Reports of Radiotherapy and Oncology
Volume:1 Issue: 3, Dec 2013

Cancer is a chronic disease with an increasing incidence. Other than common complications of chronic diseases, the vague prognosis and early threat of cancers may induce tension and fears among patients. Such fears are of the main destructive aspects of cancer that make it a physically and emotionally weakening disease. Patients and In this study, we evaluated 111 patients with cancer who had been treated in the specialized cancer treatment center of Zahedan. They were asked to fill a questionnaire containing 44 questions about their fears and anxieties. We categorized the fears into social, individual, sexual, and disease related groups and these groups were analyzed according to the patients’ characteristics. 26.1% of the patients were men and 73.9% were women with the mean ages of 45.9 and 44.9 years respectively. The majority of patients (79.3%) were married. T test analysis revealed that women experienced more social (P= 0.001) and personal fears (P= 0.015) than men. Married patients had more sexual fears than other groups (P= 0.001). One-way ANOVA for examining the effect of educational attainment, showed that the only variable with statistically significant difference among the means was the sexual fears (F (3, 108) =3.417, p=0.020). The patients with higher education levels had lower scores in sexual fears than other groups, meanwhile such type of the fears were more in the group of middle school education. Cancer is accompanied by different types of fears that affect the patient’s quality of life and satisfaction with treatment. It sees that detecting these fears and trying to resolve them, may help patients to have less stress during their life with cancer.

Abdominal donor site flaps are the standard for autologous breast reconstruction. Because of extreme variations of abdominal wall vascular anatomy between individuals, and even two hemi-abdomens of the same person, it seems valuable to use a sensitive method for preoperative evaluation. In this study, we evaluated the effects of preoperative abdominal wall computed tomographic angiography (CTA) in women who had undergone delayed unilateral breast reconstruction with abdominal perforator flaps. Between October 2007 and June 2008, 24 women with breast cancer were admitted to Henri Mondor General Hospital, Creteil, France, for breast reconstruction. We used CTA to identify the perforator vessels for dissection and compared the results with other previously used techniques. There was an absolute correlation between the radiological information and intraoperative findings. An average of one hour was saved in delayed unilateral breast reconstruction with deep inferior epigastric artery perforator flap by using CTA preoperatively. Computed tomographic angiography provides valuable preoperative information in identification of the most suitable perforator, and its use before abdominal flaps breast reconstructions could be recommended.

Adjuvant Online! (AOL) is used extensively by oncologists in Iran to treat patients with breast cancer; however, it has never been validated for use in Iran, and its predictions might not be applicable to Iranian patients. The aim of this study was to evaluate the usefulness of this program in predicting the outcomes of Iranian patients with breast cancer. Patients and 368 patients who were treated between 1997 and 2010 at Jorjani Cancer Center entered the study. Data for each patient, including tumor size, number of positive nodes, tumor grade, ER status, and adjuvant systemic therapy, were entered into the AOL program (version 8.0), and the calculated disease free survival (DFS) was compared with the observed one. Analyses were performed using Cox regression modeling and SPSS 17.0 software, and P values < 0.05 were considered significant. Observed disease free survival (DFS)in our study was 72 months, while the calculated DFS by AOL was 68 months. In all subgroups of AOL, calculated DFS was less than observed DFS except for patients receiving Tamoxifen + Aromatase Inhibitors + Ovarian Ablation hormone therapy, for whom the calculated DFS was 2 percent more than the observed one. AOL underestimated overall survival and disease free survival rates in Iranian patients with breast cancer, which in our opinion was mainly due to the shorter period of follow-up in our study. Although AOL is widely used by Iranian oncologists, we believe that developing an Iranian version of a prediction tool would better predict the prognosis of our patients.

Invasive breast cancer is the most common carcinoma in women. Immunohistochemistry classification now plays a key role in prognostic identification and prediction of outcome in this disease. Based on recent gene expression studies, immunohistochemical subtypes are as follows: Luminal A (ER+ and /or PR+, HER2-), luminal B (ER+ and /or PR+, HER2+), HER2+/ ER-, PR-, and basal-like (ER-, PR-, HER2-). These molecular differences have been shown to correlate with clinical features, such as survival, and sensitivity to treatment. In this study we evaluated the association between different subtypes with histological type, grade, tumor stage, lymph node positive ratio, lymph node status, recurrence, and survival. Patients and We retrieved the clinical records of 580 patients with breast cancer who were treated at Mahdieh Institute of oncology in Hamadan, Iran between Oct 2004 and Oct 2011, and we evaluated clinicopathological data of these patients. mean age of patients was 47.22 ± 11.1 years. Of 573 patients, 116 (20.2%) were ER /PR+, HER2+, 257 (44.9%) were ER /PR+, HER2-, 72 (12.6%) were ER /PR-, HER2+, 124 (21.6%) were ER /PR-, HER2- and 4 were not undefined. The estimated median follow up period for all subjects was 4.9 years (range 3 months to 6.9 years). The overall survival for all patients was 88.21% and the disease free survival was 83.7%. The interesting result of this study was the lower incidence of positive axillary lymph nodes in triple negative subtypes. Five-year relative survival rates were higher for patients with ER/PR+ and negative lymph nodes (p< 0.05). This study highlighted the importance of immunohistochemical subtypes. As our patients were good representatives of breast cancer in western Iran and this study showed some differences with literature, further research should be directed at standardization of molecular and immunohistochemical methods in our country.

The aim of this study was to address the current lack of knowledge regarding the effects of yoga, an ancient oriental science, on reduction of stress and increase of Quality of Life (QoL) for breast cancer patients. Patients and 27 breast cancer patients, who had completed their standard medical therapies, including surgery (modified radical mastectomy), chemotherapy and radiotherapy, were recruited from the Mehrane Charity Centre. The patients were randomly assigned to a yoga intervention group (n: 16) or a wait list (control group) (n: 11) for 32 sessions (16 weeks) of a yoga program. The pre- and post-yoga quality of life assessments for the patients were conducted using the Iranian Version of the EORTC QLQ-BR23 questionnaire. After 16 weeks of yoga intervention and evaluation of physical, social, emotional, functional, sexual and body image well-being, it was revealed that our experimental group (mean age of 48.5±6.6 years old) had a significant decrease in emotional and sexual disturbance and experienced an improvement in positive body imaging compared with the control group (mean age: 46.9±8 years old) (P value<0.05). Furthermore, significant improvement in functional, emotional, and body image well-being was observed after yoga intervention in the experimental group in comparison to baseline condition (P value<0.05). Results of this study provide evidence for beneficial effects of a yoga program on the quality of life among breast cancer survivors.

Renal oncocytoma is a benign renal tumor, which is commonly asymptomatic and discovered incidentally with diagnostic imaging. This benign tumor occasionally co-exists with a malignant neoplasm, which may be present within or near the oncocytoma; in addition a few rare cases of renal oncocytoma have simulated a malignant course, showing extension to branches of the renal vein or distant metastasis. Report of the case: A rare case of renal oncocytoma has been reported in a 56 year- old woman, who referred with distant metastatic disease.

Although colon cancer is one of the most common human cancers, skin metastasis in this disease is rare and necessitates pathological confirmation. Report of the case: Herein we present a 33 year old man with rectal cancer with ascites. Six cycles of Oxaliplatin based chemotherapy were given. The ascites improved. After three weeks, skin lesions appeared in the upper trunk, both chest wall and back, with extension to the anterior neck Fine Needle Aspiration from the lesions showed malignancy and second line chemotherapy was started. Although the skin lesions showed partial response, unfortunately, the patient died after the fourth chemotherapy injection. Skin metastasis in colorectal cancer, although rare, is a devastating sign, and a careful dermatologic examination should be included in these patients’ follow up visits.