Martine Devos

Multidisciplinary management of breast cancer

Breast cancer, with an increasing incidence, is the most frequently diagnosed cancer in women worldwide. The treatments proposed, generally a combination of surgery, radiotherapy, chemotherapy, endocrine therapy and/or targeted therapy, are constantly improving, allowing a reduction in the mortality rate, but they are still causing many side effects, not only early but also late, which leads us to consider the post-cancer period as a chronic condition. Side effects, reviewed in this commentary, may affect physical functions, psychological status, social situation, body composition, well-being and quality of life of the patient. In view of the extent of these areas in which side effects of breast cancer and of its treatments can be found, the supportive care offered at the end of treatment need to be multidisciplinary. Different supportive care interventions may be proposed to the patients such as psychological and behavioral interventions, complementary therapies, diet interventions, physical activity/rehabilitation or also physiotherapy interventions for example, all having shown some beneficial effects in the literature. The benefits of these supportive care interventions are thereby already established and they are described in this article, but others studies will be needed to clearly define indications and most optimal modalities of application to reduce side effects and improve quality of life of patients.

Factors associated with self-perceived burden to the primary caregiver in older patients with hematologic malignancies: an exploratory study

Although cancer patients frequently experience self‐perceived burden to others, this perception has not been enough studied. The aim of this study was to investigate the prevalence of self‐perceived burden to the primary caregiver (SPB‐PC) and associated factors in an older patient population with hematologic malignancies at the time of chemotherapy initiation.

Exercise and Education Program After Breast Cancer: Benefits on Quality of Life and Symptoms at 3, 6, 12, and 24 Months’ Follow-up

Background Various clinical trials have demonstrated the benefits of physical training offered during and/or after breast cancer treatments. However, given the variety of adverse events that may be encountered, physical training could be combined with psychologic, relational, and social guidance. This kind of multidisciplinary program, as well as its long‐term effects, have been little studied so far. Therefore, the objective of our study was to determine the benefits at 3, 6, 12, and 24 months of a 3‐month exercise and education program among women after breast cancer treatment. Patients and Methods Two hundred nine outpatients treated for primary breast carcinoma were divided into a control group (n = 106) and an experimental group (n = 103) which underwent a 3‐month rehabilitation program including physical training and psychoeducational sessions. The assessments, performed before the program and at 3, 6, 12, and 24 months after inclusion, included validated questionnaires on quality of life and symptoms. Results The analyses revealed an improvement in quality of life and symptoms after the exercise and education program within the experimental group and a maintenance of these improvements during the 2 years of follow‐up. These improvements were significantly better than those in the control group, clearly demonstrating that the program has benefits. Conclusion This trial identified the benefits of a well‐detailed 3‐month exercise and education program over 24 months’ follow‐up among women after breast cancer treatment. Micro‐Abstract This trial identified the benefits on quality of life and symptoms of a 3‐month exercise and education program over 24 months’ follow‐up among a population of 209 women treated for breast cancer. We found an improvement in quality of life and symptoms after rehabilitation in the experimental group and a maintenance of these improvements during the 2 years of follow‐up.

Cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy: a longitudinal cohort study.

Despite the well‐known negative impacts of cancer and anticancer therapies on cognitive performance, little is known about the cognitive compensatory processes of older patients with cancer. This study was designed to investigate the cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy.

Influence of a multidisciplinary post-breast cancer rehabilitation program on lifestyle and behavior faced with physical activities

B the gaps in cancer care is a daunting task that requires self-awareness, education, and advocacy founded in the Code of Ethics for Nurses and aligned with our Nursing’s Social Policy Statement (ANA, 2010). Though ethical underpinnings of both the code and social contract with individuals, families, and communities remain constant, healthcare is constantly evolving. One of the most important roles of nurses as leaders in healthcare is to give voice to the under-served and ensure fairness and equity to all people regardless of race, creed, gender, or economic status (ANA, 2010). Now, with growing visibility of marginalized US populations, the healthcare industry and its providers are challenged to meet the needs of the LGBTQ populations in an equitable and just way. For several decades, grassroots efforts, championed by the Fenway Institute (Boston, MA) and many of our national medical and nursing organizations (IOM, ANA,), have called for an adjustments to the binary healthcare structure that has yet to address the new norms of an expanding diversity of culture. Inherent in the lack of readiness to support the LGBTQ community are deficits in provider information, ineffective communication, confusion surrounding gender and sexuality differences and conscious and unconscious biases that interfere with the ability to recognize and to deliver appropriate healthcare. Despite this trending need, pre-professional education has dedicated limited amount of time in preparing nurses, nurse practitioners and medical staff in the standards of care for LGBTQ people. For the purpose of this presentation, cancer risk assessment, screenings, healthcare practices, and health promotion for LGBTQ people, from the very young to the elderly, will be explored. Strategies to provide a compassionate, and welcoming environments to gender, non-conforming individuals will be discussed. Recommendations for nursing education and preparedness using evidence-based applications in clinical practice will be offered.Exercise stage b 3.152 Contemplation .281 1.208 0.054 1.325 (0.124-14.143) Preparation .851 1.282 0.441 2.342 (0.190-28.866) Action 1.291 1.298 0.989 3.636 (0.285-46.305) Maintenance 1.944 1.368 2.020 6.990 (0.478-102.125) Table1 the predictive factor analysis of glycemic control Introduction It is important for patients with diabetes mellitus to understand the importance of drug compliance and healthy lifestyle. However, the actual condition of this management is not ideal. The behavior of personality traits is an important factor of compliance. There is a close relationship between personality traits, self-discipline, and selfcare. It is critical to understand the personality traits of subjects for glycemic control. Methods This study was conducted in the Division of Metabolism in a teaching hospital in Taiwan. There were 219 patients with Type 2 diabetes under survey with questionnaires. The effective sample size is 214. Results a) The older the patients have the lower the risk of poor glycemic control. b) Increase of every 10 years of age, the risk of poor glycemic control decreases by 9.2%. c) Increased fasting blood glucose of 10mg/dl increases 59% risk of poor glycemic control. d) Increased every 10 g/dl TG makes the increase of risk for poor glycemic control by 39%. e) Patients with prudent personality or agreeable personality have a lower risk of poor glycemic control but without significant difference. f) Neuroticism personality is an important predictor for poor glycemic control g) Neuroticism personalities have a 7.52 times higher risk of poor glycemic control.