Adenocarcinoma of the appendix — case study

The following study presents the case of a 58-year-old woman who was diagnosed, during the diagnosis of an ovarian tumor, with mucous metastatic adenocarcinoma of the appendix. Due to the severity of the disease and the low degree of differentiation of the cancer, the treatment of the patient required a continuous and intensive systemic treatment lasting three years. A significant role in the course of the disease was also played by surgical interventions, since the patient underwent 4 reoperations due to local recurrence. The history of the disease is an example of the problems in the therapy and diagnosis of atypical tumors resulting from non-specific symptoms and different evolution of the disease

Leczenie ukierunkowane molekularnie chorych na niedrobnokomórkowego raka płuca

Rak płuca stanowi najczęstszą przyczynę zgonów z powodu choroby nowotworowej zarówno u mężczyzn, jak i u kobiet w Polsce i na świecie. Chorzy z rozpoznaniem niedrobnokomórkowego (NDRP) niepłaskonabłonkowego raka płuca, a także chorzy z nowotworem o nieokreślonym podtypie histologicznym (NOS) mogą odnieść korzyść z leczenia celowanego, ponieważ w tych typach nowotworów najczęściej stwierdza się obecność zaburzeń molekularnych, takich jak mutacja aktywująca w genie EGFR, rearanżacja genów ALK, ROS1 czy NTRK oraz mutacja w genie BRAF. Zaburzenia te są dodatnim czynnikiem predykcyjnym odpowiedzi na leczenie inhibitorami kinazy tyrozynowej. Podkreśla się konieczność oznaczeń molekularnych u chorych na zaawansowanego niedrobnokomórkowego niepłaskonabłonkowego raka płuca przed kwalifikacją do chemioterapii systemowej i w przypadku stwierdzenia zaburzeń molekularnych — zastosowania terapii celowanej w 1. linii leczenia

Erlotinib therapy in advanced non small-cell lung cancer

Erlotynib jest jednym z inhibitorów kinazy tyrozynowej receptora naskórkowego czynnika wzrostu. Terapia tymi cząsteczkami może przynieść korzyść taką jak wydłużenie czasu przeżycia oraz poprawy jakości życia w wyselekcjonowanej grupie chorych z niedrobnokomórkowym rakiem płuca (NDRP). Chorzy odnoszący największą korzyść z tej terapii to pacjenci z potwierdzoną obecnością mutacji aktywującej w obrębie genu EGFR, w dobrym stanie ogólnym. Leki te są dobrze tolerowane, podanie ich nie wymaga hospitalizacji co jest bardzo ważne dla chorych oraz ich rodzin. W pracy przedstawiono przypadek mężczyzny leczonego erlotynibem.Erlotinib is one of epithelial growth factor receptor tyrosine kinase inhibitors. Treatment of selected patient groups may result in prolonged survival time and improved quality of life during therapy. Patients who benefit most from this therapy are those with confirmed activating mutations within the EGFR gene, in good general condition. These drugs are well tolerated and do not require hospitalization, which is very important for the patients and their families We present the case of a male with advanced non small cell lung cancer who receives erlotinib

Gruczolakorak wyrostka robaczkowego

Przedstawiono przypadek 58-letniej kobiety z rozpoznanym w diagnostyce guza jajnika przerzutowym gruczolako­rakiem śluzowym wyrostka robaczkowego. Ze względu na zaawansowanie choroby oraz niski stopień zróżnicowania nowotworu leczenie pacjentki wymagało trwającej 3 lata ciągłej i intensywnej terapii systemowej. Znaczącą rolę w przebiegu choroby odgrywały również interwencje chirurgiczne, gdyż pacjentka przeszła 4 reoperacje z powodu wznowy miejscowej. Historia choroby tej chorej jest przykładem problemów w terapii i diagnostyce nietypowych nowotworów wynikających z ich niespecyficznych objawów oraz odmiennej ewolucji choroby

Tobacco smoking in Wielkopolska towards the end of 20th century

Tobacco smoking is the cause of 30% of deaths among men and 7% among women in Poland. Such data call for detailed analysis. Previous researche on frequency of smoking was focused on the analysis of all-Poland population. The following research was aimed at the description of tobacco smoke exposure in population of Wielkopolska in the late 1990s. Smoking habits in Wielkopolska is more prevalent in men than women and this prevalence is sustained in time. The smoking habit among men decreased during the last 5 years of the 20th century, however it is higher among women (1996: 47.5% men and 27.7% women, 2000: 41.9% men and 29.9% women). The positive fact is the raising percentage of both men and women who give up smoking. The results show that the level of education is a strong predictor of smoking among men: the higher education, the lower percentage of smokers. This relation does not seem to be that obvious in women. The place of living is another factor influencing the percent age of smoking people - the prevalence is lower in cities, especially among men. Presented results show that there are similar changes in smoking habits in Wielkopolska as observed nationwide. The difference concerns slightly lower percentage of tobacco users among men and higher among women in Wielkopolska than in nationwide population. Distribution of involvement of subsequent categories (i.e. gender, age, education and place of living) follow the pattern observed in general population. The knowledge about smoking habits in Wielkopolska forms the ground for actions within the frame of evidence based medicine, systematic assessment of frequency of smoking would allow taking up appropriate preventive actions such as youth education and therapeutic (treatment of smoking habit) actions. Pneumonol. Alergol. Pol. 2005, 73, 128-134

Salinomycin – a breakthrough in the treatment of ovarian cancer?

It is believed that cancer stem cells are the primary cause of cancer chemotherapy resistance, metastasis and relapse. The cancer stem cells form a small population of cells present in the tumor (accounting for less than 2% of the tumor mass) and have properties which enable them to survive chemo- and radiotherapy. These cells have the ability to self-renew, do not undergo apoptosis, display overexpression of the ALDH1A1 enzyme and ABC genes which encode transport proteins, and furthermore make use of various signaling pathways (Wnt, Notch, Hedgehog). Cancer stem cells may be identified and isolated from the tumor based on the characteristic biomarkers (CD44+, CD133+, CD117+, BMi1, Oct-4, nestin). It has been demonstrated that salinomycin, an antibiotic obtained from Streptomyces albus, eliminates cancer stem cells, which are resistant to treatment with cytostatics. Salinomycin causes apoptosis of these cells through a number of mechanisms, including the disruption of the Na+/K+ ion balance in biological membranes, inhibition of the Wnt pathway and resistance to transporters, increase in the activity of caspases, activation of the MAPKp38 pathway and inhibition of the nuclear transcription factor NF-κB. Salinomycin has an effect on many types of cancer. It may turn out to be a breakthrough in the therapy of chemotherapy-resistant cancers

Sexual well being of breast cancer patients

Introduction. Breast cancer is the most common cancer in women – both in Poland and around the world. In terms of the mortality rate, it subsides brest cancer with lung cancer. In 2018, almost 2 million new cases were reported worldwide, and almost 44 million women have been diagnosed with breast cancer in the last 5 years. Material. The aim of this paper is to present ways to improve the sexual well being of breast cancer patients. Methods. Analysis of the literature by oncologists, gynecologists, and psychologists was used for theoretical discussion. Results. Sexuality is an extremely important part of every woman’s life, including those suffering from breast cancer. Surgery of the breast, a symbol of a woman’s sexuality, and the negative effects of cancer therapy can alter a woman’s perception of her own body and lower her libido. Sexual therapy which should be based on multi-faceted activities, is an extremely important part of breast cancer treatment. Conclusions. Therapeutic possibilities may be based on psychological and sexual therapies as well as pharmacological support (moisturizers, silicone lubricants, tampons inserted for several minutes with 4% vaginal lidocaine before intercourse, topical gels with estrogens, ospemifen, DHEA, testosterone)

Stanowisko polskich ekspertów dotyczące stosowania leku brygatynib w leczeniu chorych na niedrobnokomórkowego raka płuca z rearanżacją genu ALK

Brygatynib jest nowym inhibitorem kinazy ALK II generacji zarejestrowanym w 2018 roku w krajach Unii Europejskiej w leczeniu chorych z ALK+ niedrobnokomórkowym rakiem płuca, po wcześniejszym leczeniu kryzotynibem. W badaniu klinicznym II fazy u chorych z opornością na kryzotynib uzyskano dla zarejestrowanej dawki brygatynibu medianę czasu przeżycia wolnego od progresji wynoszącą 16,7 miesiąca, a medianę całkowitego czasu przeżycia — 34,1 miesiąca. Długotrwałe odpowiedzi na brygatynib zaobserwowano również w zakresie zmian w ośrodkowym układzie nerwowym. Mediana czasu do progresji wewnątrzczaszkowej u chorych z wcześniejszymi zmianami w mózgu wyniosła 18,4 miesiąca. W badaniu III fazy porównującym brygatynib z kryzotynibem wykazano zmniejszenie ryzyka progresji choroby lub zgonu o 51%, w tym u chorych z przerzutami w mózgu o 80%. Lek charakteryzuje się dobrym profilem tolerancji. Najczęściej występujące działania niepożądane to: biegunka, nudności, bezobjawowy wzrost aktywności kinazy kreatynowej, kaszel oraz osłabienie. Lek ten stanowi cenną opcję terapeutyczną u chorych z zaawansowanym niedrobnokomórkowym rakiem płuca z rearanżacją genu ALK po niepowodzeniu leczenia kryzotynibem, zarówno śródczaszkowej, jak i w obszarze innych ognisk choroby

Sexual Health in breast cancer patients in Poland

Introduction.Breast cancer is the most common malignancy among women in Poland and in the world, with a mor­tality rate second only to that of lung cancer. Breasts are one of the most important symbols of femininity and sexuality. Cancer surgery, but also systemic therapy (chemotherapy and hormone therapy) cause a change in the perception of one’s body. The aim of the survey proposed by us was to assess interest in sex by breast cancer patients during and after oncological treatment, as well as to identify ways to improve the quality of patients’ sex lives. Materials and methods.The proposed survey consisted of 3 parts: the first part included questions about the demo­graphic, in the second part there were the author’s questions about sexual dysfunction (12 questions), in the third part there was the Female Sexual Function Index (FSFI) form assessing the sexual functioning of women. The questionna­ires were made available online from October 13, 2020 to December 20, 2020 through the social networks of patient organizations involved in breast cancer care. 287 women diagnosed with breast cancer were included in the survey. Results.Before the disease almost all patients were sexually active and had a partner (95.5%; n = 274); at the time of filling the questionnaire only slightly more than half of the patients remained sexually active ( 57.1%; n = 164). About 30.7% (n = 88) stated that the disease was the main reason for not being sexually active. More than 60% of patients (60.9%; n = 137) used products to improve the comfort of sexual intercourse, mainly lubricants (39.7%; n = 114). Only about 1/3 of the patients (32.1%; n = 92) were satisfied with their sex life, 48.1% (n = 138) stated they were not satisfied with their sex life, 19.9% (n = 57) did not answer this question. The main reasons for lack of satisfaction with sex life included: decreased libido (65.9%; n = 189), vaginal dryness (55.1%; n = 158). The mean score of forms filled out by the respondents was 24.50 in FSFI form. Conclusions.Assessment of sexual dysfunction in patients with breast cancer should be performed on a routine basis before treatment and regularly during treatment

The repeated use of high dose rate brachytherapy for locally recurrent lung cancer

PurposeTo assess the effect of repeated palliative treatment with high dose rate brachytherapy in patients with advanced lung cancer.Material and MethodsFifty-six patients, 25.3% of a total of 221 patients treated for lung cancer with HDR brachytherapy were treated twice, using High Dose Rate Brachytherapy. All patients were qualified for repeated brachytherapy due to the recurrence of intrabronchial tumour and acceptable remissions after the first treatment. The survival times were compared with selected clinical data. Correlations between survival times and subjective breathing difficulties were analyzed separately.ResultsThe median survival time in the whole group of patients was 8.9 months. The period of obtaining a positive clinical response was correlated with a longer survival time (log-rank test, p=0.0009, F Cox test, p=0.007). In the multivariate analysis other statistically important prognostic factors were also included: the clinical stage of the primary tumour (F Cox test, p=0.04), and the interval between the first and second treatment (F Cox, p=0.004). None of the analyzed factors (dyspnoea, cough, haemoptysis and pain) had any influence on survival.ConclusionRepeated HDR brachytherapy in advanced lung cancer was an efficient method that in many patients led to regression of symptoms and improvement in life quality