Thesis (Ph.D.)--University of Nebraska-Lincoln, 2007. / Title from title screen (site viewed Nov. 9, 2007). PDF text: 195 p. : ill. ; 9 Mb. UMI publication number: AAT 3266775. Includes bibliographical references. Also available in microfilm and microfiche formats.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 9 uppsatser.

Diss. (sammanfattning) Umeå : Univ., 2005. / Härtill 4 uppsatser.

The present study is based on the finding that treatment with the new anticancer drug, ICRF 159, completely inhibited the formation of metastases in mice implanted with the Lewis lung carcinoma (3LL), at doses which had little effect on the growth rate of the primary tumour. The mode of action of the drug appeared to be on the development of the blood vessels of the primary tumour. Studies were carried out to demonstrate the nature of the changes occurring in the structure and function of tumour blood vessels brought about by treatment with ICRF 159. X-ray angiography, carbon black (Pelikan ink) labelling and intravital staining with lissamine green have demonstrated that many of the characteristics of tumour blood vessels were absent In tumours treated with ICRF 159. Further, the blood vessels of treated tumours were relatively normal in structure and arrangement. Any alteration of the morphology of tumour blood vessels may affect the rate of blood flow through the tumour. As this could be critical for most therapeutic modalities, the rate of blood flow through 3LL tumours treated with ICRF 159 was measured but was found not to be significantly different from control values. It has been reported that tumour blood vessels are abnormally sensitive to serotonin at doses which have little effect on the blood vessels of normal tissue. Although control 3LL tumours demonstrated a marked response to serotonin, no such effect was shown in tumours treated with ICRF 159. Finally, It was demonstrated that ICRF 159 did not alter the viability of 3LL cells found in areas of the tumour which were devoid of functional blood vessels. These cells were capable of propagating the growth of new tumours. The profound modification of the morphology and functional character of tumour blood vessels brought about by treatment with ICRF 159, termed "angiometamorphic", could be of considerable importance in the treatment of primary and secondary tumours.

<p> Recent advancement in cancer management has led to improved survival rates resulting in an increase in the number of cancer survivors. Several studies have shown the crucial role of spirituality in coping with the disease process in this vulnerable population. The purpose of this research project was to deepen the understanding about the spiritual experiences of cancer survivors in long-term Brahma Kumaris Raja Yoga Meditation (BK-RYM) practitioners. This study asked, &ldquo;What is the lived spiritual experience of cancer survivorship in long term Brahma Kumaris Raja Yoga meditation practitioners?&rdquo; Research studies are lacking in cancer survivors with history of long-term meditation practice prior to cancer diagnosis. </p><p> A qualitative inquiry with interpretative phenomenological analysis (IPA) approach was chosen to gain a deeper understanding of the role of meditation in the life of cancer survivors. A total of six participants with history of cancer diagnosis were recruited from BK-RYM centers across the North America, South America and Australia. All the participants were interviewed in an in-depth, and open-ended manner. The interviews were audio-recorded, transcribed and analyzed using Smith and Osborn&rsquo;s (2008) approach to IPA. </p><p> Seven super-ordinate themes with 28 themes as well as three outlier themes arose after thorough analysis. Super-ordinate themes included (a) mental stability and clarity, (b) spiritual connection and self-empowerment, (c) personal relationships with God, (d) healing practices, (e) empowering support system, (f) positive health outcomes, and (g) post-cancer spiritual growth. The three outlier sub-themes were grouped under the theme of &ldquo;transient mental changes&rdquo; and comprised of (a) shock as the initial reaction; (b) mind as a battlefield; (c) matter over mind. New themes identified were daily spiritual education, healing environment, maintaining same spiritual routine amidst cancer therapy, soul consciousness (in the context of cancer), detachment, and spiritual silence. </p><p> Integration of spiritually focused meditation early on at the time of cancer diagnosis could improve quality of life and well-being in cancer survivors. Such spiritual measures have implication to reduce healthcare cost by decreasing cancer related complications. Future research should focus on studying the impact of implementation of spiritual distress screening programs in cancer and other chronic ailments.</p><p>

<p> The purpose of this study was to determine the taste function of post-laryngectomy head and neck cancer survivors and examine associations with dietary intake and malnutrition status. In this randomized, double-blinded, controlled trial, participants were tested in their ability to identify solutions of the five basic tastes of bitter, salty, sour, sweet, and umami. A 24-hour dietary recall was conducted to determine dietary intake and participants were screened for positive markers of malnutrition. At low concentration, 33.3% of participants were able to identify bitter, 16.7% salty, 16.7% sour, 0% sweet, and 0% umami. There were no reported positive features of malnutrition though a majority of participants&rsquo; 24-hour dietary recall showed energy intake below recommendation. Positive correlations were found between energy intake and correct identification scores for sour at medium (<i>r</i> = 0.956, <i>p</i> = 0.003) and low (<i>r</i> = 0.912, <i> p</i> = 0.011) concentrations and umami at low concentration (<i> r</i> = 0.854, <i>p</i> = 0.031). Findings suggest that taste impairment is a long-term post-treatment effect in post-laryngectomy head and neck cancer survivors though adaptation seems to occur. These findings promote the need for preventative or rehabilitative interventions for taste impairment to prevent subsequent alterations in dietary intake and maximize quality of life.</p><p>

<p> Teens with cancer can face a myriad of psychological symptoms. These symptoms include those related to depression, medical trauma, and anxiety, in addition to any of the typical trials of adolescence. Although healthy teens navigate normal developmental challenges by turning to their peers, family, and social institutions (such as places of worship, etc.), teens with cancer are often isolated from their support networks due to lengthy hospital stays and recovery. The unique challenges faced by adolescents with cancer set them apart from their healthy peers, families, and social institutions in ways that may be difficult to surmount. Electronic means to communicate both privately and publicly were neither widely accessible nor mastered by teens prior to the 1990s. Currently, however, not only are social networking platforms accessible and available to most teens, but there are also websites specifically geared for the use of teens with cancer. The aims of the current research were to (A) enlist teens with cancer to produce video narratives about their experiences with their illness, (B) explicitly characterize and investigate the videos&rsquo; content while comparing this to the content of healthy teens discussing a stressful event, and (C) determine what aspects of the production were helpful to the teens making them and predicted to be helpful to those watching them as compared to their healthy peers. Results suggested that while significant difficulties were faced with recruitment of adolescents with cancer (and adolescents with the most severe symptoms and treatment of cancer did not particularly benefit from this exercise), a number of factors relating to resilient qualities within the narrative and legacy making had a positive impact on the narrator (regardless of group), planned health related behaviors, and perceived relationships with others (notably the adolescents with cancers&rsquo; medical team). The positive impact of producing one&rsquo;s narrative on film, especially when the narrator allowed themselves to be the primary subject of the narrative and had a greater understanding of their story as a whole, was statistically stronger in adolescents with cancer compared to their peers. While more research is needed to further characterize these relationships, one could tentatively say that making testimonial videos is indeed beneficial for adolescents with cancer.</p><p>

Chinese people traditionally hesitate to talk about illness and death as these topics are considered bad luck. Studies indicate that Chinese cancer patients seldom have the opportunity to share their deep feelings, although many experience “fear of death.” Clarifying one's meaning in life can facilitate overcoming this fear. This qualitative study therefore explored how U.S. resident Chinese immigrants with metastatic cancer search for meaning at the end of their lives. Data were gathered by a topical life history method, using life-story, in-depth interviews. Results show that participants appreciated having opportunities to share their experiences. They described how the interviews gave them a deeper understanding of themselves; by recalling their life events they realized how meaningful their lives were. Narrative analysis of 12 participant interviews revealed six themes: suffering and impending death; compassion and love; joy and value; hope and faith; readjustment and transcendence; and empowerment and peaceful dying. Participants simultaneously faced physical, psychological, spiritual and moral suffering, including physical discomfort, shock and denial, fear, psychological conflict, loss, loneliness, hopelessness, powerlessness, worry, uncertainty, and guilt. Despite this suffering, participants experienced compassion and love from religious practices and the caring and support of family and others. They experienced joy and value by feeling satisfied with their quality of life, having good relationships with family and friends, practicing religion, appreciating the present moment, and keeping everyday life normal. Participants built hope and faith by continuing to live, believing in a possible cure, having religious beliefs and getting encouragement from family and others. They readjusted and transcended suffering by accepting the unexpected in life, looking for positive impacts of having cancer, and developing a positive attitude toward living with cancer. They felt empowered and prepared to die peacefully by maintaining good symptom control, remaining independent, and finding peace of mind. Significantly, 8 of the 12 participants took both western and eastern medicines for cancer control. Besides hoping for a cure, participants believed that eastern medicines could promote physical comfort and help them die peacefully. This study's results have both theoretical and practical value for a fuller understanding of Chinese immigrants with cancer. One implication for oncology nurses is involving family members and religious beliefs in the care of Chinese clients with metastatic cancer.

Objective: To examine the effect of treatment and tumour factors on the overall survival (OS) of patients completing chemo-radiation (CRT) for stage IIB cervical cancer. Materials and methods: Retrospective audit of 228 patients with stage IIB cervical cancer treated between 1995 and 2010, who received CRT with at least 45 Gy external beam radiation, two to four brachytherapy insertions, and one or more cycles of concurrent weekly cisplatin (40mg/m², capped at 60 mg/week). Results: Mean tumour size was 5.5cm, bilateral parametrial involvement in 40% of patients, lateral parametrial involvement in 50%, and vaginal spread in 43%. Mean total dose to Point A was 83 Gy (range 61-96) linear quadratic equivalent dose to 2 Gy/fraction. Mean overall treatment time (OTT) was 45 days. The average weekly haemoglobin (AWHB) during treatment was 11.6 g/dL (range 8.8-15.5). Blood transfusions before or during chemo-radiation were given in 33% of patients. Two thirds of patients completed five or six cycles of weekly cisplatin. Reasons for fewer than five cycles were: scheduling failure, neutropaenia, and/or renal impairment. No outcome differences were observed for Monday vs. Thursday cisplatin administration. The 5-year OS was 60%. Patients completing fewer than six cycles had a worse OS (55 vs. 76%, p=0.02). By multiple regression analysis for OS, only six cycles of cisplatin, squamous histology, and AWHB>10g/dL were significant. Conclusions: Maintaining HB>10 and administering six cycles of weekly cisplatin at the dose regimen used appear to be requirements for maximal benefit during CRT of stage IIB cervical cancer.

Women with metastatic breast cancer experience diminished quality of life (QOL) as a consequence of disease, treatment or psychosocial issues. The role of the nurse includes providing interventions to promote QOL. QOL is a multidimensional concept, including affective and cognitive aspects, that has the potential to improve through use of effective psychosocial and behavioral interventions. Expressive writing (EW) is a psycho-behavioral intervention developed by Pennebaker to promote disclosure: narrative formation resulting in catharsis, reframing and integration. EW has been related to positive health outcomes in healthy and ill samples. Gaps in the literature were identified in exploring both use of EW and cognitive processes of disclosure in cancer patients. The purpose of this secondary analysis was to explore the relationship between patterns of language used in EW texts and QOL in women with metastatic breast cancer. Usage patterns of affect, causal and insight words in EW texts from a sample (n = 68) who completed baseline and three month QOL assessments were identified through use of the Linguistic Inquiry and Word Count (LIWC). Relationships between these patterns of language and QOL were explored. QOL was measured using the Functional Assessment of Cancer Therapy - Breast (FACT-B), assessing overall QOL status and subscales: physical well-being, social/family well-being, emotional well-being and functional well-being. The correlation between word pattern use and QOL was investigated using general linear regression. No relationship was observed between positive affect language and QOL. A statistically significant relationship was demonstrated between positive affect language use and emotional well-being subscale scores (β = 1.87, p = 0.02). No relationships were observed with QOL scores and progressive use of causal or insight language. Ten complete EW texts were manually scored to validate LIWC data. Evaluation of text containing grammatical errors, idiomatic language, or complex expression of ideas was inadequate with LIWC. A significant difference between LIWC and manual word counts for negative language was identified. Although no significant difference was noted in word counts for causal or insight language, differences in contextual meaning were noted. Further research including the use of qualitative methods to examine content and contextual use of language is warranted.