12 results on '"Rogers, Paul C."'
Search Results
2. Psychological distress of adolescent and young adult childhood cancer survivors in a South African cohort.
- Author
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Van Zyl A, Kruger M, Ndlovu S, Meehan SA, and Rogers PC
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- Humans, Child, Adolescent, Young Adult, Adult, South Africa epidemiology, Stress, Psychological epidemiology, Stress, Psychological etiology, Stress, Psychological psychology, Neoplasms therapy, Neoplasms psychology, Cancer Survivors psychology, Psychological Distress
- Abstract
Background: We investigated psychological distress in a South African childhood cancer survivor (CCS) cohort., Methods: Adult CCSs treated at Tygerberg Hospital, Cape Town, completed the Brief Symptom Inventory-18. Internal consistency was acceptable: Cronbach's alpha values were 0.91 (Global Severity Index (GSI)), 0.85 (depression), 0.83 (somatization), and 0.75 (anxiety). We compared results utilizing different case rules (GSI T scores of ≥50, ≥57, and ≥63) for the identification of psychological distress., Results: Forty CCSs (median age 24 years; median follow-up period 16 years) participated. Most (58%; 23 out of 40) completed school or tertiary education, were unmarried (90%; 36 out of 40), and unemployed (59.5%; 22 out of 37). The diagnoses included hematological malignancies (65%; 26 out of 40) and solid tumors (35%; 14 out of 40). The GSI T scores of ≥63, ≥57, and ≥50 identified 10% (four out of 40), 32.5% (13 out of 40), and 45% (18 out of 40) of survivors with psychological distress, respectively. Radiotherapy (odds ratio (OR) 4.6; p = .035), presence of ≥six late effects (OR 7.5; p = .026), and severe late effects (OR 6.6; p = .024) were significant risk factors (GSI T score ≥57). Follow-up period of 11-20 years (OR 7.3; p = .034) was significant for a GSI T score ≥50., Conclusion: This South African CCS cohort had higher levels of psychological distress utilizing the GSI T score ≥50 and ≥57 case rules than reported in the literature. Most were unmarried or unemployed. Significant contributing factors were radiotherapy, number and severity of late effects, and follow-up period. CCSs must be screened for psychological distress., (© 2022 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC.) more...
- Published
- 2023
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3. The relevance of nutrition to pediatric oncology: A cancer control perspective.
- Author
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Rogers PC and Barr RD
- Subjects
- Child, Child Nutrition Disorders diet therapy, Child Nutrition Disorders metabolism, Child Nutrition Disorders pathology, Humans, Neoplasms metabolism, Neoplasms pathology, Nutritional Status, Neoplasms diet therapy, Nutritional Support methods
- Abstract
It is indisputable that adequate and appropriate nutrition is fundamental to the health, growth, and development of infants, children, and adolescents, including those with cancer. Nutrition has a role in most of the accepted components of the cancer control spectrum, from prevention through to palliation. The science of nutrigenomics, nutrigenetics, and bioactive foods (phytochemicals), and how nutrition affects cancer biology and cancer treatment, is growing. Nutritional epigenetics is giving us an understanding that there are possible primary prevention strategies for pediatric cancers, especially during conception and pregnancy, which need to be studied. Primary prevention of cancer in adults, such as colorectal cancer, should commence early in childhood, given the long gestation of nutritionally related cancers. Obesity avoidance is definitely a target for both pediatric and adult cancer prevention, commencing in childhood. There is now compelling evidence that the nutritional status of children with cancer, both overweight and underweight, does affect cancer outcomes. This is a potentially modifiable prognostic factor. Consistent longitudinal nutritional assessment of patients from diagnosis through treatment and long-term follow-up is required so that interventions can be implemented and evaluated. While improving, there remains a dearth of basic and clinical nutritional research in pediatric oncology. The perspective of evaluating nutrition as a cancer control factor is discussed in this article., (© 2020 Wiley Periodicals, Inc.) more...
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- 2020
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4. A Framework for Adapted Nutritional Therapy for Children With Cancer in Low- and Middle-Income Countries: A Report From the SIOP PODC Nutrition Working Group.
- Author
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Ladas EJ, Arora B, Howard SC, Rogers PC, Mosby TT, and Barr RD
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- Child, Developing Countries, Humans, Neoplasms therapy, Poverty, Neoplasms diet therapy, Nutrition Policy, Nutrition Therapy methods, Nutritional Status, Nutritional Support methods
- Abstract
The utilization of adapted regimens for the treatment of pediatric malignancies has greatly improved clinical outcomes for children receiving treatment in low- and middle-income countries (LMIC). Nutritional depletion has been associated with poorer outcomes, increased abandonment of therapy, and treatment-related toxicities. Surveys have found that nutritional intervention is not incorporated routinely into supportive care regimens. Establishing nutritional programs based upon institutional resources may facilitate the incorporation of nutritional therapy into clinical care in a way that is feasible in all settings. We present a framework for establishing and monitoring of nutritional care based on the infrastructure of institutions in LMIC., (© 2016 Wiley Periodicals, Inc.) more...
- Published
- 2016
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5. Proactive enteral tube feeding in pediatric patients undergoing chemotherapy.
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Sacks N, Hwang WT, Lange BJ, Tan KS, Sandler ES, Rogers PC, Womer RB, Pietsch JB, and Rheingold SR
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- Adolescent, Adult, Case-Control Studies, Child, Child, Preschool, Feasibility Studies, Female, Follow-Up Studies, Humans, Infant, Male, Pilot Projects, Prognosis, Young Adult, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Enteral Nutrition, Intubation, Gastrointestinal, Neoplasms drug therapy, Neoplasms rehabilitation, Nutritional Status
- Abstract
Background: To determine feasibility and safety of proactive enteral tube feeding (ETF) in pediatric oncology patients., Methods: Pediatric patients with newly diagnosed brain tumors, myeloid leukemia or high-risk solid tumors were eligible. Subjects agreeing to start ETF before cycle 2 chemotherapy were considered proactive participants (PPs). Those who declined could enroll as chart collection receiving nutritional standard of care. Nutritional status was assessed using standard anthropometric measurements. Episodes of infection and toxicity related to ETF were documented from diagnosis to end of therapy. A descriptive comparison between PPs and controls was conducted., Results: One hundred four eligible patients were identified; 69 enrolled (20 PPs and 49 controls). At diagnosis, 17% of all subjects were underweight and 26% overweight. Barriers to enrollment included physician, subject and/or family refusal, and inability to initiate ETF prior to cycle 2 of chemotherapy. Toxicity of ETF was minimal, but higher percentage of subjects in the proactive group had episodes of infection than controls. Thirty-nine percent of controls eventually started ETF and were twice as likely to receive parenteral nutrition. PPs experienced less weight loss at ETF initiation than controls receiving ETF and were the only group to demonstrate improved nutritional status at end of study., Conclusions: Proactive ETF is feasible in children with cancer and results in improved nutritional status at end of therapy. Episodes of infection in this study are concerning; therefore, a larger randomized trial is required to further delineate infectious risks and toxicities that may be mitigated by improved nutritional status., (© 2013 Wiley Periodicals, Inc.) more...
- Published
- 2014
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6. The impact of nutritional status on outcomes: a neglected area of research.
- Author
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Rogers PC and Ladas EJ
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- Female, Humans, Male, Body Mass Index, Osteosarcoma surgery, Postoperative Complications
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- 2011
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7. Childhood, adolescent, and young adult cancer survivors research program of British Columbia: objectives, study design, and cohort characteristics.
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McBride ML, Rogers PC, Sheps SB, Glickman V, Broemeling AM, Goddard K, Hu J, Lorenzi M, Peacock S, Pritchard S, Rassekh SR, Siegel L, Spinelli JJ, Teckle P, and Xie L
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- Adolescent, British Columbia, Child, Preschool, Cohort Studies, Follow-Up Studies, Humans, Infant, Newborn, Medical Record Linkage, Population Groups, Registries, Research Design, Survivors, Young Adult, Neoplasms epidemiology, Outcome Assessment, Health Care methods
- Abstract
Background: The Childhood, Adolescent, and Young Adult Cancer Survivors Research Program (CAYACS) has been established in the province of British Columbia (BC), Canada, to carry out research into late effects and survivor care in multiple domains, and to inform policy and practice., Procedure: This program identifies a survivor cohort and comparison groups from population-based registries and links their records to population-based files of outcomes and outcome determinants, to create a research database and conduct studies of long-term outcomes and care., Results: The initial cohort consisted of all 5-year survivors of cancer or a tumor diagnosed under age 25 years from 1970 to 1995, who were residents in BC at the time of diagnosis, and followed till 2000 (3,841 subjects). Seven percent have died, and 77% have treatment information available. Data on death and second cancer occurring in BC are available. Late morbidity and healthcare utilization information is available for 68% of survivors (79% of those diagnosed from 1981). Education outcomes are available for 71% of those born during 1978-1995 and diagnosed under age 15 years., Conclusions: Use of registries, administrative databases, and record linkage methodologies is a cost-effective and comprehensive means to conduct survivorship research. This program should add to knowledge of risks of late effects and impacts on care, inform development of strategies to manage risks, evaluate the effects of surveillance and interventions, and assess new risks as the cohort ages, more recent survivors enter the cohort, and treatments change., ((c) 2010 Wiley-Liss, Inc.) more...
- Published
- 2010
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8. Children's Oncology Group (COG) Nutrition Committee.
- Author
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Rogers PC, Melnick SJ, Ladas EJ, Halton J, Baillargeon J, and Sacks N
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- Body Composition, Body Mass Index, Body Weight, Child, Humans, Child Nutrition Sciences, Neoplasms metabolism, Neoplasms pathology
- Abstract
The Children's Oncology Group (COG) Nutrition Committee was established to further the knowledge of nutrition in children with cancer by education and the conduct of clinical trials. A survey of COG institutions revealed lack of conformity in evaluation and categorization of nutritional status, and criteria for nutritional intervention. The Committee subsequently established specific categories of malnutrition (Underweight and Overweight) based on ideal body weight or body mass index. An algorithm was developed as a guideline for nutritional intervention as well as references and resources for determining estimated needs. The Committee embarked on concepts for clinical trials of nutritional interventions. The first pilot study, evaluating the feasibility of using an immunoneutraceutical precursor for glutathione production, has been completed. This study showed weight gain and improvement in glutathione status. A pilot trial of proactive enteral feeding for patients at high risk of malnutrition has commenced. The Committee believes that nutrition is relevant to all aspects of cancer control. The paucity of nutritional investigation in children with cancer needs to be rectified., ((c) 2007 Wiley-Liss, Inc.) more...
- Published
- 2008
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9. Risk of a second malignant neoplasm among 5-year survivors of cancer in childhood and adolescence in British Columbia, Canada.
- Author
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MacArthur AC, Spinelli JJ, Rogers PC, Goddard KJ, Phillips N, and McBride ML
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- Adolescent, Breast Neoplasms epidemiology, Breast Neoplasms etiology, British Columbia epidemiology, Central Nervous System Neoplasms epidemiology, Central Nervous System Neoplasms etiology, Child, Child, Preschool, Cohort Studies, Female, Follow-Up Studies, Humans, Incidence, Infant, Infant, Newborn, Leukemia epidemiology, Leukemia etiology, Lymphoma epidemiology, Lymphoma etiology, Male, Neoplasms therapy, Neoplasms, Second Primary etiology, Neoplasms, Second Primary mortality, Registries statistics & numerical data, Risk, Time Factors, Neoplasms, Second Primary epidemiology, Survivors statistics & numerical data
- Abstract
Background: We examined second malignancies, a recognized late effect of therapy among survivors of childhood and adolescent cancer, among a recent, population-based cohort of 2,322 5-year survivors diagnosed before 20 years of age in British Columbia (BC), Canada between 1970 and 1995., Procedure: Survivors and second malignancies were identified from the BC Cancer Registry. Risk of second malignancy was evaluated using standardized incidence ratios (SIRs), absolute excess risk (AER), and cumulative risk. The effect of demographic, temporal, and disease-related characteristics on risk was assessed., Results: Fifty-five second malignancies were observed after 26,071 person-years of follow-up. Relative rate of developing a second malignancy among survivors was 5 times higher than expected (SIR = 5.0, 95% CI, 3.8-6.5), and absolute excess risk was 1.7 deaths per 1,000 person-years. Cumulative incidence of a second malignancy was 5.1% at 25 years after diagnosis of the first cancer. SIRs and absolute excess risk of subsequent cancer was higher among females (SIR = 5.9, 95% CI, 4.5-8.3 and AER = 2.66). While relative risk of second cancer was higher for those diagnosed before 10 years of age (SIR = 10.6, 95% CI, 7.1-16.0), absolute excess risk was slightly higher for those diagnosed after 10 years of age. SIRs were significantly elevated for all follow-up periods, but absolute excess risk of a second cancer was highest among patients surviving more than 15 years., Conclusions: Increased risk of a subsequent neoplasm is evident among childhood cancer survivors diagnosed in more recent periods than has been previously reported, continues years after diagnosis, and varies according to several risk factors. Continued surveillance is essential to quantify and characterize long-term and changing risks for appropriate follow-up. more...
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- 2007
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10. Mortality among 5-year survivors of cancer diagnosed during childhood or adolescence in British Columbia, Canada.
- Author
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MacArthur AC, Spinelli JJ, Rogers PC, Goddard KJ, Abanto ZU, and McBride ML
- Subjects
- Adolescent, Breast Neoplasms epidemiology, Breast Neoplasms etiology, British Columbia epidemiology, Cardiovascular Diseases etiology, Cardiovascular Diseases mortality, Cause of Death, Central Nervous System Neoplasms epidemiology, Central Nervous System Neoplasms etiology, Child, Child, Preschool, Cohort Studies, Female, Follow-Up Studies, Humans, Incidence, Infant, Infant, Newborn, Kaplan-Meier Estimate, Leukemia epidemiology, Leukemia etiology, Lymphoma epidemiology, Lymphoma etiology, Male, Neoplasms therapy, Neoplasms, Second Primary etiology, Neoplasms, Second Primary mortality, Proportional Hazards Models, Registries statistics & numerical data, Respiratory Tract Diseases etiology, Respiratory Tract Diseases mortality, Risk, Time Factors, Mortality, Survivors statistics & numerical data
- Abstract
Background: Ongoing monitoring of late mortality among survivors of a childhood or adolescent cancer is essential to appropriately evaluate risk in more recent cohorts and with longer follow-up. We examined overall and cause-specific mortality in a population-based cohort of 2,354 individuals diagnosed with a cancer or tumor prior to 20 years of age between 1970 and 1995 in British Columbia (BC), Canada who survived at least 5 years., Procedure: Late deaths in a survivor cohort ascertained from the BC Cancer Registry were identified using death registrations. Standardized mortality ratios, absolute excess risk of death, and cumulative risk of death were determined. Demographic, temporal, and disease-related factors in risk of late mortality were also assessed., Results: After 24,491 person-years of follow-up, there were 181 deaths, 139 of which were cancer related. Excess risk of late mortality among survivors was 7 deaths per 1,000 person-years at risk (AER = 6.6). Standardized mortality ratio (SMR) was ninefold higher relative to the underlying BC population (SMR = 9.1, 95% CI, 7.8-10.5), and was greatest for those with a recurrence within 5 years of diagnosis, and for those diagnosed with acute lymphoblastic leukemia and nervous system tumors. Absolute excess risk of late death was significantly higher for males and for those diagnosed prior to 1980, but did not vary according to age at diagnosis. Relative mortality was significantly increased due to cancer-related causes of death (SMR = 81.7, 95% CI, 68.6-95.8), as well as circulatory (SMR = 9.7, 95% CI, 4.2-19.1) and respiratory (SMR = 16.8, 95% CI, 4.6-43.0) diseases., Conclusions: In this population-based cohort with long follow-up, there continues to be excess late mortality among childhood and adolescent cancer survivors due to both cancer and non-cancer causes, even among more recently diagnosed survivors. more...
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- 2007
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11. Standards of nutritional care in pediatric oncology: results from a nationwide survey on the standards of practice in pediatric oncology. A Children's Oncology Group study.
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Ladas EJ, Sacks N, Brophy P, and Rogers PC
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- Child, Clinical Trials as Topic, Guideline Adherence standards, Guidelines as Topic standards, Humans, Malnutrition diet therapy, Malnutrition etiology, Nutritional Support methods, Oncology Nursing standards, Quality of Life, Neoplasms complications, Neoplasms mortality, Nutrition Surveys, Nutritional Support standards
- Abstract
Background: The prevalence of malnutrition in children with cancer ranges between 8% and 60%. Malnutrition is strongly associated with the nature of treatment and increases an individual's risk of infection. Clinical studies have suggested that nutrition intervention may decrease toxicity and improve survival in the oncology population. In order to identify the standards of practice in the nutritional management of a child with cancer, we conducted an international survey in institutions that are part of the Children's Oncology Group (COG) consortium., Procedure: Surveys were submitted to 233 participating COG institutions. We requested one member in three disciplines complete the survey: physician, registered dietitian, and nurse or nurse practitioner. The survey was returned to the nutrition sub-committee of COG., Results: Fifty-four percent of institutions responded to the survey. We found no consistency in the provision of nutrition services. Assessment of nutritional status does not routinely occur and different indices are employed to indicate the nutrition status of a patient. Institutions rely upon different guidelines when categorizing malnutrition. When nutrition intervention is clinically indicated, a variety of approaches are employed., Conclusions: This survey did not find standardized nutrition protocols being employed in the pediatric oncology population. The effect of varied nutrition practices on the quality of life, toxicity, and outcome in children with cancer is unknown. Prior to the initiation of clinical trials, uniform guidelines need to be developed and validated. Future clinical trials need to investigate the most efficacious method of nutrition assessment and intervention and its effect on quality of life, toxicity, and survival in children with cancer. more...
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- 2006
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12. Obesity in pediatric oncology.
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Rogers PC, Meacham LR, Oeffinger KC, Henry DW, and Lange BJ
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- Adolescent, Adult, Age Factors, Antineoplastic Combined Chemotherapy Protocols adverse effects, Body Mass Index, Bone Marrow Transplantation, Child, Child, Preschool, Female, Humans, Life Style, Male, Recurrence, Treatment Outcome, Leukemia, Myeloid, Acute complications, Leukemia, Myeloid, Acute mortality, Leukemia, Myeloid, Acute therapy, Obesity complications, Obesity mortality, Obesity therapy, Precursor Cell Lymphoblastic Leukemia-Lymphoma complications, Precursor Cell Lymphoblastic Leukemia-Lymphoma mortality, Precursor Cell Lymphoblastic Leukemia-Lymphoma therapy
- Abstract
Today's obesity pandemic began in the United States, spread to Western Europe and other developed regions, and is emerging in developing countries. Its influences on outcomes of childhood cancer are unknown. A recent Children's Oncology Group symposium considered epidemiology of obesity, pharmacology of chemotherapy and outcomes in obese adults with cancer, excess mortality in obese pediatric patients with acute myeloid leukemia (AML), and complications in obese survivors. The salient points are summarized herein. Body mass index (BMI) is the accepted index of weight for height and age. In the US, obesity prevalence (BMI > 95th centile) is increasing in all pediatric age groups and accelerating fastest among black and Hispanic adolescents. Pharmacologic investigations are few and limited: half-life, volume of distribution, and clearance in obese patients vary between drugs. Obese adults with solid tumors generally experience less toxicity, suggesting underdosing. For patients undergoing bone marrow transplantation, obese adults generally experience greater toxicity. In pediatric acute myeloblastic leukemia, obese patients have greater treatment-related mortality (TRM), similar toxicity and relapse rates, and inferior survival compared with patients who are not obese. An excess of female survivors of childhood leukemia who received cranial irradiation are obese. Ongoing treatment effects of childhood cancer may predispose to a sedentary lifestyle. These findings call for measures to prevent obesity, retrospective and prospective studies of chemotherapy pharmacology of analyzed according to BMI and outcomes, additional studies of the obesity impact on outcomes in pediatric cancer, and promotion of a healthy lifestyle among survivors., (2005 Wiley-Liss, Inc.) more...
- Published
- 2005
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