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Vandœuvre-lès-Nancy, France

Genetic or epidemiological tests can be used to determine a person’s risk of developing a new or recurrent familial breast cancer. Not only cognitive but factors such as anxiety influence understanding of and confidence in the results, decision-making, and satisfaction with testing. Emotion plays a strong role in the perception of risk information but is frequently underemphasized in the medical communication. We discuss and put into context several reflections that explore the whole setting and course of life after being labeled as a person at high risk. © 2014, Springer-Verlag France. Source

Hannoun-Levi J.-M.,Center Antoine Lacassagne | Hannoun-Levi J.-M.,University of Nice Sophia Antipolis | Peiffert D.,Institute Of Cancerologie Of Lorraine

For more than a century, brachytherapy has been a treatment of choice for delivering a high dose in a small volume. However, over the past 15years, this irradiation technique has stalled. Even so, brachytherapy allows the delivery of the right dose at the right place by dispensing with target volume motion and repositioning. The evolution of brachytherapy can be based on a road-map including at least the following three points: the acquisition of clinical evidence, teaching and valuation of the procedures. The evolution of brachytherapy will be also impacted by technological considerations (end of the production of low dose rate 192 iridium wires). Regarding the evolution toward a personalized treatment, brachytherapy of the future should take its place as a partner of other modern external beam radiation techniques, be performed by experimented actors (physicians, physicists, technicians, etc.) who received adequate training, and be valued in proportion to the delivered medical service. © 2013 Société française de radiothérapie oncologique (SFRO). Source

Gangler A.,Institute Of Cancerologie Of Louest | Lesur A.,Institute Of Cancerologie Of Lorraine | Dalenc F.,Institute Claudius Regaud

The growing number of breast cancer survivors challenges healthcare organizations, particularly oncology specialty and primary care providers. Currently, in France, the follow-up care is based on detection of recurrences, of second primary contralateral breast cancer, of long-term treatment sequelae, in addition to psychosocial consequences of cancer and its treatment. This review will discuss the evidence base and intents of breast cancer survivorship care plans (CSCPs) as a wellness model for cancer survivors in clinical setting, mainly providing health promotion recommendations such as regular exercise. The CPCPs involve multidisciplinary approach and patient–physician communication. Therefore, this comprehensive care will improve their quality of life, treatment compliance, and general health care maintenance. This article offers innovative guidance to implement the post-cancer patient care and includes the relevant templates to be submitted to the patients. © 2016, Springer-Verlag France. Source

Demoor-Goldschmidt C.,Institute Of Cancerologie Of Louest | Bernier V.,Institute Of Cancerologie Of Lorraine
Bulletin du Cancer

Pediatric radiotherapy did not differ technically from adult radiotherapy but its characteristics, its difficulties and challenges are specific. Thanks in part to this treatment, overall survival of French children with cancer is around 80%. It is therefore important to integrate in the elaboration of the treatment planning potential side long-term effects. Indeed, whatever the technique is, even the most sophisticated, it is usually inevitable that healthy nearby organs receive a dose of radiation. Dose limits on organs at risk come from adult data and are adapted for children. After the treatment, it is important to graduate the potential risks of side effects to propose a personalized monitoring protocol avoiding excessive medicalization. This article presents the medical thinking concerning radiotherapy in different anatomical areas (brain, head and neck, chest, abdomen) including concepts of dose level corresponding to side effects usually described. In parallel, we present follow-up recommendations with the aim to preserve an optimal quality of life for the adults cured of a childhood cancer, currently called survivors. © 2015 Société Française du Cancer. Publié par Elsevier Masson SAS. Tous droits réservés. Source

Bressenot A.,University of Lorraine | Salleron J.,Institute Of Cancerologie Of Lorraine | Bastien C.,University of Lorraine | Danese S.,center | And 2 more authors.

Background: Assessment of disease activity in UC is important for designing an optimal therapeutic strategy. No single histology score is considered optimum. The aim of this study was to compare intraobserver reproducibility and the interobserver agreement of available histological UC activity indexes. Methods: One hundred and two biopsy specimens (collected between 2003 and 2014) were scored blindly by three pathologists by determining Geboes, Riley, Gramlich and Gupta indexes and global visual evaluation (GVE). Intraobserver reproducibility and interobserver agreements for index and items of index were studied by intraclass correlation coefficient for quantitative parameter and by ê values and Krippendorff index for qualitative parameters. Relationship between indexes was studied by computation of Pearson's and Spearman's correlation coefficients. Results: Geboes, Riley, Gramlich and Gupta indexes and GVE showed good intraobserver reproducibility and a good interobserver agreement. Histological items that showed the best interobserver agreement were 'erosion/ulceration or surface epithelial integrity' and 'acute inflammatory cells infiltrate/neutrophils in lamina propria'. The five scores were strongly correlated. Conclusions: Correlation between indexes is strong. Intraobserver reproducibility and interobserver agreement for all indexes is very good. Histological items that showed the best interobserver agreement are 'erosion/ulceration' and 'acute inflammatory cells infiltrate/neutrophils in lamina propria'. Source

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