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1.
Rev Med Liege ; 76(5-6): 307-310, 2021 May.
Artigo em Francês | MEDLINE | ID: mdl-34080356

RESUMO

The present article emphasizes the crucial importance of fundamental research and translational research in oncology. These two approaches are complementary and open new perspectives for future anti-cancer therapies in clinical practice.


Assuntos
Neoplasias , Pesquisa Médica Translacional , Humanos , Imunoterapia , Oncologia , Neoplasias/terapia
2.
Rev Med Liege ; 76(5-6): 387-391, 2021 May.
Artigo em Francês | MEDLINE | ID: mdl-34080368

RESUMO

Cancers are rare pathologies in children. Improvement in survival rates has been obtained thanks to new therapeutic strategies based on the identification of risk factors. Targeted therapies in paediatric oncology are new treatments providing hope that cure is achievable without long-term sequelae.


Assuntos
Oncologia , Neoplasias , Criança , Humanos , Neoplasias/tratamento farmacológico , Taxa de Sobrevida
3.
Rev Med Liege ; 76(5-6): 408-412, 2021 May.
Artigo em Francês | MEDLINE | ID: mdl-34080372

RESUMO

Cardio-oncology is a new interdisciplinary specialty that has emerged over the past ten years. With the development of increasingly potent cancer therapies which improve cancer survival, but at the cost of cardiovascular toxicity, the demand for specialized cardio-oncology services has emerged. Also, cardiovascular diseases are more common and more serious in cancer patients than in the general population. Cardio-oncology focuses on the prevention, detection, monitoring, and treatment of cardiovascular diseases in cancer patients, mostly those occurring as a side effect of chemo- and radiotherapy.


Assuntos
Doenças Cardiovasculares , Sistema Cardiovascular , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Neoplasias , Doenças Cardiovasculares/terapia , Humanos , Oncologia , Neoplasias/terapia
4.
Clin Adv Hematol Oncol ; 19(6): 390-395, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34106913

RESUMO

The provision of specialty palliative care alongside oncology care is now recommended by the American Society of Clinical Oncology (ASCO) on the basis of multiple randomized trials showing that it leads to better symptom control, less depression and anxiety, improved quality of life, improved caregiver quality of life, and even longer survival. That said, simply not enough palliative care specialists are available to provide concurrent care, so oncologists are tasked with providing the greatest part of primary palliative care. It is useful to think of primary palliative care as comprising 2 skill sets, or "bundles": the first symptom assessment and management, and the second communication. Symptom assessment begins with the use of a standardized scale that emphasizes the assessment of anxiety, depression, physical symptoms, and coping strategies. Communication requires knowing how much information the patient and family want, especially about prognosis, and involves shared decision making. It also encompasses advance care planning, starting with the identification of a medical power of attorney and proceeding to a discussion about hospice and end-of-life treatment choices. The communication skill set includes providing caregiver support and spiritual care referral, making culturally appropriate decisions, and providing a specific statement of non-abandonment near the end of life. If specialty palliative care is involved, data show that the effect on quality of life and end-of-life choices is most meaningful if consultation is started at least 3 months before death. In this article, we provide a brief overview of the benefits of incorporating palliative care into routine oncologic practice and offer clinical pearls on how best to deliver the tenets of palliative care in the outpatient and inpatient settings.


Assuntos
Neoplasias/terapia , Cuidados Paliativos/métodos , Humanos , Oncologia/métodos , Neoplasias/diagnóstico , Neoplasias/epidemiologia , Qualidade de Vida , Avaliação de Sintomas
5.
Rev Med Suisse ; 17(743): 1155-1158, 2021 Jun 16.
Artigo em Francês | MEDLINE | ID: mdl-34133092

RESUMO

Over the last decade, surgical management of colon cancer became more individualized due to new preoperative, surgical and oncological strategies. Recent high-level evidence demonstrated a favorable impact of these advanced concepts, which require proper planning and challenging surgical management form a technical standpoint, on cancer-specific survival. To tailor the best strategy, cases have to be discussed in multidisciplinary tumor boards with specialists in medical oncology, radiology, gastroenterology and pathology. In this review, these innovations are summarized within their scientific context, with focus on new strategies of preoperative bowel preparation, neoadjuvant chemotherapy and technical aspects, to illustrate the complexity of current colon cancer management.


Assuntos
Neoplasias do Colo , Gastroenterologia , Neoplasias do Colo/cirurgia , Humanos , Oncologia , Terapia Neoadjuvante
6.
Curr Oncol ; 28(3): 2007-2013, 2021 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-34073214

RESUMO

The COVID-19 situation is a worldwide health emergency with strong implications in clinical oncology. In this viewpoint, we address two crucial dilemmas from the ethical dimension: (1) Is it ethical to postpone or suspend cancer treatments which offer a statistically significant benefit in quality of life and survival in cancer patients during this time of pandemic?; (2) Should we vaccinate cancer patients against COVID-19 if scientific studies have not included this subgroup of patients? Regarding the first question, the best available evidence applied to the ethical principles of Beauchamp and Childress shows that treatments (such as chemotherapy) with clinical benefit are fair and beneficial. Indeed, the suspension or delay of such treatments should be considered malefic. Regarding the second question, applying the doctrine of double-effect, we show that the potential beneficial effect of vaccines in the population with cancer (or those one that has had cancer) is much higher than the potential adverse effects of these vaccines. In addition, there is no better and less harmful known solution.


Assuntos
COVID-19/prevenção & controle , Tomada de Decisão Clínica/ética , Neoplasias/tratamento farmacológico , Seleção de Pacientes/ética , Tempo para o Tratamento/ética , Antineoplásicos/administração & dosagem , COVID-19/epidemiologia , COVID-19/imunologia , COVID-19/virologia , Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/efeitos adversos , Humanos , Oncologia/ética , Neoplasias/imunologia , Neoplasias/mortalidade , Neoplasias/psicologia , Pandemias/prevenção & controle , Qualidade de Vida , Fatores de Risco , SARS-CoV-2/imunologia , Fatores de Tempo , Vacinação/efeitos adversos , Vacinação/ética
7.
Rinsho Ketsueki ; 62(5): 424-428, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-34108324

RESUMO

The standard of care for lymphoid tumors has been established and is continually being updated, using the evidence generated through clinical research and development, including multicenter phase III trials. The Japan Clinical Oncology Group-Lymphoma Study Group is a multicenter research group that has been developing treatments for lymphoid malignancies for >40 years. This group is fully equipped with a system that guarantees a high level of scientific accuracy and quality and has produced considerable evidence based on the results of phase III trials. There are currently several issues in advancing clinical research. The strict legal regulation by the clinical trial act would be a burden for researchers in conducting clinical researches. From the perspective of developing a standard of care, researchers should always be aware of the difference in the significance between investigator-led and sponsor-led clinical trials that are intended to gain regulatory approval. Incorporating patient opinions from the early stages of treatment development and implementing genomic medicine are considered important issues for promoting clinical research.


Assuntos
Neoplasias , Humanos , Japão , Oncologia
8.
Curr Treat Options Oncol ; 22(7): 58, 2021 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-34097148

RESUMO

OPINION STATEMENT: Cardio-oncology is a field dedicated to the prevention, diagnosis, and management of cardiovascular disease in cancer patients before, during, and after cancer therapy. It is an emerging field with limited opportunities for structured education and training. In the year 2021, we cannot define the requirements of cardio-oncology training without acknowledging the impact of the global coronavirus disease 19 (COVID-19) pandemic. While this pandemic poses significant health risks to patients with cancer and cardiovascular disease as well as the providers who care for them, it also allows novel opportunities for the nascent field of cardio-oncology to readily adapt. In this article, we detail how the COVID-19 pandemic has impacted all aspects of cardio-oncology training, how programs and trainees can adapt to these challenges, and how lessons learned from the COVID-19 era can continue to positively impact cardio-oncology training for the foreseeable future.


Assuntos
COVID-19/complicações , Doenças Cardiovasculares/prevenção & controle , Neoplasias/tratamento farmacológico , COVID-19/virologia , Doenças Cardiovasculares/induzido quimicamente , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/virologia , Humanos , Oncologia/tendências , Neoplasias/complicações , Neoplasias/patologia , Neoplasias/virologia , SARS-CoV-2/patogenicidade
9.
Am Soc Clin Oncol Educ Book ; 41: e13-e19, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34061560

RESUMO

The COVID-19 pandemic and the simultaneous increased focus on structural racism and racial/ethnic disparities across the United States have shed light on glaring inequities in U.S. health care, both in oncology and more generally. In this article, we describe how, through the lens of fundamental ethical principles, an ethical imperative exists for the oncology community to overcome these inequities in cancer care, research, and the oncology workforce. We first explain why this is an ethical imperative, centering the discussion on lessons learned during 2020. We continue by describing ongoing equity-focused efforts by ASCO and other related professional medical organizations. We end with a call to action-all members of the oncology community have an ethical responsibility to take steps to address inequities in their clinical and academic work-and with guidance to practicing oncologists looking to optimize equity in their research and clinical practice.


Assuntos
Equidade em Saúde/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/estatística & dados numéricos , Oncologia/métodos , Neoplasias/terapia , Racismo/prevenção & controle , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/virologia , Equidade em Saúde/ética , Disparidades em Assistência à Saúde/ética , Humanos , Oncologia/ética , Oncologia/organização & administração , Neoplasias/diagnóstico , Pandemias , Saúde Pública/ética , Saúde Pública/métodos , Saúde Pública/estatística & dados numéricos , Racismo/ética , SARS-CoV-2/isolamento & purificação , SARS-CoV-2/fisiologia , Estados Unidos
10.
Am Soc Clin Oncol Educ Book ; 41: e339-e353, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34061565

RESUMO

Optimizing the well-being of the oncology clinician has never been more important. Well-being is a critical priority for the cancer organization because burnout adversely impacts the quality of care, patient satisfaction, the workforce, and overall practice success. To date, 45% of U.S. ASCO member medical oncologists report experiencing burnout symptoms of emotional exhaustion and depersonalization. As the COVID-19 pandemic remains widespread with periods of outbreaks, recovery, and response with substantial personal and professional consequences for the clinician, it is imperative that the oncologist, team, and organization gain direct access to resources addressing burnout. In response, the Clinician Well-Being Task Force was created to improve the quality, safety, and value of cancer care by enhancing oncology clinician well-being and practice sustainability. Well-being is an integrative concept that characterizes quality of life and encompasses an individual's work- and personal health-related environmental, organizational, and psychosocial factors. These resources can be useful for the cancer organization to develop a well-being blueprint: a detailed start plan with recognized strategies and interventions targeting all oncology stakeholders to support a culture of community in oncology.


Assuntos
Esgotamento Profissional/psicologia , Oncologia/métodos , Neoplasias/terapia , Oncologistas/psicologia , Estresse Psicológico/prevenção & controle , Esgotamento Psicológico/prevenção & controle , Esgotamento Psicológico/psicologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/virologia , Humanos , Internet , Satisfação no Emprego , Oncologia/organização & administração , Neoplasias/diagnóstico , Pandemias , SARS-CoV-2/isolamento & purificação , SARS-CoV-2/fisiologia , Apoio Social , Estados Unidos
11.
BMC Health Serv Res ; 21(1): 461, 2021 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-33990198

RESUMO

BACKGROUND: Multidisciplinary team meeting (MDM) processes differ according to clinical setting and tumour site. This can impact on decision making. This study aimed to evaluate the translation of MDM recommendations into clinical practice across solid tumour MDMs at an academic centre. METHODS: A retrospective audit of oncology records was performed for nine oncology MDMs held at Liverpool Hospital, NSW, Australia from 1/2/17-31/7/17. Information was collected on patient factors (age, gender, country of birth, language, postcode, performance status, comorbidities), tumour factors (diagnosis, stage) and MDM factors (number of MDMs, MDM recommendation). Management was audited up to a year post MDM to record management and identify reasons if discordant with MDM recommendations. Univariate and multivariable regression analyses were performed to assess for factors associated with concordant management. RESULTS: Eight hundred thirty-five patients were discussed, median age was 65 years and 51.4% were males. 70.8% of patients were presented at first diagnosis, 77% discussed once and treatment recommended in 73.2%. Of 771 patients assessable for concordance, management was fully concordant in 79.4%, partially concordant in 12.8% and discordant in 7.8%. Concordance varied from 84.5% for lung MDM to 97.6% for breast MDMs. On multivariable analysis, breast and upper GI MDMs and discussion at multiple MDMs were significantly associated with concordant management. The most common reason for discordant management was patient/guardian decision (28.3%). CONCLUSION: There was variability in translation of MDM recommendations into clinical practice by tumour site. Routine measurement of implementation of MDM recommendations should be considered as a quality indicator of MDM practice.


Assuntos
Comunicação Interdisciplinar , Equipe de Assistência ao Paciente , Idoso , Austrália/epidemiologia , Feminino , Humanos , Masculino , Oncologia , Estudos Retrospectivos
12.
Rev Bras Enferm ; 74(suppl 1): e20201080, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34037167

RESUMO

OBJECTIVE: to describe the experience of a private outpatient network for hematology and oncology treatment in the adoption of management tools to face the risk of contamination by SARS-CoV-2. METHOD: an experience report on the use of a root cause analysis method to identify potential risks of contamination by COVID-19 among patients and employees. Through the risks identified through the Ishikawa Diagram, we built an action plan, linked to the 5W2H tool, for planning and decision-making implemented. RESULTS: the number of attendances in person and people circulating in the units was reduced, protective distance measures and new protection barriers were fundamental to control the risks of spreading COVID-19 in patients and employees. FINAL CONSIDERATIONS: the management tools served as a valuable tool in the construction of measures, making the measures in question more clearly and applicable.


Assuntos
Adaptação Psicológica , Instituições de Assistência Ambulatorial/estatística & dados numéricos , COVID-19/psicologia , Oncologia/métodos , Saúde do Trabalhador , Guias como Assunto , Humanos , Pandemias , Equipamento de Proteção Individual , SARS-CoV-2
13.
Cancer Control ; 28: 10732748211017166, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34044598

RESUMO

BACKGROUND: On March 11, 2020, the World Health Organization (WHO) declared Coronavirus Disease (COVID-19) a pandemic. Hospitals around the world began to implement infection prevention and control (IPC) measures to stop further spread and prevent infections within their facilities. Healthcare organizations were challenged to develop response plans, procure personal protective equipment (PPE) that was in limited supply while continuing to provide quality, safe care. METHODS: As a comprehensive cancer center with immunocompromised patients, our efforts began immediately. Preventative measures were established and, as of September 2020, over 14,000 patients have been tested within the facility. From March 2020 through September 2020, only one case of hospital acquired (HA) COVID-19 was identified among our patients. Two cases of suspected community acquired (SCA) cases were also identified. Following the Centers for Disease Control (CDC) guidance, IPC measures were implemented within the facility as information science about the virus developed. This article addresses the IPC measures taken, such as enhancing isolation precautions, implementing screening protocols, disinfecting and reusing N95 respirators, by the center throughout the pandemic as well as the challenges that arouse with a new and emerging infectious disease. CONCLUSIONS: The infection control measures implemented at our comprehensive cancer center during the COVID-19 pandemic allowed our center to continue to provide world class cancer care with minimal COVID-19 infection transmission among patients and team members.


Assuntos
COVID-19/prevenção & controle , Institutos de Câncer , Transmissão de Doença Infecciosa/prevenção & controle , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/transmissão , Transmissão de Doença Infecciosa/estatística & dados numéricos , Humanos , Incidência , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Controle de Infecções/normas , Oncologia , SARS-CoV-2/isolamento & purificação
15.
Clin J Oncol Nurs ; 25(3): 347-350, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34019021

RESUMO

The Community Oncology Unit (COU) in Nazareth, Israel, provides complete medical treatments to patients who live in the rural area of the country. During the COVID-19 pandemic, oncology nurses face additional challenges in facilitating cancer care. Pertinent adjustments are being made at the COU to maintain patients' safety and enable continuous oncology therapy by coordinating patients' COVID-19 testing and vaccination program.


Assuntos
COVID-19/epidemiologia , Neoplasias/enfermagem , Papel do Profissional de Enfermagem , Enfermagem Oncológica , COVID-19/virologia , Teste para COVID-19 , Vacinas contra COVID-19/administração & dosagem , Humanos , Israel , Oncologia , Neoplasias/terapia , Pandemias , SARS-CoV-2/isolamento & purificação
16.
Stud Health Technol Inform ; 281: 123-127, 2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34042718

RESUMO

The development of precision medicine in oncology to define profiles of patients who could benefit from specific and relevant anti-cancer therapies is essential. An increasing number of specific eligibility criteria are necessary to be eligible to targeted therapies. This study aimed to develop an automated algorithm based on natural language processing to detect patients and tumor characteristics to reduce the time-consuming prescreening for trial inclusions. Hence, 640 anonymized multidisciplinary team meeting (MTM) reports concerning lung cancer were extracted from one teaching hospital data warehouse in France and annotated. To automate the extraction of 52 bioclinical information corresponding to 8 major eligibility criteria, regular expressions were implemented and evaluated. The performance parameters were satisfying: macroaverage F1-score 93%; rates reached 98% for precision and 92% for recall. In MTM, fill rates variabilities among patients and tumors information remained important (from 31.4% to 100%). The least reported characteristics and the most difficult to automatically collect were genetic mutations and rearrangement test results.


Assuntos
Ciência de Dados , Processamento de Linguagem Natural , Data Warehousing , França , Humanos , Oncologia
17.
Stud Health Technol Inform ; 278: 110-117, 2021 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-34042883

RESUMO

INTRODUCTION: Health-related quality of life (HR-QoL) as a parameter for patient well-being is becoming increasingly important.[1] Nevertheless, it is mainly used as an endpoint in studies rather than as an indicator for adjustments in therapy. In this paper we will present an approach to gradually integrate quality of life (QoL) as a control element into the care delivery of oncology. CONCEPT: Acceptance, usability, interoperability and data protection were identified and integrated as key indicators for the development. As an initial approach, a questionnaire tool was developed to provide patients a simplified answering of questionnaires and physicians a clearer presentation of the results. IMPLEMENTATION: As communication standard HL7 FHIR was used and known security concepts like OpenID Concept were integrated. In a usability study, first results were achieved by asking patients in the waiting room to answer a questionnaire, which will be discussed with the physician in the appointment. This study was conducted in 2019 at theSLK Clinics Heilbronn and achieved 86% participation of all respondents with an average age of 67 years. DISCUSSION: Although the evaluation study could prove positive results in usability and acceptance, it is necessary to aim for longitudinal surveys in order to include QoL as a control element in the therapy. However, a longitudinal survey through questionnaires leads to decreasing compliance and increasing response bias. [2] For this reason, the concept needs to be expanded. With sensors a continuous monitoring can be carried out and the data can be mapped to the individual, interpreted by machine learning. CONCLUSION: Questionnaires are a concept that has been successfully applied in studies for years. However, since care delivery poses different challenges, the integration of new concepts is inevitable. The authors are currently working on an extension of the use of questionnaires with patient generated data through sensors.


Assuntos
Registros Eletrônicos de Saúde , Qualidade de Vida , Idoso , Criança , Atenção à Saúde , Feminino , Humanos , Recém-Nascido , Oncologia , Gravidez , Inquéritos e Questionários
18.
Stud Health Technol Inform ; 278: 203-210, 2021 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-34042895

RESUMO

In the field of oncology, a close integration of cancer research and patient care is indispensable. Although an exchange of data between health care providers and other institutions such as cancer registries has already been established in Germany, it does not take advantage of internationally coordinated health data standards. Translational cancer research would also benefit from such standards in the context of secondary data use. This paper employs use cases from the German Cancer Consortium (DKTK) to show how this gap can be closed using a harmonised FHIR-based data model, and how to apply it to an existing federated data platform.


Assuntos
Registros Eletrônicos de Saúde , Neoplasias , Gerenciamento de Dados , Alemanha , Humanos , Oncologia , Pesquisa Médica Translacional
20.
Recent Results Cancer Res ; 218: 149-173, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34019168

RESUMO

The care of pediatric cancer patients is a vast departure from cancer care of adults. While the available treatment modalities-chemotherapy, radiation, and surgery-are the same, the diseases, care-delivery, and outcomes differ greatly. And just as 'children are not just little adults,' pediatric bioethics occupies a distinct place within the broader field of bioethics. In this chapter, we will begin with an introduction to fundamental principles and frameworks for understanding ethical issues in pediatrics, highlighting the triadic nature of medical decision-making between a physician, the child-patient, and the child's parent as the surrogate decision-maker. We will then delve into further details of how these principles and frameworks shape the care of children with cancer, examining specific ethical challenges commonly encountered by pediatric oncologists. We will traverse this landscape by examining issues involving (a) informed consent; (b) research involving children; (c) end of life; (d) genetic and genomic testing; and (e) professionalism. We also examine ethical challenges in clinical research, in children and more broadly. While not an exhaustive exploration of the myriad ethical issues one might encounter in pediatric cancer medicine and clinical trials, this chapter provides readers with a foundation for further reading.


Assuntos
Neoplasias , Pediatria , Adulto , Criança , Tomada de Decisões , Humanos , Consentimento Livre e Esclarecido , Oncologia , Neoplasias/terapia
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