DOI: 10.37421/2576-3857.2023.08.204
Akhil Agarwal*, Amitabha Dey, Ishan Patel, Shashank Srinivasan and Ankita Jain
DOI: 10.37421/2576-3857.2023.8.490
Background: Cancer patients navigate through complex and dynamic health services/systems after diagnosis to receive high-quality and effective care. An understanding of a cancer patient’s journey will help in improving the quality of care. A survey was conducted on patients and medical oncologists across India with an objective to map various aspects of patient journey from diagnosis to treatment and follow-up for advanced Breast Cancer (BC) and Lung Cancer (LC).
Methods: A multidimensional survey was shared with adult patients diagnosed with advanced stage (stage III B and stage IV) breast or lung cancer who were undergoing therapy and medical oncologists who have more than 10-years of experience in treating breast or lung cancer.
Results: A total of 100 patients with a diagnosis of Stage III B/IV breast cancer (BC), 100 patients with Stage III B/IV Lung Cancer (LC), and 55 medical oncologists participated in the survey. It was noted that similar numbers of BC (49%) and LC (50%) patients were not aware about cancer symptoms and treatments while the surveyed medical oncologists believed only 11% and 20% patients were not aware of cancer symptoms and treatment, respectively. Selecting the right specialist was reported to be the primary challenge faced by patients. As per surveyed medical oncologists, only 5% of them discuss support from Patient Advocacy Groups (PAGs) with all their patients. The majority of medical oncologists (79%) reported that less than 30% of patients join PAGs. Most patients were expecting empathy and time for counselling from their medical oncologists.
Conclusion: Coordinated and comprehensive cancer care is essential for patients with advanced LC and BC. The survey results also highlight the importance of screening high risk populations, importance of educational material for patients, counseling on treatment plan, information about financial support programs, counseling on mental well-being, nutritional support, and information about PAGs.
DOI: 10.37421/2576-3857.2023.08.199
Heterochromatin Protein 1α (HP1α) is a critical player in chromatin organization and gene regulation, and its dysregulation has been implicated in various cellular processes, including cell proliferation and cancer development. This review focuses on the role of HP1α as a characteristic of cell proliferation that is pertinent to clinical oncology. Extensive research has demonstrated that HP1α plays a dual role in regulating cell proliferation. On one hand, it functions as a transcriptional repressor, modulating the expression of genes involved in cell cycle control and DNA replication. On the other hand, HP1α has also been found to interact with numerous signaling pathways and transcription factors, thereby promoting cell proliferation under certain conditions. Aberrant expression and localization of HP1α have been observed in various types of cancer, including breast, prostate, lung, and colorectal cancer. Furthermore, studies have shown that altered HP1α expression is associated with poor prognosis and resistance to conventional therapies in cancer patients. Understanding the molecular mechanisms underlying HP1α's involvement in cell proliferation is of significant interest in clinical oncology. Targeting HP1α and its associated pathways may offer promising therapeutic opportunities for cancer treatment. In addition, HP1α expression levels and subcellular localization can potentially serve as diagnostic and prognostic biomarkers in clinical practice.
DOI: 10.37421/2576-3857.2023.08.198
This study aims to compare the clinical efficacy of posaconazole and fluconazole as antifungal prophylaxis in the field of hematology. Antifungal prophylaxis plays a crucial role in preventing invasive fungal infections, which are a significant cause of morbidity and mortality in immunocompromised patients, particularly those undergoing Hematopoietic Stem Cell Transplantation (HSCT) or intensive chemotherapy. A comprehensive literature review was conducted to identify relevant studies comparing the clinical outcomes of posaconazole and fluconazole prophylaxis in hematology patients. The primary endpoints assessed were the incidence of IFIs, overall survival, and adverse events associated with each antifungal agent. The results of the reviewed studies demonstrated that posaconazole had superior efficacy compared to fluconazole in preventing IFIs in hematology patients. Posaconazole prophylaxis was associated with a significantly lower incidence of IFIs, including invasive aspergillosis and candidiasis, when compared to fluconazole. Additionally, posaconazole showed a favorable impact on overall survival, suggesting its potential as a more effective antifungal prophylactic agent in this patient population.
DOI: 10.37421/2576-3857.2023.08.196
Angiogenesis, the tumour microenvironment, and proteoglycans play pivotal roles in cancer biology. Angiogenesis, the formation of new blood vessels, is a critical process for tumour growth and metastasis. The tumor microenvironment, consisting of various cellular and non-cellular components, provides a supportive niche for cancer progression. Proteoglycans, a class of complex molecules, are involved in modulating both angiogenesis and the tumour microenvironment. Angiogenesis in cancer is driven by a delicate balance of pro-angiogenic and anti-angiogenic factors. Tumour cells release pro-antigenic factors, such as Vascular Endothelial Growth Factors (VEGFs), to stimulate the sprouting of new blood vessels from existing vasculature. The tumour microenvironment, including immune cells, fibroblasts, and extracellular matrix components, also contributes to angiogenesis through the secretion of angiogenic factors and remodelling of the surrounding vasculature. Disrupting angiogenesis has emerged as a promising therapeutic strategy in cancer treatment, with the development of anti-antigenic drugs targeting VEGF signalling.
DOI: 10.37421/2576-3857.2023.08.197
A core of several tetraspanin proteins organizes other membrane proteins like growth factor receptors, integrins, and Human Leukocyte Antigen (HLA) antigens in these complexes. Albeit most tetraspanin proteins have been concentrated separately, tetraspanin proteins and their edifices can affect cell grip and motility, associations with stroma or influence announcing development factors, and for the greater part of them no ligand has been distinguished. Although they are found in all cell types, these proteins have primarily been studied functionally in lymphoid cells. Tetraspanins have been identified as metastasis suppressors in some tumors, but their significance is still unclear. Data are also available for these tumors. They are outlined, along with some of their implications for tumor biology and areas that require additional research. The biological properties of tumor cells, particularly those pertaining to tumor adhesion and dissemination, can be significantly affected by membrane proteins that are involved in cellular interactions with other cells or the stroma as well as signaling pathways. The tetraspanins, a brand-new class of membrane proteins, are beginning to gain importance in cell biology but have received very little attention in the context of cancer biology up until this point.
DOI: 10.37421/2576-3857.2023.08.202
DOI: 10.37421/2576-3857.2023.08.200
DOI: 10.37421/2576-3857.2023.08.201
DOI: 10.37421/2576-3857.2023.08.203
DOI: 10.37421/2576-3857.2023.08.190
DOI: 10.37421/2576-3857.2023.8.185
The purpose of establishing Clinical Quality Registries (CQRs) was to compare clinical outcomes between hospitals or regions within a nation. The purpose of this study was to identify these CQRs for gynaecological oncology, to summarize their characteristics, processes, and QIs, and to determine whether it would be feasible to conduct future international comparisons in order to obtain a global overview of these CQRs.
DOI: 10.37421/2576-3857.2023.8.188
This paper explores the lessons learned from mentoring in radiation oncology from a remote setting. It discusses the challenges faced by mentors and mentees in maintaining effective communication, establishing trust, and fostering professional development in a virtual environment. The paper highlights the importance of leveraging available technologies and platforms to facilitate mentorship activities, such as video conferencing, online learning platforms, and virtual tumor boards. Drawing from experiences and best practices, the paper provides practical recommendations for successful remote mentoring in radiation oncology. It emphasizes the need for structured mentorship programs, clear communication channels, and goal-oriented mentoring relationships. Strategies for promoting engagement, building mentor-mentee rapport, and ensuring continued professional growth are explored.
DOI: 10.37421/2576-3857.2023.8.189
DOI: 10.37421/2576-3857.2023.8.191
DOI: 10.37421/2576-3857.2023.8.192
DOI: 10.37421/2576-3857.2023.8.193
DOI: 10.37421/2576-3857.2023.8.186
Urological cancers, including prostate, bladder, and kidney cancers, pose a significant healthcare challenge worldwide. To address this challenge, effective research and clinical management require comprehensive and accurate data collection. However, traditional manual data collection methods are time-consuming, error-prone, and limited in their ability to handle large-scale datasets. In this paper, we present the Cancer Research Uro-Oncology Database (CRUOD), a novel automated system designed to streamline the collection and management of uro-oncology data. CRUOD leverages advanced technologies such as natural language processing, machine learning, and cloud computing to automate data extraction, standardization, and storage processes.
DOI: 10.37421/2576-3857.2023.08.187
The increasing reliance on digital technologies and interconnected systems in radiation oncology practices has introduced new vulnerabilities and risks associated with cyber security attacks. These attacks can have severe consequences, including compromising patient data, disrupting critical treatment processes, and causing financial losses. Therefore, it is crucial for radiation oncology practices to implement robust cyber security measures to safeguard their operations and protect patient information. This paper presents a comprehensive overview of the strategies and best practices for protecting radiation oncology practices from cyber security attacks. It explores the unique challenges and vulnerabilities specific to this field, such as the interconnectedness of treatment planning systems, electronic medical records, and medical devices. The paper discusses the potential consequences of cyber threats and emphasizes the importance of proactive risk assessment and mitigation.
DOI: 10.37421/2576-3857.2023.8.194
DOI: DOI: 10.37421/2576-3857.2023.8.215
DOI: DOI: 10.37421/2576-3857.2023.8.216
DOI: DOI: 10.37421/2576-3857.2023.8.217
DOI: DOI: 10.37421/2576-3857.2023.8.218
Oncology clinical care is continually evolving, driven by advancements in research, technology and a deepening understanding of the complex nature of cancer. This abstract outlines strategies and innovations aimed at enhancing the quality of oncology clinical practices, with a focus on improving patient outcomes, optimizing treatment protocols and fostering multidisciplinary collaboration. The first section delves into personalized medicine and its role in tailoring oncological treatments to individual patients. We explore the integration of genomics, biomarkers and molecular profiling to identify targeted therapies, minimizing adverse effects and maximizing treatment efficacy. Emphasis is placed on how these innovations contribute to a paradigm shift in oncology, moving towards precision medicine. Next, the abstract discusses the significance of data-driven approaches in oncology clinical quality. Harnessing the power of big data, artificial intelligence and machine learning enables healthcare providers to extract meaningful insights, predict treatment responses and identify patterns that inform evidence-based decision-making. Effective communication and collaboration among various healthcare professionals, including oncologists, surgeons, radiologists and nurses, are vital for comprehensive cancer care. Strategies for fostering interdisciplinary teamwork and improving communication channels are highlighted.
DOI: DOI: 10.37421/2576-3857.2023.8.218
Radiation oncology, a vital component of cancer treatment, utilizes high-energy radiation to destroy cancer cells, reduce tumor growth, and alleviate symptoms. Over the years, advancements in technology, treatment approaches, and patient-centric care have significantly transformed the field of radiation oncology, making it an integral part of comprehensive cancer management. Precise targeting of tumors is achieved through real-time imaging during treatment, reducing radiation exposure to healthy tissues. Customized radiation beams adjust the intensity and shape, maximizing dose delivery to the tumor while minimizing damage to surrounding healthy tissues.
DOI: DOI: 10.37421/2576-3857.2023.8.219
Mentoring plays a pivotal role in the development and progression of professionals in the field of radiation oncology. As a complex and everevolving specialty, it demands not only expertise but also guidance, support, and continuous learning. Mentoring relationships, characterized by the transfer of knowledge, skills, and wisdom, are crucial in shaping the careers of aspiring radiation oncologists, ensuring the delivery of high-quality patient care, and fostering the future of the field. The discussion further explores how mentorship facilitates the development of critical thinking skills, hands-on technical expertise, and adaptability to clinical challenges. The abstract underscores the role of mentoring in bridging the gap between theoretical knowledge and practical application, preparing mentees for the complexities of their roles. It emphasizes the perpetuation of expertise through effective mentorship, leading to sustained knowledge transfer and encouraging innovation in the field. The conclusion reinforces mentorship as the cornerstone of success in radiation oncology, shaping individual careers and influencing the advancement of the entire field. The abstract concludes by advocating for structured mentorship programs, diversity, and continuous learning to strengthen the mentorship culture in radiation oncology. It envisions a future where mentorship remains integral to shaping the next generation of radiation oncologists and pushing the boundaries of knowledge and practice in patient care and innovation.
DOI: DOI: 10.37421/2576-3857.2023.8.220
DOI: DOI: 10.37421/2576-3857.2023.08.221
DOI: DOI: 10.37421/2576-3857.2023.8.222
DOI: DOI: 10.37421/2576-3857.2023.08.223
Uro-oncology is a specialized branch of medicine that focuses on the diagnosis and treatment of cancers affecting the genitourinary system, which includes the kidneys, bladder, prostate, testes, and adrenal glands. The field of uro-oncology has witnessed significant advancements in recent years, revolutionizing both the diagnosis and treatment of urological cancers, while concurrently emphasizing patient-centric care. Prostate cancer is the most prevalent cancer among men. Advances in diagnostic tools, such as multiparametric MRI and targeted biopsy techniques, have improved accuracy in detecting and staging prostate cancer. Innovations in imaging technologies and minimally invasive surgical approaches, like robotic-assisted surgery, have enhanced both diagnosis and treatment outcomes for bladder cancer.
DOI: 10.37421/2576-3857.2023.8.208
Cancer remains a formidable global health challenge, responsible for millions of deaths each year. However, the landscape of cancer care is rapidly evolving, with a growing emphasis on prevention, early detection and timely intervention. This abstract highlights the critical role of awareness in cancer screening and early detection as a potent strategy to save lives. The importance of awareness cannot be overstated, as it serves as the first line of defense against cancer. This awareness encompasses understanding the risk factors associated with various types of cancer, recognizing warning signs and symptoms and appreciating the value of regular screenings. Public health campaigns, educational initiatives and community outreach programs play pivotal roles in disseminating this knowledge and empowering individuals to take proactive steps in their health journey. In conclusion, this abstract underscores the pivotal role of awareness in cancer screening and early detection, highlighting the transformative potential it holds in saving lives and reducing the global cancer burden. By fostering a culture of health consciousness and ensuring equitable access to screening and diagnostic tools, we can collectively work towards a future where cancer is detected early, treated effectively and ultimately defeated.
Fatimah Almoaraj*, Hala Omer, Esraa AlQasem, Badriah Alomari, Ashraf Khairy, Qasim Alharbi, Omar Chamdine, Saad ALdaama and Maher El Doussouki
DOI: 10.37421/2576-3857.2023.08.205
Background: Central venous lines are important part in management of pediatric oncology patients, in spite of that, obtaining these access carry risk of complication. Central Venous Catheter-related Thrombosis (CVCT) is one of the major complications.
Methods: This is a single-center retrospective study; we analyzed all pediatric oncology patients with a Central Venous Catheter (CVC) over 3 years period, focused on the CVCT risk factor and its outcome. Data were retrieved from patients’ hard and electronic medical records and collected in the Redcap system.
Results: A total of 323 CVCs were inserted in 266 pediatric oncology patients, 14 CVCT episodes were discover (4.33%) which was occurred in 13 patients. The incidence of CVCT was highest among hematological malignancy 10 out of 13 patients. Using steroid as part of chemotherapy was recognized as significant risk for CVCT (P value: 0.019), having a peripherally inserted central catheter PICC or femoral line compared with an implantable port Cath were associated with increased risk of CVCT (P value <.001) besides of that the risk of thrombosis increased with subsequent insertions of the central line compared with a single central line insertion (P value: .004). 50% of CVCT were asymptomatic, LMWH was used in 9 episodes and line removed in 7, complete resolution occurred in 10 episodes.
Conclusion: The use of CVC is a crucial corner in managing pediatric oncology patients and improves their quality of life, yet it is associated with significant complications, such as infection, thrombosis, and dysfunction.
The pediatric oncologists and pediatric surgeons should pay special attention to ensure optimal and appropriate CVC placement methods and post-insertion care which may play an essential role in minimizing CVC-associated complications.
Prospective studies are crucial to evaluate the clinical significance of CVC-dysfunction and its impact on the development of thrombosis, infection, or outcome of children with cancer. And to provide recommendations to improve the preventive strategies for such events.
Gillian Hurwitz*, Lesley Moody, Zahra Ismail, Monika Duddy and Lisa Barbera
DOI: 10.37421/2576-3857.2023.08.206
Introduction: Routine symptom screening for cancer patients using Patient Reported Outcome Measures (PROMs) is standard practice in Ontario to identify physical and emotional symptoms that can go undetected by clinicians. However, provider response to PROMs is essential to addressing symptom burden. To measure clinician response, a Regional Cancer Centre (RCC) chart audit process was developed to determine whether clinical teams acknowledged, assessed and/or addressed commonly experienced oncology symptoms outlined in the Edmonton Symptom Assessment System (ESAS).
Methods: Annually, RCCs received a chart audit tool with preset options. Sites audited charts for seven of the ESAS symptoms using a business intelligence tool to access patient charts based on sampling parameters. RCCs were required to audit charts of patients whose ESAS symptom scores were moderate to severe (4-10), with at least five charts in the moderate range (4-6).
Results: Overall, 4,679 charts from all 14 RCCs were examined in the FY 2016/17 and FY2017/18 audits (2,377 charts and 2,302 charts, respectively). Depression (45.5%) and anxiety (49.0%) were the least likely to be recorded in the patient’s chart, whereas pain (75.1%) was the most likely to be noted. Patients reporting depression and anxiety were the least likely to be offered assessments (49.8% and 51.1%, respectively) and interventions (47.0%, 46.5%, respectively). Patients reporting pain were the most likely to receive assessments (72.2%) and interventions (64.3%).
Conclusion: Chart audits help measure clinical response to PROMs, providing useful information on the gaps in care, including response to emotional symptoms and can inform local quality improvement initiatives.
We performed Photo Dynamic Therapy using liposome-ICG (indocyanine green) in the peripheral blood of the two patients (Patient X and Patient Y, hereafter), both of whom had recovered from cancer. Patient X, with cervical cancer, received hysterectomy three years ago and Patient Y with gastric cancer had Endoscopic Submucosal Dissection (ESD) 6 years ago. One week before and after PDT, whole RNA sequences and quantification of the monocytes isolated from their blood were examined. Correlated expressions of highly increased or decreased in RNAs were: increases in FAM156B, PHLDA2, NME1-NME2 and decreases in TRIM49D2, FRI3-ITI, LOC100133050 and FAM186B). All the increased RNAs revealed anti-oncogenic properties and all the decreased ones revealed oncogenic properties. As most of these RNAs are regulated by methylation, the PDT therapy may serve to epigenetically lower the risks of cancer.
DOI: 10.37421/2576-3857.2023.8.207
A cancer diagnosis can be a life-altering moment. It is a journey that starts with the initial shock of discovery and leads to a series of critical decisions about treatment and care. Understanding the stages of cancer from diagnosis to treatment and beyond is essential for patients and their families as they navigate this challenging path. In this article, we'll break down the stages of cancer, offering insights into each phase and the importance of ongoing support.
DOI: 10.37421/2576-3857.2023.8.209
Cancer is a complex disease, often arising from a combination of genetic and environmental factors. While lifestyle choices such as smoking, diet and physical activity play a significant role in cancer risk, genetic factors also contribute to an individual's susceptibility to the disease. In this article, we will delve into the connection between genetics and cancer risk, exploring how inherited genetic variations can influence one's likelihood of developing cancer.
DOI: 10.37421/2576-3857.2023.8.210
DOI: 10.37421/2576-3857.2023.8.211
DOI: 10.37421/2576-3857.2023.8.213
DOI: 10.37421/2576-3857.2023.8.214
DOI: 10.37421/2157-7145.2022.7.156
DOI: 10.37421/2157-7145.2022.7.155
DOI: 10.37421/2157-7145.2022.7.158
DOI: 10.37421/2157-7145.2022.7.159
DOI: 10.37421/2157-7145.2022.7.157
Esra Muhimid*, Hala Omer, Esraa Al-Qasim, Omyma Ali, Saif El-Deen Al-Horani and Saad AL-Damaa
Context: Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer worldwide, and it accounts for 30% of all cancer cases in children of Saudi Arabia. Relapsed leukemia is the fourth malignant disease in pediatrics.
Aim: This study aims to describe the clinical characteristics and outcomes of pediatric Relapsed ALL.
Settings and design: This retrospective study was conducted at a single tertiary hospital in Saudi Arabia.
Methods and data analysis: Clinical data and outcomes of all cases with relapsed acute lymphoblastic leukemia under age of 16 year diagnosed and treated from 1 January 2012 till 31 December 2020. All patients' data and information were retrieved from patients’ hard and electronic medical records and collected in REDCap system. Data analysis was done by using Statistical Package for the Social Sciences (SPSS) program version.
Results: Within the first four years of the study period, 155 cases were diagnosed with acute leukemia. In this study the relapse rate for acute lymphoblastic leukemia was 13% with overall survival about 47%, and the disease progression related mortality was 54%, while the treatment related mortality was 45% with overall mortality of 52%.
Conclusion: Relapsed ALL becomes a serious problem in pediatric oncology with relatively poor outcomes. The difficulty in treating relapse disease with satisfying results compels us to enhance the therapy for the newly diagnosed patients at the front lines considering more effective and better treatment options. Promising new molecular and immunological targeted therapies and improved HSCT technologies should be rapidly integrated into trials for subsets of higher-risk patients at initial diagnosis. Further refining of the risk stratification with the increased focus on the importance of analyzing detailed cytogenetics and molecular data in the era of application of next-generation sequencing followed subsequently by tailored risk-adapted therapy is the cornerstone of modern relapse therapy. International collaboration is essential to serve as a platform for progress in the treatment of relapsed childhood ALL.
We have designed a nanoparticle drug delivery system. The system included PLGA, paclitaxel (PTX) and transferrin (TF). This system can specifically target to liver cancer cells through intravenously administration. The PLGA-PTX-TF nanoparticles show excellent liver cancer treatment effect (IC50 4.79 g/mL) and are dose dependent in vitro. The PLGA-PTX-TF nanoparticle also show noticeable anti-tumor efficacy in vivo compared to PLGA-PTX (anti-cancer rate: 79.09% vs. 35.47%). Therefore, PLGA-PTX-TF nanoparticles can be considered as an effective anticancer drug delivery system for liver cancer therapy for the clinical use.
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