Care Pathway for Cancer Survivorship in Korea: Trend of Breast Cancer Pathway from 2003 to 2010 / 대한의료정보학회지

OBJECTIVES: The survival rate of cancer patients has exceeded 60%. Although cancer survivors may die of other diseases except cancer, the health management system including chronic disease prevention-management for cancer survivors, has not been established in the diverse aspects. Therefore, services according to care pathway of cancer patients need to be provided through a support system based on a platform concept that can be used to meet patient needs in various ways. METHODS: A sample cohort database (2002–2010) of approximately 1 million persons—2% of the whole nation (50 million)—was used to estimate cancer survivors through a principal care pathway for cancer management. The sample cohort database was built to estimate the number of breast cancer survivors in the five stage: ‘Diagnosis and treatment,’‘Supportive care,’‘Monitoring,’‘Progress illness,’ and ‘Hospice care’. In this way, the scale of breast cancer survivors was estimated. RESULTS: There were 330 (9.8%) cases of the incidence of cancer in 2010 in the ‘Diagnosis and treatment.’ Among the cases of the incidence of cancer in the previous year, the number of one-year survivors was 328 (9.7%); these were included in the category ‘Supportive care.’ In the ‘Monitoring’ category, 2,593 (76.9%) who maintained health lives were included. A total of 84 (2.5%) survivors were checked to identify an ongoing disease; these were included in the category ‘Progress illness.’ In the category ‘Hospice care,’ 36 (1.1%) end-stage cancer patients requiring hospice care were included. CONCLUSIONS: We established a care pathway by survival stage in order to fulfill prevention and health management services post-treatment management steps.

Study of plasma transforming growth factor-beta 1 level as a useful tumor marker in various cancers

BACKGROUND: Many investigators have found transforming growth factor-1 (TGF-1) to be elevated in tumors. Changes in responsiveness to TGF-1 have been linked to malignant transformation, tumor progression and tumor regression. Many malignant cell lines of epithelial or hematopoietic origin are refractory to the antiproliferative effects of TGF-1. However, a little is known about the association of TGF-1 with progression of malignant tumor. METHODS: In this study, we measured the plasma level of TGF-1 in various cancer patients and evaluated the utility of plasma TGF-1 as a possible tumor marker. Plasma TGF-1 levels were measured using enzyme-linked immunosorbent assay in cancer patients and normal controls. Carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP) as tumor marker were compared with TGF-1 in the aspects of sensitivity and specificity. RESULTS: The mean of plasma TGF-1 levels was 1.2 19 +/-0.834 ng/ml in normal controls, 5.491 +/-3.598 ng/ml in breast cancer, 12.670 +/-10.386 ng/ml in lung cancer, 5.747 +/-3.228 ng/ml in hepatocellular carcinoma and 10.854 +/-7.996 ng/ml in cervical cancer. In comparison with CEA and AFP, TGF-1 is more sensitive. CONCLUSION: We conclude that the high levels of TGF-1 are common in the plasma of cancer patients. These result s suggest that the plasma TGF-1 level can be a potent tumor marker in various cancer patients.