Due to changes in UK and Scottish policy and NHS directives, there have been many changes and improvements in the way information is provided to patients affected by cancer and their families over the last decade. The information provided should be accurate, detailed and tailored to the individual’s needs across the whole of their cancer trajectory. People affected by laryngeal cancer could be classed as a “Cinderella” group as there is a lack of research with this group of patients and their families, in comparison to other types of cancer, even though the impact of treatment can have a profound and debilitating effect on the individual and their family’s quality of life. How this group of patients and their families use and source information to help them make sense of their experiences across their trajectory is unknown, therefore this study explored the role of information based on the experiences of people affected by laryngeal cancer across their cancer trajectory. The study adopted an interpretive prospective longitudinal approach, using two in-depth qualitative interviews with twenty patients and eighteen carers from across the main treatment pathways associated with this type of cancer. The data were analysed using Framework Analysis and influenced by Dingwall’s Illness Action Model. Four broad thematic headings were developed to explain the role of information: “Search for Normality”, “Illusion of Certainty”, “Reality of Uncertainty” and “Culture of Caring”. Relationships were identified between these headings at four key stages across the cancer trajectory. The ii broad theme “Search for Normality” overarched the whole of the cancer trajectory explaining how information was sourced and used to help this group understand their experience of symptoms. The main findings from the study show that two broad categories of information are used: information from health professionals and experiential information from one’s own and others’ experiential knowledge of health and illness. Both categories of information are sourced and used in different ways at different stages over the course of the trajectory and become inextricably linked over time. The study shows that information is not an entity that can be studied on its own but needs to be studied and explained in the ways it is situated, used and experienced within the context of the complex needs and experiences of this group of patients and their families. This study is the first longitudinal study to provide an explanation of the role of information with people affected by laryngeal cancer across their cancer trajectory. The findings show how the different types of information used from the various sources influence how people affected by laryngeal cancer perceive and understand their diagnosis, treatment and the outcome of treatment. The study findings suggest that health professionals need to situate information in the context of the individual’s understanding and prior knowledge of health and illness to ensure that it does not set unrealistic expectations, with a clear need for continuity and supportive care identified in the post-treatment and follow-up phases.

published_or_final_version / Social Work / Master / Master of Social Sciences

The purpose of this hermeneutic phenomenology study was to explore and describe the meaning employees attribute to the lived experiences of returning to work after cancer treatment. Semi-structured interviews were held with eight participants and a thematic data analysis method was used. The results indicate that cancer survivors experience various challenges that make it difficult to function as they did before the diagnosis when they return to work. A critical hermeneutical reflection against the literature followed the structural analysis and resulted in a contextual framework that incorporated the individual and organisational perspective on the various influences involved in supporting cancer survivors to maintain their wellbeing when they return to work. Four phases, repression, comprehension, activation and reintegration, were identified when they tried to cope/adjust on their return to work. The corresponding forms of organisational support they expected through these phases were labelled motivation, information, navigation and stabilisation. / Industrial and Organisational Psychology / M. Com. (Industrial and Organisational Psychology)

M.Cur. (Psychiatric Nursing) / A diagnosis of cancer causes certain fears to arise in a patient, as well as among his family, activating intense emotional responses in everyone concerned. Examples of such emotions are anger. self-reproach, gUilt, heartache, helplessness and mourning. An acceptance of the circumstances does not necessarily occur, and the phases of the mourning process may be continually interchanging. As a result of all these emotions experienced by the patient with cancer as well as his family, mental discomfort is likely to occur. The family has to adapt its usual mechanism for handling internal discomfort, in order to include the pressure and demands to which they will be exposed as a result of the cancer and treatment thereof. Family cohesion will not necessarily be advanced as a result of this heightened pressure, and additional pressure may be placed on relationships within the family. Members of a family often find it difficult to discuss openly their fears, worries and feelings. for the simple reason that they are scared of becoming upset themselves, or alternately upsetting the rest of the family. Holding themselves back in this way may lead to a feeling of being isolated, which in turn leads to feelings of uncertainty being experienced. In this way the members of a family may find themselves becoming less and less involved with each other and with the patient's treatment, all as a result of not being able to talk about their fears and other intense emotions and therefore not being able to realise all these feelings. As a result of the family's uncertainty concerning their handling of the situation, they experience a loss of control and a change in their ability to handle their situation. These factors contribute to their experience of mental discomfort. Mental discomfort is not visible to others, therefore it is very rarely treated by the multiprofessional team. If the members of the team notice the existence of such discomfort, they will still emphasise the medical treatment, since they themselves may be uncertain as to any effective treatment for such a family. The registered nurse who is in continuous contact with the patient and his family, therefore has the challenge to support the family who suffers from mental discomfort in order to lessen their suffering and facilitate their striving towards achieving wholeness once more, whether in hospital, at home or in a community centre. There are several methods of interaction available for the treatment of such a family. Mental discomfort can be reduced by psychiatric nursing accompaniment. The purpose of this study was to explore and describe the folloWing: the contribution made by psychiatric nursing accompaniment through the medium of a psychiatric nursing specialist, as regards lessening the mental discomfort of the family of a patient being treated in an oncology unit or at home. A further purpose was to set certain guidelines for the registered nurse, concerning her support of the family of a patient in an oncology unit or at home, thereby lessening their mental discomfort. An exploratory, descriptive, contextual study was done on a family with one member who has been diagnosed with cancer, and who received treatment in an oncological unit and at home. This family submitted themselves to psychiatric nursing accompaniment. A purposive, non-selective sample was used and the family had to satisfy certain specific criteria pertaining to mental discomfort...

L’anxiété est très fréquente chez des patientes présentant un cancer du sein non-métastatique et peut avoir des répercussions importantes sur leur prise en charge médicale ainsi que sur leur bien-être physique et psychologique. S’il existe une littérature abondante sur le sujet, de nombreuses questions subsistent concernant l’évaluation et la prise en charge de l’anxiété durant la radiothérapie et dans la phase de rémission qui suit. <p><p>Ce travail de thèse a investigué ces questions au travers de deux études empiriques répondant aux objectifs suivants: (a) l’évaluation de l’évolution et des prédicteurs de l’anxiété durant le traitement de radiothérapie et (b) le développement et l’évaluation de l’efficacité de deux interventions psychologiques de groupe sur la régulation de l’anxiété après la radiothérapie. <p><p>Les résultats de la première étude (a) montrent que les niveaux d’anxiété les plus élevés sont observés lors de la simulation et de la première séance de radiothérapie et diminuent, ensuite, rapidement jusqu’à la fin du traitement. Bien que les niveaux d’anxiété soient relativement faibles pour de nombreuses patientes et semblent être de nature anticipatoire, certaines patientes présentent des niveaux cliniquement significatifs d’anxiété. De plus, un niveau cliniquement significatif d’anxiété à la première séance de radiothérapie est prédit par des facteurs liés à la communication entre les patientes et l’équipe de radiothérapie. Les résultats de la seconde étude (b) indiquent qu’une intervention de groupe à composantes multiples qui combine le soutien, les techniques cognitivo-comportementales et l’hypnose est plus efficace qu’une intervention de groupe à composante unique basée sur le soutien pour aider les patientes à mieux réguler leur anxiété après la radiothérapie. <p><p>Les résultats de ce travail de thèse soulignent l’importance d’évaluer l’anxiété chez les patientes à des moments critiques de leurs parcours médical et d’identifier les patientes qui présentent des niveaux cliniquement significatifs d’anxiété pour leur offrir un soutien adapté. Ces résultats suggèrent également d’améliorer les prises en charge afin de réduire l’anxiété des patientes. Des prises en charge offertes par les équipes de radiothérapie nécessitent une personnalisation de la communication établie avec les patientes et l’utilisation de stratégies proactives d’évaluation, d’information et de soutien. Des prises en charge psychologiques de groupe nécessitent quant à elles de combiner les composantes thérapeutiques les plus optimales. Enfin, ce travail de thèse souligne l’importance de continuer à développer et à améliorer les méthodes d’évaluation et d’intervention.<p> / Doctorat en Sciences Psychologiques et de l'éducation / info:eu-repo/semantics/nonPublished

In this work, we found that proliferation-related prognostic gene signatures could aid treatment decision-making independent of age. This is clinically relevant for the younger breast cancer population given the potential long-term side effects of adjuvant systemic chemotherapy and hence the need to identify patients who are less likely to benefit adjuvant chemotherapy. In addition, it was clear that young age at diagnosis adds extra biological complexity, which is independent of differences in breast cancer subtype distribution. This includes enrichment with known breast cancer targets like RANKL. Whilst these results require further validation, either experimentally or in other clinical data sets, it suggests that separate therapeutic approaches may need to be specifically designed in order to improve outcomes for breast cancer arising in young women. In this regard, and based on our results and supportive evidence from other studies, we initiated a proof-of-concept prospective phase II neoadjuvant study investigating the role of denosumab, a RANKL inhibitor on modulating tumor biology in young premenopausal breast cancer patients. <p>We found that diagnosis during pregnancy does not significantly influence the classic pathological features or the prevalence of breast cancer subtypes. We also did not find obvious differences in the distribution of PIK3CA mutations. However, we found that tumors diagnosed during pregnancy have activated serotonin receptor signaling and high expression of potential breast cancer targets; of particular interest IGF1, and PDL1. Such differences appeared to be reflected in the normal pregnant breast underscoring the potential role of the pregnant breast microenvironment on the tumor transcriptome. We were not able to associate these genes with prognosis, which could be partly due to lack of statistical power. Of note, we cannot confirm whether any of these aberrations are key drivers of the biology of tumors diagnosed during pregnancy. Nevertheless, this remains the first study to look into the biology of this relatively rare disease and hence we believe it would serve as a very valuable resource for future research in this field. We are planning to perform targeted gene sequencing to further refine our understanding of the potential effect of pregnancy on the biology of these tumors. <p>In the last part of this work addressing the safety of pregnancy following breast cancer diagnosis, we identified that available studies suffered major limitations related to study design including selection bias and lack of information on patients with history of an ER-positive disease. This has resulted in advising against pregnancy in women with prior history of breast cancer. Our subsequent study has robustly addressed most of the limitations in older studies and clearly showed that pregnancy following breast cancer is safe even in women with a history of ER-positive disease. Hence, this study would provide a very important resource for the oncology community, which would aid adequate fertility counseling for young breast cancer survivors. This work is currently serving as the basis for a new prospective study by the IBCSG to test the safety of early interruption of tamoxifen in young women with early breast cancer seeking subsequent pregnancy. <p> / Doctorat en Sciences biomédicales et pharmaceutiques / info:eu-repo/semantics/nonPublished

M.A. / A diagnosis with cancer causes certain fears in a patient, as well as, their family. It activates intense emotional responses in everybody concerned. Reach for Recovery play a huge role in mastectomy patients and their family's lives. It is there to support the patient and to understand what the patient is experiencing. Reach for Recovery is a selfhelp group, functioning under the name of the Cancer Association of South Africa. The group was started in 1952 in the USA, at a time when there was a tendency to discourage patients from discussing their operations with other patients. Therese Lasser, a mastectomy patient, realized that not enough was being done for women whose life had changed dramatically in the span of a few hours. The goal of the study was to do training for Reach for Recovery volunteers. To assess if the Reach for Recovery volunteer is fulfilling in the need of the mastectomy patient. A qualitative approach, using an inductive strategy, was followed to achieve the aim of the study. Focus groups are being used to gather information about the functioning of the Reach for Recovery groups at present. Focus groups were held in the Far East Rand and the West Rand with the Reach for Recovery support groups. The purpose of the focus group was to identify the needs of the mastectomy patients, to enable the researcher to identify guidelines for the Reach for Recovery programme. A literature control was done after the central themes were identified. After having compared the results of the focus group with the relevant literature certain conclusions were drawn and recommendations made. In conclusion to this study, guidelines were designed to be used in the Reach for Recovery programme when the training is done.

Thesis (M. (Nursing)) -- University of Limpopo, 2022 / Caring for terminally ill cancer patients is considered stressful and heartbreaking. Oncology nurses often consider leaving the nursing profession because of the high levels of stress experienced by these health care professionals. The aim of this study was to investigate the experiences and the practices of nurses who care for terminally ill cancer patients in the Pietersburg Provincial Hospital in the Capricorn District of the Limpopo Province. The objectives of this study were to explore and describe the experiences and practices of nurses who care for terminally ill cancer patients and further to describe the relationship between certain demographic variables and nurses’ experiences of death. An additional objective was to develop recommendations and strategies that might assist management of the Pietersburg Provincial Hospital with the development of appropriate skills and the implementation of emotional support that could assist nurses who care for dying cancer patients in the oncology wards. The study followed a phenomenological, descriptive, exploratory and contextual research design, which assisted the researcher to describe and explore the experience and practices of nurses caring for terminally ill cancer patients. Semi-structured interview method was used to collect data, making use of an interview guide, was used because it is a more free-flowing approach, with its structure being limited only by focusing on the research. Field notes were captured during the data collection session by the researcher. A voice recorder was used to capture all the interview sessions. The initial data analysis started with the researcher listening to the recordings and transcribing verbatim all statements made by the participants. Tesch’s open coding data analysis method was used by following the proposed eight steps to analyse qualitative data as outlined in Creswell (2013). Ethical standards as set in Babbie (2013) were adhered to by the researcher. The researcher requested permission to conduct the study from the Limpopo Department of Health Ethics Research Committee and informed consent was obtained from the participants before collecting data. Privacy of the participants was ensured as participants were never called by their names. In the study participants shared different views with respect to caring for dying cancer patients. Some participants regarded caring for cancer patients as stressful and heartbreaking. Other oncology nurses blamed the management for not providing them with courses to assist them with caring for dying cancer patient, nor providing debriefing sessions for them. On the other hand, some oncology nurses believed that relocating to other wards was a better solution. The participants suggested the following improvements for caring for dying cancer patients; oncology nurses should be offered short courses to assist them with the challenges that they come across with regard to caring for dying cancer patients. Oncology nurses need support from the management and colleagues in order to cope with the workload. Oncology nurses need psychological assistance to help them with the psychological stressors they experience. Family members and patients need health education on how to deal anticipatory grief. / University of Limpopo

No description available.

Thesis (M.Tech.: Radiography) - Dept. of Radiography, Durban Institute of Technology, 2003 1 v. (various pagings) / Cancer is an inexorably progressive disease and a favourable outcome in its management often depends on early intervention (Mackillop, Zhou and Quirt, 1995: 532). Early detection of the disease is therefore important for a favourable outcome to be achieved. When the disease is diagnosed at a late stage, the treatment that is offered is only palliative. Palliative treatment is only offered with the aim to relieve the local symptoms of advanced disease. The treatment intent is therefore not curative but only to give the patient a better quality of life, which sometimes is not possible especially for very advanced disease. In KwaZulu-Natal the incidence of Zulu speaking patients presenting with a late stage disease to the major cancer treatment centres is very high with the result that the majority of these patients can only be offered palliative treatment (Pervan, Cohen and Jaftha, 1995 : 162). Aim of the study is to investigate the factors that contribute to the late presentation of rural Zulu patients with cancer to the two major provincial cancer treatment centers in KwaZulu-Natal (prior to December 2002).