Thursday, October 07, 2010
prior abstract - new commentary: EvidenceUpdates - Phase III trial of carboplatin plus paclitaxel with or without gemcitabine in first-line treatment
Oncology - Gynecology - "This negative study extends the evidence base indicating that triplet chemotherapy increases toxicity without significant survival benefit in ovarian cancer patients. Further increases in survival for this group will need to come from alternate strategies."
alternate link to abstract:
Phase III trial of carboplatin plus paclitaxel with or without gemcitabine in first-line treatment of epithelial ovarian cancer
These strategies can help us maintain healing relationships with our patients by maintaining their trust, confidence, and satisfaction. Cultivating relational aspects of medical practice requires an interchange and takes time. Experienced doctors know this and continue to do so because being present and staying with the patient during difficult times is a pillar of moral and ethical training and a fundamental attribute of a good physician.
Correspondence/Response: Patient Information and Decision Aids in Oncology: Need for Communication Between Patients and Physicians — JCO
"In their recent contribution to Journal of Clinical Oncology, Brace et al1 report on the knowledge and opinions of physicians caring for patients with cancer in the province of Ontario, Canada, about patient decision aids......Brace et al1 must be congratulated for collecting this comprehensive data set on the oncologists' perspective on this important topic. However, it is possible that the rates of decision aid use by patients may actually be higher than suggested by the percentages for physicians responding to the questionnaire. Access to disease-specific patient decision aids is provided freely on the Internet, and patients may make use of these tools without discussing them with their treating oncologists..."cont'd
Response to Vodermark (Erin D. Kennedy):
We appreciate the comments by Vordermark1 about our recent contribution to Journal of Clinical Oncology.2
"...We agree that the Internet certainly has the potential to be an excellent and accessible information resource for both patients and physicians. The results presented by Vordermark et al3 and Adler et al4 are both interesting and timely, given that these data suggest that patients seeking information on the Internet are not comfortable discussing the information with their physicians. This is similar to our own group's experience in which patients seem to be increasingly more confident in the information they find on the Internet rather than in their own physicians. This is somewhat concerning, and we must begin to question whether we as physicians are slowly losing the ability to connect with our patients.......To accomplish this, researchers need to involve (not avoid) physicians in both the development and implementation of pDAs and decision support tools. "
Phase I Study of Vorinostat in Patients With Advanced Solid Tumors and Hepatic Dysfunction: A National Cancer Institute Organ Dysfunction Working Group Study — JCO
Note: abstract does not indicate if ovarian cancer patients were included in this phase 1 study
abstract: Longitudinal Assessment of Cognitive Changes Associated With Adjuvant Treatment for Breast Cancer: Impact of Age and Cognitive Reserve — JCO
Note: ages of participants
The new facility will include the Women’s College Research Institute (WCRI), making women’s health research a key focus.
‘Our research institute is one of the few in the world – and the only one in Canada – devoted to women’s health and innovations in ambulatory care,’ said Dr. Lorraine Lipscombe, an endocrinologist at Women’s College Hospital and a scientist at the WCRI who spoke at the event.
‘Our scientists ask questions that are not only unique to women’s lives, but that are specific to distinct communities of women.’
"Some notable results:
* Only 30 per cent of respondents said they felt empowered when dealing with health-care providers. A great many women had less positive feelings: 45 per cent said they felt isolated when visiting a hospital, 57 per cent said they felt afraid, 63 per cent felt frustrated and 76 per cent felt anxious.
* Sixty-five per cent of women felt they were treated like a number rather than a person, and 70 per cent felt the focus was on rushing them through their appointments and treatments rather than discussing their needs and circumstances.
* The vast majority – 88 per cent of respondents – said it was essential to approach health care holistically, treating the whole person rather than isolated body parts. However, less than half that number (43 per cent) felt that hospitals and health-care facilities actually achieved this.
* Most women prefer to remain in the community – and in their lives – while their conditions are treated. Ambulatory care – or outpatient treatment, as opposed to being admitted to hospital – was the preference of 90 per cent of respondents.
* A health-care facility that is knowledgeable about, sensitive to, and actively addresses diverse cultures was important to 80 per cent of respondents.
* More than 85 per cent of women feel women’s health issues should be a research priority for a health-care institution. However, only 56 per cent think institutions successfully keep women’s health at the forefront of research programs."