International Journal of Cancer Management
Volume:10 Issue: 5, May 2017

Context: The incidence of breast malignancy is increasing and it became evident that chemotherapy protocols that are based on anthracyclines and trastuzumab, which are being used in these patients, have cardiotoxic effect. Traditional imaging methods could detect the advance stage of chemotherapy-induced cardiomyopathy when cardiac function is significantly impaired. New imaging tools, primarily speckle tracking analysis, could improve detection of cardiotoxicity.
Evidence Acquisition: We searched PubMed, Medline, OVID and EMBASE databases for the studies published from January, 1990 up to May, 2016 in the English language using the following keywords: “chemotherapy”, “cardiac toxicity”, “left ventricle”, “anthracyclines”, and “trastuzumab”.
Studies show that early signs of chemotherapy-mediated cardiotoxicity in breast cancer patients could be identified even one week after the introduction of anthracycline treatment. Investigations also reported deterioration of the left ventricular mechanics 3, 6 and 12 months after chemotherapy. This suggests that left ventricular strain should be used as an important marker of the left ventricular dysfunction, which might be used simultaneously for detection of cardiotoxicity and for the monitoring of potential improvement of left ventricular function after chemotherapy interruption.
New imaging tools provide insight in cardiac function and mechanics, much better than traditional methods. The ability of mechanical changes to predict subsequent cardiotoxicity needs to be evaluated in larger multicenter and longitudinal studies.

Testicular germ cell tumors (TGCTs) account for only 1% - 2% of all male neoplasma.
The aim of this study is to evaluate clinicopathological features, treatment options and overall survival (OS) in patients with TGCT in Kermanshah province, Iran.
In this retrospective study, 39 patients that referred to oncology clinic in Kermanshah Province, Iran were included. All patients were diagnosed with TGCT between 2000 and 2014 and completed primary therapy (orchidectomy) than 37 patients was treated with chemotherapy and out of 37 patients, 9 patients were treated with radiotherapy in different parts of body (brain, mediastinal, or retro peritoneal). In the first diagnosis, serum tumor markers such as lactate dehydrogenase, α-fetoprotein, and human chorionic gonadotropin had been measured. Statistical analyses, survival and diagrams were performed using the SPSS 19, Prism and Excel 2007, respectively.
The mean age at diagnosis for the patients was 34.6 years (ranging 16 - 63 years). We divided the patients to two age groups, twenty-five (64.1%) were placed in age First of all, seminoma has a higher percentage in TGCT patients. Second, the mean age in TGCT patients is between 30 and 35 years. Third, in our study, brain metastasis had higher prevalence compared to other studies. At last, the OS in our study was similar to those of other studies.

Lymphatic spread is a common feature of ovarian cancer both in early and advanced stages of the disease. There is also a controversial problem of the impact of para-aortic lymph node dissection between gynecologist oncologist experts. The aim of this study is evaluating the effect of Para aortic Lymph node dissection in ovarian cancer patients.
This descriptive cross-sectional study was performed on 100 ovarian cancer patients admitted in department of gynecology oncology of Ghaem hospital, Mashhad University of Medical Sciences, Iran, from November 2013 - 2014. All patients underwent surgical staging surgery and optimal debulking surgery as possible. In addition, concurrent systematic pelvic and para-aortic lymphadenectomy up to the level of inferior mesenteric artery was performed.
A total of 100 patients were studied. The mean age was 47 years (SD = 13). In 73 patients optimal cytoreductive surgery was done with para aortic lymphadenectomy. 53 cases (72.6%) were in primary cytoreductive surgery and 20 cases (27.3%) in interval debulking surgery groups. Positive paraaortic lymph node in the first group was 6 cases (11.3) and in the second group was 2 cases (10%). 27 patients were in apparent stage I and 46 patients were in stage II-III-IV of disease. We found positive paraaortic lymph node in 11% of total patients. We found positive paraaortic lymph node without positive pelvic lymph node in two patients.
Lymph node dissection will produce a significant benefit in accurate and complete surgical staging; it will reduce residual disease and then progression-free survival.

Previous studies suggested that Cannabis sativa has anti-cancer properties influencing tumor size and metastasis properties. Microtubule associated proteins (MAPs) such as tau binds to the microtubules and leads to cancer metastasis. Stathmin is a cytosolic phosphor-protein which can induce the depolymerization of microtubules in cancer cell lines, stathmin and tau over expressions, and leads to reduced sensitivity to taxane. It seems that C. Sativa can impress microtubule-associated proteins existing in breast cancer stem cells.
The effects of the extract of Cannabis Sativa on stathmin and tau relative gene expression were studied.
Tau and stathmin relative gene expressions were evaluated at different concentrations of C. Sativa extract (final concentrations 0.1, 1, 10, and 100 μg/mL) using real-time quantitative PCR. In order to understand the mechanism, AM281 (Cannabinoid receptor 1) was administrated with extract too.
The extract exhibited significant differences (P C. sativa extract dose-dependently influences tau and stathmin relative gene expressions, which may reduce cancer metastasis.

Human epidermal growth factor receptor 2 (HER2) overexpression and amplification have been studied as a therapeutic and prognostic target in a number of tumors although conflicting data exist about the incidence and clinical consequence of HER2/neu status in the patients with colorectal cancer. The aim of the present study was to evaluate the immunohistochemical expression of HER2/neu and its relationship with clinicopathological parameters and prognostic factors.
This study involved 50 specimens of malignant colorectal cancer lesions and HER-2/neu expression was evaluated by the Hercep-Test Kit.
Out of 50 cases, most of them (76%) were HER2/neu negative and in 12 (24%) cases, HER2/neu positive immunostaining were detected. 24% (n = 12), 36% (n = 18), 30% (n = 15), and 10% (n = 5) were scored as 3, 2, 1, and 0 respectively. No significant association was noted between HER-2/neu expression and patients’ age, tumor size, gender, location, grade and stage (P > 0.05).
The immunohistochemical evaluation of HER2/neu overexpression for potential targeted anti-HER2 therapy may not be valuable for the patients with colorectal cancer and also studies with larger sample sizes using standardized tests are needed to understand the exact biologic role of HER-2/neu in this type of tumor.

There is very limited evidence about the differences between proteome of breast cancer tissue and the adjacent normal tissue. Given the importance of identifying factors involved in the tumorogenesis of breast cancer; herein we aimed to compare the proteome of HER2 negative invasive ductal carcinoma and their adjacent normal tissues.
During the removal surgery, 50 mg of cancer tissue as well as 50 mg of adjacent normal tissue were obtained from 5 female patients with ductal carcinoma in stage 3. The total protein content of the tissues was extracted and subjected to two-dimensional gel electrophoresis and MALDI-TOF MS/MS mass spectrometry.
A total of 1300 spots were found in the cancer tissues and 751 spots in the adjacent normal tissues, 46 of which were matched between the groups. Cytoskeletal keratin types I and II showed a 4-fold increase (P It seems that overexpression of galectin-1, the types I and II keratin, as well as down-regulation of collagen VI and alpha 1-antitrypsin in the cancer nest might be implicated in the progression of advanced breast carcinoma, and therefore, be used as independent biomarkers for the disease. However, much more studies are suggested to confirm our results.

Cytotoxic effects of Frankincense resin have been shown on some cancer cell lines. Due to its low side effects, this study was designed to evaluate the anticancer properties of water soluble elements of Frankincense oleo-gum-resin on human oral squamous cell carcinoma cell line.
Oleo-gum-resin was macerated in ethanol. After filtration, the water soluble fraction of dried residue was extracted. KB cells were treated with 0, 62.5, 125, 250 and 500 μg/mL concentrations of obtained Frankincense aqueous fractions and with Doxorubicin as positive control. Frankincense induced cell cytotoxicity; apoptosis and proliferation were investigated using WST assay, Annexin V-FITC/PI, and Ki-67 staining, respectively. Data were analyzed using Kruskal-Wallis test by SPSS 17 software.
IC50 of 137.21 μg/mL was obtained from Frankincense aqueous fraction after 48 hours. The percentage of apoptotic cells was elevated in a time- and dose-dependent manner. There was no statistical difference in the Ki-67 expression of KB cells, using different concentration of Frankincense aqueous fraction after 24 and 48 hours (P = 0.083). Doxorubicin inhibited cells growth essentially through apoptosis.
Frankincense aqueous fractions seem to suppress KB cell growth through the induction of apoptosis and necrosis rather than the inhibition of proliferation and hence might be a potential anticancer agent. Structural analysis and purification of potent components are suggested for determining more definitive results.

Metastasis is one the most important causes of death among the patients diagnosed with breast cancer. Tau protein is a cytoskeletal protein which competes with paclitaxel and attenuates its effects. So increased tau protein may promote metastasis progression. Duloxetine is an antidepressant inhibiting serotonin, norepinephrine reuptake. In this study we tried to investigate the effects of duloxetine in tau gene expression in breast cancer cell line.
Duloxetine was prepared with the doses of 2, 20 and 100 µM per litter. MCF7 (Michigan Cancer Foundation-7) cell line was treated for 24 hours. The toxicity of duloxetine was estimated by 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2-H-tetrazolium bromide (MTT ) assay and the extent of tau protein expression was evaluated by quantitative real-time polymerase chain reaction (qRT-PCR).
Statistically all concentrations of duloxetine significantly decreased cell viability in comparison to control groups. However, paclitaxel showed more cytotoxicity effects. According to the results of qRT-PCR, tau expression increased at 20 and 100 µM concentration of duloxetine.
It seems that duloxetine, a drug for pain relief in patients with cancer, should be used with caution for metastasis promotion in breast cancer patients.

Immunohistochemistry (IHC) of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (Her2) are important prognostic factors of breast cancer. However, discordance between IHC findings of primary tumor and ipsilateral metastatic lymph nodes (IMLNs) has been reported that might affect the criteria for adjuvant therapies in breast cancer in the future.
Sample size of the current study was estimated 50 (Macnemar test). We performed IHC for ER, PR, and Her2 on IMLNs of 50 paraffin embedded blocks of breast cancer patients with regional lymphadenopathy during the period. All-red score 2 was regarded as negative and 3 as positive for ER/PR. Her2 results were classified to 1 ( 0 and 1), 2, and 3. We used SPSS 16 to insert and analyze the data.
Mean age of patients was 49 yrs, and mean tumor size was 4.8 ± 3.53 cm. Twenty-four samples were pN1, 17 pN2, and 9 pN3. ER and PR were positive in 50% and 52 % of tumoral samples and 78% and 76% of IMLNs, respectively (fisher exact test, P = 0.003 and P = 0.011, respectively). The discrepancy between IHC of primary tumor and IMLNs for ER, PR and Her2 was 32% (P = 0.000), 24% (P = 0.002), and 48%, respectively. Overall, 34 patients (68%) showed disagreement in at least one of their receptors.
Discrepancy between IHC results of primary tumor and IMLNs was significant. Since metastatic clones in metastatic lymph nodes (MLNs) are potential sources of systemic metastasis, routine IHC on MLNs could play an important role in determining prognosis, indication for FISH, and finally, choosing adjuvant treatment.

Preoperative concurrent chemoradiotherapy may improve surgical results and patient survival rates in gastric adenocarcinomas. We aimed to assess tumor resectability and pathologic response rates in patients with locally advanced proximal gastric and esophagogastric junction adenocarcinomas by preoperative CRT and toxicity evaluation of treatment.
The patients with proximal gastric or esophagogastric junction adenocarcinoma who had locally advanced disease on basis of endoscopic and imaging findings were candidates for preoperative concurrent chemoradiotherapy. Eligible patients underwent radiotherapy 45-50.4/1.8-2 Grays, five days in week concurrent with chemotherapy by 5-fluorouracil and leucovorin or capecitabine. 4 - 6 weeks after completion of this treatment, non-metastatic patients underwent surgery and all resected specimens evaluated for completeness of resection and pathologic response rate of tumor to preoperative treatment. The patients were followed for postoperative complications in a short time.
35 out of 41 enrolled patients completed preoperative treatment without any mortality and significant toxicity. Ultimately, 22 patients underwent surgery. From these, 2 (9%) had unresectable tumors, 2 (9%) underwent incomplete resection and 18 (82%) completely resected. In pathologic evaluations, 52% showed complete and partial pathologic responses and 48% showed no pathologic response to preoperative treatments. Male gender was significantly associated with tumor pathologic response (P value = 0.034). Postoperative complications were seen in only two patients.
Preoperative concurrent chemoradiotherapy with 5 fluorouracil and leucovorin or capecitabine followed by surgery is a tolerable and safe treatment in patients with locally advanced proximal gastric and EGJ adenocarcinomas. It resulted in promising high rates of tumor resectability and pathologic response.

Long non coding RNAs (lncRNAs) are of functional non coding RNAs which have been shown to be involved in several important pathways in cancer development and progression. Among them is Hox transcript antisense intergenic RNA (HOTAIR) whose overexpression has been detected in several cancer types. In addition, its functional polymorphisms have been shown to be associated with breast cancer risk in certain populations.
The aim of the present study was to investigate the effects of three HOTAIR polymorphisms (rs12826786, rs1899663 and rs4759314) and their haplotypes on breast cancer risk in a sample of Iranian population.
This study is a case-control study which consisted of 122 unrelated breast cancer patients from Hamadan University hospital and 200 normal females who were referred to a routine health survey in 2015. Genomic DNA was extracted from blood samples of all participants using the standard salting out method. Tetra-primer ARMS-PCR method was used for analyses of rs12826786, rs1899663, and rs4759314 genotypes. Comparison of genotype and allele frequency between the breast cancer patients and the control group was performed using Pearson chi-square test considering odds ratio (OR) and 95% confidence intervals (CI) for calculation of the relative risk. Haplotype frequencies for HOTAIR were calculated using SNPStats online program.
No significant difference has been found in allele and genotype frequencies of polymorphisms between case and control groups. Furthermore, no specific HOTAIR haplotype was shown to be associated with breast cancer risk in the analyzed population.
These polymorphisms do not seem to be associated with breast cancer risk in this population. However, further research is needed to evaluate the results of the present study in larger patient samples.

Cancer is one of the major threatening factors of human health worldwide. Unfortunately, chemotherapy, the powerful arm of cancer therapy, is accompanied with many side effects, so alternative treatments with greater specificities and fewer side effects are highly required.
Human cancer cell lines including SW-742, HCT116, HepG2, Hep2, MKN45 and LNcap were selected and the anti-cancer potential of Cyrtopodion scabrum extract (CsE) on their growth was studied. Vero cells were used to study the potential cytotoxicity on the normal cells. Cell cycle analysis and DNA fragmentation assay were also performed.
CsE was toxic (30% - 78%) to all the cell lines, with the highest cytotoxicity on SW742, MKN45 and HepG2, respectively. A high selectivity index (> 2) was observed for the extract on SW742 and MKN45 cell lines. DNA laddering pattern, as well as a significant increase in the number of the cells accumulated in sub-G1 and G2-phase of the cell cycle compared to the control untreated cells, was also observed.
CsE suppressed the human cancer cells selectively and probably through apoptosis and G2 arrest mechanism. It could suggest a promising alternative/complementary treatment for cancer patients, especially those who suffer from digestive tract cancer.

Choriocarcinoma is a gestational trophoblastic tumor that mainly affects women of childbearing age and rarely occurs in postmenopausal women especially following a long latent period from previous pregnancies. In this case report, we introduce three cases of postmenopausal choriocarcinoma with different clinical signs and symptoms.
Case Report: The first patient was admitted with vaginal wall metastasis, and the second and third cases with postmenopausal vaginal bleeding. They were referred to the department of gynecology-oncology at Ghaem hospital in 2015. One case had stage I and two patients stage III of the disease. Treatment was initiated with EMA-CO regimen according to the histopathology of choriocarcinoma in these patients. Complete remission was achieved with chemotherapy for all three cases.
Concusions: The possibility of choriocarcinoma should be considered as a differential diagnosis in postmenopausal vaginal bleeding and in postmenopausal women with metestatic lesions.

Laryngeal adenoid cystic carcinoma (LACC) is a very rare cancer among laryngopharyngeal malignancies with varieties in presentation.
Here, we discuss a case of 54-year-old female who was admitted in the emergency department with long-term dyspnea, hoarseness, and stridor. Cervicothoracic multi detector computed tomography (MDCT) scan showed a mass in the laryngeal area and the pathology reported adenoid cystic carcinoma in the biopsy. Total laryngectomy and partial pharyngectomy was taken into action. The adjuvant radiotherapy was performed too.
Although adenoid cystic carcinoma is rare, it is advised to use both CT-scan and deep biopsy to make definite diagnosis. Surgical excision is necessary and follow up is advised, although surgical excision of this tumor is extremely challenging case by case.