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Endocrine Therapies
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
Adjuvant drug therapy may include the use of chemotherapy, molecularly targeted agents, endocrine therapy, bisphosphonate agents, or the use of biological agents (e.g., antibodies). The decision to use adjuvant drug therapy is usually based on factors including disease prognosis, the risks and benefits of treatment, and predictive factors such as the status of key biomarkers such as the estrogen (ER) and progesterone (PR) receptors, and the presence or absence of HER2. Patients who have low or negligible levels of these three biomarkers are described as having “triple negative” breast cancer (i.e., they are ER-ve/PR-ve/HER2-ve), and this is considered one of the most challenging conditions to successfully treat. There are also a growing number of sophisticated assays available (e.g., Oncotype DXTM, MammostatTM, and MammaPrintTM) to assist clinicians with evaluating prognosis and disease progression through the analysis of mutation profiles in multiple genes, and these are described in Chapter 10.
Cranial Neuropathies I, V, and VII–XII
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Some patients require more than one medication for symptom control, and 25–50% of patients eventually stop responding to drug therapy. For these patients, one of several surgical procedures can be undertaken. These include percutaneous procedures on the gasserian ganglion, and procedures performed on the trigeminal root including stereotactic radiosurgery and microvascular decompression (MVD).22 MVD offers the longest duration of pain relief; however, no clinical trials have established the efficacy of any of these surgical procedures.26
The People and Their Drugs
Published in Mickey C. Smith, E.M. (Mick) Kolassa, Walter Steven Pray, Government, Big Pharma, and the People, 2020
Mickey C. Smith, E.M. (Mick) Kolassa, Walter Steven Pray
As valuable as the sick role model is for understanding patient behavior, it should be clear that it does not apply to all cases. How, for example, is the chronically ill patient to “recover?” Indeed, such people cannot, but they can adopt a chronic illness role. This role is frequently a difficult one and medication may be not only part of the solution but also part of the problem. The benefits of Drug therapy that works are most easily understood as the elimination of problems.
The predictive value of MiR-221 in cancer chemoresistance: a systematic review and meta-analysis
Published in Expert Review of Anticancer Therapy, 2023
Yuxi Liu, Jingwen Li, Junying Li, Han Yan, Bing Qiao, Yadan Wang, Yu Hu, Chunyan Sun
Human cancers are a large group of malignant diseases, which cause incalculable economic and social burdens all over the world. According to the GLOBOCAN, there were approximately 18.1 million new cancer cases and 9.6 million deaths from cancer in 2018 [1]. Drug therapy is one of the most common approaches in cancer treatment. In the past few decades, with the fast development of drug therapy strategies, including endocrine therapies, targeted drugs, and immunotherapies, the prognosis of cancer patients has been largely improved [2]. However, many cancer patients develop drug resistance during continuous drug application and disease progression. Drug resistance becomes a major obstacle in cancer treatment, and it is necessary to explore the functional molecules underlying drug resistance to identify the biomarkers and develop novel therapeutic targets.
Is My E/M Visit Separately Billable?
Published in Oncology Issues, 2022
But what if there has been a change in the patient or there is no pre- or post-surgical period attached to the E/M visit? In these scenarios, providers may have an opportunity to bill for the E/M visit, in addition to any of the other services delivered on that same day. In the below scenarios, providers can bill a separate E/M visit, but they must also review new or recent diagnostic findings and/or results with the patient:The patient presents with a new problem or complaint. Examples include bone pain, dizziness, cognitive changes, deep vein thrombosis, or plural effusion symptoms.The patient presents with a side effect to their drug therapy, requiring assessment, intervention, or a new prescription. Examples include nausea, pain, fever, diarrhea, or mouth sores.There is a change in the drug therapy treatment plan that requires a discussion with the patient. Examples include need for new drug regimen, palliative care, or hospice.The patient has an adverse drug reaction, requiring assessment and/or intervention by the provider.
Comparing Aerobic Exercise with Yoga in Anxiety Reduction: An Integrative Review
Published in Issues in Mental Health Nursing, 2022
Amanda K. Cole, Tamera Pearson, Mary Knowlton
Anxiety disorders are often underrecognized and undertreated by primary care physicians (Bandelow et al., 2017). First line pharmacological treatment for anxiety disorders are selective serotonin reuptake inhibitors (SSRIs) and selective serotonin norepinephrine reuptake inhibitors (SNRIs) (Bandelow et al., 2017). Common side effects from both classes of medication include nausea, restlessness, headache, fatigue, increased or decreased appetite, weight gain, tremor, sexual dysfunction (Bandelow et al., 2017). The onset of these side effects is most prevalent in the first two weeks of drug therapy and can lead to medication noncompliance or discontinuation of the medication altogether (Bandelow et al., 2017; Mason et al., 2019). There is also a risk of treatment failure with medications and often a requirement for more than one pharmacologic medication to manage anxiety. The first line nonpharmacologic treatment is cognitive behavioral therapy (CBT) in which a trained therapist helps correct distorted, maladaptive beliefs using thought exercises or real experiences to facilitate symptom reduction and improve functioning (Lebow, 2020). For CBT to work, the person needs to be highly motivated and willing to dedicate effort, both in and out of therapy sessions. Unfortunately, there is still an element of cultural disproval of psychotherapy that may hinder someone from seeking this type of treatment (Mason et al., 2019).