A. Redondo Sánchez

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.

Cáncer de ovario

Resumen Introduccion El cancer de ovario se asocia a una elevada mortalidad, debido a que en la mayoria de las pacientes se diagnostica en estadios avanzados. Diagnostico/tratamiento La estadificacion se establece tras la realizacion de una cirugia reglada, y supone el principal factor pronostico de esta enfermedad. En los estadios iniciales el tratamiento sera la cirugia, seguida de quimioterapia adyuvante cuando existan factores de riesgo. En los estadios avanzados, la cirugia citorreductora sera la primera aproximacion terapeutica siempre que sea posible, seguida de quimioterapia. El esquema de tratamiento estandar debe contener al menos un platino y un taxano y, aunque todavia existen controversias, la eficacia podria incrementarse con la administracion semanal de paclitaxel, la administracion intraperitoneal de la quimioterapia o la adicion de bevacizumab a la quimioterapia. En la recaida, la quimioterapia sera el tratamiento principal. En la recaida platinosensible el estandar es carboplatino en combinacion. En la recaida platinorresistente existen varias opciones de monoquimioterapia. La adicion de bevacizumab a la quimioterapia de la recaida incrementa la supervivencia libre de progresion (SLP). El tratamiento de mantenimiento con inhibidores de PARP tras la obtencion de una respuesta con quimioterapia en la recaida platino sensible tambien incrementa la SLP, siendo especialmente eficaces en las pacientes con mutacion germinal o somatica en los genes BRCA.

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.

Cáncer de cérvix y endometrio

In Spain, 12,000 women are diagnosed annually with gynecologic cancer, including endometrial, ovarian and cervical cancer. Cervical cancer is the most common gynecological tumor in women between 35 and 55 years in our country. Its history is linked to infection with the human papilloma virus. Endometrial cancer is the most common female genital tumors. Endometrial hyperplasia is the precursor unquestionably of the most common form of endometrial adenocarcinoma. This two neoplasms have great impact, socio and healthy repercussion and whose symptoms depend on the stage at which the disease is detected, making possible, in both, an early diagnosis or in incipient stages. Its main prognostic factor is postoperative staging. Radio and adjuvant chemotherapy have been shown to increase locoregional control in locally advanced disease. In disseminated disease, chemotherapy has a palliative play.