Clinical Oncology

[Mucositis - prevention and therapy]

NAGY Zsuzsanna, VALTINYI Dorottya

SEPTEMBER 05, 2015

Clinical Oncology - 2015;2(03)

[Side-effects are critical challenges in cancer therapy. These complications can threaten the quality of life, sometimes the life itself. One of the most frequent side effects is mucositis, the damage of mucosa, either in the oral cavity (oral mucositis, OM), or in the gastrointestinal tract (gastrointestinal mucositis, GIM). Prevention is a key action for the effi cient supportation. Recognition of OM is relative easy, but of GIM is rather diffi cult. The risk factors could come from the patients and/or can be caused by the therapy. The successful management of mucositis mostly depends on the cooperation of the patient, which is highly infl uenced by the success of care (e.g. decreasing the level of pain). In general, mucositis (especially oral mucositis) a well managable disease, burt more informations are required to increase the quality of prevention and therapy. Such expectation could be realized by specifi c and sensitive biomarkers, however, they are still missing]

COMMENTS

0 comments

Further articles in this publication

Clinical Oncology

[A structured approach to test the clinical benefi t of treatments of advanced cancer]

ALESSANDRO Pastorino, ALBERTO Sobrero

Clinical Oncology

[Ablation of liver cancer]

DOROS Attila

[Ablative therapies of the malignant liver tumors are used frequently all over the world. It is a very well tolareted minimally invasive treatment, followed by a short observation period. Patients might be sent home within 24 hours. Nowadays, there is suffi cient data supporting its effectiveness in the treatment of early primary liver cancer, equalling the results of surgical resection. The situation is different in liver metastasis, especially from coloectal cancer. In these cases ablative techniques have a supporting role, limiting their action on the multimorbid patients and small non-resectable tumors. These facts and trends - worldwide and in Hungary - are discussed, focusing on effectiveness, places in therapeutic protocols and domestic diffi culties.]

Clinical Oncology

[Up-to-date treatment of head and neck cancers]

PACZONA Róbert, CSENKI Melinda, HIDEGHÉTY Katalin

[The head and neck squamous cell cancer is often detected at an advanced stage, resulting in dismal prognosis despite the relevant developments of the oncotherapy in the last decades. The introduction of new techniques, new drugs and combinations though improves the survival for certain subgroups of patients, meanwhile the organ-function preservation and side effects reduction approaches lead to improved quality of life. The preventive-supportive care prior and during the therapy (dental care, nutrition, toxicity management) and the complex rehabilitation has paramount importance. MRI and 18FDG PET-CT and the advanced methods of molecular pathology became part of the diagnostic work up. The selection of the therapy based on the tumor characteristics, HPV detection, on the patient’s condition and wishes, as well as on multi-disciplinary team decision based on the available technical options. Early stage tumors can be successfully treated either by surgery alone or by radiation therapy. For locally advanced cases concomittant chemo-radiotherapy stays in the axis of the complex management using advanced radiation technique (IGRT-adaptive- IMRT) with cisplatin (or if contraindicated with cetuximab), which could be complemented by induction chemotherapy and/or surgery. Several new approaches are currently being tested in clinical studies after establishment of cisplatine-cetuximab treatment for recurrent/metastatic tumors. In the future, detection of molecular processes and driver mutations could result in development of more effective targeted anti-tumor agents, and individual molecular tumor profi le guided therapy, including the various forms and combinations with emerging immunotherapy.]

Clinical Oncology

[Treatment of testicular germ cell tumors – an up-date]

BAKI Márta

[The frequency of germ cell tumors is about 1% of all male cancers. The incidence increases in developed countries. The prevalence is the highest among the young males. The histologic type, extent of disease and therapy is based on international guidelines. The surgery, radio- and chemotherapy can achieve cure in the germ cell cancer patients. Regarding the late toxicity, the minimal invasive tumors are suggested to keep on the wait and see policy. The complex therapy of poor risk groups reached more than 80% permanent remission rate. The chemotherapy is based on cisplatin, but in second and third line therapy paclitaxel, gemcitabin and oxaliplatin is widely used. After the cure of germ cell cancer patients the careful follow up is mandatory.]

Clinical Oncology

[Angiogenesis – antiangiogenesis]

PAKU Sándor, SEBESTYÉN Anna, KOPPER László

[Tumor growth requires vascularization to be supplied by oxygen and nutritients. The vascular network could be different between tumors, even during the development of the same tumor (local and systemic spreading), from the occupation of already present vessels to the real angiogenesis (i.e, proliferation of endothelial cells). Moreover, the tumor cells can create channels, mimicking the normal vessels. This spectrum in morphology should be refl ected in the therapeutic response, in the effectiveness of antiangiogens, but the how is unknown. It is sure that acceptable clinical activity can be achieved only with combinations, both with traditional cytotoxic and targeting drugs. The clinical advantage can be hampered by increased toxicity, demanding supportive actions. One of the key decisions is to select the proper therapy considering the patient and the tumor characteristics (today increasingly at molecular level) and predict the response to the therapy. Such (bio)markers are still missing, although intensive research trying the best. Since the main target of antiangiogenic drugs (today and tomorrow) the VEGF/R family, a useful marker is expected from them. The inhibition of angiogenesis is a logical step against the solid tumors and these steps slowly but steadily can improve the patients life-time, as well as their quality of life.]

All articles in the issue

Related contents

Journal of Nursing Theory and Practice

[Competencies of Community Nurses, Opportunities of Extensions in Adult General Practices of Cegléd .]

JÓZSA Edit

[Aims of the study: The local community nurses can use their present abilities between given conditions and how these abilities could be extended. Sample and methods: 137 evaluable questionnaires were returned from 14 family doctors’ patients and 12 questionnaires were from community nurses. The questionnaires consisted of open and closed questions. The data was processed by SPSS and Excel software. Statistics were made by descriptive statistic means and Fischer exact tests. Results: During my survey it turned out that patients don’t utilize basic adult health care means such as measuring blood pressure and blood-sugar and lab examinations. Conclusions: Most of the community nurses can’t utilize most of their abilities and knowledge. They don’t have the opportunity to perform health education or just to talk to the patients face-to-face. My thesis surfaces the fact that community workers and doctors should work coordinate. It’s not true in relation of all the general practitioners and nurses.]

Lege Artis Medicinae

[Written and pictorial content in magazines and their possible relationship to eating disorders]

SZABÓ Kornélia, TÚRY Ferenc

[In the current study we reviewed the literature on studies exploring the magazine reading frequency, written and pictorial contents appearing in magazines and their connection to eating disorders. Reading different fashion and fitness magazines has effect on readers through several indirect and direct factors and through trustable and false information. They affect readers' body satisfaction, self-esteem, eating habits and more generally their health behavior. Different theories have been explained to account for these associations and several other studies examined empirically the connection between the frequency of magazine reading and eating disorders, as well as the symptoms leading to eating disorders. METHODS - We analyzed and summarized articles between 1975 and 2009 from online databases. We used the following sources: Science Direct (http://www.sciencedirect. com/), Springer-Verlag GmbH (http://www.springerlink.com/) and SAGE Publications Ltd (http://online.sagepub. com/). RESULTS - The pictorial and written magazine contents were associated with the development and maintenance of eating disorders or with symptoms that might lead to eating disorders. The publications comparing to previous years found elevated number of unhealthy food advertisements, unhealthy and radical diet plans and exercise programs. Furthermore the magazines contained conflicting messages about nutrition, body functions and eating disorders. CONCLUSION - Written and pictorial magazine contents, messages might increase the risk for development of eating disorders, especially in vulnerable individuals.]

Journal of Nursing Theory and Practice

[Socio-cultural environment as a factor influencing perception of overweight and obesity]

VĚRA Olišarová, VALÉRIE Tóthová, FRANTIŠEK Dolák

[The increase of incidence of overweight and obesity is a worldwide problem. Its therapy, as well as prevention, require holistic perception of the issue. The results demonstrate that these diseases cannot be perceived separately but from the perspective of health impact. The socio-economic area, the influences of ethnicity, cultural particularities and a lot of other factors must be considered. This article is focusing on the relation between the socio-cultural environment and perception of overweight and obesity as factors which can be directly reflected with preventive and therapeutic measures. The results show that ethnicity, cultural particularities, acculturation level, social status etc. are factors that influence the incidence of the relevant diseases to some degree. At present, there is lack of sufficient research studies which support the creation and implementation of culturally adequate interventions not only on the territory of the Czech Republic but worldwide. ]

Lege Artis Medicinae

[Reducing lung cancer mortality through prevention]

KOVÁCS GÁBOR, OSTOROS Gyula, PATAKI Géza

[Effective therapy for lung cancer is yet unknown and the role of prevention has continuously increased. In practice, primary prevention of lung cancer means the reduction of smoking either by cessation or by patient education. Screening for lung cancer, considered as a secondary prevention measure, has long been debated. The previously negative attitude for screening has slowly changed in the past years. New studies have been organised recently to make screening more effective. In high risk groups, helical CT-scans with low dose X-ray exposure are preferred and the effectivity of sputum citology completed with immunocytochemical tests is under investigation. Determining the risk group, we focus on age, smoking history, airway obstruction and certain tumour markers. With the help of traditional chest X-rays approximately one third of new cases of lung cancer are discovered in Hungary. Our reasonable target is to identify 60-70% of the new NSCLC cases by risk group screening (age>40 years, smoking>20 P.Y., decrease of FEV1>15%, family lung cancer history and previous asbestos exposure) and by organising population screening more effectively.]

Clinical Neuroscience

[The impact of the vitamin D in neurological diseases and neurorehabilitation: from demencia to multiple sclerosis. Part I: The role of the vitamin D in the prevetion and treatment of multiple sclerosis]

SPEER Gábor

[The world-wide incidence of vitamin D deficiency is high, independently of age. Multiple sclerosis is a chronic disorder, occuring in those who possess or are exposed to a combination of genetic and environmental risk factors. One of the environmental factors associated with the development is vitamin D. Vitamin D is an immunomodulatory agent, its role is verified in many of autoimmune diseases. Vitamin D inhibits IL-6, IL-17 and IL-23 secretions which are crucial in Th1 and Th17 differentiation and also decreases proinflammatorical cytokine production. Moreover it enhances the immunosuppressive IL-10 cytokine secretion and inhibits the T-reg cell development. These cytokines and cells are essential for the pathomechanism of multiple sclerosis. Data have shown, that the vitamin D levels above 100 nmol/l (40 ng/ml) is essential for the prevention of multiple sclerosis. Below this level the vitamin D supplementation is reasonable. In pregnancy, the vitamin D deficiency at the last two semester increases the risk for the multiple sclerosis of the infant. The optimal vitamin D level for multiple sclerosis patients is 100-150 nmol/l (40-60 ng/ml). There is no consensus for the role of vitamin D in multiple sclerosis yet, but until the achieving this, the diagnosis and the treatment of the vitamin D deficiency is crucial for scelrosis multiplex patients and in cases of elevated risk. Data shows, that in patient with multiple sclerosis the normal vitamin D level is suboptimal, however the exact role of vitamin D and doses must be clarified by interventional studies.]