Date of Award

5-1-2005

Degree Type

Restricted Access Dissertation

Degree Name

Doctor of Public Health

Field of Study

Social and Behavioral Sciences

Department

School of Public Health

First Advisor

Adela Gonzalez

Second Advisor

Sue Lurie

Third Advisor

Antonio Rene

Abstract

Oliva, Sonnia B., Radiation Treatments in Women Suffering From Advanced Breast or Cervical Cancer Pain: Is It Underutilized For Palliation? Doctor of Public Health (Social and Behavioral Sciences), May 2005, 43 pp., 3 tables, 4 figures, references, 39 titles. The research is to study if radiation treatments are under-utilized in metastatic breast and cervical cancer for palliative therapy and to explore the usage of various radiation-therapy modalities that are currently being used for women with these diagnoses. Studies indicate that radiation treatments specifically external beam radiation and radiopharmaceutical therapy for painful metastatic bone disease are the most effective at relieving bone pain. Studies find that breast cancer is known to be a cancer associated with bone metastasis, and literature review supports the conclusion that cervical cancer may also present with bone metastasis. The literature review includes the pervasiveness of pain suffering, issues surrounding why it is so difficult to treat pain, how cancer causes pain, and past study results of radiation effectiveness for bone metastases. The study population is secondary data attained from the Surveillance Epidemiology and End Results (SEER) Program and included 65 years of age and older with Stage IV breast or cervix uteri cancers. The total sample analyzed included 6,505 breast cancer cases and 758 cervix uteri cancer cases. Logistic regression of data found that women with Stage IV breast cancer compared to women with a diagnosis of Stage IIIB breast cancer are 30% less likely to have radiation with a p-value of less than .001. A diagnosis of cervix uteri cancer of Stage IV was also found to be significant with a women being 57% less likely to have radiation compared to a diagnosis of Stage IIIB cervix uteri cancer. The results of this study support the underutilization of radiation in Stage IV breast and cervical cancers for palliative purposes. The World Health Organization’s model of resource allocation in cancer care recommended palliative, symptom-modifying therapy simultaneously with disease-modifying therapy. In summary, this study provides the first known population-based data on radiation utilization of invasive breast and cervix uteri cancers controlling for age, marital status and race/ethnicity in the United States.

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