D. Samanta, A. Avinash, S. Senapati, Suchitra Samal, Tapas Kumar Dash, Abhisekh Kumar Sarangi
Abstract Introduction Pediatric malignancy represents 5% of total cancer diagnosed in India. Due to delayed diagnosis and inaccessibility to healthcare system, the overall outcome is poor in our country. The clinicodemographic profile of childhood malignancy is well described in the Western world and in certain parts of India. The incidence of pediatric malignancy in Eastern India, especially Odisha, has not yet been reported that has motivated us to conduct such a study. Objective This study aims to evaluate the clinicodemographic profile and pattern of childhood malignancy among pediatric patients who received the treatment at a tertiary cancer institute of Odisha. Materials and Methods It was a retrospective observational study, carried out for a period of 8 years, from January 1, 2013 to December 31, 2020 at a tertiary cancer center in Eastern India. A total of 759 eligible childhood malignancy patients were recruited in the study. IBM SPSS v23 was used for descriptive statistical analysis, that is, number and percentage of various clinicodemographic parameters of the above patients. Result Childhood malignancy accounted for 1.6% of all cancers reported during the above study period. The male to female ratio was 1.8:1. Out of 759 eligible childhood cancer patients, majority of patients were suffering from leukemia (173; 22.8%) followed by malignant bone tumors (137; 18.0%), and lymphoma (122; 16%). Leukemia was predominant in the age group of 0 to 14 years; lymphoma, central nervous system neoplasms, germ cell tumors malignant bone tumors, and soft tissue sarcoma (STS) were common in the age group of 10 to 18 years; neuroblastoma, retinoblastoma, and renal and hepatic tumors were seen commonly in the age group of 0 to 9 years. The most common presentation in leukemia was fever, while lymphadenopathy was the chief complaint in lymphoma. Local swelling and pain were the presenting symptoms in malignant bone tumors, while STS patients had painless swelling. Conclusion This study provides an overview of the burden and pattern of childhood malignancy for the state of Odisha and acts as a roadmap for the clinicians to conduct further research in the field of pediatric oncology.
{"title":"Clinicodemographic Profile of Childhood Cancer in a Mining State, Odisha: A Retrospective Analysis","authors":"D. Samanta, A. Avinash, S. Senapati, Suchitra Samal, Tapas Kumar Dash, Abhisekh Kumar Sarangi","doi":"10.1055/s-0043-1768180","DOIUrl":"https://doi.org/10.1055/s-0043-1768180","url":null,"abstract":"Abstract Introduction Pediatric malignancy represents 5% of total cancer diagnosed in India. Due to delayed diagnosis and inaccessibility to healthcare system, the overall outcome is poor in our country. The clinicodemographic profile of childhood malignancy is well described in the Western world and in certain parts of India. The incidence of pediatric malignancy in Eastern India, especially Odisha, has not yet been reported that has motivated us to conduct such a study. Objective This study aims to evaluate the clinicodemographic profile and pattern of childhood malignancy among pediatric patients who received the treatment at a tertiary cancer institute of Odisha. Materials and Methods It was a retrospective observational study, carried out for a period of 8 years, from January 1, 2013 to December 31, 2020 at a tertiary cancer center in Eastern India. A total of 759 eligible childhood malignancy patients were recruited in the study. IBM SPSS v23 was used for descriptive statistical analysis, that is, number and percentage of various clinicodemographic parameters of the above patients. Result Childhood malignancy accounted for 1.6% of all cancers reported during the above study period. The male to female ratio was 1.8:1. Out of 759 eligible childhood cancer patients, majority of patients were suffering from leukemia (173; 22.8%) followed by malignant bone tumors (137; 18.0%), and lymphoma (122; 16%). Leukemia was predominant in the age group of 0 to 14 years; lymphoma, central nervous system neoplasms, germ cell tumors malignant bone tumors, and soft tissue sarcoma (STS) were common in the age group of 10 to 18 years; neuroblastoma, retinoblastoma, and renal and hepatic tumors were seen commonly in the age group of 0 to 9 years. The most common presentation in leukemia was fever, while lymphadenopathy was the chief complaint in lymphoma. Local swelling and pain were the presenting symptoms in malignant bone tumors, while STS patients had painless swelling. Conclusion This study provides an overview of the burden and pattern of childhood malignancy for the state of Odisha and acts as a roadmap for the clinicians to conduct further research in the field of pediatric oncology.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42696794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. T. Sari, T. Wiguna, S. D. Elvira, I. Widyahening, Rinoldy Mangiri, Apul S. Napitupulu, Nathania Sutandi, Silvia Tanumiharjo, R. Sitorus
Abstract Introduction Coronavirus disease 2019 (COVID-19) has affected both physical and mental aspect of people worldwide, especially the high-risk group such as pediatric cancer patients. Children with cancer were considered both clinically and mentally vulnerable during this pandemic. They were also affected by the self-isolation, quarantine, and social distancing policy taken as a respond to public threat. Objectives To evaluate the impact of social distancing and health protocol during COVID-19 on the mental health profile of children with cancer in Indonesia. Methods A cross-sectional study evaluating the mental health of children with cancer during COVID-19 pandemic was conducted in Cipto Mangunkusumo Hospital, Jakarta, Indonesia from June to September 2020. An online questionnaire was used to collect demographics of parents and children, children's Strength and Difficulties Questionnaire (SDQ) score, and parents' Self-Reporting Questionnaire (SRQ). SDQ score consists of five subscales, including the emotional symptoms, conduct problems, hyperactivity, peer relationships problems and prosocial behavior. Cancer types were grouped into retinoblastoma, nonretinoblastoma (other solid tumors), and leukemia. Results There were 156 valid responses, consisting of 42 patients with retinoblastoma, 34 patients with nonretinoblastoma (other solid tumors), and 80 patients with leukemia. Pandemic-related lifestyle changes did not significantly impact emotional or behavioral problems. Children with normal total SDQ (odds ratio [OR]: 473, p = 0.001) and emotional scores (OR: 3.19, p = 0.07) had parents with normal SRQ scores (<6). Leukemia patients with shorter diagnosis period had worse hyperactivity score ( p = 0.01). On the contrary, leukemia inpatients had better prosocial scores than outpatients ( p = 0.03). More bilateral retinoblastoma patients ( p = 0.04) with longer duration of cancer diagnosis ( p = 0.03) faced peer problems. Conclusions Our study revealed that lifestyle changes during early COVID-19 pandemic were not major factors impacting emotional and behavioral problems in children with cancer. However, disease-related factors pose great challenges; thus, a holistic mental health support system should be available to both children and parents.
{"title":"Mental Wellbeing among Children with Cancer during COVID-19 Pandemic in Indonesia: A Cross-sectional Study","authors":"T. T. Sari, T. Wiguna, S. D. Elvira, I. Widyahening, Rinoldy Mangiri, Apul S. Napitupulu, Nathania Sutandi, Silvia Tanumiharjo, R. Sitorus","doi":"10.1055/s-0043-1768053","DOIUrl":"https://doi.org/10.1055/s-0043-1768053","url":null,"abstract":"Abstract Introduction Coronavirus disease 2019 (COVID-19) has affected both physical and mental aspect of people worldwide, especially the high-risk group such as pediatric cancer patients. Children with cancer were considered both clinically and mentally vulnerable during this pandemic. They were also affected by the self-isolation, quarantine, and social distancing policy taken as a respond to public threat. Objectives To evaluate the impact of social distancing and health protocol during COVID-19 on the mental health profile of children with cancer in Indonesia. Methods A cross-sectional study evaluating the mental health of children with cancer during COVID-19 pandemic was conducted in Cipto Mangunkusumo Hospital, Jakarta, Indonesia from June to September 2020. An online questionnaire was used to collect demographics of parents and children, children's Strength and Difficulties Questionnaire (SDQ) score, and parents' Self-Reporting Questionnaire (SRQ). SDQ score consists of five subscales, including the emotional symptoms, conduct problems, hyperactivity, peer relationships problems and prosocial behavior. Cancer types were grouped into retinoblastoma, nonretinoblastoma (other solid tumors), and leukemia. Results There were 156 valid responses, consisting of 42 patients with retinoblastoma, 34 patients with nonretinoblastoma (other solid tumors), and 80 patients with leukemia. Pandemic-related lifestyle changes did not significantly impact emotional or behavioral problems. Children with normal total SDQ (odds ratio [OR]: 473, p = 0.001) and emotional scores (OR: 3.19, p = 0.07) had parents with normal SRQ scores (<6). Leukemia patients with shorter diagnosis period had worse hyperactivity score ( p = 0.01). On the contrary, leukemia inpatients had better prosocial scores than outpatients ( p = 0.03). More bilateral retinoblastoma patients ( p = 0.04) with longer duration of cancer diagnosis ( p = 0.03) faced peer problems. Conclusions Our study revealed that lifestyle changes during early COVID-19 pandemic were not major factors impacting emotional and behavioral problems in children with cancer. However, disease-related factors pose great challenges; thus, a holistic mental health support system should be available to both children and parents.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45859332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Rhabdomyosarcoma (RMS) is a malignant soft tissue tumor of skeletal muscle origin. The head and neck, urinary tract, and extremities are the common sites of origin. Embryonal, alveolar, pleomorphic, and spindle/sclerosing are subtypes. It is more common in childhood and rare among adults. The incidence and risk factors for this disease are mainly largely unknown. RMS is sporadic in most instances; however, it is attributed to familial syndromes in some situations—its metastasis to the lungs, bone marrow, and lymph nodes. Breast and ovary involvement is scarce. Diagnostic workup mainly includes contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI). However, 18 F-fluro-deoxyglucose positron emission tomography ( 18 F-FDG-PET/CT) and PET/MRI are increasing contribution to providing functional insights about tumor biology and improving the diagnostic accuracy of the imaging workup. This report presents a case of the neck's embryonal RMS metastasizing simultaneously to the breast and ovary. PET/CT imaging revealed the unusual pattern, further validated by histopathology.
{"title":"Paranasal Sinus Embryonal Rhabdomyosarcoma Metastasizing to Breast and Ovary on PET/CT—A Case Report with the Review of Literature","authors":"Vijay Singh, V. Saini, M. Ora, S. Gambhir","doi":"10.1055/s-0043-1768179","DOIUrl":"https://doi.org/10.1055/s-0043-1768179","url":null,"abstract":"Abstract Rhabdomyosarcoma (RMS) is a malignant soft tissue tumor of skeletal muscle origin. The head and neck, urinary tract, and extremities are the common sites of origin. Embryonal, alveolar, pleomorphic, and spindle/sclerosing are subtypes. It is more common in childhood and rare among adults. The incidence and risk factors for this disease are mainly largely unknown. RMS is sporadic in most instances; however, it is attributed to familial syndromes in some situations—its metastasis to the lungs, bone marrow, and lymph nodes. Breast and ovary involvement is scarce. Diagnostic workup mainly includes contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI). However, 18 F-fluro-deoxyglucose positron emission tomography ( 18 F-FDG-PET/CT) and PET/MRI are increasing contribution to providing functional insights about tumor biology and improving the diagnostic accuracy of the imaging workup. This report presents a case of the neck's embryonal RMS metastasizing simultaneously to the breast and ovary. PET/CT imaging revealed the unusual pattern, further validated by histopathology.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43351714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract The main aim of this article is to contribute to a complete patient perspective on the psychosocial impact of colorectal cancer. The details included patient personal experience of being a colorectal cancer survivor and perception regarding psychosocial support during management of the illness. Health professionals should assume that patients may have difficulty in illness management and should encourage a discussion of patients' concerns.
{"title":"Surviving Colorectal Cancer: More Than Treatment","authors":"Belsiyal C. Xavier","doi":"10.1055/s-0043-1768242","DOIUrl":"https://doi.org/10.1055/s-0043-1768242","url":null,"abstract":"Abstract The main aim of this article is to contribute to a complete patient perspective on the psychosocial impact of colorectal cancer. The details included patient personal experience of being a colorectal cancer survivor and perception regarding psychosocial support during management of the illness. Health professionals should assume that patients may have difficulty in illness management and should encourage a discussion of patients' concerns.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42686420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract When diagnosed with cancer, the patients and their family go through emotional turmoil across the different phases: diagnosis, assessment, treatment, and aftercare, which decrease their quality of life and well-being. Previously, many studies have highlighted the association of metacognition with the development and maintenance of mental health conditions. Several recent studies have pointed out the significant role of dysfunctional metacognitive beliefs in the context of chronic disease. Thus, the present study aims to explore the role of metacognitive processes in cancer. The researchers conducted a narrative review of literature using PubMed, Semantic Scholar, and Science Direct. A total of 31 articles were selected and analyzed. This review article established that patients with cancer and caregivers experience metacognitive beliefs, which are associated with emotional distress, and the effectiveness of metacognitive therapy in reducing distress. This study also provides insight into the broader scope to advance research in this field.
{"title":"Metacognitive Processes in Cancer: A Review","authors":"Rekha Rashmi, C. Vanlalhruaii","doi":"10.1055/s-0043-1768050","DOIUrl":"https://doi.org/10.1055/s-0043-1768050","url":null,"abstract":"Abstract When diagnosed with cancer, the patients and their family go through emotional turmoil across the different phases: diagnosis, assessment, treatment, and aftercare, which decrease their quality of life and well-being. Previously, many studies have highlighted the association of metacognition with the development and maintenance of mental health conditions. Several recent studies have pointed out the significant role of dysfunctional metacognitive beliefs in the context of chronic disease. Thus, the present study aims to explore the role of metacognitive processes in cancer. The researchers conducted a narrative review of literature using PubMed, Semantic Scholar, and Science Direct. A total of 31 articles were selected and analyzed. This review article established that patients with cancer and caregivers experience metacognitive beliefs, which are associated with emotional distress, and the effectiveness of metacognitive therapy in reducing distress. This study also provides insight into the broader scope to advance research in this field.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":"44 1","pages":"398 - 407"},"PeriodicalIF":0.2,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41566364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Suchismita Nath, Sultana S. Nasrin, A. Samanta, Anzum Nuzhad, Pritha Ghosh, A. Manna, Satyasundar Pradhan, Suresh Maity, Srikanta Pal, P. Mohapatra, Subhasis Jana
Abstract Cervical cancer (CC) results from a subsequent process, starting from the infection of normal cervical epithelium with oncogenic human papillomavirus and gradually progressing to cervical intraepithelial neoplasia (CIN), before finally developing into invasive cervical cancer (ICC). Over recent decades, dietary micronutrients have gained much attention due to their pivotal role in cancer prevention. We reviewed several relevant literature studies to investigate the protective roles of dietary nutrient intake in CC. Dietary intake of vitamin C, green–yellow vegetables, and provitamin A carotenoids that are rich sources of antioxidants may widely inhibit the process of CC development, whereas vitamins A and D might be more helpful in preventing the early events in the disease development. Vitamin E, lycopene, and folate are more effective for the treatment of high-grade CIN. Fruits exert their protective effects in the late stages of the cancer process, thus playing a vital role in ICC prevention. Polyphenols, flavonoids, and polyunsaturated fatty acids are more often used in cases of CC in combination with chemotherapy and radiotherapy. Thus, as a primary prevention strategy, the health benefits of various nutrients in CC must be clarified by vitro and in vivo approaches rather than epidemiological studies.
{"title":"The Effects of Dietary Nutrient Intake on Cervical Cancer: A Brief Review","authors":"Suchismita Nath, Sultana S. Nasrin, A. Samanta, Anzum Nuzhad, Pritha Ghosh, A. Manna, Satyasundar Pradhan, Suresh Maity, Srikanta Pal, P. Mohapatra, Subhasis Jana","doi":"10.1055/s-0043-1768049","DOIUrl":"https://doi.org/10.1055/s-0043-1768049","url":null,"abstract":"Abstract Cervical cancer (CC) results from a subsequent process, starting from the infection of normal cervical epithelium with oncogenic human papillomavirus and gradually progressing to cervical intraepithelial neoplasia (CIN), before finally developing into invasive cervical cancer (ICC). Over recent decades, dietary micronutrients have gained much attention due to their pivotal role in cancer prevention. We reviewed several relevant literature studies to investigate the protective roles of dietary nutrient intake in CC. Dietary intake of vitamin C, green–yellow vegetables, and provitamin A carotenoids that are rich sources of antioxidants may widely inhibit the process of CC development, whereas vitamins A and D might be more helpful in preventing the early events in the disease development. Vitamin E, lycopene, and folate are more effective for the treatment of high-grade CIN. Fruits exert their protective effects in the late stages of the cancer process, thus playing a vital role in ICC prevention. Polyphenols, flavonoids, and polyunsaturated fatty acids are more often used in cases of CC in combination with chemotherapy and radiotherapy. Thus, as a primary prevention strategy, the health benefits of various nutrients in CC must be clarified by vitro and in vivo approaches rather than epidemiological studies.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45545201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Measurable residual disease (MRD) in multiple myeloma (MM) has emerged as one of the strongest and independent biomarkers to evaluate therapeutic response for the prediction of long-term treatment outcome. With the incorporation of MRD in response assessment criterion by International Myeloma Working Group, it has become the routine parameter to be assessed at various time points after therapy. Among various techniques to assess MRD, multiparametric flow cytometry (MFC)-based MRD estimation has evolved dramatically over the last two decades achieving sensitivity comparable to molecular methods. Next-generation flow cytometry with the incorporation of innovative tools in MRD detection including consortium-based guidelines for preanalytical and analytical factors led to the overall improvement in MFC-based MRD detection. However, flow cytometry assays suffer from inherent challenges ranging from procedural hemodilution to lack of harmonization and standardization across the centers. This review article outlines and summarizes the essential laboratory prerequisites for reproducible MRD analysis by flow cytometry. Furthermore, a brief account of the utility of MRD evaluation in clinical practice as predictor of response and long-term treatment outcome has also been discussed. Considering the evolution of MFC-based MRD over two decades from a scientific research tool to a routine clinical diagnostic assay, it needs to be explored further in studying complex phenomenon like clonal evolution, clonal switches, and identification of treatment refractory clones for guiding more effective therapies improving overall survival.
{"title":"Voyage of Measurable Residual Disease (MRD) Assessment in Multiple Myeloma Using Multiparametric Flow Cytometry","authors":"N. Das, Ritu Gupta","doi":"10.1055/s-0043-1768176","DOIUrl":"https://doi.org/10.1055/s-0043-1768176","url":null,"abstract":"Abstract Measurable residual disease (MRD) in multiple myeloma (MM) has emerged as one of the strongest and independent biomarkers to evaluate therapeutic response for the prediction of long-term treatment outcome. With the incorporation of MRD in response assessment criterion by International Myeloma Working Group, it has become the routine parameter to be assessed at various time points after therapy. Among various techniques to assess MRD, multiparametric flow cytometry (MFC)-based MRD estimation has evolved dramatically over the last two decades achieving sensitivity comparable to molecular methods. Next-generation flow cytometry with the incorporation of innovative tools in MRD detection including consortium-based guidelines for preanalytical and analytical factors led to the overall improvement in MFC-based MRD detection. However, flow cytometry assays suffer from inherent challenges ranging from procedural hemodilution to lack of harmonization and standardization across the centers. This review article outlines and summarizes the essential laboratory prerequisites for reproducible MRD analysis by flow cytometry. Furthermore, a brief account of the utility of MRD evaluation in clinical practice as predictor of response and long-term treatment outcome has also been discussed. Considering the evolution of MFC-based MRD over two decades from a scientific research tool to a routine clinical diagnostic assay, it needs to be explored further in studying complex phenomenon like clonal evolution, clonal switches, and identification of treatment refractory clones for guiding more effective therapies improving overall survival.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45415507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Mukherjee, Bidisha Samanta, Varuna Sharma, Aagon Krishna Shrestha, S. Chattopadhyay, Chitralekha Bhowmick, J. Ghosh, S. Ganguly, S. Agrawal, S. Datta
Abstract Introduction Breast cancer is the most frequent cancer among women. In the last few decades, the outcome of breast cancer has improved significantly in terms of survivorship and quality of life. However, it is crucial that alongside managing the disease, breast cancer services address and manage associated or co-occurring psychiatric illnesses such as acute stress reactions, procedural anxieties, adjustment issues, depression, and fear of recurrence, which leads to an overall better experience of the patient. Objective There is a paucity of data on the patterns of psychiatric morbidity in patients with breast cancer who access psycho-oncology services in a naturalistic setup outside research studies from India. The current study focused on exploring this alongside reporting the common treatment methods adopted for this group of patients. Materials and Methods Real-life data from electronic patient records were retrospectively reviewed for all patients with breast cancer accessing integrated psycho-oncology services in a tertiary care hospital in India over three 3 years (2018–2020). The various psychiatric morbidities were reported, along with associated cancer demographic data, disease characteristics, and treatment details. Results Of all the breast cancer patients ( n = 338) in the calendar years 2018 to 2020 reviewed by psycho-oncology services, the most common psychiatric diagnosis was depressive illness ( n = 100, 29.6%), followed by adjustment disorders ( n = 68, 20.1%) and anxiety ( n = 66, 19.5%). There was a significant minority with serious enduring mental illnesses such as schizophrenia ( n = 11, 3.3%) and bipolar disorders ( n = 14, 4.1%). On the other hand, 14.2% ( n = 48) of the patients with breast cancer who attended Psycho-oncology outpatient department did not have any psychiatric syndrome. Around 16.3% of patients could be managed without a prescription for any medications and almost half of the patients needed only one psychotropic medicine. Psychological interventions were used for 45.6% of patients. Conclusions Integrated psycho-oncology services in a cancer hospital catering to patients with breast cancer help in psychiatric assessment, diagnosis, and addressing the mental health needs of patients. The treatment offered needs to be nuanced and individualized and may require a combination of psychotropic medications and psychological techniques.
{"title":"When Do Patients with Breast Cancer Seek Help from Psycho-oncology Services? A 3-Year Retrospective Study from India","authors":"A. Mukherjee, Bidisha Samanta, Varuna Sharma, Aagon Krishna Shrestha, S. Chattopadhyay, Chitralekha Bhowmick, J. Ghosh, S. Ganguly, S. Agrawal, S. Datta","doi":"10.1055/s-0043-1768048","DOIUrl":"https://doi.org/10.1055/s-0043-1768048","url":null,"abstract":"Abstract Introduction Breast cancer is the most frequent cancer among women. In the last few decades, the outcome of breast cancer has improved significantly in terms of survivorship and quality of life. However, it is crucial that alongside managing the disease, breast cancer services address and manage associated or co-occurring psychiatric illnesses such as acute stress reactions, procedural anxieties, adjustment issues, depression, and fear of recurrence, which leads to an overall better experience of the patient. Objective There is a paucity of data on the patterns of psychiatric morbidity in patients with breast cancer who access psycho-oncology services in a naturalistic setup outside research studies from India. The current study focused on exploring this alongside reporting the common treatment methods adopted for this group of patients. Materials and Methods Real-life data from electronic patient records were retrospectively reviewed for all patients with breast cancer accessing integrated psycho-oncology services in a tertiary care hospital in India over three 3 years (2018–2020). The various psychiatric morbidities were reported, along with associated cancer demographic data, disease characteristics, and treatment details. Results Of all the breast cancer patients ( n = 338) in the calendar years 2018 to 2020 reviewed by psycho-oncology services, the most common psychiatric diagnosis was depressive illness ( n = 100, 29.6%), followed by adjustment disorders ( n = 68, 20.1%) and anxiety ( n = 66, 19.5%). There was a significant minority with serious enduring mental illnesses such as schizophrenia ( n = 11, 3.3%) and bipolar disorders ( n = 14, 4.1%). On the other hand, 14.2% ( n = 48) of the patients with breast cancer who attended Psycho-oncology outpatient department did not have any psychiatric syndrome. Around 16.3% of patients could be managed without a prescription for any medications and almost half of the patients needed only one psychotropic medicine. Psychological interventions were used for 45.6% of patients. Conclusions Integrated psycho-oncology services in a cancer hospital catering to patients with breast cancer help in psychiatric assessment, diagnosis, and addressing the mental health needs of patients. The treatment offered needs to be nuanced and individualized and may require a combination of psychotropic medications and psychological techniques.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44473715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sugeeth Mt, G. Narayanan, Anoop Tm, S. Nair, Prakash Np, J. Km, R. Nair
Abstract Introduction : Burkitt's lymphoma (BL) is a highly aggressive B cell non-Hodgkin lymphoma (NHL) having three distinct subtypes: endemic, sporadic, and immunodeficiency-associated BL. Sporadic BL accounts for only 1 to 2% of adult NHL. Objectives : The objective of this article was to study the clinical profile and treatment outcome of patients with BL. Materials and Methods : This was a retrospective study of 60 patients with BL conducted in the department of medical oncology at a tertiary cancer center in India during a 10-year period. Patients with BL/leukemia above 14 years of age diagnosed during the study period were included and their clinical presentation, treatment details, and outcome were studied. Results : Among 60 cases with BL, there were 41 males and 19 females. The median age at presentation was 42 years (range: 14–81 years). The main symptoms were lymphadenopathy, abdominal pain, and abdominal distension. Two patients each had paraparesis, breast lump, and jaw swelling and one patient had involvement of the cervix. Thirteen patients had features of tumor lysis at presentation. The Ann Arbor stage was I in 17, II in 16, III in 5, and IV in 22. Fifty-five patients received combination chemotherapy that included hyper-cyclophosphamide, vincristine, adriamycin, dexamethasone ± rituximab (hyper-CVAD ± R; 35), cyclophosphamide, adriamycin, vincristine, prednisolone/ cyclophosphamide, vincristine, prednisolone ± rituximab CHOP ± R (13), Berlin-Frankfurt-Munich protocol (4), and others (3). Thirty-four patients attained remission, 13 patients had progressive disease, and 8 patients died during chemotherapy. At a median follow-up of 113 months, 58% patients were alive. Conclusions : BL accounts for 1.57% of NHL above the age of 14 years with male preponderance. Intensive, short-duration chemotherapy is the standard treatment. Treatment with hyper-CVAD ± R gives 8-year progression-free survival and overall survival (OS) of 60%. Treatment with CHOP ± R is an alternative option in elderly frail patients with an 8-year OS of 46%.
{"title":"Treatment Outcome of Burkitt's Lymphoma in Adolescents and Adults: A Retrospective Study","authors":"Sugeeth Mt, G. Narayanan, Anoop Tm, S. Nair, Prakash Np, J. Km, R. Nair","doi":"10.1055/s-0043-1768177","DOIUrl":"https://doi.org/10.1055/s-0043-1768177","url":null,"abstract":"Abstract Introduction : Burkitt's lymphoma (BL) is a highly aggressive B cell non-Hodgkin lymphoma (NHL) having three distinct subtypes: endemic, sporadic, and immunodeficiency-associated BL. Sporadic BL accounts for only 1 to 2% of adult NHL. Objectives : The objective of this article was to study the clinical profile and treatment outcome of patients with BL. Materials and Methods : This was a retrospective study of 60 patients with BL conducted in the department of medical oncology at a tertiary cancer center in India during a 10-year period. Patients with BL/leukemia above 14 years of age diagnosed during the study period were included and their clinical presentation, treatment details, and outcome were studied. Results : Among 60 cases with BL, there were 41 males and 19 females. The median age at presentation was 42 years (range: 14–81 years). The main symptoms were lymphadenopathy, abdominal pain, and abdominal distension. Two patients each had paraparesis, breast lump, and jaw swelling and one patient had involvement of the cervix. Thirteen patients had features of tumor lysis at presentation. The Ann Arbor stage was I in 17, II in 16, III in 5, and IV in 22. Fifty-five patients received combination chemotherapy that included hyper-cyclophosphamide, vincristine, adriamycin, dexamethasone ± rituximab (hyper-CVAD ± R; 35), cyclophosphamide, adriamycin, vincristine, prednisolone/ cyclophosphamide, vincristine, prednisolone ± rituximab CHOP ± R (13), Berlin-Frankfurt-Munich protocol (4), and others (3). Thirty-four patients attained remission, 13 patients had progressive disease, and 8 patients died during chemotherapy. At a median follow-up of 113 months, 58% patients were alive. Conclusions : BL accounts for 1.57% of NHL above the age of 14 years with male preponderance. Intensive, short-duration chemotherapy is the standard treatment. Treatment with hyper-CVAD ± R gives 8-year progression-free survival and overall survival (OS) of 60%. Treatment with CHOP ± R is an alternative option in elderly frail patients with an 8-year OS of 46%.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47649438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Plasma cell dyscrasias are a heterogeneous group of neoplasms characterized by abnormal proliferation of plasma cells with or without over production of monoclonal immunoglobulins. Chromosomal abnormalities are acquired either early in the course of the disease or during disease progression. Plasma cell dyscrasias are categorized into multiple cytogenetic subtypes that form an integral component of risk-stratified treatment protocols. The primary genetic events are IgH gene translocations and non-random gains of chromosomes 3/5/7/9/11/15/19 and or 21. The secondary genetic events consist of chromosome 1 abnormalities (1p deletion and 1q gain or amplification), deletion 17p/TP53, deletion 13q, and MYC gene rearrangements. Plasma cells being at the end of differentiation spectrum of B cells, have low proliferative potential precluding the use of karyotyping in identification of chromosomal abnormalities. Analysis of enriched plasma cells using interphase fluorescent in situ hybridization (FISH) is the technique of choice for identifying these abnormalities. It is essential to enrich plasma cells before the FISH analysis, and numerous plasma cell enrichment techniques have been described. In the paper, we review the cytogenetic approach to identify clinically significant genetic aberrations including the effective use of FISH panels and plasma cell enrichment techniques.
{"title":"Role of Conventional Cytogenetics and FISH in the Laboratory Work Up of Plasma Cell Dyscrasias","authors":"A. Dhabe, Samiparna Das, M. Parihar","doi":"10.1055/s-0043-1762920","DOIUrl":"https://doi.org/10.1055/s-0043-1762920","url":null,"abstract":"Abstract Plasma cell dyscrasias are a heterogeneous group of neoplasms characterized by abnormal proliferation of plasma cells with or without over production of monoclonal immunoglobulins. Chromosomal abnormalities are acquired either early in the course of the disease or during disease progression. Plasma cell dyscrasias are categorized into multiple cytogenetic subtypes that form an integral component of risk-stratified treatment protocols. The primary genetic events are IgH gene translocations and non-random gains of chromosomes 3/5/7/9/11/15/19 and or 21. The secondary genetic events consist of chromosome 1 abnormalities (1p deletion and 1q gain or amplification), deletion 17p/TP53, deletion 13q, and MYC gene rearrangements. Plasma cells being at the end of differentiation spectrum of B cells, have low proliferative potential precluding the use of karyotyping in identification of chromosomal abnormalities. Analysis of enriched plasma cells using interphase fluorescent in situ hybridization (FISH) is the technique of choice for identifying these abnormalities. It is essential to enrich plasma cells before the FISH analysis, and numerous plasma cell enrichment techniques have been described. In the paper, we review the cytogenetic approach to identify clinically significant genetic aberrations including the effective use of FISH panels and plasma cell enrichment techniques.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45816131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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