Oncology
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Comparative Study
A treatment selection protocol for recurrent ovarian cancer patients: the role of FDG-PET/CT and staging laparoscopy.
To investigate the best diagnostic and staging strategy for recurrent ovarian cancer. ⋯ The combination of FDG-PET/CT and staging laparoscopy has a significant effect on the multimodal approach to the population of patients with recurrent ovarian cancer. Such techniques should be considered complementary, because of the potential of each one to identify a different setting of the disease.
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To identify physician selection factors in the treatment of locally advanced head and neck cancer and how treatment outcome is affected by Tumor Board recommendations. ⋯ Disease sites remained the key determining factor for treatment selection. Multidisciplinary approaches provided optimal treatment outcome for locally advanced head and neck cancer, with overall survival in these patients being comparable to that reported in randomized clinical trials.
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Comparative Study
Controlled-release oxycodone in the treatment of neuropathic pain of nonmalignant and malignant causes.
To assess the efficacy and safety of controlled-release oxycodone in patients with moderate to severe neuropathic pain of nonmalignant and malignant causes. ⋯ The use of opioids for neuropathic pain is not fully accepted by the majority of physicians at present. This study shows that controlled-release oxycodone is a safe, well-tolerated and effective medication for neuropathic pain.
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Cancer pain management had received relatively little attention until the late 1990s, when approximately 100,000 new cancer cases and 60,000 cancer deaths occurred each year in Korea. In 2001, a Cancer Pain Management Guideline was prepared for the first time by the Korean Society of Hospice and Palliative Care. This guideline facilitated cancer pain management by health professionals since then. ⋯ The Korean government first published the Cancer Pain Management Guideline for health care professionals in 2004 and expanded the medical reimbursement criteria for cancer pain management, which reflect the government's support and interest in cancer pain care. The cancer pain surveys conducted in 2001 and 2006 demonstrated a significantly increased patient satisfaction on pain control (37% in 2001, n = 3,006 vs. 42% in 2006, n = 3,737, p = 0.003). Therefore, cancer pain management has been systematically approached both by health professionals as well as the government and resulted in a vast improvement in cancer pain control.
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Within Malaysia's otherwise highly accessible public healthcare system, palliative medicine is still an underdeveloped discipline. Government surveys have shown that opioid consumption in Malaysia is dramatically lower than the global average, indicating a failure to meet the need for adequate pain control in terminally ill patients. Indeed, based on daily defined doses, only 24% of patients suffering from cancer pain receive regular opioid analgesia. ⋯ Additional barriers include the fact that no training in palliative care is given to medical students, and that smaller clinics often lack facilities to prepare and stock cheap oral morphine. A number of initiatives aim to improve the situation, including the establishment of palliative care departments in hospitals and implementation of post-graduate training programmes. Campaigns to raise public awareness are expected to increase patient demand for adequate cancer pain relief as part of good care.