scholarly journals 1419Cancer mortality burden and quality of life in Argentina: geographical pattern and measures of association

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Sonia Alejandra Pou ◽  
Camila Niclis ◽  
Natalia Tumas ◽  
Laura Rosana Aballay ◽  
Maria del Pilar Diaz
Keyword(s):  
Quality Of Life ◽  
Cancer Mortality ◽  
Hot Spot ◽  
Cold Spot ◽  
Cancer Type ◽  
Geographical Pattern ◽  
Measures Of Association ◽  
Geographic Disparities ◽  
Mortality Burden

Abstract Background Health outcomes are often related to the conditions in which people live. Previous studies indicated that cancer mortality is non-randomly distributed between social groups and regions in Argentina. We aimed to analyze geographical pattern of mortality due to the most prevalent cancers in Argentina (2013-2015), from a quality of life approach. Methods Age-standardized mortality rates (ASMR) for specific cancer types (breast, lung, prostate, colon, cervix, stomach) was estimated by direct method (2013-2015 period). Mortality maps at a departmental scale (n = 511) were constructed by using a Getis-Ord Hot Spot spatial analysis. A Quality of Life Index (QLI, continuous score) for Argentina 2010 was used. Poisson mixed models with a random intercept were performed to estimate IRRs (relative risk) as measures of association. Results Breast, lung, and colon cancers show the most clear ASMR geographical patterns, which locate an extensive cold spot (lower and correlated rates) in the northwestern region of Argentina and a hot spot (higher and correlated rates) in the Pampeana (center-east) region . Particularly, breast and cervix cancers showed confronting mortality geographic patterns and opposite relationships with the departmental QLI (IRR 1.23 and 0.78, respectively). A direct association was found for lung (IRR 1.46/1.15 for women/men) and colon cancer (IRR 1.57/1.49 for women/men). Conclusions Results evidence geographic disparities in cancer mortality burden linked to the quality of life of populations at departmental scale in Argentina. Key messages Geographic disparities in cancer mortality are linked to the quality of life in Argentina. Mortality-QLI relationship varies according the cancer type.

scholarly journals Outcomes Related to Percutaneous Nephrostomies (PCN) in Malignancy-Associated Ureteric Obstruction: A Systematic Review of the Literature

2021 ◽  
Vol 10 (11) ◽  
pp. 2354
Author(s):  
Francesca J. New ◽  
Sally J. Deverill ◽  
Bhaskar K. Somani
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Previous Treatment ◽  
Cochrane Library ◽  
Cancer Type ◽  
Ureteric Obstruction ◽  
Survival Times ◽  
Advanced Malignancies ◽  
The Impact

Background: Malignant ureteric obstruction occurs in a variety of cancers and has been typically associated with a poor prognosis. Percutaneous nephrostomy (PCN) can potentially help increase patient longevity by establishing urinary drainage and treating renal failure. Our aim was to look at the outcomes of PCN in patients with advanced cancer and the impact on the patients’ lifespan and quality of life. Materials and Methods: A literature review was carried out for articles from 2000 to 2020 on PCN in patients with advanced malignancies, using MEDLINE, EMBASE, Scopus, CINAHL, Cochrane Library, clinicaltrials.gov, and Google Scholar. All English-language articles reporting on a minimum of 20 patients who underwent PCN for malignancy-associated ureteric obstruction were included. Results: A total of 21 articles (1674 patients) met the inclusion criteria with a mean of 60.2 years (range: 21–102 years). PCN was performed for ureteric obstruction secondary to urological malignancies (n = −633, 37.8%), gynaecological malignancies (n = 437, 26.1%), colorectal and GI malignancies (n = 216, 12.9%), and other specified malignancies (n = 205, 12.2%). The reported mean survival times varied from 2 to 8.5 months post PCN insertion, with an average survival time of 5.6 months, which depended on the cancer type, stage, and previous treatment. Conclusions: Patients with advanced malignancies who need PCN tend to have a survival rate under 12 months and spend a large proportion of this time in the hospital. Although the advent of newer chemotherapy and immunotherapy options has changed the landscape of managing advanced cancer, decisions on nephrostomy must be balanced with their survival and quality of life, which must be discussed with the patient.

scholarly journals Meeting Psychosocial Needs to Improve Health: A Prospective Cohort Study

2019 ◽  
Author(s):  
Austyn Snowden ◽  
Jenny Young ◽  
Jan Savinc
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Health Status ◽  
Cancer Type ◽  
Cancer Stage ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Abstract Background Cancer impacts on patients and their families across a range of different domains. For that reason, optimal cancer care has moved away from a disease-centric focus to a more holistic approach in order to proactively support people with their individual needs and concerns. While international policy clearly advocates this agenda, implementation into routine care is limited. Therefore, relevant interventions that measurably improve patient outcomes are essential to understand if this ideal is to become routine multidisciplinary practice. The aim of this study was to analyse the impact of a proactive, holistic, community-based intervention on health-related quality of life in a cohort of people diagnosed with cancer. Secondary aim was to explore the relationship between changes in health status and: cancer type, cancer stage, number of concerns expressed and change in severity of concerns pre and post intervention. Method Prospective observational cohort study. A convenience sample of 437 individuals were referred to the service ‘Improving the Cancer Journey (ICJ) in the UK. Each completed the Euroqol EQ-5D-3L and visual analogue scale (VAS) and a Holistic Needs Assessment (HNA) during initial visit to the service and again at follow-up review, approximately 4 months later. Change between scores was tested with paired t-tests and relationships between variables with multiple regression models. Results Participants were White British with median age between 50-64 years. Cancer type and stage were varied. There was a statistically significant improvement in EQ-5D scores over time (t(330)=7.48, p<.001). The strongest predictor of change was a decrease in severity of concerns. Cancer stage ‘palliative care’ contributed to a reduction in health status. Conclusion This study is the first to show that a holistic community intervention dedicated to supporting the individual concerns of participants has a statistically and meaningful impact on participants’ health-related quality of life. The mean change in EQ-5D scores was more than the ‘minimally important clinical difference’ described in the literature. This is important because while quality of life has multiple determinants this study has reported that it is possible to capture a meaningful improvement as a function of reducing someone’s personally identified concerns.

Predictors of Quality of Life in Young Adults Diagnosed With Cancer

2020 ◽  
Vol 29 (8) ◽  
pp. 587-597
Author(s):  
Charmaine A. McKie ◽  
Adeyinka O. Laiyemo
Keyword(s):  
Quality Of Life ◽  
Young Adults ◽  
Health Status ◽  
Cancer Survivors ◽  
Functional Status ◽  
Cancer Type ◽  
Health Related ◽  
Perception Of Health ◽  
The Impact

A cross-section correlational study was conducted to evaluate the overall quality of life in young adults (AYAs) diagnosed with cancer, and the impact of health-related and non-health-related factors on their quality of life. Fifty-six AYA cancer survivors were recruited to elicit the impact of biological function (cancer type and comorbidity), symptoms, functional status, general perception of health status, gender, and characteristics of the environment on quality of life. Participants experienced higher than average quality of life. Symptoms, functional status, and general perception of health status were significant predictors of quality of life in this group of AYAs diagnosed with cancer. In delivering quality cancer care, nurses must be able to thoroughly assess symptom status, AYA cancer survivors’ perception of their health status, and functioning in order to implement supportive measures to help improve their quality of life.

An open-label trial of SMK treatment of advanced metastatic cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e22095-e22095
Author(s):  
Steve Hoffman ◽  
Howard Bruckner ◽  
Giuseppe Del Priore ◽  
Daniel Gurell ◽  
Ruslan Mull ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Native American ◽  
Cancer Cells ◽  
Median Survival ◽  
Metastatic Cancer ◽  
Pain Medication ◽  
Cancer Type ◽  
Open Label ◽  
Novel Therapy

e22095 Background: SMK is a novel therapy that creates alteration in defenses to oxidative stress and increases free radical availability to the cancer cell. SMK is designed to penetrate the living cancer cells and introduce multiple mechanisms to kill the cell. Inducing transfer of electrons in the cancer cells allow catalyzed external free radicals to react and stress the cell. SMK is a combination of low dose agents used for non-cancer treatment. Methods: IRB approved study for metastatic cancer. No additional chemotherapy allowed. First 30 subjects meeting criteria were consented. SMK given orally and SQ, 5 days/wk, 6 weeks (1 cycle). Eligible subjects had cycles 2 and 3. Results: Average age 57.5 (30-81); 70% female; 30% Male. 90% Caucasian, 3.3% each- Asian, Hispanic, Native American. Cancer type: 43% breast, 20% lung, 10% pancreatic, 6.6% each: bile duct and prostate with bone metastasis, 3.3% each: colon, tongue, appendix and thyroid. 100% Breast cancer subjects had metastasis: 15% each: bone, lung, bone/lymph 8% each: lung, lymph, bone/brain/lung, bone/brain/spine, bone/liver, bone/brain, liver/bones/lymph. 10% treated for 1 cycle, 90% 2 -3 cycles. 13.3% maintained same ECOG rating. 76.6% had 1 pt, 6.6% had 2 pt, and 3.3% had 3 pt improvement. 13.3% had 1 pt decrease, 23.3% maintained the same, 63.3% had 1-3 pt improvement in health on EORTC (1-7) rating. 13.3% had a 1 pt decrease, 20% maintained the same, 66.7% had 1-4 pt improvement in quality of life on EORTC (1-7) rating. 56.6% gained 1-13lbs. 16.6% same weight, 26.6% lost 1-4 lbs. 73.3% had 1-8 pt. pain reduction (scale 1-10). 19.9% had minimal or moderate pain and maintained. 6.6% had minimal pain and had a 1 pt increase. 46.6% were on pain medication. 43% no longer needed pain medication after study. 100% Health and quality of life significantly improved: 16.6% show no uptake on a PT scan; 16.6% have significant reduction in quantity and/or size of the tumor; 26.8% have reduction in quantity/size of the tumor; 40% have a stable disease; 90% -Alive, median survival 257 days to date. 10% died, median survival 163 days.Total median survival 247 days (from first day of treatment). 100% had hyperpigmentation. No SMK related adverse events reported. Conclusions: SMK is a very promising treatment for metastatic cancer.

The association of polypharmacy with functional status impairment, frailty, and health-related quality of life in older adults with gastrointestinal malignancy: Results from the Cancer and Aging Resilience Evaluation (CARE) registry.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 118-118
Author(s):  
Darryl Alan Outlaw ◽  
Chen Dai ◽  
Mustafa Al-Obaidi ◽  
Smith Giri ◽  
Smita Bhatia ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Daily Living ◽  
Cancer Type ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

118 Background: The majority of new cancer diagnoses occur in adults greater than 65 years of age. Polypharmacy is a common and potentially devastating problem amongst older adults; however, its prevalence and impact in older adults with gastrointestinal (GI) malignancy is poorly understood. Our objective was to examine the prevalence of polypharmacy and its association with functional status impairments, frailty, and health-related quality of life (HRQoL) in older adults with GI malignancy. Methods: The Cancer and Aging Resilience Evaluation (CARE) registry at the University of Alabama at Birmingham (UAB) is an ongoing prospective cohort study that uses a brief geriatric assessment (CARE survey) in older adults with cancer. We evaluated older adults diagnosed with GI malignancy prior to starting cancer therapy. Our primary outcomes of interest were functional status impairments, including dependence in activities of daily living (ADL) and instrumental activities of daily living (IADL), frailty (as defined by a frailty index derived using the principles of deficit accumulation), and HRQoL (assessed via PROMIS 10 global that includes physical and mental scores). Patients were dichotomized into those taking ≥9 vs. < 9 medications. Multivariable analyses examined associations between polypharmacy and the above-listed outcomes, adjusted for age, sex, race, cancer type, cancer stage, and comorbidities. Results: Overall, 357 patients met eligibility criteria; mean age: 70.1 years; primary diagnoses: colorectal (33.6%), pancreatic (24.6%), hepatobiliary (16.2%), gastroesophageal (10.9%), other (14.6%). Patients reported taking a mean of 6.2 medications: 27.7% with 0-3 medications, 48.2% with 4-8 medications, and 24.1% with ≥ 9 medications. Patients taking ≥ 9 medications were more likely to report limitations in ADL (adjusted odds ratio [aOR] 3.29, 95% CI 1.72-6.29) and IADL (aOR 2.86, 95% CI 1.59-5.14). Polypharmacy was also associated with frailty (aOR 3.06, 95% CI 1.73-5.41) and lower physical (aOR 2.82, 95% CI 1.70-4.69) and mental (aOR 1.73, 95% CI 1.03-2.91) HRQoL. Conclusions: Independent of comorbid conditions, polypharmacy was associated with functional status limitations, frailty, and reduced HRQoL in older adults with GI malignancy. Further study of specific medications and interactions is warranted in order to reduce the negative consequences of polypharmacy in this growing and vulnerable population.

Cancer survivorship outcomes in immigrants.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6111-6111 ◽  
Author(s):  
Phyllis Noemi Butow ◽  
Lynley Aldridge ◽  
Melanie Bell ◽  
Ming Sze ◽  
Maurice Eisenbruch ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Survivors ◽  
Cancer Survivorship ◽  
Unmet Need ◽  
Depression Scale ◽  
Cancer Registries ◽  
Cancer Type ◽  
Care Needs ◽  
Cross Sectional

6111 Background: Immigration is increasing world-wide. Cancer survivorship is now recognised as a period of difficult adjustment for all patients, and possibly more so for immigrants. We explored disparities in quality of life outcomes for immigrant (IM) versus Anglo-Australian (AA) cancer survivors. Methods: In a cross-sectional design, cancer survivors were recruited through the New South Wales, Queensland and Victorian Cancer Registries in Australia. IM participants, their parents and grandparents were born in a country where Chinese, Greek, or Arabic is spoken and spoke one of those languages. AAs were born in Australia and spoke English. All were diagnosed with cancer 1-3 years previously. Questionnaires (completed in preferred language) included the Hospital Anxiety and Depression Scale (anxiety/ depression), FACT-G (quality of life) and Supportive Care Needs Survey (unmet needs). Outcomes were compared between AA and IM groups in adjusted regression models that included age, gender, socio-economic status, education, marital status, religion, time since diagnosis and cancer type (prostate, colorectal, breast and other). Results: There were 599 participants (response rate 41%). Consent was unrelated to demographic and disease variables. AA and IM groups were similar except that immigrants had higher proportions in the low and highly educated groups (p < 0.0001), and higher socioeconomic status (p = 0.0003). In adjusted analyses (see table), IMs had clinically significant higher depression (possible range 0-21), greater unmet information and physical needs, and lower quality of life than AAs. The possible range for the latter three is 0-100. Conclusions: Immigrants experience poorer outcomes in cancer survivorship, even after adjusting for socio-economic, demographic and disease differences. Interventions are required to improve their adjustment after cancer. Results highlight areas of unmet need that might be better addressed by the health system (particularly with regard to provision of information and support. [Table: see text]

Adherence to yoga practice improves symptom control and quality of life in breast cancer patients undergoing conventional treatment.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11511-e11511
Author(s):  
Rao M. Raghavendra ◽  
Kodaganur Srinivasachar Gopinath ◽  
B S Srinath ◽  
Shekhar Patil ◽  
P Shashidhara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Patients ◽  
Controlled Trial ◽  
Symptom Control ◽  
Cancer Type ◽  
Breast Cancer Patients ◽  
Life Outcomes ◽  
Quality Of Life Outcomes

e11511 Background: Adherence plays an important role in success of mind body interventions such as yoga. In this study we evaluated the effects of adherence to yoga intervention on psychological and quality of life outcomes. Methods: Adherence to yoga program was assessed in a randomized controlled trial comparing yoga (n=45) vs. supportive therapy in breast cancer patients with stage II and III disease undergoing primary surgery followed by adjuvant radiotherapy and chemotherapy. Subjects were assessed for self reported symptoms and affective states using symptom checklist, Spielberger’s State Trait Anxiety, Becks Depression Inventory and Functional Living Index in cancer for Quality of life following surgery and during radiotherapy and chemotherapy. Adherence was categorized based on number of sessions of yoga practiced at home per week [regular (>5 sessions), not so regular (3-5 sessions), occasionally (upto 2 sessions)].Multiple hierarchical regression analysis was used to examine the variance in the above outcomes explained by independent prognostic variables (age group, clinical stage of cancer, type of surgery, respective baseline psychological outcomes and regularity of practice) in yoga group alone. Model B includes these four variables plus regularity of practice. Results: Regularity of practice emerged as a secondary predictor for symptom severity following surgery (β= 0.38, p=0.007) and primary predictor for depression (β= 0.37, p=0.05) and severity of symptoms (β= 0.42, p=0.04) during radiotherapy and depression(β= 0.35, p=0.05), severity of symptoms (β= 0.45, p=0.03), anxiety trait(β= 0.40, p=0.03) and quality of life (β= -0.61, p=0.001) during chemotherapy. Conclusions: Adherence to mind body interventions such as yoga improves psychological and quality of life outcomes in breast cancer patients undergoing conventional cancer treatment.

Integrative medicine modality utilization and impact on quality of life in cancer patients: A single academic cancer center experience.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 169-169
Author(s):  
Denise Millstine ◽  
Krisstina L. Gowin ◽  
Tony Chon
Keyword(s):  
Quality Of Life ◽  
Cancer Therapy ◽  
Natural Product ◽  
Integrative Medicine ◽  
Mayo Clinic ◽  
Disease Stage ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Cancer Type

169 Background: The majority of patients with cancer incorporate integrative medicine strategies into their cancer experience however; patient reported preferences and impact on quality of life is limited. We present cancer patient utilization for specific integrative medicine modalities within the Mayo Clinic Arizona Comprehensive Cancer center and describe the patient perceived impact on quality of life. Methods: Patients and family members attending the 2015 Living with Cancer Symposium at Mayo Clinic Arizona completed a survey indicating whether specific integrative medicine modalities were utilized during cancer treatment and whether utilization had an impact on the patients perceived quality of life. Patient diagnoses and stage were collected. A total of 119 patient surveys were completed and analyzed. Results: The patient diagnoses included hematologic malignancies (27%), breast (25%), prostate (18%), and other (30%). Disease stage was nearly evenly distributed with stage I (21%), stage II (20%), stage III (16%), stage IV (15%), and unknown (28%). The most commonly utilized integrative modalities included nutrition (54%), natural product supplementation (34%), massage (33%), exercise (31%) including yoga (23%) and tai chi (1%), breathing and meditation interventions (26-28%), support groups (23%), and pet therapy (17%). The majority of patients (64%) reported integrative intervention utilization led to an enhanced quality of life during cancer therapy. Conclusions: At a single academic cancer center, in a cancer type and stage diverse population, the majority of patients (64%) reported improved quality of life during cancer therapy with integrative medicine intervention utilization. Nutrition, natural product supplementation, massage, exercise, and meditative modalities were most commonly utilized. Interestingly, a large proportion of patients analyzed in this questionnaire-based study were afflicted with hematologic disease, a population underrepresented in the current integrative medicine intervention research. More studies exploring the feasibility and impact of integrative therapies in the hematologic patient population are needed.

Do elderly and young patients derive similar relative survival benefits from novel oncology drugs? A systematic review and meta-analysis.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10029-10029 ◽  
Author(s):  
Vanessa Sarah Arciero ◽  
Sierra Cheng ◽  
Erica McDonald ◽  
Mahin Iqbal Qureshi ◽  
Ronak Saluja ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Elderly Patients ◽  
Young Patients ◽  
Relative Survival ◽  
Sensitivity Analyses ◽  
European Medicines Agency ◽  
Cancer Type ◽  
Patient Subgroups

10029 Background: Elderly patients are commonly believed to derive less benefit from cancer drugs, even if they fulfil clinical trial eligibility. We aim to examine if novel oncology drugs provide differential treatment outcomes for elderly and young patients on clinical trials. Methods: A systematic review of randomized control trials (RCTs) cited for clinical efficacy evidence in novel oncology drug approvals by the Food and Drug Administration, European Medicines Agency, and Health Canada between 2006 and 2015 was conducted. Studies reporting age-based subgroup analyses for overall or progression free survival (OS/PFS), were considered. Independent reviewers extracted survival hazard ratios (HRs) and confidence intervals (CIs) for age-based subgroups. Meta-analyses based on an inverse variance random effects model were performed to examine patient subgroups < 65 and ≥ 65 years separately, and pooled HRs were compared to examine if differences in relative survival benefits existed between patient subgroups. Sensitivity analyses were conducted specific to cancer type, primary endpoint, and the type of systemic treatment. Results: Eighty-five RCTs, including 55,512 patients, reported age-based survival outcomes and were included. One study reported age-based toxicity and no studies age-based quality of life results. Pooled HRs [95% CIs] for patients < 65 and ≥ 65 years were 0.60 [0.56-0.65] and 0.66 [0.61-0.72], respectively with no difference between the two subgroups ( P= 0.08). All sensitivity analyses revealed similar results. Conclusions: Our results suggest that elderly and young patients derive similar relative survival benefits from novel oncology drugs. In settings where there is no other direct high-level evidence of elderly patients deriving less benefit than younger patients, it is reasonable to consider offering novel oncology drugs to elderly patients who fulfil trial eligibility. There is, however, a need to report age-based toxicity and quality of life results to support patient discussions regarding the balance of treatment benefit and harm, to encourage informed individualized decision-making.

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