Purpose: Colorectal cancer is known as the most common gastrointestinal cancers. As the age increases, the risk for this cancer also increases, so the only way to improve and hope for life in these patients is early diagnosis of the disease. So far, numerous molecular studies have been carried out on microRNAs in colorectal cancer. In addition, since some of them can be identified as cancer biomarkers. Therefore, in this study we have investigated the expression level of Mir-30d and Mir-181a as cancer biomarkers. Method: The changes of Mir-30d and Mir-181a expression levels in 60 colorectal tumor tissues and 60 adjacent tumor tissues, after RNA extraction and cDNA synthesis were surveyed using the Real Time-PCR method. Results: The results have reported a considerable reduction in the expression level of Mir-30d in tumor tissues, as well as a significant increase in the expression level of Mir-181a tumor expression in tumor tissues (P<0.05). In addition, the correlation between Mir-30d and Mir181a showed that there was a significant difference between the level of expression of mir-30d with age and TNM stage of CRC (P<0.05), whilst these correlations were not observed for Mir-181a (P>0.05).
Cancer and Clinical Oncology wishes to acknowledge the following individuals for their assistance with peer review of manuscripts for this issue. Their help and contributions in maintaining the quality of the journal is greatly appreciated. Cancer and Clinical Oncology is recruiting reviewers for the journal. If you are interested in becoming a reviewer, we welcome you to join us. Please find the application form and details at http://www.ccsenet.org/reviewer and e-mail the completed application form to cco@ccsenet.org. Reviewers for Volume 8, Number 1 Aditya R Bele, University of Florida, USA Anand Kumar, Banaras Hindu University, India Behjatolah Monzavi-Karbassi, University of Arkansas for Medical Sciences, USA Hua Wang, Memorial Sloan Kettering Cancer Center, China Julita Kulbacka, Wroclaw Medical University, Poland Kartik Anand, Houston Methodist Cancer Center, USA Maral Mazloumi Tabrizi, Islamic Azad University, Iran Premila Leiphrakpam, University of Nebraska Medical Center, USA Vignesh Viswanathan, Stanford University, USA
Treatment of metastatic colorectal cancer (mCRC) is one of the most challenging and important problems in oncology at present moment. This article presents the interim results of treatment of patients with colorectal cancer, who were enrolled from 2016 till 2019 (n=60) with the use of maintenance metronomic chemotherapy. Metronomic regimen consisted of oral capecitabine 500 mg 3 times a day and oral cyclophosphane 50 mg daily. The control arm consisted of mCRC patients who received the same induction chemotherapy without maintenance from 2011 till 2015 (n=70). Median follow-up time was 18.5 months. Median progression-free survival (PFS) was 9.0 and 7.4 months in the maintenance and control arms respectively. Median overall survival (OS), counted from the beginning of induction chemotherapy, is currently 22.9 months in the maintenance arm, and 14.7 months in control. High expression levels of genes, encoding enzymes TS (thymidylate synthetase), DPD (dihydropyrimidine dehydrogenase) and receptor VEGFR1, low expression level of gene TP (thymidylate phosphorylase), as well as low levels of tumor markers CEA and СА 19-9 are the prognostic factors of sensitivity to metronomic chemotherapy given to colorectal cancer patients. Based on these data, we identified a group of patients who are recommended to use this method of treatment.
Pre- and perinatal loss and grief tend to be referred to as complicated grief denoting the experience of ongoing trauma. It is considered a burden for the affected parents, their families and the helping professionals alike. Yet this phenomenon remains an underrepresented field in analytical studies. Our aim is to systematically review the literature that deals with personal grief caused by pre- and perinatal loss - as experienced by healthcare staff. We shall present a comprehensive view of relevant international and national attitudes including existing grief management options. The above-mentioned complex issue deserves greater attention, which should result in the establishment of dynamic, up-to-date support programmes on all professional levels.
Treatment of recurrent glioblastoma multiforme (rGBM) poses a difficult challenge. Therefore, the purpose of this report was to evaluate objective response (OR), progression-free survival (PFS), overall survival (OS), and the incidence of adverse events (AEs) in rGBM patients, age 19-70 years, who were treated with antineoplaston AS2-1 (Astugenal) plus targeted therapy. A retrospective analysis was performed. Tumor response was assessed by gadolinium-enhanced magnetic resonance imaging (MRI). Twenty-nine adult rGBM patients were treated between 9/11/2015 and 06/23/2018. Seven had no prior treatment with bevacizumab elsewhere, had radiologic evidence of rGBM, and had MRI assessment of tumor response. The median treatment time was 101 days (range: 55-208 days). OR was seen in six patients (85.7%) with complete disappearance of gadolinium enhancement in four patients (57.1%) and a 50% or greater reduction in gadolinium enhancement in two patients (28.6%). Progressive disease was seen in one patient (14.3%). The median time to first response was 29 days (range: 22-96 days) while the median duration of response was 141 days (range 55-739+ days). Six- and 12-month PFS was 57% and 19%, respectively while 6- and 12-month OS at was 86% and 54%, respectively. Treatment was well-tolerated with no patients experiencing grade 3 or 4 antineoplaston-related toxicity. Regarding response to treatment and toxicity, AS2-1 plus targeted therapy compares favorably with other reported rGBM therapies. Duration of response was shortened by the ill-advised decision of some patients to discontinue treatment after a tumor response was achieved.
Purpose: With the extent of breast tissue manipulation using oncoplastic surgical techniques, there lies a challenge in marking the tumor bed for adjuvant radiation therapy planning. Two competing techniques in doing so exist and involve the traditional placement of surgical clips in the surgical tumor bed or the newer technique of placing a Biozorb marker in the tumor bed. Our goal was to perform a cost-utility assessment to see which tumor bed marking approach is more cost-effective. Based on device list prices and clinical outcomes from a comprehensive literature review, we assessed if an approach either dominated or had an incremental cost-utility ratio of less than $50,000/QALY since either would signify cost-effectiveness. Results: From a cost comparison, the Biozorb marker ($1250) was far costlier than the clip applier device ($50). Our PRISMA search (Figure 1) reviewed 133 articles for clip placement and 42 articles for Biozorb placement in oncoplastic surgery with 2 clip placement articles and 3 Biozorb articles meeting criteria. The available data for either marking technique suggests reasonable tumor bed identification for adjuvant radiation treatment without clear clinical advantages supporting one technique over the other. Overall clinical equivalence in the setting of a clear cost advantage suggests dominant cost-effectiveness in favor of clips. Conclusion: Using surgical clips to identify the tumor bed in oncoplastic surgery is dominant and more cost-effective over the Biozorb technique as clips are relatively inexpensive while both techniques reasonably identify the tumor bed.
Background/Aim: Anaplastic Lymphoma Kinase (ALK) rearrangement has evaluated activity of NSCLC compared with other molecular subtypes (EGFR, KRAS). Many studies demonstrated that patients with ALK rearrangement positive NSCLC have improved with a good response rates and progression (free survival) when treated with either monotherapy or by a combination therapy compared with EGFR-mutated, KRAS/EGFR/ALK wild type or KRAS-mutated. The aim of this study was to detect and study the signal pattern of normal ALK and compare it to that of mutated ALK with gene rearrangement in cases of non-small cell lung cancer and Inflammatory conditions by implementing the CISH technique. In addition to correlate ALK signal pattern with the histopathological type and grade as well as the age and sex of the patients.Materials & Methods: Forty patients with NSCLC and Inflammatory diseases were enrolled in a comparative cross sectional study. The tissue blocks were sectioned on non-charged slides for the preparation of routine H&E staining. Positively charged slides were used for tissue sections prepared for chromogenic in situ hybridization procedure to detect ALK gene.Results: ALK gene signal break apart was detected in (18/20, 90%) of malignant cases; (0/20, 0%) of non-neoplastic lung lesions. There was a significant statistical difference in their distribution, p < 0.05. While There was no significant association between any disease status and sex P value = 1.000NS. The CISH test was 100% sensitive using negative score as a cutoff point and 90.9% specific. The score was divided into three levels that categorized the cases, so there were six cases in score one (1-32%), nine cases in score two (33-67%) and three cases in score three (68-100%).Conclusion: Detection of ALK rearrangement in the early diagnosis of NSCLC is highly sensitive and can save a lot of efforts in planning chemotherapy regimens. Results were very promising in identifying this mutation by a sensitive and highly specific test. The ALK gene rearrangement could be an early mutation and it is needed as an initiating step for the carcinogenesis process. The presence of a double gene mutation, however, could be the cause of a higher-grade cancer.
Objective: To assess tolerance, local control, and survival outcomes for HIV (human immunodeficiency virus) positive patients with locally advanced cervical cancer (CC) treated with external beam radiation therapy (EBRT) and/or brachytherapy from an Assistance Publique - Hôpitaux de Paris (APHP) retrospective cohort.Methods: Between 2000 and 2014, 28 HIV positive patients presenting with a non-metastatic CC were treated in one of the five APHP radiation therapy centers. Fifteen patients (54%) underwent primary surgery. Twenty-four patients (88%) received EBRT, with concurrent chemotherapy in 22 cases, and 68% received brachytherapy.Results: The median follow-up was 58 months. At 5 years, local control (LCR) and overall survival rates (OS) were 56% and 46.5% respectively. A grade 3-4 acute toxicity (mainly hematological toxicity) was reported in 18 patients (64%). In univariate analysis, total irradiation dose (p=0.03) and cisplatin-based chemotherapy (p=0.005) were predictive of acute toxicity. A grade 3-4 late toxicity (mainly gastro-intestinal and renal) was observed in 7 patients (25%). In univariate analysis, HIV stage at diagnosis (p=0.02) and an initial CD4 count <200/mm3 (p=0.03) were predictive factors of late toxicity.Conclusion: In this study including HIV positive patients with CC, local control and overall survival rates seemed to be lower than those reported in the literature for non-HIV patients. We also reported an increase in acute and late toxicity, mainly hematological, underlying the fundamental role of immunosuppression in tolerance to radiation therapy.
Objectives To prospectively evaluate the accuracy in tumor extent and size assessment of Digital Breast Tomosynthesis (DBT) and Magnetic Resonance Imaging (MRI) in women with known breast cancer, with pathological size as the gold standard. Methods From May 2014 to April 2016, 50 patients with known breast cancer were enrolled in our prospective study. All patients underwent MRI on a 3T magnet and DBT projections. Two radiologists, with 15 and 7 years of experience in breast imaging respectively, evaluated in consensus each imaging set unaware of the final histological examination. MR and DBT sensitivity, PPV and accuracy were calculated, using histology as the gold standard. McNemar test was used to compare MR and DBT sensitivity. Correlation and regression analyses were used to evaluate MRI vs Histology, DBT vs Histology and MRI vs DBT lesions tumor size agreement to histological results. Results On histological examination 70 lesions were detected. MRI showed 100% sensitivity, 96% PPV and 96% accuracy; DBT sensitivity was 81%, PPV 92% and accuracy 77%. McNemar test p-value was 0.0003. Lesions size Pearson correlation coefficient was 0.97 for MRI vs Histology, 0.92 for DBT vs Histology, (p-value<0.0001). MRI vs DBT regression coefficient was 0.83. Conclusions MRI confirmed to be the most accurate imaging technique in preoperative staging of breast cancer. However, DBT showed very good accuracy, sensitivity and tumor size assessment and could be a valid tool for preoperative staging when MRI is contraindicated.
Cancer and Clinical Oncology wishes to acknowledge the following individuals for their assistance with peer review of manuscripts for this issue. Their help and contributions in maintaining the quality of the journal is greatly appreciated. Cancer and Clinical Oncology is recruiting reviewers for the journal. If you are interested in becoming a reviewer, we welcome you to join us. Please find the application form and details at http://www.ccsenet.org/reviewer and e-mail the completed application form to cco@ccsenet.org. Reviewers for Volume 7, Number 2 Aditya R Bele, University of Florida, USA Anand Kumar, Banaras Hindu University, India Chandra Sekhar Bathula, Washington State University, USA Dhaarini Murugan, Oregon Health and Science University, USA Hua Wang, Memorial Sloan Kettering Cancer Center, China Juan Luis Callejas Valera, UCSD/Moores Cancer Center, United States Kartik Anand, Houston Methodist Cancer Center, USA Kaushik Thakkar, Stanford University, USA Manal Mehibel, Stanford University, USA Mark G Trombetta, Drexel University College of Medicine, USA Mona Mostafa Mohamed, Cairo University, Egypt Rajesh Kumar, Cancer Center MGH/Harvard Medical School, USA Sunil Kumar, University of North Carolina at Chapel Hill, USA Wright Jacob, University of Glasgow, United Kingdom Xi Yang, Stanford University, USA
Background: Aberrant promoter methylation of CpG islands is an important mechanism for regulation of gene expression. Recent data suggest that epigenetic abnormalities may occur very early in lung carcinogenesis. Systemic methylation changes may be a diagnostic marker for tumor development or prognosis. In this study, the expression and methylation of KMT2D and IGF2 genes were investigated in the lung cancer tissue compared to the adjacent normal tissue.Methods: The status of methylation of KMT2D and IGF2 genes were investigated in 30 patients with NSCLC after genomic DNA extraction using bisulfite treatment and MS-HRM method and the expression of these genes were checked by Real-Time PCR method in same samples.Results: For KMT2D gene, the expression and methylation level increased in 46.6% and 6.67% (respectively) for tumor samples comparison with normal samples (P>0.05). Also, for IGF2 gene 50% tumor samples overexpressed and 50% tumor samples showed that reduced expression comparison with the normal samples (P>0.05). In addition, 96.66% of tumor tissues did not show any change in methylation level for IGF2 gene promoter (P>0.05).Conclusion: This study showed that expression and methylation level of KMT2D and IGF2 genes did not change in NSCLC tumor samples compared to normal samples. However, this study was designed as a pilot study, and further investigations are required to confirm our findings.
Malignant brain tumors are a heterogeneous group of diseases arising from different cell types that affect both adults and children. The high recurrence rate of malignant brain tumors typically is due to reappearance of focal masses, indicating that a sub population of tumor cells are insensitive to current therapies and may be responsible for reinitiating tumor growth. It is generally agreed that the resistant tumor cells are comprised of cancer stem cells or tumor-initiating cells. While brain tumor stem cells (BTSCs) were first isolated within the last decade, much of the early research has been focused on identifying the BTSC markers and therapeutic targets. The challenge however, is to translate this knowledge to therapeutics. In the current review, we survey the remedial strategies to target BTSCs, which includes diagnostic, pharmacologic, immunologic, viral, and post-transcriptional approaches.
Background: Lung cancer is the leading cause of cancer-related deaths worldwide and the 5-year survival rate is still very poor due to the lack of effective tools for early detection. Epigenetics and especially studies on DNA methylation have given important information towards a better achievement of lung cancer pathogenesis in the recent decades. The inactivation of tumor suppressor genes via promoter hypermethylation is an obvious mechanism and is straightly related to carcinogenesis. In this study, we compared the methylation status of KLF11 and PCDH9 genes in non-small cell lung cancer and adjacent normal tissues. Methods: Genomic DNA was extracted from 30 tumor tissues, bisulfite treated and were analyzed in terms of promoter methylation status of KLF11 and PCDH9 genes by high resolution melting method. Statistical analysis was carried out by chi-square test. Results: No significant difference in methylation level at the PCDH9 promoter region in NSCLC tumors compared with non-tumor tissues was observed (P = 0.3132, chi-square test). In contrast, the difference in methylation levels between normal and tumor tissue samples for the promoter of the KLF11 gene was quite significant (P = 0.0001). Conclusions: Promoter methylation of KLF11 gene is an important mechanism in the development of NSCLC, therefore, it could be used as one of the potential therapeutic goals for molecular targeted therapy and epigenetic treatment. The role of the PCDH9 gene in the development of lung cancer is complex and requires more research and a larger statistical population.
Cancer and Clinical Oncology wishes to acknowledge the following individuals for their assistance with peer review of manuscripts for this issue. Their help and contributions in maintaining the quality of the journal is greatly appreciated.Cancer and Clinical Oncology is recruiting reviewers for the journal. If you are interested in becoming a reviewer, we welcome you to join us. Please find the application form and details at http://www.ccsenet.org/reviewer and e-mail the completed application form to cco@ccsenet.org.Reviewers for Volume 7, Number 1Aditya R Bele, University of Florida, USAChandra Sekhar Bathula, Washington State University, USAChunbo He, University of Nebraska Medical Center, USADr. Donghui Zhou, Iupui, United StatesHemendra Mod, AARUNI HOSPITAL PVT LTD, IndiaProfessor Mark G Trombetta, Drexel University College of Medicine, United StatesKaushik Thakkar , Stanford University, USAManal Mehibel, Stanford University, USANishitha Reddy Thumallapally, Staten Island University Hospital, USASha Zhu, UMass Medical School, United StatesSourav Banerjee, University of California San Diego, USASunil Kumar, University of North Carolina at Chapel Hill, USASwapna Aravind Gudipaty, University of Utah, USA
Despite the advanced medical technology nowadays, breast cancer incidence rate is still increasing worldwide. This is due to females lack of knowledge and awareness about the breast screening. Therefore, the objective of this study is to explore the factors that influence females’ intention towards breast cancer early diagnosis with health belief model and provide practical recommendations. To evaluate the proposed hypotheses in this study, 600 self-administrated questionnaires were distributed to Malaysian female who is 18 years old and above with the usage of non-probable sampling approach (convenience sampling approach). Given that, the findings demonstrate perceived barriers has the greatest impact towards females’ breast cancer early diagnosis intention, followed by perceived severity and perceived susceptibility. The contribution of this study is to evaluate the relationships between perceived severity, perceived susceptibility and perceived barriers towards females’ breast screening intention with the mediating variable of attitude. To support this, health believe model and theory of planned behaviour are employed in this research.
Purpose: To evaluate the value of estrogen and progesterone receptors on core biopsy specimens of patients with ductal carcinoma in situ. Introduction: The immunohistochemical determination of the estrogen receptor (ER) and progesterone receptor (PR) status is predictive of the response of patients with invasive cancer to hormonal therapy. The value of the receptor status prior to definitive surgery with either breast conservation or mastectomy for patients with ductal carcinoma in situ (DCIS) and no invasive component is less clear. Methods: We identified through the tumor registry 344 patients with breast cancer diagnosed from 2014 through 2015. Two hundred seventy-seven patients had invasive cancer at diagnosis. Results: Of the remaining 67 patients with DCIS or atypical hyperplasia alone on core biopsy, 15 (22%) patients were found to have invasive cancer at the time of definitive surgery. Forty-six patients without an invasive component had definitive surgery at the study institution, of which three had a component of higher grade DCIS than on the core biopsy. Fourteen patients (30%) underwent a mastectomy. Conclusion: A significant proportion (29%) of patients with DCIS alone on core biopsy had either an invasive component at the time of definitive surgery or a higher grade DCIS component. An additional 14/46 (30%) of patients chose mastectomy, for whom consideration of adjuvant endocrine therapy for contralateral risk reduction did not depend on the receptor status of the index DCIS. Cost savings could be realized if the determination of ER is deferred until after definitive surgery. Determination of PR on DCIS specimens can be omitted entirely.
Aims: To identify and estimate salivary VEGF of breast cancer patients using non invasive method. Methods: ELISA, Zymography, Immunoblot. Results: We observed that saliva of breast cancer patients express appreciably high VEGF compare to non breast cancer saliva samples. Conclusion: The findings indicate salivary VEGF as a potential breast cancer marker using non invasive method.
Aim: The aim of this study is to explore the lived experiences of parents pertaining to how cancer in their family affected their lives. In particular the study detailed the participants’ challenges and the strategies they adopted in dealing with the challenges. Methodology: An exploratory phenomenology method was used to guide the study. The participants were selected from the Paediatric Oncology Clinic at The Wendy Fitzwilliam’s Paediatric Hospital. Triangulation of different strategies namely, a focus group interview and four key informant interviews were utilized to collect data from ten parents. The data was audiotaped, transcribed and organized into codes and themes. Results: In the main, findings revealed three main themes: reliance on spirituality to cope, psychosocial challenges, and social support system. This study revealed that the lived experiences of parents who care for their children diagnosed with Cancer, are like a never-ending struggle. Discussion: Regardless of the substantial progress in the treatment of Cancer, childhood Cancer is still emotionally, physically, and psychologically challenging for parents and nurses. This was discussed vis a vis literature. Recommendation: The themes highlighted offer opportunities for additional qualitative and quantitative research in the field of oncology and its impact on Trinidadian parents and the Trinidad family system and dynamics. However, further research is needed from the nursing perspective to focus on paediatric oncology.
Hypoxanthine Guanine Phosphoribosyltransferase (HPRT) is a housekeeping enzyme involved in the purine synthesis of guanine and inosine in the salvage pathway. While other salvage pathway enzymes, such as TK1, have been established as biomarkers for both cancer cell proliferation and cancer development, little research been done to evaluate whether HPRT has the same potential as a cancer biomarker. We designed this study to determine if HPRT has value as an identifier of malignancy within the most common types of cancer. We utilized histological samples from lung, colon, prostate, and breast cancer with additional normal tissue to evaluate whether there was any elevation of HPRT within malignant samples. In addition, we also assessed general HPRT expression within patient’s samples from The Cancer Genome Atlas (TCGA) to confirm clinical relevance. We found that within a subset of patients, there was significant elevation of HPRT when compared to normal tissue controls. This elevation was seen in 33-55% of the malignant samples and appears to have no dependence on cancer stage. There were slight differences in staining patterns among all the organ types, but overall each organ displayed the same pattern of ‘HPRT high’ and ‘HPRT low’ populations within malignant samples. We found that in our TCGA samples, there was a similar elevation of HPRT that was significant when compared to normal controls. Overall, as an upregulated enzyme that does not directly correlate with stage, HPRT could become a valuable marker in the early diagnosis of a variety of solid tumors.
Objective: Many patients describe travel to cancer treatment as inconvenient and a practical hardship and it may be perceived or experienced as a barrier to treatment. We investigated which impact cancer treatments has on the family of the patients, especially for the most frequent cancer type prostate, breast, colon and lung cancer.The aim was to identify groups of patients with an increased burden for the family.Method: All patients coming in February 2012 for chemotherapy to one of the four centres of the hospital or to the unique private practice were asked to answer a survey. The questionnaire covered items as gender, date of birth, living place, kind of cancer, kind of treatment and questions covering different aspects of the travel: how the patient travelled to the centre, how long the travel lasted, which kind of support was necessary to travel and who provided this support, whether the accompanying person had to absent herself from her workplace, whether the patient lives alone or not and how many journeys to health care providers the patients had in the last month were included in the analysisResults: 298 patients answered to all required questions (73%). 186 came accompanied, a vast majority by a member of the family and one out of four of the accompanying person had to leave the workplace. Help at home is almost exclusively provided by family members. Patients have several journeys to health care providers per month.Conclusions: The type of cancer has an impact on the support needed and must added to the previously published factors as age, gender and distance. The journey to the cancer treatment is not the unique journey to health care providers the patients have and increase the burden for the patient and the family.
