Neoplasms Commons^™

Pain Management In Nursing Home Residents With Cancer And Dementia With And Without Hospice Services, Todd Bryant Monroe

Theses and Dissertations (ETD)

Aims: We sought to identify differences in pain management between two groups; nursing home residents with malignant cancer and dementia with and without hospice services.

Methods: Decedent records from 2003-2009 were assessed for diagnosis of dementia and cause of death as cancer. Ten malignant cancer diagnoses were determined a priori from the CDC 2004 data on the top 10 malignant cancers for all races and genders. Fifty-five decedents from 10 nursing homes were included in the final sample. Four instruments were used: Minimum Data Set (MDS) a standardized assessment tool required of most U.S. nursing homes. A large …

Pax5 Haploinsufficiency Cooperates With Bcr-Abl1 To Induce Acute Lymphoblastic Leukemia, Christopher B. Miller

Theses and Dissertations (ETD)

Acute lymphoblastic leukemia (ALL) is the commonest pediatric malignancy and comprises several distinct subtypes each with its own unique pathogenesis, clinical behavior, and response to therapy. Chromosomal aberrations are a hallmark of ALL but alone fail to induce leukemia. Pediatric ALLs can be divided into several categories based on the expression of several genetically conserved chromosomal translocations including the t(9,22)[BCR-ABL1], t(1,19)[TCF3-PBX1], t(12,21)[ETV6-RUNX1], MLLrearranged leukemia’s, hyperdiploid and hypodiploid karyotypes, and T-lineage leukemia. Each translocation confers a characteristic transforming phenotype within the cell in which it originates but is alone insufficient to induce overt leukemia. …

The Role Of Inflammation In The Early Radiation Response, Christy Marie Wilson

Theses and Dissertations (ETD)

Radiation is one of the principal treatments for adults and children with brain tumors, and is one of the oldest established treatments for tumors of all types. Currently, the limiting factor for the use of radiation is the effect on normal tissue adjacent to the tumor. Toxicity, including early and late effects from radiation, limits the dose administered to the tumor and reduces the probability of cure. This work has three aims in its attempt to understand and limit early radiation damage: characterize the role of the inflammatory molecules tumor necrosis factor alpha (TNF) and intracellular adhesion molecule-1 (ICAM-1) in …

The Combined Effect Of In-Situ Tumor And Irradiation On Peritumoral Brain Vasculature, Janice Ann Zawaski

Theses and Dissertations (ETD)

In the USA, 200,000 brain tumors are diagnosed each year with glioma representing 8.4% of the 200,000. The standard treatment for glioma consists of surgical resection, when possible, followed by radiation therapy (RT) and/or chemotherapy. Radiation therapy is one of the most effective treatments of brain tumors; however, the therapeutic ratio of RT is limited by damage to the normal tissue. We hypothesize that tumor growth has an adverse effect on the peritumoral tissue through the angiogenic/inflammatory environment it creates rendering it susceptible to further damage by RT which may be prevented by using anti-angiogenic/anti-inflammatory agents. We have developed a …

Manipulation Of The Moloney Murine Leukemia Virus Envelope Protein In An Effort To Develop Directly And Indirectly Targeted Retroviral Vectors For Use In Human Gene Therapy, Geneva M. Vasser

Theses and Dissertations (ETD)

Highly effective, targeted therapies against cancer would revolutionize the way people recover from this devastating illness. Gone would be the lingering side effects of the current non-specific treatments and in their place would be faster recovery times, better quality of life both during and after treatment, and less ambiguity about whether or not treatment was effective. This concept will elude modern medicine until treatments can be tailored to the patient's individual and unique disease. This concept of a transient, targeted, and tailored vehicle aimed at cancer cells lends itself to the use of replication deficient retroviral gene therapy vectors with …

Molecular Profile Of Women With And Without Secondary Breast Cancer After The Treatment Of Pediatric Hodgkin Lymphoma, Belinda Neal Mandrell

Theses and Dissertations (ETD)

dentification of genetic risk factors associated with the development of secondary cancers would facilitate identification of at risk patients and permit modification of therapy and heightened surveillance that may reduce cancer-related morbidity and mortality. Women survivors of pediatric Hodgkin lymphoma (HL) have an increased risk of morbidity and mortality associated with secondary effects of therapy, with a 35-75 fold excess risk of developing breast cancer over the general population. The mechanism for secondary breast cancer among Hodgkin survivors is not understood. Researchers have postulated that the familial characteristics of HL could be associated with mutations found within familial cancer syndromes; …

Sleep, Fatigue And Caregiver Burden In Parents Of Children With Acute Lymphoblastic Leukemia (All), Jerithea Tidwell

Theses and Dissertations (ETD)

Parents often report that their child diagnosed with acute lymphoblastic leukemia (ALL) and receiving steroid therapy experience altered sleep patterns, fatigue, irritability, and other behavioral changes. As a consequence, parents may experience altered sleep, fatigue, and increased caregiver burden. If so, the differences seen in parental sleep efficiency and sleep duration may be attributed to the child experiencing altered sleep secondary to receiving dexamethasone. The purpose of this study was to describe, caregiver sleep, fatigue, and caregiver burden immediately before and during their child’s dexamethasone pulse in continuation therapy for ALL and to compare parent quality of sleep and fatigue …

Uncovering P53 Mutations And Abnormal Gene Expression In Pediatric Adrenocortical Cancer, Alina Nico West

Theses and Dissertations (ETD)

Pediatric adrenocortical cancer is extremely rare and often fatal (approximately 0.3-0.4 cases per million worldwide; 50% 5-year survival). The incidence of pediatric adrenocortical cancer in southern Brazil is 10-15 times higher than the worldwide incidence. Due to the rarity of adrenocortical cancer, especially in children, underlying gene dysregulation and mechanisms of tumorigenesis of the adrenal gland are very poorly described in the literature. However, it is well-known that the tumor suppressor p53, which is mutated in over 50% of all human cancers, is commonly mutated in pediatric adrenocortical cancer. In addition, evidence strongly suggests that if a child has adrenocortical …

The Role Of Multi-Drug Resistance Associated Protein 4 And P-Glycoprotein In Resistance Of Neuroblastoma To Topotecan And Irinotecan, Patricia Kellie Turner

Theses and Dissertations (ETD)

High-risk neuroblastoma presents a significant therapeutic challenge because the 5-year survival rate remains less than 30% despite the use of surgery, multi-agent chemotherapy, radiation, and autologous bone marrow transplant. Novel therapeutic modalities are under development. The camptothecin analogs topotecan and irinotecan have been identified as successful cytotoxic agents. For topotecan, pharmacokinetically guided dosing to achieve a systemic exposure associated with preclinical anti-tumor activity in neuroblastoma xenograft models is feasible and has elicited favorable responses in children with high-risk neuroblastoma. However, some children with high-risk disease did not respond to the putatively effective topotecan systemic exposure. These children represent a subset …

Dental Maturation In Children Treated For Acute Lymphocytic Leukemia, Michael Grey Weathersby

Theses and Dissertations (ETD)

Acute lymphocytic leukemia (ALL) is a life-threatening disease primarily affecting children. Treatment currently consists of chemotherapy sometimes in combination with head irradiation. The literature documents the damage of treatment to the teeth (e.g., congenital absence, microdontia, abnormal crown- root ratios). The present study assessed the effects of treatment for ALL on the tempos of dental maturation (i.e., dental age) in a mixed longitudinal sample of 72 children treated for ALL at St Jude's Children's' Research Hospital, Memphis, Tennessee. Panoramic radiographs had been taken as indicated to assess and maintain dental health in this retrospective study. Dental age was quantified both …

Hand-Wrist Bone Age In Children Treated For Acute Lymphoblastic Leukemia, Mary Elizabeth Martin

Theses and Dissertations (ETD)

Acute Lymphoblastic Leukemia (ALL) is the most common malignancy of childhood, constituting 31 percent of all childhood malignancies. Treatment strategies to target ALL include chemotherapeutic agents, irradiation of the neck and/or spine, and bone marrow transplantation. The aggressive nature of antineoplastic therapies often produces numerous craniofacial and dental sequelae as well as additional harmful effects to the entire body. Cranial irradiation may adversely affect the hypothalamic-pituitary axis decreasing growth hormone production. Consequently, children with ALL may experience a transient or permanent reduction in growth iatrogenically. Hand-wrist radiographs are valuable for evaluating maturational status in children with ALL. These radiographs allow …