A5002447665- Palliative Care and End-of-Life Issues
- Economic and Financial Impacts of Cancer
- Global Cancer Incidence and Screening
- Cancer survivorship and care
- Health Systems, Economic Evaluations, Quality of Life
- Childhood Cancer Survivors' Quality of Life
- Colorectal Cancer Screening and Detection
- Pancreatic and Hepatic Oncology Research
- Gastric Cancer Management and Outcomes
- Colorectal Cancer Treatments and Studies
- Lung Cancer Treatments and Mutations
- Cancer Treatment and Pharmacology
- Multiple and Secondary Primary Cancers
- Breast Cancer Treatment Studies
- Cancer Genomics and Diagnostics
- Lung Cancer Diagnosis and Treatment
- Genetic factors in colorectal cancer
- Cholangiocarcinoma and Gallbladder Cancer Studies
- Family Support in Illness
- Esophageal Cancer Research and Treatment
- Clinical practice guidelines implementation
- Healthcare Policy and Management
- Advances in Oncology and Radiotherapy
- Colorectal Cancer Surgical Treatments
- Grief, Bereavement, and Mental Health
Canadian Partnership Against Cancer
2015-2024
University of Toronto
2015-2024
Institute for Clinical Evaluative Sciences
2015-2024
Sunnybrook Health Science Centre
2015-2024
Health Sciences Centre
2015-2024
Centre for the Observation and Modelling of Earthquakes, Volcanoes and Tectonics
2024
Ontario Institute for Cancer Research
2014-2023
Queen's University
2011-2023
Princess Margaret Cancer Centre
2012-2023
University of Calgary
2020-2022
To characterize the aggressiveness of end-of-life cancer treatment for older adults on Medicare, and its relationship to availability healthcare resources.We analyzed Medicare claims 28,777 patients 65 years who died within 1 year a diagnosis lung, breast, colorectal, or other gastrointestinal between 1993 1996 while living in one 11 US regions monitored by Surveillance, Epidemiology, End Results Program.Rates with chemotherapy increased from 27.9% 29.5% (P =.02). Among those received...
The vital role played by family caregivers in supporting dying cancer patients is well recognized, but the burden and economic impact on poorly understood. We prospectively examined psychosocial, occupational of caring for a person with terminal illness.We studied 89 women advanced breast receiving care at either Ottawa or Hamilton regional centres Ontario. Patients were followed until their death study completion 3 years. identified principal caregiver to participate study. Karnofsky...
<h3>Background</h3> Life-sustaining medical care of patients with advanced cancer at the end life (EOL) is costly. Patient-physician discussions about EOL wishes are associated lower rates intensive interventions. <h3>Methods</h3> Funded by National Institute Mental Health and Cancer Institute, Coping With a longitudinal multi-institutional study 627 cancer. Patients were interviewed baseline followed up through death. Costs for unit hospital stays, hospice care, life-sustaining procedures...
Objective To analyze prognostic factors influencing pancreatic cancer survival following curative resection, using prospectively collected, population-based data. Summary Background Data Several studies have analyzed the determinants of long-term in postresection patients, but majority these been single-institutional chart reviews yielding inconsistent results. Methods This retrospective cohort study examined 396 Medicare-eligible patients over age 65 who were diagnosed with nonmetastatic...
Purpose National guidelines recommend that discussions about end-of-life (EOL) care planning happen early for patients with incurable cancer. We do not know whether earlier EOL lead to less aggressive near death. sought evaluate the extent which discussion characteristics, such as timing, involved providers, and location, are associated aggressiveness of received Patients Methods studied 1,231 stage IV lung or colorectal cancer in Cancer Care Outcomes Research Surveillance Consortium, a...
Abstract Comorbid conditions are the major threat to life for many cancer survivors, yet little is known about quality of noncancer‐related health care they receive. The authors analyzed Medicare claims 14,884 Medicare‐eligible, 5‐year colorectal carcinoma survivors who were diagnosed initially while lived in a region monitored by Surveillance, Epidemiology, and End Results (SEER) Program compared them with matched controls had no history drawn from 5% sample. In both univariable...
For many diseases, specialized care (i.e., rendered by a specialist) has been associated with superior-quality better outcomes). We examined associations between physician specialty and outcomes in population-based cohort of elderly ovarian cancer surgery patients.We analyzed the Medicare claims, specialty, all women aged 65 years or older who underwent for pathologically confirmed invasive epithelial January 1, 1992, December 31, 1999, while living an area monitored Surveillance,...
Purpose Ontario's cancer system is unique because it has implemented two standardized assessment tools population-wide to improve care: the Edmonton Symptom Assessment System (ESAS) measures severity of nine symptoms (scale 0 10; 10 indicates worst) and Palliative Performance Scale (PPS) performance status 100; death). This article describes trajectory ESAS PPS scores 6 months before death. Patients Methods Observational cohort study decedents between 2007 2009. Decedents required ≥1 or in...
Purpose To describe trends in the aggressiveness of end-of-life (EOL) cancer care a universal health system Ontario, Canada, between 1993 and 2004, to compare with findings reported United States. Methods A population-based, retrospective, cohort study that used administrative data linked registry data. Aggressiveness EOL was defined as occurrence at least one following indicators: last dose chemotherapy received within 14 days death; more than emergency department (ED) visit 30...
<h3>Importance</h3> Patients with advanced-stage cancer are receiving increasingly aggressive medical care near death, despite growing concerns that this reflects poor-quality care. <h3>Objective</h3> To assess the association of end-of-life bereaved family members’ perceptions quality and patients’ goal attainment. <h3>Design, Setting, Participants</h3> Interviews 1146 members Medicare patients lung or colorectal in Cancer Care Outcomes Research Surveillance study (a multiregional,...
Background: National guidelines recommend that physicians discuss end-of-life (EOL) care planning with patients cancer whose life expectancy is less than 1 year. Objective: To evaluate the incidence of EOL discussions for stage IV lung or colorectal and where, when, whom these take place. Design: Prospective cohort study diagnosed from 2003 to 2005. Setting: Participants lived in Northern California, Los Angeles County, North Carolina, Iowa, Alabama received 5 large HMOs 15 Veterans Health...
To evaluate measures that could use existing administrative data to assess the intensity of end-of-life cancer care.Benchmarking standards and statistical variation were evaluated using Medicare claims 48,906 patients who died from 1991 through 1996 in 11 regions United States. We assessed accuracy by comparing 150 medical records one hospital affiliated treatment center.Systems not providing overly aggressive care near end life would be ones which less than 10% receive chemotherapy last 14...
The number, nature, and costs of serious adverse effects experienced by younger women receiving chemotherapy for breast cancer outside clinical trials are unknown.From a database medical claims made individuals with employer-provided health insurance between January 1998 December 2002, we identified 12,239 63 years age or newly diagnosed cancer, whom 4075 received during the 12 months after initial diagnosis 8164 did not. Diagnostic codes eight chemotherapy-related were identified. Total...
Abstract BACKGROUND: Guidelines recommend advanced care planning for terminally ill patients with <1 year to live. Few data are available regarding when physicians and their typically discuss end‐of‐life issues. METHODS: A national survey was conducted of caring cancer about timing discussions prognosis, do not resuscitate (DNR) status, hospice, preferred site death patients. Logistic regression used identify physician practice characteristics associated earlier discussions. RESULTS:...
To compare expectations for cancer survivorship care between patients and their physicians primary providers (PCPs) oncologists.Survivors were surveyed to evaluate regarding physician participation in follow-up, screening other cancers, general preventive health, management of comorbidities.Of 992 eligible survivors 607 surveyed, 535 (54%) 378 (62%) assessable, respectively. Among respondents, 255 (67%) PCPs 123 (33%) oncologists. Comparing with oncologists, highly discrepant cancers than...
Both tyrosine kinase inhibitors targeting the vascular endothelial growth factor (VEGF) receptor and bevacizumab, a monoclonal antibody VEGF, have antitumor activity in neuroendocrine tumors (NETs). Temozolomide, an oral analog of dacarbazine, also has against NETs when administered alone or combination with other agents. We performed phase II study to evaluate efficacy temozolomide bevacizumab patients locally advanced metastatic NETs.Thirty-four (56% carcinoid, 44% pancreatic NETs) were...
Magnetic resonance imaging (MRI) with targeted biopsy is an appealing alternative to systematic 12-core transrectal ultrasonography (TRUS) for prostate cancer diagnosis, but has yet be widely adopted.To determine whether MRI only was noninferior TRUS biopsies in the detection of International Society Urological Pathology grade group (GG) 2 or greater cancer.This multicenter, prospective randomized clinical trial conducted 5 Canadian academic health sciences centers between January 2017 and...