A.M. Jiménez Gordo

Employment in a cohort of breast cancer patients

BACKGROUND Breast cancer survivors can have problems in returning to work. However, the importance of work to cancer survivors has until recently received little attention. AIMS To investigate employment- and work-related disability in a cohort of breast cancer patients to identify possible discrimination and other obstacles to remaining in work. METHODS Questionnaire study of breast cancer patients employed at diagnosis and where diagnosis had been confirmed at least 6 months before the interview. Participants completed a questionnaire concerning cancer-related symptoms and work-related factors and clinical details were obtained from their medical records. RESULTS The study included 96 consecutive patients with breast cancer aged between 18 and 65 years. In total, 80% of patients were unable to work after diagnosis, but 56% returned to work at the end of treatment. The sequelae of the disease or its treatment and the stage of disease were independently associated with the ability to work after the end of treatment. Only one patient did not tell his/her employers and coworkers about his/her disease. In total, 29% noticed changes in their relation with co-workers and managers, usually in the sense that they tried to be helpful. None reported job discrimination. CONCLUSION Breast cancer survivors in this study encountered some problems in returning to work, mainly linked to the sequelae of their disease and its treatment rather than to discrimination by employers or colleagues.

Linfoma T primario intestinal: a propósito de dos casos con revisión de la literatura

Lymphomas of the gastrointestinal tract are the most common type of primary extranodal lymphomas and about 15-20% of these are primary intestinal lymphomas. They may be or B or T- cell. Intestinal T-cell lymphomas are much less common and they can be enteropathy-associated. This disease occurs in adults with abdominal pain often associated with intestinal perforation. The course is aggressive. The major problem is to distinguish this disease from a benign ulcer. Two cases with differents clinical and pathologic features are reported with a review in the literature of this uncommon entity.

Protocolo diagnóstico y terapéutico del dolor de origen óseo en el paciente oncológico

Resumen La morbilidad osea es un problema que ocurre en muchos pacientes con cancer. Incluye dolor secundario a los tratamientos oncologicos y a la afectacion del hueso por la neoplasia, que en el 99% de los casos se debe a metastasis de otro origen, principalmente del pulmon, de la mama y de la prostata. Ademas del tratamiento del dolor propiamente dicho, los bifosfonatos son unos farmacos que se utilizan con frecuencia. Su accion se debe a una inhibicion de la actividad de los osteoclastos y pueden prevenir, reducir e, incluso, retrasar las complicaciones esqueleticas en pacientes en distintos estadios de la enfermedad.

Protocolo diagnóstico y terapéutico de la diarrea en el paciente oncológico

Resumen La diarrea es una de las complicaciones digestivas mas frecuentes en el enfermo oncologico, y es un efecto secundario de muchos tratamientos antineoplasicos. En los casos graves puede provocar deshidratacion, insuficiencia renal aguda y desequilibrio electrolitico, motivo de ingreso y deterioro de su calidad de vida. Sus causas pueden ser multiples, y puede estar asociada a entidades graves como la enterocolitis necrotizante. Es necesario hacer un correcto diagnostico e inicio precoz de la rehidratacion que es el tratamiento fundamental junto con aquellos especificos para determinadas etiologias.

Protocolo diagnóstico y terapéutico de las náuseas y vómitos en el paciente oncológico

Nausea and vomiting in the cancer patient may have different causes. However, these frequently occur in relation to chemo- and radiotherapy treatments. Their types are: acute emesis, which occurs in the first 24 hours of treatment; delayed, which appears after and may last for several days; and anticipatory, which occurs prior to chemotherapy treatment. The following are used for their treatment: serotonin receptor inhibitors (ondansetron, granisetron and palonosetron), which are frequently used in combination with steroids (dexamethasone); neurokinin receptor inhibitors (aprepitant and fosaprepitant); other drugs (phenothiazines, haloperidol, metoclopramide, domperidone, benzodiazepines, antacids, anticholinergic, cannabinoids, etc.). Cytostatics are classified as highly emetogenic (they are treated with neurokinin inhibitors, antiserotoninergics and dexamethasone), moderately emetogenic (antiserotoninergics, dexamethasone and occasional neurokinin inhibitors are recommended), low risk (treatment with dexamethasone) and minimum risk (they do not require prophylactic antiemetics). Their efficacy should be reevaluated in each cycle to adapt the treatment to each individual need.

Actividad laboral en una cohorte de pacientes con linfoma non Hodgkin

Background. Cancer affects many dimensions determining quality of life, including work. However, the importance of work to cancer survivors has received little attention. Aim. Employment and work-related disability were investigated in a cohort of non-Hodgkin´s lymphoma patients to describe a possible discrimination and other work issues. Patients and Methods. The study included consecutively 37 non-Hodgkin´s lymphoma patients who were employed at diagnosis. The questionnaire included cancerrelated symptoms and work-related factors. Clinical details were obtained from the medical record. Patients were interviewed face to face and 32 variables were recorded. The study was approved by the Ethical Committee of Hospital La Paz. All patients gave consent to participate. Results. Eighty six per cent of patients were unable to work after diagnosis, but 68% returned to work at the end of treatment. The type of worker and the sequelae of the disease or its treatment were independently associated with the ability to work after the end of treatment. Almost all patients told their employers and co-workers about their disease. None reported job discrimination. Conclusions. This is the first exploratory study in Spain about labour reintegration in non-Hodgkin´s lymphomas. Further studies are necessary