Wim Demey MD

5-Fluorouracil-induced coronary vasospasm: case report and discussion

5-Fluorouracil is one of the most widely used chemotherapeutic agents. It has been included in the treatment of a number of solid tumours, including upper gastrointestinal, colorectal and breast cancer, for many years. It is the backbone of several chemotherapy regimens, particularly in the treatment of gastrointestinal tract adenocarcinomas. Unfortunately, cardiotoxicities may be expected to occur regularly. As 5-fluorouracil is widely used, cardiotoxicity due to 5-fluorouracil is a relatively common problem. The case of a 64-year old man with invasive intestinal adenocarcinoma, who developed chest pain during his first mFOLFOX cycle, is presented. We see in this case and in the literature that recurrence of cardiac toxicity is high, even with premedication. There is some evidence that replacing the fluoropyrimidine by raltitrexed is safe and efficacious for patients with 5-fluorouracil (cardiac) toxicity in the setting of colorectal cancer.

(BELG J MED ONCOL 2015;9(5):194–98)

Quality management of breast cancer patients

Quality indicators are used to monitor the quality of care of cancer patients. They are divided into structural, process, outcome, and service indicators. Information about quality indicators must be given to all partners involved, leading to optimisation of treatment strategies and reduction of treatment variability. The aim is to achieve quality cancer care within everyone’s reach, with a focus on patient needs. Although disparities are present for various reasons, an in depth analysis is highly informative.

(BELG J MED ONCOL 2015;9(3):107–12)

Highlights from the 5th International Congress of Breast Disease Centres

The 5^th International Congress of Breast Disease Centres was held in Antwerp, February 5–7, 2015, following previous versions in Paris. The focus was on multidisciplinary care, quality management, and economic issues. Over fifty key opinion leaders from all over the world (fifteen countries, four continents) discussed different aspects of multidisciplinary breast care. Among the participants were the presidents of professional societies such as EUSOMA, ECCO, ESTRO, NAPBC USA, and the general director of SIS. The next congress will be held in Paris, February 4–6, 2016.

(BELG J MED ONCOL 2015;9(2):77–9)

Are patients better treated in clinical trials?

The accepted opinion in the oncological community is that patients are better off when treated within the context of a clinical trial. However, based upon a critical analysis of the available literature, there is little unbiased evidence of outcome improvement. Important ethical considerations must be taken into account. Also a lot of problems arise with the regulation of the trials and the administrative burden. Patients must be enrolled in a clinical trial on the basis of improving treatment options for future patients.

(BELG J MED ONCOL 2014;8(3):94–7)

Panniculitis in a patient with pancreatic acinar cell carcinoma

We describe the case of a 75 year old woman who was diagnosed with pancreatic acinar cell carcinoma after she presented with subcutaneous nodules on the lower legs compatible with panniculitis. This case illustrates the need for a thorough search for internal disease in case of panniculitis to diagnose potentially life-threatening illness in an early stage. (BELG J MED ONCOL 2012;6:124–128)