Combined surgical and chemotherapy treatment for invasive primary urethral cancer: a case presentation

Abstract Background The European Association of Urology (EAU) defines primary urethral carcinoma (PUC) as a carcinoma that arises in the urethra without a previous diagnosis of carcinoma elsewhere in the urinary system. It is considered as a rare cancer, accounting for less than 1% of all malignant tumors and 5% of malignant tumors of the urinary system. The difficulty in diagnosis and its rarity can lead to delayed diagnosis and decreased survival. We think that a case report to be made in the literature for this rare disease with no consensus on treatment will contribute to disease management. Case presentation In this article, we describe the diagnosis and treatment process of a 75-year-old patient who was diagnosed with primary urethral cancer and had urethral discharge and difficulty in urination. The biopsy result from the suspected hyperemic area in the urethra in cystourethroscopy was primary urethral cancer. Urethrectomy followed by urethroplasty was performed on the patient's 2-cm primary urethral cancerous tissue. In the postoperative first month, an F-18 FDG whole-body PET scan for oncological evaluation showed increased pathological F-18 FDG uptake in the periphery of the mass in the penile urethra and indistinguishable boundaries from the prostatic urethra. After this, adjuvant gemcitabine and carboplatin therapy was planned by the oncology team. Conclusions Based on our outcome in this case, we believe that chemotherapy combined with surgery increases the chance of successful treatment in locally advanced urethral cancer

Patient and doctor delays in the diagnosis and treatment of non-small cell lung cancer in Turkey

WOS: 00020937040047

Patient and physician delay in the diagnosis and treatment of non-small cell lung cancer in Turkey

WOS: 000351233200014PubMed ID: 25670053Aim: The early diagnosis and treatment of lung cancer are important for the prognosis of patients with lung cancer. This study was undertaken to investigate patient and doctor delays in the diagnosis and treatment of NSCLC and the factors affecting these delays. Materials and methods: A total of 1016 patients, including 926 (91.1%) males and 90 (8.9%) females with a mean age of 61.5 +/- 10.1 years, were enrolled prospectively in this study between May 2010 and May 2011 from 17 sites in various Turkish provinces. Results: The patient delay was found to be 49.9 +/- 96.9 days, doctor delay was found to be 87.7 +/- 99.6 days, and total delay was found to be 131.3 +/- 135.2 days. The referral delay was found to be 61.6 +/- 127.2 days, diagnostic delay was found to be 20.4 +/- 44.5 days, and treatment delay was found to be 24.4 +/- 54.9 days. When the major factors responsible for these delays were examined, patient delay was found to be more frequent in workers, while referral delay was found to be more frequent in patients living in villages (p < 0.05). We determined that referral delay, doctor delay, and total delay increased as the number of doctors who were consulted by patients increased (p < 0.05). Additionally, we determined that diagnostic and treatment delays were more frequent at the early tumour stages in NSCLC patients (p < 0.05). Discussion: The extended length of patient delay underscores the necessity of educating people about lung cancer. To decrease doctor delay, education is a crucial first step. Additionally, to further reduce the diagnostic and treatment delays of chest specialists, multidisciplinary management and algorithms must be used regularly. (C) 2015 Elsevier Ltd. All rights reserved