Tumor lysis syndrome (TLS) is a rare serious acute complication of cancer therapy, reported mainly following chemotherapy in patients with large tumor load and chemosensitive disease. These are mainly patients with non-Hodgkin's lymphoma, leukemia and rarely in solid tumors. It is less frequently described after radiotherapy for lymphoid and hematological malignancies. TLS following radiotherapy for solid tumors is a very rare complication. In this report/review we describe a seventy-three-year-old male patient with progressive metastatic carcinoma of the breast to the lungs, liver and bone. He was referred for radiotherapy because of generalized bony pains. The patient was planned for sequential hemi-body irradiation starting with the more symptomatic upper half body. After premedication, he was given 8.5 Gy to the mid point at the maximum chest separation with anterior lung attenuator limiting uncorrected lung dose to 6.15 Gy. A further 3.5 Gy electron boost to the fungating breast tumor was given to the 100%. Forty-eight hours after irradiation he developed hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia and renal failure. These clinical and biochemical changes are typical of tumor lysis syndrome (TLS). Despite hydration, and treating the hyperuricemia, the patient developed coma and died eight days after irradiation. The prophylaxis and management of TLS and in high-risk patients are described to avoid this frequently fatal complication.
Background: Breast Cancer (BC) is the most frequently occurring cancer among Egyptian women. This study aimed to determine the effectiveness of a health education program on raising the knowledge related to BC, its risk factors, and some related preventive practices among women living in an urban slum area in Alexandria. Patients and Methods: A pre-/post-test interventional study was conducted during 2009–2010 on a random sample of women aged 30–65 years (n = 486) living in a slum area in Alexandria, Egypt. 20 health education sessions were carried out to educate the women on BC risk factors and some preventive practices. Previously trained nurses educated the sampled women on breast self-examination (BSE). The women’s knowledge and opinion about BC and their practice of BSE were evaluated before and 3 months after the intervention. Results: The findings indicated a significant increase in the mean knowledge score regarding BC and the mean opinion score regarding some BC risk factors. A significant increase in the practice of BSE was observed post intervention. Conclusion: This study confirms the effectiveness of intervention programs in improving the knowledge about BC risk factors and practice of BSE even in a group of women with a low literacy rate living in a slum area.
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