Palliative care among adult cancer survivors: Knowledge, attitudes, and correlates.

Objective: Palliative care (PC) is patient and family-centered supportive care intended to improve symptom management, reduce caregiver burden, coordinate care, and improve quality of life for patients diagnosed with serious illness. Optimally, PC is begun close to initial diagnosis and delivered in synchrony with disease-specific treatment until symptom relief or patient death. The purpose of this study was to examine cancer survivors' knowledge and perceptions of PC using a nationally representative sample of US adults from the Health Information National Trends Survey (HINTS).

Neuropsychological outcomes on Head Start III: a prospective, multi-institutional clinical trial for young children diagnosed with malignant brain tumors.

Background: Current pediatric brain tumor treatment focuses on titrating toxicity based on risk factors while simultaneously improving survivorship. The Head Start (HS) protocols I to IV (1991-present) use high-dose chemotherapy (HDCTx) with an aim of reducing or eliminating cranial irradiation in very young children, the most vulnerable to its effects.

Methods: We examined estimated Full Scale IQ, overall Adaptive Functioning, Working Memory, Processing Speed, and Verbal and Nonverbal Memory outcome data for 43 HS III patients diagnosed between ages 2 months and 7 years from 15 institutions in the United States and Canada.

Brain Irradiation and Gadobutrol Administration in Pediatric Patients with Brain Tumors: Effect on MRI Brain Signal Intensity.

Purpose To determine whether treatment affects MRI signal intensity in pediatric patients with primary brain tumors independent of the administration of macrocyclic gadolinium-based contrast agents (GBCAs). Materials and Methods This retrospective, single-center study included 78 patients (mean age, 7.7 years ± 5.

Changes in Signal Intensity of the Dentate Nucleus and Globus Pallidus in Pediatric Patients: Impact of Brain Irradiation and Presence of Primary Brain Tumors Independent of Linear Gadolinium-based Contrast Agent Administration.

Purpose To determine whether whole-brain irradiation, chemotherapy, and primary brain pathologic conditions affect magnetic resonance (MR) imaging signal changes in pediatric patients independent of the administration of gadolinium-based contrast agents (GBCAs). Materials and Methods This institutional review board-approved, HIPAA-compliant study included 144 pediatric patients who underwent intravenous GBCA-enhanced MR imaging examinations (55 patients with primary brain tumors and whole-brain irradiation, 19 with primary brain tumors and chemotherapy only, 52 with primary brain tumors without any treatment, and 18 with neuroblastoma without brain metastatic disease). The signal intensities (SIs) in the globus pallidus (GP), thalamus (T), dentate nucleus (DN), and pons (P) were measured on unenhanced T1-weighted images.

Pregnancy in a Patient With a Malignant Brain Tumor Taking Temozolomide: Case Report and Review of the Literature.

Temozolomide (TMZ), an alkylating agent used in the treatment of malignant gliomas, is a pregnancy category D medication that is not advised for use in pregnant women. We report the case of a 19-year-old woman with anaplastic oligodendroglioma (high-grade glioma) who became pregnant during maintenance chemotherapy consisting of TMZ 200 mg/m(2) administered 5 days monthly. The TMZ was immediately discontinued after she developed a positive pregnancy test.

Structural brain alterations in children an average of 5 years after surgery and chemotherapy for brain tumors.

Young children with brain tumors are often treated with high-dose chemotherapy after surgery to avoid brain tissue injury associated with irradiation. The effects of systemic chemotherapy on healthy brain tissue in this population, however, are unclear. Our objective was to compare gray and white matter integrity using MRI procedures in children with brain tumors (n = 7, mean age 8.

Premature carotid artery disease in pediatric cancer survivors treated with neck irradiation.

Background: While carotid artery disease and strokes have been documented in adult cancer patients treated with neck irradiation, little information is available on pediatric patients. The purpose of this study is to determine if carotid disease is more prevalent among pediatric cancer survivors treated with neck irradiation than among healthy controls.

Procedure: Thirty pediatric cancer survivors who received neck irradiation (2,000-6,660 cGy) and 30 healthy subjects underwent bilateral carotid ultrasounds.

The role of the long-term follow-up clinic in discovering new emerging late effects in adult survivors of childhood cancer.

Our understanding of late effects in long-term survivors of childhood cancer is continually evolving as significant numbers of survivors are entering middle to later adulthood. Effects of conventional treatment on premature aging are being recognized, as are long-term effects of newer therapies. Clinicians in long-term follow-up clinics are in a unique position to monitor for recognized late effects and to be alert to signs and symptoms of late effects that have not been previously reported in the pediatric cancer literature.

Premature carotid artery disease in long-term survivors of childhood cancer treated with neck irradiation: a series of 5 cases.

Background: Follow-up studies find an increase in stroke and carotid artery disease incidence in adult cancer patients treated with neck irradiation. These radiation-related late effects are now being detected in young adult survivors of childhood cancer.

Observations: This report includes 5 pediatric cancer survivors, ages 23 to 40, who presented with advanced carotid artery stenosis 17 to 36 years after receiving neck irradiation.

Factors associated with health-related quality of life in pediatric cancer survivors.

Background: Childhood cancer survivors are at risk for late effects of disease and treatment that may be attributed to multiple causes. This study describes health-related quality of life (HRQOL) in childhood cancer survivors and identifies factors related to poor quality of life outcomes.

Procedure: Patients age 8-18 years, who attended the long-term information, follow-up, and evaluation (LIFE) clinic at Childrens Hospital Los Angeles during a 1-year time-period were eligible for the study.

Recognizing health risks in childhood cancer survivors.

Purpose: To provide information about the special health needs of childhood cancer survivors through a discussion of Wilms' tumor, a common childhood renal tumor, and case studies of two survivors of Wilms' tumor, who encountered significant health problems as adults. This information may be generalized to many cancer survivors.

Data Sources: Actual case studies as well as extensive review of the current literature on childhood cancer survivorship.