Chemotherapy for HIV associated Kaposi's sarcoma

HIV associated Kaposi’s sarcoma is a malignant, multifocal systemic disease that originates from the vascular endothelium. In contrast to the classical KS found in older men, in whom the tumors usually occur on the lower legs and feet, HIV-associated KS does not have a preferential pattern of localization

Chemotherapy-Related Tumour Lysis Syndrome

Two types of tumour lysis syndrome (TLS) ; 1. Laboratory TLS: 25% increase in potassium, phosphate and uric acid, or decline in calcium from baseline. Occur within 4 days of initiating chemotherapy. Patients on standard of care. Minimum of two out of four criteria. 2. Clinical tumour lysis syndrome: Laboratory TLS plus renal failure, cardiac arrhythmias or sudden death. A new definition has been suggested by Cairo and Bishop to include values above upper limit of normal. Study used Hande and Garrow definition

Is the biology of breast cancer in Africa changing?

Background: Incidence of breast cancer (BC) is increasing in Africa, with higher case-mortality compared to non-African settings. Prior studies have shown that BC in Africa has a much higher proportion of estrogen-receptor (ER) negative and triple negative (TN) cancers, subsets with poorer prognosis regardless of the setting. However, there is growing evidence that these differences may partly be attributed to prior study designs and resources.Objectives: To determine the status of hormone receptor ER, PR and growth factor Her2 status on breast cancer.Design: A prospective study.Setting: Histopathology and immunohistochemistry laboratary at Moi Teaching and Referral HospitalSubjects: Tissue specimens from 100 breast cancer patients.Results: Patients mean age at the time of diagnosis was 45 years, 98% of cases were in women, 90% were infiltrating ductal carcinoma, and the majority were poorly differentiated. Sixty-two percent were ER positive 44% were PR positive and 22% were Her-2 /neu . Twenty-four percent of cases were TN.Conclusion: With improved access to in-country reliable IHC, our study supports the growing data that African breast cancer is not radically biologically different from breast cancers outside Africa

Palmar-plantar erythrodysesthesia associated with capecitabine chemotherapy: a case report

We report a case of a 62 year-old patient who developed Palmar-plantar erythrodysesthesia upon receiving four cycles of capacitabine-based chemotherapy. She was on post surgical adjuvant treatment for invasive well differentiated adenocarcinoma of the colon. The clinical and therapeutic aspects of this chemotherapeutic adverse effect are discussed

Barriers to uptake of breast cancer screening in Kenya

Objectives: To conduct clinical breast cancer screening in three sites in Western Kenya and explore community barriers to screening uptake.Design: Cross-sectional study.Setting: Western Kenya specifically, Mosoriot, Turbo, and Kapsokwony.Subjects: Community members (18 years and older) who did not attend the screening events.Outcome Measure: The outcome measure was having heard about the breast cancer screening events. Both structured and open-ended questions were used for datacollection. Item frequency, correlations, and content analyses were performed.Results: A total of 733 community members were surveyed (63% women, median age 33 years, IQR=26-43). More than half (55%) of respondents had heard about the screening but did not attend. The majority of those who had heard about this particular screening had knowledge of screening availability in general (45% vs. 25%, p<0.001). Only 8.0% of those who heard and 6.0% of those who had not heard of the screening event hadpreviously undergone clinical breast exam (p=0.20). Reasons for not attending the screening event were personal factors, including busy schedule (41.0%), perceived low personal risk (12.7%), lack of transport (4.2%), as well as health facility factors such as poor publicity (14.4%) and long queues (8.7%).Conclusion: Barriers to breast cancer screening uptake were associated with inadequate publicity, perceived long waits at event and busy lives among community women

Impact of an Educational Intervention on Breast Cancer Knowledge in Western Kenya

Our objective was to assess the effectiveness of educational sessions that accompanied breast cancer screening events in three communities in western Kenya between October and November 2013. Five hundred and thirty-two women were recruited to complete a test of breast cancer-relevant knowledge and randomly allocated to ‘pre-test’ or ‘post-test’ groups that immediately preceded or followed participation in the educational sessions. The education was organized as a presentation by health professionals and focused mainly on causes of breast cancer, early and late cancer presentation signs, high-risk groups, screening methods to find early-stage breast cancer, self-breast exam procedures and treatment options for this disease. Participants were invited to ask questions and practice finding nodules in silicone breast models. The median age was 35 years (interquartile range: 28–45), and 86% had not undergone breast cancer screening previously. Many individual items in our test of knowledge showed statistically significant shifts to better-informed responses. When all items in the assessment questionnaire were scored as a ‘test’, on average there was a 2.80 point (95% CI: 2.38, 3.22) significant improvement in knowledge about breast cancer after the educational session. Our study provides evidence for the effectiveness of an educational strategy carefully tailored for women in these communities in Kenya

Forequarter amputations at the Moi teaching and referral hospital

Background: Forequarter amputation is an uncommon procedure. It is performed for high grade sarcomas of the proximal humerus, scapula and axillary region; that are not responding to induction chemotherapy or tumour progression with vascular invasion.Objective: To document the indications and results of forequarter amputations done at the Moi Teaching and Referral Hospital.Methods: Records of patients that had received a forequarter amputation in Moi Teaching and Referral Hospital between February 2012 and February 2017 were retrieved. The patient’s demographics, indication for surgery, complications and duration of survival post-operatively were noted and further analyzed.Results: A total of twelve patients were found that had a forequarter amputation done on their upper extremity. Eight were male while four were female. Ten patients (83.3%) were operated on for sarcomas including: synovial sarcoma, neurofibrosarcoma, Ewing’s sarcoma, Kaposi’s sarcoma, rhabdomyosarcoma, enchondroma, osteosarcoma and poorly differentiated sarcoma. Two patients (15.4%) were operated for squamous cell carcinoma. All the amputations were primary surgeries. Survival was 77.7% at six months and 44.4% after one year.Conclusion: The most common indication for forequarter amputation was a limb sarcoma. A one-year survival rate of 44.4% was found following forequarter amputation of a limb

Incidence of chemotherapy-related tumour lysis syndrome at Kenyatta National Hospital, Nairobi

No Abstract. East African Medical Journal Vol. 84 (3) 2007: pp. 100-10