Cancer nursing
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Comparative Study
Concordance of quality-of-life assessments between terminally ill cancer patients and their primary family caregivers in Taiwan.
Physical or cognitive deterioration may hamper the ability or willingness of cancer patients to participate and remain in quality-of-life (QOL) research at the end of life. Use of family caregivers as proxy informants to report patients' QOL has been suggested as a way of resolving the problem of nonresponse bias and nonrandom missing data in end-of-life research. However, there is a dearth of information in the literature about the extent of concordance of QOL assessments between terminally ill patients and their family caregivers outside Western countries. ⋯ At the individual patient level, family caregivers were best able to assess functional dependency, followed by symptom distress, but were least reliable when evaluating the psychological-social-spiritual concerns of patients. The conclusion made by Western researchers that family caregivers can act as a not perfect but reliable alternative source of QOL data for terminally ill cancer patients who are no longer able to speak for themselves is cross-culturally confirmed in this study. It is suggested from the findings that, for family caregivers to function well in their role as proxy informants on the psychological reactions and social/spiritual domains of QOL as well as surrogate decision makers for terminally ill cancer patients in Asian countries, an open and frequent dialogue between terminally ill cancer patients and their family caregivers should become standard.
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Review
Gefitinib (Iressa, ZD1839) and tyrosine kinase inhibitors: the wave of the future in cancer therapy.
Targeted therapies are one of the latest innovative trends in cancer therapy. The epidermal growth factor receptor (EGFR) is a target found in high concentrations in several solid tumors including lung, breast, colorectal, and brain. Tyrosine kinase inhibitors, such as gefitinib (Iressa, ZD1839), block the EGFR. ⋯ A phase 2 trial of gefitinib in first-relapse glioblastoma multiforme demonstrated median overall survival from treatment start of 39.4 weeks compared with 40 weeks with standard chemotherapy. Gefitinib is an oral agent with a mild toxicity profile, and thus, may be an optimal addition to chemotherapeutic regimens for some solid tumors. Gefitinib is potentially a vital and useful weapon in the arsenal of cancer therapies.
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The purpose of this study was to describe the experience of managing lymphedema in breast cancer survivors. A descriptive phenomenological method was used as a guide for developing a bracket, gathering data, and analyzing data. A cross-sectional design with a purposive sampling technique was employed. ⋯ The study revealed that the women's major intentions of managing lymphedema were to keep in mind the consequences, prevent lymphedema from getting worse, get ready to live with lymphedema, and integrate the care of lymphedema into daily life. Findings of the study provided an insightful alternative to the compliance approach to lymphedema management. Instead of merely evaluating breast cancer survivors' degree of compliance with treatment, it is suggested that researchers and practitioners should also assess the impact of the presence or absence of the women's intentions on lymphedema management.