International Journal of Cancer Management
Volume:5 Issue: 4, Autumn 2012

Accurate Diagnosis of Breast Cancer is of prime importance. Fine Needle Aspiration test or «FNA”, which has been used for several years in Europe, is a simple, inexpensive, noninvasive and accurate technique for detecting breast cancer. Expending the suitable features of the Fine Needle Aspiration results is the most important diagnostic problem in early stages of breast cancer. In this study, we introduced a new algorithm that can detect breast cancer based on combining artificial intelligent system and Fine Needle Aspiration (FNA). We studied the Features of Wisconsin Data Base Cancer which contained about 569 FNA test samples (212 patient samples (malignant) and 357 healthy samples (benign)). In this research, we combined Artificial Intelligence Approaches, such as Evolutionary Algorithm (EA) with Genetic Algorithm (GA), and also used Exact Classifier Systems (here by Fuzzy C-Means (FCM)) to separate malignant from benign samples. Furthermore, we examined artificial Neural Networks (NN) to identify the model and structure. This research proposed a new algorithm for an accurate diagnosis of breast cancer. According to Wisconsin Data Base Cancer (WDBC) data base, 62. 75% of samples were benign, and 37. 25% were malignant. After applying the proposed algorithm, we achieved high detection accuracy of about»96. 579%” on 205 patients who were diagnosed as having breast cancer. It was found that the method had 93% sensitivity, 73% specialty, 65% positive predictive value, and 95% negative predictive value, respectively. If done by experts, Fine Needle Aspiration (FNA) can be a reliable replacement for open biopsy in palpable breast masses. Evaluation of FNA samples during aspiration can decrease insufficient samples. FNA can be the first line of diagnosis in women with breast masses, at least in deprived regions, and may increase health standards and clinical supervision of patients. Such a smart, economical, non-invasive, rapid and accurate system can be introduced as a useful diagnostic system for comprehensive treatment of breast cancer. Another advantage of this method is the possibility of diagnosing breast abnormalities. If done by experts, FNA can be a reliable replacement for open biopsy in palpable breast masses. Evaluation of FNA samples during aspiration can decrease insufficient samples.

The locally advanced head and neck cancer with fixed nodes are incurable and has a short survival. This study aims to evaluate the symptom relief, disease response and acute toxicity after palliative hypofractionated radiotherapy. Between December 2010 to June 2011, previously untreated 50 patients who had histopathologically proved of head and neck squamous cell carcinoma with fixed node of stage IV, Eastern Cooperative Oncology Group (ECOG) performance status 2-3 were offered palliative radiotherapy (20 Gy/5Fr/5 Days). Patients were evaluated at 15th and 30th day after completion of treatment for disease response (WHO), palliation of symptoms using symptomatic response grading and acute toxicities (Radiation Therapy Oncology Group, RTOG). The most common presenting complaint was pain followed by dysphagia. Majority of patients (60-70%) had appreciable relief in their presenting symptom. In our study, we observed Partial Response (PR) in majority of patients (92 %); no patient had progressive or stable disease. None of the patients experienced radiation toxicities that required hospital admission. Almost all patients showed grade one and two acute skin and mucosal toxicities one month after completion of treatment. Advanced head and neck cancer with fixed neck node should be identified for suitable palliative hypofractionated radiotherapy to achieve acceptable symptom relief in great proportion of patients.

Researches mainly focus on patients who suffer from cancer. Families and parents have been neglected in these researches although they experience levels of stress, depression and anxiety. This research aims at studying the effectiveness of Hope Therapy based on group therapy on hope and depression of mothers with children suffering from cancer in Aliasghar Children''s Hospital, Tehran (2010). In this applied and semi-experimental research, 20 mothers were selected based on Snyder Hope Scale and Beck Depression Inventory (pre-test). They were randomly assigned into two groups of experimental and control. Intervention based on Hope Therapy protocol was executed on the experimental group for eight weeks (eight sessions, each lasted for 2 hours). Afterwards, post-test was performed for both groups. After eight weeks, the experimental group completed questionnaires and the follow up phase. Results demonstrated that Hope Therapy increases hope (p<0.05), and decreases depression in mothers of children with cancer (p<0.001). Covariance analysis indicated that Hope Therapy significantly decreases depression and increases hope of mothers whose children suffer from cancer. Follow up results showed no significant changes in hope of this group of mothers in the two months after post-test, but depression was decreased significantly during this period. It was concluded that effectiveness of Hope Therapy may be continued during the follow up phase. Keywords: Hope Therapy; Mother; Child; Neoplasms; Depression

Lymphoma is a malignancy, arises from lymphoid tissue. Nowadays, it is the ninth most common cancer in Iran. The risk factors of malignant lymphomas have not well determined, but since 20 years ago till now, too many epidemiological researches have been concerning either Non-Hodgkin Lymphoma (NHL) or Hodgkin''s Disease (HD). It is a common usual hypothesis that idiosyncratic reaction to common physical, chemical, and viral agents could lead to lymphoma without obvious immune deficiency. Some occupations has reported to cause increasing «NHL» risks, such as rubber industry, veterinaries, uranium mining, metal working, asbestos exposing, farming, textile industry, and benzene exposing. The roles of ionizing radiation, benzene and other environmental agents have not been clear, because of the lack of confirmed evidences for relation between the occupational and environmental agents with «HD». A case-control study with 150 cases of malignant lymphoma and 150 controls have performed in Tehran. Data have selected through face-to-face interviews about the medical and occupational histories. In this study, there was a significantly increased risk for Non-Hodgkin Lymphoma in these occupations; welders, metal workers, founders, aluminium workers OR=4. 6[Confidence Interval (CI): 1. 47-14. 35] and increased risk for Hodgkin''s Disease in drivers OR=2. 34[(CI): 0. 86-6. 35]. We have found out decreased NHL risk in office workers OR=0. 54 [(CI): 0. 29-1. 02] and also found out a non-significant increased NHL risk in farmers OR=1. 58 [(CI): 0. 82-3. 03]. In this study, we have found no relation between smoking and HD, or NHL. The results of this study suggest that several occupations could alter the risk of Non-Hodgkin Lymphoma and Hodgkin''s Disease.

Our previous studies revealed an inhibitory effect of ICD-85 (venom derived peptides) on MDA-MB231 and HL-60 cell lines, through induction of apoptosis. The purpose of this study was to investigate apoptosis-induced mechanism on HeLa and MRC-5 cells by ICD-85 through activation of caspase-8. Cell viability, cytosolic enzyme Lactate Dehydrogenase (LDH) and cell morphology were assessed under unexposed and ICD-85 exposed conditions.Caspase-8 activity was assayed by caspase-8 colorimetric assay Kit. The results show that Inhibitory Concentration 50% (IC50) value of ICD-85 for HeLa cells at 24 h was estimated and found to be 25.32±2.15µg/ml. Furthermore, treatment of HeLa cells with ICD-85 at concentrations of 1.6×10 and 2.6×10µg/ml did not significantly increase LDH release. Morphological changes in HeLa cells on treatment with ICD-85 compared with untreated HeLa cells consistent with an apoptotic mechanism of cell death, such as cell shrinkage which finally results in the generation of apoptotic bodies. However, when MRC-5 cells were exposed to ICD-85, no significant changes in cell morphology and LDH were observed at concentrations below 2.6×10µg/ml. Also, the apoptosis-induction mechanism by ICD-85 on HeLa cells was found through activation of caspase-8 and the activity of caspase-8 in HeLa cells was 1.5 folds more than its activity on MRC-5 cells. Therefore, the apoptosis-induced mechanisms by ICD-85 are through activation of caspase-8 and concerning the least cytotoxic effect on MRC-5 cells, ICD-85 may be used as anticancer compound to inhibit growth of cancer cells.

Cancer is the second cause of death in the world, and colon cancer is the third cause of death and is one of the most common cancers which will cure with early diagnosis, treatment and sufficient follow up. Assessing factors which affect this cancer is important for prolonging patient survival. Socioeconomic factors are among effective factors of cancer morbidity and mortality. Because mortality rates for colon cancers vary by socioeconomic characteristics, this study has been performed to recognize the relationship between socioeconomic factors with treatment and follow up of colon cancer. This was a cross-sectional, descriptive study for patients with colon cancer registered in Cancer Research Center of Shahid Beheshti University of Medical Sciences from April 2005 to November 2006. Patients were selected randomly, and the study was conducted using questionnaires filled by interviewing the patients via phone (if a patient was dead, the questions were asked from their family members). Data analysis was done using SPSS (version 19) software. The study was performed on 520 colon cancer patients with age range of 23-88 years. The mean age of the patients was 63 (S.D. = 11.8) and the median age was 64.Two hundred thirty seven (45.4%) patients were female and 283(54.4%) were male. Using Chi- square test, age< 60 (P=0.002) and female gender (P=0.034) had a significant correlation with complete treatment and there was a significant relationship between complete follow up and age< 60 (P=0.037), academic education (P=0.02) and having insurance (P=0.021). Multiple logistic regression tests were used to evaluate concurrent effects of variables on treatment and follow up. Correlated variables to complete treatment include: age< 60 (P=0.001), and female gender The Odds Ratio (OR) of completing treatment for patients under 60 years of age versus patients above 60 years was 3.13 (95% C.I. 1.55 to 6.34), and the OR of completing treatment for women versus men was 1.91(95% C.I. 1.33 to 2.74). Correlated variables to follow up were academic education () and having insurance. The OR of cancer follow up in illiterate patients versus college-educated patients was 0.45(95% C.I. 0.24 to 0.82), and the OR of cancer follow up in patients without insurance versus patients with health was 0.46(95% C.I. 0.21 to 0.98). Age is a correlated factor on completing colon cancer treatment. Women have more complete colon cancer treatment than men. Academic education and having insurance were the most important factors among socioeconomic factors observed in a five-year follow up after treatment. As the population of the old is increasing, executing effective interventions to improve treatment and follow up procedures for old patients is of prime importance. It seems that increasing the insurance contribution in follow up measures may lead to increase in the regular follow up and may affect patients'' survival.

Breast cancer is the most common malignancy in Iranian women. Mutations in BRCA1 gene is one of the important genetic predisposing factors in breast cancer. This gene is a tumor suppressor that plays an important role in regulating the functions of RAD51 protein for strand invasion in homologous recombination repair. The BRCA1 gene has amplified in the DNA isolated from breast cancer patients'' leukocytes, using Polymerase Chain Reaction technique. The PCR products have sequenced using an automated DNA sequencer and subsequently obtained data have aligned with the human BRCA1 DNA sequences available online. In this study, we have considered nine different mutations on 60 examined chromosomes from 30 patients, living in Kerman province. A deletion of one adenine (c.1017delA) and insertion of one cytosine (c.969InsC) have found as the most frequent (20%) mutation in this survey. A substitution of thymine for adenine (c.999T>A) has detected as the second common BRCA1 gene defect (6.7%). The other mutations have identified as single nucleotide replacement including: c.792A>C, c.825G>C, c.822T>A, c.1068A>G, c.969A>T and c.966T>C. The identified BRCA1 mutations were in accordance with the previous reports. To our knowledge, four mutations: (c.969InsC, c.792A>C, c.825G>C, c.822T>A) which have identified in this study, have not been previously reported in the literature. A larger cohort study would help identifying all relevant BRCA1 mutations in this population.

After chemo/radiation therapy, mucositis is one of the most common side effects, so timely nursing care and instructed home care, significantly could decrease cost of medical care, and then increase quality of life.This review summarizes preventive and therapeutic intervention of mucositis (localized or systemic), between some of patients with cancer.Keywords: Mucositis; Radiotherapy; Primary prevention; Therapeutics

Anorectal melanoma is one of the rare but significant malignancies of the anorectal area. This malignancy currently accounts for 1% of all types of melanoma and less than 1% of all the anorectal area malignancies. Very rare cases of this disease have been reported worldwide.Anorectal melanoma is mostly diagnosed while treating other benign conditions of this area such as hemorrhoids with conventional modalities. Its treatment of choice has always been a controversial issue. In this study, clinical pathology and outcome of 7 cases with anorectal melanoma referred to Omid Oncology Teaching Hospital during 2001-2011 were assessed. Out of seven cases, 2 patients had been diagnosed with hemorrhoids and undergone surgery and 2 other cases had been referred with the primary diagnosis of lymphoma. Initially, only in 3 cases melanoma was diagnosed in clinico-pathology setting. Three cases of patients had distant metastases to the liver, lungs, omentum and mesentery, while the other 4 patients had advanced local disease. No patient had been diagnosed in the primary stages of the disease. The mean time duration between symptoms onset to diagnosis of disease had been 8 months. The median survival time was 5 months. Rare anorectal melanoma and its similar manifestations to other common anorectal conditions can delay the diagnosis, therefore should be considered as an uncommon differential diagnosis. The disease''s outcome is poor and most probably delay in the diagnosis has an important role in the treatment results.

Primary Kaposi sarcoma of penis is very rare. We will introduce a 47 years old male patient referred to our clinic from dermatology service, in this report. The patient suffered from itchy penile papules around coronal region. The lab tests had revealed a negative serology of HIV but tissue PCR was positive for Human Herpesvirus-8 (HHV8). Histological findings were compatible with Kaposi sarcoma. Primary Kaposi sarcoma of penis is rare but could occur in HIV negative patients.