Miscellaneous tips

Here are some clinical oncology pearls I was thinking about lately. This may increase over time. If there are patients or oncologists out there with interesting observations that might be useful to others, please share them.

1. Consider urea cream for xeloda patients. Urea cream, 40%, to hands and feet BID. I think they make it from urine. One patient related that the corn-huskers in Nebraska used to pee on their hands to remedy the dry cracked skin they got from shucking ears of corn (!) I have used it on two patients getting xeloda, and they both related marked improvement in their skin from it.

2. Focalin is a handy thing to use for cancer fatigue. Many patients are already on a lot of meds, so are reluctant to take one more. Also, I'm not sure it's more effective than ritalin, but there was a trial presented at ASCO this year that was well-received. I've tried it on a few people, and it seems to work 50% of the time. I start at 2.5mg per day, and increase slowly.

3. I have started advocating ice cream for patients will poor appetites. It is a lot cheaper and tastier than Boost, and it is packed with calories. It also is plentiful and available in interesting flavors. We have a lot of patients who have "responded" to ice cream "treatments".

4. I have two patients who have responded impressively to neurontin for nerve-compression pain. A brachial and abdominal nerve compression each responded very nicely to neurontin. It doesn't seem to help much for chemo-induced neuropathy.

More "tips" to follow; feel free to contribute your own. These "tips" are just printed here for your enjoyment and are not meant to diagnose or treat a particular patient. You may consider printing out something that looks interesting to discuss with your doctor or patient. These data are not peer-reviewed, just observations from my clinical practice.