Preparing ourselves, our trainees, and our patients: A commentary on truthtelling

Massachusetts General Hospital, Boston, Massachusetts, United States
Journal of Clinical Oncology (Impact Factor: 17.88). 03/2007; 25(4):456-7. DOI: 10.1200/JCO.2006.09.6941
Source: PubMed
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    ABSTRACT: In order to discuss and understand the experiences of oncologists faced with the task of communicating difficult news to children and their close family members, a bibliographical review was conducted in the Virtual Health Library databases containing the literature published by PubMed, Lilacs, Scielo, Scopus and SciVerse with input on the theme. The articles available evaluated by thematic analysis reveal the following aspects: the lack of studies focusing on the perception of professionals about imparting difficult news; communication as a strategy by which psychosocial, cultural, bioethical, legal and emotional aspects are handled; that more is expected from physicians than they were trained for. It was also seen that the information and training of professionals in strategies regarding how to handle the communication of difficult news needs to be ongoing in order to keep up with the dynamism of the occurrences and the physician-patient relations in the oncological field in which patients tend to be or feel under constant life-threatening conditions.
    Ciencia & saude coletiva 09/2013; 18(9):2747-56. DOI:10.1590/S1413-81232013000900030
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    ABSTRACT: We previously reported results of the phase 2, multicenter PINNACLE study, which confirmed the substantial single-agent activity of bortezomib in patients with relapsed or refractory mantle cell lymphoma (MCL). We report updated time-to-event data, in all patients and by response to treatment, after extended follow-up (median 26.4 months). Median time to progression (TTP) was 6.7 months. Median time to next therapy (TTNT) was 7.4 months. Median overall survival (OS) was 23.5 months. In responding patients, median TTP was 12.4 months, median duration of response (DOR) was 9.2 months, median TTNT was 14.3 months, and median OS was 35.4 months. Patients achieving complete response had heterogeneous disease characteristics; among these patients, median TTP and DOR were not reached, and median OS was 36.0 months. One-year survival rate was 69% overall and 91% in responding patients. Median OS from diagnosis was 61.1 months, after median follow-up of 63.7 months. Activity was seen in patients with refractory disease and patients relapsing following high-intensity treatment. Toxicity was generally manageable. Single-agent bortezomib is associated with lengthy responses and notable survival in patients with relapsed or refractory MCL, with considerable TTP and TTNT in responding patients, suggesting substantial clinical benefit.
    Annals of Oncology 03/2009; 20(3):520-5. DOI:10.1093/annonc/mdn656 · 6.58 Impact Factor