This study evaluates the quality of life (QOL) for elderly community residents on both health-related and subjective QOLs, while comparing QOL-related factors between so-called “younger old” (residents in the age bracket of 65-74) and “older old” (those in that of 75 and over) in regard to QOL-related factors. Questionnaires were distributed to 929 residents in both age groups who affiliated themselves with a senior citizens’ club in City “K” in 2009. Data on 596 persons were analyzed in this study. Results pertinent to basic attributes, health status, lifestyle habits, social exchange, and QOL were analyzed in a multivariate method. Among residents in the age bracket of 65-74, the subjective sense of well-being, the frequency of going out, gender, the frequency of conversations with neighbors, financial security, and bedtime hours were looked upon as factors contributory to improvements in QOL, whereas low back pain, the frequency of mutual support among neighbors, high GDS scores, personal activities, and numbness were taken in as factors deteriorative to QOL. Among the over-75s, the subjective sense of well-being, cardiac disorders, and financial security were regarded as factors contributory to improvements in QOL, whereas low back pains and cardiac disorders were looked upon as factors deteriorative to QOL. To improve the elderly’s QOL, it is considered essential to step up their efforts to manage and relieve depression and low back pains.

More patients are now surviving cancer thanks to early diagnosis and improved treatment. Chronic pain in cancer survivors is problematic and the risk of chronic therapy with opioids includes abuse or addiction. We describe a patient with lymphoma whose behavior became aberrant while under treatment with opioid analgesics to manage anxiety after a painful tumor disappeared. Using opioid analgesics to manage emotional distress rather than pure physical pain has been defined as chemical coping, which is considered as an early stage of abuse or addiction. Knowledge of opioid analgesics and aberrant drug-related behaviors is necessary to manage chronic pain in cancer survivors.

OBJECTIVE: To investigate the clinical significance of systematic retroperitoneal lymphadenectomy during interval debulking surgery (IDS) in advanced epithelial ovarian cancer (EOC) patients. METHODS: We retrospectively reviewed the medical records of 124 advanced EOC patients and analyzed the details of neoadjuvant chemotherapy (NACT), IDS, postoperative treatment, and prognoses. RESULTS: Following IDS, 98 patients had no gross residual disease (NGRD), 15 had residual disease sized <1 cm (optimal), and 11 had residual disease sized > or =1 cm (suboptimal). Two-year overall survival (OS) and progression-free survival (PFS) rates were 88.8% and 39.8% in the NGRD group, 40.0% and 13.3% in the optimal group (p<0.001 vs. NGRD for both), and 36.3% and 0% in the suboptimal group, respectively. Five-year OS and 2-year PFS rates were 62% and 56.1% in the lymph node-negative (LN-) group and 26.2% and 24.5% in the lymph node-positive (LN+) group (p=0.0033 and p=0.0024 vs. LN-, respectively). Furthermore, survival in the LN+ group, despite surgical removal of positive nodes, was the same as that in the unknown LN status group, in which lymphadenectomy was not performed (p=0.616 and p=0.895, respectively). Multivariate analysis identified gross residual tumor during IDS (hazard ratio, 3.68; 95% confidence interval, 1.31 to 10.33 vs. NGRD) as the only independent predictor of poor OS. CONCLUSION: NGRD after IDS improved prognosis in advanced EOC patients treated with NACT-IDS. However, while systematic retroperitoneal lymphadenectomy during IDS may predict outcome, it does not confer therapeutic benefits.
Adult ; Aged ; Aged, 80 and over ; Cytoreduction Surgical Procedures/*methods/mortality ; Disease-Free Survival ; Female ; Humans ; Lymph Node Excision/*methods/mortality ; Lymphatic Metastasis ; Middle Aged ; Neoplasms, Glandular and Epithelial/mortality/*surgery ; Ovarian Neoplasms/mortality/*surgery ; Retroperitoneal Space ; Retrospective Studies ; Treatment Outcome

Headaches caused by metastatic brain tumors result from dural tension and traction of the sites of nociceptive nerves that originates from displacement of cerebral vessels and intracranial hypertension caused by the tumor. Causes of such headaches also include meningeal irritation resulting from intrathecal dissemination of tumor and carcinomatous meningitis.Treatment of headaches resulting from intracranial hypertension involves alleviation of cerebral edema and reduction of intracranial pressure using hyperosmolar therapy and steroid administration, but treatment is often complicated by a lack of pressure reduction. We encountered 2 cases of headaches with intracranial hypertension that did not improve following hyperosmolar therapy and steroid administration, but resolved with increased opioid dose.In cases where intracranial pressure does not decrease, or for headaches attributed to direct stimulus of intracranial nociceptive nerves rather than intracranial hypertension, attempts to treat the patient with initiation or increased dosage of opioids may prove effective from a clinical standpoint.

Context: In addition to opioids, oxygen therapy is often administered to cancer patients suffering from dyspnea before death, but there are few reports of adverse effects of this treatment. Objectives: To clarify the frequency of adverse effects of oxygen therapy for hospitalized cancer patients before death. Methods: A retrospective study of all patients who died and were discharged from the palliative care unit in Komaki City Hospital from January 2016 to June 2018 was performed. Patients to whom oxygen therapy had already been administered at the time of admission were excluded in the study. Results: The study included 257 patients, with 195 (76%) in the oxygen therapy group (O2+). The cumulative rate of oxygen therapy was 36% seven days before death, 54% three days before death, and 76% a day before death. The adverse effects included a sense of restraint for 64 cases (31%), exacerbation of delirium for 27 cases (14%), nasal/oral hemorrhage for 25 cases (13%), dryness for 5 cases (3%), and deterioration of subjective symptoms for 4 cases (2%). Along with these effects, temporary interruption of oxygen therapy was observed in 76 cases (39%). Conclusion: Oxygen therapy was started in half of the cases within 3 days before death. The adverse events to occur frequently were feeling of restriction and exacerbation of delirium.