European journal of cancer care
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Eur J Cancer Care (Engl) · Nov 2010
ReviewOncological emergencies: clinical importance and principles of management.
Oncological emergencies are common conditions associated with significant morbidity and mortality. Delay in diagnosis and treatment can result in unfavourable outcomes. Cancer itself, cancer-related hormones or cytokines, or treatment effects can cause emergency problems. ⋯ Localised back pain is the most common presenting symptom while late presentation of neurological deficit is associated with irreversible outcomes. Magnetic resonance imaging is the investigation of choice. Treatment includes corticosteroids, radiotherapy and/or decompressive surgery.
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Eur J Cancer Care (Engl) · Sep 2010
ReviewNot telling the truth: circumstances leading to concealment of diagnosis and prognosis from cancer patients.
While autonomy has gradually become a key concept in the doctor-patient relationship, truth-telling is far from being the norm in many countries in the world. Despite the general agreement on the benefits of open communication between physicians and cancer patients, there is still strong resistance against disclosure of cancer diagnosis and prognosis in many cultures. Although fear of causing psychological morbidity to patients and their reluctance to find out the truth are two main justifications of non-disclosure attitudes, there are other important contributing factors that need to be further explored and better understood including those related to the relatives, doctors and healthcare systems. Cultural disparities in attitudes towards truth-telling persist; however, these differences should not be used as excuses not to respect the rights and individual preferences of cancer patients by making assumptions based on their age, sex, type of cancer, language and/or cultural background.
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Eur J Cancer Care (Engl) · May 2010
ReviewBest supportive care in lung cancer trials is inadequately described: a systematic review.
The objective of the paper was to identify and discuss clinical terms associated with the availability and delivery of best supportive care for patients with lung cancer in randomised controlled clinical trials. Systematic review was carried out of relevant studies without language restrictions identified through Medline, EMBASE, Science Citation Index (Web of Science and ISI Proceedings) and Cochrane Library. Reference lists of retrieved articles were also searched to identify further studies. ⋯ None of the identified studies provided a clear definition of a patient pathway in relation to best supportive care, or a clear list of components. Clinical studies are being conducted without a clear definition of the best supportive care provided in the comparator arms of trials. Inadequate definitions mean that all direct and indirect comparisons in trials comparing active treatments with best supportive care must be interpreted with caution.
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Eur J Cancer Care (Engl) · Mar 2007
ReviewAnxiety, depression and quality of life of cancer patients undergoing radiation therapy: a cross-sectional study in a community hospital outpatient centre.
The purpose of the present study is to determine the impact of illness characteristics and psychopathological comorbidity on the quality of life (QoL) of radio-oncological patients in health-related and individual dimensions. Sixty-three of 93 eligible patients (40 women and 23 men) were included in the study during their radiation therapy visit to an outpatient centre annexed to a community hospital in Southern Bavaria, Germany. In a semi-structured interview, we elicited individually relevant life domains rated by the patients according to the 'Schedule for the Evaluation of Individual Quality of Life - Direct Weighting'. ⋯ Psychopathological comorbidity has a considerable influence on QoL of patients undergoing radiotherapy. Measuring the individual QoL appears as an adapted needs assessment and helps the psychotherapist in focusing on the patient's problems and desires. Furthermore, the patient's QoL is a main target in providing or planning mental health care in non-university oncological services.
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Eur J Cancer Care (Engl) · Mar 2007
ReviewFactors predicting the use of complementary and alternative therapies among cancer patients in Iran.
This study was carried out to examine the factors that predicting the use of complementary and alternative medicine (CAM) among cancer patients in Tehran, Iran. Predicting factors included were patients' demographic characteristics, type of cancer, the knowledge of diagnosis, time since diagnosis, satisfaction with their care physician, fear of recurrence and measures of anxiety, depression and global quality of life. In total, 625 cancer patients were studied, and 35% (n=219) reported that they used or were using CAM. ⋯ The results of logistic regression analysis indicated that the use of CAM among cancer patients was associated with the fear of cancer recurrence (OR=2.03, 95% CI=1.45-2.85, P<0.0001) and dissatisfaction with their care physician (OR=1.98, 95% CI=1.36-2.89, P<0.0001). The results indicate that apart from the prayer and spiritual healing, the use of the other common methods of CAM among Iranian cancer patients is unpopular. However, the findings suggest that the use of CAM is more common among cancer patients who suffer from fears, uncertainties and dissatisfaction, and these might be a marker of greater psychological distress in users as compared with non-users.