General Information on Cancer Staging and End-Results Reporting.- Purposes and Principles of Cancer Staging.- Cancer Survival Analysis.- Head and Neck.- Lip and Oral Cavity.- Pharynx.- Larynx.- Nasal Cavity and Paranasal Sinuses.- Major Salivary Glands.- Thyroid.- Mucosal Melanoma of the Head and Neck.- Digestive System.- Esophagus and Esophagogastric Junction.- Stomach.- Small Intestine.- Colon and Rectum.- Anus.- Gastrointestinal Stromal Tumor.- Neuroendocrine Tumors.- Liver.- Intrahepatic Bile Ducts.- Gallbladder.- Perihilar Bile Ducts.- Distal Bile Duct.- Ampulla of Vater.- Exocrine and Endocrine Pancreas.- Thorax.- Lung.- Pleural Mesothelioma.- Musculoskeletal Sites.- Bone.- Soft Tissue Sarcoma.- Skin.- Cutaneous Squamous Cell Carcinoma and Other Cutaneous Carcinomas.- Merkel Cell Carcinoma.- Melanoma of the Skin.- Breast.- Breast.- Gynecologic Sites.- Vulva.- Vagina.- Cervix Uteri.- Corpus Uteri.- Ovary and Primary Peritoneal Carcinoma.- Fallopian Tube.- Gestational Trophoblastic Tumors.- Genitourinary Sites.- Penis.- Prostate.- Testis.- Kidney.- Renal Pelvis and Ureter.- Urinary Bladder.- Urethra.- Adrenal.- Ophthalmic Sites.- Carcinoma of the Eyelid.- Carcinoma of the Conjunctiva.- Malignant Melanoma of the Conjunctiva.- Malignant Melanoma of the Uvea.- Retinoblastoma.- Carcinoma of the Lacrimal Gland.- Sarcoma of the Orbit.- Ocular Adnexal Lymphoma.- Central Nervous System.- Brain and Spinal Cord.- Lymphoid Neoplasms.- Lymphoid Neoplasms.

AJCC Cancer Staging Manual

Ductal carcinoma in situ (DCIS) of the breast represents a heterogeneous group of neoplastic lesions in the breast ducts. The goal for management of DCIS is to prevent the development of invasive breast cancer. This manuscript focuses on the NCCN Guidelines Panel recommendations for the workup, primary treatment, risk reduction strategies, and surveillance specific to DCIS.

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Clinical practice guidelines in oncology

Depression is the psychiatric syndrome that has received the most attention in individuals with cancer. The study of depression has been a challenge because symptoms occur on a broad spectrum that ranges from sadness to major affective disorder and because mood change is often difficult to evaluate when a patient is confronted by repeated threats to life, is receiving cancer treatments, is fatigued, or is experiencing pain. Although many research groups have assessed depression in cancer patients since the 1960s, the reported prevalence (major depression, 0%-38%; depression spectrum syndromes, 0%-58%) varies significantly because of varying conceptualizations of depression, different criteria used to define depression, differences in methodological approaches to the measurement of depression, and different populations studied. Depression is highly associated with oropharyngeal (22%-57%), pancreatic (33%-50%), breast (1.5%-46%), and lung (11%-44%) cancers. A less high prevalence of depression is reported in patients with other cancers, such as colon (13%-25%), gynecological (12%-23%), and lymphoma (8%-19%). This report reviews the prevalence of depression in cancer patients throughout the course of cancer.

Prevalence of depression in patients with cancer.

Objective: To review systematically prospective, observational, cohort studies of the association between positive well-being and mortality using meta-analytic methods. Recent years have witnessed increased interest in the relationship between positive psychological well-being and physical health. Methods: We searched general bibliographic databases: Medline, PsycINFO, Web of Science, and PubMed up to January 2008. Two reviewers independently extracted data on Study characteristics, quality, and estimates of associations. Results: There were 35 studies (26 articles) investigating mortality in initially healthy Populations and 35 studies (28 articles) of disease populations. The meta-analyses showed that positive psychological well-being was associated with reduced mortality in both the healthy population (combined hazard ratio (HR) = 0.82; 95% Confidence Interval (Cl) = 0.76-0.89; p < .001) and the disease Population (combined FIR = 0.98; CI = 0.95-1.00; p = .030) studies. There were indications Of publication bias in this literature, although the fail-safe numbers were 2444 and 1397 for healthy and disease Population studies,, respectively. Intriguingly, meta-analysis of studies that controlled for negative affect showed that the protective effects of positive psychological well-being were independent of negative affect. Both positive affect (e.g., emotional well-being, positive mood, joy, happiness, vigor, energy) and positive trait-like dispositions (e.g., life satisfaction, hopefulness, optimism, sense of humor) were associated with reduced mortality in healthy population Studies. Positive psychological well-being was significantly associated with reduced cardiovascular mortality in healthy population studies, and with reduced death rates in patients with renal failure and with human immunodeficiency virus-infection. Conclusions: The Current review suggests that positive psychological well-being has a favorable effect on survival in both healthy and diseased populations.

Positive psychological well-being and mortality: a quantitative review of prospective observational studies.

Thank you for downloading textbook of work physiology physiological bases of exercise. As you may know, people have look hundreds times for their chosen novels like this textbook of work physiology physiological bases of exercise, but end up in infectious downloads. Rather than reading a good book with a cup of tea in the afternoon, instead they cope with some harmful virus inside their desktop computer.

Textbook Of Work Physiology Physiological Bases Of Exercise

1in the teaching of communication skills in medical schools has increased since the early seventies but, despite this growing interest, relatively limited curricular time is spent on the teaching of communication skills. The limited attention to the teaching of these skills applies even more to the physicians’ clinical years, when attention becomes highly focused on biomedical and technical competence. Continuing training after medical school is necessary to refresh knowledge and skills, to prohibit decline of performance and to establish further improvements. Objective This review provides an overview of evaluation studies of communication skills training programmes for clinically experienced physicians who have finished their undergraduate medical education. The review focuses on the training objectives, the applied educational methods, the evaluation methodology and instruments, and training results. Methods CD-ROM searches were performed on MedLine and Psychlit, with a focus on effect-studies dating from 1985. Results Fifteen papers on 14 evaluation studies were located. There appears to be some consistency in the aims and methods of the training programmes. Course effect measurements include physician self-ratings, independent behavioural observations and patient outcomes. Most of the studies used inadequate research designs. Overall, positive training effects on the physicians’ communication behaviour are found on half or less of the observed behaviours. Studies with the most adequate 2 designs report the fewest positive training effects. Conclusion Several reasons are discussed to explain the limited findings. Future research may benefit from research methods which focus on factors that inhibit and facilitate the physicians’ implementation of skills into actual behaviours in daily practice.

/pdf/teaching-clinically-experienced-physicians-communication-3o8cpbcqti.pdf

Teaching clinically experienced physicians communication skills. A review of evaluation studies.

Objectives: To describe prospectively the long-term changes of quality of life and mood in patients with squamous cell carcinoma of the head and neck treated with surgery and/or radiotherapy



Patients and Methods: One hundred seven patients completed the European Organization for Research and Treatment of Cancer (EORTC) Core Questionnaire, the EORTC Head and Neck Cancer Module, and the Center for Epidemiological Studies Depression Scale before treatment, and 6, 12, 24, and 36 months later



Results: There was limited deterioration of physical and role functioning and of many head and neck symptoms at 6 months, with improvement thereafter After 36 months only physical functioning, taste/smell, dry mouth, and sticky saliva were significantly worse, compared with baseline Female sex, higher cancer stage, and combination treatment were associated with more symptoms and worse functioning Despite physical deterioration, there was a gradual improvement of depressive symptomatology and global quality of life



Conclusion: Treatment for head and neck cancer results in short-term morbidity, most of which resolves within 1 year Despite an initially high level of depressive symptomatology, there is gradual improvement of psychological functioning and global quality of life over the course of 3 years In this prospective study, the impact of the disease and its treatment in long-term survivors seems to be less severe than it is often assumed to be

Long-term quality of life of patients with head and neck cancer.

Background

Quality of life (QOL) has become an important issue in head and neck cancer. Explanation of factors predicting QOL after treatment has important implications for patient management.



Methods

In this prospective study we analyzed which pretreatment factors predicted QOL after surgery and/or radiotherapy with curative intent in a cohort of 153 patients with cancer of the oral cavity, oropharynx, hypopharynx, or larynx. The patients completed the EORTC Core Questionnaire, the EORTC Head and Neck Cancer module, and the Center for Epidemiologic Studies Depression scale before treatment and 6 and 12 months later. The influence of gender, age, performance status, and depressive symptoms at baseline, site, stage, and treatment on QOL (and its dimensions) and depressive symptoms after 6 and 12 months was studied, using linear regression analysis.



Results

A high level of depressive symptoms and a low performance status at baseline and combination treatment were significant predictors of increased severity of symptoms and poor functioning after treatment. Treatment was a predictor of head and neck symptoms, whereas performance status and depressive symptoms were predictors of general symptoms and functioning. Gender and age had little predictive value.



Conclusions

Patients with depressive symptoms or a low performance status who receive combination treatment for cancer of the head and neck are at risk for physical and psychologic morbidity after treatment. Special attention should be given to these patients in rehabilitation programs. © 2000 John Wiley & Sons, Inc. Head Neck 22: 398–407, 2000.

Wynand J. G. Ros

Papers

Teaching clinically experienced physicians communication skills. A review of evaluation studies.

Long-term quality of life of patients with head and neck cancer.

Pretreatment factors predicting quality of life after treatment for head and neck cancer.

Sociodemographic factors and quality of life as prognostic indicators in head and neck cancer

A prospective study on quality of life of patients with cancer of the oral cavity or oropharynx treated with surgery with or without radiotherapy