Multidisciplinary Cancer Investigation
Volume:3 Issue: 3, Jul 2019

Malignant peritoneal mesothelioma (MPM) is a malignancy that arises from the mesothelial lining of the abdominal cavity and largely manifests as a diffuse process. There are two hallmark features of MPM. First, MPM may progress and present itself diversely among patients. While some patients may endure a quick tumor progression that is refractory to seemingly successful initial therapeutic cytoreductive surgery, other patients many survive several years despite the presence of disease. Second, the disease usually progresses in the abdominal cavity with clinically relevant systemic metastases being rare and therefore patients suffer morbidity and mortality from loco-regional disease progression. When MPM disseminates outside the abdomen, it only occurs in the setting of advanced intra-abdominal disease. The majority of patients present with nonspecific signsand symptoms, which often results in a diagnosis of MPM when the condition is already fairly advanced. As the diagnosis is often made late, patients who are treated with only supportive care have a median survival of less than one year. The combination of systemic cisplatin with pemetrexed has an overall response rate of approximately 25%. However, as primary therapy, these agents have not been shown to meaningfully alter the natural history of the disease. Operative cytoreduction and regional chemotherapy administered as hyperthermic intraoperative peritoneal chemotherapy or early postoperative intraperitoneal chemotherapy has been found to improve survival in appropriately selected patients.

Anthracyclines are one of the classes of chemotherapy drugs that  are widely used to treat many types of cancers including breast cancer. Taking this class of medications has a significant relationship with cardiac dysfunction. N-acetylcysteine has antioxidant properties and may be effective in preventing cardiac dysfunctions. In this study, we investigated the effect of N-acetylcysteine in preventing cardiotoxicity in breast cancer patients receiving anthracycline.
 A  total  of  60  breast  cancer  patients  who  underwent  chemotherapy  with anthracyclines were enrolled in the present case-control study and divided into two groups. The case group received 600 mg of N-acetylcysteine per day adjacent to chemotherapy; while  the  control  group  did  not  receive  this  medication.  One  month  after  the  last chemotherapy session, troponin I was measured as a predictor of cardiotoxicity.
Troponin I was positive in one patient in the case group compared with 3 patients in the control group without any significant difference among groups (P> 0.05) However, the respective mean±SD level of troponin I was 0.120±0.039 and 0.192±0.063 in the case and control groups with a statistically significant difference among groups (P <0.001).
Administration of 600 mg N-acetylcysteine per day during the anthracycline- based chemotherapy protocol in breast cancer patients may reduce the mean troponin I levels which can be a prediction of reduced anthracyclines cardiotoxicity.

Iron metabolism was found to be implicated in several cancers. Few epidemiologic studies; focusing on iron intake and lung cancer (LC), reported positive associations between heme iron and red meat. Based on estimates of iron contents in representative foods, we conducted the present study with the aim of analyzing dietary iron and its role on the incidence of LC in Uruguayan men, since this population has the highest meat intake worldwide.
A case-control study was performed on 843 LC cases and 1466 controls; using a specific multi-topic questionnaire including a food frequency questionnaire. This matched case-control study was designed according to age-frequency, urban/rural residence, and country region. Food-derived nutrients were calculated from available databases. Total dietary iron was calculated according to its animal, plant, heme and non-heme source after being adjusted by energy. Odds Ratios (ORs) were estimated by logistic regression; being adjusted for potential confounders.
Iron intake was associated with LC risk. Total (OR=3.26), animal (OR=3.73), heme (OR=2.94), and animal non-heme (OR=3.15) iron were positively associated with LC; whereas plant (OR=0.66) and non-heme fraction in total iron (OR=0.56) were inversely associated with LC incidence. Risks were very similar for all histological types of tumors. In addition, stratified analyses showed higher ORs for intense smokers and intense “maté” drinkers.
The source and proportions of dietary iron might be of importance as a link to lung carcinogenesis; suggesting that low intakes of animal sources and high consumption of plant sources could be healthier. Further studies are needed to clarify this point.