165 research outputs found

    Syöpäpotilaan hoidon moniammatilliset suunnittelukokoukset - laadukkaan syövänhoidon kultastandardi

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    Moniammatilliset syöpäpotilaiden hoidon suunnittelukokoukset (multidisciplinary team meeting eli MDT-kokous) ovat muodostuneet syövänhoidon kultastandardiksi. MDT-työskentelyn hyötyjä ovat potilaiden paremmat hoitotulokset, hoitosuositusten noudattaminen ja jopa taloudelliset hyödyt. Euroopan syöpäverkoston (Organization of European Cancer Institutes, OECI) laatukriteereissäkin MDT-toiminta on keskeisessä osassa. MDT-työskentely on viime vuosien aikana joutunut suurenevien paineiden alle syövän ilmaantumisen ja uusien hoitomuotojen lisääntymisen vuoksi. Tämä paine on johtanut tehokkaiden MDT-kokousten toimintatapojen tunnistamiseen tutkimuksilla ja Britanniassa kokousten virtaviivaistamispilottiin. Potilaskeskeisyyden parantaminen MDT-kokouksissa lisää toteutuneiden hoitosuositusten osuutta ja siten toiminnan tehokkuutta. Teknologinen kehitys, kuten tekoälyn ja päätöksenteon tukijärjestelmien integrointi MDT-työskentelyyn, mahdollistaa tulevaisuudessa kokousten entistä paremman standardoinnin ja tehostamisen.Peer reviewe

    The past and present of prostate cancer and its treatment and diagnostics : A historical review

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    The prognosis of local prostate cancer has improved drastically during the past 60 years. Similarly, the prognosis in metastatic stage is constantly improving due to a number of new pharmaceuticals introduced over the past 10 years. Previously, only palliative treatments were available for prostate cancer, but today, there are multiple options for treatment with curative intent: robotic-assisted radical prostatectomy, stereotactic radiotherapy and brachytherapy. Additionally, life-prolonging chemotherapeutic and androgen-suppressive treatments, as well as diagnostic imaging and staging, have improved considerably. This review summarizes the history of the treatment and diagnostics of prostate cancer, with a focus on the past 60 years. The aim was to provide a concise and easy-to-read introduction on the matter for all people that work with prostate cancer, as well as for patients. The literature was thoroughly examined covering the period from the earliest traceable records to the latest state-of-the-art studies.Peer reviewe

    Uusilla lääkkeillä parempaa hoitoa eturauhassyöpään

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    Viime vuosina eturauhassyövän hoitoon on tullut useita tehokkaita lääkkeitä, joita käytetään kastraatioresistenssin kehityttyä ja joiden hyödyntämistä tutkitaan syövän aiemmassakin hoitovaiheessa. Uusia hormonaalisesti vaikuttavia lääkkeitä ovat muun muassa GnRH-antagonisti degareliksi, toisen polven antiandrogeeni entsalutamidi (MDV3100) ja CYP17:n estäjä abirateroni. Solunsalpaajien osalta dosetakselista on tullut uusi johdos kabatsitakseli. Luustoetäpesäkkeiden aiheuttamien komplikaatioiden ehkäisynä denosumabi ja luustopesäkkeiden hoitona 233radiumkloridi ovat osoittaneet tehonsa satunnaistetuissa kliinisissä tutkimuksissa. Uusien lääkkeiden optimaalinen antojärjestys ja niiden yhdisteleminen ovat vilkkaan tutkimuksen kohteena

    Uusilla lääkkeillä parempaa hoitoa eturauhassyöpään

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    Viime vuosina eturauhassyövän hoitoon on tullut useita tehokkaita lääkkeitä, joita käytetään kastraatioresistenssin kehityttyä ja joiden hyödyntämistä tutkitaan syövän aiemmassakin hoitovaiheessa. Uusia hormonaalisesti vaikuttavia lääkkeitä ovat muun muassa GnRH-antagonisti degareliksi, toisen polven antiandrogeeni entsalutamidi (MDV3100) ja CYP17:n estäjä abirateroni. Solunsalpaajien osalta dosetakselista on tullut uusi johdos kabatsitakseli. Luustoetäpesäkkeiden aiheuttamien komplikaatioiden ehkäisynä denosumabi ja luustopesäkkeiden hoitona 233radiumkloridi ovat osoittaneet tehonsa satunnaistetuissa kliinisissä tutkimuksissa. Uusien lääkkeiden optimaalinen antojärjestys ja niiden yhdisteleminen ovat vilkkaan tutkimuksen kohteena

    Undergraduate curriculum in palliative medicine at Tampere University increases students' knowledge

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    Background: Education in palliative medicine (PM) at medical schools reveals wide variation despite the increasing importance of palliative care. Many universities present poor description of the benefits and detailed content of the total curriculum in PM. Using the recommendations of European Association for Palliative Care (EAPC) as a reference, we evaluated the content and outcomes of the curriculum in PM at the University of Tampere, Finland. Methods: We searched for a PM curriculum by examining the teaching offered by every specialty and compared it to EAPC recommendations. Students' knowledge was evaluated using a progress test over three consecutive years. Results: We found 53.5 teaching hours addressing PM issues, which exceeds the recommendation of the EAPC. Basics, symptom management, ethics, and communication skills were well established, while education in psychosocial/spiritual aspects, teamwork and self-reflection failed to reach the recommendations. Out of the maximum of 4.0, the progress test mean scores in PM among the third, fourth, fifth and sixth year students were 0.1 (SD 0.71), 0.69 (SD 1.28), 1.38 (SD 1.46) and 2.53 (SD 1.26), respectively (p <0.001). This growing knowledge was associated with the timely increase in teaching provided through the PM discipline. In addition, the students who completed the optional PM course achieved better mean scores (2.66; SD 1.27) than the others (1.33; SD 1.43) (p <0.001). Conclusions: The curriculum in PM at the University of Tampere is integrated into the teaching of many disciplines and complied well with the EAPC recommendations. This education led to increasing knowledge in PM among medical students.Peer reviewe

    Acute Side-effects of Different Radiotherapy Treatment Schedules in Early Prostate Cancer

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    BACKGROUND: Optimal radiation therapy (RT) fractionation in early prostate cancer in elderly patients is controversial. We compared acute toxicities of fractionation schedules: 78/2 Gy, 60/3 Gy and 36.25/7.25 Gy, in this single-centre study. We also evaluated the effect of the rectal immobilization system Rectafix on quality of life (QoL). PATIENTS AND METHODS: Seventy-three patients with one or two intermediate prostate cancer risk factors according to National Comprehensive Cancer Network criteria were recruited. Twenty-one patients were treated with 78/2 Gy and 60/3 Gy, and 31 patients with 36.25/7.25 Gy. Their QoL data were assessed with regard to genitourinary, gastrointestinal and sexual wellbeing at the beginning and end of RT and at 3 months after treatment. Rectafix was used in the 78/2 Gy and 60/3 Gy groups. RESULTS: There were no statistically significant QoL differences in between the treatment groups 3 months after RT. The 78/2 Gy group had significantly increased bowel movements between baseline and 3 months after RT (p=0.036). At 3 months after RT, this group also had significantly more erectile dysfunction than the 60/3 Gy group (p=0.025). At the end of RT, the 78/2 Gy group had more symptoms than the 36.25/7.25 Gy group. Rectafix did not reduce acute toxicities in the 78/2 Gy or 60/3 Gy groups. CONCLUSION: Treatment with the 78/2 Gy schedule is no longer to be recommended due to its increased acute toxicity compared to treatments of 60/3 Gy and 36.25/7.25 Gy. The shortest schedule of 36.25 Gy in five fractions seems to be a convenient treatment option with tolerable acute toxicity.publishedVersionPeer reviewe
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