Journal of Cancer and Allied Specialties
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AN UNUSUAL MASS OF THE CHEST WALL IN A 7 YEARS OLD CHILD: AN ASKIN'S TUMOUR
Full text linkAskin’s tumour is a primitive neuroectodermal tumour developing from the soft tissues of the chest wall. It is commonly misdiagnosed due to features similar to other round blue cell tumours. The approach for its diagnosis and treatment is complex and requires a multidisciplinary team. The recommended treatment is chemotherapy and surgical excision mainly. The prognosis is dependent on many factors. We managed a child of Askin’s tumour using modalities such as neoadjuvant chemotherapy and surgical excision and found a good response.Key words: Chest wall mass, Askin’s tumour, Ewing sarcom
MR ENTEROGRAPHY: AN EMERGENT TECHNIQUE FOR CHARACTERIZATION OF SMALL BOWEL LESIONS IN ONCOLOGICAL AND NON-ONCOLOGY DISEASES
No full textSmall bowel is not easily accessed by endoscope and diagnosis of its pathology relies on clinical assessment and imaging. Traditional contrast studies have the disadvantage of not including the mural and extramural details. This is best seen with magnetic resonance enterography (MRE) which is rapidly replacing computed tomography enterography due to better soft tissue resolution and lack of ionizing radiation. Comprehensive MRE requires axial and coronal T1- and T2-WI, high-resolution diffusion-weighted images, fat-suppressed three-dimensional T1-W breath-hold gradient-echo images of the abdomen, and pelvis before and after intravenous gadolinium-based contrast material administration. MRE is the preferred imaging technique for small bowel pathology due to its ability to show mural and extramural details which allow differentiation in acute, active, and chronicity of changes. Being radiation free, there is no age limitation for its use
COMPARISON OF CURRENT SCREENING FOR PREVALENCE OF DEPRESSION AND ANXIETY WITH STANDARDIZED SCREENING TOOLS I PATIENT HEALTH QUALITY -9 AND GENERALIZED ANXIETY DISORDERS-7 AMONG ADULT INPATIENTS AT SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL & RESEARCH CENTRE (SKMCH&RC)
No full textPurpose: Screening for depression and anxiety for inpatients at Shaukat Khanum Memorial Cancer Hospital and Research Centre is done by nursing team by asking patients two questions from a structured admission tool aimed toward depression and anxiety. We audited the use of the current method of screening for depression and anxiety against standard screening tools for depression and anxiety i.e., Patient Health Questionnaire (PHQ)-9 and Generalised AnxietyDisorder (GAD)-7. The aim was improvement of screening for depression and anxiety amongst cancer inpatients.Methods: We used a cross-sectional method to observe if the current screening method was being completed on admission on an inpatient ward of 40 patients on one particular day. Second, we delivered PHQ-9 and GAD-7 as screening tools on the same inpatients on the same day to compare with the current screening method.Results: Prevalence of depression was 54.5% (n = 18) and that of generalized anxiety was 36.4% (n = 12), regardless of severity, when using PHQ-9 and GAD-7. Comparatively, the current method of screening was able to pick up 16.6% (n = 3) of cases of depression and 16.6% (n = 2) of cases of generalised anxiety.Conclusion: We concluded that improvement was required in the screening process for depression and anxiety by devising a new screening tool specific to our cancer population.Key words: Anxiety, cancer, depression, screenin
PNEUMATOSIS INTESTINALIS - A RARE CLINICAL FINDING REQUIRING MULTIMODALITY TREATMENT
Full text linkThis is a case report of Pneumatosis intestinalis (PI), which has traditionally been associated with immediate operative intervention and a high mortality rate. We present a case of ulcerative colitis that developed Pneumatosis intestinalis and was managed at our hospital. A 29 year old male with known history of ulcerative colitis presented with an acute exacerbation. A week into his treatment, PI developed. Emergency total colectomy with end ileostomy was performed. Postoperatively, he remained critically ill and expired during same hospitalization after 45 days.Key words: Pneumatosis intestinalis, Ulcerative Colitis, Adalumima
HYBRID SCINTIGRAPHY OF RARE SPLENIC HAMARTOMA
Full text linkSplenic hamartoma, also known as splenoma, splenic adenoma or nodular hyperplasia, is a rare benign splenic tumor. It is composed of disordered vascular channels with abnormal mixture of red or white splenic pulp. Mostly it is asymptomatic and encountered incidentally at imaging, surgery or autopsy. Radiologically hamartomas are almost identical to hemangioma. In such circumstances radiolabelled blood pool imaging and radiocolloid scintigraphy helps to differentiate the two entities. We present a case of asymptomatic splenic lesion on hybrid radionuclide imaging with SPECT-CT, findings suggestive of hamartoma. Key Words: Splenic hamartoma, SPECT-CT, Radiocolloid scintigraph
CASTLEMAN DISEASE: A GREAT MIMICKER OF METASTASES IN RADIOIODINE REFRACTORY THYROID CANCER
Full text linkA 27-year-old male underwent total thyroidectomy for thyroid swelling. Histopathology showed papillary thyroid carcinoma [T3 - 6.0 cm] with extra-thyroidal extension. The patient was treated with 150 mCi radioactive iodine(RAI) as adjuvant ablative therapy. Radioiodine refractory disease was identified 1-year post-RAI therapy with elevated thyroglobulin levels and negative I-131 whole body scan. F-18 FDG positron emission tomography/computedtomography scan showed activity in the right thyroid bed and multilevel right cervical nodes. Right-sided modified neck dissection was done, which showed Castleman disease (hyaline vascular type) in right cervical nodes. The most probable cause of elevated tumour markers was found out to be 0.6 cm right thyroid bed nodule on follow-up ultrasonography. Our patient also had coexistent conditions as; osteopoikilosis and Hepatitis C along with thyroid carcinoma.Key words: Castleman disease, lymph node, radioiodine, thyroid cance
UNMET SUPPORTIVE CARE NEEDS AMONG BONE SARCOMA PATIENT IN SARAWAK
Full text linkPurpose: This study aimed to determine the prevalence of unmet supportive care needs among bone sarcoma patients in Kuching, Sarawak and explored the relationship between these needs with various associated factors. Methods: It was a descriptive cross-sectional study conducted among all bone sarcoma patients recruited from Sarawak General Hospital in Kuching, Sarawak. Data collection was done using an adopted questionnaire via interview assisted survey. Unmet needs were assessed using the 59-item Supportive Care Needs Survey (SCNS-SF59). Data was entered and analyzed using SPSS version 20. Results: A total of 75 respondents participated in the study. The patients were mainly above 36 years (56%), Sarawak natives (33.3%) and married (54.7%). Majority of patients were not undergoing any active treatment (52%). Nine out of 10 items with highest ‘moderate’ to ‘high’ level unmet needs were from the domain of Health system and information. Needs from Physical and daily living, and sexuality domains were found to have statistically significant associations with ethnicity, age and marital status. Conclusion: Patients who were diagnosed with bone sarcoma had substantive unmet supportive care needs in relation with their illness trajectory. It is important that such needs to be acknowledged in order to provide quality healthcare services to them. Key words : bone sarcoma, unmet needs, Malaysia, SCNS-SF59,supportive care need
COMPARISON OF DOCUMENTED PATIENT CARE BEFORE AND AFTER IMPLEMENTATION OF END OF LIFE CARE PATHWAY FOR TERMINALLY ILL PATIENTS AT SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL AND RESEARCH CENTRE
Full text linkPurpose: Shaukat Khanum Memorial Cancer Hospital and Research Cancer primarily deals with cancer patients and has various departments which provide best-integrated lifesaving care. However, when patients who have been given all possible medical and oncological treatment still progress their disease, they are then referred for best supportive care to palliative care department. The aim of this paper was to audit documented care for palliative patients before and after implementation of end of life care (ELC) pathway.Materials and Methods: We used a retrospective method to audit 45 terminally ill patients over a period of 3 months. Then, a re-audit was done over a period of 3 months and data were collected for patients who were started on SKM-ELC pathway.Results: Results show that the implementation of ELC pathway, 67% of the patients were not prescribed PRN medications for symptom control, 20% of the patients were not reviewed for the need of assisted nutrition and for 20% of the patient’s primary team were not even notified that the patient is dying. After the ELC pathway implementation, it was found that 100% of patients were reviewed for PRN medications and assisted nutrition. Oncologists were timely notified that the patient is dying.Conclusion: In summary, we can say that implantation of ELC pathway has significantly improved documented patients care in all aspects.Key words: Cancer, care for dying, end of life care, goals of care pathwa