• The Korean Journal of Pain
• /
• 제10권2호
• /
• pp.304-307
• /
• 1997

Continuous epidural infusion, a combination of local anesthetic and opioid, have been widely administered for treatment of chronic cancer pain. A serious complications of epidural block is paraplegia which can also be caused by : direct spinal cord injury, epidural hematoma, epidural abscess, ischemic change, neurotoxicity, preexisting disease. Continuous epidural block for pain control of patient with cervical cancer was performed at $T_{12}/L_1$ interspace. A 4 cm catheter was inserted cephalad into the epidural space. After four months, back pain and motor weariless of lower extremities progressively developed. Spine CT showed bony destruction and soft mass-like lesion at $T_9$ & $T_{12}$ spine. We propose paraplegia was caused by spinal cord compression which resulted from vertebral metastasis of cervical cancer.

• The Korean Journal of Pain
• /
• 제23권1호
• /
• pp.88-91
• /
• 2010

The piriformis syndrome is a condition allegedly attributable to compression of the sciatic nerve by the piriformis muscle. Recently, magnetic resonance neurography and electrophysiologic study have helped to diagnose piriformis syndrome. High dose radiotherapy could induce acute and delayed muscle damage. We had experienced piriformis syndrome with fatty atrophy of piriformis muscle after radiotherapy for recurrent cervical cancer.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권13호
• /
• pp.5283-5286
• /
• 2014

Stage of cervical cancer may adversely affect the quality of life (QOL) among patients. The objective of this study was to predict the QOL among cervical cancer patients by the stage of their cancer. A cross-sectional study from September 2012 until January 2013 was conducted among cervical cancer patients who completed treatment. All patients completed a interviewer-guided questionnaire comprising four sections: (A) socio-demographic data, (B) medical history, (C) QOL measured by general health status questionnaire (QLQ-30) and (D) cervical cancer specific module CX-24 (EORTC) was used to measured patient's functional, symptom scale and their global health status. Results showed that global health status, emotional functioning and pain score were higher in stage III cervical cancer patients while role functioning was higher in stage I cervical cancer patients. Patients with stage IV cancer have a lower mean score in global health status (adjusted b-22.0, 95 CI% -35.6, -8.49) and emotional functioning (adjusted b -22.5, 95CI% -38.1, -6.69) while stage III had lower mean score in role functioning (adjusted b -14.3, 95CI% -25.4, -3.21) but higher mean score in pain (adjusted b 22.1, 95 CI% 8.56, 35.7). In conclusion, stage III and IV cervical cancers mainly affect the QOL of cervical cancer patients. Focus should be given to these subgroups to help in improving the QOL.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권8호
• /
• pp.3345-3350
• /
• 2015

Background: Evaluation of health-related quality of life (HRQOL) in cervical cancer patients is important in order to design the interventions for improving patient outcomes. Reports of HRQOL among cervical cancer patients in Indonesia are limited. Moreover, measurement using EQ-5D-3L is to our best knowledge has hitherto not been performed. This study aimed to examine the HRQOL of cervical cancer patients in Indonesia using EQ-5D-3L. Materials and Methods: A cross-sectional study was conducted by interviewing cervical cancer patients using the EQ-5D-3L questionnaire. Percentages of patients who reported having problems in each dimension of EQ-5D as well as EQ-5D index score (utility) were calculated. Results: Our findings indicated that the most frequent reported problems were pain/discomfort (67.8%) followed by anxiety/depression (57.5%). The mean of EQ-5D VAS was 75.8 (SD=17.0). The mean (SD) utility scores were 0.85 (0.19), 0.76 (0.20), 0.71 (0.21), and 0.77 (0.13) for cervical cancer patients in stage I, II, III, and IV, respectively. Conclusions: Cervical cancer significantly affects patient HRQOL. Efforts should be made to improve the quality of life of cervical cancer patients especially in terms of pain /discomfort and anxiety/depression reduction.

• The Korean Journal of Pain
• /
• 제12권1호
• /
• pp.132-135
• /
• 1999

Although the vast majority (about 70%) of patients with cancer will have pain directly related to neoplastic invasion into pain-sensitive bone and soft tissue structures,as many as 20% of the adults will have pain caused directly by cancer therapy. Treatment related pain problems are important for several reasons; their appearance may be confused with more omnious pain syndromes associated with tumor recurrence or progression that may be directly lead to death of the patient; when severe, compliance with recommandations for further therapy may be adversely affected. Now, we report a case of postsurgical pain syndrome after radical neck dissection in a patient with tonsilar cancer. The pain after radical neck dissection result from injury to the cervical plexus,cranial nerve,and cervical sympathetics. In our case, we ruled out soft tissue infection and tumor recurrence,and successfully treated with gasserian ganglion block with pure alcohol in the patient having neuropathic pain in the mandible and preauricular region after radical neck dissection.

• 대한의생명과학회지
• /
• 제27권1호
• /
• pp.28-34
• /
• 2021

The main cause of cervical cancer is a persistent infection with high-risk human papillomavirus (HR-HPV). Cervical cancer is reported as a preventable cancer in more than 80% of cases with early diagnosis and appropriate treatment. Papanicolaou test (Pap test) has been a global strategy to prevent cervical cancer, and recently, HPV test has been reported to be effective against cervical cancer and precancerous lesions. However, pelvic examinations give patients anxiety, discomfort, pain, distress, and psychological stress. HPV test via a urine sample caused less physical and psychological stress and more advantage than the Pap test. Therefore, it is necessary to study the usefulness of the HPV test for easy-to-collect urine samples. A total of 220 samples were collected from a pair of cervical and urine samples from 110 women and only 108 pairs of samples out of 110 were used because 2 cases were not amplified by β-globin. Among 108 pairs of cervical and urine samples, the prevalence of HPV was 37.0% (40/108) in cervical samples, 34.3% (37/108) in urine samples and HR-HPV was 22.2% (24/108) in cervical samples, 18.5% (20/108) in urine samples. In this study, urine samples showed a lower positive rate of HPV than cervical samples. There were many variables that could affect the condition of the urine sample. However, the HR-HPV agreement rate of the cervix and urine samples was 94.44% and the Kappa value was 0.823, which was "almost perfect". Through these results showed the significance of cervical cancer screening using a urine sample. Cervical screening is crucial, as cervical cancer can be prevented in more than 90% of cases. Urine samples collected by non-invasive methods may have the potential advantage of increasing acceptance of cervical cancer screening. Therefore, it is necessary to develop a new cervical cancer screening strategy using urine samples through further study based on the results of this study.

• The Korean Journal of Pain
• /
• 제11권1호
• /
• pp.105-108
• /
• 1998

Backgrounds: Cervical epidural nerve block is useful in the management of a variety of acute, chronic and cancer related pain syndromes involving the head, face, neck and upper extrimity. To safely perfom the cervical epidural block, an appreciation of the expected distance from skin to epidural space is important. We studied the distance from skin to cervical epidural space of adults to determine if any relationship exists between patient height, weight and neck circumference and the distance from skin to epidural space. Methods: Patients 170, suffering from neck and upper extremity pain with cervical HIVD(herniated intervertebral dics) were selected. Cervical epidural block was performed at $C_{6\sim7}$ or $C_{7-}T_1$ intervertebral space. Then measured the distance from skin to epidural space and analysed the relationship between age, height, weight and neck circumference and the distance from skin to epidural space. Results: The cervical epidural depth of male $C_{6\sim7}$, male $C_{7-}T_1$, female $C_{6\sim7}$ and female $C_{7-}T_1$ groups were $5.17{\pm}0.63$, $5.47{\pm}0.59$, $4.84{\pm}0.56$ and $5.01{\pm}0.60$ cm respectively. Cervical epidural depth significantly correlated with body weight, ponderal index and neck circumference. Conclusions: The distance from skin to cervical epidural space has significant relationships with weight, ponderal index and neck circumference. Although experience is important, patient's weight and neck circumference are indicating factor, of the cervical epidural depth.

• The Korean Journal of Pain
• /
• 제18권2호
• /
• pp.275-278
• /
• 2005

Percutaneous cordotomy is a useful method for cancer pain management. Candidates for cervical cordotomy include those patients with unilateral cancer pain below the shoulder, with a life expectancy of less than 1 year, who can not be adequately treated by other less invasive methods. However, various complications can occur following a cordotomy, with the most serious being respiratory dysfunction. Herein, we report a case of transient respiratory dysfunction following a percutaneous cervical cordotomy.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권7호
• /
• pp.3095-3099
• /
• 2016

Background: Cervical cancer is the most frequently diagnosed cancer among women in India. Understanding quality of life (QOL) in women undergoing chemo-radiotherapy for cervical cancer will help in introducing interventions for better care and outcomes in these women. This study assessed QOL before and after chemo-radiotherapy in cervical cancer patients. Materials and Methods: This follow-up study covered sixty-seven newly diagnosed women with advanced cervical cancer (stages 2b to 4b). Structured questionnaires (the European Organization for Research and Treatment of Cancer, EORTC QLQ-C30 and EORTC QLQ-CX24) were used to assess the change in QOL after 6 months of treatment. Results: The mean age of women at the time of detection of cervical cancer was $52.3{\pm}11.29$ years (Range 30-75 years). Six months survival was 92.53%. The mean global health score of cervical cancer patients after six months of treatment was 59.52, which was significantly higher than the pre-treatment score of 50.15 (p=0.00007). Physical, cognitive and emotional functioning improved significantly (p<0.05) after treatment. Fatigue, pain, insomnia and appetite loss improved but episodes of diarrhea increased after treatment. The mean "symptoms score" using EORTC QLQ-CX24 post treatment was 20.0 which was significantly lower as compared to the pre- treatment score 30.0 (p<0.00001). Sexual enjoyment and sexual functioning decreased significantly after treatment. Conclusions: QOL of newly diagnosed cervical cancer patients improved significantly following chemo-radio therapy. Enhancement was also demonstrated on three of the five functional scales of EORTC QLQ-C30. To further improve QOL, interventions focusing on social and psychological support and physical rehabilitation may be needed.

• Radiation Oncology Journal
• /
• 제29권4호
• /
• pp.269-276
• /
• 2011

Purpose: To determine the incidence, risk factors, and clinical characteristics of pelvic insufficiency fracture (PIF) in patients with cervical cancer. Materials and Methods: Between July 2004 and August 2009, 235 patients with non-metastatic cervical cancer were treated with definitive chemoradiation or postoperative radiotherapy. Among 235 patients, 117 (49.8%) underwent the first positron emission tomography/computed tomography (PET/CT) within 1 year after radiotherapy. The median radiation dose was 55 Gy (range, 45 to 60 Gy). Medical charts and imaging studies, including PET/CT, magnetic resonance imaging (MRI), CT. bone scintigraphy were reviewed to evaluate the patients with PIF. Results: Among 235 patients, 16 developed PIF. The 5-year detection rate of PIF was 9.5%. The 5-year detection rate of PIF in patients who underwent the first PET/CT within a year was 15.6%. The median time to development of PIF was 12.5 months (range, 5 to 30 months). The sites of fracture included 12 sacroiliac joints, 3 pubic rami, 3 iliac bones, and 1 femoral neck. Eleven of 16 patients having PIF complained of hip pain requiring medications. One patient required hospitalization for pain control. The significant risk factors of PIF were old age, body mass index less than 23, bone mineral density less than -3.5 SD, and the first PET/CT within a year after radiotherapy. Radiation dose and concurrent chemotherapy had no impact on PIF rate. Conclusion: PIFs were not rare after pelvic radiotherapy in cervical cancer patients in the era of PET/CT. Timely diagnosis and management of PIF can improve quality of life in patients with cervical cancer, in addition to reducing unnecessary medical expenses.