1
|
Eng L, Chan RJ, Chan A, Charalambous A, Darling HS, Grech L, van den Hurk CJG, Kirk D, Mitchell SA, Poprawski D, Rammant E, Ramsey I, Fitch MI, Cheung YT. Perceived Barriers Toward Patient-Reported Outcome Implementation in Cancer Care: An International Scoping Survey. JCO Oncol Pract 2024:OP2300715. [PMID: 38457755 DOI: 10.1200/op.23.00715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/15/2023] [Accepted: 01/24/2024] [Indexed: 03/10/2024] Open
Abstract
PURPOSE Implementation of patient-reported outcomes (PROs) collection is an important priority in cancer care. We examined perceived barriers toward implementing PRO collection between centers with and without PRO infrastructure and administrators and nonadministrators. PATIENTS AND METHODS We performed a multinational survey of oncology practitioners on their perceived barriers to PRO implementations. Multivariable regression models evaluated for differences in perceived barriers to PRO implementation between groups, adjusted for demographic and institutional variables. RESULTS Among 358 oncology practitioners representing six geographic regions, 31% worked at centers that did not have PRO infrastructure and 26% self-reported as administrators. Administrators were more likely to perceive concerns with liability issues (aOR, 2.00 [95% CI, 1.12 to 3.57]; P = .02) while having nonsignificant trend toward less likely perceiving concerns with disruption of workflow (aOR, 0.58 [95% CI, 0.32 to 1.03]; P = .06) and nonadherence of PRO reporting (aOR, 0.53 [95% CI, 0.26 to 1.08]; P = .08) as barriers. Respondents from centers without PRO infrastructure were more likely to perceive that not having access to a local PRO expert (aOR, 6.59 [95% CI, 3.81 to 11.42]; P < .001), being unsure how to apply PROs in clinical decisions (aOR, 4.20 [95% CI, 2.32 to 7.63]; P < .001), and being unsure about selecting PRO measures (aOR, 3.36 [95% CI, 2.00 to 5.66]; P < .001) as barriers. Heat map analyses identified the largest differences between participants from centers with and without PRO infrastructure in agreed-upon barriers were (1) not having a local PRO expert, (2) being unsure about selecting PRO measures, and (3) not recognizing the role of PROs at the institutional level. CONCLUSION Perceived barriers toward PRO implementation differ between administrators and nonadministrators and practitioners at centers with and without PRO infrastructure. PRO implementation teams should consider as part of a comprehensive strategy including frontline clinicians and administrators and members with PRO experience within teams.
Collapse
Affiliation(s)
- Lawson Eng
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, ON, Canada
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
| | - Alexandre Chan
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, CA
| | - Andreas Charalambous
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
- Department of Nursing, University of Turku, Turku, Finland
| | - H S Darling
- Department of Medical Oncology, Command Hospital Air Force, Bangalore, India
| | - Lisa Grech
- School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Medicine Monash Health, Monash University, Melbourne, VIC, Australia
| | | | - Deborah Kirk
- School of Nursing and Midwifery, Edith Cowan University, Bunbury, WA, Australia
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia
| | - Sandra A Mitchell
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | - Dagmara Poprawski
- Department of Oncology, King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Elke Rammant
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Imogen Ramsey
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
| | - Margaret I Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|
2
|
Darling HS, Mohan R, Sud R. Epidemiology of cancer in adolescents and young adults from a tertiary care hospital in Southern India. J Cancer Res Ther 2023; 19:2036-2044. [PMID: 38376314 DOI: 10.4103/jcrt.jcrt_1185_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 06/26/2022] [Indexed: 02/21/2024]
Abstract
PURPOSE This study aimed to analyze cancer pattern among adolescents and young adults (AYA) in a tertiary care center in South India. MATERIALS AND METHODS A retrospective study was undertaken from January 2018 to December 2021 on AYA cancer patients (aged 15-39 years). RESULTS Totally, 369 cases of AYA cancers were identified for analyzing the frequency and pattern of cancer distribution. The most common cancers were breast cancer, thyroid cancer, and astrocytoma. All the cancers were more common in males than in females, except for breast, thyroid, gonadal cancers, and unspecified malignant neoplasms. CONCLUSION Cancer distribution patterns are distinct among AYA in terms of epidemiology and biology.
Collapse
Affiliation(s)
- H S Darling
- Department of Medical Oncology and Hemato-oncology, Command Hospital Air Force, Bangalore, Karnataka, India
| | - Raj Mohan
- Department of Surgical Oncology, Command Hospital Air Force, Bangalore, Karnataka, India
| | - Rahul Sud
- Department of Medical Oncology, Command Hospital Air Force, Bangalore, Karnataka, India
| |
Collapse
|
3
|
Dwivedi S, Mukherjee D, Lohia N, Thakur N, Hans R, Mohan R, Sud R, Darling HS. Association of tobacco exposure with demographic and clinicopathological factors in patients of oral squamous cell carcinoma - A single-center experience. J Cancer Res Ther 2023; 19:S608-S613. [PMID: 38384026 DOI: 10.4103/jcrt.jcrt_910_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/14/2022] [Indexed: 02/23/2024]
Abstract
INTRODUCTION Almost a third of the global load of oral squamous cell carcinoma (OSCC) occurs in India and can be attributed to the widespread use of tobacco and tobacco-related products in this part of the sub-continent. MATERIALS AND METHODS Records of 274 patients of OSCC treated between January 2018 and December 2019 in our institute were analyzed for the study for history of tobacco abuse and distribution of associated demographic, clinical, and pathological factors. RESULTS The age of the patients in the study ranged from 31 to 82 years with a median age of 60 years. The ratio of oral cancer in males: females was 3:1. Exposure to tobacco was seen in the majority of patients (89%) who reported with oral carcinoma. Smokeless tobacco in the form of gutka was the most common abused tobacco, followed by bidi in our study. Tongue and buccal mucosa (38% and 36%, respectively) were the most common sites. Significant statistical correlation of tobacco use was seen with age, gender, clinical, and pathological tumor stages. CONCLUSION With tobacco being the main cause of OSCC, further studies with a larger number of patients and preferably with a comparison arm of non-tobacco OSCC would help in elucidating the exact clinical and statistical correlation of tobacco with the clinicopathological factors.
Collapse
Affiliation(s)
- Surjeet Dwivedi
- Department of Surgical Oncology, Army Hospital Research and Referral, New Delhi, India
| | - Debashish Mukherjee
- Department of Surgical Oncology, Army Hospital Research and Referral, New Delhi, India
| | - Nishant Lohia
- Department of Radiation Oncology, Command Hospital Air Force, Bangalore, Karnataka, India
| | - Nikhil Thakur
- Department of Radiation Oncology, Army Hospital Research and Referral, New Delhi, India
| | - Raj Hans
- Department of Radiation Oncology, Army Hospital Research and Referral, New Delhi, India
| | - Raj Mohan
- Department of Surgical Oncology, Command Hospital Air Force, Bangalore, Karnataka, India
| | - Rahul Sud
- Department of Medical Oncology, Command Hospital Air Force, Bangalore, Karnataka, India
| | - H S Darling
- Department of Medical Oncology, Command Hospital Air Force, Bangalore, Karnataka, India
| |
Collapse
|
4
|
Darling HS, Jaiswal P, Tiwari NR. MCQs on "Sequential chemotherapy after definitive radiotherapy in markedly elderly patients with advanced esophageal cancer". Indian J Cancer 2022; 59:263-264. [PMID: 35946185 DOI: 10.4103/ijc.ijc_725_22] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- H S Darling
- Departments of Medical Oncology and Hemato-oncology, Command Hospital Air Force, Bangalore, Karnataka, India
| | - Pradeep Jaiswal
- Surgical Oncology, Command Hospital Air Force, Bangalore, Karnataka, India
| | - Nishant R Tiwari
- Department of Internal Medicine, B. J. Govt. Medical College, Pune, Maharashtra, India
| |
Collapse
|
5
|
|
6
|
Darling HS. Author's reply to Andrade. Cancer Res Stat Treat 2022. [DOI: 10.4103/crst.crst_87_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
7
|
Darling HS, Jaiswal P, Lohia N, Tiwari NR. MCQs on "Human papillomavirus and head and neck squamous cell carcinoma in a UK population: Is there an association?". Indian J Cancer 2022; 59:107-109. [PMID: 35645051 DOI: 10.4103/ijc.ijc_330_22] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- H S Darling
- Department of Medical Oncology and Hemato-Oncology, Command Hospital Air Force, Bengaluru, Karnataka, India
| | - Pradeep Jaiswal
- Department of Surgical Oncology, Command Hospital Air Force, Bengaluru, Karnataka, India
| | - Nishant Lohia
- Department of Radiation Oncology, Command Hospital, Lucknow, Uttar Pradesh, India
| | - Nishant R Tiwari
- Department of Internal Medicine, B.J. Govt. Medical College, Pune, Maharashtra, India
| |
Collapse
|
8
|
Ramsey I, Chan A, Charalambous A, Cheung YT, Darling HS, Eng L, Grech L, Hart NH, Kirk D, Mitchell SA, Poprawski D, Rammant E, Fitch MI, Chan RJ. Exercise counselling and referral in cancer care: an international scoping survey of health care practitioners' knowledge, practices, barriers, and facilitators. Support Care Cancer 2022; 30:9379-9391. [PMID: 36173560 PMCID: PMC9521001 DOI: 10.1007/s00520-022-07342-6] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/22/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE Evidence supports the role of prescribed exercise for cancer survivors, yet few are advised to exercise by a healthcare practitioner (HCP). We sought to investigate the gap between HCPs' knowledge and practice from an international perspective. METHODS An online questionnaire was administered to HCPs working in cancer care between February 2020 and February 2021. The questionnaire assessed knowledge, beliefs, and practices regarding exercise counselling and referral of cancer survivors to exercise programs. RESULTS The questionnaire was completed by 375 participants classified as medical practitioners (42%), nurses (28%), exercise specialists (14%), and non-exercise allied health practitioners (16%). Between 35 and 50% of participants self-reported poor knowledge of when, how, and which cancer survivors to refer to exercise programs or professionals, and how to counsel based on exercise guidelines. Commonly reported barriers to exercise counselling were safety concerns, time constraints, cancer survivors being told to rest by friends and family, and not knowing how to screen people for suitability to exercise (40-48%). Multivariable logistic regression models including age, gender, practitioner group, leisure-time physical activity, and recall of guidelines found significant effects for providing specific exercise advice (χ2(7) = 117.31, p < .001), discussing the role of exercise in symptom management (χ2(7) = 65.13, p < .001) and cancer outcomes (χ2(7) = 58.69, p < .001), and referring cancer survivors to an exercise program or specialist (χ2(7) = 72.76, p < .001). CONCLUSION Additional education and practical support are needed to equip HCPs to provide cancer survivors with exercise guidelines, resources, and referrals to exercise specialists.
Collapse
Affiliation(s)
- Imogen Ramsey
- Rosemary Bryant AO Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, SA Australia
| | - Alexandre Chan
- School of Pharmacy & Pharmaceutical Sciences, Department of Clinical Pharmacy Practice, University of California, Irvine, CA USA
| | - Andreas Charalambous
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus ,Department of Nursing, University of Turku, Turku, Finland
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - H. S. Darling
- Department of Medical Oncology, Command Hospital Air Force, Bangalore, India
| | - Lawson Eng
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Canada
| | - Lisa Grech
- School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Medicine Monash Health, Monash University, Melbourne, Australia ,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia ,Health Sciences, Swinburne University, Melbourne, Australia ,Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Nicolas H. Hart
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA Australia ,Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA Australia ,School of Nursing, Queensland University of Technology, Kelvin Grove, QLD Australia ,Institute for Health Research, University of Notre Dame Australia, Fremantle, WA Australia
| | - Deborah Kirk
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA Australia
| | - Sandra A. Mitchell
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD USA
| | - Dagmara Poprawski
- Department of Oncology, King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia ,College of Medicine and Public Health, Flinders University, Bedford Park, South Australia Australia
| | - Elke Rammant
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Margaret I. Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON Canada
| | - Raymond J. Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA Australia
| |
Collapse
|
9
|
Darling HS. Do you have a standard way of interpreting the standard deviation? A narrative review. Cancer Res Stat Treat 2022. [DOI: 10.4103/crst.crst_284_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
|
10
|
Darling HS. Dealing powerfully with statistical power: A narrative review. Cancer Res Stat Treat 2022. [DOI: 10.4103/crst.crst_173_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
11
|
Darling HS. MCQs on "Factors affecting pathological response and survival following neoadjuvant chemoradiotherapy in rectal cancer patients". Indian J Cancer 2021; 58:590-591. [PMID: 34975098 DOI: 10.4103/0019-509x.334635] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- H S Darling
- Department of Medical Oncology and Hemato-Oncology, Command Hospital Air Force, Bangalore, Karnataka, India
| |
Collapse
|
12
|
Darling HS, Jaiswal P, Lohia N, Tiwari NR. MCQs on "Feasibility, uptake and real-life challenges of a rural cervical and breast cancer screening program in Vellore, Tamil Nadu, South India". Indian J Cancer 2021; 58:425-427. [PMID: 34558442 DOI: 10.4103/ijc.ijc_1020_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- H S Darling
- Department of Medical Oncology and Hemato-Oncology, Command Hospital Air Force, Bangalore, Karnataka, India
| | - Pradeep Jaiswal
- Department of Surgical Oncology, Command Hospital Air Force, Bangalore, Karnataka, India
| | - Nishant Lohia
- Department of Radiation Oncology, Command Hospital, Lucknow, Uttar Pradesh, India
| | - Nishant R Tiwari
- Department of Internal Medicine, B.J. Government Medical College, Pune, Maharashtra, India
| |
Collapse
|
13
|
Cheung YT, Chan A, Charalambous A, Darling HS, Eng L, Grech L, van den Hurk CJG, Kirk D, Mitchell SA, Poprawski D, Rammant E, Ramsey I, Fitch MI, Chan RJ. The use of patient-reported outcomes in routine cancer care: preliminary insights from a multinational scoping survey of oncology practitioners. Support Care Cancer 2021; 30:1427-1439. [PMID: 34524527 PMCID: PMC8440726 DOI: 10.1007/s00520-021-06545-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/04/2021] [Indexed: 11/18/2022]
Abstract
Background There exists scant evidence on the optimal approaches to integrating patient-reported outcomes (PROs) in clinical practice. This study gathered oncology practitioners’ experiences with implementing PROs in cancer care. Methods Between December 2019 and June 2020, we surveyed practitioners who reported spending > 5% of their time providing clinical care to cancer patients. Respondents completed an online survey describing their experiences with and barriers to using PROs in clinical settings. Results In total, 362 practitioners (physicians 38.7%, nurses 46.7%, allied health professionals 14.6%) completed the survey, representing 41 countries (Asia–Pacific 42.5%, North America 30.1%, Europe 24.0%, others 3.3%). One quarter (25.4%) identified themselves as “high frequency users” who conducted PRO assessments on > 80% of their patients. Practitioners commonly used PROs to facilitate communication (60.2%) and monitor treatment responses (52.6%). The most commonly reported implementation barriers were a lack of technological support (70.4%) and absence of a robust workflow to integrate PROs in clinical care (61.5%). Compared to practitioners from high-income countries, more practitioners in low-middle income countries reported not having access to a local PRO expert (P < .0001) and difficulty in identifying the appropriate PRO domains (P = .006). Compared with nurses and allied health professionals, physicians were more likely to perceive disruptions in clinical care during PRO collection (P = .001) as an implementation barrier. Conclusions Only a quarter of the surveyed practitioners reported capturing PROs in routine clinical practice. The implementation barriers to PRO use varied across respondents in different professions and levels of socioeconomic resources. Our findings can be applied to guide planning and implementation of PRO collection in cancer care. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-021-06545-7.
Collapse
Affiliation(s)
- Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Alexandre Chan
- School of Pharmacy & Pharmaceutical Sciences, Department of Clinical Pharmacy Practice, University of California, Irvine, LA, USA
| | - Andreas Charalambous
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus.,Department of Nursing, University of Turku, Turku, Finland
| | - H S Darling
- Department of Medical Oncology, Command Hospital Air Force, Bangalore, India
| | - Lawson Eng
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Canada
| | - Lisa Grech
- School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Medicine Monash Health, Monash University, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.,Health Sciences, Swinburne University, Melbourne, Australia.,Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | - Deborah Kirk
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia
| | - Sandra A Mitchell
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Dagmara Poprawski
- Department of Oncology, King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Elke Rammant
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Imogen Ramsey
- Rosemary Bryant AO Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Margaret I Fitch
- Bloomberg Faculty of Nursing, University of Toronto, 207 Chisholm Ave, Toronto, ON, Canada.
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, 5042, Australia.
| |
Collapse
|
14
|
Darling HS, Jaiswal P, Lohia N, Tiwari N. MCQs on "Study of pathological complete response rate with neoadjuvant concurrent chemoradiation with paclitaxel in locally advanced breast cancer". Indian J Cancer 2021; 57:435-436. [PMID: 33078750 DOI: 10.4103/ijc.ijc_1079_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- H S Darling
- Department of Medical Oncology and Hemato-oncology, Command Hospital Air Force, Bangalore, Karnataka, India
| | - Pradeep Jaiswal
- Department of Surgical Oncology, Command Hospital Air Force, Bangalore, Karnataka, India
| | - Nishant Lohia
- Department of Radiation Oncology, Command Hospital, Lucknow, Uttar Pradesh, India
| | - Nishant Tiwari
- Department of Internal Medicine, B.J. Govt. Medical College, Pune, Maharashtra, India
| |
Collapse
|
15
|
|
16
|
Darling HS. Basics of statistics - 5: Sample size calculation (iii): A narrative review for the use of computer software, tables, and online calculators. Cancer Res Stat Treat 2021. [DOI: 10.4103/crst.crst_88_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
17
|
Abstract
Globally, rare cancers as a group are commoner than any single common cancer. They represent an unmet medical need, and this issue gets further amplified in India due to various reasons, including the limited accessibility of healthcare system to the population at large. The scarce available data yet only represents the tip of the iceberg, due to poor registration and incomplete medical cover. Rare cancers, as a consequence, are driven further away from attention of the policy.makers and financial authorities. Poor research prospectives and lesser administrative support restrict the research in this field. There is an urgent need for initiating studies exclusively on rare cancers in India, considering their prevalence and deprived management, as many countries are already pursuing work in this field. All such inadequacies ultimately affect the patient outcomes. In this review, after discussing these aspects, we suggest a stepwise approach to improve the care of rare cancers in India.
Collapse
Affiliation(s)
- H S Darling
- Department of Medical Oncology and Hemato-oncology, Narayana Superspeciality Hospital, Gurugram, Haryana, India
| | - Sameer Rastogi
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
18
|
Darling HS, Viswanath S, Singh R, Ranjan S, Pathi N, Rathore A, Pathak A, Sud R. A clinico-epidemiological, pathological, and molecular study of lung cancer in Northwestern India. J Cancer Res Ther 2020; 16:771-779. [PMID: 32930117 DOI: 10.4103/jcrt.jcrt_473_17] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Introduction Lung cancer is the most common malignant disease and is the topmost cause of cancer deaths in the world across all age groups and in both sexes. It is the most common cause of cancer deaths in developed countries and is also rising at an alarming rate in the developing countries. Objective The present study was undertaken to explore the clinicopathological and molecular profile of bronchogenic carcinoma in northwestern population of India. Materials and Methods A total of 136 consecutive patients with histologically proven bronchogenic carcinoma, registered between May 2014 and April 2016 at a tertiary care hospital in New Delhi, India, were analyzed. Results Out of a total of 136 diagnosed cases, 6% were in the third to fourth decade of life, 49% in the fifth to sixth decade, and 45% in the seventh decade and above. Seventy-one percent of patients were male. Smoking was the major risk factor in 65.40% of patients. About 33% of female patients were smokers with a significant overlap in the use of smoking objects. Twenty-one percent of patients had been initially empirically treated with antitubercular therapy. Most common symptoms at presentation were cough, dyspnea, weight loss, and chest pain. Pleural effusion, paraneoplastic phenomenon, clubbing, peripheral lymphadenopathy, and Pancoast syndrome were the major signs at presentation. Twenty-one percent of nonsmokers and 40% of smoker patients presented with ECOG Performance Status 3 or 4. Ninety-three percent of patients presented in stage III or IV. Metastases to skeleton, brain, liver, pleura, adrenals, lung, and distant lymph nodes were present in 30.8%, 16.9%, 15.4%, 15.4%, 14.7%, 13.2%, and 11.8%, respectively. Fiberoptic bronchoscopy was found to be the most efficient diagnostic procedure as compared to transthoracic and thoracoscopic methods. Histologically, squamous cell carcinoma, adenocarcinoma, and small cell carcinoma and its variants were seen in 35.30%, 44.9%, and 15.40% cases, respectively. Nearly 4.4% of patients were diagnosed as poorly differentiated carcinoma. Driver mutations (epidermal growth factor receptor or anaplastic lymphoma kinase) were detected in 48% (25 of 52 tested) of adenocarcinomas and 55.55% (5 of 9 tested) of young, nonsmoker, female squamous cell carcinoma patients. Conclusion This study highlights that the adenocarcinoma incidence is surpassing squamous cell carcinoma in Indian lung cancer patients also, as observed in Western population. Mean age at diagnosis is about one decade earlier than in the Western population. Driver mutations are more common in India than in the West as also reported in other Asian studies.
Collapse
Affiliation(s)
- H S Darling
- Department of Medical Oncology, Artemis Hospital, Gurugram, Haryana, India
| | - Sundaram Viswanath
- Department of Medical Oncology, Army Hospital Research and Referral, New Delhi, India
| | - Rajeshwar Singh
- Department of Medical Oncology, Army Hospital Research and Referral, New Delhi, India
| | - Subhas Ranjan
- Department of Medical Oncology, Army Hospital Research and Referral, New Delhi, India
| | - Nikhil Pathi
- Department of Medical Oncology, Army Hospital Research and Referral, New Delhi, India
| | - Anvesh Rathore
- Department of Medical Oncology, Army Hospital Research and Referral, New Delhi, India
| | - Abhishek Pathak
- Department of Medical Oncology, Army Hospital Research and Referral, New Delhi, India
| | - Rahul Sud
- Department of Medical Oncology, Army Hospital Research and Referral, New Delhi, India
| |
Collapse
|
19
|
Darling HS, Jayalakshmi S, Jaiswal P. MCQs on "Study of ER, PR, HER2/neu, p53, and Ki67 expression in primary breast carcinomas and synchronous metastatic axillary lymph nodes". Indian J Cancer 2020; 57:198-200. [PMID: 32445324 DOI: 10.4103/ijc.ijc_306_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- H S Darling
- Department of Medical Oncology and Hemato-Oncology, Narayana Superspeciality Hospital, Gurugram, Karnataka, India
| | - S Jayalakshmi
- Department of Radiation Oncology, Artemis Hospital, Gurugram, Karnataka, India
| | - Pradeep Jaiswal
- Department of Surgical Oncology, Command Hospital, Bangalore, Karnataka, India
| |
Collapse
|
20
|
Darling HS, Jayalakshmi S, Jaiswal P. MCQs on "Stereotactic body radiation therapy for medically inoperable early stage lung cancer: Tata Memorial Hospital perspective and practice recommendations". Indian J Cancer 2020; 57:25-26. [PMID: 32129296 DOI: 10.4103/ijc.ijc_1019_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- H S Darling
- Department of Medical Oncology and Hemato-oncology, Narayana Superspeciality Hospital, Gurugram, Haryana, India
| | - S Jayalakshmi
- Department of Radiation Oncology, Artemis Hospital, Gurugram, Haryana, India
| | - Pradeep Jaiswal
- Department of Surgical Oncology, Command Hospital, Bengaluru, Karnataka, India
| |
Collapse
|
21
|
Darling HS, Jayalakshmi S, Jaiswal P. MCQs on "Prevalence, patterns, and sociocultural factors associated with use of tobacco-based dentifrices ( Gul) in India". Indian J Cancer 2020; 57:321-322. [PMID: 32788436 DOI: 10.4103/ijc.ijc_810_20] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- H S Darling
- Department of Medical Oncology and Hemato-oncology, Command Hospital, Bangalore, Karnataka, India
| | - S Jayalakshmi
- Department of Radiation Oncology, Artemis Hospital, Gurugram, Haryana, India
| | - Pradeep Jaiswal
- Department of Surgical Oncology, Command Hospital, Bangalore, Karnataka, India
| |
Collapse
|
22
|
|
23
|
|
24
|
|
25
|
Darling HS, Jayalakshmi S, Jaiswal P. MCQs on "Analysis of postoperative radiotherapy effects within risk groups in patients with FIGO I, II, and III endometrial cancer". Indian J Cancer 2019; 56:348-349. [PMID: 31607705 DOI: 10.4103/ijc.ijc_868_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- H S Darling
- Department of Medical Oncology and Hemato-Oncology, Narayana Superspeciality Hospital, Gurugram, Haryana, India
| | - S Jayalakshmi
- Department of Radiation Oncology, Artemis Hospital, Gurugram, Haryana, India
| | - Pradeep Jaiswal
- Department of Surgical Oncology, Command Hospital, Bangalore, Karnataka, India
| |
Collapse
|
26
|
|
27
|
Darling HS. Ammunition to Immunotherapy: The “Nobel” Journey. Indian J Med Paediatr Oncol 2019. [DOI: 10.4103/ijmpo.ijmpo_90_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- HS Darling
- Department of Medical Oncology and Hemato-oncology, Narayana Superspeciality Hospital, Gurugram, Haryana, India
| |
Collapse
|
28
|
Darling HS, Jayalakshmi S, Jaiswal P. MCQs for "Concurrent chemoradiotherapy for head and neck cancers in older patients: Outcomes and their determinants". Indian J Cancer 2019; 56:267-268. [PMID: 31389392 DOI: 10.4103/ijc.ijc_571_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- H S Darling
- Department of Medical Oncology and Hemato-oncology, Narayana Superspeciality Hospital, Gurugram, Haryana, India
| | - S Jayalakshmi
- Department of Radiation Oncology, Artemis Hospital, Gurugram, Haryana, India
| | - Pradeep Jaiswal
- Department of Surgical Oncology, Command Hospital, Bangalore, Karnataka, India
| |
Collapse
|
29
|
Darling HS, Jayalakshmi S, Jaiswal P. MCQs for "Analysis of clinicopathological and immunohistochemical parameters and correlation of outcomes in gastrointestinal stromal tumors". Indian J Cancer 2019; 56:144-145. [PMID: 31062733 DOI: 10.4103/ijc.ijc_354_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- H S Darling
- Department of Radiation Oncology, Artemis Hospital, Gurugram, Haryana, India
| | - S Jayalakshmi
- Department of Radiation Oncology, Artemis Hospital, Gurugram, Haryana, India
| | - Pradeep Jaiswal
- Department of Surgical Oncology, Command Hospital, Bangalore, Karnataka, India
| |
Collapse
|
30
|
Affiliation(s)
- H. S. Darling
- Medical Oncology & Hemato-oncology, Artemis Hospital, Gurugram, India
| | | |
Collapse
|
31
|
Darling HS. Testing alternate biochemotherapy combinations in recurrent/metastatic head and neck cancer - Putting the best foot forward. Indian J Cancer 2019; 56:2-3. [PMID: 30950434 DOI: 10.4103/ijc.ijc_746_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- H S Darling
- Consultant, Department of Medical Oncology and Hemato-oncology, Artemis Hospital, Gurugram, Haryana, India
| |
Collapse
|
32
|
Darling HS, Jayalakshmi S, Jaiswal P. MCQs for “Treatment in resectable non-metastatic adenocarcinoma of stomach: Changing paradigms”. Indian J Cancer 2019; 56:81-82. [DOI: 10.4103/ijc.ijc_210_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
33
|
|
34
|
Affiliation(s)
- H S Darling
- Army Hospital, R & R, Delhi Cantt 110 010, India.
| |
Collapse
|
35
|
Darling HS, Marwah V, Rajput AK, Varma PP, Singh KK. Low dose methylprednisolone induced bradycardia. J Assoc Physicians India 2013; 61:920-922. [PMID: 24968553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Methylprednisolone induced arrhythmias, especially bradycardia, are well known. Most of the available reports suggest the occurrence of these arrhythmias with high dose intravenous therapy. We, hereby report a case of low dose methylprednisolone induced bradycardia.
Collapse
|
36
|
Darling HS, Lambert GH. Therapeutic orphans. Pediatrics 1992; 89:689. [PMID: 1557260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
|