Employment status in cancer patients the first five years after diagnosis-a register-based study.

PURPOSE: Work is important for identity formation, social status, and economic independency. Although some evidence within the field of work and cancer survivorship exists, no study has so far investigated employment status across all cancer diagnoses. Thus, the aim of the present study was to investigate the impact of all cancer diagnoses on employment status. METHODS: Danish cancer patients aged 20-60 years, diagnosed between 2000 and 2015, were identified through Danish registers and matched 1:5 with cancer-free controls. Logistic and linear regression was performed separately in 11 cancer types to assess and compare work status and work participation between cancer patients and cancer-free controls one, three, and five years after diagnosis. RESULTS: A total of 111,770 cancer patients and 507,003 cancer-free controls were included. All cancer types had lower chances of working one year after diagnosis (ORs between 0.05 and 0.76), with lung, colorectal, upper gastrointestinal, and blood cancer patients having the lowest chances. After three years, 10 of 11 cancer types had lower chances (ORs between 0.39 and 0.84). After five years, there were minimal differences between cancer patients and controls among most cancer types (ORs between 0.75 and 1.36). CONCLUSION: Most cancer patients had lower chances of working compared with the general population until five years after diagnosis. However, patients with certain cancer types experienced lower chances of working all years, despite improvement over time. IMPLICATIONS FOR CANCER SURVIVORS: The knowledge will help increase awareness on challenges regarding work-life after cancer. Furthermore, the distinguishing between diagnoses can inform to more targeted vocational rehabilitation.

Validation of the PHEEM instrument in a Danish hospital setting.

The Postgraduate Hospital Educational Environment Measure (PHEEM) has been translated into Danish and then validated with good internal consistency by 342 Danish junior and senior hospital doctors. Four of the 40 items are culturally dependent in the Danish hospital setting. Factor analysis demonstrated that seven items are interconnected. This information can be used to shorten the instrument by perhaps another three items.

Treatment of symptomatic metastatic prostatic cancer with cyproterone acetate versus orchiectomy: a prospective randomized trial.

During a 2-year period, 37 patients with symptomatic metastatic prostatic cancer were included in a prospective randomized phase-III trial. Nineteen patients were randomized to subcapsular orchiectomy, and 18 to cyproterone acetate (CPA) treatment with a dose of 50 mg b.i.d. The median age of the patients was 74 years (range 48-88 years), with no differences between the treatment groups. At 3, 6, and 12 months after initiation of the therapy and then every 6 months, patients were clinically and biochemically examined, and isotope scans and X-rays were performed. All patients were followed until death. Relief from symptoms was found following 3 months of treatment in 70.6% (95% confidence limits = 44.0-89.7%) of the patients treated with CPA, and in 83.3% (95% confidence limits = 58.6-96.4%) of the orchiectomized patients. The median time to relapse was 9 months in the CPA group, and 11 months in the orchiectomy group (p greater than 0.05). The median survival time was 13 months, with no differences between the groups. The treatment of advanced prostatic cancer with CPA is found to be a valuable alternative to orchiectomy.

Perforated duodenal ulcer managed by simple closure versus closure and proximal gastric vagotomy.

A prospective randomized trial of simple closure versus closure and proximal gastric vagotomy was conducted in 50 consecutive patients with perforated duodenal ulcer. There was one postoperative death in each group and no difference in postoperative morbidity. After a median follow-up of 54 months (24-96) the cumulative recurrence rate after simple suture was 52 per cent against 16 per cent after proximal gastric vagotomy and closure (P less than 0.01). The recurrence rate after proximal gastric vagotomy for perforated duodenal ulcer was comparable to the recurrence rate seen after the electively performed operation.

Anal profilometry correlated to colpo-cysto-urethrography in female urinary bladder suspension defects.

Of 40 women with urinary bladder suspension defects verified by CCU were investigated with anal profilometry, 25 had anterior suspension defects had 15 posterior suspension defects. The profiles were superimposed to demonstrate morphological changes. The slopes of the profiles were correlated to slopes of profiles from a normal material. There was significant difference between normal and pathological slopes. The morphological changes of the profiles in relation to the anatomy of the pelvic floor is discussed.

Anal profilometry, a method of investigating the physiology of the anal canal and the pelvic floor.

Fifty women and 50 men without diseases in their minor pelvis were investigated with anal profilometry. The method were tested with different sizes of catheters and different perfusion rates. The profiles have been superimposed to demonstrate similaryties. To demonstrate the influence of the levator any muscles on the profile 5 patients were investigated, before, during and after extradural analgesy.

Changes in symptoms and colpo-cystourethrography in 35 patients before and after total abdominal hysterectomy: a prospective study.

35 women, referred for simple total hysterectomy, were evaluated pre- and postoperatively for bladder suspension and urodynamic changes. Although all patients denied urological problems, more than half of the patients had some degree of stress and/or urge incontinence. 40% had radiological signs of bladder suspension defects. At postoperative examination the symptomatology of incontinence had declined but the radiological pathologic findings had increased. On this basis it may be concluded that it is unpredictable what happens to the bladder and its suspension following simple hysterectomy.

Effect of emepronium bromide (Cetiprin) on symptoms and urinary bladder function after transurethral resection of the prostate. A double-blind randomized trial.

75 patients were randomized to be treated with either emepronium bromide (Cetiprin) 200 mg 4 times a day or placebo after transurethral resection of the prostate. The patients were evaluated urodynamically pre- and postoperatively, and further evaluated by micturition symptom charts. No significant differences in symptoms or objective findings were found between the patients treated with emepronium bromide and those treated with placebo.