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Worldwide, the number of cancer survivors is increasing, owing to improvements in cancer therapy, resulting in an increased need to address the physical and mental sequelae of cancer. This paper introduces a Danish psychosocial cancer intervention and presents the baseline characteristics of the cancer survivors with respect to cancer site, sociodemographic variables, social network, lifestyle, self-rated health and the prevalence of cancer-related late effects. The study is part of the FOCARE research project, in which the long-term effects of the rehabilitation programme are evaluated systematically. The study is based on data from a self-administered baseline questionnaire filled in by 2 174 cancer survivors who registered for a 1-week, publicly paid rehabilitation retreat and were invited to participate in the FOCARE study in the period 25 November 2002 to 31 December 2005. The response rate at baseline was 86% (n = 1876). Most participants were younger women with breast cancer. They were generally well educated and working. The cancer survivors reported having comprehensive social networks and being physically active. Several cancer-related symptoms were reported by women with cancers at selected sites, of which fatigue was the most prevalent. More than half reported good-to-excellent self-rated health, while fair-to-poor health was reported by 40%, most of whom were survivors of lung (56%) and haematological (48%) cancers. The results indicate that Danish cancer survivors experience considerably reduced physical health, possibly as late physical effects of treatment. The problems reported by the cancer survivors suggest that cancer rehabilitation should include these aspects of living after cancer and take account of differences among cancer survivors with regard to cancer site, sex, age, family, working status and social position. These challenges might be addressed optimally in multi-dimensional rehabilitation programmes. [ABSTRACT FROM AUTHOR]

Prevalence of peripheral neuropathy (PN) has been studied in patients undergoing treatment with taxanes, platinums and vinca alkaloids. The prevalence is unknown in the general oncological cancer population, characterized by advanced age, comorbidities and heterogeneous treatments. A cross-sectional survey was administered to all adult patients, attending outpatient services at three Danish departments of oncology. The survey contained the EORTC-CIPN20, the EORTC-QLQ-C30, the GAD7 and PHQ9 questionnaires. A high PN symptom score was defined as a summary score ≥30 points on the CIPN20. P-values were adjusted for multiple testing. With an overall response rate of 83% (2839 patients), prevalence of PN was 17% overall, varying from 6 to 33% between diagnosis groups. A high score was more common among females (19 vs. 14%, p =.008), smokers (21 vs. 15%, p =.04), patients living alone (21 vs. 15%, p =.002) and patients using cannabis (29 vs. 15%, p <.001), as well as patients suffering from diabetes (26 vs. 16%, p <.001), cardiac heart disease (27 vs. 16%, p <.001), arthritis (32 vs. 15%, p <.001) or chronic obstructive pulmonary disease (25 vs. 16%, p =.01). High score patients were also older (69ys vs 67ys, p =.048) and more likely experiencing polypharmacy (OR = 3.38 [95% CI, 2.64;4.35]). Patients with a high CIPN20 symptom score scored worse on all EORTC QLQ-C30 function and symptom scales. The mean adjusted C30 SumScore difference was −18.66 ([95% CI, −20.31; −17.02], p <.001). Symptoms of PN are experienced widely across cancer groups in the oncology setting. PN symptoms were associated with clinically relevant worse health-related quality of life and with patient-related factors as living alone, various comorbidities, polypharmacy, and cannabis use. [ABSTRACT FROM AUTHOR]

PurposeThe aim of the study was to test the hypothesis that head and neck cancer (HNC) patients benefit from specialized follow-up (FU), as this strategy ensures timely detection of relapses for successful salvage treatment. This was done by evaluation of the pattern of failure, the temporal distribution of recurrences, and the outcome of salvage treatment in a contemporary cohort of HNC patients. MethodsThe study evaluated a cohort of 2062 consecutive patients treated with curative intent at Aarhus University Hospital from 1 January 2000 to 31 December 2013. The database of DAHANCA contained recordings of recurrent disease in 567 patients with primary tumors of the larynx, pharynx, oral cavity, nasal cavity, paranasal sinuses and salivary glands. A review of medical records was performed in order to update and supplement the database. ResultsFailures of the 567 patients were primarily in T-site (65%) followed by N-site (36%) and M-site (22%). The vast majority of the first recurrences occurred within the first years after primary treatment; 62%, 82%, and 91% within the first, second and third year, respectively. Totally, 51% were amenable for salvage treatment, and 44% benefited from salvage in terms of a complete response. Permanent tumor control was observed in 128 patients (23%) after one or two salvage attempts. The highest salvage rate was recorded in patients with primary glottic carcinoma (41%) and the lowest among hypopharyngeal cancers (2%). Asymptomatic recurrence was recorded in 12% of all recurrences and this was found to be a positive prognostic factor for disease-specific survival, as they had significantly better outcome after salvage. ConclusionOur data support the usefulness of specialized FU in terms of early detection of recurrent disease. In particular patients with silent recurrences benefited from early detection, as they had a significantly lower risk ratio of death from primary HNC. [ABSTRACT FROM PUBLISHER]

The article discusses highlights of the 6th Acta Oncologica Symposium held in Aarhus, Denmark, on June 5-7, 2008, that was dedicated to image-guided radiotherapy (IGRT). The symposium aims to evaluate the current knowledge in the field of IGRT, which offers promise to improve the clinical outcome of cancer treatment. Clinical sessions covered tumor sites in the pelvis, thorax, head-and-neck and brain.

The invasive disease free survival, the overall survival, and the relative risk of death compared to the Danish population as well as the risk of recurrence and new malignancies is reported for low-risk breast cancer patients of the DBCG 89-A programme. The study includes a comparison between those patients who, according to the present criteria, would be defined low-risk and those who would be defined high-risk (the retrospective low→high-risk group) and a comparison of treatment by mastectomy and BCS combined with radiation therapy. The DBCG 89-A programme scheduled 10 years of follow-up. Data was supplemented by record linkage to the Hospital Discharge Registry (date of event) and the Central Population Registry (date of death). The study population consisted of 8 850 patients. With 12 years of follow-up 3 811 events (43%) were recorded: loco-regional recurrence 8%, distant recurrence 11%, contralateral cancer 6%, secondary cancer 8%, and deaths 11%. The DBCG registry had an incomplete reporting of events in these low-risk patients, due to premature discontinuation of control. The incidence of recurrences was higher for the retrospective low → high-risk group than for the low-risk group. The 10-year overall survival was 76%; lower in the retrospective low → high-risk group (71%) than in the low-risk group (83%). The 5-year survival following local recurrence was 68% after mastectomy and 81% after BCS. The risk of mortality was higher than in the general population for all subgroups of patients. The relative risk of mortality expressed in terms of the standardized mortality ratio was 10.4 for young patients (26-39 years) and 1.2 for old patients aged 70-74 years and 1.3 for patients in the retrospective low-risk group and 1.9 for patients in the low → high-risk group. The loco-regional treatment given did not cure all patients, in particular young patients and those of the retrospective low → high-risk group. [ABSTRACT FROM AUTHOR]