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  • 1
    ISSN: 1569-8041
    Keywords: carcinogenesis ; endometrium ; tamoxifen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Anti oestrogenic treatment is widely used for breastcancer treatment and prevention of recurrence. Because of concomitantestrogenic effects, tamoxifen exerts carcinogenic properties on theendometrium. Although secondary endometrial cancers usually present as pureadenocarcinomas, other types of rare tumors have also been reported. Patients and methods:Herein we describe the clinical,pathological as well as therapeutic aspects of a new case of endometrialmesodermal mixed tumor occurring after long-term tamoxifen therapy. Results:The present case occured five years after cessation ofa five years tamoxifen treatment. The patient failed to respond to doxorubicinand cyclophosphamide when combined to 5-fluorouracil (5-FU), but she reachedcomplete response when the same two drugs were used with carboplatin,suggesting the potential usefullness of platinum derivatives. Conclusions:A longer latency period might be observed forendometrial mesodermal mixed tumors as compared to adenocarcinomas and couldjustify a prolonged clinical and ultrasonographic follow-up of patients duringand after tamoxifen treatment. When indicated, chemotherapy might require theuse of platinum derivatives in this particular type of secondary tumor.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-7339
    Keywords: Palliative care ; Terminal cancer patients ; Family ; Questionnaire
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to evaluate the quality of care for terminal cancer patients at our institution, as assessed by families in a questionnaire sent 6 months after the death of the patient. We evaluated the quality of information given to the patients and to their families, the patients' “comfort” at the end of their lives (nursing, pain, psychological support) and the families' opinions about the practical conditions at the time of death (in our institution or at home). A total of 105 consecutive patients who died in our institution between January and June 1989 were included in the study; the vast majority had breast or head and neck cancers. We obtained a total of 48 answers from the 105 families that received the questionnaire. Of these, 87.5% were satisfied with the terminal nursing care, 77% were satisfied with the information given to patients and 60% with the information given to families. The treatment for pain was considered to be inefficient or incomplete by 21% of the families; 32 families (67%) considered that the death of terminal cancer patients should occur in the hospital where the patient had been treated and 12% felt that it should occur at home. This study led us to examine various means for improving the quality of care for our terminal cancer patients.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1569-8041
    Keywords: genetic testing ; medullary thyroid carcinoma ; psychometric scores ; psychosocial impact ; quality of life
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Many crucial problems are associated with the diagnosis of inherited cancer susceptibility. One of the most important is related to the psychosocial consequences of the knowledge by the patients and their relatives of their own genetical status. Little data are available in the literature, mainly from studies including small numbers of selected and motivated patients. Patients and methods: From January till December 1997, we studied the psychometric and quality of life parameters of 77 subjects followed in two French specialized centers. These subjects had been treated for either sporadic or familial or were at risk for medullary thyroid carcinoma. All patients had previously attended genetic counselling with detection of germline Ret-mutations, were informed on their own genetic risk, had good short-term prognosis and performance status and did not receive recent cancer treatment. Each patient was invited to answer two questionnaires, the hospital anxiety and depression scale (HADS) and the subjective quality of life profile (SQLP). Results: We report herein the descriptive results of this study (HADS and SQLP scores and distributions) and describe the individual clinical covariates that might explain the observed differences between subgroups of individuals. Although psychometric scores appeared similar in these subgroups, quality of life scores were lower in Ret-mutation carriers. Genetically-predisposed patients were less satisfied and expressed more expectations for favourable change in their quality of life. Conclusion: This finding suggests a high level of frustration and latent unsatisfaction related either to the management of the genetic information given by the clinicians and its psychosocial consequences or simply to the knowledge of the genetic risk of cancer. Further studies on the individual consequences of genetic testing, information delivery and when necessary psychotherapeutic interventions, are needed to insure the quality of presymptomatic genetic testing in this field of oncology.
    Type of Medium: Electronic Resource
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