Basic and Clinical Cancer Research
Volume:9 Issue: 3, Summer 2017

During the natural disasters, like flood and earthquake the main attentions are generally devoted to provide essential lifesaving services and support to affected people. Hospitals are usually occupied with the casualties who need urgent care after each massive disaster.
Although cancer patients, as well as all other patient with a chronic disease, needs their regular care, they may face specific challenges to visit hospitals, and clinics and receive standard of care according to the planned schedules. For instance, clinicians and nurses who are living in the city with their family may leave the hospitals, and even the city to protect themselves and their families. Therefore, the hospital will not function as routine. On the other hands, the patients may lose their relative and properties and faces challenges to commute to the hospital for the scheduled visits, treatment. Patients will prioritize other issues in the field and postpone their treatment and care.
Being shocked by the news of Kermanshah earthquake, we had the sympathy about people who were suffering from the disaster and losing their homes, families, and etc. while we were thinking about the specific sufferings that the cancer patients may face during such a devastating event, we contacted a few cancer specialists and discussed their viewpoints and experience during the earthquake and came up with important insights about the situation of cancer patients living in the earthquake region. Dr Arash Golpazir, a cancer surgeon working in Kermanshah provinces stated that “ we continued our routine clinical practice without any pauses”. We also heard similar response by Dr Mazaher Ramazani, a senior pathologists who stated that “ we worked with full capacity in the lab and had no disturbances”. However, Dr Mehrdad Payandeh, the senior oncologist had different experience and emphasized that “ we had a higher workload during the first days, but with a harder works by personnel, we managed the situation and retuned to our routines and soon everything became stable”. He also stated that ”some of our patients who were scheduled to be visited for their chemotherapy could not reach the clinics as planned. This was due to the fact that they lost their property and relatives who supported them to attend the clinics during their treatment. As the same time they had to look for a place to stay with their families, leading to ignore their treatment plan and prioritize other lifesaving issues”. He believed that “hospital should be prepared for these situation and follow-up the patients and try to assist them with special supports that was not defined previously”. In general “health care system should be more prepared for these situations and prioritize the patient needs in collaboration with the other working service providers” he added. We share the same opinion and believe that such supports will not be available, unless hospitals and supporting agencies be prepared for situation.
Unfortunately, there is no data about the extent of the problem and sufferings cancer patients faced during the earthquake. In addition, the priorities and action plans were not set for such special situation, which seems to be an important priority in Iran, that is located in the earthquake faultlines and has experienced several earthquakes during the last decade.
We suggest collecting more evidences about problems and shortcoming of cancer care in Kermanshah earthquake and use them for advocacy and preparing a plan for cancer care during the natural disaster. All stakeholders, including governments and non-governmental agencies should join this discussion and find their important role during the natural disasters.

Burden of cancer is increasing worldwide, especially in the low and middle income countries (LMICs), including Iran. Several reports have been published about cancer statistics in Iran, although they had shortcomings and provided variable results. We reported the most valid cancer statistics about Iran.
We used Globocan database and reported age standardize incidence rate (ASR), mortality rate (ASMR), and five-year prevalence of cancer in Iran in 2012, and compared it with the results of 2008. We also provided the projection of cancer incidence for 2035 and estimated the life time cancer risks by age 75.
ASRs per 100,000 were 134.7 for men and 120.1 for women. The most common cancers were breast (ASR 28.1), colorectal (ASR 10.5), stomach (ASR 9.7) cancers in women and stomach (ASR 20.6), bladder (ASR 13.2), prostate (ASR 12.6) cancers in men. The ASR was about 19% higher in 2012 (127.7/100,000) compared to 2008 (107.3/100,000). ASR of all cancer sites will increase about 2.17 times by 2035. ASMR was about 20% higher in men (90.4/100,000) than women (72.7/100,000) in 2012. The highest ASMRs was observed for breast cancer (9.9/100,000) in women and stomach cancer (17.3/100,000) in men. Five-year prevalence of all cancers was 79,194 for men and 90,521 for women in 2012. Lifetime risk of occurrence of all types of cancer was 25%. In other words, 1 in 4 Iranian people will be diagnosed with cancer before the age of 75 years.
Stomach and breast cancers were the most common cancers in Iranian men and women, respectively. Iran and other LMICs will experience major increase in the incidence and mortality of cancer in the next decades. They need to collocate further resources for cancer surveillance system and monitor the cancer statistics for evidence based cancer control program.

Hypoxia is a common phenomenon in cancer cells, related to angiogenesis and cell proliferation the hypoxia-inducible factor family (HIFs) is the primary transcriptional factor to hypoxic stress. Cancer-testis (CT) antigens are almost expressed in male germ cells, aberrantly expresses in some malignancies as well. The CT gene, TSGA10, prevents the nuclear accumulation of HIF-α and may be involved in organ-specific regulation of hypoxic gene expression during sperm maturation. TSGA10 is supposed to regulate the HIF expression in germ cells and cancer cells. The HIF-α subunit has three isoforms, involved in oxygen transport, angiogenesis and tumor metastasis, which their detection is the subject of the current study.
Three cell lines, MCF7, MDA-MB-231 and HeLa were cultured, passaged and categorized into normal and synchronized groups. The cells were subjected to RNA extraction and reverse-transcribed into cDNAs. Real time RT-PCR was performed to amplify TSGA10 and HIF-α isoforms and HPRT, as the normalizer gene, using appropriate primers. The REST and SPSS software were used for statistical analysis.
The expression of three isoforms of HIF-α in HeLa cell line was higher than MCF7, and MCF7 was higher than MDA-MB-231. Moreover, the expression relationship between HIF-α isoforms and TSGA10 was evaluated in each three cell lines as well. The results were significant in all cases with P =0.01. Before and after synchronization in each three cell lines, the isoform expressions of HIF-α and TASGA10 were evaluated, and the results were revealed their dependent expression. The relationship between HIF-α isoforms and TSGA10 expression was compared with each other. The cell lines with less TSGA10 expression had the higher expression of HIF-α isoforms and vice versa, according to the extent of TSGA10.
The significant relationship between expressions of TSGA10 and HIF-α isoforms is confirmed.

The authors selected European Organization for Research and Treatment (EORTC) C30 and EORTC QLQ CR29 to specify bowel, bladder, and sexual dysfunction of Iranian colorectal cancer patients.
A sample of 100 patients with colorectal cancer attending Iran Cancer Institute from March 2012 to March 2013 at first-line chemotherapy in the adjuvant or palliative settings participated in the study. Patients responded to the study questionnaires at the beginning and after 3-4 cycles of chemotherapies. Responses to the core questionnaire (QLQ-C30) and the QLQ-CR29 were linearly converted into 0-100 scores, using the EORTC guidelines. Correlations between the QLQ-C30 and QLQ-CR29 were examined, using Pearson’s product moment correlation in order to assess construct validity. Known groups’ comparon examined the ability of EORCT-CR29 to dtinguh between subgroups of patients with and without a stoma. Sensitivity to changes over time was examined by the response to chemotherapy in palliative or neoadjuvant settings. Internal constency was measured using Cronbach’s alpha coefficient with estimates of a magnitude of 0.7.
The mean age of patients was 53.6. Based on clinical and pathologic staging, 60% of the patients had presented while their cancer was in stage IV with dtant metastas at the time of referring to the clinic. Thirty-three percent of patients, almost all from rectal tumor group, had a permanent ostomy. In general, the correlation between the EORTC QLQ-C30 and QLQ-CR29 was in the expected directions, demonstrating that functional scales of both questionnaires had a positive correlation with each other while negative correlation was observed between functional and symptom subscales. In addition, the QLQ-CR29 differed considerably between patients with and without a stoma.The QLQ-CR29 results showed improved functioning scores after treatment and at the same time symptoms decreased. The Cronbach’s alpha for the scales ranged from 0.48-0.77.
In general, the Iranian version of the EORTC QLQ-CR29 worked well and now could be used in outcome studies in colorectal cancer.

Invasive papillary carcinoma of the breast is a rare form of breast cancer with the prevalence of about 0.5 to 2% of all diagnosed invasive breast tumors. This study aimed to report the first case of microinvasive papillary carcinoma with mucinous differentiation and ductal carcinoma in situ component. A 35-year-old woman had a history of left breast mass without pain, discharge or weight loss. Fine needle aspiration noticed papillary carcinoma. Frozen section diagnosis was invasive carcinoma with papillary feature and free marked margin. Permanent diagnosis on May 4,2017 showed microinvasive papillary carcinoma with ductal carcinoma in situ, high grade and mucinous carcinoma. The tumor didnt have frank invasion and metastasis. In conclusion, microinvasive papillary carcinoma is a tumor with minimal invasion and low axillary lymph node metastasis that can combine to mucinous differentiation and/or ductal carcinoma in situ component.