Journal of Integrative Oncology

Background: Multiple genes are known to influence the cancer metastasis but the effect of the germline heritable genetic polymorphisms on the predisposition and metastasis is not yet well known. Signal-induced proliferation associated gene1 (SIPA1) was considered as a modifying factor in the breast carcinoma (BC) metastasis process. Molecular studies on Sipa 1 gene suggested its essential role as cell adhesion regulator and metastasis modulator. The present study relied on the hypothesis that Sipa1 gene may be contributed to the risk of breast cancer occurrence and aggressiveness as well.
Objective: We aimed to examine the association of SIPA1 single nucleotide polymorphisms (SNPs) and human breast cancer incidence and prognosis in Egyptian female patients.
Patient and Methods: Two common SNPs (rs3741378 C>T and rs746429 A>G) were genotyped in 80 Egyptian females; 50 patients with breast cancer and 30 breast carcinoma free females.
Results: The rs3741378 TT genotype enhanced the incidence of breast carcinoma in comparison with the genotypes rs3741378 CC and TC (X2=7.08, P=0.029), Sipa 1 rs3741378 T allele had a high frequency in BC cases compared to controls (OR (95%)=2.593 (1.339-5.02), P=0.04). Sipa 1 rs3741378 TT genotype also displayed significant association with clinical stages, grades and lymph node metastasis (X2=12.73, P=0.013), (X2=10.88, P=0.028), (X2=6.534, P=0.010; OR (95%)=0.324 [0.134-0.781]), respectively. Pointing to those patients carrying the rs3741378 TT genotype had a higher tumor progression rate with advanced tumor grades. Oppositely, these associations could not be detected for rs746429 A>G.
Conclusion: Our results suggest that the Sipa1 promoter rs3741378 C>T SNP was contributed to BC risk and progression, which may be considered as a foretelling biomarker of BC risk and progression.

Background: Cancer patients have a 4 to 7 fold increase in the frequency of Venous Thromboembolism (VTE) during treatment and VTE is a common cause of death. Oncology massage has been traditionally contraindicated in patients with thromboembolism, but studies show oncology massage improves symptoms and quality of life.
Objectives: The purpose of this study was to review the safety and patient reported outcomes of massage in oncologic patients with a recent history of VTE.
Methods: After obtaining UT MD Anderson institutional review board approval, 25 patients who received oncology massage for symptom relief and quality of life, following the diagnosis of VTE were retrospectively reviewed. Edmonton Symptom Assessment Scale (ESAS) scores were reviewed pre- and post-massage, as well as complications within 30 days requiring return to the Emergency Room or hospital re-admission.
Results: 19 patients with complete ESAS scores reported a significant improvement in pain, fatigue, anxiety and well-being. Eleven patients (44%) returned to the emergency department within 30 days of their most recent massage, due to disease progression, fatigue and diarrhea. None of the 25 patients had complications due to massage. One patient experienced a new VTE 7 days after finishing massage, (patient was off anti-coagulation secondary to a pseudoaneurysm bleed).
Conclusions: Our study suggests that if precautions are taken not to massage the anatomic site of the VTE, patients are afebrile and have >50,000 platelets with no coagulopathy, oncologic massage is a safe, non-invasive intervention even following VTE for improvement in generalized pain, fatigue and quality of life.

Invasive or infiltrating ductal carcinoma is the most common type of breast cancer while primary squamous cell carcinoma of breast is extremely rare occurring in 0.04%-0.1% of all breast cancer cases known for aggressive behaviour and poor prognosis. We hereby report a case of primary squamous cell carcinoma of breast in a 31-yearold female who presented with a left breast lump of 2 months duration. Lumpectomy done at another non-oncology centre showed invasive ductal carcinoma with margin positivity for which she underwent modified radical mastectomy at our institute. Post-operative immune-histopathology revealed triple negative squamous cell carcinoma. Her metastatic work-up with whole-body positron emission tomography scan was negative. She was treated with adjuvant chemotherapy doxorubicin, cyclophosphamide and docetaxel followed by loco-regional radiotherapy to left chest wall which she tolerated well. No hormonal therapy was given in view of hormone receptor negativity. She is presently on follow-up for more than 6 months without any evidence of recurrence or distant metastasis. This case is being presented to highlight its extreme rarity, it’s occurrence in a young female, the diagnostic and therapeutic challenges it presented and the overall prognosis of this neoplasm.

A unique subgroup of breast cancer, the Triple negative Breast carcinoma (TNBC) is on the rising trend. TNBC occurrence is around 15-20% of all breast cancers. Therefore this makes it an ideal target for therapeutic exploitation. TNBC is defined by the absence of a target, therefore, there is absence of a tailored targeted therapy, leaving its management depend on conventional cytotoxic regimens. The presence of AR in ER negative cases is 30%, in TNBC the AR positivity is <20% (some studies have even accounted that the overall AR positivity in Breast cancer is 60-70%). This group of patients poses a major challenge to the physicians and patientsThe total breast cancer patients between the periods of October 2014 to February 2014 were 734 cases, 142 cases were triple negative breast cancer cases as demonstrated by the Immunohistochemistry. Androgen receptor was considered positive if >10% of cells showed positivity in Immunohistochemistry. Androgen receptor is Negative amongst a majority of 88% of patients with 12% remaining AR Positive off which 8% is High, 3 Medium and 1 Low Positive. The p value is 0.000 which is <0.05 hence the value is significant. The percentage of AR positivity in TNBC in this study concurs with the literature findings. This explains the importance of the same in TNBC as it seems to be an important avenue for therapeutic targeting because, this group of patients do not have much options for treatment. Further studies, with the use of androgen receptor blockade through drugs like Bicalutamide/Enzalutamide/Abireterone in AR positive TNBC could be studied to know the survival improvement.

Background: Prior research reveal the benefits of yoga in managing fatigue, stress and psychosocial outcomes in cervical carcinoma; however, a definite structured yoga program is unavailable. In this study an effort is made to develop and validate a structured yoga program for cervical carcinoma.
Methods: A detailed review of ancient and contemporary yoga literature was conducted to design a basic yoga program. Five yoga experts, who fulfilled the inclusion criteria validated the program. 27 practices were rated as (i) not essential, (ii) useful but not essential, and (iii) essential; Lawshe's content validity ratio (CVR) was calculated.
Results: Eighteen practices exhibited significant content validity (cut-off value: 0.99, as calculated by applying Lawshe's formula for the CVR). One practice was added to the module by the experts, making a total of 19 practices including meditation. Yoga nidra was added as a special practice on days of high fatigue.
Conclusions: The designed program received good content validity and thus is valid for cervical cancer. The program is to be applied on patients to assess its acceptability and feasibility.