Since cancer survival rates are rising, there is growing attention for longterm side effects of cancer and its treatment. A common side effect is the negative impact of treatment on sexuality of... Show moreSince cancer survival rates are rising, there is growing attention for longterm side effects of cancer and its treatment. A common side effect is the negative impact of treatment on sexuality of patients and their partners. Patient and partners as well as healthcare professionals experience several barriers to discuss this topic, like lack of time and lack of knowlegde. Two-thirds of the cancer patients reported to be in need of information regarding sexual health; especially those who were younger, who reported a negative impact of cancer on sexuality and those who were diagnosed less than two years ago. Patients and partners reported to prefer to discuss sexual health with nurse practitioners throughout the treatment proces. Besides, satisfaction with sexual life after treatment is related to satisfaction before treatment, not only with current sexual function.Widely available information and defining responsibility within the oncology treatment team would be helpful to improve communication around sexual health in cancer care. Additionally, specialized clinics would tackle soms frequently reported barriers of discussing sexuality. More reseach is needed on the implementation of sexual healthcare in oncology practice to deliver continuum of care, which will ultimately improve patient care. Show less
Once prostate cancer has spread to the skeleton, patients cannot be cured from their disease. Identification of the cell(s) of origin of prostate cancer as well as the neoplastic cell(s) involved... Show moreOnce prostate cancer has spread to the skeleton, patients cannot be cured from their disease. Identification of the cell(s) of origin of prostate cancer as well as the neoplastic cell(s) involved in the formation of distant metastases is, therefore, fundamental to understanding of carcinogenesis and metastasis. The functional identification of metastasis-initiating cells is a prerequisite for properly targeted therapy of metastatic disease in advanced prostate cancer. In chapter 2 of this thesis, the possible use of aldehyde dehydrogenase (ALDH) as marker for the identification and isolation of tumor-initiating and metastasis-initiating cells in prostate cancer is studied. In chapter 3, the functional role of a single ALDH isoform (ALDH7A1) in metastatic prostate cancer is investigated by knockdown studies in vitro and in vivo. In chapter 4, the functional involvement of _v integrins in the formation of a metastatic stem/progenitor prostate cancer phenotype is studied. Subsequently, in chapter 5, the targeting of integrins by a novel non-peptide integrin antagonist is evaluated in vitro and in preclinical models of prostate cancer progression and metastasis. Finally, general conclusions and discussions are described in chapter 6. Show less
