scholarly journals The Potential to Source a Patient’s Imaginative Powers in Treating Cancer: Illustrated in Three Cases

2019 ◽  
Vol 27 (1) ◽  
pp. 55-60
Author(s):  
Martin Roesch
Keyword(s):  
Quality Of Life ◽  
Overall Survival ◽  
Randomized Trials ◽  
Pancreatic Tumor ◽  
Case Reports ◽  
Evaluation Criteria ◽  
Human Patient ◽  
Complementary Approach ◽  
Negative Side Effects

Background: The imaginative power of a human patient has the big advantage of sourcing his/her own depth leading to first-hand experiencing. Such experiences have a potential to make a deep impact that can be instrumental to the process of healing. Successful healing is almost inevitably linked to new recognitions and perceptions, changes in attitudes or changes in lifestyle. Therapists in charge may find that they cannot exert direct control over this process but nevertheless, there is a big inherent potential to such processes as a truly complementary approach to clinical oncology. Case Reports: Going by the characteristic of the matter, it seems impossible to conduct randomized trials; rather, we have to learn from the very individual experiences and try to find common traits. Hence, in this contribution, it is “just” three cases that are presented: patients with a pancreatic tumor, lung metastasis, and a colon carcinoma. Still, the same objectives of evaluation criteria as in any conventional clinical trial, namely overall survival and quality of life, are followed here. The presented cases are set against expected outcomes of the guideline-oriented therapy options. Conclusion: Quality of life has improved in all three cases, expected overall survival extended in one case, the second is still to be verified. Certainly beneficially, however, is the ratio of effect to – in these cases – no negative side effects.

scholarly journals Doublets, triplets, or quadruplets of novel agents in newly diagnosed myeloma?

Hematology ◽  
2012 ◽  
Vol 2012 (1) ◽  
pp. 354-361 ◽  
Author(s):  
S. Vincent Rajkumar
Keyword(s):  
Quality Of Life ◽  
Multiple Myeloma ◽  
Overall Survival ◽  
Randomized Trials ◽  
Initial Therapy ◽  
Current Data ◽  
Newly Diagnosed ◽  
Patient Reported ◽  
The World

Abstract The treatment of multiple myeloma is evolving rapidly. A plethora of doublet, triplet, and quadruplet combinations have been studied for the treatment of newly diagnosed myeloma. Although randomized trials have been conducted comparing older regimens such as melphalan-prednisone with newer regimens containing drugs such as thalidomide, lenalidomide, or bortezomib, there are few if any randomized trials that have compared modern combinations with each other. Even in the few trials that have done so, definitive overall survival or patient-reported quality-of-life differences have not been demonstrated. Therefore, there is marked heterogeneity in how newly diagnosed patients with myeloma are treated around the world. The choice of initial therapy is often dictated by availability of drugs, age and comorbidities of the patient, and assessment of prognosis and disease aggressiveness. This chapter reviews the current data on the most commonly used and tested doublet, triplet, and quadruplet combinations for the treatment of newly diagnosed myeloma and provides guidance on choosing the optimal initial treatment regimen.

Quality-of-Life Scores Predict Outcome in Metastatic but Not Early Breast Cancer

2000 ◽  
Vol 18 (22) ◽  
pp. 3768-3774 ◽  
Author(s):  
Alan S. Coates ◽  
Christoph Hürny ◽  
Harriet F. Peterson ◽  
Jürg Bernhard ◽  
Monica Castiglione-Gertsch ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Overall Survival ◽  
Randomized Trials ◽  
Prognostic Significance ◽  
Well Being ◽  
Adjuvant Setting ◽  
Premenopausal Patients ◽  
And Coping

PURPOSE: We compared the prognostic value of quality-of-life (QL) scores in the adjuvant setting and after relapse in two randomized trials of the International Breast Cancer Study Group. PATIENTS AND METHODS: More than 2,000 premenopausal and postmenopausal patients with node-positive breast cancer who were participating in randomized trials that compared adjuvant therapies completed QL assessments for physical well-being, mood, appetite, and coping at study entry and at months 3 and 18 if they remained relapse-free and, in case of relapse, at 1 month and at 6 months after relapse. Cox regression models were used to test the relationship between QL scores and disease-free survival (DFS), in the adjuvant setting, or overall survival, in the case of postrelapse QL measurement. All models were stratified by language/country group and included other factors related to QL and/or outcome. RESULTS: DFS was not significantly predicted by QL scores at baseline or month 18, or by changes in QL score between baseline and months 3 or 18. In contrast, after relapse, QL scores were predictive for subsequent overall survival. One month after relapse, better mood (P = .04) in premenopausal patients and better appetite (P = .005) in postmenopausal patients were associated with longer survival. Six months after relapse, better physical well-being (P = .03) and appetite (P = .03) in premenopausal patients and better physical well-being (P < .0001), mood (P = .002), appetite (P = .0001), and coping (P = .0001) in postmenopausal patients predicted longer survival. CONCLUSION: Any prognostic significance of QL scores in the adjuvant setting is minimal or obscured by chemotherapy effects, but there is strong prognostic significance of QL scores after disease relapse. The contrast suggests that patient perception of the severity of underlying illness may determine reported QL scores.

scholarly journals Effects of Pharmacologic Therapy on Health-Related Quality of Life in Elderly patients with Atrial Fibrillation: A systematic Review of Randomized and Nonrandomized Trials

2013 ◽  
Vol 7 ◽  
pp. CMC.S10628 ◽  
Author(s):  
Carl J. Pepine
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Systematic Review ◽  
Elderly Patients ◽  
Randomized Trials ◽  
Rhythm Control ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

This systematic review assessed the impact of atrial fibrillation (AF) and pharmacotherapy on health-related quality of life (HRQOL) in elderly patients. Highly prevalent in the elderly, AF is associated with morbidity and symptoms affecting HRQOL. A PubMed and EMBASE search (1999-2010) was conducted using the terms atrial fibrillation, elderly, quality of life, Medicare, and Medicaid. In all, 504 articles were identified and 15 were selected (studies examining pharmacotherapy [rate or rhythm control] and HRQOL in AF patients with a mean age > 65 years). Information, including study design, cohort size, and HRQOL instruments utilized, was extracted. Five observational studies, 5 randomized trials comparing rate and rhythm control, 3 randomized trials investigating pharmacologic agents, and 2 trials examining HRQOL, depression, and anxiety were identified. Elderly AF patients had reduced HRQOL versus patients in normal sinus rhythm, particularly in domains related to physical functioning. HRQOL may be particularly affected in older AF patients. Although data do not indicate whether a pharmacologic intervention or single treatment strategy—namely rate versus rhythm control—is better at improving HRQOL, either of these strategies and many pharmacologic interventions may improve HRQOL in elderly AF patients. Based on reviewed data, an algorithm is suggested to optimize HRQOL among elderly patients.

scholarly journals Pretreatment Quality of Life Is an Independent Prognostic Factor for Overall Survival in Patients with Advanced Stage Non-small Cell Lung Cancer

2009 ◽  
Vol 4 (9) ◽  
pp. 1075-1082 ◽  
Author(s):  
Yingwei Qi ◽  
Steven E. Schild ◽  
Sumithra J. Mandrekar ◽  
Angelina D. Tan ◽  
James E. Krook ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Advanced Stage ◽  
Small Cell Lung

scholarly journals Systematic Review of Radiofrequency Ablation and Pulsed Radiofrequency for Management of Cervicogenic Headache

2015 ◽  
Vol 2;18 (2;3) ◽  
pp. E109-E130
Author(s):  
Amit Asopa
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Randomized Trials ◽  
Primary Outcome ◽  
Cervicogenic Headache ◽  
Pulsed Radiofrequency ◽  
Rf Ablation ◽  
High Quality ◽  
Level Of Evidence

Background: Cervicogenic headache is a secondary headache that has a source in the upper cervical spine. There is a small but growing body of evidence to establish effectiveness of radiofrequency (RF) neurotomy, and the pulsed RF (PRF) procedure for management of cervicogenic headache. Objective: To investigate the clinical utility of RF neurotomy, and PRF ablation for the management of cervicogenic headache. Study Design: Systematic review. Methods: The review included relevant literature identified through searches of PubMed, Cochrane, Clinical trials, U.S. National Guideline Clearinghouse and EMBASE from 1960 to January 2014.The quality assessment and clinical relevance criteria utilized were the Cochrane Musculoskeletal Review Group criteria for randomized control trials and the Newcastle-Ottawa Scale criteria for observational studies. The level of evidence was classified as good, fair, and poor based on the quality of evidence. Outcomes Measured: The primary outcome measures were reduction in pain scores and improvement in quality of life. Results: The primary outcome measures were headache relief and improved quality of life. Twenty five studies were identified for full text review of these, 9 studies met inclusion criteria. There were 5 non-randomized, among them 4/5 were of moderate quality, 3/5 showed RF ablation and 1/5 showed PRF as an effective intervention for cervicogenic headache. There were 4 randomized trials among them 2/4 were of high quality, 3/4 investigated RF ablation as an intervention for CHA, 1/4 investigated PRF ablation as an intervention for CHA and none of the randomized studies showed strong evidence for RF and PRF ablation as an effective intervention for CHA. Limitations: In the selected studies there were inconsistencies between randomized trials, flaws in trial design, and gaps in the chain of evidence. Conclusion: There is limited evidence to support RF ablation for management of CHA as there are no high quality RCTs and/ or multiple consistent non-RCTs without methodological flaws. There is poor evidence to support PRF for CHA as there are no high quality RCTs or Non-RCTs. Key Words: Chronic pain, cervicogenic headache, radiofrequency (rf) neurotomy, pulsed radiofrequency (PRF) ablation, reduction in pain, improvement in quality of life, level of evidence

scholarly journals Efficacy of mistletoe extract as a complement to standard treatment in advanced pancreatic cancer: study protocol for a multi-centre, parallel group, double-blind, randomised controlled clinical trial (MISTRAL)

2020 ◽  
Author(s):  
Kathrin Wode ◽  
Johanna Hök Nordberg ◽  
Gunver Sophia Kienle ◽  
Nils Elander ◽  
Britt-Marie Bernhardson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pancreatic Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Advanced Pancreatic Cancer ◽  
Health Related Quality ◽  
Mistletoe Extract ◽  
Related Quality ◽  
Health Related

Abstract Background Most pancreatic cancer patients present with advanced stage at diagnosis with extremely short expected survival and few treatment options. A multimodal palliative approach is necessary for symptom relief and optimisation of health-related quality of life. In a recent open-label trial of mistletoe extract for advanced pancreatic cancer patients not eligible for chemotherapy, promising results on improved overall survival and better health-related quality of life were reported. The objective of the present study is to assess the value of mistletoe extract as a complement to standard 18 treatment (palliative chemotherapy or best supportive care) in advanced pancreatic cancer patients with 19 regard to overall survival and health-related quality of life. Methods The trial is prospective, randomised, double-blind, multicentre, parallel group and placebo-controlled. In total 290 participants are randomly assigned to placebo or mistletoe extract given subcutaneously in increasing dosage from 0.01mg to 20mg three times per week for nine months. Stratification is performed for site and palliative chemotherapy. Main inclusion criteria are advanced pancreatic cancer and Eastern Cooperative Oncology Group performance status zero to two; main exclusion criteria are life expectancy less than four weeks and neuroendocrine tumour of the pancreas. Two ancillary studies on sub-sets of participants are nested in the trial: a biomarker study collecting blood samples and a cross-sectional qualitative study with semi-structured face-to-face interviews. Discussion To our knowledge, this is the first placebo-controlled randomised trial assessing the impact of mistletoe extract as a complement to standard treatment on overall survival and health-related quality of life in patients with advanced pancreatic cancer. The presented trial with its two nested ancillary studies exploring biomarkers and patient experiences is expected to give new insights into the treatment of advanced pancreatic cancer. Trial registration EU Clinical Trial Register, EudraCT Number 2014-004552-64. Registered 19 January 2016, https://www.clinicaltrialsregister.eu/ctr-search/trial/2014-004552-64/SE

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