bluuebunny/crossref_metadata_2025 huggingface dataset:
Infrared‐based protein detection arrays for quantitative proteomics
Authors: Loebke Christian , Sueltmann Holger , Schmidt Christian , Henjes Frauke , Wiemann Stefan , Poustka Annemarie , Korf Ulrike
Published: February 2007

The advancement of efficient technologies to comply with the needs of systems biology and drug discovery has so far not received adequate attention. A substantial bottleneck for the time‐resolved quantitative description of signaling networks is the limited throughput and the inadequate sensitivity of currently established methods. Here, we present an improved protein microarray‐based approach towards the sensitive detection of proteins in the fg‐range which is based on signal detection in the near‐infrared range. The high sensitivity of the assay permits the specific quantification of proteins derived from as little as only 20 000 cells with an error rate of only 5%. The capacity is limited to the analysis of up to 500 different samples per microarray. Protein abundance is determined qualitatively, and quantitatively, if recombinant protein is available. This novel approach was called IPAQ (infrared‐based protein arrays with quantitative readout). IPAQ offers a highly sensitive experimental approach superior to the established standard protein quantification technologies, and is suitable for quantitative proteomics. Employing the IPAQ approach, a detailed analysis of activated signaling networks in biopsy samples and of crosstalk between signaling modules as required in drug discovery strategies can easily be performed.
A study of patients who appear with far advanced cancer at Yaounde General Hospital, Cameroon, Africa
Authors: Ekortarl AnnCommy , Ndom Paul , Sacks Alexandra
Published: February 2007

Background: This is a preliminary study to identify patients with cancer who appeared with very advanced disease and to report the common reasons for their delay. It was undertaken because the numbers of such patients appeared to be increasing.

Method: A convenience sample of 20 patients were identified by the oncologist (P.N.) as appearing with very late stage disease or appearing and not returning until a late stage. They were interviewed by the psychologist (A.E.) to determine: symptom onset; treatment sought; reasons for seeking consultation; beliefs, fears, and level of information about cancer; and willingness to be treated.

Results: The primary reasons given for waiting so long to seek care were: inability to pay for medical care (10); inadequate diagnosis by general doctors leading to time lost before coming for consultation; (9); beliefs, fears, cultural factors, ignorance (9). More than one factor could be identified in half the patients.

Conclusion: Understanding the factors that influence delay is important to improving the outcomes for cancer patients. Factors that contribute to delay in developing countries appear to be largely the paucity of appropriate health care, coupled with poor information, and beliefs and fears about cancer. Copyright © 2007 John Wiley & Sons, Ltd.
Psycho‐oncology: Overview, obstacles and opportunities
Authors: Holland Jimmie C.
Published: February 2007

Worldwide, psychological and social issues in cancer were not the subject of scientific inquiry until the past two decades. Since then, a new subspecialty of oncology has evolved, psycho‐oncology. It addresses two dimensions of cancer: the emotional responses of patients at all stages of disease, as well as their families and caretakers (psychosocial); and the pyschological, social and behavioral factors that may influence cancer morbidity and mortality (psychobiological). Obstacles to development have been the facts of small numbers of clinicians and investigators worldwide and the few valid assessment instruments and research methods available to the biomedical community. These obstacles are increasingly giving way to the louder demand of the public for maximal quality of life in cancer care. Psycho‐oncology is attaining subspeciality status by presently bringing a set of clinical skills in counseling, behavioral and social interventions to oncology, by providing training curricula which teach basic knowledge and skills in the area, and through creating a body of research and scholarly information about clinically relevant issues in the care of patients with cancer. Since it is increasingly recognized that psychological, social and behavioral variables influence treatment outcome, attention will likely to continue to increase. The field must meet the challenges of the 1990's in psychosocial care and availability of services, support for training clinicians and investigators in psycho‐oncology, and implementation of an exciting research agenda. The focus of new research will encourage collaborative investigations combining biological and psychosocial variables, quality of life research in clinical trials, controlled studies of psychotherapeutic, behavioral and psychopharmacologic research, and crosscultural studies that will examine differences in prevention and detection, health care systems, alternative therapies and meta analyses.
Psychological response to cancer diagnosis and disease outcome in patients with breast cancer and lymphoma
Authors: Morris Tina , Pettingale Keith , Haybittle John
Published: February 2007

The relationship between psychological response (PRD) to cancer diagnosis measured three months post‐diagnosis and disease outcome up to five years later was studied prospectively in a consecutive series of 107 women with early (T0 – 2, N0 – 1, M0) breast cancer and a consecutive series of 61 men and women with Hodgkin's and Non‐Hodgkin's lymphoma. It was only possible to assign 138 patients (88 breast cancer and 50 lymphoma) to single psychological response categories. In those who could be so categorised a significant trend of worsening prognosis as response varied from ‘fighting spirit’ or ‘denial’ through ‘anxious preoccupation’ to ‘stoic acceptance’ or ‘hopelessness/helplessness’, was demonstrated for both overall survival (χ2 = 5.49; p = 0.02) and recurrence‐free survival (χ2 = 6.09; p = 0.015). Male lymphoma patients who had died by five years tended to have higher scores on the suppression of anger scales of the Courtauld Emotional Control Scale and the‘Powerful Others Scale’ of the Mental Health Locus of Control Scale; they more often reported avoiding seeking information or‘keeping busy’ as a way of avoiding thinking about their diagnosis. The relative values of psychological test scores and semi‐structured interview data in the study are discussed.
Report of the british psychosocial oncology group annual conference 1991
Authors: Hopwood Penelope , Barnett Mandy , Cull Ann , Fallowfield Lesley , Watson Maggie , Wilkinson Susie
Published: February 2007

The 8th Conference of the British Psychosocial Oncology Group was held in London on 9–10 December 1991 and attracted over 120 participants. The conference was extended from its usual one day format to one and a half days, to allow more time for both a formal and informal exchange of ideas. Eight invited speakers participated, but proferred papers and posters remained an important focus of the meeting. This is the largest annual conference in Britain for professionals working in psychosocial oncology and an important forum for the presentation of research. As in previous years, the conference attracted a number of newcomers, indicating the continued expansion of this field of research.

A number of topical issues were presented in keynote papers by invited speakers. New work in cancer prevention and the associated areas of counselling families at risk and ethical issues, formed one symposium. Communication skills and relevant training needs in paediatric and adult oncology were an important theme of the conference and intervention studies formed the third main topic.
Psychotropic adjuvant analgesics for cancer pain
Authors: Breitbart William
Published: February 2007

The mainstay of pharmacological interventions for cancer pain continues to be the appropriate use of narcotic analgesics. There is, however, growing awareness and acceptance of the benefits derived for cancer pain patients from psychiatric contributions to pain control, including the use of psychotropic adjuvant analgesics. Knowledge of the indications and usefulness of psychotropic drugs in cancer pain will be most rewarding, particularly since these drugs are useful not only in the treatment of psychiatric complications of cancer, but also as adjuvant analgesic agents in the management of cancer pain. This paper reviews the literature on the use of antidepressants, psychostimulants, neuroleptics and anxiolytics in the management of cancer pain. Mechanisms of analgesia, drug selection, recommendations for clinical usage and issues for future research are discussed. The appropriate and timely use of psychotropic adjuvant analgesic drugs represents an opportunity for active psychiatric contribution to the multidisciplinary management of cancer pain.
Remembering ‘bad news’ consultations: An evaluation of tape‐recorded consultations
Authors: Hogbin Brian , Jenkins Valerie A. , Parkin Alan J.
Published: February 2007

Two groups of women with a diagnosis of breast cancer were interviewed by a consultant surgeon. The consultation was recorded and one group of women were allowed to take the tape away and make reference to it during the preoperative period. Provision of tapes was found to enhance patients' understanding of their treatment and resulted in fewer visits to their general practitioners. Use of tapes did not, however, reduce psychological morbidity. The study also indicated that partners experience comparable degrees of psychological morbidity and that women who undergo wide local excisions remain significantly more anxious postoperatively than women who have mastectomies.
Do psychosocial factors influence the course of breast cancer? A review of recent literature, methodological problems and future directions
Authors: Mulder C. L. , Pompe G. Van Der , Spiegel D. , Antoni M. H. , De Vries M. J.
Published: February 2007

The course of breast cancer is highly variable, and only part of the variability in progression rate can be predicted by clinicopathological factors. It is suggested that some of the variation may be ascribed to behavioral factors, but their importance in determining progression of breast cancer is still controversial. Several groups have found an association between progression of breast cancer and psychosocial factors including stressful life events, the expression of negative emotions—anger and anxiety—the presence of hopelessness, social support, and participating in psychosocial counselling. However, other groups failed to confirm these results. Here we review psycho‐oncology research studies with breast cancer patients including those employing cross‐sectional, longitudinal and experimental designs. Results of these studies, methodological problems and future directions for this line of research are discussed.
Disclosure of concerns in breast cancer
Authors: Pistrang Nancy , Barker Chris
Published: February 2007

This study examined recently diagnosed breast cancer patients' ‘helping relationships’, that is, whom they turned to for emotional support and what was the nature of these interactions. We conceptualized the key elements of helping relationships in terms of two communication variables: self‐disclosure and empathy. The study aimed to systematically assess women's levels of concerns about various aspects of breast cancer, to whom they disclosed these concerns, and differences in their communication patterns with different helpers. Women were most concerned about the uncertainty of recurrence of cancer and the effect of their illness on people close to them. They identified informal helpers (in particular, partners, close female relatives and female friends), rather than formal helpers, as the most important person to whom they confided. Communication with partners was more problematic than communication with relatives and friends: the largest difference was in perceived empathy, indicating that women felt less understood by their partners. The results were discussed in relation to the help‐seeking and social support literatures.
Depression in patients with cancer
Authors: Mermelstein Hindi T. , Lesko Lynna
Published: February 2007

This paper reviews the clinical aspects of depression in cancer from the perspective of prevalence, diagnosis, clinical symptoms, classification and treatment. Clinical trials, reported since 1960, of psychosocial, psychopharmacologic and behavioral interventions are critically evaluated. Therapeutic guidelines are offered for the management of the depressed patients with cancer. Research directions are suggested for the future.
A qualitative evaluation of the experience of surgery after false positive results in screening for familial ovarian cancer
Authors: Pernet A. L. , Wardle J. , Bourne T. H. , Whitehead M. I. , Campbell S. , Collins W. P.
Published: February 2007

This study describes the experience of screening and surgery in a sample of women who received false positive results during screening for familial ovarian cancer. It was hypothesised that these women might feel bitter and hostile at having been exposed to so much anxiety and suffering for the removal of a cyst. The results from both prospective questionnaire measures and retrospective interviews indicated that women were neither severely distressed nor angry about their experiences. The sensitive management of the screening process by clinic staff and a remarkable faith in the benefits of early intervention held by the women involved, appeared to have contributed to this positive outcome. Women's acceptance of major surgery seemed to be based on the premise that body parts which were not crucial to survival, and which were at risk of malignancy, were best removed under the circumstances. They seemed to derive considerable comfort from the belief that surgery rendered them invulnerable to the disease that had, in most cases, caused their mother a painful death. Nevertheless, many women described considerable stress at various stages in the procedure. An improvement in the quality and timing of information may further reduce anxiety.
Psychological adaptation to facial disfigurement in a female head and neck cancer patient
Authors: Die‐Trill Maria , Straker Norman
Published: February 2007

Head and neck cancer patients are often confronted with changes in their physical appearance that may be devastating to the patient and to those around them. This article describes the positive psychological adjustment of a young female with head and neck cancer to prolonged facial deformity. It illustrates critical variables in the psychological adaptation of these patients as well as the need for ongoing, supportive relationships with family and members of hospital staff. The ways which the psychotherapist had of overcoming the negative feelings initially elicited by the patient's overwhelming disfigurement are also discussed.
The post‐treatment resource program: Portrait of a program for cancer survivors
Authors: Zampini Karrie , Ostroff Jamie S.
Published: February 2007

To meet the specialized needs of the growing population of individuals who have successfully completed their cancer treatment, a support program for cancer survivors was developed. The philosophy of the program reflects the belief that preparation and support for dealing with the challenges of cancer survivorship enhances quality of life. In keeping with this approach, the physical, psychological, insurance and employment issues experienced by many cancer survivors are addressed through educational, counseling and peer support services. Recommendations for implementing a post‐treatment program are also described.
A cancer experience: Relationship of patient psychosocial responses to care‐giver burden over time
Authors: McCorkle Ruth , Yost Linda Shegda , Jepson Christopher , Malone Dolores , Baird Susan , Lusk Edward
Published: February 2007

Cancer affects not only ill persons but also family members and close friends. An original study from which this report is derived used a longitudinal design to follow patients discharged from one of seven hospitals with one or more complex care problems requiring home care. A total of 233 patients with multiple solid tumors diagnoses and 103 care‐givers were included in the original study. Interviews were conducted at discharge and at three and six months post‐discharge. This report examined the responses of a subset of 34 subjects (17 patients and their care‐givers) for whom patient and care‐giver variables were complete on all three occasions. Findings indicate that these patients were being discharged from the hospital with acute care needs. By three and six months posthospitalization, patients' conditions stabilized or improved but their care‐givers continued to report similar levels of burden. Patient psychosocial responses were strongly correlated with care‐givers' financial impact, impact on schedule, and physical care‐giving responsibility at three and six months. Results highlight the importance of developing interventions that reduce family care‐givers' burden in providing post‐hospital nursing care for patients with complex care requirements.
Pre‐chemotherapy nervousness as a marker for anticipatory nausea: A case of a non‐causal predictor
Authors: Kvale Gerd , Glimelius Bengt , Hoffman Katarina , Sjödén Per‐Olow
Published: February 2007

A significant but non‐causal relationship between pre‐chemotherapy nervousness and development of anticipatory nausea (AN) in cancer patients is reported. A comprehensive psychosocial care program with the aim of improving the total situation of patients treated with chemotherapy (n = 119) was carried out in Uppsala during 1987–1989. Multiple quality‐of‐life (QL) recordings were employed for the project patients in all phases of treatment. A comparable pre‐project group, treated one month previously at the same wards, served as controls (n = 54). For this group, QL was recorded at a mean of 5 months after start of treatment. Pre‐chemotherapy nervousness at the first chemotherapy course was a highly significant predictor for AN after 5 months of treatment in the project patients, and was also significantly related to AN in the pre‐project group. All but two patients who developed AN had experienced post‐treatment nausea and vomiting (PN/V). There was also a significant interaction between pre‐project/project groups and severity of AN/PN after 5 months of treatment, indicating that project patients had developed less severe AN despite more severe PN compared to the pre‐project patients. The reduction of AN severity was, however, of marginal clinical importance, as indicated by non‐significant differences in reported AN in the two groups, when severity of PN was not considered. The most important means by which AN can be reduced is by eliminating post‐treatment nausea and vomiting.
An educational intervention for newly‐diagnosed cancer patients undergoing radiotherapy
Authors: Pruitt Brian T. , Waligora‐Serafin Barbara , McMahon Terry , Byrd Gary , Besselman Lynn , Kelly Gerald M. , Drake Diane Ash , Cuellar Dian
Published: February 2007

This is a prospective, randomized pilot trial of an educational intervention for newly‐diagnosed cancer patients under going radiotherapy. The trial was conducted in a relatively rural area in northwest Texas. Our hypothesis was that the intervention would reduce psychological distress. A group of 31 patients who were predicted by the Omega Screening Instrument to be at high risk for psychological distress were selected to be the subjects for this study. The patients were randomly assigned either to the intervention (n = 15) or to a control group (n = 16). The intervention was a series of three one‐hour individual sessions which gave information about radiotherapy and cancer, coping strategies, and communication skills. The sessions occurred during the second, third, and fourth weeks of each patient's radiotherapy. Psychological distress was measured with the Brief Symptom Inventory (BSI) at study entry, and one and three months later. We also used the Inventory of Current Concerns (ICC) to determine the specific areas of concern which were correlated with psychological distress. Knowledge gained was measured with a 15‐item multiple choice test which we developed from the factual material in the intervention and which we administered to both groups at entry, one month and three months. The intervention group's mean scores on the BSI Depression subscale fell over the three months on study, while those of the control group rose. The difference was statistically significant. However, the BSI scores overall were not different between the groups. Psychological distress in both groups was correlated most closely with Health, Existential, and Self‐Appraisal concerns on the ICC. Knowledge, as measured by the multiple choice test, did not increase in the intervention group, and there was no statistically significant difference between the scores of the intervention and control groups at any time. Since the BSI Depression scale has independent convergent validity with other measures of depression, we believe that the change in the intervention group's Depression scores could represent a meaningful effect. However, the lack of any measurable increase in knowledge suggests that any benefit of the educational intervention was probably non‐specific, resulting more from individual attention than from information gained.
A partially testable, predictive model of psychosocial factors in the etiology of cervical cancer i. Biological, psychological and social aspects
Authors: Goodkin Karl , Antoni Michael H. , Sevin Bernd , Fox Bernard H.
Published: February 2007

The current research in the biological, psychological and social domains of cervical cancer are reviewed. Research related to each domain is critically reviewed and summarized. The research so far conducted in each domain is extended by suggestions for future, integrative directions. An overview is given of these three areas pointing to the likelihood of association with cervical cancer for each of the factors reviewed in each domain. Estimated likelihoods of association were based upon both the number and quality of studies conducted. Immunological aspects of each domain may mediate some (but not all) of the effects of the factors identified. In a companion review, the immunological aspects of each domain are covered, the theoretical model is developed and a set of integrative hypotheses across domains are set forth.
A partially testable, predictive model of psychosocial factors in the etiology of cervical cancer ii. bioimmunological, psychoneuroimmunological, and socioimmunological aspects, critique and prospective integration
Authors: Goodkin Karl , Antoni Michael H. , Sevin Bernd , Fox Bernard H.
Published: February 2007

This review is the companion to the foregoing paper critically reviewing research on the biological, psychological and social aspects of the etiology of cervical cancer. The immune system mediates some (but not all) of the effects of these factors. Factors with relevant immunological associations for cervical oncogenesis are examined here. A critical review of research presented in both papers is offered at the conclusion of each aspect. This is followed by a tabular summary of the immunological studies relevant to the biological, psychological and social aspects of cervical cancer. Estimated likelihoods of association for the immunological factors selected within each aspect are given based upon both the number and quality of studies conducted, and are followed by selected comments. The paper concludes with a theoretical integration of the entire model (represented in both reviews) and the promulgation of a set of integrative hypotheses across domains (including their immunological aspects) for the purpose of illustrating the potential utility of this model in addressing future research questions.
Psychiatric aspects of bone marrow transplantation: Part II: Life beyond transplant
Authors: Lesko Lynna M.
Published: February 2007

As delineated in Part I of this series, bone marrow transplantation (BMT) is being used as an innovative and often curative treatment for many hematological and solid tumor cancers, and non‐malignant diseases such as aplastic anemia, severe combined immunodeficiency disease and hereditary syndromes (thalassemia and the mucopolysaccharide dyscrasias). Currently there is a small but burgeoning field of literature that is investigating the medical sequelae, psychological, social and sexual adjustment (and quality of life) after having undergone a successful transplant. A knowledge of the long‐term medical toxicity of BMT is mandatory in the light of its influences on psychological convalescence and recovery. Part II of this series (1) briefly describes the long‐term medical sequelae of BMT, (2) addresses clinical papers and research in the area of quality of life after BMT, and (3) explores psychological and psychosocial predictors in BMT adjustment.
Doctor‐patient communication and subsequent mental health in women with gynaecological cancer
Authors: Paraskevaidis E. , Kitchener H. C. , Walker L. G.
Published: February 2007

A total of 117 women attending a gynaecological oncology follow‐up clinic completed the Hospital Anxiety and Depression Scale (HADS), the Courtauld Emotional Control Scale (CECS) and a 72‐item ad hoc questionnaire designed to assess their evaluation of doctor‐patient communication and the perceived impact of diagnosis and treatment. Women who were anxious and/or depressed at follow‐up were more critical of doctor—patient interaction, particularly regarding the amount of information given. Young women, and married or widowed women, had more emotional difficulties and needs, as did those who had had a long remission. Although 47% of the women reported being too shocked to take in details at the time the diagnosis was confirmed, only 3% felt that they had been given too much information at that time and 23% would have preferred more information. During the ensuing month, 39% would have liked further information although 21% did not wish this. In many cases, therefore, there is a need for repeated information giving consultations. Routine use of HADS and CECS may help the clinician to identify and monitor patients most at risk of psychological problems.
The adjustment of siblings of pediatric cancer patients—a sibling and parent perspective
Authors: Breyer Joanna , Kunin Howard , Kalish Leslie A. , Patenaude Andrea Farkas
Published: February 2007

A total of 73 siblings of pediatric cancer patients and their parents completed a questionnaire about the siblings' reactions to the illness of their brother or sister. Descriptive information was obtained about the reactions, stresses, relationships, communication and behavior of the healthy sibling. From this data and from case examples, specific impressions emerged with treatment and research implications. These included the importance of the involvement of the healthy sibling with the ill siblings' treatment and the importance of assessing family interaction style to facilitate effective clinical interventions. Suggestions about direction for future empirical studies were made.
Psychosocial counseling of cancer patients by telephone: A brief note on patient acceptance of an outcall strategy
Authors: Marcus Alfred C. , Cella David , Sedlacek Scot , Crawford E. David , Crane Lori A. , Garrett Kathy , Quigel Christine , Gonin Rene
Published: February 2007

Telephone counseling of cancer patients has existed on a limited basis for a number of years. One aspect of telephone counseling that has not been adequately explored involves using an outcall strategy, in which the counseling service would call the patient according to a prearranged schedule. Such a strategy could be used to overcome the potentially significant barrier of requiring the patient to proactively call the counseling service. As a preliminary phase in the development of a larger program of research on telephone counseling of cancer patients, two feasibility studies were conducted to assess patient willingness to receive outcall telephone counseling and their willingness to share sensitive psychosocial concerns over the telephone. The results obtained from both feasibility studies suggest that telephone outcalls are feasible for both breast and prostate cancer patients. Additional research is proposed to test the efficacy of psychosocial counseling by telephone using an outcall format.
Mianserin in oncology: The issue of psychotropic‐related neutropenia
Authors: Berard Raymond , Wood Lucille , Viljoen Gary
Published: February 2007

In the psychopharmacological treatment of depression in cancer patients, mianserin appears to have advantages over other antidepressants. However, it is, claimed to be associated with an unacceptably high incidence of neutropenia. This claim was assessed by investigating the frequency of reported cases of mianserin‐related neutropenia against the estimated prescription figures in South Africa. Simultaneously, a more specific assessment was carried out in the form of a 10‐year retrospective analysis of all patients presenting with neutropenia to the Department of Haematology, Groote Schuur Hospital, South Africa. Ten patients (18% of the total) demonstrated a psychotropic drug‐related neutropenia, and in no instance could mianserin be incriminated. The haematological lesion reversed upon withdrawal of the drug in eight out of these patients as opposed to 12 out of 22 in the non‐drug‐related, idiopathic group. It would appear that the incidence of mianserin‐related neutropenia is no higher than with other psychotropic drugs and, similarly, the condition is reversible. It is concluded that mianserin would therefore be an appropriate first‐line agent in the treatment of depression in cancer patients, subject to suggested conditions.
Neuropsychiatric disturbance in cancer patients with epidural spinal cord compression receiving high dose corticosteroids: A prospective comparison study
Authors: Breitbart W. , Stiefel F. , Kornblith A. B. , Pannullo S.
Published: February 2007

In order to examine the impact of corticosteroids upon psychiatric symptomatology in cancer patients, we prospectively studied two groups: 50 cancer patients with epidural spinal cord compression (ESCC) receiving a standard tapering course of high‐dose dexamethasone (i.e. 100 mg loading dose followed by 96 mg per day tapered to 0 mg over 3–4 weeks), and a comparison group of 50 patients with the same cancer diagnoses and a similar extent of metastatic disease but without ESCC who did not receive dexamethasone. Psychiatric disorder, psychological distress, pain, mental status, physical performance status, medical events, and psychotropic and analgesic use were assessed in both groups at four points during the course of corticosteroid therapy or hospitalization. Measures included: (1) DSM‐III‐R psychiatric diagnosis; (2) Brief Psychiatric Rating Scale; (3) Hamilton Depression Scale; (4) Hamilton Anxiety Rating Scale; (5) Profile of Mood States; (6) Memorial Pain Assessment Card; (7) Mini‐Mental State Examination; and (8) Karnofsky Performance Status Score. While the overall rate of DSM‐III‐R psychiatric disorders was not significantly different between groups, patients receiving corticosteroids had a significantly greater incidence of major depressive syndromes (x2 = 6.08, p < 0.05), in particular organic mood disorder—depressed (x2 = 6.40, p < 0.05). There was also a tendency for a greater incidence of delirium (x2 = = p < 0.10) in the corticosteroid group. The corticosteroid group was significantly more depressed than the comparison group over time as measured by the non‐somatic items of the Hamilton Depression Rating Scale (F = 3.98, p < 0.02), and more anxious, as measured by the non‐somatic items of the Hamilton Anxiety Rating Scale (p < 0.10). Thus, a tapering regimen of high‐dose corticosteroids has an influence on the incidence and nature of neuropsychiatric disturbance in cancer patients with ESCC, resulting in a significantly greater incidence of depressive symptoms and disorders.
Information needs and decision‐making preferences of children with cancer
Authors: Ellis Robert , Leventhal Brigid
Published: February 2007

Surveys discussing information needs and decision‐making preferences were administered to 50 children with cancer (ages 8–17) and 60 accompanying parents. Children wanted information on all aspects of their disease and its treatment, particularly prognosis. 76% of children wanted to be told a percent chance for cure, no matter what it was. Only 38% of parents wanted their children to be given this information (p < 0.01). 95% of patients wanted to be told if they were terminally ill. The majority felt that the treatment decision was the physician's. Although 96% of patients did not want to make their own decisions about curative therapy, 63% of adolescents (≥13) wanted to make their own decisions about palliative therapy vs. 28% of younger patients (p = 0.018). Patients felt that people should be allowed to make decisions about participation in medical research at age 14, for treatment of minor medical problems at 16, and to refuse potentially curative therapy for cancer at 17. Parents often want to shield their children from adverse information, but most children want to be fully informed about their disease. Children usually do not want to make decisions about their initial therapy, but many feel that they should decide about palliation.
Cancer patients' attitudes to final events in life: Wish for death, attitudes to cessation of treatment, suicide and euthanasia
Authors: Owen Cathy , Tennant Christopher , Levi John , Jones Michael
Published: February 2007

One hundred patients with cancer were interviewed regarding their attitude to a range of final life events in both their current real and hypothetical future circumstances. Patients who anticipated a future possible role for the more passive options of wishing death to come early or ceasing all treatment, were more hopeless and had a reduced quality of life. Patients however who anticipated a role for the more active options of suicide and/or euthanasia were less fatalistic and did not report a reduced quality of life. The desire for suicide was particularly positively related to younger age, a personal psychiatric past history, and a number of treatment‐related variables reflecting increased patient autonomy.
Nurses' narratives concerning ethically difficult care situations: Interpretation by means of lögstrup's ethics
Authors: Åström G. , Norberg A. , Jansson L. , Hallberg I. R.
Published: February 2007

Lögstrup's ethics were used as a theoretical framework when interpreting 18 nurses' narratives about situations where it had been hard to know what was the right and good thing to do for a cancer patient. The phenomenological hermeneutic interpretation focused on (a) the nurses' experiences of sovereign and perverted utterances of life, ethical demands, interdependence and power; and (b) on the nurses' ways of relating to the ethical dimensions of the situation. In narratives about overwhelming care situations, the nurses did not make a conscious interpretation of whether the patients' demands were also the ethical demands of the situation. In these situations there seemed to be distrust and destructive interdependence between the co‐workers and it was seemingly difficult to be moved by the sovereign utterances of life. In narratives about situations which were possible to grasp, the nurses made a conscious effort to interpret the ethical demands of the situation and acted in accordance with their interpretation until a new interpretation was necessary. The interdependence among the co‐workers was used constructively in order to care for the patient.
The ethical dimensions of undermedication of pain
Authors: Ventafridda Vittorio
Published: February 2007

Pain is one of the major problems in advanced cancer patients. Reports of prevalence studies show an incidence ranging 25–90% in the terminal period (Bonica, 19080). Since the population is aging, the magnitude of this problem is growing large. The problem is greater due to the fact that palliative care is a neglected area; several million cancer patients suffer needlessly every day, making undertreatment of pain an ethical issue.
Adjuvant psychological therapy for patients with cancer: Outcome at one year
Authors: Moorey Stirling , Greer Steven , Watson Maggie , Baruch John D. R. , Robertson Bernadette M. , Mason Anne , Rowden Linda , Tunmore Robert , Law Matthew , Bliss Judith M.
Published: February 2007

Patients attending the Royal Marsden Hospital with newly diagnosed cancers or first recurrence were screened for psychological morbidity. A total of 174 patients who met the inclusion criteria were randomly allocated to either adjuvant psychological therapy, a brief, cognitive—behavioural treatment specially designed for cancer patients, or a routine care control. This paper reports the results of the study one year after the baseline assessment. A total of 134 patients completed questionnaires at one year. Patients who received therapy showed significantly less psychological distress measured on the Psychological Adjustment to Illness Scale. There was a tendency for patients in the therapy group to show more change on measures of helplessness and anxiety. Using the criteria for psychological morbidity employed at the time of entry into the study, at one year only 19% of therapy patients were still in the clinical range for anxiety compared with 44% of the control patients; 11% of therapy patients were in the clinical range for depression compared with 18% of the control patients. This study demonstrates that a brief psychological intervention can produce improvement in psychological functioning which persists up to 10 months after the end of the intervention; in particular, the number of patients who would still meet criteria for ‘caseness’ is reduced. These findings justify further investigation of the efficacy of adjuvant psychological therapy in cancer patients.
Psychological morbidity in the families of patients with cancer
Authors: Kissane David W. , Bloch Sidney , Burns W. Ivon , McKenzie Dean , Posterino Maria
Published: February 2007

An empirical study of 102 families of palliative care patients was undertaken to identify the prevalence of psychological morbidity in family members. Beck Depression Inventory‐derived caseness was identified in one‐half of patients, one‐third of spouses and one‐quarter of offspring, suggesting that psychological distress reverberates substantially throughout the nuclear family. Anger was significantly more common in the offspring, who perceived their families to have poorer communication, cohesion and more conflict than their parents, suggesting that information about the illness may not be adequately transmitted to them. The family as a group is the most appropriate recipient of care, and family meetings are advocated to promote communication, support and mutual understanding.
Bone marrow transplantation from programmed donor, five years on
Authors: Burgio Roberto G, , Verri Anna Pia , Nespoli Luigi
Published: February 2007

Certain peculiarities of a bone marrow transplantation (BMT), between two minor siblings are reconsidered; the recipient a 6.5 year old girl with an adult‐type chronic myeloid leukemia, was an only child, and her parents programmed a second pregnancy hoping that the future brother (sister) could be a compatible donor for BMT.

Five years after this unusual and successful BMT, the psychological profiles of the recipient, the donor and their parents are substantially normal. We can therefore consider favourable perspectives for well adjusted and normal relationships among the family members, as well as for the psycho‐intellectual development of these children.

Furthermore the re‐evaluation of the ethical questions and doubts concerning this ‘special experience’ suggests that the sons' and parents' rights have been fully respected.
Clinical update
Authors: Holland Jimmie , Breitbart William
Published: February 2007

This issue inaugurates a new Section of Psycho‐Oncology called Clinical Update. It is edited by Dr Donna reenberg, Editor of the ASPOA Newsletter and Dr William Breitbart, Editor of the Network Newsletter. Both psychiatrists review the literature regularly to identify articles for their Newsletters which they believe are of interest to professionals working in psycho‐oncology. This section integrates information from their Newsletters into Psycho‐Oncology making their reviews available to our broader audience. Dr Ann Cull has agreed to participate t o assure review of the European journals.
Psycho‐oncology: Its aims, achievements and future tasks
Authors: Greer S.
Published: February 2007

This paper contains an overview of psycho‐oncology. A definition of this discipline and its aims is given. Advances in knowledge are described in the following areas: the psychological toll of cancer and its treatments, psychological factors affecting quality of life, psychological precursors of cancer, psychological prognostic factors and psychobiological research. Advances in clinical practice comprise the development and controlled evaluation of psychological therapy for cancer patients. Finally, some major challenges facing psycho‐oncology in the immediate future are listed.
A randomized study of a rehabilitation program for cancer patients: The ‘starting again’ group
Authors: Berglund Gunilla , Bolund Christina , Gustafsson Ulla‐Lena , Sjödén Per‐Olow
Published: February 2007

This study compares, in a prospective randomized design, a rehabilitation ‘Starting again’ program for cancer patients (n = 98) and a control condition (n = 101). Assessments were carried out pre‐ and post‐intervention and at a 3 months follow‐up. The program consisted of 11 structured, two‐hour sessions run for a period of seven weeks by an oncology nurse specialist assisted by experts in various fields. The contents focused on physical training, information and coping skills training. Patients in the ‘Starting again’ condition improved significantly more than controls with respect to physical training, physical strength, body avoidance, appraisal of having received sufficient information, fighting spirit and frequency of sleeping problems. Results indicate improvement with respect to the three areas focused on in the ‘Starting again’ program: physical training, information and coping skills training.
Effects of behavioral intervention on plasma cortisol and lymphocytes in breast cancer patients: An exploratory study
Authors: Schedlowski Manfred , Jung Carsten , Schimanski Giesela , Tewes Uwe , Schmoll Hans‐Joachim
Published: February 2007

In order to evaluate the effects of a behavioral intervention on endocrine and immunological parameters, 24 breast cancer patients were investigated after standard surgical treatment of their tumors and without adjuvant tumor treatment. Of these, 14 patients were allocated to the intervention group and 10 patients served as controls. Interventions were conducted once a week over a period of 10 weeks. To determine short‐ and longer‐term intervention effects on plasma concentration of cortisol and lymphocyte numbers, blood samples were taken before and after the second and 10th session. Psychological variables such as illness‐related coping showed no changes within the intervention period (10 weeks). However, there were short‐ (pre‐ versus post sessions) and longer‐term (9 weeks) reductions in plasma levels of cortisol in the intervention group. In parallel to the reduced plasma concentration of cortisol, a short‐term increase of lymphocyte numbers after the second and the 10th session, as well as an increase over a period of nine weeks in the intervention group, was observed. This data indicate that behavioral intervention influences endocrine and immunological functions in breast cancer patients.
Do cancer suicides differ from others?
Authors: Hietanen Päivi , Lönnqvist Jouko , Henriksson Markus , Jallinoja Piia
Published: February 2007

Based on a nationwide psychological autopsy study comprising all suicides committed in Finland during one year (n = 1397), victims who had suffered from cancer (n = 60) were compared with other suicides. Cancer suicides were significantly older and more often male, which required adjusting the control group (n = 60) for age and sex. The cancer suicides had more pain and were more often physically disabled. The social network of cancer patients was stronger: 93% of them and 65% of the control cases had a significant other. Family histories of mental disorder were more common in the control group. Cancer was the main underlying factor in the suicide process in 62% of the cancer patients and a contributing factor in 23%. Background factors of the suicide process of the cancer patients with terminal illness (n = 18) were different from those with cancer in remission and from victims among the general population. The frequency of physical symptoms and of depression before suicide in cancer patients emphasizes the need for more competent palliative care and psychological support for cancer patients.
Parents' recall on the diagnosis of cancer in their child
Authors: Eiser C. , Parkyn T. , Havermans T. , McNinch A.
Published: February 2007

Mothers (n = 28) and fathers (n = 23) of 30 children with cancer were interviewed separately about their recall of the period immediately before the diagnosis, and their experiences during the diagnostic interview. Information about how the children were told, and by whom, was also elicited. Parents reported considerable delay between the time when they first sought professional advice about their child and the diagnosis being confirmed (mean = 17 weeks). The longer it took for parents to achieve a diagnosis, the more they subsequently blamed the general practitioner (p < 0.05). All children over 8 years of age were informed about treatment, usually by the consultant. On diagnosis, all parents recalled that information was given about cancer and proposed treatment. Fewer recalled that any information was given about side‐effects, complications or the cause. Implications for when these issues should be considered are discussed. Many parents felt unable to ask questions even when given the opportunity. The data point to the need to improve communications between families, specialist hospitals and local services.
Quality of life questionnaires in cancer clinical trials: Imputing missing values
Authors: Morris Jenny , Coyle Douglas
Published: February 2007

Quality of life is increasingly being used as a measure of outcome in comparative cancer clinical trials. Even when quality of life studies are well funded vis‐à‐vis data collection and processing, it is unlikely that data sets will be 100% complete, leading to problems at the data analysis stage. Missing data can arise as a consequence of whole assessments being missed due to death or other reasons, or as a result of single items being omitted from particular questionnaires. This paper addresses the latter category of missing data and examines the effects on subscale scores of imputing values for missing items from the Hospital Anxiety and Depression Scale and the psychological complaints subscale of the Rotterdam Symptom Checklist.