1/22. Experiences with high dose radiopeptide therapy: the health physics perspective.One of the new, promising areas of nuclear medicine involves radiolabeled low-molecular-weight peptides for the diagnosis and management of cancer. somatostatin analogous peptides bind to membrane receptors on tumors with high specificity. These analogues, when radiolabeled with 123I, 131I, 99mTc, or (111)In, allow for external scintigraphic imaging or radioguided surgical resection of tumors. somatostatin analogues with high tumor binding affinity have also been used for high-dose radiotherapy at the Medical Center of louisiana since 1994. Although we had extensive prior experience with relatively high-dose 131I administration for thyroid ablation, our personnel protection, contamination control, and other safety techniques required significant modification to ensure effective contamination and radiation exposure control. As therapy with radiolabeled peptides becomes more widely utilized, the controls developed at our institution may be implemented by others to maintain exposures ALARA.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
2/22. Use of complementary and alternative medicine in hawaii cancer patients.This research investigated complementary and alternative medicine (CAM) use by Hawai'i cancer patients. Thirty-six percent of patients used CAM, most commonly religious/spiritual therapy and herbal treatments. CAM use was linked with younger age, female gender, Catholic religion, and more education. More research is needed to inform decision-making.- - - - - - - - - - ranking = 5keywords = medicine (Clic here for more details about this article) |
3/22. Disentangling ethical and psychological issues--a guide for oncologists.The rapid growth of bioethics has injected a new style of analysis into medicine. It requires philosophical rigor, yet is deeply embedded in human situations that frustrate abstract thinking and are laced with subjective factors. These interlaced ethical and psychological components can lead to conflicts and dilemmas. Doctors, as experts and decision-makers, play a key role, but will benefit from additional skills to disentangle these situations. This paper notes ways in which patients, families and caregivers are newly vulnerable and delineates how ethical dilemmas and psychological issues mold or frustrate decision-making. To help physicians manage such cases, a method of systematic analysis, the 'situational diagnosis', and a related hierarchy of interventions, is described and illustrated with case examples.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
4/22. When does the responsibility of our care end: bereavement.Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at massachusetts General Hospital, founded the Kenneth B. Schwartz Center. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient, support to caregivers, and sustenance to the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members. Two vignettes are presented of a caregiver's response to the death of a patient, contrasting the extremes of involved compassion for the family and fractured relationships. grief for loss is an inevitable part of life and a common part of cancer care. Support of the bereaved may be one of the hardest tasks for cancer care professionals, who are confronted with the limits of modern medicine. There is a responsibility to provide grieving families with support and care; care that goes beyond the death. A compassionate response helps both those who suffer and those who care. Complicated and uncomplicated bereavement, grief reactions, resources for bereavement counseling, and the role of condolence letters are reviewed.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
5/22. Dual-modality PET/CT tomography for clinical oncology.diagnosis and follow-up in clinical oncology are traditionally based on computed tomography (CT). In recent years, however, functional imaging using positron emission tomography (PET) has been recognized as an important imaging modality and adjunct to CT that provides complementary metabolic information in many oncology applications. To overcome the challenges of aligning independently acquired PET and CT image sets several ad hoc concepts of integrating PET and CT imaging in a single device have been proposed. This article comments on the development of the first combined dual-modality PET/CT prototype at the University of Pittsburgh, and illustrates commercial advances to dual-modality PET/CT tomography. The current PET/CT designs from the major manufacturers comprise a commercial CT scanner in tandem with a commercial PET scanner. While the level of physical integration is actually less than that of the original prototype it is fair to assume that current PET/CT models may serve as intermediate solutions towards near-future design concepts that aim at greatly reduced costs of the dual-modality tomographs and offer a greater level of physical integration. The goal of the next generation of PET/CT systems is to design and build a device specifically for imaging the function and anatomy of cancer in the most informative and effective way without necessarily conceptualizing it as combined PET and CT scanners. Such a concept of a diagnostic imaging device relates more to a disease management approach rather than the usual division into medical specialities such as radiology and nuclear medicine.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
6/22. Integrated cancer care: linking medicine and therapies.Many patients receiving conventional cancer care benefit from complementary therapies. A cancer centre offering complementary therapies tailors them to meet each patient's needs and complement conventional therapies. To integrate care, it was important to gain the trust and cooperation of colleagues in conventional disciplines. This was done by focusing on thorough needs assessments and evaluation to demonstrate the value of the therapies on offer.- - - - - - - - - - ranking = 4keywords = medicine (Clic here for more details about this article) |
7/22. The experience of indigenous traditional healing and cancer.Indigenous traditional healing is an ancient, deeply rooted, complex holistic health care system practiced by indigenous people worldwide. However, scant information exists to explain the phenomenon of indigenous medicine and indigenous health. Even less is known about how indigenous healing takes place. The purpose of this study is to describe the meaning and essence of the lived experience of 4 indigenous people who have been diagnosed with cancer and have used indigenous traditional healing during their healing journey. The researcher used a qualitative phenomenological methodology to collect and analyze interview data. Interviews were conducted with 4 self-identified indigenous people, ages 49 to 61, from diverse tribes. time since cancer diagnosis varied from 2 to 20 years; types of cancer included lung, prostate, sarcoma of the leg, and breast. Four themes and 2 subthemes emerged (1) receiving the cancer diagnosis (with subthemes of knowing something was wrong and hearing something was wrong), (2) seeking healing, (3) connecting to indigenous culture, and (4) contemplating life's future. This study demonstrates that 4 individuals with cancer integrated Western medicine and traditional healing to treat their cancer. This knowledge provides necessary data about the phenomena of being healed by indigenous healers. Such data may serve as an initial guide for health care professionals while interacting with indigenous people diagnosed with cancer. Accordingly, traditional healing may be used to decrease health disparities.- - - - - - - - - - ranking = 2keywords = medicine (Clic here for more details about this article) |
8/22. homeopathy as a supportive therapy in cancer.Three cases of cancer in which homeopathic treatment was used in a complementary role are described: A 64-year-old male with metastatic adenocarcinoma of the rectum. The patient refused surgery. He was treated constitutionally with lycopodium. He survived nearly 3 years with no further hospitalization or other complications. A 77-year-old female with terminal squamous cell carcinoma of the cheek previously treated with radiotherapy. There was intense pain not relieved by available treatment. Calc Carb was prescribed on constitutional grounds and gave very good pain relief. A 70-year-old male with carcinoma of the larynx. He had been receiving homeopathic treatment after the diagnosis because of his faith in it. He was advised to have surgery, radiation and chemotherapy, which he underwent immediately. This treatment was followed by homeopathic constitutional treatment. Ferrum-phos was prescribed. There was a good response. The patient was symptom-free at 3 year follow-up. Homeopathic medicines prescribed on constitutional grounds may play a useful role in supportive and palliative for patients with malignant disease.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
9/22. Functional anatomic imaging in radiation therapy planning.Improvements in techniques for the delivery of curative radiation have paralleled the advances in three-dimensional imaging devices, specifically, computed tomography and magnetic resonance imaging. These modalities supply the high-resolution image data which, when transferred to radiotherapy computers, allows the construction of a "virtual patient" and calculation of radiation dose that can be delivered within a three-dimensional volume. Although anatomic methods have long been the main stay of cancer imaging, it now clear that functional imaging, provided by positron emission tomography and other nuclear medicine techniques, provides additional critical information regarding tumor biologic activity. The additional step of fusion of functional and anatomic images further refines radiation treatment planning.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
10/22. Cardiopulmonary rehabilitation and cancer rehabilitation. 3. Cancer rehabilitation.This self-directed learning module highlights the treatment and rehabilitation of patients with cancer. It is part of the study guide on cardiac, pulmonary, and cancer rehabilitation in the Self-Directed Physiatric education Program for practitioners and trainees in physical medicine and rehabilitation. This article reviews medical and rehabilitation issues in patients with various types of cancer. Cases were selected to allow discussion of problems seen in both younger and older patient populations. Identification of common sequelae of cancer and cancer treatments, associated rehabilitation challenges, and appropriate interventions are included. overall Article Objective: To summarize the medical and rehabilitation issues in patients with various types of cancer.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
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