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1.
Biol Pharm Bull ; 47(4): 758-763, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38569843

RESUMEN

Enoxaparin and daikenchuto are commonly administered to prevent venous thromboembolism and intestinal obstruction after gynecological malignancy surgery. However, the effects of their combined use on hepatic function are not well studied. This study aimed to clarify the effects of the coadministration of enoxaparin and daikenchuto on hepatic function. First, Japanese Adverse Drug Event Report (JADER) data were analyzed to identify signals of hepatic disorders. Second, a retrospective observational study of patients who underwent surgery for gynecological malignancies was conducted. This study defined hepatic disorders as an increase in aspartate aminotransferase (AST) or alanine aminotransaminase (ALT) levels above the reference values, using 1-h postoperative values as the baseline. The analysis of JADER data revealed an increased risk for hepatic disorders with the coadministration of enoxaparin and daikenchuto. An observational study also showed higher odds ratios (95% confidence intervals) for the occurrence of hepatic disorders in the coadministration group (4.27; 2.11-8.64) and enoxaparin alone group (2.48; 1.31-4.69) than in the daikenchuto alone group. The median increase in the ALT level was also higher in the coadministration group (34; 15-59) than in the enoxaparin alone (19; 6-38) and daikenchuto alone groups (8; 3-33). In conclusion, our study suggests that compared with the use of enoxaparin or daikenchuto alone, enoxaparin and daikenchuto coadministration increases the risk of hepatic disorders, with more significant increases in AST and ALT levels. Healthcare workers need to be aware of these potential side effects when combining these drugs after surgery for gynecological malignancies.


Asunto(s)
Neoplasias de los Genitales Femeninos , Panax , Extractos Vegetales , Zanthoxylum , Zingiberaceae , Femenino , Humanos , Enoxaparina/efectos adversos , Neoplasias de los Genitales Femeninos/cirugía , Neoplasias de los Genitales Femeninos/tratamiento farmacológico , Anticoagulantes/efectos adversos , Complicaciones Posoperatorias/prevención & control , Complicaciones Posoperatorias/inducido químicamente , Complicaciones Posoperatorias/tratamiento farmacológico
2.
J Cell Mol Med ; 28(6): e18115, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38436544

RESUMEN

Ovarian cancer is one of the most common gynaecological malignancies with poor prognosis and lack of effective treatment. The improvement of the situation of ovarian cancer urgently requires the exploration of its molecular mechanism to develop more effective molecular targeted drugs. In this study, the role of human ribosomal protein l35a (RPL35A) in ovarian cancer was explored in vitro and in vivo. Our data identified that RPL35A expression was abnormally elevated in ovarian cancer. Clinically, high expression of RPL35A predicted short survival and poor TNM staging in patients with ovarian cancer. Functionally, RPL35A knock down inhibited ovarian cancer cell proliferation and migration, enhanced apoptosis, while overexpression had the opposite effect. Mechanically, RPL35A promoted the direct binding of transcription factor YY1 to CTCF in ovarian cancer cells. Consistently, RPL35A regulated ovarian cancer progression depending on CTCF in vitro and in vivo. Furthermore, RPL35A affected the proliferation and apoptosis of ovarian cancer cells through PPAR signalling pathway. In conclusion, RPL35A drove ovarian cancer progression by promoting the binding of YY1 and CTCF promoter, and inhibiting this process may be an effective strategy for targeted therapy of this disease.


Asunto(s)
Neoplasias de los Genitales Femeninos , Neoplasias Ováricas , Proteínas Ribosómicas , Femenino , Humanos , Apoptosis/genética , Proliferación Celular/genética , Neoplasias Ováricas/genética , Proteínas Ribosómicas/genética , Proteínas Ribosómicas/metabolismo , Factor de Transcripción YY1/genética , Factor de Transcripción YY1/metabolismo , Factor de Unión a CCCTC/genética
3.
Body Image ; 49: 101705, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38531169

RESUMEN

The purpose of this qualitative study was to explore the thoughts, feelings, attitudes, and perceptions of adults diagnosed with gynecologic cancer on their body, and the role of yoga in shaping these aspects. A phenomenological research design was used. Fifteen women (Mage=50.1 ± 13.5 years, range=28-66) who practice yoga at least once/week completed a sociodemographic survey online, two semi-structured interviews, and a 30-day journal online. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using interpretative phenomenological analysis. Participants' responses and the authors' interpretations were summarized into four main superordinate themes: (1) internal monologue of the changed body, (2) balancing act between acceptance and improvement, (3) value of taking time to prioritize oneself by practicing yoga, and (4) transformative catalysts of expectation and mindset on body-related self-perceptions after yoga. Body functionality and appearance, and their sexual health were often deeply interconnected, and impacted participants' self-perceptions and behaviours. Yoga was a vehicle for growth and acceptance; however, participants' expectations and mindsets before and during yoga could lead to negative self-perceptions after yoga. The findings underscore the importance of integrating yoga - a holistic practice - into survivorship care programs, while emphasizing the need to address expectations and attitudes that could hinder positive outcomes.


Asunto(s)
Imagen Corporal , Neoplasias de los Genitales Femeninos , Investigación Cualitativa , Autoimagen , Yoga , Humanos , Yoga/psicología , Femenino , Adulto , Persona de Mediana Edad , Neoplasias de los Genitales Femeninos/psicología , Anciano , Imagen Corporal/psicología
4.
Curr Probl Cancer ; 49: 101080, 2024 04.
Artículo en Inglés | MEDLINE | ID: mdl-38490881

RESUMEN

BACKGROUND: Due to the paucity of reliable data to determine the components of family-based comprehensive care for cancer in India, we explored the familial implications of gynaecological and breast cancer diagnosis and treatment through a mixed-method study. METHODS: The mixed method study included 130 women aged above 18 with a confirmed diagnosis of gynaecological or breast cancer recruited from three selected tertiary hospitals in Kerala, India. Information on quality of life (36-Item Short Form Survey (SF-36)), psychological distress (distress thermometer), and the familial, interpersonal, social, and community impacts of cancer (semi-structured interview guide) were elicited. Linear regression was used to identify the factors associated with distress and the factors were explored further using thematic analysis. RESULTS: Patients included in the study (n = 130; mean age 57.5 years) had moderate or mild (66.9%) to severe (25.4%) distress. Concerns about work (93%), difficulty in; home care and housing (82%), care for dependents (65%), unempathetic family (87.6%), isolation (70%), and body image (65%) were major reasons for their distress. Physiological, social, and family-related stressors among the respondents included challenges in physical functioning, intense physical symptoms like fatigue, loss of appetite and sleep, role restrictions, alterations in family responsibilities, functional dependency, inadequate family support, challenges in social and interpersonal interactions, and an unsupportive work environment. CONCLUSION: Cancer is a health crisis that involves psychological, social, and economic distress, compelling professionals to design multifaceted individualized care packages rather than only concentrating on medical management to alleviate their distress.


Asunto(s)
Neoplasias de la Mama , Neoplasias de los Genitales Femeninos , Calidad de Vida , Humanos , Femenino , India/epidemiología , Persona de Mediana Edad , Neoplasias de la Mama/psicología , Neoplasias de la Mama/epidemiología , Neoplasias de los Genitales Femeninos/psicología , Neoplasias de los Genitales Femeninos/epidemiología , Neoplasias de los Genitales Femeninos/terapia , Calidad de Vida/psicología , Adulto , Anciano , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología , Distrés Psicológico , Familia/psicología
5.
Semin Nucl Med ; 54(2): 270-292, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38342655

RESUMEN

Gynecologic malignancies, consisting of endometrial, cervical, ovarian, vulvar, and vaginal cancers, pose significant diagnostic and management challenges due to their complex anatomic location and potential for rapid progression. These tumors cause substantial morbidity and mortality, often because of their delayed diagnosis and treatment. An estimated 19% of newly diagnosed cancers among women are gynecologic in origin. In recent years, there has been growing evidence supporting the integration of nuclear medicine imaging modalities in the diagnostic work-up and management of gynecologic cancers. The sensitivity of fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET) combined with the anatomical specificity of computed tomography (CT) and magnetic resonance imaging (MRI) allows for the hybrid evaluation of metabolic activity and structural abnormalities that has become an indispensable tool in oncologic imaging. Lymphoscintigraphy, using technetium 99m (99mTc) based radiotracers along with single photon emission computed tomography/ computed tomography (SPECT/CT), holds a vital role in the identification of sentinel lymph nodes to minimize the surgical morbidity from extensive lymph node dissections. While not yet standard for gynecologic malignancies, promising therapeutic nuclear medicine agents serve as specialized treatment options for patients with advanced or recurrent disease. This article aims to provide a comprehensive review on the nuclear medicine applications in gynecologic malignancies through the following objectives: 1) To describe the role of nuclear medicine in the initial staging, lymph node mapping, response assessment, and recurrence/surveillance imaging of common gynecologic cancers, 2) To review the limitations of 18F-FDG PET/CT and promising applications of 18F-FDG PET/MRI in gynecologic malignancy, 3) To underscore the promising theragnostic applications of nuclear medicine, 4) To highlight the current role of nuclear medicine imaging in gynecologic cancers as per the National Comprehensive Cancer Network (NCCN), European Society of Surgical Oncology (ESGO), and European Society of Medical Oncology (ESMO) guidelines.


Asunto(s)
Neoplasias de los Genitales Femeninos , Medicina Nuclear , Humanos , Femenino , Neoplasias de los Genitales Femeninos/diagnóstico por imagen , Neoplasias de los Genitales Femeninos/terapia , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Fluorodesoxiglucosa F18 , Tomografía de Emisión de Positrones , Imagen Molecular , Estadificación de Neoplasias , Radiofármacos
6.
Int J Clin Oncol ; 29(4): 363-371, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38381162

RESUMEN

BACKGROUND: In Japan, comprehensive cancer statistics data have been collected through national cancer registries, but these data are rarely summarized and reported in research articles. METHODS: Here, we compiled the national registry data on malignant tumors originating from gynecologic organs (ovary, corpus uteri, cervix uteri) in Japan. RESULTS: The number of new patients in 2019 was 13,380, 17,880, and 10,879, respectively, and the number of deaths in 2021 was 5081, 2741, and 2894, respectively. Compared with 40 years ago, the incidence of ovarian cancer has tripled, the incidence of uterine corpus cancer (mainly endometrial cancer) has increased eightfold, the mortality rate of uterine corpus cancer has tripled, and the incidence of cervical intraepithelial cancer has increased ninefold in data standardized by the world population. Compared with the United States, the incidence rate of ovarian cancer has overtaken and the mortality rate of uterine corpus cancer is the same, while both the incidence and mortality rates of cervical cancer are higher in Japan. CONCLUSION: The incidence of gynecologic cancer is increasing significantly in Japan.


Asunto(s)
Neoplasias de los Genitales Femeninos , Neoplasias Ováricas , Neoplasias del Cuello Uterino , Neoplasias Uterinas , Humanos , Femenino , Incidencia , Japón/epidemiología , Tasa de Supervivencia , Neoplasias de los Genitales Femeninos/patología , Neoplasias Uterinas/patología , Neoplasias del Cuello Uterino/patología , Neoplasias Ováricas/patología , Sistema de Registros
7.
Pain Manag Nurs ; 25(3): e223-e229, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38423804

RESUMEN

PURPOSE: This study aimed to examine the effect of integrated music-video therapy on pain and anxiety of gynecologic cancer patients at different stages of brachytherapy. DESIGN: This study used a single-group crossover design. METHODS: Data on 27 patients diagnosed with gynecologic cancer and receiving brachytherapy were collected from February 2018 to January 2019. Participants' pain and anxiety levels were measured four times using a numerical rating scale (before, during, after applicator insertion, and during the radiation). In addition, vital signs were measured three times (before, after applicator insertion, and during radiation). Data were analyzed for frequency and percentage. The normality and homogeneity of the dependent variables were tested using the Kolmogorov-Smirnov and Mann-Whitney U tests, respectively. RESULTS: Significant differences were found between the experimental and control phases in pain degree during radiation exposure (Z = -1.68, p = .046) and anxiety degree during applicator insertion (Z=-4.42, p = .000), after applicator insertion (Z = -4.85, p = .000), and during radiation exposure (Z = -5.38, p = .000). However, no significant difference was found between the changes in blood pressure, pulse, and respiration at any time point. CONCLUSIONS: The findings suggest the need to actively employ integrated music-video therapy to reduce acute pain and anxiety in gynecologic cancer patients undergoing brachytherapy. CLINICAL IMPLICATIONS: This study provides insights into the methodological approaches for implementing integrated music-video therapy in clinical practice, targeting the reduction of acute pain and anxiety triggered by gynecological surgeries and procedures.


Asunto(s)
Ansiedad , Braquiterapia , Neoplasias de los Genitales Femeninos , Musicoterapia , Manejo del Dolor , Humanos , Femenino , Braquiterapia/métodos , Braquiterapia/efectos adversos , Braquiterapia/psicología , Musicoterapia/métodos , Musicoterapia/normas , Persona de Mediana Edad , Ansiedad/psicología , Ansiedad/etiología , Ansiedad/terapia , Manejo del Dolor/métodos , Manejo del Dolor/normas , Anciano , Neoplasias de los Genitales Femeninos/radioterapia , Neoplasias de los Genitales Femeninos/psicología , Neoplasias de los Genitales Femeninos/complicaciones , Adulto , Estudios Cruzados , Dimensión del Dolor/métodos , Dolor/psicología , Dolor/etiología
8.
Gynecol Oncol ; 183: 120-125, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38368180

RESUMEN

OBJECTIVES: To evaluate safety, efficacy, and feasibility of apixaban for postoperative venous thromboembolism (VTE) prophylaxis following open gynecologic cancer surgery at a comprehensive cancer center. METHODS: This retrospective, cohort study included patients with gynecologic cancer who underwent open surgery between 3/2021 and 3/2023 and received 28-day postoperative VTE prophylaxis. Patients on therapeutic anticoagulation preoperatively were excluded. Predictors of 90- and 30-day VTE and 30-day bleeding events were determined using multivariable logistic regression, adjusting for known confounders. RESULTS: 452 patients were included in the cohort: 348 received apixaban and 104 received enoxaparin. Those who received enoxaparin were more likely to be American Society of Anesthesiologists class III/IV (compared to I/II) (p = 0.033), current or former smokers (p = 0.012) and have a higher BMI (p < 0.001), Charlson Comorbidity Index (p = 0.005), and age (p = 0.046). 30-day VTE rate was significantly lower in the apixaban group (0.6%) compared to the enoxaparin group (6.2%) (adjusted OR 0.13, 95% CI 0.03-0.56; p = 0.006). 90-day VTE rate was 2.7% and 6.2% in the apixaban and enoxaparin groups, respectively (adjusted OR 0.85, 95% CI 0.38-1.92; p = 0.704). Major bleeding complications (2.4% vs. 2.0%) and minor bleeding complications (0.9% vs. 3.0%) were similar in the apixaban and enoxaparin groups, respectively, on multivariate analyses. The median patient out of pocket cost was $10 (IQR 0.0-40.0) for apixaban and $20 (IQR 3.7-67.7) for enoxaparin (p = 0.001). CONCLUSIONS: Our findings along with previously published data suggest that apixaban should be considered the standard of care for VTE prophylaxis in patients undergoing open surgery for gynecologic malignancies.


Asunto(s)
Enoxaparina , Estudios de Factibilidad , Neoplasias de los Genitales Femeninos , Complicaciones Posoperatorias , Pirazoles , Piridonas , Tromboembolia Venosa , Humanos , Femenino , Piridonas/administración & dosificación , Piridonas/efectos adversos , Piridonas/uso terapéutico , Tromboembolia Venosa/prevención & control , Tromboembolia Venosa/etiología , Pirazoles/efectos adversos , Pirazoles/administración & dosificación , Pirazoles/uso terapéutico , Neoplasias de los Genitales Femeninos/cirugía , Estudios Retrospectivos , Persona de Mediana Edad , Complicaciones Posoperatorias/prevención & control , Enoxaparina/administración & dosificación , Enoxaparina/efectos adversos , Enoxaparina/uso terapéutico , Anciano , Procedimientos Quirúrgicos Ginecológicos/efectos adversos , Procedimientos Quirúrgicos Ginecológicos/métodos , Inhibidores del Factor Xa/administración & dosificación , Inhibidores del Factor Xa/efectos adversos , Inhibidores del Factor Xa/uso terapéutico , Estudios de Cohortes , Adulto , Anticoagulantes/administración & dosificación , Anticoagulantes/efectos adversos , Anticoagulantes/uso terapéutico
9.
Curr Mol Pharmacol ; 17: e18761429263063, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38284731

RESUMEN

Gynecological cancers are serious life-threatening diseases responsible for high morbidity and mortality around the world. Chemotherapy, radiotherapy, and surgery are considered standard therapeutic modalities for these cancers. Since the mentioned treatments have undesirable side effects and are not effective enough, further attempts are required to explore potent complementary and/or alternative treatments. This study was designed to review and discuss the anticancer potentials of baicalin against gynecological cancers based on causal mechanisms and underlying pathways. Traditional medicine has been used for thousands of years in the therapy of diverse human diseases. The therapeutic effects of natural compounds like baicalin have been widely investigated in cancer therapy. Baicalin was effective against gynecological cancers by regulating key cellular mechanisms, including apoptosis, autophagy, and angiogenesis. Baicalin exerted its anticancer property by regulating most molecular signaling pathways, including PI3K/Akt/mTOR, NFκB, MAPK/ERK, and Wnt/ß-catenin. However, more numerous experimental and clinical studies should be designed to find the efficacy of baicalin and the related mechanisms of action.


Asunto(s)
Neoplasias de la Mama , Flavonoides , Neoplasias de los Genitales Femeninos , Humanos , Flavonoides/farmacología , Flavonoides/uso terapéutico , Femenino , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/patología , Neoplasias de los Genitales Femeninos/tratamiento farmacológico , Transducción de Señal/efectos de los fármacos , Animales , Apoptosis/efectos de los fármacos , Antineoplásicos/farmacología , Antineoplásicos/uso terapéutico , Autofagia/efectos de los fármacos
10.
J Psychosoc Oncol ; 42(2): 223-241, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-37462260

RESUMEN

PURPOSE: Improved management of pain and co-morbid symptoms (sleep disturbances, psychological distress) among women undergoing surgery for suspected gynecologic malignancies may reach a population vulnerable to chronic pain. PARTICIPANTS: Women undergoing surgery for a suspected gynecologic malignancy. METHOD: We conducted a pilot randomized controlled trial of eHealth Mindful Movement and Breathing (eMMB) compared to an empathic attention control (AC). Semi-structured interviews were conducted by telephone (n = 23), recorded, transcribed, coded, and analyzed using thematic analysis. FINDINGS: Participants reported overall high acceptability such that all would recommend the study to others. Positive impacts of practicing eMMB included that it relieved tension, facilitated falling asleep, and decreased pain. Participants also reported high adherence to self-directed eMMB and AC writing practices and described facilitators and barriers to practicing. CONCLUSIONS: This qualitative feedback will inform future research to assess the efficacy of eMMB for reducing pain and use of remotely-delivered interventions more broadly. CLINICAL TRIAL REGISTRATION NUMBER: NCT03681405.


Asunto(s)
Neoplasias de los Genitales Femeninos , Atención Plena , Telemedicina , Humanos , Femenino , Proyectos Piloto , Neoplasias de los Genitales Femeninos/cirugía , Dolor
11.
J Clin Nurs ; 33(3): 1110-1121, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37984464

RESUMEN

BACKGROUND: Gynaecological cancer illness and treatment have a significant impact on women's sexual health and concerns regarding sexual health are known to be an unmet need in survivors. The digital support programme Gynea was designed to enhance women's health, including sexual health, after gynaecological cancer treatment. This study aimed to explore how cancer survivors experienced participation in Gynea. METHODOLOGY: This is a phenomenological hermeneutic study. Individual, in-depth semi-structured interviews were conducted to explore lived experiences. Twenty women were interviewed after completing the Gynea programme. The transcripts were analysed using Lindseth and Norberg's phenomenological hermeneutic method. FINDINGS: Three main themes (with subthemes) emerged from the analysis: (1) A silent existential trauma; (2) Redefining sexual health; (3) Communicating with a partner about sexuality. The women redefined sexual health rather than just being sexual intercourse, being a rediscovery of the body. The women's increased awareness and understanding of their own sexual health empowered their communication about their sexuality with their partners. This was important for regaining sexual health and intimacy in their relationships. CONCLUSION: Participation in Gynea helped to strengthen the women's sexual integrity. Knowledge and support empowered them to take care of their sexual needs and communicate these with their partners. IMPLICATIONS FOR PATIENT CARE: Healthcare services and nurses need to be aware that sexual health is an existential state of being, in which good sexual health does not necessarily equate to sexual function, but rather to sexual empowerment. Digital support with nurse guidance can support women in caring for their sexual health after cancer illness by thematizing sexual health with a holistic approach and should be part of the medical treatment. PATIENT OR PUBLIC CONTRIBUTION: Twenty gynaecological cancer survivors contributed by sharing their experiences from the sexual health module in Gynea.


Asunto(s)
Neoplasias de los Genitales Femeninos , Salud Sexual , Femenino , Humanos , Conducta Sexual , Sexualidad , Parejas Sexuales , Neoplasias de los Genitales Femeninos/radioterapia
12.
Qual Life Res ; 33(3): 679-689, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38019323

RESUMEN

PURPOSE: Psychosexual distress is known to be a common complication of treatment for gynaecological cancer (GC), affecting the sexual quality of life (SQoL) for an increasing number of young gynaecological cancer survivors (YGCS). The SQoL in YGCS study aimed to identify strategies that are acceptable and helpful to YGCS in protecting and improving SQoL, using a salutogenic approach. METHODS: A qualitative study was undertaken with young women aged 18-45 and pre- or perimenopausal at diagnosis. Semi-structured interviews were conducted on Zoom and a thematic analysis of transcripts was completed in NVivo. RESULTS: Fifteen interviews with YGCS revealed three themes for strategy development: psychosexual education, psychosocial support, and healthcare policy and strategy to establish SQoL as standard care in gynaecologic oncology. CONCLUSION: The strategies put forward by YGCS showed the need for a holistic, patient-centric, and multidisciplinary approach to SQoL. A better understanding of the strategies acceptable to YGCS, including the importance of using a trauma-informed approach to communication and care, can help healthcare providers play a vital role in protecting and improving SQoL.


Asunto(s)
Supervivientes de Cáncer , Neoplasias de los Genitales Femeninos , Humanos , Femenino , Neoplasias de los Genitales Femeninos/psicología , Calidad de Vida/psicología , Conducta Sexual/psicología , Supervivientes de Cáncer/psicología
13.
Health (London) ; 28(1): 90-107, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-35900050

RESUMEN

This paper explores post-treatment experiences of women who have had radiotherapy for gynaecological cancer. Drawing on data from a project which explored post-treatment wellbeing, conceptual metaphors of ghosts/haunting are used to engage with enduring legacies of cancer and 'neglected matters' in post-treatment trajectories. Current arrangements of care contribute to the idea that participants are 'out of the other side of cancer' once active treatment completes. Despite broader ambitions for holistic cancer rehabilitation, fragilities of body and mind persist, even when the outward representation is one of health, of looking well, of moving on. We show how neglected matters of cancer (visceral late effects, psychological suffering and lives not lived) are part of living with and beyond cancer. These 'ghosts' manifest in chronic states of unsettledness that are temporarily relieved by individualised 'fixes', such as mobilisation of 'mind over matter' discourse and mindfulness. This discourse and its associated tools are a powerful yet impoverished framing of approaches to living with and beyond cancer. We argue for the need to attend to 'neglected matters' of post-treatment trajectories differently.


Asunto(s)
Neoplasias de los Genitales Femeninos , Femenino , Humanos , Neoplasias de los Genitales Femeninos/psicología , Neoplasias de los Genitales Femeninos/radioterapia
14.
BMJ Open ; 13(12): e074313, 2023 12 19.
Artículo en Inglés | MEDLINE | ID: mdl-38114285

RESUMEN

OBJECTIVES: To explore the use of complementary and alternative medicine (CAM) by Chinese gynaecological oncology patients undergoing chemotherapy and discuss measures to address the existing gaps. DESIGN: Qualitative phenomenology. Semistructured in-depth interview. Colaizzi's method data analysis. SETTING: A tertiary general hospital. PARTICIPANTS: 16 gynaecological oncology patients (mean age 51.7) having undergone ≥1 chemotherapy cycle were recruited by purposive sampling. RESULTS: Six themes were generated. The participants were under-informed about CAM concept and options. They were open to explore various modalities after chemotherapy as long as it could alleviate symptoms. The gynaecological patients with cancer sought information about CAM from diverse sources, with professional expertise being the most desirable way to seek information. They used CAM as a strategy to support continued chemotherapy and for symptom alleviation. Financial burden was not stressed but they had concerns about sustainability of some therapies. Their attitudes toward different CAM types varied. Some were sceptical about the efficacy. CONCLUSIONS: The Chinese gynaecological oncology patients may be under-informed about CAM. They are open to use various CAM therapies for symptom relief and as a support strategy. However, their attitudes toward specific therapies may vary. Some may host scepticism about certain CAM modalities. The patients actively seek information on CAM and treatment resources but prefer professional expertise to other sources. Financial burden due to continued CAM use is inconclusive due to possible sampling bias. Sustainability of CAM therapies is a common concern because of limited resources and access. Education on CAM should be incorporated into the curriculum of healthcare professionals. Oncologists and nurses should educate gynaecological patients with cancer on the concept and options of CAM, preferably with information tailored to patient's individual needs. Health authorities should advocate provisions of diverse CAM services and develop the necessary technologies such as network of local care resources.


Asunto(s)
Terapias Complementarias , Neoplasias de los Genitales Femeninos , Neoplasias , Femenino , Humanos , Persona de Mediana Edad , Neoplasias/terapia , Terapias Complementarias/métodos , Neoplasias de los Genitales Femeninos/tratamiento farmacológico , Curriculum , Escolaridad , China
15.
Int J Gynecol Cancer ; 33(12): 1957-1965, 2023 Dec 04.
Artículo en Inglés | MEDLINE | ID: mdl-38011988

RESUMEN

Hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment option for epithelial ovarian cancer following cytoreductive surgery. The intraperitoneal spread of the disease makes the peritoneal cavity an ideal target for drug delivery. HIPEC has shown promising results in improving overall survival in epithelial ovarian cancer patients when performed during interval cytoreductive surgery. Recent studies have provided level 1 evidence supporting increased overall survival in stage III ovarian cancer patients treated with HIPEC during interval cytoreduction. Meta-analyses have further confirmed the survival improvement in women receiving HIPEC. Despite its inclusion in guidelines, many centers have been hesitant to implement HIPEC programs due to perceived obstacles, such as increased morbidity, cost, and resource requirements. Studies have shown that morbidity rates are acceptable in selected patients, and the addition of HIPEC to cytoreductive surgery is cost effective. Therefore, the main barrier to implementing HIPEC programs is related to resource requirements and logistics, but with proper preparation, these challenges can be overcome. Establishing a successful HIPEC program requires institutional support, a knowledgeable and dedicated team, adequate resources and equipment, and proper training and audit. This review aims to provide evidence based information to guide the development of successful HIPEC programs, including preoperative, anesthetic, and surgical considerations. It also reviews the different equipment and protocols for the perfusion and common postoperative events.


Asunto(s)
Neoplasias de los Genitales Femeninos , Hipertermia Inducida , Neoplasias Ováricas , Femenino , Humanos , Carcinoma Epitelial de Ovario/tratamiento farmacológico , Quimioterapia Intraperitoneal Hipertérmica , Neoplasias Ováricas/tratamiento farmacológico , Neoplasias Ováricas/cirugía , Terapia Combinada , Neoplasias de los Genitales Femeninos/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Hipertermia Inducida/métodos , Canadá/epidemiología , Procedimientos Quirúrgicos de Citorreducción/métodos , Tasa de Supervivencia
16.
J Music Ther ; 60(4): 410-434, 2023 Dec 30.
Artículo en Inglés | MEDLINE | ID: mdl-37503863

RESUMEN

The primary aim of this randomized controlled trial pilot was to investigate the potential effectiveness of the music psychotherapy method, Guided Imagery and Music (GIM), to assist female patients who are undergoing chemotherapy treatment for breast or gynecologic cancer. A secondary aim was to suggest performance improvements regarding the protocol and the resources required to undertake a future larger scale study. The researchers randomized participants (n = 20) into two groups: Intervention group (n = 10) and Control group (n = 10). The Intervention group received a series of six individual, short GIM sessions whereas the Control group received two verbal counseling sessions that took place at Week 1 and at Week 6 of treatment. All participants in the study completed the Profile of Mood States (POMS-Brief); Cancer Fatigue Scale (CFS); and Herth Hope Index (HHI) before the beginning of Week 1 and again after Week 6 or, in the case of the Intervention group, after the last GIM session. All participants also completed two Visual Analogue Scales (VAS-Hope; VAS-Fatigue) weekly or after each session throughout the duration of the trial. The results of the Intervention group receiving GIM showed medium pre-post effect sizes for the CFS, HHI, and POMS questionnaires, and significant positive changes for the VAS-H and VAS-F questionnaires. As seen from this initial data outcome, a brief series of GIM sessions shows promise to be beneficial for increasing hope, decreasing fatigue, and mitigating distressed mood for female patients undergoing treatment for breast or gynecologic cancer.


Asunto(s)
Neoplasias de los Genitales Femeninos , Musicoterapia , Música , Humanos , Femenino , Música/psicología , Imágenes en Psicoterapia/métodos , Musicoterapia/métodos , Neoplasias de los Genitales Femeninos/terapia , Fatiga/etiología , Fatiga/terapia
17.
Altern Ther Health Med ; 29(6): 242-247, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37295012

RESUMEN

Context: Gynecological malignancies can pose a serious threat to women's physical and mental health, and lymphedema is one of the common complications after surgery for malignant tumors. Comprehensive nursing might be able to reduce the lymphedema that occurs after surgery and help accelerate patients' postoperative rehabilitation process. Objective: The study intended to explore the effects of a comprehensive nursing intervention for patients with lower-limb lymphedema after surgery for malignant gynecological tumors. Design: The research team performed a retrospective controlled study. Setting: The study took place at Sichuan Cancer Hospital in Chengdu, China. Participants: Participants were 90 patients who received surgical treatment at the hospital for malignant gynecological tumors between April 2020 and July 2021. Intervention: The research team divided participants into two groups: (1) 45 in the intervention group who received a comprehensive nursing intervention based on a meta-heuristic learning model, and (2) 45 in the control group, who received routine nursing. The nursing intervention occurred for both groups for one year, from admission for surgery, baseline, to the end of treatment, postintervention. Outcome Measures: The research team: (1) assessed the efficacy postintervention of the nursing intervention for the two groups, (2) measured the circumference of participants' lower-limb edema at baseline and postintervention, (3) determined the incidence of lymphedema between baseline and postintervention in the two groups, (4) measured the nursing satisfaction scores of the two groups postintervention, and (5) evaluated participants' quality of life using the Abbreviated World Health Organization Quality-of-Life (WHOQOL-BREF) scale at baseline and postintervention. Results: Postintervention: (1) the efficacy of the nursing intervention for the intervention group was 95.56%, which was a significantly higher rate than that of the control group, at 82.22% (P = .044); (2) the intervention group's decrease in the mean circumference at 10 cm below the knee was significantly greater, from 40.43 ± 1.75 cm to 34.93 ± 1.94 cm, than that of the control group, from 39.93 ± 2.01 cm to 35.89 ± 2.27 cm (P = .034), and that group's decrease in the mean circumference at 10 cm above the knee was also significantly greater, from 49.50 ± 3.06 cm to 44.12 ± 2.14 cm, than that of the control group, from 49.13 ± 3.11 cm to 46.10 ± 1.94 cm (P < .001); (3) of the 45 participants in the intervention group, only one had lymphedema (2.22%), which was a significantly lower rate than that of the control group, at six participants out of 45 (13.33%), with P = .049; (4) the intervention group's mean score for nursing satisfaction was 86.59 ± 3.96, which was significantly higher than that of the control group, at 82.22 ± 5.61 (t = 4.269, P < .001); and (5) the intervention group's mean score on the WHOQOL-BREF scale was 25.52 ± 2.94, which was significantly higher than that of the control group, at 22.28 ± 3.00 (t = 5.174, P < .001). Conclusions: A comprehensive nursing intervention after surgery for patients with gynecological malignancies can reduce the incidence of lymphedema, be more effective, and enhance patients' satisfaction with nursing care and their quality of life.


Asunto(s)
Neoplasias de los Genitales Femeninos , Linfedema , Humanos , Femenino , Neoplasias de los Genitales Femeninos/complicaciones , Neoplasias de los Genitales Femeninos/cirugía , Calidad de Vida , Estudios Retrospectivos , Proyectos de Investigación , Linfedema/cirugía
18.
Obstet Gynecol ; 142(1): 196-210, 2023 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-37348095

RESUMEN

Health disparity, defined by the Centers for Disease Control and Prevention (CDC) as "preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations," is seen across multiple diseases. We conducted an evidence review of health disparities and inequities and their mitigation strategies related to ovarian cancer as part of a CDC-sponsored project to develop educational materials for clinicians on the prevention and early diagnosis of gynecologic cancers. Our review found profound disparities in outcomes such as survival, treatment, and stage at diagnosis by factors such as race and ethnicity, insurance, socioeconomic status, and geographic location. We found little direct evidence on mitigation strategies. Studies support equivalent response to equivalent treatment between groups, suggesting that adherence to National Comprehensive Cancer Network guidelines can at least partially mitigate some of the differences.


Asunto(s)
Neoplasias de los Genitales Femeninos , Neoplasias Ováricas , Femenino , Humanos , Estados Unidos/epidemiología , Etnicidad , Clase Social , Disparidades en Atención de Salud
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