Integração com a Atenção Primária à Saúde: Experiência de uma Unidade de Referência em Cuidados Paliativos Oncológicos / Integration with Primary Health Care: Experience of a Referral Unit in Palliative Oncology Care / Integración con Atención Primaria de Salud: Experiencia de una Unidad de Derivación en Atención Oncológica Paliativa

O Sistema Único de Saúde (SUS) brasileiro se baseia na universalidade, equidade e integralidade, com foco na participação popular, na regionalização e hierarquização, bem como na descentralização, como seus princípios. Visa dessa forma a garantir o acesso da população à saúde em todos os níveis de atenção. O Hospital do Câncer IV (HC IV), unidade de Cuidados Paliativos do Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA), tem como perfil assistencial os pacientes com câncer avançado sem possibilidade de tratamento modificador da doença oriundos das outras unidades do INCA. O HC IV/INCA tem como missão "promover e prover cuidados paliativos oncológicos da mais alta qualidade, com habilidade técnica e humanitária". Dessa maneira, pretende-se minimizar o sofrimento humano proveniente das esferas física, psíquica, social e espiritual e promover qualidade de vida

The principles of the National Health System (SUS) are based in the universality, equity, and integrality, targeted to the participation of the individuals, regionalization and hierarchy and decentralization. It attempts to ensure the population the access to health across all levels of attention . The "Hospital do Câncer IV (HC IV)" Palliative Care Unit of the National Cancer Institute José Alencar Gomes da Silva (INCA), provides care to patients with advanced cancer without possibility of disease modifying treatment referred from other INCA units. HC IV/ INCA's mission is to "promote and provide high quality palliative oncologic care with technical and humanitarian proficiency" . Following this logic, it endeavors to minimize the human suffering of physical, psychic, social and spiritual nature, and improve the quality of life

The Impact of Zoledronic Acid and Radioactive Iodine Therapy on Morbi-Mortality of Patients with Bone Metastases of Thyroid Cancer Derived from Follicular Cells.

OBJECTIVE: Bone metastases bring greater morbi-mortality to patients with differentiated thyroid carcinoma (DTC). Treatment was limited to radioactive iodine (RAI) and local approaches. Currently, bisphosphonates are included in the therapeutic arsenal. The aim of this study is to evaluate the impact of bone metastases and their treatment with zoledronic acid (ZA) and RAI therapy. METHODS: We retrospectively review 50 DTC patients with structurally evident bone metastases followed in a tertiary cancer center from 1994 to 2018. Clinical-pathologic characteristics, skeletal related events (SRE), and therapeutic approaches were recorded. RESULTS: Among the 50 patients analyzed, 22 underwent ZA adjuvant therapy and 28 did not. Mortality rate was 44%. Those patients presented SREs more frequently (90.9 vs. 67.9% the survival group, p = 0.05) and also had a greater number of bone lesions (40.9 vs. 10.7% had more than 6 metastatic sites, p = 0.03). The same group of patients was analyzed before and after therapy with ZA and the incidence of SRE decreased from 1.81 (0-8) before therapy to 0.29 (0-7) after therapy (p = 0.006). Comparing similar groups of 22 patients treated with ZA with 28 patients not treated, there was a trend of better overall survival (OS) in the group that received this drug (147 vs. 119 months, p = 0.06) and significantly improvement when bone metastases were RAI avid 155 (125-185) versus 120 (85-157) months, p < 0.01. Conclusion : ZA can successfully diminish the chance of having new SRE and possibly affect OS in DTC patients with bone metastases. The positive impact of RAI adjuvant treatment on OS is directly associated with RAI uptake.

Phantom limb phenomena in cancer amputees.

PURPOSE: The objective of this study was to determine the prevalence of phantom pain and correlated conditions such as phantom sensations and stump pain in a population of cancer patients who had undergone limb amputation. METHOD: A cross-sectional study was carried out in adult patients submitted to limb amputation, who were being followed up at the Physiotherapy Department between April 3 and November 30, 2006. The presence of phantom pain and associated conditions was quantified using a verbal numerical scale. The data obtained were analyzed for means, medians, and proportions with their respective confidence intervals, as appropriate. RESULTS: Seventy-five patients participated in this study, 50 men (66.7%) and 25 women (33.3%). Mean age was 54.4 years (SD +/- 18.5); range 19 to 88 years. The prevalence of phantom pain was 46.7% (95%CI: 35.1 to 58.6), phantom sensation 90.7% (95%CI: 81.7 to 96.2), and surgical stump pain 32.0% (95%CI: 21.7 to 43.8). CONCLUSION: Phantom pain and phantom sensations are highly prevalent among cancer patients. Further studies should be carried out to determine the main factors associated with their onset.

Metástase óssea: revisão da literatura / Bone metastases: literature review

Os autores sumarizam os aspectos históricos relevantes e os conceitos atuais sobre abordagem de pacientes com doença óssea metastática. Eles mostram a importância da história clínica, evolução e diagnóstico, avaliando osestudos radiológicos, cintilográficos e opções de tratamento. A conclusão é que o manuseio da mestástase óssea deve levar em conta o prognóstico e a expectativa de vida.

Osteossarcoma parosteal de escápula / Parosteal osteosarcoma of the scapula

O osteossarcoma parosteal (OSP) ocorre, predominantemente, em ossos longos, acometendo o terço distal do fêmur em cerca de 60 por cento dos casos. Relata-se um caso de OSP situado em escápula, sendo este o terceiro publicado na literatura.

Condrossarcoma extra-ósseo: estudo descritivo de 1983 a 1998 no INCA / Extraosseous chondrosarcoma: a descriptive study from 1983 to 1998 at the Brazilian National Cancer Institute

Este trabalho tem por objetivo um estudo epidemiológico e retrospectivo dos casos de condrossarcoma extra-ósseo no INCA no período de 1983 a 1998. Avalia freqüência dadoença, idade média dos pacientes, sexo, cor, tratamento e curva de sobrevida. Estes dados foram comparados com os achados da literatura, sem diferença significativa.

Estudo Descritivo dos Casos de Tumor de Células Gigantes Submetidos a Tratamento Cirúrgico no INTO no Período de 2000 a 2005

Avaliar casos de tumor de células gigantes com diagnóstico histopatológico prévio (feito através de biopsia) tratados cirurgicamente no INTO pelo grupo de tumor ósseo