Abstracts from 8th Congress of the European Federation of Internal Medicine / European Journal of Internal Medicine 20S (2009), S1–S283 S111

n %

Gender Females 118 58,4Males 84 41,6

Marital status Married 159 78,7Single 43 21,3

Education Primary school 85 42,1Middle school 39 19,3High school 52 25,7University 26 12,9

Occupation Housewife 84 41,6Retired 59 29,2Student 4 2,0Employed 55 27,3

Income level Bad 18 8,9Good 184 91,1

Employment status Employed 39 19,3Not employed 163 80,7

Health insurance Uninsured 6 3,0Insured 196 97,0

n %

Diagnosis Breast cancer 55 27,2Colo-rectal cancer 34 16,8Lung cancer 27 13,4Gastric cancer 11 5,4Skin cancer and Sarcomas 4 2,0Gynecological Cancer 29 14,4Lymphoma 15 7,4Bone cancers 9 4,5Head and Neck Cancer 5 2,5Urological cancer 13 6,4

Location of disease Primary disease 135 66,8Metastatic disease 67 33,2

EGOC Performance Score 0 118 58,41 60 29,72 24 11,9

Surgical therapy No 74 36,6Yes 123 60,9

Radiation therapy No 129 63,9Yes 65 32,2

Chemotherapy Platin based therapy 88 43,6Fluorouracil based therapy 22 10,9Taxane based therapy 28 13,9Doxorubicine based therapy 17 8,4Target therapy 28 13,9Other chemo regimens 19 9,4

health insurance. During treatment physical symptoms’ distress was higherthan psychological and social symptoms’ distress and fatigue, impairmentin sleep habits, dry mouth, nausea and alopecia were the symptoms mostoften reported by the cancer patients. Most often used non-pharmacologicalinterventions were resting and sleeping for fatigue and dinking liquids andoral care for dry mouth.Discussion & conclusion: Although most of the cancer patients experiencedifferent symptoms related to chemotherapy only small number of patientsprefer to use non-pharmacological interventions in their symptom manage-ment. When poorly controlled, symptoms can effect both the treatment andthe QOL of person with cancer. Distressing symptoms have led to delays orinterruptions in administering treatments. Although the physician remains thecentral figure in the treatment of cancer patients, oncology nurses must bemore proactive and innovative in patient care, education, and counseling inorder to maximize symptom control of patients in our country.When poorly controlled, symptoms can effect both the treatment and theQOL of person with cancer. Distressing symptoms have led to delays orinterruptions in administering treatments. Although the physician remains thecentral figure in the treatment of cancer patients, oncology nurses must bemore proactive and innovative in patient care, education, and counseling inorder to maximize symptom control of patients with cancer in our country.Keywords: cancer, chemotherapy, non-pharmacological interventions

P0319OVARIAN HYPERSTIMULATION BY TAMOXIFEN

Inês Silva, Vera Tomé, João Oliveira. Instituto Português De Oncologia –Lisboa - Portugal

Tamoxifen (TAM) is a non-steroidal antiestrogenic used in breast cancerpatients as an adjuvant therapy, as well as in metastatic disease. TAM’smechanism of action is not still completely understood; however, besidesits major antiestrogenic effect (inhibits the attachment of estradiol to theestrogen receptor, reducing its levels), it has also a weak estrogenic effect.

These mechanisms are responsible for TAM’s association to increased riskof endometrial hyperplasia, polyps, cysts and carcinoma, as well as ovariancysts.The authors present the case of a 54 year old, pre-menopausal, caucasianwoman with the diagnosis of invasive ductal breast carcinoma (T2N0M0;positive estrogen and progesterone receptors). Lumpectomy and right regionallymph node resection were performed followed by chemotherapy (FEC) andradiotherapy. After the 6th cycle of chemotherapy, the patient was started onTAM (20 mg qid), maintaining annual gynaecological follow-up and pelvicUS.After 18 months’ therapy of TAM, the patient was amenorrheic (negativepregnancy test). Pelvic ultrasound revealed functional ovarian cysts, with con-current very high levels of estradiol (> 1000) and normal progesterone levels.Suspicion of Ovarian Hyperstimulation syndrome lead to TAM’s withdrawalwith consequent normalisation of estradiol level 4 months later.The rarity of this entity disclosed some pertinent questions: what should bethe right decision in face of an Ovarian Hyperstimulation syndrome inducedby TAM? Three alternatives are discussed: TAM’s withdrawal, “wait and see”(keeping TAM) or concomitant use of an GnRH-a agent.

P0320STUDYING THE STRESS, THE CONDITIONS LEADING TO STRESSAND THEIR AFFECTS IN CAREGIVERS OF CANCER PATIENTS

Yurdanur Çetınkaya, Çıçek Fadiloglu, Fısun Senuzun, Tülay Altun. HealthSciences

Introduction: The fundamental aim of this descriptive study was to determinethe situations causing stress in care providers of cancer patients and their shortand long term affectsObjectives: The sampling of study comprised of 110 primary caregivers whoprovide care to their relatives who have received cancer diagnosis.Materials & methods: The individual information form developed by theresearcher to obtain information related to the characteristics of caregiversincluded total 15 questions concerning sociodemographic variables such asage, gender, level of education, marital status, present employment status,number of individuals in the family, number of children, place of residence,social security, income status, his/her relationship with person who is receivingcare. Caregivers have completed the Caregiver Reaction Assessment.Results: Caregiver Stress Index (CSI) is a scale developed by Pearl et al.in 1990 to identify and define those difficulties encountered during care de-livering process. Identifying the patients’ cognitive status and their behaviorscausing problems can facilitates orienting the activities and roles of careproviders. The conflicts in family, the conflict between employment role andcar providing role, social support to care providing are very important for acare providing experience. Index comprises of 13 questions (0-1). Each “yes”answer indicates a need for support in that area. 7 or a higher score showsa high level of stress. Scale’s validity and reliability analyses for the Turkishcommunity were conducted. The total mean scores and standard deviation ofthe Index were found as 9,54±0,74.Discussion & conclusion: As a conclusion, It was observed that individualswho provide care to cancer patients experience a higher level of stress.Keywords: Care provider, stress, stress of cancer, family.

P0321ADENOID CYSTIC CARCINOMA OF THE BREAST WITH CEREBRALMETASTIZATION: A CLINICAL NOVELTY

Inês Silva, Vera Tomé, João Oliveira. Instituto Português De Oncologia –Lisboa - Portugal

Adenoid cystic carcinoma (ACC) is a rare variant of adenocarcinoma thatinvolves especially major and minor salivary glands, but may occur in othersites such as breast, trachea, bronchi, lacrimal glands, skin, cervix and vulva.ACC of the breast is rare, corresponding to < 1% of all breast cancers (150reported cases in literature). In contrast with extra-mamarian ACC, the ACCof the breast has an excellent prognosis. In fact, metastization is infrequent (7reported cases, with the lung as the preferential site) and usually no axillarynode involvement is seen.Nowadays, authors recommend treatment with simple mastectomy (becausetumoral recurrence after local excision occurs), with exception of large tumorsor node involvement in which modified radical mastectomy is required.Despite an excellent prognosis, local recurrence and distant metastasis mayappear differed in time (rare), requiring a close follow-up with periodicthorough clinical examination and chest X-ray.