Social networks, social support and social negativity: A qualitative study of head and neck cancer caregivers' experiences.

Head and neck cancer is a serious form of cancer that can generate substantial physical and psychosocial morbidity. Informal caregivers can help patients to manage head and neck cancer and its emotional impacts, both during and after treatment. Caregivers, however, can experience considerable stress as a result of their caring activities. Supportive relationships can protect caregivers from psychosocial strain. Thirty-one head and neck cancer caregivers were interviewed about their experiences of accessing social support from their social networks; difficulties that they experienced accessing this support; and strategies that they used to address these difficulties. Results suggest that head and neck cancer caregivers strongly value social support, but can find it difficult to obtain, and a number of them experience socially negative responses from their networks. Some carers attempt to answer or supplement support deficiencies by turning to non-human coping supports, such as pets, spiritual figures or medication. Implications for theory and practice are discussed.

Transitional cell carcinoma of the upper ureter metastatic to the thoracic spine presenting as a spinal cord compression.

We performed a left nephroureterectomy for a gentleman with transitional cell carcinoma of the upper ureter. Histological analysis revealed it to be a T1 lesion, but to be highly mitotically active. The gentleman defaulted on adjuvant therapy and defaulted on follow-up. He represented with symptoms of acute spinal cord compression and magnetic resonance imaging demonstrated a lesion at T6/7. Neurosurgical resection of the lesion showed it to be a metastatic deposit from the ureteric primary. Despite surgical debulking and subsequent radiotherapy to the lesion, the patient died secondary to metastatic complications. This case report is of interest to the surgeon as it demonstrates both the high metastatic potential of upper tract carcinomas and educates the surgeon on the presentation of acute spinal cord compression.

Extraskeletal myxoid chondrosarcoma of the cerebellopontine angle presenting during pregnancy.

Extraskeletal myxoid chondrosarcoma (EMC) is a rare soft-tissue sarcoma, which usually occurs in the lower extremities. It is often associated with chromosomal translocations. The clinical, radiological and pathological findings in extraskeletal myxoid chondrosarcoma, with an origin in the cerebellopontine angle, are described along with the issues associated with management of this tumour presenting acutely in a 26-year-old woman who was 20 weeks pregnant.

The effect of acetazolamide on breath holding at high altitude.

The effect of altitude and acetazolamide on breath holding was studied in 20 individuals. Breath holding time was reduced progressively during ascent. There was an additional reduction in the acetazolamide group at low but not at high altitude. The initial difference between the two groups may have been related to a lower CSF pH when on acetazolamide. At high altitude the finding of similar breath holding times in the two groups may have been due to acclimatization in the placebo group.