This article chronicles a failed research project.We designed and carried out a psychological intervention aimed at increasing esogastric and lung cancer patients’emotional competencies after treatments.We present th...This article chronicles a failed research project.We designed and carried out a psychological intervention aimed at increasing esogastric and lung cancer patients’emotional competencies after treatments.We present the final protocol of the study,a randomized controlled trial in a public hospital,and describe the difficulties encountered and our subsequent reflections,to provide researchers and clinicians with advice for the implementation of such interventions.Firstly,the role of psychology,emotions,and emotional competencies,is still underacknowledged in cancer care.Pedagogical efforts must be made to convince both physicians and patients of the importance of those elements.Secondly and consequently,even distressed patients sure to benefit from such an intervention,do not take it up.In particular,male patients often declined the intervention due to gender stereotypes,and as such creativity is needed to present such interventions in a motivating way for patients.Finally,and most importantly,even if there is a good rationale for a psychological intervention and all favorable conditions are present,it is essential to first conduct a feasibility/pilot study.Indeed,even the most thorough preparation is no guarantee of anticipating all issues due to important gaps between theory and practice.展开更多
A novel coronavirus(severe acute respiratory syndrome coronavirus 2)first detected in Wuhan,China,has spread rapidly since December 2019,causing more than 1.4 million confirmed infections and 15000 fatalities(as of Ap...A novel coronavirus(severe acute respiratory syndrome coronavirus 2)first detected in Wuhan,China,has spread rapidly since December 2019,causing more than 1.4 million confirmed infections and 15000 fatalities(as of April 9,2020).The outbreak was declared a pandemic by the World Health Organization on March 11,2020.Isolation,quarantine,social distancing,and community containment measures were rapidly implemented in China,which helped in containing the disease.However,other low-and middle-income countries lack such extensive infrastructural capacities and resources.Cancer patients are particularly at high risk of infection and mortality due to immunosuppression.Hence self-quarantine is recommended for them.Additionally,it is becoming impossible to maintain the continuity of care when cancer patients have to avoid physical visits.Social media applications,e.g.,Facebook and WhatsApp,can provide educational group program and psychosocial support to these patients while maintain social distancing.We have analyzed their use in this review article and how it could change the follow-up of cancer patients during this pandemic.展开更多
Objective:To explore the impact of the application and implementation of risk-based cancer care planning in patients with cervical cancer radiotherapy on the complications and self-care ability of patients.Method:This...Objective:To explore the impact of the application and implementation of risk-based cancer care planning in patients with cervical cancer radiotherapy on the complications and self-care ability of patients.Method:This study recruited selected patients who came for cervical cancer radiotherapy in a tertiary hospital in Xianyang City,Shaanxi Province from November 2020 to November 2021.One hundred patients were recruited.Nursing management was carried out,and cancer care planning under the concept of conventional care and risk were applied.The effects of different nursing methods on patients were compared and analyzed.Results:The patients in the experimental group had higher scores of self-care ability and lower complication rate.All data were significantly different from those of the control group(P<0.05),and the nursing effect on the experimental group was better.Conclusion:The application and implementation of the risk-based cancer care planning in patients who received cervical cancer radiotherapy has significant clinical effects,which is beneficial to reduce the incidence of patients’adverse reactions and promote patient recovery.展开更多
Background: Lung cancer is the leading cause of cancer death in Australia, with only modest improvements in survival. This study aims to identify factors impacting on diagnosis and management of lung cancer with parti...Background: Lung cancer is the leading cause of cancer death in Australia, with only modest improvements in survival. This study aims to identify factors impacting on diagnosis and management of lung cancer with particular reference to Australian primary care. Methods: A sequential mixed method modified approach employing interview and a two-phased survey technique. Following telephonic interviews with 31 health professionals (individuals representing general practitioners, specialized physicians, nurses and allied health practitioners), interview data was analysed using qualitative thematic analysis, and surveys using descriptive statistics. Emergent themes were organised under patient, provider and system factors. Interviews ceased upon saturation of data. Results: Multiple patient, provider and systems issues were seen to contribute to adverse health outcomes. There is a strong relationship between smoking and outcomes, and factors related to higher smoking rates such as a lower socioeconomic status. For smokers, guilt and/or denial was considered a reason for delay in the decision to seek medical care for cough or shortness of breath. Aboriginal people under-report morbidity related to smoking and chronic obstructive pulmonary disease;other patients fail to recognise the significance of their symptoms. Discussion: Despite the poor prognosis of lung cancer diagnosis, increased awareness of presentation and treatment options can address disparities in health outcomes.展开更多
<em>Aim</em><span "=""><span>: Fundamentally, aggressive care is considered to be avoided for the patients at the end of life. However, this is not always adhered in real-world p...<em>Aim</em><span "=""><span>: Fundamentally, aggressive care is considered to be avoided for the patients at the end of life. However, this is not always adhered in real-world practice. We attempted to determine whether, and if so how, the aggressive care is made for patients with ovarian cancer during the last month prior death. </span><i><span>Methods</span></i><span>: Enrolled were a total of 104 patients with ovarian cancer (including fallopian tube or primary peritoneal cancer), who were treated in Kuopio University Hospital in Finland during 2009-2014. The aggressive care was defined according to the standards outlined by the National Quality Forum;shortly, chemotherapy, emergency-room/intensive-care visit/admission, hospital admission, and death in hospital.</span></span><span "=""> </span><i><span>Results</span></i><span>: Two thirds of patients (67%) had received at least one form of aggressive care during the last month of their lives. Especially, admission in hospital in the last 30 days of life was the most common form of aggressive cancer care. Younger patients (<72 years) received significantly more often aggressive care than the older patients (80% vs 43%, p</span><span "=""> </span><span>=</span><span "=""> </span><span "=""><span>0.004). Those women that underwent end-of-life discussions earlier than one month prior to death had significantly less aggressive care than those women that had discussions during the last month (48% vs. 90%,</span><i> </i><span>p</span></span><span "=""> </span><span>=</span><span "=""> </span><span "=""><span>0.001). </span><i><span>Conclusions</span></i><span>: Ovarian cancer patients received commonly at least one form of aggressive care at the end of their lives. More efforts should be taken to improve the quality of palliative and end-of-life care.</span></span>展开更多
Background: Despite art therapy has been widely used in cancer population to improve their physical and mental health, painting therapy, as one form of art therapy, is seldom applied to adult cancer patients independe...Background: Despite art therapy has been widely used in cancer population to improve their physical and mental health, painting therapy, as one form of art therapy, is seldom applied to adult cancer patients independently. Therefore, how painting therapy affects adult cancer patients’ health outcomes needed to be explored sufficiently. Objectives: The purpose of this review was to assess and synthesize the latest evidence of painting therapy concerning adult cancer patients, and to provide some inspiration for clinical staff. Methods: A literature research of PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL, PsychoInfo, Psydex, CENTRAL, Google Scholar, British Library, CNKI, Wanfang, CQVIP electronic databases were undertaken with the following key words: art therapy, painting, drawing, cancer, neoplasm, tumor, carcinoma and oncology. A narrative synthesis was used according to PRISMA and the quality of study was assessed using acritical assessment tool. Results: Eleven papers reporting nine different research projects met the inclusion criteria. Generally speaking, painting therapy positively affected health outcomes. The impacts on patients include improvements in quality of life, coping with disease, mental health and somatic symptoms. However, inconsistency still exists. Three studies failed to show positive effects of painting therapy on post-traumatic growth, distress and coping behavior in participants. Conclusion: Robust evidence was found in rehabilitation of patients with various types of cancer. Painting therapy evidently affected cancer patients in a positive direction. However, the application of painting therapy to cancer patients needs to be explored further due to few studies on this topic.展开更多
The number of long-term colorectal cancer (CRC) survivors has increased substantially over the past three decades due to both ongoing advances in early detection and improvements in cancer therapies. Adult survivors o...The number of long-term colorectal cancer (CRC) survivors has increased substantially over the past three decades due to both ongoing advances in early detection and improvements in cancer therapies. Adult survivors of CRC experience chronic health conditions due to normal issues associated with aging, which is further compounded by the long-term adverse effects of having had cancer and anti-cancer therapies. In addition, they are at a higher risk for CRC recurrences, new primary cancers, and other co-morbidities. This article will provide an overview of the clinical care of adult survivors of CRC. Epidemiologic data will be presented followed by a discussion of the approach to the care of long-term adult survivors of CRC, including surveillance of recurrences and new primary cancers, interventions to manage both physical and psychological consequences of cancer and its treatments, and strategies to address concerns related to unemployment and disability. Finally, we will explore the challenges of healthcare delivery, especially with respect to the coordination of follow-up between cancer specialists and primary care physicians, so as to ensure that all of the survivor’s health needs are met promptly and appropriately.展开更多
According to data from the International Agency for Research on Cancer(IARC),nearly 20 million new cancer cases were diagnosed in 2022,with the number of cancer-related deaths reaching 9.7 million.Research indicates t...According to data from the International Agency for Research on Cancer(IARC),nearly 20 million new cancer cases were diagnosed in 2022,with the number of cancer-related deaths reaching 9.7 million.Research indicates that the lifetime risk of developing cancer is as high as 20%,and the number of cancer deaths among men is significantly greater than that among women(Bray et al.,2024).Cancer has become a major burden on society.展开更多
Objective: To explore the current status and influencing factors of supportive care needs in patients with muscle-invasive bladder cancer after surgery, and to provide a reference for the development of targeted inter...Objective: To explore the current status and influencing factors of supportive care needs in patients with muscle-invasive bladder cancer after surgery, and to provide a reference for the development of targeted intervention strPan ategies. Methods: A general data questionnaire and supportive care needs scale were used to investigate 107 patients with muscle-invasive bladder cancer after surgery. Results: The total score of supportive care needs in patients with muscle-invasive bladder cancer after surgery was (98.48 ± 9.07). Multiple linear regression analysis showed that age, primary caregiver, medical payment method, number of hospitalizations and postoperative time were important influencing factors of supportive care needs in patients with muscle-invasive bladder cancer after surgery (P Conclusion: The supportive care needs of patients with muscle-invasive bladder cancer after surgery are at a low level. Medical staff should identify them early, pay more attention to young patients, patients without medical insurance and patients with multiple hospitalizations, and provide targeted nursing measures to meet their supportive care needs.展开更多
BACKGROUND As a consequence of the economic crisis,the sociopolitical instability and the advent of the coronavirus disease-19 pandemic,nested challenges faced the Lebanese healthcare system.These have resulted in cri...BACKGROUND As a consequence of the economic crisis,the sociopolitical instability and the advent of the coronavirus disease-19 pandemic,nested challenges faced the Lebanese healthcare system.These have resulted in critical shortages of essential resources,including medications vital for oncologic patients.AIM To assess the ramifications of the ongoing economic crisis on oncology patient care focusing on our outpatient oncology department.METHODS A questionnaire was distributed during the month of February 2022 to oncology patients in Hôtel Dieu de France University Hospital in Beirut during their outpatient therapy.The primary objective was to assess the far-reaching impact of the economic crisis on patient care and the resulting psychological implications.RESULTS Among 182 interviewed patients,31.87%experienced treatment interruption mainly due to acute drug shortages.Despite 87.91%of the patients benefiting from third-party coverage,69.60%had to self-pay for their medications leading to 69.78%of patients perceiving that healthcare was more difficult to access after 2020.Psychologically,one-third of the patients exhibited symptoms of anxiety and/or depression,with 7 patients reporting suicidal ideations.Notably,37.93%of patients who interrupted cancer treatment reported a history of comorbidities,and 89.66%who altered their treatment cited financial difficulties.CONCLUSION Lebanese cancer patients face complex challenges spanning economic,healthcare,and psychological realms.Income inequalities exacerbated by the economic crisis hindered healthcare access.展开更多
Traditional tumor-node-metastasis staging overlooks key prognostic factors such as inflammation and nutrition,limiting individualized treatment in colorectal cancer.Integrating biochemical markers with artificial inte...Traditional tumor-node-metastasis staging overlooks key prognostic factors such as inflammation and nutrition,limiting individualized treatment in colorectal cancer.Integrating biochemical markers with artificial intelligence can significantly improve survival prediction and treatment personalization by analyzing complex,multimodal data.This evolving approach holds transformative potential for precision oncology.展开更多
Colorectal cancer (CRC) is a common neoplasia in the Western countries, with considerable morbidity and mortality. Every fifth patient with CRC presents with metastatic disease, which is not curable with radical inten...Colorectal cancer (CRC) is a common neoplasia in the Western countries, with considerable morbidity and mortality. Every fifth patient with CRC presents with metastatic disease, which is not curable with radical intent in roughly 80% of cases. Traditionally approached surgically, by resection of the primitive tumor or stoma, the management to incurable stage IV CRC patients has significantly changed over the last three decades and is nowadays multidisciplinary, with a pivotal role played by chemotherapy (CHT). This latter have allowed for a dramatic increase in survival, whereas the role of colonic and liver surgery is nowadays matter of debate. Although any generalization is difficult, two main situations are considered, asymptomatic (or minimally symptomatic) and severely symptomatic patients needing aggressive management, including emergency cases. In asymptomatic patients, new CHT regimens allow today long survival in selected patients, also exceeding two years. The role of colonic resection in this group has been challenged in recent years, as it is not clear whether the resection of primary CRC may imply a further increase in survival, thus justifying surgery-related morbidity/mortality in such a class of short-living patients. Secondary surgery of liver metastasis is gaining acceptance since, under new generation CHT regimens, an increasing amount of patients with distant metastasis initially considered non resectable become resectable, with a significant increase in long term survival. The management of CRC emergency patients still represents a major issue in Western countries, and is associated to high morbidity/mortality. Obstruction is traditionally approached surgically by colonic resection, stoma or internal by-pass, although nowadays CRC stenting is a feasible option. Nevertheless, CRC stent has peculiar contraindications and complications, and its long-term cost-effectiveness is questionable, especially in the light of recently increased survival. Perforation is associated with the highest mortality and remains mostly matter for surgeons, by abdominal lavage/drainage, colonic resection and/or stoma. Bleeding and other CRC-related symptoms (pain, tenesmus, etc.) may be managed by several mini-invasive approaches, including radiotherapy, laser therapy and other transanal procedures.展开更多
AIM:To systematically review the evidence for the effectiveness of fast-track program vs traditional care in laparoscopic or open surgery for gastric cancer.METHODS:PubMed,Embase and the Cochrane library databases wer...AIM:To systematically review the evidence for the effectiveness of fast-track program vs traditional care in laparoscopic or open surgery for gastric cancer.METHODS:PubMed,Embase and the Cochrane library databases were electronically searched for published studies between January 1995 and April 2013,and only randomized trials were included.The references of relevant studies were manually searched for further studies that may have been missed.Search terms included"gastric cancer","fast track"and"enhanced recovery".Five outcome variables were considered most suitable for analysis:postoperative hospital stay,medical cost,duration to first flatus,C-reactive protein(CRP)level and complications.Postoperative hospital stay was calculated from the date of operation to the date of discharge.Fixed effects model was used for meta-analysis.RESULTS:Compared with traditional care,fasttrack program could significantly decrease the postoperative hospital stay[weighted mean difference(WMD)=-1.19,95%CI:-1.79--0.60,P=0.0001,fixed model],duration to first flatus(WMD=-6.82,95%CI:-11.51--2.13,P=0.004),medical costs(WMD=-2590,95%CI:-4054--1126,P=0.001),and the level of CRP(WMD=-17.78,95%CI:-32.22--3.35,P=0.0001)in laparoscopic surgery for gastric cancer.In open surgery for gastric cancer,fast-track program could also significantly decrease the postoperative hospital stay(WMD=-1.99,95%CI:-2.09--1.89,P=0.0001),duration to first flatus(WMD=-12.0,95%CI:-18.89--5.11,P=0.001),medical cost(WMD=-3674,95%CI:-5025--2323,P=0.0001),and the level of CRP(WMD=-27.34,95%CI:-35.42--19.26,P=0.0001).Furthermore,fast-track program did not significantly increase the incidence of complication(RR=1.39,95%CI:0.77-2.51,P=0.27,for laparoscopic surgery;and RR=1.52,95%CI:0.90-2.56,P=0.12,for open surgery).CONCLUSION:Our overall results suggested that compared with traditional care,fast-track program could result in shorter postoperative hospital stay,less medical costs,and lower level of CRP,with no more complications occurring in both laparoscopic and open surgery for gastric cancer.展开更多
Rectal adenocarcinoma is an important cause of cancer-related deaths worldwide, and key anatomic differences between the rectum and the colon have significant implications for management of rectal cancer. Many advance...Rectal adenocarcinoma is an important cause of cancer-related deaths worldwide, and key anatomic differences between the rectum and the colon have significant implications for management of rectal cancer. Many advances have been made in the diagnosis and management of rectal cancer. These include clinical staging with imaging studies such as endorectal ultrasound and pelvic magnetic resonance imaging, operative approaches such as transanal endoscopic microsurgery and laparoscopic and robotic assisted proctectomy, as well as refined neoadjuvant and adjuvant therapies. For stage Ⅱ and Ⅲ rectal cancers, combined chemoradiotherapy offers the lowest rates of local and distant relapse, and is delivered neoadjuvantly to improve tolerability and optimize surgical outcomes, particularly when sphincter-sparing surgery is an endpoint. The goal in rectal cancer treatment is to optimize diseasefree and overall survival while minimizing the risk of local recurrence and toxicity from both radiation and systemic therapy. Optimal patient outcomes depend on multidisciplinary involvement for tailored therapy. The successful management of rectal cancer requires a multidisciplinary approach, with the involvement of enterostomal nurses, gastroenterologists, medical and radiation oncologists, radiologists, pathologists and surgeons. The identification of patients who are candidates for combined modality treatment is particularly useful to optimize outcomes. This article provides an overview of the diagnosis, staging and multimodal therapy of patients with rectal cancer for primary care providers.展开更多
Value-based care model has been evolving to organize medical services around the patient and provide the full cycle of care for a medical condition.The full cycle of care model encompasses inpatient,outpatient,rehabil...Value-based care model has been evolving to organize medical services around the patient and provide the full cycle of care for a medical condition.The full cycle of care model encompasses inpatient,outpatient,rehabilitation as well as supportive care such as palliative care and nutrition support.Cancer rehabilitation and palliative care have emerged as two important parts of value-based practice for oncology patients.More clinical evidence suggests that early intervention of oncology rehabilitation program and palliative care are likely to improve the patient outcome and reduce the overall medical cost for the patient and his or her family as well as for medical service providers.Although interest has been raised in Chinese oncologists,but effectiveness of incorporating these two services in clinical practices has not been adequately demonstrated.An understanding of scope of cancer rehabilitation and palliative care may help facilitate the integration of both into the oncology care continuum in efforts to improve patients'physical,psychological,cognitive,functional health and quality of life.展开更多
Colorectal cancer(CRC) is a common health problem,representing the third most commonly diagnosed cancer worldwide and causing a significant burden in terms of morbidity and mortality,with annual deaths estimated at 70...Colorectal cancer(CRC) is a common health problem,representing the third most commonly diagnosed cancer worldwide and causing a significant burden in terms of morbidity and mortality,with annual deaths estimated at 700000. The western way of life,that is being rapidly adopted in many regions of the world,is a well discussed risk factor for CRC and could be targeted in terms of primary prevention. Furthermore,the relatively slow development of this cancer permits drastic reduction of incidence and mortality through secondary prevention. These facts underlie primary care physicians(PCPs) being assigned a key role in health strategies that enhance prevention and prompt diagnosis. Herein,we review the main topics of CRC in the current literature,in order to better understand its pathogenesis,risk and protective factors,as well as screening techniques. Furthermore,we discuss preventive and screening policies to combat CRC and the crucial role served by PCPs in their successful implementation. Relevant articles were identified through electronic searches of MEDLINE and through manual searches of reference lists.展开更多
AIM: To examine the quality of surgical care and longterm oncologic outcome after D2 gastrectomy for gastric cancer.METHODS: From 1999 to 2008, a total of 109 consecutive patients underwent D2 gastrectomy without rout...AIM: To examine the quality of surgical care and longterm oncologic outcome after D2 gastrectomy for gastric cancer.METHODS: From 1999 to 2008, a total of 109 consecutive patients underwent D2 gastrectomy without routine pancreaticosplenectomy in a multimodal setting at our institution. Oncologic outcomes together with clinical and histopathologic data were analyzed in relation to the type of surgery performed. Staging was carried out according to the Union for International Cancer Control criteria of 2002. Patients were followedup for five years at the outpatient clinic. The primary measure of outcome was long-term survival with the quality of surgery as a secondary outcome measure. Clinical data were retrospectively collected from the patient records, and causes of death were obtained from national registries.RESULTS: A total of 109 patients(58 men) with a mean age of 67.4 ± 11.2 years underwent total gastrectomy or gastric resection with D2 lymph node dissection. The tumor stage distribution was as follows: stageⅠ,(27/109) 24.8%; stage Ⅱ,(31/109) 28.4%; stage Ⅲ,(41/109) 37.6%; and stage Ⅳ,(10/109) 9.2%. Forty patients(36.7%) received chemotherapy or chemoradiotherapy. The five-year overall survival rate for all 109 patients was 45.0%, and was 47.1% for the 104 patients treated with curative R0 resection. The five-year disease-specific survival rates were 53.0% and 55.8%, respectively. In a multivariate analysis, body mass index and tumor stage were independent prognostic factors for overall survival(both P < 0.01), whereas body mass index, tumor stage, tumor site, Lauren classification, and lymph node invasion were prognostic factors for cancer-specific survival(all P < 0.05). Postoperative 30-d mortality was 1.8% and 30-d, surgical(including three anastomotic leaks, two of which were treated conservatively), and general morbidities were 26.6%, 12.8%, and 14.7%, respectively.CONCLUSION: D2 dissection is a safe surgical option for gastric cancer, providing quality surgical care and long-term oncologic outcomes that are in line with current Western standards.展开更多
<strong>Purpose:</strong> Disease-related Stigma is negative emotions, attitudes, stereotypes, and beliefs about diseases. Cancer is one of the diseases that can be exposed to stigma. Regarding the effects...<strong>Purpose:</strong> Disease-related Stigma is negative emotions, attitudes, stereotypes, and beliefs about diseases. Cancer is one of the diseases that can be exposed to stigma. Regarding the effects of stigma on the quality of life;admission and adherence to treatment, and considering stigma as a barrier to health promotion and cancer screening, the aim of this study was to provide a care plan for reducing stigma in cancer. <strong>Methods:</strong> This research was carried out during three phases of qualitative, quantitative studies and a review of the literature. The qualitative phase was conducted by conventional content analysis to find effective factors on the reduction of stigma through face to face semi-structured interviews. The quantitative phase was a cross-sectional descriptive study to measure the level of stigma. By using both quantitative and qualitative findings, and a review of the literature, a comprehensive care plan to reduce stigma in families with cancer patients was developed. <strong>Results:</strong> The results showed two categories of data;1) reducing stigma at the individual or family level which needs increasing awareness, teaching coping skills, and support, as well as counseling;and 2) stigma reduction at the community level and policy rules which involve public education and cultural changes. <strong>Conclusion:</strong> Implementation of a care plan for reducing stigma can increase the physical and psychological health outcomes of people influenced by cancer, and at the community level, improves the attitude toward cancer and the success of screening programs, and ultimately reduces disability and mortality of the disease.展开更多
As one of the methods of palliative care,aromatherapy has been applied gradually in clinical nursing work in China in recent years.Through aromatherapy,terminal cancer patients can get not only relieves of physical sy...As one of the methods of palliative care,aromatherapy has been applied gradually in clinical nursing work in China in recent years.Through aromatherapy,terminal cancer patients can get not only relieves of physical symptoms,but also spiritual relaxation and peace,thus have improved quality of life at the end stage.In this paper,we report in detail about how aromatherapy was applied for symptom control in a cancer patient with unknown primary malignancy and multiple metastasis and its effects on the terminal life of this patient.展开更多
Objective: Art as a therapy helps in reparation and recovery. The aim of this study was to see the response of the cancer patients and their carers residing in Bangladesh towards art therapy and the perceived effect o...Objective: Art as a therapy helps in reparation and recovery. The aim of this study was to see the response of the cancer patients and their carers residing in Bangladesh towards art therapy and the perceived effect of art therapy on their physical and psychological condition. Method: The study was a record review study conducted through a cross-sectional descriptive method from July to November 2018. Along with the cancer patients, their immediate carers were enrolled in this study since patients and their carers both suffer from the distress that comes with the diagnosis of cancer. In-depth interviews and focused group discussions of art therapy were conducted with our study population at BPSCF and B中央人民政府. Findings: After art therapy, there was an improvement in sensory perception and self-perception, physical and psychological condition, communication and social skills and helped in more personal integration and built stronger insight among the patients and carers. Majority of the participants of art therapy felt good and wanted to continue art therapy. Significance of results: The results of this study will help to create awareness among the community about the importance of psychotherapies like art therapy in the life of the cancer patients and their carers. Introducing the concept of art therapy will also help the public health practitioners to improvise palliative care services in Bangladesh in a very cost-effective approach.展开更多
文摘This article chronicles a failed research project.We designed and carried out a psychological intervention aimed at increasing esogastric and lung cancer patients’emotional competencies after treatments.We present the final protocol of the study,a randomized controlled trial in a public hospital,and describe the difficulties encountered and our subsequent reflections,to provide researchers and clinicians with advice for the implementation of such interventions.Firstly,the role of psychology,emotions,and emotional competencies,is still underacknowledged in cancer care.Pedagogical efforts must be made to convince both physicians and patients of the importance of those elements.Secondly and consequently,even distressed patients sure to benefit from such an intervention,do not take it up.In particular,male patients often declined the intervention due to gender stereotypes,and as such creativity is needed to present such interventions in a motivating way for patients.Finally,and most importantly,even if there is a good rationale for a psychological intervention and all favorable conditions are present,it is essential to first conduct a feasibility/pilot study.Indeed,even the most thorough preparation is no guarantee of anticipating all issues due to important gaps between theory and practice.
文摘A novel coronavirus(severe acute respiratory syndrome coronavirus 2)first detected in Wuhan,China,has spread rapidly since December 2019,causing more than 1.4 million confirmed infections and 15000 fatalities(as of April 9,2020).The outbreak was declared a pandemic by the World Health Organization on March 11,2020.Isolation,quarantine,social distancing,and community containment measures were rapidly implemented in China,which helped in containing the disease.However,other low-and middle-income countries lack such extensive infrastructural capacities and resources.Cancer patients are particularly at high risk of infection and mortality due to immunosuppression.Hence self-quarantine is recommended for them.Additionally,it is becoming impossible to maintain the continuity of care when cancer patients have to avoid physical visits.Social media applications,e.g.,Facebook and WhatsApp,can provide educational group program and psychosocial support to these patients while maintain social distancing.We have analyzed their use in this review article and how it could change the follow-up of cancer patients during this pandemic.
文摘Objective:To explore the impact of the application and implementation of risk-based cancer care planning in patients with cervical cancer radiotherapy on the complications and self-care ability of patients.Method:This study recruited selected patients who came for cervical cancer radiotherapy in a tertiary hospital in Xianyang City,Shaanxi Province from November 2020 to November 2021.One hundred patients were recruited.Nursing management was carried out,and cancer care planning under the concept of conventional care and risk were applied.The effects of different nursing methods on patients were compared and analyzed.Results:The patients in the experimental group had higher scores of self-care ability and lower complication rate.All data were significantly different from those of the control group(P<0.05),and the nursing effect on the experimental group was better.Conclusion:The application and implementation of the risk-based cancer care planning in patients who received cervical cancer radiotherapy has significant clinical effects,which is beneficial to reduce the incidence of patients’adverse reactions and promote patient recovery.
文摘Background: Lung cancer is the leading cause of cancer death in Australia, with only modest improvements in survival. This study aims to identify factors impacting on diagnosis and management of lung cancer with particular reference to Australian primary care. Methods: A sequential mixed method modified approach employing interview and a two-phased survey technique. Following telephonic interviews with 31 health professionals (individuals representing general practitioners, specialized physicians, nurses and allied health practitioners), interview data was analysed using qualitative thematic analysis, and surveys using descriptive statistics. Emergent themes were organised under patient, provider and system factors. Interviews ceased upon saturation of data. Results: Multiple patient, provider and systems issues were seen to contribute to adverse health outcomes. There is a strong relationship between smoking and outcomes, and factors related to higher smoking rates such as a lower socioeconomic status. For smokers, guilt and/or denial was considered a reason for delay in the decision to seek medical care for cough or shortness of breath. Aboriginal people under-report morbidity related to smoking and chronic obstructive pulmonary disease;other patients fail to recognise the significance of their symptoms. Discussion: Despite the poor prognosis of lung cancer diagnosis, increased awareness of presentation and treatment options can address disparities in health outcomes.
文摘<em>Aim</em><span "=""><span>: Fundamentally, aggressive care is considered to be avoided for the patients at the end of life. However, this is not always adhered in real-world practice. We attempted to determine whether, and if so how, the aggressive care is made for patients with ovarian cancer during the last month prior death. </span><i><span>Methods</span></i><span>: Enrolled were a total of 104 patients with ovarian cancer (including fallopian tube or primary peritoneal cancer), who were treated in Kuopio University Hospital in Finland during 2009-2014. The aggressive care was defined according to the standards outlined by the National Quality Forum;shortly, chemotherapy, emergency-room/intensive-care visit/admission, hospital admission, and death in hospital.</span></span><span "=""> </span><i><span>Results</span></i><span>: Two thirds of patients (67%) had received at least one form of aggressive care during the last month of their lives. Especially, admission in hospital in the last 30 days of life was the most common form of aggressive cancer care. Younger patients (<72 years) received significantly more often aggressive care than the older patients (80% vs 43%, p</span><span "=""> </span><span>=</span><span "=""> </span><span "=""><span>0.004). Those women that underwent end-of-life discussions earlier than one month prior to death had significantly less aggressive care than those women that had discussions during the last month (48% vs. 90%,</span><i> </i><span>p</span></span><span "=""> </span><span>=</span><span "=""> </span><span "=""><span>0.001). </span><i><span>Conclusions</span></i><span>: Ovarian cancer patients received commonly at least one form of aggressive care at the end of their lives. More efforts should be taken to improve the quality of palliative and end-of-life care.</span></span>
文摘Background: Despite art therapy has been widely used in cancer population to improve their physical and mental health, painting therapy, as one form of art therapy, is seldom applied to adult cancer patients independently. Therefore, how painting therapy affects adult cancer patients’ health outcomes needed to be explored sufficiently. Objectives: The purpose of this review was to assess and synthesize the latest evidence of painting therapy concerning adult cancer patients, and to provide some inspiration for clinical staff. Methods: A literature research of PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL, PsychoInfo, Psydex, CENTRAL, Google Scholar, British Library, CNKI, Wanfang, CQVIP electronic databases were undertaken with the following key words: art therapy, painting, drawing, cancer, neoplasm, tumor, carcinoma and oncology. A narrative synthesis was used according to PRISMA and the quality of study was assessed using acritical assessment tool. Results: Eleven papers reporting nine different research projects met the inclusion criteria. Generally speaking, painting therapy positively affected health outcomes. The impacts on patients include improvements in quality of life, coping with disease, mental health and somatic symptoms. However, inconsistency still exists. Three studies failed to show positive effects of painting therapy on post-traumatic growth, distress and coping behavior in participants. Conclusion: Robust evidence was found in rehabilitation of patients with various types of cancer. Painting therapy evidently affected cancer patients in a positive direction. However, the application of painting therapy to cancer patients needs to be explored further due to few studies on this topic.
文摘The number of long-term colorectal cancer (CRC) survivors has increased substantially over the past three decades due to both ongoing advances in early detection and improvements in cancer therapies. Adult survivors of CRC experience chronic health conditions due to normal issues associated with aging, which is further compounded by the long-term adverse effects of having had cancer and anti-cancer therapies. In addition, they are at a higher risk for CRC recurrences, new primary cancers, and other co-morbidities. This article will provide an overview of the clinical care of adult survivors of CRC. Epidemiologic data will be presented followed by a discussion of the approach to the care of long-term adult survivors of CRC, including surveillance of recurrences and new primary cancers, interventions to manage both physical and psychological consequences of cancer and its treatments, and strategies to address concerns related to unemployment and disability. Finally, we will explore the challenges of healthcare delivery, especially with respect to the coordination of follow-up between cancer specialists and primary care physicians, so as to ensure that all of the survivor’s health needs are met promptly and appropriately.
文摘According to data from the International Agency for Research on Cancer(IARC),nearly 20 million new cancer cases were diagnosed in 2022,with the number of cancer-related deaths reaching 9.7 million.Research indicates that the lifetime risk of developing cancer is as high as 20%,and the number of cancer deaths among men is significantly greater than that among women(Bray et al.,2024).Cancer has become a major burden on society.
文摘Objective: To explore the current status and influencing factors of supportive care needs in patients with muscle-invasive bladder cancer after surgery, and to provide a reference for the development of targeted intervention strPan ategies. Methods: A general data questionnaire and supportive care needs scale were used to investigate 107 patients with muscle-invasive bladder cancer after surgery. Results: The total score of supportive care needs in patients with muscle-invasive bladder cancer after surgery was (98.48 ± 9.07). Multiple linear regression analysis showed that age, primary caregiver, medical payment method, number of hospitalizations and postoperative time were important influencing factors of supportive care needs in patients with muscle-invasive bladder cancer after surgery (P Conclusion: The supportive care needs of patients with muscle-invasive bladder cancer after surgery are at a low level. Medical staff should identify them early, pay more attention to young patients, patients without medical insurance and patients with multiple hospitalizations, and provide targeted nursing measures to meet their supportive care needs.
文摘BACKGROUND As a consequence of the economic crisis,the sociopolitical instability and the advent of the coronavirus disease-19 pandemic,nested challenges faced the Lebanese healthcare system.These have resulted in critical shortages of essential resources,including medications vital for oncologic patients.AIM To assess the ramifications of the ongoing economic crisis on oncology patient care focusing on our outpatient oncology department.METHODS A questionnaire was distributed during the month of February 2022 to oncology patients in Hôtel Dieu de France University Hospital in Beirut during their outpatient therapy.The primary objective was to assess the far-reaching impact of the economic crisis on patient care and the resulting psychological implications.RESULTS Among 182 interviewed patients,31.87%experienced treatment interruption mainly due to acute drug shortages.Despite 87.91%of the patients benefiting from third-party coverage,69.60%had to self-pay for their medications leading to 69.78%of patients perceiving that healthcare was more difficult to access after 2020.Psychologically,one-third of the patients exhibited symptoms of anxiety and/or depression,with 7 patients reporting suicidal ideations.Notably,37.93%of patients who interrupted cancer treatment reported a history of comorbidities,and 89.66%who altered their treatment cited financial difficulties.CONCLUSION Lebanese cancer patients face complex challenges spanning economic,healthcare,and psychological realms.Income inequalities exacerbated by the economic crisis hindered healthcare access.
文摘Traditional tumor-node-metastasis staging overlooks key prognostic factors such as inflammation and nutrition,limiting individualized treatment in colorectal cancer.Integrating biochemical markers with artificial intelligence can significantly improve survival prediction and treatment personalization by analyzing complex,multimodal data.This evolving approach holds transformative potential for precision oncology.
文摘Colorectal cancer (CRC) is a common neoplasia in the Western countries, with considerable morbidity and mortality. Every fifth patient with CRC presents with metastatic disease, which is not curable with radical intent in roughly 80% of cases. Traditionally approached surgically, by resection of the primitive tumor or stoma, the management to incurable stage IV CRC patients has significantly changed over the last three decades and is nowadays multidisciplinary, with a pivotal role played by chemotherapy (CHT). This latter have allowed for a dramatic increase in survival, whereas the role of colonic and liver surgery is nowadays matter of debate. Although any generalization is difficult, two main situations are considered, asymptomatic (or minimally symptomatic) and severely symptomatic patients needing aggressive management, including emergency cases. In asymptomatic patients, new CHT regimens allow today long survival in selected patients, also exceeding two years. The role of colonic resection in this group has been challenged in recent years, as it is not clear whether the resection of primary CRC may imply a further increase in survival, thus justifying surgery-related morbidity/mortality in such a class of short-living patients. Secondary surgery of liver metastasis is gaining acceptance since, under new generation CHT regimens, an increasing amount of patients with distant metastasis initially considered non resectable become resectable, with a significant increase in long term survival. The management of CRC emergency patients still represents a major issue in Western countries, and is associated to high morbidity/mortality. Obstruction is traditionally approached surgically by colonic resection, stoma or internal by-pass, although nowadays CRC stenting is a feasible option. Nevertheless, CRC stent has peculiar contraindications and complications, and its long-term cost-effectiveness is questionable, especially in the light of recently increased survival. Perforation is associated with the highest mortality and remains mostly matter for surgeons, by abdominal lavage/drainage, colonic resection and/or stoma. Bleeding and other CRC-related symptoms (pain, tenesmus, etc.) may be managed by several mini-invasive approaches, including radiotherapy, laser therapy and other transanal procedures.
文摘AIM:To systematically review the evidence for the effectiveness of fast-track program vs traditional care in laparoscopic or open surgery for gastric cancer.METHODS:PubMed,Embase and the Cochrane library databases were electronically searched for published studies between January 1995 and April 2013,and only randomized trials were included.The references of relevant studies were manually searched for further studies that may have been missed.Search terms included"gastric cancer","fast track"and"enhanced recovery".Five outcome variables were considered most suitable for analysis:postoperative hospital stay,medical cost,duration to first flatus,C-reactive protein(CRP)level and complications.Postoperative hospital stay was calculated from the date of operation to the date of discharge.Fixed effects model was used for meta-analysis.RESULTS:Compared with traditional care,fasttrack program could significantly decrease the postoperative hospital stay[weighted mean difference(WMD)=-1.19,95%CI:-1.79--0.60,P=0.0001,fixed model],duration to first flatus(WMD=-6.82,95%CI:-11.51--2.13,P=0.004),medical costs(WMD=-2590,95%CI:-4054--1126,P=0.001),and the level of CRP(WMD=-17.78,95%CI:-32.22--3.35,P=0.0001)in laparoscopic surgery for gastric cancer.In open surgery for gastric cancer,fast-track program could also significantly decrease the postoperative hospital stay(WMD=-1.99,95%CI:-2.09--1.89,P=0.0001),duration to first flatus(WMD=-12.0,95%CI:-18.89--5.11,P=0.001),medical cost(WMD=-3674,95%CI:-5025--2323,P=0.0001),and the level of CRP(WMD=-27.34,95%CI:-35.42--19.26,P=0.0001).Furthermore,fast-track program did not significantly increase the incidence of complication(RR=1.39,95%CI:0.77-2.51,P=0.27,for laparoscopic surgery;and RR=1.52,95%CI:0.90-2.56,P=0.12,for open surgery).CONCLUSION:Our overall results suggested that compared with traditional care,fast-track program could result in shorter postoperative hospital stay,less medical costs,and lower level of CRP,with no more complications occurring in both laparoscopic and open surgery for gastric cancer.
文摘Rectal adenocarcinoma is an important cause of cancer-related deaths worldwide, and key anatomic differences between the rectum and the colon have significant implications for management of rectal cancer. Many advances have been made in the diagnosis and management of rectal cancer. These include clinical staging with imaging studies such as endorectal ultrasound and pelvic magnetic resonance imaging, operative approaches such as transanal endoscopic microsurgery and laparoscopic and robotic assisted proctectomy, as well as refined neoadjuvant and adjuvant therapies. For stage Ⅱ and Ⅲ rectal cancers, combined chemoradiotherapy offers the lowest rates of local and distant relapse, and is delivered neoadjuvantly to improve tolerability and optimize surgical outcomes, particularly when sphincter-sparing surgery is an endpoint. The goal in rectal cancer treatment is to optimize diseasefree and overall survival while minimizing the risk of local recurrence and toxicity from both radiation and systemic therapy. Optimal patient outcomes depend on multidisciplinary involvement for tailored therapy. The successful management of rectal cancer requires a multidisciplinary approach, with the involvement of enterostomal nurses, gastroenterologists, medical and radiation oncologists, radiologists, pathologists and surgeons. The identification of patients who are candidates for combined modality treatment is particularly useful to optimize outcomes. This article provides an overview of the diagnosis, staging and multimodal therapy of patients with rectal cancer for primary care providers.
文摘Value-based care model has been evolving to organize medical services around the patient and provide the full cycle of care for a medical condition.The full cycle of care model encompasses inpatient,outpatient,rehabilitation as well as supportive care such as palliative care and nutrition support.Cancer rehabilitation and palliative care have emerged as two important parts of value-based practice for oncology patients.More clinical evidence suggests that early intervention of oncology rehabilitation program and palliative care are likely to improve the patient outcome and reduce the overall medical cost for the patient and his or her family as well as for medical service providers.Although interest has been raised in Chinese oncologists,but effectiveness of incorporating these two services in clinical practices has not been adequately demonstrated.An understanding of scope of cancer rehabilitation and palliative care may help facilitate the integration of both into the oncology care continuum in efforts to improve patients'physical,psychological,cognitive,functional health and quality of life.
文摘Colorectal cancer(CRC) is a common health problem,representing the third most commonly diagnosed cancer worldwide and causing a significant burden in terms of morbidity and mortality,with annual deaths estimated at 700000. The western way of life,that is being rapidly adopted in many regions of the world,is a well discussed risk factor for CRC and could be targeted in terms of primary prevention. Furthermore,the relatively slow development of this cancer permits drastic reduction of incidence and mortality through secondary prevention. These facts underlie primary care physicians(PCPs) being assigned a key role in health strategies that enhance prevention and prompt diagnosis. Herein,we review the main topics of CRC in the current literature,in order to better understand its pathogenesis,risk and protective factors,as well as screening techniques. Furthermore,we discuss preventive and screening policies to combat CRC and the crucial role served by PCPs in their successful implementation. Relevant articles were identified through electronic searches of MEDLINE and through manual searches of reference lists.
基金Supported by the Central Hospital of Central Finland
文摘AIM: To examine the quality of surgical care and longterm oncologic outcome after D2 gastrectomy for gastric cancer.METHODS: From 1999 to 2008, a total of 109 consecutive patients underwent D2 gastrectomy without routine pancreaticosplenectomy in a multimodal setting at our institution. Oncologic outcomes together with clinical and histopathologic data were analyzed in relation to the type of surgery performed. Staging was carried out according to the Union for International Cancer Control criteria of 2002. Patients were followedup for five years at the outpatient clinic. The primary measure of outcome was long-term survival with the quality of surgery as a secondary outcome measure. Clinical data were retrospectively collected from the patient records, and causes of death were obtained from national registries.RESULTS: A total of 109 patients(58 men) with a mean age of 67.4 ± 11.2 years underwent total gastrectomy or gastric resection with D2 lymph node dissection. The tumor stage distribution was as follows: stageⅠ,(27/109) 24.8%; stage Ⅱ,(31/109) 28.4%; stage Ⅲ,(41/109) 37.6%; and stage Ⅳ,(10/109) 9.2%. Forty patients(36.7%) received chemotherapy or chemoradiotherapy. The five-year overall survival rate for all 109 patients was 45.0%, and was 47.1% for the 104 patients treated with curative R0 resection. The five-year disease-specific survival rates were 53.0% and 55.8%, respectively. In a multivariate analysis, body mass index and tumor stage were independent prognostic factors for overall survival(both P < 0.01), whereas body mass index, tumor stage, tumor site, Lauren classification, and lymph node invasion were prognostic factors for cancer-specific survival(all P < 0.05). Postoperative 30-d mortality was 1.8% and 30-d, surgical(including three anastomotic leaks, two of which were treated conservatively), and general morbidities were 26.6%, 12.8%, and 14.7%, respectively.CONCLUSION: D2 dissection is a safe surgical option for gastric cancer, providing quality surgical care and long-term oncologic outcomes that are in line with current Western standards.
文摘<strong>Purpose:</strong> Disease-related Stigma is negative emotions, attitudes, stereotypes, and beliefs about diseases. Cancer is one of the diseases that can be exposed to stigma. Regarding the effects of stigma on the quality of life;admission and adherence to treatment, and considering stigma as a barrier to health promotion and cancer screening, the aim of this study was to provide a care plan for reducing stigma in cancer. <strong>Methods:</strong> This research was carried out during three phases of qualitative, quantitative studies and a review of the literature. The qualitative phase was conducted by conventional content analysis to find effective factors on the reduction of stigma through face to face semi-structured interviews. The quantitative phase was a cross-sectional descriptive study to measure the level of stigma. By using both quantitative and qualitative findings, and a review of the literature, a comprehensive care plan to reduce stigma in families with cancer patients was developed. <strong>Results:</strong> The results showed two categories of data;1) reducing stigma at the individual or family level which needs increasing awareness, teaching coping skills, and support, as well as counseling;and 2) stigma reduction at the community level and policy rules which involve public education and cultural changes. <strong>Conclusion:</strong> Implementation of a care plan for reducing stigma can increase the physical and psychological health outcomes of people influenced by cancer, and at the community level, improves the attitude toward cancer and the success of screening programs, and ultimately reduces disability and mortality of the disease.
基金supported by the Educational Reform Project of Peking Union Medical College(2015zlgc0120)~~
文摘As one of the methods of palliative care,aromatherapy has been applied gradually in clinical nursing work in China in recent years.Through aromatherapy,terminal cancer patients can get not only relieves of physical symptoms,but also spiritual relaxation and peace,thus have improved quality of life at the end stage.In this paper,we report in detail about how aromatherapy was applied for symptom control in a cancer patient with unknown primary malignancy and multiple metastasis and its effects on the terminal life of this patient.
文摘Objective: Art as a therapy helps in reparation and recovery. The aim of this study was to see the response of the cancer patients and their carers residing in Bangladesh towards art therapy and the perceived effect of art therapy on their physical and psychological condition. Method: The study was a record review study conducted through a cross-sectional descriptive method from July to November 2018. Along with the cancer patients, their immediate carers were enrolled in this study since patients and their carers both suffer from the distress that comes with the diagnosis of cancer. In-depth interviews and focused group discussions of art therapy were conducted with our study population at BPSCF and B中央人民政府. Findings: After art therapy, there was an improvement in sensory perception and self-perception, physical and psychological condition, communication and social skills and helped in more personal integration and built stronger insight among the patients and carers. Majority of the participants of art therapy felt good and wanted to continue art therapy. Significance of results: The results of this study will help to create awareness among the community about the importance of psychotherapies like art therapy in the life of the cancer patients and their carers. Introducing the concept of art therapy will also help the public health practitioners to improvise palliative care services in Bangladesh in a very cost-effective approach.
