Some drugs used to treat cancer raise a patient's risk of febrile neutropenia. Febrile neutropenia is a condition that involves a fever and a low number of neutrophils (a type of white blood cell) in the blood. Having a low number of neutrophils puts a patient at risk of infection. Colony-stimulating factors (CSFs) are medications sometimes given to patients getting cancer treatment to prevent or treat febrile neutropenia. CSFs are given as an injection under the skin or into a vein.
Current guidelines say that doctors should give CSF during cancer treatment based on how likely it is that the drugs will raise the risk of febrile neutropenia. Research shows that many doctors do not follow these guidelines. This may be harming patients. Underuse of CSFs can raise a patient's risk for febrile neutropenia. Overuse or unneeded use of CSFs can lead to side effects, like bone and muscle pain, but give no benefit and can be costly to the patient.
In some clinics there is an automated system that helps doctors decide when to use CSFs. The system prescribes CSFs when there is a high risk that the drugs will cause febrile neutropenia. It does not prescribe CSFs when there is a low risk that the drugs will cause febrile neutropenia. The research study team wants to find out if this type of system can help doctors use CSF when it is needed and not use it when it is not needed. The study team also wants to learn about the benefits and risks of using CSF with cancer treatment drugs that have a moderate (not high and not low) risk of febrile neutropenia.
Studies have shown that cancer patients may be at high risk for financial problems because of the cost of treatment. These financial problems can be stressful and sometimes might cause patients to avoid or refuse treatment. We want to measure how often financial problems happen in patients with colorectal cancer, using questionnaires that collect information about finances and quality of life. In order to get a full picture of the financial impact of colorectal cancer, we also want to collect credit reports for all patients in this study.
A majority of patients diagnosed with cancer are over age 65, yet most cancer treatments are developed in a younger population. Older cancer patients are more likely to experience side effects. There is no standard way to treat chemotherapy side effects in older patients. A Geriatric Assessment (GA) can be used to predict who is at risk for side effects but there is no standard way to decrease this risk. Also, there is not agreement on how information from a GA can be used to develop ways to prevent or treat side effects.
The purpose of this study is to find out if the GA can help improve and develop a standard approach for reducing and/or preventing chemotherapy side effects in older cancer patients. The GA is intended to determine an older patient's level of independence taking into account health conditions, physical performance (walking, leg strength, and balance), nutrition, social support and memory. Several tests as well as questionnaires are used. The combined results establish what is called a patient's functional age, which may be quite different from the actual age. Functional age can help better predict a patient's tolerance of and likely response to cancer treatments as well as provide other important age-related information not routinely captured by cancer doctors. If you decide to participate in this study, you will receive the GA.
The purpose of this study is to test whether patients undergoing a breast MRI (magnetic resonance imaging) before breast surgery will have better results after the surgery.
MRI is a medical imaging method that uses magnets to make images of the body. MRI helps doctors to tell the difference between cancer and normal tissue in the body. MRI uses dyes ("contrast agents") that are injected into the veins to help create the images of the body's tissues.
Breast tumors are routinely evaluated using mammograms and ultrasound before surgery. This study would like to find out if using MRI in addition to mammography before surgery improves our ability to evaluate tumors and decide what kind of surgery is best for the patient.