La astenia tumoral: un síndrome poco estudiado

Fatigue is one of the most common symptoms in patients with cancer. Doctor have not paid much attention to it for years, probably because there were not therapeutic options in many cases. We hereby revise the features of this syndrome: definition, pathogenesis, epidemiology, biochemical markes and treatment. We have summarised the main conclusions from our book “Tumoral fatigue”, the first written in Spanish about this topic, which is framed in the recently created Asthenos group

Astenia, dolor y sufrimiento

Introduction: The asthenia is a frequent symptom in the oncological patients who have important repercussions on their quality of life. In spite of its prevalence and relevance, some experts recognize that the great ignorance of this symptom exists. On the other hand the patients do not express the importance that stops they has the asthenia sensation, since they consider it inevitable. This fact is left patent in a study that compared the relative importance that each oncologist gave to the asthenia and the pain, with that it gave the patient him. Objective: To evaluate that symptom pain or asthenia worries to the oncological patients more and how can be helped to alleviate the suffering them that these symptoms can produce to him. Method: One has evaluated 187 oncological patients, in chemotherapy treatment, in the Service of Medical Oncology of the La Paz Hospital, of Madrid; on its preoccupations, the subjective perception of suffering and if there is something helps them to alleviate its suffering. Results: The 81 of the patients refers that there are different aspects that worry to them, like ill being, the family, future, pain and fatigue. The subjective perception of suffering is in EVA of 0-3 for 41% and the fatigue in EVA of 4- 7 in a 37% of the people worried about these symptoms. Also a 68% make some strategy to control the fatigue and 84% to control the pain. 62% of the patients worried about the pain and 57% of which is worried about the fatigue consider that it would be possible to be helped them to confront these symptoms

La astenia tumoral: un síndrome poco estudiado

Fatigue is one of the most common symptoms in patients with cancer. Doctor have not paid much attention to it for years, probably because there were not therapeutic options in many cases. We hereby revise the features of this syndrome: definition, pathogenesis, epidemiology, biochemical markes and treatment. We have summarised the main conclusions from our book “Tumoral fatigue”, the first written in Spanish about this topic, which is framed in the recently created Asthenos group

Aspectos psicológicos de la astenia

The asthenia is a frequent symptom in the patients with cancer and has important repercussions on its quality of life. In this article east problem is approached from a psychological perspective, basing on empirical data and theoretical and scientific approaches to us of the field of psychology, with the purpose of obtaining a greater knowledge of this multifactorial phenomenon to be able to help as far as possible to confront better east form problem to multidiscipline and to diminish the suffering that can produce the in the patients with cancer. One concludes that the present boarding front to the disease emphasizes the necessity to conserve the habitual activities at a level adapted without causing frustration. The rest and lack of physical activity, like answer to the fatigue, they can (separately or jointly) induce or increase the asthenia. It is not only necessary to investigate in symptoms like the depression, the pain, or the asthenia of independent form, but also jointly; an effective treatment of the depression can alleviate the asthenia, but inversely the suitable treatment of pain can increase the asthenia. It is necessary to establish a measurement instrument that is valid, trustworthy, sensible to the changes, with that the different professionals we pruned to compare results

Organización de los cuidados continuos

Continuos care is the integral care to the ill person in his all reality. We have to initiate the integral care to the cancer patient in the diagnostic phase and we have to continuos it along all the evolutive process with a special attention in the final phase, being an essential component in the cancer treatment. The target is to support the best quality of live in the sense of well-being in the physical mental and social status. For that, we need the coordination of the different levels of medical care, to obtain the global target. Continuos care has a lot of scenarios (home, hospital, and hospice) in which the role of different professionals is basic. Symptomatic treatment will be more important along the illness is progressing, but se have to remember that we have to support and treat all the psychological and social needs along all the process

Astenia, dolor y sufrimiento

Introduction: The asthenia is a frequent symptom in the oncological patients who have important repercussions on their quality of life. In spite of its prevalence and relevance, some experts recognize that the great ignorance of this symptom exists. On the other hand the patients do not express the importance that stops they has the asthenia sensation, since they consider it inevitable. This fact is left patent in a study that compared the relative importance that each oncologist gave to the asthenia and the pain, with that it gave the patient him. Objective: To evaluate that symptom pain or asthenia worries to the oncological patients more and how can be helped to alleviate the suffering them that these symptoms can produce to him. Method: One has evaluated 187 oncological patients, in chemotherapy treatment, in the Service of Medical Oncology of the La Paz Hospital, of Madrid; on its preoccupations, the subjective perception of suffering and if there is something helps them to alleviate its suffering. Results: The 81 of the patients refers that there are different aspects that worry to them, like ill being, the family, future, pain and fatigue. The subjective perception of suffering is in EVA of 0-3 for 41% and the fatigue in EVA of 4- 7 in a 37% of the people worried about these symptoms. Also a 68% make some strategy to control the fatigue and 84% to control the pain. 62% of the patients worried about the pain and 57% of which is worried about the fatigue consider that it would be possible to be helped them to confront these symptoms

Aspectos psicológicos de la astenia

The asthenia is a frequent symptom in the patients with cancer and has important repercussions on its quality of life. In this article east problem is approached from a psychological perspective, basing on empirical data and theoretical and scientific approaches to us of the field of psychology, with the purpose of obtaining a greater knowledge of this multifactorial phenomenon to be able to help as far as possible to confront better east form problem to multidiscipline and to diminish the suffering that can produce the in the patients with cancer. One concludes that the present boarding front to the disease emphasizes the necessity to conserve the habitual activities at a level adapted without causing frustration. The rest and lack of physical activity, like answer to the fatigue, they can (separately or jointly) induce or increase the asthenia. It is not only necessary to investigate in symptoms like the depression, the pain, or the asthenia of independent form, but also jointly; an effective treatment of the depression can alleviate the asthenia, but inversely the suitable treatment of pain can increase the asthenia. It is necessary to establish a measurement instrument that is valid, trustworthy, sensible to the changes, with that the different professionals we pruned to compare results

La reinserción laboral en los pacientes con cáncer colorrectal

Aim: Employment and work-related disability were investigated in a cohort of colorectal cancer patients to describe a possible discrimination and other work issues. Patients and Methods: The study included consecutively 73 colorectal cancer patients who were employed at diagnosis. The questionnaire included cancer-related symptoms and work-related factors. Clinical details were obtained from the medical record. Patients were interviewed face to face. The study was approved by the Ethical Committee of La Paz Hospital. All patients gave consent to participate. Results: Eighty six per cent of patients were unable to work after diagnosis, but 55% returned to work at the end of treatment. The age, having a metastatic illness and the sequelae of the disease or its treatment were independently associated with the ability to work after the end of treatment. Almost all patients told their employers and co-workers about their disease. Conclusions: This is the fi rst exploratory study in Spain about labour reintegration in colorectal cancer. Further studies are necessary.Objetivo: Analizar los factores que infl uyen en la vuelta al trabajo en una cohorte de enfermos con cáncer colorrectal y los posibles problemas de discriminación que pueden tener. Pacientes y métodos: El estudio incluyó 73 pacientes consecutivos diagnosticados de un cáncer colorrectal y empleados en el momento del diagnóstico. Los pacientes rellenaron un cuestionario que incluía aspectos demográficos, clínicos y laborales. El estudio fue aprobado por el Comité Ético y de Investigación Clínica del Hospital La Paz. Todos los pacientes dieron su consentimiento para participar en el estudio y para la utilización de los datos de su historia clínica. Resultados: El 86% de los pacientes pasaron a inactivos tras comenzar el tratamiento de la enfermedad y un 45% lo seguían estando tras éste. No hubo diferencias en la influencia de las distintas variables analizadas con respecto a la actividad laboral tras el diagnóstico. Sin embargo, la edad avanzada, el tener un estadio IV de la enfermedad y la presencia de secuelas derivadas del tumor o del tratamiento de éste, sí infl uyeron en la reinserción laboral una vez fi nalizado el tratamiento específico. La mayoría de los pacientes no creían que el tener la enfermedad les perjudicaría en su puesto de trabajo y, en casi todos los casos, tanto sus compañeros como sus jefes conocían que tenían un tumor. Conclusiones: Éste es el primer estudio exploratorio en nuestro país acerca de la reinserción laboral de los pacientes diagnosticados de una neoplasia maligna colorrectal. Son necesarios más trabajos para poder establecer las medidas adecuadas para la mejora de este proceso

Returning to work in colorectal cancer patients

Aim: Employment and work-related disability were investigated in a cohort of colorectal cancer patients to describe a possible discrimination and other work issues. Patients and Methods: The study included consecutively 73 colorectal cancer patients who were employed at diagnosis. The questionnaire included cancer-related symptoms and work-related factors. Clinical details were obtained from the medical record. Patients were interviewed face to face. The study was approved by the Ethical Committee of La Paz Hospital. All patients gave consent to participate. Results: Eighty six per cent of patients were unable to work after diagnosis, but 55% returned to work at the end of treatment. The age, having a metastatic illness and the sequelae of the disease or its treatment were independently associated with the ability to work after the end of treatment. Almost all patients told their employers and co-workers about their disease. Conclusions: This is the fi rst exploratory study in Spain about labour reintegration in colorectal cancer. Further studies are necessary