scholarly journals Conversations on Cancer Chemotherapy Cessation in Patients With Advanced Cancer: Qualitative Findings From a Multi-Institutional Study

2020 ◽  
Vol 38 (2) ◽  
pp. 175-179
Author(s):  
Jeremiah Stout ◽  
Ashok Kumbamu ◽  
Jon Tilburt ◽  
Cara Fernandez ◽  
Gail Geller ◽  
...  
Keyword(s):  
Side Effects ◽  
Real Time ◽  
Advanced Cancer ◽  
Cancer Chemotherapy ◽  
Therapeutic Options ◽  
Oncology Patients ◽  
Patients With Cancer ◽  
Multiple Factors ◽  
Audio Recordings ◽  
Clinic Visits

Purpose: As many as 20% of oncology patients receive chemotherapy in the last 14 days of their lives. This study characterized conversations between patients and cancer clinicians on chemotherapy cessation in the setting of advanced cancer. Methods: This 3-site study captured real-time, audio-recorded interviews between oncology clinicians and patients with cancer during actual clinic visits. Audio-recordings were reviewed for discussion of chemotherapy cessation and were analyzed qualitatively. Results: Among 525 recordings, 14 focused on stopping chemotherapy; 14 patients participated with 11 different clinicians. Two types of nonmutually exclusive conversation elements emerged: direct and specific elements that described an absence of effective therapeutic options and indirect elements. An example of a direct element is as follows: “…You know this is…always really tough…But I—I think that you may need more help…I think we’re close to stopping chemotherapy…And hospice is really helpful to have in place…” In contrast, the second conversation element was more convoluted: “…transplant is not an option and surgery is not an option…The options…are taking a pill…It doesn’t shrink the tumor…It may help you live a little longer. But I’m worried if [you] had the pill, it’s still a therapy and it still has side effects. I [am] worried if I give it to you now, that you’re so weak, it will make you worse.” No relationship seemed apparent between conversation elements and chemotherapy cessation. Conclusions: Conversations on chemotherapy cessation are complex; multiple factors appear to drive the decision to stop.

scholarly journals Alternative Methods to Treat Nausea and Vomiting from Cancer Chemotherapy

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Mohammad Ali Sheikhi ◽  
Ahmad Ebadi ◽  
Abdolhassan Talaeizadeh ◽  
Hossein Rahmani
Keyword(s):  
Side Effects ◽  
Cancer Chemotherapy ◽  
Massage Therapy ◽  
Nausea And Vomiting ◽  
Alternative Methods ◽  
Herbal Therapy ◽  
Patients With Cancer ◽  
Recent Advances ◽  
Patients Experience ◽  
Medicinal Therapy

Chemotherapy Induced Nausea and Vomiting (CINV) is among the most intensive side effects and critical concerns for patients with cancer. Most of these patients experience nausea and vomiting after chemotherapy. Sometimes, this is so annoying that it may prevent them from continuing the therapy. With the recent advances, a variety of therapeutic methods are innovated and applied to control CINV. Among them, the main methods include medicinal therapy, relaxation, and herbal therapy. Yet, using dexamethasone together with massage therapy and ginger is identified as the most effective method.

STEROIDSTOFFWECHSEL BEI BRUSTKREBS. III.

1959 ◽  
Vol XXXII (I) ◽  
pp. 23-32 ◽  
Author(s):  
Kurt Schubert ◽  
Hans Schröder
Keyword(s):  
Advanced Cancer ◽  
Liver Damage ◽  
Adsorption Chromatography ◽  
Hepatic Insufficiency ◽  
Loading Test ◽  
Patients With Cancer ◽  
Urinary Steroids ◽  
Normal Women

ABSTRACT A testosterone test using two different dosages was carried out simultaneously in 7 women suffering from metastasizing carcinoma of the mamma and in 3 normal women. In each case the urinary steroids were estimated before the beginning of the test and after administration of 50 mg and 100 mg of testosterone respectively; the interval between the single estimations being one week. The use of fractionated hydrolysis enabled a mild fission of the conjugates and the classification of the products into free steroids, glucuronosides, sulfates and unknown conjugates. The 17-ketosteroids and the testosterone were estimated by means of Girard's separation and adsorption chromatography. During the loading test with testosterone different behaviours became evident, which had not been realized before. The behaviour of the 17-ketosteroids rendered possible the differentiation of normal women from patients with cancer of the breast yet without hepatic insufficiency, and furthermore of these latter ones from those with a liver damage in addition to the cancer of the breast. The glucuronosides of the 17-ketosteroids are only depressed, when there exists a pronounced damage of the liver; the loading test making possible an extension of the range of recognizable damages. Furthermore, the behaviour of dehydroepiandrosterone (II/III), of androsterone (IV), and of aetiocholanolone (V) lends itself to this differentiation. In advanced cancer of the breast the values of II/III are invariably low, whilst IV and V often increase temporarily. The relation of IV to V may be altered in a different way. The excretion of not transformed testosterone is less in patients than in normal women and especially low in patients with liver damage.

scholarly journals Polypharmacy and Malnutrition Management of Elderly Perioperative Patients with Cancer: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1961
Author(s):  
Eiji Kose ◽  
Hidetaka Wakabayashi ◽  
Nobuhiro Yasuno
Keyword(s):  
Side Effects ◽  
Cancer Cachexia ◽  
Drug Effects ◽  
Drug Efficacy ◽  
Nutritional Management ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Drug Induced ◽  
Anabolic Resistance ◽  
Patients With Cancer ◽  
The Impact

Malnutrition, which commonly occurs in perioperative patients with cancer, leads to decreased muscle mass, hypoalbuminemia, and edema, thereby increasing the patient’s risk of various complications. Thus, the nutritional management of perioperative patients with cancer should be focused on to ensure that surgical treatment is safe and effective, postoperative complications are prevented, and mortality is reduced. Pathophysiological and drug-induced factors in elderly patients with cancer are associated with the risk of developing malnutrition. Pathophysiological factors include the effects of tumors, cachexia, and anorexia of aging. Metabolic changes, such as inflammation, excess catabolism, and anabolic resistance in patients with tumor-induced cancer alter the body’s ability to use essential nutrients. Drug-induced factors include the side effects of anticancer drugs and polypharmacy. Drug–drug, drug–disease, drug–nutrient, and drug–food interactions can significantly affect the patient’s nutritional status. Furthermore, malnutrition may affect pharmacokinetics and pharmacodynamics, potentiate drug effects, and cause side effects. This review outlines polypharmacy and malnutrition, the impact of malnutrition on drug efficacy, drug–nutrient and drug–food interactions, and intervention effects on polypharmacy or cancer cachexia in elderly perioperative patients with cancer.

Receptiveness and barriers to clinical trial participation for oncology patients from a public safety-net hospital.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 83-83
Author(s):  
Victor Yundeh Chiu ◽  
Jacob S. Berkowitz ◽  
Joshua Rodriguez ◽  
Jade Law ◽  
Kristina Lee ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Side Effects ◽  
Public Safety ◽  
Safety Net ◽  
Trial Participation ◽  
Religious Leader ◽  
Annual Income ◽  
Oncology Patients ◽  
Wage Loss ◽  
Safety Net Hospital

83 Background: Oncologic clinical trial enrollment is low, particularly in underserved populations. Increasing enrollment of public safety-net hospital patients is important to ensure representation of the general population and reduces cancer outcome disparities. To tailor clinical trial outreach, we sought to characterize attitudes towards trial participation of oncology patients at Olive View—UCLA Medical Center (OVMC), a public safety-net hospital in Los Angeles County. Methods: We developed a 39-question survey (Qualtrics, Provo, UT). It was administered via tablets to a convenience sample of patients in OVMC’s medical oncology clinic and infusion center during 2020—2021. The survey was offered to patients fluent in English or Spanish. Results: Of 165 patients who were offered the survey, 11 declined due to illiteracy in any language, 4 did not finish the survey. Median age was 54 (range: 20-81); 63% were female. The majority (76%) reported an annual income below $25,000; 39% did not complete high school. Self-identified ethnicity was Hispanic/Latino (73%), non-Hispanic White (12%), Asian-Pacific Islander (9%), and Black (4%). Based on a 5-point Likert scale of comfort speaking English, 48% had English proficiency (EP). Overall, 69% of patients expressed interest in trials. When considering participation, patients would seek advice from their physician (86%), family (32%), other medical staff (14%), alternative medicine practitioner (7%), friend (6%), or religious leader (4%). Concerns regarding trial participation were lack of knowledge regarding trials (47%), fear of side effects (43%), frequent visits (25%), cost (20%), transportation (14%), wage loss (9%), and inability to determine own treatment (4%). Patients found the following modalities useful for learning about trials: website (43%), paper handout (39%), video (37%), discussion with prior participants (34%). Patients with annual income > $25,000 were significantly more concerned about cost (33.3% v. 15.8%, p = 0.04) and treatment side effects (61.1% v. 36.8%, p = 0.02). EP patients were more likely to find a website (54.2% vs. 32.1%, p = 0.01) or discussion with prior participants (45.8% v. 23.1%, p < 0.01) helpful compared to low EP patients. Conclusions: There is considerable interest in oncologic clinical trials in this predominantly Hispanic/Latino population. This population had significant trust in physicians for guidance on trial enrollment, and had minimal concern for out-of-pocket cost, wage loss, or transportation issues. The majority of patients did not find additional informational resources helpful. Structural barriers rather than patient-level variables are likely the primary drivers of low oncologic trial enrollment. Future efforts should focus on improving access to appropriate trials and leveraging the physician-patient relationship for increasing trial participation.

Age affects the efficacy of immune checkpoint inhibitors in patients with advanced cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 2638-2638
Author(s):  
Yongjie Wang ◽  
Ronghua Yang ◽  
Dong Wang ◽  
Donghua Zhao ◽  
Peng Li ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Advanced Cancer ◽  
Immune Checkpoint ◽  
Older Patients ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Sign Test ◽  
Patients With Cancer ◽  
The Impact ◽  
Effect Of Age

2638 Background: Immune checkpoint inhibitors (ICIs), such as programmed death(ligand)1 (PD-(L)1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitors, have dramatic effects on treatment in patients with various malignancies. High tumor mutation burden (TMB) is predictive of clinical response to ICI in multiple cancer types. Although age-related immune dysfunction might induce difference on the efficacy of ICIs between younger and older patients, the potential effect of age on the efficacy of ICIs remains little known and controversial. Herein, we aimed to analysis the association between age and the efficacy of ICIs based on MSKCC cohort. Methods: We screened out 1661 patients having complete information with advanced cancer, whose tumors underwent next-generation sequencing (NGS) detection and who were treated with at least one dose of ICI in MSKCC cohort. All patients were divided into two groups according to age, the younger group (age ≤50-year old) and the older group (age > 50-year old). We further analyzed the differences in overall survival (OS) and TMB between the two groups. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated via Cox regression model for OS and P-values were calculated via the Wilcoxon sign test for TMB. We analyzed the effect of age on ICI in lung cancer using the same way. Results: In 1661 patients with cancer in our study, 312 (19%) younger and 1349 (81%) older patients were found. The pooled HRs for OS was 1.28 (95% CI: 1.09-1.52) in younger group compared with older group. In 1661 patients with cancer, there was 350 (21%) patients with lung cancer, including 30 (9%) younger and 320 (91%) older patients. The pooled HRs for OS was 1.45 (95% CI: 0.95-2.23) in younger group compared with older group in lung cancer. In addition, TMB in older group was higher than in younger group and significant difference of TMB was found via the Wilcoxon sign test (p = 2.6e-10) between the two groups, especially in lung cancer (p = 1e-4). Conclusions: Our study assessed the impact of age on the efficacy of ICIs using the threshold of 50 years old for the first time and we founded that patients in older group had higher TMB and longer OS than younger group.

scholarly journals Seroconversion rates following COVID-19 vaccination amongst patients with malignant disease- the impact of diagnosis and cancer-directed therapies

2021 ◽  
Author(s):  
Astha Thakkar ◽  
Jesus Gonzalez Lugo ◽  
Niyati Goradia ◽  
Radhika Gali ◽  
Lauren C. Shapiro ◽  
...  
Keyword(s):  
Passive Immunization ◽  
High Rate ◽  
Oncology Patients ◽  
Post Vaccination ◽  
Patients With Cancer ◽  
Immunization Strategies ◽  
Checkpoint Inhibitor Therapy ◽  
Hormonal Therapies ◽  
Anti Cd20 ◽  
The Impact

As COVID-19 has been shown to adversely affect patients with cancer, prophylactic strategies are critically needed. We determined the immunogenicity of COVID-19 vaccination in a cohort of cancer patients that had received full dosing with one of the FDA-approved COVID-19 vaccines. 201 oncology patients underwent anti-spike protein SARS-CoV-2 IgG testing post-vaccination and demonstrated a high rate of seroconversion (94%) overall. When compared to solid tumors (98%), a significantly lower rate of seroconversion was observed in patients with hematological malignancies (85%), particularly recipients of anti-CD20 therapies (70%) and stem cell transplantation (74%). Patients receiving immune checkpoint inhibitor therapy (97%) or hormonal therapies (100%) demonstrated high seroconversion post-vaccination. Patients with prior COVID-19 infection demonstrated higher anti-spike IgG titers post-vaccination. Relatively lower IgG titers were noted following vaccination with the adenoviral when compared to the mRNA-based vaccines. These data demonstrate generally high immunogenicity of COVID-19 vaccination in oncology patients and identify vulnerable cohorts that need novel vaccination or passive immunization strategies.

scholarly journals Dental lasers applications in visible wavelength operational band

2020 ◽  
Vol 18 (2) ◽  
pp. 890
Author(s):  
Mahmoud M. A. Eid ◽  
Iraj Sadegh Amiri ◽  
Ahmed Nabih Zaki Rashed ◽  
Preecha Yupapin
Keyword(s):  
Side Effects ◽  
Oral Cancer ◽  
Optical Fiber ◽  
Real Time ◽  
Dental Clinic ◽  
Treatment Unit ◽  
Visible Wavelength ◽  
Display Unit ◽  
Dental Lasers ◽  
Early Caries

<p>There is no doubt that radiation has many side effects in our lives, so our goal in this study is to reduce our use of radiation in the diagnosis of tooth caries, and in order to achieve this goal we used the field of optical fiber in the detection of some diseases associated with oral and dental medicine. This diagnosis was accomplished by shedding light on the teeth, to be diagnosed and creating an image that allows the doctor to examine them and determine whether there are caries or any root problems. The principle is also used to detect oral cancer, fractures, and cracks in bones. This study also allows us to detect early caries, and this method saves time because it gives the diagnosis at the same time while the patient is in the treatment unit of the dental clinic. Thus the main advantages of this method are, enable the dentist to view images on the display unit attached to the clinic in real-time, compare current photos with old photos of the same patient. Also, the dentist can create a photo archive of each tooth individually and can retrieve and compare them whenever he wants.    </p>

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