International Journal of Cancer Management
Volume:10 Issue: 7, Jul 2017

Context: Cancer is the second cause of death. All cancer types are increasing in most countries. Almost 80% of cancer related deaths disproportionately happen in less developed countries. Middle East is a unique region with a huge wave of cancer. This cancer surge is sure to be a shock for people. The present review discusses current status of cancer and evidence related to cancer preventive effects of physical activity (PA) among studies conducted in the Middle East region.
Evidence Acquisition: A comprehensive search was performed in three major databases of Cochrane, Pubmed and Tripdatabase (up to January 2016). Among the resulted 32 English-language articles, eighteen were fully reviewed. Cancer preventive effects (as relative risks or risk reduction) were extracted and tabulated.
It had been confirmed earlier that regular PA decreases the risk of many diseases including some types of neoplasms. Exercise can play a crucial role indirectly through weight loss, but obesity prevention does not explain all impacts of PA. As a high proportion of people in developing countries have sedentary lifestyle, even a small risk may be associated with a high population-attributable risk (PAR). Although PA during rest and vocational activities are not protective, there is powerful evidence on strong preventive effect for vigorous intensity PA. The higher-intensity PA is more effective than exercise of longer duration. Existing clinical guidelines recommend at least 150 min of medium or 75 min of high-intensity exercise per week.
Totally about 9-19% of cancer cases are in strong relationship to physical inactivity. To better deal with the epidemic surge of cancer it is necessary to improve public knowledge on cancer preventive effect of PA. In one word some pivotal measures like avoiding tobacco exposure, consuming a healthy diet and staying physically active can substantially decrease one’s risk of cancer. Policymakers should decrease public exposure to carcinogens in the environment, and ensure that precise and sufficient information is provided for whole society and support them to adopt and implement healthy lifestyles.

Oral squamous cell carcinoma (OSCC) is one of the most common malignancies in head and neck. The patients usually have a poor prognosis because they do not understand the significance of early symptoms. Then, the timely treatment may be lost. In recent years, network analysis is growing in the target identification concepts and can provide opportunities in pathway analysis. These could provide valuable information for drug development and progression monitoring of cancers such as OSCC.
PubMed Database was used as the main source and “Oral cancer” and “11-dehydrosinulariolide” and “Proteomics” were the keywords for the search process. We focused on articles that studied the differentially expressed proteins of cell lines of OSCC (Ca9-22 and CAL-27) and melanoma cell line (A2058) after 11-dehydrosinulariolideon treatment. The topological features of differentially expressed proteins were analyzed using Cytoscape Version 3.4.0. Module selection of the protein-protein interactions (PPI) networks was done using MCODE plug-in. In addition, gene ontology (GO) enrichment analysis of modules in related PPI networks was assessed.
Network analysis show that UBC, HSPA5 and GAPDH are the common central proteins between the three treated cell lines. The GO terms of the gene list of each of the correlated modules of networks are mostly related to four functions such as protein folding and assembly, metabolic processes, translation, and apoptotic pathways.
Despite introduction of different protein panels related to the effect of 11-dehydrosinulariolide on cancerous cell lines in the previous studies, here a common biomarker panel is represented.

The number of new cancer cases in the elderly is growing because of the aging population.
Cancer data of the elderly (65 years and older) were collected from Iran cancer registry in 2007. Local Moran’s I was used as a measure of spatial analysis to identify the cluster patterns.
The overall cancer incidence rates were 862.4 and 474.8 per 100,000 in men and women, respectively. Prostate cancer and breast cancer were the most common types of cancer in men and women, correspondingly. Using the Local Moran’s I tool, we identified more spatial clusters among men than women. Districts 1, 2, 3 and 6 in the north of Tehran were hot spots for prostate cancer and district 16 in the south of Tehran was the cool spot for this type of cancer, and districts 1 and 3 were the hot spots for breast cancer.
More cancer hot spots were located in the north of Tehran where districts are more privileged, and more cool spots were located in the south of the city where districts are more underprivileged.

The thyroid cancer (TC) is one of endocrine malignancies which contributes to more than 50% of all deaths from endocrine cancers. Gene polymorphisms including DNA repair genes such as XRCC1 (X-ray repair cross-complementing group 1) gene are thought to modify DNA repair capacity and relate to cancer risk.
The aim of the study was to detect the association between XRCC1 polymorphisms and increased risk of thyroid carcinoma among Iranian-Azeri patients.
This case-control study was performed on 114 differentiated thyroid carcinoma patients and 91 normal control subjects. Single nucleotide polymorphisms (SNPs) of 194 C > T and 399 G > A of XRCC1 gene were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).
In the present study, polymorphism at codon 194 of the XRCC1 gene was not found in case and control groups (P = NC (not calculated). All of the case and control subjects were 194C/C. Unlike 399 G > A genotype (P Based on these results, the XRCC1 399 G > A genotype could be used as a useful molecular biomarker to predict genetic susceptibility for differentiated thyroid carcinoma in Iranian-Azeri patients.

Tumor angiogenesis is an important procedure for the tumor development as it confirms oxygen and nutrients source to increase cells through the expansion of new blood vessels, potentially causing cancer development and metastasis. Emodin, a tyrosine kinase inhibitor, is an innate anthraquinone derivative found in the roots and rhizomes of several plants. Pharmacological studies have revealed that emodin displays various biological roles, such as anti-inflammatory, antibacterial and anticancer action. Studies have confirmed that emodin prevents cell growth in some types of cancer cells. Therefore, inhibition of angiogenesis is a new strategy for cancer treatment.
In this study, we aimed to determine the effect of emodin on expression of VEGF-A and VEGFR-2 genes in MCF-7 cell line.
Comparative cell viability was measured by MTT assay after treatment with different concentrations of emodin (0, 10, 20, 30, 40 and 50μM) for 24, 48, 72 hours. To investigate apoptosis in cells treated with emodin (0, 10, 20, 30, 40 and 50 µM), flow cytometry was used. Finally, alterations in expression of VEGF-A and VEGFR-2genes were analyzed by real time PCR.
Emodin showed an anti-cancer effect with concentration of 20 μM as IC50 in MCF-7 cells. Emodin induced apoptosis and significantly reduced mRNA level of VEGF-A and VEGFR-2 gene in MCF-7 cell line in a dose dependent manner.
Based on results obtained, emodin significantly reduced mRNA level of VEGF-A and VEGFR-2 gene in MCF-7 cell line in a dose dependent manner.

Body image disturbance is a common complication after chemotherapy. The present study aimed to investigate the effect of continuous care model on body image among breast cancer patients undergoing chemotherapy.
This clinical trial was conducted on 78 breast cancer patients undergoing chemotherapy in Ahwaz, Iran in 2013. Firstly, paired subjects were selected among identical subjects, and were randomly assigned to study and control groups. In the study group, continuous care model was administrated, and body image evaluation questionnaire was adopted to evaluate cancer patients’ body image. Body image was assessed in two time points (once before the intervention on day four of chemotherapy and once again two months after the intervention). Data were analyzed by independent t-test and chi-square test using SPSS16.
Mean score of body image was significantly higher before intervention compared to after in the study group (17.8 ± 5.5 VS 8.5 ± 5) (P = 0.0001). There was no significant difference between mean scores of body image before the intervention in the study and control group (P = 0.744), and before and after the intervention in the control group (P = 0.5).
With regard to results, nurses are suggested to administrate continuous care model to improve patients’ body image as an available and cost effective method.

To establish a cut-off value for signal intensity ratio (SIR) in dual-phase chemical shift MRI and also to evaluate the sensitivity and specificity of this method in order to differentiate benign from malignant focal vertebral lesions.
Totally 51 patients (28 men and 23 women) with a mean (± SD) age of 52.61 ± 13.52 years (range, 27 - 81 years) with 116 vertebral focal lesions were studied. MR imagining was performed using a 1.5-Tesla superconducting system. Chemical shift sequences for sagittal in-phase (IP) were obtained at RT/ET 100 - 165/4.2 and out-phase (OP) 100 - 165/2.4. All images were sent to a picture archiving and communication system (PACS) work station and areas with abnormal SI on the T1 and T2 sequences were identified on the IP/OP. An elliptical cursor to define region of interest was used to describe the area with abnormality on the IP and OP images. We calculated the signal intensity ratio or SIR (SI of OP/SI of IP) to compare the OP with the IP images. Air was selected as the reference contrast as not influenced by fatty infiltration.
SIR of 0.73 (OP images compared with IP images) can be used as the best cut-off value to identify benign (SIR SIR values from out-phase and in-phase images (chemical shift MR imaging) may be useful for quantitatively differentiating benign from malignant focal vertebral lesions with high specificity and sensitivity. SIR values in neoplastic focal lesions were greater than benign lesion and a value of 0.73 can be used as a cut off to differentiate between benign and malignant focal lesions.

Exercise is a major non-pharmacological intervention to improve quality of life in breast cancer patients. Given the enhanced utilization of exercise programs worldwide and lack of proper guidelines for breast cancer exercise programs in Iran, a group of different experts gathered to draw an exercise framework in these populations
This is a qualitative study using a focus group discussion method. Eight participants with different expertise were gathered. We had a moderator and two assistant moderators.
After analyzing, two challenging themes emerged: (1) conducting different types of exercise as home-based, and (2) pre-participation assessments. We had seven subthemes for the first theme, which in turn were divided into three categories: aerobic exercises, resistance training, and exercise intensity monitoring. Also we extracted two subthemes for pre-participation assessments.
Based on opinion of different experts who are involved in breast cancer care process, conducting different types of exercise as home-based, and pre-participation assessment should be considered.

Children with acute lymphoblastic leukemia who are receiving chemotherapy are at risk of developing a wide range of neurological disorder during medical treatment. This study was conducted to compare working memory performance, attention maintenance and executive function in children with ALL and healthy children.
This causal-comparative research was performed on 50 children with acute lymphoblastic leukemia and 50 healthy children (their sibling) who were between the ages of 7 and 12 years in Children hospital. We used random sampling method. N-back working memory test (N-Back) for working memory function, continuous performance test (CPT) for attention maintenance, and Wisconsin card sorting test (WCST) for executive function and flexibility were applied.
Independent T-test and Mann-Whitney tests were used to analyze the findings. Children with ALL have more deficiency in working memory performance (accuracy; correct response: r = 0.01 and unanswered r = 0.008) and executive functions compared to the control group (% Correct: r = 0.03, % Errors: r = 0.01, Categories achieved: r = 0.017, Failures to maintain set: r = 0.001). But there were no significant differences in attention maintenance scores between the two groups.
Children with ALL compared to their healthy siblings show a weak function in cortical regions and frontal lobe. Bio-psycho-social factors lead to cognitive disruption in ALL group.

Pleomorphic Xanthoastrocytoma (PXA) is a rare astrocytic neoplasm which mostly affects supratentorial region. The vast majority are sporadic, with only rare examples described in association with neurofibromatosis 1 (NF1), a genetic disorder with neurocutaneous manifestations. Co-occurrence of these 2 rare entities with neoplasm of melanocytes, Cutaneous Malignant Melanoma (CMM), is described in this report for the first time.
A 34-year-old female with established diagnosis of NF1 and left optic nerve glioma from childhood was presented with visual field impairment, decreased level of consciousness and right VI and VII cranial nerves paresis. An irregular hyperpigmented skin lesion was also noted on thoracic area, which histopathological and immunohistochemistry (IHC) study with S100 confirmed CMM. Brain MRI demonstrated high signal intensity mass in right cerebellopontine. Right retro-mastoid craniectomy and total resection of tumor was performed and histopathological investigation of excised lesion along with IHC study with glial fibrillary acidic protein (GFAP), confirmed PXA. Sanger sequencing showed positive BRAF T1799A mutation in both PXA and melanoma’s tissue.
The association between BRAF gene mutations and human cancers such as PXA and CMM was discovered. This first ever co-occurrence of mentioned rare disorders emphasizes on probable role of BRAF gene in pathogenesis and whether its inhibitors could serve as an adjuvant agent to facilitate surgical approaches to complex lesions.

We present a rare case of breast papillary carcinoma associated with intracystic component in a woman with a long history of autoimmune hypothyroidism and multiple sclerosis.
The patient was a 59-year-old woman presented with complaints of pain and swelling in her right breast. She was a known case of autoimmune hypothyroidism since 20 years and secondary progressive multiple sclerosis since 13 years ago. She had received frequent interferon, corticosteroid and cytotoxic therapy for her multiple sclerosis. On imaging studies, there were multiple large cystic-solid lesions in the right breast and with presumptive diagnosis of infectious collection or phyllodes tumor, she finally underwent simple mastectomy. On gross pathological evaluation, a large multi-loculated cyst filled with blood clots and necrotic debris was identified. In serial sections, a 7 cm solid tumoral mass with papillary projections protruding into the cyst cavity was seen. Although the gross appearance of the lesion resembled an angiosarcoma accompanied by cystic hemorrhagic necrosis, after the microscopic evaluation of the specimen, papillary breast carcinoma associated with intracyctic component was finally diagnosed.
The aim of this study was to describe a rare variant of invasive breast cancer presenting with a large solid-cyctic mass in a woman with long standing autoimmune disorders.

Neurofibroma is a rare benign tumor that often originates from peripheral nerve sheath. The solitary type can be seen in middle-aged people. Hyalinization is a rare phenomenon that can be observed in fibrous tumors.
In this report, a 46-year-old male patient with a hard mass in proximal femoral is presented. He had central necrosis in the initial imaging studies. The mass was painful and caused signs of local anesthetic for the patient. Extensive hyalinization was observed in the central part of the mass in histopathological studies. S100 protein was widely positive, but CD34 and bcl2 were negative. No necrosis was observed.
The extensive central hyalinization is very rare in fibrous tumors and is observed for the first time in neurofibroma. Hyalizination in the work up prior to surgical treatment led to misdiagnosis of the radiologist and the surgeon. Detailed pathological examination is very important to definitive diagnosis.