International Journal of Cancer Management
Volume:12 Issue: 5, May 2019

Cancer continues to be the first cause of mortality and morbidity all over the world, while the incidence of cancer is expected to increase by 50% over the next 20 years. Since the incidence of most of the cancers is increasing daily, it has been more important to find related environmental risk factors. The epidemiological evidence indicates the effect of disinfection byproducts (DBPs) through drinking water, as an environmental exposure, on most of the cancers. The goal of the current study was to combine the results of most recent publications regarding the relationship between DBPs and their carcinogenic effects. Evidence Acquisition: Using the main keywords of “cancer”, “drinking water”, and “disinfection byproducts”, a comprehensive search was done among several research databases. Based on the previous studies, DBPs could cause most types of cancers, mainly including gastrointestinal, renal, bladder, breast, liver, and thyroid cancers. Liver and renal cancers are the most common target organs for toxicity by DBPs. Among the various DBPs, trihalomethanes are the most studied due to their relatively high prevalence and concentration in drinking water. Also, haloacetic acids, such as trichloroacetic acid and dichloroacetic acid, have been known as one of the most affecting risk factors. Unregulated DBPs, such as Mutagen X and Formaldehyde, are also of importance as they mostly have irreversible systemic effects. Providing safe drinking water resources, restriction of unreasonable usage of disinfectants, and alternating disinfectants with less harmful products could be the possible ways to overcome this crisis. Disinfection byproducts can result in cancer development, especially in liver and kidneys. Providing safe drinking water resources, using the membrane filters and changing the chlorination point are effective ways to encounter the risk of DBP poisoning.

Head and neck squamous cell carcinoma (HNSCC) is the sixth common cancer worldwide. A hallmark of cancer progression is degradation of the extracellular matrix by matrix metalloproteinases (MMPs) that allows cancer cells to invade the surrounding tissue. The purpose of this study was to evaluate the levels of MMP-2 and 9 in serum and salivary of HNSCC patients and compare it with a healthy group. Twenty patients with newly diagnosed HNSCC, who had not received any treatment, referred to Omid and Ghaem hospitals, Mashhad, Iran, and twenty healthy controls were voluntarily included in this study. Salivary and blood samples were collected from both groups and the concentration of MMP-2 and MMP-9 were measured by enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed by SPSS using Student t-test or Mann-Whitney with significance level of ≤ 0.05. In cancer patients, the serum level of MMP-9 was significantly higher than that of in the healthy group (P < 0.001). However, salivary MMP-9 was higher in cancer patients, this difference was not significant (P = 0.736). There was no significant difference between the study groups for the levels of serum (P = 0.283) and salivary MMP-2 (P = 0.764). There was a correlation between salivary and serum levels of both markers in cancer patients (P = 0.046 and P = 0.011 for MMP-2 and MMP-9, respectively), on the contrary, there was not a correlation between them in the healthy controls (P = 0.628 and P = 0.064, for MMP-2 and MMP-9, respectively). A direct correlation between the salivary level of MMP-9 and tumor grade was also detected (P = 0.045). The salivary analysis indicates that an altered composition for MMPs in HNSCC, suggesting a potential diagnostic tool for oral cancer. The serum level of MMP-9 appears to be a reliable marker for early diagnosis in HNSCC patients.

In order to increase the acceptance level of the cervical cancer screening behavior among women, understanding the associated factors of the behavior is necessary. The aim of this study was to evaluate the cognitive determinants of Pap smear screening (PSS) behaviors among rural women in Tabriz, Iran. In this cross sectional study, multistage random sampling was employed to recruit 220 rural women in Tabriz, Iran. A valid and reliable health behavior model (HBM)-based instrument was completed by all the respondents. The odds ratio of perceived benefits in multivariable was 1.18 (1.08 - 1.27) i.e. with one unit increase in perceived benefits, odds cervical cancer screening behavior 18% increases, and age = 0.94 (0.91 - 0.98) i.e. with one unit increase in age, odds cervical cancer screening behavior 6% decreases were statistically significant. The HBM was promising in determining the cognitive predictors of PSS behavior. Healthcare providers may specifically focus on perceived benefits and perceived barriers for designing PSS promotion interventions.

Based on the literature review, the available information regarding late toxicities after intensity modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC) is limited to a few countries. This study provides an opportunity to evaluate the delayed toxicities among Iranian patients with NPC that underwent IMRT. Between February 2016 and September 2018, 32 patients were treated with IMRT for NPC at Shohada-e Tajrish Hospital. The majority of them were in the advanced clinical stage and all received platinum-based induction and/or concurrent chemotherapy. Our typical prescription dose was 70.2 Gy to the gross tumor volume (GTV) in 2 Gy per fraction. Uninvolved regional lymph nodes received 59.4 Gy. Considering the minimum follow-up time of 6 months, we aimed mainly at evaluating the rate of delayed toxicities, including xerostomia, hearing loss, and eyeball damages. Toxicities were categorized based on either RTOG/EORTC or LENT/SOMA criteria. The median follow-up time was 12 months (6 - 32 months). The occurrence rates of grade ≥ 2 xerostomia, grade ≥ 2 hearing loss, optic neuropathy, and retinopathy were 28%, 10%, 4%, and 7%, respectively. Based on the dose-volume histogram analysis, averages of mean doses to the parotid glands, submandibular glands, oral cavity, and cochlea were 32.3 Gy, 58.9 Gy, 41.8 Gy, and 44.9 Gy, respectively. Our experience of using IMRT in the treatment of NPC revealed equivalent toxicities (except for hearing loss) in comparison with high-experienced centers.

Among all types of malignant diseases, breast cancer has worldwide importance because of the high mortality rate in women aged fewer than 50 in the developing countries. Identification of immunogenic antigens and the generation of specific antibodies against cancer cells are the most successful strategies for early detection and effective treatment of breast cancer. In the current study, a chimeric protein consisting of two specific surface antigens, MUC1 and HER2, were used for the production of chitosan nanoparticles and evaluated as a vaccine candidate. The pET-28a expression vector harboring the HER2-MUC1 gene was constructed. Expression of the protein in E. coli BL21 (DE3) was induced using IPTG. The recombinant HER2-MUC1 (HM) protein was purified using a Ni-NTA column and confirmed by western blotting. Chitosan nanoparticles containing the target protein were prepared and the lymphocytes viability was evaluated using MTT assay. The expression of the recombinant protein with molecular weight of 40 kDa was confirmed using SDS-PAGE and Western blotting. The electric charge and the size of the nanoparticles were determined and verified by a Zeta Sizer device. The evaluation of IgG and IgA titration suggested that inducing humoral and mucosal immune responses by administering nanoparticles containing the chimeric protein. Analysis of cell-mediated immunity showed that the chimeric HM protein could induce specific splenocyte proliferation in immunized mice. It seems that HM nanoparticles can be utilized as a vaccine candidate for inducing the cellular and humoral immune response against breast cancer.

Osteosarcoma accounts for about 3% of childhood cancers and this tumor is the most common primary bone tumor. Lung and bones are the most common sites of metastases. Brain metastases are very rare and account for approximately 1.8% to 5.6% of all metastases. In this study, we reported osteosarcoma in a 12-year-old girl with primary lung metastases and subsequent brain metastases. In patients with osteosarcoma and evidence of pulmonary metastasis, performing brain imaging, even without evidence of neurologic sign and symptoms is reasonable.