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Locating Cancer Information for Your Clinicians and
Patients
Liz BrackeenStephanie Fulton
Survey Monkey Results
Wiki Navigation:http://mla09cancer.pbworks.com/
Class Objectives
• Participants will acquire and apply cancer searching techniques through examples
• Participants will gain knowledge of a variety resources for finding cancer information through discussions and examples
Cancer 101 Patient Question:
How did this (cancer) happen to me?
10
Cancer 101 Patient Question:
Understanding Cancer Series http://www.cancer.gov/cancertopics/UnderstandingCancer/ Fact Sheets: Risk Factors and Possible Causes http://www.cancer.gov/cancertopics/factsheet
Multiple Myeloma Research Foundation: Causes and Incidencehttp://myeloma.org/pdfs/ph08-eng_h3-web.pdf
Group Activity:
How many cancer/oncology societies can you name?
12
Cancer 101 Clinical Question:
What is searched when I use the cancer limit in PubMed?
14
Cancer 101 Clinical Question:
15PubMed - Cancer Hedge Detailshttp://www.nlm.nih.gov/bsd/pubmed_subsets/cancer_strategy.html
Core Collection and JournalsCA: A Cancer Journal for CliniciansCancerCancer Research Journal of Clinical OncologyJournal of the National Cancer Institute Oncology Nursing ForumNature Reviews CancerLancet Oncology
Clinical Question:You have recently diagnosed a
50 year old male with early stage multiple myeloma. He wants to know if there is any
benefit to starting therapy now versus waiting. He is otherwise
healthy and not overly interested in starting treatment
unless he can see a clear benefit.
19
What is our clinical question?
Does therapy improve the outcome for the patient?
Does starting chemotherapy immediately after diagnosis for early stage multiple myeloma increase overall survival?
Clinical Question:
21
http://search.ebscohost.com/login.aspx?authtype=uidUsername: sccPassword: mla
Diagnosis Patient Question:
I have these results from the lab and I
need to figure out what they
mean.22
Diagnosis Patient Question:
Lab Tests Onlinehttp://www.labtestsonline.org/
Books:A Manual of Laboratory and Diagnostic Tests
Mosby's Manual of Diagnostic and Laboratory Tests
Procedureshttp://www.nlm.nih.gov/medlineplus
Diagnostic Test Type of CancerBRCA-1 and BRCA-2 risk of developing breast or ovarian cancer
Cancer Antigen 15-3 monitor the response to treatment of invasive breast cancer
PSA symptoms suggestive of prostate cancer & regular intervals after prostate cancer treatment
CA-125 monitor treatment for ovarian cancer or to detect recurrence
hCG Monitor germ cell tumorsAFP Tumor Markers monitor therapy for certain cancers of the
liver, testes, or ovaries
CEA to monitor cancer treatment, including response to therapy and recurrence
CA 19-9 monitor response to pancreatic cancer treatment
EGFR helps to guide treatment and determine prognosis of solid tumors
http://www.labtestsonline.org
Diagnosis Clinical Question:
27
Explain the differences in searching for diagnosis using keyword, MeSH, and Clinical Queries in PubMed.
Diagnosis Clinical Question:
28
PubMed Clinical Querieshttp://www.ncbi.nlm.nih.gov/corehtml/query/static/clinical.shtml
MeSH Subheadings Hierarchyhttp://www.nlm.nih.gov/mesh/2009/introduction/subhierarchy.html
Types of TreatmentSurgery
Prophylactic surgeryDiagnostic surgeryStaging surgeryCurative surgery Debulking (cytoreductive) surgery Palliative surgerySupportive surgery Reconstructive surgery Laser surgery Electrosurgery CryosurgeryMohs
Chemotherapy (over 100 drugs)oral topical intravenous intramuscular subcutaneousintra-arterialintrathecalintrapleuralintraperitonealintravesicalintralesional/intratumoral
Radiation
External BeamBrachytherapyParticle BeamIMRTStereotactic radiosurgery3–D conformal radiation Intraoperative radiation therapy (IORT)Prophylactic cranial irradiationSystemic radiation therapy
OtherRadiofrequency AblationHormone TherapyAngiogenesis Inhibitors TherapyBiological TherapyPeripheral Blood Stem Cell TransplantationGene Therapy for CancerHyperthermia in Cancer TreatmentLaser-induced interstitial thermotherapy Photodynamic Therapy for CancerTargeted Cancer Therapiessmall-molecule drugsApoptosis-inducing” drugsMonoclonal antibodiesInterleukinsInterferonsNonspecific immunomodulating agentsComplementary and Alternative MedicineCancer Vaccine
Treatment/Clinical Trial Patient Question:
The treatment they have been giving me for my colon cancer has stopped working, I need to
find out about my other options.
33
Treatment/Clinical Trial Patient Question:
UT MD Anderson Guidelineshttp://www.mdanderson.org/education-and-research/resources-for-professionals/clinical-tools-and-resources/clinical-resources.html
NCCN Guidelineshttp://www.nccn.org/
NCI Guidelineshttp://www.cancer.gov/cancertopics/pdq/
UpToDatehttp://www.uptodate.com/patients
Clinical Trialshttp://clinicaltrials.govhttp://www.cancer.gov/clinicaltrialshttp://www.centerwatch.com
Drug Information Clinical Question:
35
What are the contraindications for tamoxifen? Should I be
concerned if patient is taking Tamiflu? Letrozole?
Drug Information Clinical Question:
36https://online.epocrates.com/
Complementary/Integrative Medicine Group Activity:
Brainstorm alternative complementary therapies
that might be used for cancer by patients or practitioners?
37
Complementary/Integrative Medicine Patient Question:
What herbs are good for pancreatic cancer?
38
Complementary/Integrative Medicine Patient Question:
MD Anderson CIMERhttp://www.mdanderson.org/departments/CIMER/
Natural Standardhttp://naturalstandard.com login/pw: mdacc/mdacc
National Center for Complementary and Alternative Medicinehttp://nccam.nih.gov/
CAMlinehttp://www.camline.ca
Side Effects Patient Question:
My wife’s Dr. wants her to do chemotherapy and radiation & I
would like to find some information about the side
effects.
40
Side Effects Patient Question:
41
Chemotherapy and Youhttp://www.cancer.gov/cancertopics/chemotherapy-and-youRadiation Therapy and You http://www.cancer.gov/CANCERTOPICS/RADIATION-THERAPY-AND-YOUCancerCare Managing Side Effects http://www.cancercare.org/reading_room/connect_booklets.phpMedlinePlus Tutorialhttp://www.nlm.nih.gov/medlineplus/
Side Effects Clinical Question:
What are long term side effects of Cisplatin in testicular cancer
patients?
43
Side Effects Clinical Question:
44
http://scopus.com/registerUsernames: use from handoutPassword:
(TITLE-ABS-KEY(injurious OR undesirable) AND TITLE-ABS-KEY(effect* OR reaction* OR event* OR incident*)) OR (TITLE-ABS-KEY("adverse effect*" OR "adverse reaction*" OR "adverse event*" OR "adverse incident*" OR "adverse outcome" toxic OR toxicity OR "chemically induced" OR injurious OR undesirable OR "bad reaction" OR poison* OR lethal OR "drug safety" OR "drug induced" OR "Drug Toxicity" OR "drug safety" OR "adverse drug reaction" OR intoxication OR "side effect*" OR "late effect*"))
Scopus Safety Hedge
Nutrition Patient Question:
What do I eat if I have pancreatic cancer?
48
Nutrition Patient Question:
PanCan Diet and Nutritionhttp://www.pancan.org/section_facing_pancreatic_cancer/learn_about_pan_cancer/diet_and_nutrition/
Eating Hints for Cancer Patients – NCIhttp://www.cancer.gov/cancertopics/eatinghints
AICR - American Institute for Cancer Researchhttp://www.aicr.org/
Nutrition and Physical Activity During and After Cancer Treatmenthttp://caonline.amcancersoc.org/cgi/content/full/56/6/323
Nutrition
critical care x nutrition Nutrition in cancer survivors
articles on nutrition and radiotherapyenteral or Parenteral feeding X early vs late X ICU
Enteral feeding - height of bedEnteral feeding – residualsEnteral Feeding – flushing
Benefit/harm of OG and NG tubes in the ORenteral parenteral tpn tube feeding
Prognosis Patient Question:
I have stage IV breast cancer with lung and liver mets.
How long do I have?
51
Prognosis Patient Question:
52
What do you say to a patient or a family member?
How can you ask this question so that a Dr. can answer it?
Statistics Question:
I need statistics for bladder cancer.
53
Statistics Question:Cancer statistics, 2010. Jemal A, Siegel R, Xu J, Ward E. CA Cancer J Clin. 2010 Sep-Oct;60(5):277-300. PMID: 20610543 NCI List is a great place to start for definitions and links to SEER; State Cancer Profiles http://www.cancer.gov/statistics Most requested graphs and figures from the American Cancer Societyhttp://www.cancer.org/Research/CancerFactsFigures/CancerFactsFigures/most-requested-tables-figures-2010 National Center for Health Statisticshttp://www.cdc.gov/nchs/fastats/cancer.htm CDC - U.S. Cancer Statistics Interactive Atlashttp://apps.nccd.cdc.gov/DCPC_INCA/DCPC_INCA.aspx National Cancer Institute - Cancer Mortality Maps & Graphshttp://www3.cancer.gov/atlasplus/ International Agency for Research on Cancer – CANCER Mondial http://www-dep.iarc.fr/dephome.htm Dialog's Incidence & Prevalence Database (465) http://library.dialog.com/bluesheets/html/bl0465.html
54
CA-A CANCER JOURNAL FOR CLINICIANS 2010; 60;277-300
Advanced Cancer Patient Question:
We just got the news that they are stopping treatment and we need some resources for talking with
the family.
My husband has a brain tumor and I just want to know what is going
to happen? 56
Advanced Cancer Patient Question:
Coping with Advanced Cancer – NCIhttp://www.cancer.gov/cancertopics/advancedcancer
CancerCare Advanced Cancers http://www.cancercare.org/get_help/special_progs/advanced_cancers.php
FamilyDoctor.org: Palliative Carehttp://familydoctor.org/online/famdocen/home/common/cancer/caregivers/palliative.html
MD Anderson Clinical Center for Targeted Therapyhttp://www.mdanderson.org/patient-and-cancer-information/care-centers-and-clinics/clinics/clinical-center-for-targeted-therapy/index.html
HPNA Patient/Family Teaching Sheetshttp://www.hpna.org/DisplayPage.aspx?Title=Patient/Family%20Teaching%20Sheets
Conclusions
Prevention
Screening
Psychosocial issues
Spirituality
Survivorship
Pediatric Cancer
…
Evaluative Questions
What is one thing you learned today or one thing that went well?
What is something that we can do better?