• Journal of Korean Academy of Nursing
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• v.45 no.6
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• pp.812-822
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• 2015

Purpose: The purpose of this study was to examine the effect of lifestyle intervention on the development of fatigue, nutritional status and quality of life of patients with gynecologic cancer. Methods: A nonequivalent control group quasi-experimental design was used. Participants were 49 patients with gynecologic cancer. They were assigned to the experiment group (n=24) or the control group (n=25). The lifestyle intervention for this study consisted of physical activity, nutritional education, telephone call counseling, health counseling, monitoring for lifestyle, and affective support based on Cox's Interaction Model of Client Health Behavior and was implemented for six weeks. Results: Significant group differences were found for fatigue (p =.037), nutritional status (p =.034) and social/family well-being (p =.035) in these patients with gynecologic cancer. Conclusion: Results indicate that this lifestyle intervention is effective in lessening fatigue, and improving nutritional status and social/family well-being. Therefore, nurses in hospitals should develop strategies to expand and provide lifestyle interventions for patients with cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4637-4642
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• 2016

Purpose: To evaluate palliative care for patients with gynecologic cancer in Japan. Materials and Method: A questionnaire asking facility characteristics, systems to coordinate palliative care, current status of end-of-life care, provision of symptom relief, palliative radiation therapy and chemotherapy, and cases of death from gynecological cancer, was mailed to facilities treating gynecologic cancer. Results: A total of 115 facilities (29.3% of the total) responded to the questionnaire. Of these, 33.0 (29.0%) had a palliative care ward. End-of-life care was managed by obstetricians and gynecologists in 72.0% of the facilities. The site where end-of-life care was provided was most often a ward in the department where the respondent worked. The waiting period for transfer to a hospice was 2 weeks or more in 52% of facilities. Before the start of primary treatment, pain control was managed by obstetrians and gynecologists in 98.0% of facilities. Palliative radiation therapy or chemotherapy was administered at 93.9% and 92.0% of facilities, respectively. Of the 115 facilities, 34.0 (29.6%) reported cases of death from gynecological cancer. There were 1,134 cases of death. The median time between the last cycle of chemotherapy and death was 85 days for all gynecological cancers. The proportion of patients receiving chemotherapy in the last 30 and 14 days of life were 17.4% and 7.1%, respectively. Conclusions: This large-scale survey showed characteristics of palliative care given to patients with gynecologic cancer in Japan. Assessment of death cases showed that the median time between the last cycle of chemotherapy and death was relatively short.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.11
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• pp.4571-4576
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• 2015

Background: To investigate the inhibitory effect and the underlying mechanism of triptolide on cultured human endometrial carcinoma HEC-1B cells and corresponding xenograft. Materials and Methods: For in vitro studies, the inhibition effect of proliferation on HEC-1B cell by triptolide was determined by MTT assay; cell cycle and apoptosis of the triptolide-treated and untreated cells were detected by flow cytometry. For in vivo studies, a xenograft tumor model of human endometrial carcinoma was established using HEC-1B cells, then the tumor-bearing mice were treated with high, medium, and low-dose ($8{\mu}g$, $4{\mu}g$ and $2{\mu}g/day$) triptolide or cisplatin at $40{\mu}g/day$ or normal saline as control. The mice were treated for 10-15 days, during which body weight of the mice and volume of the xenograft were weighted. Then expression of Bcl-2 and vascular endothelial growth factor (VEGF) was analyzed by SABC immunohistochemistry. Results: Cell growth was significantly inhibited by triptolide as observed by an inverted phase contrast microscope; the results of MTT assay indicated that triptolide inhibits HEC-1B cell proliferation in a dose and time-dependent manner; flow cytometry showed that low concentration (5 ng/ml) of triptolide induces cell cycle arrest of HEC-1B cells mainly at S phase, while higher concentration (40 or 80 ng/ml) induced cell cycle arrest of HEC-1B cells mainly at G2/M phase, and apoptosis of the cells was also induced. High-dose triptolide showed a similar tumor-inhibitory effect as cisplatin (-50%); high-dose triptolide significantly inhibited Bcl-2 and VEGF expression in the xenograft model compared to normal saline control (P<0.05). Conclusions: triptolide inhibits HEC-1B cell growth both in vitro and in mouse xenograft model. Cell cycle of the tumor cells was arrested at S and G2/M phase, and the mechanism may involve induction of tumor cell apoptosis and inhibition of tumor angiogenesis.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6077-6081
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• 2012

Background: This study was performed to analyze the prognostic implications of pretreatment or preoperative thrombocytosis in women with gynecologic malignancies. Material and Methods: We surveyed 2 medical databases, PubMed and EMBASE, to identified all relevant studies. A total of 14 (n=3,490) that evaluated the link between thrombocytosis and 5-year survival were included. REVMAN version 5.1 was used for our analysis and publication bias was evaluated using the Begg's funnel plot and tested by STATA 11.0. Risk ratios (RRs) with 95% confidence intervals (CIs) generated by the random effect model were used to assess the strength of any association. Results: 709(20.3%) of the 3,490 patients exhibited thrombocytosis (platelet counts > $400{\times}10^9/L$) at primary diagnosis, and their mortality was 1.62-fold higher compared with the others (RR=1.62, 95%CI=[1.28-2.05], p<0.0001). Thrombocytosis failed to have a stronger effect on the survival of advanced patients of stages III to IV in our study (n=478, RR=1.29, 95% CI=[1.13-1.48], p=0.0003), nor in women with cervical cancer in stage IB (n=1371, RR=1.73, 95% CI=[1.71-2.58], p=0.007). In addition, when adjusted for different carcinoma, it was associated with worse prognosis for all except the ones with vulvar cancer (n=201, RR=0.43, 95% CI=[0.14-1.29], p=0.13). Conclusions: This meta-analysis indicated that thrombocytosis might be associated with a worse prognosis for patients with gynecologic malignancies but without specificity or sensitivity for the ones in advanced stage. When adjusted for different gynecologic malignancies, it showed a significant effect on survival of all except vulvar cancers.

• Women's Health Nursing
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• v.24 no.3
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• pp.287-296
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• 2018

Purpose: To determine impacts of psychological distress, gender role attitude, and housekeeping sharing on quality of life of gynecologic cancer survivors. Methods: Subjects completed questionnaires consisting of four measurements: FACT-G (ver. 4) for quality of life, anxiety and depression from SCL-90-R for psychological distress, gender role attitude, and housekeeping sharing. A total of 158 completed data sets were analyzed by descriptive statistics, independent t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis using SPSS 21.0 program. Results: Quality of life was significantly and negatively correlated with psychological distress (r=-0.64, p<.001), but not with gender role attitude (r=-0.14, p=.820) or housekeeping sharing (r=0.08, p=.350). Psychological distress was significantly and positively correlated with gender role attitude (r=0.25, p<.010). Factors that significantly impacted quality of life were type of cancer (t=2.27, p=.025), number of treatment methods (t=2.58, p=.011), education level (t=3.33, p<.001), and psychological distress (t=-9.96, p<.001). Conclusion: Nursing interventions that can relieve psychological distress need to be developed for gynecologic cancer survivors. Nurses need to put priority on ovarian cancer survivors who have low education level with multiple treatment methods when performing nursing interventions to improve the quality of life of gynecologic cancer survivors.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.5589-5597
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• 2013

The aim of this review article was to evaluate the relationship and the possible etiological mechanisms between endometriosis, leiomyoma (LM) and adenomyosis and gynecological cancers, such as ovarian and endometrial cancer and leiomyosarcoma (LMS). MEDLINE was searched for all articles written in the English literature from July 1966 to May 2013. Reports were collected systematically and all the references were also reviewed. Malignant transformation of gynecologic benign diseases such as endometriosis, adenomyosis and LM to ovarian and endometrial cancer remains unclear. Hormonal factors, inflammation, familial predisposition, genetic alterations, growth factors, diet, altered immune system, environmental factors and oxidative stress may be causative factors in carcinogenesis. Early menarche, low parity, late menopause and infertility have also been implicated in the pathogenesis of these cancers. Ovarian cancers and endometriosis have been shown to have common genetic alterations such as loss of heterozygosity (LOH), PTEN, p53, ARID1A mutations. MicroRNAs have also been implicated in malignant transformation. Inflammation releases proinflammatory cytokines, and activates tumor associated macrophages (TAMS) and nuclear factor kappa b (NF-KB) signaling pathways that promote genetic mutations and carcinogenesis. MED12 mutations in LM and smooth muscle tumors of undetermined malignant potential (STUMP) may contribute to malignant transformation to LMS. A hyperestrogenic state may be shared in common with pathogenesis of adenomyosis, LM and endometrial cancer. However, the effect of these benign gynecologic diseases on endometrial cancer should be studied in detail. This review study indicates that endometriosis, LM, adenomyosis may be associated with increased risk of gynecological cancers such as endometrial and ovarian cancers. The patients who have these gynecological benign diseases should be counseled about the future risks of developing cancer. Further studies are needed to investigate the relationship between STUMPs, LMS and LM and characteristics and outcome endometrial carcinoma in adenomyotic patients.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3561-3564
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• 2013

Background: The negative effects of gynecologic cancer on women's health is multidimensional. Sexual problems arising after chemotherapy are decreased interest and vaginal lubrication, lack of orgasm and dyspareunia and sense of reduction in sexual attractiveness in general. The purpose of this study was to evaluate changes that patients who receive chemotherapy for a gynecologic oncology disorder experience in their sexual functions. Materials and Methods: A descriptive/cross-sectional and qualitative study was performed. The Female Sexual Function Index (FSFI) was used in order to collect data on sexual capacity. The quantitative data obtained were evaluated with frequency and percentage calculations while content analysis was performed for the qualitative data. Results: All of the information related to sexuality was provided by the physician. Chemotherapy treatment affected sexuality negatively in 55.9%. Since receiving the diagnosis, 52.9% of women had experienced no sexual intercourse at all. Those who had an FSFI score of 30 and below made up 75% of the women. After the content analysis of data obtained during in in-depth interviewing, we focused on three main themes: desire for sexual intercourse, problems experienced during sexual intercourse, and coping with problems. Conclusions: An integrated system where sexual problems can be handled professionally should be present during gynecological cancer treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6233-6237
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• 2014

Background: Intraperitoneal spread of gynecologic cancers is a major cause of mortality and morbidity and often presents with malignant ascites. Microscopic tumor spread can be demonstrated by a peritoneal wash cytology and help assess the prognosis of the disease. In our study, the roles of paraoxonase and ceruloplasmin, measured in peritoneal washing fluid of patients operated for gynecologic pathologies in differential diagnosis was investigated. Materials and Methods: Patients operated for malign or benign gynecologic pathologies in Antalya Education and Research Hospital Gynecology Clinic between 2010-2012 were included in the study. Samples were obtained during surgery. Results: A statistically significant difference was detected between patients with benign and malign diseases with regards to PON1 levels measured in peritoneal washing fluid (p:0.044), the average values being $64.2{\pm}30.8$ (Range 10.8-187.2) and $41.4{\pm}21.4$ (Range 10.4-95.5), respectively. No significant variation was evident for ceruloplasmin. Conclusions: Paraoxonase levels measured in peritoneal washing fluid may contribute to the differentiation of malign-benign diseases in gynecologic pathologies.

• Journal of Korean Academy of Nursing
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• v.43 no.5
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• pp.681-689
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• 2013

Purpose: The purpose of this study was to examine effects of the Permission, Limited Information, Specific Suggestions, Intensive Therapy (PLISSIT) model sexual health enhancement program on, and development in, sexual function, sexual distress, marital intimacy, and subjective happiness of women with gynecologic cancer and their husbands. Methods: The comprehensive program (4 session, 90 minutes per session) was developed based on the PLISSIT model. Participants were 43 couples, 21 assigned to the experimental group who attended the 4-week program, and 22 to the control group. Sexual function, sexual distress, marital intimacy, subjective happiness of the women, marital intimacy, subjective happiness of husbands were determined by a questionnaire that was completed by the participants before and after the program. The control group received the intervention post experiment. Chi-square test, t-test, Fisher's exact test were used to test the effectiveness of the program. Results: Post intervention results showed significant differences between the groups for sexual function, sexual distress, and marital intimacy in the women and for subjective happiness in the husbands. Conclusion: Results indicate that the sexual health enhancement program is effective in improving sexual function, lowering sexual distress, increasing marital intimacy, and subjective happiness in women with gynecologic cancer and their husbands.

• Asian Oncology Nursing
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• v.10 no.1
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• pp.88-94
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• 2010

Purpose: This study was to identify the effect of hand massage on comfort in women with gynecologic cancer undergoing chemotherapy. Methods: A nonequivalent control group pretest-posttest design was used for this study. Hand massage was provided to the experimental group for 5 min (2.5 min for each side) once on admission day, twice from the second day until the day before discharge, and once in the morning on discharge day. Results: Findings showed no significant differences in pre and post levels of general, physical, psycho-spiritual, social and environmental comfort. However, women's comfort levels in all domains were increased after the chemotherapy in the experimental group. Conclusion: Although there were some increases in women's comfort levels on all domains after the treatment, hand massage was not proved as a statistically useful nursing intervention in comforting women with gynecologic cancer. The results suggest that hand massage could be effective if it is applied longer than it was in this study. The future implications of hand massage in patients with various cancers are discussed.