1/23. anxiety symptoms and panic attacks preceding pancreatic cancer diagnosis.Cancer of the pancreas is a highly malignant disease with a very poor prognosis. depression and anxiety occur more frequently in cancer of the pancreas than they do in other forms of intra-abdominal malignancies and other cancers in general. Yet, the etiology of psychiatric symptoms in patients with cancer of the pancreas may not be traced solely to poor prognosis, pain, or existential issues related to death and dying. In as many as half of patients that go on to be diagnosed with the disease, symptoms of depression and anxiety precede knowledge of the diagnosis. This observation has raised speculation that mood and anxiety syndromes are related to disruption in one of the physiologic functions of the pancreas. In this paper, we present a patient who had no prior psychiatric history and developed panic attacks just prior to diagnosis of her cancer. To our knowledge, this is the first report in the literature where panic attacks, not simply anxiety, presented prior to a pancreatic cancer diagnosis. Her symptoms resolved following resection of the tumor. Implications of such phenomena for the diagnosis and treatment of anxiety and depression in pancreas cancer are discussed.- - - - - - - - - - ranking = 1keywords = cancer (Clic here for more details about this article) |
2/23. fatigue in women receiving adjuvant chemotherapy for breast cancer: characteristics, course, and correlates.This study investigated the characteristics, course, and correlates of fatigue in women receiving adjuvant chemotherapy for breast cancer. Fifty-four patients were assessed before the start of chemotherapy and during the first three treatment cycles. An age-matched sample of women with no cancer history was assessed at similar time intervals for comparison purposes. Results indicated that breast cancer patients experienced worse fatigue than women with no cancer history. These differences were evident before and after patients started chemotherapy. In addition, fatigue worsened among patients after treatment started. More severe fatigue before treatment was associated with poorer performance status and the presence of fatigue-related symptoms (e.g., sleep problems and muscle weakness). Increases in fatigue after chemotherapy started were associated with continued fatigue-related symptoms and the development of chemotherapy side effects (e.g., nausea and mouth sores). These findings demonstrate the clinical significance of fatigue in breast cancer patients before and during adjuvant chemotherapy treatment. Results also suggest that aggressive management of common side effects, such as nausea and pain, may be useful in relieving chemotherapy-related fatigue.- - - - - - - - - - ranking = 0.9keywords = cancer (Clic here for more details about this article) |
3/23. An exercise intervention for advanced cancer patients experiencing fatigue: a pilot study.fatigue is reported by advanced cancer patients to be their most prevalent and distressing symptom. Despite this, few interventions have been developed and tested to manage this debilitating symptom. This paper describes a pilot study undertaken to test the effects of a 28-day exercise intervention on levels of fatigue in advanced cancer patients. All participants were able to increase their activity levels with no increase in reported fatigue. Furthermore, a trend was noted in all patients toward increased quality of life scores and decreased anxiety scores. All participants described a sense of satisfaction in attaining increased activity levels. These preliminary pilot results suggest that patients who initially report the highest levels of fatigue may achieve the largest decrease in fatigue scores. These findings provide support for the suitability of this intervention for the palliative care population and justify the importance of further hypothesis testing.- - - - - - - - - - ranking = 0.6keywords = cancer (Clic here for more details about this article) |
4/23. Wegener's granulomatosis triggered by infection?Wegener's granulomatosis is a systemic disease of unknown origin, although recent studies suggest that auto-immune mechanisms and infection play a role in the pathogenesis of this disease. Wegener is characterized by a necrotizing vasculitis involving the lungs (pulmonary infiltrates), the upper airways and the kidneys (rapidly progressive glomerulonephritis). We present a case of a male patient admitted because of progressive deterioration of the general condition with weight loss, a unilateral neck mass, unilateral purulent rhinorrea and fever. CT-scan evaluation demonstrated a unilateral expanding mass in the sing-nasal cavity, obliterating the ethmoid complex. MRI revealed signs of intracranial inflammatory reaction and onset of absedation. A malignancy was suspected but a diagnosis of Wegener's granulomatosis was established based on histologic criteria (nasal biopsy) and a positive titer for anti-cytoplasmic antibodies (cANCA). During follow-up, nasal carriage of Staphyloccocus Aureus could be documented. An overview of Wegener's granulomatosis will be provided with emphasis on the potential role of acute infections as a trigger for Wegener's granulomatosis and the head and neck manifestations.- - - - - - - - - - ranking = 0.0011249232466182keywords = kidney (Clic here for more details about this article) |
5/23. methylphenidate for fatigue in advanced cancer: a prospective open-label pilot study.Psychostimulants such as methylphenidate are used for fatigue in cancer patients. We report a prospective, open-label, pilot study of the successful use of methylphenidate to treat fatigue in nine of 11 consecutive patients with advanced cancer. Seven had received radiation or chemotherapy, a median of three weeks (range from one to 30 weeks) prior to methylphenidate. A rapid onset of benefit was noted, even in the presence of mild anemia. Sedation and pain also improved in some. Only one patient had side effects severe enough to stop the medication.- - - - - - - - - - ranking = 0.6keywords = cancer (Clic here for more details about this article) |
6/23. Primary amyloidosis (AL) presenting with nephrotic syndrome: a case report and discussion.Primary amyloidosis (AL) is a rare disorder with only eight cases per million a year. AL is a plasma cell disorder in which neoplastic clonal plasma cells in the bone marrow produce monoclonal immunoglobulin light chains that form protease resistant amyloid fibrils. AL fibrils accumulate within tissues systemically, causing progressive organ impairment to ultimate death. Median survival in AL with treatment is only 17 months depending upon variable prognostic factors. Most patients present with nephrotic syndrome and associated peripheral edema because the kidney is the most common organ involved in AL. This article describes the case of a patient who presented to City Hospital in Martinsburg, W.Va., and was diagnosed with primary amyloidosis, and reviews the current literature on this illness.- - - - - - - - - - ranking = 0.0011249232466182keywords = kidney (Clic here for more details about this article) |
7/23. The last 48 hours of life: a case study of symptom control for a patient taking a Buddhist approach to dying.Caring for a patient dying of cancer can, at times, be extremely difficult. Sarah was 39 years old when she died, survived by her husband and two children aged 6 and 4 years. During the weeks leading up to her death, Sarah held extensive discussions with family and the multidisciplinary team. Her goal was to live the remainder of her last few hours as comfortable as possible and to die a "peaceful death". terminal care is an important phase of life, one in which individuals have the right to expect quality of care to ensure that their death occurs with dignity. Sarah practised buddhism on a daily basis. Issues of spirituality, serenity and peacefulness in dying were very important to her to ensure a good rebirth.- - - - - - - - - - ranking = 0.1keywords = cancer (Clic here for more details about this article) |
8/23. Gastric carcinoma in a 13-year-old girl.Gastric cancer is uncommon before the fifth decade of life. The appearance of adenocarcinoma in young adults has motivated molecular studies that aimed to identify inherited mutations. Moreover, carcinoma of the stomach in the young adult is sufficiently rare to generate considerable interest in each occurrence of it, especially when it occurs in the gastroesophageal junction. We report a case of gastric carcinoma in a 13-year-old girl, who was referred to our service with weakness, malaise, weight loss, and slight dysphagia. An upper endoscopy with biopsy revealed a gastric Borrmann III tumor, with invasion of the distal esophagus; histopathological analysis revealed a moderately differentiated adenocarcinoma. During staging, she was diagnosed with several metastases, including the lymph nodes, liver, spleen, and ovary. She was referred for radiochemotherapy and died within 4 months. We should consider and investigate the possibility of malignancy even in young patients with persistent symptoms or anemia, in order to diagnose this malignancy at earlier stages.- - - - - - - - - - ranking = 0.1keywords = cancer (Clic here for more details about this article) |
9/23. Exceptionally elevated creatine kinase levels in a laryngectomized patient: hypothyroid myopathy.We present a laryngectomized patient with unspecific complaints of fatigue whose laboratory findings were out of proportion with the clinical presentation. The enormously high blood levels of creatine kinase (CPK) (8000 IU/l, normal range 30-190 IU/l) and thyroid-stimulating hormone (100 mU/l, normal range 0.5-4.5 mU/l) led to diagnosis and treatment of and recovery from hypothyroid myopathy. hypothyroidism reduces the ability of the muscle to maintain its adequate energetic economy, via several suggested mechanisms. This may lead to injury (myopathy) that allows enzymes such as CPK to leak out of cells and causes elevation of their serum levels. To our knowledge, this is the first reported case of a patient previously treated for head and neck cancer who developed hypothyroid myopathy, presenting with exceptionally elevated CPK levels. This is noteworthy, since hypothyroidism may be easily avoided by a comprehensive follow-up of patients treated for head and neck cancer.- - - - - - - - - - ranking = 0.2keywords = cancer (Clic here for more details about this article) |
10/23. health seeking related to ovarian cancer.Critical review of general health-seeking models showed a need for expansion to include the early and atypical symptom period associated with ovarian cancer and the role of self and primary care in the diagnostic process. Data from family functioning research showed that in the self-care phase, the initial gastrointestinal symptoms were unrecognized as serious, given common sense labels, and self-managed. When primary care provider care was sought, misdiagnoses occurred three fourth of the time. Diagnostic delays occurred in these 2 phases of care. An expansion of a model of health seeking links personal and family risks and adds early symptom data may be obtained through monthly self-monitoring by women using a symptom checklist. Organization of risks and symptom information assists in interpretation of disparate streams of data and gives a recommended outcome: high personal risk level high family risk level high early and persistent symptoms presence = high need for a prompt gynecological evaluation. The restructured health-seeking process requires women be taught how to monitor their ovarian health. nurses and primary care providers need frequent continuing education updates and the health media need current and accurate information about this malignancy.- - - - - - - - - - ranking = 0.5keywords = cancer (Clic here for more details about this article) |
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