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  • 1
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2022
    In:  Journal of Clinical Oncology Vol. 40, No. 16_suppl ( 2022-06-01), p. e24088-e24088
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 40, No. 16_suppl ( 2022-06-01), p. e24088-e24088
    Abstract: e24088 Background: Up to one third of cancers in high-income populations can be attributed to lifestyle factors (nutrition & physical activity). Data on dietary beliefs in Irish patients with cancer are lacking. This study aims to evaluate how patients with cancer conceptualize the effect of diet on their disease and treatment & determine if attitudes vary according to age, gender, education, disease type, treatment type & treatment intent. Methods: This is a questionnaire-based study, carried out in an Irish oncology unit over a 3-week period in April 2021. Patients with an active cancer diagnosis attending the oncology day ward were invited to participate. We adapted a previously used questionnaire following expert review. A combination of yes/no and Likert scale responses were used: Have you changed your diet since you received your diagnosis? (Yes/no). To what degree do you think that...(Likert): Diet may contribute to the condition that you are being treated for?. Your diet after diagnosis helps your sense of health and wellness?. Diet can help relieve side effects of treatment?. Diet helps in preventing cancer recurrence?. Demographic and treatment data were recorded from patient charts. Responses were compared across demographic variables including gender, age, highest education level, primary cancer location/type and treatment intent using Chi-squared/Fishers exact test. A P-value of 〈 0.05 was considered significant. Results: 130 patients were invited to take part & 113 responded (response rate 87%). 80% reported changing their diet since diagnosis, with no significant difference according to demographic variables. Most (68%) patients expressed a belief that diet played some role in their cancer development although only 15% believed that diet contributed ‘a lot’. Most patients (83%) believed that diet after a cancer diagnosis has an impact on their sense of health and well-being, and 32% expressed a strong belief in this regard (Likert scale 4, ‘a lot’). 75% believed that diet has some impact on managing treatment side effects. 81% believed that diet has some impact on cancer recurrence, and 30% believed it has a major impact (Likert scale 4). On multivariate analysis we found stronger beliefs in the impact of diet on cancer development (p = 0.049) and recurrence risk (p = 0.05) among men than women, and stronger belief in the impact of diet on recurrence risk among patients receiving treatment with curative versus palliative intent (p = 0.045). Conclusions: Most patients reported changing their diet following their cancer diagnosis, and most patients felt that diet had some impact on all of the areas studied including cancer development, health and well-being, managing side effects and cancer recurrence. Men expressed stronger beliefs than women in the impact of diet on cancer development and recurrence risk, and patients being treated with curative intent also expressed stronger beliefs in the impact of diet on cancer recurrence.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2022
    detail.hit.zdb_id: 2005181-5
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  • 2
    In: Mesentery and Peritoneum, AME Publishing Company, Vol. 3 ( 2019-02), p. AB103-AB103
    Type of Medium: Online Resource
    ISSN: 2616-2725
    Language: Unknown
    Publisher: AME Publishing Company
    Publication Date: 2019
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  • 3
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2013
    In:  Journal of Clinical Oncology Vol. 31, No. 15_suppl ( 2013-05-20), p. 1115-1115
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 31, No. 15_suppl ( 2013-05-20), p. 1115-1115
    Abstract: 1115 Background: Breast cancer is currently staged according to the TNM (tumors, nodes, metastases) classification of the American Joint Committee on Cancer (AJCC) Staging System. Lymph node ratio (LNR, the ratio of positive axillary lymph nodes to the total number of nodes examined) may provide additional prognostic information to that provided by TNM scores. Furthermore, LNR may potentially identify subpopulations within the traditional AJCC stages that are at increased risk of adverse outcomes. Methods: We performed a single institution retrospective study of all patients diagnosed with early breast cancer between January 2000 and January 2011. Patients were divided into low- (≤0.14), intermediate- (0.15-0.39) and high-risk (≥0.4) LNR groups. We assessed the impact of LNR and conventional AJCC staging parameters on overall survival (OS) and disease-free survival (DFS). Results: 786 patients were included in the analsyis, 238 of whom were node positive. As expected nodal status according to pathologic nodal (pN) stage was prognostic for OS and DFS with OS decreasing from 88.3% in pN1 patients to 40.8% in those with pN3 disease (p 〈 0.001). LNR was also significantly associated with prognosis. OS decreased from 94% in the low-risk LNR group to 64% in the high-risk group, while DFS decreased from 92% in the low-risk LNR group to 50% in the high-risk (p 〈 0.001). When Stage III patients were divided into low- and high-risk LNR groups, OS decreased from 100% in the low LNR group to 63% in the high LNR group (p 〈 0.05). Similarly, DFS decreased from 96% in the low LNR group to 56% in the high LNR group (p 〈 0.05). A similar trend was not observed when Stage III patients were stratified according to pN status. LNR was also found to be prognostic when pN1 patients were divided into low- and high-risk LNR groups. Although both LNR and nodal status were significantly associated with OS and DFS on univariate analysis, LNR retained its significance on multivariate analysis, while nodal status did not. Conclusions: LNR can identify subpopulations within the traditional AJCC staging that are at higher risk of adverse outcomes. These findings should be examined in larger retrospective studies and, if validated, be considered as a stratification factor in future adjuvant trials.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2013
    detail.hit.zdb_id: 2005181-5
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  • 4
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2017
    In:  Journal of Clinical Oncology Vol. 35, No. 15_suppl ( 2017-05-20), p. e18125-e18125
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 15_suppl ( 2017-05-20), p. e18125-e18125
    Abstract: e18125 Background: Colorectal cancer (CRC) is commonly treated in both adjuvant and palliative settings with Oxaliplatin. Painful peripheral neuropathy resulting in dose adjustments is a well recognized side effect in up to 30% of cases. Relative dose intensity (RDI), an expression of the percentage of planned dose received at a scheduled time, is a tool used to measure how closely a prescription has been adhered to. Studies have suggested a decreased RDI ( 〈 85%) is associated with inferior outcomes. The aim of this study was to calculate the RDI for CRC patients undergoing treatment with Oxaliplatin, to investigate reasons for dose delays and reductions and to calculate a Charlson Co-Morbidity Index Score (CCIS) for each patient Methods: CRC patients treated with Oxaliplatin from 2010-2016 within the BSHC were identified using pharmacy lists and pathology reports. The following exclusion criteria were applied: non first line Oxaliplatin and excluding cycles after three months. Data was obtained through a systematic, retrospective chart review. An audit of the chemotherapy prescriptions allowed the RDI to be calculated and the CCIS was calculated using a colorectal specific Index previously described. Results: We identified 176 eligible patients, 83 charts were available for review and 69 charts contained all necessary information to be included. Xelox (61%), Folfox-6 (35%) and Flox (4%) were the chemotherapy agents involved in this study. The average RDI achieved was 87.47%, with a range of 25%-103.17%. The primary cause for dose adjustments was peripheral neuropathy (64%). The CCIS range was 0 -3, with results demonstrating a significant connection between a higher CCI and lower RDI, see table 1. Conclusions: A CCIS ≤ 1 correlates to achieving a higher RDI, with each of these subgroups achieving above the acceptable cut off for RDI ( 〉 85%), as such certain co-morbidities may be early predictors of reduced RDI. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2017
    detail.hit.zdb_id: 2005181-5
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  • 5
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2018
    In:  Journal of Clinical Oncology Vol. 36, No. 15_suppl ( 2018-05-20), p. e15666-e15666
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 36, No. 15_suppl ( 2018-05-20), p. e15666-e15666
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2018
    detail.hit.zdb_id: 2005181-5
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  • 6
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2018
    In:  Journal of Clinical Oncology Vol. 36, No. 6_suppl ( 2018-02-20), p. 289-289
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 36, No. 6_suppl ( 2018-02-20), p. 289-289
    Abstract: 289 Background: Patients with metastatic prostate cancer receive several therapies which may be associated with a tendency to overweight and impaired glucose tolerance. These include androgen deprivation therapy and long term steroid therapy. We set out to assess the prevalence of overweight and diabetes/prediabetes in a cohort of patients attending an oncology day ward for a variety of systemic therapies. Methods: We performed a retrospective review of the medical records of men attending an oncology day ward for prostate cancer treatment. As part of their usual care, these men had regular height and weight checks and also had periodic hemoglobin A1C (HbA1C) measurements performed. The prevalence of prediabetes and diabetes in this patient population was assessed from the HbA1C results using the American Diabetes Association 2016 definitions. Information on patient steroid use (and type), and treatment type were also recorded. Results: Among 34 men with metastatic prostate cancer, the mean age was 74 (range 57-88). Therapies received included androgen deprivation therapy in all cases, with chemotherapy or novel androgen receptor pathway inhibitors such as abiraterone and enzalutamide. Only 12% had a pre-existing diagnosis of diabetes mellitus (all type 2). The majority (79%) are overweight or obese. 59% have pre-diabetes as per the American Diabetes Association 2016 Guidelines, while a further 24% meet criteria for diabetes. Only 18% have HbA1c in the normal range. 56% are on continuous long term steroid therapy, usually as part of their prostate cancer therapy. A further 23% receive intermittent steroids. Only 21% had received no steroids in the 6 months prior to first HbA1C check. 18% had castrate-sensitive disease and 82% had castrate resistant disease. Even among patients with castrate sensitive disease, 2/3 had abnormal HbA1c values. Conclusions: Overweight and prediabetes are very prevalent in men receiving systemic therapies for metastatic prostate cancer. A large percentage of men are on long-term steroid therapy which may be contributing to their risk of these conditions. Intervention is required for this group of patients to reduce the impact of therapy on cardiovascular and overall health.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2018
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
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  • 7
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2019
    In:  Journal of Clinical Oncology Vol. 37, No. 15_suppl ( 2019-05-20), p. 3076-3076
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 37, No. 15_suppl ( 2019-05-20), p. 3076-3076
    Abstract: 3076 Background: Tumor testing for potentially actionable somatic mutations via commercially available panel tests has entered routine clinical practice in many countries. In Ireland the cost of these tests is not covered by insurance companies and must be paid for by patients. Use of these tests is sporadic and depends on patient and clinician factors (including ability to pay). Existing data suggest that such testing results in a direct impact on patient therapy in a minority of patients only. We reviewed the impact of somatic mutation testing on treatment selection and outcomes in patients attending a medical oncology service in a teaching hospital in Ireland. Methods: We performed a retrospective study of patients who had commercial panel testing performed as part of routine oncology care. All patients opportunistically tested between 2013 and 2018 were included. Patients having focused molecular tests for approved therapies (e.g. RAS mutations in colon cancer, EGFR and ALK mutations in non-small cell lung cancer) were excluded.We reviewed medical records to assess the frequency and utility of mutations detected, the impact of testing on next and subsequent lines of therapy, and the effectiveness of therapy. Results: 74 panel tests were performed in 71 patients. 39 tests (53%) detected mutations, of which 21 (28%) were potentially actionable. 36 patients (51%) had further treatment after testing was performed. 9 tests (12%) led to test-based treatment. The mean duration of test-based treatment was 34 days (range 1-90 days). No patients had benefit from test based treatment, defined as tumour response or disease stabilisation on restaging scans. 23 patients died within 90 days of panel tests being requested. Among patients starting and completing a subsequent line of therapy after testing, the mean duration of therapy with test-based treatment was 39 days (range 6-90) and for standard of care treatment was 56 days (range 1-262 days). Conclusions: While testing for tumor-specific somatic mutations with proven predictive benefit is very useful, somatic mutation panel testing for non standard of care genetic alterations is not of utility in this real world setting. Its role in Ireland should be limited to identification of suitable early phase clinical trials. Discussions of panel testing should include frank discussion of expected benefits, and should also address factors such as patient ability to travel for clinical trials. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2019
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
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