Cancer care for LGBTQ2SPIA+ Patients

As previously discussed in the literature, the lesbian, gay, bisexual, trans, queer, two-spirit, pansexual, intersex, asexual, plus (LGBTQ2SPIA+) population faces multiple healthcare barriers.

In a new study from the University of Alberta (Canada), undergraduate researchers surveyed 214 radiation therapists involved in cancer care to assess their knowledge, attitudes, and practice behaviors related to this patient population. The study revealed knowledge gaps, with over 70% of the therapists not familiar with all terms associated with LGBTQ2SPIA+. While 74.5% reported experience caring for the LGBTQ2SPIA+ community, only 33% included appropriate gender pronouns when caring for LGBTQ2SPIA+ cancer patients. 87% of the surveyed providers expressed interest in receiving more education on the LGBTQ2SPIA+ community needs. While not generalizable to all Canadian radiation therapists, the results identified gaps that should be addressed to provide inclusive care. The study was published in the Journal of Medical Imaging and Radiation Sciences.

One of this study’s findings is that over 70% of respondents were unsure if specific resources were available for the LGBTQ2SPIA+ population at their cancer center. Here are two resources available to the MSKCC LGBTQ2SPIA+ healthcare providers and patients:
-The National LGBT Cancer Network resources to providers: LGBTQ cultural competency trainings.
– MSKCC resources for LGBTQ2SPIA+ cancer patients: https://www.mskcc.org/about/lgbt-healthcare-msk

Finding Clinical Trials

Searching efficiently for clinical trials is often challenging for researchers. The majority of clinical trials are not published in peer-review publications. Therefore, the results are never reported and disseminated (1). Additionally, there are multiple clinical trial registries with considerable overlap (2).

While the aim of the International Clinical Trials Registry Platform (ICTRP), launched in 2007 by the World Health Organisation (WHO) (3), is to act as a single platform to search for clinical trials, it has been reported by Glanville and Knelangen that “even though ClinicalTrials.gov is included in the WHO ICTRP Search Portal, not all ClinicalTrials.gov records can be successfully retrieved via searches of the ICTRP Search Portal”(4). To be comprehensive when searching for clinical trials, we will need to search across multiple registers.

Here are some steps that may be helpful when searching for clinical trials:

Finding clinical trials from registries:

Finding clinical trials with published results:

  • PubMed clinical queries
    A broad therapy search will retrieve clinical trials, if you are interested in Randomized Clinical trials only, you can change the scope from broad to specific/narrow.

  • The Cochrane Central Register of Controlled Trials (CENTRAL)
    The records are pulled mainly from the databases PubMed and Embase.

  • ClinicalTrials.gov
    In the advanced search, you can select “Studies with Results” to retrieve only studies where the results have been reported:

Finding clinical trials for COVID-19:

For information on clinical trials at MSKCC, please visit the following page: https://www.mskcc.org/cancer-care/clinical-trials

References

  1. DeVito NJ, Bacon S and Goldacre B. Compliance with legal requirement to report clinical trial results on ClinicalTrials.gov: a cohort study. The Lancet 2020; 395: 361-369. DOI: 10.1016/S0140-6736(19)33220-9.
  2. van Valkenhoef G, Loane RF and Zarin DA. Previously unidentified duplicate registrations of clinical trials: an exploratory analysis of registry data worldwide. Systematic Reviews 2016; 5: 116. DOI: 10.1186/s13643-016-0283-8.
  3. Karam G and Ross AL. The WHO International Clinical Trials Registry Platform: Providing global clinical trial information to all. On Medicine. 2020.
  4. Lefebvre C GJ, Briscoe S, Littlewood A, Marshall C, Metzendorf M-I, Noel-Storr A, Rader T, Shokraneh F, Thomas J, Wieland LS. . Chapter 4: Searching for and selecting studies. In: Higgins JPT TJ, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (ed) Cochrane Handbook for Systematic Reviews of Interventions version 61 (updated September 2020). Cochrane, 2020.
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Oncologic Hospital Readmissions

Cancer patients are at a higher risk of hospital readmissions than the general population. A recent study conducted by a team at the Boston University School of Medicine (Boston, MA) identified avoidable oncologic readmissions and their causes. The researchers conducted a retrospective chart review over a six-month period, during which 203 patients were discharged. While 68.7% of readmissions could not have been avoided, the authors found that 31.3% were potentially avoidable. Most of those potentially avoidable readmissions were due to ascitic or pleural fluid reaccumulation. Based on those findings, the researchers offer solutions such as performing supervised procedures in the outpatient setting. Addressing the issues could decrease readmissions in an oncology service. The study was published in JCO oncology practice.