Psychosocial care for breast cancer: physicians' perspective

Many literatures have documented that psychosocial care can improve health outcomes and reduce morbidity in women with breast cancer. The aim of this study was to evaluate the opinion of the breast cancer professional team members on integration of psychosocial care in regular management of breast cancer. A cross sectional sample of 313 physicians involving in diagnosis, treatment and supportive care for breast cancer patients were interviewed using a questionnaire. The majority of participants [52.7%] declared that psychosocial care is necessary for all patients with breast complaints. All except one of the respondents irrespective to their age and job believed that providing the patients with psychosocial supportive care definitively have some positive points for the patients with breast cancer. Of all respondents, 29.6% thought it should be offered as soon as suspicion is raised toward breast cancer, 54.7% preferred to provide such care after the diagnosis of malignancy is confirmed, 11.3% thought it should be prescribed before surgery and 4.4% believed that care should be provided before adjuvant therapy. The necessity of providing psychosocial care for breast cancer patients was mentioned by the majority of respondents; however there are some major differences among the team members of breast cancer care in regard to psychosocial supportive care. The results of this study highlight the insufficient collaboration among medical team members and the necessity of multidisciplinary approach to all aspects of the important disease through programmed sessions and provide the patients with an integrated comprehensive care

Gastric pull-up reconstruction for pharyngolaryngoesophagectomy in head and neck cancer and cervical esophageal squamous cell carcinoma

There are many techniques for reconstruction after total pharyngolaryngoesophagectomy. The use of a transposed stomach to restore gastrointestinal continuity, and this combined cervical and abdominal approach for pharyngolaryngoesophagectomy and gastric pull up has become one of the most popular. This retrospective study is a review of 50 consecutive Iranian patients who underwent pharyngolaryngoesophagectomy and gastric pull up in Amir-Alam Hospital affiliated to Tehran University of Medical Sciences, to determine the complication and survival rates. The clinical data of 50 consecutive cases of cervical esophagus carcinoma and squamous cell carcinoma of the hypopharynx treated by pharyngolaryngoesophagectomy and gastric pull-up were analysed. The age, gender, operating room time, operative mortality, major postoperative complications and survival rate were retrieved. Survival time was studied using Kaplan-Meier method. The postoperative complications were wound infection in five patients, pulmonary complications in ten, Stomal stenosis in six, cutaneous fistula in four, Gastric outlet obstruction in three. There were no intraoperative deaths. One month mortality was 10 per cent. The median survival for patients who underwent pharyngolaryngoesophagectomy and gastric pull-up procedures was 21 months and the 5-year survival was 18%