[A case of unresectable advanced pancreatic cancer treated by gemcitabine-based chemotherapy following cancer pain alleviation by low-dose matrix-type transdermal fentanyl].

Cancer pain often makes patient's performance status worsen and is one of the difficulties in anti-cancer therapy. We report a case of unresectable advanced pancreatic cancer with cancer pain, which was treated by matrix-type transdermal fentanyl following slow-releasing oxycodone, which caused severe constipation. Rotation to matrix-type transdermal fentanyl (Durotep MT 2.1 mg) releaved severe constipation as well as cancer pain. The patient could take gemcitabine-based chemotherapy. Low-dose matrix-type transdermal fentanyl (Durotep MT 2.1 mg) is useful for opioid rotation from low-dose morphine or oxycodone with uncontrolled side effects, and it contributes to continuation of anti-cancer therapy.

[Examination about the influence for daily life that nail and skin disorders induced by docetaxel in patients with breast cancer].

Docetaxel is one of the most important chemotherapeutic agents for the breast cancer patients. However, it has also experienced as toxicities causing nail diformation and skin trouble, and is considered as adverse elements other than edema and neurotoxicity. It is expected to have tremendous influence on women's daily life-decrease in quality of life. Nail and skin toxicity might occur among patients treated with docetaxel more frequently than evidence in the clinical medical records. Therefore, we have conducted a questionnaire investigation, targeting the patients who had been treated with docetaxel. Between March, 2004 and February, 2006, 52 patients, who had been prescribed docetaxel at the time of the surgery, or for their relapse, became subject to the evaluation. Skin impediments have found most during the second and the third courses; the contents include discomfort towards their beauty and housework. Influence to their daily life that the patients feel do not necessarily match the contents that doctors have recognized. In conclusion, this investigation evidenced that the troubles on quality of life such as nail and skin troubles, should be paid more attention, as well as major side effects such as edema, neutropenia, and neurotoxicity.

[Mohs paste for unresectable local lesion of breast cancer].

A 45-year-old woman with a local recurrence on her left chest wall discharged massive exudates. At every gauze exchange, blood was still oozing out. After using Mohs paste twice, the surface had been fixed chemically and dried up, so she did not have to exchange gauze, and there was no more bleeding. A 55-year-old woman was suffering massive exudates and offensive smell from her right primary breast cancer that formed a massive bulge with a deep ulcer in the center. Because her serum hemoglobin declined to 4.4 g/mL due to continuous bleeding, she needed to undergo blood transfusion. After using Mohs paste twice, the bleeding stopped almost completely. Now she uses Mohs paste by herself at home at her convenience. A 69 year-old woman suffered from an offensive odor and continuous bleeding from a local recurrence in the skin of her abdomen. A single use of Mohs paste relieved her from bleeding and the smell. Three patients had experienced no adverse events except mild pain and their QOL improved considerably. Mohs paste is in the hope of improving the QOL for the breast cancer patients with local advanced, unresectable skin lesions.