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PubMed1989

Ultrasonographic assessment of the regression of bladder and renal lesions due to Schistosoma haematobium after treatment with praziquantel.

The effect of praziquantel on urinary tract lesions due to Schistosoma haematobium was assessed by ultrasound in an endemic village in Niger. Ten months after treatment with praziquantel, bladder and renal lesions among the 149 patients were assessed. The parasitological cure rate was 87%. Ultrasonography proved to be an excellent tool to assess pathological changes. It is reliable, quickly performed, well accepted by the community and permits the definition of a "regression-rate" of the pathological lesions. Ten months after treatment, the "regression-rate" of bladder lesions was 68% and of renal lesions was 73%. The presence of bladder lesions had a negative influence on the regression of renal lesions. Nearly all renal lesions, without bladder lesions, regressed within the ten months period of observation. This study permitted the identification of a group of persons whose bladder lesions did not regress and who were possibly more vulnerable to the development of bladder cancer, thus requiring long-term follow-up.

Adolescent↗
PubMed1986

Cure rates in small cell and non-small cell carcinoma of the lung utilizing high-dose radiotherapy and chemotherapy.

From 1967 to 1977, 72 patients with small cell carcinoma of the lung were seen. Thirty-five of these patients had unilaterally localized lesions (limited disease) and were treated with cobalt 60 radiation therapy (6,000 rad in six weeks) followed by chemotherapy consisting of cyclophosphamide (Cytoxan), vincristine, methotrexate and lomustine (CCNU) (Group A). The remaining 37 patients with extensive disease were treated with similar chemotherapy alone, or in combination with local palliative radiotherapy to the symptomatic area (Group B). For Group A the five-year survival rate was 20 percent, while for both groups combined, it was only 5 percent.During this same period 560 patients with non-small cell carcinomas were treated. The five-year survival rate for those patients with operable, resectable lesions was 33 percent, while for those with unilateral, inoperable, unresectable lesions, it was 10 percent. Thus, it would appear that the results in limited small cell and non-small cell carcinomas of the lung utilizing high-dose radiotherapy followed by chemotherapy are comparable, and that limited small cell carcinoma of the lung patients with high-dose radiotherapy followed by chemotherapy can survive longer than those patients with stage III, non-small cell lung carcinoma.While the two- to five-year survival rates in small cell carcinoma demonstrate no appreciable differences, in non-small cell carcinomas there are significant two- to five-year survival differences. These improved results probably are due to the increased sensitivity of small cell carcinoma to high-dose local radiotherapy and to the chemotherapeutic vulnerability of circulating and microscopic metastatic cancer cells.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1994

[Factors affecting health behavior of the people aged forties--a test of the health belief model].

The health behavior of 1120 persons, aged in their forties, living in a city, a mountain village and a fishing village were analyzed according to the Health Belief Model. Women practiced more health behaviors than men. People living in the city and mountain village practiced more than people in fishing village. Company employees, farmers and housewives practiced more than self-employeds and fishermen. Education level had no significant influence in the practice of health behavior. As predicted, people who believed in the effectiveness of health behavior practiced more health behaviors. On the other hand, people who perceived barriers to health behavior practiced less. Paradoxically, people who perceived vulnerability to hypertension, cerebrovascular disease or cancer, and the seriousness of these diseases, practiced less health behaviors. Stepwise multiple regression analysis revealed that health beliefs, social supports and information from mass media could account for 33.0% of the Health Behavior Score variation. Perceived barriers to health behavior was the strongest determinant for practice of health behavior. Perceived barriers may account for gender and occupational differences in health behavior.

Adult↗
PubMed1990

An immunohistochemical study of copper, zinc-containing superoxide dismutase detected by a monoclonal antibody gastric mucosa and gastric cancer.

The immunohistochemical localization of copper, zinc-superoxide dismutase (Cu,Zn-SOD) in human gastric mucosa and gastric cancer was studied using a monoclonal antibody. In gastric mucosa, parietal cells, pyloric glandular cells and foci of intestinal metaplasia showed positive staining in the cytoplasm and/or nucleus. The wide distribution of Cu, Zn-SOD in the gastric mucosa suggests cell function may be vulnerable to active oxygen species. In gastric cancer, 34 of 70 cases showed a positive reaction for Cu, Zn-SOD. There was a relationship between the grade of Cu,Zn-SOD immunoreactivity and the histological type of gastric cancer, well-differentiated types of gastric cancer being more frequently positive. The positive cases of poorly-differentiated adenocarcinoma were characterized by a pattern of diffusely infiltrative invasion. These results suggest that some types of gastric cancer are resistant to active oxygen species.

Adenocarcinoma↗
PubMedDate not supplied

Surviving cancer; what does it mean for you? An evaluation of a clinic based intervention for survivors of childhood cancer.

BACKGROUND: To evaluate a clinic based intervention designed to improve attitude to follow-up, increase self-efficacy or confidence to care for health, and raise awareness of possible vulnerability to future health issues among survivors of childhood cancer. The intervention included an information booklet, treatment summary and separate information sheets, which were explained to survivors as part of routine follow-up care. PROCEDURE: Survivors (n=263; mean age=21 years; >5 years since diagnosis) attending one of seven United Kingdom Children's Cancer Study Group (UKCCSG) late-effects follow-up clinics completed questionnaires before and after the intervention. Outcome measures included self-ratings of importance of follow-up, readiness to change behaviour, self-efficacy, perceived vulnerability, and ratings of informativeness and emotional content of the written material. RESULTS: Responders were more likely to be female than non-responders, held more positive views about the importance of follow-up and perceived themselves to be more vulnerable to health risk. After the intervention, responders reported that they were more prepared to change their behaviour, had increased self-efficacy, but also perceived themselves to be more vulnerable to future health problems. CONCLUSIONS: We conclude that the intervention is a relatively simple way to enhance awareness among survivors about the importance of follow-up and need for vigilance in their healthcare. Difficulties in recruiting survivors who failed to attend are considered.

Adult↗
PubMed2005

Ethics of palliative surgery in patients with cancer.

BACKGROUND: Surgery is an important palliative method for patients with advanced malignant disease. In addition to concerns related to clinical decision making, various moral challenges are encountered in palliative surgery. Some of these relate to the patients and their illness, others to the surgeons, their attitudes, skills and knowledge base. METHOD AND RESULTS: Pertinent moral challenges are addressed and analysed with respect to prevailing perspectives in normative ethics. The vulnerability of patients with non-curable cancer calls for moral awareness. Demands regarding sensibility and precaution in this clinical setting represent substantial challenges with regard to the 'duty to help', benevolence, respect of autonomy and proper patient information. Moreover, variations in definition of palliative surgery as well as limited scientific evidence with respect to efficacy, effectiveness and efficiency pose methodological and moral problems. Therefore, a definition of palliative surgery that addresses these issues is provided. CONCLUSION: Both surgical skill and much moral sensibility are required to improve palliative care in surgical oncology. This should be taken into account not only in clinical practice but also in education and research.

Beneficence↗
PubMed1996

Ethical issues in pain management.

The elderly are a vulnerable group and many will face several chronic illnesses, with cancer being likely among them. Each year approximately one million elderly are abused, with the most vulnerable being those who rely on family members for their care. Humphrey stated that old age "is sufficient cause to give up" even when the individual is not suffering. Humphrey's statement exemplifies how much our society has come to devalue the elderly. Opponents of euthanasia and assisted suicide as alternatives to effective palliative care contend that we are degrading not only the sanctity of life for the elderly, but we are also undermining the goals of medicine.

Aged↗
PubMed2005

Defining and measuring reproductive concerns of female cancer survivors.

Although women diagnosed with cancer during their childbearing years are at significant risk for infertility, we know little about the relationship between infertility and long-term quality of life (QOL). To examine these relationships, we assessed psychosocial and reproductive concerns and QOL in 231 female cancer survivors. Greater reproductive concerns were significantly associated with lower QOL on numerous dimensions (P<.001). In a multiple regression model, social support, gynecologic problems, and reproductive concerns accounted for 63% of the variance in QOL scores. Women who reported wanting to conceive after cancer, but were not able to, reported significantly more reproductive concerns than those who were able to reproduce after cancer (P<.001). These preliminary data suggest that at least for vulnerable subgroups, the issue of reproductive concerns is worthy of additional investigation to assist cancer survivors living with the threat or reality of infertility.

Adult↗
PubMed2006

Patient characteristics and hospital quality for colorectal cancer surgery.

OBJECTIVE: To assess associations of patient characteristics with quality-related characteristics of the hospitals where they were treated for colorectal cancer and the role of these associations in disparities in treatment quality affecting vulnerable patient groups or variations across health plans. SETTING: Population-based cancer registry in California. PARTICIPANTS: A total of 38 237 patients diagnosed with stage I-III (non-metastatic) colorectal cancer in California between 1994 and 1998. METHODS: Registry data were linked with hospital discharge abstracts, US census data, and Medicare enrollment data. The associations of patients' sociodemographic, clinical, and geographic covariates with treatment at high-volume institutions were assessed with logistic regression. The associations of patients' covariates with the risk-adjusted 30-day mortality rates of the hospitals where they received surgery were tested with linear regression. RESULTS: Patients with more advanced tumor stage or more extensive comorbidity, those of Hispanic or Asian race/ethnicity, and those from less affluent communities were less likely to undergo surgery at high-volume institutions and were treated at hospitals with higher risk-adjusted 30-day postoperative mortality rates than those who were less severely ill, white, or more affluent, respectively (all P < 0.05). Black patients also received surgery at hospitals with above-average mortality. Among patients 65 years and older, Medicare managed-care enrollees underwent surgery in higher-volume hospitals than Medicare fee-for-service enrollees, and there was substantial variation in hospital volume and adjusted hospital mortality among Medicare managed-care plans. CONCLUSION: Improving access of sicker, poorer, and minority patients to high-quality hospitals for cancer surgery may improve their outcomes. Further study of processes affecting hospital referral is warranted.

Adult↗
PubMed1999

Long-term complications and post-treatment follow-up of patients with Wilms' tumor.

An increasing number of children with Wilms' tumor can expect to be cured, reflecting the undisputed progress made in the treatment of children with this renal cancer. However, it does underscore the need to screen survivors for late effects of cancer therapy. Some of the late effects, such as those following radiation therapy, should be expected after a considerable latent period. Others, such as those occurring after the administration of certain chemotherapeutics agents, are commonly immediate, usually transient, but occasionally permanent. Although children seem to tolerate acute toxicities of therapy better than do adults, the growing child may be more vulnerable to the delayed adverse sequelae of cancer therapy, such as effects on growth, fertility, and neuropsychological function. This article reviews many of the late effects seen in survivors of Wilms' tumor and the way in which these effects relate to the different therapeutical modalities used (surgery, chemotherapy, and radiation).

Antineoplastic Agents↗
PubMed2026

Oncogenic SF3B1 mutations alter the splicing of mRNA noncoding regions to induce a novel therapeutic vulnerability.

Oncogenic mutations of SF3B1 are common in myeloid cancers, chronic lymphocytic leukemia (CLL), and select solid tumors. Their mechanistic basis for promoting oncogenesis has been investigated in detail, with the stereotyped missplicing of messenger RNA (mRNA) protein coding sequences most intensively studied. These changes, in genes such as MAP3K7, BRD9, and ABCB7, typically lead to loss of function, thus contributing to cancer pathogenesis. Here, we systematically analyzed the impact of mutant SF3B1 on noncoding regions of mRNA transcripts across disease types, in both cell lines and primary patient specimens. This identified numerous novel and highly reproducible splicing alterations in such regions. Studies of a target gene, DCAF16, revealed multiple complex mutation-induced alterations in its 5' and 3' untranslated regions (UTRs). Remarkably, these were mechanistically associated with increased DCAF16 protein levels in SF3B1-mutant cells, representing, to our knowledge, the first time that oncogenic SF3B1 has been found to increase levels of a target protein in a gain-of-function manner. DCAF16 is a substrate recognition adapter for the DDB1/CUL4 E3 ubiquitin ligase complex. Novel protein degrader small molecules that coopt DCAF16 to degrade BRD4 as a neosubstrate demonstrated preferential selectivity for SF3B1-mutant cancers and CLL primary patient specimens due to increased DCAF16 protein levels. In turn, this reveals the therapeutic relevance of mutant SF3B1 dysregulation of transcript UTRs and uncovers a novel strategy for the treatment of these important neoplasms.

Humans↗
PubMed1994

The change of life, the sorrow of life: menopause, bad blood and cancer among Italian-Australian working class women.

This paper explores the discourse of menopause, health and illness among 20 middle aged Italo-Australian working class women living in Melbourne. Using the methods of interpretative anthropology and the perspectives of critical feminist theory, I argue that women's discourse about health and illness is one way in which they express feelings of loss over the fertility of their youth, ambivalences about their lives in Australia, and grief over a life left behind in Italy. These losses are experienced physically and expressed metaphorically through conditions of bad blood and nerves and are perceived to contribute to their vulnerability to a range of diseases including cancer. For these women, the change of life is experienced as the end of life and their fear of cancer is representative of their fears of social and physical death. Cancer is also seen to be a disease more common in Australia and is used as a metaphor for expressing anxieties relating to feelings of placelessness, of being disconnected from one's roots, and anxieties about becoming old and dying far from "home."

Adult↗
PubMed2001

Predictors of intentions to use tobacco among adolescent survivors of cancer.

OBJECTIVE: To examine the relationship between knowledge of tobacco-related health risks, perceptions of vulnerability to these health risks, and future intentions to use tobacco in a sample of adolescent survivors of cancer. METHODS: Written self-report questionnaires were administered to 46 survivors, 10-18 years of age (61% males, 93.5% Caucasian). RESULTS: Overall, survivors were generally knowledgeable about tobacco-related health risks, perceived themselves to be vulnerable to these health risks, and reported low future intentions to use tobacco. Regression analyses indicated that demographic factors, treatment-related variables, knowledge, and perceived vulnerability explained 28% of the variance in intentions scores, F:(6, 39) = 2.52, p <.05. Age and knowledge were significant predictors, indicating that older adolescent survivors and those with lower knowledge scores reported greater intentions to use tobacco. CONCLUSIONS: Young survivors will benefit from risk counseling interventions that educate them about their susceptibility to specific tobacco-related health risks secondary to their cancer treatment. Intensive tobacco prevention programs that target older adolescents should be developed.

Adolescent↗
PubMed1978

Ego strength and psychosocial adaptation to cancer.

This study investigated a patient's ego strength (Es) at the time of an initial cancer diagnosis and its relationship, over time, to mood disturbance, vulnerability, self-reported physical symptom totals, current concerns, coping strategies, and effectiveness in the resolution of problems. The subjects were 163 newly diagnosed male and female cancer patients representing five primary tumor sites. All patients were seen for an initial evaluation, at which time they completed Barron's Es scale, the Profile of Mood States, the Inventory of Current Concerns, and a semistructured interview. Ratings on patient vulnerability, coping strategies, and problem resolutions were made at each of the five follow-ups. Results showed that psychosocial adaptation to cancer was related to a patient's ego strength. Es correlated positively with a patient's use of effective coping strategies. The concept of Es and problems with Es assessment were discussed within a cognitive-ego analytic frame of reference.

Adaptation, Psychological↗
PubMedDate not supplied

Looming threat-processing style in a cancer cohort.

OBJECTIVE: Looming threat-processing style, where threats are perceived to be progressing (looming) at a frightening velocity, is implicated in anxiety vulnerability. This study aims to validate a new measure of looming, the looming cancer, and explore its clinical correlates in a chronic lymphocytic leukemia (CLL) cohort. METHODS: In a cross-sectional design, 105 CLL patients completed the Looming Cancer Scale, Looming Cognitive Style Questionnaire (LCSQ), SF-36, Beck Anxiety Inventory (BAI) and Beck Depression Inventory II (BDI-II). RESULTS: Exploratory factor analysis reduced the 20-item Looming Cancer Scale to a 10-item version, which demonstrated good psychometric properties (Cronbach's alpha=.926). Convergent validity was demonstrated by Pearson correlation with the LCSQ (0.418), BAI (0.380), BDI-II (0.336) and the mental component score of the SF-36 (-0.434) (all P<.001). Divergent validity was demonstrated by a lack of correlation with the SF-36 physical component score and cross tabulation frequencies of high and low loomers. High vs. low loomers showed significantly more anxiety (31% vs. 13%), depression (23% vs. 2%) and mixed anxiety-depression (18% vs. 2%). An area under the receiver operating characteristic curve analysis revealed high sensitivity (82%) and specificity (69%) in detecting mixed anxiety-depression using a cutoff score of >/=20/30. CONCLUSIONS: The Looming Cancer Scale is a valid measurement of looming cognitive style and is the first time that the looming construct has been studied in a cancer cohort. The importance of this research lies in its potential to identify populations vulnerable to developing anxiety, depression and mixed anxiety-depression symptoms.

Adult↗
PubMed2002

Epidemiology and primary prevention of thyroid cancer.

The purpose of this review is to provide an account of our present knowledge about the epidemiology of nonmedullary thyroid carcinoma, to discuss the effects of environment, lifestyle and radiation on the risk of developing thyroid cancer, and to discuss aspects on primary prevention of the disease. In areas not associated with nuclear fallout, the annual incidence of thyroid cancer ranges between 2.0-3.8 cases per 100,000 in women and 1.2-2.6 per 100,000 in men, women of childbearing age being at highest risk. Low figures are found in some European countries (Denmark, Holland, Slovakia) and high figures are found in Iceland and Hawaii. Differences in iodine intake may be one factor explaining the geographic variation, high iodine intake being associated with a slightly increased risk of developing thyroid cancer. In general, lifestyle factors have only a small effect on the risk of thyroid cancer, a possible protective effect of tobacco smoking has been recently reported. Because of the (small) increase in risk of thyroid cancer associated with iodination programs, these should be supervised, so that the population does not receive excess iodine. The thyroid gland is highly sensitive to radiation-induced oncogenesis. This is verified by numerous reports from survivors after Hiroshima and Nagasaki, the Nevada, Novaja Semlja and Marshal Island atmospheric tests, and the Chernobyl plant accident, as well as by investigations of earlier medical use of radiation for benign diseases in childhood. These reports are summarized in the review. There appears to be a dose-response relation for the risk of developing cancer after exposure to radioactive radioiodine. The thyroid gland of children is especially vulnerable to the carcinogenic action of ionizing radiation. Thus, the incidence of thyroid cancer in children in the Belarus area was less than 1 case per million per year before the Chernobyl accident, increasing to a peak exceeding 100 per million per year in certain areas after the accident. It is a social obligation of scientists to inform the public and politicians of these risks. All nuclear power plants should have a program in operation for stockpiling potassium iodide for distribution within 1-2 days after an accident.

Humans↗
PubMed2001

Issues in measuring quality of life in childhood cancer: measures, proxies, and parental mental health.

The relationship between child- and parent-reported quality of life (QOL) and the effects of parental mental health, illness stressors, and child vulnerability was explored using two measures of QOL: the Pediatric Cancer Quality Life-32 (Varni et al., 1998a) and the Disquol (Eiser, Cotter, Oades, Seamark, & Smith, 1999). Thirty-two children with acute lymphoblastic leukaemia (mean age = 8.92 years) and 36 parents completed measures of QOL when attending routine clinic. In addition, parents also completed the General Health Questionnaire (GHQ-28), perception of the child's vulnerability, and illness-related stressors. Significant correlations were found between the overall scores on the two child-completed QOL measures, with a range of poor, moderate to good correlations found between the individual subscales. Poor to moderate concordance was found between child and parent reports. Children who self-reported poorer QOL had mothers who were more depressed. Parents who reported poorer QOL for their child reported more illness stressors and perceived their child as being more vulnerable. Assumptions that concordance between child and parent ratings of QOL is a necessary requirement for new measures of QOL are challenged.

Adult↗
PubMed2006

Better late than never: reflections on the delayed prioritization of cervical cancer in international health.

Cervical cancer has disproportionately affected the world's most vulnerable women for generations, yet only recently has the disease become an international health priority. Using ethnographic evidence from a study in Iquitos, Peru, I identify three factors that have contributed to a historic blind spot regarding cervical cancer in underdeveloped regions: (a) transition theories predicting the emergence of cancer with increasing societal development, (b) chronic vs. infectious disease categories that miss the significance of infectious-associated cancers, and (c) dependence on epidemiologic statistics from underdeveloped regions for determining health care priorities. Implications for theory and education are discussed.

Attitude to Health↗