International Journal of Cancer Management
Year:2018 | Volume:11 | Issue:7|Papers Count:9

Background: Health-related quality of life in cancer patients has been interested to researchers in the domain of health in recent decades. Mental adjustment to cancer is a concept known as an important indicator of life quality, well-being and health of cancer patients. The aim of this paper is to examine the relation between mental adjustment to cancer and health-related quality of life (HRQoL) among some women with breast cancer. Methods: 100 patients were non-randomly selected from hospitals and oncology clinics in Kermanshah and Shiraz cities, Iran. These patients completed the functional assessment of cancer treatment-breast (FACT-B) in order to measure HRQoL and mini-mental adjustment to cancer questionnaire (Mini-MAC). Data were analyzed by using correlation and regression. Results: The results show that helplessness/hopelessness (58%), fighting spirit (40%), fatalism (33%) and preoccupation anxiety (18%) explain the variance of HRQoL. Conclusions: According to the findings, there is no relation between cognitive avoidance styles and HRQoL, and it can be concluded that coping styles helplessness/hopelessness and fighting spirit are the best predictors of HRQoL in patients with breast cancer. Consequently, the evaluation of the coping styles and emergency interventions in order to enhance coping with illness in cancer patients, decrease the sense of helplessness/hopelessness and anxiety are recommended, which in turn are accompanied by increasing HRQoL.

Background: Chronic diseases such as cancer are associated with many psychosocial issues that affect the various aspects of the health of individuals and families. Stigma is one of the problems in cancer that has devastating outcomes. Objectives: The aim of this study is to explain the meaning of stigma and its effect on patients with cancer from the point of view of Iranian stakeholders. Methods: This qualitative study was carried out with the participation of 14 people including individuals with cancer, their families, and cancer therapeutic team members by purposive sampling method and semi-structured interviews at Shohada Tajrish, and Imam Hossein (AS) Hospitals, Cancer Research Center of Shahid Beheshti University of Medical Sciences of Tehran and Shahid Beheshti Hospital of Kashan, from February to April 2017. The number of interviews was determined by data saturation. A conventional content analysis method was used. To ensure the accuracy of the qualitative data, the Lincoln and Guba criteria were considered. Results: From the data analysis, 4 main themes were obtained: (1) cancer as a terrible and pitiful disease, (2) communication breakdown, (3) concealing the disease, (4) identity crisis. Conclusions: Stigma in cancer is the negative beliefs, superstitions, and cultural stereotypes that result from unawareness. The consequences of stigma influence the patients and their families; more broadly, it leads to the failure of screening and early detection programs, which requires careful attention from policymakers and healthcare providers.

Background: Ziziphus jujuba, which is known as "Annab" or "Onnab" in Iran, is an effective compound against some cancer cell lines. The present study aimed to investigate the anti-mutagenic and anticancer effects of the aqueous extract of Z. jujuba on C643 human thyroid carcinoma cells. Methods: C643 cells were cultured in (Roswell Park memorial institute) RPMI 1640 medium (Sigma) supplemented with 10% fetal bovine serum (FBS), penicillin-streptomycin, and L-glutamine. After incubating the cultures at 37º C with 5% CO2, MTT assay was used to determine the inhibitory effect of Z. jujuba on cell proliferation. Cell cycle progression was monitored by sub-G1 apoptosis assay using flow cytometry. Finally, anti-mutagenicity properties of the extract were evaluated using a standard reverse mutation assay (Ames test), which was performed with a histidine auxotroph strain of Salmonella typhimurium (TA100) and exposure to a carcinogenic substance (sodium azide). Results: The aqueous extract of Z. jujuba inhibited the growth of C643 cells in a concentration range of 0. 5-2 mg/mL and exhibited cytotoxic effects on C643 cells in a concentration-dependent manner (IC50: 1. 671 mg/mL). The mechanism of action was the induction of apoptosis in the cells. The results of Ames test indicated a significant difference in the anti-mutagenic effects of Z. jujuba aqueous extract and controls (distilled water and sodium azide) (1. 671 mg/mL) (P < 0. 01). In addition, the herbal extract prevented reverted mutations and the hindrance percent was 87. 97%. Conclusions: According to the results, the aqueous extract of Z. jujuba fruit exerted anti-proliferative and apoptotic effects on C643 thyroid carcinoma cell lines and may be potentially useful as an anticancer agent.

Background: MicroRNAs (miRNAs) are small endogenous non-coding RNAs with fundamental roles in the regulation of protein expression that is involved in the pathogenesis of many cancers including breast cancer. Among them is miR-206, whose role as a tumor suppressor gene has been demonstrated in breast cancer. Consequently, the identification of its putative target in breast cancer is of practical value. Methods: In the present study, we have suggested a new approach for the identification of miR-206 target genes with possible role in breast cancer pathogenesis. We used 15 online tools for the prediction of miR-206 target genes as well as gene expression data produced by DNA microarray technology. Results: By combining these two sets of data, we suggested a list of miR-206 target genes with possible involvement in breast cancer. In addition, we depicted an interaction network including miR-206 and its putative targets. Conclusions: Considering the complexity of miR-206 interactions with several targets, such in silico analyses would considerably lessen the work load of laboratory experiments.

Context: The most common cancer and cause of cancer-related death in pregnant and breastfeeding patients is breast cancer. In the world, the incidence of pregnancy-associated breast cancer (P. A. B. C) is increasing, which is due to the fact that women delay their pregnancy up to the middle ages. According to the definition of P. A. B. C, a pregnancy-associated breast cancer is a case of breast cancer that occurs during pregnancy or up to 1 year after delivery. The aim of this paper is to review the clinical findings and novel imaging methods and findings, which help to diagnose pregnancy-associated breast cancer early. Evidence Acquisition: We reviewed the papers with subjects of PABC and imaging modalities in PABC by searching the medical and health databases such as PubMed, Google Scholar, as well as clinical trials. Results: The most frequent manifestation is a painless mass sensation. The most prevalent pathology of PABC is high-grade ductal carcinoma. The first diagnostic tool and most sensitive modality of imaging in this disease is ultrasound. Mammography during pregnancy and lactation is a safe method, which performs in symptomatic patients or in patients with positive ultrasound findings. MRI is not recommended during pregnancy, but it is completely harmless in breastfeeding patients and it is usually used as the complementary modality. Conclusions: Timely diagnosis of PABC requires complete knowledge of clinical symptoms and accurate interpreting of the images in different diagnostic modalities including mammography, ultrasound, and MRI. It should be noted that delay in diagnosis of PABC is the most common cause of low survival rate and bad prognosis.

Background: Breast cancer is the first cause of cancer-related deaths among women in Iran. Objectives: The aim of the present study was to compare the traditional statistical analysis and data mining technique as the research methods for identifying the prognostic factors regarding the survival time of patients with breast cancer. Decision tree method is one of the predictive models that used in the medical fi eld. The most used algorithms are classification and regression trees (CART), the quick, unbiased, efficient statistical tree (QUEST), Chi-square automatic interaction detector (CHAIDs) algorithm, and the C5. 0 algorithm. Methods: We used data for 438 patients, who were referred to cancer research center in Shahid Beheshti University of Medical Sciences. The patients were visited and treated during 1992 to 2012 and followed up until October 2014. The data were analyzed by regression logistic and decision tree method. Six measures for evaluation of predictive performance of different models were used. Results: The C5. 0 algorithm performed better than CHAID, QUEST, CART algorithms, and the logistic regression in predicting breast cancer survival. The multiple logistic regression results indicated that the factors of age at diagnosis, histologic grade, axillary lymph node status, and type of surgery were statistically significant with regard to the probability of death in patients with breast cancer. Moreover, based on C4. 5 they reported that tumor size, age of menarche, hormonal therapy, axillary nodal status, and histological grade are the most prominent variables. Conclusions: The more precise methods can identify the more accurate predictors. The decision tree method was able to predict the probability of death more accurately compared with the conventional logistic regression. Some improvements for classical classification tree such as boosting and bagging have been developed in order to obtain better predictive performance. We suggest that the modern classification tree method in the breast cancer context be the focus of future studies.

Background: One of the most common clinical problems is the differentiation of vertebral marrow lesions, particularly in the elderly patients. Since clinical staging, treatment strategy, and prognosis in malignant and benign lesions are different, it is very essential to determine the benign and malignant nature of vertebral pathologies. Objectives: The aim of this study was to assess the value of diffusion weighted magnetic resonance imaging and chemical shift in the diagnosis, characterization, and differentiation of benign and malignant vertebral bone marrow lesions and to define the sensitivity and the specificity in differentiating benign and malignant vertebral lesions according to the optimal cut-off Apparent-diffusion-coefficient (ADC) values and signal intensity ratio (SIR). Methods: This study included 39 patients with 86 untreated vertebral lesions that underwent the routine MRI sequences of the spine as well as the two non-routine sequences (DWI and in/opposed phase). The optimal cut-off ADC value and SIR were determined for the differentiation of benign and malignant lesions. We used the biopsy results and clinical follow-up, as the gold standard to classify the vertebral marrow lesions as benign and malignant. Results: Of the examined 39 patients, 67 focal lesions were included that 42 lesions proved to be malignant and 25 lesions diagnosed as benign. The results of this study showed that the ADC values of benign lesions were significantly (P < 0. 001) higher than untreated metastatic lesions. SIR values were calculated 1. 155 ± 0. 183 in malignant lesions, while it was 0. 649 ± 0. 341 in benign lesions. Threshold analysis yield optimal cut-off point that showed ADC min and ADC mean and SIR had high sensitivity, specificity, and accuracy in the discrimination of benign and malignant lesions. Conclusions: Quantitative diffusion weighted and chemical shift MR imaging are effective non-invasive technique in differentiating benign from malignant vertebral bone marrow lesions that provide additional information to the routine MRI sequences.

Background: The mainstay of treatment for ovarian cancers is surgical resection and post-operative chemotherapy to minimize the chance for recurrence. Metformin has been evidenced to increase the cytotoxic effects of chemotherapy in malignant cells and tissues by altering several gene expression pathways. Objectives: This study evaluated clinical efficacy of adding metformin to chemotherapy regimen for patients with ovarian cancers. Methods: The patients were divided in two groups; the study group received 500 mg metformin 3 times a day in addition to standard chemotherapy sessions after surgical resection of the primary ovarian cancer. The control group received only the standard chemotherapeutic agents after surgery. The patients were followed for up to 4 years and recurrence rate and their disease free survival after surgical resection statistically were compared between two groups. Results: The recurrence of the primary malignancy occurred in 13. 3% of the study cases versus 67. 5% in control group. Disease free survival was 48 months in the study group, which was significantly longer than the control group (25. 7 months). Conclusions: The results of this study demonstrate that adding metformin to the chemotherapy regimen of patients undergoing surgery for ovarian cancer can clinically improve the outcome of treatment by decreasing the overall rate of recurrence and prolonging the disease free survival in these patients.

Background: The increasing in prostate specific antigen (PSA) level not only causes concern for the patiens, but also leads to unnecessary investigation of these patients. The age of these patients is generaly high and may require colonoscopy for various reasons. The results of a few recent studies on the effect of colonoscopy on PSA level were controversial. Objectives: Therefore, we decided to study the effect of colonoscopy on PSA level in Iran and compare these results with the results of previous study in other countries. This was the first study in Iran to report such finding. Methods: Forthy-two patients between 40 to 70 years included in a prospective study, before and after study in Imam Reza hospital in Tehran, Iran from 2016 to 2017. Colonoscopy was performed in all of patients and the PSA level was measured before and 72 hours after colonoscopy. The result was analyzed with paired t test and ANOVAs test and the level of significant was 0. 05. Results: The mean of total PSA before colonoscopy was 1. 87 ng/mL with standard deviation (SD) 1. 04 ng/mL and total PSA after colonoscopy was 2. 02 ng/mL with standard deviation 1. 13 ng/mL that was statistically significant (P = 0. 01). Conclusions: According to the finding of the present research, colonoscopy increases the PSA level. Another finding of the present study was that these changes are particularly significant in older than 50 years. In patients with high levels of PSA, before performing any other diagnostic procedure, it is necessary to question for a colonoscopy before measuring PSA. If this is done, the PSA should be repeated for 7 to 14 days after colonoscopy.