To see the other types of publications on this topic, follow the link: Sein – Cancer – Aspect social.
Journal articles on the topic 'Sein – Cancer – Aspect social'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Sein – Cancer – Aspect social.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Löwy, Ilana. "Cancer du sein et tamoxifène : la gestion d’une incertitude thérapeutique." Sciences Sociales et Santé 30, no. 1 (January 2012): 73–83. http://dx.doi.org/10.1684/sss.2012.0104.
Full text
2
Sarradon-Eck, Aline, and Isabelle Pellegrini. "Le traitement adjuvant du cancer du sein par tamoxifène. Entre risques et bénéfices thérapeutiques." Sciences Sociales et Santé 30, no. 1 (January 2012): 47–71. http://dx.doi.org/10.1684/sss.2012.0103.
Full text
3
Dekeuwer, C. "Transmission des informations médicales et projet d’enfant : le conseil génétique dans le contexte du rétinoblastome et du cancer du sein et des ovaires dit héréditaire." Éthique & Santé 10, no. 1 (March 2013): 34–42. http://dx.doi.org/10.1016/j.etiqe.2012.11.009.
Full text
4
Bourgier, C., I. Dumas, H. Marsiglia, C. Rossier, N. Taright, B. Biron, and G. Auzac. "Irradiation partielle accélérée du cancer du sein : aspect théorique." Cancer/Radiothérapie 16, no. 5-6 (September 2012): 470–72. http://dx.doi.org/10.1016/j.canrad.2012.05.015.
Full text
5
Vignal, P. "Cancer du sein développé dans une glande mammaire accessoire : aspect échographique." Imagerie de la Femme 17, no. 1 (March 2007): 49–50. http://dx.doi.org/10.1016/s1776-9817(07)88608-1.
Full text
6
Thai, J., N. Howard, and E. Buckley. "Equality in Breast Cancer Treatment? A Systematic Review of the Utilisation of Primary Treatment Within Priority Population Groups in Australia." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 83s. http://dx.doi.org/10.1200/jgo.18.25500.
Full textAbstract:
Background: Australia has a high standard of health and healthcare compared with many other OECD countries, with life expectancies among the highest in the world. However, this attainment is not reflected equally across all population subgroups within Australia. Translation evidence from clinical trials into practice varies, leading to attenuated effects across subgroups. Variable effects also occur due to differences in access to interventions and cancer treatment services. Priority subgroups can experience poorer access to healthcare and overall health outcomes due, in part, to the influence of social, environmental and political factors Aim: This study aimed to determine the extent to which inequalities exist across subgroups of the Australian population with breast cancer, as relating to cancer treatment (surgery, radiotherapy and chemotherapy). Methods: A systematic literature review was undertaken in December 2017 to identify and quantify the inequalities in treatment utilization across priority subgroups in Australia. MEDLINE, Embase, Scopus, Web of Science and Cumulative Index to Nursing and Allied Health Literature were used to identify the literature. Identification of relevant articles resulted from screening the full text of all articles identified, with each article assessed against predefined inclusion criteria. Quality assessment was used to inform the qualitative synthesis to explore the relationship between priority subgroups and the utilization of primary breast cancer treatment. The protocol for this systematic review was registered with the PROSPERO database on the December 19, 2016. Results: A total of 2030 articles were screened for eligibility, with 29 articles included in the final review. Results highlight an underutilization of breast cancer treatment (surgery, radiotherapy and chemotherapy) across priority subgroups compared with the nonpriority populations, including aboriginal women (4%-15% less likely to receive breast conserving surgery), elderly (9% more likely to have no surgery), women of greater socioeconomic disadvantage (13%-28% less likely to receive breast conserving surgery), and women living remotely (20%-38% less likely to receive breast conserving surgery). Similar differentials in utilization were seen with adjuvant therapies. Conclusion: Evaluation of health services and treatment utilization is an important aspect of cancer control programs. In quantifying the underutilization of health services for breast cancer treatments, it is clear that variations exist in the treatment of breast cancer among priority populations in Australia. Greater understanding of the barriers to treatment among these population groups are needed to minimize inequalities that exist in cancer treatment and cancer outcomes in Australia.
7
Sadot, Sophie, and Mario Campone. "Aspect thérapeutique des métastases osseuses du cancer du sein : rôle des bisphosphonates." Revue du Rhumatisme 75, no. 4 (April 2008): 339–42. http://dx.doi.org/10.1016/j.rhum.2008.02.001.
Full text
8
Guéroult-Accolas, L. "Mon réseau® cancer du sein, un réseau social de proximité." Oncologie 18, no. 2-3 (April 2016): 171–75. http://dx.doi.org/10.1007/s10269-016-2600-1.
Full text
9
Momtahen, S., A. Sadreddin Kazzazi, and M. Kadivar. "Assessment of gynecological malignancies based on pathologic reports in five general hospitals in Tehran (1995–2005)." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 5550. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.5550.
Full textAbstract:
5550 Background: Various histological types of gynecological tumors may develop from different etiological aspects. The observed differences in cancer incidence are mainly due to different individual and social risk factors. Step toward establishing a nation wide registry is being taken in this study. Methods: To give a relative frequency of female genital tract malignant tumors in Iran we designed a cross-sectional study included 450 women with definite diagnosis of gynecological cancer based on pathologic reports in five pathologic centers, Iran University of Medical sciences, Tehran, 1995–2005. WHO classification of gynecological tumors and International Federation of Gynecology and Obstetrics (FIGO) were used as basis of study. Spss 14 and correlation test was used for data analysis. Results: The average age of diagnosis was (50±0.7). 49.6% were menopausal. 82.7% were multipar. 89.8% were nonsmoker. 9.3% had history of using OCP. Ovarian cancers (55.5%), uterus cancers (24.9%) and cervical cancers (19.6%) were diagnosed. Surface epithelial-stromal tumor was the most frequent type of ovarian tumors (78.4%). Endometrial adenocarcinoma (70.5%) and squamous cell carcinoma (83%) were most frequent types of uterus and cervical cancers respectively.Well differentiated tumors were seen in 45%, 37% and 36% of uterus, cervical and ovarian tumors. In tumors of uterus and cervix the most frequent stage of diagnosis was stage IIA. The most metastatic diagnosed cases were seen between ovarian tumors (39.7%). Conclusions: Comparison with data published as review articles in NEJM till 2006, the most frequent gynecologic cancer in our study (ovarian cancer) is different to them; also the median age of our patients is lower than them. [Table: see text] No significant financial relationships to disclose.
10
Khullar, Nandika, Tejbir Singh, Mohan Lal, and Jasleen Kaur. "Impact of cancer diagnosis on different aspects of life of patients of cancer breast and cancer cervix uteri: a cross sectional study at Government Medical College, Amritsar, Punjab." International Journal Of Community Medicine And Public Health 5, no. 5 (April 24, 2018): 2053. http://dx.doi.org/10.18203/2394-6040.ijcmph20181722.
Full textAbstract:
Background: Advancements in understanding about the etiology and pathogenesis of cancer has led to increased awareness regarding the clinical course of disease and its appropriate treatments. This is the major reason behind longer life expectancy in cancer patients. However, this longer life is not necessarily an easy one due to debilitating nature of both the disease and its treatment modalities. This study was done to assess the impact of cancer diagnosis on the psycho-social aspects of patient’s lives.Methods: All patients of cancer breast and cancer of cervix uteri, who reported between January 1, 2013 to December 31, 2015; at Radiotherapy Department, Guru Nanak Dev Hospital, Government Medical College, Amritsar and were residents of Amritsar District, were listed and a total of 127 patients were included in the study. Patients were interviewed using a pre-tested, pre-designed questionnaire at their place of residence.Results: Assessing the demands of the altered lives of cancer patients in different aspects like modifications in daily living, loss of work and pleasure, reformed religious/spiritual opinions, social support received etc. It is seen that social life of patients is affected after diagnosis of cancer. However, social support received by the patients and families is similar as compared to before diagnosis.Conclusions:Maximal impact of cancer, its diagnosis and treatment is on various aspects of the life of patients not only immediate family but relatives, friends and neighbours lend psychological, social and economic support in such situations which helps a cancer survivor cope with the trauma and carry on with their lives.
11
Farook, A., and Balaji Arumugam. "A retrospective analysis of cancers in a rural tertiary care centre." International Journal Of Community Medicine And Public Health 8, no. 9 (August 27, 2021): 4319. http://dx.doi.org/10.18203/2394-6040.ijcmph20213531.
Full textAbstract:
Background: In the last couple of decades, cancer incidence has been raising heavily, probably due to our changing lifestyle, habits, and increased life expectancy. The situation is so alarming that every fourth person is having a lifetime risk of cancer.Methods: The study was conducted as a retrospective study among the various cancer patients admitted in our tertiary care centre for a period of 10 years from 2011 to 2020. The data and the case sheets from the hospital records were obtained from the MRD department. The case sheets were reviewed by the investigators on the variables viz age, gender, diagnosis, cancer site, investigations and treatment aspects. The data were entered in the MS excel sheet and analyzed using Statistical package for social sciences (SPSS) software version 21. The data were expressed in terms of frequencies and percentages.Results: Total cases reported were 121 of which in the year 2014 and 2015, the cancer cases reported were 32% and 26% respectively. Then again there was a peak in 2018 and 2019 with 8% and 31% with one case each in the year 2017 and 2020. High prevalence is seen with Breast cancer, which showed 60% followed by carcinoma stomach which is 18% and carcinoma rectum which is 9%. The cancers showed low prevalence, which is 1% include carcinoma prostate, carcinoma larynx, gastro intestinal stromal tumor and retro peritoneal lipo sarcoma.Conclusions: Our study revealed that the cancer cases are high and it showed increasing trend which suggests that the population based cancer registries to be made at all levels of health care to identify the time trends so that prevention measures can be implemented at the community level.
12
Hébert, Maude, Frances Gallagher, and Denise St-Cyr Tribble. "La théorisation enracinée dans l’étude de la transition des perceptions de l’état de santé de femmes atteintes d’un cancer du sein." Approches inductives 2, no. 1 (January 19, 2015): 92–121. http://dx.doi.org/10.7202/1028102ar.
Full textAbstract:
Être diagnostiquée d’un cancer du sein entraîne un changement important dans l’état de santé d’une personne provoquant un processus interne, soit une transition entre les perceptions de santé et de maladie. Ce processus interne reflète un processus social. La méthodologie de la théorisation enracinée permet de mettre en lumière ce processus. Le but de la présente étude est de proposer une modélisation de la transition des perceptions de l’état de santé de femmes diagnostiquées de ce cancer. Ainsi, 32 femmes, à divers moments dans la trajectoire de la maladie, ont été rencontrées lors d’une entrevue individuelle semi-dirigée. Les résultats illustrent que les perceptions de l’état de santé se modulent tout au long de la trajectoire de la maladie. La santé devient plus précieuse et le cancer surmontable. Les femmes redéfinissent leur état de santé en ne se déclarant pas malades du cancer du sein et en apprenant à vivre avec une épée de Damoclès au-dessus de leur tête.
13
Buetto, Luciana Scatralhe, and Marcia Maria Fontão Zago. "Meanings of quality of life held by patients with colorectal cancer in the context of chemotherapy." Revista Latino-Americana de Enfermagem 23, no. 3 (July 3, 2015): 427–34. http://dx.doi.org/10.1590/0104-1169.0455.2572.
Full textAbstract:
OBJECTIVE: this study's aim was to interpret the meanings assigned to quality of life by patients with colorectal cancer undergoing chemotherapy.METHOD: the ethnographic method and the medical anthropology theoretical framework were used. Data were collected through semi-structured interviews and participant observations with 16 men and women aged from 43 to 75 years old undergoing chemotherapy in a university hospital.RESULTS: the meanings and senses describe biographical ruptures, loss of normality of life, personal and social suffering, and the need to respond to chemotherapy's side effects; chemotherapy is seen as a transitional stage for a cure. Quality of life is considered unsatisfactory because the treatment imposes personal and social limitations and QoL is linked to resuming normal life.CONCLUSIONS: the meanings show the importance of considering sociocultural aspects in the conceptualization and assessment of quality of life.
14
Kwong See, Sheree T. "Mary Lee Hummert and Jon F. Nussbaum (Eds.). Aging, Communication and Health: Linking Research and Practice for Successful Aging. Mahwah, NJ: Lawrence Erlbaum, 2001." Canadian Journal on Aging / La Revue canadienne du vieillissement 22, no. 1 (2003): 133–34. http://dx.doi.org/10.1017/s0714980800003792.
Full textAbstract:
RÉSUMÉCe livre rédigé est le résultat de dialogue et de discussions suivant la Troisième conférence internationale sur la communication, le vieillissement et la santé, tenue en 1996. Le livre reflète le thème de la conférence et affirme la conviction que la communication est un lien essentiel dans la promotion de la santé et du vieillissement réussi. Les écrits proviennent de personnes érudites, de réputations internationales et de disciplines variées. Les rédacteurs ont divisé le livre en trois sections, chacune mettant au premier plan un aspect unique d'une relation réussi entre la communication, la santé et le vieillissement. Ce livre est une ressource clé pour les académiques intéressés à la communication et au vieillissement. De plus, chaque chapitre se termine avec des suggestions utiles afin de lier la recherche à la pratique. Ce livre est une ressource précieuse pour les prestataires en service de santé qui travaillent au sein d'une clientèle âgée
15
Darling, Gail. "A prospective comparison of the FACT-e and EORTC-QLQC30 and OG25 questionnaires for evaluating changes in health-related quality of life in patients with esophageal cancer." Journal of Clinical Oncology 31, no. 4_suppl (February 1, 2013): 130. http://dx.doi.org/10.1200/jco.2013.31.4_suppl.130.
Full textAbstract:
130 Background: The FACT-E (Functional Assessment of Cancer Therapy– Esophageal) and the EORTC QLQ-C30 (European Organization for Research on Treatment of Cancer Quality of Life Questionnaire) and its cancer-specific module (OG25) are two validated instruments used to assess quality-of-life (QOL) in patients with esophageal cancer. This study investigates the differences between these two instruments. Methods: This is a prospective study of 22 consecutive patients treated with chemoradiation followed by surgery. Questionnaires were self-administered at each of the following: baseline (prior to treatment), 6-8 weeks and 12-14 weeks following start of chemoradiation, and 1, 3, 6, 9, 12, and 18 months following esophagectomy. Mixed model regression was applied to model the repeated measures of the two questionnaires to compare slopes. Results: Of the 22 patients, 20 proceeded to surgery. Overall survival and disease-free survival at 18 months were 59% and 55% respectively. Comparison of the QOL domains over time showed good correlation for physical and functional well-being, with an apparent variation in the magnitude of the changes over time for the latter. The questionnaires were discordant with respect to social and total well-being. Social well-being showed a return to baseline by 1 month post-op using the FACT, but never recovered to baseline for the EORTC. FACT Total well-being recovered to baseline by 9 months, while the EORTC only approached baseline values by 18 months. The disease-specific modules showed post-operative symptom improvement with the FACT and a deterioration with the EORTC. There was also discordance in emotional well being. Conclusions: Domain comparisons of the EORTC and FACT questionnaires showed differing results. Discordance was seen for emotional, social and overall QOL, as well as symptomatology. The EORTC total and physical well-being domains showed a similar pattern of change over time. These findings might result from the overall tendency of the EORTC to emphasize physical aspects of QOL. Thus these two instruments appear to measure different aspects of QOL, which may affect their clinical utility.
16
Fortin, Pierrette, Anne Charron, Jacinthe Beauchamp, Sylvie Morin, and Jovanie Lagacé. "Corps, femmes et féminité : le vécu des jeunes femmes atteintes du cancer du sein au Nouveau-Brunswick." Recherches féministes 23, no. 2 (February 21, 2011): 71–89. http://dx.doi.org/10.7202/045667ar.
Full textAbstract:
La recherche menée par les auteures en 2008 avait pour objet d’accroître les connaissances sur le vécu personnel, conjugal et familial des jeunes femmes francophones qui ont été atteintes du cancer du sein au Nouveau-Brunswick et qui y ont survécu. Pour ce faire, quinze femmes francophones de la province ont accepté de participer à une entrevue semi-dirigée. L’importance de développer des stratégies d’adaptation qui englobent certaines dimensions du soutien social pour améliorer leur qualité de vie s’en est dégagée. Par ailleurs, les résultats révèlent que l’impact de la maladie et des traitements sur leur image et leur estime de soi est étroitement lié à leur identité de femme, de mère et de conjointe.
17
Kumar, Divjot Singh, Ali Moghaddamjou, and Winson Y. Cheung. "Young adult cancer survivors' (CS) follow-up care expectations of their primary care providers (PCPs) and oncologists." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): 9598. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.9598.
Full textAbstract:
9598 Background: The delivery of cancer survivorship care can be complicated by a lack of clarity surrounding physician roles during follow-up. This can be particularly challenging for young adult CS who face unique needs. Our aim was to characterize young CS’ follow-up care expectations of their PCPs and oncologists. Methods: A self-administered survey was mailed to all CS diagnosed with cancer from 2005 to 2009, aged 20 to 39 years at the time of diagnosis, evaluated at any 1 of 5 regional cancer centers in British Columbia, and lived beyond 2 years. The questionnaire focused on demographics, prior treatment, and CS attitudes regarding physician responsibilities during survivorship, specifically their views about their PCPs’ and oncologists’ roles. Descriptive statistics and regression analyses were used to summarize these expectations and to determine if they differed based on physician type. Results: A total of 426 patients were included (response rate 59%): current median age was 40 years (range 24-45) and 301 (71%) were women. Common tumor sites were breast (48%), testicular (27%), and gynecological (18%). Most patients (63 and 65%, respectively) expected PCPs to be responsible for following their most recent cancer and screening for future cancers. Nearly all (85 and 93%, respectively) indicated that PCPs should also provide preventive care and manage their co-morbidities. Conversely, a significant proportion (65%) felt that oncologists should remain responsible for addressing side effects of cancer treatments throughout survivorship. In terms of fertility discussions, half of patients viewed this as a role for oncologists whereas the remainder perceived this to be more suitable for PCPs. Interestingly, neither PCPs nor oncologists were seen to have any significant role in addressing social reintegration, interpersonal relationships, or sexual function, with <30% of respondents expecting these to be discussed by either physician. Conclusions: Young adult CS expect PCPs to be responsible for most aspects of their ongoing care. More clarity regarding physician roles is required with respect to specific survivorship issues, such as fertility, sexual function and psychosocial health.
18
Zarębska, Aneta, Marcin Pencuła, and Mirosław Jabłoński. "Economic aspect of treatment in geriatrics." Polish Journal of Public Health 126, no. 4 (December 1, 2016): 187–91. http://dx.doi.org/10.1515/pjph-2016-0039.
Full textAbstract:
Abstract Introduction. There are few publications related to the economic analysis of the cost of care and treatment of geriatric patients as compared with other fields of medicine. Aging of the population, especially in highly civilized countries is inevitable. Cost index is used in the literature to analyse the utility costs. They reflect the so-called cost-effectiveness of medical procedures with the estimated remaining number of years adjusted quality of life. Aim. Economic evaluation of treatment in geriatrics. Rating demographic and economic situation in Poland on the basis of statistical data. Material and methods. PubMed database was searched through and the base of Polish Central Statistical Office (CSO) was used. Qualified articles on the economic efficiency of the treatment of older people in terms of coexistence of multi morbidity were used for the analysis. Also, the existing legal acts and publications of the Polish National Health Fund, the reports from the Supreme Chamber of Control, data from the CSO, the Ministry of Health and Social Insurance Office were taken into account. Statistical analyses were performed basing on data from the CSO. Conclusions. Multiple morbidities are usually correlated with a significant increase in the use of resources, as it “multiplies” the costs of health and social care. The incidence of comorbidities has increased due to the effectiveness of treatment of chronic diseases, such as cancer, together with the increasing age of the patients. So there is a need for a system of health and social care, which will take into account the economics, and which will evolve and follow the problems that emerge. First of all, the authors recognize the need to create a properly equipped hospital wards and geriatric clinic. It is also important to take into account the cost-incurrence of geriatric treatment so that the provider would have the ability to optimally treat patients comprehensively and not only their singular particular diseases.
19
Walker, Sara J., Yiyi Chen, Amy Eiko Leatherwood, Kyungjeen Paik, Brandy Mirly, Charles R. Thomas, and Arthur Hung. "Association of spiritual well-being pre- and post-radiotherapy for prostate cancer with health-related quality of life and psychological state." Journal of Clinical Oncology 35, no. 5_suppl (February 10, 2017): 214. http://dx.doi.org/10.1200/jco.2017.35.5_suppl.214.
Full textAbstract:
214 Background: Cancer survivors often experience psychological stress, with impact on quality of life (QOL) and mortality. Religious/spiritual identity and well-being (WB) can also significantly relate to QOL among individuals with cancer. The specific aim of the current study investigates correlates of spiritual (WB), QOL, and psychological state before and after radiotherapy for prostate cancer (PC). We hypothesized that 1) positive correlations between pre-treatment spiritual WB and health-related QOL will be seen both time points and that 2) negative correlations between spiritual WB and depression and anxiety will be seen at both points. Methods: The PHQ-9 and GAD-7 assessed depression and anxiety, respectively. The FACT-P assessed physical, social, emotional, and functional WB. The FACIT-Sp-Ex assessed spiritual WB. Our sample ( N= 65) had mean age of 68 (range 52-81) and education of 16 years (range 10-20). Most participants (82%) identified as European-American. Associations were assessed by Pearson’s correlation coefficients. Results: Pre-treatment spiritual WB positively correlated with social, emotional, and functional well-being (all p < .001). Spiritual and physical WB were not significantly related. Spiritual WB negatively correlated with depression and anxiety (both p < .001). Among a smaller subsample ( N = 39) with pre-, mid-, and post-treatment assessment, spiritual WB significantly increased over time, p < .001. Post-treatment spiritual WB again correlated with social, emotional, and functional WB (all p < .001) and did not correlate with physical WB. Spiritual WB was again negatively correlated with anxiety ( p < 0.05), but it was no longer associated with depression. Conclusions: Assessing and addressing spiritual WB can be helpful in itself, as well as in better understanding QOL and psychological state. Future directions include more fine-grained assessment of pre- and post-treatment spiritual WB in order to better understand which aspects of religious/spiritual identity relate more or less closely to post-treatment QOL for different stages of PC.
20
Chen, Hong, Carol Komaromy, and Christine Valentine. "From hope to hope: The experience of older Chinese people with advanced cancer." Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 19, no. 2 (October 19, 2014): 154–71. http://dx.doi.org/10.1177/1363459314555238.
Full textAbstract:
In our study that explored the current end-of-life care provision for Chinese older people with advanced/terminal cancer, hope emerged as a significant aspect of coping with their condition. Drawing on data from in-depth interviews with a group of older people, their family carers and health professionals, this article explores participants’ constructions of hope in terms of what they were hoping for, how their hopes helped them cope with their illness and what sociocultural resources they drew on to build and sustain these hopes. While acknowledging similarities to Western studies of hope in terminal illness, this article identifies significant divergences in terms of the impact of different sociocultural values and their implications for clinical practice in light of an unfavourable health care environment for patients with advanced cancer and a social support system sustained mainly by Chinese families. It argues that hope represents an important resource for coping with terminal illness among these patients.
21
Kristensen, Marianne Boll, Irene Wessel, Anne Marie Beck, Karin B. Dieperink, Tina Broby Mikkelsen, Jens-Jakob Kjer Møller, and Ann-Dorthe Zwisler. "Effects of a Multidisciplinary Residential Nutritional Rehabilitation Program in Head and Neck Cancer Survivors—Results from the NUTRI-HAB Randomized Controlled Trial." Nutrients 12, no. 7 (July 17, 2020): 2117. http://dx.doi.org/10.3390/nu12072117.
Full textAbstract:
Head and neck cancer survivors frequently experience nutritional challenges, and proper rehabilitation should be offered. The trial objective was to test the effect of a multidisciplinary residential nutritional rehabilitation programme addressing physical, psychological, and social aspects of eating problems after treatment. In a randomized controlled trial, 71 head and neck cancer survivors recruited through a nationwide survey were randomized to the program or a wait-list control group. Inclusion was based on self-reported interest in participation. The primary outcome was change in body weight. Secondary outcomes included physical function, quality of life, and symptoms of anxiety and depression. Differences between groups at the 3-month follow-up were tested. No significant differences were seen in body weight change, but there were overall trends towards greater improvements in physical function (hand grip strength: p = 0.042; maximal mouth opening: p = 0.072) and quality of life (“Role functioning”: p = 0.041; “Speech problems”: p = 0.040; “Pain”: p = 0.048) in the intervention group. To conclude, a multidisciplinary residential nutritional rehabilitation program had no effect on body weight in head and neck cancer survivors with self-reported interest in participation, but it may have effect on physical function and quality of life. Further research on relevant outcomes, inclusion criteria, and the program’s effect in different subgroups is needed.
22
Pennant, Sarah, Simon C. Lee, Suzanne Holm, Kelli N. Triplett, Laura Howe-Martin, Ryan Campbell, and Julie Germann. "The Role of Social Support in Adolescent/Young Adults Coping with Cancer Treatment." Children 7, no. 1 (December 23, 2019): 2. http://dx.doi.org/10.3390/children7010002.
Full textAbstract:
Adolescents/young-adult (AYA) cancer patients are a psychosocially at-risk group as they are often less well-studied than other age cancer cohorts. Therefore, they experience disparities in access to developmentally informed treatment. Social support has been determined as an important aspect of AYAs’ cancer experience, but additional research was needed to describe specific behaviors AYAs found helpful and to explore how AYAs seek opportunities for additional support. As part of a larger qualitative study, study aims were to determine how AYAs (ages 15–26) cope during cancer treatment and examine how social support interacts with individual AYA coping. Participants included 10 AYA cancer patients undergoing treatment (mean age = 18.9 years) and 10 parents (mean age = 45.6 years). Descriptively, participants scored within the normal to high range on measures of hope, depression/anxiety/stress, quality of life, and social support. Participants completed semi-structured, audio-recorded interviews that were transcribed and coded as generated. Qualitative analysis was guided by principles of grounded theory and utilized the constant comparative approach. Themes within social support groups included presence, distraction, positive attitude, and maintaining AYA autonomy, communication, and advocacy. Results suggest social supports provide additional coping resources for AYAs with cancer through supplementing individual coping strategies. Future directions/implications for intervention/treatment are discussed.
23
KILLEEN, LORRY. "Cancer and personhood." Palliative and Supportive Care 2, no. 2 (June 2004): 203–5. http://dx.doi.org/10.1017/s1478951504040271.
Full textAbstract:
The effects of a disease alter every aspect of the person's being. Even with a fairly mild illness, treatment of the disease will change the patient's work and social habits, family relationships, and outlook. When the illness is cancer, and when, as in this particular case, death was almost certain in a short and measured time, the effect on the person is enormous. Generally, medicine, in accord with traditional religious teaching, stressed the division of man into two parts: body and soul. The body was the proper focus of temporal care and the soul belonged to the spiritual domain, the churches and their clergy. Church teaching explained that the body waged a constant battle with the soul and was a source of temptation and sin—sloth, greed, lust, and pride—these appetites had to be chastened so the soul could survive its brief earthly visit and enjoy eternal salvation after the death of the body. Medicine, therefore, looked at all parts of the body and tried to make them work well together. What kind of a person was left, after the body had been worked on, was not the concern of medicine.
24
Burcham, Sandra, and Jacqueline Matthews. "Earlier access to palliative medicine: An experience of integration into a community oncology practice." Journal of Clinical Oncology 34, no. 26_suppl (October 9, 2016): 92. http://dx.doi.org/10.1200/jco.2016.34.26_suppl.92.
Full textAbstract:
92 Background: A growing body of evidence supports the integration of palliative care as a standard for comprehensive cancer care. Through our experience as an inpatient palliative care provider, with 50% of our population having advanced cancer, we recognized the value proposition to provide continuity in the outpatient setting. Innovative Care Solutions developed a partnership with a large, community oncology program late 2015 for a palliative care multidisciplinary team to be embedded into one location of their practice. Methods: A full-time palliative licensed independent social worker (LISW) was dedicated to educate and engage screening process development. Utilizing the NCCN Distress Thermometer, referrals for care provision were then directed by the LISW to the most appropriate palliative care provider. The LISW addressed communication, goals of care discussions and advance directives. Identification of symptoms, including high level distress or mental health needs, were scheduled to see the palliative physician or advanced practice nurse, available two half days per week within the cancer center. Results: In the first quarter of service, the LISW screened a total of 85 patients, with 54 requiring PC interventions. Complex symptom needs were identified in seventeen percent, thirty percent were seen for psychosocial needs, and twenty percent were seen for completion of an advance directive. Thirty-six percent were seen for medical decision making. Conclusions: Integrating palliative care services in a community-based oncology practice has realized numerous positive patient outcomes and opportunities for further design. Using an evidenced based screening tool, identification of needs in an early access model appear to enable the patient to improve adherence to the medical plan care and avoid ER utilization. Symptom management has shown improved quality of life scores and PPS, and patient’s seen for psychosocial needs are able to explore aspects of person, as opposed to illness, that has improved overall well-being. Further program design will focus on integration of screening for all patients with advanced solid tumor, recurrent/refractory, and formalization of quality data tracking benchmarked to a web-based registry.
25
Bârsu, Cristian. "ASPECT ON HEALTH SOCIOLOGY AND SOCIAL MEDICINE REFLECTED IN THE STUDIES OF CONSTANTIN STANCA (1889-1969)." Medicine and Pharmacy Reports 87, no. 3 (August 5, 2014): 207–9. http://dx.doi.org/10.15386/cjmed-310.
Full textAbstract:
Constantin Stanca (1889-1969) was the first director of the Institute for the Study and Prevention of Cancer from Cluj between 1929 and 1940 and the founder of the Gynecologic Oncology Surgery Department of this Institute. During his important career in gynecology and surgical oncology, which took place in Cluj and in Bucharest, he was also interested in medical sociology and in social medicine. Our paper presents some of Stanca’s objectives in these domains: to increase the health status of women, to prevent gynecological diseases and to improve women’s working conditions, especially in factories.
26
O'Brien, M. A., J. C. Carroll, D. P. Manca, B. Miedema, P. A. Groome, T. Makuwaza, J. Easley, et al. "Multigene expression profile testing in breast cancer: is there a role for family physicians?" Current Oncology 24, no. 2 (April 27, 2017): 95. http://dx.doi.org/10.3747/co.24.3457.
Full textAbstract:
Background Family physicians (fps) play a role in aspects of personalized medicine in cancer, including assessment of increased risk because of family history. Little is known about the potential role of fps in supporting cancer patients who undergo tumour gene expression profile (gep) testing.Methods We conducted a mixed-methods study with qualitative and quantitative components. Qualitative data from focus groups and interviews with fps and cancer specialists about the role of fps in breast cancer gep testing were obtained during studies conducted within the pan-Canadian canimpact research program. We determined the number of visits by breast cancer patients to a fp between the first medical oncology visit and the start of chemotherapy, a period when patients might be considering results of gep testing.Results The fps and cancer specialists felt that ordering gep tests and explaining the results was the role of the oncologist. A new fp role was identified relating to the fp–patient relationship: supporting patients in making adjuvant therapy decisions informed by gep tests by considering the patient’s comorbid conditions, social situation, and preferences. Lack of fp knowledge and resources, and challenges in fp–oncologist communication were seen as significant barriers to that role. Between 28% and 38% of patients visited a fp between the first oncology visit and the start of chemotherapy.Conclusions Our findings suggest an emerging role for fps in supporting patients who are making adjuvant treatment decisions after receiving the results of gep testing. For success in this new role, education and point-of-care tools, together with more effective communication strategies between fps and oncologists, are needed.
27
Sangermano, Sarah, Anthony James Caprio, Shannon Cormier, and Markecia Cooper. "Development of a senior oncology clinic for geriatric cancer patients." Journal of Clinical Oncology 35, no. 5_suppl (February 10, 2017): 134. http://dx.doi.org/10.1200/jco.2017.35.5_suppl.134.
Full textAbstract:
134 Background: By 2030, more than 70% of all new cancer diagnoses will affect patients older than 65. The National Comprehensive Cancer Network recommends performing a Comprehensive Geriatric Assessment for elderly patients with cancer. Levine Cancer Institute (LCI) has developed a Senior Oncology Clinic to address the unique needs of geriatric oncology patients. Methods: Prior to the clinic visit, the patient completes a standardized questionnaire. During the visit, the patient is evaluated by a pharmacist, physical or occupational therapist, geriatrician and oncologist. The pharmacist reviews the vaccination history, prescription and non-prescription medications, and supplements. The therapist assesses balance, strength, and fatigue. The geriatrician assesses cognition, medical comorbidities, and geriatric syndromes. The oncologist screens for depression, and reviews oncologic treatment options. Final recommendations are sent by the team to the referring provider and primary care physician. Results: The Senior Oncology Clinic at LCI saw 31 survivors in 2015, and has seen 24 survivors in 2016. Patients receive referrals to a variety of services such as outpatient therapy, nutrition services, and social work. Recommendations are shared with referring providers to address common conditions in older adults as well as cancer-specific treatment recommendations. Due to the success of the program, the clinic has recently been expanded to a second site, LCI-Albemarle. This site utilizes a telemedicine model to provide the clinic at a rural location. Challenges to the program’s effectiveness include provider scheduling, clinic space, data management, and administrative management. A Program Coordinator was recently hired to oversee these aspects of the clinic. Patient challenges include transportation, medical complexity of the population, and missed appointments. Conclusions: A Senior Oncology Clinic is an effective way to perform a multidisciplinary assessment to guide cancer treatment in the geriatric population. These assessments can improve treatment decisions, detect geriatric syndromes, and recommend interventions to help improve the quality of life.
28
Gadgil, Pranjali V., Shona Milon Nag, Anupama Dutt Mane, Rebecca DeSouza, Rama Sivaram, and Sudeep Gupta. "Breast cancer survivorship in urban India." Journal of Clinical Oncology 33, no. 28_suppl (October 1, 2015): 108. http://dx.doi.org/10.1200/jco.2015.33.28_suppl.108.
Full textAbstract:
108 Background: With increasing breast cancer burden, there is need for survivorship programs in developing countries. The Indian Breast Cancer Survivors Conference is a unique initiative, to address this need in urban India. A survey of participants at this meet was conducted to aid planning of future events. Methods: Participants filled a 3-page bilingual questionnaire. Data gathered included demographics, education, treatment and side effects, health behaviors, and social impact of diagnosis. Results: Demographic: 205 breast cancer survivors registered from 5 cities. 190 participated in the study. Mean age was 51.5 years (27-79). 61.6 % reported having one or more college degrees and 86.5% were married. Diagnosis and Treatment: Mean age at diagnosis was 47.5 yrs (22-72). Median time from diagnosis was 36 m (3m-19 yrs). Mastectomy was reported as the surgical treatment by 52.1% (6% reconstruction), 72.9 % reported lymph node removal and 10.8% could not specify surgical details. 90% received chemotherapy; 76.8% underwent radiation (97.3% in lumpectomy pts); 61% took endocrine therapy and 5.1 % interrupted it before 5 years. Side Effects:Arthralgia (64%) and anxiety (60.9%) were most frequent self- reported problems followed by surgical site pain (56.1%), depression (53.9%), cognitive deficits (52.2%), skin/ hair/ nail problems (48.2%), hot flashes (48.2%), arm swelling (48.2%) and vaginal dryness (38.2%). Social Impact:Survivors whowere married or in a relationship described their relationship as stronger after diagnosis in 57.8%, unchanged in 37.4% and weaker in 4.7%. Two were married after diagnosis and none reported separation or divorce. Health Behaviors: Regular surveillance visits were reported by 93.3 % (168/180) of participants (65 with their medical oncologist, 50 with surgeon, 23 with both) 5.5% had not seen their oncologist in 2 years. Alternative medical treatment was used by 29.1% (53/182); 26 used Ayurvedic, 13 homeopathic and 14 other. This was discussed with an oncologist by 62.3%. Regular exercise at least 3 times/week was reported by 73.7% and walking (88.8%) or yoga (22.2%) were preferred. Conclusions: The presented data highlights aspects of breast cancer survivorship in urban Indian women that can be used to plan survivorship programs in future.
29
Young, Daniel, Nabangshu Das, Anthonia Anowai, and Antoine Dufour. "Matrix Metalloproteases as Influencers of the Cells’ Social Media." International Journal of Molecular Sciences 20, no. 16 (August 7, 2019): 3847. http://dx.doi.org/10.3390/ijms20163847.
Full textAbstract:
Matrix metalloproteinases (MMPs) have been studied in the context of cancer due to their ability to increase cell invasion, and were initially thought to facilitate metastasis solely through the degradation of the extracellular matrix (ECM). MMPs have also been investigated in the context of their ECM remodeling activity in several acute and chronic inflammatory diseases. However, after several MMP inhibitors failed in phase III clinical trials, a global reassessment of their biological functions was undertaken, which has revealed multiple unanticipated functions including the processing of chemokines, cytokines, and cell surface receptors. Despite what their name suggests, the matrix aspect of MMPs could contribute to a lesser part of their physiological functions in inflammatory diseases, as originally anticipated. Here, we present examples of MMP substrates implicated in cell signaling, independent of their ECM functions, and discuss the impact for the use of MMP inhibitors.
30
Rivera Rivera, Jessica N., and Jessica L. Burris. "A Systematic Literature Review and Head-to-Head Comparison of Social Support and Social Constraint in Relation to the Psychological Functioning of Cancer Survivors." Annals of Behavioral Medicine 54, no. 3 (October 3, 2019): 176–92. http://dx.doi.org/10.1093/abm/kaz037.
Full textAbstract:
Abstract Background Quality of life is a multidimensional concept that includes perceptions of one’s physical, psychological, social, and spiritual functioning, all of which are theorized to be interdependent. The focus of this study is social functioning, which itself is a multidimensional concept that includes social support and social constraint among other things. In cancer survivors, social support receives most of the research attention, but social constraint may have a stronger influence on quality of life. Purpose This systematic literature review evaluates which aspect of social functioning—social support or social constraint—has a stronger relationship with the psychological functioning of cancer survivors. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in the identification and review of 32 independent records. Multiple measures of social support and social constraint were used across studies, with most having adequate psychometric properties. Psychological outcomes were divided into (a) general distress, (b) cancer-specific distress, (c) general well-being, and (d) cancer-specific well-being. Results For general and cancer-specific distress, social constraint exhibited a larger association with distress than social support. Similarly, for general well-being, most studies reported a stronger association with social constraint than social support. For cancer-specific well-being, the opposite was true such that associations were stronger for social support than social constraint. Conclusions Results highlight the importance of considering social constraint when examining quality-of-life outcomes like psychological distress and well-being. Findings support social constraint as a target in interventions to reduce cancer survivors’ distress, while social support could be considered in attempts to promote cancer-specific well-being.
31
Sloan, Jeff A., Matthew M. Clark, Carol A. Janney, Teresa A. Rummans, Susan M. Geyer, James R. Cerhan, and Thomas M. Habermann. "Quality of Life Concerns of Long-Term Lymphoma Survivors: Results of a Pilot Study." Blood 106, no. 11 (November 16, 2005): 4695. http://dx.doi.org/10.1182/blood.v106.11.4695.4695.
Full textAbstract:
Abstract Relatively little is known about the quality of life (QOL) status among long-term (5–20 year) lymphoma survivors. Using the Mayo Tumor Registry, we identified eligible patients who were 16 years or older at diagnosis, U.S. residents, first diagnosed with Hodgkin or non-Hodgkin lymphoma from 1984–1998, diagnosed and/or initially treated at Mayo Clinic Rochester, and survived for 5 to 20 years (N=2,485). In October of 2004, we mailed a 23-page survey to 95 randomly selected patients; 7 were found to be ineligible (deceased or too ill). Of the 88 remaining patients, we were able to find a correct address for 82, and 57 completed a survey for a 70% participation rate. QOL assessments included the Functional Assessment of Cancer Therapy - General (FACT-G), and a series of linear analogue self-assessment (LASA) single-item QOL measures. Results for the pilot sample were compared to normative data for each measure relating to general cancer patient populations. All scores were transformed onto a 0–100 point scale (higher score meaning higher functioning) for ease of comparison. Of the 54 patients with complete data for analysis, the mean age at survey was 60.8 years (6.3–19.9). The mean time since diagnosis was 12.0 years (6.3–19.9), and 52% had survived more than 11 years. The mean total score for the FACT-G was 89 compared to a norm of 74 for cancer patients. Higher scores were also seen in the lymphoma survivors in each of the four FACT-G subdomains (physical, social/family, emotional and functional well-being) compared to normative cancer patient populations. The global LASA QOL measure was also higher among lymphoma survivors (mean score of 82 compared to a norm of 77), and only 7% reported a global QOL score of 50 or lower, indicative of impaired QOL. Functioning among the lymphoma survivors was higher compared to general cancer patients on the mental, physical, emotional, social, pain, fatigue, financial, and legal LASA items, while functioning was similar to general cancer patients on the spiritual and support LASA items. However, scores suggestive of impaired QOL were reported by more than 10% of the patients for the social (17%), pain frequency (31%), fatigue (20%), and financial concerns (25%) items of the LASA. There were suggestive results of effect sizes indicating that smokers had lower FACT-G physical and emotional scores, and lower LASA mental and physical QOL scores, although none achieved statistical significance. In conclusion, this pilot sample of long-term lymphoma survivor patients reported having high QOL on most domains of the FACT-G and LASA relative to other cancer patient populations. There appears to be a subset of patients who experience impaired QOL and who may require further interventions, particularly in the QOL domains of social, pain, fatigue, and financial functioning. These results also suggest that awareness of smoking status may be important. Further larger studies are needed to confirm these preliminary data and to evaluate other aspects of QOL.
32
Kunos, Charles A., and Rita Abdallah. "Financial Toxicity Encountered in Therapeutic Radiopharmaceutical Clinical Development for Ovarian Cancer." Pharmaceuticals 13, no. 8 (August 5, 2020): 181. http://dx.doi.org/10.3390/ph13080181.
Full textAbstract:
Financial toxicity or the debt a cancer survivor incurs from the costs of their medical cancer care is an understudied aspect in the clinical development of experimental therapeutic agents. The United States National Cancer Institute (NCI) Cancer Therapy Evaluation Program studies experimental therapeutic agents like radiopharmaceuticals in both early and late phase trials, which provide opportunities to comprehend more clearly the possible sources of financial toxicity incurred by cancer survivors. We reviewed the academic scholarship describing fiscal and social costs involved in the development of therapeutic radiopharmaceuticals. Because many ovarian cancer survivors outlive their disease through initial and, perhaps, multiple treatment courses, these women and their treatments provide context for our discussion on financial toxicity. 16 (27%) of 60 articles discuss financial toxicity incurred by women with ovarian cancer; none described financial toxicity associated with regulatory agency-approved or experimental therapeutic radiopharmaceuticals. Fiscal costs of radiopharmaceutical dose and schedule and social costs of individual productivity loss or asset expenditure arose as primary financial toxicities. The development of radiopharmaceuticals for women with ovarian cancer remains a high priority for the NCI Cancer Therapy Evaluation Program. Weighing radiopharmaceutical clinical benefit against measures of financial toxicity is challenging and warrants further study in prospective radiopharmaceutical clinical trials.
33
Rosenbaum, Ernest, Robert W. Garlan, Naama Hirschberger, Alison L. Siegel, Lisa D. Butler, and David Spiegel. "The Life Tape Project: Increasing Family Social Support and Symbolic Immortality with a Brief Existential Intervention for Cancer Patients and Their Families." OMEGA - Journal of Death and Dying 53, no. 4 (December 2006): 321–39. http://dx.doi.org/10.2190/f143-5363-3442-5163.
Full textAbstract:
Cancer poses a powerful threat to the emotional equilibrium of patients and their families. A key role of the family and medical team is to provide a supportive environment as the patient confronts the reality of death. Few interventions have been developed to help families support patients in dealing with fears of death and dying. We present one such approach, the Life Tape Project (LTP), that helps bring families closer together, increases communication, and acts as an existential intervention leading to greater sense of legacy, meaning, self-awareness, identity, and connection. Additionally, the results of a pilot study exploring the benefits of the LTP are presented, and we describe symbolic immortality, an aspect of existential coping, to illuminate how existential and social support factors can work together to benefit patients and their families.
34
Nakajima, Riho, Masashi Kinoshita, Hirokazu Okita, and Mitsutoshi Nakada. "NCOG-41. FUNCTIONAL OUTCOME FOLLOWING NON-DOMINANT HEMISPHERIC GLIOMA SURGERY FROM THE ASPECT OF INDEPENDENCE LEVEL, COGNITIVE FUNCTION AND RETURN TO SOCIAL LIVES." Neuro-Oncology 22, Supplement_2 (November 2020): ii138. http://dx.doi.org/10.1093/neuonc/noaa215.579.
Full textAbstract:
Abstract BACKGROUND Functional outcome has been paid much attention in surgery for eloquent area or dominant hemisphere. Little is known about functional outcome following surgery for non-dominant hemispheric gliomas, although some resent reports revealed the importance of right cerebral hemisphere on glioma surgery. Here, we investigated functional outcome of right cerebral hemispheric gliomas from the aspect of independence level, cognitive function, and return to social lives. METHODS Totally 82 patients with right cerebral hemispheric gliomas who underwent surgery for resection in Kanazawa university hospital were studied. Patients were divided into two groups, WHO grade II/III and IV. Karnofsky Performance Status (KPS), Mini-mental state examination (MMSE), and whether or not to return to work at pre-operation and chronic phase were evaluated. To reveal responsible region for decline of each index, the voxel-based lesion symptom (VLSM) analyses were performed. RESULTS MMSE; no difference was found through postoperative course in grade II/III, whereas postoperative score of grade IV was declined significantly compared with pre-operation (25.1 and 21.9 point; p=0.048). KPS; preoperative independence level was maintained until chronic phase in grade II/III (94.7 and 89.5). While, in grade IV, postoperative KPS was declined significantly than that of pre-operation (82.0 and 70.0, p=0.007). Results of the VLSM analysis revealed that patients who resected temporo-parietal junction in grade IV showed significantly low KPS score. Return to social lives; Reintegration ratio of working population was 71% and 35% for grade II/III and IV, respectively. Of these, as for grade II/III gliomas, the cingulate cortex and medial orbito-frontal cortex relate to return to social lives. CONCLUSIONS Functional outcome following surgery depends on tumor grade and resected region in right cerebral hemispheric gliomas.
35
Chen, Bai Qi Peggy, Monica P. Parmar, and Kimberley Gartshore. "Prodiguer du soutien aux femmes atteintes d’un cancer du sein avancé : l’incidence de l’état fonctionnel altéré sur leurs rôles sociaux." Canadian Oncology Nursing Journal 24, no. 3 (August 5, 2014): 199–203. http://dx.doi.org/10.5737/1181912x243199203.
Full text
36
Stan, D. L., S. Pruthi, S. Jenkins, K. Lackore, and C. A. Thompson. "Needs and preferences of breast cancer survivors: A cross-sectional survey." Journal of Clinical Oncology 29, no. 27_suppl (September 20, 2011): 147. http://dx.doi.org/10.1200/jco.2011.29.27_suppl.147.
Full textAbstract:
147 Background: The Institute of Medicine recommends development of cancer survivorship care models that are patient centered. We designed a cross-sectional survey to determine the medical and psychosocial needs and preferences of breast cancer survivors. Methods: We identified a random sample, stratified by age and chemotherapy usage, of 600 women from MN, WI, and IA, ages 18-99, within 1-5 years of diagnosis of stage 0-3 breast cancer and seen at our institution. Results: We received 329 surveys (response rate 55%). Respondents were a mean age of 58 years (range 26-89) and a mean of 3.3 years from cancer diagnosis (range 1.2-5.4). 96% were white and stage distribution was: 15% stage 0, 35% stage 1, 32% stage 2, 15% stage 3, and 3% missing. Treatment included mastectomy (60%), lumpectomy (40%), radiation (61%), chemotherapy (55%) and hormonal therapy (50%). Most common treatment-related sequelae were neuropathy (38%), chest wall or arm pain (27%), and lymphedema (26%). Over half (52%) report worry and 45% report fatigue as a problem in the past week. 74% stated that their medical needs were met, whereas 49% said their psychological and spiritual needs were met (p<0.01). 68% understood the follow-up plan after treatment was complete. Perceived barriers to follow up care were anxiety (30%) and lack of coordination (10%). When queried about post-treatment care, the following aspects were considered important (% of patients ranking ≥7 on scale 0-10: 0=not important, 10=very important): breast/chest wall exam (88%); screening for osteoporosis (71%), colorectal cancer (69%), and heart disease (65%); educational materials (64%); mammography (63%); physical therapy (61%); diet and exercise counseling (60%); and complementary/alternative medicine information (53%). Less important were psychology (44%), gynecology (43%), chaplain services (35%), support groups (32%), social work (20%), and infertility experts (4%). 60% expressed interest in attending a survivorship clinic. Conclusions: This survey provides unique data on breast cancer survivors, and efforts should be made to optimize medical and psychosocial care in line with their needs and preferences. These results will be imperative in designing a wellness and survivorship clinic.
37
Pollak, Kathryn I., Robert M. Arnold, Amy S. Jeffreys, Stewart C. Alexander, Maren K. Olsen, Amy P. Abernethy, Celette Sugg Skinner, Keri L. Rodriguez, and James A. Tulsky. "Oncologist Communication About Emotion During Visits With Patients With Advanced Cancer." Journal of Clinical Oncology 25, no. 36 (December 20, 2007): 5748–52. http://dx.doi.org/10.1200/jco.2007.12.4180.
Full textAbstract:
Introduction Cancer care involves addressing patient emotion. When patients express negative emotions, empathic opportunities emerge. When oncologists respond with a continuer statement, which is one that offers empathy and allows patients to continue expressing emotions, rather than with a terminator statement, which is one that discourages disclosure, patients have less anxiety and depression and report greater satisfaction and adherence to therapy. We studied whether oncologist traits were associated with empathic opportunities and empathic responses. Patients and Methods We audio-recorded 398 clinic conversations between 51 oncologists and 270 patients with advanced cancer; oncologists also completed surveys. Conversations were coded for the presence of empathic opportunities and oncologist responses. Analyses examined the relationship with oncologists' demographics, self-reported confidence, outcome expectancies, and comfort to address social versus technical aspects of care. Results In 398 conversations, 37% contained at least one empathic opportunity; the range was 0 to 10, and the total empathic opportunities was 292. When they occurred, oncologists responded with continuers 22% of the time. Oncologist sex was related to the number of empathic opportunities; female patients seen by female oncologists had the most empathic opportunities (P = .03). Younger oncologists (P = .02) and those who rated their orientation as more socioemotional than technical (P = .03) were more likely to respond with empathic statements. Conclusion Oncologists encountered few empathic opportunities and responded with empathic statements infrequently. Empathic responses were more prevalent among younger oncologists and among those who were self-rated as socioemotional. To reduce patient anxiety and increase patient satisfaction and adherence, oncologists may need training to encourage patients to express emotions and to respond empathically to patients' emotions.
38
Rosenthal, Carolyn J. "Suzanne Kingsmill and Benjamin Schlesinger. The Family Squeeze: Surviving the Sandwich Generation. Toronto: University of Toronto Press, 1998." Canadian Journal on Aging / La Revue canadienne du vieillissement 18, no. 4 (1999): 513–17. http://dx.doi.org/10.1017/s0714980800010072.
Full textAbstract:
RÉSUMÉCe livre s'adresse au profane plutôt qu'au spécialiste ou à l'universitaire. Bien que son titre laisse entendre qu 'il soit d'abord destiné aux adultes d'âge moyen aux prises avec les demandes conflictuelles de leurs enfants et de leurs parents âgés, la préface précise clairement que le livre vise un lectorat plus vaste incluant quiconque est submergé par des demandes d'adolescents ou d'enfants adultes ou de parents âgés. Le style du livre est dégagé et divertissant; on y vit les défis d'une famille et plus particulièrement de Rebecca, une femme de 52 ans sur le marché du travail, entourée de trois enfants toujours à la maison et de parents âgés de 80 ans. Chaque chapitre présente un aspect propre aux familles vieillissantes (p. ex.: les jeunes adultes toujours à la maison ou qui y reviennent, les parents âgés, la génération du milieu, la participation des frères et soeurs aux soins des parents, l'aide du secteur de soins officiel, la planification de l'avenir). La principale faiblesse du livre consiste à appliquer l'étiquette de génération sandwich à presque toutes les relations familiales et à son manque de spécificité en regard de la notion de «sandwich». Plus précisément, les auteurs ne font pas la distinction entre les sentiments de conflit ou de culpabilité, les comportements ordinaires d'aide au sein d'une famille et la fourniture de soins à des degrés inhabituels. Lorsque l'ensemble des relations familiales ou des types d'aide ou de conflit sont regroupés sous le terme de «génération sandwich,» les parents âgés sont blâmés outre mesure du stress des filles adultes. Le terme laisse croire que les parents âgés sont un fardeau pour leurs enfants. L'abus du terme déprécie les aîné(e)s et les filles absolument coincées entre les soins à fournir aux différentes générations.
39
Jarero, Ignacio, Lucina Artigas, Susana Uribe, and Laura Evelyn García. "Le protocole EMDR intégratif de traitement de groupe pour les patients atteints de cancer." Journal of EMDR Practice and Research 12, no. 2 (May 2018): E31—E40. http://dx.doi.org/10.1891/1933-3196.12.2.e31.
Full textAbstract:
L’expérience du cancer est un facteur de stress particulier au sein de l’infrastructure de l’état de stress post-traumatique (ESPT) car cette maladie débilitante implique des facteurs de stress permanents, et elle est à la fois aiguë et potentiellement chronique. Le cancer peut s’accompagner d’un large éventail d’effets négatifs connexes, tels que la détection d’une tumeur, le diagnostic, la gravité de la maladie et le pronostic, l’agressivité des traitements, la mutilation et le dysfonctionnement physique, les effets secondaires du traitement, les perturbations du fonctionnement physique, social et professionnel et, parfois, la récidive et un diagnostic de maladie terminale. Cet article fournit une description détaillée de l’application clinique du protocole intégratif de traitement de groupe de désensibilisation et de retraitement par les mouvements oculaires (EMDR-IGTP) adapté aux patients adolescents et adultes atteints de cancer et vivant avec un stress traumatique continu. Ce protocole administre les huit phases du traitement EMDR individuel à un groupe de patients en utilisant une composante de l’art-thérapie (c’est-à-dire des dessins) et le « butterfly hug » (BH – le « câlin de papillon », une méthode de stimulation bilatérale autoadministrée utilisée pour traiter le matériel traumatique). Une étude antérieure (Jarero et coll., 2015) avait montré qu’après six séances d’EMDR-IGTP, on observait une diminution significative des symptômes d’ESPT liés au diagnostic et au traitement de différents types de cancer chez des femmes adultes. Les effets se maintenaient lors de la séance de suivi, 90 jours plus tard. Dans le présent article, nous discutons de la manière dont on peut se servir de ce protocole pour fournir efficacement un traitement EMDR intensif à de grands groupes de patients, et nous donnons des instructions détaillées pour son utilisation, afin d’aborder l’une des principales dimensions psychologiques du cancer : les réactions de stress traumatique permanentes que connaissent les patients. Un exemple clinique illustre le processus de traitement.
40
Levine, Alison Spatz, and Judith Balk. "Yoga and Quality-of-Life Improvement in Patients with Breast Cancer: A Literature Review." International Journal of Yoga Therapy 22, no. 1 (January 1, 2012): 95–100. http://dx.doi.org/10.17761/ijyt.22.1.624787874t3k7075.
Full textAbstract:
Objective: Women undergoing treatment for breast cancer often turn to complementary and alternative medicine (CAM), including yoga, for improvement of mood, quality of life (QOL), sleep, and treatment-related side effects. The extant literature was reviewed to examine the clinical effects of yoga practice on QOL for patients with breast cancer. QOL was defined as physical well-being, social functioning, emotional health, and function-al adaptation. Methods: Seven databases, including PubMed, Ovid MEDLINE, CINAHL, Embase, PsycINFO, Cochrane Library, and Web of Science were used to search for studies of patients with breast cancer that included a yoga intervention and QOL assessment. Attention was paid to assessing study population, outcome variables, the type of yoga intervention used, and methodological strengths and limitations. Results: Seventy-one articles were identified that fit the search criteria. Although the literature provided evidence of QOL benefits of yoga for patients with breast cancer, no specific aspect of yoga was identified as being most advantageous. Conclusion: Although participation in yoga programs appeared to benefit patients with breast cancer, greater methodological rigor is required to understand the mechanisms that contribute to their effectiveness.
41
Montague, Meg, Ron Borland, and Craig Sinclair. "Slip! Slop! Slap! and SunSmart, 1980-2000: Skin Cancer Control and 20 Years of Population-Based Campaigning." Health Education & Behavior 28, no. 3 (June 2001): 290–305. http://dx.doi.org/10.1177/109019810102800304.
Full textAbstract:
The Anti-Cancer Council of Victoria has been running sun protection programs for more than 20 years: Slip! Slop! Slap! from 1980 to 1988 and SunSmart from 1988 to the present. The Victorian Health Promotion Foundation has provided funding for the SunSmart program for the past 13 years. These programs have played an important role in changing the whole society’s approach to the sun and have resulted in marked reductions in sun exposure. This article describes the social, political, economic, and organizational context within which these programs developed. Then 10 areas are discussed that illustrate a critical aspect of the development and implementation of this successful systemwide health promotion program. These areas focus on key aspects of the context within which the program operates and on issues that derive from the experience of implementing program strategies. In summary, the success of the two programs is described as having been built on two key foundations: the vital integration of research and evaluation, on one hand, and a strong basis of consistency and continuity, on the other.
42
Cho, Hae Lin, David Gibbes Miller, and Scott Y. H. Kim. "Understanding people’s ‘unrealistic optimism’ about clinical research participation." Journal of Medical Ethics 46, no. 3 (August 31, 2019): 172–77. http://dx.doi.org/10.1136/medethics-2019-105377.
Full textAbstract:
BackgroundResearchers worry that patients in early-phase research experience unrealistic optimism about benefits and risks of participation. The standard measure of unrealistic optimism is the Comparative Risk/Benefit Assessment (CRBA) questionnaire, which asks people to estimate their chances of an outcome relative to others in similar situations. Such a comparative framework may not be a natural way for research participants to think about their chances.ObjectiveTo examine how people interpret questions measuring unrealistic optimism and how their interpretations are associated with their responses.MethodsUsing an early-phase cancer trial vignette, we administered the CRBA to 297 adults from the general public. They estimated their comparative chances of risk and benefit (7-point scale: −3 less likely to +3 more likely), then provided rationales for their estimates.ResultsFor both CRBA benefit and risk questions, about 50% of respondents chose 0 (the ‘correct’ response of ‘average likelihood’), and 50% chose a non-0 response. Respondents’ rationales for their estimates showed that overall only about 40%–44% gave comparative rationales, indicating that they interpreted the CRBA as intended. 68.7% of respondents who gave the ‘correct’ 0 rating gave comparative rationales, whereas only 11.6% of respondents who gave non-0 ratings did so. A similar trend was seen for chances of risk (p<0.001 for both).ConclusionResearch participants may not understand comparative benefit and risk questions as intended; attributions of unrealistic optimism may require additional evidence that the respondents’ estimates are intended to be comparative.
43
Αυδή, Ευρυνόμη, Δέσποινα Ζηλιασκοπούλου, and Παγώνα Ρούσση. "H εμπειρία της μαστεκτομής: Στίγμα και μεταβολές στην ενσώματη ταυτότητα." Psychology: the Journal of the Hellenic Psychological Society 19, no. 2 (October 15, 2020): 144. http://dx.doi.org/10.12681/psy_hps.23613.
Full textAbstract:
Breast cancer and its treatment have significant effects on a bodily, psychological and social level. Although there are many studies of breast cancer and its effects on women’s lives, the research literature that examines the experience of mastectomy and the meaning that women themselves attribute to it is relatively limited. This paper exploresthe experience of mastectomy in relation to social representations regarding femininity and health, which provide the context for and affect the personal meaning attributed to the experience, as well as women’sdecisions regarding treatment. The findings of a phenomenological study, based on interviews with eight women that had undergone mastectomy for breast cancer, are presented. The analysis focuses on aphenomenological description of the experience of mastectomy, whilst taking into account the fact that the female breast has particularly strong connotations of femininity, sexuality and motherhood, that is,important aspects of women’s identity. It seems that a central aspect of women’s experience of mastectomy is a sense that they are somehow ‘different’ and this sense is associated with a stigmatised identity. The ways in which women seem to manage the double stigma, associated with the identity of a cancer patient and with that of a ‘deficient’ woman, are further discussed in the paper.
44
Hanifah, Nurul, Ito Wasito, and Boy Subiroso Sabarguna. "Design Model of Deep Stacking Network for Breast Cancer Prediction Using Microarray." Advanced Science Letters 24, no. 8 (August 1, 2018): 6095–96. http://dx.doi.org/10.1166/asl.2018.12636.
Full textAbstract:
Breast cancer diagnosis currently relies on clinical information, image radiology and histopathology. However molecular biology aspect needs to be considered for accurate diagnoses. Microarray technology allows the analysis of thousands of gene expression to be used as additional information for breast cancer diagnosis. This study aims to use microarray for breast cancer diagnosis by using machine learning. Machine learning is widely used for pattern analysis and can be used for microarray dataset, such as deep stacking network (DSN). Design of DSN is stacked each of base module which using a simple form of the multilayer perceptron. Using DSN is suitable for complex data like microarray dataset because it has a deep architecture (deep learning). Furthermore, DSN model does not use stochastic gradient descent which is difficult to be implemented on large scale of machine learning. In Indonesia, microarray technology is still not well known, therefore the current studies only use secondary data from cancer patients overseas. DSN which is a deep learning model is suitable to be used for microarray dataset that has a complex structure. Suggested for subsequent study using primary data from patient cancer in Indonesia so that the design model will be more suitable to be implemented for cancer patients in Indonesia.
45
Jerop, Caren, Kibiwott Kurgat, and George Mose. "SILENCE AS COMMUNICATION: A PHENOMENOLOGICAL STUDY OF CERVICAL CANCER PATIENTS AND CAREGIVERS IN KENYA." JOURNAL OF SOCIAL SCIENCE RESEARCH 14 (February 28, 2019): 3114–21. http://dx.doi.org/10.24297/jssr.v14i0.8134.
Full textAbstract:
Managing a serious diagnosis is a complex and challenging process thus effective communication is a critical aspect of cancer management. However, this has not been given the much needed emphasis. This study therefore sought to examine the influence of communication on cancer management. It adopted an interpretivist research paradigm which is a qualitative approach. It employed the phenomenological method to obtain data from cervical patients and their caregivers. Specifically, a range of in-depth interviews and observations were used to collect data from eight patients and eight caregivers purposively sampled within Uasin Gishu County. Data from the interviews were then analyzed thematically and presented in narrative form using paraphrases and quotations. Ethical issues such as informed consent, confidentiality and official authorization were observed at all levels. The findings of the study indicated that the patients and caregiver downplayed their feelings so as to protect themselves and their loved ones. Social cultural factors and stigma also contributed to their silence. It is concluded that silence is draining and patients and caregivers need to be encouraged by medical practitioners, family and the support groups to share their feelings. Based on the findings of this study, it is necessary for the patients and caregivers to have a platform where they will be able to share their experience.
46
Bakos, M., T. Jankovic, V. Krcmery, and M. Dubovcova. "Social Aspects of Diagnosis and Treatment of Non-palpable Breast Lesions. Important Factor affecting Quality of Life in Cancer Patients undergoing Surgery." Clinical Social Work and Health Intervention 12, no. 2 (June 30, 2021): 25–30. http://dx.doi.org/10.22359/cswhi_12_2_04.
Full textAbstract:
Introduction: The social aspect of breast cancer presents a serious problem all the time. Quality of women´s life after surgery must be compared to life before it. Breast cancer treatments today are likely to cause less physical deformity from surgery than two decades ago but are more complex and extend over a longer period of time. Non-palpable breast lesions are findings with non-biologically specified importance, which can be responsible for development of cancer. The authors present the diagnosis and the results of the treatment of patients with non-palpable breast lesions. They were hospitalized at the Department of Surgery in Nitra from Jan uary 2014 untilJuly 2017 and we used the SNOLLmethod or wire guided excision under ultrasound control or digital stereotaxic. Results: From January 2014 until July 2017 there were 122 patients diagnosed with non-palpable breast lesions at the Department of Surgery at our hospital. 76 (62.3%) of these patients were diagnosed with carcinoma. Wire Guided Localization was performed in 99 (81.1%) patients; sentinel node was found in 41 (33.6%) patients using the SNOLL method. From all the patients a reoperation was conducted in 4 cases (3.3%) for close or positive margin status and in 3 cases (2.5%) for false negative perioperative sentinel biopsy. Conclusion: The technique combining 99mTc-MAA (albuminmacro aggregate marked by 99Technecium) and nanocoloid is a reliable localization method for non-palpable lesions and sentinel nodes. SNOLL is a practical and oncological safe technique of excision of a subclinical lesion in combination with sentinel biopsy. This technique brings new visions for the future, especially for quality of life after surgery, changes in body image and sexuality.
47
Novakov, Ivana, Svetlana Popovic-Petrovic, Sonja Ilincic-Zlatar, Milanka Tatic, and Mirjana Sevo. "What contributes the most to the breast cancer patients’ quality of life during the therapy - clinical factors, functional and affective state or social support?" Vojnosanitetski pregled 78, no. 4 (2021): 445–55. http://dx.doi.org/10.2298/vsp190501024n.
Full textAbstract:
Background/Aim. As significant advances in cancer treatment have occurred over the past decades, the crucial questions in oncology nowadays are not related only to the treatment of the illness but also to the quality of life (QOL) of patients. The aim of our study was to explore which set of determinants (clinical, functional, affective, or social) has the greatest impact on explaining QOL in women who live with the diagnosis of breast cancer. Methods. The research was conducted on 64 women (with a mean age of 58.36 ? 11.30) while undergoing radiation therapy at the Oncology Institute of Vojvodina, Serbia. Quality of Life Instrument ? Breast Cancer Patient Version (QOL-BC) questionnaire was used for evaluation of physical, psychological, social, spiritual, and general well-being, the Upper Extremity Functional Index (UEFI) was applied for the assessment of the upper extremity function, the Depression, Anxiety, and Stress Scale-21 Items (DASS-21) was used for measuring symptoms of depression, anxiety, and stress, the Medical Outcomes Survey, Social Support Survey (MOS-SSS) served for evaluation of social support; demographic and clinical data of patients were also collected. Results. Analysis of Variance (ANOVA) with repeated measures [F(2.03, 127.80) = 20.24, p < 0.001] showed that in our sample, physical QOL was significantly better from all other domains, while social QOL was significantly lower from both physical and psychological aspect. A hierarchical regression analysis [F(8, 55) = 7.16, p < 0.001, R2 = 0.51] showed that patients who received adjuvant chemotherapy and experienced high levels of stress and poor social support usually had diminished general QOL. Introduction of affective-related variables [?R2 = 0.16, p(?F) < 0.01] and social support [?R2 = 0.05, p(?F) < 0.05] led to a significant increase in proportion of explained variance over and above the clinical and functional variables. Conclusion. Our results indicate that psychological and social resources are more important in predicting QOL compared to clinical and functional factors. At the same time, the social, psychological, and spiritual well-being of patients is significantly worse compared to the physical QOL, meaning that there is still much left to be done regarding the progress from a purely somatic to a holistic approach in the treatment of breast cancer.
48
Elkateb, N., W. Monir, and M. Abdelhady. "Quality of Life of Egyptian Cancer Patients in Relation With the Types and Quality of Information Given." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 111s. http://dx.doi.org/10.1200/jgo.18.25200.
Full textAbstract:
Background: The concept of quality of life (QOL) refers to the ability to enjoy normal life activities; it is a complex combination of satisfactory functioning in essential four core domains — physical, psychological/emotional, social and quality of life is an important aspect of care in the clinical setting; nurses can improve patients´ quality of life by ensuring they are competent in daily practice, and by giving patients a high quality holistic care based on safe, effective intervention and providing required information. Aim: To evaluate the quality of life of cancer patients in relation to different treatment modalities and evaluate the impact of the information given on the quality of life. Methods: A convenient sample of adult cancer patients recruited from a university hospital, Cairo, Egypt. Data were collected through self-administered questionnaire or patient structured interview. Tools used: EORTC QLQ-C30 (Version 3) and QLQ-INFO25. Data analysis includes descriptive statistics and exploration of relationships between key variables; physical, emotional, social well-being, type of treatment, information given and quality of life. Results: Preliminary results revealed significant correlation between fatigue, emotional disturbance and quality of life. Lack of information is also correlated with low quality of life. Patients expressed their needs for more clarification about treatment, coping with disease and future consideration. Conclusion: Quality of life should be assessed frequently by nurses throughout treatment phases to identify patients at risk. Nurses also should emphasize on proper patients teaching and counseling to promote physical psychosocial balance and improve quality of life.
49
Buki, Lydia P., Zully A. Rivera-Ramos, Marlen Kanagui-Muñoz, Puncky P. Heppner, Lizette Ojeda, Emaan N. Lehardy, and Kari A. Weiterschan. "“I never heard anything about it”: Knowledge and psychosocial needs of Latina breast cancer survivors with lymphedema." Women's Health 17 (January 2021): 174550652110024. http://dx.doi.org/10.1177/17455065211002488.
Full textAbstract:
Objective: Breast cancer is the most commonly diagnosed form of cancer and the leading cause of cancer-related death among Latina women in the United States. One aspect of recovery that has been underrepresented in the English-language literature is the recovery of Latina women who have developed lymphedema, a debilitating condition characterized by persistent swelling of the arm, hand, chest, and/or breast. To fill this research gap, a study was conducted to examine the lived experiences of Latina women with breast cancer-related lymphedema. Methods: Given the limited scholarship on this topic, qualitative methods were used to obtain a foundational and nuanced understanding of Latina women’s experiences. Semi-structured interviews were conducted with a sample of 10 Latina survivors with breast cancer-related lymphedema. Data were analyzed through thematic analysis and constant comparison methodology. Results: The data analysis yielded three major themes: knowledge of lymphedema, impact of lymphedema diagnosis, and coping with lymphedema. Participants had limited knowledge of lymphedema and its risk factors upon diagnosis, in addition to barriers accessing quality care. They also noted psychological distress related to a significant financial burden as well as social anxiety related to interacting with others while wearing compression gloves or sleeves. A major coping strategy was receiving social support from friends, family, peers in structured support groups, and spiritual/religious groups or practices. Conclusions: Our findings bring to light contextual factors that may place Latina breast cancer survivors at increased risk for lymphedema and for experiencing a high burden managing their condition. Recommendations are provided for primary, secondary, and tertiary prevention.
50
Ochoa, Michele Stayer, Stefanie Mooney, Cristiane Decat Bergerot, Kathleen Burns, Finly Zachariah, Rupinder Kaur Sidhu, Jill Prudhomme-Hunter, et al. "Impact of a patient and family meeting program for patients with metastatic genitourinary cancer receiving treatment in the ambulatory care setting." Journal of Clinical Oncology 36, no. 34_suppl (December 1, 2018): 31. http://dx.doi.org/10.1200/jco.2018.36.34_suppl.31.
Full textAbstract:
31 Background: Palliative care in the ICU is recognized as a vital aspect of care delivery but less evidence exists regarding utilization in ambulatory care. Family meetings are considered a relevant strategy to discuss concerns around patients’ illness and treatment. This pilot study sought to describe preliminary results of the Patient and Family Meeting Program (FMP) implemented in October, 2017 in a genitourinary oncologic clinic. Methods: FMP is offered for high-risk patients with ≤ two year prognosis. Program includes: (1) patient identification, (2) orientation, (3) family meeting, and (4) post-meeting follow-up. After identification, social worker orients the patient/family, addresses advance directives, and assesses values regarding care. During the meeting, social worker introduces and elicits understanding of medical situation, physician provides medical information and recommendations, and social worker assists reconciling medical recommendations with patient values. During follow-up, educational materials are provided, referrals are made as indicated, and follow-up meetings are held by request. Results: 51 patients were identified. Most of them were male (69%) with a median age of 68 years, and diagnosed with renal cell carcinoma (47%), prostate cancer (27%), or urothelial cancer (26%). 48 orientations were conducted, and 18 family meetings were held. Hospice was recommended to 16 patients, and 69% were admitted. 6 cases were referred to supportive medicine. Oncologists spent on average 21 minutes with each family. In the inpatient setting, 3 family meetings were requested; all patients were referred to hospice, and 2 were enrolled. Conclusions: Findings indicate the feasibility/benefit of FMP; a high prevalence of patients were referred and enrolled in hospice. Meetings require little extra time for the physician. Also, this program favored better integration between the health care team and patient/family. Results provide support for expanding this program to other specialties. Extending the value of family meetings in ambulatory care is a unique opportunity to enhance essential psychosocial support to oncology patients with greatest need.