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Prevalence and characterization of breakthrough pain in patients with cancer in Spain: the CARPE-DIO study.

We aimed to evaluate the prevalence, characteristics and impact of breakthrough pain (BTP) in patients with cancer attending the main specialties involved in the diagnosis and management of BTP in Spain using a multicenter, observational, cross-sectional, multidisciplinary study. Investigators had to record all patients seen at the clinic during 1 month, determine whether the patients had cancer pain, and apply the Davies algorithm to ascertain whether the patients were suffering from BTP. Of the 3,765 patients with cancer, 1,117 (30%) had cancer-related pain, and of these patients, 539 had BT

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… the medical oncologist 17 . … Thus, in a recent study conducted by 108 medical oncologists, Camps et al . reported a prevalence of 91% of BTP using the Davies algorithm 17 . …

Assessment of Bone Health Education in US Multiple Myeloma and Solid Tumor Patients at Risk for Skeletal-Related Events.

PURPOSE: Cancer patients with bone metastasis (BM) from solid tumors or multiple myeloma (MM) have an increased risk of painful skeletal-related events (SREs), which can decrease quality of life and increase mortality. Bone targeting agents (BTAs) can help delay or prevent SREs; however, a significant portion of eligible patients are not receiving BTA therapy. This study was conducted to understand patient awareness of cancer-related bone health and to identify opportunities to improve bone health education in cancer patients at risk of SREs. METHODS: The online BonE heAlth eduCatiOn Needs as

Impact and Diagnostic Gaps of Comprehensive Genomic Profiling in Real-World Clinical Practice.

Purposenext-generation sequencing based comprehensive genomic profiling (CGP) is becoming common practice. Although numerous studies have shown its feasibility to identify actionable genomic alterations in most patients, its clinical impact as part of routine management across all cancers in the community remains unknown.Methodswe conducted a retrospective study of all patients that underwent CGP as part of routine cancer management from January 2013 to June 2017 at an academic community-based NCI-designated cancer center. CGP was done in addition to established first tier reflex molecular tes

Epidemiology, Pathophysiology, and Management of Cancer-Associated Ischemic Stroke.

Cancer and stroke are leading causes of global disability and mortality. With improvements in cancer-associated mortality and advancements in treatment of active malignancy, it is more common to encounter patients with ischemic stroke and active malignancy. Evidence suggests that cancer-associated ischemic stroke is a unique subtype of stroke; however, there is limited guidance when considering diagnostic workup, secondary prevention, rehabilitation, and future directions within this population. In this narrative review, we aim to describe the epidemiology, pathophysiological mechanisms, manag

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… Several unique risk factors as well as treatment considerations exist when treating patients with active cancer that create challenges for neurologists and oncologists when treating this subgroup of patients. … Multiple pathophysiological mechanisms exist within this population that increase the risk of stroke and present unique challenges for neurologists and oncologists. …

Surviving Cancer, Lacking Support: The Hidden Burden of Modern Radiation Oncology in the Treatment of Oligometastatic Disease.

The management of oligometastatic disease has undergone a significant paradigm shift over the past two decades. Once considered uniformly incurable, selected patients with metastatic disease can now achieve prolonged progression-free survival, durable disease control, and, in carefully selected cases, long-term remission or cure through metastasis-directed therapies. Advances in stereotactic ablative radiotherapy (SABR), surgery, systemic therapies, and the emerging concept of Curative Oligometastatic Radiotherapy (CORT) have challenged the traditional distinction between curative and palliati

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… The growing use of SABR positions radiation oncologists as key figures in this oncological area [ 29 ]. … Follow-up may variably fall to the treating radiation oncologist, medical oncologist, supportive oncology team, primary care physician, or combinations thereof, often resulting in fragmented care and unmet supportive needs. …

The Extent of Engagement With Telehealth Approaches by Patients With Advanced Cancer: Systematic Review.

BackgroundTelehealth approaches are increasingly being used to support patients with advanced diseases, including cancer. Evidence suggests that telehealth is acceptable to most patients; however, the extent of and factors influencing patient engagement remain unclear.ObjectiveThe aim of this review is to characterize the extent of engagement with telehealth interventions in patients with advanced, incurable cancer reported in the international literature.MethodsThis systematic review was registered with PROSPERO (International Prospective Register of Systematic Reviews) and is reported in lin

Mobile Application to Promote Adherence to Oral Chemotherapy and Symptom Management: A Protocol for Design and Development.

BackgroundOral chemotherapy is increasingly used in place of traditional intravenous chemotherapy to treat patients with cancer. While oral chemotherapy includes benefits such as ease of administration, convenience, and minimization of invasive infusions, patients receive less oversight, support, and symptom monitoring from clinicians. Additionally, adherence is a well-documented challenge for patients with cancer prescribed oral chemotherapy regimens. With the ever-growing presence of smartphones and potential for efficacious behavioral intervention technology, we created a mobile health inte

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… The study team then sends these reports via secure email to users’ medical oncologists and oncology nurse practitioners. … We sent symptom reports to oncologists by HIPAA-compliant email instead. Thus, we cannot guarantee that oncologists open the symptom report emails that we send them. …

Risk assessment and prevention of cancer-associated venous thromboembolism in ambulatory patients with solid malignancies.

Venous thromboembolism remains a major cause of morbidity and mortality among ambulatory cancer patients, necessitating effective risk assessment and prevention strategies. Despite the availability of risk assessment models and guidelines recommending primary thromboprophylaxis with low-molecular-weight heparins or direct oral anticoagulants, the application of these strategies is inconsistent. This review provides an overview of the current state-of-the-art venous thromboembolism risk assessment and thromboprophylaxis in ambulatory patients with cancer, focusing on existing risk assessment mo

Methods for measuring financial toxicity after cancer diagnosis and treatment: a systematic review and its implications.

Patients experiencing financial distress as a side-effect of cancer are not only reported in the United States, but also in third-party payer healthcare systems in Europe. Since validated survey instruments are a prerequisite for robust and comparable results, we aimed to compile and classify available instruments to enable both a better understanding of the underlying construct of financial toxicity and to facilitate further studies that are adjustable to various healthcare systems. We did a systematic literature search on studies that provide data on perceived cancer-related financial distre

Practical guidance for the management of inflammatory bowel disease in patients with cancer. Which treatment?

Clinicians involved in the treatment of inflammatory bowel disease (IBD) increasingly come across patients with current or previous history of malignancies. With increasing and earlier use of immunosuppression and biologics in IBD patients, the question arises whether these treatments further increase the risk of new or recurrent cancers. A number of population-based observational studies have now reported the odds of development of new or recurrent cancers with thiopurines and antitumour necrosis factors (anti-TNFs). These data combined with data arising from treatment registries from other i

Research in haematological cancers: What do patients in the Netherlands prioritise?

IntroductionThe experiential knowledge of patients can provide research communities with complementary perspectives on disease. The aim of this study was to identify and prioritise everyday problems and research needs of haematological cancer patients and people who have undergone a stem cell transplantation.MethodsA mixed-method participatory research approach (the Dialogue Model) was applied, including interviews (n = 19), four focus group discussions (n = 27), a questionnaire (n = 146) and a stakeholder dialogue meeting (n = 30) with patients in the Netherlands.ResultsPatients' physical dis

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… Ignorance and a lack of empathy of haematological oncologists are frequently mentioned. … The Oncologist, 5(5), 353–360. 10.1634/theoncologist.5-5-353 Efficace, F. , Cocks, K. , Breccia, M. , Sprangers, M. , Meyers, C. A. , Vignetti, M. , … Mandelli, F. (2012). …

Ethical considerations for hematologic precursor conditions.

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… A survey of patients and oncologists 7 compared attitudes toward disclosure of genomic tumor testing results of uncertain actionability: 74.6% of patients were interested in receiving results, yet only 23.6% of clinicians would choose to share them. … Jacobson 12 illustrated this dilemma in the context of medical oncology through his essay “The Oncologist’s Wager.” When a patient has no evidence of disease after surgery, adjuvant therapy is often pursued to reduce risk of recurrence. …

Prolonged recovery time from zoledronic Acid induced acute tubular necrosis: a case report and review of the literature.

Acute tubular necrosis (ATN) due to bisphosphonates has been reported with Zoledronic acid but the time to recovery (if any) has been usually less than 4 months. Possible recovery time from ATN of any cause is usually less than 6 months. In this paper, we present the case of a 59-year-old Caucasian female with metastatic breast cancer who had received 16 monthly injections of Zoledronic acid for treatment of tumor induced hypercalcemia and developed several episodes of mild acute kidney injury which resolved by withholding treatment. Unfortunately, after the sixteenth injection, the patient ex

Shared-Care in Complex Malignant Hematology: An Integrative Review Using the RE-AIM Evaluation Framework.

Complex malignant hematology (CMH) shared-care programs have been established to support patients with access to care closer to home. This integrative review examined what is known about CMH shared-care using the RE-AIM evaluation framework. We searched five electronic databases for articles published until 16 January 2024. Articles were included if they were qualitative or quantitative studies, reviews or discussion papers, and reported on an experience with shared-care (defined as a reciprocal, ongoing patient-sharing relationship between a specialist centre and community hospital) for patie

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… Community hospital staff were described as either hematologists/oncologists or community oncologists, or those with experience in managing cytopenias, chemotherapy administration, and central venous catheter care [ 9 , 18 , 21 , 23 , 24 , 25 , 26 ]. … Association between geographic access to cancer care, insurance, and receipt of chemotherapy: Geographic distribution of oncologists and travel distance. J. Clin. Oncol. 2015;33:3177–3185. doi: 10.1200/JCO.2015.61.1558. 6. Ontario Health Ontario Cancer Statistics. 2022. …

Qualitative analysis of cancer care experiences among rural cancer survivors and caregivers.

PurposeRural (vs urban) patients experience poorer cancer outcomes and are less likely to be engaged in cancer prevention, such as screening. As part of a community needs assessment, we explored rural cancer survivors' and caregivers' experiences, perceptions, and attitudes toward cancer care services.MethodsWe conducted 3 focus groups (N = 20) in Spring 2021 in rural Nebraska.FindingsThree patterns of cancer diagnosis were regular care/screening without noticeable symptoms, treatment for symptoms not initially identified as cancer related, and symptom self-identification. Most participants, r

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… BACKGROUND In the United States, rural residents have less access to specialized health care compared to their urban counterparts. 1 , 2 , 3 The rural health care system is spread out and has fewer specialists, including oncologists, radiologists, pathologists, surgeons, and radiation oncologists. 3 … Other participants noted the difficulty of rural cancer centers retaining specialists, referring to the turn‐over as “radiation oncologist of the month.” …

Bridging the gap: a pre-post feasibility study of embedding exercise therapy into a co-located cancer unit.

PurposeTo establish the feasibility of embedding a flexible, exercise-based rehabilitation program into a cancer treatment unit to allow cancer survivors early exercise support.MethodA pre-post study was conducted using Bowen's Framework to describe key domains of feasibility: demand (referrals), acceptability (uptake, attendance, satisfaction), implementation (resources), practicality (adverse events, costs) and limited-efficacy (function, quality of life, self-efficacy). Participants were medically stable, adult cancer survivors receiving curative or palliative treatment for cancer at the he

Bladder preservation in non-metastatic muscle-invasive bladder cancer (MIBC): a single-institution experience.

The aim of this study is to access the feasibility, toxicity profile, and tumour outcome of an organ preservation curative approach in non-metastatic muscle-invasive bladder cancer. A retrospective analysis was conducted on patients affected by M0 bladder cancer, who refused cystectomy and were treated with a curative approach. The standard bladder preservation scheme included maximal transurethral resection of bladder tumour (TURBT) and combination of radiotherapy and platin-based chemotherapy, followed by endoscopic evaluation, urine cytology, and instrumental evaluation. Thirteen patients f

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… and Radiation Oncologists becomes of extreme importance, in order to reach an optimal multidisciplinary approach. … Urinary bladder preservation for muscle invasive bladder cancer: a survey among radiation oncologists of Lombardy, Italy. Tumori. 2015;101:174–8. doi: 10.5301/tj.5000235. 16. …

Challenges in the integration of palliative care for patients with hematologic malignancies: an analysis of the surprise question in a prospective cohort study.

BackgroundThe Surprise Question (SQ), "Would I be surprised if this patient were to die in the next 12 months?", identifies patients at high risk of death who might benefit from palliative care (PC). However, little is known about its application in oncohematology.ObjectivesTo evaluate the performance of the SQ among inpatients with hematologic malignancies.Design and settingA prospective cohort study was conducted between September and December 2021, including patients admitted to the Hematology Ward of the University Hospital in Salvador, Brazil.MethodsPhysicians answered the SQ (not surpris

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… Gerlach et al. 23 reported that hematologic oncologists considered the SQ a valuable tool for stimulating reflection and promoting patient-centered care, facilitating an understanding of the finiteness of life. … Odejide OO Cronin AM Condron N Timeliness of end-of-life discussions for blood cancers: a national survey of hematologic oncologists JAMA Intern Med 2016 176 2 263 5 10.1001/jamainternmed.2015.6599 26720644 22. …

Management of skeletal metastases: An orthopaedic surgeon's guide.

Skeletal metastasis is a common cause of severe morbidity, reduction in quality of life (QOL) and often early mortality. Its prevalence is rising due to a higher rate of diagnosis, better systemic treatment, longer lives with the disease and higher disease burden rate. As people with cancer live longer and with rising sensitivity of body imaging and surveillance, the incidence of pathological fracture, metastatic epidural cord compression is rising and constitutes a challenge for the orthopedic surgeon to maintain their QOL. Metastatic disease is no longer a death sentence condemning patients

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… Management of skeletal metastases is no longer a simple task of fixing a fracture, but involves a multidisciplinary coordination between medical oncologists, radiation oncologists and the surgeon. … A discussion with the multidisciplinary team which includes at least a medical oncologist and radiation oncologist and preferably also an interventional radiologist is required to make the final treatment decision. …

Factors affecting pretransplant muscle strength in allogeneic stem cell transplant candidates prior transplantation.

PurposePhysical performance is crucial for prognosis after allogeneic hematopoietic stem cell transplantation (allo-HCT). Cardiorespiratory fitness has already been shown to have prognostic value, and there is increasing evidence that muscle strength and associated parameters (e.g., sarcopenia) are also of clinical relevance. Therefore, there is a need for the quantification of muscle strength and defining risk factors for reduced performance values.MethodsMaximal voluntary isokinetic (MVIC) and isometric (MIPT) muscle strength was assessed 2.4 ± 7.1 days prior admission for allo-HCT with a st