International Journal of Cancer Management
Volume:8 Issue: 1, Feb 2015

Pain has been one of the most debilitating symptoms of cancer. The aim of this study was to evaluate residents'' knowledge, attitude, and practice regarding pain control in cancer patients. In a descriptive study, 69 randomly selected third-year various residents practicing in teaching hospitals of Shahid Beheshti School of medicine participated in this study. They have provided their demographic characteristics and completed a questionnaire, based on their “knowledge”, “attitude” and “practice” regarding cancer pain and its management. Data analysis has performed using SPSS v.19. A p value of less than 0.05 has considered as significant. Obtained Data from 69 participants including 32 anesthesiology residents has included to our study. The average scores were 35.8±6.1 (ranging from 20 to 49) for the residents'' attitude, 25.1±9.1 (ranging from 0 to 53) for their knowledge and 11.2±4.1 (ranging from 0 to 17) for their practice. The overall scores of the questions have related to attitude and knowledge were higher for residents of anesthesiology but the difference was not statistically significant (A: 37.1±4.9 vs. 34.7±6.8, p=0.106, K: 27.2±11.8 vs. 23.3±5.6, p=0.076). The average score for questions on physician'' practice was significantly higher in residents of anesthesiology (P: 12.8±3.2 vs. 9.7±4.2, p=0.001). In order to provide patients with adequate pain relief, it has seemed advisable for medical schools to focus on improving the educational curriculum and integrating it into clinical practice.

Hereditary non-polyposis colorectal cancer (HNPCC) is a common hereditary cancer predisposing syndrome has molecular and clinicopathological features still have remained ambiguous within Iranian populations. We discuss in this article some molecular and clinicopathological features of the condition. The study was a descriptive retrospective and designed on 1659 colorectal cancer (CRC) patients were screened based on early-onset disease and Amsterdam II criteria during 14 years (2000-2013). Immunohistochemistry (IHC) staining was set up to detect expression of mismatch repair (MMR) genes on paraffin-embedded tissue sections of 31 HNPCC-CRC tumors. SPSS 19 software was used to analyze the data. IHC-MMR staining was absent in 7/31 individuals (22.6%) of which 4 cases showed IHC-Absent (IHC-A) in both MSH2 and MSH6 (57.1%), in 2 cases both MLH1 and PMS2 had negative staining (28.6%), and just in one case, MSH6 was defective (14.3%). The frequency of CRC among IHC-A and IHC-Present (IHC-P) families was 67.5% and 27.9%, respectively. Also the most frequent extracolonic cancers in IHC-A group were: stomach (10%), small bowel (5%), and prostate (5%); and in IHC-P group: stomach (18.4%), lung (10.9%), and breast (7.5%). Average age of IHC-A individuals at diagnosis was 38.0 versus 45.3 years in IHC-P individuals. Overall, 20.8% and 57.1% of our index CRCs were localized proximal to the splenic flexure in IHC-P and IHC-A groups, respectively. Given the lack of enough information about molecular aspects of hereditary cancer syndromes like HNPCC in Iran, more evaluations are necessary on larger samples using complementary techniques such as MSI-testing and mutation analyses.

Cervical cancer has been shown to be highly associated with human papillomavirus (HPV) infection. The viral oncogenes E6 and E7 are constantly expressed by the tumor cells and are therefore potent targets for therapeutic genetic vaccination. In the present study, it was investigated the potential effect of HPV-16 E6, E7 and L1 co-administration to activate specific cytotoxic T lymphocytes in tumor mice models. The HPV-16 E6, E7 and L1 genes from Iranian isolate were separately inserted into the mammalian expression vector, pcDNA3, to construct the DNA vaccine candidates. Tumor-bearing Animals (C57BL/6 mice) were immunized with the vaccine candidate; then, Lymphocyte Proliferation Assay (LPA) and relative tumor volume measurements were carried out in order to examine the immunological effects of the vaccine. Obtained results showed that co-administration of the HPV-16 E6, E7 and L1 DNA induced HPV-16 specific cellular immune responses and also protected against TC-1-induced tumor in vivo compared with negative controls. The results showed that mixed delivery systems might be valuable to improve the magnitude of the induced immune responses and confirmed therapeutic effects of HPV-16 E6, E7 through cytotoxic T lymphocyte induction and illustrate the new promising role for HPV-16 L1 CTL epitopes as a suitable CTL inducer.

Nasopharyngeal carcinoma (NPC) is known as a highly distinct kind of head and neck cancer. This distinction is due to its clinical presentation, epidemiology, outcome, and treatment. There have not been any reports of epidemiological analysis of NPC in Iran. The aim of this study is to evaluate the incidence rates and trends of nasopharyngeal carcinoma in the Iranian population during 2004 to 2009. The data were collected from the Iranian national cancer data system registry. All the cases of nasopharyngeal carcinoma (with the topography code 11 and histology of carcinoma) were retrieved and analyzed from an overall cancer database during a 6-year period. The data were analyzed using SPSS, version 16. To determine the current incidence of NPC in Iran, we examined the NPC cases from 2004 to2009. A total of 1431 cases (981 male and 450 female NPC patients) were analyzed epidemiologically in this study. The mean age of the patients was 47.1 years. The incidence was 0.33 per 100000 persons. The overall incidence rate had increased annually (P <0.05). The incidence of NPC gradually increased with age. Prefectures bordering the Caspian Sea proved to have a higher incidence than the other studied areas. Our study indicated an increasing trend in the incidence of nasopharyngeal carcinoma. Therefore; attempts should be precipitated for prevention.

Surgery is usually the first treatment for breast cancer which is followed by some complications such as chronic pain. Post mastectomy pain syndrome (PMPS) is a common complication among breast cancer survivors and is considered as a chronic neuropathic pain in the side of surgery which persists more than three months. The exact mechanisms and related risk factors of the chronic pain after breast surgery are unknown. The aim of this study was to investigate the association of body mass index (BMI) and age with PMPS. In this case-control study, a total of 122 women were assessed; of these, 61 women were diagnosed with PMPS and selected as cases and 61 pain-free patients were selected as controls. The demographic and clinical characteristics of participants were collected through questionnaires and medical record of patients. Logistic regression model was used to determine the association of BMI and age with PMPS, adjusted for demographic and clinical characteristics. No significant differences were found in means of weight (68.02±8.80 vs. 68.67±11.82, p=0.726), BMI (26.38±3.28 vs. 27.10±6.03, p=0.410), and age (46.34±11.67 vs. 48.54±12.57, p=0.319) between those with PMPS and those not reporting PMPS. A non-significant slight increase in odds ratio of PMPS was observed in obese category compared to normal weight category [OR=1.152 (95% CI 0.405-3.275), p=0.908], but after adjusting the confounding factors, the risk of pain development was attenuated in obese subjects [OR=0.748 (95% CI 0.228-2.459), p=0.633]. Also, non-significant decrease in odds ratios of PMPS was found in 20-39 y, 40-49 y, and 50-59 y ages categories compared to oldest age category [adjusted OR= 0.781 (95% CI 0.213-2.866), p=0.576; adjusted OR=0.485 (95% CI 0.152- 1.554), p=0.183; adjusted OR=0.735 (95% CI 0.206-2.627), p=0.628; respectively]. In contrast with some observational studies, present study showed that high BMI and younger age might not be associated with increased risk of PMPS development. Further research is necessary to determine the main risk factors and directionality and causal mechanisms for associations of these risk factors with chronic pain after mastectomy.

Cancer has been known as a class of dangerous diseases which cause tremendous physical and emotional problems to both patients and their families. In spite of medical advances, cancer is still considered to be equal with death and pain. This study aims to analyze the emotional distress and the causes in breast cancer patients. This study was a quantitative study which tries to analyze the emotional distress in 82 breast cancer patients referred to the Radiotherapy and Oncology Department of Razi Hospital in Rasht, northern Iran. In this study, the emotional distress is analyzed based on a standard questionnaire which contains demographic information, distress thermometer, and a section devoted to the probable causes. Among the 82 patients that participated in this study, 32 patients (39%) suffered from severe emotional distress which had a statistically significant relationship (p<0.009) with the functional status of the patients. Taking care of children, fear, anxiety, difficulties of taking bath and wearing clothes, family problems, fever and nasal dryness are the most common issued related to emotional distress. Emotional distress can affect the quality of life of breast cancer patients. Therefore, oncology specialists should utilize mental health services to improve their patients’ mental health as well as to control the consequences of the disease.

B-cell non-Hodgkin’s lymphoma (NHL) is a common malignancy of lymphoid tissues. Different types of NHL show various behaviors, prognoses, and responses to treatment. Evaluation of disease activity in NHL can be helpful in managing and even increasing the patient’s survey.Methods and In total, 121 patients (76 males and 45 females), and their age range were 18-53 years, were evaluated in this study. The mean level of serum carbohydrate antigen 125 (CA-125) was 89.3±18.5 u/ml, ranging from 27 to 135 u/ml. There were significant differences in International Prognostic Index (IPI) score (p=0.002), stage of the disease (p=0.006), mortality rate (p=0.02), and relapse rate (p=0.04) between patients with serum CA-125 level <35 u/ml and patients with CA-125 level >35 u/ml. CA-125 seems to be a useful and reliable tumor marker for monitoring a patient with NHL. It might be the time to consider CA-125 in staging, prognostic scoring, or decision making about NHL treatment.

Radiotherapy plays an important role in the management of most malignant and many benign primary central nervous system (CNS) tumors. Radiotherapy affects both tumor cells and uninvolved normal cells; so, it is important to estimate absorbed dose to organs at risk in this kind of treatment. The aim of this study was to determine the absorbed dose to chiasma, lens, optic nerve, retina, parotid, thyroid and submandibular gland in frontal lobe brain tumors radiotherapy based on treatment planning system (TPS) calculation and direct measurement on the phantom. A head and neck phantom was constructed using natural human bone and combination of paraffin wax and Sodium Chloride (NaCl) as tissue-equivalent material. Six cylinders were made of phantom material which had cavities to insert Thermoluminescent Dosimeters (TLDs) at several depths in order to measure absorbed dose to chiasma, lens, optic nerve, retina, parotid, thyroid and submandibular gland. Three routine conventional plans associated with tumors of this region and a new purposed technique were performed on the phantom and dose distribution and absorbed dose to critical organs were compared using treatment planning system (TPS) calculation and direct measurement on the phantom. Absorbed doses were measured with calibrated TLDs and are expressed in centigray (cGy). In all techniques absorbed dose to all organs except the lenses were at their tolerance dose levels and in the new purposed technique, absorbed dose to chiasma was significantly reduced. Our findings showed differences in the range of 1-5% in all techniques between TPS calculation and direct measurements for all organs except submandibular glands and thyroid. Because submandibular glands and thyroid are far from primary radiation field, TLD reading in these regions although small but differs from TPS calculation which shows very smaller doses. This might be due to scattered radiation which is not well considered in the TPS. In the new technique, because the chiasma is out of the radiation field, absorbed dose was reduced significantly.

Not only the expand development of knowledge for reducing risk factors, but also the improvement in early diagnosis and treatment of cancer, and socioeconomic inequalities could affect cancer incidence, diagnosis stage, and mortality. The aim of this study was investigation the relationships between family levels of socioeconomic status and distribution of breast cancer risk factors. This descriptive cross-sectional, study has conducted on 526 patients who were suffering from breast cancer, and have registered in Cancer Research Center of Shahid Beheshti University of Medical Sciences from March 2008 to December 2013. A reliable and valid questionnaire about family levels of socioeconomic status has filled by interviewing the patients via phone. For analyzing the data, Multinomial logistic regression, Kendal tau-b correlation coefficient and Contingency Coefficient tests have executed by SPSS19. The mean age of the patients was 48.30 (SD=11.41). According to the results of this study, there was a significant relationship between family socioeconomic status and patient''s age at diagnosis of breast cancer (p value<0.001). Also, the relationships between socioeconomic status and number of pregnancies, and duration of breast feeding were significant (p value> 0.001). In the multiple logistic regressions, the relationship between excellent socioeconomic status and number of abortions was significant (p value> 0.007). Furthermore, the relationships between moderate and good socioeconomic statuses and smoking were significant (p value=0.05 and p value=0.02, respectively). The results have indicated that among those patients having better socioeconomic status, age at diagnosis of breast cancer, number of pregnancies and duration of breast feeding was lower, also number of abortions was more than the other patients. Among those patient with moderate and good socioeconomic status, the odds of being smoker were lower than the others. According to the results of this study, it was really important to focus on family socioeconomic status as a critical and effective variable on breast cancer risk factors among the Iranian women.

Leptomeningeal carcinomatosis (LMC) from gastrointestinal cancer would be rare. A 56-years old man with complaint of dyspepsia and histopathologic examination of the biopsy specimens has shown: adenocarcinoma. At the end of adjuvant chemo radiation therapy, the patient has affected by headache and mild confusion. In cerebrospinal fluid (CSF) cytology, a plenty of malignant cells have seen and unfortunately after a short time for about 4 days after ICU admission, the patient has died. This could be due to heavy burden of disease in central nervous system.

Breast Sarcomas have relatively been rare and accounted for 1% of all primary malignant tumors of the breast. Pure and primary chondrosarcoma of the male breast would be an extremely rare tumor. It might arise either from the breast stroma itself, or from underlying bone or cartilage. A 65-year-old man has presented with a rapidly growing breast mass since 5 months. Physical examination has established a large firm to hard mass with regular margins in the region of right breast. There was no axillary lymphadenopathy. Contrast enhanced MRI of breasts has shown a mixed-signal intensity multi lobulated cystic-solid mass (10.4 cm × 10.3 cm ×9.9 cm) appearing predominantly hyper intense on T2W and hypo intense on T1W. The tumor has diagnosed as a low-grade chondrosarcoma of the breast by histopathological and immunohistochemistry analysis. Right sided radical mastectomy with grafting has done. It has seemed to be very important to identify the mammary primary sarcomas as entity separated from the carcinomas of the breast.

Physical agents such as ultraviolet or ionizing radiation and repetitive trauma have been related to the causation of cancer in humans. Much less clear is the association between exposure to radiofrequency, such as radar and microwave radiation to the development of cancer. Sporadic case reports and small series suggest that this type of radiation might lead to cancer or contribute to its evolution. The association between radiofrequency and testicular damage and cancer is unproved, but clinical and experimental data are suggestive of such possibility. In this paper we have reported three cases of seminoma in person who worked in the same place that exposed to radio frequency (RF) waves.