• Title/Summary/Keyword: Secondary cancer

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30 Years of Radiotherapy Service in Southern Thailand: Workload vs Resources

  • Phungrassami, Temsak;Funsian, Amporn;Sriplung, Hutcha
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권12호
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    • pp.7743-7748
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    • 2013
  • Background: To study the pattern of patient load, personnel and equipment resources from 30-years experience in Southern Thailand. Materials and Methods: This retrospective study collected secondary data from the Division of Therapeutic Radiology and Oncology and the Songklanagarind Hospital Tumor Registry database, Faculty of Medicine, Prince of Songkla University, during the period of 1982-2012. Results: The number of new patients who had radiation treatment gradually increased from 121 in 1982 to 2,178 in 2011. Shortages of all kinds of personnel were demonstrated as compared to the recommendations, especially in radiotherapy technicians. In 2011, Southern Thailand, with two radiotherapy centers, had 0.44 megavoltage radiotherapy machines (cobalt or linear accelerator) per million of population. This number is suboptimal, but could be managed cost-effectively by prolonging machine operating times during personnel shortages. Conclusions: This study identified a discrepancy between workload and resources in one medical school radiotherapy center in Southern Thailand. This information is crucial for future strategic planning both regionally and nationally.

유방암 환자의 분노관리 자기효능감 증진 프로그램 개발 (Development of a Program for Anger Management Based on Self-efficacy in Patients with Breast Cancer)

  • 오복자;최승이
    • 성인간호학회지
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    • 제21권2호
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    • pp.199-211
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    • 2009
  • Purpose: The purpose of this study was to develop a program for anger management based on self-efficacy. Methods: In this study, four types of approaches to enhance anger control were developed; 1) a role play for vicarious experiences; 2) an assertive training for anger expression; 3) a 30-minute long education program & a 20-minute long telephone call coaching for verbal persuasion; and 4) a booklet for anger management and self care behaviors. One group pretest-posttest design was used for evaluating the program. Study subjects were 6 cancer patients undergoing chemotherapy. The group were received a 4-week intervention, 60 ~ 90 minutes a day weekly, and measured the variables at baseline, 4 weeks later. Anger-in, anger-out, and anger-control were measured by STAXI-K. Data was analysed by Wilcoxon using SPSS/WIN 12.0 program. Anger situation was analysed according to primary anger-thoughts and secondary anger-thoughts based on cognitive theories of anger. Results: The program for anger management consisted of a role play, assertive training, education, telephone call coaching and a booklet. The program revealed significantly less Anger-in (Z = -1.997, p = .046), anger-out (Z = -2.207, p = .027). No difference, however, was found in anger control (Z= -1.826, p=.068). Conclusion: This evaluation suggested that more assertive training and longer intervention may be needed to maximize anger control.

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Gastric Adenocarcinoma Secondary to Primary Gastric Diffuse Large B-cell Lymphoma

  • Sakr, Riwa;Massoud, Marcel Antoine;Aftimos, Georges;Chahine, Georges
    • Journal of Gastric Cancer
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    • 제17권2호
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    • pp.180-185
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    • 2017
  • Despite the decreasing incidence and mortality from gastric cancer, it remains a major health problem worldwide. Ninety percent of cases are adenocarcinomas. Here, we report a case of gastric adenocarcinoma developed after successful treatment of prior primary gastric diffuse large B-cell lymphoma (DLBCL). Our patient was an elderly man with primary gastric DLBCL in whom complete remission was achieved after R-CHOP (cyclophosphamide, adriamycin, vincristine, prednisolone plus rituximab) chemotherapy. Helicobacter pylori infection persisted despite adequate treatment leading to sustained chronic gastritis. The mean time to diagnose metachronous gastric carcinoma was seven years. We believe that a combination of many risk factors, of which chronic H. pylori infection the most important, led to the development of gastric carcinoma following primary gastric lymphoma. In summary, patients who have been successfully treated for primary gastric lymphoma should be followed up at regular short intervals. H. pylori infection should be diagnosed promptly and treated aggressively.

Nine months versus 12 months of adjuvant trastuzumab for patients with HER2-positive breast cancer

  • El-Enbaby, Ashraf Mahmoud;El Moneim, Nadia Ahmed Abd;Khedr, Gehan Abd El atti;Elwany, Yasmine Mohamed Nagy
    • 대한종양외과학회지
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    • 제14권2호
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    • pp.108-115
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    • 2018
  • Purpose: This study aimed to compare the results of treatment with adjuvant trastuzumab for 9 months versus 12 months in human epidermal growth factor 2 (HER2)-positive breast cancer patients. The primary endpoint was disease-free survival. Secondary endpoints included cardiac safety, tolerability, and overall survival. Methods: The study included 60 non-metastatic HER2-positive breast cancer patients. All study patients underwent surgery, received adjuvant chemotherapy, radiotherapy and hormonal therapy if indicated. Thirty patients were randomized in each group. Group I patients received adjuvant trastuzumab for 12 months, while group II patients received adjuvant trastuzumab for 9 months. Patients were assessed by clinical examination and Echocardiography during treatment. Results: After median follow-up of 12 months, 90% of the patients in group I were disease free and 83.3% of patients in group II were disease free (P=0.402). All studied population in both groups I and II were alive at the end of the 1-year follow-up period after the completion of adjuvant trastuzumab treatment thus overall survival is 100%. Conclusion: Trastuzumab is tolerable and its side effects are reversible. Nine months of adjuvant trastuzumab treatment is more cost effective than the standard 12 months.

간호사의 암성 통증관리 수행정도와 관련요인: 개인 및 병원 기관 요인 (Factors Affecting Nurses' Pain Management for Cancer Patients: Personal and Hospital Institution Aspects)

  • 송호정;김광숙
    • 임상간호연구
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    • 제16권3호
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    • pp.25-37
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    • 2010
  • Purpose: The purpose of this study was to examine potential factors related to the management of cancer pain, that is, hospital institutional factors as well as personal aspects of nurses. Methods: This study was a descriptive research study in which 229 RNs working in 2 tertiary medical institutions in Seoul and 4 secondary medical institutions in Seoul, Incheon and Gyeonggi were surveyed. Results: It was found that nurses' knowledge about pain intervention, their working division and their knowledge about the use of analgesics had different effects on their pharmacologic interventions. These 3 variables explained 14.5% of the variance regarding pharmacologic interventions. On the other hand, nurses' knowledge about pain interventions and nursing organization were variables affecting non-pharmacologic interventions by the nurses. These two variables explained 22.1% of the variance regarding non-pharmacologic interventions by the nurses. Conclusion: The findings indicate that nursing organization, one of hospital institutional factors, had significant effects on non-pharmacologic interventions. Therefore, to increase effective pain management by nurses, an organizational system should be established such as placement of nurse practitioners, improvement of nurses' autonomy in pain management, and development and distribution of standardized guidelines.

Li-Fraumeni 증후군 환자에서 방사선 치료 후 발생한 유방암: 증례 보고 (Breast Cancer after Radiation Therapy in a Patient with Li-Fraumeni Syndrome: A Case Report)

  • 윤인나;차은숙;김정현;이지은;정진
    • 대한영상의학회지
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    • 제83권1호
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    • pp.246-251
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    • 2022
  • Li-Fraumeni 증후군(이하 LFS)은 TP53 종양 억제 유전자의 생식세포 돌연변이로 인한 상염색체 우성 종양 유발 유전 질환이다. LFS 환자에서는 치료 후 치료와 관련된 암이 발생하기 때문에 LFS 환자에서 발생한 유방암의 치료에 있어 방사선 요법을 피해야 한다. 저자들은 LFS 환자에서 발생한 유방 육종의 방사선 및 화학 요법 치료 후 발생한 유방암 증례를 보고한다.

말단 회장의 게실염에 동반된 혈전정맥염: 증례 보고 (Superior Mesenteric Venous Thrombophlebitis with Terminal Ileal Diverticulitis: A Case Report)

  • 박양일;김영한;이병희
    • 대한영상의학회지
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    • 제81권6호
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    • pp.1492-1496
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    • 2020
  • 장간막 혈전정맥염은 장의 허혈 및 경색을 일으킬 수 있는 드문 질환으로, 게실염이나 충수돌기염 등의 염증성 장질환으로 인해 이차적으로 발생한다. 게실 질환에 의해 발생한 장간막 혈전정맥염의 빈도는 매우 낮고 증상이 비특이적이므로 영상학적 진단이 매우 중요하다. 저자들은 61세 여성의 전산화단층촬영에서 말단 회장의 게실염에 동반된 상장간막 혈전정맥염으로 진단받고 항생제, 경구 항응고제 치료 및 우반 결장 절제술 후 혈전정맥염이 소실된 증례를 경험하여 보고한다.

방광요로상피암에서 드물게 나타나는 피부와 목 림프절로의 전이: 증례 보고 (Rare Manifestation of the Cutaneous and Cervical Lymph Node Metastases of Urothelial Carcinoma of Urinary Bladder: A Case Report)

  • 심우열;박노혁;정윤양
    • 대한영상의학회지
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    • 제84권6호
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    • pp.1403-1407
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    • 2023
  • 방광암의 림프절 전이는 방광의 림프순환에서 처음과 두 번째로 거쳐 가는 외/내 장골, 폐쇄림프절과 총장골림프절에서 주로 일어난다. 방광암에서 횡격막을 넘어서 일어나는 전이는 드물고, 두경부로의 전이는 예후가 좋지 않으며 생존율도 낮다. 방광요로상피암 환자에서 뼈나 그 외에 고형장기로의 전이 없이 목 피부의 염증성 변화와 함께 림프절전이를 동반하는 것은 드문 증례이므로 이에 보고하고자 한다.

국립암센터의 양성자 치료를 위한 수동형 다엽 콜리메이터 개발 (Development of Manual Multi-Leaf Collimator for Proton Therapy in National Cancer Center)

  • 이누리;김태윤;강동윤;최재혁;정종휘;신동호;임영경;박정훈;김태현;이세병
    • 한국의학물리학회지:의학물리
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    • 제26권4호
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    • pp.250-257
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    • 2015
  • 양성자 치료를 위해서는 Snout이 부착된 받침대(gantry)를 사용하는데 빔의 형태를 만들기 위해 환자 종양의 크기와 거리에 맞게 황동 차폐체(aperture)가 많이 사용된다. 또한 빔의 거리를 보정하기 위해 PMMA를 이용한 거리 보상체도 사용된다. 이렇게 황동으로 만들어진 차폐체의 경우 가공하는데 많은 시간이 소요되며 비용 발생이 높다. 또한 치료 사용되었던 차폐체의 방사선 노출에 따라 재사용이 어렵다. 이러한 단점을 보안하기 위해 황동 차폐체 대신 X-선 치료에서 사용되는 수동형 다엽 콜리메이터 시스템을 도입하였다. 수동형 다업 콜리메이터는 여러 개의 황동판을 조립하여 차폐체를 제작하는 방식이다. 본 연구는 제작된 수동형 다엽 콜리메이터의 방사화 실험 및 필름을 이용해 선량측정을 진행하였다. 다엽 콜리메이터를 투과한 2차 발생 선량 1% 이하였으며, 여러 번의 230 MeV의 빔에서도 방사화가 2시간 이내에서 감소하였다. 이렇게 개발된 수동형 다엽 콜리메이터를 임상에 적용하여 일반 차폐체와 수동형 다엽 콜리메이터를 감마지표 분석을 했을 시 99.74%의 높은 일치도가 측정되었다. 또한, 일반 황동 차폐체에 비해 수동형 다엽 콜리메이터를 제작하는데 소요되는 비용과 시간을 1/10 이상 단축시킬 수 있다. 개발된 수동형 다엽 콜리메이터는 성공적으로 양성자 환자치료에 사용하고 있다.

Testicular Cancer and Testicular Self-Examination; Knowledge, Attitudes and Practice in Final Year Medical Students in Nigeria

  • Ugwumba, Fred O;Ekwueme, Osa Eloka C;Okoh, Agharighom D
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권11호
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    • pp.4999-5003
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    • 2016
  • The testicular cancer (TCa) incidence is increasing in many countries, with age-standardized incidence rates up to 7.8/100,000 men in the Western world, although reductions in mortality and increasingly high cure rates are being witnessed at the same time. In Africa, where rates are lower, presentation is often late and morbidity and mortality high. Given this scenario, awareness of testicular cancer and practice of testicular self-examination among future first response doctors is very important. This study was conducted to determine knowledge and attitude to testicular cancer, and practice of testicular self-examination (TSE) among final (6th) year medical students. In addition, the effect of an intervention in the form of a single PowerPoint(R) lecture, lasting 40 minutes with image content on testicular cancer and testicular self examination was assessed. Pre and post intervention administration of a self-administered structured pre tested questionnaire was performed on 151 medical students, 101 of whom returned answers (response rate of 66.8%). In the TC domain, there was a high level of awareness of testicular cancer, but poor knowledge of the age group most affected, with significant improvement post intervention (p<0.001). Notable also was the poor awareness of the potential curability of TC, this also being improved following the intervention (p<0.001). A poor level of awareness and practice of testicular self-examination pre-intervention was found considering the nature of the study group..Respondents had surprisingly weak/poor responses to the question "How important to men's health is regular testicular self-examination?" Answers to the questions "Do you think it is worthwhile to examine your testis regularly?" and "Would you be interested in more information on testicular cancer and testicular self-examination?" were also suboptimal, but improved post intervention p<0.001, p<0.001 and p=0.037. Age, gender and marital status were without specific influence. In conclusion, this study showed poor levels of knowledge regarding epidemiology of TCa and its potential curability when detected early. There was also a poor awareness of, practice of, and poor attitudes to TSE. The significant improvement in these parameters post intervention indicates value in educational intervention. We recommend inclusion of TCa coverage and TSE teaching in the secondary school curriculum (targeting adolescents). Greater emphasis should also be given to testicular cancer in the curricula of medical schools and other training institutions for health care personnel.