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La souffrance des medecins, notamment celle des internes, reste peu abordee bien que le syndrome de burnout soit une realite. L’Association des jeunes oncologues basnormands (Ajon) a mis en place un groupe de reflexion afin de creer un espace d’echange. Ces reunions, animees par un oncologue ou un psychologue, assurent un soutien et permettent de prendre du recul par rapport a des situations difficiles. Cela constitue une aide et une formation pour mieux gerer le stress inherent a notre pratique clinique aupres des malades et/ou de leurs proches.

Des etudes ont montre que le traitement par chimiotherapie adjuvante du cancer du sein peut etre associe a des deficits cognitifs legers. Ces troubles ont un impact negatif sur la qualite de vie des patientes, et la comprehension de leur origine et des processus alteres est actuellement un des enjeux importants de ce nouveau theme de recherche. Peu d’etudes ont ete realisees aupres de patientes âgees, alors que l’âge est le facteur de risque le plus important pour ce cancer. Cet article propose une synthese de la litterature et discute de l’incidence de tels troubles chez les patients âges.

Aim: The announcement device was an emblematic measure of the first French Plan Cancer aiming at enabling patients to have a listening and information time after diagnosis announcement and treatment proposition: the different aspects of the treatments including side effects are discussed during these specific clinics. This procedure includes a medical and paramedical consultation. Nausea and vomiting (CINV) are still one of the most common side effects of the chemotherapy (CT) despite of known risk factors and efficient supportive treatments. Hypothesizing patients with good information on CINV and preventive supportive treatments may have less CINV, our study aimed to assess the relation between the patient's satisfaction of information delivered during the diagnosis announcement procedure and the incidence of CINV after the first cycle of chemotherapy. Methods: This prospective multicentric study assessed the frequency and intensity of CINV among patients naive of CT after the first cycle of treatment, using the MASCC Antiemesis Tool (MAT). CINV were defined by≥1 emetic episode or reported nausea intensity≥3 on a 0-10 scale. Multivariate analysis was used to identify various factors related to overall CINV onset, including satisfaction defined as a satisfaction score equal or above median on a 0-10 scale for≥1 announcement consultation. Results: Data from 291 patients (women: 85.2%; mean age: 57 years) from 4 centers were analyzed. Median satisfaction score were 9 and 10 for medical/paramedical consultations (1st quartile: 8 and 9, respectively): 67% of patients were satisfied of announcement device. 40.4% of patients reported acute CINV, 34.8% delayed CINV and 52.4% overall CINV. Four independent predictive factors of CINV were found: motion sickness history (OR 2.73), highly emetogenic CT (OR 2.12), anxiety (OR 2.09) and age under 57 (OR 1.99). No relation was noted between announcement consultation satisfaction and risk of CINV. Conclusions: The announcement consultation satisfaction was not linked to lower CINV frequency. In fact, even "unsatisfied" patients gave a high score, not allowing to clearly identify the impact of satisfaction on CINV. Disclosure: All authors have declared no conflicts of interest.