The Existential Framework of Meaning-Centered Psychotherapy

2017 ◽  
Author(s):  
William Breitbart
Keyword(s):  
Cancer Patients ◽  
Clinical Setting ◽  
Jacques Derrida ◽  
Viktor Frankl ◽  
Cancer Setting ◽  
Existential Concerns

This chapter briefly reviews the existential framework and context in which meaning-centered psychotherapy (MCP) for cancer patients was developed. As an introduction to MCP in the cancer setting, readers of this chapter will be exposed to basic existential philosophical and psychotherapeutic constructs that were influential in developing MCP and that will be of benefit to practitioners of MCP in the clinical setting. The contributions of such important existential psychotherapists and philosophers as Irvin Yalom, Viktor Frankl, Kierkegard, Heidegger, Jacques Derrida, and others are distilled for the reader in a manner specifically aimed at elucidating how universal existential concerns are incorporated into MCP.

scholarly journals Sensitivity, specificity, and accuracy of a liquid biopsy approach utilizing molecular amplification pools

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jessica Garcia ◽  
Nick Kamps-Hughes ◽  
Florence Geiguer ◽  
Sébastien Couraud ◽  
Brice Sarver ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Clinical Setting ◽  
High Sensitivity ◽  
Sequencing Error ◽  
Lung Cancer Patients ◽  
Mutation Discovery ◽  
Sensitivity Specificity ◽  
Next Generation Sequencing Ngs ◽  
Digital Polymerase Chain Reaction

AbstractCirculating cell-free DNA (cfDNA) has the potential to be a specific biomarker for the therapeutic management of lung cancer patients. Here, a new sequencing error-reduction method based on molecular amplification pools (MAPs) was utilized to analyze cfDNA in lung cancer patients. We determined the accuracy of MAPs plasma sequencing with respect to droplet digital polymerase chain reaction assays (ddPCR), and tested whether actionable mutation discovery is improved by next-generation sequencing (NGS) in a clinical setting. This study reports data from 356 lung cancer patients receiving plasma testing as part of routine clinical management. Sequencing of cfDNA via MAPs had a sensitivity of 98.5% and specificity 98.9%. The ddPCR assay was used as the reference, since it is an established, accurate assay that can be performed contemporaneously on the same plasma sample. MAPs sequencing detected somatic variants in 261 of 356 samples (73%). Non-actionable clonal hematopoiesis-associated variants were identified via sequencing in 21% of samples. The accuracy of this cfDNA sequencing approach was similar to that of ddPCR assays in a clinical setting, down to an allele frequency of 0.1%. Due to broader coverage and high sensitivity for insertions and deletions, sequencing via MAPs afforded important detection of additional actionable mutations.

Individual Meaning-Centered Psychotherapy for Advanced Cancer Patients

2017 ◽  
Author(s):  
William Breitbart ◽  
Wendy G. Lichtenthal ◽  
Allison J. Applebaum ◽  
Melissa Masterson
Keyword(s):  
Clinical Trials ◽  
End Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Therapeutic Intervention ◽  
Well Being ◽  
Existential Psychology ◽  
Advanced Cancer Patients ◽  
Spiritual Well Being ◽  
Existential Concerns

Among the advanced cancer population, existential concerns are major issues that promote significant distress. For patients who are facing death, meaning and the preservation of meaning are not only clinically and existentially important but also central concepts to a therapeutic intervention. Based on Viktor Frankl’s logotherapy and the principles of existential psychology and philosophy, “meaning-centered psychotherapy” was developed to help patients with advanced cancer sustain or enhance a sense of meaning, peace, and purpose in their lives. This chapter provides an overview of work developing and testing individual meaning-centered psychotherapy (IMCP). It provides an overview of the session content in the IMCP intervention. It also presents findings from clinical trials, which support the efficacy of IMCP as an intervention to increase a sense of meaning, spiritual well-being, and hope while decreasing end-of-life despair. Furthermore, it presents difficult scenarios that may arise when delivering IMCP for clinicians interested in this work.

Event, Death, and Poetry

2018 ◽  
Vol 62 (1) ◽  
pp. 253-268
Author(s):  
Harris B. Bechtol ◽  
Keyword(s):  
Jacques Derrida ◽  
Focal Point ◽  
Continental Philosophy ◽  
The Other ◽  
Current Debate ◽  
Paul Celan ◽  
The World ◽  
Novel Approaches ◽  
Existential Concerns

Since Heidegger, at least, the theme of the event has become a focal point of current debate in continental philosophy. While scholars recognize the important contributions that Jacques Derrida has made to this debate, the significance of his considerations of the death of the other for his conception of the event has not yet been fully appreciated. This essay focuses on Derrida’s efforts to develop the notion of the event in reference to the death of the other through his engagement with Paul Celan in “Rams—Between Two Infinities, The Poem.” I argue that Derrida’s approach results in a three-fold contribution to the debate about the character of the event. Derrida turns to one of Celan’s poems in an effort to find the kind of speech that attests to the event in its singularity, and in this turn, he develops not only the structure of the event’s appearance in the death of the world when the other dies but also the ethical impetus that accompanies this event of the death of the other, namely a call for workless mourning. Through Derrida’s contribution, we learn that the concern for the event not only includes novel approaches to ontology but also attempts to weave together ontological, ethical, as well as existential concerns.

Serious Adverse Drug Reactions (sADRS) Associated with Hematopoietic Growth Factors: A Systematic Review From the Southern Network on Adverse Reactions (SONAR) Program

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2555-2555 ◽  
Author(s):  
LeAnn Norris ◽  
Zaina Qureshi ◽  
Sara Barnato ◽  
Stephen Lai ◽  
Charles Bennett
Keyword(s):  
Growth Factors ◽  
Cancer Patients ◽  
Absolute Risk ◽  
Baseline Risk ◽  
Hematopoietic Growth Factors ◽  
Total N ◽  
Thrombopoietin Receptor Agonists ◽  
Receptor Agonists ◽  
Thrombopoietin Receptor ◽  
Cancer Setting

Abstract Abstract 2555 Erythrpoiesis stimulating agents (ESAs) and the granulocyte hematopoietic growth factors granulocyte colony stimulating factor (G-CSF) and pegylated G-CSF revolutionized supportive care approaches to anemia and neutropenia, respectively. Thrombopoietin-receptor agonists improve antibody-mediated thrombocytopenia management. For these drugs, as with all agents, a comprehensive understanding of sADRs is important, however, often difficult to do. We reviewed sADRS described in meta-analyses and web-site materials maintained by regulatory agencies and manufacturers reports (1989 to July 2010; n=2,094). Overall, 28 systematic reviews, six package inserts, three medication guides, four FDA Risk Evaluation and Mitigation Systems (REMS) materials, 16 Summaries of Product Characteristics/Product Assessment Reports were included. For ESAs, common sADRs associated with increased relative risks (RRs) included: mortality among cancer patients with chemotherapy-associated anemia or cancer patients not receiving active treatment (RRs: 1.1–1.2); cerebrovascular and cardiovascular events among chronic kidney disease patients ((RRs: 1.3, 1.9), and venous thromboembolism in the cancer setting (RRs;16-1.7). For G-CSF/pegylated-GCSF, rare instances of myelodysplasia/acute myeloid leukemia (MDS/AML) associated with statistically increased RRs were reported among breast cancer patients receiving chemotherapy in trials reported from one NCI-sponsored clinical trials group, one meta-analysis, and one review of Medicare/SEER databases (RR: 1.9–2.1), although the absolute risks were very small (< 2 per 100,000 treated patients). Other rarely reported sADRs (total N < 20) included splenic rupture following G-CSF stimulation of healthy peripheral blood stem donors. Bone marrow fibrosis and collagen deposition were reported with thrombopoietin receptor agonists, although the implications of this finding is uncertain. Also, instances of VTEs were reported among persons who developed high platelet counts following administration of these thrombopoeitin receptor agonists. SADRs are commonly associated with ESA administration in a range of settings, are uncommon occurrences with G-CSF/pegylated G-CSF, and are not well characterized for thrombopoieitin receptor agonists. Formal pharmacovigilance initiatives are ongoing, including FDA mandated REMS with restricted distribution requirement for ESAs in the cancer setting (APPRISE) and the NEXUS and the PROMACTA CARES programs for thrombopoeitin receptor agonists. ESAs (Cancer) ESAs (CKD) G-CSF/Pegylated G-CSF VTE Mortality Cerebrovascular and CVD AML/MDS RR 1.57 and 1.67 1.10 to 1.17 1.34 and 1.92 2.14 and 1.92 95% CI 1.31–1.87 and 1.35–2.06 1.02–1.20 and 1.06–1.30 1.03–1.74 and 1.38–2.26 1.12–4.08 and 1.19–3.07 Baseline Risk Absolute Risk Common Common Common Rare (2/100,000) Disclosures: Bennett: Pfizer: Consultancy.

scholarly journals Distinct gut microbial communities and metabolic functions are associated with cachexia in lung cancer patients

2020 ◽  
Author(s):  
Yueqiong Ni ◽  
Zoltan Lohinai ◽  
Yoshitaro Heshiki ◽  
Balazs Dome ◽  
Judit Moldvay ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Gut Microbiota ◽  
Cancer Patients ◽  
Clinical Setting ◽  
Gut Microbiome ◽  
Microbial Composition ◽  
Shotgun Metagenomics ◽  
Lung Cancer Patients ◽  
Microbial Species ◽  
Functional Pathways

Abstract Background Cachexia is associated with decreased survival in cancer patients and has a prevalence of up to 80%. The etiology of cachexia is poorly understood, and limited treatment options exist. Here, we investigated the role of the human gut microbiome in the clinical setting by integrating shotgun metagenomics and plasma metabolomics of 38 lung cancer patients, with known cachexia status. Results The cachexia group showed significant differences in the gut microbial composition, functional pathways of the metagenome, and the related plasma metabolites compared to non-cachectic patients. Branched-chain amino acids (BCAAs), methylhistamine, as well as vitamins, were significantly depleted in the plasma of cachexia patients, which was also reflected in the depletion of relevant gut microbiota functional pathways. The enrichment of plasma BCAAs and 3-oxocholic acid in non-cachectic patients were positively correlated with the gut microbial species Prevotella copri and Lactobacillus gasseri, respectively. Furthermore, the gut microbiota capacity for lipopolysaccharides biosynthesis was significantly enriched in the cancer cachectic patients. The involvement of gut microbiome in cachexia was further observed in a high-performance machine learning model that uses solely gut microbial taxonomic and pathway features to differentiate cachectic from non-cachectic cancer patients. Conclusions Our study demonstrates the links between host metabolism and specific gut microbial species and functions in a clinical setting, suggesting that the gut microbiota could have an influence on cachexia with possible future therapeutic applications.

Communicating the introduction of psychology services in the palliative care (PC) cancer setting: A randomized double blind trial.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 129-129
Author(s):  
Sujin Ann-Yi ◽  
Kimberson Cochien Tanco ◽  
Cindy L. Carmack ◽  
Diane D. Liu ◽  
Swati Bansal ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Depression Scale ◽  
Empirical Support ◽  
Double Blind ◽  
Psychosocial Services ◽  
Significant Difference ◽  
Scale Scores ◽  
High Distress ◽  
Cancer Setting ◽  
Clinical Trial Information

129 Background: Despite high distress and empirical support for psychosocial services for cancer patients, the utilization of these services continue to be low. Our aims are to ascertain if the manner of introducing psychology services impact patients’ acceptance of services and identify factors associated with acceptance and barriers of psychology utilization. Methods: 100 PC cancer patients who have not received prior psychology services were randomized to observe two video vignettes: one showed a physician introducing a counselor and psychology services to the patient (PI); another showed a counselor entering and introducing psychology services alone (CI). Randomization was stratified using baseline Hospital Anxiety and Depression Scale scores. After viewing both videos, patients completed a survey regarding preference, attitudes, and barriers for psychology services. Patients were blinded regarding the purpose of the study and investigators were blinded to content and order of videos presented. Results: 64 patients reported a preference with 34 preferring PI (p=0.37) and 36 reporting no difference. Younger patients preferred PI (85.7%) versus CI (14.3%, p=0.03). Most reported being aware of available psychology services (N=63), and half (N=50) had been offered psychology services by their physician. Only 40 (40%) patients felt psychology services would be helpful for them, and 43 (43%) reported it would be beneficial for their family/caregivers. Those who found it helpful for themselves or family had higher anxiety than those who did not find it helpful (p=0.03 and p=.02 respectively). The most commonly endorsed barriers for psychology services were travel (N=25) and finances (N=21). Conclusions: We found no significant difference in preference of introduction of psychology services except in patients less than 40 years old who preferred PI. Patients with higher anxiety felt psychology services were helpful for self and family. Only 40% perceived psychology services as useful for self and family. More research is needed to investigate the most effective approach for introducing psychology services to increase perception of usefulness and utilization in cancer patients. Clinical trial information: NCT03035448.

Physical Testing in Cancer Patients: Practical Testing in a Clinical Setting

2021 ◽  
Vol 8 (2) ◽  
pp. 77-88
Author(s):  
Timia van Soom ◽  
◽  
Nick Gebruers ◽  
Wiebren Tjalma ◽  
Goof Schep ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Clinical Setting ◽  
Physical Testing

Existential concerns of terminally ill cancer patients receiving specialized palliative care in Japan

2004 ◽  
Vol 12 (2) ◽  
pp. 137-140 ◽  
Author(s):  
Tatsuya Morita ◽  
Masako Kawa ◽  
Yoshifumi Honke ◽  
Hiroyuki Kohara ◽  
Etsuko Maeyama ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Terminally Ill ◽  
Terminally Ill Cancer Patients ◽  
Specialized Palliative Care ◽  
Existential Concerns

Clinical trials

2019 ◽  
pp. 267-274
Keyword(s):  
Clinical Trials ◽  
Cancer Patients ◽  
Legal Framework ◽  
Final Part ◽  
Ethical Approval ◽  
History Of ◽  
Cancer Setting ◽  
Reduce Risk ◽  
Trial Setting

This chapter explores the role of clinical trials within the cancer setting. It covers the history of clinical trials within medicine and describes the key stages of ethical approval and the legal framework within which clinical trials exist. Phases of clinical trials are also covered, as well as nurses' responsibilities within a trial setting. The final part of the chapter explores the vulnerable nature of many cancer patients and how to reduce risk for these patients.

Characteristics, interventions, and outcomes of misdiagnosed delirium in cancer patients

2010 ◽  
Vol 8 (2) ◽  
pp. 125-131 ◽  
Author(s):  
Tomomi Wada ◽  
Makoto Wada ◽  
Mei Wada ◽  
Hideki Onishi
Keyword(s):  
Retrospective Study ◽  
Cancer Patients ◽  
Initial Assessment ◽  
Psychiatric Consultation ◽  
Precipitating Factors ◽  
High Prevalence ◽  
Psychiatric Complication ◽  
Life Issues ◽  
Cancer Setting ◽  
End Of Life Issues

AbstractObjective:Although delirium is a common psychiatric complication in cancer patients, it is often not accurately recognized. To date, the characteristics and outcome of misrecognized patients are unclear in the cancer setting. This retrospective study was planned to determine the recognition by oncologists at the psychiatric consultation, characteristics, reversibility and outcome of misrecognized patients with delirium.Method:We reviewed charts of 60 patients diagnosed with delirium by the psycho-oncologists who were referred to the psychiatric consultation by the oncologists. Information about demographics, initial assessment by the oncologists, delirium subtype, precipitating factors, intervention for delirium, reversibility, and final status was obtained.Results:Twenty-two among 60 delirious patients were misrecognized by the oncologists at the time of consultation. They were often diagnosed as having anxiety or other psychiatric disorders. Misrecognized participants were significantly younger than accurately recognized cases of delirium. The psychiatrists made suggestions to the oncologists for all the referred patients, even when they were accurately diagnosed with delirium before consultation. For the correctly recognized patients, the main suggestion was pharmacological reevaluation. For the misdiagnosed cases, the psychiatrists suggested a reconsideration of the strategy for cancer treatment and the provision of information to the patient's family members about their condition.Significance of Results:Despite its high prevalence, delirium is difficult to diagnose for non-psychiatric physicians. Its detection is important not only to give the best treatment option to cancer patients but also to provide the best opportunity to inform their family about their condition and end-of-life issues.

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