Motivations of patients seeking supportive care for cancer from physicians prescribing homeopathic or conventional medicines: results of an observational cross-sectional study.

BACKGROUND & AIMS: The motivations of patients who consult a homeopathic (GP-Ho) or conventional (GP-CM) general practitioner for supportive care during cancer treatment have not been widely studied. We investigated the reasons why cancer patients consult a GP-Ho versus a GP-CM for supportive care and the GPs' motivations for their prescriptions. METHODS: This observational survey was carried out in France between October 2008 and October 2011. GPs across France were randomly selected and asked to recruit four cancer patients each. At inclusion, the sociodemographic and clinical (including psychological) characteristics and medical history of the patients were recorded by the GPs and the patients noted their quality of life (QoL) and anxiety/depression using the Quality of Life Questionnaire-C30 (QLQ-C30) and Hospital Anxiety and Depression Scale (HADS) self-questionnaires. The main motivations of the patients regarding the type of GP consultation and the main reasons for the GPs' prescriptions were recorded. RESULTS: Six hundred and forty four patients were included in the analysis: 399 consulted a GP-CM (n = 112) and 245 a GP-Ho (n = 73). Patients consulting a GP-Ho were more often female [OR = 1.93; 95%CI: 1.11-3.35; p = 0.02], employed in a professional capacity [OR = 6.57; 95%CI: 1.96-21.99; p = 0.002], have a shorter time since cancer diagnosis [OR = 2.19; 95%CI: 1.24-3.87; p = 0.007], have received targeted anticancer therapy [OR = 3.70; 95%CI: 1.67-8.18; p = 0.001] and have a high QLQ-C30 score for constipation [OR = 1.01; 95%CI: 1.00-1.02; p = 0.001]. Patients mainly consulted a GP-Ho to receive overall care (73.5% vs. 64.9%; p = 0.024) and medicines to prevent anticancer treatment-related side-effects (63.7% vs. 41.4%; p < 0.0001). In contrast, patients consulted a GP-CM to receive psychological care (50.1% vs. 40.8%; p = 0.021) and more information regarding the oncologists' strategic decisions (p < 0.0001). There was a significantly greater prescription of psychotropic drugs by GP-CM (53.7% vs. 22.4%, p < 0.0001). CONCLUSIONS: Patients consulting a GP-Ho or GP-CM had different motivations for seeking supportive care. There was a significantly greater prescription of psychotropic drugs by GP-CM.

[Follow-up of renal cancer. Guidelines of the Comité de Cancérologie de l'Association Française d'Urologie]. / Suivi du cancer du rein.

The follow-up of renal cancer is essentially based on thoracoabdominal computed tomography (CT). The duration of this follow-up and the frequency of examinations depend on the patient's level of risk. Early detection of metastases has a limited therapeutic value at the present time, apart from tumours with a good prognosis or for the management of complications. Recent publications on targeted treatments raise new hopes and may lead to a modification of follow-up guidelines.

[Non-radiological investigation of cystic renal tumours]. / Apport de la détection cytologique dans les tumeurs kystiques du rein.

Cystic renal tumours represent 5% of all renal tumours. 1% of them are malignant. Non-radiological investigation of cystic renal tumours is still a controversial issue, essentially due to the rarity of these tumours. Although Bosniak class I and IV tumours theoretically do not present any diagnostic difficulties, it is difficult to confirm or exclude the malignancy of class II and III tumours at the time of their discovery. Percutaneous histological or cytological samples give a high rate of false-negative results and are difficult to interpret, but repeated specimens may avoid surgical exploration in one half of cases. Some authors adopt a more invasive approach due to the low yield of these examinations and the life-threatening risk related to the tumour. The difficulty of frozen section examination is due to the fact that it must specify the nature of the lesion and not the surgical margin with a considerable risk of false-negative results, especially when the tumour is confined to the cyst or when it is necrotic. One possible line of research could be analysis of the composition of cyst fluid, but a more readily available solution would consist of adaptation of Bosniak's classification in order to improve its inter-observer reproducibility and therefore reduce the need for invasive examinations.

[Can ofloxacin constitute an alternative antitubercular treatment for BCG hepatitis?]. / BCGite: l'ofloxacine peut-elle constituer une alternative au traitement antituberculeux?

The authors report a case of severe BCG hepatitis resistant to tuberculostatic therapy and treated with ofloxacin. Modern antibiotics, such as certain fluoroquinolones, can constitute an alternative to tuberculostatic therapy in the management of serious adverse effects of BCG therapy.