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Prevalence and Survival Patterns of Patients with Bone Metastasis from Common Cancers in Thailand

  • Phanphaisarn, Areerak;Patumanond, Jayantorn;Settakorn, Jongkolnee;Chaiyawat, Parunya;Klangjorhor, Jeerawan;Pruksakorn, Dumnoensun
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4335-4340
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    • 2016
  • Background: Bone metastasis is a single condition but presents with various patterns and severities. Skeletal-related events (SREs) deteriorate overall performance status and reduce quality of life. However, guidelines for early detection and management are limited. This study includes a survey of the prevalence of bone metastasis in cases with common cancers in Thailand as well as a focus on survival patterns and SREs. Materials and Methods: A retrospective cohort analysis was conducted using a database of the Chiang Mai Cancer Registry and the Musculoskeletal Tumor Registry of the OLARN Center, Chiang Mai University. The prevalence of bone metastasis from each type of primary cancer was noted and time-to-event analysis was performed to estimate cancer survival rates after bone metastasis. Results: There were 29,447 cases of the ten most common cancers in Thailand, accounting for 82.2% of the entire cancer registry entries during the study period. Among those cases, there were 2,263 with bone metastases, accounting for 7.68% of entries. Bone metastasis from lung, liver, breast, cervix and prostate are common in the Thai population, accounting for 83.4% of all positive cases. The median survival time of all was 6 months. Of the bone metastases, 48.9% required therapeutic intervention, including treatment of spinal cord and nerve root compression, pathological fractures, and bone pain. Conclusions: The frequency of the top five types of bone metastasis in Thailand were different from the frequencies in other countries, but corresponded to the relative prevalence of the cancers in Thailand and osteophilic properties of each cancer. The results of this study support the establishment of country specific guidelines for primary cancer identification with skeletal lesions of unknown origin. In addition, further clinical studies of the top five bone metastases should be performed to develop guidelines for optimal patient management during palliative care.

Psychosocial Reaction Patterns to Alopecia in Female Patients with Gynecological Cancer undergoing Chemotherapy

  • Ishida, Kazuko;Ishida, Junko;Kiyoko, Kanda
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.1225-1233
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    • 2015
  • This study aims to clarify the psychosocial reactions of female patients with gynecological cancer undergoing chemotherapy and in the process of suffering from alopecia and to examine their nursing support. The target group comprised female patients who had received two or more cycles of chemotherapy, were suffering from alopecia, and were aged 30-65. Data were collected from semi-structured interviews, conducted from the time the patients were informed by their doctors that they might experience alopecia due to chemotherapy to the time they actually experienced alopecia and until they were able to accept the change. Inductive qualitative analysis was employed to close in on the subjective experiences of the cancer patients. The results showed the existence of six phases in the psychosocial reactions in the process of alopecia: phase one was the reaction after the doctor's explanation; phase two was the reaction when the hair starts to fall out; phase three was the reaction when the hair starts to intensely fall out; phase four was the reaction when the hair has completely fallen out; phase five was the reaction to behavior for coping with alopecia; and phase six was the reaction to change in interpersonal human relationships. The results also made it clear that there are five types of reaction patterns as follows: 1) treatment priority interpersonal relationship maintenance type; 2) alopecia agitated interpersonal relationship maintenance type; 3) alopecia agitated interpersonal relationship reduction type; 4) alopecia denial interpersonal relationship reduction type; and 5) alopecia denial treatment interruption type. It is important to find out which of the five types the patients belong to early during treatment and provide support so that nursing intervention that suits each individual can be practiced. The purpose of this study is to make clear the process in which patients receiving chemotherapy come to accept alopecia and to examine evidence-based nursing care on patients with strong mental distress from alopecia.

Disease Related Stress Experienced by women with Mastectomy : Q Methodology (유방 절제술 후의 질병관련 스트레스 : Q-방법)

  • Kim, Nam-Choi;Kim, Hee-Seung;Yoo, Yang-Sook;Yong, Jin-Sun;Song, Mi-Sun
    • Korean Journal of Women Health Nursing
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    • v.9 no.4
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    • pp.379-389
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    • 2003
  • Purpose: To identify the type of disease-related stress experienced by women who received mastectomy for breast cancer using Q methodology. Method: Q sample included 30 statements obtained from literature and interviews with women with mastectomy. P sample consisted of 22 patients with mastectomy. The data were collected from November to December 2002 and analyzed using QUANL program. Result : Four types of disease-related stress experienced by women with mastectomy were found. Type 1 was manifested for a short duration following surgery and characterized by lowered self-esteem, feelings of emptiness and depression because of impaired body image. Type 2 was characterized by declined physical strength, resulting in frequent fatigue in the daily life and less intimate relationship with spouse. Type 3 was manifested by perfectionists with strong sense of self-pride who received or considered breast reconstruction surgery. Type 4 was reported by those who had long period of post-surgery. This type reported a strong sense of discomfort for wearing an artificial breast but didn't show any intention of trying breast reconstruction surgery. Conclusion: Women with mastectomy were found to experience different type of disease-related distress. Therefore, nurses should assess the type of stress the patient experiences following a mastectomy to provide appropriate nursing care.

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Commonest Cancers in Pakistan - Findings and Histopathological Perspective from a Premier Surgical Pathology Center in Pakistan

  • Ahmad, Zubair;Idrees, Romana;Fatima, Saira;Uddin, Nasir;Ahmed, Arsalan;Minhas, Khurram;Memon, Aisha;Fatima, Syeda Samia;Arif, Muhammad;Hasan, Sheema;Ahmed, Rashida;Pervez, Shahid;Kayani, Naila
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1061-1075
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    • 2016
  • Context: There are no recent authoritative data about incidence and prevalence of various types of cancers in Pakistan. Aim: To determine the frequency of malignant tumors seen in our practice and provide a foundation for building a comprehensive cancer care strategy. Materials and Methods: 10,000 successive cases of solid malignant tumors reported in 2014 were included. All cases had formalin fixed, paraffin embedded specimens available and diagnosis was based on histological examination of H&E stained slides plus ancillary studies at the Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi. The latest WHO classifications were used along with the latest CAP protocols for reporting and the most updated TNM staging. Results: There were 9,492 (94.9%) primary tumors while 508 (5.1%) were metastatic. Some 5,153 (51.5%) were diagnosed in females and 4,847 (48.5%) in males. The commonest malignant tumors in females were breast (32%), esophagus (7%), lymphomas (6.8%), oral cavity (6.7%) and ovary (4.8%), while in males they were oral cavity (13.9%), lymphomas (12.8%), colorectum (7.9%), stomach (6.9%) and esophagus (6.6%). Malignant tumors were most common in the 5th, 6th and 7th decades. About 8% were seen under 20 years of age. Conclusions: Oral cavity and gastrointestinal cancers continue to be extremely common in both genders. Breast and esophageal cancers are prevalent in females. Lung and prostate cancer are less common than in the west. Ovarian cancer was very common but cervix cancer was less so.

The Effects of Foot Reflex Zone Massage on Patients Pain and Sleep Satisfaction Following Mastectomy (발반사 마사지가 유방암 환자의 수술 후 통증과 수면만족도에 미치는 효과)

  • Park, Ji-Won;Yoo, Hye-Ra;Lee, Hong-Suk
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.13 no.1
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    • pp.54-60
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    • 2006
  • This study, a quasi-experimental study using a nonequivalent control group pretest-posttest design. conducted a survey on 30 patients test group and control group of IS patients sampling an adjacent population at random - who are operated on the breast cancer and are in the A University Hospital located in Suwon, to examine into the effects of foot reflex zone massage on their pain and sleep satisfaction through the nursing interventions. It gave them a foot reflex zone massage for the total 30 minutes-basic massage 10 minutes and reflex massage 20 minutes required to alleviate their pain day in day out covering a two-month period from the first of July to the first of September 2004. for the purpose of collecting data. It launched into a two-round foot reflex zone massage at 6 and 24 hours since mastectomy through a direct visit at the hospital room to measure pain intensity, physiological index(pulse and blood pressure) and sleep satisfaction of them. The results are as follows. First, it showed that there is all the difference between pain intensity of test group and that of control group. In result, the first hypothesis, pain of test group. which measure at 6(p=.000) and 24 hours(p=.001) since mastectomies, will be bigger than that of control group, was established. Second, it showed that there is all the difference between physiological index of test group and that of control group. In result. the second hypothesis, pulse(p= .025, p= .002), systolic blood pressure(p= .004, p=.012) and diastolic blood pressure(p=.004. p= .003) of test group, which investigate at 6 and 24 hours since mastectomies, will be bigger than that of control group, was established. Third, it showed that there is a significant difference between sleep satisfaction of test group and that of control group(p=.000). In result, the fourth hypothesis, sleep satisfaction of test group. which examine in the morning after mastectomies, will be bigger than that of control group, was established. In the result. a foot reflex zone massage is seen to be effective in the pain reduction and sleep promotion of patients who are operated on breast cancer, and in providing them with more qualitative care by improving confidence between them and nurses through a physical touch. Also, it can be applied to a clinical examination through an independent nursing intervention.

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Health-related quality of life by oral health behavior and oral health status for the Middle-aged people (중장년층의 구강보건행동과 구강건강상태에 따른 건강관련 삶의 질)

  • Moon, Bo-Ae;Jeong, Sun-Rak;Jang, Jung-Yoo;Kim, Keon-Yeop
    • Journal of Korean society of Dental Hygiene
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    • v.15 no.2
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    • pp.197-204
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    • 2015
  • Objectives: The purpose of this study was to investigate the relation between health-related quality of life and oral health behavior and oral health status, and to provide the basic data for national oral health policy. Methods: The primary data of the 5th National Health Examination and Nutritional Survey(NHANES) in 2012 were used in this study. The subjects were 2,243 middle-aged people(40-59 years old), 827 persons were excluded for missing value or having diseases affecting quality of life(depression, stroke, cardiac infarction, angina, liver cancer, stomach cancer, colon cancer, breast cancer, cervical cancer, lung cancer, thyroid cancer, other cancers, arthritis), and 1,416 data were finally analyzed. Results: In health-related quality of life by subjects' characteristics, there was significant difference in gender, age, education, family income, and employment status(p<0.01) except for current smoking. Oral health behavior didn't have significant relation to health-related quality of life, but better oral health status showed better health-related quality of life(p<0.01). Conclusions: In conclusion, this study suggested that there was close relationship between the oral health status and health-related quality of life in moddle aged people. Therefore, national oral health policy is needed for the oral health promotion with commitment of oral prophylaxis and care programs to the individual and community.

The Effect of the Cancer Genetic Education Program for Nurses (간호사를 위한 종양유전교육 프로그램의 효과)

  • Choi, Kyung-Sook;Jang, Eun-Sil;Jun, Myung-Hee;Jung, Ji-Young;Park, Jung-Ae
    • Asian Oncology Nursing
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    • v.10 no.2
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    • pp.240-246
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    • 2010
  • Purpose: Advancing genetic knowledge for oncology nurses is especially important in Korea because physicians have launched to incorporate genetic risk assessment and genetic testing into their practice. The purpose of this paper was to identify the effect of the first academic cancer genetic risk assessment and counseling course for Korean nurses. Methods: Thirty-five nurses were recruited and educated from June 8 to 14, 2006 in Seoul, Korea. Two measurement tools were used: 'knowledge about the hereditary breast and ovarian cancer (HBOC)' and 'knowledge about the cancer genetics'. Results: Students' score of knowledge about HBOC at pre-education was $12.22{\pm}2.23$ and after education, it increased to $13.62{\pm}1.76$. This change was statistically significant (t=-3.253, p=.003). The score of knowledge about cancer genetics at pre-education was $11.31{\pm}3.44$, and after education it has increased to $16.17{\pm}1.94$. It also was statistically significant (t=-6.92, p=.000). Conclusion: This program was effective to be a starting point for establishing genetic educational planning for the oncology nurses in Korea. This academically-based course is recognized as valuable by oncology nurses. With this new knowledge, nurses can begin to expand their role in delivering comprehensive cancer care services in Korea.

The Changes of Quality of Life in Cancer Patients Treated with Chemotherapy (화학치료를 받는 암 환자 '삶의 질'의 변화에 관한 연구)

  • Kim, Byung-Soo;Choi, In-Keun;Park, Kyeung-Hwa;Yoon, So-Young;Oh, Sang-Chul;Seo, Jae-Hong;Choi, Chul-Won;Shin, Sang-Won;Kim, Yeul-Hong;Kim, Jun-Suk
    • Journal of Hospice and Palliative Care
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    • v.4 no.2
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    • pp.130-136
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    • 2001
  • Purpose : It is very important to endow the cancer patients underwent chemotherapy with satisfactory quality of life (QOL). However, little is known about the factors influencing QOL during chemotherapy. Therefore, we designed this study to find out the factors influencing QOL in the cancer patients who underwent chemotherapy. Methods : Ninety-seven cancer patients were studied, prospectively. The patients' characteristics were as follows; median age(range): 48(19{\sim}83) years, male:female; 57:40, PS:0,1/2,3;55/42 patients, diagnosis(number): lymphoma (28), lung cancer (22), gastrointestinal cancer (18), sarcoma (12), breast cancer (12), gynecological cancer (5), Stage: I,II/III.IV;37/60 patients. We used EORTC QLQ-C30 questionnaires to evaluate QOL. EORTC QLQ-C30 scores were performed before the onset of chemotherapy and after the end of 3 cycles of chemotherapy. The correlation of these scores with performance status (PS), diagnosis, disease stage, response to chemotherapy, and regimen related toxicity was evaluated. Results : The responder group (CR, PR) demonstrated marked improvement of social functional and emotional scales to non-responder group (SD,PD) (P=0.024, 0.045). Non-hematologic regimen related toxicity such as mucositis, nausea and vomiting was significantly correlated with pain scale change (P=0.043). Other factors had no notable correlation with QOL changes. Conclusion : Our preliminary study results may suggest as follows. The response to chemotherapy is associated with the change of social functional and emotional scales and the severity of non-hematologic regimen related toxicity is associated with pain scale change.

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Radiation-induced Pulmonary Toxicity following Adjuvant Radiotherapy for Breast Cancer (유방암 환자에서 보조적 방사선치료 후의 폐 손상)

  • Moon, Sung-Ho;Kim, Tae-Jung;Eom, Keun-Young;Kim, Jee-Hyun;Kim, Sung-Won;Kim, Jae-Sung;Kim, In-Ah
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.109-117
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    • 2007
  • [ $\underline{Purpose}$ ]: To evaluate the incidences and potential predictive factors for symptomatic radiation pneumonitis (SRP) and radiographic pulmonary toxicity (RPT) following adjuvant radiotherapy (RT) for patients with breast cancer. A particular focus was made to correlate RPT with the dose volume histogram (DVH) parameters based on three-dimensional RT planning (3D-RTP) data. $\underline{Materials\;and\;Methods}$: From September 2003 through February 2006, 171 patients with breast cancer were treated with adjuvant RT following breast surgery. A radiation dose of 50.4 Gy was delivered with tangential photon fields on the whole breast or chest wall. A single anterior oblique photon field for supraclavicular (SCL) nodes was added if indicated. Serial follow-up chest radiographs were reviewed by a chest radiologist. Radiation Therapy Oncology Group (RTOG) toxicity criteria were used for grading SRP and a modified World Health Organization (WHO) grading system was used to evaluate RPT. The overall percentage of the ipsilateral lung volume that received ${\geq}15\;Gy\;(V_{15}),\;20\;Gy\;(V_{20})$, and $30\;Gy\;(V_{30})$ and the mean lung dose (MLD) were calculated. We divided the ipsilateral lung into two territories, and defined separate DVH parameters, i.e., $V_{15\;TNGT},\;V_{20\;TNGT},\;V_{30\;TNGT},\;MLD_{TNGT}$, and $V_{15\;SCL},\;V_{20\;SCL},\;V_{30SCL},\;MLD_{SCL}$ to assess the relationship between these parameters and RPT. $\underline{Results}$: Four patients (2.1%) developed SRP (three with grade 3 and one with grade 2, respectively). There was no significant association of SRP with clinical parameters such as, age, pre-existing lung disease, smoking, chemotherapy, hormonal therapy and regional RT. When 137 patients treated with 3D-RTP were evaluated, 13.9% developed RPT in the tangent (TNGT) territory and 49.2% of 59 patients with regional RT developed RPT in the SCL territory. Regional RT (p<0.001) and age (p=0.039) was significantly correlated with RPT. All DVH parameters except for $V_{15\;TNGT}$ showed a significant correlation with RPT (p<0.05). $MLD_{TNGT}$ was a better predictor for RPT for the TNGT territory than $V_{15\;SCL}$ for the SCL territory. $\underline{Conclusion}$: The incidence of SRP was acceptable with the RT technique that was used. Age and regional RT were significant factors to predict RPT. The DVH parameter was good predictor for RPT for the SCL territory while $MLD_{TNGT}$ was a better predictor for RPT for the TNGT territory.

Screening for in vitro Cytotoxic Activity of Seaweed, Sargassum sp. Against Hep-2 and MCF-7 Cancer Cell Lines

  • Mary, J. Stella;Vinotha, P.;Pradeep, Andrew M.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6073-6076
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    • 2012
  • Discovery of anticancer drugs that kill or disable tumor cells in the presence of normal cells without undue toxicity is a potential challenge for therapeutic care. Several papers in the literature have emphasized the potential implications of marine products such as seaweeds which exhibit antitumor activity. Study attempts to screen the antitumor effect of Sargassum sp, against chosen cell lines such as MCF-7 (Breast cancer) and Hep-2 (Liver Cancer). Ethanol extract of Sargassum sp. was concentrated using a Soxhlet apparatus and dissolved in DMSO. In vitro cytotoxic activity of Sargassum sp at various concentrations ($100{\mu}g/ml-300{\mu}g/ml$) screened for antitumor effect against the chosen cell lines using MTT assay (3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide, a yellow tetrazole). The study documented that the percentage of cell viability has been reduced with increased concentration, as evidenced by cell death. Sargassum sp extract shows potential cytotoxic activity ($P{\leq}0.05$) with $IC_{50}$ of $200{\mu}g/ml$ and $250{\mu}g/ml$ against Hep-2 and MCF-7 cell lines respectively. The ethanol fraction of Sargassum sp induced cell shrinkage, cell membrane blebbing and formation of apoptotic bodies with evidence of bioactive components as profound influencing factors for anti-tumor effects. Further research need to be explored for the successful application of Sargassum sp as a potent therapeutic tool against cancer.