Disclosing bad news of cancer: patients’ preference for communication

2021 ◽  
pp. 1-9
Author(s):  
Sabah Uddin Saqib ◽  
Khawaja Muhammad Inam Pal
Keyword(s):  
Cancer Patients ◽  
Management Plan ◽  
Family Counseling ◽  
Stage At Diagnosis ◽  
Cross Sectional ◽  
Breaking News ◽  
Different Types ◽  
Communication Demands ◽  
Current Stage

Abstract Introduction: The majority of cancer patients’ relatives in developing countries, especially in Pakistan prefers and demand, and in most times impose a “do not tell approach”, while counselling for patients disease. Thus, the aim of the current study is to first assess patients’ understanding about his or her disease and see preferences regarding the manner in which physicians’ deliver news about cancer diagnosis and its management plan. Material and methods: This was a cross-sectional qualitative study. Patients were approached and interviewed while having their regular follow-up. An immediate relative of the patient was also included in the study to see family perception regarding disease after their consent. This study enrolled 55 patients with 6 different types of cancers. Results: This study shows that 35 (65.5%) patients did not know stage at diagnosis while 40 (72.7%) patients did not know the current stage of their disease. In 22 (40%) cases, patient’s family knew diagnosis ahead of patient and 19 (86.3%) families asked clinicians to hide diagnosis news from the patient. This study demonstrates, specialist oncologist for breaking news, family counseling, helping patient to figure out how to tell diagnosis to others, telling news directly to the patient and the effects of cancer on daily life are preferred area to communicate on first visit. Conclusion:  Disclosing cancer news is always an unfavorable experience not only for patient and family but also clinician as well. In our population both patient understanding and communication demands improvements. Continuous...

scholarly journals Utility of telemedicine in COVID-19 pandemic: our experience at a tertiary cancer center in North East India

2020 ◽  
Vol 8 (11) ◽  
pp. 4027
Author(s):  
Ashok Kumar Das ◽  
Sumanjit S. Boro ◽  
Anupam Das ◽  
Partha Pratim Medhi ◽  
Kaberi Kakati ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Task Force ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Cancer Center ◽  
Cross Sectional ◽  
Ongoing Treatment ◽  
North East ◽  
Phone Calls

Background: Telemedicine is a very useful tool of communication between the doctor and the patient. The aim of this study was to find out the utility of telemedicine during the lockdown period of COVID-19 pandemic in North East India.Methods: It is a cross sectional study among the cancer patients at our center on follow up or ongoing treatment and analysis of all the data acquired from telephonic conversation with our patients from 30th March, 2020 to 3rd May, 2020. Have contacted 4181 patients during this period over phone. All phone calls were done by respective department doctors.Results: From the demographic data, we get that 35.4% of patients were at good physical condition, 3.5% with poor general condition, 11.6% patients having ongoing treatment in our institute, 21.1% patients expired, 0.9% patients have nonmalignant diagnosis, 1.4% patients left the institute due to various reasons. Analyzed this data with brain storming sessions amongst the COVID-19 task force doctors and tried to find out solutions of each problem.Conclusions: Telemedicine cannot replace conventional method of in person treatment, but it proved to be a useful tool during the COVID-19 pandemic for patient follow up and treatment of cancer patients.

Cancer patients use of nonproven therapy: a 5-year follow-up study.

1998 ◽  
Vol 16 (1) ◽  
pp. 6-12 ◽  
Author(s):  
T Risberg ◽  
E Lund ◽  
E Wist ◽  
S Kaasa ◽  
T Wilsgaard
Keyword(s):  
Survival Rate ◽  
Cancer Patients ◽  
Cumulative Risk ◽  
Faith Healing ◽  
High Educational Level ◽  
Cross Sectional ◽  
Follow Up Study ◽  
Number Of Patients ◽  
Oncologic Patients

PURPOSE To investigate the prospective pattern of use of alternative medicine, here called nonproven therapy (NPT), among oncologic patients during a 5-year period, and the relationship between this use and survival, a questionnaire-based follow-up study was performed at the Department of Oncology, University of Tromsø, from 1990 to 1996. PATIENTS AND METHODS Two-hundred fifty-two patients answered the first questionnaire during the period July 1990 to July 1991. Eligible patients were mailed follow-up questionnaires after 4, 12, 24 and 60 months. A telephone interview performed after the last follow-up questionnaire showed little disagreement with the prospective collected information as regards the number of patients reported as users of NPT (kappa, 0.92). RESULTS The number of patients who reported ever using NPT in each cross-sectional part of the study varied between 17.4% and 27.3%. However, the estimated cumulative risk of being a user of NPT during the follow-up period was 45%. Seventy-four percent of NPT users in this north Norwegian study population used faith healing or healing by hand (spiritual NPT) alone or in combination with other forms of NPT. The proportion of patients who used spiritual versus nonspiritual forms of NPT was consistent throughout the follow-up period. Women were more often users than men (50% v 31%, P = .002). Patients older than 75 years of age seldomly used NPT. The 5-year observed survival rate was not influenced by the use of NPT. Adjusted for sex, age, and diagnosis, patients with a high educational level had a borderline higher 5-year survival rate than patients with less education (P = .06). CONCLUSION Our results demonstrate that cross-sectionally designed studies will underestimate the number of ever-users of NPT in a cancer patient population. The use of NPT does not influence observed survival among cancer patients seen in north Norway.

Loss to follow-up of cancer patients in the poorest district of the United States.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6123-6123 ◽  
Author(s):  
Antranik Mangardich ◽  
Aleksandra Mamorska-Dyga ◽  
Doru Paul ◽  
Ghulam Khan ◽  
Svetlana Vassel ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Retention Rate ◽  
Mental Health Center ◽  
The United States ◽  
Stage At Diagnosis ◽  
South Bronx ◽  
Loss To Follow Up ◽  
Significant Difference ◽  
Cancer Types

6123 Background: Loss to follow-up (LFU) of cancer patients is a serious dilemma, and has only been narrowly studied. Lincoln Medical and Mental Health Center (LMMHC) serves South Bronx (SB), the poorest district in the nation. The purpose of this study was to assess rates of LFU and correlate it with age, sex, ethnicity, race, cancer types, and stage at diagnosis. Methods: We collected data from 1,552 patients diagnosed with invasive cancer in LMMHC between 2006-2010. The data collected were age, sex, ethnicity, race, type of cancer, stage, LFU, treatment, and vital status. Results: From the 1,552 patients, roughly 25 % were LFU, with 50% receiving some initial form of treatment. The remaining percentages are shown below (Table). A higher rate of LFU was with patients younger than 65 (OR: 1.38, 95% CI: 1.08-1.76). There was no correlation between sex and LFU. Non-Hispanics were more likely to be LFU compared to Hispanics (OR: 1.39, 95% CI: 1.07 – 1.8). Blacks were more likely to be LFU compared to non-Blacks (OR: 1.43, 95% CI: 1.12–1.82). There was no significance between LFU and stage at diagnosis. Looking at cancer specific data, colon cancer (C) and head and neck cancers (HN) had the highest percentage of LFU (30% each). There was higher LFU rate for C compared to breast cancer (B) (OR: 1.7, 95% CI: 1.03-2.8), prostate cancer (P) (OR: 1.88, 95% CI: 1.18-3.02), and lung cancer (L) (OR: 1.64 95% CI: 0.94- 2.8). HN patients were more likely LFU compared to B (OR: 2.4, 95% CI: 1.13-5.2), P (OR: 2.69, 95 % CI: 1.28-5.68), and L (OR: 2.3, 95% CI: 1.05-5.19) patients. There was no significant difference between C and HN patients in respect to LFU. Conclusions: In the SB, LFU rates are related to age, ethnicity, race, and type of cancer. Younger patients, blacks, non-Hispanics, and those with C and HN cancers were most likely to be LFU, the latter likely due to the lack of a HN surgeon at LMMHC. We hope that with focus on race, ethnicity, and cancer-specific disparities in LFU rates, we will improve the retention rate of our cancer patients in the future. [Table: see text]

Elimination of second-hand smoke (SHS) exposure after a lung or head and neck (HN) cancer diagnosis and subsequent patient smoking cessation.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 183-183 ◽  
Author(s):  
Lawson Eng ◽  
Devon Alton ◽  
Yuyao Song ◽  
Delaram Farzanfar ◽  
Olivia Krys ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Cohort Study ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Quit Smoking ◽  
Shs Exposure

183 Background: Exposure to SHS after a cancer diagnosis is associated with continued smoking in lung and HN cancer patients (PMID: 24419133, 23765604). However, smoking is a social activity. We evaluated whether elimination of SHS exposure around and after a diagnosis of lung or HN cancer is associated with smoking cessation in the cancer patient. Methods: Lung and HN cancer patients from Princess Margaret Cancer Centre (2006-12) completed questionnaires at diagnosis and follow-up (median 2 years apart) that assessed smoking history and SHS exposures (cohort study). Multivariate logistic regression analysis evaluated the association of elimination of SHS exposure after a diagnosis of cancer with subsequent smoking cessation, adjusted for significant covariates. A cross-sectional study (2014-15) of 183 lung and HN smoking patients assessed consistency in associations and interest in SHS cessation programs. Results: For the cohort study, 261/731 lung and 145/450 HN cancer patients smoked at diagnosis; subsequent quit rates were 69% and 50% respectively. 91% of lung and 94% of HN cancer patients were exposed to SHS at diagnosis while only 40% (lung) and 62% (HN) were exposed at follow-up. Elimination of SHS exposure was associated with smoking cessation in lung (aOR = 4.76, 95% CI [2.56-9.09], P< 0.001), HN (aOR = 5.00 [1.61-14.29], P< 0.001), and combined cancers (aOR = 5.00 [3.03-8.33], P< 0.001). The cross-sectional study has similar cessation and SHS exposure rates and a similar association for elimination of SHS with smoking cessation (aOR = 3.42 [1.16-10.10], P= 0.03). However when asked directly, only 26% of patients quit smoking with another individual and 13% of patients exposed to SHS had at least 1 interested party in joining a SHS cessation program. Conclusions: Elimination of SHS exposure around patients is significantly associated with smoking cessation in lung and HN cancer patients, but few patients quit smoking together with others around them, despite the ‘teachable moment’ with a cancer diagnosis. Clinicians should encourage patients and their household/friends to quit smoking together to improve cessation rates in cancer patients and those around them.

Follow-up of cancer patients at the Colorectal Multidisciplinary Clinic: The University of the Philippines - Philippine General Hospital (UP-PGH) experience.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18022-e18022
Author(s):  
Frederic Ivan Leong Ting ◽  
Danielle Benedict Leoncio Sacdalan ◽  
Josephine Anne Lucero Sacdalan ◽  
Dennis Lee Sacdalan
Keyword(s):  
Cancer Patients ◽  
General Hospital ◽  
The Philippines ◽  
Treatment Center ◽  
Design Strategies ◽  
Cross Sectional ◽  
Multidisciplinary Clinic ◽  
Rectal Cancers ◽  
The University

e18022 Background: The University of the Philippines - Philippine General Hospital (UP-PGH) Colorectal Multidisciplinary Team is composed of colorectal surgeons, radiation oncologists, and medical oncologists tasked with the care of patients with colon and rectal cancers in a multidisciplinary clinic. Patients that have been lost to follow-up after initial work-up and treatment return later with more advanced disease if at all they come back for treatment. This is a concern because cancers of the colon and rectum are potentially curable if addressed in a timely manner by patient and physician. Moreover, aggressive follow-up of potentially curable colon and rectal cancers has been shown to improve patient outcomes. Identifying factors that contribute to poor patient follow-up will allow the team to design strategies that will lead to more patients completing treatment. This study aimed to identify the different factors that influence follow-up among Filipino cancer patients presenting at the UP-PGH Colorectal multidisciplinary clinic. Methods: This is a 6 month prospective cross-sectional pilot study where a questionnaire was designed to evaluate patient views regarding factors that contribute to continued follow-up as well as factors associated with poor follow-up at the colorectal multidisciplinary clinic. Patients were allowed to state multiple factors as they see fit. Descriptive statistics were employed in the analysis of data. Results: Of the 97 responders, 39 (40%) patients identified belief in the effectiveness of the treatment and trust in their physicians, 33 (34%) stated adequacy of family support , and 31 (32%) noted affordability of treatment as factors contributing to patient follow-up. In contrast, 44 (45%) patients identified financial constraints, and 7 (7%) stated the far distance of their home to the treatment center as potential causes of poor follow-up. Other potential causes of poor follow-up identified were fear and anxiety about treatment, intolerable side-effects, and long lines at the clinic -all with 2 (2%) responses each. Conclusions: Healthcare decisions in the Philippines are affected by an interplay of factors. This study has identified belief in treatment efficacy, trust in their attending physician, financial factors, and clinic accessibility as influencing continued patient follow-up. Future endeavors may be directed towards these factors to improve follow-up and care at the colorectal multidisciplinary clinic.

scholarly journals Endometrial cancer patients’ preferences for follow-up after treatment: A cross-sectional survey

2020 ◽  
Vol 45 ◽  
pp. 101722 ◽  
Author(s):  
Kinta Beaver ◽  
Susan Williamson ◽  
Chris J. Sutton ◽  
Anne Gardner ◽  
Pierre Martin-Hirsch
Keyword(s):  
Endometrial Cancer ◽  
Cancer Patients ◽  
Cross Sectional Survey ◽  
Cross Sectional

scholarly journals Discharge of breast cancer patients to primary care at the end of hospital follow-up: A cross-sectional survey

2013 ◽  
Vol 49 (8) ◽  
pp. 1836-1844 ◽  
Author(s):  
Carriene Roorda ◽  
Annette J. Berendsen ◽  
Manon Haverkamp ◽  
Klaas van der Meer ◽  
Geertruida H. de Bock
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Cross Sectional Survey ◽  
Cross Sectional

scholarly journals Progastrin, a New Blood Biomarker for Multiple Cancers Allowing a New Strategy for Screening, Early Detection and Monitoring

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 211s-211s
Author(s):  
A. Prieur ◽  
V. Kepenekian ◽  
T. Mazard ◽  
L. Payen ◽  
D. Maucourt-Boulch ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Peritoneal Carcinomatosis ◽  
Cancer Patients ◽  
Early Stage ◽  
Diagnostic Value ◽  
Stage Ii ◽  
Breast Cancers ◽  
Different Types

Background: The majority of cancers evolve for years before becoming symptomatic. But once symptomatic, it is often too late for the patients to be cured. It is thus of paramount importance to improve early cancer screening in the general population as well as in genetically predisposed individuals. Moreover, although there is an undeniable progress in treatments, in particular in the immuno-oncology field, there is a growing need for circulating biomarkers to monitor treatment efficacy to better impact patient health and social economics. Aim: Progastrin (PG) is abnormally released in the blood of patients with colorectal cancer (CRC), as the gene coding for PG is a direct target of the WNT/β-catenin oncogenic pathway involved in tumorigenesis of many organs and activated from the very first steps of tumorigenesis, allowing the detection of PG in early stage cancers. The objective was to assess the diagnostic value of PG in a series of different types of cancers (early and advanced stages), as well as the role of PG as a circulating biomarker for treatment follow-up in patients with peritoneal carcinomatosis, a metastatic disease where imaging monitoring is impossible (due to the small size of lesions). Methods: Progastrin was measured in plasma EDTA samples using the ELISA cancerREAD technology. For the evaluation of PG in cancer patients, 673 samples were collected for comparison with 119 healthy volunteers. For the follow-up monitoring, patients were enrolled during management of peritoneal carcinomatosis (before or after neoadjuvant chemotherapy, or surgery). The diagnostic value of PG concentrations at inclusion in 190 GI cancer patients was assessed against 80 control samples. Results: Progastrin was detected in 77% of cancer patients, all cancers combined. The diagnosis area under the ROC curve of PG was 0.9114, P < 0.0001. Sensitivity ranged from 71% (breast cancer) to 87% (skin melanoma). All the 15 different types of cancers tested were positive. Early stage detection was assessed for colorectal and breast cancers with a sensitivity of 62.5% for adenomatous polyps, and 68.2% for stage 0 and I breast cancers. Sensitivity increased up to 82% for stage II colorectal cancer and to 78% for stage II-IV breast cancers. For the follow-up of peritoneal carcinomatosis patients, median PG levels decreased whatever the GI subtype with sequential treatments from 4.4 pM at inclusion time, to 1.3 after adjuvant chemotherapy. A trend for better PFS was observed in patients with PG decline after surgery. Conclusion: Progastrin assay is a simple and inexpensive blood test exhibiting high diagnostic accuracy for multiple gastro-intestinal, gynecologic, skin cancers. It may be used for cancer screening before tumor localization. It also exhibits promising therapeutic monitoring value during treatment in advanced CRC patients. Assessment of PG value as a multitumor screening biomarker, and as a monitoring test, is ongoing.

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