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Efficacy of Individualized Cancer Management 个性化癌症管理的功效
Pub Date : 2023-10-31 DOI: 10.47363/jcrr/2023(5)181
Kangla Tsung
Individualized cancer management is the opposite of the standardized care adapted for current clinical practice by the mainstream medicine. It is not a fancy concept but a logic and inevitable reality derived from the intrinsic characteristics of cancer and host antitumor response. The question is not whether it should be done but how it is done. One missing aspect of individualized management is how to measure its effectiveness. Unlike standardized management that compares therapy efficacy among different management plans by the statistical criteria on the entire groups of patients but not individual patient in the group, individualized management can measure the efficacy on individual patient. This is not only possible, but necessary. A true individualized cancer therapy is not only based on personal situation for each patient, but must also satisfy the criterion that the outcome of selected therapy is predictable for that patient, a feature that current standardized care does not have. Therapy selection based on the individualized assessment of the status of antitumor immunity in each patient is the essential part of individualized management. Thus, treating each patient according to the status of his antitumor immunity should be the most critical skills a physician needs to master when facing each individual cancer patient. In the past seven years, we have been exploring individualized management of cancer through recognizing and manipulating antitumor immunity in each patient. Our combined experiences indicate a significant benefit to patient survival with reduced costs even when such effort was not perfect in the past. With time and more learning, we see this practice becoming more and more practical in a clinical setting. When this individualized approach becomes guideline for cancer management, we will see a significant leap of clinical improvement on both patient survival and cancer cure rate
癌症个体化治疗与主流医学为适应当前临床实践而采取的标准化治疗截然相反。它不是一个花哨的概念,而是从癌症的内在特征和宿主抗肿瘤反应中得出的逻辑和必然的现实。问题不在于是否应该这样做,而在于如何去做。个体化管理缺少的一个方面是如何衡量其有效性。与标准化管理不同的是,标准化管理是通过对整组患者的统计标准来比较不同管理方案的疗效,而不是对组内的单个患者进行比较,而个体化管理则可以衡量单个患者的疗效。这不仅是可能的,而且是必要的。真正的癌症个体化治疗不仅要根据每个患者的个人情况,还必须满足所选疗法的结果对该患者是可预测的这一标准,而目前的标准化治疗不具备这一特点。在对每位患者的抗肿瘤免疫状况进行个体化评估的基础上选择治疗方法,是个体化治疗的重要组成部分。因此,根据每个患者的抗肿瘤免疫状况进行治疗,应该是医生面对每个癌症患者时需要掌握的最关键的技能。在过去的七年中,我们一直在探索通过识别和控制每个患者的抗肿瘤免疫来实现癌症的个体化治疗。我们的综合经验表明,即使在过去这种努力并不完美的情况下,也能显著提高患者的生存率并降低成本。随着时间的推移和更多的学习,我们看到这种做法在临床环境中越来越实用。当这种因人而异的方法成为癌症治疗的指导原则时,我们将看到患者生存率和癌症治愈率都会有一个显著的飞跃。
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引用次数: 0
Navigating the Future: Nanotechnological Strategies for Tackling Hepatocellular Carcinoma 领航未来:应对肝细胞癌的纳米技术战略
Pub Date : 2023-10-31 DOI: 10.47363/jcrr/2023(5)180
Annu Kumari
Hepatocellular carcinoma (HCC), a widely prevalent form of liver malignancy, is a leading contributor to cancer-related mortality globally, despite advances in preventive and diagnostic technologies. It is closely associated with cirrhosis, with major contributions from hepatitis B and C infections and alcohol consumption. Early detection of HCC is crucial as it is often diagnosed at an asymptomatic stage. Radiological screenings and serological markers are effective methods of achieving early detection. Various surgical methods, including liver transplantation, and therapies such as radiofrequency lesioning and chemoembolization, are employed to treat this disease. However, due to limited donor availability and late diagnosis, treatment can be delayed. Tumour size, liver disease severity, and patient’s overall health are among the factors that influence the disease. Nanotechnology, a field that involves the precise manipulation of materials at the nanometer scale and the targeted delivery of therapeutic agents, presents a promising solution for HCC therapy. The utilization of nanoparticle-based therapies allows for the specific targeting of tumour-associated antigens, which enhances drug delivery and reduces drug-induced toxicity. Furthermore, nanomaterials such as carbon nanoparticles and biochemical sensors aid in the detection of oncological markers. Nanomedicine-based approaches possess the potential to revolutionize HCC therapy by improving drug delivery and targeting liver cancer stem cells. Specifically, targeted ligand-mediated therapy using saccharide or polysaccharide compounds, antibodies, peptides, and aptamers shows promise for liver-specific HCC treatment. Additionally, nanotherapy aimed at liver cancer stem cells (LCSCs) provides new possibilities to overcome the limitations of conventional treatments and improve patient outcomes. Ultimately, nanotechnology-based approaches hold great potential in enhancing the effectiveness of HCC therapy and offer new avenues for precision medicine in cancer treatment.
肝细胞癌(HCC)是一种广泛流行的肝脏恶性肿瘤,尽管预防和诊断技术不断进步,但它仍是导致全球癌症相关死亡率的主要因素。它与肝硬化密切相关,乙型肝炎和丙型肝炎感染以及饮酒也是主要诱因。早期发现 HCC 至关重要,因为它通常是在无症状阶段被诊断出来的。放射学筛查和血清学标记是实现早期发现的有效方法。目前已采用包括肝移植在内的各种手术方法以及射频病变和化疗栓塞等疗法来治疗这种疾病。然而,由于供体有限和诊断较晚,治疗可能会延误。肿瘤大小、肝病严重程度和患者的整体健康状况都是影响该疾病的因素。纳米技术是一个涉及在纳米尺度上精确操纵材料和靶向输送治疗剂的领域,它为 HCC 治疗提供了一种前景广阔的解决方案。利用基于纳米粒子的疗法可以对肿瘤相关抗原进行特异性靶向治疗,从而增强药物输送并降低药物毒性。此外,碳纳米粒子和生化传感器等纳米材料有助于检测肿瘤标志物。基于纳米药物的方法通过改善给药和靶向肝癌干细胞,具有彻底改变 HCC 治疗的潜力。具体来说,使用糖或多糖化合物、抗体、肽和适配体进行配体介导的靶向治疗有望用于肝脏特异性 HCC 治疗。此外,针对肝癌干细胞(LCSCs)的纳米疗法为克服传统疗法的局限性和改善患者预后提供了新的可能性。最终,基于纳米技术的方法在提高 HCC 治疗效果方面具有巨大潜力,并为癌症治疗中的精准医学提供了新途径。
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引用次数: 0
Metastatic Tumors of Unknown Primary (Muos) Definition, Frequency and General Considerations 原发不明的转移性肿瘤(Muos)的定义、频率和一般考虑
Pub Date : 2023-08-31 DOI: 10.47363/jcrr/2023(5)177
M. Hunis, A. Hunis
Metastatic tumors of unknown primary (MUOs) present a diagnostic challenge due to the absence of an identifiable primary tumor site. The diagnostic approach for MUOs involves a comprehensive evaluation that includes clinical assessment, imaging studies, laboratory tests, and tissue sampling. Various imaging modalities, such as CT, MRI, PET scans, and ultrasound, are used to assess the extent of metastasis and identify potential primary tumor sites. Treatment options for MUOs include systemic therapies like chemotherapy, targeted therapy, immunotherapy, and hormone therapy, along with supportive care measures. Prognosis varies widely and is influenced by factors such as the extent of metastasis, tumor characteristics, treatment response, and patient factors [1]. Artificial intelligence (AI) has the potential to aid in diagnosis and management through image analysis, predictive modeling, pathology analysis, and risk assessment. The integration of AI requires careful validation and collaboration between healthcare professionals and AI experts. A multidisciplinary approach is crucial for optimal management of MUOs, and ongoing research aims to enhance diagnostic methods, treatment strategies, and prognostic models.
原发不明的转移性肿瘤(MUOs)由于缺乏可识别的原发肿瘤部位而给诊断带来挑战。muo的诊断方法包括综合评估,包括临床评估、影像学检查、实验室检查和组织取样。各种成像方式,如CT、MRI、PET扫描和超声,用于评估转移的程度和确定潜在的原发肿瘤部位。muo的治疗方案包括全身治疗,如化疗、靶向治疗、免疫治疗和激素治疗,以及支持性护理措施。预后差异很大,受转移程度、肿瘤特征、治疗反应、患者因素等因素影响[1]。人工智能(AI)有潜力通过图像分析、预测建模、病理分析和风险评估来帮助诊断和管理。人工智能的整合需要医疗保健专业人员和人工智能专家之间的仔细验证和协作。多学科方法对于优化muo的管理至关重要,目前正在进行的研究旨在加强诊断方法、治疗策略和预后模型。
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引用次数: 0
A Study to Assess the Effect of Structured Teaching Programme on Knowledge of Patients with Acute Myeloid Leukaemia on Chemotherapy Schedule, Side Effects and its Management at a Tertiary Cancer Centre 某三级肿瘤中心急性髓系白血病患者化疗方案、副作用及治疗的结构化教学方案效果评估研究
Pub Date : 2023-06-30 DOI: 10.47363/jcrr/2023(5)172
Rashmi Methry
Acute myeloid leukemia (AML) is a hematopoietic stem cell disorder characterized by a block in differentiation of hematopoiesis, resulting in growth of a clonal population of neoplastic cells or blasts. Chemotherapeutics leads to side effects. To minimize potential toxicities and to maximize the optimal quality of life, nurse can assist the patient by providing instructions and making the care provider equipped with knowledge. The aim of the study was to assess the knowledge regarding chemotherapy, its side effects and its management in patients with AML and to assess the effect of structured teaching programme in experimental and control group. Quantitative, quasi-experimental pretest posttest control group design study was done It was found that there is significant improvement in posttest knowledge score in experimental group (P value -0.000) and number of participants correctly answered to the items in questionnaire increased after the structured teaching program in experimental group.
急性髓性白血病(AML)是一种造血干细胞疾病,其特征是造血分化受阻,导致肿瘤细胞或母细胞克隆群的生长。化疗有副作用。为了最大限度地减少潜在的毒性和最大限度地提高最佳生活质量,护士可以通过提供指导和使护理人员具备知识来帮助患者。本研究旨在评估急性髓性白血病(AML)患者化疗知识、化疗副作用及化疗管理,并评估实验组和对照组结构化教学方案的效果。通过定量、准实验的前测后测对照组设计研究,发现实验组学生的后测知识得分有显著提高(P值为-0.000),且实验组结构化教学方案后正确回答问卷项目的人数有所增加。
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引用次数: 0
Public Policies on Cancer 有关癌症的公共政策
Pub Date : 2023-06-30 DOI: 10.47363/jcrr/2023(5)175
A. Hunis
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引用次数: 0
A Rare Case of Malignant Phyllodes Tumor in a Young Female 年轻女性恶性叶状瘤1例
Pub Date : 2023-06-30 DOI: 10.47363/jcrr/2023(5)173
Quader Naseer
Phyllodes tumours are rare breast tumours that represent less than 1% of all breast tumours. They can be classified into three categories based on their histological features: benign, borderline, and malignant. Malignant phyllodes tumours are the most aggressive and can metastasize to distant organs. Here we report a case of a 26-year-old female with a malignant phyllodes tumour of the breast. The patient underwent wide local excision followed by adjuvant radiotherapy. We discuss the diagnostic and therapeutic challenges of managing this rare malignancy.
叶状瘤是一种罕见的乳腺肿瘤,占所有乳腺肿瘤的不到1%。根据其组织学特征可分为三类:良性、交界性和恶性。恶性叶状肿瘤最具侵袭性,可转移到远处器官。我们在此报告一位26岁女性患乳腺恶性叶状瘤的病例。患者行大面积局部切除,并行辅助放疗。我们讨论诊断和治疗的挑战管理这种罕见的恶性肿瘤。
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引用次数: 0
Unraveling the Cancer Metabolism: Fasting Reset, Ketogenic Diet? and Therapeutic Strategies 解开癌症代谢:禁食重置,生酮饮食?治疗策略
Pub Date : 2023-06-30 DOI: 10.47363/jcrr/2023(5)176
Eric B. Berg, G. Tenenbaum, Maurice Israel
Cancer cells harness a mechanism known as ketolysis to generate energy, a process that involves the enzymes SCOT and ACAT1, instrumental in the creation of a crucial molecule named acetyl-CoA. This molecule plays a vital role in cellular energy production. Interestingly, cancer cells are capable of alternative methods for generating acetyl-CoA, such as the incorporation of external acetate. Although restraining the function of SCOT and ACAT1 may decelerate cancerous growth, it could potentially impede the tumor cells’ ability to produce necessary new membranes for their survival.
癌细胞利用一种被称为酮解的机制来产生能量,这一过程涉及到酶SCOT和ACAT1,有助于产生一种名为乙酰辅酶a的关键分子。这种分子在细胞能量产生中起着至关重要的作用。有趣的是,癌细胞能够用其他方法生成乙酰辅酶a,比如与外部醋酸盐结合。尽管抑制SCOT和ACAT1的功能可能会减缓癌细胞的生长,但它可能会阻碍肿瘤细胞产生生存所需的新膜的能力。
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引用次数: 0
Synchronous Serous Carcinoma of Ovary and Clear Cell Carcinoma of Kidney 卵巢同步浆液性癌和肾透明细胞癌
Pub Date : 2022-12-31 DOI: 10.47363/jcrr/2022(4)168
Namratha Sai Reddy B, N. Vaddeboina
Synchronous dual primary cancers have been reported in the past while majority of these are sporadic only few are hereditary. There have been a couple of case reports of synchronous primary ovarian cancer and renal cell carcinoma (RCC) and the first reported case was in 1988 by Myoga et al. Currently there is no clear explanation about synchronous RCC and ovarian cancers but steroid hormones & its receptors are thought to play a role. It is important for the clinician and the pathologist to rule out the possibility of metastatic deposits for the better management of the disease. Here we report a rare presentation of dual synchronous primaries of Clear cell RCC and High grade serous ovarian cancer in a 48year old female.
同步双原发癌在过去也有报道,其中大多数是散发的,只有少数是遗传性的。有几例同步原发性卵巢癌和肾细胞癌(RCC)的病例报道,1988年Myoga等人首次报道了一例。目前对同步RCC和卵巢癌的关系还没有明确的解释,但类固醇激素及其受体被认为在其中起作用。对于临床医生和病理学家来说,为了更好地治疗这种疾病,排除转移性沉积的可能性是很重要的。我们在此报告一位48岁的女性,罕见地出现透明细胞癌和高级别浆液性卵巢癌的双同步原发。
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引用次数: 0
Non-Small Cell Lung Cancer Metastases to Breast, Colon and Skin: A Case Report 非小细胞肺癌转移至乳房、结肠及皮肤1例报告
Pub Date : 2022-12-31 DOI: 10.47363/jcrr/2022(4)169
A. Mohammed, H. Bakhribah, R. Tulbah
Bronchogenic carcinoma is a leading cause of cancer mortality worldwide. Of lung cancer cases overall, 50% have metastasis at presentation, mostly to the brain, bone, liver, the adrenal glands ,thoracic cavity and non-regional lymph nodes .This case report presents a female patient with three rare sites of lung cancer metastasis: breast, colon, and skin. Her initial presentation was a several-month history of a mass in the left breast and in the upper abdominal wall, dyspepsia, weight loss, and intermittent per rectal bleeding. Diagnosis of this case was difficult because of the challenge to differentiate between primary breast cancer and metastasis. However, the diagnosis was made by the interpretation of images and immunohistochemistry.
支气管源性癌是世界范围内癌症死亡的主要原因。在所有的肺癌病例中,50%的患者在发病时有转移,主要转移到脑、骨、肝、肾上腺、胸腔和非区域淋巴结。本病例报告了一位女性患者在三个罕见的肺癌转移部位:乳房、结肠和皮肤。她最初的表现是几个月的左乳房和上腹壁肿块史,消化不良,体重减轻,间歇性直肠出血。这个病例的诊断很困难,因为很难区分原发性乳腺癌和转移性乳腺癌。然而,诊断是通过图像和免疫组织化学的解释。
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引用次数: 0
The Impact of Sequencing Human Genome on the Psychosomatic Illnesses 人类基因组测序对心身疾病的影响
Pub Date : 2022-09-30 DOI: 10.47363/jcrr/2022(4)165
A. H. Khan
This abstract attempts to explore if psychosomatic illnesses are genetic in origin. The word psychosomatic comes from two roots: psycho meaning mind and somatic meaning body. The symptoms of psychosomatic illnesses are caused by emotional stress rather than an organic, physical source in the body. Our mind is outside of our brain and cannot be studied, but we can study its effect our body. To ensure if the psychosomatic illnesses have any association with our body and to identify the root cause of these illnesses in our body if any, we sequenced the human genome that is we read the entire book of our life. Our genome provides the total genetic information that make us humans. It carries the greatest catalog of human genes on planet Earth. Our genome consists of 46 volumes of encyclopedia called chromosomes which carry 24,000 chapters called genes. Of all genes in our genome, 16,000 are good genes, 6,000 bad (or mutated) genes responsible for causing six thousand different diseases and 2,000 pseudogenes which have lost their functions. Out of 6,000 variants, not a single mutated gene is linked to any symptom of psychosomatic disorders such as stress, hypertension, respiratory ailments, gastrointestinal disturbances, migraine, tension, headaches, pelvic pain, impotence, frigidity, dermatitis, ulcers. stress and anxiety. We examine the association of any of these psychosomatic symptoms with any of those six thousand mutated genes in our genome, we found no correlation with genetic diseases. We conclude that psychosomatic illnesses are not organic in nature and cannot be treated with organic molecules.
这篇摘要试图探讨心身疾病是否有遗传起源。“psychosomatic”一词有两个词根:psycho意为“精神”,somatic意为“身体”。心身疾病的症状是由情绪压力引起的,而不是体内的有机物质来源。我们的思想在我们的大脑之外,无法研究,但我们可以研究它对我们身体的影响。为了确定心身疾病是否与我们的身体有关,并确定这些疾病的根本原因,如果有的话,我们对人类基因组进行了排序,也就是说,我们阅读了我们生命的整本书。我们的基因组提供了使我们成为人类的全部遗传信息。它携带着地球上最大的人类基因目录。我们的基因组由46卷叫做染色体的百科全书组成,其中包含24000个叫做基因的章节。在我们基因组的所有基因中,16000个是好基因,6000个坏(或突变)基因导致6000种不同的疾病,2000个失去功能的假基因。在6000个变异中,没有一个突变基因与任何心身疾病的症状有关,比如压力、高血压、呼吸系统疾病、胃肠道紊乱、偏头痛、紧张、头痛、骨盆痛、阳痿、寒战、皮炎、溃疡。压力和焦虑。我们检查了这些心身症状与我们基因组中6000个突变基因中的任何一个的关系,我们发现与遗传疾病没有关联。我们得出结论,心身疾病本质上不是有机的,不能用有机分子治疗。
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引用次数: 0
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Journal of Cancer Research Reviews & Reports
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