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Research and Reviews for the Practicing Oncologist
Information and communication needs of Chinese American breast cancer patients: perspectives on survivorship care planning
Objective To examine the experiences of CABCS to better understand their information and communication needs and their preferences for survivorship care plans (SCPs).
Methods 16 CABCS, aged 37-72 years, were recruited through community-based organizations in the Northeast United States to participate in one-on-one telephone interviews about their breast cancer survivorship experience. The semistructured interviews were conducted in Mandarin, Cantonese, or English. Two investigators transcribed and translated the audio recordings into English and analyzed the interview transcripts using established methods of qualitative content analysis.
Results Three main themes were identified through analysis of interview transcripts: the need for evidence-based and culturally and linguistically appropriate health information; the role of language or communication barriers and culture in accessing care and communicating with providers; and preferences for SCP elements and format.
Limitations The sample may not be representative of the entire population of CABCS.
Conclusions The findings provide insight into the information and communication needs and SCP preferences of CABCS. Understanding the cultural nuances that underlie these needs and preferences is critical for improving CABCS’s quality of life after treatment for cancer. SCPs that incorporate Chinese-language resources and address the unique cultural needs of this population should be developed and they should include information about diet and nutrition as well as traditional Chinese medicine.
Funding This work was supported in part by the NIH-NCI’s Community Network Program Center, ACCHDC (U54CA153513, PI: Dr Grace Ma) and P30 CA06927.
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Objective To examine the experiences of CABCS to better understand their information and communication needs and their preferences for survivorship care plans (SCPs).
Methods 16 CABCS, aged 37-72 years, were recruited through community-based organizations in the Northeast United States to participate in one-on-one telephone interviews about their breast cancer survivorship experience. The semistructured interviews were conducted in Mandarin, Cantonese, or English. Two investigators transcribed and translated the audio recordings into English and analyzed the interview transcripts using established methods of qualitative content analysis.
Results Three main themes were identified through analysis of interview transcripts: the need for evidence-based and culturally and linguistically appropriate health information; the role of language or communication barriers and culture in accessing care and communicating with providers; and preferences for SCP elements and format.
Limitations The sample may not be representative of the entire population of CABCS.
Conclusions The findings provide insight into the information and communication needs and SCP preferences of CABCS. Understanding the cultural nuances that underlie these needs and preferences is critical for improving CABCS’s quality of life after treatment for cancer. SCPs that incorporate Chinese-language resources and address the unique cultural needs of this population should be developed and they should include information about diet and nutrition as well as traditional Chinese medicine.
Funding This work was supported in part by the NIH-NCI’s Community Network Program Center, ACCHDC (U54CA153513, PI: Dr Grace Ma) and P30 CA06927.
Click on the PDF icon at the top of this introduction to read the full article.
Objective To examine the experiences of CABCS to better understand their information and communication needs and their preferences for survivorship care plans (SCPs).
Methods 16 CABCS, aged 37-72 years, were recruited through community-based organizations in the Northeast United States to participate in one-on-one telephone interviews about their breast cancer survivorship experience. The semistructured interviews were conducted in Mandarin, Cantonese, or English. Two investigators transcribed and translated the audio recordings into English and analyzed the interview transcripts using established methods of qualitative content analysis.
Results Three main themes were identified through analysis of interview transcripts: the need for evidence-based and culturally and linguistically appropriate health information; the role of language or communication barriers and culture in accessing care and communicating with providers; and preferences for SCP elements and format.
Limitations The sample may not be representative of the entire population of CABCS.
Conclusions The findings provide insight into the information and communication needs and SCP preferences of CABCS. Understanding the cultural nuances that underlie these needs and preferences is critical for improving CABCS’s quality of life after treatment for cancer. SCPs that incorporate Chinese-language resources and address the unique cultural needs of this population should be developed and they should include information about diet and nutrition as well as traditional Chinese medicine.
Funding This work was supported in part by the NIH-NCI’s Community Network Program Center, ACCHDC (U54CA153513, PI: Dr Grace Ma) and P30 CA06927.
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Small victories add up to paradigm shifts for hard-to-treat tumors
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Ramucirumab for advanced gastric or GEJ adenocarcinoma in previously treated patients with disease progression
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Pooling knowledge to tailor an integrated delivery system
What an exciting and challenging year 2014 has been! As it draws to a close, we also celebrate the first year of the merger between The Journal of Supportive Oncology and Community Oncology to form our current title, The Journal of Community and Supportive Oncology. We hope that by combining the clinical and supportive/palliative components of our specialty, we are able to serve as a vital forum and resource by providing you with a “one-stop shop” to support you in your practice of oncology.
Click on the PDF icon at the top of this introduction to read the full article.
What an exciting and challenging year 2014 has been! As it draws to a close, we also celebrate the first year of the merger between The Journal of Supportive Oncology and Community Oncology to form our current title, The Journal of Community and Supportive Oncology. We hope that by combining the clinical and supportive/palliative components of our specialty, we are able to serve as a vital forum and resource by providing you with a “one-stop shop” to support you in your practice of oncology.
Click on the PDF icon at the top of this introduction to read the full article.
What an exciting and challenging year 2014 has been! As it draws to a close, we also celebrate the first year of the merger between The Journal of Supportive Oncology and Community Oncology to form our current title, The Journal of Community and Supportive Oncology. We hope that by combining the clinical and supportive/palliative components of our specialty, we are able to serve as a vital forum and resource by providing you with a “one-stop shop” to support you in your practice of oncology.
Click on the PDF icon at the top of this introduction to read the full article.
A feasibility study of dignity therapy in patients with stage IV colorectal cancer actively receiving second-line chemotherapy
Objectives To assess the feasibility of DT relatively early in the disease trajectory (primary endpoint) and the effect on death acceptance, distress, symptoms, quality of life, peacefulness, and advanced care planning (secondary outcome endpoint).
Methods Stage IV colorectal cancer patients who progressed on first-line chemotherapy were enrolled. Patients received DT over 2 visits and had outcome measures assessed pre-DT, immediately post-DT and 1 month post-DT.
Results 15 of 17 patients (88%) who were approached enrolled in the study. Most of the patients who completed DT reported being satisfied and felt it was helpful, that it increased their sense of meaning, that it would be helpful to their family, and that it increased their sense of dignity, their sense of purpose, and their will to live.
Limitations This is a small study that lacks power for statistical significance of findings. There is no control group for comparison.
Conclusions DT is a highly feasible, satisfying, and meaningful intervention for advanced colorectal cancer patients who are receiving chemotherapy earlier in the course of their and may result in an understanding of disease and goals of care at the end of life. Larger feasibility and exploratory studies are warranted in advanced cancer patients.
Funding American Cancer Society (ACS-IRG 93-037-15)
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Objectives To assess the feasibility of DT relatively early in the disease trajectory (primary endpoint) and the effect on death acceptance, distress, symptoms, quality of life, peacefulness, and advanced care planning (secondary outcome endpoint).
Methods Stage IV colorectal cancer patients who progressed on first-line chemotherapy were enrolled. Patients received DT over 2 visits and had outcome measures assessed pre-DT, immediately post-DT and 1 month post-DT.
Results 15 of 17 patients (88%) who were approached enrolled in the study. Most of the patients who completed DT reported being satisfied and felt it was helpful, that it increased their sense of meaning, that it would be helpful to their family, and that it increased their sense of dignity, their sense of purpose, and their will to live.
Limitations This is a small study that lacks power for statistical significance of findings. There is no control group for comparison.
Conclusions DT is a highly feasible, satisfying, and meaningful intervention for advanced colorectal cancer patients who are receiving chemotherapy earlier in the course of their and may result in an understanding of disease and goals of care at the end of life. Larger feasibility and exploratory studies are warranted in advanced cancer patients.
Funding American Cancer Society (ACS-IRG 93-037-15)
Click on the PDF icon at the top of this introduction to read the full article.
Objectives To assess the feasibility of DT relatively early in the disease trajectory (primary endpoint) and the effect on death acceptance, distress, symptoms, quality of life, peacefulness, and advanced care planning (secondary outcome endpoint).
Methods Stage IV colorectal cancer patients who progressed on first-line chemotherapy were enrolled. Patients received DT over 2 visits and had outcome measures assessed pre-DT, immediately post-DT and 1 month post-DT.
Results 15 of 17 patients (88%) who were approached enrolled in the study. Most of the patients who completed DT reported being satisfied and felt it was helpful, that it increased their sense of meaning, that it would be helpful to their family, and that it increased their sense of dignity, their sense of purpose, and their will to live.
Limitations This is a small study that lacks power for statistical significance of findings. There is no control group for comparison.
Conclusions DT is a highly feasible, satisfying, and meaningful intervention for advanced colorectal cancer patients who are receiving chemotherapy earlier in the course of their and may result in an understanding of disease and goals of care at the end of life. Larger feasibility and exploratory studies are warranted in advanced cancer patients.
Funding American Cancer Society (ACS-IRG 93-037-15)
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David Henry's JCSO podcast, November 2014
Among the items featured in Dr David Henry’s monthly podcast for The Journal of Community and Supportive Oncology, are reports on congestive heart failure during induction with anthracycline-based therapy in patients with acute promyelocytic leukemia and on the impact of aprepitant on emesis control, dose intensity, and recurrence-free survival in head and neck cancer patients on cisplatin chemotherapy. Two articles focus on patient quality of life: one examines peripheral neuropathy and its impact on QoL after chemotherapy and another looks at QoL and symptoms after stereotactic body radiotherapy in early-stage lung cancer. There’s also a Case Report about a patient with superior vena cava syndrome as an initial presentation of low-grade follicular lymphoma, a feature article on choice of anesthesia during cancer surgery and patient outcomes, and a comprehensive and informative round-up of ASCO’s 2013-2014 guideline releases, updates, and endorsements.
Among the items featured in Dr David Henry’s monthly podcast for The Journal of Community and Supportive Oncology, are reports on congestive heart failure during induction with anthracycline-based therapy in patients with acute promyelocytic leukemia and on the impact of aprepitant on emesis control, dose intensity, and recurrence-free survival in head and neck cancer patients on cisplatin chemotherapy. Two articles focus on patient quality of life: one examines peripheral neuropathy and its impact on QoL after chemotherapy and another looks at QoL and symptoms after stereotactic body radiotherapy in early-stage lung cancer. There’s also a Case Report about a patient with superior vena cava syndrome as an initial presentation of low-grade follicular lymphoma, a feature article on choice of anesthesia during cancer surgery and patient outcomes, and a comprehensive and informative round-up of ASCO’s 2013-2014 guideline releases, updates, and endorsements.
Among the items featured in Dr David Henry’s monthly podcast for The Journal of Community and Supportive Oncology, are reports on congestive heart failure during induction with anthracycline-based therapy in patients with acute promyelocytic leukemia and on the impact of aprepitant on emesis control, dose intensity, and recurrence-free survival in head and neck cancer patients on cisplatin chemotherapy. Two articles focus on patient quality of life: one examines peripheral neuropathy and its impact on QoL after chemotherapy and another looks at QoL and symptoms after stereotactic body radiotherapy in early-stage lung cancer. There’s also a Case Report about a patient with superior vena cava syndrome as an initial presentation of low-grade follicular lymphoma, a feature article on choice of anesthesia during cancer surgery and patient outcomes, and a comprehensive and informative round-up of ASCO’s 2013-2014 guideline releases, updates, and endorsements.
A round-up of ASCO’s 2013-2014 guideline releases, updates, and endorsements
1. Follow-up care, surveillance, and secondary prevention measures for survivors of colorectal cancer1,2
Since 2006, ASCO has adopted a policy of endorsing clinical practice guidelines developed by others in order to increase the number of such guidelines available for ASCO membership. Recently, the society endorsed the guidelines for colon cancer follow-up created by the Cancer Care Ontario (CCO). These guidelines include surveillance recommendations that are very similar to the 2005 ASCO guidelines and the current NCCN guidelines, with a few minor differences. However, unlike NCCN and previous ASCO guidelines, the current guidelines include statements about secondary prevention, written survivorship plans for the patient’s other providers, and the futility of surveillance tests in patients who are not candidates for surgery or systemic therapy due to comorbid disease.
Click on the PDF icon at the top of this introduction to read the full article.
1. Follow-up care, surveillance, and secondary prevention measures for survivors of colorectal cancer1,2
Since 2006, ASCO has adopted a policy of endorsing clinical practice guidelines developed by others in order to increase the number of such guidelines available for ASCO membership. Recently, the society endorsed the guidelines for colon cancer follow-up created by the Cancer Care Ontario (CCO). These guidelines include surveillance recommendations that are very similar to the 2005 ASCO guidelines and the current NCCN guidelines, with a few minor differences. However, unlike NCCN and previous ASCO guidelines, the current guidelines include statements about secondary prevention, written survivorship plans for the patient’s other providers, and the futility of surveillance tests in patients who are not candidates for surgery or systemic therapy due to comorbid disease.
Click on the PDF icon at the top of this introduction to read the full article.
1. Follow-up care, surveillance, and secondary prevention measures for survivors of colorectal cancer1,2
Since 2006, ASCO has adopted a policy of endorsing clinical practice guidelines developed by others in order to increase the number of such guidelines available for ASCO membership. Recently, the society endorsed the guidelines for colon cancer follow-up created by the Cancer Care Ontario (CCO). These guidelines include surveillance recommendations that are very similar to the 2005 ASCO guidelines and the current NCCN guidelines, with a few minor differences. However, unlike NCCN and previous ASCO guidelines, the current guidelines include statements about secondary prevention, written survivorship plans for the patient’s other providers, and the futility of surveillance tests in patients who are not candidates for surgery or systemic therapy due to comorbid disease.
Click on the PDF icon at the top of this introduction to read the full article.
Is choice of anesthesia during cancer surgery linked to outcome?
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Superior vena cava syndrome as an initial presentation of low-grade follicular lymphoma
Superior vena cava (SVC) syndrome refers to a constellation of symptoms produced by the obstruction of blood flow through the SVC, resulting in symptoms of dyspnea, facial and upper-extremity edema, cough, chest pain, and dysphagia.1 Malignancies represent 60%-85% of the etiologies of SVC syndrome. Cumulatively, lymphoma and lung cancer represent 95% of malignancy-related SVC syndrome etiologies, with non-small-cell lung cancer (NSCLC) reported in about 50% of cases, small-cell lung cancer (SCLC) in about 25%, and non-Hodgkin lymphoma (NHL) in 10 % of all cases.1,2
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Superior vena cava (SVC) syndrome refers to a constellation of symptoms produced by the obstruction of blood flow through the SVC, resulting in symptoms of dyspnea, facial and upper-extremity edema, cough, chest pain, and dysphagia.1 Malignancies represent 60%-85% of the etiologies of SVC syndrome. Cumulatively, lymphoma and lung cancer represent 95% of malignancy-related SVC syndrome etiologies, with non-small-cell lung cancer (NSCLC) reported in about 50% of cases, small-cell lung cancer (SCLC) in about 25%, and non-Hodgkin lymphoma (NHL) in 10 % of all cases.1,2
Click on the PDF icon at the top of this introduction to read the full article.
Superior vena cava (SVC) syndrome refers to a constellation of symptoms produced by the obstruction of blood flow through the SVC, resulting in symptoms of dyspnea, facial and upper-extremity edema, cough, chest pain, and dysphagia.1 Malignancies represent 60%-85% of the etiologies of SVC syndrome. Cumulatively, lymphoma and lung cancer represent 95% of malignancy-related SVC syndrome etiologies, with non-small-cell lung cancer (NSCLC) reported in about 50% of cases, small-cell lung cancer (SCLC) in about 25%, and non-Hodgkin lymphoma (NHL) in 10 % of all cases.1,2
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Quality of life and symptoms after stereotactic body radiotherapy in early-stage lung cancer patients
Objective To describe QoL and symptoms in a small, prospective cohort of early-stage NSCLC patients treated with SBRT.
Methods 19 NSCLC patients who were medically unfit for surgery or chose not to undergo surgery were included in the study. All of the patients were treated with SBRT between 2009 and 2013 at a single comprehensive cancer center. Patients completed a baseline assessment of functional and cognitive status, symptoms, psychological distress, and overall QoL. Questionnaires were repeated at 6 and 12 weeks after accrual.
Results There were no significant differences in all outcomes across the 3 evaluation time points. Overall QoL scores were moderate, and the lowest score was observed for the functional well-being domain. The most severe symptoms at baseline were pain, lack of energy, cough, nervousness, difficulty sleeping, shortness of breath, and worry. Severity scores for pain, lack of energy, and cough increased, whereas nervousness, difficulty sleeping, and worry decreased at the 12 week evaluation.
Limitations Small sample size and lack of sufficient diversity in the cohort. Conclusions QoL scores remained relatively stable across time. Anxiety improved after SBRT, whereas symptoms such as generalized pain, lack of energy, and cough worsened. The findings suggest that SBRT is overall a well-tolerated treatment with no significant decrement in patient-centered outcomes.
Funding/sponsorship This research was supported by grant 5 P01 CA136396-02 (PI: Ferrell) from the National Cancer Institute.
Click on the PDF icon at the top of this introduction to read the full article.
Objective To describe QoL and symptoms in a small, prospective cohort of early-stage NSCLC patients treated with SBRT.
Methods 19 NSCLC patients who were medically unfit for surgery or chose not to undergo surgery were included in the study. All of the patients were treated with SBRT between 2009 and 2013 at a single comprehensive cancer center. Patients completed a baseline assessment of functional and cognitive status, symptoms, psychological distress, and overall QoL. Questionnaires were repeated at 6 and 12 weeks after accrual.
Results There were no significant differences in all outcomes across the 3 evaluation time points. Overall QoL scores were moderate, and the lowest score was observed for the functional well-being domain. The most severe symptoms at baseline were pain, lack of energy, cough, nervousness, difficulty sleeping, shortness of breath, and worry. Severity scores for pain, lack of energy, and cough increased, whereas nervousness, difficulty sleeping, and worry decreased at the 12 week evaluation.
Limitations Small sample size and lack of sufficient diversity in the cohort. Conclusions QoL scores remained relatively stable across time. Anxiety improved after SBRT, whereas symptoms such as generalized pain, lack of energy, and cough worsened. The findings suggest that SBRT is overall a well-tolerated treatment with no significant decrement in patient-centered outcomes.
Funding/sponsorship This research was supported by grant 5 P01 CA136396-02 (PI: Ferrell) from the National Cancer Institute.
Click on the PDF icon at the top of this introduction to read the full article.
Objective To describe QoL and symptoms in a small, prospective cohort of early-stage NSCLC patients treated with SBRT.
Methods 19 NSCLC patients who were medically unfit for surgery or chose not to undergo surgery were included in the study. All of the patients were treated with SBRT between 2009 and 2013 at a single comprehensive cancer center. Patients completed a baseline assessment of functional and cognitive status, symptoms, psychological distress, and overall QoL. Questionnaires were repeated at 6 and 12 weeks after accrual.
Results There were no significant differences in all outcomes across the 3 evaluation time points. Overall QoL scores were moderate, and the lowest score was observed for the functional well-being domain. The most severe symptoms at baseline were pain, lack of energy, cough, nervousness, difficulty sleeping, shortness of breath, and worry. Severity scores for pain, lack of energy, and cough increased, whereas nervousness, difficulty sleeping, and worry decreased at the 12 week evaluation.
Limitations Small sample size and lack of sufficient diversity in the cohort. Conclusions QoL scores remained relatively stable across time. Anxiety improved after SBRT, whereas symptoms such as generalized pain, lack of energy, and cough worsened. The findings suggest that SBRT is overall a well-tolerated treatment with no significant decrement in patient-centered outcomes.
Funding/sponsorship This research was supported by grant 5 P01 CA136396-02 (PI: Ferrell) from the National Cancer Institute.
Click on the PDF icon at the top of this introduction to read the full article.