1.General understanding of the disease
Before asking about their condition, patients should have a general understanding of the development of their disease so that they can better ask about their condition and more easily understand the doctor’s presentation of their condition.
2.Commissioning friends and relatives to ask
For ethical reasons, doctors tend to be more relaxed and confide in patients’ family members or friends when talking to them about their condition in more detail. Therefore, it is recommended that patients can entrust their relatives or very close friends to communicate with the doctor to learn more about the real situation of their condition.
3. Prepare relevant questions
Before asking questions about their condition, patients must prepare the questions they want to ask and keep their emotions in check. The doctor understands the patient’s desire to understand his or her condition and is willing to provide the patient with as much information as possible. Some patients get so excited when they see the doctor that they completely or partially forget the questions they want to ask the doctor. Here, it is recommended that patients can write down the questions they want to consult on paper before seeing the doctor, so that they can achieve the purpose of coming to the hospital and let the doctor understand their situation as soon as possible.
4.Detailed report on the recent physical condition
In addition, seeing a doctor is a process of mutual communication between the doctor and the patient, so if the patient wants to know more about his or her health, he or she must report his or her recent health condition to the doctor at the same time as asking him or her. For example, if there have been any abnormalities, the patient should tell the doctor carefully when they occurred, how long they lasted, and how they were treated. For the doctor, the more information that can be collected about the patient’s medical history, the deeper the understanding of the patient will be, so that the doctor’s judgment will be more comprehensive and accurate after integrating all aspects of information.
5.More consultation with treatment-related issues
Patients should learn as much as possible about treatment-related issues during the consultation, such as whether there is an opportunity for surgery? Can surgery achieve radical cure? If radical resection cannot be done, can neoadjuvant chemotherapy or radiotherapy be used to wait for the tumor to shrink before surgery? For patients who have lost the chance of surgery, they should find out as much as possible whether the current diagnosis of their condition is clear and whether there is an accurate pathological histological diagnosis? If there is no pathological diagnosis, patients should actively cooperate with the doctor to perform a puncture biopsy to clarify the diagnosis. If possible, the patient should also learn as much as possible about the content of the treatment plan prescribed for him/her by the doctor, what drugs are used? What is the efficacy of the chosen chemotherapy regimen? What are the toxic reactions? Are there any new drugs that are more effective? Patients can even ask if there are clinical studies of appropriate new drugs for their condition, because after the failure of first- or second-line treatments, clinical studies of new drugs may be a worthwhile approach to try.
The above suggestions are all in principle, but when it comes to each patient, it is important to analyze the specific problems.
Featured 2 How can clinical research help cancer patients?
At present, with the continuous improvement of treatment, the survival of patients with advanced cancer has been significantly extended, but when the tumor often still progresses after receiving multiple protocols and drugs, this faces the dilemma of having no drugs available. Participating in a clinical research study is a good option at this time.
What is a clinical research study?
A clinical study is any systematic study of a drug in humans (patients or healthy volunteers) to confirm or reveal the action, adverse effects and/or absorption, distribution, metabolism and excretion patterns of the drug under study. The purpose of the study is to determine the efficacy and safety of the study drug. Clinical studies are generally divided into Phase I, II, III and IV clinical studies, with the size and purpose of each phase varying.
Patients’ misconceptions about clinical studies
At present, most Chinese patients have misunderstandings about clinical research, and many of them equate participation in clinical drug research with “mice”. Many patients with advanced tumors, although they have exhausted their money for treatment, would rather give up than participate in clinical studies that may prolong their survival, improve their quality of life and are free of charge.
The significance of participating in clinical studies
First of all, a clinical trial is a new drug development study that is closely designed to find better therapeutic effects. The drugs under study are often proven to be effective in preliminary cellular, animal or human trials and have the potential to bring benefits to patients. Clinical studies have a strict process and monitoring, through which a more standardized and better treatment can be obtained. Therefore, patients who participate in research studies have the first chance to be saved compared to other patients. Secondly, through clinical research, more effective drugs for pancreatic cancer can be discovered, bringing hope to all pancreatic cancer patients.
In foreign countries, the vast majority of oncology patients will participate in various clinical studies under the advice of their doctors. These patients can save a large amount of treatment cost while getting effective treatment. Therefore, oncology patients should have the courage to actively participate in relevant clinical studies and create a chance for themselves!
Featured 3 Pain treatment: Can opioid analgesics be addictive?
According to relevant statistics, about 1/4 of newly diagnosed cancer patients, 1/3 of cancer patients undergoing treatment and 3/4 of advanced cancer patients have combined pain. Pain greatly affects the quality of life of cancer patients, shakes their confidence in overcoming the disease, and makes the subsequent anti-tumor treatment difficult, so pain control should be an important part of anti-tumor treatment.
How to control cancer pain?
Firstly, we should provide targeted treatment for the causes of cancer pain, including anti-tumor drug therapy, radiation therapy and bone resorption inhibitor therapy. For example, pain caused by bone metastases can be treated with bone resorption inhibitors to reduce bone destruction and control pain, and pain relief radiotherapy can be administered if necessary; pain caused by tumors can be controlled with the remission of tumors after treatment with appropriate anti-tumor drugs. Secondly, analgesic drugs can be used to treat the pain. Analgesic drugs include non-steroidal anti-inflammatory drugs (NSAID) represented by aspirin, weak opioids represented by codeine, and strong opioids represented by morphine. In addition, antidepressants and anticonvulsants can be used to assist in pain relief. Again, non-pharmacological treatments such as nerve blocks or blockade therapy, invasive techniques such as patient-controlled analgesia (PCA), or psychotherapy may be used.
Are opioid analgesics addictive?
The World Health Organization (WHO) has long since moved away from the term “addiction” and replaced it with the term “drug dependence”, which is defined by the WHO as The WHO defines “drug dependence” as “the physiological and behavioral use of psychoactive drugs (narcotic drugs) as a daily priority to varying degrees, characterized by a desire to obtain and use these drugs, and by chronic drug-seeking behavior”. The incidence of opioid “addiction” is related to the form of drug, route of administration, and method of administration. Direct intravenous injection of opioids can result in a sudden increase in blood levels, which can lead to euphoria and toxic reactions that can easily lead to “addiction”. In cancer pain treatment, opioids are often administered in controlled-release and extended-release formulations, which can be absorbed orally or through the skin to avoid excessive peak drug concentrations in the blood and to keep the active drug in the blood constant to a certain extent. This standardized approach to drug administration can significantly reduce the risk of “addiction” while ensuring optimal analgesic treatment. Therefore, the risk of “addiction” to opioid analgesics is extremely low (reported to be less than 4 in 10,000).
What are the side effects of opioid analgesics?
The most common side effects of opioids for pain include constipation, nausea and vomiting, and sometimes excessive sedation, respiratory depression, and urinary retention, but the latter three are rare. You should tell your healthcare provider if you notice any of these symptoms during the course of your medication.
Constipation Methods to prevent constipation include: ① Drink more water; ② Eat high-fiber foods, vegetables, fruits, etc.; ③ Exercise properly, abdominal massage, and develop good habits of regular bowel movements; ④ Take laxatives such as stool softeners or marijuana pills under the guidance of your doctor.
Nausea and vomiting generally may occur when taking opioids for the first time, often the reaction will be automatically reduced after 3 to 5 days of taking the drug, and can be relieved after treatment with antiemetic drugs. Commonly used antiemetics include: drugs to promote gastrointestinal motility, such as metoclopramide (gastric rehab), domperidone (morpholine), etc.; glucocorticoids and haloperidol; central antiemetics, such as ondansetron, toltesetron, etc. For severe vomiting that cannot be tolerated, the opioid variety can be adjusted or the dose reduced.
Excessive sedation Generally manifested as sleepiness or drowsiness, the incidence is low, and mostly occurs with initial dosing or more rapid dose increases. Since chronic pain can cause insomnia, and excessive sedation can occur when pain is controlled by analgesics. It is necessary to determine whether this is due to chronic poor sleep and the normal need for sleep after good pain control; if symptoms continue to worsen, drug overdose should be alerted. The dose of morphine-based drugs should not be too high when first used, and the dose of morphine-based drugs can be reduced and the number of doses increased or replaced with other painkillers when symptoms appear.
Respiratory depression The normal respiratory rate of a person in a quiet state is 16-20 times per minute, and if it is less than 12 times per minute, it is called respiratory depression. However, pain itself is an antagonist of the central depressant effect of opioids. Respiratory depression can only be reduced with the standardized use of oral or skin-applied opioids in the treatment of cancer pain.
Urinary retention Urinary retention is the accumulation of large amounts of urine in the bladder that cannot be excreted, with an incidence of less than 5%. Once it occurs, patients should be encouraged and induced to urinate on their own, and the perineum should be flushed with warm water, and if necessary, catheterization is feasible.
Featured 4 Breast cancer: Patients should be cautious in consuming dairy products with high fat content
What do breast cancer patients need to pay attention to when choosing dairy products in their daily life? Recommended by the editors is a study whose findings tell us that dairy products with high fat content may increase the risk of death from breast cancer, while dairy products with low fat content do not increase the risk of breast cancer recurrence or death – the
The Journal of the National Cancer Institute (J Natl CancerInst) published an observational study that evaluated the relationship between cumulative mean milk fat and disease regression in 1893 patients diagnosed with early invasive breast cancer between 1997 and 2000.
The results found that high-fat dairy products were strongly associated with an increased risk of death after breast cancer diagnosis, whereas low-fat dairy intake was not associated with either breast cancer recurrence or patient survival.
Featured 5 Colorectal cancer: Survival rates have improved significantly
Colorectal cancer outcomes have improved significantly
From 1940 to 1960, the 5-year survival rate of colorectal surgery patients in the United States was 48% to 56% for colon cancer and 44% to 50% for rectal cancer.
The analysis of 30,000 cases of colon and rectal cancer in the United Kingdom from 1960 to 1987 showed that the 5-year survival rates after surgery were 56.1% and 45.1%, respectively.
In the United States, the 5-year survival rates for colon and rectal cancer from 1975 to 2005 were 66% and 69%, respectively (59% and 57% in the 1980s); the Norwegian Cancer Center reported a 5-year survival rate of >70.0% (54.9% in the 1980s) after radical surgery for rectal cancer.
In the southeast of the Netherlands, the 5-year survival rate for rectal cancer was 61% (49% in the 1980s) with the application of total rectal mesenteric resection and preoperative radiotherapy from 1995 to 2000; and the 5-year survival rate for rectal cancer after surgery was 75% at Fudan University Cancer Hospital in Shanghai.
Screening saves patients’ lives
The incidence and mortality rate of colorectal cancer in large cities in China have increased by about 5% annually. In the United States, the decline began in the mid-1980s and became more pronounced in the mid-1990s, attributed to screening and elimination of causative risk factors and improved treatment.
The most important tool to control the epidemic of colorectal cancer is screening, which can eliminate precancerous patients; achieve “three early” (early detection, early diagnosis, early treatment), and the cure rate of early colorectal cancer can reach 90%.
In the United States, screening is not recommended for people under 50 years of age, and the incidence of colorectal cancer has been increasing by 2% per year for both men and women since 1994. In China, large-scale population screening for colorectal cancer was carried out in 2007, and the number of people initially screened from 2010 to 2012 reached more than 460,000, with 1,455 cases detected, and the early diagnosis rate was nearly 90%, and most of them were treated in time.
Featured 6 Liver cancer: What should be done for patients in the middle and late stages who cannot be removed surgically?
What should be done for middle and advanced stage liver cancer that cannot be removed surgically? How to control tumor recurrence and metastasis? Experts give the answer to this question: comprehensive treatment featuring “intervention” and “minimally invasive” can enable many patients to live with tumor for a long time and improve the quality of life; drug treatment + moderate physical exercise can increase the immunity and resistance of tumor patients and prevent tumor metastasis. Tumor metastasis recurrence. This is the information obtained by the reporter from the 5th China Cancer Interventional and Minimally Invasive Therapy Conference and the 4th Shanghai International Conference on Comprehensive Interventional Therapy for Liver Cancer held in Shanghai from April 11 to 13.
According to academician Tang Zhaoyou, director of the Institute of Liver Cancer of Fudan University and a famous liver cancer expert, it has been confirmed that cancer is not only a local lesion but also a systemic lesion. Some cancers are born with the potential to invade and metastasize. He cited the example that during the 40 years from 1968 to 2009, the 5-year survival rate of small liver cancers has basically not changed much, although the treatment level and equipment have improved greatly. Cancer is a chronic disease and no single therapy has been found so far that can completely overcome it, and even early diagnosis and treatment do not completely solve the problem. For now, the key is to control recurrence, and tumor patients should be prepared for “long-term survival with tumor”. Therefore, comprehensive treatment and physical exercise are very important.
Academician Tang said that the method of interferon drug to suppress tumor and physical exercise can improve the immunity and resistance of patients and prevent tumor metastasis and recurrence. The Institute of Liver Cancer of Fudan University once did an experiment: researchers inoculated human liver cancer to nude mice, and when the tumor grew, it metastasized to lungs and other organs, eventually leading to the death of the nude mice. Later, the researchers divided the nude mice with human liver cancer into moderate swimming group and excessive swimming group, and the nude mice in the moderate swimming group swam in warm water of 28-30℃ for 8 minutes a day, while the nude mice in the excessive swimming group swam in warm water of 30℃ for 14 minutes a day.
Academician Tang told reporters 4 cases: 1 patient with small liver cancer resected, cancer thrombus, after several times of intravascular chemotherapy, interferon plus swimming 3 times a week, 11 years without recurrence; 1 patient with liver cancer resected, lung metastasis and then resected, with interferon plus swimming, 5 years without recurrence; 1 patient with liver cancer resected in 2001, chemotherapy, 1 year after recurrence and then resected, after 3 recurrences, doing radiofrequency ablation, accepting the recommendation interferon plus swimming, swam 1000 meters per day, no recurrence for 8 years; another patient with liver cancer in Indonesia, insisted on swimming after surgery and is still alive more than 10 years later.