To date, systemic treatments, including hormone therapies or chemotherapy, are used at different stages of prostate cancer disease. Several types of complications can occur during systemic treatment in prostate cancer, depending on the therapeutic range. The most common with hormone therapy are fatigue, muscle loss, bone loss, high blood pressure and metabolic syndromes. For chemotherapy, the most significant risk is related to hematological toxicity, but peripheral neuropathies, mucositis, diarrhea and hypersensitivity reactions may also occur. The quality of the pre-treatment assessment and the rigorousness of patient follow-up make it possible to anticipate most of these events, to prevent them or to manage them at an early stage when they occur. The most important aspect is patient education, which involves comprehensive information and the implementation of supportive care as soon as the treatment is initiated. Specialized advice (e. g. cardiological or endocrinological) is recommended in the event of uncontrolled symptomatology. The resumption of treatment leading to a major complication should be the subject of a multidisciplinary discussion taking into account the severity of the event, its reversibility, the patient's life expectancy and the expected efficacy of the molecule.

Multimodal regimens consist en more than one treatment to treat localized prostate cancer. They are now proposed routinely for high-risk diseases. Different approaches could be defined: In conclusion, multimodal regimens increase the risk of side effects compared to surgery or radiotherapy alone. Indications of these approaches muste be discussed with the patients after a careful evaluation of the benefit/risk ratio.

The oral route is becoming increasingly important in the panel of anti-cancer therapeutics, but it generates difficulties (adherence, management of adverse effects...). In order to secure medication management, the pharmaceutic team chose to set up pharmaceutical consultations. Its objectives are multiple: understanding of treatment for better adherence, pharmaceutical analysis, enhancement of the city-hospital link. This work presents the setting up of the pharmaceutical consultations and makes an assessment after one year.

Dihydropyrimidine dehydrogenase (DPD) deficiency is the main cause of early severe toxicities induced by fluoropyrimidines (FP). The French Group of Clinical Oncopharmacology (GPCO)-Unicancer and the French Pharmacogenetics Network (RNPGx) initiated two surveys, one addressed to oncologists, the other to biologists, in order to evaluate routine practices regarding DPD deficiency screening at national level, as well as compliance, motivations and obstacles for implementation of these tests. These anonymized online surveys were performed with the logistic assistance of the Francophone Federation of Digestive Oncology (FFCD) and the support of numerous medical and biological societies. The surveys were conducted in 2016-2017 before the creation of the French INCa/HAS expert panel, which contributed to the drafting of rules and recommendations for DPD deficiency screening published in December 2018. In all, 554 questionnaires from clinicians were analyzed (23% participation) and 35 from biologists. The main arguments raised by clinicians for justifying the limited practice of DPD deficiency screening were: the lack of recommendations from medical societies or Health Authorities, delays in obtaining results, and the lack of adequate reimbursement by the health insurance system. The goal of these surveys was to provide the French Health Authorities with an overview on nationwide DPD-deficiency screening practices and thus help to design recommendations for the standardization and improvement of the management and safety of cancer patients receiving FP-based chemotherapy.

Darier and Ferrand dermatofibrosarcoma (DFS) is a rare skin tumor characterized by its local aggressiveness and a high risk of recurrences. Prognosis depends essentially on the quality of treatment. Complete response in Darier and Ferrand dermatofibrosarcoma with healthy margins, initially judged inoperable after 1 year of neoadjuvant imatinib-based treatment, has been rarely described in literature. We here report the case of a young female patient treated in the Department of Medical Oncology in FES for locally advanced DFS with complete response, in order to assess the role of imatinib and of targeted therapies in the treatment of DFS.

Testicular cancers are the most frequent and the most curable cancers in young men. Treatments of these cancers represent a great success with cure rate over to 95 %. However, chemotherapy side effects may occur during or after several years post-treatment. This review aimed to highlight complications and physical and psychological side effects occurring mainly after chemotherapy treatment for testicular cancer, and to propose a personalized post-cancer plan specific for patients treated for testicular cancer. Treatments of these cancers can cause short-term complications (asthenia, nausea, vomiting, alopecia..). These side effects disappear within a few months after the end of the treatments. Late complications may occur several years post-treatment. Cardiovascular disease, metabolic syndrome and secondary neoplasia represent the most severe late effects among patients treated for testicular cancer. Given the increased incidence of these chemotherapy-induced side effects, it is indispensable to establish a specific follow up which must include a particular vigilance on the risk of occurrence of second cancer, a follow-up of the cardio-vascular risk factors, pulmonary and auditory follow-up, and early detection of psychosocial disorders.

Primary mediastinal non-Hodgkin's lymphoma(PMNHL) is a rare cancer. Exceptionally, it can be complicated by tracheœsophageal fistulas, directly connecting the esophagus and the trachea and secondary to esophageal tumor or chemotherapy (hence the interest of our case). We report the case of a 24-year old Moroccan female patient, treated for primary mediastinal large B cell NHL revealed by dyspnœa associated with dysphagia and alteration of general condition. The patient underwent chemotherapy but her health condition worsened after a second treatment due to the occurrence of recurrent pulmonary infections associated with cough during meals making swallowing impossible. Esogastroduodenal fibroscopy was performed which confirmed the diagnosis of tracheœsophageal fistula. Outcome was marked by patient's death despite endoscopic stent placement and a good response to chemotherapy. Early discovery of tracheœsophageal fistula in patients with PMNHL is essential because it enables the implementation of an appropriate treatment.

The perceptions that postgraduate medical students have about cancer and chemotherapy could have an impact on the quality of their interactions with their future patients. We conducted this study in order to highlight their representational field for chemotherapy and cancer.

Oral anticancer drugs have disrupted hospital and community practices. A better coordination and patient support for medication and adverse events management by primary care providers (general practitioner, community pharmacist and liberal nurse) could improve the situation. The CHIMORAL study evaluated a model of coordination by territorial health networks.

The emergence of oral cancer treatment in oncology has shifted patient follow-up from the hospital to the home. This trend has resulted in an increase in phone and e-mail interactions initiated by patients, but also by pharmacists, by liberal nurses, by general practitioners, and an increase in calls to the emergency response services (SAMU) both for real or perceived emergencies. This increased volume of patient and pharmacist communication has caused significant disruption in the daily activity of affected oncology departments and in particular of the secretariats. The procedures for formulating and securing appropriate responses within a short time frame are generally not established, and as a result, there is a risk that decisions made could be inappropriate for the patient's situation, especially in the case of complications.. Tracking responses to phone calls is necessary and answers should be noted in the medical file, including side effects, in particular the serious AEs for a good quality of care. This guideline describes best practices for oncologists who manage "incoming" calls from patients or professionals involved in the care pathway.

Long-term evaluation of the incidence of sexual dysfunction from patients who were treated by orchidectomy, chemotherapy, and retroperitoneal lymphadenectomy for testicular cancer.

Vulvar cancer is a rare neoplastic disorder accounting for less than 5% of female genital cancers. This study aims to describe the epidemiological, clinical, paraclinical, therapeutic and evolutionary profile of vulvar cancer in the population of the eastern region of Morocco. We conducted a retrospective study of all patients treated for vulvar cancer in the Oncology Center, University Hospital Mohammed VI in Oujda, Morocco from June 2007 to January 2014. The study included 34 patients with an average age of 65.7 years, of whom 52.9% were multiparous. The most frequent reason for consultation was pruritus (94.1% of cases). The median of consultation time was 16 months, ranging from 2 months to 8 years. Ignorance and modesty were the major causes of diagnostic delay, since 73.5% of patients already had locally advanced disease at diagnosis. Surgical treatment was proposed to 61.4% of cases and was based on radical vulvectomy associated with bilateral inguinal lymphadenectomy in 68.5% of cases. Adjuvant radiotherapy was indicated in 41.2% of cases, 5.9% of patients underwent neo-adjuvant radiotherapy while 20.6% underwent exclusive radiotherapy associated with concomitant chemotherapy. Palliative chemotherapy was proposed to 8.8% of patients. The overall survival rate at 3 years was 65%, locoregional or distant recurrence rate was 17.3%. Cultural and social characteristics of patients of the eastern region of Morocco treated for vulvar cancer are factors influencing treatment and outcomes. Additional prevention and awareness efforts should be made in order to reduce the rates of locally advanced tumors and to enable curative treatment for this population.

This study aimed to investigate the epidemiological, clinical, therapeutic and evolutionary features of undifferentiated carcinoma of the nasopharynx in adults. We conducted a retrospective cohort study of 163 patients aged 17 years old and over, treated for non metastatic undifferentiated carcinoma of the nasopharynx. The average age of our patients was 46,5 years, with a sex-ratio of 1.7; 35.57% of patients had locally advanced tumors (T3-T4) and 52.27% had advanced regional lymph nodes involvement (N2-N3). Neoadjuvante chemotherapy was performed in 77% of patients and 93.8% of patients underwent concomitant radiochemotherapy. After a mean follow-up interval of 40.8 months overall survival was 92.9% and relapse-free survival (RFS) was 78.9%. Relapse-free survival was caculated according to different prognostic factors, revealing a statistically significant difference based on lymph nodes involvement; three-year RFS rates were 88%, 82.6%, 80.8% and 61.5% in patients with tumor classified as N0, N1, N2 and N3, respectively (p = 0.02). Nasopharyngeal cancer is a complex disease, but progress has been made thanks to advances in radiotherapy and molecular biology. Concomitant radiochemotherapy is the therapeutic standard for patients with clinical stage greater than or equal to T2, or greater than or equal to N1. The innovative techniques in radiation therapy appear promising and they could reduce late toxicity while ensuring an excellent local control rate.

Nausea and vomiting induced by chemotherapy. Nausea and vomiting induced by chemotherapy impact heavily anticancer treatment safety. It is necessary to define correctly, assess frequently and treat perfectly, following national or international guidelines. New treatment are currently developed in the field of emesis protection. Old drugs may help patients. Physicians as well as nurses and caregivers have to be involved in emesis protection. It is one of the key topic in cancer care management.

Radiation recall dermatitis is an uncommon inflammatory reaction of the skin appearing after several days to several years at the site of previous irradiation; it is precipitated by the use of triggering drugs, although rarely by BRAF or MEK inhibitors.

Apart from myeloma, primary prophylaxis of venous thromboembolism (VTE) in ambulatory cancer patients treated with chemotherapy is underused, despite its proven benefit for pancreatic cancer and to a lesser extent for lung cancer. This prophylaxis has been showed to be effective for myeloma, pancreas but in absolute numbers these cancers lead to a few venous thromboembolic events. Up to date, VTE risk scores cannot be used as a discriminatory criterion to select a high-risk population that could really benefit from this prevention. VTE depends in part on oncogenic mutations of tumor cells that result in an imbalance between activation and inhibition pathways that are involved in venous thrombus formation. So, stratification of risk of VTE in cancer patients could be considered from a clinical and molecular point of view and result in a tailored prophylaxis. This "personalized medicine" that is currently used for the anti-tumor treatment of many cancers and hematological malignancies, could lead to a more effective prophylaxis of VTE in cancer patients.