The salience of existential concerns across the cancer control continuum

2012 ◽  
Vol 10 (2) ◽  
pp. 123-133 ◽  
Author(s):  
Virginia Lee ◽  
Carmen G. Loiselle
Keyword(s):  
Lived Experience ◽  
Cancer Survival ◽  
Meaning Making ◽  
Cancer Control ◽  
Recurrent Cancer ◽  
Advanced Stages ◽  
Potential Impact ◽  
Different Levels ◽  
Existential Concerns

AbstractDespite significant improvement in cancer survival, the fear of death still remains rooted in individuals' beliefs about cancer. Existential fears pertaining to cancer cut across the cancer control continuum and taint decisions related to prevention, screening, surveillance, and follow-up recommendations, as well as the overall management of cancer-related issues. However, individuals are innately predisposed to cope with their cancer-related fears through mechanisms such as reliance on the process of meaning making. To better appreciate the potential impact of existential concerns across the cancer control continuum, the Temporal Existential Awareness and Meaning Making (TEAMM) model is proposed. This tripartite model depicts three types of perceived threats to life related to cancer including a “social awareness” (i.e., cancer signals death), “personalized awareness” (i.e., I could die from cancer), and the “lived experience” (i.e., It feels like I am dying from cancer). This construal aims to enhance our understanding of the personal and contextual resources that can be mobilized to manage existential concerns and optimize cancer control efforts. As such, existential discussions should be considered in any cancer-related supportive approach whether preventive, curative, or palliative, and not be deferred only until the advanced stages of cancer or at end of life. Further delineation and validation of the model is needed to explicitly recognize and depict how different levels of existential awareness might unfold as individuals grapple with a potential, actual, or recurrent cancer.

scholarly journals Occupational Class and Cancer Survival in Korean Men: Follow-Up Study of Nation-Wide Working Population

2020 ◽  
Vol 17 (1) ◽  
pp. 303 ◽  
Author(s):  
Hye-Eun Lee ◽  
Masayoshi Zaitsu ◽  
Eun-A Kim ◽  
Ichiro Kawachi
Keyword(s):  
Cancer Survival ◽  
Cancer Control ◽  
Control Policy ◽  
Good Prognosis ◽  
Occupational Class ◽  
Occupational Classification ◽  
Employment Insurance ◽  
Lower Socioeconomic ◽  
Managerial Positions

Background: We aimed to describe inequalities in site-specific cancer survival across different occupational classes in Korean men. Methods: Subjects included cancer diagnosed members of the national employment insurance program during 1995–2008. A total of 134,384 male cases were followed by linking their data to the Death registry until 2009. Occupational classes were categorized according to the Korean Standard Occupational Classification (KSOC). Hazard ratio adjusting age and diagnosed year were calculated for each occupation by cancer sites. Results: Men in service/sales and blue-collar occupations had lower survival of all cancer sites combined and esophagus, stomach, colorectal, liver, larynx, lung, prostate, thyroid cancer and non-Hodgkin’s lymphoma than men in professional and managerial positions. Cancer sites with good prognosis like prostate cancer showed wider gap across occupational class. Conclusions: Considerable inequalities in cancer survival were found by occupation among Korean men. Cancer control policy should more focus on lower socioeconomic occupational class.

Impact of renal insufficiency on cancer survival: Results of the IRMA-2 study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9585-9585 ◽  
Author(s):  
V. Launay-Vacher ◽  
N. Janus ◽  
J. Spano ◽  
J. Gligorov ◽  
I. Ray-Coquard ◽  
...  
Keyword(s):  
Renal Insufficiency ◽  
Cancer Patients ◽  
Large Scale ◽  
Cancer Survival ◽  
Cox Regression ◽  
Rank Test ◽  
Risk Of Death ◽  
Tumour Metastasis ◽  
Potential Impact

9585 Background: Data are scant on the potential impact of renal insufficiency (RI) on the morbidity and mortality of cancer patients. The IRMA-2 study was started to evaluate the potential association between RI and cancer survival. Methods: Data were collected for cancer patients presenting at one of the 19 IRMA-2 centers in March 2005. Data included: sex, age, weight, serum creatinine, type of tumour, metastasis (bone and/or visceral). GFR was estimated with the abbreviated MDRD (aMDRD) formula at the inclusion. RI was defined as an aMDRD <60 mL/min/1.73m2. Patients were retrospectively followed during 2 years after the inclusion. Survival analyses were performed with the log-rank test, survival median with the Mann-Whitney test, multivariate analysis with the Cox regression. Results: 4267 cancer patients (breast 1601, colorectal 575, lung 407, ovarian 269, prostate 224) with available data (aMDRD and follow-up) were included in the analysis. Median age 59.0, mean weight 66.2, 62.9% were women. 51.2% of these patients were alive at the end of the follow-up. RI was strongly linked to mortality (p<0.0001), when analysing all type of patients and tumors. When the same analysis was performed for non-metastatic patients (n=2382), RI was also associated with mortality (p<0.0001). Similar results were found when comparing the survival medians of the same populations ( table ). Finally, 2 Cox models adjusted for sex, age, and the 5 main types of tumor were associated with a significant increase in the risk of death for patients with aMDRD<60 as compared to patients without ( Table ). Conclusions: IRMA-2 is the first large scale study reporting an association between RI and a reduced cancer survival. Cancer patients with aMDRD<60 seemed to be more at risk of death for the following 2 years even in non metastatic patients. IRMA-2 underlines that assessing, monitoring and managing renal function in cancer patients is crucial in order to prevent or at least minimise renal dysfunction because of its potential impact on survival. [Table: see text] No significant financial relationships to disclose.

Looking Beyond Survival: How Are We Looking at Survivorship?

2006 ◽  
Vol 24 (32) ◽  
pp. 5166-5169 ◽  
Author(s):  
Eva Grunfeld
Keyword(s):  
Cancer Survivorship ◽  
Cancer Care ◽  
Cancer Survival ◽  
Control Strategies ◽  
Cancer Control ◽  
International Perspective ◽  
Access To Treatment ◽  
Follow Up Care

Background The prevalence of cancer survivors is increasing worldwide. This creates the imperative to look beyond cancer survival to cancer survivorship. This review explores cancer survivorship from an international perspective in two ways: from a cancer control perspective through a review of cancer control strategies and from a cancer care perspective through a review of clinical practice guidelines and research on cancer follow-up care. Results Many national cancer control strategies or cancer charities consider survivorship obliquely, primarily under the umbrellas of quality of life and rehabilitation. Few have well-developed policies or plans specifically directed at survivorship. Cancer follow-up care is recognized internationally as a pressing health care issue. Many countries have tested new and innovative models to deliver follow-up care. Similarly, many countries have developed guidelines that specifically address follow-up care. Few studies or guidelines address the broader, multifaceted aspects of cancer survivorship. Discussion This review suggests that research and recognition of cancer survivorship as a unique phase of the cancer care trajectory need to be improved. In many of the poorer countries of the world, the imperative remains the basics of cancer care: timely diagnosis, access to treatment, and alleviation of suffering.

scholarly journals “I Was Like an Autumn Leaf That Looks Pretty From the Outside, but Would Break Once You Touched It”: A Case Study of the Lived Experience of Breast Cancer Survival

2021 ◽  
Author(s):  
Wafa Hamad ALmegewly ◽  
Dinah Gould ◽  
Sally Anstey
Keyword(s):  
Breast Cancer ◽  
Lived Experience ◽  
Cancer Survival ◽  
Meaning Making ◽  
Healthcare Providers ◽  
Structured Interview ◽  
Hermeneutic Phenomenological ◽  
Autumn Leaf ◽  
The Impact

In this hermeneutic phenomenological case study, we explored the lived experiences of one Saudi Arabian woman, Sahara, living with breast cancer and after, identifying her culture’s impact on the “meaning-making” process. We derived the data from a semi-structured interview and analyzed using interpretive phenomenological analysis (IPA). The themes were: (1) “discourse”: being a breast cancer patient; (2) “sociality”: the complex sense of living with visibility and invisibility; and (3) “selfhood”: regaining the sense of being normal. The study benefits healthcare providers, who need to understand women’s life-world, the impact of culture when designing a program of survival care, and the response to their needs.

scholarly journals Few Losses to Follow-up in a Sub-Saharan African Cancer Cohort via Active Mobile Health Follow-up

2020 ◽  
Vol 189 (10) ◽  
pp. 1185-1196 ◽  
Author(s):  
Milena Foerster ◽  
Angelica Anele ◽  
Charles Adisa ◽  
Moses Galukande ◽  
Groesbeck Parham ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Median Time ◽  
Mobile Health ◽  
Cancer Survival ◽  
Controlled Trial ◽  
Cancer Control ◽  
Sub Saharan Africa ◽  
Next Of Kin ◽  
Sub Saharan

Abstract Accurate survival estimates are needed for guiding cancer control efforts in sub-Saharan Africa, but previous studies have been hampered by unknown biases due to excessive loss to follow-up (LTFU). In the African Breast Cancer—Disparities in Outcomes Study, a prospective breast cancer cohort study, we implemented active mobile health follow-up, telephoning each woman or her next-of-kin (NOK) trimonthly on her mobile phone to update information on her vital status. Dates of every contact with women/NOK were analyzed from diagnosis in 2014–2017 to the earliest of September 1, 2018, death, or 3 years postdiagnosis. The cumulative incidence of being LTFU was calculated considering deaths as competing events. In all, 1,490 women were followed for a median of 24.2 (interquartile range (IQR), 14.2–34.5) months, corresponding to 8,529 successful contacts (77% of total contacts) with the women/NOK. Median time between successful contacts was 3.0 (IQR, 3.0–3.7) months. In all, 71 women (5.3%) were LTFU at 3 years: 0.8% in Nigeria, 2.2% in Namibia, and 5.6% in Uganda. Because of temporary discontinuity of active follow-up, 20.3% of women were LTFU after 2 years in Zambia. The median time to study notification of a death was 9.1 (IQR, 3.9–14.0) weeks. Although the present study was not a randomized controlled trial, in this cancer cohort with active mobile health follow-up, LTFU was much lower than in previous studies and enabled estimation of up-to-date and reliable cancer survival.

Linguistic fire and human cognitive powers

2012 ◽  
Vol 20 (2) ◽  
pp. 275-294 ◽  
Author(s):  
Stephen J. Cowley
Keyword(s):  
Lived Experience ◽  
Cognitive Theory ◽  
Cultural Practices ◽  
Meaning Making ◽  
Human Cognition ◽  
Action Perception ◽  
Cultural Traditions ◽  
Word Forms ◽  
Species Specific ◽  
Opening Up

To view language as a cultural tool challenges much of what claims to be linguistic science while opening up a new people-centred linguistics. On this view, how we speak, think and act depends on, not just brains (or minds), but also cultural traditions. Yet, Everett is conservative: like others trained in distributional analysis, he reifies ‘words’. Though rejecting inner languages and grammatical universals, he ascribes mental reality to a lexicon. Reliant as he is on transcriptions, he takes the cognitivist view that brains represent word-forms. By contrast, in radical embodied cognitive theory, bodily dynamics themselves act as cues to meaning. Linguistic exostructures resemble tools that constrain how people concert acting-perceiving bodies. The result is unending renewal of verbal structures: like artefacts and institutions, they function to sustain a species-specific cultural ecology. As Ross (2007) argues, ecological extensions make human cognition hypersocial. When we link verbal patterns with lived experience, we communicate and cognise by fitting action/perception to cultural practices that anchor human meaning making.

scholarly journals Development and evaluation of the Good Grief program for young people bereaved by familial cancer

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Pandora Patterson ◽  
Fiona E. J. McDonald ◽  
Elizabeth Kelly-Dalgety ◽  
Bianca Lavorgna ◽  
Barbara L. Jones ◽  
...  
Keyword(s):  
Social Support ◽  
Personal Growth ◽  
Unmet Needs ◽  
Meaning Making ◽  
Familial Cancer ◽  
Psychosocial Needs ◽  
Program Satisfaction ◽  
Death Of A Parent

Abstract Background Adolescents and young adults (AYAs) bereaved by the death of a parent or sibling from cancer report unique psychosocial needs and can have difficulty adjusting to their loss. Unaddressed, this can result in poor long-term bereavement outcomes. This paper describes the development and evaluation of Good Grief – a 3-day camp-based program focused on meeting coping, social support, and respite needs of AYAs bereaved by familial cancer. Methods One hundred and nine Australian AYAs (68% female; age: 12–25 years, M = 16.63) participated in the evaluation. Grief intensity (Texas Revised Inventory of Grief), meaning-making (Grief and Meaning Reconstruction Inventory), trauma coping (Perceived Ability to Cope with Trauma Scale) and unmet needs (Bereaved Cancer Needs Instrument) measures were administered pre-program and 3-months post-program. Acceptability was measured after each session and at the program’s conclusion. Appropriateness was measured at 3-month follow-up. Thirteen participants were interviewed three months post-program on their perceptions of the program. Results Participants reported high program satisfaction, engagement with psychosocial sessions, and enjoyment of recreational activities. Significant improvements were observed in trauma coping abilities and reductions in unmet needs for managing emotions, social support, respite, future planning, and accessing information and support domains. No change was evident in grief intensity or meaning-making as measured quantitatively. Interviews supported these quantitative findings but also identified evidence of personal growth, a component of meaning-making. Conclusions Good Grief is a highly acceptable and beneficial intervention that addresses the unique needs of AYAs bereaved by familial cancer.

scholarly journals Telephone follow-up of oncology patients: the contribution of the nurse specialist for a Service-Dominant Logic in hospital

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Corinne Rochette ◽  
Anne Sophie Michallet ◽  
Stéphanie Malartre-Sapienza ◽  
Sophie Rodier
Keyword(s):  
Patient Activation ◽  
Central Element ◽  
Cancer Control ◽  
Control Unit ◽  
Active Phase ◽  
Nurse Specialist ◽  
Structured Interviews ◽  
Service Dominant Logic ◽  
Dominant Logic

Abstract Background The French healthcare system is characterised by a shift towards outpatient care and the desire to develop telemedicine affirmed in the collective commitment “Ma santé 2022” presented by President Macron in 2018. In France, remote patient follow up has recently been developed in the active phase of cancer treatment inspired by the patient navigation approach used in other countries. According to Service-Dominant Logic (S-D L), patients become more active. Their role in co-production of services is strengthened and their behaviours changed. Telephone follow-ups can contribute to modifying the relationship between the patient and the nurse navigators in charge of it, moving logically from a passive attitude from the patient to a more active one. Methods This study was carried out at Léon Bérard, a cancer control unit, in France. It concerned patients treated in an oncohaematology department, who benefited from telephone follow-ups carried out by nurse specialists during the active phase of their treatment. The multidisciplinary research team including social science researchers, physicians and carers developed a research protocol to study this pilot case. Essentially based on a qualitative approach, it was validated by the centre’s management to study this follow-up on patients’ behaviours. The 1st phase of the research, based on 24 semi-structured interviews with patients undergoing treatment undertaken from November 2018 to September 2019, is presented. Results The Telephone follow-up was a positive experience for all patients. The action of the nurse specialist helped to develop certain dimensions of in-role and extra-role behaviour that created value. The patients’ discourse has reported a positive follow-up in its clinical dimensions, its psychological dimensions and an enhanced quality of life. We detected a patient activation through their roles but it remained limited. The telephone follow-up also created a patient dependency. Conclusions The telephone follow-up is a relevant tool for patients undergoing treatment and it deserves to be more widely deployed. It brings comfort and creates a relationship based on trust but at the same time it limits the emancipation of the patient, which is a central element of the S-D logic and its empowerment.

scholarly journals Present and Future of Parkinson’s Disease in Spain: PARKINSON-2030 Delphi Project

2021 ◽  
Vol 11 (8) ◽  
pp. 1027
Author(s):  
Diego Santos García ◽  
Marta Blázquez-Estrada ◽  
Matilde Calopa ◽  
Francisco Escamilla-Sevilla ◽  
Eric Freire ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
New Technologies ◽  
Management Strategies ◽  
Multidisciplinary Teams ◽  
Modified Delphi ◽  
Advanced Stages ◽  
Diagnostic Capacity ◽  
Socio Economic Impact

Parkinson’s disease (PD) is a chronic progressive and irreversible disease and the second most common neurodegenerative disease worldwide. In Spain, it affects around 120.000–150.000 individuals, and its prevalence is estimated to increase in the future. PD has a great impact on patients’ and caregivers’ lives and also entails a substantial socioeconomic burden. The aim of the present study was to examine the current situation and the 10-year PD forecast for Spain in order to optimize and design future management strategies. This study was performed using the modified Delphi method to try to obtain a consensus among a panel of movement disorders experts. According to the panel, future PD management will improve diagnostic capacity and follow-up, it will include multidisciplinary teams, and innovative treatments will be developed. The expansion of new technologies and studies on biomarkers will have an impact on future PD management, leading to more accurate diagnoses, prognoses, and individualized therapies. However, the socio-economic impact of the disease will continue to be significant by 2030, especially for patients in advanced stages. This study highlighted the unmet needs in diagnosis and treatment and how crucial it is to establish recommendations for future diagnostic and therapeutic management of PD.

scholarly journals Decelerated tumor growth due to hypothyroidism with prolongation of survival in a patient with lung adenocarcinoma: a case report

2019 ◽  
Vol 48 (3) ◽  
pp. 030006051988530
Author(s):  
Jia Hou ◽  
Shan-Shan Xiong ◽  
Zhao-Qi Huang ◽  
Xing-Dong Cai
Keyword(s):  
Lung Cancer ◽  
Lung Adenocarcinoma ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Tumor Therapy ◽  
Stage Iv ◽  
Small Cell Lung ◽  
Anti Cancer ◽  
Advanced Stages

Lung adenocarcinoma is a form of non-small-cell lung cancer with high mortality in the advanced stages, and is one of the most common histological subtypes of lung cancer in most countries. Prognosis of lung adenocarcinoma is generally poor, with a median survival of 4–13 months. We report a case of unusually prolonged survival of a patient with advanced lung adenocarcinoma complicated by hypothyroidism. A 71-year-old man with stage IV lung adenocarcinoma presented with hypothyroidism. Surprisingly, without any anti-tumor and anti-hypothyroidism therapy, he survived this lung cancer for longer than 2.5 years before his last follow-up visit. Patients with advanced lung adenocarcinoma rarely survive for longer than 2 years, even after therapy. We hypothesize that hypothyroidism is the cause for this discrepancy. Thyroid hormones can promote growth of carcinoma. Therefore, hypothyroidism appears to be beneficial to anti-cancer therapy. We believe that hypothyroidism, as an adverse event commonly occurring in anti-tumor therapy (e.g., an immune checkpoint inhibitor), might not be able to be completely eliminated.

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