Showing papers by "Carol Sawka published in 2004"
TL;DR: Primary care follow-up of breast cancer patients is a safe and acceptable alternative to specialist follow-ups, and there were no differences between groups in QL as measured by the SF36 Physical and Mental Component Scales and the HADS anxiety and depression scales.
Abstract: 665 Background: Breast cancer patients usually receive follow-up in cancer centers. From the results of preliminary research (Grunfeld, BMJ 1996;313:665), we hypothesized that routine follow-up in primary care is a safe and acceptable alternative to follow-up in specialist care. Methods: Women with early stage breast cancer who had completed adjuvant therapy (patients may have continued on adjuvant hormonal therapy), who were disease free and between 9 and 15 months after diagnosis, were allocated to receive follow-up in a cancer center according to usual practice (CC arm) or follow-up from their family physician (FP arm). Patients in the FP arm were referred back to the cancer center if diagnosed with recurrence or a new primary cancer. The primary outcome was a comparison of the rate of ‘serious clinical events’ (SCE) defined as any one of the following: spinal cord compression, pathological fractures, hypercalcaemia, uncontrolled local recurrence, brachial plexopathy, or poor functional status (Karnofs...
18 citations
TL;DR: Examination of patterns of T use in three Canadian provinces found the presence of a centralized cancer system led to better adherence to federal agency recommendations and less restrictive guidelines may facilitate earlier use of T.
Abstract: 633 Background: New therapies for breast cancer are not always readily and appropriately adopted in clinical practice. The objective of this study was to examine patterns of T use in three Canadian provinces: Ontario (ON), Quebec (QC) and British Columbia (BC). While all 3 provinces have publicly funded health care systems, the care delivery models are different. ON has a centralized cancer system with the use of evidence based guidelines and the requirement for completion of new drug eligibility forms. BC has a more centralized system with less restrictive guidelines and implementation requirements. QC has none of these factors. In 1999 the federal regulatory agency approved T for use as a single agent or combined with chemotherapy in HER 2 positive metastatic breast cancer (MBC). ON and BC guidelines recommended T for use in combination with paclitaxel (P) or vinorelbine (V) (the latter in BC only) after anthracycline failure or as a single agent after taxane failure. Methods: Case specific data were co...
4 citations