Percutaneous Nephrostomy Infusion: Nursing Considerations for Treatment of Upper Urinary Tract Urothelial Carcinoma.

An intrarenal approach using a percutaneous nephrostomy tube is a novel method to deliver chemotherapy and biotherapy to patients with upper urinary tract urothelial carcinoma. A paucity of evidence exists regarding basic nursing implications for this unique treatment option. This column will provide suggested guidelines to administer intrarenal treatment via a percutanous nephrostomy tube.
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A case report and review of transitional cell carcinoma in children.

Transitional cell carcinoma (TCC) is a rare cause of hematuria in children. This type of urothelial bladder tumor is typically low grade and carries a good prognosis. In this article, a case report is presented along with a review of the literature on TCC in children.

Urothelial cancers: ureter, renal pelvis, and bladder.

OBJECTIVES: To review the diagnosis, treatment, and nursing management of patients with urothelial cancers. DATA SOURCES: PubMed, Ovid MEDLINE, Text books, and clinical experience. CONCLUSION: Progress is being made in the surgical and systemic management of urothelial cancers, and the oncology nurse is in a position to make an impact on patient education and overall quality of life. IMPLICATIONS FOR NURSING PRACTICE: Nursing care begins at pre-diagnostic testing and continues through treatment for metastatic disease. Nurses must be knowledgeable about diagnostic tests, treatment options, and the quality-of-life implications of associated surgeries and/or treatments to support and guide patients. Education should be comprehensive, addressing not only treatment side effects but also long-term implications on patients' lives and lifestyles.

[Bilateral periorbital metastases of transtional cell carcinoma of the bladder]. / Bilaterale periorbitale Metastasen eines Urothelkarzinoms der Harnblase.

Bladder cancers account about 3% of malignant tumors and often metastasize to regional lymph nodes, liver, lungs and skeleton. Metastases in the area of the orbital region are very rare. When eyelid swelling, proptosis, diplopia, or ocular pain occurs, an underlying neoplastic process should always be suspected. Due to the rapid progression of orbital metastases, diagnosis and early initiation of palliative therapy is important.

Caring for a patient with a fungating malignant lesion in a hospice setting: reflecting on practice.

This article attempts to demonstrate the process of using experiential learning to reflect on nursing practice. This will be discussed in relation to the Atkins and Murphy's model of reflection. A case study will be used to demonstrate the complex issues of symptom management and the implications for improving and maintaining a consistent quality of holistic care within a hospice. The case of 'Sylvia', a 68-year-old woman with a diagnosis of incurable cancer, will be discussed in relation to the management of a fungating malignant lesion, pain management, the control of malodour, and maintaining dignified and respectful care and optimizing self-esteem and quality of life.

Evaluation of nurse-led follow up for patients undergoing pelvic radiotherapy.

This study reports results from a randomised controlled trial of nurse-led care and was designed to determine whether nurse-led follow up improved patients morbidity and satisfaction with care in men treated with radical radiotherapy for prostate and bladder cancer. The aim was to compare outcomes in terms of toxicity, symptoms experienced, quality of life, satisfaction with care and health care costs, between those receiving nurse-led care and a group receiving standard care. The study population was of men prescribed radical radiotherapy (greater than 60 Gy). Participants completed self-assessment questionnaires for symptoms and quality of life within the first week of radiotherapy treatment, at week 3, 6 and 12 weeks from start of radiotherapy. Satisfaction with clinical care was also assessed at 12 weeks post-treatment. Observer-rated RTOG toxicity scores were recorded pre-treatment, weeks 1, 3, 6 and 12 weeks from start of radiotherapy. The results presented in this paper are on 115 of 132 (87%) of eligible men who agreed to enter the randomised trial. 6 men (4%) refused and 11 (8%) were missed for inclusion in the study. Data were analysed as a comparison at cross-sectional time points and as a general linear model using multiple regression. There was no significant difference in maximum symptom scores over the time of the trial between nurse-led follow-up care and conventional medical care. Differences were seen in scores in the initial self assessment of symptoms (week 1) that may have been as a result of early nursing intervention. Those men who had received nurse-led care were significantly more satisfied (P < 0.002) at 12 weeks and valued the continuity of the service provided. There were also significant (P < 0.001) cost benefits, with a 31% reduction in costs with nurse-led, compared to medically led care. Evidence from this study suggests that a specialist nurse is able to provide safe follow up for men undergoing radiotherapy. The intervention focused on coping with symptoms, and provided continuity of care and telephone support. Further work is required to improve the management of patients during and after radiotherapy.

Nursing issues in the management of urinary diversions in women.

Cancer and urinary diversion via orthotopic or cutaneous stomas in women result in significant physiological and psychosocial issues. Patient counseling, education, and follow-up care are best achieved by the intervention of a multidisciplinary health care team. Urologic and enterostomal therapy nursing support in these endeavors can contribute to facilitating a positive outcome.