Depression Among Cancer Patients–A Reality Where Therapeutic Nihilism Cannot be Accepted

2017 ◽  
Vol 41 (S1) ◽  
pp. S236-S236
Author(s):  
M. Marinho ◽  
J. Marques ◽  
M. Bragança
Keyword(s):  
Cancer Patients ◽  
Cancer Progression ◽  
Negative Impact ◽  
Early Recognition ◽  
Related Factors ◽  
Symptoms Of Depression ◽  
Loss Of Self ◽  
Life Threatening ◽  
Keywords Cancer ◽  
Competing Interest

IntroductionCancer is a life-threatening disease, characterized by a great deal of uncertainty and unpredictability. Thus, several stressors and emotional upheavals pervade the everyday life of cancer patients and can lead to the development of depression.ObjectivesTo review the recent research related to depression in cancer patients.MethodsLiterature review based on PubMed/MEDLINE, using the keywords “cancer” and “depression”.ResultsIt is estimated that 20–25% of cancer patients meet the criteria for major depressive syndrome at some point in their illness. Depression is associated with a negative impact on treatment adhesion, cancer progression and quality of life, besides increasing suicide risk. However, it is often unrecognized and untreated. Importantly, the mistaken belief that depressive symptoms are expected in this group, the overlap between the neurovegetative symptoms of depression, the somatic symptoms of cancer and its treatment, as well as the effects of comorbid diseases make the diagnosis of major depression so complex in these patients. Some of the most helpful diagnostic indicators are feelings of hopelessness, worthlessness, excessive guilt, loss of self-esteem, and wishes to die. The several risk factors for the development of depression in cancer patients can be divided into four broad categories, namely cancer-related factors, cancer treatment-related factors, psychiatric history, and social factors. Effective management of depression consists in a combination of psychotherapy and psychopharmacology.ConclusionDepression in cancer patients has serious consequences, however appropriate psychiatric intervention can do it over. Thus, its early recognition and appropriate management is imperative.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Cancer-Associated Cachexia: A Systemic Consequence of Cancer Progression

2020 ◽  
Vol 4 (1) ◽  
pp. 391-411
Author(s):  
Anup K. Biswas ◽  
Swarnali Acharyya
Keyword(s):  
Cancer Patients ◽  
Cancer Progression ◽  
Metastatic Cancer ◽  
Therapeutic Strategies ◽  
Invasive Growth ◽  
Wasting Syndrome ◽  
Life Threatening ◽  
And Function ◽  
Related Mortality

Cancer is a life-threatening disease that has plagued humans for centuries. The vast majority of cancer-related mortality results from metastasis. Indeed, the invasive growth of metastatic cancer cells in vital organs causes fatal organ dysfunction, but metastasis-related deaths also result from cachexia, a debilitating wasting syndrome characterized by an involuntary loss of skeletal muscle mass and function. In fact, about 80% of metastatic cancer patients suffer from cachexia, which often renders them too weak to tolerate standard doses of anticancer therapies and makes them susceptible to death from cardiac and respiratory failure. The goals of this review are to highlight important findings that help explain how cancer-induced systemic changes drive the development of cachexia and to discuss unmet challenges and potential therapeutic strategies targeting cachexia to improve the quality of life and survival of cancer patients.

scholarly journals Prevention and treatment of venous thromboembolism in cancer patients: project of clinical guidelines

2020 ◽  
Vol 27 (3) ◽  
pp. 75-88
Author(s):  
S. M. Kozhukhov ◽  
N. V. Dovganich ◽  
I. I. Smolanka ◽  
I. A. Kryachok ◽  
O. F. Ligirda
Keyword(s):  
Venous Thromboembolism ◽  
Cancer Patients ◽  
Cancer Progression ◽  
Bleeding Risk ◽  
Treatment Modalities ◽  
Bleeding Events ◽  
Related Factors ◽  
Management Algorithm ◽  
Cancer Associated Thrombosis ◽  
Active Cancer

Cancer-associated thrombosis is an actual issue in the intersection of cardiology and oncology. Active cancer counts for approximately 20 % of the total number of cases of venous thromboembolism (VTE), and VTE is one of the leading cause of death in cancer patients, second only to cancer progression. VTE in cancer has some features that distinguish it from other VTE cases. The combination of cancer-related, treatment-related and patient-related factors increases their overall risk of VTE. The experts of the Cardio-Oncology working group have created a practical approach guideline for the management of VTE in cancer patients based on a multi-disciplinary strategy, ESMO, ASCO recommendations. This document has collected information on VTE, bleeding events and treatment modalities in cancer patients that may be beneficial for clinicians in determining strategies of anticoagulant therapies in these patients. Clinicians of various specialties using these recommendations will be able to determine the most appropriate VTE management algorithm, taking into account the bleeding risk, the type of cancer with its treatment, and drug interactions.

scholarly journals Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial

2016 ◽  
Vol 30 (12) ◽  
pp. 1181-1197 ◽  
Author(s):  
Roland R Griffiths ◽  
Matthew W Johnson ◽  
Michael A Carducci ◽  
Annie Umbricht ◽  
William A Richards ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Depressed Mood ◽  
Well Being ◽  
High Dose ◽  
Depression And Anxiety ◽  
Double Blind ◽  
Symptoms Of Depression ◽  
Life Threatening ◽  
Clinically Significant

Cancer patients often develop chronic, clinically significant symptoms of depression and anxiety. Previous studies suggest that psilocybin may decrease depression and anxiety in cancer patients. The effects of psilocybin were studied in 51 cancer patients with life-threatening diagnoses and symptoms of depression and/or anxiety. This randomized, double-blind, cross-over trial investigated the effects of a very low (placebo-like) dose (1 or 3 mg/70 kg) vs. a high dose (22 or 30 mg/70 kg) of psilocybin administered in counterbalanced sequence with 5 weeks between sessions and a 6-month follow-up. Instructions to participants and staff minimized expectancy effects. Participants, staff, and community observers rated participant moods, attitudes, and behaviors throughout the study. High-dose psilocybin produced large decreases in clinician- and self-rated measures of depressed mood and anxiety, along with increases in quality of life, life meaning, and optimism, and decreases in death anxiety. At 6-month follow-up, these changes were sustained, with about 80% of participants continuing to show clinically significant decreases in depressed mood and anxiety. Participants attributed improvements in attitudes about life/self, mood, relationships, and spirituality to the high-dose experience, with >80% endorsing moderately or greater increased well-being/life satisfaction. Community observer ratings showed corresponding changes. Mystical-type psilocybin experience on session day mediated the effect of psilocybin dose on therapeutic outcomes. Trial Registration ClinicalTrials.gov identifier: NCT00465595

VTE risk assessment in cancer

2016 ◽  
Vol 07 (01) ◽  
pp. 20-25
Author(s):  
I. Pabinger ◽  
C. Ay
Keyword(s):  
Risk Assessment ◽  
Cancer Patients ◽  
Medical Oncology ◽  
Clinical Importance ◽  
Cancer Surgery ◽  
Ambulatory Setting ◽  
Oncology Patients ◽  
Related Factors ◽  
Risk Assessment Models ◽  
Increased Risk

SummaryVenous thromboembolism (VTE) in patients with cancer is associated with an increased morbidity and mortality, and its prevention is of major clinical importance. However, the VTE rates in the cancer population vary between 0.5% - 20%, depending on cancer-, treatment- and patient-related factors. The most important contributors to VTE risk are the tumor entity, stage and certain anticancer treatments. Cancer surgery represents a strong risk factor for VTE, and medical oncology patients are at increased risk of developing VTE, especially when receiving chemotherapy or immunomodulatory drugs. Also biomarkers have been investigated for their usefulness to predict risk of VTE (e.g. elevated leukocyte and platelet counts, soluble P-selectin, D-dimer, etc.). In order to identify cancer patients at high risk of VTE and to improve risk stratification, risk assessment models have been developed, which contain both clinical parameters and biomarkers. While primary thromboprophylaxis with lowmolecular- weight-heparin (LMWH) is recommended postoperatively for a period of up to 4 weeks after major cancer surgery, the evidence is less clear for medical oncology patients. Thromboprophylaxis in hospitalized medical oncology patients is advocated, and is based on results of randomized controlled trials which evaluated the efficacy and safety of LMWH for prevention of VTE in hospitalized medically ill patients. In recent trials the benefit of primary thromboprophylaxis in cancer patients receiving chemotherapy in the ambulatory setting has been investigated. However, at the present stage primary thromboprophylaxis for prevention of VTE in these patients is still a matter of debate and cannot be recommended for all cancer outpatients.

Overexpression of microRNA-21 in the Serum of Breast Cancer Patients

MicroRNA ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 58-63
Author(s):  
Batool Savari ◽  
Sohrab Boozarpour ◽  
Maryam Tahmasebi-Birgani ◽  
Hossein Sabouri ◽  
Seyed Mohammad Hosseini
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cancer Progression ◽  
Tumor Resection ◽  
Tumor Grade ◽  
Healthy Controls ◽  
Breast Cancer Patients ◽  
Serum Samples ◽  
Post Surgery ◽  
Polymerase Chain

Background: Breast cancer is the most common cancer diagnosed in women worldwide. So it seems that there's a good chance of recovery if it's detected in its early stages even before the appearances of symptoms. Recent studies have shown that miRNAs play an important role during cancer progression. These transcripts can be tracked in liquid samples to reveal if cancer exists, for earlier treatment. MicroRNA-21 (miR-21) has been shown to be a key regulator of carcinogenesis, and breast tumor is no exception. Objective: The present study was aimed to track the miR-21 expression level in serum of the breast cancer patients in comparison with that of normal counterparts. Methods: Comparative real-time polymerase chain reaction was applied to determine the levels of expression of miR-21 in the serum samples of 57 participants from which, 42 were the patients with breast cancer including pre-surgery patients (n = 30) and post-surgery patients (n = 12), and the others were the healthy controls (n = 15). Results: MiR-21 was significantly over expressed in the serum of breast cancer patients as compared with healthy controls (P = 0.002). A significant decrease was also observed following tumor resection (P < 0.0001). Moreover, it was found that miR-21 overexpression level was significantly associated with tumor grade (P = 0.004). Conclusion: These findings suggest that miR-21 has the potential to be used as a novel breast cancer biomarker for early detection and prognosis, although further experiments are needed.

Effect of Undertriage on the Outcomes of Cancer Patients with Febrile Neutropenia, Sepsis, and Septic Shock

2021 ◽  
pp. 105477382199968
Author(s):  
Anas Alsharawneh
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Length Of Stay ◽  
Febrile Neutropenia ◽  
Cancer Patients ◽  
Emergency Setting ◽  
Extended Length ◽  
Life Threatening ◽  
Sepsis And Septic Shock ◽  
Timely Treatment

Sepsis and neutropenia are considered the primary life-threatening complications of cancer treatment and are the leading cause of hospitalization and death. The objective was to study whether patients with neutropenia, sepsis, and septic shock were identified appropriately at triage and receive timely treatment within the emergency setting. Also, we investigated the effect of undertriage on key treatment outcomes. We conducted a retrospective analysis of all accessible records of admitted adult cancer patients with febrile neutropenia, sepsis, and septic shock. Our results identified that the majority of patients were inappropriately triaged to less urgent triage categories. Patients’ undertriage significantly prolonged multiple emergency timeliness indicators and extended length of stay within the emergency department and hospital. These effects suggest that triage implementation must be objective, consistent, and accurate because of the several influences of the assigned triage scoring on treatment and health outcomes.

scholarly journals Prevention and management of major complications in percutaneous endoscopic gastrostomy

2021 ◽  
Vol 8 (1) ◽  
pp. e000628
Author(s):  
Kurt Boeykens ◽  
Ivo Duysburgh
Keyword(s):  
Clinical Practice ◽  
Abdominal Wall ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Early Recognition ◽  
Endoscopic Technique ◽  
Abdominal Wound ◽  
Review Of The Literature ◽  
Endoscopic Gastrostomy ◽  
Major Complications ◽  
Life Threatening

BackgroundPercutaneousendoscopic gastrostomy is a commonly used endoscopic technique where a tube isplaced through the abdominal wall mainly to administer fluids, drugs and/orenteral nutrition. Several placement techniques are described in the literaturewith the ‘pull’ technique (Ponsky-Gardener) as the most popular one.Independent of the method used, placement includes a ‘blind’ perforation of thestomach through a small acute surgical abdominal wound. It is a generally safetechnique with only few major complications. Nevertheless these complicationscan be sometimes life-threatening or generate serious morbidity.MethodAnarrative review of the literature of major complications in percutaneousendoscopic gastrostomy.ResultsThis review was written from a clinical viewpoint focussing on prevention andmanagement of major complications and documentedscientific evidence with real cases from more than 20 years of clinical practice.ConclusionsMajorcomplications are rare but prevention, early recognition and popper management areimportant.

scholarly journals Avoidance of Healthcare Utilization in South Korea during the Coronavirus Disease 2019 (COVID-19) Pandemic

2021 ◽  
Vol 18 (8) ◽  
pp. 4363
Author(s):  
Minjung Lee ◽  
Myoungsoon You
Keyword(s):  
General Population ◽  
South Korea ◽  
Healthcare Utilization ◽  
Online Survey ◽  
Negative Impact ◽  
Sociodemographic Characteristics ◽  
Related Factors ◽  
First Case ◽  
Significant Difference ◽  
Health Related

Avoidance of healthcare utilization among the general population during pandemic outbreaks has been observed and it can lead to a negative impact on population health. The object of this study is to examine the influence of socio-demographic and health-related factors on the avoidance of healthcare utilization during the global outbreak of a novel coronavirus (COVID-19) in 2020. Data were collected through an online survey four weeks after the Korea Centers for Disease Control and Prevention (KCDC) confirmed the first case in South Korea; 1000 subjects were included in the analysis. The logit model for regression was used to analyze the associations between sociodemographic and health-related factors regarding the avoidance of healthcare utilization. Among the participants, 73.2% avoided healthcare utilization, and there was no significant difference in the prevalence of healthcare avoidance between groups with (72.0%) and without (74.9%) an underlying disease. Sociodemographic characteristics (e.g., gender, age, income level, and residential area) were related to healthcare avoidance. Among the investigated influencing factors, residential areas highly affected by COVID-19 (i.e., Daegu/Gyeoungbuk region) had the most significant effect on healthcare avoidance. This study found a high prevalence of healthcare avoidance among the general population who under-utilized healthcare resources during the COVID-19 outbreak. However, the results reveal that not all societal groups share the burden of healthcare avoidance equally, with it disproportionately affecting those with certain sociodemographic characteristics. This study can inform healthcare under-utilization patterns during emerging infectious disease outbreaks and provide information to public health emergency management for implementing strategies necessary to improve the preparedness of the healthcare system.

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