The Cancer Institute (WIA - Womens' Indian Association), also known as the Adyar Cancer Institute, is a non-profit cancer treatment and research centre based in Chennai, Tamil Nadu. The Cancer Institute (WIA) was established in the year 1952 under the leadership of Dr. Muthulakshmi Reddy. In 1974, the institute became the Regional Cancer Centre and declared as a "Centre of Excellence" by the Ministry of Health and Family Welfare.
Abstract Objectives Smokeless tobacco (SLT) products are widely consumed in India, contributing significantly to the burden of oral cancer and systemic diseases. Despite their popularity, limited data exist on heavy metal contamination and associated health risks, particularly for filtered khaini, which is often perceived as safer than traditional khaini. Thus, the objectives of the study are to quantify heavy metal concentrations in khaini and filtered khaini and evaluate the associated non-carcinogenic and carcinogenic health risks. Study design Samples of filtered khaini (FK) and conventional khaini (K) were analysed for 20 heavy metals using inductively coupled plasma mass spectrometry (ICP-MS). Mean concentrations were compared using the Mann–Whitney U test. Estimated daily intake (EDI), hazard quotient (HQ), hazard index (HI), and target cancer risk (TCR) were calculated based on oral (buccal) exposure scenarios at absorption fractions of 6%, 20%, 25%, and 100%. Cancer slope factors (CSFs) were derived from U.S. EPA and WHO databases. Results FK contained significantly higher concentrations (p ≤ 0.05) of Pb, Cd, As, Cr, Ni, Co, Cu, Zn, Fe, Mn, Al, Ba, V, Se, U, and Be than khaini. Non-carcinogenic risk assessment at 25% absorption yielded an HI = 1.224 for FK and 0.592 for khaini, indicating potential chronic health effects for the former. The total target cancer risk at 6% absorption was 0.264 for FK and 0.147 for khaini, dominated by arsenic and cadmium contributions. Conclusion FK exhibits markedly higher heavy-metal contamination and health-risk indices than traditional khaini. Both products present lifetime cancer risks far exceeding acceptable limits (10⁻⁶–10⁻⁴), underscoring the need for regulatory surveillance and public-health intervention to mitigate oral and systemic toxicity from smokeless-tobacco use. Graphical Abstract
The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Cervical Cancer provide diagnostic workup, staging, and various treatment recommendations for cervical cancer based on clinical and surgical staging. This selection from the NCCN Guidelines for cervical cancer specifically focuses on diagnosis and workup, principles of staging and surgery, and primary treatment recommendations for early-stage and advanced disease and provides a detailed overview of systemic therapy recommendations for cervical cancer.
To assess the effectiveness and safety of cyclophosphamide and topotecan in children with relapsed or refractory extracranial solid tumors. This study included children with relapsed or refractory extracranial solid tumors treated with cyclophosphamide (250 mg/m2/day) and topotecan (0.75 mg/m2/day) for 5 days, 3-weekly, between January 2012 and February 2024. Event-free-survival (EFS) and overall survival (OS) were estimated using the Kaplan–Meier method. Eighteen patients with median (range) age 6 (2–13) years (72
