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Role of Qualified Exercise Professionals in Medical Clearance for Exercise: Alberta Cancer Exercise Hybrid Effectiveness-Implementation Study.

BackgroundCurrent guidelines endorse the integration of exercise into cancer care. The diagnosis of cancer and its treatment, however, may introduce factors that make exercise engagement difficult, especially for individuals with advanced stages of disease. In this paper, we describe the baseline screening and triage process implemented for the Alberta Cancer Exercise (ACE) hybrid effectiveness-implementation study and share findings that highlight the multifaceted complexity of the process and the direct role of the clinical exercise physiologist (CEP).MethodsACE was a hybrid effectiveness-im

Bridging the gap - Establishing a dental-oncology service in a cancer centre.

Dental disease remains the most common non-communicable disease worldwide. It predisposes patients to significant morbidities following bone modifying agents or radiation therapy to the head and neck. Preventative dental regimes effectively reduce the risk of both medication-related osteonecrosis of the jaw (MRONJ) and osteoradionecrosis (ORN) in these patients. Co-ordination of routine dental care as a component of mainstream oncology treatment optimises long term outcomes for oncology patients. This case series offers insights into patient, institutional and social difficulties that challeng

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… For oncologists, the dental-oncology interface is most evident in the conditions of medication-related osteonecrosis of the jaw (MRONJ) and osteoradionecrosis (ORN). These well-recognised conditions have devastating quality of survival implications for patients [ 4 ]. … In the USA, MASCC/ISOO/ASCO Clinical Practice Guideline on Medication-Related Osteonecrosis of the Jaw published in 2019 has also provided clinical guidance for oncologists on best practice to prevent MRONJ in oncology [ 13 ]. …

Cutaneous Skin Toxicities of Oncological Targeted Therapies: Comprehensive Overview of Mechanisms, Management, and Research Gaps-A Narrative Review.

Targeted therapies in oncology have become a mainstay in therapy of numerous types of cancers. They work by targeting and utilizing (activating, inhibiting, or modulating) molecular pathways that are crucial in pathogenesis of certain cancers and can be divided into numerous classes according to their mechanism. However, since the antigens and molecules they target can take part in homeostasis of the skin and the integument, cutaneous toxicities are a common occurrence. The frequency of certain cutaneous adverse events (CAEs) depends on the causal drug and varies even between drugs of the same

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… Oncologist. 2021;26(2):e316–26. 10.1002/onco.13552. 33021006 10.1002/onco.13552 PMC7873330 52. … Treatment of epidermal growth factor receptor antagonist-induced skin rash: results of a survey among German oncologists. Onkologie. 2010;33(3):94–8. 10.1159/000277656. 20215799 10.1159/000277656 72. …

Palliative prognostic scores for survival prediction of cancer patients: a systematic review and meta-analysis.

BACKGROUND: The palliative prognostic score is the most widely validated prognostic tool for cancer survival prediction, with modified versions available. A systematic evaluation of palliative prognostic score tools is lacking. This systematic review and meta-analysis aimed to evaluate the performance and prognostic utility of palliative prognostic score, delirium-palliative prognostic score, and palliative prognostic score without clinician prediction in predicting 30-day survival of cancer patients and to compare their performance. METHODS: Six databases were searched for peer-reviewed stud

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… Comparison of the accuracy and characteristics of the prognostic prediction of survival of identical terminally ill cancer patients by oncologists and palliative care physicians . … Oncologist . 2012 ; 17 ( 3 ): 446 - 454 . doi: 10.1634/theoncologist.2011-0397 22379068 PMC3316931 71 Matsunuma R , Tanbo Y , Asai N , et al Prognostic factors in patients with terminal stage lung cancer . …

Chemotherapy Treatment Modifications During the COVID-19 Outbreak at a Community Cancer Center in New York City.

PurposeAs a result of their immunocompromised status associated with disease and treatment, patients with cancer face a profound threat for higher rates of complications and mortality if they contract the coronavirus disease 2019 infection. Medical oncology communities have developed treatment modifications to balance the risk of contracting the virus with the benefit of improving cancer-related outcomes.MethodsWe systemically examined our community cancer center database to display patterns of change and to unveil factors that have been considered with each decision. We studied a cohort of 28

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… Oncologists had to consider the benefits of continuing or initiating cancer treatment, with many of these being myelosuppressive or immunosuppressive in nature, or both, against the risk of patients contracting the virus and developing severe complications. … The senior author (Y.X.) interviewed each of the five medical oncologists to gather the following information on every patient: cancer type; nature of treatment and status of disease: metastatic, adjuvant or primary treatment; treatment regimen; modification(s) made; who—provider or patient—initiated …

Patterns of Treatment for Metastatic Pathological Fractures of the Spine: The Efficacy of Each Treatment Modality.

BACKGROUND: Metastatic pathological fractures of the spine are a major problem for cancer patients; however, there is no consensus on treatment strategy. The purpose of this study was to evaluate various treatment options by analyzing their patterns for metastatic pathological fractures of the spine. METHODS: In this study, 54 patients (male:female = 36:18) who were diagnosed with metastatic pathological fractures of spine were recruited. Demographic data, origin of cancer, type of treatment, and results were obtained from electronic medical records. Treatment options were divided into radiot

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… Information concerning spinal pathological fractures included related symptoms, initial oncologist consultation at the department, primary treatment methods, and secondary treatment methods. … Various factors such as primary cancer type, preoperative ambulation, or performance status should be considered when deciding on surgical treatment. 7 , 16) In this study, RT was the most common initial treatment used by oncologists. …

A multidisciplinary bone metastases clinic at Toronto Sunnybrook Regional Cancer Centre - A review of the experience from 1999 to 2005.

Our objective in this study was to review the experience of a one-stop multidisciplinary bone metastases clinic (BMC) that offers a coordinated multidisciplinary approach to the care of cancer patients with bone metastases in a tertiary cancer centre. Patients with symptomatic bone metastases were referred to BMC and assessed by a team of specialists in various disciplines - interventional radiology, orthopedic surgery, palliative medicine, and radiation oncology. At initial consultation, patient demographics, reasons for referral, and case disposition were recorded. From January 1999 to Febru

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… Treatment for symptomatic bone metastases often involves multiple care providers including medical and radiation oncologists, pain specialists, surgeons, and other health care professionals. … Patients were assessed by an orthopaedic surgeon, a radiation oncologist and a pain specialist at the consultation. The team then made a joint recommendation based on their assessments. Nursing and radiation therapy support was also provided. …

Effect of healthcare professional-delivered health literacy interventions on patient reported outcomes in cancer patients - a systematic review.

BACKGROUND: Cancer impairs quality of life (QoL) and mental wellbeing and other patient-reported outcomes (PROs). Health literacy (HL) in cancer patients can be an intermediary factor and can improve PROs. For this reason, the aim of this systematic review is to identify HL interventions delivered by healthcare professionals (HCPs) that have an impact on PROs. METHODS: We carried out a comprehensive literature search on 1 December 2023 across nine databases and included studies 1) with HL interventions delivered through HCPs aiming to have an effect on HL, HL-related outcomes, anxiety, depress

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… Anxiety scores could be significantly reduced and knowledge improved by a virtual reality education about radiotherapy led by radiation oncologists [ 45 ]. This virtual reality tool consisted of a visual and audio education about different treatment environments and radiotherapy machines. … Oncologist. 2022;27(8):e650–60. 65. Sato K, Watanabe T, Katsumata N, Sato T, Ohashi Y. Satisfying the needs of Japanese cancer patients: A comparative study of detailed and standard informed consent documents. Clin Trials. 2014;11(1):86–95. 66. …

Quality indicators and patient outcome measures for palliative care in cancer patients: a systematic review.

IntroductionWith the exponential rise in global cancer incidence, the surge in demand for palliative care has outstripped capacity, limiting patients' access to quality and holistic palliative care, especially in low- and middle-income countries. Despite an upturn in research activity, evidence in palliative care remains limited, given its complexity as well as the shortage of standardised quality indicators (QIs) and patient outcome measures (POMs). The objective of this systematic review is to assess the QIs and POMs used to evaluate palliative care service on aggregated and individual level

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… for oncologists was effective. … Blended online learning for oncologists to improve skills in shared decision making about palliative chemotherapy: a pre-posttest evaluation. Support Care Cancer. 2023;31(3):184. doi: 10.1007/s00520-023-07625-6. 58. Zapata CB, Dionne-Odom JN, Harris HA, et al. …

Stereotactic body radiotherapy for treatment of spinal metastasis: A systematic review of the literature.

BACKGROUND: Advances in local and systemic therapies continue to improve overall survival for patients with cancer, increasing the incidence of spine metastases. Up to 15% of patients with solid tumors develop spinal metastases. Spinal metastases can be particularly devastating for quality of life given the potential pain, neurological deficits from spinal cord compression or cauda equina syndrome, spinal instability, and pathological fractures that may result. Stereotactic body radiotherapy (SBRT) with or without adding less invasive surgical techniques for stabilization or separation has gai

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… , radiation oncologists, and neurosurgeons are becoming increasingly necessary as treatment paradigms switch from palliative-based care to a focus on delivering durable symptom management and prevention given improved systemic control and extended survival for patients with metastatic cancer. 6 , 7 Historically … Several frameworks and algorithms have been created to assist oncologists, radiation oncologists, and neurosurgeons in their decision making. …

Venous and Arterial Thromboembolism in Patients With Cancer: JACC: CardioOncology State-of-the-Art Review.

Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, represents a major cause of morbidity and mortality in patients with cancer. Arterial thromboembolism, including myocardial infarction and stroke, is also prevalent. Risk differs in subgroups, with higher rates observed in specific cancers including pancreas, stomach, and multiple myeloma. Thromboprophylaxis is recommended for most patients with active cancer hospitalized for medical illnesses and after major cancer surgery. Outpatient thromboprophylaxis is not routinely recommended, but emerging data suggest

The concept of exceptionality: a legal farce?

How do we decide which treatments should be offered by the National Health Service (NHS) when we cannot afford to fund them all? In the absence of a positive appraisal by the National Institute for Health and Clinical Excellence (NICE), which mandates the provision of a treatment by the NHS, Primary Care Trusts (PCTs) are free to decide whether to provide a particular drug to some, or all, of their population. However, as public bodies, it is a well-established principle of Administrative Law that PCTs are not at liberty to fetter the exercise of their own discretion. They must recognise the p

Second-Class Care: How Immigration Law Transforms Clinical Practice in the Safety Net.

This article examines how U.S. immigration law extends into the health care safety net, enacting medical legal violence that diminishes noncitizens' health chances and transforms clinical practices. Drawing on interviews with health care workers in three U.S. states from 2015 to 2020, I ask how federal citizenship-based exclusions within an already stratified health care system shape the clinical trajectories of noncitizens in safety-net institutions. Focusing specifically on cancer care, I find that increasingly anti-immigrant federal policies often reshape clinical practices toward noncitize

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… “Ethical Challenges: Oncologists’ Role in Immigrant Health Care.” Journal of Oncology Practice 6(5):247–48. Jimenez Anthony. 2021. “The Legal Violence of Care: Navigating the U.S. Health Care System while Undocumented and Illegible.” … The Oncologist 25(7):552–54. Page Kathleen R., Flores-Miller Alejandra. 2021. “Lessons We’ve Learned—COVID-19 and the Undocumented Latinx Community.” New England Journal of Medicine 384(1):5–7. Park Lisa Sun-Hee. 2011. …

Patient Preferences in Targeted Pharmacotherapy for Cancers: A Systematic Review of Discrete Choice Experiments.

BackgroundTargeted pharmacotherapy has been increasingly applied in cancer treatment due to its breakthroughs. However, the unmet needs of cancer patients are still significant, highlighting the urgency to investigate patient preferences. It is unclear how patients deliberate their choices between different aspects of targeted therapy, including cost, efficacy, and adverse events. Since discrete choice experiments (DCEs) have been widely applied to patient preference elicitation, we reviewed DCEs on targeted therapy for different cancers. We also synthesized evidence on the factors influencing

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… Patient, oncologist, and payer preferences for adjuvant endocrine therapy and CDK4/6 inhibitor regimens in early-stage breast cancer: a discrete choice experiment. Patient Prefer Adher. 2021;15:611–623. doi: 10.2147/PPA.S298670. 67. … Patients' and oncologists' preferences for second-line maintenance PARP inhibitor therapy in epithelial ovarian cancer. Future Oncol. 2022;18(4):491–503. doi: 10.2217/fon-2021-0567. Associated Data Supplementary Materials Supplementary file1 (DOCX 66 kb) …

Safety, Precautions, and Modalities in Cancer Rehabilitation: an Updated Review.

Purpose of reviewProviding rehabilitation to patients with cancer can be challenging due to the medical complexity associated with the illness and its treatments. This article provides the reader with a summary of frequently encountered medical conditions in the cancer population and associated safety considerations and precautions. An update on treatment modalities commonly used for symptom management is also presented.Recent findingsCancer and cancer treatments can cause changes in multiple organ systems. Special considerations and precautions are necessary to provide safe and effective reha

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… Ultimately, if the treatment is causing severe impairments, consider discussion with the treating oncologist. … Reliability of the Spinal Instability Neoplastic Score (SINS) among radiation oncologists: an assessment of instability secondary to spinal metastases. Radiat Oncol. 2014;9:69. doi: 10.1186/1748-717X-9-69. 33. …

Basket Trials for Intractable Cancer.

Currently, genomic characterization has become standard of care for tumor types such as non-small cell lung cancer, breast cancer, melanoma, and colorectal cancer. A deep understanding of genomic alterations in different tumor types would help identify potentially actionable genomic changes which occur across a wide variety of tumor types. A basket trial is a new type of clinical trial for which eligibility is based on the presence of a specific genomic alteration, irrespective of histology. Basket trials are phase II screening trials for the off-label use of a targeted drug in patients with t

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… The relative rarity of cancer among younger patients limits the familiarity of oncologists with the diagnostic and therapeutic aspects ( 43 ). For example, STS is a biologically heterogeneous malignancy with more than 50 subtypes. … Oncologist use and perception of large panel next-generation tumor sequencing. Ann Oncol. (2017) 28:2298–304. 10.1093/annonc/mdx294 …

Beyond the rare: a case of pseudomyogenic hemangioendothelioma treated sequentially with everolimus, denosumab, and pazopanib.

Pseudomyogenic hemangioendothelioma is an ultra-rare vascular sarcoma that most commonly affects young adults, with a male predominance. It is diagnosed using a combination of imaging studies, histopathological examinations, and immunohistochemical staining. Surgical excision is the mainstay of treatment for pseudomyogenic hemangioendothelioma, with the goal of achieving a wide local excision and reducing the risk of recurrence. The role of systemic therapies is not well established because of the rarity of pseudomyogenic hemangioendothelioma, uncertainty regarding its response to currently ap

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… DISCUSSION The diagnosis and management of ultra-rare sarcomas are challenging for pathologists, orthopedic surgeons, radiation oncologists, and medical oncologists. ( 8 – 10 ) Pseudomyogenic hemangioendothelioma is an ultra-rare indolent vascular tumor initially described as "pseudomyogenic (fibroma-like … PMC7170657 35 Zhang SL Liang L Ji Y Wang ZM Zhou YH The benefit of everolimus in recurrent/epithelioid angiosarcoma patients: case reports and literature review Oncotarget 2017 8 55 95023 95029 29212287 10.18632/oncotarget.21832 PMC5706933 36 Wan X Helman LJ The biology behind mTOR inhibition in sarcoma Oncologist …

Unstable Pathologic Vertebral Fractures in Multiple Myeloma : Propensity Score Matched Cohort Study between Reconstructive Surgery with Adjuvant Radiotherapy and Radiotherapy Alone.

ObjectiveAlthough radiotherapy (RT) is recommended for multiple myeloma (MM) involving spine, the treatment of choice between reconstructive surgery with RT and RT alone for pathologic vertebral fractures (PVFs) associated with structural instability or neurologic compromises remains controversial. The purpose of this study was to evaluate the clinical efficacies of reconstructive surgery with adjuvant RT for treatment of MM with PVFs by comparing with matched cohorts treated with RT alone.MethodsTwenty-eight patients underwent reconstructive surgery followed by RT between 2008 and 2015 in a s

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… However, decision for reconstructive surgeries was determined via a multidisciplinary approach by a team of orthopedic surgeons, hemato-oncologists, and radiation oncologists. … acid versus pamidronate in the treatment of skeletal metastases in patients with breast cancer or osteolytic lesions of multiple myeloma: a phase III, double-blind, comparative trial Cancer J 7 377 387 2001 11693896 30 Sezer O Myeloma bone disease: recent advances in biology, diagnosis, and treatment Oncologist …

Feasibility of Outpatient Stem Cell Transplantation in Multiple Myeloma and Risk Factors Predictive of Hospital Admission.

High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) remains the standard of care for multiple myeloma (MM) patients. Although outpatient ASCT has been shown to be safe and feasible, the procedure is overall rare with most patients in the US undergoing inpatient ASCT. Furthermore, hospitalization rates for patients that undergo outpatient ASCT remain high. Adequate markers that predict hospitalization during outpatient ASCT are lacking, yet would be of great clinical value to select patients that are suited to outpatient ASCT. In this study we aimed to elucidate diffe

Feasibility Study of Physician Orders for Life-Sustaining Treatment for Patients with Terminal Cancer.

PurposePhysician Orders for Life-Sustaining Treatment (POLST) form is a legal document for terminally ill patients to make medical decisions with physicians near the end-of-life. A multicenter prospective study was conducted to evaluate the feasibility of POLST administration in actual oncological practice.Materials and methodsPatients with terminal cancer, age ≥ 20 years, and capable of communicating were eligible. The primary endpoint was the completion rate of POLST. Data about physicians' or patients' barriers were also collected.ResultsFrom June to December 2017, 336 patients from seven h

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… In Korea, attitudes toward discussion of EOL care or AD may become more favorable according to previous surveys conducted among patients with cancer, their families, oncologists, and the general public [ 5 , 6 ]. … Participants We designed a prospective, multicenter study that included medical oncologists from seven general hospitals. Eligibility criteria were patients aged ≥ 20 years with terminal cancer. …