This study was conducted to develop and evaluate guidelines for cancer patients' symptoms management such as nausea/vomiting, fatigue, constipation, diarrhea, and oral mucositis. Based on the literature review, assessment path to identify each stage of five symptoms were also developed. Guidelines for symptom management of each stage of the symptoms were developed. Guidelines then were evaluated by a panel of experts. Finally, 95 cancer patients were recruited and asked to use the guidelines for their symptom management. Levels of understanding of and satisfaction with assessment path and management guidelines were surveyed. Prevalence rate of five symptoms varied ranging from 20% (diarrhea) to 47% (nausea/vomiting). Regarding the level of understanding of each symptom most of the cancer patients indicated that they were easy and sufficient. Regarding the easiness of use of the symptom management guidelines, most of cancer patients indicated that they were easy to use. Regarding the nursing intervention on each symptom, most of cancer patients indicated that they were easy and helpful. More information was added with feedback from the patients. The result of this study has implications on development of customized patient education materials based on assessment path and symptom management guidelines.
The purpose of this study was to evaluate the patient education provided by the pharmacist for cancer patients receiving chemotherapy in the hospital. One time patient medication teaching including verbal instruction and written materials were provided by a pharmacist for cancer patients receiving chemotherapy on the first or second day of hospitalization. After providing medication teaching by a pharmacist a written survey was performed in order to measure the patient's satisfaction with the medication teaching and to evaluate the effectiveness of the patient medication teaching. This one-time patient medication teaching by a pharmacist was provided for 44 solid and hematological cancer patients (23 male, 21 female). The results of 27 written surveys completed by the cancer patients revealed that almost all cancer patients $(96.3\%)$ felt that medication teaching is a must in order to understand and accept the chemotherapy by cancer patients. In addition, almost all patients $(92.6\%)$ stated that they were extremely satisfied with the medication teaching provided by the pharmacist. The levels of understandings on the chemotherapy.
Background: Studies evaluating smoking cessation treatment outcomes in cancer patients are scarce, despite smoking cessation importance in cancer care. We sought to add to the literature by evaluating smoking cessation in a challenging group of cancer patients (medium-to-heavy smokers) visiting an out-patient smoking cessation clinic (SCC) in a cancer center in Amman, Jordan. Materials and Methods: Patients smoking >9 cigarettes per day (CPD) and referred to the SCC between June 2009 and May 2012 were studied. Clinic records were reviewed to measure demographic and baseline clinical characteristics, and longitudinal (3-, 6- and 12- month) follow-up by phone/clinic visit was conducted. At each follow-up, patients were asked if they experienced medication side-effects, if they had returned to smoking, and reasons for failing to abstain. Descriptive and multivariable logistic regression analyses were performed. Results: A total of 201 smokers were included in the analysis. The 3-month abstinence was 23.4% and significantly associated with older age, being married, and presenting with lower (${\leq}10ppm$) baseline carbon monoxide (CO) levels. On a multivariable level, lower CO levels, a higher income (relative to the lowest income group), being older, and reporting severe dependence (relative to dependence reported as 'somewhat' or 'not') were significant predictors of higher odds of abstinence at three months. Reasons for failing to quit included not being able to handle withdrawal and seeing no value in quitting. Long-term ARs did not reach 7%. Conclusions: In a sample of Jordanian smokers (>9CPD) with cancer and receiving smoking cessation treatment, ARs were low and further declined with time. Results underscore the need for more aggressive patient management and rigorous follow-up during and after smoking cessation treatment, particularly when this takes place in challenging settings. Observed reasons for failure to abstain should be used to tailor counseling practices.
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.
Because cancer is not curable, patients who suffer from the cancer disease may have physical, psychological and spiritual problems for the rest of their lives. Especially, when cancer patients do not have the meaning in their lives, they will experience spiritual distress seriously. This study was conducted to provide a basis for nursing intervention strategies to minimize the cancer patients' spiritual distress and understand the relationship between the meaning of life and the spiritual distress in cancer patients. The samples were composed of 62 cancer patients who were inpatients or outpatients of three university hospital and one general hospital in Seoul. Data collection was carried out from January 10,1998 to May 30, 1998. Data were analyzed using a SAS program for descriptive statistic, Pearson correlation, t-test, ANOVA, LSD test and linear regression. The results were as follows; 1. The scores on the meaning of life scale ranged from 20 to 140 with a mean of 94. 16(Standard error: 2.79). 2. The scores on the spiritual distress scale ranged from 13 to 91 with a mean of 62. 29(Standard error: 1.38). 3. There were significant correlations between the meaning of life and the spiritual distress(r=.53. p=.00). 4. The linear regression analysis showed that the meaning of life explained 29% of the spiritual distress. 5. In the degree of the meaning of life and the spiritual distress according to the general characteristics, the level of the meaning of life in cancer patients were different by age(F=3. 42, p=.03), marriage status(F=6.06, p=.00), religion(F=4.21, p=.01), thought about treatment of cancer(F=3.76, p=.04). And the level of the spiritual distress in cancer patients were different by religion(F=7.56, p=.00). In conclusion, the meaning of life was identified as important variable that was contributed to reduce the spiritual distress in cancer patients.
Purpose: The purpose of this study was to examine the effects of aroma hand massage on pain, state anxiety and depression in hospice patients with terminal cancer. Methods: This study was a nonequivalent control group pretest-posttest design. The subjects were 58 hospice patients with terminal cancer who were hospitalized. Twenty eight hospice patients with terminal cancer were assigned to the experimental group (aroma hand massage), and 30 hospice patients with terminal cancer were assigned to the control group (general oil hand massage). As for the experimental treatment, the experimental group went through aroma hand massage on each hand for 5 min for 7 days with blended oil-a mixture of Bergamot, Lavender, and Frankincense in the ratio of 1:1:1, which was diluted 1.5% with sweet almond carrier oil 50 ml. The control group went through general oil hand massage by only sweet almond carrier oil-on each hand for 5 min for 7 days. Results: The aroma hand massage experimental group showed more significant differences in the changes of pain score (t=-3.52, p=.001) and depression (t=-8.99, p=.000) than the control group. Conclusion: Aroma hand massage had a positive effect on pain and depression in hospice patients with terminal cancer.
Aim: To report the results of radiotherapy with or without chemotherapy in the patients with oral cancer. Methods: Over the 2003-2009 periods, a total number of 69 patients with squamous cell carcinoma of the oral cavity that refused surgery or had unresectable tumor were enrolled in this study. A total dose of 60 to 70 Gy (2 Gy per day) was given to the primary tumor and clinically positive nodes. In the patients with locoregionally advanced disease (57 patients with $T_3$, $T_4$ lesions and/ or $N^+$) induction chemotherapy following by concomitant chemoradiation was used. Induction chemotherapy consisted of 3 cycles of Cisplatin and 5-Flourouracil with or without Docetaxel. Weekly cisplatin was used in concomitant protocol. Kaplan-Meier method was used to calculate overall survival. Log-rank test and Cox regression model were used for comparison purposes. Results: Median follow-up was 32 months. The mean age of the patients was 59.2 years. The overall response rate after induction chemotherapy was 68.4%. Actuarial overall survival rates after 2 and 3 years were 38% and 26%, respectively. Clinical stage emerged as the only independent predictor of survival. Conclusion: Outcome of the patients with oral cancer is poor. Presenting with an advanced stage lesion contributed to this result. The role of chemotherapy in advanced cases remains to be defined.
Purpose: Alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and Golgi protein 73 (GP73) levels have been widely used as tumor markers for the diagnosis of hepatocellular carcinoma (HCC). The aim of this study was to investigate whether these tumor markers could be used to monitor short-term treatment response and recurrence of HCC in patients undergoing radiofrequency ablation (RFA). Methods: Between July 2012 and July 2013, 53 consecutive patients with newly diagnosed HCC were prospectively enrolled in this study. Among these, 32 patients underwent RFA, after which they were followed up prospectively at the First Hospital of Jilin University in China. Results: AFP, AFP-L3, and GP-73 values pre-RFA were not associated with tumor size, whereas AFP and GP-73 levels tended to be associated with tumor number, the presence of vascular invasion, deterioration of liver function, advanced-stage disease, and a poor performance status. GP-73 levels were dramatically elevated in the patients with hepatitis C-associated HCC. Neither pre-RFA nor 1-month post-RFA tumor marker values were associated with short-term outcome. The short-term recurrence rate of AFP-positive patients measured 1 month post-RFA was obviously higher than that of AFP-negative patients. Conclusions: AFP and GP-73 values were associated with clinical variables representing tumor growth and invasiveness, and the AFP value measured 1 month post-RFA was a strong predictor of short-term recurrence in patients with HCC.
In patients having long-standing ulcerative colitis (UC), the risk of colorectal cancer (CRC) increased compared with general population. Dysplasia is a precancerous lesion of colitic patients, and traditionally total proctocolectomy was considered as a standard therapy to prevent colorectal cancer in UC patients. However, even with ileal pouch-anal anastomosis (IPAA), patients who underwent total proctocolectomy may experience early and late postoperative complications, such as ileus, bleeding, pouchitis, and so on. In addition, the bowel movement after proctocolectomy with IPAA reaches a median of seven times per day, and a considerable proportion of patients require daytime and nighttime pads. Change in the strategy for managing dysplasia started from two early studies, which suggested polypectomy for polypoid dysplasia to prevent CRC in colitic patients. After that, many studies supported that polypectomy should be the first option for the management of polypoid dysplasia. Moreover, recent studies suggested the feasibility of endoscopic submucosal dissection as a therapeutic option for non-polypoid dysplasia, although long term, large studies should be followed.
Kim, Hoon;Kim, Seul Ki;Lee, Jung Ryeol;Hwang, Kyung Joo;Suh, Chang Suk;Kim, Seok Hyun
Clinical and Experimental Reproductive Medicine
/
v.44
no.4
/
pp.181-186
/
2017
With advances in the methods of cancer treatment used in modern medicine, the number of breast cancer survivors has been consistently rising. As the number of women who wish to become pregnant after being diagnosed with breast cancer increases, it is necessary to consider fertility preservation in these patients. However, medical doctors may be unaware of the importance of fertility preservation among cancer patients because most patients do not share their concerns about fertility with their doctors. Considering the time spent choosing and undergoing treatment, an early referral to a reproductive specialist is the best way to prevent a delay in cancer treatment. Since it is not easy to make decisions on matters related to cancer diagnosis and fertility, patients should be provided with enough time for decision-making, and to allow for this, an early referral will provide patients with sufficient time to choose an appropriate method of fertility preservation. The currently available options of fertility preservation for patients with breast cancer include cryopreservation of embryos, oocytes, and ovarian tissue and gonadotropin-releasing hormone agonist treatment before and during chemotherapy. An appropriate method of fertility preservation must be selected through consultations between individual patients and health professionals and analyses of the pros and cons of different options.
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