ABSTRACT
INTRODUCTION: During the treatment course, cancer patients are prone to develop acute symptoms that are either treatment-related or cancer-related. Emergency services are available during the whole day to manage the acute problems of patients with chronic diseases, including cancer patients. Previous studies have shown that palliative care (PC) provided at the beginning of stage IV lung cancer diagnosis helped to reduce emergency visits and increase survival rates. METHOD: A retrospective study was conducted on lung cancer patients with confirmed histopathology of non-small cell cancer and small cell lung cancer who visited the emergency department (ED) from 2019 to 2021. The demographic data, disease-related-data causes of ED visits (including disposition), number of emergency visits, and palliative referral and impact on the outcome and frequency of emergency visits were reviewed. RESULTS: Of a total number of 107 patients, the majority were male (68%), the median age was 64 years old, and almost half of them were smokers (51%). More than 90% of the patients were diagnosed with non-small cell lung cancer (NSCLC), more than 90% with stage IV, and a minority underwent surgery and radiation therapy. The total number of ED visits amounted to 256, and 70% of the reasons for ED visits were respiratory problems (36.57%), pain (19.4%), and gastrointestinal (GI) causes (19%), respectively. PC referral was performed only for 36% of the participants, but it had no impact on the frequency of ED visits (p-value > 0.05). Besides, the frequency of ED visits had no impact on the outcome (p-value > 0.05), whereas PC had an impact on the live status (p-value < 0.05). CONCLUSION: Our study had similar findings to another study regarding the most common reason for ED visits among lung cancer patients. Improving PC engagement for patient care would render those reasons preventable and affordable. The palliative referral improved survival among our participants but had no impact on the frequency of emergency visits, which may be due to the small number of patients and the different populations included in our research. A national study should be conducted to obtain a larger sample and to determine the impact of PC on ED visits.
ABSTRACT
Lipoblastoma is an extremely rare disease and mostly affects the infant to pediatric age group. Primarily, it involves the extremities, head and neck region, and rarely, the retroperitoneal region. Retroperitoneal lipoblastoma mainly presents with either abdominal pain or distension. We report a case of a 24-year-old male who presented with acute cord compression and underwent decompression and fixation with biopsy. Histopathology established the presence of lipoblastoma. Further staging workup showed no metastasis. Immunostaining and cytogenetics were positive for CD34 and negative for desmin, DNA damage-inducible transcript 3 (DDIT3), mouse double minute 2 (MDM2)(12q15), and pleomorphic adenoma gene 1 (PLAG1). The patient underwent resection of the retroperitoneal mass with intraoperative radiation therapy to the tumor bed. The histopathology identified the mass as retroperitoneal lipoblastoma. The postoperative course was uneventful and CT images showed no recurrence or metastasis. This was a unique case of retroperitoneal lipoblastoma in an adult with a unique clinical presentation.
ABSTRACT
We report an unusual case of primary gastric synovial sarcoma in a young woman who presented with chronic abdominal pain. Esophagealgastricendoscopy showed a gastric fundus mass measuring 2 cm × 3 cm. Biopsy confirmed a primary synovial sarcoma. Staging work-up was negative for metastasis. The patient underwent surgery, and the histopathology results did not suggest the need for adjuvant chemotherapy.
ABSTRACT
We report a rare case of multiple primary malignancies, double primary lung cancers, and synchronous colon cancer. Double primary lung cancers were synchronous with adenocarcinoma of the sigmoid (carcinoid tumor and adenocarcinoma). The patient subsequently underwent two surgeries, for lung and colon cancer, followed by four cycles of carboplatin and pemetrexed treatment for the lung adenocarcinoma, with an uneventful chemotherapy course. The patient has been followed up closely for the last 18 months via CT scans and tumor marker tests and has shown no evidence of recurrence or metastasis.
ABSTRACT
Objective The recent coronavirus pandemic (SARS-CoV-2) has severely increased the burden on the field of oncology, leading to the implementation of new rules to overcome its negative impact. An important issue is the psychological impact of the pandemic on already vulnerable populations, such as oncology staff, as reported by oncology associations. This study assessed the anxiety level among oncology staff during the coronavirus disease 2019 pandemic and related it to its risk factors and the effectiveness of departmental interventions that seek to provide coping methods. Methods A cross-sectional survey was administered to the oncology staff at our oncology center. Generalized anxiety disorder scale "yes-or-no" questions were used to determine secondary objectives regarding the concern of infection and the impact of a departmental intervention on overcoming distress. Results Overall, 199 participants were included in the analysis; more than 60% were women, with a median age of 34 years. More than 50% had anxiety and the most significant risk factors were parenthood and contraction of infection (P-value 0.03 and 0.02, respectively). Most responders reported an increase in the workload during the pandemic, but coping methods applied by the administration had improved anxiety levels as reported by a majority of the responders. Conclusion Oncology staff members have been negatively affected by the pandemic, although coping methods helped to improve anxiety. In the future, attention must be focused on the most vulnerable groups.
