International Journal of Cancer Management
Volume:10 Issue: 8, Aug 2017

Cancer is one of the most common causes of death in human society. Epidemiological information has an important role in planning for prevention, diagnosis and treatment of cancer in communities.

The aim of this study was to evaluate epidemiological aspects of the premalignant and malignant epithelial lesions during a 43-year period in faculty of dentistry, Mashhad University of Medical Sciences, Iran.

In this retrospective-descriptive study, all archived records in oral pathology department of dental school, Mashhad University of Medical Sciences in northeast of Iran, during the period of 1971 - 2013 were investigated. A total of 11126 pathology reports were evaluated. Age, gender, primary site and histologic type of the lesions were extracted from patient’s records. Data were analyzed using SPSS statistical software (V. 21), Chi-square, Fisher’s exact and Mann-Whitney tests.

Among 11126 patients, 1066 (9.55%) cases had premalignant and malignant lesions, with mean age of 53.18 ± 16.45, ranging from 11 to 97 years. Squamous cell carcinoma with 86.2% was the most common malignant tumor and lichen planus with 74.6% was the most common premalignant lesion. 523 (49.5%) of the patients were men and 532 (50.5%) were women. Buccal mucosa was the most frequently involved area in malignant tumors (114 cases) and premalignant lesions (274 cases).

The epidemiological pattern of premalignant and malignant lesions in Iran is nearly similar to those reported from other studies with differences in some cases. Also the findings of this study show that the routine examination of oral mucosa is important and emphasize the development of screening policies and primary prevention programs for malignant and premalignant oral lesions.

This study aims to investigate self-awareness of individuals, regarding oral potentially malignant disorders and oral cancer, who are at higher risk of developing them because of their adverse habits.

Demographic data from 500 patients was noted and subjects were interviewed for adverse habits, using a structured questionnaire. As part of the interview, six questions regarding awareness of OPMD and oral cancer were asked and responses were noted on 3-point-scale (yes/no/ not sure). The subjects’ awareness of risk factors and their knowledge of clinical symptoms as possible indicators of OPMD and oral cancer were also assessed. A standardized oral mucosal examination was performed according to WHO (1997) guidelines. Awareness of the presence/absence of OPMD was assessed using 4 questions which were confirmed by histopathologic analysis.

Awareness of oral cancer was 70.4%, but only 33.4% for OPMD. Statistically significant differences in awareness among different age groups, gender, level of education, monthly income and type of tobacco use were observed. The majority of subjects were not aware of the symptoms of oral cancer and of OPMD. 77% and 60% subjects were aware that tobacco and alcohol consumption are risk factors for oral cancer but only 14% and 8.6% were aware of these as risk factors for OPMD. 45.4% of the study population had OPMD while 50.6% were aware of it.

Knowledge of oral cancer and OPMD was poor among subjects with high risk of developing oral cancer, indicating an urgent need to implement public health education and promotion strategies

The use of ultrasonographic guide is a suggested way to ease the obturator nerve block procedure. Accordingly, in this study, the procedures by selective obturator nerve block with and without use of ultrasonographic guide were compared.

This interventional study was performed as an open-label randomized clinical trial among 50 consecutive subjects under surgery for intramural tumors of urinary bladder in a training hospital in 2016. The subjects were randomly assigned to be operated under spinal anesthesia accompanied with selective obturator nerve block (10 mL of 1.5% lidocaine adding 1:200000 epinephrine) with or without ultrasonographic guide. The outcomes were compared across the groups.

There was no statistically significant difference between the onset time in group without guide (6.3 ± 2.2 minutes) and that in the guided group (5.9 ± 2.1 minutes). The time required for the nerve block (4.4 ± 1.3 minutes versus 1.7 ± 0.8 minutes) was significantly shorter (P = 0.001). There were less complications in the group with use of ultrasonographic guide showing significant difference (P = 0.01). The success rate in block was significantly higher in the group with ultrasonographic guide (100% versus 92%, P > 0.05).

Finally, according to the obtained results, it may be concluded that ultrasonography guidance would improve efficacy of obturator nerve block compared with conventional techniques.

Brachytherapy is an integral component of the definitive treatment of locally advanced cancer cervix. Cervical Brachytherapy has evolved from the time when dose prescription was largely empirical, to the image based conformal brachytherapy advocated by Groupe Europeen de Curie Therapie-European society for therapeutic radiology and oncology (GEC-ESTRO) and American brachytherapy society (ABS).

To explore the feasibility of transabdominal ultrasound (USG) as an imaging modality for conformal brachytherapy (intracavitary) in locally advanced cancer cervix.

Twenty-five patients with locally advanced cervix cancer (FIGO 2009 IB2 to IIIB) treated with definitive chemoradiation and brachytherapy were included in this study. Two plans were generated for each patient at each brachytherapy session – 1) standard orthogonal X-Ray plan with dose presciption to Point A and 2) plan based on USG imaging and clinical assessment. The two plans were compared with respect to doses received at point A, international commission on radiation units and measurements (ICRU) 38 urinary bladder and rectal points. Actual Brachytherapy doses were prescribed to the USG (and clinically) delineated target and patients followed up to 15 months minimum for assessing local control and late toxicity.

USG based planning resulted in statistically significant reduction of doses received at organs at risk (OAR) i.e. ICRU 38 bladder (P

Considering the ease of availability, inexpensiveness, quick and good soft tissue imaging offered by ultrasound, this modality’s potential for conformal brachytherapy should be further explored, especially in limited resource settings and where the disease burden is high.

Colorectal cancer (CRC) is one of the most prevalent cancers in the world. Cancer stem cells (CSC) have been reported in many human tumors and are thought to be responsible for tumor initiation, therapy resistance, progression, relapse, and metastasis. Recent studies revealed that microRNAs (miRNA) play important roles in maintaining stemness of embryonic stem cells and CSCs.

With regard to the crucial role of cancer stem cells in colon cancer initiation and maintenance, the miRNA expression profile in primary and cell line cancer stem cells compared to non-stem cells cancer cells were evaluated.

In this study, a population of colon CSCs from primary colon cancer and human HT-29 colonic adenocarcinoma cell line was isolated from serum free medium and their microRNA profiles were evaluated using miRNA PCR array.

The isolated cells with high expression of EPCAMﰠ markers showed greater colony-forming efficiency and higher tumorigenic potential. Furthermore, expression of ‘‘stemness’’ genes including C-myc, Klf4, Nanog, Sox2 and Oct4 was higher in isolated cancer stem cells. Moreover, miRNA expression profile of colon CSCs was performed using miRNA PCR array. There are 39 differentially expressed miRNAs, 24 of which had lower mean expression in the cancer stem cells samples. By contrast, 15 miRNAs had higher expression levels in CSCs samples. Of these, miR-495, miR-125, and miR-199a were the most significantly up-regulated miRNAs.

Our results suggest that miRNAs might play important roles in maintenance and regulation of colon CSCs and specific miRNA expression signatures may contribute to cancer initiation and expansion.

Oral mucositis is a frequent yet serious adverse event associated with chemotherapy in acute myeloid leukemia. Although a wide spectrum of drugs has been tested for prophylaxis of oral mucositis, few of them are satisfactory. There is currently substantial clinical interest in zinc (Zn) as an antioxidant and a protective agent against chemotherapy -relatednormal tissue injury. Therefore, in the present study, we investigated whether zinc prevents oral mucositis associated with chemotherapy in patients with AML.

A total of 140patients with AML were randomly selected and divided into two groups where the case groups received zinc sulfate 220 mg orally and the control groups received placeboes 3 times a day during their chemotherapy course. Data were analyzed by SPSS version 15 software. Mann-Whitney U test was used to evaluate mucositis, and pain intensity.

The incidence rates of mucositis were all markedly lower in oral zinc sulfate group than in control (P = 0.004).

Zinc is available for preventing the complications of oral mucositis, and thus for improving patient quality of life.

Lots of research has been dedicated to negative consequences of cancer, but few probably studied personal growth and self-enhancement and its related variables after experiencing this disease. The aim of this research was to predict posttraumatic growth based on coping strategies and gender in patients with cancer.

Using a correlational method and a questionnaire tool, 120 patients (65 females and 55 males, mean age 47 ± 14.72) were selected among hospitalized patients in Firouzgar, Ayatollah Taleghani and Rasoul Akram hospitals in Tehran. They completed post traumatic growth inventory (PTGI) and coping responses inventory (CRI). Descriptive statistics, independent t-test, correlation tests and multiple linear regression were used for data analysis by SPSS version 20.

Findings indicated that among problem-oriented coping strategies, cognitive assessment and seeking social support explains 53% of PTG changes (P 0.05).

Results showed that problem-oriented strategies especially re-evaluation can support the patients to strive to re-conceptualize their experience and make it easier to deal with. In this regard, clinical interventions such as training problem-focused coping skills and facilitating measures to provide social support may also be helpful.

Various epidemiological studies have related fine particles (PM2.5) to incidence of lung cancer. In addition, particulate air pollution has been classified as Group 1 carcinogen by international agency for research on cancer (IARC) in 2013.

The aim of this study was to quantify the number of gender-specific lung cancer deaths due to exposure to PM2.5 among individuals aged over 30 years using WHO AirQ model in 10 cities of Iran during March 2013-March 2016.

Hourly concentrations of PM2.5 were obtained from department of environment (DOE) of Iran and Tehran air quality control company (TAQCC). Demographic information and baseline incidence (BI) were acquired from statistical center of Iran, ministry of health and medical education, respectively. AirQ model was used to quantify the lung cancer deaths among males and females aged over 30 years.

The highest lung cancer deaths were in Tehran with approximately 407 cases of death during the whole three-year period. The total deaths among men and women in the whole period were 433 and 431 cases, respectively. The sum of lung cancer deaths due to PM2.5 exposure in all the 10 cities during these 3 years were estimated 864 cases. In addition, the attributable proportion of lung cancer due to PM2.5 exposure in each city was estimated. Despite the high number of lung cancer deaths in Tehran, higher AP values were observed in cities such as Isfahan, Ahvaz, Khoram Abad and Arak, reflecting the higher risk of death per unit of population.

The results of this study could be used by authorities for making air pollution reduction strategies and plans. Furthermore, any reduction in attributed mortality and hospitalization reduces financial burden in health organizations.

Triple negative breast cancer (TNBC) is characterized by negative result of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) in immunohistochemical (IHC) staining and an interesting topic of research today. Various studies have been reported in western countries on TNBC, all insisted of the poorer prognostic of TNBC than other subtypes of breast cancer. However extensive data from Iran is lacking.

The aim of this study was to analyze the clinical, pathological profile and survival of TNBC patients at our institute.

Medical records of 1910 breast cancer patients in the Shahid Beheshti University of Medical Sciences cancer research center database with data on 180 patients of TNBC patients was collected between September 2002 and December 2014 and reviewed for clinicopathological profile and survival analysis.

The median age at diagnosis was 48 years. Fourteen patients (7.8 %) had stage I, 88 patients (48.9%) had stage II, 57 (31.7 %) had stage III, 8 (4.4%) patients had stage IV at first diagnosis and 13 patients (7.2%) with unknown stage. The median follow-up time was 41 months. 149 patients were without any with recurrences at the last follow up and 31 patients were with recurrence. Median interval for recurrence development was 39 months. Five years disease free survival (DFS) was 71%. Overall survival (OS) at 5 years for all patients was 56%. According to univariate cox regression 5-year DFS analysis, unfavorable prognostic factors in our study were as follows: grade III of tumor, positive LVI, presence of lymph node positive, stage II and stage III at diagnosis. According to multivariate cox regression 5-year OS analysis unfavorable prognostic factors were as follows: age: 40, grade III versus grade I of tumor, stage III at diagnosis versus Stage I, and visceral recurrence.

We observed that most clinical and pathological TNBC characteristics in Iranian patients are consistent with others findings in literature, such as younger age at diagnosis, high grade tumors, advanced stage at diagnosis, and short time of 5-year DFS and 5-year OS. Longer follow-up of these patients is required for more mature data on these cancers.

Although tuberculosis has been a very common disease in endemic areas, isolated involvement of the breast was uncommon. The coexistences of breast carcinoma and tuberculosis mastitis was very rare but could create a dilemma in the diagnosis and treatment, as there were usually no pathognomonic features to differentiate malignancy from breast tuberculosis.

We have reported the case of a 40-year-old woman referred with a painful lump in her left breast and nipple retraction. Mammography has shown an irregular mass and pleomorphic micro calcifications. Breast ultrasound has revealed a hypo echoic irregular mass. The first diagnosis was breast carcinoma. Histological study confirms high grade ductal carcinoma in situ. There was also evidence of tuberculosis mastitis at histological examination of the breast specimen.

Breast tuberculosis has known as a rare disease even in endemic countries. Coexistence of breast carcinoma and tuberculosis mastitis is very rare but it could lead to many problems regarding diagnosis and treatment.

Pure non-gestational ovarian choriocarcinoma is a rare malignant condition with aggressive behavior. The tumor arises from germ cells of ovarian. Few cases have been reported in the literature. We present a case of pure ovarian choriocarcinoma with disseminated tumor in pelvic.

A 16-year-old girl was referred to Ghaem hospital, Mashhad University of Medical Sciences, Mashhad, Iran in April 2016 with acute abdominal pain, abdomino pelvic mass and vaginal bleeding. In addition, an extremely high level of sub unit of human chorionic gonadotropin β-hCG was detected. Based on the emergency condition, she underwent laparotomy and left salpingo-oophorectomy with suboptimal resection of the tumor. Histopathology revealed a tumor compatible with pure non-gestational ovarian choriocarcinoma. Adjuvant chemotherapy was performed based on 4 courses of bleomycin-etoposide-cisplatin (BEP) regimen. She is now under chemotherapy.

We recommend the use of minimally invasive, fertility-preserving surgeries in patients with non-gestational ovarian choriocarcinomas.

Laparoscopic adrenalectomy is a safe procedure that was performed in 1992 for the first time. Morbid obesity is an independent risk factor for complications of adrenalectomy in postoperative period and conversion of laparoscopy to open procedure. Recent data show that laparoscopic adrenalectomy can reduce the recovery time, wound complications and hospital stay in morbidly obese and diabetic patients.

A 37-year-old morbidly obese diabetic female that was a candidate for bariatric surgery with chief complaint of right flank pain and large complex adrenal mass in preoperative ultrasonography confirmed by CT-scan and MRI was the case of this study. The patient underwent laparoscopic lateral transabdominal adrenalectomy and was discharged two days after operation without any complications. The pathologic study report was myelolipoma.

Laparoscopic adrenalectomy may be considered as a safe procedure in morbidly obese patients and can reduce the perioperative complications and recovery period in comparison with the open approach.