International Journal of Cancer Management
Volume:11 Issue: 1, Jan 2018

Context: Cutaneous squamous cell carcinoma (CSCC) is the second most common type of skin cancer and its incidence continues to rise worldwide. While the majority of CSCCs have excellent prognosis, a subset have the propensity to cause poor outcomes.
Evidence Acquisition: A thorough Pubmed search was done and a collection of CSCC-relevant articles were selected based on the expert opinion.
A number of high-risk factors have been identified including perineural invasion (PNI), desmoplastic growth pattern, poor differentiation, high risk location and large diameter. Various staging systems have been developed based on these high-risk factors. Radiologic imaging is important for high-stage tumors and is likely associated with more aggressive management.
Although surgical management is the gold standard, newer therapies such as programmed cell death protein-1 (PD-1) inhibitors show promise for locally advanced or metastatic disease. Despite advances in treatment, early diagnosis and prevention of CSCC is still the most important measure to ensure good outcomes.

The aims of this study were to establish the clinical value of multi-parametric flow cytomentry (MFC) in multiple myeloma (MM) and monoclonal gammopathy of undetermined significance (MGUS).
We analyzed bone marrow aspirates from 112 MM and 17 MGUS patients by MFC, using 3 combinations of 9 color labeling: a, CD38 / CD138 / CD45 / CD56 / CD19 / CD27 / CD117 / CD20 / CD33; b, CD38 / CD138 / CD45 / cytoplasmic Kappa / cytoplasmic Lambda; and c, CD38 / CD138. MFC data were classified based on clinical features and prognosis factors.
Myeloma’s patients compared to MGUS group had plasma cells (PCs) with abnormal immunophenotypic patterns, including high CD56 and CD20 expression and weak or negative CD45, CD19, and CD27 expression without significant median differences in expression of CD33 and CD117. Multiple myeloma patient with low expression of CD19, CD27 or CD45, overexpression of CD56 or with a high proportion of PCs at diagnosis demonstrated shorter overall survival times. Moreover, MM patients with combined abnormal expressions of 4 or 5 antigens demonstrated shorter survival times (P = 0.001). These high-risk MFC patients were associated with poor clinical outcomes, including ISS stage III and DS stage III, low hemoglobin levels, and elevated serum beta2-microglobilin (P = 0.01, P = 0.006, P = 0.01 and P = 0.008, respectively).
The present study highlights the benefits of assessing abnormal antigen expression for clinical uses. These measures could facilitate proper diagnosis of disorders and improve risk stratification for a targeted early treatment regimen.

Cancer is a major public health concern all over the world. The aim of the current study is to demonstrate changing trends of cancer incidence from 2006 to 2009 in Tehran (capital city of Iran) and evaluate the effect of living in different regions according to their median socioeconomic status (SES) on cancer cumulative incidence.
The incident cases were obtained from the population based cancer register of ministry of health and medicine in Iran; we examined the annual percent changes (APCs) and overall trends of total cancer incidence across regions in Tehran. The age and sex standardized incidence rates were computed by the direct method. Poisson regression and negative binominal regression model were used to assess the existence of trends across 4 consecutive years, as well as the effect of living in each region, literacy rate, and employment rate across regions on this trend. All the analyses were done by Stata 12.0 software.
The findings of this study showed downward and nonlinear trend during 4 years. The age-standardized incidence rate (ASR) was higher in men compared to women in this period. ASRs for overall 4 years were 114 and 101 per 10,0000 men and women, respectively. Average annual percent change based on ASR and regression model for each sex was the same and around -5% and -6%, respectively. Incidence rate also differed between districts so that north and center districts had higher incidence than southern parts in both sexes. The lowest rate ratio attributed to district 17 and 18 located in south of Tehran and the highest rate ratio attributed to district 6 for each sex compared to the baseline district 16. Results reported the sharp increase of 59% and 37% in district 6 compared to district 16 in men and women, respectively. Better regional social status increased the risk of cancer among women. Also, the results showed a partially significant interaction with higher decrease in annual trend of cancer rate in socially more deprived regions.
The results showed downward and nonlinear decreasing trend during 4 years, especially in regions with lower socioeconomic status. Incidence rate also differed between districts so that northern regions had higher incidence than southern regions. Spatio-temporal Analysis of these cancer rates with adjustment for more regional socio-economic characteristics may better explain the disparities in rate of cancer in different districts across time.

Ellagic acid (EA) is a polyphenol, whose anti-cancer properties have been demonstrated in several cancer studies, but the poor water solubility and low bioavailability have limited its therapeutic potential.
The present study proposed to develop solid lipid nanoparticles (SLNs) as a delivery system for improving the anti-cancer capability of EA on prostate cancer cell line.
EA-loaded SLNs were prepared by hot homogenization technique and characterized by different techniques. Cytotoxicity of EA and EA-loaded SLNs on prostate cancer cell line (PC3) was evaluated by 3-(4, 5-Dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay, and nucleus condensation, or chromatin fragmentation (the signs of apoptosis) were studied by 4’-6-diamidino-2-phenylindole (DAPI) staining. The expression of B-cell lymphoma 2 (Bcl-2) and Bcl-2-associated X protein (Bax), which are involved in apoptosis, were evaluated by quantitative reverse transcription polymerase chain reaction (qRT-PCR).
The nanoparticles with appropriate characteristics (particle size of 96 nm and Encapsulation Efficiency of 88%) were prepared. The in vitro drug release profile showed a burst release in the first hours and followed by a sustained EA release until 72 hours. EA-loaded SLNs displayed a good stability for 4 weeks of storage at 4 - 8°C. Cytotoxicity evaluations demonstrated that EA-loaded SLNs prevented prostate cancer cells growth in a low IC50 value compared to the EA. The results of qRT-PCR demonstrated that EA causes up-regulation of Bax and this regulation intensified when EA was loaded into SLNs, but there was no punctual correlation between the EA and EA-loaded SLNs in down-regulation of Bcl-2.
The results strengthen our hope that loading EA into SLNs could possibly overcome the therapeutic limitations of EA and make it more effective in prostate cancer therapy.

Idarubicin is an anthracycline antibiotic drug widely used in chemotherapy. Dexrazoxane is an iron chelator used clinically against anthracyclines-induced cardiotoxicity. The present study was designed to determine the possible genoprotection of dexrazoxane on idarubicin-induced DNA damage and oxidative stress.
In this study, the induction of DNA damage by idarubicin was examined on HepG2 cells, using comet assay. Cells were exposed to different concentrations of idarubicin in order to find the minimum and suitable genotoxic concentration. To survey the genoprotective effects of dexrazoxane, cells were subjected to several safe concentrations of dexrazoxane (10, 50, 100, and 200 µM) for 24 hours followed by 1 hour exposure to established genotoxic concentration of idarubicin (0.05 µM). Lipid peroxidation was assessed as a biomarker to show the index of oxidative stress and a possible mechanism underlying this amelioration.
Dexrazoxane pre-treatment significantly reduced different parameters of DNA migration such as tail length, % DNA in tail, and tail moment. Moreover, the treatment of dexrazoxane (200 µM) decreased the severity of idarubicin-induced lipid peroxidation.
Dexrazoxane in addition to cardioprotection against idarubicin-induced cardiotoxicity has the potential to attenuate its DNA damage and lipid peroxidation in normal cells of patients with cancer treated with idarubicin.

Gastric cancer (GC) is the fourth major malignancy and the second leading cause of cancer-related deaths worldwide. Northern and northwestern areas of Iran are among the high risk areas for GC. Studies have shown that dietary components are implicated in the etiology of GC. The index of nutritional quality (INQ) is a method of quantitative and qualitative analysis of single foods, meals, and diets. We aimed to assess the association of INQ with GC, and to evaluate the nutrient intake of GC patients.
The present case-control study included 82 cases and 95 healthy controls attending specialized centers in Tabriz, Iran, from December 2014 to May 2016. INQ scores were computed based on dietary intake assessed using a validated 168-item food frequency questionnaire (FFQ). Logistic regression models were used to estimate multivariable ORs adjusted age, gender, Body Mass Index (BMI), smoking, residency, education, and regular physical activity.
After controlling for several covariates, inverse associations were observed between GC risk and INQs of vitamins A, B6, and D (ORvitA = 0.25 (0.06 - 0.98); ORvitB6 = 0.10 (0.04 - 0.28); and ORvitD = 0.14 (0.02 - 0.84)). Cases had higher intake of total fat, saturated fatty acids, beef, lamb meat, salt, and paprika compared to controls. On the other hand, controls had higher intake of vitamin A, vitamin, vitamin B6, copper, poultry, low fat milk, tea, coffee, turmeric, and saffron compared to cases.
Subjects who follow a more healthy and nutrient-rich diet, especially in terms of vitamins A, B6, and D, are at lower risk of having GC, compared to those who consume a more unhealthy, nutrient-poor diet.

The diagnosis of cancer can cause great spiritual crises in persons and affect various aspects of their lives.
This study was conducted to design a psychometric spiritual needs assessment scale of patients with cancer in Iran.
This methodological research was conducted in 2 parts: qualitative and quantitative. Interviews were conducted with 18 patients with cancer who were referred to Imam Khomeini Hospital in Tehran with the maximum diversity of the patients occurring in the qualitative stage for explaining the spiritual needs of patients. The purposive sampling method was applied to this study. The interviews were analysed with the content analysis method, and eventually classes related to patients’ spiritual needs were conducted. Also, the terms of the scale were designed in this way. In the quantitative stage, content validity, formal validity, structure validity (exploratory factor analysis), and convergent validity were evaluated with internal consistency and retests of the scale.
The 4 themes, Connection, Search for Peace, Find Meaning and Purpose, and Achieve Transcendence were extracted from the codes obtained. The intended scale was, then, designed. The content validity index and validity ratio of tools of content validity were determined. Content validity was applied during the assessment of face validity assessment of written comments of experts. In addition, 10 patients were examined on the scale. An exploratory factor analysis indicated the 5 factors of the designed scale. Finally, a scale was obtained with 38 terms in 5 subscales and its scoring was determined in a 6-episode Likert. Cronbach’s alpha for the total scale was estimated 0.81; for the religious dimension, this was 0.88, for meaning and purpose 0.77, for peace 0.70, for connection 0.74, and for support and nationalism 0.67, respectively. The result of the retest was also estimated ICC = 0.89.
The spiritual needs scale in patients with cancer can measure different aspects of spiritual needs and is reliable and valid. It is suggested that the spiritual needs assessment scale of patients with cancer be used in different populations of patients with cancer separated on the basis of sex, age, type of cancer, and stage of the cancer and the spiritual needs of these patients be determined. Also, the designed scale is validated in other places and with different cultural conditions.

Patients with breast cancer often experience severe psychological distress after awareness of cancer and during the course of treatment, and have lower physical and psychological quality in their life.
The aim of this study is to investigate the relationship between defense mechanisms in cancer patients with various aspects of their quality of life.
The present study is a correlational study. Participants were 96 women with breast cancer who were referred and hospitalized at Imam Khomeini hospital in Tehran in summer of 2015 and were selected by convenience sampling. They completed defense mechanisms and general quality of life questionnaires. Data were analyzed using canonical correlation model.
Two significant canonical functions were identified in data. First canonical function showed that too much use of displacement and regression defense mechanisms are accompanied with low level of quality of life in physical, cognitive and role aspects. Second canonical function showed that too much use of reaction formation and projection defense mechanisms are associated with lower levels of quality of life in cognitive and role aspects.
Paying attention to psychological factors and defense mechanisms that are used by cancer patients could help clinical therapists to make very effective mental health interventions.

In recent years, the incidence of various types of cancer including lymphoma has been on the rise. Although there have been developments in terms of knowledge of its biology and treatments, its etiology is still less known. In this respect, lifestyle and dietary factors can play important roles in the etiology of lymphoma. Thus, the purpose of the present study was to investigate the lifestyle and the dietary style in patients with lymphoma of the head and neck.
This study was a retrospective case-control research. The patient group (57 people) was selected from the department of oncology at Razi hospital in the city of Rasht and the control group (57 individuals) was selected out of healthy individuals referred to Guilan school of dentistry. Then, both groups completed questionnaires concerning the research variables. After collecting the required information, the data were entered into the SPSS Software (version 21) to evaluate the dietary style and the lifestyle in the both groups.
Comparing the lifestyle in both study groups, the rate of smoking (P The consumption of red meat, herbs, and fruit, as well as the body mass index were considered as predictors of lymphoma. Furthermore, smoking was directly correlated with the incidence of lymphoma.

Tongue squamous cell carcinoma is one of the prominent cancers in the oral cavity. Molecular investigations based on interaction analysis can be promising towards providing a better resolution of malignant neoplasms. Here, the protein-protein interaction network of tongue cancer is studied.
The protein-protein interaction network was constructed by the application of Cytoscape 3.5.1 and the related algorithms. Centrality analysis via the degree, betweenness, and closeness centralities was conducted.
The result indicated that there are seven chief proteins in the network foundation. Moreover, enrichment evaluation suggested two associated biological processes including Response to UV-A, Response to interlukin-7, cellular response to alcohol, and catenin import into nucleus process using CluePedia.
It can be concluded that the identified central panel proteins and their related biological processes can shed light on the neoplasm mechanisms and are worth pursuing for clinical approaches.

Spindle cell carcinoma (SpCC) is an unusual subtype of squamous cell carcinoma with an aggressive behavior. The occurrence of this tumor in maxillary sinus has rarely been reported.

This case report describes the diagnosis, management, and follow-up of a 35-year-old female, who presented with Spindle cell carcinoma of maxillary sinus.

The behavior of maxillary sinus SpCC seems to be more aggressive than Spindle cell carcinoma of other sites and shows a poor prognosis.

Primary renal lymphoma (PRL) is rare while secondary involvement of the kidney by lymphoma is not infrequent. All morphologic varieties of lymphoma can involve kidney. The most common reported PRL is large B cell lymphoma. To our knowledge no prior case of primary renal mantle cell lymphoma (MCL), pleomorphic variant, has been reported.
A 67-year-old male presented with right flank pain. On examination a right sided abdominal mass and a unilateral varicocele were detected. On imaging studies there was a large mass of right kidney without nodal or other organs involvement. He underwent right nephrectomy. On gross pathological evaluation, a deformed kidney which was almost totally involved by tumor with hemorrhagic nodular cut surfaces was identified. Histologic evaluation and immunohistochemistry (IHC) staining followed by fluorescence in situ hybridization (FISH) study for t (11; 14) (q 13; q 32) / CCND1 - IGH confirmed diagnosis of MCL, pleomorphic type. Finally the patient was admitted in another hospital for continuing the treatment and received chemotherapy there. After one year of initial diagnosis the patient is still alive.
The aim of this manuscript was to highlight a possible presentation of primary MCL, pleomorphic variant.