Soins de support en oncologie: concepts, accomplissements et nouveaux défis.

The aim of supportive care in oncology is to treat the cancer related symptoms and to deal with the side effects of the treatments of the neoplastic disease. The goal of this article is to present a review of the current state of knowledge in this field by successively exposing the achievements of the last few years, the not yet solved problems and the challenges caused by the new therapeutics against cancer. This article will expose the achievements in the control of cancer related symptoms like cerebral metastases, compressive syndromes, denutrition, dyspnea, bone metastases, thromboembolic events and pain. The recent progress in the management of the side effects of chemotherapy were accomplished in treatment or prevention of mucositis, nausea, febrile neutropenia, anemia and cardiotoxicity of the anthracyclines. The unsolved problems in supportive care are alopecia, thrombocytopenia, cancer-related fatigue and cachexia. Finally, these last years saw the advent of many agents of molecular-targeted therapy in medical oncology which currently form part of the current clinical practice. These treatments have their own side effects, different from those of the cytotoxic, hormonal or immunotherapeutic agents. It is necessary to know these side effects and their management in order to provide the best quality of care to the patients who receive these treatments.English AbstractJournal ArticleReviewinfo:eu-repo/semantics/publishe

Conséquences thérapeutiques des progrès de la biologie moléculaire en oncologie.

This review article presents the improvements made in the field of molecular biology in oncology and their diagnostic and therapeutic consequences. As an illustration, three types of tumors for which these projections strongly modified the management will be used as a basis in this article: breast cancer, kidney cancer and colorectal cancer. Indeed, the last years, new prognostic factors (natural evolution of a specific patient's tumor) and predictive factors (prediction of the responsiveness to anticancer therapies) have emerged for these tumors. In addition, a better comprehension of the mechanisms implied in the development of cancers allowed the advent of many molecular-targeted therapies, which constitute a true revolution in oncology.English AbstractJournal ArticleReviewinfo:eu-repo/semantics/publishe

Transitoriness in cancer patients: a cross-sectional survey of lung and gastrointestinal cancer patients.

Despite earlier diagnosis and advancements in treatment, cancer remains a leading cause of death in the world (13% of all deaths according to the World Health Organization) among men and women. Cancer accounts for approximately 20% of the deaths in the USA every year. Here, we report the findings from a cross-sectional survey of psychosocial factors in lung and gastrointestinal cancer patients. The aim of the study was to explore the associations among transitoriness, uncertainty, and locus of control (LOC) with quality of life. Transitoriness is defined as a person's confrontation with life's finitude due to a cancer diagnosis. A total of 126 patients with lung or gastrointestinal cancer completed eight self-reporting questionnaires addressing demographics, spiritual perspective, symptom burden, transitoriness, uncertainty, LOC, and quality of life. Transitoriness, uncertainty, and LOC were significantly associated with one another (r = 0.3267, p = 0.0002/r = 0.1994, p = 0.0252, respectively). LOC/belief in chance has a significant inverse relationship with patients' quality of life (r = -0.2505, p = 0.0047). Transitoriness, uncertainty, and LOC were found to have a significant inverse relationship with patients' quality of life (transitoriness state: r = -0.5363, p = 0.0000/trait: r = -0.4629, p = 0.0000/uncertainty: r = -0.4929, p = 0.0000/internal LOC: r = 0.1759, p = 0.0489/chance LOC: r = -0.2505, p = 0.0047). Transitoriness, uncertainty, and LOC are important concepts as they adversely influence patients' quality of life. Incorporating this finding into the care of cancer patients may provide them with the support they need to cope with treatment and maintenance of a positive quality of life