Oncology KW seminars for exam 2
Inhoud
Lecture 9 – KW seminar: Health-related quality of life in cancer ........................................................... 2
Lecture 10 – KW seminar: Hematology. .................................................................................................. 7
Lecture 11 – KW seminar: Radiotherapy ............................................................................................... 14
Lecture 12 – KW seminar: Principles of immunotherapy for head and neck cancer. ........................... 21
Lecture 13 – KW seminar: Lung cancer ‘Clinic’...................................................................................... 31
Lecture 14 – KW seminar: Molecular Imaging ...................................................................................... 39
,Lecture 9 – KW seminar: Health-related quality of life in cancer
Patient story of Cath (56 year old woman).
- November 2012 → Diagnosis of a tumor on the tongue and in the lymph glands on both sides
of the neck.
- December 2012 – Februari 2013 → Surgery of the tongue (and tongue replacement),
chemotherapy and radiotherapy.
(Long-term) symptoms.
- General:
o Changed body image.
o Fatigue and sleep problems.
o Anxiety and depression.
o Cognitive problems.
o Pain.
o Sexuality.
o Etc.
- Tumor-specific (e.g. head and neck cancer):
o Problems with eating.
o Problems with social eating.
o Speech problems.
o Shoulder problems.
o Etc.
- Symptoms have negative influence on the patients health-related quality of life.
Health related quality of life in cancer → Definition.
- HRQOL is a multidimensional concept that refers to patient’s subjective perception of the
effect on their disease and treatment on physical, psychological, and social aspects of daily
life.
- HRQOL is defined as patient reported physical, mental, and social functioning.
- Definition health of WHO → Health is a state of complete physical, mental, and social well-
being, and not merely the absence of disease.
Health-related quality of life in caner → Domains.
- Physical:
o Pain
o Sexuality
o Sleep
o Fatigue
o Body image
o Diarrhea
o Constipation
o Loss of appetite
o Nausea
o Lymphedema
o Daily life
o Hearing
,- Psychological:
o Anxiety
o Depression
o Memory & concentration
- Social:
o Social life
o Loneliness
o Relationships
o Children
o Finances
o Work
o Communication with care providers
- Head and neck cancer:
o Swallowing
o Speech
o Shoulder function
o Taste and smell
o Lymphedema
o Oral function
- Breast cancer:
o Hormonal therapy
o Menopausal symptoms
o Body image
o Sexuality
o Fertility issues
o Hereditary BC
o Lymphedema
o Fibrosis
o Arm/shoulder function
o Breast reconstruction
o Breast prothesis
- Colorectal cancer:
o Bladder and urinary problems
o Stools
o Bloated feeling
o Scars
o Hereditary CRC
o Diarrhea
o Constipation
o Stoma care
o Pain
o Body image
, Measuring HRQOL → How?
- Patient-reported outcome measures (PROMs) → Questionnaires completed by patients.
o Generic → Can be used for more diseases.
o Disease-specific → Can only be used by patients with a specific disease.
o Domain-specific → Asking about specific side effects in physical, psychological and
social domains or disease domain specific.
o Symptom-specific → Asks about specific symptoms.
o Preference-based measures.
- OncoQuest → Touch screen computer system where patients can fill in several
questionnaires.
- After completing the questionnaire the results are automatically processed and then the
patient will discuss the results with a nurse and the nurse will give advise how the symptoms
and the quality of life can be increased.
o Example picture:
▪ Patient did the questionnaire 4
times → The 4 different bars.
▪ In the upper panels, a high score
means a good outcome.
▪ In the lower panels (less yellow), a
high score means a more severe
outcome.
- Oncokompas:
o A supportive care self-management platform.
o Measure → Structured monitoring of health-related quality of life.
o Learn → Feedback by means of a 3-colour system and tailored self-care advice.
o Act → Based on the outcome of the test a database with (evidence based)
supportive care options are provided to the patient.
Measuring HRQOL among patients in cancer → Why?
- Increase symptom awareness → Not only under patients but also under the physician.
o It also improves symptom recall.
- Improve communication → Among patient and physician and among different physicians.
o Improved interdisciplinary discussions.
o Facilitates interprofessional communication.
o Improves understanding of patient experience.
o Prompt discussion of relevant topics.
- Improve symptom management and HRQOL.
o If you know what
the symptoms are
and what
problems it gives,
the problems can
be better managed
and therefore
improve quality of
life.
Inhoud
Lecture 9 – KW seminar: Health-related quality of life in cancer ........................................................... 2
Lecture 10 – KW seminar: Hematology. .................................................................................................. 7
Lecture 11 – KW seminar: Radiotherapy ............................................................................................... 14
Lecture 12 – KW seminar: Principles of immunotherapy for head and neck cancer. ........................... 21
Lecture 13 – KW seminar: Lung cancer ‘Clinic’...................................................................................... 31
Lecture 14 – KW seminar: Molecular Imaging ...................................................................................... 39
,Lecture 9 – KW seminar: Health-related quality of life in cancer
Patient story of Cath (56 year old woman).
- November 2012 → Diagnosis of a tumor on the tongue and in the lymph glands on both sides
of the neck.
- December 2012 – Februari 2013 → Surgery of the tongue (and tongue replacement),
chemotherapy and radiotherapy.
(Long-term) symptoms.
- General:
o Changed body image.
o Fatigue and sleep problems.
o Anxiety and depression.
o Cognitive problems.
o Pain.
o Sexuality.
o Etc.
- Tumor-specific (e.g. head and neck cancer):
o Problems with eating.
o Problems with social eating.
o Speech problems.
o Shoulder problems.
o Etc.
- Symptoms have negative influence on the patients health-related quality of life.
Health related quality of life in cancer → Definition.
- HRQOL is a multidimensional concept that refers to patient’s subjective perception of the
effect on their disease and treatment on physical, psychological, and social aspects of daily
life.
- HRQOL is defined as patient reported physical, mental, and social functioning.
- Definition health of WHO → Health is a state of complete physical, mental, and social well-
being, and not merely the absence of disease.
Health-related quality of life in caner → Domains.
- Physical:
o Pain
o Sexuality
o Sleep
o Fatigue
o Body image
o Diarrhea
o Constipation
o Loss of appetite
o Nausea
o Lymphedema
o Daily life
o Hearing
,- Psychological:
o Anxiety
o Depression
o Memory & concentration
- Social:
o Social life
o Loneliness
o Relationships
o Children
o Finances
o Work
o Communication with care providers
- Head and neck cancer:
o Swallowing
o Speech
o Shoulder function
o Taste and smell
o Lymphedema
o Oral function
- Breast cancer:
o Hormonal therapy
o Menopausal symptoms
o Body image
o Sexuality
o Fertility issues
o Hereditary BC
o Lymphedema
o Fibrosis
o Arm/shoulder function
o Breast reconstruction
o Breast prothesis
- Colorectal cancer:
o Bladder and urinary problems
o Stools
o Bloated feeling
o Scars
o Hereditary CRC
o Diarrhea
o Constipation
o Stoma care
o Pain
o Body image
, Measuring HRQOL → How?
- Patient-reported outcome measures (PROMs) → Questionnaires completed by patients.
o Generic → Can be used for more diseases.
o Disease-specific → Can only be used by patients with a specific disease.
o Domain-specific → Asking about specific side effects in physical, psychological and
social domains or disease domain specific.
o Symptom-specific → Asks about specific symptoms.
o Preference-based measures.
- OncoQuest → Touch screen computer system where patients can fill in several
questionnaires.
- After completing the questionnaire the results are automatically processed and then the
patient will discuss the results with a nurse and the nurse will give advise how the symptoms
and the quality of life can be increased.
o Example picture:
▪ Patient did the questionnaire 4
times → The 4 different bars.
▪ In the upper panels, a high score
means a good outcome.
▪ In the lower panels (less yellow), a
high score means a more severe
outcome.
- Oncokompas:
o A supportive care self-management platform.
o Measure → Structured monitoring of health-related quality of life.
o Learn → Feedback by means of a 3-colour system and tailored self-care advice.
o Act → Based on the outcome of the test a database with (evidence based)
supportive care options are provided to the patient.
Measuring HRQOL among patients in cancer → Why?
- Increase symptom awareness → Not only under patients but also under the physician.
o It also improves symptom recall.
- Improve communication → Among patient and physician and among different physicians.
o Improved interdisciplinary discussions.
o Facilitates interprofessional communication.
o Improves understanding of patient experience.
o Prompt discussion of relevant topics.
- Improve symptom management and HRQOL.
o If you know what
the symptoms are
and what
problems it gives,
the problems can
be better managed
and therefore
improve quality of
life.
