• Title/Summary/Keyword: Old Cancer Patients

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Prevalence of Depression and its Correlations: a Cross-sectional Study in Thai Cancer Patients

  • Maneeton, Benchalak;Maneeton, Narong;Mahathep, Pojai
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2039-2043
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    • 2012
  • Objectives: Depression is common in cancer patients. However, only limited evidence is available for Asian populations. The authors therefore examine the prevalence of depression in Thai patients with cancer. In addition, associated factors were determined. Methods: This cross-sectional study was conducted in cancer patients admitted to a university hospital during December 2006 - December 2007. The Patient Health Questionnaire (PHQ-9) was used to assess all cancer patients. Suicidal risk was assessed by using the Mini-International Neuropsychiatric Interview (MINI) in the module of suicidal risk assessment. Results: Of 108 cancer patients, 29.6 % were diagnosed with a depressive disorder (mild, 14.8 %; moderate, 5.6 %; severe, 9.3 %). However, only 25.0 % of these were recognized as being depressed by the primary physician. According to the MINI., 28.1 % of these depressed cancer patients had a moderate to severe level of suicidal risk. In addition, the findings suggest that increased risk of depression is significantly associated with increased pain score, lower number of cancer treatments (< 2 methods), increased educational duration (>13 years), increased age (> 50 years old) and being female. Conclusions: The prevalence of depression is high in Thai cancer patients. However, depressive disorder in those patients is frequently undiagnosed. It is associated with several factors including pain, a number of cancer treatments, education duration, age and sex. To improve quality of life, increase compliance with treatments and prevent of suicide, screening for depressive disorders in this patient group is strongly recommended.

The Clinical Characteristics in Patients with Lung Cancer Under 45 Years of Age (45세 이하 약년자 폐암 94례의 임상적 특징)

  • Park, Hye-Jung;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho;Han, Sung-Beom;Jeon, Young-Jun;Hyun, Dae-Sung;Lee, Sang-Chae;Kim, Chang-Ho;Park, Jae-Yong;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.5
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    • pp.550-560
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    • 2002
  • Background : Lung cancer is the leading cause of cancer-related mortality in both men and women. Although most cases of lung cancer occur in the sixty to eight decades of life, 5 to 10% are diagnosed at a young age. There are characteristic features in young patients with lung cancer that differ from those in older patients with lung cancer. The purpose of this study was to determine if the basal characteristics and survival in young patients with lung cancer differed from those of old patients. Methods : We retrospectively reviewed the medical records of 94 young patients who were under 45 years of age and compared them with 1,728 old patients (= 46 years of age) in 4 medical schools at Daegu, between August 1986 and July 1995. Results : Significantly more female patients and adenocarcinomas were found in the young patients group. when compared to the old patients. Cough and sputum were the most frequent presenting symptom in both age groups. This was followed by chest discomfort, dyspnea and hemoptysis. The rates of smoking was significantly lower in the young patients. There was no statistical difference in the severity of the disease in terms of staging between the two age groups. Young patients received treatment more frequently than the older patients. The location of the primary tumors was equally frequent in both the upper and lower lobe. However, the survival was bettrer in the young patients(median survival time, 67.3 weeks), when compared to the old patients (median survival time, 26.8 weeks) (p<0.05). Conclusion : Females and adenocarcinoma patients were predominant in young patients with lung cancer. The young patients appeared to have significantly better prognosis.

Prostate Cancer in Younger and Older Patients: Do We Treat Them Differently?

  • Situmorang, Gerhard Reinaldi;Umbas, Rainy;Mochtar, Chaidir A.;Santoso, Rachmat Budi
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4577-4580
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    • 2012
  • Diagnostic and therapeutic strategies of prostate cancer may largely influenced by patients' age at presentation. This study is aimed to evaluate the characteristics, diagnostic and treatment strategies in prostate cancer patients in our centres. A cross-sectional analytic study of prostate cancer data in two main referral cancer centres, Cipto Mangunkusumo General Hospital and Dharmais National Cancer Centre from 1995-2010, was therefore performed. Patients were divided into 2 sub-populations; below 60 years (younger patients) and 75 years old and above (older patients). PSA levels, diagnostic modalities, Gleason score and therapeutic options were analysed for both and compared using bivariate analysis. 152 patients were <60 years and 210 were ${\geq}75$ years. There was no statistical difference in mean PSA level (797.9ng/mL vs 345.3 ng/mL, respectively; p>0.05) and diagnosis was made by biopsy in majority of patients in both groups (68.2% and 71.6% in younger and older groups respectively). Most presented with an advanced disease stage (65.1% and 66.0%, respectively) and there was no statistically significant difference in mean Gleason scores f (8.1 vs 7.7; p>0.05). Primary androgen deprivation therapy (PADT) was the main treatment for overall patients (48.0% and 50.7%, respectively). Radiotherapy and radical prostatectomy are the main therapeutic modalities for younger patients with local and locally advanced disease (39.6% and 35.4% respectively), while the majority of older patients with the same disease stage were treated with radiotherapy and PADT (45.8% and 39.0% respectively). Differences observed in treatment modalities were statistically significant (p<0.0003). We conclude that there is no difference in disease clinical aggressiveness of the two groups but significant differences were observed in therapeutic strategies utilised with younger and older patients.

Clinical Evaluation of the Lung Cancer (폐암의 임상적 고찰)

  • 최순호
    • Journal of Chest Surgery
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    • v.11 no.1
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    • pp.26-34
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    • 1978
  • We observed 82 cases of primary lung cancer clinically and statistically, which had been experienced at the dept. of thoracic surgery, Chonnam University Hospital, during the period of 13 years from 1964 to 1967. The results obtained were as follows: Peak incidence of age was from 5th decade to 6th decade, and the ratio of male to female was 3: 1. The frequency of lung cancer was higher in the heavy smoker than in the lighter smoker, and undifferentiated carcinoma showed low resectability in spite of the shorter clinical duration. Major symptoms were coughing and chest tightness & pain, especially coughing was initial symptom in the majority of patients. Of the 82 cases, operation was performed in the 32 cases [39%], but resection was possible in the 22 cases [27%]. The delaying factors led patients to an inoperable stage were physician’s misdiagnosis of bronchogenic carcinoma due to non-specific symptoms and signs of the patients, old age patients were dependence on herb medicine, and poor economical condition of the patients in our region especially. Basic conditions of treatment in lung cancer were early detection & early surgery, so, chest P-A would be checked per 3 to 6 months interval associated with sputum cytology in the smoker over 45 age routinely.

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A Registry Program for Familial Gastric Cancer Patients Referred to Cancer Institute of Iran

  • Etemadi, Mehrnoosh;Pourian, Mandana;Shakib, Asyeh;Sabokbar, Tayebeh;Peyghanbari, Vahideh;Shirkoohi, Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2141-2144
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    • 2014
  • Background: Gastric cancer is the second most common cause of cancer death. It has a poor prognosis with only 5-10% of hereditary etiology. If it is diagnosed, it could be helpful for screening the other susceptible members of a family for preventive procedures. Usually it is identified by symptoms such as presence of cancer in different members of family, some special type of pathology such as diffused adenocarcinoma, having younger age and multiple cancer syndromes. Hence, designing a registry program can be a more practical way to screen high risk families for a preventive program. Materials and Methods: Based on the inclusion criteria, a questionnaire was prepared. After pilot on a small number of patients, the actual data was collected from 197 patients and processed in SPSS 16.0. Results: Totally, 11.8% of the patients were younger than 45 years old. Blood type 'A' was dominant and males had a higher risk behavior with higher consumption of unhealthy food. Adenocarcinoma was reported in majority of cases. 21.8% of the patients had the including criteria for familial gastric cancer (FGC). Conclusions: The high percentage of FGC population compared to the other studies have revealed a need to design an infrastructural diagnostic protocol and screening program for patients with FGC, plus preventive program for family members at risk which could be done by a precise survey related to frequency and founder mutations of FGC in a national registry program.

Survey for Alternative Therapy Used by Cancer Patients Receiving Radiation Therapy (방사선치료 암 환자의 대체요법 경험실태 조사연구)

  • Park Cheol Woo;Park Tae-Jin
    • The Journal of Korean Society for Radiation Therapy
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    • v.13 no.1
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    • pp.75-90
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    • 2001
  • Although it is presumed that cancer patients take various alternative therapies, the present status is not well recognized. The purpose of this study is to survey alternative therapies used by cancer patients receiving radiation therapy and then, find associated factors of taking alternative therapies. The study subjects were composed of those who receiving radiation therapy in the department of radiation oncology in 5 hospitals located at Extended Busan city and who were on follow-up after medical cure. They were 394 male and female patients over 20 years old. The mean age of the subjects was 53.2 years old and the age ranged from 23 to 83 years old. 188 patients($47.7\%$) used alternative therapies. Total 68 different kinds of alterative therapies were used, average 7.3 kinds per patient were experienced, and average total cost expenditure was 2,830,000 won. Among the alternative therapies, black bean($38.8\%$) was the most commonly used and brown rice($38.3\%$), ganoderm lucidum($37.8\%$), elm tree($33.5\%$), and phellinus linteus($30.8\%$) were followed in order of frequency. However in considering the time, cost and effort spent, phellinus linteus was the first. In terms of cost, phellinus linteus was the highest with average expenditure of 2,740,000 won. Among the motivation of using alternative therapies, expecting auxiliary help for the hospital therapy was the highest ($31.4\%$). About half of users($56.9\%$) of alternative therapies were recommended by their relatives to use alternative therapies. In comparing the characteristics of experienced and unexperienced groups, alternative therapy was experienced significantly more in patients of younger age(p=0.001), in patient of higher educational level(p=0.001), and in patients of higher income(p=0.030) The proportion of using alternative therapies was significantly higher in the group treated with chemotherapy(p=0.005), and in the patients who did not satisfy with radiation therapy(p=0.001). The frequency of drinking was significantly higher tendency in the inexperienced group(p=0.046), There was no significant difference in marital status, job, religion, other disease, surgical operation of the cancer and smoking staus between the two groups. Among the unexperienced group, $34.0\%$ of the patients did not take the alternative therapies because they did not have know]edge for the alternatives, and $22.3\%$ worried about negative effects on hospital-based therapy $58.7\%$ of them were willing to take the alternative therapies if the effects and safety were proven by the government or research institutes. $21.9\%$ of the patients wanted to take the alternatives if they were affordable. $72.3\%$ of the patients was willing to take them if their families recommend, but $27.2\%$ responded they would not take them in any situation. Conclusively, various kinds of alternative therapies which were not proved medically were exposed to patients, In these circumstances, it is required to investigate, study and evaluate the medical effects and safety of the alternative therapies.

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Familial Breast Cancer Registry Program in Patients Referred to the Cancer Institute of Iran

  • Sabokbar, Tayebeh;Khajeh, Elias;Taghdiri, Foad;Peyghambari, Vahideh;Shirkoohi, Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2675-2679
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    • 2012
  • Introduction: Annually a considerable number of people die because of breast cancer, a common disease among women also in Iran. Identifying risk factors and susceptible people can lead to prevention or at least early diagnosis. Among susceptibility risks, 5-10% of patients have a family history predisposing factor which can influence the risk of incidence among the family. Having a registry program can be a more practical way to screen high risk families for preventive planning. Method: Based on inclusion criteria, a questionnaire was prepared and after a pilot study on a small number of patients, actual data were collected on 400 patients and processed in SPSS 16.0. Results: Totally, 28.2%of the patients were younger than 40 years old and 36.8% had the included criteria for familial breast cancer (FBC). 102 patient's samples could be compared for receptor presentation. Similar to other studies, the number of triple negative breast cancers increased as the age decreased. Conclusion: The high percentage of patients with FBC among 400 cases in this study demonstrates that in order to design an infrastructural diagnostic protocol and screening of patients with FBC, a precise survey related to frequency and founder mutations of FBC is needed nationwide.

Factors to consider for surgical in elderly patients with oral cancer

  • Lee, Sung-Tak;Kim, Jin-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.5
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    • pp.388-393
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    • 2021
  • At present, in Korea, due to developments in medicine and technology and an increasing mean lifespan, the expected lifetime for elderly people is increasing (at 70 years, the expected additional lifespan is 14.8 years for males and 18.3 years for females). However, among all causes of death, malignant neoplasm is ranked first for all ages. Further, the incidence rate of oral cancer tends to increase with age. Thus, oral and maxillofacial surgeons have increased opportunity to experience the 'oldest old' patients with oral cancer. Elderly patients commonly have several comorbidities, poor general condition, limited socioeconomic support, fear of various postoperative complications, and perception of short for the rest of their life. In this situation, the patient, caregiver, and surgeon often choose undergraded treatment rather than standard treatment for oral squamous cell carcinoma owing to patient age. In elderly patients with oral cancer, ablation of tumor or reconstructive surgery is challenging for surgeons. Oral and maxillofacial surgeons must evaluate carefully the patient's medical condition and make a decision regarding treatment plans after sufficient discussion with patient and caregivers. We review the literature to consider the factors involved for deciding on a treatment plan regarding surgery in elderly patients with oral cancer.

Incidence and Risk Factors for Leptomeningeal Carcinomatosis in Breast Cancer Patients with Parenchymal Brain Metastases

  • Jung, Jong-Myung;Kim, Sohee;Joo, Jungnam;Shin, Kyung Hwan;Gwak, Ho-Shin;Lee, Seung Hoon
    • Journal of Korean Neurosurgical Society
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    • v.52 no.3
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    • pp.193-199
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    • 2012
  • Objective : The objective of study is to evaluate the incidence of leptomeningeal carcinomatosis (LMC) in breast cancer patients with parenchymal brain metastases (PBM) and clinical risk factors for the development of LMC. Methods : We retrospectively analyzed 27 patients who had undergone surgical resection (SR) and 156 patients with whole brain radiation therapy (WBRT) as an initial treatment for their PBM from breast cancer in our institution and compared the difference of incidence of LMC according to clinical factors. The diagnosis of LMC was made by cerebrospinal fluid cytology and/or magnetic resonance imaging. Results : A total of 27 patients (14%) in the study population developed LMC at a median of 6.0 months (range, 1.0-50). Ten of 27 patients (37%) developed LMC after SR, whereas 17 of 156 (11%) patients who received WBRT were diagnosed with LMC after the index procedure. The incidence of LMC was significantly higher in the SR group compared with the WBRT group and the hazard ratio was 2.95 (95% confidence interval; 1.33-6.54, p<0.01). Three additional factors were identified in the multivariable analysis : the younger age group (<40 years old), the progressing systemic disease showed significantly increased incidence of LMC, whereas the adjuvant chemotherapy reduce the incidence. Conclusion : There is an increased risk of LMC after SR for PBM from breast cancer compared with WBRT. The young age (<40) and systemic burden of cancer in terms of progressing systemic disease without adjuvant chemotherapy could be additional risk factors for the development of LMC.

Successful Outcome of Elderly Patients with Advanced Malignant Melanoma by Standardized Allergen-removed Rhus verniciflua Stokes Extract and Bojungikki-tang: Two Cases

  • Jung, Hyunsik;Lee, Sanghun
    • The Journal of Korean Medicine
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    • v.35 no.4
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    • pp.98-103
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    • 2014
  • Objectives: Advanced malignant melanoma (MM) has a poor prognosis, with an expected 2-year survival rate of 10 to 20%. It has long been recognized as an immunogenic tumor, and is worse for elderly patients. Many studies have suggested that herbal treatments improve immune functions, but few clinical studies have reported on this topic. Patients and History: We present two cases of female patients (72 and 77 years old, respectively) with advanced MM. The 72-year-old female patient was, at first, diagnosed with MM with multiple bone metastases. She received resection of the primary lesion, but refused further chemotherapy. The 77-year-old female patient was diagnosed with cutaneous MM of the left heel, with suspicion of sentinel node lymphadenopathy; however, she also refused any conventional treatment due to old age. Course of Therapy and Results: Both patients were exclusively treated with standardized allergen-removed Rhus verniciflua stokes (aRVS) extract combined with Bojungikki-tang (BT, Bu-Zhong-Yi-Qi-Tang in Chinese or Hochu-ekki-to in Japanese). Both patients are still alive and doing well (Feb. 2014), demonstrating that the 72-year-old patient has lived for 27 months and the 77-year-old patient has lived for 31 months without disease progression since the aRVS and BT administration. Conclusion: We suggest that the combination of aRVS extract and BT could be a candidate for overcoming the cancer's immunoediting process especially for elderly MM patients intolerant of conventional treatment.