ecancermedicalscience最新文献

Background: The incidence of colorectal cancer has been increasing worldwide. Middle- and low-income countries are also experiencing surge. This is due to a rapidly growing population.

Methods: All patients diagnosed and presenting to Indira Gandhi Medical College, Shimla, the sole tertiary cancer care centre in Himachal Pradesh, India, during the study period from January 2017 to December 2018, were included in the study and were followed till 60 months. Data were collected on clinical characteristics, pathology, treatment received and survival outcomes, specifically overall survival (OS) and disease-free survival (DFS). A Kaplan-Meier survival curve was constructed and multiple regression analysis was conducted to identify factors influencing survival, with a significance level set at p < 0.05.

Results: A total of 165 patients participated in the study, with a predominance of male subjects, a median age of 60 years and 34% of participants being under 50 years of age. The most prevalent symptoms were anorexia and weight loss, affecting 97% of the cohort, with the rectum identified as the most common site of involvement in 42% of cases. Histopathological analysis revealed signet ring-type morphology in 15% of the cases. The majority of patients presented with advanced stages, specifically stage 3 (36%) and stage 4 (32%). A multimodal treatment strategy was employed, involving collaboration among radiation oncologists, surgeons and medical oncologists. After a follow-up period of 60 months, 22 patients were lost to follow-up and only 23 patients remained alive. Multiple regression analysis indicated that only the stage of the disease significantly influenced overall survival (OS) and DFS.

Conclusion: Limited health awareness, coupled with the challenging topography of the region, has led to a significant number of defaulters. This, in conjunction with the advanced stage of the disease and inadequate access to healthcare, has contributed to suboptimal OS and DFS rates. Further epidemiological investigations, including genetic analyses, are necessary to better characterise the presentation of this disease.

Background: Cancer remains a significant public health challenge, being the second leading cause of death in urban areas and the fourth in rural regions of India. The estimated 1.15 million new cancer cases in 2018 are projected to double by 2040. Despite the critical importance of early detection, cancer screening rates in rural India remain alarmingly low. This study investigates barriers to breast and cervical screening among women in remote villages of Karnataka using the Health Belief Model (HBM) as a theoretical framework.

Methods: A community-based screening program for oral, breast and cervical cancer, was implemented in three taluks of Chikkaballapur district, Karnataka, from September to November 2021. Quantitative data from 4,974 screened women were complemented by qualitative interviews with 292 women who did not consent to screening, particularly for breast and cervical cancer. Interviews were guided by HBM constructs perceived susceptibility, severity, barriers, benefits, cues to action and self-efficacy and analysed thematically.

Results: Out of the 4,974 women who participated in screening clinics, less than 10% consented to clinical breast examination and none to cervical screening. Major barriers to screening included socio-cultural factors (stigma, lack of awareness, peer pressure), economic constraints (work priorities and financial insecurity), psychological barriers (fear of outcomes and lack of healthcare trust) and physical challenges (accessibility and seasonal constraints). Fear of treatment outcomes and financial implications were prominent psychological deterrents. Mitigation strategies were noted to address these barriers, including awareness campaigns, flexible camp timings and local stakeholder engagement.

Conclusion: Addressing barriers to cervical and breast cancer screening requires a holistic, community-centred approach informed by theoretical models like HBM. Sustainable interventions must prioritise awareness, accessibility and affordability to bridge critical healthcare gaps and reduce the burden of cancer in rural India.

Background: Multiple myeloma (MM), a plasma cell malignancy, predominantly affects individuals aged 65-74 years. However, its occurrence in younger populations (<55 years) is rare, posing unique challenges. This study explores the clinical presentation, outcomes and treatment regimens for MM patients aged 30-55, aiming to unravel age-specific patterns.

Methods: A retrospective chart review was conducted at Aga University Hospital, Karachi, focusing on MM patients aged 30-55 years. Data included patient demographics, clinical features, treatment modalities and outcomes. Statistical analysis employed STATA version 16.0, incorporating survival estimates, log-rank tests and Cox proportional survival regression models.

Results: This study encompassed 68 confirmed MM patients, categorised by age groups: 30-40 years (13.23%), 41-50 years (44.11%) and 51-55 years (42.64%). Predominantly male (1.3:1 ratio), bone pains were prevalent among all groups, with 51-55 years exhibiting the highest pathological fracture rate. 30-40 years group showed higher renal impairment rates and lactate dehydrogenase levels. Velcade, thalidomide and dexamethasone were commonly used first-line regimens in the entire cohort in 41.17% of patients, closely followed by cyclophosphamide, bortezomib and dexamethasone in 29.41%. Partial response was predominant in the 30-40 years group, while other age groups showed varied responses. The younger patients demonstrated lower deep treatment response rates than their older counterparts. Progression-free survival was 37, 52 and 45 months orderly in each group, with a p-value of <0.001. The median overall survival (OS) for the entire group was 50.6 months (4.2 years), with OS rates of 77.8% (CI: 95%), 90.0% (CI: 95%) and 86.2% (CI: 95%), respectively, with a p-value of <0.001. Median OS in months was 45, 55.5 and 52, with a p-value of 0.08.

Conclusion: This single-center study sheds light on younger MM patients' unique challenges and treatment patterns. Despite the rarity of this age group's affliction, the findings underscore significant differences in clinical presentations, treatment responses and outcomes compared to the typical elderly MM population. The study highlights the importance of tailored approaches in managing MM across different age brackets, emphasising the need for further research to optimise therapeutic strategies and improve prognosis in this distinct patient cohort.

Background: Cervical cancer is a major public health issue in Morocco, ranking as the second most common cancer among women. Beyond its physical burden, a diagnosis of cervical cancer significantly affects patients emotionally and socially, often leading to anxiety, depression and social isolation. Despite the high prevalence of this cancer, limited research has explored its psychosocial impact within the Moroccan context.

Methods: This study assessed the psychosocial impact of cervical cancer diagnosis among women treated at the Radiotherapy Department of Hassan II University Hospital in Fez. Emotional distress was evaluated using the Hospital Anxiety and Depression Scale (HADS), while quality of life (QoL) was measured using the WHOQOL-BREF tool. Coping strategies were analysed using the Brief Cope Inventory. All tools were validated in Moroccan Arabic dialect for cultural relevance.

Results: A total of 100 patients were enrolled. Emotional distress was notable, with 38% of participants experiencing significant anxiety (HADS score >8) and 25% reporting symptoms of depression. QoL scores (WHOQOL-BREF) were moderate, with significant deficits in physical and psychological health domains. Coping strategies predominantly included religious practices and family support, which correlated with better management of emotional distress. Social consequences, such as marital tension and isolation, were frequently reported but were mitigated by robust familial support.

Conclusion: The study highlights the profound psychosocial burden of cervical cancer diagnosis in Moroccan women. Integrated support programs encompassing physical, emotional, social and spiritual care are urgently needed to improve patient outcomes. Future research should focus on culturally tailored interventions to enhance coping mechanisms and overall QoL.

There is a critical need for overcoming stigmas and enhancing awareness of childhood cancer in South Africa, where the underreporting and late diagnosis of cases significantly impact survival rates. Despite the global increase in childhood cancer cases, South Africa's statistics reveal a stark contrast, with only 70-80 children diagnosed per million, far below the expected incidence. The WHO's Global Initiative for Childhood Cancer aims for a 60% survival rate by 2030, highlighting the urgency of addressing these issues. South Africa's late diagnosis of childhood cancer is impacted by prevalent myths surrounding childhood cancer, such as misconceptions about contagion and inheritance, which hinder early diagnosis and treatment compliance. The integration of traditional health practitioners into awareness campaigns is emphasised as a vital strategy for increasing referrals and reducing stigma. The role of civil society and patient advocates in implementing educational initiatives, including the Siluan Early Warning Signs of Cancer in Children, to improve awareness among healthcare workers and communities, acts as a catalyst for progress. These initiatives, often collaborative nature, undertaken by civil society and patient advocate groups to enhance knowledge, reduce stigma and create pilot initiatives build awareness in communities and kick-start political will to develop policies that can ensure a supportive environment for children with cancer and their families.

Purpose: This study aims to explore the knowledge regarding cancer causes and prevention among university students. Research on cancer awareness and comprehension is vital for promoting both individual and public health, particularly in regions with high cancer prevalence.

Methods: A self-administered questionnaire survey was used to assess the comprehension and knowledge of cancer. The sum of sample was 756 university students from various departments who participated in the survey. Data were analysed using Microsoft Excel and SPSSv.20 programs. Statistical significance was determined using chi-square tests and p-values.

Results: The student's provenance of cancer education were reported as 20% from both friends or family and social media. Barely, 19.68% felt confident about their knowledge of cancer, while 33.8% of students preferred cancer awareness and campaigns as their primary source of learning about cancer. Overall, 59.5% of students demonstrated some level of knowledge related to Cancer. The association between student's knowledge and awareness on cancer education scores was statistically significant (p = 0.000).

Conclusion: The majority of students perceive unassured in their knowledge of cancer and hence, strengthening awareness campaigns and educational initiatives is crucial for promoting early detection and prevention, enhance the quality of treatment and reduce stigma. Furthermore, there is a dearth of information on the high-risk human papillomavirus vaccine and individuals should be made aware of the significance of getting vaccinated as a preventive step.

Caring for patients with cancer is now being conducted in the era of a triple planetary crisis, which threatens our future on the planet. The impacts of this crisis are profound - disrupting cancer care due to displacement from extreme weather events, increasing cancer incidence and worsening cancer outcomes due to pollution, and threatening food and economic security due to loss of biodiversity. Clear that these changes will worsen in the coming years. The burden of these changes are not equitable, with the greatest impacts on countries that have contributed least to the crisis. While healthcare is the fifth leading cause of greenhouse gas emissions, climate awareness and activism in healthcare are low. This paper examines the relationship between climate change and cancer care, highlighting regional disparities, environmental drivers of cancer risk, and the need for systemic adaptation. We present case studies from the Philippines, Nigeria, and Brazil each illustrating how climate-related events affect oncology delivery in vulnerable settings. We then explore how pollution, heat, and plastic use intersect with cancer risk and outcomes. Finally, we outline practical strategies and evidence-based toolkits for decarbonising cancer care across surgery, radiotherapy, medical oncology, and clinical trials. These insights, informed in part by global collaboration during London Global Cancer Week 2024, support the urgent integration of sustainability into oncology practice worldwide.

Cervical cancer is the gynecological malignancy that ranks third worldwide. It consists histologically of multiple subtypes, such as squamous cell carcinoma, which is the most common (65%), then adenocarcinoma (15%) and other types such as neuroendocrine, adenosquamous and carcinosarcoma tumours, which are less common. According to the World Health Organisation, lymphoepithelioma-type carcinoma has been described as an uncommon subtype and a variant of squamous cell carcinoma of the cervix. Its pathogenesis is related to the presence of the human Epstein-Barr virus and human papillomavirus. We present the case of a woman diagnosed with squamous cell lymphoepithelioma-like carcinoma of the cervix that was comprehensively managed with radical hysterectomy alone, presenting a good response and without recurrence.

With the rising incidence of cancer in low and lower-middle-income countries, the burden of pneumonia, which causes disproportionate morbidity and mortality in cancer patients, presents an evidence gap. We conducted a 1-year prospective cohort study in the oncology ICU at Tata Medical Center Kolkata, to determine the incidence, risk factors, etiology and impact of pneumonia on length of stay and mortality. Pneumonia was identified via daily ICU rounds using clinical and radiological features. A 1:1 age and sex matched comparison cohort without pneumonia was included. Etiology of pneumonia was determined using microscopy, culture, ELISA, PCR and cartridge-based nucleic acid amplification tests. Logistic regression was used to study risk factors, Cox regression for mortality and linear regression for hospital and ICU length of stay. There were 2279 ICU admissions. We recruited 711 patients: 355 had pneumonia, 356 did not. The incidence of pneumonia was 15.6% (95% CI: 14.1%-17.1%); 51.8% were community-acquired (CAP) and 48.2% were hospital-acquired (HAP). Seventy percent of CAP patients experienced recent healthcare exposure, with 28% hospitalised. All-cause 90-day mortality (6.4 per 1000 person-days) was 9 times higher in pneumonia patients. Lengths of hospital stay (18.6 days), ICU stay (10.9 days) and mechanical ventilation (2 days) were higher in pneumonia patients. Seventy-three percent of pneumonia patients had positive microbiology from lower respiratory samples. Gram-negative bacilli were frequent in both CAP and HAP. Influenza A/B was frequent in the monsoon and Haemophilus influenzae in the winter. Bone-marrow transplant, hematological malignancies, neutropenia and chronic obstructive pulmonary disease increased pneumonia risk. CAP, hematological malignancies and neutropenia increased the risk of death by day 90. Pneumonia, both CAP and HAP, increased mortality and hospital and ICU length of stay in adults with cancer. Gram-negative bacilli were common in both CAP and HAP. Tailored infection control programmes and an emphasis on adult vaccination are imperative to pneumonia prevention.