Information on the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), later termed coronavirus disease (COVID-19), first emerged by the end of 2019. As the pandemic spread, cancer patients ...were immediately recognized as a high-risk population with regard to COVID-19 infection. Moreover, epidemiological measures, like social distancing and lockdowns, additionally burdened patients with cancer. Even outside pandemic breast cancer patients are prone to psychological distress with prevalence ranging approximately 20-40%. This multicentric study aimed to examine the impact of COVID-19 pandemic on the level of distress among breast cancer patients in Croatia while the first wave of COVID-19 pandemic.
Fife hundred forty-five breast cancer patients were offered to participate in the study. A total of two hundred and one patient, with disease stages ranging I-IV, completed the questionnaire. The questionnaire consisted of disease and socio-demographic characteristics followed by the Distress Thermometer and a problem list. The cut off value of 4 was used to define the high level of distress within Distress Thermometer.
High distress level was reported in 54.2% of patients. The most significant problems reported by the participants of our study affected emotions, causing worry, sadness, depression, fear, and nervousness. Additionally, specific practical problems emerged (e.g., child care, housing, and work/school), most probably partly due to the lockdowns and social distancing. Interestingly enough, none of the socio-demographic or disease characteristics were linked to the level of distress.
During first wave of COVID-19 pandemic more than half of breast cancer patients, undergoing active oncologic treatment, experienced a high level of distress. Therefore, distress driven by the COVID-19 pandemic should be promptly addressed and additional psychological and social support, targeting specific practical and emotional problems, should be provided for those patients. All the more so as global COVID-19 pandemic far exceeded the duration of the first wave.
Onkologija predstavlja važan segment sveukupnoga hrvatskoga zdravstvenog sustava. Sama onkologija
jedna je od trenutačno najpropulzivnijih medicinskih struka te smo svakodnevno svjedoci ekspanzivnog ...rasta
novih modaliteta onkološkog liječenja. Ove činjenice nameću imperativ stvaranja onkološke mreže koja bi kao
zadatak imala standardiziranje onkološkog liječenja i osiguravanje dostupnosti novih modaliteta liječenja za sve
oboljele od zloćudnih bolesti, neovisno o njihovom mjestu boravka.¹ Hrvatska već ima prepoznate i definirane
regionalne onkološke centre u sklopu kliničkih bolničkih centara u Zagrebu, Rijeci, Osijeku i Splitu. Nasreću, u
Hrvatskoj postoji tradicija, stara nekoliko desetljeća, razvoja onkoloških centara u općim i županijskim bolnicama.
Poimence, to su neklinički onkološki centri u Županijskoj bolnici Čakovec, Općoj bolnici Dubrovnik, Općoj bolnici
Karlovac, Općoj bolnici Koprivnica, Općoj bolnici Pula, Općoj bolnici Slavonski Brod, Općoj bolnici Šibenik, Općoj
bolnici Varaždin i Općoj bolnici Zadar. Svrha ovoga istraživanja, provedenog u svim nekliničkim onkološkim
centrima
Hrvatske te korištenjem podataka Državnog zavoda za statistiku i Hrvatskog zavoda za zdravstveno osiguranje,
bila je uvidjeti kako je trenutno organizirana onkološka skrb u Republici Hrvatskoj i koja je uloga nekliničkih
onkoloških centara u liječenju bolesnika sa zloćudnim bolestima u Republici Hrvatskoj.
The coronavirus disease (COVID-19) pandemic has greatly affected the oncology community worldwide. Lockdowns, an epidemiological measure, have made it difficult for oncologists to provide care. In ...this study, we analysed the impact of the COVID-19 pandemic on Croatian cancer care.
This was a multicentre cross-sectional observational study of 422 patients who received systemic oncology therapy during the pandemic. The patients completed a survey to capture their views on the impact of the COVID-19 pandemic on their cancer care. Univariate descriptive and bivariate analyses were performed to analyse the relationship between the patients' perspective on the impact of the COVID-19 pandemic on cancer care and the quality of Croatian cancer care and their clinical and sociodemographic data.
Discontinuation or change in cancer treatment during the COVID-19 pandemic was observed in 10.2% of cases. Most did not change their place of treatment owing to the lockdown (97.6%). 14.7% of the patients felt that the quality of cancer care received had changed during the pandemic.
In the first few months of the pandemic, Croatia had a favourable epidemiological situation. However, 25% of patients with cancer reported that the pandemic affected cancer treatment and the quality of cancer care.
Renal cell carcinoma (RCC) is not a single disease. A number of different types of cancer occur in the kidney and each is caused by different genes with different histology and clinical course. ...Studies of hereditary kidney cancer sydromes have led to identification of the main kidney cancer genes: VHL, MET, FH, SDH, FLCN, TSC1 and TSC2. Mutations in each of these genes lead to dysregulation of at least one metabolic pathway that is mediated by oxygen, iron, energy and nutrient sensing suggesting that renal cell cancer is a disease of dysregulated cellular metabolism. A more improved understanding of molecular pathways has led to development of targeted therapies. Targeted agents against VEGF, VEGFR and mTOR continue to
play a crucial role in the management of metastatic RCC. However, complete response is extremely rare, resistance in tumor cells develops frequently and adverse effects of therapy are not unusual finding. For that reason further genetic and epigenetic changes, metabolic aberrations as well as immune response are beeing investigated in numerous studies to find new targets for more personalized therapy.
Liječenje onkoloških bolesnika mora se temeljiti na multidisciplinarnom pristupu, a provodi se u specijaliziranim onkološkim centrima. Nakon završetka specifičnog onkološkog liječenja daljnje ...praćenje uglavnom provode onkolozi, ali je uloga liječnika primarne zdravstvene zaštite (PZZ) sve važnija i potrebno ju je jasno definirati. Trenutačno se većina preporuka za praćenje ne temelji na prospektivnim studijama, već se zasniva na stručnim mišljenjima pojedinih onkoloških centara ili specijalista. Hrvatsko društvo za internističku onkologiju (HDIO) ovim preporukama želi standardizirati i racionalizirati dijagnostičke postupke u praćenju onkoloških bolesnika nakon završetka primarnog liječenja.
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