Gan to kagaku ryoho. Cancer & chemotherapy
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Gan To Kagaku Ryoho · May 2011
Assessment of dyspnea in terminally ill cancer patients: role of the thoracic surgeon as a palliative care physician.
Many cancer patients suffer from rapidly-progressing dyspnea that is difficult to relieve. ⋯ Palliative care physicians who specialize in the respiratory system can, to some extent, predict the occurrence of rapidly progressive dyspnea in cancer patients. It is important to explain the methods of relieving dyspnea to the patient, the patient's family, and the oncologist early, so that decisions on how to manage dyspnea can be made in advance.
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After the introduction of imatinib, the outcome for patients with advanced gastro-intestinal stromal tumor (GIST) was vastly improved. However, resistance to imatinib has become a new problem. ⋯ Sunitinib is the first drug that showed an effectiveness for treating GIST refractory to imatinib. New molecular target drugs for overcoming imatinib resistance are being developed now.
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Gan To Kagaku Ryoho · Apr 2011
Case Reports[Successful withdrawal from disseminated intravascular coagulation caused by disseminated carcinomatosis of bone marrow originated from gastric cancer treated by sequential therapy consisting of MTX and 5-FU and palliative radiotherapy].
A 5 8-year-old man with severe back pain caused by multiple vertebral metastases developed disseminated intravascular coagulation(DIC). We adopted palliative radiotherapy(8 Gy/1 day)for palliation of his back pain as initial treatment. Afterwards, we started sequential chemotherapy consisting of methotrexate(MTX)and 5-fluorouracil(5-FU). After two courses, DIC was resolved, and the patient was discharged in fair condition after five more courses of MTX and 5-FU therapy.
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Prognostic benefits of lymph node dissection have been proven for patients with breast cancer or gynecological malignancies; however, one of the complications associated with this procedure is lymphedema. We reviewed therapies for secondary lymphedema, including complex decongestive physiotherapy, skin care, manual lymphatic drainage, compression bandaging and garments, and limb exercises. The challenge to secondary lymphedema in Jikei University Hospital, consisting of Aggressive Protocol for Patients with LymphedemA Using SophisticatEd methods(APPLAUSE)has been implemented. Jikei Lymphedema Assessment Scale(JLA-Se)and the LPG technic®, have also been introduced.
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Cancer-related pain affects approximately 90% of those in all stages of the disease. Pain is both a sensation and an emotional experience, and thus it has been defined as total pain. ⋯ The clinical application of pain management should be employed only after a complete and comprehensive assessment and evaluation. The present overview article focuses on nonsteroidal anti-inflammatory drugs (NSAIDs), opioids and adjuvant analgesia.