Fwd: Do nurses and cancer patients agree on cancer patients' coping resources, emotional distress and quality of life?

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From: HubMed - cancer <rssfwd@rssfwd.com>
Date: Fri, Jul 25, 2008 at 11:44 PM
Subject: Do nurses and cancer patients agree on cancer patients' coping resources, emotional distress and quality of life?
To: mesothelioma77@gmail.com


[1]Eur J Cancer Care (Engl). 2008 Jul; 17(4): 350-60
Mårtensson G, Carlsson M, Lampic C

The present study examines differences, associations and agreement in cancer patients' and their nurses' ratings of cancer patients' coping resources, emotional distress and quality of life. The study sample includes 90 individual patient-nurse pairs. The patient and nurse in each pair independently completed the Cancer Behaviour Inventory, the Hospital Anxiety and Depression Scale and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being. The results indicate a distinct pattern in which nurses overestimate patients' emotional distress and underestimate patients' coping resources and quality of life. A nurse who overestimated a patient's emotional distress and underestimated his/her resources for handling the situation was also likely to underestimate the patient's quality of life. Patient-nurse pairs who demonstrated consistent agreement differed from remaining pairs in that they had a larger percentage of nurses with advanced education and previous responsibility for their patients' care and in that they had higher frequencies of patients who had previously received care at the ward >5 days. Nurses caring for patients with cancer should be aware of the risk of making systematic misjudgements of patients' status. Increased attention to patients' internal resources may improve nurses' ability to make correct assessments and plan for individualized care.



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Source: http://www.hubmed.org/display.cgi?uids=18652002
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Fwd: Development and evaluation of a cancer-related fatigue patient education program: protocol of a randomized controlled trial.

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From: HubMed - cancer <rssfwd@rssfwd.com>
Date: Fri, Jul 25, 2008 at 11:44 PM
Subject: Development and evaluation of a cancer-related fatigue patient education program: protocol of a randomized controlled trial.
To: mesothelioma77@gmail.com


[1]BMC Nurs. 2008 Jul 23; 7(1): 12
Stuhldreher N, Reif K, de Vries U, Gorres S, Petermann F

ABSTRACT: BACKGROUND: Cancer-related fatigue (CRF) and its impact on patients' quality of life has been an increasing subject of research. However, in Germany there is a lack of evidence-based interventions consistent with the multidimensional character of fatigue. The objective of this study is to develop and evaluate a self-management program for disease-free cancer patients to cope with CRF. METHODS: Based on evidence extracted from a literature review, a curriculum for the self-management program was elaborated. The curriculum was reviewed and validated by an interdisciplinary expert group and the training-modules will be pretested with a small number of participants and discussed in terms of feasibility and acceptance. To determine the efficacy of the program a randomised controlled trial will be carried out: 300 patients will be recruited from oncological practices in Bremen, Germany, and will be allocated to intervention or control group. The intervention group participates in the program, whereas the control group receives standard care and the opportunity to take part in the program after the end of the follow-up (waiting control group). Primary outcome measure is the level of fatigue, secondary outcome measures are quality of life, depression, anxiety, self-efficacy and physical activity. Data will be collected before randomisation, after intervention, and after a follow-up of 6 months. DISCUSSION: Because there are no comparable self-management programs for cancer survivors with fatigue, the development of the curriculum has been complex; therefore, the critical appraisal by the experts was an important step to validate the program and their contributions have been integrated into the curriculum. The experts appreciated the program as filling a gap in outpatient cancer care. If the results of the evaluation prove to be satisfactory, the outpatient care of cancer patients can be broadened and supplemented. Trial Registration: Clinical Trials NCT00552552.



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Source: http://www.hubmed.org/display.cgi?uids=18651943
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Fwd: Rationale for folate receptor alpha targeted therapy in "high risk" endometrial carcinomas.

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From: HubMed - cancer <rssfwd@rssfwd.com>
Date: Thu, Jul 24, 2008 at 7:29 AM
Subject: Rationale for folate receptor alpha targeted therapy in "high risk" endometrial carcinomas.
To: mesothelioma77@gmail.com


[1]Int J Cancer. 2008 Jul 21;
Brown Jones M, Neuper C, Clayton A, Mariani A, Konecny G, Thomas MB, Keeney G, Hartmann L, Podratz KC

Advanced and recurrent endometrial cancers account for the majority of deaths from this disease with limited therapeutic options. High grade, and nonendometrioid histology, pathologically characterize the endometrial tumors associated with adverse outcome and are classified as "high risk". The identification of molecular prognostic factors that might be targeted for therapy among "high risk" endometrial cancers is an active area of investigation. We hypothesize that the FRalpha, highly expressed in endometrial cancer cells, is a potential target for this disease. Our objectives were to determine if FRalpha overexpression is associated with adverse prognostic factors and worse outcome. Three hundred and thirty-two endometrial cancer cores were arrayed onto a tissue microarray and stained using a FRalpha-specific monoclonal antibody. Staining was scored as absent or weak and moderate or strong. Forty-one percent of 310 evaluable cases stained moderate/strong. Moderate/strong FRalpha staining was significantly associated with other poor prognostic factors including: advanced stage, nonendometrioid histology and high grade. An association was observed between moderate/strong FRalpha staining and recurrence (p

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Source: http://www.hubmed.org/display.cgi?uids=18646191
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Fwd: Should adnexal mass size influence surgical approach? A series of 186 laparoscopically managed large adnexal masses.

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From: HubMed - cancer <rssfwd@rssfwd.com>
Date: Fri, Jul 25, 2008 at 11:44 PM
Subject: Should adnexal mass size influence surgical approach? A series of 186 laparoscopically managed large adnexal masses.
To: mesothelioma77@gmail.com


[1]BJOG. 2008 Jul; 115(8): 1020-7
Ghezzi F, Cromi A, Bergamini V, Uccella S, Siesto G, Franchi M, Bolis P

OBJECTIVE: To evaluate the feasibility and safety of laparoscopic management of adnexal masses > or = 10 cm in size. DESIGN: Prospective cohort study. SETTING: Two Gynecology Departments of University Hospitals. POPULATION: All women presenting with an adnexal mass > or = 10 cm in diameter were candidates for laparoscopic management. Women were excluded from laparoscopic approach if there was evidence of ascites or gross metastatic disease. Neither the sonographic features of the cyst nor elevated serum CA125 level was used to exclude women from having a laparoscopic approach. METHODS: A single operative protocol was followed for all women. All removed specimens were sent for immediate pathological evaluation. MAIN OUTCOME MEASURES: Rate of conversion to laparotomy, incidence of cancer encountered, and operative complications. RESULTS: One hundred and eighty-six women underwent laparoscopic evaluation for an adnexal mass of 10 cm or larger in size. The average preoperative mass size was 12.1 +/- 4.9 cm. A benign pathological condition was found in 86.6% (161/186) of the women, primary ovarian cancer in 16 (8.6%) women, a metastatic tumour of gastrointestinal origin in 1 (0.5%) woman, and a low malignant potential ovarian tumour in 8 (4.3%) women. Laparoscopic management was successful for 174 (93.5%) women. Reasons for conversion to laparotomy included anticipated technical difficulty (n = 7) and malignancy (n = 5). No intraoperative complications occurred in the entire study group. CONCLUSIONS: The vast majority of large adnexal masses can be safely resected laparoscopically, provided that there is expertise in laparoscopic surgery, immediate access to frozen section diagnosis, and preparation of patient to receive an adequate cancer surgery where indicated.



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Source: http://www.hubmed.org/display.cgi?uids=18651883
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Fwd: Comparison of HER-2 and Hormone Receptor Expression in Primary Breast Cancers and Asynchronous Paired Metastases: Impact on Patient Management.

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From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Fri, Jul 25, 2008 at 11:44 PM
Subject: Comparison of HER-2 and Hormone Receptor Expression in Primary Breast Cancers and Asynchronous Paired Metastases: Impact on Patient Management.
To: mesothelioma77@gmail.com


[1]Oncologist. 2008 Jul 23;
Guarneri V, Giovannelli S, Ficarra G, Bettelli S, Maiorana A, Piacentini F, Barbieri E, Dieci MV, D'Amico R, Jovic G, Conte P

Introduction. The assessment of hormone receptors (HRs) and human epidermal growth factor receptor (HER)-2 is necessary to select patients who are candidates for hormonal and anti-HER-2 therapy. The evaluation of these parameters is generally carried out in primary tumors and it is not clear if reassessment in metastatic lesions might have an impact on patient management. The primary aim of this analysis was to compare HER-2 and HR status in primary tumors versus metastatic sites in breast cancer patients. Patients and Methods. Seventy-five patients with available samples from primary tumors and paired metastases were included. HER-2 status was evaluated by immunohistochemistry (IHC) and/or fluorescence in situ hybridization (FISH); HR status was assessed by IHC. Results. Nineteen percent of primary tumors were HER-2 positive; 77% were HR positive. Sites of biopsied or resected metastases were: locoregional soft tissues (n = 30), liver (n = 20), central nervous system (n = 5), bone (n = 5), pleura (n = 4), distant soft tissues (n = 3), abdomen (stomach, colon, peritoneum) (n = 3), bronchus (n = 3), and bone marrow (n = 2). For paired metastases, the HER-2 status was unchanged in 84% of cases; two patients changed from positive to negative, while 10 patients converted from negative to positive (agreement, 84%; kappa = 0.5681). A change in HR status was observed in 16 cases (21%): nine cases from positive to negative and seven cases from negative to positive (agreement, 78.7%; kappa = 0.4158). Conclusions. Further studies are necessary to better define the level of discordance in HER-2 or HR status between primary tumors and paired metastases. However, a biopsy of metastatic disease can be recommended, if feasible with minimal invasiveness, because treatment options might change for a significant proportion of patients.



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Source: http://www.hubmed.org/display.cgi?uids=18650259
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