scholarly journals The impact of cancer therapy on the endocrine system in survivors of childhood brain tumours

2004 ◽  
Vol 11 (4) ◽  
pp. 589-602 ◽  
Author(s):  
H K Gleeson ◽  
S M Shalet
Keyword(s):  
Quality Of Life ◽  
Cancer Therapy ◽  
Brain Tumours ◽  
Final Height ◽  
Cranial Irradiation ◽  
Early Puberty ◽  
Gh Therapy ◽  
Childhood Brain Tumours ◽  
The Impact

Survival rates are improving following cancer therapy for childhood brain tumours. There is therefore a growing cohort of survivors at risk of late effects of cancer therapy. Endocrine problems are very common in these patients. The recognition and prompt management of these are essential to prevent further morbidity and impairment of quality of life. Cranial radiation can damage hypothalamic–pituitary function, most frequently affecting GH status; however, higher radiation doses may cause more widespread hypothalamic–pituitary damage. Early puberty secondary to cranial irradiation is now being managed with gonadotrophin-releasing hormone analogues to improve final height. Prompt diagnosis and management of GH deficiency may improve final height outcome; continued GH therapy beyond final height aids the achievement of adult body composition (lean body mass and bone mass) and GH therapy in adulthood improves quality of life. Both cranial irradiation alone and with spinal irradiation can result in radiation damage to the thyroid resulting in hypothyroidism and thyroid nodules, a high proportion of which are malignant. Gonadal damage secondary to spinal irradiation and adjuvant chemotherapy may have long-term consequences including infertility.

scholarly journals Effect of different modalities of treatment on the quality of life of breast cancer patients in Egypt

1997 ◽  
Vol 3 (1) ◽  
pp. 68-81
Author(s):  
Fatma M. El Sharkawi ◽  
Mahmoud F. Sakr ◽  
Hoda Y. Atta ◽  
Hafez M. Ghanem
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Therapy ◽  
Adjuvant Therapy ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Breast Cancer Therapy ◽  
Egyptian Women ◽  
The Impact

The impact of breast cancer therapy on the quality of life [QL] of Egyptian women was studied. Patients were divided into four groups:1:mastectomy alone;2:surgery plus radiotherapy;3:surgery plus chemotherapy;and 4:triple modality. The results revealed that all the four domains of QL of women having adjuvant therapy [groups 2, 3, or 4] were significantly altered compared to those who underwent mastectomy alone. Triple modality adversely affected global QL the most compared to radiotherapy or chemotherapy;radiotherapy had significantly less effect on QL compared to chemotherapy. Triple modality predicted the worst QL. QL measures should be incorporated with the traditional end points for evaluation of treatment and patients given health education on the effects of each therapy

scholarly journals QOL-32. THE PROMOTE STUDY: HEALTH-RELATED QUALITY OF LIFE COMMUNICATION NEEDS OF CHILDREN, ADOLESCENTS, AND THEIR FAMILIES ATTENDING OUTPATIENT CONSULTATIONS AFTER TREATMENT FOR A BRAIN TUMOUR

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii437-iii437
Author(s):  
Shelly Stubley ◽  
Anita Freeman ◽  
Christina Liossi ◽  
Anne-Sophie Darlington ◽  
Martha Grootenhuis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Brain Tumour ◽  
Brain Tumours ◽  
Emotional Health ◽  
Health Related Quality ◽  
Childhood Brain Tumours ◽  
Related Quality ◽  
Health Related ◽  
Communication Needs

Abstract BACKGROUND Childhood brain tumours and their treatment can reduce health-related quality of life (HRQoL) and cause anxiety and depression, withdrawal, and social isolation. Improved communication within outpatient consultations may allow early identification and treatment of these issues. We explored family communication needs in survivors of childhood brain tumours receiving six-monthly follow-up outpatient review within the English NHS. METHODS Semi-structured interviews were conducted with 18 families whose child aged 8–17 years had finished treatment for a brain tumour within the preceding five years. Thematic analysis used the Framework Method. RESULTS Adjusting to change and finding a “new normal” was the overarching theme to emerge. HRQoL issues included fatigue, coping with physical changes, challenges at school, isolation, and adjusting to changes in abilities. Survivors described a need for greater knowledge about and more support with changes in cognitive functioning. Parents spoke about the impact on the wider family and their changed role in supporting the child’s HRQoL. Communication barriers included short-term memory loss, shyness, and the need to suppress or regulate emotions evoked by these issues. Communication needs included more information regarding recovery and rehabilitation and/or help managing anxiety or emotional health. CONCLUSION The above communication needs and barriers should be addressed. Having a digital record to document and monitor this information systematically could improve service planning and provide patients and their families with the resources to reach their full potential and experience a better HRQoL.

Comprehensiveness of Quality of Life Instruments in Capturing Concerns Related to Chemotherapy-Induced Neutropenia

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1311-1311
Author(s):  
Lathi A Nina ◽  
Pierre Isogai ◽  
Nicole Mittmann ◽  
Carlo DeAngelis ◽  
Matthew Cheung ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Therapy ◽  
Functional Assessment ◽  
Regression Models ◽  
Well Being ◽  
Linear Regression Models ◽  
Specific Instrument ◽  
Relationship Of ◽  
The Impact

Abstract Neutropenia is a serious hematologic consequence of cancer chemotherapy that can lead to further complications such as febrile neutropenia (FN). FN is potentially life threatening and often requires hospitalization. Few studies have evaluated the impact of neutropenia on quality of life (QoL). This study quantified QoL using two nonneutropenia-specific instruments, the EQ-5D questionnaire, a generic tool used to measure health-related QoL, and the Functional Assessment of Cancer Therapy - General (FACT-G) questionnaire, and a neutropenia-specific instrument, the Functional Assessment of Cancer Therapy - Neutropenia (FACT-N) questionnaire. The FACT-G is a 27-item questionnaire that examines QoL in patients with cancer using four subscales. A neutropenia-specific subscale (NSS) has been developed for use with the FACT-G; this combined questionnaire is the FACT-N. Data were collected from patients, who provided informed consent, and who were admitted to Sunnybrook Health Sciences Centre, Toronto, Canada, for the treatment of chemotherapy-induced FN. Linear regression models were fitted to examine the relationship of scores from the neutropenia-specific instrument with those obtained from the other instruments. Two models were fitted using the NSS as the response variable. Predictors for the regression models were the FACT-G scores for each of the subscales (physical, emotional, social and functional wellbeing) and the five domains of the EQ-5D (mobility, self-care, usual activity, pain/discomfort and anxiety/depression) along with the visual analog scale (VAS) component of this tool. The physical and emotional wellbeing subscales of the FACT-G had a strong relationship to the NSS (p < 0.05); the social and functional well-being subscales had a much weaker relationship (p > 0.5). For the EQ-5D, the pain/discomfort domain had the strongest relationship to the NSS (p=0.18); the remaining domains, with or without the VAS, all demonstrated a weaker relationship (p > 0.5). Model fit was assessed by the adjusted R2 statistic; it was 0.54 when FACT-G subscales were used as the predictors compared to −0.04 for the EQ-5D domains indicating that the FACT-G was a better predictor of neutropenia-related concerns. Neutropenia concerns appear to be more closely related to cancer specific QoL compared to general quality of life as demonstrated by the stronger relationship of the NSS to the FACT-G than to the EQ-5D. This may be due to the comprehensiveness of the FACT-G questionnaire where a possible score anywhere from 0 to 24 or 28 can be obtained in each of the subscales, compared to three-point descriptive system for each of the domains of the EQ-5D.

Psychometric evaluation of the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group—Neurotoxicity (Fact/GOG-Ntx) questionnaire for patients receiving systemic chemotherapy

2003 ◽  
Vol 13 (6) ◽  
pp. 741-748 ◽  
Author(s):  
E. A. Calhoun ◽  
E. E. Welshman ◽  
C.-H. Chang ◽  
J. R. Lurain ◽  
D. A. Fishman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Cancer Therapy ◽  
Functional Assessment ◽  
Gynecologic Oncology ◽  
Psychometric Evaluation ◽  
Gynecologic Oncology Group ◽  
Oncology Group ◽  
The Impact

The purpose of this study was to validate the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group—Neurotoxicity (FACT/GOG-Ntx) questionnaire. The FACT/GOG-Ntx is the FACT-G plus an eleven-item subscale (Ntx subscale) that evaluates symptoms and concerns associated specifically with chemotherapy-induced neuropathy. Two groups of women with ovarian cancer completed the FACT/GOG-Ntx: one group with known neurotoxicities and one group of chemotherapy-naive women newly diagnosed with ovarian cancer. Levels of patient neuropathy, severity of toxicity, and patient quality of life from diagnosis of ovarian cancer to 12 months post-diagnosis were assessed. The Ntx subscale significantly differentiated the two groups at baseline and 3- and 6-month follow-ups, demonstrating significantly fewer problems among chemotherapy-naive patients than among patients with known neuropathy. The FACT/GOG-Ntx is a reliable and valid instrument for assessing the impact of neuropathy on health-related quality of life. The Ntx subscale demonstrated sensitivity to meaningful clinical distinctions and change over time.

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