Extensive notes of the KW seminars for Oncology exam 2
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Course
Oncology (AB_1184)
Institution
Vrije Universiteit Amsterdam (VU)
This document contains extensive notes of the lectures of the KW seminars that belong to the second exam of oncology. Many pictures are included with an explanations. It is in it English because the exam will also be in English. There is also a document available with notes of the other lectures an...
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Lecture 9 – KW seminar: Health-related quality of life in cancer ........................................................... 2
Lecture 10 – KW seminar: Hematology. .................................................................................................. 7
Lecture 11 – KW seminar: Radiotherapy ............................................................................................... 14
Lecture 12 – KW seminar: Principles of immunotherapy for head and neck cancer. ........................... 21
Lecture 13 – KW seminar: Lung cancer ‘Clinic’...................................................................................... 31
Lecture 14 – KW seminar: Molecular Imaging ...................................................................................... 39
,Lecture 9 – KW seminar: Health-related quality of life in cancer
Patient story of Cath (56 year old woman).
- November 2012 → Diagnosis of a tumor on the tongue and in the lymph glands on both sides
of the neck.
- December 2012 – Februari 2013 → Surgery of the tongue (and tongue replacement),
chemotherapy and radiotherapy.
(Long-term) symptoms.
- General:
o Changed body image.
o Fatigue and sleep problems.
o Anxiety and depression.
o Cognitive problems.
o Pain.
o Sexuality.
o Etc.
- Tumor-specific (e.g. head and neck cancer):
o Problems with eating.
o Problems with social eating.
o Speech problems.
o Shoulder problems.
o Etc.
- Symptoms have negative influence on the patients health-related quality of life.
Health related quality of life in cancer → Definition.
- HRQOL is a multidimensional concept that refers to patient’s subjective perception of the
effect on their disease and treatment on physical, psychological, and social aspects of daily
life.
- HRQOL is defined as patient reported physical, mental, and social functioning.
- Definition health of WHO → Health is a state of complete physical, mental, and social well-
being, and not merely the absence of disease.
Health-related quality of life in caner → Domains.
- Physical:
o Pain
o Sexuality
o Sleep
o Fatigue
o Body image
o Diarrhea
o Constipation
o Loss of appetite
o Nausea
o Lymphedema
o Daily life
o Hearing
,- Psychological:
o Anxiety
o Depression
o Memory & concentration
- Social:
o Social life
o Loneliness
o Relationships
o Children
o Finances
o Work
o Communication with care providers
- Head and neck cancer:
o Swallowing
o Speech
o Shoulder function
o Taste and smell
o Lymphedema
o Oral function
- Breast cancer:
o Hormonal therapy
o Menopausal symptoms
o Body image
o Sexuality
o Fertility issues
o Hereditary BC
o Lymphedema
o Fibrosis
o Arm/shoulder function
o Breast reconstruction
o Breast prothesis
- Colorectal cancer:
o Bladder and urinary problems
o Stools
o Bloated feeling
o Scars
o Hereditary CRC
o Diarrhea
o Constipation
o Stoma care
o Pain
o Body image
, Measuring HRQOL → How?
- Patient-reported outcome measures (PROMs) → Questionnaires completed by patients.
o Generic → Can be used for more diseases.
o Disease-specific → Can only be used by patients with a specific disease.
o Domain-specific → Asking about specific side effects in physical, psychological and
social domains or disease domain specific.
o Symptom-specific → Asks about specific symptoms.
o Preference-based measures.
- OncoQuest → Touch screen computer system where patients can fill in several
questionnaires.
- After completing the questionnaire the results are automatically processed and then the
patient will discuss the results with a nurse and the nurse will give advise how the symptoms
and the quality of life can be increased.
o Example picture:
▪ Patient did the questionnaire 4
times → The 4 different bars.
▪ In the upper panels, a high score
means a good outcome.
▪ In the lower panels (less yellow), a
high score means a more severe
outcome.
- Oncokompas:
o A supportive care self-management platform.
o Measure → Structured monitoring of health-related quality of life.
o Learn → Feedback by means of a 3-colour system and tailored self-care advice.
o Act → Based on the outcome of the test a database with (evidence based)
supportive care options are provided to the patient.
Measuring HRQOL among patients in cancer → Why?
- Increase symptom awareness → Not only under patients but also under the physician.
o It also improves symptom recall.
- Improve communication → Among patient and physician and among different physicians.
o Improved interdisciplinary discussions.
o Facilitates interprofessional communication.
o Improves understanding of patient experience.
o Prompt discussion of relevant topics.
- Improve symptom management and HRQOL.
o If you know what
the symptoms are
and what
problems it gives,
the problems can
be better managed
and therefore
improve quality of
life.
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