Background Statistics reveal that the number of women diagnosed with breast cancer is increasing in Egypt. It is seen as a terrifying disease due to its high mortality rate and its impacts on the self-image and the sexual relationship. Many of its patients experience psychological reactions and may have psychiatric morbidities. The present study aimed to identify the prevalence and associated psychosocial factors of anxiety, depressive disorders, and perceived stress among breast cancer patients in Menoufia university hospitals. This cross-sectional study was conducted in the Clinical Oncology Department, Menoufia University. Sixty patients were subjected to questionnaires for socio-demographic data, structured psychiatric clinical interview to screen for psychiatric diagnoses, Beck Depression Inventory (BDI-II) for measuring the emotional, cognitive and motivational symptoms of depression, Manifest Anxiety Scale to assess the degree of anxiety, and Perceived Stress Scale (PSS-10) to assess stress level. Results The prevalence of depressive symptoms, anxiety symptoms, and perceived stress were 68.6%, 73.3%, and 78.1% respectively. Moderate to severe anxiety, depression, and stress were more prevalent among advanced disease patients, patients who underwent surgery, married patients, patients who were living in rural areas, illiterate, and those without satisfactory income but without statistically significant difference except for the effect of occupation on the anxiety state as unemployed patients had significantly higher prevalence of moderate to severe anxiety (100%) than employed patients p = 0.003. Conclusion Depressive disorders, anxiety, and perceived stress are common psychiatric disorders among the studied breast cancer patients. Understanding these common psychiatric disorders and associated stress can help to plan for their management.
Extended adjuvant metronomic capecitabine is well tolerated with patient compliance. These results need to be compared in a study with control arm, larger sample, as well as longer follow-up.
Background: Bladder cancer (BC) is one of the most common malignancies in Egypt, representing about 8.7% of cancers in both sexes with more predominance in males, making identification of valuable predictive and prognostic markers, mandatory. Cullin-RING ligases (CRL) play an important role in the ubiquitination of cell cycle-related proteins or other proteins (e.g., DNA replication protein, signal transduction protein). Regulator of Cullins-1 (ROC-1) is a key subunit of CRL. P21 belongs to the family of cyclin dependent kinase inhibitors (CKIs) which regulates cell cycle by inactivating Cyclin-Dependent Kinases key regulators of the cell cycle. CAIX a highly active member of the family of carbonic anhydrases has gained much interest as a hypoxic marker. Hypoxia is a consequence of the rapid growth of many tumors, including bladder cancer, and is an important regulator of gene expression and resistance to chemotherapy and radiotherapy. Therefore the purpose of this study is to evaluate the role of ROC-1, CAIX and P21 and its relationship with the clinico-pathological features of bladder cancer in Egyptian patients. Methods: Using the standard immunohistochemical technique, ROC-1, CAIX and P21 expression in 80 primary bladder carcinomas and 15 normal bladder specimens as control group were assessed. The bladder carcinoma cases included 50 cases with muscle invasive bladder cancer and 30 cases with non-muscle invasive bladder cancer. Results: Over expression of ROC-1, CAIX and P21 in BC were significantly associated with muscularis propria invasion and high grade BC. ROC-1, CAIX and P21, showed significant inverse relationship in primary BC cases. CAIX expression was significantly higher in BC compared with controls. Regarding the survival analysis, expression of ROC-1, CAIX and P21 didn't affect the survival of BC patients. Conclusions: High expression of ROC-1, CAIX and P21 could be promising potential biomarkers for identifying patients with poor prognostic factors in bladder cancer serving as potential targets for cancer therapy.
MNS16A genetic variations are associated with DLBCL susceptibility.
Background: The identification of biomarkers would improve the management of advanced urinary bladder carcinoma. Aim: The current study assessed the potential prognostic role of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in advanced stage bladder cancer. Methods: Forty-six patients with advanced urinary bladder carcinoma were included in the study. After consent, CRP and ESR were measured before treatment, after 2 cycles of chemotherapy and at the end of treatment. The relation between CRP and ESR serum measurements and patients' characteristics and treatment response were assessed. Results: Both CRP and ESR were elevated in all included patients with mean values ± standard deviation: 35.43 ± 12.65 and 57.17 ± 18.15, respectively. The baseline CRP level was higher in patients with metastatic disease. ESR was significantly elevated in association with squamous cell carcinoma pathology and hydronephrosis and in patients who died within one year of diagnosis (p = 0.003, 0.001 and 0.03; respectively). Patients who experienced disease progression after 2 cycles of platinum-based chemotherapy had higher levels of CRP and ESR. Serial measurements during the course of treatment revealed that both CRP and ESR levels declined significantly during treatment mainly among responding patients (p = 0.001). Conclusion: CRP and ESR might be useful noninvasive biomarkers in advanced urinary bladder carcinoma.
Background: Lymphedema caused by breast cancer is one of the side effects of therapy. It is defined as arm edema in breast cancer patients caused by surgery or radiation therapy interrupting the flow of the axillary lymphatic system, resulting in fluid accumulation in the subcutaneous tissue of the arm, decreased tissue distensibility around the joints, and increased weight of the extremity. Objective: This study was conducted to detect the effect of combination of intermittent pneumatic compression and kinesiotape on post mastectomy lymphedema. Patients and methods: Thirty females diagnosed with post mastectomy lymphedema were assigned randomly into two equal groups. Group A (Study group) received intermittent pneumatic compression (IPC) with kinesiotape (KT) in addition to complete decongestive therapy (manual lymphatic drainage-compression bandage-medical exercises-skin care) three times per week for 4 weeks. While, Group B (Control group) received only complete decongestive therapy 3 times per week for 4 weeks. Assessment of lymphedema and shoulder range of motion (flexion-abduction-external rotation) were done by tape measurement and goniometer respectively before and after 4 weeks. Results: There was no significant difference in lymphedema size and shoulder range of motion (ROM) between groups pre-treatment (p > 0.05). Comparison between groups post treatment revealed a significant decrease in lymphedema size and a significant increase in shoulder ROM of the study group compared with that of the control group (p >0.05). Conclusion:The results suggested that IPC in combination with KT was an effective method in post mastectomy lymphedema more than complete decongestive therapy only.
Objectives: We aim to characterize the serial quantitative apparent diffusion coefficient (ADC) changes of the target disease volume using diffusion-weighted imaging (DWI) acquired weekly during radiation therapy (RT) on a 1.5T MRLinac and correlate these changes with tumor response and oncologic outcomes for head and neck squamous cell carcinoma (HNSCC) patients as part of a programmatic RIDEAL biomarker characterization effort. Methods Thirty patients with pathologically confirmed HNSCC who received curative intent RT at the University of Texas MD Anderson Cancer Center, were included in this prospective study. Baseline and weekly Magnetic resonance imaging (MRI) were obtained, and various ADC parameters (mean, 5th, 10th, 20th, 30th, 40th, 50th, 60th, 70th, 80th, 90th and 95th percentile) were extracted from the target regions of interest (ROIs). Baseline and weekly ADC parameters were correlated with response during RT, locoregional control, and the development of recurrence using the Mann Whitney U test. The Wilcoxon signed rank test was used to compare the weekly ADC versus baseline values. Weekly volumetric changes (Delta volume) for each ROI were correlated with Delta ADC using Spearmans Rho test. Recursive partitioning analysis (RPA) was performed to identify the optimal Delta ADC threshold associated with different oncologic outcomes. Results: There was an overall significant rise in all ADC parameters during different time points of RT compared to baseline values for both gross primary disease volume (GTVP) and gross nodal disease volumes (GTVN). The increased ADC values for GTVP were statistically significant only for primary tumors achieving complete remission (CR) during RT. RPA identified GTVP Delta ADC 5th percentile >13% at the 3rd week of RT as the most significant parameter associated with CR for primary tumor during RT (p <0.001). Baseline ADC parameters for GTVP and GTVN did not significantly correlate with response to RT or other oncologic outcomes. There was a significant decrease in residual volume of both GTVP and GTVN throughout the course of RT. Additionally, a significant negative correlation between mean Delta ADC and Delta volume for GTVP at the 3rd and 4th week of RT was detected (r = - 0.39, p = 0.044 and r = - 0.45, p = 0.019, respectively). Conclusion: Assessment of ADC kinetics at regular intervals throughout RT seems to be correlated with RT response. Further studies with larger cohorts and multiinstitutional data are needed for validation of Delta ADC as a model for prediction of response to RT. Keywords: DWI, ADC, MRLinac, Head and neck cancer, oncologic outcomes, diffusion
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