Articles

Palliative Care: A Shift in Paradigm

BJMO - volume 15, issue 6, october 2021

C. Langenaeken MD, G. Huysmans MD

SUMMARY

The integration of palliative care (PC) in standard oncological care (SOC) has become ‘state-of-the art’. Its benefits have increasingly been appreciated and extensively studied, and guidelines have been developed to achieve this goal. However, an integrated, patient-centred approach also implies detecting patients care needs at an earlier stage and defining PC in a different way, i.e. based on care needs instead of life expectancy only. The ‘Palliative Care Indicator Tool’ PICT is instrumental in identifying the palliative patient and distinguishing different levels of needs in the palliative population. The status of ‘palliative patient’, access to PC benefits and facilities and the organisation and reimbursement of PC services should be based on care needs instead of life expectancy. Palliative care for every palliative patient requires an educated workforce, particularly with regard to communication skills, and the presence of a multidisciplinary team. Discussing goals of care (GoC), advance care planning (ACP) and end-of-life decisions (ELD) should be the basis for ‘negotiated care’.

(BELG J MED ONCOL 2021;15(6):315-20)

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5-Fluorouracil-induced coronary vasospasm: case report and discussion

BJMO - volume 9, issue 5, september 2015

K. R. Meesschaert MD, D. Van Aken MD, P. Goetstouwers MD, D. Verhoeven MD, PhD, C. Langenaeken MD, M. Strijbos MD, PhD, Wim Demey MD

5-Fluorouracil is one of the most widely used chemotherapeutic agents. It has been included in the treatment of a number of solid tumours, including upper gastrointestinal, colorectal and breast cancer, for many years. It is the backbone of several chemotherapy regimens, particularly in the treatment of gastrointestinal tract adenocarcinomas. Unfortunately, cardiotoxicities may be expected to occur regularly. As 5-fluorouracil is widely used, cardiotoxicity due to 5-fluorouracil is a relatively common problem. The case of a 64-year old man with invasive intestinal adenocarcinoma, who developed chest pain during his first mFOLFOX cycle, is presented. We see in this case and in the literature that recurrence of cardiac toxicity is high, even with premedication. There is some evidence that replacing the fluoropyrimidine by raltitrexed is safe and efficacious for patients with 5-fluorouracil (cardiac) toxicity in the setting of colorectal cancer.

(BELG J MED ONCOL 2015;9(5):194–98)

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Quality management of breast cancer patients

BJMO - volume 9, issue 3, july 2015

D. Verhoeven MD, PhD, P. Goetstouwers MD, C. Langenaeken MD, Wim Demey MD, M. Strijbos MD, PhD

Quality indicators are used to monitor the quality of care of cancer patients. They are divided into structural, process, outcome, and service indicators. Information about quality indicators must be given to all partners involved, leading to optimisation of treatment strategies and reduction of treatment variability. The aim is to achieve quality cancer care within everyone’s reach, with a focus on patient needs. Although disparities are present for various reasons, an in depth analysis is highly informative.

(BELG J MED ONCOL 2015;9(3):107–12)

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Highlights from the 5th International Congress of Breast Disease Centres

BJMO - volume 9, issue 2, may 2015

D. Verhoeven MD, PhD, Wim Demey MD, I. Biltjes MD, P. Dirix MD, PhD, P. Van Dam MD, PhD, M. Strijbos MD, PhD, C. Langenaeken MD

The 5th International Congress of Breast Disease Centres was held in Antwerp, February 5–7, 2015, following previous versions in Paris. The focus was on multidisciplinary care, quality management, and economic issues. Over fifty key opinion leaders from all over the world (fifteen countries, four continents) discussed different aspects of multidisciplinary breast care. Among the participants were the presidents of professional societies such as EUSOMA, ECCO, ESTRO, NAPBC USA, and the general director of SIS. The next congress will be held in Paris, February 4–6, 2016.

(BELG J MED ONCOL 2015;9(2):77–9)

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Are patients better treated in clinical trials?

BJMO - volume 8, issue 3, july 2014

D. Verhoeven MD, PhD, C. Langenaeken MD, Wim Demey MD, S. Meers MD, PhD

The accepted opinion in the oncological community is that patients are better off when treated within the context of a clinical trial. However, based upon a critical analysis of the available literature, there is little unbiased evidence of outcome improvement. Important ethical considerations must be taken into account. Also a lot of problems arise with the regulation of the trials and the administrative burden. Patients must be enrolled in a clinical trial on the basis of improving treatment options for future patients.

(BELG J MED ONCOL 2014;8(3):94–7)

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Caring for the oncologist: caregiver stress and staff support in oncology

BJMO - volume 8, issue 2, may 2014

C. Langenaeken MD, W. Rombouts MA

Although oncology is a very rewarding profession, it can be demanding and stressful. Work-related stress, a lack of meaning in work and problems with work-life balance may lead to distress and burnout. The phenomenon of oncologist distress and burnout is reviewed with a focus on care for the caregiver. A person-oriented approach focusing on promoting personal wellness, factors that bring satisfaction to work, resilience, and positive emotions may provide important coping strategies, adding to the standard focus on job-related factors. Guided intervision may benefit the oncologist and his team by providing a forum for discussing job- and team-related issues, gaining insight through reflection and providing support and meaning-making.

(BELG J MED ONCOL 2014;8(2):38–43)

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Belgian Society of Medical Oncology (BSMO) task force on breast cancer survivorship

BJMO - volume 7, issue 5, december 2013

E. de Azambuja MD, PhD, H. A. Azim Jr. MD, PhD, L. Buisseret MD, C. Langenaeken MD, D. T’Kint de Roodenbeke MD

Summary

Advances in screening, diagnostic procedures, surgical techniques, knowledge about molecular pathways and targets, and new treatment options have substantially improved the outcome of breast cancer patients. Care for breast cancer survivors has thus become an essential part of care for breast cancer patients. Therefore, the Belgian Society of Medical Oncology set-up a task force charged with developing guidance on issues important for breast cancer patients who have completed their primary treatment.

(BELG J MED ONCOL 2013;7(5):142–55)

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