OBJECTIVE: Palliative Care (CP) is essential for the identification and management of symptoms reported by patients with metastatic cancer. Such assistance promotes higher quality of life for patients and families throughout the disease continuum, by anticipation, prevention and relief of suffering. In Brazil, the CP is still incipient in the context of Oncology care. Thus, the present study aims to characterize the main demands reported by cancer patients at stage IV, as well as to identify the factors associated with symptoms in order to determine those most at psychological risk.
METHODS: This is a descriptive and prospective study conducted with 253 patients diagnosed with metastatic cancer, undergoing a palliative chemotherapy treatment in a public hospital, located in Sao Paulo. To this end, patients were evaluated regarding the distress (Distress Thermometer), anxiety and depression (Hospital Anxiety and Depression Scale), and the quality of life (Functional Assessment of Chronic Illness Therapy - General). The data analysis procedures included the descriptives analysis, simple linear correlation and logistic regression.
RESULTS: The average age of patients was 56.6 years, 64.4% female, 51% married, and 54.2% had elementary school. Breast (29.2%) and gastrointestinal (28.9%) cancers were the most frequent. Almost half of patients (44.7%) reported a moderate and severe distress, and 21.7% showed symptoms of anxiety and 16.6% of depression. The correlation was significant among these psychosocial symptoms (ps<0.001), with higher scores of distress associated with a worse quality of life, with consequent negative impact on the physical, social/family, emotional and functional well-being (ps<0.001). In addition, young age, fear, worry, fatigue, pain, sleep, anxiety and depression were factors associated with a greater psychological risk.
CONCLUSION: Patients with metastatic cancer reported numerous physical and psychological symptoms. This high prevalence significantly impacted on the quality of life of these patients, highlighting the importance of early insertion of CP. We noted that the cancer care need to consider the screening routine that helps the identification of symptoms, to adequate propose a treatment targeted to the patients needs, in order to anticipate and prevent the suffering of these patients.
Keywords: Palliative care; Psycho-oncology; Distress; Quality of life; Public service
OBJECTIVE: Skin cancer is the most common in Brazil especially in Santa Catarina. Interleukin-10 (IL-10) is an immunosuppressive cytokine that can allow the escape of cancer cells of the immune system, thereby polymorphisms in the IL-10 gene have been implicated in susceptibility and the development of malignancies. This study aimed to analyze the frequencies of the alleles and genotypic at position -1082 of the promoter region of IL-10 and its association with skin carcinomas.
METHODS: This was a case-control study which analyzed 90 samples, and the test group of 49 skin tissue carcinoma and the control group by 41 scrapings oral mucosa of healthy individuals. The ARMS-PCR was used to identify the polymorphism.
RESULTS: The allelic frequency for the control group was 70% for the A allele and 30% for G; in the test group gave 44% to 56% allele A and allele G Genotype frequency observed in the control group was AA (42%), AG (56%) and GG (25), while in group test was AA (24%), AG (39%) and GG (37%). There was a statistical difference between groups for both the allelic frequency, as for genotype (p <0.05).
CONCLUSION: There was a higher prevalence of the G allele and genotype AG and GG in the test group compared to the control group, a factor that could be an adjuvant in the development of skin carcinomas. This result demonstrates the importance of developing immune response in the malignant transformation process.
Keywords: Immunosuppression; Interleukin-10; Polymorphism; Epithelial carcinoma
The complex anatomy surrounding lower rectal cancer, as well as its aggressive biological behavior, creates surgical challenges. Furthermore, patients with lower rectal cancer have a poorer prognosis, compared to tumors in the middle and upper rectum. Thus, it is essential to adopt new strategies to optimize the results of surgical treatment. Magnetic resonance imaging has become a crucial tool for successfully selecting and completing surgery, as it provides a high anatomical resolution and the ability to define the tumor's relationship with the sphincter complex. New surgical techniques based on magnetic resonance imaging can also improve patients' oncological and functional outcomes. This review examines the modern approach to treating lower rectal cancer, and aims to simplify the complex decisions that surgery currently requires. The PubMed database was searched using the terms "lower rectal cancer", "colorectal surgery", and "magnetic resonance imaging". Milestone reports from recent years have been addressed in this review.
Keywords: Rectal neoplasms/surgery; Colorectal surgery; Colorectal neoplasms; Magnetic resonance imaging
Malignancy related to donor after transplantation is a very rare situation that can be classified in two categories. The first is donor cell derived malignancy and the second, most rare, is tumor transmission which include the development of malignancy in a misdiagnosed donor pre-existent solid organ. This condition has good prognosis mainly because of recipient immune response, and patients are treated with explatantion of the graft associated with immunotherapy withdraw. Accordingly, we report two cases of female patients that have received their kidneys and tumors transplanted from the same male donor which DNA analysis confirm the same donor origin. Both patients were treated with the same therapy but different disease presentation.
Keywords: Adenocarcinoma; Transplantation; Transmission; Neoplasms/immunology