Impact of two different exercise programs on persistent cancer-related fatigue and physical fitness

Cancer-related fatigue is a common symptom in patients with cancer, which is experienced by 70% to 100% of these patients and brings some impairment of physical and mental performance, hinders their working or carrying out regular daily activities, and hence results in a substantial reduction of the quality of life. Physical exercise has consistently been identified as a central element of rehabilitation for many chronic diseases like cancer, and increasing evidence supports the contention that physical activity is a valuable intervention that can be utilized in conjunction with conventional therapies during CRF treatment. Objective: The aim of this study was to assess the impact of a program of physical exercise on fatigue levels and physical performance of cancer patients. Method: A consecutive series of 44 adult patients with neoplastic disease (solid or hematological), with a medical diagnosis of fatigue, who were enrolled in an oncological treatment, with the ability to walk and willing to enter a rehabilitation program of exercise for at least 4 consecutive months. The exercise program was performed two times per week, each session lasting one hour and consisting of aerobic, resistance, and flexibility exercises. The protocol was divided into aerobic exercise and resistance training combined with aerobic exercise. The patients were evaluated with two assessments: one prior to their beginning the exercise program and other at the end of the four-month program. In both assessments the patients completed the Revised Piper Fatigue Scale and the six-minute walk test. The primary outcome of change over baseline and after 16 weeks in PFS-R score and six-minute walk test were compared using a two sample two-sided t-test for both groups. Alpha level was set at p < 0.05. Results: After 16 weeks, the patients who participated in the aerobic or the combined exercise program reported significantly higher levels of physical functioning (6-minute walking test, p = 0.0009 and p = 0.001, respectively) and significantly lower fatigue (PFS-R, p = 0.003 and p = 0.002, respectively) than at the beginning the exercise program. Conclusion: The results of patients who underwent aerobic or aerobic + anaerobic exercise showed statistically significant improvement of physical performance and of fatigue. Data from this study corroborates with the literature showing that exercise programs with aerobic or resistance exercises are an effective strategy for the treatment of fatigue. The results of this study confirm that physical exercise could be useful in rehabilitation of cancer survivors, especially for fatigued patients.A fadiga relacionada ao câncer é um dos sintomas mais comuns entre pacientes com câncer, relatada em 70% a 100% desses pacientes resultando em uma reduçao significativa da qualidade de vida, funcionalidade e independência. O exercício físico tem sido identificado como um elemento central de reabilitaçao de muitas doenças crônicas como câncer, e cada vez mais evidências apoiam a tese de que a atividade física é uma intervençao útil, que pode ser utilizada em conjunto com terapias convencionais durante o tratamento da fadiga relacionada ao câncer. Objetivo: Avaliar o impacto de dois programas de exercício físico sobre os níveis de fadiga e desempenho físico de pacientes com câncer. Método: Relato de uma série consecutiva de 44 doentes adultos com doença neoplásica (sólido ou hematológicas), e diagnóstico médico de fadiga, submetidos a dois diferentes programas de exercício físico. Todos os doentes foram avaliados quanto a desempenho físico com o uso do teste de caminhada de 6 minutos e avaliados quanto aos níveis de fadiga com o teste de Piper, antes e depois de 4 meses de atividade física supervisionada (exercícios aeróbicos isolados e treino de resistência combinado ao exercícios aeróbicos). Resultados: Após 16 semanas, os doentes que participaram do programa de exercícios aeróbicos ou que participaram do protocolo de exercício aeróbico combinado com anaeróbio, relataram níveis significativamente mais elevados do desempenho físico (6 minutos teste de caminhada, p = 0,0009 e p = 0,001, respectivamente) e níveis de fadiga significativamente menor (PFS- R, p = 0,003 e p = 0,002, respectivamente) do que no início do programa de exercícios. Conclusão: Estes resultados demonstram que tanto um protocolo de exercício aeróbico quanto de exercício aeróbico combinado com exercício anaeróbio apresentam melhora significativa do desempenho físico e dos níveis de fadiga de doentes oncológicos. Os dados deste estudo corroboram a literatura mostrando que a atividade física é uma estratégia eficaz para o tratamento da fadiga. Os resultados deste estudo confirmam que o exercício físico pode ser útil na reabilitaçao de sobreviventes de câncer, especialmente para pacientes com fadiga oncológica

Ovarian adenosarcoma simulating a simple cyst in a young patient

Müllerian adenosarcoma is a rare, mixed tumor that can occur throughout the female genital tract, but is most commonly found in the uterus. Ovarian adenosarcoma is rarer and has a poorer prognosis than uterine adenosarcoma. Data on the clinicopathological features of ovarian adenosarcoma are limited, and, due to its rarity, the management is controversial. The authors report a case of a 25-year-old patient who presented with recurrent abdominal pain. Sonography and laparotomy showed an ovarian cyst, and pathologic examination confirmed the diagnosis of cystic low-grade adenosarcoma. The patient remains free of recurrence 6 months after diagnosis. The authors call attention to the differential diagnosis of ovarian masses, especially in young patients, and to the lack of evidence on the management of this neoplasm in the literature

Plasmacytoid urothelial carcinoma: a case of histological variant of urinary bladder cancer with aggressive behavior

Plasmocytoid variant urothelial carcinoma (PVUC) of the urinary bladder is a rare histological variant of transitional cell carcinoma. Data regarding PVUC shows that this neoplasia presents a distinctive clinical outcome represented by aggressive behavior and poor survival rate. The authors report a case of a 57-year-old male patient with a 3-month history of hematuria and pelvic pain. Radical cystectomy with lymphadenectomy was performed and pathological examination showed a pT3pN0 PVUC of the bladder. The patient remained free of recurrence for 8 months, but the disease recurred involving the abdominal wall and subcutaneous tissue. Chemotherapy provided a positive clinical response and relief of symptoms. The authors call attention to the aggressiveness of this rare variant of bladder cancer and recommend radical surgery and multidisciplinary management of this neoplasm

Environmentally sustainable : how are the practices in the organic food tourist route?

This study analyzes Environmentally Sustainable Practices (ESPs) in the Organic Food Tourist Route (OFTR) in South Brazil. Data collection included interviews with open and closed questions about ESPs and the Barometer of Tourism Sustainability (BTS) tool. Eight owners or managers of OFTR’s enterprises answered questions online or personally. Content analysis and descriptive statistics were used. Results indicated that tourism enterprises adopt ESPs according to each reality since some are dedicated to producing and commercializing organic products, while others are dedicated to lodging and guided tours. Managers realize the importance of adopting ESPs, enabling a decrease in expenses and the supply of organic products. Since tourists are concerned and careful with the environment nowadays, sustainability must be considered, becoming a differential. The enterprises develop ESPs, which makes the route potentially sustainable, following the standards established by the BTS. In order to achieve the “sustainable” level, the enterprises on the route need to improve their performance in many items whose results were less sustainable. From a theoretical perspective, this study contributed to understanding how ESPs were developed in enterprises and how they contribute to tourism development. The understanding of tourist routes expanded with an emphasis on sustainability, the environmental dimension, the ESPs, and organic agriculture. The BTS enabled the assessment of the sustainability of OFTR’s enterprises

Should extragonadal germ cell tumors be included in studies of families with testicular germ cell tumors?

Abstract\ud \ud \ud \ud Background\ud \ud Family history is among the few established risk factors for testicular germ cell tumor (TGCT). Approximately 1.4% of newly diagnosed TGCT patients report a positive family history of TGCT. Sons and siblings of TGCT patients have four- to six fold and eight- to tenfold increase in TGCT risk, respectively. In twins of men with TGCT the relative risk of testicular cancer is 37.5 (12.3-115.6). Nevertheless, information about the occurrence of TGCT in relatives of patients with extragonadal germ cell tumor is limited.\ud \ud \ud \ud Case report\ud \ud A 24 year-old male patient was diagnosed with a mediastinum tumor and was submitted to image-guided biopsy, which revealed a seminoma. Two months later, his non-identical asymptomatic twin brother was submitted to an elective ultrasound of the testes, which showed a left testicular mass of 4.2 cm. This patient underwent orchiectomy revealing a seminoma of the left testis. There are no other cases of seminoma or other types of cancers reported in first-degree relatives in this family.\ud \ud \ud \ud Conclusions\ud \ud Although familial aggregations of TGCT have been well described, to the best of our knowledge, no data concerning the association of gonadal and extragonadal germ cell tumor in relatives has been previously reported. Further investigation on this association is warranted and may help in improving our knowledge of familial pattern inheritance.We thank the patients and their family, without whose cooperation this report would not have been possible

Acquired hemophilia A in a patient with advanced prostate cancer

Acquired hemophilia A (AHA) is a rare disorder that results from the presence of autoantibodies against the clotting factor VIII (FVIII) causing hemorrhagic disorders. This entity is mostly associated with autoimmune diseases, pregnancy, the postpartum period, drugs and malignancy. Among the solid cancers, prostate neoplasm is the most common cause of AHA. The management of AHA involves the control of active bleeding and the use of specific therapies to eliminate the inhibitor. The authors describe the case of an 87-year-old man with prostate cancer who developed a bleeding disorder 5 years after the cancer diagnosis. Treatment with prednisone did not reach a satisfactory clinical response, which was only achieved with the association of azathioprine. The patient became asymptomatic with no further bleeding episodes, but developed a fatal sepsis after 3 months of treatment with these immunosuppressive agents

Lactate and base deficit are predictors of mortality in critically ill patients with cancer

Cancer patients frequently require admission to intensive care unit. However, there are a few data regarding predictive factors for mortality in this group of patients. The aim of this study was to evaluate whether arterial lactate or standard base deficit on admission and after 24 hours can predict mortality for patients with cancer.Journal ArticleSCOPUS: ar.jinfo:eu-repo/semantics/publishe