scholarly journals Understanding symptom appraisal and help-seeking in people with symptoms suggestive of pancreatic cancer: a qualitative study

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e015682 ◽  
Author(s):  
Katie Mills ◽  
Linda Birt ◽  
Jon D Emery ◽  
Nicola Hall ◽  
Jonathan Banks ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Help Seeking ◽  
Survival Rates ◽  
Initial Symptom ◽  
Self Medication ◽  
Gastrointestinal Conditions ◽  
Symptom Appraisal ◽  
Age Range ◽  
Specific Symptoms ◽  
Symptom Changes

ObjectivePancreatic cancer has poor survival rates due to non-specific symptoms leading to later diagnosis. Understanding how patients interpret their symptoms could inform approaches to earlier diagnosis. This study sought to explore symptom appraisal and help-seeking among patients referred to secondary care for symptoms suggestive of pancreatic cancer.DesignQualitative analysis of semistructured in-depth interviews. Data were analysed iteratively and thematically, informed by the Model of Pathways to Treatment.Participants and settingPancreatic cancer occurs rarely in younger adults, therefore patients aged ≥40 years were recruited from nine hospitals after being referred to hospital with symptoms suggestive of pancreatic cancer; all were participants in a cohort study. Interviews were conducted soon after referral, and where possible, before diagnosis.ResultsTwenty-six interviews were conducted (cancer n=13 (pancreas n=9, other intra-abdominal n=4), non-cancer conditions n=13; age range 48–84 years; 14 women). Time from first symptoms to first presentation to healthcare ranged from 1 day to 270 days, median 21 days. We identified three main themes. Initial symptom appraisal usually began with intermittent, non-specific symptoms such as tiredness or appetite changes, attributed to diet and lifestyle, existing gastrointestinal conditions or side effects of medication. Responses to initial symptom appraisal included changes in meal type or frequency, or self-medication. Symptom changes such as alterations in appetite and enjoyment of food or weight loss usually prompted further appraisal. Triggers to seek help included a change or worsening of symptoms, particularly pain, which was often a ‘tipping point’. Help-seeking was often encouraged by others. We found no differences in symptom appraisal and help-seeking between people diagnosed with cancer and those with other conditions.ConclusionsGreater public and healthcare professional awareness of the combinations of subtle and intermittent symptoms, and their evolving nature, is needed to prompt timelier help-seeking and investigation among people with symptoms of pancreatic cancer.

scholarly journals Qualitative cross-country comparison of whether, when and how people diagnosed with lung cancer talk about cigarette smoking in narrative interviews

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023934
Author(s):  
Senada Hajdarevic ◽  
Birgit H Rasmussen ◽  
Trine L Overgaard Hasle ◽  
Sue Ziebland
Keyword(s):  
Lung Cancer ◽  
Cigarette Smoking ◽  
Help Seeking ◽  
Smoking Status ◽  
Survival Rates ◽  
Narrative Interviews ◽  
Defensive Strategies ◽  
Country Comparison ◽  
Symptom Appraisal ◽  
Cross Country

ObjectivesTo compare and examine whether, when and how patients with lung cancer in three countries, with different survival rates, talk about cigarette smoking and its relationship with help-seeking.DesignA qualitative cross-country comparison with analysis of narrative interviews.SettingParticipants in Sweden, Denmark and England were interviewed during 2015–2016. Interviews, using a narrative approach, were conducted in participants’ home by trained and experienced qualitative researchers.ParticipantsSeventy-two men and women diagnosed with lung cancer were interviewed within 6 months of their diagnosis.ResultsThe English participants, regardless of their own smoking status, typically raised the topic of smoking early in their interviews. Smoking was mentioned in relation to symptom appraisal and interactions with others, including health professionals. Participants in all three countries interpreted their symptoms in relation to their smoking status, but in Sweden (unlike England) there was no suggestion that this deterred them from seeking care. English participants, but not Swedish or Danish, recounted reluctance to consult healthcare professionals with their symptoms while they were still smoking, some gave up shortly before consulting. Some English patients described defensive strategies to challenge stigma or pre-empt other people’s assumptions about their culpability for the disease. A quarter of the Danish and 40% of the Swedish participants did not raise the topic of smoking at any point in their interview.ConclusionThe causal relationship between smoking and lung cancer is well known in all three countries, yet this comparative analysis suggests that the links between a sense of responsibility, stigma and reluctance to consult are not inevitable. These findings help illuminate why English patients with lung cancer tend to be diagnosed at a later stage than their Swedish counterparts.

Cirurgia Paliativa em Pacientes com Tumor Periampular Irressecável: Estudo Retrospectivo de 5 Anos em um Hospital em São José dos Campos – SP/Surgical Palliation in Patients with Unresectable Periampullary Tumor: a Retrospective Study of 5 Years in a Hosp

1970 ◽  
Vol 3 (4) ◽  
pp. 9-20
Author(s):  
José Henrique Gomes Torres ◽  
Rosyane Rena De Freitas
Keyword(s):  
Pancreatic Cancer ◽  
Retrospective Study ◽  
Survival Rates ◽  
Periampullary Tumor ◽  
The Past ◽  
Palliative Procedure ◽  
Surgical Palliation ◽  
Head Of The Pancreas ◽  
Keywords Pancreatic Cancer ◽  
Main Complication

Objetivo: Avaliar diferentes métodos paliativos quanto a sua resolução, complicações e sobrevida em pacientes com tumor periampular irressecável. Materiais e métodos: Estudo retrospectivo com análise dos prontuários de pacientes com tumor periampular irressecável e que foram submetidos a procedimento paliativo no Hospital Municipal Dr José de Carvalho Florence nos últimos cinco anos. Resultados: O principal tumor periampular foi o de cabeça de pâncreas, com incidência de 94%, acometendo pacientes com média de 66 anos, sem preferência por sexo. Os procedimentos mais realizados foram derivação biliar e colocação de endoprótese através de colangiopancreatografia endoscópica retrógrada, apresentando sobrevidas de 586 e 56 dias, respectivamente. Conclusão: A coledocojejunostomia foi o procedimento mais realizado e apresentou menor tempo de internação e maiores sobrevida e tempo de permanência anictérico. Pneumonia foi a complicação mais frequente.  Palavras chave: Câncer pancreático, Colangiocarcinoma, Cuidados paliativos.  Objective: To evaluate different palliative methods concerning its resolution, complications and survival in patients with unresectable periampular tumor. Materials and methods: Retrospective study analysing records of patients with unresectable periampullary tumor and who underwent palliative procedure in the Hospital Municipal Dr José de Carvalho Florence in the past five years. Results: The main periampullary tumor was the head of the pancreas, with an incidence of 94%, affecting patients with an average of 66 years old, regardless of gender. The most common procedures were bypass and biliary stent, with survival rates of 586 and 56 days, respectively. Conclusion: Coledocojejunostomy was the procedure which was the most often performed and showed a shorter hospital stay and longer survival time and time without jaundice. Pneumonia was the main complication.  Keywords: Pancreatic cancer, Cholangiocarcinoma, Palliative care  

scholarly journals Microbial Associations with Pancreatic Cancer: A New Frontier in Biomarkers

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3784
Author(s):  
Mark Stasiewicz ◽  
Marek Kwaśniewski ◽  
Tomasz M. Karpiński
Keyword(s):  
Pancreatic Cancer ◽  
Helicobacter Pylori ◽  
Survival Rates ◽  
Health Concern ◽  
Current State ◽  
Increased Risk ◽  
Microbial Biomarkers ◽  
New Frontier ◽  
Microbial Associations ◽  
Fungal Genus

Pancreatic cancer (PC) remains a global health concern with high mortality and is expected to increase as a proportion of overall cancer cases in the coming years. Most patients are diagnosed at a late stage of disease progression, which contributes to the extremely low 5-year survival rates. Presently, screening for PC remains costly and time consuming, precluding the use of widespread testing. Biomarkers have been explored as an option by which to ameliorate this situation. The authors conducted a search of available literature on PubMed to present the current state of understanding as it pertains to the use of microbial biomarkers and their associations with PC. Carriage of certain bacteria in the oral cavity (e.g., Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Streptococcus sp.), gut (e.g., Helicobacter pylori, Synergistetes, Proteobacteria), and pancreas (e.g., Fusobacterium sp., Enterobacteriaceae, Pseudomonadaceae) has been associated with an increased risk of developing PC. Additionally, the fungal genus Malassezia has likewise been associated with PC development. This review further outlines potential oncogenic mechanisms involved in the microbial-associated development of PC.

scholarly journals Current State of “Omics” Biomarkers in Pancreatic Cancer

2021 ◽  
Vol 11 (2) ◽  
pp. 127 ◽  
Author(s):  
Beste Turanli ◽  
Esra Yildirim ◽  
Gizem Gulfidan ◽  
Kazim Yalcin Arga ◽  
Raghu Sinha
Keyword(s):  
Pancreatic Cancer ◽  
Personalized Medicine ◽  
Biomarker Discovery ◽  
Survival Rates ◽  
Postoperative Recurrence ◽  
Molecular Biomarkers ◽  
Background Information ◽  
Current State ◽  
Pancreatic Cancer Screening ◽  
The Future

Pancreatic cancer is one of the most fatal malignancies and the seventh leading cause of cancer-related deaths related to late diagnosis, poor survival rates, and high incidence of metastasis. Unfortunately, pancreatic cancer is predicted to become the third leading cause of cancer deaths in the future. Therefore, diagnosis at the early stages of pancreatic cancer for initial diagnosis or postoperative recurrence is a great challenge, as well as predicting prognosis precisely in the context of biomarker discovery. From the personalized medicine perspective, the lack of molecular biomarkers for patient selection confines tailored therapy options, including selecting drugs and their doses or even diet. Currently, there is no standardized pancreatic cancer screening strategy using molecular biomarkers, but CA19-9 is the most well known marker for the detection of pancreatic cancer. In contrast, recent innovations in high-throughput techniques have enabled the discovery of specific biomarkers of cancers using genomics, transcriptomics, proteomics, metabolomics, glycomics, and metagenomics. Panels combining CA19-9 with other novel biomarkers from different “omics” levels might represent an ideal strategy for the early detection of pancreatic cancer. The systems biology approach may shed a light on biomarker identification of pancreatic cancer by integrating multi-omics approaches. In this review, we provide background information on the current state of pancreatic cancer biomarkers from multi-omics stages. Furthermore, we conclude this review on how multi-omics data may reveal new biomarkers to be used for personalized medicine in the future.

scholarly journals PCV for Oligodendroglial Tumors: In Search of Prognostic Factors for Response and Survival

2001 ◽  
Vol 28 (3) ◽  
pp. 215-223 ◽  
Author(s):  
David Fortin ◽  
David. R. Macdonald ◽  
J. Gregory Cairncross ◽  
Larry Stitt
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Survival Rates ◽  
Multivariable Analysis ◽  
Cancer Center ◽  
Chemotherapy Response ◽  
Initial Symptom ◽  
Oligodendroglial Tumors ◽  
Vascular Proliferation ◽  
Predicting Outcome

Background:We report survival and pretreatment prognostic factors for survival and chemosensitivity in 53 oligodendrogliomas treated with PCV (procarbazine, lomustine and vincristine) chemotherapy.Methods:A total of 53 patients with histologically proven oligodendroglioma, anaplastic oligodendroglioma or oligo-astrocytoma and treated with PCVwere extracted from the London Regional Cancer Center database. A retrospective review was conducted to evaluate overall survival and pretreatment prognostic factors for survival and chemosensitivity.Results:The median survival time from diagnosis was 123.6 months. The overall five- and ten-year survival rates were 72.7% and 52.7% respectively. Age <40, seizure as an initial symptom, absence of cognitive deficit and presence of a homogeneous hypodense lesion without contrast enhancement on the initial pretreatment CT scan were all factors independently associated with favorable outcome. The presence of increased cellularity, pleomorphism, mitosis, vascular proliferation and grading as an anaplastic lesion using these surrogates on pathological assessment, were all associated with an unfavorable outcome in univariable analysis. In multivariable analysis, only the anaplastic grading and presence of increased cellularity were significant determinants of unfavorable survival. The only factor adversely associated with chemosensitivity was the presence of a focal symptom at presentation.Conclusion:Overall survival is significantly longer in oligodendroglial lesions than in fibrillary astrocytic tumors. A two tier grading system using standard morphological features seems accurate in predicting outcome in these patients. The presence of a neoplastic astrocytic component does not seem to impact the outcome. No clinical, radiological or pathological factor could be identified to reliably predict chemotherapy response.

scholarly journals Role of computed tomography in the determination of resectability of carcinoma pancreas

2019 ◽  
Vol 6 (11) ◽  
pp. 4068
Author(s):  
M. N. Sasikumar ◽  
Chintha Salam A.
Keyword(s):  
Computed Tomography ◽  
Pancreatic Cancer ◽  
Vascular Invasion ◽  
Survival Rates ◽  
Vascular Involvement ◽  
Borderline Resectable ◽  
Neoplastic Processes ◽  
Carcinoma Pancreas ◽  
Operative Findings

Background: Pancreatic cancer is one of the most aggressive neoplastic processes. Inspite of progress in the diagnosis and treatment of malignancies, the resectability and survival rates for pancreatic cancer are very poor. This study aims to determine the accuracy of computerised tomography in assessing the resectability of carcinoma pancreas.Methods: 66 patients with carcinoma pancreas, who were judged fit for surgery were studied. All cases had undergone preoperative contrast enhanced triphasic computed tomography (CT) for assessing the resectability. Radiological data was compared with per operative findings for assessments regarding vascular invasion and resectability.Results: Of the 66 cases, resectability reported by CT was 59 (89.4%). The rest of 7 (10.6%) cases were reported as unresectable. Per operatively vascular involvement was found in 14 (21.2%) cases and with no vascular invasion in 52 (78.8%) cases. All the unresectable cases reported in CT (7 cases) turned out to be unresectable. Out of 59 cases reported as resectable, 43 (65.2%) cases under went Whipples procedure, while rest of the 23 (34.8%) cases underwent palliative procedures. Out of these 23 cases, 14 (21.2%) cases were unresectable due to vascular involvement.Conclusions: The study has shown that CT does assess the operability in carcinoma pancreas, assessing mainly unresectability though less effective in assessing resectability. The role of endoscopic ultrasound and laparoscopic ultrasound in aiding CT in further assessment of resectable and borderline resectable cases are to be considered for further research.

(A Clinicopathological Aspects of Resectable Pancreatic Neoplasm)

2021 ◽  
Vol 6 (15) ◽  
pp. 39-44
Author(s):  
Şeref Dokcu ◽  
Mehmet Ali Çaparlar ◽  
Salim Demirci
Keyword(s):  
Pancreatic Cancer ◽  
Survival Analysis ◽  
Survival Rates ◽  
Pancreatic Neoplasm ◽  
Population Based ◽  
Clinicopathological Features ◽  
Categorical Variables ◽  
Malignant Neoplasms ◽  
Continuous Variables ◽  
Common Diagnosis

Aim Pancreatic cancer is one of the deadliest malignant neoplasms. As with many malignant neoplasms, survival rates depend on the histopathological type of cancer, its stage, tumor size, and treatment. In this study, we aimed to classify pancreatic cancer according to clinicopathological features and histological subtypes. Material and method The data of all adult patients diagnosed and treated for pancreatic neoplasm in our clinic were collected retrospectively from the hospital's computerized database and medical files. Patients were categorized according to their clinicopathological features. Chi-square test and Fisher's exact test were used for between-group comparisons, and t-test was used for independent samples for quantitative data. Data were expressed as mean ± SD for continuous variables and numbers and percentages for categorical variables. A value of p<0.05 was considered significant. Results The mean age of the patients was 60.5 years, 70.8% were male. There were five types of tumors defined histopathologically, and the most common diagnosis was adenocarcinoma (76.9%). The most common localization of the tumor was head and neck (44.4%). Whipple surgery was performed predominantly in 69.2% of patients, and distal pancreatectomy in 29.0%. Postoperative complications were observed in more than one third (34%) of the patients. The main complications were pancreatic cyst (16.3%). In the survival analysis performed with the Kaplan-Meier test, median survival of 30.5 months, and overall survival (OS) at 1.2 and 5 years were 67.8%, 40.5%, and 16.6%, respectively. Discussion However, survival analysis results were optimistic compared to population-based studies as all patients had resectable tumors.

Cancer Survival Is (Mostly) Improving

Pained ◽  
2020 ◽  
pp. 245-246
Author(s):  
Michael D. Stein ◽  
Sandro Galea
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Pancreatic Cancer ◽  
Survival Rate ◽  
Cancer Diagnosis ◽  
Cancer Survival ◽  
Prostate Cancer Screening ◽  
Survival Rates ◽  
The United States ◽  
Cervical Cancers

This chapter discusses how the 5-year survival rates for the most common cancers in the United States improved by nearly 20% since the 1970s. While promising overall, low survival rates persist for pancreatic, liver, lung, esophageal, brain, and many other cancers. Meanwhile, 5-year survival for uterine and cervical cancers worsened. Pancreatic cancer has the lowest 5-year survival rate at 8.2%. In contrast, prostate cancer had the greatest 5-year survival increase from 67.8% to 98.6%, most likely reflecting a substantial uptick in prostate cancer screening and early detection. Five-year survival with leukemia also improved significantly, from 34.2% to 60.6%, likely resulting from improved treatments. As such, in both detection and treatment, the United States is making progress. For the millions of Americans who face a cancer diagnosis, this is cause for hope.

Acceptance of Mental Illness Among Men

2016 ◽  
pp. 102-114
Author(s):  
Lauren Mizock ◽  
Zlatka Russinova
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Help Seeking ◽  
Health Resources ◽  
Health Conditions ◽  
Self Medication ◽  
Supportive Relationships ◽  
Clinical Strategies ◽  
Traditional Masculinity ◽  
The Impact

This chapter explores the unique barriers and facilitators to acceptance that men with serious mental illness may experience. The values associated with traditional masculinity are discussed as they pertain to the process of accepting mental illness. Barriers specific to men in our research studies are detailed, including avoidance of help-seeking and self-medication with substance abuse. In addition, the literature on misdiagnosis and underdiagnosis of mental health conditions among men is presented. Facilitators to the process of acceptance for men in the present research are discussed, including accessing supportive relationships and other mental health resources. Several participant case narratives are provided in order to demonstrate the impact of various masculinities on the process of acceptance. A clinical strategies list, discussion questions, activities, the “Men’s Acceptance of Mental Health Worksheet,” and an explanatory table are included at the close of the chapter.

Sign in / Sign up

Export Citation Format

Share Document