CONTACTS
SUBJECTS
Case Management Health Care SDS Records Management Command Control M
5803 -
5803 - ..
5804 - Summary/Objective
5805 -
580501 - Follow up ref SDS 9 0000, ref SDS 8 0000.
580502 -
580503 -
580504 -
580506 - ..
5806 -
5807 -
5808 - Progress
5809 -
580901 - Millie received ref DRT 1 0001 dated yesterday on 090205 from Doctor
580902 - Stritter commenting on telecon consultation for 2nd opinion.
580903 - ref SDS 9 NM4H
580904 -
580905 - 1. It was great talking with you today. I am very impressed at
580906 - how well you and Rod have managed all the complexities
580907 - (clinical, logistical and financial) of your case. I'm no
580908 - longer surprised at how well you have done with this aggressive
580909 - type of breast cancer that usually is much harder to control.
580910 - ref DRT 1 0001
580912 - ..
580913 - During examination at UCSF on 070201 0800 Jackie and Brigid commented
580914 - that SDS records provide accurate patient history and in much greater
580915 - detail than commonly occurs in the medical chart for case management.
580916 - ref SDS 1 407N Jackie feels that health care providers do not have
580917 - time to create detailed records, nor to provide feedback that verifies
580918 - accuracy. ref SDS 1 GV4J
580920 - ..
580921 - On 090203 1206 Doctor Al-Bussam advised that Millie's medical history
580922 - provides a well ordered record on 090121, ref SDS 5 NU5H, that enabled
580923 - timely review of Millie's complex patient history, ref SDS 7 8488;
580924 - and, that accurate understanding enabled determining Millie can get
580925 - treatment for cancer in time to be effective. ref SDS 7 OE4F
580927 - ..
580928 - A few weeks ago on 090121 Glenna called and said Doctor Rugo requested
580929 - help finding chemotherapy agents and protocols discussed for Millie's
580930 - next systemic treatment, using the SDS well ordered record of patient
580931 - history, ref SDS 5 Y67L, and cited the "work plan" on 081016 that
580932 - guided complex work in progress to start Millie's last treatment with
580933 - sunitinib. ref SDS 3 J36R
580935 - ..
580936 - Previously, on 080403 Doctor Rugo requested assistance for UCSF on
580937 - coordinating Millie's care with Kaiser. ref SDS 2 4U9O A few months
580938 - later on 081017, the doctor thanked Millie for coordinating the UCSF
580939 - work plan at Kaiser on getting Millie ready to start the next clinical
580940 - trial at UCSF. ref SDS 4 RI6I
580942 - ..
580943 - [On 090213 1140 primary care physician at Kaiser credits
580944 - command and control of the record enables case management
580945 - to extend Millie's longevity surviving cancer much longer
580946 - than expected for disease trajectory. ref SDS 11 NY7L
580948 - ..
580949 - [On 090213 1140 case study shows rising complexity of
580950 - Millie's patient history has increased the number of tasks
580951 - required to prescribe and implement treatments, ref SDS 11
580952 - IG5O, and citing Doctor Stritter's report today.
580953 - ref SDS 0 7Q7J
580955 - ..
580956 - [On 090213 1140 case study patient advised to get affairs
580957 - in order for life ending in months. ref SDS 11 L19H
580959 - ..
580960 - [On 090220 0157 case study shows starting Millie's
580961 - treatment for 6th relapse of IBC required 112 tasks over 3
580962 - weeks. ref SDS 13 4V5M
580964 - ..
580965 - [On 090616 1245 Doctor Rugo reports Millie is lucky to have
580966 - thorough patient history to help medical team find crucial
580967 - details. ref SDS 17 JU9M
580968 -
580969 -
580970 -
580971 -
580972 -
5810 -
SUBJECTS
Vitamin E Pentoxifyline Trental Prevent Side Effects Radiation Hyper
7903 -
790401 - ..
790402 - Radiation Side Effects Reduce with Vitamin E Pentoxifylline (Trental)
790403 -
790404 -
790405 - 2. One thing I forgot to tell you about. Vitamin E plus
790406 - pentoxifylline (Trental), ref SDS 0 NL4I, may help prevent
790407 - radiation therapy side effects. Bring a copy of this email in
790408 - to your radiation oncologist and find out if they have any
790409 - objection to you trying this. FYI, if you do start Trental,
790410 - they initially will have to monitor your PT more carefully and
790411 - possibly reduce the Coumadin dose. ref DRT 1 LS5O
790413 - ..
790414 - Gwen attached to her letter an abstract on Vitamin E plus
790415 - pentoxifylline (Trental) to reduce side effects of radiation
790416 - treatment...
790417 -
790418 - [On 090209 0018 Millie's letter to medical team asks about
790419 - treating side effects from radiation and hyperthermia with
790420 - Vitamine and pentoxifylline. ref SDS 10 745R
790422 - ..
790423 - [On 090218 1205 Millie asks medical team for feedback on
790424 - treatment for side effects, and whether Vitamin E plus
790425 - pentoxifylline is a solution, since this will require
790426 - coordination with Gloria to adjust Coumadin treatments for
790427 - Millie's pulmonary embolism. ref SDS 12 TH7V
790429 - ..
790430 - [On 090312 0800 Doctor Hsu discloses that severe side
790431 - effects from radiation and hyperthermia, which were
790432 - reported on 090310 to look worse than IBC, ref SDS 14
790433 - O56X, will be treated beginning on 090317 after ending
790434 - treatment with cream, ref SDS 15 F860; the doctor did
790435 - not discuss Vitamin E plus pentoxifylline (Trental),
790436 - ref SDS 15 6P8K, but proposed providing "cream" to treat
790437 - radiation side effects. ref SDS 15 F852
790439 - ..
790440 - [On 090317 Millie receives Silvadene Cream 1% from Doctor
790441 - Hsu, ref SDS 16 M442, and also received instructions from
790442 - Miranda for application, including an orientation for
790443 - bandaging to recover from expanding sores caused by
790444 - radiation and hyperthermia treatments. ref SDS 16 ET46
790445 -
790447 - ..
790448 - 1. A randomized trial of pentoxifylline and vitamin E versus
790449 - standard follow-up after breast irradiation to prevent breast
790450 - fibrosis, evaluated by tissue compliance meter (TCM).
790451 - ref DRT 1 LS79
790453 - ..
790454 - 2. Sub-category: Local-Regional Therapy
790456 - ..
790457 - 3. Category: Breast Cancer--Local-Regional and Adjuvant Therapy
790459 - ..
790460 - 4. Meeting: 2008 ASCO Annual Meeting
790462 - ..
790463 - 5. Abstract No: 597
790464 - Citation: J Clin Oncol 26: 2008 (May 20 suppl; abstr 597)
790465 - Author(s): G. M. Jacobson, B. J. Smith
790467 - ..
790468 - 6. Abstract:
790470 - ..
790471 - 7. Background: Radiation induced fibrosis (RIF) is a common side
790472 - effect of therapeutic radiation. The combination of
790473 - pentoxifylline (PTX) and vitamin E has been demonstrated to
790474 - reverse long standing radiation fibrosis. We conducted an
790475 - institutional randomized clinical trial to determine if
790476 - pentoxifylline and vitamin E given orally for 6 months
790477 - following breast or chest wall irradiation, was effective in
790478 - preventing radiation induced fibrosis. Methods: 37 breast
790479 - cancer patients with localized disease were randomized to
790480 - treatment with oral pentoxifylline 400 mg. TID and 400 IU
790481 - vitamin E daily for 6 months following radiation, or standard
790482 - follow up.
790484 - ..
790485 - 8. Baseline Radiation Therapy Oncology Group (RTOG) acute effects
790486 - were documented. RTOG late effects were documented at
790487 - follow-up visits.
790489 - ..
790490 - 9. Measurements with tissue compliance meter (TCM) were obtained
790491 - from the treated and untreated breasts/chest wall in subjects
790492 - and controls at 18 months to evaluate tissue compliance as a
790493 - surrogate objective measurement of fibrosis. Differences in
790494 - RTOG late effects and TCM measurements were evaluated by the
790495 - Wilcoxon rank sum test. 18 patients were randomized to
790496 - PTX/vitamin E with 19 controls. One subject discontinued her
790497 - medication at 1 month. 33 patients have been followed a minimum
790498 - of 6 months, with evaluation of RTOG late effects in 32. 20
790499 - patients have been followed for 18 months, 18 have been
790500 - measured with the TCM. Results: The average difference in the
790501 - PTX/ vitamin E group was 0.78 mm; the average difference in the
790502 - control group was 3.7 mm.
790504 - ..
790505 - 10. According to the Wilcoxon rank sum test, the difference between
790506 - the treated and control group was significant (p=0.0228). Late
790507 - effects were modest in these patents: the average RTOG late
790508 - effects score in the PTX/vitamin E group was 0.46 and 1.23 in
790509 - the control group (p=0.0516). Conclusions: In this study of
790510 - post-radiation therapy breast cancer patients randomized to
790511 - treatment with PTX/vitamin E or standard follow-up; there was a
790512 - significant difference in radiation fibrosis as measured by a
790513 - tissue compliance meter, with decreased fibrosis in the treated
790514 - group (p=0.0228). The differences in RTOG late effects were
790515 - marginally non-significant, but late effects were modest in
790516 - both groups.
790517 -
790518 -
790519 -
790520 -
790521 -
790522 -
790523 -
790524 -
790525 -
790526 -
790527 -
790528 -
790529 -
7906 -