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Publisher: RMIT Publishing   (Total: 400 journals)

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Showing 1 - 200 of 400 Journals sorted alphabetically
40 [degrees] South     Full-text available via subscription   (Followers: 2)
Aboriginal and Islander Health Worker J.     Full-text available via subscription   (Followers: 14)
Aboriginal Child at School     Full-text available via subscription   (Followers: 5)
About Performance     Full-text available via subscription   (Followers: 11)
Access     Full-text available via subscription   (Followers: 25)
ACCESS: Critical Perspectives on Communication, Cultural & Policy Studies     Full-text available via subscription   (Followers: 9)
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ACORN : The J. of Perioperative Nursing in Australia     Full-text available via subscription   (Followers: 17, SJR: 0.103, h-index: 4)
Adelaide Law Review     Full-text available via subscription   (Followers: 19)
Advocate: Newsletter of the National Tertiary Education Union     Full-text available via subscription   (Followers: 1)
Agenda: A J. of Policy Analysis and Reform     Full-text available via subscription   (Followers: 1)
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AIMA Bulletin     Full-text available via subscription   (Followers: 4)
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Analysis     Full-text available via subscription   (Followers: 3)
Ancient History : Resources for Teachers     Full-text available via subscription   (Followers: 4)
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Annals of the Royal Australasian College of Dental Surgeons     Full-text available via subscription   (Followers: 4, SJR: 0.101, h-index: 11)
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Appita J.: J. of the Technical Association of the Australian and New Zealand Pulp and Paper Industry     Full-text available via subscription   (Followers: 14, SJR: 0.18, h-index: 27)
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Arena J.     Full-text available via subscription   (Followers: 1)
Around the Globe     Full-text available via subscription   (Followers: 1)
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Artlink     Full-text available via subscription   (Followers: 5)
Asia Pacific J. of Clinical Nutrition     Full-text available via subscription   (Followers: 10, SJR: 0.672, h-index: 51)
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Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Ageing Agenda     Full-text available via subscription   (Followers: 6)
Australian and Aotearoa New Zealand Psychodrama Association J.     Full-text available via subscription  
Australian and New Zealand Continence J.     Full-text available via subscription   (Followers: 3)
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Australian Bulletin of Labour     Full-text available via subscription   (Followers: 2)
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Australian Grain     Full-text available via subscription   (Followers: 2)
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Australian Humanist, The     Full-text available via subscription   (Followers: 3)
Australian Indigenous Law Review     Full-text available via subscription   (Followers: 19)
Australian Intl. Law J.     Full-text available via subscription   (Followers: 23)
Australian J. of Acupuncture and Chinese Medicine     Full-text available via subscription   (Followers: 3, SJR: 0.106, h-index: 3)
Australian J. of Adult Learning     Full-text available via subscription   (Followers: 15, SJR: 0.159, h-index: 7)
Australian J. of Advanced Nursing     Full-text available via subscription   (Followers: 11, SJR: 0.225, h-index: 26)
Australian J. of Asian Law     Full-text available via subscription   (Followers: 4)
Australian J. of Cancer Nursing     Full-text available via subscription   (Followers: 8)
Australian J. of Civil Engineering     Full-text available via subscription   (Followers: 5, SJR: 0.17, h-index: 3)
Australian J. of Dyslexia and Learning Difficulties     Full-text available via subscription   (Followers: 8)
Australian J. of Emergency Management     Full-text available via subscription   (Followers: 10, SJR: 0.401, h-index: 18)
Australian J. of French Studies     Full-text available via subscription   (Followers: 7, SJR: 0.1, h-index: 5)
Australian J. of Herbal Medicine     Full-text available via subscription   (Followers: 3, SJR: 0.109, h-index: 7)
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Australian J. of Legal History     Full-text available via subscription   (Followers: 14)
Australian J. of Mechanical Engineering     Full-text available via subscription   (Followers: 3, SJR: 0.129, h-index: 4)
Australian J. of Medical Science     Full-text available via subscription   (Followers: 1, SJR: 0.122, h-index: 5)
Australian J. of Multi-Disciplinary Engineering     Full-text available via subscription   (Followers: 2)
Australian J. of Music Education     Full-text available via subscription   (Followers: 3)
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Australian J. of Parapsychology     Full-text available via subscription   (Followers: 2)
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Australian J. of Water Resources     Full-text available via subscription   (Followers: 6, SJR: 0.226, h-index: 9)
Australian J. on Volunteering     Full-text available via subscription   (Followers: 2)
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Australian Life Scientist     Full-text available via subscription   (Followers: 2, SJR: 0.1, h-index: 2)
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Australian Mathematics Teacher, The     Full-text available via subscription   (Followers: 6)
Australian Nursing J. : ANJ     Full-text available via subscription   (Followers: 6)
Australian Orthoptic J.     Full-text available via subscription  
Australian Primary Mathematics Classroom     Full-text available via subscription   (Followers: 4)
Australian Screen Education Online     Full-text available via subscription   (Followers: 2)
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Australian Sugarcane     Full-text available via subscription  
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Australian Tax Forum     Full-text available via subscription   (Followers: 3)
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Australian Voice     Full-text available via subscription   (Followers: 6)
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Breastfeeding Review     Full-text available via subscription   (Followers: 17, SJR: 0.31, h-index: 19)
British Review of New Zealand Studies     Full-text available via subscription   (Followers: 4)
Brolga: An Australian J. about Dance     Full-text available via subscription   (Followers: 1)
Cancer Forum     Full-text available via subscription   (SJR: 0.143, h-index: 10)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Chain Reaction     Full-text available via subscription  
Childrenz Issues: J. of the Children's Issues Centre     Full-text available via subscription  
Chiropractic J. of Australia     Full-text available via subscription   (SJR: 0.107, h-index: 3)
Chisholm Health Ethics Bulletin     Full-text available via subscription   (Followers: 1)
Church Heritage     Full-text available via subscription   (Followers: 4)
Commercial Law Quarterly: The J. of the Commercial Law Association of Australia     Full-text available via subscription   (Followers: 4)
Communicable Diseases Intelligence Quarterly Report     Full-text available via subscription   (Followers: 2, SJR: 0.567, h-index: 27)
Communication, Politics & Culture     Open Access   (Followers: 13)
Communities, Children and Families Australia     Full-text available via subscription   (Followers: 2)
Connect     Full-text available via subscription   (Followers: 2)
Contemporary PNG Studies     Full-text available via subscription  
Context: J. of Music Research     Full-text available via subscription   (Followers: 8)
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Creative Approaches to Research     Full-text available via subscription   (Followers: 13)
Critical Care and Resuscitation     Full-text available via subscription   (Followers: 18, SJR: 1.737, h-index: 24)
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Culture Scope     Full-text available via subscription   (Followers: 4)
Current Issues in Criminal Justice     Full-text available via subscription   (Followers: 10)
Dance Forum     Full-text available via subscription   (Followers: 2)
DANZ Quarterly: New Zealand Dance     Full-text available via subscription   (Followers: 3)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Deakin Law Review     Full-text available via subscription   (Followers: 14)
Developing Practice : The Child, Youth and Family Work J.     Full-text available via subscription   (Followers: 19)
Early Days: J. of the Royal Western Australian Historical Society     Full-text available via subscription  
Early Education     Full-text available via subscription   (Followers: 8)
EarthSong J.: Perspectives in Ecology, Spirituality and Education     Full-text available via subscription   (Followers: 1)
East Asian Archives of Psychiatry     Full-text available via subscription   (Followers: 2, SJR: 0.331, h-index: 7)
Educare News: The National Newspaper for All Non-government Schools     Full-text available via subscription  
Educating Young Children: Learning and Teaching in the Early Childhood Years     Full-text available via subscription   (Followers: 17)
Education in Rural Australia     Full-text available via subscription   (Followers: 1)
Education, Research and Perspectives     Full-text available via subscription   (Followers: 10)
Educational Research J.     Full-text available via subscription   (Followers: 17)
Electronic J. of Radical Organisation Theory     Full-text available via subscription   (Followers: 3)
Employment Relations Record     Full-text available via subscription   (Followers: 2)
English in Aotearoa     Full-text available via subscription   (Followers: 1)
English in Australia     Full-text available via subscription   (Followers: 2, SJR: 0.19, h-index: 6)
Essays in French Literature and Culture     Full-text available via subscription   (Followers: 7)
Ethos: Official Publication of the Law Society of the Australian Capital Territory     Full-text available via subscription   (Followers: 5)
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Extempore     Full-text available via subscription  
Family Matters     Full-text available via subscription   (Followers: 10, SJR: 0.259, h-index: 8)
Federal Law Review     Full-text available via subscription   (Followers: 21)
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Focus on Health Professional Education : A Multi-disciplinary J.     Full-text available via subscription   (Followers: 7)
Food New Zealand     Full-text available via subscription   (Followers: 4)
Fourth World J.     Full-text available via subscription   (Followers: 1)
Frontline     Full-text available via subscription   (Followers: 18)
Future Times     Full-text available via subscription   (Followers: 2)
Gambling Research: J. of the National Association for Gambling Studies (Australia)     Full-text available via subscription   (Followers: 5)
Gay and Lesbian Law J.     Full-text available via subscription   (Followers: 2)
Gender Impact Assessment     Full-text available via subscription   (Followers: 1)
Geographical Education     Full-text available via subscription   (Followers: 2)
Geriatric Medicine in General Practice     Full-text available via subscription   (Followers: 8)
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Great Circle: J. of the Australian Association for Maritime History, The     Full-text available via subscription   (Followers: 7)
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Journal Cover Cancer Forum
  [SJR: 0.143]   [H-I: 10]   [0 followers]  Follow
    
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   ISSN (Print) 0311-306X
   Published by RMIT Publishing Homepage  [400 journals]
  • Volume 41 Issue 2 - Impact of financial costs of cancer on patients - the
           Australian experience
    • Abstract: Paul, Christine L; Fradgley, Elizabeth A; Roach, Della; Baird, Hannah
      Although healthcare in Australia is largely publicly funded, there are out-of-pocket costs associated with diagnosis, treatment and survival, even in the public system. In Australia, people with cancer report relatively high out-of-pocket health costs and a heavy burden of out-of-pocket costs relative to income. These costs include travel, hospital stays, specialist fees, parking, treatment prescriptions and over-the-counter medications for supportive care. The financial impacts of the disease extend to reduced or lost employment, early retirement and reduced incomes. The financial costs of cancer in Australia are also unequally distributed in that some cancer types are more costly to the individual. Those living in rural and remote areas also face greater out-of-pocket costs, as do those who use the private health system. Cancer-related costs are not restricted to those experiencing a diagnosis of cancer, but also extend to carers and families and can be enduring. While reducing costs is an important long-term goal, ameliorating financial impacts is also important in the short term. The heavy burden associated with cancer may be reduced if the expected costs of treatment and the availability of assistance become part of treatment conversations and processes.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 2 - Overview: Cost of cancer to the patient
    • Abstract: McCaffrey, Nikki
      The escalating financial cost of cancer to patients and their families is emerging as a global phenomenon. Despite diversely funded healthcare systems internationally, cancer causes substantial financial burden to individuals in many different countries, including the USA, Canada and Ireland. Australia is no exception and the articles in this Forum explore the many facets of financial costs in this context.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 2 - Support for research 2017
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 2 - Financial toxicity - what it is and how to measure it
    • Abstract: Gordon, Louisa G; Merollini, Katharina MD; Lowe, Anthony; Chan, Raymond J
      The term 'financial toxicity' is broadly used to describe the distress or hardship arising from the financial burden of cancer treatment. In much the same way as physical side-effects of treatment like fatigue, nausea or blood toxicities, financial problems after cancer diagnosis are a major contributor to poorer quality of life, treatment non-adherence and delayed medical care. This article describes what financial toxicity is, how it is measured, how common it is and what the implications are for further research and clinical practice. A recent review shows a wide range of measures used to describe the financial burden of cancer. Using monetary measures, the magnitude of financial stress was between 28-48% in cancer populations. Possible solutions to reduce the family financial burden include mandating full disclosure of doctors' fees and charges related to treatment and strategies to empower patients to improve their treatment decision making. Furthermore, screening tools such as the COST-FACIT 11-item survey may assist health professionals to identify those patients at high risk of financial stress and refer them to support services. Minimising financial stress is important for patients and measuring financial toxicity helps to expose flaws in health systems and subsequently ensure that citizens receive quality cancer care.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 2 - Measurement of resource utilisation in cancer clinical
           studies - tools, issues and challenges
    • Abstract: Shih, Sophy TF; Carter, Rob
      Inclusion of economic evaluations alongside cancer clinical trials necessitates the collection and analysis of resource utilisation and cost data alongside outcomes. The purpose of this paper is to describe and discuss the measurement of cost in clinical studies, particularly resource utilisation. Cost data collection can be conducted retrospectively through linkage of treatment data with claims data, such as Medicare, or by patient recall (questionnaires). Prospective approaches include the patient diary. Measures and data collection tools are usually modified by researchers to fit the purpose and target population of their specific study. There is strong agreement on the inclusion of direct medical and non-medical costs in economic evaluations. The balance of opinion is that inclusion of indirect costs is appropriate; but agreement on exactly 'which indirect costs' and in 'what context' differs. However, narrow study perspectives mean that inter-sectoral resources are often overlooked. In addition to the two cancerspecific instruments included in the Database of Instruments for Resource-Use Measurement, there are numerous resource utilisation measurement tools used in a broad range of clinical research with heterogeneous intervention characteristics and outcome measures. Despite this, very few studies report validated cost/resource use instruments. Further, many cost analyses ignore long-term care costs, nonmedical costs borne by patients and important costs incurred in other sectors, such as social services. There is no 'gold standard' for resource utilisation instruments and the agenda for future research is lengthy. For example, many issues such as recall length, accuracy in recall of medical terms and medicines, specificity versus comprehensiveness of the instrument and missing data, remain to be addressed. Innovation in mobile technology will likely revolutionise data collection and may overcome many of the existing barriers to robust measurement of resource utilisation for cancer clinical trials and improve societal decision making.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 2 - Cost of informal caregiving in cancer care
    • Abstract: Girgis, Afaf; Lambert, Sylvie
      In 2015, approximately 2.7 million Australians were unpaid caregivers, including partners, family members, friends and neighbours. However, the true population of Australian caregivers may be under-estimated due to lack of carer self-identification, and this may be even more so for Australians of culturally and linguistically diverse backgrounds and Aboriginal and Torres Strait Islanders. Increasing cancer incidence and survival has resulted in a corresponding increase in the demand for unpaid caregivers, prompting in-depth exploration of the economic, psychosocial and physical impact of caring. Caregivers' physical health is significantly impacted and is sometimes reported to be lower than the patients they care for, perhaps as a consequence of prioritising the patient's needs and health over their own. Caregivers are also at increased risk of poorer psychological outcomes than the general population, reporting high levels of depression and anxiety. The financial impact is significant, with informal caregiving representing 18-33% of the total financial cost of cancer. The burden of this financial responsibility can adversely impact caregivers' quality of life, limiting their capacity to fulfil other caregiving roles and also having a direct adverse impact on the patients' quality of life. This paper reviews the costs of caregiving, from a financial, physical and psychosocial perspective.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 2 - Regulatory and government funding agency consideration
           of monetary costs to the cancer patient
    • Abstract: Schubert, Camille
      The Australian healthcare system aims to provide accessible healthcare to all citizens, and on a global scale it appears to achieve good health outcomes, with relative efficiency. However, the system is complex and despite various public funding programs, numerous out-of-pocket expenses to patients remain; in cancer patients these are estimated to be significant. The types of costs associated with healthcare are described here, as are the main public healthcare funding schemes in Australia. Decision-makers for these schemes do request information regarding patient costs in economic analyses, however the extent to which cost data are available is limited. Generally and primarily for the practical reasons - but sometimes with a philosophical consideration - only limited information on patient healthcare-related costs will have been considered before a funding recommendation is made. There is a concern that without increased consideration of patient costs, the existing network of public funding schemes in Australia may not adequately ensure the affordability of healthcare.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 2 - Clinical application of optimal care pathways at a
           regional cancer centre
    • Abstract: Kinder, Skye; Gough, Karla; Krishnasamy, Meinir
      Objective: To assess the feasibility of clinical application of recently produced Optimal Care Pathways and explore patterns of care for oncology patients receiving care based in the City of Greater Bendigo.

      Design, setting and participants: A retrospective audit of hospital administrative and medical records data undertaken at Peter MacCallum Cancer Centre (PeterMac) and Bendigo Health between January and June 2016. Eligible cases were PeterMac patients with a residential address in the City of Greater Bendigo and who received care based at the PeterMac Bendigo campus as a new patient between 01 January and 31 December 2015.

      Outcome measures: Congruence of routine care with timeframes for steps described in the Optimal Care Pathways for cancer patients commissioned by the Victorian Department or Health and Human Services.

      Results: Assessment of congruence of routine care to the Optimal Care Pathways was complicated by missing data. Where data were available, many pathways of care did not fit the Optimal Care Pathway process map template, due to screening-related or asymptomatic presentations or appropriate deviations in clinical management responsive to individual patient need.

      Conclusion: This study is the first to report feasibility of mapping routine care against the parameters recommended by the Optimal Care Pathways, and to provide guidance for the future assessment of usual care of cancer services to best practice guidelines.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 2 - Concerns about cost of future medical care as a factor
           in advance care planning: Review and agenda for future research
    • Abstract: Ford, Timothy R; Cummings, Robin C; Cassel, JBrian
      This review explores the evidence for a relationship between healthcare related financial concerns and advance care planning. Large-scale surveys of public opinion in the US have found that people perceive the financial domain to be an important aspect of quality of life and a major concern regarding end-of-life care, and qualitative research has found that financial worries have been found to be a distinct domain of patients' self-perceived burden on their family. Concerns about being a burden on others have some influence on treatment decisions and advance care planning. Healthcare related financial concerns have some basis in fact, as consumers' out-ofpocket costs continue to escalate in some countries. Further research is warranted about healthcare related financial concern and its impact on motivation for engaging in advance care planning, and the content of those plans. A conceptual model of the relationship is proposed to guide further research. This includes three sets of variables: person characteristics such as health literacy, marital/family status and health state; the trait or state of healthcare related financial concern; and behavioral outcomes such as advance care planning and treatment decisions.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 2 - Unemployment after cancer - a hidden driver of
           financial toxicity
    • Abstract: Koczwara, Bogda
      While financial toxicity due to the high costs of cancer treatment is increasingly recognised as a significant challenge for cancer patients and survivors, the impact of reduced work participation as a major driver of financial toxicity is only just coming to light. Unemployment and reduced employment after a cancer diagnosis is associated with reduced financial reserves, impaired quality of life, and possibly reduced survival. Loss of work after cancer disproportionally impacts on those already more vulnerable, such as low income employees and the very young, with impact persisting for some for many years. Research needs to focus on quantifying and predicting the impact of reduced work participation on quality and quantity of survival, and development of interventions to assist with meaningful work participation for cancer survivors.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 2 - Faculty of radiation oncology
    • Abstract: Forstner, Dion
      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 2 - Medical Oncology Group of Australia
    • Abstract: Karapetis, Chris
      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 2 - Clinical Oncology Society of Australia
    • Abstract: Malica, Marie
      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 2 - Cancer Council Australia
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 2 - Centre for Behavioural Research in Cancer (CBRC),
           Victoria
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 2 - Newcastle Cancer Control Collaborative (New-3C), NSW
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 2 - Behavioural Research and Evaluation Unit (BREU),
           Cancer Council SA
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 2 - Western Australian Cancer Prevention Research Unit
           (WACPRU), Curtin University
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - Clinical Oncology Society of Australia, COSA
    • Abstract: Malica, Marie
      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - Faculty of Radiation Oncology
    • Abstract: Forstner, Dion
      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - Medical Oncology Group of Australia
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - Behavioural Research and Evaluation (BREU), Cancer
           Council SA
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - Centre for Behavioural Research in Cancer (CBRC),
           Victoria
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - Newcastle Cancer Control Collaborative (New-3C), NSW
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - Western Australian Cancer Prevention Research Unit
           (WACPRU), Curtin University
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - Cancer Council Australia
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - Supportive care for women with breast cancer living in
           rural Australia
    • Abstract: Fox, William; Powell, Margaret; Hyland, Vanessa; Honeyball, Florian
      Breast cancer is the most common cancer diagnosis among women in Australia. The incidence in rural/remote areas is lower compared to metropolitan areas however management in non-metropolitan regions is complicated by reduced access to support services, screening and diagnostic tools, as well as cultural factors and the tyranny of distance. Despite improvements in technology, reducing the disparity of care between rural and metropolitan patients, further investment in known solutions and supportive care research is required to assist with managing the individual psychosocial needs of women as they go through their breast cancer journey, in order to improve rural patients' poorer outcomes.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - The role and supportive care needs of the partners and
           carers of women with breast cancer
    • Abstract: Girgis, Afaf; Levesque, Janelle V; Smith, Allan; Durcinoska, Ivana; Gerges, Martha
      More than 15,000 women are expected to be diagnosed with breast cancer in Australia in 2016. The shift towards delivering cancer care through ambulatory treatment centres means that partners, relatives, children, siblings and friends of women diagnosed with breast cancer are commonly required to provide much-needed care and support for these women post-treatment. The role of 'carer' can take many different forms and for some, it can be equivalent to a full-time job, with many carers reporting having more things to do than they can handle. Being a carer can be a positive experience, for example some husbands of breast cancer patients undergoing active treatment reported both interpersonal and intrapersonal benefits of caring, such as feeling closer to their partner and growing as a person. However, there is ample evidence that taking on the role of carer has significant impacts on carers' physical and mental health and many carers feel illprepared for that role, especially if the care requires them to address complex medical needs while also supporting their loved one with the psychological challenges experienced following a cancer diagnosis. The inter-relationship between patients' and carers' wellbeing is well-documented, with evidence suggesting that carers' physical and mental wellbeing may influence patient status. Hence, offering informal carers interventions that are structured, goal-oriented and time-limited is recommended to support them in their roles, and many argue that family carers should be considered a 'co-user', or 'co-client' of cancer services.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - Fertility after breast cancer and strategies to help
           women achieve pregnancy
    • Abstract: Peate, Michelle; Stafford, Lesley; Hickey, Martha
      Around a quarter of breast cancer patients are premenopausal at diagnosis. As cancer treatment can increase premature menopause, fertility and pregnancy after breast cancer are important issues for many women. This review summarises the literature on fertility after breast cancer and strategies to help women achieve pregnancy - specifically, the risk of infertility, fertility measurement after cancer, the impact of future pregnancy on prognosis, birth outcome, contraception, the psychosocial impact of infertility and pregnancy and assisted reproduction after breast cancer. Pregnancy rates after breast cancer are low. Nonetheless, it is important that women are made aware of the potential impact on their fertility and given information regarding their options for fertility preservation before treatment and about their options after treatment to achieve a pregnancy. Decisions to conceive are challenging as women are weighing up their desire for children against fears of recurrence and potential inability to detect future cancers. Providing evidence-based information and psychosocial support to breast cancer survivors who wish to conceive is an important clinical issue in need of greater attention.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - Chemotherapy induced alopecia and strategies to manage
           its impact
    • Abstract: Shaw, Joanne; Boyle, Fran
      Chemotherapy-induced hair loss is a common and distressing side effect of some chemotherapy agents, and is ranked as one of the top three most distressing side effects by patients. Hair loss (alopecia) is more prominent on the scalp but affects the eyebrows, eyelashes, beard, axillary and pubic hair and typically begins within the first three weeks of starting chemotherapy. Patients report lower quality of life, high levels of distress, negative body image and feelings of loss of control associated with their alopecia. For most patients regrowth occurs after treatment completion but the colour and structure of hair can be altered, prolonging the negative impact on patient sense of wellbeing. The impact of chemotherapy-induced alopecia on patients is underestimated by many health professionals. Management is typically to camouflage the loss by wearing a wig, head scarf, or hat/turban. Scalp cooling with coolant based devices to reduce chemotherapy-induced alopecia has been available in Europe for more than a decade, but has only recently been introduced in Australia. Scalp cooling works by reducing local concentration of chemotherapy agents and decreasing metabolic uptake by hair follicle cells. Given the significance of hair loss to patients, further research to ameliorate this common side effect of chemotherapy treatment is urgently required.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - Cancer-related cognitive impairment in adult cancer
           survivors: A review of the literature
    • Abstract: Bray, Victoria J; Dhillon, Haryana M; Vardy, Janette L
      Cognitive symptoms are commonly reported by cancer patients. Qualitative research has shown that up to 70% of cancer patients experience symptoms of varying magnitude. Several studies have demonstrated only a weak association between self-reported cognitive symptoms and objective cognitive impairment on formal neuropsychological testing. Conversely, cognitive symptoms have been consistently shown to be associated with other patient reported outcomes, including anxiety/depression, fatigue and quality of life. Cognitive symptoms can have a major impact on individual's personal and professional lives. Initially, the terms 'chemo brain' or 'chemo fog' were used, as it was believed that cognitive changes were a direct result of chemotherapy treatment. It is now clear that the aetiology of cognitive change is more complex, with several studies showing presence of impairment in patients with a new cancer diagnosis, prior to commencement of systemic therapy. The exact aetiology of cognitive impairment is unknown, but it is likely multifactorial. There has been interest in the evaluation of pharmacological and cognitive training strategies for the management of cognitive impairment in cancer patients. Most recently, a large randomised study of a home-based, online cognitive rehabilitation program showed improvements in cognitive symptoms and patient reported outcomes. However, there remains no universally accepted treatment.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - Anxiety and depression in women with breast cancer
    • Abstract: Beatty, Lisa; Kissane, David
      Anxiety and depression are the two most prevalent psychiatric presentations among women with breast cancer. If left untreated, anxiety and depression can have serious psychological, medical and health service utilisation consequences. These include reduced likelihood of accepting, tolerating and adhering to recommended treatments, and increased toxicities and severity of medical symptoms that, in turn, can increase healthcare costs and reduce quality of life. Risk factors for anxiety and depression in women with breast cancer include: a past history of anxiety or depressive disorder; younger age at diagnosis (
      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - Sexual dysfunction after breast cancer: A review of
           treatments and strategies
    • Abstract: Tay, Rebecca; Gibney, Triecia; Antill, Yoland C
      Background: Sexual dysfunction is an extremely common event affecting the wellbeing of women with breast cancer. It includes physical and psychological factors that may occur during early treatment and extend into the years following diagnosis. Without appropriate recognition and management, quality of life may be significantly reduced to a point where treatment compliance is impacted.

      Aim: To assist healthcare workers to identify and manage sexual dysfunction in patients with breast cancer.

      Methods: This article reviews both physical and psychological aspects of sexual dysfunction, together with the potential impact that breast cancer treatments will have on sexuality; additionally strategies for management are described.

      Conclusion: Strategies to improve the recognition of sexuality issues together with approaches to management that are acceptable for the patient while not increasing breast cancer recurrence risk are vital.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - 'Not one size fits all': A brief review of models of
           care for women with breast cancer in Australia
    • Abstract: Porter-Steele, Janine; Tjondronegoro, Dian; Seib, Charrlotte; Young, Leonie; Anderson, Debra
      The impact of a breast cancer diagnosis goes beyond the early diagnosis and treatment phases. While survival has improved significantly over the last decade, women report ongoing quality of life (survivorship) concerns as a result of their diagnosis and treatment. There are many models of supportive care available in Australia, including those provided by specialist breast care nurses, general practitioners, peer support groups and cancer support agencies and councils, and more recently those provided through virtual platforms. Most models of care in Australia recognise the need to provide supportive care throughout the treatment trajectory and beyond, yet there remains an inconsistent pattern in providing coordinated supportive care post completion of acute treatment. This review provides a brief synopsis of some of the models of supportive care available within and outside of Australia.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - Supportive care in advanced breast cancer
    • Abstract: Kirsten, Laura; Hobbs, Kim
      Improvements in outcomes for women diagnosed with advanced breast cancer make it imperative to address their wellbeing and medium to long-term supportive care needs. This paper highlights the need for specialised interventions directed towards the amelioration of psychological and social distress for this patient cohort and their caregivers. Screening to identify the supportive care needs of patients should occur at critical time points across the treatment trajectory. While many people respond well to support services to facilitate adjustment to a cancer diagnosis and treatment, as needs become more complex there is a requirement for specific referral to tailored interventions that aim to optimise psychosocial wellbeing. Referral to appropriately skilled psychooncology professionals should be the 'gold standard' to help people with advanced disease deal with the existential issues that arise. The lack of availability of skilled clinicians is one of the main barriers to the provision of high level psycho-oncology services. Health professionals and service providers need to consider new technologies and modalities to improve the reach of supportive care interventions for patients who are unable to access traditional face-to-face services. A challenge for psycho-oncology professionals is to undertake research to make psycho-oncology services more accessible and meaningful to the most vulnerable populations.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - 2016 Tom Reeve award for outstanding contributions to
           cancer care
    • Abstract: Boyle, Fran
      It was a great honour to be presented with the Tom Reeve award at COSA this year, and to have the opportunity to reflect on Tom's many contributions to leadership in the Australian oncology scene, and to my own career development.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - Overview: Supportive care in breast cancer
    • Abstract: Butow, Phyllis
      As survival after breast cancer increases, the focus of research and practice is increasingly turning to supportive care. This Forum is focussed on breast cancer in women.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 41 Issue 1 - Strategies to support shared decision making in breast
           cancer
    • Abstract: Rutherford, Claudia; Zdenkowski, Nicholas
      Shared decision making is a key component of patient-centred and evidence-based healthcare. Its integration into routine care is of interest to healthcare providers, consumers and policymakers who want to improve the quality of healthcare. The process of shared decision making enables healthcare providers and a patient with a condition that has more than one available clinically appropriate management strategy, to make a joint health decision. The decision takes into account the best available evidence, in conjunction with the patient's values and preferences and understanding of the benefits and harms of available options. There is unequivocal evidence that shared decision making improves the quality of healthcare decisions, reduces unwarranted variation in care, and improves patient outcomes. Despite these benefits, shared decision making has not been systematically adopted in clinical practice in Australia. Strategies exist that can help healthcare professionals who treat patients with breast cancer incorporate shared decision making into their practice. We review these strategies, including patient decision aids, patient navigators, decision coaches, and online risk calculators.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - Clinical Oncology Society of Australia, COSA
    • Abstract: Malica, Marie
      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - Faculty of Radiation Oncology, RANZCR
    • Abstract: Forstner, Dion
      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - Medical Oncology Group of Australia, MOGA
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - Newcastle Cancer Control Collaborative (New-3C), NSW
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - Behavioural Research and Evaluation Unit (BREU),
           Cancer Council SA
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - Western Australian Cancer Prevention Research Unit
           (WACPRU), Curtin University
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - Cancer Council Australia
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - Adjuvant therapy of HER2 positive disease: Can we do
           better, or are we already giving too much treatment'
    • Abstract: Wilcken, Nicholas
      Thanks to careful persistent research, the outlook for women diagnosed with early HER2 positive breast cancer has improved markedly over the last two decades. The evolution of HER2-targeted treatments has been a game changer, and the pathology report that reads "HER2 amplified" is not as dreaded as it once was. Clinical trials have proven the safety and effectiveness of adjuvant trastuzumab, and longer term follow-up has been reassuring. However, now is a good time to reflect on these achievements and ask ourselves two questions: how can we do better, and can some patients get by with less treatment'

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - HER2 positive metastatic breast cancer: What happens
           after first line failure'
    • Abstract: Chan, Arlene
      For women with metastatic HER2 positive breast cancer, the introduction of trastuzumab into routine practice was transformative. More recently, the addition of pertuzumab has further improved the outlook. However in almost all cases, the disease unfortunately progresses. Much research has gone into what to do next. Fortunately we now have evidence to support a number of strategies, with the underlying understanding that HER2 blockade should be continued for as long as possible. Historically, lapatinib was the first anti-HER2 agent to show activity after relapse on trastuzumab. Subsequently the effectiveness of T-DM1 (Kadcyla) has been demonstrated, as has the use of alternating chemotherapy agents with trastuzumab. Research is now focussed on understanding and combating the mechanisms of resistance to anti-HER2 agents that inevitably develop. Promising data suggest that mTOR inhibitors, PI3 kinase inhibitors and immune-activating therapies may be helpful.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - Brain metastases: A subtype-specific medical approach
    • Abstract: Phillips, Claire
      In the past, brain metastases were essentially all treated in the same way, and heralded a poor prognosis. Improvements in ways of delivering radiotherapy as well as in anaesthetic and neurosurgical techniques and in imaging mean that much more can be achieved. A knowledge of what subtype of breast cancer is being treated is now critical to take into account, especially in HER2 positive disease, where an expanding array of anti-HER2 drugs means that extra-cranial disease may be controlled for many years. Ideally, brain metastases should be managed in a multidisciplinary setting, so that imaging, radiation oncology and neurosurgery input can be combined.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - Immunotherapy in breast cancer: The subtype story
    • Abstract: Luen, Stephen J; Loi, Sherene
      Great hopes have been accorded to the potential of immunotherapy to exploit host anti-tumour immunity and deliver improved survival outcomes. Impressive results in cancers known to be immunogenic have led to a plethora of immunotherapy trials in several cancer types, including breast cancer. Descriptions of tumour-infiltrating lymphocytes in early breast cancer have unravelled the landscape of immunogenicity across the breast cancer subtypes, and provide rationale for investigation into immunotherapeutic approaches. Subsequently, numerous clinical trials have been launched, predominantly with checkpoint blockade. While triple negative and HER2-positive breast cancers appear to be more immunogenic than ER-positive/HER-2 negative breast cancers, responses to checkpoint blockade are still seen in this subtype, suggesting that subtype alone may not be a sufficient predictor of response to immunotherapies. Moreover, tumour-intrinsic contributors towards immunogenicity and immune-evasion are increasingly being explored, as is the ability of conventional therapies to modulate the immune microenvironment. Reports from early phase trials in breast cancer show that while immunotherapeutic approaches may not be suitable for all breast cancer patients, there are promising signs for a potential role of immunotherapy in the treatment of selected breast cancers.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - Triple negative breast cancer: Proven and promising
           systemic therapies
    • Abstract: Bergin, Alice; Oakman, Catherine; Lindeman, Geoffrey J
      Triple-negative breast cancer (TNBC) is a heterogeneous disease. While simply defined by immunohistochemical parameters, TNBC actually encompasses a raft of tumour subtypes with variable prognoses and treatment sensitivities. Systemic treatment decisions for patients with TNBC are becoming increasingly complex. In many cases, decision-making remains hampered by the current lack of predictive and prognostic biomarkers, and as such, chemotherapy remains the mainstay of systemic treatment options. Sequential anthracycline and taxane regimens, delivered as either neoadjuvant or adjuvant therapy, are widely accepted as the 'standard of care' in early stage disease. TNBC in BRCA1 and BRCA2 mutation carriers are more likely to be sensitive to platinum-based chemotherapy and PARP inhibition. The role for these approaches is currently under investigation in large clinical trials for this population. As with certain other solid tumours, harnessing the immune system to tackle this challenging breast cancer subtype is showing some promise and the role of immunotherapy in TNBC is currently being investigated in large clinical trials. Data on safety and efficacy are eagerly awaited but will need to take into account the heterogeneous nature of this disease.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - Tamoxifen, CYP2D6 and endoxifen in the treatment of
           hormone sensitive breast cancer: Demystifying the connections
    • Abstract: Lee, Clara Inkyung; Gurney, Howard
      The role of the selective oestrogen receptor modulator, tamoxifen, is well established in the treatment of hormone sensitive breast cancer. The metabolism of tamoxifen to its active metabolites is however complex. Despite much research, a conclusive stance on the clinical implications of CYP2D6, active metabolites including endoxifen in efficacy and toxicity, is yet to be reached. Herein we examine the literature to clarify the connections between tamoxifen, CYP2D6 and endoxifen with resultant clinical recommendations.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - Bone health in the treatment of postmenopausal women
           with Aromatase Inhibitors and premenopausal women treated with ovarian
           suppression and Aromatase inhibitors: A hands-on guide
    • Abstract: Lee, Clara I
      In postmenopausal women, and premenopausal women treated concomitantly with ovarian suppression, aromatase inhibitors are a standard of care in the adjuvant treatment of hormone sensitive breast cancer. Dosed daily for up to ten years, these drugs are not without significant toxicity. Given such protracted duration of treatment and that the majority of women treated in this setting have very favourable disease free and overall survival from their early stage breast cancer, long-term toxicity is a particular concern. The most concerning long-term toxicity is the deleterious effect of aromatase inhibitors on bone density. Accelerated bone loss due to aromatase inhibitors confers increased fracture risk and thereby significant morbidity. Therefore it is important to investigate and monitor bone health prior to commencement of and during aromatase inihibitor treatment, and ensure appropriate measures to optimize bone health are instituted. Recommendations from the summary of the literature to date, relevant to the Australian setting are outlined in this paper.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - The 'enablers': Inhibitors of mTOR, PI3K and CDK that
           prolong endocrine sensitivity
    • Abstract: Wilcken, Nicholas
      For many years, tamoxifen and the aromatase inhibitors have been the mainstay of treatment for ER positive breast cancer, although it has been apparent that resistance to these drugs is a limiting factor. We are now at the beginning of a new era, as drugs that block the development of endocrine resistance are becoming available. Pre-clinical research has given us an understanding of some of the molecular mechanisms of endocrine resistance, identifying new targets for drug development. Chief among these are the PI3 kinase/AKT pathway and the cell cycle control mechanism governed by cyclins and cyclin dependent kinases (CDKs). We are now in the process of integrating mTOR inhibitors, PI3kinas inhibitors and CDK 4/6 inhibitors into clinical practice on the back of clinical trial results that show they can prolong the effects of endocrine agents.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - Breast cancer: A disease of subtypes
    • Abstract: Wilcken, Nicholas
      As cancer medicine moved into the 21st century, the long relationship between molecular biology and clinical care was finally consummated with the aid of biomathematics, and the era of the cancer subtype was born. The intuitive understanding that clinicians had - that not all breast cancers behaved the same - was given a molecular basis, and has subsequently informed our care and produced new tools with which to contain this disease.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - Centre for Behavioural Research in Cancer (CBRC),
           Victoria
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - Cancer Council Australia Student Essay Competition
           2016: How best to teach and learn about cancer in medical schools: Moving
           towards a patient-centred approach that reflects the needs of Australia
    • Abstract: McRae, Robert J
      Cancer has recently overtaken heart disease to become the number one cause of mortality both globally and in Australia. As such, adequate oncology education must be an integral component of medical school if students are to achieve learning outcomes that meet the needs of the population. The aim of this review is to evaluate the current state of undergraduate oncology education and identify how Australian medical schools can improve oncology learning outcomes for students, and by derivative, improve health care outcomes for Australians with cancer. The review shows that oncology is generally not well represented in medical school curricula, that few medical schools offer mandatory oncology or palliative care rotations, and that junior doctors are exhibiting declining oncology knowledge and skills. To address these issues, Australian medical schools should implement the Oncology Education Committee's Ideal Oncology Curriculum, enact mandatory oncology and palliative care clinical rotations for students, and in doing so, appreciate the importance of students' differing approaches to learning.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - Clinical Oncology Society of Australia: Cancer care
           coordinator position statement summary
    • Abstract:
      The growing demand for cancer care, increasing complexity of cancer and its treatments, a shrinking workforce, and rising costs, present major challenges to the delivery of cancer care. In this context, effective coordination of care across different clinicians, teams and health services is essential to high-quality cancer care. Consumers consistently identify coordination of care to be a priority issue and an important influence on their cancer experience. Coordination of care has also been identified as a critical element of person-centred care and is an important element of national safety and quality standards for health care services.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 3 - W Brian Fleming
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - Ethical aspects of cancer screening
    • Abstract: Carter, Stacy M
      Screening for cancer or cancer risk is well-established in high-income countries. This article considers ethical aspects of cancer screening. Ethical evaluation of screening depends on a contested evidence base, interacts with people's fear of cancer, and their enthusiasm for technology in general and screening in particular. Cancer screening is both a clinical and a public health activity, and so the often-conflicting frameworks from both clinical ethics and public health ethics are relevant to its evaluation. Cancer screening is an intrusion by health services into the lives of well individuals and so requires strong justification. Cancer screening can and should prevent harms to physical health, but its ability to do so is contingent on many factors and finely balanced; screening can also affect psychological wellbeing. When communicating about screening programs, care must be taken to support rather than undermine the autonomy of people considering participation. The benefit offered by cancer screening programs should be large enough to justify the opportunity costs of screening and the consequent cascade of intervention. Treatment should be offered in a way that avoids creating financial strain for individuals. Other relevant ethical issues include equity of opportunity and outcome in screening and accountability to communities. It is not clear how population-level and individual-level outcomes and interests in cancer screening should be balanced; future work should focus on resolving these difficult issues.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - Ethical justifications in alcohol-related health
           warning discourses
    • Abstract: Muhlack, Emma; Eliott, Jaklin; Carter, Drew; Braunack-Mayer, Annette
      Cancer is the second most common cause of alcohol-related death in both men and women in Australia. In view of this and other health risks, mandatory health warnings on alcoholic beverages have been proposed in Australia and introduced elsewhere. This paper reviews academic literature and statements from selected advocacy groups to identify the ethical justifications that are used in relation to mandatory health warnings on alcoholic beverages. The paper then analyses how these justifications relate to the ethics of public health interventions in the context of cancer prevention. This involves examining the potential tension between the utilitarian nature of public health interventions and the liberalism characteristic of many of the societies in which those interventions occur.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - Ethics in cancer
    • Abstract: Olver, Ian
      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - Calendar of meetings
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - Support for research funding 2016
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - Faculty of Radiation Oncology
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - Clinical Oncology Society of Australia
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - Cancer Council Australia
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - Western Australian Cancer Prevention Research Unit
           (WACPRU), Curtin University
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - Newcastle Cancer Control Collaborative (New-3C), NSW
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - Centre for Behavioural Research in Cancer (CBRC),
           Victoria
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - Behavioural Research and Evaluation Unit (BREU),
           Cancer Council SA
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - Current ethical issues in advanced cancer care
    • Abstract: Gillam, Lynn
      Despite continuing advances in treatment, cancer continues to be a major cause of suffering and death, and so symptom management and end of life care will continue to be an important aspect of cancer care for the foreseeable future. An integral part of providing this care, for all clinicians involved, is understanding and managing the ethical dimensions of such care, and meeting the challenges of patient and public expectations - for relief of pain and other suffering, and for dignity and control at the time of death. This paper will highlight two aspects of care of patients with advanced cancer which are current, ethically contentious and need to be considered by all health professional working with these patients. These are medical use of cannabis and terminal sedation.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - Ethical issues around phase I and phase III clinical
           trials in cancer
    • Abstract: Tattersall, Martin HN
      The results of phase III (randomised) cancer clinical trials underpin evidence-based clinical practice. A standard comparator (control arm) is crucial so that the real value of an intervention can be tested. The goal of phase I trials is to assess the toxicity of a new drug and to determine the maximally tolerable dose to be recommended for subsequent studies to identify efficacy. Guidelines on informed consent intend to inform patients considering enrolment in clinical trials, but surveys of patients participating in cancer trials indicate that patient misunderstanding is common.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - What consent model is ethically justifiable in cancer
           population research'
    • Abstract: Xafis, Vicki
      The important role that explicit informed consent plays in the conduct of research cannot be denied. Inhumane medical research has prompted over many decades the articulation of guidelines, legislation, and codes to ensure that research participants are protected from the harms inherent in some forms of research. However, there are now certain kinds of research, such as large epidemiological studies or data linkage studies, which offer potentially great benefits for whole populations but which, at the same time pose minimal, if any, harms to those included. These forms of research should not be required to adhere to the traditional informed consent requirements for the reasons articulated in this paper. The paper focuses on consent options for cancer population studies and examines the ethical issues associated with each model.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - Negotiating limits to the funding of high cost cancer
           medicines
    • Abstract: Lipworth, Wendy; Ghinea, Narcyz; Kerridge, Ian
      The cost of pharmaceuticals is overwhelming health budgets around the world. A growing proportion of this burden stems from the ever-increasing demand for subsidisation of cancer medicines. Those making decisions about which cancer medicines should be subsidised are often criticised by patients, clinicians and the pharmaceutical industry for withholding life-saving treatments from patients in desperate need. While their arguments are emotionally compelling, these critics often fail to recognise the complexity of resource allocation decisions, and the challenges faced by those making such decisions. In this article we describe two of these challenges: 1) the need for decision-makers to balance their desire to rescue those in desperate need against their responsibility to consider population-level opportunity costs and to make decisions based on solid evidence of cost-effectiveness; and 2) their need to negotiate 'fair' prices for medicines when they lack negotiating power, and when prices seem to be more reflective of what the 'market will bear' than what the medicines are really 'worth'. We conclude that, while there is no easy solution to these challenges, there is a need for greater transparency and procedural fairness, so that stakeholders are both more alert to the complexity of decisions about funding high cost cancer medicines, and more willing to accept the outcomes of these decisions.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - Ethical issues arising in the use of genomics in
           cancer
    • Abstract: Otlowski, Margaret
      This paper examines ethical issues in relation to genomics that arise in connection with their use in cancer, focusing primarily on the clinical context. The role of genomics in cancer is investigated through the lens of 'personalised medicine' or 'precision medicine', and the implementation of contemporary genomics into mainstream clinical practice. The paper explores the impact that 'next generation sequencing' (high throughput sequencing) is having, including whole genome sequencing, exome sequencing and the use of cancer panel testing. It also examines a number of ethical-legal issues which regularly arise in the context of next generation sequencing technologies, in particular: consent; privacy; management of clinical findings and results back; and the scope of a physician's/doctor's duty to a patient over time and whether there is a duty to recontact. This is an area where medical technology is rapidly developing and ethical, as well as legal principles need to be reassessed from time to time so we can recalibrate to take account of these advancements. While next generation sequencing holds remarkable potential, some caution in its deployment is warranted so that there is good preparedness for the outcomes. To this end, cancer panel tests appear to be a good compromise to address the clinical questions at hand while avoiding the problem of too much information.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - Big data in an indigenous health context:
           Opportunities and obstacles
    • Abstract: Garvey, Gail; Percival, Nikki; Izquierdo, Liz; Moodie, David; Moore, Suzanne
      The ability of health researchers to unearth previously unsuspected health risks, trends and commonalities at a population level through matching information across different datasets is well attested. However, as more of this type of research is conducted, the spotlight is being shone on the barriers to accessing these data. Less well known are the complexities experienced by researchers working with datasets in an Aboriginal and Torres Strait Islander health context. We present the insights of a number of researchers, clinicians and public sector representatives who have extensive experience of data linkage in the Aboriginal and Torres Strait Islander health sector, on key issues and practical and ethical implications of utilising big datasets. Obstacles are further highlighted in the experiences of a national multicentre cancer cervical screening study. While researchers must at all times respect the individuals whose information is contained within these datasets, and abide by the legislative structures governing their use, measures to streamline data linkage processes are required. Realising the potential of existing health data that previously has not been available may underpin significant improvements in indigenous health and ultimately life expectancy.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 2 - Medical Oncology Group of Australia incorporated, MOGA
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Role of the microenvironment in chronic pancreatitis
           and pancreatic cancer
    • Abstract: Pinho, Andreia V; Apte, Minoti V; Wilson, Jeremy S; Rooman, Ilse
      Chronic pancreatitis, an inflammatory disease of the exocrine pancreas, has been reported to be a major risk factor for the development of pancreatic ductal adenocarcinoma. Evidence from pre-clinical mouse models has shown that both diseases share a common origin in the digestive enzyme-producing acinar cells, through acinar to ductal metaplasia. Moreover, both diseases are characterised by the presence of an abundant stroma, the components of which include activated pancreatic stellate cells and immune cell infiltrates, which signal to epithelial cells through the production of cytokines and chemokines. In this review we explore the links between chronic pancreatitis and pancreatic ductal adenocarcinoma, with particular reference to the role of the microenvironment in both diseases. A better understanding of the nature of the epithelial and stromal changes, as well as their interactions, has led to trialling novel therapeutic strategies for the prevention and/or treatment of pancreatic cancer.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Genomics of pancreatic tumours - what we now know
    • Abstract: Patch, Ann-Marie; Barbour, Andrew; Waddell, Nicola
      Each year, over 2500 patients in Australia are diagnosed with pancreatic cancer. Pancreatic cancer is one of the most lethal tumour types with a five year survival of just 5%, thus there is a need to find alternative approaches to treatment. In recent years, the application of next generation sequencing has revealed the complex genomic landscape of pancreatic cancer, uncovering the mutation processes that occur during tumour development and has begun to identify new or repurposed therapeutic opportunities for pancreatic cancer patients. The identification of targets for therapy is a crucial goal of the large next generation sequencing studies as we move into an era of targeted or personalised medicine, where drugs will be selected based on the characteristics of a patient's tumour. Due to the large degree of heterogeneity in pancreatic cancer, a personalised approach to treatment seems particularly warranted. This review will summarise some of the key findings from genome sequencing of pancreatic cancer, describing the major driver genes and perturbed pathways, and highlighting some of the new potential and promising therapeutic opportunities that have been uncovered.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Pancreatic cancer
    • Abstract: Chantrill, Lorraine; Goldstein, David
      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Calendar of meetings
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Behavioural Research and Evaluation Unit (BREU),
           Cancer Council SA
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - 2015 Tom Reeve award: Hopes, wishes and time well
           spent
    • Abstract: Currow, David C
      The Tom Reeve Award for Outstanding Contributions to Cancer Care, offered annually by the Clinical Oncology Society of Australia (COSA), formally recognises a national leader who has made a significant contribution to cancer care. Since its inception in 2005, when the inaugural Award was presented to Professor Tom Reeve himself, there have been nine recipients from diverse cancer disciplines.

      In its 10th year of this prestigious Award, the 2015 recipient of the Tom Reeve Award was Professor David Currow. Professor Currow is the Chief Cancer Officer, NSW and Chief Executive Officer, Cancer Institute NSW, the NSW Government's cancer control agency. He was appointed to the position in March 2010. Prior to that he was the foundation Chief Executive Officer of Cancer Australia, the Commonwealth's cancer control agency.

      Professor Currow accepted the Award at the COSA Annual Scientific Meeting in Hobart on 18 November 2015 and delivered an inspiring and meaningful oration that challenged the audience to consider their personal and professional perspectives on end of life care.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Pancreatic neuroendocrine tumours - a rare pancreatic
           tumour
    • Abstract: Chan, David L; Pavlakis, Nick; Roach, Paul; Bailey, Dale; Arena, Jennifer; Segelov, Eva
      Pancreatic neuroendocrine tumours are rare tumours that can either present with syndromes from excess hormonal production or from mass effect - from the primary or metastases. They vary widely in clinical course, with the main determinants of outcome being TNM staging and pathological grade. The available treatment options depend largely on the grade of the tumour - somatostatin analogues, targeted agents, chemotherapy and PRRT for lG1 and G2 PNETs, and chemotherapy as the mainstay of treatment for high grade NET/NECs. The paucity of randomised evidence in the treatment of this disease argues for ongoing research to understand the molecular genetics underlying PNETs, to develop possible future treatment options, as well as optimising use of existing ones.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Inherited pancreatic cancer
    • Abstract: McKay, Skye H; Humphris, Jeremy L; Johns, Amber L; Gill, Anthony J; Tucker, Katherine
      Up to 10% of pancreatic cancer cases have a heritable component. Some of these are clearly defined tumour predisposition syndromes known as hereditary pancreatic cancers, but most are familial cases, defined by family history and where the underlying genetic causes remain unknown. Genetic counselling is important in suspected inherited pancreatic cancer cases, to enable risk assessment and relevant genetic testing. Screening trials are available for at-risk individuals (i.e. > 5% lifetime risk), although more long-term data is required to determine the risks, benefits and optimal approaches to pancreatic cancer surveillance.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Pancreatic cancer diagnosis and screening
    • Abstract: Phan, Vinh-An; Saxena, Payal; Stoita, Alina; Nguyen, Nam
      Pancreatic cancer is uncommon, but is projected to become the second leading cause of cancer-related death by 2030. The dismal five year survival of 5% reflects the advanced stage of the disease at presentation, at which time surgery is not possible. The establishment of clinical and pathological diagnosis currently relies on dedicated 'pancreatic protocol' CT, MRI/cholangiopancreatography, endoscopic ultrasound and guided fine needle aspiration. Given surgical resection of early stage cancer is curative at least in some cases, the concept of screening high-risk individuals to detect the cancer at its earliest stage has been evaluated over the last 10 years. Although the advances in imaging modalities, particularly those without radiation exposure, such as endoscopic ultrasound and MRI have made screening programs safe and feasible, studies demonstrating the impact of these programs on survival outcomes are lacking. Thus, screening of high-risk individuals is not ready for widespread clinical practice and should be conducted by clinicians who have expertise in endoscopic ultrasound for screening of high-risk individuals in a research setting with prospective data collection.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Novel therapeutics and preclinical imaging for
           pancreatic cancer - view from the lab
    • Abstract: Akerman, Anouschka; Vennin, Claire; Sharbeen, George; Warren, Sean C; Timpson, Paul; Phillips, Phoebe A
      Pancreatic cancer is a devastating disease with a five-year survival rate of 6%. A key driver of disease progression is the tumour microenvironment, which is characterised by fibrosis. A dynamic interplay between tumour cells, pro-fibrogenic pancreatic stellate cells and a dense extracellular matrix impedes effective drug delivery and promotes chemoresistance and metastases. In addition, mutations in pancreatic cancer are highly heterogeneous, making it difficult to effectively treat all patients with one approach. Thus, any effective pancreatic cancer treatment should consider targeting both pancreatic cancer cells and the stromal compartment. While basic research has provided promising new leads on therapeutic targets for this disease, many of them remain 'undruggable' by conventional approaches. Advances in nanoparticle technology and intravital preclinical imaging of live tumours is providing new insight into the behaviour of the disease in vivo and guiding how best to target this disease with higher specificity and lower off-target toxicity. Here, we describe in brief, key advancements in both rapidly emerging fields and highlight their current and future application in the treatment of pancreatic cancer.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Pancreatic cancer: Is the surgeon still relevant'
    • Abstract: Butler, Nick; Samra, Jaswinder; Nikfarjam, Mehrdad; Barbour, Andrew P
      Despite advances in multimodal therapy, surgery remains central to the management of patients with resectable pancreatic adenocarcinoma. Complete surgical clearance of disease offers the only real, albeit slim, chance of cure. For the greater proportion of patients with resectable macroscopic but occult microscopic disease, who ultimately recur early, short-term outcomes are still better compared to other currently available treatment modalities. Morbidity rates following pancreatic resection are worse than cancer surgery data for other intra-abdominal sites however, and involved margins are an unsurprising predictor of poor oncological outcome. Patient selection is therefore key. Refinements in surgical technique and treatment algorithms, such as the evolving use of neoadjuvant therapy, have improved appropriate selection for surgery, resectability rates and early postoperative outcomes. Review of contemporary Australian observational follow-up data highlights favourable local morbidity and mortality results, but persistently disappointing long-term survival outcomes reflective of the international picture. The surgeon's current role remains to achieve complete local resection with minimal morbidity. Such an achievement maximises the successful utilisation of multimodal therapies targeting microscopic disease, and preserves the remaining quality of life for those patients with ultimately incurable disease suffering from aggressive tumour biology.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Palliative care in advanced pancreatic cancer
    • Abstract: Muircroft, Wendy; Currow, David
      The management of patients with advanced pancreatic cancer often requires a multi-disciplinary approach with individualised therapy. Addressing the underlying causes of several of the troublesome symptoms that are relatively unique to the pathophysiology of pancreatic cancer is crucial in order to optimise the function and comfort of people diagnosed with this poor prognosis cancer. Early recognition and response is likely to improve outcomes later in the course of the disease, but more work needs to be done to compare expectant and reactive approaches to the most troublesome symptoms in advanced pancreatic cancer. Given such a poor outlook, referral to a palliative care service that has an active, team-based approach that includes dietetics, gastroenterology, interventional pain expertise and liaison psychiatry is likely to deliver the best possible outcomes. Such programs need to be in centres with sufficient caseload to ensure that meaningful outcomes can be measured prospectively and these teams are also best placed to incorporate new knowledge and approaches as the evidence base continues to evolve.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Patterns of care - improving equity of access to
           optimal care
    • Abstract: Neale, Rachel E; Burmeister, Elizabeth
      People diagnosed with pancreatic cancer suffer the worst five-year survival of any cancer. Resection of the primary tumour currently provides the only potential for cure. Increasing the proportion of patients who undergo surgical resection and ensuring that this occurs in a high-volume setting may lead to population-level survival gains. Access to chemotherapy in both adjuvant and palliative settings may lead to further improvements. Worse survival has been reported for patients from lower socio-economic and rural areas than those who are wealthier and living in major cities. Management in higher-volume hospitals tends to be associated with higher survival. Differences in patient factors such as age, performance status and the presence of co-morbidities may partly explain the survival discrepancies. However, international and limited Australian data suggest that not all patients receive optimal treatment, and that variability in care may be related to socio-demographic factors. There is considerable investment in identifying new strategies for diagnosis and treatment. However, immediate improvements could be made by implementing policies and procedures that enable all patients to be managed by high-performing multidisciplinary teams, ensuring receipt of optimal curative and supportive treatment modalities. This will also enable full realisation of benefits expected to accrue from the development of new treatments over the coming decades.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - The changing landscape of systemic therapy in advanced
           pancreatic cancer
    • Abstract: Sabanathan, Dhanusha; Nagrial, Adnan M; Chin, Venessa T
      Pancreatic cancer is a highly lethal disease due to its late presentation and its innate resistance to treatment. Although much research has been conducted in order to discover and develop new therapeutic targets to combat this disease, the survival gains for patients have been modest. This review aims to synopsize the current literature which has framed the approach to first and second line therapy of advanced disease. We look at the evolution of targeted therapies and briefly discuss current trials evaluating the role of immunotherapy. Finally, we cover the future of pancreatic cancer, in particular the essential role that predictive and prognostic biomarkers need to take in order to change the way we approach clinical trial design and management of patients.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Radiotherapy in locally advanced pancreatic cancer
    • Abstract: McGrath, Alycea; Van Hazel, Guy; Dean, Andrew; Yusoff, Ian; Johansson, Mikael; Spry, Nigel
      While radiotherapy was considered an important treatment modality in locally advanced pancreatic cancer for several decades, the presentation of the LAP 07 trial results have impressed a concept that radiotherapy provides no benefit in this patient group. Further analysis however, revealed that the use of radiotherapy in the LAP 07 trial was associated with better local control and a greater chemotherapy-free interval, both meaningful palliation benefits. Further, the initiation of radiation was delayed by a four month period of induction treatment that employed a drug with only an 8% response rate, and progression free survival control of 3.1 months. A detailed review of the literature to date demonstrates that modern radiotherapy in locally advanced pancreatic cancer has a significant local effect, is well tolerated and associated with improved quality of life through providing durable local control, and in a subset population, resulting in long-term survival. Perhaps the most important conclusion of the LAP 07 study, which was very well conducted, is that delaying a local therapy for four months is not an effective sequencing strategy when the induction treatment is of borderline efficacy in a cancer with a rapid progression characteristic. While newer agents are improving survival, the outlook remains dismal. Optimising the integration of radiation needs to be a priority to define how this modality can assist the modest gains that have come about from a very large number of chemotherapy sequencing studies.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Radiotherapy for pancreatic cancer
    • Abstract: O'Connor, Chelsie; Kneebone, Andrew; Lee, Mark
      The role of radiotherapy in pancreatic cancer is controversial. Its utility in treatment has been investigated in a number of clinical settings, including before and after surgery for operable cancers and in the treatment of locally advanced, inoperable disease. Adjuvant treatment has had mixed results in trials and there is now interest in better selecting patients who may benefit from neoadjuvant treatment. The benefit of radiotherapy continues to be poorly defined, due in part to the large number of differing treatment regimens that have been investigated. This article reviews the current evidence for radiotherapy in pancreatic cancer, with a focus on identifying those patients who are most likely to benefit from radiotherapy treatment. It will also discuss some of the planning considerations.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Western Australian Cancer Prevention Research Unit
           (WACPRU), Curtin University
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Newcastle Cancer Control Collaborative (New-3C), NSW
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Centre for Behavioural Research in Cancer (CBRC),
           Victoria
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Integrated psychosocial and supportive care needed for
           patients with pancreatic cancer
    • Abstract: Gooden, Helen; Tiller, Kerry; Mumford, Jan; White, Kate
      Pancreatic cancer is acknowledged as one of the most challenging diseases in the 21st century. Despite the recent focus on research and novel therapies, by 2030 pancreatic cancer is projected to be the second leading cause of cancer death after lung cancer. With incidence and mortality rising against the trend in other cancers, the importance of a whole team approach to achieve best quality of life and care is critical. Recent Australian research has reported significant unmet needs for psychosocial and supportive care for people affected by pancreatic cancer. Nihilism has been identified as a problem in pancreatic cancer that affects clinicians, patients, carers and families. This can lead to loss of hope and people becoming disengaged from care, resulting in increased distress, poor quality of life and signs of demoralisation. Meaning-centred therapies can help with reducing demoralisation, improving existential wellbeing, increasing dignity and legacy building. Effective interventions can ease the existential distress that is often experienced at end of life and help family members during the grieving process. Essential in providing optimal care for patients and caregivers is timely and appropriate discussions about the importance of palliative care in managing symptoms and improving quality of life. Early integration of psychosocial and supportive care is recommended to achieve best quality of life and relieve suffering.

      PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Research on relocation for specialist treatment -
           Leukaemia Foundation of Queensland and Griffith University
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Medical Oncology Group of Australia (MOGA)
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
  • Volume 40 Issue 1 - Faculty of Radiation Oncology (RANZCR)
    • PubDate: Thu, 2 Nov 2017 11:47:19 GMT
       
 
 
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