International Journal of Cancer Management
Volume:1 Issue: 2, Spring 2008

Breast Carcinoma is the first malignancy among Iranian ladies and the second cause of death due to cancers after gastric carcinoma. According to the World Health Organization the annual incidence rate of breast cancer will rise 1.8 to 2 percent. It is one of the most important health problems. Five year survival is one of the indicators used for evaluation of the quality of care to different types of malignancies. In this study we decided to compare the result of mastectomy and breast conserving surgery in the survival of patients with breast carcinoma.. This is a retrospective study using data from breast carcinoma cases in a private clinic under supervision of the author during years 1994 until 2007. These cases base on the clinical status underwent surgery as mastectomy or breast conserving with other necessary treatment. The number of patients with acceptable follow up was 464 cases that 441 were included to define survival. The data were analyzed by SPSS and survival estimated by Kaplan Mayer method. Survival curve was estimated for 441 cases of them, six cases were men and the age of patients was 22 to 104 years old with average of 53.24 years and standard deviation of 12.41. The most cases were among 45-55 years old. Five and ten years survival for all cases was 81 % and 77% respectively. These data for mastectomies patients was 78 and 70 percent and for breast preserving cases was 86 and 78 percent which was not significant in log rank test with p-value equally 0.13. There was no significant difference between mastectomies patients versus breast preserving cases in all clinical stages although the crude data shows better situation in breast preserving surgery (BPS). Breast cancer is one of the most important health problems, nowadays breast preserving surgery is choice treatment for stage I and II throughout the world. In this study overall 5 years survival was 81% comparable with developed countries with different health delivery system and quality of care and it is much better than other reports from Iran, regional and comparable countries. Because of many reasons such as physical, social and psychological effect of BPS, we recommend it as the best choice for managing breast cancer patients in stage I and II and even III in clinically approved cases in Iran similar to other countries.

evidence suggests that the incidence of many cancers including bowel cancer vary according to socioeconomic status and education. In case of colorectal cancer, the direction of this association might be even different for anatomical subsites. The aim of this study was to describe the variation in the incidence of colorectal cancer by subsites across North of England and correlate it with community deprivation. Incidence data were obtained from a population- based cancer registry for the period 1976-2000. Small areas were characterized by their affluence or lack of it, by deriving a Townsend score for each Enumeration District from the 1991 census. The age-standardized incidence rates were calculated for different sites of colorectal cancer for each fifth. The association of each fifth with incidence was also studied using Poisson regression. in men, the age standardized incidence for rectal cancer ranged from 18.3 (for fifth 1, most affluent) to 22.3 (for fifth 5, most deprived) but the trend for proximal cancer was reverse (9.4 for fifth 1 and 8.8 for fifth 5). Poisson models showed a significant inverse association between deprivation level and proximal cancer in both genders. Rectal cancer had a positive significant association with deprivation level in men (RR+1.25, 95% CI, 1.19-1.32). the association of socioeconomic status with proximal cancer was different from that with rectal cancer. Socioeconomic status is not a direct risk factor and might consider as a proxy for life style factors. This indicates that lifestyle correlates of different subsites of bowel cancer differ. Therefore, the different sites of CRC should not be combined in aetiological studies.

According to the statistics over 30000 deaths occur annually in Iran due to cancer with an incidence of over 70000 new cases; this growing rate is similar to the developing world. These figures do not take into account other chronic illnesses like diabetes, heart failure, gastro-intestinal disorders, chronic neurological disorders and lung disease, which all warrant palliative care.A systematic review was conducted until the end of 2007, to find out the ways that palliative care services are provided for Muslim patients suffering from cancer. Only three papers met the criteria as being original research either quantitative or qualitative, published during the last 10 years. Our findings conceded that very few papers are available in Islamic context about spiritual care at the end of life, where only one was quantitative. While cancer is rapidly increasing specially in developing world, the need of terminally ill patients with other conditions should be equally considered. Despite the fact that spirituality in Islamic societies exists profoundly, spiritual care must be institutionalised for patients who are in most need at their end of life, which needs more evidence.

Currently, cancers are among the important and main problems of health system in Iran and around the world. In young men under 20 to 35 years of age, malignant masses of testis are the most common tumours. The main pathologic feature of these masses is germ cell tumour and about half of them are seminoma. Since seminoma is very prevalent in the forth decade, being affected with this tumour leads to losing many years of healthy life. In a cross sectional study, investigating 139 records of patients with testis tumour revealed 61 patients with stage-1 seminoma. Thirty three patients underwent para-aortic and unilateral pelvic irradiation (54%) while 28 patients only underwent para-aortic irradiation (46%). The administered radiotherapy dosage varied between 25-40 Gy. Mean age of the patients was 37.8 of whom the youngest was 15 and the oldest was 64 years of age. Only one recurrent patient was seen in this cohort who was in para-aortic group. There was no significant difference in recurrence rate between the two radiotherapy methods. (p= 0.7). Considering fewer complications of para-aortic irradiation and the insignificant difference in the recurrence rate between the two methods of radiotherapy, para-aortic method could be more appropriate and acceptable in the treatment of testicular cancer.

This study was conducted to determine the outcomes of the project of ‘Integration of Breast Cancer Screening and Early Detection’ into Primary Health Care (PHC) System and to detect the incidence rate, mortality rate and the stage of reported breast cancers, during the timeframe of the project in Shahre-Kord. A prospective cohort study was conducted, reviewing medical records of all women aged over 30 in Shahre-Kord district who participated in the screening project between 1997 and 2006. Patients’ demographic data, risk factors, diagnostic approach, treatments after definite diagnosis, and time of death of the deceased patients due to breast cancer were investigated from four sources: Provincial Health Centre, direct conversation via telephoning and interview, medical records of patients admitted to Seyed-Al Shohada Hospital, Isfahan (as the only referral oncology hospital in the region), and the provincial vital registry system as a part of national cancer registry. Overall 52200 women were eligible to enter the study and in this population, 40 breast cancer cases were detected. Incidence rate of breast cancer in women older than 30 years, during the timeframe of study, is estimated as 77.6 per 100000. Clinical features of the patients were as follow: stage-IIA (20%), stage-IIB (40%), stage-IIIA (30%) and stage-IIIB (10%). All 40 cases of cancer underwent pathology diagnosis, which showed infiltrative ductal carcinoma in 38%, invasive ductal carcinoma in 33%, ductal carcinoma in 25%, and infiltrative coloidal carcinoma in 4% of them. During the study, 31 cases (77.5%) survived and 9 cases (22.5%) died, all due to breast cancer.Discussion and The mean age of breast cancer in this study was significantly lower than Western countries. Mortality rate due to breast cancer in this study during ten year follow up was 1.73 in 100000 women population, which is less than the national figure of 3.16 in 100000.

The prevalence of adnexal tumour has been reported to vary between one in eight thousands to 2.3% of pregnancies according to investigational techniques administered. Broader use of ultrasonography in pregnancy and the increasing rate of caesarean section (c-section) could be expected to lead to the diagnosis of more adnexal tumours compared to previous studies.Aim and To identify the histological types, clinical manifestations, prevalence of malignant forms, and to assess the risk of two selected treatment approaches i.e. surgical (invasive) vs. conservative. This retrospective descriptive study was conducted on patients admitted to Mahdieh Hospital, Tehran, between 2002-2006 with confirmed adnexal tumours in the third trimester of pregnancy. Patients’ medical records were reviewed for age, gestational age, parity, the reason for admission, diagnostic approach for adnexal tumour, ultrasound characteristics (where available), surgical and histopathological findings. In all, 45 patients were recognised. Mean age was 27.8 (±4.8) and mean gravity was 2.1 (±1.2). Incidence rate for surgically confirmed adnexal malignancy in the third trimester was one in 570 live births and one in every 184 caesarean section. In forty three patients, diagnosis and tumour resection occurred during caesarean section of whom the reason for c-section was the adnexal mass in five cases, 33 were accidentally found during c-section due to obstetrics indications and the remainder (5 cases) was due to both causes. One case underwent tumour resection after post-partum tuboligation and one after vaginal delivery followed by laparatomy. No complication due to malignancy was found. Diagnostic procedure was ultrasonography only in 10 patients (23%). of whom, half were in the third trimester and half were detected in the first trimester with the adnexal mass being 5-10 cm in diameter. All were benign in line with histological features. In 35 patients, no mass was reported despite ultrasonography. All had benign features in histopathology and the most frequent diagnosis was paratubal cyst followed by serous-cyst adenoma. Adnexal tumour complications in the third trimester are not frequent and the risk of malignancy is low. Therefore, if diagnosed, it is not a definite indication for an urgent surgical intervention provided that ultrasonographic feature of the mass is benign. In a cross sectional study, investigating 139 records of patients with testis tumour revealed 61

Depression is common in today world and this article seeks to address issues related to depression in cancer surgery. Surgical situations and their effects on patients, as well as depression in the family and the surgeon are highlighted

Giant cell tumor of soft parts is a rare neoplasm that mainly affects adulst and the elderly and is usually located in the extremities. Here we report a child with giant cell tumor of soft tissue, which is a very rare condition in childhood.Clinical presentation: A 5 year old girl presented with a 5 month history of left lower extremity pain. She had developed paraplegia before admission. On examination, mild left lumbosacral swelling and tenderness was found. Abdominal and pelvic CT-Scan revealed an expansile lytic lesion of the left side of sacrum with significant soft tissue component extending toward the left iliac bone. Lumbar MRI revealed a space occupying lesion originating from posterior L5 elements, projecting toward the L1.Intervention: The patient underwent surgery. A firm epidural hemorrhagic tumor of L5, S1, S2 with no spinal cord involvement was found. Partial tumor resection (measuring 3*1*0.5 cm in maximal diameter) and laminectomy was done. Primary giant cell tumors of soft tissue are distinctive, rare neoplasms that exhibit a wide clinicopathologic spectrum similar to osseous GCTs and need to be differentiated from other giant cell rich soft tissue tumors. Recognition of this tumor is important due to its behavior as a low grade malignancy, but this cannot be predicted and metastasis does occur rarely.