Patterns of care and predictors of adjuvant therapies in elderly patients with glioblastoma

Amsbaugh, M.J. et al. Cancer | Published online: 27 April 2017

Background: The objectives of this study were to characterize patterns of care and to identify predictors for adjuvant therapy in elderly patients with glioblastoma in the modern era.

Conclusions: In this analysis of elderly patients who had glioblastoma diagnosed from 2004 through 2012, a significant increase in the receipt of combined-modality therapy was observed. Combined-modality treatment produces improved survival outcomes and should be considered as adjuvant treatment for carefully selected elderly patients.

Read the abstract here

Tobacco packaging design for reducing tobacco use

The Cochrane Database of Systematic Reviews has published ‘Tobacco packaging design for reducing tobacco use’.

Image source: http://www.cochranelibrary.com/

Tobacco use is the largest single preventable cause of death and disease worldwide. Standardised tobacco packaging is an intervention intended to reduce the promotional appeal of packs and can be defined as packaging with a uniform colour (and in some cases shape and size) with no logos or branding, apart from health warnings and other government-mandated information, and the brand name in a prescribed uniform font, colour and size. Australia was the first country to implement standardised tobacco packaging between October and December 2012, France implemented standardised tobacco packaging on 1 January 2017 and several other countries are implementing, or intending to implement, standardised tobacco packaging.The objective of the study was to assess the effect of standardised tobacco packaging on tobacco use uptake, cessation and reduction.

The available evidence suggests that standardised packaging may reduce smoking prevalence. Only one country had implemented standardised packaging at the time of this review, so evidence comes from one large observational study that provides evidence for this effect. A reduction in smoking behaviour is supported by routinely collected data by the Australian government. Data on the effects of standardised packaging on non-behavioural outcomes (e.g. appeal) are clearer and provide plausible mechanisms of effect consistent with the observed decline in prevalence. As standardised packaging is implemented in different countries, research programmes should be initiated to capture long term effects on tobacco use prevalence, behaviour, and uptake. The researchers did not find any evidence suggesting standardised packaging may increase tobacco use.Read the full text here

Breast cancer e-support program vs routine care

Zhu, J. et al. (2017) BMC Cancer. 17:291

Background: Women with breast cancer undergoing chemotherapy suffer from a number of symptoms and report receiving inadequate support from health care professionals. Innovative and easily accessible interventions are lacking. Breast Cancer e-Support is a mobile Application program (App) that provides patients with individually tailored information and a support group of peers and health care professionals. Breast Cancer e-Support aims to promote women’s self-efficacy, social support and symptom management, thus improving their quality of life and psychological well-being.

Discussion: This is the first study of its kind in China to evaluate the use of a mobile application intervention with a rigorous research design and theoretical framework. This study will contribute to evidence regarding the effectiveness of a theory-based mobile application to support women with breast cancer undergoing chemotherapy. The results should provide a better understanding of the role of self-efficacy and social support in reducing symptom distress and of the credibility of using a theoretical framework to develop internet-based interventions. The results will provide evidence to support the implementation of an innovative and easily accessible intervention that enhances health outcomes.

Read the full protocol here

Acid-suppressing therapies and subsite-specific risk of stomach cancer

Wennerström, E.C.M. et al. (2017) British Journal of Cancer 116(4) pp. 1234-1238

Image source: Collin Grady – Flickr // CC BY 2.0

Image shows Pepcid AC, a H₂RA.

Background: Associations of stomach cancer risk with histamine type-2 receptor antagonists (H₂RA) and proton-pump inhibitors (PPI) are controversial. We hypothesised that proximal extension of Helicobacter pylori infection from acid suppression would disproportionately increase cancers at proximal subsites.

Conclusions: Moderate exposures to acid-suppressive drugs did not favour proximal tumour localisation. Given confounding by indication, these findings do not resolve potential contribution to gastric carcinogenesis overall.

Read the full abstract here

Issues of Survivorship and Rehabilitation in Soft Tissue Sarcoma

Gerrand, C. & Furtado, S. Clinical Oncology | Published online: 22 April 2017

As the number of survivors of extremity soft tissue sarcoma increases, so does the need to understand the experience of survivors and develop measures, systems and services that support rehabilitation into normal life roles.

Survivorship includes considerations of the physical, psychological and social domains, of which the physical sequelae of treatment are the best characterised in the literature. The survivorship experience may include disability, pain, lymphoedema, psychological problems, as well as difficulty with employment, relationships and lower quality of life.

Rehabilitation strategies for extremity sarcoma patients must be personalised, holistic and begin early in the pathway, ideally before the first treatment intervention.The International Classification of Functioning, Disability and Health model is a useful framework for combining assessments, including objective outcome measures, which can be combined into a rehabilitation prescription. Research is needed to develop an evidence base for rehabilitation interventions to support patients with extremity soft tissue sarcoma.

Read the full abstract here

Women with incurable breast cancer receiving insufficient care

Three quarters (76%) of NHS trusts and health boards say that they do not have enough specialist nursing care for people with incurable secondary breast cancer | OnMedica

The survey of 155 NHS trusts and health boards by Breast Cancer Care found that 42% of organisations surveyed do not provide specialist nursing care for people with incurable breast cancer, in stark comparison to the majority (95%) of people with primary breast cancer having a named clinical nurse specialist for support.

This is despite half (49%) of NHS trusts and health boards saying a main benefit of specialist nursing is reducing lengthy periods in hospital – often unnecessary if symptoms and treatment are managed well – saving the NHS money by freeing up beds.

Read the overview by OnMedica here

Amino acids in diet could be key to starving cancer

Cutting out certain amino acids from the diet of mice slows tumor growth and prolongs survival, according to new research | ScienceDaily

SPOTzillah – Wikipedia // CC BY-SA 4.0

Image shows glycine; a white crystalline solid

Researchers at the Cancer Research UK Beatson Institute and the University of Glasgow found that removing two non-essential amino acids — serine and glycine — from the diet of mice slowed the development of lymphoma and intestinal cancer.

The researchers also found that the special diet made some cancer cells more susceptible to chemicals in cells called reactive oxygen species.

Chemotherapy and radiotherapy boost levels of these chemicals in the cells, so this research suggests a specially formulated diet could make conventional cancer treatments more effective.

Read the full commentary here

The original research abstract is available here

The Potential Role of an Acute Oncology Service

Bruce, C.M. et al. Clinical Oncology | Published online: 17 April 2017

Highlights:

• There is ample scope to work with primary care to reduce cancer patient admissions.
• Only one quarter of cancer patients had an inpatient oncologist review.
• Median length of stay was 6 days; the literature suggests an AOS could reduce this.
• A pilot suggests a reduction in number of bed days can be achieved with an AOS.
• An AOS is likely to have a positive impact at an individual and national level.

Read the full abstract here

LGB people with cancer share video experiences

Cancer is complex, but so are our sexualities | The University of Manchester & Macmillan Cancer Support

The unique experiences of lesbian, gay, bisexual and queer people with cancer have been shared on a new video hub highlighting differences in their care, and issues around sex, support and bereavement.

The aim of the videos, which were filmed during 2016 by lecturer in nursing Dr Maurice Nagington are designed to help people understand the thoughts and feelings of LGB people with cancer and their own experiences of care.

The site https://lgbcancer.wordpress.com/ is designed for NHS staff as a resource to guide their contact with this group.

Read the full overview here

 

One Hospital System’s Journey to Reduce Clostridium Difficile

Delaney, M.B. Journal of Emergency Nursing | Published online: 4 April 2017

Problem: Albert Einstein defines insanity as doing the same thing over again but expecting different results. Although the United States claims to reduce antibiotic abuse, practice strict isolation, and clean meticulously, the burden of Clostridium difficile outpaces goals. Unless innovative approaches are tried, we risk culling elderly, immunosuppressed, and otherwise debilitated populations. Emergency departments are a primary access point for patients who are unable to wait for primary care. As a result, many patients with diarrhea are seen in emergency departments.

Methods: This article describes one hospital system’s quality improvement trial of disposable commode pails (DCPs) for high-acuity patients in 3 of 5 institutions. The rationale was to prevent staff from touching surfaces heavily contaminated with C difficile. Staff members were not to wash or reuse commode buckets between patients. Instead, DCPs were substituted, and only the commode chairs were wiped. For quantitative date, C difficile infections (CDIs) were compared across hospitals. Staff members were surveyed for qualitative data.

Read the full abstract here