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5.
Lancet Oncol ; 22(2): 182-189, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33485458

RESUMEN

BACKGROUND: The growing demand for cancer surgery has placed a global strain on health systems. In-depth analyses of the global demand for cancer surgery and optimal workforce requirements are needed to plan service provision. We estimated the global demand for cancer surgery and the requirements for an optimal surgical and anaesthesia workforce, using benchmarks based on clinical guidelines. METHODS: Using models of benchmark surgical use based on clinical guidelines, we estimated the proportion of cancer cases with an indication for surgery across 183 countries, stratified by income group. These proportions were multiplied by age-adjusted national estimates of new cancer cases using GLOBOCAN 2018 data and then aggregated to obtain the estimated number of surgical procedures required globally. The numbers of cancer surgical procedures in 44 high-income countries were divided by the actual number of surgeons and anaesthetists in the respective countries to calculate cancer procedures per surgeon and anaesthetist ratios. Using the median (IQR) of these ratios as benchmarks, we developed a three-tiered optimal surgical and anaesthesia workforce matrix, and the predictions were extrapolated up to 2040. FINDINGS: Our model estimates that the number of cancer cases globally with an indication for surgery will increase by 5 million procedures (52%) between 2018 (9 065 000) and 2040 (13 821 000). The greatest relative increase in surgical demand will occur in 34 low-income countries, where we also observed the largest gaps in workforce requirements. To match the median benchmark for high-income countries, the surgical workforce in these countries would need to increase by almost four times and the anaesthesia workforce by nearly 5·5 times. The greatest increase in optimal workforce requirements from 2018 to 2040 will occur in low-income countries (from 28 000 surgeons to 58 000 surgeons; 107% increase), followed by lower-middle-income countries (from 166 000 surgeons to 277 000 surgeons; 67% increase). INTERPRETATION: The global demand for cancer surgery and the optimal workforce are predicted to increase over the next two decades and disproportionately affect low-income countries. These estimates provide an appropriate framework for planning the provision of surgical services for cancer worldwide. FUNDING: University of New South Wales Scientia Scholarship and UK Research and Innovation Global Challenges Research Fund.


Asunto(s)
Anestesia/tendencias , Planes de Sistemas de Salud/tendencias , Fuerza Laboral en Salud/tendencias , Neoplasias/cirugía , Anestesia/economía , Prestación de Atención de Salud/economía , Prestación de Atención de Salud/tendencias , Salud Global/economía , Planes de Sistemas de Salud/economía , Fuerza Laboral en Salud/economía , Humanos , Renta , Neoplasias/economía , Neoplasias/epidemiología , Cirujanos/economía
6.
Lancet Oncol ; 22(2): 173-181, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33485459

RESUMEN

BACKGROUND: Estimating a population-level benchmark rate for use of surgery in the management of cancer helps to identify treatment gaps, estimate the survival impact of such gaps, and benchmark the workforce and other resources, including budgets, required to meet service needs. A population-based benchmark for use of surgery in high-income settings to inform policy makers and service provision has not been developed but was recommended by the Lancet Oncology Commission on Global Cancer Surgery. We aimed to develop and validate a cancer surgery benchmarking model. METHODS: We examined the latest clinical guidelines from high-income countries (Australia, the UK, the EU, the USA, and Canada) and mapped surgical treatment pathways for 30 malignant cancer sites (19 individual sites and 11 grouped as other cancers) that were notifiable in Australia in 2014, broadly reflecting contemporary high-income models of care. The optimal use of surgery was considered as an indication for surgery where surgery is the treatment of choice for a given clinical scenario. Population-based epidemiological data, such as cancer stage, tumour characteristics, and fitness for surgery, were derived from Australia and other similar high-income settings for 2017. The probabilities across the clinical pathways of each cancer were multiplied and added together to estimate the population-level benchmark rates of cancer surgery, and further validated with the comparisons of observed rates of cancer surgery in the South Western Sydney Local Health District in 2006-12. Univariable and multivariable sensitivity analyses were done to explore uncertainty around model inputs, with mean (95% CI) benchmark surgery rates estimated on the basis of 10 000 Monte Carlo simulations. FINDINGS: Surgical treatment was indicated in 58% (95% CI 57-59) of newly diagnosed patients with cancer in Australia in 2014 at least once during the course of their treatment, but varied by site from 23% (17-27) for prostate cancer to 99% (96-99) for testicular cancer. Observed cancer surgery rates in South Western Sydney were comparable to the benchmarks for most cancers, but were higher for some cancers, such as prostate (absolute increase of 29%) and lower for others, such as lung (-14%). INTERPRETATION: The model provides a new template for high-income and emerging economies to rationally plan and assess their cancer surgery provision. There are differences in modelled versus observed surgery rates for some cancers, requiring more in-depth analysis of the observed differences. FUNDING: University of New South Wales Scientia Scholarship, UK Research and Innovation-Global Challenges Research Fund.


Asunto(s)
Países Desarrollados/economía , Neoplasias de Células Germinales y Embrionarias/economía , Neoplasias/economía , Neoplasias Testiculares/economía , Australia/epidemiología , Benchmarking/economía , Canadá/epidemiología , Manejo de Datos , Guías como Asunto/normas , Humanos , Neoplasias/epidemiología , Neoplasias/cirugía , Neoplasias de Células Germinales y Embrionarias/epidemiología , Neoplasias Testiculares/epidemiología , Reino Unido/epidemiología
7.
Support Care Cancer ; 29(1): 485-490, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32405963

RESUMEN

AIM: To assess financial distress (FD) and its impact on symptom expression and other quality of life issues PATIENTS AND METHODS: Advanced cancer patients admitted to inpatient and outpatient clinics were selected. Standard epidemiological data including age, gender, primary cancer diagnosis, and Karnofsky level were recorded. Data regarding marital status, number of cohabitants, religious belief, educational level, and family income (< 1000, 1000-3.000, > 3000 euros), as well as extra costs not covered by health care system, were collected. Symptom burden including FD was measured by Edmonton Symptom Assessment Scale (ESAS), FACT-G (Functional Assessment of Cancer Therapy-General), and HADS (Hospital Anxiety Depression scale) were measured. RESULTS: Two hundred thirty-six patients were evaluated. The mean FD was 3.55 (SD 3.1). One hundred patients (42%) had a FD of ≥ 4. There was an inverse correlation between FD and income (P = 0.032). Most patients incurred in extra-costs, the most frequent being for drugs (n, 114). FD was inversely associated with age (P = 0.024), marital status (divorced or separated, P = 0.005), ESAS anxiety (P = 0.006), total ESAS (P = 0.019), physical well-being (P = 0.033), poor social family well-being (P = 0.004), emotional well-being (P = 0.045), poor functional well-being (P = 0.019), HADS-A (P = 0.003), and global HADS (P = 0.034). Family income was inversely related to age (P = 0.023), education level (P < 0.0005), less number of hospital admissions in the last month (P = 0.020), physical well-being (P = 0.039), social/family well-being (P = 0.020), and total well-being (P = 0.001). CONCLUSION: FD is very common in advanced cancer patients. FD was associated with anxiety, depression, and poor quality of life. The screening of FD may allow to develop effective interventions of social support.


Asunto(s)
Neoplasias/economía , Calidad de Vida/psicología , Evaluación de Síntomas/métodos , Estudios Transversales , Femenino , Humanos , Masculino , Neoplasias/psicología
8.
Support Care Cancer ; 29(1): 349-358, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32361832

RESUMEN

PURPOSE: Fighting cancer is a costly battle, and understanding the relationship between patient-reported financial toxicity (FT) and health outcomes can help inform interventions for post-treatment cancer survivors. METHODS: Stages I-III solid tumor, insured US cancer survivors (N = 103) completed a survey addressing FT (as measured by the standardized COST measure) and clinically relevant health outcomes (including health-related quality of life [HRQOL] and adherence to recommended survivorship health behaviors). Univariate and multivariate analyses were used to assess demographic and disease-specific correlates of FT, and to assess the predictive value of FT on HRQOL and adherence to survivorship health behaviors. RESULTS: Approximately 18% of respondents noted FT levels associated with significant financial burden. In univariate analyses, after correcting for multiple comparisons, greater FT was associated with unpartnered status, non-retirement, and lower level of educational attainment. Greater FT was also significantly associated with HRQOL components of anxiety, fatigue, pain, physical functioning, and social functioning. FT was not significantly associated with any measured survivorship health behaviors. In multivariate analyses, FT was found to be a meaningful predictor of patient-reported anxiety, fatigue, physical functioning, and social functioning above and beyond theoretically and statistically relevant demographic characteristics. CONCLUSIONS: Although overall levels of FT were lower among cancer survivors in this sample, as compared with active treatment patients assessed in previous studies, financial burden continued to be a concern for a significant minority of cancer survivors and was associated with components of reduced HRQOL. Further research is needed to understand FT among underinsured survivors and those treated in community oncology settings. IMPLICATIONS FOR CANCER SURVIVORS: Incorporation of FT assessment into survivorship care planning could enhance clinical assessment of survivors' FT vulnerability, help address the dynamic and persistent challenges of survivorship, and help identify those most in need of intervention across the cancer care continuum.


Asunto(s)
Supervivientes de Cáncer/psicología , Costo de Enfermedad , Gastos en Salud , Neoplasias/economía , Calidad de Vida/psicología , Adulto , Ansiedad/psicología , Fatiga/psicología , Femenino , Conductas Relacionadas con la Salud , Humanos , Masculino , Persona de Mediana Edad , Grupos Minoritarios , Neoplasias/terapia , Medición de Resultados Informados por el Paciente , Encuestas y Cuestionarios , Supervivencia
9.
Bull Cancer ; 107(11): 1129-1137, 2020 Nov.
Artículo en Francés | MEDLINE | ID: mdl-33036742

RESUMEN

PURPOSE: Human, material, and financial resources being limited, the organization of the care system must allow an efficient allocation of resources. The management of cancers leads to specific and repetitive care for which the reimbursement of transport costs represents a high cost. We carried out an analysis of the additional transport costs, linked to the care of patients in Île-de-France, in a center other than the radiotherapy center closest to their home. MATERIALS AND METHODS: Using data from the Île-de-France Regional Health Agency, we have created a model evaluating the additional cost linked to transport generated by the care of a radiotherapy patient far from his home. In order to take into account the uncertainties linked to the hypotheses made in the development of the model, we carried out deterministic and probabilistic sensitivity analyzes. RESULTS: In the base case, the additional annual cost related to transport was 841,176 euros in Île-de-France. The probabilistic sensitivity analysis reports a total annual additional cost of 2,817,481 euros. CONCLUSION: Our results are similar to a report from the General Inspectorate of Social Affairs published in July 2011, which then pointed to an additional cost of between 4 and 6 million euros annually. The long-term care of cancer patients from their homes contributes to a deterioration in the quality of life linked to travel times, a delay in the care of potential treatment complications, and the spread of infectious diseases, such as COVID-19, and bacteria resistant to antibiotics.


Asunto(s)
Ambulancias/economía , Instituciones Oncológicas/provisión & distribución , Accesibilidad a los Servicios de Salud/economía , Neoplasias/radioterapia , Transporte de Pacientes/economía , Ambulancias/estadística & datos numéricos , Costos y Análisis de Costo , Francia , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Modelos Estadísticos , Neoplasias/economía , Paris , Calidad de Vida , Asignación de Recursos , Factores de Tiempo , Transporte de Pacientes/estadística & datos numéricos , Incertidumbre
11.
Support Care Cancer ; 28(10): 4645-4665, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32653957

RESUMEN

PURPOSE: Financial toxicity related to cancer diagnosis and treatment is a common issue in developed countries. We seek to systematically summarize the extent of the issue in very high development index countries with publicly funded healthcare. METHODS: We identified articles published Jan 1, 2005, to March 7, 2019, describing financial burden/toxicity experienced by cancer patients and/or informal caregivers using OVID Medline Embase and PsychInfo, CINAHL, Business Source Complete, and EconLit databases. Only English language peer-reviewed full papers describing studies conducted in very high development index countries with predominantly publicly funded healthcare were eligible (excluded the USA). All stages of the review were evaluated in teams of two researchers excepting the final data extraction (CJL only). RESULTS: The searches identified 7117 unique articles, 32 of which were eligible. Studies were undertaken in Canada, Australia, Ireland, UK, Germany, Denmark, Malaysia, Finland, France, South Korea, and the Netherlands. Eighteen studies reported patient/caregiver out-of-pocket costs (range US$17-US$506/month), 18 studies reported patient/caregiver lost income (range 17.6-67.3%), 14 studies reported patient/caregiver travel and accommodation costs (range US$8-US$393/month), and 6 studies reported financial stress (range 41-48%), strain (range 7-39%), or financial burden/distress/toxicity among patients/caregivers (range 22-27%). The majority of studies focused on patients, with some including caregivers. Financial toxicity was greater in those with early disease and/or more severe cancers. CONCLUSIONS: Despite government-funded universal public healthcare, financial toxicity is an issue for cancer patients and their families. Although levels of toxicity vary between countries, the findings suggest financial protection appears to be inadequate in many countries.


Asunto(s)
Neoplasias/economía , Femenino , Humanos , Masculino , Neoplasias/epidemiología
12.
Artículo en Inglés | MEDLINE | ID: mdl-32630745

RESUMEN

In view of an efficient use of the Italian National Health Service-funded healthcare resources, a novel data-processing strategy combining information from multiple sources was developed in a regional cancer network of northern Italy. The goal was to calculate the annual overall cost of care pathways of six disease groups in 10,486 patients. The evaluation was conceived as a population-based cost description from the perspective of the Italian National Health Service. Costs occurred during a defined time period for a cross-section of patients at varying stages of their disease were measured. The total cancer care cost was €81,170,121 (11.1% of total local health expenditure), with a cost per patient of €7741.17 and a cost per capita of €204.62. Surgical, inpatient and day-hospital medical admissions, radiotherapy, drugs, outpatient care, emergency admissions, and home and hospice care accounted for 21.2%, 24.1%, 6.2%, 28.2%, 14.0%, 0.9%, and 5.4% of the total cost, respectively. The highest cost items included drugs (cost per capita, €22.95; 11.2% of total cost) and medical admissions (€14.51; 7.1%) for blood cancer, and surgical (€14.56; 7.1%) and medical admissions (€13.60; 6.6%) for gastrointestinal cancer. The information extracted allows multidisciplinary cancer care teams to be more aware of the costs of their clinical decisions.


Asunto(s)
Costos de la Atención en Salud/estadística & datos numéricos , Neoplasias/economía , Medicina Estatal , Atención Ambulatoria , Gastos en Salud , Hospitalización , Humanos , Italia/epidemiología , Neoplasias/epidemiología , Neoplasias/terapia
14.
Public Health ; 185: 130-138, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32622220

RESUMEN

OBJECTIVES: Health insurance availability and affordability are vital elements in diagnosis and treatment of patients with cancer and thus constitute clinical significance as well. Although past studies have explored the disparity in mortality figures for patients with different insurance statuses, this population-based study is pioneering in analyzing the changes in cancer mortality risks over time amid macroeconomic shifts. STUDY DESIGN: The study uses Surveillance Epidemiology and End Results (SEER) data of 424,889 non-elderly patients with breast, cervical, ovarian, and uterine cancer diagnosed during 2007-2010 and 2011-2015. METHODS: In addition to discussing incidence figures and insurance patterns, the study uses Kaplan-Meier and Cox's proportional hazard models to examine the changes in survival probability and mortality risks for insurance-stratified patients with female-specific cancer across the two time periods. RESULTS: Patients without insurance have an increased risk of mortality over time relative to insured patients. Moreover, uninsured patients face this heightened risk more than Medicaid patients. DISCUSSION: Despite public policy measures as well as advancements in diagnostic facilities and treatment technology, the increased relative mortality of patients without insurance limits the long-term affordability of cancer treatment for economically vulnerable patients in comparison with insured patients.


Asunto(s)
Cobertura del Seguro/estadística & datos numéricos , Seguro de Salud/estadística & datos numéricos , Neoplasias/mortalidad , Adolescente , Adulto , Neoplasias de la Mama/mortalidad , Femenino , Humanos , Incidencia , Cobertura del Seguro/economía , Seguro de Salud/economía , Medicaid/economía , Pacientes no Asegurados , Persona de Mediana Edad , Neoplasias/economía , Neoplasias/epidemiología , Neoplasias Ováricas/mortalidad , Factores de Riesgo , Programa de VERF , Estados Unidos , Neoplasias del Cuello Uterino/mortalidad , Neoplasias Uterinas/mortalidad , Adulto Joven
15.
Gan To Kagaku Ryoho ; 47(7): 1007-1011, 2020 Jul.
Artículo en Japonés | MEDLINE | ID: mdl-32668840

RESUMEN

The Japanese government set the target to "reduce health inequalities" in the second version of "Healthy Japan 21". However, it is not enough to monitor the socioeconomic inequalities in cancer. In England, National Health Service(NHS) targeted to "tackle the inequalities in cancer" since 2000. In this review, I introduced some researches for the socioeconomic inequalities in cancer in Japan. We monitored the area-level socioeconomic inequalities in mortality using vital statistics data in Japan using the areal-based deprivation index. Among total inequalities in all cause of death, inequalities in cancer death is the most contributed. Inequalities in lung cancer mortality were widest for both sexes, which is related to the inequalities in smoking rate. We also monitored socioeconomic inequalities in stage-specific incidence using population-based cancer registry. For most of cancer sites, higher late-stage incidence were observed in the more deprived area, which might be due to poor access to the cancer screening in those area. Socioeconomic inequalities in cancer survival were also observed, especially for the cancer sites which has favor prognosis. Although stage at diagnosis plays an important role in these socioeconomic inequalities, other factors such as co-morbidities are likely play a part. We need further study to understand the mechanism of inequalities in cancer using more clinically detail database in near future.


Asunto(s)
Neoplasias , Medicina Estatal , Femenino , Humanos , Incidencia , Japón , Masculino , Neoplasias/economía , Neoplasias/terapia , Factores Sexuales , Factores Socioeconómicos
16.
Cancer Immunol Immunother ; 69(10): 1947-1958, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32676716

RESUMEN

OBJECTIVES: Scientific advances in the last decade have highlighted the use of immunotherapy, especially immune checkpoint inhibitors, to be an effective strategy in cancer therapy. However, these immunotherapeutic agents are expensive, and their use must take into account economic criteria. Thus, the objective of the present study was to systematically identify and review published EE related to the use of ipilimumab, nivolumab or pembrolizumab in melanoma, lung cancer, head and neck cancer or renal cell carcinoma, and to assess their quality. METHODS: The systematic literature research was conducted on Medline via PubMed and the Cochrane Central Register of Controlled Trials to identify economic evaluations published before July 2018. The quality of each selected economic evaluation was assessed by two independent reviewers using the Drummond checklist. RESULTS: Our systematic review was based on 32 economic evaluations using different methodological approaches, different perspectives and different time horizons. Three-quarters of the economic evaluations are full (n = 24) with a Drummond score ≥ 7, synonymous of "high quality". Among them, 66% reported a strategy that was cost-effective. The most assessed immunotherapeutic agent was nivolumab. In patients with renal cell carcinoma or head and neck cancer, it was less likely to be cost-effective than in patients with melanoma or lung cancer. CONCLUSIONS: Whether or not these findings will be confirmed remains to be seen when market approval to cover more indications is extended and new effective immunotherapeutic agents become available.


Asunto(s)
Antineoplásicos Inmunológicos/economía , Análisis Costo-Beneficio , Inmunoterapia/economía , Neoplasias/tratamiento farmacológico , Neoplasias/economía , Antineoplásicos Inmunológicos/uso terapéutico , Humanos , Neoplasias/inmunología , Neoplasias/patología , Pronóstico
17.
Public Health ; 185: 306-311, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32717672

RESUMEN

OBJECTIVES: The global patterns of cancer incidences and mortality rates are slowly shifting towards low- and middle-income countries. Through our article, we highlight the societal cost associated with premature mortality and morbidity of cancer in Nepal. The monetary loss is indicative of the severity of the issue and it serves to motivate the policymakers realize the urgency in devising appropriate cancer control strategies. STUDY DESIGN: The study design is a cross-sectional study using the GLOBOCAN 2012 data. METHODS: Using the human capital approach, we measure the number of years of life lost (YLL) and the number of years of productive life lost (YPLL) due to cancer in Nepal. RESULTS: We found that following diagnosis, a Nepali patient with cancer is likely to lose out on 19.64 years of their life; the average number of YLL is higher for females (22.2 years vs 16.8 years in males). After adjusting for labor force participation rate and predicted growth rate of the economy, we found that cancer led to a total productivity loss of $149 million (males) and $121 million (females) in 2012. The burden of the top five cancers accounted for almost half of the total productivity loss in both the genders. Cervical and lung cancer incur the maximum cost to society, respectively, for females and males. CONCLUSIONS: The article highlighted the severity of the cancer issue and emphasized the urgency needed in devising cancer control policies in Nepal.


Asunto(s)
Esperanza de Vida , Mortalidad Prematura , Neoplasias/economía , Neoplasias/epidemiología , Adolescente , Adulto , Anciano , Costo de Enfermedad , Estudios Transversales , Empleo , Femenino , Humanos , Incidencia , Renta , Neoplasias Pulmonares/economía , Masculino , Persona de Mediana Edad , Neoplasias/mortalidad , Neoplasias/prevención & control , Nepal/epidemiología , Neoplasias del Cuello Uterino/economía , Adulto Joven
18.
J Med Internet Res ; 22(6): e19691, 2020 06 24.
Artículo en Inglés | MEDLINE | ID: mdl-32501807

RESUMEN

BACKGROUND: During the coronavirus disease (COVID-19) pandemic, patients with cancer in rural settings and distant geographical areas will be affected the most by curfews. Virtual management (telemedicine) has been shown to reduce health costs and improve access to care. OBJECTIVE: The aim of this survey is to understand oncologists' awareness of and views on virtual management, challenges, and preferences, as well as their priorities regarding the prescribing of anticancer treatments during the COVID-19 pandemic. METHODS: We created a self-administrated electronic survey about the virtual management of patients with cancer during the COVID-19 pandemic. We evaluated its clinical sensibility and pilot tested the instrument. We surveyed practicing oncologists in Gulf and Arab countries using snowball sampling via emails and social media networks. Reminders were sent 1 and 2 weeks later using SurveyMonkey. RESULTS: We received 222 responses from validated oncologists from April 2-22, 2020. An awareness of virtual clinics, virtual multidisciplinary teams, and virtual prescriptions was reported by 182 (82%), 175 (79%), and 166 (75%) respondents, respectively. Reported challenges associated with virtual management were the lack of physical exam (n=134, 60%), patients' awareness and access (n=131, 59%), the lack of physical attendance of patients (n=93, 42%), information technology (IT) support (n=82, 37%), and the safety of virtual management (n=78, 35%). Overall, 111 (50%) and 107 (48%) oncologists did not prefer the virtual prescription of chemotherapy and novel immunotherapy, respectively. However, 188 (85%), 165 (74%), and 127 (57%) oncologists preferred the virtual prescription of hormonal therapy, bone modifying agents, and targeted therapy, respectively. In total, 184 (83%), 183 (83%), and 176 (80%) oncologists preferred to continue neoadjuvant, adjuvant, and perioperative treatments, respectively. Overall, 118 (53%) respondents preferred to continue first-line palliative treatment, in contrast to 68 (30%) and 47 (21%) respondents indicating a preference to interrupt second- and third-line palliative treatment, respectively. For administration of virtual prescriptions, all respondents preferred the oral route and 118 (53%) preferred the subcutaneous route. In contrast, 193 (87%) did not prefer the intravenous route for virtual prescriptions. Overall, 102 (46%) oncologists responded that they would "definitely" prefer to manage patients with cancer virtually. CONCLUSIONS: Oncologists have a high level of awareness of virtual management. Although their survey responses indicated that second- and third-line palliative treatments should be interrupted, they stated that neoadjuvant, adjuvant, perioperative, and first-line palliative treatments should continue. Our results confirm that oncologists' views on the priority of anticancer treatments are consistent with the evolving literature during the COVID-19 pandemic. Challenges to virtual management should be addressed to improve the care of patients with cancer.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Encuestas de Atención de la Salud , Neoplasias/terapia , Oncólogos , Neumonía Viral/epidemiología , Pautas de la Práctica en Medicina/estadística & datos numéricos , Telemedicina/métodos , Femenino , Costos de la Atención en Salud , Humanos , Internet , Masculino , Neoplasias/economía , Pandemias , Pautas de la Práctica en Medicina/economía , Telemedicina/economía
20.
Biochim Biophys Acta Rev Cancer ; 1874(1): 188381, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32492470

RESUMEN

The United States Food and Drug Administration has permitted number of therapeutic agents for cancer treatment. Most of them are expensive and have some degree of systemic toxicity which makes overbearing in clinical settings. Although advanced research continuously applied in cancer therapeutics, but drug resistance, metastasis, and recurrence remain unanswerable. These accounts to an urgent clinical need to discover natural compounds with precisely safe and highly efficient for the cancer prevention and cancer therapy. Gambogic acid (GA) is the principle bioactive and caged xanthone component, a brownish gamboge resin secreted from the of Garcinia hanburyi tree. This molecule showed a spectrum of biological and clinical benefits against various cancers. In this review, we document distinct biological characteristics of GA as a novel anti-cancer agent. This review also delineates specific molecular mechanism(s) of GA that are involved in anti-cancer, anti-metastasis, anti-angiogenesis, and chemo-/radiation sensitizer activities. Furthermore, recent evidence, development, and implementation of various nanoformulations of gambogic acid (nanomedicine) have been described.


Asunto(s)
Antineoplásicos Fitogénicos/administración & dosificación , Nanomedicina/métodos , Neoplasias/terapia , Fármacos Sensibilizantes a Radiaciones/administración & dosificación , Xantonas/administración & dosificación , Animales , Antineoplásicos Fitogénicos/economía , Quimioradioterapia/economía , Quimioradioterapia/métodos , Ensayos Clínicos Fase II como Asunto , Relación Dosis-Respuesta a Droga , Portadores de Fármacos/química , Costos de los Medicamentos , Garcinia/química , Humanos , Nanomedicina/economía , Nanopartículas/química , Neoplasias/economía , Fármacos Sensibilizantes a Radiaciones/economía , Resinas de Plantas/química , Resultado del Tratamiento , Xantonas/economía , Ensayos Antitumor por Modelo de Xenoinjerto
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