Quality of life, coping, and psychological and physical symptoms after surgery for non-metastatic digestive tract cancer.

OBJECTIVE: The aim of this study was to investigate the impact of curative surgery for non-metastatic digestive tract cancers on quality of life (QoL), psychological status, and coping strategies. METHODS: A prospective, transversal, multicenter study was conducted in 404 patients: 361 with colorectal, 44 with gastroesophageal, and 35 with pancreaticobiliary cancer six months after surgery. Participants completed questionnaires evaluating QoL, including functioning (EORTC-QLC-C30), coping strategies (Mini-MAC), and psychological distress (BSI-18). RESULTS: The effects of surgery had a strong impact on functional domains, global QoL, and symptoms, especially in pancreaticobiliary and gastroesophageal cancer. Patients with pancreaticobiliary and gastroesophageal cancer had lower functional scale scores than those with colorectal cancer. Fatigue, appetite loss, diarrhea, depression, and psychological distress were the most common symptoms after surgery. Subjects with pancreaticobiliary cancer reported more fatigue, pain, insomnia, depression, somatization and psychological distress, whereas individuals with gastroesophageal cancer exhibited more fatigue, nausea/vomiting, diarrhea, depression, psychological distress, and helplessness than those with colorectal cancer. Only participants with colorectal cancer displayed improved QoL six months post-surgery, albeit their psychological state had worsened. CONCLUSION: Surgeons should discuss expectations regarding symptoms and QoL with patients prior to surgery to minimize physical and psychological impact.

Tratamiento psicológico de las náuseas y vómitos anticipatorios inducidos por quimioterapia por radioterapia / No disponible

La emesis producida por la quimioterapia y radioterapia puede afectar significativamente la calidad de vida de los pacientes con cáncer. La emesis anticipatoria es una respuesta condicionada que aparece en pacientes antes de recibir el ciclo de quimioterapia ya que se basa en un aprendizaje de una experiencia negativa con dicho tratamiento. El objetivo de este artículo es revisar los tratamientos eficaces, farmacológicos y psicológicos, para el control de la emesis anticipatoria. El mejor tratamiento para prevenir la emesis anticipatoria es el control de la emesis aguda y tardía. Los nuevos fármacos antieméticos, como el palonosetrón o el aprepitant, suelen evitar las náuseas y los vómitos por la quimioterapia, pero no mejoran las náuseas y vómitos anticipatorios. Las intervenciones conductuales, como la relajación muscular progresiva y el entrenamiento en desensibilización sistemática, deben considerarse métodos importantes para la prevención y el tratamiento de la emesis anticipatoria (AU)

Chemotherapy-induced or radiotherapy-induced nausea and vomiting can significantly affect patients´ quality of life. Anticipatory emesis is a conditioned response which occurs before patients receive their next chemotherapy cycle. It is based on the learning of a patient´s negative experience. The aim of this article is to review effective treatments, pharmacological and psychological, for the control of anticipatory emesis. The best treatment to prevent anticipatory emesis is the control of acute and delayed emesis. The new antiemetic drugs, palonosetron and aprepitant, are usually able to prevent nausea and vomiting from chemotherapy, but not to improve anticipatory nausea and vomiting. Behavioral interventions such as progressive muscle relaxation training and systematic desensitization should be considered important methods for preventing and treating anticipatory emesis (AU)