International Journal of Cancer Management
Volume:13 Issue: 3, Mar 2020

 Patient-reported outcomes (PROs) are widely utilized in research and clinical practice. The functional assessment of cancer therapy-breast cancer (FACT-B) provides effective indexes addressing different dimensions of quality of life (QoL) in patients with breast cancer.

 The study aimed at evaluating the validity of the functional assessment of cancer therapy-breast symptom index (FBSI-6 and -8) on Iranian patients.

 Overall, 223 patients from three cancer centers participated in the present study. Internal consistency was assessed via Cronbach’s alpha and inter-item correlations. Spearman’s rho correlation was utilized to evaluate convergent/divergent validity and performance of the target indexes in terms of psychosocial distress, compared to trial outcome index-physical/functional/breast (TOI-PFB), as well as TOI emotional/social/breast (TOI-ESB) cancer subscales. The known-groups analysis, using Mann-Whitney U and Kruskal-Wallis tests, was conducted based on the history of metastasis, chemotherapy, radiotherapy, mastectomy, and time since diagnosis. P value < 05 was considered significant.

 Both of the target indexes showed acceptable internal consistency. They were highly correlated with physical wellbeing and TOI-PFB, moderately with functional wellbeing and breast cancer subscale, lowly with the arm subscale, and very lowly with social wellbeing (P < 0.0001). All indexes showed significant and negative correlations with distress symptoms (P < 0.0001). The FBSI-8 slightly outperformed FBSI-6 in terms of distress symptoms. No significant differences were seen in the target indexes based on clinical characteristics, including metastasis, chemotherapy, radiotherapy, mastectomy surgery, and time since diagnosis.

 The current study confirmed the validity of FBSI-6 and -8 among Iranian women with breast cancer. Further research is required to evaluate the more profound properties of FBSI.

 Childhood cancer leads to emotional disruption and distress in mothers.

 The aim of this study was to determine how much maternal distress tolerance could predict parenting style and the child’s attachment behaviors.

 In this cross-sectional study, which was carried out in May and June 2018 in Mahak Hospital (a specialized pediatric oncology hospital), based on Morgan tables, 130 mothers of children with cancer (leukemia or brain tumor) participated. The available sampling method was used. Simultaneous multiple regression analysis by SPSS 24 was applied for data analysis.

 The results of this study showed that the level of low distress tolerance predicted authoritarian parenting style (P < 0.05) and high tolerance predicted logistic authority (P < 0.001), while the permissive style was not predicted with maternal disturbances. On the other hand, high tolerance foresaw positive adaptive evolution and low tolerance projected emotional response and negative behaviors of the child with cancer (P < 0.001), but could not predict avoidance behavior.

 Mothers with more ability for disruption tolerance tended to use the authoritative parenting style and mothers, who were more disrupted, were more likely to use authoritarian style. Mothers with less disturbance in the development of positive adaptive evolution and management of emotional reactions and negative behaviors in the patient’s child were more effective (or at least had a more positive perception of their child’s excitement and behavior), but maternal disturbances had a disturbing behavior in children with cancer. The education of distress management is recommended for mothers with a child with cancer.

 The heterogeneous nature of acute myeloid leukemia (AML) and the hurdle to find a suitable treatment strategy for this malignancy put this type of leukemia at the top of the list of the priorities for finding a valuable biomarker to improve its treatment and predict the outcome of the patients.

 Given the involvement of the variety of signaling pathways, foremost the PI3K axis in the pathogenesis of human cancers, we aimed to investigate the expression of the most important downstream targets of this pathway to propose a plausible mechanism underlying AML pathogenesis.

 In this case-control study, the blood samples from 30 patients diagnosed with AML were collected and after extracting their RNAs, the expression levels of Akt, c-Myc, CIP2A, and PP2A were evaluated using qRT-PCR analysis. For the control group, we also collected blood samples from 10 healthy volunteers. Afterward, by applying statistical analysis, we determined the probable correlation between the expressions of the aforementioned genes.

 There was a significant elevation in the expression levels of Akt, c-Myc, and CIP2A coupled with the meaningful reduction in the expression level of PP2A in AML samples. However, we failed to find any significant association between the expression level of the indicated genes and age, sex, and the percentage of the blasts.

 As the most straightforward interpretation of our results, we propose that probably the association between PI3K and c-Myc which is built through the interaction between CIP2A and PP2A may play a pivotal role in the pathogenies of AML and any component of this axis could serve as a potential new target for more profound treatment strategy. However, further detailed investigations in this field are required to clarify the exact role of this interesting testis-specific pathway in the context of hematological malignancies, in particular AML.

 The use of regional methods in various types of surgery such as mastectomy is very popular today. Various methods, including Pecs I-II block, erector spinae, epidural thoracic, and paravertebral block have been used in these operations, each with its own advantages and disadvantages. Recent studies on the effect of μ receptor stimulation on the likelihood of recurrence and metastasis have been published, which make the use of a suitable regional approach with low complications and high efficacy attractive. Among the side effects of breast surgery in patients with cancer are nausea and vomiting, the risk of which is reduced through regional procedures that reduce the need for opioids.

 We randomly divided 64 patients into two pectoralis block (Pecs B) and erector spinae block (ESB) groups. Visual analogue scale (VAS) scores at 2, 4, 6, and 10 hours, nausea and vomiting, need for opioids, and hemodynamic changes were recorded.

 The analyses showed that pain score was significantly higher in the Pecs B group compared to the ESB group, while VAS score, as well as the frequency of opioid use, were lower, which could be due to medial branch of the anterior intercostal nerve. Hemodynamic changes were also significantly greater in the ESB group, which could be due to the proximity of the block to the thoracic sympathetic nerves and spinal cord.

 Despite the statistically significant differences in analgesia and hemodynamic changes, the seemingly superiority of the Pecs B is not clinically significant and the use of both types of the block is selective. Regarding the need for opioids and nausea, Pecs B showed a tangible advantage over ESB.

 Intraoperative radiotherapy (IORT) within breast conserving surgery (BCS) is progressively utilized to deliver the optimal dose of radiotherapy immediately after the excision of cancer during the same operation to the well-vascularized tissue and to the margin of resected cancer to damage the cancer cells, which might remain nearby the tumor just on time without no delay as radical irradiation for particular cases or as boost dose for others.

 This study reports 54-month single-center experiences after introduction to deliver IORT (50 kV x-ray) as a tumor bed boost in BCS for breast cancer and comparison with external beam radiation therapy (EBRT). In this retrospective study, 255 patients (stages 1 - 3) with breast cancer were treated with BCS and IORT in the Cancer Research Center, Shahid Beheshti University of Medical Sciences (April 2014-September 2018). They received 20 Gy IORT as a boost compared with 321 patients in the same stages with EBRT.

 Within 54 months, there were 3 (1.2%) occurrences of local recurrence in IORT patients compared with 8 (2.5%) local recurrences in EBRT patients (P = 0.361) and 12 (4.7%) metastasis in the IORT group vs. 20 (6.2%) in the EBRT group (P = 0.724). The 5-year disease-free survival (DFS) was 85.1% in the IORT group compared with 86% in the EBRT group.

 IORT tumor bed boost with 50 kV x-ray during breast conserving therapy had a better outcome, but it was not significant compared with EBRT.

 Hedgehog signaling pathway abnormality plays an important role in the development of various cancers. PTCH1 and SMO proteins are essential receptors in the hedgehog signaling pathway. Quinacrine as a derivative of 9-aminoacridine revealed an inhibitory effect on the growth of some cancer cells. Triple-negative breast cancer with stem cell-like characteristics remains a poor prognostic type.

 In this study, the effect of quinacrine on patched1 protein receptor (PTCH1) and smoothened protein receptor (SMO) gene expression in the hedgehog signaling pathway was evaluated in MDA-MB 231 breast cancer cell line.

 Toxicity of quinacrine was determined based on the MTT assay results. MDA-MB 231 breast cancer cells were treated with 0.5 µM quinacrine for 72 hours. The alteration of the hedgehog signaling pathway was studied by quantitative assessment of PTCH1 and SMO gene expression. Results were evaluated using t-test and were analyzed based on P < 0.05.

 This study showed that 0.5 µM quinacrine decreases SMO gene expression involved in the hedgehog signaling pathway (-2.1 fold) in MDA-MB 231 breast cancer cell line (P = 0.007). Quinacrine had no significant effect on PTCH1 gene expression (P = 0.059).

 The SMO gene inhibition by quinacrine could affect breast cancer cells growth with respect to its oncogenic role.

 Persistent Mullerian duct syndrome (PMDS) is a scarce type of male pseudohermaphroditism due to anti-Mullerian hormone dysfunction. So, Mullerian duct derivatives such as the uterus, cervix, fallopian tubes, and two-thirds of the vagina are seen in a normal phenotypic and genotypic male. Considering and assessing the clinical manifestations, associated diseases, histopathology, and imaging findings can be clues in the management of such cases.

 Here, we describe a case of PMDS with left inguinal hernia and bilateral cryptorchidism and discuss the management and review of the literature. Also, the case has a history of brain mass with a pathologic diagnosis of ganglioneuroma. Is there a correlation between PMDS and extragenital neoplasm? it needs more investigation in the future.

 Bilateral cryptorchidism could provide us with a hint toward PMDS diagnosis. However, genetic counseling will be required, particularly in parental consanguinity.