Access to communication technologies in a sample of cancer patients: an urban and rural survey.

Background: There is a growing awareness among providers of the symptom burden experienced by cancer patients. Systematic symptom screening is difficult. Our plan was to evaluate a technology-based symptom screening process using touch-tone telephone and Internet in our rural outreach cancer program in Indiana.

Zoledronic acid is superior to pamidronate for the treatment of bone metastases in breast carcinoma patients with at least one osteolytic lesion.

Background: Treatment with zoledronic acid (Zol) was compared with a dose of 90 mg of pamidronate (Pam) in breast carcinoma (BC) patients with at least 1 osteolytic lesion based on data from a Phase III, randomized trial.

Methods: Overall, 1130 patients with breast carcinoma who had all types of bone metastases (osteolytic, mixed, or osteoblastic by radiology) were randomized to receive treatment with either 4 mg of Zol or 8 mg of Zol as a 15-minute infusion or 90 mg of Pam as a 2-hour infusion every 3-4 weeks for 12 months. A skeletal-related event (SRE) was defined as a pathologic fracture, spinal cord compression, radiotherapy, or surgery to bone.

Use of a depression screening tool and a fluoxetine-based algorithm to improve the recognition and treatment of depression in cancer patients. A demonstration project.

Helping oncologists to identify and treat depression is an important step in improving the overall care of people with cancer. In previous work performed in our community-based, ambulatory oncology outreach network, we validated a depression screening tool, put into place depression screening programs, and taught oncologists how to follow up on screening with brief, reliable clinical interviews. Subsequently, we provided these oncologists with a fluoxetine-based antidepressant algorithm to follow for the treatment of their depressed patients.

A pilot exploration of the antiemetic activity of olanzapine for the relief of nausea in patients with advanced cancer and pain.

This open-label pilot study explored the antiemetic activity of olanzapine, an atypical antipsychotic, in patients with advanced cancer requiring opioid analgesics for pain. Fifteen patients received 2 days of a washout and placebo "run-in" followed by two day periods on each of three doses of olanzapine (2.5 mgs, 5 mgs, and 10 mgs).

A pilot study of oncology staff perceptions of palliative care and psycho-oncology services in rural and community settings in Indiana.

Although there has been an increased interest in health care delivery for rural community populations, concerns remain regarding the lack of access to primary health care and specialty services (such as palliative care), particularly in rural areas that are medically underserved (MU). This survey was conducted to examine the perceptions of palliative care services in rural communities and toward identifying perceived barriers that interfere with accessing palliative care services. In conducting the study, personnel from various disciplines throughout the Community Cancer Care (CCC) network (the largest private provider of oncology services in Indiana) completed a survey that assessed their perceptions of the strengths and weaknesses of the available palliative care services in their communities.