Background: Ovarian cancer is the third commonest cause of cancer death from gynaecologic tumors in Kenya. Early disease causes minimal, nonspecific, or no symptoms therefore, most patients are diagnosed when the dise...Background: Ovarian cancer is the third commonest cause of cancer death from gynaecologic tumors in Kenya. Early disease causes minimal, nonspecific, or no symptoms therefore, most patients are diagnosed when the disease is at an advanced stage. Overall, prognosis for these patients remains poor but has not been described in Kenya. Objectives: To describe the histological types, therapeutic methods used, therapeutic outcome and the survival rate at 2 years. Methods: This was a retrospective cross-sectional descriptive study undertaking a 10-year review of case records of patients treated for cancer of the ovary between 1998 and 2008 in Kenyatta National Hospital. Results: Majority of the patients (73.3%) presented with advanced stage of disease (stages III & IV). Epithelial tumors (86.2%) are the commonest histological type, with 45.7% of them being serous type. Chemotherapy was the most (46.0%) used therapeutic option, with vomiting and diarrhea being the leading morbidity associated with it. Survival at 2 yrs from diagnosis was 50% as per the Kaplan-Meier time survival estimate. Conclusion: There is need to improve the quality of data on cancer care and information systems in general to provide a reliable source of information to guide research and policy in oncology. Further, the late presentation to hospital calls for innovative strategies to improve ovarian cancer awareness and uptake of screening tests. There is need to lobby Governments in resource limited setting to subsidize cancer of the ovary care and invest in lower level health facilities to promote early diagnosis and decongest the referral hospital.展开更多
Pregnancy associated breast cancer is defined as breast cancer diagnosed during pregnancy or in the first postpartum year. The incidence is rare;however it is important to be aware of its occurrence with the increased...Pregnancy associated breast cancer is defined as breast cancer diagnosed during pregnancy or in the first postpartum year. The incidence is rare;however it is important to be aware of its occurrence with the increased challenges posed by delays in diagnosis, treatment and optimization of maternal and fetal outcomes. The case report presented is of a 36 years old, Para 0 + 2 known diabetic and hypertensive pregnant woman, first seen in the antenatal clinic at 14 weeks of gestation. The patient requested for a breast examination following National campaigns conducted during the International Breast Cancer Awareness month. The examination revealed a grossly enlarged right breast with “peau de orange” skin changes. The patient eventually underwent radical mastectomy. Histopathology revealed a grade 3 invasive ductal carcinoma with lymphovascular invasion (Stage TNM). This case is presented to highlight missed opportunities in antenatal clinic settings for screening, diagnosis and treatment of cancer of the breast in pregnancy. The role of a multidisciplinary approach to management has also been emphasized.展开更多
文摘Background: Ovarian cancer is the third commonest cause of cancer death from gynaecologic tumors in Kenya. Early disease causes minimal, nonspecific, or no symptoms therefore, most patients are diagnosed when the disease is at an advanced stage. Overall, prognosis for these patients remains poor but has not been described in Kenya. Objectives: To describe the histological types, therapeutic methods used, therapeutic outcome and the survival rate at 2 years. Methods: This was a retrospective cross-sectional descriptive study undertaking a 10-year review of case records of patients treated for cancer of the ovary between 1998 and 2008 in Kenyatta National Hospital. Results: Majority of the patients (73.3%) presented with advanced stage of disease (stages III & IV). Epithelial tumors (86.2%) are the commonest histological type, with 45.7% of them being serous type. Chemotherapy was the most (46.0%) used therapeutic option, with vomiting and diarrhea being the leading morbidity associated with it. Survival at 2 yrs from diagnosis was 50% as per the Kaplan-Meier time survival estimate. Conclusion: There is need to improve the quality of data on cancer care and information systems in general to provide a reliable source of information to guide research and policy in oncology. Further, the late presentation to hospital calls for innovative strategies to improve ovarian cancer awareness and uptake of screening tests. There is need to lobby Governments in resource limited setting to subsidize cancer of the ovary care and invest in lower level health facilities to promote early diagnosis and decongest the referral hospital.
文摘Pregnancy associated breast cancer is defined as breast cancer diagnosed during pregnancy or in the first postpartum year. The incidence is rare;however it is important to be aware of its occurrence with the increased challenges posed by delays in diagnosis, treatment and optimization of maternal and fetal outcomes. The case report presented is of a 36 years old, Para 0 + 2 known diabetic and hypertensive pregnant woman, first seen in the antenatal clinic at 14 weeks of gestation. The patient requested for a breast examination following National campaigns conducted during the International Breast Cancer Awareness month. The examination revealed a grossly enlarged right breast with “peau de orange” skin changes. The patient eventually underwent radical mastectomy. Histopathology revealed a grade 3 invasive ductal carcinoma with lymphovascular invasion (Stage TNM). This case is presented to highlight missed opportunities in antenatal clinic settings for screening, diagnosis and treatment of cancer of the breast in pregnancy. The role of a multidisciplinary approach to management has also been emphasized.
