Archive for the ‘Follow up Treatment’ Category

Cancer Follow-Ups Are A Waste Of Time

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Posted 06 Oct 2010 — by James Street
Category Follow up Treatment

29 Sep 2010

The current follow-up system for cancer patients is a waste of time and needs to be completely overhauled, according to Jane Maher, Chief Medical Officer at Macmillan Cancer Support writing for BBC Scrubbing Up.

Instead cancer patients should be given ‘the skills and knowledge to self-manage their condition, and provide support if needed, which would be far more effective at spotting reoccurrences of cancer.’

At the moment cancer patients who survive initial treatment enter what is called the ‘follow-up system’ – regular appointments to check that the cancer has not returned. Jane Maher, says: ‘The current system is wasteful, ineffective, and not the best way to spot many recurrent cancers.’

But there is surprisingly little evidence that this method is the best way to spot recurrences of cancer or the other possible long term health consequences of being treated for cancer.

Jane draws on recent work which ‘suggests that around 70% of recurrence for breast cancer could be detected by either patients noticing symptoms themselves or by surveillance testing alone, with a face-to-face appointment if needed.’

She continues ‘this is only possible if patients are helped to understand their illness, can access regular tests and know how and when to contact specialists if problems arise.’

Plus, one in five people living after treatment for cancer will develop long term emotional, psychological and physical problems that seriously affect their quality of life. Yet there are few, if any, NHS services specifically for cancer survivors.

The NHS needs to radically transform the way it provides support for patients following hospital treatment.

In the UK there are already two million people surviving cancer. This figure will grow to four million by 2030 due to better cancer treatment, earlier diagnosis and people living longer – these millions need comprehensive post-treatment support.

Notes

1. Traditionally, follow-up involves out-patient department visits with a consultant, backed up with diagnostic tests.

2. Due to advances in treatment, more people are living longer and having to cope with the consequences of cancer. In the UK there are already two million people surviving cancer. This figure will grow to four million by 2030 due to better cancer treatment, earlier diagnosis and people living longer.

3. Macmillan Cancer Support works with the Department of Health and NHS Improvement Services as part of the National Cancer Survivorship Initiative (NCSI).

Source:
Macmillan Cancer Support


Article URL: http://www.medicalnewstoday.com/articles/202862.php

Main News Category: Cancer / Oncology

Age and Other Factors Influence Osteosarcoma Outcomes

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Posted 11 Aug 2010 — by James Street
Category Age and osteosarcoma, Chemotherapy, Follow up Treatment, Osteosarcoma Outcomes

By Will Boggs, MD

NEW YORK MAR 30, 2006 (Reuters Health) – Age, alkaline phosphatase level, tumor volume,
and other factors influence the outcomes for osteosarcoma of the extremity treated with
neoadjuvant chemotherapy, according to a report by Italian investigators published in the March
1st issue of Cancer.

Optimal treatment is neoadjuvant chemotherapy, Dr. Gaetano Bacci from Istituto Ortopedico
Rizzoli, Bologna, told Reuters Health. “However in some cases (about 10%) with small tumor,
especially if located in expendable bones (for instance, fibula), immediate surgery followed by
chemotherapy could be better.”

Dr. Bacci and colleagues evaluated the influence of several patient- and treatment-related
prognostic factors in a series of 789 patients with nonmetastatic osteosarcoma of the extremities
treated with neoadjuvant chemotherapy and followed for at least 5 years.

After a follow-up ranging from 5 to 22 years, more than half the patients (n=440) remained
continuously event-free, the authors report. Another 313 had a recurrence, 20 developed a
second neoplasm, and 10 patients died.

Age of 14 years or younger, elevated serum alkaline phosphatase at presentation, tumor volume
200 mL or more, inadequate surgical margins, and poor histologic response to preoperative
chemotherapy each independently predicted a high risk of recurrence, the results indicate.

The first recurrences were isolated lung metastases in 243 patients (77.6%), isolated bone
metastases in 26 patients (8.3%), combined lung and bone metastases in 5 patients (1.6%), and
other sites in 3 patients (0.9%), the researchers note. The average time to recurrence was 24.5
months.

Among 313 patients who relapsed, 171 (54.6%) were treated with surgery alone, 43 (13.7%)
received surgery plus a second-line chemotherapy, 24 (7.7%) received chemotherapy only, and 6
(1.9%) received radiotherapy. Nearly two thirds of patients treated for the first recurrence entered
remission.

Overall, after a median of 8 years follow-up, 19.8% of patients who relapsed were alive and
disease-free after the last treatment for systemic recurrence, the investigators report. Another 5
patients were alive with uncontrolled disease, and 246 relapsed patients had died.

When the surgical margins are inadequate, 30% of patients experience local recurrence in spite of
chemotherapy, Dr. Bacci said. “Local recurrence in osteosarcoma is a dramatic event because it
is almost always associated with systemic relapse. The post-relapse outcome of patients who
experience local recurrence is worse than the outcome of patients who relapse with only lung
metastases.”

For this reason, patients with osteosarcoma should be surgically treated in very selected centers
with a vast experience in the treatment of bone tumors, Dr. Bacci concluded.

SOURCE:

* Cancer 2006;106:1154-1161.

No Cancer Risk with Bisphosphonates

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Posted 11 Aug 2010 — by James Street
Category Bone repair, Chemotherapy, Follow up Treatment, Molecular Osteosarcoma Studies, Osteosarcoma
By Charles Bankhead, Staff Writer, MedPage Today
Published: August 11, 2010
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
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