Wood D.,Beaumont Cancer Institute |
Patricolo G.E.,Integrative Medicine
Alternative and Complementary Therapies | Year: 2013
Guided imagery belongs to the mind-body area of CAM. In guided imagery, the subject's thoughts and imagination are focused and directed toward a specific goal by a facilitator. Guided imagery involves all five senses and is based on the understanding that the body and mind are connected, and that the mind can influence the body. Guided imagery is a low-cost treatment that is portable, can be self-administered by the subject with minimal guidance, and has no known side-effects for most patients. This article discusses how guided imagery can be incorporated into different clinical settings and how it can be used to benefit employees, patients, and caregivers in a cost effective manner that can potentially lower employer and insurance costs. © 2013, Mary Ann Liebert, Inc. 2013.
Dallo F.J.,Oakland University |
Zakar T.,Oakland University |
Borrell L.N.,Lehman College, CUNY |
Fakhouri M.,Beaumont Cancer Institute |
Jamil H.,Wayne State University
Journal of Cancer Education | Year: 2011
The objective of this study was to examine which factors are associated with increased cancer knowledge among a sample of 866 Arab Americans 40 years of age or older. Individuals were invited to attend a cancer educational intervention and obtain a free cancer health screening. They were asked to complete a precancer and postcancer knowledge survey after the brief educational intervention. Using logistic regression, we found that the intervention increased cancer knowledge and the variables most associated with this improvement were having low education, being unemployed, having lived in the USA for 0-5 years, older age, not having insurance, and not exercising. Our study showed that these interventions may be more effective if tailored to the participant's educational, employment, duration in the US, and health behavior status. Future studies should examine whether cancer screening actually increases after an educational intervention. © Springer 2010.
Smith B.D.,University of Texas M. D. Anderson Cancer Center |
Smith B.D.,Shaw Regional Cancer Center |
Bentzen S.M.,University of Wisconsin - Madison |
Correa C.R.,University of Michigan |
And 12 more authors.
International Journal of Radiation Oncology Biology Physics | Year: 2011
Purpose: In patients with early-stage breast cancer treated with breast-conserving surgery, randomized trials have found little difference in local control and survival outcomes between patients treated with conventionally fractionated (CF-) whole breast irradiation (WBI) and those receiving hypofractionated (HF)-WBI. However, it remains controversial whether these results apply to all subgroups of patients. We therefore developed an evidence-based guideline to provide direction for clinical practice. Methods and Materials: A task force authorized by the American Society for Radiation Oncology weighed evidence from a systematic literature review and produced the recommendations contained herein. Results: The majority of patients in randomized trials were aged 50 years or older, had disease Stage pT1-2 pN0, did not receive chemotherapy, and were treated with a radiation dose homogeneity within ±7% in the central axis plane. Such patients experienced equivalent outcomes with either HF-WBI or CF-WBI. Patients not meeting these criteria were relatively underrepresented, and few of the trials reported subgroup analyses. For patients not receiving a radiation boost, the task force favored a dose schedule of 42.5 Gy in 16 fractions when HF-WBI is planned. The task force also recommended that the heart should be excluded from the primary treatment fields (when HF-WBI is used) due to lingering uncertainty regarding late effects of HF-WBI on cardiac function. The task force could not agree on the appropriateness of a tumor bed boost in patients treated with HF-WBI. Conclusion: Data were sufficient to support the use of HF-WBI for patients with early-stage breast cancer who met all the aforementioned criteria. For other patients, the task force could not reach agreement either for or against the use of HF-WBI, which nevertheless should not be interpreted as a contraindication to its use. Copyright © 2011 Elsevier Inc.
Patricolo G.E.,Beaumont Health System |
Armstrong K.,Beaumont Health System |
Riutta J.,Beaumont Health System |
Lanni T.,Beaumont Cancer Institute
Breast | Year: 2015
Lymphedema is a serious complication that involves the accumulation of protein-rich fluid in the interstitial space. Lymphedema is common after treatment for breast cancer, especially for those patients receiving axillary lymph node dissection. Severe lymphedema is associated with serious morbidities such as swelling, fibrosis, decreased function, reduced range of motion, infection, and pain. Here, we discuss a unique, multi-disciplinary approach to effectively manage patients during and after breast cancer therapy. In this approach, patient education and screening are implemented in various departments throughout the health care system, including Physical Therapy and Rehabilitation, Integrative Medicine, and the Breast Care Center, which houses the Lymphedema Clinic. Early patient education and regular screening are combined with aggressive treatment for overt disease to effectively manage lymphedema in the at-risk population. © 2014 Elsevier Ltd.
PubMed | Beaumont Cancer Institute
Type: Journal Article | Journal: American journal of clinical oncology | Year: 2013
In order to demonstrate the impact of multidisciplinary care in the community oncology setting, we evaluated treatment decisions after the initiation of a dedicated prostate and genitourinary (GU) multidisciplinary clinic (MDC).In March 2010, a GU MDC was created at William Beaumont Hospital with the goal of providing patients with a comprehensive multidisciplinary evaluation and consensus treatment recommendations in a single visit. Urologists, radiation, and medical oncologists along with ancillary support staff participated in this comprehensive initial evaluation. The impact of this experience on patient treatment decisions was analyzed.During the first year, a total of 182 patients were seen. Compared with previous years, low-risk MDC patients more frequently chose external beam radiation therapy (41.1% vs. 26.6%, P=0.02), and active surveillance (14.3% vs. 6.1%, P=0.02) and less frequently prostatectomy (30.4% vs. 44.0%, P=0.03). Similar increases in external beam were seen in intermediate and high-risk patients. Increased use of hormonal therapy was found in high-risk patients compared with the years before the initiation of the MDC (76.2% vs. 51.1%, P=0.03). Increased adherence to National Comprehensive Cancer Network (NCCN) guidelines was seen with intermediate-risk patients (89.8% vs. 75.9%, P=0.01), whereas nonsignificant increases were seen in low-risk (100% vs. 98.9%, P=0.43) and high-risk patients (100% vs. 94.2%, P=0.26).The establishment of a GU MDC improved the quality of care for cancer patients as demonstrated by improved adherence to National Comprehensive Cancer Network guidelines, and a broadening of treatment choices made available.
PubMed | Beaumont Cancer Institute
Type: Journal Article | Journal: Clinical breast cancer | Year: 2012
Limited data exist on the use of accelerated partial breast irradiation (APBI) in patients with ductal carcinoma in situ (DCIS). The purpose of this analysis was to evaluate clinical outcomes after APBI in patients with DCIS.Between December 2002 and December 2010, 99 patients with DCIS underwent APBI as part of their breast-conserving therapy (BCT). Partial breast irradiation techniques included interstitial brachytherapy, balloon-based brachytherapy, and 3-dimensional conformal radiotherapy (3D-CRT). Clinical outcomes including local recurrence, regional recurrence, disease-free survival (DFS), cause-specific survival, and overall survival (OS) were analyzed.Mean follow up was 3.0 years, with a mean patient age of 61.8 years. At 5 years, the rates of local recurrence and regional recurrence were 1.4% and 0%, respectively. Overall survival was 94%, whereas cause-specific survival was 100%. No difference was noted in local control for each treatment technique. When comparing rates using the Eastern Cooperative Oncology Group (ECOG) E-5194 trial groupings, the rate of local recurrence in our cohort was 2.0% for patients with grade I/II disease < 2.5 cm and 0% for grade III < 1.0 cm, representing a 50% and 100% decrease, respectively, in local recurrence compared with excision alone.Patients with DCIS treated with APBI had excellent clinical outcomes regardless of the APBI technique used. Until the publication of prospective phase III trials, these data confirm previous reports highlighting the efficacy of APBI in the treatment of noninvasive carcinoma of the breast.