Bulletin du cancer
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The continuing growth of the Internet has transformed the access to medical information. However, there are still little data on the quality of e-Health information available. This study examined the content and readability of paediatric neuro-oncology information on the Internet in the French language. ⋯ The mean readability score was 19.8 (6-32), indicative of poor accessibility by readability and complex vocabulary content. The poor quality of e-Health information is not specific of Web sites in French. The role of cooperative groups and the Health Care System in providing and disseminating clear and compelling medical information is essential.
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Dyspnea is a very common symptom in cancer patients. It is an important symptom because it interferes with patient's quality of life and because its treatment is often difficult. Dyspnea may be defined as an uncomfortable awareness of breathing. ⋯ Morphine can decrease the sensation of dyspnea by its central effects and is useful especially in palliative setting. Benzodiazepines reduce anxiety induced by dyspnea. Physiotherapy, support of patient and family must not be neglected.
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Disclosure of a cancer diagnosis and, more often that of a poor prognosis facilitates the creation of a conspiracy of silence, also called a collusive situation. It is often imposed by the patient's relatives. ⋯ In order to resolve conflicts and improve the lived experience of difficult moments, it is preferable to break into the collusion by initiating a dialogue. A clinical vignette illustrates an approach to take in everyday practice.
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Geriatric oncology represents a novel specialty which can be defined as specific older cancer patients management. It includes a validated geriatric procedure, the comprehensive geriatric assessment, which is the best way of approaching the complex interacting medical problems of frail older patients. ⋯ Geriatric assessment may provide either guidelines for anti-cancer treatment in the elderly, or guidelines for the management of older patients with cancer. Two clinical research ways are now developed : firstly the definition of the most relevant geriatric variables allowing clinical trials in such a heterogeneous population; secondly, the determination and the validation of a specific tool to screen frail and vulnerable older patients, and the study of the geriatric assessment impact on the quality of life of older cancer people.
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Gastrointestinal stromal tumors (GIST) are rare tumors occuring at all levels of the gastrointestinal tract, whose estimated incidence may be close to 2 new cases per 100 000 persons per year. GIST derive from the interstital cells of Cajal (ICC) responsible for the motility of the GI tract, or from a common precursor of ICC and of the smooth muscle cells of the digestive tract. GIST cells express the c-kit protoconcogene under an activated form, either mutated or constitutively activated, as well as the CD34 Ag. ⋯ Resistance are now being observed however. GIST has become the first model of a solid tumor treated efficiently by a treatment targetting the initial genetic alteration of the disease. Numerous question regarding the integration of this treatment with surgery and the long term outcome of these patients still remain to be answered however.