[Pain related to head and neck cancers during disease progression]. / Les douleurs liées aux cancers des voies aérodigestives supérieures lors de l'évolution.

Head and neck cancers can be revealed by pain symptoms caused by an excess of nociception. Other pain sometimes occurs during the cancer's progression such as neuropathic or mixed pain. These should incite the clinician to be watchful so as not to miss recurrence of the cancer. Treatment is complex, requiring management by a multidisciplinary team.

[Pain when removing a silicon Blake drain]. / Douleur lors de l'ablation des drains en silicone de Blake.

OBJECTIVES: A prospective analysis of pain intensity and related factors observed when removing a Blake suction drain after head and neck surgery. MATERIALS AND METHODS: An inception cohort of 100 patients managed at a single institution (university teaching and tertiary referral center), by 10 surgeons, during the months of March-July 2004. Two different scales were used to evaluate pain (see and ). The variables under analysis were: age, gender, comorbidity, overall pain and psychological status, anti-pain treatment, type of disease (benign vs malignant), type of surgery performed, location of the drain, number of drains removed and delay from surgery. RESULTS: No complications were noted at the time of drain removal. The volume drained varied from 10 to 450 cc (mean value 90 cc). At the time of drain removal no pain was noted in 50% to 60% of patients according to the scale used. Minimal pain and strong pain were noted in 45% - 36% and 5% - 4% of patients, respectively. Among the variables under analysis, the age of the patient was the only variable significantly related to the intensity of pain noted at the time of removal of the drain whatewer scale was used for analysis. Pain was statistically more pronounced as age declined (p=0.011 and p=0.04 according to the scales used). CONCLUSION: At our department, due to its very good drainage ability, its facility of use and the very low intensity of pain noted at the time of removal, the Blake drain has replaced the time honoured Redon-Jost drain conventionally used after head and neck surgery.

[Psychological management of patients with head and neck cancer]. / Prise en charge psychologique des patients atteints d'un cancer de la tête et du cou.

We recall the particular features of head and neck cancer in terms of the patient's image of his body and discuss the main character traits encountered in patients with this type of cancer. Psychological factors which must be taken into consideration in therapeutic management are presented. Five specific situations are discussed: announcing the diagnosis, proposing the initial therapeutic scheme, palliative treatment, end of life situations. The role of each member in the health care team is discussed in light of what the patient expects.