• Title/Summary/Keyword: 재가 암 환자

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Degree of Pain, and Barriers and Satisfaction with Pain Management among Home Care Cancer Patients (재가 암환자의 통증, 통증관리 장애정도 및 통증관리 만족도)

  • Moon, Young-Me;Ham, Ok-Kyung;Kim, Jung-Hee;Lim, Ji-Young
    • Journal of Korean Public Health Nursing
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    • v.22 no.2
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    • pp.177-185
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    • 2008
  • Purpose: To investigate the degree of pain, and to identify barriers to and satisfaction with pain management, in an effort to provide baseline data for effective pain management interventions. Methods: The study design was descriptive and correlational. A total of 100 cancer patients who were cared for at home participated in this study. Questions regarding self-rated pain, as well as barriers to and satisfaction with pain management were included in the study instruments. The data were collected by nurses using a face-to-face interview method in May of 2008. Results: Thirty six percent of the participants were in their 70's and 18.0% suffered from cancer of the large intestine. The usual degree of pain was reported as 3.43 out of 10 points, and the study patients were generally moderately satisfied with their pain management (M=$3.15{\pm}0.78$; range, 1-5). The mean barrier score was $3.24{\pm}0.52$ (range, 1-5) and concerns regarding the progress of cancer was the most highly evaluated barrier. There was a negative relationship between the degree of pain and satisfaction with pain management, and between barriers to and satisfaction with pain management. Conclusion: The precise evaluation of pains is crucial to the proper management of pain, and the education and promotion of proper pain management practices may help to overcome barriers to pain management for cancer patients.

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Different $^{18}$F-FDG Uptake According to Tumor location and Morphology of Cholangiocarcinoma and Its Clinical Implication (담관암의 위치와 형태에 따른 $^{18}$F-FDG 섭취량의 차이와 임상적 의의)

  • Lee, Won-Seok;Lee, Yoon-Jae;Lim, Seok-Tae;Sohn, Myung-Hee;Lee, Seung-Ok
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.4
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    • pp.317-322
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    • 2009
  • Purpose: $^{18}$F-flurodeoxyglucose (FDG) uptake on positron emission tomography (PET) scan has been found to reflect tumor aggressiveness and prognosis in various types of cancer. However, pattern of FDG uptake in biliary malignancies and its clinical significance have not been studied well. The purpose of this study was to assess the additional value of $^{18}$F-FDG PET in differential diagnosis and prognosis of cholangiocarcinoma (CC) according to the tumor location and tumor morphology. Materials and Methods: From April 2005 to May 2008, eighty two patients (M:F = 55:27, age 66.2$\pm$9.6 yrs) with CC underwent $^{18}$F-FDG PET. For semiquantitative analysis, the maximum standardized uptake value (SUV$_{max}$) was obtained from the primary tumor. The difference of SUV$_{max}$ according to the tumor location and tumor growth pattern, such as scirrhous type, nodular type, polypoid type were compared. Results: Overall sensitivity of PET scan was 81.7% in CC. SUV$_{max}$ on PET scan in intrahepatic CC was significantly higher compared to extrahepatic CC. In extrahepatic CC, polypoid type showed significantly higher SUV$_{max}$ compared to scirrhous type. Conclusion: $^{18}$F-FDG PET may have a significant impact on clinical decision-making and on the management of intrahepatic cholangiocarcinoma. And it is related to the shape of the tumor and the sensitivity of detection is higher in the mass-forming type than in the scirrhous type.

Palliative Irradiation Using Helical Tomotherapy in Recurrent Pelvic Tumors with Prior Radiotherapy (방사선치료 후 재발한 골반암에서 토모테라피를 이용한 고식적 재치료)

  • Kay, Chul-Seung;Yoo, Eun-Jung;Kim, Ji-Hoon;Ro, Duck-Young;Kim, Ki-Jun
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.133-140
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    • 2010
  • Purpose: We retrospectively investigated the effect of irradiation using helical tomotherapy in recurrent pelvic tumors that underwent prior irradiation. Materials and Methods: Fourteen patients with recurrent pelvic tumors consisting of rectal cancer (57.1%), cervical cancer (35.7%) and cancer with an unknown origin (7.1%) were treated with tomotherapy. At the time of irradiation, median tumor size was 3.5 cm and 7 patients complained of pain originating from a recurrent tumor. The median radiation dose delivered to the gross tumor volume, clinical target volume, and planning target volume was 50 Gy, 47.8 Gy and 45 Gy, respectively and delivered at 5 fractions per week over the course of 4 to 5 weeks. Treatment response and duration of local disease control were evaluated using the Response Evaluation Criteria in Solid Tumors (ver. 1.0) and the Kaplan-Meyer method. Treatment-related toxicities were assessed through Common Terminology Criteria for Adverse Events (ver. 3.0). Results: The median follow-up time was 17.3 months, while the response rate was 64.3%. Symptomatic improvement appeared in 6 patients (85.7%). The median duration time of local disease control was 25.8 months. The rates of local failure, distant failure, and synchronous local and distant failure were 57.1%, 21.4%, and 7.1%, respectively. Acute toxicities were limited in grade I or II toxicities, except for one patient. No treatment related death or late toxicity was observed. Conclusion: Helical tomotherapy could be suggested as a feasible palliative option in recurrent pelvic tumors with prior radiotherapy. However, to increase treatment effect and overcome the limitation of this outcome, a large clinical study should be performed.

The Effects of Integrated Intervention Program for Community Dwelling Cancer Patients' Quality of Life, Depression and Self Care Agency (통합중재프로그램이 지역사회 재가 암환자들의 삶의 질, 우울, 자가간호역량에 미치는 효과)

  • Kang, Young Sil;Kwon, In Soo;Hong, Eunyoung
    • Journal of Korean Public Health Nursing
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    • v.30 no.3
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    • pp.445-455
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    • 2016
  • Purpose: This study was performed to identify the effects of an integrated nursing intervention program on the quality of life, depression and self care agency of community dwelling cancer patients. Methods: The design of this study was a quasi-experimental, one group pre-post test. A total of 25 community dwelling cancer patients in J city were included in this study. An integration intervention was 30 times, 10 weeks program. The data were collected between May and November of 2014. The collected data were analyzed using SPSS 18.0 through paired t-test. Results: There were significant differences in the quality of life (p=.007) and self-care agency (p=.042) after 10 week's intervention. Conclusion: The results indicate that an integrated intervention program including educational, cognitive, emotional and physical intervention is effective for community dwelling cancer patients. Further attention should be paid to the intensity and period of an integrated intervention program.

A study for ontology-diagnosis framework research based on pathology-knowledge for automated cancer diagnosis of biopsy samples (조직세포의 자동화된 암 진단을 위한 병리지식 기반의 온톨로지 진단프레임워크에 관한 연구)

  • Song, Jae-Won;Lee, Ju-Hong
    • Proceedings of the Korea Information Processing Society Conference
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    • 2011.04a
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    • pp.1051-1053
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    • 2011
  • 본 논문은 병리진단지식을 활용한 조직세포 영상의 암진단을 위한 온톨로지 기반의 진단 프레임워크를 제안한다. 병리진단 분야는 환자로부터 획득한 조직셈플을 전자현미경을 이용하여 조직의 구조적 특징과 형태학적특징을 기반으로 진단을 한다. 이러한 형태의 진단은 의사의 주관적인 경험에 많이 의존하기 때문에 같은 병증에 대해서도 의사들마다 다른 진단을 하게 된다. 최근 이러한 주관적인 경험에 의한 오진을 줄이고자 주어진 조직세포 영상의 형태학적 특징들의 정량적인 수치들을 이용하는 컴퓨터 보조진단(CAD)시스템들이 많이 이용되고 있다. 그러나 이러한 진단 시스템의 요소기법들은 하나의 병증만을 진단하는데 활용되기 때문에 구성기술의 재사용성은 매우 떨어진다. 따라서 본 논문은 요소기술들의 재활용성을 높이고, 객관화된 병리진단을 위한 온톨로지 기반의 진단 프레임워크를 제시한다.

The Association Between Cancer and Network Structure of Depressive Symptoms (암과 우울증상 네트워크 구조의 연관성)

  • Hwang, Hwijin;Lee, Kyung Kyu;Lee, Seok Bum;Lee, Jung Jae;Kim, Kyoung Min;Kim, Dohyun
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.121-127
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    • 2021
  • Objectives : The characteristics of depressive symptoms in patients with cancer is different from those in control group. However, few research has focused on the association between depressive symptoms in cancer patients. The aim of this study was to compare the network structure of depressive symptoms between patients with cancer and normal control. Methods : This study was based on cohort data from Korea National Health and Nutrition Examination Survey in 2016-2018. The Patient health Quetionnaire-9 (PHQ-9) was used to assess depressive symptoms in 599 patients with cancer and 599 age-sex matched controls. We estimated network structure of depressive symptom using Isingfit model. Results : There was no significant difference of each PHQ-9 item score. There were strong associations between symptoms were concentration problem-psychomotor activity, anhedonia-depressed mood, and depressed mood-suicidal ideation in both groups. Strength centrality of worthlessness was significantly higher in patients with cancer. Conclusions : These results suggest that worthless is associated with other depressive symptoms more tightly in patients with cancer. Worthless can serve as important treatment targets for intervention of depression in patients with cancer.

Effects of Pain Management Education on Pain of the Terminal Cancer Patients at Home (통증관리 교육이 재가 말기암 환자의 통증에 미치는 효과)

  • Kwon, In-Gak;Whang, Moon-Sook;Kim, Ji-Hyeon
    • Asian Oncology Nursing
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    • v.2 no.1
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    • pp.36-49
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    • 2002
  • The purpose of this study was to evaluate the effects of the pain management education on pain of the terminal cancer patients at home. For evaluating the effectiveness of the intervention modified Patient Outcome Questionnaire (APS, 1995) including patients concerns with cancer pain management, pain intensity, and interference of daily activities related to pain were measured before and after the education in control group and experimental group and the differences were compared with each other. Satisfaction with pain management was measured after the intervention. Pain management education was delivered to 16 experimental group patients by home care nurses, who were provided with 3-hour education on cancer pain management by one of the researchers. Pain management education included common misconceptions about cancer pain control and pharmacological and non-pharmacological interventions and emphasis was put on the importance of pain reports and patients' active participation in pain management. The results of the study were as follows. Patients concerns with pain management were decreased more greatly in the experimental group than those of the control group. The worst, average, and present pain intensities during the last 24 hours were decreased more greatly in the experimental group, and total score and each subcategory of the interference of daily living, except walking, were decreased more greatly in the experimental group. And satisfaction score with total pain management and nurses response to the pain reports were higher in the experimental group. The results of this study suggest that pain management education given to the patients by home care nurses is a very useful intervention to improve pain of the cancer patients at home. This positive result is thought to derive from patients' active pain report and participation in pain control and the use of powder form sustained release morphine for breakthrough pain control in part. Further studies with increased sample size from more institutions are recommended and early introduction of short acting morphine is strongly suggested for effective cancer pain control.

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Development and Effect of the Integrated Health Promotion Program for Cancer Survivors Living at Home (재가암 환자 통합건강증진 프로그램 개발 및 효과)

  • Yoon, Hee Sang;Hwang, Eun A
    • Research in Community and Public Health Nursing
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    • v.32 no.1
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    • pp.51-63
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    • 2021
  • Purpose: This study aimed to develop an integrated health promotion program for cancer survivors residing in the community based on the shared care model, and evaluate its effectiveness. Methods: A quasi-experimental trial was conducted. The participants consisted of 35 cancer survivors with completed intensive cancer therapy at the cancer hospital. The intervention group (n=20) and the control group (n=15) were recruited from among a district home cancer patient registrations. The intervention group participated in an integrated health promotion program based on the MAPP (Mobilizing for Action through Planning and Partnership) development process. The program consisted of physical, psycho-social and body image units. The participants were assessed before the program, and immediately after the program. Data were collected between July 1 and September 2, 2018 using FACT-G quality of life (QOL), distress thermometer (DT), and resilience. The data were analyzed by performing a χ2 test, Fisher's exact test, Mann-Whitney test, and ranked ANCOVA using SPSS. Results: The intervention group reported a higher QOL overall and significantly higher social/family well-being than the control group. Distress was significantly lower in intervention group than in the control group. Resilience had no significant difference between the two groups. Conclusion: These findings indicate that the integrated health promotion program base on the shared care model and MAPP development process could be effective intervention for improving social/family well-being and the QOL, and reducing distress of cancer survivors at home. Community health center nurses need to provide intervention to support self-care competency for cancer survivors' comprehensive care with physical, psycho-social, and body image to help them adjust their life to a moderate risk group in the community.

Survival and Compliance with the Use of Radiation Therapy for Anaplastic Thyroid Carcinoma (미분화 갑상선암에서 방사선치료 순응도와 생존기간)

  • Oh, Yoon-Kyeong;Jang, Ji-Young;Chung, Woong-Ki
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.229-236
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    • 2008
  • Purpose: The purpose of this study was to evaluate the impact of the use of external radiation therapy (ERT) in terms of survival and compliance in patients with anaplastic thyroid carcinoma. Materials and Methods: The medical records of 17 patients with anaplastic thyroid carcinoma treated with ERT between 1993 and 2002 were retrospectively reviewed. ERT was administered after surgery in 14 patients and after a biopsy in three patients. Among the 14 patients who had undergone surgery, nine underwent a curative resection and five underwent a palliative resection. Six patients had associated well-differentiated thyroid carcinomas and 14 patients were diagnosed with a tumor size exceeding 5 cm. The radiation dose ranged from $6{\sim}70\;Gy$ (median dose, 37.5 Gy). Eleven patients completed the planned course of ERT, whereas six patients did not. The follow-up period ranged from $1{\sim}104$ months (median, 5 months; mean, 20 months). Results: Five patients started the ERT without the presence of a gross mass and all of the patients competed ERT without a re-growth of tumor. Twelve patients (four patients after a curative resection, five patients after a palliative resection and three patients after a biopsy) started ERT with a gross mass present and only six patients were able to complete the planned course of ERT. Among the six patients who completed ERT, two patients showed a marked regression of the tumor mass, whereas two patients showed slight regression and two patients showed no response. The median survival was five months (range, $1{\sim}104$ months) and the mean survival was 21 months. The overall survival was 41% at 1-year, 24% at 2-years and 12% at 5-years. Significant prognostic factors included the number of primary tumors present, tumor size, whether surgery was performed and completion of ERT as planned. Long-term survivors showed a tendency of having smaller sized initial tumors and smaller sized pre-ERT tumors than the short-term survivors. Conclusion: This study suggests that patients with a small initial tumor (${\leq}5\;cm$), which was treated by surgery (curative resection or palliative resection) before ERT, and without rapid re-growth of the mass seen at the surgical site at the beginning of the ERT course, would be the best candidates for postoperative ERT. In contrast, patients with a large initial tumor (>5 cm) and did not undergo surgery before ERT or that rapid re-growth of the mass was observed at the surgical site are likely to have a short survival time, along with the interruption of ERT. In these cases, the role of ERT is very limited and the omission of ERT could be considered.

A Case of Improvement of Metastatic Ovarian and Endometrial Cancer Treated by Integrative Medicine Therapy Combined with Chemotherapy (항암치료와 통합암치료 병용으로 호전된 전이성 난소 및 자궁내막암 환자 1례)

  • Jin, Yong Jae;Shin, Kwang Soon;Ha, Jee Yong
    • Journal of Korean Traditional Oncology
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    • v.19 no.1
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    • pp.33-41
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    • 2014
  • This report is aimed to investigate the effect of Integrative Medicine Therapy (IMT) in treating metastasized ovary and endometrial cancer. A 51-year-old woman who was diagnosed double primary ovarian and endometrial cancer in 2009. The patient was treated with Laparoscopic Assisted Vaginal Hysterectomy (LAVH), Bilateral Salpingo Oophorectomy (BSO) Pelvic Lymph Node Dissection (PLND), adjuvant chemotherapy till Sep. in 2013. But metastases to Rt. External Iliac artery, Aortocaval area Lymph Nodes, Liver(caudate lobe), Rt. Buttock subcutaneous area, Lt. Gastric Area Lymph Nodes were found. Finally, the patient decided to be treated by IMT including Abnoba Viscum, Vitamin C, herbal medication and pharmacopuncture combined with chemotherapy. The efficacy was evaluated with Positron Emission Tomography and Computed Tomography (PET-CT) and Abdomen Computed Tomography (CT). The metastatic tumor in liver was disappeared and Rt. external iliac artery, aortocaval area Lymph Nodes, Rt. buttock subcutaneous area were also decreased after 6 months treatment. These results suggest that IMT may have a potential role for metastatic cancer.