Advanced carcinoma gallbladder.

Gallbladder cancer is a relatively rare form of malignancy. As yet, the progress in its management is very slow, which leads to high mortality and very low survival. There is a dire need to help this class of patients by bringing in resources to find ways to reduce its dismal prognosis. At present, the best chances for this disease are early radical surgery. But in patients with invasion of adjacent organs, extended surgery, excising the invaded tissue, may be justified. In patients with distant lymph-node metastasis, even without adjacent organ invasion, radical surgery may not achieve a good outcome.1 Here, combination chemotherapy or chemo-radiotherapy may have some benefits.

Impact of group psychotherapy in chemotherapy induced vomiting for treatment of advanced breast and lungs cancer.

OBJECTIVE: To assess the effect of group psychotherapy in the management of the side effects of chemotherapy treatment in advanced breast and lung cancer. DESIGN: A randomized control study. PLACE AND DURATION OF STUDY: This study was conducted in the department of Oncology, King Fahad Hospital, Madina Munawra, KSA, from January 2002 to June 2005. PATIENTS AND METHODS: One hundred patients treated with chemotherapy for advanced stage (IIIB and IV) breast and lung cancer were selected with ECOG performance status of 0 or 1. All patients received anti-emetic medications half an hour before chemotherapy. All those patients in this category who completed fist line chemotherapy with 6 cycles were included. Fifty were subjected to group discussions with other patients, family members and medical staff. This was labeled group A. The other 50 were not included in group discussion and were labeled group B. Both the group received similar standard chemotherapy and pre-medication for vomiting as per their disease and chemotherapy schedule. Breast and lung cancer patients were 29 and 21 in each arm respectively. At the end of the discharge, grade 2 and above of vomiting, according to common terminology criteria for adverse events (CTCAE) was counted for all patients in both the arms A and B, over full length of treatment for 6 cycles, and then were compared statistically. RESULTS: Mean with standard deviation for adverse event (vomiting) in group A and B was 6.2 + 2.6 and 13.4 + 3.8 respectively per cycle of treatment. It was observed that group psychotherapy had statistically significant effect (p-value < 0.05) on the management of vomiting. CONCLUSION: Group psychotherapy can be used to reduce the incidence of vomiting in advanced breast and lung cancer patients treated with chemotherapy.