ABSTRACT
BACKGROUND: Survivorship care plans (SCP) should outline pertinent information about cancer treatment and follow-up. METHODS: We descriptively analyzed the content of 74 colorectal cancer SCPs completed as part of a randomized, controlled trial of SCPs at an academic and community cancer center. Surveillance recommendations were compared with American Cancer Society, American Society of Clinical Oncology and National Comprehensive Cancer Network guidelines. RESULTS: SCP information provided in >80% of the plans included participant age, cancer diagnosis, details, and side-effects of treatment (surgery, chemotherapy, radiation) and health promotion recommendations. SCP content documented less frequently included predisposing conditions, genetic counseling/testing information and staging. Posttreatment surveillance recommendations were documented in >90% SCPs. For stage 2-3 cancer, rates of guideline concordant recommendations were 100% for colonoscopy surveillance (Year 1 only), 87% for imaging surveillance, 65% for carcinoembryonic antigen surveillance, and 33% for follow-up visits. Excluding colonoscopy, >15 unique recommendations were listed for each modality across stages and sites, with more variation at the academic site. CONCLUSIONS: SCPs consistently recorded information about cancer diagnosis and treatment but omitted critical information about cancer-specific details denoting risk. Surveillance recommendations varied considerably between cancer centers. Future work to improve the consistency of surveillance recommendations documented in SCPs may be needed.
Subject(s)
Cancer Survivors/statistics & numerical data , Continuity of Patient Care/standards , Documentation/statistics & numerical data , Neoplasms/therapy , Patient Care Planning/standards , Practice Patterns, Physicians'/standards , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prognosis , Survival Rate , SurvivorshipABSTRACT
The interaction between Schistosoma mansoni and platelets of non-immune mice has been studied in vivo and in vitro. A moderate thrombocytopaenia was observed in mice 2 days after they had been infected percutaneously with 200 cercariae. A rabbit anti-mouse platelet antiserum, 25 microL of which injected subcutaneously induced a nearly 900% reduction in blood platelet count 24 h later, was used to investigate the effects of severe thrombocytopaenia on S. mansoni infections. In replicate experiments worm burdens were significantly increased in mice that were thrombocytopaenic at the time of infection when compared with untreated mice. Induction of thrombocytopaenia on day 4 after infection had no effect on worm count. Platelets isolated from non-immune mice were shown to adhere to the surfaces of and kill mechanically transformed schistosomula in vitro. Platelets may thus be an innate mechanism of defence against schistosome infection, and the thrombocytopaenia that occurs during patent schistosome infections may be a strategy that helps secondarily incoming parasites evade this type of host defensiveness.
