Menée aux Etats-Unis auprès de 77 patients atteints de cancer et traités dans des services de soins palliatifs, cette étude observationnelle rétrospective analyse l'efficacité d'analgésiques non-opioïdes adjuvants dans la prise en charge de la douleur et leur impact sur la réduction des doses d'opioïdes prescrits

Use of non-opioid analgesics as adjuvants to opioid analgesia for cancer pain management in an inpatient palliative unit: does this improve pain control and reduce opioid requirements?

Shinde, Shivani ; Gordon, Pamela ; Sharma, Prashant ; Gross, James ; Davis, MellarP

Background : Cancer pain is complex, and despite the introduction of the WHO cancer pain ladder, few studies have looked at the prevalence of adjuvant medication use in an inpatient palliative medicine unit. In this study, we evaluate the use of adjuvant pain medications in patients admitted to an inpatient palliative care unit and whether their use affects pain scores or opiate dosing. Methods : In this retrospective observational study, patients admitted to the inpatient palliative care unit [...]

Cet article passe en revue les différents aspects du délire chez les patients atteints de cancer, son diagnostic, sa prise en charge et ses traitements

Delirium in patients with cancer: assessment, impact, mechanisms and management

Lawlor, Peter G. ; Bush, Shirley H.

Delirium is a frequent neurocognitive complication in patients with cancer, particularly in patients with advanced-stage disease (in whom a combination of factors might trigger an episode) and in patients with a high degree of predisposing vulnerability, such as the elderly or patients with dementia. The communicative impediments associated with delirium generate distress for the patient and their family, and substantive challenges for health-care practitioners, who might have to contend with [...]

Menée en Australie par entretiens auprès de 15 participants âgés de 24 à 81 ans, cette étude qualitative analyse leurs perceptions relatives à l'utilisation de la morphine dans les soins anti-cancéreux

Exploring the myths of morphine in cancer: views of the general practice population

Grant, Matthew ; Ugalde, Anna ; Vafiadis, Platon ; Philip, Jennifer

Background : Morphine is widely used in cancer care, and understanding the concerns and perceptions of patients, family and friends is vital to managing pain and distress effectively. The ‘myths of morphine’ have frequently been discussed in medical literature, yet the extent to which such views are held is not clear. This qualitative project explores the perceptions and attitudes of the wider community towards morphine use in cancer care, to understand this ‘mythology’ according to those who [...]

A partir d'une revue systématique de la littérature (70 études), cette étude américaine analyse l'efficacité d'un outil "MFSI-SF" permettant d'évaluer les symptômes de fatigue chez des patients atteints de cancer

Systematic review of the Multidimensional Fatigue Symptom Inventory-Short Form

Donovan, KristineA ; Stein, KevinD ; Lee, Morgan ; Leach, CorinneR ; Ilozumba, Onaedo ; Jacobsen, PaulB

Purpose Fatigue is a subjective complaint that is believed to be multifactorial in its etiology and multidimensional in its expression. Fatigue may be experienced by individuals in different dimensions as physical, mental, and emotional tiredness. The purposes of this study were to review and characterize the use of the 30-item Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF) in published studies and to evaluate the available evidence for its psychometric properties. Methods A [...]

A partir d'une revue systématique de la littérature publiée entre 2000 et 2012 (37 études), cette étude analyse les complications et le résultat esthétique d'une reconstruction mammaire, selon que l'opération a lieu avant ou après la radiothérapie

‘Reconstruction: Before or after postmastectomy radiotherapy?’ A systematic review of the literature

Berbers, Judith ; van Baardwijk, Angela ; Houben, Ruud ; Heuts, Esther ; Smidt, Marjolein ; Keymeulen, Kristien ; Bessems, Maud ; Tuinder, Stefania ; Boersma, Liesbeth J.

Objective : The aim of this review is to investigate the effect of timing of the reconstruction and radiotherapy, with respect to complication rate and cosmetic outcome, with a special focus on the timing of the placement of the definite implant. Methods : PubMed was searched for publications between January 2000 and December 2012. Of 37 eligible studies, timing of reconstruction, type, and incidence of complications were recorded. First, we calculated the weighted mean including confidence [...]

A partir des données des registres américains des cancers portant sur 50 520 patients atteints d'un cancer de la vessie de stade 0 à III, cette étude de cohorte analyse l'association entre une cystectomie, une dérivation urinaire à partir d'un segment intestinal et le risque de fracture osseuse

Risk of Fracture After Radical Cystectomy and Urinary Diversion for Bladder Cancer

Gupta, Amit ; Atoria, Coral L. ; Ehdaie, Behfar ; Shariat, Shahrokh F. ; Rabbani, Farhang ; Herr, Harry W. ; Bochner, Bernard H. ; Elkin, Elena B.

Purpose : Radical cystectomy and urinary diversion may cause chronic metabolic acidosis, leading to long-term bone loss in patients with bladder cancer. However, the risk of fractures after radical cystectomy has not been defined. We assessed whether radical cystectomy and intestinal urinary diversion are associated with increased risk of fracture. Patients and Methods : Population-based study using SEER-Medicare–linked data from 2000 through 2007 for patients with stage 0-III bladder cancer. [...]

A partir de 597 échantillons cervicaux provenant de 31 pays et collectés de 1986 à 2011, cette étude analyse la prévalence d'une infection par le papillomavirus humain et sa distribution par sous-type histologique dans des cas de néoplasies intraépithéliales vaginales de grade 2/3 et de cancer vaginal invasif

Large contribution of human papillomavirus in vaginal neoplastic lesions: A worldwide study in 597 samples

Alemany, L. ; Saunier, M. ; Tinoco, L. ; Quirós, B. ; Alvarado-Cabrero, I. ; Alejo, M. ; Joura, E. A. ; Maldonado, P. ; Klaustermeier, J. ; Salmerón, J. ; Bergeron, C. ; Petry, K. U. ; Guimerà, N. ; Clavero, O. ; Murillo, R. ; Clavel, C. ; Wain, V. ; Geraets, D. T. ; Jach, R. ; Cross, P. ; Carrilho, C. ; Molina, C. ; Shin, H. R. ; Mandys, V. ; Nowakowski, A. M. ; Vidal, A. ; Lombardi, L. ; Kitchener, H. ; Sica, A. R. ; Magaña-León, C. ; Pawlita, M. ; Quint, W. ; Bravo, I. G. ; Muñoz, N. ; de Sanjosé, S. ; Bosch, F. X.

Aim : This work describes the human papillomavirus (HPV) prevalence and the HPV type distribution in a large series of vaginal intraepithelial neoplasia (VAIN) grades 2/3 and vaginal cancer worldwide. Methods : We analysed 189 VAIN 2/3 and 408 invasive vaginal cancer cases collected from 31 countries from 1986 to 2011. After histopathological evaluation of sectioned formalin-fixed paraffin-embedded samples, HPV DNA detection and typing was performed using the SPF-10/DNA enzyme immunoassay [...]

Menée au Royaume-Uni auprès de 247 cas et 1 235 témoins, cette étude analyse le délai entre l'apparition de symptômes liés à la maladie, la présentation du patient chez le médecin généraliste et le diagnostic de cancer du poumon

Symptom lead time distribution in lung cancer: natural history and prospects for early diagnosis

Ades, Anthony E ; Biswas, Mousumi ; Welton, Nicky J ; Hamilton, William

Background: Before their diagnosis, patients with cancer present in primary care more frequently than do matched controls. This has raised hopes that earlier investigation in primary care could lead to earlier stage at diagnosis. Methods: We re-analysed primary care symptom data collected from 247 lung cancer cases and 1235 matched controls in Devon, UK. We identified the most sensitive and specific definition of symptoms, and estimated its incidence in cases and controls prior to diagnosis. We [...]

Menée en Corée auprès de 229 patients atteints d'un cancer du côlon de stade III et recevant une chimiothérapie adjuvante après un traitement chirurgical, cette étude évalue l'effet de la diminution de leur masse musculaire sur la toxicité du traitement et sur la survie

Effect of muscle mass on toxicity and survival in patients with colon cancer undergoing adjuvant chemotherapy

Jung, Hee-Won ; Kim, JinWon ; Kim, Ji-Yeon ; Kim, Sun-Wook ; Yang, HyunKyung ; Lee, JoonWoo ; Lee, Keun-Wook ; Kim, Duck-Woo ; Kang, Sung-Bum ; Kim, Kwang-il ; Kim, Cheol-Ho ; Kim, JeeHyun

Purpose : The purpose of this study was to elucidate the effect of decreased muscle mass on the toxicity and survival of patients with colon cancer treated with adjuvant chemotherapy after surgery. Methods : We reviewed the data of 229 consecutive patients with stage III colon cancer who received adjuvant oxaliplatin, 5-fluorouracil, and leucovorin chemotherapy at a single center between 2003 and 2010. Baseline muscle mass was assessed by measuring the cross-sectional area of the psoas muscle [...]

A partir des données de 13 registres américains des cancers portant sur des participantes âgées de 20 à 79 ans et atteintes d'un cancer du sein diagnostiqué entre 1992 et 2008, cette étude analyse l'évolution de la survie à 5 ans des patientes, en fonction du statut du récepteur hormonal et du stade de la maladie

Trends in 5-year survival rates among breast cancer patients by hormone receptor status and stage

Chen, Lu ; Linden, HannahM ; Anderson, BenjaminO ; Li, ChristopherI

Improvement in breast cancer survival has been observed in recent decades in the U.S., but it is unclear if similar survival gains are consistent across breast cancer subtypes, especially with regards to more advanced stages of the disease. Data were from 13 population-based cancer registries participating in the surveillance, epidemiology, and end results (SEER) program, consisting of women between 20 and 79 years of age diagnosed with invasive breast cancer between 1992 and 2008. 2-year [...]

Menée au Canada par enquête auprès de 1 626 survivantes d'un cancer gynécologique, cette étude évalue l'association entre la pratique d'une activité physique et la croissance post-traumatique

Associations between exercise and posttraumatic growth in gynecologic cancer survivors

Crawford, JenniferJ ; Vallance, JeffK ; Holt, NicholasL ; Courneya, KerryS

Purpose : Exercise improves numerous psychosocial outcomes in cancer survivors; however, few studies have examined posttraumatic growth. The primary objective of this study was to examine the association between exercise and posttraumatic growth in gynecologic cancer survivors (GCS). Methods : Using the Alberta Cancer Registry, a random sample of endometrial, ovarian, and cervical cancer survivors were mailed a self-report survey that assessed demographic and medical variables, aerobic and [...]

Menée au Danemark par questionnaire auprès de 196 patients atteints d'un cancer hématologique et suivis pendant un an, cette étude évalue l'association entre les niveaux de fatigue, de dépression et d'anxiété après le diagnostic de la maladie, le retour au travail et la durée des arrêts de travail pour maladie

Are fatigue, depression and anxiety associated with labour market participation among patients diagnosed with haematological malignancies? A prospective study

Horsboel, Trine A. ; Bültmann, Ute ; Nielsen, Claus V. ; Nielsen, Bendt ; Andersen, Niels T. ; de Thurah, Annette

Objectives The objectives of this study are to examine levels of fatigue, depression and anxiety following diagnosis of a haematological malignancy, to determine the incidence of return to work (RTW) and long-term sickness absence (LTSA) during 1-year follow-up and to examine whether fatigue, depression and anxiety are associated with RTW and LTSA in this group of cancer patients. Methods Questionnaire-based data on fatigue, depression and anxiety were obtained at baseline. In all, 196 patients [...]

Menée en Allemagne auprès de 1 021 patients atteints de cancer, cette étude observationnelle analyse les trajectoires de soins et la survie des patients après leur prise en charge dans des unités hospitalières spécialisées de soins palliatifs

Care trajectories and survival after discharge from specialized inpatient palliative care—results from an observational follow-up study

Kötzsch, Franziska ; Stiel, Stephanie ; Heckel, Maria ; Ostgathe, Christoph ; Klein, Carsten

Background : Little is known about the patients’ individual care trajectories after discharge or transfer from inpatient palliative care units (PCU) to other care settings. This study aims to survey the further care trajectory and overall survival from the time of discharge of patients in a palliative care situation. Patient groups from either the PCU or the palliative care mobile support team (PCMT) are compared in order to analyze the demographic data, discharge settings, frequency of changes [...]

Cet article analyse les enjeux éthiques associés à la mise en oeuvre d'essais cliniques de traitements anticancéreux dans des pays en voie de développement

Ethics of Cancer Clinical Trials in Low-Resource Settings

Joffe, Steven ; Miller, Franklin G.

Debates surrounding the appropriate design and conduct of clinical research in low-resource settings have bedeviled the scientific, policy, and bioethics communities for decades. Historically, controversies primarily involved trials related to infectious disease. With the growing lobalization of cancer clinical trials and the recognition of cancer as a public health threat in developing as well as developed countries, these debates will increasingly engage the cancer research community...  [...]

Menée aux Etats-Unis, cette étude présente les travaux d'un réseau de prévention et de lutte contre le cancer pour améliorer la mise en pratique des résultats de la recherche en prévention des cancers

The Cancer Prevention and Control Research Network: An Interactive Systems Approach to Advancing Cancer Control Implementation Research and Practice

Fernandez, Maria E ; Melvin, Cathy ; Leeman, Jennifer ; Ribisl, Kurt M. ; Allen, Jennifer D ; Kegler, Michelle C ; Bastani, Roshan ; Ory, Marcia G ; Risendal, Betsy C ; Hannon, Peggy A ; Kreuter, Matthew W ; Hebert, James R.

Background: Although cancer research has advanced at a rapid pace, a gap still remains between what is known about how to improve cancer prevention and control (CPC) and what is implemented as best practices within healthcare systems and communities. The Cancer Prevention and Control Research Network (CPCRN), with over 10 years of dissemination and implementation research experience, aims to accelerate the uptake and use of evidence-based CPC interventions. Methods: The collective work of the [...]