Current Therapeutic Approaches in Cervical Cancer Based on the Stage of the Disease: Is There Room for Improvement?

Cervical cancer continues to be among the most common malignancies in women, and in recent decades, important measures have been taken to reduce its incidence. The first and most important steps to achieve this goal are oriented toward prevention through screening programs and vaccination, mainly against oncogenic human papillomavirus (HPV) strains 16 and 18. The therapeutic approach is based on the diagnosis and treatment guidelines for cervical cancer, which establish for each stage (FIGO, TNM) specific conduct. These guidelines summarize quite precisely the elements of therapeutic practice, but, in some places, they leave optional variants based on which nuanced approaches could be established. Adherence to these guidelines, which include the performing of minor or major surgery, with or without chemotherapy and radiation therapy, combined with advanced imaging investigations, has been able to lead to a substantial increase in survival. The purpose of this literature review is to discuss the diagnosis and treatment options in cervical cancer depending on the histological type, FIGO staging, and patient performance index, taking into account the hospital resources available in middle-income countries (percentage of gross domestic product allocated to health services around 5.5%, in the case of Romania).

Health information seeking behaviour and decision making by patients undergoing breast cancer surgery: A qualitative study.

BACKGROUND: Information is critical for patients having to decide about the best treatment option, and an in-depth understanding of their information behaviour can help health and information services to improve and facilitate their access to reliable information. OBJECTIVE: To investigate the health information-seeking behaviour and information sources and their roles in decision making among breast cancer patients in Romania in the context of the surgical treatment. METHODS: Semi-structured interviews were conducted with 34 patients who were treated surgically for breast cancer at the Bucharest Oncology Institute. RESULTS: Most participants searched for information independently, before and after the operation, and their information needs evolved during the progression of their disease. The surgeon was regarded as the most trusted source of information. Most patients adopted a paternalistic or a shared approach for decision making. DISCUSSION: Besides findings consistent with research from other countries, our study also revealed findings in contrast to previous research. None of the interviewed patients made any reference to the library as a source of information even if books were mentioned. CONCLUSIONS: Health information specialists should develop a detailed guide and online information services to help physicians and other health professionals to provide relevant and reliable health care information to surgical inpatients from Romania.