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Financial support systems for cancer care in India: A qualitative exploratory study.

PURPOSE: The financial toxicity (FT) of cancer care adversely impacts treatment initiation, compliance and completion in low-and middle-income countries like India. This qualitative study aimed to map the financial support systems for cancer care and associated barriers and facilitators in India. METHODS: Semi-structured interviews were conducted with oncologists working in various settings (public/private, for-profit/not-for-profit, urban/rural). A deductive classification was first applied to organise support system resources into two categories: (1) resources for treatment centres and (2) …

Large Language Models to Help Appeal Denied Radiotherapy Services.

PURPOSE: Large language model (LLM) artificial intelligences may help physicians appeal insurer denials of prescribed medical services, a ta … an OpenAI application programming interface with 53 examples of appeal letters written by radiation oncologists. Twenty test prompts with simulated patient histories were programmatically presented to the LLMs, and output appeal letters were scored by three blinded radiation oncologists for language representation, clinical detail inclusion, clinical reasonin …

Paradoxes in advance care planning: the complex relationship of oncology patients, their physicians, and advance medical directives.

PurposeMany seriously ill patients with cancer do not discuss prognosis or advance directives (ADs), which may lead to inappropriate and/or … unicating their ADs is beneficial and train primary care physicians, house staff, hospitalists, and oncologists to initiate these difficult discussions.

Relative value unit impact of complex skin closures to academic surgical melanoma practices.

BACKGROUND: Melanoma excisions frequently are associated with significant soft-tissue defects, creating the need for complex closures. These closures could be performed by either surgical oncologists or plastic surgeons. We sought to quantify the relative value units (RVUs) and describe the practice patterns of 2 academic surgical subspecialties after a melanoma excision. METHODS: After institutional review board approval, a retrospective data analysis of a billing database was conducted on all melanoma patients undergoing an excision and closure by surgical oncology and plastic surgery depar…

Соблюдение основанных на фактах рекомендаций по лечению костного здоровья, боли и мобильности пациентов с множественной миеломой: смешанный метод в палестинской системе здравоохранения.

Были разработаны рекомендации по оценке, регулированию и мониторингу состояния здоровья, боли и мобильности костных костей у пациентов с множественной миеломой, основанные на принципе " консенсус/доказательства " . Это исследование было проведено с целью оценки соответствия гематологов-онкологов принятым на основе консенсуса/доказательств рекомендациям в отношении оценки, регулирования и мониторинга состояния здоровья костей, боли и мобильности у пациентов с множественной миеломой, которые получали медицинскую помощь в палестинской системе здравоохранения. Рекомендации, основанные на

Совпадение в аннотации оригинала
BackgroundConsensus/evidence-based recommendations for assessing, managing, and monitoring bone health, pain, and mobility in patients with multiple myeloma were developed. This study was conducted to assess the adherence of the hematologists-oncologists to the consensus/evidence-based recommendations for assessing, managing, and monitoring bone health, pain…

Cholangiocarcinoma and Gallbladder Cases: An Expert Panel Case-Based Discussion.

Cholangiocarcinoma and gallbladder malignancies are aggressive gastrointestinal malignancies with management dependent on resectability, comorbidities, and location. A multidisciplinary discussion with medical oncologists, radiation oncologists, and surgeons is necessary to determine the optimal treatment approach for each patient. Surgical resection offers the best chance for a long-term cure. Recent studies, such as the phase II SWOG S0809 and the phase III BILCAP study have highlighted the importance of adjuvant treatment with radiation therapy and chemotherapy, respectively, in resected di…

Surgical therapy of bone metastases.

The treatment of patients with cancer epitomizes the importance of using a collaborative team approach to optimize patient care. Physician team members most commonly are radiation oncologists, general surgeons, surgical oncologists, thoracic surgeons, neurosurgeons, and orthopedic surgeons. When patients are receiving chemotherapy, their medical oncologist frequently takes responsibility for coordinating care among the various team members and initiating consultations with necessary providers. When patients develop bone metastases or chemotherapy-induced bone loss (CTIBL), the orthopedic surge…

Mesonephric-like adenocarcinoma of the female genital tract: Pathologic diagnosis, clinical outcomes, and novel therapeutics.

In 2016, McCluggage and colleagues first defined mesonephric-like adenocarcinoma (MLA) of the uterus and extra-uterine sites. Following this initial description, the World Health Organization officially recognized MLA as a type of uterine and ovarian carcinoma and subsequent studies have further refined the morphologic definition, immunohistochemical profile, molecular underpinnings, and clinical behavior in this rare entity. A consortium of pathologists, gynecologic oncologists, medical oncologists, radiation oncologists, as well as basic science collaborators with expertise in MLA was conven…

Multidisciplinary approach of early breast cancer: the biology applied to radiation oncology.

Early breast cancer treatment is based on a multimodality approach with the application of clinical and histological prognostic factors to determine locoregional and systemic treatments. The entire scientific community is strongly involved in the management of this disease: radiologists for screening and early diagnosis, gynecologists, surgical oncologists and radiation oncologists for locoregional treatment, pathologists and biologists for personalized characterization, genetic counselors for BRCA mutation history and medical oncologists for systemic therapies.Recently, new biological tools h…

Rating general practitioner consultation performance in cancer care: does the specialty of assessors matter? A simulated patient study.

BACKGROUND: Patients treated for prostate cancer may present to general practitioners (GPs) for treatment follow up, but may be reticent to … deo recorded and assessed for quality by two sets of assessors- a team of two GPs and two Radiation Oncologists deploying the Leicester Assessment Package (LAP). LAP scores by the GPs and Radiation Oncologists were compared. RESULTS: Eight GPs participated. In Series 1 the range of LAP scores by GP assessors was 61%-80%, and 67%-86% for Radiation Oncologist …

Physician risk perceptions and surveillance practices for tyrosine kinase inhibitor long-term effects in pediatric CML.

Chronic myeloid leukemia (CML) is effectively treated with long-term tyrosine kinase inhibitor (TKI) therapy, yet little is known about risks of prolonged TKI exposure in young patients, and long-term effect monitoring is not standardized. We surveyed North American pediatric oncologists (n = 119) to evaluate perceived risk of and surveillance practices for potential toxicities associated with prolonged TKI exposure in children and adolescents/young adults (AYAs) with CML. Survey domains included general and specific risk perceptions and surveillance practices for asymptomatic patients on chro…

Consideration of Metastasis-Directed Therapy for Patients With Metastatic Colorectal Cancer: Expert Survey and Systematic Review.

BACKGROUND: A survey of medical oncologists (MOs), radiation oncologists (ROs), and surgical oncologists (SOs) who are experts in the management of patients with metastatic colorectal cancer (mCRC) was conducted to identify factors used to consider metastasis-directed therapy (MDT). MATERIALS AND METHODS: An online survey to assess clinical factors when weighing MDT in patients with mCRC was developed based on systematic review of the literature and integrated with clinical vignettes. Supporting evidence from the systematic review was included to aid in answering questions. RESULTS: Among 75…

Optic disc and peripapillary tumors.

This review covers the tumors either originating or seen close to the optic disc in the peripapillary area. Most of the optic disc tumors are diagnosed on clinical examination. In a few atypical cases, ancillary imaging, such as optical coherence tomography, fluorescein angiography, and ultrasonography, may be required to demonstrate characteristic features. The majority of these tumors have systemic associations, and hence, a multidisciplinary approach involving ocular oncologists, neurophysicians, radiation oncologists, and medical oncologists is the need of the hour. The treatment of optic …

A multidisciplinary approach to gastrointestinal bleeding in cancer patients.

Gastrointestinal bleeding remains one of the most challenging areas in medicine today, especially in the patient with cancer. New techniques … are members of a unique group, gastrointestinal bleeding may also require intervention by surgical oncologists, medical oncologists, and radiation oncologists. This review will address the multidisciplinary approach required for the proper diagnosis and management of gastrointestinal bleeding in patients with cancer.

How I treat squamous ENT cancer.

The definition of 'head and neck cancer' (HNC) identifies squamous cell carcinoma arising from the pharynx, the larynx and the oral cavity. Most of them are induced by smoking and alcohol abuse, but tumours arising in the nasopharynx and in the oropharynx may be virus induced, Epstein-Barr virus and human papillomavirus, respectively. Medical oncologists are involved in HNC in locally advanced disease and in relapsed/metastatic disease not suitable for salvage radiotherapy or surgery. A close cooperation with surgeons and in particular with radiation oncologists is required in the first situat…

Electronic monitoring of symptoms and syndromes associated with cancer: methods of a randomized controlled trial SAKK 95/06 E-MOSAIC.

BACKGROUND: In patients with advanced, incurable cancer, anticancer treatment may be used to alleviate cancer-related symptoms, but monitoring of them in daily practice is rarely done. We aim to test the effectiveness of a real-time symptom and syndrome assessment using the E-MOSAIC software installed in handheld computer generating a longitudinal monitoring sheet (LoMoS) provided to the oncologists in a phase III setting. METHODS: In this prospective multicentre cluster randomized phase-III trial patients with any incurable solid tumor and having defined cancer related symptoms, who receive …

Current practice of cancer predisposition testing in pediatric patients with CNS tumors in the United States.

An estimated 8.6% of all pediatric patients with central nervous system tumors (CNSTs) have underlying hereditary cancer predisposition (HCP … s) when assessing pediatric patients with CNSTs for HCP. We received 60 responses from 21 pediatric oncologists, 10 neuro-oncologists, 28 genetics providers, and one neuro-oncologist/geneticist. Results demonstrate genetic counselors, followed by oncologists, most often facilitated consent, ordered testing, and selected which test to order. The most ordered t …

Impact of deep learning model uncertainty on manual corrections to MRI-based auto-segmentation in prostate cancer radiotherapy.

BACKGROUND: Deep learning (DL)-based organ segmentation is increasingly used in radiotherapy. While methods exist to generate voxel-wise uncertainty maps from DL-based auto-segmentation models, these maps are rarely presented to clinicians. PURPOSE: This study aimed to evaluate the impact of DL-generated uncertainty maps on experienced radiation oncologists during the manual correction of DL-based auto-segmentation for prostate radiotherapy. METHODS: Two nnUNet DL models were trained with 10-fold cross-validation on a dataset of 434 patient cases undergoing ultra-hypofractionated MRI-only ra…

The UK's radiotherapy workforce shortage: Reforming regulation to address the gap.

The UK's National Health Service faces an acute cancer workforce deficit across all specialities. The Royal College of Radiologists reports a 17% shortfall in consultant clinical oncologists today, which is projected to reach 26% by 2030. At the same time, cancer incidence is rising, with over half a million new diagnoses in the UK expected annually by 2040, many of whom will need radiotherapy at some point in their care. The UK's dual-trained clinical oncology model, requiring competence in both radiotherapy and systemic therapy, sets it apart from many other countries. Given the increasing c…

Balancing fertility potential and oncologic and obstetric risks: a vignette study on decision-making in fertility-sparing surgery for early-stage cervical cancer.

OBJECTIVE: Fertility-sparing surgery offers the opportunity to preserve fertility but comes with higher oncologic and obstetric risks. This study aims to identify key factors influencing decision-making of women with early-stage cervical cancer. METHODS: We conducted a vignette-based study involving former patients and gynecologic oncologists in the Netherlands. Eligible patients were aged 25-42 years at the time of surgery and underwent radical trachelectomy or radical hysterectomy for early-stage cervical cancer between 2014 and 2024. All Dutch gynecologic oncologists were invited. Four vig…