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Cancer-related fatigue (CRF) is one of the most common symptoms in clinical cancer patients.It is associated with cancer itself or with cancer-related therapies.It is a persistent and subjective tiredness experience.It not only affects the patient;s physical,psychological and physical condition,social function,quality of life,but also may cause interruption of cancer-related treatment and affect the patient's life.However,the etiology and mechanism of CRF are not fully understood.Many foreign scholars believe that the occurrence of CRF may be related to anemia,obesity,tumor type,insomnia,inflammatory cytokines,hypothalamic-pituitary-adrenal axis and so on.As cancer patients demand higher quality of life,CRF are increasingly receiving medical attention.In this paper,the related factors and mechanisms of CRF are stated.
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Cancer is the most cause death of among adolescents and young adults (AYAs).Psychological distress caused by cancer affects AYAs' effective coping abilities of disease,physical symptoms and treatment.This paper mainly introduces the related concepts,screening tools and intervention progress of psychological distress of AYAs cancer patients to deepen the understanding of these among clinical professionals and provide reference for implement effective interventions to patients.
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Pregnancy complicated with hematologic malignancies is a rare and serious disease that severely endangers pregnant women and their fetuses.It's often difficult to make early diagnosis because of the special physiological changes of pregnancy.The treatment is mainly based on chemotherapy and biotherapy,and assisted with radiotherapy.The obstetrical treatment should be individualized with multidisciplinary collaboration on the basis of principles of cancer therapy by taking into account characteristics of different types of malignancies,interaction between pregnancy and tumor,patient's age and reproductive requirement.Also,neonatal care and long-term follow-up should be strengthened.
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Objective To investigate the effect of restrictive intravenous fluid on the complications and quality of life in the advanced hepatocellular carcinoma patients.Methods Clinical data of Three hundred and fifty-seven cases with advanced hepatocellular carcinoma from Mar 2010 to Mar 2016 was retrospectively analyzed.One hundred and sixty-eight cases were recruited in the restrictive intravenous fluid (RIF) group,and One hundred and eighty-nine cases were involved in the control group.The average volume of intravenous fluid of each day,plasma albumin concentration,splanchnocoel hydrops rate,phlebitis,incidence of vomiting,cancer related pain degree,anxiety degree were compared in the two groups.Results The average volume of intravenous fluid of each day in the RIF group [(720.29 ± 106.84) ml] were much lower than that in the control group [(1 820.36±342.12)ml] (P ＜0.05).The plasma albumin concentration in the RIF group [(35.65 ± 2.21)g/L] were higher than that in the control group [(32.25 ±2.32)g/L] (P ＜0.05).The rate of splanchnocoel hydrops,phlebitis,vomiting,bedsores,and hypstatic pneumonia in RIF group were 6.25％,4.69％,8.59％,3.9％,11.72％ and those in the control group were 13.97％,10.92％,17.47％,10.04％,and 24.45％,respectively (P ＜ 0.05).Moreover,the scores of cancer related pain and anxiety were much lower in the RIF group (5.21 ± 1.09,39.12 ± 5.54) than those in the control group(5.68 ± 1.18,41.56 ± 6.78) (P ＜ 0.01).Conclusions Restrictive intravenous fluid therapy can decrease the cancer associated complications and improved the quality of life in the advanced hepatocellular carcinoma patients.
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Pregnancy complicated with hematologic malignancies is a rare and serious disease that severely endangers pregnant women and their fetuses.It's often difficult to make early diagnosis because of the special physiological changes of pregnancy.The treatment is mainly based on chemotherapy and biotherapy,and assisted with radiotherapy.The obstetrical treatment should be individualized with multidisciplinary collaboration on the basis of principles of cancer therapy by taking into account characteristics of different types of malignancies,interaction between pregnancy and tumor,patient's age and reproductive requirement.Also,neonatal care and long-term follow-up should be strengthened.
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Objective To investigate the effect of restrictive intravenous fluid on the complications and quality of life in the advanced hepatocellular carcinoma patients.Methods Clinical data of Three hundred and fifty-seven cases with advanced hepatocellular carcinoma from Mar 2010 to Mar 2016 was retrospectively analyzed.One hundred and sixty-eight cases were recruited in the restrictive intravenous fluid (RIF) group,and One hundred and eighty-nine cases were involved in the control group.The average volume of intravenous fluid of each day,plasma albumin concentration,splanchnocoel hydrops rate,phlebitis,incidence of vomiting,cancer related pain degree,anxiety degree were compared in the two groups.Results The average volume of intravenous fluid of each day in the RIF group [(720.29 ± 106.84) ml] were much lower than that in the control group [(1 820.36±342.12)ml] (P ＜0.05).The plasma albumin concentration in the RIF group [(35.65 ± 2.21)g/L] were higher than that in the control group [(32.25 ±2.32)g/L] (P ＜0.05).The rate of splanchnocoel hydrops,phlebitis,vomiting,bedsores,and hypstatic pneumonia in RIF group were 6.25％,4.69％,8.59％,3.9％,11.72％ and those in the control group were 13.97％,10.92％,17.47％,10.04％,and 24.45％,respectively (P ＜ 0.05).Moreover,the scores of cancer related pain and anxiety were much lower in the RIF group (5.21 ± 1.09,39.12 ± 5.54) than those in the control group(5.68 ± 1.18,41.56 ± 6.78) (P ＜ 0.01).Conclusions Restrictive intravenous fluid therapy can decrease the cancer associated complications and improved the quality of life in the advanced hepatocellular carcinoma patients.
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Solid organ transplantation (SOT) is an effective treatment for organ failure in clinic.At present,the survival time of organ transplant recipients is significantly prolonged.The high incidence of a disease and mortality of new malignancies after transplantation has become a common long-term complication in transplant patients.Colorectal cancer (CRC) in the new malignant patients is increasing.This article summarizes the domestic and foreign related research of de novo CRC in SOT patients to provide a theoretical basis for clinical treatment of de novo CRC after transplantation.
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Objective To explore the clinical features of sentinel polyps (rectal polyps with proximal colon carcinoma) and its correlation with proximal colon carcinoma.Methods From January 2011 to June 2015,the clinical features of 331 hospitalized patients with rectal polyps were retrospectively analyzed.According to whether the patient with colon carcinoma,the clinical data of rectal polyps patients were divided into pure polyps group (n =294) and sentinel polyps group (n =37).The characteristics under endoscopy,clinical pathological features,treatment and prognosis of two groups were observed.Results The positive rate of tumor marker of sentinel polyps group was higher (67.6 ％,25/37) than that of pure polyps group (6.8 ％,20/294;x2 =32.174,P ＜ 0.01).When compared to pure polyps group,most polyps of sentinel polyps group were in maximum diameter over 1 cm [62.2％ (23/37) vs 46.9 ％ (138/294)],multi-polyps [n ＞5,43.2％ (16/37)vs11.6％ (34/294)] and adenomatous polyp [83.8 ％ (31/37) vs 35.7 ％ (105/294)] (x2 =10.863,15.686,and 22.653,P ＜0.01).Majority of the proximal colon carcinoma with rectal polyps was papillary adenoearcinoma and tubular adenocarcinoma which was account for 75.7 ％ (28/37);Duke A,29.7％ (11/37),Duke B,29.7％ (11/37),Duke C,24.3％ (9/37) and Duke D,16.2％ (6/37).96.6 ％ (282/294) of patients with pure polyps underwent endoscopic treatment and all of them were cured and discharged.40.5％ (15/37) of patients of sentinel polyps group accepted the radical operation and 24.3％ (9/37) received endoscopic submucosal dissection.Conclusions If multiple,maximum diameter over 1 cm and adenomatous rectal polyps were detected under colon endoscope,the possibility of carcinogenesis of the polyps or the proximal colon should be aware.The patient should be followed up in short-term and complete the whole colon examination.
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Objective To investigate the clinical efficacy of hydrogen-rich water (HRW) combined with oxycodone hydrochloride controlled-release tablets (OHCT) in the treatment of malignant neuropathic pain (MNP) patients.Methods Eighty MNP patients were randomly divided into two groups:OHCT group (group A,n =40) and HRW combined OHCT group (group B,n =40).The visual analog scale (VAS) score,frequency of pain outbreaks,pain relief rate,average dose of OHCT per day,and adverse reactions were observed.Results The VAS scores and frequency of pain outbreaks in groups A and B were significantly reduced after treatment (P ＜0.05).Compared to group A,the VAS scores,pain relief rate,outbreak pain and average dose of OHCT per day in group B were significantly improved after 14 and 28 days of treatment (P ＜ 0.05),and the adverse reactions,such as constipation,nausea and vomiting,in group B were significantly less than those in group A (P ＜ 0.05).Conclusions HRW combined with OHCT can effectively improve the MNP,and reduce average dose of OHCT per day and adverse reactions.
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Objective To investigate the sleep quality of cancer patients before and after cancer so as to take effective measures to improve sleep quality of cancer patients.Methods In Xinjiang autonomous region,72 cancer patients in the Department of Oncology and Radiotherapy were surveyed for the study group and 61 benign patients as control group.The instruments including self-made general status and sleep status survey before cancer,and the Pittsburgh sleep quality index scale were used respectively.Results In the study group,40 people had sleep disorders (55.5％) before the cancer,significantly higher than control group people in 15 (24.5％),and the total Pittsburgh sleep quality index (PSQI) scores on average (14.00 ±2.39) were significantly higher than the control group (11.19 ± 2.45).The PSQI had seven sleep quality factors,with the statistical differences between two groups (P ＜ 0.05).Conclusions Chronic insomnia patients are more prone to cancer,cancer patients sleep quality is poorer,and the adjustment of the sleep disorders has more importance.Paying more attention to the regulation of cancer patients to sleep helps to improve the patient's quality of life.
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Objective To investigate the optimal dose of oxycodone for severe pain in cancer patients so as to try to alleviate the suffering rapidly.Methods Totally 135 cases with severe pain in terminal cancer patients were randomly divided into groups A,B,and C,45 cases in each group.Groups A,B,and C were treated with oxycodone hydrochloride sustained-release tablets 20 ～ 140 mg/d,150 ～ 290 mg/d,300 ～ 640 mg/d,respectively.Pain relief and incidence of adverse reactions were evaluated 2 weeks later.Results Pain intensity scores (numerical rating scale,NRS) in 3 groups dropped with statistical difference (P ＜ 0.05).Pain relief rates in groups B and C were statistically significant compared to group A (P ＜ 0.05).Quality of life score (appetite,mental status,sleep,daily activities,and interpersonal life) in group C had statistical significance compared to groups A and B (P ＜ 0.05).Group C had slightly higher incidence of adverse reactions than that of groups A and B without significant difference (P ＞ 0.05).Conclusions Large dose and extra large dose of oxycodone hydrochloride sustained-release tablets can effectively relieve severe pain in advanced cancer patients.Extra large dosage can improve patient's quality of life in spite of the higher incidence of adverse reactions,and patients can still be tolerated well.
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Esophageal carcinoma(EC) is one of the most common malignancies,which is difficult to cure.The median overall survival is less than 1 year,and the 5-year survival rate is less than 10％.Previous reports cited the incidence of brain metastasis (BM) from esophageal cancer to be approximately 0.4％ ～ 5.1％,and most of the reports come from America and Japan.The incidence of BM from EC is increased.However,because of the rarity of BM from EC,there are no established treatment guidelines.This report provides a comprehensive view of the clinical characteristics,treatment and prognosis of brain metastasis from esophageal carcinoma.
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Lynch syndrome.(LS) is an autosomal dominant condition caused by a mutation in the mismatch repair genes (MMR).Endometrial cancer (EC) is the most common extra-colonic cancers of LS Ⅱ type.Among the female members of LS family with the MMR gene mutation,EC has an overall lifetime risk more than 35％.LS-associated EC is more likely present as the clinical pathological characteristics of early age of onset,endometrioid adenocarcinoma,lower grade,lower uterine segment involvement,and better prognosis.LS patients with family history and early age of onset should be performed with a combined screening and genetic testing,while high-risk patients should be taken clinical monitoring methods as endometrial biopsy.Oral contraceptives mav be reasonable chemopreventive agents in the patients with LS.Although prophylactic hysterectomy with bilateral salpingo-oophorectomy is an effective strategy to prevent EC in women with LS,preoperative counseling should address the trade-offs between the reduction in the risk of cancer,and the risks and side effects of surgery.The patients need hormone replacement therapy after surgery.
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Objective To evaluate the behavior and bone destruction of the mouse model of bone cancer pain signs. Method A mouse model of bone cancer pain signs was developed by intra-femur inoculations of Lewis lung carcinoma cells in C57BL/6 mice. Spontane-ous lifting time, ambulatory score and paw withdrawal latencies to radiant heat stimulation were measured in alternative days throughout the experiment. The structural damage of the femur were monitored by radiogram on the 7th, 15th and 23rd day respectively, and the pathohisto-logical changes of the femur bones were observed by hematoxylin-eosin staining (HE) staining on the same days. Meanwhile, the glial fibril-lary acid protein (GFAP) immunohistochemistry changes of the spinal cord in lumbar segments on the 23rd day after inoculation were ob-served. Results Mice received intra-femur inoculation of Lewis lung carcinoma cells gradually developed spontaneous pain, which was be-ginning on the 11th day after inoculation, followed by move-evoked pain and thermal allodynia. On the 23rd day after inoculation, X-ray film showed that medullary cavity of ipsilateral distal femur were filled with tumor cells and full thickness cortical bone was lost. Furthermore, tumor cells invaded peripheral muscles. Astrocytes on the inoculated side of the spinal cord were activated. Conclusion Lewis lung carci-noma cells were a good choice to build a mouse bone cancer pain.