International Journal of Cancer Management
Year:2018 | Volume:11 | Issue:6|Papers Count:10

Background: The close link between molecular subtypes and different histological types of breast cancer has recently been taken into consideration. Objectives: The present study aimed at evaluating the reproductive risk factors in relation to molecular subtypes and histological features of breast cancer in a large group of Iranian patients. Methods: This historical cohort study was conducted on 1988 women diagnosed as different subtypes of breast cancers recruited in 2011 to 2016 from cancer research center in Shahid Beheshti University of Medical Sciences, Iran. Data on molecular markers were obtained from hospital files obtaining originally from immunohistochemical staining technique. Based on the pathological reports in hospital recorded files, the histological patterns of the cancer was also determined. The patients were followed for 5 years to assess the 5-year survival and compared the survival across the different molecular subtypes. Results: The highest mean age was found for the group with HER2-overexpression and the lowest for those with luminal A (P = 0. 045). The most and the least tumor size was revealed in triple negative group and luminal A group, respectively (P = 0. 035). The mean number of lymph nodes involved in breast cancer was significantly higher in luminal B subtypes compared to luminal A and triple negative subtypes (P = 0. 004). The tumor stages III-IV were found in 31. 6% of patients with luminal A subtype, 42. 2% in patients with luminal B, 34. 3% in patients with HER2 overexpression, and 26. 0% in those with triple negative subtype (P = 0. 006). The histological patterns of the tumor were powerfully different in terms of the molecular subtypes of tumor so that luminal A subtype was found more in ILC pattern, luminal B subtype was found more in DCIS pattern, HER2-overexpression subtype was revealed more in DCIS pattern, and triple negative subtype was found more in IDC pattern. Based on the long-term survival analysis, 5-year survival was found to be 98. 3% in luminal A group, 98. 3% in luminal B group, 100% in HER2 overexpression, and 98. 1% in triple negative with no difference between different molecular subtypes. The lowest 5-year survival was found in the patients aged higher than 30 years at first pregnancy and live birth with triple negative subtype (survival rate of 75. 0%). The long-term survival was adversely associated with the tumor stage but independent to tumor molecular subtypes. Conclusions: Age at first live birth, tumor size, lymph node involvement, tumor stage, and histological pattern of breast cancer are linked to its molecular subtype. The lower long-term survival of breast cancer can be predicted by advanced age (especially in triple negative subtype) and by higher tumor stage independent to molecular subtype.

Context: Many studies have reported contradictory results about the relationship between selenium levels and the risk of lung cancer. Objectives: This study was performed with the aim of evaluating the relationship between selenium and lung cancer. Methods: The present systematic review and meta-analysis was carried out according to preferred reporting items for systematic reviews and metaanalyses (PRISMA) guidelines. Using MeSH keywords, two reviewers independently searched international databases including PubMed, Science Direct, Cochrane, EMBASE, Web of Science, CINAHL, Scopus, and Google Scholar. The data were combined, using comprehensive Meta-Analysis Software Version 2 based on the random effects model. The tests were considered significant at P < 0. 05. Results: In 15 high-quality studies including 13 case-control and 2 cohort studies, 84 199 subjects (2 434 cases and 81 765 controls) were studied. The odds ratio (OR) of lung cancer in the highest quintile of selenium exposure compared to the lowest quintile was 0. 55 (95% CI: 0. 35 to 0. 86, P < 0. 01). The results of the standardized mean difference between serum selenium concentrations in lung cancer and healthy groups in 11 studies (1446 cases and 77917 controls) was-0. 32 μ g/L (95% CI:-0. 53 to-0. 11, P = 0. 003). This value for toenails selenium in 3 studies (620 cases and 2 709 controls) was-0. 13 μ g/g (95% CI:-0. 22 to-0. 038, P = 0. 006). In subgroup analysis, it was determined that gender (P = 0. 28), type of studies (P = 0. 70), and measurement of selenium samples (P = 0. 46) were not influencing factors. Conclusions: The results of the study indicated the preventive role of increased selenium levels in the incidence of lung cancer. Moreover, the selenium could be used as a predictive variable.

Background: Acute lymphoblastic leukemia (ALL) is a malignancy of lymphoid progenitors in bone marrow, peripheral blood, and extra medullar, which accounts for 1/4 of childhood cancers. Objectives: Regarding the uncertainties of the exact causes of the disease and the importance of identifying risk factors of acute lymphoblastic leukemia, this study aimed at investigating the causes of pre-and post-natal birth in children with ALL. Methods: This case-control study was performed on 156 patients with ALL and 85 patients without ALL in a 4-year period in Ali Asghar, Shahid Faghihi, and Shahid Motahari Hospitals in Shiraz, Iran between January 2013 and March 2017. The student's t and Chi-square tests were used. To evaluate relationships between various variables, Pearson's or Spearman's correlation analyses were used. The data were analyzed, using the SPSS 16 software. Results: Based on the findings of this study, the presence of Dawn's syndrome and familial history of leukemia and brain tumors were identified as risk factors for the incidence of ALL in children. There was no significant relationship with the history of abortion, radiation exposure, economic status, place of residence, birth rate, etc. Conclusions: The results indicate that among pre-and post-birth causes, the presence of Down syndrome and familial history of leukemia and brain tumors were as risk factors for the incidence of ALL in children. Due to the fact that therapeutic protocols are useful for the treatment of ALL in children, the results of this study and similar studies can be effective in preventing and managing the disease in children.

Background: Palatal neoplasms may demonstrate different microscopic features compared with other anatomic area of the oral cavity, which is due to the accumulation of a large amount of salivary gland structure. Objectives: Due to lack of adequate information on malignant neoplasms of this unique anatomic site, the current study aimed at evaluating the prevalence of palatal cancers in Iranian population during a 6-year period. Methods: The files of Iran cancer registry, ministry of health and Medical education have been used as the source of the materials from 2003 to 2009 for this study. This center has been collecting data on patients with cancer from all main hospitals located in various cities of Iran. All palatal malignant lesions were recorded. Patients' gender, decades of life, and histopathologic type of cancers were evaluated. Statistical analysis was performed, using SPSS 21 software and the results with P < 0. 05 were considered significant. Results: Palatal cancers accounted for 8. 66% of the oral malignancies. During this period, 303 cases of palatal malignancies had been registered in this center. The majority of cases were in the 5th to 8th decades of life with male to female ratio 1. 29. Salivary gland malignancies were the most common cancers in palatal region (47. 19%) followed by epithelial cancers (36. 3%) and non-Hodgkin lymphoma (5. 94%). Conclusions: This study provided a large series of demographic data and microscopic variations of palatal cancers in Iran, which may contribute to precise diagnosis and better treatment of these malignancies.

Introduction: Breast cancer is considered to be the most common diagnosis of cancer in the world. Psychological distresses help to increase the mortality rate in breast cancer and psychotherapy plays an important role in managing syndromes. On the other hand, the effectiveness of acupuncture on psychological indices in patients with breast cancer has a research support. So far, no study has been done to compare the two approaches in patients with breast cancer. Case Presentation: in a single-case experimental design in the form of ABCABC design with multiple baselines with follow-up of 6 months (TCTR20180605001), during January to October 2015, a 37-year-old woman with infiltrating lobular carcinoma (ILC) with metastasis invasion of axillary lymph nodes with dysthymic syndromes, was selected through targeted sampling, and after twenty-one days of evaluation (A1), she was treated for three weeks with auricular acupuncture (B1). After six months, the second phase of the assessment in the form of baseline of second intervention was performed for three weeks (A2) and then three weeks mindfulness-based cognitive therapy (MBCT) (B2) was performed. Phase C1 was performed as follow-up acupuncture and six months after mindfulness cognitive therapy follow-up (C2) was done. Pain index was considered as the primary outcome and depression index as secondary outcome and the results were evaluated through the control of the trend of the multiple baselines through visual analysis. Conclusions: Data analysis showed that acupuncture was associated with a reduction in pain in the patient (P < 0. 05), but there was no significant decrease in depression index (P > 0. 05). Also, the mindfulness significantly reduced the depression and pain index (all < 0. 05). However, the effectiveness of these treatments was not maintained during the follow-up phase (all < 0. 05). These findings can be useful in convergence of therapeutic models in order to formulate effective interventions strategies and to be considered as a link between psychological and biological approaches.

Background: Colorectal cancer (CRC) is one of the causes of death in the world and Iran. Screening reduces the risk of CRC mortality. The rate of CRC screening is low among Iranian adults. Objectives: The aim of this study was to identify factors influencing Iranian adults' decision about CRC screening. Methods: This qualitative study was conducted in Hamadan, Iran, between January and April 2015. The data were collected through 10 focus group discussions with 61 people, who had not undergone screening tests. The purposive sampling method was used in this study. We audiotaped and transcribed the interviews and extracted major themes from the data. Results: The mean age of the participants was 54. 92 ± 8. 21 years old. We identified 6 themes across the focus groups, including 1, awareness and knowledge; 2, financial problems; 3, low priority of health concerns; 4, fear of detection of cancer; 5, problems related to the nature of CRC screening tests; and 6, mistrust in the health care system. Conclusions: The findings of this study provide insight into the factors influencing CRC screening among Iranian adults and can help policy makers and health planners in designing effective interventions for increasing CRC screening rates.

Background: Iodine-131 therapy is one of the main strategies in the treatment of thyroid diseases such as hyperthyroidism and thyroid cancer. Iodine-131 emits high-energy beta particles and gamma rays. Although this technique is considered safe, there are many in vivo and in vitro studies reporting genotoxic damage induced by I-131. Induction of oxidative stress is one of the main mechanisms of therapeutic plan with I-131 and also mentioned as a side effect of it. Objectives: The aim of this study was to determine the effect of Nano-curcumin on chromosomal damages in peripheral blood lymphocyte by micronuclei (MN) assay in patients with differentiated thyroid carcinoma (DTC) after therapeutic dose of I-131 as a clinical trial. Methods: Twenty-one patients with DTC treated with I-131, activity (5. 5 GBq) for destructing remnant thyroid functional tissue, were randomly selected to receive curcumin (nano-form, 160 mg/day for 10 days; n = 11) or placebo (n = 10) in a double-blind manner. We obtained blood samples from each patient before treatment and one week after radioiodine therapy. We calculated the number of MN in blood samples. The present study is the first clinical trial for investigating curcumin effectiveness to reduce genotoxicity effects by radiation after radioiodine therapy. Results: The frequency of MN in lymphocyte was significantly increased at one week after I-131 treatment in placebo and curcumin groups. The frequency of MN in the curcumin group was significantly lower than placebo group after I-131 therapy. Nevertheless, there were no significant differences between both groups in White Blood Cell (WBC), Red Blood Cell, platelets, and hemoglobin level at before and after I-131 therapy. Conclusions: The results of this study confirm that the administration of curcumin to the patients, in nano-micelle form, may prevent the genetic damage induced by I-131 in human lymphocyte.

Background: The aim of this study was the prediction of colorectal cancer screening based on the extended parallel processing model regarding the moderating role of cancer-related literacy and cancer-related empowerment. Methods: In a cross sectional survey, 366 participants among individuals who attended to the specialized internal clinics of Semnan, Iran were selected by convenience sampling. The participants completed the assessment of colon cancer literacy, health education impact questionnaire, colorectal cancer screening questionnaire, colorectal cancer screening decision quality instrument, and demographic checklist. Finally, the data were analyzed with descriptive statistics and structural equation modeling, using SPSS-20 and LISREL 8. 8 software. Results: The final model was approved and the model had a good fitness of the data observed. Perceived susceptibility, perceived self-efficacy, and perceived response efficacy indirectly predicted defensive avoidance through cancer-related literacy (P < 0. 05). Perceived severity and perceived response efficacy indirectly predicted defensive avoidance through fear of cancer (P < 0. 05). Perceived susceptibility and perceived response efficacy indirectly predicted defensive avoidance through health-related empowerment (P < 0. 05). In addition, the effect of perceived self-efficacy on the fear of cancer was non-significant (P > 0. 05) and perceived severity had a direct effect on the defensive avoidance (P < 0. 05). Conclusions: It is concluded that designing the tailored health-promoting programs is crucial to improve perceived self-efficacy, perceived response efficacy, cancer-related literacy, and health-related empowerment for engagement to the colorectal cancer screening. In addition, decreasing or controlling the fear of cancer, perceived susceptibility, and perceived severity, as leading causes of defensive avoidance in colorectal cancer screening, is important.

Background: Breast cancer is the most common cancer among women worldwide. Objectives: Regarding the effect of delay on survival in patients with breast cancer and the high incidence of delayed presentation in these patients in Iran, we decided to study the factors affecting delay in seeking treatment in patient with breast cancer in Kerman, South-east of Iran. Methods: In this cross sectional study, 80 cases (with delay time less than 3 months) and 80 controls (patients with delay time more than 3 months) were enrolled. A questionnaire including demographic characteristics, knowledge, attitude, and Health belief model (HBM) subscales was used for data collection after reliability and validity assessment. Results: The majority of the patients were housewives (73. 2%) and most of the patients lived in urban areas (63. 7%). The results of multivariate logistic regression showed that there was a significant relationship between the perceived barriers OR = 1. 48 (CI 95% = 1. 18-1. 86), cues to action OR = 0. 72 (CI 95% = 0. 55-0. 93), perceived susceptibility OR = 0. 87 (CI 95% = 0. 78-0. 97), and the first symptom OR = 0. 259 (CI 95% = 0. 08-0. 79) with delay in seeking treatment in patients with breast cancer. Conclusions: According to the results, health belief and knowledge about breast cancer were two important factors affecting delay in treatment seeking in patients with breast cancer in Kerman, Iran. In order to reduce this delay, appropriate health education programs should be performed.

Background: Post-operative nausea and vomiting (PONV) still continues to be a serious problem. Incidence of PONV is more than 20% to 30%. Intravenous fluid administration seems to decrease PONV. Objectives: The aim of this study was to evaluate the effect of pre-operative and intraoperative intravenous hydration in comparison to routine hydration on PONV in breast cancer surgery. Methods: This study was performed on 105 female patients with ASA class grade I and II; they were randomly divided to 3; group 1: routine hydration (1. 5 cc/kg/h normal saline). Group 2: routine hydration + 5 cc/kg of ringer lactate serum 80 to 90 minutes before surgery, and group 3: routine hydration + 5 cc/kg post-operative pain, anti-emetic and analgesic administration were compared between 3 groups, using VAS and cortila questionnaire. Results: There were no significant difference between 3 groups considering demographic data (age, literacy, weight, height, etc. ) duration of breast cancer, cancer stage, pre-operative fasting time, duration of surgery, etc. Blood loss was significantly lower in intraoperative fluid supplementation group (P < 0. 05), but PONV and post-operative pain were significantly lower in those who received pre-operative fluid supplementation. They also needed less anti-emetic or analgesic administration. Conclusions: Pre-operative fluid supplementation showed to be an effective prophylactic strategy in PONV. Type of fluid and its volume need more evaluation in future studies.