• 제목/요약/키워드: Breast lymphoma

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Patients with Cancer and their Relatives Beliefs, Information Needs and Information-Seeking Behavior about Cancer and Treatment

  • Kav, Sultan;Tokdemir, Gamze;Tasdemir, Reyhan;Yalili, Ayse;Dinc, Didem
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권12호
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    • pp.6027-6032
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    • 2012
  • Purpose: To identify cancer patient and relatives beliefs, information needs, information-seeking behavior and information sources about cancer and treatment. Methods: This research was conducted at two hospitals of a university. Data was collected via questionnaires and the Turkish version of the Miller Behavioral Style Scale (MBSS) to assess information-seeking behavior. The sample included 82 patients and 54 relatives. Results: Patients were receiving treatment mostly for breast, gynecologic, lung cancer and leukemia/ lymphoma. All of them indicated that they want to be informed by a doctor about their diagnosis and treatment first. Other information sources were internet, media and nurses. The majority of the patients and half of their relatives agreed that "cancer is curable and preventable disease". Only 2.5% of patients agreed with the statement "I don't want to get information about disease which disturbs me". According the data obtained from MBSS; the mean patients MBSS score ($6.41{\pm}3.2$) was higher than their relatives ($5.46{\pm}3.1$). Respondents with higher education and younger age indicated more information-seeking behavior. Conclusions: Patients and their relatives differ in some of their information-seeking behavior. Patients beliefs and their strategies for coping with their illness can constrain their wish for information and their efforts to obtain it. Healthcare professionals need to assess and be sensitive to the information-seeking behavior of cancer patients and their relatives.

Survival of Brain Metastatic Patients in Yazd, Iran

  • Akhavan, Ali;Binesh, Fariba;Heidari, Samaneh
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권8호
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    • pp.3571-3574
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    • 2014
  • Background: Brain metastasis occurs when cancerous cells come from a known (or sometimes an unknown) primary tumor to the brain and implant and grow there. This event is potentially lethal and causes neurologic symptoms and signs. These patients are treated in order to decrease their neurologic problems, increase quality of life and overall survival. Materials and Methods: In this study we evaluated clinical characteristics of 206 patients with brain metastases referred to our center from 2004 to 2011. Results: The mean age was 53.6 years. The primary tumors were breast cancer (32%), lung cancer (24.8%), lymphoma (4.4%), sarcoma (3.9%), melanoma (2.9%), colorectal cancer (2.4%) and renal cell carcinoma (1.5%). In 16.5% of the patients, brain metastasis was the first presenting symptom and the primary site was unknown. Forty two (20.4%) patients had a single brain metastasis, 18 patients (8.7%) had two or three lesions, 87 (42.2%) patients had more than three lesions. Leptomeningeal involvement was seen in 49 (23.8%) patients. Thirty five (17%) had undergone surgical resection. Whole brain radiation therapy was performed for all of the patients. Overall survival was 10.1 months (95%CI; 8.65-11.63). One and two year survival was 27% and 12% respectively. Conclusions: Overall survival of patients who were treated by combination of surgery and whole brain radiation therapy was significantly better than those who were treated with whole brain radiation therapy only [13.8 vs 9.3 months (p=0.03)]. Age, sex, primary site and the number of brain lesions did not show significant relationships with overall survival.

C1420T Polymorphism of Cytosolic Serine Hydroxymethyltransferase and Risk of Cancer: a Meta-analysis

  • Zhong, Shan-Liang;Zhang, Jun;Hu, Qing;Chen, Wei-Xian;Ma, Teng-Fei;Zhao, Jian-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권5호
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    • pp.2257-2262
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    • 2014
  • A series of studies have explored the role of cytosolic serine hydroxymethyltransferase (SHMT1) C1420T polymorphism in cancer risk, but their results were conflicting rather than conclusive. To derive a more precise estimation of the association between C1420T and cancer risk, the present meta-analysis of 28 available studies with 15,121 cases and 18,023 controls was conducted. The results revealed that there was no significant association between the polymorphism and cancer risk overall. In stratified analysis by cancer type (breast cancer, gastrointestinal cancer, leukemia, lymphoma, and others), the results showed that 1420T allele was associated with decreased risk in leukemia (CT vs. CC: OR= 0.825, 95% CI =0.704-0.966; and CT+TT vs. CC: OR= 0.838, 95% CI = 0.722-0.973), but the same results were not present for other cancer types. When subgroup analysis was performed by source of control (population-based [PB] and hospital-based [HB]), a borderline inverse association was observed for the HB subgroup (CT vs. CC: OR= 0.917, 95% CI = 0.857-0.982) but not for the PB subgroup. Stratifying by geographic area (America, Asia and Europe), significant inverse association was only found in Asia subgroup (CT vs. CC: OR= 0.674, 95% CI = 0.522-0.870). In summary, the findings suggest that SHMT1 C1420T polymorphism is not associated with overall cancer development, but might decrease cancer susceptibility of Asians as well as reduce leukemia risk. Large well-designed epidemiological studies will be necessary to validate the risk identified in the current meta-analysis.

Financial Burden of Cancer Drug Treatment in Lebanon

  • Elias, Fadia;Khuri, Fadlo R;Adib, Salim M;Karam, Rita;Harb, Hilda;Awar, May;Zalloua, Pierre;Ammar, Walid
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3173-3177
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    • 2016
  • Background: The Ministry of Public Health (MOPH) in Lebanon provides cancer drugs free of charge for uninsured patients who account for more than half the total case-load. Other categories of cancer care are subsidized under more stringent eligibility criteria. MOPH's large database offers an excellent opportunity to analyze the cost of cancer treatment in Lebanon. Materials and Methods: Using utilization and spending data accumulated at MOPH during 2008-2013, the cost to the public budget of cancer drugs was assessed per case and per drug type. Results: The average annual cost of cancer drugs was 6,475$ per patient. Total cancer drug costs were highest for breast cancer, followed by chronic myeloid leukemia (CML), colorectal cancer, lung cancer, and Non-Hodgkin's lymphoma (NHL), which together represented 74% of total MOPH cancer drug expenditure. The annual average cancer drug cost per case was highest for CML ($31,037), followed by NHL ($11,566). Trastuzumab represented 26% and Imatinib 15% of total MOPH cancer drug expenditure over six years. Conclusions: Sustained increase in cancer drug cost threatens the sustainability of MOPH coverage, so crucial for socially vulnerable citizens. To enhance the bargaining position with pharmaceutical firms for drug cost containment in a small market like Lebanon, drug price comparisons with neighboring countries which have already obtained lower prices may succeed in lowering drug costs.

암환자에서 암발생부위와 생존기간에 따른 사망전 1년간의 의료비용 (Medical Expenses by Site of Cancer and Survival Time among Cancer Patients in the Last One Year of Life)

  • 이지전;유원곤;김소윤;김광기;이상욱
    • Journal of Preventive Medicine and Public Health
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    • 제38권1호
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    • pp.9-15
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    • 2005
  • Objectives : To analyze medical expenses by cancer site and survival time among cancer patients in their last year of life. Method : The study subjects were 45,394 people that had died of cancers in 2002, were registered by the Korea Central Cancer Registry and received National Health Insurance benefit in the last year (360 days) of life. Personal identification data, general characteristics, dates of death and cancer incidence, and site of cancer were collected from the National Statistical Office and the Korea Central Cancer Registry, and merged with the data of the individual medical expenses of the Health Insurance Review Agency. Results : Average monthly cost curves were U-shaped with high costs near the time of diagnosis and death, and lower costs in between. Medical expenses in the last year of life were around 30.3, 16.7, 13.0, and 12.1 million won among leukemia, lymphoma, ovarian cancer, and breast cancer patients, respectively. Digestive organ cancers including stomach, esophagus, liver, pancreas, and colorectal cancers had relatively low medical expenses. Medical expenses in the last year of life were inverse U-shaped with high expenses near one year of survival. Average monthly cost in the 12 months before death among the patients who had survived $10{\sim}15$ years were more than two-fold greater than the cost before diagnosis among those who had survived for less than one year. Conclusions : Leukemia was the most expensive cancer. It is possible that once diagnosed as cancer, medical expenses do not return to the level before diagnosis. Further research will be needed to understand the magnitude and change of the medical expenses among cancer patients with long term follow up data.

Enhancing value of quality assurance rounds in improving radiotherapy management: a retrospective analysis from King Hussein Cancer Center in Jordan

  • Khader, Jamal K.;Al-Mousa, Abdelatif M.;Mohamad, Issa A.;Abuhijlih, Ramiz A.;Al-Khatib, Sondos A.;Alnsour, Anoud Z.;Asha, Wafa A.;Ramahi, Shada W.;Hosni, Ali A.;Abuhijla, Fawzi J.
    • Radiation Oncology Journal
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    • 제37권1호
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    • pp.60-65
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    • 2019
  • Purpose: The quality assurance (QA) chart rounds are multidisciplinary meetings to review radiation therapy (RT) treatment plans. This study focus on describing the changes in RT management based on QA round reviews in a single institution. Materials and Methods: After 9 full years of implementation, a retrospective review of all patients whose charts passed through departmental QA chart rounds from 2007 to 2015. The reviewed cases were presented for RT plan review; subcategorized based on decision in QA rounds into: approved, minor modifications or major modifications. Major modification defined as any substantial change which required patient re-simulation or re-planning prior to commencement of RT. Minor modification included treatment plan changes which didn't necessarily require RT re-planning. Results: Overall 7,149 RT treatment plans for different anatomical sites were reviewed at QA rounds. From these treatment plans, 6,654 (93%) were approved, 144 (2%) required minor modifications, while 351 (5%) required major modifications. Major modification included changes in: selected RT dose (96/351, 27%), target volume definition (127/351, 36%), organs-at-risk contouring (10/351, 3%), dose volume objectives/constraints criteria (90/351, 26%), and intent of treatment (28/351, 8%). The RT plans which required major modification according to the tumor subtype were as follows: head and neck (104/904, 12%), thoracic (12/199, 6%), gastrointestinal (33/687,5%), skin (5/106, 5%), genitourinary (16/359, 4%), breast (104/2387, 4%), central nervous system (36/846, 4%), sarcoma (11/277, 4%), pediatric (7/251, 3%), lymphoma (10/423, 2%), gynecological tumors (2/359, 1%), and others (11/351, 3%). Conclusion: Multi-disciplinary standardized QA chart rounds provide a comprehensive and an influential method on RT plans and/or treatment decisions.

Paraoxonase 1 (PON1) Q192R Gene Polymorphism and Cancer Risk: A Meta-Analysis Based on 30 Publications

  • Zhang, Meng;Xiong, Hu;Fang, Lu;Lu, Wei;Wu, Xun;Huang, Zhan-Sen;Wang, Yong-Qiang;Cai, Zhi-Ming;Wu, Song
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권10호
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    • pp.4457-4463
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    • 2015
  • Common genetic variation Q192R in the paraoxonase 1 (PON1) gene has been considered to be implicated in the development of many cancers. Nevertheless, results from the related studies were inconsistent. To elucidate the association, we performed a meta-analysis for 8,112 cases and 10,037 controls from 32 published case-control studies. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of the association by STATA 12.0 software. Overall, we revealed that the PON1-192R allele was associated with a reduced risk of the overall cancers. Moreover, in the stratified analysis by cancer types (breast cancer, prostate cancer, brain cancer etc.), the results showed that PON1-192R allele was associated with a decreased risk in breast cancer (R vs Q: OR=0.605, 95% CI=0.378-0.967, $P_{heterogeneity}=0.000$; RR vs QQ: OR=0.494, 95% CI=0.275-0.888, $P_{heterogeneity}=0.002$; RQ vs QQ: OR=0.465, 95% CI=0.259-0.835, $P_{heterogeneity}=0.000$; and RR+RQ vs QQ: OR=0.485, 95% CI=0.274-0.857, $P_{heterogeneity}=0.000$), and associated with prostate cancer in homozygote (RR vs QQ: OR=0.475, 95% CI=0.251-0.897, $P_{heterogeneity}=0.001$) and recessive models (RR vs RQ+QQ: OR=0.379, 95% CI=0.169-0.853, $P_{heterogeneity}=0.000$), while an increased risk was identified in lymphoma (R vs Q: OR=1.537, 95% CI=1.246-1.896, $P_{heterogeneity}=0.944$; RR vs QQ: OR=2.987, 95% CI=1.861-4.795, $P_{heterogeneity}=0.350$; RR+RQ vs QQ: OR=1.354, 95% CI=1.021-1.796, $P_{heterogeneity}=0.824$; and RR vs RQ+QQ: OR=2.934, 95% CI=1.869-4.605, $P_{heterogeneity}=0.433$), and an increased risk in prostate cancer under heterozygote comparison (RQ vs QQ: OR=1.782, 95% CI=1.077-2.950, $P_{heterogeneity}=0.000$) and dominant models (RR+RQ vs QQ: OR=1.281, 95% CI=1.044-1.573, $P_{heterogeneity}=0.056$). When subgroup analysis that performed by the control source (hospital based or population based), a decreased risk of the overall cancers was revealed by homozygote (RR vs QQ: OR=0.601, 95% CI=0.366-0.987, $P_{heterogeneity}=0.000$) and dominant models (RR vs RQ+QQ: OR= 0.611, 95% CI=0.384-0.973, $P_{heterogeneity}=0.000$) in hospital based group. Stratifying by ethnicity, a significantly reduced risk of the overall cancers under allele contrast model (R vs Q: OR=0.788, 95% CI=0.626-0.993, $P_{heterogeneity}=0.000$) was uncovered in Caucasian. In summary, these findings suggested that PON1 Q192R polymorphism was associated with a reduced risk of the overall cancers, nevertheless, it might increase cancer susceptibility of prostate and lymphoma risk. Large well-designed epidemiological studies will be continued on this issue of interest.

고형암에 대한 항암화학요법 치료 중 병발한 결핵의 특성 (Characteristics of Tuberculosis Detected during Chemotherapy for a Solid Tumor)

  • 김덕겸;이세원;강영애;윤영순;유철규;김영환;한성구;심영수;임재준
    • Tuberculosis and Respiratory Diseases
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    • 제58권3호
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    • pp.285-290
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    • 2005
  • 연구 배경 : 면역 기능 저하를 초래하여 결핵의 재활성화에 관여할 것으로 생각되는 주기적인 항암화학요법치료 중인 고형암 환자에서 발생한 결핵의 임상적 특징과 치료 반응을 파악하고자 하였다. 대상 및 방법 : 2000년 1월부터 2004년 7월까지 국내 일개 3차 병원에서 항암화학요법 치료 중에 세균학적으로, 병리학적으로 또는 임상적으로 진단된 결핵 환자 중 기존에 알려진 결핵 재활성화의 위험 요인이 없는 22명을 대상으로 후향적 연구를 시행하였다.. 결 과: 22명의 평균 연령은 56.5세(21세-78세)였고, 남녀비는 3.4:1였다. 폐결핵이 가장 흔한 양상이었으며 (20례, 90.9%), 기저 질환으로 위암 (10례, 45.4%)과 림프종(4례, 18.2%)이 흔하였으며, 폐암, 두경부암, 유방암, 자궁경부암 및 난소암 순이었다. 15례 (68.2%)에서 환자가 흉부 방사선 사진 상 결핵 반흔이 있었다. 간기능이 저하된 1명을 제외한 21명이 isoniazid와 rifampicin을 기본으로 하는 초치료를 시작하였으며, 평균 치료기간은 $9.9{\pm}2.4$개월이었다. 기저 질환으로 사망한 5명을 제외하면 70.6%의 환자가 치료를 완료하였다. 결 론 : 항암화학요법 치료 중에 발생한 결핵의 임상적인 특징 및 치료에 대한 반응은 기존에 보고된 일반 인구에서 발생한 폐결핵의 특성과 크게 다르지 않았다.

PET 이용 현황 및 전망 (Current Status and Future Perspective of PET)

  • 이명철
    • 대한핵의학회지
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    • 제36권1호
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    • pp.1-7
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    • 2002
  • Positron Emission Tomography (PET) is a nuclear medicine imaging modality that consists of systemic administration to a subject of a radiopharmaceutical labeled with a positron-emitting radionuclide. Following administration, its distribution in the organ or structure under study can be assessed as a function of time and space by (1) defecting the annihilation radiation resulting from the interaction of the positrons with matter, and (2) reconstructing the distribution of the radioactivity from a series of that used in computed tomography (CT). The nuclides most generally exhibit chemical properties that render them particularly desirable in physiological studies. The radionuclides most widely used in PET are F-18, C-11, O-15 and N-13. Regarding to the number of the current PET Centers worldwide (based on ICP data), more than 300 PET Centers were in operation in 2000. The use of PET technology grew rapidly compared to that in 1992 and 1996, particularly in the USA, which demonstrates a three-fold rise in PET installations. In 2001, 194 PET Centers were operating in the USA. In 1994, two clinical and research-oriented PET Centers at Seoul National University Hospital and Samsung Medical Center, was established as the first dedicated PET and Cyclotron machines in Korea, followed by two more PET facilities at the Korea Cancer Center Hospital, Ajou Medical Center, Yonsei University Medical Center, National Cancer Center and established their PET Center. Catholic Medical School and Pusan National University Hospital have finalized a plan to install PET machine in 2002, which results in total of nine PET Centers in Korea. Considering annual trends of PET application in four major PET centers in Korea in Asan Medical Center recent six years (from 1995 to 2000), a total of 11,564 patients have been studied every year and the number of PET studies has shown steep growth year upon year. We had 1,020 PET patients in 1995. This number increased to 1,196, 1,756, 2,379, 3,015 and 4,414 in 1996,1997,1998,1999 and 2000, respectively. The application in cardiac disorders is minimal, and among various neuropsychiatric diseases, patients with epilepsy or dementia can benefit from PET studios. Recently, we investigated brain mapping and neuroreceptor works. PET is not a key application for evaluation of the cardiac patients in Korea because of the relatively low incidence of cardiac disease and less costly procedures such as SPECT can now be performed. The changes in the application of PET studios indicate that, initially, brain PET occupied almost 60% in 1995, followed by a gradual decrease in brain application. However, overall PET use in the diagnosis and management of patients with cancer was up to 63% in 2000. The current medicare coverage policy in the USA is very important because reimbursement policy is critical for the promotion of PET. In May 1995, the Health Care Financing Administration (HCFA) began covering the PET perfusion study using Rubidium-82, evaluation of a solitary pulmonary nodule and pathologically proven non-small cell lung cancer. As of July 1999, Medicare's coverage policy expanded to include additional indications: evaluation of recurrent colorectal cancer with a rising CEA level, staging of lymphoma and detection of recurrent or metastatic melanoma. In December of 2001, National Coverage decided to expand Medicare reimbursement for broad use in 6 cancers: lung, colorecctal, lymphoma, melanoma, head and neck, and esophageal cancers; for determining revascularization in heart diseases; and for identifying epilepsy patients. In addition, PET coverage is expected to further expand to diseases affecting women, such as breast, ovarian, uterine and vaginal cancers as well as diseases like prostate cancer and Alzheimer's disease.

하이브리드 균형 표본 유전 알고리즘과 극한 기계학습에 기반한 암 아류형 분류기 (Cancer subtype's classifier based on Hybrid Samples Balanced Genetic Algorithm and Extreme Learning Machine)

  • ;;최용수
    • 디지털콘텐츠학회 논문지
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    • 제17권6호
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    • pp.565-579
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    • 2016
  • 본 논문에서는 극한 기계학습을 이용하는 하이브리드 균형 표본 유전자 알고리즘(hSBGA-ELM)을 기반으로 한 새로운 암 아류형 분류자를 제안하였다. 제안 된 암 아류형 분류자는 정확한 암 아류형 분류기 설계를 위해 공개 전체암지도 (Global Cancer Map)로부터 15063개의 유전자 발현 데이터를 사용합니다. 제안된 방법에서는 14가지(유방암, 전립선 암, 폐암, 대장 암, 림프종, 방광, 흑색 종, 자궁, 백혈병, 신장, 췌장, 난소, 중피종 및 CNS)의 암 아류형을 효율적으로 분류합니다. 제안 된 hSBGA-ELM은 유전자 선택 절차 및 암 아류형 분류를 하나의 프레임 워크로 단일화 한다. 제안 된 하이브리드 균형 표본 유전 알고리즘은 GCM 데이터베이스에서 이용 가능한 16,063 개의 유전자로부터 암 아류형 분류를 담당하는 축소된 강인 유전자 셋을 찾는다. 선택/축소된 유전자 세트는 익스트림 기계학습을 이용하여 암 아류형 분류기를 구성하는데 사용된다. 결과적으로, 크기가 축소된 강인 유전자 집합이 제안하는 암 아류형 분류기의 안정된 일반화 성능을 보장하게 한다. 제안 된 hSBGA-ELM은 암에 관여하는 것으로 예측되는 95개의 유전자를 발견하였으며 기존의 암 아류형 분류기와의 비교를 통해 제안 된 방법의 효율을 보여준다.