Tumor lysis syndrome (TLS) is an oncological emergency characterized by various metabolic abnormalities, such as hyperuricemia, hyperphosphatemia, hyperkalemia and hypocalcemia. Although TLS is rare in solid tumors, it has been reported in various cancers and sarcomas. It can be caused by chemotherapy, radiotherapy, surgical procedures. TLS in solid tumors may be lethal when it once develops. Hence, prophylaxis is considered important in medium risk diseases. We experienced the case that serum lactate dehydrogenase (LDH) level had elevated drastically a month prior to the onset of TLS in hypopharyngeal cancer. It is suggested that monitoring of LDH may be helpful for predicting the onset of TLS.

To improve the quality of palliative care in the Kyoto region, we thought that closely connecting hospice and palliative care units (PCU) is necessary. Subsequently, we established the Kyoto PCU Liaison Committee in September 2017. This committee was created as a place to casually discuss the problems that individual PCU facilities have, deliberate on their worries together, grow and develop, and support newly launched facilities. Furthermore, discussions were held on current topics (emergency hospitalization, blood transfusion, smoking, bereaved family meetings, etc.) at the liaison meetings. While meetings were adjourned in 2020 due to the COVID-19 pandemic, we continued to exchange opinions on infection control, PCU management, etc., using the email network at first. Later, these meetings resumed via web conference systems. Thus, by having face-to-face relationships on a daily basis, we were able to maintain cooperation between PCUs even during the pandemic, and collaborate with cancer treatment hospitals. Overall, by forming a team of PCUs in Kyoto Prefecture, we aim to enable patients and their families to live with peace of mind wherever they are.