Ashley L de Padua1, Kimberly Strickland2, Mary Patrick3, John F Ditunno1,4,5. 1. 1Thomas Jefferson University Hospitals, Department of Rehabilitation Medicine, Philadelphia, PA USA. 2. 2Thomas Jefferson University Hospitals, Department of Hematology and Medical Oncology, Philadelphia, PA USA. 3. 3Main Line Health, Radnor, PA USA. 4. 4Sidney Kimmel Medical College, Philadelphia, PA USA. 5. Regional Spinal Cord Injury Center of the Delaware Valley, Philadelphia, PA USA.
Abstract
INTRODUCTION: Women with spinal cord injury (SCI) and who develop breast cancer are a vulnerable and potentially overlooked population. They experience risk factors owing to decreased mobility and are at risk for unique complications from their oncologic treatment. CASE PRESENTATION: A 54-year-old woman who suffered a T6 AIS A traumatic SCI in 1981, who was diagnosed 32 years later with estrogen receptor and progesterone receptor positive and human epidermal growth factor receptor 2-negative invasive ductal carcinoma. During the course of her chemotherapy, she experienced several complications, including reflexive diaphoresis, urinary tract infection, leukopenia, anemia, dehydration, and weakness. These contributed to the development of a stage 4 ischial pressure sore, which required complex treatment. DISCUSSION: There is a paucity of literature examining the complications of chemotherapy that may be unique to those with SCI. Physiatrists will be seeing more women undergoing oncologic care, as this population of patients ages. A multidisciplinary approach that takes into account the pathophysiologic changes associated with SCI is crucial to understand and prevent complications that could affect their outcomes and contribute to increased cost in a value-based health-care system.
INTRODUCTION: Women with spinal cord injury (SCI) and who develop breast cancer are a vulnerable and potentially overlooked population. They experience risk factors owing to decreased mobility and are at risk for unique complications from their oncologic treatment. CASE PRESENTATION: A 54-year-old woman who suffered a T6 AIS A traumatic SCI in 1981, who was diagnosed 32 years later with estrogen receptor and progesterone receptor positive and human epidermal growth factor receptor 2-negative invasive ductal carcinoma. During the course of her chemotherapy, she experienced several complications, including reflexive diaphoresis, urinary tract infection, leukopenia, anemia, dehydration, and weakness. These contributed to the development of a stage 4 ischial pressure sore, which required complex treatment. DISCUSSION: There is a paucity of literature examining the complications of chemotherapy that may be unique to those with SCI. Physiatrists will be seeing more women undergoing oncologic care, as this population of patients ages. A multidisciplinary approach that takes into account the pathophysiologic changes associated with SCI is crucial to understand and prevent complications that could affect their outcomes and contribute to increased cost in a value-based health-care system.
Authors: Barbara M Bates-Jensen; Marylou Guihan; Susan L Garber; Amy S Chin; Stephen P Burns Journal: J Spinal Cord Med Date: 2009 Impact factor: 1.985