Job stress and satisfaction among the staff members at a cancer center

Article Abstract:

Factors influencing job stress and staff turnover in oncology (cancer) units are of considerable interest. The author describes the responses of staff members to questions about the rewards and stresses that influence job satisfaction at the Dana-Farber Cancer Institute in Boston, MA. Almost all subjects reported high job satisfaction, with the sole exception being pediatric social workers, who reported only moderate rates of job satisfaction. The most important goals and rewards of both nurses and physicians stemmed from: (1) control of disease, (2) emotional care given to patients, and (3) teaching and informing both patients and staff members. Physicians were more likely to place a higher emphasis on cure-treatment goals than nurses. Physicians reported being greatly influenced by their clinical training, especially by in-house staff physicians. Nurses were more influenced by formal classroom and integrated class-clinical experiences. Staff members frequently cited the great emotional involvement they developed with "special patients," particularly those patients under their care for long periods of time. One third of the staff thought that it was possible to be a friend with a patient and still maintain their professional relationship; some physicians even thought that befriending patients was an appropriate role when they no longer were responsible for the treatment decisions affecting a specific patient. By far, helping patients was the greatest reward related to working in the cancer center. Interdisciplinary teamwork was the aspect of the work environment that was most often identified as helping staff members achieve goals. Staffing limitations and time constraints were the aspect of the work environment that interfered most in achieving goals. Staff turnover, which was high in some disciplines, was not reported as a major source of discomfort within the work environment. Over 80 percent of the staff reported a "change in attitude" toward cancer and working with cancer patients within the first two years at the cancer center. It was also reported in this study that differences in attitude, training, and orientation between nurses and physicians were not a major source of stress.

Psychological aspects, Job stress, Job satisfaction, Nurse and physician, Nurse-physician relationship, Burn out (Psychology), Medical personnel and patient, Medical personnel-patient relations

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Cancer chemotherapy after solid organ transplantation

Article Abstract:

The drug cyclosporine suppresses the rejection of transplanted organs, and its introduction has brought about a great increase not only in the probability of successful transplantation but also in the total number of transplantations. So great, in fact, is the success of organ transplantation that it is now being considered as a possible treatment in some types of cancer. The surgical removal of a cancer prior to its metastatic spread may yield improved disease-free survival. When conventional surgical removal is not possible, as when the tumor mass is distributed throughout the liver or when cancer cells are in the wall of the heart, transplantation may be the only possible surgical solution. However, concern has been raised about the possible deleterious effects of combining the immunosuppressive drugs (such as cyclosporine) necessary to prevent transplant rejection with the chemotherapeutic agents necessary to kill cancer cells which might be left behind. The chemotherapeutic drugs might directly injure the newly transplanted organ, might complement the immunosuppressive drugs and result in excessive immunosuppression, or might result in an unacceptable risk of sepsis (major infection). The cases of five children (aged 1 to 12 years) now illustrate that, though these concerns are valid, they will not prevent the effective use of chemotherapy in transplant patients. Four patients receiving liver transplants and one receiving a heart transplant were given chemotherapy after the surgical removal of the affected organ and transplantation of a donor organ. One patient died of liver rejection, but the rejection was observed to have begun even prior to the administration of chemotherapy. One patient developed lymphoproliferative disease which persisted even after the immunosuppressive drugs were withdrawn; this patient died of sepsis after a bone marrow transplantation. One patient remains alive without evidence of disease 21 months after her transplantation. The results indicate that transplantation surgery followed by chemotherapy may be a therapeutic option in some cases of cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Complications and side effects, Physiological aspects, Chemotherapy, Transplantation of organs, tissues, etc., Organ transplantation, Tissue transplantation, Transplantation, Immunosuppressive agents, Cyclosporine, Cyclosporins

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The selective killing effect of special wavelength light in the treatment of human superficial cancer

Article Abstract:

Thirty-four patients with a variety of superficial cancers were treated by irradiation with light. All the tumors were carcinomas, and all were accessible to irradiation from the surface. The cancers were irradiated with wavelengths comparable to those emitted by an electric light bulb. A power density of between one and six watts per square centimeter was used. Cycles of three to five minutes for each square centimeter of tumor area were repeated every other day for a week, and then biweekly until the tumor died and fell off. This generally took 15 treatments. The authors state that 28 cases were cured using this method, and attribute the method's success to the greater absorbance of cancer tissue for light compared with normal tissue. In addition, the authors point out that the temperature at the tumor surface was measured to be roughly 60 degrees centigrade. Therefore, hyperthermia is responsible for at least a portion of the therapeutic effect (42-45 degrees is fatal for most cells). The authors also mention that the method is currently in use in the seven hospitals in China where this research took place. (Consumer Summary produced by Reliance Medical Information, Inc.)

Thermotherapy, Phototherapy

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