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).

This research is a follow up of a "Breast Week" which was organized in Freetown, Sierra Leone. The specific objective of this study was to assess the effectiveness of the knowledge and teachings given to the women who participated in this project. The unrecorded cases of breast lumps and breast cancer observed in women in Sierra Leone prompted the researcher to undertake this present study. A quantitative approach was adopted and a structured interview schedule and an observational checklist guided the data collection process. A sample size of 120 women (10%) who participated in the "breast week" was obtained through systematic sampling. The first part of the study involved assessment of the theoretical background of the research topic followed by the second phase during which the women demonstrated Breast Self-Examination to detect abnormalities of the breasts. Discussions and analysis of the findings are presented in three sections. Texts from open ended questions were categorized and explained in numerical terms as the study was quantitative in nature. The data was processed through use of SPSS and Microsoft Excel. Frequency counts were applied to the data, use of non-parametric tests on the number of women who practiced Breast Self-Examination before and after the breast week showed a statistically significant difference in the number of women now practicing BSE as a screening method for breast cancer after receiving the health education. It was found that the majority of the women linked breast cancer to the signs and symptoms associated with it and were able to describe the disease as one that kills women if not promptly detected and/or treated appropriately. Findings indicate that the majority of the women (78.3%) had previously had mmor breast problems. An assessment of the effectiveness of knowledge on breast cancer showed that these women could identify breast cancer as a disease that affects women and may cause deaths if not detected on time or treated promptly. These women were able to demonstrate to the researcher how they examine their breasts to exclude abnormalities. Three women had breast lumps detected through examination of the breasts during the breast week. Two of them had had the lumps removed and are currently on medication. One of the women who had a breast lump detected was financially constrained and could not afford the cost of surgery. The number of women who can now perform BSE increased (95.0%) after having the knowledge on breast cancer and BSE. The majority of the women (97.4%) received information on how to examine their breasts for breast cancer through the information provided during the breast week. It is thus concluded that the objectives of the breast week were met. / Thesis (M.N.)-University of Natal, Durban, 2004.

SAMMANFATTNING Bakgrund Vid ett cancerbesked ges mycket information som kan ge psykologiska reaktioner hos patienten.  Att ge individuellt stöd, information och ett bra bemötande är viktigt för att patienten ska känna sig trygga och delaktig i sin vård. Syfte Att utvärdera bröstcancerpatientens upplevelse av information, stöd, bemötande och delaktighet i samband med sitt återbesök hos kontaktsjuksköterska efter operation på Bröstmottagning. Metod En tvärsnittsstudie med kvantitativ ansats då huvudfokus var patientens upplevelse av information, stöd, bemötande och delaktighet. Patienterna fick svara på en elektronisk enkät direkt efter sitt återbesök på mottagningen. Totalt svarade 48 patienter på enkäten. Resultat  Resultatet visade en mycket hög nöjdhetsgrad bland bröstcancerpatienter vad gäller information, stöd, bemötande och delaktighet i samband med återbesöket hos kontaktsjuksköterskan efter bröstkirurgi. Äldre kvinnor var mer nöjda med informationen jämfört med de yngre. Utbildningsnivå hade ingen betydelse för hur nöjd patienten var eller uppfattningen av delaktighet och stöd. Inte heller kunde man påvisa några signifikanta skillnader mellan information och delaktighet mellan de som genomgått bröstbevarande kirurgi kontra tagit bort hela bröstet. Slutsats Kontaktsjuksköterskan har således en viktig roll på mottagningen när det gäller omvårdnad och vårdkvalitet ur ett patientperspektiv. Att kunna identifiera områden som är i behov av förbättring är viktigt. Analysen ger stöd för att det arbetssätt som kontaktsjuksköterskorna och läkarna har idag är positivt för patienten då studien påvisade att majoriteten av patienterna var mycket nöjda med information, stöd, bemötande och kände sig delaktiga vid sitt återbesök hos kontaktsjuksköterska. Nyckelord: Stöd, bemötande, information, patientdelaktighet, bröstcancer patienter. / ABSTRACT Background When a cancer diagnosis is given much information that cause psychological reactions. To provide individual support, information and good treatment is important for the patient to feel confident and involved in their care. Aim To evaluate breast cancer patient's experience of information, support, treatment and involvement during her visits at the contact nurse after surgery at the outpatient clinic. Method A cross-sectional study with a quantitative approach when the main focus was the patient's experience of information, support, treatment and participation. The patients were asked to answer an electronic questionnaire directly after her return visit to the clinic. In total, 48 patients participate in the survey. Results The results showed a very high degree of satisfaction among breast cancer patients in terms of information, support, treatment and participation in connection with the return visit of the contact nurse after breast surgery. Older women were more satisfied with the information compared to younger women. Level of education had no impact on how satisfied patients were or perceptions of participation and support.  There were no significant changes concerning information and participation from those who have undergone breast conserving surgery versus removal of the entire breast. Conclusion The contact nurse plays an important role on reception when it comes to care and quality of care from a patient perspective. To identify areas in need of improvement is important. The analysis provides support for the work procedure that the contact nurses and doctors today are positive using for the breast cancer patients. The study demonstrated that the majority of patients were very satisfied with the information, support, and treatment and felt involved in the visit of the contact nurse. Keyword: Support, treatment, information, patient involvement , breast cancer patients.

A suppressed immune system is a complicating health factor in cancer patients that keeps them from achieving the highest quality of life possible. Moderate exercise is thought to boost the immune system in cancer patients. The aim of this project was to determine the effects of an eight week aerobic exercise program on the mucosal immune system of cancer survivors compared to non-cancer patients. Our hypothesis was that the immune system of the cancer patients would positively respond to a moderate exercise program, specifically increasing antibody production. To examine our hypothesis, five cancer and six non-cancer patients undertook a supervised moderate aerobic exercise program at the University of Northern Colorado. The subjects performed an incremental peak treadmill test to exhaustion at the start of the program and after 8 weeks of training. Saliva samples were taken at specific times for each peak exercise test: prior to testing, immediately after testing, and 30 minutes post-test. Enzyme-Linked ImmunoSorbent Assays (ELISA) were performed at Ball State University to analyze the levels of immunoglobulins (IgA, IgG, IgM) in saliva samples of cancer and non-cancer patients. Our findings demonstrated there was a significant increase in IgG after 8 weeks of moderate exercise in non-cancer patients 30 minutes after the treadmill test. A significant increase was also seen in salivary IgA levels after 8 weeks of moderate exercise in cancer patients 30 minutes after the treadmill test was administered, supporting our hypothesis that exercise enhances immune function. Eight weeks of moderate exercise has been shown to enhance immune function demonstrated by the increase of IgA and IgG levels in saliva. / Department of Biology

Cancer-treatment-induced bone loss (CTBL) is a well-recognized co-morbidity that affects many cancer patients. Commonly used to treat breast and prostate cancer patients, hormone suppression therapy (HST) may accelerate bone loss, resulting in osteopenia or osteoporosis. Because of their broad clinical utility, lifestyle and dietary modifications, such as regular participation in bone-stressing exercise and calcium supplementation, are starting to play a much larger role in the prevention and treatment of CTBL. However, only limited information is available on the effects that these factors may have on bone mineral density (BMD). Purpose. The purpose of this investigation was to assess the degree of BMD change from the onset of HST to 6 months and to examine the impact that physical activity and calcium intake may have on BMD. Methods. Twelve subjects (8 females and 4 males) undergoing HST for breast or prostate cancer were enrolled in the study. BMD at the spine, dual femur, and total body was assessed by dual-energy x-ray absorptiometry at 0 and 6 months. In addition, subjects wore an accelerometer to assess physical activity level and completed a lifestyle questionnaire at baseline, 3, and 6 months after starting therapy. Aside from the 7 non-exercise subjects, 5 subjects chose to participate in The Cancer Exercise Program at Ball Memorial Hospital or complete bone-stressing exercises at home. Results. No significant changes in BMD were observed after 6 months of HST between the groups at any of the sites. When all subjects were examined together, a significant BMD decrease of 3.2% was observed at the lumbar spine. The accelerometer and lifestyle questionnaires revealed that the males were more active than the females and the exercisers were more active than the non-exercisers at both baseline and after 6 months of HST. Supplementation with calcium did not affect BMD changes at any site;although it is possible this is an effect of gender as all males were included in the same group. Lifestyle factors such as history of smoking and alcoholism were also examined, but were not correlated to changes in BMD. Conclusion. Treatment with HST results in decreases in BMD, particularly at the spine. Bone-stressing exercise helped maintain or improve total body BMD in 3 of the 5 subjects the exercise group. There appears to be no difference in BMD between those who supplemented with calcium and those who did not. / School of Physical Education, Sport, and Exercise Science

As the development of medical treatments and the increase in longevity of human life interface with the rising cost of medical care, the issue of quality of life appears to be coming to the forefront in understanding how health care decisions will best be realized for patients. Ethical questions relating to matters such as cost-effective economics, physician-assisted suicide, and quantity of life versus quality of life make the construct of quality of life even more important to ascertain.Quality of life can be an elusive construct to define as well as a difficult one to measure; however, recent literature has shown promising trends. Many quality-of-life measures have been developed in recent years. Initially these measures focused on life satisfaction in general. Then instruments for healthrelated concerns were developed. In the last decade such measures have become more specific as several have emerged to identify the quality-of-life experience regarding a particular illness, such as cancer. The current step is the development of measures for specific populations in oncology. Another trend is the move from objective to subjective measures of assessment. A third trend is movement toward a multidimensional perspective, with the latest addition being the inclusion of a spiritual domain.This project explored the unique experience of cancer patients with recurrent or metastatic disease by utilizing qualitative methodology to describe common themes which emerged from the data. Focus group sessions centered around defining quality of life and discussing the factors that diminish or enhance a meaningful quality of life. A unique contribution of this study was the involvement of the participants as co-researchers in the analysis of the data. Thirteen central themes were identified: control, attitude, humor, death, gratitude, faith, fear, pain, social comparison, social support, financial concerns, information and knowledge, and the focus group experience. The findings confirmed the recent trends in quality-of-life research--multidimensionality, subjectivity, and the uniqueness of a specific cancer population, those with recurrent or metastatic disease. With this elicitative data, future research could include the development of a quality-of-life instrument for this population of oncology patients with more advanced cancer. / Department of Counseling Psychology and Guidance Services

In the treatment of early stage breast cancer, both mastectomy and lumpectomy followed by radiation therapy have been recognized as having similar survival rates. Increasingly, women are being given the opportunity to choose which of these surgical treatment options they wish to pursue. Decisions tend to be made rather quickly, and some women may later regret their treatment choice. In this study, an instrument (Breast Cancer Treatment Inventory (BCTI)) was developed that identified five primary sources of influence that affect women's breast cancer treatment decisions: cosmetic outcome, preparedness, physician's choice, short-term effects, and long-term effects. Items were generated and refined by oncology professionals and breast cancer survivors, followed by a pilot study conducted with members of a breast cancer support group. The resulting 28-item scale was completed by 139 early stage breast cancer patients. A series of oblique factor analyses yielded a five-factor solution with reliabilities ranging from .66 - .87. Content validity was enhanced by involving oncology experts and women with breast cancer in the item generation procedures. Use of the BCTI may assist women through a methodical and effective decision-making process. The BCTI may also be appropriate for research studiesinvolving the process and prediction of treatment selection since it meets requirements for ease of administration, brevity, reliability, and validity. / Department of Counseling Psychology and Guidance Services

The high incidence of cancer and the accompanying medical and psychological effects thereof make exploring cancer patients' experiences regarding their illness potentially valuable. The aim of this study was to qualitatively explore cancer patients' illness experiences during a listening group intervention. Secondary analysis was done on data previously collected by Strydom (2006), for his study on "Cancer patients' and non-cancer patients' experiences of the listening group technique." The use of this post-modernist approach, in which the individual is seen as the expert in his/her own life, makes the data gathered by Strydom (2006) eminently suitable for gaining a true understanding of cancer patients' illness experiences. Analysis of the data yielded twelve prevalent themes namely, support, perspectives and experiences in medical context, perspectives on life and death, emotional experiences, religion, role of knowledge and information pertaining to cancer, finances, concern for others, loss, desire for survival, humour, and physical symptoms. In an attempt to make sense of these themes a framework suggesting moderating factors that would influence cancer patients' illness experiences and outcomes, is proposed. Due to the rising number of cancer survivors and the fact that finishing the treatment seldom indicates the end of the cancer experience, it is suggested that further research regarding the development of a survivorship care programme within the South African context be undertaken. / Thesis (M.A. (Psychology))--North-West University, Potchefstroom Campus, 2009.

The high incidence of cancer and the accompanying medical and psychological effects thereof make exploring cancer patients' experiences regarding their illness potentially valuable. The aim of this study was to qualitatively explore cancer patients' illness experiences during a listening group intervention. Secondary analysis was done on data previously collected by Strydom (2006), for his study on "Cancer patients' and non-cancer patients' experiences of the listening group technique." The use of this post-modernist approach, in which the individual is seen as the expert in his/her own life, makes the data gathered by Strydom (2006) eminently suitable for gaining a true understanding of cancer patients' illness experiences. Analysis of the data yielded twelve prevalent themes namely, support, perspectives and experiences in medical context, perspectives on life and death, emotional experiences, religion, role of knowledge and information pertaining to cancer, finances, concern for others, loss, desire for survival, humour, and physical symptoms. In an attempt to make sense of these themes a framework suggesting moderating factors that would influence cancer patients' illness experiences and outcomes, is proposed. Due to the rising number of cancer survivors and the fact that finishing the treatment seldom indicates the end of the cancer experience, it is suggested that further research regarding the development of a survivorship care programme within the South African context be undertaken. / Thesis (M.A. (Psychology))--North-West University, Potchefstroom Campus, 2009.

This thesis explores the experience of living with cancer and a terminal prognosis from the dying individual's perspective. It is based on qualitative sociological research. My study group comprised nineteen hospice patients, eighteen women and one man, aged 27 to 67, all of whom had been diagnosed with cancer. Thirty focused interviews were conducted; each respondent was interviewed at least once with a sub-group being interviewed a second or third time dependent upon symptoms, willingness to participate again and the need to explore issues further. My thesis is a sociological account of respndents' views and experiences. Its focus is the management and negotiation of dying and death at an individual level. A central tenet of my thesis is how self-identity is constructed and negotiated in different social encounters, in both the public and the private sphere. With reference to the public sphere I consider respondents' experiences of communicating with health professionals, and the difficulties they encountered. Within this discussion I look at how respondents constructed understandings of their illness within the context of their own biographies. I also discuss individuals' experiences of treatment, and the choices they made about this. In addition, I examine respondents' hopes and fears for their own deaths, and I suggest the notion of a 'good enough' death may be useful in interpreting their views. Repsondents perceived they had a spoiled identity as a result of their cancer and dying status. As a result, they spent a great deal of time and effort engaging in emotional work, in order to reassert their more valued roles. Much has been written about the emotional work of paid and unpaid carers. Here I suggest attention must also be given to the work of dying individuals themselves. However, I do not conceive of this emotional work as selfless, rather I suggest such work has benefits for individuals themselves. Emotional work enabled them to reaffirm or renegotiate more valued self-identities while alive, but in addition, I suggest that it also meant that respondents were able to contribute towards their own 'disembodied' after-death identities.