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1.
Strahlenther Onkol ; 2024 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-39313732

RESUMEN

PURPOSE: We evaluated the efficacy of low-dose radiotherapy for painful shoulder syndrome from an orthopedic perspective. METHODS: Patients with painful shoulder syndrome were recruited for this retrospective clinical quality assessment from January 2011 to December 2017. Patients were treated with a linear accelerator or an orthovoltage device at individual doses of 0.5-1.0 Gy and total doses of 3.0-6.0 Gy. To assess response, we used the von Pannewitz score with five levels: "worsened," "unaffected," "improved," "significantly improved," and "symptom free." "Good treatment success" was defined as "significantly improved" and "symptom free." Within-group and between-group differences were statistically evaluated. RESULTS: Of 236 recruited patients (150 women, 86 men; mean age 66.3 [range 31-96] years), 180 patients underwent radiotherapy with a linear accelerator and 56 with an orthovoltage device. Fractionation was 12â€¯× 0.5 Gy in 120 patients, 6â€¯× 0.5 Gy in 74, and 6â€¯× 1 Gy in 42 patients. Treatments were completed in one series for 223 and in two series at least 6 weeks apart for 13 patients. Of the 236 patients, 163 patients (69.1%) agreed to be re-interviewed at a median of 10.5 (range 4-60) months after radiotherapy completion. Directly after radiotherapy, 30.9% (73 patients) had "good treatment success," which had increased to 55.2% (90 patients) at follow-up. CONCLUSION: Protracted pain improvement with low-dose radiotherapy is possible in painful shoulder syndrome. Patients with refractory pain because of subacromial syndrome or shoulder osteoarthritis should also be evaluated for radiotherapy.

2.
Breast Dis ; 41(1): 503-511, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36641650

RESUMEN

BACKGROUND: In breast cancer patients, there is an elevated risk of developing osteoporosis during treatment which should be addressed by optimizing 25(OH) levels. OBJECTIVE: The aim was to assess the prescription, information and physician-patient communication on vitamin D and bone density in Germany. METHODS: We developed a standardized questionnaire concerning bone density measurement, vitamin D (blood level testing, prescription), information and communication regarding vitamin D. The questionnaire was distributed at the annual meeting of all group leaders of the Women's Cancer Support Association to all participants. RESULTS: Overall, 224 participants completed the questionnaire; 77.7% reported having had at least one bone density measurement test. The number was 84.4% in patients treated with aromatase inhibitor and 43.7% reported that their bone density was too low. In total, 51.3% patients reported at least one vitamin D blood test and 45.1% reported that vitamin D had been primarily addressed by a physician. As many as 74.1% of those reporting a test result had a deficiency; 91.6% of those with a low level got a prescription and 28.4% took vitamin D autonomously. CONCLUSIONS: The awareness on risk of osteoporosis, prevention, early diagnosis and treatment are insufficiently addressed in a patient group with high risk of osteoporosis. More attention should be paid to the phenomenon of vitamin D deficiency or insufficiency in routine care.


Asunto(s)
Neoplasias de la Mama , Osteoporosis , Deficiencia de Vitamina D , Humanos , Femenino , Vitamina D/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Osteoporosis/diagnóstico , Osteoporosis/prevención & control , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/prevención & control , Grupos de Autoayuda
3.
Integr Cancer Ther ; 20: 15347354211043199, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34581221

RESUMEN

BACKGROUND: Increasingly, patients with cancer are asking for additional, complementary therapy options for treating the side effects of oncological therapy. Thus, the members of the Breast and Bowel Center Nahe at the Sankt Marienwörth Hospital Bad Kreuznach decided to define the content of this type of counseling for patients before treatment. METHODS: In 2018, a team of internal oncologists, gynecological oncologists, radio-oncologists, nutritionists, psycho-oncologists, and study nurses met several times to define the content of counseling. To inform the team, an intensive literature review was conducted. RESULTS: Counseling content was determined for complementary treatment options for the most frequent side effects of oncological therapies. Counseling sessions were formulated as frontal lectures (slide presentations), given at regular intervals for patients and relatives. These lectures were highly appreciated by patients. CONCLUSION: These counseling sessions increased patient understanding of both useful complementary measures and harmful measures they should not use.


Asunto(s)
Terapias Complementarias , Oncólogos , Consejo , Hospitales , Humanos , Oncología Médica
4.
Strahlenther Onkol ; 195(12): 1068-1073, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31456003

RESUMEN

PURPOSE: The aim of this retrospective clinical quality assessment was to evaluate the efficacy of low-dose radiotherapy (RT) for painful benign skeletal disorders. METHODS: Patients with different painful benign skeletal disorders (arthrosis and enthesopathies) were recruited for this retrospective clinical quality assessment between January 2014 and December 2015. RT was applied with a linear accelerator. Single doses of 0.5 Gy (total dose 3.0-5.0 Gy) were used. Pain was measured before and immediately after RT (early response) by a 10-point visual analogue scale (VAS). We defined a VAS score of 0-2 as a good response. Pain relief was measured during follow-up. RESULTS: A total of 598 evaluable patients (394 females, 204 males) with a mean age of 61.4 years (range 33-81 years) were recruited. The median VAS score was 7.0 (interquartile range [IQR] 2) before treatment and 5.0 (IQR 4) upon completion of RT (p < 0.001). A good response was achieved upon completion of RT in 83 patients (13.9%), with a median follow-up of 38 months (range 29-47 months) in 373 patients (62.4%; p < 0.001). In general, RT had a better effect on enthesopathies than on arthrosis. CONCLUSION: Low-dose RT is a very effective treatment for the management of painful benign skeletal disorders. Due to the delayed onset of analgesic effects, low-dose RT results in significantly improved long-term efficacy compared to the results immediately after RT. These findings confirm the results of other retrospective, prospective, and randomized trials.


Asunto(s)
Entesopatía/radioterapia , Osteoartritis/radioterapia , Dolor/radioterapia , Garantía de la Calidad de Atención de Salud , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Investigación sobre Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Dosificación Radioterapéutica , Estudios Retrospectivos , Escala Visual Analógica
5.
Integr Cancer Ther ; 17(4): 1132-1136, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30354843

RESUMEN

INTRODUCTION: The supply of selenium (Se) varies widely in Germany. Therefore, a laboratory study was conducted in patients treated at a family doctor practice in Brandenburg, Germany, to determine whether there is a general Se deficiency in this area; specifically, whether Se concentrations differ with age, sex, or presence of cancer. Moreover, we tested the effects of a Se supplementation on whole blood Se levels (WBSL). METHODS: In 2006, WBSL were analyzed in 871 patients (496 females, 375 males, median age: 67 years). Of these, 143 (78 females, 65 males) had cancer and were in an aftercare situation. From 2006 to 2012, 317 patients (76 with tumors, 241 without tumors) received continuous Se supplementation with sodium selenite (300 µg per day) and annual WBSL measurements. WBSL were compared by Student's t test for paired and independent samples. RESULTS: The initial WBSL of all patients was 97.2 ± 20.7 µg/L (mean ± SD). WBSL did not differ with regard to age or sex, but patients with cancer had the lowest WBSL. Se supplementation increased mean WBSL in both patients with (to 128.5 µg/L) and without (to 119.52 µg/L) cancer ( P < .001). DISCUSSION: Patients with cancer displayed significantly lower WBSL than patients without cancer, indicating a negative effect of tumors on Se uptake, absorption, or metabolism. Significant influences of age or sex were not observed. Selenite supplementation efficiently improved WBSL to concentrations considered necessary for health benefits.


Asunto(s)
Selenio/sangre , Adulto , Anciano , Anciano de 80 o más Años , Suplementos Dietéticos , Femenino , Alemania , Humanos , Masculino , Persona de Mediana Edad , Médicos , Adulto Joven
6.
Adv Radiat Oncol ; 3(3): 240-244, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30197936

RESUMEN

PURPOSE: Radiation therapy (RT) is a common treatment for benign diseases in Germany. Because the treatment concepts are inconsistent, we conducted this pattern-of-care study on behalf of the German Cooperative Group on Benign Diseases to evaluate treatment standards in Germany. METHODS AND MATERIALS: Questionnaires were mailed to all radiation therapy facilities in Germany. We assessed the treatment equipment, annual number of patients, treatment indications, and, in particular, treatment strategies in patients with benign diseases in 2014. RESULTS: We evaluated questionnaires returned by 116 participating institutions, of which 41 were ambulatory health care centers, 28 were private institutions, 27 were community hospitals, and 20 were university hospitals. On average, 2 linac accelerators and 2 megavoltage units were available in each institution. In 2014, a total of 36,830 patients were treated for benign diseases: 16,989 for degenerative diseases (peritendinitis humeroscapularis n = 2691; epicondylitis humeri n = 3788; heel spur n = 10,510); 14,936 for osteoarthritis (coxarthrosis n = 2230; gonarthrosis n = 2623; omarthrosis n = 2691; rhizarthrosis n = 2440; polyarthrosis n = 2297; others n = 2655); 1563 for hyperproliferative diseases (morbus Dupuytren n = 960; morbus Ledderhose n = 441; keloids n = 139; pterygium of the conjunctiva n = 3; other hyperproliferative diseases n = 20); 2440 for functional disorders (gynecomastia n = 843; Graves' disease n = 205; lymphatic fistula n = 178; heterotopic ossification prophylaxis n = 1214); 859 for stereotactic RT in the central nervous system (arteriovenous malformation n = 53; meningioma n = 425; acoustic neuroma n = 201; pituitary adenoma n = 131; others n = 49), and 43 for rare indications (pigmented villonodular synovitis n = 20 or vertebral hemangioma n = 23). The mean whole dose was <10 Gy in the treatment of degenerative disorders, 25 Gy for hyperproliferative diseases, 15 Gy for functional disorders, and <50 Gy for stereotactic RT. CONCLUSIONS: In 2014, RT had an important role in the treatment of benign diseases. Because treatment concepts are inherent, we recommend treatment based on the guidelines written by the German Cooperative Group on Benign Diseases.

7.
Nutrients ; 10(4)2018 Apr 13.
Artículo en Inglés | MEDLINE | ID: mdl-29652817

RESUMEN

Introduction: Se measurement and supplementation in radiation oncology is a controversial issue. The German Working Group Trace Elements and Electrolytes in Oncology (AKTE) has conducted a number of studies on this issue, which are summarized in this review. Strategies have been tested and developed, aiming to stratify the patients with a potential need for supplemental Se and how best to monitor Se supplementation with respect to health effects and risks. Methods: We analyzed blood and tissue Se-levels of different tumor patients (n = 512). Two randomized phase III clinical studies were conducted for testing a potential radioprotective effect of supplemental Se during radiation therapy in patients with uterine cancer (n = 81) and head and neck tumor patients (n = 39). Results: A relative Se deficit in whole blood or serum was detected in the majority of tumor patients (carcinomas of the uterus, head and neck, lung, rectal or prostate cancer). In prostate cancer, tissue Se concentrations were relatively elevated in the carcinoma centre as compared to the surrounding compartment or as compared to tumor samples from patients with benign prostatic hyperplasia. Adjuvant Se supplementation successfully corrected Se-deficiency in the patients analyzed and decreased radiotherapy-induced diarrhea in a randomized study of radiotherapy patients with carcinomas of the uterus. Survival data imply that Se supplementation did not interfere with radiation success. Some positive effects of supplemental Se in the prevention of ageusia (loss of taste) and dysphagia due to radiotherapy were noted in a second randomized trial in patients with head and neck cancer. We have not observed any adverse effects of supplemental Se in our studies. Conclusions: Se supplementation yielded promising results concerning radioprotection in tumor patients and should be considered as a promising adjuvant treatment option in subjects with a relative Se deficit.


Asunto(s)
Suplementos Dietéticos , Neoplasias/radioterapia , Compuestos de Selenio/administración & dosificación , Selenio/administración & dosificación , Selenio/sangre , Animales , Alemania/epidemiología , Humanos , Neoplasias/epidemiología
8.
Radiat Oncol ; 13(1): 71, 2018 Apr 19.
Artículo en Inglés | MEDLINE | ID: mdl-29673383

RESUMEN

BACKGROUND: The aim of this prospective clinical quality assessment was to evaluate the short-term and long-term efficacy of low dose radiotherapy (RT) for calcaneodynia, achillodynia, painful gonarthrosis, painful bursitis trochanterica, and painful shoulder syndrome. METHODS: Between October 2011 and October 2013, patients with calcaneodynia, achillodynia, painful gonarthrosis, painful bursitis trochanterica, and painful shoulder syndrome were recruited for this prospective clinical quality assessment. Single doses of 0.5-1.0 Gy and a total dose of 6.0 Gy per series were used. Pain was measured before and directly after RT (early response) with a visual analogue scale (VAS). Additionally, pain relief was measured with the four-scale pain score according to "von Pannewitz" (VPS) immediately at the end of RT and during follow-up. Within this context we defined a good response as complete pain relief and markedly improved. The assessment of the long-term efficacy was carried out by a telephone survey. RESULTS: 703 evaluable patients (461 female, 242 male) with a mean age of 63.2 years (28-96) were recruited for this prospective clinical quality assessment. In 254 patients RT was performed with the linear accelerator, 449 patients received orthovoltage radiotherapy. After a median follow-up of 33 months (3-60) 437 patients could be reached for evaluation of follow up results. The mean VAS value before treatment was 6.63 (1.9-10) and immediately on completion of RT 4.51 (0-10) (p < 0,001). Concerning the VPS immediately on completion of RT, a good response could be achieved in 264/703 patients (37.6%), and with the follow up in 255/437 patients (58.4%) (p < 0.001). Only in patients with gonarthrosis we could not observe a significantly improved long-term success in comparison to the results immediately after RT (30.2% versus 29.9%). CONCLUSION: Low dose RT is a very effective treatment for the management of calcaneodynia, achillodynia, painful gonarthrosis, painful bursitis trochanterica, and painful shoulder syndrome. Due to the delayed onset of analgesic effects low dose RT results in a significantly improved long-term efficacy in comparison to the results immediately after RT particularly in patients with calcaneodynia, achillodynia, bursitis trochanterica, and shoulder syndrome.


Asunto(s)
Tendón Calcáneo/efectos de la radiación , Bursitis/radioterapia , Calcáneo/efectos de la radiación , Enfermedades del Pie/radioterapia , Osteoartritis de la Rodilla/radioterapia , Dolor de Hombro/radioterapia , Tendinopatía/radioterapia , Tendón Calcáneo/patología , Adulto , Anciano , Anciano de 80 o más Años , Calcáneo/patología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Estudios Prospectivos , Dosificación Radioterapéutica , Síndrome , Resultado del Tratamiento
10.
Int J Radiat Oncol Biol Phys ; 98(4): 958-963, 2017 07 15.
Artículo en Inglés | MEDLINE | ID: mdl-28258900

RESUMEN

PURPOSE: To prospectively evaluate the short-term and long-term efficacy of low-dose radiation therapy (RT) for calcaneodynia, achillodynia, painful gonarthrosis, and painful bursitis trochanterica in elderly patients aged ≥70 years. METHODS AND MATERIALS: Between October 2011 and October 2013, patients aged ≥70 years with painful degenerative disorders of joints were recruited for a prospective trial. Single doses of 0.5 to 1.0 Gy and a total dose of 6.0 Gy per series were used. Pain was measured before and right after RT (early response) with a 10-point visual analogue scale. Additionally, pain relief was measured with the 4-point pain scale according to "von Pannewitz" immediately on completion of RT and during follow-up. We defined a good response as complete pain relief and markedly improved. RESULTS: A total of 166 evaluable patients with a mean age of 76.6 years (range, 70-90 years) with calcaneodynia (n=51), achillodynia (n=8), painful gonarthrosis (n=80), and painful bursitis trochanterica (n=27) were recruited. The mean visual analogue scale value before treatment was 6.38 and immediately upon completion of RT was 4.49 (P<.001). Concerning the von Pannewitz status immediately on completion of RT, 6 patients were free of pain, 56 were much improved, 47 reported slight improvement, and 57 experienced no change. After a median follow-up of 29 months, 109 patients could be reached for evaluation of follow-up results. Thirty-three patients were free of pain, 21 had marked improvement, 18 had some improvement, and 37 experienced no change. Therefore, a good response immediately on completion of RT could be achieved in 62 of 166 patients, and with the follow-up in 54 of 109 patients (P=.001). CONCLUSIONS: Low-dose RT is a very effective treatment for the management of painful degenerative disorders of joints in the elderly. Low-dose RT offers a low-risk, genuinely conservative, noninvasive therapeutic alternative for elderly patients.


Asunto(s)
Enfermedades Óseas/radioterapia , Artropatías/radioterapia , Dolor Musculoesquelético/radioterapia , Tendón Calcáneo/efectos de la radiación , Anciano , Anciano de 80 o más Años , Enfermedades Óseas/complicaciones , Bursitis/complicaciones , Bursitis/radioterapia , Calcáneo/efectos de la radiación , Femenino , Fémur , Humanos , Artropatías/complicaciones , Masculino , Dolor Musculoesquelético/etiología , Dimensión del Dolor , Estudios Prospectivos , Dosificación Radioterapéutica , Estadísticas no Paramétricas , Tendinopatía/complicaciones , Tendinopatía/radioterapia , Resultado del Tratamiento
11.
Melanoma Res ; 27(3): 238-242, 2017 06.
Artículo en Inglés | MEDLINE | ID: mdl-28252553

RESUMEN

Biological-based (BbCAM) methods from complementary and alternative medicine (CAM) may interact with cancer treatments, reduce efficacy, or enhance adverse effects. Although CAM usage has been evaluated well in other cancer entities, data on melanoma patients are still missing. The aim of this study was to determine CAM usage of melanoma patients using a standardized questionnaire to identify potential interactions with established and new systemic melanoma therapies. This multicenter study was carried out in seven German skin cancer centers. During routine care contact, CAM usage of former and current melanoma treatment was assessed in melanoma patients. The probability of interaction was classified into four categories ranging from 'interaction unlikely' (I), 'possible' (II), 'likely' (III), or 'no data' (IV). The questionnaire was filled out by 1157 patients, of whom 1089 were eligible for evaluation. CAM usage was reported by 41% of melanoma patients, of whom 63.1% took BbCAM such as vitamins, trace elements, supplements, or phytotherapeuticals. Of 335 patients with former or current therapy, 28.1% used BbCAM. The melanoma treatment included interferon, radiotherapy, chemotherapy, BRAF-inhibitor, or other tyrosine kinase inhibitors and ipilimumab. On the basis of our model of likelihood of interaction, we found that 23.9% of those on cancer therapy and 85.1% of those also using BbCAM were at some risk of interactions. The main limitation of our study is that no reliable and comprehensive database on clinical relevant interactions with CAM in oncology exists. Most patients receiving a melanoma-specific treatment and using BbCAM methods are at risk for interactions, which raises concerns on the safety and treatment efficacy of these patients. To protect melanoma patients from potential harm by the combination of their cancer treatment and CAM usage, patients should systematically be encouraged to report their CAM use, while oncologists should be trained on evidence of CAM, and patient guidance for saver CAM use.


Asunto(s)
Antineoplásicos/uso terapéutico , Terapias Complementarias , Medicamentos Herbarios Chinos/administración & dosificación , Interacciones de Hierba-Droga , Melanoma/tratamiento farmacológico , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Melanoma/patología , Persona de Mediana Edad , Pronóstico , Encuestas y Cuestionarios
12.
Eur J Cancer ; 71: 70-79, 2017 01.
Artículo en Inglés | MEDLINE | ID: mdl-27984769

RESUMEN

BACKGROUND: About half of patients with cancer use complementary and alternative medicine (CAM). So far, data on melanoma patients are missing. OBJECTIVE: The aim of our study was to evaluate the prevalence and predictors for the use of CAM in this patient group. METHODS: All patients with melanoma being attended at one of 7 skin cancer centres in Germany between March 2012 and March 2013 were invited to take part in a survey using a structured questionnaire on CAM. The physicians filled in a second part on the diagnosis, state and former and current therapy. RESULTS: Nearly half of the 1089 participants (41.0%) used CAM and half of those using CAM (56.8%) marked that this made them feel better. Biological-based CAMs which consists of substances taken were used by 25.9% of all patients (63.1% of those using CAM). Predictors of CAM use were education, psychological support, interest in CAM and previous CAM use. CAM users show higher physical activity, more often use psychosocial help and have contact with a self-help group. Family and friends (41.0%) as well as print media (41.7%) are the main sources of information. Most important reasons to use CAM are to strengthen one's own forces (57.7%) or the immune system (63.4%) and to be able to do something for oneself (53.7%). CONCLUSION: Communication on CAM should become a regular topic in counselling melanoma patients. To increase safety, patients and physicians must have access to evidence-based information on these methods and their interactions with modern cancer treatments.


Asunto(s)
Terapias Complementarias/estadística & datos numéricos , Melanoma/terapia , Aceptación de la Atención de Salud/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Terapias Complementarias/métodos , Estudios Transversales , Femenino , Alemania , Conocimientos, Actitudes y Práctica en Salud , Humanos , Modelos Logísticos , Persona de Mediana Edad
13.
Med Princ Pract ; 26(1): 41-49, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-27607437

RESUMEN

OBJECTIVE: To analyze the financial burden of complementary and alternative medicine (CAM) in cancer treatment. MATERIALS AND METHODS: Based on a systematic search of the literature (Medline and the Cochrane Library, combining the MeSH terms 'complementary therapies', 'neoplasms', 'costs', 'cost analysis', and 'cost-benefit analysis'), an expert panel discussed different types of analyses and their significance for CAM in oncology. RESULTS: Of 755 publications, 43 met our criteria. The types of economic analyses and their parameters discussed for CAM in oncology were cost, cost-benefit, cost-effectiveness, and cost-utility analyses. Only a few articles included arguments in favor of or against these different methods, and only a few arguments were specific for CAM because most CAM methods address a broad range of treatment aim parameters to assess effectiveness and are hard to define. Additionally, the choice of comparative treatments is difficult. To evaluate utility, healthy subjects may not be adequate as patients with a life-threatening disease and may be judged differently, especially with respect to a holistic treatment approach. We did not find any arguments in the literature that were directed at the economic analysis of CAM in oncology. Therefore, a comprehensive approach assessment based on criteria from evidence-based medicine evaluating direct and indirect costs is recommended. CONCLUSION: The usual approaches to conventional medicine to assess costs, benefits, and effectiveness seem adequate in the field of CAM in oncology. Additionally, a thorough deliberation on the comparator, endpoints, and instruments is mandatory for designing studies.


Asunto(s)
Terapias Complementarias/economía , Neoplasias/terapia , Terapias Complementarias/métodos , Análisis Costo-Beneficio , Atención a la Salud/economía , Humanos , Neoplasias/economía , Oncólogos/economía
14.
Med Oncol ; 33(5): 52, 2016 May.
Artículo en Inglés | MEDLINE | ID: mdl-27090799

RESUMEN

Complementary and alternative medicine (CAM) is used widely among cancer patients. Beside the risk of interaction with cancer therapies, interactions with treatment for comorbidities are an underestimated problem. The aim of this study was to assess prevalence of interactions between CAM and drugs for comorbidities from a large CAM usage survey on melanoma patients and to classify herb-drug interactions with regard to their potential to harm. Consecutive melanoma outpatients of seven skin cancer centers were asked to complete a standardized CAM questionnaire including questions to their CAM use and their taken medication for comorbidities and cancer. Each combination of conventional drugs and complementary substances was evaluated for their potential of interaction. 1089 questionnaires were eligible for evaluation. From these, 61.6% of patients reported taking drugs regularly from which 34.4% used biological-based CAM methods. Risk evaluation for interaction was possible for 180 CAM users who listed the names or substances they took for comorbidities. From those patients, we found 37.2% at risk of interaction of their co-consumption of conventional and complementary drugs. Almost all patients using Chinese herbs were at risk (88.6%). With a high rate of CAM usage at risk of interactions between CAM drugs and drugs taken for comorbidities, implementation of a regular assessment of CAM usage and drugs for comorbidities is mandatory in cancer care.


Asunto(s)
Terapias Complementarias/métodos , Melanoma/epidemiología , Melanoma/terapia , Adulto , Anciano , Anciano de 80 o más Años , Comorbilidad , Terapias Complementarias/efectos adversos , Medicamentos Herbarios Chinos/uso terapéutico , Femenino , Formularios Homeopáticos como Asunto , Alemania/epidemiología , Interacciones de Hierba-Droga , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Vitaminas/uso terapéutico
15.
Integr Cancer Ther ; 15(1): 10-6, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26721796

RESUMEN

PURPOSE: Many cancer patients use complementary and alternative medicine (CAM) during or after their therapy. Because little is known about CAM in palliative care, we conducted 2 surveys among patients and professionals in the palliative setting. PARTICIPANTS AND METHODS: Patients of a German Comprehensive Cancer Center were interviewed, and an independent online survey was conducted among members of the German Society for Palliative Care (DGP). RESULTS: In all, 25 patients and 365 professional members of the DGP completed the survey (9.8% of all members); 40% of the patients, 85% of the physicians, and 99% of the nurses claimed to be interested in CAM. The most important source of information for professionals is education, whereas for patients it is radio, TV, and family and friends. Most patients are interested in biological-based methods, yet professionals prefer mind-body-based methods. Patients more often confirm scientific evidence to be important for CAM than professionals. CONCLUSIONS: To improve communication, physicians should be trained in evidence for those CAM methods in which patients are interested.


Asunto(s)
Actitud del Personal de Salud , Terapias Complementarias/métodos , Terapias Complementarias/psicología , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/psicología , Cuidados Paliativos/métodos , Cuidados Paliativos/psicología , Femenino , Empleos en Salud , Humanos , Masculino , Comodidad del Paciente/métodos , Encuestas y Cuestionarios
16.
J Cancer Res Clin Oncol ; 141(8): 1449-55, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25702103

RESUMEN

PURPOSE: A high percentage of cancer patients use complementary and alternative medicine (CAM). The aim of our study was to learn more about the association of CAM usage, information needs, perceived impact of disease, locus of control and self-efficacy of cancer patients. METHODS: We asked patients attending a series of lectures on CAM using a standardized questionnaire which integrated questions on information needs, CAM and validated short questionnaires on self-efficacy, perception of the disease and locus of control of reinforcement. RESULTS: One hundred and eighty-five patients answered the questionnaire, from whom 45 % used CAM. Sixty percentage disclosed using CAM to the general practitioner and 57 % to the oncologist. Physicians and nurses, print media and the Internet are the most important source of information on CAM (used by 20-25 % each). Impact on neither daily life, perceived personal control nor coherence was associated with CAM usage, disclosure to physicians or sources of information. There also was no association between CAM usage and self-efficacy. In contrast, there was a significant association between CAM user rate and a high external locus of control. CONCLUSION: While CAM usage is agreed upon by many physicians due to the idea that it helps patients to become active and feel more in control of the disease, our data are in favor of the contrary. A strong perception of external locus of control seems to be a driver of CAM usage. Physicians should be aware of this association when counseling on CAM.


Asunto(s)
Terapias Complementarias/estadística & datos numéricos , Neoplasias/psicología , Neoplasias/terapia , Percepción , Autoeficacia , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Control Interno-Externo , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios
17.
Strahlenther Onkol ; 191(1): 1-6, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25238992

RESUMEN

BACKGROUND AND PURPOSE: The purpose of this article is to summarize the updated DEGRO consensus S2e guideline recommendations for the treatment of benign painful degenerative skeletal disorders with low-dose radiotherapy. MATERIALS AND METHODS: This overview reports on the role of low-dose radiotherapy in the treatment of enthesiopathies (shoulder syndrome, trochanteric bursitis, plantar fasciitis, and elbow syndrome) and painful arthrosis (knee, hip, hand, and finger joints). The most relevant aspects of the DEGRO S2e Consensus Guideline Radiation Therapy of Benign Diseases 2014 regarding diagnostics, treatment decision, dose prescription as well as performance of radiotherapy and results are summarized. RESULTS: For all indications mentioned above, retrospective and some prospective analyses have shown remarkable effects in terms of pain relief. Nevertheless, the Level of Evidence (LoE) and the Grade of Recommendation (GR) vary: LoE 1b-4 and GR A-C. CONCLUSION: Low-dose radiotherapy for painful degenerative skeletal disorders is effective in the majority of the patients and therefore it may be a reasonable therapeutic alternative when simple and non-invasive methods have been used without persistent success. For all discussed entities, single fraction doses of 0.5-1.0 Gy and total doses of 3.0-6.0 Gy/series applied with 2-3 fractions per week are recommended.


Asunto(s)
Artralgia/diagnóstico , Artralgia/radioterapia , Guías de Práctica Clínica como Asunto , Oncología por Radiación/normas , Radioterapia/normas , Enfermedades Reumáticas/diagnóstico , Enfermedades Reumáticas/radioterapia , Artralgia/etiología , Alemania , Humanos , Dosis de Radiación , Planificación de la Radioterapia Asistida por Computador/normas , Enfermedades Reumáticas/complicaciones
18.
Radiat Oncol ; 9: 289, 2014 Dec 16.
Artículo en Inglés | MEDLINE | ID: mdl-25511764

RESUMEN

Considering the review by Puspitasari and colleagues, an additional discussion of the endpoints of the Se supplementation studies described would be helpful. In our view, selenium can safely be given to selenium-deficient cancer patients prior to and during radiotherapy. Therefore, in order to help the radiation oncologist in decision making, we strongly advocate to determine the selenium status prior to and during a potential adjuvant selenium supplementation, e.g. when trying to ease the side-effects of radiation treatment or in the aftercare situation when the selenium status may become insufficient.


Asunto(s)
Suplementos Dietéticos , Neoplasias/radioterapia , Traumatismos por Radiación/prevención & control , Radioterapia/efectos adversos , Selenio/uso terapéutico , Humanos
19.
Integr Cancer Ther ; 13(6): 463-7, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25015649

RESUMEN

PURPOSE: In 2010, we reported that selenium (Se) supplementation during radiation therapy (RT) is effective for increasing blood Se levels in Se-deficient cervical and uterine cancer patients, and reduced the number of episodes and severity of RT-induced diarrhea. In the current study, we examine whether of Se supplementation during adjuvant RT affects long-term survival of these patients. PATIENTS AND METHODS: Former patients were identified and questioned with respect to their health and well-being. RESULTS: A total of 81 patients were randomized in the initial supplementation study, 39 of whom received Se (selenium group, SeG) and 42 of whom served as controls (control group, CG). When former patients were reidentified after a median follow-up of 70 months (range = 0-136), the actuarial 10-year disease-free survival rate in the SeG was 80.1% compared to 83.2% in the CG (P = .65), and the actuarial 10-year overall survival rate of patients in the SeG was 55.3% compared to 42.7% in the CG (P = .09). CONCLUSIONS: Our extended follow-up analysis demonstrates that Se supplementation had no influence on the effectiveness of the anticancer irradiation therapy and did not negatively affect patients' long-term survival. In view of its positive effects on RT-induced diarrhea, we consider Se supplementation to be a meaningful and beneficial adjuvant treatment in Se-deficient cervical and uterine cancer patients while undergoing pelvic radiation therapy.


Asunto(s)
Selenio/sangre , Selenito de Sodio/uso terapéutico , Neoplasias del Cuello Uterino/radioterapia , Neoplasias Uterinas/radioterapia , Adulto , Anciano , Anciano de 80 o más Años , Diarrea/etiología , Diarrea/prevención & control , Suplementos Dietéticos , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Traumatismos por Radiación/prevención & control , Radioterapia Adyuvante/efectos adversos , Radioterapia Adyuvante/métodos , Selenio/deficiencia , Tasa de Supervivencia , Factores de Tiempo , Neoplasias del Cuello Uterino/patología , Neoplasias Uterinas/patología
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