International Journal of Cancer Management
Volume:12 Issue: 12, Dec 2019

Cancer is one of the leading causes of death globally. It changes the patient’s life, and not only causes many physical and emotional symptoms but also reduces the quality of life (QOL) in patients during the advanced stages of cancer. Today, the main approach in taking care of these patients is to provide supportive and palliative care with the aim of enhancing the QOL in patients and their families and to reduce the cost of treatment and health care. This study was conducted with the aim of comparing the policies and the strategies related to cancer supportive and palliative care in the selected countries, using the World Health Organization (WHO) guideline in the United Kingdom (UK), Malaysia, and South Africa.

This study is a comparative study. The data were collected through reviewing scientific and administrative documents, WHO website and reports, the Ministry of health websites, and other authoritative websites. The search was done through texts in English and the databases, including Science Direct, Scopus, and PubMed between 2000 and December 2018. We used a strategy search according to Medical Subject Headings, using the keywords (cancer, palliative care, supportive care, patients, policies, programs, strategies, UK, Malaysia, and South Africa). The data were analyzed by content analysis approach, using MAXQDA software version 11.

The rates of cancer and mortality differed according to the health differences in the selected countries. With regard to palliative care, various policies and programs were implemented. The implementation of more policies was carried out by the Ministry of Health. In some countries, adequate funding was available to support programs. Countries have been trying to provide decent manpower to provide services. Despite the successes achieved in implementing palliative care programs, some factors, such as inadequate healthcare structures and insufficient financial resources have caused problems in implementing programs.

Countries should consider palliative care as one of the important priorities of the health system and a way of enhancing QOL in patients with cancer and their families, and with regard to the context of each country, focusing on each area of practical guide, reviewing the status and available facilities, and learning from the experiences of other countries should be considered to achieve this goal.

Anti-tumor effects of crocin have been investigated in different tumors; however, its precise molecular mechanism is not exactly elucidated.

In the present investigation, we have studied pro-apoptotic and anti-proliferative properties of crocin and cisplatin combination on cervical cancer cells.

Cell viability and apoptosis assays were monitored by MTT, Hoechst 33258 staining methods, respectively. The expression levels of apoptotic related genes, including Bax, Bcl-2, p53 mRNA, and miR-365 were analyzed by quantitative reverse transcription- polymerase chain reaction (qRT-PCR). Using Western blot, we have also assessed the protein expression of the above apoptotic genes.

The results of this study demonstrated that the combination treatment of cells with crocin and cisplatin significantly reduced the proliferation of cancer cells and induced apoptosis. Furthermore, the Bax/Bcl-2 ratio and the mRNA level of p53 markedly increased in treated cells, whereas it decreased miR-365 expression, an upstream regulator of Bcl2 and Bax.

Accordingly, crocin could be a potential candidate for more evaluations such as in vivo studies, since it shows a proper in vitro anticancer effect. It is also suggested that a combination of crocin and cisplatin could be applied as an effective and promising chemotherapy strategy.

Stress hyperglycemia during surgeries has been reported to increase the possibility of surgical site infections (SSIs) and worsen the patient’s prognosis.

The aim of the present study was to evaluate the correlation between perioperative blood sugar level and SSIs in patients undergoing mastectomy.

In this prospective case-control study, 158 female patients undergoing mastectomy were included with diabetes as an exclusion criterion. Blood glucose levels were measured in 5 phases for each patient.

Among 158 studied patients, 8 (5.5%) developed SSIs. Four patients (2.74%) in the control group and 4 patients (50%) in the case group had hyperglycemia in at least one of the stages. Logistic regression analysis demonstrated associations between SSI development and any blood glucose value of more than 150 mg/dL. It seems that age, medical history, current smoking, tumor characteristics, previous chemoradiotherapy, surgical duration, administration of prophylactic antibiotics, and other surgical factors have not been significantly correlated with SSI.

As hyperglycemia is an easily controllable factor, the control of blood sugar levels during the perioperative period is recommended in patients undergoing breast surgeries to decrease SSI rates.

Gastric cancer is one of the most frequent cancers among men and women. Patients with gastric cancer are mostly diagnosed in advanced stages because of asymptomatic progression. Due to the heterogeneity and poor prognosis of this cancer, a comprehensive study at the transcriptome level gene expression is needed to find the various genes and mechanisms involved in gastric cancer. Differentially expressed genes (DEG) derived from high-throughput RNA-sequencing could lead to the achievement of new molecular biomarkers.

In this study, after transcriptome reanalysis, we focused on the genes involved in epithelial-mesenchymal transition (EMT) via extracellular matrix (ECM). We have aimed at finding mRNA level changes in new candidate genes among Iranian patients with gastric cancer.

Six gastric cancer and two normal sequencing raw sample datasets were collected from the European Nucleotide Archive (ENA). The bioinformatic pipeline was used to reanalyze raw datasets and get DEGs, using the DESeq2 package. After analyzing, THBS2, OSMR, and CHI3L1 genes were selected for validation and verification in 25 confirmed adenocarcinoma gastric cancer patients and non-malignant normal tissues from the Iranian population by real-time polymerase chain reaction (PCR).

The bioinformatic analysis of raw datasets revealed many upregulated and downregulated genes in gastric cancer tissues compared with normal samples. Then, real-time PCR verified the upregulation of THBS2, OSMR, and CHI3L1 genes in a group of Iranian patients with gastric cancer. Analyzing graphs showed a significant increase in the expression of targeted genes in patients with gastric cancer (P < 0.0001, P = 0.0016, and P = 0.0002, respectively).

The results validated an obvious increase in the expression of THBS2, OSMR, and CHI3L1 genes in gastric cancer of Iranian patients. These genes are involved in EMT and may have a role in cancer invasion if tested further for their diagnostic and prognostic value in larger sample sizes.

Acute myeloid leukemia (AML) is a hematopoietic malignancy result from abnormal proliferation and accumulation of myeloid progenitors. It is considered as the most common form of acute leukemia in adults. Previous reports have demonstrated the increased levels of some immune system checkpoints, such as PD-1, TIM-3, and TIGIT on T cells of AML patients. AML can be associated with the elevated expression of Blimp-1 transcription factor in patients. It has shown that B lymphocyte-induced maturation protein 1 (Blimp-1) encoded by Prdm1 is negatively regulated by both Bach2 and BCL6 transcription factors with some epigenetic factors, including HDAC3 and NCoR1.

The present study aimed to investigate the expression level of two important genes, Bach2 and HDAC3, in peripheral blood samples of Iranian patients with AML compared to the healthy control group.

A total of 24 patients with de novo AML and 15 healthy individuals were studied. Total RNA was extracted from peripheral blood samples and relative expressions of Bach2 and HDAC3 genes were determined by quantitative real-time PCR. Data were analyzed using Graphpad Prism 7 software.

Comparison of the relative gene expression in the patients and control groups revealed that Bach2 and HDAC3 were down-regulated in AML patients by 4.97 and 6.14-fold, respectively (P = 0.0017 and P = 0.0026).

The reduction in the expression levels of Bach2 and HDAC3 genes in AML patients might be regarded as one of the clues that could explain the increased levels of the Blimp-1 and also some immune checkpoints in these patients.

Catechol-O-methyltransferase (COMT) gene is one of the genes involved in estrogen metabolism, which plays a role in the detoxification of estrogen metabolites. Gene polymorphisms can affect the expression of the enzyme and contribute to the incidence of breast cancer.

Two functional polymorphisms, rs2020917 and rs2075507, were studied in the position of COMT gene promoter with the potential for breast cancer.

In the present case-control study, 103 women suffering from breast cancer and 100 healthy women were selected within the same age range. After blood sampling, the DNA of samples was extracted by the saturated salt method. Then, the specimens were amplified with specific primer and determined by genotype RFLP-PCR method.

The two groups were similar in terms of age in the spectrum, but they had a significant difference in body mass index (BMI). GG mutant genotype of rs2075507 polymorphism indicated a statistically significant relationship between the two groups and increased the risk of breast cancer by 2.27%. The rs2020917 polymorphism showed no difference between the two groups, but it had a significant relationship with BMI. A combination of the genotypes showed that the individuals carrying GG/CC genotypes increased the risk of breast cancer in their body by a factor of 2.45.

The results from two functional polymorphisms in the distal promoter of COMT gene indicated the relationship between rs2075507 and the risk of breast cancer, and rs2075507 mutant genotypes and wild rs2020917 genotype were highly susceptible to breast cancer. BMI was significantly different between the two groups and also with rs2020917 polymorphism. Further studies in this area will provide stronger results.