Madappa N. Kundranda, MD, PhD, Department of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ, USA.
Joseph Mikhael, MD, Department of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ, USA.

Multiple myeloma (MM) is an uncommon malignant plasma cell disorder that often presents in older adults. An accurate diagnosis is critical as a spectrum of plasma cell disorders have been defined, including monoclonal gammopathy of undetermined significance, smouldering/asymptomatic multiple myeloma, multiple myeloma, and plasma cell leukemia. Although multiple myeloma is incurable disease, survival over 7 years is possible, during which patients can enjoy a good quality of life. Many therapeutic options now exist for individuals with MM who are ineligible for autologous stem cell transplantation; these include adding thalidomide, bortezomib, and lenalidomide to the current standard of melphalan and prednisone.
Key words: multiple myeloma, MGUS, older adults, plasma cell leukemia, supportive care.

Scott M. Sellick, PhD, CPsych, Associate Research Scientist & Director of Supportive Care, Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON.

Approximately 25% of persons with cancer report symptoms that meet the diagnostic criteria for the most prevalent mood disorders, including major depression, dysthymic minor depression, and adjustment disorder with depressed mood. This is two to four times the incidence found among the general population. To simply consider depression as “normal” precludes the possibility that some very good things can happen when patients are properly diagnosed and referred to a psychosocial program to be seen by a psychiatrist, psychologist, or social worker. Asking about a patient’s general mood or spirits needs to become as routine as asking about pain. While screening instruments can be very helpful, single questions are equally useful for identifying patients with this unmet need. Otherwise, patients remain feeling helpless or that their condition is hopeless, and this can easily spiral into despair and significantly worsened depression.
Key words: cancer, depression, psychosocial, supportive care, coping.

Margaret Fitch, RN, PhD, Head, Oncology Nursing and Supportive Care; Director, Psychosocial and Behavioural Research Unit,Toronto Sunnybrook Regional Cancer Centre, Toronto, ON.

Ovarian cancer has more than a physical impact.There are also emotional, psychosocial, spiritual, and practical consequences for those women diagnosed with the disease. These women face many challenges— lives are changed irrevocably with the diagnosis, and life becomes a series of transitions. In caring for women with ovarian cancer, health care providers must be sensitive to myriad concerns these patients may have and try to understand the issues from the perspective of those experiencing them.
Structures and processes need to be established within care facilities that allow patients to have regular comprehensive assessment, good symptom management, effective communication, and individually tailored support.The availability of timely and relevant referral to other experts when needed is of key importance at moments of care transition.
Keywords: supportive care, ovarian cancer, older women, psychosocial concerns, emotion.