bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing the Needs and the Quality of Life of Women With Advanced Breast Cancer
Authors: Berta M.G. , Chacón M. , Rivero S. , Ostinelli A. , Mandó P. , Ferro N. , Checchia S.
Published: September 2018

Background and context: Each year, 19,000 women are diagnosed with breast cancer in Argentina, which represents 16,8% of total cancer incidence. Although most of them are diagnosed with early stage, a significant number of them have or will develop advanced breast cancer (ABC). Argentina, after Uruguay, is the country of America with the highest mortality rate for breast cancer, with 19.9 deaths each 100,000 women, and there is a significant difference in the mortality rate across regions within the country. Due to the advances in treatments, some women with ABC can live for extended periods of time. Their lives are affected by anxiety and uncertainty, and periods of well-being alternate with others affected by the reality of the cancer progression and the effects of treatments. We will survey a representative number of women with ABC from different regions of Argentina, about their quality of life. This study will provide useful data about the needs of this population in terms of information, care, and other resources, as well as about gaps and disparities in accessing of services. Aim: To generate evidence about the quality of life and needs of ABC patients, that will support a public awareness campaign, raising the voices of these patients. To recommend interventions and determine the baseline for further evaluations of their efficacy. Strategy/Tactics: The assessment of the quality of life (QOL) will be performed using the EORTC QLQ-C30 version 3.0 and EORTC QLQ-BR23 questionnaires. However, a set of questions will be added to measure some outcomes such as psychosocial and medical aspects that are not considered by these questionnaires. Authorization will be obtained from the ethics committees, and informed consent will be provided by all patients. Program/Policy process: A study based on a descriptive analysis of the data will be conducted. A sample of patients diagnosed with metastatic breast cancer in several private/public centers/hospitals in Argentina will be surveyed. The clinical history and a script of open questions so that patients will be able to freely express their concerns will be used as instruments. The results and conclusions of the survey will be communicated to the centers. An awareness campaign through the media will be conducted. Outcomes: We expect that by means of this survey we will have evidence about the real needs of this group of patients, and in this way we will be able to raise their voices and create awareness about their situation, as well as propose interventions or new approaches to improve their quality of life.
Navigating Muddy Waters: Clearing Waves While Keeping Ourselves Afloat
Authors: Aziz S. , Thoo M. , Noor S. Md , Nair S. , Somasundaram S.
Published: September 2018

Background and context: As the oldest cancer-related nongovernmental organization in Malaysia, the National Cancer Society of Malaysia regularly receives proposals for collaborations. While many are mutually beneficial, some are “risky”. Examples include partnerships with fast food companies, health supplements which benefits are vastly exaggerated, or fundraisers being held at bars or pubs. While these campaigns are accepted norms within the region, they might not conform to the standards of more mature markets. As we are expected to promote these activities or products on our digital media accounts, we risk overcrowding our pages, or being perceived as endorsing a product or behavior. Aim: Keeping donors happy while maintaining credibility Strategy/Tactics: The current strategy for NCSM's digital outreach is to focus on education/awareness instead of marketing. Also, we match the campaign's values with that of NCSM when deciding whether to promote it. When promoting a campaign, we stay neutral or personalise the donation. Above all, we play “devil's advocate”, focus on the impact of the funds raised, and stay firm on our decision. Program/Policy process: Out of 12 social media posts each week, no more than 2 is on marketing campaigns. Donors, instead of the product, are featured in a personalised “Why I Give” post. At times, we also prioritize well-meaning campaigns over others. For fundraisers held in bars/pubs, we ask for compromises (e.g., to ban smoking in the area for a short time, or that we do not promote the alcohol manufacturer). We are also proactive in checking the promotional content and insist that the donor remove any unproven information. Outcomes: NCSM's Facebook page grew organically (without ad buys) from 4000 in 2016 to 15,000 in 2017. We have about 60 new followers each week, negligible “unfollows” even on marketing-heavy times, and a minimum reach of 15,000 people. Education content is more popular (2300 reach per post versus 400); the same trend is observed for personalised versus product-based posts (3700 vs 400). To date, we have good relationships with our donors, and have not received comments on any partnerships. What was learned: It's intention, and not visual or monetary value, that counts: our audiences are more appreciative of quality content, even if marketing/product posts might look better. Also, staff and survivors can sense sincere donors, which makes a difference in our promotional efforts (positive versus matter-of-fact tones). Well-meaning donors do adhere to our promotion guidelines, and do agree to not being promoted. In addition, featuring donors is a great way to publicise an activity without mentioning the product. Most importantly, being able to justify collaborations within the organization protects its integrity and credibility.
Is There Any Association Between Processed Meat Consumption and Colorectal Cancer Risk in Morocco?
Authors: Deoula M. Mint Sidi , El Kinany K. , Boudouaya H.A. , Hatime Z. , Huybrechts I. , Benslimane A. , Errabih I. , Badre W. , El Abkari M. , Abbaoui S. , Khouchani M. , El Rhazi K.
Published: September 2018

Background: Colorectal cancer (CRC) is the third most commonly diagnosed malignancy and the fourth leading cause of cancer-related deaths worldwide. A large body of epidemiologic research show that countries where people eat more red meat and processed meat are also countries where the risk of CRC is high. The processed meat intake was described as a convincing risk factor for CRC according to the recent report of the World Cancer Research Fund published in 2017. In Morocco the incidence of CRC is increased significantly during the last years according to the Cancer Registry of the Greater Casablanca region. In addition to the imported of modern processed meat; this country is characterized also by the presence of their traditional processed meat as: quaddid (obtained by salting and sun-drying of meat) and khlii (obtained from salted-dried meat, which is cooked and conditioned in fat). In contrast, no studies have been conducted previously to evaluate the association between processed meat and CRC risk. Aim: This study aimed to evaluate the association between processed meat intake and CRC risk in Morocco. Methods: A case-control study was conducted in 5 major public health hospitals in Morocco. Each case was matched with a control by age (±5 years), sex and center. Dietary data were collected by a validated Food Frequency Questionnaire including traditional processed meat (quaddid and khlii) and modern processed meat (delicatessen meat). Conditional logistic regression was done to predict the association between processed meat consumption and CRC risk. Results: Among 500 cases and 500 controls matched by age; sex and center, 50.9% were male and 49.1% were female. The mean age was 55.53 ± 14.53 years. Among the cases, 44.5% was diagnosed with colon cancer, and 55.5% with rectum cancer. Most participants live in the urban area; never attend school and are poor. The bivariate analysis was used to evaluate the association between processed meat intake and CRC. We found no statistical significant between the occurrence of CRC and consumption of traditional processed meat (OR = 1.04; 95% CI, 0.74-1.48; P = 0.43). While, this study found strong significant association between modern processed meat and CRC risk (OR = 9.23; 95% CI, 3.91-21.77; P = 0.00). Conclusion: This study support that high consumption of modern processed meat such delicatessen meat increased the risk of CRC. In contrast, this study did not provide evidence that traditional processed meat is related to CRC risk in Morocco. We could explain this association by the low consumption of traditional processed meat in this study sample. In addition, the increases in the urbanization could also reduce the consumption of these types of traditional processed meat. Further studies are needed to evaluate the association between meat consumption and CRC risk in the context Moroccan.
Unique Partnership to Roll Out Cancer Awareness and Screening Program for High-Risk Population in Maharashtra
Authors: Nair S. , Nikam K.
Published: September 2018

Background and context: India is one of the few countries to have National Cancer Control Program and emphasis is given on tobacco related cancers because of high prevalence of such practices in India. As per the Global Adult survey 2016 around 30% of Indian population consume tobacco in any other form. Bus drivers, conductors and support staff of two leading public transport companies will be targeted by Indian Cancer Society as they are among high risk population with huge percentage of employees addicted with tobacco. Through this unique partnership, Indian Cancer Society (ICS) will promote tobacco deaddiction, cancer awareness and early detection of cancer among their staff. Aim: ICS is aiming at reaching out to around 1.20 Lakh bus drivers, conductors and support staff through this project in the span of 2 years. Strategy/Tactics: Cancer awareness will be created among targeted as well as general population by means of posters, banners, IEC leaflets. Depot managers will be sensitized about cancer, ill effects of tobacco consumption and importance of early detection. All eligible employees will be screened for commonest cancers in India like oral, breast, cervical and prostate. Tobacco deaddiction activities like support group meetings, experience sharing activities, role plays etc. will be organized for employees to facilitate tobacco deaddiction. Program/Policy process: Baseline survey was conducted for the sample size of 1000 employees in the month of March 2018 to assess their knowledge, attitude and practices related to tobacco addiction and cancer awareness. BCC and IEC activities will be planned based on the findings of baseline survey. Customized cancer screening packages will be developed based on the age and risk profile of employees. Support group meetings will be organized for employees with tobacco addiction. Outcomes: In the tenure of 2 years, cancer awareness will be created among 1.20 Lakh bus drivers, conductors and support staff. 75%–80% of these population will undergo cancer screening. General population residing in 30 districts of Maharashtra will be reached out through the cancer awareness drive organized at bus depots. Burden on the health system of these two transport companies will be reduced due to improved knowledge and health practices among their staff. Conclusion: With mandatory CSR, the private sector is keen on focusing on diseases with measurable outcome. Partnerships between government and NGOs can provide opportunities for private sector to collaborate; to reduce the burden of cancer through awareness and facilitate early detection thus improving chance of cure. This PPP model will provide structured quality cancer screening facility to identified high risk population and will facilitate early cancer detection. Best practices will be imbibed and tobacco deaddiction activities will be sustained beyond the project period.
Spices May Prevent Human Cancers
Authors: Moolky A. , Moolky N. , Ankush M. , Usha K. , Nagabhushan M.
Published: September 2018

Industrial and domestic use of fossil fuel (coal, gasoline, natural gas), wood burning (for heating, cooking, forest wild fire), and tobacco smoking releases harmful chemicals to human environment. Air pollutants include a mixture of noxious gases such as carbon monoxide, carbon dioxide, nitrous oxide, polycyclic aromatic hydrocarbons (PAHs). PAHs are cancer causing agents are highly toxic and mutagenic/genotoxic. Spices are widely used on a daily basis around the world. Some of the major spices/active principles used in large quantities are turmeric (curcumins), ginger (gingerol, shaogol, zingerone), betel leaf (hydroxy chavicol) and catechu (catechin).With short-term mutagenic assay, these spices extract and their active principles are nonmutagenic. We have tested these compounds against well-known mutagenic/carcinogenic PAHs, benzo(a)pyrene (BaP) and dimethyl(a)benzanthracene (DMBA). Nontoxic doses of extracts of spices/principles, turmeric/curcumins, ginger/gingerol, shaogol, zingerone, betel leaf/hydroxy chavicol and catechu/catechin dose dependently decreased the mutagenicity of BaP and DMBA. The protective activities of these compounds were also confirmed by animal tumor models. Nitrite is a water pollutant that is a precursor of mutagenic/carcinogenic nitrosamines and nitrosoamides. Amines/amides are present in vegetables and cured meat. Human stomach maintains acidic conditions, favors the chemical reaction of nitrite with amines/amides to form mutagenic/carcinogenic nitrosamines/amides. We mimic these conditions and have shown that turmeric and ginger their active principles dose dependently block the formation of nitrosamines/amides. Further the human efficacy of turmeric extract and its principle curcumin was confirmed in cigarette and bidi smokers. Consuming turmeric and curcumin reduced excretion of mutagens in human smokers. Large quantity of active principle are present in these spices, turmeric - curcumin 2%-2.5%, ginger - gingerol, shaogoal, zingerone - 2%-2.5%, betel leaf - hydroxychavicol 5%-10% and catechu - catechu 40%-50%. Human consumption of these spices may play an important role reducing the harmful effects of environmental toxicants, thus reducing cancer and other age related human chronic degenerative diseases.
Home-Based Care Practitioners: A Strategy for Continuum of Care for Very Ill Patient
Authors: Mukasahaha D. , Uwinkindi F. , Grant L. , Downing J. , Turyahikayo J. , Leng M. , Muhimpundu M.A.
Published: September 2018

Background: Rwanda Ministry of Health in collaboration with partners has initiated an innovative initiative named Home Based Care Practitioners (HBCPs) to respond to the burden of long-term hospitalization for end of life patients. Aim: The program aims at providing home-based care to accompany patients and their families in their home, reduce unnecessary pain and suffering for those with chronic or terminal conditions, provide counseling to the patients and their families, early diagnosis of NCDs and improve awareness on prevention of NCDs risk factors and effectively refer them to either health facilities or community-based resources that can be of further help. Methods: The HBCPs is implemented into phases; phase one has started with a pilot of 200 HBCPs in 100 cells surrounding nine provincial and referral hospitals of Rwanda; 2 practitioners for both gender in each cell, with a criteria of completion at least secondary school. They have undergone a training of 120 credits (900 hours), equivalent of four months for theory and two months of practice. After training they have been deployed into the community with a supervision of health centers in collaboration with hospitals and Rwanda Biomedical Center. Results: During the implementation period of 6 months, 1663 NCDs patients have been transferred from health facility (OPD) to HBCPs for routine follow-up, 482 palliative care patients have been reported on end of life care by HBCPs, there is a remarkable linkage between facilities and community care ensured by supervisory relationship between health services providers and home based care practitioners, long-term admission has reduced the cost for the family and the facility due to the discharge of care from hospital to home. Conclusion: In a limited setting of social and economic cost of providing frivolous care in an expensive hospital for chronic or terminal conditions that would be better managed through treatment or palliative care at home (or less acute setting) home based care effort can better meet the needs of Rwandans at the community level and has started to show the efficiency in providing quality care to people in need of palliative care.
Knowledge, Attitude and Practices on Cancer Education and Prevention: A Cross-Sectional Survey
Authors: Ghose S. , Datta S.S.
Published: September 2018

Background: Lifestyle associated cancers are 1 of the top 5 leading causes of death in the world and India sees a million new cases yearly. Early detection is an effective way to reduce incidences and mortality for preventable cancers. There is significant delay in detection for a large proportion of cancer patients in India. Lack of awareness about cancer has been shown to be a major contributor to treatment delay in many countries. The current study looked at the cancer awareness in an urban Indian population to address the gap of information about cancer prevention. Aim: To quantify knowledge about cancer in an urban population and find sociodemographic associations of lack of knowledge. We also wanted to compare knowledge of people from general population with those having some knowledge due to a family member being under treatment. Methods: Data were collected from 2 stratums: family members of cancer patients, Internet using community from general population, non-Internet using community dwellers. Subject selection was randomized. A prevalidated questionnaire was used. Data were analyzed using STATA 13. Results: Respondents (n = 846) were family of cancer patients (n = 146, 17.3%), community dwellers (n = 175, 20.7%) and community Internet users (n = 525, 62.1%). No association of knowledge with age, gender, and income was found ( P values 0.84, 0.25, 0.93 respectively). Statistically significant association of cancer knowledge with education was found ( P < 0.001). There is significant difference in knowledge between Internet using and non-Internet using community ( P < 0.001). Conclusion: Education impacts cancer knowledge of the population. The population having access to Internet has a higher knowledge than nonusers; but exposure to cancer treatment does not result in higher knowledge on cancer. These results will inform prevention and health education policies and aid in designing awareness and screening programs for preventing cancer.
Knowledge of Cervical Cancer and Acceptability of Prevention Strategies Among HPV-Vaccinated and Nonvaccinated Adolescents in Eldoret, Kenya
Authors: Mburu A. , Itsura P.
Published: September 2018

Background: Primary prevention of cervical cancer with the introduction of the human papilloma virus (HPV) vaccines is the next generation means to reduction of the disease burden in developing countries. Sexually active adolescents have the highest rates of prevalent and incident HPV infection rates with over 50%–80% having infections within 12 months of initiating intercourse. From May 2012 to March 2013, through the Gardasil Access Program, Eldoret received 9600 vaccine doses and vaccinated over 3000 girls aged 9-14. Despite this, there is little information on the knowledge of cervical cancer among adolescents and their amenability to accepting cervical cancer prevention strategies. Aim: To compare the knowledge of cervical cancer and acceptability of prevention strategies among vaccinated and nonvaccinated adolescents after an HPV vaccination initiative in Eldoret, Kenya. Methods: A cross-sectional comparative study carried out in 6 public schools which were clustered into 2 groups of 2. 60 vaccinated and 120 nonvaccinated adolescents were randomly selected from each of the schools by proportionate allocation. IREC approval obtained and signed consent got from the parents. Data collection was then carried out using interviewer-administered questionnaires. Results: The median age of the participants was 14.0 (IQR: 13.0-15.0). Of 60 vaccinated adolescents, 56 (93.3%) had heard of the HPV vaccine compared with 6 (5%) of unvaccinated participants ( P < 0.001). Fifty-eight (96.7%) of vaccinated participants heard of cervical cancer compared with 61 (50.8%) unvaccinated participants ( P < 0.001). The participants were not different in their knowledge of risk factors for developing cervical cancer or its symptoms but overall, the vaccinated participants had a significantly higher knowledge score compared with the unvaccinated participants 14.4 (95% CI: 12.2-16.7). Both cohorts identified the school as the commonest source of information for health matters as compared with social media or hospitals. The 2 groups also showed similarity in their selection of cervical cancer prevention strategies acceptable to them like delaying sexual debut until after the teenage years and frequency of using barrier method for protection against sexually transmitted infections. Similar proportions of participants from both cohorts showed high acceptability of screening modalities for cervical cancer (85% vs 86.7%, P = 0.940). Of the unvaccinated participants, 63.7% expressed willingness to be vaccinated. Conclusion: Exposure to the HPV vaccine was associated with a higher knowledge of cervical cancer. The adolescents predominantly rely on the school for their information. They show remarkable acceptability for cervical cancer prevention strategies but are limited by the dearth of information they have.
The Role of the Psychooncology Team in the Multidisciplinary Team Management of Breast Cancer Patients - From Diagnosis to After Treatment: A Qualitative Study at MISR Cancer Center
Authors: Sallam I. , Amira G. , Youssri A.
Published: September 2018

Background: According to the cultural and socioeconomic factors, breast cancer patients (BCP) experienced a relatively low health-related quality of life (Qol) during the journey of breast cancer treatment, that influence patient adaptation to the situation from diagnosis to after treatment. And the further effect on either starting the treatment or its continuation. This merited conducting a qualitative study to explore the importance of the psychooncological approach to BCP and the impact on commencing and continuation of treatment and follow-up. Aim: To describe the impact and importance of the psychooncology team in the cancer center and the effect of their approach on the BCP's Qol. Methods: The study involved 114 interviewed participants, excluding patients with wide variety of chronic illnesses, only 91 patients are the focused study group. Of which 11 patients group (1) refused to join the psychooncological approach due to cultural, and socioeconomic issues, and 80 patients group (2) joined and followed up by the team. Both groups are regularly surveyed. Qualitative and quantitative measurements were used. Data were collected as follows, at time of diagnosis, after surgery and after chemo-radiation therapies from group (1) and for group (2) after the psychooncology team management and care. Developing the psychooncology team for the cancer center. 2 psychooncologists, 5 psychoeducating nurses and a group therapy sessions at a world standard levels of care with ethics committee approvals, and caring for patients' privacy. Close follow-up and evaluation of the performance and Qol of our BCP, raising the awareness about psychoeducation and psychological approach importance for BCP that would help them cope with daily life challenges to improve Qol. Results: Category Group N. Diagnosis related depression N. Surgery related depression N. Treatment related depression Free of depression Group (1) No= 11 3 (27%) 2 (18%) 5 (45%) 1 (10%) Group (2) No= 80 12 (15%) 9 (11.3%) 23 (28.7%) 36 (45%) Conclusion: Results indicate that the most critical depressing points is at time of diagnosis and chemo-radiation therapy. Group (2) has positive indication and alternation on the level of Qol and a significant improvement on level of depression when compared with group (1). This study highlighted the importance of psychooncology team in BCPs' survivorship. It also brings to attention the important role of the government, health policy makers and health plans toward enriching all cancer centers with the psychooncology team. To maximize health and health care for BCP.
Collaboration Reinforces Public Private Partnerships, a Benefit to Cancer Services
Authors: Walters G.A.
Published: September 2018

Introduction: Collaboration within the Health sector in South Africa is becoming pivotal in respect of cancer, HIV-AIDS, tuberculosis and NCD's screening and treatment to communities living in South Africa. Collaboration with the private sector has been the key driver as government cannot provide funding and as part of CSI initiatives, private sector has to have a quick win. This is how NGOs receive funding from the private sector to deliver cancer services to communities within rural areas in South Africa. Our collaboration is built on Public Private Partnerships (PPP) platform. Our collaboration continues within an alliance structure that allows PinkDrive to build footprint as well as create greater platforms and networks for funding, strategic opportunities and building a greater recognized service orientated base. Objective: The primary objective of the introduction of collaboration for PinkDrive-MBTM is to create a 1-roof testing where communities/society can receive cancer and other related services from corporate funding and sponsored health/social services. The other objective is to collaborate on best practices, successful processes delivered at many points creating awareness and informing the nation who are either infected or affected by cancer. Methods: 1. We work closely with corporates who are seeking effective health campaigns for their CSI/CSR initiatives or projects. 2. Once funding is confirmed and designated areas are identified, PinkDrive/MBTM then collaborates with identified partners to take cancer and other services (health screening and testing) to the respective remote/rural area. 3. Remote areas with reduced access to specialized health and basic care services are specifically targeted especially HIV-AIDS. 4. Collaboration allows PinkDrive/MBTM and its partners to captured patient histories, identification, and treatment (pre- and postscreening) for effective screening services. Results: 1. In a collaborative structure, we have found that the patient is privy to understanding the level, importance and stage of cancer with other related illnesses. 2. Through collaborative structures, holistic healthcare services and medical treatments are monitored, measured and managed appropriately at the relevant healthcare institutions. 3. Due to the funding received by corporates for such cancer services, PinkDrive mobile trucks are on the road offering its cancer services with other partners. Conclusion: Collaborative initiatives are good success stories incorporating best practices and also benefitting the patients and medical professional. The PinkDrive-MBTM mobile truck is recognized and individuals will always elaborate on how they receive their results speedily and at their doorsteps.
Systemic Delivery of Sirna-Based Therapeutics Using Single-Walled Carbon Nanotubes
Authors: Tan Y.-F. , Cheong S.-K. , Leong C.-O.
Published: September 2018

Background: Carbon nanotubes (CNTs) are potential candidates for drug, antigen and nucleic acid delivery vehicle in nanomedicine. The large surface of CNTs provides structural advantages and allows loading of functional groups or therapeutics such as nucleic acid, drugs and proteins. Aim: Our study is to deliver siRNA to cells using single walled carbon nanotube (SWNT) to achieve gene silencing effect. Methods: SWNT was functionalized by dissolving 1 mg of HiPCo SWNTs and 5 mg of PL-PEG-NH or PL-PEG-maleimide in 5 mL of water, sonicated for 60 min at room temperature and centrifuged for 6 h. The supernatant were collected and measured their concentration at 808 nm by ultraviolet-VIS-NIR spectrometer. The resulted noncovalent functionalized SWNTs were further conjugated with a 5′-thiolated siRNA against GFP (siGFP) and RFP (siRFP). In vitro silencing of GFP and RFP expression by SWNT-siRNA were evaluated in stable expression cell lines by fluorescence spectroscopy. Results: A range of 50%–80% GFP expression knocked down was observed in H1299, HeLa, MCF-7 and 293T cells by SWNT-siGFP. SWNT conjugated with both siGFP and siRFP were shown knocking down both GFP and RFP simultaneously in H1299 stable coexpression cell line. Also, gene silencing was observed despite incubation with inhibitors on different cellular internalization pathways. They are chlorpromazine for clathrin-mediated endocytosis inhibitor, genistein for caveolae-mediated endocytosis inhibitor and sodium azide for energy depletion agent. We also found that the internalization of SWNT by the nonphagocytic cells (H1299) did not solely depend on single cellular entry pathway to achieve the gene silencing effect. Conclusion: The successful knockdown of GFP expression in different cell lines indicated that siRNA were released from the conjugated SWNT-siRNA in the cytoplasm and silent the gene expression. It is also indicated that 2 different types of siRNA targets could be conjugated with SWNT and achieved 2 different gene silencing effects simultaneously.
High Level of ASXL1 Protein Is Associated With Better Disease-Free Survival in Colorectal Cancer
Authors: Lee K.
Published: September 2018

Background: ASXL1 gene is on chromosome region 20q11.21. Either amplification in cervical cancer or truncation mutations in colorectal cancers with microsatellite instability (MSI), malignant myeloid diseases, chronic lymphocytic leukemia, liver, prostate and breast cancers occurred. The functional and the prognostic roles of ASXL1 mutations and the expression of protein in colorectal cancer are still unknown. Aim: The aim of this study is to investigate the functional roles of ASXL1 mutations and the expression of protein in colorectal cancer. Methods: We performed NGS of 10 colorectal cancer with peritoneal seeding to find genetic markers for aggressive phenotype. All showed a frameshift deletion at codon 1934delG. To clinically validate the functional and the prognostic roles of the mutations, we performed an immunohistochemical staining (IHC) on tissue microarrays of 414 consecutive colorectal cancers. Results: The ASXL1 protein expression was strong positive in 5.8% (24 patients), moderate positive in 38.5% (157 patients) and negative in 55.6% (227 patients). The patients with negative ASXL1 expression had more lymph node metastasis than the patients with strong positive expression [59.0% (134/227 patients) vs 33.3% (8/24 patients), P = 0.038]. None of the patients with strong positive expression had recurrent disease in the stage I-III cancers [0% (0/21 patients) vs 19.4% (27/139 patients) vs 18.9% (34/180 patients)] and the disease-free survival rate of the patients with strong positive expression was significantly better than that of the patients with moderate positive or negative expression ( P = 0.037; P = 0.031). Conclusion: The decreased level of the expression of the ASXL1 protein was associated with lymph node metastasis in its progression of cancer. Strong positive ASXL1 protein expression was a 'good' prognostic factor of colorectal cancers. The ASXL1 protein might be tumor suppressive in colorectal cancer.
Raising the Voice of Metastatic Breast Cancer Patients in Argentina: An Inspirational Campaign to Highlight to Share Patients Unique Life Vision and Patients' Unmet Needs
Authors: Bello M.L.
Published: September 2018

Background and context: In Argentina, every year 19,000 new breast cancer cases are diagnosed, and 30% of those cases will advance to a metastatic stage. In fact, breast cancer is the first cause of female death by tumors in Argentina. Previously, BC awareness campaigns developed by local NGOs, medical societies and/or government authorities focused their efforts in early diagnosis, and there weren't initiatives raising the awareness of those women suffering from advanced or metastatic BC. In fact, a regional survey that included Argentina reported that only 50% of respondents knew anything about mBC. Particularly in Argentina, 76% of adults considered that media and key influencers were not paying enough attention to the mBC burden of disease. Furthermore, every time mBC was mentioned, it was with a negative connotation, more of a “sentence of death” than a positive message. Aim: To raise the voice of Argentinian metastatic breast cancer patients to ensure that their situation and needs are known and addressed by the general public, media, and government authorities. Strategy/Tactics: In 2016, Pfizer along with four cancer patient advocacy organizations (MACMA, ACIAPO, SOSTEN and ACILCO) worked together to change that situation. Eleven women with mBC shared their testimonies through in-depth interviews with a message full of hope and positive feelings. These women's experience inevitably led them to take a different view at life. For them, words changed their meaning following diagnosis, when their life changed. With admirable simplicity and integrity, they shared these meanings that invited us all to appreciate life differently. These testimonies were included in a dictionary called Palabra de Mujer (Woman's Voice) where powerful words as life, love, friendship, future, among others were redefined while compared with the literature academy formal meaning. These women and the NGOs participated in a media campaign that included a press-conference, live interviews for TV shows, interviews for most important magazines and newspapers and participation at local “Grammys”. To gain a national reach, the campaign had the support of advertising and a Web site where video testimonies could be found and the dictionary downloaded for free. The dictionary was also distributed to patients at different levels: patient advocacy groups, public hospitals, payers and physicians' offices. Outcomes: This campaign had a wide stakeholder reach, with an impact of +79 million impressions, 5000 dictionaries distributed and more than 50,000 unique visits to the landing page ( www.palabrademujer.com.ar ). Moreover, the city of Buenos Aires declared Palabra de Mujer of sanitary and social interest, recognizing the initiative at the legislature. Additionally, the participant NGOs are still asking for more and more dictionaries as, any time they give one of them to a mBC patient, feedback is powerful and full of hope.
Incidences and Trends of Lung Cancer in Western Kenya for the Period Between 2012-2016
Authors: Atundo L. , Chite F. , Chesumbai G. , Kosgei A.
Published: September 2018

Background: Lung cancer diagnosis has been a challenge in western Kenya due to the technicalities related to screening and diagnostic procedures. The burden in the adult population is largely unknown, as most patients are managed for Pulmonary Tuberculosis, since both have similar clinical manifestations. The Eldoret Cancer Registry (ECR) provides statistics and epidemiologic profile across western region of Kenya. Aim: The aim of this study is to establish lung cancer incidences in relation to year of diagnosis, age, gender and stage at diagnosis across western Kenya region. Methods: A retrospective review of all cases of lung cancer disease diagnosed at Moi Teaching and Referral Hospital from 2012 to 2016 were identified from the ECR. Data on year of incidence, age, gender, stage at diagnosis and county of origin was analyzed Results: Out of the 60 patients diagnosed with lung cancer, the findings were as follows: In 2012 there were 11 cases representing 18.3%, 2013 10 cases (16.7%), 2014, 12 cases (20%), 2015 12 cases (20%) and 2016, 15 cases (25%). Incidences by age were in the following cohorts; 0-27 years 1 case representing 1.7%, 30-39 years (4) 6.7%, 40-49 years (8) 13.3%, 50-59 years (17) 28.3%, 60-69 years (12) 20%, 70-79 years (15) 25%, above 80 years (3) 5%. Incidences by gender: male had 38 cases at 63.3% and female had 22 cases at 36.7%. Incidence by stage at diagnosis; stage iv (6) 10%, unknown stage (54) 90%. Conclusion: 2016 had the highest incidence and may be associated with the increased awareness on screening services at MTRH. Most cases were between 50-79 years and could be attributed to the slow disease progression and delays in early diagnosis. Higher incidences were in males and may be related to susceptibilities to risks factors such as smoking and industrial fumes respectively. There's need for early diagnosis and disease staging as most cases were at stage 4 and unknown.
Potential Application of Bone Scintigraphy in Nasopharyngeal Carcinoma With Skull Base and Adjacent Bony Involvement
Authors: Zanial A.Z. , Hassan S.Z. Amir
Published: September 2018

Background: Bone scintigraphy has an established role to evaluate skeletal metastasis by detecting lesions earlier compared with radiographic changes. Skull base and adjacent bony involvement could possibly be evaluated using bone scintigraphy and might influence nasopharyngeal carcinoma (NPC) treatment planning. Skull base lesions in NPC are also associated with concomitant skeletal metastases. Aim: To determine clinical characteristics of NPC patients with skull base lesions and adjacent bony involvement who underwent bone scintigraphy and their scan findings. Methods: Bone scintigraphy performed for 87 NPC patients between June 2014 and February 2018. Whole-body imaging acquired at 3 hours after 99mTc methylene diphosphonate (MDP) injection. Clinical information and scintigraphic findings were compiled. Patients with prior evidence and/or bone scintigraphic features of skull base lesions or adjacent bony involvement were included (n = 46). Synchronous malignancy or ongoing bone infection cases were excluded. Results: 17 patients had prior evidence of skull base or adjacent bony involvement that were all subsequently positive on bone scintigraphy. We detected another 29 patients with MDP-avid skull base or adjacent bony involvement. Average age of entire cohort was 51 years. Approximately 78% were males. Majority were ethnic Chinese (48%). Most patients (57%) had stage 4 diseases prior to bone scintigraphy with 9 patients demonstrating distant metastasis mainly to lungs and bones. Only 28 patients were receiving ongoing treatment. Overall, 18 patients (39%) showed concomitant MDP-avid skeletal metastases on whole-body imaging. Patients whom already had existing documented distant metastasis were significantly associated with concomitant MDP-avid skeletal metastases ( P < 0.05), while other parameters including gender, age, ethnicity, disease staging and treatment status showed no significant correlation. Conclusion: Bone scintigraphy could potentially be used to assess skull base and adjacent bony involvement besides concomitant skeletal metastasis among our cohort of NPC patients.
Cross-talk of TGF-β and Wnt/β-Catenin Pathways Leading to Epithelial Mesenchymal Transition in Oral Submucous Fibrosis in Indian Population
Authors: Rakheerathnam K.K. , Ranganathan K. , Devaraj S. Niranjali
Published: September 2018

Background: Oral squamous cell carcinoma (OSCC) is a predominant type of cancer in India. It has been observed that OSSC is preceded by premalignant lesions or otherwise reported as potentially malignant disorders (PMD) by WHO during the year 2005. PMD include various oral mucosal diseases such as leukoplakia, erythroplakia, oral submucous fibrosis (OSMF), oral lichen planus, discoid lupus erythematosus and actinic keratosis etc. Literature surveys have highlighted that areca nut–associated oral squamous cell carcinoma is the third most common malignancy in the developing world and OSMF has been reported as the PMD of the oral cavity that has high prevalence rate in India. Since the exact mechanism behind this fibrosis condition is yet to be identified, we propose that, components in areca nut could interfere with certain signaling pathways in the human system that could lead to this precancerous stage. Aim: 1. To investigate the molecular mechanism involved in EMT by cross-talk between TGF-β and Wnt/β-catenin pathways in OSMF patients. 2. To explore the role of HSP90 inhibition in this cross-talk under hypoxic condition. Methods: OSMF tissue samples were obtained via punch biopsy, from patients with areca nut chewing habit and control tissues were collected from healthy individuals. OSMF patients who underwent any local treatment of oral mucosa or those who have any systemic disorder were excluded from the study. Initially, the expression pattern of various TGF-β and Wnt signaling pathway molecules were studied immunohistochemically to confirm the role of these pathways in OSMF. The gene expression of Wnt5a, Wnt3a, GSK-3β, β-catenin, cMyc, TGFβ1, smad3, E-cadherin, snail, α-SMA and Twist were studied by quantitative real time PCR (qRT-PCR). The results of qRT- PCR were further confirmed by Western blot analysis. Human gingival derived fibroblast cells were cultured and the cells were grouped into 2. Group I- normoxia, group II- hypoxia, group III- hypoxia + 17-AAG (an inhibitor of HSP90). mRNA and protein expression patterns were revealed by qRT-PCR and Western blot analysis for HSP90, HIF-1α, Wnt5a, β-catenin, cMyc, TGF-β1, Smad3, p-Smad3, E-cadherin, N-cadherin, Snail and α-SMA. Immunofluorescence analysis of expression of HSP90, HIF-1α, vimentin, snail, TGF-β1, Smad3 were also carried out. Results: The results obtained revealed that, TGF-β and Wnt/β-Catenin signaling molecules are involved in OSMF leading to EMT. The same pattern was observed when the cells were maintained under hypoxic conditions. Conclusion: Overall, this study describes the cross-talk of TGF-β and Wnt/β-Catenin pathways in EMT in tissues collected from OSMF patients and also when the cells were maintained under normoxic and hypoxic conditions. Inhibition of this signaling cross-talk might help to identify a new strategy for therapeutic intervention.
Rank-Based Fecal Hemoglobin Concentration for Assessing Colorectal Neoplasms of National-Wide Colorectal Cancer Screening in Taiwan
Authors: Peng S.-M.
Published: September 2018

Background: Fecal hemoglobin concentration has shown potential of predicting colorectal cancer and colorectal adenoma. Accordingly, it is of great interest to use fecal hemoglobin concentration to stratify population into risk groups of colorectal disease. Aim: This study aims to predict the risk of colorectal neoplasia by using quantitative fecal hemoglobin concentration with a rank-based method. Methods: Using data from Taiwanese nationwide colorectal cancer screening program between 2004 to 2009 following up until 2012, fecal hemoglobin concentration regarded as the ordinal outcome was used to predict the risk of colorectal adenoma. Accelerated failure time model on fecal hemoglobin was used to evaluate the differences across 4 categories of outcome, including colorectal cancer, advanced adenoma, nonadvanced adenoma, and normal colon. We converted the adjusted percentile values of each group of colorectal neoplasia into the corresponding risk with Bayesian underpinning. Results: The adjusted median fecal hemoglobin concentration of nonadvanced adenoma was 57.0, advanced adenoma was 82.4, and colorectal cancer was 163.1 µg/g feces compared with normal colon. The corresponding risks of 2 groups when the fecal hemoglobin concentration reached the median were 4.0%, 4.8%, and 29.5%. Risk of reaching other percentile of 2 groups of colorectal neoplasm can be acquired on the basis of adjusted percentile value of fecal hemoglobin. Conclusion: Based on quantitative fecal hemoglobin concentration and survival model analysis, we estimated the risk of developing colorectal neoplasia by percentile of fecal hemoglobin concentration.
Thyroid Cancer Profile: Experience of Liga Contra El Cancer Honduras 2014-2017
Authors: Bejarano S. , Berlioz C. , Loucel S.M. , Caballero C. , Alas C. , Awad K.
Published: September 2018

Background: In recent years we have observed increase in thyroid carcinoma TC incidence at cancer centers in Honduras. TC is linked to exposure to ionizing radiation. Other risks factors described in literature are obesity, diabetes, nitrites and nitrates in diet and alcohol. DNA rupture, activation of oncogenes, and secretion of inflammatory cytokines are initial events that derive in mutations and malignant transformation. Papillar, follicular and undifferentiated carcinoma are the histologic types. Little is known about TC in the population, and there are no efficient models for prevention and early detection to date. Aim: Describe the clinical and demographic profile of patients diagnosed with TC at La Liga Contra el Cancer Hospital LCC from 2014-2017, with intention to identify patterns that allow approaches to pathogenicity and prevention. Methods: We revised 103 medical records of all TC patients treated at LCC from Jan 2014-December 2017 to obtain information about geographical origin, age, gender, localization of tumor, identifiable risk factor, treatment and outcomes. A digital database was in Microsoft Office Excel and exported to SPSS. Patient information was deidentified before data extraction. Results: 91.3% patients were female. Median age 49.3 ± 15.6 years (95% CI, 46.05-52.2). Patients went from 11/18 departments (political division), 74% gathered in the northern zone of the country. Histology type: papillary 91.3%; follicular 4.9%, anaplasic 1.9%; medullary 1.0%. Papillary TC, 37% of patients were in fifth decade, 22.9% in patients 31-40 yo, 17.3% in patients 41-50 yo, 9.7% were under 30s. Clinical stage at diagnosis: I I (n = 24) 23.6%, II (n = 13), 12.6%. III (n = 18), 17.5%. IV (n = 14), 15.6%; not suitable for staging 5.8%, the rest had no precise information for staging. 12.6% of patients reported family history of cancer (any type), 33% of patients reported comorbidities. Conclusion: Thyroid carcinoma has increased in the last years, from our experience we can identify that women are mostly affected, with papillary type being the most common. Ages affected are between 41-60 years old. One third of patients had comorbidities as hypothyroidism, diabetes and arterial hypertension. 74% reside in the northern zone of Honduras, there is need to elucidate if it is a matter of geographical location of the LCC. No emerging risk factors were identified in this cohort. More research is needed to profile thyroid carcinoma in our region.