Development and Feasibility of a Group Cognitive-Behavioral Therapy for Fear of Cancer Recurrence

This paper describes the development, content, and preliminary results of a group cognitive-behavioral therapy (CBT) for fear of cancer recurrence (FCR). A manualized CBT intervention was developed and offered to 38 patients with various cancer types and stages in two hospitals. Four weekly group CBT sessions were administered by two licensed psychologists as part of routine care. Patients completed self-report scales before the first treatment session and, a second time, 1 month after the last session.Overall, 33 patients had clinical levels of FCR at baseline. The participants’ satisfaction toward the group CBT for FCR was high. Significant reductions on the total score and most subscales of the Fear of Cancer Recurrence Inventory (FCRI) were observed, as well as significant improvements on most of the other psychological variables measured (i.e., insomnia, anxiety, depression, dysfunctional beliefs about cancer, and intolerance of uncertainty). In addition, 52% of the patients with clinical levels of FCR (FCRI-severity subscale score ≥ 13) at baseline no longer reached this clinical threshold at posttreatment.These preliminary results suggest that our group CBT for FCR is well accepted and feasible, and shows promising efficacy for decreasing FCR and improving other psychological variables among cancer patients. The next step is to investigate the efficacy of this minimal intervention in larger and controlled clinical trials, as well as its usefulness as part of a stepped care approach.This low-cost intervention is easy to implement in various clinical settings and has a strong potential to help large numbers of patients with FCR.     

Predictors of adherence to aerobic exercise in rectal cancer patients during and after neoadjuvant chemoradiotherapy

This pilot study explored predictors of adherence to exercise during and after neoadjuvant chemoradiotherapy (NACRT) in rectal cancer patients. Eighteen rectal cancer patients were prescribed three supervised aerobic exercise sessions/week during NACRT followed by ≥150 min/week of unsupervised aerobic exercise after NACRT. Although not statistically significant, adherence to supervised exercise during NACRT was meaningfully better for patients who were women (d = .82; P = .12), younger (d = ?.62; P = .30), married (d = .62; P = .42), with better mental health (r = .32; P = .21), fewer diarrhea symptoms (r = .48; P = .052), and higher anticipated enjoyment (r = .31; P = .23), support (r = .32; P = .22), and motivation (r = .31; P = .23). After NACRT, adherence was significantly better for patients who reported worse mental health (r = ?.56; P = .046) and meaningfully better for patients who were women (d = .54; P = .38), better educated (d = .77; P = .22), had no comorbidities (d = ?.63; P = .17), and exercised at baseline (d = 1.05; P = .12). Demographics, tumor side effects, and motivational variables may predict adherence to exercise during and after NACRT.     

末期癌症患者的临终关怀

临终关怀与末期癌症关系密切,末期癌症患者是临终关怀的主要对象,这也是姑息医学的主要内容。作为发展中的学科,本文对临终关怀的发展、目的、内容及其在末期癌症患者中的实施作一综述。     

台湾地区姑息医学制度的建立及法律实践

姑息治疗在提高晚期癌症患者生活质量、实施临终关怀、给予病人及其家属全面周到的照顾诸方面起着重要作用。在台湾,已为姑息治疗立法并实施了10年,积累了丰富的经验。这项法律本身及其细则、附件等配套文件使姑息治疗更加规范可行。研究规范的姑息治疗及台湾的相关法律可以帮助我们更好的理解姑息治疗的理念,帮助发展大陆同道构建有效实用的...     

对T1G3膀胱癌治疗方法的探讨

T1G3膀胱癌有高复发和进展倾向,选择恰当的治疗方法成为难题。使用BCG治疗可促肿瘤进展和转移,但可保留膀胱。膀胱切除也许提供了最好的治疗方案,但膀胱切除仍会复发且具有手术风险,且被认为是过度治疗。此文从哲学角度来探讨T1G3膀胱癌的治疗方法,以便为临床实践和进一步的研究提供思路。     

靶向药物不良反应的认识与思考

新的靶向药物出现提高了抗癌疗效,降低了毒性,使转移性恶性肿瘤患者从治疗中获益。靶向药物耐受性好,通常出现轻微或中度的毒副反应。尽管大多数不良反应是可以得到迅速处理的,但是严重的甚至危及生命的不良反应仍能够发生。因此,为更好地指导临床实践工作,该文综述了实体瘤治疗中常用靶向药物的主要不良反应和安全数据,并按照药物的作用靶...     

克服肿瘤干细胞耐药性的策略和思路

肿瘤干细胞（cancersterncells,CSCs）是肿瘤细胞的祖细胞。已有的研究表明,肿瘤干细胞对多种化疗药物具有耐药性,是导致肿瘤治疗后复发的根源。研究针对肿瘤干细胞的治疗方法,克服肿瘤干细胞耐药性,将给肿瘤治疗模式带来全新的改变,有望彻底改善肿瘤患者的预后。     

浅析当前中医药抗肿瘤最佳时机的选择

恶性肿瘤是导致人类死亡的主要原因,而目前固有的治疗手段似乎已达到一个瓶颈,传统中医药虽有一定疗效,但仍处于从属地位,如何选择恰当时机干预肿瘤,从而取得事半功倍的效果是当代中医学应当思考的问题。笔者结合中医学对恶性肿瘤的认识以及目前中医药抗肿瘤现状,探讨选择最佳时机在中医药抗肿瘤事业中的重要意义,并初步认为中医药抗肿瘤最佳时机在于干预肿瘤病因及肿瘤早期病变。此外,笔者结合目前临床中医药最佳时机抗肿瘤可能存在的不足,提出简要建议。     

Theological Strategies,Constructing Meaning,and Coping with Breast Cancer: A Qualitative Study

Examines ways in which the experience of breast cancer has impacted the theology and the ability to create meaning for 10 female breast cancer patients. Discusses three theological strategies emerging from participant interviews: 1) God causes cancer for a purpose, 2) God does not cause cancer, but there can still be meaning in illness, and 3) cancer is just part of life and has no inherent meaning, though meaning can be constructed through the experience.     

Measurement of Depressive Symptoms in Women With Breast Cancer and Women With Clinical Depression: A Differential Item Functioning Analysis

Differential item functioning (DIF) analyses of the Beck Depression Inventory-II (BDI-II) were conducted on samples of 267 women with breast cancer and 294 women with clinical depression. Patterns of items in which there was significant and nonsignificant DIF were identified using statistical tests and measures of DIF effect size. At the most general level, 15 of 21 BDI-II items were associated with nontrivial DIF suggesting that the item responses of these samples do not reflect the same underlying construct. Factor analyses of the BDI-II using a psychometrically defensible method for item level factor analysis supported the conclusions from the DIF analyses. These findings suggest that researchers and practitioners should apply caution when interpreting self-report depression symptoms in breast cancer patients.