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Introduction: The caregivers of cancer patients may experience changes in their routine that affect their quality of life. The aim of the study was to identify the domains that compromise the quality of life (QoL) of the caregivers of patients with gastrointestinal cancer (GIC). Methods: A descriptive, observational study with caregivers of patients diagnosed with GIC during chemotherapy therapy was done. The caregivers answered 2 questionnaires, SF-36 (short form health survey 36) and CBS (caregiver burden scale). Results: 100 caregivers of 100 patients with GIC were included. The mean age of the patients was 62.2±13 years. Most of them had colorectal cancer (66%), ECOG 0-1 (87%) and stage II/III (81%) disease. Among caregivers, 81% had less than 60 years old and 76% were female. According to the SF-36, lower levels were observed in the emotional, physical aspects and vitality and the best average in functional capacity. Regarding the CBS instrument, the general strain domain and disappointment was the more affected. Stage or ECOG was not associated to the caregivers QOL or burden. High schooling level of the patients was associated with a better quality of life and less burden of the caregivers. Ageing caregivers had a worst QoL and an increased burden. Conclusion: Most of caregivers were women and youngers, and had a worst quality of life in emotional role, physical aspects and vitality, and an increased burden in general strain and disappointment.

Objetivou-se identificar a QV de pacientes com câncer gastrointestinal e dor crônica e caracterizar os dados sociodemográficos, clínicos, terapêuticos e de gradação da dor, associando-os aos domínios de QV. Trata-se de um estudo transversal, quantitativo, do qual participaram pacientes com câncer gastrointestinal e dor crônica, atendidos em ambulatório de gastroenterologia oncológica de um hospital geral, na cidade de São Paulo, Brasil. Utilizou-se um questionário sociodemográfico e clínico, o instrumento EORTC -QLQC30 e o Brief Pain Inventory (BPI). Os dados foram submetidos a análise descritiva, frequências absolutas e porcentuais, e analítica, buscando-se correlacionar os domínios de QV, Dor, Performance Status (PS) dos pacientes, mediante o coeficiente de correlação de Spearman. Para comparar os domínios das escalas do QLQ-C30 e BPI com as variáveis de interesse, utilizou-se Teste T. Participaram do estudo 13 pacientes, maioria sexo masculino, casado, religioso, classificação econômica C2 (61,5%). Todos encontravam-se com dor no momento da coleta de dados, com média 2,54 (DP=2,88) pelo BPI e com pior escore referido das últimas 24 horas em 8,15 (DP=2,03). As principais alterações de QV evidenciadas foram, além da dor: fadiga, insônia e perda de apetite, sendo que quanto mais avançada a doença, piores os sintomas e o prejuízo funcional. Os dados evidenciaram que os pacientes convivem com dor de intensidade moderada e, se pior estado clínico, maior intensidade. A dor compromete a qualidade de vida desses pacientes em múltiplos aspectos, evidenciando que medidas precisam ser empreendidas para favorecer o controle álgico, do esquema terapêutico medicamentoso às atividades educativas e assistenciais.

Older individuals are more likely to develop solid cancers, but at the same time are more sensitive to the side effects of chemotherapy. In addition, older adults are more likely to present with chronic diseases (comorbidities) and immunosenescence that may decrease immunosurveillance against cancer. Clinical outcomes for the older patient with cancer are different from the younger patient and require different research and treatment approaches. Thus, alternative therapeutic approaches tailored specifically to the older patients are required. Colorectal cancer (CRC) has a high incidence in older individuals and is the third leading cause of cancer death globally. Anti-hypertensives are used by a large proportion of older patients and some studies have pointed to a positive impact of angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) on CRC outcomes. As we have previously shown in a mouse model, lung metastases express ACE and contain many infiltrating myeloid-derived suppressor cells (MDSC); particularly high levels of MDSC are also present in the blood of older patients with CRC and other cancers, and are associated with disease severity. In this Commentary, we hypothesize that one mechanism responsible for the positive impact of ACEi or ARB on the outcome of CRC is the modulation of myeloid cells contributing to their maturation to non-suppressive neutrophils/monocytes and diverting them away from retaining an immature MDSC phenotype.