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Vilafranca del Penedès, Spain

Ferrer M.,IMIM Hospital del Mar Research Institute | Ferrer M.,CIBER ISCIII | Ferrer M.,Autonomous University of Barcelona | Guedea F.,Institute Catala dOncologia | And 20 more authors.
Radiotherapy and Oncology | Year: 2013

Purpose To assess long-term quality of life (QoL) impact of treatments in localized prostate cancer patients treated with radical prostatectomy, external beam radiotherapy or brachytherapy. Material and methods Observational, prospective cohort study with pre-treatment QoL evaluation and follow-up until five years after treatment. 704 patients with low or intermediate risk localized prostate cancer were consecutively recruited in 2003-2005. QoL was measured by the EPIC questionnaire, with urinary irritative-obstructive, incontinence, bowel, sexual, and hormonal scores (ranging 0-100). Results Brachytherapy's QoL impact was restricted to the urinary domain, Generalized Estimating Equation models showed score changes at five years of -12.0 (95% CI = -15.0, -9.0) in incontinence and -5.3 (95% CI = -7.5, -3.1) in irritative-obstructive scales. Compared to brachytherapy, radical prostatectomy fared +3.3 (95% CI = +0.0, +6.5) points better in irritative-obstructive but -17.1 (95% CI = -22.7, -11.5) worse in incontinence. Sexual deterioration was observed in radical prostatectomy (-19.1; 95% CI = -25.1, -13.1) and external radiotherapy groups (-7.5; 95% CI = -12.5, -2.5). Conclusions Brachytherapy is the treatment causing the least impact on QoL except for moderate urinary irritative-obstructive symptoms. Our study provides novel long-term valuable information for clinical decision making, supporting brachytherapy as a possible alternative to radical prostatectomy for patients seeking an attempted curative treatment, while limiting the risk for urinary incontinence and sexual impact on QoL. © 2013 Elsevier Ireland Ltd. All rights reserved. Source

Leon C.,Institute Oncologic del Vall | Mirapeix R.,Institute Oncologic del Vall | Blasco T.,Autonomous University of Barcelona | Arcusa A.,Institute Oncologic del Valles | And 2 more authors.
Psicooncologia | Year: 2013

Purpose: To compare the effectiveness of a Mindfulness-Based Stress Reduction (MBSR) intervention versus a psychoeducational standard intervention in oncological patients. Method: MBSR intervention was applied following a 2'5 h-session schedule, across 10 weekly sessions. Patients (n= 20) had to practice mindfulness daily at home during 45 minutes. In the psychoeducational group (n=17) a schedule of 8 weeekly sessions of 2'5 h each was applied. Following a pre-post design, the following questionnaires were applied to both groups of patients: STAI (to assess both state and trait anxiety), BDI (Depression) and EORTC-QLQ-C-30 (quality of life). Results: In the MBSR group, scores in anxiety and depression decreased at post-treatment assessment whereas quality of life scores increased. These differences reached statistical significance. In the psychoeducational group only state anxiety scores decreased at post-treatment, with the difference reaching statistical significance. Conclusions: MBSR produces higher improvements in emotional states and quality of life than those obtained following a psycho educational standard procedure. However, it cannot be stated that MBSR must be always the intervention to be applied in all cases, since it is not clear that all patients could follow the guidelines, tasks and exercices required by this technique. Source

Leon C.,Institute Oncologic del Valles | Mirapeix R.,Hospital Parc Tauli de Sabadell | Arcusa A.,Institute Oncologic del Valles | Blasco T.B.,Autonomous University of Barcelona
Psicooncologia | Year: 2012

Purpose: To state the rate of patients who would ask for psychological assistance, once they have known their diagnosis and treatment assigned. To find the profile of these patients considering their demographic, clinical and psychosocial features. Method: A sample of 236 patients assisted at Consorci Sanitari de Terrassa (CST) was assessed using a questionnaire which asked for demographic and social features, as well as for some psychological variables (mood states, coping problems, previous anxiety or depression disorders) during the months which followed the diagnosis. Results: 24% of patients were interested in receiving psychological assistance. These patients were younger, expressed mood alterations and coping difficulties, and did not have previous anxiety or depression disorders. There were no differences between patients who asked for psychological assistance and those who do not, in gender, educational level, social relationships, diagnostic, or prognosis. Months from the knowledge of diagnosis were also unrelated with desire of receiving psychological assistance. Conclusions: A definition of what does mean "psychological assistance" is needed in order to understand why only 22% of patients ask for this resource. Sociodemographic and clinical variables were unrelated with desire of receiving psychological assistance. Younger patients with psychological distress and without previous history of emotional disturbance are more prone to ask for psychological assistance. Source

Blanco A.,University of Santiago de Compostela | de la Hoya M.,Laboratorio Of Oncologia Molecular | Osorio A.,Human Genetics Group | Diez O.,Autonomous University of Barcelona | And 19 more authors.
PLoS ONE | Year: 2013

Background: The PALB2 gene, also known as FANCN, forms a bond and co-localizes with BRCA2 in DNA repair. Germline mutations in PALB2 have been identified in approximately 1% of familial breast cancer and 3-4% of familial pancreatic cancer. The goal of this study was to determine the prevalence of PALB2 mutations in a population of BRCA1/BRCA2 negative breast cancer patients selected from either a personal or family history of pancreatic cancer. Methods: 132 non-BRCA1/BRCA2 breast/ovarian cancer families with at least one pancreatic cancer case were included in the study. PALB2 mutational analysis was performed by direct sequencing of all coding exons and intron/exon boundaries, as well as multiplex ligation-dependent probe amplification. Results: Two PALB2 truncating mutations, the c.1653T>A (p.Tyr551Stop) previously reported, and c.3362del (p.Gly1121ValfsX3) which is a novel frameshift mutation, were identified. Moreover, several PALB2 variants were detected; some of them were predicted as pathological by bioinformatic analysis. Considering truncating mutations, the prevalence rate of our population of BRCA1/2-negative breast cancer patients with pancreatic cancer is 1.5%. Conclusions: The prevalence rate of PALB2 mutations in non-BRCA1/BRCA2 breast/ovarian cancer families, selected from either a personal or family pancreatic cancer history, is similar to that previously described for unselected breast/ovarian cancer families. Future research directed towards identifying other gene(s) involved in the development of breast/pancreatic cancer families is required. © 2013 Blanco et al. Source

Avila M.,IMIM Hospital del Mar Research Institute | Avila M.,CIBER ISCIII | Avila M.,University Pompeu Fabra | Becerra V.,IMIM Hospital del Mar Research Institute | And 35 more authors.
International Journal of Radiation Oncology Biology Physics | Year: 2015

Purpose: Studies of patients' preferences for localized prostate cancer treatments have assessed radical prostatectomy and external radiation therapy, but none of them has evaluated brachytherapy. The aim of our study was to assess the preferences and willingness to pay of patients with localized prostate cancer who had been treated with radical prostatectomy, external radiation therapy, or brachytherapy, and their related urinary, sexual, and bowel side effects. Methods and Materials: This was an observational, prospective cohort study with follow-up until 5 years after treatment. A total of 704 patients with low or intermediate risk localized prostate cancer were consecutively recruited from 2003 to 2005. The estimation of preferences was conducted using time trade-off, standard gamble, and willingness-to-pay methods. Side effects were measured with the Expanded Prostate Index Composite (EPIC), a prostate cancer-specific questionnaire. Tobit models were constructed to assess the impact of treatment and side effects on patients' preferences. Propensity score was applied to adjust for treatment selection bias. Results: Of the 580 patients reporting preferences, 165 were treated with radical prostatectomy, 152 with external radiation therapy, and 263 with brachytherapy. Both time trade-off and standard gamble results indicated that the preferences of patients treated with brachytherapy were 0.06 utilities higher than those treated with radical prostatectomy (P =.01). Similarly, willingness-to-pay responses showed a difference of €57/month (P =.004) between these 2 treatments. Severe urinary incontinence presented an independent impact on the preferences elicited (P<.05), whereas no significant differences were found by bowel and sexual side effects. Conclusions: Our findings indicate that urinary incontinence is the side effect with the highest impact on preferences and that brachytherapy and external radiation therapy are more valued than radical prostatectomy. These time trade-off and standard gamble preference assessments as well as the willingness-to-pay estimation could be useful to perform respectively cost-utility or cost-benefit analyses, which can guide health policy decisions. © 2015 Elsevier Inc. Source

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