Pub Date : 2017-05-04DOI: 10.1080/23809000.2017.1339557
P. Chia, B. Devitt, T. Clay, S. McLachlan, P. Mitchell, T. John
ABSTRACT Background: Patients are increasingly being asked to undergo repeat biopsies for both clinical and research reasons as targetable resistance mutations and molecular drivers are discovered in lung cancer. We aimed to investigate patient’s and physician’s attitudes towards re-biopsies in lung cancer. Methods: Patients attending the lung oncology clinic at an academic centre in Melbourne were invited to complete a questionnaire assessing their attitudes on re-biopsies. Physicians were invited to complete an online questionnaire through the Australasian Lung Trials Group (ALTG). Results: Eighty nine respondents (50 patients and 39 health professionals) completed their respective questionnaires. The most important factor in a patient’s decision to undergo re-biopsy was their oncologist’s recommendation (25/44, 57%). Most physicians (36/39, 92%) supported repeat biopsies to investigate for therapeutic biomarkers. 53% (20/38) of physicians were happy to recommend research-only biopsies, and 48% (22/46) of patients were agreeable to it. The majority of patients would agree to a re-biopsy in order to participate in a clinical trial 27/45 (60%) or on progression of disease to check on the resistance mechanism 32/46 (70%). Conclusions: Lung cancer patients’ decisions concerning re-biopsies were strongly influenced by their oncologists’ recommendations. Only about 50% of both patients and clinicians would consider a biopsy solely for research purposes.
{"title":"Attitudes of patients and physicians on repeat biopsies for lung cancer","authors":"P. Chia, B. Devitt, T. Clay, S. McLachlan, P. Mitchell, T. John","doi":"10.1080/23809000.2017.1339557","DOIUrl":"https://doi.org/10.1080/23809000.2017.1339557","url":null,"abstract":"ABSTRACT Background: Patients are increasingly being asked to undergo repeat biopsies for both clinical and research reasons as targetable resistance mutations and molecular drivers are discovered in lung cancer. We aimed to investigate patient’s and physician’s attitudes towards re-biopsies in lung cancer. Methods: Patients attending the lung oncology clinic at an academic centre in Melbourne were invited to complete a questionnaire assessing their attitudes on re-biopsies. Physicians were invited to complete an online questionnaire through the Australasian Lung Trials Group (ALTG). Results: Eighty nine respondents (50 patients and 39 health professionals) completed their respective questionnaires. The most important factor in a patient’s decision to undergo re-biopsy was their oncologist’s recommendation (25/44, 57%). Most physicians (36/39, 92%) supported repeat biopsies to investigate for therapeutic biomarkers. 53% (20/38) of physicians were happy to recommend research-only biopsies, and 48% (22/46) of patients were agreeable to it. The majority of patients would agree to a re-biopsy in order to participate in a clinical trial 27/45 (60%) or on progression of disease to check on the resistance mechanism 32/46 (70%). Conclusions: Lung cancer patients’ decisions concerning re-biopsies were strongly influenced by their oncologists’ recommendations. Only about 50% of both patients and clinicians would consider a biopsy solely for research purposes.","PeriodicalId":91681,"journal":{"name":"Expert review of quality of life in cancer care","volume":"2 1","pages":"181 - 202"},"PeriodicalIF":0.0,"publicationDate":"2017-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/23809000.2017.1339557","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49424500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-28DOI: 10.1080/23809000.2017.1321957
V. Biassoni, M. Massimino, M. C. Oprandi, C. Clerici, L. Veneroni, C. Corti, E. Schiavello, F. Spreafico, G. Poggi
ABSTRACT Introduction: It is well known that, with advances in the treatment of cancer patients achieving a 5-year overall survival of over 75% nowadays, pediatric neuro-oncologists are worried about long-term sequelae that frequently demand lifelong care and multiple specialist skills. Areas covered: This review aims to discuss the main issues concerning cancer survivors’ disabilities and rehabilitation, including cognitive and neuropsychological aspects, language and social skills, the return to school, starting or returning to work, endocrinological impairments, and supportive measures. The review also covers some experimental rehabilitation pathways based on advanced tools or techniques to provide an overview of the currently-available options for improving patients’ quality of life. We have included our findings deriving from a lengthy experience (2000–2015) of assessing brain tumor patients and managing their intensive tailored rehabilitation. A case report on a patient’s coping with childhood cancer into adult life has been added to give a pragmatic example of the psychological needs and difficulties of young cancer survivors during the necessary transition from pediatric age into adulthood adaptation. Expert commentary: It is important to stress that the tremendous progress made to date in our knowledge of pediatric neuro-oncology and in our management of patients has to be accompanied by a day-to-day effort to provide for their tailored rehabilitation, striving to bridge the gap that separates them from the normal life and experiences of their healthy peers.
{"title":"Rehabilitation for children and young people surviving a brain tumor, and their transition to adult services: the main challenges","authors":"V. Biassoni, M. Massimino, M. C. Oprandi, C. Clerici, L. Veneroni, C. Corti, E. Schiavello, F. Spreafico, G. Poggi","doi":"10.1080/23809000.2017.1321957","DOIUrl":"https://doi.org/10.1080/23809000.2017.1321957","url":null,"abstract":"ABSTRACT Introduction: It is well known that, with advances in the treatment of cancer patients achieving a 5-year overall survival of over 75% nowadays, pediatric neuro-oncologists are worried about long-term sequelae that frequently demand lifelong care and multiple specialist skills. Areas covered: This review aims to discuss the main issues concerning cancer survivors’ disabilities and rehabilitation, including cognitive and neuropsychological aspects, language and social skills, the return to school, starting or returning to work, endocrinological impairments, and supportive measures. The review also covers some experimental rehabilitation pathways based on advanced tools or techniques to provide an overview of the currently-available options for improving patients’ quality of life. We have included our findings deriving from a lengthy experience (2000–2015) of assessing brain tumor patients and managing their intensive tailored rehabilitation. A case report on a patient’s coping with childhood cancer into adult life has been added to give a pragmatic example of the psychological needs and difficulties of young cancer survivors during the necessary transition from pediatric age into adulthood adaptation. Expert commentary: It is important to stress that the tremendous progress made to date in our knowledge of pediatric neuro-oncology and in our management of patients has to be accompanied by a day-to-day effort to provide for their tailored rehabilitation, striving to bridge the gap that separates them from the normal life and experiences of their healthy peers.","PeriodicalId":91681,"journal":{"name":"Expert review of quality of life in cancer care","volume":"2 1","pages":"137 - 152"},"PeriodicalIF":0.0,"publicationDate":"2017-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/23809000.2017.1321957","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41732229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-04DOI: 10.1080/23809000.2017.1307088
Stefan Lauer-Riffard, S. Schug
ABSTRACT Introduction: Fentanyl buccal soluble film (FBSF) uses the newly developed BioErodible MucoAdhesive (BEMA®) drug delivery technology to manage breakthrough pain in opioid-tolerant, adult cancer patients. According to the limited studies available, this formulation of transmucosal fentanyl achieves a high bioavailability and rapid onset of pain relief for episodes of breakthrough cancer pain. Areas covered: The purpose of this article is to review the pharmacokinetics, tolerability and efficacy of FBSF in comparison to other preparations of transmucosal fentanyl. Expert commentary: FBSF seems to be a generally well-tolerated option for the transmucosal delivery of fentanyl in breakthrough cancer pain episodes. Unfortunately, double-blind head-to-head studies comparing FBSF with other opioids for the treatment of breakthrough cancer pain are missing. Hence, many important questions remain unanswered and need to be addressed in the future by clinically meaningful independent studies. These should include studies about clinically relevant differences between rapid onset opioids with regard to tolerability, efficacy, safety, cost-effectiveness and potential for dependency and misuse.
{"title":"The efficacy and safety of Onsolis (fentanyl buccal) for the treatment of cancer pain","authors":"Stefan Lauer-Riffard, S. Schug","doi":"10.1080/23809000.2017.1307088","DOIUrl":"https://doi.org/10.1080/23809000.2017.1307088","url":null,"abstract":"ABSTRACT Introduction: Fentanyl buccal soluble film (FBSF) uses the newly developed BioErodible MucoAdhesive (BEMA®) drug delivery technology to manage breakthrough pain in opioid-tolerant, adult cancer patients. According to the limited studies available, this formulation of transmucosal fentanyl achieves a high bioavailability and rapid onset of pain relief for episodes of breakthrough cancer pain. Areas covered: The purpose of this article is to review the pharmacokinetics, tolerability and efficacy of FBSF in comparison to other preparations of transmucosal fentanyl. Expert commentary: FBSF seems to be a generally well-tolerated option for the transmucosal delivery of fentanyl in breakthrough cancer pain episodes. Unfortunately, double-blind head-to-head studies comparing FBSF with other opioids for the treatment of breakthrough cancer pain are missing. Hence, many important questions remain unanswered and need to be addressed in the future by clinically meaningful independent studies. These should include studies about clinically relevant differences between rapid onset opioids with regard to tolerability, efficacy, safety, cost-effectiveness and potential for dependency and misuse.","PeriodicalId":91681,"journal":{"name":"Expert review of quality of life in cancer care","volume":"2 1","pages":"61 - 66"},"PeriodicalIF":0.0,"publicationDate":"2017-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/23809000.2017.1307088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44176361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-04DOI: 10.1080/23809000.2017.1313683
K. Andrikou, M. Salati, A. Fontana, A. Spallanzani, S. Pipitone, F. Gelsomino, M. Barbolini, S. Cascinu
ABSTRACT Introduction: Gastric cancer (GC) is the fifth most common cancer and the third leading cause of cancer-related death worldwide. For patients with advanced gastric cancer (AGC), systemic chemotherapy remains the standard of care, improving survival and quality of life (QoL); however prognosis remains poor. Areas covered: Several clinical trials have been evaluated the efficacy of different combination regimens in AGC patients. This review will underline existing literature on the role of chemotherapy in the management of AGC, discussing the key determinants of treatment decision aiming at identify the optimal chemotherapy regimen for individual patients and the role of addition of biological agents in these regimens. Expert commentary: Despite the progress in understanding of the molecular subtypes of GC, chemotherapy remains the backbone of treatment for all-line setting in well-selected AGC patients. Moreover, several trials have failed to demonstrate a benefit of targeted agents and to date only trastuzumab and ramucirumab and apatinib only in China are approved in the treatment of this disease. Therefore, an improved patient selection before and during therapy with a better definition of predictive biomarkers are really needed.
{"title":"Advanced gastric cancer: is there an optimal chemotherapy regimen?","authors":"K. Andrikou, M. Salati, A. Fontana, A. Spallanzani, S. Pipitone, F. Gelsomino, M. Barbolini, S. Cascinu","doi":"10.1080/23809000.2017.1313683","DOIUrl":"https://doi.org/10.1080/23809000.2017.1313683","url":null,"abstract":"ABSTRACT Introduction: Gastric cancer (GC) is the fifth most common cancer and the third leading cause of cancer-related death worldwide. For patients with advanced gastric cancer (AGC), systemic chemotherapy remains the standard of care, improving survival and quality of life (QoL); however prognosis remains poor. Areas covered: Several clinical trials have been evaluated the efficacy of different combination regimens in AGC patients. This review will underline existing literature on the role of chemotherapy in the management of AGC, discussing the key determinants of treatment decision aiming at identify the optimal chemotherapy regimen for individual patients and the role of addition of biological agents in these regimens. Expert commentary: Despite the progress in understanding of the molecular subtypes of GC, chemotherapy remains the backbone of treatment for all-line setting in well-selected AGC patients. Moreover, several trials have failed to demonstrate a benefit of targeted agents and to date only trastuzumab and ramucirumab and apatinib only in China are approved in the treatment of this disease. Therefore, an improved patient selection before and during therapy with a better definition of predictive biomarkers are really needed.","PeriodicalId":91681,"journal":{"name":"Expert review of quality of life in cancer care","volume":"2 1","pages":"123 - 132"},"PeriodicalIF":0.0,"publicationDate":"2017-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/23809000.2017.1313683","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45157690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-04DOI: 10.1080/23809000.2017.1301778
Y. Fujii, H. Ida, Tatsushi Shimokuni, F. Haraguchi
ABSTRACT Introduction: The understanding of neuroanatomy in emetic pathway has been re-evaluated recently, and the pharmacological care of patients, who suffer from cancer-related nausea and vomiting, has dramatically changed. Areas covered: This review will focus on innovative antiemetics in both aspects of basic pharmacology and evidence-based medicine by latest literatures in the palliative care field. Expert commentary: Although a number of studies have evaluated the clinical effectiveness of traditional antiemetics, such as metoclopramide, recommendations of these antiemetics are very weak due to a lack of well-designed randomized-control trials. Newer antiemetics have shown potential efficacy for the treatment of refractory nausea, which is non-responsive to traditional antiemetics. Olanzapine, asenapine, and mirtazapine are novel antipsychotics that target multiple neurotransmitter receptors, leading to a superior therapeutic outcome and fewer side effects. Cannabinoids can be said to be ‘innovative’ when used in this manner. Although this class of drugs has a possibility to effectively treat cancer-related emesis, major adverse effects were observed in recent systematic reviews and may limit its clinical application. Kampo medicines are widely used in Japan for the relief of gastrointestinal symptoms related to advanced cancer, and their mechanism of action is gradually becoming better understood. Innovative antiemetics are highly anticipated medications, and further investigations are warranted.
{"title":"Treatment of nausea with innovative antiemetics","authors":"Y. Fujii, H. Ida, Tatsushi Shimokuni, F. Haraguchi","doi":"10.1080/23809000.2017.1301778","DOIUrl":"https://doi.org/10.1080/23809000.2017.1301778","url":null,"abstract":"ABSTRACT Introduction: The understanding of neuroanatomy in emetic pathway has been re-evaluated recently, and the pharmacological care of patients, who suffer from cancer-related nausea and vomiting, has dramatically changed. Areas covered: This review will focus on innovative antiemetics in both aspects of basic pharmacology and evidence-based medicine by latest literatures in the palliative care field. Expert commentary: Although a number of studies have evaluated the clinical effectiveness of traditional antiemetics, such as metoclopramide, recommendations of these antiemetics are very weak due to a lack of well-designed randomized-control trials. Newer antiemetics have shown potential efficacy for the treatment of refractory nausea, which is non-responsive to traditional antiemetics. Olanzapine, asenapine, and mirtazapine are novel antipsychotics that target multiple neurotransmitter receptors, leading to a superior therapeutic outcome and fewer side effects. Cannabinoids can be said to be ‘innovative’ when used in this manner. Although this class of drugs has a possibility to effectively treat cancer-related emesis, major adverse effects were observed in recent systematic reviews and may limit its clinical application. Kampo medicines are widely used in Japan for the relief of gastrointestinal symptoms related to advanced cancer, and their mechanism of action is gradually becoming better understood. Innovative antiemetics are highly anticipated medications, and further investigations are warranted.","PeriodicalId":91681,"journal":{"name":"Expert review of quality of life in cancer care","volume":"2 1","pages":"109 - 121"},"PeriodicalIF":0.0,"publicationDate":"2017-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/23809000.2017.1301778","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45380104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-04DOI: 10.1080/23809000.2017.1307089
F. Gibson, S. Pearce, L. Fern, A. Martins, D. Kelly
ABSTRACT Introduction: The challenges of achieving timely cancer diagnosis in adolescents and young adults are recognised. However, contributing factors and associated clinical and psychosocial outcomes are poorly understood. Areas covered: We present a scoping review of existing evidence into time intervals to diagnosis and potential mechanisms influencing the identification of cancer symptoms and impact on a timely diagnosis. Charting data using Walters ‘pathways to treatment’ we summarise the diagnostic pathway into four interval categories: appraisal, help-seeking, diagnostic, and pre-treatment, and illustrate where evidence exists and where unanswered questions remain. Expert commentary: Whilst the research base has expanded over the last decade in cancer care there continues to be limited research that reveals the complexity of the timeliness of diagnosis in this population. There are unique issues facing this age group in terms of rarity of cancer, complexity of symptoms and problems with healthcare system access that create a constellation of challenges. We offer explanations for diagnostic difficulties in this age group, and explain how, with the limited available evidence, we are still seeking solutions to what is a uniquely complex problem.
{"title":"Improving the identification of cancer in young people: A scoping review","authors":"F. Gibson, S. Pearce, L. Fern, A. Martins, D. Kelly","doi":"10.1080/23809000.2017.1307089","DOIUrl":"https://doi.org/10.1080/23809000.2017.1307089","url":null,"abstract":"ABSTRACT Introduction: The challenges of achieving timely cancer diagnosis in adolescents and young adults are recognised. However, contributing factors and associated clinical and psychosocial outcomes are poorly understood. Areas covered: We present a scoping review of existing evidence into time intervals to diagnosis and potential mechanisms influencing the identification of cancer symptoms and impact on a timely diagnosis. Charting data using Walters ‘pathways to treatment’ we summarise the diagnostic pathway into four interval categories: appraisal, help-seeking, diagnostic, and pre-treatment, and illustrate where evidence exists and where unanswered questions remain. Expert commentary: Whilst the research base has expanded over the last decade in cancer care there continues to be limited research that reveals the complexity of the timeliness of diagnosis in this population. There are unique issues facing this age group in terms of rarity of cancer, complexity of symptoms and problems with healthcare system access that create a constellation of challenges. We offer explanations for diagnostic difficulties in this age group, and explain how, with the limited available evidence, we are still seeking solutions to what is a uniquely complex problem.","PeriodicalId":91681,"journal":{"name":"Expert review of quality of life in cancer care","volume":"2 1","pages":"101 - 87"},"PeriodicalIF":0.0,"publicationDate":"2017-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/23809000.2017.1307089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42853639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-01DOI: 10.1080/23809000.2017.1297204
R. Navari
ABSTRACT Introduction: Chemotherapy-induced nausea and vomiting (CINV) is associated with a significant deterioration in quality of life and is perceived by patients as a major adverse effects of the treatment. Areas covered: In order to minimize the effects of CINV on patients’ quality of life, practitioners should prescribe prophylactic antiemetics using the recommendations of the various international antiemetic guidelines. In addition, patients’ specific risk factor for CINV should be assessed to determine if additional interventions should be implemented for specific patients prior to the first course of chemotherapy. Expert commentary: If patients develop breakthrough, refractory, and/or anticipatory CINV despite the use of guideline directed antiemetics, additional antiemetics and/or non-pharmacologic interventions should be implemented. The purpose of the review is to outline an approach for the assessment and implementation of effective prophylactic measures to prevent CINV.
{"title":"Cancer patients at high risk for chemotherapy-induced nausea and vomiting – prediction assessments/tools","authors":"R. Navari","doi":"10.1080/23809000.2017.1297204","DOIUrl":"https://doi.org/10.1080/23809000.2017.1297204","url":null,"abstract":"ABSTRACT Introduction: Chemotherapy-induced nausea and vomiting (CINV) is associated with a significant deterioration in quality of life and is perceived by patients as a major adverse effects of the treatment. Areas covered: In order to minimize the effects of CINV on patients’ quality of life, practitioners should prescribe prophylactic antiemetics using the recommendations of the various international antiemetic guidelines. In addition, patients’ specific risk factor for CINV should be assessed to determine if additional interventions should be implemented for specific patients prior to the first course of chemotherapy. Expert commentary: If patients develop breakthrough, refractory, and/or anticipatory CINV despite the use of guideline directed antiemetics, additional antiemetics and/or non-pharmacologic interventions should be implemented. The purpose of the review is to outline an approach for the assessment and implementation of effective prophylactic measures to prevent CINV.","PeriodicalId":91681,"journal":{"name":"Expert review of quality of life in cancer care","volume":"2 1","pages":"103 - 108"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/23809000.2017.1297204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46040532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-02DOI: 10.1080/23809000.2017.1270761
Crystal L. Park, M. Brodeur, D. Daniel
The 2006 landmark report by the Adolescent and Young Adult Oncology Progress Review Group argued that adolescent and young adult (AYA) survivors – those diagnosed with cancer between ages 15 and 39 – had been largely overlooked, falling in the cracks between pediatric survivors and mid-to-late life adult survivors [1]. The release of this report spurred research focused on AYA survivorship experiences. Yet most of what we have learned is simply descriptive, highlighting AYA survivors’ many unmet needs and the negative impacts of cancer on their future lives. Surprisingly, little research has examined how AYA survivors’ experiences with cancer affect their wellbeing (i.e. their broadly-defined psychological and physical health-related quality of life(HRQOL)). We assert that a meaning-centered approach is helpful in making sense of the disparate literature regarding aspects of AYA’s cancer experiences relevant to their well-being. We conclude with promising avenues for future research and intervention. AYA survivors tend to have lower levels of well-being and often continue to experience cancer-related distress. A review of 35 quantitative and qualitative studies of HRQOL found that AYA survivors reported lower HRQOL compared with healthy peers and with older cancer survivors [2]. For example, one study found higher levels of distress in AYA survivors compared to a matched healthy sample at one-year post-diagnosis [3], and a large study of multiple cohorts similarly found that AYA survivors reported poorer physical and emotional wellbeing than matched peers [4]. In addition, AYA survivors often report high levels of posttraumatic stress symptoms (i.e. reexperiencing, avoidance, and hyperarousal) [5]. Furthermore, AYA survivors, like other cancer survivors, have poorer health behaviors than does the general population. For example, one recent large-scale survey comparing AYA cancer survivors with the general population in the USA showed that survivors were more likely to be current smokers, obese, and lacking in physical activity than were respondents without a cancer history [6]. This is particularly important given that AYA survivors’ positive health behaviors and HRQOL are positively related [7]. These lower levels of well-being and heightened levels of distress are quite concerning and suggest a need for interventions specifically focused on the unique concerns of AYA survivors. However, it is important to note that, within each study, individuals vary greatly in how well they fare, suggesting that some AYA survivors are relatively psychologically resilient while others are less so. One central determinant of this resilience, demonstrated across many studies, is meaning, particularly the meaning AYA survivors make of their cancer experience and the meaning they ascribe to the cancer’s implications for achieving their future goals. A cancer diagnosis is highly disruptive to an individual’s global sense of meaning, and AYA survivors who report mor
{"title":"What determines the well-being of adolescents and young adults with cancer? a meaning perspective","authors":"Crystal L. Park, M. Brodeur, D. Daniel","doi":"10.1080/23809000.2017.1270761","DOIUrl":"https://doi.org/10.1080/23809000.2017.1270761","url":null,"abstract":"The 2006 landmark report by the Adolescent and Young Adult Oncology Progress Review Group argued that adolescent and young adult (AYA) survivors – those diagnosed with cancer between ages 15 and 39 – had been largely overlooked, falling in the cracks between pediatric survivors and mid-to-late life adult survivors [1]. The release of this report spurred research focused on AYA survivorship experiences. Yet most of what we have learned is simply descriptive, highlighting AYA survivors’ many unmet needs and the negative impacts of cancer on their future lives. Surprisingly, little research has examined how AYA survivors’ experiences with cancer affect their wellbeing (i.e. their broadly-defined psychological and physical health-related quality of life(HRQOL)). We assert that a meaning-centered approach is helpful in making sense of the disparate literature regarding aspects of AYA’s cancer experiences relevant to their well-being. We conclude with promising avenues for future research and intervention. AYA survivors tend to have lower levels of well-being and often continue to experience cancer-related distress. A review of 35 quantitative and qualitative studies of HRQOL found that AYA survivors reported lower HRQOL compared with healthy peers and with older cancer survivors [2]. For example, one study found higher levels of distress in AYA survivors compared to a matched healthy sample at one-year post-diagnosis [3], and a large study of multiple cohorts similarly found that AYA survivors reported poorer physical and emotional wellbeing than matched peers [4]. In addition, AYA survivors often report high levels of posttraumatic stress symptoms (i.e. reexperiencing, avoidance, and hyperarousal) [5]. Furthermore, AYA survivors, like other cancer survivors, have poorer health behaviors than does the general population. For example, one recent large-scale survey comparing AYA cancer survivors with the general population in the USA showed that survivors were more likely to be current smokers, obese, and lacking in physical activity than were respondents without a cancer history [6]. This is particularly important given that AYA survivors’ positive health behaviors and HRQOL are positively related [7]. These lower levels of well-being and heightened levels of distress are quite concerning and suggest a need for interventions specifically focused on the unique concerns of AYA survivors. However, it is important to note that, within each study, individuals vary greatly in how well they fare, suggesting that some AYA survivors are relatively psychologically resilient while others are less so. One central determinant of this resilience, demonstrated across many studies, is meaning, particularly the meaning AYA survivors make of their cancer experience and the meaning they ascribe to the cancer’s implications for achieving their future goals. A cancer diagnosis is highly disruptive to an individual’s global sense of meaning, and AYA survivors who report mor","PeriodicalId":91681,"journal":{"name":"Expert review of quality of life in cancer care","volume":"2 1","pages":"1 - 3"},"PeriodicalIF":0.0,"publicationDate":"2017-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/23809000.2017.1270761","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43538723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-02DOI: 10.1080/23809000.2017.1264259
S. Antoniu, Marius Apostu, Ovidiu Alexinschi, D. Mosoiu
ABSTRACT Introduction: Chronic neuropathic pain is recognized as a major cause of poor quality of life due to the variable effectiveness of the existing analgesic therapies. In palliative care, chronic pain is often associated with depression, fatigue and other forms of ailments which up-regulate reciprocally. Dextromethorphan, a NMDA receptor antagonist was evaluated in various phenotypes of neuropathic pain but subsequently this was abandoned. Areas covered: Review of the literature on the clinical efficacy of dextromethorphan in neuropathic pain in an attempt to better position such a therapy in palliative care settings. Expert commentary: Dextromethorphan holds a good therapeutic potential in palliative care due to its analgesic, antidepressant and neuroprotective effects but further studies are needed to support this approach.
{"title":"Dextromethorphan for chronic neuropathic pain in palliative care","authors":"S. Antoniu, Marius Apostu, Ovidiu Alexinschi, D. Mosoiu","doi":"10.1080/23809000.2017.1264259","DOIUrl":"https://doi.org/10.1080/23809000.2017.1264259","url":null,"abstract":"ABSTRACT Introduction: Chronic neuropathic pain is recognized as a major cause of poor quality of life due to the variable effectiveness of the existing analgesic therapies. In palliative care, chronic pain is often associated with depression, fatigue and other forms of ailments which up-regulate reciprocally. Dextromethorphan, a NMDA receptor antagonist was evaluated in various phenotypes of neuropathic pain but subsequently this was abandoned. Areas covered: Review of the literature on the clinical efficacy of dextromethorphan in neuropathic pain in an attempt to better position such a therapy in palliative care settings. Expert commentary: Dextromethorphan holds a good therapeutic potential in palliative care due to its analgesic, antidepressant and neuroprotective effects but further studies are needed to support this approach.","PeriodicalId":91681,"journal":{"name":"Expert review of quality of life in cancer care","volume":"2 1","pages":"12 - 5"},"PeriodicalIF":0.0,"publicationDate":"2017-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/23809000.2017.1264259","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42235635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-02DOI: 10.1080/23809000.2017.1271980
S. Carnio, S. Novello
ABSTRACT Introduction: The global quality of life (QoL) in patients with advanced or metastatic non-small cell lung cancer (NSCLC) is a major clinical problem. Often the QoL’s data from clinical trials do not reflect the real life. Further improvements are needed to get reproducible methods to assess patients’ QoL within oncology units in daily clinical practice. Areas covered: This review explored QoL’s aspects of NSCLC patients through a collection of articles published in the last five years on PubMed. The aim was to highlight the importance of QoL and its management in these patients. Expert commentary: A better interpretation of clinical trials’ results is necessary, to identify more adequately the risks/benefits profile of the chosen treatment. The introduction of the early palliative care (EPC) and the conduction of studies focused on survival objectives as well as on QoL might be a valuable help to improve NSCLC management.
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