1.Intervention of a clinical psychologist in the treatment of an autistic patient with pancreatic cancer: a report on a surgical case
Naoko Nagai ; Kazuhiko Hashimoto ; Hatsumi Izawa ; Tomoko Yamada ; Noriko Honda ; Atsushi Naito ; Yuko Itani ; Yo Sasaki
Palliative Care Research 2010;5(2):323-326
Case: A 40-year-old woman. Clinical diagnosis: Autistic disorder with mild mental retardation. Case report: The patient underwent pancreaticoduodenectomy for the treatment of her pancreatic cancer. We held several conferences with individuals from different medical fields and examined the influence of the patient's autistic disorder on the perioperative conditions. The senior author, a clinical psychologist, conducted repeated individual, acceptive, and sympathetic interviews with the patient and her family and maintained supportive relationships with them as an honorary family member. Thus, the clinical psychologist helped reduce the patient's anxiety about the medical treatment. Conclusion: The participation of a clinical psychologist in the medical conferences enabled the medical staff to understand the complications involved and provide mental support to the patient and her family. Palliat Care Res 2010; 5(2): 323-326
2.Ritodrine hydrochloride was remarkably effective for pain of uterus metastases from thymic carcinoma, a case report
Yasoo Sugiura ; Naoko Izawa ; Etsuo Nemoto ; Masako Shida ; Shizuka Kaseda ; Chie Inomoto
Palliative Care Research 2012;7(2):530-536
A forties year-old female visited our hospital on March 2011, complaining chest discomfort. Computed tomography (CT) revealed a huge mass in the anterior mediastinum combined with multiple masses in the lungs, the uterus and the bone. Since no abnormal shadow had been noticed on the chest radiograph on January 2011,they seemed to have grown very rapidly in a short period. The pathological diagnosis following needle biopsies of mediastinal and uterine cervix tumors was undifferentiated carcinoma of the thymus metastasizing to the uterus. She was also suffering from the pain on the right femur and intermittent hypogastralgia due to metastases to the bone and uterus. Although NSAIDs and oxicodone relieved the pain on the right femur, they could not significantly reduce the hypogastralgia. Judging from the nature of the frightful hypogastralgia, the cause was estimated to be not somatalgia but splanchnodynia. Ritodorine hydrochloride, which was then adnimistered for the purpose of inhibiting the contraction of the uterine, was remarkably effective in reducing the pain. According to the literatures reviewed concerning metastases of the extrapelvic malignant tumors to the uterus, the median survival period after occurrence of metastases was 14 months. This report suggests that the administration of Ritodorine hydrochloride can keep the quality-of-life of these patients without suffering from the pain due to metastatic tumor to the uterus.