Psychological care reflecting the specifics of the course of viral infection in SARS-CoV-2 oncological patients with oxygenation disorder - a case series.

BACKGROUND: During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, patients treated with acute coronavirus disease 2019 (COVID-19) in intensive care units (ICU) have suffered from neuropsychiatric complications such as anxiety, depression, and confusion. Conditions related to the environment have the potential to worsen these symptoms. In combination with virus-dependent neuroinflammation, they form a "toxic" mixture. Discussion and planning strategies for providing psychological care in the ICU during the pandemic have revealed a great current challenge. CASE SERIES: We share our experience concerning psychological interventions for oncological patients with oxygen saturation depletion. Our observation of two SARS-CoV-2 patients suggests a close time-related association between the increase in inflammatory markers interleukin 6 (IL-6) and C-reactive protein (CRP) and intensive anxiety in the fast development of breath shortening in acute COVID-19 infection due to brain hypoxia and potential neuroinflammation. CONCLUSION: As cytokine IL-6 regulates induction of CRP gene expression, the changes in IL-6 concentrations associated with anxiety symptoms and breath shortening in the observed cluster can be detected hours earlier than changes in CRP levels, with a diagnostic implication for the clinicians. The SARS-CoV-2 patients with oncological diseases treated in our ICU asked for personal bedside contact with clinical psychologists, considered it irreplaceable and reported this psychological care as beneficial.

Screening of Psychological Distress 4.5 Years after Diagnosis in Breast Cancer Patients Compared to Healthy Population.

BACKGROUND: Survival rate of breast cancer patients has improved significantly in recent years. Cancer diagnosis represents a great psychological distress for patients which may not stem solely from the disease itself. Patients may experience higher distress even several years after treatment. PATIENTS AND METHODS: The study was carried out at the Department of Obstetrics and Gynecology and Department of Internal Medicine, Haematology and Oncology, Faculty Hospital Brno. Results of 85 patients at 4.5 years after diagnosis of breast cancer compared to 72 healthy controls are presented in this paper. The data were collected in the form of semi-structured interviews, from the patients medical records and by Symp-tom Check List-90. RESULTS: The overall rate of psychological distress (GSI) 4.5 years after breast cancer dia-gnosis does not differ significantly (p = 0.703) from the healthy population. Also, we did not find any statistically significant relationship between the observed factors and the level of psychological distress in breast cancer patients. CONCLUSION: Screening investigation showed no difference in the psychological distress in breast cancer patients 4.5 years following diagnosis, compared with the healthy population.

Change in Quality of Life Measured over Time in Czech Women with Breast Cancer.

BACKGROUND: This study examined the impact of breast cancer on quality of life (QOL) of Czech women by comparing the QOL of breast cancer patients with that of age-matched healthy controls. METHODS: The sample consisted of 74 breast cancer patients who filled in self-assessment questionnaires retrospectively before treatment and at the time of the study. In addition, 73 healthy controls completed the same battery of questionnaires. QOL was assessed using the Rand 36-Item Health Survey, the Life Satisfaction Questionnaire, and the Czech research version of Functional Assessment of Breast Cancer Therapy. The Wilcoxon paired test and Mann-Whitney U test were used for data analysis. RESULTS: A statistically significant decline in QOL in breast cancer patients was found for the following components: Physical Functioning (p = 0.021), Role Functioning-Physical (p < 0.001), Bodily Pain (p = 0.001), General Health (p = 0.031), Role Functioning-Emotional (p = 0.023), and Physical Well-being (p = 0.001). The only significant increase over time was observed in Social/Family Well-being (p = 0.024). For most of the components, patients showed a statistically significant lower QOL than that of healthy controls. A recent diagnosis, advanced disease stage, more comorbidities, a higher BMI, and other sociodemographic characteristics were associated with a higher incidence of a lower QOL over time. CONCLUSION: Perceived QOL decreased over time in breast cancer patients mainly in components such as physical and emotional functioning, bodily pain, and general health, with several risk factors strongly influencing this change. The QOL of patients was lower than that of the non-cancer population, indicating that subsequent care should be improved to minimize the adverse effects that breast cancer has on QOL.

Predicting Vitality Change in Older Breast Cancer Survivors after Primary Treatment--an Approach Based on Using Time-related Difference of Pro-inflammatory Marker C-reactive Protein.

BACKROUND: We aimed to determine prognosis of vitality change and functional status of breast cancer survivors after primary oncological treatment using time-related differences of elevated levels of highly sensitive proinflammatory C-reactive protein (CRP). PATIENTS AND METHODS: The test group consisted of 46 elderly breast cancer survivors (median age was 65 years) who completed Vitality Scale of Short Form 36 (SF-36) after completing treatment and another retrospectively at diagnosis. Data on tumor-related factors, treatment, and outcomes were obtained retrospectively from medical records, and linear regression analysis was performed. CRP was followed at diagnosis and one year after primary treatment. Within the scope of this study, clinically important difference in the Vitality Scale was set at five points of change. RESULTS: Results showed a statistically significant relationship between CRP change and vitality component of SF-36 change (rs = - 0.350, p = 0.023) in which a decrease in CRP inversely correlated with the quality of life component. The overall change was 1.078 of the vitality scale score (approximately 1 point) for each 1 unit decrease of CRP (1 mg/ L). Association of CRP levels (before and after treatment, its difference between these time points) with age, number of comorbidities and stage of the disease was analyzed and no statistically significant relationship was found in our study. CONCLUSION: Preliminary results suggested time-related differences in elevated CRP levels as a potentially suitable predictor for change in vitality status for long term, chronic condition for older breast cancer survivors. We suggest the interpretation schema including an understanding that CRP change of 5 mg/ L and more should be considered a potential risk factor for subsequent negative clinical outcomes.

[Methods of Assesing Quality of Life in Women with Breast Cancer -  Overview and Basic Characteristics]. / Metody hodnocení kvality zivota u zen s karcinomem prsu -  prehled a základní charakteristika.

BACKGROUND: For the assessment of health -related quality of life (HRQOL) in women with diagnosis of breast carcinoma, patient-eported outcome measures are reported that allow subjective assessment of quality of life related to health status and satisfaction with treatment and medical care. However, their research use is still limited by the low availability of reliable and valid tools tested on samples of specific populations with malignant disease. AIM: The aim of the article is to provide review and short description of available instruments related to HRQOL of patients with a history of treatment for breast cancer with evidence of validation in the breast cancer population. RESULTS: In this review 15 validated patientreported outcome measures are presented specifically relating to HRQOL in women with breast carcinoma. CONCLUSION: Most of the presented measures are suitable in research and clinical trials but not for individual use in clinical practice. Most of the specific measures for assessing HRQOL in patients with breast cancer are not yet available in Czech language and Czech cultural environment adapted versions. Research versions of some of these measures are available in Czech, but these methods have not yet been validated in the Czech Republic. Lack of available tools for use in our conditions means significant limiting factor for research as well as for clinical practice in the Czech Republic. On the other hand, it also offers great scope for validation studies.

[Psychoneuroimmunology in context of comprehensive breast cancer treatment]. / Aplikace poznatku psychoneuroimunologie v kontextu komplexní onkologické lécby karcinomu prsu.

BACKGROUND: Numerous studies have proven a relationship between stress and cancer progression or recurrence, and on the other hand, positive effects of psychological and social support and interventions on cancer patients quality of life. PURPOSE: This review article aims to provide an overview of recent studies that dealt with effects of psychosocial interventions on health and psychological state of breast cancer patients, from cellular and immune response over coping skills to overall survival. CONCLUSION: Both short- and long-term studies have proven positive effects of psychosocial interventions on levels of stress hormones, cellular (immune) response and general patients quality of life. On the other hand, findings on overall survival are contradictory and cannot provide unambiguous conclusions.