• Title/Summary/Keyword: Geriatric oncology

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Burdens among Caregivers of Older Adults with Advanced Cancer and Risk Factors

  • Chindaprasirt, Jarin;Limpawattana, Panita;Pakkaratho, Pornvaree;Wirasorn, Kosin;Sookprasert, Aumkhae;Kongbunkiat, Kannikar;Sawanyawisuth, Kittisak
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1643-1648
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    • 2014
  • Family caregivers of older cancer patients face many challenges in managing illness. The burden impacts physical, emotional, spiritual, and social health. The objective of this study was to identify burden among caregivers of older patients with advanced cancer, and associated factors. Materials and Methods: Caregivers of older cancer patients were randomly interviewed from March-September 2012. Information on baseline characteristics and caregiver burden using the Zarit Burden Inventory (ZBI) was collected. Descriptive statistics were used to analyze baseline data, with univariate and multiple linear regression to analyze factors associated with higher burden. Results: One hundred and fifty participants were assessed. The mean ZBI was $19.2{\pm}12.9$ (95%CI, 17.1, 21.2). Two-thirds of caregivers reported no burden (63%) and the main impact variable on ZBI was guilt. High burdens were associated with single caregiver, relationship with the patient as siblings, presence of migraines, and cancer types of the patients. Conclusions: Caregiver burden of Thai cancer patients is low. This unexpected small number could be the result of the socio-cultural viewpoint. Assessment of caregivers and focusing on related factors should be incorporated into treatment plans.

Mortality, Length of Stay, and Cost Associated with Hospitalized Adult Cancer Patients with Febrile Neutropenia

  • Chindaprasirt, Jarin;Wanitpongpun, Chinadol;Limpawattana, Panita;Thepsuthammarat, Kaewjai;Sripakdee, Warunsuda;Wirasorn, Kosin;Sookprasert, Aumkhae
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.1115-1119
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    • 2013
  • Background: Febrile neutropenia (FN) is a serious complication following chemotherapy and is associated with significant mortality and financial expenditure. The aim of this study was to evaluate risk factors for longer length of stay (LOS) and mortality and cost of treatment among hospitalized adults with cancer who developed febrile neutropenia in Thailand. Materials and Methods: Information on illness of inpatients and casualties came from hospitals nationwide and from hospital withdrawals from the 3 health insurance schemes in fiscal 2010. The data covered 96% of the population and were analyzed by age groups, hospital level, and insurance year schemes in patients with febrile neutropenia. Results: A total of 5,809 patients were identified in the study. The mortality rate was 14%. The median LOS was 8.67 days and 69% of patients stayed for longer than 5 days. On bivariate analysis, age, cancer type, and infectious complications (bacteremia/sepsis, hypotension, fungal infections, and pneumonia) were significantly associated with longer LOS and death. On multivariate analysis, acute leukemia and infectious complications were linked with longer LOS and death significantly. The median cost of hospitalized FN was THB 33,686 (USD 1,122) with the highest cost observed in acute leukemia patients. Conclusions: FN in adult patients results in significant mortality in hospitalized Thai patients. Factors associated with increased mortality include older age (>70), acute leukemia, comorbidity, and infectious complications.

A Study for Curriculum Development for Advanced Nurse Practitioner Program (전문간호사 양성을 위한 간호대학원 교과과정 및 운영방안 개발)

  • 조원정;이태화;김소야자;장순복;이원희;김광숙
    • Journal of Korean Academy of Nursing
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    • v.32 no.6
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    • pp.917-928
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    • 2002
  • The traditional nursing roles have become increasingly blurred. Nurses are now working in different ways and at higher levels of practice that enable nurses to adapt their roles and take on new responsibilities. The advanced role of nurses requires a different kind of master-level prepared education. Method & Result: This article describes an curriculum development process in preparing registered nurses for their advanced nurese' roles in the area of acute adult health nursing, geriatric nursing, pediatric nursing, neonatal intensive care nursing and oncology nursing. Several important issues to be solved regarding introduction of APN were also discussed. Conclusion: The curriculum that was proposed in the study will equip nurses to meet the challenges of future healthcare provision and will be a model to other areas of nursing practice and curriculum development.

Implementation of Proteomics for Cancer Research: Past, Present, and Future

  • Karimi, Parisa;Shahrokni, Armin;Nezami Ranjbar, Mohammad R.
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2433-2438
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    • 2014
  • Cancer is the leading cause of the death, accounts for about 13% of all annual deaths worldwide. Many different fields of science are collaborating together studying cancer to improve our knowledge of this lethal disease, and find better solutions for diagnosis and treatment. Proteomics is one of the most recent and rapidly growing areas in molecular biology that helps understanding cancer from an omics data analysis point of view. The human proteome project was officially initiated in 2008. Proteomics enables the scientists to interrogate a variety of biospecimens for their protein contents and measure the concentrations of these proteins. Current necessary equipment and technologies for cancer proteomics are mass spectrometry, protein microarrays, nanotechnology and bioinformatics. In this paper, we provide a brief review on proteomics and its application in cancer research. After a brief introduction including its definition, we summarize the history of major previous work conducted by researchers, followed by an overview on the role of proteomics in cancer studies. We also provide a list of different utilities in cancer proteomics and investigate their advantages and shortcomings from theoretical and practical angles. Finally, we explore some of the main challenges and conclude the paper with future directions in this field.

The Myth of Not Disclosing the Diagnosis of Cancer: Does it Really Protect Elderly Patients from Depression?

  • Silay, Kamile;Akinci, Sema;Ulas, Arife;Silay, Yavuz Selim;Akinci, Muhammed Bulent;Ozturk, Esin;Canbaz, Merve;Dilek, Imdat;Yalcin, Bulent
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.837-840
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    • 2015
  • Background: The disclosure of a diagnosis of cancer is complex, particularly in older patients. The aim of this study was to investigate the association between age and not knowing the diagnosis, and its impact on mood. Materials and Methods: The study included 70 patients with various types of solid and hematologic cancer in early stages, which were followed up in an outpatient oncology/hematology clinic in Turkey between January, 2014 and June, 2014. Initially the caregivers of patients were asked whether the patients knew their diagnosis or not. A questionnaire for the Geriatric Depression Scale was then administered to the patients. Patient age, gender, marital status and education level were noted and analyzed with respect to knowing the diagnosis and depression. Results: Of the 70 patients, 40% of them were female. The mean age was $68.2{\pm}8.9$. The rate of the patients who does not know their diagnosis was 37.1% (n=26). The overall depression rate with GDS was found 37.1% (n=26) among the participants. There was no association with knowing the diagnosis (p=0.208) although the association between not knowing the diagnosis and age was significant (p=0.01). Conclusions: In this study we revealed no association between not knowing the diagnosis and depression in elderly patients. Contrary to what some has thought, the patient is not protected from psychological distress by not being informed about the diagnosis. We believe this study and similar ones will help to discuss and further explore patient autonomy, the principle of respect to self-determination and end of life issues in different cultures.

Associations between Vitamin D Receptor (VDR) Gene Polymorphisms and Colorectal Cancer Risk and Effect Modifications of Dietary Calcium and Vitamin D in a Japanese Population

  • Takeshige, Nobuyuki;Yin, Guang;Ohnaka, Keizo;Kono, Suminori;Ueki, Takashi;Tanaka, Masao;Maehara, Yoshihiko;Okamura, Takeshi;Ikejiri, Koji;Maekawa, Takafumi;Yasunami, Yohichi;Takenaka, Kenji;Ichimiya, Hitoshi;Terasaka, Reiji
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.2019-2026
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    • 2015
  • Much interest has been drawn to possible associations between vitamin D receptor (VDR) gene polymorphisms and colorectal cancer risk in conjunction with potentially protective effects of calcium and vitamin D. In a study of 685 cases of colorectal cancer and 778 community controls in Japan, we examined the associations of the FokI, BsmI, ApaI, and TaqI polymorphisms with colorectal cancer risk and effect modification by dietary calcium and vitamin D. Genotypes were determined by the PCR-RFLP method. The ApaI polymorphism seemed to be associated with a decreased risk of colorectal cancer, particularly of rectal cancer. The adjusted odds ratio of colorectal cancer for the ApaI AA and Aa genotypes combined versus the aa genotype was 0.83 (95% confidence interval [CI] 0.67-1.02), and the corresponding value for rectal cancer was 0.75 (95%CI 0.56-0.99). A decreased risk of colorectal cancer for the ApaI AA and Aa genotypes combined was more evident in individuals with high calcium intake (interaction p=0.055). The FokI polymorphism seemed to be associated with a decreased risk of colon cancer among those with high vitamin D intake (interaction p=0.09). The BsmI and TaqI polymorphisms were unrelated to colorectal cancer risk, and the null associations were not modified by calcium or vitamin D intake. In conclusion, the ApaI polymorphism may be associated with a decreased risk of colorectal cancer in Japanese, dependent on dietary calcium intake.

Folate-Related Nutrients, Genetic Polymorphisms, and Colorectal Cancer Risk: the Fukuoka Colorectal Cancer Study

  • Morita, Makiko;Yin, Guang;Yoshimitsu, Shin-Ichiro;Ohnaka, Keizo;Toyomura, Kengo;Kono, Suminori;Ueki, Takashi;Tanaka, Masao;Kakeji, Yoshihiro;Maehara, Yoshihiko;Okamura, Takeshi;Ikejiri, Koji;Futami, Kitaroh;Maekawa, Takafumi;Yasunami, Yohichi;Takenaka, Kenji;Ichimiya, Hitoshi;Terasaka, Reiji
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6249-6256
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    • 2013
  • One-carbon metabolism plays an important role in colorectal carcinogenesis. Meta-analyses have suggested protective associations of folate and vitamin $B_6$ intakes with colorectal cancer primarily based on studies in Caucasians, and genetic polymorphisms pertaining to the folate metabolism have been a matter of interest. Less investigated are the roles of methionine synthase (MTR) and thymidylate synthetase (TS) polymorphisms in colorectal carcinogenesis. In a study of 816 cases and 815 community controls in Japan, we investigated associations of dietary intakes of folate, methionine, vitamin $B_2$, vitamin $B_6$, and vitamin $B_{12}$ with colorectal cancer risk. The associations with MTR 2756A>G, MTRR 66A>G, and TSER repeat polymorphism were examined in 685 cases and 778 controls. Methionine and vitamin $B_{12}$ intakes were inversely associated with colorectal cancer risk, but the associations were totally confounded by dietary calcium and n-3 fatty acids. The other nutrients showed no association with the risk even without adjustment for calcium and n-3 fatty acids. The TSER 2R allele was dose-dependently associated with an increased risk. The MTR and MTRR polymorphisms were unrelated to colorectal cancer risk. There was no measurable gene-gene or gene-nutrient interaction, but increased risk associated with the TSER 2R allele seemed to be confined to individuals with high folate status. This study does not support protective associations for folate and vitamin $B_6$. The TSER 2R allele may confer an increased risk of colorectal cancer. The role of the TSER polymorphism in colorectal carcinogenesis may differ by ethnicity.