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Palliative,surgery,pain control,symptom control

Zhiye Du, Wei Guo, Rongli Yang, Xiaodong Tang, Tao Ji, Dasen Li
OBJECTIVE: To investigate the impact of surgery on local control and quality of life for patients with sacral metastases and to determine whether the complications of surgery were acceptable. METHODS: Curettage for metastatic lesions of the sacrum was performed in 154 patients with obvious sacral nerve compression symptoms between July 1997 and July 2014. Potential risk factors were evaluated in univariate analysis for associations with local control; multivariate conditional logistic regression was used to identify the combined effects...
2016: PloS One
Hiroyuki Matsuzaki, Soichiro Ishihara, Kazushige Kawai, Takeshi Nishikawa, Toshiaki Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Hiroaki Nozawa, Shigeru Yamada, Toshiaki Watanabe
BACKGROUND: The need for surveillance of rare late recurrence of rectal cancer has not yet been established. Local control of unresectable skeletal metastasis is important for palliation of symptoms and support for systemic chemotherapy. CASE PRESENTATION: A Japanese man underwent preoperative pelvic irradiation (50.4 Gy/28 Fr) and low anterior resection at the age of 57 years. The pathological stage was II (T3N0M0). Nine years after the surgery, his carcinoembryonic antigen (CEA) level showed rapid elevation, although he had no symptoms...
December 2016: Surgical Case Reports
Mir Alireza Hoda, Thomas Klikovits, Madeleine Arns, Karin Dieckmann, Sabine Zöchbauer-Müller, Christian Geltner, Bernhard Baumgartner, Peter Errhalt, Barbara Machan, Wolfgang Pohl, Jörg Hutter, Josef Eckmayr, Michael Studnicka, Martin Flicker, Peter Cerkl, Walter Klepetko
Treatment of malignant pleural mesothelioma (MPM) depends on performance status of the patient, tumor stage, and histological differentiation. Chemotherapy (CHT) can be administered as first- and second-line treatment in unresectable MPM or as neoadjuvant or adjuvant treatment before or after surgery. A combination of an antifolate and platinum-based CHT is the only approved standard of care. Several targeted and immunotherapies are in evaluation and further studies are warranted to determine the therapeutic value of these new treatment options...
September 2016: Wiener Klinische Wochenschrift
Zhuo Zhang, Daniel J Leong, Lin Xu, Zhiyong He, Angela Wang, Mahantesh Navati, Sun J Kim, David M Hirsh, John A Hardin, Neil J Cobelli, Joel M Friedman, Hui B Sun
BACKGROUND: Curcumin has been shown to have chondroprotective potential in vitro. However, its effect on disease and symptom modification in osteoarthritis (OA) is largely unknown. This study aimed to determine whether curcumin could slow progression of OA and relieve OA-related pain in a mouse model of destabilization of the medial meniscus (DMM). METHODS: Expression of selected cartilage degradative-associated genes was evaluated in human primary chondrocytes treated with curcumin and curcumin nanoparticles and assayed by real-time PCR...
2016: Arthritis Research & Therapy
Yang Cong, Shi-kai Wu
Unlike conventional radiation therapy, stereotactic radiation therapy (SRT) is an emerging tumor-ablative radiation technology with a high-dose delivery to targets while dramatically sparing adjacent normal tissues. The strengths of SRT involve noninvasive and short-course treatment, high rates of tumor local control with a low risk of side effects. Although the scientific concepts of radiobiology fail to be totally understood currently, SRT has shown its potential and advantages against various tumors, especially for those adjacent to less tolerable normal organs (spinal cord, optic nerve, bowels, etc...
November 2015: Chinese Journal of Applied Physiology
Jacek Polanski, Beata Jankowska-Polanska, Joanna Rosinczuk, Mariusz Chabowski, Anna Szymanska-Chabowska
Lung cancer is the major cause of oncologic-related death worldwide. Due to delayed diagnosis, 5-year survival rate accounts for only 15%. Treatment includes surgery, adjuvant chemotherapy, and radiation therapy; however, it is burdened by many side effects. Progress of the disease, severity of its symptoms, and side effects decrease significantly the quality of life (QoL) in those patients. The level of self-assessed QoL helps in predicting survival, which is especially important among patients receiving palliative care...
2016: OncoTargets and Therapy
Katherine E Poruk, Christopher L Wolfgang
Pancreatic adenocarcinoma is the fourth leading cause of cancer death in the United States. Surgical resection offers the best opportunity for prolonged survival but is limited to patients with locally resectable disease without distant metastases. Regrettably, most patients are diagnosed at a point in which curative surgery is no longer a treatment option. In these patients, management of symptoms becomes paramount to improve quality of life and potentially increase survival. This article reviews the palliative management of unresectable pancreatic cancer, including potential palliative resection, surgical and endoscopic biliary and gastric decompression, and pain control with celiac plexus block...
April 2016: Surgical Oncology Clinics of North America
Rachel Galot, Nicolas Christian, Marie Bitar, Emmanuel Seront
A 68-year-old man with a history of bladder cancer presented with perineal pain and penile priapism. The work up showed multiple lesions strictly located in the penis; biopsy confirmed metastases of bladder cancer. Surgery was judged unfeasible and chemotherapy failed to improve symptoms. Radiotherapy was therefore delivered on the whole penis and resulted in a rapid clinical benefit and persistent control of the disease. Penile metastases are very rare and no consensus exists concerning their management; radiotherapy appears as a promising therapeutic option not only to palliate pain but also to control the disease...
January 27, 2016: BMJ Case Reports
Sarah E Cousins, Emma Tempest, David J Feuer
BACKGROUND: This is an update of the original Cochrane review published in Issue 4, 2000. Intestinal obstruction commonly occurs in progressive advanced gynaecological and gastrointestinal cancers. Management of these patients is difficult due to the patients' deteriorating mobility and function (performance status), the lack of further chemotherapeutic options, and the high mortality and morbidity associated with palliative surgery. There are marked variations in clinical practice concerning surgery in these patients between different countries, gynaecological oncology units and general hospitals, as well as referral patterns from oncologists under whom these patients are often admitted...
2016: Cochrane Database of Systematic Reviews
Friedhelm Raue, Karin Frank-Raue
After surgery, patients with medullary thyroid carcinoma (MTC) should be assessed regarding the presence of residual disease, the localization of metastases, and the identification of progressive disease. Postoperatively, patients with MTC are staged to separate those at low risk from those at high risk of recurrence. The TNM staging system is based on tumor size, extra-thyroidal invasion, nodal metastasis, and distant spread of cancer. In addition, the number of lymph-node metastases, the number of compartments involved, and the postoperative calcitonin (CTN) and carcinoembryonic antigen (CEA) levels should be documented...
2015: Recent Results in Cancer Research
Özgür Haki Yüksel, Ayhan Verit, Ahmet Ürkmez
In locally advanced prostate cancer with bladder invasion, frequently encountered problems such as bleeding, urinary retention, hydronephrosis, and pain create distress for the patients. Therefore patients' quality of life is disrupted and duration of hospitalization is prolonged. Relevant literature about accurate staging and treatment of locally advanced prostate cancer with bladder invasion was investigated. Locally advanced prostate cancer can present as a large-volume aggressive tumor extending beyond boundaries of prostate gland, and involving neighboring structures which can be involved as recurrence(s) following initial local therapy...
June 2015: Archivio Italiano di Urologia, Andrologia
Stefano Berti, Alessia Ferrarese, Cosimo Feleppa, Elisa Francone, Valter Martino, Claudio Bianchi, Emilio Falco
BACKGROUND: In patients affected by distal biliary obstruction deemed unsuitable for pancreatoduodenectomy, biliary diversion is the only proposable option. Defined goals of this treatment are: relief from jaundice preventing its related complications, reduction of in-hospital stay and adequate control of pain. Palliation can be obtained either by surgical or conservative procedures (endoscopic stenting or percutaneous treatment). Considering early complications' incidence, surgical approach has always been reserved for low surgical risk patients with longer survival perspectives, while recently developed long-lasting patency stents enlarged mini-invasive application resort...
September 2015: International Journal of Surgery
Andrew M Blakely, Jane McPhillips, Thomas J Miner
BACKGROUND: Surgical palliation of cancer is best defined as procedures performed with non-curative intent to improve quality of life or control symptoms of advanced malignancy. Soft tissue involvement of advanced malignancies may produce symptoms such as pain, bleeding, or odor that significantly reduce quality of life. Literature on outcomes of palliative resection of soft tissue malignancy for local or regional control is lacking. METHODS: Soft tissue resections performed with palliative intent for locoregional control were identified from a prospectively maintained palliative surgery database at a tertiary care center from January 2004 to July 2013...
April 2015: Annals of Palliative Medicine
Francesco Iovino, Michele Orditura, Pasquale Pio Auriemma, Francesca Romana Ciorra, Giovanni Giordano, Consiglia Orabona, Francesco Bara, Renato Sergio, Beatrice Savastano, Alessio Fabozzi, Maria Maddalena Laterza, Jole Ventriglia, Angelica Petrillo, Carminia Maria Della Corte, Ferdinando DE Vita
Bone metastasis is an uncommon event in advanced gastric cancer patients and bone metastases are rarely detected as isolated lesions. However, eleven years after treatment for locally advanced gastric cancer, including total gastrectomy followed by adjuvant chemotherapy, a 49-year-old female was admitted to the IX Division of General Surgery of the Second University of Naples (Naples, Italy) exhibiting severe progressive neurological symptoms. Magnetic resonance imaging indicated vertebral abnormalities, with evidence of marrow infiltration in several vertebral bodies; however, a contrast-enhanced computed tomography scan did not detect disease progression to other sites...
March 2015: Oncology Letters
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