Proportion cured models applied to 23 cancer sites in norway.

Proportion cured models applied to 23 cancer sites in norway.

Abstract

BACKGROUND: Statistical cure is reached when a group of patients has the same mortality as cancer-free individuals. Cure models predict the cured proportion and the median survival of fatal cases. Cure models have seldom been applied and tested systematically across all major cancer sites.

METHODS: Incidence and follow-up data on 23 cancer sites recorded at the Cancer Registry of Norway 1963-2007 were obtained. Mixture cure models were fitted to obtain trends and up-to-date estimates (based on period approach) assuming cured and uncured groups exist.

RESULTS: The model converged for cancers of the mouth and pharynx, oesophagus, stomach, colon, rectum, liver, gallbladder, pancreas, lung and trachea, ovary, kidney, bladder, CNS, non-Hodgkin lymphoma (only for males) and leukaemia. The proportion of cured patients increased 1963-2002 for both sexes, with the largest changes (in %) seen for leukaemia (46.4 and 46.7) and CNS (35.9, 42.0), males given first. Median survival time for the uncured cases increased for colon and rectal cancer, and there was a three- fold increase in median survival time for patients with fatal ovarian cancers. Cancers of bladder and CNS had the highest up-to-date proportion cured (in %) (67.4 and 64.0, respectively), pancreas and liver were amongst the lowest (5.7 and 9.9, respectively).

CONCLUSION: Cure models are useful when monitoring progress in cancer care, but must be applied and interpreted with caution. The absolute estimates of the cure proportion are speculative, and should not be calculated where cure is not medically anticipated. © 2012 Wiley Periodicals, Inc.

http://www.ncbi.nlm.nih.gov/m/pubmed/22927104/?i=13&from=ovarian%20cancer

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Anticipatory Loss and Early Mastectomy for Young Female BRCA1/2 Mutation Carriers.

Anticipatory Loss and Early Mastectomy for Young Female BRCA1/2 Mutation Carriers.

Abstract

Young women who carry BRCA1/2 mutations face difficult decisions in managing their hereditary breast/ovarian cancer risk. Through this National Cancer Institute study, we sought to understand the process by which some young women choose risk-reducing bilateral mastectomy (RRBM) instead of alternative risk-management options. Data indicate that electing to undergo RRBM, although difficult, is experienced as a way to sidestep potentially devastating outcomes, such as stressful and costly high-risk screening, chemotherapy or radiation, or putting loved ones through the challenges of a cancer diagnosis. The decision to pursue RRBM is often the product of screening fatigue, encouragement from loved ones, and/or a sense of urgency to put one's high-risk period behind one. By understanding how young carriers make decisions about surgical risk reduction, providers can better guide, counsel, and support patients in the important tasks surrounding this life-changing medical decision, thereby helping to increase the duration and quality of their lives.

PMID

 22927701 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/m/pubmed/22927701/?i=9&from=ovarian%20cancer

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PDF: Emerging treatment options for management of malignant ascites in patients with ovarian cancer

Emerging treatment options for management of malignant ascites in patients with ovarian cancer

http://www.dovepress.com/emerging-treatment-options-for-management-of-malignant-ascites-in-pati-peer-reviewed-article-IJWH

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Emerging treatment options for management of malignant ascites in patients with ovarian cancer.

Emerging treatment options for management of malignant ascites in patients with ovarian cancer.

Abstract

Malignant ascites affects approximately 10% of patients with recurrent epithelial ovarian cancer and is associated with troublesome symptoms, including abdominal pressure and distension, dyspnea, bloating, pelvic pain, and bowel/bladder dysfunction. To date, no effective therapy has been identified for the treatment of malignant ascites in patients with recurrent, advanced ovarian cancer. In this article, we discuss currently existing options for the treatment of ascites associated with ovarian cancer, and review the literature as it pertains to novel, targeted therapies. Specifically, preclinical and clinical trials exploring the use of the antiangiogenic agents, bevacizumab and vascular endothelial growth factor-trap, as well as the nonangiogenic agent, catumaxomab, will be reviewed. Despite current limitations in treatment, knowledge regarding management options in the palliation of ascites is critical to practicing physicians. Ultimately, as with all novel therapies, symptom relief and treatment goals must be weighed against patient discomfort and potentially significant adverse events.

http://www.ncbi.nlm.nih.gov/m/pubmed/22927770/?i=8&from=ovarian%20cancer

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Oophorectomy: the debate between ovarian conservation and elective oophorectomy.

Oophorectomy: the debate between ovarian conservation and elective oophorectomy.

ABSTRACT: Ovarian cancer remains the fifth deadliest cancer among women because of its early asymptomatic nature and lack of efficacious screening methods, leading to frequent late-stage diagnosis. Elective oophorectomy is an option for women undergoing benign hysterectomy as a means of reducing their ovarian cancer risk. Benefits also include reduced risk of repeat surgical operation due to adnexal masses and reduced anxiety related to perceived risk of ovarian and breast cancer. The potential negative side effects of elective oophorectomy, such as decreased cognition and sexual function and increased risk of osteoporosis and cardiac mortality, offer support for ovarian conservation. The implications of this elective procedure and the possible consequences without it require physicians to review the pros and cons with patients in light of the patient's individual circumstances and ovarian cancer risk.

PMID

 22929033 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/m/pubmed/22929033/?i=4&from=ovarian%20cancer

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Changes in short-term health-related quality of life in women undergoing gynecologic oncologic laparotomy: an associated factor analysis.

Changes in short-term health-related quality of life in women undergoing gynecologic oncologic laparotomy: an associated factor analysis.

Journal

Support Care Cancer. 2012 Aug 29

Abstract

PURPOSE: The primary purpose of this study is to evaluate health-related quality of life (HR-QOL) of gynecologic cancer patients undergoing laparotomy.

METHODS: Women who underwent laparotomy by gynecologic cancer completed the European Organization for Research and Treatment of Cancer (EORTC) Quality of life questionnaires (QLQ-C30 and QLQ-OV28) presurgery and at 1 month.

RESULTS: Of the 181 women studied between January 2007 and March 2008, 116 women (64.1 %) had ovarian cancer, 27 (14.9 %) had cervical cancer, and 29 (16.0 %) had endometrial cancer. By 1 month post-surgery, there was a significant decrease in HR-QOL on the global, abdominal/gastrointestinal (GI) score, body image, chemotherapy side effects, and other single items of the OV28 questionnaire, as well as on physical, role and social functioning, fatigue, nausea and vomiting, pain, insomnia, constipation, appetite loss, and financial difficulties items on C30 questionnaires. Emotional functioning on C30 questionnaires was significantly improved 1 month after surgery. The majority of these items persisted 1 month after surgery only in patients with ovarian cancer. Abdominal/GI score on OV28 questionnaires as well as role and physical functioning on C30 questionnaires were significantly lower between baseline and postsurgical HR-QOL in women with other gynecologic malignancies.

CONCLUSION: The results suggest a significant impact of HR-QOL among gynecologic cancer patients 1 month after laparotomy, particularly among those with ovarian cancer.

http://www.ncbi.nlm.nih.gov/m/pubmed/22930239/?i=2&from=ovarian%20cancer

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CANDISC: NCI Trials Program Looks for Net Gains

NCI Trials Program Looks for Net Gains

http://m.cancerdiscovery.aacrjournals.org/content/early/2012/08/15/2159-8290.CD-NB2012-091.full

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Gender bias in leading scientific journals

http://www.sciencedaily.com/releases/2012/08/120830102851.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily+%28ScienceDaily%3A+Latest+Science+News%29&utm_content=Google+Reader


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CEU Bulletin, July 2012 | Cochrane Clinical Answers

Cochrane Clinical Answers

Wiley and the Cochrane Editorial Unit are working on a project to create a new product: Cochrane Clinical Answers (CCAs). CCAs are aimed at clinicians at the point of care, and they use evidence from Cochrane systematic reviews to create short answers to clinical questions. The content is developed by drawing out key information from Cochrane Reviews (an automated process), then a team of freelance clinicians (associate editors) and the CCA Editor use this evidence to create the clinical answers. All CCAs are then signed off by The Cochrane Library Editor-in-Chief, David Tovey.

We currently have 53 CCAs going through the editorial process, 32 of which have been signed off. Alongside the editorial work, the CCA website is being developed, and we are aiming for a clear, uncomplicated design that is easy and quick to use. Market testing of the site has been completed and Wiley is currently working to incorporate both market testing and CEU feedback. The site is due to launch later in the year and will be on display at the Cochrane Colloquium in Auckland. If Cochrane Review Groups would like to be involved in this project in any way, or if they have any questions, please do contact me.

Karen Pettersen (kpettersen@wiley.com), CCA editor

http://www.editorial-unit.cochrane.org/ceu-bulletin-july-2012#Bull2

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Chat With a Doctor: Ovarian Cancer — Health Hub from Cleveland Clinic

http://health.clevelandclinic.org/2012/08/chat-with-a-doctor-ovarian-cancer/?utm_source=rss&utm_medium=rss&utm_campaign=chat-with-a-doctor-ovarian-cancer


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Am. J. Epid. - The Forgotten Griever: A Nationwide Follow-up Study of Mortality Subsequent to the Death of a Sibling

The Forgotten Griever: A Nationwide Follow-up Study of Mortality Subsequent to the Death of a Sibling

http://m.aje.oxfordjournals.org/content/176/4/338.short?rss=1

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Fruit and vegetable intake and impact on pancreatic cancer....

".....Associations were similar for men and women separately and across studies. These results suggest that fruit and vegetable intake during adulthood is not associated with a reduced pancreatic cancer risk."

http://www.google.ca/reader/i/?source=mog&hl=en&gl=ca#stream/feed%2Fhttp%3A%2F%2Faje.oxfordjournals.org%2Frss%2Fcurrent.xml


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Risks of Primary Extracolonic Cancers Following Colorectal Cancer in Lynch Syndrome

Risks of Primary Extracolonic Cancers Following Colorectal Cancer in Lynch Syndrome:

Background
Lynch syndrome is a highly penetrant cancer predisposition syndrome caused by germline mutations in DNA mismatch repair (MMR) genes. We estimated the risks of primary cancers other than colorectal cancer following a diagnosis of colorectal cancer in mutation carriers.

Methods
We obtained data from the Colon Cancer Family Registry for 764 carriers of an MMR gene mutation (316 MLH1, 357 MSH2, 49 MSH6, and 42 PMS2), who had a previous diagnosis of colorectal cancer. The Kaplan–Meier method was used to estimate their cumulative risk of cancers 10 and 20 years after colorectal cancer. We estimated the age-, sex-, country- and calendar period–specific standardized incidence ratios (SIRs) of cancers following colorectal cancer, compared with the general population.

Results
Following colorectal cancer, carriers of MMR gene mutations had the following 10-year risk of cancers in other organs: kidney, renal pelvis, ureter, and bladder (2%, 95% confidence interval [CI] = 1% to 3%); small intestine, stomach, and hepatobiliary tract (1%, 95% CI = 0.2% to 2%); prostate (3%, 95% CI = 1% to 5%); endometrium (12%, 95% CI = 8% to 17%); breast (2%, 95% CI = 1% to 4%); and ovary (1%, 95% CI = 0% to 2%). They were at elevated risk compared with the general population: cancers of the kidney, renal pelvis, and ureter (SIR = 12.54, 95% CI = 7.97 to 17.94), urinary bladder (SIR = 7.22, 95% CI = 4.08 to 10.99), small intestine (SIR = 72.68, 95% CI = 39.95 to 111.29), stomach (SIR = 5.65, 95% CI = 2.32 to 9.69), and hepatobiliary tract (SIR = 5.94, 95% CI = 1.81 to 10.94) for both sexes; cancer of the prostate (SIR = 2.05, 95% CI = 1.23 to 3.01), endometrium (SIR = 40.23, 95% CI = 27.91 to 56.06), breast (SIR = 1.76, 95% CI = 1.07 to 2.59), and ovary (SIR = 4.19, 95% CI = 1.28 to 7.97).

Conclusion

Carriers of MMR gene mutations who have already had a colorectal cancer are at increased risk of a greater range of cancers than the recognized spectrum of Lynch syndrome cancers, including breast and prostate cancers.

How Radiation Oncologists Would Disclose Errors: Results of a Survey of Radiation Oncologists and Trainees

How Radiation Oncologists Would Disclose Errors: Results of a Survey of Radiation Oncologists and Trainees:

Purpose: To analyze error disclosure attitudes of radiation oncologists and to correlate error disclosure beliefs with survey-assessed disclosure behavior.

Conclusions: The surveyed radiation oncologists chose to respond with full disclosure at a high rate, although ideal disclosure practices were not uniformly adhered to beyond the initial decision to disclose the occurrence of the error.

ongoing: (gyn cancers) ChemoFx® PRO - A Post-Market Data Collection Study - Full Text View - ClinicalTrials.gov

ChemoFx® PRO - A Post-Market Data Collection Study - Full Text View - ClinicalTrials.gov

ongoing: A Study of ChemoFx® Chemoresponse Assay in Solid Tumors - ChemoFx® Registry Study - Full Text View - ClinicalTrials.gov

A Study of ChemoFx® Chemoresponse Assay in Solid Tumors - ChemoFx® Registry Study - Full Text View - ClinicalTrials.gov

ongoing: Carboplatin and Paclitaxel With or Without Bevacizumab After Surgery in Treating Patients With Recurrent Ovarian Epithelial Cancer, Primary Peritoneal Cavity Cancer, or Fallopian Tube Cancer - Full Text View - ClinicalTrials.gov

Carboplatin and Paclitaxel With or Without Bevacizumab After Surgery in Treating Patients With Recurrent Ovarian Epithelial Cancer, Primary Peritoneal Cavity Cancer, or Fallopian Tube Cancer - Full Text View - ClinicalTrials.gov

An eClinical trial system for cancer that integrates with clinical pathways and electronic medical records

An eClinical trial system for cancer that integrates with clinical pathways and electronic medical records:

Background
Various information technologies currently are used to improve the efficiency of clinical trials. However, electronic medical records (EMRs) are not yet linked to the electronic data capture (EDC) system. Therefore, the data must be extracted from medical records and transcribed to the EDC system. Clinical pathways are planned process patterns that are used in routine clinical practice and are easily applicable to the medical care and evaluation defined in a trial protocol. However, few clinical pathways are intended to increase the efficiency of clinical trials.

Purpose
Our purpose is to describe the design and development of a new clinical trial process model that enables the primary use of EMRs in clinical trials by integrating clinical pathways and EMRs.

Methods
We designed a new clinical trial model that uses EMR data directly in clinical trials and developed a system to follow this model. We applied the system to an investigator-initiated clinical trial and examined whether all data were extracted correctly. At the protocol development stage, our model measures endpoints based on clinical pathways with the same diagnosis. Next, medical record descriptions and the format of the statistical data are defined. According to these observations, screens for entry of data, which are used both in clinical practice and for study, are prepared into EMRs with an EMR template, and screens are prepared for data checks on our EMR retrieval system (ERS). In an actual trial, patients are registered and randomly assigned to a protocol treatment. The protocol treatment is executed according to clinical pathways, and the data are recorded to EMRs using EMR templates. The data are checked by a local data manager using reports created by the ERS. After edit checks and corrections, the data are extracted by the ERS, archived in portable document format (PDF) with an electronic signature, and transferred in comma-separated values (CSV) format to a coordinating centre. At the coordinating centre, the data are checked, integrated, and made available for a statistical analysis.

Results
We verified that the data could be extracted correctly and found no unexpected problems.

Limitation
To execute clinical trials in our system, the EMR template and efficient ERSs are required. Additionally, to execute multi-institutional clinical trials, it is necessary to create templates appropriate for EMRs at all participating sites and for the coordinating centre to validate local templates and procedures.

Conclusion
We proposed and pilot tested a new eClinical trial model. Because our model is integrated with routine documentation of clinical practice and clinical trials, redundant data entries were avoided and the burden on the investigator was minimised. The reengineering of the clinical trial process would facilitate the establishment of evidence in the future.

Vancouver, BC: The Effect of Direct-to-Consumer Genetic Tests on Anticipated Affect and Health-Seeking Behaviors: A Pilot Survey | Abstract

The Effect of Direct-to-Consumer Genetic Tests on Anticipated Affect and Health-Seeking Behaviors: A Pilot Survey | Abstract

Gynecologic Oncology - Identification of the optimal pathway to reach an accurate diagnosis in the absence of an early detection strategy for ovarian cancer

Gynecologic Oncology - Identification of the optimal pathway to reach an accurate diagnosis in the absence of an early detection strategy for ovarian cancer

Abstract

Objectives

There is a lack of knowledge about the health care events experienced by individual patients that lead to a definitive diagnosis of ovarian cancer (OC). The goal of this study was to describe the various pathways and to identify an optimal path to accurate diagnosis.

Methods

Women who were referred to gynecologic oncology for a suspected OC were enrolled to this study. Medical records (MRs) from all health care providers were obtained from the time the patient recalled first suspecting a health issue through the time of diagnosis to build a decision tree model. A Monte Carlo simulation was conducted of 83,000 patients to identify the optimal pathway to reach diagnosis.

Results

In the Monte Carlo simulation, gynecologic oncologists and gynecologists accounted for the most efficient diagnosis in over 37.9% and 29.2% of suspected OC cases, respectively, in terms of the least amount of time to reach diagnosis. Gynecologic oncologists were further associated with the fewest health care visits needed to reach diagnosis in 37% of the simulation cases; however, 23% of trials were indifferent to any specific provider.

Conclusions

The decision tree provides a more comprehensive view of the complexity in reaching an accurate diagnosis of OC. This analysis was able to identify the health care utilization patterns that underlie the events that occur to reach an accurate diagnosis in the setting of a suspected OC, and was able to identify the most efficient pathways that utilize the fewest health care resources in the least amount of time.

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Highlights

► The Monte Carlo simulation found differences in efficiency to reach diagnosis in terms of both time and fewest healthcare visits
► Gynecologic oncologists were the most rapid and efficient entry point for patients to reach diagnoses in the Monte Carlo simulation
► Many healthcare resources (provider visits, tests and assessments) are utilized in the absence of early detection strategies for ovarian cancer

2012 (understanding) Abdominal and Pelvic CT

Abdominal and Pelvic CT

Current Opinion in Oncology- The management of small-cell carcinomas of the gynecologic tract

http://mobile.journals.lww.com/co-oncology/_layouts/oaks.journals.mobile/abstractviewer.aspx?year=2012&issue=09000&article=00016


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CEBP: Oophorectomy and Breast Cancer inBRCA Mutation Carriers—Letter

Oophorectomy and Breast Cancer inBRCA Mutation Carriers—Letter

 Authors

The article by Kotsopoulos and colleagues (1) shows that oophorectomy significantly decreased the incidence of breast cancer in carriers of deleterious BRCA mutations, with OR, 0.52 [95% confidence interval (CI), 0.40–0.66]. This is an important result. The authors, however, wrongly interpreted their results writing that "women who underwent surgical menopause had a 48% decrease in the risk of developing breast cancer." An OR, in fact, is a good estimate of the relative risk (i.e., the risk ratio) only if the disease is rare, but in mutation carriers, the disease is very frequent. The source population actually included about 4,000 cases of 5,000 women, a proportion fairly consistent with the estimated penetrance of BRCA mutations. With such a large proportion of cases in the source population, the unbiased risk ratio could be of the order of 0.67, corresponding to 33% decrease in breast cancer risk, still a major effect. The same flawed interpretation was present in several previous articles from the same group.

Disclosure of Potential Conflicts of Interest

There are no potential conflicts of interest.

• Received May 18, 2012.
• Accepted May 22, 2012.

• ©2012 American Association for Cancer Research.

Reference

1. ↵ 
   1. Kotsopoulos J, 
   2. Lubinski J, 
   3. LynchH, 
   4. Kim-Sing C, 
   5. Neuhausen SL,
   6. Demsky R, 
   7. et al.
    

   Oophorectomy after menopause and the risk of breast cancer in BRCA1 andBRCA2 mutation carriers? Cancer Epidemiol Biomarkers Prev2012;21:1089–96.

1. Published OnlineFirst June 4, 2012; doi: 10.1158/1055-9965.EPI-12-0603 Cancer Epidemiol Biomarkers PrevAugust 2012 21; 1389

• 
  

http://m.cebp.aacrjournals.org/content/21/8/1389.short

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CEBP: Lipid Profiles and Risk of Breast and Ovarian Cancer in the Swedish AMORIS Study

http://m.cebp.aacrjournals.org/content/21/8/1381.short


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BMJ Group blogs: BMJ » Blog Archive » Martin Wiseman, Kathryn Allen, and Rachel Thompson: Weighing the evidence on cancer prevention

http://blogs.bmj.com/bmj/2012/08/28/martin-wiseman-kathryn-allen-and-rachel-thompson-weighing-the-evidence-on-cancer-prevention/


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ScienceDirect.com - Gynecologic Oncology - Prolonged postoperative venous thrombo-embolism prophylaxis is cost-effective in advanced ovarian cancer patients

Prolonged postoperative venous thrombo-embolism prophylaxis is cost-effective in advanced ovarian cancer patients

Abstract

Objective

The purpose of this study was to investigate the cost-effectiveness of prolonged prophylaxis with enoxaparin in high-risk surgical patients with ovarian cancer. In addition, we sought to quantify the impact of prolonged prophylaxis (PP) on the incidence of venous thromboembolism (VTE), its related complications, and overall patient survival.

Methods

A Markov decision analytic model was used to estimate the costs, resource allocation and outcomes associated with the prolonged use of enoxaparin, for a total of four weeks after surgery, in patients undergoing primary debulking surgery for stage IIIC ovarian cancer. We estimated incremental cost per quality-adjusted life-year (QALY) at one and five year intervals; the estimated reduction in VTE episodes, bleeding episodes, and survival at the five year interval for a simulated cohort of 10,000 women.

Results

The incremental cost effectiveness ratio (ICER) for prolonged prophylaxis (PP) was $5236/QALY and $-1462/QALY at one and five years respectively. For patients receiving PP, the model estimated a 12% reduction in the clinically evident VTE episodes and a higher five-year survival (31.61% vs. 29.96%; p < 0.0001). Resource allocation analysis reveals that 95% of initial investment cost of prolonged enoxaparin is recovered within one year.

Conclusions

In ovarian cancer patients undergoing open abdominal surgery, prolonged VTE prophylaxis not only improves patient outcomes, but is also a cost saving strategy when modeled over five years. A significant reduction in the episodes of VTE and a higher overall survival warrants consideration for the routine use of PP in this patient population.

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Highlights

► Prolonged VTE prophylaxis is a cost saving strategy when modeled over five years in post-operative ovarian cancer patients. ► Our model estimates improved overall survival and decreased number of venous thromobembolic events with prolonged prophylaxis.

Keywords

• Prolonged 

BMC Cancer | Abstract | Derivation and characterization of matched cell lines from primary and recurrent serous ovarian cancer

http://www.biomedcentral.com/1471-2407/12/379/abstract


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Non-adherence patient care.......

"....Non-adherence is a problem but it is not the patient's problem. It is really an indication that something has gone wrong in the process of delivering care..."

http://www.google.ca/reader/i/?source=mog&hl=en&gl=ca#stream/feed%2Fhttp%3A%2F%2Fwww.cancerworld.org%2Ffeed.html


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JCO Editorial Accumulating Evidence for the Effect of Chemotherapy on Cognition

http://m.jco.ascopubs.org/content/early/2012/08/26/JCO.2012.43.5776.full.pdf#page=1


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Recommendations for including multiple symptoms as endpoints in cancer clinical trials - 2012 - Cancer

Recommendations for including multiple symptoms as endpoints in cancer clinical trials 

A report from the ASCPRO (Assessing the Symptoms of Cancer Using Patient-Reported Outcomes) Multisymptom Task Force

http://onlinelibrary.wiley.com/doi/10.1002/cncr.27744/abstract

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BRAF Mutation is associated with early stage disease and improved outcome in patients with low-grade serous ovarian cancer - Grisham - 2012 - Cancer - Wiley Online Library

Original Article

BRAF Mutation is associated with early stage disease and improved outcome in patients with low-grade serous ovarian cancer

Article first published online: 28 AUG 2012

DOI: 10.1002/cncr.27782

Copyright © 2012 American Cancer Society

Issue

http://onlinelibrary.wiley.com/doi/10.1002/cncr.27782/abstract;jsessionid=F24E520FC29B350ED720ABB4426E8946.d02t02

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JCP High grade serous carcinoma of the ovary with a yolk sac tumour component in a postmenopausal woman: report of an extremely rare phenomenon

http://m.jcp.bmj.com/content/65/9/853.short?rss=1


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Is long-term weight loss possible after menopause?

http://www.sciencedaily.com/releases/2012/08/120828093238.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily+%28ScienceDaily%3A+Latest+Science+News%29&utm_content=Google+Reader


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Mandated "GMO Food" Disclosure: Labeling for Thee but Not for Me - Forbes

Labeling for products that meet the USDA-NOP standards (Photo credit: Wikipedia)

http://www.forbes.com/sites/wlf/2012/08/28/mandated-gmo-food-disclosure-labeling-for-thee-but-not-for-me/

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JOP : Attitudes of Patients With Cancer About Personalized Medicine and Somatic Genetic Testing

http://m.jop.ascopubs.org/content/early/2012/08/07/JOP.2012.000626


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Practical Guidance: The Use of Social Media In Oncology Practice

http://m.jop.ascopubs.org/content/early/2012/07/17/JOP.2012.000610


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Journal of Oncology Practice-Do High Symptom Scores Trigger Clinical Actions? An Audit After Implementing Electronic Symptom Screening

Do High Symptom Scores Trigger Clinical Actions? An Audit After Implementing Electronic Symptom Screening

 Authors

1. Hsien Seow, PhD,
2. Jonathan Sussman, MD, MSc,
3. Lorraine Martelli-Reid, RN, MN, NP,
4. Greg Pond, PhD, PStat and
5. Daryl Bainbridge, PhD

1. McMaster University; and Juravinski Cancer Centre, Hamilton, Ontario, Canada

1. Corresponding author: Hsien Seow, PhD, Cancer Care Ontario Research Chair in Health Services Research, Assistant Professor, Department of Oncology, McMaster University, 699 Concession St, 4th floor, Rm 4-229, Hamilton, Ontario L8V 5C2, Canada; e-mail: seowh@mcmaster.ca.

Abstract

Purpose: Standardized, electronic, symptom assessment is purported to help identify symptom needs. However, little research examines clinical processes related to symptom management, such as whether patients with worsening symptoms receive clinical actions more often. This study examined whether patient visits with higher symptom scores are associated with higher rates of symptom documentation in the chart and symptom-specific actions being taken.

Methods: Retrospective chart reviews on cancer patient visits at a regional cancer center. An electronic Edmonton Symptom Assessment Scale (ESAS), a validated tool to measure symptoms, was implemented center-wide to standardize symptom screening at every patient visit. The independent variable was ESAS scores for pain and shortness of breath, categorized by severity: 0 (none), 1-3, 4-6, 7-10 (severe). Outcomes included symptom documentation in the chart on the visit date and symptom-related action(s) taken within 1 week.

Results: Nine hundred twelve visits were identified. Pain and shortness of breath were documented in 51.8% and 29.7% of charts, and a related-action occurred in 16.9% and 3.9% of charts, respectively. As ESAS severity score category increased from none to severe, the proportion of visits with pain documented increased significantly (36.9%, 49.2%, 55.2%, and 71.4%; P < .001). Likewise, as ESAS score severity increased, the proportion of visits with a pain-related action increased significantly (4.2%, 10.6%, 21.3%, and 37.0%; P < .001). Trends were similar for shortness of breath.

Conclusion: Results show a positive association between higher symptom scores and higher rates of documentation and clinical actions taken. However, symptom-related actions were documented in a minority of visits in which symptoms were noted as severe.

http://m.jop.ascopubs.org/content/early/2012/08/21/JOP.2011.000525

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JOP : Journal of Oncology Practice - patient/physician discussions regarding cancer costs (abstract)

"Conclusion: Patients' comfort with and desire to discuss cancer costs exceed that of oncologists, suggesting a need to educate oncologists on this important topic. A patient's desire to understand treatment-associated cost does not equate with a desire for cost to influence medical decision making."

http://m.jop.ascopubs.org/content/8/4/e50.short?rss=1


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