Journal of the National Comprehensive Cancer Network : JNCCN
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J Natl Compr Canc Netw · Jul 2003
Assessment of pain caused by invasive procedures in cancer patients.
Invasive procedures are commonly required in the diagnosis and management of cancer in adults. However, little is known regarding the prevalence and severity of procedure-related pain in this patient population. This prospective study was conducted to determine the frequency and types of invasive procedures performed in a large comprehensive cancer center, the intensity of pain associated with these procedures, the types of periprocedural analgesics administered, and how these patients would like their procedural pain to be managed in the future. ⋯ There was no statistical relationship between patients' pain ratings and their satisfaction with the pain control they received during the procedures. This study represents the largest descriptive study of procedural pain in adult cancer patients. As more than 50% of these patients experienced moderate to severe pain during procedures, further studies are needed to improve the control of procedure-related pain in patients with cancer.
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J Natl Compr Canc Netw · Jul 2003
Practice GuidelineDistress management. Clinical practice guidelines.
The evaluation and treatment model expressed in the NCCN Distress Management Guidelines recommends that each new patient be rapidly assessed in the office or clinic waiting room for evidence of distress using a brief screening tool (the Distress Thermometer and Problem List) presented in Figure 1 (see page 369). A score of 5 or greater on the thermometer should trigger further evaluation and referral to a psychosocial service. The choice of which service should be determined by the problem areas specified on the Problem List. ⋯ Presently, the quality of the psychological care patients receive is not routinely monitored. Accrediting bodies have not directly examined the quality of psychosocial care, nor have they established minimal performance standards for its delivery. The panel believes that psychosocial care should and will eventually be on our institution's report cards.
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Cancer-related fatigue (CRF) is the most prevalent symptom of cancer, occurring in 60% to 90% of patients and surpassing pain in frequency. CRF may increase patients' anxieties and hamper their quality of life. ⋯ Since then, we have gained clinical insights into the planning, development, and evolution of this endeavor. Our objective is to share our experiences and provide preliminary analysis of the first 123 patients evaluated in this clinic.
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J Natl Compr Canc Netw · Jan 2003
ReviewEpidermal growth factor receptor as a target in cancer therapy.
Epithelial cancers have been found to overexpress the receptor to epidermal growth factor (EGFR). These include head and neck, breast, colon, lung, prostate, kidney, ovary, brain, pancreas, and bladder. ⋯ Antibodies such as IMC-C225 specifically target EGFRs, whereas tyrosine kinase inhibition by many small molecules is less specific but is also effective. This report focuses on EGFR and novel compounds that target it.
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J Natl Compr Canc Netw · Jan 2003
ReviewNew targeted therapies for non-small-cell lung cancer: a focus on the epidermal growth factor receptor.
Advances in chemotherapy and multimodality treatments of patients with non-small-cell lung cancer (NSCLC) have improved outcomes for these patients over the past decade. Unfortunately, gains have been modest, and new therapeutic strategies are eagerly awaited. Therapies that target receptors vital to the proliferation and survival of cancer cells are particularly attractive areas of research. ⋯ Phase II trials involving patients with advanced NSCLC and whose disease is progressive after chemotherapy have demonstrated clear clinical benefit. Studies are ongoing, integrating EGFR-targeted therapy with chemotherapy and radiation in patients with earlier stage NSCLC, as well as in chemoprevention. In all of these settings, a further understanding of the biology of EGFR in relationship to other cellular events will be critical in optimizing therapeutic approaches with these novel agents.