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Orange Cove, CA, United States

Ash R.B.,The Center for Cancer Prevention and Treatment
Oncology (Williston Park, N.Y.) | Year: 2013

Over one-quarter of a million cases of breast cancer are diagnosed in the United States each year, many of which are early stage.The radiotherapeutic options after breast-conserving surgery in early-stage breast cancer are evolving quickly, with a focus on minimizing treatment volume, toxicity, and treatment duration. One such emerging option is intraoperative radiotherapy (IORT), administered either as a single fraction or as a boost.With many centers seeking to adopt such technology, there are licensing, proctoring, staffing, technical support, and reimbursement issues that need to be considered. We have reviewed the current international experience and describe one community cancer center's experience with initiating an IORT breast cancer program. Source


Kaminska-Winciorek G.,The Center for Cancer Prevention and Treatment | Gajda M.,Clinical Oncology Ward | Wydmanski J.,Branch | Tukiendorf A.,Center of Oncology of Poland
Asian Pacific Journal of Cancer Prevention | Year: 2015

Background: Skin self-examination (SSE) may facilitate early diagnosis of melanoma at a potentially curable stage. Little data are available concerning the SSE frequency and knowledge about the symptoms of melanoma in non-patient populations. The aim of our study was to assess the performance of skin self-examination, recognition of potential melanoma symptoms as well as behavior related to sun exposure among web users in Poland. Materials and Methods: A cross-sectional study was conducted among readers of a scientific portal. Invited respondents were asked to complete an online questionnaire. Finally, statistical analysis was conducted on 4,919 surveys towards potential clinical signs of melanoma and SSE performance. Results: Approximately 60% of respondents had ever performed SSE in their life. Only 18.4 % declared performance on a regular, monthly, basis. Factors promoting this activity were established to be bigger place of residence, higher education and sensitive skin phototype, higher level of knowledge concerning melanoma, safe tanning rules and, especially, past surgical excision of naevi. Declared longer use of tanning beds was linked to understanding better the importance of clinical features of melanoma. Awareness of hazardous behavior during sunbathing is associated with the attempts to change them. Conclusions: Regular SSE is not a common practice, whilst the knowledge about the clinical features of melanoma is varied. Therefore, constant pressure should be put on promotion of regular skin self-examination and teaching its proper techniques, including familiarity with the ABCD (asymmetry; border; color; diameter) rule and its extension of "EFG" (elevated, firm, progressive growth) criteria. Source


Arnold B.,FACITtrans LLC | Mitchell S.A.,U.S. National Cancer Institute | Lent L.,FACITtrans LLC | Mendoza T.R.,University of Texas M. D. Anderson Cancer Center | And 9 more authors.
Supportive Care in Cancer | Year: 2016

Purpose: The U.S. NCI’s PRO-CTCAE is a library of self-report items for assessing symptomatic adverse events in cancer clinical trials from the patient perspective. The aim of this study was to translate and linguistically validate a Spanish version. Methods: PRO-CTCAE’s 124 items were translated from English into Spanish using multiple forward and back translations. Native Spanish speakers undergoing cancer treatment were enrolled at six cancer treatment sites. Participants each completed approximately 50 items and were then interviewed using cognitive probes. The interviews were analyzed at the item level by linguistic themes, and responses were examined for evidence of equivalence to English. Items for which ≥20 % of participants experienced difficulties were reviewed, and phrasing was revised and then retested in subsequent interviews. Items where <20 % of respondents experienced difficulties were also reviewed and were considered for rephrasing and retesting. Results: One hundred nine participants from diverse Spanish-speaking countries were enrolled (77 in Round 1 and 32 in Round 2). A majority of items were well comprehended in Round 1. Two items presented difficulties in ≥20 % of participants and were revised/retested without further difficulties. Two items presented difficulties in <20 %, and when retested exhibited no further difficulties. Two items presented difficulties in <20 %, but were not revised due to lack of alternatives. Sixteen items presented difficulties in ≤12 % and were not revised because difficulties were minor. Conclusions: The Spanish PRO-CTCAE has been developed and refined for use in Spanish-speaking populations, with high levels of comprehension and equivalence to the English PRO-CTCAE. Trial registration: ClinicalTrials.gov:NCT01436240 © 2016, Springer-Verlag Berlin Heidelberg (outside the USA). Source


Bennett A.V.,University of North Carolina at Chapel Hill | Mitchell S.A.,U.S. National Cancer Institute | Mendoza T.R.,University of Texas M. D. Anderson Cancer Center | Reeve B.B.,University of North Carolina at Chapel Hill | And 22 more authors.
Health and Quality of Life Outcomes | Year: 2016

Background: PRO-CTCAE is a library of items that measure cancer treatment-related symptomatic adverse events (NCI Contracts: HHSN261201000043C and HHSN 261201000063C). The objective of this study is to examine the equivalence and acceptability of the three data collection modes (Web-enabled touchscreen tablet computer, Interactive voice response system [IVRS], and paper) available within the US National Cancer Institute (NCI) Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) measurement system. Methods: Participants (n = 112; median age 56.5; 24% high school or less) receiving treatment for cancer at seven US sites completed 28 PRO-CTCAE items (scoring range 0-4) by three modes (order randomized) at a single study visit. Subjects completed one page (approx. 15 items) of the EORTC QLQ-C30 between each mode as a distractor. Item scores by mode were compared using intraclass correlation coefficients (ICC); differences in scores within the 3-mode crossover design were evaluated with mixed-effects models. Difficulties with each mode experienced by participants were also assessed. Results: 103 (92%) completed questionnaires by all three modes. The median ICC comparing tablet vs IVRS was 0.78 (range 0.55-0.90); tablet vs paper: 0.81 (0.62-0.96); IVRS vs paper: 0.78 (0.60-0.91); 89% of ICCs were ≥0.70. Item-level mean differences by mode were small (medians [ranges] for tablet vs. IVRS = -0.04 [-0.16-0.22]; tablet vs paper = -0.02 [-0.11-0.14]; IVRS vs paper = 0.02 [-0.07-0.19]), and 57/81 (70%) items had bootstrapped 95% CI around the effect sizes within +/-0.20. The median time to complete the questionnaire by tablet was 3.4min; IVRS: 5.8; paper: 4.0. The proportion of participants by mode who reported "no problems" responding to the questionnaire was 86% tablet, 72% IVRS, and 98% paper. Conclusions: Mode equivalence of items was moderate to high, and comparable to test-retest reliability (median ICC = 0.80). Each mode was acceptable to a majority of respondents. Although the study was powered to detect moderate or larger discrepancies between modes, the observed ICCs and very small mean differences between modes provide evidence to support study designs that are responsive to patient or investigator preference for mode of administration, and justify comparison of results and pooled analyses across studies that employ different PRO-CTCAE modes of administration. Trial registration: NCT Clinicaltrials.gov identifier: NCT02158637 © 2016 Bennett et al. Source


Ash R.B.,The Center for Cancer Prevention and Treatment | Williams V.L.,The Center for Cancer Prevention and Treatment | Wagman L.D.,The Center for Cancer Prevention and Treatment | Forouzannia A.,The Center for Cancer Prevention and Treatment
ONCOLOGY (United States) | Year: 2013

Over one-quarter of a million cases of breast cancer are diagnosed in the United States each year, many of which are early stage. The radiotherapeutic options after breast-conserving surgery in early-stage breast cancer are evolving quickly, with a focus on minimizing treatment volume, toxicity, and treatment duration. One such emerging option is intraoperative radiotherapy (IORT), administered either as a single fraction or as a boost. With many centers seeking to adopt such technology, there are licensing, proctoring, staffing, technical support, and reimbursement issues that need to be considered. We have reviewed the current international experience and describe one community cancer center's experience with initiating an IORT breast cancer program. Source

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