BACKGROUND: Anxiety, depression, and psychological distress are common syndromes of advanced cancer; all have a negative impact on overall quality of life. However, these symptoms are not monitored explicitly and they are managed only by pharmacotherapy. Given the complex etiology of these symptoms, this biomedical approach is inadequate and inefficient. MATERIALS AND METHODS: Here, we present the results of a longitudinal assessment of distress, anxiety, and depression in a sample of 126 patients treated with palliative systemic therapy for advanced cancer in the PALINT trial. Symptoms and quality of life were assessed regularly using the Hospital Anxiety and Depression Scale (HADS) and The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), respectively. RESULTS: The baseline prevalence of significant distress, anxiety, and depression was 32,6; 35,9; and 56,5%, respectively. A decreasing trend in the prevalence of distress and anxiety occurred after 2 and months - distress (19.4 and 16.3%), anxiety (20.9 and 16.3%), and depression (46.3 and 46.9%). However, these changes did not reach statistical significance. The presence of anxiety and depression correlated negatively with overall quality of life. CONCLUSION: High rates of distress, anxiety, and depression are a strong argument for implementation of systematic screening for psychological distress, and for comprehensive psychosocial support for all patients with advanced cancer throughout the disease trajectory. The HADS questionnaire is a suitable tool for this type of screening. This work was supported by the grant of Ministry of Health AZV 15-33590A. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 3. 12. 2018 Accepted: 24. 3. 2019.
- Klíčová slova
- anxiety, depression, palliative therapy,
- MeSH
- deprese epidemiologie etiologie MeSH
- kvalita života * MeSH
- lidé středního věku MeSH
- lidé MeSH
- longitudinální studie MeSH
- nádory psychologie terapie MeSH
- paliativní péče * MeSH
- prevalence MeSH
- senioři MeSH
- úzkost epidemiologie etiologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
Pain is one of the most important and most frequent symptoms of malignancy. Its intensity and prevalence is growing with disease status. Pain should be present in early stage cancer patients also. Pain is, together with other symptoms (anorexia, nausea, depression, anxiety, sleep disturbances), factor of patients quality-of-life and proper therapy is responsible for overall patient satisfaction and activity. Right pain management is always multidimensional and pain should be assessed at each contact. In review article we would like to bring some alerts of pain context in complexity of cancer and we would like to stress some forms of acute pain management.
- MeSH
- akutní bolest etiologie terapie MeSH
- chronická bolest etiologie terapie MeSH
- lidé MeSH
- management bolesti metody MeSH
- měření bolesti MeSH
- nádory komplikace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
Patients with advanced cancer experience a significant number of physical symptoms and psychological distress, which worsen their quality of life (QOL). Palliative care is oriented to prevent and relieve suffering and promote QOL of patients with advanced cancer. In oncology, the role of palliative care is traditionally perceived to be the treatment after the antineoplastic therapy is finished. A concept of early integration of palliative care into standard oncology practice has been recently introduced. There is a lot of data supporting this concept of parallel application of both oncology care and palliative care. Early palliative care has been shown to provide benefits in QOL, mood, symptoms, health care utilization and survival. In this review, we summarize published data about benefits and difficulties of early palliative care. We also discuss the model of general and specialized palliative care integrated into oncological practice, their differences and consequences.
We present a case of a young 26-year-old woman, who has been suffering from localised scleroderma (morphea) for 15 years. Recently, a lesion on the dorsum of her right foot ulcerated. Based on a CT scan and X-ray a diagnosis of ulcerative osteomyellitis was established. The patient was treated with a combination of antibiotics. Subsequent histological examinations showed granulomatous tissue and chronic inflammatory changes on top of pseudoepiteliomatous hyperplasia. The patients status was deteriorating, which resulted in a limb amputation under the knee. Three months later, there was a metastasis of squamous cell carcinoma found in the patients inguinal lymph node. In spite of combined therapy (surgery, radioterapy and systemic chemotherapy), new metastases occurred and the patient succumbed to the disease several months afterwards. The case was concluded as a squamous cell carcinoma camouflaged by osteomyelitis. Malignant turn of localised sclerodema is very rare. It usually occurs on the lower extremities of patients with a long course of the disease and is associated with pansclerotic or generalised variants of morphea.
- MeSH
- amputace MeSH
- antibakteriální látky terapeutické užití MeSH
- dospělí MeSH
- fatální výsledek MeSH
- lidé MeSH
- lokalizovaná sklerodermie komplikace MeSH
- lymfatické metastázy MeSH
- nádory kůže etiologie terapie MeSH
- osteomyelitida diagnostické zobrazování terapie MeSH
- rentgendiagnostika MeSH
- spinocelulární karcinom etiologie terapie MeSH
- vředy na noze (od hlezna dolů) etiologie terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- antibakteriální látky MeSH
BACKGROUND: As a part of the development of a new prospective payment model for radiotherapy we analyzed data on costs of care provided by three comprehensive cancer centers in the Czech Republic. Our aim was to find a combination of variables (predictors) which could be used to sort hospitalization cases into groups according to their costs, with each group having the same reimbursement rate. We tested four variables as possible predictors - number of fractions, stage of disease, radiotherapy technique and diagnostic group. METHODS: We analyzed 7,440 hospitalization cases treated in three comprehensive cancer centers from 2007 to 2011. We acquired data from the I COP database developed by Institute of Biostatistics and Analyses of Masaryk University in cooperation with oncology centers that contains records from the National Oncological Registry along with data supplied by healthcare providers to insurance companies for the purpose of retrospective reimbursement. RESULTS: When comparing the four variables mentioned above we found that number of fractions and radiotherapy technique were much stronger predictors than the other two variables. Stage of disease did not prove to be a relevant indicator of cost distinction. There were significant differences in costs among diagnostic groups but these were mostly driven by the technique of radiotherapy and the number of fractions. Within the diagnostic groups, the distribution of costs was too heterogeneous for the purpose of the new payment model. CONCLUSION: The combination of number of fractions and radiotherapy technique appears to be the most appropriate cost predictors to be involved in the prospective payment model proposal. Further analysis is planned to test the predictive value of intention of radiotherapy in order to determine differences in costs between palliative and curative treatment.
- MeSH
- frakcionace dávky záření MeSH
- hospitalizace ekonomika statistika a číselné údaje MeSH
- klasifikační systém DRG MeSH
- lidé MeSH
- nádory radioterapie MeSH
- náklady a analýza nákladů * MeSH
- onkologická péče - zařízení ekonomika statistika a číselné údaje MeSH
- prospektivní platební systém ekonomika MeSH
- radioterapie ekonomika MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Acupuncture is one of the methods of traditional Chinese Medicine (TCM). In Asia, methods of TCM are quite often used in oncological patients in combination with classical medicine. In Europe and North America, the position of the TCM is not so clear. In the last few years, some studies were done which were supposed to verify scientifically the effectiveness of acupuncture in the treatment of some symptoms in oncological patients and adverse effects of oncological treatment. Results of these studies indicate that acupuncture is effective in the treatment of pain, nausea, vomiting and xerostomia. The International Society of Integrative Oncology formulated some recommendations for using methods of TCM in oncological patients. In this field, there is still a lot of possibilities for further studies which could help acupuncture to become an important therapeutic method even in our region.
- MeSH
- akupunkturní terapie * MeSH
- bolest etiologie MeSH
- lidé MeSH
- nádory komplikace MeSH
- nauzea etiologie terapie MeSH
- tradiční čínská medicína MeSH
- xerostomie etiologie terapie MeSH
- zvracení etiologie terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
- Severní Amerika MeSH
Breakthrough cancer pain has been defined as a transitory increase in pain intensity that occurs despite relatively stable and adequately controlled background pain. More than half of cancer patients with chronic pain suffer by some form of breakthrough cancer pain. The management of breakthrough cancer pain is comprehensive and includes pharmacological and nonpharmacological approaches. The principal treatment strategies are optimization of regular analgesic medication combined with effective rescues medication. The new transmucosal forms of fentanyl represent an important improvement in our treatment options.
- MeSH
- aplikace bukální MeSH
- fentanyl aplikace a dávkování terapeutické užití MeSH
- lidé MeSH
- management bolesti MeSH
- měření bolesti MeSH
- nádory komplikace farmakoterapie MeSH
- opioidní analgetika terapeutické užití MeSH
- průlomová bolest farmakoterapie etiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- fentanyl MeSH
- opioidní analgetika MeSH
- MeSH
- lidé MeSH
- nádory terapie MeSH
- paliativní péče MeSH
- péče o umírající * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- lidé MeSH
- paliativní péče statistika a číselné údaje MeSH
- péče v hospici statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Evropa MeSH
- MeSH
- lidé MeSH
- nádory mortalita MeSH
- paliativní péče * MeSH
- péče o umírající MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
