International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
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Int. J. Gynecol. Cancer · Apr 2011
Religious and spiritual beliefs of gynecologic oncologists may influence medical decision making.
Religious (R) and spiritual (S) beliefs often affect patients' health care decisions, particularly with regard to care at the end of life. Furthermore, patients desire more R/S involvement by the medical community; however, physicians typically do not incorporate R/S assessment into medical interviews with patients. The effects of physicians' R/S beliefs on willingness to participate in controversial clinical practices such as medical abortions and physician-assisted suicide has been evaluated, but how a physician's R/S beliefs may affect other medical decision-making is unclear. ⋯ Our results suggest that gynecologic oncologists' R/S beliefs may affect patient care but that most physicians fail to take an R/S history from their patients. More work needs to be done to evaluate possible barriers that prevent physicians from taking a spiritual history and engaging in discussions over these matters with patients.
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Int. J. Gynecol. Cancer · Apr 2011
Complementary and alternative medicine use among women receiving chemotherapy for ovarian cancer in 2 patient populations.
The authors evaluated attitudes toward complementary and alternative medicine (CAM) use in 2 populations of women receiving chemotherapy for epithelial ovarian cancer (EOC). ⋯ Complementary and alternative medicine use is common in women receiving chemotherapy for EOC. Increasingly, interactions between CAM and prescribed medication are being identified. Oncologists should be aware and actively inquire about CAM use. Although patterns of CAM use differed, the motivation for starting CAM was similar, highlighting the need to address supportive care in all patients.
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Int. J. Gynecol. Cancer · Jan 2011
The long-term efficacy of neoadjuvant chemotherapy followed by radical hysterectomy compared with radical surgery alone or concurrent chemoradiotherapy on locally advanced-stage cervical cancer.
The purpose of this study was to compare the long-term survival of patients with locally advanced cervical cancer (stages IB2-IIB) treated with neoadjuvant chemotherapy followed by radical hysterectomy (hysterectomy plus pelvic lymph node dissection) (NACT + RS) with the survival of those treated with radical surgery (hysterectomy plus pelvic lymph node dissection) (RS) or concurrent chemoradiotherapy (CCRT). ⋯ Neoadjuvant NACT + RS improves the long-term DFS and OS of patients with locally advanced cervical cancer stage IB2-IIB compared with RS alone and especially compared with CCRT. In the NACT + RS group, NACT with TP improves the long-term DFS and OS of patients compared with patients who had PVB chemotherapy regimen. These results may provide some useful information for clinicians to treat patients with locally advanced cervical carcinoma.
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Int. J. Gynecol. Cancer · Dec 2010
Highly accurate detection of ovarian cancer using CA125 but limited improvement with serum matrix-assisted laser desorption/ionization time-of-flight mass spectrometry profiling.
Our objective was to test the performance of CA125 in classifying serum samples from a cohort of malignant and benign ovarian cancers and age-matched healthy controls and to assess whether combining information from matrix-assisted laser desorption/ionization (MALDI) time-of-flight profiling could improve diagnostic performance. ⋯ We report unexpectedly good performance of serum CA125 using threshold classification in discriminating healthy controls and women with benign masses from those with invasive ovarian cancer. This highlights the dependence of diagnostic tests on the characteristics of the study population and the crucial need for authors to provide sufficient relevant details to allow comparison. Our study also shows that MS profiling information adds little to diagnostic accuracy. This finding is in contrast with other reports and shows the limitations of serum MS profiling for biomarker discovery and as a diagnostic tool.
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Int. J. Gynecol. Cancer · Oct 2010
ReviewNerve sparing in radical surgery for early-stage cervical cancer: yes we should!
Radical hysterectomy with pelvic lymphadenectomy is considered to be the cornerstone in the treatment of early-stage cervical cancer. Although survival in early-stage cervical cancer is up to 95%, long-term morbidity with regard to bladder, bowel, and sexual function is considerable. ⋯ Some authors have presented surgical techniques to preserve the autonomic nerves (ie, the hypogastric nerves and the splanchnic nerves) without compromising radicality. Safety, efficacy, and the surgical techniques of nerve-sparing radical hysterectomy are presented, and data confirm that whenever the decision is made to perform a radical hysterectomy, nerve-sparing techniques should be considered.