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Biomedical subjects

P A Ganz

Publications and source records attributed to P A Ganz.

At least 109 records · Page 6Linked to original sources
PubMed1985

The psychosocial impact of cancer on the elderly: a comparison with younger patients.

This report examines the psychosocial impact of cancer in 240 men according to age using a recently developed cancer-specific survey instrument. Overall, younger patients experienced more frequent or severe psychosocial and treatment-related problems than the older patients, especially in relation to work and chemotherapy. In addition, younger patients experienced more difficulty dealing with the health care setting. The authors conclude that the elderly cancer patient experiences less psychosocial disruption from cancer than do younger individuals.

Activities of Daily Living↗
PubMed1984

Living with cancer: the Cancer Inventory of Problem Situations.

With the recent improvement in cancer therapy, patients are living for extended periods of time. There is little information on the day-to-day problems that these patients experience. The paucity of such information is due to the absence of instruments specifically designed to document these problems. The authors have developed an instrument, The Cancer Inventory of Problem Situations (CIPS), and present a study of 84 cancer patients using the CIPS. Preliminary evaluation of the instrument in this small and heterogeneous group of patients demonstrates that cancer has a significant, extensive impact on psychosocial and physical functioning. Cancer patients have moderate to severe problems in personal care, activity management, involvement with the health care system, work, and interpersonal interactions.

Activities of Daily Living↗
PubMed1984

Karnofsky performance status revisited: reliability, validity, and guidelines.

Little research has been conducted documenting the reliability and validity of the Karnofsky Performance Status (KPS) scale, and guidelines based on empirical data do not exist to govern its use. Two hundred ninety-three cancer patients completed a questionnaire that assesses their physical and psychosocial difficulties. Physicians rated patients on the KPS and a subsample of 75 patients was used to evaluate interrater reliability. Analyses were conducted to evaluate the interrater reliability and construct validity of the KPS. The KPS was shown to have good reliability and validity. Detailed examination of the reliability data suggested areas in which physicians err in their judgments. Multiple regression techniques were used to empirically identify seven behaviorally based questions that would be helpful in predicting KPS scores. The seven variables included weight loss, weight gain, reduced energy, difficulty walking, driving, grooming, and working part time. An interview approach with behaviorally based guidelines is presented using these variables to obtain relevant data and make more accurate KPS ratings. With the approach suggested and the guidelines presented, oncologists may train themselves to use the KPS in a standard way, which should increase reliability and validity of the KPS and has implications for patients and research studies that use KPS as a stratifying variable.

Activities of Daily Living↗
PubMed1984

Monitoring the therapy of lung cancer with alpha-1-acid glycoprotein.

Alpha-1-Acid glycoprotein is an acute-phase serum protein which is found in increased amounts in patients with a variety of cancers. This paper describes the application of discriminant analysis to the comparison of plasma levels of alpha-1-acid glycoprotein in 95 patients with lung cancer and 84 patients without known cancer. Using this technique, alpha-1-acid glycoprotein measurement yielded a sensitivity of 89% and specificity of 84% in the detection of active lung cancer. In addition, a new method for analysis of serial tumor marker data is presented which demonstrates that normalization of alpha-1-acid glycoprotein levels during antineoplastic therapy correlates with a significantly prolonged relapse-free survival in lung cancer patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

Evaluation of a radioimmunoassay for alpha 1-acid glycoprotein to monitor therapy of cancer patients.

A new radioimmunoassay for alpha 1-acid glycoprotein (AGP) for monitoring the therapy of cancer patients was evaluated. Plasma levels of this glycoprotein were measured in 49 normal healthy volunteers, 71 patients with illnesses other than cancer, 190 patients with solid tumors, and 58 patients with hematologic neoplasms. Plasma levels of AGP were elevated in 89% of the solid tumor patients and 87% of the patients with hematologic neoplasms who had newly diagnosed, locally recurrent, or metastatic cancer. Only 18% of patients with illnesses other than cancer and normal renal function had elevations of plasma AGP. Serial measurements of AGP may be useful for monitoring therapy in several tumor types, including small-cell lung cancer, colon cancer, lymphoma, and non-small-cell lung cancer.

Evaluation Studies as Topic↗
PubMed1980

Amphotericin B plus combination chemotherapy for extensive non-small cell bronchogenic carcinoma.

Sixteen patients with extensive non-small carcinoma of the lung were treated with methotrexate, vincristine, cyclophosphamide, and adriamycin. Cyclophosphamide and adriamycin were administered after pretreatment with amphotericin B. Amphotericin B-related toxicity was mild; cytotoxic chemotherapy-related toxicity was tolerable. The partial response rate was 12.5% and median survival was between 19 and 20 weeks. Response rate and survival were not superior to those of a similar drug combination lacking amphotericin B.

Amphotericin B↗
PubMed1980

Lung cancer in younger patients.

Carcinoma of the lung is rare in younger patients, but occasional reports of this condition have appeared in the literature. This article reviews the clinical and pathological patterns of bronchogenic carcinoma in 96 patients, 40 years old or younger seen at UCLA (University of California, Los Angeles) Hospital between 1956 and 1976. This review confirms the finding in other reports of a higher proportion of women among younger patients with lung cancer as well as a relatively low incidence of squamous cell carcinoma. Using comparative data from the UCLA and California tumor registries, we could find no significant difference in survival of the younger patients when compared with the general population of patients with lung cancer.

Adult↗
PubMed1978

Responses of patients with neoplastic diseases to influenza virus vaccine.

Little information is available concerning influenza immunization in patients with malignancies receiving chemotherapy. A large number of ambulatory patients are receiving chemotherapy for metastatic disease as well as adjuvant chemotherapy for microscopic disease, and they should be considered at higher risk for complications should they contract influenza. Seventeen oncology patients and 15 control subjects were given bivalent influenza vaccine (A/NJ/76-A/Vic/75) and their serologic responses were monitored. Although their responses were less than controls, nearly 50% of the oncology patients had a greater than fourfold rise in antibody titer, suggesting that a humoral antibody response could be achieved in spite of their underlying disease and immunosuppressive chemotherapy. No adverse reactions or deterioration of patient's clinical status were noted with vaccination. We conclude that significant antibody titer responses can be achieved in this population of patients.

Adult↗
PubMedDate not supplied

Missing quality of life data in cancer clinical trials: serious problems and challenges.

Measurement of quality of life (QOL) in cancer clinical trials has increased in recent years as more groups realize the importance of such endpoints. A key problem has been missing data. Some QOL data may unavoidably be missing, as for example when patients are too ill to complete forms. Other important sources are potentially avoidable and can broadly be divided into three categories: (i) methodological factors; (ii) logistic and administrative factors; (iii) patient-related factors. Logistic and administrative factors, for example, staff oversights, have proven to be most important. Since most QOL measurements require patient self-report, it is usually not possible to rectify the failure to collect baseline data or any follow-up assessments. There is strong evidence that such data are not 'missing at random', and cannot be ignored without introducing bias. Although several approaches to the analysis of partly missing data have been described, none is entirely satisfactory. Prevention of avoidable missing data is better than attempted cure. In July 1996, an international conference on missing QOL data in cancer clinical trials reported the experience of most major groups involved. This paper will serve as an introduction to the problem and provide an estimation of its magnitude, and approaches to its prevention and solution.

Bias↗
PubMedDate not supplied

Compliance with quality of life data collection in the National Surgical Adjuvant Breast and Bowel Project (NSABP) Breast Cancer Prevention Trial.

This paper describes compliance with the completion of a quality of life questionnaire in the Breast Cancer Prevention Trial, a large multi-centre randomized trial that is studying the efficacy of Tamoxifen in preventing breast cancer. In the first 4875 women enrolled in the control arm of the study, there was a very high rate of questionnaire completion at baseline, 3 months, 6 months and 12 months of follow-up (89.8 per cent completed forms at 12 months). The sample was examined according to demographic and risk factors, as well as by recruitment cohort. There was a significantly poorer compliance rate for the most recently recruited cohort that was followed-up during a time of substantial external negative publicity related to clinical trial research. Nevertheless, the overall compliance with completion of quality of life data in this trial is very high, which is probably attributable to the high educational status of the trial participants.

Adult↗
PubMedDate not supplied

Quality of life in patients with heart failure: do gender differences exist?

OBJECTIVE: The purpose of this study was to evaluate gender differences in quality of life (QOL) in a large sample of age-matched and ejection fraction (EF)-matched patients with heart failure. DESIGN: Matched comparisons of secondary data were used. SETTING: The setting consisted of multicenter Studies of Left Ventricular Dysfunction trials. SAMPLE: The sample included 1382 patients (691 men and 691 women) who were age-matched and EF-matched. OUTCOME MEASURES: Global QOL and the QOL dimensions of physical function, emotional distress, social health, and general health were measured using the Ladder of Life, items from the Profile of Mood States Inventory, the Functional Status Questionnaire, the beta-Blocker Heart Attack Trial instrument, and an item from the RAND Medical Outcomes Study instrument. RESULTS: Women had significantly worse general life satisfaction, physical function, and social and general health scores than men. There were no significant differences found between gender groups for current life situation or emotional distress. After controlling for New York Heart Association classification, women still had significantly worse ratings for intermediate activities of daily living (a sub-dimension of physical functioning) and social activity. CONCLUSIONS: Despite controlling for age, EF, and New York Heart Association classification, women had worse QOL ratings than did men for intermediate activities of daily living and social activity. Research should focus on identifying why differences exist and developing measures to improve QOL, particularly physical functioning, in women with heart failure.

Female↗
PubMedDate not supplied

Sexuality following breast cancer.

This article provides sex and marital therapists with detailed, multifaceted descriptions of sexuality after breast cancer based on survey responses from 863 breast cancer survivors. One third of women reported that breast cancer had had a negative impact on her sex life, and most reported negative changes in at least some areas. Nonetheless, breast cancer survivors did not differ from age-matched, healthy women on a standard measure of sexuality. Women who were most likely to report a negative impact on sexuality from cancer were those who had experienced changes in hormonal status, problems in their relationships, and difficulties with vaginal dryness. On the basis of these findings, we offer suggestions for health professionals and therapists treating breast cancer survivors.

Breast Neoplasms↗
PubMedDate not supplied

Professional attitudes toward hospice care.

Among studies made to determine the need for and feasibility of a hospice program at a major university hospital, a survey was made of the hospital professional staff's attitudes towards hospice care. The anonymous questionnaire was distributed in July 1983 to 395 faculty physicians, Department of Medicine house staff, hospital nurses, and clinical social workers. Among the 243 respondents (62% response rate), only 38% felt that current services were "satisfactory," with 90% of respondents indicating that the hospital needs a hospice program.

Attitude of Health Personnel↗
PubMedDate not supplied

Advocating for the woman with breast cancer.

Health care workers and breast cancer survivors have an important role to play as advocates for breast cancer patients. At the most basic level, advocates must ensure that the patient has access to medical care. In addition they must help to ensure that the quality of care is optimal, enhancing the likelihood of survival, rehabilitation, and psychological adaptation. This article describes important advocacy issues for women with breast cancer, including informational needs, patient-physician communication, choice of primary surgical treatment, reconstructive surgery, adjuvant therapy, psychosocial issues, and employment and insurance problems.

Breast Neoplasms↗