Qualidade de vida de pacientes com câncer de mama em terapia adjuvante

O objetivo do estudo foi avaliar a Qualidade de Vida (QV), identificar os domínios afetados em pacientes comcâncer de mama em terapia adjuvante e correlacioná-los com características sócio-demográficas, clínicas e terapêuticas.Estudo transversal, realizado com 35 pacientes entre agosto de 2007 e dezembro de 2008. Utilizou-se oinstrumento Quality of Life Core-30-Questionnaire (QLQ-C30). A Qualidade de Vida geral foi considerada poucosatisfatória. Os domínios afetados foram: função emocional, insônia, dor e fadiga. Nas correlações, as pacientesacima de 60 anos apresentaram pior escore na função emocional, as submetidas à cirurgia referiram mais constipação,as que realizavam radioterapia obtiveram pior escore para QV geral e as que estavam em quimioterapia hámais de seis ciclos apresentaram a função emocional afetada e dispnéia. Concluiu-se que os tratamentos adjuvantesafetaram de algum modo as pacientes, causando déficit na função emocional e relataram mais sintomas, prejudicandoassim sua QV

Depression in Cancer: the many biobehavioural pathways driving tumor progression

Major Depressive Disorder (MDD) is common among cancer patients, with prevalence rates up to four-times higher than the general population. Depression confers worse outcomes, including non-adherence to treatment and increased mortality in the oncology setting. Advances in the understanding of neurobiological underpinnings of depression have revealed shared biobehavioral mechanisms may contribute to cancer progression. Moreover, psychosocial stressors in cancer promote: (1) inflammation and oxidative/nitrosative stress; (2) a decreased immunosurveillance; and (3) a dysfunctional activation of the autonomic nervous system and of the hypothalamic-pituitary-adrenal axis. Consequently, the prompt recognition of depression among patients with cancer who may benefit of treatment strategies targeting depressive symptoms, cognitive dysfunction, fatigue and sleep disturbances, is a public health priority. Moreover, behavioral strategies aiming at reducing psychological distress and depressive symptoms, including addressing unhealthy diet and life-style choices, as well as physical inactivity and sleep dysfunction, may represent important strategies not only to treat depression, but also to improve wider cancer-related outcomes. Herein, we provide a comprehensive review of the intertwined biobehavioural pathways linking depression to cancer progression. In addition, the clinical implications of these findings are critically reviewed

THE ROLE OF THE LIVER IN MODULATING ADRENOCORTICAL ACTIVITY.

THE ROLE OF THE LIVER IN MODULATING ADRENOCORTICAL ACTIVITY