• Asian Pacific Journal of Cancer Prevention
• /
• 제13권7호
• /
• pp.3061-3064
• /
• 2012

Aim: An epidemiological shift has resulted in increase in the prevalence of non-communicable diseases (NCD). Unlike other NCDs which are easily and definitely preventable, the knowledge of cancer prevention is still limited at present. Various aetiological factors are difficult to control since those are habit forming. Hence an available remedy remains its secondary and tertiary prevention for which appropriate planning is of paramount importance. Evidence based planning requires careful analysis of data with a view to prioritize various cancers. Keeping in view the fact that the adaptation of smoking free status in Chandigarh city might have a far reaching positive effect on the cancer related morbidity of the people, the following study was undertaken to provide base line data to be used for future comparisons. Methods: The registers maintained in the Department of Radiotherapy were checked and those belonging to the years 1999 to 2009 were utilized to analyze the cancer morbidity in respect to age, sex, and year of presentation to health care facility. Results: A total of 4,600 cancer patients (males=2276, females=2324) demonstrated a gradual increase in the number of cancer cases from 150 in the year 1999 to 783 in the year 2009. The most common cancers amongst males were cancer of gastro-intestinal tract (GIT) and lung (including larynx) constituting 37.3% and 27.1% of the total, respectively. In females these were cancers of breast and cervix representing 33.3% & 17.6% of total cancer cases, respectively, and lung cancer constituted 5.3%. The maximum cases of bone cancer (53.8% of all bone cancers) were observed amongst children aged less than 20 years and lung cancer (48.2% of all lung cancers) among the elderly aged 60-69 years. The.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권sup3호
• /
• pp.101-105
• /
• 2016

The number of deaths is often measured to monitor the population health status and priority of health problems. However, number of years of life lost (YLL) is a more appropriate indicator in some cases. We have calculated the YLL of adult cancers and its trend over the past few years in Yazd to provide planners with baseline data. Data obtained from death registration system were used to calculate the YLL, based on each individual's age at death, and the standardized expected YLL method was applied with a discount rate of 0.03, an age weight of 0.04, and a correction factor of 0.165. All data were analyzed and prepared in Epi6 and Excel 2007. A total of 3,850 death records were analyzed. Some 550 patients in Yazd province aged ${\geq}20$ die annually due to cancer (male: female ratio 1.3). The average ages at death in lung, CNS, breast cancer and leukemia cases were 68.5, 59, 58.7 and 61, respectively. The age group of 40-59 with 21 % had the highest cancer mortality percentage. Premature cancer deaths have caused 40,753 YLL (5,823 YLL annually). Females lose on average more life years to cancer than do men (11.6 vs 9.8 years). Lung cancer (12.1%), CNS tumors (11.7%) and leukemia (11.4 %) were the leading causes terms of YLL due to all cancers in both sexes. From 2004 to 2010, cancer-caused YLL as a fraction of all YLL increased from 12.8 to 15.2 %. This study can help in the assessment of health care needs and prioritization. Cancer is the major cause of deaths and the trend is increasing. The use of YLLs is a better index for measurement of premature mortality for ranking of diseases than is death counts. Longer periods of observation will make these trends more robust and will help to evaluate and develop, better public health interventions.

• 한국병원경영학회지
• /
• 제12권3호
• /
• pp.1-19
• /
• 2007

This study focused on finding the variation of medical service utilization and medical payments of the patients died by three, cancers, stomach, breast, and colon cancer. For this study, data of the one-year episodes of the health insurance subscribers died in 2004 were selected. The frequency of medical visits, the lengths of slays, the days of outpatient visits, the total period of medical services and the total medical payments were compared by the characteristics of the suppliers and utilizers. The data of the patients died by cerebrovascular diseases and cancer in 2004 were selected. To select the dead by cerebrovascular diseases and cancer in 2004, were matched the 2004 reimbursement data of all medical institutions to the data of funeral fee payment by the National Health Insurance Corporation from January 2004 to May 2005 for the death in 2004. The results of the analysis were as follow. The variation of medical service utilization of the dead by cancers were not small in Korea. The current study found that the variation of medical care utilization was influenced by the factors of suppliers, such as types and locations of medical institutions and the factors of users, such as sex and age. It was suspected that the reimbursement by fee-for-service contributed to the variation quite a lot, but we could not compare the variation between the different reimbursement systems in Korea. The results of the study suggested that tile factors of suppliers and utilizers should he reviewed to reduce the under use and over use expressed by variations of medical service utilization. The processes of care, effective communication and management system should be investigated for the equity of medical service utilization. Additionally, prospective payment could he recommended to reduce the high variation of medical service Use. To find the variation caused by under use and over use, further study need to control the severity of diseases, socio-economic status of the users and the system factors.

• Journal of Microbiology and Biotechnology
• /
• 제28권9호
• /
• pp.1563-1572
• /
• 2018

Gold nanoparticles (AuNP) and their conjugates have been gaining a great deal of recognition in the medical field. Meanwhile, extended-spectrum ${\beta}$-lactamases (ESBL)-producing bacteria are also demonstrating a challenging problem for health care. The aim of this study was the biosynthesis of AuNP using Rosa damascenes petal extract and conjugation of ceftriaxone antibiotic (Cef-AuNP) in inhibiting ESBL-producing bacteria and study of in vitro anticancer activity. Characterization of the synthesized AuNP and Cef-AuNP was studied. ESBL-producing strains, Acinetobacter baumannii ACI1 and Pseudomonas aeruginosa PSE4 were used for testing the efficacy of Cef-AuNP. The cells of MCF-7 breast cancer were treated with previous AuNP and Cef-AuNP at different time intervals. Cytotoxicity effects of apoptosis and its molecular mechanism were evaluated. Ultraviolet-visible spectroscopy and Fourier transform infrared spectroscopy established the formation of AuNP and Cef-AuNP. Transmission electron microscope demonstrated that the formed nanoparticles were of different shapes with sizes of 15~35 nm and conjugation was established by a slight increase in size. Minimum inhibitory concentration (MIC) values of Cef-AuNP against tested strains were obtained as 3.6 and $4{\mu}g/ml$, respectively. Cef-AuNP demonstrated a decrease in the MIC of ceftriaxone down to more than 27 folds on the studied strains. The biosynthesized AuNP displayed apoptotic and time-dependent cytotoxic effects in the cells of MCF-7 at a concentration of $0.1{\mu}g/ml$ medium. The Cef-AuNP have low significant effects on MCF-7 cells. These results enhance the conjugating utility in old unresponsive ceftriaxone with AuNP to restore its efficiency against otherwise resistant bacterial pathogens. Additionally, AuNP may be used as an alternative chemotherapeutic treatment of MCF-7 cancer cells.

• 대한간호학회지
• /
• 제41권2호
• /
• pp.225-235
• /
• 2011

Purpose: To describe psychosocial adjustment of low-income Koreans who have cancer. Methods: Data were collected during 2008 using individual in-depth interviews with 18 Korean people with cancer. The income status of the participants was low, 11 were recipients of the National Basic Livelihood Protection program. Mean age was 58.3 yr and 11 were female. Five participants had stomach cancer, five, colorectal cancer, and four, breast cancer. Data were analyzed using grounded theory methodology. Results: The core category emerged as 'bearing up alone with double suffering'. 'Poverty and cancer: A double suffering' emerged as a causal condition. The adjustment process consisted of three stages: 'forming a treatment will to live', 'practicing for the cure', and 'restructuring self and repaying favors'. Each stage indicated action-interaction strategies which were employed to bear up alone with double suffering during the illness process. Self-reflection, parental responsibility, and support from the public sector played important roles in overcoming the double suffering. Two types of consequences were identified: Transcended life and strained life suppressed by poverty and cancer. Conclusion: The results provide insights into the psychosocial adjustment process for low income Korean with cancer and can be used in developing and implementing efficient home-care services for these people.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권sup3호
• /
• pp.201-204
• /
• 2016

This study aimed to quantify associations of the human development inequality (HDI) index with incidence, mortality, and mortality to incidence ratios for eight common cancers among different countries. In this ecological study, data about incidence and mortality rates of cancers was obtained from the Global Cancer Project for 169 countries. HDI indices for the same countries was obtained from the United Nations Development Program (UNDP) database. The concentration index was defined as the covariance between cumulative percentage of cancer indicators (incidence, mortality and mortality to incidence ratio) and the cumulative percentage of economic indicators (country economic rank). Results indicated that incidences of cancers of liver, cervix and esophagus were mainly concentrated in countries with a low HDI index while cancers of lung, breast, colorectum, prostate and stomach were concentrated mainly in countries with a high HDI index. The same pattern was observed for mortality from cancer except for prostate cancer that was more concentrated in countries with a low HDI index. Higher MIRs for all cancers were more concentrated in countries with a low HDI index. It was concluded that patterns of cancer occurrence correlate with care disparities at the country level.

• Journal of Gastric Cancer
• /
• 제23권1호
• /
• pp.224-249
• /
• 2023

Gastric cancer is heterogeneous in morphology, biology, genomics, and treatment response. Alterations in human epidermal growth factor receptor 2 (HER2) overexpression, microsatellite instability (MSI) status, programmed death-ligand 1 (PD-L1) levels, and fibroblast growth factor receptor 2 (FGFR2) can be used as biomarkers. Since the combination of fluoropyrimidine/platinum plus trastuzumab that was investigated in the ToGA trial was approved as a standard of care in HER2-positive patients in 2010, no other agents showed efficacy in the first- (HELOISE, LOGiC, JACOB trials) and second- (TyTAN, GATSBY, T-ACT trials) line treatments. Despite the success in treating breast cancer, various anti-HER2 agents, including a monoclonal antibody (pertuzumab), an antibody-drug conjugate (ADC; trastuzumab emtansine [T-DM1]), and a small molecule (lapatinib) failed to translate into clinical benefits until the KEYNOTE-811 (first-line) and DESTINY-Gastri01 (≥second-line) trials were conducted. The incorporation of HER2-directed treatment with immune checkpoint inhibitors in the form of a monoclonal antibody or ADC is now approved as a standard treatment. Despite the promising results of new agents (engineered monoclonal antibodies, bi-specific antibodies, fusion proteins, and small molecules) in the early phase of development, the management of HER2-positive gastric cancer requires further optimization to achieve precision medicine with a chemotherapeutic backbone. Treatment resistance is a complex process that can be overcome using a combination of chemotherapy, targeted agents, and immune checkpoint inhibitors, including novel agents. HER2 status must be reassessed in patients undergoing anti-HER2 treatment with disease progression after the first-line treatment. As a general guideline, patients who need systemic treatment should receive chemotherapy plus targeted agents, anti-angiogenic agents, immune checkpoint inhibitors, or their combinations.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권3호
• /
• pp.1225-1233
• /
• 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.

• Radiation Oncology Journal
• /
• 제22권3호
• /
• pp.192-199
• /
• 2004

목적: 유방암에 대한 방사선치료의 적정성과 안전성을 보장하고 궁극적으로 치료 효과를 향상시키기 위한 방사선치료 기술 표준화를 위하여 우리나라 전국의 병원을 대상으로 하는 치료 형태 조사연구(Patterns of Care Study)를 계획하였다. 그 첫 단계로 유방보존적 수술 후 시행한 방사선치료 방법에 대하여 조사하고 분석 하였다. 대상 및 방법: 조사하고자 하는 입력 문항을 개발하였고 동시에 인터넷을 통하여 조사자가 직접 입력할 수 있도록 Web 기반 입력 프로그램(www.pcs.re.kr)을 개발하였다. 대상 환자들은 1998년도와 1999년도에 유방보 존술 후 방사선치료를 받은 환자로 전수 조사를 하지 않고 표본 추출하여 조사하였다. 입력 문항은 127개로 병력과 이학적 소견, 수술 소견과 병리 소견, 항암화학요법, 호르몬요법, 방사선치료계획, 방사선치료, 치료 중 부작용, 치료 효과, 합병증, 미용 효과 등 10군으로 나누어져 있다. 15개 병원에서 입력된 261명의 데이터를 분석 하였다. 결과: 연령은 24$\~$85세(중앙값 45세)였다. 병리학적 유형은 관상피암종이 88.9$\%$로 대부분을 차지하였으며 수질성암종이 4.2$\%$, 소엽상피암종이 1.5$\%$였다. 병기는 AJCC (American Joint Committee on Cancer) 5판에 따라 분류하였으며 T1이 59.7$\%$,T2가 29.5$\%$,Tis가 8.8$\%$였으며 전체의 42.5$\%$가 Tlc에 해당하였다. 전체 환자의 91.2$\%$에서 액와림프절 곽청술이 시행되었고 69.7$\%$의 환자들에서는 액와림프절 전이가 없었으며 림프절 전이가 3개 이하인 경우가 15.3$\%$, 4$\~$9개가 4.2$\%$, 10개 이상 전이된 경우가 1.9$\%$였다. 따라서 병기 0기가 8.4$\%$, I기, 44.9$\%$, IIA기, 33.3$\%$, IIB기 8.4$\%$였다. 에스트로겐수용체와 프로게스테론수용체 검사는 각각71.6, 70.9 $\%$에서 이루어졌다. 유방보존적 수술 방법은 단순절제술(excision/lumpectomy)이 37.2$\%$, 광범위절제술이 11.5$\%$ 사분원절제술(quadrantectomy)이 23$\%$, 부분절제술(partial mastectomy)이 27.5$\%$에서 시행되었다. 수술 후 10예 (3.8$\%$)에서 절제연이 양성이었고 10예는 절제연이 종양에서 2 mm 이내였다. 항암화학요법은 I기에서 54.7$\%$, IIA기에서 83.9$\%$, IIB에서 100$\%$ 시행되었다. 방사선치료는 1예를 제외한 모든 환자들이 계획된 방사선량의 90$\%$ 이상을 조사 받음으로써 순응도가 매우 높은 치료임을 알 수 있었다. 방사선치료의 범위는 전체의 88$\%$가 유방만 치료받았고 5$\%$는 유방과 쇄골상부림프절을, 4.2$\%$는 유방, 쇄골상부림프절에 액와림프절후방추가 조사를 하였으며, 유방, 쇄골상부림프절과 함께 내유방림프절을 치료하였던 예는 1예(0.4$\%$) 뿐이었다. 유방 치료에 사용된 방사선의 종류는 Co-60가 8명(3.1$\%$), 4 MV X-ray가 115명(44.1$\%$), 6 MV X-ray가 125명(47.8$\%$)이었으며 11명(4.2$\%$)은 10 MV X-ray를 사용하였다. 조사된 방사선량은 유방 전체에 45$\~$59.4 Gy (중앙값 50.4), 원발 병소에 대한 추가 조사가 8$\~$20 Gy (중앙값 10 Gy)로 총 방사선 조사선량은 50.4$\~$70.4 Gy (중앙값 60.4 Gy)였다. 결론: 조기 유방암에 대한 진단과 병기 결정 과정, 유방보존적 수술 후 시행되는 방사선치료는 큰 편향이 없이 권고안대로 잘 시행되고 있었다. 다만 원발 병소에 대한 추가 치료는 비교적 다양하게 적용되고 있는데 이것이 치료 결과에 어떤 영향을 미치는지 추적조사연구가 필요하며 방사선치료 계획상의 세부 사항에 대한 분석과 평가가 향후 이루어져야 할 것이다.

• 종양간호연구
• /
• 제1권1호
• /
• pp.5-17
• /
• 2001

It is known that aggressive treatment of chemotherapy, radiation and autogenous stem cell transplantation is effective for prevention of recurrence in the high-risk breast cancer patients. It was assumed that this procedure takes a longer time and decreases the quality of life more than the standard adjuvant chemotherapy. However, there are few studies comparing the quality of life of patients having bone marrow transplantation and adjuvant chemotherapy. Most of the studies were focused on the quality of life in one point of time, such as only during the early treatment stage, only overall quality of life rather than specific dimensions of the quality of life. The purposes of this study are 1) to identify the difference of the quality of life between two different treatment patterns, adjuvant chemotherapy and autogenous stem cell transplantation: 2) to identify the mostly affected dimension and the periods of time affected by the treatment patterns; and 3) to identify the trajectories of quality of life in each treatment pattern. This is a time series design that measures 4 different points of times. At the beginning of the study, 19 patients were placed in the chemotherapy group and 12 in the group of auto-peripheral blood stem cell transplantation. The inclusion criterion was the advanced disease stage of 3 or over with metastasis of more than 5 lymph nodes. The exclusion criteria were 1) anyone who has metastasis to other organ; 2) anyone who had psychological problems. Ferrell's Quality of Life Scale for Cancer Survivors 41 items on a 10 point scale was used. The QOL-CS includes 4 dimensions, which were labeled physical, psychological, social, and spiritual. The Cronbach‘s alpha of this scale was 0.89. Mann-Whitney U test and Friedman test were used to test each hypothesis. In comparison of the two groups, the quality of life of the bone marrow transplantation group dramatically increased at the 3rd and 6th month after transplantation, while the chemotherapy groups results stayed lower. The most affected dimension of the quality of life at the end of the treatment was the physical dimension. However, it and increased along with time, while the psychological dimension values remained low over the long-term period. Intensive nursing care is needed during the entire period of chemotherapy in all patients having chemotherapy, and is also required for right after cases of bone marrow transplantation.