Cancer rehabilitation: closing the gap in low- and middle-income countries

Anwar, Sumadi Lukman; Adistyawan, Guritno; Wulaningsih, Wahyu; Erlangga, Zulrahman; Gütenbrunner, Christoph; Nugraha, Boya

doi:10.23736/s1973-9087.18.04843-8

Cited by 8 publications

(7 citation statements)

References 4 publications

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“…Specific measures might be addressed to younger women with breast cancer as the proportion is relatively high as well as a higher risk of distant metastasis [32]. Patient age has also been incorporated in the treatment plans by considering aggressive therapy, physical functioning, quality of life, and body image [32,33].…”

Section: Discussionmentioning

confidence: 99%

Risk factors of distant metastasis after surgery among different breast cancer subtypes: a hospital-based study in Indonesia

et al. 2020

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Background: More than one third of breast cancer patients including those that are diagnosed in early stages will develop distant metastasis. Patterns of distant metastasis and the associated risks according to the molecular subtypes are not completely revealed particularly in populations of patients with delayed diagnosis and advanced stages. Methods: Breast cancer patients (n = 1304) admitted to our institute (2014-2017) were evaluated to identify the metastatic patterns and the associated risks. Metastatic breast cancers at diagnosis were found in 245 patients (18.7%), and 1059 patients were then grouped into non-metastatic and metastatic groups after a median follow-up of 3.8 years. Results: Infiltration of the tumor to the skin and chest wall prevailed as the most powerful predictor for distant metastasis (OR 2.115, 95% CI 1.544-2.898) particularly in the luminal Alike subtype (OR 2.685, 95% CI 1.649-4.371). Nodal involvement was also significantly associated with the risk of distant metastasis (OR 1.855, 95% CI 1.319-2.611), and the risk was higher in the Luminal Alike subtype (OR 2.572, 95% CI 1.547-4.278). Luminal Alike subtype had a significant higher risk of bone metastasis (OR 1.601, 95% CI 1.106-2.358). In respect to treatment, a combination of anthracyclines and taxanes-based chemotherapy was significantly associated with lower distant organ spread in comparison with anthracycline-based chemotherapy (OR 0.510, 95% CI 0.355-0.766) and the effect was stronger in Luminal Alike subtype (OR 0.417, 95% CI 0.226-0.769). Classification into Luminal and non-Luminal subtypes revealed significant higher risks of bone metastasis in the Luminal subtype (OR 1.793, 95% CI 1.209-2.660) and pulmonary metastasis in non-Luminal breast cancer (OR 1.445, 95% CI 1.003-2.083).

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Section: Discussionmentioning

confidence: 99%

Risk factors of distant metastasis after surgery among different breast cancer subtypes: a hospital-based study in Indonesia

et al. 2020

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“…Although remarkable improvement has been made during the past two decades for treatment and detection of postoperative recurrences, the clinical recommendations have not been implemented in every hospital. Especially in low-resource settings, there are typically only a few centers that have facilities for thyroid scan, radionucleotide ablation iodine (RAI) testing, and systematic monitoring and follow-up [ 10 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Extrathyroidal extension and cervical node infiltration are associated with recurrences and shorter recurrence-free survival in differentiated thyroid cancer: a cohort study

et al. 2022

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Background Differentiated thyroid cancer has excellent overall survival. However, around 20% of patients experience recurrent diseases after a certain time of follow-up. Therefore, identification of risk factors for recurrence is necessary to adjust treatment and surveillance planning. Methods A retrospective study was conducted of 312 patients with differentiated thyroid cancer who received surgery with and without adjuvant treatment. Clinical and pathological risk factors were analyzed for recurrences. Results After median follow-up of 57 months, 109 of 312 patients (34.9%) developed recurrences. Extrathyroidal extension and positive cervical nodes were significantly associated with recurrences (OR = 2.449, 95%CI:1.260–4.760, P = 0.008 and OR = 3.511, 95%CI:1.860–6.626, P < 0.001; respectively). Lympho-vascular invasion (LVI) and tumor multifocality were also associated with increased risk of recurrence (OR = 2.577, 95%CI:1.380–4.812, P = 0.003 and OR = 1.602, 95%CI:1.001–2.495, P = 0.050; respectively). Using multivariable regression, only older age and tumor infiltration to the lymph nodes were significantly associated with recurrences (OR = 2.227, 95%CI:1.037–4.782, P = 0.040 and OR = 2.966, 95%CI:1.470–5.986, P = 0.002; respectively). In addition, T4, cervical lymph node infiltration, older age, and LVI were associated with shorter recurrence-free survival. Conclusion Recurrence rates in our study population are relatively high. Extrathyroidal extension, positive neck lymph node, and older age were associated with recurrence risks of well differentiated thyroid cancers.

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“…There are limited reports on the inclusion of rehabilitation services within the health insurance policies for cancer care in children. 30,31 Development of PR modules, addressing the ratio of economic benefits and allocation of resources toward exercise-based PR are strong requirements for feasible exercise programs in cancer patients from LMICs. Multidisciplinary resource teams involving physical therapists, occupational therapists, speech and language pathologists, psychologists, and social workers would be needed to design customized PR programs.…”

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confidence: 99%

Implementation of physical rehabilitation programs for children with cancer across low‐ and middle‐income countries: A need of the hour perspective

Prabhu,

Maiya,

Bhat K

2024

Pediatric Blood & Cancer

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Childhood cancer care in recent times has evolved to better advanced therapeutic regimens alongside improved supportive care lowering upsurged mortality rates over five decades. 1 Although accessibility to medical measures including pharmacotherapy, bone marrow transplantation, surgical-palliative care strategies, and behavioral counseling is better in high-income countries (HICs), barriers toward childhood cancer rehabilitation exist in both low-and high-resource settings in these countries. [2][3][4][5][6] Spanning the cancer trajectory, a global estimate study 7 on childhood and adolescent cancers reports data estimates from five international World Health Organization (WHO)-recognized research programs including International Incidence of Childhood Cancer, Third Edition (IICC-3), 8 Global Cancer Observatory (GLOBOCAN), 9 Global Burden of Disease Study (GBD) 2016, 10 SurvCan, 11 and CONCORD (CONCORD-3). 12 Greater than 90% of children from low-and middle-income countries (LMICs) have reported to be at a greater risk of developing childhood cancers when compared to HICs. 7,13 In addition, a dearth of childhood cancer registries with unstructured data availability and limited access to essential cancer-care facilities would result in lower hospital or day care admissions, further leading to lesser accessibility to physical rehabilitation (PR) services. 6,7 Scarce resources and affordable medical services promulgate the incidence, morbidity, or mortality of childhood cancers. 14,15 The global burden of childhood cancer analysis study Abbreviations: DALYs, disability adjusted life years; GBD, Global Burden of Disease; HICs, high-income countries; HRQoL, health-related quality of life; LMICs, low-and middle-income countries; MI, Mortality Index; PR, physical rehabilitation.

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Cancer rehabilitation: closing the gap in low- and middle-income countries

Cited by 8 publications

References 4 publications

Risk factors of distant metastasis after surgery among different breast cancer subtypes: a hospital-based study in Indonesia

Risk factors of distant metastasis after surgery among different breast cancer subtypes: a hospital-based study in Indonesia

Extrathyroidal extension and cervical node infiltration are associated with recurrences and shorter recurrence-free survival in differentiated thyroid cancer: a cohort study

Implementation of physical rehabilitation programs for children with cancer across low‐ and middle‐income countries: A need of the hour perspective

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