Advanced Cancer: Managing Symptoms and Quality of Life

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Natalie Pulenzas (Editor)
Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada

Breanne Lechner (Editor)
Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada

Nemica Thavarajah (Editor)
Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada

Edward Chow, PhD (Editor)
Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada

Joav Merrick, MD, MMedSci, DMSc, (Editor)
Medical Director, Health Services, Division for Intellectual and Developmental Disabilities, Ministry of Social Affairs and Social Services, Jerusalem, Israel
Division of Adolescent Medicine, KY Children’s Hospital, Department of Pediatrics, Lexington, Kentucky, USA
National Institute of Child Health and Human Development, Jerusalem, Israel
Division of Pediatrics, Hadassah Hebrew University Medical Centers, Mt Scopus Campus, Jerusalem, Israel
School of Public Health, Georgia State University, Atlanta, Georgia, USA

Series: Health and Human Development
BISAC: MED078000

Bone metastases are a common event for cancer patients. We have developed an innovative and unique clinical research program dedicated to palliative radiation oncology at the Odette Cancer Centre, Sunnybrook Health Sciences Centre, and specifically, a multidisciplinary clinic for bone metastases. The development of this program introduces an effective strategy to conduct research in palliative radiation oncology.

Symptom control is very important for the quality of life for bone and brain metastases patients. This is an evolving active field of research as greater emphasis is being placed into understanding the goals of improving not only a patient’s survival, but the ability for therapies to improve the quality of a patient’s life.

In this book we present the EORTC QLQ-C30 questionnaire, which was used in a multi-center study with patients recruited from Edmonton, Alberta, Canada; Kaohsiung, Taiwan; Kerala, India; Nicosia, Cyprus; Sao Paulo, Brazil; Taipei, Taiwan; Tanta, Egypt; and Toronto, Ontario, Canada, with brain and bone metastases. It was found that the difficulties bone and brain metastases patients experience are different in several ways. Patients with bone metastases have more pain and reduced physical functioning.

However, patients with brain metastases have more severe role functioning deficits. With use of the QLQ-C30, it was also found that there is ambiguity regarding the root of patient issues. Future studies that require more comprehensive disease-specific findings should include disease-specific assessment modules such as the QLQ-BM22 and QLQ-BN20. Important domains such as the minimal clinically important difference should also be established in individual subgroups of patients to assist in clinical trial design. (Imprint: Nova Biomedical )

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Table of Contents

Table of Contents

INTRODUCTION

SECTION ONE: CASE REPORTS

Chapter 1. A Unique Case of Long-bone Disease Responding to Radiotherapy Alone
(Martin Leung, Janet Nguyen, Joel Rubenstein, Edward Chow, Lori Holden, Kristopher Dennis and Florencia Jon, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 2. Painful Sacral Insufficiency Fracture Simulating Metastatic Disease from Primary Breast Cancer
(Florencia Jon, Janet Nguyen, Joel Rubenstein, Lori Holden, Michelle Ross, Gunita Mitera, Kristopher Dennis and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 3. Pathological Fracture of the Tibia in a Patient with Invasive Ductal Carcinoma of the Breast: A Case Report of a Rare Finding
(Esther Chan, Florencia Jon, Lori Holden, Kristopher Dennis and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 4. Renal Mass – Primary or Metastatic? The Search for a Definitive Diagnosis
(Justin Kwong, Florencia Jon, Linda Sugar, Bonnie O’Hayon, Lori Holden, Janet Nguyen, Michelle Ross, Cassandra Uy, Luluel Khan, Kristopher Dennis and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 5. Suspicious Perianal Lesion in a Patient with Renal Cell Carcinoma
(Cassandra Uy, Florencia Jon, Corwyn Rowsell, Bonnie O’Hayon, Sherif Hanna, Georg Bjarnason, Lori Holden, Janet Nguyen, Michelle Ross, Justin Kwong, Arjun Sahgal, Luluel Khan, Kristopher Dennis and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 6. Osteonecrosis of the Jaw Appearing as Bone Metastases in a Bone Scan in a Patient with Breast Cancer
(Gillian Bedard, Liang Zeng, Sunil Verma, Natalie Lauzon, Lori Holden, Kristopher Dennis, Michael Poon and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 7. Unusual Presentation of Osteolytic Bone Metastases in Prostate Adenocarcinoma
(Michelle Zhou, Liang Zeng, Monique Christakis, Michael Poon, Emily Chen, Natalie Lauzon, Nemica Thavarajah, Julia DiGiovanni and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 8. Asymptomatic Presentation of Lung and Bone Metastases in a Patient with Breast Cancer
(Michael Poon, Emily Chen, Linda Probyn, Liang Zeng, Natalie Lauzon, Lori Holden and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 9. Prophylaxis with Radiation Treatment after Surgery to the Cervical Spine for Established Heterotopic Ossification
(Gemma Cramarossa, Emily Chen, Liang Zeng, Cyril Danjoux, Kevin Higgins, Nicholas Phan, Richard Aviv, Natalie Lauzon, Kristopher Dennis and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 10. Good Surgical Outcome and Long Survival in a Patient with Occipitocervical Instability Requiring Occiput to C3 Fixation
(Michael Poon, Michael Ford, Liang Zeng, Monique Christakis, Emily Sinclair, Natalie Lauzon, Marko Popovic and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 11. Pain Relief through Palliative Radiation Therapy in a Patient with Cervical Spine Bone Metastases
(Rehana Jamani, Liang Zeng, Linda Probyn, Natalie Lauzon, Lori Holden, Nemica Thavarajah, Erin Wong and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 12. Single Fraction Palliative Radiation Treatment in the Treatment of Bone Metastases with Soft Tissue Mass
(Nicholas Lao, Michael Poon, Linda Probyn, Marko Popovic, Ronald Chow, Natalie Lauzon and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 13. Radiation Therapy Alone for Established Heterotopic Ossification
(Erin Wong, Gemma Cramarossa, Gillian Bedard, Linda Probyn, Lori Holden, Edward Chow and Natalie Lauzon, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 14. Focal Myositis as a Presentation of Paraneoplastic Syndrome in Pancreatic Cancer
(Erin Wong, Gillian Bedard, Linda Probyn, Natalie Pulenzas, Breanne Lechner, Lori Holden, Edward Chow and Natalie Lauzon, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 15. Heterotopic Ossification: Mimics of Other Benign and Malignant Etiologies
(Gillian Bedard, Liang Zeng, Natalie Lauzon, Linda Probyn, Kristopher Dennis and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

SECTION TWO: QUALITY OF LIFE ASSESSMENT TOOLS

Chapter 16. Quality of Life Measures Used in Radiation Therapy Trials for Patients with Metastatic Spinal Cord Compression (MSCC)
(Gunita Mitera, Nadil Zeiadin, Arjun Sahgal, Joel Finkelstein, Edward Chow and Andrew Loblaw, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 17. The Palliative Performance Scale: Examining its Correlation to the Karnofsky Performance Scale in an Outpatient Palliative Radiation Oncology Clinic
(Sarah Campos, Liying Zhang, Emily Sinclair, May Tsao, Elizabeth A Barnes, Cyril Danjoux, Arjun Sahgal, Philiz Goh, Shaelyn Culleton, Gunita Mitera and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 18. Confirmatory Factor Analysis of Brief Pain Inventory (BPI) Functional Interference Clusters in Patients with Bone Metastases
(Edward Chow, Jennifer James, Andrea Barsevick, William Hartsell, Sarah Ratcliffe, Charles Scarantino, Robert Ivker, John Suh, Ivy Petersen, Andre Konski, William Demas and Deborah Bruner, Odette Cancer Centre, Toronto, Canada and others)

Chapter 19. Correlation of the Palliative Performance Scale with the Karnofsky Performance Status in an Outpatient Palliative Radiotherapy Clinic
(Shaelyn Culleton, Kristopher Dennis, Kaitlin Koo, Liying Zhang, Liang Zeng, Justin Kwong, Janet Nguyen, Florencia Jon, Lori Holden, Elizabeth Barnes, May Tsao, Cyril Danjoux, Arjun Sahgal and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 20. Comparison of Baseline Quality of Life Scores in Patients with Bone and Brain Metastases as Assessed using the EORTC QLQ-C30
(Michael Poon, Liang Zeng, Liying Zhang, Ling-Ming Tseng, Ming-Feng Hou, Alysa Fairchild, Vassilios Vassiliou, Reynaldo Jesus-Garcia, Mohamed A Alm El-Din, Aswin Kumar, Fabien Forges, Wei-Chu Chie, Arjun Sahgal, Erin Wong and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada, and others)

Chapter 21. Comparison of Baseline Quality of Life Scores in Patients with Bone and Brain Metastases as Assessed using the EORTC QLQ-C15-PAL
(Julia Di Giovanni, Liang Zeng, Liying Zhang, Vassilios Vassiliou, Takefumi Satoh, Palmira Foro, Brigette BY Ma, Wei-Chu Chie, Arjun Sahgal, Michael Poon and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada, and others)

Chapter 22. Review of Brain Metastases Research in the Rapid Response Radiotherapy Program (RRRP)
(Natalie Pulenzas, Breanne Lechner, Nemica Thavarajah and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

SECTION THREE: SYMPTOM MANAGEMENT

Chapter 23. Review of Symptom Cluster Research in the Rapid Response Radiotherapy Program (RRRP)
(Breanne Lechner, Natalie Pulenzas, Nemica Thavarajah and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada

Chapter 24. Symptom Clusters in Metastatic Cancer: A Critical Appraisal
(Harleen Bedi, Amanda Hird, Sarah Campos and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 25. Symptom Clusters in Patients with Prostate Cancer: A Literature Review
(Nemica Thavarajah, Emily Chen, Gillian Bedard, Natalie Lauzon, Michelle Zhou, Dominic Chu and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 26. Dedicated Out-Patient Palliative Radiation Treatment Clinics for Patients with Advanced Cancer
(Justin Kwong, Florencia Jon, Lori Holden, Liang Zeng, Shaelyn Culleton, Cyril Danjoux, May Tsao, Elizabeth Barnes, Arjun Sahgal, Kristopher Dennis and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 27. Needs Assessment of Patients and their Caregivers
(Luluel Khan, Sarah Hugh, Shah Ansari, Andrew Chiang, Liang Zeng, Roseanna Presutti, Gunita Mitera, Liying Zhang, Elizabeth Barnes, Cyril Danjoux, Arjun Sahgal, Edward Chow and May Tsao, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 28. Determining the Accuracy of Health Care Professionals in Predicting the Survival of Patients with Advanced Metastatic Cancer
(Edward Chow, George Hruby, Kristin Harris, Katherine Enright, Emily Sinclair and Grace Chan, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 29. Rapid Response Radiotherapy Program and Multidisciplinary Bone Metastases Clinic
(Janet Nguyen, Arjun Sahgal, Emily Sinclair, Gunita Mitera, Macey Farhadian, Cyril Danjoux, Joel Finkelstein, Albert Yee, Michael Ford, Robyn Pugash, Urban Emmenegger, Anita Chakraborty and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 30. Barriers to Prescription of Sublingual Fentanyl Tablets for Breakthrough Cancer Pain in an Out-Patient Cancer Center
(Marissa Slaven, Frederick A Spencer and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada and others)

SECTION FOUR: RADIATION INDUCED NAUSEA AND VOMITTING (RINV)

Chapter 31. Review of Radiation-Induced Nausea and Vomiting Research in the Rapid Response Radiotherapy Program
(Natalie Pulenzas, Breanne Lechner, Nemica Thavarajah and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 32. Radiation-Induced Nausea and Vomiting in a Palliative Radiotherapy Clinic
(Roseanna Presutti, Janet Nguyen, Lori Holden, Carlo DeAngelis, Shaelyn Culleton, Gunita Mitera, May Tsao, Elizabeth A Barnes, Cyril Danjoux, Arjun Sahgal, Nadia Salvo, Luluel Khan and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 33. Evaluation of a Daily Diary for Assessing the Prevalence of Radiation Induced Emesis (RIE)
(Victoria Haid, Kinshuk Kumar, Eman Al Duhaiby, Jocelyn Pang, Carlo DeAngelis, Mark Pasetka, Yoo-Joung Ko, Janet Nguyen, Kristopher Dennis, Edward Chow and Hans T Chung, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

SECTION FIVE: BONE METASTASES

Chapter 34. Review of Bone Metastases Research in the Rapid Response Radiotherapy Program (RRRP)
(Breanne Lechner, Natalie Pulenzas, Nemica Thavarajah and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 35. Conventional Radiation Treatment and Bone Metastases
(Shaelyn Culleton, Sheldon Kwok and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 36. Palliative Radiotherapy of Bone Metastases and Pain Flare
(Roseanna Presutti, Amanda Hird, Carlo DeAngelis, Alysa Fairchild, Tanya Holt, Andrew Loblaw and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada and others)

Chapter 37. Bone Metastases and Quality of Life
(Roseanna Presutti, Janet Nguyen, Amanda Hird, Alysa Fairchild, Mark Clemons, Marc Kerba, Arjun Sahgal and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada and others)

Chapter 38. Positron Emission Tomography and Bone Metastases
(Gillian Bedard, Liang Zeng, Henry Lam, Natalie Lauzon, Katharine Hicks and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

SECTION SIX: ADVANCED LUNG DISEASE

Chapter 39. A Review of the Impact of Oxygen Therapy in Patients with Advanced Lung Disease
(Kaitlin Koo, Justin Kwong, Janet Nguyen, Florencia Jon, Liang Zeng, Kristopher Dennis, Lori Holden, Shaelyn Culleton, Luluel Khan, Amanda Caissie and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 40. Long-Term Survival in Patients with Brain Metastases from Non Small Cell Lung Carcinoma
(Rehana Jamani, Kristopher Dennis, Florencia Jon, Nemica Thavarajah, Alex Mingay, Emily Chen, Janet Nguyen, Natalie Lauzon and Edward Chow, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

Chapter 41. Palliative Radiotherapy in the Treatment of Lung Metastases or Advanced Lung Cancer
(Jasmine Nguyen, Dominic Chu, Gillian Bedard, Erin Wong, Flo Jon, Cyril Danjoux, Elizabeth Barnes, May Tsao, Lori Holden, Edward Chow and Natalie Lauzon, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada)

SECTION SEVEN: ACKNOWLEDGEMENTS

Chapter 42. About the Editors

Chapter 43. About the Rapid Response Radiotherapy Program at the Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada

Chapter 44. About the National Institute of Child Health and Human Development in Israel

Chapter 45. About the Book Series “Health and Human Development”

SECTION EIGHT: INDEX

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