Burnout Syndrome among Doctors in Greek Oncology Departments.

Objective: Economic crisis and austerity has dramatic consequences for health care professionals' mental health. This study aimed to investigate the prevalence of burnout syndrome among doctors working in public or private oncology departments in Greece and its association with factors determined by economic crisis. Method : Medical or radiation oncologists who are members of the National Oncology Societies and practicing oncology at least for one year were enrolled in this study. An On-Line questionnaire consisting of the Maslach Burnout Inventory and an informative questionnaire was utilized. Results: Eighty-six On-Line questionnaires waere analyzed. Radiation oncologists had significantly higher Depersonalization (DP), whereas medical oncologists had significantly higher Emotional Exhaustion (EE) scores. Registrars had higher scores compared to consultants in all subscales of the burnout syndrome. Factors such as ''hospitals are not safe due to the lack or reductions in medical supplies and personnel shortage'' and ''receiving less than 50% of annual leave'' were associated with significantly higher levels of EE. Factors such as ''not afraid of moving abroad'' and ''receiving 100% of annual leave'' were associated with significantly higher levels of low Personal Accomplishments (PA). The principal component analysis yielded three principal components: 'future insecurity', 'feeling secure while working' and 'working conditions associated with burnout syndrome. Conclusion: Several factors associated with austerity resulting from economic crisis significantly influenced prevalence of burnout syndrome among oncologists in Greece. Further studies need to be conducted to mobilize policy makers to develop and implement policies to improve oncologists' mental health.

Fournier Gangrene in a patient receiving chemo-radiation for rectal cancer.

We herein present a case of a 24-year-old patient with a cT4N+ rectal cancer who developed Fournier's gangrene (FG) 1 week after the completion of preoperative chemoradiotherapy. The patient was promptly referred to the surgical department where she was treated with antibiotics and repeated surgical debridement. FG is a rare and life-threatening situation that needs to be managed aggressively with no delay. The clinical image above is unique and characteristic of this clinical entity.

Penile Mondor's disease in a patient treated with radical chemoradiation for anal cancer.

Penile Mondor's disease is a rare condition characterized by sclerosing thrombophlebitis of the superficial dorsal penile vein. Usually its causes are benign, but it is also evident in cancer patients. We report the case of a 62-year-old man with a cT4 anal cancer (infiltration of corpora spongiosa and penile bulb), associated with extensive loco-regional lymphadenopathy, who developed painful lumps in the midline of the anterior penile surface while receiving radical chemoradiotherapy. Physical examination revealed two palpable cord-like swellings located 2 cm from the pubic symphysis. Color Doppler ultrasound established the diagnosis of Mondor's disease. The patient was successfully managed with non-steroidal anti-inflammatory drugs. The causative factors were pelvic malignancy and radiotherapy. The diagnosis was challenging since Mondor's disease is a rare condition and the differential diagnosis included malignancy progression. This is the first case report describing penile Mondor's disease in a patient with anal cancer under chemoradiotherapy.

Comparison of International Guidelines on Mucosal Melanoma of the Head and Neck: A Comprehensive Review of the Role of Radiation Therapy.

Mucosal melanomas of the head and neck are rare pathological entities that correlate with poor prognosis due to their high propensity for local failure and distant metastases. The exact role of radiation therapy in the management of mucosal melanoma patients has not yet been fully proven, even though in everyday clinical practice these patients are referred for radiotherapy, in an effort to improve locoregional control. The guidelines of various societies on the role of radiation therapy for the treatment of mucosal melanoma of the head and neck region are very limited. We reviewed and analyzed the guidelines developed in the U.S.A. (National Comprehensive Cancer Network), Canada (Cancer Care Ontario and Canadian Medical Association), Europe (European Society for Medical Oncology and European Society for Radiotherapy and Oncology) and Australia and New Zealand (Cancer Council Australia) and isolated evidence for the management of mucosal melanomas of the head and neck region with radiation therapy worldwide.

Long-term disease stabilization following treatment with erlotinib in heavily pretreated patients with wild-type epidermal growth factor receptor non-small-cell lung carcinoma: Two case reports.

Lung adenocarcinomas carrying epidermal growth factor receptor (EGFR) mutations have been identified as a unique group of entities that depend on EGFR for their proliferation and metastasis. The introduction of reversible EGFR tyrosine kinase inhibitors, such as erlotinib, has significantly affected the management of metastatic disease in this subset of patients. Interestingly, although erlotinib is highly effective in patients with EGFR mutations, it may occasionally prove useful, even in the absence of mutations. We herein present the course of two heavily pretreated patients who achieved remarkable disease stabilization over several years, despite harbouring no EGFR mutations. Our cases underscore the fact that further research is required to identify which subset of patients will benefit the most from this treatment, as a substantial minority may present with favourable outcomes.