Journal of the National Comprehensive Cancer Network : JNCCN
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J Natl Compr Canc Netw · Jul 2003
Practice GuidelineDistress management. Clinical practice guidelines.
The evaluation and treatment model expressed in the NCCN Distress Management Guidelines recommends that each new patient be rapidly assessed in the office or clinic waiting room for evidence of distress using a brief screening tool (the Distress Thermometer and Problem List) presented in Figure 1 (see page 369). A score of 5 or greater on the thermometer should trigger further evaluation and referral to a psychosocial service. The choice of which service should be determined by the problem areas specified on the Problem List. ⋯ Presently, the quality of the psychological care patients receive is not routinely monitored. Accrediting bodies have not directly examined the quality of psychosocial care, nor have they established minimal performance standards for its delivery. The panel believes that psychosocial care should and will eventually be on our institution's report cards.
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J Natl Compr Canc Netw · Jul 2003
Seeking drug treatment for OxyContin abuse: a chart review of consecutive admissions to a substance abuse treatment facility in Kentucky.
The abuse of prescription opioids has been reported to be on the rise and has gained much public attention, especially given the recent media coverage devoted to the abuse of sustained-release oxycodone (OxyContin, Purdue Pharma LP, Stamford, CT). We tracked admissions to our substance abuse program to put OxyContin abuse into perspective as a presenting problem in the region. A total of 258 admissions to a psychiatric facility for opioid dependence over a 15 month period, for the treatment of prescription opioid abuse, were examined in this chart-review study. ⋯ Polysubstance abuse, including OxyContin abuse, was a significant presenting problem to our Addictive Disease Unit between October 2000 and December 2001. Although this chart-review study is not designed to be indicative of the epidemiology of OxyContin abuse, it offers some insight into the nature of this phenomenon in a particular region during the height of public attention paid to it. A follow-up prospective study to examine this phenomenon in multiple regions, further away chronologically from the increased media attention, is underway.
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Cancer-related fatigue (CRF) is the most prevalent symptom of cancer, occurring in 60% to 90% of patients and surpassing pain in frequency. CRF may increase patients' anxieties and hamper their quality of life. ⋯ Since then, we have gained clinical insights into the planning, development, and evolution of this endeavor. Our objective is to share our experiences and provide preliminary analysis of the first 123 patients evaluated in this clinic.
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J Natl Compr Canc Netw · Jan 2003
ReviewNew targeted therapies for non-small-cell lung cancer: a focus on the epidermal growth factor receptor.
Advances in chemotherapy and multimodality treatments of patients with non-small-cell lung cancer (NSCLC) have improved outcomes for these patients over the past decade. Unfortunately, gains have been modest, and new therapeutic strategies are eagerly awaited. Therapies that target receptors vital to the proliferation and survival of cancer cells are particularly attractive areas of research. ⋯ Phase II trials involving patients with advanced NSCLC and whose disease is progressive after chemotherapy have demonstrated clear clinical benefit. Studies are ongoing, integrating EGFR-targeted therapy with chemotherapy and radiation in patients with earlier stage NSCLC, as well as in chemoprevention. In all of these settings, a further understanding of the biology of EGFR in relationship to other cellular events will be critical in optimizing therapeutic approaches with these novel agents.
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J Natl Compr Canc Netw · Jan 2003
ReviewEpidermal growth factor receptor as a target in cancer therapy.
Epithelial cancers have been found to overexpress the receptor to epidermal growth factor (EGFR). These include head and neck, breast, colon, lung, prostate, kidney, ovary, brain, pancreas, and bladder. ⋯ Antibodies such as IMC-C225 specifically target EGFRs, whereas tyrosine kinase inhibition by many small molecules is less specific but is also effective. This report focuses on EGFR and novel compounds that target it.