scholarly journals Financial toxicity in patients with cancer attending a public Australian tertiary hospital: A pilot study

2020 ◽  
Vol 17 (3) ◽  
pp. 245-252
Author(s):  
Luke McLean ◽  
Wei Hong ◽  
Sue‐Anne McLachlan
2021 ◽  
Vol 10 (10) ◽  
pp. 2110
Author(s):  
Oyeon Cho ◽  
Do-Wan Kim ◽  
Jae-Youn Cheong

Plasma exosomal miRNAs are key regulators of cell-cell interactions associated with several biological functions in patients with cancer. This pilot study aimed to investigate the log2 fold change (log2FC) of the expression of exosomal miRNAs and related mRNAs in the blood of patients with cervical cancer to identify prognostic markers better than those currently available. We sequenced plasma exosomal RNA from 56 blood samples collected from 28 patients with cervical cancer, who had been treated with concurrent chemoradiotherapy (CCRT). Changes in the expression of miRNAs and mRNAs before and after CCRT were represented as log2FC. Their biological functions were studied by miRNA-mRNA network analysis, using ingenuity pathway analysis, after the selection of two groups of miRNAs, each associated with early progression (EP) and metastasis, also described as initial stage. Seven patients experienced EP, three of whom died within four months after progression. Reduced levels of miR-1228-5p, miR-33a-5p, miR-3200-3p, and miR-6815-5p and increased levels of miR-146a-3p in patients with EP revealed unresolved inflammation, with accompanying increased expression of PCK1 and decreased expression of FCGR1A. Increased levels of miR-605-5p, miR-6791-5p, miR-6780a-5p, and miR-6826-5p and decreased levels of miR-16-1-3p (or 15a-3p) were associated with the degree of metastasis and led to the systemic activation of myeloid, endothelial, and epithelial cells, as well as neurons, phagocytes, and platelets. Log2FCs in the expression of miRNAs and mRNAs from plasma exosomes after CCRT are associated with EP and metastasis, reflecting unresolved inflammation and systemic microenvironmental factors, respectively. However, this study, supported by preliminary data insufficient to reach clear conclusions, should be verified in larger prospective cohorts.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
J. S. Hopstaken ◽  
D. van Dalen ◽  
B. M. van der Kolk ◽  
E. J. M. van Geenen ◽  
J. J. Hermans ◽  
...  

Abstract Background Over the past decades, health care services for pancreatic surgery were reorganized. Volume norms were applied with the result that only a limited number of expert centers perform pancreatic surgery. As a result of this centralization of pancreatic surgery, the patient journey of patients with pancreatic tumors has become multi-institutional. To illustrate, patients are referred to a center of expertise for pancreatic surgery whereas other parts of pancreatic care, such as chemotherapy, take place in local hospitals. This fragmentation of health care services could affect continuity of care (COC). The aim of this study was to assess COC perceived by patients in a pancreatic care network and investigate correlations with patient-and care-related characteristics. Methods This is a pilot study in which patients with (pre) malignant pancreatic tumors discussed in a multidisciplinary tumor board in a Dutch tertiary hospital were asked to participate. Patients were asked to fill out the Nijmegen Continuity of Care-questionnaire (NCQ) (5-point Likert scale). Additionally, their patient-and care-related data were retrieved from medical records. Correlations of NCQ score and patient-and care-related characteristics were calculated with Spearman’s correlation coefficient. Results In total, 44 patients were included (92% response rate). Pancreatic cancer was the predominant diagnosis (32%). Forty percent received a repetition of diagnostic investigations in the tertiary hospital. Mean scores for personal continuity were 3.55 ± 0.74 for GP, 3.29 ± 0.91 for the specialist and 3.43 ± 0.65 for collaboration between GPs and specialists. Overall COC was scored with a mean 3.38 ± 0.72. No significant correlations were observed between NCQ score and certain patient-or care-related characteristics. Conclusion Continuity of care perceived by patients with pancreatic tumors was scored as moderate. This outcome supports the need to improve continuity of care within multi-institutional pancreatic care networks.


2021 ◽  
Vol 48 (4) ◽  
pp. 431-439
Author(s):  
Susan Birkhoff ◽  
Cynthia Waddington ◽  
Jordan Williams ◽  
Leslie Verucci ◽  
Maureen Dominelli ◽  
...  

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 149-149
Author(s):  
Meera Vimala Ragavan ◽  
Rosie Cunningham ◽  
Andrea Incudine ◽  
Hala Borno ◽  
Thomas Stivers

149 Background: Financial toxicity is characterized by financial burden that patients face. Patients and providers are seldom aware of available resource to help mitigate this growing problem. To date, our understanding of the myriad of financial repercussions of cancer treatment remains limited. Prior published research has largely been single center, thereby limiting generalizability across the United States. This study leveraged a national, multi-ethnic sample of patients who receive financial support services including comprehensive financial assistance, navigation, planning, and a guidebook with relevant resources from a non-profit entity (Family Reach) to evaluate financial stress in during cancer treatment. Methods: Patients were identified for study participation if they received at least one financial support resource from Family Reach between 1/1/2020-6/30/2020. An 11-item survey was sent electronically to all eligible participants who were given a one-month time frame to complete. A multivariate model was employed to identify sociodemographic predictors of high financial distress. Results: A total of 832 patients were contacted, of whom 330 (40%) completed the survey. Demographic information is included in table. Patient reported financial distress in the prior week was high, with 46% of patients reporting a distress level of seven or higher on a ten-point scale. In a multivariate regression, Hispanic/Latinx ethnicity was associated with a higher distress rating and higher patient reported financial stress. Lower annual household income was associated with lower reports of feeling in financial control, lower reports of meeting monthly expenses, and higher reports of financial stress. Conclusions: Patient-reported financial distress was high in a national sample of patients with cancer who had utilized at least one financial resource provided by Family Reach. Hispanic ethnicity and Lower Annual Income were predictors of higher patient-reported financial distress. Larger samples are needed to confirm these patterns. Delivery systems should develop targeted interventions, including referrals to organizations providing financial assistance, for patient populations at high risk for financial toxicity. [Table: see text]


2019 ◽  
Vol 15 (8) ◽  
pp. 460-461
Author(s):  
Francesco Perrone ◽  
Massimo Di Maio ◽  
Fabio Efficace ◽  
Ciro Gallo ◽  
Diana Giannarelli ◽  
...  

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Lisbeth O. Rygg ◽  
Hildfrid V. Brataas ◽  
Bente Nordtug

Background. This article examines personnel and patient experiences of videoconferencing (VC) trials on tablet computers between oncology certified nurses (OCNs) and patients with cancer who live at home. The study points to organizational pitfalls during the introduction process. In many different arenas, the use of VC has increased recently owing to improved Internet access and capacity. This creates new opportunities for contact between patients living at home and their nurses. Video conferencing presupposes knowledge about Internet access, training, and usability of technological equipment. The aim of this pilot study was to illuminate patients’ and nurses’ experiences of the technical functionality, usability, and training of tablet use in VC in primary cancer care. The results point to the drawbacks concerning the introduction of VC. Method. A pilot study with an explorative design was used to describe patients’ and OCNs’ experiences of technical functionality and usability of VC on tablet computers. After a three-month trial, data were gathered, focusing on both patients’ and nurses’ perspectives. Individual interviews with four female OCNs, aged 32–65 (mean 46), and six patients with cancer, two men and four women aged 49–78 (mean 69), were content-analyzed. Results. The analysis revealed two main categories: network connectivity and tablet usability and training and educational pitfalls. Conclusion. When planning VC implementation, the organizational leadership should consider network access and stability, as well as individualized VC training on tablets. Ensuring patient safety should also be a priority. Further research should provide knowledge of technological and educational pitfalls, and possible implications of VC on the care quality of nursing.


2018 ◽  
Vol 4 (Supplement 1) ◽  
pp. 22s-22s
Author(s):  
Khin Saw Aye ◽  
KhinThet Wai ◽  
Yan Naing Swe ◽  
Ssu Wynn Mon ◽  
Nan Cho Nwe Mon ◽  
...  

Abstract 57 Purpose The cancer burden is rising and threatens the social and economic development of low- and middle-income countries, including Myanmar, in the ASEAN region. A quality cancer registry plays a unique role in planning, the evaluation of cancer control program, treatment, and palliative care. To date, there is a paucity of studies in Myanmar that have focused on the implementation of a population-based cancer registry. In addition, the concept of telemedicine with the use of information technology applications as appropriate during implementation needs to be introduced. Such an approach may be beneficial to those working at the grassroots level for the overall improvement of the processes of community reporting, confirmation of diagnoses, effective referral for palliative care, and the establishment of cancer registries. Methods A pilot study was therefore carried out to formulate the strategic approach for establishing a population-based cancer registry in Hlegu Township in Northern Yangon District, Myanmar. First, the cancer data entry software was created and installed on mobile phones as an information technology tool to initialize telemedicine. Next, 15 health assistants in Hlegu Township were trained in the collection of data and the entry of basic information on patients with cancer, including name, age, gender, national ID, education, occupation, primary diagnosis, and the site of metastasis of confirmed cancer cases through mobile phone applications and reported to the cancer database unit at the Department of Medical Research. Results A total of 126 patients with cancer were registered in Hlegu Township from June 2016 to May 2017. The estimated prevalence of disease is 4.6 per 10,000 people. The most common age at cancer diagnosis was 46 to 65 years (73.58%). Female sex was 2.5 times predominant than male sex (72% v 27%). Among 91 registered female patients with cancer, the three most common cancers were breast (32.35%), cervix (16.17%) and uterine (15.17%). Eighty-five patients with cancer (67.46%) received their diagnosis in public hospitals. Overall, 59% of patients received combination treatment, 19% received surgery only, 16% were treated with traditional medicine, 3% were treated with radiotherapy only, and 3% were treated with chemotherapy only. Conclusion This study is a first step in applying the concept of telemedicine to the creation of a population-based cancer registry in a resource-limited setting. More concerted efforts are needed to move toward a well-established population-based cancer registry in Myanmar. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.


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