Miehen rintasyöpä

English summaryPeer reviewe

Luustolääkkeet estävät varhaisvaiheen rintasyöpää sairastavien murtumia ja parantavat taudin ennustetta

English summaryPeer reviewe

Nivolumab-associated pemphigoid-like blistering dermatosis after sun exposure

Non peer reviewe

Celiac disease in patients with severe liver disease: gluten-free diet may reverse hepatic failure

Peer reviewe

Eturauhassyöpää sairastavan potilaan luusto

Vertaisarvioitu.Eturauhassyöpä ja sen androgeenideprivaatiohoito (ADT) altistavat potilaan osteoporoosille ja luunmurtumille. Eturauhassyövän toteamisvaiheessa tulisi arvioida murtumariski ja aloittaa ainakin elintapahoitoon perustuva murtumien ehkäisy. Luustolääkkeiden käyttö ADT:hen liittyvän osteoporoosin hoidossa ei ole riittävästi vakiintunut. Luuhun levinnyt eturauhassyöpä voi aiheuttaa kipua, palliatiivisen sädehoidon tarvetta, murtumia tai selkäydinkompressiota. Näiden luustokomplikaatioiden estossa ja hoidossa käytetään bisfosfonaatteja ja denosumabia, mutta niiden hyöty on osoitettu vasta eturauhassyövän edettyä kastraatioresistenttiin vaiheeseen. Eturauhassyövän systeemihoitokin voi vähentää luuston haittatapahtumia. Luustoetäpesäkkeiden aiheuttamaa kipua lievitetään kipulääkkeiden lisäksi ulkoisella sädehoidolla.Peer reviewe

A graphical LASSO analysis of global quality of life, sub scales of the EORTC QLQ-C30 instrument and depression in early breast cancer

We aimed to (a) investigate the interplay between depression, symptoms and level of functioning, and (b) understand the paths through which they influence health related quality of life (QOL) during the first year of rehabilitation period of early breast cancer. A network analysis method was used. The population consisted of 487 women aged 35-68 years, who had recently completed adjuvant chemotherapy or started endocrine therapy for early breast cancer. At baseline and at the first year from randomization QOL, symptomatology and functioning by the EORTC QLQ-C30 and BR-23 questionnaires, and depression by the Finnish version of Beck's 13-item depression scale, were collected. The multivariate interplay between the related scales was analysed via regularized partial correlation networks (graphical LASSO). The median global quality of life (gQoL) at baseline was 69.9 +/- 19.0 (16.7-100) and improved to 74.9 +/- 19.0 (0-100) after 1 year. Scales related to mental health (emotional functioning, cognitive functioning, depression, insomnia, body image, future perspective) were clustered together at both time points. Fatigue was mediated through a different route, having the strongest connection with physical functioning and no direct connection with depression. Multiple paths existed connecting symptoms and functioning types with gQoL. Factors with the strongest connections to gQoL included: social functioning, depression and fatigue at baseline; emotional functioning and fatigue at month 12. Overall, the most important nodes were depression, gQoL and fatigue. The graphical LASSO network analysis revealed that scales related to fatigue and emotional health had the strongest associations to the EORTC QLQ-C30 gQoL score. When we plan interventions for patients with impaired QOL it is important to consider both psychological support and interventions that improve fatigue and physical function like exercise.Peer reviewe

Long-term effects of aromatase inhibitor withdrawal on bone mineral density in early breast cancer patients : 10-year follow-up results of the BREX study

Purpose: We aimed to provide long-term bone mineral density (BMD) data on early breast cancer patients of the BREX (Breast Cancer and Exercise) study. The effects of exercise and adjuvant endocrine treatment 10 years after randomization were analyzed, with special emphasis on aromatase inhibitor (AI) therapy discontinuation at 5 years. Methods: The BREX study randomized 573 pre- and postmenopausal breast cancer patients into a 1-year supervised exercise program or a control group. 372 patients were included into the current follow-up analysis. BMD (g/cm2) was measured by dual-energy X-ray absorptiometry at lumbar spine (LS), left femoral neck (FN), and the total hip. Separate groups were displayed according to baseline menopausal status, and whether the patient had discontinued AI therapy at 5 years or not. Results: The BMD change from 5 to 10 years did not significantly differ between the two randomized arms. AI discontinuation at 5 years had statistically significant BMD effects. The FN BMD continued to decrease in patients who discontinued AI therapy during the first 5-year off-treatment, but the decrease was three-fold less than in patients without AI withdrawal (− 1.4% v. − 3.8%). The LS BMD increased (+ 2.6%) in patients with AI withdrawal during the first 5 years following treatment discontinuation, while a BMD decrease (-1.3%) was seen in patients without AI withdrawal. Conclusion: This study is to our knowledge the first to quantify the long-term impact of AI withdrawal on BMD. Bone loss associated with AI therapy seems partially reversible after stopping treatment. Trial registration: http://www.clinicaltrials.gov/ (Identifier Number NCT00639210).Peer reviewe

A graphical LASSO analysis of global quality of life, sub scales of the EORTC QLQ-C30 instrument and depression in early breast cancer

We aimed to (a) investigate the interplay between depression, symptoms and level of functioning, and (b) understand the paths through which they influence health related quality of life (QOL) during the first year of rehabilitation period of early breast cancer. A network analysis method was used. The population consisted of 487 women aged 35-68 years, who had recently completed adjuvant chemotherapy or started endocrine therapy for early breast cancer. At baseline and at the first year from randomization QOL, symptomatology and functioning by the EORTC QLQ-C30 and BR-23 questionnaires, and depression by the Finnish version of Beck's 13-item depression scale, were collected. The multivariate interplay between the related scales was analysed via regularized partial correlation networks (graphical LASSO). The median global quality of life (gQoL) at baseline was 69.9 +/- 19.0 (16.7-100) and improved to 74.9 +/- 19.0 (0-100) after 1 year. Scales related to mental health (emotional functioning, cognitive functioning, depression, insomnia, body image, future perspective) were clustered together at both time points. Fatigue was mediated through a different route, having the strongest connection with physical functioning and no direct connection with depression. Multiple paths existed connecting symptoms and functioning types with gQoL. Factors with the strongest connections to gQoL included: social functioning, depression and fatigue at baseline; emotional functioning and fatigue at month 12. Overall, the most important nodes were depression, gQoL and fatigue. The graphical LASSO network analysis revealed that scales related to fatigue and emotional health had the strongest associations to the EORTC QLQ-C30 gQoL score. When we plan interventions for patients with impaired QOL it is important to consider both psychological support and interventions that improve fatigue and physical function like exercise

Associations between Physical Exercise, Quality of Life, Psychological Symptoms and Treatment Side Effects in Early Breast Cancer

Peer reviewe