International Journal of Cancer Management
Volume:10 Issue: 10, Oct 2017

Context: Oral mucositis is a common complication in patients with cancer therapy. Oral and dental care should be considered as a vital component of caring before, during and after chemotherapy. This study aimed to assess the methodological quality of existing CPGs about cancer therapy-induced mucositis.
Evidence Acquisition: We conducted a review of extant CPGs for the management of mucositis. After screening the guidelines based on inclusion and exclusion criteria, three CPGs were selected and assessed by 5 appraisers by using AGREE II instrument.
Assessed CPGs gained the highest scores in the clarity of the presentation domain. Scope, purpose (median score, 63.3%), and stakeholder involvement (median score, 54.4%) were found respectively and the lowest scores were in editorial independence domain. The scores in applicability (median score, 30%), rigor of development (median score, 28.8%), and editorial independence (median score, 26.7%) domains were unfavorable. Also, every appraiser scored the overall quality of CPGs.
Quality of mucositis CPGs needs to be improved. In other words, designing high-quality CPGs in this area is necessary.

Context: Prior research over the past few decades has shown that the hypofractionated external beam radiation therapy could be a valuable method with an outstanding potential to treat the prostate cancer. The alpha-beta ratio (α/β) is an indication of the fractionation sensitivity of a particular cell type. Values of α/β ≥ 10 Gy are responsible for early-responding normal tissues and most tumors, while values of α/β Evidence Acquisition: This review article aimed to investigation the details of radiobiological and clinical trials which are reported to highlight the characteristics of hypofractionation for the prostate cancer treatment based on the investigation of clinical results from hypofractionated treatments.
With the sufficient radiobiological and physiological research studies, it may be claimed that if α/β value for prostate cancer is less than the adjacent surrounding organs at risk and by applying fewer and larger fractions; a better therapeutic ratio can be achieved for the patient.
Radiobiological modeling can play a major role in the design of new protocols. Also, one should be aware that in modeling the hypofractionated treatment, normal tissue iso-effects are significantly important and some assumptions needed to be made regarding α/β values for the critical normal tissue complication endpoint.

Use of complementary and alternative medicine (CAM) among cancer patients is not exactly defined.
The aim of this study was to determine the use of CAM and associated factors among Iranian cancer patients, reasons behind this use, satisfaction and information about complementary and alternative therapy.
To assess CAM usage by adult cancer patients, a questionnaire was designed and distributed among the patients admitted in Amir Oncology hospital affiliated to the Shiraz University of Medical Sciences in Shiraz, South of Iran. The questionnaire consisted of 29 items including patients’ socio-demographic characteristics and questions about CAM use.
A total number of 36 cancer patients participated in this study. The majority of respondents (94.4%) used or were using at least one CAM product or practice till the study date. Altogether, the most common type of CAM used among cancer patients was praying (86.1%). The most popular herbs in herbals subgroup were Mint and Garlic with 41.7%. Multivitamins and vitamin C were more favored than other vitamins and minerals (33.3%). No major side effects were reported regarding CAM use. The most reliable source of information about complementary medicine was reported to be physicians.
Iranian cancer patients frequently use CAM in addition to medical treatments. Therefore, it is important for oncologists to be aware of CAM use, its effects and adverse reactions to guide their patients.

Resiliency is a very important component in chronic diseases like cancer. Therefore, investigating factors affecting resiliency seems to be necessary. The current study investigates the relationship between cognitive emotion regulation strategies (CERS) and resiliency, on one hand, and the CERS role in predicting resiliency, on the other hand, among the studied population.
In a correlational method, 121 patients with advanced cancer, who have hospitalized in January 2015 to July 2015 in ALA cancer prevention and control center, were selected. Instruments include the Garnefski-Alt cognitive emotion regulation questionnaire and Connor-Davidson resilience inventory. Pearson correlation coefficient and multiple linear regression were used for data analysis with SPSS 20.
Findings indicate that regression model is significant and CERS can predict 95% of resiliency in the level of 99%. Also, adaptive strategies can explain resiliency’s changes (62%) more than maladaptive strategies (40%) in this group. In the regression model, more use of refocus on planning, putting in to perspective, acceptance and positive refocusing as well as less use of catastrophizing, positive reappraisal, self-blame, and other-blame can predict resilience strongly. Among these strategies, catastrophizing and refocus on planning were common strategies contributing to resilience.
These findings suggested that emotion regulation strategies chosen by patients with advanced cancer can effect on their resiliency’s status. This issue might help us to determine potential targets for applying psychotherapeutic interventions based on CERS education in order to improve resiliency in this group.

Anemia is a key indicator of malignancy risk and iron deficiency anemia (IDA) is the most considerable contributor, accounting for 50% of all causes of anemia. The present study aimed at evaluating the endoscopic and colonoscopic findings in patients with IDA without gastrointestinal (GI) symptoms.
One-hundred and eighteen patients with IDA were selected for this cross sectional study. IDA was defined according to the world health organization criteria. All patients were assessed by endoscopy and colonoscopy.
Out of 118 patients with IDA without GI symptoms, 84 patients (71.2%) were older than 50 years and 40 patients (33.9%) were male. According to colonoscopy reports, colon cancer was prominent finding in 10.2% of patients and based on Endoscopic findings, gastritis (16.9%). Of 20 gastritis patients, 19 patients were tested for Helicobacter pylori (H. pylori) that was positive in 13 patients (68.4%). Out of 12 patients with colon cancer, 8 patients (66.7%) were males and 4 (33.3%) of them were females (P = 0.030) that the most common cancers were right-side colons and well differentiated adenocarcinoma.
Colon cancer in male patients with IDA has significant risk and asymptomatic patients with IDA have an increased risk of gastric and colorectal neoplasia and should undergo examination of the upper and lower GI tract. Also, gastritis with H. pylori can positively associate with colon and gastric cancers in patients with IDA. Further studies are necessary to assess the association between IDA and risk of malignancy.

Interleukin (IL-12) and the granulocyte-monocyte colony-stimulating factor gene (GM-CSF) have been used as immunotherapeutic agents in cancer gene therapy as they activate dendritic cells and boost anti-tumor immune responses. IL-12 and GM-CSF have different roles in anti-tumor immune response.
The aim of present study was to investigate the anti-tumor effects of combined gene therapy with GM-CSF and IL-12 in a fibrosarcoma mouse model.
To investigate the combined therapeutic effect of GM-CSF and IL-12, WEHI 164 tumor cells were transfected with Murine GM-CSF (m-GM-CSF) and Murine IL-12 (m-IL-12) genes, using Lipofectamine. The fibrosarcoma mouse model was established by subcutaneous injection of transfected cells to Balb/c mice. Mice were sacrificed and the tumors were extracted. Tumor sizes were measured by caliper. The expression of GM-CSF, IL-12 and IFN-γ was studied by real-time PCR and immunoblotting. The expression of Ki-67 (a proliferation marker) in tumor masses was studied by immunohistochemistry staining.
The tumor size was reduced in IL-12 GM-CSF group (P Combination therapy with GM-CSF and IL-12 displayed significant therapeutic effects and represented a promising gene therapy strategy for cancer.

Reactive oxygen species are highly active intermediates, which lead to cellular damage during imbalance between oxidative stress/antioxidant towards oxidative stress. Free radicals have been proposed to have a crucial role in development and progression of human cancer.
The main aim of this study was to assess the changes in 8-hydroxy-deoxyguanosine (8-OHdG), nitrite (NO2-), and nitrate (NO3-) levels in patients with Stage I multiple myeloma (MM).
The serum samples were obtained from 34 patients with stage I MM (22 males and 12 females at stage I) who were matched with healthy control group. Total serum of NO2- and NO3- levels, in addition to serum 8-OHdG levels, were assayed by using the commercial assay kit.
Compared with the healthy case group, the levels of serum NO2- and NO3- (2.54 ± 0.49 vs. 1.75 ± 0.52 µmol/L, P Significantly increase in oxidative DNA damage and end-products of nitric oxide (NO) metabolism levels in patients with stage I MM suggest the possible involvement of oxidative stress in MM disease. These alterations can be associated with the imbalance in oxidant-antioxidant status in these patients and may contribute to carcinogenesis of MM by oxidative DNA damage.

Breast cancer is the most frequently diagnosed cancer among women. Although several targeted therapies have been applied for patients with breast cancer, due to its heterogeneous nature, several patients do not benefit from these treatment modalities. Consequently, it is necessary to identify novel markers, which participate in the development of breast cancer. Recently, long non-coding RNAs (lncRNAs) have gained attention in this regard. Among them is lncRNA-gastric carcinoma high expressed transcript 1 (lncRNA-GHET1), whose participation in gastric and bladder cancers have been identified.
In the present study, we aimed at identifying lncRNA-GHET1 expression in breast cancer tissues compared with their adjacent non-cancerous tissues (ANCT) in a cohort of Iranian patients.
We evaluated the expression of GHET1 in 47 samples of invasive ductal carcinoma of breast in comparison with their ANCTs by means of quantitative real time-PCR.
GHET1 has been shown to be up-regulated in 26% (13 out of 47) breast tumor samples compared with their paired ANCTs. Transcript levels of GHET1 were shown to be associated with body mass index. No other significant association was found between the level of transcripts and patients’ clinical data, such as estrogen receptor, progesterone receptor, Her2/neu status, tumor stage or grade.
GHET1 is possibly contributed in the pathogenesis of a fraction of breast cancers

Numerous qualitative studies have been carried out on the safety and clinical use of GNPs as a radio-sensitizer in tumors, using proton therapy and the results have been promising. However, some quantitative studies should be conducted in order to examine the factors affecting this method.
Monte Carlo simulation was performed by MCNPX code to assess pristine Bragg peak, spread-out bragg peak (SOBP), and secondary particle production enhancement in GNPs radio-sensitized tumor using proton therapy.
The results show several percent dose enhancement within and its reduction after the tumor site. A little increase in neutron production and no deviation for photon production is indicated.
Finally, it can be concluded that sensitization of a realistic tumor can be beneficial during the proton therapy.

Cancer is a disease which affects both the patient and family members. Family caregivers of these individuals have been recognized as the undercover patients, the problems and experiences of whom should be evaluated. The present research has been aimed to provide a deep understanding of the experiences and consequences of care in family caregivers of patients with cancer in the terminal phase.
The present research has been conducted by a qualitative content analysis method. The sampling method was purposeful and it was progressed until data saturation. The data were gathered through in-depth semi-structured interviews, and then, were analyzed via content analysis.
From the total 18 interviews, 413 initial concepts (codes) were obtained. Finally, three main concepts (categories) were extracted after data analysis, including: 1, inhibition; 2, challenges and consequences of care; and 3, supportive-palliative factors.
According to the family caregivers’ condition in Iran, that is, caring overload, informational and emotional inhibition, and spirituality as a way of alleviation and adaptability, the emergent need for counseling and psychological-social-informational-spiritual support particular to this culture, seems to be necessary.

Recently, in an effort to fully characterize the underlying genetic causes of the acute myeloid leukemia (AML), attention has been devoted to the newest aspect of gene expression regulations which inferred to the regulatory long none coding RNAs.
ANRIL is one of the disease associated lncRNAs which is transcribed from a critical genomic region that has an important role in the expression regulation of its neighbor genes CDKN2A and CDKN2B encoding 3 major tumor suppressor genes p14ARF, p15INK4b and p16INK4a.
Since the identified variants in the CDKN2A and CDKN2B genes or ANRIL locus are reported to be associated with tumorigenesis in different cancers, we investigate 4 single nucleotide polymorphisms (SNP) of ANRIL in Iranian AML patients in comparison to control individuals
The results showed significant association neither for allelic and genotypic frequencies nor for haplotype blocks with AML patients versus control subjects.
With regard to the indicated roles of ANRIL in epigenetic gene expression regulation, exploring its AML-associated genetic defects or its aberrant expression in patients is still a growing area of research and further investigations may illustrate its potential to serve as a diagnostic biomarker or a therapeutic target for AML.

Cervical cancer is the fourth most common cancer in women. Since pluripotency genes are one of the main contributors of cancer, designing novel combinational therapies that target them would be helpful.
In this study we assayed the anticancer effects of crocin and cisplatin on cervical cancer cells through suppression of Sox2 and Nanog. OV2008 cells were treated with crocin and cisplatin, and the viability and apoptosis were assessed by the MTT and Flowcytometery respectively. The expression levels of mRNA of pluripotency genes were detected by Real-Time PCR analysis.
Our data showed that treatment of OV2008 cells with crocin and cisplatin decrease cell viability in a dose- and time-dependent manner. Also cell cycle analysis indicated that the percentage of apoptotic cells significantly increased after treatment. Moreover, this treatment led to down-regulation of Sox2 and Nanog genes.
So it would be proposed that crocin in combination with cisplatin could induce cytotoxicity in cervical cancer cells through inhibition of pluripotency genes.

Primitive neuroectodermal tumor (PNET) of kidney is a rare clinical condition. We report a young girl with PNET of kidney.
A 14-year-old female presented with chronic flank pain. Imaging studies revealed a huge renal mass with left renal vein thrombosis. Histopathological findings were consistent with PNET, which was later confirmed by immunohistochemistry and she received adjuvant chemotherapy.
PNET is a rare clinical condition in urology and it should be considered in young patients with a renal mass, especially when it is huge. Treatment plan includes radical nephrectomy along with neoadjuvant chemotherapy.

Testicular cancer is a rare neoplasm that afflicts men particularly in specific age-range. 5% to 6% of these tumors are non-germ cell tumors, in which Leydig cell tumors (LCTs) are included.
This case report describes an uncommon presentation of a Leydig tumor cell in a 53 year old man with gynecomastia and gynecodynia
LCT is a rare neoplasm of the testis; its origin is still unknown and it could also present out of the normal range-age with the highest incidence. The radical surgery is still preferred, even if an organ sparing approach is reported. There are a lot of reports and case series in literature about LCT’s but our work focus the attention of uncommon signs of presentation of this disease, expecially gynecodynia.