In the management of metastatic kidney cancer, enlarged nephrectomy is part of a multimodal approach with systemic treatment. The lack of data on its place in the management of metastatic kidney cancer in Africa and particularly in Senegal motivated this study. Aim: to assess the place of cytoreductive nephrectomy in the management of metastatic kidney cancer in our daily practice. Patients and methods: This was a retrospective, descriptive and analytical study from January 2010 to December 2014 on patients aged 18 years and over operated for metastatic kidney cancer. The variables studied were prognostic: Performance Status, tumor stage, sites and number of metastatic sites, prognosis group according to Heng's model, histological type and Furhman grade of the nephrectomy specimen, follow-up postoperative course and overall survival. Results: A total of 12 patients were included. The mean size of the largest axis of the tumors was 14.06±5.3 cm with extremes of 8.2 and 23.8 cm and the tumor was graded T3 in 6 cases. The majority of patients had a single metastatic site and the lung was the most common metastatic site in 9 cases. In half of the cases the ECOG-PS score was 1. In 6 cases the patients were classified in the Heng intermediate prognosis group. Lymph node dissection was associated with nephrectomy in 4 cases. Renal adenocarcinoma was the most common histologic type in 8 cases and Furhman's grade was only specified in 6 cases. The mean duration of follow-up was 10.1±13.4 months (range 1 and 39 months), overall survival at 2 years was poor and only 2 patients were alive 3 years and 4 years after their nephrectomy. Conclusion: metastatic kidney cancer is uncommon in our context, most of our patients consult with advanced stage tumors. Systemic treatment remains difficult for our populations to access. Nephrectomy remains the main weapon at our disposal.
Aim: This paper aims to report the second case of mucinous carcinoma of the scrotum revealed by scrotal fistulas listed in the literature and highlight the difficulties in the search and difficulties encountered in the management of urogenital cancers in developing countries. Case presentation: This was a 62-year-old patient who had consulted for fistulized lesions of the scrotum associated with urinary disorders. Physical examination found budding lesions in the scrotum from which mucus was leaking. The diagnostic assessment carried out consisted of a biopsy sample of the scrotal lesions, a blood analysis and medical imaging, which led to the diagnosis. The mutilating nature of the surgery proposed to the patient after multidisciplinary consultation meeting and the expensive cost of chemotherapy drugs constituted the limits of the patient's therapeutic management. Conclusion: Mucinous carcinoma of the scrotum is rare and primary lesion should always be sought. The presence of budding lesions of the scrotum with discharge of mucus should suggest the diagnosis.
Background and context: Among the 1.6 million women diagnosed with breast cancer each year worldwide, 1500 cases occur in Cameroonian women, 99% of which arise at advanced stage as there is no organized screening program in the country. Most of the women die because of lack of good diagnostic technique, lack of good treatment and medical insurance. 99% of Cameroonian women with breast cancer probably need palliative care and this is only well established in three medical centers. Most of these women are abandoned and will die in rural areas where they are managed by marabous and traditional healers. Our team has 22 years of experience in cancer screening, diagnosis, treatment and research in Cameroon. This year, SPARC METASTATIC BREAST CANCER CHALLENGE (SPARC MBC) is offering a unique opportunity to enhance our skills, particularly for women with metastatic breast cancer through this pilot initiative. Aim: To establish a pilot palliative care initiative for Cameroonian women with metastatic breast cancer and improve their quality of life. Strategy/Tactics: Using social media and an ambulatory patient care program, we plan to: 1) Establish a holistic palliative care pilot program; establish home visits and perform regular telephone calls to patients. 2) Introduce collaborations with traditional healers 3) Initiate training for health professionals. 4) Develop communication strategies for patients and provide them with psychosocial support. 5) Implement strategies for the provision of pain relieve drugs such as morphine. Program/Policy process: Advocacy visits to communities, hospitals and universities; training of community health professionals, social workers and traditional healers; and mobilization of breast cancers patients. Outcomes: It is expected that through this project, we will improve number of breast cancers detected, increase accessibility to treatment and palliative care for women diagnosed with breast cancer, reduce progression to advanced stages and mortality due to breast cancer, improve treatment outcome particularly among women with advanced stages of breast cancer, trained health professionals on palliative care and breast cancer control. What was learned: SPARC MBC is now offering a unique opportunity for Cameroonian women. We have started a sustainable palliative care program. Health professionals and social workers are now following training, mostly using social media for long distance training, or onsite in our institution. Unfortunately, we overadvertised during the first phase of this program and we are afraid we may not be able to cover the whole country and this may be discriminating or frustrating for some patients. On the other hand, some patients are now coming to our center from some neighboring countries with other cancer subtypes like prostate, cervix, liver, etc. as advertisement with WhatsApp and other social media is widespread and we are afraid we will be unable to cover this epidemic.
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