Cécile Charles

Nail toxicities induced by systemic anticancer treatments

Patients treated with systemic anticancer drugs often show changes to their nails, which are usually well tolerated and disappear on cessation of treatment. However, some nail toxicities can cause pain and functional impairment and thus substantially affect a patients quality of life, especially if they are given taxanes or EGFR inhibitors. These nail toxicities can affect both the nail plate and bed, and might present as melanonychia, leukonychia, onycholysis, onychomadesis, Beaus lines, or onychorrhexis, as frequently noted with conventional chemotherapies. Additionally, the periungual area (perionychium) of the nail might be affected by paronychia or pyogenic granuloma, especially in patients treated with drugs targeting EGFR or MEK. We review the nail changes induced by conventional chemotherapies and those associated with the use of targeted anticancer drugs and discuss preventive or curative options.

Changes in psychological adjustment over the course of treatment for breast cancer: the predictive role of social sharing and social support.

Although research on social sharing suggests it could be an important factor in subsequent adjustment, it has rarely been examined in combination with the nature of the support received by patients. The goal of this study was to determine whether and to what extent social sharing concerning the disease and perceived social support after breast surgery explain psychological adjustment at the end of the treatment.

Synthèse des résultats

A l’issue de ces deux etudes, un certain nombre de resultats ont pu etre mis en evidence; certains viennent confirmer des donnees anterieures, d’autres permettent d’ouvrir des perspectives cliniques ou de recherche, en particulier ceux qui mettent en lumiere des besoins non ou insuffisamment pris en charge ou ceux qui rendent compte des liens entre l’adolescent et sa mere autour de l’expression conjointe de leurs difficultes ou de leurs souhaits d’aide.

Impact of dermatologic adverse events induced by targeted therapies on quality of life

BACKGROUND Investigations about the impact of dermatologic adverse events on quality of life in the context of targeted therapies are quite recent and results vary in some dimensions. This article aims to summarize the existing data and to clarify needs in terms of clinical management and future research. METHODS A literature review was done with Pubmed, Medline, Scopus and PsycInfo databases and it combined the empirical studies published in English and in French over the past ten years. RESULTS AND CONCLUSIONS Dermatologic adverse events globally have a low to moderate impact on quality of life, mainly in the physical and emotional domains. Reasons for inter-individual variations in adjustment and long-term impact are still not well known. Making quality of life assessments systematic, making early referrals of patients to dermatology consultations and giving more attention to individual experience were identified as measures that could help prevent deterioration in quality of life.

Choix thérapeutiques : s’appuyer davantage sur les représentations individuelles des traitements

Interest for representations about cancer treatments and their side effects is increasing because their central role has been proved in how patients cope with illness and symptoms and how they react emotionally. Through a synthesis of the literature, this paper has two objectives: firstly, to clarify the current state of knowledge in this field, and secondly to point out the manner that bringing out these individual representations during oncological consultations contributes to preventing difficulties and treatment discontinuation and facilitates medical decision processing.

L’éthique soignante face au refus de soins

Caregivers can find themselves faced with a refusal of nursing care. A number of questions are then raised. While it is firstly important to understand the reasons for this refusal and what is at stake for the patient, there are a number of nursing strategies in place, not least of all dialogue and analysis. The role of the multi-disciplinary team is essential in such situations.Caregivers can find themselves faced with a refusal of nursing care. A number of questions are then raised. While it is firstly important to understand the reasons for this refusal and what is at stake for the patient, there are a number of nursing strategies in place, not least of all dialogue and analysis. The role of the multi-disciplinary team is essential in such situations.

Choix thérapeutiques : s’appuyer davantage sur les représentations individuelles des traitementsThe importance of individual beliefs about cancer treatments for therapeutic decisions

Interest for representations about cancer treatments and their side effects is increasing because their central role has been proved in how patients cope with illness and symptoms and how they react emotionally. Through a synthesis of the literature, this paper has two objectives: firstly, to clarify the current state of knowledge in this field, and secondly to point out the manner that bringing out these individual representations during oncological consultations contributes to preventing difficulties and treatment discontinuation and facilitates medical decision processing.

La dyade mère-patient

Il s’agit ici de decrire les facteurs associes a la detresse de l’adolescent et du jeune adulte d’une part, a celle de sa mere d’autre part; de decrire la perception par la mere des difficultes presentees par son enfant; enfin, d’analyser les facteurs associes au souhait d’aide tant des patients que de leurs meres. Rappelons a ce niveau que l’etude ici porte uniquement sur les dyades mere-patient, soit 64 dyades belges et 101 dyades francaises. L’interet de l’analyse de cette dyade mere-patient est de rendre possible l’etude des interactions en son sein. Ainsi, les facteurs associes a la detresse, a la perception des difficultes et au souhait d’aide seront recherches parmi les caracteristiques du patient mais aussi parmi les caracteristiques maternelles, nous permettant d’apprehender la dyade qu’ils constituent comme un systeme.

Les adolescents et jeunes adultes

En Belgique, 95 dyades mere-adolescent eligibles ont ete contactees pour participer a l’etude entre avril 2004 et janvier 2006. Parmi celles-ci, 4 adolescents n’ont pas desire participer a l’etude (motifs des refus non repertories) et 8 parents ont refuse que leur enfant participe a l’etude, craignant que la passation prenne trop de temps (n=2), que l’enfant ne soit pas capable physiquement de repondre (n=1) ou ne le souhaite pas (n=1), ou parce que ne voyant pas l’interet de l’etude (n=1). Trois parents n’ont pas souhaite motiver leur refus. Huit dyades n’ont pas repondu au questionnaire dans le temps imparti (dossiers incomplets). Soixante-quinze dyades mere-adolescent ont donc participe a l’ensemble de l’etude.