International Journal of Cancer Management
Volume:15 Issue: 5, May 2022

The use of neoadjuvant chemoradiation has enhanced local control in rectal cancer patients.

The aim of this study was to evaluate the feasibility and efficacy of adding a high dose rate (HDR) brachytherapy (BRT) boost in locally advanced rectal cancer.

This retrospective trial was conducted based on the medical records of patients with rectal cancer, who were referred to a tertiary hospital for neoadjuvant treatment. Fifteen patients who were treated with HDR brachytherapy boost after completion of external beam radiotherapy (EBRT) and concurrent chemotherapy were enrolled in the intervention group and 15 patients who were clinically matched (age, sex, stage, and distance of tumor from anal verge) were selected as the control group. EBRT schedule and concurrent chemotherapy regimen were similar in the two groups. The rate of pathological complete response (PCR), downstaging (T staging), and frequency of side effects were compared between the two groups of the study.

The mean age of patients was 57.97 ± 9.11 years and 18 patients (60%) were male. The results showed that T 3 and N 1 rectal cancer had the highest frequency among patients. Downstaging was observed in 66.7% and 80% of the control and intervention groups, respectively (P: 0.40). The rate of PCR was not different in the two groups (13.3% in both groups, P > 0.99). There were no significant differences in terms of treatment complications between the two groups, as well.

HDR-BRT boost for rectal cancer is feasible and might improve downstaging in rectal cancer, but not PCR

The nature of cancer is such that it causes several problems for patients and caregivers. As a vital source of support for patients with cancer, family caregivers must seek assistance and make use of available resources to overcome these issues and offer better care for the patient.

This study aimed at exploring the challenges of seeking help in Iranian family caregivers of patients with cancer from supportive sources.

This qualitative study was conducted from 2019 to 2021 on 15 family caregivers with a wide variety of caring experiences and 13 health professionals (i.e. nurse, physician, social worker, clergyman, and family counselor who were engaged with services for the patient and caregiver) via purposive sampling and semi-structured in-depth interviews in a central cancer care hospital in Isfahan. Graneheim and Lundman’s conventional qualitative content analysis approach was used to analyze the data. To assess data trustworthiness, Lincoln and Guba’s criteria were used. Data management was performed using MAXQDA (v. 10) software.

Four main categories were identified consisted of (1) being strained by social desirability; (2) stigmatizing attitudes toward help-seeking; (3) reactive self-forgetfulness; and (4) resistance to change.

The need to develop and implement interventions geared to enhance family caregivers’ preferred attitudes and personal skills in order to overcome socio-cultural obstacles to help-seeking behaviors was underlined in this research. Both health care professionals and the community should be prepared to make support services more accessible and usable for family caregivers.

Adherence to the treatment regimen is among the behaviors, which predict the successful control of the disease and decrease its intensity and negative consequences, which is influenced by several factors. The patient’s beliefs and attitudes toward the disease are effective factors in disease management and adherence to treatment, and spiritual health is one of these influential variables.

The aim of this study was to determine the mediating role of spiritual health in adherence to treatment in patients with cancer.

In this descriptive correlational study, the participants were 234 Iranian patients with cancer, who were selected through convenience sampling, admitted to the oncology wards of 9 selected teaching hospitals in the northern, southern, eastern, and western provinces of the country, as well as the capital in 2021. The research instruments included the Demographic and Clinical Information Questionnaire, Spiritual Well-Being Scale, and Morisky Medication Adherence Scale-8. The path analysis was done to determine the factors related to the degree of adherence to treatment, taking into account the mediating role of spiritual health.

The mean age of the participants in the study was 47.27 ± 15.36. The mean scores for spiritual health and adherence to treatment were 76.70 ± 13.75 and 6.47 ± 2.1, respectively. A positive and significant relationship was found between spiritual health and adherence to treatment (P-value < 0.05). The variables of marital status, the time of diagnosis, and being a religious person had a direct effect on spiritual health, and the time of diagnosis indirectly affected treatment adherence.

According to the results, the level of spiritual health and adherence to the treatment in patients with cancer was moderate. In addition, the variable of diagnostic time affected adherence to treatment indirectly. Besides, in examining the factors affecting spiritual health, the findings indicated the effect of the variables “being religious”, “marital status”, and “the time of diagnosis”. In addition to strengthening spiritual health, it is necessary to highlight the need to follow therapeutic diets in these patients. Therefore, it is suggested to consider a program to meet the patients with cancer spiritual needs along with the physical care program.

Valproic acid (VPA), a branched short-chain fatty acid and histone deacetylase (HDAC) inhibitor, has diverse biological activities in human cells, including anti-cancer properties.

In the present study, we tested the cytotoxicity of VPA on the proliferation, cell cycle, and apoptosis of the human cervical cancer cell line, HeLa.

HeLa cell line was cultured in Dulbecco’s modified eagle medium (DMEM) and the cytotoxicity effect of VPA (at 0 - 100 mM) on the HeLa cell was evaluated, using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay for 3 incubation times (24, 48, and 72 h). The effects of VPA on cell cycle arrest and apoptosis were evaluated, using flow cytometry. In addition, the alterations in the expression of Bax, Bcl-2, p53, and p21 were assessed with real-time polymerase chain reaction (PCR).

Valproic acid reduced the viability of HeLa cells in a concentration- and time-dependent manner, and the IC50 values at 24, 48, and 72 h were 32.06, 21.29, and 14.51 mM, respectively. Further, VPA treatment remarkably increased the apoptosis of HeLa cells and arrested cells at the sub-G1 phase with a significant reduction in G2-M phase populations. The real-time PCR results demonstrated a significant increase in the expression of pro-apoptotic genes, including Bax, p53, and p21, as well as a reduction in the levels of the anti-apoptotic gene, Bcl-2.

Valproic acid inhibits the proliferation of the HeLa cell line through the induction of the intrinsic pathway of apoptosis in a p35-dependent manner.

Breast sarcomas are a group of rare and non-epithelial malignancies that account for less than 1% of breast cancers. There are few epidemiologic studies on this type of cancer due to its rarity.

In this study, the database of the Iran National Cancer Registry (INCR) from March 2009 to March 2014 was used to calculate the age-specific incidence rate for breast sarcoma in Iran. Moreover, age-standardized incidence rate (ASR) for pathologic subtypes, pathologic grades, and different regions of the country were determined.

Totally, 258 breast sarcoma patients were included in this study in Iran. The ASR of breast sarcoma was 1.17 (95% CI: 1.02, .32) and 0.60 (95% CI: 0.52, 0.67) per million person-years for women and the total population, respectively. ASR was 0.03 (95%CI: 0.01, 0.06) per million person-years for male patients. The highest age-specific incidence rate for malignant phyllodes was observed among patients aged 55 to 59 years (1.0; 95% CI: 0.5, 1.5), and for other sarcomas, it was found among those aged 70 to 74 years (0.9; 95% CI: 0.2, 1.6). The most prevalent pathologic grade of sarcoma was grade 3 with an ASR of 0.40 (95% CI: 0.34, 0.46) per million person-years.

Compared to western countries, Iran has a lower incidence of breast sarcoma in women, a higher incidence rate in men, and older onset age. As in other countries, malignant phyllodes tumors and angiosarcomas are the most common subtypes. In addition, breast sarcoma incidence rates in different grades are similar across countries.

The use of molecular methods in cancer diagnosis has led to a better prognosis. One of the important gene families in the carcinogenic pathways of various cancers is the forkhead box (FOX) family genes. Moreover, developmental transcription factors and proapoptotic proteins play critical roles in cell function and carcinogenesis.

The current study aimed to evaluate the expression of A1 FOXA1, FOXA2, SOX10, and growth arrest specific 2 (GAS2) genes in oral squamous cell carcinoma (OSCC) tumors due to biomarker discovery and early diagnosis of cancer.

To evaluate the expression of FOXA1, FOXA2, SOX10, and GAS2 genes, 30 OSCC samples and 30 normal specimens were obtained from Imam Khomeini Hospital Cancer Institute. RNA extraction and cDNA synthesis were done by relevant kits. After a specific primer design for FOXA1, FOXA2, SOX10, and GAS2 genes, real-time PCR was done to evaluate the genes’ expression for molecular biomarker discovery and validation. ANOVA and independent t-test were used to analyze the data.

Significant differences were observed in the expression of the studied genes in tumor and control tissues (P < 0.001). The results showed that FOXA1, GAS2, and SOX10 expressions in tumor and normal cells have significant differences (P < 0.001). Regardless of FOXA1, FOXA2 and SOX10, there was a significant difference in the expression of GAS2 genes in term patients’ age (P < 0.05) and overexpressed in patients over 55 years. SOX10 gene is upregulated in grade II OSCC tumors but there is no significant difference in expression of FOXA1, FOXA2, and GAS2 in different stages and grades. The ROC curve analysis, FOXA1, and FOXA2 showed AUC = 0.66 and AUC = 0.57 respectively. Meanwhile, SOX10 and GAS2 showed AUC = 0.9 and AUC = 1 respectively.

In general, the expression of FOXA1, GAS2, and SOX10 genes in cancer and control tissues were different, and therefore the role of these genes in OSCC is confirmed. Also, in the present study, the biomarker potential of SOX10 and GAS2 genes for OSCC diagnosis was demonstrated. In the current study, the important role of the studied genes in OSCC diagnosis was shown. However, further studies are needed to confirm this.