RESUMO
PURPOSE: The state of limited resource settings that Coronavirus (COVID-19) pandemic has created globally should be taken seriously into account especially in healthcare sector. In oncofertility, patients should receive their fertility preservation treatments urgently even in limited resource settings before initiation of anticancer therapy. Therefore, it is very crucial to learn more about oncofertility practice in limited resource settings such as in developing countries that suffer often from shortage of healthcare services provided to young patients with cancer. METHODS: As an extrapolation during the global crisis of COVID-19 pandemic, we surveyed oncofertility centers from 14 developing countries (Egypt, Tunisia, Brazil, Peru, Panama, Mexico, Colombia, Guatemala, Argentina, Chile, Nigeria, South Africa, Saudi Arabia, and India). Survey questionnaire included questions on the availability and degree of utilization of fertility preservation options in case of childhood cancer, breast cancer, and blood cancer. RESULTS: All surveyed centers responded to all questions. Responses and their calculated oncofertility scores showed different domestic standards for oncofertility practice in case of childhood cancer, breast cancer, and blood cancer in the developing countries under limited resource settings. CONCLUSIONS: Medical practice in limited resource settings has become a critical topic especially after the global crisis of COVID-19 pandemic. Understanding the resources necessary to provide oncofertility treatments is important until the current COVID-19 pandemic resolves. Lessons learned will be valuable to future potential worldwide disruptions due to infectious diseases or other global crises.
Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/prevenção & controle , Atenção à Saúde/normas , Preservação da Fertilidade/métodos , Neoplasias/terapia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus/isolamento & purificação , COVID-19 , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Atenção à Saúde/economia , Países em Desenvolvimento , Feminino , Preservação da Fertilidade/economia , Preservação da Fertilidade/estatística & dados numéricos , Humanos , Neoplasias/virologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , SARS-CoV-2 , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Attributing negative stereotypes to older adults (ageism) may lead to undertreatment, but little is known about the prevalence of ageism among physicians treating patients with cancer in Ibero-America. We studied stereotypes of aging among Mexican physicians-in-training. MATERIALS AND METHODS: Physicians-in-training attending an oncology meeting answered the "Negative Attributes and Positive Potential in Old Age" survey. Ten questions assessed positive characteristics of aging (PPOA; score 1-4, higher scores represent a positive perception), and four assessed negative characteristics (NAOA; score 1-4, higher score representing a negative perception). Descriptive statistics were used to analyze the questionnaires. Participants completed the "Image-of-Aging" question by writing five words describing older adults and young individuals. Each word was rated from - 5 (negative) to + 5 (positive), and presented as word clouds. RESULTS: One hundred physicians-in-training (median age 28.5) were included. For the PPOA scale, the mean score was 2.9 (SD 0.4), while for the NAOA scale it was 2.1 (SD 0.4). Perceptions of aging were better among women and trainees enrolled in geriatrics and/or oncology-related programs. In the "Image-of-Aging" questions, median rating of words describing older adults was - 2, compared to + 3 for young individuals (p < 0.001). Among words used to describe older adults, the most frequent was "frail/frailty" (n = 45), while "health" (n = 46) was the most frequent for younger individuals. CONCLUSIONS: Mexican physicians-in-training showed mostly negative perceptions of aging, exemplified by the use of negative terms to describe older adults. Creating educational initiatives aimed at decreasing ageism among oncology trainees is necessary across Ibero-America.
Assuntos
Etarismo/psicologia , Envelhecimento/psicologia , Atitude do Pessoal de Saúde , Internato e Residência/estatística & dados numéricos , Estereotipagem , Adulto , Idoso , Etarismo/estatística & dados numéricos , Feminino , Idoso Fragilizado , Fragilidade , Geriatria/educação , Humanos , Masculino , Oncologia/educação , México , Negativismo , Fatores Sexuais , Inquéritos e Questionários , Adulto JovemRESUMO
A 61-year-old male patient with metastatic poorly differentiated squamous cell carcinoma of the larynx to lymph nodes and lung was treated with a third-line chemotherapy regimen of paclitaxel, nimotuzumab and low-dose methotrexate, receiving a total of 30 cycles. The response was complete and maintained at 16 months. Nimotuzumab is a humanized monoclonal antibody used to treat squamous cell carcinomas of the head and neck. This third-line chemotherapy combination with paclitaxel-nimotuzumab-methotrexate seems to be an active combination and needs further evaluation in clinical trials to validate its use in heavily treated patients.