The larger the gene name, the more frequently that gene is defective in that #cancer type.A diagram showing the major cancer genes for some cancers. GENETICS ABNORMALITIES OF DIFFERENT CANCERSĪ diagram showing the major cancer #genes for some #cancers. #cancersurvivorship #globalhealth #cancerjourney #indopacific #cancerrecovery #cancersurvivor #qualityhealthcare #accesstocare #surveillance #diversity #culture #disparities #gaps #barriers #socioeconomic #outcomes #research #cancerresearch #healthcarepolicy #navigation #carecoordination #patienteducation #resources #unmetneeds #guidelines #evidencebasedmedicine #evidencebasedpractice #healthcarejobs #collaboration #partnership #globalhealthcare * Collaboration and partnerships with large centers and non-profit advocacy groups to not only share and possibly duplicate examples of success, but also to leverage global resources to improve the standard of care. * Tailored programs and guidelines to address unmet aspects such as psychosocial outcomes, unemployment, patient perception and experience, models of care, quality of care, navigation, and education. * Classification of predictors of poor outcomes and implementation of policies to address disparities in cancer survivorship. * Systematic investigation of the gaps, barriers, and outcomes for various cancers by disease stage, treatment, and adverse events. * Improved research efforts across countries and health systems focusing on unique medical, social, and cultural needs. #questionforgroup: Which of the following initiatives do you feel would have the biggest impact on improving cancer survivorship in this region? There are many challenges that these patients face, variably throughout the region, which have to be addressed systematically in order to improve the overall cancer care and survivorship in the region:ġ) Diverse medical, social, and cultural needs of the patients themselves.Ģ) Variable perceptions of coping, anxiety, traditional healing, and cultural "cancer stigma".ģ) Disparate income and access to quality healthcare including adequate follow-up.Ĥ) Inefficient care coordination and navigation leading to delays in care.ĥ) Lack of consistent evidence-based education, patient resources, and practice guidelines.Ħ) Lack of access to a robust health system workforce including oncology-trained physicians, specialists, nurses, and support staff. I also reviewed a recent study which investigated the challenges and opportunities in cancer survivorship particularly in the Indo-Pacific, an expansive area with diverse social, economic, and cultural aspects of healthcare. In this article, we review the main indications, contraindications, and controversies of SLNB in breast cancer in the light of the most recent publications.In a recent edition of the MedPage Today / American Society of Clinical Oncology (ASCO) Reading Room, I published this article on the important topic of cancer survivorship which includes multiple phases of recovery, requiring different aspects of care for the surveillance/prevention of recurrent cancer and the management of the long-term effects of cancer therapy. Moreover, SLNB remains an unstandardized procedure surrounded by many unresolved controversies concerning the technique itself. More than 20 years after its introduction, there are still aspects concerning SLNB and ALND that are currently debated. Sentinel lymph node biopsy has become the standard of care for primary treatment of early breast cancer and has replaced ALND to stage clinically node-negative patients, thus reducing ALND-associated morbidity. Therefore, the SLN is the first to be affected by metastasis if the tumor has spread, and a tumor-free SLN makes it highly unlikely for other nodes to be affected. The concept of SLNB is based on the notion that tumors drain in an orderly manner through the lymphatic system. Sentinel lymph node biopsy (SLNB) is a less invasive method of assessing nodal involvement. However, ALND may result in lymphedema, nerve injury, shoulder dysfunction, and other short-term and long-term complications limiting functionality and reducing quality of life. The histology of all resected nodes at the time of axillary lymph node dissection (ALND) has traditionally been regarded as the most accurate method for assessing metastatic spread of disease to the locoregional lymph nodes. Because imaging techniques have limited sensitivity to detect metastasis in axillary lymph nodes, the axilla must be explored surgically. Axillary lymph node status, a major prognostic factor in early-stage breast cancer, provides information important for individualized surgical treatment.
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