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 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a prospective study, the prevalence of 15 physical symptoms and symptom groups was evaluated in 1635 cancer patients referred to a pain clinic. In addition to pain, patients suffered an average of 3.3 symptoms: insomnia (59%), anorexia (48%), constipation (33%), sweating (28%), nausea (27%), dyspnea (24%), dysphagia (20%), neuropsychiatric symptoms (20%), vomiting (20%), urinary symptoms (14%), dyspepsia (11%), paresis (10%), diarrhea (6%), pruritus (6%), and dermatological symptoms (3%). While symptom prevalence was influenced by tumor site, pain intensity, and opioid treatment, only a minor relationship was seen between symptoms and gender, age, or tumor stage. The data emphasize that it is not sufficient to simply address pain during the treatment of patients with cancer pain; a more global approach to symptom management is necessary.
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PMID:Prevalence and pattern of symptoms in patients with cancer pain: a prospective evaluation of 1635 cancer patients referred to a pain clinic. 796 90

In common with any medical problem, careful assessment and an analytical approach are the keystones to effective symptom control in advanced cancer. When dealing with such symptoms the multi-faceted pathophysiology must be considered, and due attention paid to the affective component of pain and other symptoms. Adequate care given to history taking and a knowledge of the likely pathogenesis of symptoms in advanced cancer can prevent unnecessary investigations and fruitless trials of inappropriate symptomatic remedies. The treatment chosen should be the simplest effective regimen tailored to the individual patient. The importance of explanation to the patient cannot be overstated and is an integral part of any treatment and the sole component of many. This paper reviews the management of common symptoms in advanced cancer (dyspnoea, nausea and vomiting, constipation, anorexia-cachexia syndrome, hypercalcaemia, confusion, insomnia and depression.
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PMID:Control of common symptoms in advanced cancer. 808 Feb 22

This study investigated, in a convenience sample of 279 patients with cancer, the trajectories of symptoms and loss of physical functioning over time, the relationships of these variables to age and co-morbidity, and differences existing according to cancer site (breast, lung, colorectal/gastrointestinal, urinary/reproductive, lymphoma, and "other"). The patients were surveyed twice; at intake (wave I, n = 279) and 6 months later (wave II, n = 160). Findings indicated, at wave I, that age and co-morbidity were significantly correlated, and loss of physical functioning was associated primarily with symptoms and, to a lesser degree, with age. Loss of function scores varied significantly according to cancer site, with higher levels for patients with lung cancer and lower levels for patients with breast or colorectal/gastrointestinal cancer. The most frequently occurring symptoms were fatigue, insomnia, pain, and nausea. Average levels of symptoms and loss of physical functioning were lower at wave II, indicative of a possible treatment-related effect (at wave II, a smaller percentage of patients had recently undergone treatment). Although co-morbidity was only modestly correlated with symptoms and loss of function for the total sample, it was highly correlated with both symptoms and loss of physical functioning for the younger patients (those younger than 60 years of age). The significant link that was identified between symptoms and loss of physical functioning has important implications for physicians, nurses, and other healthcare providers caring for patients with cancer as they deal with symptom management and quality-of-life issues.
Cancer Pract
PMID:Loss of physical functioning among patients with cancer: a longitudinal view. 811 37

This study compared the psychological adjustment of parents and families of children with cancer, with the adjustment of parents and families in the community. In the weeks after their children's diagnoses, the mothers of children with cancer reported significantly more anxiety and insomnia, somatic symptoms and social dysfunction than mothers in the community. These problems had declined by the time of a 1 year follow-up assessment. However, at the follow-up assessment the mothers of children with cancer reported significantly more symptoms of depression and somatic symptoms than mothers in the community. A similar pattern of findings was evident among the fathers although the fathers generally reported less distress than was reported by the mothers. The results also suggest that a year after the children's diagnoses, the families in which there was a child with cancer were functioning less effectively than the families in the community.
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PMID:A prospective study of the psychological adjustment of parents and families of children with cancer. 824 Aug 63

In the framework of a study on the rehabilitation needs in gastric and oesophageal cancer patients, 100 gastric and 100 oesophageal cancer patients were interviewed on their subjective emotional state and physical functioning. The potentially cured patients were admitted to our in-patient aftercare programme an average 9.5 months following primary treatment. Major psychological distress was reported by 69.5% of the patients. Brooding, unrest, nervousness, and insomnia were the most frequently named complaints in both groups. 93% reported physical limitations, and 80% felt their conditions of life more or less restricted by their disease. 50% of all patients reported lack of drive, 30% an inclination to withdraw and a basic attitude of resignation. No significant differences between gastric and oesophageal cancer patients were found concerning type and frequency of the complaint.
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PMID:[Subjective discomfort of stomach cancer and esophageal cancer patients in after-care]. 831 Jan 74

An initial clinical trial of alpha-difluoromethylornithine given p.o. daily for 6 months was carried out in 27 subjects free of disease following surgery for malignancy or in a defined high-risk group for cancer. The aim was to determine the highest nontoxic dose, principal side effects, and pharmacokinetic parameters. The starting dose was 200 mg/m2/day in divided doses with escalation each month in the absence of toxicity to 6400 mg/m2/day or to the highest nontoxic dose, whichever was lower. When the highest nontoxic dose was reached, this dose was continued to complete 26 weeks of treatment. Twenty-two subjects completed 26 weeks of alpha-difluoromethylornithine treatment of whom 20 reached a nontoxic dose of at least 1600 mg/m2/day. The dose-limiting toxicity was loss of high-tone auditory acuity on an audiogram. Other side effects included diarrhea, fatigue, joint pain, insomnia, and rash. Pharmacokinetics were linear with dose. Area under the plasma concentration x time curve and maximum plasma concentration of alpha-difluoromethylornithine did not predict for development of ototoxicity. The dose for phase II chemoprevention studies should not exceed 1600 mg/m2/day.
Cancer Epidemiol Biomarkers Prev
PMID:Evaluation of alpha-difluoromethylornithine as a potential chemopreventive agent: tolerance to daily oral administration in humans. 831 77

Lung cancer is the number one cause of cancer-related death for women in the United States, yet studies describing the experience of women living with lung cancer are nonexistent. A sample of 69 women with lung cancer described their symptom distress using the Symptom Distress Scale (SDS). The majority of the women (86%) had been diagnosed with primary or recurrent lung cancer within the 2 years previous, 78% had non-small-cell lung cancer, and 43% were currently receiving treatment. The most prevalent and most distressing symptoms included fatigue, frequent pain, and insomnia. Poor outlook, dyspnea, and appetite disruptions were other common distressing problems. Sixty-one percent of the subjects had two or more serious symptoms. Forty-one percent of those subjects with fatigue concurrently experienced frequent pain, and 31% had insomnia. Those with recurrent disease had significantly greater levels of distress (P = 0.03). Concurrent respiratory disease, previous chemotherapy, recurrent lung cancer, no surgical treatment, and low income were associated with a high level of symptom distress (P < 0.05). Treatment was not a significant factor relating to distress. Distress was strongly correlated to quality of life (r = 0.72, P < 0.001) and functional status (r = 0.71, P < 0.001). Poverty-level income was a weak predictor of distress among demographic and disease/treatment variables, accounting for 17% of the variance. Combined with recurrence, the model accounted for 26% of the variance.
Cancer Pract
PMID:Correlates of symptom distress in women with lung cancer. 832 26

A total of 109 survivors of curative therapy for nonseminomatous germ cell testicular tumor was interviewed an average of 9 years after treatment to assess long-term physical, emotional and sexual sequelae. An age-matched group of healthy men were interviewed similarly as controls. Of the physical sequelae loss of ejaculation was prominent (30% of the patients) and appeared directly related to retroperitoneal lymph node dissection surgery (p < 0.01). Hypofertility was apparent among patients during the posttreatment period compared to controls (p < 0.01). Other physical complications were present in 35% of the patients and 8% were severe. Laparotomy was associated with incisional hernia and radiotherapy with gastrointestinal complications (p < 0.001). Psychoemotional status was similar among patients and controls before cancer diagnosis but 60% of the patients had obvious emotional problems during the treatment period, which were more severe in those who had a history of such problems. Anxiety, often with insomnia, affected 49% of the patients, while irritability and depression were noted in 34%. At the interview 30% of the patients versus 5% of the controls had psychoemotional dysfunction (p < 0.001) but half of the affected patients had a history of problems preexisting the diagnosis of cancer. Sexual complaints were encountered in 19% of the patients before cancer diagnosis compared to only 7% of the controls (p < 0.02). During cancer therapy 57% of the patients had sexual symptoms, primarily loss of erection and decreased frequency of intercourse. Residual problems were more prevalent among patients (38%) than controls (11%, p < 0.001). Sexual impairment was associated with direct treatment effects and persisted more often when symptoms developed during the treatment period. Although direct treatment related effects should decrease with modern single modality therapy, appropriate attention should be placed on counseling to help avoid long-term psychoemotional and sexual complications of the disease process and its treatment.
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PMID:Quality of life in long-term survivors of nonseminomatous germ cell testicular tumors. 838 21

Preoperative interleukin 2 (IL2) administration has been performed, in order to diminish the post-operative immunodepression in cancer patients. The aim of this study was to compare two different ways of preoperative IL2 administration, ie, intravenous (iv) and subcutaneous (sc), in terms of feasibility and tolerance. Nineteen surgical procedures were performed in 18 patients: a) 10 following the administration of 12 IU/m2/24 hours IL2 IV, with a continuous infusion, from day 5 to day 3 before surgery; b) 9 following the administration of 18 IU IL2, in 2 SC injections per day, from day 4 to day 2 before surgery. Tolerance was evaluated by both clinical and biological parameters, before, during, and after surgery. Hyperthermia and capillary leak syndrome were more important in the iv versus sc injection group. Insomnia and digestive troubles were more frequent in the iv injection group as well. However, we noticed few and equivalent cutaneous and respiratory complications in both groups. In conclusion, the tolerance of IL2 was better after sc versus iv injection. However, the toxicity of iv infusion of IL2 was moderate and could be limited by preventive treatments; moreover there was no consequence on the scheduled surgical procedure.
Bull Cancer 1995 Dec
PMID:[Feasibility and tolerance evaluation of 2 routes of preoperative administration of interleukin 2]. 874 72

A growing number of surgical trials include quality of life variables in the overall assessment of outcomes. This is believed to broaden the criteria for choice of treatment and the evaluation of treatment regimens. The present study is a baseline evaluation of the health-related quality of life in patients with gastric cancer facing surgery. The quality of life in these patients was related to that of other patient groups referred for surgical interventions and general population groups. Our study included 103 consecutive patients with carcinoma of the stomach considered amenable to a curative major surgical procedure. The quality of life evaluation was based on a battery of questionnaires, covering general body symptoms, mood level and functional limitations. Patients with gastric cancer reported more neurasthenic complaints such as reduced sexual interest, insomnia and poor appetite as well as a lower mood level than the general population. The gastric cancer group also showed a markedly lower mood level in comparison with a group of cancer survivors 2-3 years after diagnosis and patients with intermittent claudication. The mental well-being of gastric cancer patients matched that of cancer survivors with one or more recurrences. Overall, 25% of the gastric cancer patients reported functional limitations regarded as clinically significant. Patients with intermittent claudication reported more and patients with small cell lung cancer markedly more limitations. We conclude that although patients with gastric cancer showed a low level of limitations on average, problems in the areas of sleep/rest, home management and, especially, eating were frequently reported.
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PMID:Quality of life in gastric cancer prior to gastrectomy. 899 94


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