When a cardiologist is asked to evaluate the cardiac toxic effects of chemotherapy, he/she can use several tools: ECG, echocardiography, coronary angiography, ventriculography, and cardiac MRI. Of all these, the fastest and easiest to use is the ECG, which can provide information on the occurrence of cardiac toxic effects and can show early signs of subclinical cardiac damage. These warning signs are the most desired to be recognized by the cardiologist, because the dose of chemotherapeutics can be adjusted so that the clinical side effects do not occur, or the therapy can be stopped in time, before irreversible side effects. This review addresses the problem of early detection of cardiotoxicity in adult and pediatric cancer treatment, by using simple ECG recordings.

Pain is a highly debilitating emotional and sensory experience that significantly affects quality of life (QoL). Numerous chronic conditions, including cancer, are associated with chronic pain. In the setting of malignancy, pain can be a consequence of the tumor itself or of life-saving interventions, including surgery, chemotherapy, and radiotherapy. Despite significant pharmacological advances and awareness campaigns, pain remains undertreated in one-third of patients. To date, opioids have been the mainstay of cancer pain management. The problematic side effects and unsatisfactory pain relief of opioids have revived patients’ and physicians’ interest in finding new solutions, including cannabis and cannabinoids. The medical use of cannabis has been prohibited for decades, and it remains in Schedule 1 of the Misuse of Drugs Regulations. Currently, the legal context for its usage has become more permissive. Various preclinical and observational studies have aimed to prove that cannabinoids could be effective in cancer pain management. However, their clinical utility must be further supported by high-quality clinical trials.

The treatment of metastatic melanoma changed dramatically with the discovery of immune checkpoint inhibitors (ICIs). Patients face prolonged exposure to these agents, which can frequently generate a large spectrum of adverse reactions. It has been shown that a considerable number of patients treated with ICIs achieve a durable response to treatment that is maintained even after cessation. We present the case of a 75-year-old man with metastatic melanoma who underwent 95 cycles of nivolumab without significant treatment-related toxicities or progression. Future studies are needed to define more clearly the optimal duration of anti-programmed cell death protein 1 (PD-1) agents in patients with good tolerance and no progression. Patients could avoid discomfort caused by frequent physician visits, high additional costs, and possible adverse reactions that may occur after such a long period of exposure to immunotherapy.

Scope: The rationale of the present study is to measure the impact of chemotherapy on the pain caused by the disease. Materials and Methods: The present study was based on the completion of two standardized questionnaires for the assessment of physical symptoms (Brief Pain Inventory—BPI—and the revised Edmonton Symptom Assessment System—ESASr) in three different moments. The research was conducted at the Oncology Institute “Prof. Dr. Ion Chiricuță” Cluj-Napoca between 2022 and 2023. Results: 24 patients were included in the study, and they received different cytostatic treatment regimens, adapted to the underlying pathology. We analyzed the distribution of all symptoms from the ESASr and the total score. In terms of the general situation, if we exclude pain, there is never a difference between Time 2 and 3. Furthermore, in all cases where there is a statistically significant effect, there is a difference between Time 1 and 3. We also analyzed the distribution of activities with which pain interacts in BPI. Regarding the general situation, three patterns of influence of pain on the examined parameters are found: for general activity, mood, ability to work, and sleep, there are significant differences between moments 1 and 2 and 1 and 3, without significant differences between moments 2 and 3. The second pattern identified refers to the lack of effect of pain on the ability to walk and on the relationship with other people. The peculiarity is represented by the influence on the enjoyment of life that was significantly improved only from Time 1 to 3. Conclusions: The present study demonstrated a considerable effect of cytostatic treatment on the management of cancer-related pain, as shown across different evaluations.

Biventricular metastatic heart tumors from gynecological malignancies presented as an acute coronary syndrome with ST segment elevation are an unusual finding. We present a case of stage-4 vulvar carcinoma that metastasized in both the left and right ventricle. The particularity of the case is the echocardiographic aspect in the emergency room: multiple, large, hyperechogenic masses disseminated in the myocardium, with pericardial extension, in context of acute coronary syndrome with ST segment elevation.