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3.
Appl. cancer res ; 40(10): [1-10], Oct. 19, 2020. tab
Artigo em Inglês | LILACS | ID: biblio-1129407

RESUMO

Background: Cancer survivorship results in an increased number of physical and psychosocial health issues. Engaging in physical activity in natural environments is often thought of as restorative. Despite the potential benefits of engaging in physical activity in natural environments there are no sustainable community-based programs for cancer survivors that employ this form of physical activity. This study aims to evaluate the impact of an 8-week trail-walking (TW) program on anxiety in a population of adult cancer survivors. Methods: The TW program consisted of two trail walks per week for 8 weeks led by a hiking guide. Individuals were eligible to participate if they were 19 years or older, were a cancer survivor, were not on active immunotherapy, and had medical clearance from their physician for physical activity. While 12 participants signed up for the program, 9 participants (N = 9, 8 F, 1 M) completed the program. A mixed methodology included preand-post quantitative program surveys and post-program interviews. Questionnaires measured generalized anxiety, sleep disturbances, self-efficacy, self-esteem, psychological well-being and depression as well as pre-and-post hike state anxiety. Data was analysed using paired t-tests. Interviews were transcribed verbatim and an inductive thematic analysis was conducted to consolidate meaning and identify themes using NVivo 11 software. Results: Average attendance was 74% of the 16 hikes. There was no significant reduction in the primary outcome of generalized anxiety (p = .38). There was a significant reduction in perceived stress after 8-weeks (p = .03) and a significant reduction in state anxiety after TW (p < .001). None of the other secondary outcomes were statistically significant (p > .05). Four overarching themes, or benefits, emerged from qualitative data analysis: (a) benefits of program design (b) physical benefits, (c) psychological benefits, and (d) social benefits. Conclusions: These findings demonstrate the utility of a TW program for cancer survivors in order to promote physical, psychological and social health. Feasibility of a TW program would be contingent on access to natural areas for TW and an instructor-led program with other cancer survivors.


Assuntos
Humanos , Masculino , Feminino , Ansiedade , Exercício Físico , Adulto , Sobreviventes de Câncer
4.
N Z Med J ; 133(1523): 41-54, 2020 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-33032302

RESUMO

AIM: The aim of this study was to determine the prevalence of dental developmental disturbances in long-term survivors of childhood malignancies in New Zealand children. This study reports associations with potential risk factors to inform oncologists and dentists of the likelihood of dental abnormalities. METHODS: The study population was children aged 14-16 years old who were diagnosed with cancer prior to 10 years of age. A total of 156 children were eligible, of which 59 participated in this study. The indices used in this study were Holtta's Defect Index (HDI), and Oral Health Impact Profile-14 (OHIP-14). RESULTS: The prevalence of agenesis was 15.3%, microdontia 6.8% and root abnormalities 32.2%. Cyclophosphamide equivalent doses above 8,000mg/m2, stem cell therapy (SCT), and head and neck radiation therapy (HNRT) were associated with a higher mean number of teeth missing due to agenesis. SCT and HNRT were associated with a higher total HDI. A binary logistic regression was carried out to determine the odds of agenesis and found that HNRT was the main contributing factor (OR=7.7, p-value=0.04). The linear regression model found that dactinomycin and agenesis correlated with the largest mean OHIP-14. CONCLUSION: This study found that childhood cancer survivors in New Zealand had a high prevalence of developmental dental abnormalities and it identified potential risk factors related to their cancer treatment. Inequitable access to oral rehabilitation for this patient group argues for a mechanism for consistent improved access to publicly funded dental care across district health boards in New Zealand.


Assuntos
Anodontia , Sobreviventes de Câncer/estatística & dados numéricos , Neoplasias , Adolescente , Anodontia/complicações , Anodontia/epidemiologia , Antineoplásicos Alquilantes/efeitos adversos , Antineoplásicos Alquilantes/uso terapêutico , Estudos Transversais , Ciclofosfamida/efeitos adversos , Ciclofosfamida/uso terapêutico , Feminino , Humanos , Masculino , Neoplasias/complicações , Neoplasias/epidemiologia , Neoplasias/terapia , Nova Zelândia , Prevalência , Radioterapia/efeitos adversos , Transplante de Células-Tronco/efeitos adversos
5.
BMC Public Health ; 20(1): 1520, 2020 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-33032564

RESUMO

BACKGROUND: New approaches on paediatric cancer treatment aim to maintain long-term health. As a result of radiotherapy, chemotherapy or surgery, paediatric cancer survivors tend to suffer from any chronic health condition. Endocrine dysfunction represents one of the most common issues and affects bone health. Exercise is key for bone mass accrual during growth, specifically plyometric jump training. The iBoneFIT study will investigate the effect of a 9-month online exercise programme on bone health in paediatric cancer survivors. This study will also examine the effect of the intervention on body composition, physical fitness, physical activity, calcium intake, vitamin D, blood samples quality of life and mental health. METHODS: A minimum of 116 participants aged 6 to 18 years will be randomized into an intervention (n = 58) or control group (n = 58). The intervention group will receive an online exercise programme and diet counselling on calcium and vitamin D. In addition, five behaviour change techniques and a gamification design will be implemented in order to increase the interest of this non-game programme. The control group will only receive diet counselling. Participants will be assessed on 3 occasions: 1) at baseline; 2) after the 9 months of the intervention; 3) 4 months following the intervention. The primary outcome will be determined by dual energy X-ray absorptiometry (DXA) and the hip structural analysis, trabecular bone score and 3D-DXA softwares. Secondary outcomes will include anthropometry, body composition, physical fitness, physical activity, calcium and vitamin D intake, blood samples, quality of life and mental health. DISCUSSION: Whether a simple, feasible and short in duration exercise programme can improve bone health has not been examined in paediatric cancer survivors. This article describes the design, rationale and methods of a study intended to test the effect of a rigorous online exercise programme on bone health in paediatric cancer survivors. If successful, the iBoneFIT study will contribute to decrease chronic health conditions in this population and will have a positive impact in the society. TRIAL REGISTRATION: Prospectively registered in isrctn.com: isrctn61195625 . Registered 2 April 2020.


Assuntos
Densidade Óssea , Sobreviventes de Câncer/estatística & dados numéricos , Terapia por Exercício/métodos , Telemedicina , Adolescente , Criança , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Projetos de Pesquisa
8.
J Cancer Res Ther ; 16(4): 941-945, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32930148

RESUMO

Immune-checkpoint inhibitors have shown to prolong survival in patients with metastatic non-small cell lung cancer. Programmed death ligand 1 (PD-L1) expression is associated with a higher probability of response, although some patients with PD-L1 negative tumors may also respond or show durable stabilizations. However, the optimal strategy after progression to immunotherapy (IO) is not yet defined. Patients with oligometastatic disease may benefit from local treatments such as radiotherapy (RT), achieving significant local control rates. In addition, RT is claimed to have numerous immunogenic effects that could synergize with IO. We present the case of a complete responder to nivolumab that after a monotopic adrenal relapse received stereotactic body radiation therapy, followed by maintenance nivolumab achieving a partial response that is still ongoing. Aspects such as mechanisms of acquired resistance to PD-L1 inhibitors, the optimal management after progression, and the potential interplay between IO and RT are briefly reviewed and discussed.


Assuntos
Adenocarcinoma de Pulmão/mortalidade , Adenocarcinoma de Pulmão/terapia , Antígeno B7-H1/antagonistas & inibidores , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/terapia , Nivolumabe/uso terapêutico , Adenocarcinoma de Pulmão/imunologia , Adenocarcinoma de Pulmão/patologia , Antineoplásicos Imunológicos/uso terapêutico , Antígeno B7-H1/biossíntese , Antígeno B7-H1/imunologia , Sobreviventes de Câncer , Terapia Combinada , Progressão da Doença , Feminino , Humanos , Neoplasias Pulmonares/imunologia , Neoplasias Pulmonares/patologia , Pessoa de Meia-Idade , Prognóstico , Radiocirurgia/métodos , Taxa de Sobrevida
9.
Am J Clin Oncol ; 43(9): 660-666, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32889837

RESUMO

OBJECTIVE: The objective of this study was to assess sexual minority and heterosexual survivors' perceived quality of cancer care and identify demographic, clinical, and psychosocial characteristics associated with patient-centered quality of care. MATERIALS AND METHODS: Four cancer registries provided data on 17,849 individuals who were diagnosed with stage I, II, or III colorectal cancer an average of 3 years prior and resided in predetermined diverse geographic areas. A questionnaire, which queried about sexual orientation and other eligibility criteria was mailed to all cancer survivors. Of these, 480 eligible survivors participated in a telephone survey. Quality of cancer care was defined by 3 measures of interpersonal care (physician communication, nursing care, and coordination of care) and by rating cancer care as excellent. We used generalized linear models and logistic regression with forward selection to obtain models that best explained each quality of care measure. RESULTS: Sexual minority survivors rated physician communication, nursing care, and coordination of care similarly to heterosexual survivors, yet a significantly higher percentage of sexual minority survivors rated the overall quality of their cancer care as excellent (59% vs. 49%). Sexual minority survivors' greater likelihood of reporting excellent care remained unchanged after adjusting for demographic, clinical, and psychosocial characteristics. CONCLUSIONS: Sexual minority survivors' ratings of quality of colorectal cancer care were comparable or even higher than heterosexual survivors. Sexual minority survivors' reports of excellent care were not explained by their interpersonal care experiences.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Neoplasias Colorretais/terapia , Heterossexualidade/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adulto , Sobreviventes de Câncer/psicologia , Neoplasias Colorretais/enfermagem , Comunicação , Procedimentos Clínicos/normas , Feminino , Pesquisas sobre Serviços de Saúde , Heterossexualidade/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados de Enfermagem/normas , Relações Médico-Paciente , Sistema de Registros , Minorias Sexuais e de Gênero/psicologia , Estados Unidos , Adulto Jovem
10.
J Cardiovasc Magn Reson ; 22(1): 64, 2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32892749

RESUMO

BACKGROUND: Pediatric cancer survivors are at increased risk of cardiac dysfunction and heart failure. Reduced peak oxygen consumption (peak VO2) is associated with impaired cardiac reserve (defined as the increase in cardiac function from rest to peak exercise) and heart failure risk, but it is unclear whether this relationship exists in pediatric cancer survivors. This study sought to investigate the presence of reduced peak VO2 in pediatric cancer survivors with increased risk of heart failure, and to assess its relationship with resting cardiac function and cardiac haemodynamics and systolic function during exercise. METHODS: Twenty pediatric cancer survivors (8-24 years; 10 male) treated with anthracycline chemotherapy ± radiation underwent cardiopulmonary exercise testing to quantify peak VO2, with a value < 85% of predicted defined as impaired peak VO2. Resting cardiac function was assessed using 2- and 3-dimensional echocardiography, with cardiac reserve quantified from resting and peak exercise heart rate, stroke volume index (SVI) and cardiac index (CI) using exercise cardiovascular magnetic resonance (CMR). RESULTS: Twelve of 20 survivors (60%) had reduced peak VO2 (70 ± 16% vs. 97 ± 14% of age and gender predicted). There were no differences in echocardiographic or CMR measurements of resting cardiac function between survivors with normal or impaired peak VO2. However, those with reduced peak VO2 had diminished cardiac reserve, with a lesser increase in CI and SVI during exercise (Interaction P < 0.01 for both), whilst the heart rate response was similar (P = 0.71). CONCLUSIONS: Whilst exercise intolerance is common among pediatric cancer survivors, it is poorly explained by resting measures of cardiac function. In contrast, impaired exercise capacity is associated with impaired haemodynamics and systolic functional reserve measured during exercise. Consequently, measures of cardiopulmonary fitness and cardiac reserve may aid in early identification of survivors with heightened risk of long-term heart failure.


Assuntos
Antraciclinas/efeitos adversos , Antibióticos Antineoplásicos/efeitos adversos , Sobreviventes de Câncer , Aptidão Cardiorrespiratória , Teste de Esforço , Tolerância ao Exercício , Cardiopatias/diagnóstico por imagem , Imagem Cinética por Ressonância Magnética , Lesões por Radiação/diagnóstico por imagem , Adolescente , Fatores Etários , Cardiotoxicidade , Criança , Feminino , Nível de Saúde , Cardiopatias/induzido quimicamente , Cardiopatias/fisiopatologia , Hemodinâmica , Humanos , Masculino , Consumo de Oxigênio , Valor Preditivo dos Testes , Lesões por Radiação/etiologia , Lesões por Radiação/fisiopatologia , Radioterapia/efeitos adversos , Fatores de Risco , Adulto Jovem
11.
PLoS One ; 15(9): e0233271, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32881858

RESUMO

BACKGROUND: Survivors of Head and Neck Cancer experience specific problems in functional performance. The aim of this study was to obtain the test-retest reliability of measurements on Maximal Mouth Opening (MMO), shoulder and neck function, lower and upper body strength, level of mobility and walking ability. MATERIALS AND METHODS: Test-retest study design. Measurements on MMO (intra- and extra orally), Active range of motion of shoulders and neck, 30 Seconds Chair Stand Test, Grip Strength, Timed Up and Go test, and Six Minute Walk test. RESULTS: In total 50 participants were included. The mean age was 68.6. ± 9.9 years and median time since end of treatment was 3.0 years (Q1-Q3: 1.0-5.25 years). We found good to excellent test-retest reliability on the core set of measurements (Intraclass Correlation Coefficient (ICC) 0.77 to 0.98). Measurement of MMO with cardboard card, forward flexion shoulder and Six Minute Walk test had a relatively small measurement error (Smallest Detectable Change (SDC) % 5.4% - 15.1%). Measurement of MMO with a caliper, shoulder abduction, shoulder external rotation, later flexion and rotation of the neck, grip strength, 30 Seconds Chair Stand Test, and Timed up and Go test had a relatively large measurement error (SDC% 19.8% - 44.7%). CONCLUSION: This core set of measurements on physical performance is found reliable and therefore able to differentiate in physical performance. The reported measurement errors should be taken into consideration when interpreting the results of repeated measurements. IMPLICATIONS FOR CANCER SURVIVORS: A core set of physical measurements can be used to measure physical performance in survivors of Head and Neck Cancer.


Assuntos
Sobreviventes de Câncer , Neoplasias de Cabeça e Pescoço/fisiopatologia , Desempenho Físico Funcional , Amplitude de Movimento Articular , Idoso , Feminino , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Boca/fisiopatologia , Força Muscular , Pescoço/fisiopatologia , Equilíbrio Postural , Ombro/fisiopatologia , Caminhada
12.
Medicine (Baltimore) ; 99(36): e21869, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899017

RESUMO

BACKGROUND: Tai Chi has been reported to be potentially effective for health and well-being of cancer survivors. It is worth to assess the effectiveness and safety of Tai Chi on immunological function in people with cancer. METHODS: All relevant randomized controlled trials (RCT) will be reviewed on Tai Chi for immunological function in cancer survivors. Literature searching will be conducted until March 9, 2019 from major English and Chinese databases: Cochrane Library, Excerpta Medica Database (EMBASE), PubMed, CINAHL, Sprotdicus, American Association for Cancer Research Journals, Sino-Med database, China National Knowledge Infrastructure, Chinese Science and Technique Journals Database, and Wanfang Data Chinese database. Two authors will conduct data selection and extraction independently. Quality assessment will be conducted using the risk of bias tool recommended by the Cochrane Collaboration. We will conduct data analysis using Cochrane's RevMan software (V.5.3). Forest plots and summary of findings tables will illustrate the results from a meta-analysis if sufficient studies with the same outcomes are identified. Funnel plots will be developed to evaluate reporting bias. RESULTS: This review will summarize the evidence on Tai Chi for immunological function in cancer survivors. CONCLUSIONS: We hope that the results of this study will provide significant evidence to assess the value Tai Chi practice on immunological function in cancer survivors. ETHICS AND DISSEMINATION: Ethics approval is not required as this study will not involve patients. The results of this study will be submitted to a peer-reviewed journal for publication.


Assuntos
Sobreviventes de Câncer , Tai Ji , Humanos , Neoplasias/imunologia , Revisões Sistemáticas como Assunto
13.
Pediatr Blood Cancer ; 67(12): e28702, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32969160

RESUMO

Childhood, adolescent, and young adult (CAYA) cancer survivors may be at risk for a severe course of COVID-19. Little is known about the clinical course of COVID-19 in CAYA cancer survivors, or if additional preventive measures are warranted. We established a working group within the International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG) to summarize existing evidence and worldwide recommendations regarding evidence about factors/conditions associated with risk for a severe course of COVID-19 in CAYA cancer survivors, and to develop a consensus statement to provide guidance for healthcare practitioners and CAYA cancer survivors regarding COVID-19.


Assuntos
Betacoronavirus , Sobreviventes de Câncer , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Neoplasias/terapia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Adolescente , Adulto , Criança , Pré-Escolar , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Feminino , Humanos , Masculino , Neoplasias/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Guias de Prática Clínica como Assunto , Adulto Jovem
14.
Bull Cancer ; 107(9): 867-880, 2020 Sep.
Artigo em Francês | MEDLINE | ID: mdl-32919610

RESUMO

INTRODUCTION: Few studies have explored the long-term occupational situation after cancer. The aim of our study were to study the employment status among long-term cancer survivors and to compare it to cancer-free controls from the general population at 5, 10 or 15 years after cancer diagnosis. METHODS: From data of a registry-based study, long-term survivors from breast,cervical and colorectal cancer, randomly selected from three tumor registries in France, were compared to cancer-free controls randomly selected from electoral lists. We selected active cancer survivors and cancer-free controls aged less than 60 at the time of the survey. We have studied the employment status of cases vs. controls and the factors associated with employment status. RESULTS: At 5, 10 or 15 years after diagnosis, we did not observe any significant difference in employment status between cases and controls. Among cases, 17% had lost their jobs. Older age, lower incomes, lower education, a short-term employment contract, the presence of co-morbidities, fatigue and a worse quality of life were associated with job loss. DISCUSSION: Although the employment status of the cases was comparable to that of the controls, efforts should be intensified to make it easier for patients diagnosed with cancer to return to work.


Assuntos
Sobreviventes de Câncer , Emprego/estatística & dados numéricos , Adulto , Neoplasias da Mama/terapia , Neoplasias Colorretais/terapia , Estudos Transversais , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Fatores de Tempo , Neoplasias do Colo do Útero/terapia , Adulto Jovem
15.
Jpn J Clin Oncol ; 50(11): 1325-1329, 2020 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-32776092

RESUMO

This study aimed to examine the prevalence and associated factors of perceived cancer-related stigma among Japanese cancer survivors. In this web-based survey involving 628 Japanese cancer survivors, perceived cancer-related stigma, quality of life (Quality of Life-Cancer Survivors Instrument), psychological distress (K6) and perceived social support (multidimensional scale of perceived social support) were evaluated. Perceived cancer-related stigma was endorsed by 61.2% of the participants. Perceived cancer-related stigma was significantly associated with quality of life (R = 0.35-0.37), psychological distress (R = 0.35) and perceived social support (R = 0.10). Logistic regression analysis demonstrated that cancer survivors at younger ages (odds ratio = 0.96), with low income (odds ratio = 2.49), with poorer performance status (odds ratio = 2.33), and with breast, urinary or gynecological cancers (odds ratio = 4.27, 4.01, 4.01, respectively) were at higher risk for perceived cancer-related stigma.


Assuntos
Sobreviventes de Câncer/psicologia , Neoplasias/psicologia , Estigma Social , Adulto , Idoso , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida/psicologia , Apoio Social , Inquéritos e Questionários
16.
Cancer Causes Control ; 31(11): 1011-1019, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32839916

RESUMO

PURPOSE: Previous studies have shown an overall decreased risk of second cancers among prostate cancer survivors, but this has not been comprehensively examined by race/ethnicity. We conducted a retrospective cohort study of 716,319 one-year survivors of prostate cancer diagnosed at ages 35-84 during 2000-2015 as reported to 17 US Surveillance, Epidemiology and End Results (SEER) registries. METHODS: We estimated standardized incidence ratios (SIRs) for second primary non-prostate malignancies by race/ethnicity (non-Latino white, Black, Asian/Pacific Islander [API] and Latino), by Gleason, and by time since prostate cancer diagnosis. Poisson regression models were used to test heterogeneity between groups with the expected number as the offset. RESULTS: 60,707 second primary malignancies were observed. SIRs for all second cancers combined varied significantly by race/ethnicity: SIRwhite: 0.88 (95% confidence interval: 0.87-0.89), SIRLatino: 0.92 (0.89-0.95), SIRBlack: 0.97 (0.95-0.99), and SIRAPI: 1.05 (1.01-1.09) (p-heterogeneity < 0.001). SIRs for all cancers combined were higher among survivors of higher vs. lower Gleason prostate cancers irrespective of race/ethnicity. We observed significant heterogeneity by race/ethnicity in SIRs for 9 of 14 second cancer types investigated including lung, bladder, kidney, and liver. CONCLUSIONS: Our results confirm that most prostate cancer survivors have lower risks of second cancers than expected, but the magnitude varied by race/ethnicity. Exceptionally, API men had small but significantly increased risk. Further research to understand drivers of the observed race/ethnicity heterogeneity is warranted.


Assuntos
Sobreviventes de Câncer , Segunda Neoplasia Primária/epidemiologia , Neoplasias da Próstata/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Grupos Étnicos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Estudos Retrospectivos , Risco , Programa de SEER , Estados Unidos
17.
Health Qual Life Outcomes ; 18(1): 273, 2020 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-32762775

RESUMO

BACKGROUND: Reproductive concerns are common among young cancer survivors and include worries related to different aspects of fertility and parenthood. The Reproductive Concerns After Cancer (RCAC) scale is an 18-item scale with six dimensions, developed to capture a variety of such concerns. The aim of the present study was to describe the cultural adaptation of the RCAC scale into Swedish and evaluate its psychometric properties among young women who have undergone treatment for cancer. METHODS: The RCAC was forward translated from English into Swedish and assessed for cultural adaptation based on a two-panel approach followed by cognitive interviews with the target group. For the psychometric evaluation, a Swedish cohort of 181 female young adult breast cancer survivors completed a survey including the RCAC scale approximately 1.5 years post-diagnosis. Psychometric properties were examined by analyses of construct validity (confirmatory factor analysis and convergent validity), data quality (score distribution, floor and ceiling effects), reliability and known-groups validity. RESULTS: The confirmatory factor analysis yielded an acceptable fit (RMSEA 0.08, SRMR 0.09, CFI 0.92). Convergent validity was demonstrated by a negative correlation of moderate size (- 0.36) between the RCAC total score and the emotional function scale of the EORTC QLQ-C30. Reliability measured with Revelle Ω total was satisfactory (0.73-0.92) for five of the dimensions, and poor for the dimension Becoming pregnant (Revelle Ω total = 0.60); Cronbach's alpha showed a similar pattern. Known-groups validity was indicated by significant RCAC mean score differences (MD), reflecting more concerns among women with a certain (MD 4.56 [95% CI 3.13 to 5.99]) or uncertain (MD 3.41 [95% CI 1.68 to 5.14]) child wish compared to those with no wish for (additional) children. CONCLUSION: The translation and cultural adaptation of the Swedish RCAC has resulted in a scale demonstrating construct and known-groups validity, and satisfactory reliability for five of six dimensions. The dimension Becoming pregnant showed non-optimal internal consistency and should undergo further evaluation. The Swedish RCAC is recommended to be used in research settings for measurement of concerns related to fertility and parenthood in young women with cancer.


Assuntos
Sobreviventes de Câncer/psicologia , Infertilidade Feminina/psicologia , Inquéritos e Questionários/normas , Neoplasias da Mama/psicologia , Criança , Comparação Transcultural , Análise Fatorial , Feminino , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Reprodutibilidade dos Testes , Suécia , Traduções , Adulto Jovem
18.
Nat Commun ; 11(1): 3872, 2020 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-32747627

RESUMO

The optimal post-treatment surveillance strategy that can detect early recurrence of a cancer within limited visits remains unexplored. Here we adopt nasopharyngeal carcinoma as the study model to establish an approach to surveillance that balances the effectiveness of disease detection versus costs. A total of 7,043 newly-diagnosed patients are grouped according to a clinic-molecular risk grouping system. We use a random survival forest model to simulate the monthly probability of disease recurrence, and thereby establish risk-based surveillance arrangements that can maximize the efficacy of recurrence detection per visit. Markov decision-analytic models further validate that the risk-based surveillance outperforms the control strategies and is the most cost-effective. These results are confirmed in an external validation cohort. Finally, we recommend the risk-based surveillance arrangement which requires 10, 11, 13 and 14 visits for group I to IV. Our surveillance strategies might pave the way for individualized and economic surveillance for cancer survivors.


Assuntos
Sobreviventes de Câncer , Monitorização Fisiológica/métodos , Carcinoma Nasofaríngeo/terapia , Neoplasias Nasofaríngeas/terapia , Adulto , Análise Custo-Benefício , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Cadeias de Markov , Pessoa de Meia-Idade , Monitorização Fisiológica/economia , Carcinoma Nasofaríngeo/diagnóstico , Carcinoma Nasofaríngeo/economia , Neoplasias Nasofaríngeas/diagnóstico , Neoplasias Nasofaríngeas/economia , Recidiva Local de Neoplasia , Medicina de Precisão/economia , Medicina de Precisão/métodos , Fatores de Risco
19.
Adv Exp Med Biol ; 1252: 165-174, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32816278

RESUMO

Safety of pregnancy occurring after breast cancer treatment has been studied largely, but it is still debatable. These studies have generally showed that overall and disease-free survival in breast cancer survivors with subsequent pregnancy is not less than those without future pregnancy . Also, breast cancer survivors treated with chemotherapy , radiation therapy, or both had no increased risk of congenital anomalies, single gene disorders, or chromosomal syndromes in their offspring. However, it appears that the incidence of preterm labor, low birth weight, and fetal anomalies is higher in these cases.These issues as well as safe time interval from breast cancer treatment to pregnancy , safe contraceptive method after breast cancer, counseling about pregnancy in survivors, and how to follow up the patient for breast cancer recurrence during pregnancy are discussed in this chapter.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Gravidez/fisiologia , Aconselhamento , Intervalo Livre de Doença , Feminino , Humanos , Recém-Nascido , Recidiva Local de Neoplasia , Resultado da Gravidez
20.
Int J Sports Med ; 41(9): 628-629, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32750723

RESUMO

Dear Editor,International Journal of Sports MedicineThe analysis of the study entitled "Exercise Interventions and Cardiovascular Health in Childhood Cancer: a Meta-Analysis" 1 was very interesting. The authors of this meta-analysis aimed to summarize the evidence on the effects of physical training intervention over three weeks on cardiovascular and cardiorespiratory outcomes in childhood cancer survivors (CCS). In addition, they addressed endpoints related not only to cardiac structure and function, but also to cardiorespiratory fitness.


Assuntos
Sobreviventes de Câncer , Neoplasias , Criança , Exercício Físico , Terapia por Exercício , Humanos , Aptidão Física
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