Locating Cancer Information for Your Clinicians and

Patients

Liz BrackeenStephanie Fulton

Survey Monkey Results

Wiki Navigation:http://mla09cancer.pbworks.com/

Class Objectives

• Participants will acquire and apply cancer searching techniques through examples

• Participants will gain knowledge of a variety resources for finding cancer information through discussions and examples

Cancer 101 Patient Question:

How did this (cancer) happen to me?

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Cancer 101 Patient Question:

Understanding Cancer Series http://www.cancer.gov/cancertopics/UnderstandingCancer/ Fact Sheets: Risk Factors and Possible Causes     http://www.cancer.gov/cancertopics/factsheet 

Multiple Myeloma Research Foundation: Causes and Incidencehttp://myeloma.org/pdfs/ph08-eng_h3-web.pdf 

Group Activity:

How many cancer/oncology societies can you name?

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Cancer 101 Clinical Question:

What is searched when I use the cancer limit in PubMed?

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Cancer 101 Clinical Question:

15PubMed - Cancer Hedge Detailshttp://www.nlm.nih.gov/bsd/pubmed_subsets/cancer_strategy.html

Core Collection and JournalsCA: A Cancer Journal for CliniciansCancerCancer Research Journal of Clinical OncologyJournal of the National Cancer Institute Oncology Nursing ForumNature Reviews CancerLancet Oncology

Clinical Question:You have recently diagnosed a

50 year old male with early stage multiple myeloma. He wants to know if there is any

benefit to starting therapy now versus waiting. He is otherwise

healthy and not overly interested in starting treatment

unless he can see a clear benefit.

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What is our clinical question?

Does therapy improve the outcome for the patient?

Does starting chemotherapy immediately after diagnosis for early stage multiple myeloma increase overall survival?

Clinical Question:

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http://search.ebscohost.com/login.aspx?authtype=uidUsername: sccPassword: mla

Diagnosis Patient Question:

I have these results from the lab and I

need to figure out what they

mean.22

Diagnosis Patient Question:

Lab Tests Onlinehttp://www.labtestsonline.org/

Books:A Manual of Laboratory and Diagnostic Tests

Mosby's Manual of Diagnostic and Laboratory Tests

Procedureshttp://www.nlm.nih.gov/medlineplus

Diagnostic Test Type of CancerBRCA-1 and BRCA-2 risk of developing breast or ovarian cancer

Cancer Antigen 15-3 monitor the response to treatment of invasive breast cancer

PSA symptoms suggestive of prostate cancer & regular intervals after prostate cancer treatment

CA-125 monitor treatment for ovarian cancer or to detect recurrence

hCG Monitor germ cell tumorsAFP Tumor Markers monitor therapy for certain cancers of the

liver, testes, or ovaries

CEA to monitor cancer treatment, including response to therapy and recurrence

CA 19-9 monitor response to pancreatic cancer treatment

EGFR helps to guide treatment and determine prognosis of solid tumors

http://www.labtestsonline.org

Diagnosis Clinical Question:

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Explain the differences in searching for diagnosis using keyword, MeSH, and Clinical Queries in PubMed.

Diagnosis Clinical Question:

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PubMed Clinical Querieshttp://www.ncbi.nlm.nih.gov/corehtml/query/static/clinical.shtml

MeSH Subheadings Hierarchyhttp://www.nlm.nih.gov/mesh/2009/introduction/subhierarchy.html

Types of TreatmentSurgery

Prophylactic surgeryDiagnostic surgeryStaging surgeryCurative surgery Debulking (cytoreductive) surgery Palliative surgerySupportive surgery Reconstructive surgery Laser surgery Electrosurgery CryosurgeryMohs

Chemotherapy (over 100 drugs)oral topical intravenous intramuscular subcutaneousintra-arterialintrathecalintrapleuralintraperitonealintravesicalintralesional/intratumoral

Radiation

External BeamBrachytherapyParticle BeamIMRTStereotactic radiosurgery3–D conformal radiation Intraoperative radiation therapy (IORT)Prophylactic cranial irradiationSystemic radiation therapy

OtherRadiofrequency AblationHormone TherapyAngiogenesis Inhibitors TherapyBiological TherapyPeripheral Blood Stem Cell TransplantationGene Therapy for CancerHyperthermia in Cancer TreatmentLaser-induced interstitial thermotherapy Photodynamic Therapy for CancerTargeted Cancer Therapiessmall-molecule drugsApoptosis-inducing” drugsMonoclonal antibodiesInterleukinsInterferonsNonspecific immunomodulating agentsComplementary and Alternative MedicineCancer Vaccine

Treatment/Clinical Trial Patient Question:

The treatment they have been giving me for my colon cancer has stopped working, I need to

find out about my other options.

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Treatment/Clinical Trial Patient Question:

UT MD Anderson Guidelineshttp://www.mdanderson.org/education-and-research/resources-for-professionals/clinical-tools-and-resources/clinical-resources.html

NCCN Guidelineshttp://www.nccn.org/

NCI Guidelineshttp://www.cancer.gov/cancertopics/pdq/

UpToDatehttp://www.uptodate.com/patients

Clinical Trialshttp://clinicaltrials.govhttp://www.cancer.gov/clinicaltrialshttp://www.centerwatch.com

Drug Information Clinical Question:

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What are the contraindications for tamoxifen? Should I be

concerned if patient is taking Tamiflu? Letrozole?

Drug Information Clinical Question:

36https://online.epocrates.com/

Complementary/Integrative Medicine Group Activity:

Brainstorm alternative complementary therapies

that might be used for cancer by patients or practitioners?

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Complementary/Integrative Medicine Patient Question:

What herbs are good for pancreatic cancer?

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Complementary/Integrative Medicine Patient Question:

MD Anderson CIMERhttp://www.mdanderson.org/departments/CIMER/

Natural Standardhttp://naturalstandard.com login/pw: mdacc/mdacc

National Center for Complementary and Alternative Medicinehttp://nccam.nih.gov/

CAMlinehttp://www.camline.ca

Side Effects Patient Question:

My wife’s Dr. wants her to do chemotherapy and radiation & I

would like to find some information about the side

effects.

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Side Effects Patient Question:

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Chemotherapy and Youhttp://www.cancer.gov/cancertopics/chemotherapy-and-youRadiation Therapy and You http://www.cancer.gov/CANCERTOPICS/RADIATION-THERAPY-AND-YOUCancerCare Managing Side Effects http://www.cancercare.org/reading_room/connect_booklets.phpMedlinePlus Tutorialhttp://www.nlm.nih.gov/medlineplus/

Side Effects Clinical Question:

What are long term side effects of Cisplatin in testicular cancer

patients?

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Side Effects Clinical Question:

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http://scopus.com/registerUsernames: use from handoutPassword:

(TITLE-ABS-KEY(injurious OR undesirable) AND TITLE-ABS-KEY(effect* OR reaction* OR event* OR incident*)) OR (TITLE-ABS-KEY("adverse effect*" OR "adverse reaction*" OR "adverse event*" OR "adverse incident*" OR "adverse outcome" toxic OR toxicity OR "chemically induced" OR injurious OR undesirable OR "bad reaction" OR poison* OR lethal OR "drug safety" OR "drug induced" OR "Drug Toxicity" OR "drug safety" OR "adverse drug reaction" OR intoxication OR "side effect*" OR "late effect*"))

Scopus Safety Hedge

Nutrition Patient Question:

What do I eat if I have pancreatic cancer?

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Nutrition Patient Question:

PanCan Diet and Nutritionhttp://www.pancan.org/section_facing_pancreatic_cancer/learn_about_pan_cancer/diet_and_nutrition/

Eating Hints for Cancer Patients – NCIhttp://www.cancer.gov/cancertopics/eatinghints

AICR - American Institute for Cancer Researchhttp://www.aicr.org/

Nutrition and Physical Activity During and After Cancer Treatmenthttp://caonline.amcancersoc.org/cgi/content/full/56/6/323

Nutrition

critical care x nutrition Nutrition in cancer survivors

articles on nutrition and radiotherapyenteral or Parenteral feeding X early vs late X ICU

Enteral feeding - height of bedEnteral feeding – residualsEnteral Feeding – flushing

Benefit/harm of OG and NG tubes in the ORenteral parenteral tpn tube feeding

Prognosis Patient Question:

I have stage IV breast cancer with lung and liver mets.

How long do I have?

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Prognosis Patient Question:

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What do you say to a patient or a family member?

How can you ask this question so that a Dr. can answer it?

Statistics Question:

I need statistics for bladder cancer.

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Statistics Question:Cancer statistics, 2010. Jemal A, Siegel R, Xu J, Ward E. CA Cancer J Clin. 2010 Sep-Oct;60(5):277-300. PMID: 20610543 NCI List is a great place to start for definitions and links to SEER; State Cancer Profiles http://www.cancer.gov/statistics  Most requested graphs and figures from the American Cancer Societyhttp://www.cancer.org/Research/CancerFactsFigures/CancerFactsFigures/most-requested-tables-figures-2010  National Center for Health Statisticshttp://www.cdc.gov/nchs/fastats/cancer.htm  CDC  - U.S. Cancer Statistics Interactive Atlashttp://apps.nccd.cdc.gov/DCPC_INCA/DCPC_INCA.aspx  National Cancer Institute - Cancer Mortality Maps & Graphshttp://www3.cancer.gov/atlasplus/   International Agency for Research on Cancer – CANCER Mondial http://www-dep.iarc.fr/dephome.htm  Dialog's  Incidence & Prevalence Database (465) http://library.dialog.com/bluesheets/html/bl0465.html  

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CA-A CANCER JOURNAL FOR CLINICIANS 2010; 60;277-300

Advanced Cancer Patient Question:

We just got the news that they are stopping treatment and we need some resources for talking with

the family.

My husband has a brain tumor and I just want to know what is going

to happen? 56

Advanced Cancer Patient Question:

Coping with Advanced Cancer – NCIhttp://www.cancer.gov/cancertopics/advancedcancer

CancerCare Advanced Cancers http://www.cancercare.org/get_help/special_progs/advanced_cancers.php

FamilyDoctor.org: Palliative Carehttp://familydoctor.org/online/famdocen/home/common/cancer/caregivers/palliative.html

MD Anderson Clinical Center for Targeted Therapyhttp://www.mdanderson.org/patient-and-cancer-information/care-centers-and-clinics/clinics/clinical-center-for-targeted-therapy/index.html

HPNA Patient/Family Teaching Sheetshttp://www.hpna.org/DisplayPage.aspx?Title=Patient/Family%20Teaching%20Sheets

Conclusions

Prevention

Screening

Psychosocial issues

Spirituality

Survivorship

Pediatric Cancer

…

Evaluative Questions

What is one thing you learned today or one thing that went well?

What is something that we can do better?