Nursing Care in Patient with Advanced Cancer: The Experience of the Adult Oncology Unit of Lomé

Background: Cancer patients suffer physical, psychological, spiritual, and social pains, especially in the advanced stage. Nurses spend more time with patients than any other healthcare team member. This study aimed to assess nurses’ behavior and care experiences in patients with advanced cancer and explore patients’ perceptions of nursing care. Methods: A cross-sectional study was conducted with eight nurses and thirty patients with advanced cancer hospitalized in the oncology unit at Sylvanus Olympio Teaching Hospital of Lomé from July to August 2020. Results: The mean age of nurses was 34.3 years ranging from 23 to 48 years. There were five men (62.5%) and three women (37.5%). The mean duration of working in oncology nursing of all was less than two years. Only one nurse has training in palliative care. Stress (100%), sadness (100%), and fear (50%) were the most frequently expressed feeling of nurses. The frequently expressed difficulties were the lack of training in palliative care (87.5%), insufficiency of nursing staff (75%), and helplessness in front of the patient’s distress (75%). Among the thirty patients, were 22 women (72.7%) and 8 men (27.3%). The needs expressed by the patients were psychological support (n = 11;36.7%), pain relief (n = 10;33.3%), and moral support (n = 9;30%). Most of the patients (73.3%) affirmed that nurses did not inform them well about their disease. Three (10%) were very satisfied with the care provided, 23 patients (76.7%) were satisfied and 4 (13.3%) were unsatisfied. Conclusion: This study revealed that nursing care in Togolese patients with cancer faces many difficulties and there is a need for providing specialized oncology nursing.

Management of Obstructive Renal Failure in Adults at the Sylvanus Olympio University Hospital

Background: Obstructive nephropathies are a topical issue in urology and nephrology consultations, but no study has yet been conducted on the subject in our country. Objective: Describe the epidemiological, clinical, therapeutic and evolutionary profile of obstructive nephropathies at the Sylvanus Olympio University hospital of Togo. Method: It was a descriptive and cross-sectional study with a collection of retrospective data over a period of 08 years (2012-2019) which focused on obstructive nephropathies in the Urology-Andrology, Nephrology and Internal Medicine departments at the medical clinic of CHU SO. The diagnosis of obstructive nephropathy is retained on the basis of radiological and medical imaging results. Results: The study population included 131 patients. The annual hospital frequency was 2.84 cases for 100 admissions. The mean age was 56.72 ± 17.76 years. These patients were mostly male (72.52%). The most frequent age group was 60 - 80 years. Common symptoms at presentation were loin pain (45.75%) and dysuria (25.95%). The average length of probable course of the disease before hospitalization was 636.94 ± 258.88 days (21 months). The etiologies of obstructive nephropathy were largely dominated by prostatic tumors in half of the cases (45.80%). Among these patients, 121 have presented renal failure (92.36%). The average serum creatinine at admission was 59.01 ± 21.56 mg/l. Of the 121 patients with obstructive nephropathy presenting renal failure, 54 (44.63%) had decreased their serum creatinine at the output of more than 25%. The open surgery (54.20%) was the main treatment. There was an improvement in kidney function in patients who had a shorter duration of disease progression and who did not have a history of loin pain, oliguria and that the etiologies of the disease were not tumors. Tumoral etiologies, the presence of a history of high blood pressure, oedema of the lower members, oliguria, and a longer duration of disease progression and sex were factors associated with the occurrence of end-stage renal disease. Conclusion: Renal failure is the main complication of obstructive nephropathy in Togo, hence the importance of an early diagnosis for better care.

Computed Tomography Evaluation of Tumor Response in Oncology in Togo

Cancer is common in our setting and represents a real public health concern in sub-Saharan Africa. This work aimed to assess the role of computed tomography in the follow-up of patients treated for cancer in Togo. This was a retrospective descriptive study carried out over a period of one year, on patients with cancer, treated in the medical oncology unit of CHU Sylvanus Olympio and having undergone at least two CT scans after cancer treatment. Computed tomography evaluation was performed according to the RECIST 1.1 guidelines. We had found 46 patients. The mean age of the patients was 54.22 years with a female predominance (sex ratio 1:2.5). Cancers mainly involved the urogenital system (60.8%) followed by the digestive system (28.3%). Carcinoma represented 93.5% of cases, mainly adenocarcinoma (45.7%). 74 target lesions were present at baseline, with 18.9% and 11.6% disappearing at the first and second assessments respectively. 36 non-target lesions were present at baseline, with 25% and 22.2% disappearing at the first and second assessments respectively. New lesions were found in the abdominal region in 54.5% of cases and in the thoracic region in 41.3% at the first and second assessments respectively. 58.7% of patients had a stable disease at the first assessment and 39.1% had progression at the second assessment. 50% of them had received chemotherapy in combination with surgery. Computed tomography using the RECIST 1.1 guidelines is a necessity in monitoring tumor extensions and in the follow-up of cancer patients.