Chronic pain is one of the most common and most bothersome symptoms in cancer patients, which occurs especially often in the elderly population. Although methods of pain treatment are well known, it is not uncommon for individuals with chronic or terminal illnesses to remain underdiagnosed or untreated. Effective pain management has become the measure of success in oncology therapy. For this reason, effective pain management has become an indispensable success factor of multidisciplinary oncological therapy. Along with the growing interest in the holistic approach in medicine, and hence in interdisciplinary treatment, the management of cancer pain in older patients was presented.

S t r e s z c z e n i eWstęp: Opieka paliatywna to kompleksowa opieka nad nieuleczalnie chorym, której podstawowym zadaniem jest poprawa jakości życia i utrzymanie optymalnej sprawności pacjenta.Cel pracy: Ocena wpływu domowej opieki paliatywnej na poprawę jakości życia, zmniejszenie nasilenia objawów choroby i poprawę stopnia sprawności pacjentek z zaawansowanym rakiem piersi. Materiał i metody:Badanie zostało przeprowadzone pomiędzy majem 2016 r. a grudniem 2018 r. u 144 pacjentek z zaawansowanym rakiem piersi skierowanych do leczenia hospicyjnego. Dwukrotnie przeprowadzono ocenę nasilenia objawów, stopnia sprawności i subiektywnej jakości życia, po raz pierwszy w dniu pierwszej lekarskiej wizyty domowej po objęciu pacjentki opieką hospicjum, po raz drugi w 28. dniu opieki.Wyniki: Objawami o największym nasileniu w badanej grupie były: złe samopoczucie, brak apetytu, ból i zaparcia. Po miesiącu odnotowano istotną poprawę jakości życia pacjentek oraz zmniejszenia nasilenia większości objawów (bólu, przygnębienia, nudności, wymiotów, braku apetytu, duszności, zaparć). Stopień sprawności pacjentek nie uległ znaczącej zmianie.Wnioski: Pomimo że program specjalistycznej opieki paliatywnej prowadzony w warunkach domowych nie wpłynął na wzrost sprawności funkcjonalnej pacjentek, to w ciągu 4 tygodni zaobserwowano znaczący spadek nasilenia większości objawów oraz wzrost jakości życia chorych.

Introduction:The purpose of this study was to evaluate the use of complementary and alternative therapies (CAT) by palliative care patients treated at home in Poland. Patients and methods: A total of 241 adult patients with advanced or metastatic cancer who were qualified for palliative care provided at home filled out the CAT screening tool. Data were analysed to assess CAT use association with several variables. Results: 82.16% of individuals who completed the survey declared using CAT at least once in the last 12 months. Self-help practices were the most used CAT category (74.47%), it was followed by herbal medicine and dietary supplements (62.66%) and visits to CAT providers (41.91%). CAT use was more prevalent among women, patients with basic education, and patients currently married and widowed. The most common reason pointed for using CAT was to improve well-being (35.4%). 50.5% of CAT users declared that they find used therapy helpful or very helpful. The study revealed an exceptionally high prevalence of spiritual practices (self-prayer, spiritual healing) in comparison to previous European studies conducted among the cancer patient population. Conclusions:The study indicated that usage of CAT among advanced cancer patients treated at home is significant, with a higher prevalence of spiritual practices than reported in previous studies among cancer patients in Europe.

Introduction.A novel coronavirus, causing severe acute respiratory syndrome 2 (SARS-CoV-2) has spread globally since its emergence in December 2019. The mRNA SARS-CoV-2 vaccines have been proven to be an efficient and safe disease control means among adult patients without immunocompromising conditions. However, cancer patients were among the group of people that was initially excluded from the registration trials. Material and methods. 60 patients, enrolled to this study, had been voluntarily vaccinated either with the BNT162b2 or mRNA-1273 SARS-CoV-2 vaccine between March and June 2021 and have been undergoing systemic treatment in the Clinical Oncology Unit of the University Clinical Center of the Medical University of Silesia in Katowice, Poland. Patients received 2 injections of vaccine 21 days apart and were tested with Elecsys® Anti-SARS-CoV-2 immunoassay (Roche Diagnostics, France) for the presence of anti-S-protein antibodies in the patients' serum. The serum samples were collected 2 to 8 weeks after receiving the second dose of vaccine. Results. The BNT162b2 vaccine was administered to 57 patients, while the mRNA-1273 vaccine -to 3 patients. Seroconversion was achieved in 83.33% of patients. The median amount of anti-S-protein antibodies was 75,9 U/ml.There were no statistically significant differences in terms of age between the group with seroconversion and the group without seroconversion (Mann-Whitney U-test p = 0.762). There was no statistically significant correlation between neither the BMI (Spearman test, p = 0.079) norage (Spearman test, p = 0.762) and anti-S-protein antibody levels. Just as the diagnosis (primary tumor localization), clinical stage, type of modality (chemotherapy, chemoradiotherapy, immunotherapy) and the goal of treatment (radical, palliative) were not statistically significant in terms of anti-S-protein antibody levels. Conclusions. Due to the high number of unresponsive or poorly responsive results, patients undergoing systemic therapy should be advised to maintain other measures of disease control such as distancing, usage of masks. Nevertheless, implementing mRNA SARS-CoV-2 vaccinesinimmunocompromised patientsduring systemic therapyis reasoned, valuable and safe.

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