Basic and Clinical Cancer Research
Volume:3 Issue: 1, Winter 2011

After cardiovascular events and trauma, cancer is the third leading cause of death in Iran; Based on Globocan2008, about 70000 cancer cases were diagnosed in Iran and about 40,000 patients were died of cancer in 2008. Due to poor prognosis and low survival rate of cancer patients, improvement of health care infrastructure and is necessary to mitigate burden of cancer in Iran and many other developing countries. I t has been estimated that cancer will take over other causes soon and in 2030 it will rank number one among the causes of death. Due to the importance of attention to cancer, local and international efforts are needed to combat this deadly disease. World Health Organization (WHO) advice individual countries to plan and implement a comprehensive control program. Cancer care needs a multidisciplinary team, including oncosurgeons, oncologists, radiotherapists and radiologists. Multidisciplinary clinics create a collaborative atmosphere among the cancer specialists, leading a drastic and effective decision for individual patient in the joint clinics.As surgery is the cornerstone in the treatment of majority of cancers, oncosurgeons has a critical role in such clinics, leading to better survival for patients with their involvement in the decision and treatment of the patients. It has been shown that hospital volume, skill and attitude of surgeon, new surgical techniques and proper use of adjuvant treatment and other advances in the treatment of patients have led to a positive impact on the patient outcome and improved prognosis of cancer worldwide.. Cancer institute is the scientific pole of cancer care in Islamic Republic of Iran and provides high standard services for cancer patients including diagnosis, treatment, and palliative care. We have inaugurated the fellowship of cancer surgery since 2007 and train general surgeons with the latest techniques and methods introduced in the cancer surgery. In collaboration with other clinical disciplines in our joint clinics, our fellows learn how to manage sophisticated cancer cases. This program offers an invaluable opportunity to general surgeon to get familiar with the management of different types and complicated cancer patients. We believe that this initiative will pave the way for better prognosis and higher quality of life among cancer patients at the regional and national level

Due to the marked increase in the burden of cancer both in the developed and developing countries, World Health Organization recommends planning and implementation of comprehensive cancer control program in all countries. We evaluated evolutionary progress of the population based cancer registries (PBCR), as an essential component of the cancer control program. We studied frequency and coverage of cancer registries worldwide in overall and stratified by regions and countries, using the data published in the “Cancer in Five Continents (CI5)” volume I-IX. Using the population proportion of the study unit as the weight, we estimated weighted average of the registration coverage in the studied countries and regions. We found that coverage of cancer registry is increasing worldwide. In overall, 224 PBCRs estimate cancer incidence in 19.6% of world population. While the coverage was almost complete in the western countries, some counties particularly in Africa and Asia lack even a single cancer registry. The lowest coverage was generally observed in Africa (1.4%) and Southeastern Asia (2%). Using information technology, lead to a considerable increase in the coverage of cancer registries in the US, where it increased from 14% percent in 1997 to 96% in 2002. Developing countries must prioritize establishment of cancer registration system. Looking at the developed countries with well-functioning registries may help establish an efficient registration system in developing countries. Using advance information technology will help achieve an efficient and optimal PBCR

The present study was performed to investigate the effects of trace elements particularity Se, Zn and Cu on tumor genesis in breast cancer. The inhibitory effect of Se, Zn and Cu, on telomerase activity was analyzed in human breast tumor tissues and breast cancer (T47D) cells. Tissue specimens from 24 women with benign breast disease and 32 women with breast cancer specimens (ductal carcinoma, lobular carcinoma) were collected during surgery. In addition venous blood samples were obtained for assessing the trace elements. T47D cell line was cultured and treated with trace elements. Telomerase activity then was measured with TRAP assay in cell line and tissue extracts. There was a significant difference between tissue and serum levels of Cu, Se and the ratio of Cu/Zn in patients and controls (P<0.001). After treating with 100 μm/L Zn So4, 10 μm /L Cu So4 for 6 hours, telomerase activity of T47D cells was markedly increased. But after treating with 10, and 30 μm /L selenium-L- methionin, telomerase activity was markedly inhibited. Telomerase activity of T47D cells for 24 hours were 0.93, 0.60 and for 48 hours were 0.76, 0.12 respectively (control 49.2℅). There were variations in serum level of Zn and Cu in breast cancer patients. Association between trace elements level and telomerase activity level can be exploited as prognostic and diagnostic marker for breast cancer.

Background. We evaluated the efficacy of a simple belly-board device (BBD) designed and made in our department for reduction of small bowel inside the post-operative pelvic radiotherapy fields of rectal carcinomas. A very simple BBD was designed and manufactured in our department. It was made of acrylic glass, and was 128 cm long, 40 cm wide, and 9 cm high, with a 25x25 cm square opening, the lower border of which was set to be positioned about 3 cm above patients’ iliac crest. Patients to be treated post-operatively for rectal cancers were simulated using oral contrast with and without the BBD for postero-anterior (PA) and lateral fields. The small bowel surface area (SBSA) inside the fields was measured and compared in the films with and without the BBD. Twenty-one patients, mean age 56 years, male-to-female ratio 2:1, 12 abdominoperineal (APR) and 9 low anterior resection (LAR), gave consent for this study. The mean SBSA were 7 and 13 cm2 in the lateral fields and 29 and 60 cm2 in the PA fields with and without the BBD, respectively (p = 0.001). The mean reduction in SBSA was 61% in the lateral fields, 53% in the PA fields, and 57% in both lateral and PA fields

In this study we evaluated the incidence of hypothyroidism in patients who received external beam radiation due to cancer, when radiation portals included thyroid gland. This prospective study was conducted from April 2004 to December 2005 among patients with head and neck or breast malignancies who referred to Radiation Oncology Department of Cancer Institute, Imam Khomeini hospital, treated with external beam radiotherapy. All patients received radiation to the thyroid gland. Thyroid function was tested at the beginning of treatment, 3 months and 6 months after the completion of radiotherapy. In all 34 patients were included in the study. The median age of patients was 53 years. Eighteen patients were female and 16 were male. All patients received external radiotherapy. They received radiation ranging from 5000 cGY (14 patients 41.2%) to 7400 cGY (1 patient 2.9%) with median of 6000 cGY. Physical examination of thyroid at the beginning of treatment was normal and all of the patients were euthyroid. The results from TSH test showed significant difference at baseline, after 3 and 6 months follow-up (P = 0.001) The findings indicated that none of the patients developed hypothyroidism in a period of six months after completion of radiotherapy. However, it seems that 6 months fallow-up is early for judgment about evaluation of patients for hypothyroidism state and it needs further follow up for minimum of 12 months

The study aimed to examine the association between human leukocyte antigen (HLA) class II allele frequencies and breast cancer in Iranian women. A total of 100 patients with pathologically proven breast cancer who referred to Cancer Institute were randomly selected and compared with a group of age matched healthy blood donors (n = 80). HLA class II alleles were determined by amplification of DNA followed by HLA-typing using sequence-specific primer (SSP) for each allele. The frequency of HLA-DQA1*0301 (P=0.001, OR=3.4) and HLA-DRB1*1303 (P=0.02, OR=2.3) among breast cancer patients was significantly higher than those in control group. HLA-DQA1*0505 (P=0.003, OR=0.4), HLA-DRB1*1301 (P=0.002, OR=0.12) and HLA-DQA1*0101 (P=0.01, OR=0.21) alleles showed negative association with breast cancer. The findings suggest that HLA-DQA1*0301 allele is mainly associated with increased risk of breast cancer in Iranian female patients. HLA-DQA1*0505 and HLA-DRB1*1301 alleles are suggested as protective genetic factors against breast cancer. The findings confirm that specific alleles of HLA class II influence breast cancer risk.

Tongue cancer is one of the most common cancers of the oral cavity, excluding lip, and the median age of the patients is approximately 60 years. Treatment results of a total of 110 patients with oral tongue cancer admitted to cancer Institute of Tehran University between1999-2003 were retrospectively analyzed. The patients were treated by surgery or radiotherapy or chemotherapy in a curative setting. The median age at the time of first visit was 67 years (range 27-91years).51 patients (46.4%) were female and 59 (53.6%) were male.Primary treatment was surgery in 86 patients (78.2%), radiotherapy alone in 12 patients (10.9%), chemo radiation in 3 patients (2.7%) and chemotherapy (as neo adjuvant therapy) in 8 patients (7.3%).Median dose of radiation in patients who received radiotherapy was 6000CGY in the range of (5000-7500 CGY).Median of follow-up of patients was 10 months in range of (1-78) months. Local and loco-regional recurrence remains a major clinical problem in oral cavity tumors. Additional studies and detailed analysis of the selection criteria and treatment outcomes across trials are needed to define the best treatment modalities.

GBM is the most common and malignant astrocity tumor and it is persistent to common treatment so, these patients have a very low survival. Several researchers around the world, including Iran, have been investigated GBM-cell line in vitro. However in vivo studies have not been fulfilled. As standard cell line (U-87MG) derived from human GBM and total GBM tumor derived from 3 patients were heterotypic ally injected into 4-6 weeks old athymic nude mice. Pathologic investigation by H&E, GFAP and Ki-67 were examined 2 months post implantation. GBM characteristics appeared in H&E and GFAP and the rate of proliferation was 6% and in direct xenograft tumor was 9% which was consistent with the pathologic result of patient. GBM Xengraft is the most suitable model for in vivo investigation and researcher can evaluate new treatments for this tumor. On the other hands, Pharmacogenomics differences in treatment response could be indicated among Iranians.

Breast cancer is the second most common cause of brain metastasis. Although patient prognosis is poor, isolated brain metastasis occasionally can be an option for treatment with curative intent in breast cancer patients. We report a patient with invasive ductal carcinoma of the breast who developed an isolated right frontal lobe metastasis within 5 months of finishing her breast cancer treatment. Despite aggressive course of primary disease the metastasis was successfully controlled by surgical excision and adjuvant whole brain radiation therapy. The patient is now quiet well and disease free approximately six years after treatment of brain metastasis. A small subgroup of brain metastasis with breast primary can have a considerable survival with adequate local treatmen

Brooke-Spiegler Syndrome (BSS) is a rare autosomal dominant disease characterized by the development of multiple adnexal cutaneous tumors such as cylindromas, trichoepitheliomas and spiradenomas. Case Description: A 49 years old female patient presented with a history of gradual appearance of multiple nodules situated predominantly on the scalp and face. Pathologic examination of lesions revealed cylindroma with foci of spiradenoma. Brooke-Spiegler Syndrome (BSS) caused by various mutations of the cylindromatosis gene (CYLD), a tumor suppressor gene resulting in multiple cylindromas and trichoepitheliomas. Malignant transformation may develop within solitary cylindromas, but more common in multiple variant and requires careful followup surveillance.