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Sahgal A, Myrehaug S, Siva S, Masucci L, Foote M, Brundage M, Butler J, Chow E, Fehlings M, Gabos Z, Greenspoon J, Kerba M, Lee Y, Liu M, Maralani P, Thibault I, Wong R, Hum M, Ding K, Parulekar W. CCTG SC.24/TROG 17.06: A Randomized Phase II/III Study Comparing 24Gy in 2 Stereotactic Body Radiotherapy (SBRT) Fractions Versus 20Gy in 5 Conventional Palliative Radiotherapy (CRT) Fractions for Patients with Painful Spinal Metastases. Int J Radiat Oncol Biol Phys 2020; 108:1397-1398. [DOI: 10.1016/j.ijrobp.2020.09.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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McLennan A, Kerba M, Subnis U, Campbell T, Carlson LE. Health care provider preferences for, and barriers to, cannabis use in cancer care. ACTA ACUST UNITED AC 2020; 27:e199-e205. [PMID: 32489269 DOI: 10.3747/co.27.5615] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Limited research has been conducted about the perspectives of oncology health care providers (hcps) concerning the use of cannabis in cancer care and their potential role in advising patients. We sought to determine the barriers encountered by hcps with respect to medical cannabis and their preferred practices in this area. Methods An anonymous survey about cannabis was distributed to oncology hcps at the Tom Baker Cancer Centre in Calgary, Alberta. The 45-question survey measured the opinions of hcps about cannabis use and authorization in oncology. Results Of 103 oncology hcps who participated in the study, 75% were women. By hcp type, the most commonly reported professional groups were oncology nurse (40%), radiation therapist (9%), and pharmacist (6%). Of respondents, 75% reported providing direct care to cancer patients. More than half (69%) had spoken to a patient about cannabis in the preceding month, and 84% believed that they lacked sufficient knowledge about cannabis to make recommendations. Barriers such as monitoring the patient's use of cannabis (54%), prescribing an accurate dose (61%) or strain (53%), and having insufficient research (50%) were most commonly reported. More than half of hcps (53%) would be interested in receiving more information or training about the use of cannabis in oncology. Conclusions The survey indicated that this group of oncology hcps believed that they lacked sufficient knowledge about cannabis to make recommendations to patients. In addition to that lack of knowledge, a number of notable barriers were reported, and more than half the hcps indicated interest in learning more about cannabis in the future.
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Affiliation(s)
- A McLennan
- Department of Psychosocial Oncology, Holy Cross Cancer Centre, University of Calgary, Calgary, AB
| | - M Kerba
- Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB
| | - U Subnis
- Department of Psychosocial Oncology, Holy Cross Cancer Centre, University of Calgary, Calgary, AB
| | - T Campbell
- Department of Psychosocial Oncology, Holy Cross Cancer Centre, University of Calgary, Calgary, AB
| | - L E Carlson
- Department of Psychosocial Oncology, Holy Cross Cancer Centre, University of Calgary, Calgary, AB
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Kerba M. Strong reasons make strong actions: medical cannabis and cancer-a call for collective action. ACTA ACUST UNITED AC 2019; 26:160-161. [PMID: 31285657 DOI: 10.3747/co.26.5127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Call it cannabis, not marijuana or weed [...]
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Affiliation(s)
- M Kerba
- Tom Baker Cancer Centre and Cumming School of Medicine, University of Calgary, Calgary, AB
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Earp MA, Sinnarajah A, Kerba M, Tang PA, Rodriguez-Arguello J, King S, Watanabe SM, Simon JE. Opportunity is the greatest barrier to providing palliative care to advanced colorectal cancer patients: a survey of oncology clinicians. ACTA ACUST UNITED AC 2018; 25:e480-e485. [PMID: 30464700 DOI: 10.3747/co.25.4021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Palliative care (pc) is part of the recommended standard of care for patients with advanced cancer. Nevertheless, delivery of pc is inconsistent. Patients who could benefit from pc services are often referred late-or not at all. In planning for improvements to oncology pc practice in our health care system, we sought to identify barriers to the provision of earlier pc, as perceived by health care providers managing patients with metastatic colorectal cancer (mcrc). We used the Michie Theoretical Domains Framework (tdf) and Behaviour Change Wheel (bcw), together with knowledge of previously identified barriers, to develop a 31-question survey. The survey was distributed by e-mail to mcrc health care providers, including physicians, nurses, and allied staff. Responses were obtained from 57 providers (40% response rate). The most frequently cited barriers were opportunity-related-specifically, lack of time, of clinic space for consultations, and of access to specialist pc staff or services. Qualitative responses revealed that resource limitations varied by cancer centre location. In urban centres, time and space were key barriers. In rural areas, access to specialist pc was the main limiter. Self-perceived capability to manage pc needs was a barrier for 40% of physicians and 30% of nurses. Motivation was the greatest facilitator, with 89% of clinicians perceiving that patients benefit from pc. Based on the Michie tdf and bcw model, interventions that best address the identified barriers are enablement and environmental restructuring. Those findings are informing the development of an intervention plan to improve oncology pc practices in a publicly funded health care system.
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Affiliation(s)
- M A Earp
- W21C Research and Innovation Centre, Cumming School of Medicine, Calgary, AB
| | - A Sinnarajah
- Department of Oncology, University of Calgary, Calgary, AB.,Department of Community Health Sciences, University of Calgary, Calgary, AB.,Department of Family Medicine, University of Calgary, Calgary, AB
| | - M Kerba
- Department of Oncology, University of Calgary, Calgary, AB
| | - P A Tang
- Department of Oncology, University of Calgary, Calgary, AB
| | | | - S King
- Division of Internal Medicine, Department of Medicine, University of Calgary, Calgary, AB
| | - S M Watanabe
- Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB
| | - J E Simon
- Department of Oncology, University of Calgary, Calgary, AB.,Department of Community Health Sciences, University of Calgary, Calgary, AB.,Division of Internal Medicine, Department of Medicine, University of Calgary, Calgary, AB
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Martell K, Fairchild A, LeGerrier B, Sinha R, Baker S, Liu H, Ghose A, Olivotto IA, Kerba M. Rates of cannabis use in patients with cancer. ACTA ACUST UNITED AC 2018; 25:219-225. [PMID: 29962840 DOI: 10.3747/co.25.3983] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background A comprehensive assessment of cannabis use by patients with cancer has not previously been reported. In this study, we aimed to characterize patient perspectives about cannabis and its use. Methods An anonymous survey about cannabis use was offered to patients 18 years of age and older attending 2 comprehensive and 2 community cancer centres, comprising an entire provincial health care jurisdiction in Canada (ethics id: hreba-17011). Results Of 3138 surveys distributed, 2040 surveys were returned (65%), with 1987 being sufficiently complete for analysis (response rate: 63%). Of the respondents, 812 (41%) were less than 60 years of age; 45% identified as male, and 55% as female; and 44% had completed college or higher education.Of respondents overall, 43% reported any lifetime cannabis use. That finding was independent of age, sex, education level, and cancer histology. Cannabis was acquired through friends (80%), regulated medical dispensaries (10%), and other means (6%). Of patients with any use, 81% had used dried leaves.Of the 356 patients who reported cannabis use within the 6 months preceding the survey (18% of respondents with sufficiently complete surveys), 36% were new users. Their reasons for use included cancer-related pain (46%), nausea (34%), other cancer symptoms (31%), and non-cancer-related reasons (56%). Conclusions The survey demonstrated that prior cannabis use was widespread among patients with cancer (43%). One in eight respondents identified at least 1 cancer-related symptom for which they were using cannabis.
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Affiliation(s)
- K Martell
- Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary
| | - A Fairchild
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton
| | - B LeGerrier
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton
| | - R Sinha
- Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary
| | - S Baker
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton
| | - H Liu
- Department of Oncology, Central Alberta Cancer Centre, University of Calgary, Calgary; and
| | - A Ghose
- Department of Oncology, Jack Ady Cancer Centre, University of Calgary, Calgary, AB
| | - I A Olivotto
- Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary
| | - M Kerba
- Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary
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Alghamdi M, Taggar A, Kerba M, Tilley D, Kostaras X, Sia M. A Slippery Slope? Declining Radiation Oncology Referral Rates in Alberta for High-Risk Prostate Cancer Between 2005 and 2012. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Taggar A, Alghamdi M, Tilley D, Kostaras X, Kerba M, Sia M. Assessing Guideline Adherence: Referral Patterns of Post Prostatectomy Patients to Radiation Oncologists. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kerba M, Miao Q, Zhang-Salomons J, Mackillop W. Defining the Need for Prostate Cancer Radiotherapy in the General Population: a Criterion-based Benchmarking Approach. Clin Oncol (R Coll Radiol) 2010; 22:801-9. [DOI: 10.1016/j.clon.2010.07.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2010] [Revised: 05/13/2010] [Accepted: 07/13/2010] [Indexed: 11/17/2022]
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Caissie A, Zhang L, Clemons M, Fairchild A, Kerba M, Vassiliou V, Nguyen J, Sahgal A, Culleton S, Chow E. An International Study of EORTC BM22 and C15 Symptom/quality of Life Scores Showing Association with Radiation Response of Bone Metastases. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kerba M, Wu J, Cheetham K, Mckimmon E, Taylor M, Hagen N. Utilization of Radiotherapy for Palliation of Bone Metastases: Review of Fractionation and Site of Treatment during a 3-Year Period at a Regional Cancer Centre. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Wu J, Kerba M, Cheetham K, Eigl B, Hagen N. Utilization of Radiotherapy for Palliation of Bone Metastases: A 3-Year Patterns of Practice Study at a Regional Cancer Centre. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kerba M, Miao Q, Zhang-Salomons J, Mackillop W. Defining the Need for Breast Cancer Radiotherapy in the General Population: a Criterion-based Benchmarking Approach. Clin Oncol (R Coll Radiol) 2007; 19:481-9. [PMID: 17467249 DOI: 10.1016/j.clon.2007.03.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2006] [Revised: 02/22/2007] [Accepted: 03/06/2007] [Indexed: 11/16/2022]
Abstract
AIMS Determining the appropriate rate of radiotherapy is important for ensuring optimal radiotherapy utilisation and accessibility. A criterion-based benchmark (CBB) was developed for estimating the need for radiotherapy in incident breast cancer cases. Our primary objective was to compare an evidence-based estimate (Ebest) of need against the CBB. These estimates were then compared with radiotherapy rates in Ontario, Canada and the USA. Surgical rates were also examined. MATERIALS AND METHODS Benchmarks were defined in Ontario as communities in proximity to cancer centres and without long waiting lists. Patient data from 1997 to 2001 were prospectively collected from radiotherapy cancer centres. Surgical data were obtained from the Canadian Institute for Health Information database. The public use file of Surveillance, Epidemiology and End Results (SEER) described treatment in the USA. RESULTS In total, 4241 cases of breast cancer were diagnosed in benchmark communities. The overall radiotherapy rate by Ebest was 64.0% (95% confidence interval: 58.1-69.8%) compared with the CBB of 60.7% (59.3-62.1%). In comparison, Ontario's overall radiotherapy rate was 55.6% (55.0-56.1%) and in SEER it was 49.3% (48.9-49.6%). Adjuvant radiotherapy rates after lumpectomy were 100% in Ebest and 83.6% (82.0-85.1%) by the CBB. The Ebest and CBB post-mastectomy rates were 21.9% (20.6-23.3%) and 34.6% (32.5-36.7%), respectively. Observed post-lumpectomy radiotherapy rates were 75.1% in Ontario and 65.3% in SEER. Post-mastectomy radiotherapy rates were 29.5% in Ontario and 17.0% in SEER. CONCLUSIONS CBB provides a reasonable estimate of the overall need for radiotherapy in breast cancer. Observed radiotherapy rates in Ontario and the USA suggest an age-related decrease in the use of radiotherapy. The benchmark estimate suggests a shortfall of adjuvant breast radiotherapy utilisation in Ontario.
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Affiliation(s)
- M Kerba
- Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Ontario, Canada
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