Follow-up includes the permanent contact with and health education of the patient, the surveillance and control of the adverse effects of surgery, oncological therapies or radiotherapy, the screening of metachronous cancers, and the comprehensive (physical, psychological and social) rehabilitation of the patient which may be enhanced by healthy life-style. The early detection and curative management if necessary, of local/regional tumor relapse is still a priority but the routine screening of distant metastases by means of imaging studies or tumor marker tests is not justified. Supportive therapy means to endocrine therapy, available social support in Hungary, and the key issues and managing tools of physical and psychooncological care are provided. Individual solution of special issues (breast cancer risk/genetic mutation, pregnancy) may be served by widening options. Ideally, follow-up is practised by a cooperative team of oncologists, surgeons, breast radiologists, social workers, physiotherapists, psychiatrists. The follow-up approach should be comprehensive and holistic.
Chemotherapy is a common treatment of neoplasm with highly varying outcome. The efficiency of the therapy and the caused side effects depend strongly on the tolerance rate of the patient. The tolerance is expected to be higher for active people. Here we present a preliminary work on setting up a protocol for monitoring the activity rate of patients during chemotherapeutic treatment. Our setup consists of a set of commercial fitness devices and a central server for evaluating data. We showcase criteria for selecting the appropriate device and discuss the possibilities of scaling up the configuration. We also consider aspects of patients' anonymity and how the proposed protocol compares to traditional methods.
The development of a recommendation was intended for the follow-up of breast cancer patients treated with curative intent in Hungary. Follow-up includes the permanent contact with and health education of the patient, the surveillance and control of the adverse effects of oncological therapies or radiotherapy, the screening of metachron cancers, and the comprehensive (physical, psychological and social) rehabilitation of the patient. The early detection of local/regional tumor relapse is essential with careful follow-up, but there is no need for screening of distant metastases by means of imaging studies or tumor marker tests. If adjuvant endocrine therapy is needed, optimal adherence should be ensured with supportive therapy. In rare cases, special issues such as breast cancer risk/genetic mutation, pregnancy are raised, which should be thoughtfully discussed in view of recent advances in oncology. Follow-up is generally practised by the oncologist, however, in some cases the social worker, the physiotherapist, the psychooncologist, or in special cases, the lymphoedema expert is to be involved. The follow-up approach should be comprehensive and holistic.A nemzetközi ajánlások és legújabb irodalmi adatok áttekintése alapján kívántunk ajánlást adni az emlõrák miatt kuratív ellátásban részesült betegek gondozásának magyarországi gyakorlatához. A gondozás magába foglalja a beteggel történõ kapcsolattartást, egészségnevelést, a betegség tüneteinek, illetve az onkológiai kezelés és a sugárterápia mellékhatásainak felismerését, menedzselését, a további daganatokra vonatkozó szûrést és a beteg teljes körû (fizikai, lelki és szociális) rehabilitációját. Fontos a lokális/regionális daganatkiújulás korai detektálása gondos követéssel, de nincs szükség a távoli áttétek kutatására képalkotó vizsgálatokkal vagy tumormarker-meghatározással. Amennyiben adjuváns hormonterápia szükséges, a jó adherenciát a mellékhatások megfelelõ szupportálásával segítsük. Egyes esetekben speciális kérdések (emlõrákrizikó/mutációhordozás, gyermekvállalás) is felmerülhetnek, ezek tapintatos, gondos és hozzáértõ megbeszélése az onkológia fejlõdésének tükrében elengedhetetlen. A gondozást általában onkológus végzi, de a beteg ellátásában szükség lehet a team szociális munkás, fizioterapeuta és pszichoonkológus tagjának, olykor nyiroködéma-szakembernek a bevonására. A gondozás legyen teljes körû és holisztikus szemléletû.
Follow-up includes ongoing contact with and health education of the patient, surveillance and control of the adverse effects of surgery, oncological therapies or radiotherapy, screening of metachronous cancers, and comprehensive (physical, psychological and social) patient rehabilitation, which may be enhanced by a healthy lifestyle. Primary attention should be paid to early detection and, when needed, curative treatment of local/regional tumour recurrences. Similarly, with the hope of curative solution, it is important to recognize the entity of a low-mass and relatively indolent recurrence or metastasis (oligometastasis); however, there is still no need to investigate distant metastases by routine diagnostic imaging or assess tumour markers. Below there is a list of possible sources of support, with respect to adjuvant hormone therapy continued during long-term care, social support resources, pivotal points and professional opportunities for physical and mental rehabilitation. Individual solutions for specific issues (breast cancer risk/genetic mutation, pregnancy) are provided by constantly widening options. Ideally, a complex breast cancer survivorship programme is practised by a specially trained expert supported by a cooperative team of oncologists, surgeons, breast radiologists, social workers, physiotherapists, psycho-oncologists and psychiatrists. The approach of follow-up should be comprehensive and holistic.
Introduction: EuropaColon, a European CRC patient organisation, planned and executed a survey in 12 European countries on the Unmet Needs of Patients Living with mCRC. The aim of this patient survey was to understand the challenges and needs of those living with mCRC and their health-related quality-of-life challenges. Recruitment in Hungary, Serbia and Spain was completed. The objective of this paper is to describe basic demographics and patient responses about discovery of the disease in these four countries. Methods: The survey included sections on demographics, patient discovery of the disease, diagnosis and treatment. The section on patient discovery comprised of 13 questions, including reasons for contacting physicians, symptoms experienced, the delay between first symptoms and seeking clinical help, and misdiagnosis. IRB approval, where needed, was sought for the survey. Clinicians and nurses together with EuropaColon partner organisations recruited patients for the survey. Patients could complete either a paper-based survey or an on-line form. Data entry from the paper surveys was done by EuropaColon. Results: Altogether 578 surveys were collected and analyzed with 170 from Serbia, 163 from Poland, 112 from Spain and 103 from Hungary. Most surveys were received in paper format (80%). Completion rates varied across responses, but in general were high. Average age of patients across these countries was 70.4, ranging from 63.2 years in Spain to 81.3 in Poland. The sample included 55% men and 45% women. Most patients had a secondary education and were retired (64%). Approximately 50% of patients were diagnosed on a routine exam or due to symptoms not related to CRC, while only 4% were discovered through screening programmes. 56% of patients would have participated in screening if invited. CRC symptom awareness in the analyzed sample was very low – only 26% of patients knew what symptoms may have been associated with CRC. Although 35% of patients waited less than a month from observing symptoms, 33% waited 1-3 months, 14% waited 3-6 months and the rest even longer. Similar delays were observed for diagnosis. Importantly, 23.5% indicated that they were misdiagnosed. Overall, 48% of patients were 'very satisfied' with the process of establishing a diagnosis however, there was large variation across countries – including 35% in Hungary who were 'not satisfied at all'. Conclusion: The survey captured a large and diverse patient population and is a reflection of patients with recent experiences. Patient awareness of CRC is low, with few respondents recognizing symptoms and seeking help without delay. Misdiagnosis levels are still high. The attitude towards screening programmes is positive among patients, but despite the existence of different types of screening programmes in these countries, awareness and compliance rates are low. The understanding of CRC needs to be improved at patient level and most importantly at clinical diagnosis.
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