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Acta Scientific Cancer Biology

ISSN(p): | ISSN(e):2582-4473
Journal Papers (86) Details
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Indexed Journal

1 Lung Cancer , Andrew Hague
The ease with which cancer is stopped by CellSonic surprises oncologists and delights patients. Cancer is an electrical fault. The behaviour of the cells is corrected by changing the voltage to that of healthy cells, a process called electroporation. There is no surgery and no drugs. This is biophysics, not biochemistry. There are no side effects and the replication of mutating cancer cells is stopped immediately. Then starts the healing of the damage caused by can-cer and the usual problems in patients unfortunate to have been treated with chemotherapy and radiation.
2 Abdominal Adiposity as a Risk Factor for Colorectal Cancer , He Liu
Colorectal cancer is the third most commonly diagnosed cancer type with a rising trend worldwide. In recent years, it has become more evident colorectal cancer is associated with obesity, which is also a global health issue. According to the 2020 update by the World Health Organization, worldwide obesity has nearly tripled in the last 45 years. Over one-third of the adults were overweight, and 13% were obese
3 Assessment of Knowledge and Application of CBCT Among Dental Professionals – A Questionnaire Study , Reshma Ramachandran and Sushmini Hegde
Background: CBCT is an imaging technique which uses a cone shaped radiation that is focused on a 2D detector. It has been widely accepted in practice in radiology as well as academic and hospital settings. The present study is aimed to assess the knowledge and application on CBCT among dental professionals.Materials and Methods:A validated questionnaire was distributed among 250 dental professionals.Results: Most of the respondents were unsure about the radiation exposure of CBCT when compared to other types of imaging and all of them were willing for a CBCT hands on.
4 Radiotherapy - A Focused Ray of Hope   , Aklanta Kumar Gogoi, Shivu ME, Ravi Varma M, Swati Pichika and Karthik D Yadav
Oral carcinoma has occupied the sixth position with the 5 year survival rate at 50% or even less. Over the years various other diagnostic methods have been added for the process of diagnosis, however they are just adjunctive to the screening methods. Right treatment at the right time remains as a very important aspect even today and is considered to play a vital role in achieving a good prognosis. Treatment includes surgery, chemotherapy, radiotherapy and many more. However, the role of each of the treatment is to eradicate oral carcinoma but has its own side effects. Radiotherapy can be used as a single modality as well as an adjuvant to the surgical management after surgery. However, the side effects is a matter of concern in radiotherapy.
5 Radiomics in Oncology , Houman Sotoudeh
Radiology is the backbone of cancer diagnosis and manage-ment. Traditionally the radiologic diagnosis is made by human and visual evaluation of the images, but this approach has some limita-tions. Usually, the human radiologist uses a few features (e.g. the size of lesion, density, sharpness of the lesion, and the enhance-ment after contrast injection). However, the medical images con-tain much more information that is not visible by the naked hu-man eyes. In this context, Radiomics has great momentum in the oncologic imaging field.
6 Leiomyosarcoma of Inferior Vena Cava Arising from the Confluence of Right Adrenal Vein Masquerading as a Suprarenal Mass - A Case Report , Rakesh Manilal Sharma; Sandeep Maheswara Reddy Kallam; B Vishal Rao and Ashwin Giridhar
Leiomyosarcoma (LMS) is a malignant mesenchymal tumour, which originates from the smooth muscle cells. Leiomyosarcoma of vascular origin most commonly originates from inferior vena cava (IVC). Around 400 cases of IVC leiomyosarcoma were reported in literature till date. Here we report a case of a 58-year-old male diagnosed to have right large palpable supra renal mass. Contrast enhanced computed tomography (CECT) of abdomen and pelvis revealed a well-defined soft tissue mass measuring around 10 cms with heterogeneous post contrast enhancement at right suprarenal region with a clinical differential diagnosis of adreno cortical carcinoma and retroperitoneal leiomyosarcoma was made. Intra-operatively right adrenal gland was normal, and the mass was seen arising from the side wall of IVC at the confluence of right adrenal vein. Complete excision of mass done, followed by repair of IVC rent. Histopathological examination showed leiomyosarcoma. Adrenal gland was normal, margins were free of tumour and immu-nohistochemistry (IHC) was positive for caldesmon and smooth muscle actin (SMA). Patient was on follow up for the past 1 year without local recurrence or distant metastasis.
7 Comparing the Effectiveness of Different Scoring System in “See and Treat Approach” for Cervical Precancerous Case Management , Priya Ganesh Kumar and Akshay Ganesh Kumar
Indian healthcare is largely in the private domain which is not covered under any reimbursement program. Patients below the poverty line (BPL patients) show higher prevalence of sexually transmittable infections, of which HPV is one of the major contributor. “See and Treat” approach is largely favoured for treating the high grade cervical or lower genital abnormalities suspected to proceed to invasive disease in the foreseeable future. Colposcopy procedure is both diagnostic as well as curative for high grade cervical precancer and thus occupies an undisputed centre stage of cervical cancer prevention and control program in the clinical set up. A Reid Colposcopy Index (RCI) for grading the lesion severity determines colour change due to acetic acid, Margin Vascular pattern of the lesion along with change in colour with Lugol’s iodine and converts the subjective threshold for diagnosis and hence treatment intervention into a semiobjective one. The swede score has added the parameter of size of the lesion as well. The colposcopy grade scoring system therefore guides prediction of histologic diagnosis of the disease as well as determines which of these high grade lesions warrant immediate treatment by simple procedures like cryotherapy, thermocoagulation, leep therapy. “See and Treat” ap-proach is particularly also beneficial in the rural population settings where a trained clinical or pathological expertise may not be immediately available and skilled health workers may be trained to detect and eliminate the precursor disease. In our study, out of 650 cases who underwent colposcopy for varied reasons, 84 cases were detected to have lesions (12.9%). These lesions were scored according to RCI and Swede scoring systems. The lesions were biopsied for prospective histopathological findings. The clinical sensi-tivity, specificity, PPV, NPV, concordance and discordance between the two scoring systems were determined with histopathological diagnoses of high grade disease. In Reid’s scoring system, RCI score of ≥4 is taken as qualifying for HSIL detection and thus warrants treatment. In Swede scoring, a score of ≥ 5 is considered positive, warranting treatment. As per standard guidelines and protocol, CIN 1cases are usually kept under surveillance whereas CIN 2 and CIN 3 cases are taken up for treatment. In our practice, all case of CIN 1 were recalled for follow up, RCI scored well in terms of all the above parameters. RCI scored better as compared to Swede in terms of comparing overtreatment –RCI 24 % as compared to 42 % in swede. In our data of 84 samples the correlation between the scoring system of Swede and RCI was 0.65. However, the REID scoring had high concordance with histopathology compared to Swede sys-tem (R = 0.71 between REID and HP and R = 0.65 between Swede and HP). RCI is a better scoring system to avoid unnecessary over treatment as compared with Swede system in “See and treat” programs adopted in rural areas and camp set up. As per our study, our recommendation will be to safely use Swede score cut-off at ≥5, in the case of Reid score a cut-off of at ≥4 in “See and Treat” program.
8 Fine Needle Aspiration Cytology Findings of Breast Lesions in Female Patients Presenting with Palpable Breast Lumps at Makerere University College of Health Sciences, Kampala-Uganda , Kinalwa Sulaiman; Abila Derrick Bary and Mwesigwa Boaz
Background: Palpable breast lumps are a common manifestation encountered by physicians during clinical practice. The use of fine-needle aspiration cytology (FNAC) method has proven to be quick, simple and cost-effective in the evaluation of these lumps for benign, atypical and malignant changes. This study aims to determine the type of breast lesions diagnosed by FNAC and to determine the age-wise distribution for such lesions.Methodology: A prospective study consisting of 291 females presenting with palpable breast lesions was carried out at Makerere College of Health Sciences (MakCHS) pathology laboratory from January 2019 to May 2019. FNAC results were grouped into tier five reporting categories as C1, C2, C3, C4 and C5 in accordance to the International Academy of Cytology (IAC).Results: Out of the 291 cases examined, 14 (4.8%) were insufficient (C1), 192 (66%) were benign (C2), 9 (3.0%) were atypical (C3), 15 (5.2%) were suspicious of malignancy (C4) and 61 (21%) were malignant (C5). In the benign category, lesions of fibroadenoma were the most commonly diagnosed constituting 110/192 (57.3%) whereas under the malignant category lesions of invasive ductal carcinoma were the most commonly diagnosed constituting 27/61 (44.3%). The peak age group for benign lesions was 21 - 30 years whereas the peak age group for malignant lesions was 41 - 50 years.Conclusion: Fine-needle aspiration cytology (FNAC) was found to be an effective diagnostic tool in the categorization of palpable breast lumps into benign, malignant, atypical, suspicious and inadequate categories.
9 Clinical Conundrums in Ovarian Cancer – A Genetic and Molecular Based Approach – Importance of Personalized Standard-of-care Therapy , PK Prem Ravi Varma
Epithelial ovarian cancer is the most lethal gynecological malignancy. It can be divided into five main histological subtypes: high grade serous, endometrioid, clear cell, mucinous and low grade serous. These histological subtypes are distinct disease entities at the clinical and molecular level. There is significant genetic heterogeneity in ovarian cancer, particularly within the high grade serous subtype. This subtype of ovarian cancer has been the focus of much research effort to date, revealing molecular subgroups at both the genomic and transcriptomic level that have clinical implications. Therefore stratifying ovarian cancer patients based on the un-derlying biology remains in its infancy. This article summarizes the molecular changes that characterize the five main ovarian cancer subtypes and highlight potential opportunities for targeted therapeutic intervention and outline priorities for future research.
10 Glioblastoma Multiforme , Jardson Peixinho
Neoplasia is the proliferation of cells of a given tissue, which are out of the control of the organism and tend to autonomy, causing serious damage to its host.Tumors can be classified as: benign and malignant. Benign tumor cells grow more slowly while malignant tumor cells grow faster and disorderly.In the case of brain tumors, we can classify them according to their aggressiveness, where the degree can vary from I to IV, and the higher the degree, the greater the aggressiveness of the tumor.Gliomas is the term used to designate tumors (neoplasms) originating from brain glial cells. Glioblastoma Multiforme (GBM) fits in Grade IV tumors, originates in glial cells, has no defined form, and is highly lethal and in cases of removal there is recurrence. Imaging methods are used to locate the lesion extremely useful to determine the extent of the disease.
11 A Tale of Two Leukemias , Sajjad A Bhatti and Abdulraheem Yacoub
Chronic lymphocytic leukemia (CLL) is the most common adult leukemia [1], characterized by the accumulation of mature but functionally incompetent CD5+ monoclonal B cells. Chronic myelogenous leukemia (CML) is a myeloproliferative neoplasm charac-terized by a reciprocal translocation between chromosomes 9 and 22, leading to BCR-ABL1 fusion gene with constitutive tyrosine kinase activity resulting in dysregulated and uncontrolled proliferation of granulocytes.
12 The Best of the Genitourinary Cancers Symposium 2021 in Kidney Cancer , Melisa Hunis and Adrian P Hunis
The congress of the American Society of Oncology on genito-urinary tumors, held virtually between February 11 and 13, 2021, is one of the largest congresses on genitourinary neoplasms. Next, we will review the works that have attracted the most attention in kidney cancer.
13 Awareness of Basics of Radiation, Dose Levels of Imaging Procedures and Radiation Safety among the Nurses in an Academic Hospital in Himachal Pradesh, India: Results of a Cross Sectional Study , Nitin Gupta, Munider Negi, Sumit Kumar, Vandana Khushawa, Vishal Kaundal, Shilpa Sood and Shalini Verma
Objective: To illustrate our institutional experience about the awareness of basics of radiation, dose levels of imaging procedures and radiation safety among the nurses in Himachal Pradesh.Methods: Data was obtained from a multiple question based survey conducted in a group of nurses from the various departments between May 20, 2020 and June 01, 2020. The survey was designed to assess the knowledge and awareness of basic radiation types and effects, dose exposure levels and radiation protection among the participants. Questionnaires were distributed both physically where ever feasible and online using google form. Participation to the survey was voluntary and completely anonymous.Results: Regarding the question of type of radiation that is harmful for living beings, 93.4% of the participants correctly responded that ionizing radiation is harmful, 3.6% said non ionizing radiation is harmful while 3% were not sure about it. Overall, 41.6% of the respondents were aware that of radiation is helpful in diagnosing diseases, treating cancer and can cause cancer. Only 30% of the respondents felt the need to confirm LMP or pregnancy status of a woman of child bearing age before subjecting her to an abdominal/pelvic CT or a nuclear medicine procedure, where as a small but significant 6.8% responded that the radiation dose received from these modalities is very low and of no concern where as 3.6% respondents reported that they were not sure of what should be done. Only 34.6% of the participants were able to tell that children are mostly affected with radiation. Overall 88.97% of the respondents found that it is very important to have knowledge of the radiation dose of common radiological investigations and procedures. Only 48.5% of the participants were aware of nuclear medicie department, others were not aware of it.Overall 66.9% of the participants thought that their knowledge needed improvement and that they would prefer a workshop to update themselves where as 22% par-ticipants though class room lectures would be appropriate to enhance their radiation dose levels and safety related awareness. Only 32 % of the participants were aware that radiation is used to diagnosing, treating and can cause cancer. Only 18 % of the participants were able to tell DEXA Scan, Kidney Scan tests, Thyroid Scan and Bone Scan come under Nuclear Medicine department. Only 10% of the participants were able to say that the modalities which uses ionising radiation are X-Rays, CT scan, PET Scan, Throid scan. The radiation exposure from background radiation was correctly estimated by 45.9%.Conclusion: The results of our study show that the knowledge of nurses in our institute is significantly worse due to lack of their formal training. And there is need to create awareness among the nurses starting from their clinical training period. Future studies should investigate knowledge of radiation protection and performance of radiation protection behavior in nurses, such as those working in the general ward or specialized departments, and educational needs should also be studied to develop customized radia-tion protection education programs.
14 Telomeropathies - A Genetic Conglomerate , Gurpreet Kaur, Priyanka mishra, Preeti Tripathi, Seema Tyagi, Haraprasad Pati and Manoranjan Manapara
Telomeres are repeated TTAGGG hexanucleotides and proteins associated with them. Telomeres function to form a stable end of the chromosome and protect it from being recognized as a DNA fragment that needs repair. Telomeropathies or ‘telomere biol-ogy disorders’ are rare and heterogenous diseases that are caused by mutations in the maintenance of telomerase or the damage response system (DDR). Telomeropathies or telomere biology disorders (TBDs) may be classified as primary and secondary. Primary telomeropathies are due to defects in the telomere maintenance machinery whereas secondary telomeropathies are caused by fail-ures in the DDR.Dyskeratosis congenita (DKC) which is an inherited bone marrow failure syndrome is the classical example of the telomeropathy syndromes. Progressive telomere loss or attrition is associated with and is likely to be an etiology of malignant transformation. Over 85% of malignant tumors show positivity for telomerase, in contrast most normal tissues are telomerase-negative, and owing to this telomerase enzyme has become an excellent target in research for newer therapies that inhibit telomerase and shorten telomeres in malignant cells. In aplastic anemia, patients with the shortest telomeres are four- to five times more likely to have clonal evolution of disease and undergo progression to myelodysplastic syndrome and leukemia. The telomeropathies hence resemble a spectrum of disorders rather than being distinct diseases.Diagnosis of a telomeropathies needs awareness with regards to the clinical features the laboratory results and the molecular testing. Due to the rarity of telomeropathies and a low degree of suspicion the diagnosis may often be missed. For some telomer-opathies early diagnosis will translate into overall survival benefits and improved quality of life. In this review, we give an overview of the pathophysiology, signs and symptoms of the disorders caused by defects in telomere biology and touch upon the detection of telomeropathies in the laboratory.
15 Disturbed Steroid Hormonal Milieu is a Potential Cause of Cancer , P D Gupta
Environment and diet regulate menstrual cycle in human fe-males. The length of the period between menarche (activation of ovarian hormones) and menopause (inactivation of ovarian hor-mones) depends on 4 hormones, estrogens, progesterone, follicu-lar stimulating hormone and luteinizing hormone [1]. In our epi-demiological survey we found now menarcheal age is decreasing.
16 Breast Cancer Management during the COVID-19 Pandemic: A Review of the Dynamic and Evolving Guidelines and Some Personal Thoughts , Rayan Daoud, Rebecca Badawi, Romy Younan and Georges El Hachem
Nearly, every country around the world is being challenged in every direction by the lethal infectious disease known as COVID-19. The COVID-19 viral pandemic accountable for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease has drasti-cally influenced our work worldwide in the management of patients in terms of diagnosis and surgical treatment of cancer - including breast cancer. In fact, oncology practice has been transformed in response to this crisis. Today, more than ever, oncologists are post-poning chemotherapies, delaying curative surgeries and switching intravenous to oral therapies. This is due to the fact that cancer patients are at a significantly higher risk of getting infected with COVID-19 since their immune system can be compromised. The reality has to do with both that they have cancer and that they are on therapy for their cancer. As medical oncologists, it is our duty to make sure that these cancer patients are treated appropriately with a minimal exposure risk to this crushing virus. Herein, we are presenting a review that introduces the evolving guidelines for management of breast cancer patients in view of this pandemic, along with various methods of risk classifications. We also sought to include a personal analysis and hypothesis for the best optimal oral treatment in a particular bundle of breast cancer patients.
17 Distal Subtotal Gastrectomy for Middle-third Gastric Carcinoma in Selected Patients: Short-term and Long-term Outcomes , Ramiz B Bayramov, Ramila T Abdullayeva and Simara E Huseynova
Objective:Here we describe cases of carcinoma of the middle-third of the stomach for that > 80% distal subtotal gastrectomy was carried out providing adequate proximal resection margin and jejunum was anatomized to the lesser curvature side of the stomach at the level of the esophagogastric junction just below the cardiac sphincter. Material and Methods: From January 2014 till December 2020 54 patients with middle-third gastric carcinoma underwent radi-cal intent surgery. In all of the patients excluding 5 (3 men, 2 women, mean age 62 year) was carried out total gastrectomy (with Roux-en-Y reconstruction) plus D2 lymph node dissection. In the mentioned 5 patients > 80% distal subtotal gastrectomy plus D2 lymph node dissection was carried out providing adequate proximal resection margin. In the reconstruction step of the surgery the greater curvature was invaginated with purse string suture according to the traditional technique and the gastrojejunoanas-tomosis was created to the lesser curvature side of the stomach at the level of the esophagogastric junction just below the cardiac sphincter as mentioned above. The gastrointestinal continuity was reconstructed as an omega loop and in 4 patients, as a Roux-en-Y reconstruction in one. Results: No postoperative complications developed. Oral nutrition started on the 3rd or 4th postoperative days and intravenous infu-sion discontinued on 5th or 6th days. One patient died of multiple liver metastases after 18 months following surgery without any signs of locoregional recurrence. During 3 - 62 months’ control period no patient has complained of the signs of gastroesophageal reflux or dysphagia. 4 patients are alive for 3 - 62 months (mean 38 months) following surgery. Conclusion: In some patients with middle-third gastric carcinoma, who refuse deprivation of the stomach totally or have higher postoperative risk for total gastrectomy, > 80% distal subtotal gastrectomy can be carried out if tumor-free proximal resection mar-gin can be provided.
18 Small Things, Big Responses , Abhimanyu Mohanta
mall is beautiful'' is a popular proverb. But, small is power-ful and has big responses which can be well apprehended in con-nection with role of microRNA (miRNA or miRs) in cancer biology. MicroRNAs are small, endogenous, non-coding RNAs with 19-24 nucleotides in length regulating post-transcriptional gene expres-sion [1]. Normally, these control many biological processes includ-ing growth, development, cellular metabolism and body immunity during patho-physiological conditions. Under abnormal condition, miRNAs express aberrantly and may act as oncogenes, tumor suppressors, or metastasis regulators. Multiple factors including malfunctioning of the miRNA processing machinery, mutation of oncogene due to positional effects, and epigenetic mechanisms contribute a lot to the complex miRNA-mediated gene network misregulation followed by tumorigenesis and metastasis
19 Reversing Prostate Problem in Natural Ways, Naval Kumar Verma
It’s one of the most important organs for male sexual and urological wellbeing. Although it’s a small walnut like structure beneath bladder, but its role is much bigger than its size. The prostate normally gets bigger with age. After middle age, changing hormone levels can cause the prostate to increase five times or more in size, but now a days due to modern lifestyle, major part of male popula-tion is suffering from prostate problems. These prostate problems not only disturb the functional life of a person but also create an imbalance in the personal life too. Anatomically, prostate gland is comprised of zones and lobes. Main function of prostate gland is in sexual sphere, where it pro-duces PSA which is an essential protein that helps to keep the semen in its liquid state. This PSA, when gets increased, can lead to cancer or any prostate problem
20 The Importance of Cardio-oncology , Manuel Bazan Milián
Cardio-oncology is an emerging field of today medicine. This term may be familiar to some people but it is unknown for many others. There has been a rapid increase of cardio-oncological clin-ics worldwide. Although it is not accompanied by comprehensive scientific data that established guidelines of cardiotoxicity han-dling.
21 Comparison of Hyperfractionated Radiotherapy with Concomitant Chemotherapy and Conventional Chemoradiotherapy in Locally Advanced Head and Neck Cancer Treated with Volumetric Modulated Arc Technique (VMAT) , Chatakonda S Snehit, Bhaskar Vishwanathan, Geeta S Narayanan, Shashidhar V Kapurmath, Vandana S Kushwaha, Sowmya S Narayanan and Ramya Venugopal
Background: Concomitant Chemoradiotherapy (CRT) is standard approach for treating locally advanced head and neck squamous cell carcinoma (HNSCC). Altered fractionation such as hyperfractionated radiotherapy (HF) has also shown similar survival benefits as compared to conventional CRT. To determine whether addition of concomitant chemotherapy to hyperfractionated radiotherapy further improves outcome in HNSCC patients treated with modern volumetric arc modulated radiotherapy (VMAT). Methods: From January 2018 to March 2019, thirty four patients with stage III-IV HNSCC (excluding oral cavity, nasopharynx and paranasal sinus) were randomly assigned to hyperfractionated HFCRT (VMAT) with concomitant chemotherapy arm with radiation dose 81.6Gy/68 fractions,1.2Gy/fraction, twice daily, 5days/week or Conventional CRT (VMAT) arm with radiation dose 70GY/35 fractions, 2Gy/fraction, once daily, 5days/week, seventeen patients in each arm. Concurrent cisplatin 40mg/m2/week was given in both arm from first week. Overall survival (OS), Disease free survival (DFS) and toxicities were assessed.Results: The cisplatin full dose was received by 94.1% and 82.4% patients in HFCRT (VMAT) and CRT (VMAT) arm respectively. High grade (3-4) acute skin and mucosal were higher in HFCRT (VMAT) arm (47.1%) in comparison to CRT (VMAT) arm (17.6%) with no statistical significance (p = 0.067). Late toxicity was similar in both arms. The OS was better in HFCRT (VMAT) arm with median overall survival-17 months as compared to CRT (VMAT) arm with median overall survival -12 months, however, difference did not reach significance (log-rank test, p = 0.341), with similar trend in DFS.Conclusion: Hyperfractionated HFCRT (VMAT) with concomitant chemotherapy showed an encouraging trend for OS and DFS with acceptable toxicity profile. A larger study with longer follow up needed to elucidate possible superiority of HFCRT over CRT.
22 Molecules and Clonality in Cancer , Daniel Gandia
ancer is without doubt, one of the most important Internal Medicine diseases.The advances in the clinical setting treatment of this disease are huge, with the advantage, that many Basic Science disciplines, such as Molecular Biology, Biochemistry and Pharmacology positively impact in the understanding of this process.We discover permanently new basic Cancer cell issues, such as modifications of normal biochemical pathways that the cell uses for its metabolism and growth, but when Cancer is present, the al-terations are many and may not be all countable yet.
23 Holistic Homeopathic Approach to Cure Patients with Cancer; Case Series , Seyedaghanoor Sadeghi
Disregarding the various factors leading to cancer, the statistics has increased awfully during the last decade globally. Case No. 1: Mrs. Z.A. aged 21 was seen in the Autumn of 2010. Four months after getting married, she developed a huge mass on the left side of her neck. Pathologic examination of her biopsied mass turned out to be Hodgkin lymphoma. The well-known homeopathic rem-edy called Phosphorus was selected for her. Mrs. Z.A. was followed 4 times during one year after being 1st seen. No recurrence was reported, neither observed in the patient, meaning a complete cure occurred by homeopathic method of healing. Case No. 2: Mrs. T.M., A lady aged 44 was seen by the author in 2009. Fourth stage invasive ductal carcinoma was diagnosed based on the pathologi-cal biopsies. An integrative approach was planned and considered by the author. Mrs. T.M. was not used to including vegetables and fruits in her family’s daily food plate. Therefore, the author suggested the patient to consider healthy veggies and fruits. She started feeling better. She could not even walk and would lie on the back all the time so a physiotherapist was asked to see the patient. He guided her how to do simple physical exercises to strengthen her musculature. Then she felt better and was referred to an oncologist to go under chemotherapy. She was seen by a radiotherapist for radiotherapy. This took 4 years. The next 4 years Mrs. T.M. selected homeopathy to be done by the author. Homeopathy improved her nightly pains, increased her hope and energy by prescribing safe homeopathic remedies like Carcinosinum. Thus, she lived for 96 months. Case 3: A lady aged 72 suffering from Multiple Myeloma, underwent paramount homeopathic healing process for her renal failure, by decreasing her serum creatinine from 13.7 to 2 mg/dl. Thus, considering the remarkable homeopathic healing in the 3 patients, double-blind and meta-analysis clinical trials are suggested to evaluate this healing method to consider it for millions of cancerous conditions.Keywords: Carcinosinum; Cancer; Radiotherapy
24 In-Vivo Photodynamic Therapy Studies in Cancer , Süleyman Kaleli, Muhammad Alif Mazlan and Muhammad Lokman MD ISA
The traditional surgical method for cancer treatment has not been successful in removing primary or metastatic tumors. Che-motherapy and radiation therapy methods, as well as cancer cells and healthy cells affect the process of treatment nausea, hair loss, immune system weakness, such as there are many side effects. Photodynamic therapy (PDT) is a regulator for the treatment of many malignant carcinomas that can cause immunogenic apoptosis. Despite these adversities in surgery, chemotherapy and radiation therapy, significant progress has been made in PDT research recently. This review article is aimed to present recent studies.
25 HDAC11 Enzyme: Multifaceted Roles and New Avenues in Cancer Therapy , Vasundhara Sharma
Histone deacetylases (HDACs) are enzymatically super-active in various malignancies, deacetylating lysine (K) moieties of amino acids, and altering the functional properties of a plethora of his-tone and non-histone proteins. Histone deacetylase 11 (HDAC11), a novel class IV HDAC, is a newly discovered HDAC, regulating mul-tiple physiological programs in a wide variety of normal tissues and cancer cells. Enzymatically, it is a modest deacetylase as well as a deacylase of target proteins.
26 Тumor Microenvironment and Obesity , L Bubnovskaya*, I Ganusevich and D Osinsky
The worldwide obesity epidemic is a growing public health problem. Obesity is associated with the development of many dis-orders such as insulin resistance, cardiovascular disease, diabetes, depression. Epidemiologic, clinical, and preclinical data suggest that various common types of cancer are affected by obesity and it was revealed a link between obesity and the more aggressive character of malignancy. Obesity is decided as an independent prognostic factor of recurrence and survival.
27 Clinical Implications in Understanding Prostate Cancer Biology: From Androgen Receptor to Molecular Target Therapy in Metastatic Castration Resistant Prostate Cancer , Eliza Dalsasso Ricardo*, Angel AT Uchiyama, Denis S Shimba and Ariel G Khan
Prostate cancer is one of the most common malignancies in the world. For a long time, the cornerstone of treatment for advanced disease has been the manipulation of hormonal pathway of testosterone since is well stablished that androgen receptor regulates prostate growth, differentiation and apoptosis in regular and cancer cells. However, during the treatment of metastatic disease with androgen deprivation therapy resistance mechanisms appear, which led to the development of new treatments, such as second-generation anti-androgens-like (such as enzalutamide, apalutamide and darolutamide), and abiraterone acetate. In addition to the development of this new antiandrogens the deeper knowledge about DNA damage repair and their pathways such as direct reversal, mismatch repair, base excision repair, homologous recombination and the non-homologous end joining, resulted in new opportuni-ties of treatment. Recently, PARP inhibitors have showed their efficacy in the treatment of advanced prostate cancer. Therefore, the aim of this article is to review the current knowledge about cancer prostate biology and its clinical implications.
28 The Assembled Ossein-Osteoid Osteoma , Anubha Bajaj
Osteoid osteoma is a miniature, benign, bone -forming tumefac-tion which manifests a nidus of vascular osteoid circumscribed by sclerotic bone and constitutes an estimated 10% of benign bone tumours. Osteoid osteoma was initially scripted by Jaffe in 1935
29 Does the Type of Surgery After Preoperative Systemic Therapy for T3/T4 Breast Cancer Impact Survival? , Jamila Alazhri1, Tulay Koru-Sengul2, Feng Miao, Margaret M Byrne and Eli Avisar
Introduction: Our purpose was to study the impact of the extent of surgery on survival of women with T3/T4 breast cancer treated with preoperative systemic therapy (PST) in form of chemotherapy, hormonal therapy, or both. Methods: Population-based Florida Cancer Data Registry was screened for women diagnosed with T3/T4 breast cancer who received PST followed by either breast conserving surgery (BCS) or mastectomy. A multivariable Cox regression model was used to identify significant predictors of overall survival. Adjusted hazard ratio (aHR) and 95% confidence interval (95%CI) were calculated.Results: Out of 712 patients receiving PST, 72 (10%) had BCS and 640 (90%) had mastectomy. After covariable adjustment, patients who received both chemo and hormonal PST had better prognosis than patients with chemotherapy alone (aHR=1.90, 95%CI: 1.20 - 3.01, p = 0.006) or hormonal therapy alone (1.95, 0.84 - 4.56, p = 0.122). Hispanic origin (0.50, 0.27 - 0.92, p = 0.027) positively impacted survival. Medicare (1.70, 1.08 - 2.68, p = 0.021) and uninsured (1.69, 1.10 - 2.60, p = 0.016) compared to private insurance, poorly-differentiated/undifferentiated (2.24, 1.04 - 4.82, p = 0.039) compared to well-differentiated grade, and distant SEER stage (4.13, 1.68 - 10.12, p = 0.002) compared to localized were significant predictors of worse survival. There was no significant difference in survival between women who had mastectomy compared to BCS (1.35, 0.82 - 2.21, p = 0.234). In the subgroup of patients who had mastectomy, radiotherapy resulted in significantly better survival than no radiotherapy (HR 0.68, 0.47-0.99, p = 0.044).Conclusion: The type of surgery after PST for T3/T4 breast cancer does not impact overall survival. BCS could be considered for patients with T3/T4 tumors after PST.
30 Determinants of Multidrug Resistance Tuberculosis: A Systematic Review and Meta-analysis , Kaleab Tesfaye Tegegne*, Andualem Zenebe, Abiyu Ayalew Asse-fa, Mekibib Kassa Tessema, Eleni Tesfaye Tegegne, Alelign Tadele Abebe4, Berhanu Bifato and Muse Rike
Objective: The aim of this systemic review and meta-analysis was to determine demographic, behavioral and clinical risk factors for multiple drug-resistant. 19 studies were included in the systemic review and meta-analysis. Keywords: Multidrug Resistance Tuberculosis; Alcohol; Smoking; Diabetes Mellitus; Gender; Educational Status Materials and Methods: Search engines: PubMed/Medline, Web of Science, Scopus and Google scholar were used to search related literatures on MDR TB and selected determinates of MDRTB. All data were independently extracted. We used a random-effects model according to the DerSimonian and Laird method. Results: The risk of having MDR-TB in patients who have informal education was 0.67 times lower than that of patients who have formal education (RR = 0.67; 95% CI, 0.46 to 0.96). The risk of having MDR-TB in patients who have Diabetes Mellitus was 1.33 times higher than that of patients who have no Diabetes Mellitus (RR of 1.33 and 95% CI, 1.01 to 1.77).Conclusion: This systemic review and meta-analysis indicated that the risk of having MDR-TB in patients who have informal education was 0.67 times lower than that of patients who have formal education and the risk of having MDR-TB in patients who have Diabetes Mellitus was 1.33 times higher than that of patients who have no Diabetes Mellitus. Our review did not showed the presence of association between MDR TB and other selected variables gender, smoking and alcohol. We recommend interested researchers on MDR TB to do further research on patient’s educational level as a risk factor for MDR-TB in order to explain the variation in MDR TB among patients with formal education and patients with informal education.
31 COVID 19 in Cancer Afflicted Children - Impact and Lessons Learnt So Far , Priti S Mehta
COVID 19 has affected Cancer afflicted children in multiple ways. Postponement of chemotherapy, shortage of beds, delayed elective surgeries, radiotherapy, contracting Covid infection due to Immunosuppressed state, shortage of blood and blood products are few of them. However, it has also taught us certain lessons as to continue chemotherapy in cancers which affect the long term prognosis. The concept of chronic viral shedders, non-requirement of repeat RT-PCR testing, avoiding use of colony stimulating factors during active infection are some of the lessons learnt so far. The fact that children per se and that includes children with cancer too are not affected seriously till date in this pandemic brings some solace to the treating physicians.
32 Lung Cancer , Andrew Hague
The ease with which cancer is stopped by CellSonic surprises oncologists and delights patients. Cancer is an electrical fault. The behaviour of the cells is corrected by changing the voltage to that of healthy cells, a process called electroporation. There is no surgery and no drugs. This is biophysics, not biochemistry. There are no side effects and the replication of mutating cancer cells is stopped immediately. Then starts the healing of the damage caused by can-cer and the usual problems in patients unfortunate to have been treated with chemotherapy and radiation.
33 Abdominal Adiposity as a Risk Factor for Colorectal Cancer , He Liu
Colorectal cancer is the third most commonly diagnosed cancer type with a rising trend worldwide. In recent years, it has become more evident colorectal cancer is associated with obesity, which is also a global health issue. According to the 2020 update by the World Health Organization, worldwide obesity has nearly tripled in the last 45 years. Over one-third of the adults were overweight, and 13% were obese
34 Assessment of Knowledge and Application of CBCT Among Dental Professionals – A Questionnaire Study , Reshma Ramachandran and Sushmini Hegde
Background: CBCT is an imaging technique which uses a cone shaped radiation that is focused on a 2D detector. It has been widely accepted in practice in radiology as well as academic and hospital settings. The present study is aimed to assess the knowledge and application on CBCT among dental professionals.Materials and Methods:A validated questionnaire was distributed among 250 dental professionals.Results: Most of the respondents were unsure about the radiation exposure of CBCT when compared to other types of imaging and all of them were willing for a CBCT hands on.
35 Radiotherapy - A Focused Ray of Hope   , Aklanta Kumar Gogoi, Shivu ME, Ravi Varma M, Swati Pichika and Karthik D Yadav
Oral carcinoma has occupied the sixth position with the 5 year survival rate at 50% or even less. Over the years various other diagnostic methods have been added for the process of diagnosis, however they are just adjunctive to the screening methods. Right treatment at the right time remains as a very important aspect even today and is considered to play a vital role in achieving a good prognosis. Treatment includes surgery, chemotherapy, radiotherapy and many more. However, the role of each of the treatment is to eradicate oral carcinoma but has its own side effects. Radiotherapy can be used as a single modality as well as an adjuvant to the surgical management after surgery. However, the side effects is a matter of concern in radiotherapy.
36 Radiomics in Oncology , Houman Sotoudeh
Radiology is the backbone of cancer diagnosis and manage-ment. Traditionally the radiologic diagnosis is made by human and visual evaluation of the images, but this approach has some limita-tions. Usually, the human radiologist uses a few features (e.g. the size of lesion, density, sharpness of the lesion, and the enhance-ment after contrast injection). However, the medical images con-tain much more information that is not visible by the naked hu-man eyes. In this context, Radiomics has great momentum in the oncologic imaging field.
37 Leiomyosarcoma of Inferior Vena Cava Arising from the Confluence of Right Adrenal Vein Masquerading as a Suprarenal Mass - A Case Report , Rakesh Manilal Sharma; Sandeep Maheswara Reddy Kallam; B Vishal Rao and Ashwin Giridhar
Leiomyosarcoma (LMS) is a malignant mesenchymal tumour, which originates from the smooth muscle cells. Leiomyosarcoma of vascular origin most commonly originates from inferior vena cava (IVC). Around 400 cases of IVC leiomyosarcoma were reported in literature till date. Here we report a case of a 58-year-old male diagnosed to have right large palpable supra renal mass. Contrast enhanced computed tomography (CECT) of abdomen and pelvis revealed a well-defined soft tissue mass measuring around 10 cms with heterogeneous post contrast enhancement at right suprarenal region with a clinical differential diagnosis of adreno cortical carcinoma and retroperitoneal leiomyosarcoma was made. Intra-operatively right adrenal gland was normal, and the mass was seen arising from the side wall of IVC at the confluence of right adrenal vein. Complete excision of mass done, followed by repair of IVC rent. Histopathological examination showed leiomyosarcoma. Adrenal gland was normal, margins were free of tumour and immu-nohistochemistry (IHC) was positive for caldesmon and smooth muscle actin (SMA). Patient was on follow up for the past 1 year without local recurrence or distant metastasis.
38 Comparing the Effectiveness of Different Scoring System in “See and Treat Approach” for Cervical Precancerous Case Management , Priya Ganesh Kumar and Akshay Ganesh Kumar
Indian healthcare is largely in the private domain which is not covered under any reimbursement program. Patients below the poverty line (BPL patients) show higher prevalence of sexually transmittable infections, of which HPV is one of the major contributor. “See and Treat” approach is largely favoured for treating the high grade cervical or lower genital abnormalities suspected to proceed to invasive disease in the foreseeable future. Colposcopy procedure is both diagnostic as well as curative for high grade cervical precancer and thus occupies an undisputed centre stage of cervical cancer prevention and control program in the clinical set up. A Reid Colposcopy Index (RCI) for grading the lesion severity determines colour change due to acetic acid, Margin Vascular pattern of the lesion along with change in colour with Lugol’s iodine and converts the subjective threshold for diagnosis and hence treatment intervention into a semiobjective one. The swede score has added the parameter of size of the lesion as well. The colposcopy grade scoring system therefore guides prediction of histologic diagnosis of the disease as well as determines which of these high grade lesions warrant immediate treatment by simple procedures like cryotherapy, thermocoagulation, leep therapy. “See and Treat” ap-proach is particularly also beneficial in the rural population settings where a trained clinical or pathological expertise may not be immediately available and skilled health workers may be trained to detect and eliminate the precursor disease. In our study, out of 650 cases who underwent colposcopy for varied reasons, 84 cases were detected to have lesions (12.9%). These lesions were scored according to RCI and Swede scoring systems. The lesions were biopsied for prospective histopathological findings. The clinical sensi-tivity, specificity, PPV, NPV, concordance and discordance between the two scoring systems were determined with histopathological diagnoses of high grade disease. In Reid’s scoring system, RCI score of ≥4 is taken as qualifying for HSIL detection and thus warrants treatment. In Swede scoring, a score of ≥ 5 is considered positive, warranting treatment. As per standard guidelines and protocol, CIN 1cases are usually kept under surveillance whereas CIN 2 and CIN 3 cases are taken up for treatment. In our practice, all case of CIN 1 were recalled for follow up, RCI scored well in terms of all the above parameters. RCI scored better as compared to Swede in terms of comparing overtreatment –RCI 24 % as compared to 42 % in swede. In our data of 84 samples the correlation between the scoring system of Swede and RCI was 0.65. However, the REID scoring had high concordance with histopathology compared to Swede sys-tem (R = 0.71 between REID and HP and R = 0.65 between Swede and HP). RCI is a better scoring system to avoid unnecessary over treatment as compared with Swede system in “See and treat” programs adopted in rural areas and camp set up. As per our study, our recommendation will be to safely use Swede score cut-off at ≥5, in the case of Reid score a cut-off of at ≥4 in “See and Treat” program.
39 Fine Needle Aspiration Cytology Findings of Breast Lesions in Female Patients Presenting with Palpable Breast Lumps at Makerere University College of Health Sciences, Kampala-Uganda , Kinalwa Sulaiman; Abila Derrick Bary and Mwesigwa Boaz
Background: Palpable breast lumps are a common manifestation encountered by physicians during clinical practice. The use of fine-needle aspiration cytology (FNAC) method has proven to be quick, simple and cost-effective in the evaluation of these lumps for benign, atypical and malignant changes. This study aims to determine the type of breast lesions diagnosed by FNAC and to determine the age-wise distribution for such lesions.Methodology: A prospective study consisting of 291 females presenting with palpable breast lesions was carried out at Makerere College of Health Sciences (MakCHS) pathology laboratory from January 2019 to May 2019. FNAC results were grouped into tier five reporting categories as C1, C2, C3, C4 and C5 in accordance to the International Academy of Cytology (IAC).Results: Out of the 291 cases examined, 14 (4.8%) were insufficient (C1), 192 (66%) were benign (C2), 9 (3.0%) were atypical (C3), 15 (5.2%) were suspicious of malignancy (C4) and 61 (21%) were malignant (C5). In the benign category, lesions of fibroadenoma were the most commonly diagnosed constituting 110/192 (57.3%) whereas under the malignant category lesions of invasive ductal carcinoma were the most commonly diagnosed constituting 27/61 (44.3%). The peak age group for benign lesions was 21 - 30 years whereas the peak age group for malignant lesions was 41 - 50 years.Conclusion: Fine-needle aspiration cytology (FNAC) was found to be an effective diagnostic tool in the categorization of palpable breast lumps into benign, malignant, atypical, suspicious and inadequate categories.
40 Clinical Conundrums in Ovarian Cancer – A Genetic and Molecular Based Approach – Importance of Personalized Standard-of-care Therapy , PK Prem Ravi Varma
Epithelial ovarian cancer is the most lethal gynecological malignancy. It can be divided into five main histological subtypes: high grade serous, endometrioid, clear cell, mucinous and low grade serous. These histological subtypes are distinct disease entities at the clinical and molecular level. There is significant genetic heterogeneity in ovarian cancer, particularly within the high grade serous subtype. This subtype of ovarian cancer has been the focus of much research effort to date, revealing molecular subgroups at both the genomic and transcriptomic level that have clinical implications. Therefore stratifying ovarian cancer patients based on the un-derlying biology remains in its infancy. This article summarizes the molecular changes that characterize the five main ovarian cancer subtypes and highlight potential opportunities for targeted therapeutic intervention and outline priorities for future research.
41 Glioblastoma Multiforme , Jardson Peixinho
Neoplasia is the proliferation of cells of a given tissue, which are out of the control of the organism and tend to autonomy, causing serious damage to its host.Tumors can be classified as: benign and malignant. Benign tumor cells grow more slowly while malignant tumor cells grow faster and disorderly.In the case of brain tumors, we can classify them according to their aggressiveness, where the degree can vary from I to IV, and the higher the degree, the greater the aggressiveness of the tumor.Gliomas is the term used to designate tumors (neoplasms) originating from brain glial cells. Glioblastoma Multiforme (GBM) fits in Grade IV tumors, originates in glial cells, has no defined form, and is highly lethal and in cases of removal there is recurrence. Imaging methods are used to locate the lesion extremely useful to determine the extent of the disease.
42 A Tale of Two Leukemias , Sajjad A Bhatti and Abdulraheem Yacoub
Chronic lymphocytic leukemia (CLL) is the most common adult leukemia [1], characterized by the accumulation of mature but functionally incompetent CD5+ monoclonal B cells. Chronic myelogenous leukemia (CML) is a myeloproliferative neoplasm charac-terized by a reciprocal translocation between chromosomes 9 and 22, leading to BCR-ABL1 fusion gene with constitutive tyrosine kinase activity resulting in dysregulated and uncontrolled proliferation of granulocytes.
43 The Best of the Genitourinary Cancers Symposium 2021 in Kidney Cancer , Melisa Hunis and Adrian P Hunis
The congress of the American Society of Oncology on genito-urinary tumors, held virtually between February 11 and 13, 2021, is one of the largest congresses on genitourinary neoplasms. Next, we will review the works that have attracted the most attention in kidney cancer.
44 Awareness of Basics of Radiation, Dose Levels of Imaging Procedures and Radiation Safety among the Nurses in an Academic Hospital in Himachal Pradesh, India: Results of a Cross Sectional Study , Nitin Gupta, Munider Negi, Sumit Kumar, Vandana Khushawa, Vishal Kaundal, Shilpa Sood and Shalini Verma
Objective: To illustrate our institutional experience about the awareness of basics of radiation, dose levels of imaging procedures and radiation safety among the nurses in Himachal Pradesh.Methods: Data was obtained from a multiple question based survey conducted in a group of nurses from the various departments between May 20, 2020 and June 01, 2020. The survey was designed to assess the knowledge and awareness of basic radiation types and effects, dose exposure levels and radiation protection among the participants. Questionnaires were distributed both physically where ever feasible and online using google form. Participation to the survey was voluntary and completely anonymous.Results: Regarding the question of type of radiation that is harmful for living beings, 93.4% of the participants correctly responded that ionizing radiation is harmful, 3.6% said non ionizing radiation is harmful while 3% were not sure about it. Overall, 41.6% of the respondents were aware that of radiation is helpful in diagnosing diseases, treating cancer and can cause cancer. Only 30% of the respondents felt the need to confirm LMP or pregnancy status of a woman of child bearing age before subjecting her to an abdominal/pelvic CT or a nuclear medicine procedure, where as a small but significant 6.8% responded that the radiation dose received from these modalities is very low and of no concern where as 3.6% respondents reported that they were not sure of what should be done. Only 34.6% of the participants were able to tell that children are mostly affected with radiation. Overall 88.97% of the respondents found that it is very important to have knowledge of the radiation dose of common radiological investigations and procedures. Only 48.5% of the participants were aware of nuclear medicie department, others were not aware of it.Overall 66.9% of the participants thought that their knowledge needed improvement and that they would prefer a workshop to update themselves where as 22% par-ticipants though class room lectures would be appropriate to enhance their radiation dose levels and safety related awareness. Only 32 % of the participants were aware that radiation is used to diagnosing, treating and can cause cancer. Only 18 % of the participants were able to tell DEXA Scan, Kidney Scan tests, Thyroid Scan and Bone Scan come under Nuclear Medicine department. Only 10% of the participants were able to say that the modalities which uses ionising radiation are X-Rays, CT scan, PET Scan, Throid scan. The radiation exposure from background radiation was correctly estimated by 45.9%.Conclusion: The results of our study show that the knowledge of nurses in our institute is significantly worse due to lack of their formal training. And there is need to create awareness among the nurses starting from their clinical training period. Future studies should investigate knowledge of radiation protection and performance of radiation protection behavior in nurses, such as those working in the general ward or specialized departments, and educational needs should also be studied to develop customized radia-tion protection education programs.
45 Telomeropathies - A Genetic Conglomerate , Gurpreet Kaur, Priyanka mishra, Preeti Tripathi, Seema Tyagi, Haraprasad Pati and Manoranjan Manapara
Telomeres are repeated TTAGGG hexanucleotides and proteins associated with them. Telomeres function to form a stable end of the chromosome and protect it from being recognized as a DNA fragment that needs repair. Telomeropathies or ‘telomere biol-ogy disorders’ are rare and heterogenous diseases that are caused by mutations in the maintenance of telomerase or the damage response system (DDR). Telomeropathies or telomere biology disorders (TBDs) may be classified as primary and secondary. Primary telomeropathies are due to defects in the telomere maintenance machinery whereas secondary telomeropathies are caused by fail-ures in the DDR.Dyskeratosis congenita (DKC) which is an inherited bone marrow failure syndrome is the classical example of the telomeropathy syndromes. Progressive telomere loss or attrition is associated with and is likely to be an etiology of malignant transformation. Over 85% of malignant tumors show positivity for telomerase, in contrast most normal tissues are telomerase-negative, and owing to this telomerase enzyme has become an excellent target in research for newer therapies that inhibit telomerase and shorten telomeres in malignant cells. In aplastic anemia, patients with the shortest telomeres are four- to five times more likely to have clonal evolution of disease and undergo progression to myelodysplastic syndrome and leukemia. The telomeropathies hence resemble a spectrum of disorders rather than being distinct diseases.Diagnosis of a telomeropathies needs awareness with regards to the clinical features the laboratory results and the molecular testing. Due to the rarity of telomeropathies and a low degree of suspicion the diagnosis may often be missed. For some telomer-opathies early diagnosis will translate into overall survival benefits and improved quality of life. In this review, we give an overview of the pathophysiology, signs and symptoms of the disorders caused by defects in telomere biology and touch upon the detection of telomeropathies in the laboratory.
46 Disturbed Steroid Hormonal Milieu is a Potential Cause of Cancer , P D Gupta
Environment and diet regulate menstrual cycle in human fe-males. The length of the period between menarche (activation of ovarian hormones) and menopause (inactivation of ovarian hor-mones) depends on 4 hormones, estrogens, progesterone, follicu-lar stimulating hormone and luteinizing hormone [1]. In our epi-demiological survey we found now menarcheal age is decreasing.
47 Breast Cancer Management during the COVID-19 Pandemic: A Review of the Dynamic and Evolving Guidelines and Some Personal Thoughts , Rayan Daoud, Rebecca Badawi, Romy Younan and Georges El Hachem
Nearly, every country around the world is being challenged in every direction by the lethal infectious disease known as COVID-19. The COVID-19 viral pandemic accountable for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease has drasti-cally influenced our work worldwide in the management of patients in terms of diagnosis and surgical treatment of cancer - including breast cancer. In fact, oncology practice has been transformed in response to this crisis. Today, more than ever, oncologists are post-poning chemotherapies, delaying curative surgeries and switching intravenous to oral therapies. This is due to the fact that cancer patients are at a significantly higher risk of getting infected with COVID-19 since their immune system can be compromised. The reality has to do with both that they have cancer and that they are on therapy for their cancer. As medical oncologists, it is our duty to make sure that these cancer patients are treated appropriately with a minimal exposure risk to this crushing virus. Herein, we are presenting a review that introduces the evolving guidelines for management of breast cancer patients in view of this pandemic, along with various methods of risk classifications. We also sought to include a personal analysis and hypothesis for the best optimal oral treatment in a particular bundle of breast cancer patients.
48 Distal Subtotal Gastrectomy for Middle-third Gastric Carcinoma in Selected Patients: Short-term and Long-term Outcomes , Ramiz B Bayramov, Ramila T Abdullayeva and Simara E Huseynova
Objective:Here we describe cases of carcinoma of the middle-third of the stomach for that > 80% distal subtotal gastrectomy was carried out providing adequate proximal resection margin and jejunum was anatomized to the lesser curvature side of the stomach at the level of the esophagogastric junction just below the cardiac sphincter. Material and Methods: From January 2014 till December 2020 54 patients with middle-third gastric carcinoma underwent radi-cal intent surgery. In all of the patients excluding 5 (3 men, 2 women, mean age 62 year) was carried out total gastrectomy (with Roux-en-Y reconstruction) plus D2 lymph node dissection. In the mentioned 5 patients > 80% distal subtotal gastrectomy plus D2 lymph node dissection was carried out providing adequate proximal resection margin. In the reconstruction step of the surgery the greater curvature was invaginated with purse string suture according to the traditional technique and the gastrojejunoanas-tomosis was created to the lesser curvature side of the stomach at the level of the esophagogastric junction just below the cardiac sphincter as mentioned above. The gastrointestinal continuity was reconstructed as an omega loop and in 4 patients, as a Roux-en-Y reconstruction in one. Results: No postoperative complications developed. Oral nutrition started on the 3rd or 4th postoperative days and intravenous infu-sion discontinued on 5th or 6th days. One patient died of multiple liver metastases after 18 months following surgery without any signs of locoregional recurrence. During 3 - 62 months’ control period no patient has complained of the signs of gastroesophageal reflux or dysphagia. 4 patients are alive for 3 - 62 months (mean 38 months) following surgery. Conclusion: In some patients with middle-third gastric carcinoma, who refuse deprivation of the stomach totally or have higher postoperative risk for total gastrectomy, > 80% distal subtotal gastrectomy can be carried out if tumor-free proximal resection mar-gin can be provided.
49 Small Things, Big Responses , Abhimanyu Mohanta
mall is beautiful'' is a popular proverb. But, small is power-ful and has big responses which can be well apprehended in con-nection with role of microRNA (miRNA or miRs) in cancer biology. MicroRNAs are small, endogenous, non-coding RNAs with 19-24 nucleotides in length regulating post-transcriptional gene expres-sion [1]. Normally, these control many biological processes includ-ing growth, development, cellular metabolism and body immunity during patho-physiological conditions. Under abnormal condition, miRNAs express aberrantly and may act as oncogenes, tumor suppressors, or metastasis regulators. Multiple factors including malfunctioning of the miRNA processing machinery, mutation of oncogene due to positional effects, and epigenetic mechanisms contribute a lot to the complex miRNA-mediated gene network misregulation followed by tumorigenesis and metastasis
50 Reversing Prostate Problem in Natural Ways, Naval Kumar Verma
It’s one of the most important organs for male sexual and urological wellbeing. Although it’s a small walnut like structure beneath bladder, but its role is much bigger than its size. The prostate normally gets bigger with age. After middle age, changing hormone levels can cause the prostate to increase five times or more in size, but now a days due to modern lifestyle, major part of male popula-tion is suffering from prostate problems. These prostate problems not only disturb the functional life of a person but also create an imbalance in the personal life too. Anatomically, prostate gland is comprised of zones and lobes. Main function of prostate gland is in sexual sphere, where it pro-duces PSA which is an essential protein that helps to keep the semen in its liquid state. This PSA, when gets increased, can lead to cancer or any prostate problem
51 The Importance of Cardio-oncology , Manuel Bazan Milián
Cardio-oncology is an emerging field of today medicine. This term may be familiar to some people but it is unknown for many others. There has been a rapid increase of cardio-oncological clin-ics worldwide. Although it is not accompanied by comprehensive scientific data that established guidelines of cardiotoxicity han-dling.
52 Comparison of Hyperfractionated Radiotherapy with Concomitant Chemotherapy and Conventional Chemoradiotherapy in Locally Advanced Head and Neck Cancer Treated with Volumetric Modulated Arc Technique (VMAT) , Chatakonda S Snehit, Bhaskar Vishwanathan, Geeta S Narayanan, Shashidhar V Kapurmath, Vandana S Kushwaha, Sowmya S Narayanan and Ramya Venugopal
Background: Concomitant Chemoradiotherapy (CRT) is standard approach for treating locally advanced head and neck squamous cell carcinoma (HNSCC). Altered fractionation such as hyperfractionated radiotherapy (HF) has also shown similar survival benefits as compared to conventional CRT. To determine whether addition of concomitant chemotherapy to hyperfractionated radiotherapy further improves outcome in HNSCC patients treated with modern volumetric arc modulated radiotherapy (VMAT). Methods: From January 2018 to March 2019, thirty four patients with stage III-IV HNSCC (excluding oral cavity, nasopharynx and paranasal sinus) were randomly assigned to hyperfractionated HFCRT (VMAT) with concomitant chemotherapy arm with radiation dose 81.6Gy/68 fractions,1.2Gy/fraction, twice daily, 5days/week or Conventional CRT (VMAT) arm with radiation dose 70GY/35 fractions, 2Gy/fraction, once daily, 5days/week, seventeen patients in each arm. Concurrent cisplatin 40mg/m2/week was given in both arm from first week. Overall survival (OS), Disease free survival (DFS) and toxicities were assessed.Results: The cisplatin full dose was received by 94.1% and 82.4% patients in HFCRT (VMAT) and CRT (VMAT) arm respectively. High grade (3-4) acute skin and mucosal were higher in HFCRT (VMAT) arm (47.1%) in comparison to CRT (VMAT) arm (17.6%) with no statistical significance (p = 0.067). Late toxicity was similar in both arms. The OS was better in HFCRT (VMAT) arm with median overall survival-17 months as compared to CRT (VMAT) arm with median overall survival -12 months, however, difference did not reach significance (log-rank test, p = 0.341), with similar trend in DFS.Conclusion: Hyperfractionated HFCRT (VMAT) with concomitant chemotherapy showed an encouraging trend for OS and DFS with acceptable toxicity profile. A larger study with longer follow up needed to elucidate possible superiority of HFCRT over CRT.
53 Molecules and Clonality in Cancer , Daniel Gandia
ancer is without doubt, one of the most important Internal Medicine diseases.The advances in the clinical setting treatment of this disease are huge, with the advantage, that many Basic Science disciplines, such as Molecular Biology, Biochemistry and Pharmacology positively impact in the understanding of this process.We discover permanently new basic Cancer cell issues, such as modifications of normal biochemical pathways that the cell uses for its metabolism and growth, but when Cancer is present, the al-terations are many and may not be all countable yet.
54 Holistic Homeopathic Approach to Cure Patients with Cancer; Case Series , Seyedaghanoor Sadeghi
Disregarding the various factors leading to cancer, the statistics has increased awfully during the last decade globally. Case No. 1: Mrs. Z.A. aged 21 was seen in the Autumn of 2010. Four months after getting married, she developed a huge mass on the left side of her neck. Pathologic examination of her biopsied mass turned out to be Hodgkin lymphoma. The well-known homeopathic rem-edy called Phosphorus was selected for her. Mrs. Z.A. was followed 4 times during one year after being 1st seen. No recurrence was reported, neither observed in the patient, meaning a complete cure occurred by homeopathic method of healing. Case No. 2: Mrs. T.M., A lady aged 44 was seen by the author in 2009. Fourth stage invasive ductal carcinoma was diagnosed based on the pathologi-cal biopsies. An integrative approach was planned and considered by the author. Mrs. T.M. was not used to including vegetables and fruits in her family’s daily food plate. Therefore, the author suggested the patient to consider healthy veggies and fruits. She started feeling better. She could not even walk and would lie on the back all the time so a physiotherapist was asked to see the patient. He guided her how to do simple physical exercises to strengthen her musculature. Then she felt better and was referred to an oncologist to go under chemotherapy. She was seen by a radiotherapist for radiotherapy. This took 4 years. The next 4 years Mrs. T.M. selected homeopathy to be done by the author. Homeopathy improved her nightly pains, increased her hope and energy by prescribing safe homeopathic remedies like Carcinosinum. Thus, she lived for 96 months. Case 3: A lady aged 72 suffering from Multiple Myeloma, underwent paramount homeopathic healing process for her renal failure, by decreasing her serum creatinine from 13.7 to 2 mg/dl. Thus, considering the remarkable homeopathic healing in the 3 patients, double-blind and meta-analysis clinical trials are suggested to evaluate this healing method to consider it for millions of cancerous conditions.Keywords: Carcinosinum; Cancer; Radiotherapy
55 In-Vivo Photodynamic Therapy Studies in Cancer , Süleyman Kaleli, Muhammad Alif Mazlan and Muhammad Lokman MD ISA
The traditional surgical method for cancer treatment has not been successful in removing primary or metastatic tumors. Che-motherapy and radiation therapy methods, as well as cancer cells and healthy cells affect the process of treatment nausea, hair loss, immune system weakness, such as there are many side effects. Photodynamic therapy (PDT) is a regulator for the treatment of many malignant carcinomas that can cause immunogenic apoptosis. Despite these adversities in surgery, chemotherapy and radiation therapy, significant progress has been made in PDT research recently. This review article is aimed to present recent studies.
56 HDAC11 Enzyme: Multifaceted Roles and New Avenues in Cancer Therapy , Vasundhara Sharma
Histone deacetylases (HDACs) are enzymatically super-active in various malignancies, deacetylating lysine (K) moieties of amino acids, and altering the functional properties of a plethora of his-tone and non-histone proteins. Histone deacetylase 11 (HDAC11), a novel class IV HDAC, is a newly discovered HDAC, regulating mul-tiple physiological programs in a wide variety of normal tissues and cancer cells. Enzymatically, it is a modest deacetylase as well as a deacylase of target proteins.
57 Тumor Microenvironment and Obesity , L Bubnovskaya*, I Ganusevich and D Osinsky
The worldwide obesity epidemic is a growing public health problem. Obesity is associated with the development of many dis-orders such as insulin resistance, cardiovascular disease, diabetes, depression. Epidemiologic, clinical, and preclinical data suggest that various common types of cancer are affected by obesity and it was revealed a link between obesity and the more aggressive character of malignancy. Obesity is decided as an independent prognostic factor of recurrence and survival.
58 Clinical Implications in Understanding Prostate Cancer Biology: From Androgen Receptor to Molecular Target Therapy in Metastatic Castration Resistant Prostate Cancer , Eliza Dalsasso Ricardo*, Angel AT Uchiyama, Denis S Shimba and Ariel G Khan
Prostate cancer is one of the most common malignancies in the world. For a long time, the cornerstone of treatment for advanced disease has been the manipulation of hormonal pathway of testosterone since is well stablished that androgen receptor regulates prostate growth, differentiation and apoptosis in regular and cancer cells. However, during the treatment of metastatic disease with androgen deprivation therapy resistance mechanisms appear, which led to the development of new treatments, such as second-generation anti-androgens-like (such as enzalutamide, apalutamide and darolutamide), and abiraterone acetate. In addition to the development of this new antiandrogens the deeper knowledge about DNA damage repair and their pathways such as direct reversal, mismatch repair, base excision repair, homologous recombination and the non-homologous end joining, resulted in new opportuni-ties of treatment. Recently, PARP inhibitors have showed their efficacy in the treatment of advanced prostate cancer. Therefore, the aim of this article is to review the current knowledge about cancer prostate biology and its clinical implications.
59 The Assembled Ossein-Osteoid Osteoma , Anubha Bajaj
Osteoid osteoma is a miniature, benign, bone -forming tumefac-tion which manifests a nidus of vascular osteoid circumscribed by sclerotic bone and constitutes an estimated 10% of benign bone tumours. Osteoid osteoma was initially scripted by Jaffe in 1935
60 Does the Type of Surgery After Preoperative Systemic Therapy for T3/T4 Breast Cancer Impact Survival? , Jamila Alazhri1, Tulay Koru-Sengul2, Feng Miao, Margaret M Byrne and Eli Avisar
Introduction: Our purpose was to study the impact of the extent of surgery on survival of women with T3/T4 breast cancer treated with preoperative systemic therapy (PST) in form of chemotherapy, hormonal therapy, or both. Methods: Population-based Florida Cancer Data Registry was screened for women diagnosed with T3/T4 breast cancer who received PST followed by either breast conserving surgery (BCS) or mastectomy. A multivariable Cox regression model was used to identify significant predictors of overall survival. Adjusted hazard ratio (aHR) and 95% confidence interval (95%CI) were calculated.Results: Out of 712 patients receiving PST, 72 (10%) had BCS and 640 (90%) had mastectomy. After covariable adjustment, patients who received both chemo and hormonal PST had better prognosis than patients with chemotherapy alone (aHR=1.90, 95%CI: 1.20 - 3.01, p = 0.006) or hormonal therapy alone (1.95, 0.84 - 4.56, p = 0.122). Hispanic origin (0.50, 0.27 - 0.92, p = 0.027) positively impacted survival. Medicare (1.70, 1.08 - 2.68, p = 0.021) and uninsured (1.69, 1.10 - 2.60, p = 0.016) compared to private insurance, poorly-differentiated/undifferentiated (2.24, 1.04 - 4.82, p = 0.039) compared to well-differentiated grade, and distant SEER stage (4.13, 1.68 - 10.12, p = 0.002) compared to localized were significant predictors of worse survival. There was no significant difference in survival between women who had mastectomy compared to BCS (1.35, 0.82 - 2.21, p = 0.234). In the subgroup of patients who had mastectomy, radiotherapy resulted in significantly better survival than no radiotherapy (HR 0.68, 0.47-0.99, p = 0.044).Conclusion: The type of surgery after PST for T3/T4 breast cancer does not impact overall survival. BCS could be considered for patients with T3/T4 tumors after PST.
61 Determinants of Multidrug Resistance Tuberculosis: A Systematic Review and Meta-analysis , Kaleab Tesfaye Tegegne*, Andualem Zenebe, Abiyu Ayalew Asse-fa, Mekibib Kassa Tessema, Eleni Tesfaye Tegegne, Alelign Tadele Abebe4, Berhanu Bifato and Muse Rike
Objective: The aim of this systemic review and meta-analysis was to determine demographic, behavioral and clinical risk factors for multiple drug-resistant. 19 studies were included in the systemic review and meta-analysis. Keywords: Multidrug Resistance Tuberculosis; Alcohol; Smoking; Diabetes Mellitus; Gender; Educational Status Materials and Methods: Search engines: PubMed/Medline, Web of Science, Scopus and Google scholar were used to search related literatures on MDR TB and selected determinates of MDRTB. All data were independently extracted. We used a random-effects model according to the DerSimonian and Laird method. Results: The risk of having MDR-TB in patients who have informal education was 0.67 times lower than that of patients who have formal education (RR = 0.67; 95% CI, 0.46 to 0.96). The risk of having MDR-TB in patients who have Diabetes Mellitus was 1.33 times higher than that of patients who have no Diabetes Mellitus (RR of 1.33 and 95% CI, 1.01 to 1.77).Conclusion: This systemic review and meta-analysis indicated that the risk of having MDR-TB in patients who have informal education was 0.67 times lower than that of patients who have formal education and the risk of having MDR-TB in patients who have Diabetes Mellitus was 1.33 times higher than that of patients who have no Diabetes Mellitus. Our review did not showed the presence of association between MDR TB and other selected variables gender, smoking and alcohol. We recommend interested researchers on MDR TB to do further research on patient’s educational level as a risk factor for MDR-TB in order to explain the variation in MDR TB among patients with formal education and patients with informal education.
62 COVID 19 in Cancer Afflicted Children - Impact and Lessons Learnt So Far , Priti S Mehta
COVID 19 has affected Cancer afflicted children in multiple ways. Postponement of chemotherapy, shortage of beds, delayed elective surgeries, radiotherapy, contracting Covid infection due to Immunosuppressed state, shortage of blood and blood products are few of them. However, it has also taught us certain lessons as to continue chemotherapy in cancers which affect the long term prognosis. The concept of chronic viral shedders, non-requirement of repeat RT-PCR testing, avoiding use of colony stimulating factors during active infection are some of the lessons learnt so far. The fact that children per se and that includes children with cancer too are not affected seriously till date in this pandemic brings some solace to the treating physicians.
63 Gold Nanoparticles in Cancer Therapy , Saeid Moghassemi
Gold nanoparticles are at the vanguard of nanoparticles nowa-days due to their outstanding chemical and physical properties, which can be used in a variety of scientific areas.
64 Radiation Therapy for Prostate Cancer Not Operated , Nkoua Epala B*, Vestris P, Bougas S and Vinh-Hung V
Prostate cancer is the most common male cancer in Martinique. Radiation therapy plays a key role in the management of pros-tate cancer at the localized stage, in particular the intermediate and high-risk risks according to D’Amico’s classification, but also at the locally advanced stage. The patients selected in this study all benefited from conformal radiotherapy with Volumetric Intensity Modulation by Arc Therapy in the acronym VMAT. It seemed appropriate to report our findings on the treatment of prostate cancer by VMAT at the Clarac Hospital of the University Hospital Center (CHU) in Martinique
65 A Successful Ovarian Cancer Case ,  Andrew Hague
A lady discovered she had ovarian cancer in 2016 and was treated by CellSonic. The tumour remained big and had to be surgically removed after the cancer was stopped. Since then, cancer diagnostics have progressed and the electrical properties can now be easily detected allowing CellSonic to advance from stopping cancer in a patient to stopping cancer in a population.The patient is well and has approved this article.
66 Networking Between Cell Biology, Genetics and Personalized Management: Focusing on Circulating Tumor Cells and D1853N Polymorphism , Parvin Mehdiour
Cells act as the bridges within the tissues’ territory, capable for initiating the cascade of events.Cancer is the platform of puzzles to be unmasked. There is available knowledge in cancer, but is required to be revised. However, restoration is a verbalizing item in cancer research.This commentary is aimed to highlight: 1) The protagonist and influence of “Cell Biology” and “Genetics” in the personalized cancer management, and 2) to provide the key and basic information for the clinicians who are interested in’ linking the insights’ in brief.In spite of the remarkable efforts by clinicians in cancer medicine, so far, the lack of comprehensive strategy towards cancer progression is noticeable. Bridging between Cell Biology and Genetics has an influential impact on cancer management including early detection and personalized approach in prognosis, prevention, and therapy. So, lets apply the multi-disciplinary movements in cancer managements by considering the bridging system between Cell Biology/Genetics/personalized clinical managements.Conclusively, a triangle of Single Cell, Molecular, and Pedigree-based approaches would manage the personalized strategy in cancer managements. In this regard, the application of circulating tumor cells (CTCs) for an early detection and the key impact of D1853N polymorphism in ATM gene, as a predisposing factor, are provided at a glance
67 Current Situation and Future of High Intensity Focused Ultrasound Therapy for Oncology , Yadav Ajay Kumar, Yuan Gengbiao, Fan Yongzeng, Haitao Ran, Mork Chanrith, Jin Chengbing and Gnawali Suman
Day by day, High-intensity focused ultrasound (HIFU) therapy is becoming more familiar in oncology because it is non-invasive technique with fewer side effects and provides promising therapeutic results. Several HIFU therapy applications have approved by many approval authorities of several countries since last decade. In fact, now, HIFU is approved for the clinical treatment of uterine fibroid, bone pain palliation, ablation of the prostate carcinoma, pancreatic carcinoma, hepatocellular carcinoma (HCC), breast car-cinoma, renal cell carcinoma (RCC) treatment of essential tremor as a first neurological application etc. Besides of this, HIFU is also broadly using in face and neck cosmetic reconstruction from last few decades and proving promising results. It is a novel, emerging, therapeutic modality that uses ultrasound waves, propagated through tissue media, as carriers of energy. HIFU has great potential for tumor ablation and the main mechanisms of HIFU ablation involve mechanical and thermal effects. In our review, we are trying to include an overview of basic principle of HIFU therapy, it’s both types i.e., USG guided HIFU and MRI guided HIFU, their limitations and overview on future in oncology
68 Mathematical Models and their Application in Cancer Growth , Fuad Mugarab-Samedi, Sahbaz Heir and Saboor Ul-Bashar
Cancer is defined as a collection of related diseases. The common prevailing factor in all different forms of cancer is that the cancer cell begins to divide without any control and invades nearby tissues, spreading through the lymph system [1]. Although solutions are found for restraining further spread or eliminating diseased cells, most of the methods fail to predict the early signs of such an occur-rence. A useful catalyst utilized by specialists is using variant forms of differential equations, particularly ordinary differential equa-tions (ODE's). By using ordinary differential equations, such as the Malthusian model and the Gompertzian model, and state which method would be more efficient. Models such as the "Gompertzian growth curve" helps us visualize the growth rate of a cancerous cell. The Gompertzian model describes the cancer growth as a curve, which then has an almost exponential growth rate followed by a slower growth rate, which reaches a plateau as tumors grow larger [2]. Finally, we will use Matlab to code a graph that describes the mathematical growth models. In this paper, we will reveal how we can use ordinary differential equations to solve cancer growth spread, while also touching on some other models.
69 Impact of Blood Culture Utilization on Antibiotics Choice in Chemotherapy Induced Febrile Neutropenia in Solid Tumours , S Gilani, G Hegarty, J Whithurst and Z Rehman
Blood cultures are important tools for the evaluation of sepsis in febrile neutropenia (FN) patients. Febrile neutropenia remains a serious complication of anticancer systemic chemotherapy with increased mortality worldwide. NICE (National Institute of Clini-cal Excellence) UK issued clinical practice guideline to prevent and manage febrile neutropenia in cancer patients [1]. There was also a genuine concern about diagnostic dilemma and management of febrile neutropenia during recent pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) associated disease COVID-19 [2]. Healthcare resources were already limited and were overwhelmed rapidly by large influx of patients [3]. Routine medical care including management of cancer patient was severely disrupted [4]. This led to the developments of rapid guidelines to manage cancer patients across the world [5]. NICE and other bod-ies issued rapid guidelines to manage febrile neutropenia during COVID-19 period [6]. Majority of guidelines consider blood culture an essential part in assessment of sepsis in febrile neutropenia [1]. This prospective study was done in hospitalized patients who developed febrile neutropenia while on chemotherapy, looking at various factors and their impact on outcome. The objective of this study was to evaluate whether antibiotic choice is affected by blood culture utilization in febrile neutropenia [7].
70 High-grade Serous Umbilical Adenocarcinoma. About a Case , Massiel S Fernández B, Saúl Dorfman, Medardo Briceño V, Eladio Torres, María Elena Viloria de Alvarado and Iván Añez
Primary malignant umbilical tumors are very rare, representing 20%, within umbilical pathologies, and only 0.1% in general frequency. We present a case of a female patient with a history of Primary Umbilical Adenocarcinoma in 2017, untreated and for 2019 extensive umbilical tumor with incisional biopsy that reports: Serous Large Duct Adenocarcinoma. Immunohistochemistry: Adenocarcinoma derived from remnant of the omphalomesenteric duct or yolk duct. She receives preoperative chemotherapy and in May 2020, a Wide Resection is performed, plus reconstruction with Polypropylene mesh. As findings, a 20x20 cm lesion is evident, which involves all the layers of the skin, subcutaneous cell tissue up to the peritoneum, with the omentum involved in the surgical piece. Additionally, cavity-like liver MT lesions are evident. Biopsy reports High-grade Serous Primary Umbilical Adenocarcinoma.
71 Nanoparticle Delivery of siRNAs in Epithelial Ovarian Cancer Treatment , Hakmin Mun1* and Helen Townley1
Epithelial ovarian cancer (EOC) is the most fatal gynaecologi- cal cancer with a 5-year survival rate of only 46% [1]. Since most symptoms in the initial stage of EOC are uncertain and effective early detection techniques have not been developed, approxi- mately 75% of EOC cases are diagnosed at an advanced stage [2]. The fast-spreading metastatic cancer cells require urgent and ef- fective therapy, but the current treatments such as chemotherapy, radiation, and surgery are not efficacious enough to cure EOC com- pletely. Surgical debulking of ovarian tumours followed by pacli- taxel and platinum-based chemotherapy is considered as a stan- dard therapy, but this still results in recurrence in the majority of cases [3]. Oligonucleotide-based therapy employing RNA interfer- ence (RNAi) holds great promise as a therapy for metastatic EOC. During RNAi processes, microRNAs (miRNAs) or small interfering RNAs (siRNAs) can bind to messenger RNAs (mRNAs) with com- plementary sequences and then neutralize the binding mRNAs, leading to prevention of the gene expression. SiRNA molecules are double-stranded oligonucleotides with 20 to 25 base pairs in length, and upon cellular entry they split into single-stranded RNAs, which further guide a ribonucleoprotein, RNA-induced si- lencing complex (RISC), to degrade the complementary mRNAs. The efficient gene-silencing potential of siRNAs provides an option to treat many diseases which are caused by the unusual expression of single or multiple genes [4].
72 Diagnostic Implication of Bone Marrow Mesenchymal Stem Cells (BMSC) Exosomal MicroRNA-632 on Chronic Atrophic Gastritis , Zaibiao Wang1, Manman Yin2, Jiayun Shao3, Jie Peng1, Longhai Li2 and Liye MA4*
Evidence has indicated the significance of microRNAs (miRNAs) derived from Bone marrow mesenchymal stem cells (BMSC)exo- somes (BMSC-exo). We aimed to investigate the potential of miR-632 as a therapeutic target for diagnosis and treatment for chronic atrophic gastritis. We collected 96 serum samples from patients with chronic atrophic gastritis and the expression level of miR-632 was investigated in these samples by RT-qPCR. The relationship between the miRNA level and prognosis and patients’ characteristics was evaluated. The expression of miR-632 was significantly not associated with the sex, age, pathogenic site, and the size of serum BMSC-exo (p > 0.05), but miR-632 expression was related to the development of chronic atrophic gastritis and neoplastic progres- sion: gastric cancer of intestinal type group> chronic atrophic gastritis complicated with intraepithelial neoplasia group> chronic atrophic gastritis complicated with intestinal metaplasia group> chronic non-atrophic gastritis group (p < 0.05). Downregulated expression of miR-632 predicted greater survival (124.23 ± 12.43 months) compared to the higher miR-632 expression with survival time of 68.34 ± 10.90 months (p < 0.05). Expression level of miR-632 relates to the inflammation-mediated carcinogenesis and prog- nosis of chronic atrophic gastritis, which still further requires systematic investigation. Keywords: BMSC; Chronic Atrophic Gastritis; MicroRNA-632; Inflammation-mediated Carcinogenesis; Exosome
73 Cancer Therapy and Microfluidics , Saeid Moghassemi
Microfluidics is a novel field that involves manipulating fluids in channels with diameters of tens of micrometers, which has got- ten a lot of attention in the recent decade, and there are a lot of different channel designs. Microfluidics might have an impact on everything from chemical synthesis to biological analysis to optics and information technology. However, it is still in its infancy [1- 3]. Cancer is one of the most common causes of death across the world and microfluidics has a lot of potential in cancer detection, and it's also becoming a popular technique for learning about can- cer biology. Researchers and formulation scientists are becoming more interested in microfluidic techniques due to their capacity to effectively evaluate new drug primary, saving money, material, and time, and the ability to manufacture various system morphologies from nano to microscale [4,5].
74 Looking for New Strategies for Gynecological Cancer , Margarita S Alfie1 and Adrian P Hunis2*
In order to achieve better results in survival, new strategies try to cover that need not meet in gynecological cancers. At the ASCO Annual Meeting several works for ovarian cancer will be presented. The Surgical treatment without residual disease is associated with better survival and prognosis. Additional strategies to achieve complete response were evaluated in the abstracts session. Folate receptor α is overexpressed in a number of solid tu- mours, such as ovarian. Pafolacianine sodium is a fluorescent marker made of near- infrared dye and a ligand that allows it to bind to receptors over- expressed in ovarian cancer cells. When injected, the agent binds to folate receptors and will illuminate when used under near- infrared light. This mechanism of action allows for greater confi- dence that surgery resulted in a complete resection. Pafolacianine sodium injection is injected as a single-dose intravenous infusion prior to surgery.
75 Somatic Mutations and Cancer , Muhammad Saleem1, Munir Ahmed2, Aamir Ali Abro3 and Gang Chen1
Most of the mutations that accumulate in somatic cells throughout the life time of a person do not have any effects but some mutations can cause serious consequences like cancer (which after originating from a a single cell due to mutations in the genome starts to behave abnormally). There was a limited information of mutational processes and its consequences but recent advances in genome sequencing technologies due to unprecedented efforts has greatly revolutionized our understandings in this regard. In this review, I have briefly summarized about our current knowledge of the somatic mutations that that lead to cancer, its causes, possible ways which we are using for further studies and future premises. Keywords: Somatic Mutations; Cancer; Aging; Genome; Repair Mechanism; Driver Mutations; Passenger Mutations; DNA Sequencing Technology
76 A Review on Systemic and New Cancer Hallmarks , Akruti Amol Ingole1, Anjali Vijay Petle2, Surbhi Balwant Dhoke3, Piyush Jagdish Balgote4, Anirban Goutam Mukherjee5 and Uddesh Ramesh Wanjari3*
The body system is dependent on each other through communication, cancer development can be supported by the new cancer- induced pathological systemic networks (CISPN), and the entire organism is “cancerized.” The significant anomaly in the transition of epithelial cells to mesenchymal cells plays a vital role in neural crest migration. The metastatic program follows a transformed cellu- lar communication process that, activated once, causes dispersed tumors at a distance from the original site. This review aims to pro- vide an idea of various systemic and new hallmarks and several altered networking processes that eventually end up causing cancer. Keywords: Cancer; Hallmarks; Inflammation; Cytokines; Tumor
77 Oncology in Lebanon: From Shortage of Drugs to Shortage of Lives , Rebecca Badawi1, Lina El Murr2 and Georges El Hachem2*
Lebanon, a country nicknamed by “Switzerland of the East” in the 1950’s due to its financial power and stability at the time, is witnessing its worst economic crisis in decades. This oasis of pros- perity and diversification has collapsed into poverty and chaos with increasing social, financial and security challenges daily.
78 Escalation of Efficacy and Prevention of Chemoresistance in Various Cancer Therapies by the Utilization of Targeting the Crosstalk Amongst MAPK/ERK Along with Hippo/MST Signaling - A Comprehensive Review , Kulvinder Kochar Kaur1*, Gautam Allahbadia2 and Mandeep Singh3
Earlier having reviewed the treatment of ovarian cancer, endometrial carcinoma, gestational trophoblastic disease ( GTD), along with colorectal cancer, breast cancer etc, here we decided to comprehensively evaluate the crosstalk of various signaling pathway implicated in cancer therapy, in particular how the crosstalk amongst mitogen activated protein kinase (MAPK )/extracellular signal -regulated kinase (ERK1/2) signaling pathway with the Hippo/MST signaling pathway knowledge might impact on the generation of newer therapies by getting insight into the harms of physiology of phosphatidyl inositide 3-kinase (PI3K)/activator of protein kinase B (AKT/mammalian target of rapamycin (mTOR) pathway and combining therapies targeting Hippo/MST signaling pathway might avoid in the generation of chemoresistance. In particular the ERK represents a part of the MAPK signaling pathway that is amarkedly conserved pathway of signal transduction. This MAPK gets constituted by three separate kinases, like RAF/MEK as well as ERK. Im- pairment of the MAPK signaling takes place in a lot of pathophysiological conditions that are inclusive of neurodegenerative diseases, (NGD), Metabolic Syndrome (MetS) in addition to lot of cancers. Targeted hampering of the unique kinases belonging to the MAPK signaling pathway with the utilization of certain synthetic agents might work out to be of significant advantage for the treatment of cancer. Interaction of the MAPK signaling pathway with other proteins in addition to signaling pathways possess a key influence on the Clinical results of targeted treatments, besides possessing a significant part at the time of generation of drug resistance In can- cers. Here we have tried to detail the interaction of the MAPK signaling pathway with rest of the signaling pathways specifically its crosstalk with the Hippo/MST signaling pathway, besides detailing how it may prove advantageous on utilization of targeting of these particular pathways In combination in the generation of anticancer treatments that turn out to possess greater efficacy. Keywords: MAPK; ERK; Hippo; MST; PI3K; YAP; Cancer; Caspases; Natural Agents; Apoptosis
79 COVID-19 WAR, Pharmacotoxicologic Issues for Cancer Patients , Bahram Alamdary Badlou*
The cancerogenic processes are causing more death rates in- Hospitals than any other disease. The side effects of the cancer pa- tients’ routine treatment and the death triangle machinery were described previously (Badlou BA., et al. 2018-2021). Besides the COVID-19 variants’ death rates increased above 4.4 million, glob- ally (Augustus 2021). Either cancerogenous or the COVID-19 vari- ants’ killing mechanism are not elucidated completely.
80 Is the SARS-COV-2 Carcinogenic? , Sreelekha Ray*
SRS-CoV-2: Severe Acute Respiratory Syndrome Coronavirus 2; circRNA: Circular RNA; MERS-CoV: Middle East Respiratory Syn- drome Coronavirus; Pre-mRNA: Precursor Messenger RNA; miR- NA: MicroRNA; m6A: N6-methyladenosine; IG-1: Retinoic acid-in- ducible Gene I; COVID-19: Corona Virus Disease 2019; NK: Natural Killer; CD8+: Cluster of Differentiation 8; CD4+: Cluster of Differen- tiation 4; PD-1: Programmed Death-1; PDL-1: Programmed Death Ligand-1; IFN-1: Interferon-1; AR: Androgen Receptor; pRB: Reti- noblastoma Protein
81 COVID-19 WAR, Pharmacotoxicologic Issues for Cancer Patients , Bahram Alamdary Badlou*
The cancerogenic processes are causing more death rates in- Hospitals than any other disease. The side effects of the cancer pa- tients’ routine treatment and the death triangle machinery were described previously (Badlou BA., et al. 2018-2021). Besides the COVID-19 variants’ death rates increased above 4.4 million, glob- ally (Augustus 2021). Either cancerogenous or the COVID-19 vari- ants’ killing mechanism are not elucidated completely.
82 Anesthetic Management of a Patient with Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-Like Symptoms (MELAS): A Case Report , Refaat Shehab1* and MO Ababneh2
Mitochondrial encephalopathy, lactic acidosis, stroke-like symptoms (MELAS) syndrome is a specific mitochondrial myopathy that results in defects in respiratory enzyme complexes I and IV. This ultimately causes defects in aerobic metabolism, especially in high-energy-requiring organs, leading to an obvious concern with anesthetic management. Mitochondrial disease (MD) is recognized as an important cause of a wide range of physiologic changes that affect the periopera- tive period [1], strongly affected by anesthetics. We managed a 36-year male patient with MELAS, underwent a ureteroscopy, lithotripsy and indwelling double J stent exchange. The patient was successfully managed with a spinal/epidural anaesthesia. Keywords: MELAS; Anesthetic Management; Myopathy; Genetics
83 Human Saliva: A Prognostic, Diagnostic and Therapeutic Tool-Kit , Abhimanyu Mohanta*
Saliva is an extracellular fluid produced and secreted by salivary glands in the mouth. About 93% by volume is secreted by the ma- jor salivary glands and the remaining 7% by the minor glands. In humans, biochemically, approximately 99% of saliva is water and the other 1% is composed of organic and inorganic molecules [1]. Organic substances include exfoliated epithelial cells (from which DNA can be extracted), white blood cells, mucus,, enzymes (such as amylase and lipase), antimicrobial agents such as secretory IgA, and lysozymes [2]. Saliva consists of both full-length and partially degraded forms of mRNA, its association with macromolecules may protect salivary RNA from degradation [3].
84 Carcinoma Right Breast with Right Inguinal Lymph Nodes Metastasis, A Rare Case Report , Hemant Pandey*, Sapna Manocha, GK Jadhav and Divya Piyushi
Most common lymphatic spread of carcinoma breast is ipsilateral axiilary lymph nodes, internal mammary lymph nodes and su- praclavicular lymph nodes. Inguinal lymph nodes involvement in carcinoma breast is quite uncommon. Surgery and irradiation for breast cancer may interfere with conventional pathways of spread, leading to bizarre patterns of dissemination through lymphatics or through hematogenous route. Other possible reasons could be occurrence of primary breast cancer in accessory breast tissue retained in the vulva following involution of milk line. We describe a case of right breast carcinoma who developed right ingquinql lymph node mets, brain mets after one month of neoadjuvant chemotherapy and mastectomy. Keywords: Inguinal Lymph Node Mets; Breast carcinoma
85 Significance of Fertility Preservation in Patients Undergoing Cancer Chemotherapy Specifically in Adolescents/Young Adults Requiring Alkylating Agent - A Short Communication , Kulvinder Kochar Kaur1*, Gautam Allahbadia2 and Mandeep Singh3
With the greater advancements in field of cancer treatment, the survival rates have escalated remarkably, thus the need arising for the fertility preservation in the survivors with regards to oocyte/embryo/ovarian tissue cryopreservation has assumed great importance particularly for those receiving chemotherapy that too with alkylating agents. Furthermore, the need further is enhanced in younger adults along with adolescents diagnosed for cancer and need chemotherapy and are yet to attain puberty where it might not be feasible to do cryopreservation of oocytes. The aim of this short communication is to emphasize on the young cancer patients in whom a diagnosis of cancer is made and which patients stand a chance of generation of diminished ovarian reserve (DOR) who receive chemotherapy as well as the agents that justify evaluation of Antimullerian hormone (AMH) as well as other investigations required prior to initiation of chemotherapy. Keywords: Cancer; Chemotherapy; Alkylating Agents; Fertility Preservation
86 Enzyme Inactivation Method: Effects and Steps to Do , Tran Van Luyen
An enzyme is a special biological molecule that activates and controls (catalyzes) all metabolic processes in the cell. Each en- zyme per process, independent and unique. Based on these prop- erties, enzymes are used for different purposes. For example, if we want to stop or control a certain process, we can inactivate a spe- cific enzyme. There are some difficulties when we do this work are: • Find the right enzyme and • Find a way to inactivate the enzyme. To date, science has known hundreds of thousands of different enzymes involved in hundreds of thousands of different biochemi- cal reactions. Enzymes are divided into three categories: pure pro- tein, cofactor enzyme and coenzyme.