direction to guide optimization of cancer care practice within BC's healthcare system. IMPLICATIONS FOR CANCER SURVIVORS Optimizing the PCP-led survivorship care model will be a valuable contribution to the field of cancer survivorship care and will hopefully lead to more widespread use of this model, ultimately lessening the growing demand for cancer-specific care by cancer specialists.
Collapse
Affiliation(s)
- Brian D Hayes
- Southern Medical Program, Faculty of Medicine, University of British Columbia, Kelowna, Canada
| | - Hannah G Young
- Southern Medical Program, Faculty of Medicine, University of British Columbia, Kelowna, Canada
| | - Siavash Atrchian
- BC Cancer, Kelowna, Canada
- Department of Surgery, Division of Radiation Oncology and Developmental Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | - Matthew J Stork
- Centre for Chronic Disease Prevention and Management, Faculty of Medicine, University of British Columbia, 1088 Discovery Avenue, Kelowna, BC, V1V 1V7, Canada
| | - Satvir Pandher
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Sofia Samper
- Centre for Chronic Disease Prevention and Management, Faculty of Medicine, University of British Columbia, 1088 Discovery Avenue, Kelowna, BC, V1V 1V7, Canada
| | - Sarah McCorquodale
- Southern Medical Program, Faculty of Medicine, University of British Columbia, Kelowna, Canada
- Centre for Chronic Disease Prevention and Management, Faculty of Medicine, University of British Columbia, 1088 Discovery Avenue, Kelowna, BC, V1V 1V7, Canada
| | | | - Christine Voss
- Southern Medical Program, Faculty of Medicine, University of British Columbia, Kelowna, Canada.
- Centre for Chronic Disease Prevention and Management, Faculty of Medicine, University of British Columbia, 1088 Discovery Avenue, Kelowna, BC, V1V 1V7, Canada.
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
| |
Collapse
|
2
|
Hayes BD, Fossey MPM, Poormasjedi-Meibod MS, Erskine E, Soriano JE, Scott B, Rosentreter R, Granville DJ, Phillips AA, West CR. Experimental high thoracic spinal cord injury impairs the cardiac and cerebrovascular response to orthostatic challenge in rats. Am J Physiol Heart Circ Physiol 2021; 321:H716-H727. [PMID: 34448635 DOI: 10.1152/ajpheart.00239.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 08/24/2021] [Indexed: 11/22/2022]
Abstract
Spinal cord injury (SCI) impairs the cardiovascular responses to postural challenge, leading to the development of orthostatic hypotension (OH). Here, we apply lower body negative pressure (LBNP) to rodents with high-level SCI to demonstrate the usefulness of LBNP as a model for experimental OH studies, and to explore the effect of simulated OH on cardiovascular and cerebrovascular function following SCI. Male Wistar rats (n = 34) were subjected to a sham or T3-SCI surgery and survived into the chronic period postinjury (i.e., 8 wk). Cardiac function was tracked via ultrasound pre- to post-SCI to demonstrate the clinical utility of our model. At study termination, we conducted left-ventricular (LV) catheterization and insonated the middle cerebral artery to investigate the hemodynamic, cardiac, and cerebrovascular response to a mild dose of LBNP that is sufficient to mimic clinically defined OH in rats with T3-SCI but not sham animals. In response to mimicked OH, there was a greater decline in stroke volume, cardiac output, maximal LV pressure, and blood pressure in SCI compared with sham (P < 0.034), whereas heart rate was increased in sham but decreased in SCI (P < 0.029). SCI animals also had an exaggerated reduction in peak, minimum and mean middle cerebral artery flow, for a given change in blood pressure, in response to LBNP (P < 0.033), implying impaired dynamic cerebral autoregulation. Using a preclinical SCI model of OH, we demonstrate that complete high thoracic SCI impairs the cardiac response to OH and disrupts dynamic cerebral autoregulation.NEW & NOTEWORTHY This is the first use of LBNP to interrogate the cardiac and cerebrovascular responses to simulated OH in a preclinical study of SCI. Here, we demonstrate the utility of our simulated OH model and use it to demonstrate that SCI impairs the cardiac response to simulated OH and disrupts dynamic cerebrovascular autoregulation.
Collapse
Affiliation(s)
- Brian D Hayes
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mary Pauline Mona Fossey
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Experimental Medicine, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Erin Erskine
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jan Elaine Soriano
- Departments of Physiology and Pharmacology, Cardiac Sciences, Clinical Neurosciences, Libin Cardiovascular Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Berkeley Scott
- Departments of Physiology and Pharmacology, Cardiac Sciences, Clinical Neurosciences, Libin Cardiovascular Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ryan Rosentreter
- Departments of Physiology and Pharmacology, Cardiac Sciences, Clinical Neurosciences, Libin Cardiovascular Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - David J Granville
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Aaron A Phillips
- Departments of Physiology and Pharmacology, Cardiac Sciences, Clinical Neurosciences, Libin Cardiovascular Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Christopher R West
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
3
|
Abstract
Patients who require urgent warfarin reversal often receive four-factor prothrombin complex concentrate (4F-PCC), which is traditionally dosed according to weight and initial INR. Our institution implemented a fixed-dose 4F-PCC strategy, using an initial dose of 1500 units. We evaluated the frequency with which the initial fixed dose 4F-PCC was inadequate, as defined by need for supplemental dosing. As part of the protocol, if the initial fixed-dose 4F-PCC is administered and does not achieve INR goal, then the remainder of the standard weight- and INR-based dosing can be given. During the study period, 63 patients on warfarin received 4F-PCC using the fixed-dose protocol. Based on the INR following 4F-PCC administration, 11 patients (17%) were eligible to receive a supplemental dose based on failure to achieve their specified INR goal. Two of the 11 patients eligible for supplemental 4F-PCC dosing received the second dose, both with initial supratherapeutic INRs > 3.5. We found that most patients given an initial fixed-dose 4F-PCC achieved their INR goals, and of those who did not, most did not receive supplemental dosing, suggesting that clinical providers felt that adequate hemostasis had been achieved. In addition, fixed-dose 4F-PCC was able to be given rapidly, with few dosing errors, suggesting that this is a reasonable option for 4F-PCC delivery.
Collapse
Affiliation(s)
- L Fuh
- Department of Pharmacy, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA.
| | - J N Goldstein
- Department of Emergency Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - B D Hayes
- Department of Pharmacy, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| |
Collapse
|
4
|
Chai PR, Ferro EG, Kirshenbaum JM, Hayes BD, Culbreth SE, Boyer EW, Erickson TB. In Reply to "Hydroxychloroquine Overdose: What Are the Exact Roles of Diazepam and Potassium Infusion?". J Med Toxicol 2020; 17:85-86. [PMID: 32926301 PMCID: PMC7489187 DOI: 10.1007/s13181-020-00812-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- P R Chai
- Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA. .,Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, USA. .,The Fenway Institute, Boston, MA, USA. .,The Koch Institute for Integrated Cancer Research, Massachusetts Institute of Technology, Boston, MA, USA.
| | - E G Ferro
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - J M Kirshenbaum
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - B D Hayes
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA.,Department of Pharmacy, Massachusetts General Hospital, Boston, MA, USA
| | - S E Culbreth
- Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.,Department of Pharmacy, Brigham and Women's Hospital, Boston, MA, USA
| | - E W Boyer
- Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.,The Fenway Institute, Boston, MA, USA
| | - T B Erickson
- Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.,Harvard Humanitarian Institute, Boston, MA, USA
| |
Collapse
|
5
|
Chai PR, Ferro EG, Kirshenbaum JM, Hayes BD, Culbreth SE, Boyer EW, Erickson TB. Intentional Hydroxychloroquine Overdose Treated with High-Dose Diazepam: an Increasing Concern in the COVID-19 Pandemic. J Med Toxicol 2020; 16:314-320. [PMID: 32514696 PMCID: PMC7278768 DOI: 10.1007/s13181-020-00790-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/28/2020] [Accepted: 05/28/2020] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Recent attention on the possible use of hydroxychloroquine and chloroquine to treat COVID-19 disease has potentially triggered a number of overdoses from hydroxychloroquine. Toxicity from hydroxychloroquine manifests with cardiac conduction abnormalities, seizure activity, and muscle weakness. Recognizing this toxidrome and unique management of this toxicity is important in the COVID-19 pandemic. CASE REPORT A 27-year-old man with a history of rheumatoid arthritis presented to the emergency department 7 hours after an intentional overdose of hydroxychloroquine. Initial presentation demonstrated proximal muscle weakness. The patient was found to have a QRS complex of 134 ms and QTc of 710 ms. He was treated with early orotracheal intubation and intravenous diazepam boluses. Due to difficulties formulating continuous diazepam infusions, we opted to utilize an intermitted intravenous bolus strategy that achieved similar effects that a continuous infusion would. The patient recovered without residual side effects. DISCUSSION Hydroxychloroquine toxicity is rare but projected to increase in frequency given its selection as a potential modality to treat COVID-19 disease. It is important for clinicians to recognize the unique effects of hydroxychloroquine poisoning and initiate appropriate emergency maneuvers to improve the outcomes in these patients.
Collapse
Affiliation(s)
- Peter R Chai
- Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.
- Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, USA.
- The Fenway Institute, Boston, MA, USA.
- The Koch Institute for Integrated Cancer Research, Massachusetts Institute of Technology, Boston, MA, USA.
| | - E G Ferro
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - J M Kirshenbaum
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - B D Hayes
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
- Department of Pharmacy, Massachusetts General Hospital, Boston, MA, USA
| | - S E Culbreth
- Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Department of Pharmacy, Brigham and Women's Hospital, Boston, MA, USA
| | - E W Boyer
- Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- The Fenway Institute, Boston, MA, USA
| | - T B Erickson
- Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Harvard Humanitarian Institute, Boston, MA, USA
| |
Collapse
|
6
|
Krenz JR, O'Brien ME, Lee J, Hayes BD. Evaluation of esmolol for heart rate control in patients with acute aortic dissection. Am J Emerg Med 2020; 44:312-314. [PMID: 32354528 DOI: 10.1016/j.ajem.2020.04.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/02/2020] [Accepted: 04/06/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Acute aortic dissection is a serious and life-threatening condition that requires prompt, effective management. The purpose of this study was to evaluate the efficacy and safety of esmolol for heart rate control in patients with acute aortic dissection in the Emergency Department (ED). METHODS This was a retrospective, descriptive analysis of patients treated for type A or type B acute aortic dissection in the ED at an academic medical center. The primary outcome was the proportion of patients achieving strict (≤60 bpm) or lenient (≤80 bpm) heart rate control within the first 60 min of therapy at the study site. The primary safety endpoint was the incidence of hypotension, defined as a systolic blood pressure of <90 mmHg or a mean arterial pressure of ≤60 mmHg. RESULTS Of 266 patients screened, 40 patients met inclusion criteria. Thirty-three patients (82.5%) attained lenient rate control within the first 60 min of esmolol therapy. Eleven patients (27.5%) achieved a strict heart rate goal within the first 60 min of esmolol therapy. Five patients (12.5%) experienced an episode of hypotension during the first 3 h of esmolol therapy. CONCLUSION In patients treated with esmolol infusion for acute aortic dissection, a lenient HR goal was achieved in most patients. In contrast, esmolol was not associated with attainment of strict HR control in most patients included in this sample. Further studies are warranted to evaluate the exact role of esmolol in acute aortic dissection in a larger patient population.
Collapse
Affiliation(s)
- J R Krenz
- Department of Pharmacy, Massachusetts General Hospital, United States of America
| | - M E O'Brien
- Department of Pharmacy, Massachusetts General Hospital, United States of America.
| | - J Lee
- Department of Emergency Medicine, Harvard Medical School, United States of America; Department of Surgery, Harvard Medical School, United States of America
| | - B D Hayes
- Department of Pharmacy, Massachusetts General Hospital, United States of America; Department of Emergency Medicine, Harvard Medical School, United States of America
| |
Collapse
|
7
|
Breen KJ, O'Neill A, Murphy L, Fan Y, Boyce S, Fitzgerald N, Dorris E, Brady L, Finn SP, Hayes BD, Treacy A, Barrett C, Aziz MA, Kay EW, Fitzpatrick JM, Watson RWG. Investigating the role of the IGF axis as a predictor of biochemical recurrence in prostate cancer patients post-surgery. Prostate 2017; 77:1288-1300. [PMID: 28726241 DOI: 10.1002/pros.23389] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 06/22/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Between 20% and 35% of prostate cancer (PCa) patients who undergo treatment with curative intent (ie, surgery or radiation therapy) for localized disease will experience biochemical recurrence (BCR). Alterations in the insulin-like growth factor (IGF) axis and PTEN expression have been implicated in the development and progression of several human tumors including PCa. We examined the expression of the insulin receptor (INSR), IGF-1 receptor (IGF-1R), PTEN, and AKT in radical prostatectomy tissue of patients who developed BCR post-surgery. METHODS Tissue microarrays (TMA) of 130 patients post-radical prostatectomy (65 = BCR, 65 = non-BCR) were stained by immunohistochemistry for INSR, IGF-1R, PTEN, and AKT using optimized antibody protocols. INSR, IGF1-R, PTEN, and AKT expression between benign and cancerous tissue, and different Gleason grades was assessed. Kaplan-Meier survival curves were used to examine the relationship between proteins expression and BCR. RESULTS INSR (P < 0.001), IGF-1R (P < 0.001), and AKT (P < 0.05) expression was significantly increased and PTEN (P < 0.001) was significantly decreased in cancerous versus benign tissue. There was no significant difference in INSR, IGF-1R, or AKT expression in the cancerous tissue of non-BCR versus BCR patients (P = 0.149, P = 0.990, P = 0.399, respectively). There was a significant decrease in PTEN expression in the malignant tissue of BCR versus non-BCR patients (P = 0.011). Combinational analysis of the tissue proteins identified a combination of decreased PTEN and increased AKT or increased INSR was associated with worst outcome. We found that in each case, our hypothesized worst group was most likely to experience BCR and this was significant for combinations of PTEN+INSR and PTEN+AKT but not PTEN+IGF-1R (P = 0.023, P = 0.028, P = 0.078, respectively). CONCLUSIONS Low PTEN is associated with BCR and this association is strongly modified by high INSR and high AKT expression. Measurement of these proteins could help inform appropriate patient selection for postoperative adjuvant therapy and prevent BCR.
Collapse
Affiliation(s)
- Kieran J Breen
- UCD School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland
| | - Amanda O'Neill
- UCD School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland
| | - Lisa Murphy
- UCD School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland
| | - Yue Fan
- UCD School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland
| | - Susie Boyce
- UCD School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland
- UCD School of Mathematical Sciences, Dublin, Ireland
| | - Noel Fitzgerald
- UCD School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland
| | - Emma Dorris
- UCD School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland
| | - Lauren Brady
- Department of Histopathology and Morbid Anatomy, Trinity Translational Medicine Institute, Trinity College, Dublin, Ireland
- Department of Histopathology, St. James's Hospital, Dublin, Ireland
| | - Stephen P Finn
- Department of Histopathology and Morbid Anatomy, Trinity Translational Medicine Institute, Trinity College, Dublin, Ireland
- Department of Histopathology, St. James's Hospital, Dublin, Ireland
| | - Brian D Hayes
- Department of Histopathology and Morbid Anatomy, Trinity Translational Medicine Institute, Trinity College, Dublin, Ireland
- Department of Histopathology, St. James's Hospital, Dublin, Ireland
| | - Ann Treacy
- Department of Histopathology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Ciara Barrett
- Department of Histopathology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Mardiana Abdul Aziz
- Department of Histopathology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Elaine W Kay
- Department of Pathology, RCSI Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - John M Fitzpatrick
- UCD School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland
| | - R William G Watson
- UCD School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland
| |
Collapse
|
8
|
Hayes BD, Brady L, Pollak M, Finn SP. Exercise and Prostate Cancer: Evidence and Proposed Mechanisms for Disease Modification. Cancer Epidemiol Biomarkers Prev 2016; 25:1281-8. [PMID: 27389872 DOI: 10.1158/1055-9965.epi-16-0223] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 06/27/2016] [Indexed: 11/16/2022] Open
Abstract
Exercise has many potential benefits in relation to cancer. Apart from primary prevention, these include improvement of nonspecific cancer-related symptoms, amelioration of symptoms and cardiovascular risk factors related to cancer treatment, and improvements in various quality-of-life-related factors. Increasing evidence also points toward improved cancer-free and overall survival in cancer patients who undertake regular exercise, findings which should encourage further research in this area. Obesity is known to be associated with a proinflammatory, prothrombotic humoral milieu, which may promote aggressiveness in prostate cancer through interactions with NK-cell-mediated killing of circulating tumor cells, through platelet-circulating tumor cell interactions, and through alterations in adipokine and myokine profile among others. Physical activity reduces levels of systemic inflammatory mediators and so exercise may represent an accessible and cost-effective means of ameliorating the proinflammatory effects of obesity in cancer patients. This review outlines the evidence for the benefits of exercise in these patients, focusing on prostate cancer, and delineates current theories of the underlying biological mechanisms. Cancer Epidemiol Biomarkers Prev; 25(9); 1281-8. ©2016 AACR.
Collapse
Affiliation(s)
- Brian D Hayes
- Department of Histopathology, Cork University Hospital, Wilton, Cork, Ireland. Department of Histopathology & Morbid Anatomy, Trinity College, Dublin, Ireland.
| | - Lauren Brady
- Department of Histopathology & Morbid Anatomy, Trinity College, Dublin, Ireland
| | - Michael Pollak
- Departments of Medicine and Oncology, McGill University, Montreal, Quebec, Canada
| | - Stephen P Finn
- Department of Histopathology & Morbid Anatomy, Trinity College, Dublin, Ireland. Department of Histopathology, St. James's Hospital, Dublin, Ireland
| |
Collapse
|
9
|
Hayes BD, O’Riordan JM, Stuart C, Muldoon C. Rectal Site and Suboptimal Nodal Yield Predict Systemic Recurrence in Resected Colorectal Carcinoma. Int J Surg Pathol 2014; 22:505-11. [DOI: 10.1177/1066896914534464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We assessed the contribution of histopathological features to systemic recurrence (SR) in patients with colorectal cancer, using a case-control design: 71 cases and 184 controls were included, with a mean time until SR of 1.4 ± 0.1 years and a mean follow-up of controls of 1.6 ± 0.06 years. Cases had significantly greater odds of rectal site (odds ratio [OR] = 1.82), stage ≥pT3 (OR = 2.11), suboptimal (<12) lymph node yield (OR = 4.6), stage ≥pN1 (OR = 2.46), KRAS mutation (OR = 2.76), and extramural venous invasion (OR = 1.97). By multiple regression analysis, rectal site, stage ≥pT3, suboptimal lymph node yield, and lymph node positivity independently predicted SR. Rectal cancers were more likely to have a suboptimal node yield than nonrectal cancers (relative risk = 1.6) among the entire cohort. We conclude that rectal cancers have greater risk of SR than colon cancers. A lower yield of lymph nodes in rectal cancer specimens may contribute to this.
Collapse
Affiliation(s)
- Brian D. Hayes
- St James’s Hospital, Dublin, Ireland
- Trinity College Dublin, Ireland
| | | | | | | |
Collapse
|
10
|
Hayes BD, Finn SP. Kidney volume correlates with tumor diameter in renal cell carcinoma and is associated with histological poor prognostic features. Int J Surg Pathol 2013; 22:39-46. [PMID: 24319047 DOI: 10.1177/1066896913511525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
We aimed to correlate kidney volume (KV) in renal cell carcinoma nephrectomy specimens with tumor diameter (TD), macroscopic growth pattern, and histological features associated with poor prognosis. Histopathology reports, macroscopic specimen photographs, and selected glass slides were retrospectively reviewed. KV was approximated to the volume of an ellipsoid. A total of 273 specimens were identified with median KV 245 cm(3). Kidneys larger than this contained larger tumors (7.5 vs 4.5 cm). KV was significantly greater in tumors of high grade, involving perinephric fat, exhibiting venous invasion, and involving renal sinus. There was a robust linear correlation between KV and TD (r = 0.602) and a weaker correlation between kidney diameter (KD) and TD (r = 0.53). In pT1 tumors, KV (r = 0.40) also correlated better with TD than did KD (r = 0.27). By multiple regression analysis, both TD and venous invasion independently predicted both KD (R (2) = 38.27%) and KV (R (2) = 51.97%). KV and KD correlate well with TD and histopathological features of aggressiveness, although KD correlates better overall and in the pT1 subset.
Collapse
|
11
|
Hayes BD, Brodie C, O'Doherty A, Quinn CM. High-Grade Histologic Features of DCIS are Associated with R5 Rather than R3 Calcifications in Breast Screening Mammography. Breast J 2013; 19:319-24. [DOI: 10.1111/tbj.12106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Brian D. Hayes
- Department of Histopathology; St Vincent's University Hospital; Elm Park; Dublin; Ireland
| | - Caroline Brodie
- Department of Histopathology; University College Hospital; Galway; Ireland
| | - Ann O'Doherty
- Merrion Breast Screening Unit; St Vincent's University Hospital; Elm Park; Dublin; Ireland
| | | |
Collapse
|
12
|
Abstract
A 51-year-old woman had a 35 mm circumscribed calcified lesion identified on screening mammography, designated R4. Excision showed a fibroadenoma with multiple foci of lobular neoplasia (atypical lobular hyperplasia and classical lobular carcinoma in situ [LCIS]). A focus of microinvasive lobular carcinoma (MILC) was also present, confirmed on immunohistochemistry. The MILC cells were ER positive, Her-2-negative, and e-cadherin negative. Microinvasive carcinoma, defined as "invasive carcinoma with no focus measuring >1 mm" (TNM UICC 7th edition) is usually encountered in ductal carcinoma in situ but may occur with classical, florid, or pleomorphic LCIS. In one series MILC constituted 0.4% of all invasive lobular carcinomas and was present in 0.4% of all LCIS. MILC is a histologically subtle lesion, the identification of which lends further weight to the concept of lobular neoplasia as a precursor lesion. MILC has been observed in hamartoma but, to our knowledge, has not previously been reported in fibroadenoma.
Collapse
|
13
|
Hayes BD, Muldoon C. Utility of examination of further blocks in negative appendicectomy specimens. J Clin Pathol 2012; 66:356-7. [PMID: 23268323 DOI: 10.1136/jclinpath-2012-201332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
14
|
Ahmad S, Manecksha R, Hayes BD, Grainger R. Case report of a symptomatic giant renal oncocytoma. Int J Surg Case Rep 2011; 2:83-5. [PMID: 22096690 DOI: 10.1016/j.ijscr.2010.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Revised: 07/02/2010] [Accepted: 11/28/2010] [Indexed: 10/18/2022] Open
Abstract
Renal oncocytomas are benign tumours, often asymptomatic, and picked incidentally on radiological imaging. We present a case report of a symptomatic giant renal oncocytoma in a 61-year old man having lower back/right flank pain. A large right renal mass was identified on abdominal CT scan. Radiological features were not sufficient to differentiate this lesion from renal cancer. Right radical nephrectomy was performed. Typical features of oncocytoma, without evidence of malignancy, were seen on histological examination of the specimen. In this report, we discuss literature review of radiological, genetic, and pathological characteristics of renal oncocytoma.
Collapse
Affiliation(s)
- Sarfraz Ahmad
- Department of Urology, The Adelaide and Meath Hospital Incorporating, the National Children Hospital Tallaght, Dublin 24, Ireland
| | | | | | | |
Collapse
|
15
|
Abstract
Spindle cell lesions within lymph nodes generally raise concern for metastasis. We report the 1st intranodal hybrid schwannoma/perineurioma arising in an inguinal lymph node in a 13-year-old boy. Presentation comprised a painless, slowly enlarging mass in a patient with no clinical features of neurofibromatosis.
Collapse
Affiliation(s)
- Brian D Hayes
- Department of Histopathology, Our Lady's Children's Hospital, Dublin 12, Ireland.
| | | |
Collapse
|
16
|
Ryan AJA, Robson A, Hayes BD, Sheahan K, Collins P. Primary cutaneous peripheral T-cell lymphoma, unspecified with an indolent clinical course: a distinct peripheral T-cell lymphoma? Clin Exp Dermatol 2011; 35:892-6. [PMID: 20456402 DOI: 10.1111/j.1365-2230.2010.03849.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Primary cutaneous peripheral T-cell lymphomas (PTL), unspecified, are rare lymphomas, with a poor prognosis. They grow and disseminate rapidly, leading to widespread disease. We report a case of PTL, unspecified occurring on the nose. Despite its aggressive histology, this tumour behaved indolently. It is remarkably similar, clinically and histologically, to four recently described cases that occurred on the ear.
Collapse
Affiliation(s)
- A J A Ryan
- Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland.
| | | | | | | | | |
Collapse
|
17
|
Hayes BD, Feeley L, Quinn CM, Kennedy MM, O'Doherty A, Flanagan F, O'Connell AM. Axillary fine needle aspiration cytology for pre-operative staging of patients with screen-detected invasive breast carcinoma. J Clin Pathol 2011; 64:338-42. [DOI: 10.1136/jcp.2010.084772] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
IntroductionFine needle aspiration cytology (FNAC) of radiologically abnormal axillary lymph nodes in patients with breast cancer can identify patients suitable for primary axillary clearance (AC) rather than sentinel node biopsy, enabling surgical axillary staging by a single operation. This study assessed the accuracy of FNAC in predicting positive axillary lymph nodes.Methods161 patients with screen-detected invasive carcinoma and who had pre-operative FNAC of a radiologically abnormal axillary lymph node were identified from two screening units, The axillary FNAC reports were correlated with sentinel node biopsy and AC reports, and sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated.ResultsFNAC had a moderate sensitivity (66.3%) and NPV (71.8%), and a high specificity (98.7%) and PPV (98.3%). Most patients (86%) had a single axillary operation. The sensitivity was highest in grade 3 (81.8%) and ductal type (77.8%) tumours. The sensitivity was lower in tumours of special type (34.8%), grade 1 tumours (50%) and those without lymphovascular invasion (LVI) (55.9%). The NPV was highest in pT1 (86.7%) and in grade 1 (84.5%) tumours, and lowest (44%) in tumours with LVI. The PPV was 100% in grade 1 and 3 tumours, stage pT2 and pT3 tumours and those without LVI, and was high (>96%) in all other groups. In lymph-node-positive patients, the mean number of lymph nodes involved was higher in the case of a positive (6.4) than negative FNAC (4.4).ConclusionsFNAC of ultrasonically abnormal axillary lymph nodes achieved surgical staging by a single operation in most patients with screen-detected invasive breast carcinoma, with moderate sensitivity and high specificity.
Collapse
|
18
|
Dillon MF, Hayes BD, Quinn CM, Advani V, Masterson C, Evoy D, McDermott EW. The Extent of Axillary Lymph Node Clearance Required Following Detection of Sentinel Node Micrometastases. Breast J 2010; 16:533-6. [PMID: 20626393 DOI: 10.1111/j.1524-4741.2010.00959.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Sentinel node (SN) micrometastases are an indication to proceed to axillary clearance. The aim of this study is to determine the extent and level of axillary clearance required for patients with SN micrometastases. All patients with SN micrometastases which were followed by axillary clearances from 1999 to 2007 were identified. Slides were reviewed by a histopathologist to detail characteristics of SN micrometastases including size and site. The SN micrometastases and primary tumor characteristics were correlated with the presence and level of non-SN micrometastases. Fifty patients who had micrometastases followed by axillary clearances were identified. Of those 18% (n = 9) had non-SN metastases.Seven patients had metastases to level I, one patient had metastases to level I and III and one patient had non-SN metastases to level III only. No patient had metastases to level II. Patients with non-SN metastases had very limited number of non-SNs involved (maximum 2 non-SNs). No variable, including site of the micrometastasis, was predictive of non-SN metastases. In patients with SN micrometastases, a limited level I axillary clearance can be justified in view of the low number of additional nodes involved and in particular, the low (4%) rate of spread to level II ⁄ III nodes.
Collapse
Affiliation(s)
- Mary F Dillon
- Department of Surgery, St. Vincent's University Hospital, Dublin, Ireland.
| | | | | | | | | | | | | |
Collapse
|
19
|
Hayes BD, O'Doherty A, Quinn CM. Correlation of needle core biopsy with excision histology in screen-detected B3 lesions: the Merrion Breast Screening Unit experience. J Clin Pathol 2009; 62:1136-40. [DOI: 10.1136/jcp.2009.067280] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
20
|
|
21
|
Hayes FE, Shameerudeen CL, Sanasie B, Hayes BD, Ramjohn CL, Lucas FB. Ecology and behaviour of the critically endangered Trinidad piping-guan Aburria pipile. ENDANGER SPECIES RES 2009. [DOI: 10.3354/esr00153] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
22
|
Curtin K, Hayes BD, Holland CL, Katz LA. Computer-generated intervention for asthma population care management. Eff Clin Pract 1998; 1:43-6. [PMID: 10345260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- K Curtin
- Health Care Plan, Amherst, NY, USA
| | | | | | | |
Collapse
|