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Objetivo: Evaluar si existen diferencias basadas en la edad en la aproximación diagnóstica y de tratamiento del cáncer de mama. Se analizan aspectos éticos, como justicia, beneficencia y autonomía, en relación a la toma de decisiones. Material y Método: Estudio descriptivo cuantitativo y corresponde a un análisis retrospectivo de la base de datos del Centro de la Mama de Clínica Alemana de Santiago, en la que se analiza información de las mujeres de 70 años o más en relación a motivo consulta, estadio de la enfermedad al momento del diagnóstico y tratamientos recibidos y se la compara con la obtenida del grupo de mujeres menores de 70 años. Resultados: No hay diferencia en la oportunidad de la consulta, en el acceso al diagnóstico ni en el tipo de cirugía entre los dos grupos. Existen diferencias significativas en relación a la indicación de tratamientos adyuvantes como quimioterapia, radioterapia y hormonoterapia. El grupo de mujeres mayores de 70 años reciben menos terapias que las mujeres de menor edad. No existe información respecto a los motivos que expliquen esta diferencia. Discusión: Actualmente, mujeres mayores se encuentran en buenas condiciones generales, con una expectativa de vida mayor a 75 años. Es importante tratar sus enfermedades sin limitar a priori el acceso a protocolos de tratamiento, evitando la discriminación por edad. Conclusión: Se propone incorporar una evaluación geriátrica protocolizada con el objetivo de mejorar la atención de este grupo etario, preservando de esta manera los principios de justicia, beneficencia y autonomía en pacientes mayores.
Objective: To evalúate if there are differences on the diagnostic approach and breast cancer treatment based on women age. We analyze ethical aspects like justice, beneficence and autonomy in regards of decision making. Material and Method: Descriptiva and quantitative study that correspond and analysis of the Data Base of the Breast Cancer Center in Clínica Alemana de Santiago, in which we gather the information of women 70 years or more in relation to consultation motive, illness stage and treatments received, compare with the obtain in the group of women under 70 years. Results: There are no differences in the opportunity to reach consultation, access to diagnosis neither the type of surgery. There are significant differences in considering adjuvant treatment like chemotherapy, radiotherapy and hormonal therapy. The group of women with 70 years or older, receive less treatments than the younger group. There is no information that explains this differences. Discussion: In current days, women of the third and fourth age are in good general conditions and their life expectancy is over 75 years old. It is important to treat their diseases without limiting access to them only because of their age, avoiding this type of discrimination. Conclusion: it is proposed to incorporate a geriatric evaluation to improve quality of clinical attention in this age group, aiming to preserve justice, beneficence and autonomy principles in older patients.
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A commercial albumin-bound paclitaxel nano-formulation has been considered a gold standard against breast cancer. However, its application still restricted unfavorable pharmacokinetics and the immunogenicity of exogenous albumin carrier. Herein, we report an albumin-bound tumor redox-responsive paclitaxel prodrugs nano-delivery strategy. Using diverse linkages (thioether bond and disulfide bond), paclitaxel (PTX) was conjugated with an albumin-binding maleimide (MAL) functional group. These pure PTX prodrugs could self-assemble to form uniform and spherical nanoparticles (NPs) in aqueous solution without any excipients. By immediately binding to blood circulating albumin after intravenous administration, NPs are rapidly disintegrated into small prodrug/albumin nanoaggregates
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Five cases of various diseases associated with breast cancer treatment including arthralgia, menopausal symptoms, chemotherapy-associated symptoms (nausea, vomiting, numbness, pain, general fatigue), and anxiety neuroses during follow-up were treated with Kampo medicine and a favorable course was obtained. Combined use of Kampo treatment can reduce the suffering caused by the side effects of breast cancer treatment, alleviate mental symptoms, prevent recurrence, and improve the patients' health. Kampo medicine plays a role in cancer supportive care for breast cancer.
RESUMO
@#Oestrogen receptor (ER)-positive breast cancer is one of the common forms of breast cancer affecting women worldwide. ER-positive breast cancer patients are subjected to antioestrogen therapy such as selective oestrogen receptor modulator (SERM) and aromatase inhibitors (AIs). Recently, the emergence of resistance to anti-oestrogen treatment is under intensive focus. The different mechanisms postulated to explain the occurrence of resistance in ER-positive breast cancer treatment include the loss of ER function and the crosstalk between signalling pathways in cancer cells. Recent literature highlighted that the cholesterol biosynthesis pathway acts as a novel mechanism underlying resistance to oestrogen deprivation. The present study aimed to highlight the role of cholesterol biosynthesis in anti-oestrogen treatment resistance, putatively suggesting an alternative plant-based treatment using andrographolide from Andrographis paniculata. The hypolipidaemic effect of andrographolide can be utilised to prevent the resistance in the treatment of ER-positive breast cancer contributed by cholesterol biosynthesis.