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Management of Conditions and Symptoms
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Amy J. Litterini, Christopher M. Wilson
Progressive liver failure, associated with diagnoses such as cirrhosis, hepatitis, and primary or metastatic liver cancer (see Chapter 9, malignant neoplasms), often results in ascites. Ascites is the accumulation of fluid within the abdominal cavity, which in advanced cases, distends the abdomen causing discomfort, pressure, nausea, and bloating for the patient. Shortness of breath can also occur due to increased pressure on the diaphragm; if fluid migrates across the diaphragm, ascites can also cause pleural effusion. Bilateral lower extremity swelling, as well as umbilical hernia are possible with significant ascites. The severe sense of fullness, and tightness in the abdominal cavity and chest, often restricts comfortable range of motion and functional mobility. The diagnosis is typically made by physical exam, ultrasound, and/or MRI or CT scanning. When associated with disseminated cancer, it is referred to as malignant ascites.
Oncology
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
A number of general symptoms are associated with the oncologic disorders. Anemia is present in over half of patients with disseminated cancer and may be the first symptom of malignant disease. Hemorrhage occurs as a result of tumor invasion of blood vessels, causing intravascular coagulation and thrombocytopenia. Fever occurs In many patients with cancer, usually due to infections. Malnutrition, or the cachexia of malignancy, is often the most debilitating aspect, resulting from a combination of anorexia, loss of adipose tissue and protein stores, and abnormal glucose tolerance effects. Other manifestations may include neurological disorders, effusions, obstruction of the superior vena cava, hypercalcemia, and psychological effects. Most patients experience pain.
Malignancy And Anticoagulation
Published in Genesio Murano, Rodger L. Bick, Basic Concepts of Hemostasis and Thrombosis, 2019
The most significant report on the use of anticoagulants in malignancy is that of Thornes.29 A controlled study was done on 128 patients with one of the following malignancies: lymphosarcoma, (non-Hodgkins), carcinoma of the ovary, or carcinoma of the breast. The patients had untreated disseminated cancer and were comparably staged. All had the same chemotherapy, except that alternate patients were placed on warfarin. The prothombin time was increased to one and a half to two times the normal value. All patients were regularly followed by the same physician. The end point of the study was mortality. The warfarin-treated group had a 2 year survival of 40.6% as compared to 17.8% for the control group. It was interesting that, in the breast carcinoma patients on warfarin, a reduction in the dose of cytotoxic agents was possible.
Interventional oncological treatment of breast cancer liver metastasis (BCLM): single center long-term evaluation over 26 years using thermoablation techniques like LITT, MWA and TACE in a multimodal application
Published in International Journal of Hyperthermia, 2023
Thomas J. Vogl, Jason Freichel, Tatjana Gruber-Rouh, Nour Eldin Nour Eldin, Sven Becker, Christine Solbach, Ulrich Stefenelli, Nagy N. N. Naguib
Breast cancer (BC) is the most commonly diagnosed cancer in women [1–3]. BC is described as a heterogeneous disease with specific molecular subtypes, which are associated with different prognoses and responses to different treatments. Approximately 50% of all patients diagnosed with BC develop metastases. Common metastatic sites are lung, liver, brain and bones [4,5]. Liver metastases resulting from breast cancer (BCLM) develop in approximately 50% of all patients with metastatic BC and rank among the most common first sites of spread [5] In advanced stages of breast cancer, metastases restricted to the liver develop in approximately 5–12% of the patient [6]. BCLM has been identified as an indicator of the presence of disseminated cancer with a very poor prognosis even if it appears to be limited to a single organ. BCLM rarely presents itself with symptoms until the liver function deteriorates beyond a certain threshold [7]. Surgical approaches, like liver transplantation or resection, are pursued. However, only a minority of cases fit the necessary requirements. Furthermore, surgical resections of liver metastases from breast cancer are still a subject of discussion.
Race, Age, and Lack of Insurance Increase Risk of Suicide Attempt in Trauma Patients
Published in Archives of Suicide Research, 2022
Jamie E. Temko, Areg Grigorian, Cristobal Barrios, Michael Lekawa, Larry Nahmias, Catherine M. Kuza, Jeffry Nahmias
In conclusion, in a large national database study of suicide attempts in adult trauma patients, Asian race was associated with increased risk of suicide attempt compared to White race. Specifically, Asian race was associated with >2.5 times increased risk of suicide attempt with a knife. White race was associated with a higher risk of suicide attempt via gun compared to Black, Asian, and Hispanic patient populations. Additionally, patients younger than 40 years old, without insurance, and with comorbid psychiatric illness or comorbid disseminated cancer were at increased risk for suicide attempt. Future studies should examine the association between firearm suicide attempts in White patient populations and between knife suicide attempts in Asian and Hispanic patients. More targeted research will hopefully lead to improved suicide prevention efforts for patients of different racial and ethnic backgrounds.
Impact of Minimally Invasive Approach to Radical Cystectomy in Bladder Cancer Patients with Malnutrition
Published in Nutrition and Cancer, 2023
Cyrus Adams-Mardi, Andrew Sparks, Michael Whalen
Patients undergoing RC with postoperative diagnosis of non-disseminated bladder cancer from 2005 to 2018 were analyzed. Patients with disseminated cancer were excluded (distant metastasis staging category M1), as were those with documented retroperitoneal lymphadenopathy or pelvic lymphadenopathy in an effort to include only patients with localized disease. Patients without at least one of the malnutrition criteria (low serum albumin (<3.5 g/dL), >10% 6-month preoperative weight loss, or BMI <18.5 kg/m2 as determined by height and weight) were excluded from the exposure group.