Cancer investigation
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A subset of breast cancer survivors are reporting cognitive impairment after cancer treatment, which has commonly been attributed to the receipt of chemotherapy and colloquially termed "chemobrain." For some, a fear of this side effect enters into their decision regarding therapy. Our review of the literature reveals that so-called "chemobrain" is complex and that factors other than chemotherapy may affect cognitive function, including the impact of surgery and anesthesia, hormonal therapy, menopause, anxiety, depression, fatigue, supportive care medications, genetic predisposition, comorbid medical conditions, or possibly paraneoplastic phenomenon. ⋯ Large, multicenter studies are needed to better understand the magnitude and mechanism of cognitive changes in cancer survivors and to assess the impact of cognitive changes on the patient's daily lives. We propose that the phenomenon commonly referred to as "chemobrain" would be more accurately labeled "cancer- or cancer-therapy-associated cognitive change."
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Cancer investigation · Sep 2007
Case ReportsTemozolomide treatment of an adult with a relapsing medulloblastoma.
Temozolomide is an oral cytotoxic agent that has demonstrated its interest in high grade glioma tumors. This drug can be used either concomitantly with radiotherapy or as chemotherapy. ⋯ An initial partial response was observed for this previously heavily treated patient. This observation suggests this drug may be useful in medulloblastoma, either as conventional chemotherapy or for use together with radiotherapy.
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Cancer investigation · Apr 2007
Comparative Study Clinical TrialTropisetron, ondansetron, and granisetron for control of chemotherapy-induced emesis in Turkish cancer patients: a comparison of efficacy, side-effect profile, and cost.
Tropisetron, ondansetron, and granisetron are considered equally efficacious, supported by several international studies. However, there are interindividual variations in their metabolism that could affect efficacy. The clustering of such variations may change from one to another nation. Therefore, their equality must be validated in Turkish patients. The aim of this study was to compare their efficacies, side-effect profiles, and costs in the prophylaxis of emesis induced by moderate to high emetogenic chemotherapies. ⋯ There were no differences among the 3 serotonin antagonists with respect to efficacy and frequency of side-effects in our patients. Tropisetron is the least expensive at current prices. The choice may be based on other parameters, such as ease of administration and patient preference.
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The area of oncology in particular deals with patient treatments that entail significant risk. The approach of Jewish law is valuable in formulating a generic approach to the area of risky medical treatments and is beneficial in understanding the choices that Jewish patients might make regarding their care.
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Until recently physicians have been reluctant to disclose a poor prognosis to patients for fear of harming them with the bad news and/or taking away their will to live. In the last decades we have seen a reversal of practice among Western physicians, and most doctors readily disclose to their patients the full extant of their disease. ⋯ This emphasis on complete honesty with patients might not reflect the practice in non-Western cultures. In disclosing a poor prognosis to a patient the physician must do so with cultural sensitivity, compassion and letting the patient decide how much he or she wants to know.