International Journal of Cancer Management
Volume:10 Issue: 9, Sep 2017

Context: Breast cancer is one of the leading causes of death among women all over the world. Prognostic markers can be used for patient survival. Likewise, these biomarkers are able to generate main information related to clinical manner of breast gland tumors. Interleukin-8 (IL-8) is a chemotactic cytokines caused initiation of an inflammatory response.
Evidence Acquisition: We performed a computerized search in Medline/PubMed databases with key words: IL-8, breast cancer, and oxidative stress.
IL-8 secretion motivates the expression of adhesion molecule, including fibronectin in human inflammatory breast cancer cells. IL-8 activates PI3K/Akt pathway, which in turn activates NF-κB resulted up-regulation of integrin β3 expression and increases the invasion of breast cancer cells. Therefore, it seems that IL-8/PI3K/Akt/NF-κB/integrin β3 axis may be used for therapeutic intervention of breast cancer with metastasis status. NF-κB plays an important role in IL-8 gene transcription via several signals, such as LPS, TNF-alpha, and oxidative stress. Oxidative stress caused angiogenic factor production, such as vascular endothelial growth factor and IL-8 via cancer cells. Moreover, there is inverse relation between ER level and IL-8, but the mechanism of IL-8 action in estrogen receptor-negative breast cancer is largely unknown. Estrogen receptor and growth factor in breast cancer cells is influenced by mitogen activated protein kinase (MAPK) cascade, as a part of IL-8 signaling pathway.
According to these studies, interleukin-8 may be as a main biomarker for breast cancer. It seems that signaling pathway of IL-8 may be used for therapeutic intervention of breast cancer. Also oxidative stress and breast cancer cells with lacking estrogen receptor generate more interleukin-8.

Context: At present schistosomiasis is endemic in 78 countries, affecting more than 260 million people. Schistosomiasis haematobia alone affects more than 112 millions.
Evidence Acquisition: We performed a computerized search of in PubMed database with keywords: Bladder Cancer Cost and Schistosomiasis Mass Treatment.
Bladder cancer is an important sequelae of this infection. In low-resource countries, where this disease is endemic, individuals inflicted with bladder cancer have very limited access to treatment and death is most probably certain.
Mass treatment with praziquantel is an easy, safe, and inexpensive treatment that could save the lives of thousands and reduce the morbidity of millions.

The present study aims at evaluating the safety and efficacy of ureteral reimplantation and its influence on quality of life in the complete ureteral obstruction due to prostate cancer.
In a prospective randomized study, 86 patients with complete ureteral obstruction were randomized into 2 groups: group 1 (ureteral reimplantation) and group 2 (nephrostomy). Biochemical values, complications, and survival of patients were recorded.
The mean age of patients were 72.20 ± 7.77 and 74.26 ± 7.56 years in group 1 and group 2, respectively (P ₌ 0.21). The mean decrease in Creatinine values were not significant between 2 groups (P = 0.639). The mean survival of patients after intervention were 22.42 ± 0.87 months in group1 and 20.48 ± 0.65 in group 2 (P = 0.0001). No major complications were happened in group 1. Main delayed complications in group 1 were ureteral stricture at the anastomosis point 20% (n = 8), UTI 27.5% (n = 11), and permanent pain at the operation site 15% (n = 6). In group 2, 100% of patients had experienced complications, including: febrile UTI 65.2% (n = 30), perirenal abscess 10.8% (n = 5), dislodgement of nephrostomy tube 30.4% (n = 14), local inflammation and dermatitis of nephrostomy tract 54.3% (n = 25), and hemorrhage during nephrostomy placement 4.3 (n = 2). Likewise, all of them (100%) had social inconvenience, local pain and discomfort in tract and sutures of tube, urine leakage and odor, and need to regular replacement of tube.
Reimplantation is a safe and effective option in the management of complete ureteral obstruction due to advanced prostate cancer with significant benefits in overall survival and patient satisfaction.

Regarding the patient autonomy principle, patients have the right to make informed decisions about their medical care. In situations like cancer diagnosis, telling the truth is still a challenge for health care providers, especially in eastern countries.
The present cross sectional study was conducted from March to June 2016, in which the convenience sampling method was used. The questionnaire used to collect data consisted of 3 parts. The first part included demographic characteristics; the second part consisted of 22 items that examined the patient's attitudes towards truth-telling; third part of the questionnaire was Ende (1989) autonomy preference index (API).
The overall scores showed that the participants had a positive tendency to truth-telling and self-determination. The majority of participants believed that knowing the truth might make them more cooperative during treatment period, prevent unnecessary treatments, and help them deal better with their difficulties. Participants reported their preferences for decision making as low and seeking information as high. They preferred that leave decisions be made by doctors. However, they reported a positive attitude towards information seeking.
The results of this study showed that Iranian patients with cancer had highly positive attitudes towards truth-telling and self-determination. Patients expect that their physician play the main decision maker role. Moreover, the preference for self-decision making is high, correlated with education level.

The present study aims at investigating the relationship between religious coping behaviors and depression in Iranian patients with cancer.
In this cross sectional study (October to December, 2015), 380 patients with cancer, admitted to the associated university’s medical sciences hospitals (Sari, Iran), were entered to the present study, using non-random sampling (accessible sampling). Data were collected by demographic questionnaire, center for epidemiological studies depression scale (CES-D), and religious coping questionnaire (RCOPE). The statistical package for social sciences, version 20.0 (SPSS Inc., Chicago, IL, USA) was used for data analysis by descriptive and infernal statistic tests (Spearman’s correlation and generalized linear models).
Males (48.39 ± 13 ± 39; CI95: 46.41 - 50.38) were older than females (45.33 ± 18.44; CI95: 42.79 - 47.87). The results of spearman correlation test suggested that there was a negative and significant correlation between positive religious coping and depression (r = 0.134, P = 0.009). In addition, there was a significant relationship between depression and level of education (P Considering the adverse effects of depression on the treatment process and secondary problems, more comprehensive studies should be conducted on the effects of religious coping on depression in order to take effective steps towards the intervention and health promotion of these patients.

Mucositis is the most common complication of radiotherapy in patients with head and neck (H and N) cancers.
This study surveyed the efficacy of a herbal compound containing Alcea digitata Alef and Malva sylvestris L. in prevention of radiation-induced mucositis in patients with head and neck cancer.
In the present study, a total of 23 patients were examined and assigned to 2 groups. The herbal drug and the placebo (provided from Avicel) were administered for 7 weeks, from the beginning of radiotherapy to 2 weeks after the completion of the treatment. During weekly visits, mouth pain score (MPS) was assessed, using visual analog scale (VAS) and severity of mucositis was checked by investigators.
Patients in control group showed more severe mucositis from second week, compared with drug group (p Therefore, not only the severity of mucositis and the average of MPS were significantly lower in drug group compared with control group, but also they were invariant during the study and showed no uptrend.

The present study aims at identifying an applicable longitudinal marker from the serum human chorionic gonadotropin (hCG) levels during 3 weeks after mole evacuation for predicting the gestational trophoblastic neoplasia (GTN) in patients with partial or complete molar pregnancy.
In this historical cohort study, 201 documents of patients with hydatidiform mole (according to their pathological reports) were investigated. A two-stage shared random effects model was used to describe the relationship between repeated measures of β-hCG (as a longitudinal indicator) and incidence of GTN. A receiver operating characteristic (ROC) curve was used to determine the power of repeated β-hCG values for predicting GTN.
Among all patients, 171 cases (85.1%) had spontaneous remission and GTN was detected in 30 cases (14.9%). The modeling approach used in the current study revealed that the repeated measures of β-hCG concentration (in weeks 0, 1, 2, and 3) can correctly classify approximately 86.7% of patients with GTN and 83.0% of patients without GTN. The repeated measures of β-hCG concentration had higher predictive accuracy than cross sectional values of this marker for early detection of GTN.
In general, findings of the present study showed that the three-week β-hCG concentration is a powerful marker for predicting GTN in women with molar pregnancy (with AUC of 91.2%). Thus, monitoring the three-week trend of this marker is recommended for early detection of this malignancy in these women.

CD44 isoforms are known to be possible diagnostic and prognostic markers in colorectal cancer (CRC).
The present study aims at investigating the expression of CD44 standard (CD44s) isoform in CRC by immunohistochemistry (IHC) as well as exploring its clinicopathological correlations.
A total of 102 patients, who underwent surgery for primary colorectal adenocarcinoma, were enrolled in this study. IHC staining for CD44 was performed on pathology samples and defined as: staining 50% as strong/extensive expression level.
The patients’ mean age was 62.8 ± 15.67 years. IHC staining for CD44s demonstrated low expression level in 56%, moderate in 24%, and extensive in 20% of the participants. The only association was found between CD44 expression level and patients’ age (P = 0.03) as 25% of tumors in patients younger than 60 years old expressed CD44 expression strongly in contrast to 16.1% of the patients older than 60 years old. No other association was found between tumor histology, stage, gender, tumor location, lymphovascular invasion, perineural invasion, lymph node metastasis, or tumor subtype (P > 0.05).
No relation was found between CD44s expression and any tumoral characteristics of CRC. It seems that CD44s are not helpful in improving the prognostic or diagnostic power in CRC.

It is better that the haplotypes and combined genotypes of fas molecular markers to be studied rather than each polymorphism, independently.
The present study aims at investigating whether the fas-1377G/A (rs2234767),-670A/G (rs1800682) polymorphisms as well as their combined genotypes and haplotypes affect the risk of developing breast tumors.
This study was conducted on 200 Iranian patients with breast cancer and 186 controls. The fas-1377G/A,-670A/G polymorphisms were determined, using tetra-ARMS-PCR and RFLP-PCR, respectively. The java stat online statistics package and SHEsis programs were used for data analysis. PNI modeler program was applied for in silico analysis.
The results of the present study did not show any significant differences in the genotype distribution of fas rs2234767, rs1800682 as well as their haplotypes and genotype combinations between cases and controls. Furthermore, in silico analysis indicated that fas-1377,-670 polymorphisms change the interaction of proteins with the promoter of fas.
The findings of this study proposed that the fas promoter variants did not have a major effect on the risk of breast cancer. Further studies are required to validate these conclusions across various populations. Based on in silico analysis, there was an altered binding pattern of proteins to the promoter of fas around the polymorphisms.

Axillary lymph node dissection is still the standard procedure performed for patients with breast cancer with clinically palpable axillary nodes or positive nodes confirmed by various methods. Sentinel lymph node (SLN) biopsy has recently emerged as a substitute for axillary dissection in patients with clinically negative axillary nodes and can spare some of the patients the need for re-operative lymphadenectomy.
In this descriptive retrospective study, patients with definite diagnosis of breast cancer treated in the Shohada-e Tajrish hospital during 2008 - 2014 were identified. Of these patients, subjects who had undergone intraoperative frozen section analysis of the SLN biopsy and had a report of a permanent section analysis were included. Age and the results of frozen section and permanent section analyses were extracted from the medical records and proceeded by SPSS statistical software v.22.
A total of 135 eligible women were included with the mean age of 48.85 ± 11.62 years. Frozen section analysis of SLN biopsy accurately identified 36 positive cases and 89 negative cases with an overall accuracy of 92.6%. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated to be 81.8%, 97.8%, 94.7% and 91.7%, respectively. The correlation between 2 analyses was found to be statistically significant (Pearson’s R = 0.830, P Intraoperative frozen section analysis of SLN biopsy in patients with breast cancer is a useful method, which can determine the need for immediate axillary dissection and can spare the patients with positive results, the need for reoperation.

Breast cancer is the most frequent diagnosed solid cancer among Iranian females and it comprises 25% of all cancer new cases in women. Breast cancer is uncommon in very young women ( 35 years). However, extensive data from Iran is insufficient.
The aim of this study was to compare the clinical, pathological profile, and prognostic factors between patients with breast cancer with age ≤ 35 years and > 35 years at our institute.
The medical records of 1,910 patients with breast cancer in the Shahid Beheshti University of Medical Sciences Cancer Research Center database were reviewed between September 2002 and December 2014. A total of 199 patients with breast cancer were identified as very young group (age ≤ 35 years) and 398 patients, as less young group (age > 35 years), were selected and matched based on a time-stratified 2:1 approach. Finally, 597 patients with breast cancer were selected for the study.
The 5-year progression free survival (PFS) rate was 66% in very young group and 91% in not very young group that were significantly lower in patients with age ≤ 35 years than patients with age > 35 years.
We observed that very young women had worse outcome compared with not very young women. However, longer follow up of these patients is required for more mature data on these cancers.

Adenoid cystic carcinoma (ACC) of the breast is a rare tumor, especially observed in males.
We presented a 42-year-old man, initially diagnosed with small cell carcinoma (SCC) by core needle biopsy. He underwent breast modified radical mastectomy (MRM) and axillary lymph node dissection; his final histopathological diagnosis was ACC. After surgery, although the patient was recommended to have post-operative chemo-radiotherapy, he did not comply. The patient is on follow-up for more than a year with no recurrence until now.
ACC of the breast is a rare malignancy with excellent prognosis and favorable tumor biology. It could be mistaken with triple negative breast cancer, ductal carcinoma in situ (DCIC), and small cell carcinoma.

Renal rhabdomyosarcoma is a rare malignant mesenchymal tumor, representing 1% - 3% of all renal malignant tumors.
In the present study, we discussed about a 33-year-old woman with a botryoid type embryonal rhabdomyosarcoma of the left kidney presented with gross hematuria.
This very rare tumor in adults should be considered in differential diagnosis among undifferentiated malignant tumors.