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1.
Br J Nurs ; 29(3): S18-S24, 2020 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-32053451

RESUMO

BACKGROUND: Patients with haematological cancers are surviving longer due to increasingly effective treatments. Many patients continue to need support and advice after treatment ends. AIMS: To review the support needs of patients after treatment for haematological cancer, in order to establish nursing measures for supporting them. Methods: A literature review and thematic analysis of six primary research articles. FINDINGS: Three themes were identified: a sense of abandonment, education about late effects, and becoming a survivor. CONCLUSION: Understanding an individual's support needs after treatment for haematological cancer enables nurses to offer sensitive, individualised care to patients. A tailored survivorship plan, led by a specialist nurse, helps to meet the ongoing holistic needs of haematological cancer patients.


Assuntos
Sobreviventes de Câncer/psicologia , Necessidades e Demandas de Serviços de Saúde , Neoplasias Hematológicas/enfermagem , Relações Enfermeiro-Paciente , Apoio Social , Humanos
2.
Medicine (Baltimore) ; 99(5): e18968, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32000424

RESUMO

BACKGROUND: Lung cancer is one of the most common cancers worldwide, and approximately half of the patients with lung cancer receiving chemotherapy suffer from cancer-related fatigue (CRF). Herbal medicines (HMs) have been used in Oriental countries for centuries as tonics. Various beneficial effects of HM on fatigue and cancer have been reported. However, the effectiveness and safety of HM for CRF in lung cancer patients have not been synthesized. The purpose of this systematic review is to evaluate the effectiveness and safety of HM for CRF in patients with lung cancer, regardless of their cancer type or stage. METHODS AND ANALYSIS: A comprehensive search will be conducted in 12 electronic medical databases including 5 English-language databases (Medline via PubMed, EMBASE via Elsevier, the Cochrane Central Register of Controlled Trials [CENTRAL], the Allied and Complementary Medicine Database [AMED] via EBSCO, and the Cumulative Index to Nursing and Allied Health Literature [CINAHL] via EBSCO), 4 Korean-language databases (Oriental Medicine Advanced Searching Integrated System [OASIS], Koreanstudies Information Service System [KISS], Research Information Service System [RISS], and Korea Citation Index [KCI]), 2 Chinese-language databases (China National Knowledge Infrastructure [CNKI] and Wanfang Data), and 1 Japanese-language database (CiNii). Only randomized controlled trials (RCTs) and quasi-RCTs on HM for CRF will be allowed. The severity of fatigue assessed using a validated tool will be considered as theprimary outcome. The secondary outcomes will include the patients' quality of life, activities of daily life, incidence of adverse events, and total effective rate. Two independent researchers will perform the study selection, data extraction, and quality assessment. RevMan version 5.3 will be used for data synthesis. The methodological quality of the included RCTs will be assessed using the Cochrane Collaboration's risk of bias tool. In the meta-analysis, for dichotomous data and continuous data, risk ratio and mean difference, respectively, will be estimated with their 95% confidence intervals. According to the heterogeneity, either a fixed-effects or a random-effects model will be used. ETHICS AND DISSEMINATION: Ethical approval is not required because individual patient data are not included. The findings of this systematic review will be disseminated through a peer-reviewed publication or conference presentation. PROSPERO REGISTRATION NUMBER: CRD42019141660.


Assuntos
Sobreviventes de Câncer , Medicamentos de Ervas Chinesas/uso terapêutico , Fadiga/tratamento farmacológico , Fadiga/etiologia , Medicina Herbária/métodos , Neoplasias Pulmonares/complicações , Medicina Tradicional do Leste Asiático/métodos , Revisão Sistemática como Assunto , Humanos , Projetos de Pesquisa
3.
Med Clin North Am ; 104(2): 239-250, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32035566

RESUMO

Individuals with cancer commonly experience functional impairments. Symptoms may present immediately or years to decades following their treatment. These impairments may include fatigue, pain, neuropathy, lymphedema, or radiation fibrosis syndrome and have the potential to deleteriously impact their function and quality of life. Cancer rehabilitation is a comprehensive resource that facilitates maximizing and maintaining cancer survivors' physical, social, psychological, and vocational functioning. This article covers the common functional impairments experienced by cancer survivors and the treatment strategies used in cancer rehabilitation. Application of these services can enhance the ongoing care for cancer survivors.


Assuntos
Sobreviventes de Câncer/psicologia , Neoplasias/reabilitação , Desempenho Físico Funcional , Qualidade de Vida , Humanos , Neoplasias/terapia , Recuperação de Função Fisiológica
4.
Med Clin North Am ; 104(2): 251-262, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32035567

RESUMO

Cancer affects millions of individuals, and approximately half will develop functional impairments. Cancers that commonly, either from direct effects or from its treatments, result in functional impairments include breast, head and neck, brain, and spinal cord tumors. There is a plethora of potential impairments including pain, spasticity, dystonia, weakness, and neurogenic bowel or bladder. This article reviews the functional impairments frequently encountered in breast, head and neck, brain, and spinal cord tumors. The authors also discuss management and treatment options incorporated in comprehensive cancer rehabilitation to address these impairments to maximize and maintain function and quality of life.


Assuntos
Neoplasias Encefálicas/reabilitação , Neoplasias da Mama/reabilitação , Sobreviventes de Câncer/psicologia , Neoplasias de Cabeça e Pescoço/reabilitação , Qualidade de Vida , Neoplasias da Medula Espinal/reabilitação , Humanos , Recuperação de Função Fisiológica
6.
Integr Cancer Ther ; 19: 1534735419893766, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32009481

RESUMO

Purpose: To assess the feasibility, safety, and preliminary effectiveness of a 12-week multimodal Qigong Mind-Body Exercise (QMBE) program for breast cancer survivors with persistent post-surgical pain (PPSP). Methods: This was a single-arm mixed-methods pilot study. Primary outcome measures were feasibility (recruitment, adherence) and safety. Validated self-report questionnaires were used to evaluate a constellation of interdependent symptoms, including pain, fatigue, mood, exercise, interoceptive awareness, and health-related quality of life at baseline and 12 weeks. A subset of the instruments was administered 6 months postintervention. Shoulder range of motion and grip strength were objectively assessed at baseline and 12 weeks. Qualitative interviews were conducted at baseline and 12 weeks. Results: Twenty-one participants were enrolled; 18 and 17 participants, respectively, completed the 12-week and 6-month outcome assessment. No serious adverse events were reported. Statistically significant improvements were observed at 12 weeks in pain severity and interference, fatigue, anxiety, depression, perceived stress, self-esteem, pain catastrophizing, and several subdomains of quality of life, interoceptive awareness, and shoulder range of motion. Changes in pain, fatigue, pain catastrophizing, anxiety, depression, and quality of life were clinically meaningful. Postintervention effects were sustained at 6 months. Conclusions: QMBE is a safe and gentle multimodal intervention that shows promise in conferring a broad range of psychosocial and physical benefits for breast cancer survivors with PPSP. Results support the value of future studies evaluating the impact of QMBE on multiple outcomes relevant to breast cancer survivors with PPSP.


Assuntos
Neoplasias da Mama/psicologia , Terapia por Exercício/métodos , Terapias Mente-Corpo/métodos , Dor Pós-Operatória/terapia , Qigong , Qualidade de Vida , Adulto , Sobreviventes de Câncer , Exercício , Fadiga/terapia , Estudos de Viabilidade , Feminino , Humanos , Pessoa de Meia-Idade , Dor , Projetos Piloto , Resultado do Tratamento
7.
Int J Sports Med ; 41(3): 141-153, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31935777

RESUMO

This study analyzed the effects of physical exercise interventions on cardiovascular endpoints in childhood cancer survivors. Relevant articles were systematically searched in PubMed, CINAHL, and Web of Science databases (since inception to 11th September 2019). We performed a meta-analysis (random effects) to determine the mean difference (expressed together with 95% confidence intervals) between pre- and post-intervention values for those cardiovascular endpoints reported in more than three studies. Twenty-seven studies (of which 16 were controlled studies) comprising 697 participants were included. Only three studies reported adverse events related to exercise interventions. Exercise resulted in an increased performance on the 6-minute walk distance test (mean difference=111 m, 95% confidence interval=39-183, p=0.003) and a non-significant trend (mean difference=1.97 ml∙kg-1∙min-1, 95% confidence interval=-0.12-4.06, p=0.065) for improvement in peak oxygen uptake. Furthermore, left ventricular ejection fraction was preserved after exercise interventions (mean difference=0.29%, 95% confidence interval=-1.41-1.99, p=0.738). In summary, exercise interventions might exert a cardioprotective effect in childhood cancer survivors by improving - or attenuating the decline of - physical capacity and cardiovascular function. Further studies, particularly randomized controlled trials, are needed to confirm these benefits.


Assuntos
Sobreviventes de Câncer , Aptidão Cardiorrespiratória/fisiologia , Terapia por Exercício , Pressão Sanguínea/fisiologia , Criança , Endotélio Vascular/fisiologia , Teste de Esforço , Frequência Cardíaca/fisiologia , Humanos , Consumo de Oxigênio/fisiologia , Volume Sistólico/fisiologia
9.
BMJ ; 368: l6794, 2020 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-31941657

RESUMO

OBJECTIVE: To investigate the impact of modifications to contemporary cancer protocols, which minimize exposures to cardiotoxic treatments and preserve long term health, on serious cardiac outcomes among adult survivors of childhood cancer. DESIGN: Retrospective cohort study. SETTING: 27 institutions participating in the Childhood Cancer Survivor Study. PARTICIPANTS: 23 462 five year survivors (6193 (26.4%) treated in the 1970s, 9363 (39.9%) treated in the 1980s, and 7906 (33.6%) treated in the 1990s) of leukemia, brain cancer, Hodgkin lymphoma, non-Hodgkin lymphoma, renal tumors, neuroblastoma, soft tissue sarcomas, and bone sarcomas diagnosed prior to age 21 years between 1 January 1970 and 31 December 1999. Median age at diagnosis was 6.1 years (range 0-20.9) and 27.7 years (8.2-58.3) at last follow-up. A comparison group of 5057 siblings of cancer survivors were also included. MAIN OUTCOME MEASURES: Cumulative incidence and 95% confidence intervals of reported heart failure, coronary artery disease, valvular heart disease, pericardial disease, and arrhythmias by treatment decade. Events were graded according to the National Cancer Institute's Common Terminology Criteria for Adverse Events. Multivariable subdistribution hazard models were used to estimate hazard ratios by decade, and mediation analysis examined risks with and without exposure to cardiotoxic treatments. RESULTS: The 20 year cumulative incidence of heart failure (0.69% for those treated in the 1970s, 0.74% for those treated in the 1980s, 0.54% for those treated in the 1990s) and coronary artery disease (0.38%, 0.24%, 0.19%, respectively), decreased in more recent eras (P<0.01), though not for valvular disease (0.06%, 0.06%, 0.05%), pericardial disease (0.04%, 0.02%, 0.03%), or arrhythmias (0.08%, 0.09%, 0.13%). Compared with survivors with a diagnosis in the 1970s, the risk of heart failure, coronary artery disease, and valvular heart disease decreased in the 1980s and 1990s but only significantly for coronary artery disease (hazard ratio 0.65, 95% confidence interval 0.45 to 0.92 and 0.53, 0.36 to 0.77, respectively). The overall risk of coronary artery disease was attenuated by adjustment for cardiac radiation (0.90, 0.78 to 1.05), particularly among survivors of Hodgkin lymphoma (unadjusted for radiation: 0.77, 0.66 to 0.89; adjusted for radiation: 0.87, 0.69 to 1.10). CONCLUSIONS: Historical reductions in exposure to cardiac radiation have been associated with a reduced risk of coronary artery disease among adult survivors of childhood cancer. Additional follow-up is needed to investigate risk reductions for other cardiac outcomes. TRIAL REGISTRATION: ClinicalTrials.gov NCT01120353.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica , Sobreviventes de Câncer/estatística & dados numéricos , Cardiopatias , Neoplasias , Radioterapia , Risco Ajustado , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Cardiotoxicidade , Criança , Estudos de Coortes , Feminino , Cardiopatias/induzido quimicamente , Cardiopatias/classificação , Cardiopatias/epidemiologia , Humanos , Incidência , Masculino , Neoplasias/classificação , Neoplasias/tratamento farmacológico , Neoplasias/epidemiologia , Neoplasias/radioterapia , Modelos de Riscos Proporcionais , Radioterapia/efeitos adversos , Radioterapia/métodos , Estudos Retrospectivos , Risco Ajustado/métodos , Risco Ajustado/tendências , Estados Unidos/epidemiologia
10.
Integr Cancer Ther ; 19: 1534735419890017, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31906724

RESUMO

The purpose of this essay is to inform others that it is possible to survive breast cancer with brain metastases. The second author is the subject patient and a long-term survivor of systemic metastatic breast cancer with numerous brain metastases (corresponding to 8% survivor group). We credit her survival to a combination of (1) medicine as practiced by an excellent oncologist with whom we developed a partnership to manage the patient's health, (2) our informed exploration of the available scientific knowledge including a review of scientific research articles that go beyond conventional care, and (3) the patient's supplementation with numerous repurposed drugs and other substances reported to have antitumor properties. Alongside her conventional treatment (the medical standard of care), it seems likely that this supplementation has been a key factor in the patient's long-term survival. We also point out that the lack of follow-up magnetic resonance imaging brain scans for early detection of brain metastases poses substantial risks for patients with HER2+ metastatic breast cancer in non-central nervous system locations. Thus, we suggest that research be conducted on such early detection for possible inclusion in the recommendations for the medical standard of care. Finally, medical doctors and also patients with backgrounds in biological science may wish to consider potential options and advantages of repurposed drugs and other substances reported in scientific publications when the medical standard of care has limited options for advanced cancer and other severe chronic health conditions. However, any efforts along this line by patients should be in collaboration with their medical doctors.


Assuntos
Neoplasias Encefálicas/tratamento farmacológico , Neoplasias da Mama/terapia , Carcinoma Ductal/terapia , Anticorpos Monoclonais Humanizados/administração & dosagem , Anticorpos Monoclonais Humanizados/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/secundário , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Sobreviventes de Câncer , Carcinoma Ductal/patologia , Sistema Nervoso Central/efeitos dos fármacos , Sistema Nervoso Central/patologia , Feminino , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Induzidas por Radiação , Tomografia por Emissão de Pósitrons , Receptor ErbB-2 , Fatores de Tempo
11.
Integr Cancer Ther ; 19: 1534735419890682, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31957499

RESUMO

Background: There is a paucity of research on the long-term impact of stress-reduction in Hispanic/Latina breast cancer (BC) survivors, a growing minority. In this article, we assess the long-term efficacy of an 8-week training program in mindfulness-based stress reduction (MBSR) on quality of life (QoL) in Hispanic BC survivors. Methods: Hispanic BC survivors, within the first 5 years of diagnosis, stages I to III BC, were recruited. Participants were enrolled in bilingual, 8-week intensive group training in MBSR and were asked to practice a- home, daily. They were also provided with audio recordings and a book on mindfulness practices. Patient-reported outcomes for QoL and distress were evaluated at baseline, and every 3 months, for 24 months. Results: Thirty-three self-identified Hispanic women with BC completed the MBSR program and were followed at 24 months. Statistically significant reduction was noted for the Generalized Anxiety Disorder measure (mean change -2.39, P=0.04); and Patient Health Questionnaire (mean change -2.27, P=0.04), at 24 months, compared with baseline. Improvement was noted in the Short-Form 36 Health-related QoL Mental Component Summary with an increase of 4.07 (95% confidence interval = 0.48-7.66, P=0.03). However, there was no significant change in the Physical Component Summary. Conclusions: Hispanic BC survivors who participated in an 8-week MBSR-based survivorship program reported persistent benefits with reduced anxiety, depression, and improved mental health QoL over 24 months of follow-up. Stress reduction programs are beneficial and can be implemented as part of a comprehensive survivorship care in BC patients.


Assuntos
Neoplasias da Mama/terapia , Sobreviventes de Câncer/psicologia , Hispano-Americanos/psicologia , Atenção Plena/métodos , Qualidade de Vida/psicologia , Estresse Psicológico/terapia , Adaptação Psicológica , Adulto , Neoplasias da Mama/etnologia , Neoplasias da Mama/psicologia , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Saúde Mental , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Medidas de Resultados Relatados pelo Paciente , Senso de Coerência , Estresse Psicológico/psicologia , Resultado do Tratamento
12.
Int J Radiat Oncol Biol Phys ; 106(2): 300-309, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31669565

RESUMO

PURPOSE: Current incidence methods for reporting mild or moderate symptoms capture the (first) occurrence of an event and do not allow distinguishing between patients who suffer from long-lasting versus transient morbidity. This paper introduces a new methodological approach that identifies cancer survivors who have clinically relevant, long-lasting symptoms (patients with late, persistent, substantial and treatment-related symptoms, [LAPERS]). METHODS AND MATERIALS: LAPERS can be evaluated in patients with baseline information and at least 3 late follow-up assessments after treatment. LAPERS identifies individual patients with a given symptom that is substantial (above a predefined clinically relevant threshold) and must be present in at least half of the follow-ups. Baseline morbidity is accounted for by requiring the median of the late symptom score to be worse than the baseline condition. The LAPERS approach was applied to 4 relevant patient-reported genito-urinary/gastrointestinal symptoms within the prospective, longitudinal EMBRACE study (An intErnational study on MRI-guided BRachytherapy in locally Advanced CErvical cancer, www.embracestudy.dk). LAPERS was compared with crude incidence and prevalence rates. RESULTS: Within the EMBRACE cohort, 651/1044 patients (62%) had baseline and long-term follow-up available (median follow-up: 42 months). There was a considerable gap between LAPERS, crude incidence, and prevalence rates. The proportion of patients with LAPERS events was 3.8-4.8 times lower than crude incidences. The highest prevalence rates across follow-up times were 1.8-2.6 times lower than crude incidences. CONCLUSIONS: These findings indicate limitations of incidence methods for reporting substantial patient-reported symptoms because a considerable proportion of patients with symptoms do not experience them persistently over time, as they may fluctuate or get successfully treated. In contrast, the LAPERS method for longitudinal analysis identifies patients with clinically relevant, long-lasting symptoms.


Assuntos
Medidas de Resultados Relatados pelo Paciente , Radioterapia Conformacional/efeitos adversos , Radioterapia Guiada por Imagem/efeitos adversos , Avaliação de Sintomas/métodos , Neoplasias do Colo do Útero/radioterapia , Idoso , Braquiterapia , Sobreviventes de Câncer , Diarreia/epidemiologia , Progressão da Doença , Feminino , Inquéritos Epidemiológicos , Humanos , Incidência , Estudos Longitudinais , Imagem por Ressonância Magnética Intervencionista , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Qualidade de Vida , Radioterapia Guiada por Imagem/métodos , Radioterapia de Intensidade Modulada/efeitos adversos , Avaliação de Sintomas/estatística & dados numéricos , Transtornos Urinários/epidemiologia
13.
J Surg Res ; 246: 34-41, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31561176

RESUMO

BACKGROUND: We examined factors associated with postoperative complications, 1-year overall and cancer-specific survival after epithelial ovarian cancer (EOC) diagnosis. METHODS: Patients who underwent surgery for EOC between 2004 and 2013 were included. Multivariable models analyzed postoperative complications, overall survival, and cancer-specific survival. RESULTS: Among 5223 patients, surgical complications were common. Postoperative complications correlated with increased odds of overall and disease-specific survival at 1 y. Receipt of chemotherapy was similar among women with and without postoperative complications and was independently associated with a reduction in the hazard of overall and disease-specific death at 1-year. Extensive pelvic and upper abdomen surgery resulted in 2.26 times the odds of postoperative complication, but was associated with longer 1-year overall 0.53 (0.35, 0.82) and disease-specific survival 0.54 (0.34, 0.85). CONCLUSIONS: Although extent of surgery was associated with complications, the survival benefit from comprehensive surgery offset the risk. Tailored surgical treatment for women with EOC may improve outcomes.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Carcinoma Epitelial do Ovário/cirurgia , Procedimentos Cirúrgicos de Citorredução/efeitos adversos , Neoplasias Ovarianas/cirurgia , Complicações Pós-Operatórias/epidemiologia , Idoso , Carcinoma Epitelial do Ovário/mortalidade , Procedimentos Cirúrgicos de Citorredução/métodos , Intervalo Livre de Doença , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Ovarianas/mortalidade , Complicações Pós-Operatórias/etiologia , Sistema de Registros/estatística & dados numéricos , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Fatores de Tempo
14.
Int J Cancer ; 146(5): 1324-1332, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31523804

RESUMO

Modern cancer therapy has led to a growing number of pediatric and young adult cancer survivors, who are prone to increased morbidities caused by the late effects of therapy. The aim of our study was to investigate pediatric and young adult cancer survivors' morbidity due to renal and bone metabolism diseases and especially to study bone metabolism in cancer survivors with renal disease. Patients were identified from the Finnish Cancer Registry, and the cohort consisted of 13,860, 5-year survivors of cancer diagnosed below the age of 35 years. Healthy siblings were used as the comparison cohort. Information on the main outcomes was linked from the national Care Register for Health Care. Hazard ratios (HRs) comparing cancer survivors to siblings were calculated for various outcomes. The patient cohort was separated into two age groups, pediatric (0-19 years) and young adults (20-34 years). Significantly elevated HRs (p < 0.0001) in survivors were observed in both age groups for scoliosis (HR 1.6, 95% confidence interval [CI] 1.3-2.0), osteoporosis (HR 5.2, 95% CI 2.4-11.4), osteonecrosis (HR 12.7, 95% CI 5.4-29.7), nephritis (HR 1.9, 95% CI 1.5-2.2) and kidney failure (HR 3.6, 95% CI 2.4-5.3) for all. For cancer survivors with a renal outcome, the risk for developing any outcome of bone metabolism was increased (HR 2.3, 95% CI 1.4-3.6). These results show that pediatric and young adult cancer survivors have an elevated risk for long-term, adverse outcomes related to renal function and bone metabolism. These results suggest follow-up care for young cancer patients.


Assuntos
Doenças Ósseas Metabólicas/epidemiologia , Sobreviventes de Câncer/estatística & dados numéricos , Nefropatias/epidemiologia , Neoplasias/terapia , Adolescente , Antineoplásicos/efeitos adversos , Doenças Ósseas Metabólicas/etiologia , Criança , Pré-Escolar , Feminino , Finlândia/epidemiologia , Seguimentos , Nível de Saúde , Humanos , Incidência , Lactente , Recém-Nascido , Nefropatias/etiologia , Masculino , Neoplasias/complicações , Neoplasias/mortalidade , Modelos de Riscos Proporcionais , Radioterapia/efeitos adversos , Sistema de Registros/estatística & dados numéricos , Fatores de Risco , Irmãos , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Adulto Jovem
15.
Gynecol Oncol ; 156(1): 185-193, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31839336

RESUMO

OBJECTIVE: The majority of endometrial cancer patients are overweight or obese at cancer diagnosis. Obesity is a shared risk factor for both endometrial cancer and diabetes, but it is unknown whether endometrial cancer patients have increased diabetes risks. The aim of our study was to investigate diabetes risk among endometrial cancer patients. METHODS: Endometrial cancer patients diagnosed between 1997 and 2012 in Utah (n = 2,314) were identified. Women from the general population (n = 8,583) were matched to the cancer patients on birth year and birth state. Diabetes diagnoses were identified from electronic medical records and statewide healthcare facility databases. Cox proportional hazards models were used to estimate hazard ratios for diabetes after cancer diagnosis. RESULTS: Endometrial cancer survivors had a significantly higher risk of type II diabetes when compared to women from the general population in the first year after cancer diagnosis (HR = 5.22, 95% CI = 4.05, 6.71), >1-5 years after cancer diagnosis (HR = 1.67, 95% CI = 1.31, 2.12), and >5 years after cancer diagnosis (HR = 1.65, 95% CI = 1.29, 2.11). Endometrial cancer patients who were obese at cancer diagnosis had a three-fold increase in type II diabetes risk (HR = 2.99, 95%CI = 2.59, 3.45). Although endometrial cancer patients diagnosed at distant stage had a higher risk of diabetes, cancer treatment did not appear to contribute to any diabetes risks. CONCLUSIONS: In conclusion, endometrial cancer survivors had a higher risk of diabetes than women in the general population. These results suggest that long term monitoring for diabetes is indicated for endometrial cancer survivors.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Diabetes Mellitus Tipo 2/epidemiologia , Neoplasias do Endométrio/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Neoplasias do Endométrio/mortalidade , Feminino , Humanos , Pessoa de Meia-Idade , Risco , Programa de SEER , Estados Unidos/epidemiologia
16.
Support Care Cancer ; 28(1): 55-64, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30980258

RESUMO

PURPOSE: To facilitate access to and provision of psychosocial care to cancer patients in the community, the Cancer Support Community (CSC) developed CancerSupportSource® (CSS), an evidence-based psychosocial distress screening program. The current study examined the psychometric properties and multi-dimensionality of a revised 25-item version of CSS, and evaluated the scale's ability to identify individuals at risk for clinically significant levels of depression and anxiety. METHODS: CSS development and validation were completed in multiple phases. Exploratory factor analysis was completed with 1436 individuals diagnosed with cancer to examine scale dimensionality, and nonparametric receiver operating characteristic (ROC) curve analyses were used to determine scoring thresholds for depression and anxiety risk scales. Internal consistency reliability and convergent and discriminant validity were also examined. Confirmatory factor analysis and intraclass correlation coefficients were subsequently calculated with a separate sample of 1167 individuals to verify the scale factor structure and examine test-retest reliability. RESULTS: Five factors were identified and confirmed: (1) emotional well-being, (2) symptom burden and impact, (3) body image and healthy lifestyle, (4) health care team communication, and (5) relationships and intimacy. Psychometric evaluation of the total scale and factors revealed strong internal consistency reliability, test-retest reliability, and convergent and divergent validity. Sensitivity of CSS 2-item depression and 2-item anxiety risk scales were .91 and .92, respectively. CONCLUSIONS: Results indicate that CancerSupportSource is a reliable, valid, multi-dimensional distress screening program with the capacity to screen for those at risk for clinically significant levels of depression and anxiety.


Assuntos
Sobreviventes de Câncer/psicologia , Programas de Rastreamento/métodos , Neoplasias/psicologia , Psicometria/métodos , Estresse Psicológico/diagnóstico , Adulto , Idoso , Ansiedade/diagnóstico , Ansiedade/etiologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/etiologia , Depressão/diagnóstico , Depressão/etiologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/etiologia , Feminino , Humanos , Masculino , Programas de Rastreamento/normas , Pessoa de Meia-Idade , Neoplasias/complicações , Neoplasias/diagnóstico , Psicometria/normas , Reprodutibilidade dos Testes , Apoio Social
17.
Support Care Cancer ; 28(1): 43-54, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30980259

RESUMO

PURPOSE: Guidelines for cancer survivors recommend both aerobic physical activity (PA) and strength training (ST). Few kidney cancer survivors (KCS) are meeting single-activity or combined guidelines; therefore, examining factors influencing PA participation is warranted. The purpose of this study is to examine demographic, medical, social-cognitive, and environmental correlates of meeting independent (i.e., aerobic-only, strength training (ST)-only) and combined guidelines (i.e., aerobic and ST) in KCS. METHODS: KCS (N = 651) completed self-reported measures of PA and demographic, medical, social-cognitive, and perceived environmental factors. Built environment was assessed using the geographic information systems (GIS). Multinomial logistic regressions were conducted to determine the correlates of meeting the combined versus independent guidelines. RESULTS: Compared with meeting neither guideline, meeting aerobic-only guidelines was associated with higher intentions (p < .01) and planning (p < .01); meeting ST-only guidelines was associated with higher intentions (p = .02) and planning (p < .01), lower perceived behavioral control (PBC) (p = .03), healthy weight (p = .01), and older age (p < .01); and meeting the combined guidelines were associated with higher intentions (p < .01), planning (p = .02), higher instrumental attitudes (p < .01), higher education (p = .04), better health (p < .01), and localized cancer (p = .05). Additionally, compared with neither guideline, meeting aerobic-only (p < .01) and combined (p < .01) guidelines was significantly associated with access to workout attire. Compared with neither guideline, meeting aerobic-only guidelines was associated with proximity to retail (p = .02). CONCLUSION: PA participation correlates may vary based on the modality of interest. Interventions may differ depending on the modality promoted and whether KCS are already meeting single-modality guidelines.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Terapia por Exercício/métodos , Neoplasias Renais/epidemiologia , Neoplasias Renais/reabilitação , Cooperação do Paciente/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Sobreviventes de Câncer/psicologia , Cognição/fisiologia , Estudos Transversais , Demografia , Exercício/fisiologia , Exercício/psicologia , Terapia por Exercício/normas , Feminino , Humanos , Intenção , Neoplasias Renais/psicologia , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto/normas , Treinamento de Resistência , Autorrelato , Comportamento Social , Meio Social , Fatores Socioeconômicos , Inquéritos e Questionários
18.
Support Care Cancer ; 28(1): 65-71, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30982094

RESUMO

OBJECTIVE: The aim of the present study was to evaluate oral health-related quality of life (OHRQoL) among breast cancer survivors and identify possible factors associated with the outcome. METHODS: A cross-sectional study was conducted with 151 women in follow-up at a hospital after treatment for breast cancer. Data were collected on socio-demographic characteristics, general health, and breast cancer. Clinical examinations were performed to determine caries experience using the decayed, missing, and filled teeth (DMFT) index. The Oral Health Impact Profile (OHIP-14) questionnaire was administered for the assessment of OHRQoL. Logistic regression analysis was performed to identify associated factors after adjustments for confounding variables. RESULTS: The mean OHIP-14 score was 12.8 (SD 10.92). The prevalence of negative impact was 58.9%. A negative impact was associated with depression, the diagnosis of breast cancer, chemotherapy, number of restored teeth, and xerostomia (p < 0.05). In the adjusted analysis, only the oral variables remained significantly associated with the outcome. CONCLUSION: A greater number of restored teeth and xerostomia exert a negative impact on the OHRQoL of women who have survived breast cancer, which suggests the need for special attention to the oral health of this population.


Assuntos
Neoplasias da Mama/epidemiologia , Sobreviventes de Câncer/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Qualidade de Vida , Adulto , Idoso , Neoplasias da Mama/complicações , Estudos Transversais , Assistência Odontológica/normas , Assistência Odontológica/estatística & dados numéricos , Cárie Dentária/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Bucal/normas , Prevalência , Inquéritos e Questionários
19.
Support Care Cancer ; 28(1): 201-210, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30997595

RESUMO

INTRODUCTION: Fear of cancer recurrence (FCR) in people with breast cancer affects treatment recovery, quality of life, service utilisation and relationships. Our aim was to investigate how specialist breast cancer nurses (SBCN) respond to their patients' fears of cancer recurrence and analyse SBCN's views about embedding a new psychological intervention, the Mini-AFTERc, into their consultations. METHOD: A mixed methods sequential design was used, informed by normalisation process theory. Phase 1: UK SBCNs were emailed a web-based survey to investigate how breast cancer survivors' FCR is currently identified and managed, and their willingness to utilise the Mini-AFTERc. Phase 2: a purposive sample of respondents (n = 20) were interviewed to augment phase 1 responses, and explore views on the importance of addressing FCR, interest in the Mini-AFTERc intervention, its content, skills required and challenges to delivering the intervention. RESULTS: Ninety nurses responded to the survey. When SBCN's were asked to identify the proportion of patients experiencing FCR in their caseload, there was no consensus on the size of the problem or unmet need. They estimated that 20-100% people experience moderate FCR and 10-70% severe FCR. The interviews identified that clinical conversations are focused primarily on giving information about signs and symptoms of recurrence rather than addressing the psychological aspects of fear. CONCLUSION: Findings indicate wide variability in how FCR was identified, assessed and supported by a sample of UK SBCNs. The introduction of a structured intervention into practice was viewed favourably and has implications for nursing and health professional ways of working in all cancer services.


Assuntos
Neoplasias da Mama/enfermagem , Medo , Recidiva Local de Neoplasia/psicologia , Enfermeiras e Enfermeiros/psicologia , Percepção , Transtornos Fóbicos/enfermagem , Adulto , Idoso , Atitude do Pessoal de Saúde , Neoplasias da Mama/complicações , Neoplasias da Mama/patologia , Neoplasias da Mama/psicologia , Sobreviventes de Câncer/psicologia , Medo/psicologia , Feminino , Implementação de Plano de Saúde/normas , Humanos , Oncologia/métodos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/enfermagem , Recidiva Local de Neoplasia/prevenção & controle , Transtornos Fóbicos/etiologia , Padrões de Prática em Enfermagem/normas , Qualidade de Vida , Especialidades de Enfermagem , Inquéritos e Questionários
20.
Support Care Cancer ; 28(1): 185-192, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31001691

RESUMO

PURPOSE: The objective of our study was to assess the rate of work adjustments 1 year after the diagnosis in a population of female breast cancer (BC) survivors, in the context of the French system of social protection. We also characterised these adjustments and their influence on the reduction of professional exclusion of patients 1 year after the diagnosis. METHODS: This observational, prospective study was conducted from February 2015 to April 2016 among female patients with BC. Inclusion criteria were women aged between 18 and 65 years, treated for BC and integrated into the labour market at the time of diagnosis (working or on sick leave). Exclusion criteria were metastatic BC, retired patients and refusal to participate. A 1-year follow-up was scheduled, and data collection was performed with questionnaires. RESULTS: In total, 213 patients were included between February 2015 and April 2016. One year after the diagnosis (T1), among 185 BC survivors, 78 (42.2%) patients were working. Among them, 13 patients did not interrupt their occupational activity and 65 returned to work after a period of sick leave. Sixty-four patients returned to work after the end of chemotherapy (after 6 months), and one returned to work before this therapeutic threshold. Sixty-six patients (35.7%) benefited from at least one adjustment of their work conditions to facilitate their return to work (RTW) or maintenance at work: working hours were decreased for 43 patients, and workstation changes were performed for 22 patients. An occupational health physician was involved for some patients; work adjustments were prescribed to 42 patients, 7 patients had medical restrictions for physical reasons and 4 patients had restrictions for psychological reasons. Forty-three patients benefited from part-time work prescribed for therapeutic reasons. CONCLUSIONS: Referral to occupational health physicians and work adjustments remain limited in the process of RTW or maintenance at work after BC in France, despite their positive impact.


Assuntos
Neoplasias da Mama/epidemiologia , Sobreviventes de Câncer/estatística & dados numéricos , Retorno ao Trabalho , Ajustamento Social , Adaptação Psicológica/fisiologia , Adolescente , Adulto , Idoso , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/psicologia , Neoplasias da Mama/reabilitação , Sobreviventes de Câncer/psicologia , Emprego/psicologia , Emprego/estatística & dados numéricos , Feminino , França/epidemiologia , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Retorno ao Trabalho/psicologia , Retorno ao Trabalho/estatística & dados numéricos , Licença Médica/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
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