Implementation of a nationwide population-level cancer screening in Bhutan: A programmatic experience.

This article delves into Bhutan's adept execution of a nationwide cancer screening initiative within the Health Flagship Programme, concentrating on gastric, cervical, and breast cancers. Despite challenges like the COVID-19 pandemic, infrastructure constraints, logistical complexities, health human resource shortages, and data management issues, the programme succeeded. The procurement and logistics management ensured the timely provision of essential medical equipment and test kits. Robust political commitment, a comprehensive advocacy programme, and community engagement were pivotal for the programme's success. Impressive screening coverage for all three cancers showcased the transformative impact on cancer care, integrating technology and fostering community involvement. Recommendations highlight the need for strengthened integration, strategic approaches, and ongoing evaluation, positioning Bhutan's programme as a potential model for nations facing similar health challenges.

A survey of multidisciplinary healthcare providers utilizing the KNOWintegrativeoncology.org educational platform.

BACKGROUND: Although the vast majority of cancer patients use natural health products (NHPs), 59% of oncology healthcare providers (HCP) report not receiving any education on NHPs. KNOWintegrativeoncology.org (KNOW) is a web-based educational platform that provides up-to-date evidence on NHPs used in cancer care with a user-friendly interface. KNOW is a database of human studies systematically gathered from MEDLINE and EMBASE. We surveyed HCPs before and after accessing KNOW to identify their information needs regarding NHPs in cancer care, their preferred way to receive information, barriers they face accessing NHP information, and to obtain feedback on the website. METHODS: Recruitment was done through Beaumont Health Systems, the Society for Integrative Oncology, and the Andrew Weil Centre for Integrative Medicine, University of Arizona. HCPs who consented completed an initial survey and then a follow-up survey after being given access to KNOW for 4-6 weeks. Participants were required to access KNOW at least three times before completion of the follow-up survey. RESULTS: A total of 65 participants completed the initial survey, with 60% (n = 39) from the conventional medical community, 33% (n = 21) from the integrative medicine community, and 7% (n = 5) from the research community. The majority of participants (82%; n = 53) preferred educational websites to email updates, podcasts/webinars, in-house experts, PubMed searches and smartphone apps. The most common barriers identified to accessing information on NHPs were time, accessibility at point-of-care, and credibility of sources. A high number of participants were lost to follow up, with 18 participants demographically representative of the initial sample of 65 completing the follow-up survey. Half (n = 9) of participants stated accessing the KNOW website changed their clinical practice. Close to 90% (n = 16) reported they would recommend KNOW to a colleague. CONCLUSION: Oncology HCPs reported preferring to use, and already relying on, numerous web-based educational platforms to gather information on NHPs, with time, accessibility, and credibility being common barriers to obtaining information. Our study findings highlight the promise of the KNOW web-based educational platform in reducing barriers to accessing up-to-date information on NHPs in busy cancer care settings.

Closing the Cancer Care Gap in India.

Cancer burden in India is increasing. Cancer treatment today is multi-disciplinary requiring the coordination of many specialists for best outcomes. Bringing such expertise together to the district level is the greatest challenge for cancer care in any country, moreover in India. This article focuses on the step-wise journey to make comprehensive cancer care center in a small city.

Knowledge, attitudes, and practices of Filipino clinical practitioners regarding fertility preservation in cancer patients / Philippine Journal of Obstetrics and Gynecology

Background@#Treatments for cancer have negative impact on fertility. Presently, there are technologies available to preserve the fertility of cancer patients even before gonadotoxic treatment is given. Several clinical practice guidelines on fertility preservation interventions for cancer patients have already been released. Among developed countries, Oncofertility is already an established field of clinical practice.@*Objectives@#This study aims to determine the knowledge, attitudes, and practices of Filipino clinical practitioners on fertility preservation in cancer patients.@*Methodology@#This was a cross-sectional study carried out between June and September 2019 using a self- administered questionnaire. The questionnaires were sent to clinicians (medical oncologists, hematologists, surgical oncologists, and radiation oncologists) who were directly involved in the treatment patients with cancer.@*Results@#There were 213 respondents composed of 91 surgical oncologists (varied subspecialties), 81 medical oncologists, and 41 radiation oncologists. Most of the clinical practitioners, 58-85%, have not encountered patients who have availed of any fertility preservation method. In terms of knowledge, 53-73% of respondents were aware about some fertility preservation options, but had minimal knowledge. Ninety five percent of study participants acknowledged the need for more information on fertility preservation. Majority of clinicians (57%) have never referred to a fertility specialist; and only 38% have referred a patient for fertility preservation. The following factors were cited as barriers to discussion of fertility preservation: lack of knowledge of clinicians, poor success rates of fertility preservation, poor prognosis of patients, and prohibitive costs of treatment.@*Conclusion@#There is an acute need to increase knowledge and awareness about fertility preservation methods and international fertility preservation guidelines among Filipino health practitioners treating cancer patients.

Early Palliative Care: Pro, but Please Be Precise!

BACKGROUND: By definition, palliative care (PC) is applicable already in early stages of incurable and life-threatening diseases, in conjunction with therapies that are intended to prolong life, such as for example chemo- or radiotherapy. Many patients suffer from distressing symptoms or problems in early phases of such illness. Therefore, it is not a question of "if" PC should be integrated early into oncology, but "how." General PC is defined as an approach that should be delivered by healthcare professionals regardless of their discipline. This is often referred to as "general" or "primary" PC. For this, routine symptom assessment, expertise concerning basic symptom management, and communication skills are basic requirements. Communication skills include the willingness to engage in discussions concerning patients' fears, worries and end-of-life issues without the fear of destroying hope. Specialist PC is provided by specialist teams regardless of the patients' disease, be it cancer or non-cancer. Such teams should be integrated in the care of PC patients depending on the availability of these services and the patients' needs. Key messages: "Early PC" must not be used synonymously with "early specialist PC" because much of the PC is delivered as basic oncology PC. For the integration of specialist PC, the identification of triggers is warranted in different institutions to facilitate a meaningful and effective cooperation. Such cooperations should be based on patients' needs, but must also account for questions of availability and resources.

The Oncologic Emergency Medicine Fellowship.

The United States cancer population is growing and is projected to grow further. The current cancer population has a high rate of emergency department admission. Further training about oncologic emergencies may be needed and would ideally strive to care for the whole patient, including sequelae of the malignancy, progressive disease, symptom control, adverse effects of treatment, and palliative care. The James Cancer Hospital at The Ohio State University Wexner Medical Center and The University of Texas MD Anderson Cancer Center fellowship training programs in oncologic emergency medicine are described.

Exercise Improves Physical Function and Mental Health of Brain Cancer Survivors: Two Exploratory Case Studies.

Background Malignant brain tumors are unpredictable and incurable, with 5-year survival rates less than 30%. The poor prognosis combined with intensive treatment necessitates the inclusion of complementary and supportive therapies that optimize quality of life and reduce treatment-related declines in health. Exercise therapy has been shown to be beneficial in other cancer populations, but no evidence is available for brain cancer survivors. Therefore, we report results from 2 preliminary cases. Methods Two female patients diagnosed with glioblastoma multiforme and oligodendroglioma participated in a structured and supervised 12-week exercise program. The program consisted of two 1-hour resistance and aerobic exercise sessions per week and additional self-managed aerobic sessions. Outcome measures of strength, cardiovascular fitness, and several psychological indicators (depression, anxiety, and quality of life) were recorded at baseline, after 6 weeks and at the conclusion of the intervention. Results Exercise was well tolerated; both participants completed all 24 sessions and the home-based component with no adverse effects. Objective outcome measures displayed positive responses relating to reduced morbidity. Similar positive responses were found for psychological outcomes. Scores on the Hospital Anxiety and Depression Scale showed clinically meaningful improvements in depression and total distress. Conclusion These findings provide initial evidence that, despite the difficulties associated with brain cancer treatment and survivorship, exercise may be safe and beneficial and should be considered in the overall management of patients with brain cancer.