Patient knowledge and expectations of anti-cancer treatments in the advanced disease setting.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24187-e24187
Author(s):  
Darren Cowzer ◽  
Maeve Hennessy ◽  
Anna Linehan ◽  
zac coyne ◽  
Daniel Creegan ◽  
...  
Keyword(s):  
Advanced Disease ◽  
Symptom Burden ◽  
School Level ◽  
Cancer Treatments ◽  
Incurable Cancer ◽  
Incurable Disease ◽  
Improve Symptom ◽  
Systemic Treatments ◽  
International Data ◽  
University Level

e24187 Background: Systemic treatments can improve symptom burden and prolong life in patients with advanced cancer. However, these therapies come with associated toxicities and in some cases can result in reduced quality of life for patients with no possibility of cure. International data has suggested that this cohort of patients have a poor understanding surrounding the goals of treatment in the advanced disease setting. We aimed to evaluate the expectations for cure and palliation from systemic therapies among patients with advanced, incurable cancer in our institution. Methods: Patients on active treatment attending the Oncology Day Ward completed anonymous questionnaires over a four week period. Personal demographics, decision making for treatment and expectation of benefit and toxicity was assessed. Analysis was carried out on patients assessed to have advanced metastatic disease. Results: 254 patients completed the questionnaire. 217 patients were assessed to have metastatic/incurable disease based on responses. 57% were male, 56% were age 30-64 and 35% had completed university level education. 42% of patients stated that treatment was very likely or somewhat likely to cure their cancer. Among patients who reported that a cure was very likely, there were more men (62%) compared to women (38%), more patients were aged less than 65 (62%) compared to over 65 (38%) and more patients had only completed elementary school level education (71%) compared to university level education (29%). Most patients (84%) felt treatment was either very likely or somewhat likely to help them live longer. 68% of patients felt treatment would help them with problems related to their cancer and 33% of patients felt that treatment was very likely to have side effects or complications. 22% of patients stated that doctors made decisions without their input. Conclusions: Many patients receiving treatment for incurable cancers do not understand that it is unlikely to be curative. Male gender, younger age and a lower level of education appears to be associated with unrealistic expectations. This could compromise their ability to make informed treatment decisions. More effective communication around goals of treatment and end of life care may help to improve patients understanding and expectations around the outcomes of chemotherapy.

1511 Symptom burden among patients with newly diagnosed incurable cancer

2015 ◽  
Vol 51 ◽  
pp. S208
Author(s):  
S. Alsirafy ◽  
R. Radwan ◽  
R. Fawzy ◽  
W. El-Sherief ◽  
H. Abd El-Aal ◽  
...  
Keyword(s):  
Symptom Burden ◽  
Newly Diagnosed ◽  
Incurable Cancer

scholarly journals Malignant websites? Analyzing the quality of prostate cancer education web resources

2018 ◽  
Vol 12 (10) ◽  
Author(s):  
Kevin Kobes ◽  
Ilene B. Harris ◽  
Glenn Regehr ◽  
Ara Tekian ◽  
Paris-Ann Ingledew
Keyword(s):  
Prostate Cancer ◽  
Grade Level ◽  
Cancer Education ◽  
School Level ◽  
Cancer Information ◽  
High School Level ◽  
Web Resources ◽  
Inaccurate Information ◽  
University Level

Introduction: Prostate cancer patients are using more web resources to inform themselves about their cancer. However, patients may receive out-of-date or inaccurate information due to lack of regulation. The current study looks to systematically analyze the quality of websites accessed by patients with prostate cancer.Methods: The term “prostate cancer” was searched in Google and the metasearch engines, Yippy and Dogpile, and the top 100 hits related to patient information were compiled from over 32 million hits. A standardized tool was used to examine 100 sites with respect to attribution, currency, usability, and content.Results: Of the top 100 websites relating to prostate cancer information, only 27% identified an author, of which 16% had their credentials displayed. The majority of websites disclosed ownership (97%). Over half of the websites did not include the date of the last update and of those that did, only 66% were current within two years. According to the Flesch Kincaid grade level tool for readability, the majority (87%) of sites were found to be at a high school level, while 6% were at university level. Finally, content varied among websites; 90% of sites provided information on detection and workup and treatments, but only 14% of sites included information on prognosis.Conclusions: The reliability of websites presenting prostate cancer information is questionable. There were noted deficiencies in attribution, currency, and readability. While information on detection and treatment is well-covered, information related to prognosis is lacking.

Assessing Symptom Burden and Depression in Subjects With Chronic Respiratory Insufficiency

2021 ◽  
pp. 082585972110495
Author(s):  
Heidi A. Rantala ◽  
Sirpa Leivo-Korpela ◽  
Lauri Lehtimäki ◽  
Juho T. Lehto
Keyword(s):  
Respiratory Insufficiency ◽  
Advanced Disease ◽  
Depression Scale ◽  
Symptom Burden ◽  
Depression Score ◽  
Assessment System ◽  
Dry Mouth ◽  
Depression Symptom ◽  
Shortness Of Breath ◽  
Chronic Respiratory Insufficiency

Objectives: Patients with chronic respiratory insufficiency suffer from advanced disease, but their overall symptom burden is poorly described. We evaluated the symptoms and screening of depression in subjects with chronic respiratory insufficiency by using the Edmonton symptom assessment system (ESAS). Methods: In this retrospective study, 226 subjects with chronic respiratory insufficiency answered the ESAS questionnaire measuring symptoms on a scale from 0 (no symptoms) to 10 (worst possible symptom), and the depression scale (DEPS) questionnaire, in which the cut-off point for depressive symptoms is 9. Results: The most severe symptoms measured with ESAS (median [interquartile range]) were shortness of breath 4.0 (1.0-7.0), dry mouth 3.0 (1.0-7.0), tiredness 3.0 (1.0-6.0), and pain on movement 3.0 (0.0-6.0). Subjects with a chronic obstructive pulmonary disease as a cause for chronic respiratory insufficiency had significantly higher scores for shortness of breath, dry mouth, and loss of appetite compared to others. Subjects with DEPS ≥9 reported significantly higher symptom scores in all ESAS categories than subjects with DEPS <9. The area under the receiver operating characteristic curve for ESAS depression score predicting DEPS ≥9 was 0.840 ( P < .001). If the ESAS depression score was 0, there was an 89% probability of the DEPS being <9, and if the ESAS depression score was ≥4, there was an 89% probability of the DEPS being ≥9. The relation between ESAS depression score and DEPS was independent of subjects’ characteristics and other ESAS items. Conclusions: Subjects with chronic respiratory insufficiency suffer from a high symptom burden due to their advanced disease. The severity of symptoms increases with depression and 4 or more points in the depression question of ESAS should lead to a closer diagnostic evaluation of depression. Symptom-centered palliative care including psychosocial aspects should be early integrated into the treatment of respiratory insufficiency.

Clinical psychology in palliative care

2015 ◽  
Author(s):  
Anja Mehnert
Keyword(s):  
Advanced Disease ◽  
Symptom Burden ◽  
Adjustment Disorder ◽  
Physical Symptom ◽  
Emotional States ◽  
Loss Of Control ◽  
Medical Needs ◽  
Hastened Death ◽  
Major Factors ◽  
Depressive Episodes

The psychosocial implications of disease progression result in a range of challenges for both the patient and the caregiver. The consequences of advanced disease can comprise emotional states such as anxiety, distress and depressive episodes, fear of being a burden to others, loss of control, anger, loss of sense of dignity, uncertainty, and changes in close relationships and social roles. Adjustment disorder, anxiety disorder, depressive disorder, and the demoralization syndrome represent common disorders and phenomena among patients with advanced cancer. Moreover, uncontrollable pain and high unrelieved physical symptom burden, depression, feelings of helplessness and hopelessness, delirium, and low family support are major factors in the desire for thoughts of suicide and the desire for hastened death. Caregivers play an important and challenging role, providing emotional and social support for the patient, helping with medical needs, and meeting increasingly complex instrumental needs such as running the household and work.

To Tell or Not to Tell: The Community Wants to Know About Expensive Anticancer Drugs As a Potential Treatment Option

2009 ◽  
Vol 27 (34) ◽  
pp. 5830-5837 ◽  
Author(s):  
Linda Mileshkin ◽  
Penelope E. Schofield ◽  
Michael Jefford ◽  
Emilia Agalianos ◽  
Michele Levine ◽  
...  
Keyword(s):  
Anticancer Drugs ◽  
General Public ◽  
Financial Burden ◽  
Treatment Options ◽  
Potential Treatment ◽  
Cancer Treatments ◽  
Incurable Cancer ◽  
Cross Sectional ◽  
Medical Oncologists ◽  
The Government

Purpose Many new cancer treatments are available only at significant financial cost to the patient. We previously reported that Australian medical oncologists commonly do not discuss unsubsidized, expensive anticancer drugs (EACD) because of concern about causing distress. We argued that this position was not consistent with modern ethical principals but wanted to seek the community viewpoint. Methods A cross-sectional telephone survey of the Australian general public was performed. Respondents' views were sought about three hypothetical scenarios in which they were diagnosed with incurable cancer and an EACD treatment (out-of-pocket cost US$25,000) was available. Results Responses were obtained from 1,255 respondents (response rate, 43%). One hundred thirty-seven (11%) had a prior cancer diagnosis. Ninety-one percent of respondents wanted to be told by their doctor about an EACD that could improve survival by an additional 4 to 6 months, with 51% prepared to pay for it. People were more willing to pay if the drug could improve quality of life (71%) or if there was no effective standard treatment (76%). Sixty-eight percent believed the government should pay. Cost would be a significant financial burden for 31% of those willing to pay. Those more likely to want to be informed were younger, employed, better-educated, or had higher income levels (P < .05). Responses did not vary with the person's personal experience of cancer. Of the 9% who did not wish to be informed, half of these were concerned about the information causing distress. Conclusion The Australian general public wants to be informed about EACD as potential treatment options, even if they are not willing or readily able to pay for them.

Relationship between symptom burden and hospital length of stay (LOS) in patients with incurable cancer.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. 10123-10123
Author(s):  
Ryan David Nipp ◽  
Areej El-Jawahri ◽  
Samantha M.C. Moran ◽  
Sara D'Arpino ◽  
Connor Johnson ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Symptom Burden ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Incurable Cancer

scholarly journals High Symptom Burden Among Patients With Newly Diagnosed Incurable Cancer in a Developing Country

2016 ◽  
Vol 51 (5) ◽  
pp. e1-e5 ◽  
Author(s):  
Samy A. Alsirafy ◽  
Hesham H. Abd El-Aal ◽  
Dina E. Farag ◽  
Riham H. Radwan ◽  
Wessam A. El-Sherief ◽  
...  
Keyword(s):  
Developing Country ◽  
Symptom Burden ◽  
Newly Diagnosed ◽  
Incurable Cancer

scholarly journals Beyond Theoretical Education: The Prospects for National Wealth in Dhofar

2016 ◽  
Vol 6 (2) ◽  
pp. 19
Author(s):  
Ali Tigani ElMahi
Keyword(s):  
University Education ◽  
School Level ◽  
Scientific Management ◽  
National Wealth ◽  
Development Plans ◽  
Prime Objective ◽  
University Level ◽  
The University ◽  
And Training ◽  
Primary School Level

Dhofar region in southern Oman possesses a wealth of livestock. This wealth is managed traditionally by different Dhofari groups in a distinct landscape and ecological conditions. By the seventies, development addressed all aspects of live in the Sultanate. Education turned out to be a prime objective in development plans. In Dhofar, young generations of pastoralists found their way into education. It is known that the route of education starts directly from primary school level to the university level. Consequently, theoretical university education detach and disengage young Dhofaris from their forefathers’ traditional profession and most of all their wealth. Dhofar’s livestock is unequivocally a national wealth that needs to be invested and developed by young Dhofari generations, trained in modern scientific management in order to investment in Dhofar’s livestock . Therefore, it is a call for a focused education and training to address the potential of the region and its wealth. The paper attempts to draw attention to a situation which is taking place in Dhofar region and proposes certain recommendations. 

scholarly journals Characteristics Associated With Functional Changes During Systemic Cancer Treatments: A Systematic Review Focused on Older Adults

2021 ◽  
Vol 19 (9) ◽  
pp. 1055-1062
Author(s):  
Kah Poh Loh ◽  
Vivian Lam ◽  
Katey Webber ◽  
Simran Padam ◽  
Mina S. Sedrak ◽  
...  
Keyword(s):  
Older Adults ◽  
Functional Status ◽  
Older Adult ◽  
Functional Decline ◽  
Functional Change ◽  
Cancer Treatments ◽  
Functional Changes ◽  
Systemic Treatments ◽  
Wide Range ◽  
Patient Reported

Background: Maintaining functional status is important to older adults with cancer, but data are limited on how systemic treatments affect functional status. We systematically reviewed changes in functional status during systemic cancer treatments and identified characteristics associated with functional decline and improvement. Methods: We searched PubMed, Embase, Web of Science, and Cochrane Register of Controlled Trials for articles examining characteristics associated with functional changes in older adults during systemic cancer treatment published in English between database inception and January 11, 2019 (PROSPERO CRD42019123125). Findings were summarized with descriptive statistics. Study characteristics between older adult–specific and non–older adult–specific studies were compared using the Fisher exact test. Results: We screened 15,244 titles/abstracts and 519 full texts. The final analysis included 44 studies, which enrolled >8,400 patients; 39% of studies focused on older adults (1 study enrolled adults aged ≥60 years, 10 enrolled adults aged ≥65 years, and 6 enrolled adults aged ≥70 years). Almost all studies (98%) used patient-reported outcomes to measure functional status; only 20% used physical performance tests. Reporting of functional change was heterogeneous, with 48% reporting change scores. Older adult–specific studies were more likely to analyze functional change dichotomously (29% vs 4%; P=.008). Functional decline ranged widely, from 6% to 90%. The most common patient characteristics associated with functional decline were older age (n=7 studies), worse performance status (n=4), progressive disease status (n=4), pain (n=4), anemia (n=4), and worse nutritional status (n=4). Twelve studies examined functional improvement and identified 11 unique associated characteristics. Conclusions: Functional decline is increasingly recognized as an important outcome in older adults with cancer, but definitions and analyses are heterogeneous, leading to a wide range of prevalence. To identify patients at highest risk of functional decline during systemic cancer treatments, trials need to routinely analyze functional outcomes and measure characteristics associated with decline (eg, nutrition).

scholarly journals Advances in immunotherapy for colorectal cancer: a review

2020 ◽  
Vol 13 ◽  
pp. 175628482091752 ◽  
Author(s):  
Gol Golshani ◽  
Yue Zhang
Keyword(s):  
Colorectal Cancer ◽  
Literature Review ◽  
Cancer Survival ◽  
Advanced Colorectal Cancer ◽  
Advanced Disease ◽  
Survival Rates ◽  
Cancer Treatments ◽  
Gastrointestinal Malignancies ◽  
Current Role

Immunotherapy is a new and exciting modality of cancer treatments. Its role in gastrointestinal malignancies has been promising, especially in advanced disease. Although various therapies are available for treatment of advanced colorectal cancer, survival rates for these patients remain very poor. The application of immunotherapy in colorectal cancer has shown remarkable results for a subset of patients with mismatch-repair-deficient mutations or microsatellite instability in their tumors. This literature review evaluates the current role of immunotherapy in advanced colorectal cancer, potential challenges clinicians face with immunotherapy-based regimens, and the possible future approach of combined modality immunotherapy.

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