Cancer
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Randomized Controlled Trial
Update of the decitabine experience in higher risk myelodysplastic syndrome and analysis of prognostic factors associated with outcome.
Therapy for patients with myelodysplastic syndrome (MDS) with hypomethylating agents, like decitabine and 5-azacitidine, has produced favorable results. In this study, the authors update their experience with decitabine in patients with MDS and analyze the cytogenetic response patterns and prognostic factors associated with decitabine therapy. ⋯ The longer term experience with decitabine in MDS was favorable. Pretreatment prognostic factors may predict the outcome of patients who receive decitabine therapy for MDS.
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African American men experience worse prostate cancer outcomes compared with those of Caucasian men, not only in incidence and mortality rates, but also in coping with the side effects of treatment. Unfortunately, African American men have been significantly under-represented in research evaluating the efficacy of psychosocial interventions for improving coping in prostate cancer survivors. This pilot study explored the feasibility and efficacy of coping skills training (CST), an intervention developed to enhance coping with treatment side effects in a sample of African American prostate cancer survivors and their intimate partners. ⋯ Partners who underwent CST reported less caregiver strain, depression, and fatigue, and more vigor, with moderate effect sizes observed that approached conventional levels of statistical significance. These preliminary findings suggest that telephone-based CST is a feasible approach that can successfully enhance coping inAfrican American prostate cancer survivors and their intimate partners. Cancer 2007. (c) 2006 American Cancer Society.
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Many barriers, including being uninsured or having less than comprehensive health insurance coverage, reduce access to palliative and end-of-life care by inner city minorities. Medicaid or Medicare coverage alone can limit options for pain and symptom management, especially when late referrals make it more difficult to achieve symptom control. Patient affiliation with a religion could offset perceived difficulties with pain medication as well as negative pain and symptom attitudes. ⋯ Conversely, less hopeful attitudes by religious-affiliated patients covered only by Medicaid serve as clues to coping difficulties and problem domains. Palliative care programs should carefully consider how to integrate religious support networks as pipelines for program referrals and potential partners for care. Cancer 2007. (c) 2006 American Cancer Society.
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Prevention, including routine cancer screening, is key to meeting national goals for the elimination of death and suffering due to cancer. Since 1991, the U. S. government has invested in programs such as the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to detect breast and cervical cancer early among uninsured low-income women. ⋯ Analysis did indicate that public insurance, or Medicaid, was equal to private insurance in promoting increased testing for African Americans and Hispanics, but not for non-Hispanic whites. Assuring that Medicaid remains available for women in this nonelderly group and increasing access to free screening sites can lead us closer to national screening goals, yet policies still need to address racial/ethnic disparities in insurance and service delivery. Cancer 2007. (c) 2006 American Cancer Society.
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Comparative Study
Intensity-modulated or conformal radiotherapy improves the quality of life of patients with nasopharyngeal carcinoma: comparisons of four radiotherapy techniques.
It was reported previously that the dosimetric superiority of conformal radiotherapy (RT), either 3-dimensional conformal RT (3D-CRT) or intensity-modulated RT (IMRT), over conventional 2D-RT translated into clinical benefits for patients with nasopharyngeal carcinoma (NPC). In this study, the authors compared quality-of-life (QOL) outcomes of NPC survivors who received treatment with 1 of 4 different RT techniques at a single institute during different periods. ⋯ Conformal RT substantially improved head and neck-related symptoms and broad aspects of QOL for survivors of NPC.