Background: Western physicians tend to favour complete disclosure of a cancer diagnosis to the patient, while non-Western physicians tend to limit disclosure and include families in the process; the latter approach is prevalent in clinical oncology practice in India. Few studies, however, have examined patient preferences with respect to disclosure or the role of family members in the process. Materials and Methods: Structured interviews were conducted with patients (N=127) in the medical oncology clinic of a tertiary referral hospital in Bangalore, India. Results: Patients ranged in age from 18-88 (M=52) and were mostly male (59%). Most patients (72%) wanted disclosure of the diagnosis cancer, a preference significantly associated with higher education and English proficiency. A majority wanted their families to be involved in the process. Patients who had wanted and not wanted disclosure differed with respect to their preferences regarding the particulars of disclosure (timing, approach, individuals involved, role of family members). Almost all patients wanted more information concerning their condition, about immediate medical issues such as treatments or side effects, rather than long-term or non-medical issues. Conclusions: While most cancer patients wanted disclosure of their disease, a smaller group wished that their cancer diagnosis had not been disclosed to them. Regardless of this difference in desire for disclosure, both groups sought similar specific information regarding their cancer and largely favoured involvement of close family in decision making. Additional studies evaluating the influence of factors such as disease stage or family relationships could help guide physicians when breaking bad news.
Background: Tumor associated fatigue (TAF) or cancer related fatigue (CRF) is not a new concept. Nonetheless, no real headway has been made in the quantitative analysis of its successful treatment via cognitive behavioral therapy. Since 20 to 30% of all breast cancer patients suffer from anxiety and/or depression within the first year of their diagnosis, this issue needs to be addressed and a standard treatment protocol has to be developed. This study focused on developing a simple, reproducible and short (8 weeks) protocol for the cognitive behavioral therapy support of tumor associated fatigue patients. Materials and Methods: Between the year 2011 and 2012, 23 breast cancer patients fulfilled the diagnosis TAF requirements and were introduced into this study. Our method focused on a psycho-oncological support group using a predetermined, highly structured and reproducible, cognitive behavioral therapy treatment manual. Eight weekly, 90 minute sessions were conducted and patients were evaluated before and after this eight session block. Tumor fatigue specific questionnaires such as the multidimensional fatigue inventory (MFI) as well as the hospital anxiety and depression scale (HADS) were used in order to quantitatively evaluate patient TAF. Results: Of the 23 patients enrolled in the study, only 7 patients fulfilled the TAF diagnostic criteria after the psycho-oncological group treatment. This represents a 70% reduction in diagnosable tumor associated fatigue. The HADS analysis showed a 33% reduction in patient anxiety as well as a 57% reduction in patient depression levels. The MFI scores showed a significant reduction in 4 of the 5 evaluate categories. With the exception of the "mental fatigue" MFI category all results were statistically significant. Conclusions: This study showed that a highly structured, cognitive behavioral therapy group intervention will produce significant improvements in breast cancer patient tumor associated fatigue levels after only 8 weeks.
Cancer is a disease that threatens the individual's life. This is why the cancer patient goes through psychosocial pain in the form of a trauma. Thus, the previous researches have only focused on the cancer patient's psychosocial distress. However, the cancer patients who have grown more mature and brought upon positive changes in their lives have been clinically observed. Because of this, researches regarding the ways that social welfare can intervene in order to examine the cancer patients' positive changes and growth which breaks away from the previous pathological point of view of the cancer patients are being actively conducted in other countries. But it turns out that there aren't enough basic researches related to this topic and thereby the need to lay out the basis for social welfare intervention. Therefore, this research examines positive changes and growth that may result from the traumatic experience of having a cancer. The predictable factors regarding this are analyzed in order to provide the basic information that may promote clinical intervention for cancer patient's posttraumatic growth. For this, the information from 206 cancer patients who have agreed to participate in the research have been used to predict and evaluate the predictable factors for the cancer patient's post-traumatic growth and hierarchy multiple regression haven been analyzed. As the result of the research, main factor of the post-traumatic growth is found to be social support and coping. The positive reconstruction of coping has been discovered to be the strongest predictable factor for cancer patient's posttraumatic growth. Based on this result, the advice for further research and implications for social welfare have been given.
The purpose of this study was to assess the nutritional status of cancer patients and non-cancer patients who were admitted to an internal medical department and to determine the degree of malnutrition among these patients. The study was performed from May to July l996 with 151 subjects recruited from the general medical department at D University Hospital. For nutritional assessment the anthropometric and biochemical assessment were performed. Biochemical measurements included serum hemoglobin, albumin, and lymphocytes. For anthropometric assessment, patient's body weight, skinfold thickness in four areas, body mass index, and percent of body fat were measured. The results were as follows : 1) Of the 151 patients who were studied, 47 patients had cancer while 104 patients had non cancer related disease. The mean age of the cancer patients was 57 and 52 for non cancer patients. The percentage of patients who had lost body weight during the last 6 months was 29.8% in cancer patients and 15.4% in non cancer patients. This percentage difference between the 2 groups was statistically significant. However, there was no statistical significance between the 2 groups in gastrointestinal symptoms which lasted more than 2 weeks. 2) There was a statistically significant difference in nutritional status(lympocyte : P=.002 ; skinfold thickness in four areas : p<0.05) between the cancer and the non-cancer patients. The percentage of the patients who had the possibility of malnutrition was 65.5% in cancer patients and 6% in non-cancer patients. 3) There was a correlation between the weight loss during the last 6 months before admission and body mass index and skinfold thickness.
Nasopharyngeal cancer is malignant tumor of nasopharyngeal area that is characterized of lymphadenopathy, pain, otitis media, hearing loss and cranial nerve palsy and may present symptoms similar to temporomandibular disorder such as facial pain and trismus. In this case, the patient with symptoms similar to temporomandibular disorder after surgery for otitis media presented with facial paresthesia and masticatory muscle weakness. Examinaion of trigemimal nerve was shown sensory and motor abnormaility. The patient was referred to a neurologist. Nasopharyngeal cancer was suspected on computed tomography and magnetic resonance imaging and was confirmed by biopsy. If the patient presenting with paresthesia and muscle weakness the cranial nerve examination should be performed regardless of typical temporomandibular disorder symptom. The neurologic symptom can be caused by neoplasm such as brain tumor and nasopharyngeal cancer. Nasopharyngeal cancer on rosenmuller fossa can develop otitis media. Therefore, the patient with otitis media history should be consulted to otorhinolaryngologist to examin the nasopharyngeal area.
This study was performed on the basis of clinical consideration about patient who has hepatocholangiocarcinoma, and pancreatic cancer. Cancer has gradually increased morbidity and mortality all over the world including Korea. Western medicine has treated with surgical therapy, chemotherapy, radiotherapy and immunotherapy, but has not obtained outstanding results and has a difficulty due to side effects by those therapies. In this study, we recognized that symptom including hypochondriac pain by cancer are rapidly decreased with herbal medication treatment and acupuncture therapy. Oriental medicine treatment is applied throughly on the basis of the oriental medicine principle and the prescriptions were used Naeso-oksultang(內消沃雪湯). According to the above results, we can know this patient has improvement of patient's symptom on administration of oriental medicine treatment, it is helpful in decresing symptoms of patient and in improving quality of life.
The purpose of the study is to explore and describe the lived experience of family members with gastric cancer patients using the grounded theory methodology. The participants were ten spouses of gastric cancer patients who had some kind of treatment at the hospital. They were asked open-ended and descriptive questions in order for them to talk about their experiences in their own terms. As the interveiw progressed the questions became more specific to discuss themes and working hypotheses that emerged from the analysis of previous interviews. All interviews were tape-recorded and transcribed for the analysis. Constant the core category that was emerged from the comparative analysis is “magmaggam” which can be described as a psychological distress due to a high level of uncertainty regarding the health of the patient and the future of the caregivers. Psychological distress includes several emotional feelings such as frustration. anxiety, fear, guilty, and self depreciation. Subcategories or strategies related to the core category are 1) managing illness, 2) using folk medicine, 3) giving the patient a reason to live, 4) being patient, 5) losing reality, 6) anticipatory experience on the patient's death and parting, and 7) changing interpersonal relationships. The results of this study would help clinical nurses to develop nursing intervention to help spouses of gastric cancer patients establish efficient coping strategies in dealing with the problems they face.
Purpose: The study was to examine the relationships between stress, ways of coping and burnout among family caregivers of cancer patients. Methods: Data were collected by self-reported questionnaires from 207 family caregivers of cancer patients at one university hospital and one general hospital in Busan, Korea. The instruments included a Stress Scale, a Ways of Coping Scale and a Burnout Scale. The collected data were analyzed using frequency, percentage, t-test, ANOVA, Scheffe's test, and Pearson's correlation coefficients with the SPSS WIN 19.0 program. Results: Stress was found to have significant relationships with age, relation to the patient, education, monthly income, degree of care-giving, financial burden and activities of daily living of patient. In active coping, there were significant differences according to education and religion. Passive coping was significantly related to gender. In burnout, there were significant differences according to age, relation to the patient, education, occupational status, monthly income, degree of care-giving, financial burden and activities of daily living of patient. Stress and burnout showed a positive correlation, while there was a negative correlation between burnout and active coping. Conclusion: These results suggest that promoting active coping would better support family caregivers of cancer patients in managing burnout effectively.
Objectives : The purpose of this study is to report the effect of Korean medicine on the pancreatic carcinoma patient. Method : A patient was diagnosed as unresectable pancreatic carcinoma. She complained insomnia, abdominal pain, dyspepsia and sleep disturbance. She was treated by Korean medicine composed of acupuncture, herbal medication and wild ginseng pharmacopuncture. Results : All symptoms took a favorable turn after Korean medicine treatment. As treatment was performed, as intensity of pain, insomnia, dyspepsia and fatigue were decreased. Conclusion : This study suggests that Korean medicine treatment has effectiveness for improvement of cancer related symptoms of a pancreatic carcinoma patient. Consequently, the treatment is helpful in improving quality of life.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
/
v.35
no.3
/
pp.114-122
/
2022
Objective : The purpose of this study is to report the effect of Korean medicine treatments of abducens nerve palsy after cancer immunotherapy. Methods : A 63-year-old male patient who was suffering hepatocellular carcinoma had left eye abduction restriction, diplopia, and decreased visual acuity after taking 5th cancer immunotherapy(atezolizumab + bevacizumab). Western medicine was administered for 3 weeks, but there was no response. The patient was treated with herbal medicine, acupuncture, electroacupuncture, moxibustion and bee venom pharmacoacupuncture for 4 weeks. Result : The patient's eye abduction restriction and diplopia were resolved. Visual acuity was improved from NRS(Numerical Rating Scale) 8 to NRS 2. The patient continued immunotherapy and there was no worsening of symptoms. No adverse events were observed. Conclusions : This study shows that Korean medicine treatments were effective on abducens nerve palsy after cancer immunotherapy.
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