International Journal of Cancer Management
Volume:14 Issue: 2, Feb 2021

Although conventional therapies improve the conditions of patients with cancer, adverse side effects, and resistance to different therapies have convinced scientists to use alternative methods to overcome these problems. One of the most promising research directions is the application of specific types of bacteria and their components to prevent and treat different cancers. Apart from the ability of bacteria to modulate immune responses, various particular properties such as toxin production and anaerobic lifestyle, have made them one of the potential candidates to help cancer therapy.

In this review, the latest information on the role of bacteria in carcinogenesis and cancer prevention in PubMed, Google scholar, and Science Direct databases in 2020 were considered using a combination of keywords “bacteria”, “carcinogenesis”, “cancer” and “prevention”.

Bacteria-cancer interactions can be studied in 2 areas of bacteria and carcinogenesis and the other bacteria and cancer treatment or prevention. In this review, bacterial carcinogenicity has been mentioned with 3 main mechanisms: bacterial toxin, bacterial metabolites, and chronic inflammation caused by bacteria. Bacterial-mediated tumor therapy (BMTT) is briefly discussed in 8 mechanisms including tumor-targeting bacterial therapy, gene therapy and vectors, bacterial products, arginine metabolism, magnetotactic bacteria, combination bacteriolytic therapy (COBALT), immunomodulation of bacteria in cancer, and immune survival.

The importance of bacteria in terms of diversity in their interaction with humans, as well as their components that can affect homeostasis and the immune system, has made them a powerful factor in describing the human condition in health and disease. These important elements can be used in the prevention and treatment of many complex diseases with different origins like cancer. The present study can provide an overview of the role of bacteria in cancer development or prevention and potential approaches for bacteria in cancer therapy

Systematic application of a cervical cancer screening program reduces the socioeconomic burden of the disease. Evaluation of screening programs using performance indicator sets and applying cultural, economic, and social considerations minimize the negative impacts of screening and maximize its benefits.

The present study aimed at developing and evaluating performance indicators of a cervical cancer screening program based on the guidelines of Iran Ministry of Health and Medical Education to identify shortcomings and improve national programs.

A total of 839 out of 2504 care checklists for middle-aged women in Rasht, Iran, from 2014 to 2018 were studied. Indicators were evaluated based on the guidelines of Iran Ministry of Health and Medical Education on care for middle-aged individuals in 6 areas of screening intensity, screening the program performance, the participation of individuals, compliance of the implementation with guidelines, etc.

The eligible women coverage index was 34%. The index of participation in the first run Pap test was 45.53% in 2014. The study findings showed that with the implementation of the plan on participants, the test rate increased by 39.1%. The indices of identification of high-risk individuals based on medical histories, identification of abnormal Pap smears, and participation continuity in the program were 54.84, 33.73%, respectively and 1.32% in 2015, which decreased to < 1% in 2016. The compliance rate with the guidelines was 64.94%, and the performance recording index was 22.40%.

Due to the low coverage rate and other performance indicators, especially the low continuity index, the attention of policy-makers and program managers should be drawn to potential shortcomings of screening programs, such as active implementation, in order to promote women’s health status.

In recent years, several studies have shown the association between exercise and decreased risk of mortality in patients with breast cancer. However, the effects of combined resistance and endurance training on salivary Interleukin-12 (IL-12), tumor necrosis factor (TNF-α), Cortisol, and Testosterone levels in patients with breast cancer have not been investigated.

This study aimed at determining the effect of 8 weeks of combined resistance and endurance training on salivary IL-12, TNF-α, Cortisol, and Testosterone levels in women with breast cancer.

Forty-two postmenopausal women with breast cancer were randomly selected and divided into training (intervention) and control groups. The training group performed resistance training with 2 to 3 sets, 10 to 18 repetitions, 50 to 70% 1 repetition maximum (1RM), and aerobic exercise with 50 to 70% maximum heart rate (maxHR) (12-14 degrees borg scale) for 20 to 40 minutes for 8 weeks. The salivary IL-12, TNF-α, cortisol, and testosterone levels were measured, using the enzyme-linked immunosorbent assay (ELISA) method. Two-way analysis of variance repeated measure was also used to analyze variance with the confidence interval of 95%.

In the training group, there was a significant decrease in salivary TNF-α levels, cortisol, TNF-α/IL-12 ratio, and variables of weight, fat percentage, body mass index (BMI), and waist circumference (P < 0.05). Also, the results showed a significant increase in salivary testosterone and testosterone/cortisol ratio in the intervention group (P < 0.05). However, no significant changes were observed in the interaction between-group and time in IL-12 and waist–hip ratio (WHR) values (P > 0.05).

The results indicate that resistance and endurance training could be used as a useful method to improve salivary pro-inflammatory factors and hormonal levels in patients with breast cancer. Medical oncologists can underline a resistance and endurance training program for patients with breast cancer under their care.

Testis-specific protein on Y chromosome (TSPY) is the output of a tandem gene cluster. TSPY expression has been observed in gonadoblastoma and numerous distinct kinds of germ cell tumors, such as carcinoma in situ/intratubular germ cell neoplasia, seminoma, and extragonadal intracranial germ cell tumors (GCT). Myrtus communis extract rich inα-pinene showed high antioxidant and anticancer activity against a TSPY.

The molecular weight and theoretical isoelectric of the TSPY proteins were calculated, using the ExPASSY ProtParam tools. Some software like mega 6, BioEdit, NEB cutter (New England Biolabs), and CAP3 were used to analyze clustering and find restriction enzymes on the TSPY sequence. To evaluate the nucleotide diversity of all sequences, the number of diverse situations and Tajima’s and Watterson’s estimators of theta were assessed. Nucleotide polymorphism can be measured by several parameters, such as haplotypes diversity, nucleotide diversity, Theta using Dnasp software. To find interaction networks of protein-protein search tool for the retrieval of interacting genes/proteins (STRING) tools and to predict 3D structure, SWISS-MODEL was used; however, for docking protein-peptide based on interaction, Swiss Dock, Galaxy web, and CABS-dock software were employed.

We report a high (0.91) dN/dS index, positive Tajima’s D, Fu, and Li’s tests, and a non-significant D test suggesting the occurrence of old modifications or a decrease of newborn mutations in the TSPY gene family. Interestingly, several hub proteins produced a strong chain or an operative module within their protein groups, such as nucleosome assembly protein (1NAP1L), RBMXL2, TBL1Y, and AMELY, which are all associated with the same cellular appliance elements and/or genetic uses. The docking of the TSPY target with α-pinene using docking revealed that the computationally-prognosticated lowest energy networks of TSPY are established by intermolecular hydrogen bonds and stacking interactions.

The results of this study demonstrated that α-pinene interacts with the TSPY protein target and could be developed as a promising candidate for the new anticancer agent.

The conservative character of the cell cycle outlined that any dysregulation in the regulatory components of this process in normal cells opens a gate toward neoplastic transformation.

Given the critical role of cyclin-dependent kinases (CDKs) in cancer pathogenesis and based on their frequent aberrancy in human leukemia, the present study aimed at evaluating the suppressive effect of a multi-CDK inhibitor AT7519 on acute myeloid leukemia-derived U937 cells.

To assess the anti-leukemic effects of the inhibitor on acute myeloid leukemia (AML) cells, we used MTT and trypan blue assays. Flow cytometric analysis and q-RT-PCR were also applied to evaluate the impact of AT7519 on cell cycle and apoptosis.

The results suggested that suppression of CDK in U937 cells hampered the proliferation of leukemic cells through a G2/M arrest mediated by p21 gene. Additionally, the anti-survival impact of AT7519 on these cells was shown to be along with the apoptosis initiation not only through the increment of pro-apoptotic gene expression but also through diminishing the mRNA levels of both Pin1 and Survivin. Notably, the potent anti-leukemic property of this agent has become more prominent when we found that the blockage of CDKs in AML cells could synergize with the cytotoxic effect of vincristine (VCR). To the best of our knowledge, little is known about the molecular mechanisms of resistance to AT7519 and we proposed that the effectiveness of this agent was partially attenuated through either c-Myc or autophagy activation in U937 cells.

This study suggests that the pharmacological targeting of CDKs could probably unwind the complexity of therapeutic obstacles on the way of acute leukemia, either in the context of mono- or combined-modal strategy.

Fibroblast growth factor 9 (FGF9) or Glia activating factor (GAF) is categorized in the paracrine class of the FGF family, which is involved in various cancer development and progressions. Interestingly, the invasion role of FGF9 in colorectal cancer (CRC) was not clarified up to now.

In the present investigation, the lymphatic and vascular invasion characteristic of FGF9 was figured out in fresh frozen (FF) tissue samples and paired Formalin-fixed, paraffin-embedded (FFPE) tissues.

The present invasion study according to FGF9 expression evaluation was performed on 80 cancerous resected fresh tissues and 40 paired paraffined block specimens parallel with 80 adjacent non-tumoral tissue samples. RNA extraction and cDNA synthesis were performed; qRT-PCR at mRNA level was applied. FGF9 expression correlation with clinical parameters was defined by the MannWhitney U-test. ROC curve and Kaplan-Meier analyses were designed to show the value of prognostic biomarker of FGF9.

Accordingly, 52% of fresh tissue samples and 51% of FFPE specimens were upregulated in comparison with corresponding normal tissues. A significant correlation was seen between FGF9 expression level and tumor stage (P < 0.0017, P < 0.03), lymph node metastasis (P < 0.001, P < 0.047), and vascular invasion (P < 0.004, P < 0.047) in fresh tissue samples and paraffined blocks, respectively. ROC was created to distinguish stage I and II from III and IV in FF and FFPE samples, respectively (P < 0.002, P < 0.031). Likewise, the AUC evaluation in both fresh and paraffined samples was similar. The overall survival was lower in 3 years of follow-up in patients with CRC with overexpression of FGF9 (P < 0.02).

Altogether, it can be deduced that lymphatic and vascular invasion correlated with FGF9 upregulation since FGF9 can be used as an effective prognostic biomarker according to pathologic results even in paraffined block samples or FF tissue specimens in CRC.

One of the most important alterations in breast cancer treatment is the change of view in axillary lymph node management. At the moment, sentinel lymph node biopsy (SLNB) is the standard care in axillary lymph node management. However, in patients with clinically positive lymph nodes or in patients, who have no willingness to receive radioactive drugs, axillary lymph node dissection (ALND) must be done. To the best of our knowledge, there is no overall survival (OS) benefit in ALND, especially at the early stage of breast cancer, during which this procedure is not justified.

Herein, we have reported the results of 27 years of experiments in limited axillary lymph node dissection (LALND) in comparison to ALND as well as the relationship among the number of removed lymph nodes, OS, and disease-free survival (DFS) at the early stage of breast cancer.

OS and DFS for 588 cases, who were at the early stage of breast cancer and treated by LALND between 1984 and 2019, were compared with 1026 patients, who were treated by ALND during the same interval in this study. Notably, SLNB cases were excluded.

The results revealed no significant difference among the groups in terms of DFS (P = 0.268, 0.123, and 0.333). Also, there was no difference in terms of OS between the LALND group (1 - 4 nodes, 5 - 6 nodes, and 7 - 8 nodes) and ALND group (≥ 9 nodes) in patients without lymph node involvement (AHR less than 2). However, in the patients with axillary lymph node metastasis (N1, N2), similar results were obtained. Correspondingly, in this group, the best results were observed in those patients, whose 7 - 8 lymph nodes were removed.

Regarding the results of the current study; it can be concluded that performing the LALND in the defined anatomic range and removing 7 - 8 lymph nodes instead of removing 10 lymph nodes are not inferior when it is not possible to do SLNB (there is no access to it) and/or being a contraindication to do it for evaluating the status of axillary lymph nodes in the patients at the early stage of breast cancer.

Reconstruction of the surgically created defects in the head and neck regions is a crucial step in the patients’ treatment plan. Regarding the involved tissues, various flaps and grafts have been introduced in the literature. The pectoralis major myocutaneous flap (PMMF) is one of the most versatile flaps with many variations for providing more advantages. Also, when bone tissue is needed, it can be reconstructed via an osteomyocutaneous flap including rib, sternum, or clavicle.

In this article, a case of oral squamous cell carcinoma with the extension to facial structures and, then, reconstructed with PMMF was presented, in which a medial half of clavicle bone was resected and employed as a free bone graft.

Sectioning clavicle not only increases the arc of rotation and mobility of the PMMF but also provides a new source of bone graft in the vicinity. Besides, the survival of the graft and integration with the native bone is noteworthy