• 정신신체의학
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• 제25권1호
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• pp.56-62
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• 2017

Objectives : The objective of this study was to investigate the relationship between psychological distress and pain in cancer patients. Methods : 249 patients with cancer who visited National Health Insurance Service Ilsan Hospital between April 2013 and March 2014 were evaluated with National Cancer Center Psychological Symptom Inventory(NCC-PSI) which consisted of Modified Distress Thermometer(MDT) and Modified Impact Thermometer(MIT). Each scale was divided into 3 subscales targeting separate symptoms: insomnia, anxiety, and depression. Psychological distress was defined as positive for those who scored above the cutoff values in at least one of all six subscales. The Numeric Rating Scale for Pain(NRS-Pain) was used to assess the subjective severity of pain. Logistic regression was performed to investigate the association between psychological distress and pain. Results : Univariate logistic regression analysis showed that pain, gender, compliance, and two subscale scores of Hospital Anxiety and Depression Scale(HADS) were significantly associated with psychological distress. Multivariate logistic regression analysis showed that pain and HADS anxiety subscale score maintained a statistically significant association with psychological distress adjusted for variables including age, gender, years of education, Eastern Cooperative Oncology Group performance status, cancer stage, Charlson Comorbidity Index, compliance, and HADS depression subscale score. One point increase in pain was 1.31 times more likely to cause psychological distress. In secondary analysis, pain was significantly associated with all subscales of NCC-PSI, except MIT-anxiety subscale. Conclusions : This study suggests that NCC-PSI, a screening tool for psychological distress, reflects pain. We recommend that physicians who treat cancer patients consider the examination of psychological distress which provides comprehensive evaluation of various factors regarding quality of life.

• 대한암한의학회지
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• 제25권1호
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• pp.11-24
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• 2020

Objective : Radiodermatitis is a common sequelae in 95% of patients receiving radiation therapy, which is important to be well managed as it can affect the patient's quality of life as well as the cancer treatment schedule. The aim of this study is to review and summarize the interventions available for the treatment of acute radiodermatitis, including traditional Korean medicine, and to propose treatment algorithms for clinicians. Methods : To collect studies about managements for radiodermatitis, domestic and foreign database were used such as Korean journal of traditional knowledge portal (KTKP), Korean studies information service system (KISS), national discovery or science leaders (NDSL), and oriental medicine advance searching integrated system (OASIS), Pubmed, Google scholar and Scopus. Results : Thirty-two studies were selected. There were nine studies on usual care and dressing, eleven studies on chemical agents, two studies on biological preparations, and ten studies on herbal medicines. Conclusion : Hygienic options and dressings have proved to be useful in the management of radiodermatitis. Chemical agents such as corticosteroid, statin, and topical antibiotic agent have proved to alleviate symptoms and severity, regenerate damaged skin, and prevent secondary infection. In biological preparations, EGF (epidermal growth factor) and GM-CSF (granulocyte-macrophage colony-stimulating factor) could be used to protect skin and prevent radiodermatitis. For herbal medicines, Calendula, catechin, β-sitosterol, and Jaungo (紫雲膏) may be effective for symptoms including pain, itching, and burning sensation induced by radiation therapy. Because of some research with conflicting results, further studies are needed to propose an algorithm for more optimal treatments.

• Asian Pacific Journal of Cancer Prevention
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• 제15권3호
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• pp.1155-1162
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• 2014

Background: Despite mixed survival data, the utilization of contralateral prophylactic mastectomy (CPM) for the prevention of a contralateral breast cancer (CBC) has increased significantly over the last 15 years, especially among women less than 40. We set out to look at our own experience with CPM, focusing on outcomes in women less than 40, the sub-population with the highest cumulative lifetime risk of developing CBC. With an extended follow-up, we hoped to demonstrate differences in the long-term disease free survival (DFS) and overall survival (OS) among groups who underwent the procedure (CPM) versus those that did not (NCPM). Materials and Methods: We performed a retrospective review of all breast cancer patients less than age 40 diagnosed at Mount Sinai Medical Center between January 1, 1980 and December 31, 2010 (n=481). Among these patients, 42 were identified as having undergone CPM, while 195 were confirmed as being CPM-free during the observation period. A univariate and multivariate analyses were performed. Results: The CPM group had a significantly higher percentage of patients who were diagnosed between 2000 and 2010 (95.2% vs 40%, p=0.0001). The CPM group had significantly smaller tumors (0-2cm.: 41.7% vs 24.8%, p=0.04). Among the entire group of patients, the overall five- and 10-year DFS were 81.3% and 73.3%, respectively. CPM was significantly associated [HR 2.35 (1.02, 5.41); p=0.046] with 10-year OS, although a similar effect was not observed for five-year OS. Conclusions: We found that CPM has increased dramatically over the last 15 years, especially among white women with locally advanced disease. In patients less than 40, who are thought to be at greatest cumulative risk of secondary breast cancer, CPM provided an OS advantage, regardless of genetics, tumor or patient characteristics, and which was only seen after 10 years of follow-up.

• Asian Pacific Journal of Cancer Prevention
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• 제16권11호
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• pp.4759-4768
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• 2015

Background: Several studies have investigated predictive and prognostic biomarkers for patients treated with anti-epidermal growth factor receptor (EGFR) agents in lung cancer. However, the conclusion is controversial. Materials and Methods: A meta-analysis was conducted to evaluate the associations of mutant K-ras, PIK3CA and PTEN deficiency with the efficacy of anti-EGFR agents in lung cancer. The primary endpoint was objective response rate (ORR). The secondary endpoints were overall survival (OS) and progression-free survival (PFS). Results: A total of 61 studies were included in the final meta-analysis. The result showed that K-ras mutation was a good predictor for ORR (RR=0.42, 95%CI, 0.33-0.55, p=0.000) and an effective prognostic marker for OS (HR=1.37, 95%CI, 1.15-1.65, p=0.001) and PFS (HR=1.33, 95%CI, 1.05-1.69, p=0.019). However, PTEN deficiency or PIK3CA mutation did not show any significance predictive value for ORR (PTEN, RR=0.82, 95%CI, 0.56-1.19, p=0.286; PIK3CA, RR=1.08, 95%CI, 0.17-6.66, P=0.938). And PTEN deficiency or expression of PIK3CA did not show significance prognostic value for OS (PTEN, HR=0.88, 95%CI, 0.31-2.46,P=0.805; PIK3CA, HR=0.79, 95%CI: 0.23-2.68, P=0.706). Conclusions: Our meta-analysis showed that K-ras mutation may be an effective predictor in lung cancer patients treated with anti-EGFR agents. Whereas, the predictive and prognostic value of PTEN deficiency and PIK3CA mutation need to be further investigated.

• Asian Pacific Journal of Cancer Prevention
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• 제15권24호
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• pp.10779-10782
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• 2015

Purpose: Analysis of descriptive epidemiological characteristics of pancreatic cancer in Vojvodina, Serbia. Materials and Methods: The study covers population of Vojvodina in the period from 2000 to 2009. The method used for data processing was the descriptive. The data, referring to a specified period of time, were analyzed from chronological and demographic aspects and according to histological diagnosis. Results: In the period from 2000 to 2009, there were 2,108 registered cases of pancreatic cancer of which 1,886 had a fatal outcome. Standardized incidence rates varied between 5.7 and 9.1 per 100,000 population in males and between 4.2 and 5.3 in females. Linear incidence trends in males in the specified period of time, based on crude (r=0.7883, p<0.05) and standardized (r=0,6373, p<0,05) incidence rates, demonstrated increase. Annual percent increase in the crude incidence rate was 4.5% in males, and 2.8% in females. Age-standardized mortality rates varied between 5.2 and 7.5 per 100,000 population in males and 3.6 and 4.7 in females. Linear mortality trends in males in the specified period of time, based on crude (r=0.8795, p<0.05) and standardized (r=0.7669, p<0.05) mortality rates, also demonstrated annual percent increase. Conclusions: Data analysis shows unfavorable onco-epidemiological situation related to pancreatic cancer in Vojvodina, in aspects of both incidence and mortality. Absence of primary and secondary prevention does not allow medical institutions to successfully fight against this disease.

• Journal of Preventive Medicine and Public Health
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• 제33권4호
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• pp.505-512
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• 2000

Objective : To estimate the significance of the Pap smear as a screening tool for cervical cancer. Methods : A total of 79,840 Pap smear results peformed at Pusan Paik Hospital over the 20 year period from 1979 to 1998 were collected and analyzed. Results : The number of Pap smear cases increased markedly during this period, and the results as a whole were classified as of 96.4% normal and benign cytology, 2.2% pre-cancerous cytology, and 1.4% cervical cancer. The relative frequency of cervical cancer decreased from 1.6% in 1979 to 0.7% in 1998. About 64% of the Pap smears were distributed within the age range of 30 to 49 years, and the rate of cervical cancer increased with age, age of marriage and experience of childbirth (p<0.01). The overall agreement of Pap smear results with histologic diagnosis by one histologic degree was 92.7%(1,128/1,217) with 73 overestimated cases and 16 underestimated cases of Pap smear compared to histologic diagnosis. Conclusion : This result implies that the Pap smear is an excellent screening tool for cervical cancer with respect to both its scale and validity. Periodic and active Pap smear testing would be helpful for the secondary prevention of cervical cancer.

• 여성건강간호학회지
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• 제27권4호
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• pp.368-378
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• 2021

Purpose: The purpose of this study was to explore the association between breastfeeding and the prevalence of breast, thyroid, and cervical cancer among Korean adult women. Methods: The study was a secondary analysis of data from the Korea Genome and Epidemiology Study. The final samples were 113,944 Korean women among 173,205 urban-based cohort participants collected between 2004 and 2013 for adults aged forty and over. To determine the association between female cancers and breastfeeding experience, the number of childbirth, and total breastfeeding duration, logistic regression analysis was done. The demographic characteristics, health behavior, and female history were adjusted. Results: The prevalence of breast cancer was 1.37 times higher in the non-breastfeeding group than in the breastfeeding group. Compared to having breastfed for more than 36 months, the prevalence of thyroid cancer was 1.68 times higher at breastfeeding for 13 to 36 months, 1.67 times higher at breastfeeding for 6 to 12 months, and 2.06 times higher at breastfeeding less than 6 months. Also, the prevalence of cervical cancer was 1.54 times higher at breastfeeding for 13 to 36 months, compared to breastfeeding for more than 36 months. Conclusion: The study found that breastfeeding experience and a longer breastfeeding duration are associated with reduced risk of breast, thyroid, and cervical cancer in Korean women. It can be used as a basis for encouraging breastfeeding, and suggests further research on modifiable factors that reduce cancer risks.

• 융합신호처리학회논문지
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• 제23권4호
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• pp.256-263
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• 2022

피부암은 세계에서 가장 흔한 질병 중 하나로 국내에선 발병률이 지난 5년 동안 약 100%가 증가했고 미국에선 매년 500만여 명이 피부암을 진단받는다. 피부암은 주로 자외선의 노출로 피부 조직이 오랜 시간 손상되면서 발생하게 된다. 피부암의 악성종양인 흑색종은 피부 위에서 발생하는 멜라닌 세포 모반과 생김새가 유사해 2차 징후가 발생하지 않는 한 일반인이 자각하기 어려운 점이 있다. 본 논문에서는 이러한 피부암의 조기 발견과 분류를 위해 피부암 병변 윤곽선 검출 알고리즘과 피부암 병변 분류를 수행하는 딥러닝 모델인 CRNN을 제안한다. 실험 결과 본 논문에서 제안하는 윤곽선 검출 알고리즘을 이용할 시 분류 정확도가 97%로 가장 높은 정확도를 보였고 Canny 알고리즘의 경우 78%를 보였고 Sobel의 경우 55%, Laplacian의 경우 46%를 보였다.

• 대한한의학회지
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• 제44권4호
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• pp.26-40
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• 2023

Objectives: This study was to evaluate the effectiveness and safety of Bojungikgi-tang for lung cancer patients with anorexia. Methods: This was a single-arm, open-label, and single-center trial, and suitable participants took Bojungikgi-tang (Buzhongyiqi-tang in Chinese, Hochuekki-to in Japanese) three times a day before or between meals for six weeks (42 days). After registration of clinical trials (visit 2), they visited the hospital every three weeks (visits 3 and 4) and measured or tested the effectiveness or safety evaluation variables to analyze the results. The primary outcome was the anorexia/cachexia subscale (A/CS) of functional assessment of anorexia/cachexia therapy (FAACT) score. Results: Seventeen lung cancer patients were included in the intention-to-treat (ITT) analysis. Lung cancer patients had higher A/CS of FAACT scores after six weeks of Bojungikgi-tang administration compared to that at the baseline. This was not significant four lung cancer (p=0.1668). In the secondary outcomes, the visual analog scale (VAS) score of anorexia decreased significantly (p=0.0009), and the CD4/CD8 ratio (p=0.0396) and CD4 levels (p=0.0345) significantly increased after six weeks of treatment. No serious adverse events were reported with Bojungikgi-tang in lung cancer patients. Conclusions: Bojungikgi-tang can be an effective and safe treatment for anorexia in lung cancer patients undergoing chemotherapy.

• Asian Pacific Journal of Cancer Prevention
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• 제13권2호
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• pp.421-425
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• 2012

Cancer can be a major cause of poverty. This may be due either to the costs of treating and managing the illness as well as its impact upon people's ability to work. This is a concern that particularly affects countries that lack comprehensive social health insurance systems and other types of social safety nets. The ACTION study is a longitudinal cohort study of 10,000 hospital patients with a first time diagnosis of cancer. It aims to assess the impact of cancer on the economic circumstances of patients and their households, patients' quality of life, costs of treatment and survival. Patients will be followed throughout the first year after their cancer diagnosis, with interviews conducted at baseline (after diagnosis), three and 12 months. A cross-section of public and private hospitals as well as cancer centers across eight member countries of the Association of Southeast Asian Nations (ASEAN) will invite patients to participate. The primary outcome is incidence of financial catastrophe following treatment for cancer, defined as out-of-pocket health care expenditure at 12 months exceeding 30% of household income. Secondary outcomes include illness induced poverty, quality of life, psychological distress, economic hardship, survival and disease status. The findings can raise awareness of the extent of the cancer problem in South East Asia and its breadth in terms of its implications for households and the communities in which cancer patients live, identify priorities for further research and catalyze political action to put in place effective cancer control policies.