Updated clinical guidelines on the oral management of oncology patients

2019 ◽  
Vol 10 (2) ◽  
pp. 62-65
Author(s):  
Navdeep Kumar
Keyword(s):  
Quality Of Life ◽  
Cancer Treatment ◽  
Clinical Guidelines ◽  
Oral Care ◽  
Oncology Patients ◽  
Dental Services ◽  
Before And After ◽  
After Cancer

As the rate of dentists treating children and adults who present before and after cancer treatment increases, appropriate preventive regimens, timely oral care and improved dental services are crucial for improving patients’ quality of life. https://www.rcseng.ac.uk/dental-faculties/fds/publications-guidelines/clinical-guidelines/

Regaining a satisfactory quality of life and predicting functional decline after major cancer surgery in older adults: The Geriatric Oncology Surgical Assessment and Functional rEcovery after Surgery (GOSAFE) study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 12051-12051
Author(s):  
Isacco Montroni ◽  
Giampaolo Ugolini ◽  
Nicole Saur ◽  
Antonino Spinelli ◽  
Siri Rostoft ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Functional Recovery ◽  
Functional Outcomes ◽  
Older Patients ◽  
Functional Decline ◽  
Geriatric Oncology ◽  
Cancer Surgery ◽  
Before And After ◽  
After Cancer

12051 Background: Older cancer patients value quality of life (QoL) and functional outcomes as much as survival but surgical studies lack specific data. The international, multicenter GOSAFE study (ClinicalTrials.gov NCT03299270) aims to evaluate patients’ QoL and functional recovery (FR) after cancer surgery and to assess predictors of FR Methods: GOSAFE prospectively collected functional and clinical data before and after major elective cancer surgery on senior adults (≥70 years). Surgical outcomes were recorded (30, 90, and 180 days post-operatively) with QoL (EQ-5D-3L) and FR (Activities of Daily Living (ADL), Timed Up and Go (TUG) and MiniCog), 26 centers enrolled patients from February 2017 to April 2019. Results: 942 patients underwent a major cancer resection. Median age was 78 (range 70-95); 52.2% males, ASA III-IV 49%. 934 (99%) lived at home, 51% lived alone, and 87% were able to go out. Patients dependent (ADL < 5) were 8%. Frailty was detected by means of G8 ≤14 in 68.8% and fTRST ≥2 in 37% of patients. Major comorbidities (CCI > 6) were reported in 36% and 21% had cognitive impairment according to MiniCog (2.2% self-reported). 25% had > 3 kg weight loss, 27% were hospitalized in the last 90 days, 54% had ≥3 medications (6% none). Postoperative overall morbidity was 39.1% (30 day) and 22.5% (90 day), but Clavien-Dindo III-IV complications were only 13.4% and 6.9% respectively. 30/90/180-day mortality was 3.6/6/8.9% (10/30/33% in patients with severe functional disability). At 3 months after surgery, QoL was stable/improved (mean EQ-5D index 0.78 was equivalent before vs. after surgery, while the EQ-5D VAS score > 60 raised from 74.3% at baseline to 80.2%, p < 0.01). 76.6% experienced postoperative FR/stability. Logistic regression analysis showed that ASA 3-4, CCI≥7 and CD III-IV complications are significantly associated with functional decline while a G8 > 14 has a positive association with functional recovery. Age is not associated with functional outcomes. Conclusions: The largest prospective study on older patients undergoing structured frailty assessment before and after major elective cancer surgery has shown that QoL remains stable/improves after cancer surgery. The majority of patients return to independence and G8 can predict functional recovery. Older patients with multiple comorbidities, high ASA score or postoperative severe complications are likely to functionally deteriorate after oncologic surgery Clinical trial information: NCT03299270 .

scholarly journals Case management to increase quality of life after cancer treatment: a randomized controlled trial

BMC Cancer ◽  
2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Nathalie Scherz ◽  
Irène Bachmann-Mettler ◽  
Corinne Chmiel ◽  
Oliver Senn ◽  
Nathalie Boss ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Case Management ◽  
Cancer Treatment ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
After Cancer

scholarly journals A Real-Time Mobile Intervention to Reduce Sedentary Behavior Before and After Cancer Surgery: Usability and Feasibility Study (Preprint)

2019 ◽  
Author(s):  
Carissa A Low ◽  
Michaela Danko ◽  
Krina C Durica ◽  
Abhineeth Reddy Kunta ◽  
Raghu Mulukutla ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sedentary Behavior ◽  
Real Time ◽  
Perioperative Period ◽  
Cancer Surgery ◽  
System Usability Scale ◽  
Before And After ◽  
Mobile Intervention ◽  
After Cancer

BACKGROUND Sedentary behavior (SB) is common after cancer surgery and may negatively affect recovery and quality of life, but postoperative symptoms such as pain can be a significant barrier to patients achieving recommended physical activity levels. We conducted a single-arm pilot trial evaluating the usability and acceptability of a real-time mobile intervention that detects prolonged SB in the perioperative period and delivers prompts to walk that are tailored to daily self-reported symptom burden. OBJECTIVE The aim of this study is to develop and test a mobile technology-supported intervention to reduce SB before and after cancer surgery, and to evaluate the usability and feasibility of the intervention. METHODS A total of 15 patients scheduled for abdominal cancer surgery consented to the study, which involved using a Fitbit smartwatch with a companion smartphone app across the perioperative period (from a minimum of 2 weeks before surgery to 30 days postdischarge). Participants received prompts to walk after any SB that exceeded a prespecified threshold, which varied from day to day based on patient-reported symptom severity. Participants also completed weekly semistructured interviews to collect information on usability, acceptability, and experience using the app and smartphone; in addition, smartwatch logs were examined to assess participant study compliance. RESULTS Of eligible patients approached, 79% (15/19) agreed to participate. Attrition was low (1/15, 7%) and due to poor health and prolonged hospitalization. Participants rated (0-100) the smartphone and smartwatch apps as very easy (mean 92.3 and 93.2, respectively) and pleasant to use (mean 93.0 and 93.2, respectively). Overall satisfaction with the whole system was 89.9, and the mean System Usability Scale score was 83.8 out of 100. Overall compliance with symptom reporting was 51% (469/927 days), decreasing significantly from before surgery (264/364, 73%) to inpatient recovery (32/143, 22%) and postdischarge (173/420, 41%). Overall Fitbit compliance was 70% (653/927 days) but also declined from before surgery (330/364, 91%) to inpatient (51/143, 36%) and postdischarge (272/420, 65%). CONCLUSIONS Perioperative patients with cancer were willing to use a smartwatch- and smartphone-based real-time intervention to reduce SB, and they rated the apps as very easy and pleasant to use. Compliance with the intervention declined significantly after surgery. The effects of the intervention on postoperative activity patterns, recovery, and quality of life will be evaluated in an ongoing randomized trial.

scholarly journals Fertility Preservation and Sexual Health After Cancer Therapy

2017 ◽  
Vol 13 (10) ◽  
pp. 643-651 ◽  
Author(s):  
Nigel Pereira ◽  
Glenn L. Schattman
Keyword(s):  
Quality Of Life ◽  
Sexual Dysfunction ◽  
Sexual Function ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Fertility Preservation ◽  
Cancer Treatments ◽  
Life Issues ◽  
After Cancer

Recent developments in cancer diagnostics and treatments have considerably improved long-term survival rates. Despite improvements in chemotherapy regimens, more focused radiotherapy and diverse surgical options, cancer treatments often have gonadotoxic side-effects that can manifest as loss of fertility or sexual dysfunction, particularly in young cancer survivors. In this review, we focus on two pertinent quality-of-life issues in female cancer survivors of reproductive age—fertility preservation and sexual function. Fertility preservation encompasses all clinical and laboratory efforts to preserve a woman’s chance to achieve future genetic motherhood. These efforts range from well-established protocols such as ovarian stimulation with cryopreservation of embryos or oocytes, to nascent clinical trials involving cryopreservation and re-implantation of ovarian tissue. Therefore, fertility preservation strategies are individualized to the cancer diagnosis, time interval until initiation of treatments must begin, prognosis, pubertal status, and maturity level of patient. Some patients choose not to pursue fertility preservation, and the conversation then centers around other quality of life issues. Not all cancer treatments cause loss of fertility; however, most treatments can directly impact the physical and psychosocial aspects of sexual function. Cancer treatment is also associated with fear, anxiety, and depression, which can further decrease sexual desire, function, and frequency. Sexual dysfunction after cancer treatment is generally ascertained by compassionate inquiry. Strategies to promote sexual function after cancer treatment include pelvic floor exercises, clitoral therapy devices, pharmacologic agents, as well as couples-based psychotherapeutic and psycho-educational interventions. Quality-of-life issues in young cancer survivors are often best addressed by utilizing a multidisciplinary team consisting of physicians, nurses, social workers, psychiatrists, sex educators, counselors, or therapists.

Feasibility and acceptability of yoga to improve psychosocial and physical function among patients with lung cancer: A pilot study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24068-e24068
Author(s):  
Mary E Medysky ◽  
Donald Richard Sullivan ◽  
Anna Tyzik ◽  
Charles R. Thomas ◽  
Kerri M. Winters-Stone
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Depressive Symptoms ◽  
Cancer Treatment ◽  
Physical Function ◽  
Grip Strength ◽  
Chair Stand ◽  
Hand Grip ◽  
After Cancer

e24068 Background: Patients with lung cancer suffer from depression symptoms, reduced quality of life (QOL), and declines in physical function during and after cancer treatment. Since yoga is a low energy demand form of exercise, we hypothesized that yoga is a feasible, safe, and efficacious strategy to mitigate these problems in lung cancer patients. Purpose: 1) Determine the feasibility, acceptability, and safety of a yoga program in patients (pts) with lung cancer during or soon after cancer treatment; 2) Determine the preliminary efficacy of yoga to improve depressive symptoms, quality of life, and physical function among pts with lung cancer. Methods: This study was a single group 12-week (wk) pilot trial of low-moderate intensity yoga among pts with stages I-IV lung cancer (n = 20) during (n = 14) or after (n = 6) cancer treatment. Assessments conducted at baseline, 6- and 12-wks included the Patient Health Questionnaire-8, Functional Assessment of Chronic Illness Therapy-Lung (FACT-L), 6-minute walk distance (6MWD), hand grip strength, chair stand time, and flexibility (back scratch and sit-reach) tests. Results: At baseline, 20 pts, including those with metastatic disease (n = 8), enrolled and 7 pts (35%) withdrew by 6-wks due to poor/worsening health. No further withdrawals occurred at 12-wks. Among pts (n = 13) who completed the study, adherence to the intervention was 75% and 78% at 6 and 12-wks, respectively. No moderate or serious adverse events were reported. Over 12 wks, depressive symptoms (average = -1.8 ±1.23, 43.9% change) decreased, improvements in QOL improved (average = +4 ±2.9, 6.5% change),6MWD (average = +22.6m ±15.9, 6.5% change), hand grip strength (average = +1.6kg ±1.2, 5.7% change), chair stand time (average = -3sec ±2.1, 5.8% change), and upper (average = -10.8cm ±7.5, 49.4% change) and lower (average = -11.9cm ±8.4, 74.6% change) body flexibility occurred. Conclusions: In this sample of lung cancer pts, a 12-week yoga program was modestly feasible, was shown to be safe and potentially beneficial for psychosocial and physical function. Though retention was lower than expected due to early pt withdrawal for poor health, adherence to supervised practice among those pts who were able to complete the intervention exceeded the target goal. Among pts with stage I-IV lung cancer yoga may be a useful strategy to improve psychosocial outcomes and physical functioning, though alternate delivery approaches for pts with advanced disease deserves further exploration. Clinical trial information: NCT03649737 .

scholarly journals The positive impact of dental care on the patient's quality of life after cancer treatment: a case report

2020 ◽  
Vol 9 (9) ◽  
pp. e650997639
Author(s):  
Caroline Gomes Carvalho ◽  
João Victor Frazão Câmara ◽  
Paulo Sérgio da Silva Santos
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Oral Health ◽  
Cancer Treatment ◽  
Dental Treatment ◽  
Positive Impact ◽  
Antineoplastic Treatment ◽  
After Cancer ◽  
The Impact

Objective: To report the case of a patient after cancer treatment and evaluate the impact of oral health on quality of life, through the Oral Health Impact Profile (OHIP-14) before, during, and after dental treatment. Methodology: A patient after antineoplastic treatment attended the clinic specialized. In all consultations, OHIP-14 was applied. Case report: A 68-year-old man diagnosed with keratinizing squamous cell carcinoma of the larynx (T3N0MX), undergoing chemotherapy and adjuvant radiotherapy (2878.2 Grays) and vertical partial laryngectomy surgery without ganglionic emptying. After CT, he complained of tooth loss and discomfort in the tongue after radiotherapy. Ex-drinker for 5 years, ex-smoker for 6 months, but alcoholic for> 10 years and smoker <50 years. Side effects of antineoplastic treatment included labial dryness, hyposalivation, dental fractures, residual roots, changes in swallowing, pain during mouth opening, and cervical movement. The results OHIP-14 was medium (17.85), weak (3.52), weak (2.84) and null impact of oral health on quality of life in the initial consultation, throughout the dental treatment, at the end of dental treatment and 1 year and 2 months after dental treatment, respectively. There was a high impact on psychological discomfort (3.55), medium on psychological disability (1.6), and functional limitation (2.04), in 2015, 2017, and 2018, respectively. Conclusion: The performance of the dentist on the late oral effects of chemotherapy and radiotherapy had a positive impact on improving the quality of life after cancer treatment, with the help of the multidisciplinary team. 

scholarly journals Rehabilitation for children and adolescents after cancer: importance and implementation in Austria

2021 ◽  
Author(s):  
Gustav Fischmeister ◽  
David Riedl ◽  
Gabriele Sanio ◽  
Thomas Bogendorfer ◽  
Bernhard Holzner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pediatric Patients ◽  
Inpatient Rehabilitation ◽  
Rehabilitation Center ◽  
Pediatric Rehabilitation ◽  
Quality Of Life Inventory ◽  
Before And After ◽  
Sick Children ◽  
After Cancer

SummaryUntil 2018 only adults had access to rehabilitation in Austria, but since then 5 centers for pediatric rehabilitation with different indications have been established with the goal of improving the health of sick children and young adults. The pediatric rehabilitation center “Leuwaldhof”, which is located south of Salzburg, is the only pediatric oncologic rehabilitation center in Austria. It offers rehabilitation and recovery for pediatric patients who suffered from malignancies, as well as for their families and siblings, but also for acute or chronic disease in metabolism or digestion. Cancer and its treatment significantly decrease the quality of life (QoL) of pediatric patients and their families. Families often have to split up during the months of chemotherapy if there are siblings in the family and very often it is the mother who stays with the sick child in the hospital. To facilitate recovery for the families in these difficult times, interdisciplinary and family-oriented inpatient rehabilitation has recently been implemented in Austria. To evaluate the improvements during the rehabilitation, the QoL of the patients and families has been routinely assessed since the opening of the center. In a specifically designed ‘life app’, patients and families complete the Pediatric Quality of Life Inventory (PedsQL; generic score and cancer module) before and after rehabilitation on their own electronic devices. Data of 98 patients and 124 parents between June 2018 and December 2019 show significant improvements in QoL. Our goal is to support the children and their families to help them return to normal life. Our results show rehabilitation helps achieve this important goal.

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