ABSTRACT
PURPOSE: The potential of physical activity to improve function and quality of life of an individual with advanced cancer is now established. The purpose of this survey of oncologic healthcare providers (OHPs) is to understand their attitude towards physical activity for individuals living with bony metastases and to assess requirements to confidently provide physical activity recommendations. METHODS: A web-based survey administered through Qualtrics™ included questions on participant demographics and attitude questions ranked on a Likert scale. Eligibility was a physician or nurse practitioner currently providing care in the cancer care system of a public healthcare system in Canada. 338 participants were identified and invited to participate in this survey. RESULTS: The response rate was 34.6%. The majority of OHPs believed physical activity is important (89%) and safe (82%) in individuals living with bony metastases. OHPs agreed that these individuals looked to them for physical activity recommendations (74%) and that these recommendations would be followed (58%). Yet, 86% of OHPs felt they required more information before they could recommend physical activity to individuals living with bony metastases, and less than half (43%) of OHPs felt confident enough to prescribe physical activity. CONCLUSIONS: OHPs agree that physical activity for individuals living with bony metastatic cancer is beneficial and safe. However, OHPs are not confident in their ability to recommend physical activity to this population. IMPLICATIONS FOR CANCER SURVIVORS: There is a need to create physical activity guidelines for individuals living with bony metastases and improve access to rehabilitation services.
Subject(s)
Cancer Survivors , Neoplasms , Exercise , Health Personnel , Humans , Medical Oncology , Quality of LifeABSTRACT
INTRODUCTION: The years since 2005 have seen major changes in cancer treatment and significant increases in the number of anticancer drugs available. However, there are relatively few published data to reflect how those changes are affecting the activity and workload of oncology services. To explore the effects of those changes, we reviewed the population-based cancer treatment activity on Vancouver Island for the period 2010-2015. METHODS: Information about new patient referrals, radiation courses, new chemotherapy cycles commenced, total intravenous (IV) chemotherapy treatment visits, and pharmacy activity for oral anticancer drug prescriptions was obtained from BC Cancer Agency databases. RESULTS: During the 5-year study period, the Vancouver Island population increased by 2.8% and the number of new referrals to the BC Cancer Agency increased by 17.7%. The overall number of radiation courses increased by 6.1%. In contrast, IV chemotherapy activity increased by 52.1% for new courses commenced and by 62% for total IV chemotherapy attendances. Oral anticancer drug prescriptions rose by 22.9% during the 5-year period. CONCLUSIONS: Our study documents substantial recent increases in cancer therapy activity in terms of patient referrals and particularly IV chemotherapy and oral anticancer therapy. The data reported here could be of value in planning for future care provision.
ABSTRACT
Myelodysplastic syndromes (MDS) are clonal hematopoietic stem cell disorders primarily seen in the elderly that are characterized by ineffective hematopoiesis and a propensity to develop AML. Clinicians may be hesitant to refer older patients with unexplained cytopenias and/or macrocytosis for a bone marrow biopsy (BM), and consequently undiagnosed patients may be deprived access to effective treatments. Previously, we described factors which were independently predictive of a diagnosis of MDS at time of bone marrow: age ≥65, mean cell volume (MCV), red cell distribution width (RDW), and lactate dehydrogenase (LDH), and suggested a scoring system to calculate the post-test probability of MDS [1]. In this study we validate this scoring system in a cohort of 313 individuals who underwent bone marrow examinations for the investigation of unexplained cytopenias and or macrocytosis over a 3 year period at our institution (2006-2008). Thirty-two percent of all patients were diagnosed with MDS and 9% had suspected MDS. The post-test likelihood of a diagnosis of MDS increased from 12% when none of the four identified factors were present to 48% when 3 or more factors were present. This scoring system can be used to guide the diagnostic testing of patients presenting with unexplained cytopenias or macrocytosis.
