• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5639-5644
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• 2014

Objective: This study aimed to determine effects of doctor-patient communication on the quality of life among breast cancer survivors in 16 communities in southern China. Methods: Multistage random sampling was to use to recruit 260 females from the Guangzhou Cancer Registry Database who were diagnosed with breast cancer. A questionnaire provided data on the doctor-patient communication (including the doctor's attitude, the patient's participation with the medical decision and information about the disease) and QOL (quality of life), as measured using FACT-B. Univariate analysis, non-conditional logistic regression was used to evaluate the associations between the doctor-patient communication and QOL. Results: Females who received good attitudes from doctors demonstrated higher FACT-B (OR=4.65, 95% CI: 1.68-12.86), social well-being (OR=5.88, 95% CI: 2.16-16.05), emotional well-being (OR=4.77, 95% CI: 1.92-11.88), and functional well-being ((OR=5.26, 95% CI: 1.90-14.52) compared to the females who encountered worse attitudes from their doctor, adjusting for age, education, marriage, employment, family income, years since diagnosis, TNM stage, radiation therapy, chemotherapy and side effects, particularly when the TNM stage was 0-II and the patients exhibited no side effects. Regardless of the length of time after diagnosis, doctors' good attitudes resulted in higher QOL scores. Conclusions: This study demonstrated that the doctor-patient communication has a significant association with the QOL of breast cancer survivors, mainly dependent on the doctors' attitude. Effective intervention is required to develop optimal doctor-patient communication.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7539-7545
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• 2014

Background: It has been proved that participating in exercise improves colorectal cancer patients' prognosis. This study is to identify barriers to exercise in Korean colorectal cancer patients and survivors. Materials and Methods: A total of 427 colorectal cancer patients and survivors from different stages and medical status completed a self-administered questionnaire that surveyed their barriers to exercise and exercise participation. Results: The greatest perceived exercise barriers for the sampled population as a whole were fatigue, low level of physical fitness, and poor health. Those under 60-years old reported lack of time (p=0.008), whereas those over 60 reported low level of physical fitness (p=0.014) as greater exercise barriers than their counterparts. Women reported fatigue as a greater barrier than men (p<0.001). Those who were receiving treatment rated poor health (p=0.0005) and cancer-related factors as greater exercise barriers compared to those who were not receiving treatment. A multivariate model found that other demographic and medical status were not potential factors that may affect exercise participation. Further, for those who were not participating in physical activity, tendency to be physically inactive (p<0.001) and lack of exercise skill (p<0.001) were highly significant barriers, compared to those who were participating in physical activity. Also, for those who were not meeting ACSM guidelines, cancer-related exercise barriers were additionally reported (p<0.001), compared to those who were. Conclusions: Our study suggests that fatigue, low level of physical fitness, and poor health are most reported exercise barriers for Korean colorectal cancer survivors and there are differences in exercise barriers by age, sex, treatment status, and physical activity level. Therefore, support for cancer patients should be provided considering these variables to increase exercise participation.

• The Journal of the Korea Contents Association
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• v.14 no.7
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• pp.356-366
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• 2014

The purpose of this study was to identify the impact of the mood state on the quality of life (QOL) of the female breast cancer survivor. The study was cross-sectional survey. This study was conducted from September 10th to September 20th, 2013. The subjects were 120 breast cancer survivors in Seoul city in Korea. The obtained data were analyzed by SPSS/WIN 21.0 program. The mean score of mood state was 39.20 and the mean score of the quality of life was 83.59. The levels of mood state and the quality of life were negatively correlated. The significant factors influencing quality of life were vigor and anger of the mood state, religion that explained 39.1% of the variance. The results suggests that appropriate support service should be provided to improve the quality of life after nurses evaluate breast cancer survivor's mood states and identify the symptoms of mood disturbances.

• Biomedical Science Letters
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• v.24 no.2
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• pp.76-86
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• 2018

Breast cancer is one of the most common cancers affecting women worldwide. Although the survival rate of breast cancer has increased, breast cancer still results in a high mortality rate. Breast cancer deaths are caused by metastasis that occurs in organ dysfunction. Recently, there have been many studies on circulating tumor cells (CTCs), which are related to breast cancer metastasis in the blood. Recent studies have demonstrated that some CTCs do not express epithelial markers. Therefore, in this study, total RNA was extracted from blood without separating out the CTCs, and the characteristics of the CTCs were analyzed by RT-qPCR. Cyclin D1 and twist-related protein 1 (TWIST1) are well-known markers for predicting the prognosis of patients with breast cancer. However, few studies have demonstrated the use of CCND1 and TWIST1 in blood as diagnostic and prognostic markers of breast cancer. In this study, patients with late-stage breast cancer had overexpressed CCND1 and TWIST1 than patients with different stages of breast cancer (P < 0.001 and P < 0.01, respectively). The relative expression level of CCND1 in survivors was higher than in patients who died (P = 0.06). The relative expression level of TWIST1 in survivors was lower than in patients who died (P = 0.08). Overall CCND1 and TWIST1 were not useful as markers for the diagnosis of breast cancer through blood. However, we showed the possibility of using CCND1 and TWIST1 as prognostic markers, and a large-scale study is needed to confirm the usefulness of these prognostic markers.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.2213-2218
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• 2012

Introduction: Worldwide, breast cancer is the commonest cause of cancer death in women. However, the survival rate varies across regions at averages of 73%and 57% in the developed and developing countries, respectively. Objective: This study aimed to determine the survival rate of breast cancer among the women of Malaysia and characteristics of the survivors. Method: A retrospective cohort study was conducted on secondary data obtained from the Breast Cancer Registry and medical records of breast cancer patients admitted to Hospital Kuala Lumpur from 2005 to 2009. Survival data were validated with National Birth and Death Registry. Statistical analysis applied logistic regression, the Cox proportional hazard model, the Kaplan-Meier method and log rank test. Results: A total of 868 women were diagnosed with breast cancer between January 2005 and December 2009, comprising 58%, 25% and 17% Malays, Chinese and Indians, respectively. The overall survival rate was 43.5% (CI 0.573-0.597), with Chinese, Indians and Malays having 5 year survival rates of 48.2% (CI 0.444-0.520), 47.2% (CI 0.432-0.512) and 39.7% (CI 0.373-0.421), respectively (p<0.05). The survival rate was lower as the stages increased, with the late stages were mostly seen among the Malays (46%), followed by Chinese (36%) and Indians (34%). Size of tumor>3.0cm; lymph node involvement, ERPR, and HER 2 status, delayed presentation and involvement of both breasts were among other factors that were associated with poor survival. Conclusions: The overall survival rate of Malaysian women with breast cancer was lower than the western figures with Malays having the lowest because they presented at late stage, after a long duration of symptoms, had larger tumor size, and had more lymph nodes affected. There is an urgent need to conduct studies on why there is delay in diagnosis and treatment of breast cancer women in Malaysia.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.10
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• pp.4409-4419
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• 2015

The Bhopal gas tragedy involving methyl isocyanate (MIC) is one of the most horrific industrial accidents in recent decades. We investigated the genotoxic effects of MIC in long-term survivors and their offspring born after the 1984 occurrence. There are a few cytogenetic reports showing genetic damage in the MIC-exposed survivors, but there is no information about the associated cancer risk. The same is true about offspring. For the first time, we here assessed the micronucleus (MN) frequency using cytokinesis-blocked micronucleus (CBMN) assay to predict cancer risk in the MIC-affected population of Bhopal. A total of 92 healthy volunteers (46 MIC-affected and 46 controls) from Bhopal and various regions of India were studied taking gender and age into consideration. Binucleated lymphocytes with micronuclei (BNMN), total number of micronuclei in lymphocytes (MNL), and nuclear division index (NDI) frequencies and their relationship to age, gender and several lifestyle variabilities (smoking, alcohol consumption and tobacco-chewing) were investigated. Our observations showed relatively higher BNMN and MNL (P<0.05) in the MIC-affected than in the controls. Exposed females (EF) exhibited significantly higher BNMN and MNL (P<0.01) than their unexposed counterparts. Similarly, female offspring of the exposed (FOE) also suffered higher BNMN and MNL (P<0.05) than in controls. A significant reduction in NDI (P<0.05) was found only in EF. The affected group of non-smokers and non-alcoholics featured a higher frequency of BNMN and MNL than the control group of non-smokers and non-alcoholics (P<0.01). Similarly, the affected group of tobacco chewers showed significantly higher BNMN and MNL (P<0.001) than the non-chewers. Amongst the affected, smoking and alcohol consumption were not associated with statistically significant differences in BNMN, MNL and NDI. Nevertheless, tobacco-chewing had a preponderant effect with respect to MNL. A reasonable correlation between MNL and lifestyle habits (smoking, alcohol consumption and tobacco-chewing) was observed only in the controls. Our results suggest that EF and FOE are more susceptible to cancer development, as compared to EM and MOE. The genotoxic outcome detected in FOE reflects their parental exposure to MIC. Briefly, the observed cytogenetic damage to the MIC-affected could contribute to cancer risk, especially in the EF and FOE.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.383-386
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• 2012

Background: Cancer survivors are at increased risk of second cancers. Lymphoproliferative disorders (LPD) are common neoplasms that are primary or subsequent cancers in cases of multiple primary cancer. We here analyzed metachronous or synchronous LPD in multiple primary cancers. Methods: Between 2001 and 2010, LPD were assessed retrospectively in 242 multiple primary cancers patients. Results: Forty nine (20.2%) patients with LPD were detected. Six patients had two LPD where one patient had three LPD. The median age of patients was 60.5 years (range: 28-81). LPD were diagnosed in 29 patients as primary cancer, in 23 patients as second cancer, and in three patients as third cancer in multiple primary cancers. Primary tumor median age was 56 (range: 20-79). Diffuse large B cell lymphoma (n=16), breast cancer (n=9), and lung cancer (n=6) were detected as subsequent cancers. Alklylating agents were used in 19 patients (43.2%) and 20 patients (45.5%) had received radiotherapy for primary cancer treatment. The median follow-up was 70 months (range: 7-284). Second malignancies were detected after a median of 51 months (range: 7-278), and third malignancies with a median of 18 months (range: 6-72). Conclusions: In this study, although breast and lung cancer were the most frequent detected solid cancers in LPD survivors, diffuse large B cell lymphoma was the most frequent detected LPD in multiple primary cancers.

• Journal of Gastric Cancer
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• v.20 no.2
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• pp.176-189
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• 2020

Purpose: This study evaluated differences and shifting patterns in the health-related quality of life (HRQoL) of 5-year gastric cancer survivors after either a distal subtotal gastrectomy (DSG) or total gastrectomy (TG). Materials and Methods: We analyzed the prospectively collected HRQoL data of 528 patients who survived 5 years without recurrence using the European Organization for the Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire and the EORTC Quality of Life Questionnaire-Stomach module according to the type of surgery. The purpose was to identify the proportion of patients with deteriorating HRQoL and to assess the clinical significance of these changes. Results: Deteriorating HRQoL was prevalent in both groups, including a large proportion of the DSG group. Decreased overall health status and scores on several function scales were less in the DSG group, while increases on the symptom scales were higher in the TG group. For most of the scales, gaps in HRQoL during the early postoperative period did not merge within the 5 years. Scores on the diarrhea and body image scales revealed "moderate changes" in both groups. Conclusions: During the 5-year period after surgery, the TG group suffered from inferior HRQoL compared to the DSG group. However, a large proportion of the DSG group also suffered HRQoL deterioration. In general, the TG group experienced more HRQoL decline, with diarrhea and body image being the major concerns for both groups. To improve HRQoL after gastrectomy, patients must be better informed about post-gastrectomy symptoms. These symptoms must be vigorously investigated, and medical interventions should be available parallel to nutritional support. Favorable evidence of function-preserving gastrectomy should be established and disseminated to improve the HRQoL of early gastric cancer patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.1
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• pp.197-207
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• 2020

The purpose of this study was to identify the predictors of death anxiety among community-dwelling elderly cancer survivors in Korea. This study was a descriptive correlation study with 216 elderly cancer survivors who live in the jurisdiction of community health centers in Chugbuk province. Data of this study were collected from February 27 to March 15 2019 by a structured questionnaire. The data were analyzed using independent t-test, one-way ANOVA, Pearson's correlation coefficient, and hierarchical multiple regression. In the results, the mean score of death anxiety was 2.47±0.39 out of 4.0, while that of ego integrity was 2.60±0.29, depression 6.35±4.0, and awareness of a good death 2.97±0.35. Based on the hierarchical multiple regression analysis, subjects' awareness of a good death had the greatest impact on death anxiety (β = 0.255, p < .001), followed by depression (β = 0.185, p = .020) and religion (no= 1; β= 0.148, p = .021). These factors explained 16.4% of death anxiety (F=8.04, p<.001). Therefore, the results of this study are expected to be utilized as basic data for developing an intervention program that will be designed to reduce the death anxiety in elderly cancer survivors.

• Communications for Statistical Applications and Methods
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• v.24 no.1
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• pp.43-65
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• 2017

We propose a flexible cure rate survival model by assuming that the number of competing causes of the event of interest has the Poisson distribution and the time for the event follows the gamma-G family of distributions. The extended family of gamma-G failure-time models with long-term survivors is flexible enough to include many commonly used failure-time distributions as special cases. We consider a frequentist analysis for parameter estimation and derive appropriate matrices to assess local influence on the parameters. Further, various simulations are performed for different parameter settings, sample sizes and censoring percentages. We illustrate the performance of the proposed regression model by means of a data set from the medical area (gastric cancer).