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Ensuring patient-centered care in cancer

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https://www.readbyqxmd.com/read/28704594/critical-diagnoses-in-cytopathology-experience-at-a-large-medical-center
#1
Juan Xing, Lindsey Seigh, Sara E Monaco, N Paul Ohori, Samuel A Yousem, Rajnikant Amin, Liron Pantanowitz
BACKGROUND: Critical values have been well established and accepted in laboratory medicine, but to the authors' knowledge are less well accepted in anatomic pathology. Herein, the authors used a reporting process whereby reports with critical diagnoses were coded to ensure that the patient's clinical team was promptly notified electronically of this finding. The aim of the current study was to determine whether this coding mechanism was used appropriately for critical cytopathology diagnoses in the study health care system...
July 13, 2017: Cancer
https://www.readbyqxmd.com/read/28645785/contraceptive-counseling-in-reproductive-aged-women-treated-for-breast-cancer-at-a-tertiary-care-institution-a-retrospective-analysis
#2
Sara L Johansen, Klaira Lerma, Kate A Shaw
OBJECTIVE: To assess the frequency of documented contraceptive and fertility preservation counseling for women treated for breast cancer. STUDY DESIGN: We conducted a chart analysis of female breast cancer patients (n=211) ages 18-45 receiving chemotherapy treatment at Stanford Comprehensive Cancer Center from 2010-2014. Primary outcomes of contraceptive counseling and fertility preservation counseling documentation were assessed for frequency. Secondary outcomes included pregnancy testing, contraception use, and pregnancy during treatment...
June 20, 2017: Contraception
https://www.readbyqxmd.com/read/28643745/adjuvant-hypofractionated-radiation-in-carcinoma-breast-photon-versus-electron-comparison-of-treatment-outcome
#3
G Prameela Chelakkot, Rahul Ravind, K Sruthi, Namrata Chigurupati, Sanketh Kotne, Raghavendra Holla, Ram Madhavan, M Dinesh
BACKGROUND: Breast cancer tissue is sensitive to hypofractionation. This is an analysis of patients treated with hypofractionated protocols since 2009, at our tertiary cancer center. METHODS: Details of breast cancer patients treated with adjuvant hypofractionated external beam radiation therapy (EBRT) from January 2009 to December 2014 were retrieved and analyzed. RESULTS: One thousand seven hundred and eighty patients received adjuvant EBRT during this period...
April 2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28641097/long-term-complications-after-hematopoietic-cell-transplantation
#4
REVIEW
Navneet S Majhail
The prevalence of autologous and allogeneic hematopoietic cell transplantation (HCT) survivors continues to increase. Among patients whose disease remains in remission for the first 2-5years after transplantation, it is estimated that approximately 80-90% will be alive over the subsequent 10years. However, the relative mortality rates of such patients continue to remain higher than those of their general population peers, with late complications contributing to significant long-term morbidity and mortality...
June 13, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28595934/secular-trends-in-prostate-biopsy-criteria-and-outcomes-the-dartmouth-experience
#5
Lael Reinstatler, Cody Rissman, John D Seigne, Elias S Hyams
OBJECTIVE: To evaluate trends in prostate biopsy and cancer diagnosis at a center with conservative screening practices in the pre- and post-2012 era. More restrictive prostate-specific antigen (PSA) screening guidelines have led to lower rates of screening, biopsy, and diagnosis of prostate cancer. It is not clear, however, how regions with low baseline screening rates (the Lebanon, New Hampshire hospital referral region centered on Dartmouth-Hitchcock Medical Center had the lowest rate of screening among Medicare patients in 2012) have responded to these guidelines...
July 10, 2017: Urology
https://www.readbyqxmd.com/read/28561713/collaborating-with-advanced-practice-providers-impact-and-opportunity
#6
Heather M Hylton, G Lita Smith
Although significant progress has been made in cancer care, access to coordinated, high-quality care across the cancer care continuum remains a challenge for many patients. With significant workforce shortages in oncology anticipated, physician assistants (PAs) and nurse practitioners (NPs)-known collectively as advanced practice providers (APPs)-are considered to be a part of the solution to bridging the gap between the supply of and demand for oncology services. APPs are integral to the provision of team-based care in oncology, and optimizing the roles of all members of the patient's care team is vital to ensuring the teams are cost-effective and that each team member is performing at the functional level intended...
2017: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/28535101/design-challenges-of-an-episode-based-payment-model-in-oncology-the-centers-for-medicare-medicaid-services-oncology-care-model
#7
Ronald M Kline, L Daniel Muldoon, Heidi K Schumacher, Larisa M Strawbridge, Andrew W York, Laura K Mortimer, Alison F Falb, Katherine J Cox, Carol Bazell, Ellen W Lukens, Mary C Kapp, Rahul Rajkumar, Amy Bassano, Patrick H Conway
The Centers for Medicare & Medicaid Services developed the Oncology Care Model as an episode-based payment model to encourage participating practitioners to provide higher-quality, better-coordinated care at a lower cost to the nearly three-quarter million fee-for-service Medicare beneficiaries with cancer who receive chemotherapy each year. Episode payment models can be complex. They combine into a single benchmark price all payments for services during an episode of illness, many of which may be delivered at different times by different providers in different locations...
July 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28514670/radiation-safety-in-children-with-congenital-and-acquired-heart-disease-a-scientific-position-statement-on-multimodality-dose-optimization-from-the-image-gently-alliance
#8
REVIEW
Kevin D Hill, Donald P Frush, B Kelly Han, Brian G Abbott, Aimee K Armstrong, Robert A DeKemp, Andrew C Glatz, S Bruce Greenberg, Alexander Sheldon Herbert, Henri Justino, Douglas Mah, Mahadevappa Mahesh, Cynthia K Rigsby, Timothy C Slesnick, Keith J Strauss, Sigal Trattner, Mohan N Viswanathan, Andrew J Einstein
There is a need for consensus recommendations for ionizing radiation dose optimization during multimodality medical imaging in children with congenital and acquired heart disease (CAHD). These children often have complex diseases and may be exposed to a relatively high cumulative burden of ionizing radiation from medical imaging procedures, including cardiac computed tomography, nuclear cardiology studies, and fluoroscopically guided diagnostic and interventional catheterization and electrophysiology procedures...
July 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28501117/institutional-variation-in-surgical-care-for-early-stage-breast-cancer-at-community-hospitals
#9
Christopher M Dodgion, Stuart R Lipsitz, Marquita R Decker, Yue-Yung Hu, Sudha R Pavuluri Quamme, Anita Karcz, Leonard D'Avolio, Caprice C Greenberg
BACKGROUND: There is significant institutional variation in the surgical care of breast cancer, and this may reflect access to services and resultant physician practice patterns. In previous studies, specialty care has been associated with variation in the operative treatment of breast cancer but has not been evaluated in a community setting. This study investigates these issues in a cohort of 59 community hospitals in the United States. MATERIALS AND METHODS: Data on patients receiving an operation for breast cancer (2006-2009) in a large, geographically diverse cohort of hospitals were obtained...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28469440/the-exercise-of-autonomy-by-older-cancer-patients-in-palliative-care-the-biotechnoscientific-and-biopolitical-paradigms-and-the-bioethics-of-protection
#10
REVIEW
Márcio Niemeyer-Guimarães, Fermin Roland Schramm
Toward the end of life, older cancer patients with terminal illness often prefer palliative over life-extending care and also prefer to die at home. However, care planning is not always consistent with patients' preferences. In this article, discussions will be centered on patients' autonomy of exercising control over their bodies within the current biotechnoscientific paradigm and in the context of population aging. More specifically, the biopolitical strategy of medicine in the context of hospital-centered health care control and of the frail condition of cancer patients in the intensive care unit will be considered in terms of the bioethics of protection...
2017: Palliative Care
https://www.readbyqxmd.com/read/28460082/reducing-cancer-burden-in-the-population-an-overview-of-epidemiologic-evidence-to-support-policies-systems-and-environmental-changes
#11
Elizabeth A Platz
"Reducing Cancer Burden in the Population: Epidemiologic Evidence to Support Policies, Systems, and Environmental Changes" is a compilation of 11 reviews addressing aspects of primary prevention of cancer (early life factors, vitamin D, and periodontal disease and the oral microbiome); primary and secondary prevention (in the transgender population); surveillance following secondary prevention (personalizing follow-up of patients diagnosed with an adenoma based on colorectal cancer risk); tertiary prevention (physical activity as an adjuvant to cancer treatment, measurement of patient-reported physical functioning in cancer treatment trials, and implementation of palliative care recommendations); and all 3 (changing epidemiology of oral cancers)...
January 1, 2017: Epidemiologic Reviews
https://www.readbyqxmd.com/read/28456948/advance-care-planning-communication-oncology-patients-and-providers-voice-their-perspectives
#12
Jennifer L Bires, Elizabeth F Franklin, Helen M Nichols, John G Cagle
Advance care planning helps to ensure that patients' end-of-life preferences are understood and discussed with providers. It is an important component of patient-centered care, particularly when patients are facing life-limiting illness. It also has ethical implications for providers, yet evidence suggests that these conversations are not always occurring, particularly in underserved populations. The aim of this study was to understand the challenges and personal beliefs regarding ACP through interviews with patients undergoing active cancer treatment and their oncology providers...
April 29, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/28421454/quality-indicators-in-endoscopic-ablation-for-barrett-s-esophagus
#13
REVIEW
Samuel Han, Sachin Wani
Barrett's esophagus (BE) is a well-established premalignant condition for esophageal adenocarcinoma (EAC); a cancer that is associated with a poor 5-year survival rate. Several strategies have been explored in the context of reducing the burden of EAC. Endoscopic eradication therapy (EET) is considered the standard of care for the management of patients with BE with dysplasia and early neoplasia; a practice that has been endorsed by all gastroenterology societal guidelines. The effectiveness of EET has been demonstrated in multiple studies and contemporary management includes a combination of endoscopic mucosal resection (EMR) of all visible lesions followed by eradication of the remaining BE using ablative techniques of which radiofrequency ablation (RFA) has the best evidence supporting effectiveness and safety...
April 18, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28390420/partnering-with-patients-in-translational-oncology-research-ethical-approach
#14
Marie-France Mamzer, Nathalie Duchange, Sylviane Darquy, Patrice Marvanne, Claude Rambaud, Giovanna Marsico, Catherine Cerisey, Florian Scotté, Anita Burgun, Cécile Badoual, Pierre Laurent-Puig, Christian Hervé
BACKGROUND: The research program CARPEM (cancer research and personalized medicine) brings together the expertise of researchers and hospital-based oncologists to develop translational research in the context of personalized or "precision" medicine for cancer. There is recognition that patient involvement can help to take into account their needs and priorities in the development of this emerging practice but there is currently no consensus about how this can be achieved. In this study, we developed an empirical ethical research action aiming to improve patient representatives' involvement in the development of the translational research program together with health professionals...
April 8, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28288595/mindful-yoga-for-women-with-metastatic-breast-cancer-design-of-a-randomized-controlled-trial
#15
RANDOMIZED CONTROLLED TRIAL
James W Carson, Kimberly M Carson, Maren K Olsen, Linda Sanders, Laura S Porter
BACKGROUND: Women with metastatic breast cancer (MBC) have average life expectancies of about 2 years, and report high levels of disease-related symptoms including pain, fatigue, sleep disturbance, psychological distress, and functional impairment. There is growing recognition of the limitations of medical approaches to managing such symptoms. Yoga is a mind-body discipline that has demonstrated a positive impact on psychological and functional health in early stage breast cancer patients and survivors, but has not been rigorously studied in advanced cancer samples...
March 13, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28284760/a-peer-review-process-as-part-of-the-implementation-of-clinical-pathways-in-radiation-oncology-does-it-improve-compliance
#16
Brian J Gebhardt, Dwight E Heron, Sushil Beriwal
PURPOSE: Clinical pathways are patient management plans that standardize evidence-based practices to ensure high-quality and cost-effective medical care. Implementation of a pathway is a collaborative process in our network, requiring the active involvement of physicians. This approach promotes acceptance of pathway recommendations, although a peer review process is necessary to ensure compliance and to capture and approve off-pathway selections. We investigated the peer review process and factors associated with time to completion of peer review...
January 19, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28177857/end-of-life-care-in-nunavik-quebec-inuit-experiences-current-realities-and-ways-forward
#17
Shawn Renee Hordyk, Mary Ellen Macdonald, Paul Brassard
BACKGROUND: Increasing longevity for Inuit living in Nunavik, northern Quebec, has resulted in heightened rates of cancers and chronic diseases necessitating complex treatments. Consequently, end-of-life (EOL) care, once the domain of Inuit families and communities, has come to include professionalized healthcare providers with varying degrees of awareness of factors to consider in providing care to Inuit populations. OBJECTIVE: To better understand the factors shaping EOL care in Nunavik to support the development of a sustainable model of care...
June 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28156561/a-qualitative-investigation-of-mindfulness-practice-to-support-advance-care-planning-acp
#18
Ann H Cottingham, Kathleen A Beck-Coon, Paul R Helft
15 Background: Despite ongoing attempts to increase ACP in the U.S, a national longitudinal study of patients with cancer found no significant change in participation in end-of-life (EOL) discussions or living will completion between 2000-2012. A key barrier to ACP includes emotional discomfort talking about EOL care preferences. Mindfulness practices facilitate emotional regulation through present-centered awareness and non-reactive coping. In this pilot, an intervention combining mindfulness training, mindful communication skill development, and information about ACP was hypothesized to increase ACP in patients with cancer...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156459/changing-the-culture-for-psychosocial-care-does-it-need-changing
#19
Patricia A Parker, Daphine Lambert, Sujin Ann-Yi, Alan D Valentine, Frank V Fossella, Eduardo Bruera, Janet L Williams, Lorenzo Cohen
70 Background: National organizations recommend routine screening for psychosocial distress in cancer patients. American College of Surgeons (ACoS) Commission on Cancer mandates screening for accreditation with requirements for timing/method/tool for screening; assessment/referral; and documentation. METHODS: MD Anderson routinely screens patients for distress with policies and algorithms for the process. We sought to enhance this standard process by incorporating a dedicated psychosocial liaison in the clinic to ensure screening based on NCCN guidelines, follow-up with patients at the medical visit, and clear documentation and referral per ACoS standards...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152969/utilizing-an-a3-project-to-improve-assessment-of-oral-chemotherapy-adherence-across-a-five-site-enterprise
#20
Kathleen Dunn, Debra Kay Allen, Diane Denny, Maurie Markman
136 Background: Cancer Treatment Centers of America, Inc. (CTCA) is a national network of five hospitals that specialize in treating patients fighting complex or advanced-stage cancer. During the fall of 2013, two of the five centers began the pursuit of Quality Oncology Practice Initiative (QOPI) certification. A third site began QOPI certification the spring of 2014 and the remaining two sites followed suit the spring of 2015. This process brought attention to the patient population receiving oral chemotherapy and the importance of careful monitoring of those self-administering their cancer treatment regimens...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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