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Biomedical subjects

P F Engstrom

Publications and source records attributed to P F Engstrom.

At least 109 records · Page 6Linked to original sources
PubMed1984

Educating the older cancer patient: obstacles and opportunities.

Cancer is a serious health problem among the elderly, with over 50% of all cancers occurring in the 11% of the population over age 65. Little research, however, has focused on the educational needs of elderly cancer patients and little is known about the emotional and psychological impact of cancer in this population. This paper describes two surveys which provide baseline data on the knowledge, attitudes, and beliefs of older people about cancer. These findings have implications for programs directed both at the healthy elderly and at older cancer patients.

Age Factors↗
PubMed1983

Combination chemotherapy containing semustine (MeCCNU) in patients with advanced colorectal cancer previously treated with 5-fluorouracil (5-Fu).

Two hundred thirty-two patients with advanced measurable colorectal cancer previously treated with 5-fluorouracil (5-Fu) were randomized to one of the following treatments: A) semustine (MeCCNU) plus vincristine (VCR); B) MeCCNU plus dacarbazine (DTIC); C) MeCCNU plus DTIC plus VCR; D) MeCCNU plus beta-2'-deoxythioguanosine (beta-TGdR). Platelet nadirs less than 50,000/mm3 were noted in 9% (Treatment A) to 19% (D) of the patients while WBC nadirs less than 2,000/mm3 were noted in 7% (B) to 12% (C,D) of the patients. Severe vomiting was noted in 2% (D) to 14% (B) of the patients. The partial response rates and median survival times from date of randomization were as follows: Treatment A: 3/54 (6%), 19 weeks; B: 9/59 (16%), 28 weeks; C: 3/60 (5%), 25 weeks; D: 2/59 (4%), 19 weeks. Differences in response rate and median survival are not statistically significant.

Antineoplastic Agents↗
PubMed1983

The dentist as a referral source of first episode head and neck cancer patients.

This analysis was conducted to shed more light on the role of the dentist in the detection and referral of patients with head and neck cancer. No other study of the referral practices of dentists has examined the characteristics of these patients in contrast to those referred by physicians to understand the selection of pathways to care. The findings reported here indicate that: "anatomical provinces" exist for both types of practitioners that are well recognized by the lay community and perhaps reinforced by the health field; advanced stage referrals on the parts of physicians may occur because patients delayed seeking care until symptoms required medical attention; and dentists as a group may b better prepared to detect oral cavity lesions, but not lesions at other head and neck sites. The findings of this study, as well as those of Adams and others and Pogrel, suggest the need for improved educational programs about head and neck cancer directed to the public as well as physicians and dentists. The public should be aware not only of the etiology of head and neck cancers and the associated signs and symptoms, but also of the availability of the dentist, as well as the physician, as a diagnostic resource. Furthermore, educational programs should be developed in dental and medical schools to teach and reinforce detection and diagnostic skill including soft-tissue examination procedures; the use of the indirect mirror for examination of the base of the tongue, larynx, and the lower posterior pharyngeal wall; and biopsy techniques.

Dentists↗
PubMed1983

Research in cancer patient education and compliance.

A study design has been presented which has the advantage of combining the research questions of education program evaluation and patient compliance. While it would be possible to evaluate education programs in other ways (e.g., using a sample of all program participants rather than a sample of all patients for whom a regimen was recommended), such an alternative design would not assess the potentially significant proportion of noncompliance which might occur when the regimen recommendation is made. It is the specification of inception cohorts as the study population that allows the accrual of more complete compliance data for the regimen as well as evaluation data for the education program. Given the recognized need for data on the compliance of cancer patients, the added cost of specifying inception cohorts for education program evaluations seems small. The proposed research design has the potential to contribute to cancer control programs: 1. a careful evaluation of new education programs for patients; 2. modifications of education programs based on feedback from professionals and patients during the initial implementation; 3. needed data on cancer patient compliance with extended detection and treatment regimens; and 4. increased understanding of the process of patient compliance, including identification of key variables in the health belief model which account for compliance among cancer patients.

Evaluation Studies as Topic↗
PubMed1982

Combination chemotherapy of advanced colorectal cancer utilizing 5-fluorouracil, semustine, dacarbazine, vincristine, and hydroxyurea: a phase III trial by the Eastern Cooperative Oncology Group (EST: 4275).

Patients who had measurable evidence of recurrent or metastatic colorectal carcinoma following surgery and radiotherapy but no prior chemotherapy were randomized to one of five combination chemotherapy programs. Four of the treatments utilized five consecutive days of fluorouracil (FU) (days 1--5 and days 36--40) plus one oral dose of semustine (ME) (day 1) every ten weeks: (A) FU + ME; (B) FU + ME + vincristine (VC) (day 1 and day 36); (C) FU + ME + dacarbazine (DC) (days 1, 2, 36, 37); (D) FU + ME + VC + DC. The fifth treatment option(E) used a weekly treatment program of FU I.V. on day 1 plus hydroxyurea (HU) P.O. on day 4. The overall response rate was 13% (60/472) and the median survival time from start of therapy for all patients was 31 weeks. The response rate and the median survival time for each combination was (A) 9/103 = 9%, 26 weeks; (B) 10/92 = 11%, 28 weeks; (C) 15/101 = 15%, 37 weeks; (D) 11/91 = 12%, 27 weeks; (E) 15/85 = 18%, 38 weeks. There is no statistical difference in response rate or survival duration among any of the treatment options. The therapies containing DC produced the only complete responses (3 patients on treatment C and 2 on D). Treatment D was also associated with the longest median response duration (Treatment D = 55 weeks). Treatment A (FU + ME) was associated with the highest incidence of life-threatening toxicity.

Antineoplastic Agents↗