Rajiv Samant - Academia.edu (original) (raw)

Papers by Rajiv Samant

Journal of Clinical Oncology, May 20, 2020

e19249 Background: Healthcare providers (HCPs) strive to maximize the experience for cancer patie... more e19249 Background: Healthcare providers (HCPs) strive to maximize the experience for cancer patients. Published reports suggest a variety of characteristics that are considered important. We decided to survey our patients undergoing radiotherapy to determine what they considered desirable traits and characteristics. Methods: An ethics approved 35-item patient satisfaction survey evaluating respondent experience was developed by an interdisciplinary team of HCPs working in the radiation medicine program. It was an anonymous, voluntary, paper-based survey for self-completion. It evaluated a variety of domains with respect to the quality of care patients received, and was administered to patients undergoing radiotherapy. Results: A total of 199 patients completed the survey. The median age was 68, with approximately 54% women and 45% men (1% unreported). Most patients (85%) had been diagnosed with their cancer within the previous year, and the commonly reported malignancies (61%) were breast, prostate and lung cancers. Almost all (95%) “agreed" or "strongly agreed" about the importance of physicians being sensitive and compassionate. Over 90% felt they received adequate explanations about their treatment, and had their questions answered. The vast majority (93%) felt included in the decision-making process. They reported the 5 most important qualities among the HCPs as follows (in descending order): knowledge, kindness, honesty (answering questions/giving information), good communicator and cheerful attitude. Most (>70%) reported feeling connected with their HCPs. Although overall satisfaction was high, there were areas for improvement identified. These included patients being offered future appointments to discuss their diagnosis and treatment, receiving information about clinical trials and other treatment options, and being given contact information for psychosocial and community resources. Also, HCPs tended to focus mainly on the physical needs of patients and to a lesser degree on their emotional needs, but spiritual and cultural needs were not routinely addressed (<10%). Conclusions: Reassuringly, cancer patients receiving radiation report high rates of satisfaction across many aspects of their care. The qualities most appreciated serve as a reminder to clinicians that their role is more than just that of a medical expert. These findings also reinforce the different aspects of holistic care that can be improved.

International Journal of Radiation Oncology Biology Physics, Oct 1, 2017

Pain Research & Management, 2012

Current Oncology, Aug 1, 2012

Conclusions Although conformal radiotherapy alone for localized prostate cancer had no effect on ... more Conclusions Although conformal radiotherapy alone for localized prostate cancer had no effect on serum hemoglobin, testosterone, or erythropoietin, tab led to a significant decline in testosterone, which was followed by decline in hemoglobin that was not a result of a deficiency of erythropoietin.

Journal of Cancer Education, Mar 16, 2010

Shared decision making (SDM) and effective communication are essential components of cancer care.... more Shared decision making (SDM) and effective communication are essential components of cancer care. Residents in oncology-related specialties were surveyed about communication skills and SDM. The response rate was 77% (17/22), and 93% stated that communication skills were very important for their specialty. Most (76%) thought their communication skills were adequate, but areas of difficulty included discussing end-of-life issues, giving hope when the prognosis was bleak and dealing with hostile patients. Only 58% of respondents had heard the term SDM, and 29% were aware of its meaning. More SDM and communication training are required for future oncology physicians.

Breast Journal, Nov 1, 2001

The purpose of this study was to compare the characteristics of primary breast cancers (PBCs) and... more The purpose of this study was to compare the characteristics of primary breast cancers (PBCs) and metachronous contralateral breast cancers (MCBCs). Between 1984 and 1996, 236 women treated with curative intent for PBC who developed a MCBC >6 months after initial diagnosis (without previous evidence of distant metastases) were retrospectively evaluated for clinical and pathologic characteristics and method of diagnosis of their tumors. There were more noninvasive cancers among the MCBCs than the PBCs (11.4% and 5.1%, respectively, p < 0.02). Among the invasive cancers, the mean size of the MCBCs was smaller than the PBCs (1.94 versus 2.55 cm, p < 0.001). MCBCs were more likely than PBCs to be mammographically detected (46.2% versus 19.9%, p < 0.001). Tumor size was correlated with the method of diagnosis. The mean tumor size was 1.39, 2.02, and 2.69 cm for mammogram-, physician-, and patient-detected tumors, respectively. Among patients having axillary lymph node dissections, mammogram- and physician-detected tumors were less likely to have lymph node metastases than patient-detected tumors (22.0% versus 41.2%, p < 0.005). Regular follow-up of breast cancer patients diagnoses MCBCs when they are smaller and less likely to have nodal metastases than PBCs mainly because of early mammographic detection.

Current Oncology, Feb 1, 2010

Breast Cancer Research and Treatment, Mar 1, 1999

CA: A Cancer Journal for Clinicians, Aug 28, 2008

Although cancer management is becoming more structured with disease-specific guidelines and clini... more Although cancer management is becoming more structured with disease-specific guidelines and clinical pathways, many decisions remain complex. Contributing to this complexity is the need to make value tradeoffs between benefits and harms across cancer treatment and/or screening options. Since there is no "best" option for everyone, decisions are defined as being of higher quality when informed with the latest scientific evidence and based on patients' informed values associated with outcomes of options. However, clinicians are not good judges of patients' values, and patients often have inadequate knowledge, unrealistic expectations, and decisional conflict that interfere with their involvement in decision making. Effective approaches to support patient involvement into clinical decisions include clinicians trained in shared decision making, question prompt sheets, patient decision aids, and decision coaching by nurses and other allied health professionals. Based on systematic review of 23 randomized trials of cancer patient decision aids, patients exposed to decision aids are more likely to participate in decision making and achieve higher-quality decisions. This review highlights key historical changes leading to patient involvement in decision making, summarizes evidence on effective interventions to support shared decision making, explores strategies to implement these interventions in oncology practices, and identifies future directions.

Radiotherapy and Oncology, Sep 1, 2022

Radiotherapy and Oncology, Sep 1, 2022

Radiotherapy and Oncology, Sep 1, 2022

Radiotherapy and Oncology, Sep 1, 2022

Case reports in hematology, 2016

Current Oncology, Aug 1, 2020

Radiotherapy and Oncology, Sep 1, 2005

International Journal of Radiation Oncology Biology Physics, Sep 1, 2008

International Journal of Medical Robotics and Computer Assisted Surgery, May 22, 2019

Journal of Cancer Education, Jan 11, 2021

Journal of Palliative Care, Dec 1, 2001

Family physicians play an important role in the management of cancer patients with advanced incur... more Family physicians play an important role in the management of cancer patients with advanced incurable disease (1--6), and palliative care is an area of growing importance in clinical medicine (5-7). However, training and education in palliative care have not been priorities for undergraduate and postgraduate medical education (4,8,9). As a result, many family physicians currently in practice have not been adequately trained for dealing with cancer patients and their palliative care needs (5,10,11). Although specialized palliative care programs are gradually being developed throughout Canada and elsewhere (9,12-14), they cannot fill the role of the primary care physician. Family physicians are still responsible for the care of the vast majority of cancer patients with advanced stage incurable disease (1,4,15,16). Therefore, increasing efforts in the area of education and training will be necessary to better prepare family physicians for dealing with the palliative care needs of their patients (2,4,7,8). The Fraser Valley Cancer Centre (located in Surrey, British Columbia, Canada) has been working to improve palliative care services in its catchment area. In order to determine the educational needs of family physicians regarding palliative care, we decided to do a survey to determine their education, training, and interest in expanding their knowledge.

Journal of Clinical Oncology, May 20, 2020

e19249 Background: Healthcare providers (HCPs) strive to maximize the experience for cancer patie... more e19249 Background: Healthcare providers (HCPs) strive to maximize the experience for cancer patients. Published reports suggest a variety of characteristics that are considered important. We decided to survey our patients undergoing radiotherapy to determine what they considered desirable traits and characteristics. Methods: An ethics approved 35-item patient satisfaction survey evaluating respondent experience was developed by an interdisciplinary team of HCPs working in the radiation medicine program. It was an anonymous, voluntary, paper-based survey for self-completion. It evaluated a variety of domains with respect to the quality of care patients received, and was administered to patients undergoing radiotherapy. Results: A total of 199 patients completed the survey. The median age was 68, with approximately 54% women and 45% men (1% unreported). Most patients (85%) had been diagnosed with their cancer within the previous year, and the commonly reported malignancies (61%) were breast, prostate and lung cancers. Almost all (95%) “agreed" or "strongly agreed" about the importance of physicians being sensitive and compassionate. Over 90% felt they received adequate explanations about their treatment, and had their questions answered. The vast majority (93%) felt included in the decision-making process. They reported the 5 most important qualities among the HCPs as follows (in descending order): knowledge, kindness, honesty (answering questions/giving information), good communicator and cheerful attitude. Most (>70%) reported feeling connected with their HCPs. Although overall satisfaction was high, there were areas for improvement identified. These included patients being offered future appointments to discuss their diagnosis and treatment, receiving information about clinical trials and other treatment options, and being given contact information for psychosocial and community resources. Also, HCPs tended to focus mainly on the physical needs of patients and to a lesser degree on their emotional needs, but spiritual and cultural needs were not routinely addressed (<10%). Conclusions: Reassuringly, cancer patients receiving radiation report high rates of satisfaction across many aspects of their care. The qualities most appreciated serve as a reminder to clinicians that their role is more than just that of a medical expert. These findings also reinforce the different aspects of holistic care that can be improved.

International Journal of Radiation Oncology Biology Physics, Oct 1, 2017

Pain Research & Management, 2012

Current Oncology, Aug 1, 2012

Conclusions Although conformal radiotherapy alone for localized prostate cancer had no effect on ... more Conclusions Although conformal radiotherapy alone for localized prostate cancer had no effect on serum hemoglobin, testosterone, or erythropoietin, tab led to a significant decline in testosterone, which was followed by decline in hemoglobin that was not a result of a deficiency of erythropoietin.

Journal of Cancer Education, Mar 16, 2010

Shared decision making (SDM) and effective communication are essential components of cancer care.... more Shared decision making (SDM) and effective communication are essential components of cancer care. Residents in oncology-related specialties were surveyed about communication skills and SDM. The response rate was 77% (17/22), and 93% stated that communication skills were very important for their specialty. Most (76%) thought their communication skills were adequate, but areas of difficulty included discussing end-of-life issues, giving hope when the prognosis was bleak and dealing with hostile patients. Only 58% of respondents had heard the term SDM, and 29% were aware of its meaning. More SDM and communication training are required for future oncology physicians.

Breast Journal, Nov 1, 2001

The purpose of this study was to compare the characteristics of primary breast cancers (PBCs) and... more The purpose of this study was to compare the characteristics of primary breast cancers (PBCs) and metachronous contralateral breast cancers (MCBCs). Between 1984 and 1996, 236 women treated with curative intent for PBC who developed a MCBC >6 months after initial diagnosis (without previous evidence of distant metastases) were retrospectively evaluated for clinical and pathologic characteristics and method of diagnosis of their tumors. There were more noninvasive cancers among the MCBCs than the PBCs (11.4% and 5.1%, respectively, p < 0.02). Among the invasive cancers, the mean size of the MCBCs was smaller than the PBCs (1.94 versus 2.55 cm, p < 0.001). MCBCs were more likely than PBCs to be mammographically detected (46.2% versus 19.9%, p < 0.001). Tumor size was correlated with the method of diagnosis. The mean tumor size was 1.39, 2.02, and 2.69 cm for mammogram-, physician-, and patient-detected tumors, respectively. Among patients having axillary lymph node dissections, mammogram- and physician-detected tumors were less likely to have lymph node metastases than patient-detected tumors (22.0% versus 41.2%, p < 0.005). Regular follow-up of breast cancer patients diagnoses MCBCs when they are smaller and less likely to have nodal metastases than PBCs mainly because of early mammographic detection.

Current Oncology, Feb 1, 2010

Breast Cancer Research and Treatment, Mar 1, 1999

CA: A Cancer Journal for Clinicians, Aug 28, 2008

Although cancer management is becoming more structured with disease-specific guidelines and clini... more Although cancer management is becoming more structured with disease-specific guidelines and clinical pathways, many decisions remain complex. Contributing to this complexity is the need to make value tradeoffs between benefits and harms across cancer treatment and/or screening options. Since there is no "best" option for everyone, decisions are defined as being of higher quality when informed with the latest scientific evidence and based on patients' informed values associated with outcomes of options. However, clinicians are not good judges of patients' values, and patients often have inadequate knowledge, unrealistic expectations, and decisional conflict that interfere with their involvement in decision making. Effective approaches to support patient involvement into clinical decisions include clinicians trained in shared decision making, question prompt sheets, patient decision aids, and decision coaching by nurses and other allied health professionals. Based on systematic review of 23 randomized trials of cancer patient decision aids, patients exposed to decision aids are more likely to participate in decision making and achieve higher-quality decisions. This review highlights key historical changes leading to patient involvement in decision making, summarizes evidence on effective interventions to support shared decision making, explores strategies to implement these interventions in oncology practices, and identifies future directions.

Radiotherapy and Oncology, Sep 1, 2022

Radiotherapy and Oncology, Sep 1, 2022

Radiotherapy and Oncology, Sep 1, 2022

Radiotherapy and Oncology, Sep 1, 2022

Case reports in hematology, 2016

Current Oncology, Aug 1, 2020

Radiotherapy and Oncology, Sep 1, 2005

International Journal of Radiation Oncology Biology Physics, Sep 1, 2008

International Journal of Medical Robotics and Computer Assisted Surgery, May 22, 2019

Journal of Cancer Education, Jan 11, 2021

Journal of Palliative Care, Dec 1, 2001

Family physicians play an important role in the management of cancer patients with advanced incur... more Family physicians play an important role in the management of cancer patients with advanced incurable disease (1--6), and palliative care is an area of growing importance in clinical medicine (5-7). However, training and education in palliative care have not been priorities for undergraduate and postgraduate medical education (4,8,9). As a result, many family physicians currently in practice have not been adequately trained for dealing with cancer patients and their palliative care needs (5,10,11). Although specialized palliative care programs are gradually being developed throughout Canada and elsewhere (9,12-14), they cannot fill the role of the primary care physician. Family physicians are still responsible for the care of the vast majority of cancer patients with advanced stage incurable disease (1,4,15,16). Therefore, increasing efforts in the area of education and training will be necessary to better prepare family physicians for dealing with the palliative care needs of their patients (2,4,7,8). The Fraser Valley Cancer Centre (located in Surrey, British Columbia, Canada) has been working to improve palliative care services in its catchment area. In order to determine the educational needs of family physicians regarding palliative care, we decided to do a survey to determine their education, training, and interest in expanding their knowledge.