scholarly journals Overdiagnosis: An Understudied Issue in Hepatocellular Carcinoma Surveillance

2017 ◽  
Vol 37 (04) ◽  
pp. 296-304 ◽  
Author(s):  
Nicole Rich ◽  
Neehar Parikh ◽  
Amit Singal
Keyword(s):  
Quality Of Life ◽  
Hepatocellular Carcinoma ◽  
Side Effects ◽  
Early Detection ◽  
Solid Tumors ◽  
Population Based ◽  
Lung Cancers ◽  
Hepatocellular Carcinoma Surveillance

AbstractOverdiagnosis, the detection of clinically insignificant disease that would not otherwise impact the patient's lifespan, is a phenomenon that has been described in several solid tumors, such as prostate, breast, thyroid, and lung cancers. Population-based efforts to reduce hepatocellular carcinoma (HCC) mortality in cirrhosis patients by screening and early detection may result in the overdiagnosis of HCC. One of the harms of overdiagnosis is subsequent overtreatment, which can result in increased costs, as well as physical side effects, psychological harms, and poorer quality of life. In this review, the authors explore the potential for overdiagnosis in HCC.

CLO19-050: Risk of Health- Related Quality of Life (HRQOL) Events in Patients With Advanced Solid Tumors Treated With Cabozantinib: A Combined Analysis of Four Phase 3 Randomized Controlled Trials

2019 ◽  
Vol 17 (3.5) ◽  
pp. CLO19-050
Author(s):  
Sriman Swarup ◽  
Anita Sultan ◽  
Nusrat Jahan ◽  
Upama Sharma ◽  
Nimesh Adhikari ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Solid Tumors ◽  
Meta Analysis ◽  
Health Related Quality ◽  
Phase 3 ◽  
Randomized Controlled ◽  
Related Quality ◽  
Health Related

Background: VEGFR, KIT, RET, and MET pathways are implicated in several solid tumors. Cabozantinib is an oral inhibitor of these kinase pathways, and hence has found its use in treatment of multiple malignancies. However, it has several side effects that can limit tolerance amongst patients. We performed a systematic review and meta-analysis of randomized controlled trials (RCT) to determine the risk of health-related quality of life (HRQOL) events in patients with advanced solid tumors treated with cabozantinib. Methods: We systematically conducted a comprehensive literature search using MEDLINE, EMBASE databases, and meeting abstracts through September 30, 2018. Phase 3 trials that mention HRQOL events like pain, arthralgia, fatigue, and reduced appetite as adverse effects were incorporated in the analysis. Mantel-Haenszel method was used to calculate the estimated pooled risk ratio (RR) with 95% CI. Random effects model was applied. Results: 4 phase 3 RCTs with a total of 2,703 patients with medullary thyroid cancer, prostate cancer, renal cell carcinoma, and hepatocellular carcinoma were eligible. Studies comparing cabozantinib (C) vs everolimus, C vs placebo, C vs prednisone were included in the analysis. The relative risks of all-grade side effects were as follows: fatigue, 1.378 (95% CI: 1.236–1.536; P<.0001); asthenia, 1.704 (95% CI: 1.190–2.441; P=.004); reduced appetite, 2.088 (95% CI: 1.471–2.964; P<.0001); back pain, 1.047 (95% CI: 0.871–1.259; P=.626); pain in limbs, 1.444 (95% CI: 1.128–1.847; P=.004); arthralgia, 0.982 (95% CI: 0.707–1.363; P=.912). The RR of high-grade side effects were as follows: fatigue, 1.937 (95% CI: 1.483–2.528; P<.0001); asthenia, 2.211 (95% CI: 1.536–3.184; P<.0001); reduced appetite, 4.329 (95% CI: 2.372–7.900; P<.0001); back pain, 1.227 (95% CI: 0.738–2.040; P=.431); pain in limbs, 2.933 (95% CI: 1.127–7.635; P=.028); arthralgia, 0.820 (95% CI: 0.394–1.709; P=.597). Conclusion: Our meta-analysis showed that cabozantinib contributed to significant toxicity of all grades of fatigue, asthenia, pain in limbs, and reduced appetite. Identifying and addressing these toxicities will be important in improving quality of life for these patients.

scholarly journals PROBLEMS OF EARLY DIAGNOSIS OF CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY

2021 ◽  
pp. 34-39
Author(s):  
P.I. Pilipenko ◽  
◽  
V.Е. Voytsitsky ◽  
Yu.А. Dobresko ◽  
◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Peripheral Neuropathy ◽  
Side Effects ◽  
Early Detection ◽  
Early Diagnosis ◽  
Oncologic Patients ◽  
Effect Of Treatment ◽  
Hands And Feet

Chemotherapy-induced peripheral neuropathy (CIPN) is a progressive, long-lasting and often irreversible condition characterized by pain, numbness, tingling, and sensitization to cold in the hands and feet that affects 30 to 40% of patients undergoing chemotherapy. This leads to disability and a deterioration in the quality of life of patients against the background of the absence of tumor progression, representing a serious side effect of treatment. There are certain clinical risk factors for CIPN, but none of them accurately indicates the severity and possibility of developing the disease in oncologic patients. Prediction, early detection and monitoring of side effects of chemotherapy is of great importance in the treatment of cancer patients. Further research in this field will make it possible to correctly and effectively plan and carry out treatment and rehabilitation arrangements using preventive technologies.

Predictors of Health-Related Quality of Life in Hepatocellular Carcinoma

2009 ◽  
Author(s):  
Leigh A. Gemmell ◽  
T. Clark Gamblin ◽  
Jennifer M. Hammond ◽  
Sonja Likumahuwa ◽  
Richard Schulz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hepatocellular Carcinoma ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Proton Pump Inhibitors in 2021: Pros, Cons, and Everything in Between

2021 ◽  
pp. 263451612110217
Author(s):  
Joshua A. Sloan ◽  
Philip O. Katz
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Adverse Events ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Drug Class ◽  
Life Threatening

The medical and lay literature has exploded with reports of adverse events associated with proton pump inhibitors over the last 10 to 15 years. The dissemination of these reports to patients and clinicians have created substantial concerns regarding what has been an exceptionally valuable drug class, dramatically improving patient quality of life, and in many cases preventing life threatening side effects of other medication. Patients are more frequently seeking to avoid these medications, and practitioners are reducing or discontinuing them to the patient’s detriment due to a misunderstanding of the data. This review will discuss the data regarding the most commonly publicized adverse events and attempt to put them in perspective.

scholarly journals Quality of life, symptoms and dietary habits in oncology outpatients with malnutrition: A cross-sectional study

2021 ◽  
Vol 38 (2) ◽  
Author(s):  
Mira Sonneborn-Papakostopoulos ◽  
Clara Dubois ◽  
Viktoria Mathies ◽  
Mara Heß ◽  
Nicole Erickson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
At Risk ◽  
Side Effects ◽  
Dietary Habits ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
University Hospital ◽  
Cross Sectional ◽  
European Organization

AbstractCancer-related malnutrition has a high prevalence, reduces survival and increases side effects. The aim of this study was to assess oncology outpatients and risk of malnutrition. Reported symptoms and quality of life (QoL) in patients found to be at risk of malnutrition or malnourished were compared to patients without malnutrition. Using a standardized questionnaire, the European Organization for Research and Treatment of Cancer Questionnaire for Quality of Life and the Mini Nutritional Assessment (MNA), patients in an outpatient cancer clinic undergoing chemotherapy treatment at a German University Hospital were assessed for nutrition, risk of malnutrition and quality of life. Based on the MNA, 39 (45.9%) patients were categorized as malnourished or at risk for malnutrition. Loss of appetite (n = 37.6%, p < 0.001) and altered taste sensation (n = 30,3%, p < 0.001) were the symptoms most frequently associated with reduced food intake. Patients with risk of malnutrition scored lower on the global health status (n = 48.15%, p = 0.001). Side effects of cancer treatments lead to a higher risk of malnutrition and as a consequence lower QoL. These side effects should be addressed more efficiently in cancer care.

scholarly journals Quality of life among people living with HIV in England and the Netherlands: a population-based study

2021 ◽  
Vol 8 ◽  
pp. 100177
Author(s):  
Stephanie Popping ◽  
Meaghan Kall ◽  
Brooke E. Nichols ◽  
Evelien Stempher ◽  
Lisbeth Versteegh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
The Netherlands ◽  
Population Based ◽  
People Living With Hiv ◽  
Population Based Study ◽  
Living With Hiv

scholarly journals Maintaining musculoskeletal health using a behavioural therapy approach: a population-based randomised controlled trial (the MAmMOTH Study)

2021 ◽  
pp. annrheumdis-2020-219091 ◽  
Author(s):  
Gary J Macfarlane ◽  
Marcus Beasley ◽  
Neil Scott ◽  
Huey Chong ◽  
Paul McNamee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
High Risk ◽  
Primary Outcome ◽  
Population Based ◽  
Behavioural Therapy ◽  
Short Course ◽  
Life Years ◽  
Secondary Outcomes ◽  
Randomised Controlled

ObjectiveCognitive–behavioural therapy (CBT) has been shown to be effective in the management of chronic widespread pain (CWP); we now test whether it can prevent onset among adults at high risk.MethodsA population-based randomised controlled prevention trial, with recruitment through UK general practices. A mailed screening questionnaire identified adults at high risk of CWP. Participants received either usual care (UC) or a short course of telephone CBT (tCBT). The primary outcome was CWP onset at 12 months assessed by mailed questionnaire. There were seven secondary outcomes including quality of life (EuroQol Questionnaire-five dimensions-five levels/EQ-5D-5L) used as part of a health economic assessment.Results996 participants were randomised and included in the intention-to-treat analysis of which 825 provided primary outcome data. The median age of participants was 59 years; 59% were women. At 12 months there was no difference in the onset of CWP (tCBT: 18.0% vs UC: 17.5%; OR 1.05; 95% CI 0.75 to 1.48). Participants who received tCBT were more likely to report better quality of life (EQ-5D-5L utility score mean difference 0.024 (95% CI 0.009 to 0.040)); and had 0.023 (95% CI 0.007 to 0.039) more quality-adjusted life-years at an additional cost of £42.30 (95% CI −£451.19 to £597.90), yielding an incremental cost-effectiveness ratio of £1828. Most secondary outcomes showed significant benefit for the intervention.ConclusionsA short course of tCBT did not prevent onset of CWP in adults at high risk, but improved quality of life and was cost-effective. A low-cost, short-duration intervention benefits persons at risk of CWP.Trial registration numberClinicalTrials.gov Registry (NCT02668003).

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