Friendship during patients' stable and unstable phases of incurable cancer:a qualitative interview study

Objectives:Little is known about the added value of friendship during the care of intensive cancer disease trajectories. Friends, however, can play an important (caring-)role to increase their friends' (mental) well-being. We explored the experiences and desires of friends while their ill friends were-most of the time-in a stable phase of incurable cancer. Design:Qualitative study in the Netherlands based on 14 in-depth interviews with friends of patients living with incurable cancer. Interviews were performed at the home setting or the friend's office. Data gathering was inspired by grounded theory and analysed with a thematic analysis. Setting:The home setting/friend's office. Results:Friends reported to experience difficulties in how and how often they wanted to approach their ill friends. They emphasised the ever-present knowledge of cancer inside their friends' body as a time bomb'. They seemed to balance between the wish to take care for their ill friend, having a good time and not knowing what their ill friend desired at specific times. Some friends felt burdened with or forced to provide more care than they could, although they acknowledged that this relationship provided space to reflect about their own life. Conclusions:Friends are constantly negotiating and renegotiating their relationship depending on the severity of the disease, transparency of patients about their illness, their previous experiences and personal circumstances in life. Although a decrease in friendship may impact a patient's quality of life, friends also need to be protected against providing more care than they are willing or able to give. Healthcare professionals, being aware of this phenomenon, can assist in this.</p

Patterns and risk of first and subsequent recurrences in women within ten years after primary invasive breast cancer

Background: Previous studies suggest a distinct pattern and a number of predictive factors for breast cancer recurrence. However, only few studies include data on recurrence site and no study provides data regarding second and third breast cancer recurrence after local and regional recurrence. The aim of this study was to analyse the occurrence, timing and predictive factors of first and subsequent local (LR), regional (RR) or distant (DM) recurrence during the first 10 years after treatment for primary invasive breast cancer in women. Methods: Women with stage I-III invasive breast cancer diagnosed in 2003 and treated with curative intent were selected from the Netherlands Cancer Registry (N = 9797). Median follow-up was 10 years. Multivariable cox proportional hazards regression was used to model the hazard of recurrence over time for site-specific first recurrence and for subsequent recurrences after LR or RR. Predictive factors were identified for first and for subsequent recurrences. All tests were two-sided and probability values of 2 cm, grade III and negative ER were predictive factors for first RR and tumour size >2 cm, grade II or III, increasing number of involved lymph nodes and negative progesterone-receptor (PR) status were predictive factors for first DM. After a LR 109/379 patients (28.7%) developed subsequent recurrence: 11 patients had another LR (2.9%), 13 patients had RR (3.4%) and 85 patients (22.4%) had DM. Median time to second recurrence was 1.1 year (IQR 0.3–2.5 year). Tumour size >2 cm, grade III, primary tumour histology (other vs invasive ductal), >3 positive lymph nodes and negative PR-status were predictive factors for a second recurrence after LR. After a first RR 79/156 patients (50.6%) developed subsequent recurrence: 8 patients had LR (5.1%), 3 patients had RR (1.9%) and 68 patients (43.6%) had DM. Median time to second recurrence was 1.1 year (IQR 0.5–2.1 year). In multivariable analysis, no predictive factor for a second recurrence after RR was identified. After previous LR or RR a third subsequent recurrence occurred in 18 patients (9.6%). Conclusions: The pattern of first recurrence was similar for LR, RR and DM. To improve personalized follow-up, predictive factors could be taken into account. However, this study showed no explicit predictive factor for site specific recurrence and subsequent recurrences after LR and RR. Future studies that take treatment characteristics into account are needed

olaparib maintenance therapy in patients pts with platinum sensitive relapsed psr ovarian cancer oc and stable disease sd following platinum based chemotherapy

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LBA36Association of PD-L1 expression and gene expression profiling with clinical response to pembrolizumab in patients with advanced recurrent ovarian cancer: Results from the phase II KEYNOTE-100 study

ispartof: Ann Oncol vol:29 Suppl 8 pages:viii728- ispartof: location:England status: publishe