TAILIEUCHUNG - Practice Parameters for the Management of Rectal Cancer (Revised)

Repression/Denial. In a meta-analytic review of the literature of psychosocial fac- tors and the development of breast cancer, McKenna and colleagues (1999) found sig- nificant effect sizes for an association between breast cancer and the use of a coping strategy based on denial/repression. Astudy by Jensen (1983) provides important evidence supporting the idea that repres- sion involves disregulation of the immune system that, in turn, influences cancer. In a prospective study of women with breast cancer, Jensen found that at follow-up subjects with a repressive coping style and reduced levels of self-reported negative emotions had poorer outcomes (including death) than those who did not meet this profile. Specifically, Jensen. | Diseasesofthe Colon Rectum Practice Parameters Practice Parameters for the Management of Rectal Cancer Revised Prepared by The Standards Practice Task Force The American Society of Colon and Rectal Surgeons Joe J. Tjandra . John W. Kilkenny . W. Donald Buie . Neil Hyman . Clifford Simmang . Thomas Anthony . Charles Orsay . James Church . Daniel Otchy . Jeffrey Cohen . Ronald Place . Frederick Denstman . Jan Rakinic . Richard Moore . Mark Whiteford . The American Society of Colon and Rectal Surgeons is dedicated to assuring high-quality patient care by advancing the science prevention and management of disorders and diseases of the colon rectum and anus. The Standards Committee is composed of Society members who are chosen because they have demonstrated expertise in the specialty of colon and rectal surgery. This Committee was created to lead international efforts in defining quality care for conditions related to the colon rectum and anus. This is accompanied by developing Clinical Practice Guidelines based on the best available evidence. These guidelines are inclusive and not prescriptive. Their purpose is to provide information on which decisions can be made rather than dictate a specific form of treatment. These guidelines are intended for the use of all practitioners health care workers and patients who desire information about the management of the conditions addressed by the topics covered in these guidelines. It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all of the circumstances presented by the individual patient. STATEMENT OF THE PROBLEM Colorectal adenocarcinoma is the second leading cause of cancer deaths in western countries. Rectal Reprints are not .

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