International Journal of Cancer Management
Volume:12 Issue: 3, Mar 2019

 Esophageal cancer is considered as a malignant disease with fatal consequences worldwide. In cancers, it is the sixth most common cause of mortality in the world. The aim of the current study was to assess the cost-effectiveness of esophageal cancer treatments by performing a systematic review.  We conducted systematic searches in Medline through PubMed, Scopus, Cochran Library, EMBASE, and Web of Science databases. The search was limited to English language publications and studies published before July 17, 2018. Of 2487 records, 14 articles met our inclusion criteria. Most were conducted in The United States of America (USA) and The United Kingdom (UK). The majority of the evaluations (8) followed a healthcare system perspective. Of 14 included studies, 4 compared esophagectomy with endoscopy treatment (ET), 2 compared esophagectomy with chemotherapy regimens, 2 contrasted chemotherapy regimens, and 5 studied compared palliative cares. Among all the assessed studies, the ET was more cost-effective than esophagectomy, but there were contradictory results in palliative care for the treatment of esophageal cancer.

We evaluated the effect of socio-economic status (SES) inequality on metastasis, recurrence, stage, grade, and self-rated health (SRH) in patients with gastrointestinal cancers (GIC). This cohort study was conducted on 409 patients suffering from GIC (April to October, 2018), who were referred to one of the hospitals of Arak University of Medical Sciences (Arak, Iran). They were entered to the study, using non-random sampling (accessible sampling). The SES was calculated by an asset-based questionnaire. The principle component analysis (PCA) was performed to estimate the household SES. The concentration index (C) was used to measure the SES inequality, and the binary logistic regression was employed to investigate the association of recurrence and metastasis with other variables. The variance analysis was also used to investigate the relationship between SES and other variables. The data were analyzed with Stata (V. 13) software. The total C index for metastasis, recurrence, stage, grade, SRH, and SRH-age was obtained as 0.089 (0.053, 0.121), -0.106 (-0.118, -0.065), 0.073 (0.069, 0.078), 0.035 (0.001, 0.051), 0.018 (0.010, 0.026), and 0.097 (0.063, 0.112), respectively. Moreover, the results of variance analysis showed a significant statistical association between SES and age, marital status, education, job, supplementary insurance, SRH-age, chemotherapy, and surgery (P < 0.05). Regarding the level of SES, the results of this study did not show the inequality in metastasis, recurrence, and stage. However, there was an inequality in grade and SRH by the SES levels in patients with GIC.

The key enzyme of methylenetetrahydrofolate reductase (MTHFR) is involved in DNA biosynthesis and repair. The role of MTHFR C677T polymorphism in susceptibility to breast cancer is controversial. In the present case-control investigation, 297 individuals consisted of 100 patients with breast cancer and 197 healthy women were studied for MTHFR C677T genotypes, using PCR-RFLP method. The frequency of MTHFR TT genotype was 10% in patients and 3% in controls (P = 0.008). The presence of TT genotype was associated with susceptibility to breast cancer [OR = 1.97, 95%CI: 1.16-3.36, P = 0.012]. The T allele of MTHFR was found in 30% of the patients compared to 27.6% healthy controls (P = 0.024) that enhanced the risk of breast cancer by 1.56 times (95% CI: 1.06 - 2.3, P = 0.024). There were 71 individuals (71%) with the age of breast cancer diagnosis ≤ 51 years old. Comparing patients with the age of cancer diagnosis ≤ 50 years old with those > 51 years old group indicated a higher frequency of MTHFR TT genotype in the latter (20.7%) compared to the first group (5.6%, P = 0.05). Our study demonstrated an association between the MTHFR C677T polymorphism with the risk of breast cancer among population of Western Iran. Also, our study suggests that the MTHFR TT genotype could be a risk factor for breast cancer in postmenopausal women.

Breast cancer is the most malignant disease among women worldwide. The main purpose of this study was to investigate psychological factors on progress of cancer. A total of 150 patients with breast cancer, who had attended the Cancer Research Center of Shahid Beheshti University of Medical Sciences from 2012 to 2014, were selected and assessed by patient clinical demographic questionnaire, NEO personality inventory (NEO PI), multidimensional scale of perceived social support (MSPSS), and stressful life events scale. 32.9% of patients has been diagnosed with stage 1, 39.9% with stage 2, 26.6% with stage 3, and 0.7% with stage 4 cancer. Among the personality traits, only conscientiousness has a significant correlation with the amount of lymph nodes. The effect size is 4.9%. In evaluating recurrence control with social support and personality traits, only conscientiousness and neuroticism have a significant correlation with lymph nodes. Correlation between the variables was not significant with the control of the effects of adverse events. Psychosocial elements are among the factors affecting the treatment of patients with breast cancer. In this regard, stressful life events, especially the incidents associated with one’s spouse and family, and the social support indicators influence the treatment and recovery of the patients.

Skin cancer is one of the most common cancers and excessive Ultraviolet (UV) radiation is the most important environmental risk factor for this cancer. Protective behaviors against sunlight are the most important measures in preventing the disease. The present study aimed to determine the effect of educational program based on the protection motivation theory on preventive behaviors of skin cancer among the farmers in Kashan city. This interventional study was conducted on 120 rural farmers in Kashan in 2018. The participants were selected via simple random sampling and divided into 2 groups such as intervention (n = 60) and control (n = 60). Both of 2 groups completed a questionnaire, which was consisted of items developed based on the protection motivation theory, in before and 2 months after the intervention. Participants in the intervention group were trained through lectures, questions and answers, posters, pamphlets, and booklets. The collected data were analyzed by SPSS version 20 using independent t-test, chi-square test, and covariance analysis. There was no significant difference between the intervention and control groups in terms of the mean scores of all the variables (P > 0.05) before the training intervention and after implementing the educational program, a significant difference was observed in all the constructs of the protection motivation theory in the intervention group, as compared with the control group (P < 0.05). The results of this study confirmed the effectiveness of intervention based on the protection motivation theory in changing perceptions and behaviors related to skin cancer prevention; thus, this theory can be considered as a basis for the educational program.

The major side effect of cisplatin (CP) therapy in patients with cancer is nephrotoxicity, which limits the treatment. In two protocols of CP treatments, we tested 3 weeks of hormone therapy against CP induced nephrotoxicity in bilateral orchiectomized (OR) and ovariectomized (OV) rats. A total of 101 OR and OV rats were subjected to receive 3 weeks of testosterone (Ts, 10 mg/kg/week) and estradiol (Es, 250 µg/kg/week), respectively, followed by two protocols of CP therapies; continuous (divided) doses (3 mg/kg/day for period of 5 days) as protocol 1 and single dose (7.5 mg/kg) as protocol 2. The measurements were performed by the end of the 4th week. CP increased the serum levels of blood urea nitrogen (BUN) and creatinine (Cr) in both OR and OV rats, which were related to the protocols of CP treatments. Es (not Ts) in protocol 2 attenuated the serum levels of BUN and Cr. Ts significantly increased body weight loss in protocol 1 compared with control group (P < 0.05). Es did not attenuate kidney tissue damage score (KTDS) in protocol 1 treated animal, but KTDS was decreased by Es in protocol 2 treated Rats. Hormone replacement therapy did not alter Cr clearance compared with control group. It seems that hormone therapy could not protect the kidney against CP induced nephrotoxicity.