scholarly journals Disability pension among gynaecological cancer survivors with or without radiation-induced survivorship syndromes

2021 ◽  
Author(s):  
Adnan Noor Baloch ◽  
Mats Hagberg ◽  
Sara Thomée ◽  
Gunnar Steineck ◽  
Helena Sandén
Keyword(s):  
Radiation Therapy ◽  
Cancer Survivors ◽  
Disability Pension ◽  
Postal Questionnaire ◽  
Gynaecological Cancer ◽  
Relative Risks ◽  
Specific Syndrome ◽  
Patient Reported ◽  
Radiation Induced ◽  
Reported Data

Abstract Purpose Gynaecological cancer patients treated with external radiation therapy to the pelvis may face long-lasting and long-term gastrointestinal syndromes. The aim of this study was to assess the association between such radiation-induced survivorship syndromes and disability pension among gynaecological cancer survivors treated with pelvic radiation therapy. Methods This prospective register study included gynaecological cancer survivors (n=247) treated during 1991–2003, alive at the time of the study, and <65 years of age. In 2006, they completed a postal questionnaire measuring patient-reported outcomes. The self-reported data were linked to the national register on disability pensions. Relative risks and risk differences with 95% confidence intervals (CIs) of being granted a disability pension were estimated using log-binomial regression. Results Gynaecological cancer survivors with gastrointestinal syndromes had a higher risk of disability pension than survivors without such syndromes. Survivors with blood discharge syndrome had a 2.0 (95% CI 1.3–3.2) times higher risk of disability pension than survivors without blood discharge syndrome. The relative risk among survivors with urgency syndrome was 1.9 (1.3–2.9) and for leakage syndrome, 2.1 (1.4–3.1). Adjusting for age did not affect our interpretation of the results. Conclusions Gynaecological cancer survivors with a specific radiation-induced survivorship syndrome have a higher risk of disability pension than survivors without that specific syndrome. Implications for Cancer Survivors The findings highlight the need for more awareness and knowledge regarding the potential role of radiation-induced survivorship syndromes for continuing work among gynaecological cancer survivors. Work-life-related parameters should be considered during radiotherapy and rehabilitation after treatment.

scholarly journals Buccal mucosal graft urethroplasty for radiation-induced urethral strictures: an evaluation using the extended Urethral Stricture Surgery Patient-Reported Outcome Measure (USS PROM)

2020 ◽  
Vol 38 (11) ◽  
pp. 2863-2872 ◽  
Author(s):  
Malte W. Vetterlein ◽  
◽  
Luis A. Kluth ◽  
Valentin Zumstein ◽  
Christian P. Meyer ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Urethral Stricture ◽  
Outcome Measure ◽  
Patient Reported Outcome ◽  
Patient Reported Outcome Measure ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft ◽  
Surgery Patient ◽  
Patient Reported ◽  
Radiation Induced

Abstract Objectives To evaluate objective treatment success and subjective patient-reported outcomes in patients with radiation-induced urethral strictures undergoing single-stage urethroplasty. Patients and methods Monocentric study of patients who underwent single-stage ventral onlay buccal mucosal graft urethroplasty for a radiation-induced stricture between January 2009 and December 2016. Patients were characterized by descriptive analyses. Kaplan–Meier estimates were employed to plot recurrence-free survival. Recurrence was defined as any subsequent urethral instrumentation (dilation, urethrotomy, urethroplasty). Patient-reported functional outcomes were evaluated using the validated German extension of the Urethral Stricture Surgery Patient-Reported Outcome Measure (USS PROM). Results Overall, 47 patients were available for final analyses. Median age was 70 (IQR 65–74). Except for two, all patients had undergone pelvic radiation therapy for prostate cancer. Predominant modality was external beam radiation therapy in 70% of patients. Stricture recurrence rate was 33% at a median follow-up of 44 months (IQR 28–68). In 37 patients with available USS PROM data, mean six-item LUTS score was 7.2 (SD 4.3). Mean ICIQ sum score was 9.8 (SD 5.4). Overall, 53% of patients reported daily leaking and of all, 26% patients underwent subsequent artificial urinary sphincter implantation. Mean IIEF-EF score was 4.4 (SD 7.1), indicating severe erectile dysfunction. In 38 patients with data regarding the generic health status and treatment satisfaction, mean EQ-5D index score and EQ VAS score was 0.91 (SD 0.15) and 65 (SD 21), respectively. Overall, 71% of patients were satisfied with the outcome. Conclusion The success rate and functional outcome after BMGU for radiation-induced strictures were reasonable. However, compared to existing long-term data on non-irradiated patients, the outcome is impaired and patients should be counseled accordingly.

scholarly journals Radiation-Induced Heart Disease: A Clinical Update

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Syed Wamique Yusuf ◽  
Shehzad Sami ◽  
Iyad N. Daher
Keyword(s):  
Radiation Therapy ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Cancer Therapy ◽  
Cancer Survivors ◽  
Cardiovascular Effects ◽  
Cardiac Complication ◽  
Morbidity And Mortality ◽  
Radiation Induced ◽  
Effects Of Radiation

Cardiovascular diseases and cancer are the two leading causes of morbidity and mortality worldwide. Improvement in cancer therapy has led to increasing number of cancer survivors, some of whom may suffer from adverse cardiovascular effects of radiation therapy. Longterm followup is essential, as the cardiac complication may manifest years after completion of radiation therapy. In this paper, we have discussed the cardiovascular effects of radiation therapy.

scholarly journals Investigating Respondents and Nonrespondents of a Postal Breast Cancer Questionnaire Survey Regarding Differences in Age, Medical Conditions, and Therapy

Breast Care ◽  
2016 ◽  
Vol 11 (2) ◽  
pp. 139-143 ◽  
Author(s):  
Anna L. Frobeen ◽  
Christoph Kowalski ◽  
Verena Weiß ◽  
Holger Pfaff
Keyword(s):  
Breast Cancer ◽  
Selection Bias ◽  
Questionnaire Survey ◽  
Cancer Control ◽  
Hospital Staff ◽  
Postal Questionnaire ◽  
Cross Sectional ◽  
Old Patients ◽  
Patient Reported ◽  
Reported Data

Background: Collecting patient-reported data via postal questionnaires is a common and frequently used technique. Selection bias may occur through lost data from nonrespondents. This study investigated differences in characteristics between respondents and nonrespondents of a postal breast cancer survey. Patients and Methods: The investigation was based on a cross-sectional postal questionnaire survey for the mandatory annual routine (re-)certification of accredited breast centers in North Rhine-Westphalia in 2010. Out of 4,444 patients meeting the inclusion criteria who gave their consent to participate, 3,856 respondents sent back a questionnaire and 588 nonrespondents did not. Using logistic regression, differences between respondents and nonrespondents regarding information gathered through hospital staff concerning age, affected breast, UICC (Union for International Cancer Control) staging and grading, ASA (American Society of Anesthesiologists) classification, neoadjuvant chemotherapy, and type of surgery were assessed. Results: Very young and very old patients sent back their questionnaire significantly less frequently, as did patients who showed a later cancer stage and poorer general health and those who underwent mastectomy. Conclusion: Differences exist between respondents and nonrespondents with regard to age, disease, and therapy characteristics that need to be considered for the interpretation and generalizability of survey results due to selection bias.

Prognostic factors affecting severity of radiation-induced fibrosis.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. e280-e280
Author(s):  
Ahmed M Maklad ◽  
Hanan Abdel-Rady Assaf ◽  
Essameldin Abdelaziz Nada ◽  
Ashraf Elyamany ◽  
Asmaa A Badran
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Prognostic Factors ◽  
Cancer Survivors ◽  
Lower Limbs ◽  
Improve Quality ◽  
Factors Affecting ◽  
Detailed Medical History ◽  
Radiation Induced

e280 Background: Evaluation of prognostic factors affecting Radiation Induced Fibrosis (RIF) to help for decreasing its incidence and to improve quality of life for cancer survivors. Methods: Thirty patients were included in this study .It was carried out at faculty of medicine, Sohag University Hospital, Egypt during the period between July 2012 and July 2013 after approval of university ethical committee. We included all patients with (RIF) which is persistent or appeared after 6 months of completion of radiation therapy. Detailed medical history and clinical examination were done for all patients included in the study. We categorized the patients according to severity of RIF into four grades according RTO 2010. Assessment of pain was done according to 0–10 Numeric Pain Rating Scale. Results: Thirty patients with RIF were included in the study. The age of the studied patients ranged from 21- 65 years with a Mean 48,33 ± SD of 10,88. 56.7% of the cases were more than 50 years old. Female patients were 73.3%. BMI of the studied patients ranged from 19-40 kg/cm2 with a Mean 28.03 ± SD of 6.98. 26.7%patients were smokers.43.3% patientshadprevious history of acute radio dermatitis.60% had breast tumor. Chest was affected in 19 (60%) patients, back in 3 (10%) patients, neck in 4 (13%) patients, lower limbs in 2 (7%) patients, and face in 2 (7%) patients.T1 represented in 30%, T2 in 36.7%, T3 in 13.3% while T4 in 20% of the included patients. Twenty four (80%) patientsreceived chemotherapy before radiation. We documented a significant relation between BMI and severity of RIF (p = 0.007).Severity of RIF was significantly associated with higher BMI (p = 0.007), higher radiation doses (p = 0.02), higher number of radiotherapy treatment fraction (p = 0.03), higher radiation field sizes (p = 0.003), and patients with duration of more than one year of RIF (p < 0.001). Patients from rural areas documented higher degree of RIF (p = 0.03). Conclusions: It is important to give more attention to RIF as a one of late toxicity of radiation therapy. It can be minimized by avoiding its predisposing factors to improve quality of life of cancer survivors.

A retrospective case series looking at the effectiveness of hyperbaric oxygen in treating radiation cystitis.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 127-127 ◽  
Author(s):  
Scott Gorenstein ◽  
Aaron Katz ◽  
Kimberly Regan ◽  
Donna Hangan
Keyword(s):  
Radiation Therapy ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Radiation Treatment ◽  
Case Series ◽  
University Hospital ◽  
Radiation Cystitis ◽  
Patient Reported ◽  
Radiation Induced

127 Background: A side effect of radiation therapy to treat genitourinary cancers is radiation-induced cystitis, which in its most severe form can be hemorrhagic cystitis (HC). Some studies have found the incidence of HC in radiation patients to range from 3% to 6.5% after radiation therapy and can develop anywhere from 6 months after radiation therapy to 10 years or more after the last treatment. The severity of symptoms, which includes hematuria, may drastically reduce quality of life. Recent studies have shown that hyperbaric oxygen therapy has improved symptoms of radiation cystitis in around 80% of patients. Methods: Sixty patients who received hyperbaric oxygen therapy (HBOT) for radiation-induced cystitis since 2010 at Winthrop University Hospital were identified. IRB approval was obtained for contacting these patients to gather outcome data. Patient reported outcomes were evaluated using a questionnaire that assessed the type and duration of radiation treatment, treatment other than HBOT for HC symptoms, surgical intervention, and patient perceived outcomes of HBOT. Results: 36 patients were consented. The average age of the patient was 71 with a range from 29-91. The majority of the patients 78% had prostate cancer with the Colon, Uterinem, Bladder and Testicular cancer also included The average time from completion of radiation to onset of symptoms was 3 years. The mean number of treatments was 35 with a range of 18-120 treatments. All treatments were for 90 minutes at 2.4 ATA. The majority of the patients (24) had external beam radiaiation and 12 patients had a urological procedure after completion of their therapy. 78 % of the patients reports either moderate improvement or complete resolution of symptoms. Conclusions: This case series seems to demonstrate that Hyperbaric Oxygen Therapy appears to be an effective treatment for radiation cystitis, however additional studies are necessary.

Survivorship after lower gastrointestinal cancer: Patient reported outcomes and planning for care.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 695-695
Author(s):  
Melissa Frick ◽  
Carolyn Vachani ◽  
Margaret K. Hampshire ◽  
Christina Bach ◽  
Karen Arnold-Korzeniowski ◽  
...  
Keyword(s):  
Sexual Dysfunction ◽  
Cancer Survivors ◽  
Anal Cancer ◽  
Patient Reported Outcomes ◽  
Long Term Effects ◽  
Gi Cancer ◽  
Patient Reported ◽  
Radiation Induced

695 Background: There is significant need for quality follow-up care to optimize long-term outcomes for the growing population of lower gastrointestinal (GI) cancer survivors. Patient-reported outcomes (PROs) provide valuable information regarding late- and long-term effects. Methods: Using a convenience sample from 1,129 colon, rectal and anal cancer survivors (n=792, 218, and 119, respectively) who utilized an Internet-based survivorship care plan (SCP) tool, we examined patient-reported demographics, treatment, and toxicity data. Responses from a follow-up survey were reviewed. Results: Median age of diagnosis was 51 years and median current age was 54 years. 81% of respondents were Caucasian and 58% were female. The most commonly reported late- and long-term effects for all survivors were neuropathy (65%), fatigue (56%), cognitive changes (49%), changes in GI function (43%), sexual dysfunction (22% in males, 43% in females), and radiation-induced dermatologic effects including changes in color/texture of skin (39%) and loss of flexibility in radiated areas (31%). The prevalence of these effects varied with length of time since treatment and treatment modality. Anal cancer patients reported a high prevalence of sexual dysfunction and radiation-induced dermatologic effects. Over 87% of users reported satisfaction levels of "good" to "excellent" using this tool, and 69% reported they intend to share SCP with their healthcare team. Conclusions: For lower GI cancer survivors, it is feasible to obtain PROs from an Internet-based survivorship tool. Survivors report a wide spectrum of late- and long-term side effects, which can be used to inform counseling at time of diagnosis, as well as help anticipate and respond to disease- and treatment-related sequelae during follow-up. We are among the first to report on PROs in anal cancer survivors. Further investigation on the impact of SCPs on healthcare communication and use is needed.

scholarly journals Late symptoms in long-term gynaecological cancer survivors after radiation therapy: a population-based cohort study

2011 ◽  
Vol 105 (6) ◽  
pp. 737-745 ◽  
Author(s):  
H Lind ◽  
A-C Waldenström ◽  
G Dunberger ◽  
M al-Abany ◽  
E Alevronta ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Cohort Study ◽  
Cancer Survivors ◽  
Population Based ◽  
Gynaecological Cancer

scholarly journals Patient-reported sexual toxicity after radiation therapy in long-term prostate cancer survivors

2015 ◽  
Vol 113 (5) ◽  
pp. 802-808 ◽  
Author(s):  
C E Olsson ◽  
D Alsadius ◽  
N Pettersson ◽  
S L Tucker ◽  
U Wilderäng ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Cancer Survivors ◽  
Prostate Cancer Survivors ◽  
Patient Reported

Phase II study of lovastatin to prevent rectal injury from radiation therapy for prostate cancer.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 120-120
Author(s):  
Mitchell Steven Anscher ◽  
Michael G. Chang ◽  
Drew Moghanaki ◽  
Mihaela Rosu ◽  
Ross Mikkelsen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Rectal Bleeding ◽  
Large Population ◽  
Rectal Injury ◽  
Target Number ◽  
Curative Intent ◽  
Patient Reported ◽  
Radiation Induced

120 Background: Late radiation induced rectal injury remains an issue. Large population based studies indicate an incidence of at least 15%. Statins have been shown to reduce the risk of late radiation injury in animal models. The purpose of this study was to prospectively test lovastatin as a potential protector against radiation induced rectal injury, particularly bleeding. Methods: Eligible patients included men with adenocarcinoma of the prostate who were to be treated with radiation therapy with curative intent. Patients receiving primary radiation therapy (external beam alone, brachytherapy alone, or a combination of both) or post-prostatectomy radiation were eligible, as long as the minimum dose to the rectum was 60 Gy. Patients began lovastatin 20-80 mg/d on day 1 of radiation. Lovastatin was continued for 1 year and patients were followed for an additional year. Patients were seen at 1, 2, 4, 6, 9, 12, 18, 21 and 24 months after treatment. At each follow-up, they were assessed for GI, GU and erectile complications using both patient reported (IIEF, EPIC) and physician reported (CTCAE v3) instruments. The primary endpoint of the study was the incidence of rectal bleeding at 24 months (Grade 2 or higher). Results: From April 2007 through May 2013, 73 patients were enrolled. 21 patients either withdrew or were removed from the study due to noncompliance with the lovastatin regimen or toxicity from the drug. Patients who withdrew or were removed were replaced, in order to achieve the target number of 53 evaluable patients with complete 2-year follow-up. A total of 50 patients are evaluable. All but 2/50 evaluable patients achieved the 24-month follow-up goal. At 24 months, there were a total of 4 patients with rectal bleeding attributable to radiation; 3 were grade 2 and 1 was grade 3 (4/48=8%). Conclusions: The incidence of rectal bleeding at 2 years in this population of patients receiving lovastatin during and after radiation therapy for prostate cancer was less than expected based on historical controls. These data suggest that statins may be useful to protect patients from radiation induced rectal injury. Clinical trial information: NCT00580970.

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