OBJECTIVE: To understand if COVID-19 pandemic impacts on delays in non-metastatic HER2-negative breast cancer diagnosis and in the beginning/development of neoadjuvant chemotherapy, as well as on changes in treatment plan to Paclitaxel intensification doses, impaired patients’ quality of life and mental health. METHODS: This is a cross-sectional study of 67 women diagnosed with non-metastatic HER2-negative breast cancer during the first sixteen months of COVID-19 pandemic and receiving neoadjuvant treatment due to pandemic impossibility of immediate definitive cancer surgery following the neoplasm diagnosis. Sociodemographic, Functional Assessment of Cancer Therapy Scale - General, Beck Anxiety and Depression Inventory were used for outcomes assessment. Inferential analysis was performed by Mann-Whitney, Pearson's chi-squared, and Fisher's exact tests. The adopted significance was 5%. RESULTS: The study revealed that the oncological diagnosis delays caused a worsening of the patients' physical (8 x 21; p = 0.001), functional (13 x 21; p = 0.03) and general (61 x 83; p = 0.004) well-being; retardment in the beginning of neoadjuvant chemotherapy decreased physical well-being (13 x 21; p = 0.01). Changes in treatment plan, to Paclitaxel doses intensification, had a negative effect on functional well-being (20 x 25.5; p = 0.04). COVID-19 pandemic impacts on neoplasm diagnosis and neoadjuvant treatment delays were also associated with psychosocial manifestations, including higher levels of severe anxiety (60% x 14.5%; p = 0.03 and 40% x 14%; p = 0.04) and depression (40% x 3.2%; p = 0.004 and 60% x 5.3%; p = 0.03) respectively. CONCLUSION: The present study shows that COVID-19 pandemic impacts on non-metastatic HER2-negative breast cancer patients’ diagnosis and neoadjuvant chemotherapy impaired patients' quality of life and mental health.
Introduction: Oncological surgery is one of the main pillars in the cancer treatment. Despite the significant advances of immunotherapies, target therapies, chemotherapies, and radiotherapies, surgery continues as an essential therapy. Objective: to present an updated overview of the oncological surgery’s role, highlighting its evolution throughout history and the current approaches and techniques in cancer treatment. Methods: Narrative and exploratory bibliographic study. The research was carried out in the Medline and Embase databases, using the terms (((surgical oncology)) OR ((surgery) AND (cancer) OR (tumors))). Results: Oncological surgery has made significant advances over its history. Currently, what prevails is the minimally invasive mentality with the techniques of video laparoscopy and robotic surgery. Although access is not uniform throughout the world, the expectation is that more popularization of these techniques will occur in the coming years. The oncological surgery is indicated to prevent, diagnose, evaluate the disease’s spread, curative treatment, sequelae and complications management, as well as palliation. Conclusion: Surgery is a procedure that improves the quality of life and increases cancer patients’ survival. The knowledge of its applicability, different techniques, and future expectations is essential for the correct orientation, referral to specialists, and patient’s follow-up.
Primary gastrointestinal melanomas (PGM) are usually asymptomatic in the early stages, leading to misdiagnosis. We reported the case of a 75-year-old male patient admitted to our service due to hematochezia, and fatigue. Primary investigation showed small bowel intussusception and surgical treatment was performed. Histopathology and immunohistochemistry analysis identified primary small bowel amelanotic melanoma at an advanced tumor stage. Whereas the patient had a sudden impairment of performance status during hospitalization, no curative oncological approach could be performed. This report highlights the clinical and imaging findings that led to the primary gastrointestinal amelanotic melanoma diagnosis in an elderly patient with intestinal intussusception. The early recognition of prior intussusception signs in adults and elder patients may lead to an earlier oncological diagnosis and a better prognosis.
Objective: The aim of this study was to establish correlations between well-being and breast cancer (BC)-related aspects. Methods: Women with BC diagnosis (n=42) were interviewed and National Gross Happiness was assessed through an adaptation of the Second Gross National Happiness Survey Questionnaire. Cancer-related data were also assessed, such as staging, anatomopathological results, hormonal status, and surgical modality. Results: The mean age during BC diagnosis was 43.8 years. The overall happiness self-perception (HSP) score found was 8.8 out of 10. Unhappy feelings or deprived humor were reported by 61.8% of the interviewed women. Good doctor-patient relationship (DPR) during treatment was reported by 92.3% of the study population, and those who reported it had higher overall HSP scores in comparison with those who reported problems regarding their DPR. Besides, 97.6% of the interviewed women had surgical treatment, and our data showed no significant changes in the overall HSP scores among patients undergoing mastectomy and lumpectomy. Conclusion: Women with BC are prone to experience unhappiness and have deprived humor, despite having high overall HSP scores. Besides, in contrast to our original thoughts, the modality of surgical treatment did not have a significant impact on HSP scores.
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