For hundreds of years, the physician-patient relationship has seen the physician as the authoritative, sometimes dictatorial, healer — the unquestioned expert on care, protocols and medical regimens. The patient assumed the role of a passive receiver of information, taking orders and instruction from the doctor.
Most research regarding fertility in young women with breast cancer has focused on long-term survivors. Little is known about how fertility concerns affect treatment decisions or fertility preservation strategies at the time of initial cancer diagnosis.
Marie Ennis-O'Connor's insight:
Among the first 620 eligible respondents included in this analysis, median age was 37 years (range, 17 to 40 years); 425 women (68%) discussed fertility issues with their physicians before starting therapy, and 319 (51%) were concerned about becoming infertile after treatment. Because of concerns about fertility, four women (1%) chose not to receive chemotherapy, 12 (2%) chose one chemotherapy regimen over another, six (1%) considered not receiving endocrine therapy, 19 (3%) decided not to receive endocrine therapy, and 71 (11%) considered receiving endocrine therapy for < 5 years; 65 (10%) used fertility preservation strategies. Greater concern about fertility was associated with younger age, nonwhite race, not having children, and receipt of chemotherapy.
Many young women with newly diagnosed breast cancer have concerns about fertility, and for some, these substantially affect their treatment decisions. Only a minority of women currently pursue available fertility preservation strategies in this setting.
From a philosophical standpoint, one of the things I hate most about cancer is the use of “war” analogies. The “battle” may mobilize patients and families, but it may also interfere with education and informed decision making. And both patients and clinicians often take recurrence or disease progression personally as a failure. Even when everything is done perfectly, the outcomes aren’t. Why compound grief with the unnecessary stigma of “losing the war”?
My friend, fellow breast cancer survivor Gai Comans, has just released a new guide called “Survivor Secrets – Empower Your Life”. And, alongside some other names which will be familiar to you, I am honored to be one of the 21 inspirational survivors interviewed.
The well-being of informal carers of people with dementia is an important public health issue. Caring for an elderly relative with dementia may be burdensome and stressful, and can negatively affect the carer’s social, family, and professional life. The combination of loss, the physical demands of caregiving, prolonged distress, and biological vulnerabilities of older carers may compromise their physical health, increase social isolation, and increase the risk of anxiety and depressive disorders. Caregiver stress is also linked to negative outcomes for the recipient of care and costs to society, including increased nursing home and hospital admissions. Consequently, carer support interventions are an important component of dementia care. Computer-mediated carer support offers a range of potential advantages compared to traditional face-to-face support groups, including accessibility and the possibility of tailoring to meet individual needs, but there has been little research on its effectiveness so far.
Breast cancer patients receiving radiotherapy showed decreased fatigue as a result of cognitive behavioral therapy plus hypnosis (CBTH), according to a study recently published in the Journal of Clinical Oncology.
The European Cancer Patient's Bill of Rights is the result of two years of work by the European Cancer Concord (ECC), an equal partnership between European oncology leaders and patients and their representatives who have come together to address the significant disparities that exist for European cancer patients. ECC is a patient-centered initiative, born out of the need to deliver an optimal standard of cancer care and research for Europe's citizens. Strengthening and upholding the rights of the individual cancer patient/cancer survivor are the guiding principles of this initiative.
Patient advocacy groups are an increasingly valuable resource for pharma manufacturers and FDA throughout the drug development process, since they provide, among other things, a crucial perspective, according to a New York Pharma Forum panel last...
Physical activity has been associated with improved outcomes for cancer survivors. Compared to their urban counterparts, rural Australians experience a health disadvantage, including poorer survival rates after diagnosis of cancer. The aim of this pilot feasibility study was to gain insight into the experiences of rural cancer survivors engaging in an online resource designed to increase regular walking.
Marie Ennis-O'Connor's insight:
This online pedometer-based walking intervention is feasible and effectively increases motivation for walking and enhances health-related quality of life in South Australian rural cancer survivors. A randomized controlled trial of this intervention is warranted.
Amid studies of novel targeted therapies, genetic analyses of tumors, and new ways to approach the treatment of breast cancer, a low-tech study presented at the 2013 San Antonio Breast Cancer Symposium found that a yearlong exercise program reduced joint pain associated with aromatase inhibitors in breast cancer survivors.1 This is the first study to examine the impact of exercise vs usual care on the side effects of aromatase inhibitors.