We recruited 50 cancer patients and their caregivers with the aim of extending our knowledge of emotional, personality and psychosocial variables, and comparing their reciprocal experience of the disease. The patients and caregivers were administered four of the questionnaires included in the Cognitive Behavioral Assessment 2.0, the Family Strain Questionnaire and the Satisfaction with Life Scale. The patients were characterised by significantly greater emotional disturbances than their caregivers, who were emotionally stable and had a relatively low level of perceived strain despite their high level of hostility and state anxiety. The intra-scale correlations highlighted the fact that the perception of distress depends on neuroticism and the presence of anxiety and depression (which are themselves known to be connected with neuroticism). The everyday life of the caregivers seemed to be characterised by restricted social relationships and interests; a relatively large proportion also declared that they had practical problems related to disease management, economics and some embarrassing and stigmatic aspects of the disease itself.
The knowledge and practice of breast self-examination (BSE) was investigated among 500 women with operable breast tumors between 35 and 64 years of age (all successively operated) and 652 healthy women, matched with the previous group for 5-year age groups from 35 to 54 years. Only 39.9% of breast cancer women and 34.5% of the controls practiced BSE, starting from 45 years, and it is used less frequency by the women with a poor education and those in a lower economic bracket. Among the 500 breast cancer patients, those who practiced the self-examination had a higher number of tumors with a diameter no greater than 2 cm and a lower number with a diameter larger than 4 cm. In addition, in this group the percentage of unaffected axillary lymph nodes (N-) was 58.8% compared to 48.8% for the group that did not practice self-examination, and the percentage of the cases with more than 3 metastatic lymph nodes (N+ greater than 3) was 20.0% in the first group and 27.3% of the second one. These differences were statistically significant. The correlation between tumor diameter and the histologic lymph node stage is equally evident, since there is a progressive reduction in N- cases and a contemporary progressive increase in N+ (greater than 3) cases with increasing breast tumor diameter. Therefore, we can infer that the lack of practice of BSE causes a diagnostic and therapeutic delay, which is responsible for aggravation of the prognosis.
This combined program is effective and probably curative in localized stage intermediate- to high-grade NHL, with low toxicity, also in elderly people. Patients with NHL of the testis, as primary site, require CNS prophylaxis due to the high likelihood of CNS relapse.
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