Physikalische Medizin Rehabilitationsmedizin Kurortmedizin, Nov 14, 2005
Fragestellung: Das Symptom krebsassoziertes Fatiguesyndrom („Fatigue“) wird in der Literatur als ... more Fragestellung: Das Symptom krebsassoziertes Fatiguesyndrom („Fatigue“) wird in der Literatur als ein allgemeines, persistierendes und subjektives Gefuhl der Erschopfung beschrieben, welches in Zusammenhang mit der Krebserkrankung oder deren Behandlung steht und die betroffenen Patienten in ihrer Leistungsfahigkeit und ihren taglichen Verrichtungen behindert, was wiederum zu einer Einschrankung der Lebensqualitat (QOL) und der „Sozialen Partizipation“ fuhren kann. Die vorliegende Querschnittsuntersuchung hatte das Ziel, Zusammenhange zwischen dem Symptom „Fatigue“ mit der QOL und mit der „Sozialen Partizipation“ an Wiener Karzinompatienten unter ambulanter palliativer Chemotherapie zu untersuchen. Methode: 98 konsekutive Patienten (Durschnittsalter 56±8 Jahre) mit fortgeschrittener Karzinomerkrankung und infauster Prognose wurden in die Studie eingeschlossen. Alle Studienteilnehmer lebten zuhause und erhielten an der Abteilung fur Onkologie des Wiener Allgemeinen Krankenhauses als ambulante Patienten palliative Chemotherapien. Die Zielparameter „Fatigue“ und „Soziale Partizipation“ wurden anhand Visueller Analog-Skalen (VAS) registriert und dokumentiert. Die Erfassung der Lebensqualitat erfolgte mittels der deutschen Version des „SF-36 Health Survey“ (SF-36). Mittels statischer Analysen (Spearman-Korrelation) wurden Korrelationen zwischen „Fatigue“ und QOL sowie „Fatigue“ und „Sozialer Partizipation“ untersucht. Ergebnis: Es wurde keine signifikante Korrelation zwischen „Fatigue“ mit der QOL-Domane „Korperlicher Schmerz“ gefunden. Dagegen ergaben sich signifikante negative Korrelationen zwischen „Fatigue“ mit den QOL-Domanen „Korperliche Funktionsfahigkeit“ (p<0.0001, r=–0.56), „Korperliche Rollenfunktion“ (p<0.0001, r=–0.60), „Mentale Gesundheit“ (p=0.0003, r=–0.36), „Emotionelle Rollenfunktion“ (p<0.0001, r=–0.42), „Vitalitat“ (p<0.0001, r=–0.67), „Allgemeiner Gesundheitszustand“ (p=0.0016, r=–0.32) und „Soziale Kompetenz“ (p=0.0006, r=–0.34). Zusatzlich zeigte sich eine signifikante negative Korrelation zwischen dem Symptom „Fatigue“ mit der von den Patienten angegebenen „Sozialen Partizipation“ (p<0.0001, r=–0.44). Diskussion: Die Ergebnisse dieser Studie an ambulanten Wiener Patienten weisen auf einen negativen Einfluss des Symptoms „Fatigue“ auf die meisten Domanen der QOL und auf die „Soziale Partizipation“ bei Karzinompatienten unter palliativer Chemotherapie hin. Zusatzlich unterstreichen sie die klinische, Relevanz dem aktivitats- und funktionslimitierenden Symptom „Fatigue“ in der Rehabilitation solcher Patienten suffizient entgegenzuwirken.
A 48-year-old female patient suffering from advanced breast cancer with metastatic bone disease p... more A 48-year-old female patient suffering from advanced breast cancer with metastatic bone disease participated in an aerobic exercise program consisting of ergometer cycling three times a week for 1 year. Feasibility, safety and beneficial effects of the program were proven for the patient in this case study. VO(2)max (20.2% after 16 weeks, 52.7% after 12 months) and peak work capacity (15.5% after 16 weeks, 35.7% after 12 months) had increased. The patient experienced a marked improvement in physical performance and in quality of life. Aerobic exercise, initiated and executed with appropriate care, may serve as a useful additional means of palliative treatment in some cancer patients with bone metastases.
In Austria, cancer rehabilitation is an important issue in the management of cancer patients. Sur... more In Austria, cancer rehabilitation is an important issue in the management of cancer patients. Survival rates and survival time of cancer patients are increasing, and cancer rehabilitation is an important part in the treatment and care of cancer patients with the goal to improve functional status, quality of life, and (social) participation. Today, in Austria there are approximately 600 beds for inpatient rehabilitation. The field of outpatient rehabilitation will maybe be expanded after evaluating the existing pilot projects. Beside other specialities, the field of Physical Medicine and Rehabilitation (PM&amp;amp;amp;amp;amp;amp;amp;amp;amp;R) plays an important role in cancer rehabilitation. In cancer rehabilitation, especially activating modalities from PM&amp;amp;amp;amp;amp;amp;amp;amp;amp;R such as exercise are very important and well-accepted parts to improve functional status, quality of life, and participation of patients.
When thyroid and other cancers are &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;a... more When thyroid and other cancers are &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;cured&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; it is often assumed that the patients are able to resume their normal lives. This was a cross-sectional study to evaluate health-related quality of life (HRQOL) and to identify rehabilitation needs of patients with non-metastatic thyroid cancer under thyroxine supplementation therapy. Included in the study were 150 consecutive patients with differentiated thyroid cancer (age 52 +/- 14 years, range 25-83 years; male/female 39/111). All patients had a history of total thyroidectomy followed by radioiodine ablation, were free of metastatic disease and under levothyroxine treatment. The mean period since the diagnosis of thyroid cancer was 5.5 +/- 6 years (range 0-23 years). Health-related quality of life was evaluated using the SF-36 Health Survey. The findings were compared with sex- and age-matched reference values. &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Role-emotional&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Vitality&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; were significantly lower ( P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001 and P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.005, respectively) in the group as a whole ( n = 150). In the subgroup of patients with a recent (less than 1 year) diagnosis of thyroid cancer ( n = 51), however, the following subscales were significantly lower: &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Mental Health&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; ( P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01), &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Role-emotional&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; ( P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001), &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Role-physical&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; ( P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.005),…
ABSTRACT Purpose: The present methodological observation aimed to compare assessment of pain and ... more ABSTRACT Purpose: The present methodological observation aimed to compare assessment of pain and of pain related disability when using different tools in Viennese outpatients suffering from advanced cancer during palliative chemotherapy. Materials and Methods: A total of 100 consecutive patients with a median age of 59 years (range 27.0-72.0 years) were included in this cross-sectional observation. All participants were suffering from metastatic cancer and, receiving palliative chemotherapy as outpatients at the Department of Oncology in the General Hospital of Vienna. Pain was registered on Visual analogue scale (VAS) and by using the SF-36 Health Survey subscale &quot;Bodily pain&quot;. The Pain Disability Index (PDI) was used to measure the degree of interference with normal role functioning caused by chronic pain. Associations between various outcome variables were quantified using Spearman&#39;s correlation coefficient. P-values &lt;= 0.05 were considered to be statistically significant. Results: &quot;Bodily pain&quot; showed a Spearman correlation coefficient of -0.87(p&lt;0.001)and -0.86 (p&lt;0.001) with VAS and PDI, respectively. PDI and VAS gave a Spearman correlation of 0.94 (p&lt;0.001). The various subscales of PDI showed moderate to high correlations with scores on &quot;Bodily pain&quot; (Spearman coefficients ranging from -0.55 for the subscale Life support activity to -0.84 for the subscale recreation, all p&lt;0.001) as well as with scores on VAS (Spearman coefficients ranging from 0.64 for the subscale Life support activity to 0.91 for the subscale recreation, all p&lt;0.001). Conclusions: The findings of the present investigation in Viennese Outpatients suffering from advanced cancer during palliative chemotherapy indicate high correlations between pain measured by VAS or by SF-36 subscale &quot;Bodily pain&quot;, with disability related to pain and its impact on QOL measured using PDI. All instruments seem to be adequate for pain assessment in this patient group. For clinical practice of pain assessment in patients with different advanced cancer we recommend the usage of VAS for simple assessing intensity of pain. SF-36 should be used, if assessment of QOL including &quot;Bodily pain&quot; is required. Assessment by PDI should be recommended as long as no ICF (International Classification of Functioning, Disability and Health) Core-sets are available, or to accomplish established Core sets for assessing disability related to pain in advanced cancer.
The serum cytokine levels (in particular interleukine-6 (IL-6) and tumour necrosis factor-alpha (... more The serum cytokine levels (in particular interleukine-6 (IL-6) and tumour necrosis factor-alpha (TNF-alpha)) of 61 advanced stage cancer patients receiving palliative chemotherapy as outpatients were determined with quantikine immunoassays. The values were correlated with body mass index (BMI), weight loss and appetite. Furthermore cytokine levels of patients who have died within one year were compared with those of patients who have survived more than a year. Serum levels of IL-6 (median: 1.93 pg/ml, range: 0.32-42.87) and of TNF-alpha (median: 2.55 pg/ml, range: 1.03-34.06) did not correlate with BMI, weight loss and appetite. Serum IL-6 levels of patients with survival time less than one year were significantly higher than the levels of patients who survived more than one year, no significant differences in TNF-alpha serum levels were evident. The data of this observation are consistent with current literature. Due to changes in serum levels of proinflammatory cytokines in response to chemotherapy and additional therapy, it is unlikely that IL-6 and TNF-alpha can be used as independent indicators for weight loss and appetite. Nevertheless, high serum levels of IL-6 correlate with short-time mortality.
Physikalische Medizin Rehabilitationsmedizin Kurortmedizin, Nov 14, 2005
Fragestellung: Das Symptom krebsassoziertes Fatiguesyndrom („Fatigue“) wird in der Literatur als ... more Fragestellung: Das Symptom krebsassoziertes Fatiguesyndrom („Fatigue“) wird in der Literatur als ein allgemeines, persistierendes und subjektives Gefuhl der Erschopfung beschrieben, welches in Zusammenhang mit der Krebserkrankung oder deren Behandlung steht und die betroffenen Patienten in ihrer Leistungsfahigkeit und ihren taglichen Verrichtungen behindert, was wiederum zu einer Einschrankung der Lebensqualitat (QOL) und der „Sozialen Partizipation“ fuhren kann. Die vorliegende Querschnittsuntersuchung hatte das Ziel, Zusammenhange zwischen dem Symptom „Fatigue“ mit der QOL und mit der „Sozialen Partizipation“ an Wiener Karzinompatienten unter ambulanter palliativer Chemotherapie zu untersuchen. Methode: 98 konsekutive Patienten (Durschnittsalter 56±8 Jahre) mit fortgeschrittener Karzinomerkrankung und infauster Prognose wurden in die Studie eingeschlossen. Alle Studienteilnehmer lebten zuhause und erhielten an der Abteilung fur Onkologie des Wiener Allgemeinen Krankenhauses als ambulante Patienten palliative Chemotherapien. Die Zielparameter „Fatigue“ und „Soziale Partizipation“ wurden anhand Visueller Analog-Skalen (VAS) registriert und dokumentiert. Die Erfassung der Lebensqualitat erfolgte mittels der deutschen Version des „SF-36 Health Survey“ (SF-36). Mittels statischer Analysen (Spearman-Korrelation) wurden Korrelationen zwischen „Fatigue“ und QOL sowie „Fatigue“ und „Sozialer Partizipation“ untersucht. Ergebnis: Es wurde keine signifikante Korrelation zwischen „Fatigue“ mit der QOL-Domane „Korperlicher Schmerz“ gefunden. Dagegen ergaben sich signifikante negative Korrelationen zwischen „Fatigue“ mit den QOL-Domanen „Korperliche Funktionsfahigkeit“ (p<0.0001, r=–0.56), „Korperliche Rollenfunktion“ (p<0.0001, r=–0.60), „Mentale Gesundheit“ (p=0.0003, r=–0.36), „Emotionelle Rollenfunktion“ (p<0.0001, r=–0.42), „Vitalitat“ (p<0.0001, r=–0.67), „Allgemeiner Gesundheitszustand“ (p=0.0016, r=–0.32) und „Soziale Kompetenz“ (p=0.0006, r=–0.34). Zusatzlich zeigte sich eine signifikante negative Korrelation zwischen dem Symptom „Fatigue“ mit der von den Patienten angegebenen „Sozialen Partizipation“ (p<0.0001, r=–0.44). Diskussion: Die Ergebnisse dieser Studie an ambulanten Wiener Patienten weisen auf einen negativen Einfluss des Symptoms „Fatigue“ auf die meisten Domanen der QOL und auf die „Soziale Partizipation“ bei Karzinompatienten unter palliativer Chemotherapie hin. Zusatzlich unterstreichen sie die klinische, Relevanz dem aktivitats- und funktionslimitierenden Symptom „Fatigue“ in der Rehabilitation solcher Patienten suffizient entgegenzuwirken.
A 48-year-old female patient suffering from advanced breast cancer with metastatic bone disease p... more A 48-year-old female patient suffering from advanced breast cancer with metastatic bone disease participated in an aerobic exercise program consisting of ergometer cycling three times a week for 1 year. Feasibility, safety and beneficial effects of the program were proven for the patient in this case study. VO(2)max (20.2% after 16 weeks, 52.7% after 12 months) and peak work capacity (15.5% after 16 weeks, 35.7% after 12 months) had increased. The patient experienced a marked improvement in physical performance and in quality of life. Aerobic exercise, initiated and executed with appropriate care, may serve as a useful additional means of palliative treatment in some cancer patients with bone metastases.
In Austria, cancer rehabilitation is an important issue in the management of cancer patients. Sur... more In Austria, cancer rehabilitation is an important issue in the management of cancer patients. Survival rates and survival time of cancer patients are increasing, and cancer rehabilitation is an important part in the treatment and care of cancer patients with the goal to improve functional status, quality of life, and (social) participation. Today, in Austria there are approximately 600 beds for inpatient rehabilitation. The field of outpatient rehabilitation will maybe be expanded after evaluating the existing pilot projects. Beside other specialities, the field of Physical Medicine and Rehabilitation (PM&amp;amp;amp;amp;amp;amp;amp;amp;amp;R) plays an important role in cancer rehabilitation. In cancer rehabilitation, especially activating modalities from PM&amp;amp;amp;amp;amp;amp;amp;amp;amp;R such as exercise are very important and well-accepted parts to improve functional status, quality of life, and participation of patients.
When thyroid and other cancers are &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;a... more When thyroid and other cancers are &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;cured&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; it is often assumed that the patients are able to resume their normal lives. This was a cross-sectional study to evaluate health-related quality of life (HRQOL) and to identify rehabilitation needs of patients with non-metastatic thyroid cancer under thyroxine supplementation therapy. Included in the study were 150 consecutive patients with differentiated thyroid cancer (age 52 +/- 14 years, range 25-83 years; male/female 39/111). All patients had a history of total thyroidectomy followed by radioiodine ablation, were free of metastatic disease and under levothyroxine treatment. The mean period since the diagnosis of thyroid cancer was 5.5 +/- 6 years (range 0-23 years). Health-related quality of life was evaluated using the SF-36 Health Survey. The findings were compared with sex- and age-matched reference values. &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Role-emotional&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Vitality&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; were significantly lower ( P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001 and P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.005, respectively) in the group as a whole ( n = 150). In the subgroup of patients with a recent (less than 1 year) diagnosis of thyroid cancer ( n = 51), however, the following subscales were significantly lower: &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Mental Health&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; ( P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01), &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Role-emotional&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; ( P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001), &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Role-physical&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; ( P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.005),…
ABSTRACT Purpose: The present methodological observation aimed to compare assessment of pain and ... more ABSTRACT Purpose: The present methodological observation aimed to compare assessment of pain and of pain related disability when using different tools in Viennese outpatients suffering from advanced cancer during palliative chemotherapy. Materials and Methods: A total of 100 consecutive patients with a median age of 59 years (range 27.0-72.0 years) were included in this cross-sectional observation. All participants were suffering from metastatic cancer and, receiving palliative chemotherapy as outpatients at the Department of Oncology in the General Hospital of Vienna. Pain was registered on Visual analogue scale (VAS) and by using the SF-36 Health Survey subscale &quot;Bodily pain&quot;. The Pain Disability Index (PDI) was used to measure the degree of interference with normal role functioning caused by chronic pain. Associations between various outcome variables were quantified using Spearman&#39;s correlation coefficient. P-values &lt;= 0.05 were considered to be statistically significant. Results: &quot;Bodily pain&quot; showed a Spearman correlation coefficient of -0.87(p&lt;0.001)and -0.86 (p&lt;0.001) with VAS and PDI, respectively. PDI and VAS gave a Spearman correlation of 0.94 (p&lt;0.001). The various subscales of PDI showed moderate to high correlations with scores on &quot;Bodily pain&quot; (Spearman coefficients ranging from -0.55 for the subscale Life support activity to -0.84 for the subscale recreation, all p&lt;0.001) as well as with scores on VAS (Spearman coefficients ranging from 0.64 for the subscale Life support activity to 0.91 for the subscale recreation, all p&lt;0.001). Conclusions: The findings of the present investigation in Viennese Outpatients suffering from advanced cancer during palliative chemotherapy indicate high correlations between pain measured by VAS or by SF-36 subscale &quot;Bodily pain&quot;, with disability related to pain and its impact on QOL measured using PDI. All instruments seem to be adequate for pain assessment in this patient group. For clinical practice of pain assessment in patients with different advanced cancer we recommend the usage of VAS for simple assessing intensity of pain. SF-36 should be used, if assessment of QOL including &quot;Bodily pain&quot; is required. Assessment by PDI should be recommended as long as no ICF (International Classification of Functioning, Disability and Health) Core-sets are available, or to accomplish established Core sets for assessing disability related to pain in advanced cancer.
The serum cytokine levels (in particular interleukine-6 (IL-6) and tumour necrosis factor-alpha (... more The serum cytokine levels (in particular interleukine-6 (IL-6) and tumour necrosis factor-alpha (TNF-alpha)) of 61 advanced stage cancer patients receiving palliative chemotherapy as outpatients were determined with quantikine immunoassays. The values were correlated with body mass index (BMI), weight loss and appetite. Furthermore cytokine levels of patients who have died within one year were compared with those of patients who have survived more than a year. Serum levels of IL-6 (median: 1.93 pg/ml, range: 0.32-42.87) and of TNF-alpha (median: 2.55 pg/ml, range: 1.03-34.06) did not correlate with BMI, weight loss and appetite. Serum IL-6 levels of patients with survival time less than one year were significantly higher than the levels of patients who survived more than one year, no significant differences in TNF-alpha serum levels were evident. The data of this observation are consistent with current literature. Due to changes in serum levels of proinflammatory cytokines in response to chemotherapy and additional therapy, it is unlikely that IL-6 and TNF-alpha can be used as independent indicators for weight loss and appetite. Nevertheless, high serum levels of IL-6 correlate with short-time mortality.
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