Changes in internet use and wishes of cancer survivors: A comparison between 2005 and 2017.

BACKGROUND: Given the major changes in internet use for health communication, the objective of the current study was to compare the internet use and wishes of cancer survivors between 2005 and 2017. METHODS: The authors drew a sample of 390 patients in 2005 and 539 patients in 2017 who were diagnosed with breast (128 patients in 2005 and 143 patients in 2017), prostate (96 patients in 2005 and 126 patients in 2017), or gynecologic (89 patients in 2005 and 188 patients in 2017) cancer or lymphoma (77 patients in 2005 and 82 patients in 2017) in 4 different hospitals for the periods 2002 through 2004 and 2014 through 2016. These patients were sent a paper-based questionnaire that contained 45 questions regarding demographics and 4 functions of internet use: content, communication, community, and e-health. RESULTS: The response in 2017 (53%) was lower than that in 2005 (75%). Survivors browsed the internet most frequently to search for information regarding cancer shortly after being diagnosed and while waiting for treatment. There was little change noted with regard to the relative importance attached to the various subjects. In 2017, significant increases were evident with regard to finances (+33%), health care insurance (+29%), and genetics and/or heritability (+27%). The wishes expressed in 2005 by patients were realized in part in 2017. CONCLUSIONS: A significant sample of cancer survivors in the Netherlands have indicated that the internet is an important source of information regarding their illness. However, little change was evident over the past 15 years with regard to patients' priorities regarding their wishes for internet use. The wishes of users in 2005 were found to accurately reflect the internet use of the majority of patients in 2017. The results of the current study support the belief that health care professionals should expand their online services and tailor them toward the needs and wishes of their patients.

Torsion of the ovary: a known but frequently missed diagnosis.

Torsion of the ovary or fallopian tube is a rare acute gynaecological disorder, seen by different medical specialists. The diverse clinical presentation is one of the main reasons this diagnosis is frequently missed at first presentation. For the preservation of ovarian function it is of utmost importance to diagnose an ovarian torsion at an early stage. We will describe the medical history of three patients with a torsion of one of the ovaries to illustrate the variety of clinical presentation. A medical history of pelvic operations or enlarged ovaries often predisposes to torsion of the ovary or fallopian tube. Treatment policy will differ depending on the stage of life. Ovariopexy can be considered to prevent the ovary from torsion and to maintain its function. Torsion of the ovary is an acute gynaecological disorder with an incidence of 3% in a series of acute gynaecological complaints. It is a disorder in which the ovary and the fallopian tube can be affected, combined as well as separated. Although every specialist is familiar with the disorder, the diagnosis in acute presentation is frequently missed. To bring this entity and its great variability in clinical presentation into focus once again, we will highlight three patients out of a series of 13. Furthermore, we will discuss the possible causes of the disorder and present a proposition for treatment.