Thursday, February 23, 2012
abstract: Improving Psychological Adjustment Among Late-Stage Ovarian Cancer Patients: Examining the Role of Avoidance in Treatment
Improving Psychological Adjustment Among Late-Stage Ovarian Cancer Patients: Examining the Role of Avoidance in Treatment
Improving Psychological Adjustment Among Late-Stage Ovarian Cancer Patients: Examining the Role of Avoidance in Treatment
Data suggest that individuals dealing with a cancer diagnosis are less likely to suffer from depression, anxiety, and psychological distress when they cope with their condition from a stance of emotional and cognitive acceptance (e.g. Dunkel, et al., 1992; Stanton, et al., 2000). Although traditional CBT often includes some acceptance-oriented elements, recent variants of CBT, such as Acceptance and Commitment Therapy (ACT), have acceptance as a central focus. ACT targets emotional distress directly through acceptance of difficult thoughts and emotions.
The current study is a preliminary comparison of ACT and treatment as usual (TAU) in the treatment of emotional distress among women with late-stage ovarian cancer.
Forty-seven women diagnosed with Stage III or IV ovarian cancer were randomly assigned to one of two treatment conditions. Treatment consisted of 12 face-to-face meetings with a therapist, each following a TAU or ACT protocol. Results indicate that both groups showed improved mood and quality of life following the intervention. The ACT group showed significantly greater improvements compared to the TAU group. Furthermore, mediation analyses indicate that the effects of treatment were mediated by cognitive avoidance.
Although the study is limited by the implementation of treatment in both conditions by a single therapist, the TAU group showed improvements that were consistent with effect sizes available in the literature, suggesting that the intervention was a credible and effective control treatment.
These findings provide preliminary support for the use of ACT (Acceptance and Commitment Therapy) in ovarian cancer populations. Further work is needed to investigate the effectiveness in other oncology populations as well as investigate potential patient characteristics which may interact with these interventions.
(BRCA's) Cancer cure hopes as genetic code hereditary breast disease is mapped for first time - media
Cancer cure hopes as genetic code hereditary breast disease is mapped for first time
"....The study also included teams from the Institut Curie in France, the University Medical Centre Utrecht in the Netherlands, The Cancer Research UK London Research Institute in London and the University of Nottingham.
Last week the ICR, writing in the British Journal of Cancer, said all women under 50 who are diagnosed with triple-negative (TN) breast cancer should be screened for the BRCA1 gene fault, which also carries with it an additional high risk of developing ovarian cancer....."
media: 'Cinderella cancers' that doctors miss: Multiple visits to the GP needed for proper diagnosis (re: Lancet Oncology)
'Cinderella cancers' that doctors miss: Multiple visits to the GP needed for proper diagnosis | Mail Online
"...But the study, published in The Lancet Oncology journal, said there were ‘wide variations’ depending on the type of cancer and patient......
The study, which looked at 24 different cancers, comes amid concerns that some patients are not given the best chance of beating the disease because of delays in diagnosis.
The study shows patients with breast, melanoma, testicular and endometrial cancers were more likely to be referred to a specialist after just one or two consultations.
However, those with some less common cancers such as multiple myeloma, pancreatic, stomach and ovarian, as well as those with lung and colon cancers and lymphomas, were more likely to require three or more GP visits....."
"The fight against counterfeit drugs must be strengthened without further delay. It needs consensus among all countries and interested parties, and requires wise and bold leadership from WHO. An indispensable goal of the campaign is ensuring the availability of genuine and affordable essential medicines in developing countries."
New Meaningful-Use Rules Stress Online Contact With Patients:
The proposed rules, which would not take effect until 2014, would require physicians to begin receiving secure messages from patients to earn an EHR bonus — and avoid a Medicare penalty.
Medscape Medical News
National Foundation for Cancer Research Funds Novel Approach to Early Stage Ovarian Cancer - MarketWatch (press release)
National Foundation for Cancer Research Funds Novel Approach to Early ... - MarketWatch (press release):
National Foundation for Cancer Research Funds Novel Approach to Early ...
MarketWatch (press release)
The new grant, entitled "SQUID Imaging for Detection of Early Stage Ovarian Cancer," will augment Dr. Bast's ongoing program at The University of Texas MD Anderson Cancer Center with this emerging technology. Dr. Bast is a world leader in the early ...
and more »
Cepmed Launches Online Personalized Medicine Portal: Media Release, Montreal
The Centre of Excellence in Personalized Medicine (Cepmed), announced today that they have launched a web-based Personalized Medicine Portal for Canadians and joined DNA Direct by Medco's Genomic Medicine Network (GMN).
Cepmed's Personalized Medicine Portal (Portal) provides information and decision making tools that will help patients understand how genetic testing can be used to inform treatment decisions and enable better communication between patients and providers. The Portal, available at www.cepmed.com, provides information about access to specific genetic tests in each Province. "Many of the stakeholders have told us that there is a dearth of reliable, evidence based information concerning personalized medicine tests. A centralized source of information about which tests exist, who should take them and how they should be interpreted is what we are offering through our partnership with DNA Direct by Medco. We believe this resource will contribute to improved patient outcomes and savings to the health care system." - Dr. Clarissa Desjardins - CEO, Cepmed.
According to the Personalized Medicine Coalition, there are more than 50 genetic tests currently available that can inform treatment decisions and drug therapy for a wide range of diseases.(i) With the availability of these tests, support and demand for personalized medicine is growing internationally. However, effective integration of personalized medicine into clinical care is challenging. It is widely thought that effective adoption of personalized medicine will require the participation of informed and engaged patients and healthcare providers.
Cepmed plans to use the Portal as a key element of implementation studies in personalized medicine, collaborating with healthcare providers, patient organizations and the public to define how personalized medicine is best applied within the Canadian health care system. These studies will be informed by Cepmed's participation in DNA Direct by Medco's GMN. The GMN brings together leaders in personalized medicine and offers opportunities to establish multi-site studies in genomics, with a particular focus on real-world or implementation studies.
"We are excited about this opportunity to expand our Genomic Medicine Network to include a premier personalized medicine organization in Canada," said Joan Kennedy, President of DNA Direct by Medco. "Cepmed will add a unique perspective and new types of collaboration opportunities across the network."
About DNA DirectDNA Direct, a wholly owned subsidiary of Medco Health Solutions, Inc. (NYSE:MHS), delivers guidance and decision support for genomic medicine to patients, providers and payers. The company's comprehensive clinical programs are unique to genomic medicine and combine proprietary technology with genetic expertise; including a national call center of genetic experts, web-based applications, and educational resources and training. DNA Direct is based in San Francisco. For more information, visit www.dnadirect.com.
Cepmed is a non-profit organization dedicated to promoting personalized medicine through research, commercialization, and education. Cepmed participates in several public-private partnerships that have funded studies in translational medicine and pharmacogenomics. Cepmed has established expert physician panels in cardiology, oncology, and a multi-disciplinary Strategic Advisory Panel. Cepmed is working with these panels to ensure that personalised medicine is effectively incorporated into routine medical practice, resulting in improved health care in Canada.
Founded by Dr. Jean Claude Tardif at the Montreal Heart Institute, Cepmed makes use of the Beaulieu-Saucier Pharmacogenomics Centre, the Montreal Heart Institute Coordinating Centre (MHICC) and the Montreal Heart Institute Biobank in its projects. It is a Centre of Excellence for Commercialization and Research (CECR) and supported by the Canadian Government and Genome Quebec as well as private partners including Merck, Pfizer, AstraZeneca and Novartis.
(i) "The Case for Personalized Medicine, 3rd Edition", published by the Personalized Medicine Coalition in 2011
Director of Advocacy and Promotion
Centre of Excellence in Personalised Medicine
Whole genome sequencing in health services:
The rapid development of fast, affordable whole genome sequencing (WGS) technologies is set to bring major changes to clinical and public health practice. The potential benefits within the next few years are significant: improved diagnosis and management of inherited diseases and cancer, and more personalised use of treatments and therapies.
The potential benefits of the new technologies are significant: improved diagnosis and management of inherited diseases and cancer, and more personalised use of treatments and therapies. However,successful delivery of a more efficient and effective system of healthcare using genomics requires:
- Creation of new biomedical informatics expertise within the NHS and building databases that will drive better understanding of which genomic variants affect health.
- Use of targeted forms of genome analysis that minimise unexpected (incidental) findings and telling patients only about medically important information that arises.
- Better understanding of genomic data interpretation among health professionals
The full report is available as a free electronic download at Next steps in the sequence.
Whole genome sequencing overview is also available.
Adam Cohen: Why Genetic Discrimination Is Illegal - GenOmics
links to this article: " Can You Be Fired for Your Genes?"
Genetic Information Non-Discrimination Act Charges:
The following chart represents the total number of charge receipts filed and resolved under Genetic Information Non-Discrimination. The data are compiled by the Office of Research, Information and Planning from data compiled from EEOC's Integrated Mission System.
Blogger's Note: to view, register (free)
Clinical Oncology News - Revamping the NCI Clinical Trials Cooperative Groups
Line-up of the NCI Cooperative Groups After Consolidation
- The Cancer and Leukemia Group B Cooperative Group (CALGB), the North Central Cancer Treatment Group (NCCTG) and the American College of Surgeons Oncology Group (ACOSOG) have merged to form The Alliance for Clinical Trials in Oncology.
- The Eastern Cooperative Group (ECOG) and the American College of Radiology Imaging Network (ACRIN) have announced a merger.
- The Southwest Oncology Group (SWOG) will remain independent.
- The National Surgical Adjuvant Breast and Bowel Project (NSABP), the Radiation Therapy Oncology Group (RTOG) and the Gynecologic Oncology Group (GOG) are reportedly forming a confederation, although details are pending.
- The Children’s Oncology Group (COG) is exempt from the consolidation.
The Medicare Advantage Success Story — Looking beyond the Cost Difference: New England Journal of Medicine Ahead of Print.
U.S. Medicare - Study calls CMS' CT scan measure inaccurate - Healthcare business news and research | Modern Healthcare
A study in the Annals of Emergency Medicine concludes that a new imaging efficiency measure from the CMS known as OP-15 is not accurate in determining which hospitals perform CT scans under appropriate circumstances.
"Although patience is said to be a virtue, it is a commodity that many patients cannot afford, since there is much demand for an immediate clinical return on investment in genomics research. However, biology and health care systems are complex, and it is unrealistic to expect that the march of clinical progress will accelerate at the same rate as technological advances. That said, the advances described in the second Genomic Medicine review series show that genomics has made great strides toward improving human health."
Patients’ experiences and views of an emergency and urgent care system - Knowles - 2011 - Health Expectations
Background Surveys of patients’ experiences and views of health care usually focus on single services. During an unexpected episode of ill health, patients may make contact with different services and therefore experience care within an emergency and urgent care system. We developed the Urgent Care System Questionnaire and used it to describe patients’ experiences and views of an emergency and urgent care system in England.
Methods A market research company used quota sampling and random digit dialling to undertake a telephone survey of 1000 members of the general population in July 2007.
Results 15% (151/1000) of the population reported using the emergency and urgent care system in the previous 3 months. Two thirds of users (68%, 98/145) contacted more than one service for their most recent event, with a mean of 2.0 services per event. Users entered the system through a range of services: the majority contacted a daytime GP in the first instance (59%, 85/145), and 12% (18/145) contacted either a 999 emergency ambulance or an emergency department. Satisfaction with all aspects of care diminished when four or more services had been contacted.
Conclusions This is the first study to describe patients’ experiences and views of the emergency and urgent care system. The majority of patients experienced a system of care rather than single service care. There was an indication that longer pathways resulted in lower levels of patient satisfaction. Health care organisations can undertake similar surveys to identify problems with their system or to assess the impact of changes made to their system.
A Rational Approach to the Management of Recurrent or Persis... : Clinical Obstetrics and Gynecology
A Rational Approach to the Management of Recurrent or Persistent Ovarian Carcinoma
THIGPEN, TATE MD
Evidence supports the current paradigm for the management of patients with recurrent or persistent ovarian carcinoma. The paradigm requires that patients be classified as platinum-sensitive or platinum-resistant. Patients who achieve a complete response with platinum-based therapy and experience at least 6 months free from recurrence should be categorized as having chemosensitive disease and should be retreated with carboplatin-based doublets. Patients who progress while receiving treatment, whose best response is stable disease, or who experience a complete response of <6 months duration should be categorized as having chemoresistant disease and should be treated with a nonplatinum single agent.