International Journal of Cancer Management
Year:2012 | Volume:5 | Issue:3|Papers Count:10

Malignant diseases are among prevalent health problems in developing and developed countries. Cancer is the second cause of death in developed countries and the third or fourth in developing countries depending on the age pattern of communities and fronting them with risk factors. Therefore, cancer management is of prime importance and deserves more attention from health policy makers and managers worldwide. Health policy makers should keep an eye on the changes in incidence, prevalence, and burden of malignant diseases, and should also monitor changes in cancer diagnosis and treatment. With a history of more than 50 years, radiation therapy has become one the most efficient and popular procedures in cancer management in recent decades. More than 60% of cancer cases need radiation therapy. Different rays such as: X-Ray, Gamma Ray, Electron, and so on are used treat different types of cancer. Linear accelerator machines are more popular in radiation departments as they have provided great opportunity for cancer management, and improved the use of new X-Ray machines for treating special cases. The main goal of radiation therapy is as follows: 1) Dose distribution between tumors 2) Dose limiting normal tissue 3) Respect normal tissue tolerance These goals are more accessible and practical if radiation therapy is performed during surgery when the site of radiation is clear and all the neighboring tissues are protected. Therefore, much effort was done by surgeons and radiation therapists to emerge the operating and radiation rooms, however, they were not fully satisfied. Nowadays, as mobile machines have been produced and used by surgeons with collaboration of radiation oncologists and physicists in theater rooms, the dream of using intra operative radiation therapy in operation rooms is about to come true. Now the X=Ray and Electron () mobile machines are available and cancer surgeons use them for all kinds of malignancies such as esophagus, stomach, colorectal, pancreas, prostate, Gyns, cholangiosarcoma, and retroperitoneal sarcomas. Breast cancer is a more popular site managed by IORT by breast surgeons.Although there are many scientific documents and text books supporting the intra operative radiation therapy, it is not practiced throughout the world, and some reasons for this lack of use are as follows: 1- Expenses of machines 2- Limitation of manufacturers 3- Limitation of education 4- Team work is not well defined 5- Business and economic issues 6- Short time follow up for some types of cancers Some advantages of using IORT are as follows: 1- The most appropriate site is radiated 2- The procedure is guided by a surgeon who is more close to the site as an involved specialist 3- No delay in treatment 4- Other organs are not radiated 5- external radiation complication (s) are avoided 6- Protect none involved organs and avoid complications 7- Time limitation and time saving for patients and involved departments managing the case, whether it is used as complete radiation or as boost (this method is absolutely accepted) 8- Cost efficiency and beneficence for patients, insurance companies, and public and private sectors.Therefore, the question remains whether IORT is flying or is just landing? and whether it has established as a well accepted procedure in cancer management.

Background: Functional defects in mitochondria are involved in the induction of cell death in cancer cells. The process of programmed cell death may occur through the mechanisms of apoptosis. Several potential lead molecules such as Camptothecin (CPT) and its analogues have been isolated from plants with anticancer effect. The aim of the present study was to understand the necrotic effect versus apoptotic nature of CPT in HeLa cancer cells.Methods: The antiproliferative activity of CPT was estimated through 3- (4, 5-Dimethyl thiazol-2-yl) -2, 5-diphenyl tetrazolium bromide (MTT) assay and DNA fragmentation analysis using gel electrophoresis. Lactate Dehydrogenase (LDH) activity and cell morphology were assessed under control and CPT exposed conditions to evaluate the necrotic effect of CPT.Results: The results showed that CPT inhibited the proliferation of HeLa cells in a dose-dependent manner with an Inhibitory Concentration 50% (IC50) of 0.08±0.012mg/ml. However the significant (P<0.05) increase happens in LDH activity at concentrations 1×10-1mg/ml and above. Morphological changes showed that CPT in low concentrations induced an apoptotic mechanism of cell death, such as cell shrinkage and characteristic rounding of dying cells, while at high concentrations showed necrosis changes. The characteristic DNA ladder formation of CPT-treated cells in agarose gel electrophoresis confirmed the results obtained by light microscopy and LDH assay.Conclusion: Camptothecin as an anticancer drug may have antiproliferative effect on HeLa cancer cells in low concentrations, through its nature of induction of apoptosis. The border line between necrotic effect and apoptotic nature of CPT in HeLa cancer cells has been found to be at concentration of 1×10-1mg/ml.

Background: Gastric Cancer (GC) is one of the most commonly diagnosed malignancies. Genetic variation in genes encoding cytokines and their receptors, determine the intensity of the inflammatory response, which may contribute to individual differences in the outcome and severity of the disease. Interleukin-10 (IL-10) is a multifunctional cytokine with both immunosuppressive and antiangiogenic functions. Polymorphisms in the IL-10 gene promoter genetically determine inter-individual differences in IL-10 production. In the present study, we investigated the association between the IL-10 –1082 G/A polymorphism and the susceptibility to gastric cancer in a South Indian population from Andhra Pradesh.Methods: We genotyped 100 patients diagnosed with gastric cancer and 132 healthy control subjects for -1082G/A single nucleotide polymorphism by Amplification Refractory Mutation System-Polymerase Chain Reaction (ARMS-PCR) method followed by agarose gel electrophoresis.Results: The distribution of IL-10 genotypes at -1082 G/A were GG 18%, GA 35% and AA 47% in gastric cancer patients and GG 31.82%, GA 37.88% and AA 30.3% in control subjects. The allelic frequencies of G and A were 0.355 and 0.645 in GC patients and 0.508 and 0.492 in control subjects respectively. The IL-10 -1082 A allele was associated with risk of gastric cancer (OR=1.873, 95%CI-1.285-2.73 and P=0.001048**).Conclusion: Our study indicates that allele A of IL-10-1082 G/A polymorphism may be considered as one of the important risk factor in the etiology of gastric cancer.

Background: The purpose of the present study was to investigate the frequency of getting such health screenings as mammography and breast self-examination among a group of women and also to identify the role of health beliefs in predicting mammography practice.Methods: The data were collected from a convenience sample of 113 female staff at the University of Shiraz and Shiraz University of Medical Sciences. The participants completed the Champion Health Beliefs Scale (CHBS) designed to measure patients' perception on mammography of breast cancer screening. The scale assesses health beliefs components such as perceived susceptibility, perceived benefits of mammography screening, and perceived barriers to mammography screening. The participants also answered several questions on practicing Breast Self-Examination (BSE), mammography screening behaviors and health factors such as family history of cancer, and physicians' recommendation for mammography.Results: The results indicated that 51% of women had BSE, and only 21% had a mammogram. Logistic regression showed that physician's recommendation, and the perceived barriers significantly predicted mammography screening, explaining 27% of the total variance of mammography practice. The participants who saw fewer barriers to have a mammogram and those who had been recommended to have one by their physician were more likely to get it. The present study provides some supports for the health beliefs model.Conclusion: Data indicated that perceived barriers to have a mammogram predicted not getting one, and physicians' recommendation predicted getting a mammogram by women.

Background: Acute lymphoblastic leukemia is a lymphoid malignancy, resulting from autonomous proliferation of monoclonal abnormal stem cell. The aim of this study was to evaluate the response rate and prognostic factor of adult patients suffering from acute lymphoblastic leukemia, who were treated with chemotherapy in south east of Iran and demographic methods were used for this study.Methods: This study was conducted in Ali Ebne Abitaleb Hospital in south east of Iran (Zahedan) from 2003-2010. All adult patients with acute lymphoblastic leukemia in hematology ward received Vincristin, Daunorubicin, Cyclophosphamide, Prednisolone and high dose Methotrexate for induction therapy. All patients' information was recorded and multivariate analysis and survival studies were performed by using Kaplan-Meier statistics.Results: Sixty six adult patients entered. Mean age of them was 33 years old (16-68), that 53 (80.3%) cases were male and 13 cases were female. Fifty one (77.3%) cases experienced complete remission and 15 (22.7%) cases had no remission state. In the following year 53% (33) was alive with complete remission and 47% (31) were dead. Median survival was 13 months. In the end of study 30 cases were in complete remission and alive and 36 (54.5%) were dead.Conclusion: Our results were comparable with other studies and minimally better than those studies.

Background: Studies show that cancer treatment procedures could increase stress in children and adolescents diagnosed with cancer. This study was conducted to determine the frequency of stressors in children and adolescents with cancer, and to compare it in boys and girls.Methods: Relevant information was collected via a structured interview with 70 children and their mothers. Subjects were divided into four age groups of 0-3, 4-7, 8-12, 13-18. Stressors in physical, social and psychological aspects were determined and ranked. The main question asked was: "During the period of your disease, what has caused you the most suffering?" Whilst interviewing the mothers, this question was altered to: "During the period of your child's disease, what caused him/her to suffer the most?" The answers were reflected back to the respondents, and were categorized in a validated check list after their confirmation.Results: The most stressing items in the 0 to 3 age group were found to be worry, pain due to treatment procedures, and separation from their immediate family. In 4 to 7 age group, they were procedural pain, worry and fatigue. For the 8 to 12 age group, pain, separation from family and worry were the most stressing items. For the 13 to 18 age group, the main stressors were worry, pain, and parting from friends and losing them. Analysis by "Mann-Whitney U test" showed no significant differences in stressors between girls and boys.Conclusion: Our findings revealed that worry and procedural pain are the most common stressors in children treated for malignancy. Caregivers need to be aware of this fact and should take appropriate steps to relieve these stressors.

Based on a common belief, herbal medicine with the least possible side effects should be the center of attention in cancer care, however, in many cases they have not been properly studied with reliable clinical trials in human subjects. In this review, it was attempted to identify the available evidence on the use and clinical effects of herbs in cancer care. The research consists of two major parts including immunomodulator and chemo preventive herbal compounds whose mechanism, biological response, anticancer element of extract and related benefits were completely studied. Also, the safety of herbal anticancer compounds was discussed. Although the use of herbal medicines in treating cancer shows less chemotherapy-induced, toxicity, more researches are required to reach their full therapeutic potentials.

Background: Global death toll of Acute Leukemia (AL), as a heterogeneous group of hematopoietic malignancies, is rather high, i.e. almost 74% of 300,000 new cases die every year. This reflects a poor prognosis of this malignancy in most parts of the world, where contemporary and rather complex remedies are not available. There are a few well documented reports about the epidemiologic features of AL at national level in Iran. This retrospective study demonstrates demographic and laboratory features of Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia (ALL) patients admitted to the main referral oncology hospitals in the ex-Iran University of Medical Sciences in Tehran (Firoozgar and Rasoul-Akram hospitals) during the last decade (2001-2011).Methods: Medical records of all patients admitted to the both hospitals diagnosed with AML and ALL were reviewed during the study period for demographic, biological and clinical characteristics at diagnosis.Results: Four-hundred fifty five patients were diagnosed with AML and ALL, who admitted to the both hospitals during ten years, of whom 59.6% (271 patients) were male. Fifty five percent of patients had AML and 44.6% had ALL, both significantly dominated in men (p<0.001). AML patients died more significantly (p<0.05) and the most deaths occurred in older patients (p<0.001). Initial WBC count was significantly related to death (p=0.001), where the least death (13%) occurred in the group with initial WBC between 5-10×103/mL and most of deceased had an initial WBC more than 10×103/mL. Logistic regression showed that age, fever and WBC were significant prognostic factors.Conclusion: Demographic characteristics of AL patients were almost the same as other global reports. Most deaths occurred in older patients, those who had fever, and patients with higher WBC count at first admission, which warrants more investigations accurately and also improvements in hospital records.

A 16-day-old female was referred with congenital swelling on her right shoulder. On examination, there was a hard, round, ecchymotic, nontender, slightly movable, warm and shiny 10x15 cm mass on the right axillary pits which was extended to the right side of neck and chest wall. The mass separated the shoulder from the chest wall causing paralysis of right hand. Chest X-ray, ultrasound and MRI with contrast demonstrated a soft tissue mass suspected to be a hemangioma. The mass rapidly increased in size despite aggressive steroid therapy with rupture and bleeding. On the 45th post natal day the baby was taken to operating room to control the bleeding and if possible total excision of the mass. The mass was separated easily from the surrounding tissue and was excised along with right upper extremity. At the end of surgery the baby had cardiac arrest, and apparently died of Disseminated Intravascular Coagulation (DIC). The final pathology report was Rhabdomyosarcoma (RMS).

Currently, localized pulpalgia is listed as a rare manifestation of chemotherapy treatments in patients with malignant tumors. The neuropathy originated from neurotoxicity of anticancer drugs is usually described as a diffuse jaw pain or numbness in orofacial structures. This article reports localized tooth pain as a possible outcome of administrating high dosage chemotherapy drugs particularly in the last cycles of application.