Marzena Kamińska

Breast cancer risk factors

Breast cancer is the most frequently diagnosed neoplastic disease in women around menopause often leading to a significant reduction of these womens ability to function normally in everyday life. The increased breast cancer incidence observed in epidemiological studies in a group of women actively participating in social and professional life implicates the necessity of conducting multidirectional studies in order to identify risk factors associated with the occurrence of this type of neoplasm. Taking the possibility of influencing the neoplastic transformation process in individuals as a criterion, all the risk factors initiating the process can be divided into two groups. The first group would include inherent factors such as age, sex, race, genetic makeup promoting familial occurrence of the neoplastic disease or the occurrence of benign proliferative lesions of the mammary gland. They all constitute independent parameters and do not undergo simple modification in the course of an individuals life. The second group would include extrinsic factors conditioned by lifestyle, diet or long-term medical intervention such as using oral hormonal contraceptives or hormonal replacement therapy and their influence on the neoplastic process may be modified to a certain degree. Identification of modifiable factors may contribute to development of prevention strategies decreasing breast cancer incidence.

Quality of life and occurrence of depression under chemotherapy in patients suffering from lung carcinoma.

INTRODUCTION AND OBJECTIVE In Poland, lung carcinoma is the most frequent malignant neoplasm in men and the third most frequent in women. The neoplastic disease causes enormous psychic stress and may lead to depressive reactions. The purpose of this research was to assess the quality of life and the occurrence of depression in patients suffering from lung neoplasms and undergoing chemotherapy. MATERIALS AND METHOD The research covered 102 patients (test group TG) with lung carcinoma and undergoing chemotherapy. In the research, standardised questionnaires: EORTC-QLQ-C30, Beck Depression Inventory and a matrix developed by the researcher were applied. The control group (CG) consisted of 60 healthy people who were examined by the Beck Depression Inventory. RESULTS A highly statistically significant dependency was found (p<0.01) between the general quality of life and the occurrence of depression. 51.5% of those examined with a very low level of general quality of life had the symptoms of severe depression. Those examined who had a very high level of general quality of life did not have features of severe depression. A statistically significant dependency (p<0.01) was ascertained between the occurrence of depression and the health condition of those examined. CONCLUSIONS Depression symptoms occur more frequently and with greater intensity in patients suffering from lung neoplasm, compared to the group of healthy people (p<0.01). A statistically significant connection between marital status, place of residence, and assessment of quality of life was found out (p<0.05).

The problem of fatigue in patients suffering from neoplastic disease

Modern therapeutic management of patients with cancer is associated with many adverse side effects, including fatigue defined as weariness, burnout, lassitude, malaise, apathy, impatience, and/or inability to perform daily activities. It occurs frequently before the diagnosis of cancer and may persist for a long time after the end of cancer therapy. It is a common problem that occurs regardless of the type of cancer and applied therapeutic procedure. The appearance of this symptom significantly affects the quality of life of patients and often reduces the effectiveness of implemented treatment. The symptom of fatigue occurs among approximately 80% of patients treated with chemotherapy and/or radiotherapy, as well as among more than 75% of patients with metastatic disease. Causes of fatigue include metabolic and immune system disorders as well as increased level of tumour necrosis factor α (TNF-α). Recent studies also indicate a significant contribution of other cytokines, especially pro-inflammatory ones, i.e. interleukin-1 (IL-1), interleukin-6 (IL-6), soluble tumour necrosis factor receptor type II (sTNF type II) and C-reactive protein (CRP). A patient reporting fatigue should be properly diagnosed and thoroughly interviewed by doctors. Patients are mostly treated non-pharmacologically (by means of physical exercise and psychotherapy) and pharmacologically (by applying methylphenidate and methylprednisolone). What is also extremely important is proper education of the patient and their closest family/friends on the symptoms, which significantly reduces anxiety and stress. On the other hand therapeutic management hinders the subjectivity of feeling and lack of standardised scales to rate symptoms.

Primary and secondary prevention of breast cancer

INTRODUCTION Breast cancer is the most common cancer among women and is the second cancer frequently occurring worldwide of newly-diagnosed cancers. There is much evidence showing the influence of life style and environmental factors on the development of mammary gland cancer (high-fat diet, alcohol consumption, lack of physical exercise), the elimination of which (primary prevention) may contribute to a decrease in morbidity and mortality. Secondary prevention, comprising diagnostic tests (e.g. mammography, ultrasonography, magnetic resonance imaging, breast self-examination, as well as modern and more precise imaging methods) help the early detection of tumours or lesions predisposing to tumours. OBJECTIVE The aim of this study paper is to review current knowledge and reports regarding primary and secondary prevention of breast cancer. STATE OF KNOWLEDGE It is estimated that nearly 70% of malign tumours are caused by environmental factors, whereas in breast cancer this percentage reaches 90-95%. There are national programmes established in many countries to fight cancer, where both types of prevention are stressed as serving to decrease morbidity and mortality due to cancers. CONCLUSIONS Cancer prevention is currently playing a key role in the fight against the disease. Behaviour modification, as well as greater awareness among women regarding breast cancer, may significantly contribute towards reducing the incidence of this cancer. Another important aspect is the number of women undergoing diagnostic tests, which still remains at an unsatisfactory level.

Comparison of biopsychosocial functioning of women of different nationalities in the perimenopausal period

Introduction The perimenopausal age is a time of many changes in womens health. Changes in womens health affect all spheres of life, because health is not merely the absence of disease or infirmity but full psychological, physical and social well-being. Presentation and comparison of the biopsychosocial functioning of women of different races and nationalities in perimenopause, identification of the most common menopause symptoms occurring among women and their needs. Material and methods Work supported with research examples. Using the PubMed database, the medical literature was searched for works that contain the key words menopause and race or ethnicity published between 1996 and 2013 and available in English. Literature in Polish is a supplementary issue. Results Various demographic processes taking place in the countries of Africa, North and South America, Asia and Europe are the basis for observing the situation in perimenopausal women in these countries. Caucasian women living in North America and Europe most often experience the negative symptoms of menopause, hindering daily functioning, and women living in urbanized countries in Asia best assess their health condition, both psychosocial and physical. Conclusions Biopsychosocial functioning of women varies among countries. Developing countries should be given the necessary support and financial information to ensure the health and quality of life in perimenopausal women. In most countries of the world there has been observed the need to promote womens health, particularly research aimed at prevention, increasing physical activity and attention to nutrition.

Acceptance of the illness and the quality of life of patients with breast cancer

Abstract Introduction. Breast cancer is the most frequent cancer diagnosed in women. Its treatment is a combined therapy and the sequence and time are established according to the accepted standards in Poland. Consequences posed by this disease include disorder in the physical, mental and social spheres in women. Adapting to cancer is very important for the process of treatment, and the acceptance of the disease is the determinant. Aim. The aim of the study was to determine and compare the degree of acceptance of the illness and the assessment of quality of life among breast cancer patients during cancer treatment. Material and methods. The survey included 85 ill people treated in a conserving way and 94 ill people treated by breast amputation. Patients after the surgical procedure were subjected to adjuvant treatment involving chemotherapy (90 women) and/or endocrine therapy (87 women). The study used standardized questionnaires EORTC (European Organisation for Research and Treatment of Cancer): QLQC-30 and the scale (AIS Approval IIIness Scale). Results. The highest level of acceptance of the disease, so the best ability to adapt to cancer have those women who have undergone radical mastectomy and adjuvant hormone therapy during the treatment. The lowest level of acceptance of the illness, expressed as a negative assessment was observed in women after BCT and during chemotherapy treatment. The use of the EORTC QLQC-30 to assess the overall health and quality of life of patients allowed us to capture statistically significant differences in the percentages stating good health, with the relatively highest negative response rates which were observed in the subgroups treated with chemotherapy and hormone therapy. With regard to the highest quality of life, the percentage of negative responses was observed in subgroups treated with the use of hormone therapy and after mastectomy. Conclusions. Good acceptance of the disease was obtained by women treated for breast cancer who have undergone mastectomy in the course of adjuvant endocrine therapy. The assessment of general health and quality of life was influenced by oncological treatment. Patients during chemotherapy and hormone therapy showed a negative impact of this form of treatment on overall well-being and functioning.Patients after mastectomy and during hormone therapy treatment showed a comparatively lower quality of life compared to a group of patients after BCT and during treatment with chemotherapy