Health Literacy of Oncologic Patients and Their Informal Caregivers

The haemato-oncological patient requires care due to the impact of the disease itself as well as the hard treatment. Health professionals and informal caregivers also play a central role in this multipart and demanding process of caring and management of the disease. Communication and health literacy to the patients and respective caregivers are crucial in promoting safe care. The development of quality improvement projects by health organizations has contributed to increase health literacy among its participants. Its implementation contributes to a closer relationship between health professionals, patients, and informal caregivers with a consequent improvement in the response to their needs.

The life and existential meaning of the personality of an oncological patient: a meaning analysis of concept

The article discusses the importance of personal psychological resource in the context of cancer. As such an internal resource, we have identified the vital and existential meanings, and we also determined the difference between these two concepts. The analysis of the literature has shown that one of the main problems of psychological science is search for psychological reasons for its loss and the possibility of finding meaning of life again and again rather than understanding it. We also found that a significant role in the acquisition and loss of meanings can be played by the personal qualities, personal attitude towards oneself, towards the world around, the ability to self-responsibility and to responsibility for own life.

Onco-specific sleep disorders and fatigue: tactics of psychological test and cognitive behavioral therapy

Introduction. Sleep disorders are widespread throughout the entire period of treatment of an oncological patient from the moment of diagnosis, and in many patients persist after completion of treatment. The nature of cancer and its treatment expose patients to many potential provoking and/or supportive factors that are atypical for the general population. In addition, sleep disturbance rarely manifests as a separate symptom, but more often occurs together with such symptoms as fatigue, pain, depression and/or cognitive impairment. This complicates the assessment and often requires an individual treatment plan with a team approach. AIM. of the work is to acquaint mental health specialists, oncologists, chemotherapists with the specifics of the examination of cancer-specific insomnia and fatigue, the construction of team treatment tactics, the organization of psychotherapeutic care for cancer patients. Results. The article describes for the first time the specifics of onco-specific insomnia and fatigue. The general predisposing and supporting factors of insomnia characteristic of cancer patients are systematized. The relationship between onco-specific fatigue and sleep disorders is shown. The role of pro-inflammatory cytokines as a common neuroendocrine-immune mechanism underlying the behavioral symptoms of sleep disorders, fatigue, depression and cognitive dysfunction in people with cancer is noted. Due to the limitations of the pharmacological approach, the purpose, forms, modes and approaches of using cognitive behavioral therapy protocols to minimize insomnia and fatigue are described. Based on the data of our foreign colleagues, we have proposed an algorithm for assessing sleep disorders in a patient with an oncological profile. The effectiveness of the standard protocol of cognitive behavioral psychotherapy of insomnia (SCBT-I) in a patient of the oncological profile Lavini Fiorentino is described in detail and shown; as well as the short protocol of CBT of cancer-specific insomnia by Eric Zo et al.; remote protocol of mindfulness enhancement therapy to minimize onco-specific fatigue Z.by Fieke et al. Conclusions. CBT in the framework of complex treatment has a positive effect on the immune system, reducing inflammation mediated through the hypothalamic-pituitary-adrenal axis. Despite the accumulation of evidence confirming the effectiveness of this form of psychological assistance, its availability in Russia remains extremely limited and not fully appreciated.

Prevention and treatment of thrombosis in cancer and oncohematological patients

The purpose of the review is to highlight the current possibilities for the prevention and treatment of venous thrombotic complications in patients with cancer.The data of 52 scientific sources published in the Russian and foreign press in 1997–2020 are considered.Cancer patients are at high risk of thrombotic complications, which worsen the outcome of anticancer treatment and are one of the leading causes of death. Thrombosis in an oncological patient increases the risk of death by 30 times, which is associated with fatal thromboembolism and a more aggressive course of the disease. The leading role in the pathogenesis of thrombotic complications is played by disorders in the hemostasis system caused both by the tumor itself and by therapy. Low molecular weight heparins are considered the basis for specific prophylaxis of thromboembolic complications in cancer patients. The use of low molecular weight heparins after surgery and during chemotherapy effectively reduces the incidence of venous thrombosis. Direct oral anticoagulants are promising drugs for oral administration and are indicated as one of the treatment options for patients with tumor-associated thrombosis with a low risk of bleeding and no drug interactions with ongoing systemic chemotherapy.

SARS-CoV-2 Evolution among Oncological Population: In-Depth Virological Analysis of a Clinical Cohort

Background: Oncological patients have a higher risk of prolonged SARS-CoV-2 shedding, which, in turn, can lead to evolutionary mutations and emergence of novel viral variants. The aim of this study was to analyze biological samples of a cohort of oncological patients by deep sequencing to detect any significant viral mutations. Methods: High-throughput sequencing was performed on selected samples from a SARS-CoV-2-positive oncological patient cohort. Analysis of variants and minority variants was performed using a validated bioinformatics pipeline. Results: Among 54 oncological patients, we analyzed 12 samples of 6 patients, either serial nasopharyngeal swab samples or samples from the upper and lower respiratory tracts, by high-throughput sequencing. We identified amino acid changes D614G and P4715L as well as mutations at nucleotide positions 241 and 3037 in all samples. There were no other significant mutations, but we observed intra-host evolution in some minority variants, mainly in the ORF1ab gene. There was no significant mutation identified in the spike region and no minority variants common to several hosts. Conclusions: There was no major and rapid evolution of viral strains in this oncological patient cohort, but there was minority variant evolution, reflecting a dynamic pattern of quasi-species replication.

Role of Circulating miRNAs in Therapeutic Response in Epithelial Ovarian Cancer: A Systematic Revision

Epithelial ovarian cancer (EOC) is one of the most lethal cancers worldwide, mostly due to nonspecific symptoms and a lack of screening tests, which, taken together, contribute to delayed diagnosis and treatment. The current clinical biomarker is serum CA-125, which allows the identification of most advanced primary and relapsed disease and correlates with disease burden; however, as well highlighted in the literature, CA-125 often lacks sensitivity and specificity, and is not helpful in monitoring chemotherapeutic response or in predicting the risk of relapse. Given that, the identification of novel biomarkers able to foster more precise medical approaches and the personalization of patient management represents an unmet clinical requirement. In this context, circulating miRNAs may represent an interesting opportunity as they can be easily detected in all biological fluids. This is particularly relevant when looking for non-invasive approaches that can be repeated over time, with no pain and stress for the oncological patient. Given that, the present review aims to describe the circulating miRNAs currently identified as associated with therapeutic treatments in OC and presents a complete overview of the available evidence.

The What, the Why, and the How of Liver Ablations: A Practical Guide for the Medical Oncologist

Interventional oncology plays a major role within modern oncological patient management. Image-guided thermal ablation has been recognized as a successful local therapeutic option in patients with primary and secondary malignant liver diseases, as also recalled by the recent European Society of Medical Oncology (ESMO) guidelines on colorectal metastases. As image-guided treatments may be as effective as surgery in selected patients with liver lesions, the clinical oncologist should be familiar with the indications, risks, and technical aspects of liver ablation in order to provide their patients with the best outcomes. This article provides a broad overview of the most commonly used ablation techniques and highlights the most relevant technical aspects such as the ideal setting in the operating theatre; which image-guided methods are available, including the growing application of fusion imaging; or contrast-enhanced ultrasound for guiding/monitoring the procedure. A further aim is to expand the knowledge among medical oncologists about liver ablation procedures and to provide insights into the future perspectives of percutaneous minimally invasive procedures in the liver.

The Nutritional Status of Oncological Patient Prior to Antitumor Treatment: Single-Center Prospective Observational Study

Background: Malnutrition is a frequent medical problem of cancer patients (pts) that negatively impacts of results of antitumor treatment. Aim: To study the problem of malnutrition in cancer hospital. Materials and methods: The observational study included 80 pts (30 males, age 51.613.6 years) who underwent examination before antitumor treatment (medical/surgical). Body mass index (BMI), weight loss (WL) over last 6 months, decrease in appetite before admission, reasons for decrease in food intake, physical activity, nosology, cancer staging, the time to diagnosis, therapy status, total protein (TP), albumin, absolute lymphocyte count (ALC) were evaluated. The data were analyzed by SPSS13.0 software. The results were expressed as mean SD. Results: The BMI was 25.35.4 kg/m2, WL 9.00.1%. The most common pathology were esophageal/gastric cancer (31%), stage IV (77%). 25% had received treatment within the last 612 months, 60% of the pts had received chemotherapy, of whom 36% had received 1st-line chemotherapy. Only 13% had additionally used enteral nutrition. An unwanted reduction of appetite was observed in 75% of pts. Most of them (34%) could not explain the reason of WL, 31% reported nausea/vomiting, 19% referred to anorexia; 13% showed consequences of chemotherapy toxicity (dysgeusia, stomatitis), 3% could not eat properly due to the pain syndrome. Of 60 patients who lost weight unintentionally, 54 (67.5%) had an average WL 14.19.1%. WL up to 5% was in 5 pts (6.25%), up to 10% in 14 pts (17.5%) and in 35 pts (43.75%) more than 10%. 46% retained their usual daily activity, 80% deemed it useful to include a nutritional program in the treatment. The concentration of TP was 63.58.1 g/l, albumin 34.97.4 g/l, ALC 1.60.6109/l. Conclusions: Cancer patients have direct prerequisites for the development of cachexia, and, according to our study, 6.25% of patients were at the stage of precachexia, and 61.25% already had cachexia at the time of inclusion in the study. Although their compensatory capacity is quite high, the appointment of additional nutritional support is an integral component of the management of these patients. However, according to our data, only one tenth of patients used some kind of nutritional support. Nevertheless, in case of antitumor treatment, nutritional status evaluation must be mandatory in order to address the issue of nutritional support.