Assessment of the quality of life in breast cancer depending on the surgical treatment

PURPOSE

The objective of the study is to describe QoL in women who have undergone surgical treatment for breast cancer (BC). The focus of the description is the differences in QoL between women treated by modified radical mastectomy (MRM) and women who underwent breast-conserving surgery (BCS) at the Breast and Endocrine Surgery Department of the Clinical Center of Niš, Serbia.

METHOD

From January 1, 2014, until December 31, 2017, 300 patients were treated with BCS and 300 patients with MRM. To assess the QOL, a total of 600 BC patients completed the WHOQOL-BREF questionnaires. The results were analyzed using the t test and chi-square test. WHOQOL produces a quality of life profile. It derives four domain scores: physical health, psychological, social relationships, and environment. Social and demographic factors (age, education, marital status) were collected in both groups.

RESULT

In all four domains, patients treated with conserving surgeries scored higher than patients treated with radical mastectomy. This result was controlled for a set of demographic variables. The differences in QoL scores are present on all levels of controlling variables.

CONCLUSION

According to the results of this study, the QoL in women after an MRM is significantly lower than the QoL in women after BCS. It is especially true for the environment domain. Conserving surgery should be recommended and specific, and patient-centered interventions for increasing QoL of the patients who opted for radical mastectomy should be designed. The intervention should focus on social and environmental domains.

Estimated number of people diagnosed with cancer in Brazil: data from the National Health Survey, 2013

OBJECTIVE

To describe the profile of patients who reported a medical diagnosis of cancer and describe the most prevalent types of cancer, according to selected variables.

METHODS

A descriptive study that used data from the National Survey of Health, 2013, to estimate prevalence and their values of confidence interval (95%CI).

RESULTS

Less than 2% of adults reported a medical diagnosis of cancer, with most reported by women, people over 60, among whites, residents in the village and residents of South Prostate cancer was the most reported among men and breast among women. The lowest average age of first diagnosis was identified for cervical cancer (35.4 years; 95%CI 30.3 - 40.6) and the highest for prostate (65.7 years; 95%CI 64.2 - 67.0).

CONCLUSION

The findings of this study are important for the planning of health services and access, as they show differences mainly regional.

Promoting Cancer Control in Africa With "Ubuntu": A Report of the African Organization for Research and Training in Africa (AORTIC) 10th Conference, 2015 in Marrakech, Morocco

The objectives of the African Organization for Research and Training in Cancer (AORTIC), includes bringing products of decades of advances in cancer research to African populations through local and international collaboration. The consistent and huge growth in participation in the conferences and the diversity of the nations is a witness to the success of the organization thus far. The theme for the Tenth AORTIC International Conference on Cancer in Africa in Morocco in 2015 was "Road map to Cancer Control in Africa" and topics of discussion of paramount importance for low- and middle-income African countries included childhood cancers such as BL, cancers of the cervix, breast, and prostate; cancers associated with HIV-infection such as cervical, vulvar, and anal; as well as cancer care challenges associated with palliative care. The role of environmental factors that underlie some epigenetic changes in some of the cancers was emphasized. Oral and poster presentations from various parts of the continent indicate the growth of basic and translational science of cancer in the region, with studies revealing regional diversity in the frequencies of the triple-negative breast cancer, cervical cancer, prostate cancer, HCC, and Burkitt's lymphoma. There was a sign that Africa is trying to keep pace with the paradigm shift and focusing on translational medicine. This was shown by suggestions for application of genome-wide association studies, new generation sequencing, as well as the evaluation of single nucleotide polymorphisms that may be responsible for variable susceptibility in some of the prevalent cancers in people of African descent. J. Cell. Physiol. 232: 2287-2295, 2017. © 2016 Wiley Periodicals, Inc.

The prioritisation of paediatrics and palliative care in cancer control plans in Africa

Background:

Given the burden of childhood cancer and palliative care need in Africa, this paper investigated the paediatric and palliative care elements in cancer control plans.

Methods:

We conducted a comparative content analysis of accessible national cancer control plans in Africa, using a health systems perspective attentive to context, development, scope, and monitoring/evaluation. Burden estimates were derived from World Bank, World Health Organisation, and Worldwide Palliative Care Alliance.

Results:

Eighteen national plans and one Africa-wide plan (10 English, 9 French) were accessible, representing 9 low-, 4 lower-middle-, and 5 upper-middle-income settings. Ten plans discussed cancer control in the context of noncommunicable diseases. Paediatric cancer was mentioned in 7 national plans, representing 5127 children, or 13% of the estimated continental burden for children aged 0–14 years. Palliative care needs were recognised in 11 national plans, representing 157 490 children, or 24% of the estimated Africa-wide burden for children aged 0–14 years; four plans specified paediatric palliative needs. Palliative care was itemised in four budgets. Sample indicators and equity measures were identified, including those highlighting contextual needs for treatment access and completion.

Conclusions:

Recognising explicit strategies and funding for paediatric and palliative services may guide prioritised cancer control efforts in resource-limited settings.

Burkitt lymphoma research in East Africa: highlights from the 9(th) African organization for research and training in cancer conference held in Durban, South Africa in 2013

A one-day workshop on Burkitt lymphoma (BL) was held at the 9(th) African Organization for Research and Training in Cancer (AORTIC) conference in 2013 in Durban, South Africa. The workshop featured 15 plenary talks by delegates representing 13 institutions that either fund or implement research on BL targeting AORTIC delegates primarily interested in pediatric oncology. The main outcomes of the meeting were improved sharing of knowledge and experience about ongoing epidemiologic BL research, BL treatment in different settings, the role of cancer registries in cancer research, and opportunities for African scientists to publish in scientific journals. The idea of forming a consortium of BL to improve coordination, information sharing, accelerate discovery, dissemination, and translation of knowledge and to build capacity, while reducing redundant efforts was discussed. Here, we summarize the presentations and discussions from the workshop.

Antiproliferative potential of a novel parthenin analog P16 as evident by apoptosis accompanied by down-regulation of PI3K/AKT and ERK pathways in human acute lymphoblastic leukemia MOLT-4 cells

Leukemia is one of the deadliest types of cancer. Lack of effective treatment strategies has resulted in an extensive quest for new therapeutic molecules against it. This study explores the molecular mechanism of anticancer activity of P16, a semisynthetic analog of parthenin, against the human acute lymphoblastic leukemia MOLT-4 cells. P16 displayed antiproliferative activity in different cancer cell lines; however, MOLT-4 cells showed highest sensitivity for P16 with IC50 value of 0.6μM. Further studies revealed that P16 induced cell death by apoptosis. It caused mitochondrial stress, which was mediated by the translocation of Bax from cytosol to mitochondria and release of cytochrome c into the cytosol and consequent activation of caspase-9. However, P16 was also able to activate caspase-8, thus involving both extrinsic and intrinsic pathways of apoptosis. Further, activation of caspase-3 led to cleavage of its target proteins PARP-1 and ICAD, which resulted in apoptotic DNA damage. P16 induced apoptosis was accompanied by the down-regulation of important leukemic cell survival proteins like pAKT (S473), pAKT (T308), pP70S6K, pCRAF, and pERK1/2. However, inhibition of caspases by Z-VAD-FMK reversed the down-regulatory effect of P16 on pAKT (S473) and pP70S6K, as evident by the cell viability assay and flow cytometric analysis but this inhibition did not completely reverse the antiproliferative effect of P16, thereby indicating the role of additional factors apart from caspases in P16 induced apoptosis in MOLT-4 cells. Owing to its antiproliferative potential against leukemia cells, P16 can further be explored as an effective therapeutics against leukemia.

Analysis of factors contributing to the low survival of cervical cancer patients undergoing radiotherapy in Kenya

BACKGROUND

In contrast to the developed nations, invasive cervical cancer (ICC) is the most common womens malignancy in Kenya and many other locations in sub-Saharan Africa. However, studies on survival from this disease in this area of the world are severely restricted by lack of patient follow-up. We now report a prospective cohort study of ICC in Kenyan women analysing factors affecting tumour response and overall survival in patients undergoing radiotherapy.

METHODS AND FINDINGS

Between 2008 and 2010, 355 patients with histologically confirmed ICC were recruited at the Departments of Gynaecology and Radiotherapy at Kenyatta National Hospital (KNH). Structured questionnaires were completed recording socio-demographics, tumour response and overall survival following treatment with combinations of external beam radiation (EBRT), brachytherapy and adjuvant chemotherapy. Of the 355 patients, 42% (146) were lost to follow-up while 18% (64) died during the two year period. 80.5% of patients presented with advanced stage IIB disease or above, with only 6.7% of patients receiving optimal combined EBRT, brachytherapy and adjuvant chemotherapy. Kaplan Meier survival curves projected two year survival at <20%.

CONCLUSION

Cervical cancer is preventable yet poverty, poor education, lack of cancer awareness coupled with an absence of regular screening programs, late patient presentation, sub-optimal diagnosis and treatments are major factors contributing to the alarmingly low survival rate of cervical cancer patients in Kenya. It is concluded that simple cost-effective changes in clinical practice could be introduced which would have a marked impact on patient survival in this setting.

Evaluation of the impact of NCI's Summer Curriculum on Cancer Prevention on participants from low- and middle-income countries

The National Cancer Institute (NCI) Summer Curriculum on Cancer Prevention provides scientists and health care professionals training in principles and practices of cancer prevention and control, and molecular biology and genetics of cancer. Originally intended for US scientists, the curriculum's enrollment of international scientists has increased steadily. The objective of the current study was to evaluate the curriculum's impact on knowledge, skills, and career accomplishments of the international participants from low- and middle-income countries. International participants from 1998 to 2009 completed questionnaires regarding knowledge, overall experience, and accomplishments directly associated with the curriculum. Almost all respondents agreed that the curriculum enhanced their knowledge and skills, prepared them to contribute to cancer control activities in their home countries, and addressed specific needs and achieve research goals. The NCI Summer Curriculum on Cancer Prevention gives international participants a unique opportunity to enhance their knowledge and effectively contribute to cancer control activities in their home country.

Patterns of seeking medical care among Egyptian breast cancer patients: relationship to late-stage presentation

Breast cancer is the most common cancer among Egyptian women, accounting for 37.6% of female tumors, and is often diagnosed at later stages. The objective of this study was to investigate breast cancer patient navigation through the health care system in the Nile Delta. Interviews were conducted with 163 newly diagnosed breast cancer patients at the Tanta Cancer Center (TCC), the major cancer center of the region. Patients described their medical care pathway from the initial symptom experienced until their arrival at TCC. Patients whose initial contact was with a general surgeon (OR: 7.6, 95% CI: 2.1, 27.6), primary care provider (OR: 12.2, 95% CI: 2.9, 51.0), or gynecologist (OR: 8.6, 95% CI: 1.4, 53.4) were significantly more likely to experience a delay in reaching the TCC as compared to those visiting a surgical oncologist. Overcoming health care system and patient navigation barriers in developing countries may reduce the time for breast cancer patients to reach a cancer center for early management.

Cancer mortality trends in Brazilian state capitals and other municipalities between 1980 and 2006

OBJECTIVE

To analyze the corrected trend of overall cancer mortality and leading sites in the state capitals and other municipalities of Brazil between 1980 and 2006.

METHODS

Data on deaths (n = 2,585,012) caused by cancer between 1980 and 2006 were obtained from Sistema de Informações sobre Mortalidade (Mortality Information System), and demographic data were provided by Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics). The rates of overall cancer mortality and major types were corrected by proportionally redistributing 50% of ill-defined causes of death and standardizing them by age according to the standard world population. Trend curves for Brazil and its major regions were calculated for state capitals and other municipalities according to sex, and were evaluated by means of simple linear regression.

RESULTS

Among men, ascending mortality rates were observed for lung, prostate and colorectal cancer; declining rates for stomach cancer; and stable rates for esophagus cancer. Among women, mortality from breast, lung and colorectal cancer increased, and the rates for cervical and stomach cancer declined. Mortality evolution varied across the regions of Brazil, with distinct patterns between state capitals and other municipalities.

CONCLUSIONS

The correction of mortality rates based on redistribution of ill-defined causes of death increased the magnitude of the overall cancer mortality in Brazil by approximately 10% in 1980 and 5% in 2006. In the inland municipalities no decrease or stability was identified, differently from what was observed in the state capitals. Limited scope of prevention actions and lower access to services of cancer diagnosis and treatment for the population living away from large urban centers may partly explain these differences.