Iwona Głowacka

The Assessment of the Magnitude of Frontal Plane Postural Changes in Breast Cancer Patients After Breast-Conserving Therapy or Mastectomy – Follow-up Results 1 Year After the Surgical Procedure

Breast cancer is the most common malignancy in Polish women. Management of breast cancer includes surgical treatment as well as adjuvant chemotherapy, radiotherapy, hormonal therapy, and combination regimens. One of the adverse consequences of oncological management of breast cancer may involve changes in frontal plane body posture. The objective of the study was to assess the frontal plane body posture changes in women treated for breast cancer. A prospective study including 101 of female breast cancer patients subjected to surgical treatment in the period from October 2011 to October 2012 (mastectomy was performed in 51 cases while breast conserving therapy was administered in the remaining 50 cases). The body posture in the frontal plane was assessed using the computer-assisted postural assessment system with Moiré fringe analysis. No statistically significant differences were observed in pre-operational postural parameters of interest. Exam II revealed highly significant differences in SLA values; results suggesting more pronounced dysfunction were observed in the MAS group. Exam III revealed highly significant differences in PIA, SH, SD and SLA values; results suggesting more pronounced dysfunction were observed in the MAS group. Undesirable postural changes occur both in women who were treated with radical mastectomy and in those who underwent breast-conserving surgery; breast-conserving surgery is associated with decreased severity in postural abnormalities;

Sagittal Plane Postural Changes in Female Patients with Breast Cancer after Different Surgical Techniques

To the Editor: One of the important objectives of the treatment of cancer patients is to minimize the adverse effects of the treatment while striving to maintain its radicality. Delayed outcomes of anticancer treatment may lead to postural changes of patients. Direct consequences of the disturbance in proper posture include a number of adverse outcomes such as motor organ deformities, back pains, circulatory and respiratory insufficiency, or headaches (1). Due to this facts, we think that it would be interesting to determine and compare postural changes as assessed within the sagittal plane in female patients after surgical treatment of breast cancer involving different surgical techniques and to compare sagittal plane postural changes women treated of breast cancer with body posture women before surgical procedure. We carried out a cross-sectional study which involved a group of 105 women who had undergone treatment for breast cancer. With 40 women was preformed Patey method (MAS) and with 35 women was preformed Breast Conserving Therapy (BCT). Table 1 presents somatic and clinical characteristics of study groups. Photogrammetric examinations were performed for researched groups (MAS and BCT) 2 year after the surgical procedure. All patients after mastectomy had used external breast prostheses. Patient in both exanimate groups have taken part in rehabilitation session. The scheme of examination was the following: 1 Determination of body weight, height and body mass index (BMI) 2 Examination with Moir e system Posturometric examination allows to determine about 30 postural parameters assessed in the sagittal plane. A total of six measurements (selected on the basis of the difference between the mean and median values) were used in the statistical analysis: • ALPHA – lumbosacral inclination angle, • BETA – thoracolumbar inclination angle, • GAMMA – thoracic inclination angle, • LLA – lumbar lordosis angle, • TKA – thoracic kyphosis angle, • TIA – trunk inclination angle. Address correspondence and reprint requests to: Iwona Głowacka, Department of Rehabilitation, Collegium Medicum of the Nicolaus Copernicus University in Torun, Maria Curie-Skłodowskiej Street 9, 85-094 Bydgoszcz, Poland, or e-mail: iwona.glowacka@cm.umk.pl

Overall clinical and trichoscopic analysis performed in patients who underwent pressurized intraperitoneal aerosol chemotherapy (PIPAC) treatment for peritoneal carcinomatosis – initial trial preliminary report

Introduction Cutaneous adverse events are among the remaining problematic issues of current oncology. The term peritoneal carcinomatosis (PC) refers to the advanced cancer stage. The innovative treatment of PC includes the use of pressurized intraperitoneal aerosol chemotherapy (PIPAC). Aim To present a preliminary report from an initial trial aimed at an overall clinical and trichoscopic analysis performed in patients who underwent PIPAC treatment due to PC. Material and methods For all steps of this study we obtained the consent of the local bioethics commission #KB 196/2018. Three different hair assessment methods were used in our study: 1) general clinical and patient self-feeling assessment; 2) hair pull test; 3) and trichoscopic analysis. Results No hair or scalp disorders were noted in the observation period. In the self-feeling test assessment the vast majority recognized their hair as being of comparable quality or even better in quality compared to previous forms of chemotherapy they had undergone. In all patients we observed a reduction of hair loss in the pull test in the hospitalization period. In trichoscopic analysis we found all determinants and signs of hair disorders in the assessed group. Conclusions The PIPAC is safe and is not a burdensome or aggressive form of therapy, especially according to the very important factors influencing the potential quality of hair and hair loss. The authors, however, realize that to obtain comprehensive results and evaluate this novel and promising method we need to perform more research without any limitations like those in our study.

Prevalence of biological types of breast cancer and their influence on disease staging and therapeutic management – a single-center study

According to the St. Gallen 2011 consensus, proper qualification of breast cancer patients for treatment requires taking into consideration the division into biological types of neoplasms. The goal of this work was to assess the prevalence of all biological types of breast cancer in the population of Kuyavian-Pomeranian province. We determined the influence of particular types of neoplasms on the degree of disease progression and the choice of therapeutic management. The study was conducted on a group of 2653 patients treated surgically due to malignant breast tumors in the Oncology Centre in Bydgoszcz. In the analyzed clinical material we determined the biological type of cancer as well as other prognostic factors. The most commonly identified types of cancer were luminal B1 type (38.4%) and luminal A type (27.4% of cases), followed by a triple-negative type, luminal B2 type and HER2-positive type (respectively: 11.4%, 10.2%, and 6.9% of patients). Estrogen receptors were present in 81.1% and progesterone receptors in 71.4% of subjects. HER2 overexpression was identified in 17.3% of patients. Routine use of a biology-based division into cancer types influences the choice of anti-cancer treatment. Diagnosis of luminal A type of tumor more commonly than other biological types of cancer coexists with lower clinical and pathological disease staging. It allows for more frequent use of sparing surgical techniques in patients. It also makes systemic neoadjuvant chemotherapy unnecessary in the majority of patients (differences in such cases exhibit statistical significance of p < 0.0001).

Zastosowanie elektroterapii TENS w łagodzeniu bólu porodowego / Application of TENS electrotherapy in alleviating labour pain

Abstract Introduction. Easing labour pain is an extremely important issue in obstetric practice. Various physiotherapy methods are increasingly often applied in obstetric practice. Transcutaneous electric nerve stimulation (TENS) aiming at central and peripheral modulation of pain sensation is one of them. Aim. The aim of the study was to analyse the impact of transcutaneous electrical stimulation (TENS) on easing labour pain. Summary. The TENS method is regarded as effective since it increases both the pain threshold and secretion of endogenous opioids. Non-pharmacological methods of pain management during labour, including electrotherapy TENS methods are safe and can be used in most patients.

Assessment of health behaviour of school-age youth

I n t r o d u c t i o n . Adolescence is a very important period for young people as it is the time when the patterns of health behaviour stabilize and in such form may be adopted for the rest of one’s life. This age group is also most prone to behaviour posing a risk to health and lacking behaviour good for health. The period of education is the most suitable to make teenagers aware of how much depends on themselves. Adolescence is often the time of rebellion and independent decision making which influence both the diet, way of spending fee time, personal and mental hygiene as well as abusing dangerous substance. The aim of the study was to assess the health behaviour of lower secondary school attendees in the scope of diet and physical activity by means of a questionnaire. The materials were based on research regarding health behaviour. The study group consisted of 90 students (60% male, 40% female). A questionnaire was chosen as the study method. The study was performed in 2012, from May until September. The results were comparable with HBSC results from 2006 in which 64.4% of the adolescents did not achieve the recommended physical activity minimum. The research has shown that adolescents prefer passive ways of spending their free time. Studies which monitor the state of behaviour linked with the health of the youth are carried out both internationally, nationally and locally. Poland achieves poor results in comparison to other countries when it comes to level of physical activity and amount of time spent on passive leisure.

Overall survival and disease-free survival in breast cancer patients treated at the Oncology Centre in Bydgoszcz – analysis of more than six years of follow-up

Aim of the study Malignant breast tumours are the largest oncological problem in the developed world. In the recent years the number of new diagnoses has exceeded 16,500 per year. Published data regarding far-distant results of breast cancer treatment that take under consideration the provincial division of the country may not be representative of the therapeutic effects achieved in specific oncological centres. The goal of this article is to analyse far-distant therapeutic results in breast cancer patients treated at the Oncology Centre in Bydgoszcz in 2006. They were compared with data available for Kujawsko-Pomorskie Voivodeship and with all-Poland results. Material and methods A cohort of 667 breast cancer patients at Bydgoszcz Oncology Centre between Jan 1 and Dec 31, 2006 was studied. The majority of the studied group were patients in stage I (26.2%) and II (48.3%) according to the TNM staging system, 17.5% were in stage III, and 6.4% in stage IV. The 5-year survival and 5-year disease-free survival rates were calculated. Median observation time was 79 months. Results A total of 148 patients (22.2%) suffered a relapse. There were 168 (25.2%) deaths caused by primary disease. The 5-year survival probability was 0.761 ±0.017 and the five-year disease-free survival probability was 0.807 ±0.016. Median survival time was 76.4 months, and median disease-free survival was 19.4 months. Conclusions The five-year survival probability for breast cancer patients undergoing treatment at Bydgoszcz Oncology Centre was higher than all-Poland median five-year survival probability. The observation needs to be continued and should include the assessment of treatment in subsequent time periods.

Modern Artificial Nutrition Products as a Part of Fast-Track Conception Used in Esophageal and Gastric Cancer Oncological Surgery – Application Analysis

Introduction. The esophageal and gastric cancer cases according to European statistics and meta-analysis are now still an important clinical and epidemiological problem. Surgical resection is one of the most common methods of first choice treatment in operating cases. Patients with a cancerous tumor within the esophagus or stomach in various stages of clinical staging values of T and N, are usually characterized by a considerable degree of malnutrition, mostly of a protein - calorie type. Malnutrition in this patient group is a factor significantly influencing the quality of life and prognosis in the 5-year’s survival classification system. An important element of clinical nutrition in this case, is the introduction of specific elements of the artificial diet system based on modern methods and guidelines, for example under the “Fast - Track” surgery conception. Objective: The analysis was designed to present the latest guidelines, recommendations and specific producer examples of the use of artificial diet system products in patients with esophagus or stomach cancer, with indications for non-palliative surgical tumor resection, based on Fast- Track system conception. Material and methods: In the study, we analyzed a group of scientific publications, guidelines and recommendations, selected from international gastroenterological, surgical, nutritional and dietary literature as well as material obtained in the selection of published material about the artificial diet system and clinical supplementation international producers. Conclusion . In our analysis and literature review we showed that the use of modern artificial diet products and systems under the Fast-Track conception in oncological surgery of patients operated due the esophagus and stomach cancer is important and has a positive clinical effect.

A study on the use of positron emission computed tomography analysis in recurrent colorectal cancer

Wstęp: Rak jelita grubego jest najczęstszym nowotworem złośliwym w Europie i Stanach Zjednoczonych. Nawet po doszczęt nym wycięciu guza pierwotnego wznowa choroby nowotworowej pojawia się u około 30% pacjentów. Cel: Ocena przydatności pozytonowej emisyjnej tomografii komputerowej (positron emission tomography/computed tomography – PET/CT) z wykorzystaniem 18-fluorodeoksyglukozy (FDG) w diagnostyce wznów miejscowych i przerzutów raka jelita grubego oraz odniesienie się do zależności pomiędzy wielkością wychwytu FDG a wynikami histopatologicznymi. Materiał i metody: Retrospektywnej analizie poddano 75 gu zów pochodzących od 59 chorych ze wznową lub przerzutem raka jelita grubego. Przed operacją u pacjentów wykonano badanie PET/CT. Wyniki tego badania określono za pomocą maksymalnej standardowej wartości wychwytu glukozy (SUVmax) w guzie. Wyniki: Czułość metody PET/CT w przypadku raka jelita grubego obliczono statystycznie i wyniosła ona 92%. Ujemne wyniki tego badania zależą od występowania zmian martwiczych (p < 0,01). Wartość SUVmax w guzach bez zmian martwiczych była istotnie statystycznie większa niż w guzach ze zmianami martwiczymi (p < 0,01). W przypadku guzów usuniętych u pacjentów z pierwotną lokalizacją choroby nowotworowej w odbytnicy SUVmax była istotnie statystycznie mniejsza niż u pacjentów z pierwotną lokalizacją guza w okrężnicy (p < 0,05). Wartość SUVmax w guzach zlokalizowanych w wątrobie jest istotnie statystycznie większa niż w guzach zlokalizowanych w płucach (p < 0,05). Nie stwierdzono w badanej grupie korelaAbstract