化疗后不同时间有氧运动对乳腺癌癌因性疲乏的影响

探讨化疗后不同时间运动干预对乳腺癌癌因性疲乏的影响.将60例行根治术并完成第二周期化疗,接受第三周期化疗的乳腺癌患者随机分为四组,每组15人,对照组行医院常规护理;试验组分为A、B、C三组,除常规护理外按护士制定的有氧运动干预方式分别于化疗后第1天、化疗后第3天,化疗结束后规律锻炼.使用修订的Piper疲乏量表(RPFS)对四组患者在化疗前2天、化疗后第1天(运动干预之前)和化疗后21天进行评估.结果化疗前2天四组RPFS得分均无差异(P＞0.05),化疗后21天对照组RPFS得分均高于试验组,试验C组RPFS得分高于试验A、B组.因此,化疗后及早活动能有效缓解患者的癌因性疲乏.     

乳腺癌患者的心理状况及相关因素分析

乳腺癌患者常常被各种心理问题所困扰,特别是乳腺癌根治术对女性性特征所带来的严重影响,各种心理问题更为突出。这些心理问题不但影响患者的生活质量,而且影响疾病的发生、发展及转归。本文回顾了患者的个人因素、疾病本身和治疗因素及其他社会心理因素与心理状况的关系,对乳腺癌患者进行心理干预、临床的综合诊治和防治过程提供新思路。     

晚期乳腺癌原发灶局部处理的若干问题

乳腺癌仍然是严重威胁女性健康的重大疾病。每年新发乳腺癌患者中约有6％为Ⅳ期乳腺癌,而这类患者5年生存率小于20％,局部处理（外科、放疗）可以根除局部病灶及微小转移灶,以延缓或者缓解症状,但是否可以带来生存获益尚无定论。本文对Ⅳ期乳腺癌原发灶的局部处理等方面的若干问题作一综述。     

团队合作对4838例居家癌痛患者疼痛管理的效果与思考

通过对大连医科大学附属第一医院宁养院2001年3月～2013年11月收治的4838例癌痛患者进行调查,总结归纳居家癌痛患者的疼痛控制情况,探索癌痛患者的疼痛管理方法,结果提示依靠团队合作在居家条件下免费向癌痛患者及其家属提供身体、心理、社会和精神全方位的照顾和支持,即理想的疼痛管理是“整体性疼痛”与“整体性痛苦”的治疗,不仅针对临床疼痛症状,还必须处理相关因素。     

早期乳腺癌患者术后心理状况研究

早期乳腺癌的检出率越来越高,关注治愈率同时,人们越来越关心患者术后的心理状态及生活质量.本文对保乳术及根治术后5年患者进行心理调查.保乳组患者术后心理障碍发生率明显低于根治组.保乳组患者术后心理状况影响因素主要为术后美容效果,而根治组患者心理障碍发生率与年龄、职业、家庭收入相关.两种手术方式对患者5年生存率及无病生存率的影响无明显差异,所以对于早期乳腺癌患者,在符合保乳原则的前提下,保乳手术是一种既安全又能提高生活质量的手术方式.     

术后乳腺癌患者体象对创伤后应激障碍和创伤后成长的影响：反刍的中介作用

为探讨乳腺癌患者反刍这一认知情绪调节方式在体象和创伤后应激障碍（PTSD）、创伤后成长（PTG）之间的中介作用,采用体象量表（BIS）、认知情绪调节问卷中文版（CERQ-C）、创伤后应激障碍量表（PSS）和创伤后成长问卷（PTGI）对150名乳腺癌术后患者进行研究。结果发现：（1）乳腺癌患者的体象可以正向预测PTSD和PTG;（2）乳腺癌患者的反刍在体象和PTSD的闯入性症状、回避性症状中起中介作用,在体象与PTG中的中介作用不显著。结果表明,体象既可以正向预测乳腺癌患者的PTSD和PTG,也可以通过反刍的中介作用影响PTSD。     

当前表型——乳腺癌分子靶向治疗的动态依据

乳腺癌当前表型是指乳腺癌患者在接受治疗时乳腺癌组织的受体分子表达情况.对于乳腺癌术后辅助治疗的患者,其术后病理免疫组化结果可直接作为乳腺癌当前表型使用;对于复发转移的乳腺癌患者,其转移灶、循环肿瘤细胞结合原发灶的免疫组织或细胞化学结果可用于综合判断乳腺癌当前表型.乳腺癌当前表型的检测及应用为乳腺癌分子靶向治疗提供了动态的循证医学依据,及时掌握和捕获乳腺癌细胞的表型变化,并对治疗方案作出相应调整具有重要的临床意义.将乳腺癌当前表型这一概念引入临床,保证了临床医师治疗乳腺癌的“与时俱进”.     

乳腺癌患者术后自我管理行为及其影响因素调查

调查乳腺癌患者术后自我管理行为现状,分析其影响因素.应用自我管理行为量表、中文版癌症自我技能评估量袁及自行设计的一般资料调查表对260例乳腺癌术后患者进行问卷调查,并分析其影响因素.乳腺癌患者自我管理行为处于中等偏低水平,其影响因素为自我效能感、年龄、文化程度及术式.乳腺癌患者术后自我管理现状不容乐观,且受多种因素的影响,这为制定自我管理干预方案提供了依据.     

漫谈消化系统心理问题的医源性因素

许多到消化科就诊的患者症状很多,很痛苦,花费大量医疗费用检查、用药,但是症状得不到缓解甚至加重,经过正规检查诊断后发现许多患者的诊治极不规范,因不规范的医学宣传、诊断、治疗给患者造成了极大的心理负担,产生了更多的心理性躯体症状.这种现状需要从医人员和医疗行政管理者及患者共同努力进行改进.     

活动性肺结核患者生活废弃物处理现状研究

了解居家治疗的活动性肺结核患者生活废弃物的处理现状及认知态度.本研究采用多阶段随机抽样方法,选取720例居家治疗的活动性肺结核病患者,使用自制调查问卷进行回顾性调查,采用多因素回归对居家治疗活动性肺结核病患者生活废弃物处理的影响因素进行分析.研究发现超过半数患者对生活废弃物处理持积极态度,但仅有19.6％的患者能正确处理生活废弃物.Logistic回归分析发现患者对生活废弃物处理的态度、对督导态度以及是否有专人督导是能否正确处理生活废弃物的影响因素.因此,对患者普及生活废弃物处理的意义及方法,加强对患者督导有助于改善居家治疗活动性肺结核病患者生活废弃处理现状,对于预防结核病传播、实施遏制结核病策略具有重要意义.     

Cancer Worry,Perceived Risk and Cancer Screening in First-Degree Relatives of Patients with Familial Gastric Cancer

Currently, there is a lack of evidence evaluating the psychological impact of cancer-related risk perception and worry in individuals at high risk for gastric cancer. We examined the relationships between perceived risk, cancer worry and screening behaviors among first-degree relatives (FDRs) of patients with familial gastric cancer. FDRs of patients diagnosed with familial gastric cancer with a non-informative genetic analysis were identified and contacted. Participants completed a telephone interview that assessed socio-demographic information, cancer risk perception, cancer worry, impact of worry on daily functioning, and screening behaviors. Twenty-five FDRs completed the telephone interview. Participants reported high levels of comparative and absolute cancer risk perception, with an average perceived lifetime risk of 54 %. On the other hand, cancer-related worry scores were low, with a significant minority (12 %) experiencing high levels of worry. Study participants exhibited high levels of confidence (median = 70 %) in the effectiveness of screening at detecting a curable cancer. Participants that had undergone screening in the past showed significantly lower levels of cancer-related worry compared to those that had never undergone screening. In conclusion, individuals at high-risk for gastric cancer perceived a very high personal risk of cancer, but reported low levels of cancer worry. This paradoxical result may be attributed to participants’ high levels of confidence in the effectiveness of screening. These findings highlight the importance for clinicians to discuss realistic risk appraisals and expectations towards screening with unaffected members of families at risk for gastric cancer, in an effort to help mitigate anxiety and help with coping.     

Neuropsychological Sequelae of Non-Central Nervous System Cancer and Cancer Therapy

Cancer patients report numerous adverse symptoms associated with their disease and treatment including cognitive dysfunction, fatigue, and affective distress. Cognitive dysfunction is ubiquitous in patients with primary central nervous system (CNS) cancer and recent evidence has documented similar deficits in patients with non-CNS cancer as well. Both the cancer itself and treatments including chemotherapy, biological response modifiers, and hormonal therapies have been demonstrated to adversely impact cognitive and neurobehavioral function. Neuroimaging and neurophysiological investigations have likewise revealed alterations in brain function that are helping to account for the nature of these cognitive disorders. Similarly, preclinical animal research is assisting to identify the pathophysiological mechanisms that underlie treatment-related neurotoxicities. The coalescence of multidisciplinary clinical and research efforts hold promise for the development of interventions that may offer neuroprotection in addition to currently available symptomatic therapies and cognitive rehabilitation techniques.     

Cancer and suicide

Mortality rates from suicide and cancer in 1990 in 37 European nations were positively associated.     

浅谈饮食与癌

不同国家不同地区在癌症发病率的差异很可能与不同国家、不同地区人民的饮食习惯有着密切的关系 ,某些食物中含有潜在致癌物 ,而某些食物的成份又有助于预防癌的发生。目前媒介也把主要注意力放在食物与癌的关系上。研究表明 ,因癌症死亡的人中有 35%是饮食方面的原因 ,但食物致癌的论点又常常引起争论。ｌ　吸烟与癌1.ｌ　吸烟造成的癌死亡率占全部癌症死亡率的30 % :吸烟是人类患癌的主要原因 ,吸烟与肺癌发病有直接关系 ,80 %的肺癌是吸烟所致[1] 。由于肺癌是最常见的恶性肿瘤 ,占全部癌病死亡率的 2 0 %以上[1] 。吸烟还与其它几种癌的…     

Testicular Cancer and Genetics Knowledge Among Familial Testicular Cancer Family Members

Purpose  

It was our aim to determine baseline levels of testicular cancer and genetics knowledge among members of families with Familial Testicular Cancer (FTC).     

Religiosity and Cancer Screening

Churches have been suggested as avenues to reach African-American populations with messages about health because of their strong participation in church activities. Membership in several religious denominations has been associated with healthy lifestyle practices that are associated with lower cancer-incidence rates and better coping strategies among cancer patients. Among African-American women, however, belief in God as their doctor might preempt seeking treatment for cancer. The goal of the present study was to examine the influence of church participation and religious beliefs on the utilization of breast and cervical cancer screening among low-income, predominantly African-American women. A cohort consisting of 290 women was surveyed at baseline and one year later to determine the association between screening rates in the past year and measures of religiosity. The majority of women were members of a church (88%), with fairly regular church attendance (51% reported weekly attendance), and strong beliefs regarding God's influence on their health (e.g. 88% agreed that God was their doctor). Church attendance was the only religious variable related to screening frequency in univariate analyses, with those reporting attending church 1–3 times per month more likely to receive mammography screening (p = .013). Churches can provide avenues to reach African-American women about cancer screening; strong religious beliefs do not, however, appear to keep women from receiving regular screening exams.     

Cognitive Effects of Cancer Chemotherapy in Adult Cancer Survivors: Cognitive-Behavioral Management

Problems of memory and attention following cancer chemotherapies have gained increasing research attention in the last 2 decades. The President’s Cancer Panel and the National Coalition for Cancer Survivorship formally recognized the problem as a quality of life matter in the 1990s (Ferrell and Hassey in Oncology 11:565–576, 1997; President’s Cancer Panel in Cancer Care Issues in the United States: Quality of Care, Quality of Life, National Cancer Program, National Cancer Institute, 1999). In combination with an aging population, advances in biomedical technologies for detection and treatment of life-threatening cancers, more people than ever are living with cancer or have been diagnosed and treated for cancer. An estimated 10-million individuals living in the U.S. are considered to be in “cancer survivorship” (Institute of Medicine 2005). Given the potential large scope of the problem of cognitive effects of cancer chemotherapies, there is a strong demand to address this survivorship matter and develop methods to optimally manage it. This article will summarize the current knowledge of chemotherapy-related cognitive change and describe a developing cognitive-behavioral treatment that is being studied to aid survivors with chemotherapy-related cognitive problems.     

The Familial Cancer Program of the Vermont Cancer Center: Development of a Cancer Genetics Program in a Rural Area

In response to many scientific discoveries linking cancer in certain families to inherited factors, the Vermont Cancer Center established the Familial Cancer Program (FCP) in December 1993. This multifaceted program combines the expertise of clinicians and researchers in many disciplines, including genetics, oncology, psychology, and molecular biology. The program's goals are identification of families in its region with excess cancer, provision of clinical services to such families, and use of research protocols when available and appropriate. This article describes the experience of setting up a familial cancer program in a rural area and discusses both successes and challenges in such an endeavor.     

Acute Cancer Cognitive Therapy

The utility of cognitive therapy (CT) for ambulatory cancer patients is clear but the acute cancer setting significantly shapes the therapeutic interaction, parameters, and delivery of CT. In this article, we describe how to apply CT to acute cancer settings, focusing on how this approach differs from traditionally taught, ambulatory CT. We highlight the importance of a tailored history and formulation, how the cognitive model is applied within an acute cancer context to promote coping and adaptation. Reframing must consider the "grain of truth" to many so-called distorted cognitions, such as "cancer means death." Fear of recurrence is an example of a common reframing challenge. Another is the "tyranny of positive thinking." Here there is avoidance of considering negative outcomes such as death; patients are told to "think positive," leaving them alone at a time of life-threatening crisis. Instead, acute cancer CT utilizes a stance of realistic optimism. Empathy plays a vital role in turning off the bracing reaction to threat and facilitating problem-solving. Successfully combining CT with medications is integral to this model. We also discuss how CT can be applied to discussing prognosis, the desire for hastened death and suicidality, as well as death and dying in general. Because of the ubiquitous nature of cancer, most cognitive therapists will encounter patients with cancer in their practices. Acute cancer CT is a skill set that should be widely taught to cognitive therapists and flagged as a priority for academic programs and professional organizations.