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fragility in the elderly cancer patients

Eric Leblanc, Fabrice Narducci, Lucie Bresson, Delphine Hudry
OBJECTIVE: To explore the feasibility of an oncologically acceptable management for an intermediate-risk endometrial cancer (EC) in an elderly, using the combination of transvaginal single-port laparoscopy and sentinel node policy. METHODS: For this 85-years old patient, BMI 32kg/m(2), with IB grade 2 endometrioid EC, a single vaginal approach was attempted [1] to perform a total hysterectomy, bilateral salpinago-oophorectomy and pelvic node assessment guided by SND [2]...
October 13, 2016: Gynecologic Oncology
Cecilia Becattini, Giancarlo Agnelli
Venous thromboembolism (VTE) is a common disease associated with high risk for recurrences, death, and late sequelae, accounting for substantial health care costs. Anticoagulant agents are the mainstay of treatment for deep vein thrombosis and pulmonary embolism. The recent availability of oral anticoagulant agents that can be administered in fixed doses, without laboratory monitoring and dose adjustment, is a landmark change in the treatment of VTE. In Phase III trials, rivaroxaban, apixaban, edoxaban (antifactor Xa agents), and dabigatran (an antithrombin agent) were noninferior and probably safer than conventional anticoagulation therapy (low-molecular-weight heparin followed by vitamin K antagonists)...
April 26, 2016: Journal of the American College of Cardiology
M Chodez, G Fiard, V Arnoux, J-L Descotes, J-A Long
OBJECTIVE AND METHOD: To focus on indications and results of ablative treatments (cyoablation, radiofrequency) for small renal masses, a bibliographic research was conducted in MedLine database using terms of "ablative treatment", "cryotherapy", "radiofrequency", "kidney cancer", "renal cell carcinoma". Sixty-four articles were selected. RESULTS: Carcinologic outcomes seem to be better with cryoablation than with radiofrequency. Available results have to be balanced according to surgical approach, teams' experience and duration of follow-up...
July 2015: Progrès en Urologie
Miguel J Gil-Gil, M Bellet, S Morales, B Ojeda, L Manso, C Mesia, E Garcia-Martínez, N Martinez-Jáñez, M Melé, A Llombart, S Pernas, P Villagrasa, C Blasco, J Baselga
Anthracycline and taxane-based primary chemotherapy (PCT) is the standard treatment for high-risk breast cancer (HRBC). However, conventional anthracyclines are not commonly used in elderly patients or those prone to cardiotoxicity. Pegylated liposomal doxorubicin, (PLD) has comparable efficacy, but less cardiotoxicity than conventional anthracyclines. We conducted a phase II single-arm trial to assess the efficacy and safety of PCT based on PLD followed by paclitaxel (PTX) in a HRBC population usually undertreated...
June 2015: Breast Cancer Research and Treatment
B Frediani, E Baraldi, G Cremonesi
A systematic review and a meta-analysis of data of literature were performed to evaluate the efficacy of clodronate in the reduction of risk of fractures in patients with osteoporosis or tumour diseases. A systematic review was conducted to identify original articles, reviews, and any other literature report suitable for the purposes of the meta-analysis, limited to prospective randomized trials that included a placebo or an untreated control arm. The search has identified 18 trials, 13 of which in patients with cancer diseases (breast cancer and multiple myeloma were prevalent), 4 in patients with osteoporosis/low BMD, and 1 in elderly women living in community...
October 2014: Calcified Tissue International
Emma Di Carlo, Carlo Sorrentino, Alessia Zorzoli, Serena Di Meo, Maria Grazia Tupone, Emanuela Ognio, Gabriella Mincione, Irma Airoldi
Prostate cancer (PCa) is of increasing significance worldwide as a consequence of the population ageing. Fragile elderly patients may particularly benefit from noninvasive and well tolerable immunotherapeutic approaches. Preclinical studies have revealed that the immune-regulatory cytokine IL-27 may exert anti-tumor activities in a variety of tumor types without discernable toxicity. We, thus, investigated whether IL-27 may function as anti-tumor agent in human (h) PCa and analyzed the rationale for its clinical application...
November 15, 2014: Oncotarget
Giacomo Piatto, Fabrizio Cardin, Renata Lorenzetti, Franco Mazzalai, Claudio Terranova, Carmelo Militello
This work investigates the prognostic role of advanced age as a risk factor for recurrence in a population of patients undergoing surgery for N0 stage colon cancer, and also evaluates whether that role is affected by tumor location. A population of 129 consecutive patients who underwent radical surgery for N0 stage colon cancer was selected. Patients were subdivided into three age groups: <65, 65-80 and >80. The only correlation found in the examined population between age and clinical-pathological features was between advanced age (>80) and tumor location in the right side of the colon...
June 2012: Aging Clinical and Experimental Research
Yong Sang Hong, Kyung Hae Jung, Hwa Jung Kim, Kyu-Pyo Kim, Sun Young Kim, Jae-Lyun Lee, Byoung Yong Shim, Dae Young Zang, Jee Hyun Kim, Joong Bae Ahn, Young Suk Park, Tae Won Kim
BACKGROUND: To compare 2 different strategies of chemotherapy for elderly metastatic colorectal cancer patients. METHODS: This randomized, multicenter phase II study involved 80 metastatic colorectal cancer patients aged 70 years and above (performance status [PS] 0-2) or 65 years and above (PS 2), randomly assigned to arm A (capecitabine 1250 mg/m twice daily on days 1-14) or arm B (capecitabine 1000 mg/m twice daily on days 1-14, oxaliplatin 100 mg/m on day 1 initially, 130 mg/m for subsequent cycles)...
December 2013: American Journal of Clinical Oncology
Andrew D Bunta
The current status of the population's bone health has caused considerable concern in the USA and around the world. In keeping with that situation, the US Surgeon General issued a special report on Bone Health and Osteoporosis in 2004 calling attention to a rapidly increasing healthcare problem especially linked to a growing and aging population base. The report specifically cited the medical profession's failure to treat the underlying osteoporosis in elderly individuals with fragility fractures with a 20% treatment rate as the norm...
August 2011: Osteoporosis International
L Sifer-Rivière, O Saint-Jean, M Gisselbrecht, T Cudennec, V Girre
BACKGROUND: Pilot Oncogeriatric Coordination Units (UPCOGs) were created by the French National Cancer Institute (INCA) in order to implement routine geriatric assessment of all cancer patients over 75 years of age. This article examines the role of geriatric and oncologic tools in the organization of medical oncogeriatric activities, focusing on the role and place of geriatricians. METHODS: We conducted a qualitative sociological survey in the West Paris Oncogeriatric Program (POGOP), one of the Pilot Oncogeriatric Coordination Units (UPCOGs) recently created in France...
October 2011: Annals of Oncology: Official Journal of the European Society for Medical Oncology
P F Bassi, R Falabella, L Bonadiman, R Marcolongo
Therapeutic Education (TE) means to build a partnership between doctors and patients comparing knowledge and therapeutic procedures to manage the disease and its treatment. Patients cannot be a mere passive beneficiary of therapeutic services, but they must play an active role, be conscious and participate in charging proper and community health. Patient TE is a pathway characterized by an "educational diagnosis" including identification of patient demands about pathology; an "educational-therapeutic policy" based on assignment of tasks and rules to manage every aspect of pathology; and the "evaluation" of results of patients' educational process...
July 2008: Urologia
Joan Manel Gasent Blesa, Vicente Alberola Candel
Metastatic prostate cancer is an incurable disease. After a period of hormone sensitivity that allows for the use of antiandrogens, the disease invariably progresses to a situation of androgen-independent growth, which deserves the consideration or the use of chemotherapy. As many of these patients are elderly and fragile, treatment with chemotherapy is challenging. Therefore, new drugs are required. Preclinical evidence supports the role of estrogen receptor (ER) signaling in prostate cancer. In this paper, we report the first published evidence of PSA control in a patient with metastatic prostate cancer treated with fulvestrant acetate...
2009: Case Reports in Oncology
B G Looij, D L Kreb, K Bosscha, M F Ernst, G J Jager, M J C M Rutten
Breast cancer is an important health care problem, especially in the increasing elderly generation. Treatment of these fragile patients is a challenge for the clinician. Undertreatment has been linked to a higher percentage of recurrence and cancer related morbidity, while overtreatment leads to treatment related morbidity and mortality. Minimally invasive techniques do offer new opportunities for patients, who are no candidates for conventional surgery. The tumor lesion is treated locally and selective with minimal damage to surrounding tissue, yielding an adequate local tumor control...
September 2008: Tijdschrift Voor Gerontologie en Geriatrie
Filipa Costa, Fernando J Barata
Lung cancer is the most common cause of cancer death. With the aging of the population, more than 50% of patients with non-small cell lung cancer (NSCLC) are older than 65 years. Until recently, there was some scepticism regarding treatment of patients in this age group, prevailing the notion that whatever treatment was given, the balance between the benefits and the side effects was unfavourable. The organ failure dependent of age, the comorbidities, the polimedication and the fragility of elderly people, were responsible for this generalized opinion...
November 2007: Revista Portuguesa de Pneumologia
Lise-Lotte Franklin, Britt-Marie Ternestedt, Lennart Nordenfelt
Discussion about a dignified death has almost exclusively been applied to palliative care and people dying of cancer. As populations are getting older in the western world and living with chronic illnesses affecting their everyday lives, it is relevant to broaden the definition of palliative care to include other groups of people. The aim of the study was to explore the views on dignity at the end of life of 12 elderly people living in two nursing homes in Sweden. A hermeneutic approach was used to interpret the material, which was gathered during semi-structured interviews...
March 2006: Nursing Ethics
Fausto Meriggi, Alberto Zaniboni
The world population is getting increasingly older. In Western countries, lung cancer in the most frequent cancer and more than 50% of patients who contract non-small-cell lung cancer (NSCLC) are close to 70 years old. It is therefore fundamentally important that we identify an overall strategy of screening, diagnosis and therapy designed specifically for elderly patients. NSCLC research still has relatively little material dedicated exclusively to the elderly, but recently interest has been growing, possibly due to the positive results of the most recent trials (Elderly Lung Cancer Vinorelbine Study Group (ELVIS), Southern Italy Cooperative Oncology Group (SICOG), Multicenter Italian Lung Cancer in the Elderly Study (MILES))...
February 2006: Critical Reviews in Oncology/hematology
J-J Guex
BACKGROUND: Modern sclerotherapy, using ultrasound guidance and foam sclerosants, is a reference treatment of varices of the lower limbs. Like all other techniques it should be employed in the safest, precisely described and reproducible conditions. Therefore, its contra indications must be clearly known. METHODS: Contra indications of sclerotherapy can be defined in legal notices provided by the manufacturers in compliance with regulatory standards, developed empirically, extrapolated from theoretical mechanisms, or analyzed from controlled studies...
July 2005: Journal des Maladies Vasculaires
Oliver Bonn, Gabriele Schmidt-Wolf, Frank Risse, Axel Glasmacher, Rolf Kleinschmidt, Ingo G H Schmidt-Wolf
BACKGROUND: Small-cell lung cancer is a disease affecting mostly elderly persons. Therefore, many patients show marked comorbidity and intensive chemotherapy is not possible in such patients. As the disease is most often in the 'extensive' stage at diagnosis, the therapy option is only palliative. MATERIALS/METHODS: [corrected] We used a combination therapy with vindesine and etoposide in treating 41 patients (median age: 63 years) over 155 cycles of chemotherapy...
February 2005: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
E Baumelou, D Méry-Mignard, J P Lehner et al.
Clinical benefit in oncology patients can only be derived from coordinated and successive experimental trials. The following consensus thus emerged from the working party: The assessment of tolerance during clinical trials requires the actuarial rate of acute adverse events (AE) to be registered and the development of epidemiological structures involved in long-term assessment of AE. Experimental trials have to be assessed according to descriptive epidemiological data (generated in France and Europe) and completed with observational studies on post-marketing medical practice...
July 2002: Thérapie
C Gennari
Osteoporosis, a systemic skeletal disease characterized by a low bone mass, is a major public health problem in EC member states because of the high incidence of fragility fractures, especially hip and vertebral fracture. In EC member states the high incidence of osteoporotic fractures leads to considerable mortality, morbidity, reduced mobility and decreased quality of life. In 1995 the number of hip fractures in 15 countries of EC has been 382,000 and the estimated total care cost of about 9 billion of ECUs...
April 2001: Public Health Nutrition
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