Large Bowel Obstruction following Endoscopic Spray Cryotherapy for Palliation of Rectal Cancer Bleeding.

We report a unique case of a 79-year-old woman with metastatic rectal cancer who developed bowel obstruction following endoscopic cryotherapy with liquid nitrogen for palliation of bleeding in the rectum. She developed abdominal distention and pain following the procedure. Computed tomography of the abdomen revealed a paraumbilical hernia containing a segment of transverse colon resulting in partial bowel obstruction.

#PlasticSurgery.

Background: Social media use is growing inexorably, and there is public appetite for evidence-based information. Little is known about engagement by plastic surgeons with social media. The aim of this study was to examine posting about plastic surgery on Twitter, to best inform how board-certified plastic surgeons could use the hashtag #PlasticSurgery as a tool to educate patients and the public.

Adult-onset Kaposiform hemangioendothelioma of the tongue: case report and review of the literature.

We present here a very rare clinical case of a 38-year-old man with Kaposiform hemangioendothelioma (khe) of the tongue who presented to our institution with a growth under the left side of the tongue with no pain or discomfort. There were no enlarged lymph nodes and no significant neurologic findings. Diagnostic histopathology confirmed the lesion to be khe.

Defining the survival benchmark for breast cancer patients with systemic relapse.

Background: Our original paper, published in 1992, reported a median overall survival after first relapse in breast cancer of 26 months. The current retrospective review concentrates more specifically on patients with first systemic relapse, recognizing that subsets of patients with local recurrence are potentially curable.

Methods: Records of 5,168 patients from a largely breast-cancer-specific oncology practice were reviewed to identify breast cancer patients with their first relapse between 1996 and 2006 after primary treatment.

Outcomes of systematic nutritional assessment and medical nutrition therapy in pancreatic cancer.

Objectives: We investigated the nutritional and survival outcomes of medical nutrition therapy by a registered dietitian, along with support from a dedicated nutrition and metabolic support team in pancreatic cancer patients requiring enteral or parenteral nutrition.

Methods: Subjective global assessment (SGA) was used to assess nutritional status in 304 pancreatic cancer patients. Using baseline and last SGA, patients were categorized into 3 groups: improved SGA, deteriorated SGA, and unchanged SGA.

Can quality of life assessments differentiate heterogeneous cancer patients?

Purpose: This research conducted a face validation study of patient responses to the application of an HRQOL assessment research tool in a comprehensive community cancer program setting across a heterogeneous cohort of cancer patients throughout the natural history of diagnosed malignant disease, many of whom would not be considered candidates for clinical research trial participation.

Methods: Cancer registries at two regional cancer treatment centers identified 11072 cancer patients over a period of nine years. The EORTC QLQ-C30 was administered to patients at the time of their initial clinical presentation to these centers.

Colon carcinoma with unusual metastasis to the esophagus manifesting as multiple nodules and Dysphagia: management with systemic chemotherapy.

We present here the rare clinical case of a 44-year-old gentleman with metastasis from colon carcinoma to the esophagus presenting with multiple nodules and dysphagia, which was successfully managed with systemic chemotherapy. The patient presented at our institution with 3-month history of dysphagia almost 4 years after being operated for stage III carcinoma in the sigmoid colon. Endoscopic findings showed multiple nodules at the gastroesophageal junction and mid esophagus.

Association between changes in quality of life scores and survival in non-small cell lung cancer patients.

In patients with advanced cancer, quality of life is as meaningful to patients as the actual length of life. We investigated whether changes in quality of life could predict survival in non-small cell lung cancer. Quality of life was evaluated using EORTC QLQ-C30 (European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire).

Role of nutritional status in predicting the length of stay in cancer: a systematic review of the epidemiological literature.

Background: Length of stay (LOS) has been used as a surrogate marker for patients' well-being during hospital treatment. We systematically reviewed all pertinent literature on the role of nutritional status in predicting LOS in cancer.

Methods: A systematic search of human studies published in English was conducted using the MEDLINE data base (all articles published as of December 2010).

Percutaneous endoscopic gastrostomy tube occlusion in malignant peritoneal carcinomatosis-induced bowel obstruction.

Objective: Percutaneous endoscopic gastrostomy (PEG) tube placement for decompression in advanced peritoneal carcinomatosis with bowel obstruction is a safe and feasible palliative procedure. We describe a rare, previously unreported phenomenon of PEG tube occlusion by gastric mucosal herniation.

Methods: A consecutive case series of 73 patients with advanced abdominal carcinomatosis-induced bowel obstruction from January 2007 to June 2010.

Renal cell carcinoma with unusual metastasis to the small intestine manifesting as extensive polyposis: successful management with intraoperative therapeutic endoscopy.

We present here a rare clinical case of a 53-year-old gentleman with metastasis from renal cell carcinoma (RCC) to the small intestine presenting with extensive polyposis and massive gastrointestinal bleeding which was successfully managed with intraoperative endoscopic polypectomy and segmental small bowel resection. The patient presented with melena 2 weeks after right nephrectomy for RCC. Capsule endoscopy found extensive polyposis throughout the small bowel, and the histological features confirmed the diagnosis of metastatic RCC.

Quality of life assessment as a predictor of survival in non-small cell lung cancer.

Background: There are conflicting and inconsistent results in the literature on the prognostic role of quality of life (QoL) in cancer. We investigated whether QoL at admission could predict survival in lung cancer patients.

Methods: The study population consisted of 1194 non-small cell lung cancer patients treated at our institution between Jan 2001 and Dec 2008.

The association of quality of life with potentially remediable disruptions of circadian sleep/activity rhythms in patients with advanced lung cancer.

Background: Cancer patients routinely develop symptoms consistent with profound circadian disruption, which causes circadian disruption diminished quality of life. This study was initiated to determine the relationship between the severity of potentially remediable cancer-associated circadian disruption and quality of life among patients with advanced lung cancer.

Methods: We concurrently investigated the relationship between the circadian rhythms of 84 advanced lung cancer patients and their quality of life outcomes as measured by the EORTC QLQ C30 and Ferrans and Powers QLI.

Validation of actigraphy to assess circadian organization and sleep quality in patients with advanced lung cancer.

Background: Many cancer patients report poor sleep quality, despite having adequate time and opportunity for sleep. Satisfying sleep is dependent on a healthy circadian time structure and the circadian patterns among cancer patients are quite abnormal. Wrist actigraphy has been validated with concurrent polysomnography as a reliable tool to objectively measure many standard sleep parameters, as well as daily activity.

Prevalence of serum vitamin D deficiency and insufficiency in cancer: Review of the epidemiological literature.

Vitamin D deficiency has been found to be associated with a variety of cancers, including prostate, multiple myeloma, colorectal and breast cancer. Several studies have shown vitamin D levels to have an inverse relation with cancer mortality, while others have considered it a potential risk factor. Vitamin D is believed to influence cancer prevalence, risk and survival; hence the need to assess vitamin D levels in cancer.

Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature.

Background: There are several methods of assessing nutritional status in cancer of which serum albumin is one of the most commonly used. In recent years, the role of malnutrition as a predictor of survival in cancer has received considerable attention. As a result, it is reasonable to investigate whether serum albumin has utility as a prognostic indicator of cancer survival in cancer.

Impact of oral vitamin D supplementation on serum 25-hydroxyvitamin D levels in oncology.

Background: Serum 25-hydroxyvitamin D [25(OH)D] is the major circulating form of vitamin D and a standard indicator of vitamin D status. Emerging evidence in the literature suggests a high prevalence of suboptimal vitamin D (as defined by serum 25(OH)D levels of <32 ng/ml) as well as an association between lower serum levels and higher mortality in cancer. We investigated the effect of oral vitamin D supplementation as a means for restoring suboptimal levels to optimal levels in cancer.

Dose escalation study of an anti-thrombocytopenic agent in patients with chemotherapy induced thrombocytopenia.

Background: Preclinical studies demonstrated that small chain RNA fragments accelerate the recovery of platelets numbers in animals exposed to high doses of chemotherapeutic drugs. There is anecdotal data supporting the same application in humans. The Phase I clinical trial described here was designed to investigate the relationship between the administration of small chain RNA fragments and the recovery in platelets following Chemotherapy-Induced Thrombocytopenia (CIT).

Longitudinal monitoring of CA125 levels provides additional information about survival in ovarian cancer.

Background: We investigated the prognostic impact of changes in serum CA125 levels during the first 3 months of therapy in ovarian cancer.

Methods: A case series of 170 ovarian cancer patients treated at Cancer Treatment Centers of America. Based on CA125 levels at baseline and 3 months, patients were classified into 4 groups: 1) Normal (0-35 U/ml) at baseline and three months; 2) High (>35 U/ml) at baseline, normal at three months; 3) Normal at baseline, high at 3 months; 4) High at baseline and three months.

Distribution and determinants of patient satisfaction in oncology with a focus on health related quality of life.

Background: Cancer patients usually undergo extensive and debilitating treatments, which make quality of life (QoL) and patient satisfaction important health care assessment measures. However, very few studies have evaluated the relationship between QoL and patient satisfaction in oncology. We investigated the clinical, demographic and QoL factors associated with patient satisfaction in a large heterogeneous sample of cancer patients.

Impact of improved nutritional status on survival in ovarian cancer.

Purpose: Malnutrition is a common occurrence in ovarian cancer and is a major cause of morbidity and mortality. We evaluated the impact of improvement in nutritional status on ovarian cancer survival.

Methods: A retrospective chart review was performed on a case series of 98 ovarian cancer patients.

Prevalence, sources, and predictors of soy consumption in breast cancer.

Background: A number of components in soy appear to have anticancer properties, including the isoflavones, genistein and daidzein. The use of soy by women with breast cancer is now being questioned because of the estrogen-like effects of isoflavones and possible interactions with tamoxifen. Clinicians providing nutrition counseling to these women are concerned because the availability of soy foods has increased dramatically in the past few years.

Patient satisfaction with quality of life as a prognostic indicator in ovarian cancer patients treated in an integrative treatment setting.

Extensive data show that quality of life (QoL) tools measuring the activities of daily life provide prognostic information in cancer. Ferrans and Powers Quality of Life Index (QLI) is an instrument measuring patients' satisfaction with their life. This study evaluated the association between QLI and survival in ovarian cancer.