Cancer nursing
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In 1996 two chemotherapy agents were introduced by the U. S. Food and Drug Administration (FDA) with indications for the gastrointestinal malignancies for advanced colon and pancreatic cancers. ⋯ As clinical and investigational use of irinotecan and gemcitabine increases, the oncology nurse and other members of the health care team will need to anticipate potential treatment associated toxicities and be knowledgeable in their early identification and management. As patient advocates, oncology nurses play a key role in treatment outcome and related quality of life through expert patient education, symptom recognition, and intervention individualized to patient tolerance. This first article of the series addresses irinotecan, which in 1996 was approved for the second-line therapy of metastatic colorectal cancer, recurrent or elapsed, after 5-fluorouracil (5-FU).
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The modern hospice movement had its formal beginnings in the United Kingdom with the 1967 opening of the St. Christopher's Hospice in London by Dame Cicely Saunders. Global uptake of the hospice principles and, more recently, palliative care, is widespread. ⋯ The downside of this is increased regulation, competition, and a potential loss of specificity for those who are dying. This article explores the changing face of palliative care, with particular emphasis on palliative care delivery in the developing world. These issues for developing countries include access to services, access to morphine, and professional access to information and education.
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As social entities, individuals enact roles and carry out responsibilities. Roles are learned and influenced by many social forces. They give meaning and value to life and foster a sense of belonging and contribution. ⋯ Their children ranged in age from 1 to 18 years. Content and theme analyses were performed on the transcribed texts. The findings describe the impact of the cancer on the women and their families and how they felt about any changes in their roles as mothers.
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In spite of cancer screening programs, women continue to present with advanced breast cancer. How do women decide whether and when to seek an evaluation for self-discovered symptoms? This study examined 104 narratives told by 80 Anglo-, Latina-, and African-American women who participated in 1 of 16 community-based focus groups. ⋯ Stories of advanced breast cancer also told of reliance on alternative healing, concerns about overwhelming family resources, and extreme modesty that inhibited obtaining a physical examination. Interventions aimed at earlier detection of breast cancer must connect with the beliefs and assumptions embedded in these narratives, provide pragmatic solutions for perceived constraints on seeking evaluations of self-discovered symptoms, and explore the use of community narratives to confirm the value of early detection of breast cancer.
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According to the World Health Organization (WHO) guidelines, oral morphine is the first choice drug for treating moderate to severe cancer-related pain. The fear of the side effects caused by this drug and the scarce information about prevention and management of these effects are the main reasons for the underuse of morphine. The aim of this paper is to provide a review of the literature on the side effects most frequently present both in the titration phase and during chronic administration of oral morphine and to describe the appropriate treatment.