scholarly journals INFLUENCE OF CANCER SEVERITY AND FUNCTIONAL STATUS OF CANCER ON CARDIAC PARASYMPATHETIC INDICATORS

2017 ◽  
Vol 10 (6) ◽  
pp. 312 ◽  
Author(s):  
Shilpa N Bijoor ◽  
Sourjya Banerjee ◽  
Subbalakshmi Nk
Keyword(s):  
Functional Status ◽  
Cancer Patients ◽  
Early Stage ◽  
Statistical Tests ◽  
Eastern Cooperative Oncology Group ◽  
Cancer Staging ◽  
Pain Scale ◽  
Advanced Stage ◽  
Vagal Function ◽  
Stage Stage

 Objective: To investigate the influence of cancer severity and functional status of cancer patients on cardiac parasympathetic indicators. Methods: A total of 267 patients with a fresh clinical diagnosis of solid malignant tumor not yet put on cancer therapy and 250 controls matched for age, sex of study subjects were included. Severity of cancer was defined based on the American Joint Committee on Cancer staging. Accordingly, study subjects were subdivided into early stage (Stage I and II combined) and advanced stage (Stage III and IV combined). In cancer patients, the Eastern Cooperative Oncology Group (ECOG) performance score and the Faces Pain Scale score (FPS) was noted. Two indicators of vagal function, expiratory:inspiratory ratio (E:I ratio) and root mean square of successive N-N interval difference (r-MSSD) were included. E:I ratio during deep breathing at six respiratory cycles/minute and r-MSSD at rest was obtained from 1 minute lead II electrocardiogram. Data were analyzed by applying suitable statistical tests. p≤0.05 was considered significant. Results: R-MSSD and E:I ratio was significantly reduced in the early and advanced stage of cancer compared to controls (p≤0.0001). r-MSSD and E:I ratio was significantly reduced in advanced stage compared to the early stage of cancer (p≤0.0001). r-MSSD and E:I ratio was significantly different in subgroups of stages of cancer and controls (p≤0.0001). In cancer patients, r-MSSD was negatively correlated with ECOG and FPS score (p≤0.0278, p≤0.0100). Conclusion: Severity of cancer affects vagal function. However, r-MSSD alone was associated with functional status (ECOG, FPS) of cancer patients.

scholarly journals Adjunctive Therapy in Oral Cancer

2021 ◽  
pp. 1903-1913
Author(s):  
Amit Dhawan
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Cancer ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Cancer Patients ◽  
Squamous Cell ◽  
Adjunctive Therapy ◽  
Early Stage ◽  
Advanced Stage ◽  
Oral Cancer Patients

AbstractOral squamous cell carcinoma is the third most common cancer in Indian subcontinent affecting people with lower socioeconomic status. Due to inadequate screening facilities and lack of awareness among individuals most of the oral cancer cases are detected at an advanced stage. As early stage oral squamous cell carcinoma patients can be treated with single modality treatment (surgery or radical radiotherapy), multimodality regimen (surgery followed by concurrent chemoradiation) is adopted for high risk advanced stage cancers with multiple adverse features like extra nodal extension, lymphovascular invasion and perineural spread. The chapter outlines the principles of adjunctive therapy in oral cancer patients with special reference to different techniques, indications of radiotherapy and role of chemotherapeutic regimes in improving the overall survival of advanced stage oral cancer patients.

scholarly journals Effects of Breast Cancer Adjuvant Chemotherapy Regimens on Expression of the Aging Biomarker, p16INK4a

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Shlomit S Shachar ◽  
Allison M Deal ◽  
Katherine E Reeder-Hayes ◽  
Kirsten A Nyrop ◽  
Natalia Mitin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Chemotherapy Regimen ◽  
Early Stage ◽  
Statistical Tests ◽  
Accelerated Aging ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Aging Effects ◽  
P16ink4a Expression

Abstract Background Although chemotherapy saves lives, increasing evidence shows that chemotherapy accelerates aging. We previously demonstrated that mRNA expression of p16INK4a, a biomarker of senescence and molecular aging, increased early and dramatically after beginning adjuvant anthracycline-based regimens in early stage breast cancer patients. Here, we determined if changes in p16INK4a expression vary by chemotherapy regimen among early stage breast cancer patients. Methods We conducted a study of stage I-III breast cancer patients receiving adjuvant or neoadjuvant chemotherapy. p16INK4a expression was analyzed prechemotherapy and postchemotherapy (median 6.2 months after the last chemotherapy) in peripheral blood T lymphocytes. Chemotherapy-induced change in p16INK4a expression was compared among regimens. All statistical tests were 2-sided. Results In 146 women, chemotherapy was associated with a statistically significant increase in p16INK4a expression (accelerated aging of 17 years; P < .001). Anthracycline-based regimens were associated with the largest increases (accelerated aging of 23 to 26 years; P ≤ .008). Nonanthracycline-based regimens demonstrated a much smaller increase (accelerated aging of 9 to 11 years; P ≤ .15). In addition to the type of chemotherapy regimen, baseline p16INK4a levels, but not chronologic age or race, were also associated with the magnitude of increases in p16INK4a. Patients with lower p16INK4a levels at baseline were more likely to experience larger increases. Conclusions Our findings suggest that the aging effects of chemotherapy may be influenced by both chemotherapy type and the patient’s baseline p16INK4a level. Measurement of p16INK4a expression is not currently available in the clinic, but nonanthracycline regimens offering similar efficacy as anthracycline regimens might be favored.

Increased Cyclooxygenase-2 Expression Is Associated With Chemotherapy Resistance and Poor Survival in Cervical Cancer Patients

2002 ◽  
Vol 20 (4) ◽  
pp. 973-981 ◽  
Author(s):  
G. Ferrandina ◽  
L. Lauriola ◽  
M. G. Distefano ◽  
G. F. Zannoni ◽  
M. Gessi ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Patients ◽  
Early Stage ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Rabbit Antiserum ◽  
Immunohistochemical Analysis ◽  
Response To Treatment ◽  
Advanced Stage ◽  
Cox 2

PURPOSE: To investigate the expression of cyclooxygenase (COX-2) and its association with clinicopathologic parameters and clinical outcome in patients with cervical cancer. PATIENTS AND METHODS: The study included 84 patients with stage IB to IVA cervical cancer. Patients with early-stage cases (n = 21) underwent radical surgery, whereas patients with locally advanced cervical cancer (LACC) (n = 63) were first administered neoadjuvant cisplatin-based treatment and subjected to surgery in case of response. Immunohistochemical analysis was performed on paraffin-embedded sections with rabbit antiserum against COX-2. RESULTS: COX-2–integrated density values in the overall population ranged from 1.2 to 82.3, with mean ± SE values of 27.4 ± 2.4. According to the chosen cutoff value, 36 (42.9%) of 84 patients were scored as COX-2 positive. COX-2 levels were shown to be highly associated with tumor susceptibility to neoadjuvant treatment. COX-2 showed a progressive increase from mean ± SE values of 19.9 ± 8.0 in complete responders through 31.5 ± 3.5 in partial responses to 44.8 ± 3.9 in patients who were not responsive (P = .0054). When logistic regression was applied, only advanced stage and COX-2 positivity retained independent roles in predicting a poor chance of response to treatment. COX-2–positive patients had a shorter overall survival (OS) rate than COX-2–negative patients. In patients with LACC, the 2-year OS rate was 38% in COX-2–positive versus 85% in COX-2–negative patients (P = .0001). In the multivariate analysis, only advanced stage and COX-2 positivity retained independent negative prognostic roles for OS. CONCLUSION: The assessment of COX-2 status could provide additional information to identify patients with cervical cancer with a poor chance of response to neoadjuvant treatment and unfavorable prognosis.

scholarly journals Nedaplatin: A Radiosensitizing Agent for Patients with Cervical Cancer

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Seiji Mabuchi ◽  
Tadashi Kimura
Keyword(s):  
Cervical Cancer ◽  
Cancer Patients ◽  
Concurrent Chemoradiotherapy ◽  
Early Stage ◽  
Controlled Study ◽  
Preclinical Studies ◽  
Advanced Stage ◽  
Randomized Controlled ◽  
Early Stage Cervical Cancer

Despite the recent advances in the management of cervical cancer using cisplatin-based concurrent chemoradiotherapy, substantial treatment failure still occurs, especially in advanced-stage patients and early-stage cervical cancer patients with high-risk prognostic factors. Therefore, efforts to further improve the survival and quality of life of these patients are necessary. Nedaplatin (cis-diammine-glycoplatinum), a derivative of cisplatin, was developed with the aim of producing a treatment with a similar effectiveness to cisplatin but decreased renal and gastrointestinal toxicities. Based on the promising results of preclinical studies, the clinical efficacy of nedaplatin as a radiosensitizing agent was evaluated in patients with cervical cancer. Retrospective analysis of nedaplatin-based concurrent chemoradiotherapy (CCRT) against cervical cancer suggested that nedaplatin-based CCRT can be considered as an alternative to cisplatin-based CCRT in both early-stage and advanced-stage cervical cancer patients. However, due to the lack of a randomized controlled study, nedaplatin-based CCRT has not been convincingly proven to be clinically effective in patients with cervical cancer. Further investigations in randomized controlled trials are therefore needed.

Comorbidity and functional status are independent in older cancer patients.

1998 ◽  
Vol 16 (4) ◽  
pp. 1582-1587 ◽  
Author(s):  
M Extermann ◽  
J Overcash ◽  
G H Lyman ◽  
J Parr ◽  
L Balducci
Keyword(s):  
Activities Of Daily Living ◽  
Functional Status ◽  
Cancer Patients ◽  
Daily Living ◽  
Rating Scale ◽  
Eastern Cooperative Oncology Group ◽  
Relative Weight ◽  
Tumor Stage ◽  
Comorbidity Burden ◽  
Older Cancer Patients

PURPOSE Comorbidity is a frequent and often therapeutically limiting problem in older cancer patients. However, to date, there is no standard measure of the comorbidity burden available for these patients. We tested the performance of two comorbidity scales and their relationship with functional status. PATIENTS AND METHODS The Cumulative Illness Rating Scale-Geriatric (CIRS-G) was compared with the Charlson scale in 203 patients who received a comprehensive geriatric assessment (CGA) in our Senior Adult Oncology Program (SAOP). Study end points were variability, reliability, correlation with Eastern Cooperative Oncology Group (ECOG) performance status (PS), Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL). The relative weight of comorbidity versus tumor stage in the correlations with functional status was assessed. RESULTS Median age was 75 years (range, 63 to 91). Sixty-four percent of patients scored 0 on the Charlson scale versus 6% on the CIRS-G. The correlation between the Charlson and CIRS-G was fair (p = 0.25 to 0.39). CIRS-G grade 3/4 had a fair correlation with ADL (p = 0.27). Otherwise, there was low or no correlation between comorbidity and functional status across the measures. Tumor stage was not correlated with functional status either. Correlation of ECOG PS with ADL (p = 0.51)c and IADL (p = 0.61) was moderate. Interrater and test-retest correlations were good or very good for both the Charlson and CIRS-G. CONCLUSION Comorbidity needs to be assessed independently from functional status. Both the Charlson and CIRS-G scales are reliable tools for use in trials of older cancer patients. Both can be tested in further studies as predictors of outcomes such as toxicity of treatment, changes in functional status, or survival.

scholarly journals Time, Distance and Economics Influencing Cancer Care: Experience From a Regional Cancer Center in India

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 76s-76s
Author(s):  
N. Ballari ◽  
R. Miriyala ◽  
T. Jindia ◽  
S. Gedela ◽  
L. Annam ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Cancer Patients ◽  
Early Stage ◽  
Private Insurance ◽  
Locally Advanced ◽  
Cancer Center ◽  
Advanced Stage ◽  
Early Stage Disease ◽  
Stage Disease ◽  
Time Distance

Background: There is a geographical, socioeconomical and logistic diversity among the cancer patients who reach a regional cancer center. In a developing economy like that of India's, only a minority of patients have medical insurance. So in our setup a cancer patient is met with time, distance and financial challenges. These intangible factors theoretically are expected to influence the ultimate outcome of cancer treatment. Aim: To evaluate the prevailing demographic and economic variables of cancer patients visiting our RCC and to look for any correlation among each other. Methods: The demographic details of cancer patients registered at our RCC between August 2017- September 2017 were retrieved retrospectively. Distance traveled to get to the RCC and get a diagnosis of cancer, time taken for diagnosis and initiation of treatment, and the source of finances for treatment were collected. A correlation among these factors was attempted to be identified. Statistical correlation was identified using Student t-test. Results: Among 591 patients who were analyzed, the median age of patient was 55 years old. The median time taken for the patient to reach the RCC from permanent residence after the beginning of cancer related complaints was 3.19 months. The median distance traveled for the same was 131 km. The source of income was private employment for 223 patients and government employment for 164 patients and self-employment for 200 patients. Only 164 patients had some kind of structured health scheme to manage their health care expenses. Among these, 96 patients had private insurance/reimbursement and 64 patients had government reimbursement. 384 (64%) of patients presented with advanced and locally advanced stage disease while 114 (19%) patients presented to us with early stage disease. However a correlation between delay in presentation to the RCC, distance traveled to reach the RCC, source of income and advanced stage of disease couldn't not be established. Conclusion: Majority of patients visiting our RCC is from far off places and most of these patients pay for the cancer treatment themselves without any support from government or private insurances. All these factors may be responsible for late or advanced stage presentation of cancer patients.

scholarly journals Pretreatment Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as a Stage Determination in Breast Cancer

2020 ◽  
Vol 8 (B) ◽  
pp. 1058-1063
Author(s):  
Sinta Wiranata ◽  
Ida Ayu Widya Anjani ◽  
I Putu Gede Septiawan Saputra ◽  
I Gusti Ayu Stiti Sadvika ◽  
I Putu Yuda Prabawa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Cancer Staging ◽  
Neutrophil To Lymphocyte Ratio ◽  
Solid Cancer ◽  
Cancer Stage ◽  
Advanced Stage ◽  
Breast Cancer Patients ◽  
Analysis Model ◽  
Lymphocyte Ratio

BACKGROUND: Breast cancer tends to respond differently to treatments, which are usually determined by clinicopathological characteristics. Several studies evaluated the role of the peripheral blood test as diagnostic and prognostic markers in several types of solid cancer and neutrophil-to-lymphocyte ratio (NLR) and platelet-tolymphocyte ratio (PLR) are two of them which already tested. However, the evidence in breast cancer is still lacking. AIM: Therefore, the study aimed to investigate the value of NLR and PLR as biomarkers concerning breast cancer stage. METHODS: A retrospective study was conducted using breast cancer patients’ medical records from 2014 to 2019 at Sanglah General Hospital. The histopathological records and complete blood counts of the patients were collected and analyzed risk analysis model, receiver operator characteristics analysis, and correlation of NLR and PLR with cancer staging analysis used correlation test. RESULT: One hundred five patients data were used in this study, with 35 subjects had early-stage breast cancer while 70 subjects had an advanced stage. Breast cancer staging with NLR and PLR showed significant associations (p < 0.001). Both NLR and PLR had area under the curve >0.7 (p < 0.001). The cutoff, sensitivity, and specificity values of NLR and PLR were 2.504 (71%; 70%) and 157.1 (73%; 70%). Advanced stage of breast cancer was mostly found in high NLR and PLR value with (OR: 4.231; CI = 1.791-9.995, p < 0.001) and (OR: 3.949; 95% CI = 1.679–9.287; p < 0.001). CONCLUSION: From this preliminary study, pretreatment NLR and PLR values might determine the breast cancer stage. Further research is needed to evaluate the association between grade and patient survival.

Are we seeing more obese breast cancer patients in Brooklyn?

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 182-182
Author(s):  
R. Sultana ◽  
M. Thwin ◽  
G. M. Villani ◽  
M. A. Grand ◽  
N. M. Tun
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Early Stage ◽  
Class Ii ◽  
Class I ◽  
Average Weight ◽  
Advanced Stage ◽  
Breast Cancer Patients ◽  
Obese People ◽  
Prevalence Of Obesity

182 Background: Breast cancer is the most common female cancer in the US and the second most common cause of cancer death in women. Obesity has become a significant health challenge. The prevalence of obesity among non-Hispanic black women is reported to be approximately 50% with a prevalence of Class lll obesity of 5.2%. The objective of this study was to evaluate the severity of obesity in female breast cancer patients at our facility over the last three years. Methods: A retrospective study was conducted on 191 patients treated between January 2008 and December 2010 for breast cancer. Prevalence of obesity by class (Class I = BMI from 30 to 34.99 kg/m2, Class II = BMI from 35 to 39.99 kg/m2, Class IIl= BMI greater than 39.99 kg/m2) was calculated. Pearson chi-square statistic was used to investigate the relation between classes of obesity and stages of breast cancer (early stage = CIS to stage 2, advanced stage = stage 3 and 4). Results: Data from 191 breast cancer patients with BMI of 30 or more were analyzed. Class I constituted 39.3%, Class II 34% and class III 26.7%. The majority (75.9%) were diagnosed at an early stage, 24.1% diagnosed with advanced stage. Severity of obesity was not associated with the stage of breast cancer at diagnosis (c2= 0.004, df = 2, n = 191, p > 0.5). African American women constituted the majority (78.5%) of our study population. Conclusions: Our study reveals an alarming rate of class lll obesity among our breast cancer patients. It does not show a correlation among obesity and stage of disease, The majority of patients have early stage, potentially curable breast cancer. Given the fact that obesity has been associated with an increase in mortality (cardiovascular mortality is 50% greater in obese people and 90% greater in severely obese persons in comparison with that for people of average weight) our study suggests that treatment of obesity may play an equally important role in achieving long term outcomes as treatment of breast cancer itself.

scholarly journals MiR-21 and mRNA PTEN Expression Levels and Biomarker Potential in Breast Cancer

2021 ◽  
Vol 7 (1) ◽  
pp. 46
Author(s):  
Dinna Rakhmina ◽  
Sofia Mubarika Haryana ◽  
Teguh Aryandono
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Prognostic Marker ◽  
Cancer Progression ◽  
Early Stage ◽  
Estrogen Receptor Status ◽  
Pten Expression ◽  
Future Research ◽  
Advanced Stage ◽  
Breast Cancer Patients

MiR-21 has been linked to tumorigenesis, development, and metastasis in tumor pathogenesis. All human cancers, including breast cancer, have increased expression of MiR-21, which is the only miRNA that has increased expression. PTEN expression was found to be reduced in the majority of solid tumors, including breast cancer. Since lymph node metastatic factors, estrogen receptor status, tumor grade, and tumor node metastasis (TNM) all decreased PTEN expression, the PTEN expression profile may be a very useful prognostic marker in breast cancer. PTEN inhibits PIP3 (phosphatidylinositol 3,4,5-triphosphate) activity by having protein phosphatase and lipid phosphatase activity that is the polar opposite of PI3K (Phosphatidyl Inositol 3-Kinase). The aim of this research was to see how often miR-21 and mRNA PTEN were expressed at different stages of breast cancer and whether they could be used as prognostic markers. This type of research is an observational study with a cross-sectional design. The sample size of 43 people came from breast cancer patients. Analysis of miR-21 expression and mRNA PTEN using Real-Time qPCR. The results showed that miR-21 expression increased 1.32 times at an advanced stage compared to an early stage, while mRNA PTEN expression decreased 1.33 fold at an advanced stage compared to an early stage. According to the findings, miR-21 expression in the blood plasma of breast cancer patients was upregulated at an advanced stage compared to an early stage and downregulated mRNA PTEN expression. MiR-21 which is increased at an advanced stage has the potential to be a poor prognostic marker at the stage of breast cancer. The change in miR-21 expression can be a good candidate as a molecular prognostic marker and for future research the role of miR-21 in breast cancer progression will further enrich the scientific repertoire, especially in the health and clinical fields.

scholarly journals Serum CA 19.9 as a Tumour Marker in Colorectal Cancer Staging- An Experimental Study

2020 ◽  
Vol 33 (1) ◽  
pp. 35-40
Author(s):  
Monira Parveen ◽  
Shah Md Badruddoza ◽  
SM Asafudullah ◽  
Khadiza Khanom ◽  
Arefa Sultana ◽  
...  
Keyword(s):  
Colorectal Carcinoma ◽  
Early Stage ◽  
Cancer Staging ◽  
Tumour Marker ◽  
Enzyme Linked Immunosorbent Assay ◽  
Advanced Stage ◽  
Cross Sectional ◽  
Female Ratio ◽  
Male Predominance ◽  
Preoperative Serum

This cross-sectional, descriptive observational study was carried out for a period of 24 months from January 2014 to December 2015 in the Department of Pathology and Department of Surgery, Rajshahi Medical College, Rajshahi for estimation of serum 19-9 level in total fifty four patients. Histopathological Staging was correlated with the preoperative values of serum CA 19-9 level. Data were collected by face to face interview, clinical examination and findings of laboratory investigations. Preoperative serum CA 19-9 levels were estimated by Enzyme Linked Immunosorbent Assay (ELISA) Method. The study revealed that the colorectal carcinoma was highest in the 5th and 6th decade and rectal area (46.3%) and male predominance was observed with male to female ratio being 3:2. A higher incidence of abnormal CA 19-9 level was found in Dukes’ D (100%) and Dukes’ C (84%) diseases than in Dukes’ B (76%) and Dukes’ A (75%) stages. The sensitivity of CA 19-9 in correctly detecting advanced stage CRC carcinoma from those who had early stage of the disease is (36/44) × 100 = 81.8% and its specificity in correctly excluding those who did not have advanced disease is (2/10) × 100 = 20%. The overall diagnostic accuracy is calculated to be (36 + 2)/54 = 70.37%. Regarding diagnostic values for colorectal carcinoma elevated level of serum CA 19-9 can be considered as an important diagnostic tool for differentiating advanced stage of colorectal carcinoma from its early stage TAJ 2020; 33(1): 35-40

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