Living through pelvic radiotherapy:A mixed method study of self-care activities and distressful symptoms.

Purpose: To explore patients' experience of their illness when undergoing pelvic radiotherapy by describing the presence and severity of distressful symptoms and to explore initiated self-care activities in response to illness and symptoms.

Methods: A mixed-method study was performed which included a core qualitative dataset and a supplementary quantitative dataset. Twenty-nine women undergoing five weeks of radiotherapy were prospectively interviewed during five weeks of treatment in order to capture experiences, distressful symptoms and quality of life during treatment.

Anal carcinoma - Survival and recurrence in a large cohort of patients treated according to Nordic guidelines.

Objective: To evaluate treatment outcome in a large population-based cohort of patients with anal cancer treated according to Nordic guidelines.

Material: Clinical data were collected on 1266 patients with anal squamous cell carcinoma diagnosed from 2000 to 2007 in Sweden, Norway and Denmark. 886 of the patients received radiotherapy 54-64Gy with or without chemotherapy (5-fluorouracil plus cisplatin or mitomycin) according to different protocols, stratified by tumor stage.

A population-based study of 135 lymphomas after solid organ transplantation: The role of Epstein-Barr virus, hepatitis C and diffuse large B-cell lymphoma subtype in clinical presentation and survival.

Background: Epstein-Barr virus (EBV) plays a major role in the development of post-transplant lymphoproliferative disorder (PTLD), but there is an increasing awareness of EBV-negative PTLD. The clinical presentation of EBV-negative PTLD has not been as well characterised as EBV-positive cases. Further, there is limited knowledge on the clinical importance of diffuse large B-cell lymphoma (DLBCL) cell of origin subtype post-transplant.

Population impact of heart failure and the most common forms of cancer: a study of 1 162 309 hospital cases in Sweden (1988 to 2004).

Background: The contemporary impact of heart failure (HF) versus the most common forms of cancer as reflected by related first-ever hospitalizations and subsequent case-fatality rates is unknown.

Methods And Results: Using a national registry in Sweden, we compared the rate of first-ever hospitalization and associated short- and long-term survival for HF, acute myocardial infarction (AMI), and the most common forms of cancer on an age and sex-specific basis during 1988 to 2004 in 949 733 Swedish patients (1 162 309 hospital admissions in total). Annual incidence of first-ever hospitalization for HF, AMI, and cancer in Sweden were 484, 424, and 373 (lung, colorectal, prostate, and bladder cancer combined) per 100 000 men and 470, 280, and 350 (lung, colorectal, bladder, breast, and ovarian cancer combined) per 100 000 women age >20 years.

Exploring a link between fatigue and intestinal injury during pelvic radiotherapy.

Background: The association between cancer-related fatigue and pathological processes in the body is largely unknown. This study was designed to investigate a possible linkage between fatigue and intestinal injury during pelvic radiotherapy.

Methods: Twenty-nine women undergoing pelvic radiotherapy for anal or uterine cancer were prospectively followed.

Defining stage III disease in colorectal cancer--aspects on treatment and evaluation of survival.

Background And Objective: Stage III in colorectal cancer is defined by presence of node metastasis, whereas distant growth constitutes stage IV. The aim was to describe prognosis in high risk groups of stage III in relation to survival in stage IV, along with possible effect on research and treatment.

Methods: All patients operated for stage III-IV colorectal cancer 1999-2003 (n = 591) were assessed by demography, pathology and treatment towards survival.

Components that influence assessment and management of cancer-related symptoms: an interdisciplinary perspective.

Purpose/objectives: To describe, from an interdisciplinary perspective, how cancer-related symptoms are assessed and managed in a cancer care setting and to describe the components that influence symptom management.

Design: Descriptive, qualitative, and cross-sectional.

Setting: An oncology and hematology department in a university hospital in western Sweden.

Gut toxicity during hemopoietic stem cell transplantation may predict acute graft-versus-host disease severity in patients.

Graft-versus-host disease (GVHD) is the primary complication of allogeneic, hemopoietic, stem cell transplantation (HSCT). Murine models suggest that gut toxicity, induced by the intensive chemotherapy preceding hematopoietic stem cell infusion, aggravates systemic GVHD. In HSCT patients gut toxicity correlates with chemotherapy intensity.

Epoetin alfa and darbepoetin alfa for the treatment of chemotherapy-related anemia in cancer patients in Sweden: comparative analysis of drug utilization, costs, and hematologic response.

A retrospective chart review was performed at 3 Swedish hospitals to evaluate the utilization, outcomes, and cost of using epoetin alfa or darbepoetin alfa to treat cancer patients with chemotherapy-related anemia. Data on dosage, duration of treatment, hematologic response, red blood cell transfusions, and healthcare resource consumption were collected and analyzed at various time points following the initiation of drug therapy. A significantly faster hematologic response and increase in hemoglobin were observed in patients treated with epoetin alfa.

Alternative EBNA1 expression in organ transplant patients.

In order to identify patients at risk for developing post-transplant lymphoproliferative disease (PTLD), a sensitive nested RT-PCR method for detection of EBNA1 gene expression in peripheral blood cells was used. EBNA1 expression in peripheral blood samples from 60 organ recipients was analyzed and compared with 24 healthy controls in a retrospective study. Overall, EBNA1-positive samples were detected at least once in 43% of the transplant patients with post-transplant lymphoproliferative disease, in 18% of the other transplant patients and in none of the healthy controls.

Fatigue, psychological distress, coping resources, and functional status during radiotherapy for uterine cancer.

Purpose/objectives: To evaluate how patients diagnosed with uterine cancer experience fatigue, psychological distress, coping resources, and functional status before, during, and after treatment with radiation therapy and to study whether significant correlations exist among these variables.

Design: Longitudinal, descriptive, and correlational.

Setting: The Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden.

The experience of fatigue, other symptoms and global quality of life during radiotherapy for uterine cancer.

This paper reports on how patients with uterine cancer, receiving radiotherapy, experience fatigue, other symptoms and global quality of life. The results showed that fatigue increased significantly during the therapy. Also the other symptoms; loss of appetite, nausea/vomiting and diarrhoea increased significantly and were significantly correlated to general fatigue.

Testicular lymphoma--a retrospective, population-based, clinical and immunohistochemical study.

From a population-based registry, 35 patients with histologically verified testicular lymphomas were identified: diffuse large B-cell lymphomas (DLBCL) in 33 and peripheral T-cell lymphomas in two cases. Twenty-two patients had localized disease (Pe stage I and II). Twenty-eight patients received systemic chemotherapy, 17 of whom also received intrathecal prophylaxis, and 12 out of these 17 also received radiotherapy to the contralateral testis.

Maintaining normality and support are central issues when receiving chemotherapy for ovarian cancer.

The aim of this study was to enrich the understanding of patients' perspective of being diagnosed and treated for ovarian cancer. A qualitative approach was used to obtain knowledge and insight into patients' experiences and thoughts. Ten Swedish women, diagnosed with ovarian cancer, participated in a total of 23 interviews on 3 occasions: at the time of diagnosis, during chemotherapy, and after completion of chemotherapy.

Levels of fatigue compared to levels of cytokines and hemoglobin during pelvic radiotherapy: a pilot study.

Cancer-related fatigue (CRF) is a prevalent and distressing symptom experienced by patients during cancer therapy. One proposed mechanism for the development of fatigue is the increased secretion of proinflammatory cytokines and/or the development of anemia. The major purpose of this pilot study was to investigate the levels of fatigue and cytokines during radiation therapy and determine whether there was a correlation between the two.

Fatigue, psychological distress, coping and quality of life in patients with uterine cancer.

Background: Cancer-related fatigue (CRF) is a subjectively experienced symptom that is multidimensional and multifactorial. Patients with cancer have identified fatigue as one of the major troubling symptoms and the primary cause of distress in their lives.

Aims: The major aim of the study was to examine how patients diagnosed with uterine cancer describe their experience of fatigue, psychological distress, coping resources and quality of life.

Assessment and management of cancer-related fatigue in adults.

Fatigue is one of the most prevalent and distressing symptoms of cancer, and is a common side-effect of many of the treatments available for the management of malignant disease. We critically assess the evidence for cancer-related fatigue and its treatment in adults. Little is known about the cause and mechanisms of fatigue, and research into methods of alleviating the condition has focused on treatment for anaemia and behavioural interventions, such as exercise, both of which are effective in reducing fatigue.

Early and intermediate stage Hodgkin's lymphoma--report from the Swedish National Care Programme.

In Sweden a National Care Programme provides treatment principles for Hodgkin's lymphoma (HL) since 1985, for early and intermediate stages often less extensive than international recommendations. The purpose is to evaluate long-term results of these principles. A total of 308 patients (167 men and 141 women), 17-59 yr old (median 31), diagnosed during 1985-92, pathological stage (PS) I-III1A and I-IIB and clinical stage (CS) I-IIA, mean follow-up 8.

A population-based study of the outcome for patients with first relapse of Hodgkin's lymphoma.

Background: Our aims were to evaluate the response to salvage treatment in relation to initial treatment and to evaluate prognostic factors at the time of relapse in an unselected population of relapsing patients with Hodgkin's lymphoma (HL).

Patients And Methods: In total, 124 patients younger than 60 yr of age with initial diagnosis of HL in Sweden relapsed between 1985 and 1995.

Results: Fifty-eight patients relapsed after initial treatment with radiotherapy (RT) only, 62 after combination chemotherapy (CT), of whom 30 had received additional involved-field RT, and four after a short course of CT followed by extended-field RT.

Age-adjusted chemotherapy for primary central-nervous system lymphoma--a pilot study.

Patients with primary central-nervous-system lymphoma (PCNSL) are treated with chemotherapy and cranial irradiation, which increase the risk of late neurotoxicity. The aim of this phase II trial was to investigate whether chemotherapy alone could induce durable remissions. Thirty non-immunocompromised patients were enrolled in two treatment groups, according to age.