OBJECTIVE: The aim of the present study was to acquire information on brachytherapy resources in Korea through a national survey of radiation oncologists. METHODS: Between October 2014 and January 2015, a questionnaire on the current status of brachytherapy was distributed to all 86 radiation oncology departments in Korea. The questionnaire was divided into sections querying general information on human resources, brachytherapy equipment, and suggestions for future directions of brachytherapy policy in Korea. RESULTS: The response rate of the survey was 88.3%. The average number of radiation oncologists per center was 2.3. At the time of survey, 28 centers (36.8%) provided brachytherapy to patients. Among the 28 brachytherapy centers, 15 (53.5%) were located in in the capital Seoul and its surrounding metropolitan areas. All brachytherapy centers had a high-dose rate system using (192)Ir (26 centers) or (60)Co (two centers). Among the 26 centers using (192)Ir sources, 11 treated fewer than 40 patients per year. In the two centers using (60)Co sources, the number of patients per year was 16 and 120, respectively. The most frequently cited difficulties in performing brachytherapy were cost related. A total of 21 centers had a plan to sustain the current brachytherapy system, and four centers noted plans to upgrade their brachytherapy system. Two centers stated that they were considering discontinuation of brachytherapy due to cost burdens of radioisotope source replacement. CONCLUSION: The present study illustrated the current status of brachytherapy in Korea. Financial difficulties were the major barriers to the practice of brachytherapy.
*Brachytherapy/economics ; Humans ; Neoplasms/*radiotherapy ; *Oncologists ; Republic of Korea ; Surveys and Questionnaires

OBJECTIVE: The aim of the present study was to acquire information on brachytherapy resources in Korea through a national survey of radiation oncologists. METHODS: Between October 2014 and January 2015, a questionnaire on the current status of brachytherapy was distributed to all 86 radiation oncology departments in Korea. The questionnaire was divided into sections querying general information on human resources, brachytherapy equipment, and suggestions for future directions of brachytherapy policy in Korea. RESULTS: The response rate of the survey was 88.3%. The average number of radiation oncologists per center was 2.3. At the time of survey, 28 centers (36.8%) provided brachytherapy to patients. Among the 28 brachytherapy centers, 15 (53.5%) were located in in the capital Seoul and its surrounding metropolitan areas. All brachytherapy centers had a high-dose rate system using (192)Ir (26 centers) or (60)Co (two centers). Among the 26 centers using (192)Ir sources, 11 treated fewer than 40 patients per year. In the two centers using (60)Co sources, the number of patients per year was 16 and 120, respectively. The most frequently cited difficulties in performing brachytherapy were cost related. A total of 21 centers had a plan to sustain the current brachytherapy system, and four centers noted plans to upgrade their brachytherapy system. Two centers stated that they were considering discontinuation of brachytherapy due to cost burdens of radioisotope source replacement. CONCLUSION: The present study illustrated the current status of brachytherapy in Korea. Financial difficulties were the major barriers to the practice of brachytherapy.
*Brachytherapy/economics ; Humans ; Neoplasms/*radiotherapy ; *Oncologists ; Republic of Korea ; Surveys and Questionnaires

The clinical area identified by the Philippine College of Surgeons (PCS) for the third evidence-based clinical practice guidelines (EBCPGs) was on the management of breast cancer. Funding for the research project was provided by the Philippine Council for Health Research and Development (PCHRD), and a Technical Working Group (TWG) was formed, composed of 5 general surgeons and 1 medical oncologist. The TWG was tasked to identify the clinical questions and to adhere to the PCS approved method of developing EBCPGs. The TWG decided to divide the report into two parts: Early Breast Cancer, and Locally Advanced and Metastatic Breast Cancer. This first report will focus on Early Breast Cancer The definition of early breast cancer is that used by the Early Breast Cancer Trialists Collaborative Group (EBCTG), since the regular systemic reviews (meta-analysis) of the group on the primary and adjuvant therapies of early breast cancer currently comprise the strongest evidence. "In women with "early breast cancer", all detectable cancer is, by definition, restricted to the breast and, in the case of node positive patients, the local lymph nodes can be removed surgically." The TWG began work on July 1, 2000. The literature search, limited to English publications, used both electronic and manual methods. Three electronic databases were used: 1) The Cochrane library, Issue 2, 2000; 2) National Library of Medicine-Medline (PubMed, no time limit); and HERDIN (Health Research and Development Information Network) Version 1, 1997 of DOST-PCHRD Titles of all articles were printed and at least 2 members of the TWG went over the list and checked the titles of articles whose abstract they felt should be read. The abstracts of all checked articles were printed. The printed abstracts were given to the members of the TWG, who then decided which articles were to be included for full text retrieval. The full texts were obtained from the University of the Philippines Manila Library, and were appraised using standard forms. The TWG then compiled, summarized and classified the evidence according to 3 levels and proposed a first draft to recommendations according to 3 categories.(Author)

Human ; Breast ; Breast Neoplasms ; Surgeons ; Lymph Nodes ; Oncologists

Humans ; Cardiologists ; Neoplasms/drug therapy* ; Medical Oncology ; Heart ; Oncologists

Female ; Humans ; Consensus ; Endometrial Neoplasms/therapy* ; Gynecology ; Oncologists ; China

INTRODUCTION: The difficulty of obtaining accurate and reproducible assessment of HER2 status in the Philippines, despite the predictive value of the test for HER2 positive breast cancer patients, may be sufficiently addressed if an effective multidisciplinary approach to HER2 testing is carried out. This may be accomplished by identifying disparities and similarities in HER2 testing for breast cancer.
METHODS: This is a cross-sectional study which included medical oncologists who had used trastuzumab for HER2-positive patients. Surgeons, who belonged to the same tertiary hospital as the medical oncologists were also interviewed. The survey questionnaires were administered via face-to-face, mail, or fax. Responses were kept confidential. Questionnaire responses were analysed using summary statistics.
RESULTS: There were 35 medical oncologists and 37 surgeons - 93% stated that all women diagnosed with breast cancer should be tested for HER2 at the point of diagnosis; 61% stated that the greatest barrier to initiating HER2 testing was inadequate patient funds. 57% medical oncologists and 65% surgeons believed that HER2 testing for all breast cancer patients at the point of clinical diagnosis was being observed at their hospital. 69% stated that medical oncologists or surgeons should request for HER2 test whoever saw the patients first; 59% stated that whoever saw the patient first provide the patient information about HER2 testing whereas 28% stated it is the medical oncologist who should provide information about HER2 testing. 47% medical oncologist and 63% surgeons stated that surgeons should arrange for breast tissue sample collection; 27% medical oncologists and 20% surgeons stated that pathologists should do this.
CONCLUSION: Medical oncologists and surgeons were similar in the opinion that all women diagnosed with breast cancer should be tested for HER2 at the point of diagnosis, financial capability was the greatest barrier for initiating HER2 testing, and whoever saw the patient first should provide patient education. There was disparity on who should request and who should arrange for tissue collection.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Philippines ; Breast Neoplasms ; Oncologists ; Surgeons ; Surveys And Questionnaires

INTRODUCTION: A multidisciplinary approach is essential to optimize patient care. In the practice of oncology, surgeons, medical oncologists, and pathologists are essential for the histology-based diagnosis of cancer patients. In breast cancer, hormone receptor and HER2 positivity are both predictive and prognostic, and so testing for these has been strongly recommended for every newly diagnosed breast cancer patient. A unique but meaningful information that can be provided by medical oncologists, as customers, is their satisfaction to the services (e.g. HER2 testing) and product (e.g. reports) of the pathology laboratory. Any quality initiative effort to improve HER2 testing can also be extended to hormone receptor (ER/PR) testing. This study measures the general satisfaction of medical oncologists practicing in Metro Manila with local HER2 testing services and reports.
METHODS: This cross-sectional study had survey questionnaires distributed to medical oncologists practicing in Metro Manila chosen on the basis of their considerable experience with requesting HER2tests and with the use of anti-HER2 therapy in their management of breast carcinoma patients. Demographics, practice information, rating of satisfaction per laboratory service category, and a checklist of elements of IHC/FISH reports were collected.
RESULTS: 32 medical oncologists participated in the survey, most of whom were from tertiary hospitals. Breast carcinoma cases make up around 26-50% of cancer cases in their practice. More than half request HER2 testing for their breast cancer patients. Medical oncologists are generally satisfied with the services for IHC and FISH HER2 testing (composite scores >2) provided by the laboratories. Overall, medical oncologists were very satisfied with diagnostic accuracy and completeness of relevant information in the report. Laboratory services were mostly rated good, with the exception of pathologists' responsiveness to problems and notification of equivocal results. For both IHC and FISH, patient/physician identification, date of service, specimen identification/ site/ type, results, and interpretation were reported to be included in the reports. However, time to/duration of/ type of fixation, method and image analysis method, antibody clone/ vendor, and comment that an FDA-approved method was used, were reported missing by the many.
CONCLUSION: For both IHC and FISH, overall satisfaction was found to be moderately directly correlated with diagnostic accuracy. In a country like the Philippines where quality initiatives of laboratories may still be far from ideal, medical oncologists can demand inclusion of their preferences into assessments processes by laboratories and correct assumptions of laboratory managers as to what element of the services and products they value most. Measurement of customer satisfaction can be integrated into the quality assurance programs of laboratories and corresponding hospitals.  

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Patient Care ; Oncologists ; Surgeons ; Breast Neoplasms ; Surveys And Questionnaires ; Pathologists

Malignant acute abdomen is an acute abdominal disease caused by abdominal and extra-abdominal malignant tumors or secondary to various treatments for tumors, and belongs to the category of oncologic emergencies. Malignant acute abdomen includes perforation, bowel obstruction, infection and bleeding, etc. Most of the malignant acute abdomen is urgent and critical. The postoperative morbidity and mortality of these patients are high. The treatment strategy should ideally be discussed by a multidisciplinary team, which is often infeasible in the emergent setting. Surgery should be the main measures to improve survival and quality of life, but the risk of death should be fully evaluated before surgery to determine whether the surgery can benefit patients. In addition, the timing of surgery depends mostly on the surgeon. This article explores the treatment of malignant acute abdomen from the perspective of surgical oncology.
Abdomen, Acute ; therapy ; Abdominal Neoplasms ; therapy ; Humans ; Oncologists ; Patient Care Team ; Quality of Life

Acute abdomen in patients with malignant tumors is called malignant acute abdomen, often seen in the digestive system tumor or abdominal pelvic metastasis of the other primary tumors. Bleeding, perforation, gastrointestinal obstruction, biliary obstruction with infection, acute peritonitis are acute and severe, however, prevention is more important than treatment. For high-risk patients, even if acute abdomen does not occur when the disease is diagnosed, we should make precautions, including actively local treatment of local lymph nodes or primary lesions and careful choice of drugs. Malignant acute abdomen is mainly treated by surgical intervention. However, to seize the opportunity of anti-tumor treatment while actively treating acute abdomen requires multidisciplinary team (MDT), including co-management of diagnostic team, treatment team and support team. Most patients with malignant acute abdomen are in late stage, so the role of medical oncologists can not be ignored in the prevention, intervention and management of malignant acute abdomen. For patients with potentially resectable malignant acute abdomen who are suitable for neoadjuvant therapy and technically unresectable malignant acute abdomen, the opportunity for drug treatment should be sought first. For those presenting with obstruction, bleeding or perforation during radiotherapy or chemotherapy, we should carefully evaluate the response of previous antitumor treatment, the reason of acute abdomen and discuss the option of surgery. Some concomitant medications may also increase the risk of malignant acute abdomen. Here, we discuss the role of medical oncologists in the management of malignant acute abdomen in the MDT setting.
Abdomen, Acute ; therapy ; Gastrointestinal Neoplasms ; therapy ; Humans ; Neoadjuvant Therapy ; Oncologists ; Patient Care Team

Humans ; Cardiotoxicity/etiology* ; Antineoplastic Agents/adverse effects* ; Oncologists ; Neoplasms/drug therapy*