Majority of cancer patients used CAM modalities during and even after cancer treatment. Main reasons for CAM use are to improve immunity, with expectation of fewer recurrences, and to have better quality of life. Still many patients did not reveal precise detailed information of CAM use to their physicians. Due to possible interaction between herbs and cancer drugs, it is essential for physicians to know whether their patients use CAM modalities or not and to have interest in existing evidence. This article will provide the lists of evidence and references on supplements and life styles including diet and exercise. Mind body medicine is not commonly used in Korea but there is increasing evidence on meditation and usefulness with relaxation even in supportive care.
Diet ; Humans ; Integrative Medicine ; Korea ; Life Style ; Meditation ; Mind-Body Therapies ; Quality of Life ; Recurrence ; Relaxation

Due to improved life spans, cancer incidence has increased with more aged patients presenting with cancer. Elderly cancer patients could have compromised organ function and/or comorbidities. Due to poor social support or lack of early diagnosis, treatment outcomes for elderly cancer patients are poor in general. However, with aggressive support during cancer management as well as careful selection, most elderly cancer patients can tolerate standard radiation therapy with good results based on published articles. Here, we reviewed existing articles regarding compliance and treatment results in elderly cancer patients based on tumor site.
Aged ; Comorbidity ; Compliance ; Early Diagnosis ; Humans ; Incidence

No abstract available.
Humans ; Uterine Cervical Neoplasms

A clear consensus has not been established regarding the best treatment for solitary bone metastasis. Here, we reviewed the medical records of patients with a controlled primary malignancy who had only solitary spine metastasis without metastasis to the extraspinal bone or viscera and underwent treatment between April 2007 and December 2012 with stereotactic body radiosurgery using CyberKnife, with a total dose of 24 Gy in three to four fractions. During that time, there were only four cases. This was effective in each case, and all the four patients had no local failure and remained alive at a median follow-up of 68 months (range, 64 to 80 months). Although our experience is limited, this study suggests that stereotactic body radiotherapy could be a feasible, safe, effective, and noninvasive alternative treatment for solitary spine metastasis in patients who are medically inoperable or unsuitable for surgery.
Consensus ; Follow-Up Studies ; Humans ; Medical Records ; Neoplasm Metastasis* ; Radiosurgery* ; Spine* ; Viscera

This article reviewed new trends and controversial issues, including the intensification of chemotherapy and recent brachytherapy (BT) advances, and also reviewed recent consensuses from different societies on the management of locally advanced cervical cancer (LACC). Intensive chemotherapy during and after radiation therapy (RT) was not recommended as a standard treatment due to severe toxicities reported by several studies. The use of positron emission tomography-computed tomography (PET-CT) and magnetic resonance imaging (MRI) for pelvic RT planning has increased the clinical utilization of intensity-modulated radiation therapy (IMRT) for the evaluation of pelvic lymph node metastasis and pelvic bone marrow. Recent RT techniques for LACC patients mainly aim to minimize toxicities by sparing the normal bladder and rectum tissues and shortening the overall treatment time by administering a simultaneous integrated boost for metastatic pelvic lymph node in pelvic IMRT followed by MRI-based image guided adaptive BT.
Bone Marrow ; Brachytherapy ; Consensus ; Drug Therapy ; Electrons ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Pelvic Bones ; Radiotherapy, Intensity-Modulated ; Rectum ; Urinary Bladder ; Uterine Cervical Neoplasms

PURPOSE: The purpose of this study was to identify the variables that are associated with the health related quality of life (HRQOL) for patients with breast cancer. METHODS: A total of 112 subjects were recruited from a cancer center at a university hospital by using convenience sampling. The subjects were asked to complete questionnaires about HRQOL, fatigue and social support (family and medical team support). A trained research assistant then measured the subjects' shoulder range of motion (ROM) and the arm parameters for lymphedema. The data was analyzed using t-tests, Mann-Whitney tests, ANOVA, Pearson's correlation coefficient and hierarchical multiple regression analysis. RESULTS: The HRQOL was strongly correlated with fatigue (r=-0.80, p<0.01). It was also positively correlated with family support (r=0.57, p<0.01) and medical team support (r=0.33, p<0.01). The HRQOL was significantly lower for the patients who had limited shoulder rotation. Fatigue and family support together explained 65% of the variance in the HRQOL for the patients with breast cancer, after controlling for education and income. Of them, fatigue uniquely explained 32% of the variance in the HRQOL. CONCLUSION: Fatigue was the strong predictor of the HRQOL. This result suggests that fatigue might be primary managed for improving the HRQOL of patients with breast cancer.
Arm ; Breast ; Breast Neoplasms ; Fatigue ; Humans ; Lymphedema ; Quality of Life ; Range of Motion, Articular ; Shoulder ; Surveys and Questionnaires

PURPOSE: It is not a simple task to achieve the ideal isodose curve with a standard vaginal applicator or single plane needle impant in the paravaginal tissue when primary or recurrent gynecological neoplasms (cervical cancers, vaginal cancers and vulvar cancers) are treated as a boost following external beam radiotherapy. The authors introduce the development and construction of a simple, inexpensive, customized applicator for volume implant to maximize the radiation dose to the tumor while minimizing the dose to the rectum and the bladder. MATERIALS AND METHODS: Nine patients underwent Ir-192 transperineal interstitial implantation for either recurrent (5 cases) or primary (3 cases) cervical cancers or primary vaginal cancer (1 case) between August 1994 and February 1998 at Ajou university hospital. First 3 cases were performed with a single plane implant guided by digital palpation. Because of inadequate isodose coverage in the tumor volume in first 3 cases, we designed and constructed interstitial vaginal applicator for volume implant to improve tumor dose distribution and homogeneity while sparing the surrounding normal tissue. Our applicators consist of vaginal obturator and perineal template that made of the clear acrylamide and dental mold material (Provil ). The applicators were customized individually according to the tumor size and its location. Both HDR and LDR irradiation were given with these applicators accomodating 6 Fr needles (Microselectron, Nucletron). The pretreatment planning prior to actual implant was performed whenever possible. RESULTS: Needles can be inserted easily and evenly into the tumor volume through the holes of templates, requiring less efforts and time for the implant prodecure. Our applicators made of materials available from commercial vendors. These have an advantage that require easy procedure, and spend relatively short time to construct. Also it was possible to fabricate applicators to individualize according to the tumor size and its location and to achieve the ideal isodose coverage. We found an accurate needle arrangement and ideal dose distribution through the CT scan that was obtained in 3 cases after needle implant. Three patients with primary cervical and vaginal cancers were controlled locally at final follow up. But all recurrent cases failed to do so. CONCLUSION: The authors introduce inexpensive, simple interstitial vaginal templates which were self-designed and constructed using materials available from commercial vendors such as acrylamide and dental mold material (Provil ).
Acrylamide ; Brachytherapy ; Commerce ; Follow-Up Studies ; Fungi ; Humans ; Needles* ; Palpation ; Radiotherapy ; Rectum ; Tomography, X-Ray Computed ; Tumor Burden ; Urinary Bladder ; Vaginal Neoplasms

PURPOSE: It is not a simple task to achieve the ideal isodose curve with a standard vaginal applicator or single plane needle impant in the paravaginal tissue when primary or recurrent gynecological neoplasms (cervical cancers, vaginal cancers and vulvar cancers) are treated as a boost following external beam radiotherapy. The authors introduce the development and construction of a simple, inexpensive, customized applicator for volume implant to maximize the radiation dose to the tumor while minimizing the dose to the rectum and the bladder. MATERIALS AND METHODS: Nine patients underwent Ir-192 transperineal interstitial implantation for either recurrent (5 cases) or primary (3 cases) cervical cancers or primary vaginal cancer (1 case) between August 1994 and February 1998 at Ajou university hospital. First 3 cases were performed with a single plane implant guided by digital palpation. Because of inadequate isodose coverage in the tumor volume in first 3 cases, we designed and constructed interstitial vaginal applicator for volume implant to improve tumor dose distribution and homogeneity while sparing the surrounding normal tissue. Our applicators consist of vaginal obturator and perineal template that made of the clear acrylamide and dental mold material (Provil ). The applicators were customized individually according to the tumor size and its location. Both HDR and LDR irradiation were given with these applicators accomodating 6 Fr needles (Microselectron, Nucletron). The pretreatment planning prior to actual implant was performed whenever possible. RESULTS: Needles can be inserted easily and evenly into the tumor volume through the holes of templates, requiring less efforts and time for the implant prodecure. Our applicators made of materials available from commercial vendors. These have an advantage that require easy procedure, and spend relatively short time to construct. Also it was possible to fabricate applicators to individualize according to the tumor size and its location and to achieve the ideal isodose coverage. We found an accurate needle arrangement and ideal dose distribution through the CT scan that was obtained in 3 cases after needle implant. Three patients with primary cervical and vaginal cancers were controlled locally at final follow up. But all recurrent cases failed to do so. CONCLUSION: The authors introduce inexpensive, simple interstitial vaginal templates which were self-designed and constructed using materials available from commercial vendors such as acrylamide and dental mold material (Provil ).
Acrylamide ; Brachytherapy ; Commerce ; Follow-Up Studies ; Fungi ; Humans ; Needles* ; Palpation ; Radiotherapy ; Rectum ; Tomography, X-Ray Computed ; Tumor Burden ; Urinary Bladder ; Vaginal Neoplasms

PURPOSE: To discuss the technical aspect of interstitial brachytherapy including method of implant, insertion time of radioactive source, total radiation dose, and complication, we reviewed patients who had diagnoses of soft tissue sarcoma and were treated by conservative surgery, interstitial implant and external beam radiation therapy. MATERIALS AND METHODS: Between May 1995 and Dec. 1997, ten patients with primary or recurrent soft tissue sarcoma underwent surgical resection (wide margin excision) and received radiotherapy including interstitial brachytherapy. Catheters were placed with regular intervals of 1~1.5 cm immediately after tumor removal and covering the critical structures, such as neurovascular bundle or bone, with gelform, muscle, or tissue expander in the cases where the tumors were close to those structures. Brachytherapy consisted of high dose rate, iridium-192 implant which delivered 12~15 Gy to 1 cm distance from the center of source axis with 2~2.5 Gy/fraction, twice a day, starting on 6th day after the surgery. Within one month after the surgery, total dose of 50~55 Gy was delivered to the tumor bed with wide margin by the external beam radiotherapy. RESULTS: All patients completed planned interstitial brachytherapy without acute side effects directly related with catheter implantation such as infection or bleeding. With median follow up duration of 25 months (range 12~41 months), no local recurrences were observed. And there was no severe form of chronic complication (RTOG/EORTC grade 3 or 4). CONCLUSION: The high dose rate interstitial brachytherapy is easy and safe way to minimize the radiation dose delivered to the adjacent normal tissue and to decrease radiation induced chronic morbidity such as fibrosis by reducing the total dose of external radiotherapy in the management of soft tissue sarcoma with conservative surgery.
Axis, Cervical Vertebra ; Brachytherapy* ; Catheters ; Diagnosis ; Fibrosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Radiotherapy ; Recurrence ; Sarcoma* ; Tissue Expansion Devices

Radiation therapy is an effective modality to alleviate cancer-related symptoms. To deliver radiation accurately, it is essential to secure stability of the treatment position in patients during each treatment time. However, some patients could be less cooperative due to their psychoemotional issues. We present two cases of terminal-stage cancer patients who were initially unable to lie still on the treatment table before simulation. A relaxation technique was taught to them on the bed, and they could relax and undergo radiation therapy with effective symptom relief.
Humans ; Integrative Medicine ; Posture ; Radiotherapy ; Relaxation*