Cancer practice最新文献

Purpose: This prospective, longitudinal study was aimed to describe the prevalence, severity, and pattern of symptoms over the course of radiation therapy in persons with nasopharyngeal carcinoma and to explore symptom severity by treatment modality.

description of Study: Thirty-seven patients completed this study, and 46% received chemotherapy before radiation therapy. A self-reported radiation symptom checklist and an objective mucositis assessment tool were used weekly to document oropharyngeal, skin, nose or ear, or more general side effects, and mucositis.

Results: Oropharyngeal problems were the most severe complaints during radiation therapy. All patients experienced dry mouth, taste change, difficulty in swallowing, difficulty in opening their mouths, hoarseness, sore throat, and observable mucositis. Most reported moderate-to-severe dry mouth, difficulty in swallowing, and sore throat from weeks 3 through 7. Skin problems were not prominent until week 4. Patients also lost an average of 3.9 kg during the therapy. Sequential chemotherapy and radiation therapy was associated with more severe oropharyngeal problems than radiation therapy alone, but no significant differences in other problems were found.

clinical Implications: Despite recognition of the oropharyngeal side effects associated with irradiation, effective management protocols for such symptoms have not been implemented in the studied institution. The frequency and intensity of the symptoms reported indicate an urgent need for increased vigilance about radiation-related side effects and pain management. As well, patient education about expected side effects may help mitigate the anxiety that patients experience when these symptoms occur.

Purpose: The purpose of this report is to present behavioral interventions to assist persons with lung cancer in the management of feelings of breathlessness and, thus, also to enhance their quality of life.

Overview: Breathlessness is a serious symptom that adversely affects the quality of life of persons with lung cancer. A review of the literature points to the value of exercises in assisting patients to breathe more effectively and to manage related anxiety. However, the professional literature frequently does not describe these basic interventions in enough detail to enable oncology professionals to learn them. Instructional materials, found in the popular wellness and self-help literature, are included in this article to more easily facilitate acquisition of these skills. Interventions described include exercises that enhance the use of the diaphragm when breathing and those that help to alter the breathing rhythm and to exhale more effectively.

clinical Implications: All oncology professionals should be aware of the importance of breathlessness as a problem that diminishes the quality of life for patients with lung cancer. Addressing breathlessness through the use of psychosocially oriented behavioral interventions can act as an adjunct to the medical management of this debilitating symptom.

Purpose: The purpose of this study was to examine the relationship between demographic-disease variables, spirituality, and psychosocial adjustment in a heterogeneous sample of patients with cancer.

description of Study: Participants (N = 83) accrued through the Rhode Island Hospital and the American Cancer Society completed questionnaires, and structural equation modeling was used to examine the relationships among disease and demographic factors, spirituality, and psychosocial adjustment to cancer.

Results: Of five models tested, a mediational model received the strongest support (chi-square(35)-66.61; P = .005; comparative fit index = .90; root mean square error of approximation = .09), explaining 64% of the variance in psychosocial adjustment. Being a woman, having a longer illness duration, and having a lower disease stage were related to greater levels of purpose in life and religious/existential beliefs, which, in turn, were associated with higher levels of family and social adjustment and psychological health.

clinical Implications: The results indicate that spirituality can influence how patients with cancer adjust to their diagnosis and treatment and, thus, support the need for interventions that target spirituality to promote psychosocial adjustment in this population.

Purpose: This study examined factors associated with fecal occult blood test (FOBT) and sigmoidoscopy screening use among Chinese-American women age 60 years and older.

Description of study: One hundred women were recruited from senior centers in two metropolitan areas on the east coast of the United States. Participants completed a questionnaire that included sections on demographics, health history, health insurance coverage, FOBT and sigmoidoscopy use, common and cultural barriers to colorectal cancer screening, and acculturation.

Results: Logistic regression models found greater acculturation to be a significant predictor of having had a FOBT at least once, and found both greater acculturation and physician recommendation to be significant predictors of having had a sigmoidoscopy at least once. No significant predictors were found for regular adherence to colorectal screening guidelines, which include having undergone an FOBT in the past year and sigmoidoscopy in the past 5 years.

Clinical implications: This study found that older Chinese-American women underuse FOBT and sigmoidoscopy screening, as is recommended by the American Cancer Society colorectal cancer screening guidelines. These findings suggest that cultural factors may influence the initiation of colorectal cancer screening for Chinese-American women but are not predictive of adherence to screening over time. Outreach efforts to promote colorectal cancer screening in this population might target women who are less acculturated to facilitate an initial entry into the Western healthcare system to obtain screening.