1,721,555 research outputs found
Psychosocial morbidity and adjustment to illness among long-term cancer survivors - A six-year follow-up study
No full textPsychiatric morbidity (DSM-III-R) and adjustment to illness (psychological stress, illness behavior, and coping) were prospectively studied in 52 cancer patients who had been evaluated at the time of cancer diagnosis 6 years earlier. The prevalence of psychiatric disorders decreased from 47% to 37%. Improvement in psychological adjustment (low interpersonal sensitivity, psychoticism, paranoia, disease conviction, and anxious preoccupation) was found between these two assessment points. A lifetime history of psychopathology and psychiatric problems at baseline was associated with a current mental disorder. External locus of control, low social support, abnormal illness behavior, emotional stress, and poor coping mechanisms, as evaluated at first assessment, were also associated with psychological symptoms and maladjustment to cancer at follow-up. From the data reported, the need to maintain a continuity of psychosocial care among cancer survivors is inferred
Psychiatric and psychosocial concomitants of abnormal illness behaviour in patients with cancer
No full textBackground: Previous studies of medically ill patients suggested that abnormal illness behaviour (i.e. high hypochondriasis, disease conviction, dysphoria and irritability) is associated with depressive symptoms. The present study was carried out in order examine more in detail the role of psychiatric and psychosocial variables in moulding abnormal illness behaviour in patients with cancer. Methods: Two-hundred and one newly-diagnosed cancer patients were submitted to a semistructured interview to assess past and current psychiatric disorders (DSM-III-R) and social support. Self-report questionnaires were also given in order to evaluate psychological stress symptoms (Symptom Check List-90-R - SCL-90-R), external locus of control (ELC) and illness behaviour (Illness Behaviour Questionnaire - IBQ). Results: A pattern of abnormal illness behaviour was shown in patients with a life-time history of psychiatric disorders (n = 33) and in those with a current DSM-III-R diagnosis (n = 101). IBQ dimensions were associated with SCL-90-R, ELC and low social support. The patients’ tendency to deny life events other than cancer was related both to the progression of the illness and their receiving chemotherapy. Conclusions: The study confirms the association between psychological disorders and abnormal illness behaviour and points out the role of personality variables (external locus of control) and low social support in favouring maladaptive responses to cancer
Are metastatic testicular tumors curable with high-dose chemotherapy and stem-cell rescue?
No full textExpert Forum, la gestione terapeutica del carcinoma del colon-retto in fase metastatica, il ruolo della target therapy
No full textChronic myeloid leukemia: the concepts of resistance and persistence and the relationship with the BCR-ABL1 transcript type
No full textChronic myeloid leukemia is driven by a hybrid gene, BCR-ABL1, that codes for a leukemogenic tyrosine kinase (TK) protein of 210 KDa (p210BCR-ABL1). Resistance to TK inhibitor (TKI) therapy occurs in relatively few patients, no more than 10%, while persistence of minimal residual disease during TKI therapy occurs in the great majority of patients. Resistance is a cause of death, persistence is compatible with a fairly normal length and quality of life, but may require lifelong treatment. The causes of resistance are heterogeneous, including the development of other genomic abnormalities or the altered expression of other genes, requiring different treatments. The causes of persistence may not be the same as those of resistance. We hypothesize that the variability in breakpoint position within the Major-breakpoint cluster region (M-bcr), resulting in two different messenger RNAs that may or may not include exon 14 of BCR (e13a2 and e14a2, respectively), and, as a consequence, in two p210BCR-ABL1 proteins that differ by 25 amino acids, may be a cause of persistence. The hypothesis is based on a critical review of the relationships between the BCR-ABL1 transcript types, the response to TKIs, the outcome of treatment, and the immune response, suggesting that the e14a2 transcript is associated with more and deeper molecular responses, hence with a higher probability of achieving treatment-free remission (TFR). Investigating this putative cause of persistence may help bringing more patients into stable TFR
Primary mediastinal germ cell tumors
No full textBACKGROUD: Germ cell tumors (GCTs) are a group of neoplasms usually arising in the gonads, and very rarely in sites outside the gonads, mainly in the retroperitoneum, the anterior mediastinum, and pineal gland or the coccyx (mainly in childhood). The prognosis of nonseminoma primary mediastinal GCTs (PMGCTs), is considered to be poorer compared to its retroperitoneal or gonadal counterparts and, according to the International Germ Cell Cancer Collaborative Group, it is considered by definition as a "poor risk" disease. MATERIAL AND METHODS: Our review highlights the clinical features, prognostic factors, and therapeutic strategies in PMGCTs, as described in medical literature. So far available data were obtained through a Medline search of English-language papers. RESULTS: Due to the rarity of the disease, there are no prospective studies comparing different treatment strategies. For this reason, oncology societies recommend treating PMGCTs like other GCTs, according to general risk categories. CONCLUSION: Because of the rarity of the disease, poor categorization, and the lack of novel therapeutic strategies, an International database is required to obtain more information on these tumors. Additional efforts should be done, with the aims to find effective novel therapeutic agents
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