• Title/Summary/Keyword: long-term cancer survivors

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Survey of Brassiere Related Clothing Tendency for Mastectomy Patients (유방절제 환자의 브래지어 착용 관련 의생활 분석연구)

  • Kim, Youn Joo;Koo, Da Som;Nam, Yun Ja;Seo, Kwan Sik;Lee, Eun Shin;Noh, Dong Young;Cho, Kyu Jin
    • Fashion & Textile Research Journal
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    • v.21 no.6
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    • pp.800-812
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    • 2019
  • Secondary diseases that occur during the rehabilitation of breast cancer survivors are factors that can negatively change the physical and psychological state of the patient. The rehabilitation after treatment of breast cancer survivors is an important process to prevent cancer recurrence and increase the survival rate because a negative psychological state significantly impacts the long-term survival rate. This study identifies user requirements for the development of functional bras for mastectomy patients in Korea. Participants included 133 patients with one or more breasts removed due to breast cancer and an average age of 53.2 years (53.21 ± 7.57 years, minimum 33 years, maximum 69 years). Women in their 50s had the highest participation rate of 48.9%. Most maintained the same bra size before surgery; however, some experienced changes in bra size because they are not irritated by wounds caused by surgery. Therefore, it is important to pay attention to material when designing a functional bra because it can irritate the surgical site. Only about 41.4% of bras were worn by breast cancer patients because of price burden and lack of education, not complaints related to clothing design and wearability or body shape. Most purchases at hospitals or medical institutions require consultation with a specialist who provides information about a bra mainly at the hospital. The most important considerations when buying a breast cancer bra were size, fit and shape stability.

Growth hormone treatment and risk of malig­nancy

  • Chae, Hyun-Wook;Kim, Duk-Hee;Kim, Ho-Seong
    • Clinical and Experimental Pediatrics
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    • v.58 no.2
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    • pp.41-46
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    • 2015
  • Growth hormone (GH) treatment has been increasingly widely used for children with GH deficiencies as the survival rate of pediatric patients with malignancies has increased. Both GH and insulin-like growth factor-I have mitogenic and antiapoptotic activity, prompting concern that GH treatment may be associated with tumor development. In this review, the authors examined the relationship between GH treatment and cancer risk in terms of de novo malignancy, recurrence, and secondary neoplasm. Although the results from numerous studies were not entirely consistent, this review of various clinical and epidemiological studies demonstrated that there is no clear evidence of a causal relationship between GH treatment and tumor development. Nonetheless, a small number of studies reported that childhood cancer survivors who receive GH treatment have a small increased risk of developing de novo cancer and secondary malignant neoplasm. Therefore, regular follow-ups and careful examination for development of cancer should be required in children who receive GH treatment. Continued surveillance for an extended period is essential for monitoring long-term safety.

The Effects of Utilizing Smartphone Application Peer Support on Health Behavior and Body Mass Index among Breast Cancer Survivors (스마트폰 앱을 활용한 동료지지가 유방암 생존자의 건강행위와 체질량지수에 미치는 효과)

  • Park, Gaeun;Lee, Haejung;Kim, Hyun Yul
    • Journal of Korean Academy of Nursing
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    • v.49 no.5
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    • pp.550-561
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    • 2019
  • Purpose: This study aimed to identify the effects of utilizing Smartphone Application Peer Support (SAPS) on health behavior and body mass index (BMI) among overweight or obese breast cancer survivors (BCS). Methods: A nonequivalent control group with a non-synchronized design was utilized and 36 participants (experimental group 14, control group 22) were recruited from August 2017 to September 2018. Participants were 40~65 years old, overweight or obese, had completed primary cancer treatment within the 12 months prior to the study, and had not done regular exercise during the last 6 months. The 3-month SAPS consisted of exercise and diet education (once p/2 weeks), peer support (once p/week), and self-monitoring using smartphone applications (5 times p/week). All participants underwent assessments at baseline, right after SAPS, and at 3 months after SAPS. Data were analyzed using repeated measures ANOVA. Results: At the completion of SAPS significant differences were found between groups in motivation for exercise (t=-3.24, p=.005), physical activity (t=-4.15, p<.001), total calorie intake (t=3.42, p=.002), calories from fat (t=-3.01, p=.005), intake of vegetables (t=-2.83, p=.008), and BMI (t=5.21, p<.001). Significant differences in BMI (t=4.13, p<.001) remained up to 3 months after SAPS completion. No significant differences was shown between groups in self-efficacy for exercise, either immediately after or 3 months after SAPS. Conclusion: The SAPS has the potential to improve motivation for exercise, health behavior, and BMI of BCS. However, special efforts are required to encourage participants to complete the intervention and maintain long-term effects for future trials.

What Made Her Give Up Her Breasts: a Qualitative Study on Decisional Considerations for Contralateral Prophylactic Mastectomy among Breast Cancer Survivors Undergoing BRCA1/2 Genetic Testing

  • Kwong, Ava;Chu, Annie T.W.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2241-2247
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    • 2012
  • Objective: This qualitative study retrospectively examined the experience and psychological impact of contralateral prophylactic mastectomy (CPM) among Southern Chinese females with unilateral breast cancer history who underwent BRCA1/2 genetic testing. Limited knowledge is available on this topic especially among Asians; therefore, the aim of this study was to acquire insight from Chinese females' subjective perspectives. Methods: A total of 12 semi-structured in-depth interviews, with 11 female BRCA1/BRCA 2 mutated gene carriers and 1 non-carrier with a history of one-sided breast cancer and genetic testing performed by the Hong Kong Hereditary Breast Cancer Family Registry, who subsequently underwent CPM, were assessed using thematic analysis and a Stage Conceptual Model. Breast cancer history, procedures conducted, cosmetic satisfaction, pain, body image and sexuality issues, and cancer risk perception were discussed. Retrieval of medical records using a prospective database was also performed. Results: All participants opted for prophylaxis due to their reservations concerning the efficacy of surveillance and worries of recurrent breast cancer risk. Most participants were satisfied with the overall results and their decision. One-fourth expressed different extents of regrets. Psychological relief and decreased breast cancer risk were stated as major benefits. Spouses' reactions and support were crucial for post-surgery sexual satisfaction and long-term adjustment. Conclusions: Our findings indicate that thorough education on cancer risk and realistic expectations of surgery outcomes are crucial for positive adjustment after CPM. Appropriate genetic counseling and pre-and post-surgery psychological counseling were necessary. This study adds valuable contextual insights into the experiences of living with breast cancer fear and the importance of involving spouses when counseling these patients.

A Comparative Review of Radiation-induced Cancer Risk Models

  • Lee, Seunghee;Kim, Juyoul;Han, Seokjung
    • Journal of Radiation Protection and Research
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    • v.42 no.2
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    • pp.130-140
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    • 2017
  • Background: With the need for a domestic level 3 probabilistic safety assessment (PSA), it is essential to develop a Korea-specific code. Health effect assessments study radiation-induced impacts; in particular, long-term health effects are evaluated in terms of cancer risk. The objective of this study was to analyze the latest cancer risk models developed by foreign organizations and to compare the methodology of how they were developed. This paper also provides suggestions regarding the development of Korean cancer risk models. Materials and Methods: A review of cancer risk models was carried out targeting the latest models: the NUREG model (1993), the BEIR VII model (2006), the UNSCEAR model (2006), the ICRP 103 model (2007), and the U.S. EPA model (2011). The methodology of how each model was developed is explained, and the cancer sites, dose and dose rate effectiveness factor (DDREF) and mathematical models are also described in the sections presenting differences among the models. Results and Discussion: The NUREG model was developed by assuming that the risk was proportional to the risk coefficient and dose, while the BEIR VII, UNSCEAR, ICRP, and U.S. EPA models were derived from epidemiological data, principally from Japanese atomic bomb survivors. The risk coefficient does not consider individual characteristics, as the values were calculated in terms of population-averaged cancer risk per unit dose. However, the models derived by epidemiological data are a function of sex, exposure age, and attained age of the exposed individual. Moreover, the methodologies can be used to apply the latest epidemiological data. Therefore, methodologies using epidemiological data should be considered first for developing a Korean cancer risk model, and the cancer sites and DDREF should also be determined based on Korea-specific studies.

Pre-Natal Epigenetic Influences on Acute and Chronic Diseases Later in Life, such as Cancer: Global Health Crises Resulting from a Collision of Biological and Cultural Evolution

  • Trosko, James E.
    • Preventive Nutrition and Food Science
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    • v.16 no.4
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    • pp.394-407
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    • 2011
  • Better understanding of the complex factors leading to human diseases will be necessary for both long term prevention and for managing short and long-term health problems. The underlying causes, leading to a global health crisis in both acute and chronic diseases, include finite global health care resources for sustained healthy human survival, the population explosion, increased environmental pollution, decreased clean air, water, food distribution, diminishing opportunities for human self-esteem, increased median life span, and the interconnection of infectious and chronic diseases. The transition of our pre-human nutritional requirements for survival to our current culturally-shaped diet has created a biologically-mismatched human dietary experience. While individual genetic, gender, and developmental stage factors contribute to human diseases, various environmental and culturally-determined factors are now contributing to both acute and chronic diseases. The transition from the hunter-gatherer to an agricultural-dependent human being has brought about a global crisis in human health. Initially, early humans ate seasonally-dependent and calorically-restricted foods, during the day, in a "feast or famine" manner. Today, modern humans eat diets of caloric abundance, at all times of the day, with foods of all seasons and from all parts of the world, that have been processed and which have been contaminated by all kinds of factors. No longer can one view, as distinct, infectious agent-related human acute diseases from chronic diseases. Moreover, while dietary and environmental chemicals could, in principle, cause disease pathogenesis by mutagenic and cytotoxic mechanisms, the primary cause is via "epigenetic", or altered gene expression, modifications in the three types of cells (e.g., adult stem; progenitor and terminally-differentiated cells of each organ) during all stages of human development. Even more significantly, alteration in the quantity of adult stem cells during early development by epigenetic chemicals could either increase or decrease the risk to various stem cell-based diseases, such as cancer, later in life. A new concept, the Barker hypothesis, has emerged that indicates pre-natal maternal dietary exposures can now affect diseases later in life. Examples from the studies of the atomic bomb survivors should illustrate this insight.

Hepatic Resection for Hepatic Metastases from Gastric Adenocarcinoma

  • Baek, Hyoung-Un;Kim, Sang Bum;Cho, Eung-Ho;Jin, Sung-Ho;Yu, Hang Jong;Lee, Jong-Inn;Bang, Ho-Yoon;Lim, Chang-Sup
    • Journal of Gastric Cancer
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    • v.13 no.2
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    • pp.86-92
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    • 2013
  • Purpose: The effects of hepatic resection on patients with metastatic tumors from gastric adenocarcinomas are unclear. Therefore, we analyzed early clinical outcomes in patients who underwent surgical resection for hepatic metastases from gastric adenocarcinomas. Materials and Methods: From January 2003 to December 2010, 1,508 patients with primary gastric cancers underwent curative gastric resections at the Korea Cancer Center Hospital. Of these patients, 12 with liver-only metastases underwent curative hepatic resection. Their clinical data were analyzed retrospectively. Results: The median follow-up period was 12.5 months (range, 1~85 months); no operative mortalities or major complications were observed. Three patients underwent synchronous resections, and 9 underwent metachronous resections. In the latter group, the median interval between gastrectomy and hepatectomy for hepatic metastasis was 10.5 months (range, 5~47 months). The overall 1- and 5-year survival rates of these 12 patients were 65% and 39%, respectively, with a median overall survival of 31.0 months; 2 patients survived for >5 years. Conclusions: Hepatic resection can be a feasible procedure for treating hepatic metastases from gastric adenocarcinomas. Although this study was small and involved only selected cases, the outcomes of the hepatic resections were comparable and long-term (>5 years) survivors were identified. Surgical resection of the liver can be considered a feasible option in managing hepatic metastases from gastric adenocarcinomas.

Reirradiation of head and neck cancer in the era of intensity-modulated radiotherapy: patient selection, practical aspects, and current evidence

  • Kim, Yeon Sil
    • Radiation Oncology Journal
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    • v.35 no.1
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    • pp.1-15
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    • 2017
  • Locoregional failure is the most frequent pattern of failure in locally advanced head and neck cancer patients and it leads to death in most of the patients. Second primary tumors occurring in the other head and neck region reach up to almost 40% of long-term survivors. Recommended and preferred retreatment option in operable patients is salvage surgical resection, reporting a 5-year overall survival of up to 40%. However, because of tumor location, extent, and underlying comorbidities, salvage surgery is often limited and compromised by incomplete resection. Reirradiation with or without combined chemotherapy is an appropriate option for unresectable recurrence. Reirradiation is carefully considered with a case-by-case basis. Reirradiation protocol enrollment is highly encouraged prior to committing patient to an aggressive therapy. Radiation doses greater than 60 Gy are usually recommended for successful salvage. Despite recent technical improvement in intensity-modulated radiotherapy (IMRT), the use of concurrent chemotherapy, and the emergence of molecularly targeted agents, careful patient selection remain as the most paramount factor in reirradiation. Tumors that recur or persist despite aggressive prior chemoradiation therapy imply the presence of chemoradio-resistant clonogens. Treatment protocols that combine novel targeted radiosensitizing agents with conformal high precision radiation are required to overcome the resistance while minimizing toxicity. Recent large number of data showed that IMRT may provide better locoregional control with acceptable acute or chronic morbidities. However, additional prospective studies are required before a definitive conclusion can be drawn on safety and effectiveness of IMRT.

The Change of Functional Fitness and Bone Mineral Density on a Long-Term Combined Exercise Intervention in Breast Cancer Survivors. (유방암 생존자의 장기간 복합 운동중재에 따른 기능적 체력과 골밀도의 변화)

  • Kim, Yang-Sook;Kim, Mi-Sook
    • Journal of Life Science
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    • v.18 no.7
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    • pp.968-973
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    • 2008
  • The study was to provide basic data and to examine the effect of combined exercise for 12 months on functional fitness and bone mineral density (BMD) in breast cancer survivors. The subjects of this study were 40 to 60-year-old married women (N=24) who finished their treatments chemotherapy and radiation therapy. They were divided into two groups that exercise group and exercise with alendronate group. Eighteen (T-score=$-2.2{\pm}0.8$) of the 24 women who were diagnosed osteopenia (N=15) and osteoporosis (N=3), participated in combined exercise (EG). The other six (T-score=$-4.6{\pm}0.9$) women who were diagnosed as osteoporosis (EDG), participated in the combined exercise program with osteoporosis drug (Alendronate 70 mg/w). The result of the analysis was as follows: Twelve months after, the participants (N=24) had a significant increase of the items such as sit and reach ups, grip strength (R and L) and sit ups test of functional fitness in the periods. In body composition, FM (fat mass) had significant decrease in periods. In the comparison of BMD, EG (N=18) had no change, while EDG (N=6) had significant improvement in L1, T12 and T-score after 12months. Consequently, complex exercise program (Hatha yoga, elastic band, gym ball) had positive effect on functional fitness and bone mineral density. We suggest that complex exercise program can be applied as recovery program after breast cancer surgery. Further research needs various and repetitive studies from more different targets or methods in the exercise program for its improvement.

MICRODONTIA IN A CHILD TREATED WITH CHEMOTHERAPEUTIC AGENT (항암 화학치료를 받은 아동의 치아발육이상 : 증례 보고)

  • Kye, Hi-Ran;Lee, Jae-Ho;Kim, Seong-Oh;Sohn, Heung-Kyu
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.1
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    • pp.146-150
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    • 1999
  • With the improved cure rates for childhood malignant conditions in the past decade, late effects of cancer therapy must be recognized to minimize their impact on the quality of life in long-term survivors. Chemoradiation therapy is a major part of pediatric oncology treatment and is implicated in causing tooth agenesis, microdontia, root shortening, early apical closure, and coronal hypocalcification. Dental development may be affected by illness, trauma, chemotherapy, or radiation therapy at any point prior to complete maturation. Treatment given during the first 3.5 years of life was more likely to affect the dental lamina and crown formation and result in a small tooth. Dental treatment affected by chemoradiation damage to developing teeth includes orthodontic tooth movement, prosthetic abutment consideration, periodontal health, space maintenance, requirement for home fluoride regimens to protect hypomineralized teeth, and enodontic procedures. Dental abnormalities are common in patients treated for cancer, and these children require aggressive dental follow-up. Meticulous surveillance may facilitate detection of abnormalities, enabling the dental practitioner to intervene earlier in promoting a more aggressive regimen of oral care, thus reducing the morbidity associated with dental sequelae of oncotherapy, specifically periodontal disease and malocclusion. In this case, we report microdontia of all permanent second premolar and second molar in an 8 year old boy treated with chemotherapeutic agents during period of active dental development(14 months to 38 months of age).

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