Evaluation of Nutritional Status and the Impact of Nutritional Treatment in Patients with Pancreatic Cancer.

Patients with pancreatic cancer who develop irreversible cancer cachexia have a life expectancy of less than 3 months. Therefore, it is extremely important to evaluate the patient's nutritional status as early as possible and to implement an appropriate nutritional intervention in order to reduce the risk of further weight loss and/or muscle loss, which affect the outcomes of cancer treatment and the correct nutritional treatment in patients with pancreatic cancer. A literature review was performed by using the PubMed and Cochrane quick search methodology. The main purpose of this review was to present the current approach to nutritional treatment in pancreatic cancer. The review included publications, most of which concerned clinical nutrition as part of the phase of treatment of patients with pancreatic cancer, nutritional and metabolic disorders in pancreatic cancer, and the period after pancreatic resection. Some of the publications concerned various nutritional interventions in patients with pancreatic cancer undergoing chemotherapy or surgical treatment (nutritional support before surgery, after surgery, or during palliative treatment). There is an unmet need for integrated nutritional therapy as a key part of the comprehensive care process for PC patients. Nutritional counseling is the first line of nutritional treatment for malnourished cancer patients, but pancreatic enzyme replacement therapy also constitutes the cornerstone of nutritional treatment for relieving symptoms of indigestion and maintaining or improving nutritional status.

New Treatment Options in Metastatic Pancreatic Cancer.

Pancreatic cancer (PC) is the seventh leading cause of cancer death across the world. Poor prognosis of PC is associated with several factors, such as diagnosis at an advanced stage, early distant metastases, and remarkable resistance to most conventional treatment options. The pathogenesis of PC seems to be significantly more complicated than originally assumed, and findings in other solid tumours cannot be extrapolated to this malignancy. To develop effective treatment schemes prolonging patient survival, a multidirectional approach encompassing different aspects of the cancer is needed. Particular directions have been established; however, further studies bringing them all together and connecting the strengths of each therapy are needed. This review summarises the current literature and provides an overview of new or emerging therapeutic strategies for the more effective management of metastatic PC.

Treatment Costs and Social Burden of Pancreatic Cancer.

(1) Background: Pancreatic cancer is the cancer with the third-highest mortality rate, and forecasts indicate its growing share in morbidity. The basis of treatment is inpatient chemotherapy and there is a strong focus on palliative care. (2) Methods: A literature review was conducted based on the rapid review methodology in PubMed and Cochrane databases. The search was supplemented with publications from the snowball search. Qualitative assessment of included publications was performed using AMSTAR2 modified scheme. (3) Results: The review included 17 publications, of which majority concerned direct costs related to the adopted treatment regimen. Most of the publications focused on comparing the cost-effectiveness of drug therapies and the costs of palliative treatment. Other publications concerned indirect costs generated by pancreatic cancer. They particularly focused on the economic burden of lost productivity due to sickness absence. (4) Conclusion: The increase in the incidence of pancreatic cancer translates into an increase in the costs of the health care system and indirect costs. Due to the significant share of hospitalization in the health care structure, direct costs are increasing. The inpatient treatment regimen and side effects translate into a loss of productivity for patients with pancreatic cancer. Among gastrointestinal cancers, pancreatic cancer generates the second largest indirect costs, although it has a much lower incidence rate than the dominant colorectal cancer. This indicates a significant problem of the economic burden of this cancer.

Nutritional Treatment of Patients with Colorectal Cancer.

Colorectal cancer is one of the most common cancers in Europe and the world. Cancer treatments have side effects and cause significant deterioration of the patient's nutritional status. Patient malnutrition may worsen the health condition and prevent the deliberate effects of the therapy. The aim of this review was to describe the available data about clinical nutrition in colorectal cancer patients. A large proportion of colorectal cancer patients suffer from malnutrition, which negatively affects the survival prognosis, quality of life, and oncological therapy. Therefore, monitoring nutritional status during the treatment is essential and can be used to arrange proper nutritional therapy to enhance patient responses, prevent side effects, and shorten recovery time. The principles of nutrition during anticancer therapy should mainly consider light and low-fat foods, the exclusion of lactose and gluten-containing foods in certain cases, or the introduction of special dietary products such as oral nutrition supplements and it should be tailored to patients' individual needs.

Normalization of the AIS (Acceptance of Illness Scale) questionnaire and the possibility of its use among cancer patients.

INTRODUCTION AND OBJECTIVE: Cancer triggers many negative emotions in patients which affect the quality of life and low acceptance of the illness. The level of acceptance of illness is related to the level of pain and the degree of compliance with medical recommendations. The aim of the study is evaluation of the use of the Acceptance of Illness Scale (AIS) among people with cancer. MATERIAL AND METHODS: The study involved 1,187 patients (666 women aged 21-96 (M=58.17; SD=12.88) and 521 men aged 22-96 (M=67.12; SD=13.75) diagnosed with malignant cancer under outpatient care of the Maria Sklodowska-Curie Institute - Oncology Center in Warsaw. An acceptance of illness questionnaire developed by B. J. Felton, T. A. Revensson and G. A. Hinrichsen was used. RESULTS: Socio-economic (education, place of residence, income, professional status) and medical (occurrence of metastases, type of treatment used) factors affect the level of acceptance of illness by patients. Stent standards were developed to determine the level of acceptance of illness in the low-average-high categories. CONCLUSIONS: The Acceptance of Illness Scale (AIS) should be used in the case of cancer patients. Assessment of the patient's acceptance of illness, as well as the factors affecting acceptance, will allow for the planning of appropriate treatment and psychotherapeutic support for specific patients, whose level of acceptance of illnes is the lowest.

Pain Management Strategies among Cancer Patients. Normalization of the CSQ (The Pain Coping Strategies Questionnaire) Form.

INTRODUCTION: Cancer is associated with chronic pain, which significantly reduces the quality of life. The level of pain depends on the dominant pain management strategy that the patient uses. OBJECTIVE: This study seeks to evaluate the application of the Pain Coping Strategies Questionnaire among cancer patients and develop norms allowing differentiation of patients with diagnosed cancer in terms of pain management strategies. MATERIAL AND METHODS: The study involved 1187 patients diagnosed with malignant cancer, who are under outpatient care of the Maria Sklodowska-Curie Institute-Oncology Center in Warsaw. The study used the Pain Coping Strategies Questionnaire (CSQ) elaborated by A.K. Rosentel and F.J. Keefe. RESULTS: Socioeconomic variables and medical factors affect pain management strategies chosen by patients. The area most strongly differentiated by the studied variables is praying/hoping. Factors that have the greatest impact on the choice of pain management strategies for cancer patients include education, income, and radiation therapy. Sten standards were developed to determine the severity of pain management strategies used in the low-average-high categories. CONCLUSIONS: The CSQ questionnaire should be used in cancer patients, and the result of the strategy used can be a prognostic factor for the expected effects of therapy. Knowledge of the variables most strongly affecting patients' choice of strategies that are not conducive to strengthening health attitudes and the ability to determine the severity of pain management strategies on standard scales allows us to focus psychotherapeutic activities on patients who need support most.

Pain Control: Normalization of the BPCQ Questionnaire on a Group of Patients Diagnosed with Malignant Cancer.

The purpose of this article is to examine the applicability of the Beliefs about Pain Control Questionnaire (BPCQ) among cancer patients and develop norms that allow differentiation of patients with diagnosed cancer in terms of beliefs about pain control. Normalization aims to establish the value of test results in the study population. The study involved 1187 patients diagnosed with cancer in outpatient care Maria Sklodowska-Curie Cancer Center and Institute of Oncology, in Warsaw. The applied tool was the Beliefs about Pain Control Questionnaire developed by S. Skevington. The results are most strongly differentiated in each dimension of pain control by education, income, and professional status. Sten norms were developed to determine the level of beliefs about pain control in low, average, and high categories. The BPCQ assessment applies to cancer patients, and the assessment of the location of pain control in patients will allow for the identification of patients whose standard therapy should be supplemented with psychotherapeutic support.

Normalization of the Mini-MAC (Mental Adjustment to Cancer) Questionnaire among Cancer Patients.

Cancer is associated with discomfort and many changes in patients' lives to which they must adapt. The main objective of the study was to assess the use of the mini-MAC questionnaire scale among persons diagnosed with malignant cancer and to develop standards allowing differentiation of patients with diagnosed cancer in terms of their style of adjustment to the disease. The mini-MAC questionnaire is a widely used tool in assessing coping strategies among cancer patients. Sten standards have been developed to determine the level of results on the questionnaire scales in the low-average-high categories. The study included 1187 patients diagnosed with malignant cancer who are covered by outpatient care at the Maria Sklodowska-Curie Institute-Oncology Center in Warsaw. The questionnaire concerning mental adjustment to cancer was used (mini-MAC). Patients with cancer most often adopt strategies of fighting spirit and positive reevaluation. The variables that differentiate the results most significantly include gender, presence of metastasis, and the state of undergoing chemotherapy. The mini-MAC questionnaire should be a tool for psycho-oncological diagnosis of patients' attitudes towards cancer. The obtained results indicate that cancer patients are characterized by their constructive style of adjustment to the disease.

Dietary Behaviour and Nutrition in Patients with COPD Treated with Long-Term Oxygen Therapy.

BACKGROUND: It is the first study in Poland and one of the first in the world to assess the nutrition of patients with chronic obstructive pulmonary disease (COPD) treated with long-term oxygen therapy (LTOT). METHODS: The study group consisted of 110 COPD patients treated with LTOT. Anthropometric measurements and spirometry were performed. The diet of patients was assessed using a 3-day nutrition diary. RESULTS: When assessing the degree of airflow obstruction (FEV1% N) depending on the BMI in patients treated with LTOT, a statistically significant correlation was demonstrated between the BMI and the value of the FEV% N parameter (p = 0.0093). Patients with COPD with a BMI >30 had statistically significantly higher values of FEV1% N than patients with a BMI in the range of 20-24.9 (p = 0.0278). Intake of calcium, vitamins A, C, D, E and folates was lower than the recommended daily intake in more than 95% of COPD patients. CONCLUSIONS: The diet of COPD patients treated with long-term oxygen therapy was improperly balanced, with deficiencies of important nutrients. Airflow obstruction in the respiratory tract was significantly smaller in obese patients, and greater in patients with diagnosed malnutrition.

Pain Control, Acceptance and Adjustment to the Disease among Patients with Ovarian, Endometrial and Breast Cancer in Poland.

BACKGROUND: Breast, ovarian, and endometrial cancer are among the most common causes of morbidity and mortality of women in Poland. In 2016, breast cancer was the most common cause of morbidity and the second leading cause of cancer deaths in women, endometrial cancer was the third most common cause of morbidity and the seventh leading cause of death, and ovarian cancer was the fifth most common cause of morbidity and the fourth leading cause of cancer deaths in women. The aim of the study was to assess the strategy of pain control, acceptance of the cancer and adjustment to life with disease in women with ovarian cancer, endometrial and breast cancer. This study shows how level of pain control, acceptance, and adjustment can differ among patients with the three kinds of cancer and which factors have the most influence on patients' adjustment to the disease. METHODS: The study was carried out with 481 patients diagnosed with ovarian cancer, endometrial and breast cancer. In the study BPCQ, CSQ, AIS and Mini-MAC questionnaires were used. RESULTS: In the BPCQ questionnaire the highest result was acquired in the scope of the impact of doctors (M = 16.45, SD = 4.30), differentiated by cancer location and socio-economic variables. In the CSQ test, the highest result was achieved by praying/hoping, differentiated by cancer location and socio-economic variables. The average AIS acceptance score was M = 27.48 (SD = 7.68). The highest result of the Mini-Mac scale was obtained by patients in the area of fighting spirit (M = 22.94, SD = 3.62), and these results depended on socio-economic and treatment-related variables but were not differentiated by cancer location. CONCLUSIONS: Patients attribute the highest importance in the disease to the influence of physicians, praying/hoping, and fighting spirit. The awareness of the pain management strategies of patients with cancer allows appropriate psychological support to be designed for specific groups of patients.

[Evaluation of nutritional status in patients with systemic sclerosis]. / Ocena stanu odzywienia chorych na twardzine ukladowa.

Systemic sclerosis (SSc) is a multi-organ disease with significant mortality. Diagnosis of malnutrition is sometimes difficult, and gastrointestinal disorders in patients with SSc may play a significant role in deteriorating nutritional status. Many factors can contribute to the development of eating disorders in this group of patients, including mood disorders, depression, anxiety - may reduce appetite, ulceration and skin changes, may cause difficulties in preparing and eating meals. AIM: The aim of the study was to assess the nutritional status of patients with SSc. MATERIALS AND METHODS: The study included 32 patients with diagnosed SSc, mean age 52.9±15.9 years. Anthropometric measurements were performed in all SSc patients and body composition was assessed using electrical bioimpedance (BIA). The hand grip strength range was measured using a dynamometer. RESULTS: Obesity was diagnosed in one patient (3.1%) with SSc. Most patients with SSc, as many as 19 (59.4%), had normal body weight based on BMI. 10 (31.5%) SSc patients were overweight. 2 (6.3%) patients with SSc were diagnosed with malnutrition based on BMI. In the group of patients with SSc, 2 people had deficiencies in lean body mass calculated on the basis of the Fat Free Mass Index (FFMI), while on the basis of the BMI analysis their body mass was normal. In 26 patients with SSc, the content of lean mass assessed on the basis of the FFMI index was normal, while one of these persons had a BMI below the norm and on this basis was diagnosed with malnutrition. CONCLUSIONS: Nutritional disorders are common in patients with SSc. The most common disturbance in nutritional status in SSc patients was overweight, which was present in 31,5 of patients.